Anterior Cruciate Ligament Rehabilitation for the 10- to 18-Year-Old Adolescent Athlete:Practice Guidelines Based on International Delphi Consensus

Background:There are 2 treatment options for adolescent athletes with anterior cruciate ligament (ACL) injuries—rehabilitation alone (nonsurgical treatment) or ACL reconstruction plus rehabilitation. However, there is no clear consensus on how to include strength and neuromuscular training during each phase of rehabilitation.Purpose:To develop a practical consensus for adolescent ACL rehabilitation to help provide care to this age group using an international Delphi panel.Study Design:Consensus statement.Methods:A 3-round online international Delphi consensus study was conducted. A mix of open and closed literature-based statements were formulated and sent out to an international panel of 20 ACL rehabilitation experts. Statements were divided into 3 domains as follows: (1) nonsurgical rehabilitation; (2) prehabilitation; and (3) postoperative rehabilitation. Consensus was defined as 70% agreement between panel members.Results:Panel members agreed that rehabilitation should consist of 3 criterion-based phases, with continued injury prevention serving as a fourth phase. They also reached a consensus on rehabilitation being different for 10- to 16-year-olds compared with 17- and 18-year-olds, with a need to distinguish between prepubertal (Tanner stage 1) and mid- to postpubertal (Tanner stages 2-5) athletes. The panel members reached a consensus on the following topics: educational topics during rehabilitation; psychological interventions during rehabilitation; additional consultation of the orthopaedic surgeon; duration of postoperative rehabilitation; exercises during phase 1 of nonsurgical and postoperative rehabilitation; criteria for progression from phase 1 to phase 2; resistance training during phase 2; jumping exercises during phase 2; criteria for progression from phase 2 to phase 3; and criteria for return to sports (RTS). The most notable differences in recommendations for prepubertal compared with mid- to postpubertal athletes were described for resistance training and RTS criteria.Conclusion:Together with available evidence, this international Delphi statement provides a framework based on expert consensus and describes a practice guideline for adolescent ACL rehabilitation, which can be used in day-to-day practice. This is an important step toward reducing practice inconsistencies, improving the quality of rehabilitation after adolescent ACL injuries, and closing the evidence-practice gap while waiting for further studies to provide clarity

Childhood central nervous system tumors and leukemia: Incidence and familial risk. A comparative population-based study in Utah and Norway.

Background In this study, we aimed to evaluate incidence rates and family risk of the most common childhood cancers, tumors in the central nervous system (CNS), and leukemia among individuals from Norway and individuals with Scandinavian ancestry living in Utah. Methods We used the Utah Population Database and the Norwegian National Population Register linked to Cancer registries to identify cancers in children born between 1966 and 2015 and their first‐degree relatives. We calculated incidence rates and hazards ratios. Results The overall incidence of CNS tumors increased with consecutive birth cohorts similarly in Utah and Norway (both P < 0.001). Incidence rates of leukemia were more stable and similar in both Utah and in Norway with 4.6/100 000 person‐years among children (<15 years) born in the last cohort. A family history of CNS tumors was significantly associated with risk of childhood CNS tumors in Utah HR = 3.05 (95% CI 1.80‐5.16) and Norway HR = 2.87 (95% CI 2.20‐3.74). In Norway, children with a first‐degree relative diagnosed with leukemia had high risk of leukemia (HR = 2.39, 95% CI 1.61‐3.55). Conclusion Despite geographical distance and assumed large lifestyle differences, two genetically linked pediatric populations show similar incidences of CNS tumors and leukemia in the period 1966–2015. CNS tumors and leukemia aggregated in families in both countries

A population-based study of testicular cancer risk among children and young adults from Norway and Utah, USA.

Similar family‐based cancer and genealogy data from Norway and Utah allowed comparisons of the incidence of testicular cancer (TC), and exploration of the role of Scandinavian ancestry and family history of TC in TC risk. Our study utilizes data from the Utah Population Database and Norwegian Population Registers. All males born during 1951–2015 were followed for TC until the age of 29 years. A total of 1,974,287 and 832,836 males were born in Norway and Utah, respectively, of whom 2,686 individuals were diagnosed with TC in Norway and 531 in Utah. The incidence per year of TC in Norway (10.6) was twice that observed in Utah (5.1) for males born in the last period (1980–1984). The incidence rates of TC in Utah did not differ according to the presence or absence of Scandinavian ancestry (p = 0.669). Having a brother diagnosed with TC was a strong risk factor for TC among children born in Norway and Utah, with HR = 9.87 (95% CI 5.68–17.16) and 6.02 (95% CI 4.80–7.55), respectively; with even higher HR observed among the subset of children in Utah with Scandinavian ancestry (HR = 12.30, 95% CI 6.78–22.31). A clear difference in TC incidence among individuals born in Norway and descendants of Scandinavian people born in Utah was observed. These differences in TC rates point to the possibility of environmental influence. Family history of TC is a strong risk factor for developing TC in both populations

Family history of cancer and risk of paediatric and young adult’s testicular cancer: A Norwegian cohort study

Background - The aim of this study was to examine the association of a family history of cancer with the risk of testicular cancer in young adults. Methods - This is a prospective cohort study including 1,974,287 males born 1951–2015, of whom 2686 were diagnosed with TC before the age of 30. Results - A history of TC in male relatives was significantly associated with a diagnosis of TC among children and young adults, including brothers (6.3-fold), sons (4.7-fold), fathers (4.4-fold), paternal uncles (2.0-fold) and maternal uncles (1.9-fold). Individuals with a father diagnosed with a carcinoma or sarcoma showed an elevated risk (1.1-fold and 1.8-fold, respectively). A family history of mesothelioma was positively associated with a risk of TC [(father (2.8-fold), mother (4.6-fold) and maternal uncles and aunt (4.4-fold)]. Elevated risks were also observed when siblings were diagnosed with malignant melanoma (1.4-fold). The risk of TC was also increased when fathers (11.1-fold), paternal (4.9-fold) and maternal uncles and aunts (4.6-fold) were diagnosed with malignant neuroepithelial-tumours. Conclusion - We found an increased risk of TC among children and young adults with a family history of TC, carcinoma, mesothelioma, sarcoma, malignant melanoma and malignant neuroepithelial tumours. Hereditary cancer syndromes might underlie some of the associations reported in this study

Innovasjonsarbeid i FME-ene, mars 2020

Fra innledningen. FME ZEN er et senter for miljøvennlig energi som skal utvikle løsninger for framtidens bygninger og byområder – løsninger som bidrar til at nullut-slippssamfunnet kan realiseres. FME ZEN skal vare i åtte år (2017-2024), og budsjettet er på cirka 380 millioner kroner, finansiert av Norges forskningsråd, forsknings-partnerne NTNU og SINTEF, og brukerpartnerne fra privat og offentlig sektor. NTNU er verts-institusjon og leder senteret sammen med SINTEF Community og SINTEF Energi. FME ZEN forsker på nullutslipps-områder (ZEN = Zero Emission Neighbourhood) i smarte byer. Forskere, kommuner, industri og statlige organisasjoner samarbeider i FME ZEN for å planlegge, utvikle og drifte områder med null klimagass-utslipp, over levetiden til områdene. ZEN-senteret har ni pilotprosjekter fordelt over hele Norge, som til sammen omfatter et areal på mer enn 1 million m2 og totalt mer enn 30 000 innbyggere

Innovasjonsarbeid i FME-ene, mars 2020

Fra innledningen. FME ZEN er et senter for miljøvennlig energi som skal utvikle løsninger for framtidens bygninger og byområder – løsninger som bidrar til at nullut-slippssamfunnet kan realiseres. FME ZEN skal vare i åtte år (2017-2024), og budsjettet er på cirka 380 millioner kroner, finansiert av Norges forskningsråd, forsknings-partnerne NTNU og SINTEF, og brukerpartnerne fra privat og offentlig sektor. NTNU er verts-institusjon og leder senteret sammen med SINTEF Community og SINTEF Energi. FME ZEN forsker på nullutslipps-områder (ZEN = Zero Emission Neighbourhood) i smarte byer. Forskere, kommuner, industri og statlige organisasjoner samarbeider i FME ZEN for å planlegge, utvikle og drifte områder med null klimagass-utslipp, over levetiden til områdene. ZEN-senteret har ni pilotprosjekter fordelt over hele Norge, som til sammen omfatter et areal på mer enn 1 million m2 og totalt mer enn 30 000 innbyggere.publishedVersio

Innovasjonsarbeid i FME-ene, mars 2020

Fra innledningen. FME ZEN er et senter for miljøvennlig energi som skal utvikle løsninger for framtidens bygninger og byområder – løsninger som bidrar til at nullut-slippssamfunnet kan realiseres. FME ZEN skal vare i åtte år (2017-2024), og budsjettet er på cirka 380 millioner kroner, finansiert av Norges forskningsråd, forsknings-partnerne NTNU og SINTEF, og brukerpartnerne fra privat og offentlig sektor. NTNU er verts-institusjon og leder senteret sammen med SINTEF Community og SINTEF Energi. FME ZEN forsker på nullutslipps-områder (ZEN = Zero Emission Neighbourhood) i smarte byer. Forskere, kommuner, industri og statlige organisasjoner samarbeider i FME ZEN for å planlegge, utvikle og drifte områder med null klimagass-utslipp, over levetiden til områdene. ZEN-senteret har ni pilotprosjekter fordelt over hele Norge, som til sammen omfatter et areal på mer enn 1 million m2 og totalt mer enn 30 000 innbyggere

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes