Increase in passive muscle tension of the quadriceps muscle heads in jumping athletes with patellar tendinopathy

202303 bckwAccepted ManuscriptSelf-fundedPublishe

Isometric strength of the hip abductors and external rotators in athletes with and without patellar tendinopathy

202303 bckwAccepted ManuscriptSelf-fundedPublishe

Alterations in mechanical properties of the patellar tendon is associated with pain in athletes with patellar tendinopathy

202303 bckwAccepted ManuscriptSelf-fundedPublishe

Classification of foot drop gait characteristic due to lumbar radiculopathy using machine learning algorithms

© 2019 Elsevier B.V. Background: Recently, the study of walking gait has received significant attention due to the importance of identifying disorders relating to gait patterns. Characterisation and classification of different common gait disorders such as foot drop in an effective and accurate manner can lead to improved diagnosis, prognosis assessment, and treatment. However, currently visual inspection is the main clinical method to evaluate gait disorders, which is reliant on the subjectivity of the observer, leading to inaccuracies. Research question: This study examines if it is feasible to use commercial off-the-shelf Inertial measurement unit sensors and supervised learning methods to distinguish foot drop gait disorder from the normal walking gait pattern. Method: The gait data collected from 56 adults diagnosed with foot drop due to L5 lumbar radiculopathy (with MRI verified compressive pathology), and 30 adults with normal gait during multiple walking trials on a flat surface. Machine learning algorithms were applied to the inertial sensor data to investigate the feasibility of classifying foot drop disorder. Results: The best three performing results were 88.45%, 86.87% and 86.08% accuracy derived from the Random Forest, SVM, and Naive Bayes classifiers respectively. After applying the wrapper feature selection technique, the top performance was from the Random Forest classifier with an overall accuracy of 93.18%. Significance: It is demonstrated that the combination of inertial sensors and machine learning algorithms, provides a promising and feasible solution to differentiating L5 radiculopathy related foot drop from normal walking gait patterns. The implication of this finding is to provide an objective method to help clinical decision making

Changes on tendon stiffness and clinical outcomes in athletes are associated with patellar tendinopathy after eccentric exercise

202303 bckwAccepted ManuscriptSelf-fundedPublishe

Motor ability and weight status are determinants of extra-curricular activity participation in children with developmental coordination disorder

Meeting abstractsBACKGROUND AND PURPOSE: According to the ICF model, participation in everyday activities is integral to child development. This study aimed to: (1) compare the motor performance and pattern of extra-curricular activity participation between children with and without Developmental Coordination Disorder (DCD), and (2) identify the role of motor ability and weight status in activity participation diversity amongst children with DCD. METHODS: 81 children with DCD (63 males, 18 females; mean age: 8.07 ± 1.5 years) and 67 typically developing children (48 males, 19 females; mean age: 8.25 ± 1.6 years) joined the study. Participation patterns (diversity, intensity, companionship, location and enjoyment) were evaluated using Children Assessment of Participation and Enjoyment. Motor ability was evaluated using Movement Assessment Battery for Children-2 (Movement ABC-2). Other factors that may influence participation such as body weight were also measured. Analysis of variance was used to compare the outcome variables between the two groups. Multiple regression analysis was performed to identify the significant determinants of activity participation. RESULTS: Children with DCD participated in fewer activities (p<0.001) and less frequently (p<0.001). No significant difference was found in companionship (p=0.529), location (p=0.773) and enjoyment (p=0.754) between the two groups. The DCD group had significantly poorer motor ability as measured by MABC-2 (p<0.001). A greater proportion of children in the DCD group was in the overweight/obese category than their typically developing peers (p=0.001). Multiple regression analysis revealed that motor ability alone explained 7.6% of the variance in participation diversity (F3,77=2.181, p=0.014) while weight category accounted for another 5.7% of the variance in participation diversity (F3,77=1.640, p=0.033) in children with DCD, after accounting for the effects of age and gender. CONCLUSION: Extra-curricular activity participation in children with DCD is less diverse and intense than typically developing children. Motor impairment and weight status can partly explain this deficit. Interventions aim at improving participation for children with DCD should target on motor proficiency and weight control. Copyright © 2011 Published by Elsevier B.V

Absceso recidivante por Nocardia asteroides en una paciente portadora de poliglobulia primaria Recurrent brain abscess caused by Nocardia asteroides in a patient with primary polycythaemia

La nocardiosis del sistema nervioso central (SNC) es una enfermedad poco común, cuya frecuencia ha aumentado con el crecimiento de los tratamientos inmunosupresores. El hombre se infecta por inhalación, inoculación traumática cutánea directa y tras una infección periodontal ingiriendo alimentos contaminados. La localización pulmonar es la más frecuente, siendo la fuente inicial de diseminación hemática, con predominio en piel, tejido celular subcutáneo y SNC. Es conocida la predilección de Nocardia por el SNC. Estos abscesos, asociados a altos índices de mortalidad, especialmente en pacientes inmunocomprometidos, siguen constituyendo un desafío diagnóstico y terapéutico, permaneciendo no aclarado su manejo terapéutico óptimo. A pesar de la controversia en cuanto al manejo quirúrgico de estas lesiones, el diagnóstico precoz, por aspiración esterotáxica, y la iniciación de una terapia antimicrobiana son esenciales para la buena evolución del paciente. Se presenta una paciente portadora de una poliglobulia primaria, con absceso cerebral recidivante por Nocardia asteroides de posible origen dentario.<br>Nocardiosis of the central nervous system (CNS) is an uncommon disease, but its frequency has increased due to the high number of immunosuppressive treatments. People become infected by inhalation, direct traumatic cutaneous inoculation and eating contaminated food after a periodontal abscess. Lung localization is the most frequent one, being the origin of haematic dissemination, with a high incidence in skin, subcutaneous tissue and the CNS. The preference of Nocardia for the CNS is well-known. These abscesses are a diagnostic and therapeutic challenge, since they are associated to high mortality rates, specially in immunocompromised patients; the best therapeutic management remains unclear. In spite of the existing controversy with regard to the surgical management of these lesions, an early diagnosis through stereotactic aspiration and the beginning of an antimicrobial therapy are essential to the patient’s good evolution. This paper presents a patient with a primary polycythaemia and a recurrent brain abscess by Nocardia asteroides, probably of dental origin

Pedicle screw fixation of the C7 vertebra using an anteroposterior fluoroscopic imaging technique

Cervical pedicle screws have been reported to be biomechanically superior to lateral mass screws. However, placement of these implants is a technical challenge. The purpose of this investigation was to use an anatomic and a clinical study to evaluate a technique for placement of the pedicle screws in the C7 vertebra using fluoroscopic imaging in only the anteroposterior (A/P) plane. Ten adult cadaver C7 vertebrae were used to record the pedicle width, inclination and a suitable entry point for placement of pedicle screws. A prospective study of 28 patients undergoing posterior instrumentation of the cervical spine with C7 pedicle screw placement was also performed. A total of 55 C7 pedicle screws were placed using imaging only in the A/P plane with screw trajectory values obtained by the anatomic study. Radiographs and CT scans were performed post-operatively. The average posterior pedicle diameter of C7 vertebra was 9.5 ± 1.2 mm in this study. The average middle pedicle diameter was 7.1 mm and the average anterior pedicle diameter was 9.2 mm. The average transverse pedicle angle was 26.8 on the right and 27.3 on the left. CT scans were obtained on 20 of 28 patients which showed two asymptomatic cortical wall perforations. One screw penetrated the lateral wall of the pedicle and another displayed an anterior vertebral penetration. There were no medial wall perforations. The preliminary results suggest that this technique is safe and suitable for pedicle screw placement in the C7 vertebra

Circulating Vitamin D and Colorectal Cancer Risk: An International Pooling Project of 17 Cohorts.

Background: Experimental and epidemiological studies suggest a protective role for vitamin D in colorectal carcinogenesis, but evidence is inconclusive. Circulating 25-hydroxyvitamin D (25(OH)D) concentrations that minimize risk are unknown. Current Institute of Medicine (IOM) vitamin D guidance is based solely on bone health. Methods: We pooled participant-level data from 17 cohorts, comprising 5706 colorectal cancer case participants and 7107 control participants with a wide range of circulating 25(OH)D concentrations. For 30.1% of participants, 25(OH)D was newly measured. Previously measured 25(OH)D was calibrated to the same assay to permit estimating risk by absolute concentrations. Study-specific relative risks (RRs) for prediagnostic season-standardized 25(OH)D concentrations were calculated using conditional logistic regression and pooled using random effects models. Results: Compared with the lower range of sufficiency for bone health (50-<62.5 nmol/L), deficient 25(OH)D (<30 nmol/L) was associated with 31% higher colorectal cancer risk (RR = 1.31, 95% confidence interval [CI] = 1.05 to 1.62); 25(OH)D above sufficiency (75-<87.5 and 87.5-<100 nmol/L) was associated with 19% (RR = 0.81, 95% CI = 0.67 to 0.99) and 27% (RR = 0.73, 95% CI = 0.59 to 0.91) lower risk, respectively. At 25(OH)D of 100 nmol/L or greater, risk did not continue to decline and was not statistically significantly reduced (RR = 0.91, 95% CI = 0.67 to 1.24, 3.5% of control participants). Associations were minimally affected when adjusting for body mass index, physical activity, or other risk factors. For each 25 nmol/L increment in circulating 25(OH)D, colorectal cancer risk was 19% lower in women (RR = 0.81, 95% CI = 0.75 to 0.87) and 7% lower in men (RR = 0.93, 95% CI = 0.86 to 1.00) (two-sided Pheterogeneity by sex = .008). Associations were inverse in all subgroups, including colorectal subsite, geographic region, and season of blood collection. Conclusions: Higher circulating 25(OH)D was related to a statistically significant, substantially lower colorectal cancer risk in women and non-statistically significant lower risk in men. Optimal 25(OH)D concentrations for colorectal cancer risk reduction, 75-100 nmol/L, appear higher than current IOM recommendations