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Questo studio preliminare ha analizzato il carico di allenamento di due esercitazioni tecnico-tattiche a elevato impegno fisico in calciatori di età differenti. 8 calciatori Under 16 e 8 Under 15 hanno eseguito 2 SSGs (Small Sided Games) in diverse modalità: un 4 vs 4 in “doppio quadrato” (3 x 4’) e mini-partite, con la presenza del portiere, in “gabbia” (20’ totali, dal 2 vs 2 al 4 vs 4). Gli indici di carico esterno sono stati monitorati attraverso un sistema GPS, ed è stata registrata la fatica percepita (RPE). Il 4 vs 4 ha mostrato un’intensità complessivamente maggiore rispetto alla gabbia per potenza metabolica media, distanza al minuto, distanza equivalente al minuto ed RPE. Al contrario, un’intensità maggiore è emersa nella “gabbia” per percentuale di distanza equivalente e accelerazione/decelerazione ad alta intensità. Tali differenze tra le esercitazioni sono risultate pressochè simili negli Under 15 rispetto agli Under 16. Infine, l’intensità elle 2 modalità di SSGs è risultata complessivamente maggiore negli Under 16 per tutte le variabili esaminate. In conclusione, il 4 vs 4 è più intenso della “gabbia”, essendo un lavoro più focalizzato su aspetti fisici che tecnici. I calciatori di categoria Under 16 riescono a esprimere un impegno maggiore nel 4 vs 4 e appaiono quindi più pronti a svolgere in modo ottimale tale esercitazione.

Scopo: Questo studio si propone di verificare l’esatta corrispondenza tra punti di repere cutanei ed ossei al fine di proporre una metodologia di reperizzazione manuale. Metodo: 30 soggetti sono stati selezionati casualmente tra un vasto gruppo di pazienti. Per ogni soggetto il chinesiologo individua manualmente il margine mediale della scapola ed evidenzia due punti ad esso corrispondenti. Il paziente viene posizionato dal tecnico radiologo per eseguire l’esame radiografico programmato per accertamenti clinici indipendenti da questo studio. Con apposito software (Autocad Light) è stato calcolato l’angolo formato dal margine mediale vero (MMv) e quello formato dal margine mediale reperizzato (MMr). Risultati: L’analisi statistica ha evidenziato una differenza non significativa (p>0,8) tra MMv ed MMr. Discussione: Il nostro studio propone una semplice metodologia della reperizzazione manuale. I dati ottenuti dimostrano che non esistono differenze significative fra i reperi cutanei e i reperi ossei. Conclusioni: la metodologia da noi proposta è risultata di facile applicabilità, assolutamente non invasiva e ripetibile. Parole chiave: scapola, punti di repere

An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and the outcome of biliary complications during and following laparoscopic cholecystectomy. A questionnaire was mailed to all surgeons with experience in laparoscopic cholecystectomy in the Campania region. Data were collected from January 1991 to December 2003. Each patient was requested to indicate age, gender, associated diseases, site and type of lesion, surgical experience, diagnosis, treatment and complications. Twenty-six surgeons answered the questionnaire. Fifty-one patients (36 F/15 M; mean age: 42.5 +/- 11.9, range 13-91 years) with bile duct injuries following laparoscopic cholecystectomy were reported. The most frequent lesions were main bile duct partial or total transection. The intraoperative mortality rate was 1/51 (1.9%) due to a complex biliary and vascular injury. The postoperative mortality rate of revision surgery was 5/50 (10%). T-tube positioning (n = 20) and Roux-en-Y hepato-jejunostomy (n = 20) were the procedures most frequently performed. The complication rate in patients treated with the T-tube was significantly higher than in those treated with hepatico-jejunostomy. Surgical treatment of biliary injuries following laparoscopic cholecystectomy was characterized by unusually high mortality and morbidity for a non-neoplastic disease. Roux-en-Y hepato-jejunostomy remains the procedure of choice for these injuries.

Purpose. We investigated the yield of CT and MRI in the diagnosis and staging of 15 patients with retroperitoncal sarcomas; these lesions are often asymptomatic and need radical surgery to avoid local recurrences. Material and methods. April 1993, to September 1997, fifteen patients with retroperitoneal sarcomas were examined and then operated on. CT and CT-guided FNAB were always performed, while MRI was performed in 8 patients only. Because of the high risk of sampling errors, the bioptic specimens were immediately evaluated by a pathologist: a second sampling was required in 10 cases and a third sampling in 6 cases. MRI was performed with a .5 T system (GE Vectra); T1- and T2-weighted transverse images of the abdomen were acquired in all patients and additional coronal and sagittal images were acquired for each abnormal region. All patients underwent surgery and the pathologic diagnosis was compared with CT and MR findings. Resulte. CT always allowed accurate location of the lesions and identification of their components, especially fat deposits. The cytologic examination of FNAB samples allowed the diagnosis of sarcoma in 12 of 15 cases. CT results were compared with MR findings in 8 patients and the latter method had better spatial definition of the abdominal masses, particularly of vascular structures, which is important for surgical planning. Discussion. The present-day imaging techniques are very important to plan the surgical treatment of retroperitoneal sarcomas. In particular, CT has the advantage of high spatial resolution and excellent tissue contrast from abundant retroperitoneal fat tissue; it also permits the cytologic sampling of viable tumor tissue. However the bulk of such lesions often prevents CT from determining the tumor origin, in which case MRI provides better spatial resolution and vascular detailing, which helps surgical planning. Conclusions. Both CT and MRI are major tools in the diagnosis and staging of retroperitoneal sarcomas because they can accurately define the borders of large tumors and their relationships with surrounding organs. MRI has the advantage of characterizing the blood supply to the mass, but CT is better to guide FNAB.

An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and the outcome of biliary complications during and following laparoscopic cholecystectomy. A questionnaire was mailed to all surgeons with experience in laparoscopic cholecystectomy in the Campania region. Data were collected from January 1991 to December 2003. Each patient was requested to indicate age, gender, associated diseases, site and type of lesion, surgical experience, diagnosis, treatment and complications. Twenty-six surgeons answered the questionnaire. Fifty-one patients (36 F/15 M; mean age: 42.5 +/- 11.9, range 13-91 years) with bile duct injuries following laparoscopic cholecystectomy were reported. The most frequent lesions were main bile duct partial or total transection. The intraoperative mortality rate was 1/51 (1.9%) due to a complex biliary and vascular injury. The postoperative mortality rate of revision surgery was 5/50 (10%). T-tube positioning (n = 20) and Roux-en-Y hepato-jejunostomy (n = 20) were the procedures most frequently performed. The complication rate in patients treated with the T-tube was significantly higher than in those treated with hepatico-jejunostomy. Surgical treatment of biliary injuries following laparoscopic cholecystectomy was characterized by unusually high mortality and morbidity for a non-neoplastic disease. Roux-en-Y hepato-jejunostomy remains the procedure of choice for these injuries.