The importance of using infrared thermography (IRT) to assess skin temperature (tsk) is increasing in clinical settings. Recently, its use has been increasing in sports and exercise medicine; however, no consensus guideline exists to address the methods for collecting data in such situations. The aim of this study was to develop a checklist for the collection of tsk using IRT in sports and exercise medicine. We carried out a Delphi study to set a checklist based on consensus agreement from leading experts in the field. Panelists (n = 24) representing the areas of sport science (n = 8; 33%), physiology (n = 7; 29%), physiotherapy (n = 3; 13%) and medicine (n = 6; 25%), from 13 different countries completed the Delphi process. An initial list of 16 points was proposed which was rated and commented on by panelists in three rounds of anonymous surveys following a standard Delphi procedure. The panel reached consensus on 15 items which encompassed the participants' demographic information, camera/room or environment setup and recording/analysis of tsk using IRT. The results of the Delphi produced the checklist entitled "Thermographic Imaging in Sports and Exercise Medicine (TISEM)" which is a proposal to standardize the collection and analysis of tsk data using IRT. It is intended that the TISEM can also be applied to evaluate bias in thermographic studies and to guide practitioners in the use of this technique.
Michelle H. Lee, Eveline Febriana, Maybritte Lim
et al.
Summary: Background: Postprandial glucose concentration 1-h (1 h-PG) after an oral glucose tolerance test (OGTT) has similar or superior performance to 2 h-PG in predicting type-2 diabetes mellitus (T2DM) in several populations, and is simpler to obtain in clinical practice. However, studies in Asians are scarce. We investigated the utility of elevated baseline 1 h-PG in predicting T2DM incidence within three years, and its relationship with β-cell function in 1250 non-diabetic Asian participants. Methods: Participants underwent an OGTT, an intravenous glucose challenge and a hyperinsulinemic-euglycemic clamp to determine glucose tolerance, acute insulin response (AIR) and insulin sensitivity at baseline. OGTTs were repeated every six months until study completion to monitor T2DM conversion. Findings: The area under the receiver operating characteristic curve of 1 h-PG was not significantly different from 2 h-PG (AUC1h-PG = 0.883 vs. AUC2h-PG = 0.907; ΔAUC = −0.024, P = 0.124) and the optimal 1 h-PG cut-off was ≥10.7 mmol/L. When groups of high/low 1 h-PG and 2 h-PG at baseline were compared, AIR and disposition index were significantly lower in groups with high 1 h-PG, and both had a stronger correlation with 1 h-PG, indicating that impaired β-cell function was more strongly associated with elevated 1 h-PG than 2 h-PG. Interpretation: The ability of 1 h-PG to detect Asians at risk of developing T2DM within three years is on par with 2 h-PG and the optimal cut-off is 10.7 mmol/L. Elevated 1 h-PG is associated with β-cell dysfunction. We conclude that 1 h-PG can be considered as a primary OGTT time point to identify Asians at risk for T2DM, allowing for screening at a reduced time and cost, and with lower patient burden. Funding: National Medical Research Council (NMRC), Ministry of Health (MOH; Singapore) Industry Alignment Fund [NMRC/MOHIAFCat1/0048/2016] and Janssen Pharmaceuticals Inc. (USA).
Abstract Background Sleep quality decreased can result in a major health issue in older people with age. While not all sleep changes are pathological in older people’s life, severe disturbances may lead to depression, cognitive impairments, deterioration of quality of life, significant stresses for careers and increased healthcare costs. Despite the known benefits of exercise for improving sleep quality, it is necessary to identify the optimal exercise type and dose. Objective This systematic review and network meta-analysis (NMA) combined to examine evaluated the existing evidence on the effectiveness of different exercises, and to examine the dose and response relationship between overall and specific types with improving sleep quality in older people. Methods PubMed, Cochrane Central, Web of Science, and Embase were systematically searched for this review, including studies up to April 2025. Only randomized controlled trials were included. Studies involved at least one type of exercise intervention and reported changes in sleep quality assessments. To address the limitations of relying solely on statistical significance, we also calculated the minimal clinically important difference (MCID) to determine the smallest meaningful improvement in sleep quality among older people, both overall and across different exercise doses. Data analysis and visualization were conducted using the “meta”, “netmeta”, “MBNMA”, and “ggplot2” packages in the R environment. Results A total of 62 RCTs involving 5005 older adults were included. Overall, exercise significantly improved sleep quality, with clinically meaningful improvements achieved from as early as 5 weeks of intervention. The optimal exercise type was combined aerobic and resistance training, followed by aerobic exercise, resistance training, walking, and yoga. The estimated optimal exercise dose was around 660 to 990 METs*min/week, with longer durations at 15 weeks producing the greatest benefits. Improvements were more pronounced among participants with poorer baseline sleep quality. Conclusion If older people receive the most appropriate exercise intervention, they can obtain clinically meaningful benefits of improving sleep in the elderly within the WHO guidelines for exercise doses. The results support the WHO recommendation that combine aerobic exercise and resistance training should be an important part of interventions for the older people. Protocol registration PROSPERO registration number: CRD42024566751. Graphical Abstract
Cody Ashy MD, Paul Pottanat MD, Harris Slone MD
et al.
Background: Anterior shoulder instability is associated with Hill-Sachs lesions (HSLs) in 40% to 90% of cases. When addressing anterior shoulder instability, unaddressed engaging or “off-track” HSL have a recurrence rate of 75%. Remplissage is a known technique to address recurrent instability in the setting of an engaging HSL. In this video, we demonstrate that a double-anchor-pulley technique may be used to address recurrent instability in the setting of engaging HSL. Indications: Patients with recurrent anterior shoulder instability with off-track HSL in patients with glenoid bone loss <20% are candidates for arthroscopic Remplissage. Technique Description: Patients are placed in the lateral decubitus position. Examination under anesthesia is performed to assess for degree of instability and engagement of HSL. Posterior, anterosuperior, and anteroinferior portals are established. Routine diagnostic arthroscopy is performed with identification of the HSL. While viewing from an anterosuperior portal and working through the posterior portal, the HSL bed is prepared with curettage and a bur. A 5.5-mm accessory Cannula is used through an accessory posterior portal. Two knotless all-suture self-tensioning anchors are placed in the anterior and inferior aspect of the defect, passed through the cannula, and tagged for later identification. Bankart stabilization is performed. The knotless anchors are linked to each other to perform a knotless repair with a broad area of compression. Results: Results are excellent with only a 5.6% failure rate, significant patient improvement, low complication rate, and 95.5% return to play. Discussion: We demonstrate the technical aspects of an all-arthroscopic Remplissage technique using all-suture knotless anchors to provide a simple and reproducible method of performing a Remplissage. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Olga Śpiołek, Jan Siwiec, Aleksandra Słowikowska
et al.
Introduction and purpose: Sarcoidosis is a complex, multi – system disease characterized by the formation of non – caseating granulomas that can affect nearly every organ in the body, though lungs and lymph nodes are the most commonly involved. The disease's clinical presentation is highly variable, ranging from asymptomatic cases to severe, organ-threatening manifestations, with significant implications for diagnosis and treatment. The aim of this study is to present current state of knowledge on clinical features, etiology, diagnosis and treatment methods of sarcoidosis.
Materials and methods: The review is based on the analysis of literature available on Pubmed, Google Scholar and UpToDate databases. To search for relevant scientific content the following keywords were used: sarcoidosis, symptoms, etiology, diagnosis, treatment, neurosarcoidosis, cutaneous sarcoidosis, cardiac sarcoidosis, Löfgren syndrome.
Conclusions: Despite numerous studies, the cause of sarcoidosis still remains unknown, which leaves a field for researchers for further investigation. Diagnosis of sarcoidosis is challenging, it typically involves histological confirmation through biopsy, supported by imaging studies, laboratory tests and need to exclude other causes. Treatment is limited, focused on alleviating the symptoms and preventing organ failure, therefore further research into more effective or targeted therapies is advisable.
Juliane Hannemann, Juliane Hannemann, Julius Freytag
et al.
Introduction: High altitude exposure may lead to high altitude pulmonary hypertension (HAPH) and high altitude pulmonary edema (HAPE). The pathophysiologic processes of both entities have been linked to decreased nitric oxide (NO) availability.Methods: We studied the effect of acute high altitude exposure on the plasma concentrations of asymmetric (ADMA) and symmetric dimethylarginine (SDMA), L-arginine, L-ornithine, and L-citrulline in two independent studies. We further investigated whether these biomarkers involved in NO metabolism were related to HAPH and HAPE, respectively. Fifty (study A) and thirteen (study B) non-acclimatized lowlanders were exposed to 4,559 m for 44 and 67 h, respectively. In contrast to study A, the participants in study B were characterized by a history of at least one episode of HAPE. Arterial blood gases and biomarker concentrations in venous plasma were assessed at low altitude (baseline) and repeatedly at high altitude. HAPE was diagnosed by chest radiography, and HAPH by measuring right ventricular to atrial pressure gradient (RVPG) with transthoracic echocardiography. AMS was evaluated with the Lake Louise Score (LLS) and the AMS-C score.Results: In both studies SDMA concentration significantly increased at high altitude. ADMA baseline concentrations were higher in individuals with HAPE susceptibility (study B) compared to those without (study A). However, upon high altitude exposure ADMA only increased in individuals without HAPE susceptibility, while there was no further increase in those with HAPE susceptibility. We observed an acute and transient decrease of L-ornithine and a more delayed but prolonged reduction of L-citrulline during high altitude exposure. In both studies SDMA positively correlated and L-ornithine negatively correlated with RVPG. ADMA was significantly associated with the occurrence of HAPE (study B). ADMA and SDMA were inversely correlated with alveolar PO2, while L-ornithine was inversely correlated with blood oxygenation and haemoglobin levels, respectively.Discussion: In non-acclimatized individuals ADMA and SDMA, two biomarkers decreasing endothelial NO production, increased after acute exposure to 4,559 m. The observed biomarker changes suggest that both NO synthesis and arginase pathways are involved in the pathophysiology of HAPH and HAPE.
A. Tenforde, Mary A Iaccarino, H. Borgstrom
et al.
The global pandemic due to SARS‐CoV‐2 has resulted in an expansion of telemedicine. Measures of quality and barriers for rapid use by patients and physicians are not well described.
Magdalena Choina, Kinga Pożarowska, Gracjan Rudziński
et al.
Introduction: Celiac disease (CD) is an autoimmune disease that affects genetically predisposed individuals. In course of the disease, consumption of gluten causes damage to the small intestine. Due to various clinical manifestations, diagnosing CD poses a challenge to clinicians. It has been proven by several study groups that the diagnostic delay in CD is still too long and provokes severe health complications.
Purpose: The aim of the study is to highlight the importance of diagnostic delay in CD, its consequences and possible solutions.
Description of the state of knowledge: The diagnosis of CD is based on the clinical picture, serological test, duodenal mucosal biopsies and genetic tests. Many cases of CD remain undiagnosed in spite of published guidelines for CD diagnosis. Consequently, the diagnosis is significantly delayed: the mean duration of the diagnostic process in Poland was 7.3 years. In other countries, patients the time from the onset of the symptoms to establishing CD diagnosis was up to 10 years. The diagnostic delay leads to reduced quality of life and the development of severe complications, such as neoplastic disease.
Summary: Diagnostic delay in CD is an issue of great importance. Because of the reduced quality of life and the possibility of neoplasm, it is crucial to take action in order to shorten the diagnostic process of CD.
Celina Albanus, Travis Heggie, Simone Kattner
et al.
Background: Water quality for tourists visiting South Luangwa National Park and other less developed regions is of the utmost importance in order to avoid gastrointestinal infections; one of the most common diseases among tourists. It is also important to the health of the local tourist accommodations and the local tourist economy.
Methods: Water quality samples assessing microbiological contamination were taken from the borehole and point of use in 14 tourist lodges and camps. Turbidity was assessed optically with a DelAlgua turbidity tube. For microbiological analysis, samples were incubated in the DelAgua Dual Incubator at 37°C and 44°C. Thermotolerant Escherichia coli (E. coli) was used as the
indicator bacterium for fecal pollution. Water samples were classified based of risk levels for pollution determined by the World Health Organization (WHO).
Results: Fifty percent of borehole samples showed no contamination. Two were found to be at high risk and the others ranged between low and intermediate risk. At the point of use, 80% of the samples were clean and compliant with WHO guidelines. Water contamination generally improved from the borehole to point of use. Turbidity at borehole samples were clear in 75% of possible samples. At the point of use, turbidity was clear in 81% of samples.
Conclusion: This study establishes the first baseline water quality data for tourist facilities at South Luangwa National Park in Zambia. While water quality at most sites is clean for human use, a regular monitoring system accompanied by maintenance is recommended.
The COVID-19 outbreak has brought our lives to a sudden and complete lockdown. While the numbers of confirmed cases and deaths continue to rise, people around the world are taking brave actions to mitigate transmission and save lives. The role that sports play in this pandemic is unprecedented, fascinating, and reveals the immense impact sports has on every aspect of our lives. We must all do our part to keep each other safe until this outbreak subsides and sports and humanity are back to being greater than ever. Level of Evidence Level V.
Knowledge from research evidence is wasted unless it is applied. While the scientific evidence base for many sports and exercise medicine and sports physical therapy interventions is robust, real-world implementation and evolution to scale remains an ongoing challenge. Dissemination and implementation research is important to generate evidence-informed, cost-effective and context-specific strategies for implementation partners and stakeholders to effectively apply and sustain the best research evidence in public health and clinical practice. However, this field of inquiry remains underexplored in sports and exercise medicine and sports physical therapy. Most intervention studies in sports and exercise medicine and sports physical therapy are terminated at the efficacy trial stage without considerations for best practices for translation to community and clinical settings. Lack of context-specific dissemination and implementation strategies to drive the translation of evidence-based interventions results in poor execution of, and attrition from, interventions, and this is associated with suboptimal outcomes and increased healthcare costs. Theory-driven quality research informing the successful dissemination and implementation of evidence-based interventions is needed to address lingering evidence-to-practice gaps. Dissemination and implementation research completes the final stage in the research-to-practice pipeline. It seeks to close evidence-to-practice gaps, thereby ensuring speedy application of research evidence to achieve desired public health outcomes while making more efficient use of limited resources. This review introduces sports and exercise medicine and sports physical therapy researchers and stakeholders to key concepts and principles in dissemination and implementation research.
Aristides I. Cruz, Jr., MD, MBA, Jennifer J. Beck, MD, Matthew D. Ellington, MD
et al.
Background:. Graft choice for pediatric anterior cruciate ligament reconstruction (ACLR) is determined by several factors. There is limited information on the use and outcomes of allograft ACLR in pediatric patients. The purpose of this systematic review and meta-analysis was to quantify reported failure rates of allograft versus autograft ACLR in patients ≤19 years of age with ≥2 years of follow-up. We hypothesized that there would be higher rates of failure for allograft compared with autograft ACLR in this population.
Methods:. PubMed/MEDLINE and Embase databases were systematically searched for literature regarding allograft and autograft ACLR in pediatric/adolescent patients. Articles were included if they described a cohort of patients with average age of ≤19 years, had a minimum of 2 years of follow-up, described graft failure as an outcome, and had a Level of Evidence grade of I to III. Qualitative review and quantitative meta-analysis were performed to compare graft failure rates. A random-effects model was created to compare failure events in patients receiving allograft versus autograft in a pairwise fashion. Data analysis was completed using RevMan 5.3 software (The Cochrane Collaboration).
Results:. The database search identified 1,604 studies; 203 full-text articles were assessed for eligibility. Fourteen studies met the inclusion criteria for qualitative review; 5 studies were included for quantitative meta-analysis. Bone-patellar tendon-bone (BTB) represented 58.2% (n = 1,012) of the autografts, and hamstring grafts represented 41.8% (n = 727). Hybrid allografts (autograft + supplemental allograft) represented 12.8% (n = 18) of all allograft ACLRs (n = 141). The unweighted, pooled failure rate for each graft type was 8.5% for BTB, 16.6% for hamstring, and 25.5% for allograft. Allografts were significantly more likely than autografts to result in graft failure (odds ratio, 3.87; 95% confidence interval, 2.24 to 6.69).
Conclusions:. Allograft ACLR in pediatric and adolescent patients should be used judiciously, as existing studies revealed a significantly higher failure rate for allograft compared with autograft ACLR in this patient population. Additional studies are needed to improve the understanding of variables associated with the high ACLR failure rate among pediatric and adolescent patients.
Level of Evidence:. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Małgorzata Drozd, Magdalena Marzęda, Agnieszka Blicharz
et al.
<p><strong>Introduction and purpose: </strong>Acne vulgaris, the most common skin disease, causes medical, esthetic and psychosocial problems. Isotretinoin, the vitamin A-derivative, has been the most effective treatment for acne vulgaris. It provides significant improvement and long-term remission. However, it leads to multiple side effects. The aim of our study was to evaluate the prevalence of adverse effects in patients treated with isotretinoin and analyze the most commonly reported symptoms.</p><p><strong>Material and methods</strong>: The study was conducted using original survey questionnaire addressed to members of Polish group of patients treated with isotretinoin. 196 responds were collected and confronted with current PubMed publications.<strong></strong></p><p><strong>Results: </strong>The most common mucocutaneous side effects, such as dry lip, dryness of the mucous membranes, xerodermia and dryness of the conjunctiva occurred in 92,6%, 73,5%, 66,8% and 66,3% of respondents, respectively. Both, tiredness and back pain were reported by 70,4% of respondents; myalgia - 55,1%, arthalgia - 32,1% and stiffness of joints - 26,0%. Mood change occurred in 54,6%, hair loss in 50,0%, gastrointestinal symptoms, such as abdominal pain and diarrhea – in 15,8% and 10,7%.</p><p><strong>Conclusions: </strong>All of the most common isotretinoin side effects are usually mild and dose-dependent. However, their prevalence is very high. Isotretinoin’s association to depression and suicidality remains unclear. In spite of the previous data, the risk of inflammatory bowel disease is probably not increased in patients isotretinoin exposed. However, more studies are necessary.</p>
Nutritional therapy, also known as clinical treatment is an important component of modern treatment of patients in each of the Polish hospital wards. It includes nutritional assessment, evaluation nutritive requirements and nutritive, an adequate supply of proteins, fats, electrolytes, trace elements and water, taking advantage of the way the gastrointestinal tract, or by intravenous administration [4,5]. In Poland in the Regulation of the Minister of Health of 15 September 2011, the assessment of the nutritional status of the patient, taken on the hospital ward is mandatory excluding patients from emergency departments [6,7,8]. Malnutrition is a disease of multifactorial etiology, in the diagnosis, which plays a very important role cooperation of the whole therapeutic team - nutrition. The nurse, as a member of the team, plays an essential role in the prevention and diagnosis of malnutrition in patients staying in intensive care. Nursing staff, the first to have direct contact with patients, exercising care over him. Direct contact and careful observation, to allow diagnosis of early symptoms of malnutrition [10].
Keywords: malnutrition, nurse, prevention