No abstract

Muscle injuries are one of the most common traumas occurring in sports. Despite their clinical importance, few clinical studies exist on the treatment of these traumas. Thus, the current treatment principles of muscle injuries have either been derived from experimental studies or been tested only empirically. Although nonoperative treatment results in good functional outcomes in the majority of athletes with muscle injuries, the consequences of failed treatment can be very dramatic, possibly postponing an athlete's return to sports for weeks or even months. Moreover, the recognition of some basic principles of skeletal muscle regeneration and healing processes can considerably help in both avoiding the imminent dangers and accelerating the return to competition. Accordingly, in this review, the authors have summarized the prevailing understanding on the biology of muscle regeneration. Furthermore, they have reviewed the existing data on the different treatment modalities (such as medication, therapeutic ultrasound, physical therapy) thought to influence the healing of injured skeletal muscle. In the end, they extend these findings to clinical practice in an attempt to propose an evidence-based approach for the diagnosis and optimal treatment of skeletal muscle injuries.

Antiinflammatory therapy with inhaled budesonide is an effective first-line treatment for patients with newly detected, mild asthma, and it is superior to the use of terbutaline in such patients.

Early treatment with inhaled budesonide results in long-lasting control of mild asthma. Maintenance therapy can usually be given at a reduced dose, but discontinuation of treatment is often accompanied by exacerbation of the disease.

Bilateral bone characteristics of the humerus (proximal, shaft, and distal sites) and radius (shaft and distal sites) in 12 former Finnish national-level male tennis players (mean age 30 years) and their 12 age-, height-, and weight-matched controls were measured with peripheral quantitative computed tomography (pQCT). The pQCT variables analyzed were bone mineral content (BMC), total cross-sectional area of bone (Tot.Ar), cross-sectional area of the marrow cavity (M.Cav.Ar), cortical bone (Co.Ar) and trabecular bone (Tr.Ar), volumetric density of cortical (Co.Dn) and trabecular (Tr.Dn) bone, cortical wall thickness (Co.Wi.Th), bone strength index (BSI), and principal moments of inertia (I min and I max ). In the players, significant side-to-side differences, in favor of the dominant (playing) arm, were found in BMC (ranging 14%-27%), Tot.Ar (16%-21%), Co.Ar (12%-32%), BSI (23%-37%), I min (33%-61%), and I max (27%-67%) at all measured bone sites, and in Co.Wi.Th. (5%-25%) at the humeral and radial shafts, and distal humerus. The side-to-side M.Cav.Ar difference was significant at the proximal humerus (19%) and radial shaft (29%). Concerning the players' Co.Dn and Tr.Dn, the only significant side-toside difference was found in the Co.Dn of the distal humerus, with the playing arm showing a slightly smaller Co.Dn than the nonplaying arm (؊2%). In controls, significant dominant-tonondominant side differences were also found, but with the majority of the differences being rather small, and significantly lower than those of the players. In conclusion, despite the large side-to-side differences in BMC, the volumetric bone density (Co.Dn, Tr.Dn) was almost identical in the dominant and nondominant arms of the players and controls. Thus, the players' high playing-arm BMC was due to increases in the Tot.Ar, M.Cav.Ar, Co.Ar, and CW.Th. In other words, the playing arm's extra bone mineral, and thus increased bone strength, was mainly due to increased bone size and not due to a change in volumetric bone density. These upper arm results may not be generalized to the entire skeleton, but the finding may give new insight into conventional dual-energy X-ray absorptiometry (DXA)-based bone density measurements when interpreting the effects of exercise on bone. (Bone 27:351-357; 2000)