David Sevillano Fernández

Running Pace Decrease during a Marathon Is Positively Related to Blood Markers of Muscle Damage

Background Completing a marathon is one of the most challenging sports activities, yet the source of running fatigue during this event is not completely understood. The aim of this investigation was to determine the cause(s) of running fatigue during a marathon in warm weather. Methodology/Principal Findings We recruited 40 amateur runners (34 men and 6 women) for the study. Before the race, body core temperature, body mass, leg muscle power output during a countermovement jump, and blood samples were obtained. During the marathon (27 °C; 27% relative humidity) running fatigue was measured as the pace reduction from the first 5-km to the end of the race. Within 3 min after the marathon, the same pre-exercise variables were obtained. Results Marathoners reduced their running pace from 3.5 ± 0.4 m/s after 5-km to 2.9 ± 0.6 m/s at the end of the race (P<0.05), although the running fatigue experienced by the marathoners was uneven. Marathoners with greater running fatigue (> 15% pace reduction) had elevated post-race myoglobin (1318 ± 1411 v 623 ± 391 µg L−1; P<0.05), lactate dehydrogenase (687 ± 151 v 583 ± 117 U L−1; P<0.05), and creatine kinase (564 ± 469 v 363 ± 158 U L−1; P = 0.07) in comparison with marathoners that preserved their running pace reasonably well throughout the race. However, they did not differ in their body mass change (−3.1 ± 1.0 v −3.0 ± 1.0%; P = 0.60) or post-race body temperature (38.7 ± 0.7 v 38.9 ± 0.9 °C; P = 0.35). Conclusions/Significance Running pace decline during a marathon was positively related with muscle breakdown blood markers. To elucidate if muscle damage during a marathon is related to mechanistic or metabolic factors requires further investigation.

Preoperative skin and nail preparation of the foot: comparison of the efficacy of 4 different methods in reducing bacterial load.

BACKGROUND Orthopedic surgical procedures involving the foot and ankle are associated with high rates of infection. The optimal method of preparing the skin and nails for foot and ankle surgery remains unknown. OBJECTIVE This study was conducted to compare the efficacy of 4 different methods of skin and nail preparation of the foot using various antiseptic solutions. METHODS In this prospective, randomized study, 4 methods of skin and nail preparation were compared in terms of their efficacy in eliminating bacteria from the hallux nailfold and first web space of the normal foot in 28 healthy adult volunteers. Efficacy was determined by evaluating the difference in the total bacterial load before and after skin preparation. The foot-preparation solutions evaluated were 4% chlorhexidine gluconate, 70% isopropyl alcohol, and 7.5% to 10% povidone-iodine. RESULTS The addition of alcohol to povidone-iodine was found to increase the efficacy of the preparation method. The nailfold remained contaminated after any of the preoperative skin- and nail-preparation methods studied. LIMITATIONS This study did not measure clinically relevant infections, and the results may not correlate with decreased rates of infection after surgery. CONCLUSION Incorporation of alcohol and povidone-iodine into the preoperative skin- and nail-preparation process may help reduce the bacterial load. Every effort should be made to lower the risk of contamination from the nail.

Efficacy of intraoperative surgical irrigation with polihexanide and nitrofurazone in reducing bacterial load after nail removal surgery

BACKGROUND A common challenge of nail avulsion surgery is the associated bacterial contamination and infection that can manifest. The toe has a difficult anatomy to antiseptically prepare and properly maintain throughout the surgical procedure, lending to this widespread problem. OBJECTIVE We conducted a controlled, prospective randomized study to examine the antiseptic efficacy of 3 intraoperative irrigation methods during nail avulsion surgery. METHODS We compared intraoperative antiseptic irrigation using 0.9% saline solution (24 patients), 0.2% nitrofurazone (22 patients), and 0.1% polihexanide (25 patients). Swab samples were taken from each patient at 5 distinct stages throughout the surgical procedure, and bacterial culture analysis was performed (positive culture rate, total inocula count, reduction of bacterial load, and identification of specific micro-organisms). RESULTS All 3 intraoperative irrigation methods reduced the total bacterial load, but polihexanide was significantly more effective. Furthermore, no patient from the polihexanide group developed postoperative infection. The reduction in bacterial load was lost for all 3 methods after partial nail avulsion surgery, returning to similar values as the initial presurgical bacterial load. An intraoperative irrigation step after partial nail avulsion with saline, nitrofurazone, and polihexanide was effective in reducing the bacterial load by 95.2%, 96.6%, and 99.5%, respectively. LIMITATIONS Our patients underwent phenol-based nail avulsion, resulting in no bacterial load after complete nail removal because of the intrinsic antiseptic nature of the phenol. CONCLUSIONS Intraoperative irrigation with 0.1% polihexanide substantially reduced the bacterial load and subsequent infections, highlighting the importance of an irrigation step in nail avulsion surgery.

Multimedia services for distant work and education in an IP/ATM environment

We developed, tested, and evaluated multimedia distant education applications running over an IPv6/ATM-based broadband access network. We improved the quality of service and adapted a set of distance education applications-including Digital Video Library, Virtual Workspace, and video-audio conferencing tools-to work over IPv6 and let users control the QoS.

Efficacy of preoperative and intraoperative skin and nail surgical preparation of the foot in reducing bacterial load.

BACKGROUND A common problem associated with toenail removal surgery is the accompanying bacterial infection that often ensues. The foot has a particularly difficult anatomy to prepare antiseptically for surgery, which contributes to this wide‐spread problem. OBJECTIVE To compare the antiseptic efficacy of two skin pretreatment methods before toenail avulsion surgery. METHODS Two presurgical methods were performed on 24 patients each (48 patients total). Swab samples were taken from each patient at five distinct stages (pretreatment, post‐treatment, after surgery, after saline solution irrigation of the nail bed, and after phenol application) throughout the surgical procedure, and bacterial culture analysis was performed (total inocula count and identification of specific microorganisms). RESULTS We found both methods to be effective at reducing the initial bacterial load when used at pretreatment, but the reduction in bacterial load was lost after the nail avulsion surgery, achieving values similar to the initial bacterial load before the presurgical scrub, from 5.17 and 5.04 log10 colony‐forming units (CFU)/cm2 to 4.86 and 5.07 log10 CFU/cm2, respectively. An interoperative irrigation step was effective in reducing the bacterial load by 95.2% and 95.3%, respectively. STUDY LIMITATIONS Our patients underwent phenol‐based nail avulsion, resulting in no bacterial load after complete nail removal because of the intrinsic antiseptic nature of the phenol. CONCLUSIONS Incorporation of intraoperative irrigation of sterile saline solution after nail avulsion surgery reduces potential bacterial load. Every effort should be made to lower the risk of contamination after nail plate avulsion. The authors have indicated no significant interest with commercial supporters.

Complicaciones infecciosas en cirugía digital

The authors expose the infectious complications after the accomplishment of surgical techniques in the foot as well as the antimicrobial treatment of election.