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Objective: Handball is an overhead sport in which upper quadrant joints experience significant stress, resulting in a high prevalence of shoulder pain from 15 to 28%. The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) is a validated functional test, evaluating the functional performance of the upper limbs. It is used to monitor functional recovery of the shoulder after injury and should be compared with reference values. However, such values do not exist in this sport. The purpose of this study is to determine a CKCUEST norm for handball players taking gender and playing positions into consideration. Methods: The cohort is made up of 165 athletes (112 males), aged 17.6 ±2.7 years, practising handball between 8 and 14 hours per week in high-level competition. Participants have had no shoulder, elbow or wrist complaints in the past 3 months. The test is conducted away from any physical activity. The CKCUEST is performed 3 times, the number of touches performed in 15 seconds being recorded for analysis. Power score and normalised score are calculated. Analysis of variance with post hoc correction is employed. Results: The average score found in men is higher than in women (respectively 26.7±3.6. vs. 22.7±3.3; p<0.001). The analysis by playing positions shows a difference in number of touches, power score and normalised score (p=0.26). Conclusion: Our CKUEST values are similar to studies carried out on other throwing sports (i.e. baseball) but were dependent on the playing position. Shooting is a complex action involving multiple movements and varying player positions which could explain this difference. Clinical implications: These values could be used as a benchmark during the season to detect a problem or improve the overall management of the shoulder. They could also be used as a reference for recovery tests after injury or to better understand people with shoulder injury risks, and to implement prevention strategies. [ABSTRACT FROM AUTHOR]

Aim: To study the association between player characteristics, technical components of the game and the risk of match injuries during the 2017 Men's Handball World Championship., Methods: Team physicians of the participating teams (n=24) were requested to provide injury report forms throughout the Men's Handball World Championship (France, January 2017). The individual time played, age, number of international matches played and all technical and penalty variables for each player were extracted from the official International Handball Federation (IHF) online database and used as risk factors in a general logistic linear model analysis., Results: Of 387 players, 49 sustained one or more injuries (93 injuries in total). The total incidence of match injuries was 82.1 injuries per 1000 hours (95% CI 66.2 to 100.5), non-time-loss injury incidence was 40.6 injuries per 1000 hours (95% CI 29.3 to 54.9), while time-loss injury incidence was 30.9 injuries per 1000 hours (95% CI 21.5 to 42.9). Multivariate analysis showed that age (OR 1.1, 95% CI 1.02 to 1.18, p=0.011), player position (backs: OR 6.79, 95% CI 2.25 to 20.54, p=0.001; goalkeepers: OR 5.03, 95% CI 1.15 to 21.94, p=0.031) and 2 min suspensions (1-2 times: OR 2.77, 95% CI 1.27 to 6.04, p=0.011; 3 or more times: OR 2.66, 95% CI 1.18 to 6.38, p=0.029) were significant risk factors for getting injured during competition matches., Conclusion: Age, player position (backs, goalkeepers) and 2 min suspensions were associated with match injury. Stricter rule enforcement should be considered to prevent match injuries in elite handball., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

We have studied the kinetic properties of the interaction of internal Na with four different Na transport pathways (ouabain-sensitive Na, K pump, bumetanide-sensitive Na,K cotransport, Li:Na countertransport and passive Na permeability) in erythrocytes from 197 essential hypertensive patients. This study permitted us to classify 168 of the 197 hypertensives studied into the following groups: Pump - hypertensives-six patients showing low pump affinity for internal Na and high maximal pump rate; Co - hypertensives -95 patients characterized by low cotransport affinity for internal Na and low or normal maximal outward cotransport rate. Counter + hypertensives - 35 patients characterized by low countertransport affinity for internal Na and high maximal countertransport rate; and Leak + hypertensives - 32 patients showing increased passive Na permeability. Having studied the apparent affinity of the Na,K cotransport system for external K we divided the co - hypertensives into three subgroups (symmetric, asymmetric or antisymmetric) according to the presence of low, normal or high K affinity. Forty-five hypertensive patients were submitted to antihypertensive treatment with a new diuretic and antihypertensive drug, cicletanide. Preliminary results indicate that one of the factors involved in the antihypertensive efficiency of the compound is the subgroup to which the hypertensive belongs.

The authors report 4 cases of hyperlipemia and show the great benefit which results from ileal exclusion when there is an atherogenic risk. The considerable reduction in total lipid, cholesterol, triglycerides, and prebeta-lipoproteins is constant together with clarification of the serum. In one case, angina pectoris regressed considerably, as did arteritis of the lower limbs (unlimited walking became possible, oscillometry in the leg improved from 2 to 7). Surgery is indicated whenever by lack of will power, the diet and medical treatment cannot be followed, when social and economic conditions make proper medical treatment impossible, or when the latter has failed. The existence of arterial lesions, cardiac or cerebral complications makes surgery even more urgent. Gall-stones were observed in gall bladder. The authors raise the problem of oxalate stones. Only type II familial hyperlipemia in homozygotes should be excluded: and end-to-side portacaval anastomosis seems to be preferable.