Audrey Jansen van Rensburg

Thalassemia: Lung Function with Reference to Iron Studies and Reactive Oxidant Status

Pulmonary function tests were performed in 15 thalassemic patients (age 5 years 8 months to 18 years 6 months), receiving both regular transfusions and desferrioxamine, to determine the presence and nature of any abnormalities in lung function. Reactive oxidant production from neutrophils was measured simultaneously to ascertain if a causal relationship existed between free radical production and tissue damage in the lungs. Mean total lung capacity, mean residual volume, and mean forced vital capacity were significantly reduced, indicating a restrictive pattern of lung function abnormality. In addition, the carbon monoxide diffusion was low, and hypoxemia was present in 6 of 13 patients tested. These pulmonary function abnormalities did not correlate with age, cumulative volume of transfusion, or serum ferritin levels. In addition, neutrophil reactive oxidant status did not correlate with these or with pulmonary function parameters. These results indicate that neutrophil-derived oxygen free radicals do not appear to be a major cause of lung function abnormalities in thalassemics.

Iliac artery endofibrosis in a middle-aged female long-distance runner.

Exercise-induced iliac artery endofibrosis is a recently described abnormality of the external iliac artery that typically affects younger, healthy endurance athletes. Characteristic of the initially termed cyclists iliac syndrome is lower limb pain during exercise with rapid recovery after exercise. This clinically complicated case describes an older female long-distance runner in whom an incorrect diagnosis of fibromuscular dysplasia was originally made when she presented with claudication and thrombosis of the right external iliac artery. A thrombectomy and bilateral balloon angioplasty were performed; however, her symptoms persisted. Four months later, she unexpectedly complained of dual calf claudication, a diagnosis of exercise-induced iliac artery endofibrosis was made, and a bilateral prosthetic graft bypass procedure was performed, which resulted in a good outcome.

AN INCREASING INCIDENCE OF INJURIES DURING THE SUPER RUGBY TOURNAMENT: A PROSPECTIVE STUDY OVER 4 YEARS INVOLVING 69 194 PLAYER-HOURS

Background Rugby Union has one of the highest reported incidences of match injuries among all professional sports. The Super Rugby tournament is played annually between professional rugby union teams from three rugby-playing nations in the Southern hemisphere. Objective To determine if the incidence of injuries in the Super Rugby tournament decreased over a 4-year period. Design Prospective cohort study. Setting Super Rugby tournament. Patients (or Participants) 774 male players from 5 South African teams. Assessment of Risk Factors) Medical staff of South African teams participating in the 2012, 2013, 2014 and 2015 tournaments recorded all time loss injuries (all injuries and match injuries) and exposure hours (69 194 total playing hours; 6 132 match hours). Main Outcome Measurements Incidence of all injuries and match injuries (per 1000 hours play). Results The incidence of all injuries (per 1000 player hours; 95% CI) for each year was as follows: 2012 (9.2; 7.9–10.8); 2013 (11.6; 10.1–13.3); 2014 (11.4; 9.8–13.2), and 2015 (12.4; 10.9–14.1). The incidence of all injuries in 2015 was significantly higher compared to 2012. The overall incidence of match injuries (per 1000 player hours; 95% CI) for each year was as follows: 2012 (83.3; 69.4–99.2); 2013 (120.4; 103.6–139.2); 2014 (98.6; 83.3–116.0), and 2015(119.1; 102.9–137.2). The incidence of match injuries in 2013 and 2015 was significantly higher compared to 2012 and 2014. Conclusions There is an increased incidence of all injuries and match injuries in the Super Rugby tournaments between 2012–2015. After 2012, the incidence of match injuries is consistently higher than previously reported for senior male rugby players at elite/professional level (89–96 per 1000 hrs). There is an urgent need to introduce targeted injury prevention strategies in the Super Rugby tournament to reduce the risk of injuries.

Concussion in sport: what is known and what is new?

The aim of this article was to summarise the latest definition of concussion, signs of concussion, as well as important facts on recovery and graduated return to play, for different age groups. New technologies available to the sports physician are listed.