Age-related decrease in performance of male masters athletes in sprint,sprint–endurance,and endurance events

Sport Sciences for Health - To investigate the slope of age-related performance decrease of male master athletes competing the 100 m, 400 m, and 10,000 m running events....     

Imaging Intussusception in Children’s Hospitals in the United States: Trends,Outcomes, and Costs

ObjectiveTo describe imaging utilization, outcomes, and cost in the management of intussusception between 2010 and 2017 in pediatric hospitals in the United States.MethodsAll children (under 18 years of age) with a primary diagnosis of intussusception in a large administrative database were identified. Demographics, imaging, and costs were described.ResultsThere were 17,032 children (63.3% boys, 36.7% girls, mean age: 3.2 years) that had 20,655 hospital encounters for intussusception, and 88.5% were <5 years of age. The average length of stay was 2.8 days (median: 1 day), with rates of intensive care unit admission, 3.7%; 90-day readmission, 10.5%; and mortality, 0.2%. The surgical rate was 19.6%, and 93.5% (n = 19,301) of patients underwent imaging: 87.2% (n = 16,822) received ultrasound, 69.1% (n = 13,329) had fluoroscopy, 59% (n = 11,380) had abdominal radiographs, and 8.8% (n = 1,696) had CT. The reduction success rate for fluoroscopy was 77.9%. Surgery was more common in rural patients (26.8% versus 18.7% in urban patients, P < .001). Median encounter costs were $2,675 (interquartile range: $1,637-$5,465). Imaging cost represented a quarter (median $680, interquartile range: $372-1,069) of all costs. Higher costs (median) were associated with longer length of stay (<3 days: $858 versus >3 days: $5,342; use of CT ($4,168 versus $943 in patients without a CT), and surgery ($4,434 versus $860 without surgery).ConclusionThe management of intussusception is mainly nonsurgical, most frequently involving imaging with ultrasound and fluoroscopy, and resulting in excellent outcomes in the great majority of the cases. Despite playing a central role for diagnosis and management, imaging only represents a fraction of total cost.     

Muscle reflexes in motion: how, what, and why?

Methods have been developed to study excitatory and inhibitory reflexes during human movements because dramatic task-dependent changes occur between different voluntary activities, and phase-dependent changes occur within cyclic movements. Interestingly, segmental reflexes are relatively unimportant for standing balance, although reflex responses are strong, yet they contribute substantially to force in several muscles during walking, when some reflex responses are weaker.     

Comparing amyloid-β deposition,neuroinflammation, glucose metabolism,and mitochondrial complex I activity in brain: a PET study in aged monkeys

Purpose

The aim of the present study was to compare amyloid-β (Aβ) deposition, translocator protein (TSPO) activity, regional cerebral metabolic rate of glucose (rCMRglc), and mitochondrial complex I (MC-I) activity in the brain of aged monkeys.

Methods

PET scans with ¹¹C-PIB (Aβ), ¹⁸F-BCPP-EF (MC-I), ¹¹C-DPA-713 (TSPO), and ¹⁸F-FDG (rCMRglc) were performed in aged monkeys (Macaca mulatta) in the conscious state and under isoflurane anaesthesia. ¹¹C-PIB binding to Aβ and ¹¹C-DPA-713 binding to TSPO were evaluated in terms of standard uptake values (SUV). The total volume of distribution (V _T) of ¹⁸F-BCPP-EF and rCMRglc with ¹⁸F-FDG were calculated using arterial blood sampling.

Results

Isoflurane did not affect MC-I activity measured in terms of ¹⁸F-BCPP-EF uptake in living brain. There was a significant negative correlation between ¹⁸F-BCPP-EF binding (V _T) and ¹¹C-PIB uptake (SUVR), and there was a significant positive correlation between ¹¹C-DPA-713 uptake (SUV) and ¹¹C-PIB uptake. In contrast, there was no significant correlation between rCMRglc ratio and ¹¹C-PIB uptake.

Conclusion

¹⁸F-BCPP-EF could be a potential PET probe for quantitative imaging of impaired MC-I activity that is correlated with Aβ deposition in the living brain.     

Stents in der A. femoralis superficialis – Indikationen, Technik, Ergebnisse

Aggressive risk factor modification, change of eating habits, exercise programs, and forceful antiplatelet therapy are the most important tools for the treatment of PAOD in symptomatic patients suffering from intermittent claudication. There are however no guidelines for revascularization at this stage. Endovascular treatment has been increasingly utilized over the last decade and increasingly displaced vascular surgery. Amongst numerous endovascular techniques beside PTA, stents meanwhile play the most important role due to constant technical progress. Results regarding the rate of restenosis or patency rates still remain worse compared to other vascular beds. This paper gives a review over recent results, currently available stent techniques, and possible indications for the endovascular therapy of an artery, which has turned out to be the biggest ordeal for material and construction of stents.     

Biomaterialien in der Sportmedizin – Anwendungen bei Knorpel-, Knochen-, und Bandverletzungen

Biomaterials in sports medicine have shown advancements during recent years which contributed enormously to the improvement of established and the development of new advanced therapies for cartilage, bone, and ligament injuries. Achievements in the fields of cellular and molecular biology paved the way for the development of medical products of the new generation. Special emphasis is put on imitating composition and physical properties of the extracellular matrix of the target tissue which has an enormous influence on the cellular processes during tissue healing. This review article attempts to provide an overview of current therapeutic options emerging in sports medicine that employ new biomaterials.     

Prophylaxis of contrast material-induced nephropathy in patients in intensive care: acetylcysteine, theophylline, or both? A randomized study

PURPOSE: To prospectively compare the protective effect of acetylcysteine, theophylline, and both agents combined in patients who are admitted to the intensive care unit with at least one risk factor for contrast material-induced nephropathy and who receive at least 100 mL of iodinated contrast medium. MATERIALS AND METHODS: Institutional ethics review board approval and informed consent were obtained. A total of 91 patients (mean age, 58.5 years+/-14.8 [standard deviation]; 31 women, 60 men; 150 examinations) were admitted to the intensive care unit with at least one risk factor for contrast-induced nephropathy and received either (a) 200 mg theophylline 30 minutes before contrast medium administration (group T), (b) 600 mg acetylcysteine twice daily on the day of and (if possible) the day before the examination (group A), or (c) both agents combined (group AT). The primary endpoint for this study was the incidence of contrast-induced nephropathy (chi2 test). RESULTS: Groups T, A, and AT were comparable with regard to baseline creatinine levels and the amount of contrast medium administered. The incidence of contrast-induced nephropathy in groups T, A, and AT was 2%, 12%, and 4%, respectively, and was significantly lower in group T than in group A (P=.047). There was no significant difference in the incidence of contrast-induced nephropathy between groups A and AT (P=.148) or between groups T and AT (P=.53). For group A, serum creatinine did not change after 12, 24, or 48 hours compared with baseline. Creatinine levels in group T decreased 12 hours (1.19 mg/dL+/-0.58; P=.008) and 48 hours (1.16 mg/dL+/-0.55; P=.034) after contrast material injection compared with baseline (1.25 mg/dL+/-0.61). In group AT, creatinine significantly decreased 24 hours (1.21 mg/dL+/-0.74; P=.003) and 48 hours (1.17 mg/dL+/-0.69; P<.001) after contrast material injection compared with baseline (1.28 mg/dL+/-0.74). Group A had significantly higher maximal increases in creatinine than groups T and AT (P=.014). CONCLUSION: For prophylaxis of contrast-induced nephropathy in patients who are admitted to the intensive care unit and who receive 100 mL or more of contrast medium, theophylline is superior to acetylcysteine.     

Clinical prediction rules in trauma imaging: who, how, and why?

Clinical prediction rules are multifactorial tools used to aid in clinical decision making. In radiology, clinical prediction rules are an important method for determining who should undergo imaging and, in combination with cost-effectiveness analysis, how imaging should be performed. To be useful, clinical prediction rules should be clinically important, have face validity, be reproducible and easy to use, be clinically relevant, and suggest a course of action. To insure generalizability, clinical prediction rules should also be validated in subjects distinct from those used to develop the rule. In this review, several examples from trauma imaging are used to demonstrate the development, validation, and use of clinical prediction rules.     

IGF-I,IGFBP-2, and -3: do they have a role in detecting rhGH abuse in trained men?

PURPOSE: Although the illegal use of recombinant human growth hormone (rhGH) to enhance performance is increasing among athletes, no official test for its detection has yet been implemented. The aim of this work was to study how prolonged rhGH administration in trained subjects influences the insulin-like growth factor (IGF) system, in order to evaluate new methods in antidoping tests. METHODS: Morning serum growth hormone (GH), IGF-I, IGF binding protein (BP)-2, IGFBP-3, IGF-I/IGFBP-2, and IGFBP-3/IGFBP-2 ratios were evaluated before, during (8th and 15th days), and at the end and after cessation (+3, +6, +9, +12, and +15 d) of a 3-wk treatment with different doses of rhGH (0.09 IU.kg BW(-1).d(-1) for 6 or 3 d a week, i.e., the A and B trials, respectively) in seven well-trained subjects not involved in competitive sports. The blood collections pre- and during treatment were performed immediately before the daily rhGH dose. RESULTS: In both trials, significant increases of IGF-I (higher in the A trial) and IGFBP-3 serum concentrations during rhGH administration were observed. Serum IGFBP-3 remained significantly increased in the A trial 3 d after treatment cessation. In the A trial only, two subjects had IFG-I concentrations exceeding the upper limit of the reference range. No modifications of serum GH, IGFBP-2 and IGF-I/IGFBP-2, and IGFBP-3/IGFBP-2 ratios were observed. The z-score evaluation for IGFBP-3 detected GH exposure in 100% of subjects only at end treatment in A trial. CONCLUSION: Although IGF-I and IGFBP-3 seem potentially the most specific markers of rhGH assumption, our data suggest that for antidoping purposes a single evaluation of their absolute serum concentration is not a sufficiently secure method to detect rhGH abuse in all subjects, especially in the case of low rhGH doses.     

MALDI-TOF mass spectrometric analysis of α-amanitin, β-amanitin, and phalloidin in urine

A rapid and sensitive method was developed for analysis of α-amanitin, β-amanitin, and phalloidin by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). In this method, α-cyano-4-hydroxy cinnamic acid was used as the matrix to assist the ionization of toxins. The identification of α-amanitin, β-amanitin, and phalloidin was achieved through their sodium adducts [M+Na]⁺ at m/z = 941, 942, and 811, and quantification of the three toxins was also achieved using microcystin RR at m/z = 1038 as internal standard. For all toxins, the limit of detection was 5 ng/ml, and all calibration curves were linear in the range of 10–500 ng/ml using 0.4 ml of urine. The sensitivity for identification was increased about tenfold when the tandem MS (MS–MS) mode was used for detection. Because these quantifications could be achieved in the toxin concentration range of 4–200 ng, the present MALDI-TOF MS method can serve as the most sensitive method so far reported for the analysis of these mushroom toxins. To our knowledge, this study is the first trial to analyze amanitins and phalloidin by MALDI-TOF MS (-MS).