[Inverted Takotsubo Syndrome due to Severe Scorpion Envenomation: Report of one Case]

Scorpion envenomation (SE) is common in tropical and subtropical regions. Cardio-respiratory manifestations, mainly cardiogenic shock and pulmonary oedema are the leading causes of death after scorpion envenomation. Cardiac failure can be due to massive release of catecholamines, myocardial damage induced by the venom or myocardial ischemia. Although it has been exceptionally reported, Takotsubo syndrome during SE can help to better elucidate the pathophysiology of this cardiomyopathy. We report a case of inverted Takotsubo following a SE in a 26-year-old patient admitted to the Intensive care unit department for severe scorpion envenomation. His evolution was favorable. We concluded that cardiac involvement in this case fulfills all clinical and paraclinical criteria of Takotsubo syndrome emphasizing the importance of catecholaminergic discharge during scorpion envenomation. We discuss again the management of this syndrome in this specific condition.

[Posttraumatic thromboembolic complications: Incidence, risk factors, pathophysiology and prevention]

Venous thromboembolism (VTE) remains a major challenge in critically ill patients. Subjects admitted in intensive care unit (ICU), in particular trauma patients, are at high-risk for both deep vein thrombosis (DVT) and pulmonary embolism (PE). The rate of symptomatic PE in injured patients has been reported previously ranging from 1 to 6%. The high incidence of posttraumatic venous thromboembolic events is well known. In fact, major trauma is a hypercoagulable state. Several factors placing the individual patient at a higher risk for the development of DVT and PE have been suggested: high ISS score, meningeal hemorrhage and spinal cord injuries have frequently been reported as a significant risk factor for VTEs after trauma. Posttraumatic pulmonary embolism traditionally occurs after a period of at least 5 days from trauma. The prevention can reduce the incidence and mortality associated with the pulmonary embolism if it is effective. There is no consensus is now available about the prevention of venous thromboembolism in trauma patients.

Greater volumes of static and dynamic stretching within a warm-up do not impair star excursion balance performance

Based on the conflicting static stretching (SS) literature and lack of dynamic stretching (DS) literature regarding the effects of differing volumes of stretching on balance, the present study investigated the effects of 4, 8, and 12 sets of SS and DS following a 5 min aerobic running warm-up on the star excursion balance test (SEBT). The objective was to examine an optimal stretch modality and volume to enhance dynamic balance. A randomized, within-subjects experimental design with repeated measures for stretching (SS and DS) versus no-stretching treatment was used to examine the acute effects of 10 (4 sets), 20 (8 sets), and 30 (12 sets) min, of 15s repetitions per muscle of SS and/or DS following a 5 min aerobic warm-up on the performance of the SEBT. Results indicated that a warm-up employing either SS or DS of any volume generally improves SEBT by a "small" amount with effect sizes ranging from 0.06 to 0.50 (11 of 18 conditions>75% likely to exceed the 1.3-1.9% smallest worthwhile change). Secondly, the difference between static and dynamic warm-up on this observed improvement with warm-up improvement was "trivial" to "moderate" (d=0.04 to 0.57) and generally "unclear" (only two of nine conditions>75% likely to exceed the smallest worthwhile change). Finally, the effect of increasing the volume of warm-up on the observed improvement with a warm-up is "trivial" to "small" (d<0.40) and generally "unclear" (only three of 12 conditions>75% likely to exceed the smallest worthwhile change). In summary, an aerobic running warm-up with stretching that increases core and muscle temperature whether it involves SS or DS may be expected to provide small improvements in the SEBT.

Allometric growth and reproductive biology traits of pikeperch Sander lucioperca at the southern edge of its range

This study describes some biological traits (allometric relationship, reproductive biology and condition factor) of pikeperch Sander lucioperca at the southern edge of its range. Data were compiled from field studies between January 1997 and January 2009 in three Tunisian reservoirs. Overall, 1497 fish were caught, from which 1308 specimens were sampled and dissected. Sexually undetermined, male and female fish from the different sites exhibited similar allometric growth, expressed through the equation M(T) = 5 × 10(-6) L(T) (3·06) , where M(T) is the total mass and L(T) is the total length. The exponent value is slightly but significantly greater than 3, indicating positive allometric growth. Sex ratio (males:females) was 47:53 but remained balanced only up to 55 cm L(T) and changed with increasing size towards female dominance. Spawning occurred in March and early April according to the changes in female size-adjusted gonad mass or corresponding gonado-somatic index (I(G) ) values. Thermal conditions seemed favourable in February, but March corresponded to the period of equal day and night lengths and the switch towards longer days in terms of photoperiod. Changes in both size-adjusted M(T) or Fulton's condition factor and size-adjusted liver mass or hepato-somatic index (I(H) ) were clearly associated with reproduction. Reserves were consumed during spring in association with spawning efforts. Nevertheless, the delay before the reconstitution of reserves seemed relatively long (from early spring to late summer) although both thermal and trophic conditions could be considered favourable for active feeding of the fish.