bluuebunny/crossref_metadata_2025 huggingface dataset:
Menstrual migraine: intermittent prophylaxis with a timed-release pharmacological formulation of dihydroergotamine
Authors: D'alessandro Roberto , Gamberini Gloria , Lozito Antonio , Sacquegna Tommaso
Published: July 2017

An open study was performed on 20 women between 20 and 40 years of age in order to assess the effectiveness of a slow-release pharmacological formulation of dihydroergotamine in the prevention of menstrual migraine. Therapy was started two days prior to the expected date of menstruation and continued for five days after the onset of menstrual flow. Trial lasted for five months, four patients suspended the treatment: one because of side effects and three because of “ineffectiveness of drug”. In the 16 patients who completed the study, there was a significant reduction both in intensity and duration of migraine compared to the month prior to treatment.

An essay clinique a été sur 20 femmes avec un âge minimum de 20 ans et un âge maximum de 40 ans pour étudier l'efficacité d'une preparation à libérateur différée de dihydroergotamine comme traitement preventif de la migraine cataméniale. On a commencé la thérapie deux jours avant la date attendue de la menstruation et on a continué pour 5 jours aprés le debut réel de la menstruation. La durée de l'étude a été de cinq mois. 4 patients ont du sospendre le traitement: le premier pour intolérance, les autres pour “inefficacité de la thérapie”. Entre le 16 patients qui ont fini l'étude on a vu une réduction significative de l'intensité et de la durée de la crise migraineuse en comparaison de mois avant le traitement.

In 20 donne di età compresa tra i 20 e i 40 anni é stato condotto uno studio in aperto sull'efficacia di un preparato ritardo di diidroergotamina nella prevenzione dell'emicrania catameniale (mestruale). L'assunzione del farmaco iniziava due giorni prima della data prevista di comparsa del flusso mestruale e proseguiva per i cinque giorni successivi alla comparsa della stessa. Il trattamento é proseguito per cinque mesi. In una sola paziente si é avuta la comparsa di effetti collaterali che hanno provocato la sospensione del trattamento. Nelle 16 pazienti che hanno terminato lo studio é stata rilevata, al quinto mese, una significativa riduzione sia dell'indice emicranico che della durata della cefalea rispetto al mese di pretrattamento.
Flunarizine vs. Pizotifen in Migraine Prophylaxis: A Review of Comparative Studies
Authors: Spierings Egilius LH , Messinger Harley B
Published: July 2017

Six double-blind studies have been published in which the efficacy of flunarizine and pizotifen were compared. In none of the studies were differences of statistical significance revealed for attack frequency. Secondary analysis of the three studies in which the same protocol was employed, using parametric tests on transformed data gave similar results. Pooling of the data in an attempt to enhance the power by enlarging the number of patients, actually decreased the power due to an increase in standard deviation.
Background and Introduction
Authors: Merikangas Kathleen Ries
Published: July 2017

Care of the patient is the ultimate specific act that characterizes a clinician-any taxonomic system that cannot assist a clinician to do just that will not find much acceptance.
An epidemiological approach to the nosography of chronic daily headache
Authors: Sandrini Giorgio , Manzoni Gian Camillo , Zanferrari Carla , Nappi Giuseppe
Published: July 2017

Chronic daily headache (CDH), a heterogeneous group of headaches, includes different forms that occur daily, or almost daily, over a prolonged period of time. The nosography of this group is still a matter of debate, and in the most recent classification of the IHS (1988) only a few types of CDH are included: chronic tension-type headache, coexisting migraine. This study is an epidemiological approach to identifying the clinical features of CDH and the possible factors involved in changing episodic headache in CDH. Ninety CDH outpatients were investigated using a computerized record chart. The main observed forms were: (a) chronic tension-type headache–migraine with interparoxysmal headache, an evolved form of migraine in which a constant low severity headache develops between attacks; (b) transformed migraine, an evolved form of migraine with progressive worsening of the disease which reaches the level of continuous pain with the disappearance of typical migraine attacks. Interval headaches in migraine with interparoxysmal headache partly fulfil the IHS criteria for chronic tension-type headache. Analgesic drug abuse plays a prominent role in inducing CDH and in determining its clinical features.
The clinical pharmacokinetics of zolmitriptan
Authors: Dixon R , Warrander A
Published: July 2017

Zolmitriptan (Zomig™, formerly 311C90) is a novel, oral, acute treatment for migraine. In healthy volunteers it is rapidly and extensively absorbed and has favorable oral bioavailability (approximately 40%) which is not affected by concomitant food intake. On average, 75% of its eventual Cmax is achieved within 1 h of dosing. Plasma concentrations are sustained for 4 to 6 h after dosing with single or multiple peaks in the plasma concentration-time profile, reflecting continued absorption down the gastrointestinal tract. The pharmacokinetics of zolmitriptan indicate dose proportionality over the dose range of 2.5 to 50 mg and there are no significant changes on multiple dosing. Zolmitriptan is cleared by metabolism followed by urinary excretion of the metabolites. There are three major metabolites, one of which, the N-desmethyl metabolite, is active as a 5HT1D agonist and has mean plasma concentrations approximately two thirds those of the parent compound. The other two metabolites, the N-oxide and indoleacetic acid, are inactive. The elimination half lives of zolmitriptan and its metabolites are similar, approximately 3 h. Zolmitriptan and its active metabolite are minimally protein bound in the plasma (approximately 25%). In migraine patients, plasma concentrations of zolmitriptan and its metabolites are lower during a migraine attack than outside an attack. In summary, the pharmacokinetics of zolmitriptan are simple, predictable and appropriate to an acute oral treatment for migraine.
Arthroscopically Assisted Mini-Open Rotator Cuff Repairs
Authors: Hersch Jonathan C. , Sgaglione Nicholas A.
Published: July 2017

The functional outcome of 22 consecutive patients with full-thickness rotator cuff tears repaired using an arthroscopically assisted technique was evaluated. The average follow-up was 39 months (24 to 80), and the average tear size was 3.5 cm (1 to 7). There were 14 men and 8 women, with a mean age of 56 years (29 to 80); 86% of patients (N 19) were satisfied with the results of surgery and 95% (N 21) had improvement of their symptoms. All patients had a statistically significant improvement in pain and active abduction in the scapular plane and in external rotation. Postoperative strength in external rotation and abduction averaged 95% and 97% of the contralateral shoulder, respectively. Preoperative duration of symptoms, strength, age, and tear size were found to be independent predictors of outcome. The average Constant and Murley score was 84 of 100, the average American Shoulder and Elbow Surgeons score was 81 of 100, and the average University of California, Los Angeles, score was 31 of 35. Our results show that an arthroscopically assisted repair of full-thickness, moderate-to-large rotator cuff tears using uniform surgical technique and rehabilitation protocols provides excellent outcome with regard to function, pain, and activities of daily living.
A Biomechanical Comparison of Posterior Cruciate Ligament Reconstruction Techniques
Authors: Bergfeld John A. , McAllister David R. , Parker Richard D. , Valdevit Antonio D. C. , Kambic Helen E.
Published: July 2017

Most posterior cruciate ligament reconstruction techniques use both tibial and femoral bone tunnels for graft placement. Because of the acute angle the graft must make to gain entrance into the tibial tunnel, abnormal stresses are placed on the graft that could lead to graft failure. An alternative technique for posterior cruciate ligament reconstruction involves placement of the bone plug from the graft anatomically on the back of the tibia (inlay), preventing formation of an acute angle at the tibial attachment site. We used six pairs of human cadaver knees to compare the biomechanical properties of these two techniques. One knee from each pair underwent tunnel reconstruction while the other knee underwent inlay reconstruction. There was significantly less anterior-posterior laxity in the inlay group when compared with the tunnel group from 30° to 90° of knee flexion and after repetitive loading at 90° of knee flexion. Evaluation of the grafts revealed evidence of mechanical degradation in the tunnel group but not in the inlay group. The inlay technique resulted in less posterior translation with less graft degradation than did the tunnel technique for posterior cruciate ligament reconstruction.
Meniscal Allografts—Where Do We Stand?
Authors: Rodeo Scott A.
Published: July 2017

Meniscal transplantation has been recommended for selected meniscus-deficient patients in an effort to forestall progressive joint degeneration. Meniscal allograft transplantation may be considered for patients with symptoms (pain and swelling) due to meniscal deficiency in an effort to prevent progressive articular cartilage degeneration. Medial meniscal transplantation may also be considered during concomitant anterior cruciate ligament reconstruction, since absence of the medial meniscus results in increased forces in the anterior cruciate ligament graft. Contraindications for meniscal transplantation include advanced articular cartilage degeneration (especially on the flexion weightbearing zone of the condyle), axial malalignment, and flattening of the femoral condyle. Patient evaluation should include standing, long-leg radiographs for assessment of the mechanical axis and magnetic resonance imaging with appropriate pulse sequences for evaluation of hyaline cartilage thickness. Fresh-frozen and cryopreserved allografts are currently the most commonly used transplantation materials. Appropriate graft sizing is critical; most tissue banks size the meniscus based on radiographic tibial plateau measurements. Early results of meniscal transplantation indicate predictable improvements in pain, swelling, and knee function; however, no long-term results are available. Poor results have been reported in patients with advanced cartilage degeneration. Objective evaluations often demonstrate some degree of degeneration of the posterior horn of the transplant. Earlier transplantation should be considered for patients with known meniscal deficiency.
Range of Motion after Bankart Repair
Authors: Itoi Eiji , Watanabe Wataru , Yamada Shin , Shimizu Togo , Wakabayashi Ikuko
Published: July 2017

We studied the range of shoulder motion of patients who underwent vertical as compared with horizontal capsulotomies during open Bankart repair for recurrent anterior dislocations of the shoulder. A vertical capsulotomy was used in 10 shoulders and a horizontal capsulotomy was used in 14 shoulders. Except for the method of capsulotomy, the surgical procedure and postoperative rehabilitation were the same. The range of motion was measured at 1.5, 2, 3, 4, 5, 6, 9, and 12 months after the surgery, and at the final follow-up (average, 49 months for the vertical and 26 months for the horizontal group). No dislocations recurred, and the anterior apprehension test was negative in all of the patients in both groups. External rotation in abduction was greater in the horizontal group than in the vertical group; the differences were significantly greater at 9 months and 12 months after surgery and at the final follow-up. External rotation in adduction, flexion, and internal rotation were not significantly different between the groups. We conclude that Bankart repair through a horizontal capsulotomy preserves a better range of external rotation in abduction than does a vertical approach.
Superior Labral Strain during the Throwing Motion
Authors: Pradhan Rabindra L. , Itoi Eiji , Hatakeyama Yuji , Urayama Masakazu , Sato Kozo
Published: July 2017

We studied the strain on the superior labrum of 10 fresh-frozen cadaveric shoulders with the arm in simulated positions of a pitching motion. We used linear transducers to measure the strain in both the anterior and posterior superior labrum with the arm in various planes and rotations simulating the motions of pitching: early cocking, late cocking, acceleration, deceleration, and follow-through. Predetermined loads, according to the percent of maximum voluntary contraction of the biceps muscle during each phase of pitching, were calculated and applied to the long head of the biceps tendon using a spring device. Only during the late cocking phase, when the arm was in maximal external rotation, was the increase in strain statistically significant for the anterior and posterior portions and the strain on the posterior portion significantly greater than that on the anterior portion of the labrum. The increased strain in the posterior portion may be due to the anatomic orientation of the long head of the biceps tendon at the superior labrum. The increased strain in the late cocking phase may contribute to the detachment of the labrum with the eccentric contraction of the biceps muscle that occurs with rapid extension of the elbow.
The Effectiveness of a Preseason Exercise Program to Prevent Adductor Muscle Strains in Professional Ice Hockey Players
Authors: Tyler Timothy F. , Nicholas Stephen J. , Campbell Richard J. , Donellan Sean , McHugh Malachy P.
Published: July 2017

Background:

Adductor strains are among the most common injuries in ice hockey. Hip adductor weakness has been identified as a strong risk factor.

Hypothesis:

An intervention program including muscle strengthening can reduce the incidence of adductor strains in professional ice hockey players.

Study Design:

Prospective risk factor prevention study.

Methods:

Thirty-three of 58 players from the same National Hockey League team were identified as “at risk” on the basis of preseason hip adductor strength and participated in an intervention program. The program consisted of 6 weeks of exercises aimed at functional strengthening of the adductor muscles. Injury and individual exposure data were recorded for all players.

Results:

There were 3 adductor strains in the 2 seasons subsequent to the intervention, compared with 11 in the previous 2 seasons (0.71 versus 3.2 per 1000 player-game exposures). All adductor strains were first-degree strains and occurred during games.

Conclusions:

A therapeutic intervention of strengthening the adductor muscle group appears to be an effective method for preventing adductor strains in professional ice hockey players.
Comparison of Surgical Repair or Reconstruction of the Cruciate Ligaments versus Nonsurgical Treatment in Patients with Traumatic Knee Dislocations
Authors: Richter Martinus , Bosch Ulrich , Wippermann Burkhard , Hofmann Axel , Krettek Christian
Published: July 2017

Background:

Studies of traumatic knee dislocations have failed to provide a consensus regarding the best method of treatment.

Purpose:

Our purpose was to evaluate the results after surgical repair or reconstruction versus nonsurgical treatment and to compare the influence of prognostic factors.

Study Design:

Retrospective study.

Methods:

Eighty-nine patients were treated for traumatic knee dislocation. Surgical repair or reconstruction of the cruciate ligaments was performed in 63 patients (repair, 49; reconstruction, 14). In 26 patients, nonsurgical treatment was undertaken.

Results:

At an average follow-up of 8.2 years, the mean Lysholm and Tegner scores were 75 and 3.7, respectively. The outcome in the surgical group was better than in the nonsurgical group. The scores were higher in patients who were 40 years of age or younger, who had sports injuries rather than motor vehicle accident injuries, and who had undergone functional rehabilitation rather than immobilization.

Conclusions:

Surgical repair or reconstruction of the cruciate ligaments was superior to nonsurgical treatment. Functional rehabilitation was the most important positive prognostic factor. Surgical repair or reconstruction of the cruciate ligaments is mandatory to achieve sufficient stability for functional rehabilitation. In cases of cruciate ligament avulsion, repair with transosseous fixation is a reasonable alternative to reconstruction, provided that it is performed within 2 weeks of trauma.
Revisiting the Open Bankart Experience
Authors: Magnusson Lennart , Kartus Jüri , Ejerhed Lars , Hultenheim Ingrid , Sernert Ninni , Karlsson Jon
Published: July 2017

Background

The open Bankart technique for posttraumatic recurrent anterior instability has become the procedure of choice for patients who do not respond to nonoperative treatment.

Hypothesis

The open Bankart procedure renders stable and well-functioning shoulders in the long term in a large proportion of patients.

Study Design

Retrospective follow-up study with independent reexaminers.

Methods

Fifty-four patients (54 shoulders) with symptomatic, posttraumatic, recurrent anterior shoulder instability underwent an open Bankart reconstruction procedure with suture anchors. All of the patients had a Bankart lesion. Forty-seven patients (87%) were reexamined by independent observers at a mean follow-up period of 69 months (range, 48 to 114).

Results

The recurrence rate, including both dislocations and subluxations, was 17% (8 of 47). The median Rowe score was 90 points (range, 24 to 100) at the follow-up, and the median Constant score was 88.5 points (range, 41 to 100). External rotation in abduction was a median of 90° (range, 25° to 125°) in the involved shoulders, as compared with 97.5° (80° to 125°) in the noninjured shoulders (P < 0.0001).

Conclusions

We conclude that, in the long term, the open Bankart procedure resulted in an unexpectedly high number of patients with failure in terms of stability. These results emphasize the importance of performing long-term follow-up studies after surgical reconstruction for unidirectional, posttraumatic, anterior shoulder instability using any type of technique.
Anterior Cruciate Ligament Rupture after Thermal Treatment in a Canine Model
Authors: Lopez Mandi J. , Markel Mark D.
Published: July 2017

Background:

The use of radiofrequency energy to treat damaged anterior cruciate ligaments is gaining popularity. However, complete rupture of the ligament after treatment has been reported.

Purpose:

To evaluate the effect of thermal energy applied arthroscopically to normal, intact anterior cruciate ligaments in mature dogs.

Study Design:

Controlled laboratory study.

Methods:

Monopolar radiofrequency energy was applied to the normal anterior cruciate ligament of 1 knee in 18 dogs. The contralateral anterior cruciate ligament (also normal) was sham treated. Force-plate gait analysis was performed preoperatively and at 4, 8, 12, 16, 26, and 36 weeks after surgery. Anterior cruciate ligament rupture was detected by a sudden onset of nonweightbearing and a positive drawer sign.

Results:

All treated ligaments ruptured approximately 55 days after surgery (mean, 55 days; standard error, 1.6).

Conclusions:

Although monopolar radiofrequency energy may have some potential in the treatment of lax anterior cruciate ligaments, in the application described here the result was a highly predictable deterioration and rupture of all treated anterior cruciate ligaments.

Clinical Relevance:

On the basis of these findings, we strongly recommend that strict selection and application criteria be used when considering use of this modality on anterior cruciate ligaments that are stretched or partially disrupted, or both. Use of this modality should be followed by adherence to a highly conservative rehabilitation protocol.
Multistranded Hamstring Tendon Graft Fixation with a Central Four-Quadrant or a Standard Tibial Interference Screw for Anterior Cruciate Ligament Reconstruction
Authors: Starch David W. , Alexander Jerry W. , Noble Philip C. , Reddy Suraj , Lintner David M.
Published: July 2017

Background

Tibial fixation of hamstring tendon grafts has been the weak link in anterior cruciate ligament reconstruction.

Hypothesis

Use of a central four-quadrant sleeve and screw provides superior fixation when compared with standard interference screw fixation.

Study Design

Controlled laboratory study.

Methods

In eight pairs of cadaveric knees each anterior cruciate ligament was reconstructed using either an interference screw or a central sleeve and screw on the tibial side. The specimens were then subjected to cyclic loading followed by a load-to-failure test.

Results

The load required to cause 1 and 2 mm of graft laxity, defined as the separation of the femur and the tibia at the points of graft fixation, was significantly greater with the sleeve and screw than with the interference screw (at 2 mm: sleeve and screw, 216.1 ± 30.1 N; interference screw, 167.0 ± 33.2 N). The force at initial slippage for each of the graft strands was significantly higher with use of the central sleeve and screw.

Conclusions

The four-quadrant sleeve and screw device may provide greater surface area for healing of hamstring tendon grafts and allow equal tensioning of graft strands before fixation. These factors are associated with increased strength of fixation and reduced laxity of the graft after cyclic loading.

Clinical Relevance

Use of the central four-quadrant sleeve and screw system offers increased strength of fixation in anterior cruciate ligament reconstruction with hamstring tendon graft.
Compaction Drilling Does Not Increase the Initial Fixation Strength of the Hamstring Tendon Graft in Anterior Cruciate Ligament Reconstruction in a Cadaver Model
Authors: Nurmi Janne T. , Kannus Pekka , Sievänen Harri , Järvinen Markku , Järvinen Teppo L. N.
Published: July 2017

Background

Compaction of the bone tunnel walls has been proposed to increase the fixation strength of soft tissue grafts fixed with an interference screw in anterior cruciate ligament reconstructions.

Hypothesis

Compaction drilling does not increase the initial fixation strength of the hamstring tendon graft in comparison with conventional extraction drilling.

Study Design

Randomized experimental study.

Methods

Initial fixation strength of quadrupled hamstring tendon grafts fixed with bioabsorbable interference screws was assessed in 22 pairs of human cadaveric tibiae. Bone tunnels were drilled with either a compaction drill or a conventional extraction drill. Specimens underwent a cyclic-loading test and the surviving specimens were then loaded to failure in a single-cycle load-to-failure test. Trabecular bone mineral density at the site corresponding to the actual site of the tibial bone tunnel was determined by using peripheral quantitative computed tomography.

Results

During the cyclic-loading test, no significant stiffness or displacement differences were observed between the two drilling techniques. Three specimens failed in the compaction-drilling group, whereas there were no failures in the extraction-drilling group. In the subsequent single-cycle load-to-failure test, no significant differences between the two drilling techniques were found with regard to displacement at yield load, stiffness, or mode of failure. There was no significant difference in trabecular bone mineral density between the two groups.

Conclusions

Compaction drilling does not increase the initial fixation strength of the hamstring tendon graft compared with conventional extraction drilling.
Injuries in a Modern Dance Company
Authors: Bronner Shaw , Ojofeitimi Sheyi , Rose Donald
Published: July 2017

Background

Professional dancers experience high rates of musculoskeletal injuries.

Objective

To analyze the effect of comprehensive management (case management and intervention) on injury incidence, time loss, and patterns of musculoskeletal injury in a modern dance organization.

Study Design

Retrospective/prospective cohort study.

Methods

Injury data were analyzed over a 5-year period, 2 years without intervention and 3 years with intervention, in a modern dance organization (42 dancers). The number of workers’ compensation cases and number of dance days missed because of injury were compared across a 5-year period in a factorial design.

Results

Comprehensive management significantly reduced the annual number of new workers’ compensation cases from a high of 81% to a low of 17% and decreased the number of days lost from work by 60%. The majority of new injuries occurred in younger dancers before the implementation of this program. Most injuries involved overuse of the lower extremity, similar to patterns reported in ballet companies. Benefits of comprehensive management included early and effective management of overuse problems before they became serious injuries and triage to prevent overutilization of medical services.

Conclusions

This comprehensive management program effectively decreased the incidence of new cases and lost time. Both dancers and management strongly support its continuance.
Rates and Risks of Injury during Intercollegiate Basketball
Authors: Meeuwisse Willem H. , Sellmer Rory , Hagel Brent E.
Published: July 2017

Background

Previous studies of basketball injury have not been able to assess injury incidence and risk.

Purpose

To determine rates and risks of injury in Canadian intercollegiate basketball.

Study Design

Prospective cohort study.

Methods

Standardized data were collected with a validated instrument from 98.1% of the 318 athletes on the eight men's basketball teams in the Canada West Division of the Canadian Intercollegiate Athletic Union.

Results

A total of 142 athletes sustained 215 injuries (44.7% of players injured) over the 2-year study period. The greatest number of injuries resulting in more than seven sessions of time loss involved the knee, whereas the most common injuries causing fewer than seven sessions of time loss involved the ankle. The most common mechanism of injury was contact with another player, especially in the “key.” Injuries occurred 3.7 times more often in games than during practice. Centers had the highest rate of injury, followed by guards, and then forwards. The relative risk of reinjury was significantly increased by previous injuries to the elbow, shoulder, knee, hand, lower spine or pelvis, and by concussions.

Conclusions

Risk factors for injury were previous injury, games as opposed to practice, player position, player contact, and court location.
Performance Characteristics of Volleyball Players with Patellar Tendinopathy
Authors: Lian Øystein , Refsnes Per-Egil , Engebretsen Lars , Bahr Roald
Published: July 2017

Background

Patellar tendinopathy is assumed to result from chronic tendon overload. There may be a relationship between tendon pain and jumping ability.

Hypothesis

There is no difference in performance characteristics between volleyball players with patellar tendinopathy and those without.

Study Design

Prospective cohort study.

Method

We examined the performance of the leg extensor apparatus in high-level male volleyball players with patellar tendinopathy (N = 24) compared with a control group (N = 23) without knee symptoms. The testing program consisted of different jump tests with and without added load, and a composite jump score was calculated to reflect overall performance.

Results

The groups were similar in age, height, and playing experience, but the patellar tendinopathy group did more specific strength training and had greater body weight. They scored significantly higher than the control group on the composite jump score (50.3 versus 39.2), and significant differences were also observed for work done in the drop-jump and average force and power in the standing jumps with half- and full-body weight loads.

Conclusions

Greater body weight, more weight training, and better jumping performance may increase susceptibility to patellar tendinopathy in volleyball players.
Humeral Torsion in the Throwing Arm of Handball Players
Authors: Pieper Hans-Gerd
Published: July 2017

Sport-specific upper extremity strain, mostly unilateral, during growth may lead to adaptations in soft tissue and bone. We investigated 51 male professional handball players between 18 and 39 years of age (average, 27 years), 39 right-handed and 12 left-handed. Thirty-eight players had no shoulder problems, and 13 had chronic shoulder pain. Humeral retrotorsion was determined by radiograph. The differences between the throwing and contralateral arms were compared with those of 37 controls who had no history of unilateral strain either through sports or profession. Standard statistical analysis was performed using the t-test. The retrotorsional angle of the humerus in the handball professionals' throwing arm was an average of 9.4° larger in the dominant side than in the nondominant, with a side-to-side difference up to 29°. In the control group, no statistically significant difference was found. In the group without chronic shoulder pain, the side-to-side difference was an average of 14.4° more in the throwing arm than the other side. Players with chronic shoulder pain did not exhibit this increase, even showing an average decrease of humeral retrotorsion of 5.2° in the throwing arm. The humeral retrotorsion increase can be explained as an adaptation to extensive external rotation in throwing practice during growth. Athletes who do not adapt this way seem to have more strain on their anterior capsules at less external rotation and develop chronic shoulder pain because of anterior instability.
Knee Joint Immobilization Decreases Aggrecan Gene Expression in the Meniscus
Authors: Djurasovic Mladen , Aldridge John W. , Grumbles Robert , Rosenwasser Melvin P. , Howell David , Ratcliffe Anthony
Published: July 2017

Aggrecan is the major proteoglycan of the meniscus, and its primary function is to give the meniscus its viscoelastic compressive properties. The objective of this study was to determine the effect of joint immobilization on aggrecan gene expression in the meniscus. The right hindlimbs of six mature beagles were knee cast-immobilized in 90° of flexion and supported by a sling to prevent weightbearing, while the contralateral limb was left free to bear weight. The animals were sacrificed at 4 weeks, and the anterior and posterior halves of the medial and lateral menisci were analyzed separately. Analysis of aggrecan gene expression by quantitative polymerase chain reaction showed decreased aggrecan gene expression in menisci from immobilized knees (P 0.01, two-way analysis of variance). Aggrecan gene expression decreased by a factor of 2 to 5.5 in the different regions examined. Analysis of the composition of the meniscus also showed decreased proteoglycan content and increased water content with immobilization (P 0.05, two-way analysis of variance). These results show that joint immobilization can significantly affect meniscal cellular activity and composition and can therefore potentially affect meniscal function.
Isolated Arthroscopic Meniscal Repair: A Long-Term Outcome Study (More Than 10 Years)
Authors: Johnson Michael J. , Lucas George L. , Dusek Judy K. , Henning Charles E.
Published: July 2017

A single surgeon's consecutive series of 50 arthroscopically repaired meniscal tears in 48 patients was retrospectively reviewed. None of these patients had concomitant ligament damage to the knee. The average follow-up period was 10 years, 9 months. Criteria for clinical success included 1) history of pain of grade 1 or less and absence of locking, catching, or giving way; 2) a physical examination demonstrating no significant effusion and a painless and negative jump sign; and 3) no subsequent surgical procedures on the repaired meniscus. Patient satisfaction was quite high, although clinical confirmation was possible in only 38 knees, indicating a clinical success rate of 76%. Bilateral standing radiographs were obtained on these 38 operated knees and were evaluated using Fairbank's classification. Evaluation of the radiographs revealed that 8% of the operated knees had minimal joint changes, as compared with 3% in the contralateral, nonoperated knee. This study demonstrates that arthroscopic meniscal repair in knees with isolated meniscal tears has the potential for a long-term successful clinical and radiographic outcome.
Concussion in Sports
Authors: Wojtys Edward M. , Hovda David , Landry Greg , Boland Arthur , Lovell Mark , McCrea Michael , Minkoff Jeffrey
Published: July 2017

This is a special report of the findings of the Concussion Workshop, sponsored by the AOSSM in Chicago in December 1997. Here follows a listing of the members of the workshop: Julian Bailes, MD, American Association of Neurological Surgeons; Arthur Boland, MD, AOSSM; Charles Burke III, MD, National Hockey League; Robert Cantu, MD, American College of Sports Medicine; Letha “Etty” Griffin, MD, National Collegiate Athletic Association; David Hovda, PhD, Neuroscientist, UCLA School of Medicine; Mary Lloyd Ireland, MD, American Academy of Orthopaedic Surgeons; James Kelly, MD, American Academy of Neurology; Greg Landry, MD, American Academy of Pediatrics; Mark Lovell, PhD, Neuropsychology Specialist, Henry Ford Health Systems; James Mathews, MD, American College of Emergency Physicians; Michael McCrea, PhD, Neuropsychology Specialist, Waukesha Memorial Hospital; Douglas McKeag, MD, American Medical Society for Sports Medicine; Dennis Miller, ATC, National Athletic Trainers Association; Jeffrey Minkoff, MD, AOSSM; Stephen Papadopoulus, MD, Congress of Neurological Surgeons; Elliott Pellman, MD, National Football League; Richard Quincy, MS, PT, ATC, Sports Physical Therapy, El Pomar Sports Center; Herbert Ross, DO, American Osteopathic Academy of Sports Medicine; Bryan Smith, MD, National Collegiate Athletic Association; and Edward Wojtys, MD, Workshop Chairman, AOSSM.

The views in this report do not necessarily represent the views of the entire group comprising the Concussion Workshop Group.
The Effect of Neuromuscular Training on the Incidence of Knee Injury in Female Athletes
Authors: Hewett Timothy E. , Lindenfeld Thomas N. , Riccobene Jennifer V. , Noyes Frank R.
Published: July 2017

To prospectively evaluate the effect of neuromuscular training on the incidence of knee injury in female athletes, we monitored two groups of female athletes, one trained before sports participation and the other not trained, and a group of untrained male athletes throughout the high school soccer, volleyball, and basketball seasons. Weekly reports included the number of practice and competition exposures and mechanism of injury. There were 14 serious knee injuries in the 1263 athletes tracked through the study. Ten of 463 untrained female athletes sustained serious knee injuries (8 noncontact), 2 of 366 trained female athletes sustained serious knee injuries (0 noncontact), and 2 of 434 male athletes sustained serious knee injuries (1 noncontact). The knee injury incidence per 1000 athlete-exposures was 0.43 in untrained female athletes, 0.12 in trained female athletes, and 0.09 in male athletes (P 0.02, chi-square analysis). Untrained female athletes had a 3.6 times higher incidence of knee injury than trained female athletes (P 0.05) and 4.8 times higher than male athletes (P 0.03). The incidence of knee injury in trained female athletes was not significantly different from that in untrained male athletes (P 0.86). The difference in the incidence of noncontact injuries between the female groups was also significant (P 0.01). This prospective study demonstrated a decreased incidence of knee injury in female athletes after a specific plyometric training program.
Alternatives to Acute Hospital Psychiatric Care in East-End Montreal
Authors: Lesage Alain D , Bonsack Charles , Clerc Do ris , Vanier Claude , Charron Maryse , Sasseville Marc , Luyet André , Gélinas Dan iel
Published: July 2017

Objective:

As pres sure mounts to re duce the number of costly acute care beds, gov ernments and the lit era ture pro pose top- down ra tios. Is this rea son able and fair to the re spon s ible medi cal of fi cers who, as the key care pro vid ers, will need to ad mit pa tients and de velo p dis charge plans in a reduced- beds en vi ron ment?

Method:

Treat ing phy si cians of all acute care in pa tients on a given day ( n = 212) and all new acute care ad mis sions over a 2- week pe riod ( n = 125) com pleted an adapted ver sion of the Not ting ham Acute Beds Use Sur vey (NABUS) Ques tion naire.

Results:

On a given day, only 62 of 212 in pa tients were un suited for any al ter na tive to acute care hos pi tali za tion. A floor ra tio of 18 acute care beds per 100 000 in habi tants seems ade quate for the catch ment area in ques tion, pro vided that al ter na tives to hos pi tali z ation are fully and ef fi ciently avail able. Al ter na tives es sen tially in volve an ar ray of the follow ing: su per vised resi den tial set tings, day hos pi tals, and in ten sive home care (2 to 6 hours weekly). The ra tio of in ten sive home care work ers re quired would be 25 per 100 000 in habi tants.
Analytical Solutions for Bending of Clamped Layered Composite Plates Using a Higher-Order Theory
Authors: Bhatia K. , Chandrashekhara K.
Published: July 2017

Analytical solutions are presented for the bending of clamped laminated plates using a higher-order shear deformation theory. Unlike the first-order shear deformation theory, the higher-order theory does not require a shear correction factor. The displacement field of the higher-order theory contains the same number of dependent variables as in the first-order shear deformation theory, and also accounts for the cubic variation of the in-plane displacements through the thickness. Closed-form solutions are not tractable for clamped composite plates due to the boundary conditions and anisotropy of the plate and hence approximate methods are required. In the present work, a method based on Lagrange multipliers is used to enforce the boundary conditions not satisfied by the assumed series. Results are presented for antisymmetric cross-ply and angle-ply plates to study the influence of anisotropy, aspect ratio, and loadings on the deflections and stresses of clamped plates.
Breast Implants in Cosmetic Surgery: Use of Redon Postsurgery Draining
Authors: Benhamou Franck , Amri Mahrez , Picovski David , Ohana Sydney
Published: July 2017

Introduction:

This study concerns 200 female patients who received 400 breast implants over a period of 12 months between June 2006 and June 2007. In the first group, the surgeon put in some preventive bilateral regular postsurgery Redon drains; the second group did not receive any Redon drains. This study compares the occurrence of postsurgery side effects in both patient groups, particularly the risk of hematoma, infection, and lymphorrhea.

Materials and Methods:

Only patients receiving regular bilateral implants were included in this study. In the first 6 months, we used a Redon draining system, while in the next 6 months, nothing was used. Usual, routine postsurgery surveillance was done on both groups.

Results:

There were no significant differences in the occurrence of postsurgery hematoma, infection, or lymphorrhea in either group.

Conclusion:

Insertion of a postsurgery draining system to prevent hematoma should not be a routine procedure. However, concerning the use of implants inserted through axillary incision without endoscope, the benefits of a preventive draining system should be subject to further discussions. A complementary study in the midterm on the occurrence of capsular contracture also looks necessary.
Cosmetic Otoplasty
Authors: Niamtu Joe
Published: July 2017

Introduction:

Protruding ears are a common occurrence and can affect the aesthetics and psychosocial aspects of patients. Hundreds of procedures have been described over the years, but many do not adequately address the specific problem and can prove unstable.

Materials and Methods:

The author presents a literature review and discusses the demographics, anatomy, and diagnoses related to common protruding ear deformities and describes 2 surgical procedures that have been used to treat more than 100 cases of protruding ears over a 10-year period.

Results:

The Davis procedure for conchal bowl excess and the Mustardé procedure for reconstructing the antihelical fold, which are most often performed in conjunction, have been used to successfully treat protruding ears.

Conclusions:

Although numerous procedures exist for the treatment of protruding ears, some do not adequately address the actual anatomic problem at hand. Some surgeons advocate procedures designed to create an antihelix to treat cartilage excess, which can prove unstable. The Davis and Mustardé procedures address the actual anatomic problems and have proven predictable, safe, effective, and stable in the author's cosmetic facial surgery practice.
Predictive Validity of the Teacher's School Readiness Inventory
Authors: Simner Marvin L.
Published: July 2017

This investigation was undertaken to evaluate the effectiveness of the Teacher's School Readiness Inventory (TSRI), an empirically derived five-item questionnaire, in identifying at-risk or failure-prone preschool children. Four samples totalling 453 children, screened with the TSRI in the spring of either pre-kindergarten or kindergarten, were followed through the end of first grade. The evidence showed, first, that scores on the TSRI produced an average correlation of .58 with the children's performance across the first grade curriculum and, second, that the cutoff points on this inventory correctly identified 73% to 90% of those preschool children whose subsequent work in first grade placed them at or near the bottom of the class while achieving an overall hit rate of 86%.
Characteristics of Students Referred to School Teams: Implications for Preventive Psychological Services
Authors: Cole Ester
Published: July 2017

A total of 274 multidisciplinary staff members in 54 elementary and secondary schools participated in a study that identified the characteristics of students referred to school teams. The results suggested that meetings addressed academic and learning needs more often than emotional or psychological concerns. Implications for the practice of school psychology and the development of team-facilitated prevention programs are discussed.
The Decline of Arrest Clearances for Criminal Homicide: Causes, Correlates, and Third Parties
Authors: Riedel Marc , Jarvis John
Published: July 2017

The percent of offenders arrested for murder in the United States has declined in all reporting cities from 92% in 1960 to 66% in 1997. This paper evaluates three sources of evidence that account for the decline in homicide arrests: police-based programs; changes in the character of homicides; and community and social factors. In the final section we suggest a view of homicide as self-help and explore third party behavior in relation to police cooperation, fear of retaliation, and type of homicide.
Research in progress
Authors: Pilkington Environmental Advisory Service
Published: July 2017

These articles summarize research projects in lighting and related subjects which are presently being investigated at research institutions in the UK and overseas. They have been prepared both to inform research workers of studies being undertaken elsewhere in their own or associated fields of interest and to give to those with a general interest in lighting an appreciation of the trends of current research.
Work Values and Its Impact on Managerial Effectiveness: A Relationship Study in Indian Context
Authors: Rana Geeta , Rastogi Renu , Garg Pooja
Published: July 2017

Competent managers are very important assets to any organization as they drive it to success through the challenges of global competition. Managerial effectiveness has gained much research attention in recent years due to its importance to the organization as a whole. The purpose of this study is to test the impact of work values on managerial effectiveness in Indian organizations. To this end, a survey was conducted on a sample of 300 managers working in different organizations in India. The article employs factor analysis, Pearson’s r and step-wise multiple regression analysis to determine the effect of work values on managerial effectiveness. Findings indicate that work values have a positive and significant relationship with managerial effectiveness. The study provides valuable implications for practitioners and researchers by providing a deep understanding of the relationship between work values and managerial effectiveness, and between the dimensions and aspects of the two constructs. Practitioners could use the findings of the study to identify which work values influence managerial effectiveness most and work towards incorporating those values in the organizational culture.
On Giving Substance to Collective Self-Reliance
Authors: Singh Tarlok
Published: July 2017

The central inspirations of non-alignment were political in nature. Nonaligned countries had sought to be independent of the great powers and of their military alliances and blocs. The concept of peaceful co-existence was designed to leave them free to pursue their own economic and social development. For many years, non-aligned countries thought of development primarily in national terms. Each country, acting alone, found itself in a condition of growing dependence on the richer countries. Therefore, it was natural that after the oil crisis of 1973 and the Declaration of the United Nations on the New International Economic Order, collective self-reliance should begin to be seen as the key element in the economic content of non-alignment.

While non-aligned countries have continued to stress the dominance of politics above economics, they have increasingly acknowledged that their political goals will only be achieved to the extent economic aims are realized equally by individual countries, by groups of countries, and by all of them together. In this process, the distinction between the economic objectives of non-aligned countries and of “developing countries” in general has virtually disappeared and resolutions of the non-aligned countries have stressed their own role, not separately, but together with “other developing countries.” In considering ways of achieving greater collective self-reliance, therefore, the two combinations, described respectively as the Non-aligned Movement and the Group of 77, can be viewed as one, representing the deeply felt need of all less developed countries both for a more equitable international system and for greater economic and technical co-operation amongst themselves.
Did the Ottawa Charter play a role in the push to assess the effectiveness of health promotion?
Authors: Evans Linnea , Hall Mary , Jones Catherine M. , Neiman Andrea
Published: July 2017

The Ottawa Charter contains no explicit mention of the role evidence should play in supporting the development of health promotion, nor is there a discussion on the available methods or recommendations for assessing the effectiveness of health promotion programs and policies. The authors of this paper suggest evidence and effectiveness were not prioritized in the Ottawa Charter, and consequently, attracted little attention during the early development of health promotion practice. This paper reflects upon the various implications of a push to assess the effectiveness of health promotion well after the release of the Ottawa Charter; examines progress in this area since the Ottawa Charter; and challenges the reader to continue on in their own contemplation of remaining challenges ahead, in preparation for the 19th IUHPE World Conference, of which “assessing health promotion effectiveness” is one of the key themes. (Promotion & Education, 2007, Supplement (2): pp 28-30).