Localising ingested metallic foreign bodies to guide surgical planning: A novel use for the CT metal artefact reduction algorithm.

We present the case of a 20-year-old female patient who presented following ingestion of multiple button magnets. She remained clinically well however serial abdominal radiographs demonstrated the magnets were not passing through the gastrointestinal tract and a CT was, therefore, performed for further assessment and to aid surgical planning. Artefact from the magnets made interpretation of the CT challenging. The use of a Metal Artefact Reduction (MAR) algorithm, however, enabled accurate localisation of the magnets thus guiding subsequent surgical intervention. Whilst MAR algorithms are usually used in the assessment of iatrogenic metallic devices (e.g., joint prostheses), this case demonstrates an example of their potential wider use.

The magnetic resonance imaging appearances of the interureteric crest of the urinary bladder.

PURPOSE: This study was devised to evaluate the imaging appearances of the interureteric crest (IUC) of the bladder on magnetic resonance imaging (MRI). The primary objective was to determine how commonly the IUC was observed on pelvic MRI examinations. The secondary objectives were to determine the average size of the IUC, its MRI signal characteristics and whether there is variation between men and women. By defining the imaging findings we hope to prevent misinterpretation of normal anatomy on MRI and, therefore, prevent unnecessary further investigations and procedures. METHODS: We retrospectively reviewed 114 adult patient's magnetic resonance imaging examinations of the pelvis. Two readers independently recorded information about the presence and characteristics of the IUC with a third reader used to arbitrate in cases of disagreement. RESULTS: The IUC was demonstrated on MRI in 75% of patients. It was best observed on T2w sequences as a continual ridge of low signal intensity between the ureters. The mean AP diameter of the IUC at its mid-point on the sagittal images was 2.4 mm. CONCLUSIONS: The IUC is often seen on MRI on T2w images of a non-collapsed bladder. Its characteristic appearance can be used to help the reporting radiologist confidently differentiate identify this normal structure from an area of focal bladder wall thickening that might be misinterpreted as a bladder tumor.

Forming, managing and sustaining alliances for health promotion.

ISSUE ADDRESSED: To create consistency among the health promotion alliances in which it engages, the National Heart Foundation of Australia (NHFA) undertook to develop guidelines for the formation, management and sustainability of alliances for cardiovascular health. METHODS: A condensed review of the key themes in the literature and survey of staff who were involved in health promotion alliances were conducted to guide the development of a checklist and template Memorandum of Understanding (MOU) for use by staff when engaging in health promotion alliances. RESULTS: The essential factors for forming, managing and sustaining alliances are explored extensively throughout the literature. Here we provide a condensed overview of the key themes relating to the advantages and barriers of health promotion alliances, plus a useful set of principles for forming, managing and, where applicable, sustaining health promotion alliances. CONCLUSIONS: Alliances are a crucial part of the cardiovascular health work of the NHFA and, indeed, broader approaches to promote health. These alliances may involve simply sharing knowledge and creating networks, or they may involve complex arrangements to address broad health issues.

Concurrent strength and endurance training: the influence of dependent variable selection.

Twenty-six active university students were randomly allocated to resistance (R, n = 9), endurance (E, n = 8), and concurrent resistance and endurance (C, n = 9) training conditions. Training was completed 3 times per week in all conditions, with endurance training preceding resistance training in the C group. Resistance training involved 4 sets of upper- and lower-body exercises with loads of 4-8 repetition maximum (RM). Each endurance training session consisted of five 5-minute bouts of incremental cycle exercise at between 40 and 100% of peak oxygen uptake (.VO2peak). Parameters measured prior to and following training included strength (1RM and isometric and isokinetic [1.04, 3.12, 5.20, and 8.67 rad.s(-1)] strength), .VO2peak and Wingate test performance (peak power output [PPO], average power, and relative power decline). Significant improvements in 1RM strength were observed in the R and C groups following training. .VO2peak significantly increased in E and C but was significantly reduced in R after training. Effect size (ES) transformations on the other dependent variables suggested that performance changes in the C group were not always similar to changes in the R or E groups. These ES data suggest that statistical power and dependent variable selection are significant issues in enhancing our insights into concurrent training. It may be necessary to assess a range of performance parameters to monitor the relative effectiveness of a particular concurrent training regimen.

Characteristics of titin in strength and power athletes.

The purpose of this investigation was to identify characteristics of the muscle protein titin in different athletic populations with increased levels of strength and power relative to non-athletes. Subjects fell into one of four groups: (1) non-athletes (NA) ( n=5), (2) weightlifters (WL) (n=5), (3) powerlifters (PL) (n=5), (4) sprinters (S) (n=5). A one repetition maximum in the squat exercise was performed to assess strength. In addition, countermovement vertical jump trials were performed to assess power capabilities. Peak power (W(peak)) was calculated for the vertical jumps from force plate measurements. From gel electrophoresis analyses of muscle samples, titin-1 (T1) and titin-2 (T2) protein bands were identified, quantified and expressed relative to each other. In addition the relative mobility (R(f)) of T1 and T2 was determined as an estimate of molecular weight. The NA group [%T1=47.8 (5.1), %T2=52.2 (5.1), mean (SE)] had lower T1 and higher T2 percentages than WL [%T1=62.3 (6.6), %T2=37.7 (6.6)], PL [%T1=66.8 (5.0), %T2=33.2 (5.0)] and S [%T1=65.9 (4.9), %T2=34.1 (4.9)] groups (P< or =0.10, preliminary investigation into titin and exercise justifies more liberal alpha level). No significant differences were found in R(f) of T1 or T2 between the groups. This investigation has shown that there is a differential expression of titin protein bands in competitive athletes with increased levels of strength and power in comparison to untrained non-athletic individuals. Some relationships between titin characteristics and athletic performance were observed; however, no conclusions can be made based on these data as to the contribution of titin to strength or power capabilities.