Prevention of anterior cruciate ligament injuries in soccer

Proprioceptive training has been shown to reduce the incidence of ankle sprains in different sports. It can also improve rehabilitation after anterior cruciate ligament (ACL) injuries whether treated operatively or nonoperatively. Since ACL injuries lead to long absence from sports and are one of the main causes of permanent sports disability, it is essential to try to prevent them. In a prospective controlled study of 600 soccer players in 40 semiprofessional or amateur teams, we studied the possible preventive effect of a gradually increasing proprioceptive training on four different types of wobble-boards during three soccer seasons. Three hundred players were instructed to train 20 min per day with 5 different phases of increasing difficulty. The first phase consisted of balance training without any balance board; phase 2 of training on a rectangular balance board; phase 3 of training on a round board; phase 4 of training on a combined round and rectangular board; phase 5 of training on a so-called BABS board. A control group of 300 players from other, comparable teams trained normally and received no special balance training. Both groups were observed for three whole soccer seasons, and possible ACL lesions were diagnosed by clinical examination, KT-1000 measurements, magnetic resonance imaging or computed tomography, and arthroscopy. We found an incidence of 1.15 ACL injuries per team per year in the control group and 0.15 injuries per team per year in the proprioceptively trained group (P<0.001). Proprioceptive training can thus significantly reduce the incidence of ACL injuries in soccer players.     

Spontaneous pneumatocele and pneumocephalus associated with mastoid hyperpneumatization

We present a case of spontaneous pneumatocele and pneumocephalus associated with mastoid hyperpneumatization. Collections of air such as these are normally due to injury or surgery, and more rarely, infection or tumor; exceptionally they may be spontaneous. The patient in question complained of a progressively enlarging retroauricular mass which increased in size on Valsalva maneuvers; he had no other symptoms. The etiology, skull X-rays, computed tomography and follow-up after surgery are shown here.     

Cytomegalovirus reactivation in patients with multiple myeloma

The introduction of novel antimyeloma agents has improved the outcome of multiple myeloma (MM) dramatically. However, it has also led to an increasing incidence of Herpesviridae family virus infections, including a high incidence of post‐transplant cytomegalovirus (CMV) reactivation after treatment with novel agents. We herein retrospectively assessed the CMV reactivation in all 120 newly diagnosed patients with MM consecutively seen and treated at our hospital. CMV antigenemia tests were ordered in 58 patients depending on the clinical context, and the incidence of CMV reactivation and proven/suspected CMV disease requiring antiviral therapy was 20% (24 of 120) and 11% (13 of 120) respectively, including those without stem cell transplantation (SCT). The clinical and laboratory characteristics of these patients were compared with those in 34 CMV antigenemia‐negative (CMV‐negative) patients. Patients with extramedullary disease or a low absolute lymphocyte count (ALC) had a higher risk of developing CMV reactivation. In addition, the median duration from the time of MM diagnosis to CMV reactivation was 5.0 months. These results suggest that, regardless of whether or not undergoing SCT, elderly patients with MM receiving novel agents should be monitored for CMV reactivation to allow for the timely diagnosis and treatment, especially for those with extramedullary disease.     

Survol ethnobotanique de quelques plantes utilisées contre la schistosomiase urogénitale à Lubumbashi et environs

For contributing to the assemblage of medicinal plants used against schistosomiasis in Lubumbashi and nearby, a survey was piloted in this area. This ethnobotanic survey involving 43 respondents permitted us to collect information about 61 plants used as anti-schistosomal. These species belong to 55 different genuses distributed among 32 families. The result allows us to know that these anti-schistosomial species are also used in 37 indications, including intestinal worms and malaria. Many parts of these species (bark of roots and stalks, leaves, fruits, seeds, rhizomes) are used in different manners (decoction, infusion, maceration, powder) to make different doses. Different manners of taking prepared medicines are employed: drinking, local application, painting, vapor bath, purgative. Drinking the product remains the most common way of administration.     

Documento de posicionamiento de la AEG,la SEED y la SEAP sobre calidad de la endoscopia digestiva alta para la detección y vigilancia de las lesiones precursoras de cáncer gástrico

This position paper, sponsored by the Asociación Española de Gastroenterología [Spanish Association of Gastroenterology], the Sociedad Española de Endoscopia Digestiva [Spanish Gastrointestinal Endoscopy Society] and the Sociedad Española de Anatomía Patológica [Spanish Anatomical Pathology Society], aims to establish recommendations for performing an high quality upper gastrointestinal endoscopy for the screening of gastric cancer precursor lesions (GCPL) in low-incidence populations, such as the Spanish population. To establish the quality of the evidence and the levels of recommendation, we used the methodology based on the GRADE system (Grading of Recommendations Assessment, Development and Evaluation). We obtained a consensus among experts using a Delphi method. The document evaluates different measures to improve the quality of upper gastrointestinal endoscopy in this setting and makes recommendations on how to evaluate and treat the identified lesions. We recommend that upper gastrointestinal endoscopy for surveillance of GCPL should be performed by endoscopists with adequate training, administering oral premedication and use of sedation. To improve the identification of GCPL, we recommend the use of high definition endoscopes and conventional or digital chromoendoscopy and, for biopsies, NBI should be used to target the most suspicious areas of intestinal metaplasia. Regarding the evaluation of visible lesions, the risk of submucosal invasion should be evaluated with magnifying endoscopes and endoscopic ultrasound should be reserved for those with suspected deep invasion. In lesions amenable to endoscopic resection, submucosal endoscopic dissection is considered the technique of choice.     

Basic fibroblast growth factor: effects on matrix remodeling, receptor expression, and transduction pathway in human periosteal fibroblasts with FGFR2 gene mutation.

The Crouzon syndrome, which is associated with fibroblast growth factor receptor (FGFR2) mutations, is characterized by premature fusion of cranial sutures. We used an in vitro model of cultured periosteal fibroblasts from normal subjects and from Crouzon patients with FGFR2 mutation. We analyzed the matrix turnover rate and the effects of adding FGF2 by evaluating fibronectin synthesis and the activity of some proteolytic enzymes. To assess the role of some FGF signaling molecules involved in FGFR2 regulation, we studied Grb2 tyrosine phosphorylation and the phosphotyrosine proteins associated with Grb2. The iodinate FGF binding assay was performed to quantify FGFR expression. Compared with normal fibroblasts, fibronectin synthesis was decreased in Crouzon fibroblasts, and protease activities in cells and medium were enhanced, suggesting that excess fibronectin catabolism is present. Differences were more marked when FGF2 was added. Very few phosphoproteins were visible in anti-Grb2 immunoprecipitations from Crouzon fibroblasts, which showed a significant increase in the number of high-affinity and low-affinity FGF2 receptors. These results suggest that the abnormal genotype and the Crouzon cellular phenotype are related. To compensate the low levels of tyrosine phosphorylation, Crouzon cells might increase the numbers of FGFR2, thus increasing the cell surface binding sites for FGF2.     

Urinary electrolytes and hypertension in elderly Kazakhs

Background. Deficiency of potassium (K) intake is associated with hypertension, and high dietary K intake may have a preventive effect. The prevalence of hypertension and incidence of stroke are higher in Kazakhs than in other ethnic groups in the People's Republic of China (PRC). The Barkol area in the Xinjiang region in PRC is an area with a high population of Kazakhs. We carried out a study in this region that involved blood pressure monitoring and the examination of serum and urinary electrolytes in the Kazakh and Han populations of the area. Methods. Twenty-four-hour ambulatory blood pressure monitoring and urine collections were performed for each study subject. In each subject, urine was collected simultaneously for 24 h during the blood pressure monitoring. Serum and urinary electrolytes were measured. Results. The prevalence of hypertension was higher in the Kazakh population than in the Han (men, 53%; women, 43% in the Kazakhs; men, 40%; women, 30% in the Han; P < 0.001). Urinary excretion of potassium was lower in Kazakhs than in Han (Kazakh, 18.9 ± 8.7 mmol/day; Han, 36.5 ± 11.3 mmol/day; P < 0.001). Urinary excretion of sodium was lower in Kazakhs than in Han (Kazakhs, 181.4 ± 77.6 mmol/day; Han, 194.1 ± 75.9 mmol/day; P < 0.001). Mean 24-h blood pressure was higher in Kazaks than in Han, and this value correlated positively with the urinary sodium/potassium ratio (r = 0.39; P < 0.001). Conclusions. The prevalence of hypertension was higher in Kazakhs than in Han in the Barkol area in the Xinjiang region. Kazakhs had a low intake of potassium. The sodium/potassium ratio was higher in Kazakhs than in Han. A high Na/K ratio, together with low intake of potassium, may be a factor in Kazakh hypertension. Received: February 8, 2001 / Accepted: July 5, 2001