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Patients are admitted to the surgical intensive care (SICU) unit after emergency and elective surgery. After elective surgery, for further support, or to manage coexisting comorbidities. The implementation of the ERAS (Enhanced recovery after surgery) protocols in surgery should decrease the need for ICU beds, but there will always be unpredicted complications after surgery. These will require individual management. What we can do for our surgical patients in ICU to further enhance their recovery? To promote early enhanced recovery in surgical intensive care—SICU, three areas need to be addressed, sedation, analgesia, and delirium. Tools for measurement and protocols for management in these three areas should be developed to ensure best practice in each SICU. The fourth important area is Nutrition. Preoperative screening and post-operative measurement of the state of nutrition also need to be developed in the SICU. The fifth important area is early mobilization. ERAS protocols encourage early mobilization of the critically ill patients, even if on mechanical ventilation. Early mobilization is possible and should be implemented by special multidisciplinary ICU team. All team members must be familiar with protocols to be able to implement them in their field of expertise. Personal and professional attitudes are critical for implementation. In the core of all our efforts should be the patient and his well-being.

Introduction: Maximal effort physiological tests provide information about the current functional capacity of athletes. Objective: The aim of this study was to evaluate anaerobic performance parameters in elite athletes and to compare them in terms of the specific demands of each sport. We also created and applied the new software which enables us to quantify a new parameter -explosive muscle power (EP), a major component in sports requiring explosive bursts of movement lasting from a few seconds to 1 or 2 minutes. This new parameter reflects the velocity of energy transformation from intramuscular ATP and high-energy phosphates into mechanical power. Methods: All Wingate test parameters (standard parameters) -anaerobic power (AP), anaerobic capacity (AC), and explosive power (EP) as the new parameter were recorded in 104 subjects: 30 non-athletes and 74 athletes divided into different groups depending on their sport specialty (20 rowers, 28 wrestlers and 26 soccer players). Results: Anaerobic power (AP), anaerobic capacity (AC) and explosive power (EP) were significantly higher in the group of athletes compared to non-athletes. Among athletes, significant differences were observed in some parameters according to the type of activities they are involved in. The highest values were recorded in the group of wrestlers (AP=836W; AC=16.6kJ; EP=139W/s). The values of AP (absolute values) and EP (absolute and relative values) were significantly higher in wrestlers than in soccer players and rowers, but there was no significant difference in AC among these groups. The EP variable had a distribution similar to AP. Conclusions: Alongside anaerobic power and anaerobic capacity, the assessment of explosive power may complement the anaerobic profile of athletes. Experts in the field of sports medicine and exercise physiology could find these results useful in improving test variables, which are more important for specific sports, and for evaluating and monitoring training progress. Level of Evidence I; Diagnostic studies -Investigating a diagnostic test.

Introduction: Tennis leg, a common injury of the medial head of gastrocnemius muscle in the muscle-tendon junction, is usually reported in men during recreational sports. Sudden pain is the main symptom accompanied by the feeling of rupture in the calf. Clinical examination followed by ultrasound is the standard diagnostic procedure. Objective: The main objectives of this study are to compare clinical and ultrasonographic findings in cases of tennis leg, evaluate the location and type of lesion in the medial head of gastrocnemius muscle, and evaluate the edema volume and the presence of deep vein thrombosis (DVT). Second, the healing process was monitored with ultrasound to distinguish the level of recovery and to record the presence of chronic sequelae. Methods: Eighty-one subjects with clinical symptoms of rupture of the medial head of gastrocnemius muscle participated in the study. A linear probe (7-12 MHz) was used for ultrasonographic (US) and a Doppler was used to verify the presence of DVT. Results: In 78 of 81 subjects examined, we found obvious US changes (96.3%) and three of them had no positive findings. In 67 of them, we diagnosed rupture of the medial head of the gastrocnemius muscle. Most of them had partial rupture (73.13%) and the remaining had total rupture (26.87%). The edema (30.84%) was found in the space between the aponeurosis of the gastrocnemius and soleus muscles. DVT with the clinical signs of tennis leg was observed in 5 of 81 patients (6.17%). Conclusion: Our findings indicate that ultrasound is very important for early diagnosis of muscle-tendon injuries in the leg. In addition, monitoring the healing process and assessing the chosen treatment showed a high efficiency. Ultrasonography is an effective method to identify and differentiate the sequelae of the injured muscles and vascular complications.

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Various biomarkers like certain complete blood cell count parameters and the derived ratios including neutrophil–lymphocyte ratio are commonly used to evaluate disease severity. Our study aimed to establish if baseline levels of complete blood cell count-derived biomarkers and CRP, measured before any treatment which can interfere with their values, could serve as a predictor of development of pneumonia and the need for hospitalization requiring oxygen therapy. We retrospectively analyzed the laboratory data of 200 consecutive patients without comorbidities, who denied usage of medications prior to blood analysis and visited a COVID-19 ambulance between October and December 2021. Multivariate regression analysis extracted older age, elevated CRP and lower eosinophil count as significant independent predictors of pneumonia (p = 0.003, p = 0.000, p = 0.046, respectively). Independent predictors of hospitalization were higher CRP (p = 0.000) and lower platelet count (p = 0.005). There was no significant difference in the neutrophil–lymphocyte and platelet–lymphocyte ratios between examined groups. Individual biomarkers such as platelet and eosinophil count might be better in predicting the severity of COVID-19 than the neutrophil–lymphocyte and platelet–lymphocyte ratios.

Introduction. Anaerobic capacity is much less evaluated in literature compared to aerobic component. Anaerobic performance of athletes can be measured using different motoric tests, lasting 20 to 30 seconds, one of them being the Wingate anaerobic test (WAnT). Objective. The aim of this study was to determine the work performed and power generated by athletes and non-athletes during a 30-second high intensity exercise, as well as to compare explosive characteristics of subjects using a new parameter of WAnT, named explosive power, or slope of power. Methods. All parameters of anaerobic power were investigated in 152 subjects classed into different groups depending on their physical fitness and sport specialties as follows: non-athletes (n=31), rowers (n=26), volleyball players (n=37), handball players (n=34) and judo players (n=24). The WAnT, as well as basic anthropometric measurements, was administrated to all participants. Results. Values of anaerobic parameters were higher in the group of athletes compared to physically inactive subjects. The highest values of the WAnT parameters were registered in the group of volleyball players (AP=1006 W; relative AP=11.4 W/ kg, AC=19.8 kJ), compared to athletes of other sport disciplines (volleyball, rowing and judo). The new parameter of the WAnT, explosive power, also showed highest values in volleyball players (EP=154 W/s; relative EP=1.74 W/s/kg). These differences were statistically significant (p<0.05). Conclusion. The results of laboratory tests can provide useful information on improvements in training processes. The new parameter of the WAnT could be implemented in further analyses of explosive characteristics of muscle contraction.

Vitamin D is known to affect the functions of pancreatic beta cells, but the effects of vitamin D deficiency on glucoregulatory mechanisms are still inconclusive. The aim of this study was to link vitamin D levels with parameters of insulin resistance and insulin secretion. The study included 70 male and female participants, 40 newly diagnosed patients with type 2 diabetes mellitus (T2DM) and 30 healthy controls. All participants were tested for fasting glucose, hemoglobin A1c, fasting insulin, vitamin D levels, and the HOMA indexes were calculated using HOMA2 calculator. Fasting glucose levels, insulinemia, hemoglobin A1c levels and HOMA IR were all significantly higher in the diabetic group (p<0.001), while vitamin D levels and HOMA S index were significantly lower (p<0.001). HOMA-B values did not differ between the two groups (p=0.31). Vitamin D levels moderately correlated with HOMA S and HOMA B indexes (r=0.466, p<0.001; r=0.394, p<0.001, respectively), whereas a negative correlation was found between vitamin D levels and HOMA IR (r=−0.285; p<0.001). Multiple regression analysis showed that vitamin D levels significantly predicted the values of HOMA B index (p=0.001), but they had no predictive value on HOMA IR (p=0.26). In conclusion, the group of newly diagnosed patients with T2DM showed significantly lower vitamin D values compared to the healthy control group. The connection between vitamin D, glucose levels, hemoglobin A1c and insulin secretion index underlines the role of this vitamin in glucoregulation.