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Orthopaedic Surgery Feb 2014Injury of the ulnar collateral ligament (UCL) of thumb can be incapacitating if untreated or not treated properly. This injury is notorious for frequently being missed... (Review)
Review
Injury of the ulnar collateral ligament (UCL) of thumb can be incapacitating if untreated or not treated properly. This injury is notorious for frequently being missed by inexperienced health care personnel in emergency departments. It has frequently been described in skiers, but also occurs in other sports such as rugby, soccer, handball, basketball, volleyball and even after a handshake. The UCL of the thumb acts as a primary restraint to valgus stress and is injured if hyperabduction and hyperextension forces are applied to the first metacarpophalangeal joint. The diagnosis is best established clinically, though MRI is the imaging modality of choice. Many treatment options exist, surgical treatment being offered depending on various factors, including timing of presentation (acute or chronic), grade (severity of injury), displacement (Stener lesion), location of tear (mid-substance or peripheral), associated or concomitant surrounding tissue injury (bone, volar plate, etc.), and patient-related factors (occupational demands, etc.). This review aims to identify the optimal diagnostic techniques and management options for UCL injury available thus far.
Topics: Collateral Ligaments; Diagnostic Imaging; Humans; Metacarpophalangeal Joint; Physical Examination; Rupture; Thumb
PubMed: 24590986
DOI: 10.1111/os.12084 -
PloS One 2019In men's artistic gymnastics, results that are particularly appreciated are those obtained in all-around and individual events such as the floor exercise, pommel horse,...
In men's artistic gymnastics, results that are particularly appreciated are those obtained in all-around and individual events such as the floor exercise, pommel horse, rings, vault, parallel bars and horizontal bar. However, few studies have explored the dependency of anthropometric characteristics and fitness from age category or the event preferred by gymnasts. Therefore, the aim of this study is to compare the somatic type, body composition and values of some anthropometric and fitness characteristics and indices of gymnasts according to age and preferred event. A total of 53 male gymnasts (19 seniors and 34 juniors) were examined right before the Polish Senior and Junior Championships in Artistic Gymnastics in Warsaw (May 25 to 28, 2017). We examined the characteristics of body length, skeletal system mass, muscle mass, skinfold thickness, and body mass (Tanita S.C.-330S). Body composition (Durnin and Womersley equations), somatotypes (Heath-Carter methodology), handgrip strength (Takei dynamometer), body balance (UPST), the power of the lower limbs (CMJ) were evaluated. Senior gymnasts presented higher than juniors experience, mesomorphy and had higher values in fitness tests of handgrip strength and power of lower limbs (p<0.05). The specialists in floor exercises and vault characterized in higher mesomorphy and lower ectomorphy (p<0.05) and better results of CMJ (p<0.05). We concluded: The seniors demonstrated natural predominance over juniors in several somatic and fitness variables. Detected differences can be useful in the process of identification and development of gymnastic talent. The detected effect of preferred event on certain variables that characterize body build and physical fitness can be useful for choosing a specialization in gymnastic event. A high skill level in all-around events at a national competitive level can be achieved by an athlete characterized by adequate experience, a mesomorphy somatotype component, lower limb index, pelvi-acromial index and relative HGSmax.
Topics: Adolescent; Adult; Anthropometry; Athletes; Body Composition; Body Height; Cluster Analysis; Gymnastics; Hand Strength; Humans; Male; Muscle Strength; Physical Fitness; Skinfold Thickness; Somatotypes
PubMed: 30721273
DOI: 10.1371/journal.pone.0211533 -
Archives of Disease in Childhood.... Jun 2019Fever is a common symptom in children receiving treatment for cancer. Clinicians and families are most concerned about febrile neutropenia, though non-neutropenic fever... (Review)
Review
Fever is a common symptom in children receiving treatment for cancer. Clinicians and families are most concerned about febrile neutropenia, though non-neutropenic fever often causes more challenging treatment dilemmas. This article provides a structured approach to the initial assessment, examination, investigation and risk assessment of children with fever during treatment for childhood cancer. Non-neutropenic fever in children with cancer is not well researched. There are no systematic reviews of its management and no National Institute for Health and Care Excellence (NICE) (or other international) guidance about what to do. Features to consider when managing non-neutropenic fever are discussed. Febrile neutropenia, meanwhile, is an oncological emergency and requires management using standard sepsis principles including administration of broad-spectrum antibiotics. Relevant NICE guidance provides a clear structure for treatment. Ongoing management depends on the response to initial treatment.
Topics: Anti-Infective Agents; Child; Clinical Laboratory Techniques; Disease Transmission, Infectious; Febrile Neutropenia; Fever; Humans; Immunocompromised Host; Neoplasms; Opportunistic Infections; Physical Examination; Practice Guidelines as Topic; Risk Assessment
PubMed: 30104324
DOI: 10.1136/archdischild-2017-314718 -
PloS One 2023Advanced marine ecosystem models can contain more than 100 biogeochemical variables, making data assimilation for these models a challenging prospect. Traditional...
Advanced marine ecosystem models can contain more than 100 biogeochemical variables, making data assimilation for these models a challenging prospect. Traditional variational data assimilation techniques like 4dVar rely on tangent linear and adjoint code, which can be difficult to create for complex ecosystem models with more than a few dozen variables. More recent hybrid ensemble-variational data assimilation techniques use ensembles of model forecasts to produce model statistics and can thus avoid the need for tangent linear or adjoint code. We present a new implementation of a four-dimensional ensemble optimal interpolation (4dEnOI) technique for use with coupled physical-ecosystem models. Our 4dEnOI implementation uses a small ensemble, and spatial and variable covariance localization to create reliable flow-dependent statistics. The technique is easy to implement, requires no tangent linear or adjoint code, and is computationally suitable for advanced ecosystem models. We test the 4dEnOI implementation in comparison to a 4dVar technique for a simple marine ecosystem model with 4 biogeochemical variables, coupled to a physical circulation model for the California Current System. In these tests, our 4dEnOI reference implementation performs similarly well to the 4dVar benchmark in lowering the model observation misfit. We show that the 4dEnOI results depend heavily on covariance localization generally, and benefit from variable localization in particular, when it is applied to reduce the coupling strength between the physical and biogeochemical model and the biogeochemical variables. The 4dEnOI results can be further improved by small modifications to the algorithm, such as multiple 4dEnOI iterations, albeit at additional computational cost.
Topics: Ecosystem; Algorithms; Benchmarking; Physical Examination
PubMed: 37669263
DOI: 10.1371/journal.pone.0291039 -
PloS One 2016Although ageing people could benefit from healthy diet and physical activity to maintain health and quality of life, further understandings of the diet- and physical...
Although ageing people could benefit from healthy diet and physical activity to maintain health and quality of life, further understandings of the diet- and physical activity-related mechanisms that may cause changes in health and quality of life perception are necessary. The purpose of the study was to investigate the effect of eating attitudes, body mass and image satisfaction, and exercise dependence in the relationship between physical activity and health and quality of life perception in older individuals. Hundred and seventy-nine late middle-aged, (55-64 yrs), young-old (65-74 yrs), and old (75-84 yrs) senior athletes (n = 56), physically active (n = 58) or sedentary adults (n = 65) were submitted to anthropometric evaluations (body mass, height) and self-reported questionnaires: Body Image Dimensional Assessment, Exercise Dependence Scale, Eating Attitude Test, and Short Form Health Survey (Physical Component Summary [PCS] and Mental Component Summary [MCS] of and health and quality of life perception). Senior athletes, physically active, and sedentary participants subgroups differed (P<0.05) from each other in body mass index (BMI) and several components of body image and exercise dependence. Senior athletes showed, compared to their sedentary counterparts, further differences (P<0.05) in eating attitudes and in both PCS and MCS. Mediation analysis showed that the relationship between physical activity habit and MCS, but not PCS, was indirectly explained by a serial mediation chain composed of objective BMI and subjective body image (dis)satisfaction. Findings confirm the relevant role of physically active life habits for older individuals to perceive good physical and mental health. The novelty of the three-path mediated link between physical activity level and mental health perception suggests that the beneficial effect of a physically active lifestyle on weight control can positively impinge on the cognitive-emotional dimension of mental health by ensuring the maintenance, also at older age, of a satisfactory body image.
Topics: Aged; Aged, 80 and over; Aging; Body Image; Body Weights and Measures; Exercise; Feeding Behavior; Female; Health Status; Humans; Male; Middle Aged; Models, Statistical; Perception; Personal Satisfaction; Quality of Life; Surveys and Questionnaires
PubMed: 27611689
DOI: 10.1371/journal.pone.0160805 -
Journal of Hypertension Jan 2021When assessing arterial stiffness, heart rate (HR) and blood pressure (BP) are potential confounders. It appears that the HR/BP dependences of pulse wave velocity (PWV)...
OBJECTIVES
When assessing arterial stiffness, heart rate (HR) and blood pressure (BP) are potential confounders. It appears that the HR/BP dependences of pulse wave velocity (PWV) and distensibility are different, even though both assess arterial stiffness. This study aims to compare aortic PWV as measured using pulse transit time (PWVTT) and as calculated from distensibility (PWVdist) at the same measurement site and propose a solution to the disparity in dependences of PWVTT and PWVdist.
METHODS
Adult anaesthetized rats (n = 24) were randomly paced at HRs 300-500 bpm, at 50 bpm steps. At each step, aortic PWVTT (two pressure-tip catheters) and PWVdist (pressure-tip catheter and ultrasound wall-tracking; abdominal aorta) were measured simultaneously while BP was varied pharmacologically.
RESULTS
HR dependence of PWVdist paradoxically decreased at higher levels of BP. In addition, BP dependence of PWVdist was much larger than that of PWVTT. These discrepancies are explained in that standard PWVdist uses an approximate derivative of pressure to diameter, which overestimates PWV with increasing pulse pressure (PP). In vivo, PP decreases as HR increases, potentially causing a PWVdist decrease with HR. Estimating the full pressure-diameter curve for each HR corrected for this effect by enabling calculation of the true derivative at diastolic BP. This correction yielded a PWVdist that shows HR and BP dependences similar to those of PWVTT. As expected, BP dependence of all PWV metrics was much larger than HR dependence.
CONCLUSION
Measured and calculated PWV have different dependences on HR and BP. These differences are, at least in part, because of approximations made in using systolic and diastolic values to calculate distensibility.
Topics: Animals; Aorta; Blood Pressure; Heart Rate; Pulse Wave Analysis; Rats; Vascular Stiffness
PubMed: 32784350
DOI: 10.1097/HJH.0000000000002608 -
International Journal of Environmental... Jul 2020This study aimed to identify classifier variables by considering both gait and physical fitness for identifying adults aged over 75 years and global cognitive function...
This study aimed to identify classifier variables by considering both gait and physical fitness for identifying adults aged over 75 years and global cognitive function declines in older adults. The participants included 735 adults aged 65-89 years who were asked to walk at three different speeds (slower, preferred, and faster) while wearing inertial measurement units embedded in shoe-type data loggers and to perform nine physical fitness tests. The variability in the stance phase as well as the strength, balance, and functional endurance showed a strong dependence on the age being over 75 years. The cognitive function was evaluated by the Mini-Mental State Examination; a longer stance phase at a slower walking speed and decreased grip strength and five times sit-to-stand were associated with cognitive function. These findings may be useful for determining the decline in physical performance of older adults. A longer stance phase and decreased grip strength and five times sit-to-stand may be factors that help distinguish declines in cognitive function from normal age-related declines.
Topics: Aged; Aged, 80 and over; Aging; Cognition; Female; Gait; Humans; Male; Physical Fitness; Walking; Walking Speed
PubMed: 32635202
DOI: 10.3390/ijerph17134786 -
International Journal of Occupational... Mar 2017Non-medical hospital staff members are in frequent contact with patients and therefore are required to perform a wide variety of repetitive and high-frequency...
OBJECTIVES
Non-medical hospital staff members are in frequent contact with patients and therefore are required to perform a wide variety of repetitive and high-frequency activities. The objective of this study was to assess the relationships between upper extremity activity and carpal tunnel syndrome (CTS) among non-medical hospital staff members.
MATERIAL AND METHODS
Carpal tunnel syndrome in 144 non-medical hospital staff members was diagnosed using the Nordic Musculoskeletal Questionnaire (NMQ), a physician's diagnosis, physical examination (Tinel's signs and Phalen test) and a nerve conduction velocity (NCV) test. In addition, an ergonomic assessment was performed and a video camera was used to record the physical activities at work.
RESULTS
The prevalence rate of CTS was highest for the NMQ (51.9%), followed by physician's diagnosis (49.5% for the right hand, 29.9% for the left hand), physical examination (54.7%), and nerve conduction test (motor nerve 27.5% and 25%, sensory nerve 21.7% and 15%, for right and left hands, respectively). Based on logistic regression models for the NMQ and physician's diagnoses, there was a dose-dependently higher risk of CTS with the upper extremity index among participants, but this was non-significant based on the physical examination and nerve conduction tests.
CONCLUSIONS
Nerve conduction velocity is the gold standard in diagnosis of CTS, but use of NMQ and physician's diagnosis may overestimate the incidence of CTS in workers who have been engaging in repetitive stress activities for a relatively short time. Int J Occup Med Environ Health 2017;30(2):281-290.
Topics: Adult; Carpal Tunnel Syndrome; Diagnostic Techniques, Neurological; Ergonomics; Hospitals, Teaching; Humans; Neural Conduction; Occupational Medicine; Personnel, Hospital; Physical Examination; Posture; Surveys and Questionnaires; Upper Extremity
PubMed: 28366957
DOI: 10.13075/ijomeh.1896.00566 -
BMC Medical Education Nov 2016During their pre-clinical years, medical students are given the opportunity to practice clinical skills with simulated patients. During these formative objective...
BACKGROUND
During their pre-clinical years, medical students are given the opportunity to practice clinical skills with simulated patients. During these formative objective structured clinical encounters (OSCEs), tutors from various backgrounds give feedback on students' history taking, physical exam, and communication skills. The aim of the study was to evaluate whether the content and process of feedback varied according to the tutors' profile.
METHODS
During 2013, all 2 and 3 year medical students and tutors involved in three formative OSCEs were asked to fill in questionnaires, and their feedback sessions were audiotaped. Tutors were divided into two groups: 1) generalists: primary care, general internist and educationalist physicians 2) specialists involved in the OSCE related to their field of expertise. Outcome measures included the students' perceptions of feedback quality and utility and objective assessment of feedback quality.
RESULTS
Participants included 251 medical students and 38 tutors (22 generalists and 16 specialists). Students self-reported that feedback was useful to improve history taking, physical exam and communication skills. Objective assessment showed that feedback content essentially focused on history taking and physical exam skills, and that elaboration on clinical reasoning or communication/professionalism issues was uncommon. Multivariate analyses showed that generalist tutors used more learner-centered feedback skills than specialist tutors (stimulating student's self-assessment (p < .001; making the student active in finding solutions, p < .001; checking student's understanding, p < .001) and elaborated more on communication and professionalism issues (p < 0.001). Specialists reported less training in how to provide feedback than generalists.
CONCLUSION
These findings suggest that generalist tutors are more learner-centered and pay more attention to communication and professionalism during feedback than specialist tutors. Such differences may be explained by differences in feedback training but also by differences in practice styles and frames of references that should be further explored.
Topics: Clinical Competence; Communication; Cooperative Behavior; Curriculum; Education, Medical, Undergraduate; Educational Measurement; Female; Formative Feedback; Humans; Male; Medical History Taking; Physical Examination; Problem-Based Learning; Professional Competence; Program Evaluation; Prospective Studies; Students, Medical; Surveys and Questionnaires; Switzerland; Teaching
PubMed: 27846882
DOI: 10.1186/s12909-016-0815-x -
Acta Veterinaria Scandinavica Jun 2023Veterinary telemedicine has only been adopted to some degree. One aspect that needs to be evaluated is clinical examinations using video. The objective of this study was...
BACKGROUND
Veterinary telemedicine has only been adopted to some degree. One aspect that needs to be evaluated is clinical examinations using video. The objective of this study was to evaluate agreement between a traditional physical clinical examination and a clinical examination using recorded video using finishing pigs with umbilical outpouchings (umbilical hernias, cysts, and abscesses) as the study unit. A total of 102 finisher pigs with umbilical outpouchings were clinically examined and recorded on video. Four experienced pig veterinarians were allowed to examine each pig for approximately 10 min and were individually asked to fill out a predesigned clinical record. Approximately 1 month after the physical examinations, the veterinarians individually reexamined all 102 pigs in a blinded manner, utilizing the video recordings and filling in a predesigned clinical record.
RESULTS
For all measurements using a ruler, a high Pearson correlation coefficient was observed between physical and video examinations (range 0.69-0.95). In comparison, the visual bodyweight estimation had a lower Pearson correlation coefficient (range 0.57-0.64). Substantial to almost perfect agreement was observed between the physical and video examinations for abnormal weight distribution on any leg, restricted gait movements, lameness, signs of pain, fitness for transportation, presence of wounds, and categorization of the number of wounds > 4 cm on the umbilical outpouching (mean Kappa range 0.67-0.87). Fair agreement was observed for the presence of perineal soiling, ear wounds, pendulation of umbilical outpouching, umbilical outpouching touching the legs, skin not movable over the umbilical outpouching, and umbilical outpouching wound characteristics: type, presence of crusts, active bleeding, thick wound edges, connective tissue (mean Kappa range 0.21-0.40). Slight agreement was observed for umbilical outpouching characteristics: shape, macroscopic vascularization of the skin covering the outpouching, and the presence of scars, excoriations, and fistulas (mean Kappa range 0.10-0.20). Poor agreement was observed for the presence of granulation tissue (mean Kappa = - 0.05).
CONCLUSIONS
The agreement between a physical clinical examination and a clinical examination using recorded video of the same pig varies from poor to almost perfect, depending on the clinical sign and the executing veterinarian.
Topics: Swine; Animals; Humans; Gait; Video Recording; Veterinarians; Lameness, Animal; Pain; Observer Variation; Reproducibility of Results; Swine Diseases
PubMed: 37355609
DOI: 10.1186/s13028-023-00689-8