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Aparisi Gómez MP, Ayuso Benavent C, Simoni P, Musa Aguiar P, Bazzocchi A, Aparisi F. Imaging of Bone Marrow: From Science to Practice. Semin Musculoskelet Radiol 2022; 26:396-411. [PMID: 36103883 DOI: 10.1055/s-0042-1745803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The study of the bone marrow may pose important challenges, due to its changing features over the life span, metabolic stress, and in cases of disease or treatment. Bone marrow adipocytes serve as storage tissue, but they also have endocrine and paracrine functions, contributing to local and systemic metabolism.Among different techniques, magnetic resonance (MR) has the benefit of imaging bone marrow directly. The use of advanced MR techniques for bone marrow study has rapidly found clinical applications. Beyond the clinical uses, it has opened up pathways to assess and quantify bone marrow components, establishing the groundwork for further study of its implications in physiologic and pathologic conditions.We summarize the features of the bone marrow as an organ, address the different modalities available for its study, with a special focus on MR advanced techniques and their addition to analysis in recent years, and review some of the challenges in interpreting the appearance of bone marrow.
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Affiliation(s)
- Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand.,Department of Radiology, IMSKE, Valencia, Spain
| | | | - Paolo Simoni
- Department of Radiology, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Paula Musa Aguiar
- Serdil, Clinica de Radiologia e Diagnóstico por Imagem, Porto Alegre - RS, Brazil
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Francisco Aparisi
- Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
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Russ BS. Anemia: Considerations for the Athletic Population. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kobayashi Y, Imai N, Uenishi K. Attempt to Determine the Cut-Off Value of Serum Ferritin for Iron Deficiency in Male College Student Runners. J Nutr Sci Vitaminol (Tokyo) 2020; 66:432-440. [PMID: 33132346 DOI: 10.3177/jnsv.66.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
For the evaluation of iron nutrition status, the measurement of serum ferritin levels is the most convenient and widely used technique for estimating stored iron. However, the cut-off value of serum ferritin for iron deficiency in athletes has not yet established. This study aimed to determine the cut-off value of serum ferritin to define iron deficiency in male college student runners. This study included 37-43 Japanese male college student runners for each month. Anthropometric measurements and blood collection were conducted from March to December 2018. In all months except May, significant negative correlations were observed between serum ferritin and transferrin levels, total iron binding capacity (TIBC), and unsaturated iron binding capacity. Furthermore, a significant association between serum ferritin levels and TIBC was observed by nonlinear regression analysis. The curvature radius and curvature were calculated using the data from 9 mo, and serum ferritin levels with the smallest curvature radius and the highest curvature in each month were identified. The serum ferritin levels were as follows: 35.0 ng/mL in March, 45.0 ng/mL in April, 40.0 ng/mL in June, 35.0 ng/mL in July, 35.0 ng/mL in August, 35.0 ng/mL in September, 35.0 ng/mL in October, 35.0 ng/mL in November, and 40.0 ng/mL in December. The average value was 37.2 ng/mL. In conclusion, the cut-off value of serum ferritin for defining iron deficiency in runners was determined to be 40.0 ng/mL in this study. This value (40.0 ng/mL) may be useful for iron deficiency screening in runners.
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Affiliation(s)
- Yuki Kobayashi
- Laboratory of Physiological Nutrition, Kagawa Nutrition University
| | - Nami Imai
- Laboratory of Physiological Nutrition, Kagawa Nutrition University
| | - Kazuhiro Uenishi
- Laboratory of Physiological Nutrition, Kagawa Nutrition University
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Dietary Intake, Hydration Status, and Body Composition of Three Belgian Military Groups. Mil Med 2020; 185:e1175-e1182. [DOI: 10.1093/milmed/usaa061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AbstractIntroductionMalnutrition, suboptimal hydration, and inadequate body composition can have negative consequences on soldiers’ performance and health. A recent consensus statement concerning “soldiers’ physical performance” points to the scarcity of data in specific military populations. Therefore, the aim of the present study was to assess and compare dietary intake, hydration status, and body composition of three military groups during their specific military training.Materials and MethodsEighty-five soldiers (ie, 21 in a qualification course to join the Special Forces [SF], 22 Infantrymen [Chasseurs Ardennais, CA], and 42 Recruits [REs]) participated in this 3- to 4-day study. Body mass was assessed before and after each study period. All soldiers self-reported their dietary intakes, from which energy and macronutrient intakes were calculated. In addition, their morning urine samples were collected daily to assess urine specific gravity (USG) as a measure of hydration status. Fat mass was estimated at the end of the study using bioelectrical impedance analysis.ResultsAll groups lost significant amounts of body mass (ie, mean losses ranging between 1.3 and 1.7 kg). Macronutrient intakes were not fully met in respect to the recommendations. Most notably, REs’ fat intake was high (ie, 42.3 [±1.6] energy percent [E%]), while their carbohydrate intake was low (ie, 44.5 [±2.1] E%). Furthermore, saturated fat intakes were high among all groups (ie, group means ranging between 13.6 and 21.4 E%). USG values indicated suboptimal hydration status was prevalent in all groups. Most noteworthy, for SF, only 5.4% of the USG values indicated optimal hydration. The average fat mass (%) for SF, CA, and RE was 11.2 (±3.1), 18.8 (±5.1), and 19.4 (±5.0), respectively.ConclusionThe present study showed that military men are not always adequately fed nor hydrated. These issues should be resolved by creating nutritional packages, and individual dietary and hydration strategies, all in function of military planning and weather conditions.
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Powers JM, Buchanan GR. Disorders of Iron Metabolism: New Diagnostic and Treatment Approaches to Iron Deficiency. Hematol Oncol Clin North Am 2019; 33:393-408. [PMID: 31030809 DOI: 10.1016/j.hoc.2019.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Iron deficiency anemia is the leading cause of anemia worldwide and affects many young children and adolescent girls in the United States. Its signs and symptoms are subtle despite significant clinical effects. Iron deficiency anemia is diagnosed clinically by the presence of risk factors and microcytic anemia. Improvement following a trial of oral iron therapy is confirmative. An array of iron laboratory tests is available with variable indications. Clinical trial and iron absorption data support a shift to lower-dose oral iron therapy. Intravenous iron should be considered in children who fail oral iron or who have more complex disorders.
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Affiliation(s)
- Jacquelyn M Powers
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children's Cancer and Hematology Centers, 6701 Fannin Street, Suite 1580, Houston, TX 77030, USA.
| | - George R Buchanan
- Pediatric Hematology-Oncology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, H3.104A, Dallas, TX 75390-9063, USA
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Powers JM, O'Brien SH. How I approach iron deficiency with and without anemia. Pediatr Blood Cancer 2019; 66:e27544. [PMID: 30393941 DOI: 10.1002/pbc.27544] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/13/2022]
Abstract
Iron deficiency anemia remains a common referral to the pediatric hematology-oncology subspecialist. Improved understanding of iron homeostasis, including the effects of the regulatory hormone hepcidin, recent adult and pediatric clinical trial data, as well as the availability of safer formulations of intravenous iron, have resulted in additional considerations when making treatment recommendations in such patients. Young children and adolescent females remain the most commonly affected groups, but children with complex medical or chronic inflammatory conditions including comorbid gastrointestinal disorders also require special consideration.
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Affiliation(s)
- Jacquelyn M Powers
- Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Hospital, Houston, Texas
| | - Sarah H O'Brien
- Division of Hematology/Oncology, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University, Columbus, Ohio
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YAMAGATA TETSUYUKI, SAKURABA KEISHOKU. Changes in Urine Components and Characteristics During a 415-km Mountain Ultra-Marathon. JUNTENDO IJI ZASSHI 2019. [DOI: 10.14789/jmj.2019.65.jmj19-oa03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- TETSUYUKI YAMAGATA
- Department of Sports Medicine, Juntendo University Graduate School of Medicine
- Department of Physical Therapy, Japanese School of Technology for Social Medicine
| | - KEISHOKU SAKURABA
- Department of Sports Medicine, Juntendo University Graduate School of Medicine
- Department of Sports Medicine, Juntendo University Faculty of Health and Sports Science
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Fazal AA, Whittemore MS, DeGeorge KC. Foot-strike haemolysis in an ultramarathon runner. BMJ Case Rep 2017; 2017:bcr-2017-220661. [PMID: 29237656 DOI: 10.1136/bcr-2017-220661] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This case report describes mild anaemia and intravascular haemolysis in an otherwise healthy 41-year-old ultramarathon runner. In long-distance endurance athletes, trace gastrointestinal bleeding and plasma volume expansion are recognised sources of mild anaemia, often found incidentally. However, repetitive forceful foot striking can lead to blood cell lysis in the feet, resulting in a mild macrocytic anaemia and intravascular haemolysis, as was demonstrated in the patient described herein. Mild anaemia in runners, often called 'runner's pseudoanaemia', is typically clinically insignificant and does not require intervention. However, an unexplained anaemia can cause undue worry for otherwise healthy patients and lead to costly further testing, providing an argument against routine testing with complete blood counts in healthy, asymptomatic patients.
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Affiliation(s)
- Abid A Fazal
- Department of Anesthesiology and Critical Care, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Mary S Whittemore
- Department of Family Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Katharine C DeGeorge
- Department of Family Medicine, University of Virginia, Charlottesville, Virginia, USA
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Dimitriou L, Lockey J, Castell L. Is baseline aerobic fitness associated with illness and attrition rate in military training? J ROY ARMY MED CORPS 2016; 163:39-47. [DOI: 10.1136/jramc-2015-000608] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 01/20/2016] [Accepted: 01/21/2016] [Indexed: 11/03/2022]
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Nicolette GW. "Motionyms": activity-related musculoskeletal and medical problems (or "not an eponym!!"). PHYSICIAN SPORTSMED 2015; 43:27-9. [PMID: 25599807 DOI: 10.1080/00913847.2015.1005541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Many common conditions in sports medicine are eponymous; that is, they are named for the person first describing or popularizing the diagnosis. But other medical conditions are named for the action or activity that is associated with the pathology. This article lists and references these conditions, and suggests that this group of conditions should be called "motionyms".
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Affiliation(s)
- Guy W Nicolette
- Sports Medicine Fellowship Program, University of Florida , Gainesville, FL , USA
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Balfoussia E, Skenderi K, Tsironi M, Anagnostopoulos AK, Parthimos N, Vougas K, Papassotiriou I, Tsangaris GT, Chrousos GP. A proteomic study of plasma protein changes under extreme physical stress. J Proteomics 2013; 98:1-14. [PMID: 24345577 DOI: 10.1016/j.jprot.2013.12.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 12/03/2013] [Accepted: 12/09/2013] [Indexed: 01/18/2023]
Abstract
UNLABELLED The Spartathlon race (brisk walking a distance of 246km in less than 36h) was employed as a model of severe physical stress to investigate proteomic alterations in the plasma of athletes at the start (Athens) and finish (Sparta) of the race, as well as 48h after the race (Post). The athletes' plasma was analyzed by 2D gel electrophoresis (2-DE) and the differentially expressed proteins were identified by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS). The ProteoSeek™ Albumin/IgG removal kit and the ProteoMiner™ enrichment kit were utilized to detect medium- and low-abundance proteins, whose expression may be masked due to high-abundance proteins. Our results were confirmed by Western blot and biochemical analyses. Overall fifty-two proteins were differentially expressed between the starting point, the finishing line and two days after the end of the race. Of these, thirty proteins were involved in inflammation, while the rest concerned anti-oxidation, anti-coagulation and iron and vitamin D transport. These results indicate that prolonged physical stress affects circulating stress-related proteins, which might be employed as biomarkers of stress-related diseases. BIOLOGICAL SIGNIFICANCE The current study employed the Spartathlon, as a model of prolonged endurance exercise, to identify and isolate putative biomarkers of inflammation under extreme physical stress conditions. These protein quantitative variations may pave the way to exploration and understanding of stress-related physiological processes, the stress response itself and diseases whose onset appears to be linked to stress.
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Affiliation(s)
- Edily Balfoussia
- Proteomics Research Unit, Center of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Katerina Skenderi
- Laboratory of Nutrition and Clinical Dietetics, "Harokopio" University, Athens, Greece
| | - Maria Tsironi
- Department of Internal Medicine, University of Peloponnesus, School of Nursing, Sparta, Greece
| | - Athanasios K Anagnostopoulos
- Proteomics Research Unit, Center of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Parthimos
- First Department of Pediatrics, University of Athens Medical School, Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Kostantinos Vougas
- Proteomics Research Unit, Center of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - George Th Tsangaris
- Proteomics Research Unit, Center of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
| | - George P Chrousos
- First Department of Pediatrics, University of Athens Medical School, Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
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Robach P, Boisson RC, Vincent L, Lundby C, Moutereau S, Gergelé L, Michel N, Duthil E, Féasson L, Millet GY. Hemolysis induced by an extreme mountain ultra-marathon is not associated with a decrease in total red blood cell volume. Scand J Med Sci Sports 2012; 24:18-27. [PMID: 22672635 DOI: 10.1111/j.1600-0838.2012.01481.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2012] [Indexed: 12/14/2022]
Abstract
Prolonged running is known to induce hemolysis. It has been suggested that hemolysis may lead to a significant loss of red blood cells; however, its actual impact on the erythrocyte pool is unknown. Here, we test the hypothesis that prolonged running with high hemolytic potential decreases total red blood cell volume (RCV). Hemolysis (n = 22) and RCV (n = 19) were quantified in ultra-marathon runners before and after a 166-km long mountain ultra-endurance marathon (RUN) with 9500 m of altitude gain/loss. Assessment of total hemoglobin mass (Hbmass) and RCV was performed using a carbon monoxide rebreathing technique. RUN induced a marked acute-phase response and promoted hemolysis, as shown by a decrease in serum haptoglobin (P < 0.05). Elevated serum erythropoietin concentration and reticulocyte count after RUN were indicative of erythropoietic stimulation. Following RUN, runners experienced hemodilution, mediated by a large plasma volume expansion and associated with a large increase in plasma aldosterone. However, neither Hbmass nor RCV were found to be altered after RUN. Our findings indicate that mechanical/physiological stress associated with RUN promotes hemolysis but this has no impact on total erythrocyte volume. We therefore suggest that exercise 'anemia' is entirely due to plasma volume expansion and not to a concomitant decrease in RCV.
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Affiliation(s)
- P Robach
- Medical Department, National School for Skiing and Mountaineering, Site of the National School for Mountain Sports, Chamonix, France
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Abstract
Malabsorption syndrome encompasses numerous clinical entities that result in chronic diarrhea, abdominal distention, and failure to thrive. These disorders may be congenital or acquired and include cystic fibrosis and Shwachman-Diamond syndrome; the rare congenital lactase deficiency; glucose-galactose malabsorption; sucrase-isomaltase deficiency; adult-type hypolactasia leading to acquired lactose intolerance. The pathology may be due to impairment in absorption or digestion of nutrients resulting in Nutritional deficiency, gastrointestinal symptoms, and extra gastrointestinal symptoms. Treatment is aimed at correcting the deficiencies and symptoms to improve quality of life. Common disorders of malabsorption celiac disease, pernicious anemia, and lactase deficiency are discussed in this article.
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Affiliation(s)
- Zafreen Siddiqui
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, 5909 Harry Hines Boulevard, Suite 100, Dallas, TX 75390-9067, USA.
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Merkel D, Huerta M, Grotto I, Blum D, Rachmilewitz E, Fibach E, Epstein Y, Shpilberg O. Incidence of anemia and iron deficiency in strenuously trained adolescents: results of a longitudinal follow-up study. J Adolesc Health 2009; 45:286-91. [PMID: 19699425 DOI: 10.1016/j.jadohealth.2009.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 02/02/2009] [Accepted: 02/05/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE Combat soldiers have a higher prevalence of anemia than age- and gender-matched civilians. This may be caused by hemodilution, which is typical among athletes, or by reduced body iron stores. The aim of this study was to investigate the incidence of iron-deficiency anemia in recruits to the Israel Defense Force after 6 months of training. METHODS Blood was collected from recruits before training. After 6 months of follow-up, 153 paired blood samples were collected from the initial cohort. Total blood count and serum iron, transferrin, and ferritin were measured at both time points. Soluble transferrin receptor (sTfR) was measured in 119 of the paired samples and the sTfR/log ferritin ratio was calculated. RESULTS At recruitment, mean hemoglobin concentration was 14.7 +/- .9 g/dl. Iron-transferrin saturation was 34.1% +/- 13.6%, and mean ferritin concentration was 53.6 +/- 33.2 ng/ml. Anemia prevalence (Hb <14 g/dl) was 17.6%, and 14.9% of participants were iron-deficient (ferritin <22 mg/dl). At 6 months, 50.3% of the cohort was anemic, and 27.3% demonstrated iron-store depletion. Paired analysis showed an average reduction of .83 g/dl in hemoglobin (p < .001), and of 9.8 mg/dl in ferritin (p < .001). sTfR increased from 1.9 to 2.1 mg/dl (p < .003) among recruits who became anemic. Half of the recruits experienced mild anemia after 6 months of training. Iron store depletion was observed among 24.5% of the cohort after training, as opposed to 15% at recruitment. Overall, these changes were not accompanied by a significant increase in sTfR, but among the subset of anemic subjects, there was a slight increase in index value. CONCLUSIONS In half of the cases, new-onset anemia was attributable to iron deficiency, and in the remainder, to hemodilution.
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Affiliation(s)
- Drorit Merkel
- Institute of Hematology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Córdova Martínez A, Villa G, Aguiló A, Tur JA, Pons A. Hand Strike-Induced Hemolysis and Adaptations in Iron Metabolism in Basque Ball Players. ANNALS OF NUTRITION AND METABOLISM 2006; 50:206-13. [PMID: 16407647 DOI: 10.1159/000090742] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Accepted: 06/13/2005] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Basque ball players (BBPs) make repeated hand strikes to the ball which involves continuous mechanical trauma. OBJECTIVE The aim of this work is to describe the hematological variations and changes in iron metabolism occurring in BBPs as a result of acute and continuous practice of this special sport native to Northern Spain. METHODS 40 healthy male subjects volunteered to participate in this study: 11 subjects who exercise moderately (control group) but do not play Basque ball sport and 29 professional BBPs were studied in two situations: before a match (BM group) and after a match (AM group). The following hematological parameters were determined: red blood cell count (RBC), hemoglobin and hematocrit; MCV, MCH and MCHC. The following variables were measured in serum: iron, ferritin, transferrin, transferrin saturation, proteins, and lactate dehydrogenase (LDH). Proteins and hemoglobin were determined in urine. RESULTS The BM group showed lower hematocrit, MCV, hemoglobin and serum transferrin levels, and higher LDH than controls. The AM group showed higher RBC, hemoglobin, serum proteins, iron, transferrin and LDH levels, lower plasma volume, and higher urine hemoglobin and protein levels than the BM group. CONCLUSIONS Basque ball playing induces hemolysis and increases the plasma capability to quench free iron, but its clinical consequences on iron metabolism do not seem to be enough to take an iron intake proportional to the caloric intake. In order to prevent, in the long term, the development of anemia in these peculiar sportsmen, it would be useful that medical teams observe urine blood losses and oxidative stress in these BBPs.
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Affiliation(s)
- Alfredo Córdova Martínez
- Department of Physiology and Biochemistry, School of Physiotherapy, University of Valladolid, Soria, Spain.
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Abstract
Optimal athletic performance depends on proper function of many organs, including the blood. This is underscored by the focus of endurance athletes on increased hemoglobin through training at altitude or exogenous erythropoietin. Several other aspects of the hematologic system can also affect or be influenced by physical activity. In this article, the authors briefly discuss inherited abnormalities of the blood that can manifest themselves in athletes. We then discuss the effects of exercise on the blood, and acquired abnormalities of blood cells or coagulation parameters that occur in athletes, and that can influence performance or cause other symptoms.
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Affiliation(s)
- Kelly W Mercer
- Division of Hematology/Oncology, University of Virginia School of Medicine, Box 800716, Charlottesville, VA 22908, USA
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Weijers RE, Kessels AGH, Kemerink GJ. The damping properties of the venous plexus of the heel region of the foot during simulated heelstrike. J Biomech 2004; 38:2423-30. [PMID: 16214490 DOI: 10.1016/j.jbiomech.2004.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2004] [Accepted: 10/07/2004] [Indexed: 10/26/2022]
Abstract
The damping mechanisms that are operational in the heel pad during the impact phase of locomotion have the important function to protect the musculo-skeletal system from injuries. How this is achieved is still not fully understood, as is for instance illustrated by the 'heel pad paradox', the observation that in vivo and in vitro experiments yielded widely different results. This paradox could so far only partially be explained. In the light of this paradox, and a previous study by our group, we conjectured that the venous plexus might contribute as a hydraulic shock absorber to the damping properties of the heel pad. To investigate this hypothesis in vivo, heel pads of 11 volunteers were subjected to pendulum impact tests, using velocities of 0.2, 0.4, and 0.6 m/s, and three physiologically different, consecutive conditions: (i) a relatively empty venous plexus, (ii) a congested venous plexus, and (iii) a decongested venous plexus. At congestion, the maximum impact force decreased slightly but significantly by 2.6% at 0.2 m/s and 1.8% at 0.4 m/s. This effect was no longer found at 0.6 m/s. Although these effects are rather small, they confirm the fundamental hypothesis that the venous plexus contributes to the damping properties of the heel pad during walking. It is likely that some underestimation of the effect has occurred.
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Affiliation(s)
- René E Weijers
- Department of Radiology, University Hospital Maastricht, P. Debyelaan 25, 6202 AZ Maastricht, The Netherlands.
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Paccalin M, Roy-Peaud F, Landron C, Roblot P, Becq-Giraudon B. L'estomac dans les talons. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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