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However, squatting with a resistance band is detrimental to knee kinematics as it leads to an increase in knee valgus angle and maximum tibial rotation angle. A direct correlation is recorded between an increase in resistance and an increase in these two angles. Conclusions Squatting with resistance bands is likely to increase the risk of knee injury. Coaches and clinicians who already implement this technique are advised to remove resistance band squats from training and rehabilitation programmes. Further research evaluating the long-term effects of using resistance bands during the barbell back squat should be considered. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Background Lateral ankle sprain is one of the most common musculoskeletal injuries, particularly among the sporting population. Due to such prevalence, many interventions have been tried to prevent initial, or further, ankle sprains. Current research shows that the use of traditional athletic tape can reduce the incidence of sprain recurrence, but this may be at a cost to athletic performance through restriction of motion. Kinesiology tape, which has become increasingly popular, is elastic in nature, and it is proposed by the manufacturers that it can correct ligament damage. Kinesiology tape, therefore, may be able to improve stability and reduce ankle sprain occurrence while overcoming the problems of traditional tape. Aim To assess the effect of kinesiology tape on ankle stability. Methods 27 healthy individuals were recruited, and electromyography (EMG) measurements were recorded from the peroneus longus and tibialis anterior muscles. Recordings were taken from the muscles of the dominant leg during induced sudden ankle inversion perturbations using a custom-made tilting platform system. This was performed with and without using kinesiology tape and shoes, creating four different test conditions barefoot(without tape), shoe(without tape), barefoot(with tape) and shoe(with tape). For each test condition, the peak muscle activity, average muscle activity and the muscle latency were calculated. Results No significant difference (p>0.05) was found by using the kinesiology tape on any of the measured variables while the wearing of shoes significantly increased all the variables. Conclusion Kinesiology tape has no effect on ankle stability and is unable to nullify the detrimental effects that shoes appear to have. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Objectives Limited data suggest that swimmers might be affected by poor quality of sleep significantly. The aim was to explore the prevalence of sleep disturbances in swimmers and possible link between rhinitis and sleep disturbance. Methods Study 1 was an observational case-control, questionnaire-based study involving 157 elite and non-elite swimmers, 36 non-swimming athletes and 50 controls. In study 2, we measured sleep quality and duration using actigraphy in 20 elite swimmers. We also looked for presence of sleep-disordered breathing using overnight pulse oximetry monitor. Results In study 1, we observed a significant difference in prevalence of excessive daytime sleepiness between groups of elite swimmers and controls. Pittsburgh Sleep Quality Index (PSQI) scores do not suggest that quality of sleep in group of swimmers is impaired. In study 2, we found that prevalence of obstructive sleep apnoea (OSA) in elite swimmers defined as oxygen desaturation index ≥5 was 30%. Analysis of actigraphy data revealed that on nights prior to training days, 'going to' bed time was significantly earlier and total sleep time was significantly reduced. Conclusion Swimmers and non-swimming athletes suffer significantly more with excessive daytime sleepiness than healthy controls. In elite swimmers, this is likely linked to high prevalence of OSA. PSQI scores do not suggest that quality of sleep in group of swimmers is impaired, but actigraphy shows great variations between sleep pattern preceding training and rest day. selleck chemical This seems to be associated with early-morning sessions which can be a disruptive element of weekly sleep patterns. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Objective With sensors, we are increasingly able to assess sitting behaviour during the day. However, there is no consensus among researchers on the best outcome measures for representing the accumulation of sedentary time during the day. Methods We analysed the pattern measures of sedentary behaviour. Articles reporting patterns measures in adults, in which behaviour data was collected with a sensor were included. link2 We discuss the strengths and weaknesses of the pattern measures of sedentary behaviour and provide recommendations for choosing objective measures of sedentary behaviour. Results Most studies report the number of sitting bouts during the day. Others focus on the number of breaks and/or periods of physical activity. Simple measures of sedentary behaviour were most popular. More complex pattern measures, such as the Gini index or the half-life bout duration, that capture the distribution of lengths of sitting periods in a single number, were reported sparsely. The sedentary patterns that were reporte and data processing steps. © The Author(s) 2020.Case summary A 5-year-old spayed female domestic shorthair cat was referred for severe anaemia. Findings on initial work-up were consistent with a diagnosis of idiopathic immune-mediated haemolytic anaemia. A combination of prednisolone and mycophenolate mofetil (MMF) was instituted. On revisit approximately 2 months later, red blood cell parameters were normal, but the plasma was described as icteric, prompting further investigation. Concurrent hepatopathy and pancreatitis were diagnosed, suspected as being adverse reactions to MMF, as has been reported with use of the drug in humans. Resolution of serum biochemistry abnormalities took approximately 2 months, following discontinuing MMF. At the time of writing, the cat remained clinically well 1 year after initial presentation. Relevance and novel information With increasing use of MMF as an immunosuppressive agent in cats, clinicians should be aware of both common and potentially rare adverse effects, such as those described herein. In addition, suitable monitoring tools need to be in place to facilitate early detection and appropriate management. © The Author(s) 2020.Case summary A 1-year-old spayed female domestic shorthair cat presented for evaluation of a non-weight bearing right pelvic limb lameness after falling from a 4 m height. On orthopedic examination there was substantial swelling and pain on manipulation of the right pes. Radiographs were obtained under sedation, and these revealed dorsoproximal luxations of the third, fourth and fifth metatarsophalangeal joints, and lateral rotation of the second digit. Closed manual reduction under sedation was unsuccessful and open reduction under general anesthesia was therefore performed. Combined transarticular pinning and external skeletal fixation were performed to maintain reduction of the third and fourth digits. Marked postoperative swelling of the distal pes and internal rotation of the third and fourth digits were noted within 24 h of surgery. Three weeks postoperatively, the cat had a persistent weight bearing right pelvic limb lameness and minor pin tract inflammation. All implants were removed and the limb was splinted for 1 week. Internal rotation and pin tract inflammation had resolved at the time of splint removal, and the lameness resolved within 6 weeks of surgery. The cat was not lame, but radiographs revealed mild-to-moderate degenerative osteoarthrosis when the cat was evaluated 6 months after surgery. Relevance and novel information There are limited reports describing metatarsophalangeal luxations in cats. Although several surgical techniques have been advocated, specific outcomes in clinical cases have not been reported. This report describes the clinical application and outcome of combined transarticular pinning and external skeletal fixation for the management of multiple metatarsophalangeal luxations in a cat. © The Author(s) 2020.Case summary A 6-year-old neutered female European Shorthair cat was referred for chronic, moderately pruritic, alopecic and exfoliative dermatosis that was unresponsive to antiparasitic, antibiotic or steroidal anti-inflammatory drugs. link3 The cat presented with truncular alopecia and numerous whitish adherent scales covering the whole body. Differential diagnoses included sebaceous adenitis, dermatophytosis, demodicosis, exfoliative dermatitis associated or not with thymoma, drug reaction, feline immunodeficiency virus- or feline leukaemia virus-associated dermatoses, epitheliotropic T-cell lymphoma, and Malassezia yeasts and/or bacterial overgrowth. Blood tests were within normal limits and the retrovirus tests were negative. Skin scrapings, fungal culture, coat brushing and skin cytology were negative for parasitic or microbial elements. Radiographs showed no signs of a thymic mass. Histological examination of skin biopsies revealed marked orthokeratotic hyperkeratosis, lymphocytic (CD3+) interface dermatitis and mural folliculitis with absence of sebaceous glands and occasional apoptotic cells in different epidermal layers. Clinical and histological findings were consistent with non-thymoma-associated exfoliative dermatitis syndrome. Ciclosporin A (7 mg/kg) was administered once daily. A dramatic improvement was observed after 3 weeks. Ciclosporin A intake was then progressively spaced out as the clinical signs diminished. Skin biopsies revealed resolution of hyperkeratosis, disappearance of the inflammatory infiltrate and recovery of the sebaceous glands. Relevance and novel information T-cell infiltration with signs of epidermal cytotoxicity, in the absence of infectious agents or neoplastic process, suggests an immune-mediated process, and ciclosporin A, a calcineurin inhibitor, would be the drug of choice. This is the first report showing resolution of both the clinical and histological signs of non-thymoma-associated exfoliative dermatitis. © The Author(s) 2020.Case summary A 3-year-old male neutered domestic shorthair cat was presented with a 1-week progressive and rapidly deteriorating history of lethargy and abnormal behaviour. Neurolocalisation indicated multifocal intracranial lesions (right oculomotor nerve, brainstem [obtundation, non-ambulatory tetraparesis, vestibular dysfunction and intermittent decerebrate rigidity] and possibly the thalamus [left-sided pleurothotonus]), or more likely a single brainstem lesion with mass effect. MRI of the brain demonstrated a brainstem abscess causing severe dorsal displacement particularly affecting the pons and the medulla oblongata causing cerebellar vermis herniation through the foramen magnum. CT-guided free-hand technique drainage of the brain abscess was performed and broad spectrum antibiotics were started based on sensitivity results. The cat recovered uneventfully from anaesthesia displaying marked improvement immediately after the procedure. Antibiotics were continued for 8 months; repeat imaging prior to withdrawal found complete resolution of the brainstem abscess.

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