Youth in Sport:Nutritional Needs

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Calcification in cystic renal masses: is it important in diagnosis?

PURPOSE: To determine whether the presence of calcifications in cystic renal masses is important in diagnosis and to suggest an approach to the management of calcified cystic renal masses. MATERIALS AND METHODS: Eighty-one cystic renal masses containing calcification in a wall or septum were evaluated by means of review of computed tomographic (CT) images (n = 81), follow-up CT images (n = 28), and results of pathologic examination (n = 40) by the authors in consensus. Images were evaluated for lesion size, amount and morphology of calcification, and any association of calcification with soft-tissue structures. Lesions were categorized according to the Bosniak cyst classification system; the amount of calcification was determined with a subjective grading system. Progression of calcification was qualitatively determined with available follow-up CT scans. RESULTS: Twenty-one lesions were Bosniak category II (benign) and showed small amounts and thin strands of calcification. Nineteen lesions containing more extensive calcification but no enhancing tissue were category IIF. Follow-up CT results available for 16 of these lesions (average follow-up length, 5 years 8 months) showed no substantial change. The three remaining lesions were proved benign at surgery. Twenty-five lesions were category III; surgical intervention was performed in 21 of these (benign, n = 12; malignant, n = 9). Sixteen lesions that contained obvious areas of enhancing soft tissue were category IV and proved malignant at surgery. CONCLUSION: Calcification in a cystic renal mass is not as important in diagnosis as is the presence of associated enhancing soft-tissue elements. This information should enable a reasonable approach to the management of calcium-containing renal cystic lesions.     

Hyoid-laryngeal fractures in hanging: where was the knot in the noose?

The aims of this study were to determine the frequency of hyoid-laryngeal fractures in hanging in relation to the position of the ligature knot, to reconstruct the location of the ligature knot in cases of hanging when the furrow is not detectable on the skin, and to identify the possible mechanism of neck structure injuries. We report a retrospective autopsy study which included 557 cases of suicidal hanging: 413 men and 144 women, with an average age of 52.4 +/- 17.8 years. In 57.3% of them, hyoid-laryngeal fractures were found (average age was 54.3 +/- 16.5 years): 15.1% had only hyoid bone fracture, 26% had only thyroid cartilage fracture and 16.2% had both types of injury at the same time. Hyoid-laryngeal fractures were found more often in persons aged over 30 years. Hyoid bone fracture was a weak predictor of ligature knot position in our sample. Fracture frequencies of the thyroid cartilage show a statistically significant difference in relation to the ligature knot position among persons older than 30 years, which indicated the ipsilateral and posterior position of the knot. Absence or presence of any form of hyoid-laryngeal fracture indicated that knot position was anterior or posterior, respectively. The derived data would be useful for cases where the ligature has been removed from the body of the deceased shortly after hanging, where the noose is unavailable, and in cases where the ligature mark has faded such as with soft ligatures removed promptly or in decomposed bodies.     

Arthropathy in Behçet disease: MR imaging findings in two cases

Arthropathy is part of the protean manifestations of Beh?et disease. Imaging findings reported thus far have been based on those of conventional radiography. Magnetic resonance imaging in two cases of Beh?et disease with arthropathy demonstrated synovial thickening and effusion, as well as myositis manifested by high signal intensity on T2-weighted images.     

Specialising in radiology in Switzerland: Still attractive for medical school graduates?

Purpose

To gain insight into the professional characteristics of radiologists in Switzerland and to determine how to enhance the attractiveness of radiology to medical graduates as a specialty.

Materials and methods

Data from 262 members of the Swiss Society of Radiology (m:f = 76:24%) obtained in a questionnaire survey were analysed regarding socio-demographic variables, working status, specialty, main fields of interest, career success, mentoring and reasons for the shortage of radiologists.

Results

35 (56.4%) female and 85 (45.5%) male radiologists were aged ≤45 years. 228 (87%) were board-certified; 44 (17.9%) had completed a sub-specialisation. Men worked part-time mostly just before retirement, while women worked part-time at a younger age. As reasons for specialty choice, the wide range of clinical work and the combination of technology and medicine were ranked highest. Women reported significantly less career success and support. To improve the attractiveness of radiology to graduates, radiology should be visible on medical school curricula.

Conclusion

In Switzerland, more female radiologists work part-time than male ones, and there is less career success and support for women. In order to make radiology more attractive to medical graduates as a specialty, structured residency programmes and reliable gender-respecting career support are needed.     

Cobalt chloride administration in athletes: a new perspective in blood doping?

Blood doping is an illegal and unfair way of enhancing athletic performance by increasing the oxygen carrying capacity of the blood. Currently used methods usually involve stimulation of erythropoiesis. Gene therapy targeting the hypoxia inducible factor pathway may be an attractive alternative to traditional blood doping techniques. Hypoxia activates a large number of genes with essential roles in cell and tissue adaptation to low oxygen. Cobalt chloride is a well established chemical inducer of hypoxia-like responses such as erythropoiesis. Cobalt supplementation is not banned and therefore would not be detected by current anti-doping testing. Although there is as yet no direct or anecdotal evidence of cobalt chloride administration to athletes, its use should be warned against as being not only unfair but potentially dangerous.     

Paediatric radiotherapy in Australia and New Zealand: an anachronism in 2003?

This report reviews the activities of the Paediatric Special Interest Group of the Royal Australian and New Zealand College of Radiologists in terms of its involvement with the Australian and New Zealand Children's Cancer Study Group and its research and educational activities. Examples of when and how radiotherapy is currently used in the management of paediatric malignancies are provided. Some thoughts for the future of both paediatric radiotherapy and our subspecialty are also presented.     

Heading in soccer: Is it safe?

Soccer is the world’s game, played by 120 million people around the world and 16 million in the United States. It is unique in that it forbids the use of the upper extremity, other than by the goalkeeper or when throwing the ball into play from the sideline. It is also unique in that it is the only sport in which the head is purposefully used to strike the ball. As sports medicine has evolved, so has our curiosity about how certain sport-specific skills or protective equipment might change the injury profile of a sport. For soccer, there has been some concern that heading may be associated with the development of cumulative traumatic brain encephalopathy, or the “punch drunk” syndrome described in boxers. This article discusses this question in detail, with a critical look at the literature and an emphasis on the prospective data.     

Ginseng: Is it in the root?

athletics today, there is no shortage of participants looking for an extra edge in competition. In addition, there is no shortage of nutritional supplements for athletes to use with hopes of reaping ergogenic benefits. Ginseng is and will continue to be one of these supplements consumed by athletes despite little or no scientific data to support its ergogenicity. Multiple different types of ginseng can be consumed; the most studied and most common types are Siberian, Chinese, and American. Although related, each has different active compounds, and likely, different effects on the body. There do not appear to be significant adverse effects when used for short periods, but further studies are needed to confirm this. Similarly, more studies are needed to address the ergogenic potential of ginseng. At this time, ginsengs cannot be recommended to improve athletic performance, but there may be some utility for athletes by preventing viral upper respiratory infection and improving cognition. This review evaluates recently published literature on ginseng use in athletes.