Biomechanics and Injury Prevention for Barefoot/Minimalist Running.

¼ Biomechanical studies indicate that barefoot/minimalist running coincides with a transition to an anterior foot strike, lower vertical loading rates, higher cadences, less energy absorption at the knee joint, and higher energy absorption at the ankle joint.¼ The clinical outcome studies indicate improvement of previous injuries and equivocal injury rates in the barefoot/minimal-style running groups.¼ Foot strike pattern is more important than footwear regarding injury prevention and vertical loading rate.¼ Minimalist footwear places higher degrees of stress on the ankle joints and an increased injury rate when abruptly transitioning to barefoot running. Runners must weigh the risks and benefits and take caution to properly strengthen their feet and safely transition to minimalist running.

Evaluation of the Bayer microalbumin/creatinine urinalysis dipstick.

BACKGROUND: The objective of this study was to evaluate the utility of the Bayer microalbumin/creatinine urine reagent strip compared to established laboratory methods. METHODS: Random urine specimens from low and high risk pregnancy clinics as well as a random cohort from the community were analyzed for microalbumin and creatinine using both the reagent strip and the Roche Integra 700, according to manufacturers' specifications. Sensitivity and specificity were then calculated. RESULTS: For the pregnant cohorts the sensitivities ranged from 19% to 59%, and the range of specificities was 45.4% to 84.2%. Using the microalbumin/creatinine data from the community, the sensitivity and specificity of the strip were 52.4% and 97.6%, respectively. CONCLUSION: The poor sensitivity of the microalbumin/creatinine urine reagent strip to detect significant microalbuminuria will likely limit its usefulness as a screening tool.

Prevalence, management, and outcomes of preterm prelabour rupture of the membranes of women in Canada.

OBJECTIVES: To determine the prevalence of preterm prelabour rupture of the membranes (PPROM) at Canadian university-affiliated perinatal referral centres, to assess the different management strategies, and to review neonatal outcomes. METHODS: Twelve Canadian university-affiliated perinatal referral centres provided information on their management of PPROM, and 9 participated in data collection to determine prevalence. All women presenting with PPROM during a 2-week period were observed until delivery, and obstetric and neonatal outcome data were subsequently obtained. The total number of deliveries in each centre was recorded for the same time period. We also determined the incidence of PPROM and the neonatal outcome for all women presenting with PPROM at the Kingston General Hospital from January 1999 to December 2001 by retrospective chart review. RESULTS: In the 9 academic centres, 27 women (1 with a twin pregnancy) presented with PPROM during the 2-week period. There were 1168 deliveries during the same time period, giving a prevalence of PPROM of 2.3%. Overall, 53% of placentas submitted for histopathology after PPROM demonstrated evidence of chorioamnionitis. In the retrospective chart review, we found 153 cases of confirmed PPROM from January 1999 to December 2001,an incidence of 2.8%. Clinical management in all centres was similar for most women who presented with PPROM prior to 34 weeks' gestation. Management after 34 weeks' gestation varied among the 12 centres, ranging from immediate induction of labour to expectant management and induction at a greater gestational age (GA). CONCLUSIONS: The increased neonatal morbidity associated with PPROM appears to be inversely related to GA. Increased risk of chorioamnionitis is related to increased time from PPROM to delivery.