BASEBALL PITCHING BIOMECHANICS AFTER SURGERY

Baseball pitchers with and without histories of elbow or shoulder surgery were tested with a 240 Hz automated 3D motion capture system. No differences were found between pitchers with history of UCL reconstruction and matched controls. Pitchers tested shortly after returning from UCL repair demonstrated reduced elbow extension, elbow velocity, and shoulder velocity compared to a control group, but it is unknown whether these few kinematic differences resolve with time. Pitchers with a history of SLAP repair produced less shoulder horizontal abduction, shoulder external rotation, and forward trunk tilt than matched controls. The Thoracic Outlet Syndrome case report demonstrated significantly more shoulder abduction after surgery. Thus the ability to return to normal pitching biomechanics after injury depends upon the type of surgery

Radical containing combustion derived particulate matter enhance pulmonary Th17 inflammation via the aryl hydrocarbon receptor

Abstract Background Pollutant particles containing environmentally persistent free radicals (EPFRs) are formed during many combustion processes (e.g. thermal remediation of hazardous wastes, diesel/gasoline combustion, wood smoke, cigarette smoke, etc.). Our previous studies demonstrated that acute exposure to EPFRs results in dendritic cell maturation and Th17-biased pulmonary immune responses. Further, in a mouse model of asthma, these responses were enhanced suggesting exposure to EPFRs as a risk factor for the development and/or exacerbation of asthma. The aryl hydrocarbon receptor (AHR) has been shown to play a role in the differentiation of Th17 cells. In the current study, we determined whether exposure to EPFRs results in Th17 polarization in an AHR dependent manner. Results Exposure to EPFRs resulted in Th17 and IL17A dependent pulmonary immune responses including airway neutrophilia. EPFR exposure caused a significant increase in pulmonary Th17 cytokines such as IL6, IL17A, IL22, IL1β, KC, MCP-1, IL31 and IL33. To understand the role of AHR activation in EPFR-induced Th17 inflammation, A549 epithelial cells and mouse bone marrow-derived dendritic cells (BMDCs) were exposed to EPFRs and expression of Cyp1a1 and Cyp1b1, markers for AHR activation, was measured. A significant increase in Cyp1a1 and Cyp1b1 gene expression was observed in pulmonary epithelial cells and BMDCs in an oxidative stress and AHR dependent manner. Further, in vivo exposure of mice to EPFRs resulted in oxidative stress and increased Cyp1a1 and Cyp1b1 pulmonary gene expression. To further confirm the role of AHR activation in pulmonary Th17 immune responses, mice were exposed to EPFRs in the presence or absence of AHR antagonist. EPFR exposure resulted in a significant increase in pulmonary Th17 cells and neutrophilic inflammation, whereas a significant decrease in the percentage of Th17 cells and neutrophilic inflammation was observed in mice treated with AHR antagonist. Conclusion Exposure to EPFRs results in AHR activation and induction of Cyp1a1 and in vitro this is dependent on oxidative stress. Further, our in vivo studies demonstrated a role for AHR in EPFR-induced pulmonary Th17 responses including neutrophilic inflammation

Predictors of HbA1c among Adipocytokine Biomarkers in African-American Men with Varied Glucose Tolerance

This study explored adipocytokine associations with acute and chronic hyperglycemia in African-American men (AAM). Fourteen adipocytokines were measured from men with normal glucose tolerance (NGT) or type 2 diabetes (T2D, drug-naïve MF(−) or using metformin MF(+)). Acute and chronic hyperglycemia were evaluated by 120 min oral glucose tolerance test (OGTT) and glycohemoglobin A1c (HbA1c). AAM with T2D (n = 21) compared to NGT (n = 20) were older, had higher BMI and slightly higher glucose and insulin. In the fasted state, TNF-α, IL-6, PAI-1, IL-13, adiponectin, adipsin, and lipocalin were lower in T2D vs. NGT. At 120 min post-glucose load, TNF-α, IL-6, IL-13, IL-8, PAI-1, adiponectin, adipsin, lipocalin, and resistin were lower in T2D vs. NGT. There were no statistical differences for GM-CSF, IL-7, IL-10, IP-10, and MCP-1. Regression analysis showed that fasting IL-8, TNF-α, adiponectin, lipocalin, resistin, adipsin, and PAI-1 were associated with HbA1c. After adjusting for age, BMI, glucose tolerance, and metformin use, only adipsin remained significantly associated with HbA1c (p = 0.021). The model including adipsin, TNF-α, age, BMI, and group designation (i.e., NGT, MF(−), MF(+)) explained 86% of HbA1c variability. The data suggested that adipsin could be associated with HbA1c in AAM with varied glucose tolerance

Débridement of Small Partial-thickness Rotator Cuff Tears in Elite Overhead Throwers

Elite overhead throwing athletes with rotator cuff tears represent a unique group of patients with an ultimate goal of returning to their previous level of competition. We hypothesized débridement of small partial-thickness rotator cuff tears would return the majority of elite overhead throwing athletes to their previous level of competition. Preoperative and intraoperative findings on 82 professional pitchers who had undergone débridement of partial-thickness rotator cuff tears were evaluated using our database. We obtained return to play data on 67 of the 82 players (82%); 51 (76%) were able to return to competitive pitching at the professional level and 37 (55%) were able to return to the same or higher level of competition. Of the 67 patients, 34 pitchers returned a questionnaire with a minimum followup of 18 months (mean 38 months; range 18 to 59 months). SF-12 scores were above average with a mean PSF-12 and MSF-12 of 55.04 and 56.49 respectively. An Athletic Shoulder Outcome Rating Scale score of greater than 60 was found in 76.5% of pitchers. Débridement of small partial-thickness rotator cuff tears allowed a majority of elite overhead throwing athletes to return to competitive pitching, however, returning to their previous level of competition remains a challenge for many of these players