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Biomedical subjects

D Hillis

Publications and source records attributed to D Hillis.

3 recordsLinked to original sources

Knee muscle strength in elite male gymnasts.

This study was launched to establish the profile of knee dynamic concentric strength in elite male gymnasts after it was found that three of the 10-member Canadian men's gymnastics team had incurred anterior cruciate ligament (ACL) rupture. The dynamic concentric force characteristics of the quadriceps and hamstring muscles of 84 male gymnasts were studied at the Canadian National Championships using a Kin-Com isokinetic dynamometer. These tests were performed at 90 degrees/sec and 230 degrees/sec and revealed that the hamstrings to quadriceps peak torque ratio was not only unusually low (0.5) when compared with data collected in previous research, but that this ratio was consistent across all ages, from 12 to 27 years. The torque ratios were also reported at 30 degrees, 45 degrees, and 60 degrees and it was found that the ratios decreased as the joint angle increased and again was consistent across the four age groups. It was also found that the hamstrings to quadriceps peak torque ratio did not increase (hamstrings becoming stronger relative to quadriceps) as velocity of movement increased as has been reported in other studies. It was hypothesized that the large shear forces that are generated about the knee in gymnastics (extrinsically from backward landing and intrinsically from the quadriceps eccentrically contracting), combined with the relatively weak hamstrings, could be one cause for the increasing incidence of ACL injuries in that sport. The results of this study indicate that it would be prudent for clinicians involved with gymnasts to test for knee strength imbalance and to prescribe exercises to correct it when necessary.

Adolescent

Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: A comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge.

Intravenous administration of 80 mg of recombinant tissue plasminogen activator (rt-PA, 40, 20, and 20 mg in successive hours) and streptokinase (SK, 1.5 million units over 1 hr) was compared in a double-blind, randomized trial in 290 patients with evolving acute myocardial infarction. These patients entered the trial within 7 hr of the onset of symptoms and underwent baseline coronary arteriography before thrombolytic therapy was instituted. Ninety minutes after the start of thrombolytic therapy, occluded infarct-related arteries had opened in 62% of 113 patients in the rt-PA and 31% of 119 patients in the SK group (p less than .001). Twice as many occluded infarct-related arteries opened after rt-PA compared with SK at the time of each of seven angiograms obtained during the first 90 min after commencing thrombolytic therapy. Regardless of the time from onset of symptoms to treatment, more arteries were opened after rt-PA than SK. The reduction in circulating fibrinogen and plasminogen and the increase in circulating fibrin split products at 3 and 24 hr were significantly less in patients treated with rt-PA than in those treated with SK (p less than .001). The occurrence of bleeding events, administration of blood transfusions, and reocclusion of the infarct-related artery was comparable in the two groups. Thus, in patients with acute myocardial infarction, rt-PA elicited reperfusion in twice as many occluded infarct-related arteries as compared with SK at each of seven serial observations during the first 90 min after onset of treatment.

Blood Coagulation