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Biomedical subjects

R B Birrer

Publications and source records attributed to R B Birrer.

46 records · Page 3Linked to original sources
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Accessing the scientific literature. The reality of virtual scholarship.

The age-honored practice of plowing through the Index Medicus in a good medical library to meander through citations for treasured finds is an anachronism. Today, clinicians have the astonishing capacity to bring to bear existing knowledge almost effortlessly. Virtual scholarship makes available up-to-date medical citations and their abstracts. There can be access around the clock on any topic in the office, at the bedside, or from home. Computerized searches of the medical literature promote directed continuing education and may enhance clinical care of patients.

Databases, Bibliographic↗
PubMedDate not supplied

Self-mutilation: three cases and a review of the literature.

The self-mutilating patient is an unusual psychiatric presentation in the emergency department (ED). Nonetheless, serious underlying psychiatric pathology and drug abuse are important background risk factors. A careful stepwise approach in the ED is essential, although the prognosis, follow-up, and eventual rehabilitation are poor.

Adult↗
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Managing ankle injuries in the emergency department.

We review the anatomy and physiology of the ankle joint with attention to the structures most likely to be injured. We discuss the epidemiology of ankle injuries and their physical and radiographic evaluation, including the Ottawa Ankle Rules. Treatment, consultation, and pitfalls are followed by more specific discussions of tendonitis, Achilles tendon injury, tendonous subluxations, tarsal tunnel syndrome, sonovial impingement, and injury to the os trigonum. The references provide a guide for further reading.

Ankle Injuries↗
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Martial arts injuries. The results of a five year national survey.

A 5 year national survey of martial arts was done using the National Electronic Injury Surveillance System (NEISS). Seventy-four percent of the injuries involved the extremities and 95% were mild to moderate in nature. Even though most of the injury types were contusions/abrasions (36%). lacerations (14%), and sprains/strains (28%), 15% were dislocations and fractures. Five percent of all injuries were severe, and there were 18 hospitalizations. There were no deaths. Weapon-related injuries were rare and never serious. Overall, the risk of serious injury in the sport was found to be low, especially when compared to other contact sports.

Adolescent↗
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Performance parameters in children and adolescent athletes.

Success in sports, as measured by competitive performance, is dependent upon a number of significant mental and physical components. Somatotype, motor skills, age, nutritional status, physiology, psychology, training level, genetic endowment, and injury risk are the major independent variables influencing performance. Unfortunately, the data available in this area of sports medicine are not always reliable or allow interstudy comparisons. This article reviews the historical and current information used to predict human performance in sports at the childhood and adolescent level. Although mesomorphy, and to a lesser extent ectomorphy, are positively associated with enhanced performance, successful athletes tend to have or acquire somatotypes characteristic of individuals already successful in a particular sport. For the most part, motor skills are age (chronological) and gender dependent. In general, the efficiency of movement progressively improves throughout childhood and into early adolescence and is highly dependent on environmental influences. A lower anaerobic and aerobic capacity reduces performance in the child and adolescent. Nonetheless, regular training can favourably improve motor skills and physiological fitness parameters. The relationship between endurance performance and aerobic capacity, however, is not strong at any age during childhood. Performance levels are reduced if nutrition is inadequate. A number of mental factors such as aggression, spirit, and self-confidence are also related to sports performance, although their correlation is unclear at present. Performance is influenced by the effect of genetic factors on specific traits in 30 to 85% of cases. Risk factors that negatively impact on performance levels include a history of previous injury, excessive training schedules, decreased fitness endurance, joint looseness or tightness, and certain personality traits. It is suggested that sport performance may be optimised by the early identification of individuals with positive genetic and somatotypic markers and negative risk factors. Motor skill development and physiological parameters can then be maximised by using regular, non-excessive training protocols, sound nutrition patterns, a safe environment and protective gear. Further investigations in this important area of sports medicine are essential in order to more fully characterise those criteria essential for successful sports participation. In particular, such studies should be purely longitudinal and should control for multiple confounding factors operating at different times.

Adolescent↗
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Ankle injuries and the family physician.

In transmitting the body's weight, the ankle is subject to frequent static and dynamic injury due to concentrated stresses during standing and movement. The frequency of athletic ankle injuries ranges from 10 to 90 percent, with the highest rate occurring in basketball players. There is prolonged disability and recurrent instability for months to years for 25 to 40 per cent of these patients. Because most of this trauma is handled by primary care physicians, this review presents the mechanism of injury, relevant anatomy, physical examination, and appropriate therapeutic intervention in the acute and rehabilitative phases.

Ankle↗
PubMedDate not supplied

A profile of the urban family.

Very little research work has detailed the structure and function of inner city families. A retrospective demographic analysis of three distinct New York City community districts shows a broad spectrum of living arrangements within the city as well as within separate census tracts. Urban family physicians should be aware of these trends in order to improve their delivery of care and their understanding of family dynamics.

Delivery of Health Care↗