Management of youth athletic injuries in alpine skiing

2017 ◽  
Vol 65 (3) ◽  
Keyword(s):  
High Rate ◽  
Overuse Injuries ◽  
Alpine Skiing ◽  
Traumatic Injuries ◽  
Related Risk ◽  
Early Health ◽  
Alpine Skiers ◽  
Training Need ◽  
Study Participants

The popularity of alpine skiing is growing among young athletes. However, this development also carries the risk of early health problems such as traumatic and overuse injuries. To support a long-term beneficial effect of an early sport specialization, the amount of appropriate volume and intensity of training need to be investigated. As a basis for a prospective and reliable data collection, we developed a training and injury database to repeatedly record the occurrence of traumatic injuries and overuse injuries. Study participants were 82 young talented alpine skiers aged between 9 and 14 years. We found a relatively high rate of 0,86 traumatic injuries per 1000 hours of training. In contrast a low occurence of overuse injuries were recorded (0,28/1000 hours of training). Further research is required on sport specific, age- and development-related risk factors and the appropriate amount of training to guarantee long-term health benefits of youth elite athletes.

scholarly journals Overuse injuries in the knee, back and hip of top elite female alpine skiers during the off-season preparation period: prevalence, severity and their association with traumatic preinjuries and training load

2020 ◽  
Vol 6 (1) ◽  
pp. e000892
Author(s):  
Stefan Fröhlich ◽  
Seraina Pazeller ◽  
Afsaneh Safar Cherati ◽  
Erich Müller ◽  
Walter O Frey ◽  
...  
Keyword(s):  
Knee Injury ◽  
Knee Injuries ◽  
Training Load ◽  
Research Centre ◽  
Overuse Injuries ◽  
Traumatic Injuries ◽  
Trauma Research ◽  
Preparation Period ◽  
Alpine Skiers ◽  
And Training

ObjectivesTo investigate knee, back and hip overuse injuries in top female elite alpine skiers during the off-season preparation, which has so far received little attention, and to assess their relationship with traumatic preinjuries and overall training load.MethodsA cohort of 26 females of the Swiss Alpine Ski-Team were prospectively surveyed by the use of the Oslo Sports Trauma Research Centre questionnaire. Along with the surveys also total training loads were monitored. Data on preinjuries were assessed retrospectively by baseline questionnaires and were verified by team medical records.Results57.7% of the female skiers suffered from at least one severe traumatic knee injury during their preceding career. The average 2-weekly prevalence of overuse injuries was highest for the knee, followed by the back and hip. Technique specialists (major giant slalom and slalom) were more prone to back overuse injuries than speed specialists (major super-G and downhill). The occurrence of knee overuse complaints was directly associated to previous severe traumatic knee injuries and athletes' total training hours.ConclusionIn top female elite alpine skiers, knee, back and hip overuse injuries are relatively frequent. Moreover, discipline preferences, previous traumatic injuries and the overall training load may play an important role for their manifestation.

Use Of Tai Chi Elements To Increase Respiratory Amplitude

2019 ◽  
pp. 11-20
Author(s):  
Mihai-Alexandru Citea ◽  
Marius Neculaes
Keyword(s):  
High Performance ◽  
Tai Chi ◽  
Sports Club ◽  
Optimal Functioning ◽  
Physiological Adaptations ◽  
Competitive Activity ◽  
Abdominal Breathing ◽  
Study Participants ◽  
Different Levels

High performance sport has a major impact on the physiological adaptations of the respiratory system. The importance of the optimal functioning of this system is essential to achieve top results in high performance sport but also in maintaining a long term health status. Science journals present numerous studies that highlight the benefits of practicing Tai Chi on the general population, with effects ranging from improving cardiac function, to influencing the immune system. The purpose of this study is to identify whether by practicing Tai Chi forms a athlete can change their breathing pattern and develop their respiratory amplitude. The subjects of the study were 22 fencing practitioners, accredited at the Iași Municipal Sports Club (C.S.M. Iași), aged between 14 and 18 years, with over 3 years of competitive activity. Materials and method: The study participants were evaluated initially and at the end of 7 months of practice. The frequency was 3 sessions per week, and the duration of each session was 20-30 minutes. The evaluation consisted in measuring the circumference of the thorax at 3 different levels: subaxillary, medial thorax (T6-T7) and lower rib (diaphragmatic) in maximal inspiration and expiration. Conclusions: A constant evolution is observed in most of the exposed cases. In cases where this evolution is not visible, a change in the breathing mode can be noticed, transforming from an upper rib breathing into a thoracic or abdominal breathing. With the exception of one case, all subjects had an improvement of the value in the lower rib level.

Case Report: Delayed Alemtuzumab-Induced Concurrent Neutropenia and Thrombocytopenia in Relapsing-Remitting Multiple Sclerosis

2021 ◽  
pp. 089719002110212
Author(s):  
Akaansha Ganju ◽  
James C. Stock ◽  
Kim Jordan
Keyword(s):  
Multiple Sclerosis ◽  
Case Reports ◽  
Severe Neutropenia ◽  
Cell Counts ◽  
Immune Mediated ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Study Participants ◽  
Relapsing Remitting Multiple Sclerosis

Alemtuzumab is an anti-CD52 monoclonal antibody used to treat relapsing-remitting multiple sclerosis following failure of second-line medications. It is administered intravenously in 2 treatment sequences 1 year apart. This drug is frequently associated with mild infusion reactions within days of administration, increased infection risk, and long term adverse events from secondary autoimmunity. Alemtuzumab-induced serious immune-mediated thrombocytopenia (ITP) is well-reported and occurred in 1.0-2.2% of participants in initial phase 2 and 3 trials for multiple sclerosis. Significant neutropenia, however, is rare and was only observed in 0.1% of study participants. Delayed neutropenia and/or ITP is thought to occur from secondary autoimmunity. Few case reports have described severe neutropenia occurring beyond 2 months of last alemtuzumab dose. We present an unusual case of delayed combined neutropenia and thrombocytopenia that occurred 15 months after the second infusion of alemtuzumab. The patient was asymptomatic and presented following discovery of neutropenia and thrombocytopenia during routine laboratory studies. The patient responded to steroids initially and was discharged, although outpatient cell counts subsequently revealed recurrent neutropenia and ITP. The adverse drug reaction probability (Naranjo) scale was completed and showed probable likelihood that the adverse event was alemtuzumab-related. Long term screening for delayed hematologic abnormalities, at least 4 years after initial dose, is necessary when using alemtuzumab. Greater research is needed to understand the mechanism of drug-associated neutropenia.

scholarly journals In-Situ Annealed Ti3C2Tx MXene Based All-Solid-State Flexible Zn-Ion Hybrid Micro Supercapacitor Array with Enhanced Stability

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
La Li ◽  
Weijia Liu ◽  
Kai Jiang ◽  
Di Chen ◽  
Fengyu Qu ◽  
...  
Keyword(s):  
High Energy ◽  
High Rate ◽  
High Energy Density ◽  
Electrochemical Performances ◽  
Integrated Electronics ◽  
Long Term Stability ◽  
Hybrid Supercapacitors ◽  
Portable Electronics

AbstractZn-ion hybrid supercapacitors (SCs) are considered as promising energy storage owing to their high energy density compared to traditional SCs. How to realize the miniaturization, patterning, and flexibility of the Zn-ion SCs without affecting the electrochemical performances has special meanings for expanding their applications in wearable integrated electronics. Ti3C2Tx cathode with outstanding conductivity, unique lamellar structure and good mechanical flexibility has been demonstrated tremendous potential in the design of Zn-ion SCs, but achieving long cycling stability and high rate stability is still big challenges. Here, we proposed a facile laser writing approach to fabricate patterned Ti3C2Tx-based Zn-ion micro-supercapacitors (MSCs), followed by the in-situ anneal treatment of the assembled MSCs to improve the long-term stability, which exhibits 80% of the capacitance retention even after 50,000 charge/discharge cycles and superior rate stability. The influence of the cathode thickness on the electrochemical performance of the MSCs is also studied. When the thickness reaches 0.851 µm the maximum areal capacitance of 72.02 mF cm−2 at scan rate of 10 mV s−1, which is 1.77 times higher than that with a thickness of 0.329 µm (35.6 mF cm−2). Moreover, the fabricated Ti3C2Tx based Zn-ion MSCs have excellent flexibility, a digital timer can be driven by the single device even under bending state, a flexible LED displayer of “TiC” logo also can be easily lighted by the MSC arrays under twisting, crimping, and winding conditions, demonstrating the scalable fabrication and application of the fabricated MSCs in portable electronics.

scholarly journals Endovascular Treatment of Anterior Circulation Aneurysms With the p64 Flow Modulation Device: Mid- and Long-Term Results in 617 Aneurysms From a Single Center

2021 ◽  
Author(s):  
Marta Aguilar Pérez ◽  
Elina Henkes ◽  
Victoria Hellstern ◽  
Carmen Serna Candel ◽  
Christina Wendl ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
High Rate ◽  
Long Term Results ◽  
Effective Treatment Option ◽  
Anterior Circulation ◽  
Acute Hemorrhage ◽  
Unruptured Aneurysms ◽  
Long Term Follow Up

Abstract BACKGROUND Flow diverters have become an important tool in the treatment of intracranial aneurysms, especially when dealing with difficult-to-treat or complex aneurysms. The p64 is the only fully resheathable and mechanically detachable flow diverter available for clinical use. OBJECTIVE To evaluate the safety and effectiveness of p64 for the treatment of intracranial saccular unruptured aneurysms arising from the anterior circulation over a long-term follow-up period. METHODS We retrospectively reviewed our prospectively maintained database to identify all patients who underwent treatment for an intracranial saccular (unruptured or beyond the acute hemorrhage phase) aneurysm arising from the anterior circulation with ≥1 p64 between December 2011 and December 2019. Fusiform aneurysms and dissections were excluded. Aneurysms with prior or concomitant saccular treatment (eg, coiling and clipping) were included. Aneurysms with parent vessel implants other than p64 were excluded. Anatomic features, intraprocedural complications, clinical outcome, as well as clinical and angiographic follow-ups were all recorded. RESULTS In total, 530 patients (388 females; median age 55.9 yr) with 617 intracranial aneurysms met the inclusion criteria. The average number of devices used per aneurysm was 1.1 (range 1-3). Mean aneurysm dome size was 4.8 mm (range 1-27 mm). Treatment-related morbimortality was 2.4%. Early, mid-term, and long-term angiographic follow-up showed complete or near-complete aneurysm occlusion in 76.8%, 89.7%, and 94.5%, respectively. CONCLUSION Treatment of intracranial saccular unruptured aneurysms of the anterior circulation using p64 is a safe and effective treatment option with high rate of occlusion at long-term follow-up and low morbimortality.

Scaphoid Nonunion Is a Disabling Problem in a Military Population

Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Nicholas H. Lake ◽  
Rafae Khan ◽  
Kyle W. Mombell ◽  
Mary Fergus ◽  
Dominic Gomez-Leonardelli
Keyword(s):  
Functional Outcome ◽  
Military Service ◽  
Functional Outcomes ◽  
High Rate ◽  
Scaphoid Nonunion ◽  
Military Population ◽  
Outcome Scores ◽  
The Mean ◽  
Return To Duty

Background Scaphoid nonunion can occur in up to 55% of displaced scaphoid fractures. Long-term functional outcomes of this injury are lacking. In addition, no study has published rate of return to active military service after this injury. Our goal was to educate providers and patients on expected functional outcomes and return to duty after treatment of scaphoid nonunion. Methods We conducted a retrospective review of patients who underwent scaphoid nonunion repair at our institution from 2008 to 2017. The primary outcome measures were union rates, return to duty rates, and functional outcome scores obtained by telephone call. A total of 144 patients were included and 40 responded to our call for long-term follow-up. Results A total of 72% of patients achieved union after surgery, 18% required revision surgery, and 74% of patients were able to return to full duty after surgery. However, this number progressively decreased at 1, 2, and 5 years after surgery. At an average of 5.9 years after surgery, the mean Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) score was 23.9. The mean qDASH for patients who achieved union (21.9) was significantly lower than those with persistent nonunion (29.2) ( P = .0115). Conclusion Scaphoid nonunion is a difficult problem in the military. We found a high rate of persistent nonunion often requiring revision to partial or full wrist arthrodesis. In addition, our long-term functional outcome scores demonstrate significant disability after this injury, even when union is achieved. This information can help us better counsel our patients and set expectations after treatment of this injury.

scholarly journals Moxetumomab pasudotox in heavily pre-treated patients with relapsed/refractory hairy cell leukemia (HCL): long-term follow-up from the pivotal trial

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Robert J. Kreitman ◽  
◽  
Claire Dearden ◽  
Pier Luigi Zinzani ◽  
Julio Delgado ◽  
...  
Keyword(s):  
Hairy Cell Leukemia ◽  
Residual Disease ◽  
Braf Inhibitor ◽  
Nucleoside Analogs ◽  
High Rate ◽  
Hairy Cell ◽  
Cell Leukemia ◽  
Long Term Follow Up

Abstract Background Moxetumomab pasudotox is a recombinant CD22-targeting immunotoxin. Here, we present the long-term follow-up analysis of the pivotal, multicenter, open-label trial (NCT01829711) of moxetumomab pasudotox in patients with relapsed/refractory (R/R) hairy cell leukemia (HCL). Methods Eligible patients had received ≥ 2 prior systemic therapies, including ≥ 2 purine nucleoside analogs (PNAs), or ≥ 1 PNA followed by rituximab or a BRAF inhibitor. Patients received 40 µg/kg moxetumomab pasudotox intravenously on Days 1, 3, and 5 of each 28-day cycle for up to six cycles. Disease response and minimal residual disease (MRD) status were determined by blinded independent central review. The primary endpoint was durable complete response (CR), defined as achieving CR with hematologic remission (HR, blood counts for CR) lasting > 180 days. Results Eighty adult patients were treated with moxetumomab pasudotox and 63% completed six cycles. Patients had received a median of three lines of prior systemic therapy; 49% were PNA-refractory, and 38% were unfit for PNA retreatment. At a median follow-up of 24.6 months, the durable CR rate (CR with HR > 180 days) was 36% (29 patients; 95% confidence interval: 26–48%); CR with HR ≥ 360 days was 33%, and overall CR was 41%. Twenty-seven complete responders (82%) were MRD-negative (34% of all patients). CR lasting ≥ 60 months was 61%, and the median progression-free survival without the loss of HR was 71.7 months. Hemolytic uremic and capillary leak syndromes were each reported in ≤ 10% of patients, and ≤ 5% had grade 3–4 events; these events were generally reversible. No treatment-related deaths were reported. Conclusions Moxetumomab pasudotox resulted in a high rate of durable responses and MRD negativity in heavily pre-treated patients with HCL, with a manageable safety profile. Thus, it represents a new and viable treatment option for patients with R/R HCL, who currently lack adequate therapy. Trial registration ClinicalTrials.gov identifier: NCT01829711; first submitted: April 9, 2013. https://clinicaltrials.gov/ct2/show/NCT01829711

TRIGEMINAL NERVE RADIOSURGICAL TREATMENT IN INTRACTABLE CHRONIC CLUSTER HEADACHE

Neurosurgery ◽  
2006 ◽  
Vol 59 (6) ◽  
pp. 1252-1257 ◽  
Author(s):  
Anne Donnet ◽  
Manabu Tamura ◽  
Dominique Valade ◽  
Jean Régis
Keyword(s):  
Trigeminal Neuralgia ◽  
Cluster Headache ◽  
Trigeminal Nerve ◽  
Chronic Cluster Headache ◽  
High Rate ◽  
Long Term Results ◽  
Complete Relief ◽  
Term Evaluation ◽  
The One

Abstract OBJECTIVE We have previously reported short-term results of a prospective open trial designed to evaluate trigeminal nerve radiosurgical treatment in intractable chronic cluster headache (CCH). Medium- and long-term results have not yet been reported. METHODS Ten patients presenting with a severe and drug-resistant CCH were enrolled (nine men, one woman). The radiosurgical treatment was performed according to the technique usually used for trigeminal neuralgia in our department. A single 4-mm shot was positioned at the level of the cisternal portion of the trigeminal nerve. The median distance between the center of the shot and the emergence of the nerve was 9.35 mm (range, 7.5–13.3 mm). The median of this maximum dose to the brainstem was 8.0 Gy (range, 4.0–11.1 Gy). Mean age was 49.8 years (range, 32–77 yr). Mean duration of the CCH was 9 years (range, 2–33 yr). The mean follow-up period was 36.3 months (range, 24–48 mo). RESULTS Two patients had complete relief of CCH. One patient had a good result with evolution in an episodic form. Seven patients had no improvement. Nine patients developed a new trigeminal nerve disturbance: three developed paresthesia with no hypoesthesia and six developed hypoesthesia, including two patients with deafferentation pain. Only one patient had neither paresthesia nor hypoesthesia. CONCLUSION We confirmed, with medium- and long-term evaluation, the high rate of toxicity and failure of the technique. The high toxicity, despite a methodology identical to the one used in trigeminal neuralgia, leads us to suspect an underlying specificity of the nerve in CCH. We do not recommend radiosurgery for treatment of intractable CCH.

SHORT TO MEDIUM RESULTS USING THE REMOTION TOTAL WRIST REPLACEMENT FOR RHEUMATOID ARTHRITIS

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 175-178 ◽  
Author(s):  
A. S. C. Bidwai ◽  
F. Cashin ◽  
A. Richards ◽  
D. J. Brown
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Relief ◽  
Surgical Intervention ◽  
Case Series ◽  
High Rate ◽  
Wound Breakdown ◽  
Radial Forearm ◽  
Skin Coverage

We present the clinical outcome of patients who underwent RE-MOTION Total Wrist Replacement (TWR) for the treatment of Rheumatoid arthritis involving the wrist. Ten patients were available for follow-up, ranging from one to five years after index surgery. Two patients required surgical intervention for wound breakdown, including one patient who required a radial forearm flap for skin coverage. No patients required revision surgery or conversion to fusion. Patients who did not have complications gained statistically significant pain relief and improvement in mean overall flexion. In this small case series with short to medium results patients reported an improvement in terms of flexion and pain. Despite this, the question of efficacy of TWR compared to fusion in the long term remains unanswered due to the high rate of complications.

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