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Biomedical subjects

D A Macleod

Publications and source records attributed to D A Macleod.

At least 19 recordsLinked to original sources
PubMed2001

Proactive balance strategy while maintaining a stationary wheelie.

OBJECTIVE: To test the hypothesis that a reactive balance strategy is used while maintaining a stationary wheelie, specifically that a forward pitch from the wheelie equilibrium position is associated with a forward displacement of the wheelchair and a rear pitch with rear displacement, with the displacement slightly after the change in pitch. DESIGN: Descriptive and quantitative kinematic analysis. SETTING: Kinesiologic laboratory. PARTICIPANTS: A convenience sample of 10 able-bodied adults. INTERVENTION: Subjects taught to pop and maintain a stationary wheelie for 15 seconds while remaining within a .75 x .75 m2. Three trials of 5 seconds; digitized targets videotaped for analysis. MAIN OUTCOME MEASURES: Pitch angle and rear-wheel position of the wheelchair, derived from digitized videotape and time-series analysis of phase lag. RESULTS: There was an inverse relationship between the direction of pitch and linear displacement-rear pitch was associated with forward wheel displacement and forward pitch was associated with rearward wheel displacement. The mean pitch angle +/- standard deviation was 13.6 degrees +/- 2.3 degrees and the mean horizontal position of the wheelchair was 0.0 +/- 4.9cm. There was little or no phase lag between pitch and displacement. CONCLUSIONS: Wheelie performers maintaining a stationary wheelie appeared to use a proactive balance strategy, in which they used a functional base of support that was larger than the geometric one. These findings may have significance for those who are learning and teaching wheelies and provide broader insights into the nature of dynamic balance.

Adult↗
PubMed2001

A unique insight into the incidence of rugby injuries using referee replacement reports.

OBJECTIVES: To obtain further information the incidence of injuries and playing positions affected in club rugby in Scotland. METHODS: Routine reports of injury (permanent) and blood (temporary) replacements occurring in competitive club rugby matches by referees to the Scottish Rugby Union during seasons 1990-1991 to 1996-1997 were analysed. RESULTS: A total of 3,513 injuries (87 per 100 scheduled matches) and 1,000 blood replacements (34 per 100 scheduled matches) were reported. Forwards accounted for 60% of the injury and 72% of the blood replacements. Flankers and the front row were the most commonly replaced forwards while wing and centre three quarters were the most vulnerable playing positions among backs. The incidence of injury replacements increased as the match progressed up until the last 10 minutes when the trend was reversed. Blood replacements showed a different pattern with 60% occurring during the first half of the match. CONCLUSION: The most important finding of the study was reliability of referees in documenting the vulnerability of certain playing positions, and the timing when injuries took place, thus assisting coaches and team selectors when choosing replacement players for competitive club and representative rugby matches. This study re-emphasises the need for continuing epidemiological research.

Football↗
PubMed2000

Menstruation, the oral contraceptive pill, and acute appendicitis.

OBJECTIVE: To find out if there was any association between histologically confirmed acute appendicitis, menstruation, and the use of the oral contraceptive pill. DESIGN: Retrospective study. SETTING: District general hospital, Scotland. SUBJECTS: 366 consecutive patients (median age 21, range 10-51) with histologically confirmed acute appendicitis during the period 1981-1990 were studied, 314 of whom were having menstrual cycles. 208 patients with physiological menstrual cycle were included in the study, and 82 patients were taking the oral contraceptive pill. INTERVENTIONS: Prospectively collected standardised data using computer assisted diagnosis of acute abdominal pain was used to review patients with histologically confirmed acute appendicitis. RESULTS: Acute appendicitis was confirmed in 17/208 of patients (8%) who were menstruating, which is significantly less than might be expected (p < 0.003). 5/82 (6%) of those taking oral contraception had withdrawal bleeding and acute appendicitis (p = 0.2). CONCLUSIONS: Acute appendicitis is less common among women during physiological menstruation, but no differences are noted during the withdrawal bleeding phase when taking oral contraception.

Acute Disease↗
PubMed2000

Impact of professionalism on injuries in rugby union.

OBJECTIVES: To measure the frequency and nature of injuries occurring in competitive matches since professionalism was introduced in rugby union. METHODS: The cohort study previously conducted in players from senior rugby clubs in the Scottish Borders in 1993-1994 when rugby union was an entirely amateur sport was repeated in 1997-1998. The same injury definition, outcome criteria, and method of calculating playing hours were used. In total, 803 (84%) of 960 eligible players participated, including all 30 adult players who played professionally for the Scottish Rugby Union or Border Reivers District. The 576 injury episodes in 381 of these players in competitive matches were compared with the 373 injuries in 266 players out of 975 (94%) who were eligible and registered with the same senior rugby clubs in 1993-1994. Outcomes were the occurrence of injury episodes, days away from playing or training for rugby, and time lost to employment or attendance at school/college as a consequence of being injured. RESULTS: The proportion of players who were injured almost doubled from 1993-1994 to 1997-1998, despite an overall reduction of 7% of the playing strength of participating clubs. Period prevalence injury rates rose in all age specific groups, particularly in younger players. This translated into an injury episode every 3.4 matches in 1993-94, rising to one in every 2.0 matches in 1997-1998. An injury episode occurred in a professional team for every 59 minutes of competitive play. Professional players sustained a higher proportion of recurrent injuries, particularly in the early part of the season. Some 56% of all their days lost to the game were caused by injuries to the muscles, ligaments, and joints of the knee, hip, and thigh. CONCLUSIONS: The introduction of professionalism in rugby union has coincided with an increase in injuries to both professional and amateur players. To reduce this, attention should be focused on the tackle, where many injuries occur. The International Rugby Board should place a moratorium on the use of protective equipment in competitive matches until its contribution to player morbidity has been fully assessed.

Adolescent↗
PubMed1999

Factors influencing tackle injuries in rugby union football.

OBJECTIVES: To assess the influence of selected aspects of lifestyle, personality, and other player related factors on injuries in the tackle. To describe the detailed circumstances in which these tackles occurred. METHODS: A prospective case-control study was undertaken in which the tackling and tackled players ("the cases") involved in a tackle injury were each matched with "control" players who held the same respective playing positions in the opposing teams. A total of 964 rugby matches involving 71 senior clubs drawn from all districts of the Scottish Rugby Union (SRU) were observed by nominated linkmen who administered self report questionnaires to the players identified as cases and controls. Information on lifestyle habits, match preparation, training, and coaching experience was obtained. A validated battery of psychological tests assessed players' trait anger and responses to anger and hostility. The circumstances of the tackles in which injury occurred were recorded by experienced SRU coaching staff in interviews with involved players after the match. RESULTS: A total of 71 tackle injury episodes with correct matching of cases and controls were studied. The following player related factors did not contribute significantly to tackle injuries: alcohol consumption before the match, feeling "below par" through minor illness, the extent of match preparation, previous coaching, or practising tackling. Injured and non-injured players in the tackle did not differ in their disposition toward, or expression of, anger or hostility. Some 85% of tackling players who were injured were three quarters, and 52% of injuries occurred when the tackle came in behind the tackled player or within his peripheral vision. Either the tackling or tackled player was sprinting or running in all of these injury episodes. One third of injuries occurred in differential speed tackles--that is, when one player was travelling much faster than the other at impact. The player with the lower momentum was injured in 80% of these cases. Forceful or crunching tackles resulting in injury mostly occurred head on or within the tackled player's side vision. CONCLUSIONS: Attention should be focused on high speed tackles going in behind the tackled player's line of vision. Comparative information on the circumstances of the vast majority of tackles in which no injury occurs is required before any changes are considered to reduce injuries in the tackle.

Adolescent↗
PubMed1999

Cystic hygroma in an adult: a case report.

Cystic hygromas are benign lesions arising due to an abnormality in lymphatic development and only rarely present in adults. Adequate radiological imaging prior to surgery is important as incomplete excision often leads to recurrence. Several adjunctive therapies have been shown to be beneficial in recurrent or inaccessible lesions but these are not in common use. We describe the case of a cystic lymphangioma appearing in adulthood that presented a diagnostic and therapeutic challenge.

Diagnosis, Differential↗
PubMed1996

Prognosis of elderly patients with non-specific abdominal pain.

OBJECTIVE: To examine the long term outcome of patients over 65 years presenting with acute non-specific abdominal pain. SETTING: District general hospital. DESIGN: Retrospective cohort survey. SUBJECTS: 43 patients with non-specific abdominal pain, median age 75.5 years, presenting in 1985. METHODS: Case notes were reviewed and a questionnaire sent to the patients' general practitioners to assess long term outcome. RESULTS: There was little evidence that these patients subsequently developed or died from a disease requiring surgery. However, this patient group did have a significantly poorer five year survival than a representative control group because of cardiorespiratory disorders. CONCLUSIONS: Non-specific abdominal pain in elderly patients should not be regarded as harmless but may have medical rather than surgical implications.

Abdominal Pain↗
PubMed1994

Intravenous cholangiography in preoperative assessment of patients considered for laparoscopic cholecystectomy.

This study examines the role of intravenous cholangiography in the preoperative assessment of the first 100 patients considered for laparoscopic cholecystectomy at this institution. Intravenous cholangiography detected common bile duct (CBD) stones in 10 patients, of whom only five had a dilated CBD (> 8 mm). There were no cases of inadequate visualization of the CBD using IVC and no allergic reactions to the contrast medium. All CBD stones were confirmed by either endoscopic retrograde cholangiopancreatography (ERCP) or exploration of the CBD. There have been no cases of missed CBD stones during a follow-up period of 8 to 18 months. In contrast, ultrasound scanning was only able to detect one CBD stone, and there was a 14% incidence of inadequate visualisation of the CBD. Intravenous cholangiography is a safe, inexpensive, and highly accurate technique for assessing the CBD in patients undergoing laparoscopic cholecystectomy, with false-positive and false-negative rates of 0 in this study. The timing of the investigation permits preoperative clearance of the duct by ERCP and, should this fail, the option of a single procedure of open exploration of the CBD.

Adult↗
PubMed1993

Use of Autosuture Surgiport for pleural drain insertion.

The insertion of pleural drains (tube thoracostomy) is associated with serious complications in up to 10 per cent of cases. A safe and efficient technique of tube thoracostomy using the Autosuture Surgiport is described.

Chest Tubes↗