EFFECTS OF PLANTAR ORTHOSIS ON DYNAMIC PLANTAR PRESSURE MEASUREMENTS IN RUNNERS

During the past years, the use of custom-made plantar orthoses (POs) has been sharply increased among athletes. Concurrently, a great effort has been dedicated by orthotic designers and manufacturers to improve the quality of their products. Only recently, however, systems that allow dynamic plantar pressure measurements within shoes have become available. Data and information provided by these devices can potentially reveal information about both the structure and the function of the foot and may also be used to evaluate the effectiveness of specifically designed POs on plantar foot pressure. By analyzing the pressure distribution in different plantar areas and the centre of force path as well, the aim of this work was to examine the efficacy of specific custom-made POs in athletes wearing their own running shoes. For this purpose, eleven runners were randomly selected among a population of competitive athletes wearing POs. The orthosis had been made by different laboratories using different casting methods. Each subject performed two separate running trials at 12 km/h on a motorized treadmill: one trial wearing his own custom-orthotics in the shoes, and one trial without. In the two experimental conditions, data for at least six strides for each foot was collected. The Fscan inshoe pressure measurement system was used to measure piantar pressure during all trials. The system used an ultra-thin flexible and trimmable sensor with 960sensing locations distributed evenly across the entire plantar surface. These food sensors can be customized to the individual needs and sizing of each subject. According to previous studies, the results of trials with and without orthosis appeared to show a sensitivity to this change in condition. In many ofthe examined parameters, significant changes have been found between the two experimental conditions. However, in three cases, although inserts are thoughtto redistribute and decrease local plantar pressure beneath the foot, Pos significantly increased pressure in particular areas of the metatarsal region. Furthermore, in two subjects, a dramatic pressure increase had been found in the lateral portion of the midfoot suggesting an overcorrection of the medial arch support. In four subjects the effect of POs was not significant in each of the examined parameters. In only three subjects, the centre of force path was found to deviate significantly with POs

IN-SHOE PRESSURE DISTRIBUTION DURING FENCING LUNGE

Fencing is a sport involving sharp backward and forward movements interspersed with several slower gliding steps in which lower limb agility is crucial to good movements and correct body positioning. Thus, while the upper extremity uses the weapon, the legs and feet work to get the fencer in position to it. From a biomechanical point of view, particularly stressed are the feet. Incidence of foot injury in fencing is high, and there have been many cases reported of metatarsal stress fractures, capsulitis, plantar fasciitis, and interdigital neuromas. Although it would be useful to accurately evaluate the high pressure points so that overall lower limb salvage may be improved, to our knowledge, no information about the force and pressure distribution beneath the foot of fencers performing technical actions is available. The purpose of this study was, therefore, to evaluate dynamic in-shoe plantar pressure during fencing lunge. Six right-handed foilists of national level (age: 24k5.5) were the subjects of this study. Each athlete was asked to perform the following technical actions: simple lunge; step forward-lunge; step backward-lunge; jump forward-lunge. Data for at least six trials per condition was collected. The Fscan in-shoe pressure measurement system was used to measure plantar pressure during all trials. The system uses an ultra-thin flexible and trimmable sensor with 960sensing locations distributed evenly across the entire plantar surface. These footsensors can be customized to the individual needs and sizing of each subject. The parameters examined included the centre of pressure path, time-pressure relationships, and the force and pressure in three regions of the foot (rear, mid, and forepart).Despite the apparent intersubject similarities in performing the actions, clear differences were observed in most of the examined parameters. In contrast to the above finding, the variability within-subject was low indicating a high consistency in movement execution, As expected, in all the technical actions, an asymmetrical load was placed on the lower extremities, with the right foot of the athletes particularly subjected to stress in the forward actions. The results showed that the majority of the right foot pressure was localized in the forefoot and especially over the head of the first and second metatarsal and hallux. High pressure levels, as those found here, applied too often and over a long periods of time can cause structural damage to the foot. Shoe and plantar orthosis designers should attempt to reduce such risks designing sager footwear and proper shoe inserts

IGRA test for TB in COVID-19: role of corticosteroids

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Efficacy of fatty acids dietary supplement in polyethylene glycol-induced mouse model of retinal degeneration

Current knowledge of the benefits of nutrition supplements for eye pathologies is based largely on the use of appropriate animal models, together with defined dietary supplementation. Here, C57BL6 mice were subretinally injected with polyethylene glycol (PEG)-400, an established model of retinal degeneration with a dry age-related macular degeneration (AMD)-like phenotype, an eye pathology that lacks treatment. In response to PEG-400, markers of the complement system, angiogenesis,inflammation,gliosis,andmacrophageinfiltrationwereupregulatedinbothretinasand retinal pigment epithelium (RPE)/choroids, whereas dietary supplementation with a mixture based on fatty acids counteracted their upregulation. Major effects include a reduction of inflammation, in both retinas and RPE/choroids, and an inhibition of macrophage infiltration in the choroid, yet not in the retina, suggesting a targeted action through the choroidal vasculature. Histological analysis revealed a thinning of the outer nuclear layer (ONL), together with dysregulation of the epithelium layer in response to PEG-400. In addition, immunohistofluorescence demonstrated Müller cell gliosis and macrophage infiltration into subretinal tissues supporting the molecular findings. Reduced ONL thickness,gliosis,andmacrophageinfiltrationwerecounteractedbythedietsupplement. The present data suggest that fatty acids may represent a useful form of diet supplementation to prevent or limit the progression of dry AMD

Evaluation of trace calls by Xpert MTB/RIF ultra for clinical management in low TB burden settings

Background Clinical interpretation of trace results by Xpert MTB/RIF Ultra assay (Ultra) used as an initial diagnostic test for tuberculosis (TB) may be challenging. The aim of the study was to evaluate the frequency and epidemiology of trace readouts in routine clinical practice in a low TB prevalence setting and to propose guidance on how to manage patients with trace calls considering the data available (clinical, radiological, bacteriological etc.). Materials and methods A retrospective, observational, monocentric study was conducted at IRCCS Azienda Ospedaliero-Universitaria of Bologna, Italy between November 2017—December 2020. Presumptive TB patients with at least one Ultra trace result during diagnostic workup before treatment were included in the study. Patients with ongoing anti-TB treatment at the time of the trace call result or with no clinical data available were excluded from the study. Results Fifty-nine presumptive TB patients with Ultra trace readouts were included in the study (mean age 37.0 years, 61% males). Four patients had a history of TB in the last 2 years. Twenty-five (42.4%) of the 59 samples with trace results were respiratory material. 57/59 (96.6%) patients started anti-TB treatment soon after obtaining trace results, based on clinical, radiological or other information available, while for two patients with a recent history of TB the trace result did not lead to anti-TB treatment. Culture was positive for M. tuberculosis for 31/59 (52.5%) samples with trace calls: 13/25 (52.0%) were respiratory samples and 18/33 (54.5%) non-respiratory samples. The clinical and/or radiological findings of 47/57 (82.4%) patients given anti-TB therapy improved during treatment. Conclusion In low TB incidence settings, Ultra trace calls in presumptive TB patients should be considered as true-positive and treatment should be started promptly, except in cases of recent history of TB, where careful evaluation of other diagnostic criteria is necessary before starting anti-TB treatment. A decisional algorithm for clinical management is proposed

Activation of the Thiazide-Sensitive Sodium-Chloride Cotransporter by Beta3-Adrenoreceptor in the Distal Convoluted Tubule

We previously showed that the beta-3 adrenergic receptor (BAR3) is expressed in most segments of the nephron where its agonism promotes a potent antidiuretic effect. We localized BAR3 in distal convoluted tubule (DCT) cells expressing the thiazide-sensitive sodium-chloride cotransporter (NCC). Aim of this study is to investigate the possible functional role of BAR3 on NCC modulation in DCT cells. Here, we found that, in mice, the knockout of BAR3 was paralleled by a significant attenuation of NCC phosphorylation, paralleled by reduced expression and activation of STE-20/SPS1-related proline-alanine-rich kinase (SPAK) and WNKs the main kinases involved in NCC activation. Conversely, in BAR1/2 knockout mice, we found reduced NCC abundance with no changes in the phosphorylation state of NCC. Moreover, selective BAR3 agonism promotes both SPAK and NCC activation in wild-type mouse kidney slices. In conclusion, our findings suggest a novel role for BAR3 in the regulation of NCC in DCT