ABSTRACT
Background and objective The coronavirus disease 2019 (COVID-19) pandemic has accelerated the shift towards remote consultations in the medical field, including musculoskeletal (MSK) appointments. General practitioner (GP) registrars are now routinely conducting many MSK consultations remotely; however, very little is known of their level of confidence and satisfaction regarding this new and evolving scenario, or how this may impact patient management of patients. In this study, we aimed to understand GP registrars' level of confidence and satisfaction with respect to remote MSK consultations, and the perceived impact on patient management. Study design This study involved a cross-sectional online survey of GP registrars in the West Midlands, which was conducted in January 2021. Methods The survey asked for ranked responses to questions comparing face-to-face consulting methods with remote consulting, focusing on confidence, satisfaction, onward investigations, and referral activity. Statistical analysis was performed using the R software version 4.0.3. Results The overall survey response was 21.2% (n=312/1,471). Of the respondents, 85.9% of GP registrars had not received any training to prepare them for remote MSK consultations. GP registrars generally felt that they were more confident when treating patients face-to-face compared to remote consultations (p<0.001). This was true for general MSK complaints as well as specific assessments of the hand, shoulder, spine, hip, knee, and ankle; 36.2% of GP registrars were not satisfied and 51.0% thought that their patients were not satisfied with the current quality of remote MSK consultations. Of note, 77.6% of GP registrars said that they were more likely to request additional investigations, and 75.6% stated that they were more likely to refer patients to a specialist after a remote MSK consultation. Conclusion This study highlights the need for further training to better equip primary care doctors for remote MSK consultations. With tailored training, GP registrars could offer more streamlined remote patient care for MSK complaints.
ABSTRACT
BACKGROUND: In rugby the tackle is a complex task requiring joint position sense (JPS). Injuries commonly occur during the tackle and these account for significant time lost from training and play. Simulated tackling tasks have previously shown a reduction in shoulder joint position sense and it is possible that this may contribute to injury. There is growing evidence in support of injury prevention programs, but none so far are dedicated specifically to tackling. We postulate that a brief neuromuscular warmup could alter the negative effects of fatigue on shoulder JPS. METHODS: In this field based, repeated measures design study, 25 semi-professional Rugby players participated. JPS was measured at criterion angles of 45° and 80° of right arm shoulder external rotation. Reproduction accuracy prior to and following a neuromuscular warmup and simulated tackling task was then assessed. RESULTS: In pre-warmup JPS measures, the spread of angle errors were larger at the 80° positions. Adding the warmup, the spread of the angle errors at the 80° positions decreased compared to pre-intervention measures. Two one-sided tests (TOST) analysis comparing pre- and post-testing angle errors, with the addition of the warmup, indicated no difference in JPS. CONCLUSIONS: The neuromuscular warmup resulted in a decrease in JPS error variance meaning fewer individuals made extreme errors. The TOST analysis results also suggest the neuromuscular warmup used in this study could mitigate the negative effects of tackling on JPS that has been seen in prior research. This neuromuscular warmup could play a role in preventing shoulder injuries. It can easily be added to existing successful injury prevention programs.
Subject(s)
Football/physiology , Shoulder Joint/physiology , Adult , Humans , Male , Proprioception , Rotation , Shoulder/physiology , Shoulder Injuries , Warm-Up Exercise , Young AdultABSTRACT
Various pathologies may affect the rectus femoris manifesting as an enlargement of the muscle belly. These include traumatic, inflammatory and neoplastic conditions. We did a retrospective study to provide simple guidelines that will serve as an aid for the clinician in order to diagnose lesions presenting as a mass in the rectus femoris. 81 patients with rectus femoris mass referred to tertiary oncology centre were included in the study. The most common lesions were traumatic and benign tumours. In males, traumatic was commonest (90%) and in female over 40â¯years, 60% were benign and traumatic.
ABSTRACT
SCOPE: Iron is an essential nutrient. However, in animal models, excess unabsorbed dietary iron residing within the colonic lumen has been shown to exacerbate inflammatory bowel disease and intestinal cancer. Therefore, the aims of this study were to screen a panel of alginates to identify a therapeutic that can chelate this pool of iron and thus be beneficial for intestinal health. METHODS AND RESULTS: Using several in vitro intestinal models, it is evident that only one alginate (Manucol LD) of the panel tested was able to inhibit intracellular iron accumulation as assessed by iron-mediated ferritin induction, transferrin receptor expression, intracellular (59) Fe concentrations, and iron flux across a Caco-2 monolayer. Additionally, Manucol LD suppressed iron absorption in mice, which was associated with increased fecal iron levels indicating iron chelation within the gastrointestinal tract. Furthermore, the bioactivity of Manucol LD was found to be highly dependent on both its molecular weight and its unique compositional sequence. CONCLUSION: Manucol LD could be useful for the chelation of this detrimental pool of unabsorbed iron and it could be fortified in foods to enhance intestinal health.
