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At least 919 records · Page 51Linked to original sources

Ruptured internal limiting membrane associated with blunt trauma revealed by indocyanine green staining.

PURPOSE: Description of cases of traumatic macular hole that appeared concomitant with a ruptured internal limiting membrane (ILM) that was apparent during vitrectomy only after staining with indocyanine green (ICG). METHODS: Vitrectomy with ILM peeling was performed on a 20-year-old man and a 13-year-old boy for treatment of traumatic macular holes. RESULTS: During vitrectomy, the ILM was found to be ruptured along the area of an identified macular hole only after ICG staining. After the vitrectomy, the macular holes were closed and visual acuity improved. However, visual field defect associated with apparent inner-layer retinal damage remained. CONCLUSION: Blunt trauma can cause severe inner-layer retinal damage with rupture of the ILM as well as frank macular hole formation and choroidal rupture.

Adolescent↗

Planning a spit tobacco cessation intervention: identification of beliefs associated with addiction.

We examine the relationship between beliefs regarding spit tobacco (ST) use and addiction among 473 male college athletes who currently use ST. Beliefs were assessed using methods prescribed by the Theory of Reasoned Action. Independent associations between beliefs and addiction, defined by self-reported amount of ST used per week, were found via multivariate polychotomous regression modeling. We found that with increasing addiction level, athletes were significantly more likely to believe that "ST helps me relax," "ST keeps me alert," "ST tastes good," and "ST is addicting." All athletes believed that clinicians, parents, and girlfriends do not approve of their ST use, but that male peers, coaches, and professional athletes are fairly indifferent about it. To increase quit rates, highly addicted ST users may require an intensive cessation program including nicotine replacement to overcome symptoms of withdrawal, oral substitutes for the enjoyable taste of ST, and the support of male peers and athletes who influence their social norms.

Adolescent↗

Recreational softball injuries.

Every patient who presented to an urban teaching hospital's emergency department during one season complaining of an injury sustained while playing softball was interviewed to determine the parameters of play associated with the injury. Trends were noticed toward increased frequency of injury to experienced players late in the season. A fall was the most common mechanism of injury, and player location at the time of injury was equally divided between the basepath and defense. Very few players were injured at bat. No conclusion could be drawn about the protection afforded a player from the use of a mitt or cleats. The relative rate of injury was estimated to be 2.26 injuries per 1,000 players per day, making the risk of injury for softball participants about 50% of that for recreational skiers.

Adolescent↗

Arthroscopic resection of glenoid labral tears in the athlete: a report of 29 cases.

This article is a retrospective review of 28 overhead-throwing and striking athletes who underwent 29 arthroscopic partial glenoid labral resections. Indications for the procedure were a sudden inability to perform because of pain and the presence of a palpable "click" on clinical examination. At a minimum of 2 years follow-up, there was a statistically significant difference in the functional outcome between patients with stable and those with unstable glenohumral joints. In those with stable joints, there was a 91% good or excellent functional outcome. In those with unstable joints, there was a 25% good functional outcome and a 75% fair or poor functional outcome. We also noted a statistically significant difference in labral tear location between the stable and unstable glenohumeral joints. Seven of eight superior labral tears were in stable shoulders. Fourteen of 19 anterior labral tears were in stable shoulders. Both posterior labral tears were in unstable glenohumeral joints. Injury of the glenoid labrum without anatomic instability was observed in 72% of patients. Arthroscopic resection of a longitudinal labral tear in a stable shoulder can relieve the patient's discomfort and allow him or her to return to athletic competition. No patient developed clinical subluxation as a result of labral debridement, nor did any patient convert from a subluxing shoulder to a dislocating shoulder following surgery. In patients with anterior instability and labral tears, labral debridement was not a successful alternative to formal stabilization.

Adult↗

Specificity and sensitivity of the anterior slide test in throwing athletes with superior glenoid labral tears.

This study documents the sensitivity and specificity of a clinical test to aid in the diagnosis of superior glenoid labral lesions. The anterior slide test, a method of applying an anteriorly and superiorly directed force to the glenohumeral joint, was performed on several groups of athletes. These included symptomatic athletes with isolated superior labral tears, rotator cuff tears, and instabilities, and asymptomatic athletes with rotational deficits. In addition, non-throwing athletes were tested. The sensitivity of the test was 78.4%, and the specificity was 91.5%. This study shows that the anterior slide test can be used in the clinical examination, in that it has high specificity for superior labral lesions, but not enough sensitivity to be the sole diagnostic criterion for these lesions.

Adolescent↗

Batter up! Relapse prevention for homeless veteran substance abusers via softball team participation.

Thirty-four veterans of a residential rehabilitation program for homelessness and substance abuse participated on a community-based softball team. Compared to nonparticipants, participants stayed in treatment longer and were more likely to complete all aspects of the program (inpatient and outpatient). They also were more likely to be abstinent from drugs/alcohol, employed, and housed 3 months postdischarge. Participation appeared to enhance outcomes by providing in vivo opportunities for practicing coping skills and developing supportive relationships. A softball program may be a viable adjunct treatment in which formally taught cognitive-behavioral skills can be applied in a natural, but semistructured setting.

Adult↗

The implementation of game in a 20-day head-down tilting bed rest experiment upon mood status and neurotic levels of rest subjects.

This study evaluated the effect of the implementation of game on mental health among participants in a bedrest (BR) experiment. Subjects were 12 healthy males aged 20-26, who participated in a 20-day 6-degrees head-down tilting BR experiment. The participants were asked to complete psychometrical questionnaires before, during, and after the experiment. We entrusted the participants to manage their leisure time and they intended a game in which all of them could take part over the experiment period. The general conversation and light-hearted mood among the subjects continued during the experimental period. Longitudinal data analysis showed that levels of neurosis and mood status did not deteriorate during the experiment, while our previous experiments, which were performed under the same protocol as this study except for the implementation of the game showed a distinct deterioration in psychosocial status. We consider that the implementation of game autonomously contributes to the positive effects on the mental health among the participants.

Adaptation, Psychological↗

Bilateral and recurrent myositis ossificans in an athlete: a case report and review of treatment options.

An unusual case of recurrent myositis ossificans (MO) bilaterally in the hamstring muscles of a 47-year-old athlete secondary to trauma is presented with a review of the literature of current treatment options. MO is a common condition that occurs among athletes in association with muscle and/or tendon strain or contusion. After an extensive literature review, we believe this to be the first case reported of recurrent and bilateral MO in a nonsurgical setting from recurrent hamstring strains. Plain radiographs and physical examination revealed the appearance and chronology of this pathology. Treatment options to improve flexibility and decrease morbidity are discussed along with prophylaxis for future injury. Treatment of mobility and flexibility, rehabilitation goals and treatment with nonsteroidal anti-inflammatory drugs, bisphosphonates, and magnesium are discussed along with prophylaxis.

Baseball↗

Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear.

We present the cases of 5 patients with a torn discoid lateral meniscus treated using partial central meniscectomy in conjunction with the suture repair of the tear. The patients were 4 boys and 1 girl with a mean age of 15.4 years (range, 11 to 17). Preoperatively, all patients complained of knee pain during daily or sports activities. At the final follow-up evaluation, more than 2 years later, 4 patients' conditions were graded as excellent and 1 patient's condition was graded as fair according to Ikeuchi's grading scale. The average Lysholm score improved from 83.4 points (range, 70-90) to 95.8 points (range, 89-100) postoperatively. In the 3 patients who underwent second-look arthroscopy, complete healing was seen in 2 patients. One patient had severe degenerative changes in the meniscus; the repaired site was not united and required an additional partial meniscectomy along the tear. We believe that with the current advancement in arthroscopic meniscal repair techniques, a partial central meniscectomy in conjunction with the suture repair of the peripheral tear can be effective treatment for patients with a torn complete or incomplete discoid meniscus.

Adolescent↗

Biceps pulley impingement.

We present three cases of a detached biceps pulley, which impinges on posterosuperior glenoid labrum.

Adolescent↗

Magnetic resonance imaging of the knee in asymptomatic professional basketball players.

PURPOSE: The purpose of this study was to evaluate the prevalence of articular cartilage lesions and meniscal tears on magnetic resonance imaging (MRI) scans in the knees of asymptomatic male professional basketball players. TYPE OF STUDY: A retrospective review. METHODS: Twenty players (40 knees) met the inclusion criteria of being signed by a National Basketball Association team and passing their preseason physical examination. All included athletes were assessed for the presence of articular cartilage lesions, meniscal pathology, and the presence of effusions. RESULTS: The overall prevalence of articular cartilage lesions on MRI was 47.5% in our study group. There were trochlear groove articular lesions in 25%. The lateral femoral condyle was involved in 2.5% of all knees. The medial femoral condyle was affected in 10% of all knees. The lateral tibial plateau showed articular cartilage lesions in 5%. The patella had articular cartilage lesions in 35%. The overall prevalence of various grade meniscal lesions was 20% on MRI. Medial intra-meniscal signals accounted for 87.5% and 12.5% on the lateral side. CONCLUSIONS: The results of our study show an equal to or higher prevalence of meniscal lesions in male professional basketball players than previously reported in the literature. We found a large number of patella-femoral articular cartilage lesions in our study population of male professional basketball players. These athletes perform at the highest demand level, which indicates that the presence of these lesions did not cause any symptoms. LEVEL OF EVIDENCE: Level IV, case series.

Athletic Injuries↗

Arthroscopic repair of a humeral avulsion of the glenohumeral ligament lesion.

We describe 3 cases of an all-arthroscopic technique for repair of a humeral avulsion of the glenohumeral ligament (HAGL) lesion and the postoperative clinical outcomes. From a technical perspective, the most critical part of the surgeries was the anchor insertion at an optimal position on the humerus in order to achieve proper tension of the glenohumeral ligament. The arm-free beach-chair position, which facilitates maximum internal rotation, use of a 70 degrees angled arthroscope, and an anterior-inferior trans-subscapularis tendon portal were considered key factors to accomplish this procedure.

Adult↗