Clinical and surgical outcome in patients with cervical spondylodiscitis-a single-center retrospective case series of 24 patients.

Objective: Cervical spondylodiscitis is a rare pathology, with an incidence of 0.5-2.5 per 100,000 population, posing significant potential risks. This type of infection can lead to neurological impairment in up to 29% of patients. Radical surgical debridement of the infected segment, fusion, and an intravenous antibiotic regimen remains the gold standard in most spine centers. This study aimed to analyze the surgical outcome in a tertiary spine center based on disease severity. Methods: In this study, we retrospectively included all patients diagnosed with cervical spondylodiscitis and treated at the University Hospital Augsburg between January 2017 and May 2022. We collected and analyzed baseline parameters on clinical presentation with symptoms, laboratory parameters, radiological appearance, and surgical parameters such as type of approach and implant, as well as neurological and radiological outcomes. Descriptive statistics were performed using SPSS, and relevant correlations were examined using the t-test for independent samples and the chi-square test. Results: Twenty-four patients (9%) with cervical spondylodiscitis were identified. Twenty-two (92%) surgically treated patients were subdivided into the complicated discitis group (n = 14, 64%) and the uncomplicated discitis group (n = 8, 36%). Seventeen patients (71%) presented with sepsis on admission, 17 patients (71%) were diagnosed with epidural abscess on primary imaging, and 5 patients (21%) had more than one discitis lesion at a distant spinal segment. The presence of epidural abscess was significantly associated with systemic sepsis (OR = 6.2; p = 0.03) and myelopathy symptoms (OR = 14.4; p = 0.00). The most frequently detected specimen was a multisensitive Staphylococcus aureus (10 patients, 42%). Six patients (25%) died after a median of 20 days despite antibiogram-accurate therapy, five of whom were diagnosed with a complicated type of discitis. The follow-up data of 15 patients (63%) revealed permanent neurological damage in 9 patients (38%). Notably, the surgical approach was a significant factor for revision surgery (p = 0.008), as three out of five (60%) ventrodorsal cases with complicated discitis were revised. Conclusion: Cervical spondylodiscitis represents a severe infectious disease that is often associated with permanent neurological damage or a fatal outcome, despite adequate surgical and antibiotic treatments. Complicated types of discitis may require a more challenging surgical and clinical course.

Intraoperative radiotherapy during awake craniotomies: preliminary results of a single-center case series.

Awake craniotomies are performed to avoid postoperative neurological deficits when resecting lesions in the eloquent cortex, especially the speech area. Intraoperative radiotherapy (IORT) has recently focused on optimizing the oncological treatment of primary malignant brain tumors and metastases. Herein, for the first time, we present preliminary results of IORT in the setting of awake craniotomies. From 2021 to 2022, all patients undergoing awake craniotomies for tumor resection combined with IORT were analyzed retrospectively. Demographical and clinical data, operative procedure, and treatment-related complications were evaluated. Five patients were identified (age (mean ± standard deviation (SD): 65 ± 13.5 years (y)). A solid left frontal metastasis was detected in the first patient (female, 49 y). The second patient (male, 72 y) presented with a solid metastasis on the left parietal lobe. The third patient (male, 52 y) was diagnosed with a left temporoparietal metastasis. Patient four (male, 74 y) was diagnosed with a high-grade glioma on the left frontal lobe. A metastasis on the left temporooccipital lobe was detected in the fifth patient (male, 78 y). After awake craniotomy and macroscopic complete tumor resection, intraoperative tumor bed irradiation was carried out with 50 kV x-rays and a total of 20 Gy for 16.7 ± 2.5 min. During a mean follow-up of 6.3 ± 2.6 months, none of the patients developed any surgery- or IORT-related complications or disabling permanent neurological deficits. Intraoperative radiotherapy in combination with awake craniotomy seems to be feasible and safe.

HIV-positive men who have sex with men are at high risk of development of significant liver fibrosis after an episode of acute hepatitis C.

Acute hepatitis C virus infection remains a major health concern in human immunodeficiency virus(HIV)-infected men who have sex with men (MSM). New direct-acting antiviral agent (DAA) combination therapy has not yet been approved for the treatment for acute hepatitis C virus(HCV), thereby potentially causing deferral of HCV treatment. Therefore, we aimed to study the course of liver disease after an episode of acute HCV. This study is a retrospective single-centre cohort of HIV-positive MSM with acute HCV infection. Liver fibrosis was estimated by Fibroscan® and Fibrotest® . Liver-related and non-liver-related outcomes were documented. Overall 213 episodes of acute HCV infection in 178 men were documented. Median follow-up for all included patients was 38.7 months. Spontaneous HCV clearance was found in 10.8% of patients, which was significantly associated with older age, lower HCV RNA levels, and higher ALT levels upon initial acute HCV diagnosis. Treatment with interferon-based therapy was initiated in 86.3% of cases, resulting in a sustained virological response(SVR) rate of 70.7%. After 3 years' follow-up, significant liver fibrosis of METAVIR F2 stage or higher was found in 39.4% of patients after first acute HCV diagnosis. Higher age, physician-declared alcoholism, and nonresponse to acute HCV therapy were independently associated with higher fibrosis stages. Ten patients died during the observation period (IR 1.4/100 patient-years) and four during interferon treatment. Significant liver fibrosis is a common finding in HIV-positive MSM following acute HCV infection despite high treatment uptake and cure rates, suggesting the need for close liver disease monitoring particularly if HCV treatment is deferred.

Ultrasonographic examination of the abdomen of the goat. I. Reticulum, rumen, omasum, abomasum and intestines.

This review article summarizes the ultrasonographic findings of the reticulum, rumen, omasum, abomasum and intestines of goats. Ultrasonographic examination is done on both sides with the goat in a standing position using a linear array or convex transducer with a frequency of 5.0 to 7.5 MHz. The shape, contour and motility of the reticulum are assessed; this organ appears as a crescent-shaped structure with a smooth contour immediately adjacent to the diaphragm. There are 0.8 to 2.1 reticular contractions per minute, which may be mono-, bi- and triphasic. The rumen is examined from the 8th to 12th intercostal spaces (ICSs) and flank on the left, and from the 12th ICS and flank on the right. The ruminal wall appears as a thick echoic line. The dorsal and ventral sacs of the rumen are differentiated based on the longitudinal groove, which forms an echoic notch. Differentiation of the dorsal gas cap, fibre mat and fluid layer is not always straightforward and varies among goats. The omasum is examined from the 6th to 11th ICSs on the right. Only the wall closest to the transducer can be imaged and it appears as a crescent-shaped echoic line medial to the liver. The omasal folds and the wall furthest from the transducer cannot be seen. In about two thirds of goats, active omasal motility is apparent as a transient reduction in size of several centimetres, followed by relaxation and return to its original size. There is an average of 1.1 contractions per minute. The abomasum is examined from the ventral midline and the left and right paramedian regions and can always be seen from the ventral midline. In all but a few goats the abomasum is also visible from the left and right paramedian areas. It appears as a heterogeneous, moderately echoic structure with echogenic stippling. The abomasal folds appear as prominent echoic bands in about two thirds of all goats. The small and large intestines are examined on the right from the 8th to the 12th ICSs. Loops of jejunum and ileum are seen mainly in cross-section and have a strong motility. The intestinal content is usually homogeneous and echoic and the diameter of the intestinal loops varies from 0.8 and 2.7 cm. The spiral colon and in many cases also the caecum can be imaged. The former is recognized by its garland-like appearance brought about by the centripetal and centrifugal coils of the intestine. In the spiral colon and the caecum, only the wall closest to the transducer can be imaged because of intraluminal gas. The wall appears as a thick echoic and slightly undulating line 5.6 to 8.0 cm in length. Ultrasonography is an imaging technique that is very well suited for the examination of the gastrointestinal tract of goats.

Ultrasonographic examination of the abdomen of the goat. II. Liver, spleen, urinary tract and greater omentum.

This review article describes the ultrasonographic findings of the liver, spleen, urinary tract and greater omentum that were previously obtained in studies of healthy female Saanen goats. Real-time B-mode ultrasonography and a linear or convex 5.0 to 7.5 MHz transducer are used to scan standing goats from both sides. The urinary bladder and urethra are also examined transrectally. The liver is scanned from the intercostal spaces (ICSs) on the right from dorsal to ventral. The parenchymal pattern consists of numerous fine echoes that are homogenously distributed across the entire organ. The dorsal visible margin of the liver runs parallel to the lung in a cranioventral to caudodorsal direction. The visible extent of the liver is largest in the 7th and 8th ICSs and the maximum thickness is measured in the 10th ICS. The caudal vena cava has a triangular shape in cross section and is seen only at the 11th or 12th ICS. The portal vein is oval to circular in cross section with stellate ramifications into the liver parenchyma. The gallbladder is pear-shaped and sometimes extends beyond the ventral margin of the liver depending on the amount of bile. In most goats, the gallbladder is only seen from the 9th or 10th ICS. The spleen is scanned from the left where it is almost always seen from the 11th and 12th ICSs. The parenchymal ultrasonographic pattern is similar to that of the liver. The splenic vessels are embedded in the parenchyma and are seen in longitudinal or cross section. The kidneys are best visualized from the flank and last two ICSs on the right. The ultrasonographic appearance varies with the sectional plane. In a sagittal plane through the hilus, the parenchyma is homogenous with fine, evenly distributed echoes. The medullary pyramids are seen near the sinus as oval to circular hypoechoic structures. The hyperechoic sinus is at the centre of the kidney. The urinary bladder is best visualized transrectally but can also be seen in many goats from either inguinal region. The content of the bladder is usually anechoic and the diameter ranges from 1.0 to 4.8 cm. The urethra is seen transrectally as two adjacent parallel echoic lines without an apparent lumen.

Ultrasonography of the urinary tract in 29 female Saanen goats.

The left and right kidneys, ureters, urinary bladder and urethra of 29 female clinically healthy Saanen goats were examined via transcutaneous and transrectal ultrasonography. In order to establish reference values the examinations were performed using a 5.0 MHz linear transducer to scan the right caudal costal part of the abdominal wall, right and left dorsal flanks and right and left inguinal regions of standing goats. A 5.0 MHz intracavity probe was used for transrectal ultrasonographic examination of the urinary bladder and urethra. The kidneys were examined in longitudinal and cross section and assessed subjectively. They could usually be seen from the 12th intercostal space on the right side and dorsal right flank. The right kidney was 8.0 ± 0.67 cm long and the left was 8.4 ± 0.64 cm long. The ureters could not be visualized in any of the goats. The length of the urinary bladder was 5.1 ± 1.38 cm, and its largest cross-sectional diameter was 2.6 ± 1.01 cm. The urethra was seen in 23 goats and appeared as echogenic lines with no visible lumen. The transition from the neck of the bladder to the internal urethral orifice extended beyond the brim of the pelvis in only one goat.

Echocardiography in Saanen-goats: Normal findings, reference intervals in awake goats, and the effect of general anesthesia.

Echocardiographic assessment of cardiac structures, dimensions, and mechanical function in goats is poorly documented. The goal of this study was to describe normal findings, establish normal values for two-dimensional (2DE) and M-mode (MME) echocardiography, and investigate the influence of general anaesthesia. Standardized 2DE and MME recordings were obtained on 22 healthy female Saanen goats (3.7 ± 1.1 years [mean ± SD], 60.2 ± 10.6 kg) awake (standing) and during isoflurane anesthesia (sternal recumbency). Cardiac dimensions and function were assessed and compared between treatments (awake vs. anaesthetized). Color Doppler imaging and saline contrast studies served to assess abnormal blood flow patterns. Post mortem examination was performed in a subset of 12 goats. Transthoracic echocardiography was feasible in all goats. Indices of LV systolic function proved to be significantly increased during general anesthesia. The membranous and occasionally echolucent appearance of the oval fossa suggested abnormal interatrial communication in 9 goats. Color Doppler imaging and saline contrast studies proved to be inaccurate to detect interatrial shunting of blood. Post mortem examination confirmed small persistent foramen ovale in only 3 out of 7 goats, in which it had been suspected on echocardiography.

Ultrasonographic examination of the small intestine, large intestine and greater omentum in 30 Saanen goats.

The small and large intestine of 30 healthy Saanen goats were examined ultrasonographically using a 5.0 MHz-linear transducer. The goats were examined on the right side, from the eighth rib to the caudal aspect of the flank. The small and large intestine could be easily differentiated. The descending duodenum could be imaged in 19 goats, and the jejunum and ileum seen in all goats. The jejunum and ileum were most often seen in cross-section and rarely in longitudinal section in the ventral region of the right flank. The intestinal contents were usually homogenously echoic, and active motility was observed in all the goats. The diameter of the small intestine was 0.8-2.7 cm (1.6 [0.33] cm). The spiral ansa of the colon was imaged in all the goats, and in 21 the caecum was also seen. Both these sections of large intestine were most commonly seen in the dorsal region of the right flank. The spiral ansa of the colon was easily identified by its spiral arrangement of centripetal and centrifugal gyri, which had a garland-like appearance. Because of intraluminal gas, only the wall of the colon closest to the transducer could be imaged. The diameter of the spiral colon ranged from 0.8 to 2.0 cm (1.1 [0.24] cm). Usually only the wall of the caecum closest to the transducer could be imaged and it appeared as a thick, echoic, slightly undulating line. The greater omentum could be seen in all the goats.

Clinical findings and treatment in 63 cows with haemorrhagic bowel syndrome.

The clinical, haematological and biochemical findings, treatment and outcome of 63 cows with haemorrhagic bowel syndrome are described. The general condition and demeanor were moderately to severely abnormal in all the cows. Signs of colic occurred in 27 cows, decreased rectal temperature in 46 and tachycardia in 44. With the exception of one cow, intestinal motility was decreased or absent. Transrectal palpation revealed dilatation of the rumen in 47 cows and dilatation of the small intestine in 18. Faecal output was markedly reduced or absent, and the faeces were dark brown to black and contained blood. Nine cows were euthanized immediately after physical examination. Conservative medical therapy was instituted in two cows; however, both were euthanized a few days later because of deterioration in condition. Exploratory right flank laparotomy was carried out in 52 cows. Of these, 22 were euthanized intraoperatively because of severe lesions. In 27 cows, intestinal massage to reduce the size of blood clots was carried out; 11 were euthanized several days postoperatively because of deterioration in condition. In three other cows, intestinal resection was carried out and all survived. Of the 63 cows, 19 (30.2%) survived and were healthy at the time of discharge from the clinic.

Ultrasonographic examination of the spleen in 30 goats.

The ultrasonographic appearance, location and size of the spleen in 30 healthy female Saanen goats are described. The intercostal spaces of the left thoracic wall were scanned with a 5.0 MHz linear transducer in standing goats. The appearance of the splenic parenchyma, the position of the ultrasonographically visible dorsal and ventral margins of the spleen and the distance between them, the thickness of the spleen and the diameter of the splenic vessels were determined. The spleen could be visualised in at least one examination position and it always lay between the rumen and abdominal wall. The spleen bordered the lung dorsally and was located adjacent to the left abdominal wall in the last intercostal space and area immediately caudal to the last rib. The spleen had an echogenic capsule, and its parenchyma showed a homogenous fine echotexture / echo pattern throughout the whole visible part of the spleen. The splenic vessels were seen within the parenchyma. The visible dorsal margin of the spleen ran from cranioventral to caudodorsal. The distance from the dorsal margin of the spleen to the midline of the back was greatest in the 8th intercostal space (19.7 ± 4.19 cm) and smallest in the region immediately caudal to the last rib (7.0 ± 1.07 cm). The size of the spleen was smallest in the 8th intercostal space (3.1 ± 1.24 cm) and greatest in the 11th intercostal space (8.7 ± 2.78 cm). The thickness of the spleen ranged from 2.2 ± 1.14 cm caudal to the last rib to 6.4 ± 1.78 cm in the 11th intercostal space.

Ultrasonographic findings in 63 cows with haemorrhagic bowel syndrome.

Cows with haemorrhagic bowel syndrome were examined by ultrasonography. A 5.0 MHz linear transducer was used to scan the right side of 63 standing, non-sedated cows. The small intestine was found to be dilated and had a diameter of 4.3 to 12.0 cm (mean [sd] 6.76 [1.78] cm), and there was markedly reduced or absent small intestinal motility in all the cows. In 22 (34.9 per cent) cows, empty poststenotic segments of small intestine were seen in addition to empty prestenotic intestine. In 12 (19 per cent) cows, the intestinal lumen contained localised hyperechoic material consistent with blood clots. Fluid with or without fibrin was seen between intestinal loops in 39 (61.9 per cent) cows. Accumulation of ingesta in the abomasum and sometimes in the omasum and rumen was seen in 14 (22.2 per cent) cows. Ultrasonography was considered to be a useful tool for the diagnosis of ileus. However, this imaging modality could be used to make a definitive diagnosis of haemorrhagic bowel syndrome only when a blood clot was seen in the intestinal lumen.

[Ultrasonographic findings in a goat with ascites due to a mesothelioma]. / Ultraschallbefunde bei einer Ziege mit Aszites infolge Mesotheliom.

The aim of this case report was to describe the clinical, ultrasonographic and postmortem findings in a goat with a mesothelioma. The most striking clinical sign was marked bilateral distension of the abdomen caused by ascites. Other signs included abnormal general condition, weight loss, hypothermia and increased heart rate. Ultrasonographic examination revealed accumulation of a massive amount of hypoechoic fluid in the abdominal cavity and nodular lesions on the peritoneum, omentum and wall of the omasum. Based on the clinical and ultrasonographic findings, a tentative diagnosis of ascites attributable to neoplasia was made, and the goat was euthanized. Postmortem examination confirmed the diagnosis, and based on the results of histological examination, a mesothelioma was diagnosed.

[Ultrasonographic and computed tomographic findings in a goat with mediastinal lymphocytic thymoma]. / Ultraschall- und CT-Befunde bei einer Ziege mit Thymom im Mediastinum.

This case report describes the clinical, sonographic, computed tomographic and pathological findings in a 9-year-old goat with mediastinal lymphocytic thymoma. The goat was referred to the Department of Farm Animals because of weight loss and dyspnoea. The lead clinical findings were increased heart rate, increased respiratory rate and heart sounds heard only on the right side. Ultrasonographic examination revealed a massive amount of fluid and an echogenic corrugated mass ventral to the lungs in the thoracic cavity on the left side. Computed tomography showed that the mass was very large and diffusely mineralised. A tentative diagnosis of mediastinal neoplasia was made, and the goat was euthanized. Postmortem examination revealed a cauliflower-like, pedunculated tumour, which occupied the entire left thoracic cavity and displaced the left lung. Based on histological evaluation, the tumour was diagnosed as a lymphocytic thymoma.

Sonographic findings in an alpaca with Mycobacterium kansasii infection.

This case report describes the clinical, ultrasonographic and postmortem findings in an alpaca with Mycobacterium kansasii infection. The alpaca was referred because of chronic weight loss and weakness. The results of clinical examination, haematology and serum biochemistry were not diagnostic. Ultrasonography of the liver revealed multiple, hyperechogenic lesions with a diameter of 1 to 3 cm. Histological evaluation of a liver biopsy sample showed acute, multifocal, suppurative, necrotising hepatitis. Despite treatment with antibiotics, the alpaca died. Postmortem examination revealed nodular to coalescing lesions in the liver, lungs, mediastinum, pleura and greater omentum, which could not be differentiated macroscopically or histologically from lesions caused by tuberculosis. Ziehl-Neelsen staining showed massive numbers of rods within epithelioid macrophages, which were identified as Mycobacterium kansasii by polymerase chain reaction analysis.

An unusual cause of traumatic reticulitis/reticuloperitonitis in a herd of Swiss dairy cows nearby an airport.

This report describes the findings in five cows from one dairy herd, in which all 31 cows were slaughtered or euthanised because of traumatic reticuloperitonitis. All the cows had numerous thin sharp pieces of metal attached to a magnet in the reticulum, giving the magnet a hedgehog-like appearance. Investigation revealed that the cattle had eaten forage harvested from a field immediately adjacent to an airport. The snow was cleared from the airport runways with a machine that had a wire-bristle brush attachment. Mechanical wear resulted in numerous wire bristles breaking and these were blown with the snow onto the field in question. The wire then became accidentally incorporated into the hay and grass silage at harvest the next summer and was ingested by the cattle in the fall and winter. To prevent further cases, approximately 200 tonnes of hay and grass silage contaminated with wire were discarded and 30 hectares of the 50-hectare field were cultivated and re-sown. The wire-bristles of the snow plow were replaced with plastic bristles. The cost of this and the livestock loss was several hundred thousand Swiss Francs.

Sport specific fitness testing of elite badminton players.

There is a scarcity of descriptive data on the performance capacity of elite badminton players, whose fitness requirements are quite specific. The purpose of this paper is to investigate the physiological response of elite badminton players in a sport-specific fitness test. Twelve Hong Kong national badminton team players performed a field test on a badminton court. Six light bulbs were connected to a programming device causing individual bulbs to light up in a given sequence. The players were instructed to react to the flashes by running towards them, and striking shuttles mounted in the vicinity of the bulbs. Exercise intensity was controlled by altering the interval between successive lightings. A low correlation (r = 0.65) was found between the results of the field test and the rank-order list of subjects, based on an objective on-field physiological assessment and subjective ranking. This may be explained by the requirements of other factors besides physical fitness which contribute to success in elite level badminton competition. These factors may include, for example, technical skill, mental power, and aesthetic judgements on the court. Maximum mean (s.d.) heart rate data (187(8) beats.min-1) and blood lactate values (10.4(2.9) mmol.l-1) in this study showed that players were under maximal load during the field test. From the testing data, it seems reasonable to speculate that the intensity of level 3 (20 light pulses.min-1; 3.0 s.pulse-1) and level 4 (22 light pulses.min-1; 2.7 s.pulse-1) simulates the requirement of actual games energy expenditure of the Hong Kong badminton players exercising at close to their anaerobic threshold. The results also show that an estimate of fitness can be derived from measurements involving exercise closely resembling that which is specific for the sports activity in question. Improved training advice and guidance may result from such studies.

Physiological profiles and sport specific fitness of Asian elite squash players.

There is a scarcity of descriptive data on the physiological characteristics of elite Asian squash players. The purpose of this study was to evaluate the physiological profile and sports specific fitness of Hong Kong elite squash players. It was conducted before the selection of the Hong Kong national squash team for the 1992 Asian Squash Championship. Ten elite squash players were selected as subjects for the study. Maximum oxygen uptake was measured using a continuous treadmill running test. A sports specific field test was performed in a squash court. The following means (s.d.) were observed: height 172.6(4.3) cm; weight 67.7(6.9) kg; body fat 7.4(3.4)%; forced vital capacity (FVC) 5.13(0.26) litres; maximum oxygen uptake (VO2max) 61.7(3.4) ml.kg-1.min-1; anaerobic threshold (AT) 80.2(3.3)% of VO2max; alactic power index 15.5(1.8) W.kg-1; lactic work index 323.5(29.4) J.kg-1, peak isokinetic dominant knee extensor and flexor strengths 3.11(0.29) Nm.kg-1 and 1.87(0.18) Nm.kg-1. The results show that the Hong Kong squash players have relatively high cardiorespiratory sports specific fitness and muscle strength which may be one of the key factors that contributed to the success of the Hong Kong team in the Asian Championship.

[Chondropathia patellae--study of the femoropatellar joints of healthy, athletic children]. / Chondropathia patellae--Untersuchung der Femoropatellargelenke bei gesunden, sporttreibenden Kindern.

155 children, aged 8 to 13 years, who trained regularly, were examined clinically for signs of chondropathy patellae. As control group, 200 children of the same age were included who did not take part in any sports activities except in school. 32% of the training group children showed signs suggestive of chondropathy. With increasing training age, the part of children with these signs increased from 16% in the first to 45% in the third to fourth training year. Non-training children showed in 17% positive signs of chondropathy.

Sports-specific fitness testing in squash.

Maximum oxygen uptake and the running speed at the anaerobic threshold were determined during treadmill running. Performance in these laboratory tests and performance on a squash-specific field test were compared and examined with respect to subjective ratings of squash fitness. The field test was performed in a squash court. Six light bulbs were connected to a programming device causing individual bulbs to light up in a given sequence. The players were instructed to react to the flashes by running towards and striking balloons mounted in the vicinity of the bulbs. By altering the interval between the lighting of the bulbs the intensity of exercise could be varied. The test consisted of a series of 3 min periods of exercise at increasing intensities (increased number of runs per unit of time). The results showed a low correlation (r = 0.52) between treadmill ergometry data and a rank-order list based on an independent, partly subjective estimate of fitness. A higher correlation (r = 0.90) was found for the results of the field test and the rank-order list. Maximum oxygen uptake values and anaerobic threshold values derived from laboratory measurements were thus not sufficient for a valid estimate of competition fitness in these players. The results show that a valid estimate of fitness can be derived from measurements involving exercise closely resembling that which is specific for the sports activity in question. Improved training advice and guidance may result from such studies.