Schwannomas of the hand and wrist: long-term results and review of the literature

PURPOSE

To review the long-term results of 14 cases of histopathologically confirmed schwannoma of the hand and wrist treated with intracapsular tumour removal.

METHODS

All operations were performed under loupe magnification and microsurgical dissection, and the tumour was removed after capsular (including endoneurium) incision. Patients were assessed for any residual symptoms. Sensory testing of light touch and pain was carried out.

RESULTS

The mean age of the patients at the time of operation was 38.4 years (range, 11-78 years), and the mean follow-up period was 12.6 years (range, 3-36 years). Ten of the tumours were located in the median nerve distribution, whereas 4 in the ulnar nerve distribution. Four tumours were at the wrist level, 3 at the palm level, and 7 at the digital level (3 in the index finger). Only 5 patients were correctly diagnosed preoperatively. Neurological loss was not recovered in one patient in whom the tumour was resected with the digital nerve. No recurrence or muscle atrophy was noted at the latest follow-up.

CONCLUSION

Meticulous dissection with magnification can achieve complete tumour removal without neurological loss or recurrence. Intracapsular tumour removal provides good results with a low complication rate.

Effects of home confinement on physical activity, nutrition, and sleep quality during the COVID-19 outbreak in amateur and elite athletes

INTRODUCTION

Despite the progress in the management of the pandemic caused by COVID-19, it is necessary to continue exploring and explaining how this situation affected the athlete population around the world to improve their circumstances and reduce the negative impact of changes in their lifestyle conditions that were necessitated due to the pandemic. The aim of this study was to analyze the moderating influence of physical activity (PA) and dietary habits on the impact of the COVID-19 pandemic experience on sleep quality in elite and amateur athletes.

MATERIALS AND METHODS

A total of 1,420 elite (40.1%) and amateur (59.9%) athletes (41% women; 59% men) from 14 different countries participated in a cross-sectional design study. Data were collected using a battery of questionnaires that identified sociodemographic data, sleep quality index, PA levels, dietary habits, and the athletes' perception of their experience during the COVID-19 pandemic. Means and standard deviations were calculated for each variable. The analysis of variances and the correlation between variables were carried out with non-parametric statistics. A simple moderation effect was calculated to analyze the interaction between PA or dietary habits on the perception of the COVID-19 experience effect on sleep quality in elite and amateur athletes.

RESULTS

The PA level of elite athletes was higher than amateur athletes during COVID-19 (p < 0.001). However, the PA level of both categories of athletes was lower during COVID-19 than pre-COVID-19 (p < 0.01). In addition, amateurs had a higher diet quality than elite athletes during the pandemic (p = 0.014). The perception of the COVID-19 experience as controllable was significantly higher (p = 0.020) among elite athletes. In addition, two moderating effects had significant interactions. For amateur athletes, the PA level moderated the effect of controllable COVID-19 experience on sleep quality [F (3,777) = 3.05; p = 0.028], while for elite athletes, the same effect was moderated by dietary habits [F (3,506) = 4.47, p = 0.004].

CONCLUSION

Elite athletes had different lifestyle behaviors compared to amateurs during the COVID-19 lockdown. Furthermore, the relevance of maintaining high levels of PA for amateurs and good quality dietary habits by elite athletes was noted by the moderating effect that both variables had on the influence of the controllable experience during the COVID-19 pandemic on sleep quality.

Anxiety of young female athletes with disordered eating behaviors

The aim of this study was to investigate the prevalence rate of disordered eating behaviors in young female athletes and to compare the anxiety levels of the athletes with or without disordered eating behaviors. Female athletes (n=243) of 15 to 25 years old from the city, Edirne, in Turkey participated our study. Disordered eating behaviors and anxiety levels of participants were evaluated by the Eating Attitudes Test (EAT-40) and State-Trait Anxiety Inventory. Disordered eating behaviors was reported as 40 (16.7%) among all athletes. Both state and trait anxiety scores were higher in athletes with disordered eating behaviors than the athletes without disordered eating behaviors (p=0.01). The athletes who engage in leanness and non leanness sports were reported as having similar EAT-40 scores and anxiety scores. In conclusion, athletes with disordered eating behaviors have higher state and trait anxiety scores.

Alternative to traditional stretching methods for flexibility enhancement in well-trained combat athletes: local vibration versus whole-body vibration

This study aimed to compare the effect of local vibration (LV) and whole body vibration (WBV) on lower body flexibility and to assess whether vibration treatments were more effective than traditionally used static and dynamic stretching methods. Twenty-four well-trained male combat athletes (age: 22.7 ± 3.3 years) performed four exercise protocols – LV (30 Hz, 4 mm), WBV (30 Hz, 4 mm), static stretching (SS), and dynamic stretching (DS) – in four sessions of equal duration 48 hours apart in a randomized, balanced order. During a 15-minute recovery after each protocol, subjects performed the stand and reach test (S&R) at the 15th second and the 2^nd, 4^th, 6^th, 8^th, 10^th and 15^th minute. There was a similar change pattern in S&R scores across the 15-minute recovery after each protocol (p = 0.572), remaining significantly elevated throughout the recovery. A significant main protocol effect was found for absolute change in S&R scores relative to baseline (p = 0.015). These changes were statistically greater in LV than WBV and DS. Changes in SS were not significantly different from LV, but were consistently lower than LV with almost moderate effect sizes. After LV, a greater percentage of subjects increased flexibility above the minimum detectable change compared to other protocols. Subjects with high flexibility (n = 12) benefited more from LV compared with other methods (effect size ≥ 0.862). In conclusion, LV was an effective alternative exercise modality to acutely increase lower extremity flexibility for well-trained athletes compared with WBV and traditional stretching exercises.

Acute effect of whole body vibration on isometric strength, squat jump, and flexibility in well-trained combat athletes

The purpose of this study was to investigate the effect of whole body vibration (WBV) training on maximal strength, squat jump, and flexibility of well-trained combat athletes. Twelve female and 8 male combat athletes (age: 22.8 ± 3.1 years, mass: 65.4 ± 10.7 kg, height: 168.8 ± 8.8 cm, training experience: 11.6 ± 4.7 years, training volume: 9.3 ± 2.8 hours/week) participated in this study. The study consisted of three sessions separated by 48 hours. The first session was conducted for familiarization. In the subsequent two sessions, participants performed WBV or sham intervention in a randomized, balanced order. During WBV intervention, four isometric exercises were performed (26 Hz, 4 mm). During the sham intervention, participants performed the same WBV intervention without vibration treatment (0 Hz, 0 mm). Hand grip, squat jump, trunk flexion, and isometric leg strength tests were performed after each intervention. The results of a two-factor (pre-post[2] × intervention[2]) repeated measures ANOVA revealed a significant interaction (p = 0.018) of pre-post × intervention only for the hand grip test, indicating a significant performance increase of moderate effect (net increase of 2.48%, d = 0.61) after WBV intervention. Squat jump, trunk flexion, and isometric leg strength performances were not affected by WBV. In conclusion, the WBV protocol used in this study potentiated hand grip performance, but did not enhance squat jump, trunk flexion, or isometric leg strength in well-trained combat athletes.

Neonatal purpura fulminans due to homozygous protein C deficiency

Severe and recurrent purpura fulminans developed in a Turkish boy at 1 week of age. Initial coagulation studies performed were compatible with disseminated intravascular coagulation. Subsequent investigations showed that the patient had homozygous and his healthy parents had heterozygous protein C deficiency. The episodes of purpura fulminans were controlled by infusions of fresh frozen plasma and heparinization. Oral anticoagulant therapy was given in the symptom-free period.

Variation in oil content and fatty acid composition of sesame accessions from different origins

Oil content and fatty acid composition are very important parameters for the human consumption of oilseed crops. Twenty-four sesame accessions including seven collected from various geographical regions of Turkey and 11 from different countries were investigated under field conditions for two consecutive years (2015 and 2016). The sesame accessions varied widely in their oil content and fatty acid compositions. The oil content varied between 44.6 and 53.1% with an average value of 48.15%. The content of oleic acids, linoleic acid, linolenic acid, palmitic acid,and stearic acid varied between 36.13–43.63%, 39.13–46.38%, 0.28–0.4%, 8.19–10.26%, and 4.63–6.35%, respectively. When total oil content and fatty acid composition were compared, Turkish sesame showed wide variation in oil and fatty acid compositions compared to those from other countries. However, the accessions from other countries were fewer compared to those from Turkey. It is essential to compare oil and fatty acid composition using a large number of germ plasm from different origins. In sesame oil, the average contents of oleic acid and linoleic acid were 39.02% and 43.64%, respectively, and their combined average content was 82.66%, representing the major fatty acid components in the oil from the sesame accessions used in the present study. The results obtained in this study provide useful information for the identification of better parents with high linoleic and oleic acid contents for developing elite sesame varieties with traits which are beneficial to consumer health.

Effects of pentoxifylline on the cytokines that may play a role in rejection and resistive index in renal transplant recipients

Pentoxifylline (PTX) is a nonselective phosphodiesterase inhibitor that inhibits the production of TNFalpha and IL6 and IL-10 cytokines. In renal rejection TNFalpha, IL-6, and IL-10 may have important roles. In this study, 22 renal transplant recipients treated with tacrolimus, prednisolone, and mycophenolate mofetil were prescribed PTX (2 x 600 mg/d) for 3 months (GI), and 20 similar patients not receiving PTX were used as controls (GII). Stable subjects whose serum creatinine was lower than 1.8 mg/dL and were more than 6 months posttransplant, were enrolled into this study if the blood pressure was well controlled and there was no diabetes mellitus, infection, or inflammation. At the end of 3 months TNF-alpha decreased from 4.2 +/- 2.1 to 2.4 +/- 0.7 (P = .001) and 4.0 +/- 2.2 to 3.9 +/- 1.7 (P = .718), IL-10 also decreased from 3.90 +/- 1.9 to 2.38 +/- 0.6 (P = .001) and 4.02 +/- 1.6 to 3.82 +/- 1.5 (P = .225) in GI and GII, respectively. For IL-10 and TNF-alpha the alterations between baseline and the last visit of GI and GII were significant (P < .002 for all). Resistive index (RI) decreased in GI but the difference in alterations between baseline and the last visit of GI and GII was marginal. In summary IL-10 and TNF-alpha levels decreased in stable recipients treated with PTx. RI also decreased marginally secondary to PTx treatment. PTx was well tolerated and free side effects. PTx did not affect tacrolimus levels or other biochemical and hematological parameters.

Comparative Study of the Long-Term Impact of the COVID-19 Pandemic on Mental Health and Nutritional Practices Among International Elite and Sub-Elite Athletes: A Sample of 1420 Participants from 14 Countries

BACKGROUND

Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale-21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior.

RESULTS

The results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013).

CONCLUSION

In conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality.

Side-to-side asymmetry in lower limb strength and hamstring-quadriceps strength ratio among collegiate American football players

[Purpose] The present study aimed to investigate the lower limbs injury risk factors that are based on conventional Hamstring to Quadriceps ratio and limb asymmetry index in varsity American football players. [Participants and Methods] Twenty-six varsity American football players aged 19–27 years and with 2.31 ± 1.29 years of American football experience from Dogu Akdeniz University volunteered to undergo measurements of average peak torque for isokinetic flexion and extension of dominant limb and non-dominant limb at 60°·s⁻¹ and 300°·s⁻¹. Hamstring to Quadriceps ratio and limb asymmetry index were also calculated for Hamstring and Quadriceps muscles. [Results] Statistical analysis revealed that dominant Quadriceps is stronger than non-dominant Quadriceps at 60°·s⁻¹ speed. No statistical difference was found between dominant and non-dominant Hamstring peak torque at 60°·s⁻¹ . Hamstring to Quadriceps ratio determined as normal both for 60°·s⁻¹ and 300°·s⁻¹according to the currently reported cut off value (H:Q ratio >60). Hamstring and Quadriceps limb asymmetry index also determined as normal (cut off value for LSI 10%) at 60°·s⁻¹. However, for both Hamstring and Quadriceps, side- to- side strength asymmetry at 300°·s⁻¹ was observed. [Conclusion] To prevent possible lower limb injury and to increase performance, varsity American football players who are actively training and competing might consider taking strength asymmetry into account to tailor their strength training program accordingly.

Postactivation potentiation effects of Back Squat and Barbell Hip Thrust exercise on vertical jump and sprinting performance

BACKGROUND

This study aimed to determine and compare the post-activation potentiation (PAP) effects of the Back Squat (SQ-PAP) and Hip Thrust (HT-PAP) exercises in terms of vertical jump height (VJ), 20-yard dash and 40-yard dash time in physically active university students. Considering the Force-vector theory, it was hypothesized that HT-PAP would induce greater potentiation for 40-yard dash than SQ-PAP whereas SQ-PAP would induce greater potentiation for 20-yard dash and VJ than HT-PAP.

METHODS

Seventeen kinesiology and exercise science students (8 male and 9 female) who resistance train at least 3 times/week (age, 21.71±1.49 years; body mass, 75.58±11.89 kg; height, 173.98±11.88 cm and training experience 5.47±2.00 years) joined this study. They performed three experimental sessions namely; baseline (BL), SQ-PAP loading session and HT-PAP loading session with 48 hours interval with a randomized open crossover study design. BL session was also accepted as control and familiarization session. SQ-PAP and HT-PAP exercises were performed roughly at 90% of 1 Repetition maximum (1 RM) of the subjects with three repetitions. Subjects were tested for vertical jump height (VJ), 20-yard dash and 40-yard dash time before and 8 minutes after each PAP loading exercise.

RESULTS

Statistical analysis revealed that the potentiation effects of SQ-PAP and HT-PAP exercises on VJ height, 20-yard and 40-yard dash were similar that none of the loading exercises with 8 min rest interval had any increasing or detrimental performance effect on VJ (P=0.923), 20-yard dash (P=0.133) as well 40-yard dash time (P=0.570).

CONCLUSIONS

These findings demonstrate that none of the loading protocols with above mentioned exercises have any detrimental or improving effects on VJ height, 20-yard dash and 40-yard dash time for physically active university students who joined this study. Although no acute potentiation effect has been found, this study also shows that SQ-PAP, HT-PAP exercises can be used interchangeably and safely to avoid training monotony during longer training periods for chronic adaptations.

Effects of traditional stretching versus self-myofascial release warm-up on physical performance in well-trained female athletes

OBJECTIVE

The purpose of this study was to compare the acute effects of self-myofascial release (SMR) versus traditional stretching used as a part of warm-up on physical performance in well-trained female athletes.

METHODS

Twenty-three participants (age, 21.8±1.73 years; experience in sport, 114.8±30.5 months) were recruited. Isokinetic peak torque and muscle endurance ratio were measured during knee extension and flexion at 60°/s and 180°/s. Jump height, reactive strength index, and leg stiffness were measured using a jump mat during a counter-movement jump. Hamstring flexibility was measured using a sit-and-reach test. Three interventions were performed by all athletes randomly within 72 hours intervals.

RESULTS

The jump height and hamstring flexibility test scores improved significantly more after dynamic stretching (DS) as compared to SMR and static stretching (SS). The DS and SMR exercises were more effective than the SS exercises in terms of right and left knee muscle isokinetic strength both at 60°/s, and 180°/s. With regard to keeping muscular endurance ratio (%), SS exercises were found more effective than DS and SMR exercises for only the right knee at 180°/s, but not left knee muscle.

CONCLUSION

Dynamic stretching and SMR showed better flexibility, strength, and jump performance than SS. Trainers and players may replace SS with DS and SMR to acutely improve muscle power, strength, and flexibility.

Acute Effects of Slow, Moderate and Fast Tempo Dynamic Stretching Exercises on Power in Well-Trained Male Wrestlers

Due to the potential detrimental effects of static stretching exercises on subsequent muscle power performance, athletes and trainers have started to replace static stretching with dynamic stretching exercises in their training routines. However, there are no well-accepted guidelines regarding dynamic stretching variables, including tempo/velocity, volume (reps and sets), etc. Therefore, this study aimed to evaluate the acute effects of slow, moderate, and fast tempo dynamic stretching exercises on jump height, relative power, the reactive strength index, and leg stiffness in well-trained male wrestlers. Seventeen wrestlers (aged 20.00 ± 4.06 years, wrestling experience 6.00 ± 3.09 years, and training volume per week 10.00 ± 5.69 hours) took part in the experiment under four conditions (control session, slow tempo dynamic stretching, moderate tempo dynamic stretching, and fast tempo dynamic stretching) on separate days with a 72-h interval in between, following a randomized, crossover study design. The control session consisted of a 10-min jog on a motor-driven treadmill at 6 km/h and a 0% slope. Dynamic stretching sessions consisted of seven dynamic stretching exercises performed at 50 bpm, 100 bpm, and 120 bpm, following a 5-min warm-up on a treadmill at 6 km/h and a 0% slope. After each condition, wrestlers performed a 2 x 30-s repeated vertical jump test with 5-min rest intervals in between. The best results for jump height, relative power, the reactive strength index, and leg stiffness were registered for statistical analysis. One-way repeated ANOVA results demonstrated that there were no significant differences in pairwise comparisons of all variables obtained after the four different conditions (p > 0.05). Overall, none of the slow, moderate, and fast tempo dynamic stretching exercises led to a change in repeated jump performance of well-trained male athletes. Further studies are needed to clarify the acute effects of different tempo dynamic stretching on muscular performance in well-trained wrestlers.

Kinanthropometric attributes of young male combat sports athletes

Although there are enough studies concerning the kinanthropometric attributes of players of sports such as football, basketball, or volleyball in Turkey, there are not enough studies on the same for combat sports. Hence, our aim is to assess the kinanthropometric attributes of different combat sports like karate, taekwondo, judo and kickboxing. The present study included 48 national level male athletes from four different combat sports (age, 20.3 (3.19) years; number of years playing the sport, 8.33 (4.59); height, 174.3 (7.15) cm; weight, 67.35 (10.55 kg). Skinfold thickness was measured with a skinfold caliper (Holtain Ltd., UK), and Yuhazs formula was used to calculate the body fat percentage. Somatotype assessment was carried out with a computer program (Sweat Technology Trial Version, South Australia). Width measurements were obtained with a slide caliper (HLT-100, Holtain Ltd.), and girth measurements were obtained with a non-flexible tape measure. The data obtained were analyzed with the computer program SPSS 17.0 in terms of the SD. The findings were as follows: body mass index (BMI), 22.00 (2.66) kg/m2; body fat percentage, 12.20% (3.07%); endomorphic component, 2.9 (1.30); mesomorphic component, 4.25 (1.30); and ectomorphic component, 3.10 (1.30). The cormic index was 51.99% (1.88%); Monourier index, 92.39% (4.47%); Acromio-iliac index, 60.87% (6.61%); Martine index, 6.29% (0.70%); Biacromial index, 22.58% (0.99%); and hip index, 13.91% (0.86%). The mesomorphic component was found to be dominant in our study. Although BMIs were found to be normal, body fat percentages were low. According to body proportions, the athletes who participated in this study had wide shoulders, narrow hips, and medium-sized trunks.

Sleep deprivation induced anxiety and anaerobic performance

The aim of this study was to investigate the effects of sleep deprivation induced anxiety on anaerobic performance. Thirteen volunteer male physical education students completed the Turkish version of State Anxiety Inventory and performed Wingate anaerobic test for three times: (1) following a full-night of habitual sleep (baseline measurements), (2) following 30 hours of sleep deprivation, and (3) following partial-night sleep deprivation. Baseline measurements were performed the day before total sleep deprivation. Measurements following partial sleep deprivation were made 2 weeks later than total sleep deprivation measurements. State anxiety was measured prior to each Wingate test. The mean state anxiety following total sleep deprivation was higher than the baseline measurement (44.9 ± 12.9 vs. 27.6 ± 4.2, respectively, p = 0.02) whereas anaerobic performance parameters remained unchanged. Neither anaerobic parameters nor state anxiety levels were affected by one night partial sleep deprivation. Our results suggest that 30 hours continuous wakefulness may increase anxiety level without impairing anaerobic performance, whereas one night of partial sleep deprivation was ineffective on both state anxiety and anaerobic performance. Key pointsShort time total sleep deprivation (30 hours) increases state anxiety without any competition stress.Anaerobic performance parameters such as peak power, mean power and minimum power may not show a distinctive difference from anaerobic performance in a normal sleep day despite the high anxiety level induced by short time sleep deprivation.Partial sleep deprivation does not affect anxiety level and anaerobic performance of the next day.