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BACKGROUND: Dockworkers are exposed to physical overloads that can contribute to the development of musculoskeletal disorders, leading to functional disability and absenteeism. OBJECTIVE: to map, critically appraise, and synthesize the available evidence on the prevalence of musculoskeletal diseases associated with port occupational activities. METHODS: A comprehensive search was conducted in structured and unstructured databases in August 2023, with no date or language restriction, to identify observational studies evaluating the prevalence of musculoskeletal disorders in dockworkers' occupational activity. The risk of bias was assessed using validated tools based on the included study designs. Data from studies were pooled in meta-analyses. The certainty of the evidence was assessed using the GRADE approach. RESULTS: We identified 12 analytical cross-sectional studies involving 7821 participants in ports of five countries. Most studies (75%) had a moderate methodological quality according to the Joanna Briggs Institute tool. Considering the overall worker categories and any musculoskeletal disorders, the meta-analysis showed a prevalence of 58% (95% Confidence Interval [95% CI] 37% to 78%), with degenerative spinal diseases 42% (95% CI –0.6% to 91%) and low back pain 36% (95% CI 21% to 50%) being the most prevalent conditions. Symptoms were predominantly in foremen and stevedores. The certainty of the evidence was very low. CONCLUSIONS: Musculoskeletal disorders seem prevalent among dockworkers, mainly degenerative spinal diseases and low back pain. Studies with greater methodological consistency are still needed to validate these hypotheses and assist in decision-making for implementing preventive and informational policies in maritime port management organizations. PROSPERO registry CRD42021257677. [ABSTRACT FROM AUTHOR]

Introduction Musculoskeletal injuries (MSKIs) among active duty soldiers result in more than 10 million limited duty days each year and account for more than 70% of the medically nondeployable population. Overuse injuries in lower limbs from running, foot marching long distances with heavy loads, and lifting heavy objects are the most common types of injuries in the military. Physical training and rehabilitation exercises for greater resiliency through aerobic, muscle strength, endurance, and agility conditioning programs can prevent or reduce the effects of MSKIs if Soldiers adhere to proper biomechanics and training techniques. We are introducing a three-dimensional (3D) camera-based platform for Optical Screening and Conditioning for Injury Resilience (OSCIR) that is designed to identify and correct high-risk movement patterns based on quantifiable biomechanical measurements in clinical or field settings. Our goal is to improve resilience to MSKI by offering greater access to quality of movement skills in warfighters through an autonomous device that can be used in Sports Medicine and Reconditioning Team (SMART) clinics and High-Intensity Tactical Training (HITT) sites. Materials and Methods OSCIR fuses four pairs of Kinect Azure cameras into a concise footprint to achieve suitable sampling rates and an unobstructed field of view for accurate dynamic movement tracking using a custom point cloud solution. We designed a unique multistage 3D joint tracking algorithm architecture to methodically isolate the human body point cloud from the background, identify individual limb segments, and perform iterative joint optimization at the global and local joint levels. We evaluated the feasibility of our prototype system among N  = 12 control participants (6 M/6 F; 21-37 years) in compliance with the Western Institutional Review Board (Tracking #20225920, approved on November 4, 2022). Five task-specific MSKI outcome metrics identified by end-user physical therapists and athletic trainers as indicators for movement quality were assessed across 7 lower-extremity exercises derived from standardized MSK assessment/conditioning batteries used in the military. Data were recorded concurrently by OSCIR and a reference standard Vicon motion capture system for validating system accuracy. Results Task-specific MSKI indicators for knee flexion and hip flexion range of motion achieved an average error of 4.05 ± 2.34°, while 3D position-based postural outcomes of left-right foot distance, left-right hand distance, and step length obtained mean absolute errors of 2.58 ± 2.30 cm. Results support the feasibility of our system in achieving outcomes that are comparable to currently accepted laboratory standards. Conclusions Our study describes the integration process for a 3D camera-based clinical system for MSKI conditioning and rehabilitation. The impact of our system will enable key stakeholders in the military to manage MSKIs in warfighters by automating key assessment and rehabilitation test batteries; making tests more readily accessible, and interpretations more accurate by providing objective biomechanical measures. OSCIR is undergoing turn-key design features to serve as a screening tool for warfighters to readily assess susceptibility to MSKI or as a training platform to help guide exercise techniques to achieve resiliency against future injuries. [ABSTRACT FROM AUTHOR]

The increase in repetitive strain injuries to the hand underscores the need for assessing and preventing musculoskeletal overuse associated with hand-intensive tasks. This study investigates the risk of overload injuries in soft tissue structures of the hand by analyzing the pressure distribution and location of peak pressure in the hand during snap-fit connection assembly in the automotive industry. The influence of the surface geometry of automotive trim components the pressure distribution and force imparted during strikes with the palm and the fist are investigated in a cohort of 30 subjects with extensive experience installing trim parts with snap-fit connections. Using the palm or fist (ulnar hand side) of the dominant hand, the subjects struck a simulation device with a flat, rounded, or edged surface geometry. The average peak force applied was 600 N (±122 N), nearly 3 times the force required to overcome the technical resistance of the snap-fit connector (220 N). Fist strikes exerted a 40% higher mean peak pressure and 18% higher mean pressure than did palm strikes. The pressure distribution in the region of the thenar eminence and soft tissue of the ulnar side of the hand did not differ between fist strikes on flat and edged surfaces. Considering the delicate anatomy of the hand, especially the hypothenar muscles on the ulnar side, assembling connection claps using the fist instead of the palm may prevent repetitive blunt trauma to the sensitive blood vessels and nerves in the palm. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Inferior vena cava (IVC) injury is a potentially fatal injury with a high mortality rate of 34-70%. In cases in which the patient’s condition is stable, diagnosis by computed tomography (CT) is the criterion standard. Findings on CT include retroperitoneal hematoma around the IVC, extravasation of contrast medium, and abnormal morphology of the IVC. We report a case of an IVC injury that could not be diagnosed by preoperative CT examination and could not be immediately detected during laparotomy. Case Report: A 73-year-old woman had stabbed herself in the neck and abdomen at home using a knife. When she arrived at our hospital, we found a stab wound several centimeters long on her abdomen and a cut approximately 15 cm long on her neck. We activated the massive transfusion protocol because she was in a condition of hemorrhagic shock. After blood transfusion and blood pressure stabilization, contrast-enhanced computed tomography (CT) revealed a small amount of fluid in the abdominal cavity. An otorhinolaryngologist performed successful drainage and hemostasis, and a laparotomy was performed. Gastric injury and mesentery injury of the transverse colon were identified and repaired with sutures. Subsequent search of the retroperitoneum revealed massive bleeding from an injury to the inferior vena cava (IVC). The IVC was repaired. Postoperative progress was good, and she was discharged from the hospital 65 days after her injuries. Conclusions: We experienced a case of penetrating IVC injury, which is a rare trauma. Occult IVC injury may escape detection by preoperative CT examination or during laparotomy. [ABSTRACT FROM AUTHOR]

To date, there has been a lag between the rise in E-cigarette use and an understanding of the long-term health effects. Inhalation of E-cigarette aerosol delivers high doses of nicotine, raises systemic cytokine levels, and compromises cardiopulmonary function. The consequences for muscle function have not been thoroughly investigated. The present study tests the hypothesis that exposure to nicotine-containing aerosol impairs locomotor muscle function, limits exercise tolerance, and interferes with muscle repair in male mice. Nicotine-containing aerosol reduced the maximal force produced by the extensor digitorum longus (EDL) by 30%-40% and, the speed achieved in treadmill running by 8%. Nicotine aerosol exposure also decreased adrenal and increased plasma epinephrine and norepinephrine levels, and these changes in catecholamines manifested as increased muscle and liver glycogen stores. In nicotine aerosol exposed mice, muscle regenerating from overuse injury only recovered force to 80% of noninjured levels. However, the structure of neuromuscular junctions (NMJs) was not affected by e-cigarette aerosols. Interestingly, the vehicle used to dissolve nicotine in these vaping devices, polyethylene glycol (PG) and vegetable glycerin (VG), decreased running speed by 11% and prevented full recovery from a lengthening contraction protocol (LCP) injury. In both types of aerosol exposures, cardiac left ventricular systolic function was preserved, but left ventricular myocardial relaxation was altered. These data suggest that E-cigarette use may have a negative impact on muscle force and regeneration due to compromised glucose metabolism and contractile function in male mice.NEW & NOTEWORTHY In male mice, nicotine-containing E-cigarette aerosol compromises muscle contractile function, regeneration from injury, and whole body running speeds. The vehicle used to deliver nicotine, propylene glycol, and vegetable glycerin, also reduces running speed and impairs the restoration of muscle function in injured muscle. However, the predominant effects of nicotine in this inhaled aerosol are evident in altered catecholamine levels, increased glycogen content, decreased running capacity, and impaired recovery of force following an overuse injury.

Copyright of Trabalho & Educação is the property of Work & Education of the Graduate Program, Faculty of Education, Federal University of Minas Gerais and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hand therapy clinical rotations are 12 weeks, and one common anecdotal change frequently expressed is an increase in hand strength. Quantifiable measures of change are not documented in the literature. The purpose of this study is to determine if students experience significant increases in strength during a clinical rotation. Methods: This study is a quasi-experimental, double-blinded, non-randomized sample of convenience. Grip and pinch strength were assessed pre, mid, and post clinical rotation. Demographic data were collected and reported. Paired t-tests were used to compare means between groups. SPSS 27.0 was used for data analysis. Results: After removing incomplete data sets, n = 12. Grip strength in the left hand showed a significant increase from pretest to posttest. Grip strength in the right hand showed no difference. Significant increases occurred in both right and left tripod pinch and lateral pinch strength from pretest to posttest. A significant increase was not observed for 2-point pinch strength. Discussion: This study provides insight into the changes in hand strength in students after a clinical rotation in hand therapy. Significant changes in grip and pinch strength do occur during this time. Increased load in grip and pinch patterns may have clinical implications for therapists practicing long term. [ABSTRACT FROM AUTHOR]

BACKGROUND: Early self-assessment for work-related musculoskeletal disorders (WMSDs) is crucial in preventing severe symptoms and long-term consequences. Accessible tools are necessary for proactive management. OBJECTIVE: To validate the OfficeCheck web application as a screening tool to classify office workers as capable of self-management for specific symptoms of WMSDs or requiring professional consultation. METHODS: This study was conducted to determine the criterion-related validity of OfficeCheck using physical therapy assessment as the reference standard. In total, 223 office workers who work with a computer more than two hours a day with or without symptoms of WMSDs participated in this study. All of them were classified by self-assessment on the OfficeCheck process flow (Kappa = 0.841) and physical therapy assessment, respectively. For statistical analysis, classification numbers were calculated for sensitivity, specificity, false positive rate (FPR), false negative rate (FNR), positive predictive value (PPV), and negative predictive value (NPV). RESULTS: A total of 223 workers with a mean age of 38.9±9.0 years and mean body mass index (BMI) of 24.3±5.2 kg/m2 were illustrated. The most common areas of complaint were neck/upper back and lower back/hip. The results indicated that OfficeCheck had high sensitivity (95.1%), low specificity (42.0%), low PPV (38.0%), and high NPV (95.8%). The FPR was 58.0% and the FNR was 4.9%. CONCLUSION: OfficeCheck was found to have high sensitivity to classify office workers as capable of self-management for specific symptoms of WMSDs or requiring professional consultation. The use of OfficeCheck is thus recommended for self-detection and management to stop the consequences of WMSDs. [ABSTRACT FROM AUTHOR]

Abstract Background Studies investigating vulnerable populations have shown that work-related musculoskeletal disorders have a negative impact on quality of life. However, no study has examined the body regions commonly affected by work-related musculoskeletal disorders in vulnerable populations. Objective To describe the body regions commonly affected by work-related musculoskeletal disorders in vulnerable populations. Methods Cross-sectional study. We used the ABEP questionnaire, the World Health Organization Quality of Life, the Nordic Musculoskeletal Disorders Questionnaire, the Perceived Stress Scale, and a self-report questionnaire to determine morning-evening in human circadian rhythms (chronotype assessment). To reduce the possibility of information bias, we provided prior training in the use of the instruments and created an electronic database that was filled out in duplicate (in cases of disagreement, a third researcher was consulted). We tested the normality of the data using the Shapiro–Wilk test. Results The sample consisted of 132 participants, but there was a sample loss of 41.6% (final sample n = 77). We observed the predominance of those who worked from 6 to 8 h/day, rest of 1 h during the working day, from 1 to 10 years of service and only 1 employment relationship. Regarding the quality of life, we observed a worse result in the domain related to the environment, as well as a stress level of 15.43 (± 7.52) with a maximum of 30. Finally, we observed the presence of pain self-reported by the artisanal fishermen in several regions of the body, lumbar being the most mentioned. Conclusion The neck, shoulders, arms, elbows, forearms, wrists, back, lumbar spine, and lower limbs are the most common parts of the body affected by work-related musculoskeletal disorders in artisanal fishermen.

Abstract Objective To investigate the long-term use of smartphones as a risk factor for the development of morbidities in the wrist and fingers. Methods The present is a descriptive, exploratory study with a quantitative approach based on injury prevalence among one hundred smartphone users of a private university in the state of Pernambuco, Northeastern Brazil. We applied a semi-structured questionnaire and the Boston Carpal Tunnel Questionnaire (BCTQ), as well as the Visual Analog Scale (VAS) and the Finkelstein, Phalen, reverse Phalen, and Tinel signal tests on the wrist. Results The average of the sample was of 22.73 years, with a prevalence of single, right-handed female participants. Most of them had been using smartphones for 5 to 10 years, and 85% reported discomfort in the wrist and fingers while using the device, with numbness as the most prevalent symptom. Most clinical tests were negative, and the Finklestein test showed greater positivity. The BCTQ is composed of a symptom severity scale (S scale) and a functional status scale (F scale): the overall score on the S scale was of 1.61, indicating mild to moderate symptoms, and the F scale revealed that the symptoms did not affect functionality. Conclusion There was a significant correlation between the length of use of smartphones and discomfort in the wrist and fingers; as such, smartphones are a risk factor for the development of morbidities.

Patellar tendon (PT) complaints are frequent throughout the population, with increased occurrence in athletes and, particularly, in youth competitive alpine skiers. Timely detection and treatment might improve prospects of recovery. Diagnostic modalities in clinical use to date rely on pain symptoms, manual palpation, and potentially, magnetic resonance imaging (MRI); however, MRI-based imaging yields limited sensitivity. Quantitatively measuring the morphological and mechanical properties of PTs by means of B-mode ultrasound and shear wave elastography (SWE), instead, may allow improved diagnosis or even early detection. We performed B-mode scans and three-dimensional ultrasound shear wave velocity (SWV) mapping and MRI of the PT in 106 youth skiers. A prospective one-year survey on health problems combined with clinical assessments served to categorize symptomatic and asymptomatic youth skiers. Skiers suffering from distal or proximal tendon complaints showed lower SWV in the respective tendon region than asymptomatic skiers (p = 0.035 and p = 0.019, respectively). Youth skiers with distal tendon complaints additionally exhibited decreased SWV in the proximal region compared to asymptomatic counterparts (p = 0.020). Cross-validated analysis of retrospective prediction indicated sensitivity and specificity in detecting tendon complaints in the range of 0.606–0.621 and 0.536–0.650, respectively. MRI detected distal tendon complaints with a sensitivity of 0.410 (12/29) but failed to detect any proximal cases. This study agrees with the most recent literature in that SWE holds promise as a valuable adjunct modality for the diagnosis of PT complaints or even the detection of subclinical prestages. However, to evaluate its prospective predictive value, long-term studies are warranted. Highlights Patellar tendon complaints are a frequent complaint in athletes, particularly in youth competitive alpine skiers, but timely quantitative detection of related tendon properties remains challenging. Quantitative B-mode US and three-dimensional ultrasound shear wave elastography assessments and magnetic resonance imaging were performed in youth competitive alpine skiers. Three-dimensional shear wave elastography was able to discern symptomatic from asymptomatic patellar tendons both in the distal and proximal tendon regions, whereas magnetic resonance imaging failed to detect any proximal cases. [ABSTRACT FROM AUTHOR]

OBJECTIVE. The purpose of this article is to review the anatomy and pathology of the pes anserinus to increase the accuracy of imaging interpretation of findings affecting these medial knee structures. CONCLUSION. The pes anserinus, consisting of the conjoined tendons of the sartorius, gracilis, and semitendinosus muscles and their insertions at the medial aspect of the knee, is often neglected during imaging assessment. Common pathologic conditions affecting the pes anserinus include overuse, acute trauma, iatrogenic disorders, and tumors and tumorlike lesions.

IntroductionBicycle seat pressure on the perineum may impair arousal and clitoral erection, likely contributing to genital pain and numbness experienced by female cyclists.AimWe aimed to identify the association between genital pain and numbness experienced by female cyclists and female sexual dysfunction (FSD).MethodsFemale cyclists were recruited to complete an online survey using the Female Sexual Function Index (FSFI), a validated questionnaire to assess FSD. Cyclist demographics, experience, preferred riding style, use of ergonomic cycle modifications, and genital discomfort while riding were also queried. Multivariate logistic regression analysis was used to evaluate risk factors of FSD.Main outcome measuresThe main outcome was FSFI score, which is used to diagnose FSD when the FSFI score is

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anterior knee pain is a common complaint that can be caused by a wide spectrum of disorders affecting the many varied tissues at the anterior knee. The anatomy and pathologic conditions of the anterior knee can be approached systematically by organizing the region into four layers: (a) superficial layer of fat, fascia, and bursae; (b) functional layer composed of the extensor mechanism and patellar stabilizers; (c) intracapsular extrasynovial layer containing the fat pads; and (d) intra-articular layer. The superficial layer is composed of delicate tissues that are predisposed to blunt and penetrating trauma, irritation, and infection. The extensor mechanism forms the functional layer, is responsible for knee extension and patellar stabilization, and is engaged in repetitive movements; overuse disorders dominate in this layer. The fat pads of the anterior knee are discussed collectively as an extracapsular extrasynovial layer, functioning to improve congruence and protect the articular surfaces during motion. Diseases involving the fat pads can be primary or secondary to pathologic conditions in the rest of the joint. The synovial lining and cartilage surface are in the fourth and final intra-articular layer; pathologic conditions are centered around arthritides and internal derangement. Symptoms in the anterior knee may be due to conditions affecting one or more of these interrelated layers. ©RSNA, 2018.

Running-related injuries (RRI) may result from accumulated microtrauma caused by combinations of high load magnitudes (vertical ground reaction forces; vGRFs) and numbers (strides). Yet relationships between vGRF and RRI remain unclear - potentially because previous research has largely been constrained to collecting vGRFs in laboratory settings and ignoring relationships between RRI and stride number. In this preliminary proof-of-concept study, we addressed these constraints: Over a 60-day period, each time collegiate athletes (n = 9) ran they wore a hip-mounted activity monitor that collected accelerations throughout the entire run. Accelerations were used to estimate peak vGRF, number of strides, and weighted cumulative loading (sum of peak vGRFs weighted to the 9th power) across the entirety of each run. Runners also reported their post-training pain/fatigue and any RRI that prevented training. Across 419 runs and >2.1 million strides, injured (n = 3) and uninjured (n = 6) participants did not report significantly different pain/fatigue (p = 0.56) or mean number of strides per run (p = 0.91). Injured participants did, however, have significantly greater peak vGRFs (p = 0.01) and weighted cumulative loading per run (p

Muscle tendon unit fibre mechanics of hamstring and adductor strain injuries are not well studied, with factors such as fatigue promoted as risk factors in the absence of mechanistic evidence. In this study, musculoskeletal modelling was used to estimate fibre mechanics of four hamstring (biceps femoris long head, biceps femoris short head, semimembranosus and semitendinosus) and four adductor (adductor brevis, adductor longus, adductor magnus and gracilis) muscles during an anticipated cut task. The cut task was performed by 10 healthy elite male U20 basketball players both before and immediately after they played in one (of four) competitive basketball game. Biceps femoris long head produced significantly lower (p = 0.032) submaximal force post-game in the latter part of swing (30.7% to 35.0% of stride), though its peak force occurred later (37%) and remained unchanged. Semimembranosus produced significantly lower (p = 0.006) force post-game (32.9% to 44.9% of stride), which encompassed the instance of peak force (39%). Neither fibre velocity nor fibre length of the investigated muscles were significantly affected by game-play. These finding suggest that if fatigue is a factor in hamstring and adductor muscle strain injuries and is brought about by game-play, it is unlikely through the fibre mechanisms investigated in this study. [ABSTRACT FROM AUTHOR]

Abstract: This review article explores the multifaceted aspects of early specialization in diving, focusing on its implications for injury prevalence, performance, and mental health. It highlights the increasing trend of early specialization driven by ambitions for collegiate and Olympic success, despite recommendations advocating for diversification. Divers are at risk for acute and overuse injuries, particularly during high-velocity water entries; however, data on injury patterns, especially among elite divers and early specializers, remains scarce. Recent data suggest a correlation between early specialization and reduced rates of certain injuries among youth divers, but distinguishing between acute and overuse injuries is crucial. Additionally, early specialization may pose mental health risks, with divers facing pressures related to performance, body image, and parental expectations. This article underscores the need for tailored guidelines to mitigate injury risks and promote holistic well-being among youth divers, recognizing the complex interplay between physical and psychological factors in sports specialization., (Copyright © 2024 by the American College of Sports Medicine.)

This case report focuses on 'headspin hole', a unique overuse injury in breakdancers caused by repetitive headspins. It manifests as a fibrous mass on the scalp, hair loss and tenderness. The literature on this condition is limited. We present a detailed case report of a male breakdancer in his early 30s who developed a noticeable scalp protuberance over 5 years of extensive head-spinning practice. MRI showed significant subgaleal fibrosis and thickening of the subcutis, consistent with the 'cone-head sign'. The patient underwent successful surgical tumour removal, leading to aesthetic improvement and symptom relief. Histological analysis showed extensive fibrosis with no malignancy. Postoperative follow-up indicated high patient satisfaction and a significant reduction of the mass. This case underscores the importance of recognising chronic scalp conditions in breakdancers and suggests that surgical intervention can be an effective treatment., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Low back pain can be defined as pain below the ribs and above the upper gluteal line., Objectives: The study aimed to analyze low back pain in professionals from beauty salons in the city of Fortaleza, state of Ceará., Methods: Descriptive, quantitative-qualitative, transversal, non-probabilistic research in the snowball modality, conducted between June and August 2021 in the José Walter neighborhood. Two sociodemographic questionnaires and the Quebec Back Pain Disability scale were applied, which seeks to assess how pain affects the participants' daily lives., Results: Forty-two professionals were interviewed, of which 32 women (76.2%), with a mean age of 39.45 ± 10.99 years. Women were more likely to have an onset of low back pain and to live with pain for a longer time compared to men, in addition to these professionals having a significant overload for the hours worked. 52% of respondents showed significant clinical changes, mainly in relation to stand up for 20-30 minutes (16.7%), sit in a chair for several hours (14.3%), walk several kilometers (19%), carry two bags with groceries (14.3%) and lift and carry a heavy suitcase (28.6%)., Conclusions: It was evidenced that low back pain may be related to personal or environmental factors, with a sedentary lifestyle, length of service and working hours as strong indications for the onset of low back pain, with impairment in daily tasks., Competing Interests: Conflicts of interest: None

Antarctic expeditions are exceptional challenges for the human body, and medical issues such as nutritional deficiencies, polar anemia, cold injuries, and even death have been reported. We prospectively investigated medical issues encountered by a 33-year-old female adventurer completing the longest solo unsupported one-way polar ski expedition in Antarctica, covering 1484.53 km in 70 days and 16 h from Hercules Inlet to the Ross Ice Shelf, in temperatures estimated from -12 to -50°C and wind speeds of up to 60 mi/h. The adventurer developed a debilitating overuse musculoskeletal neck injury due to poor environmental conditions (ie, poor visibility, wind, and soft snow) while pulling a heavy sled and continuously holding the neck in a flexed position for checking directions on a mounted compass. The adventurer further developed a cold injury on the left calf (polar thigh) that gradually worsened and became ulcerated and more painful throughout the expedition. Potential risk factors included cold ambient temperatures, exposure to windy conditions, and clothing. After the expedition, this injury was treated with a skin graft. Important changes in body mass were observed (ie, reduction of body mass by 26.7% after the expedition) as well as general fatigue, muscle soreness, and sleep deterioration. This case study contributes to the body of knowledge of medical issues during Antarctic expeditions and provides the first scientific account of an adventurer with polar thigh. Further research into this condition is recommended.

Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

BACKGROUND: Workplace safety is a necessary and frequent topic of discussion for researchers, employers, and workers. It is estimated that annual losses caused by work-related injuries cost the United States $140 to $145 billion. Specifically, work-related musculoskeletal disorders (WMSD) have risen from just over 10% to 50% of the total claims from 1952 to 1996, accounting for more than 345,00 days lost and more than $57 million in WSIB costs in 2015. Novel approaches to managing WMSDs, such as Active Release Techniques®, need to be explored to ensure the ongoing health of workers. OBJECTIVE: This descriptive study provides the details of the 697,002 onsite treatments across 448 sites in North America between 2014–2018 provided by Active Release Techniques® Corporate Solutions (ARTCS) practitioners. The objective was to calculate the total number of treatments, cost per closed case, percent improvement, and the number of cases referred to worker's compensation. METHODS: All charting was done on the ARTCS EMR portal. The lead author was given a spreadsheet of the results sanitized of all identifying data in order to perform the aforementioned calculations. RESULTS: From 2014 to 2018, ARTCS providers opened 199,077 new cases, with an average cost to the employer of $306.69 USD per case and an average percent improvement in pain (VNPS) of 87.2%. The most frequently treated areas were the shoulder (32,574 cases), hip (6,633 cases), and low back (27,873 cases), respectively. A total of 48,946 cases were work-related pain/discomfort, of which 1,110 (2.27%) went on to worker's compensation. CONCLUSION: ARTCS in the workplace has shown a positive trend in terms of reducing pain intensity. The cost was low as compared to worker's compensation claims, as was the rate of cases (2.27%) referred to worker's compensation. Additional studies, including prospective data collection and a control group, are warranted to substantiate this. [ABSTRACT FROM AUTHOR]

The baseball pitching motion creates valgus stress to the medial elbow, which contributes to increased medial elbow joint space gapping. The musculoskeletal systems of preadolescent baseball players are immature compared with those of adults, but it is unclear whether the repetitive pitching action causes an increase in medial elbow joint space gapping. This study aimed to examine differences in medial elbow joint space gapping based on the pitch count of preadolescent baseball players compared with those of adult players. The participants were 11 healthy preadolescent baseball players and 12 college students with baseball experience. They threw 60 maximal-effort pitches arranged into 4 sets of 15 pitches. The medial elbow joint space was measured ultrasonographically with the forearm weight before pitching and following every set of 15 pitches. Repeated-measures analysis of variance and the Bonferroni post hoc test were used to compare the medial elbow joint space among the 5 pitching sets (before pitching and after 15, 30, 45, and 60 pitches) and between the groups of preadolescent baseball players and college students. There was no significant change in the medial elbow joint space gapping of the dominant elbow based on age/pitch count (F = 0.42, P =.796). There was a significant effect of pitch count (F = 30.28, P <.001) and between-group effects (F = 4.56, P =.045). The medial elbow joint space gapping increased significantly after 60 pitches in preadolescent baseball players (P =.023) and college students (P =.021). The medial elbow joint space gapping in preadolescent baseball players was significantly wider than that in college students (P =.007 before pitching, P =.027 at 15 pitches). Sixty repetitive pitches contributed to an increase in the medial elbow joint space gapping, regardless of age. The results of this study provide further evidence when considering pitching limitations. [ABSTRACT FROM AUTHOR]

Copyright of Izmir Katip Celebi University Faculty of Health Sciences Journal / İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi is the property of Izmir Katip Celebi University, Faculty of Health Sciene Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

UNLABELLED: Shank2 is a multidomain scaffolding protein implicated in the structural and functional coordination of multiprotein complexes at excitatory postsynaptic sites as well as in psychiatric disorders, including autism spectrum disorders. While Shank2 is strongly expressed in the cerebellum, whether Shank2 regulates cerebellar excitatory synapses, or contributes to the behavioral abnormalities observed in Shank2-/- mice, remains unexplored. Here we show that Shank2-/- mice show reduced excitatory synapse density in cerebellar Purkinje cells in association with reduced levels of excitatory postsynaptic proteins, including GluD2 and PSD-93, and impaired motor coordination in the Erasmus test. Shank2 deletion restricted to Purkinje cells (Pcp2-Cre;Shank2fl/fl mice) leads to similar reductions in excitatory synapse density, synaptic protein levels, and motor coordination. Pcp2-Cre;Shank2fl/fl mice do not recapitulate autistic-like behaviors observed in Shank2-/- mice, such as social interaction deficits, altered ultrasonic vocalizations, repetitive behaviors, and hyperactivity. However, Pcp2-Cre;Shank2fl/fl mice display enhanced repetitive behavior in the hole-board test and anxiety-like behavior in the light-dark test, which are not observed in Shank2-/- mice. These results implicate Shank2 in the regulation of cerebellar excitatory synapse density, motor coordination, and specific repetitive and anxiety-like behaviors. SIGNIFICANCE STATEMENT: The postsynaptic side of excitatory synapses contains multiprotein complexes, termed the postsynaptic density, which contains receptors, scaffolding/adaptor proteins, and signaling molecules. Shank2 is an excitatory postsynaptic scaffolding protein implicated in the formation and functional coordination of the postsynaptic density and has been linked to autism spectrum disorders. Using Shank2-null mice and Shank2-conditional knock-out mice with a gene deletion restricted to cerebellar Purkinje cells, we explored functions of Shank2 in the cerebellum. We found that Shank2 regulates excitatory synapse density, motor coordination, and specific repetitive and anxiety-like behaviors, but is not associated with autistic-like social deficits or repetitive behaviors.