Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 2 - The effect of exercise on the fetus, labour and birth

This is Part 2 of 5 in the series of evidence statements from the IOC expert committee on exercise and pregnancy in recreational and elite athletes. Part 1 focused on the effects of training during pregnancy and on the management of common pregnancy-related symptoms experienced by athletes. In Part 2, we focus on maternal and fetal perinatal outcomes

A comparison in a youth population between those with and without a history of concussion using biomechanical reconstruction

OBJECTIVE: Concussion is a common topic of research as a result of the short- and long-term effects it can have on the affected individual. Of particular interest is whether previous concussions can lead to a biomechanical susceptibility, or vulnerability, to incurring further head injuries, particularly for youth populations. The purpose of this research was to compare the impact biomechanics of a concussive event in terms of acceleration and brain strains of 2 groups of youths: those who had incurred a previous concussion and those who had not. It was hypothesized that the youths with a history of concussion would have lower-magnitude biomechanical impact measures than those who had never suffered a previous concussion. METHODS: Youths who had suffered a concussion were recruited from emergency departments across Canada. This pool of patients was then separated into 2 categories based on their history of concussion: those who had incurred 1 or more previous concussions, and those who had never suffered a concussion. The impact event that resulted in the brain injury was reconstructed biomechanically using computational, physical, and finite element modeling techniques. The output of the events was measured in biomechanical parameters such as energy, force, acceleration, and brain tissue strain to determine if those patients who had a previous concussion sustained a brain injury at lower magnitudes than those who had no previously reported concussion. RESULTS: The results demonstrated that there was no biomechanical variable that could distinguish between the concussion groups with a history of concussion versus no history of concussion. CONCLUSIONS: The results suggest that there is no measureable biomechanical vulnerability to head impact related to a history of concussions in this youth population. This may be a reflection of the long time between the previous concussion and the one reconstructed in the laboratory, where such a long period has been associated with recovery from injury

Glutathione metabolism in a piglet model of colitis and protein malnutrition

Glutathione (γ-glutamyl-cysteinylglycine; GSH) is the most abundant low molecular weight thiol synthesized endogenously by all cells from glutamate, cysteine and glycine. Inflammatory bowel disease (IBD) is a debilitating condition associated with oxidative stress and protein energy malnutrition (PEM) (especially among children). The aim of this study was to investigate how nutrition and intestinal inflammation impact the regulation of GSH in red blood cells and tissues in a piglet model of dextran sodium sulfate (DSS)-induced colitis. This is the first study to combine the use of a stable isotope methodology to determine GSH synthesis and tandem mass spectrometry to analyze the concentration of GSH and its metabolites in various malnourished models of pediatric colitis. Our results demonstrated that GSH was uniquely regulated in tissues of healthy piglets, with the liver producing the most GSH. GSH concentration was ~20% lower in distal colon of well-nourished piglets with colitis and further reduced by ~60% in piglets with moderate PEM compared to healthy, well-nourished controls. Severe, but not moderate, protein deficiency altered GSH regulation on a systemic level, affecting metabolism in liver and compromising GSH concentration in red blood cells, ileal mucosa and spiral colon. No effect on GSH regulation was reported in moderately protein deficient piglets receiving a difference in protein quality or in moderately PEM piglets receiving probiotic supplementation or glucagon-like peptide 2, an anabolic hormone. In conclusion, we have demonstrated that protein malnutrition, a common consequence of IBD, exacerbates the deleterious effects of severe inflammation by affecting the regulation of GSH. Adequate protein consumption may play a more beneficial role than increasing macronutrient intake with respect to glutathione regulation during inflammation. This emphasizes the role of nutritional intervention, specifically increasing cysteine requirement, as a therapeutic approach towards rehabilitating patients with IBD.Le glutathion est l'un des principaux antioxydants de l'organisme. Il est produit de façon endogène à partir de glutamate, de cystéine et de glycine. La maladie inflammatoire de l'intestin est une condition débilitante associée au stress oxydatif et à la malnutrition protéique et énergétique (MPE), surtout chez les enfants. La présente étude avait pour but d'examiner l'effet de la nutrition et de l'inflammation intestinale sur l'état du glutathion dans les érythrocytes et les tissus en utilisant un modèle de colite induit par dextrane sulfate de sodium (DSS) chez des porcelets. Cette étude est la première à combiner l'utilisation d'isotopes stables pour déterminer la synthèse du glutathion et la spectrométrie de masse pour analyser la concentration du glutathion et de ses métabolites dans divers modèles de malnutrition et de colite pédiatrique. Nos résultats ont démontré que glutathion est uniquement régulé dans les tissus des porcelets sains, la majorité du glutathion étant produit dans le foie. La concentration de glutathion était inférieure d'environ 20% dans le côlon distal de porcelets bien nourris souffrant de colite par rapport aux porcelets sains et inférieure d'environ 60% chez les porcelets avec MPE par rapport aux porcelets bien nourris. Seulement un déficit sévère en protéines a compromis le métabolisme du foie et la concentration de glutathion dans les érythrocytes, la muqueuse iléale et le côlon spiralé. Aucun effet sur la régulation du glutathion n'a été démontré chez les porcelets recevant des protéines de différentes qualités, chez des porcelets avec MPE recevant une supplémentation probiotique ou une hormone anabolisante. En conclusion, nous avons démontré que la malnutrition protéique, une conséquence fréquente de l'inflammation intestinale, exacerbe les effets délétères de l'inflammation sévère en affectant la régulation du glutathion. La consommation adéquate de protéines peut jouer un rôle plus bénéfique que l'augmentation des macronutriments sur la régulation du glutathion. Ceci souligne le rôle de l'intervention nutritionnelle, spécifiquement l'augmentation de la cystéine, comme une approche thérapeutique à la réhabilitation des patients avec la maladie inflammatoire de l'intestin

Hemifacial Spasm in Mucopolysaccharidosis Type VI (Maroteaux–Lamy Syndrome)

Background: Hemifacial spasms are involuntary contractions of the muscles of one side of the face. Case Report: Here, we report a 5-year-old female patient with a significant past medical history, including mucopolysaccharidosis type VI, who also presented with hemifacial spasms. Further investigations showed narrowing of skull foramina and hydrocephalus, but no compression of the facial nerve. Carbamazepine was given to the patient, which caused cessation of the spasms. Discussion: Currently, there is no literature discussing the relationship between hemifacial spasms and mucopolysaccharidosis type VI; we have proposed that mucopolysaccharide deposits or dural thickening may contribute to nerve irritation