46 research outputs found

    Fifth metatarsal stress fracture in elite male football players:An on-field analysis of plantar loading

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    ObjectiveEvaluate plantar loading during ‘on-field’ common football movements in players after fifth metatarsal (MT-5) stress fracture and compare with matched healthy players.MethodsFourteen elite male soccer players participated in the study conducted on a natural grass playing surface using firm ground football boots. Seven players who had suffered a primary stress fracture (MT-5 group) and seven matched healthy players (controls, CON) performed three common football movements while in-shoe plantar loading data were collected.ResultsLarge between-group differences exist for maximal vertical force normalised to bodyweight (Fmax) at the lateral toes (2-5) of the stance leg during a set-piece kick (MT-5: 0.2±0.06 bodyweight (BW), CON: 0.1±0.05 BW, effect size (ES) 1.4) and the curved run where the MT-5 group showed higher Fmaxwith very large effect size at the lateral forefoot of the injured (closest to curve) limb when running a curve to receive a pass (MT-5 injured−CON=0.01 BW, ES 1.5). Small between-group differences were evident during straight-line running. However, between-limb analysis of MT-5 group showed significant unloading of the lateral forefoot region of the involved foot.ConclusionsElite male football players who have returned to play after MT-5 stress fracture display significantly higher maximum plantar force at the lateral forefoot and lateral toes (2-5) compared with healthy matched control players during two football movements (kick and curved run) with the magnitude of these differences being very large. These findings may have important implications for manipulating regional load during rehabilitation or should a player report lateral forefoot prodromal symptoms.</jats:sec

    Plasma miRNAs as biomarkers for endometriosis

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    STUDY QUESTION: Can plasma miRNAs be used for the non-invasive diagnosis of endometriosis in infertile women? SUMMARY ANSWER: miRNA-based diagnostic models for endometriosis failed the test of independent validation. WHAT IS KNOWN ALREADY: Circulating miRNAs have been described to be differentially expressed in patients with endometriosis compared with women without endometriosis, suggesting that they could be used for the non-invasive diagnosis of endometriosis. However, these studies have shown limited consistency or conflicting results, and no miRNA-based diagnostic test has been validated in an independent patient cohort. STUDY DESIGN, SIZE, DURATION: We performed genome-wide miRNA expression profiling by small RNA sequencing to identify a set of plasma miRNAs with discriminative potential between patients with and without endometriosis. Expression of this set of miRNAs was confirmed by RT-qPCR. Diagnostic models were built using multivariate logistic regression with stepwise feature selection. In a final step, the models were tested for validation in an independent patient cohort. PARTICIPANTS/MATERIALS, SETTINGS, METHODS: Plasma of all patients was available in the biobank of the Leuven Endometriosis Centre of Excellence. Biomarker discovery and model development were performed in a discovery cohort of 120 patients (controls= 38, endometriosis= 82), and models were tested for validation in an independent cohort of 90 patients (controls= 30, endometriosis= 60). RNA was extracted with the miRNeasy Plasma Kit. Genome-wide miRNA expression analysis was done by small RNA sequencing using the NEBNext small RNA library prep kit and the NextSeq 500 System. cDNA synthesis and qPCR were performed using the Qiagen miScript technology. MAIN RESULTS AND THE ROLE OF CHANCE: We identified a set of 42 miRNAs with discriminative power between patients with and without endometriosis based on genome-wide miRNA expression profiling. Expression of 41 miRNAs was confirmed by RT-qPCR, and 3 diagnostic models were built. Only the model for minimal-mild endometriosis (Model 2: hsa-miR-125b-5p, hsa-miR-28-5p and hsa-miR-29a-3p) had diagnostic power above chance performance in the independent validation (AUC= 60%) with an acceptable sensitivity (78%) but poor specificity (37%). LIMITATIONS, REASONS FOR CAUTION: The diagnostic models were built and tested for validation in two patient cohorts from a single tertiary endometriosis centre. Further validation tests in large cohorts with patients from multiple endometriosis centres are needed. WIDER IMPLICATION OF THE FINDINGS: Our study supports a possible biological link between certain miRNAs and endometriosis, but the potential of these miRNAs as clinically useful biomarkers is questionable in women with infertility. Large studies in well-described patient cohorts, with rigorous methodology for miRNA expression analysis, sufficient statistical power and an independent validation step, are necessary to answer the question of whether miRNAs can be used as diagnostics markers for endometriosis

    Electrophilic bromination in flow : a safe and sustainable alternative to the use of molecular bromine in batch

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    Bromination reactions are crucial in today’s chemical industry since the versatility of the formed organobromides makes them suitable building blocks for numerous syntheses. However, the use of the toxic and highly reactive molecular bromine (Br2) makes these brominations very challenging and hazardous. We describe here a safe and straightforward protocol for bromination in continuous flow. The hazardous Br2 or KOBr is generated in situ by reacting an oxidant (NaOCl) with HBr or KBr, respectively, which is directly coupled to the bromination reaction and a quench of residual bromine. This protocol was demonstrated by polybrominating both alkenes and aromatic substrates in a wide variety of solvents, with yields ranging from 78% to 99%. The protocol can easily be adapted for the bromination of other substrates in an academic and industrial environment

    Pratique actuelle pour le retour au sport après une entorse de cheville: Sondage de médecins francophones

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    peer reviewedBackground: Recommendations are available for assessment criteria for safe return-to-play (RTP) after a lateral ankle sprain. However, their current use among physicians is unknown. Methods: French-speaking physicians in Belgium, France and Switzerland were asked to complete an online survey and report their clinical assessment of selected RTP criteria. Results:The respondent sample (n = 109) included physicians with and without Sports Medicine education, varied level of experience and proportion of athletes in their practice population. Pain was the most selected criterion for safe RTP (90% of physicians), followed by ability to engage in functional tasks (82%), functional instability (73%), range of motion (61%), proprioception (47%), mechanical instability (39%), strength (38%) and swelling (31%). A low proportion of physicians use quantitative measures to assess these criteria (between 4% and 53%). Conclusions: A large proportion of physicians consider the recommended criteria for RTP decisions. However, physicians do not frequently use quantitative measures.Introduction: Il existe des recommandations concernant les critères d'évaluation pour un retour au sport (RTS) réussi à la suite d'une entorse latérale de la cheville. Cependant, leur utilisation actuelle par les médecins est inconnue. Méthodes: Des médecins francophones de Belgique, de France et de Suisse ont été invités à répondre à une enquête en ligne et à faire part de leur évaluation clinique de certains critères de RTS. Résultats: L'échantillon de répondants (n = 109) comprenait des médecins avec et sans formation en médecine du sport, un niveau d'expérience varié et une proportion d'athlètes différente dans leur patient. La douleur était le critère le plus sélectionné pour une RTS réussi (90 % des médecins), suivi de la capacité à s'engager dans des tâches fonctionnelles (82 %), de l'instabilité fonctionnelle (73 %), de l'amplitude des mouvements (61 %), de la proprioception (47 %), de l'instabilité mécanique (39 %), de la force (38 %) et du gonflement (31 %). Une faible proportion de médecins utilise des mesures quantitatives pour évaluer ces critères (entre 4% et 53%). Conclusions: Une grande proportion de médecins prend en compte les critères recommandés pour autoriser le RTS. Cependant, les médecins n'utilisent pas fréquemment des mesures quantitatives

    Medical services at the FIFA world cup Qatar 2022

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    Objective The Football World Cup is among the biggest sporting events in the world, but data to inform the requirements of medical care for such tournaments are limited. This study describes the athlete and team medical services at the FIFA World Cup Qatar 2022. Methods Three different medical service entities were identified through a needs analysis based on expert advice, team physician interviews and questionnaires prior to the event: 'Team Services' to provide any workforce or equipment needs of the teams, a 'Polyclinic' to manage any acute medical demands, and a 'recovery centre' to improve game readiness throughout the tournament. All services had been set up prior to the tournament and thoroughly tested. Results Of a total of 832 athletes, ∼1300 team delegation and ∼130 match officials, 167 individuals including 129 (77%) athletes and 38 (23%) non-athletes were assessed in the polyclinic. For the 129 athletes (median 4 players per team), medical imaging was the most requested service, which peaked during the group phase of the tournament. Most requests were received during normal working hours despite many games finishing late at night. 30 of the 32 participating teams solicited medical services for their players at least once. Three teams made use of the recovery facilities, and 17 teams requested additional medical equipment or clinical assistance. Conclusion Central imaging services was the most used medical resource at the FIFA World Cup Qatar 2022, and over half of teams required additional medical equipment or personnel. These data may inform planning of medical services for similar events in the future

    Return to sport soccer after anterior cruciate ligament reconstruction: ISAKOS consensus

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    Many factors can affect the return to pivoting sports, after an Anterior Cruciate Ligament Reconstruction. Prehabilitation, rehabilitation, surgical and psychological aspects&nbsp;play&nbsp;an essential role in the decision to return to sports. The purpose of this study is to reach an international consensus about the best conditions for returning to sports in soccer-one of the most demanding level I pivoting sports after anterior cruciate ligament (ACL) reconstruction

    Pulsed electromagnetic fields after arthroscopic treatment for osteochondral defects of the talus: double-blind randomized controlled multicenter trial

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    Background. Osteochondral talar defects usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracturing. Although this is mostly successful, early sport resumption is difficult to achieve, and it can take up to one year to obtain clinical improvement. Pulsed electromagnetic fields (PEMFs) may be effective for talar defects after arthroscopic treatment by promoting tissue healing, suppressing inflammation, and relieving pain. We hypothesize that PEMF-treatment compared to sham-treatment after arthroscopy will lead to earlier resumption of sports, and aim at 25% increase in patients that resume sports. Methods/Design. A prospective, double-blind, randomized, placebo-controlled trial (RCT) will be conducted in five centers throughout the Netherlands and Belgium. 68 patients will be randomized to either active PEMF-treatment or sham-treatment for 60 days, four hours daily. They will be followed-up for one year. The combined primary outcome measures are (a) the percentage of patients that resume and maintain sports, and (b) the time to resumption of sports, defined by the Ankle Activity Score. Secondary outcome measures include resumption of work, subjective and objective scoring systems (American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale, Foot Ankle Outcome Score, Numeric Rating Scales of pain and satisfaction, EuroQol-5D), and computed tomography. Time to resumption of sports will be analyzed using Kaplan-Meier curves and log-rank tests. Discussion. This trial will provide level-1 evidence on the effectiveness of PEMFs in the management of osteochondral ankle lesions after arthroscopy. Trial registration. Netherlands Trial Register (NTR1636)

    From “Low” to “High” Athletic Ankle sprains: A comprehensive review

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    Generally, most Grade I-III acute lateral ligament injuries can be treated conservatively. Yet despite a propensity of research regarding ankle sprains some controversy still exists as regarding the optimum treatment of grade III injuries in athletes. Physical exercise therapy combined with progressive weight bearing is a fundamental component of the functional treatment of acute lateral ligamentous injury. Generally, early active range of motion exercises is followed by strengthening exercises, proprioception, and functional exercises. Most re-injuries are probably related to inadequate neuromuscular training during the rehabilitation phase. Treatment of grade III lateral ligament injury especially in athletes remains controversial. Reviews comparing surgery vs conservative treatment have failed to demonstrate a clearly superior method. Thus, functional treatment might be preferred over surgery in most cases. However, surgical treatment may be beneficial in certain professional athletes on an individual basis. The advantage of surgical repair is significantly less objective instability when compared to non-operative treatment and this factor has been found to be predictive for future ankle sprains. Recent arthroscopic surgical techniques have been described as part of the therapeutical options in the treatment of mainly chronic ankle instability. Also, new data on the role of the calcaneo-fibular ligament in this regard highlights key points that need to be addressed before deciding for optimal treatment

    X-Linked Sideroblastic Anemia and Ataxia – RETIRED CHAPTER, FOR HISTORICAL REFERENCE ONLY

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    NOTE: THIS PUBLICATION HAS BEEN RETIRED. THIS ARCHIVAL VERSION IS FOR HISTORICAL REFERENCE ONLY, AND THE INFORMATION MAY BE OUT OF DATE. CLINICAL CHARACTERISTICS: X-linked sideroblastic anemia and ataxia (XLSA/A) is characterized by moderate anemia and early-onset spinocerebellar syndrome in males, manifest primarily as delayed walking, ataxia evident in early childhood, dysmetria, and dysdiadochokinesis. When present the intention tremor is mild and the dysarthria is mild to moderately severe. The ataxia has been described to be either non-progressive or slowly progressive. Upper motor neuron (UMN) signs in the legs, manifest by brisk deep tendon reflexes, unsustained ankle clonus, and equivocal or extensor plantar responses, are present in some males. Need for crutches or a wheelchair has been reported. Strabismus is seen in some males. Nystagmus and hypometric saccades may occur. Mild learning disability and depression are seen. The moderate hypochromic and microcytic anemia does not cause symptoms. Carrier (heterozygous) females have a normal neurologic examination and may show mild hematologic abnormalities. DIAGNOSIS/TESTING: The diagnosis of XLSA/A is suspected in males with characteristic neurologic findings and the presence of moderate hypochromic and microcytic anemia, elevated whole blood total erythrocyte protoporphyrin (TEP) and zinc erythrocyte protoporphyrin (ZnEP), and ring sideroblasts on bone marrow examination. Pappenheimer bodies are seen in peripheral blood smear. The diagnosis is confirmed in a male by identification of a hemizygous pathogenic variant in ABCB7. Females have a normal neurologic examination and may have a dimorphic blood smear with both hypochromic microcytic red blood cells and normal red blood cells; they may have ring sideroblasts on bone marrow examination. MANAGEMENT: Treatment of manifestations: Males with XLSA/A benefit from early physical therapy to facilitate acquisition of gross motor skills. Adaptive devices such as ankle fixation orthoses and walkers may be needed. Weighted eating utensils may help promote independent skills in childhood. Speech therapy may improve intelligibility problems from dysarthria. Difficulty with handwriting may be managed with computers for word processing. GENETIC COUNSELING: XLSA/A is inherited in an X-linked manner. Heterozygous females have a 50% chance of transmitting the pathogenic variant in each pregnancy. Males who inherit the pathogenic variant will be affected; females who inherit the pathogenic variant will be carriers and will usually not be affected. Males with XLSA/A will pass the pathogenic variant to all of their daughters and none of their sons. Carrier testing of at-risk female relatives and prenatal testing for a pregnancy at increased risk are possible if the ABCB7 pathogenic variant in the family is known.status: publishe
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