scholarly journals First-Rib Stress Fracture in a High-School Lacrosse Player

2011 ◽  
Vol 3 (6) ◽  
pp. 547-549 ◽  
Author(s):  
Aaron T. Wild ◽  
John P. Begly ◽  
Juan Garzon-Muvdi ◽  
Pingal Desai ◽  
Edward G. McFarland

A 14-year-old right-hand dominant female lacrosse player presented with a complaint of right shoulder and upper posterior thorax pain of 8 days’ duration. She had been playing lacrosse at the attack wing and midfielder positions and experienced insidious pain after a game. She had no history of trauma to that shoulder during that game and had not experienced an injury in the past. Six days after the pain developed, she woke up one night with a sudden increase in the pain, which brought her to tears and caused slight difficulty with breathing. The pain was located anteriorly just lateral to the right sternoclavicular joint and posteriorly in the paraspinal muscles in the upper thoracic region. Physical examination suggested a first-rib stress fracture, which was subsequently confirmed by chest and shoulder radiographs.

Commonwealth ◽  
2017 ◽  
Vol 19 (1) ◽  
Author(s):  
John Arway

The challenges of including factual information in public policy and political discussions are many. The difficulties of including scientific facts in these debates can often be frustrating for scientists, politicians and policymakers alike. At times it seems that discussions involve different languages or dialects such that it becomes a challenge to even understand one another’s position. Oftentimes difference of opinion leads to laws and regulations that are tilted to the left or the right. The collaborative balancing to insure public and natural resource interests are protected ends up being accomplished through extensive litigation in the courts. In this article, the author discusses the history of environmental balancing during the past three decades from the perspective of a field biologist who has used the strength of our policies, laws and regulations to fight for the protection of our Commonwealth’s aquatic resources. For the past 7 years, the author has taken over the reins of “the most powerful environmental agency in Pennsylvania” and charted a course using science to properly represent natural resource interests in public policy and political deliberations.


1996 ◽  
Vol 35 (4I) ◽  
pp. 399-417 ◽  
Author(s):  
John W. Mellor

The right to the flow of income from water is vigorously pursued, protected, and fought over in any arid part of the world. Pakistan is of course no exception. Reform of irrigation institutions necessarily changes the rights to water, whether it be those of farmers, government, or government functionaries. Those perceived rights may be explicit and broadly accepted, or simply takings that are not even considered legitimate. Nevertheless they will be fought over. Pakistan has a long history of proposals for irrigation reform, little or none being implemented, except as isolated pilot projects. Thus, to propose major changes in irrigation institutions must be clearly shown to have major benefits to justify the hard battles that must be fought and the goodwill of those who might win those battles for reform. Proponents of irrigation institution reform have always argued the necessity of the reforms and the large gains to be achieved. Perhaps, however, those arguments have not been convincing. This paper will briefly outline the failed attempts at irrigation reform to provide an element of reality to the discussion. It will then proceed to make the case of the urgency of reform in a somewhat different manner to the past. Finally, current major reform proposals will be presented. This paper approaches justification of irrigation reform by focusing on the agricultural growth rate. It does so because that is the critical variable influencing poverty rates and is a significant determinant of over-all economic growth rates. The paper decomposes growth rates and suggests a residual effect of deterioration of the irrigation system that is large and calls for policy and institutional reform. The data are notional, suggesting the usefulness of the approach and paves the way for more detailed empirical analysis and enquiry for the future.


CNS Spectrums ◽  
2010 ◽  
Vol 15 (S4) ◽  
pp. 3-6 ◽  
Author(s):  
Andres M. Kanner ◽  
Andrew J. Cole

A 27-year-old woman presented to the emergency room after having witnessed generalized tonic clonic seizure while asleep. Birth and development were normal. She had suffered a single febrile seizure at 13 months of age, but had no other seizure risk factors. She was otherwise well except for a history of depression for which she was taking sertraline. Depressive symptoms had been well controlled over the past 3 months, but she had been under increased stress working to finish a doctoral thesis. Neurological examination was normal. Magnetic resonance imaging (MRI) showed modest asymmetry of the hippocampi, slightly smaller on the right, but no abnormal signal and well-preserved laminar anatomy. An electroencephalogram was negative. She was discharged from the emergency room with no treatment. Three weeks later, the patient's boyfriend witnessed an episode of behavioral arrest with lip smacking and swallowing automatisms lasting 45 seconds, after which the patient was confused for 20–30 minutes. The next morning she and her boyfriend kept a previously scheduled appointment with a neurologist.


Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1275-1279 ◽  
Author(s):  
Michael J. Alexander ◽  
Peter M. Grossi ◽  
Robert F. Spetzler ◽  
Cameron G. McDougall

Abstract OBJECTIVE AND IMPORTANCE Spinal cord involvement in Klippel-Trenaunay-Weber (KTW) syndrome is rare. Cases of intradural spinal cord arteriovenous malformations (AVMs) have been associated with this syndrome. Likewise, cases of epidural hemangioma and angiomyolipoma have been reported to occur at the same segmental level as cutaneous hemangioma in KTW syndrome. This report details a rare case of an extradural thoracic AVM in a patient with KTW syndrome. CLINICAL PRESENTATION A 30-year-old man presented with a 10-month history of progressive myelopathy, bilateral lower-extremity weakness, and numbness, with the right side affected more than the left. His symptoms had progressed to the point that he was unable to walk. The patient had the characteristic manifestations of KTW syndrome, including numerous cutaneous angiomas and cavernomas, limb hypertrophy and syndactyly, and limb venous malformations. A magnetic resonance imaging scan and subsequent angiogram demonstrated a large extradural AVM causing cord compression at the T3–T4 levels. INTERVENTION The patient underwent two separate endovascular procedures, including embolization of upper thoracic and thyrocervical trunk feeders. Subsequently, he underwent T1–T4 laminectomy and microsurgical excision of the AVM. Clinically, the patient improved such that he could walk without assistance. CONCLUSION KTW syndrome represents a spectrum of clinical presentations. Although involvement of the spinal cord is uncommon, the manifestations of this syndrome may include both intradural and extradural AVMs in addition to various tumors.


2020 ◽  
pp. 442-448
Author(s):  
Yuriy A. Labyntsev ◽  
Larisa L. Shchavinskaya

The article describes the history of Votnya, a small estate on the right bank of Dniepr river in Bykhovsky uyezd of Mahilyow Governorate, at the time it belonged to the well-known slavist Ya. F. Golovatsky and his family. After Ya. F. Golovatsky ceased to be a professor of Lviv University, he, a subject of the Austrian Empire, spent here at least two years in total surrounded by the local Belarusians, predominantly Or-thodox. Ya. F. Golovatskij would regularly come here year after year in the summer months. He invested “all his savings” into the development and improvement of his Belarusian estate and created a strong household with a beautiful park. For Ya. F. Golovatsky, Votnya gradually became a vibrant research laboratory to study both the past and the present of Belarusians. This was refl ected, for example, in his assessment of the famous “Dictionary of the Belarusian dialect” by I. I. Nosovich. For many years after the death of the owner of Votnya in 1888, his widow and daughters lived in the estate. It brought income that was also used to create a special scholarship foundation named after Yakov Golovatsky in the framework of the Shevchenko Scientifi c society in Lviv.


2021 ◽  
Vol 201 (3) ◽  
pp. 534-545
Author(s):  
Janusz Zuziak

Lviv occupies a special place in the history of Poland. With its heroic history, it has earned the exceptionally honorable name of a city that has always been faithful to the homeland. SEMPER FIDELIS – always faithful. Marshal Józef Piłsudski sealed that title while decorating the city with the Order of Virtuti Militari in 1920. The past of Lviv, the always smoldering and uncompromising Polish revolutionist spirit, the climate, and the atmosphere that prevailed in it created the right conditions for making it the center of thought and independence movement in the early 20th century. In the early twentieth century, Polish independence organizations of various political orientations were established, from the ranks of which came legions of prominent Polish politicians and military and social activists.


2007 ◽  
Vol 125 (6) ◽  
pp. 354-355
Author(s):  
Thaís Bandeira Cerqueira ◽  
Natalia Bacellar Costa Lima ◽  
Romeu Magno Baptista Neto ◽  
José Cohim Moreira Filho ◽  
Luiz Eduardo Café

CONTEXT: Fraley’s syndrome is characterized by vascular compression on the superior infundibulum with secondary dilatation of the upper pole calyx, mostly located on the right side. CASE REPORT: We present the case of a 22-year-old woman with vascular compression of the upper-pole infundibulocalyceal system (Fraley’s syndrome). The patient had a history of frequent hospitalizations for emergency care due to lumbar pain over the past twelve months. The diagnosis was obtained following renal arteriography. Since the surgical treatment by means of upper-pole nephrectomy, the patient has not had any further symptoms.


10.12737/6572 ◽  
2014 ◽  
Vol 8 (4) ◽  
pp. 20-33
Author(s):  
Наталья Гаршина ◽  
Natalya Garshina

Having a look at the tourist space as a cultural specialist, the author drew attention to the fact that the closest to the modern man is a city environment he contacts and sometimes encounters in everyday life and on holidays. And every time whether he wants it or not, it opens in a dif erent way. One way of getting to know the world has long been a walking tour. It’s not just a walk hand in hand with a pleasant man or hasty movement to the right place, but namely the tour, in which a knowledgeable person with a soulful voice will speak about the past and present of the city and its surroundings, as if it is about your life and the people close to you. Turning to the beginning of the twentieth century, the experience of scientists-excursion specialists we today can learn a lot to improve the process of building up a tour, and most importantly the transmission of knowledge about the world in which we live. Well-known names of the excursion theory founders to professionals are I. Grevs, N. Antsiferov, N. Geynike and others. They are given in the context of ref ection on the historical development of walking tours, which haven’t lost their value and attract both creators and consumers of tour services.


2003 ◽  
Vol 11 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Peter Nyamu ◽  
Mullasari S Ajit ◽  
Peter K Joseph ◽  
Lakshmi Venkitachalam ◽  
Nancy A Sugirtham

Coronary artery ectasia, a variant of coronary atherosclerosis, is a relatively rare entity. Review of literature did not reveal an exclusive study on isolated ectasia. We decided to analyse the clinical presentation and angiographic prevalence of this subset. A retrospective study of patients who underwent coronary angiogram in our institute over the past six years was carried out and the epidemiological, clinical and angiographic characteristics of patients with isolated ectasia were analysed. Distribution of ectasia was with a modification of the Markis classification. Among 6938 angiograms analysed, 134 (2%) had isolated ectasia. Of the 118 symptomatic patients, 34 (25%) had a history of or presented with infarction, with correlation between the territory of infarction and the ectatic vessel in 32 patients. Of 62 patients with lipid abnormality, Hypertriglyceridemia in 42 (65%) was the most common. The left anterior descending artery was the most common vessel involved. Diffuse ectasia most commonly involved the right coronary artery. One patient had spontaneous coronary dissection. There is a relatively high prevalence of isolated coronary ectasia with predominant involvement of the right coronary vessel when diffuse and the left anterior descending artery when discrete. This entity is not innocuous and warrants a detailed study on the available management options.


2019 ◽  
Vol 46 (8) ◽  
pp. 942-960
Author(s):  
Pablo Scotto

The wide presence of the right to work in national and international legal texts contrasts with a lack of agreement about the concrete content of this right. According to the hegemonic interpretation, it consists of two elements: (a) extension of wage labour and (b) significant improvement of working conditions. However, if we study the history of right to work claims, especially from the French Revolution to 1848, we can notice that the meaning of this right was rather wider in the past. Rescuing the historical significance of the right to work may help to face the problem of the future of work. In particular, and unlike what might seem at first sight, the claim that everyone should have his or her right to work guaranteed can be a way of articulating and concretizing issues such as workplace democracy, the organization of domestic work or the transition to a sustainable society.


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