Hasil untuk "Sports medicine"

W. Chodzko-Zajko, D. Proctor, M. Fiatarone Singh et al.

J. Donnelly, S. Blair, J. Jakicic et al.

Alpa V. Patel, C. Friedenreich, Steven C. Moore et al.

Supplemental digital content is available in the text. ABSTRACT Introduction The American College of Sports Medicine convened an International Multidisciplinary Roundtable on Exercise and Cancer in March 2018 to evaluate and translate the evidence linking physical activity and cancer prevention, treatment, and control. This article discusses findings from the Roundtable in relation to the biologic and epidemiologic evidence for the role of physical activity in cancer prevention and survival. Results The evidence supports that there are a number of biologically plausible mechanisms, whereby physical activity can influence cancer risk, and that physical activity is beneficial for the prevention of several types of cancer including breast, colon, endometrial, kidney, bladder, esophageal, and stomach. Minimizing time spent in sedentary behavior may also lower risk of endometrial, colon and lung cancers. Conversely, physical activity is associated with higher risk of melanoma, a serious form of skin cancer. Further, physical activity before and after a cancer diagnosis is also likely to be relevant for improved survival for those diagnosed with breast and colon cancer; with data suggesting that postdiagnosis physical activity provides greater mortality benefits than prediagnosis physical activity. Conclusions Collectively, there is consistent, compelling evidence that physical activity plays a role in preventing many types of cancer and for improving longevity among cancer survivors, although the evidence related to higher risk of melanoma demonstrates the importance of sun safe practices while being physically active. Together, these findings underscore the importance of physical activity in cancer prevention and control. Fitness and public health professionals and health care providers worldwide are encouraged to spread the message to the general population and cancer survivors to be physically active as their age, abilities, and cancer status will allow.

Piotr Górka, Julia Frączek, Karolina Borówka et al.

Background: Hamstring muscle injuries (HMI) remain the most prevalent non-contact injury in high-speed sports, particularly football and athletics. Despite sports medicine advancements, HMI is characterised by high recurrence rates (12–33%), causing significant time loss and performance decrements. Aim: This paper provides a comprehensive literature review regarding the functional anatomy, risk factors, diagnostic classification, and evidence-based treatment strategies for HMI. Material and methods: A narrative literature review was conducted using PubMed and MEDLINE. We focused on high-quality studies (systematic reviews, randomised controlled trials, clinical guidelines) published between 2010 and 2025, covering conservative and surgical management. Results: The biceps femoris long head's bi-articular architecture and dual innervation predispose it to eccentric strain during sprinting. Diagnosis has evolved with the British Athletics Muscle Injury Classification (BAMIC), which identifies intratendinous involvement as predicting prolonged recovery. Conservative management remains the gold standard for mid-substance injuries; L-protocol (lengthening) and eccentric strengthening show superior outcomes over concentric training. Surgery is indicated for complete proximal avulsions or high-grade partial tears with retraction (>2 cm); acute repair yields better outcomes than chronic reconstruction. Conclusions: Effective HMI management requires a multimodal approach. While conservative care resolves most injuries, precise MRI diagnosis is crucial to identify surgical candidates early. Return to play must be criteria-based, prioritising restored eccentric strength, fascicle length, and sprint mechanics over time-based protocols or imaging clearance.

Takuya Kitamura, Kentaro Endo, Nobutake Ozeki et al.

Abstract Human synovial mesenchymal stem cells (MSCs) demonstrate high chondrogenic capacity for regenerative medicine. While ultrasound-guided collection procedures utilize local anesthetics for patient comfort, their effects on synovial MSCs remain unclear despite their known cytotoxicity to other MSC types. This study investigated whether clinically relevant concentrations of lidocaine and ropivacaine affect synovial MSC proliferation and differentiation. Human synovial tissue from eight donors undergoing knee surgery was minced and treated for 20 min with 0.5% lidocaine, 0.2% ropivacaine, or saline control. Following enzymatic digestion, cell viability and nucleated cell yield per synovial weight were assessed immediately and after a 14-day culture expansion. Trilineage differentiation capacity was evaluated through chondrogenic pellet culture, adipogenic Oil Red O staining, and calcification Alizarin Red staining. Cell viability, nucleated cell numbers per synovium weight, and cell yield after 14-day expansion showed no significant differences between treatments. Cartilage pellet weights, Oil Red O-positive adipogenic colonies, and calcification areas remained comparable across all groups. Lidocaine or ropivacaine can be safely used during ultrasound-guided synovial tissue collection without compromising therapeutic potential. These findings support the safe clinical implementation of ultrasound-guided synovial tissue harvesting using local anesthetics, reinforcing this process as a feasible and practical platform for synovial MSC-based regenerative therapies.

Noopur Basu, Matthew Ryan, Joshua Altman

Background: Septic arthritis is an uncommon but severe condition that can lead to rapidly progressive articular destruction and septicemia. Although the knee is the most commonly affected joint in septic arthritis, bilateral involvement is an exceedingly rare condition often associated with immunocompromising conditions, medical comorbidities or other sources of infection. Case report: A 74-year-old male immunocompetent patient presented with two to three days of atraumatic bilateral knee pain and swelling with difficulty ambulating, with presenting vital signs concerning for sepsis. Physical exam was notable for large bilateral knee effusions, warmth and significantly limited range of motion. Bilateral knee arthrocentesis was performed with synovial fluid analysis consistent with bilateral septic arthritis. The patient was managed with intravenous antibiotics and operative arthrotomy and irrigation. Synovial fluid cultures from the emergency department and operating room, as well as 4/4 blood cultures all grew Group G streptococcus. No primary source of infection was identified. The patient completed a course of intravenous antibiotics tailored to culture susceptibility and had resolution of symptoms. Why should an emergency physician be aware of this?: Polyarticular septic arthritis carries high morbidity and mortality. Although uncommon, atypical presentations and absence of usual risk factors can lead to delays or missed diagnoses in the emergency department. It is essential to maintain a high index of suspicion in the patient presenting with undifferentiated multifocal joint pain or swelling, in the appropriate clinical context, to make an early diagnosis and initiate aggressive treatment to prevent complications.

Antonina Drzewiecka, Artur Drzewiecki, Oliwia Maciaszek et al.

Introduction and Purpose: Vascular access devices (VADs) are essential for modern inpatient care, yet optimal device selection remains complex due to heterogeneous data on dwell time, indications, and complications. Peripheral options such as midline catheters (MCs) and long peripheral catheters (LPCs) are increasingly proposed as alternatives to peripherally inserted central catheters (PICCs) and central venous catheters (CVCs), particularly for intermediate-duration therapy and in patients with difficult intravenous access (DIVA). The aim of this narrative review is to synthesize current evidence on peripheral and central vascular access, focusing on peripheral intravenous catheters (PIVCs), MCs, LPCs, PICCs, and CVCs, with respect to dwell time, therapeutic indications, and complication rates, including catheter-related bloodstream infections (CRBSI) and thrombosis. State of Knowledge: PIVCs, although most commonly used, have short dwell times and high failure rates, often complicated by phlebitis, infiltration, and occlusion. Midline catheters provide longer dwell times and reduce repeated cannulation but are associated with minor mechanical complications such as superficial thrombophlebitis and occlusion. PICCs and CVCs enable prolonged delivery of vesicant and hyperosmolar therapies but carry higher risks of bloodstream infection and venous thromboembolism. Comparative studies suggest midlines may reduce CRBSI and CLABSI-reportable events relative to PICCs, at the cost of more frequent minor complications. Conclusion: No single VAD is universally optimal. Device choice should integrate therapy duration, infusate characteristics, vascular anatomy, and the balance of infectious, thrombotic, and mechanical risks. MCs and LPCs appear promising for intermediate-duration, peripherally compatible therapies; however, high-quality randomized studies are needed to refine vascular access algorithms and confirm safety signals.

Dominik Kret, Wiktoria Szlachta, Daria Twardowska et al.

Myocardial bridging (MB) of the coronary arteries has long been considered a benign anatomical variant with no significant clinical relevance. However, the development of modern imaging and functional diagnostic methods indicates that its impact on myocardial perfusion may become apparent under conditions of increased hemodynamic load, especially during physical exertion. In the context of sports science, this issue is particularly important, as even subtle coronary flow disturbances can modulate the heart's response to training load and affect exercise tolerance.The aim of this study was to present the current state of knowledge on the anatomy, pathophysiology, clinical picture, diagnosis, and therapeutic management of myocardial bridges, with particular emphasis on their functional significance under conditions of stress typical of physical activity. The article is a narrative review of the literature based on a critical analysis of anatomical, observational, and imaging studies, as well as works devoted to functional assessment and treatment strategies. Available data indicate that MBs are a common structure, but heterogeneous in terms of morphology and hemodynamic significance. Although they remain asymptomatic in most people, in selected cases they may be associated with myocardial ischemia, arrhythmias, and reduced exercise tolerance. Myocardial bridges require individualized clinical and functional assessment, and their presence should not be automatically considered insignificant, especially in the context of exercise capacity assessment.

Jihoon Jeong

Model Medicine is the science of understanding, diagnosing, treating, and preventing disorders in AI models, grounded in the principle that AI models -- like biological organisms -- have internal structures, dynamic processes, heritable traits, observable symptoms, classifiable conditions, and treatable states. This paper introduces Model Medicine as a research program, bridging the gap between current AI interpretability research (anatomical observation) and the systematic clinical practice that complex AI systems increasingly require. We present five contributions: (1) a discipline taxonomy organizing 15 subdisciplines across four divisions -- Basic Model Sciences, Clinical Model Sciences, Model Public Health, and Model Architectural Medicine; (2) the Four Shell Model (v3.3), a behavioral genetics framework empirically grounded in 720 agents and 24,923 decisions from the Agora-12 program, explaining how model behavior emerges from Core--Shell interaction; (3) Neural MRI (Model Resonance Imaging), a working open-source diagnostic tool mapping five medical neuroimaging modalities to AI interpretability techniques, validated through four clinical cases demonstrating imaging, comparison, localization, and predictive capability; (4) a five-layer diagnostic framework for comprehensive model assessment; and (5) clinical model sciences including the Model Temperament Index for behavioral profiling, Model Semiology for symptom description, and M-CARE for standardized case reporting. We additionally propose the Layered Core Hypothesis -- a biologically-inspired three-layer parameter architecture -- and a therapeutic framework connecting diagnosis to treatment.

Jinning Zhang, Jie Song, Wenhui Tu et al.

Current medical retrieval-augmented generation (RAG) approaches overlook evidence-based medicine (EBM) principles, leading to two key gaps: (1) the lack of PICO alignment between queries and retrieved evidence, and (2) the absence of evidence hierarchy considerations during reranking. We present SR-RAG, an EBM-adapted GraphRAG framework that integrates the PICO framework into knowledge graph construction and retrieval, and proposes Bayesian Evidence Tier Reranking (BETR) to calibrate ranking scores by evidence grade without predefined weights. Validated in sports rehabilitation, we release a knowledge graph (357,844 nodes, 371,226 edges) and a benchmark of 1,637 QA pairs. SR-RAG achieves 0.812 evidence recall@10, 0.830 nugget coverage, 0.819 answer faithfulness, 0.882 semantic similarity, and 0.788 PICOT match accuracy, substantially outperforming five baselines. Five expert clinicians rated the system 4.66--4.84 on a 5-point Likert scale, and system rankings are preserved on a human-verified gold subset (n=80).

Gongan Jiang, Weijun Wang, Yuhao Yang et al.

Abstract Objective Information on pathogens and sensitive antibiotics is crucial for treating periprosthetic joint infection (PJI), one of the most severe complications of joint arthroplasty. Lacking this information is not uncommon, and empirical antibiotic treatment should be adopted as a compromise. This study aimed to develop regional-specific antimicrobial regimens and provide a reference for empirical antibiotic treatment for PJI by retrospectively analyzing the pathogen profiles of PJI patients treated in our center and their antibiotic sensitivities. Methods PJI patients treated at our center from January 2018 to December 2024 were retrospectively recruited. Joint aspiration was performed preoperatively to collect synovial fluid for culture and differential cell counting, and synovial tissue samples were obtained intraoperatively from at least three different sites for culture. Patients were diagnosed according to the guidelines of the 2018 International Consensus Meeting and the European Bone and Joint Infection Society. The culture-positive rate, distribution of gram-positive pathogens, methicillin resistance, mixed infections, and multidrug resistance were analyzed. The effective coverage rates of antibiotics were determined, and appropriate empirical antibiotic regimens were proposed. Results A total of 255 PJI patients, comprising 104 males and 151 females, were included; 141 patients had hip PJI, and 114 had knee PJI. Among them, 224 patients (87.8%) had positive culture results. We isolated 335 pathogens, including 218 coagulase-negative staphylococcal infections (65.1%). Staphylococcus epidermidis was the most prevalent pathogen, with 86 isolates (25.7%), followed by Staphylococcus aureus, with 45 isolates (13.4%), and Streptococci, with 20 isolates (6.0%). In hip PJI, the most common pathogens were Staphylococcus epidermidis (50 isolates, 26.6%) and Staphylococcus aureus (30 isolates, 16.0%), and in knee PJI, Staphylococcus epidermidis was predominant (36 isolates, 24.5%). In terms of drug resistance, 48.1% of the staphylococcal strains were methicillin resistant, and 57.6% of the pathogens were multidrug resistant. Staphylococci showed 100% sensitivity to vancomycin and linezolid but were highly resistant to β-lactams and quinolones. In patients with acute postoperative PJI, the combination of vancomycin combined with ceftazidime was 98.4% effective. In patients with chronic PJI, vancomycin combined with imipenem and meropenem achieved effective coverage rates of 94.4% and 95.5%, respectively. The combination of linezolid with meropenem also achieved a 95.5% effective coverage rate. Conclusion Gram-positive bacteria were the predominant pathogens associated with PJI, with high rates of methicillin resistance and multidrug resistance. The combination of vancomycin and meropenem is an empirical antibiotic regimen for culture-negative chronic PJI patients in this region, with the combination of linezolid and meropenem as an alternative. For patients with culture-negative acute postoperative PJI, vancomycin combined with ceftazidime is suggested as the preferred empirical therapy.

Chris Brogly, Saif Rjaibi, Charlotte Liang et al.

Small Language Models (SLMs) have potential to be used for automatically labelling and identifying aspects of text data for medicine/health-related purposes from documents and the web. As their resource requirements are significantly lower than Large Language Models (LLMs), these can be deployed potentially on more types of devices. SLMs often are benchmarked on health/medicine-related tasks, such as MedQA, although performance on these can vary especially depending on the size of the model in terms of number of parameters. Furthermore, these test results may not necessarily reflect real-world performance regarding the automatic labelling or identification of texts in documents and the web. As a result, we compared topic-relatedness scores from Microsofts phi-3-mini-4k-instruct SLM to the topic-relatedness scores from 7 human evaluators on 1144 samples of medical/health-related texts and 1117 samples of sports injury-related texts. These texts were from a larger dataset of about 9 million news headlines, each of which were processed and assigned scores by phi-3-mini-4k-instruct. Our sample was selected (filtered) based on 1 (low filtering) or more (high filtering) Boolean conditions on the phi-3 SLM scores. We found low-moderate significant correlations between the scores from the SLM and human evaluators for sports injury texts with low filtering (\r{ho} = 0.3413, p < 0.001) and medicine/health texts with high filtering (\r{ho} = 0.3854, p < 0.001), and low significant correlation for medicine/health texts with low filtering (\r{ho} = 0.2255, p < 0.001). There was negligible, insignificant correlation for sports injury-related texts with high filtering (\r{ho} = 0.0318, p = 0.4466).

Carlo Dindorf, Fabian Horst, Djordje Slijepčević et al.

This chapter provides an overview of recent and promising Machine Learning applications, i.e. pose estimation, feature estimation, event detection, data exploration & clustering, and automated classification, in gait (walking and running) and sports biomechanics. It explores the potential of Machine Learning methods to address challenges in biomechanical workflows, highlights central limitations, i.e. data and annotation availability and explainability, that need to be addressed, and emphasises the importance of interdisciplinary approaches for fully harnessing the potential of Machine Learning in gait and sports biomechanics.

Robert A. Rigby, Mikis D. Stasinopoulos, Achim Zeileis et al.

We read with interest the above article by Zavorsky (2025, Respiratory Medicine, doi:10.1016/j.rmed.2024.107836) concerning reference equations for pulmonary function testing. The author compares a Generalized Additive Model for Location, Scale, and Shape (GAMLSS), which is the standard adopted by the Global Lung Function Initiative (GLI), with a segmented linear regression (SLR) model, for pulmonary function variables. The author presents an interesting comparison; however there are some fundamental issues with the approach. We welcome this opportunity for discussion of the issues that it raises. The author's contention is that (1) SLR provides "prediction accuracies on par with GAMLSS"; and (2) the GAMLSS model equations are "complicated and require supplementary spline tables", whereas the SLR is "more straightforward, parsimonious, and accessible to a broader audience". We respectfully disagree with both of these points.

Robert Sparrow, Joshua Hatherley

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It's also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare institutions. We will suggest that two questions, in particular, are deserving of further attention from philosophers and bioethicists. What does care look like when one is dealing with data as much as people? And, what weight should we give to the advice of machines in our own deliberations about medical decisions?

Ryan W. Paul, J. Sonnier, E. Johnson et al.

Background: Female sports participation continues to rise; however, inequalities between male and female athletes still exist in many areas and may extend into medical research. Purpose: The purpose of this study was to (1) compare the number of published studies evaluating male versus female athletes in various sports and (2) identify which co-ed sports currently underrepresent female athletes in the sports medicine literature. Study Design: Systematic review; Level of evidence, 4. Methods: All nonreview research studies published from 2017 to 2021 in 6 top sports medicine journals were considered for inclusion. Sports medicine studies were included that isolated athletes, reported study outcomes specific to male and/or female patients, provided study outcomes for specific sports, and evaluated ≤3 different sports. The total number of studies reporting on male and/or female athletes were compared for all sports, and odds ratios (ORs) were calculated. Comparisons of study design, level of sports participation, outcomes assessed, and study quality were also made according to participant sex. Results: Overall, 669 studies were included the systematic review. Most studies isolated male athletes (70.7%), while 8.8% isolated female athletes and 20.5% included male and female athletes. Female athletes were more frequently studied in softball and volleyball, while male athletes were more commonly researched in baseball, soccer, American football, basketball, rugby, hockey, and Australian football. Notably, male athletes were largely favored in baseball/softball (91% vs 5%; OR = 18.2), rugby (72% vs 5%; OR = 14.4), soccer (65% vs 15%; OR = 4.3), and basketball (58% vs 18%; OR = 3.2). Conclusion: Sports medicine research has favored the evaluation of male athletes in most sports, including the majority of co-ed sports. Potential reasons for this inequality of research evaluation include availability of public data and database data, financial and promotional incentives, a high percentage of male sports medicine clinicians and researchers, and sex biases in sport. While the causes of these differences are multifaceted, researchers should consider both sexes for study inclusion whenever possible, and journals should support a more balanced representation of research publications regarding male and female athletes.

Walery Zukow, Igor Popovych

Background and aim. Despite the use of drinking hydrogen rich water both in clinical and sports medicine, further research into the mechanisms of its beneficial effect remains relevant. We found that both Naftussya bioactive water per se and combined balneotherapy have an ambiguous effect on physical performance. It was also found that the preventive use of “Truskavetska” bottled water, the chemical composition of which is somewhat similar to that of Naftussya bioactive water, has both similar and different effects on the post-stress parameters of rats. We set ourselves the goal of finding out the possibility of correcting the effect of "Truskavetska" bottled water on the post-stressor state of the neuro-endocrine-immune complex, as well as the endurance of rats by enriching it with hydrogen. Material and methods. The experiment is at 26 female Wistar rats purposefully divided into three homogeneous (according to the swimming test and HRV parameters) groups. 5 animals remained intact with free access to regular daily water. Rats of the control group (n=4) for 7 days loaded through a tube with “Truskavetska” bottled table water (2 mL once), while the animals of main group (n=17) received the same water, but enriched with Hydrogen. After completing the preconditioning course, a repeated swimming stress test was performed. The next day after stressing, a number of parameters of the neuro-endocrine-immune complex and metabolism were recorded.  Results. Hydrogen rich water (HRW) minimizes the post-stressor increase in sympathetic tone and adrenal mass, and prevents the increase in catecholamines and corticosterone as well as plasma cells in the blood and rod-shaped neutrophils in the spleen. On the other hand, HRW prevents a post-stressor decrease in the intensity of macrophage phagocytosis and the bactericidal capacity of blood microphages, the content of lymphoblasts in the thymus, the activity of both antioxidant enzymes and vagal tone, and also minimizes the decrease in the content of eosinophils in the blood, non-alpha-lipoprotein cholesterol in the serum, and the mass of the spleen, in addition, the reduced content of plasma cells in the spleen reverses to an excess. Finally, the non-stress-responsive parameters of the control animals: the activity of AlT, CPhK, AsT and diene conjugates of the serum, the content of reticulocytes and Hassal’s bodies in the thymus - under the influence of HRW increase to one degree or another. Importantly, this also applies to the duration of swimming until exhaustion. A strong canonical correlation was found between the activity of antioxidant enzymes, on the one hand, and metabolic-endocrine (R=0.959) and immune (R=0.959) sets, on the other hand. Conclusion. Enrichment of "Truskavetska" bottled table water with hydrogen generally has a favorable effect on its stress-limiting and actotropic capacity, associated with antioxidant activity.

Hyojin Bae, Bongsu Kang, Chang-Eop Kim

This study examines the clinical decision-making processes in Traditional East Asian Medicine (TEAM) by reinterpreting pattern identification (PI) through the lens of dimensionality reduction. Focusing on the Eight Principle Pattern Identification (EPPI) system and utilizing empirical data from the Shang-Han-Lun, we explore the necessity and significance of prioritizing the Exterior-Interior pattern in diagnosis and treatment selection. We test three hypotheses: whether the Ext-Int pattern contains the most information about patient symptoms, represents the most abstract and generalizable symptom information, and facilitates the selection of appropriate herbal prescriptions. Employing quantitative measures such as the abstraction index, cross-conditional generalization performance, and decision tree regression, our results demonstrate that the Exterior-Interior pattern represents the most abstract and generalizable symptom information, contributing to the efficient mapping between symptom and herbal prescription spaces. This research provides an objective framework for understanding the cognitive processes underlying TEAM, bridging traditional medical practices with modern computational approaches. The findings offer insights into the development of AI-driven diagnostic tools in TEAM and conventional medicine, with the potential to advance clinical practice, education, and research.

Frederik F. Flöther

The last few years have seen rapid progress in transitioning quantum computing from lab to industry. In healthcare and life sciences, more than 40 proof-of-concept experiments and studies have been conducted; an increasing number of these are even run on real quantum hardware. Major investments have been made with hundreds of millions of dollars already allocated towards quantum applications and hardware in medicine. In addition to pharmaceutical and life sciences uses, clinical and medical applications are now increasingly coming into the picture. This chapter focuses on three key use case areas associated with (precision) medicine, including genomics and clinical research, diagnostics, and treatments and interventions. Examples of organizations and the use cases they have been researching are given; ideas how the development of practical quantum computing applications can be further accelerated are described.