Using recovery modalities between training sessions in elite athletes: does it help?

Achieving an appropriate balance between training and competition stresses and recovery is important in maximising the performance of athletes. A wide range of recovery modalities are now used as integral parts of the training programmes of elite athletes to help attain this balance. This review examined the evidence available as to the efficacy of these recovery modalities in enhancing between-training session recovery in elite athletes. Recovery modalities have largely been investigated with regard to their ability to enhance the rate of blood lactate removal following high-intensity exercise or to reduce the severity and duration of exercise-induced muscle injury and delayed onset muscle soreness (DOMS). Neither of these reflects the circumstances of between-training session recovery in elite athletes. After high-intensity exercise, rest alone will return blood lactate to baseline levels well within the normal time period between the training sessions of athletes. The majority of studies examining exercise-induced muscle injury and DOMS have used untrained subjects undertaking large amounts of unfamiliar eccentric exercise. This model is unlikely to closely reflect the circumstances of elite athletes. Even without considering the above limitations, there is no substantial scientific evidence to support the use of the recovery modalities reviewed to enhance the between-training session recovery of elite athletes. Modalities reviewed were massage, active recovery, cryotherapy, contrast temperature water immersion therapy, hyperbaric oxygen therapy, nonsteroidal anti-inflammatory drugs, compression garments, stretching, electromyostimulation and combination modalities. Experimental models designed to reflect the circumstances of elite athletes are needed to further investigate the efficacy of various recovery modalities for elite athletes. Other potentially important factors associated with recovery, such as the rate of post-exercise glycogen synthesis and the role of inflammation in the recovery and adaptation process, also need to be considered in this future assessment.     

Dynamic magnetic resonance nephrography: is saturation recovery TrueFISP advantageous over saturation recovery TurboFLASH?

PURPOSE: In this volunteer study, 2 navigator-gated strongly T1-weighted saturation-recovery (SR) sequences, a turbo fast low angle shot (TurboFLASH) and a new true fast imaging in steady precession (TrueFISP) readout technique, were compared for suitability in dynamic magnetic resonance nephrography. MATERIALS AND METHODS: Ten healthy volunteers (mean age 26.1 +/- 3.6) were equally divided into 2 subgroups. After bolus-injection of 3.75 mL of gadobutrol (approximately 0.05 mmol/kg body weight), slightly obliqued coronal single-slice images of the kidneys were recorded every 4-5 seconds during free breathing using 1 of the 2 sequences. Time-intensity curves were determined from manually drawn regions-of-interest over the kidney parenchyma. Both sequences were subsequently evaluated with regard to linearity of signal, signal to noise ratio (SNR), and time-dependent behavior of signal intensity curves. RESULTS:: The TurboFLASH readout showed better linearity of the signal behavior as compared with the TrueFISP technique (TurboFLASH: no deviation from linearity down to T1 = 400 milliseconds; TrueFISP at T1 = 700 milliseconds: 12% deviation, at T1 = 400 milliseconds: 19%). The time-intensity curves of the TrueFISP sequence exhibited distinctly lower variability than the TurboFLASH approach. The SNR increased with TrueFISP by 3.4 +/- 0.5-fold for native renal parenchyma and by 3.3 +/- 0.9 for contrast-enhanced renal parenchyma. For split renal function evaluation, the linear regression to the signal increase in the first minutes after the first pass could be performed with higher reliability using the TrueFISP technique (increase of correlation coefficient by 17.1%). CONCLUSION: A SR navigator-gated TrueFISP sequence seems most favorable for dynamic magnetic resonance nephrography due to the high signal yield and low curve variability.     

Diagnostic accuracy of short-time inversion recovery sequence in Graves’ ophthalmopathy before and after prednisone treatment

Introduction

In Graves’ Ophthalmopathy, it is important to distinguish active inflammatory phase, responsive to immunosuppressive treatment, from fibrotic unresponsive inactive one. The purpose of this study is, first, to identify the relevant orbital magnetic resonance imaging signal intensities before treatment, so to classify patients according to their clinical activity score (CAS), discriminating inactive (CAS?<?3) from active Graves’ Ophthalmopathy (GO) (CAS?>?3) subjects and, second, to follow post-steroid treatment disease.

Methods

An observational study was executed on 32 GO consecutive patients in different phases of disease, based on clinical and orbital Magnetic Resonance Imaging parameters, compared to 32 healthy volunteers. Orbital Magnetic Resonance Imaging was performed on a 1.5 tesla Magnetic Resonance Unit by an experienced neuroradiologist blinded to the clinical examinations.

Results

In pre-therapy patients, compared to controls, a medial rectus muscle statistically significant signal intensity ratio (SIR) in short-time inversion recovery (STIR) (long TR/TE) sequence was found, as well as when comparing patients before and after treatment, both medial and inferior rectus muscle SIR resulted significantly statistically different in STIR. These increased outcomes explain the inflammation oedematous phase of disease, moreover after steroid administration, compared to controls; patients presented lack of that statistically significant difference, thus suggesting treatment effectiveness.

Conclusion

In our study, we proved STIR signal intensities increase in inflammation oedematous phase, confirming STIR sequence to define active phase of disease with more sensibility and reproducibility than CAS alone and to evaluate post-therapy involvement.     

Evaluations of non-contrast enhanced MR venography with inflow inversion recovery sequence in diagnosing Budd–Chiari syndrome

Non-contrast-enhanced (NCE) inflow inversion recovery magnetic resonance venography (MRV)and digital subtraction angiography (DSA) examination were carried out in 35 patients who were suspected of having Budd–Chiari syndrome (BCS). With DSA as the reference, NCE MRV got 100% in the diagnostic sensitivity, 67.8% in the specificity, 97.1% in the accuracy, 100% in the negative predictive value, and 96.9% in the positive predictive value. The consistency between NCE MRV and DSA in the depiction of IVC was excellent. NCE MRV is regarded as an alternative method in the diagnosis of BCS.     

Transient increase in wall thickness of the left ventricular apex during recovery from “ampulla” cardiomyopathy

"Ampulla" cardiomyopathy is a syndrome characterized by transient abnormal left ventricular wall motion with hypokinesia around the apical area and hyperkinesia at the basal area, without any detectable coronary lesion. Two cases of transient wall thickening of the left ventricular apex during recovery from "ampulla" cardiomyopathy are described. Apical wall thickening was documented by left ventriculography, echocardiography, and thallium (201Tl) single-photon emission computed tomography (SPECT) during the recovery phase. The thickness of the apical wall subsequently returned to normal. Both patients underwent provocation tests. Coronary spasms were positive. This transient increase in left ventricular apical volume may have been caused by myocardial inflammation secondary to "ampulla" cardiomyopathy.     

Comparison between 360° and 180° data sampling in thallium-201 rest-redistribution single-photon emission tomography to predict functional recovery after revascularization

Whether 360° or 180° imaging should be used in cardiac thallium-201 single-photon emission tomography (SPET) studies to detect coronary artery disease remains controversial. Moreover, the relative diagnostic accuracy of 360° and 180°²⁰¹Tl SPET for the assessment of myocardial viability has never previously been studied. The aim of this study was to perform a direct comparison between 180° and 360° data sampling to detect viable myocardium in patients undergoing revascularization; in order to allow optimal detection of viability a rest-redistribution protocol was used. The²⁰¹Tl results were compared with improvement of regional wall motion abnormalities after the revascularization, which was considered as the gold standard for myocardial viability. Thirty-two patients, scheduled for revascularization, underwent rest-redistribution²⁰¹Tl SPET, using a 360° arc. Raw data along a 180° arc (45° RAO to LPO) were selected from the original 360° data sets (both early an late²⁰¹Tl images). All SPET data were analysed semi-quantitatively using circumferential profiles of the short-axis images; the data were displayed in polar maps. Criteria for viability included percentage²⁰¹Tl redistribution and percentage²⁰¹Tl activity on the late image. Regional wall motion was assessed with two-dimensional echocardiography before and 3 months after revascularization. The sensitivities of 360° and 180° imaging for the prediction of functional recovery were 82% and 89%, respectively, whereas the specificities were 51% and 55%, respectively. The diagnostic accuracy of 360° imaging was 62% and that of 180° imaging 67%. This study shows that 360° and 180° imaging have comparable diagnostic accuracy in the prediction of functional recovery after revascularization. With the newer dual-head gamma camera systems with each detector opposing each other, 360° imaging may be preferred.     

Relative fractional anisotropy value using DTI: Can it help as a prognostic tool in anticipating the recovery of stroke patients?

Objective

To evaluate the use of diffusion tensor imaging (DTI) and fractional anisotropy (FA) as prognostic tools in anticipating the recovery of stroke patients.

Physiological response to water immersion: a method for sport recovery?

Recovery from exercise can be an important factor in performance during repeated bouts of exercise. In a tournament situation, where athletes may compete numerous times over a few days, enhancing recovery may provide a competitive advantage. One method that is gaining popularity as a means to enhance post-game or post-training recovery is immersion in water. Much of the literature on the ability of water immersion as a means to improve athletic recovery appears to be based on anecdotal information, with limited research on actual performance change. Water immersion may cause physiological changes within the body that could improve recovery from exercise. These physiological changes include intracellular-intravascular fluid shifts, reduction of muscle oedema and increased cardiac output (without increasing energy expenditure), which increases blood flow and possible nutrient and waste transportation through the body. Also, there may be a psychological benefit to athletes with a reduced cessation of fatigue during immersion. Water temperature alters the physiological response to immersion and cool to thermoneutral temperatures may provide the best range for recovery. Further performance-orientated research is required to determine whether water immersion is beneficial to athletes.     

The DNA‐Buster: The evaluation of an alternative DNA recovery approach

Touch DNA recovery techniques can have limitations, as their effectiveness depends on the substrate on which the DNA of a person of interest can be found. In this study, an in-house dry-vacuuming device, the DNA-Buster, was compared to traditional methods for its DNA recovery performance from items typically examined in forensic casework. The aim was to evaluate whether this dry-vacuuming approach can recover DNA efficiently, potentially complementing the well-established recovery strategies. For this, the performances of swabbing, taping, wet- (M-Vac®) and dry-vacuuming (DNA-Buster) were investigated quantitatively and qualitatively for touch DNA deposited on carpet, cotton sweater, stone, tile and wood. For the sweater, both vacuuming methods outperformed the other collection tools quantitatively. While the highest DNA amounts for the carpet were yielded by swabbing and taping, dry-vacuuming was equally good in reaching full DNA profiles, whereas less complete profiles were observed for the M-Vac®. For stone and tile, swabbing was optimal, whereas dry-vacuuming clearly underperformed for these substrates. Taping was the best recovery method for wood. Despite applying single donor DNA after thoroughly cleaning the items, undesired DNA mixtures were detected for all recovery techniques and all substrates. The overall research findings show first that the novel dry-vacuuming method is suited for DNA recovery from textiles. Secondly, they indicate that more attention should be paid to the substrate-collection dependency to ensure best practices in recovering genetic material in a precise, confident and targeted manner from the variety of forensic casework material.     

Does partial volume corrected maximum SUV based on count recovery coefficient in 3D-PET/CT correlate with clinical aggressiveness of non-Hodgkin’s lymphoma?

Objective There is much controversy about the correlation between the degree of 2-[¹⁸F]fluoro-2-deoxy-d-glucose (FDG) uptake and clinical aggressiveness of non-Hodgkin’s lymphoma (NHL). In this study, we investigated whether partial volume corrected FDG uptake based on count recovery coefficient in 3D-positron emission tomography (PET)/computed tomography (CT) correlates with the clinical aggressiveness of NHL and improves diagnostic accuracy. Methods Forty-two patients with NHL underwent FDG-PET/CT scans (26 aggressive NHLs and 16 indolent ones). Count recovery curve was obtained using NEMA 2001 body phantom. Scan protocol and reconstructive parameters in the phantom study were the same as those in a clinical scan except for emission time. Relative recovery coefficient (RC) was calculated as RC = A/B (A, maximum pixel count of each hot sphere; B, maximum pixel count of greatest sphere). Partial volume corrected maximum count of standardized uptake value (PVC-SUV) was calculated as PVC-SUV = NC-SUV/RC (NC-SUV: non-corrected maximum count of SUV). Three parameters (NC-SUV, PVC-SUV, and size) between aggressive and indolent NHLs were compared. Results Significant differences were shown in all parameters between aggressive and indolent NHLs. Means ± SD of NC-SUV, PVC-SUV, and size was as following: NC-SUV (15.3 ± 6.9, 8.7 ± 7.0; P < 0.01), PVC-SUV (18.2 ± 8.1, 12.7 ± 7.8; P < 0.05), and size (mm, 32.4 ± 18.3, 21.9 ± 10.3; P < 0.05). When an NC-SUV of 9.5 was the cutoff for aggressive NHL, the receiver-operating-characteristic (ROC) analysis correctly identified 21 of 26 aggressive ones. Sensitivity and specificity were 81% each, and the positive and negative predictive values were 88% and 72%, respectively. When a PVCSUV of 11.2 was the cutoff, the ROC analysis revealed 81% sensitivity, 63% specificity, and positive and negative predictive values of 78% and 67%, respectively. At a cutoff for aggressive NHL of a size of 27 mm, the ROC analysis revealed 50% sensitivity, 81% specificity, and positive and negative predictive values of 81% and 50%, respectively. The comparison of area under the curve in ROC analyses indicated that NC-SUV showed the greatest diagnostic accuracy (NC-SUV 0.84, PVC-SUV 0.72, and size 0.69). Conclusions Diagnostic accuracy of PVC-SUV was inferior to that of NC-SUV. These results suggest that NC-SUV, which contains information on both size and FDG density, provides better differentiation between aggressive and indolent NHLs than PVC-SUV.     

You can’t hide encoded evidence: DNA recovery from different fabrics after washing

Bloodstains are extremely important forensic evidence for DNA profiling. The current study has been planned to quantify DNA recovery from a list of fabrics tested after washing. On each fabric, spots of blood was dotted, and the dried-bloodstained fabrics were hand washed with tap water, soaked in tap water with detergent and then hand washed, for 5 and 10 min. DNA was extracted through Chelex100 from these fabrics and quantified through Real Time PCR using the Quantifiler Human DNA Quantification kit. Results showed that DNA can be recovered from fabrics after they have been washed. The amount of recovered DNA is comparable among these fabrics and did not show significant variations with washing methods. Blends of fabrics showed the highest recovery while non-absorbent fabrics showed least DNA recovery. Knowledge of the different DNA quantities recovered from washed fabrics will be useful in solving criminal cases. The ability to recover DNA from washed fabrics could prove important in forensic casework.     

Does compensation status influence treatment participation and course of recovery from post-traumatic stress disorder?

We reviewed the empirical literature to examine how seeking compensation and/or being awarded compensation for posttraumatic stress disorder-related disability are associated with participation in mental health treatment and course of recovery. The search for relevant literature was conducted using the PubMed, PsycINFO, Medline, and PILOTS databases and yielded seven studies on veterans and five on motor vehicle accident survivors. The literature indicates that veterans who are seeking or have been awarded compensation participate in treatment at similar or higher rates than do their non-compensation-seeking counterparts. Veteran treatment outcome studies produced either null or mixed findings, with no consistent evidence that compensation-seeking predicts worse outcomes. Studies of motor vehicle accident survivors found no association between compensation status and course of recovery. Recommendations to strengthen future research in this area are provided, including using clear and consistent definitions of compensation status that differentiate compensation-seeking status from award status.     

Retrieval of the Günther Tulip and OptEase filters using the recovery cone removal system

The Recovery Cone Removal System was evaluated in vitro to determine its feasibility as an alterative retrieval device for the Günther tulip and OptEase inferior vena cava filters. The cone removal system was then used electively in eight patients to determine feasibility and safety in vivo and subsequently in a single patient when wire-snare removal failed. The Recovery Cone Removal System allowed in vitro and in vivo retrieval in all cases without difficulty or complication. The Recovery Cone Removal System offers an alternative to the wire-snare-based retrieval systems for removal of the Günther tulip and OptEase filters.