Hewittniebuhr7837

BACKGROUND Shoulder problems are common in handball, but injury risk reduction is possible by implementing a prevention program. However, player compliance to the program remains a challenge, with feedback from players that the program is too time consuming. AIM To develop a more efficient program, we aimed to assess the effect of the Oslo Sports Trauma Research Center shoulder injury prevention program on external rotation (ER) strength and internal rotation (IR) range of motion (ROM), considered to represent key risk factors for injury. METHODS Four youth handball teams (three female, one male, 57 players, mean age 17.1 yrs) were randomized to an intervention or control group. The intervention program was conducted three times per week as a part of handball warm up for 18 weeks, supervised by physical therapists. The main outcome variable was the between-group difference in ER strength and IR ROM change from baseline to post intervention. Isometric ER strength was measured with a handheld dynamometer and IR ROM with a digital goniometer. RESULTS Mean dominant shoulder isometric ER strength increased both in the intervention (10%) and the control group (6%) during the intervention, but there was no significant group by time interaction (group difference 0.06 N/kg (95% CI -0.04 to 0.17). IR ROM did not change in either group during the intervention. CONCLUSION The Oslo Sports Trauma Research Center shoulder injury prevention program did not affect the risk factors ER strength and IR ROM. The preventive effect of the program must therefore be due to other factors. This article is protected by copyright. All rights reserved.The aim of this study was to assess T2 values of the lumbar intervertebral discs in the axial and sagittal plane views and assess their respective interobserver reliability. The lumbar intervertebral discs of 23 symptomatic patients (11 female; 12 male; mean age, 44.1 ± 10.6; range, 24-64 years) were examined at 3T. Region-of-interest (ROI) analysis was performed on axial and sagittal T2 maps by two independent observers. ICC was assessed for every ROI. The interobserver agreement was excellent for the nucleus pulposus (NP) in the sagittal (0.951; CI95% 0.926-0.968) and axial (0.921; CI95% 0.845-0.955) planes. The posterior 20% region showed a higher ICC in the axial vs. the sagittal assessment (0.845; CI95 0.704-0.911 vs. 0.819; CI95 0.744-0.873). The same was true for the posterior 10%, with the axial region-of-interest showing a higher ICC (0.923; CI95 0.865-0.953 vs. 0.628; CI95 0.495-0.732). The intraobserver agreement was excellent for every ROI except the sagittal 10% region, which showed good performance (0.869; CI95 0.813-0.909). The sagittal nucleus pulposus was the best-performing region-of-interest with regard to intra- and interobserver agreement in the T2 assessment of the lumbar intervertebral disc. However, the axial NP showed more stable agreements overall and across the value range. In addition, the annular analysis showed better inter- and intraobserver agreement in the axial plane view. Statement of Clinical Significance Based on the presented analysis, we highly recommend that further studies use axial T2 mapping due to the higher intra- and interreader agreement. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.OBJECTIVE The objectives of this study are to study osmophobia and odor-triggered headaches among headache pediatric patients. BACKGROUND Achieving the correct diagnosis for headaches in younger children can be challenging. The presence of osmophobia could constitute a helpful piece of information for making the correct diagnosis of headaches among adults. check details METHODS This was a cross-sectional study. Children and adolescents with headaches who were seen consecutively at a pediatric outpatient service and had at least 1 headache attack over the previous 12 months were included. We used a semi-structured questionnaire, Pediatric Migraine Disability Assessment, State-Trait Anxiety Inventory, and Children's Depression Inventory. RESULTS About 300 patients were included; 253 had migraine, 47 had a tension-type headache; 137 had osmophobia during headaches (135 were migraineurs). "Osmophobia during headaches" for diagnosing migraine Sensitivity 54.4% (95% CI 48.2%-60.5%); specificity 95.8% (95% CI 85.8%-98.8%); positiare (OR 4.65; 95% CI 1.81, 12.0; P = .001) (logistic regression). CONCLUSIONS Osmophobia and odors as triggers for headaches are useful in diagnosing migraine and are markers for the severity of migraine in the pediatric population. © 2020 American Headache Society.OBJECTIVE To determine the characteristics of children with fetal alcohol spectrum disorders (FASD) and their mothers in a Midwestern city. METHODS Case-control samples were drawn from 2 separate first-grade cohorts (combined N = 4,047) in every city school using different methods. In Cohort Sample 1, all consented small children (≤25th centile on height, weight, and/or head circumference) entered the study along with a random sample from all enrolled students. Cohort Sample 2 was drawn totally at random. Child growth, dysmorphology, and neurobehavior were assessed using the Collaboration on FASD Prevalence (CoFASP) criteria, and mothers were interviewed. RESULTS For the samples combined, 891 children received dysmorphology examinations, and 692 were case-conferenced for final diagnosis. Forty-four children met criteria for FASD. Total dysmorphology scores differentiated diagnostic groups fetal alcohol syndrome (FAS), 16.7; partial FAS, 11.8; alcohol-related neurodevelopmental disorder (ARND), 6.1; and typica CONCLUSION This city displayed the lowest prevalence of FASD of the 4 CoFASP sites. Nevertheless, FASD were common, and affected children demonstrated a common, recognizable, and measurable array of traits. © 2020 by the Research Society on Alcoholism.OBJECTIVE To detail the characteristic traits of children with fetal alcohol spectrum disorders (FASDs) and maternal risk factors in a southeastern U.S. County. METHODS Independent samples were drawn from 2 different cohorts of first-grade students. All consented children (49.8%) were measured for height, weight, and head circumference, and those ≤ 25th centile entered the study along with a random sample drawn from all enrolled students. Study children were examined for physical growth, dysmorphology, and neurobehavior, and their mothers were interviewed. RESULTS Total dysmorphology scores discriminated well the physical traits of children across the FASD continuum fetal alcohol syndrome (FAS) = 15.8, partial FAS (PFAS) = 10.8, alcohol-related neurobehavioral disorder (ARND) = 5.2, and typically developing controls = 4.4. Additionally, a neurobehavioral battery distinguished children with each FASD diagnosis from controls. Behavioral problems qualified more children for FASD diagnoses than cognitive traits. SP study, yet children with FASD are prevalent. © 2020 by the Research Society on Alcoholism.OBJECTIVE To determine the prognostic significance of smoking in human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) when considering American Joint Committee on Cancer eighth edition (AJCC-8) stage. STUDY DESIGN Retrospective cohort study. METHODS Three hundred seventeen HPV-positive OPSCC patients with known AJCC-8 stage and smoking status ( less then 10 or ≥10 pack-years) seen at a tertiary center from 1997 to 2017 were studied. We used the Kaplan-Meier method to compare 5-year overall survival (OS) by smoking status and by clinical AJCC-8 stage and smoking status combined. Hazard ratios (HRs) were estimated with Cox proportional hazard regression for the independent effects of smoking and AJCC-8 stage. We also studied pathologic stage and estimated the combined effects of smoking and clinical stage. RESULTS The ≥10 pack-years smokers had worse 5-year OS than less then 10 pack-years smokers (93.6%; 95% confidence interval (CI) 89.7-97.8 vs. 82.3%; 95% CI 76.0%-89.1%). When stratified by AJCC-8 clinical stage, only stage I  less then 10 pack-years smokers (98.7%; 95% CI 96.3%-100.0%) had significantly better 5-year OS than their ≥10 pack-years (84.8%; 95% CI 76.4%-94.1%) counterparts. In a multivariable analysis, ≥10 pack-years smoking was associated with increased hazard of death when adjusting for AJCC-8 clinical (HR 2.52; 95% CI 1.16-5.46) and pathologic (HR 5.21; 95% CI 1.47-18.5) stage. In both analyses, stage III patients demonstrated worse survival than stage I, and smoking had greater impact at lower stages. CONCLUSIONS Smoking is a negative prognosticator in HPV-positive OPSCC and interacts with AJCC-8 clinical stage. It is important to understand the impact of smoking in HPV-positive disease when considering treatment plans and deintensification trials. LEVEL OF EVIDENCE 2b Laryngoscope, 2020. © 2020 The American Laryngological, Rhinological and Otological Society, Inc.OBJECTIVE To document prevalence and traits of children with fetal alcohol spectrum disorders (FASD) and maternal risk factors in a Rocky Mountain city. METHODS Variations on active case ascertainment methods were used in 2 first-grade cohorts in all city schools. The consent rate was 59.2%. Children were assessed for physical growth, dysmorphology, and neurobehavior and their mothers interviewed. RESULTS Thirty-eight children were diagnosed with FASD and compared with 278 typically developing controls. Total dysmorphology scores summarized well the key physical indicators of FASD and defined specific diagnostic groups. On average, children with FASD performed significantly poorer than controls on intellectual, adaptive, learning, attention, and behavioral tasks. More mothers of children with FASD reported drinking prior to pregnancy and in the first and second trimesters, and had partners with drinking problems than mothers of controls; however, reports of comorbid alcohol use and 6 other drugs were similar risk traits. © 2020 by the Research Society on Alcoholism.OBJECTIVES Vocal fold (VF) scarring and laryngeal stenosis are a significant clinical challenge. Excessive scar formation causes low voice quality or even life-threatening obstructions. Cytokines are thought to modulate multiple steps of the establishment of VF fibrosis, but there is no systematic report regarding their role in modulating VF fibrosis. This review aims to investigate the role of cytokines in modulating vocal fold fibrosis. STUDY DESIGN Literature review. METHODS This review searched for all relevant peer publications in English for the period 2009 to 2019 in the PubMed database using search terms "laryngeal stenosis," "vocal fold scarring," and "cytokines." A thorough investigation of the methods and results of the reviewed studies was performed. RESULTS Comprehensive research in various studies, including analyses of prostaglandin E2 (PGE2), granulocyte-macrophage colony-stimulating factor (GM-CSF), hepatocyte growth factor (HGF), basic fibroblast growth factor (bFGF), transforming growth factor-β3 (TGF-β3), and interleukin-10 (IL-10), supports cytokine therapy for VF scarring and laryngeal stenosis to some extent. A few clinical studies on this topic support the conclusion that HGF and bFGF can be selected as effective drugs, and no serious side effects were found. CONCLUSIONS This review describes the potential of cytokines for modulating the process of VF fibrogenesis, although cytokines are still an unproven treatment method. As no ideal drugs exist, cytokines may be considered the candidate treatment for preventing VF fibrogenesis. Laryngoscope, 2020. © 2020 The American Laryngological, Rhinological and Otological Society, Inc.