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Background The history of total hip arthroplasty dates back to the first half of the twentieth century. Data on hip endoprostheses implanted during the 1960s and 1970s suggest widely varying survival rates of the prosthesis. Case A case of a patient who underwent total hip arthroplasty in 1972 using a Sivash prosthesis, developed in 1956 in the former Soviet Union, is presented in this article. The prosthesis has remained unrevised in the patient’s body for 50 years and he continues to be widely free of implant-related symptoms. Despite the constrained metal-on-metal design of the implant, which can lead to adverse reactions to metal debris, no elevated systemic metal ion levels were detected. Conclusion The likelihood of encountering patients with prosthesis survival beyond 50 years is still rare. Nevertheless, changing demographics and the steadily improving designs and materials of hip endoprostheses may likely result in such cases.

Contains fulltext : 249492.pdf (Publisher’s version ) (Open Access), The centrally-projecting Edinger-Westphal nucleus (EWcp) hosts a large population of neurons expressing urocortin 1 (Ucn1) and about half of these neurons also express the leptin receptor (LepRb). Previously, we have shown that the peripheral adiposity hormone leptin signaling energy surfeit modulates EWcp neurons' activity. Here, we hypothesized that Ucn1/LepRb neurons in the EWcp would act as a crucial neuronal node in the brain-white adipose tissue (WAT) axis modulating efferent sympathetic outflow to the WAT. We showed that leptin bound to neurons of the EWcp stimulated STAT3 phosphorylation, and increased Ucn1-production in a time-dependent manner. Besides, retrograde transneuronal tract-tracing using pseudorabies virus (PRV) identified EWcp Ucn1 neurons connected to WAT. Interestingly, reducing EWcp Ucn1 contents by ablating EWcp LepRb-positive neurons with leptin-saporin, did not affect food intake and body weight gain, but substantially (+26%) increased WAT weight accompanied by a higher plasma leptin level and changed plasma lipid profile. We also found that ablation of EWcp Ucn1/LepRb neurons resulted in lower respiratory quotient and oxygen consumption one week after surgery, but was comparable to sham values after 3 and 5 weeks of surgery. Taken together, we report that EWcp/LepRb/Ucn1 neurons not only respond to leptin signaling but also control WAT size and fat metabolism without altering food intake. These data suggest the existence of a EWcp-WAT circuitry allowing an organism to recruit fuels without being able to eat in situations such as the fight-or-flight response.

Background The epidemiology of injury at club level in the English Women’s Domestic Club Football League is unknown. The aim of this study was to estimate the incidence, prevalence, and nature of injury in a single women’s football squad over the course of one season. Study Design Prospective single site cohort study Methods Twenty-five female footballers competing in the English Women’s Championship were observed. Data collection procedures followed the UEFA consensus guidelines (2006). Individual player exposure was recorded for all football related activity and incidence of injury per 1000h was estimated for total, match, and training activity. Prevalence, site, and type of injury was recorded. Epidemiologic incidence proportions, clinical incidence and severity was calculated to provide measures of injury burden and resource management statistics. Results A total of 18 injuries including re-injuries were sustained in 11 players providing a clinical incidence of 0.72 injuries per player. Epidemiological incidence proportion was 0.44 (95% CI: 0.24 – 0.74), thus the average probability that any player would sustain at least one injury was 44% (95% CI: 25% to 63%). The total incidence of injury was 8.0/1000h, 30.6/1000h during match play and 2.2/1000h during training. The most common sites of injury were the knee (5/18, 28%) and thigh (4/18, 22%). There was two (11%) non-time loss and 16 (89%) time-loss injuries recorded. Of the 16 time loss injuries, there were three (19%) severe, five (31%) moderate and six (37%) minor severity injuries. Of the five knee injuries, two (13%) were major severity ruptures of the anterior cruciate ligament. Injury burden was estimated to be 468 days lost/1000h. Conclusions This is the first prospective investigation capturing women’s injury incidence data from a cohort of English domestic club players. Total, match, and training incidence rate estimates are comparable to rates of single site cohort studies in Europe. The days lost fro

The worldwide rise in popularity of climbing and development of climbing as a competitive sport is reflected by its debut at the 2021 Summer Olympic Games in Tokyo. Digital primary periphyseal stress injuries in adolescent climbers may pose a significant risk to long-term skeletal health. The aim of this article is to critically review research on the diagnosis and management of primary periphyseal stress injuries of the fingers in adolescent climbers. We adopted a systematic approach to searching for relevant literature. Articles were identified after searches of the following electronic databases: Discover, Academic Search Complete, PubMed, Embase, SPORTDiscus, and ScienceDirect. Conclusive evidence suggests digital primary periphyseal stress injuries are a consequence of repetitive microtrauma. Pain reported by adolescent climbers on the dorsal aspect of the proximal interphalangeal joint should be investigated promptly to avoid serious negative consequences. Clinicians should be aware of the efficacy of imaging techniques to inform a clinical diagnosis. A conservative management approach is preferred but in rare cases surgical intervention may be necessary. A diagnostic and therapeutic algorithm for digital primary periphyseal stress injuries is presented.

Introduction: All the research investigating the cardiopulmonary capacity in climbers is focused on predictors for climbing performance. The effects of climbing on the cardiovascular system in adolescents climbing at an elite level (national team) have not been evaluated. Material and methods: Retrospective analysis of the cardiopulmonary exercise test (CPET) performed on a cycle ergometer during the annual medical examination of the entire German Junior National climbing team on one occasion and for a selected subgroup on two occasions spaced two years apart. The data from the subgroup was compared to an age- and gen der-matched control of Nordic skiers from the German Junior National Nordic skiing team. Results: 47 climbers (20 girls, 27 boys) were examined once. The VO2peak achieved by the athletes was 41.3 mL kg−1 min−1 (boys) and 39.8 mL kg−1 min−1 (girls). 8 boys and 6 girls were tested twice over a period of 27.5 months. The parameters of the exercise test measured on both occasions were significantly lower than those of the 8 male and 6 female Nordic skiers. There was no change with respect to any variables (e.g. VO2peak, peak work load, peak heart rate, peak lactate or O2 pulse) over the examined period. Conclusions: The elite climbers investigated in this study showed comparable VO2peak values to athletes from team and combat sports. The Nordic skiers to which they were compared showed significantly higher values consistent with the fact that this is an endurance sport. Even though the cardiopulmonary measurements of the Nordic skiers still improved after two years of training, no adaptations could be observed in the elite climbers