A prospective video-based analysis of injury situations in elite male football: football incident analysis

BACKGROUND: The mechanisms for football injuries are largely unknown. AIM: To describe the characteristics of injury situations in elite male football using a video-based method called football incident analysis. STUDY DESIGN: Prospective cohort study. METHODS: During the 1999 season, videotapes from 52 matches in the Icelandic elite football league were reviewed. Incidents (N = 95) were recorded when the match was interrupted by the referee because of a suspected injury. Team physical therapists recorded injuries prospectively (N = 28 time-loss injuries). RESULTS: Duels caused 84 of the incidents, mostly tackling duels (n = 54). The exposed player's attention appeared to be focused away from the opponent in 93% of the cases. The 3 main mechanisms observed were (1) breakdown attacks, tackling from the side or the front, attention focused on the ball (24%); (2) defensive tackling duels, attention focused on the ball or low ball control (20%); and (3) heading duels, attention focused on the ball in the air (13%). CONCLUSION: Most incidents and injuries occurred during breakdown attacks and when a player was involved in tackling duels. Player attention appeared to be focused mainly on the ball, not on the opponent challenging him to gain ball possession.     

The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial

BACKGROUND: Ankle sprains are the most common injuries in a variety of sports. HYPOTHESIS: A proprioceptive balance board program is effective for prevention of ankle sprains in volleyball players. STUDY DESIGN: Prospective controlled study. METHODS: There were 116 male and female volleyball teams followed prospectively during the 2001-2002 season. Teams were randomized by 4 geographical regions to an intervention group (66 teams, 641 players) and control group (50 teams, 486 players). Intervention teams followed a prescribed balance board training program; control teams followed their normal training routine. The coaches recorded exposure on a weekly basis for each player. Injuries were registered by the players within 1 week after onset. RESULTS: Significantly fewer ankle sprains in the intervention group were found compared to the control group (risk difference = 0.4/1000 playing hours; 95% confidence interval, 0.1-0.7). A significant reduction in ankle sprain risk was found only for players with a history of ankle sprains. The incidence of overuse knee injuries for players with history of knee injury was increased in the intervention group. History of knee injury may be a contraindication for proprioceptive balance board training. CONCLUSIONS: Use of proprioceptive balance board program is effective for prevention of ankle sprain recurrences.     

Immuno-endocrine and metabolic responses to long distance ski racing in world-class male and female cross-country skiers

The purpose of this study was to characterize the extent of immune, endocrine, substrate and metabolic changes during a long-distance cross-country ski race in extremely well-trained athletes and evaluate if the blood perturbations would indicate signs of health risk. Ten male (M) and six female (F) national team skiers were investigated as they followed their usual routines of race preparations. Blood samples were drawn before and immediately after a World Cup 50-km M and 30-km F ski race with a mean finish time of 142 and 104 min, respectively. Hemoglobin, electrolytes, and C-reactive protein remained unchanged for both M and F. Serum testosterone remained unchanged in M, but doubled in F. Significant increases were observed in concentrations of granulocytes (F: 5 x, M: 5 x), natural killer cells (F: 2 x, M: 1.5 x), adrenaline (F: 12 x, M:10 x), noradrenaline (F: 7 x, M:5 x), growth hormone (F: 30 x, M: 2 x), cortisol (F: 1.5 x, M:2 x), glucose (F: 2 x, M:1.5 x), creatine kinase (F: 2 x, M:2 x), uric acid (F: 1.5 x, M: 1.5 x) and non-organic phosphate (F:2 x, M:2 x), while insulin concentration decreased (F: 0.5x, M: 0.8 x). Free fatty acid (FFA) concentration increased (F:2 x, M: 3 x). In conclusion, we observed substantial changes in several immuno-endocrine, substrate and metabolic measurements after long distance cross-country ski racing and suggest that some of these marked changes may reflect the large amount of muscle mass involved during skiing.     

Borrelia burgdorferi persists in the brain in chronic lyme neuroborreliosis and may be associated with Alzheimer disease

The cause, or causes, of the vast majority of Alzheimer's disease cases are unknown. A number of contributing factors have been postulated, including infection. It has long been known that the spirochete Treponema pallidum, which is the infective agent for syphilis, can in its late stages cause dementia, chronic inflammation, cortical atrophy and amyloid deposition. Spirochetes of unidentified types and strains have previously been observed in the blood, CSF and brain of 14 AD patients tested and absent in 13 controls. In three of these AD cases spirochetes were grown in a medium selective for Borrelia burgdorferi. In the present study, the phylogenetic analysis of these spirochetes was made. Positive identification of the agent as Borrelia burgdorferi sensu stricto was based on genetic and molecular analyses. Borrelia antigens and genes were co-localized with beta-amyloid deposits in these AD cases. The data indicate that Borrelia burgdorferi may persist in the brain and be associated with amyloid plaques in AD. They suggest that these spirochetes, perhaps in an analogous fashion to Treponema pallidum, may contribute to dementia, cortical atrophy and amyloid deposition. Further in vitro and in vivo studies may bring more insight into the potential role of spirochetes in AD.     

Chronically implanted epidural electrodes in Göttinger minipigs allow function tests of epiretinal implants

Background To test the function of implantable devices for electrical stimulation of the retina, long-term registration tests of cortical-evoked potentials are required. Skin electrodes are not appropriate to provide representative recordings, due to the voluminous pneumatic frontal sinus of minipigs. Therefore, epidural electrodes were permanently implanted in minipigs and tested with visual and electrical retinal stimulation. The present study describes long-term recordings of electrically evoked cortical potentials in minipigs.Methods Three-channel silver-silver chloride electrodes were fixed on the epidura dorsal to the primary visual cortex of one hemisphere in Göttinger minipigs. Repeated light stimulation was performed and platinum-polyimide film multielectrode arrays were implanted on the retina for electrical stimulation and were later removed. Cortical potentials were recorded after stimulation with short biphasic charge-balanced currents.Results For up to 18 months, the implanted epidural electrodes allowed recording of visual cortex potentials evoked by visual or electrical retina stimulation. Small changes of response amplitudes in subsequent experiments indicated a stable location and recording properties of the cortex electrodes. Visual stimulation often yielded stronger responses for the contralateral eye. Superthreshold electrical retina stimulation evoked cortical responses with less delay compared to visual stimulation. We found threshold currents of 50 µA for charge-balanced biphasic trains of current impulses. Postoperative examination showed an attached and unchanged retina.Conclusions The minipig model is appropriate for the implantation of epiretinal stimulation electrodes and for the long-term tests of retinal implants by recording of cortical responses with chronically implanted epidural electrodes.This study was presented in part at the 100th annual meeting of the Deutsche Ophthalmologische Gesellschaft, 2002, Berlin.     

Evaluation of brominated diphenyl ether-99 toxicity with Raphidocelis subcapitata and Daphnia magna

Brominated flame retardants belong to a new class of environmental contaminants. To obtain new information regarding the effects of 2,2',4,4',5-brominated diphenyl ether (BDE-99), one of the most frequently reported congeners in freshwater biota, the inhibition of algal growth of Raphidocelis subcapitara (also known as Selenastrum capricornutum) and acute toxicity to Daphnia magna were examined. The experimental design also involved a comparison with the polychlorinated biphenyl (PCB) Aroclor 1254. The uptake of BDE-99 by R. subcapitata and the transfer to D. magna (i.e., a higher level of aquatic biota in the food chain) was also assessed to verify the bioaccumulation phenomenon. After 24 h, BDE-99 appeared to be less toxic than Aroclor 1254 to D. magna, but the two compounds showed a similar toxicity at 48 h. In contrast to Aroclor 1254, BDE-99 was nontoxic to R. subcapitata at up to 100 microM, the highest tested concentration. However, the dose-dependent decrease in survival and impairment of reproduction of D. magna fed with BDE-99-treated algal culture demonstrate uptake by R. subcapitata. Because of the high persistence and bioconcentration, polybrominated diphenyl ethers as well as PCBs might be of environmental concern for years.     

The International Neuroblastoma Pathology Classification (the Shimada system).

BACKGROUND: The International Neuroblastoma Pathology Committee, which is comprised of six member pathologists, was convened with the objective of proposing a prognostically significant and biologically relevant classification based on morphologic features of neuroblastic tumors (NTs) (i.e., neuroblastoma, ganglioneuroblastoma, and ganglioneuroma). METHODS: A total of 227 cases were reviewed. Consensus diagnoses from morphologic features (criteria described separately) based on five of six or six of six agreements by the reviewer pathologists were used for prognostic analysis. Prognostic effects of morphology, both individual and in combination, taken in conjunction with age (Shimada classification, histologic grade, and risk group), were analyzed. RESULTS: Approximately 99% of cases (224 of 227) had consensus diagnoses for categorization: neuroblastoma (Schwannian stroma-poor), 190 cases; ganglioneuroblastoma, intermixed (Schwannian stroma-rich), 5 cases; ganglioneuroma (Schwannian stroma-dominant) maturing, 1 case; ganglioneuroblastoma, nodular (composite Schwannian stroma-rich/stroma-dominant and stroma-poor), 19 cases; and NT-unclassifiable, 9 cases. For the NTs, subtype (93% consensus: undifferentiated, 6 cases; poorly differentiated, 155 cases; and differentiated, 15 cases), mitosis-karyorrhexis index (90% consensus: low, 94 cases; intermediate, 40 cases; and high, 37 cases), mitotic rate (75% consensus: low, 89 cases; high, 50 cases; and not determined, 4 cases), and calcification (100% consensus: yes, 110 cases and no, 80 cases) were recorded. Statistical analysis demonstrated that the Shimada classification system (90% consensus; 3-year event free survival: 85% for the group with favorable histology and 41% for the group with unfavorable histology; P = 0.31 x 10(-9)) had a significantly stronger prognostic effect than individual features and other combinations. CONCLUSIONS: The International Neuroblastoma Pathology Classification, a system based on a framework of the Shimada classification with minor modifications, is proposed for international use in assessing NTs.     

Ventricular shape biomarkers for Alzheimer's disease in clinical MR images

The aim of this work was to identify ventricular shape-based biomarkers in MR images to discriminate between patients with Alzheimer's disease (AD) and healthy elderly. Clinical MR images were collected for 58 patients and 28 age-matched healthy controls. After normalizing all the images the ventricular cerebrospinal fluid was semiautomatically extracted for each subject and an innovative technique for fully automatic shape modeling was applied to generate comparable meshes of all ventricles. The search for potential biomarkers was carried out with repeated permutation tests: results highlighted well-defined areas of the ventricular surface being discriminating features for AD: the left inferior medial temporal horn, the right medial temporal horn (superior and inferior), and the areas close to the left anterior part of the corpus callosum and the head of the right caudate nucleus. The biomarkers were then used as features to build an intelligent machine for AD detection: a Support Vector Machine was trained on AD and healthy subjects and subsequently tested with leave-1-out experiments and validation tests on previously unseen cases. The results showed a sensitivity of 76% for AD, with an overall accuracy of 84%, proving that suitable biomarkers for AD can be detected in clinical MR images.     

La protonthérapie en radiothérapie pédiatrique

Pediatric tumors still represent a formidable challenge despite the considerable therapeutical advances that have been reported for the past 30 years. This is largely related with the untowards side-effects of local therapy that are still acknowledged as the “price for cure”. In this setting, Proton therapy a sophisticated radiotherapeutical modality seems to represent a real breakthrough due to its unique ability to spare close and distant normal organs compared with modern photons techniques. We summarize in this paper current clinical and dosimetrical evidences including an update of the Orsay series on 108 children.