Epidemiology of Glenohumeral Instability Related to Sporting Activities Using the FEDS (Frequency, Etiology, Direction, and Severity) Classification System: A Multicenter Analysis

Background: Glenohumeral instability is common in athletes. There are an estimated 0.12 episodes of instability per 1000 sporting exposures. Instability can lead to time away from sport and an increased risk of shoulder arthritis. Purpose: To determine the prevalence, demographic data, anatomic features, and likelihood of surgery for the different types of instability as defined by the FEDS (frequency, etiology, direction, and severity) classification system for different sports. Study Design: Cohort study; Level of evidence, 3. Methods: Databases at 3 institutions (University of Iowa, Vanderbilt University, and University of Pennsylvania) were searched for International Classification of Diseases--Ninth Revision codes related to shoulder instability in 2010. Demographic data, symptoms, causes, imaging findings, and operative reports were obtained. Data were entered into a custom-designed REDCap online survey. Patients with subjective instability related to sporting activities were included for analysis. Results: A total of 184 athletes had glenohumeral instability; 20.1% were female. The mean age at the time of the first instability episode was 19.0 years for both male and female patients. The most common sports were football (29.3%), basketball (19.0%), and wrestling (9.8%). The most common type of instability based on the FEDS system was occasional, traumatic, anterior dislocation. Surgery was performed on 69.6% of athletes, and 14.1% had a recurrence of instability after surgery overall. Football had the highest rate of recurrence postoperatively at 23.8%. There was no difference in surgery rates between athletes with subluxations versus dislocations ( P = .8458). Surgery was significantly more likely in those with frequent dislocations ( P < .0001) and posterior instability ( P = .027). There was a 10.7% recurrence rate overall with conservative treatment. Conclusion: Glenohumeral instability most commonly occurs in contact sports, affects male more than female patients, and is most frequently in the anterior direction. Recurrent instability is most common in football players. Attention should be turned to the specific characteristics of each type of instability to determine the best treatment for each athlete.

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Pediatric Fractures during Skateboarding, Roller Skating, and Scooter Riding

The American Journal of Sports Medicine ◽

10.1177/0363546504269256 ◽

2005 ◽

Vol 33 (4) ◽

pp. 568-573 ◽

Cited By ~ 37

Author(s):

Charalampos Zalavras ◽

Georgia Nikolopoulou ◽

Daniel Essin ◽

Nahid Manjra ◽

Lewis E. Zionts

Keyword(s):

Demographic Data ◽

Case Series ◽

Considerable Proportion ◽

Level Of Evidence ◽

Pediatric Fractures ◽

Skeletal Injury ◽

Pediatric Fracture ◽

Level I ◽

Sporting Activities ◽

Open Injuries

Background Skateboarding, roller skating, and scooter riding are popular recreational and sporting activities for children and adolescents but can be associated with skeletal injury. The purpose of this study is to describe the frequency and characteristics of fractures resulting from these activities. Purpose Fractures from skateboarding, roller skating, and scooter riding compose a considerable proportion of pediatric musculoskeletal injuries. Study Design Case series; Level of evidence, 4. Methods Demographic data and injury characteristics were analyzed for all patients who presented to the pediatric fracture clinic of the level I trauma center from January 2001 to May 2002 after sustaining fractures due to skateboarding, roller skating, and scooter riding. Results Among a total of 2371 fractures, the authors identified 325 fractures (13.7%) that occurred during one of these activities. There were 187 patients (mean age, 13 years; 95% male) who sustained 191 skateboard-related fractures, 64 patients (mean age, 10.8 years; 54% male) who sustained 65 fractures while roller skating, and 66 patients (mean age, 9.7 years; 64% male) who sustained 69 fractures while riding a scooter. The forearm was fractured most often, composing 48.2% of skate-boarding fractures, 63.1% of roller-skating fractures, and 50.7% of fractures due to scooter riding. Of the forearm fractures, 94% were located in the distal third. In the skateboarding group, 10 of 191 (5.2%) fractures were open injuries of the forearm, compared to 6 of 2046 (0.3%) fractures caused by other mechanisms of injury (significant odds ratio, 18.8). Conclusions Skateboarding, roller-skating, and scooter-riding accidents result in a large proportion of pediatric fractures. An open fracture, especially of the forearm, was more likely to be caused by skateboarding than by other mechanisms of injury. Use of wrist and forearm protective equipment should be considered in all children who ride a skateboard.

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Belief in Protecting Others and Social Perceptions of Face Mask Wearing Were Associated With Frequent Mask Use in the Early Stages of the COVID Pandemic in the UK

Frontiers in Psychology ◽

10.3389/fpsyg.2021.680552 ◽

2021 ◽

Vol 12 ◽

Author(s):

Emma Warnock-Parkes ◽

Graham R. Thew ◽

David M. Clark

Keyword(s):

Social Anxiety ◽

Public Space ◽

Online Survey ◽

Demographic Data ◽

Health Benefit ◽

Face Mask ◽

Health Condition ◽

Social Cognitions ◽

Early Stages ◽

Increased Risk

Face masks are now seen as a key tool in the world’s recovery from the COVID-19 pandemic. However, during the early stages of the outbreak, face mask use in the United Kingdom (UK) was significantly lower than that of countries equally impacted by the virus. We were interested to explore whether social cognitions played a role in levels of mask wearing. A cross-sectional online survey of UK adults (n=908) was conducted in July 2020. Estimated face mask use and thoughts about wearing face masks were assessed using measures developed for this study. Participants also answered questions about their general mood, social anxiety and basic demographic data. Multiple regression was used to examine factors associated with mask wearing. Participants’ estimated mask wearing was low when in public spaces, such as the park (17%) or walking on the high street (36%). However, broadly fitting with UK guidance at the time, rates were considerably higher when in situations of closer proximity to others, such as on public transport (94%), in a shop or café (62%), when speaking to somebody in an enclosed public space (67%) or in a busy area when social distancing was not possible (79%). When looking at estimated mask wearing when in proximity to others, positive social cognitions (e.g., I’ll look confident and competent wearing a mask) were associated with more wearing, whereas negative social cognitions (e.g., I’ll look anxious, I’ll look foolish) were associated with less wearing. These results remained after controlling for factors that have indicated increased risk from COVID-19 (age, gender, ethnicity, presence of a health condition or pregnancy), belief about the health benefit for others and levels of depression and social anxiety. The largest predictors of mask wearing were the amount of people believed wearing a mask would keep others safe and the presence of an underlying health condition. The study findings indicate that future public health campaigns would benefit from a focus on strengthening beliefs about the protective benefits of masks, but also promoting positive social messages about wearing in public (e.g., mask wearing means you are confident and competent).

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Disparity in the risk of exposure to respirable crystalline silica dust among non-manual and manual employees in the construction industry

Safety in Extreme Environments ◽

10.1007/s42797-021-00037-x ◽

2021 ◽

Author(s):

Ben Fluck ◽

Lamine Mahdjoubi ◽

David Fluck ◽

Christopher H. Fry ◽

Thang S. Han

Keyword(s):

Health Risk ◽

Construction Industry ◽

Online Survey ◽

Demographic Data ◽

Crystalline Silica ◽

Construction Workers ◽

Increased Risk ◽

Chi Squared ◽

Risk Of Exposure ◽

Professional Project

AbstractConstruction workers are at increased health risk due to exposure to respirable crystalline silica (RCS) dust. We examined differences in health risk among non-manual and manual employees in the construction industry. The participants were drawn randomly from the construction industry by targeting UK construction workers’ websites. Online survey of construction industry employees using a questionnaire consisted of 17 items to obtain information on demographic data, employment history and health risk exposure. Chi-squared tests were used to explore differences in health risk between manual and non-manual employees, and logistic regression to determine the risk of adverse events in manual workers. Of the 47 employees invited, 45 completed the questionnaire (95% response rate). Seventeen were non-manual (professional, project managers and managers) and 28 were manual employees (tradesmen and construction workers). There was a significantly higher percentage of non-manual employees below 45 years than older group (70.6% vs 39.3%; χ2 = 4.2, p = 0.039) and they worked less than 20 years than those working longer (82.4% vs 32.1%; χ2 = 10.7, p = 0.001). Compared to non-manual workers, manual workers were more likely to work >20 years: OR = 2.2 (95% CI = 1.3–3.6); be exposed to RCS dust and smoke: unadjusted OR = 1.8 (1.1–3.1), age and length of time working in construction industry adjusted OR = 2.2(1.2–4.2); and have breathing problems: unadjusted OR = 3.9 (1.5–10.4), age, smoking and length of time working in construction industry adjusted OR = 3.7 (1.1–12.5). The risk of breathing problems was increased among individuals working more than 20 years: OR = 4.8 (1.2–18.6), exposed to dust and smoking: unadjusted OR = 3.8 (1.0–14.1), age and length of time working in construction industry adjusted OR = 5.4 (1.2–24.4), whilst those with adequate information on health hazards were associated with lower risk of breathing problems. There is an increased risk of exposure to RCS dust and pulmonary symptoms among manual employees in the construction industry. Further efforts are required to provide greater protection for this group of workers to reduce their health risk.

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Impact of COVID-19 pandemic and related isolation measures on violence against children in Egypt

Journal of Egyptian Public Health Association ◽

10.1186/s42506-021-00071-4 ◽

2021 ◽

Vol 96 (1) ◽

Author(s):

Seham Ahmed AboKresha ◽

Elsayed Abdelkreem ◽

Rasha Abd Elhameed Ali

Keyword(s):

Child Abuse ◽

Online Survey ◽

Demographic Data ◽

Psychological Impact ◽

Physical Punishment ◽

Psychological Aggression ◽

Event Scale ◽

Violence Against Children ◽

Increased Risk ◽

The Impact

Abstract Background Coronavirus disease 2019 (COVID-19) and related isolation measures have substantial adverse economic, social, and psychological consequences and expose children to increased risk of violence. The present study aimed to investigate the impact of the COVID-19 pandemic on violence against children in Egypt. Methods An online survey, in Arabic, was disseminated during the period from 9 to 13 April 2020, to parents of children who were up to 18 years old residing in Egypt, selected using a snowball sampling technique, during the period from 25 March to 8 April during the implementation of the nationwide compulsory isolation measures against COVID-19 (25 March to 8 April 2020). The survey covered three areas: socio-demographic data, psychological impact measured using the Impact of Event Scale-Revised (IES-R), and violence against children during the past 2 weeks measured using a modified parent-report of a child abuse screening tool (ICAST-P) developed by the International Society for the Prevention of Child Abuse and Neglect. Results Out of 1118 completed survey responses, 90.5% of children were subjected to violent discipline, 88.7% experienced psychological aggression, and 43.2% encountered severe physical punishment. Approximately 60% of respondents reported a moderate-to-severe psychological impact (IES-R scores ≥ 33), which was associated with a higher rate of violent discipline (OR: 9.3; 95% CI: 5.37–16.027; p < 0.001). Conclusions This is the first study in Egypt to provide evidence on the association of COVID-19 pandemic, its psychological impact, and increased rates of violence against children. Effective multilevel strategies are urgently required to protect children from violence and its catastrophic consequences during the continually evolving COVID-19 pandemic.

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Predictive modeling for peri-implantitis by using machine learning techniques

Scientific Reports ◽

10.1038/s41598-021-90642-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tomoaki Mameno ◽

Masahiro Wada ◽

Kazunori Nozaki ◽

Toshihito Takahashi ◽

Yoshitaka Tsujioka ◽

...

Keyword(s):

Machine Learning ◽

Demographic Data ◽

Risk Indicators ◽

Machine Learning Techniques ◽

Support Vector ◽

Machine Learning Methods ◽

Complex Interactions ◽

Learning Techniques ◽

Increased Risk ◽

Vector Machines

AbstractThe purpose of this retrospective cohort study was to create a model for predicting the onset of peri-implantitis by using machine learning methods and to clarify interactions between risk indicators. This study evaluated 254 implants, 127 with and 127 without peri-implantitis, from among 1408 implants with at least 4 years in function. Demographic data and parameters known to be risk factors for the development of peri-implantitis were analyzed with three models: logistic regression, support vector machines, and random forests (RF). As the results, RF had the highest performance in predicting the onset of peri-implantitis (AUC: 0.71, accuracy: 0.70, precision: 0.72, recall: 0.66, and f1-score: 0.69). The factor that had the most influence on prediction was implant functional time, followed by oral hygiene. In addition, PCR of more than 50% to 60%, smoking more than 3 cigarettes/day, KMW less than 2 mm, and the presence of less than two occlusal supports tended to be associated with an increased risk of peri-implantitis. Moreover, these risk indicators were not independent and had complex effects on each other. The results of this study suggest that peri-implantitis onset was predicted in 70% of cases, by RF which allows consideration of nonlinear relational data with complex interactions.

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Demographic Predictors of Concomitant Osteochondral Lesion of the Talus in Patients With Chronic Lateral Ankle Instability

Foot & Ankle Orthopaedics ◽

10.1177/24730114211013344 ◽

2021 ◽

Vol 6 (2) ◽

pp. 247301142110133

Author(s):

Yong Sang Kim ◽

Tae Yong Kim ◽

Yong Gon Koh

Keyword(s):

Tilt Angle ◽

Ankle Instability ◽

Osteochondral Lesion ◽

Case Series ◽

Level Of Evidence ◽

Lateral Ankle ◽

Chronic Lateral Ankle Instability ◽

Female Patients ◽

Lateral Ankle Instability ◽

Talar Tilt

Background: Osteochondral lesion of the talus (OLT) is commonly found as a concomitant pathologic lesion in a large proportion of patients with chronic lateral ankle instability (CLAI). This study investigated which characteristics in a patient with CLAI increase the risk for OLT. Methods: Three hundred sixty-four patients who underwent a modified Broström operation for their CLAI were reviewed retrospectively. The characteristics of each patient and variables associated with OLTs were investigated. Statistical analyses were performed to determine the effect of each potential predictor on the incidence of OLT, and to evaluate the associations between the patient characteristics and variables associated with OLTs. Results: Patients with OLTs were more frequently female (female vs male: 63.1% vs 43.9%, P = .003). In addition, the lesion sizes were larger in female patients (female vs male: 113.9 ± 24.9 mm2 vs 100.7 ± 18.0 mm2, P = .002), and medial lesions were more common in female patients (female vs male; 93.3% vs 81.8%, P = .036). The lesion sizes were larger in patients with a wider talar tilt angle ( P < .001), and patients with a medial OLT showed a wider talar tilt angle (12.0 ± 2.0 degrees vs 10.3 ± 2.2 degrees, P = .002). Conclusion: In this CLAI patient cohort, we found female patients to be at greater risk for OLTs than male patients. Furthermore, CLAI female patients with concomitant OLT had on average a larger lesion size, more frequent OLT medial position, and were associated with wider talar tilt angles, suggesting that females had more intrinsic ankle instability than males. Level of Evidence: Level IV, retrospective case series.

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Long-COVID Syndrome? A Study on the Persistence of Neurological, Psychological and Physiological Symptoms

Healthcare ◽

10.3390/healthcare9050575 ◽

2021 ◽

Vol 9 (5) ◽

pp. 575

Author(s):

Graziella Orrù ◽

Davide Bertelloni ◽

Francesca Diolaiuti ◽

Federico Mucci ◽

Mariagrazia Di Giuseppe ◽

...

Keyword(s):

Quality Of Life ◽

Sleep Disturbances ◽

Online Survey ◽

Clinical Presentation ◽

Demographic Data ◽

Severity Index ◽

Long Term Effects ◽

Targeted Treatments ◽

Euroqol 5D

Background: Emerging aspects of the Covid-19 clinical presentation are its long-term effects, which are characteristic of the so-called “long COVID”. The aim of the present study was to investigate the prevalence of physical, psychological, and sleep disturbances and the quality of life in the general population during the ongoing pandemic. Methods: This study, based on an online survey, collected demographic data, information related to COVID-19, sleep disturbances, and quality of life data from 507 individuals. The level of sleep disturbances and quality of life was assessed through the Insomnia Severity Index (ISI) and the EuroQol-5D (EQ-5D), respectively. Results: In total, 507 individuals (M = 91 and F = 416 women) completed the online survey. The main symptoms associated with “long COVID” were headache, fatigue, muscle aches/myalgia, articular pains, cognitive impairment, loss of concentration, and loss of smell. Additionally, the subjects showed significant levels of insomnia (p < 0.05) and an overall reduced quality of life (p < 0.05). Conclusions: The results of the study appear in line with recent publications, but uncertainty regarding the definition and specific features of “long COVID” remains. Further studies are needed in order to better define the clinical presentation of the “long COVID” condition and related targeted treatments.

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Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa067 ◽

2020 ◽

Vol 41 (1) ◽

pp. 59-71 ◽

Cited By ~ 3

Author(s):

Torsten Schlosshauer ◽

Marcus Kiehlmann ◽

Diana Jung ◽

Robert Sader ◽

Ulrich M Rieger

Keyword(s):

Risk Factors ◽

Wound Healing ◽

Surgical Technique ◽

Significant Risk ◽

Level Of Evidence ◽

Increased Risk ◽

Potential Risk Factors ◽

Wound Healing Problems ◽

Bariatric Patients

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4

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Household COVID-19 risk and in-person schooling

Science ◽

10.1126/science.abh2939 ◽

2021 ◽

pp. eabh2939

Author(s):

Justin Lessler ◽

M. Kate Grabowski ◽

Kyra H. Grantz ◽

Elena Badillo-Goicoechea ◽

C. Jessica E. Metcalf ◽

...

Keyword(s):

United States ◽

Online Survey ◽

Positive Association ◽

The United States ◽

Mitigation Measures ◽

Office Work ◽

School Based ◽

Increased Risk ◽

Extra Curricular Activities ◽

Low Levels

In-person schooling has proved contentious and difficult to study throughout the SARS-CoV-2 pandemic. Data from a massive online survey in the United States indicates an increased risk of COVID-19-related outcomes among respondents living with a child attending school in-person. School-based mitigation measures are associated with significant reductions in risk, particularly daily symptoms screens, teacher masking, and closure of extra-curricular activities. A positive association between in-person schooling and COVID-19 outcomes persists at low levels of mitigation, but when seven or more mitigation measures are reported, a significant relationship is no longer observed. Among teachers, working outside the home was associated with an increase in COVID-19-related outcomes, but this association is similar to other occupations (e.g., healthcare, office work). While in-person schooling is associated with household COVID-19 risk, this risk can likely be controlled with properly implemented school-based mitigation measures.

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Mediterranean Diet and Lifestyle Habits during Pregnancy: Is There an Association with Small for Gestational Age Infants? An Italian Single Centre Experience

Nutrients ◽

10.3390/nu13061941 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1941

Author(s):

Rachele De Giuseppe ◽

Manuela Bocchi ◽

Silvia Maffoni ◽

Elsa Del Bo ◽

Federica Manzoni ◽

...

Keyword(s):

Gestational Diabetes ◽

Mediterranean Diet ◽

Gestational Age ◽

Small For Gestational Age ◽

Small Sample Size ◽

Demographic Data ◽

Small Sample ◽

Activity Level ◽

Lifestyle Habits ◽

Increased Risk

Background. The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle habits and other SGA risk factors during pregnancy. Methods. One hundred women (16–44 years) with a pregnancy at term were enrolled. Demographic data, parity, pre-gestational BMI, gestational weight gain, pregnancy-related diseases, and type of delivery were collected. The MD adherence (MEDI-LITE score ≥ 9), physical activity level, and smoking/alcohol consumption were registered. SGA neonates were diagnosed according to the neonatal growth curves. Results. Women were divided into “SGA group” vs. “non-SGA group”. The MD was adopted by 71% of women and its adherence was higher in the “non-SGA group” (p = 0.02). The prevalence of pregnancy-related diseases (gestational diabetes/pregnancy-induced hypertension) was higher in the “SGA group” (p = 0.01). The logistic regression showed that pregnancy-related diseases were the only independent risk factor for SGA. Conclusions. MD may indirectly reduce the risk of SGA since it prevents and exerts a positive effect on pregnancy-related diseases (e.g., gestational diabetes and hypertension). The small sample size of women in the SGA group of the study imposes a major limitation to the results and conclusions of this research, suggesting however that it is worthy of further investigation.

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