bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Clinical Characteristics of Osteochondritis Dissecans of the Humeral Capitellum Among Adolescent Baseball Players
Authors: Kida Yoshikazu , Morihara Toru , Kotoura Yoshihiro , Hojo Tatsuya , Tachiiri Hisakazu , Sukenari Tsuyoshi , Iwata Yoshio , Furukawa Ryuhei , Oda Ryo , Arai Yuji , Fujiwara Hiroyoshi , Kubo Toshikazu , Matsui Tomoyuki , Azuma Yoshikazu , Seo Kazuya , Hiramoto Machiko 
Published: June 2014

Background: The prevalence and clinical characteristics of osteochondritis dissecans (OCD) of the humeral capitellum among adolescent baseball players are unknown. Purpose: To determine the OCD prevalence in adolescent competitive baseball players and to investigate the clinical characteristics of these patients. Study Design: Cross-sectional and case-control study; Level of evidence, 3. Methods: A total of 2433 baseball players (mean age, 14.5 ± 1.5 years) belonging to junior high school and high school baseball clubs were enrolled. Players completed a questionnaire, and the elbow of each player’s throwing arm was assessed by ultrasonography. Participants with abnormal results on ultrasonography were further examined through radiographic study. The OCD lesions were classified into stages based on radiographic results, and demographic data were compared between players with and without OCD lesions. Results: Osteochondritis dissecans of the humeral capitellum was found in 82 (3.4%) elbows by ultrasonography. Players with an OCD lesion began playing baseball at an earlier age ( P = .016), had a longer duration of competitive play ( P = .0013), and had experienced more present ( P = .0025) and past ( P < .0001) elbow pain compared with players without a lesion. There were no differences between the 2 groups in the position played ( P = .26). Sixty-eight patients underwent further radiographic examination for OCD (radiography, computed tomography, magnetic resonance imaging). Of these players, 10 (14.7%) were classified as having stage I OCD (radiolucent stage); 26 (38.2%), stage II (fragmentation stage); 9 (13.2%), stage III (loose body stage); 9 (13.2%), stage IV (residual stage); and 14 (23.5%), stage V (postoperative stage). Conclusion: The prevalence of OCD of the humeral capitellum, including latent cases, was 3.4% among adolescent baseball players. Players with OCD lesions began playing baseball at earlier ages, had played for longer periods, and had experienced more elbow pain. The player’s current baseball position may not be related to the existence of OCD lesions in adolescents.
Improper Trunk Rotation Sequence Is Associated With Increased Maximal Shoulder External Rotation Angle and Shoulder Joint Force in High School Baseball Pitchers
Authors: Oyama Sakiko , Yu Bing , Blackburn J. Troy , Padua Darin A. , Li Li , Myers Joseph B. 
Published: June 2014

Background: In a properly coordinated throwing motion, peak pelvic rotation velocity is reached before peak upper torso rotation velocity, so that angular momentum can be transferred effectively from the proximal (pelvis) to distal (upper torso) segment. However, the effects of trunk rotation sequence on pitching biomechanics and performance have not been investigated. Purpose: The aim of this study was to investigate the effects of trunk rotation sequence on ball speed and on upper extremity biomechanics that are linked to injuries in high school baseball pitchers. The hypothesis was that pitchers with improper trunk rotation sequence would demonstrate lower ball velocity and greater stress to the joint. Study Design: Descriptive laboratory study. Methods: Three-dimensional pitching kinematics data were captured from 72 high school pitchers. Subjects were considered to have proper or improper trunk rotation sequences when the peak pelvic rotation velocity was reached either before or after the peak upper torso rotation velocity beyond the margin of error (±3.7% of the time from stride-foot contact to ball release). Maximal shoulder external rotation angle, elbow extension angle at ball release, peak shoulder proximal force, shoulder internal rotation moment, and elbow varus moment were compared between groups using independent t tests (α < 0.05). Results: Pitchers with improper trunk rotation sequences (n = 33) demonstrated greater maximal shoulder external rotation angle (mean difference, 7.2° ± 2.9°, P = .016) and greater shoulder proximal force (mean difference, 9.2% ± 3.9% body weight, P = .021) compared with those with proper trunk rotation sequences (n = 22). No other variables differed significantly different between groups. Conclusion: High school baseball pitchers who demonstrated improper trunk rotation sequences demonstrated greater maximal shoulder external rotation angle and shoulder proximal force compared with pitchers with proper trunk rotation sequences. Clinical Relevance: Improper sequencing of the trunk and torso alter upper extremity joint loading in ways that may influence injury risk. As such, exercises that reinforce the use of a proper trunk rotation sequence during the pitching motion may reduce the stress placed on the structures around the shoulder joint and lead to the prevention of injuries.
Deficits in Glenohumeral Passive Range of Motion Increase Risk of Elbow Injury in Professional Baseball Pitchers
Authors: Wilk Kevin E. , Macrina Leonard C. , Fleisig Glenn S. , Aune Kyle T. , Porterfield Ron A. , Harker Paul , Evans Timothy J. , Andrews James R. 
Published: June 2014

Background: Injuries to the elbow joint in baseball pitchers appear common. There appears to be a correlation between shoulder range of motion and elbow injuries. Purpose: To prospectively determine whether decreased ROM of the throwing shoulder is correlated with the onset of elbow injuries in professional baseball pitchers. Study Design: Cohort study; Level of evidence, 2. Methods: For 8 consecutive years (2005-2012), passive range of motion of both the throwing and nonthrowing shoulders of all major and minor league pitchers within a single professional baseball organization were measured by using a bubble goniometer during spring training. In total, 505 examinations were conducted on 296 pitchers. Glenohumeral external rotation and internal rotation were assessed in the supine position with the arm at 90° of abduction and in the plane of the scapula. The scapula was stabilized per methods previously established. Total rotation was defined as the sum of external rotation and internal rotation. Passive shoulder flexion was assessed with the subject supine and the scapula stabilized per methods previously established. Elbow injuries and days missed because of elbow injuries were assessed and recorded by the medical staff of the team. Throwing and nonthrowing shoulder measurements were compared by using Student t tests; 1-tailed Fisher exact tests were performed to identify significant associations between shoulder motion and elbow injury. Nominal logistic regression was performed to determine the odds of elbow injury. Results: Significant differences were noted during side-to-side comparisons within subjects. There were 49 elbow injuries and 8 surgeries in 38 players, accounting for a total of 2551 days missed. Neither glenohumeral internal rotation deficit nor external rotation insufficiency was correlated with elbow injuries. Pitchers with deficits of >5° in total rotation in their throwing shoulders had a 2.6 times greater risk for injury. Pitchers with deficit of ≥5° in flexion of the throwing shoulder had a 2.8 times greater risk for injury. Conclusion: Bilateral differences in shoulder total rotation and flexion had a significant effect on the risk for elbow injuries in pitchers. Clinicians need to be aware of these findings and plan preventive programs that address these issues in hopes of reducing elbow injuries.
Poor sleep quality in systemic lupus erythematosus: does it depend on depressive symptoms?
Authors: Palagini L , Tani C , Bruno R M , Gemignani A , Mauri M , Bombardieri S , Riemann D , Mosca M 
Published: June 2014

Objectives Sleep disturbances are frequently observed in rheumatic diseases including systemic lupus erythematosus (SLE). This study aimed at evaluating the prevalence of insomnia, poor sleep quality and their determinants in a cohort of SLE patients. Methods Eighty-one consecutive SLE female patients were evaluated in a cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Beck Depression Inventory (BDI) and the Self-rating Anxiety Scale (SAS) were administered. Patients with previous diagnosis of obstructive sleep apnea or restless legs syndrome were excluded. Fifty-three women with hypertension (without SLE) were enrolled as control group (H). Results In the SLE cohort poor sleep quality (65.4% vs 39.6%, p < 0.01) and difficulty in maintaining sleep and/or early morning awakening (65.4% vs 22.6%, p < 0.001), but not insomnia (33.3% vs 22.6%, p = ns), were more prevalent than in H. Depressive symptoms were present in 34.6% of SLE vs 13.2% H patients ( p < 0.001) while state anxiety was more common in H patients (H 35.8% vs SLE 17.3%, p < 0.005). SLE was associated with a 2.5-times higher probability of presenting poor sleep quality in comparison to H (OR 2.5 [CI 1.21–5.16]). After adjusting for confounders, both depressive symptoms (OR 4.4, [1.4–14.3]) and use of immunosuppressive drugs (OR 4.3 [CI 1.3–14.8]) were significantly associated with poor sleep quality in SLE patients. Furthermore, poor sleep quality was not associated either with disease duration or activity. Conclusions In a cohort of SLE women, insomnia and poor sleep quality, especially difficulties in maintaining sleep, were common. Depressive symptoms might be responsible for the higher prevalence of poor sleep quality in SLE.
Evaluation of Posterior Malleolar Fractures and the Posterior Pilon Variant in Operatively Treated Ankle Fractures
Authors: Switaj Paul J. , Weatherford Brian , Fuchs Daniel , Rosenthal Brett , Pang Eric , Kadakia Anish R. 
Published: June 2014

Background: Substantial attention has recently been placed on fractures of the posterior malleolus. Fracture extension to the posteromedial rim (“posterior pilon variant”) may result in articular incongruity and talar subluxation. Current classification systems fail to account for these fractures. The relative frequency of this fracture, its associated patient characteristics, and the reliability of its diagnosis have never been reported in such a large series. Methods: We retrospectively identified 270 patients who met our inclusion criteria. Basic demographic data were collected. The fractures were classified according to Lauge-Hansen and AO/OTA. Additional radiographic data included whether the fracture involved the posterior malleolus and whether the fracture represented a posterior pilon variant. Univariate statistical methods, chi-square analysis, and interobserver reliability were assessed. Results: The relative frequency of posterior malleolus fracture was 50%. The relative frequency of the posterior pilon variant was 20%. No significant difference was noted with respect to the frequency of posterior malleolar or posterior pilon variant between the subgroups of the AO/OTA and Lauge-Hansen classification systems when compared to the overall fracture distribution. Patients with posterior malleolar fractures and posterior pilon variants were significantly older. Females were significantly more likely than men to sustain posterior malleolar fractures and posterior pilon variants. Patients with diabetes trended toward a greater risk of both types of fractures. Interobserver reliability data revealed substantial agreement for posterior malleolar fractures and posterior pilon variants. Conclusion: These data represent the highest reported rate of posterior malleolar involvement in operatively treated ankle fractures and is the first to describe the percentage of the posterior pilon variant in such a large series. The interobserver reliability data demonstrate substantial agreement in identification of posterior malleolar fractures and the posterior pilon variant based on plain radiographs. Certain patient characteristics such as age, sex, and diabetes may be associated with these fractures. Level of Evidence: Level III, retrospective cohort study.
Difference in Postural Control Between Patients With Functional and Mechanical Ankle Instability
Authors: Chen Henry , Li Hong-Yun , Zhang Jian , Hua Ying-Hui , Chen Shi-Yi 
Published: June 2014

Background: Lateral ankle sprain is one of the most common injuries. Since the structural and pathological differences in mechanical ankle instability (MAI) and functional ankle instability (FAI) may not be the same, it may be better to treat these as separate groups. The purpose of this study was to compare the difference in postural sway between MAI and FAI in patients with chronic ankle instability (CAI). Methods: Twenty-six patients with CAI and 14 healthy control participants were included in the study. The CAI patients were subdivided into MAI (15 patients) and FAI (11 patients) groups. Patients who were diagnosed with lateral ankle ligaments rupture by magnetic resonance imaging and ultrasonography were assigned to the MAI group. All participants performed single-limb postural sway tests 3 times on each leg with eyes closed and open. The average distances from the mean center of pressure position in the mediolateral and anteroposterior directions were recorded and compared among the 3 groups. Results: The unstable ankles in the MAI group showed significantly greater postural sway in the anterior, posterior, and medial directions compared with those in the control group with eyes closed. With eyes open, significantly greater postural sway was found in the anterior direction. In the FAI group, no difference was found in postural sway compared with those in the control group. The MAI group showed significantly greater postural sway in the anterior direction compared with the FAI group with eyes closed and open. No significant difference in postural sway was found between the unstable and stable ankles in the MAI or FAI groups, with or without vision. Conclusions: Patients with MAI have deficits in postural control, especially in anterior-posterior directions. However, no difference was found in postural sway in patients with FAI compared with healthy people. Clinical Relevance: As MAI patients suffer from deficits in postural control, balance training should be applied in those patients. In addition, special training should also include the contralateral side after a unilateral ankle ligament injured.
The Influence of Concomitant Triceps Surae Lengthening at the Time of Total Ankle Arthroplasty on Postoperative Outcomes
Authors: Queen Robin M. , Grier A. Jordan , Butler Robert J. , Nunley James A. , Easley Mark E. , Adams Samuel B. , DeOrio James K. 
Published: June 2014

Background: Concomitant procedures are being performed with total ankle replacement (TAR) to improve alignment, function, and mobility. The purpose of this study was to examine the differences in outcomes between patients who had a concomitant triceps surae lengthening (gastrocnemius recession [GSR] or triple hemisection [TAL]) versus a group that underwent TAR alone preoperatively and 1 year after TAR. Methods: For this prospective, nonrandomized study, 229 patients (37 GSR, 22 TAL, and 170 TAR alone) were examined. Patient-reported outcomes, physical performance, and lower extremity gait mechanics were completed preoperatively and 1 year postoperatively. A series of repeated measures ANOVAs were used to determine significant differences ( P < .05), and Tukey’s post hoc testing was used to follow any significant ANOVA results. Results: No difference existed in BMI, age, gender, or dorsiflexion (DF) angle at heel strike between the triceps surae lengthening groups or between preoperative and 1 year following TAR. Walking speed, the physical performance measures, the AOFAS Hindfoot Score, SF-36, peak plantar flexion angle, and the peak plantar flexion moment were significantly improved ( P < .001) postoperatively with no differences between the triceps surae lengthening groups. The peak DF angle ( P = .006) and the ankle range of motion ( P = .014) demonstrated a greater improvement from preoperative to 1 year postoperatively in the triceps surae lengthening groups in comparison to the TAR alone group. Conclusion: Significant improvements existed between preoperative and 1 year postoperatively for most of the variables of interest independent of the triceps surae lengthening group. This study demonstrated that the use of a concomitant triceps surae lengthening procedure (GSR or TAL) resulted in equivalent outcomes when compared with a group undergoing TAR alone. Level of Evidence: Level II, prospective comparative study.
The aetiology of acute neurological decline in multiple sclerosis: Experience from an open-access clinic
Authors: Tallantyre Emma C , Causon Emmie G , Harding Katharine E , Pickersgill Trevor P , Robertson Neil P 
Published: June 2014

Background: Multiple sclerosis (MS) relapses contribute to disability and influence treatment decisions. Many centres now provide open access to specialist services for patients with new symptoms. However, there is scarce literature on the spectrum of presentations encountered in this setting. Objective: The objective of this paper is to characterise presentations to an open, rapid-access MS relapse clinic and the impact on disease management. Methods: A retrospective review of outpatient episodes over a three-year period was conducted. Demographic and service data, symptoms, disability, diagnosis and management were recorded according to a standardised proforma. Results: A total of 371 attendances were analysed. A new MS relapse was diagnosed in 216 (58%) episodes, of which 56 (26%) patients had an additional diagnosis which had also contributed to their presentation. Of 266 reports of non-relapse-related symptoms, 73 were unrelated to MS. Treatment interventions were made in almost all relapsing patients and in 70% of patients presenting with acute, non-relapse-related symptoms of MS. Changes to disease-modifying therapies were considered in 28% of consultations. Conclusion: Diagnosing MS relapses is crucial for disease management and yet remains challenging. Clinicians should be aware of differential diagnoses and confounding factors. The high incidence of therapeutic interventions observed suggests that rapid-access clinics represent an effective platform for responsive disease management.
Child maltreatment in Japan
Authors: Kadonaga Tomoko , Fraser Mark W 
Published: June 2014

Summary Over the past 15 years, the number of child maltreatment incidents reported to Child Guidance Centers in Japan has increased more than three fold. Reviewing a wide range of policy white-papers and research reports in Japan, we discuss the prevalence of child maltreatment, its social construction over time, societal factors contributing to child maltreatment, and the development and design of the Japanese child welfare system. We conclude with a discussion of emerging issues and challenges. Findings A variety of risk factors exacerbate maltreatment in Japan. These include the decline of extended familial supports, low paternal involvement in childrearing, and demanding work routines for both men and women who seek professional careers. Throughout the paper, we discuss historically competing social constructions of the child, family, and work. In addition, we discuss the gendered roles of men and women in Japanese society. Japan's legacy of Shintoism and Confucianism, the institutionalization of patriarchy in the Tokugawa and Meiji Periods, and the modern constraints placed on families by Japanese corporations are explored as factors affecting child maltreatment and the services rendered by the child welfare system. Under the Child Welfare Act of 1948 and the Prevention of Child Abuse Act of 2000, approximately 90% of children in need, including maltreated children, receive care in large group home settings in Japan. Compared to other nations, Japan places great reliance on out-of-home care. Preventive systems to strengthen families and avert out of home placements have not be adequately developed. Applications Japanese scholars are re-examining the child welfare system in efforts to design family-based policies and services to both prevent maltreatment and provide alternatives to out-of-home care.
Experience in the use of collagenase clostridium histolyticum in the management of Peyronie’s disease: current data and future prospects
Authors: Egui Rojo María Alejandra , Moncada Iribarren Ignacio , Carballido Rodriguez Joaquín , Martinez-Salamanca Juan Ignacio 
Published: June 2014

Introduction: Peyronie’s disease (PD) is a chronic wound-healing disorder characterized by formation of fibrous inelastic scarring of the tunica albuginea resulting in a variety of penile deformities. In most cases, PD is accompanied by a physical and psychological impact. Xiaflex® is an injectable collagenase clostridium histolyticum (CCh) preparation consisting of a predetermined mixture of two distinct collagenases. Recently the US Food and Drug Administration (FDA) approved Xiaflex® for the nonsurgical treatment of men with PD with curvature of 30° or more and tangible scar tissue plaque in their penis. Method: This article presents a comprehensive review of the updated information on the use of Xiaflex® for the nonsurgical treatment of PD. Results: Mean improvements in penile curvature ranging from 29% to 34% and in bother domain scores have been reported. The majority of the reported adverse effects are mild or moderate and 79% resolve without intervention. Conclusion: The combined results of these trials have led to the FDA approval of CCh for the treatment of PD. However, the long-term effects and results need further investigation, with large follow-up series. Considering these results, future perspectives will probably result in the use of a combined or sequential therapy including CCh.
Safety of therapeutic hypothermia combined with primary percutaneous coronary intervention after out-of-hospital cardiac arrest
Authors: Chisholm Gro E , Grejs Anders , Thim Troels , Christiansen Evald H , Kaltoft Anne , Lassen Jens F , Kristensen Steen D , Bøtker Hans Erik , Maeng Michael 
Published: June 2014

Background: The safety of therapeutic hypothermia combined with percutaneous coronary intervention (PCI) after out-of-hospital cardiac arrest has been challenged after reports of high risk of stent thrombosis. Methods: We searched the Western Denmark Heart Registry to identify patients with an acute coronary angiography due to out-of-hospital cardiac arrest performed at our institution between September 2010 and September 2013. We identified 68 unconscious patients, who were resuscitated after out-of-hospital cardiac arrest and underwent acute PCI with stent implantation and immediate therapeutic hypothermia, and followed these for 30 days. Target temperature of 32-34°C was achieved by either an invasive or a non-invasive cooling system. Results: All patients had elevated myocardial biomarkers and 37 patients had ST-segment elevation myocardial infarction. Bare metal stents were implanted in 14 and drug-eluting stents in 54 patients. All patients received antithrombotic treatment with a standard loading dose of 300 mg acetylsalicylic acid and 10,000 units heparin intravenously prior PCI. Clopidogrel or ticagrelor was administered orally through a gastric tube immediately after PCI. During the procedure abciximab or bivalirudin was administered in 44 patients. Electrocardiographic and clinical signs of stent thrombosis were found in one patient. Conclusions: We observed one stent thrombosis in this cohort of 68 consecutive patients with out-of-hospital cardiac arrest who were treated with PCI and therapeutic hypothermia. This suggests that PCI with stent implantation can be performed with acceptable safety in these patients.