Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players?

This prospective randomized intervention investigated whether training on a balance board could reduce the amount of traumatic injuries of the lower extremities in female soccer players. A total of 221 female soccer players from 13 different teams playing in the second and third Swedish divisions volunteered to participate in the study. Seven teams (n = 121) were randomized to an intervention group and six teams (n = 100) to a control group and were followed during one outdoor season (April-October). Before and after the season muscle flexibility and balance/postural sway of the lower extremities were measured in the players. There were no significant differences in age, height, weight, muscle flexibility and balance/postural sway of the lower extremities between the intervention and the control group. During the season the players in the intervention group performed a special training program consisting of 10-15 min of balance board training in addition to their standard soccer practice and games. After a 37% drop-out the intervention group consisted of 62 players and the control group of 78 players. The results showed no significant differences between the groups with respect either to the number, incidence, or type of traumatic injuries of the lower extremities. The incidence rate of "major" injuries was higher in the intervention group than in the control group. Four of five anterior cruciate ligament injuries occurred in the intervention group, which means that we could not prevent severe knee injuries in female soccer players with balance board training. However, among the players who had been injured during the 3-month period prior to this investigation there were significantly more players from the control group than from the intervention group who sustained new injuries during the study period.     

Do patients benefit from tourniquet in arthroscopic surgeries of the knee?

Purpose

To undertake a meta-analysis of randomized controlled trials to determine whether routine use of a tourniquet is a better choice for knee arthroscopic procedures.

Methods

Randomized controlled trials which evaluated the application of a tourniquet were selected, gathering information about arthroscopic visualization and operative time. The random-effects meta-analysis was performed using relative risk calculated from the raw data.

Results

A total of five eligible studies were selected in this meta-analysis with 471 participants. There was no significant difference in visualization or operative time between the tourniquet and the non-tourniquet group.

Conclusions

There is insufficient evidence to support the hypothesis that patients would benefit from routinely applying a tourniquet. The use of a tourniquet did not show any advantage to arthroscopic procedures.

Level of evidence

Therapeutic randomized controlled trials, Level I.     

Do anatomic variants of the acromion shape in the frontal plane influence pain and function in calcifying tendinitis of the shoulder?

Purpose  

To evaluate the relationship of a large acromion index and calcifying tendinitis of the supraspinatus tendon at the shoulder.     

Do mismatches between teams affect the risk of injury in the Rugby World Cup?

The aim of this study was to assess whether differences in competing teams’ body mass and playing performance affected the risk of injury in rugby union. The study was a prospective, whole population survey of players representing all countries competing at the Rugby World Cup in 2007. The study design followed the consensus statement for epidemiological studies in rugby with the main outcome measures being the incidence and severity of match injuries. Differences in players’ average body mass and mismatches in the teams’ overall and match performances did not create greater risks of injury for the lighter or less successful teams competing at Rugby World Cup 2007.     

Do the benefits of exercise in indoor and outdoor environments during the COVID-19 pandemic outweigh the risks of infection?

Sport Sciences for Health -     

Do short-time SPECT images of bone scintigraphy improve the diagnostic value in the evaluation of solitary lesions in the thoracic spine in patients with extraskeletal malignancies?

OBJECTIVE: Single photon emission computed tomography (SPECT) images provide many details of the anatomical structure. Also about bone scintigraphy, there are many reports of the improvement of diagnosis by SPECT images. Although SPECT is useful, it requires much time. So to perform SPECT for all cases is difficult in the clinical situation. Recently, due to technical improvements in gamma cameras, we can get SPECT images in a short time. We examined diagnosis of solitary hot spots of thoracic spine in cancer patients using short-time SPECT. And we considered whether short-time SPECT contributes to the precise diagnosis of the lesion. MATERIAL AND METHODS: We performed bone scintigraphy image acquisition and both planar and short-time SPECT of the chest. Short-time SPECT was acquired in 6 minutes. We selected 36 cases with malignancy, whose bone scintigraphy demonstrated a solitary accumulation hot spot in the thoracic spine. Three experienced radiologists in nuclear medicine and 4 beginners diagnosed the images. They interpreted planar, short-time SPECT and maximum intensity projection (MIP) view of the chest of each case. The observers' response data were analyzed with receiver operating characteristic (ROC) curve analysis. RESULTS: Of the three types of images, the Az (the area under ROC curve) values of short-time SPECT were the highest in all the observers except for only one beginner. Compared with experienced observers, beginners scored lower Az values of short-time SPECT. MIP images were constructed using SPECT data, but the Az values of MIP images were not higher than those of planar images. As to diagnosis, beginners tended to interprete most of the accumulations as metastatic lesions. CONCLUSION: Short-time SPECT can be helpful to some degree, but to provide greater benefit, the observers require considerable exercise and experience.     

IMRT in a Pregnant Patient: How to Reduce the Fetal Dose?

The purpose of our study was to find a solution for fetal dose reduction during head-and-neck intensity modulated radiation therapy (IMRT) of a pregnant patient. The first step was optimization of the IMRT treatment plan with as few monitor units (MUs) as possible, while maintaining an acceptable dose distribution. The peripheral dose originating from the final IMRT plan was measured at distances reaching from the most proximal to the most distal fetal position, along the accelerator's longitudinal axis, using an anthropomorphic phantom extended with water-equivalent plastic. The measured peripheral dose was divided into leakage, and internal and collimator scatter, to find the degree to which each component influences the peripheral dose to build an appropriate shield. Collimator scatter was the greatest contributor to the peripheral dose throughout the range of the growing fetus. A shield was built and placed beneath the accelerator head, extending caudally from the field edge, to function as an extra collimator jaw. This shield reduced the fetal dose by a factor of 3.5. The peripheral dose components were also measured for simple rectangular fields and also here the collimator scatter was the greatest contributor to the peripheral dose. Therefore, the shielding used for the IMRT treatment of our patient could also be used when shielding in conventional radiotherapy. It is important for a radiation therapy department to be prepared for treatment of a pregnant patient to shield the fetus efficiently.     

Do forensic physicians have a future in the UK?

This article represents a personal view of the future of forensic physicians (police surgeons) in the UK.     

Do aspartate and asparagine acute supplementation influence the onset of fatigue in intense exercise?

AIM: Oxaloacetic acid represents a fundamental intermediary in the metabolism of energy substrate. Asparagine and aspartate constitute precursor compounds of this substance. Therefore, they could affect tricarbossilic acids cycle. Besides, it was suggested that supplementation with aspartate and asparagine determines a muscular glycogen sparing during strenuous physical exercise, even if the real effectiveness remain controversial. The aim of the present pilot study was to evaluate the hypothesis that a supplementation with oxaloacetate precursors, precisely aspartate and asparagine, could improve sport performance during high intensity endurance exercise. METHODS: We recruited 15 male trained athletes, aged from 20 to 30 years (mean age: 24.13+/-3.87 years), practicing triathlon. We administered them placebo or aspartate (7 g) and asparagine (7 g) mixture, using a double blind technique, before performing an exhaustion stress test on cycloergometer carried out to 90% of each athlete's maximum oxygen consumption, previously determined. RESULTS: We evaluated lactatemia through earlobe punctures at the end of warming up, at the maximum effort and at recovery time (3 min, 5 min, 10 min, 15 min, 30 min). Furthermore, subjects were submitted to three blood samples from brachial artery in order to assess the glycemia (before the exercise, at the end of the exercise, and 30 min after the end of the exercise). CONCLUSION: The analysis of these parameters and the results of the ergometric tests after amino acids assumption indicate that acute supplementation with aspartate and asparagine do not significantly affect physical performance in athletes practicing high intensity exercises, and that acute administration of aspartate does not cause a sparing of muscle glycogen concentration.     

Do all mucocele-like lesions of the breast require surgery?

Aim

The objective of this study is to review the imaging features and percutaneous biopsy findings of mucocele-like lesions (MLLs) of the breast and correlate these with histopathology at surgical excision (SE), where available, to determine whether all MLLs of the breast require surgery for management.

Materials and Methods

A search of two pathology databases was performed to identify 44 patients who had been diagnosed with MLL of the breast and who had corresponding imaging findings available for review. These patients' medical records were reviewed to determine patient age at diagnosis, site of disease/affected breast, symptoms at diagnosis, mammographic and sonographic findings and methods used for histopathologic diagnosis (percutaneous biopsy and/or SE).

Results

The mean age of all patients was 56 years (range, 35-76 years). Sixteen patients had MLLs diagnosed by core needle biopsy (CNB) or fine needle aspiration biopsy followed by SE. Eighteen patients had CNB without SE and had clinical and imaging follow-up. Ten patients had MLL diagnosed at SE without prior percutaneous biopsy. In total, 29 patients (66%) had MLLs without atypia, while 10 patients had MLLs associated with atypical ductal hyperplasia (ADH) (23%) and five patients had MLLs associated with ductal carcinoma in situ (DCIS) (11%). Findings were upgraded at SE following the percutaneous biopsy from ADH to DCIS in 19% (3/16) of patients.

Conclusion

Surgical excision following the identification of MLL is warranted to exclude coexisting in situ carcinoma in specific situations where CNB detects the presence of associated ADH or where a mass with indistinct or irregular margins is shown by mammography or sonography.