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1581. Fixation Using Alternative Implants for the Treatment of Hip Fractures (FAITH-2)

all patients require surgical repair of their fractures and unlike elderly hip fractures, failure of surgery offers few options for salvage. Arthroplasty is a successful treatment for elderly patients; however, a hip replacement is not a viable option for younger patients because of their higher functional demands for work and recreational activities that are not tolerated by joint replacements. There is more than one way to perform internal fixation for femoral neck fractures. Cancellous screws (...) , musculoskeletal health, and improved fracture healing. Experimental animal studies have demonstrated the concentration of vitamin D metabolites are higher at a fracture callus compared to the uninjured contralateral bone, vitamin D supplementation leads to decreased time to fracture union and increased callus vascularity, and vitamin D increases mechanical bone strength compared to controls. Clinical studies have also demonstrated that vitamin D supplementation increases the callus volume of proximal humerus

2013 Clinical Trials

1582. Treatment of large cystic medial osteochondral lesions of the talus with autologous osteoperiosteal cylinder grafts. (Abstract)

transplantation of autologous osteoperiosteal cylinder graft, which was harvested from the ipsilateral iliac crest. The visual analog scale score for pain during daily activities, American Orthopaedic Foot & Ankle Society hindfoot and ankle scores, and subjective satisfaction survey rating were obtained. Plain radiographs and magnetic resonance imaging of the ankle were obtained before and after surgery. In 13 cases second-look arthroscopy was performed 12 months postoperatively and the cartilage repair (...) was assessed with the criteria of the International Cartilage Repair Society.Sixteen patients were available for follow-up at a mean of 32.6 months (range, 24 to 48 months). The mean visual analog scale score decreased from 5.51 ± 0.83 preoperatively to 0.98 ± 0.98 at the latest follow-up, and the median American Orthopaedic Foot & Ankle Society score improved from 75 preoperatively to 90 at the latest follow-up. Seven patients resumed sporting activities. Overall, 7 patients rated the result as excellent

2013 Arthroscopy

1583. The effect of caffeine ingestion on skill maintenance and fatigue in epee fencers. (Abstract)

The effect of caffeine ingestion on skill maintenance and fatigue in epee fencers. The ergogenic effect of caffeine on sports performance focuses predominantly on endurance sports (Doherty & Smith, 2004 ) with little research on intermittent high intensity sports. This study aimed to explore the effect of caffeine ingestion on skill maintenance following fencing simulated exercise. Eleven competitive fencers participated (four female; seven male; age 33 ± 6.5 years). Following a maximal test (...) to exhaustion, fencers completed two trials assessing accuracy and reaction times (Stroop test) before and after a fatiguing protocol designed to simulate the demands of a fencing competition. Skill testing involved 30 lunges to hit a target. 500 ml placebo or 3 mg · kg(-1) caffeine supplemented drink was administered after the initial reaction and skill tests in a single-blind crossover design. The fatiguing protocol involved simulating six fights with 6-minute rests between each. Fencers rated

2013 Journal of sports sciences Controlled trial quality: uncertain

1584. Training table to the battlefield: protein recommendations for warfighters. Full Text available with Trip Pro

been tailored for these populations. Like athletes, warfighters consider protein a critical component of their diet and often incorporate protein supplements into daily diet plans. This article highlights sports nutrition principles that target energy and protein needs of athletes, considers the basis of these recommendations in the context of protein supplementation, and asserts that translating these recommendations to the warfighter is appropriate and necessary. The recommended range of protein (...) Training table to the battlefield: protein recommendations for warfighters. Warfighters represent a population of athletes for whom routine training and physical expectations for military operations parallel, and very often exceed, those of their civilian counterparts. Like athletes, warfighters require nutrition support to optimize physical condition to maintain training, sustain performance, speed recovery, and prevent injury and illness. Specifically, energy and protein requirements have

2013 Journal of Nutrition

1585. A 60day double-blind, placebo-controlled safety study involving Citrus aurantium (bitter orange) extract. (Abstract)

A 60day double-blind, placebo-controlled safety study involving Citrus aurantium (bitter orange) extract. Bitter orange (Citrus aurantium) extract and its primary protoalkaloid p-synephrine are widely consumed in dietary supplements for weight management and sports performance. p-Synephrine is also present in foods derived from a variety of Citrus species. Bitter orange extract is commonly used in combination with multiple herbal ingredients. Most clinical studies conducted on bitter orange

2013 Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association

1586. Comparison of Pre-exercise Beta-hydroxy-beta-methylbutyrate Free Acid (HMB-FA) and Cold Water Therapy for the Attenuation of Muscle Damage and Soreness

of the squat exercise only using the same loading pattern and rest interval length as T2. Following the T2 and T3 workouts subjects in CT will undergo no treatment; subjects in CW will be required to sit in a whirlpool tub for 10-min up to their umbilicus in water at 50° F - 54° F (10° C - 12° C); subjects in HMB-FA will be provided the supplement 30 min prior each workout and CW+HMB-FA will be administered together at time points describe above. Statistical Analysis Statistical evaluation of performance (...) nutritional supplement or performance enhancing drug (determined from health and activity questionnaire). Any chronic illness that causes continuous medical care Taking any type of prescription or over-the-counter medication, having any chronic illness causing you to seek medical care, pregnancy Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided

2013 Clinical Trials

1587. Effect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed subjects. Full Text available with Trip Pro

Effect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed subjects. Eurycoma longifolia is a medicinal plant commonly called tongkat ali (TA) and "Malaysian ginseng." TA roots are a traditional "anti-aging" remedy and modern supplements are intended to improve libido, energy, sports performance and weight loss. Previous studies have shown properly-standardized TA to stimulate release of free testosterone, improve sex drive, reduce fatigue, and improve well (...) -being.We assessed stress hormones and mood state in 63 subjects (32 men and 31 women) screened for moderate stress and supplemented with a standardized hot-water extract of TA root (TA) or Placebo (PL) for 4 weeks. Analysis of variance (ANOVA) with significance set at p < 0.05 was used to determine differences between groups.Significant improvements were found in the TA group for Tension (-11%), Anger (-12%), and Confusion (-15%). Stress hormone profile (salivary cortisol and testosterone

2013 Journal of the International Society of Sports Nutrition Controlled trial quality: uncertain

1588. What Does The Death of Robert Atkins Tell Us About the Atkins Diet?

cannot base decisions on what diet plan is healthy or effective for weight loss on the outcome of one patient. It doesn’t matter how famous that one person is or whether he/she originated and meticulously followed the diet. It is a ludicrous concept. Would you base your decision to engage in running based on the death of ? Fixx did much to popularize the sport of running and the concept of jogging as a source of health benefit and weight loss. He died while jogging, in fact. An autopsy concluded (...) obese man. Atkins actually weight around 200 pounds through most of his life and a hospital note on admission showed him weighing 195 pounds. A substantial weight gain of 63 pounds occurred in the 9 days after his admission due to the accumulation of fluid volume and swelling which is not uncommon in the critically ill. No autopsy was performed on Atkins but the NYME wrote on the document that he had “h/o of MI, CHF, HTN.” MI is the acronym for a myocardial infarction or heart attack. As far as we

2016 The Skeptical Cardiologist

1589. Should I Have Meniscus Surgery?

damage to the structure of the knee? This is assuming that the knee does not lock and pain is minimal. I am a very active 20 something that is involved in contact sports similar to wrestling. I am still training and perform reasonably well. The only time my knee feels uncomfortable is when its in full flexion, heel touching my butt – my knee would pop but without pain. I am able to modify my activities/ movements that do not put me in that position too often… Thanks, Louis says: Louis… in general (...) or stitched back into place. Most procedures take 15-45 minutes and you are able to go home the same day. Whether or not you can return to sports soon will depend on which procedure you had — repair versus removal. More on the here. So if you have a meniscus tear, it’s not all doom and gloom. Many tears do not require meniscus surgery. Some of them do. Some meniscus tears are repairable. Sometimes the torn portion of the meniscus is simply removed. This tear is displaced and caught between the two bones

2016 Howard J. Luks, MD blog

1590. Get a grip…

Get a grip… Get a grip… | The Sports Physio Simple, practical, honest advice Menu / You can get a lot of information from a handshake. A good, firm, vigorous handshake often tells me the individual is strong, healthy, interested and enthusiastic. However, a weak, limp, flaccid handshake often tells me the individual is cautious, timid, weak, lethargic or disinterested. And the over-the-top bone crusher handshake usually tells me the individual is trying to assert their dominance or trying (...) is preferred, and in the Middle East you never offer your left hand to shake as it’s a great insult, and a woman’s hand is never to be touched unless it is offered by her. The handshake has also evolved some rather bizarre rituals that can signify membership to a secret club or organisation, and in sports, they are often used to celebrate achievements with intricate and synchronised, fist bumps, hand slaps, and arm movements that boggle the mind. Check it! Now I always shake my patients hands when I greet

2016 The Sports Physio blog

1591. 5 Ways to Enhance Your Exercise Recovery

to comment and I will update this accordingly. Protein Supplements For Exercise Recovery: Many athletes will choose to rehydrate during a race with drinks containing both glucose to restore glycogen and protein. The thought process is that the protein is enhancing their performance. The medical literature does not necessarily support this. This reviewed the available literature and found no improvement in performance with the addition of protein to your rehydration cocktail during training or a race (...) . When recovery and perhaps an improvement in muscle mass is considered the within the recovery window and afterward may increase muscle mass and future performance if training is appropriate. Protein supplementation can include , , and . Unfortunately, protein supplementation has not been shown to diminish muscle soreness after training. . While the authors agree that protein intake definitely increases protein synthesis and theoretically muscle repair; they note that protein supplements did

2016 Howard J. Luks, MD blog

1592. Managing Knee Arthritis Pain Without Surgery

Severe arthritis of the knee on the right picture The most common methods utilized today to decrease the pain you suffer due to osteoarthritis of the knee include: NSAIDS: Over the counter anti-inflammatories Exercise and Physical Therapy Supplements/Medications Tart Cherry Juice PRP Bone Marrow Injections: Hyaluronic Acid (Gel) Injections. Bracing: Specifically “unloader” type braces. Selective arterial embolization: see below. Supplements For Knee Osteoarthritis: Most patients with osteoarthritis (...) with PRP injections is that we still need to determine exactly which way to prepare it is best, how often it should be given and we need the insurance companies to buy in since they do not cover it and it will be a cash outlay for you. When we perform PRP injections we take a sample of blood and prepare it in a centrifuge. We then inject a portion of that blood back into the knee. Within a few days to a few weeks, most of you are feeling better. In general, the more severe your arthritis, the less

2016 Howard J. Luks, MD blog

1593. For Whom The Ketosis Tolls

and heavy exertion while you are in the middle of rebuilding it, why so would you expect to be able to continue to perform exercise at previous levels while you are rebuilding your body’s internal engine? Also, why are the only resources you referenced in this journey woefully outdated?” I wouldn’t say I was engaging in hard and heavy exertion during my week in ketoland; walking a couple of miles to and from a restaurant or riding my bike at a moderate pace plus weights was the extent of it. Perhaps (...) due to long hikes with very little food and running in the mornings (5-10 miles) with no calorie intake. Around 10 years ago I got on the sports drink/carb loading thing and I’m pretty sure it was a big part of my weight gain issues. I’ve gone from training for triathlons to a much more manageable workout schedule and have dropped weight easier than when I was in my 20’s and 30’s in spite of being horribly insulin dysfunctional (A1c 5.6% trig/HDL 9.7 ). My A1c is now 5.0 and trig/HDL is 2.0 (7 lbs

2016 The Skeptical Cardiologist

1594. Is a Cure for Hepatitis B Coming? Experts Say Yes

of benifits and will slow down the scar tissue demage Hello: I am glad you are doing well. The National Institutes for Health has published fact sheets on various herbal supplements, including milk thistle. The home page is at: and the fact sheet about milk thistle is at The NIH reports, “Previous laboratory studies suggested that milk thistle may benefit the liver by protecting and promoting the growth of liver cells, fighting oxidation (a chemical process that can damage cells), and inhibiting (...) inflammation. However, results from small clinical trials of milk thistle for liver diseases have been mixed, and two rigorously designed studies found no benefit.” Please keep in mind that herbal remedies and supplements are not regulated so you don¹t really know for sure what is in them, and that the contents could change from one bottle to the next. The other problem is there is typically NO evidence (no clinical trials or data) to back up a claim for a cure, which is why the NIH fact sheets are so

2016 hepbblog

1595. Is reducing childhood obesity still a slim prospect?

. Taking out 20 per cent of sugar in products The proposal to reduce, by 20 per cent, the sugar levels in a range of foods eaten by children is a laudable aim. However, given that the food and drinks industry are being “challenged” rather than forced to do this could limit its success, and the proposal has been by major retailers for not going far enough. Public Health England has been charged with monitoring and assessing this target, but has no powers to address poor performance. If sufficient (...) of physical activity every day, 30 minutes of which should happen in school and 30 minutes at home. Suggestions are made as to how this requirement can be met in schools, and additional money for school sports is due to come from the sugar tax if it yields revenue. If 30 minutes of physical activity is successfully introduced across all schools, the big unknown relates to the remaining 30 minutes that is supposed to happen at home. Analysis of the showed that physical activity and diet are associated

2016 Nuffield Trust blog

1596. Newly Diagnosed with Hepatitis B? Acute or Chronic? Learning the HBV Basics…

a good idea to practice safe sex until you know for sure your partner is immunized and protected. Good luck! hi, may i know what medicine did u take? im also reactive in hepb surface antigen..i tried liverine capsule for 3 mos but still the result is im taking food supplement and had a test again last month and still reactive..please what medicine did u take? i want to try also.. Hello: Please know there is no cure for hepatitis B, and there is no supplement that will make the infection (...) and Asian, some countries do discriminate, unfortunately. In the U.S., only if you have a very high viral load, are there any restrictions placed on doctors who perform surgeries where there is high risk of sharp injuries. In that case, antivirals are effective in reducing viral load to allow everyone to practice medicine. Good luck. Hi. I recently did test and it came back positive for hepatitis b. I believe I am an acute carrier , please advise what drugs do I needs to take as an acute carrier. Please

2016 hepbblog

1597. Exercise-Induced Asthma

grams before Dietary salt reduction Omega 3 supplementation Avoid s (e.g. ) in Exercise-Induced Asthma (unless ) Consistent use results in worsening symptoms and decreased short-acting (rescue ) effect If s are used in Exercise-Induced Asthma, avoid use >3 days per week X. Guidelines: Sporting organization rules regarding restricted medications for Asthma Organizations United States Olympic Committee (USOC) National Collegiate Athletic Association (NCAA) No approval needed Leukotriene Modifiers (...) . Management: General Measures Maintain regular for physical conditioning Warm up and cool down for 10 minutes before and after in humidified, warm environment Cover nose and mouth during cold weather Consider heat exchange mask (available at sporting good stores) Avoid within 2 hours following a meal Avoid in high allergen, ozone or pollution IX. Management: Medications Treat related conditions Primary Agents ( , ) Use 2 puffs, 15-30 minutes before Secondary Adjunctive Agents Step 1: Leukotriene Modifiers

2015 FP Notebook

1598. Nutrition for Athletes

hydration is paramount After competitive event Drink or eat 50 gram high glycemic carbohydrate ASAP Repeat high s every 2 hours Take in over 100 grams carbohydrate in 4 hours Take in over 600 grams carbohydrate in 24 hours Start simple, liquid high and advance IV. Management: Vitamins and Minerals used by up to 80% of athletes Supplementation results in no performance improvement Supplementation may be beneficial in specific cases and Calcium may be deficient in women may be deficient in strict (...) for Athletes Aka: Nutrition for Athletes , Athletic Nutrition , Sports Nutrition II. Physiology: Nutrient Requirements Water is the most important nutrient for the athlete Carbohydrates (bulk of calorie intake for sports) Athlete requires 5-10 grams/kg/day Carbohydrates comprise 65-70% of daily calories Protein ral population protein requirements Recommended Daily Allowance = 0.8 g/kg/day Protein requirements for athletes Athletes require 1.8 grams/kg/day Athletes protein intake and output Comprise 15-20

2015 FP Notebook

1599. Exercise in Diabetes Mellitus

in rock-climbing Use caution in long-distance swimming Retinopathy Avoid weight lifting Avoid mountain climbing Avoid weight bearing s Choose stationary bike or water sports Abnormal hemodynamic response to Inappropriate response Inappropriate response May not experience l symptoms with May not experience hypoglycemic symptoms Avoid Cardiovascular disease Consider Stress Testing prior to program IV. Approach: Starting Exercise Evaluate coronary, nephropathy, , retinopathy Confirm no contraindications (...) recommended 6 to 7 days per week Duration: 20 to 60 minutes Level: 60-80% of maximum Allow time for warm up and cool down Reduces injury risk Reduces post- arrhythmia risk Perform light activity throughout the day Rise from sitting every 30 minutes VI. Management: Blood Sugar in the peri-Exercise period Check pre-exercise <100 mg/dl Snack 15-20 grams carbohydrate before 100 to 250 mg/dl No snack needed >250 with ketones (or >300 without) Delay Check etones Treat and dehydration Pre- Take more than 1 hour

2015 FP Notebook

1600. Creatine

. Epidemiology Not banned by IOC or NCAA Not detected by testing III. Physiology High energy cells (skeletal muscle) use Creatine Creatine acts as phosphate donor to form ATP Muscle stores enough for 10 seconds high intensity IV. Sources Synthesized by , , Exogenous dietary sources (Meat or fish) Typical U.S. dietary intake: 1-2 grams per day Creatine Supplement Typical Use by power sport athletes Loading: 5 grams four times daily for 5 to 7 days Maintenance: 5 grams per day V. Efficacy Mixed results from (...) randomized trials Studies find strength and mass increase (men and women) Beneficial in high intensity sports (bursts of activity <30 seconds) ball Weight lifting Variable effect in sprinters Endurance time improved in the lab Benefit not found in field performance Not effective in endurance sports No effect in and swimming References VI. Adverse Effects Weight gain (short-term, <1 week following intake) Probably safe in patient with No renal effects in later study of healthy men Anecdotal reports

2015 FP Notebook

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