Panagiotis Karagounis

In vitro bactericidal activity of human β-defensin 2 against nosocomial strains.

Human beta-defensin 2 (hBD-2) is a 41-amino acid cationic peptide of the innate immune system that serves as antimicrobial molecule. We determined the bactericidal activity of synthetic hBD-2 against nosocomial strains belonging to eight different bacterial species and exhibiting various antimicrobial resistance phenotypes. The native disulfide connectivity was found essential for the bactericidal activity of hBD-2, while sodium chloride concentration was reversely associated with its potency. hBD-2 exhibited high bactericidal activity against Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecalis, Enterococcus faecium and Staphylococcus aureus clinical strains. Characteristically, A. baumannii strains that exhibited multi-drug resistant (MDR) phenotypes were susceptible to lower concentrations of hBD-2 (vLD(90)=3.25-4.5 microg/ml) in comparison with non-MDR (wild-type) A. baumannii strains (vLD(90)=3.90-9.35 microg/ml). Bactericidal activity of hBD-2 was less pronounced against Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis strains but was significantly enhanced against strains of these species that exhibited resistance to several beta-lactam antibiotics. These observations give indications that the natural hBD-2 has a potential therapeutic role against bacterial pathogens and particularly against those exhibiting MDR phenotypes.

Treatment of plantar fasciitis in recreational athletes: two different therapeutic protocols.

Plantar fasciitis (PF) commonly causes inferior heel pain and occurs in up to 10% of the US population. Treatment protocols in most studies include the use of ice therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and stretching and strengthening protocols. The aim of the current study was to examine the effectiveness of 2 different therapeutic approaches on the treatment of PF in recreational athletes using the Pain and Disability Scale for the evaluation. A total of 38 participants with PF were randomly allocated to 2 different groups of 19 male participants in each group. Group 1 was treated with ice, non-steroidal anti-inflammatory medication, and a stretching and a strengthening program. Group 2 received the same therapeutic procedures as group 1, reinforced by acupuncture treatment. The primary outcomes, nominated a priori, were pain description and mobility-function at 1 and 2 months. Outcomes were measured with the pain scale for PF. The mean total score of the acupuncture group at the third measurement was statistically minor compared with the mean total score of the first group. Acupuncture should be considered as a major therapeutic instrument for the decrease of heel pain, combined with traditional medical approaches.

The Impact of the Spartathlon Ultramarathon Race on Athletes’ Plantar Pressure Patterns

More than 90% of injuries in runners are recorded in the lower extremity, equally affecting the regions of the knee, shank, and foot. Stress fractures are responsible for numerous running-related injuries. In the current study, the plantar pressure patterns of prerace, immediately postrace, and 24 hours after long-distance running in the Spartathlon were analyzed to compare foot loading in the respective conditions. Forty-six male participants of the Spartathlon ultramarathon were examined before, immediately after completion of the race, and 24 hours later with plantar pressure measurements during barefoot walking on a capacitive platform. The results revealed a significant increase in the peak pressure and impulse values in the forefoot areas and a decrease under the toes before and immediately after the race. On the contrary, no significant differences were found between the prerace and the 24-hour postrace values. The present findings indicate that the Spartathlon race leads to significant variations in foot-loading characteristics, especially in the peak pressure and impulse values under the forefoot and toe regions. Twenty-four-hour postrace data measurements reveal insignificant differences from the prerace statement, probably because of the restoration of local muscular activity.

Osteoarthritis of the Ankle and Foot Complex in Former Greek Soccer Players

Sports activities cause increased loads in elite athletes’ joints. Current scientific knowledge highlights the importance of applied mechanical loads on the physiology and pathophysiology of the articular cartilage. Thus, it is possible that sporting activity has a role in the development of osteoarthritis (OA), a painful and damaging joint disease. The aim of the present study was to investigate and record osteoarthritic alterations in the ankle and foot complex in former Greek soccer players and also compare them with those in the general population. The study sample consisted of 170 male, former elite soccer players, aged between 42 and 55 years (mean = 49.8 years, standard deviation [SD] = 7.4). A control group of 132 men, aged between 42 and 55 years (mean, 50.7 years, SD = 9.9), with no regular athletic activity were examined. The development of osteoarthritic alterations was recorded through a questionnaire and clinical and radiological examination. Radiographic analysis of the images in former athletes group showed not only more signs of cartilage degeneration in comparison with the control group (P < .05) but also similar clinical manifestations (pain and impaired mobility; P > .05). Osteophyte formation is a frequent disease among former soccer players—with variations on radiographic images—but it does not appear in their clinical picture. However, it is likely that both spurs and subchondral sclerosis (main findings) are preclinical manifestations of OA. Levels of Evidence: Prognostic, Level II

Tibiofemoral Angle and Its Relation to Ankle Sprain Occurrence

The lack of a normal joint orientation generates translational or shear forces across the joint. These forces can put abnormally high strain on the cartilage and the surrounding capsuloligamentous tissues. Ankle joint structure can affect or be affected by bony malformations of the surrounding areas, including the knee and hip. The aim of the current study is to examine the possible relationship between the tibiofemoral (TFA) angle and other factors (anthropometric characteristics, medical history, and age) on the occurrence of ankle sprains because its value provides useful information for the anatomical alignment of the lower extremity. The study sample consisted of 45 high-level athletes, evenly distributed among 3 sports (basketball, soccer, and volleyball). TFA measurements were made on radiographs. The study lasted 2 years. A logistic regression was used to determine the importance of each factor on the probability in question. A significance level of P = .1 was used. The factors contributing more to an ankle sprain were a previous injury of the same type followed by body mass index (BMI) and age. On the contrary, TFA was proven to be statistically nonsignificant. When the BMI variable was substituted with body inertia propensity, a derived variable, the TFA remained statistically nonsignificant. TFA magnitude does not seem to be a determinant factor that could increase the probability of spraining an ankle.

The Impact of Knee Surface Alignment on Ankle Sprain Occurrence

Background. Knee position provides useful information for the anatomical alignment of the lower extremity. Analyzing the geometric components of this alignment should yield useful information about how these factors affect the occurrence of an ankle sprain. The aim of this study is to investigate the correlation among these anthropometric characteristics and the possible future occurrence of ankle sprain injuries. Material and methods. A total of 60 elite athletes (25.2 ± 3.2 years) participated in the current study. The data used for measuring knee surface alignment were the following: anatomical alignment angle (AA), condylar hip angle (CH), tibial plateau angle (PA), and joint surface (condylar plateau) angle (CP). Standardized radiography was used in all measurements. All knee alignment measurements were made on digital radiographs. The study lasted for 18 months. A logistic regression (probit) was used for the statistical analysis of the outcomes. A significance level of P = .05 was considered. Results. The knee angle factors (AA, CH, PA, and CP) proved to be statistically nonsignificant (P > .05). Conclusions. The geometric knee surface alignment factors do not seem to be a decisive factor that would increase the probability of spraining an ankle. Levels of Evidence: Prognostic Level IV: Case Series