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Ilkka Helenius

Publications and source records attributed to Ilkka Helenius.

33 records · Page 2Linked to original sources
PubMed2005

Allergic rhinitis and pharmacological management in elite athletes.

INTRODUCTION: Only a few studies have examined the occurrence of atopy and clinically apparent allergic disease and their pharmacological management in elite athletes. The aim of the study was to assess the frequency of allergic rhinitis and the use of antiallergic medication within the subgroups of elite athletes as compared with a representative sample of young adults of the same age. METHODS: A cross-sectional survey was carried out in 2002. All the athletes (N = 494) financially supported by the National Olympic Committee comprised the study group. Of them, 446 (90.3%) filled in a structured questionnaire concerning asthma and allergies, the use of medication, characteristics of sport activities, and smoking habits. A representative sample of Finnish young adults (N = 1504) served as controls. RESULTS: The endurance athletes reported physician-diagnosed allergic rhinitis more often (36.1%) than other athletes (23.4%) or control subjects (20.2%). The use of antiallergic medication was reported by 33.3, 15.7, and 15.6% of those, respectively. Among both athletes and controls, females reported the use of antiallergic medication more often than males. Only half of those athletes reporting allergic rhinitis had used antiallergic medication during the past year. After adjusting for age and sex, OR (95% CI) for allergic rhinitis and the use of antiallergic medication were 2.24 (1.48-3.39) and 2.79 (1.82-4.28), respectively, in endurance athletes as compared with the controls. CONCLUSIONS: Endurance athletes have physician-diagnosed allergic rhinitis, and they use antiallergic medication more often than athletes in other events or control subjects. Only half of those athletes reporting allergic rhinitis take antiallergic medication. More attention needs to be paid to the optimal management of allergic rhinitis, especially in highly trained endurance athletes.

Adolescent↗
PubMed2005

Asthma, airway inflammation and treatment in elite athletes.

Highly trained athletes are repeatedly and strongly exposed to cold air during winter training and to many inhalant irritants and allergens all year round. Asthma occurs most commonly in athletes engaging in endurance events such as cross-country skiing, swimming, or long-distance running. As well as the type of training, a major risk factor is atopic disposition. A mixed type of eosinophilic and neutrophilic airway inflammation has been shown to affect elite swimmers, ice-hockey players, and cross-country skiers. The inflammation may represent a form of repeated thermal, mechanical, or osmotic airway trauma resulting in a healing or remodelling process. Elite athletes commonly use antiasthma drugs to treat exercise-induced bronchial symptoms. Only a few controlled studies have been conducted on the effects of antiasthma drugs on asthma symptoms, bronchial hyperresponsiveness and airway inflammation in elite athletes. Inhaled beta(2)-adrenoceptor agonists are effective against exercise-induced bronchospasm. In contrast, airway inflammation, bronchial hyperresponsiveness and symptoms have responded poorly to inhaled corticosteroids and leukotriene antagonists. As discontinuing high-level exercise has proved effective in reducing eosinophilic airway inflammation, exercise or training should be restricted in athletes having troublesome symptoms and sputum eosinophilia. Switching training to less irritating environments should be considered whenever possible. It appears to be difficult to change the 'natural course' of asthma in athletes by anti-inflammatory treatment.

Adrenal Cortex Hormones↗
PubMed2004

Cotrel-Dubousset (CD) or Universal Spine System (USS) instrumentation in adolescent idiopathic scoliosis (AIS): comparison of midterm clinical, functional, and radiologic outcomes.

STUDY DESIGN: A retrospective comparison of the clinical, radiologic, and functional results of Cotrell-Dubousset (CD) and Universal Spine System (USS) instrumentation for adolescent idiopathic scoliosis (AIS). OBJECTIVES: To establish whether there are any differences in outcome between the 2 instrumentation systems. SUMMARY OF BACKGROUND DATA: CD is the first complex posterior double rod instrumentation system to provide multiple hook fixation. USS instrumentation permits the use of rod translation instead of rod rotation, the option to secure pedicle hooks with fixation screws, and the option to use transpedicular screws in the lower thoracic and lumbar spine. Midterm and long-term results of USS instrumentation are lacking. METHODS: Fifty-seven (mean age, 28 years at follow up) patients treated with CD instrumentation and 55 (mean age, 23 years at follow up) patients treated with USS instrumentation for AIS participated in the study. The average follow-up rate was 80% and time 13.0 years for the CD group, and 95% and 7.8 years for the USS group. Radiographs were obtained before surgery, at 2-year follow up, and at final follow up. Additionally, a physical examination was performed by 2 independent observers, and the Scoliosis Research Society (SRS) questionnaire was completed; spinal mobility and nondynamometric trunk strength were measured at the final follow-up visit. RESULTS.: The mean Cobb angle of the instrumented thoracic curve was before surgery 55 degrees (range, 36-83 degrees for the CD and 52 degrees (range, 35-85 degrees) for the USS group. The mean number of instrumented vertebrae was 9.9 (range, 7-12) in the CD and 9.8 (range, 6-12) in the USS group. At final follow up, the mean angles were 32 degrees (range, 13-63 degrees) for the CD group and 29 degrees (range, 9-63 degrees) for the USS group (not significant). No significant difference was observed in thoracic kyphosis or lumbar lordosis between the study groups at final follow up. In the SRS questionnaire, the total score averaged 97 for the CD and 101 for the USS groups, respectively. In the questionnaire, 6 (11%) patients in the CD group, but none in the USS group, reported having low back pain often or very often at rest. No correlation was found between the Cobb angle of the thoracic or lumbar curves at follow up and the total score or back pain indexes of this questionnaire. Nondynamometric trunk strength measurements corresponded with age- and sex-adjusted reference values, on average, but patients in the CD group performed significantly better in the squatting test (P = 0.021) and patients in the USS group performed better in trunk side bending (P = 0.004). Complications were recorded in 15 (26%) patients in the CD and in 13 (24%) patients in the USS group (not significant). CONCLUSIONS: The midterm radiologic and functional outcomes were quite similar in both groups as were the SRS scores. The patients performed, on average, as well as did the reference population in nondynamometric trunk strength measurements. Intraoperative and late complications were similar in both groups.

Adult↗
PubMed2004

Asthma medication in Finnish olympic athletes: no signs of inhaled beta2-agonist overuse.

INTRODUCTION: Occurrence of asthma has been reported to be frequent in endurance athletes and especially high in winter sport athletes. Recently, the International Olympic Committee has restricted the use of inhaled beta2-agonists and requires documentation for their use. However, epidemiologic data comparing the use of antiasthmatic medication in different sport events are mostly missing. METHODS: A cross-sectional questionnaire survey was carried out in 2002. All the athletes (N = 494) financially supported by National Olympic Committee comprised the study group. Of them, 446 (90.3%) filled in a structured questionnaire concerning asthma and allergies, use of medication, characteristics of sport activities, and smoking habits. A representative sample of Finnish young adults (N = 1 504) served as controls. RESULTS: Physician-diagnosed asthma was more common in athletes as compared with controls (13.9% vs 8.4%). Use of any asthma medication was reported by 9.6% of the athletes and by 4.2% of the controls. No difference was observed in the frequency of asthma medication used by winter or summer sport athletes (10.0% vs 9.4%). Inhaled beta2-agonists were used by 7.4% and 3.0% of the athletes and controls, respectively. After adjusting for age, sex, and smoking, odds ratio with 95% confidence interval for use of any asthma medication was 0.69 (0.17-2.92) for motor skills demanding events, 1.87 (0.85-4.11) for speed and power sports, 3.00 (1.68-5.37) for team sports, and 4.16 (2.22-7.78) for endurance events as compared with controls. None of the athletes used antiasthmatic medication without physician diagnosis. CONCLUSIONS: The frequency of antiasthmatic medication is clearly lower than the occurrence of physician-diagnosed asthma in Finnish Olympic athletes. No evidence of overuse of inhaled beta2-agonists is found.

Administration, Inhalation↗
PubMed2003

Emergency procedure skills of graduating medical doctors.

In the present study final-year medical students' degree of theoretical knowledge and rate of successful performance of emergency procedures was assessed. A questionnaire was sent to all final-year medical students in Finland in 1997 (n=504) in all five medical faculties. The response rate was 80.2% (n=404). The questionnaire included questions on theoretical knowledge and successful performance of 10 emergency procedures. Over 90% of the final-year medical students knew the theory of emergency procedures, with the exceptions of chest tube insertion (84%), pericardiocentesis (47%), and planning and starting fluid infusion for an infant (83%), and over 90% had successfully performed insertion of an intravenous line (100%) and intubation of an adult (90%). However, fewer than 7% of the students had successfully performed chest tube insertion, planned fluid infusion for an infant, or pericardiocentesis. Males had significantly higher odds ratio than females for performing insertion of the intravenous line and intubation of an infant. Students with working experience had higher odds ratios for performing cardiopulmonary resuscitation. The highest overall frequency of the procedure performance was at the university in which a student logbook was systematically used. Conclusions are that final-year medical students have good theoretical knowledge of emergency procedures, but practical teaching should be encouraged, since even in emergency procedures students' experience of practical measures was low.

Adult↗
PubMed2003

Total hip arthroplasty in diastrophic dysplasia.

BACKGROUND: Diastrophic dysplasia results in severe disproportionate growth failure, multiple joint deformities, and early osteoarthritis of the hips. Mortality is increased in early childhood, but thereafter life expectancy is normal. Because of severe flexion deformities, resting pain, and diminished movements of the hip joints, total hip arthroplasty is indicated at an early age. The purpose of our study was to evaluate prospectively the midterm results of total hip arthroplasty in a consecutive series of patients with diastrophic dysplasia. METHODS: Between 1982 and 1996, forty-one total hip replacements were performed in twenty-four consecutive patients with diastrophic dysplasia (mean age, forty-one years) at our hospital. The patients were followed prospectively for a minimum of five years with clinical examination, determination of Harris hip scores, and radiographs. Twenty-two patients (thirty-eight hips) were examined clinically and radiographically at the time of follow-up, and the remaining two patients (three hips) were contacted only by telephone. The mean duration of follow-up was 7.8 years. RESULTS: The mean Harris hip score increased from 44 points (range, 25 to 66 points) before the operation to 70 points (range, 37 to 89 points) at the final follow-up examination (p < 0.001). Ten complications (24%) were recorded. Five (12%) of the forty-one hips required revision because of aseptic loosening of the acetabular component at a mean of 9.4 years after the primary operation. No revisions were due to aseptic failure of the femoral component. CONCLUSIONS: Implant survival was good and the Harris hip scores increased significantly after total hip arthroplasty in patients with diastrophic dysplasia. However, shortening femoral osteotomy and transposition of the greater trochanter, adductor and flexor tenotomies, and modification of the femoral stem were frequently needed. Total hip arthroplasty is recommended for patients with diastrophic dysplasia and severe degeneration of the hip joints, even for those who are relatively young. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.

Adult↗
PubMed2003

Total knee arthroplasty in patients with diastrophic dysplasia.

BACKGROUND: Diastrophic dysplasia results in severe disproportionate short stature, generalized joint deformities, and early osteoarthritis. The knee joint often has an abnormal valgus position and is unstable, and degeneration of all joint compartments occurs, even during growth. The purpose of our study was to evaluate the clinical and radiographic results of total knee arthroplasty in a series of patients with diastrophic dysplasia. METHODS: Between February 1992 and March 2000, twenty-one primary total knee arthroplasties were performed on fourteen consecutive patients with severe osteoarthritis due to diastrophic dysplasia. The patients were followed prospectively with clinical examinations, determination of the Hungerford knee scores, and radiographs. Preoperatively, ten knees had chronic dislocation of the patella. The mean duration of follow-up was 3.4 years. RESULTS: The mean Hungerford knee pain and total scores improved from 5.8 points and 46 points preoperatively to 50 points and 83 points, respectively, at the final follow-up examination (p < 0.001 for both comparisons). Two knees required a distal femoral corrective osteotomy because of metaphyseal angulation. None of the total knee arthroplasties had to be revised during the follow-up period. Six complications were recorded. CONCLUSIONS: Total knee arthroplasty substantially improved the function of patients with diastrophic dysplasia. Additional peripatellar procedures were commonly needed, and complications were frequent.

Arthroplasty, Replacement, Knee↗
PubMed2003

Harrington and Cotrel-Dubousset instrumentation in adolescent idiopathic scoliosis. Long-term functional and radiographic outcomes.

BACKGROUND: Previous studies have shown that the long-term clinical outcome does not correlate with the radiographic outcome in patients treated with Harrington instrumentation for adolescent idiopathic scoliosis. Cotrel-Dubousset instrumentation has been reported to provide better correction radiographically, but it is unclear whether it provides better long-term clinical or functional outcomes. We are not aware of any long-term studies comparing Harrington and Cotrel-Dubousset instrumentation. METHODS: Seventy-eight patients in whom adolescent idiopathic scoliosis was treated with Harrington instrumentation and fifty-seven in whom it was treated with Cotrel-Dubousset instrumentation participated in this study. The mean duration of follow-up was 20.8 years for the Harrington instrumentation group and 13.0 years for the Cotrel-Dubousset instrumentation group. The mean age at the time of follow-up was thirty-six years and twenty-eight years, respectively. Radiographs were made preoperatively and at the two-year and final follow-up examinations. The Scoliosis Research Society questionnaire was completed, a physical examination was performed, and spinal mobility and non-dynamometric trunk strength were measured at the final follow-up visit. RESULTS: The mean preoperative Cobb angle of the thoracic curves was 53 degrees in the Harrington instrumentation group and 55 degrees in the Cotrel-Dubousset instrumentation group. The mean numbers of vertebrae included in the instrumentation were 10.7 and 9.9, respectively. At the two-year follow-up evaluation, the mean postoperative Cobb angles were 38 degrees and 25 degrees, respectively (p < 0.0001). At the final follow-up evaluation, the mean angles were 45 degrees and 32 degrees (p < 0.0001). No significant difference in thoracic kyphosis or lumbar lordosis was observed between the study groups at the final follow-up evaluation. The average score on the Scoliosis Research Society questionnaire was 97 points in both groups. Measurements of non-dynamometric trunk strength corresponded with age and sex-adjusted reference values, on the average, but patients with Cotrel-Dubousset instrumentation performed significantly better in the squatting test (p = 0.010). Abnormal lumbar extension and trunk side-bending were significantly more common in the Harrington instrumentation group (p = 0.050 and p = 0.0061, respectively). Complications were recorded for nine (12%) of the patients treated with Harrington instrumentation and fifteen (26%) of those treated with Cotrel-Dubousset instrumentation (p = 0.027). CONCLUSIONS: Cotrel-Dubousset instrumentation yielded better long-term functional and radiographic outcomes in patients with adolescent idiopathic scoliosis than did Harrington instrumentation. However, complications were more common in the Cotrel-Dubousset instrumentation group.

Adolescent↗
PubMed2002

Comparison of long-term functional and radiologic outcomes after Harrington instrumentation and spondylodesis in adolescent idiopathic scoliosis: a review of 78 patients.

STUDY DESIGN: A retrospective follow-up study of adolescent idiopathic scoliosis after Harrington instrumentation and spondylodesis was conducted. OBJECTIVE: To correlate radiographic parameters with the Scoliosis Research Society questionnaire in terms of patient outcome, clinical findings, spine mobility, and trunk strength measurements. SUMMARY OF BACKGROUND DATA: Previous studies have shown that long-term radiologic correction can be achieved with Harrington instrumentation. It seems, however, that radiologic correction does not correlate with patient outcome. There are no previous studies on long-term results of functional outcome, including spine mobility and trunk strength measurements, after operative treatment of adolescent idiopathic scoliosis, as compared with findings in the normal population. METHODS: Of 98 consecutive patients who underwent surgery with Harrington distraction rod and posterior spondylodesis in 1979, 78 (80%) (11 males; mean age, 36 years) participated in the study. The average follow-up period was 20.8 years (range, 19.1-22.4 years). Radiographs were obtained before surgery, at the 2-year follow-up assessment, and at the 20-year follow-up assessment. Additionally, physical examination was performed, and the Scoliosis Research Society questionnaire was completed. Spine mobility and nondynamometric trunk strength measurements were obtained at the 20-year follow-up assessment. RESULTS: The mean Cobb angle of the instrumented thoracic curve was 53 degrees +/- 10 degrees before surgery, and 38 degrees +/- 11 degrees at the 2-year follow-up assessment. At the 20-year follow-up assessment, the mean angle was 45 degrees +/- 12 degrees. Degenerative changes in the noninstrumented lumbar spine (sclerosis of facets, endplate sclerosis, osteophyte formation) were noted in 17 patients (22%). Ten patients (13%) reported having low back pain often or very often at rest according to the Scoliosis Research Society questionnaire. No correlation was found between the Cobb angle of the thoracic or lumbar curves at follow-up assessment and the Scoliosis Research Society total score or back pain indexes. Neither was any association found between the Scoliosis Research Society total score and the spondylodesis fusion level. However, the magnitude of the thoracic curve at follow-up assessment showed a significant inverse correlation with the scores for Scoliosis Research Society questions about cosmetic aspects. The nondynamometric trunk strength measurements corresponded with the reference values, on the average, but did not show any correlation with the magnitude of the thoracic or lumbar curves or with the Scoliosis Research Society total score or back pain indexes. Spine mobility, especially trunk side bending, was diminished in 59% of the patients, and did not correlate with the Scoliosis Research Society total score or individual indexes. CONCLUSIONS: In patients with adolescent idiopathic scoliosis who undergo surgery with Harrington instrumentation, the overall long-term clinical outcome does not correlate with the radiologic outcome. However, a significant inverse correlation was found between the magnitude of the primary thoracic curve at follow-up assessment and the scores for questions on cosmetic matters in the Scoliosis Research Society questionnaire. Spine mobility is diminished as a result of spondylodesis, but the patients perform, on the average, as well as the normal population in nondynamometric trunk strength measurements.

Adolescent↗
PubMed2002

Lung function in diastrophic dysplasia.

Diastrophic dysplasia (DD) is a rare skeletal dysplasia characterized by short-limbed short stature, contractures and early degeneration of joints, and spinal deformities such as scoliosis. Mortality is increased in the neonatal period, in part due to tracheo- and bronchomalacia. Additionally, spinal deformities are very rigid, decreasing mobility of the chest cage. The aim of our study was to evaluate lung volumes and airway flow dynamics in patients with DD. A total of 31 patients (12 males, 19 females) underwent a detailed clinical examination measurements of standing height PA-radiography of the spine, flow-volume spirometry, and body plethysmography. The patients were assigned to two groups: children and adolescents (0-18 years, n = 18) and adults (over 18 years, n = 13). The mean spirometric parameters were mostly within the predicted value range, although the variation was wide. At least one abnormally low spirometry parameter was found in 6 (33%) of the children and adolescents and in 7 (54%) of the adults. Mean forced vital capacity (FVC) was 104% (range 48-163%) of predicted values in the children and adolescents and 95% (58-140%) of the adults. Peak expiratory flow (PEF) values were abnormal in 4 (22%) of the children and adolescents and in 5 (39%) adults. The mean plethysmographic parameters were all within the predicted value range. At least one abnormal plethysmographic value was found in 6 (33%) of the children and adolescents and in 4 (31%) of the adults. Airway resistance (Raw) was significantly higher in the adults than in the children and adolescents (P = 0.016), and was abnormally high in 3 (23%) of the adults. The angle of thoracic or thoracolumbar scoliosis correlated with the percentages of the predicted values of FVC (r(s) = - 0.66), forced expired volume in 1 sec (FEV(1)) (r(s) = - 0.56), and total lung capacity (TLC) (r(s) = - 0.67). Age correlated with the FEV(1)/FVC ratio (r(s) = - 0.41), with the maximal expired flow at 50% FEV (MEF(50)) values (r(s) = - 0.55), with the residual volume (RV) values (r(s) = - 0.47), and with the RV/TLC ratio (r(s) = - 0.43). Variable bronchial obstruction was found in 1 (6%) child and in 2 (17%) adults. Although the patients with DD had, on average, normal lung volumes, large individual variation occurred. Airway resistance was increased in adults. The angle of scoliosis correlated inversely with lung volume parameters.

Adolescent↗
PubMed2002

Surgical procedure skills of graduating medical students: effects of sex, working, and research experience.

BACKGROUND: Surgical procedures constitute an important part of every physician's daily practice. However, few studies have investigated the surgical skills of graduating medical students and, especially, factors that might be related to their degree of surgical competence. The present study sought to gather information on the basic surgical skills of graduating medical students and to establish whether factors influencing the students' competence could be identified and used to improve the teaching of basic surgical skills at medical schools. METHODS: A questionnaire was sent to all final-year medical students in Finland in 1997. It was returned by 404 (participation rate 80.2%) students. The questionnaire included questions on the theoretical knowledge and successful performance of 10 basic surgical procedures: abdominal paracentesis, application of Sengstake-Blakemoore tube, rubber-band ligation of hemorrhoids, reposition and casting of Colles' fracture, knee arthrocentesis, application of tibial traction, evacuation of subcutaneous abscess, male bladder catheterization, suprapubic catheterization, and nevus excision. RESULTS: Over 90% of the final-year medical students knew the theory of performing reposition and casting of Colles' fracture, knee arthrocentesis, urinary tract catheterization, and nevus excision, but only 32% (124/393) knew the theory of applying the Sengstake-Blakemoore tube. Nevus excision had been successfully performed by over 90% of the students. Of the emergency or duty procedures, application of the Sengstake-Blakemoore tube and abdominal paracentesis had been successfully performed by 1% (4/393) and 8% (32/393) of the students, respectively, whereas Colles' fracture reposition and suprapubic catheterization had been successfully performed by 46% of the students (182/393 and 179/393, respectively). The age-adjusted odds ratios for performing Colles' fracture reposition (OR 1.59; 95% CI 1.01 to 2.50), application of tibial traction (2.00; 1.03 to 3.89), evacuation of subcutaneous abscess (2.13; 1.25 to 3.62), and suprapubic catheterization (2.23; 1.21 to 4.09) were significantly higher among males than females. Students with working experience had higher odds ratios for performing suprapubic catheterization (OR 6.75; 95% CI 1.99 to 22.84), nevus excision (5.69; 2.49 to 13.0), reposition and casting of Colles' fracture (1.72; 1.01 to 2.94), knee arthrocentesis (4.78; 2.67 to 8.53), and evacuation of subcutaneous abscess (12.9; 6.12 to 27.1) than students without such experience. Students who had done extracurricular research had significantly lower odds ratios for performing evacuation of subcutaneous abscess (0.58; 0.34 to 0.99) than students without such experience. When the five medical faculties in Finland were compared, the highest odds ratios for performing procedures were at the university in which a student logbook was systematically used. CONCLUSIONS: Final-year medical students have fairly good theoretical knowledge of basic surgical procedures, but the successful performance rates of these procedures range from 1 to 90%. Males have performed surgical procedures significantly more often than females. Working experience clearly enhanced the surgical skills of medical students. However, research experience may impair the learning of these procedures. The systematic use of logbooks seems to be useful.

Adult↗
PubMed2002

Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: a 5-year prospective follow-up study of 42 highly trained swimmers.

BACKGROUND: Mild eosinophilic airway inflammation and bronchial hyperresponsiveness-ie, mild asthma-have been shown to affect a high proportion of endurance athletes. The persistence of airway inflammation, bronchial hyperresponsiveness, and asthma in this population is not known, however, inasmuch as follow-up studies of athletes' asthma have not been performed. OBJECTIVE: The purpose of this study was to investigate effect of finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma. METHODS: Forty-two elite competitive swimmers, most of them from the Finnish national team (37/42; 88%), were followed for 5 years in a prospective manner. All of the swimmers completed questionnaires and underwent resting spirometry, histamine challenge testing, and skin prick tests at baseline and at follow-up. Twenty-nine swimmers (69%) also gave induced sputum samples on both occasions. Sixteen (38%) of the swimmers had continued their competitive careers during follow-up (active swimmers), but 26 (62%) had stopped competing more than 3 months before the follow-up examination (past swimmers). RESULTS: Bronchial responsiveness was increased in 7 (44%) of the 16 active swimmers at baseline and in 8 (50%) of the 16 active swimmers at follow-up; it was increased in 8 (31%) of the 26 past swimmers at baseline and in 3 (12%) of the 26 past swimmers at follow-up (McNemar test, P =.025). The difference in the change in bronchial hyperresponsiveness between the study groups was significant (likelihood ratio test, P =.023). Current asthma (defined as bronchial hyperresponsiveness and exercise-induced bronchial symptoms monthly) was observed in 5 (31%) of the active swimmers at baseline and in 7 (44%) of the active swimmers at follow-up; of the past swimmers, it occurred in 6 (23%) at baseline and in 1 (4%) at follow-up (McNemar test, P =.025). The difference in the change in current asthma between the study groups was significant (likelihood ratio test, P =.0040). The sputum differential cell counts of eosinophils and lymphocytes increased significantly during the follow-up period in the active swimmers (Wilcoxon signed rank sum test; P =.033 and P =.0029, respectively); in the past swimmers, the sputum differential cell counts of eosinophils tended to decrease during the follow-up period (P =.17), whereas the differential cell counts of lymphocytes did not change significantly. The changes in the sputum differential cell counts of eosinophils between the study groups differed significantly (Mann-Whitney U test, P =.019). CONCLUSION: In swimmers who had stopped high-level training, bronchial hyperresponsiveness and asthma attenuated or even disappeared. Mild eosinophilic airway inflammation was aggravated among highly trained swimmers who remained active during the 5-year follow-up. Our results suggest that athletes' asthma is partly reversible and that it may develop during and subside after an active sports career.

Adult↗
PubMedDate not supplied

Walking ability in patients with diastrophic dysplasia: a clinical, electroneurophysiological, treadmill, and MRI analysis.

Patients with diastrophic dysplasia have walking difficulties of obscure etiology; some are even wheelchair-bound. To explore the problem, physical examination, treadmill, magnetic resonance imaging (MRI), and electroneurophysiologic studies were performed on 87 patients (56 females, 31 males) with an average age of 31 (range 3-56) years. Mobility of the spine, hips, knees, and feet was diminished. Some of the patients were obese (mean body mass index 27.0 kg/m). In the treadmill study, patients were able to walk an average of 638 m (range 0-1,618 m). On MRI, five patients showed compression of neural structures; one of them also had clinical symptoms. Somatosensory evoked potentials and electroneuromyography revealed evidence of compression of neural structure in three (3%) and two (3%) patients, respectively. The walking difficulties seem to have a multifactorial etiology: flexion contractures of the knees, early and rapid osteoarthrosis, equinus or equinovarus foot deformities, and obesity, but only rarely spinal stenosis.

Adolescent↗
PubMedDate not supplied

Magnetic resonance imaging analysis of hip joint development in patients with diastrophic dysplasia.

The authors used magnetic resonance imaging to evaluate the hip joint in patients with diastrophic dysplasia. T1- and T2-weighted images were obtained from 35 patients (25 female patients, 10 male patients) of different ages (1-39 years). The status of the joint and paraarticular soft tissues was evaluated. Hip joint congruity was good, although the joint was usually deformed. The thickness of the joint cartilage was diminished and signs of early osteoarthritis, including bone cysts and local edema, were common. The ligamentum teres was visible in only 24% of patients, suggesting abnormality of the ligamentous structures. Epiphyses were flattened or absent in all young patients. Of the 17 visible epiphyses, 7 showed avascular necrosis, indicated as a decrease in signal intensity in both T1- and T2-weighted images. It seems that proximal femoral epiphysis fails to bear normal weight pressure.

Adolescent↗