The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases

BACKGROUND Ankle sprains are common in sports and can sometimes result in a persistent pain condition. PURPOSE Primarily to evaluate clinical symptoms, signs, diagnostics and outcomes of surgery for symptomatic chondral injuries of the talo crural joint in athletes. Secondly, in applicable cases, to evaluate the accuracy of MRI in detecting these injuries. Type of study: Prospective consecutive series. METHODS Over around 4 years we studied 61 consecutive athletes with symptomatic chondral lesions to the talocrural joint causing persistent exertion ankle pain. RESULTS 43% were professional full time athletes and 67% were semi-professional, elite or amateur athletes, main sports being soccer (49%) and rugby (14%). The main subjective complaint was exertion ankle pain (93%). Effusion (75%) and joint line tenderness on palpation (92%) were the most common clinical findings. The duration from injury to arthroscopy for 58/61 cases was 7 months (5.7–7.9). 3/61 cases were referred within 3 weeks from injury. There were in total 75 cartilage lesions. Of these, 52 were located on the Talus dome, 17 on the medial malleolus and 6 on the Tibia plafond. Of the Talus dome injuries 18 were anteromedial, 14 anterolateral, 9 posteromedial, 3 posterolateral and 8 affecting mid talus. 50% were grade 4 lesions, 13.3% grade 3, 16.7% grade 2 and 20% grade 1. MRI had been performed pre operatively in 26/61 (39%) and 59% of these had been interpreted as normal. Detection rate of cartilage lesions was only 19%, but subchondral oedema was present in 55%. At clinical follow up average 24 months after surgery (10–48 months), 73% were playing at pre-injury level. The average return to that level of sports after surgery was 16 weeks (3–32 weeks). However 43% still suffered minor symptoms. CONCLUSION Arthroscopy should be considered early when an athlete presents with exertion ankle pain, effusion and joint line tenderness on palpation after a previous sprain. Conventional MRI is not reliable for detecting isolated cartilage lesions, but the presence of subchondral oedema should raise such suspicion

Building development and roads: implications for the distribution of stone curlews across the Brecks

Background: Substantial new housing and infrastructure development planned within England has the potential to conflict with the nature conservation interests of protected sites. The Breckland area of eastern England (the Brecks) is designated as a Special Protection Area for a number of bird species, including the stone curlew (for which it holds more than 60% of the UK total population). We explore the effect of buildings and roads on the spatial distribution of stone curlew nests across the Brecks in order to inform strategic development plans to avoid adverse effects on such European protected sites. Methodology: Using data across all years (and subsets of years) over the period 1988 – 2006 but restricted to habitat areas of arable land with suitable soils, we assessed nest density in relation to the distances to nearest settlements and to major roads. Measures of the local density of nearby buildings, roads and traffic levels were assessed using normal kernel distance-weighting functions. Quasi-Poisson generalised linear mixed models allowing for spatial auto-correlation were fitted. Results: Significantly lower densities of stone curlew nests were found at distances up to 1500m from settlements, and distances up to 1000m or more from major (trunk) roads. The best fitting models involved optimally distance-weighted variables for the extent of nearby buildings and the trunk road traffic levels. Significance : The results and predictions from this study of past data suggests there is cause for concern that future housing development and associated road infrastructure within the Breckland area could have negative impacts on the nesting stone curlew population. Given the strict legal protection afforded to the SPA the planning and conservation bodies have subsequently agreed precautionary restrictions on building development within the distances identified and used the modelling predictions to agree mitigation measures for proposed trunk road developments

Regulating Clothing Outwork: A Sceptic's View

By applying the strategies of international anti-sweatshop campaigns to the Australian context, recent regulations governing home-based clothing production hold retailers responsible for policing the wages and employment conditions of clothing outworkers who manufacture clothing on their behalf. This paper argues that the new approach oversimplifies the regulatory challenge by assuming (1) that Australian clothing production is organised in a hierarchical ‘buyer-led’ linear structure in which core retail firms have the capacity to control their suppliers’ behaviour; (2) that firms act as unitary moral agents; and (3) that interventions imported from other times and places are applicable to the contemporary Australian context. After considering some alternative regulatory approaches, the paper concludes that the new regulatory strategy effectively privatises responsibility for labour market conditions – a development that cries out for further debate

Locational memory of macrovessel vascular cells is transcriptionally imprinted

Vascular pathologies show locational predisposition throughout the body; further insights into the transcriptomics basis of this vascular heterogeneity are needed. We analyzed transcriptomes from cultured endothelial cells and vascular smooth muscle cells from nine adult canine macrovessels: the aorta, coronary artery, vena cava, portal vein, femoral artery, femoral vein, saphenous vein, pulmonary vein, and pulmonary artery. We observed that organ-specific expression patterns persist in vitro, indicating that these genes are not regulated by blood flow or surrounding cell types but are likely fixed in the epigenetic memory. We further demonstrated the preserved location-specific expression of GATA4 protein in cultured cells and in the primary adult vessel. On a functional level, arterial and venous endothelial cells differed in vascular network morphology as the arterial networks maintained a higher complexity. Our findings prompt the rethinking of the extrapolation of results from single-origin endothelial cell systems

Genetic Basis of Dilated Cardiomyopathy in Dogs and Its Potential as a Bidirectional Model

Cardiac disease is a leading cause of death for both humans and dogs. Genetic cardiomyopathies, including dilated cardiomyopathy (DCM), account for a proportion of these cases in both species. Patients may suffer from ventricular enlargement and systolic dysfunction resulting in congestive heart failure and ventricular arrhythmias with high risk for sudden cardiac death. Although canine DCM has similar disease progression and subtypes as in humans, only a few candidate genes have been found to be associated with DCM while the genetic background of human DCM has been more thoroughly studied. Additionally, experimental disease models using induced pluripotent stem cells have been widely adopted in the study of human genetic cardiomyopathy but have not yet been fully adapted for the in-depth study of canine genetic cardiomyopathies. The clinical presentation of DCM is extremely heterogeneous for both species with differences occurring based on sex predisposition, age of onset, and the rate of disease progression. Both genetic predisposition and environmental factors play a role in disease development which are identical in dogs and humans in contrast to other experimental animals. Interestingly, different dog breeds have been shown to develop distinct DCM phenotypes, and this presents a unique opportunity for modeling as there are multiple breed-specific models for DCM with less genetic variance than human DCM. A better understanding of DCM in dogs has the potential for improved selection for breeding and could lead to better overall care and treatment for human and canine DCM patients. At the same time, progress in research made for human DCM can have a positive impact on the care given to dogs affected by DCM. Therefore, this review will analyze the feasibility of canines as a naturally occurring bidirectional disease model for DCM in both species. The histopathology of the myocardium in canine DCM will be evaluated in three different breeds compared to control tissue, and the known genetics that contributes to both canine and human DCM will be summarized. Lastly, the prospect of canine iPSCs as a novel method to uncover the contributions of genetic variants to the pathogenesis of canine DCM will be introduced along with the applications for disease modeling and treatment

Performance and Carcass Yield of Broilers Supplemented with Plant Extract During the Finisher Phase

ABStRACt In this study, 600 one-day-old male Cobb 500 broilers were distributed according a completely randomized experimental design into the different dietary treatments. Broilers were fed the following dietary treatments: positive control diet (PC), containing 54 ppm zinc bacitracin; negative control diet (NC), with no inclusion of performance enhancers and 3% reduction in metabolizable energy, crude protein, and amino acid levels; PC up to 33 days and then NC, with the dietary addition of 75, 150, or 225 ppm plant extracts, until day 42 days of age. Broiler performance and carcass yield were evaluated. Data were analyzed using the Statistical Analysis System package (SAS Institute Inc., 2008), and submitted to polynomial regression analysis using the GLM procedure at 5% significance level. There was no influence of treatments on feed intake or weight gain, but feed conversion ratio of the broiler fed the plant extract was significantly higher (p<0.05) compared with those fed the antibiotic. There was no significant effect (p>0.05) of the applied treatments on carcass yield. We concluded that the replacement of performance-enhancing additives by plant extracts, at the evaluated inclusion levels, does not promote positive performance results

Childbirth care: the oral history of women who gave birth from the 1940s to 1980s

This study's objective was to gain a greater understanding of the changes that took place in the childbirth care model from the experience of women who gave birth in the State of Sao Paulo, Brazil from the 1940s to the 1980s. This is a descriptive study conducted with 20 women using the Thematic Oral History method. Data were collected through unstructured interviews. The theme extracted from the interviews was "The experience of childbirth". The results indicate a time and generational demarcation in the 1970s. Childbirths from 1940 to 1960 occurred in a context of transition from home to hospital births. The 1980s represents a turning point in the elements that compose the childbirth care model, such as the type and place of birth and the professional assisting women, with an increased use of technology and obstetric interventions

Estresse e Burnout entre residentes multiprofissionais

OBJECTIVE: To identify associations between high-stress and burnout syndrome in multidisciplinary residents from a federal university in Rio Grande do Sul, Brazil. METHOD: This is an analytical, cross-sectional and quantitative study. A socio-demographic questionnaire, the Work Stress Scale and the Maslach Burnout Inventory-Health Services Survey (MBI-HSS) were applied to 37 residents between April and June 2011. P-valuesOBJETIVO: Identificar la asociación entre alto estrés y Burnout en residentes Multiprofesionales de una universidad federal de Rio Grande do Sul. MÉTODO: se trata de un estudio analítico, transversal, cuantitativo. Se aplicaron un formulario de datos socio-demográficos, la Escala de Estrés en el Trabajo y el Maslach Burnout Inventory- Health Services en 37 residentes entre Abril y Junio de 2011. Valores de pOBJETIVO: identificar a associação entre alto estresse e Burnout em residentes multiprofissionais de uma universidade federal do Rio Grande do Sul. MÉTODO: trata-se de estudo analítico, transversal, quantitativo. Aplicaram-se um formulário de dados socio demográficos, a Escala de Estresse no Trabalho e o Maslach Burnout Inventory-Human Services Survey (MBI-HSS) em 37 residentes entre abril e junho de 2011. Valores de