Kobe Kaisei Hospital

To examine the association between knee valgus angles during single-leg squats (SLS) and single-leg hop landings (SLHL) in female athletes following anterior cruciate ligament reconstruction (ACLR), given the high risk of second ACL injuries related to dynamic knee valgus during landing. This cross-sectional study included 15 female athletes (mean age: 17.2 ± 1.0 years) after ACLR. Kinematic data during SLS and SLHL were collected using a three-dimensional motion analysis system composed of 10 infrared cameras and four force plates. Peak joint angles were analysed, and correlations between SLS and SLHL kinematics were evaluated. Significant positive correlations were found between SLS and SLHL for hip flexion (r = 0.68), hip adduction (r = 0.80), hip internal rotation (r = 0.90), knee valgus (r = 0.95), knee internal rotation (r = 0.99) and ankle eversion (r = 0.79). In both tasks, knee valgus was negatively correlated with hip flexion (SLS: r = -0.68; SLHL: r = -0.62) and hip internal rotation (SLS: r = -0.66; SLHL: r = -0.55) and positively correlated with hip adduction (SLS: r = 0.61; SLHL: r = 0.57). SLS and SLHL kinematics were evaluated approximately one year after ACLR and were significantly associated in female athletes. These findings suggest that the SLS may serve as a practical tool for identifying and addressing dynamic knee valgus during landing. Level III, cross-sectional observational study.

Abstract Streptococcus intermedius, a commensal bacterium in the human oral cavity, can occasionally cause severe infections in deep tissues. Here, we report the first known case of infectious blepharoconjunctivitis associated with S. intermedius sinusitis mimicking a conjunctival tumor. Smear microscopy of the eye and nasal discharge was useful for the differential diagnosis. Metagenomic analysis using MinION as adjunctive diagnostic tool has contributed to rigorous species identification of the pathogenic strain.

To identify differences in severe pain levels during prepregnancy to four months postpartum among groups along with risk factors for residual pain early in pregnancy. We examined 298 patients who participated in the questionnaire. Pain intensity was evaluated using a numerical rating scale (NRS) monthly postpartum. Four patterns emerged: recovery group (n = 200), with NRS 0-3 at 4 months postpartum; keep-high group (n = 20), with NRS ≥ 6 every month after delivery; worse group (n = 28), where NRS increased ≥ 3 during months 1-4; and mixed group (n = 50). Age, body mass index (BMI), history of back pain, breastfeeding, feeding posture, depression, and postpartum stress factors were compared. Overall, 15% patients had pain with NRS ≥ 4 before pregnancy and 33% at 4 months postpartum. NRS score of the keep-high group was the highest (4.18) before pregnancy, with a distinctive pain pattern. For participants with NRS ≥ 4 before pregnancy, the odds ratio of NRS ≥ 7 in the final month was 5.56 [95% confidence interval: 2.52-12.58, p < 0.001]. All three groups compared with the recovery group demonstrated significant differences in the questionnaires for depression (p < 0.01) and postpartum stress factors (p < 0.05). The combination of lower back and back pain was an early indicator of severe postpartum pain. Higher NRS scores before pregnancy and at multiple pain sites are early indicators of severe postpartum pain. All three groups, except the recovery group, showed a tendency for depression. However, the mixed group exhibited features similar to the recovery group.

BackgroundInflammatory cytokine levels exhibit a circadian rhythm in sera, peaking from late night to early morning in patients with rheumatoid arthritis (RA). This cytokine kinetics is a recognized therapeutic target. This clinical study aimed to evaluate the effectiveness of night-time baricitinib administration based on cytokine secretion.MethodsIn this 52-week multicenter non-randomized controlled study, 122 patients with RA were assigned to four groups: baricitinib 2 mg morning (BAR2MORN), 2 mg evening (BAR2EVE), 4 mg morning (BAR4MORN), or 4 mg evening (BAR4EVE). The primary endpoint was assessed using the 20% improvement in the American College of Rheumatology criteria (ACR20) at week 12. The secondary endpoints were ACR20/50/70 and changes in the clinical disease activity index (CDAI) through 52 weeks. The results were evaluated using the propensity score inverse probability of treatment weighted to reduce selection bias in patient background.ResultsBAR4EVE resulted in better primary endpoint improvement than BAR4MORN (78.2 vs. 43.3%; p < 0.001). No difference in improvement was observed in the primary endpoint between BAR2EVE and BAR2MORN (75.5 vs. 60.6%; p = 0.10). However, BAR2EVE demonstrated higher ACR20 at weeks 4, 24, and 52 and ACR50 at weeks 4 and 12 than BAR2MORN. BAR4EVE demonstrated higher ACR20/50 at weeks 4, 8, and 12 and ACR70 at weeks 8, 12, and 24 than BAR4MORN. CDAI changes were significantly reduced in BAR4EVE than in BAR4MORN at weeks 4 and 8.ConclusionChronotherapy targeting cytokine secretion resulted in rapid drug response, proposing a new potential application for JAK inhibitors.Trial registrationUMIN000040094, July 1, 2020.

Polypectomy-associated bleeding is the most frequentcomplication of colorectal polypectomy. An 82-year-old woman underwent polypectomy after an endoloop was placed in a pedunculated polyp in the sigmoid colon. However, the endoloop dislodged, causing massive bleeding from the stem surface. Furthermore, the bleeding vessel could not be identified because of the narrow resection surface and the presence of thrombus and hemorrhage. Therefore, several clips were removed, and polypectomy was performed again on the resection stem to open the resection surface wider and identify the bleeding vessels. Finally, the responsible arterial vessel appeared, leading to complete hemostasis. The additional stem resection may be a novel method for detecting uncontrolled bleeding after polypectomy for colorectal pedunculated polyps.

ABSTRACTObjectives:This study aimed to examine the physical characteristics of participants who can andcannot perform the short foot exercise (SFE).Methods:This prospective observational study was conducted in a university laboratory in Japan.University students (aged ≥18 years) enrolled between April and December 2024 wererecruited as participants. We measured height, weight, foot length, medial longitudinalarch height, and toe grip strength. Ultrasonography captured transverse images of theintrinsic foot muscles, including the abductor hallucis, flexor hallucis brevis, andflexor digitorum brevis. Participants received single-instruction SFE training in asitting position and were classified into two groups: SFE possible and SFE not possible.Those in the SFE not possible group received an additional 10 min of instruction beforereattempting SFE. Based on performance, participants were categorized into three groups:those who succeeded after initial instruction (SFE-A), after practice (SFE-PT), orremained incapable (SFE-NP). Statistical analysis was conducted using one-way analysisof variance (ANOVA) and multiple comparison tests for each measurement and analysisitem, with the significance level set at P < 0.05.Results:In female participants, toe grip strength was lower in the SFE-A group than in theSFE-PT and SFE-NP groups, whereas no significant differences were observed in maleparticipants or in muscle morphology and the navicular drop index in either sex.Conclusions:These findings suggest that immediate performance of the SFE may not necessarily beassociated with greater toe grip strength or larger intrinsic muscle size but may relateto coordination between intrinsic and extrinsic muscles.