Purpose
The purpose of this study is to demonstrate that inferior inclination of the glenosphere is a protecting factor from joint dislocation in reverse total shoulder replacement. The hypothesis is ...that an average of 10° of inferior inclination of the glenoid component would determine a significant inferior rate of dislocation as compared to neutral inclination.
Methods
A retrospective case (dislocation)–control (stability of the implant) study was performed. Inclusion criteria were the homogeneity of the prosthetic model and availability of pre- and postoperative imaging of the shoulder, including antero-posterior and axillary X-ray views. Glenoid and glenosphere inclination were calculated according to standardized methods. Difference in between the angles determined the inferior tilt.
Results
Thirty-three cases fit the inclusion criteria. Glenoid and glenosphere inclination measured, respectively, 74.1° and 83.5°. The average tilt of the glenosphere measured 9.4°. The average tilt in stable patients was 10.2°. Tilt in patients with atraumatic dislocation measured, respectively, −6.9° (superior tilt) and 2.4°, while it was 8.3° for the patient with traumatic instability. The association between the tilt of glenosphere and atraumatic dislocation was significant.
Conclusions
A 10° inferior tilt of the glenoid component in reverse shoulder arthroplasty is associated with a reduced risk of dislocation when compared to neutral tilt.
The free testosterone:cortisol ratio (FTCR) is widely used for studying and preventing overtraining syndrome in various sports. The use of FTCR for following overtraining syndrome was proposed ...originally with two approaches: FTCR lower than 0.35x10(-3), calculated on free testosterone (FT) in nanomoles per liter (nmol/L) and on cortisol (C) in micromoles per liter (mmole/L) or a decrease of the ratio of 30% or more in comparison with the previous value. In our experience, the use of an absolute value as a threshold is not useful, whereas the evaluation of the concentrations of hormones and their ratio in comparison with previous ones is more useful. These classical approaches are not, however, sufficient to describe the various possible physiological modifications linked to training excess and/or incomplete recovery.
We collected samples from 32 professional soccer players of an Italian First Division team, during the period July 2001-July 2003. We analyzed the values of 21 athletes during the season 2001-2002 and of 11 athletes during the season 2002-2003 (6 out of 11 were examined also during the previous one) always present when the 4 (first season) or 5 (second season) blood drawings have been performed. We applied an original, pragmatic and easy-to-use classification of FTCR values, in association with classical interpretations based on decreases of the values in comparison with previous athlete's result.
We used the traditional approaches in two consecutive seasons in a professional soccer team: the evaluation of the decrease >30% of the parameter in comparison with the previous value or with the basal (preseason) value are shown. The statistical differences between the FTCR values of the six athletes followed in both seasons were not significant.
The classification method we propose is advantageous in comparison with traditional interpretative schemes, because identify different risk categories, stratifying the interval between the values 0.35-0.8.
Bone mass is the net product of formation and resorption, which are closely regulated by the equilibrium between endogenous/exogenous factors. Sclerostin inhibits the Wnt canonical signaling and is ...considered an anti-anabolic factor. We compared sclerostin serum concentrations between genders in athletes belonging to different sport disciplines, characterized by a different weight-bearing, and in their sedentary counterparts in order to study the possible link between bone metabolism in athletes and its peripheral concentration. We also compared sclerostin levels with bone alkaline phosphatase activity, a marker of bone formation. Sixty-one elite athletes, belonging to weight-bearing (15 male rugby players, 11 male enduro racers, 8 female basketball players), high-impact (6 male tennis players, 8 female ice skaters), non weight-bearing sports (13 male cyclists) and 16 sedentary controls were enrolled. Higher levels of sclerostin were found in females. Sclerostin was higher in weight-bearing than in non-weight-bearing disciplines in males. Significant inverse age-related correlation was found. Higher bone alkaline phosphatase activity was observed in females. The young adult elite athlete represents a peculiar physiologic model for studying sclerostin behavior: the applied load increased the marker concentrations, testifying a high bone turnover rate; however, a gender effect is evident.
The circulatory diseases, in particular ischemic heart diseases and stroke, represent the main causes of death worldwide both in high income and in middle and low income countries. Our aim is to ...provide a comprehensive report to depict the circulatory disease mortality in Europe over the last 30 years and to address the sources of heterogeneity among different countries.
Our study was performed using the WHO statistical information system - mortality database - and was restricted to the 28 countries belonging to the European Union (EU-28). We evaluated gender and age time series of all circulatory disease mortality, ischemic heart diseases, cerebrovascular diseases, pulmonary and other circulatory diseases and than we performed forecast for 2016. Mortality heterogeneity was evaluated by countries using the Cochrane Q statistic and the I-squared index.
Between 1985 and 2011 SDR for deaths attributable to all circulatory system diseases decreased from 440.9 to 212.0 x 100,000 in EU-28 and a clear uniform reduction was observed. Heterogeneity among countries was found to be consistent, therefore different analysis were carried out considering geographical area.
We forecast a reduction in European cardiovascular mortality. Heterogeneity among countries could only in part be explained by both geographical and health expenditure factors.
After obtaining informed consent, we measured a series of cytokines and growth factors in serum obtained from peripheral blood of five male subjects (age 20-35 years; four cases of patella ...tendinopathy and one elbow tendinosis) to evaluate the eventual, systemic effects of such local treatment. Analysis of variance (one way analysis) performed with MedCalc software (Mariakerke, Belgium) showed a statistically significant change in EGF and CCL2, but not in VEGF, because of high interindividual variability, which has also been reported during exercise. 4 Table 1 Serum concentrations of variables before and various time intervals after treatment with platelet rich plasma Before 30 min after 3 hours after 24 hours after VEGF (pg/ml) 140 (20-302) 123 (25-392) 65 (26-232) 119 (47-232) EGF (pg/ml) 130 (22-182) 85 (3-156) 40 (3-153) 68 (7-153) CCL2 (pg/ml) 285 (107-466) 286 (70-385) 185 (101-385) 256 (96-373) Values are mean (range).
Endocannabinoids are a class of lipid mediators involved in a wide range of physiological pathways including pain perception, and immunological defences. In particular, the involvement of ...endocannabinoids in bone metabolism and bone resorption has recently been studied. Moreover, one study on total knee arthroplasty describes the probable role of endocannabinoids in pain perception after surgery. The aim of the present study was to evaluate variations of endocannabinoid concentrations in patients undergoing total hip or total knee arthroplasty before and after surgery. Sera from 23 patients were collected at three different times: before surgery and at two different times during rehabilitation, and endocannabinoids were quantified by HPLC-MS/MS analysis. Mean values of endocannabinoids in presurgical serum samples were: 6.11±0.5 ng/ml for N-palmitoylethanolamide, 1.39±0.08ng/ml for N-stearoylethanolamide, 4.84±0.04 ng/ml for N-oleoylethanolamide, 0.44±0.03ng/ml for N-arachidonoylethanolamide, 0.84±0.05ng/ml for N-linoleoylethanolamide, 0.17±0.01ng/ml for N-α-linolenoylethanolamide. Statistical analysis showed a significant decrease of all the endocannabinoids after surgery, while there were no remarkable differences between total hip and total knee arthroplasties or between genders. Moreover, the results show no significant correlation between endocannabinoid concentrations and C-reactive protein and Erythrocyte sedimentation rate. The present study shows for the first time a specific and univocal behaviour of six endocannabinoids and N-acylethanolamides in orthopaedic surgery, suggesting the endocannabinoid system as a possible pharmacological target for presurgical therapeutics.
Biochemistry and haematology are more and more important and sometimes crucial in sport medicine for diagnosing, controlling and preventing purposes. The analytical process and the global laboratory ...quality are heavily influenced by the preanalytical phase, including biological material collection, identification, storage and transport of the specimen, preparation for analyses of the specimen through centrifugation, freezing and thawing, aliquoting and sampling. The increasing interest of sport biochemistry should be linked to a knowledge of principal problems and pitfalls in the preanalytical phase of various parameters, commonly used in following training, diet, and performances of athletes, to avoid misinterpretation of data and to improve usefulness of biochemical investigations. We prepared a practical review of preanalytical aspects of principal analyses applied to the athletes. We include the choice of anticoagulant and its limits for haematological tests, the preparation and manipulation of specimens for hormonological investigation, especially for labile molecules, and for cardiac markers, lactate, cytokines, micronutrients, antioxidant molecules. Preanalytical phase of specimens different from blood are also showed, including urine and saliva, and some aspects of preparation of materials to be analyzed with molecular biology technology are treated. Stability of some analytes, when the parameter is fundamental for the clinical usefulness of the results, is supplied. Preparation of the subjects, however, including the possible influence of physical exercise and biological rhythms on the biochemical and haematological parameters, are not listed.
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