Helmet use has been shown to significantly reduce risk of

Helmet use has been shown to significantly reduce risk of

head injury in skiing and yet only a small proportion of skiers use helmets [75, 75]. There has been little research examining the role of behaviour in sports injury prevention [76]. Despite growing evidence for a number of injury prevention strategies, behavioural change on the part of the sportsperson, the coach and sometimes the adjudicators of sport, is required to prevent injury [77]. Safe sports participation for PWH involves balancing the benefits and risks of particular activities and, where possible, ensuring adequate clotting factor levels in the blood. The focus now should be on evaluating the role of injury prevention strategies including LY294002 in vivo optimal prophylactic schedules, protective equipment and preparticipation exercise programmes on bleeds risk and ensuring that proven injury prevention strategies are adopted at a community level. KF has received speaker’s fees from Baxter, CSL Behring, Pfizer, Novo Nordisk, Biotest; performed consultancy for Bayer, Baxter, Biogen, Novo Nordisk and Pfizer; and has received research support from Bayer, Wyeth/Pfizer, Baxter, and Novo Nordisk. BK has received research support from RXDX-106 Baxter Bioscience, Biogen-Idec Hemophilia, Novo Nordisk and Octapharma, and has acted as a consultant for CSL-Behring, Pfizer, Baxter Bioscience and Biogen-Idec Hemophilia. CB has no conflicts

to declare. CMK has not declared any conflicts. “
“In patients with haemophilia A, factor VIII (FVIII) prophylaxis reduces bleeding frequency and joint damage compared with on-demand therapy. To assess the effect of prophylaxis initiation age, magnetic

resonance imaging (MRI) was used to evaluate bone and cartilage damage in patients with severe haemophilia A. In this cross-sectional, multinational investigation, patients aged 12–35 years were assigned to 1 of 5 groups: primary prophylaxis started at age <2 years (group 1); secondary prophylaxis started at age 2 to <6 years (group 2), 6 to <12 years (group 3), or 12−18 years (group 4); or on-demand treatment (group 5). Joint status at ankles and knees was assessed using Compatible Additive MRI scoring (maximum and mean ankle; maximum and mean of all 4 joints) and Gilbert scores in the per-protocol population (n = 118). All prophylaxis groups had medchemexpress better MRI joint scores than the on-demand group. MRI scores generally increased with current patient age and later start of prophylaxis. Ankles were the most affected joints. In group 1 patients currently aged 27−35 years, the median of maximum ankle scores was 0.0; corresponding values in groups 4 and 5 were 17.0 and 18.0, respectively [medians of mean index joint scores: 0.0 (group 1), 8.1 (group 2) and 13.8 (group 4)]. Gilbert scores revealed outcomes less pronounced than MRI scores. MRI scores identified pathologic joint status with high sensitivity. Prophylaxis groups had lower annualized joint bleeds and MRI scores vs. the on-demand group.

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