[Pre-, intra- and postoperative care in gastrectomies and cardia resections].
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Aged↗
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Ultrasound for diagnosis of apophyseal injuries.
Avulsion injuries of the apophysis is a problem in young athletes. A correct diagnosis is necessary for establishing the appropriate treatment and the rehabilitation program. However, it is often difficult to distinguish between a simple muscle strain and an avulsion fracture. The X-ray examination is helpful only when an ossification center of the apophysis exists. Ultrasonography is considered the suitable diagnostic tool for these cases. From June 1988 to June 1993, 243 young athletes were seen with an anamnestic and clinically suspected apophyseal injury of the lower extremity. In all cases X-ray examination and ultrasound examination were performed. In 80 cases the diagnosis was confirmed by X-ray examination and in 97 by ultrasonography. Four criteria were defined for the sonographic examination: (a) a hypoechogenic zone, (b) increased distance to the apophysis, (c) dislocation of the apophysis, and (d) mobility of the apophysis on dynamic examination. These criteria are correlated to (a) edema, (b) lysis, (c) avulsion, and (d) unstable avulsion of the apophysis. Ultrasonography is a proven technique for the detection of apophyseal injuries. In comparison to X-ray examination, it has the advantages of no radiation exposure, early detection even without ossification center, and dynamic examination.
Adolescent↗
[Accidents related to physical education in school: epidemiologic and preventive approach].
Generally speaking, this category of accidents seems to cause mostly relatively mild injuries. It could explain, at least in part, why there are so few papers on this topic in the medical literature except for clinical reports usually based on hospitalized cases. The main results of a study of the 9261 physical education accidents registered within five years in primary and secondary schools in Basle and Geneva are used to illustrate their epidemiological characteristics, as well as the localization and the severity of the injuries. The sources of data are the files of the accident insurance companies. Initial operational definitions, data sources, measurement of exposure to risk and the (largely criticized) notion of individual accident proneness are constraints and conditions of a pertinent epidemiological approach which have to be carefully taken into consideration. This approach should be combined with the clinical and the ergonomical approaches in order to get the best possible pictures of the causes, mechanisms and consequences not only of accidents in general but especially of those occurring in physical activities in childhood and adolescence. Some considerations on prevention are briefly outlined here. They intend to take into account the risk factors related to the tasks, the circumstances and especially to the student himself taken as an individual involved in a growth and development dynamics.
Adolescent↗
[Sport injuries in different types of sports].
We analyzed the accidents in many different forms of sport during the period from 1964 to 1980. In soccer, 12% of all injuries were located on the head of the player, 15% on the chest or back, 18% on the arms, and 53% on the legs. In cycling, 20% of all accidents affected the head of the cyclist. 47% of the injured handball players damaged their arms. It is interesting to note that from all the so-called swimming accidents only 45% happened in the water and 55% outside the swimming-pool. The frequency of ski accidents declined, especially in children.
Athletic Injuries↗
[Educational and nutritional study on the reduction of myocardial-infarct risk].
The study aims to establish whether recovery from myocardial infarction is the strongest or, alternatively, the only motivation toward changing unhealthy habits of living and eating and to what extent such patients and overtly healthy persons are prepared to receive advice to take measures to prevent myocardial infarction.
Adult↗
[Bilateral tibial head epiphysiolysis in somersault jumping].
We are reporting about a rare case of a bilateral epiphyseal separation of the proximal tibial epiphysis which occurred to a 16 year old male at the time of bileged take-off when somersault diving. The X-rays at admission showed a bilateral proximal tibial epiphyseal separation of Salter-Harris type I on the right side and Salter-Harris type II on the left side. Both epiphyses showed a posterior dislocation. Stable, anatomical position on both sides was achieved by closed reduction under general anaesthesia and fixed by a plaster cast for five weeks. Healing occurred in anatomical position and no redislocation or growth disturbance was observed. The treatment for such separations is usually conservative; the prognosis is very good, provided that an optimal reposition with restoration of the anatomical situation has been achieved.
Adolescent↗
Rehabilitation following myocardial infarction.
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Angina Pectoris↗
Lower extremity control and dynamics during backward angular impulse generation in backward translating tasks.
Observation of complex whole-body movements suggests that the nervous system coordinates multiple operational subsystems using some type of hierarchical control. When comparing two backward translating tasks performed with and without backward angular impulse, we have learned that task-specific modifications in trunk-leg coordination contribute to the regulation of total-body center of mass (CoM) position relative to the reaction force (RF). In this study, we hypothesized that task-specific differences in trunk-leg coordination would affect the control of the lower extremity joints during the impulse-generation phase of the tasks. Eight highly skilled performers executed a series of backward translating jumps with and without backward rotation (back somersault and back timer, respectively). Sagittal plane kinematics, RFs and electromyograms of lower extremity muscles were acquired during the take-off phase of both tasks. Lower extremity joint kinetics was calculated using inverse dynamics. The results indicate that between-task differences in the relative angles between the lower extremity segments and the net joint forces/RF contributed to significant reductions in knee-extensor net joint moments and increases in hip-extensor net joint moments during the push interval of the back somersault as compared to the back timer. Between-task differences in backward trunk angular velocity also contributed to the re-distribution of work done by the lower extremity net joint moments. Between-task differences in lower extremity joint kinetics were associated with synergistic activation of the bi-articular muscles crossing the knee and hip. These results indicated that task-specific control of CoM relative to the RF in order to regulate the backward angular-impulse-involved modification in the control and dynamics of the knee and hip joints. These results indicate that between-task differences in the control objectives at the total-body level (position of CoM relative to the RF) alters the control and dynamics of the multi-joint lower extremity subsystem.
Adult↗
Association of reduced physical activity and quantitative ultrasound measurements: a 6-year follow-up study of adolescent girls.
Sonographic parameters of the heel were recorded in order to investigate the effects of changes in physical activities among 140 healthy growing peripubertal Caucasian girls. Calcaneal quantitative ultrasound measurements (Hologic Sahara) were recorded at baseline and 2- and 6-year follow-up. Broadband ultrasound attenuation, speed of sound (SOS), and T scores were documented. Altogether, 30 girls reduced their physical activity by >50% and 29 girls by 25-50%, whereas 81 girls continued at the present level or increased it. Age and physical activity together accounted for 16.7% of the variation in calcaneal T scores at baseline and for 16.4% at 2-year follow-up, whereas physical activity alone accounted for 11.3% of the variation at 6-year follow-up. The reduction in mean T scores was significant (from 2.0 to 0.8, P < 0.001) among those having discontinued their physical activity by the 6-year measurement. The changes between three groups were statistically significantly different from each other (P = 0.003). The mean SOS values decreased 16.78 meters per second (95% CI -26.9 to -6.7) among those having discontinued their physical activity between the 2- and 6-year follow-up measurements. The SOS value sensitively reacts to changes in physical activity, and consequently, it will help assess changes in bone quality. Because of such an immediate reaction, SOS is a good-quality measure for the physical condition of bone in young people and a suitable tool for detecting changes in calcaneal bone.
Adolescent↗
Effect of high impact activity on bone mass and size in adolescent females: A comparative study between two different types of sports.
The purpose of this cross-sectional study was to investigate the influence of two different types of weight-bearing activity, muscle strength, and body composition on bone mineral density (BMD), bone mineral content (BMC), and bone area in three different groups of late adolescent girls. The first group consisted of 10 females participating in competitive rope-skipping (age 17.8 +/- 0.8 years) training for 6.7 +/- 3.1 hours/week; the second group consisted of 15 soccer players (age 17.4 +/- 0.8 years) training for 6.1 +/- 2.0 hours/week; and the third group consisted of 25 controls (age 17.6 +/- 0.8 years) with physical activity of 0.9 +/- 1.1 hours/week. The groups were matched for age, height, and weight. BMD (g/cm(2)), BMC (g), and bone area (cm(2)) of the total body, lumbar spine, hip, total femur, distal femur, diaphyses of femur and tibia, proximal tibia, and humerus were measured using dual-energy X-ray absorptiometry (DXA). Bone density was also assessed in the radial forearm site of the dominant limb in the rope skippers and in 10 matched controls. The rope skippers had 22% higher BMD at the ultradistal site (P < 0.01). Both high-activity groups had significantly higher BMD (P < 0.05) at most loaded sites compared with the control group. When adjusting for differences in lean mass and starting age of sport-specific training between the activity groups, the rope-skipping group had a higher BMD of the total body, lumbar spine, and right humerus compared with the soccer group. They also had a significantly higher bone area of the total body, total femur, and the proximal femur than both other groups, and a significantly higher bone area of the tibia diaphysis, compared with the soccer group. In a multivariate analysis among all subjects (n = 50), all BMD sites, except the femur diaphysis, distal femur, and proximal tibia, were significantly related to type of physical activity (beta = 0.25-0.43, P < 0.05). The bone area values at different sites were strongly related to muscle strength and parameters related to body size [height, weight, lean mass, fat mass, and body mass index (BMI)]. In conclusion, it appears that in late adolescent women, weight-bearing activities are an important determinant for bone density, and high impact activities such as jumping also seem to be associated with a modification of the bone geometry (hence, the bone width) at the loaded sites.
Absorptiometry, Photon↗
Spinal subdural hematoma.
We report the case of a 68-year-old patient with a traumatic spinal subdural hematoma. MRI demonstrated an area of abnormal intensity and a black line in the inner part of the intradural space. We anticipate that MRI will help to make one more confident in the preoperative diagnosis of spinal subdural hematoma. The symptoms completely disappeared immediately after the operation. Spinal subdural hematoma requires immediate surgical evacuation. The prognosis for functional recovery is good if the condition is appropriately diagnosed and treated before development of irreversible paralysis. We recommend MRI to make an early diagnosis and early evacuation of spinal subdural hematoma.
Aged↗
Sports-related stress fracture of the clavicle: a case report.
Stress fracture of the clavicle is extremely rare, even in sports medicine. The authors have treated a young man who, for several years practised a traditional physical activity in which groups of people make human towers by standing on each others shoulders. For the last three years the patient experienced pain in the medial aspect of the right clavicle when he increased the intensity of his training. Bone scintigraphy revealed endosteal thickening which was indicative of a stress reaction. The mechanism of injury, the diagnosis of stress fracture, and a review of the literature are presented.
Adult↗
Exercise training and nutrient intake in elderly women.
This study examined the relationship between moderate exercise training (five 30- to 40-minute sessions per week for 12 weeks at 60% of heart rate reserve) and changes in nutrient intake in a group of 30 sedentary elderly women aged 67 to 85 years. Subjects were placed randomly into two groups (those who walked and those who did calisthenics) and were followed for 12 weeks. Measurements were done at three times (baseline, 5 weeks, and 12 weeks). Dietary intake was based on 7-day food records. The 12-week walking program resulted in a significant (12.6%) improvement in maximum oxygen consumption (VO2max) but no change in body weight or skinfold thicknesses compared with the calisthenics program. Despite the improvement in cardiorespiratory fitness, no significant group x time interaction effects were observed for most of the nutrient intake variables tested. To test the effects of high levels of physical activity on nutrient intake, cross-sectional comparisons were made at baseline between highly conditioned and sedentary elderly women. The highly conditioned elderly women had higher energy and nutrient intakes, especially when expressed on a weight-adjusted basis. However, no differences in measures of dietary quality were found. Dietitians should not expect spontaneous improvement in either the quantity or quality of nutrient intake by elderly women who adopt a moderate exercise program. Although nutrient intake was greater in highly conditioned elderly women, their level of fitness and physical activity may be beyond the reach of many elderly women.
Aged↗
Popliteal arterial thrombosis resulting from disruption of the upper tibial epiphysis.
As a result of a fall, a young athlete sustained a type 2 epiphyseal fracture of the proximal tibia. Three days later it became apparent that the popliteal artery had thrombosed and a successful arterial reconstruction was carried out.
Adolescent↗
A computational technique to determine the angular momentum of a human body.
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Biophysical Phenomena↗
The simulation of aerial movement--I. The determination of orientation angles from film data.
Quantitative mechanical analyses of human movement require the time histories of the angles which specify body configuration and orientation. When these angles are obtained from a filmed performance they may be used to evaluate the accuracy of a simulation model. This paper presents a method of determining orientation angles and their rates of change from film data. The stages used comprise the synchronization of data obtained from two camera views, the determination of three-dimensional coordinates of joint centres, the calculation of an angle from a sequence of sine and cosine values and the curve fitting of angles using quintic splines. For each stage, other possible approaches are discussed. Original procedures are presented for obtaining individual error estimates of both the film data and the calculated angles to permit the automatic fitting of quintic splines for interpolation and differentiation and for deriving the time history of an angle as a continuous function from a sequence of sine and cosine values. The method is applied to a forward somersault with 1 1/2 twists and the average error estimate of 17 orientation angles is obtained as 2.1 degrees.
Biomechanical Phenomena↗
The simulation of aerial movement--II. A mathematical inertia model of the human body.
A mathematical inertia model which permits the determination of personalized segmental inertia parameter values from anthropometric measurements is described. The human body is modelled using 40 geometric solids which are specified by 95 anthropometric measurements. A 'stadium' solid is introduced for modelling the torso segments using perimeter and width measurements. This procedure is more accurate than the use of elliptical discs of given width and depth and permits a smaller number of such solids to be used. Inertia parameter values may be obtained for body models of up to 20 segments. Errors in total body mass estimates from this and other models are discussed with reference to the unknown lung volumes.
Anthropometry↗