Scientific Rationale for a Bottom-Up Approach to Target the Host Response in Order to Try and Reduce the Numbers Presenting With Adult Respiratory Distress Syndrome Associated With COVID-19. Is There a Role for Statins and COX-2 Inhibitors in the Prevention and Early Treatment of the Disease?

The inflammatory response to and the subsequent development of Adult Respiratory Distress Syndrome (ARDS) is considered to underpin COVID-19 pathogenesis. With a developing world catastrophe, we need to examine our known therapeutic stocks, to assess suitability for prevention and/or treatment of this pro-inflammatory virus. Analyzing commonly available and inexpensive immunomodulatory and anti-inflammatory medications to assess their possible effectiveness in improving the host response to COVID-19, this paper recommends the following: (1) optimize current health-cease (reduce) smoking, ensure adequate hypertension and diabetes control, continue exercising; (2) start on an HMG CoA reductase inhibitor "statin" for its immunomodulatory and anti-inflammatory properties, which may reduce the mortality associated with ARDS; and (3) consider using Diclofenac (or other COX-2 inhibition medications) for its anti-inflammatory and virus toxicity properties.

Analysis of the Three Most Prevalent Injuries in Australian Football Demonstrates a Season to Season Association Between Groin/Hip/Osteitis Pubis Injuries With ACL Knee Injuries.

Background: Injuries are common in contact sports like Australian football. The Australian Football League (AFL) has developed an extensive injury surveillance database that can be used for epidemiological studies.

Objectives: The purpose of this study is to identify any association between the three most prevalent injuries in the AFL.

Bone biopsy of the parasymphyseal pubic bone region in athletes with chronic groin injury demonstrates new woven bone formation consistent with a diagnosis of pubic bone stress injury.

Background: There is little scientific evidence available regarding the pathologic basis for chronic groin injury in athletes, a known difficult clinical problem.

Hypothesis: Histological analysis of the superior pubic ramus in athletes with diagnosed chronic groin injury may reveal the nature of the pathologic process.

Study Design: Case series; Level of evidence, 4.

Hip joint range of motion restriction precedes athletic chronic groin injury.

Although a restricted hip range of motion has been previously associated with chronic groin injury the temporal course of this association remains unclear. Accordingly the purpose of this prospective cohort study was to report preliminary findings examining whether hip joint range of motion restriction is associated with subsequent onset of athletic chronic groin injury. End-range internal and external hip joint range of motion was determined in 29 elite Australian football players, without previous history of groin injury.

Outcome of conservative management of athletic chronic groin injury diagnosed as pubic bone stress injury.

Background: Little data exist on the results of treatment for sports-related chronic groin injury.

Hypothesis: Sports-related chronic groin injury treated with a conservative (rest) program results in a satisfactory outcome.

Study Design: Case series; Level of evidence, 4.

Assessment of physical examination and magnetic resonance imaging findings of hamstring injury as predictors for recurrent injury.

Study Design: Prospective cohort study.

Objective: To examine clinical and magnetic resonance imaging (MRI) features of hamstring muscle injury to determine if any are predictive for recurrent injury.

Background: Hamstring muscle strain injury and subsequent recurrent injury are common.

6. Doctor on the sidelines.

Effectively managing on-field emergencies is the most important role of the doctor on the sidelines. Pre-event preparation is essential and should include a formulated plan for dealing with emergencies and access to emergency equipment such as a stretcher and a bag and mask. Game day injuries should be assessed by adhering as closely as possible to a normal clinical consultation, with a proper history and examination being performed for all injuries.

Groin pain in footballers: the association between preseason clinical and pubic bone magnetic resonance imaging findings and athlete outcome.

Background: Groin pain and tenderness are common in athletes from a variety of codes of football, but little attention has been directed to the influence of magnetic resonance imaging and such clinical findings on athlete participation.

Hypothesis: Preseason groin pain, tenderness, and magnetic resonance imaging findings such as pubic bone marrow edema are associated with restricted training capacity and missed games.

Study Design: Cohort study; Level of evidence, 2.

Description of pain provocation tests used for the diagnosis of sports-related chronic groin pain: relationship of tests to defined clinical (pain and tenderness) and MRI (pubic bone marrow oedema) criteria.

The clinical assessment of groin pain in athletes is difficult, with the lack of specific clinical tests being in part responsible. Three pain provocation tests used in the diagnosis of chronic groin pain are described and their relationship to defined clinical and MRI criteria has been assessed. Eighty-nine Australian Rules football players with and without groin symptoms underwent clinical examination followed by history.

Diagnostic and prognostic value of clinical findings in 83 athletes with posterior thigh injury: comparison of clinical findings with magnetic resonance imaging documentation of hamstring muscle strain.

Background: Little is known about the clinical features of posterior thigh injuries and their contribution to accurate diagnosis and prognostic assessment of hamstring muscle strain injury.

Hypotheses: The clinical features of posterior thigh injury can be used to diagnose hamstring muscle strain and to predict duration of absence from competition.

Study Design: Prospective clinical study.

Hamstring injury in athletes: using MR imaging measurements to compare extent of muscle injury with amount of time lost from competition.

Objective: The purpose of this study was to examine relationships between MR imaging measurements of the extent of hamstring injury and the amount of time lost from competition in a group of athletes.

Subjects And Methods: Thirty-seven athletes with suspected hamstring injury underwent T1 and inversion recovery T2 turbo spin-echo MR imaging in axial and sagittal planes. The presence and dimensions of abnormal focal intra- and extramuscular T2 hyperintensity were independently recorded by two radiologists, and the muscles involved and intramuscular location of injury were noted.