Individualised reference ranges for markers of muscle recovery assessment in soccer.

Recently an individualisation algorithm has been developed and shown to significantly improve the diagnostic accuracy of creatine kinase (CK) and urea in endurance sports and Badminton. In this study, the applicability and benefit of this algorithm was evaluated using repeated measures data from 161 professional German soccer players monitored during the 2015-2017 seasons. Venous blood samples were collected after a day off (recovered state) and after a minimum of two strenuous training sessions within 48 h (non-recovered state) and analysed for CK and urea. Group-based reference ranges were derived from that same dataset to ensure the best possible reference for comparison. A z-test was conducted to analyse differences in error rates between individualised and group-based classifications. CK values for the individualised approach showed significantly lower error rates in the assessment of muscle recovery compared to both a population-based (p < .001; z-value: -17.01; test-pass error rate: 21 vs. 67%; test-fail: 19 vs. 64%) and a group-based cut-off (p < .001; z-value: -15.29; test-pass error rate: 65%; test-fail: 67%). It could be concluded that the assessment of muscle recovery in soccer using individualised interpretations of blood-borne markers may offer higher diagnostic accuracy than a population-based and a sample-specific group-based approach.HighlightsAssessing muscle recovery via CK using individualised ranges seems to offer a higher diagnostic accuracy than a sample-specific group-based analysis.Using an individualised algorithm seems to be a promising approach to overcome diagnostic problems arising from large inter- and intraindividual variability in blood parameters as it significantly improved the diagnostic accuracy of CK as a recovery marker.As recovery assessment in elite soccer ultimately aims at the accurate detection of differences in the individual player this algorithm seems to offer coaches and sport scientists a more sensitive approach compared to group-specific evaluations.

Cell type specific gene expression analysis of prostate needle biopsies resolves tumor tissue heterogeneity.

A lack of cell surface markers for the specific identification, isolation and subsequent analysis of living prostate tumor cells hampers progress in the field. Specific characterization of tumor cells and their microenvironment in a multi-parameter molecular assay could significantly improve prognostic accuracy for the heterogeneous prostate tumor tissue. Novel functionalized gold-nano particles allow fluorescence-based detection of absolute mRNA expression levels in living cells by fluorescent activated flow cytometry (FACS). We use of this technique to separate prostate tumor and benign cells in human prostate needle biopsies based on the expression levels of the tumor marker alpha-methylacyl-CoA racemase (AMACR). We combined RNA and protein detection of living cells by FACS to gate for epithelial cell adhesion molecule (EPCAM) positive tumor and benign cells, EPCAM/CD45 double negative mesenchymal cells and CD45 positive infiltrating lymphocytes. EPCAM positive epithelial cells were further sub-gated into AMACR high and low expressing cells. Two hundred cells from each population and several biopsies from the same patient were analyzed using a multiplexed gene expression profile to generate a cell type resolved profile of the specimen. This technique provides the basis for the clinical evaluation of cell type resolved gene expression profiles as pre-therapeutic prognostic markers for prostate cancer.

Artroplastia infectada do joelho: avaliação em artrodeses com semi-anéis / Infected arthroplasty of knee: avaliation in arthrodesis with semi rings

Realizaram-se no período de Janeiro de 2006 até Julho de 2008, em pacientes portadores de artroplastia total de joelho infectada oito artrodeses. Com idade média de 66,3 anos (63-80 anos), três pacientes eram do sexo masculino e cinco feminino. Utilizou-se o método de fixador externo com semi-anéis, com acompanhamento pós-operatório médio de 21 meses (12-40 meses). Trabalho multicêntrico, com pacientes respondendo prospectivamente, pré e pós-operatório, questões objetivas, através do questionário Nottingham Health Profile , que avalia qualidade de vida. Foi observado melhora de 49 por cento nos níveis de qualidade de vida pós-operatórios em relação aos pré-operatórios, assim como consolidação clínica radiográfica em todos pacientes. Tais fatos que avalizam a realização desta técnica, para tratamento da artroplastia total de joelho infectada. Nível de Evidência IV, Série de casos.

There were eight knee arthrodesis in infected total knee arthroplasties between January, 2006 and July, 2008. The mean age was 66,3 years old (63-80), three patients were male and five female. The method of choice was external fixation with semi rings and the mean follow up was 21 months (12 - 40 months). This is a multicentric prospective study with patients answering the Nottingham Health Profile, an objective questionnaire which evaluates quality of life. We observed an improvement of 49 percent in the levels of preoperatory quality of life compared to postoperatively, as well as 100 percent of radiographic union. These are facts that confirm the safe use of this technique to the treatment of infected total knee arthroplasty. Level of Evidence IV, Case series.

Granulocytic sarcoma presenting with malignant anasarca in a patient with secondary acute myeloid leukemia.

Granulocytic sarcomas (GS) are rare extramedullary tumor masses composed of immature cells derived from the hematopoietic myeloid series. GS occur in 3% to 7% of cases of acute myeloid leukemia (AML) and can present before, during, or even after the diagnosis of AML. GS can involve different organs, individually or simultaneously, including the skin, lymph nodes, bone, breast, central nervous system, and lung among others. GS involving peritoneal and pleural fluids is a rare presentation. We present an unusual case of a patient with myelodysplastic syndrome whose disease progressed into a secondary AML and developed GS in the ascitic and pleural effusions as the predominant manifestation of disease progression.