Mechanical Low Back Pain in Elite Track and Field Athletes: An observational cohort study

OBJECTIVE: The aim of the study was to gain information about the incidence of mechanical Low Back Pain (MLBP) injuries etiology in elite track and field athletes and to assess the recurrence rate. BACKGROUND: The prevalence and the etiology of Low Back Pain (LBP) in athletic populations at the elite level of competition lack of longitudinal studies focused on certain sport fields. The present study evaluates MLBP incidents in elite track and field athletes visiting National Track and Field Centre in Thessaloniki, Greece and classifies MLBP according to etiology. METHODS: One hundred and thirty Elite Track and Field Athletes with MLBP injuries were included in a 20-year observational cohort study recording the initial MLBP etiology according to a classification system based on mechanical diagnosis. It was examined if age, gender and sport category predispose the incidence of the initial MLBP etiology and if they consist risk factors for MLBP recurrence. RESULTS: Discogenic MLBP in elite track and field athletes was significantly higher at 46.9% (α= 0.05) compared with the other MLBP etiologies under consideration. Secondary findings of the present study regarding the incidence of MLBP etiology categories did not reveal significant associations with gender, age and contest categories (α= 0.05). Additionally, recurrence pathophysiology showed that discogenic MLBP obtained high recurrence rates at 0.48 (14 athletes from 29 athletes recurred) compared with other etiologies, followed by back elements injury recurrence rate at 0.24 (7 athletes out of 29). CONCLUSIONS: The study provided us with evidence of higher incidence of discogenic etiology of MLBP in elite track and field athletes. Further research is suggested in the use of etiology related LBP classification system in order to evaluate causes, prevalence and epidemiology of MLBP in athletic populations of specific sport categories. © 2017 - IOS Press and the authors

Prevalence, techniques and knowledge of rapid weight loss amongst adult british judo athletes: A questionnaire based study

Background: No investigation has analysed the RWL approaches since new rules by the International Judo Federation (IJF) regarding weigh-ins have been im-plemented in international competitions in 2014. The current study analyses the prevalence, most common methods and knowledge surrounding the effects of rapid weight loss (RWL) amongst adult UK judo athletes. Additionally, it examines differences in rapid weight loss behaviour (RWLB) between gen-der, weight-class, competitive level, age RWL began and “high”/“low” knowledge athletes. Methods: A previously validated questionnaire developed to assess RWL in judo athletes was modified by adding a knowledge section and revalidated for content. The questionnaire provided a RWLB score (higher score equated to more aggressive RWL) and a knowledge score (out of 10). 256 athletes (189 males and 66 females, aged 18-67 years) completed the questionnaire between February and April 2015. Un-paired t test, one-way ANOVA-tests and Chi-squared tests were used to test differences of mean RWLB scores and prevalence between groups. Results: The prevalence of RWL was 84%. The most common methods of RWL were increased exercise and decreased food/fluid intake. The mean knowledge score was 6.2±2.8, with most incorrect answers regarding physiological effects of RWL. No significant differences in RWLB scores were found between gen-der, “high”/“low” knowledge athletes or weight-class-es. Statistically significant differences in RWLB scores were found between different competitive levels (p=0.014) and age RWL began (p<0.01) in males but not in females. Conclusion: RWL is highly prevalent in the UK adult judo population and athletes have moderate knowledge surrounding its effects. In males, RWLB is most aggressive in elite level athletes and those that began RWL at a younger age. Therefore, updated rulings to target elite and youth level athletes should be imple-mented to reduce dangerous RWL. Level of evidence: IV. © 2017, CIC Edizioni Internazionali s.r.l. All rights reserved

Evaluation of a novel brachial cuff-based oscillometric method for estimating central systolic pressure in hemodialysis patients

Background/Aims: Elevated wave reflections and arterial stiffness, as well as ambulatory blood pressure (BP) are independent predictors of cardiovascular risk in end-stage-renaldisease. This study is the first to evaluate in hemodialysis patients the validity of a new ambulatory oscillometric device (Mobil-O-Graph, IEM, Germany), which estimates aortic BP, augmentation index (AIx) and pulse wave velocity (PWV). Methods: Aortic SBP (aSBP), heart rate-adjusted AIx (AIx(75)) and PWV measured with Mobil-O-Graph were compared with the values from the most widely used tonometric device (Sphygmocor, ArtCor, Australia) in 73 hemodialysis patients. Measurements were made in a randomized order after 10 min of rest in the supine position at least 30 min before a dialysis session. Brachial BP (mercury sphygmomanometer) was used for the calibration of Sphygmocor&apos;s waveform. Results: Sphygmocor-derived aSBP and AIx(75) did not differ from the relevant Mobil-O-Graph measurements (aSBP: 136.3 ± 19.6 vs.133.5 ± 19.3 mm Hg, p = 0.068; AIx(75): 28.4 ± 9.3 vs. 30.0 ± 11.8%, p = 0.229). The small difference in aSBP is perhaps explained by a relevant difference in brachial SBP used for calibration (146.9 ± 20.4 vs. 145.2 ± 19.9 mm Hg, p = 0.341). Sphygmocor PWV was higher than Mobil-O-Graph PWV (10.3 ± 3.4 vs. 9.5 ± 2.1 m/s, p &lt; 0.01). All 3 parameters estimated by Mobil-O-Graph showed highly significant (p &lt; 0.001) correlations with the relevant measurements of Sphygmocor (aSBP, r = 0.770; AIx(75), r = 0.400; PWV, r = 0.739). The Bland-Altman Plots for aSBP and AIx(75) showed acceptable agreement between the two devices and no evidence of systemic bias for PWV. Conclusion: As in other populations, acceptable agreement between Mobil-O-Graph and Sphygmocor was evident for aSBP and AIx(75) in hemodialysis patients; PWV was slightly underestimated by Mobil-O-Graph. © 2014 S. Karger AG, Basel

Human memory B cells originate from three distinct germinal center-dependent and -independent maturation pathways

Multiple distinct memory B-cell subsets have been identified in humans, but it remains unclear how their phenotypic diversity corresponds to the type of responses from which they originate. Especially, the contribution of germinal center-independent responses in humans remains controversial. We defined 6 memory B-cell subsets based on their antigen-experienced phenotype and differential expression of CD27 and IgH isotypes. Molecular characterization of their replication history, Ig somatic hypermutation, and class-switch profiles demonstrated their origin from 3 different pathways. CD27(-)IgG(+) and CD27(+)IgM(+) B cells are derived from primary germinal center reactions, and CD27(+)IgA(+) and CD27(+)IgG(+) B cells are from consecutive germinal center responses (pathway 1). In contrast, natural effector and CD27(-)IgA(+) memory B cells have limited proliferation and are also present in CD40L-deficient patients, reflecting a germinal center-independent origin. Natural effector cells at least in part originate from systemic responses in the splenic marginal zone (pathway 2). CD27(-)IgA(+) cells share low replication history and dominant Ig lambda and IgA2 use with gut lamina propria IgA+ B cells, suggesting their common origin from local germinal center-independent responses (pathway 3). Our findings shed light on human germinal center-dependent and -independent B-cell memory formation and provide new opportunities to study these processes in immunologic diseases. (Blood. 2011;118(8):2150-2158