A suggested model for physical examination and conservative treatment of athletic pubalgia.

BACKGROUND: Athletic pubalgia (AP) is a chronic debilitating syndrome that affects many athletes. As a syndrome, AP is difficult to diagnose both with clinical examination and imaging. AP is also a challenge for conservative intervention with randomized controlled trials showing mixed success rates. In other syndromes where clinical diagnosis and conservative treatment have been less than clear, a paradigm has been suggested as a framework for clinical decision making. OBJECTIVES: To propose a new clinical diagnostic and treatment paradigm for the conservative management of AP. DESIGN: Relevant studies were viewed with regard to diagnosis and intervention and where a gap in evidence existed, clinical expertise was used to fill that gap and duly noted. RESULTS: A new paradigm is proposed to assist with clinical diagnosis and non-surgical intervention in patients suffering with AP. The level of evidence supporting this paradigm, according to the SORT taxonomy, is primarily level 2B. CONCLUSIONS: Further testing is warranted but following the suggested paradigm should lead to a clearer diagnosis of AP and allow more meaningful research into homogeneous patient populations within the AP diagnostic cluster. Strength-of-Recommendation Taxonomy (SORT): 2B.

PET bottle use patterns and antimony migration into bottled water and soft drinks: the case of British and Nigerian bottles.

While antimony has been reported to migrate from PET bottles into contents, reports on bottled water and soft drinks usage and PET bottle reuse patterns are currently unavailable in the literature. Bottle use conditions and patterns are important determinants of antimony migration. In this work a survey assessing the pattern of bottle use and reuse in Britain and Nigeria was undertaken. The survey findings influenced the design of laboratory experiments that assessed the migration of antimony from PET bottles into water and soft drinks. Typical storage durations for bottled contents between purchase and opening for use were 7 days or less. However storage of up to one year was reported. Bottle reuse was high and similar for the two countries with reuse durations being higher in Nigeria. The antimony concentration in 32 PET bottle materials from Britain and Nigeria were similar and ranged between 177 and 310 mg kg(-1). For 47 freshly purchased British bottled contents antimony concentration ranged between 0.03 and 6.61 µg L(-1) with only one sample exceeding the EU acceptable limit. Concentrations of Cd, Ge, Zn, Al, Be, Ti, Co and Pb were also measured. At realistic temperatures of 40 and 60 °C antimony concentration in deionised water in bottles remained below the EU acceptable limit even after 48 h exposure. The limit was exceeded for most exposures at 80 °C. Concentration of antimony in some bottled contents exceeded the EU limit after 11 months of storage at room temperature. Bottle aging and increase in bottle volume were associated with decreased migration of antimony from bottles.

Olive oil or lard?: distinguishing plant oils from animal fats in the archeological record of the eastern Mediterranean using gas chromatography/combustion/isotope ratio mass spectrometry.

Distinguishing animal fats from plant oils in archaeological residues is not straightforward. Characteristic plant sterols, such as ß-sitosterol, are often missing in archaeological samples and specific biomarkers do not exist for most plant fats. Identification is usually based on a range of characteristics such as fatty acid ratios, all of which indicate that a plant oil may be present, none of which uniquely distinguish plant oils from other fats. Degradation and dissolution during burial alter fatty acid ratios and remove short-chain fatty acids, resulting in degraded plant oils with similar fatty acid profiles to other degraded fats. Compound-specific stable isotope analysis of δ(13)C(18:0) and δ(13)C(16:0), carried out by gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS), has provided a means of distinguishing fish oils, dairy fats, ruminant and non-ruminant adipose fats, but plant oils are rarely included in these analyses. For modern plant oils where C(18:1) is abundant, δ(13)C(18:1) and δ(13)C(16:0) are usually measured. These results cannot be compared with archaeological data or data from other modern reference fats where δ(13)C(18:0) and δ(13)C(16:0) are measured, as C(18:0) and C(18:1) are formed by different processes resulting in different isotopic values. Eight samples of six modern plant oils were saponified, releasing sufficient C(18:0) to measure the isotopic values, which were plotted against δ(13)C(16:0). The isotopic values for these oils, with one exception, formed a tight cluster between ruminant and non-ruminant animal fats. This result complicates the interpretation of mixed fatty residues in geographical areas where both animal fats and plant oils were in use.

Beyond SpPIN and SnNOUT: Considerations with Dichotomous Tests During Assessment of Diagnostic Accuracy.

Paramount to efficient and effective care is the determination of an accurate diagnosis that leads to the proper referral and/or intervention. In an effort to improve the clinical utility of diagnostic accuracy calculations, researchers have promoted the use of the mnemonics SpPIn (if specificity is high, a positive test rules in pathology) and SnNOut (if sensitivity is high, a negative test rules out pathology). Using examples from diagnostic accuracy studies and a review of pertinent literature, this clinimetrics corner outlines additional considerations for clinicians when consuming research in this area. The paper has three foci. First, sensitivity, specificity, and other estimates of the diagnostic accuracy of dichotomous physical examination tests should be viewed as estimates with confidence when those estimates are expressed as confidence intervals. Second, appropriate power must be considered when evaluating each study. Last, the quality of a diagnostic accuracy study can affect the generalizibility of the results to practice environments.

Analysis of yellow "fat" deposits on Inuit boots.

Irregular residues of a yellow deposit that was assumed to be seal fat used for waterproofing were observed in the creases of the outer surface of a pair of Inuit boots from Arctic Canada. A sample of this deposit detached from one of these areas on these boots was examined initially by FT-Raman microscopy, from which interesting and rather surprising results demanded further analysis using FT-IR and GC-MS. The non-destructive Raman spectroscopic analysis yielded spectra which indicated the presence of a tree resin from the Pinaceae sp. The Raman spectra were also characteristic of a well-preserved keratotic protein and indicative of adherent skin. Subsequent FT-IR spectroscopic analysis supported the attribution of a Pinaceae resin to the yellow deposit. GC-MS analysis of the same deposits identified the presence of pimaric, sandaracopimaric, dehydroabietic and abietic acids, all indicative of an aged Pinaceae resin. These results confirmed that the Inuit people had access to tree resins which they probably used as a waterproofing agent.

Stable isotope and DNA evidence for ritual sequences in Inca child sacrifice.

Four recently discovered frozen child mummies from two of the highest peaks in the south central Andes now yield tantalizing evidence of the preparatory stages leading to Inca ritual killing as represented by the unique capacocha rite. Our interdisciplinary study examined hair from the mummies to obtain detailed genetic and diachronic isotopic information. This approach has allowed us to reconstruct aspects of individual identity and diet, make inferences concerning social background, and gain insight on the hitherto unknown processes by which victims were selected, elevated in social status, prepared for a high-altitude pilgrimage, and killed. Such direct information amplifies, yet also partly contrasts with, Spanish historical accounts.

Combined FT-Raman spectroscopic and mass spectrometric study of ancient Egyptian sarcophagal fragments.

The application of combined Raman spectroscopic and GC-MS analytical techniques for the characterisation of organic varnish residues from Egyptian Dynastic funerary sarcophagal and cartonnage fragments from the Graeco-Roman period, ca. 2200 BP, is described. The nondestructive use of Raman spectroscopy was initially employed to derive information about the specific location of organic material on the specimens, which were then targeted in specific areas using minimal sampling for GC-MS analysis. In the case of the sarcophagal fragment, a degraded yellow-brown surface treatment was identified as a Pistacia spp. resin; this provides additional evidence for the use of this resin, which has previously been identified in Canaanite transport amphorae, varnishes and "incense" bowls in an Egyptian Late Bronze Age archaeological context. The cartonnage fragment also contained an organic coating for which the Raman spectrum indicated a degradation that was too severe to facilitate identification, but the GC-MS data revealed that it was composed of a complex mixture of fatty acid residues. The combined use of GC-MS and Raman spectroscopy for the characterisation of organic materials in an archaeological context is advocated for minimisation of sampling and restriction to specifically identified targets for museum archival specimens.