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To examine the effects of "operationally relevant" loads on postural stability and to determine the effects of unilateral and bilateral strength training programs on postural stability in healthy, recruit-aged men. Fifteen subjects were randomly assigned to either a unilateral (UL; n = 7) or bilateral (BL; n = 8) strength training group, which performed strength training 3 times a week for 4 weeks. Subjects completed the following pretest and post-test assessments: 1 repetition maximum in bilateral (1RM-BL) and unilateral (1RM-UL) stance positions and bilateral and unilateral balance tasks with eyes open and eyes closed. Balance tasks were performed over 3 loading conditions: body mass (BM), 50% BM, and 70% BM. Sample entropy (SE) and root mean square (RMS) were calculated from the center of pressures collected during each balance assessment. The UL strength training group showed significant improvement after training in both 1RM-UL (p < 0.01) and 1RM-BL (p < 0.01). The BL strength training group only showed significant improvement in 1RM-BL (p = 0.01). There was a significant main effect of load on RMS (p < 0.05) across all balance tasks with RMS increasing with increasing load. Sample entropy was found to decrease with increasing load in the unilateral eyes open and bilateral stance tasks. Significant increases in strength (~10 to -29%) were observed; however, increased strength alone is not enough to mitigate the effects of load carriage on the postural control, even when training is performed in stance positions that are posturally challenging. Therefore, "operationally relevant" loads negatively impact postural stability in novice load carriers when assessing nonlinear measures. [ABSTRACT FROM AUTHOR]

High rates of occupational training-related lower-limb musculoskeletal (MSK) overuse injuries are reported for British Army recruits during basic training. Foot drill is a repetitive impact loading occupational activity and involves striking the ground violently with an extended-knee (straight-leg) landing. Foot drill produces vertical ground reaction force (vGRF) equal to or greater than those reported for high-level plyometric exercises/activities. Shock absorbing footwear aid in the attenuation of the magnitude of vGRF, resulting in a reduced risk of lower-limb MSK overuse injury when running. The potential shock absorbing characteristics of standard issue British Army footwear on the magnitude of vGRF and temporal parameters of foot drill are scant. Therefore, this study sought to determine the magnitude of and examine changes in vGRF and temporal parameters of foot drill across 3 types of British Army footwear. Sampled at 1,000 Hz, the mean of 8 trials from 15 recreationally active men were collected from 4 foot drills; stand-at-ease, stand-at-attention, quick-march (QM), and halt. Analysis of a normal walk was included to act as a comparison with QM. Significant main effects (P ≤ 0.05) were observed between footwear and foot drill. The training shoe (TR) demonstrated significantly greater shock absorbing capabilities when compared with the combat boot and ammunition boot. Foot drill produced peak vGRF and peak vertical rate of force development in excess of 5 bw, and 350 bw·s, respectively. Time to peak vGRF ranged from 0.016 to 0.036 ms across foot drills, indicating that passive vGRF may not be under neuromuscular control. The marginal reductions in the magnitude of vGRF and temporal parameters in foot drill associated with the TR may act to reduce the accumulative impact loading forces experienced by recruits, subsequently minimizing the severity and rates of lower-limb MSK overuse injuries and recruit medical discharges during basic training. [ABSTRACT FROM AUTHOR]

The purpose of this study was to quantify the reliability of kinetic variables of British Army foot drill performance within untrained civilians and report the magnitude of vertical ground reaction force (vGRF) and vertical rate of force development (RFD) of foot drills. Fifteen recreational active males performed 3 testing sessions across a 1-week period, with each session separated by 24 hours. Within each testing session participants (mean ± SD; age 22.4 ± 1.7 years; height 177 ± 5.6 cm; weight 83 ± 8.7 kg) completed 10 trials of stand-at-attention (SaA), stand-at-ease (SaE), Halt, quick-march (QM) and a normal walking gait, with vGRF and vertical RFD measured on a force plate. Between-session and within-session reliability was calculated as systematic bias, coefficient of variation calculated from the typical error (CVte%), and intraclass correlation coefficient (ICC). Significant (p ≤ 0.05) between-session differences were found for the vGRF SaA and SaE, and vertical RFD SaA and SaE conditions. Significant (p ≤ 0.05) within-session differences were found for the vGRF SaA and SaE conditions. A mean vGRF CVte% ≤10% was observed across all foot drills. However, the mean vertical RFD CVte% observed was ≥10% (excluding SaE) across all foot drills. The ICC analyses indicated that the vGRF Halt, QM, SaA, and Walk condition achieved moderate to large levels of test--retest reliability, with only SaE failing to achieve an ICC value ≥0.75. The vertical RFD QM, SaE, and Walk condition achieved moderate levels of test--retest reliability, with Halt and SaA failing to achieve an ICC value ≥0.75. It was determined that a single familiarization session and using the mean of 8 trials of vGRF are required to achieve acceptable levels of reliability. [ABSTRACT FROM AUTHOR]

The article discusses the study regarding the reliability of the 1 repetition maximum (1RM) test split-squat (SS) performance as well as the efficacy of the assessment on both bilateral squat (BLS) and 1RM split-squat for the non-resistance-trained recreationally active men. The method to examine the intersession reliability of the 1RM-SS performance through repeated-mesure design was developed. The result were outlined and concludes a systematic bias in the 1RM-SS data.

The article reports a study which was conducted to identify common injury patterns and illness and profile mood states and patterns of sleep of athletes participating in a desert environment ultramarathon. The results revealed that all participants had abrasion injuries, dehydration and heat stress; stiffness in knees and shin were the most common complaints. This suggests that medical personnel at the desert races should plan and expect injuries related to soft tissue and temperature.

The etiology of cecal diverticulitis remains unclear. The majority of diverticula are solitary and probably false and may be the result of the same degenerative process seen in the more common left-sided diverticulosis. A minority are true diverticula and may be of congenital origin. Cecal diverticulitis is clinically indistinguishable from acute appendicitis although patients with cecal diverticulitis tend to be older (average age, 40 years), have a longer duration of symptoms, and present less often with nausea and vomiting. In patients with previous appendectomy and in those with more indolent symptoms, barium enema may be helpful in making the diagnosis. If nonoperative treatment is chosen, careful follow-up with air contrast barium enema and colonoscopy should be carried out. The majority of patients require surgery and two types of cecal diverticulitis are encountered at laparotomy. The usual type, accounting for two thirds of cases, is easy to recognize, has an inflamed projection from the cecal wall, and is dealt with by a limited local diverticulectomy. Some authors advocate nonsurgical treatment for this first group of patients. Incidental appendectomy is advocated to avoid confusion should symptoms occur postoperatively. The hidden variant presents as a large, indurated phlegmon and is difficult to distinguish from a perforated ceal carcinoma. With the hidden variant, right hemicolectomy is the surgical treatment of choice and carries a 1.4 percent mortality. [ABSTRACT FROM AUTHOR]

The authors present the case of a patient who developed near total colonic necrosis shortly after renal transplantation. The onset of symptoms was temporally related to the administration of sodium polystyrene (Kayexalate®; Sanofi Winthrop Pharmaceuticals, New York, NY)-sorbitol enemas for treatment of hyperkalemia. Three similar cases have been reported in the literature. The presence of uremia and the use of sorbitol appear to be common denominators in the pathophysiology of this complication. It is suggested that Kayexalate®-sorbitol enemas be avoided in renal transplant patients. [ABSTRACT FROM AUTHOR]

This is the first case report of the superior mesenteric artery syndrome developing in a patient following total proctocolectomy and ileal J-pouch anal anastomosis. In addition, this is the first demonstration of this syndrome using abdominal CT scan. A 22-year-old veteran underwent total proctocolectomy for left-sided ulcerative colitis because of failure of medical therapy. At operation an ileal J-pouch anal anastomosis was constructed. Following operation, the patient developed an intestinal obstruction. Abdominal CT scan demonstrated scant retroperitoneal fatty tissue, massive dilatation of the duodenum proximal to the midline, and tapered narrowing of the duodenum between the superior mesenteric artery and aorta. These findings indicated superior mesenteric artery syndrome: arteriomesenteric obstruction of the duodenum. Based on the experience of this case, the authors believe that compression of the duodenum by the superior mesenteric artery may be a common but unsuspected cause of prolonged postoperative ileus or early postoperative obstruction following ileal pouch anal anastomosis. [ABSTRACT FROM AUTHOR]