Efficacy and safety of autologous or allogeneic mesenchymal stromal cells from adult adipose tissue expanded and combined with tricalcium phosphate biomaterial for the surgical treatment of atrophic nonunion of long bones: a phase II clinical trial.

BACKGROUND: Autologous bone grafting is the standard treatment for the surgical management of atrophic nonunion of long bones. Other solutions, such as bone marrow mesenchymal stem cells (BM-MSC) combined with phospho-calcium material, have also been used. Here we evaluate the safety and early efficacy of a novel procedure using autologous or allogenic adipose tissue mesenchymal stromal cells (AT-MSC) seeded in a patented tricalcium phosphate-based biomaterial for the treatment of bone regeneration in cases of atrophic nonunion. METHODS: This was a prospective, multicentric, open-label, phase 2 clinical trial of patients with atrophic nonunion of long bones. Biografts of autologous or allogenic AT-MSC combined with a phosphate substrate were manufactured prior to the surgical procedures. The primary efficacy was measured 6 months after surgery, but patients were followed for 12 months after surgery and a further year out of the scope of the study. All adverse events were recorded. This cohort was compared with a historical cohort of 14 cases treated by the same research team with autologous BM-MSC. RESULTS: A total of 12 patients with atrophic nonunion of long bones were included. The mean (SD) age was 41.2 (12.1) years and 66.7% were men. Bone healing was achieved in 10 of the 12 cases (83%) treated with the AT-MSC biografts, a percentage of healing similar (11 of the 14 cases, 79%) to that achieved in patients treated with autologous BM-MSC. Overall, two adverse events, in the same patient, were considered related to the procedure. CONCLUSIONS: The results of this study suggest that AT-MSC biografts are safe for the treatment of bone regeneration in cases of atrophic nonunion and reach high healing rates. TRIAL REGISTRATION: Study registered with EUDRA-CT (2013-000930-37) and ClinicalTrials.gov (NCT02483364).

Contraindicaciones para la práctica deportiva. Documento de Consenso de la Sociedad Española de Medicina del Deporte (SEMED). Versión 2023 / Contraindications of sports practice. Consensus document of the Spanish Society of Sports Medicine (SEMED). Version 2023

La función principal de la medicina del deporte es el cuidado de la salud del deportista, no solo desde el punto de vista del tratamiento, sino también desde el de la prevención. Los reconocimientos médicos para la aptitud deportiva, una de las atribuciones principales de esta especialidad, están destinados a descubrir patologías, enfermedades o alteraciones que pueden afectar a la salud, y abarcan desde las situaciones que pueden desencadenar incidentes mortales hasta las que, sin poner en riesgo la vida, pueden afectar la salud o el rendimiento del deportista. La realización adecuada de reconocimientos para el deporte implica el diagnóstico de problemas médicos que deben analizarse, entre otros puntos de vista, desde la óptica de la aptitud para la práctica deportiva, y el médico encargado debe disponer de una guía que le oriente sobre la decisión de autorizar o no la práctica de deporte, y en caso de no autorización, la temporalidad de esta y el riesgo asumible de participación en algunos deportes. Las contraindicaciones para la práctica deportiva mejor conocidas son las de origen cardiovascular, tratadas extensamente en la literatura, pero también existen contraindicaciones del resto de aparatos y sistemas del organismo, entendiendo que el deportista es un ser completo y que el ejercicio físico afecta a todo su conjunto. Este documento, además de recoger dichas contraindicaciones, analiza los aspectos legales que afectan a los profesionales en los que recae la responsabilidad de realizar los reconocimientos y los aspectos documentales que les son propios.(AU)

Main purpose of sports medicine is reaching the health care of the athlete, not only from the point of view of treatment, but also from the point of view of prevention. The performance of preparticipation medical sports evaluation, one of the main attributions of this specialty, is aimed at the discovery of pathologies, diseases or alterations that may affect health. They might range from situations that can trigger deadly incidents, to those without putting life at risk, can affect the health or performance of the athlete. Adequate implementation of preparticipation medical sports evaluation implies the diagnosis of medical problems that must be analyzed, from other points of view such as the perspective of fitness for sport practice. In addition, the doctor in charge must have a guide for clearance for sports practice. In case of non-authorization, time for non-sports activities must be recommended in order to decrease injury risks. Cardiovascular pathologies are the best-known contraindications in sport practice, treated extensively in the literature. However, there are also contraindications secondary to problems or issues of the rest of apparatus organs and systems of the organism, knowing that the athlete represents an entity in which physical exercise affects all their sets. This document highlights those contraindications already discussed above and analyzes the legal aspects of sports practice contraindications. Medical professionals are responsible for managing the pre-participation medical sports evaluation as well as the documentary aspects that support it.(AU)

Skateboarding Injuries in Spain: A Web-Based Survey Approach.

BACKGROUND: The inclusion of skateboarding in the Tokyo 2020 Olympic Games reinforces this activity as a sport. As the number of skateboarders around the world and the difficulty of skateboarding maneuvers continue to increase, the number of skateboarding injuries may also rise. Thus, there is a need for more comprehensive investigations into the practice habits and injuries of skateboarders. PURPOSE: To describe the sports habits and skateboarding injuries of a sample of skateboarders in Spain. STUDY DESIGN: Descriptive epidemiology study. METHODS: A web-based survey was shared among skateboarders in Spain. The survey collected data related to sports habits, skateboarding practice habits, and injury history. Comparisons between subgroups of sex, age, and experience were also conducted. RESULTS: The survey was completed by 197 participants (89.3% male) with a mean age of 24.4 ± 7.1 years and a mean experience of 9.7 ± 7.2 years. Most respondents (87.8%) reported not participating in any type of skateboarding-specific physical training program. Only 27.4% took part in skateboarding competitions, with a larger number of respondents younger than 18 years participating in competitive events. The mean number of sessions per week was 3.3 ± 1.7, and the mean length of sessions was 3.3 ± 1.5 hours. The majority of participants (87.8%) reported having suffered injuries (n = 323) as a result of skateboarding, mainly affecting the lower limbs (69.7%). The most common injury type was a ligament sprain (39.6%), especially of the ankle (39.3%). This injury was also reported as the most likely to recur (70.1%). A large number of injuries (54.2%) were considered severe (ie, >21 days to recover). Most injuries occurred while skateboarding gaps or stairs, including any type of a jump that involved a difference in height between the take-off and landing surfaces (25.7%). Female participants accounted for a larger number of ligament sprains than expected, and experienced skateboarders were more likely to suffer more severe injuries and head/trunk injuries. CONCLUSION: Respondents to this survey were mainly young male adults who practiced skateboarding recreationally. Respondents of different sexes, ages, and experiences demonstrated different habits and injury patterns. The greater number of severe injuries highlights the need for injury surveillance in skateboarding to inform better prevention and rehabilitation practices.

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Contraindicaciones para la práctica deportiva. Documento de consenso de la Sociedad Española de Medicina del Deporte (SEMED-FEMEDE) / Contraindications of sports practice. Consensus document of the SPANISH Society of Sports Medicine (SEMED-FEMEDE)

La función principal de la medicina del deporte es el cuidado de la salud del deportista, no solo desde el punto de vista del tratamiento, sino también desde el de la prevención. Los reconocimientos médicos para la aptitud deportiva, una de las atribuciones principales de esta especialidad, están destinados a descubrir patologías, enfermedades o alteraciones que pueden afectar a la salud, y abarcan desde las situaciones que pueden desencadenar incidentes mortales hasta las que, sin poner en riesgo la vida, pueden afectar la salud o el rendimiento del deportista. La realización adecuada de reconocimientos para el deporte implica el diagnóstico de problemas médicos que deben analizarse, entre otros puntos de vista, desde la óptica de la aptitud para la práctica deportiva, y el médico encargado debe disponer de una guía que le oriente sobre la decisión de autorizar o no la práctica de deporte, y en caso de no autorización, la temporalidad de esta y el riesgo asumible de participación en algunos deportes. Las contraindicaciones para la práctica deportiva mejor conocidas son las de origen cardiovascular, tratadas extensamente en la literatura, pero también existen contraindicaciones del resto de aparatos y sistemas del organismo, entendiendo que el deportista es un ser completo y que el ejercicio físico afecta a todo su conjunto. Este documento, además de recoger dichas contraindicaciones, analiza los aspectos legales que afectan a los profesionales en los que recae la responsabilidad de realizar los reconocimientos y los aspectos documentales que les son propios

Main purpose of sports medicine is reaching the health care of the athlete, not only from the point of view of treatment, but also from the point of view of prevention. The performance of preparticipation medical sports evaluation, one of the main attributions of this specialty, is aimed at the discovery of pathologies, diseases or alterations that may affect health. They might range from situations that can trigger deadly incidents, to those without putting life at risk, can affect the health or performance of the athlete. Adequate implementation of preparticipation medical sports evaluation implies the diagnosis of medical problems that must be analyzed, from other points of view such as the perspective of fitness for sport practice. In addition, the doctor in charge must have a guide for clearance for sports practice. In case of non-authorization, time for non-sports activities must be recommended in order to decrease injury risks. Cardiovascular pathologies are the best known contraindications in sport practice, treated extensively in the literature. However, there are also contraindications secondary to problems or issues of the rest of apparatus organs and systems of the organism, knowing that the athlete represents an entity in which physical exercise affects all their sets. This document highlights those contraindications already discussed above and analyzes the legal aspects of sports practice contraindications. Medical professionals are responsible for managing the pre-participation medical sports evaluation as well as the documentary aspects that support it

Reconocimientos médicos para la aptitud deportiva. Documento de consenso de la Sociedad Española de Medicina del Deporte (SEMED-FEMEDE) / Pre-participation Screening Athletes. Consensus document of the Spanish Society of Sports Medicine (SEMED-FEMEDE)

La realización de actividad física-deportiva segura precisa realizar algún tipo de investigación médica sobre el estado de salud del deportista. La mayor parte de la literatura sobre este tema se centra en el descubrimiento de las enfermedades o anomalías cardiovasculares que, más frecuentemente, tienen riesgo de desencadenar un episodio de muerte súbita. Pero la actividad física tiene repercusiones notables sobre el resto del organismo, especialmente en el aparato locomotor y en el sistema metabólico, por lo que el reconocimiento médico no se debe limitar a la exploración cardiovascular, sino ampliarse al resto de los aparatos y sistemas implicados en el esfuerzo físico. Este consenso recoge los contenidos del reconocimiento médico básico para la aptitud deportiva, incluyendo antecedentes, historia deportiva y exploración por aparatos, junto con el electrocadiograma de reposo del que se describen sus hallazgos normales y patológicos, y que forma parte inexcusable del reconocimiento. El documento describe los objetivos de realización del reconocimiento, aspectos médico-legales, consideraciones sobre su coste y utilidad, los tipos de reconocimiento y los grupos de deportistas a los que van dirigidos, así como los documentos que se deben aportar en forma de informe médico y de informe de aptitud deportiva. Se hace una descripción de las contraindicaciones para la práctica deportiva y se pospone la descripción pormenorizada de las mismas, que se contemplará en un documento independiente. Este documento se realiza desde la óptica y experiencia española, y se plantea como un amplio consenso, tanto de profesionales como sobre la literatura cientíca existente sobre los reconocimientos médico-deportivos

The realization of safe physical-sport activity needs to carry out some type of medical investigation on the state of the athlete’s health. Most of the literature on this subject focuses on the discovery of cardiovascular diseases or anomalies that are most frequently at risk of triggering an episode of sudden death. However, physical activity has a significant impact on the rest of the body, especially in the locomotor system and in the metabolic system, so that medical examination should not be limited to cardiovascular exploration but should be extended to all other devices and systems involved in the physical e ort. This consensus includes the contents of the basic medical examination for sports aptitude, including antecedents, sports history and apparatus exploration, together with electrocadiograma of rest that describes its normal and pathological findings and that is an inexcusable part of the recognition. The document describes the objectives of the recognition, medical-legal aspects, considerations about their cost and utility, the types of recognition and the groups of athletes to whom they are addressed, as well as the documents that must be provided in the form of a medical report and of fitness report. A description of the contraindications for sports practice is made and a detailed description of them is postponed to be considered in an independent document. This document is made from the Spanish perspective and experience, and is considered as a broad consensus of both professionals, as well as the existing scientific literature on medical-sports surveys

Conmoción cerebral en el karate deportivo: disminución en la frecuencia en los campeonatos mundiales de karate / Cerebral concussion in sport karate: decrease in the frequency in world karate championships

Objetivo: presentar la reducción progresiva en la frecuencia de conmociones cerebrales en los Campeonatos Mundiales de Karate, a partir de los cambios en el reglamento de la Federación Mundial de Karate (FMK). Material y Método: Estudio prospectivo de las conmociones cerebrales ocurridas en los campeonatos del mundo de Madrid (2002), Monterrey (2004), Tampere (2006), Tokio (2008), Belgrado (2010) y París (2012). Resultados: La frecuencia de conmociones cerebrales, definidas según la Conferencia Internacional de Conmoción en el Deporte (Viena 2001, Praga 2004, Zurich 2008 y 2012) ha disminuido progresivamente en los Campeonatos del Mundo de Karate: una conmoción cada 230 combates en Madrid, una cada 196 en Monterrey, una cada 99 en Tampere, una cada 612 en Tokio, una cada 512 en Belgrado, y una cada 1.140 en París. Discusión y Conclusión: El uso de protecciones, la aplicación rigurosa del reglamento del karate deportivo y la educación continua en la prevención de lesiones de los competidores, técnicos y árbitros, ha disminuido la frecuencia de conmocionescerebrales en los Campeonatos del Mundo, haciendo del karate deportivo una disciplina más segura, cumpliendo con los principios del Olimpismo.

Objective: to present the progressive reduction of the frequency of cerebral concussion in the World Karate Championships, due to the changes in the Rules and Regulations of the World Karate Federation (WKF). Material and Method: Prospective study of the brain concussions occurred in the World Championships of Madrid (2002), Monterrey (2004), Tampere (2006), Tokyo (2008), Belgrade (2010) and Paris (2012). Results: The frequency of brain concussion, defined by the International Conference of Sports Concussion (Vienne 2001, Prague 2004, Zurich 2008 and 2012) has progressively diminished in the World Karate Championships: one concussion each 230 bouts in Madrid, one each 196 in Monterrey, one each 99 in Tampere, one each 612 in Tokyo, one each 512 in Belgrade, and one each 1,140 in Paris. Discussion and Conclusion: The use of protections, the rigorous enforcement of the Rules and Regulations of the Sports Karate and the continuous education inthe prevention of injury of athletes, technicians and referees, has diminished the frequency of brain concussion in the World Championships, making Karate a much safer sport, achieving Olympic principles.

Beneficios de la carrera en agua profunda en sujetos sedentarios después de ocho semanas de entrenamiento / The effect of eight weeks of deep water running in sedentary subjects

Se llevó a cabo un estudio para comprobar los beneficios cardiovasculares que un período de 8 semanas de carrera en agua profunda podrían tener en un grupo de sujetos sedentarios. La comparación de los resultados obtenidos con los encontrados en la bibliografia estuvo condicionada por la falta de trabajos publicados empleando protocolos validados y reproducibles en muestras amplias. Ocho sujetos sedentarios (siete hombres y una mujer), entre los 25 y los 40 años de edad, realizaron ocho semanas dé entrenamiento aeróbico en piscina profunda con ayuda de cinturones de flotación. La duración de las sesiones de entrenamiento varió entre 19 minutos y 48 minutos, y la intensidad se ajustó tras comprobar la frecuencia cardíaca máxima (FCM) con el test de carrera en pista de la Universidad de Montreal (UMTT), adaptándola a la piscina, y utilizando valores del 50 por ciento FCM (recuperación activa), 65 por ciento FCM (calentamiento), 75 por ciento FCM (series de 3 minutos), 80 por ciento FCM (series de 2 minutos), y 85 por ciento FCM (series de 1 minuto), para realizar un entrenamiento interválico extensivo. Se empleó el programa SPSS para Windows para realizar el análisis estadístico de las variables testadas en el trabajo: Velocidad Aeróbica Máxima Inicial (VAM1), Velocidad Aeróbica Máxima Final (VAM2), Duración Inicial del Test Aeróbico de Montreal (DI), y Duración Final del Test Aeróbico de Montreal (D2). Se demostró un aumento de VAM y D en todos los sujetos estudiados menos uno (la única mujer del estudio). A pesar de no alcanzar niveles de significación estadística, debido al tamaño de la muestra, incrementos en la VAM por encima de 1 Km.h-' representan mejoras cuantitativas para cualquier sujeto. A study was designed to test the cardiovascular benefits that eight weeks of deep water running might have on sedentary people. The comparison of the results obtained with those from the bibliography was conditioned by the lack of published works establishing valid and reproducible protocols with ample samples. Eight sedentary people (seven men and one woman) between 25 and 40 years of age did eight weeks of aerobic training sessions varying between 19 and 48 minutes, and their intensity was adjusted individually after testing the maximum heart rate (MHR) with the running track test of the University of Montreal (UMTT) and adapting it to the pool using values of 50 por ciento MHR (active recovery), 65 por ciento MHR (warm-up), 75 por ciento o MHR (3minute series), 80 por ciento MHR (2-minute series), and 85 por ciento MHR (1-minute series), to perform extensive interval training. Statistical analysis; using SPSS for Windows, was applied to the parameters tested in the study: Initial Maximal Aerobic Velocity (VAM I), Final Maximal Aerobic Velocity (VAM2), Initial Duration of the Montreal Track Test (D 1), and Final Duration of the Montreal Track Test (D2). Both VAM and D increased in all but one subject (the only woman in the study). In spite of not reaching statistical levels of significance due to the size of the sample, VAM increases of over 1 Km.h-1 represent quantitative improvements for any subject (AU)