Colorectal cancer detection in an asymptomatic population: fecal immunochemical test for hemoglobin vs. fecal M2-type pyruvate kinase

Introduction

Screening programs for colorectal cancer (CRC) are mainly based on a first-line fecal immunochemical test for hemoglobin (FIT). Fecal M2-type pyruvate kinase (M2-PK) has been evaluated in clinical settings showing promising results for early CRC detection. However, the impact of fecal M2-PK assessment on the performance of first-round CRC screening programs is not known. We investigated whether fecal M2-PK alone or in combination with FIT may improve CRC screening efficacy in the general population.

Materials and methods

A total of 1027 asymptomatic subjects (median age 66 [59-74] years; females 504 [49.1%]), identified through the general practitioners’ rosters, were invited for the collection of 2 fecal samples for FIT and M2-PK evaluation. Participants with at least positive one fecal test were referred for colonoscopy. Quality indicators for screening performance were calculated and analyzed using Fisher’s exact test.

Results

Overall, 572 subjects underwent both FIT and M2-PK assessment (participation rate 55.7%): 93 participants showed positive results for at least one test (positivity rate 16.3%). Only 10 patients were positive for both tests. Attendance rate to colonoscopy was 86.0% and a total of 65 adenomas and 7 cancers were detected. Combined use of FIT and fecal M2-PK permitted the identification of 18 more neoplasm (25%) without improving colonoscopy workload, as deduced by the comparable number needed to scope (P = 0.402).

Conclusion

The addition of M2-PK testing to FIT offers the potential to detect additional neoplasms that either do not bleed or only bleed intermittently without reducing participation rate and without increasing endoscopy workload.Key words: biomarker, colorectal cancer, occult blood, M2-type pyruvate kinase, screening     

Self-reported symptoms and risk factors for digital ischaemia among international world-class beach volleyball players

The prevalence of ischaemia-related symptoms is remarkably high among elite indoor volleyball players. Since the exposure to sport-specific demands may be higher in beach volleyball compared to indoor volleyball, the aim of this study was to assess the prevalence of ischaemia-related symptoms and associated risk factors among world-class beach volleyball players. Therefore, a questionnaire survey was performed among beach volleyball players active during the 2013 Grand Slam Beach Volleyball in the Netherlands. In total, 60 of the 128 beach volleyball players (47%) participated: 26 males and 34 females from 17 countries. The self-reported prevalence of cold or blue or pale digits in the dominant hand during or immediately after practice or competition was 38% (n = 23). Two risk factors were independently associated with symptoms of blue or pale digits: more than 14 years playing volleyball (odds ratio (OR) 4.42, 90% confidence interval (90% CI) 1.30–15.07) and sex (female) (OR 4.62, 90% CI 1.15–18.57). In conclusion, the prevalence of symptoms associated with digital ischaemia is high among international world-class beach volleyball players. Female sex and the length of the volleyball career were independently associated with an increased risk of ischaemia-related symptoms. The high prevalence of these seemingly innocuous symptoms and possible associated risk factors warrant regular monitoring since early detection can potentially prevent thromboembolic complications and irreversible tissue damage.     

How does visual manipulation affect obstacle avoidance strategies used by athletes?

Research examining our ability to avoid obstacles in our path has stressed the importance of visual input. The aim of this study was to determine if athletes playing varsity-level field sports, who rely on visual input to guide motor behaviour, are more able to guide their foot over obstacles compared to recreational individuals. While wearing kinematic markers, eight varsity athletes and eight age-matched controls (aged 18–25) walked along a walkway and stepped over stationary obstacles (180° motion arc). Visual input was manipulated using PLATO visual goggles three or two steps pre-obstacle crossing and compared to trials where vision was given throughout. A main effect between groups for peak trail toe elevation was shown with greater values generated by the controls for all crossing conditions during full vision trials only. This may be interpreted as athletes not perceiving this obstacle as an increased threat to their postural stability. Collectively, findings suggest the athletic group is able to transfer their abilities to non-specific conditions during full vision trials; however, varsity-level athletes were equally reliant on visual cues for these visually guided stepping tasks as their performance was similar to the controls when vision is removed.     

Efficacy of massage on muscle soreness,perceived recovery,physiological restoration and physical performance in male bodybuilders

It is believed that sport massage after intensive exercise might improve power and perceptual recovery in athletes. However, few studies have been done in this area. This study aimed to examine the effect of massage on the performance of bodybuilders. Thirty experienced male bodybuilders were randomly assigned to either a massage group (n = 15) or a control group (n = 15). Both groups performed five repetition sets at 75–77% of 1RM of knee extensor and flexor muscle groups. The massage group then received a 30-min massage after the exercise protocol while the control group maintained their normal passive recovery. Criteria under investigation included: plasma creatine kinase (CK) level, agility test, vertical jump test, isometric torque test, and perception of soreness. All variables were measured over 6 time periods: baseline, immediately after the DOMS inducing protocol, right after the massage, and 24, 48, and 72 h after the massage. Both groups showed significant (P < .001) decreases in jumping, agility performance, and isometric torque, but significant (P < .001) increases in CK and muscle soreness levels. The massage group in general demonstrated a better recovery rate. As such, a post-exercise massage session can improve the exercise performance and recovery rate in male bodybuilders after intensive exercise.     

A kinematic analysis of the spine during rugby scrummaging on natural and synthetic turfs

Artificial surfaces are now an established alternative to grass (natural) surfaces in rugby union. Little is known, however, about their potential to reduce injury. This study characterises the spinal kinematics of rugby union hookers during scrummaging on third-generation synthetic (3G) and natural pitches. The spine was sectioned into five segments, with inertial sensors providing three-dimensional kinematic data sampled at 40 Hz/sensor. Twenty-two adult, male community club and university-level hookers were recruited. An equal number were analysed whilst scrummaging on natural or synthetic turf. Players scrummaging on synthetic turf demonstrated less angular velocity in the lower thoracic spine for right and left lateral bending and right rotation. The general reduction in the range of motion and velocities, extrapolated over a prolonged playing career, may mean that the synthetic turf could result in fewer degenerative injuries. It should be noted, however, that this conclusion considers only the scrummaging scenario.     

Inter-participant variability in daily physical activity and sedentary time among male youth sport footballers: independent associations with indicators of adiposity and cardiorespiratory fitness

Participation in youth sport is assumed to promote and contribute towards more physically active lifestyles among children and adolescents. The aim of this study was to examine inter-participant variability in objectively measured habitual physical activity (PA) behaviours and sedentary time among youth sport participants and their implications for health. One-hundred-and-eighteen male youth sport footballers (Mean ± s = 11.72 ± 1.60) wore a GT3X accelerometer for 7 days. Average daily PA [min · day^?1, in light (LPA), moderate (MPA), vigorous (VPA) and combined moderate-to-vigorous (MVPA)] and sedentary time were calculated. Participants’ body mass index adjusted for age and sex (BMI–standard deviation score), per cent body fat (BF%), waist circumference and cardiorespiratory fitness were assessed. Results revealed that variability in daily PA behaviours and sedentary time (min · day^?1) was associated with BMI–standard deviation score [VPA (?), MVPA (?)], BF% [sedentary time (+), VPA (?), MVPA (?)], waist circumference [sedentary time (+), LPA (?)] and cardiorespiratory fitness [sedentary time (?), MPA (+), VPA (+), MVPA (+)]. Whilst sedentary time and MVPA were not related to health outcomes independent of one another, associations with markers of adiposity and cardiorespiratory fitness were stronger for sedentary time. Sedentary time was also significantly positively related to waist circumference independent of VPA. Results demonstrate inter-participant variability in habitual PA and sedentary time among youth sport participants which holds implications for their health. Thus, promoting PA and, in particular, reducing sedentary time may contribute towards the prevention of adverse health consequences associated with a physically inactive lifestyle for children and adolescents active in the youth sport context.     

The effect of limb dominance on lower limb functional performance – a systematic review

Lower limb dominance (or lateral preference) could potentially effect functional performance. Clinicians are often asked to make judgements as to when a patient has sufficiently “recovered” from an injury, typically using strength and dynamic performance outcome measures. The primary purpose of this study was to systematically review the literature in relation to limb dominance within active adult populations and discuss some limitations to current methods and relate this to current clinical practice. A search of MEDLINE and CINAHL and EMBASE databases and reference lists of those articles identified was performed. Eleven articles were selected for meta-analysis. There was no statistical effect of limb dominance for any of the functional tests: isokinetic quadriceps and hamstring tests, hamstring:quadriceps ratios, single-leg hop for distance, single-leg vertical jump and vertical ground reaction force following a single-leg vertical jump. Pooled symmetry values varied from 94.6% to 99.6% across the tests, above the clinically accepted benchmark of 90% used in clinical practice. Although the results of this study must be used with discretion, asymmetries in the tasks described in this analysis should be viewed as undesirable and remedied accordingly. Further research is needed to quantify asymmetries, particularly in relation to sport-specific contexts.     

Quantifying the offensive sequences that result in goals in elite futsal matches

The aim of this study was to quantify the type of offensive sequences that result in goals in elite futsal. Thirty competitive games in the Spanish Primera Division de Sala were analysed using computerised notation analysis for patterns of play that resulted in goals. More goals were scored in positional attack (42%) and from set pieces (27%) compared to other activities. The number of defence to offense “transitions” (n = 45) and the start of offensive plays due to the rules of the game (n = 45) were the most common type of sequences that resulted in goals compared to other patterns of play. The central offensive zonal areas were the most common for shots on goal, with 73% of all goals scored from these areas of the pitch compared to defensive and wide zones. The foot was the main part of the body involved in scoring (n = 114). T-pattern analysis of offensive sequences revealed regular patterns of play, which are common in goal scoring opportunities in futsal and are typical movement patterns in this sport. The data demonstrate common offensive sequences and movement patterns related to goals in elite futsal and this could provide important information for the development of physical and technical training drills that replicate important game situations.     

Multiple components of fitness improved among overweight and obese adolescents following a community-based lifestyle intervention

Fitness is an important component of health, and obese adolescents regularly have poor fitness. Unfortunately, few have assessed the impact of community-based lifestyle interventions on multiple components of fitness. The purpose of this study was to assess the impact of participation in a community-based intervention involving adolescents and parents on multiple components of fitness of obese adolescents. In a within-subject, waitlist controlled clinical trial with 12 months follow-up in Western Australia, participants (n = 56) completed multiple fitness measures at baseline, immediately prior to beginning an 8-week intervention and at 3, 6 and 12 months during a maintenance period. Performance on the shuttle walk was improved immediately post-intervention (increase of 42.8 m, 95% CI: 7.5, 78.2) and at 12 months post-intervention (increase of 44.6 m, 95% CI: 1.3, 87.8) compared with pre-intervention. Muscle performance of quadriceps and deltoids were improved post-intervention (increase of 1.1 (95% CI: 0.1, 2.1) kg · F and 1.0 (0.02, 2.1) kg · F, respectively) and all muscle performance measures were improved at 12 months following the intervention. There were no changes in waist circumference. A community-based lifestyle programme such as Curtin University’s Activity, Food and Attitudes Program (CAFAP) may be a viable strategy for improving fitness in overweight adolescents.