bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiofrequency Thermal Effects on the Human Meniscus: An in Vitro Study of Systems with Monopolar and Bipolar Electrodes
Authors: Vangsness C. Thomas , Polousky John D. , Parkinson Andrew B. , Hedman Thomas P. 
Published: July 2017

Background: No data exist on the cutting efficiency of monopolar versus bipolar radiofrequency energy application systems on human meniscal tissue. Purpose: To compare the effects of monopolar and bipolar thermal energy systems on human meniscal tissue. Study Design: Controlled laboratory study. Methods: Fresh-frozen menisci were cut in cross-section into 180 pie-shaped specimens. A specially designed jig was used to consistently apply radiofrequency energy to the tissue under a constant 30-g force. Three different systems were tested at the low, middle, and high ranges, with application times of 1 and 3 seconds. Thermal effects were measured by image analysis microscopy. Results: No significant differences in thermal effects were found with respect to energy output for each system. Both the individual system tested and the application time had statistically significant effects on thermal damage, with the individual system tested having a greater effect. The mean depths of thermal change produced by the Mitek (bipolar) device were 564 and 648 μm at 1 and 3 seconds applications, respectively. The Arthrocare device (bipolar) produced depths of 1444 and 1697 μm at 1 and 3 seconds. The Oratec device (monopolar) produced depths of 895 and 1057 μm, respectively. Conclusions: A differential thermal effect was created in the meniscal tissue by three commercially available radiofrequency systems. Within the parameters of the experiment, all three systems limited thermal damage to a depth of less than 2 mm. The results appeared to depend more on the particular system used, not whether it had monopolar or bipolar electrodes. Clinical Relevance: These data imply reasonably safe (less than 2 mm) thermal changes in the meniscus after radiofrequency energy application from these three systems.
Acute Grade III Medial Collateral Ligament Injury of the Knee Associated with Anterior Cruciate Ligament Tear: The Usefulness of Magnetic Resonance Imaging in Determining a Treatment Regimen
Authors: Nakamura Norimasa , Horibe Shuji , Toritsuka Yukiyoshi , Mitsuoka Tomoki , Yoshikawa Hideki , Shino Konsei 
Published: July 2017

Background: The appropriate management of acute grade III medial collateral ligament injury when it is combined with a torn anterior cruciate ligament has not been determined. Hypothesis: Magnetic resonance imaging grading of grade III medial collateral ligament injury in patients who also have anterior cruciate ligament injury correlates with the outcome of their nonoperative treatment. Study Design: Prospective cohort study. Methods: Seventeen patients were first treated nonoperatively with bracing. Eleven patients with restored valgus stability received anterior cruciate ligament reconstruction only, and six with residual valgus laxity also received medial collateral ligament surgery. Results: Magnetic resonance imaging depicted complete disruption of the superficial layer of the medial collateral ligament in all 17 patients and disruption of the deep layer in 14. Restoration of valgus stability was significantly correlated with the location of superficial fiber damage. Damage was evident over the whole length of the superficial layer in five patients, and all five patients had residual valgus laxity despite bracing. Both groups had good-to-excellent results 5 years later. Conclusions: Location of injury in the superficial layer may be useful in predicting the outcome of nonoperative treatment for acute grade III medial collateral ligament lesions combined with anterior cruciate ligament injury.
Risk Factors for Injury in Middle School Football Players
Authors: Turbeville Sean D. , Cowan Linda D. , Asal Nabih R. , Owen Willis L. , Anderson Mark A. 
Published: July 2017

Background: Little is known about the frequency of or risk factors for injuries in middle school or junior high school football players. Purpose: To examine the associations of player characteristics (injury history, conditioning, player position, special equipment) and physical parameters (body mass index, weight, height, grip strength) with risk of injury. Study Design: Prospective cohort study. Methods: We documented risk factors for injury in 646 middle school football players, 10 to 15 years of age, in the Oklahoma City, Oklahoma, school district during the 1998 and 1999 seasons. Player characteristics and physical parameters were measured at the beginning of both seasons. Logistic regression methods were used to determine whether baseline variables were associated with the odds of subsequent injury. Results: More playing experience was the only variable significantly associated with the risk of injury in multivariate analyses. This association was observed regardless of the type of injury and even after indirectly controlling for time at risk of injury by restricting analyses to first-string players. Increasing age was significantly associated with the risk of fractures. Conclusions: Results suggest that physical characteristics play a minor role in risk of injury from football in this age group.
Repair of Pars Interarticularis Defect by Segmental Wire Fixation in Young Athletes with Spondylolysis
Authors: Nozawa Satoshi , Shimizu Katsuji , Miyamoto Kei , Tanaka Mizuo 
Published: July 2017

Background Although segmental wire fixation has been successful in the treatment of nonathletes with spondylolysis, no information exists on the results of this type of surgery in athletes. Purpose To evaluate the outcome of surgical repair of pars interarticularis defect by segmental wire fixation in young athletes with lumbar spondylolysis. Methods Between 1993 and 2000, 20 athletes (6 women and 14 men; average age, 23.7) with lumbar spondylolysis were treated surgically with this technique. They were actively engaged in sports such as baseball, tennis, and golf. Nineteen athletes had one level of spondylolysis and one athlete had two levels. The level of spondylolysis was L4 in 2 athletes and L5 in 19. The average follow-up period was 3.5 years (range, 1.3 to 8.6). Surgical outcome was evaluated by radiographic examination, the Japanese Orthopaedic Association score, preoperative and postoperative sports activity levels and intensities, and the presence of complications. Results Bony fusion at the site of spondylolysis was obtained in all cases, and the Japanese Orthopaedic Association score was increased significantly after surgery (preoperatively, 21.2 ± 3.9; postoperatively, maximum 27.7 ± 1.0; recovery rate, 80.4%). All of the patients returned to their sports activities, although at varying degrees. No severe complications were noted. Conclusion We recommend this technique in cases of lumbar spondylolysis in athletes who hope to resume their sports activities.
Tibial Eminence Fractures in Children: Prevalence of Meniscal Entrapment
Authors: Kocher Mininder S. , Micheli Lyle J. , Gerbino Peter , Hresko M. Timothy 
Published: July 2017

Background Meniscal entrapment under a displaced tibial eminence fragment may be a rationale for arthroscopic or open reduction in type 2 and 3 tibial eminence fractures. Purpose To determine the prevalence of meniscal entrapment in children with type 2 and 3 tibial eminence fractures. Study Design Case series. Methods Records of a consecutive series of 80 skeletally immature patients (mean age, 11.6 years; range, 5 to 16) who underwent arthroscopic (71), open (5), or combined arthroscopic and open (4) reduction and internal fixation of type 3 tibial eminence fractures (57) or type 2 fractures that did not reduce in extension (23) from 1993 to 2001 were reviewed. Results Entrapment of the anterior horn of the medial meniscus (36), intermeniscal ligament (6), or anterior horn of the lateral meniscus (1) was seen in 26% (6 of 23) of type 2 fractures and 65% (37 of 57) of type 3 fractures. An associated meniscal tear was seen in 3.8% of patients (3 of 80). Conclusions Meniscal entrapment is common in patients with type 2 and 3 tibial eminence fractures. Arthroscopic or open reduction should be considered for type 3 fractures and for type 2 fractures that do not reduce in extension to remove the incarcerated meniscus, allowing for anatomic reduction.
Influence of the Femoral Tunnel Location and Angle on the Contact Pressure in the Femoral Tunnel in Anterior Cruciate Ligament Reconstruction
Authors: Segawa Hiroyuki , Koga Yoshio , Omori Go , Sakamoto Makoto , Hara Toshiaki 
Published: July 2017

Background The causes of bone tunnel enlargement after anterior cruciate ligament reconstruction have not been thoroughly investigated. Hypothesis A malpositioned femoral tunnel and an acute femoral tunnel angle may increase the mechanical stress in the femoral tunnel. Study Design Controlled laboratory study. Methods Three femoral tunnels (normal, anterior, and acute) and the tibial tunnel were made in four fresh-frozen cadaveric knees. Aluminum cylinders containing pressure-sensitive conductive rubber sensors at the joint entrance were inserted into the femoral tunnels. Dynamic changes in the contact pressure of the graft in the femoral tunnel were measured. Results Peak contact pressures and dynamic changes in contact pressure for the normal and anterior femoral tunnels demonstrated no differences. Maximum contact pressure of the graft was observed at the anterior portion with the knee in full extension and at the posterior portion with deep knee flexion. Consistent contact pressure occurred at the anterior aspect of the acute femoral tunnel throughout the range of motion. Mean contact pressure at the anterior region of the acute femoral tunnel was significantly higher than that of the normal femoral tunnel at 60°, 90°, and 120° of knee flexion. Conclusions The consistent contact pressure in the anterior aspect of the acute femoral tunnel may erode the anterior portion of the femoral tunnel, resulting in bone tunnel enlargement. Clinical Relevance The femoral tunnel direction in anterior cruciate ligament reconstruction is an important factor in reducing femoral tunnel enlargement.
Differences in Kinematics and Electromyographic Activity between Men and Women during the Single-Legged Squat
Authors: Zeller Brian L. , McCrory Jean L. , Ben Kibler W. , Uhl Timothy L. 
Published: July 2017

Background Numerous factors have been identified as potentially increasing the risk of anterior cruciate ligament injury in the female athlete. However, differences between the sexes in lower extremity coordination, particularly hip control, are only minimally understood. Hypothesis There is no difference in kinematic or electromyographic data during the single-legged squat between men and women. Study Design Descriptive comparison study. Methods We kinematically and electromyographically analyzed the single-legged squat in 18 intercollegiate athletes (9 male, 9 female). Subjects performed five single-legged squats on their dominant leg, lowering themselves as far as possible and then returning to a standing position without losing balance. Results Women demonstrated significantly more ankle dorsiflexion, ankle pronation, hip adduction, hip flexion, hip external rotation, and less trunk lateral flexion than men. These factors were associated with a decreased ability of the women to maintain a varus knee position during the squat as compared with the men. Analysis of all eight tested muscles demonstrated that women had greater muscle activation compared with men. When each muscle was analyzed separately, the rectus femoris muscle activation was found to be statistically greater in women in both the area under the linear envelope and maximal activation data. Conclusions Under a physiologic load in a position commonly assumed in sports, women tend to position their entire lower extremity and activate muscles in a manner that could increase strain on the anterior cruciate ligament.
Catastrophic Cheerleading Injuries
Authors: Boden Barry P. , Tacchetti Robin , Mueller Frederick O. 
Published: July 2017

Background: There are few epidemiologic studies of cheerleading injuries. Purpose: To develop a profile of catastrophic injuries in cheerleading and to describe relevant risk factors. Study Design: Retrospective cohort study. Methods: We reviewed 29 of 39 incidents of cheerleading injuries reported to the National Center for Catastrophic Sports Injury Research from 1982 to 2002. Results: Twenty-seven of the injured cheerleaders were women. There were 1.95 direct catastrophic injuries per year or 0.6 injuries per 100,000 participants. The rate of injuries among college cheerleaders was five times that of high school participants. The most common stunts performed at the time of injury were a pyramid (9) or a basket toss (8). Catastrophic injuries included 17 severe head injuries, resulting in 13 skull fractures and 2 deaths; 8 cervical fractures or major ligament injuries; 3 spinal cord contusions; and 1 concomitant head injury and cervical fracture. Conclusions: Suggestions for reducing catastrophic injuries in cheerleaders include enhancing the number and training of spotters, mandating floor mats for complex stunts, restricting complex stunts when surfaces are wet, and encouraging safety certification of coaches. Pyramids and basket tosses should be limited to experienced cheerleaders who have mastered all other skills and should be performed with spotters and landing mats.
Prospective Comparison of Arthroscopic Medial Meniscal Repair Technique
Authors: Spindler Kurt P. , McCarty Eric C. , Warren Todd A. , Devin Clinton , Connor Jason T. 
Published: July 2017

Background: Medial meniscal repairs are commonly performed with inside-out sutures and entirely arthroscopic with arrows, but few comparative evaluations on failures have been performed. Hypothesis: No differences in failure rates exist between medial meniscal repairs performed with inside-out suture or entirely arthroscopic at the time of anterior cruciate ligament reconstruction. Study Design: Prospective cohort study. Materials: A single surgeon performed 47 consecutive inside-out suture repairs from August 1991 to June 1996 and 98 consecutive entirely arthroscopic repairs with arrows from June 1996 to December 1999. All data were derived from a prospective database and rehabilitation was held constant (nonweightbearing 5 weeks). Clinical success was defined as no reoperation for failed medial meniscal repair. Statistical evaluation was by Kaplan-Meier curves and Cox proportional hazards model. Results: The inside-out suture group had 85% follow-up (40 of 47) with a median 68 months and the entirely arthroscopic group had 87% follow-up (85 of 98) with a median 27 months. There were seven failures in each group. Both Kaplan-Meier curves and the Cox proportional hazards model showed no difference in time to reoperation between techniques (P = 0.85). Three-year success rates (proportions with no reoperations) were 88% for sutures versus 89% for arrows. Conclusions: Repairs of the longitudinal posterior horn of the medial meniscus during an anterior cruciate ligament reconstruction with nonweightbearing for 5 weeks can be performed with an equivalent high degree of clinical success for both repair techniques.
Diagnostic and Prognostic Value of Clinical Findings in 83 Athletes with Posterior Thigh Injury
Authors: Verrall Geoffrey M. , Slavotinek John P. , Barnes Peter G. , Fon Gerald T. 
Published: July 2017

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. Methods For two playing seasons, the clinical features of posterior thigh injury, timing of injury, and playing days lost were recorded for Australian Rules football players. Magnetic resonance imaging was used to confirm hamstring muscle injury. Results Posterior thigh injuries associated with pain and tenderness were recorded for 83 players, with magnetic resonance imaging confirming hamstring injury in 68 (82%). Most of the hamstring injuries were sudden onset (62; 91%) and occurred after a significant warm-up period (57; 84%). Of the patients whose injuries were sudden onset and occurred after the warm-up period (N = 59), 57 (97%) had hamstring muscle strain detected on magnetic resonance imaging. Hamstring muscle injury confirmed by magnetic resonance imaging was associated with a longer absence from competition (mean, 27 days) than injuries where no hamstring injury was detected (mean, 16 days). Conclusions The clinical features of hamstring injury typically include sudden onset, pain, and tenderness, although exceptions do occur. Muscle fatigue may be important in the pathogenesis of hamstring injury.
Theory and practice in the context of health promotion program evaluation
Authors: Lobato Tavares Maria da Fátima , Santos Barros Cláudia Márcia , Baumgarten Marcondes Willer , Bodstein Regina , Cynamon Cohen Simone , Cynamon Kligerman Debora , Comarú Francisco , Santos Silva Carlos , Bógus Cláudia Maria , da Rocha Rosa Maria , Moraes de Mello Alexandre , Adesse Leila , Edmundo Katia , Mendes Rosilda 
Published: July 2017

Evaluation of health promotion (HP) actions is a major challenge, generating inquiries and reflections that can contribute on the effectiveness of the actions themselves. With the aim on fostering exchange on monitoring and evaluation experiences related to the implementation of healthy settings, the 1st Brazilian Seminar on Health Promotion Effectiveness was launched in 2005. The program included round table and workshops known as Working Groups (WG) in Brazil. The criteria used to constitute the workshops focused settings as spaces of circulation and living as an intrinsic connection to lifestyles and conditions, as well as to social and/or environmental risk factors associated with groups living in these settings day after day. Focusing on evaluation as an activity that generates knowledge, this article highlights and stimulates the discussion about some major issues arising from the theoretical-methodological approach and the discussions developed in the workshops. The debates carried out during the Seminar illustrated the different perceptions and views of the social players involved in implementation and evaluation of HP practices, disclosing a multiplicity of meanings. It became clear that procedures are needed to document a future maturation of concepts and methods, in combination with further in-depth theoretical discussion. (Promotion & Education, 2007, Supplement (1): pp 27-30)
Cardiomyopathy Associated with Clozapine
Authors: Leo Raphael J , Kreeger Joy L , Kim Kye Y , Dalmady-Israel Christina , Mailhot Claude 
Published: July 2017

Objective To report a case of symptomatic cardiomyopathy induced during treatment with clozapine, an antipsychotic of the dibenzodiazepine class. Case Summary A patient with a long psychiatric history significant for schizophrenia and no prior cardiac history developed dyspnea, malaise, and edema with a low ventricular ejection fraction during clozapine therapy. Discussion The literature concerning cardiorespiratory complications with clozapine therapy is reviewed. Conclusions Cardiorespiratory complications associated with clozapine use are rare. Caution may be warranted in patients treated with other medications, such as benzodiazepines, and in patients with underlying cardiac disease.
Plasma Concentrations of Diltiazem and Desacetyldiltiazem in an Overdose Situation
Authors: Williamson Kristin M , Dunham Gary D , De Bittner Magaly Rodriguez , Gagnon Louise 
Published: July 2017

Objective To describe the elimination of diltiazem and desacetyldiltiazem in an overdose situation. Case Summary An 18-year-old woman ingested controlled delivery diltiazem 14.94 g in a suicide attempt. After arriving at the hospital unresponsive and hypotensive, her condition progressed to complete heart block, cardiogenic shock, asystole, and acute renal failure. Supportive care consisted of vasopressors, intravenous calcium, intravenous glucagon, charcoal hemoperfusion, temporary transvenous pacing, and an intraaortic balloon pump. After 12 days in the hospital, the patient recovered fully. Discussion We report a large, documented overdose of diltiazem and detail the pharmacokinetic profiles of both diltiazem and its active metabolite, desacetyldiltiazem. Nonlinear elimination of diltiazem appears to occur at higher concentrations. Although the patient improved clinically following charcoal hemoperfusion, no dramatic effects on diltiazem elimination were apparent. Conclusions Survival following massive diltiazem overdose can be achieved with supportive care. Charcoal hemoperfusion had a limited effect on improving the clearance of diltiazem as evidenced by serial plasma concentrations.
Vancomycin Resistance: When Failure Becomes an Opportunity for Leadership
Authors: Edmiston Charles E 
Published: July 2017

Objective To discuss the emergence of the enterococci as significant nosocomial pathogens and reports of glycopeptide resistance as demonstrating the failure of healthcare professionals to limit the clinical impact of these organisms. Background The enterococci have long occupied a peculiar position in medical and surgical patients. A component of the normal gastrointestinal tract, these organisms exhibit little overt pathogenicity in healthy hosts, but are frequently recovered in patients with severe debilitative or immunosuppresive disorders. While the enterococci have always demonstrated intrinsic resistance to a broad range of antiinfective agents, recent findings of moderate to high-level glycopeptide resistance potentially threaten the limited therapeutic options for methicillin-resistant gram-positive cocci. Findings The emergence and dissemination of vancomycin-resistant enterococci are signs of much greater problems, which include incomplete success of formulary controls, unreliable detection and identification of resistant microorganisms within the hospital environment, and poor fundamental infection control practices by all healthcare professionals. Conclusions The Hospital Infection Control Practices Advisory Committee Recommendations for the Prevention and Spread of Vancomycin Resistance are an important step in resolving these issues through the elements of collegiality and shared leadership.
The Development and Validation of an Objective Method for Quantifying Hyperactivity in Children
Authors: Joost Michael G. , Salvendy Gavriel 
Published: July 2017

It has been estimated that about 10 percent of all boys aged six to twelve years are hyperactive. Often, hyperactivity is associated with learning disabilities. Despite the apparent magnitude of this problem, no valid objective and reliable measures are available to quantify hyperactivity in children. This study discusses how objective measures, using sinus arrhythmia and force platform scores were developed and validated on 30 boys (15 hyperactive and 15 non-hyperactive) aged seven to twelve years. The results indicate that, when the above objective measures were used, 77 percent of all subjects were classified into their correct groups.