FOOT-MOVEMENT, LOAD AND INJURY IN VOLLEYBALL

Many human movements are very typical to one sporting activity. Such movements may be a particular way of hittiny a ball (whole body movement) or placing the foot on the ground (one segment movement). Movements are the result of acting forces and as a consequence lead to a loading of joints, tendons and other anatanical structures. Load on the other hand is recognized as a critical factor regarding the occurence of pain and injury (Nigg, Stuessi). So movement, load and injury are related to each other. In running this relation has been pursued for a number of years, in other sports, i.e. volleyball it is almost unknown. The goal of this presentation is twofold: (1) To present a structuring of the game of volleyball in order (2) to establish a relationship between foot-movement, injury and load. Applications are presented using selected examples

Patient doses in CT examinations in Switzerland: implementation of national diagnostic reference levels

Diagnostic reference levels (DRLs) were established for 21 indication-based CT examinations for adults in Switzerland. One hundred and seventy-nine of 225 computed tomography (CT) scanners operated in hospitals and private radiology institutes were audited on-site and patient doses were collected. For each CT scanner, a correction factor was calculated expressing the deviation of the measured weighted computed tomography dose index (CTDI) to the nominal weighted CTDI as displayed on the workstation. Patient doses were corrected by this factor providing a realistic basis for establishing national DRLs. Results showed large variations in doses between different radiology departments in Switzerland, especially for examinations of the petrous bone, pelvis, lower limbs and heart. This indicates that the concept of DRLs has not yet been correctly applied for CT examinations in clinical routine. A close collaboration of all stakeholders is mandatory to assure an effective radiation protection of patients. On-site audits will be intensified to further establish the concept of DRLs in Switzerlan

An audit of diagnostic reference levels in interventional cardiology and radiology: are there differences between academic and non-academic centres?

A wide variation in patient exposure has been observed in interventional radiology and cardiology. The purpose of this study was to investigate the patient dose from fluoroscopy-guided procedures performed in non-academic centres when compared with academic centres. Four procedures (coronary angiography, percutaneous coronary intervention, angiography of the lower limbs and percutaneous transluminal angioplasty of the lower limbs) were evaluated. Data on the dose-area product, fluoroscopy time and number of images for 1000 procedures were obtained from 23 non-academic centres and compared with data from 5 academic centres. No differences were found for cardiology procedures performed in non-academic centres versus academic ones. However, significantly lower doses were delivered to patients for procedures of the lower limbs when they were performed in non-academic centres. This may be due to more complex procedures performed in the academic centres. Comparison between the centres showed a great variation in the patient dose for these lower limb procedure

Patterns of paediatric end-of-life care: a chart review across different care settings in Switzerland.

Paediatric end-of-life care is challenging and requires a high level of professional expertise. It is important that healthcare teams have a thorough understanding of paediatric subspecialties and related knowledge of disease-specific aspects of paediatric end-of-life care. The aim of this study was to comprehensively describe, explore and compare current practices in paediatric end-of-life care in four distinct diagnostic groups across healthcare settings including all relevant levels of healthcare providers in Switzerland. In this nationwide retrospective chart review study, data from paediatric patients who died in the years 2011 or 2012 due to a cardiac, neurological or oncological condition, or during the neonatal period were collected in 13 hospitals, two long-term institutions and 10 community-based healthcare service providers throughout Switzerland. Ninety-three (62%) of the 149 reviewed patients died in intensive care units, 78 (84%) of them following withdrawal of life-sustaining treatment. Reliance on invasive medical interventions was prevalent, and the use of medication was high, with a median count of 12 different drugs during the last week of life. Patients experienced an average number of 6.42 symptoms. The prevalence of various types of symptoms differed significantly among the four diagnostic groups. Overall, our study patients stayed in the hospital for a median of six days during their last four weeks of life. Seventy-two patients (48%) stayed at home for at least one day and only half of those received community-based healthcare. The study provides a wide-ranging overview of current end-of-life care practices in a real-life setting of different healthcare providers. The inclusion of patients with all major diagnoses leading to disease- and prematurity-related childhood deaths, as well as comparisons across the diagnostic groups, provides additional insight and understanding for healthcare professionals. The provision of specialised palliative and end-of-life care services in Switzerland, including the capacity of community healthcare services, need to be expanded to meet the specific needs of seriously ill children and their families

Transmissions within the tarsal gearbox

BACKGROUND: The dependence of the movements of the calcaneus, cuboid, navicular, and talus on each other have been described as the tarsal gearbox. To provide a basis of its modeling, data on transmissions between tarsal joint rotations within this gearbox are required. The feasibility of tibiocalcaneal rotations to predict tarsal joint rotations is of interest because a meaningful relation would allow the use of common motion analysis with skin markers to investigate rearfoot kinematics. METHODS: We performed linear regression analyses between tarsal joint and tibiocalcaneal rotations on the basis of magnetic resonance imaging of tibia and tarsal bone positions during quasi-static foot pronation and supination. RESULTS: In the frontal plane and transverse planes, linear models were found to predict tarsal joint rotations quite well (r(2) = 0.83-0.97 for the frontal plane and r(2) = 0.73-0.95 for the transverse plane). For each degree of talocalcaneal rotation, there was 1.8 degrees of talonavicular rotation in the frontal plane and 1.6 degrees in the transverse plane; each degree of talocalcaneal rotation resulted in 0.6 degrees of calcanealcuboid rotation in the frontal plane and 0.7 degrees in the transverse plane; each degree of calcaneocuboid rotation resulted in 3 degrees of talonavicular rotation in the frontal plane and 2.8 degrees in the transverse; each degree of tibiocalcaneal rotation resulted in 0.9 degrees of talocalcaneal rotation in the frontal plane and 0.9 degrees in the transverse plane; and each degree of tibiocalcaneal rotation resulted in 1.6 degrees of talonavicular rotation in the frontal plane and 1.3 degrees in the transverse plane. CONCLUSION: The present study provides a basis on which the tarsal gearbox in the frontal and the transverse planes under quasi-static conditions can be modeled. Furthermore, it is concluded that tibiocalcaneal rotations are practical for predicting tarsal joint rotations during quasi-static motions

Reliability of tarsal bone segmentation and its contribution to MR kinematic analysis methods

The purpose of this study was to determine the reliability of tarsal bone segmentation based on magnetic resonance (MR) imaging using commercially available software. All tarsal bones of five subjects were segmented five times each by two operators. Volumes and second moments of volume were calculated and used to determine the intra- as well as interoperator reproducibility. The results show that these morphological parameters had excellent interclass correlation coefficients (>0.997) indicating that the presented tarsal bone segmentation is a reliable procedure and that operators are in fact interchangeable. The consequences on differences in MR kinematic analysis methods of segmentation due to repetition were also determined. It became evident that one analysis method--fitting surface point clouds--was considerable less affected by repeated segmentation (cuboid: up to 0.2 degrees, other tarsal bones up to 0.1 degrees) compared to a method using principal axes (cuboid up to 6.7 degrees, other tarsal bones up to 0.8 degrees). Thus, the former method is recommended for investigations of tarsal bone kinematics by MR imaging

Patient doses in CT examinations in Switzerland: implementation of national diagnostic reference levels.

Diagnostic reference levels (DRLs) were established for 21 indication-based CT examinations for adults in Switzerland. One hundred and seventy-nine of 225 computed tomography (CT) scanners operated in hospitals and private radiology institutes were audited on-site and patient doses were collected. For each CT scanner, a correction factor was calculated expressing the deviation of the measured weighted computed tomography dose index (CTDI) to the nominal weighted CTDI as displayed on the workstation. Patient doses were corrected by this factor providing a realistic basis for establishing national DRLs. Results showed large variations in doses between different radiology departments in Switzerland, especially for examinations of the petrous bone, pelvis, lower limbs and heart. This indicates that the concept of DRLs has not yet been correctly applied for CT examinations in clinical routine. A close collaboration of all stakeholders is mandatory to assure an effective radiation protection of patients. On-site audits will be intensified to further establish the concept of DRLs in Switzerland