Ibuprofen Safety at the Golden Anniversary: Are all NSAIDs the Same? A Narrative Review

Ibuprofen first came to market about 50 years ago and rapidly moved to over-the-counter (OTC) sales. In April 2019, the National Agency for the Safety of Medicines and Health Products (ANSM) of France issued a warning for NSAID uses by patients with infectious diseases based on an analysis of 20 years of real-world safety data on ibuprofen and ketoprofen. Nevertheless, ibuprofen remains a mainstay in the analgesic armamentarium and with numerous randomized clinical trials, head-to-head studies, and decades of clinical experience. The authors offer a review of the safety of ibuprofen and how it may differ from other NSAIDs. Ibuprofen is associated with certain well-known gastrointestinal adverse effects that are related to dose and patient population. Among nonsteroidal anti-inflammatory drugs (NSAIDs), ibuprofen has a comparatively low risk of cardiovascular adverse effects. It has been associated with renal and hepatic adverse effects, which appear to depend on dose, concomitant medications, and patient population. The association of ibuprofen with infections is more complex in that it confers risk in some situations but benefits in others, the latter in cystic fibrosis. Emerging interest in the literature is providing evidence of the role of ibuprofen as a possible endocrine disrupter as well as its potential antiproliferative effects for cancer cells. Taken altogether, ibuprofen has a favorable safety profile and is an effective analgesic for many acute and chronic pain conditions, although it—like other NSAIDs—is not without risk. After 50 years, evidence is still emerging about ibuprofen and its unique safety profile among NSAIDs. The Rapid Service Fee was funded by Abbott Established Pharmaceuticals Division (EPD)

Physical activity levels and related energy expenditure during COVID-19 quarantine among the sicilian active population: A cross-sectional online survey study

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the Italian government has adopted containment measures to control the virus's spread, including limitations to the practice of physical activity (PA). The aim of this study was to estimate the levels of PA, expressed as energy expenditure (MET-minute/week), among the physically active Sicilian population before and during the last seven days of the COVID-19 quarantine. Furthermore, the relation between this parameter and specific demographic and anthropometric variables was analyzed. Methods: 802 Sicilian physically active participants (mean age: 32.27 ± 12.81 years; BMI: 23.44 ± 3.33 kg/m2) were included in the study and grouped based on gender, age and BMI. An adapted version of the International Physical Activity Questionnaire-short form (IPAQ-SF) was administered to the participants through an online survey. The Wilcoxon signed-rank test and the Kruskal-Wallis rank-sum test were used for statistical analyses. Results: As expected, we observed a significant decrease of the total weekly energy expenditure during the COVID-19 quarantine (p < 0.001). A significant variation in the MET-min/wk in the before quarantine condition (p = 0.046) and in the difference between before and during quarantine (p = 0.009) was found for males and females. The male group decreased the PA level more than the female one. Moreover, a significant difference in the MET-min/wk was found among groups distributions of BMI (p < 0.001, during quarantine) and of age (p < 0.001, both before and during quarantine). In particular, the highest and the lowest levels of PA were reported by the young and the elderly, respectively, both before and during quarantine. Finally, the overweight group showed the lowest level of PA during quarantine. Conclusion: Based on our outcomes, we can determine that the current quarantine has negatively affected the practice of PA, with greater impacts among males and overweight subjects. In regards to different age groups, the young, young adults and adults were more affected than senior adults and the elderly

Saddle Pressures Factors in Road and Off-Road Cyclists of Both Genders: A Narrative Review

: The contact point of the pelvis with the saddle of the bicycle could generate abnormal pressure, which could lead to injuries to the perineum in cyclists. The aim of this review was to summarize in a narrative way the current literature on the saddle pressures and to present the factors that influence saddle pressures in order to prevent injury risk in road and off-road cyclists of both genders. We searched the PubMed database to identify English-language sources, using the following terms: "saddle pressures", "pressure mapping", "saddle design" AND "cycling". We also searched the bibliographies of the retrieved articles. Saddle pressures are influenced by factors such as sitting time on the bike, pedaling intensity, pedaling frequency, trunk and hand position, handlebars position, saddle design, saddle height, padded shorts, and gender. The jolts of the perineum on the saddle, especially on mountain bikes, generate intermittent pressures, which represent a risk factor for various pathologies of the urogenital system. This review highlights the importance of considering these factors that influence saddle pressures in order to prevent urogenital system injuries in cyclists

Influence of occlusal vertical dimension on cervical spine mobility in sports subjects

Introduction: In the scientific literature, a number of studies have reported conflicting results regarding the effects of occlusal vertical dimension (OVD) on sports-related skills. The purpose of this study was to increase OVD in sports subjects so as to specifically investigate the influence on cervical spine mobility. In particular, we measured cervical range of motion (ROM) before and after increasing OVD in individuals, either with or without malocclusion, analyzing both sports and sedentary subjects. Materials and methods: Participants were divided into two groups: a sports group (SG) and a control group (CG), each including 18 subjects. The SG was composed of sports subjects (age: 20.11±3.45 yrs; BMI: 25.39±2.32 kg/m2), whereas the CG consisted of age-matched sedentary subjects (age: 25.78±2.26 yrs; BMI: 24.88±2.87 kg/m2). Cervical range of motion (ROM) was evaluated, by way of an accelerometer (Moover®, Sensor Medica®), before (pre-test) and after (post-test) increasing OVD. Results: The main finding of this study was that sports subjects showed no significant difference, compared to control subjects, in cervical ROM in response to increased OVD. Moreover, we found that sports and sedentary subjects alike showed no significant change in cervical spine mobility as a result of increased OVD, regardless of whether they were affected by malocclusion (class II) or represented subjects with normocclusion (class I). Conclusion: In accord with several studies reported in the literature, the findings of our study indicate that occlusal splints failed to significantly improve the physical-performance endpoint measured, i.e. cervical ROM, in sports subjects as compared to sedentary individuals. Due to the paucity of studies, characterized by conflicting results, there is as yet no compelling scientific evidence as to whether OVD positively impacts sports performance or not. Accordingly, we suggest that further scientific investigation, regarding the relationship between sports performance and OVD, be conducted in the field of sport and exercise sciences

Effects of a Postural Exercise Program on Vertical Jump Height in Young Female Volleyball Players with Knee Valgus

Background: Although a knee valgus position is related to the increase in injury risk in volleyball players, there is a lack of studies on the relationship between knee valgus and vertical jump (VJ) performance. Hence, the aim of this study was to investigate the effects of a postural exercise program on VJ height in young female volleyball players with knee valgus. Methods: This pilot study included 19 young female volleyball players divided into the following groups: the Valgus Experimental Group (VEG); the Valgus Control Group (VCG); and the Neutral Control Group (NCG). All three groups carried out the same volleyball training program. In addition, only the VEG underwent a 3-month postural exercise program of 30–45 min/session, twice/week. VJ performance was measured through the Sargent test before (T0), at 6 weeks (T1), and at 12 weeks (T2). Results: A significant effect from T0 to T1 (p = 0.0017) and from T0 to T2 (p = 0.0001) was found in the VEG. No significant differences were found over time in the VCG and in the NCG. Conclusion: An integrated postural exercise program might lead to a more balanced muscle efficiency inducing athletes to obtain a higher VJ performance

Is bodyweight affecting plantar pressure distribution in children? An observational study

The aim of this study is twofold: Firstly, to investigate the plantar pressure distribution differences in children coming from 4 different weight categories and secondly to analyze the presence of sex-related plantar pressure distribution differences. Overall, 416 children, aged 7 to 12 years old were randomly selected from 6 different local schools, and voluntarily participated in the study. Two hundred twenty six of them were men, while 190 were women (mean age: 9.93±1.02 years; height: 1.39±0.8m; body mass: 37.76±10.34kg; BMI: 19.24±4.02kg/m2). Based on the body mass index (BMI) the sample was grouped in the following categories: Underweight (UW); normal weight (NW); overweight (OW), and obese (OB). Besides, the plantar load distribution parameters (total plantar load distribution and load distribution in forefoot and rearfoot) were assessed employing freeMed Maxi; Sensor Medica device. Shapiro-Wilk test was used to test the data distribution. Between-groups comparisons were conducted using Mann-Whitney U test, or using Kruskal-Wallis test associated with pairwise comparisons. There were significant differences in load distribution between weight categories, with (OW) and (NW) being significantly different with (O), P=.03 and P=.04, respectively. No significant differences were found on load distribution on the rearfoot and forefoot between categories. The sex effect, particularly among boys, revealed a different pattern of load distribution among (O) compared with other categories. This effect was not detected among women. Different profile of load distribution on the rearfoot and forefoot between boys and girls was found, with girls bearing significantly more weight in the right rearfoot compared with boys (P=.001). It can be concluded that the weight status of the children can affect the plantar load distribution, with obese category being different from (NW) and (OW). Additionally, the sex plays a role when it comes to the load distribution in different regions of the foot. Moreover, since the young age, due to growth and development process, is accompanied with anatomical foot changes which might be affected from numerous factors, assessing plantar pressure distribution in young children results to be a quite complicated matter

External load profile during different sport-specific activities in semi-professional soccer players

BackgroundGlobal Positioning System (GPS) devices are widely used in soccer for monitoring external load (EL) indicators with the aim of maximizing sports performance.The aim of this study was to investigate the EL indicators differences in players of different playing positions (i.e., central backs, external strikers, fullbacks, midfielders, strikers, wide midfielder) between and within different sport-specific tasks and official matches.Methods1932 observations from 28 semi-professional soccer players (age: 25 +/- 6 years, height: 183 +/- 6 cm, weight: 75.2 +/- 7 kg) were collected through GPS devices (Qstarz BT-Q1000EX, 10 Hz) during the season 2019-2020. Participants were monitored during Official Match (OM), Friendly Matches (FM), Small Sided Games (SSG), and Match-Based Exercises (MBE). Metabolic (i.e., metabolic power, percentage of metabolic power > 35w, number of intense actions per minute, distance per minute, passive recovery time per minute) and neuromuscular indicators (i.e., percentage of intense accelerations, percentage of intense decelerations, change of direction per min > 30 degrees) were recorded during each task.ResultsStatistically significant differences were detected in EL indicators between playing positions within each task and between tasks. In particular, results from the two-way ANOVA tests showed significant interaction, but with small effect size, in all the EL indicators between playing positions for each task and within tasks. Moreover, statistical differences, but with small effect size, between playing positions were detected in each task and for each EL indicator. Finally, the strongest statistical differences (with large effect size) were detected between tasks for each EL indicator. Details of the Tukey post-hoc analysis reporting the pairwise comparisons within and between tasks with playing positions are also provided.ConclusionIn semi-professional soccer players, different metabolic and neuromuscular performance were detected in different playing position between and within different tasks and official matches. Coaches should consider the different physical responses related to different physical tasks and playing position to design the most appropriate training program