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Objective: Sepsis is the most serious complication of flexible ureteroscopy (F-URS) and laser lithotripsy. We assessed the influence of positive stone culture (SC) on major infectious complications (sepsis, septic shock). Methods: This prospective study enrolled adult patients deemed suitable for F-URS and laser lithotripsy from nine centers (January 2022–August 2023). Inclusion criteria were as follows: kidney stone(s), preoperative midstream urine culture (MSUC), stone(s) assessed at computed tomography scan, and SC. Exclusion criteria were as follows: bilateral procedures, ureteral stones, and children. Group 1 included patients with sterile SC. Group 2 included patients with positive SC. Data are presented as median (interquartile range). A multivariable logistic regression analysis was performed to evaluate factors associated with having a positive SC. Results: In total, 293 patients were included. Median age was 51.0 (24) years. There were 167 (57.0%) males. Group 2 included 32 (2.5%) patients. Group 2 patients were significantly older [75.0 (14) vs 51.0 (23) years, p = 0.02]. Stone features were similar. Major infectious complications were higher in Group 2 (15.6% vs 0.4%). One patient died because of sepsis in Group 2. Two out of 6 (33.3%) patients with major infectious complications had the same pathogen in MSUC and SC. In the multivariable regression analysis, diabetes (OR 3.23), symptomatic urinary infections within 3 months before operation (OR 4.82) and preoperative stent/nephrostomy (OR 2.92) were factors significantly associated with higher odds of positive SC. Conclusions: Patients with positive SC have a higher incidence of major infectious complications after F-URS lithotripsy. SC should be performed whenever feasible because there is a poor correlation between MSUC and SC. [ABSTRACT FROM AUTHOR]

Physical activity promotes metabolic health and prevents lifestyle-related diseases. Adiponectin is specifically produced by adipose tissue and comes in three forms, differing in terms of weight: trimers (LMW), hexamers (MMW), and high-molecular-weight (HMW) oligomers. The oligomers are associated with the beneficial effects of adiponectin. In this study, we aimed to investigate the impact of a single bout of exhaustive exercise on adiponectin expression in 25 male amateur athletes, divided into two groups, one comprising young adults (YAs) (n = 15), and the other comprising middle-aged adults (MAs) (n = 10). Body fat was estimated through skinfold thickness. Adiponectin levels were assessed at baseline and at 15 min and 24 h post-exercise, while HMW oligomer levels were evaluated at baseline and at 24 h post-exercise. We observed a significant increase in total adiponectin at both 15 min and 24 h after exercise, with there being a more evident effect among the YA subjects. HMW oligomers also increased significantly after exercise both in the total sample and among the YA subjects, but this was not the case in the MA subjects. The increase in adiponectin levels was significantly associated with Powerpeak. Furthermore, a significant inverse correlation was found between basal adiponectin and VO2peak and Powerpeak. In conclusion, a single bout of exhaustive exercise can rapidly and significantly enhance the basal circulating adiponectin concentration, which seems to be negatively associated with maximal aerobic capacity. [ABSTRACT FROM AUTHOR]

Workplaces cause employees to adopt sedentary behaviors for most of their daytime, negatively impacting psychophysical health. A new office concept (UP150) was designed to reduce sedentary behaviors at work through architectural changes, proactive technologies, and wellness coaches (education to active lifestyles). The present study examined the effects of the UP150 concept, previously investigated in dedicated workspaces, with a 12-month longitudinal trial in a real worksite environment. Forty-eight desk workers comprised the experimental (EG) and control (CG) groups. All participants worked in the same working environment, having the UP150 features inserted in a usual working environment, but the CG was not allowed to interact with the UP150 specifics. During the experimental year, physical (physical activity, motor efficiency, and anthropometric features), clinical (metabolic parameters and cognitive-capacity-related parameters), and psychological (well-being and discomfort, job social and psychological perceptions, and perceived workload) features were assessed. The prolonged application of the UP150 procedure in a mixed working context for involvement in corporate policies positively affected EG workers' physical (physical activity and motor efficiency increased, and body fat unchanged), clinical (blood glucose, insulin, and total cholesterol decreased; HDL increased), and psychological (well-being and social support raised; job demand and perceived workload lowered) parameters, confirming the previous studies. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the acute impact of exercise on serum irisin levels in 22 young (YA, 24.6±3.5 yrs) and in 12 middle-aged male adults (MA, 54.6±5.7 yrs) 15 min and 24 h after an incremental cycling exercise test to exhaustion. ELISA assay was used for serum irisin detection. Circulating irisin increased significantly from baseline (9.0±2.0 ng/ml) to 15 min post-exercise (10.2±2.0 ng/ml, P <0.001), but the greatest increment was detected after 24 h (13.5±2.5 ng/ml, P <0.001) reaching more than 50% of the basal release. Levels were significantly higher in YA (9.7±1.7 to 11.1±1.8 to 14.5±2.2 ng/ml) than MA (7.6±1.6 to 8.7±1.5 to 11.8± 2.2 ng/ml) for all measured time-points (P <0.05). Nevertheless, MA showed a comparable increase in serum irisin levels when compared to YA. These findings highlight the importance of acute physical exercise as a countermeasure against age-related deterioration of skeletal muscle mass and function in both YA and MA. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the dose-response relationship between internal and external training load with changes in aerobic fitness and intermittent running capacity, during different periods of the season, may help in optimizing training process. The aim of the present study was to investigate the dose-response relationships between load measures and changes in aerobic fitness and intermittent running capacity among a large cohort of professional soccer players. Methods: Training load, aerobic fitness and intermittent running capacity of 52 male adult professional players from 3 elite teams were monitored across an entire season and analyzed employing linear mixed models, with a significance level set at p≤0.05. Results: Relationships between load measures (training and match duration, sRPE-TL, total distance, high and very high-speed running distances) and changes in physical qualities were stronger during the preparation period (PREP) for both aerobic fitness (d= 0.48 to 0.76, p<0.031) and intermittent running capacity (d= 0.46 to 1.89, p<0.046). The magnitude of the relationships reduced during the first competitive period (d= 0.43 to 0.56) and the relationships became trivial in the second competitive period (d= 0.06 to 0.41, p= 0.063 to 0.846). Conclusion: The moderate to large relationships found between all measures of load and changes in physical capacities suggest that training prescription during the PREP was effective in improving players' fitness. During the competitive phase small changes in aerobic and intermittent running capacities were found, highlighting that coaching staff pursue different aims during the competitive period, such as technical and tactical training and recovery. [ABSTRACT FROM AUTHOR]

Introduction: Although spinal anesthesia (SA) may reduce postoperative morbidity, most urologists perform flexible ureterorenoscopy (fURS) under general anesthesia (GA). The objective of our study is to provide technical details, results, complications, and patients' satisfaction with fURS performed under exclusive SA. Methods: We analyzed all consecutive fURS performed under SA to treat renal stones from March 2011 to February 2017. Details of technique, operative time, outcomes, need for further treatments, complications, and patients' satisfaction were evaluated. Results: Two hundred thirty-four fURS under SA were considered. SA was performed through L2-L3 vertebral interspace in 64.1%. Patients were discharged the same day of surgery. Mean stone burden was 13.5 ± 6.6 mm and mean operative time 76.9 ± 34.6 min. Single-procedure SFR was 69.7%. Further treatments were performed in 22.8%. 96.6% had no anesthesia-related complications. No Clavien-Dindo grade ≥ IIIb complications were noticed. 99.6% of patients were satisfied with SA. No cases of conversion from SA to GA occurred. Conclusion: fURS can be performed safely and efficiently under SA, taking into account a few details of the technique. Patients' satisfaction with SA is very high, and complications are rare. Although SA is usually adopted in unfit patients for GA, it may be considered as a viable alternative in fit patients. [ABSTRACT FROM AUTHOR]

Objective: To compare stent‐related symptoms (SRS) of loop‐tail (LT) and conventional double J (DJ) stents after uncomplicated flexible ureterorenoscopy (fURS), in a prospective randomised controlled single‐blind parallel‐group study. Patients and Methods: Patients undergoing fURS were randomised into two groups: the LT Group received LT stents (Polaris™ Loop) and the DJ Group received conventional DJ stents (Vortek®). The stent was removed after 4 weeks. The Ureteric Stent Symptom Questionnaire (USSQ) was administered at 2 days, 4 and 8 weeks (baseline evaluation) after stent insertion. The primary endpoint was to compare the Urinary Symptom Index Score of the LT vs DJ groups at 4 weeks after stent insertion. The secondary endpoints were to compare the USSQ domains' subscores at 2 days and 4 weeks after stent insertion, USSQ single answers at 4 weeks, and the 4‐week USSQ domains' subscores adjusted for baseline. Results: A total of 68 patients were randomised (34 LT and 34 DJ). The answers given at 4 weeks were not significantly different between the two groups for the Urinary Symptom Index Score (P = 0.982), Pain Index Score (P = 0.169), visual analogue scale (P = 0.276), and all the other domains of the USSQ. At 4 weeks, the single‐answer analysis did not find any differences between the groups; the urinary symptoms were all comparable, as was the requirement for pain painkillers (P = 0.684) and pain during sex (P = 0.496). There were also no significant differences for every single domain score for the responses given at 2 days. The same applied to USSQ subscores at 4 weeks adjusted for the 8‐week baseline results, which were also comparable. Conclusions: The study found no differences in terms of SRS between the LT and DJ groups, either at 2 days or 4 weeks after stent insertion, with or without baseline correction. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to examine the associations between maximal and submaximal neuromuscular field tests, match physical activity levels and biological maturation in youth football players., Methods: Sixty-four football players from under 14 to under 17 age groups were assessed. Players performed a repeated-sprint ability test, counter movement jump, 10-m, and 30-m sprint test, as well as an assessment of peripheral muscle function following a multi-stage incremental (i.e., four intensity levels) change of direction test (COD). Knee extensors peak-torque (PTmax) and the decrement of torque values (dec) were considered as COD outcomes. Physical match activities were tracked by GPS technology, while rate of perceived exertion (RPE) was assessed using the CR10 Börg Scale. Pearson's correlations (90% confidence interval) were used to examine the relationships., Results: Small associations were found between field tests and match activities. The relationships increased from small to moderate for some tests when match data with RPE>5 were considered. The largest associations were found between distance covered <-2.5m·s -2 and both COD PTmax and dec when RPE>5., Conclusions: The results of the present study provide further evidence of a small-to-moderate association between muscular performance and match work-rate in young football players. Although physical and physiological evaluations fail to precisely estimate the quantity of physical activities performed during matches, it is suggested that they can be utilized to monitor the training effect over time in young football players.