Background In the pursuit of sporting success, some elite athletes prioritise peak performance over long-term health, frequently resulting in significant and enduring health consequences. The Enhanced Games (TEG) position themselves as a bold experiment in transhumanism, advocating for the use of performance-enhancing drugs (PEDs), including methods banned by World Anti-Doping Agency (WADA), to push the boundaries of human athletic potential. Objectives The aim of this study is to explore the perspectives of sport physicians, sport scientists, physiotherapists and other allied healthcare professionals on treating and supporting "enhanced athletes", with the view of informing future guidelines. Methods Participants were invited via email and personal contacts within sport medicine communities to complete a brief anonymous survey via QuestionPro (TM). Descriptive statistics were performed using Excel (TM) and RStudio (TM). Results A total of 323 healthcare professionals responded (82% were sport physicians), among whom 74% expressed a willingness to treat acute lesions and/or chronic diseases in "enhanced athletes". In comparison, a considerable minority (30%) expressed support for assisting athletes in their use of PEDs and methods under medically supervised conditions, with high consistency across professional roles. A relatively high readiness was observed in sport physicians treating acute (77% versus 58%; p < 0.01) and chronic (75% versus 63%; p = 0.11) diseases for "enhanced athletes". As far as WADA rules and/or national anti-doping laws apply, this support presupposes compliance with the code and the respective national laws to protect physicians from serious professional, legal and personal consequences. Conclusion The preliminary findings align with the broader goal of fostering a sport culture that values both peak performance and the short- and long-term health of all participants. These results emphasise the necessity of implementing professional guidelines and comprehensive support systems designed to safeguard the long-term well-being of all athletes and underscore the urgent need for further research into the impact of TEG on sport and its community.

BACKGROUND:The objective of this study was to ascertain disparities in growth and maturation between male adolescents engaged in soccer and their non-athletic counterparts, as well as to examine the injury features specific to young soccer players.METHODS:A total of 206 soccer players between the ages of 11-16 years, and 208 non-athletic peers were enrolled. Height, weight, body mass index (BMI), annual growth rate, and skeletal age evaluated using a left handwrist x-ray were determined. Biological and sexual maturation were evaluated using skinfold thickness, body composition, and Tanner stages. The game positions, initial age for playing soccer, the number of games per/ week, the number of sports injuries, date of injury, duration for return to activity, the site, nature, mechanism, and rate of injury were recorded for soccer players. Using an injury card, the characteristics of soccer player injuries were recorded.RESULTS:The mean age of the participants was 13.6 ± 1.5 years. There was no difference in the growth rates between the groups at the ages of 11.0, 12.0, and 15.0 but at the ages of 13.0 and 14.0 years growth rates were higher in the soccer group. The soccer players were taller than the controls. For all Tanner stages, soccer players had a lower BMI and total body fat percentage, as well as a faster growth rate. Injuries occurred at a rate of 39.3% per year among soccer players. The most common being toe injuries, and playing soccer increased the risk of multiple injuries. Additionally, injuries occurred more frequently in soccer players who were taller, heavier, with higher total body fat and/or higher growth rate, and most commonly occurred during Tanner stage 4. Futhermore, Tanner stage 4 had a higher incidence of two or more injuries than the other stages.CONCLUSIONS:Adolescent male soccer players have higher growth rates than their non-athletic peers, and their biological maturity status is associated with an increased risk of injury.

BACKGROUND: Sports injuries are increased due to increased sports participation in recent years. Among these, anterior cruciate ligament injuries are pretty common. Anterior cruciate ligament damage leads to instability and results in functional limitations. For this reason, postoperative rehabilitation is crucial for returning to sports.METHODS: This study included 24 male recreational athletes aged 18-35 years who underwent ACL surgery at least one year before and could not return to their pre-injury activity level. An eight-week protocol composed of strength, balance, plyometric and proprioceptive exercises was implemented. Functional questionnaires were applied before and after the protocol. In addition, isokinetic strength, balance scores, and concurrent EMG activities were measured.RESULTS: Significant differences were found between the strength, balance tests, and EMG data obtained before, during, and after the exercise program (P<0.05). Also, there were significant differences in functional questionnaire scores (P<0.05). All participants could successfully return to their pre-injury activities. There was no correlation between EMG data and isokinetic strength values (P>0.05).CONCLUSIONS: Isokinetic strength and balance measurements, EMG parameters, and functional questionnaire scores have revealed that the exercise protocol is effective and can be used in deciding to return to sports. In addition, EMG analysis can be used in proper movement management during rehabilitation, aiding strength development and monitoring muscle fatigue. However, it can not be used as a criterion for returning to sports.

of Sports Medicine Associations (EFSMA) on the International Olympic Committee (IOC) framework on fairness, inclusion and non-discrimination based on gender identity and

Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society. In response to this trend, numerous organisations came together under one umbrella in Hamburg, Germany, in April 2021 and signed the ‘Hamburg Declaration’. This represented an international commitment to take all necessary actions to increase PA and improve the health of individuals to entire communities. Individuals and organisations are working together as the ‘Global Alliance for the Promotion of Physical Activity’ to drive long-term individual and population-wide behaviour change by collaborating with all stakeholders in the community: active hospitals, physical activity specialists, community services and healthcare providers, all achieving sustainable health goals for their patients/clients. The ‘Hamburg Declaration’ calls on national and international policymakers to take concrete action to promote daily PA and exercise at a population level and in healthcare settings.

COVID-19 pandem c a ected health care serv ces all around the world.Accord ngly, med cal educat on s d srupted at every level from the f rst grade of med cal school to resdency programs.Although the theoret cal part of the educat on has somehow been cont nued w th methodolog cal changes, the cl n cal tra n ng of the sports med c ne (SM) res dents was negat vely mpacted by the pandem c.In Turkey, cl n cal tra n ng of SM res dents ma nly cons sts of exam n ng pat ents under the superv s on of professors at outpat ent cl n cs, 17 months of cl n cal rotat ons n several departments and nvolv ng n the sports rehab l tat on processes of the njured or operated athletes.As of the outburst of the pandem c, hosp tals decreased the outpat ent adm ss ons and cancelled the sports rehab l tat on serv ces to avo d unnecessary contact.Moreover, all res dents have been ass gned to COVID cl n cs, some of them worked n ntens ve care un ts, as prev ously reported.(1,2) Ustaoğlu reported that more than half of the 215 dermatolog sts were entrusted w th a task related to COVID pat ents n Turkey.(3) Res dents who started the r tra n ng n 2019 and a erward were subjected to a qu te d vergent educat on scheme than t was before pandem c.We a med to dep ct the deterorat on of res dent tra n ng n terms of outpat ent adm ssons n SM departments to d rect attent on to necess ty of future plann ng to take measures n order to el m nate the def c enc es n th s unprecedented per od.

Objective The aim of the study was to evaluate the possible effects of impact and loading on the metacarpal cartilage and hand functions in young elite athletes. Design In this cross-sectional study athletes with at least 3 yrs of sport background and who have been under a scheduled training program were enrolled. The second to fifth fingers’ metacarpal head cartilage thicknesses were measured bilaterally by using ultrasonography. Handgrip and pinch strengths were measured. Michigan Hand Outcomes Questionnaire was also completed for every participant. Results A total of 42 male athletes (19 weightlifters, 23 volleyball players) and 46 healthy control subjects were enrolled. Metacarpal cartilage thicknesses of the athletes were thicker than those of the healthy controls (all P < 0.001). There were no differences between the dominant and nondominant hands (all P > 0.05). In the weightlifting group, Michigan Hand Outcomes Questionnaire work performance and pain scores were worse than the other groups (both P < 0.001). Conclusions The presence of increased cartilage thickness measurements in the athletes suggests that sports activities might affect the metacarpal articular cartilage. Highest pain scores and lowest work performance scores in the weightlifters with highest metacarpal cartilage thickness might suggest that impact and loading during their sports play could lead to cartilage edema.

The IOC recently published its framework on fairness, inclusion and non-discrimination based on gender identity and sex variations. This framework is drafted mainly from a human rights perspective, with less consideration for medical/scientific issues. The framework places the onus for gender eligibility and classification entirely on the International Federations (IFs), even though most will not have the capacity to implement the framework. The position of no presumption of advantage is contrary to the 2015 IOC consensus. Implementation of the 2021 framework will be a major challenge for IFs that have already recognised the inclusion of trans and women athletes with differences of sexual development (DSD) using a scientific/medical solution. The potential consequences for sports that need to prioritise fairness or safety could be one of two extremes (1) exclusion of all transgender or DSD athletes on the grounds of advantage or (2) self-identification that essentially equates to no eligibility rules. Exclusion of all transgender or DSD athletes is contrary to the Olympic charter and unlawful in many countries. While having no gender eligibility rules, sport loses its meaning and near-universal support. Athletes should not be under pressure to undergo medical procedures or treatment to meet eligibility criteria. However, if an athlete is fully informed and consents, then it is their free choice to undergo carefully considered or necessary interventions for gender classification for sport to compete fairly and safely in their chosen gender. Free choice is a fundamental human right, but so is the right to fair and safe competition.

Objective: Turkish Journal of Sports Medicine (TJSM) has used a web-based software program to define the phrasal similarity of submitted articles since 2017. The aims of this study were; to determine the similarity scores obtained in the preliminary evaluation of the articles published in TJSM since 2017, and to evaluate the relationship between the similarity scores and the article type, article language, and publication year. Materials and Methods: A total of 125 articles published in TJSM from 2017 to 2020 were retrospectively reviewed from the digital archive. Research articles, review articles, and case reports were included in the analysis. Similarity scores, including total similarity score and highest match scores in All Sources mode and Match Overview mode, were obtained from Similarity Reports acquired using iThenticate plagiarism checker software. Data were recorded regarding the type and language of the article, the year of publication, whether the corresponding author was from Turkey or any other country, and similarity scores. Results: Of the 119 analyzed manuscripts, 76.5% (n=91) were research articles. The majority of the articles (95%, n=113) were submitted by authors from Turkey, and most of the articles (62.2%, n=74) were in Turkish. The median similarity score for all articles was 9.0% (Q1: 4.0 - Q3: 17.0), and the median highest matching scores were 2.0% (Q1: 1.0 - Q3: 3.0) and 3.0% (Q1: 2.0 - Q3: 6.0) for the Match Overview mode and All Sources mode, respectively. The median total similarity score and the median highest matching score from All Sources mode were significantly higher in research articles (p = 0.004 and p = 0.017, respectively) and in articles written in English (p < 0.001 for both). Conclusion: Total similarity and highest matching scores among articles published in TJSM between 2017 and 2020 were significantly higher in research articles and articles written in English.

Abstract We have retrospectively evaluated 81 hips of 80 patients who were treated with dynamic hip screw (DHS) for trochanteric region fractures between April 1987 and December 1993. Of these 33 (40.4%) were female and 47 (59.3%) were male. Left side was involved in 50 (61.7%) and right side in 31 (38.3%). The trauma that resulted in fracture was a fall in 65 (80.2%) and traffic accident in 16 (19.8%). Patients were operated on the average day of 6 (3- 15). Of these 5 (6.25%) died at the very early postoperatived period and 8 (10%) in the first three months postoperatively. Follow-up was not possible in 5 patients (6.25%) and remoining 56 patients (70%) were followed-up with a mean of 15.8 months (4-36). Loss of reduction was only seen in fractures that were not stable due to loss of bony continuity at the posteromedial corner. We think that DHS could not restore stability in this type of fracture and plates which can resist the bending moments of weight bearing should be used. Özet Trokanterik kırıklarda uyguladığımız tedavi sonuçlarını görmek için Nisan 1987 ile Aralık 1993 tarihleri arasında kırıklarına kompresyon vidalı plak (DHS) uygulanmış 80 hastanın 81 kalçası retrospektif olarak değerlendirildi. Hastaların 33 ü kadın (%40.7), 47 si erkek (%59.3) olup bunların 50 si sol (%61.7), 31 i sağ (%38.3) idi. Olguların 65 inin (%80.2) düşme sonucu, 16 sının (%19.8) trafik kazası sonucu kırıkları oluşmuştu. Hastaların grafileri ameliyat öncesi AO sınıflamasına göre değerlendirildi. Hastalar kliniğe yatmalarını takiben ortalama 6 gün (3- 15) içinde ameliyata alındı. 5 i (%6.25) erken dönemde, 8 i (% 10) ilk 3 ay içerisinde exitus olmuşlardır. 5 hasta (%6.25) takip dışı bırakılmış olup geriye kalan 56 hasta (%70) ortalama 15.8 ay (436) takip edilmişlerdir. Posteromedial kortikal devamlılığı bozulmuş (AO A2-2, Evans Tip 4) kırıkların 135° li kompresyon yapıcı plakla anatomik olarak redukte pozisyonda kaynama şansının çok düşük olduğu ve bu tur kırıklarda, eğilme yükünü alabilecek tipte plakların kullanılması gerektiği sonucuna vardık.

Diagnosis is one of the most important tasks performed by primary care physicians. The World Health Organization (WHO) recently prioritized patient safety areas in primary care, and included diagnostic errors as a high-priority problem. In addition, a recent report from the Institute of Medicine in the USA, ‘Improving Diagnosis in Health Care’, concluded that most people will likely experience a diagnostic error in their lifetime. In this narrative review, we discuss the global significance, burden and contributory factors related to diagnostic errors in primary care. We synthesize available literature to discuss the types of presenting symptoms and conditions most commonly affected. We then summarize interventions based on available data and suggest next steps to reduce the global burden of diagnostic errors. Research suggests that we are unlikely to find a ‘magic bullet’ and confirms the need for a multifaceted approach to understand and address the many systems and cognitive issues involved in diagnostic error. Because errors involve many common conditions and are prevalent across all countries, the WHO’s leadership at a global level will be instrumental to address the problem. Based on our review, we recommend that the WHO consider bringing together primary care leaders, practicing frontline clinicians, safety experts, policymakers, the health IT community, medical education and accreditation organizations, researchers from multiple disciplines, patient advocates, and funding bodies among others, to address the many common challenges and opportunities to reduce diagnostic error. This could lead to prioritization of practice changes needed to improve primary care as well as setting research priorities for intervention development to reduce diagnostic error.

The initiation and progression of puberty varies among adolescents. It is well known that the somatic, neurological and cognitive development of teenagers who engage in sports activities are positively influenced. In this study, the growth and maturity status and injury characteristics of adolescent male soccer players were compared with healthy peers.

The multifactorial nature of hip pain in youngsters may complicate the diagnosis and treatment. There are many possible causes of hip pain in athletes. A careful clinical assessment is needed to eliminate the numerous possibilities, especially when the symptoms cannot to be easily classified into one of the commonly defined clinical entities. Labral pathologies, degenerative disease of cartilage and morphological disorders causing labral pathologies, such as dysplastic hip, slipped capital femoral head and Legg-Calve-Perthes (LCP) disease are the leading pathologies among them. These disorders may present with early onset of hip pain. Although athletic injuries of the hip are less common, rehabilitation takes rather longer times. Thus, an accurate diagnosis and well-organized treatment plan are critical. Imaging methods, careful physical examination and provocative tests are helpful in making a correct diagnosis and delivering a successful treatment. In this case report, the diagnostic and treatment processes of avascular necrosis of femoral head developed following acute rupture of iliopsoas tendon in a young female rhythmic gymnast has been presented.

Objective: Turkish Journal of Sports Medicine (TJSM) has been published since 1966 as the official journal of Turkish Sports Medicine Association. By launching of open access online publication in 2016; accessiblity, visibility and number of submitted articles have been significantly increased. Materials and Method: Citation rates of the articles published in TJSM for the last three years; between 2017 and 2019 were examined to determine the impact of the open access online publication. Results: 80 articles published between 2017-2019. 93.8% (n=75) were submitted by Turkish authors. 28.7% (n=23) were submitted in English. 75% (n=60) were research articles. When the subject titles were examined; majority of the published articles were found to be as sports medicine articles (47.5%, n=38). 38.8% (n=31) of the articles were multidisciplinary, consisting of health, sports and/or engineering sciences. 46.3% of the studies were at level of evidence 3 (n=37). The impact factor for the last three years was 0.187. Citations were not significantly related to country of submission (p=0.6), study structure (multidisciplinary or not), (p=0.1), language (p=0.8), category (p=0.3) and level of evidence (p=0.9) of the studies. Conclusion: Open access online publication positively effected the accessibility and visibility of the journal, as well as submission rate and published article number per issue. Impact factor for the three years is not low, but gradual increase is expected both in submission rates and quality of the published articles.

Purpose: Hamstring injuries are the most common sport-related muscle injuries. Several Return to Play (RTP) criteria have been described to prevent re-injury after hamstring injuries. Despite the criteria, re-injury rates have not been satisfactorily improved. The purpose of this study is to investigate the utilization of RTP criteria in clinical practice. Materials and Methods: Forty-nine sports medicine specialists and twenty-six physiotherapists were included in the study. The study was conducted using a 5-point Likert-Scale questionnaire. This study is a cross-sectional study and Level of Evidence is IV. Participants were questioned about their sociodemographic characteristics, the importance of RTP criteria, the practical application of these criteria, and the factors that influence the RTP decision. The difference between importance referred to RTP criteria and practical application was analyzed with the Wilcoxon Signed Rank Test. Results: Statistical analysis revealed a significant difference between referred importance and practical application of eight out of ten RTP criteria (p<0.05). Conclusion: RTP criteria do not adequately reflect the practical application. The underlying causes of this contradictory situation should be analyzed, and a new perspective should be developed to prevent hamstring injuries and decrease the re-injury rates.