In Europe and the United States, there is an increasing prevalence of the use of autologous blood products to facilitate healing in a variety of applications. Recently, we have learned more about specific growth factors, which play a crucial role in the healing process. With that knowledge there is abundant enthusiasm in the application of concentrated platelets, which release a supra-maximal quantity of these growth factors to stimulate recovery in non-healing injuries. For 20 years, the application of autologous PRP has been safely used and documented in many fields including; orthopedics, sports medicine, dentistry, ENT, neurosurgery, ophthalmology, urology, wound healing, cosmetic, cardiothoracic, and maxillofacial surgery. This article introduces the reader to PRP therapy and reviews the current literature on this emerging treatment modality. In summary, PRP provides a promising alternative to surgery by promoting safe and natural healing. However, there are few controlled trials, and mostly anecdotal or case reports. Additionally the sample sizes are frequently small, limiting the generalization of the findings. Recently, there is emerging literature on the beneficial effects of PRP for chronic non-healing tendon injuries including lateral epicondylitis and plantar fasciitis and cartilage degeneration (Mishra and Pavelko, The American Journal of Sports Medicine 10(10):1–5, 2006; Barrett and Erredge, Podiatry Today 17:37–42, 2004). However, as clinical use increases, more controlled studies are needed to further understand this treatment.
Abstract For elite athletes who exercise at a high level, sleep is critical to overall health. Many studies have documented the effects of sleep deprivation in the general population, but few studies exist regarding specific effects in the athlete. This review summarizes the effects of sleep deprivation and sleep extension on athletic performance, including reaction time, accuracy, strength and endurance, and cognitive function. There are clear negative effects of sleep deprivation on performance, including reaction time, accuracy, vigor, submaximal strength, and endurance. Cognitive functions such as judgment and decision-making also suffer. Sleep extension can positively affect reaction times, mood, sprint times, tennis serve accuracy, swim turns, kick stroke efficiency, and increased free throw and 3-point accuracy. Banking sleep (sleep extension prior to night of intentional sleep deprivation before sporting event) is a new concept that may also improve performance. For sports medicine providers, the negative effects of sleep deprivation cannot be overstated to athletes. To battle sleep deprivation, athletes may seek supplements with potentially serious side effects; improving sleep quality however is simple and effective, benefiting not only athlete health but also athletic performance.
Joanna Olszak, Karolina Zalewa, Lidia Bartoszek
et al.
Introduction and Purpose
Disorders of consciousness, such as the vegetative state (VS) and minimally conscious state (MCS), are significant neurological conditions where patients exhibit limited or no awareness of their surroundings. Despite advancements in medical care, treatment options for these conditions remain limited, and prognosis is often poor. Deep brain stimulation (DBS) has emerged as a promising therapeutic option, particularly for patients with MCS or severe brain injuries. This review explores the clinical applications, and outcomes of DBS in the treatment of disorders of consciousness.
Material and Methods
A comprehensive literature review was conducted using the PubMed database, focusing on articles published up to the end of 2024. The search included the keywords "deep brain stimulation", "disorders of consciousness", "neuromodulation therapy", and " effectiveness" in various combinations. Relevant studies were selected based on criteria such as the effect of DBS in patients with disorders of consciousness.
Results
Several studies have shown that DBS, particularly targeting regions such as the thalamus or subthalamicnucleus, can lead to improvements in consciousness levels, responsiveness to external stimuli, and interaction with the environment. In some cases, patients in MCS have exhibited improved awareness, motor responses, and even the ability to communicate. Key factors influencing outcomes include the timing of DBS application, the extent of brain injury, and the specific brain regions targeted.
Conclusions
DBS offers a novel and potentially effective treatment for patients with disorders of consciousness, especially those in a minimally conscious state. While the results are promising, more controlled and larger-scale clinical trials areneeded to better understand the long-term efficacy, optimal timing, and appropriate patient selection.
Julia Górny, Alicja Kapciak, Katarzyna Naja
et al.
Introduction:
Water birth, involving immersion in water during childbirth, has gained popularity for its potential benefits, such as pain relief and comfort. While widely practiced in some countries, concerns regarding its safety, particularly for neonates, remain. This paper explores the maternal and fetal benefits and risks associated with water birth, as well as the epidemiological trends, medical protocols, and legal considerations.
Aim of Study:
The aim of this study is to evaluate the maternal and neonatal outcomes of water immersion and water birth, focusing on the safety, efficacy, and factors influencing its adoption in different populations.
Material and methods:
A comprehensive review of the literature on water birth including its benefits, risks and controversies was performed using the PubMed database.
Results and Conclusions:
Water immersion during labor is associated with significant maternal benefits, including reduced pain and anxiety, shorter labor, and fewer pharmacological interventions. Water birth, however, carries potential risks, such as neonatal respiratory complications and infections, although studies generally report no significant differences in neonatal outcomes compared to land birth. Epidemiological trends show higher water birth rates among women aged 30–39, while socioeconomic factors, such as deprivation, are linked to lower rates. Water birth has been shown to reduce the incidence of severe perineal tears and postpartum hemorrhage. While promising, the practice requires careful adherence to medical protocols to ensure safety, with further research needed to fully establish its long-term benefits and risks.
Femke Delanglez, Anneleen Watteyn, Bart Ampe
et al.
Catching, carrying, and loading of broilers before transport to the slaughterhouse causes stress. In this study three catching methods (two manual (inverted, upright) and one mechanical) were compared using a cost-benefit analysis of animal welfare, ergonomics and economic analysis. Depopulation of approximately 5,000 broilers per catching method per flock (upright vs. inverted vs. mechanical: n=3; upright vs. inverted: n=9; inverted vs. mechanical: n=3 flocks) was analyzed on 15 commercial farms. Economic considerations (person-hours per 1,000 chickens), ergonomics (catcher survey, ergonomic assessment of simulated catching), and animal welfare on-farm (wing flapping frequency, catcher-bird interaction) and at the slaughterhouse (catch damage and DOA prevalence) were considered. Wing flapping frequency was lower (2.0 ± 0.1 vs. 5.4 ± 0.1, P < 0.001), and catcher-bird interaction was better (3.7 ± 0.2 vs. 4.4 ± 0.2, P < 0.01) for upright catching compared to inverted catching based on a 7-point Likert scale. Prevalence of catch damage was lower for upright versus mechanical catching (15.5 ± 1.3% vs. 17.7 ± 1.4%, P = 0.046). More person-hours per 1,000 broilers were required for upright versus inverted (1.6 ± 0.1 h vs. 1.0 ± 0.1 h) and mechanical catching (0.6 ± 0.3 h) (P < 0.001). Upright catching was 1.5 and 1.2 times more expensive than inverted and mechanical catching based on 20,000 broilers. Compared to inverted catching, fair compensation would increase by €0.012 (upright) and €0.006 (mechanical) per kg of live weight. An ergonomics expert rated manual catching as very demanding, but catchers (n = 16) disliked upright catching (more labor-intensive). This study revealed animal welfare benefits of upright versus inverted (less wing flapping, better catcher-bird interaction) and mechanical catching (less catch damage), whereas mechanical catching provided the best labor conditions. Widespread application of upright catching would require testing of entire flocks and collaboration with the poultry sector to determine fair compensation, improve labor conditions and identify strategies to minimize catch and load duration.
Luca Cavaggioni, Luca Cavaggioni, Damiano Formenti
et al.
IntroductionBasketball practice for athletes with intellectual disabilities (ID) is an ancient activity that stimulates cognitive and motor performance domains. This study aims to verify the association between cognitive performance and motor abilities in basketball athletes with ID.MethodsA total of 23 participants with ID were screened on cognition (clinical reaction time and Bells test 30 s and 90 s), motor performance [handgrip strength test (HST), countermovement jump (CMJ), static balance], and anthropometry [body mass index (BMI) and skinfolds] in a cross-sectional design.ResultsA strong negative relationship was observed between clinical reaction time with HST and CMJ variables. A strong positive association was also found between Bells test 30 s with anthropometric variables (BMI) and power-related CMJ outcomes. Linear regression models revealed that the CMJ concentric mean force explained 34.3% of the variance of performance time during the clinical reaction time, and the HST combined with BMI explained 53% of the variance of cognitive ability during the Bells test 30 s.ConclusionsThese results suggest a positive correlation between cognitive and motor performance in basketball players with ID. These findings encourage further exploration of how sports interventions could ameliorate physical and cognitive health in individuals with ID.
Christopher J D'Lauro, E. R. Jones, Lily Mc Swope
et al.
Objective We aimed to quantify the female athlete composition of the research data informing the most influential consensus and position statements in treating sports-related concussions. Design We identified the most influential concussion consensus and position statements through citation and documented clinician use; then, we analysed the percentage of male and female athletes from each statement’s cited research. Data sources We searched PubMed on 26 August 2021 with no date restrictions for English language studies using the terms ‘concussion position statement’ and ‘concussion consensus statement.’ Eligibility criteria for selecting studies Based on each statement having multiple statement editions, documented clinician use, and substantial citation advantages, we selected the National Athletic Trainers’ Association (NATA, 2014), International Conference on Concussion in Sport (ICCS, 2017) and the American Medical Society for Sports Medicine (AMSSM, 2019). We extracted all cited studies from all three papers for assessment. For each paper analysing human data, at least two authors independently recorded female athlete participant data. Results A total of 171 distinct studies with human participants were cited by these three consensus and position papers and included in the female athlete analyses (93 NATA; 13 ICCS; 65 AMSSM). All three statements documented a significant under-representation of female athletes in their cited literature, relying on samples that were overall 80.1% male (NATA: 79.9%, ICCS: 87.8 %, AMSSM: 79.4%). Moreover, 40.4% of these studies include no female participants at all. Conclusion Female athletes are significantly under-represented in the studies guiding clinical care for sport-related concussion for a broad array of sports and exercise medicine clinicians. We recommend intentional recruitment and funding of gender diverse participants in concussion studies, suggest authorship teams reflect diverse perspectives, and encourage consensus statements note when cited data under-represent non-male athletes.
In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric anterior cruciate ligament (ACL) injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery and Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America, and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis, and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
This study aims to analyze the effect of Psychological Skills Training (PST), which includes goal setting, imagery, relaxation, and self-talk, on high school volleyball team players in terms of athletes’ ability to cope with sportive problems and selected performance strategies. The study groups for this research were determined in two steps. In the first step, high schools in Mersin's central districts and those carrying out educational activities with the same curriculum were reviewed so that the study groups would have similar characteristics. With the purposeful sampling method, nine Anatolian High schools located in non-vocational Anatolian type-high schools and preparing for competitions in volleyball, a young female category was determined, and two of these high schools were suitable for the study. In the second step, two high school teams were assigned as experimental groups (n = 14) and control groups (n = 14) by drawing lots. The mean ages of the participants were 14.93 (SD = .730) and 15.14 (SD = .770) for the experimental and control groups, respectively. The Personal Information Form, Coping Scale with Sports Problems (ACSI-28), and Performance Strategies Test (TOPS) were used as data collection tools. In the data analysis, a two-factor ANOVA test was used for mixed measurements. As a result, it was found that PST carried out in the school environment has no effect on athletes' ability to cope with sports problems or performance strategies other than imagery in training.
Pedro Poggiali, MD, Jared M. May, BS, Jill E. Larson, MD
et al.
ABSTRACT: Background: Clubfoot occurs in 30% of patients with myelomeningocele (MM) and is the most frequent foot deformity in patients with arthrogryposis (ART). Patients have high recurrence rates with more conservative interventions and may require talectomy. This study investigated the long-term clinical outcomes of talectomy in patients with MM and ART and identified factors associated with favorable outcomes. Methods: A retrospective chart review was performed on cases of clubfoott in MM and ART between 1975 and 2010, excluding if follow-up was <5 years or had incomplete charts. A plantigrade, stable, and braceable foot was graded as a good result. Statistical analysis included descriptive statistics, chi-square with continuity correction, Spearman correlation, and Mann-Whitney, with P < .05 reaching significance. Results: In total, 944 cases of clubfoot in patients with MM and ART were identified. Of those, 53 underwent talectomy and 31 feet were included in the analysis. Average age on talectomy date was 4.16 ± 2.46 years and the mean follow-up since surgery was 15.71 ± 8.43 years. “Good results” were found in 24 (77.4%) feet, while 7 feet (22.6%) required additional surgery. Older age at talectomy date was associated with good results at the last clinical visit (P = .03). Primary talectomies were associated with more subsequent surgeries per foot when compared with salvage talectomies (P = .03). A Functional Mobility Scale (FMS) of 3-1-1 or higher was associated with a good outcome (P = .022) and all “poor results” (7 feet, 22.6%) were found in patients with FMS lower than 3-1-1. Conclusions: Talectomy was performed in 5.6% of cases, demonstrating its rare use in treatment of clubfoot in patients with MM and ART. Nevertheless, these long-term outcomes demonstrate that talectomy surgery may be a good option for the treatment of nonidiopathic clubfoot. Good outcomes are maintained at long-term follow-up, suggesting a satisfactory correction remained until adulthood. Finally, a higher FMS was a predictor of success, suggesting that this procedure should be performed in ambulatory patients. Key Concepts: (1) Talectomy remains a rare procedure, utilized in only 5.6% of clubfoot cases of patients with myelomeningocele or arthrogryposis. (2) “Good” results, defined as a plantigrade, stable, and braceable foot was achieved in 77.4% of patients. (3) Older age at time of talectomy was associated with improved results. (4) A Functional Mobility Scale (FMS) of 3-1-1 or higher was associated with good outcomes and thus may be a predictor of success. Level of Evidence: Level IV
We report the case of a young professional soccer player who underwent cardiac MRI (CMR) for work-up of discrete intermittent chest pain and subtle ST segment elevations in the ECG after having been tested positive for SARS-CoV-2 type B.1.1.529 despite full vaccination including recent mRNA booster. Troponin levels were significantly increased and myocarditis was suspected. Comprehensive CMR including CINE and late gadolinium enhancement as well as multi-parametric T1/T2 mapping techniques revealed local hypokinesia and swelling of the posterolateral wall with non-ischemic late gadolinium enhancement and increased T2 relaxation time compatible with acute viral myocarditis. The patient was admitted to a cardiology ward for rhythm and troponin monitoring and was discharged after two days of uneventful rhythm monitoring and with decreased troponin levels. Adhering to current recommendations the patient was advised to abstain from moderate- to high-intensity sports and exercise for 3-6 months. After 6 months of exercise avoidance, follow-up ECG showed regression of prior ST segment elevations, and Holter ECG as well as a treadmill exercise stress test did not reveal any abnormalities. Follow-up CMR was performed before return-to-sports which revealed persisting myocardial fibrosis but complete regression of myocardial edemam and excluded ongoing inflammation. This example underscores the value of multi-parametric CMR tissue characterization for the work-up of suspected SARS-CoV-2 associated myocarditis, as well as for follow-up before return-to-sports.Key Words: COVID-19, Late Gadolinium Enhancement, Cardiovascular MR, Myocardial Mapping