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Kicman, A T; Brooks, R V; Cowan, D A
doi: 10.1136/bjsm.25.2.73pmid: 1751893
Human chorionic gonadotrophin (hCG) is a glycoprotein hormone which is produced in large amounts during pregnancy and also by certain types of tumour. The biological action of hCG is identical to that of luteinizing hormone, although the former has a much longer plasma half-life. Some male athletes use pharmaceutical preparations of hCG to stimulate testosterone production before competition and/or to prevent testicular shutdown and atrophy during and after prolonged courses of androgen administration. Testosterone administration can be detected by measuring the ratio of concentrations of testosterone to epitestosterone (T/E). An athlete is often considered to have failed a drug test if the urinary T/E ratio is greater than 6. In contrast, hCG administration stimulates the endogenous production of both testosterone and epitestosterone without increasing the urinary T/E ratio above normal values. Although the administration of hCG was banned by the International Olympic Committee (IOC) in 1987, no definitive test for hCG has been approved by the IOC. Currently, the only way of measuring small concentrations of hCG is by immunoassay, and this does not have a discriminating power as great as gas-liquid chromatography with mass-spectrometry which is necessary to satisfy IOC requirements. Extraction procedures and chromatographic steps could be introduced before using a selected immunoassay for hCG to meet these requirements.
doi: 10.1136/bjsm.25.2.87pmid: 1751895
In this prospective study, we have investigated incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey games. All twelve Swedish elite hockey teams were observed during the season 1988-1989 when a total number of 664 games were played. There was a total number of 285 injuries, of which the majority were minor (61%) and only 9% were classified as major. Seventy-four per cent of the injuries occurred during games and 26% during practice. The overall incidence of injury was 53.0 per 1000 player-game hours. Eighty-five per cent of injuries were caused by trauma and 15% by over-use. Injuries were most often localized to the head/face (39%) or the lower limb (32%). Most injuries resulted from stick contact or player contact including checking. A reduction of minor and moderate injuries should be possible by stricter enforcement of the hockey rules, and more widespread use of visors.
Williams, A; Stephens, R; McKnight, T; Dodd, S
doi: 10.1136/bjsm.25.2.90pmid: 1751896
Recently it has been shown that regular exercise is both physiologically and psychologically beneficial to patients with end-stage renal disease (ESRD). However, ESRD patients traditionally have a high non-adherence level to their self-care and medical regimens. To date, their adherence to exercise programmes has not been studied. Background information about employment, medical history, previous exercise habits and locus of control was obtained from 40 volunteer ESRD patients who started exercise at home. Twenty-eight participants maintained the exercise programme, consisting of aerobic activity lasting an average of 25 min, four times per week, for 12 weeks. The adherent patients were found to have encouraging support groups (75 versus 25%), to be between 41 and 60 years of age (64 versus 33%), to have been on dialysis for between 2 and 5 years, and to have loci of control (feeling of control over life events) classed as 'internal' (68 versus 25%). Factors such as sex, race, employment status and depression were found to have little influence on adherence. The major finding of this study was that patients adherent to exercise could be distinguished by unique psychological and psychosocial factors, and that adherence in this population was higher (70 compared with 50%) than some estimates for the general population.
doi: 10.1136/bjsm.25.2.94pmid: 1751897
Medial knee pain is an increasingly common presentation in sports medicine practice. A prospective review was undertaken of 72 patients, mean age 48 years, seen in 1986-1987. The physical findings which were most diagnostic were a loss of some degrees of flexion which was painful medially when forced, and tenderness over the posteromedial joint line. Treatment was either injection of local steroid, or physiotherapy, together with emphasis on quadriceps exercise. Five patients failed to respond and were referred for arthroscopy. Nine patients relapsed once but no subsequent episode has occurred. Meniscotibial ligament strain is a common cause of knee pain in middle-aged sports people.
Graham, G P; Johnson, S; Dent, C M; Fairclough, J A
doi: 10.1136/bjsm.25.2.96pmid: 1751898
A prospective study was undertaken to compare the accuracy of the Lachman test, anterior drawer test and jerk test with the KT1000 knee arthrometer in patients with proven anterior cruciate ligament deficiency. The Lachman and anterior drawer tests were found to be the most accurate indicators of anterior cruciate ligament deficiency. The KT1000 knee arthrometer was found to be totally inaccurate, which precludes its use as an objective measure of anteroposterior laxity of the knee.
Krüger-Franke, M; Siebert, C H; Pförringer, W
doi: 10.1136/bjsm.25.2.98pmid: 1751899
Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries.
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