The Role of the Inflammatory Response in Burn Injury

Burns are characterised by significant local swelling and redness around the site of injury, indicative of acute inflammation. Whilst the inflammatory response is fundamental to the healing process, triggering a cascade of cytokines and growth factors to protect against the risk of infection, it is clear that prolonged inflammation can be detrimental and lead to scarring and fibrosis. Severe burns may display chronic, persistent inflammation long after the initial burn injury and may even result in multiple organ failure (MOF) due to systemic inflammatory response syndrome (SIRS). Excessive inflammation in the early stages of healing has been identified as a causative factor in the formation of scars which can be disfiguring, functionally restrictive and may require revisionary surgeries. Therefore, it is imperative that inflammation is effectively managed following burn injuries in order to optimise the benefits it provides whilst actively preventing the complications of inflammation including SIRS, multiple organ failure (MOF) and the development of scarring and fibrosis. Reviewing the current knowledge about the role of the inflammatory response in burns and the treatments available for the management of inflammation during wound healing, highlights the importance of continued research into understanding and developing new approaches to regulate inflammatory responses post-burn injuries

Cardiac Magnetic Resonance T1 Mapping in Cardiomyopathies

Cardiac magnetic resonance (CMR) imaging has been widely used to assess myocardial perfusion and scar and is the noninvasive reference standard for identification of focal myocardial fibrosis. However, the late gadolinium enhancement (LGE) technique is limited in its accuracy for absolute quantification and assessment of diffuse myocardial fibrosis by technical and pathophysiological features. CMR relaxometry, incorporating T1 mapping, has emerged as an accurate, reproducible, highly sensitive, and quantitative technique for the assessment of diffuse myocardial fibrosis in a number of disease states. We comprehensively review the physics behind CMR relaxometry, the evidence base, and the clinical applications of this emerging technique

Quantification of training and match-load distribution across a season in elite English Premier League soccer players

Objective: To examine training and match loads undertaken by soccer players competing in the English Premier League. Methods: Using a retrospective design, external (GPS) and internal training loads (sessions ratings of perceived exertion [sRPE-TL]) were examined in 26 players across the competition phase of the 2012–2013 English Premier League season. Within-subject linear mixed-models estimated the mean effects (95% confidence interval [CI]) for load data across 6-week mesocycles and 1-week microcycles. Results: Daily sRPE-TL (95% CI range, 15 to 111 AU) and total distance (95% CI range, 179 to 949 AU) were higher during the early stages (mesocycle 1 and 2) of the competition period. Overall, high-speed activity was similar between mesocycles. Across the training week, load was greater on match day and lower pre match-day (G-1) vs. all other days, respectively (p &lt; 0.001). sRPE-TL (~70–90 AU per day) and total distance (~700–800 m per day) progressively declined over the 3 days before a match (p &lt; 0.001). High-speed distance was greater 3 days (G-3) before a game vs. G-1 (95% CI, 140 to 336 m) while very high-speed distance was greater on G-3 and G-2 than G-1 (95% CI range, 8 to 62 m; p &lt; 0.001). Conclusion: Periodisation of in-season training load is mainly evident across the weekly microcycle reflecting the recovery and preparation for matches.</p

Monitoring Fatigue During the In-Season Competitive Phase in Elite Soccer Players.

Purpose:To quantify the relationship between daily training load and a range of potential measures of fatigue in elite soccer players during an in-season competitive phase (17 d).Methods:Total high-intensity-running (THIR) distance, perceived ratings of wellness (fatigue, muscle soreness, sleep quality), countermovement-jump height (CMJ), postexercise heart-rate recovery (HRR), and heart-rate variability (Ln rMSSD) were analyzed during an in-season competitive period (17 d). General linear models were used to evaluate the influence of daily fluctuation in THIR distance on potential fatigue variables.Results:Fluctuations in fatigue (r = −.51, large, P &lt; .001), Ln rMSSD (r = −.24, small, P = .04), and CMJ (r = .23, small, P = .04) were significantly correlated with fluctuations in THIR distance. Correlations between variability in muscle soreness, sleep quality, and HRR and THIR distance were negligible and not statistically significant.Conclusions:Perceived ratings of fatigue and Ln rMSSD were sensitive to daily fluctuations in THIR distance in a sample of elite soccer players. Therefore, these particular markers show promise as simple, noninvasive assessments of fatigue status in elite soccer players during a short in-season competitive phase.</jats:sec

Visual Function of English Premier League Soccer Players

Purpose: Examine visual function of soccer players of different skill level and playing position. Methods: Elite players from an English Premier League soccer club (n=49) and intermediate players (n=31) completed an assessment on a Nike SPARQ Sensory Station of: static and dynamic visual acuity, contrast sensitivity, accommodative-vergence facility, target capture and perception span. Results: There was no difference between elite and intermediate players for all measures. However, competitive soccer players (elite, intermediate) did exhibit better performance in acuity-based measures of visual function and accommodative-vergence compared to a population of healthy non-athletic adults (n=230). With regards to player position, defensive players showed quicker accommodative-vergence facility compared to offensive players. Conclusion: Visual function of competitive soccer players is superior to non-athletic adults, but does not differentiate the elite and intermediate player. However, defensive players do exhibit faster accommodative-vergence than offensive players. We suspect that this particular visual function is advantageous for defenders given the greater demand to continually shift gaze between players located at near and far locations