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Objectives: In National Collegiate Athletic Association Division I swimmers, we examined the differences in thoracic spine rotation in swimmers with and without scapular dyskinesis and the relationship between thoracic spine rotation and shoulder pain/dysfunction according to the Kerlan-Jobe Orthopaedic Clinic (KJOC) score., Design: Cross-sectional., Setting: Laboratory-based., Participants: 34 NCAA Division I swimmers (13 males, 21 females)., Main Outcome Measures: Self-reported upper extremity function and pain assessed with the KJOC questionnaire, thoracic spine range of motion, presence of scapular dyskinesis., Results: Dyskinesis was present in 15 of 34 (44%) subjects. Thoracic rotation averaged 136.7° and KJOC averaged 87.7 with no differences between swimmers with or without dyskinesis. We observed no correlation between KJOC-identified shoulder pain/dysfunction and thoracic rotation., Conclusions: In our cohort of NCAA Division 1 swimmers, no differences were found between swimmers with or without scapular dyskinesis and extent of thoracic rotation. We found no correlation between thoracic rotation and the amount of self-reported pain and dysfunction experienced in the upper extremity. The presence of scapular dyskinesis in nearly half of our subjects indicates that swimmers need to be assessed for this abnormality. If observed, rehabilitation should address the dyskinesis and improve thoracic rotation in an attempt to alleviate further upper extremity pain and dysfunction., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To summarize and evaluate the current diagnostic accuracy of clinical measures used to diagnose Achilles tendon injuries., Data Sources: A literature search of MEDLINE, CINAHL, and EMBASE databases was conducted with key words related to diagnostic accuracy and Achilles tendon injuries., Study Selection: Original research articles investigating Achilles tendon injuries against an acceptable reference standard were included., Data Extraction: Three studies met the inclusion criteria. Quality assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. DerSimonian-Laird random-effects models were used to pool sensitivity (SN), specificity (SP), and diagnostic odds ratios with their 95% confidence intervals (CIs)., Data Synthesis: The SN and negative likelihood ratio (-LR) values for Achilles tendon rupture measures ranged from 0.73 (95% CI = 0.65, 0.81) and 0.30 (95% CI = 0.23, 0.40) to 0.96 (95% CI = 0.93, 0.99) and 0.04 (95% CI = 0.02, 0.10), respectively, whereas SP and positive likelihood ratio (+LR) values ranged from 0.85 (95% CI = 0.72, 0.98) and 6.29 (95% CI = 2.33, 19.96) to 0.93 (95% CI = 0.84, 1.00) and 13.71 (95% CI = 3.54, 51.24), respectively, with the highest SN and SP both reported in the calf-squeeze test. The SN and -LR values for Achilles tendinopathy measures ranged from 0.03 (95% CI = 0.00, 0.08) and 0.97 (95% CI = not reported) to 0.89 (95% CI = 0.75, 0.98) and 0.19 (95% CI = not reported), whereas SP and +LR values ranged from 0.58 (95% CI = 0.38, 0.77) and 2.12 (95% CI = not reported) to 1.00 (95% CI = 1.00, 1.00) and infinity, respectively, with the highest SN and SP reported for morning stiffness and palpation for crepitus. Pooled analyses demonstrated similar diagnostic properties in all 3 clinical measures (arc sign, palpation, and Royal London Hospital test), with SN and -LR ranging from 0.42 (95% CI = 0.23, 0.62) and 0.68 (95% CI = 0.50, 0.93), respectively, for the arc sign, to 0.64 (95% CI = 0.44, 0.81) and 0.48 (95% CI = 0.29, 0.80), respectively, for palpation. Pooled SP and +LR ranged from 0.81 (95% CI = 0.65, 0.91) and 3.15 (95% CI = 1.61, 6.18), respectively, for palpation, to 0.88 (95% CI = 0.74, 0.96) SP for the arc sign and 3.84 (95% CI = 1.69, 8.73) +LR for the Royal London Hospital test., Conclusions: Most clinical measures for Achilles tendon injury have greater diagnostic than screening capability.

Summer dance intensive programs are an integral part of many serious dancers' training. The risk and rate of injury in this setting have not been well studied. The goal of this data analysis is to detail the epidemiology of dance injuries reported during a summer dance intensive over a consecutive 3 year period. Data collection included information regarding the number of evaluation and treatment sessions conducted at the program's walk-in clinic, body regions injured, whether the injuries were recurrences of pre-existing conditions or newly sustained during the intensive, and at what point in the program they were recorded. Overall, more of the clinic's clientele presented with multiple injuries than with single discrete injuries. The anatomic distribution of injuries appears to be consistent with previously reported data, with the four most commonly injured body regions being ankle, pelvis and hip, knee, and lumbar spine. Injuries sustained during the intensive (IR) occurred at a 2:1 ratio to pre-intensive injuries (PR). Relative to those with PR injuries, dancers with IR injuries were far more likely to present during the first half of the program. This study is a first step toward filling a gap in the literature by describing injury incidence in a specific population within the dance community.

Parallel to the European Union acrylamide monitoring for the years 2007-2009, Switzerland performed its own monitoring, covering the whole range of products that significantly contain acrylamide (almost 300 samples per year), but focusing on those products that may result in high exposure. As reducing sugars are critical for potato products, these were included. No significant change, particularly improvement, was noticed, especially regarding those products for which substantial potential for improvement is known. 'Western-style' French fries continued to contain some four times more reducing sugars than 'traditional' fries, with correspondingly higher acrylamide in the finished product. The supply of raw potatoes low in reducing sugars by retail shops needs improvement, but there seemed to be insufficient willingness on a voluntary basis. A foreign producer was successful in penetrating the Swiss market with special potato chips containing up to 7000 microg kg(-1) acrylamide and only harsh measures could stop this. Three of about 61 products in the group of bakery ware showed a marked improvement. But there was also a store brand cracker that competed with a leading brand which contained 15 times more acrylamide (845 microg kg(-1)). Cereals contained 1080 microg kg(-1) acrylamide and even a warning did not prompt the producer to sell substantially better products one year later. It seems that only measures by the authorities will achieve improvements. The following seem promising: a limit for reducing sugars in prefabricates for French fries; the improved supply of raw potatoes low in sugars for roasting and frying; a legal limit for acrylamide content in potato chips; a general provision that products must not contain substantially more acrylamide than achievable by good manufacturing practice; and fryers with a temperature profile from an initial high to a lower final value.

We report on a monochorionic/diamniotic twin pregnancy discordant for trisomy 21. Amniocentesis (at 13(5/7) weeks) was performed following ultrasound signs of hydrops and cystic hygroma in twin 1 (T1). Prenatal karyotype showed non-mosaic trisomy 21 in T1 (47,XX,+21[7]), and low-grade mosaic trisomy 21 in twin 2 (T2) (47,XX,+21[2]/46,XX[19]). Post mortem examination of fetal skin, kidneys and lungs confirmed trisomy 21 in T1 (47,XX,+21[548]) and the placenta (47,XX,+21[200]). T2 had a normal karyotype (46,XX[648]). Analysis of microsatellite polymorphisms in multiple samples from the placenta, hand, lungs, kidneys and the umbilical cords of both twins confirmed monozygosity for all loci tested, and trisomy 21 in T1. Unexpectedly, T1 and T2 inherited different maternal alleles for markers of the most distal 4 Mbp of 21q. At least four successive events are needed to explain the genetic status of both twins and include maternal MI premature chromatids separation or maternal II meiotic nondisjunction and post-zygotic events such as, chromosome rescue, nondisjunction, an/or recombination., (Copyright 2008 Wiley-Liss, Inc.)