Hamstring-to-quadriceps fatigue ratio offers new and different muscle function information than the conventional non-fatigued ratio.

Commonly used injury risk prediction tests such as the hamstring-to-quadriceps (H:Q) strength ratio appear to be poor predictors of non-contact injury. However, these tests are typically performed in a non-fatigued state, despite accumulated fatigue being an important risk factor for both hamstring strain (HS) and anterior cruciate ligament (ACL) injuries in professional soccer players. After the effect of different H:Q calculation methods were compared and contrasted, the influence of neuromuscular fatigue on the H:Q strength ratio and the association between fatigued and non-fatigued ratio scores were examined. Thirty-five professional soccer players performed a 30-repetition isokinetic fatigue test protocol. Peak knee joint moments were computed for each repetition, and the H:Q conventional ratio (H:QCR ) was calculated using several different, previously published, methods. Knee extensor and flexor moments were statistically decreased by the sixth repetition and continued to decrease until the end of the protocol. However, the H:Q ratio was statistically decreased at the end of the test due to a significant reduction in knee flexor moment (correlation between change in knee flexor moment and change in H:Q, r≈.80; P<.01). Moreover, H:Q measured in fatigue (ie, H:QFatigue ) at the end of the test was greater than H:QCR (1.25-1.38 vs 0.70, P<.01), these variables were weakly correlated (r=.39, P=.02), and subject rankings within the cohort based on H:QCR and H:QFatigue were different (rs =0.25, P=.15). The present data suggest that H:Q ratio measurement during a fatiguing test (H:QFatigue ) provides different outcomes to the traditional H:QCR . The observed significant hamstring fatigue and the difference, and weak correlation, between H:QCR and H:QFatigue indicate that useful information might be obtained with respect to the prediction of HS and ACL injury risk. The potential predictive value of H:QFatigue warrants validation in future prospective trials.

Epidemiology of goitre in Sri Lanka in the post-iodization era.

INTRODUCTION: Previous studies of goitre in Sri Lanka proposed the presence of a goitre belt, which was refuted subsequently. Epidemiology of goitre in the post iodization era needs re-evaluation. Objectives To describe the epidemiology of goitre in Sri Lanka. METHODS: A descriptive cross-sectional study was conducted in designated zones except in conflict areas in 2006/2007. An interviewer administered questionnaire was used and patients were evaluated clinically, biochemically and cytologically. RESULTS: Among 5200 participans 426 had goitre. Mean age was 36.3 (SD 17.3) years. Goitre was commonest in the age group 40-49 years with a female pre-ponderance. The prevalence was similar in all zones with pockets of high prevalence in each zone. Overall islandwide adjusted prevalence was 6.8% (95% CI = 6.0-7.6). CONCLUSIONS: There was no identifiable goitre belt.There were pockets of high prevalence in all zones. Goitre remains a public health issue despite universal iodization.

Reversal of excessive oral anticoagulation with a low oral dose of vitamin K1 compared with acenocoumarine discontinuation. A prospective, randomized, open study.

We performed a prospective, randomized, open study in 109 outpatients under chronic anticoagulation with acenocoumarine, presenting with International Normalized Ratios (INRs) > or = 6.0 and no or minor bleeding. All the patients withheld one dose of acenocoumarine; in addition, a treated group also received 1 mg oral vitamin K1. We aimed at a post-intervention INR < 6.0, with a target zone of 2.0-4.0. The INRs were lowered from a mean of 8.1 +/- 1.7 to 4.9 +/- 2.5 in the controls (P = 0.0000) and from 8.4 +/- 2.4 to 3.3 +/- 3 in the treated patients (P = 0.0000). There were no differences in the percentage of patients with post-intervention INRs < 6.0 or within the therapeutic zone. One-third of the treated patients and only 2% of the controls reached INRs < 2.0 (P = 0.0003). Oral vitamin K1 offered no advantage to the simple discontinuation of one dose of acenocoumarine. A substantial number of treated patients were consequently exposed to under-anticoagulation.

Schistosomiasis mansoni: blockage of cercarial skin penetration by chemical agents: i. naphthoquinones and derivatives.

Skin penetration by Schistosoma mansoni cercariae may be blocked by 1,4-and 1,2-naphthoquinones applied topically. Of 23 naphthoquinone derivatives synthesized, 15 afforded almost complete protection when applied in solution to the tails of mice 24 hours before exposure to cercariae. On the basis of present evidence the 5-carbon atom side chain present in naturally occurring lapachol seems to be important for activity, and this is in accord with the previous observation that effective protective agents are liposoluble. Topically applied cercarial penetration inhibitors are presently the only prophylactic agents available for use in the field.