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Effect of plyometric versus complex training on core, lower extremity and upper extremity strength in male cricketers: a randomized controlled trial BMC Sports sciences, medicine and rehabilitation
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November 28, 2023
Stronger thigh muscles can prevent knee replacement surgery

CHICAGO, Nov. 27, 2023 /PRNewswire/ — Stronger quadriceps muscles, compared to the hamstrings, may lower the risk of total knee replacement, according to research presented today at the annual meeting of the Radiological Society of North America (RSNA). Researchers said the findings could inform strength training programs for people with advanced knee arthritis.

Advanced knee osteoarthritis is a leading cause of pain and disability worldwide. In the US alone, 14 million adults have symptomatic knee osteoarthritis, and more than half of diagnosed patients are expected to eventually undergo total knee replacement surgery.

Although stronger muscle groups are generally thought to be associated with a lower rate of total knee replacements, their relative importance is not well established. Of particular importance is the relationship between the extensors and the hamstrings, the two main muscle groups in the knee.

The extensors, the muscles at the front of the thigh, commonly called the quadriceps, are the strongest muscle group in the body and have a vital influence on walking, other activities and biomechanics. The muscles around the back of the thigh, known as the hamstrings, are responsible for the extension of the hip and flexion of the knee, making them equally essential for physical activity.

“The two muscle groups act as opposing forces, and the balance between them allows for a wide range of activities while protecting the knee joint,” says lead study author Upasana Upadhyay Bharadwaj, MD, of the University of California, San Francisco (UCSF). “An imbalance, among other factors, leads to a change in biomechanics, resulting in the progression of osteoarthritis.”

Dr. Upadhyay Bharadwaj and colleagues evaluated thigh muscle volume in 134 participants in the Osteoarthritis Initiative, a nationwide study sponsored by the National Institutes of Health. They compared 67 patients who underwent total knee replacement of one knee with 67 control participants who did not undergo knee replacement. The cases and controls were matched on variables such as age and gender.

The researchers obtained 3T MRI of the thigh at the time of surgery. They also evaluated MRI findings two years and four years before surgery. They used a previously trained deep learning model to segment and calculate the volumes of the muscles of the thigh – measurements that are difficult to calculate manually.

When comparing patients who had undergone total knee replacement with the control group, a higher ratio of quadriceps to hamstring volume was significantly associated with a lower likelihood of total knee replacement. Higher hamstring and gracilis volumes, a long, thin muscle on the inside of the thigh, were also associated with a lower likelihood of total knee replacement.

“Our research shows that in addition to strong individual muscles, larger extensor muscle groups – compared to hamstring muscle groups – are significantly associated with a lower likelihood of total knee replacement surgery within two to four years,” said Dr. Upadhyay Bharadwaj.

The study results have implications for both the interpretation of imaging studies and clinical management. The results suggest that training programs that strengthen the quadriceps in relation to the hamstrings may be beneficial.

“Although we assume that total muscle volume is important as a surrogate marker of muscle strength, the relationship, and therefore balance, between the extensor and hamstring muscles may be more important and significantly associated with a lower likelihood of total knee replacement,” Dr. Upadhyay Bharadwaj said.

Although the study focused on people with arthritis, the findings could also help inform strength training for a broader segment of the population.

“While these results are essential for targeted therapy in a population at risk for osteoarthritis, even the general public can benefit from our results by preventively incorporating appropriate strengthening exercises,” said Dr. Upadhyay Bharadwaj.

Co-authors are John A. Lynch, Ph.D., Gabby B. Joseph, Ph.D., and Thomas M. Link, MD, Ph.D.

Note: Copies of RSNA 2023 news releases and electronic images will be available online at RSNA.org/press23.

RSNA is an association of radiologists, radiation oncologists, medical physicists and related scientists who promote excellence in patient care and health care through education, research and technological innovation. The association is located in Oak Brook, Illinois. (RSNA.org)

Editor’s note: The data in these publications may differ from the data in the published abstract and the data actually presented at the meeting, as researchers continue to update their data up until the meeting. To ensure you are using the most current information, please call the RSNA Newsroom at 1-312-791-6610.

For patient-friendly information about musculoskeletal imaging, please visit RadiologyInfo.org.

SOURCE Radiological Society of North America (RSNA)

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November 28, 2023
MCRA Announces Launch of Integrated AI & Imaging Center

Led by former FDA Imaging Experts, MCRA AI & Imaging Center is the first and only integrated solution covering the medical device lifecycle with 24/7 customer support

WASHINGTON , Nov. 27, 2023 /PRNewswire/ — MCRA, the leading private independent Clinical Research Organization (CRO) and medical device, diagnostics and biologics consulting firm, is pleased to announce the launch of its AI & Imaging Center, the first and only integrated solution, led by former FDA imaging experts, covering the entire medical device lifecycle.

MCRA’s AI & Imaging Center is designed to better meet the emerging and complex needs of imaging technologies. By combining innovation, expertise and speed, we accelerate customers’ AI/ML needs faster and more efficiently.

Led by former FDA regulatory and imaging experts, the Integrated AI & Imaging Center provides critical services to medical device customers developing AI/ML-enabled devices and new imaging technologies. The AI & Imaging Center works with an extensive network of radiologists and specialists to provide world-class diagnostic and therapeutic imaging laboratory services.

MCRA’s AI & Imaging Center services address the entire lifecycle of medical device studies, including regulatory support, study design and design, data collection and aggregation, expert recruitment and training, statistical analyses, performance testing, and project and data management . MCRA’s AI & Imaging Center has already provided services ranging from protocol development to study execution and regulatory submissions for more than 50 imaging clients. As a fully integrated solution, MCRA AI & Imaging Center uses proven zero-print, advanced image analysis and data management software with 24/7 support for customers and network specialists.

Alex Cadotte, Ph.D., Senior Director, Digital Health and Imaging Regulatory Affairs, said: “As the only fully integrated AI & Imaging Center, our value lies in the expertise of our team, which consists of former FDA experts who have navigated the regulatory landscape to understand. and clinical processes. Our value proposition is to ensure that the study is designed and conducted in a manner that meets FDA expectations and ultimately reduces time to market by conducting the right study the first time.”

MCRA is excited to continue advancing imaging and digital health innovation in the medical device industry by helping customers navigate the evolving AI/ML imaging landscape. Read more about the MCRA AI & Imaging Center here.

MCRA customer Richie Christian, Head of Regulatory and Quality at Formus Labs says: “The MCRA AI & Imaging Center has provided our technologies with real insights into how the FDA thinks about best practices for AI MedTech. This deep insight allowed us to be more innovative and deliver a best-in-class product to the AI marketplace.”

Anthony Viscogliosi, CEO of MCRA said: “The MCRA AI & Imaging Center truly integrates our deep regulatory experience with clinical trial execution, technology and performance testing. This new addition to MCRA will only allow us to improve our customers’ success throughout the entire product lifecycle, with a focus on the main goal: FDA approval.”

About MCRA, LLC: MCRA is the leading private, independent clinical research organization (CRO) and consulting firm for medical devices, diagnostics and biologics. MCRA delivers its client’s industry experience and integrates its seven business value creators: regulatory, clinical research, reimbursement, healthcare compliance, quality assurance, cybersecurity and distribution logistics to deliver a dynamic, market-leading effort from concept of innovation to commercialization . MCRA’s integrated application of these key value-creating initiatives provides unparalleled value to its customers. MCRA has offices in Washington, DC, Hartford, CT, New York, NY, London, England, Winterthur, Switzerland, Eschborn, Germany and Tokyo, Japan and serves nearly 1,000 customers worldwide. Key areas of therapeutic experience include orthopedics, spine, biologics, cardiovascular, diagnostic imaging, wound care, artificial intelligence, dentistry, anesthesia, respiratory, ENT, general surgery, digital health, neurology, robotics, oncology, general and plastic surgery. urology and in vitro diagnostic (IVD) devices. www.mcra.com

About Viscogliosi Brothers, LLC: Viscogliosi Brothers, LLC (VB), founded MCRA in 2004. Headquartered in New York City, VB specializes in financing venture capital, private equity and investment banking activities for the neuromusculoskeletal industry. VB is committed to financing healthcare innovation. www.vbllc.com

For more information please contact:
Erinn Grable, business development manager
Phone: 202.552.5821 | Email: egrable@mcra.com

SOURCE MCRA, LLC

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November 27, 2023
SECRE technology paves the way for new therapies for autoimmune diseases

Scientists have developed a potentially transformative new technique that could help in the discovery and development of new therapies for a number of globally prevalent autoimmune diseases.

Conditions such as lupus, rheumatoid arthritis and inflammatory bowel disease (IBD) – as well as malfunctions in transplanted cells – are all caused by altered cytokine secretion from immune cells in the human body.

To find treatments for such diseases, experts must identify the genetic regulators of secretion so they can explore the most effective ways to inhibit them.

An international team of researchers has developed a new method called Secretion-Enabled Cell Ranking and Enrichment (SECRE), which is detailed in a study published in Nature Biomedical Technology.

They have shown that the method is accurate in sorting hundreds of millions of CRISPR-edited cells based on their secretion patterns, and in identifying the genetic regulators of cytokine secretion in an autoimmune disease. In addition, the method takes into account the detailed profiles of approved treatments and treatments in development to determine whether pre-existing therapies can be repurposed in new ways.

In the study, the researchers describe how they validated their approach against the cells known to play an essential role in the development and severity of IBD, and how they proved that this approach has the potential to find new ways to treat conditions that affect millions of people worldwide. .

The research is the result of a project lasting about four years between scientists from Great Britain, the United States and Canada, leading experts in the field of developing new tools for the diagnosis and treatment of diseases, led by Professor Shana Kelley, chairman of the Chan-Zuckerberg Institute and professor at Northwestern University.

This is an incredibly new approach that has the potential to deliver enormous benefits to patients, doctors and pharmaceutical companies working to develop new treatments. It gives us the opportunity to sort large numbers of cells based on their secretion patterns and identify therapeutic targets that can be applied to help people with conditions for which few therapeutic options currently exist. “Through our existing work we have shown that it has the potential to help identify ways to treat various autoimmune diseases, but my work is now also expanding to types of cancer, including some of the most aggressive types of brain tumors.”

Dr. Mahmoud Labib, a lecturer at the Peninsula Medical School of the University of Plymouth, and the key inventor of the approach

A possible treatment for inflammatory bowel disease?

Inflammatory bowel disease (IBD) is a long-term health condition estimated to affect approximately 7 million people worldwide. It is characterized by chronic inflammation of the digestive tract, which can result in severe abdominal pain and diarrhea, and there is currently no known cure.

As part of their work to validate their approach, the researchers examined the effect of various kinase inhibitors on CD4+ T cells, which are known to produce interferon-gamma, a protein widely implicated in several autoimmune diseases, including IBD. The inhibitors studied included XMU-MP1, a small molecule previously studied as a treatment for heart failure, hair loss and a number of other medical conditions.

In this case, the researchers used XMU-MP1 to treat mice with a form of colitis that has a similar cell secretion profile to that in people with IBD. They found that the mice experienced significantly less weight loss and reduced symptoms of colitis, while their colons appeared almost normal and showed no significant loss of intestinal stem cells.

Based on these findings, the researchers say their results suggest that using XMU-MP1 as a means to inhibit the production of interferon-gamma in the intestines may be an ideal means of controlling IBD. They also say it offers a promising future strategy for the therapeutic molecular targeting of the condition, although extensive clinical trials would be needed before it could be considered as a treatment.

How the SECRE technique works

The Secretion-Enabled Cell Ranking and Enrichment (SECRE) technique captures the secreted cytokine on the surface of the cell. These cytokines are then labeled with magnetic nanoparticles and sorted at high resolution in a microfluidic device fabricated using scaled three-dimensional printing.

The SECRE technique allows rapid and rapid sorting of cells based on their secretion patterns, making it amenable to large-scale functional genetic screening. This approach also links the functional signature of the cell to its phenotype, allowing selective sorting of specific subsets of immune cells based on specific cell surface markers and the secretion-specific factors.

Source:

Magazine reference:

Labib, M., et al. (2023). Identification of druggable regulators of cell secretion via a kinome-wide screen and high-throughput immunomagnetic cell sorting. Nature Biomedical Technology. doi.org/10.1038/s41551-023-01135-w.

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November 27, 2023
Stratasys is collaborating with Siemens Healthineers in a Landmark Research Project to advance medical imaging

The use of 3D printing can improve outcomes by providing 3D modeling to physicians with real-world scenarios to practice and reference.

EDEN PRAIRIE, Minnesota & REHOVOT, Israel, November 27, 2023–(BUSINESS WIRE)–Stratasys Ltd. (NASDAQ: SSYS), a leader in polymer 3D printing and additive manufacturing solutions, today announced it is partnering with Siemens Healthineers to conduct a groundbreaking research project designed to develop new state-of-the-art solutions develop for the advancement of medical imaging phantoms for computed tomography (CT) imaging.

CT phantoms are a crucial tool in medical imaging and a nearly universal resource in hospitals around the world. They are specialized devices used to evaluate and ensure the performance of CT scanners. Phantoms are designed to simulate certain characteristics of the human body and enable the assessment of several key metrics, including radiation dose and image quality, facilitating calibration and ensuring consistent scanner performance. The joint development uses Stratasys’ PolyJet™ technology in combination with Siemens Healthineers’ unique RadioMatrix™ technology and advanced algorithm, aimed at translating scanned patient images into specific radiopacity material characteristics of the human anatomy. The solution enables custom phantom production and the creation of ultra-realistic human anatomy characteristics with complete radiographic accuracy of patient-specific pathology that was previously not possible.

This joint project will transform the way phantoms can be used in the medical field, and in some cases even allow device manufacturers and academic institutions to replace human cadavers with 3D printed structures. Having this capability enables critical efficiency and minimizes unavoidable human variability. This work will also generate a critical amount of research data, providing important insights for advancing CT system algorithms, driving materials development and unlocking potential new application areas – and identifying future research opportunities.

“The current limitations of phantoms have long been a challenge for the radiology community,” said Erez Ben Zvi, Vice President of Medical at Stratasys. “This collaboration with Siemens Healthineers will allow us to jointly explore the tremendous potential of our radiopaque materials and 3D printing technologies to overcome these barriers.”

Starting with the production of 3D printed phantoms for smaller scale anatomies of the head and neck region, the research will include the production of increasingly larger and more complex anatomies – leading to the Phase One endpoint of 3D printing a heart model and a complete human torso with full radiographic accuracy.

“The knowledge gained from this project represents a breakthrough in medical imaging that will open new possibilities for 3D printing and imaging applications,” said Lampros Theodorakis, Head of Computed Tomography Product & Clinical Marketing at Siemens Healthineers. “We are excited about the opportunities that await us as a result of this collaboration and believe it will have long-term implications for medical and academic applications.”

About Stratasys

Stratasys is leading the global shift to additive manufacturing with innovative 3D printing solutions for industries such as aerospace, automotive, consumer products, healthcare, fashion and education. Through smart and connected 3D printers, polymer materials, a software ecosystem and on-demand parts, Stratasys solutions deliver competitive advantages at every stage of the product value chain. The world’s leading organizations turn to Stratasys to transform product design, make manufacturing and supply chains more agile, and improve patient care.

For more information about Stratasys, visit www.stratasys.com, the Stratasys blog, X/Twitter, LinkedIn or Facebook. Stratasys reserves the right to use any of the foregoing social media platforms, including the Company’s websites, to share material, non-public information pursuant to the SEC’s Regulation FD. To the extent necessary and required by applicable law, Stratasys will also include such information in its public disclosure filings.

Note to editors: High-resolution images and additional information are available upon request from the appropriate media contacts listed.

Contacts

Investor and media contacts

Stratasys Business &
North America
Chris Reese
chris.reese@stratasys.com
+1 6651 357 0877

Investor Relations
Jonah Lloyd
Yonah.Lloyd@stratasys.com
+972 74 745 4919

Europe, the Middle East and Africa
Jonathan Wake / Samantha White,
Incus Media
stratasys@incus-media.com
+44 1737 215200

Brazil, Central America and South America
Erica Massini
Erica.Massini@stratasys.com
+55 (11) 2626-9229

Stratasys Corporate & Israel
Erik Snider
Erik.Snider@stratasys.com
+972 74 745 6053

Asia
Kalyani Dwivedi
Kalyani.Dwivedi@stratasys.com
+91 80 6746 2606

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November 27, 2023
Pristine Surgical Announces Full Market Launch of Summit™ 4K Single-Use Surgical Arthroscope in the US

The pinnacle of minimally invasive surgical visualization, Summit™ is the first-of-its-kind 4K single-use surgical arthroscope designed to simplify endoscopy

MANCHESTER, NH, November 27, 2023–(BUSINESS WIRE)–Pristine Surgical, a medical device company committed to making endoscopy more efficient, consistent and safer, has accelerated the launch of its Summit™ 4K single-use surgical arthroscope – the first of its kind. After an overwhelmingly positive response during its limited market launch, Summit™ is now available to hospitals and ambulatory surgery centers across the United States.

“Summit™ is a fully integrated, single-use scope with 4K resolution that simplifies arthroscopic procedures and packs the latest in minimally invasive visualization technology into a sterile, cost-effective, ready-to-use package,” said Bryan Lord, CEO of Pristine Surgical. “I am pleased with the feedback we have received and we are excited to make this groundbreaking arthroscope available nationwide to help surgeons and their teams innovate their endoscopy suite.”

Summit™ is a brand new, 100% sterile 4K scope for every patient and is ready to use right out of the box, eliminating the time-consuming operating room set-up and tear-down process and device reprocessing required for reusable arthroscopes. It comes pre-installed with Pristine Connect™ software for seamless cloud-connected surgical image and video storage and automated inventory management.

“We developed Summit to address the challenges inherent in conventional surgical visualization – which relies on reusable arthroscopes that are becoming outdated, difficult and expensive to maintain, and prone to wear, damage and potential infections,” said Dr. Stephen J. Snyder, a pioneer in shoulder arthroscopy and Chief Medical Officer of Pristine Surgical. “It’s a major leap forward in an area that hasn’t changed much in my 40-plus years of practice, and when we saw the positive response and impact it had on our limited market launch, we were convinced that it was time to fully commercialize Summit.”

Summit integrates with a surgery center’s existing endoscopy tower, allowing ASCs to upgrade to 4K without major capital investments. It is delivered through a unique subscription scope business model and has transparent pricing to make this groundbreaking medical device cost-effective and practical. Through sustainability partnerships, Pristine Surgical will also offer recycling options to its customers.

Summit™ is available through select distributor partners in the United States. For more information or to learn how you can bring Summit to your facility, please contact info@pristinesurgical.com.

About pristine surgery

Pristine Surgical is a medical device company on a mission to simplify endoscopy. The company combines single-use endoscopes with cloud-based software to make minimally invasive visualization more efficient, consistent and safe. Pristine Surgical offers a subscription business model with transparent pricing and automated inventory management, delivering improved workflow and lower costs for the endoscopy suite. For more information, visit pristinesurgical.com or search for the company on LinkedIn.

Contacts

Dia Kalakonas
GM, Marketing Communications
Pristine surgical procedure
603-496-5493
dkalakonas@pristininesurgical.com

Photo: Business Wire

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November 27, 2023
Activity affected urinary incontinence; Let’s talk about it!

Prevalence and normalization of stress urinary incontinence in female strength athletes.

Mahoney K, Heidel RE, and Olewinski LJ Good luck Cond2023 [epub ahead of print].

Full text freely available

Take home message

Seven in ten female strength training athletes report stress urinary incontinence (SUI) in some aspect of their lives. However, fewer than 2 in 10 athletes talk to their doctor or seek treatment for SUI.

Background

Very intensive physical activity can increase the risk of SUI, an involuntary loss of urine due to increased intra-abdominal pressure. Up to 2 in 5 women may experience SUI throughout their lives, which can negatively impact an individual’s quality of life. Pelvic floor training can treat SUI. Although female strength training athletes may be at greater risk for SUI, it remains unclear how many of these athletes experience SUI and seek treatment, as well as how they would prefer to learn about SUI.

Study aim

The researchers conducted a cross-sectional study to assess female strength training athletes’ understanding and normalization of SUI, including how often female strength training athletes sought treatment for SUI.

Methods

The researchers developed a new study, which was expertly reviewed, to share on various social media platforms. The survey asked respondents about demographic information, risk factors for SUI, experience with SUI, favorite sources of information about SUI, and whether the respondent had sought treatment for SUI. Respondents to the survey were women over the age of 18 who considered powerlifting, weightlifting or strongman as their main activity.

Results

Of the 425 respondents, 69% reported experiencing SUI in some aspects of their lives. Of the athletes who experienced SUI, 61% reported that they first experienced SUI after starting their sport. About two-thirds of athletes thought SUI was a normal part of their sport. Only 17% of respondents reported talking to their doctor about SUI, and 9% sought treatment. Nearly 30% of respondents reported seeking advice about SUI from videos and articles on the internet, 23% spoke to friends and 13% spoke to their coach about SUI.

Viewpoints

Overall, the results of this study indicated that SUI is common among female strength training athletes, and most consider it a normal part of their sport. However, very few athletes turn to healthcare to address their SUI. It would be interesting to see this study replicated by asking athletes to complete the survey during competitions, as it is unclear whether women with SUI are more likely to complete the online survey. So the online survey may overestimate how many women have SUI, but the answers about engaging the health care system and where they seek advice are still likely to be informative.

Clinical implications

Clinicians who work with athletes who are at high risk for developing SUI should educate athletes about effective treatments. It can also be helpful to educate strength and conditioning coaches about SUI and available treatments.

Questions for discussion

How do you talk to your athletes about SUI? Have you noticed that other athletes have high SUI rates?

Written by Kyle Harris
Reviewed by Jeffrey Driban

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November 27, 2023

Many patients with autoimmune diseases struggle with diagnosis, costs, and inattentive care

After years of debilitating bouts of fatigue, Beth VanOrden thought she finally had an answer to her problems in 2016 when she was diagnosed with Hashimoto’s disease, an autoimmune disease.

For her and millions of other Americans, that’s the most common cause of hypothyroidism, a condition in which the thyroid, a butterfly-shaped gland in the neck, doesn’t produce enough of the hormones the body needs to regulate metabolism.

There is no cure for Hashimoto’s or hypothyroidism. But VanOrden, who lives in Athens, Texas, started taking levothyroxine, a widely prescribed synthetic thyroid hormone used to treat common symptoms such as fatigue, weight gain, hair loss and sensitivity to cold.

Most patients do well on levothyroxine and their symptoms resolve. But for others, like VanOrden, the drug isn’t as effective.

For her, that meant traveling from doctor to doctor, test to test, and treatment to treatment, spending about $5,000 a year.

“I look and act like a pretty energetic person,” said VanOrden, 38, explaining that her symptoms are not visible. “But there’s a hole in my gas tank,” she said. And “stress widens the gap.”

Autoimmune diseases arise when the immune system mistakenly attacks and damages healthy cells and tissues. Other common examples include rheumatoid arthritis, lupus, celiac disease, and inflammatory bowel disease. There are more than 80 such diseases, affecting an estimated 50 million Americans, disproportionately women. Overall, the cost of treating autoimmune diseases in the US is estimated at over $100 billion per year

Despite their frequency, finding help for many autoimmune diseases can be frustrating and expensive. Getting diagnosed can be a major hurdle because the set of symptoms is very similar to those of other medical conditions, and there are often no definitive identifying tests, says Sam Lim, clinical director of the Division of Rheumatology at Emory University School of Medicine in Atlanta . . In addition, some patients feel like they have to fight to be believed, even by a doctor. And after a diagnosis, many autoimmune patients rack up big bills while they explore treatment options.

“They’re often upset. Patients feel rejected,” Elizabeth McAninch, an endocrinologist and thyroid expert at Stanford University, says of some patients who come to her for help.

Inadequate medical education and a lack of investment in new research are two factors hindering the general understanding of hypothyroidism, according to Antonio Bianco, an endocrinologist at the University of Chicago and leading expert on the condition.

Some patients become angry when their symptoms don’t respond to standard treatments, either levothyroxine or that drug in combination with another hormone, said Douglas Ross, an endocrinologist at Massachusetts General Hospital in Boston. “We’re going to have to remain open to the possibility that we’re missing something here,” he said.

Jennifer Ryan, 42, said she has spent “thousands of dollars out of pocket” looking for answers. Doctors did not recommend thyroid hormone medication for the Huntsville, Alabama, resident, who was diagnosed with Hashimoto’s after years of fatigue and weight gain, because her levels appeared normal. She recently changed doctors and is hoping for the best.

“You don’t walk around in pain all day and there’s nothing to worry about,” Ryan said.

And health insurers typically deny coverage for new treatments for hypothyroidism, says Brittany Henderson, an endocrinologist and founder of the Charleston Thyroid Center in South Carolina, which treats patients from all fifty states. “Insurance companies want you to use the generics, even though many patients don’t do well with these treatments,” she said.

Meanwhile, the extent of America’s thyroid problems is reflected in drug sales. Levothyroxine is among the five most prescribed medications in the US each year. Yet research suggests the drug is overprescribed to people with mild hypothyroidism.

A recent study paid for by AbbVie – maker of Synthroid, a branded version of levothyroxine – found that a database of medical and pharmacy claims found that the prevalence of hypothyroidism, including milder forms, has risen from 9.5% of Americans in 2012 to 11.7%. in 2019.

The number of people diagnosed will increase as the population ages, McAninch said. Endocrine disruptors — natural or synthetic chemicals that can affect hormones — could explain some of that increase, she said.

In their search for answers, patients sometimes connect on social media, where they ask questions and describe their thyroid hormone levels, drug regimens and symptoms. Some online platforms provide information that is questionable at best, but overall, social media has increased patients’ understanding of difficult-to-resolve symptoms, Bianco said.

They also encourage each other.

VanOrden, who has been active on Reddit, has this advice for other patients: “Don’t give up. Keep standing up for yourself. There is a doctor somewhere who will listen to you.” She has started an alternative treatment — desiccated thyroid medication, an option not approved by the FDA — plus a low dose of the addiction drug naltrexone, although data is limited. She feels better now.

Research into autoimmune thyroid diseases receives little funding, so the underlying causes of immune dysfunction are not well studied, Henderson said. The medical establishment has not yet fully recognized difficult-to-treat patients with hypothyroidism, but greater recognition of them and their symptoms would help fund research, Bianco said.

“I would like a very clear, solid acknowledgment that these patients exist,” he said. “These people are real.”

Kaiser health news This article was adapted from khn.org, a national newsroom that produces in-depth journalism on health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling and journalism.

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November 27, 2023

Tested positive for COVID? Be careful out there

Higher concussion rates following COVID-19 infection in high school athletes.

Bullock GS, Emery CA, Nelson VR, etc. al, Br J Sports Med2023; [epub ahead of print]. two: 10.1136/brjsports-2022-106436.

Full text freely available

Take home message

Athletes who tested positive for a COVID-19 infection were more likely to suffer a concussion within 60 days of recovering from the infection than athletes who did not contract COVID-19.

Background

COVID-19 affects the respiratory, cardiovascular and nervous systems. In some cases, COVID-19 can lead to long-term consequences (e.g. impaired cognition). It is currently unknown whether COVID-19 infection affects the risk of sports-related concussions.

Study aim

Bullock and colleagues completed a prospective cohort study to compare concussion rates between high school athletes who recently tested positive for COVID-19 and those who did not.

Methods

The authors recruited athletes from high schools in six states. A certified athletic trainer recorded all cases of COVID-19 infection or concussion. If an athlete reported COVID-like symptoms or had an elevated temperature during a daily screening, the athletic trainer administered a COVID test. The research team also recorded when an athlete participated in a training or competition. The authors focused on the number of concussions within 60 days after an athlete returned to play following a COVID-19 infection. All data was recorded in the Players Health Rehab system, including demographic information, sports and illness data for all athletes.

Results

A total of 72,522 athletes participated in high school sports at the affected school during the 2020-2021 school year. Of these athletes, 430 had COVID-19 infections. Of the athletes with a COVID-19 infection, 32 had a concussion, and 1,241 athletes without COVID-19 had a concussion. An athlete with a history of COVID-19 was approximately 3 times more likely to suffer a concussion within 60 days of returning to play than an athlete without COVID-19.

Viewpoints

Overall, the authors found that prior COVID-19 infection increased the risk of concussion during the first 60 days after recovery from COVID-19. Therefore, the effects of a COVID-19 infection may linger after returning to play. Knowing whether this applies to other sports-related injuries would be interesting. Additionally, learning why these athletes are at greater risk for concussion (e.g., deconditioning, persistent symptoms) can help us develop prevention strategies and make informed decisions about when and how to release an athlete to play following a COVID-19 infection.

Clinical implications

Doctors should explain to patients with COVID-19 that they may experience lingering effects that predispose them to concussion. We need to help the patient make an informed decision about when to return to play after COVID-19 infection. Once an athlete returns, doctors should monitor these patients for concussions.

Questions for discussion

What other measures have you implemented in your clinical practice to monitor athletes after COVID-19 infection? Is a COVID-19 infection something you are currently documenting?

Written by Kyle Harris
Reviewed by Jeffrey Driban

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COVID recovery may require injury prevention training!
Use of cardiovascular magnetic resonance (CMR) imaging for return to athletic activities after COVID-19 infection: an expert consensus document on behalf of the American Heart Association Council on Cardiovascular Radiology and Intervention (CVRI) Leadership and endorsed by the Society for Cardiovascular Magnetic Resonance (SCMR)
Adapted physical activity in subjects and athletes recovering from Covid-19: a position statement of the Società Italiana Scienze Motorie e Sportive
Cardiopulmonary Considerations for High School Athletes During the COVID-19 Pandemic: Update to the NFHS-AMSSM Guidelines

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November 27, 2023
Sports managers need sports trainers for a better heat policy
Exercise-induced heat illness: policy adoption and influence on contextual factors reported by athletic administrators

Scarneo-Miller SE, Adams WM, Coleman KA, Lopez RM. Sports Health. Mar 5, 2023: 19417381231155107. doi: 10.1177/19417381231155107. E-publishing prior to printing. PMID: 36872595.

https://journals.sagepub.com/doi/10.1177/19417381231155107

Take home message

Most high school athletic administrators reported having a written heat illness policy in place, but they were often missing key components. The presence of an athletic trainer helped create a written policy that included more components.

Background

Sports administrators play an important role in policy acceptance. Policy measures such as addressing acute heat illness are critical as improper management can lead to poor outcomes. Unfortunately, we know little about the factors that promote and hinder the implementation of heat illness policies.

Study aim

The authors surveyed high school athletic administrators in the United States to describe the adoption of exertional heat illness policies and to examine factors that influence the adoption of these policies.

Methods

During the 2018-2019 academic school year, the research team emailed nearly 7,000 athletic administrators inviting them to complete a questionnaire asking about 1) demographics, 2) exercise-related illness policies, 3) monitoring and modification of written policy, and 4) enablers and barriers to policy development. The researchers used the precautionary adoption process model to assess an athletics administrator’s willingness to adopt policies. The adoption model is based on 8 phases, from not being aware to maintaining a written policy for more than 6 months.

Results

Of 466 athletics administrators (~48 years old, 82% male, 77% worked in the field for more than 15 years), 78% reported having a written policy on the prevention and treatment of exertional heat illness. Only 6% adopted all eleven essential elements of an exertional heat illness policy. Almost half of the managers indicated that they adopted fewer than 5 essential elements.

Older athletics administrators, those who had previously dealt with heat illness, or those with an athletic trainer on their staff were more likely to have a written policy. Additionally, state mandates and having a medical professional were the most commonly cited facilitators for adopting policies on exertional illness prevention and use of a rectal thermometer. Similarly, the most commonly reported barrier to comprehensive heat illness management was the lack of a full-time athletic trainer (11). Administrators also recognized budget constraints that limited the use of a cold water immersion pool (23%), and the top barriers to using a rectal thermometer were discomfort using the thermometer (32%), parent/guardian resistance (30 %), resistance from parents/guardians (30%). coaches (30%) and liability issues (27%).

Viewpoints

Nearly 80% of athletics administrators surveyed reported that they had a written policy on exertional heat illness. Few integrated or were aware of all the necessary components to meet best clinical practices. The authors found that access to athletic training services was associated with better adoption of exercise health policies. This finding is consistent with it being an athletic trainer who would implement such a policy. It’s worth recognizing that only 7% of administrators contacted completed the survey. Therefore, these results may not accurately reflect what is happening in high schools across the country. One possibility is that people more interested in policy or heat illness completed the survey. So these results may show us the best-case scenario for written policies (78%) that include all components (6%) – which is a worrying sign.

Clinical implications

Encouraging state mandates and schools to hire athletic trainers can ensure that there are written policies to address heat illness. Clinicians may also want to consider strategies to educate coaches and parents/guardians about the reasons for this policy, such as rectal thermometers and cold water plunge pools.

Questions for discussion

Are you having trouble adding rectal temperature to your exercise heat illness protocol? Do you communicate with your athletics administrator regarding the approval, implementation and annual review/practice of your emergency policy?

related posts
1. Management of exertional heat stroke still leaves something to be desired
2. A little more education about heat stroke due to exertion could go a long way
3. Clinical Pearl: prevention and treatment of exertional heat stroke
4. Tag us! What do coaches know about heat stroke during exertion and the role of the athletic trainer?
5. Follow guidelines to prevent exertional heat illness? Let’s reconsider these guidelines
Written by Jane McDevitt
Reviewed by Jeffrey Driban
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November 27, 2023

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A possible treatment for inflammatory bowel disease?

How the SECRE technique works

Contacts

Contacts

Prevalence and normalization of stress urinary incontinence in female strength athletes.

Take home message

Background

Study aim

Methods

Results

Viewpoints

Clinical implications

Questions for discussion

related posts

Higher concussion rates following COVID-19 infection in high school athletes.

Take home message

Background

Study aim

Methods

Results

Viewpoints

Clinical implications

Questions for discussion

related posts

Exercise-induced heat illness: policy adoption and influence on contextual factors reported by athletic administrators

Take home message

Background

Study aim

Methods

Results

Viewpoints

Clinical implications

Questions for discussion

related posts