[Effect of dietary supplements and whey protein on muscle mass and strength of the operated limb after anterior cruciate ligament reconstruction: a systematic review].

Muscle weakness and atrophy of the quadriceps muscle after anterior cruciate ligament reconstruction may persist for up to 6 months after surgery and cause re-injury to the ipsilateral or contralateral limbs. Many authors state that adequate nutritional status during the rehabilitation period can contribute to faster postoperative recovery of muscle mass and strength of the lower limb, be an adjunct to exercise, or serve an alternative treatment strategy. The purpose of the research was to conduct a systematic review of the literature and evaluate the degree of influence of dietary supplements on muscle mass and strength of the operated limb after reconstruction of the anterior cruciate ligament (ACL). Material and methods. The search for articles was carried out in international databases PubMed, Google Scholar, Cochrane Library. The time frame of the search was 22 years. To be included in the review, studies had to meet the PICOS criteria: participants were men and women over 18 years of age after ACL reconstruction; intervention - supplementation after and/or before and after ACL reconstruction; comparison - placebo group or no supplementary interventions; results - assessment of the dynamics of changes in muscle mass (cross-sectional area, muscle thickness or size of skeletal muscle fibers) and / or maximum strength (dynamic or isometric) of the operated limb; research design - randomized controlled trials (RCT). The quality of selected RCTs was assessed using the Cochrane Collaboration Risk of Bias (RoB 2) tool. Results. A total of 1397 articles were found after searching in the databases. This systematic review included 6 RCTs with a total number of patients 186. The following dietary supplements were used: leucine - 1 article, glucosam ine - 1 article, creatine - 1 article, vitamins E and C - 2 articles. One study evaluated the effect of whey protein supplementation in combination with neuromuscular electrical stimulation on isometric strength of the operated limb. When comparing the data of 3 groups in the pre- and postoperative periods, there were no statistically significant differences between the groups. When considering the protocols for taking dietary supplements based on creatine, glucosamine, vitamins E and C, none of the studies demonstrated statistically significant improvements in the parameters of maximum strength or muscle hypertrophy of the operated limb in the main groups compared with the control groups. Also, no results have been obtained indicating that these dietary supplements can slow down muscl e atrophy after surgery. In another study that evaluated the effect of leucine supplementation, by the end of the rehabilitation program, the muscle strength of the operated limb tended to increase more in the leucine group than in the placebo group, but without a statistically significant difference. At 10 cm from the patella, the femoral circumference of the operated limb in the leucine group increased more than in the placebo group, and the differences were statistically significant (р=0.009). Two studies were rated as high risk of bias, three as moderate risk, and one as low risk. Conclusion. None of the supplements used had a statistically significant effect on the muscle strength of the operated limb after ACL reconstru ction. In terms of thigh muscle hypertrophy, the only significant improvement was associated with leucine supplementation and an increase in thigh circumference at a distance of 10 cm from the patella.

IUPESM milestone developments and achievements during 1980-2022-a tribute to the contributors.

During 2020 the International Union for Physical and Engineering Sciences in Medicine (IUPESM) celebrated its 40th anniversary. At that time a paper was prepared tracing the main steps for the creation of the IUPESM (the Union formed of IOMP and IFMBE) and its very important activities for the global recognition of the professions [1]. The current paper, prepared by the IUPESM President, Vice-President and Past President, presents a chronology of the IUPESM Milestone Developments and Achievements and pays tribute to the main contributors for these achievements. Supplementary information: The online version contains supplementary material available at 10.1007/s12553-022-00667-6.

Radiation protection aspects of EMITEL Encyclopaedia of Medical Physics.

The Encyclopaedia of Medical Physics EMITEL was developed under the EU pilot project European Medical Imaging Technology e-Encyclopaedia for Lifelong Learning. This large reference material includes 3400 articles on 2100 pages supported by thousands of illustrations. All materials are available free at the website, www.emitel2.eu. The articles are grouped in seven categories--physics of: X-ray diagnostic radiology, nuclear medicine, radiotherapy, magnetic resonance imaging, ultrasound imaging, radiation protection and general terms. The radiation protection part of EMITEL includes 450 articles. These were organised in several sub-groups including: nuclear and atomic physics; ionizing radiation interactions and biological effects; radiation detection and measurement; dosimetric quantities and units; and general radiation protection and international bodies. EMITEL project was developed over 3 y and attracted as contributors 250+ senior specialists from 35 countries. After its successful launching, EMITEL is actively used by thousands of professionals around the world.

e-Learning development in medical physics and engineering.

Medical Physics and Engineering was among the first professions to develop and apply e-Learning (e-L). The profession provides excellent background for application of simulations and other e-L materials. The paper describes several layers for e-L development: Programming specific simulations; Building e-L modules; Development of e-L web-based programmes. The paper shows examples from these layers and outlines their specificities. At the end, the newest e-L development (project EMITEL) is briefly introduced and the necessity of a regularly updated list of e-L activities is emphasised.

Development of educational image databases and e-books for medical physics training.

Medical physics education and training requires the use of extensive imaging material and specific explanations. These requirements provide an excellent background for application of e-Learning. The EU projects Consortia EMERALD and EMIT developed five volumes of such materials, now used in 65 countries. EMERALD developed e-Learning materials in three areas of medical physics (X-ray diagnostic radiology, nuclear medicine and radiotherapy). EMIT developed e-Learning materials in two further areas: ultrasound and magnetic resonance imaging. This paper describes the development of these e-Learning materials (consisting of e-books and educational image databases). The e-books include tasks helping studying of various equipment and methods. The text of these PDF e-books is hyperlinked with respective images. The e-books are used through the readers' own Internet browser. Each Image Database (IDB) includes a browser, which displays hundreds of images of equipment, block diagrams and graphs, image quality examples, artefacts, etc. Both the e-books and IDB are engraved on five separate CD-ROMs. Demo of these materials can be taken from www.emerald2.net.

Chest radiography: a comparison of image quality and effective dose using four digital systems.

Image quality (IQ) and effective dose for chest radiography was compared for four digital imaging systems that used three different detector technologies: a-Si/TFT flat-panel detector (FPD), scanning-slot/charge-coupled device (CCD) and photostimuable phosphor (PSP). On each system a phantom was exposed at 125 kV(p) for automatic exposure control (AEC) and 2, 4 and 8 Gy receptor dose using identical geometrical conditions. All images were scored as softcopy images by three observers. The effective dose was calculated for each exposure condition. For AEC, superior IQ was observed for the GE FPD compared with all the other systems, which showed similar IQ performance. For all systems the entrance surface dose associated with AEC was within the European recommendations but variations in the effective dose were observed between the four systems. For identical receptor dose levels superior IQ was observed with the FPDs. Thorascan was noted for its low effective dose and Agfa CR was associated with the highest effective dose. FPD systems showed a better overall performance, followed by the CCD and PSP systems.

[CT tomography of normal parotid and mandibular salivary glands]. / CT-Densiometrie normaler Ohr- und Unterkieferspeicheldrüsen.

Computed tomography (CT) allows the differentiation of tissues by measurement of their roentgenologic densities. There are a few controversial literature data on the roentgenologic densities of the parotid and submandibular glands. These differences are, in our opinion, due to several factors: 1. The complex anatomic structure of the facial region of the skull, that demands an exact centering. In daily practice the respective imaging parameters are not always kept constant (including partial volume effects), thus introducing density errors. 2. Metallic prostheses and obturators as well as the high-density bones of the facial skull cause artefacts that impair image quality and density measurements. 3. The small density differences between the salivary glands and the adjacent soft tissues makes their differentiation difficult. 4. Different devices and parameters are used for scanning, resulting in different densities. Considering these facts, we have devised a complex method for the investigation of the parotid and mandibular salivary glands.

[Peridural morphine analgesia]. / Peridural'haia anal'geziia morfinom.

Results of peridural morphine analgesia in 122 patients after operation were analysed. The duration of analgesia was established to be longer in this case and to improve the course of the postoperative period. Side effects of morphine (nausea, vomiting, skin itch) were noted in 6% of the cases.