scholarly journals An Objective Measure of Patellar Tendon Thickness Based on Ultrasonography and MRI in University Athletes

2021 ◽  
Vol 10 (18) ◽  
pp. 4092
Author(s):  
Yusuke Nishida ◽  
Tomofumi Nishino ◽  
Kenta Tanaka ◽  
Shinzo Onishi ◽  
Akihiro Kanamori ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Objective Measure ◽  
Patellar Tendinopathy ◽  
Evidence Based ◽  
Imaging Evaluation ◽  
Cutoff Value ◽  
Elite University ◽  
Tendon Thickness ◽  
The Relationship ◽  
University Athletes

Ultrasonography and MRI are used for imaging evaluation of patellar tendinopathy, and “thickening of the tendon” is known as one of the characteristic findings. However, there are no evidence-based quantitative criteria to help evaluate this phenomenon. The purpose of this study was to investigate an objective measure of patellar tendon thickness. Patellar tendon thickness was evaluated in 65 elite university athletes using both ultrasonography and MRI. The relationship between tendon thickness and clinical patellar tendinopathy was investigated, and the cutoff value of the tendon thickness was calculated. Of the 129 knees included in the analysis, clinical patellar tendinopathy was found in 16 knees (12.4%). The proximal patellar tendon was significantly thicker in athletes with clinical patellar tendinopathy on both ultrasonography (8.3 mm vs. 5.1 mm; p < 0.001) and MRI (9.9 mm vs. 5.5 mm; p < 0.001). Setting the cutoff value to a thickness of >7.0 mm was an accurate predictor of clinical patellar tendinopathy (ultrasonography: sensitivity 81.3%, specificity 95.6%; MRI: sensitivity 100%, specificity 89.4%). Both ultrasonography and MRI measurement of the proximal patellar tendon thickness reflected the presence of clinical patellar tendinopathy. Defining “thickening of the patellar tendon” as thicker than 7.0 mm on both ultrasonography and MRI therefore has clinical significance.

Rethinking Patellar Tendinopathy and Partial Patellar Tendon Tears: A Novel Classification System

2020 ◽  
Vol 48 (2) ◽  
pp. 359-369 ◽  
Author(s):  
Mikhail Golman ◽  
Margaret L. Wright ◽  
Tony T. Wong ◽  
T. Sean Lynch ◽  
Christopher S. Ahmad ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Patellar Tendon ◽  
Classification System ◽  
Treatment Guidelines ◽  
Patellar Tendinopathy ◽  
Partial Tear ◽  
Partial Thickness ◽  
Tendon Thickness ◽  
Tendon Tears ◽  
The Relationship

Background: Patellar tendinopathy is an overuse injury of the patellar tendon frequently affecting athletes involved in jumping sports. The tendinopathy may progress to partial patellar tendon tears (PPTTs). Current classifications of patellar tendinopathy are based on symptoms and do not provide satisfactory evidence-based treatment guidelines. Purpose: To define the relationship between PPTT characteristics and treatment guidelines, as well as to develop a magnetic resonance imaging (MRI)–based classification system for partial patellar tendon injuries. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: MRI characteristics and clinical treatment outcomes were retrospectively reviewed for 85 patients with patellar tendinopathy, as well as 86 physically active control participants who underwent MRI of the knee for other conditions. A total of 56 patients had a PPTT and underwent further evaluation for tear size and location. The relationship between tear characteristics and clinical outcome was defined with use of statistical comparisons and univariate and logistic regression models. Results: Of the 85 patients, 56 had partial-thickness patellar tendon tears. Of these tears, 91% involved the posterior and posteromedial regions of the proximal tendon. On axial MRI views, patients with a partial tear had a mean tendon thickness of 10 mm, as compared with 6.2 mm for those without ( P < .001). Eleven patients underwent surgery for their partial-thickness tear. All of these patients had a tear >50% of tendon thickness (median thickness of tear, 10.3 mm) on axial views. Logistic regression showed that tendon thickness >8.8 mm correlated with the presence of a partial tear, while tendon thickness >11.45 mm and tear thickness >55.7% predicted surgical management. Conclusion: Partial-thickness tears are located posterior or posteromedially in the proximal patellar tendon. The most sensitive predictor for detecting the presence of a partial tear was patellar tendon thickness, in which thickness >8.8 mm was strongly correlated with a tear of the tendon. Tracking thickness changes on axial MRI may predict the effectiveness of nonoperative therapy: athletes with patellar tendon thickness >11.5 mm and/or >50% tear thickness on axial MRI were less likely to improve with nonoperative treatment. A novel proposed classification system for partial tears, the Popkin-Golman classification, can be used to guide treatment decisions for these patients.

scholarly journals Pain Relief after Extracorporeal Shock Wave Therapy for Patellar Tendinopathy: An Ultrasound Evaluation of Morphology and Blood Flow

2021 ◽  
Vol 11 (18) ◽  
pp. 8748
Author(s):  
Toshihiro Maemichi ◽  
Toshiharu Tsutsui ◽  
Takumi Okunuki ◽  
Takuma Hoshiba ◽  
Tsukasa Kumai
Keyword(s):  
Shock Wave ◽  
Blood Flow ◽  
Patellar Tendon ◽  
Ultrasound Imaging ◽  
Patellar Tendinopathy ◽  
Extracorporeal Shock Wave ◽  
Ultrasound Evaluation ◽  
Significant Difference ◽  
Before And After ◽  
Tendon Thickness

We aimed to investigate the changes caused by focused extracorporeal shock wave pain therapy (f-ESWT) in patients with patellar tendinopathy by means of ultrasound imaging. We included 18 knees from 11 college athletes with patellar tendinopathy. We assessed the tendon thickness and blood flow of the patellar tendon using ultrasound imaging, rest pain using NRS and tenderness using a pressure pain gauge. We recorded four measurements: immediately before f-ESWT (PRE①) and after f-ESWT (POST①) and two weeks after the first irradiation before f-ESWT (PRE②) and after f-ESWT (POST②). Only the resting pain in both the first and second irradiations showed a significant difference immediately before and after the treatment. In terms of pain changes after two weeks later, we observed significant differences in the resting pain between PRE① and PRE② and also in the resting pain, tenderness and blood flow area between PRE① and POST②. No significant difference was seen in the tendon thickness. We concluded that pain in the patellar tendon at rest decreased before and after irradiation, suggesting that f-ESWT may have influenced the nociceptive structures and had an analgesic effect.

scholarly journals A Time-Based Objective Measure of Exposure to the Food Environment

2019 ◽  
Vol 16 (7) ◽  
pp. 1180 ◽  
Author(s):  
Jason Scully ◽  
Anne Moudon ◽  
Philip Hurvitz ◽  
Anju Aggarwal ◽  
Adam Drewnowski
Keyword(s):  
Food Environment ◽  
Fast Food ◽  
Objective Measure ◽  
Mobility Patterns ◽  
Time Duration ◽  
Positioning Systems ◽  
Global Positioning ◽  
Fast Food Restaurants ◽  
Logistic Regressions ◽  
The Relationship

Exposure to food environments has mainly been limited to counting food outlets near participants’ homes. This study considers food environment exposures in time and space using global positioning systems (GPS) records and fast food restaurants (FFRs) as the environment of interest. Data came from 412 participants (median participant age of 45) in the Seattle Obesity Study II who completed a survey, wore GPS receivers, and filled out travel logs for seven days. FFR locations were obtained from Public Health Seattle King County and geocoded. Exposure was conceptualized as contact between stressors (FFRs) and receptors (participants’ mobility records from GPS data) using four proximities: 21 m, 100 m, 500 m, and ½ mile. Measures included count of proximal FFRs, time duration in proximity to ≥1 FFR, and time duration in proximity to FFRs weighted by FFR counts. Self-reported exposures (FFR visits) were excluded from these measures. Logistic regressions tested associations between one or more reported FFR visits and the three exposure measures at the four proximities. Time spent in proximity to an FFR was associated with significantly higher odds of FFR visits at all proximities. Weighted duration also showed positive associations with FFR visits at 21-m and 100-m proximities. FFR counts were not associated with FFR visits. Duration of exposure helps measure the relationship between the food environment, mobility patterns, and health behaviors. The stronger associations between exposure and outcome found at closer proximities (<100 m) need further research.

Distalising tibial tubercle osteotomy decreases patellar tendon force — A treatment rationale for recalcitrant patellar tendinopathy

The Knee ◽  
2020 ◽  
Vol 27 (3) ◽  
pp. 871-877 ◽  
Author(s):  
Michael J. Dan ◽  
Joseph Cadman ◽  
James McMahon ◽  
William C.H. Parr ◽  
David Broe ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Patellar Tendinopathy ◽  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Tendon Force

scholarly journals Countrywide survey on utilization of medical devices by GPs in Hungary: advantages of the cluster-practice model

2021 ◽  
Vol 22 ◽  
Author(s):  
Katalin Dózsa ◽  
Fruzsina Mezei ◽  
Tamás Tóth ◽  
Ábel Perjés ◽  
Péter Pollner
Keyword(s):  
Medical Devices ◽  
Point Of Care ◽  
Daily Practice ◽  
Evidence Based ◽  
Self Assessment ◽  
Practice Model ◽  
Practice Models ◽  
Integrate State ◽  
The Relationship ◽  
Further Development

Abstract Background: Expectations towards general practitioners (GPs) are continuously increasing to provide a more systematic preventive- and definitive-based care, a wider range of multidisciplinary team-based services and to integrate state-of-the-art digital solutions into daily practice. Aided by development programmes, Hungarian primary care is facing the challenge to fulfil its role as the provider of comprehensive, high quality, patient-centred, preventive care, answering the challenges caused by non-communicable diseases (NCDs). Aim: The article aims to provide an insight into the utilization of simple, digital, medical devices. We show the relationship between the primary health care (PHC) practice models and the used types of devices. We point at further development directions of GP practices regarding the utilization of evidence-based medical technologies and how such devices support the screening and chronic care of patients with NCDs in everyday practice. Methods: Data were collected using an online self-assessment questionnaire from 1800 Hungarian GPs registered in Hungary. Descriptive statistics, Wilcoxon’s test and χ2 test were applied to analyze the ownership and utilization of 32 types of medical devices, characteristics of the GP practices and to highlight the differences between traditional and cluster-based operating model. Findings: Based on the responses from 27.7% of all Hungarian GPs, the medical device infrastructure was found to be limited especially in single GP-practices. Those involved in development projects of GP’s clusters in the last decade reported a wider range and significantly more intensive utilization of evidence-based technologies (average number of devices: 5.42 versus 7.56, P<.001), but even these GPs are not using some of their devices (e.g., various point of care testing devices) due to the lack of financing. In addition, GPs involved in GPs-cluster development model programmes showed significantly greater willingness for sharing relatively expensive, extra workforce-demanding technologies (χ2 = 24.5, P<.001).

Fear, history, stigma, and bias in the COVID-19 pandemic

2020 ◽  
Vol 18 (7) ◽  
pp. 177-182
Author(s):  
Kevin Kupietz, PhD ◽  
Lesley Gray, MPH
Keyword(s):  
Emergency Management ◽  
Disease Outbreaks ◽  
Social Effects ◽  
Evidence Based ◽  
Stigma And Discrimination ◽  
Emergency Managers ◽  
Global Pandemic ◽  
New Concepts ◽  
History Of ◽  
The Relationship

Introduction: The greatest enemy of a global pandemic is not the virus itself, but the fear, rumor, and stigma that envelopes people. This article explores the context and history of fear and stigma relating to pandemic, summarizing key actions to mitigate the harms during an active pandemic.Method: Our article draws from accounts in literature and journalist accounts documenting the relationship between infectious diseases and major disease outbreaks that have garnered fear and stigmatization. Results: Fear, stigma, and discrimination are not new concepts for pandemics. These social effects run the risk of diverting attention from the presenting disease and government responses. Reactions to fear, stigma, and discrimination risk sabotaging effective efforts to contain, manage, and eradicate the disease.Conclusion: Emergency managers have an important role in dispelling myths, disseminating appropriate and evidence-based information without exacerbating fears. Knowledge about the roots of fear and bias along with a good understanding of historical plagues and pandemics is vital to ensure those in the field of emergency management can effectively manage irrational fears.

A review of intervention methods used to reduce flying-fox mortalities in heat stress events

2021 ◽  
Vol 43 (2) ◽  
pp. 137
Author(s):  
Matthew Mo ◽  
Mike Roache
Keyword(s):  
Climate Change ◽  
Systematic Review ◽  
Heat Stress ◽  
Evidence Based ◽  
Evaporative Heat Loss ◽  
Temperature And Humidity ◽  
Intervention Trials ◽  
Individual Scale ◽  
The Relationship ◽  
Flying Fox

Heat stress events in Australian flying-fox camps have resulted in significant numbers of flying-fox deaths. The frequency and intensity of such events have increased in recent decades, attributed to anthropogenic climate change. Evidence-based interventions are required to address this growing threat. Responders currently use different combinations of a range of intervention methods. We undertook a systematic review of heat stress interventions, which we classified as either ‘camp-scale’ or ‘individual-scale’. Camp-scale interventions included manual and automated misting of roost vegetation, whereas individual-scale interventions included spraying individual animals or removing them for intensive cooling and rehydration procedures. Our study showed that to date, evaluation of the efficacy of heat stress interventions has been largely anecdotal rather than empirical. This highlights the need for dedicated rigorous studies to evaluate the effectiveness of all the intervention methods described here. It will be especially important to understand the relationship between camp temperature and humidity levels and their influence on flying-foxes’ ability to regulate their body temperature, because high relative humidity reduces the ability of mammals to cool themselves using evaporative heat loss. The development of biophysiological measures such as temperature and humidity indices for different flying-fox species would enable meaningful interpretations of intervention trials under controlled conditions.

Three Emerging Spiritual Practices in the Canadian Association for Spiritual Care (CASC): From Pastoral Care and Counselling to Multi-Faith, Evidence-Based Spiritual Care and Psycho-Spiritual Therapy

2021 ◽  
pp. 154230502110366
Author(s):  
Thomas St. James O’Connor ◽  
Elizabeth Meakes
Keyword(s):  
Pastoral Care ◽  
Spiritual Care ◽  
Process Theology ◽  
Spiritual Practices ◽  
Evidence Based ◽  
Canadian Association ◽  
Spiritual Therapy ◽  
Integrated Psychotherapy ◽  
The Relationship

Describes the relationship between practice and theory (praxis) along with an examination of changes in the last 40 years in the praxis of pastoral care and counselling in the Canadian Association for Spiritual Care (CASC) that led to spiritual care and psycho-spiritual therapy. Developments in spiritual practices include growth in multi-faith, evidence-based spiritual care, and spiritually integrated psychotherapy (psycho-spiritual therapy). Suggests further areas of research and reflection including process theology.

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