Low risk of concussions in top-level karate competition.

BACKGROUND: Although it is well known that injuries occur in combat sports, the true incidence of concussions is not clearly defined in the literature for karate competition. AIM: To determine the incidence of concussions in top-level (World Karate Federation World Championships) karate competition. METHODS: Injuries that took place in 4 consecutive World Karate Championships (from 2008 to 2014) were prospectively registered. A total of 4625 fights (2916 in the male category and 1709 in the female category) were scrutinised, and concussions were identified and analysed separately for frequency (rate per fight) and injury risk. RESULTS: A total of 4 concussions were diagnosed by the attending physicians after carrying out athlete examinations. Globally, there was 1 concussion in every 1156 fights, or 0.43/1000 athlete-exposures (AE). In male athletes, the rate of concussion was 1/5832 min of fighting, and in female athletes, it was 1/6836 min. OR for concussion in women is 0.57 (95% CI 0.06 to 5.47; z=0.489; p=0.6249) and risk ratio for concussions in men is RR 1.478 (95% CI 0.271 to 8.072), p=0.528, representing a higher risk of definite concussions in men than in women, but not statistically significant. There is not a significantly higher risk of concussions in team competition (no weight limit) when compared with individual competition (held with strict weight limits for each category). CONCLUSION: The risk of concussions in top-level karate competition is low, with a tendency for an increased risk for men and for competition without weight limits, but not statistically significant with respect to women or individual competition.

Homo sapiens as physician and patient: a view from Darwinian medicine.

Medicine's cardinal diagnostic and therapeutic resource is the clinical encounter. Over the last two centuries and particularly over the last five decades the function of the clinical encounter has been eroded to the point of near irrelevance because of the atomized and atomizing influence of technology and microspecialization. Meanwhile, over the past five decades the exceptionalist view of Homo sapiens inherent in the social and religious traditions of the West has similarly undergone radical changes. H. sapiens is now best understood as a microecosystem integrated into a much broader ecosystem: the biosphere. That human microecosystem is composed of constituents derived from the archaeal, bacterial, and eukaryan domains via endosymbiotic, commensalistic and mutualistic interactions. This amalgamation of 100 trillion cells and viral elements is regulated by a composite genome aggregated over the 3.8 billion years of evolutionary history of organic life. No component of H. sapiens or its genome can be identified as irreducibly and exclusively human. H. sapiens' humanity is an emergent property of the microecosystem. Ironically as H. sapiens is viewed by evolutionary science in a highly integrated manner medicine approaches it as a balkanized, deaggregated entity through the eye of 150 different specialties. To effectively address the needs of H sapiens in its role as patient by the same species in its role as physician the disparate views must be harmonized. Here I review some conceptual elements that would assist a physician in addressing the needs of the patient in integrum, as a microecosystem, by the former address the latter as a historical gestalt being. The optimal way to recover the harmony between patient and physician is through a revitalization of the clinical encounter via an ecological and Darwinian epistemology.

Medicine in the 21st century: towards a Darwinian medical epistemology.

In this review we reflect upon the new science of Darwinian medicine. It is a tenet of modern biology that evolutionary theory as proposed by Charles Darwin and further refined via the new synthesis is the common thread that ties all of biological inquiry into a coherent whole. This review aims at making clear how evolution by natural selection is relevant to medicine. A set of pertinent examples linking Homo sapiens sapiens' present disease conditions to its evolution during the Late Pleistocene and Holocene epochs are discussed. The review concludes with observations as to the epistemological value of evolutionary theory as a heuristic tool for articulating a medical paradigm in accord with modern biology.

Plasma nitric oxide levels used as an indicator of doxorubicin-induced cardiotoxicity in rats.

INTRODUCTION: The clinical efficacy of doxorubicin is severely limited by its cardiotoxicity. The currently noninvasive techniques used to detect this complication lack sensitivity to identify its early stages. Nitric oxide (NO) is a free radical that has been implicated in the etiology of doxorubicin-induced cardiotoxicity. In the present study, we investigated whether plasmatic NO levels can be used as a noninvasive and reliable biomarker of doxorubicin-induced cardiotoxicity. MATERIALS AND METHODS: Two groups of six spontaneously hypertensive rats (SHR) were used for the experiment. Group 1 received 1.5 mg/kg intraperitoneal (IP) doxorubicin weekly for up to 9 weeks. Group 2 (Control) received nine weekly IP injection of 0.5 cm3 saline. Plasmatic NO levels and cardiac ejection fraction (EF%) were determined. Ventricular biopsies were analyzed by light microscopy according with the Billinghan score. RESULTS: Doxorubicin treatment significantly increased plasmatic NO concentration (35.30+/-5.63 microM versus 14.72+/-2.66 microM in control animals, n=6, P<0.05). In addition, doxorubicin decreased EF by 23% approximately (from 77.00+/-3.89 in controls, to 59.00+/-5.61 in doxorubicin-treated animals, n=6, P<0.05). The mean score of histological cardiac damage was 2.33+/-0.33 for doxorubicin-treated versus 0.08+/-0.08 for controls, n=6, P<0.001. DISCUSSION: Our results revealed a correlation between plasmatic NO levels, systolic function and histopathological myocardial damage. Therefore, it is plausible to postulate that plasmatic NO levels could be used as a biomarker for myocardial damage in doxorubicin-treated SHR, and may be a potential tool for noninvasive evaluation of doxorubicin-induced toxicity in humans.

Orthomolecular oncology review: ascorbic acid and cancer 25 years later.

The effect of ascorbic acid on cancer has been a subject of great controversy. This is a follow-up review of the 1979 article by Cameron, Pauling, and Leibovitz published in Cancer Research. In this updated version, the authors address general aspects of ascorbic acid and cancer that have been presented before, while reviewing, analyzing, and updating new existing literature on the subject. In addition, they present and discuss their own mechanistic hypothesis on the effect of ascorbic acid on the cancer cell. The objective of this review is to provide an updated scientific basis for the use of ascorbic acid, especially intravenously as adjuvant treatment in pharmacological nutritional oncology.

Salt and gastric cancer: a case-control study in Puerto Rico.

A total of 136 incident intestinal type gastric cancer cases and 151 age-comparable population controls were interviewed in Puerto Rico about their dietary habits with special emphasis on dietary salt consumption. All interviews were conducted at home using a quantitative dietary frequency instrument. The weekly intake of foods was estimated from the reported frequency of consumption and portion size according to a food model. The dietary salt exposure was estimated from the intake of nine selected food items which are highly salted food items commonly consumed in Puerto Rico. A strong (odds ratio [OR] = 3.34) and statistically significant (P < 0.001) unadjusted difference was found between cases and controls regarding dietary salt exposure. A statistically significant dose response for the index of salt exposure and gastric cancer was also found. The association remained positive and statistically significant after simultaneously adjusting for the confounding effects of sex, education and cigarette smoking.

Inhibition of lymphocyte capping by fatty acids in mouse and man.

Lipid-enriched diets have been related to a high cancer incidence in experimental animals for many years, and more recently, to assorted defects on the immune response. We investigated the effect of incubating human or murine (C3H/HEJ) lymphocytes with saturated (16:0) and unsaturated (18:1, 18:2, 18:3, 20:4) fatty acids (12 micrograms for each 10(7) cells), on the ability to cap with antihuman or antimouse anti-IgM, mu-chain specific antibody. Capping was also tested in obese (ob/ob, C57BL/6J) mice. Capping at 30 and 60 min was reduced by fatty acid incubation to 10-30% of control values in humans (p less than .001), and to 30% of control values in mice (p less than .01), regardless of degree of unsaturation. ob/ob capped normally. A lymphocyte membrane effect caused by fatty acids is observed in these experiments. Whether this is related to the dysimmunity caused by lipid diets cannot be assessed from our data, especially since all fatty acids, regardless of unsaturation, reduced the capping phenomenon.

The immunoregulatory role of cholesterol and other lipids: a hypothesis.

Membrane lipids play an important role in cellular responses to exogenous signals. In immunocompetent lymphocytes, marked changes in the concentrations of membrane lipids occur following cell-antigen interaction. These changes lead to an increase in membrane fluidity, thus facilitating the microaggregation of receptor-antigen complexes. This event constitutes the inductive signal for lymphocytes. Lipid profile alterations leading to increased concentration of membrane cholesterol, of polyunsaturated lipids, or of both, bring about a decrease in membrane fluidity. The latter interferes with receptor displacement preventing delivery of an inductive signal to the responding cell. Interference with microaggregation is readily brought about in interactions involving low affinity antigens, such as tumoral antigens. We postulate that in hyperlipidemic and hypercholesterolemic states there is decreased immune responsiveness to weak antigens due to the aformentioned lipid profile alterations in the membranes of immunocompetent cells. The manner in which an increase in the concentration of the lipids mentioned can lead to decreased immune responsiveness and hence to an increased incidence of malignancies in hyperlipidemic and hypercholesterolemic states is the hypothesis presented in this paper.

Protection of organs during experimental ischemia.

Cell death complicating ischemia has profound local or systematic effects on the organism. We have tried to protect the small intestine and severed extremities from the effects of ischemia by using various drugs and techniques. Occlusion of the superior mesenteric artery for 1.5 hours in anesthesized, fed rats had a 97 per cent mortality. This was improved by pretreatment with methylprednisolone and amplicillin given together. Histologic preservation was seen in treated survivors. Chlorpheniramine, diphenylhydantion and methylprednisolone or amplicillin given alone had little, if any, effect. In dogs, reimplantation of severed extremities subjected to a 1.5 to two hour warm ischemic period resulted in toxic systemic picture, and 100 per cent mortality. This was improved by perfusion with Collins solution and postoperative injection of methylprednisolone. The incidence of gangrene was decreased. The judicious use of some drugs and preservation techniques may protect organs and the organism from the consequence of ischemia.

Asbestos-induced decomposition of hydrogen peroxide.

Decomposition of H2O2 by chrysotile asbestos was demonstrated employing titration with KMnO4. The participation of OH radicals in this process was delineated employing the OH radical scavenger dimethyl sulfoxide (DMSO). A mechanism involving the Fenton and Haber-Weiss reactions as the pathway for the H2O2 decomposition and OH radical production is postulated.