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Objectives: To establish muscle-strength and -balance profiles for shoulder external rotation (ER) and internal rotation (IR) in master's swimmers. Design: Cross-sectional study. Setting: Laboratory. Participants: Six male and seven female master's swimmers and a matched control group. Measurements: Concentric and eccentric ER and IR shoulder movements were recorded (Kin-Com(TM) isokinetic dynamometer). Peak-torque values, concentric ER:IR ratios, eccentric ER:IR (conventional) ratios, and eccentric ER:concentric IR (functional) ratios were examined between groups. Results: Mean peak-torque values ranged from 21.23 to 37.69 N x m for the swimmers, which, although 15% to 27% greater than those of the controls, were not statistically different. Conventional (0.78:0.86) and functional (1.06:1.17) ratios did not differ between groups. Conclusions: These data will contribute to the development of guidelines for assessing shoulder-muscle strength in Master's swimmers. [ABSTRACT FROM AUTHOR]

Otopalatodigital spectrum disorders ( OPDSD) include OPD syndromes types 1 and type 2 ( OPD1, OPD2), Melnick-Needles syndrome ( MNS), and frontometaphyseal dysplasia ( FMD). These conditions are clinically characterized by variable skeletal dysplasia associated in males, with extra-skeletal features including brain malformations, cleft palate, cardiac anomalies, omphalocele and obstructive uropathy. Mutations in the FLNA gene have been reported in most FMD and OPD2 cases and in all instances of typical OPD1 and MNS. Here, we report a series of 10 fetuses and a neonatally deceased newborn displaying a multiple congenital anomalies syndrome suggestive of OPDSD and in whom we performed FLNA analysis. We found a global mutation rate of 44%. This series allows expanding the clinical and FLNA mutational spectrum in OPDSD. However, we emphasize difficulties to correctly discriminate OPDSD based on clinical criteria in fetuses due to the major overlap between these conditions. Molecular analyses may help pathologists to refine clinical diagnosis according to the type and the location of FLNA mutations. Discriminating the type of OPDSD is of importance in order to improve the genetic counseling to provide to families. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the incidence and causes of acute tenosynovitis of the forearm of long distance canoeists.Method: A systematic sample of canoeists competing in four canoe marathons were interviewed. The interview included questions about the presence and severity of pain in the forearm and average training distances. Features of the paddles and canoes were determined.Results: An average of 23% of the competitors in each race developed this condition. The incidence was significantly higher in the dominant than the nondominant hand but was unrelated to the type of canoe and the angle of the paddle blades. Canoeists who covered more than 100 km a week for eight weeks preceding the race had a significantly lower incidence of tenosynovitis than those who trained less. Environmental conditions during racing, including fast flowing water, high winds, and choppy waters, and the paddling techniques, especially hyperextension of the wrist during the pushing phase of the stroke, were both related to the incidence of tenosynovitis.Conclusion: Tenosynovitis is a common injury in long distance canoeists. The study suggests that development of tenosynovitis is not related to the equipment used, but is probably caused by difficult paddling conditions, in particular uneven surface conditions, which may cause an altered paddling style. However, a number of factors can affect canoeing style. Level of fitness and the ability to balance even a less stable canoe, thereby maintaining optimum paddling style without repeated eccentric loading of the forearm tendons to limit hyperextension of the wrist, would seem to be important. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to compare the electromyographic (EMG) activity of gluteal and thigh muscles of sportspeople with a recent hamstring injury with uninjured controls during a weight-bearing task. Study design Cross-sectional. Setting University laboratory. Participants 16 participants with a hamstring injury (hamstring-injured group, HG) and 18 control participants (control group (CG)) participated in the study. Main outcome measure The EMG activity of gluteal, quadriceps and hamstring muscles was recorded during a movement from double- to single-leg movement using surface electrodes. Results The EMG onsets of biceps femoris and medial hamstrings were significantly earlier for the HG injured and the uninjured sides in preparation for single-leg standing when compared with the CG average. There were no differences in onsets for the gluteal and quadriceps muscles when comparing the injured or uninjured legs of the HG to the bilateral average of the CG. Conclusion The earlier onset of the injured and the uninjured hamstrings in preparation for single leg stance of the HG in comparison with the CG suggests an alteration in the motor control of these muscles. Altered neuromuscular control following a hamstring injury may be a factor to be considered in the rehabilitation of hamstring injuries. [ABSTRACT FROM AUTHOR]

The effect of an accelerometer driven electronic postural monitor (Spineangel®) placed within the electromagnetic measurement field of the Polhemus Fastrak™ is unknown. This study assessed the reliability and accuracy of Fastrak™ linear and angular measurements, when the Spineangel® was placed close to the sensor(s) and transmitter. Bland Altman plots and intraclass correlation coefficient (2,1) were used to determine protocol reproducibility and measurement consistency. Excellent reliability was found for linear and angular measurements (0.96, 95% CI: 0.90-0.99; and 1.00, 95% CI: 1.00-1.00, respectively) with the inclusion of Spineangel®; similar results were found, without the inclusion of Spineangel®, for linear and angular measurements, (0.96, 95% CI: 0.89-0.99; and 1.00, 95% CI: 1.00-1.00, respectively). The greatest linear discrepancies between the two test conditions were found to be less than 3.5 mm, while the greatest angular discrepancies were below 3.5°. As the effect on accuracy was minimal, these findings support the conjoint use of the Fastrak™ during validation studies of the Spineangel® device. Statement of Relevance: Although previous studies have used the Fastrak™ as the gold standard measurement system, the influence of an accelerometer driven postural monitor on accuracy has not been reported. The strength of the present study has been to determine the effect of accelerometer placement within the electromagnetic field on the reliability and accuracy of the Fastrak™. [ABSTRACT FROM AUTHOR]

Multiple mitochondrial DNA (mtDNA) deletions usually have a mendelian inheritance secondary to mutation in nuclear genes. One of these is the Twinkle gene whose mutation is responsible for autosomal dominant progressive external ophthalmoplegia (PEO). The number of reported cases with mainly myopathic symptoms and possible nervous system involvement related to Twinkle gene mutation is limited. We present a new French family of whom two members displayed myopathy and neuropathy associated with PEO, and we perform a clinical review in light of other observations reported in the literature. The proband, one son and the daughter have been investigated. Southern blot analysis and long-range PCR assay have been performed from muscle biopsy specimens. Coding exons and flanking intron regions of polymerase gamma ( POLG) and DNA helicase ( Twinkle) genes were sequenced. Multiple mitochondrial DNA deletions have been found and sequencing of the Twinkle gene showed the change p.R374Q. Two other families from the literature also had the R374Q mutation. Symptoms reported in association with this mutation were myopathy, peripheral neuropathy, dysarthria and/or dysphagia, respiratory insufficiency and parkinsonism. Respiratory insufficiency caused by chest wall weakness was reported in other families with different Twinkle gene mutations, and one might provide exercise intolerance, dysarthria and/or dysphagia as symptoms in favor of the diagnosis. Occurrence of impressive emaciation was a peculiarity in our family. [ABSTRACT FROM AUTHOR]

Hamstring injuries are common in running and sprinting sports and have a high recurrence rate. Prevention and management of these injuries has focused on traditional outcomes of strength, flexibility and endurance. The aim of this review is to explore the stabilising function of the hamstring muscle group, described as increasing the stiffness of the sacro-iliac and the knee joints during weight acceptance of stance. Loss of stability of segments proximal or distal to the hamstring muscles may lead to altered muscle recruitment, potentially increasing the loading of this muscle group and, thereby, posing an increased injury risk. Intrinsic risk factors to be considered are previous knee, groin or lumbopelvic injuries; extrinsic factors include footwear and training surfaces. The effect of physiotherapy interventions on the stabilising function of the hamstrings needs to be investigated. Such research will contribute to a clearer understanding of the reasons for the high injury recurrence rate of this muscle group. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study describes a new method to detect autoantibodies against actin filaments (AAA) as a serological marker of intestinal villous atrophy (IVA) in celiac disease (CD), and reports the results of an Italian double-blind multicenter study.METHODS: IgA-AAA were analyzed by immunofluorescence using a newly developed method based on intestinal epithelial cells cultured in presence of colchicine. IgA-AAA were blindly evaluated prospectively in 223 antiendomysial antibody (AEA) and/or antitransglutaminase antibody (TGA) positive subjects and in 78 AEA and TGA negative subjects. IgA-AAA positive patients underwent an intestinal biopsy to confirm the diagnosis. Moreover, IgA-AAA were retrospectively investigated in 84 biopsy-proven CD patients and in 2,000 new consecutively collected serum samples from AEA and TGA negative nonbiopsied subjects.RESULTS: IgA-AAA were positive in 98.2% of the CD patients with flat mucosa, in 89% with subtotal villous atrophy, and in 30% with partial villous atrophy. IgA-AAA were present in none of the AEA and TGA negative nonbiopsied controls. In AEA and/or TGA positive CD patients IgA-AAA positivity significantly correlated with IVA (p<0.000 in the prospective study,p= 0.005 in the retrospective study). In the prospective study, the values of sensitivity, specificity, the positive predictive value, the negative predictive value, and the efficiency of the IgA-AAA test to identify patients with IVA were, respectively, 83.9%, 95.1%, 97.8%, 69.2%, and 87.0%. Furthermore, a significant correlation (p<0.0001) was found between the IgA-AAA serum titre and the degree of IVA (rs 0.56).CONCLUSIONS: The results of this multicenter study show that the new method for IgA-AAA detection could represent a practical diagnostic tool in AEA and/or TGA positive subjects, which would be especially useful when IVA shows a patchy distribution, when the histological picture is difficult to interpret, or when a biopsy could represent a life-threatening risk. [ABSTRACT FROM AUTHOR]

Objective To quantify the risks of urothelial cancer associated with smoking cigarettes. Subjects and methods Histories were taken from 989 patients diagnosed with urothelial cancer, 2059 electoral register controls and 1599 General Practitioner controls. Histories of patients and controls were compared by means of logistic regression. Results Statistically significant trends were observed for the risk of urothelial cancer to increase with estimated lifetime consumption of cigarettes. Among ex-smokers, risks reduced with time since quitting, and ex-smokers who quit 20 or more years ago experienced risks similar to lifelong non-smokers. Type of cigarette was not an important predictor of risk. The two control series provided estimates of 45% and 33% respectively for the percentage of cancers in the series attributable to cigarette smoking. Conclusion Cigarette smoking is the single most important cause of urothelial cancer, but stopping smoking leads quickly to reductions in risk. [ABSTRACT FROM AUTHOR]

Onchocerciasis, or river blindness, results from infection with Onchocerca volvulus. The parasite is endemic to West Africa, in both rain forest and savanna bioclimes. Several lines of evidence suggest that different strains of the parasite exist in the rain forest and savanna. Furthermore, epidemiologic evidence indicates that ocular onchocerciasis is most severe in savanna regions. This has led to the hypothesis that there is a strain association with ocular pathology. To test this hypothesis, parasites from villages in which severe and mild onchocerciasis were endemic were classified with two strain-specific DNA probes. A strong correlation (P < .001) was found between disease severity and probe recognition, supporting the hypothesis that pathogenicity is strain related. The results suggest that pFS-l and pSS-lBT may be used to predict the pathogenic potential of parasite populations throughout much of West Africa. [ABSTRACT FROM PUBLISHER]

- Partial ureteric duplication may cause delayed drainage of urine from the upper tracts because of ureteroureteric 'see-saw' reflux. This can be eliminated by the procedure of ureteropyelostomy, in which the partially duplicated ureter is converted into a bifid renal pelvis. This operation leaves a short anastomotic suture line and has a low complication rate. e report seven patients who have undergone ureteropyelostomy for symptomatic ureteroureteric reflux. All remain symptom-free after follow-up for a minimum of 1 year. [ABSTRACT FROM AUTHOR]

Ethiopia is the African country with the largest number of cattle (26 million). Because of the potential impact of cattle on the transmission and severity of trachoma, the major cause of blindness in the country, an attempt is made to document this association to justify the inclusion of the control of cattle pollution in the prevention of blindness. The prevalence of trachoma is lower in pastoralists who herd mainly camels than in pastoralists who herd mainly cattle. In the first group the prevalences of moderate and severe trachoma in children under 10 are 0.9% and trichiasis/entropion in the total population 0.2%, whereas in the second group the prevalences are 45.1% and 4.0% respectively. In Borana pastoralists with and without cattle the prevalence ratio for moderate and severe trachoma is 1.0, whereas the prevalence ratios for severe trachoma and conjunctivitis were higher in the group with cattle, 2.5 and 3.0 (p less than 0.001 for both). The elimination of cattle pollution should reduce the prevalence of severe trachoma by 45.4%. This is the first study presenting evidence of an association between cattle and trachoma. On the basis of this study a strong recommendation is made to the Ministry of Health to control cattle pollution in rural areas as a major strategy to prevent blindness in Ethiopia. [ABSTRACT FROM PUBLISHER]

The article cites several studies related to medical education. One study reports that audio and video podcasts have been used by medical students. Another study demonstrates the impact of changes in curriculum on student learning. Moreover, another survey also determines how and to what extent medical schools in China use humanities and ethics in the training of future physicians.

An interesting case of dual pathology, torsion of the appendix of the right epididymis and vermiform appendicitis, is presented. This case illustrates the diagnostic problems caused by the simultaneous presentation of conditions that cause similar symptoms and signs, and illustrates the importance of careful abdominal examination in all cases of acute scrotal pathology, and vice versa, even when the diagnosis seems clear. [ABSTRACT FROM AUTHOR]