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Debridement for osteoarthritis of the elbow in athletes.

The results of surgical treatment for osteoarthritis of the elbow in athletes were investigated. Athletic activities consisted mainly of judo wrestling and baseball; and included 26 elbows. The mean age was 32 years. The radiological changes were mild in most cases. Debridement consisted of resecting osteophytes and removing loose bodies. Pain scores were improved, and the range of movement was improved by an average of 24 degrees with an average follow-up of 4 years and 2 months. Recurrence of mild symptoms occurred in most cases.

Adolescent↗

[Long-term results of secondary orbital implants].

BACKGROUND: Secondary orbital implants are used for the correction of the post-enucleation socket syndrome (PESS). This study evaluates retrospectively the post-operative course, complications, additional surgery, long-term cosmetic and functional results, and patient's satisfaction after secondary orbital implants. PATIENTS: Nineteen out of 24 patients who underwent secondary baseball implant insertion between 1986 and 1989 for the correction of PESS were re-examined. RESULTS: Five patients had complications, 11 patients (58%) further surgery. After a mean follow-up of 8.6 years, 17 patients (89%) showed findings better than preoperatively. Two patients were unchanged. The static overall impression, assessing particularly volume deficit and symmetry, using a scale of 1 to 5, was improved from 4.5 preoperatively to 2.5. CONCLUSIONS: Secondary orbital implants improve symptoms of PESS and patient's satisfaction in a high proportion of cases also in the long term. Complications are not rare, and frequently more than one operation is necessary. There is no significant risk of long-term side effects and no reduction of the positive effect with time.

Adult↗

[Rehabilitation of anophthalmic patients. Results of a survey].

BACKGROUND: We surveyed ocularists' views on orbital implants, secondary surgical procedures, patient satisfaction, and cooperation between ophthalmologists and ocularists. METHOD: A 14-item questionnaire was sent to all 29 ocularists working in Germany all 4 in the Netherlands. RESULTS: Primary implants are generally recommended, preferably dermofat grafts and ,,baseball" implants. Outcome depends crucially upon surgical procedure and postoperative course. Scepticism is common toward secondary surgical procedures, with the success rate estimated at 70%. Cooperation between ocularists and ophthalmologists is generally regarded as unsatisfactory, also the information provided to the patients by the ophthalmologist after enucleation. CONCLUSIONS: The ocularists demand best possible enucleation techniques including the use of primary implants. However, they are critical toward secondary procedures for correcting postenucleation socket syndrome. Cooperation between ocularists and ophthalmologists need to be improved in providing patient care.

Anophthalmos↗

Extraskeletal Ewing's sarcoma mimicking traumatic hematoma.

We describe the clinical course of a 16-year-old baseball player with a history of recurrent hematoma of the thigh. The lesion was aspirated percutaneously several times and curetted under the diagnosis of traumatic hematoma. Microscopical examination revealed massive hemorrhage, necrosis, and a small number of Ewing's sarcoma cells. He died of multiple metastases. With recurrent hematoma in the soft tissue, neoplastic lesions should be ruled out.

Adolescent↗

Commotio cordis--a report of three cases.

Commotio cordis is a recognised cause of sudden death in which an apparently minor blow to the chest causes ventricular fibrillation and cardiac arrest. It is best known for causing death during games of youth baseball in the United States, but individual cases have been recorded as a result of a wide range of activities, principally sporting. The underlying biochemical and mechano-electric causes have been well documented. However, there are few reported cases where commotio cordis is implicated as the cause of death in homicide cases. We present three cases from the north-east of England where an assault caused death by this mechanism.

Adult↗

Cystic adventitial disease of the popliteal artery: elongation into the media of the popliteal artery and communication with the knee joint capsule: report of a case.

Cystic disease of the popliteal artery is a rare disorder in which most cases involve the formation of an adventitial cyst that disturbs the popliteal artery blood flow. We present herein the case of a patient presenting with popliteal artery occlusion due to compression by a cyst which formed at the media of the popliteal artery. The onset occurred during a baseball game in which he played catcher. Preoperative magnetic resonance imaging demonstrated a communication of the cyst with the adjacent knee joint. This unusual case could provide important clues to help identify the pathogenesis of this disease.

Adult↗

Teaching socially appropriate behavior to eliminate hoarding in a brain injured adult.

A brain injured male hoarded large quantities of unuseable items at every opportunity. The treatment consisted of two phases. First, he was taught to collect baseball cards. Second, after each meal, the client was provided with an apron and a glove and asked to pick up trash in the area and deposit the trash in an appropriate receptacle. If he hoarded, he was told not to pick up trash without his apron and glove and escorted to a quiet area for about 10 seconds. The procedure was successful in suppressing the behavior within 8 days.

Adult↗

Monocular blindness developing 7 days after repair of zygomaticomaxillary complex fracture. A clinical report.

Blindness following zygomaticomaxillary complex (ZMC) fracture and surgical repair is an unfortunate and uncommon complication. A review of the literature reveals fewer than 25 cases of monocular blindness resulting from zygomaticomaxillary fracture or repair. The case presented here is that of a man who was assaulted with a baseball bat and suffered a mildly displaced ZMC fracture. On admission, the patient had light perception only in his left eye. During his convalescence, vision in his left eye gradually improved to the point of allowing him to read a newspaper without difficulty. Then, 9 days after the injury (7 days after surgical repair), the patient awoke with complete blindness of the left eye. The possible mechanisms for such loss of vision are discussed.

Adult↗

Smokeless tobacco use prevents aphthous stomatitis.

Aphthous stomatitis is a common, recurrent, painful ulcerative condition of the oral mucosa. Cigarette smoking has been reported to protect against aphthous ulcers. To determine whether smokeless tobacco use also protects against aphthous ulcers, we examined the oral mucosa in 1456 professional baseball players, about half of whom were smokeless tobacco (ST) users. After controlling for the confounding effects of age, race, cigarette smoking, alcohol consumption, and dental hygiene practices, ST use was found to significantly reduce the risk of aphthous ulcers among these healthy young men (odds ratio = 0.4; p = 0.04). It has been suggested that cigarette smoking prevents aphthous ulcers by causing increased keratinization of the oral mucosa, and ST may protect by the same mechanism. Alternatively, a component of tobacco that is systemically absorbed might be responsible for protecting against aphthous ulcers. If the mechanism that protects ST users against aphthous ulcers is systemic, then nicotine is the likely protective factor.

Adolescent↗

Computer technology to evaluate body composition, nutrition, and exercise.

The use of computer technology has made it possible to make accurate determinations of body composition, nutrition, and exercise. With the FITCOMP computer assessment system, detailed measurements of physique status have been made on a variety of world-class athletes, including professional football and baseball players, as well as on diverse groups of young and older men and women throughout the United States. The FITCOMP measurement system allows the user a choice of measurement techniques: fatfolds, girths, bone diameters, and hydrostatic weighing. Combined with body composition assessment is a nutrition and exercise plan. The nutrition plan is based on guidelines formulated by the American Dietetic Association. This application of computer technology is unique, because individuals can select the foods they will eat from a list of preferred choices from the basic food groups. Individual menu plans for breakfast, lunch, and dinner are generated to provide an optimal blend of nutrients aimed at achieving ideal body mass and fat percentage. This is coupled with an aerobic exercise program that is selected by the individual from nine different forms, including walking, jogging, running, swimming, cycling, and various sport activities. The caloric output is designed to reduce total body fat through reductions in body weight of 1.4 to 2.5 pounds per week, depending on the exercise selected and total weight loss necessary to achieve a weight goal (and ideal fat percentage). The aerobic exercise plan is based on the method of overload, where intensity and duration are periodically increased dependent on individual capabilities. The use of fitness-oriented computer technology makes it possible to prepare detailed reports about current status and progress as well as to systematize record keeping.

Adipose Tissue↗

Temporal stability and predictive validity of self-assessed hand preference with first and second graders.

The test-retest reliability and predictive validity of a five-item hand preference questionnaire (writing, drawing, throwing a baseball, brushing teeth, and cutting with scissors) were investigated in a sample of 80 children attending first and second grade. After 1 month, 81% of the second choices were the same as the first choices. There were interitem differences in the reliabilities of the five items. Writing and drawing hand exhibited the greatest degree of temporal stability. Writing hand was the one task which was significantly related to visual field bias as indexed by a face perception task.

Child↗

Automated contingent reinforcement of correct posture.

This study evaluated the effectiveness of a mercury switch as a self-monitoring device to improve the sitting posture of an adult male. The participant in this study was a 31 year old man who was blind, nonambulatory, and who had been classified in the moderate range of intellectual functioning and in the severe range of adaptive functioning due to physical impairments. After determining that music practice and listening to a game show on the television channel of a radio were powerful reinforcers, a multiple baseline across the two reinforcing activities was implemented. The participant wore a mercury switch inside of a baseball cap which activated a Casio keyboard during music practice and a radio during the independent leisure activity of listening to a game show. During the treatment condition, the keyboard and radio were activated automatically by upright sitting posture. Results indicated that the participant's sitting posture increased from an average of almost 0% correct upright posture during baseline to an average of 52% during treatment.

Adult↗

Sports participation in an urban high school: academic and psychologic correlates.

PURPOSE: To study positive and negative correlates of sports participation in inner-city youth. METHODS: We distributed anonymous questionnaires to 838 students in gym classes of an urban New York City High School. Forty five percent of students were male and 55% female, with mean age 16.0 years; 64% in grades 9-10, and 36% in grades 11-12; 63% black, 27% Hispanic, and 10% other; and 30% A/B students, 38% C students, and 32% D/F students. RESULTS: All students reported some involvement in sports: 37% in 1-2 sports, 29% in 3-4 sports 24% in > or = 5 sports; 20% played on local teams, and 12% on junior or senior varsity. Approximately one-third each reported no weekday sports participation (30%), 1-2 hours per day (34%), or > or = 3 hours (36%); and 34% reported no participation on weekends, 26% reported 1-2 hours per day, and 40% > or = 3 hours. Basketball, volleyball, baseball, and weight lifting were the most common sports. Enjoyment, recreation, and competition were the most commonly reported reasons for participation. While 86% of subjects considered school "extremely" or "very" important, 35% considered sports "extremely" or "very" important. However, many believed they would "definitely" or "probably" receive an athletic scholarship (52% males, 20% females). Males reported more (p < .05) weekday, weekend, and team participation, and greater expectations (p <.001) of a future in sports. Sports involvement was not statistically associated with academic performance or scores on either the Rosenberg Self-Esteem Scale or Depression Self Rating Scale. Steroid use, at least once, was reported by 11% of males and 4% of females. Thirteen percent of students (21% males, 6% females) tried to gain weight for sports and 20% of both males and females tried to lose. Sports injuries within the past year were reported by 15% of students, and approximately three-quarters could correctly answer each of five questions about basic first aid. CONCLUSIONS: The data indicate that most of these urban youth had athletic involvement, many had unrealistic expectations for their futures, and some utilized unhealthy behaviors in an attempt to enhance performance. Among these students, no association was found between sports involvement and academic performance, self-esteem, or depression.

Adolescent↗

How do speakers avoid ambiguous linguistic expressions?

Three experiments assessed how speakers avoid linguistically and nonlinguistically ambiguous expressions. Speakers described target objects (a flying mammal, bat) in contexts including foil objects that caused linguistic (a baseball bat) and nonlinguistic (a larger flying mammal) ambiguity. Speakers sometimes avoided linguistic-ambiguity, and they did so equally regardless of whether they also were about to describe foils. This suggests that comprehension processes can sometimes detect linguistic-ambiguity before producing it. However, once produced, speakers consistently avoided using the same linguistically ambiguous expression again for a different meaning. This suggests that production processes can successfully detect linguistic-ambiguity after-the-fact. Speakers almost always avoided nonlinguistic-ambiguity. Thus, production processes are especially sensitive to nonlinguistic- but not linguistic-ambiguity, with the latter avoided consistently only once it is already articulated.

Communication↗

Sports chronobiology consultation: from the lab to the arena.

This final article, coauthored by a chronobiology consultant, a sports psychologist who applied a chronobiology-based program to an Olympic national team, a clinical neurologist, a performance data analyst, a training-conditioning coach from a major league baseball team who applied chronobiology principles to major league pitchers, and a substance abuse expert, discusses practical aspects of a sports chronobiology consultation, including the goals and current arsenal of available interventions. Short vignettes of actual cases are presented for edification, and references are made to appropriate reviews found elsewhere in this issue.

Altitude↗

Maxillofacial fracture repairs.

Oral trauma remains a common presentation in a small animal practice. Most fractures are the result of vehicular accidents. Among other causes are falls, kicks, gunshots wounds, and encounters with various hard objects ranging from baseball bats and golf clubs to horse hooves and car doors. Next in popularity are dog fights, especially when a large dog and a small dog are involved, and fights with other animals. With cats, falls from various heights are responsible for a large percentage of presentations.

Animals↗

Triangle target principle for the placement of trocars during video-assisted thoracic surgery.

OBJECTIVE: The baseball-diamond principle is generally used for trocar placement during video-assisted thoracic surgery; however, we are unable to treat all peripheral lung lesions using this principle. Therefore, we have developed another method for determining trocar placement based on a modification of the conventional principle. We have termed this method the triangle target principle. This report describes the instrument positioning that we now use for many video-assisted thoracic surgical procedures. METHODS: We position 3 trocars in an equilateral triangle, with the target lesion at the apex. One vertex of the base becomes the site of the first trocar placement for introduction of the thoracoscopic camera. Another vertex of the base becomes the site for the second trocar for forceps or the endoscopic stapler. The third trocar is for forceps and is inserted to create the vicinity of target lesion. Four types of the triangle target principle were developed according to sites of the target lesion. RESULTS: Between January 2000 and December 2002, we used this principle for 161 patients who underwent video-assisted thoracic surgery and all intrathoracic lesions were accessible except in 3 patients requiring intraoperative modifications. CONCLUSIONS: We conclude that video-assisted thoracic surgery by this principle is more effective and easier than the conventional principle to treat intrathoracic disease.

Humans↗

The endovascular management of recurrent aortic hypoplasia and coarctation in a 15-year-old male.

A 15-year-old male complained of easy fatigability, leg weakness, and pain on exertion with episodes of syncope while playing baseball. His past medical history was significant for aortic coarctation associated with a congenital bovine hypoplastic aortic arch. A recent arteriogram revealed innominate and left common carotid artery stenosis as well as recurrent coarctation. He had previously undergone three Dacron patch aortoplasties. At the age of 7, he underwent a fourth operation for recurrent coarctation and because of extensive scar tissue in the region of his prior procedures, a left subclavian artery-to-descending aortic bypass was performed. An endovascular repair to deal with the recent recurrence was performed because of prior surgical difficulties. Percutaneous balloon-expandable stents were placed in the aortic coarctation, innominate, and the left common carotid arteries. Postprocedure, ankle brachial indices were >1 and the patient remains asymptomatic after 1 year.

Adolescent↗