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Biomedical subjects

B R Cahill

Publications and source records attributed to B R Cahill.

At least 19 recordsLinked to original sources

The three critical components in the conservative treatment of juvenile osteochondritis dissecans (JOCD). Physician, parent, and child.

There has been explosive growth of intensive, year-round sports for children of both sexes, with a resulting high degree of family involvement and commitment. Consequently, a diagnosis of juvenile osteochondritis dissecans (JOCD) impacts parent and child on many different levels. Compliance is the key element when a conservative treatment plan for JOCD is appropriate. An informed physician understands the dynamics between the "compliance triad" of physician, parent, and child, and recognizes that compliance is a process with foreseeable stages and characteristic behaviors.

Adolescent↗

Prevalence of anabolic steroid use among illinois high school students.

This study was conducted to quantify anabolic steroid use in Illinois, investigate student knowledge and perception of anabolic steroid use, and identify characteristics of the anabolic steroid user. We surveyed 3047 freshman and senior high school students from 38 high schools, randomly selected from three school enrollment sizes and five geographic locations, using a six-page anonymous questionnaire. Anabolic steroid use was reported by 58 (1.9%) of the participants, 44 of 1477 (3%) males and 14 of 1562 (0.9%) females. Thirty-four of 1679 (2%) freshman and 24 of 1366 (1.8%) seniors reported use. Anabolic steroids were used in all possible school enrollment sizes and geographic locations (matrix cells). Four (7%) of the users reported starting at age 10 or younger. A teacher/coach was reported as a primary source by 8 (14%) of the users, as well as identified by 11 (19%) of the users as the individual they knew using anabolic steroids. It appears that anabolic steroids are being introduced to students in elementary and junior high schools, and that teachers/coaches are actively involved in their use.

Journal Article↗

Atraumatic osteolysis of the distal clavicle. A review.

Atraumatic osteolysis of the distal clavicle (AODC) in athletes is a stress failure syndrome of the distal clavicle. It is related to intolerable exercise doses. For some athletes, the acromioclavicular joint is the weak link in the musculoskeletal system. There is never a history of a major injury to the acromioclavicular joint. It occurs principally in young athletes who have a long history of training and performance. It is further characterised by athletes who generally have an associated intense strength training programme. The condition will inexorably progress to decrease the level of performance and later interfere with activities of daily living. If the athlete is unwilling to alter his or her exercise training and performance regimen, she or he will eventually become surgical candidates. The results of excision of the distal clavicle for AODC are good or excellent in virtually all cases. The diagnosis of AODC is confirmed by the history of accumulative exercise doses and the key historical feature of intensive participation in strength training. Local tenderness will be found at the acromioclavicular joint, plain radiographs will show degenerative changes in the vast majority of cases and joint scintigraphy must be positive to confirm the diagnosis.

Acromioclavicular Joint↗

The effects of hydraulic resistance strength training in pre-pubertal males.

In order to examine the effectiveness and safety of hydraulic resistance strength training in young males, 26 pre-pubertal males (mean age = 8.2 +/- 1.3 yr) completed a 14-wk strength training study. Subjects were evaluated before and after the 14-wk experimental period for pubertal state (Tanner's sexual maturity rating, serum testosterone, and serum dihydroepiandrosterone sulfate). Effectiveness of the strength training program was determined by measuring pre-post differences in: isokinetic strength for flexion and extension at the knee and elbow joints at two speeds (30 degrees and 90 degrees X s-1) (KIN COM, Chattecx, Inc., Chattanooga, TN), flexibility, standing long jump, vertical jump, body composition parameters, maximal oxygen consumption, and creatinine phosphokinase. Safety of strength training was assessed by biphasic musculoskeletal scintigraphy before and after the program and by physician evaluation of complaints by subjects. Strength training subjects (N = 16) participated in a 45 min/session, 3 session/wk, 14-wk supervised strength training program with an attendance rate of 91.5%. Participants performed concentric work using hydraulic resistance equipment (Hydra-Fitness Industries, Belton, TX). Eccentric work was not performed. Control subjects (N = 10) did not strength train but did participate in sport activities and activities of daily living. Results indicated that strength training subjects increased isokinetic strength as a result of strength training (average concentric work/repetition increases by 18.5 to 36.6% for the eight motions tested; torque scores over the first 90% of the range of motion increases by 13.1 to 45.1% for the eight motions tested). These changes were significantly greater than changes seen in the control group (P less than 0.05). Strength training subjects also demonstrated significant improvements (as compared to control subjects) in vertical jump (+10.4%), flexibility (+8.4%), and maximal oxygen consumption [+19.4% (l X min-1), +13.8% (ml X kg X min-1)] after the experimental period. Musculoskeletal scintigraphy revealed no evidence of damage to epiphyses, bone, or muscle as a result of strength training. Only one strength training-related injury was reported (left shoulder pain, 3 strength training sessions missed). In contrast, six strength training subjects sustained injuries during activities of daily living, resulting in 47 missed strength training sessions. It was concluded that, in the short term, supervised concentric strength training using hydraulic resistance equipment is safe and effective in pre-pubertal boys.

Anthropometry↗

Understanding shoulder pain.

The impingement syndrome is a frequent occurrence in the throwing athlete. Sports medicine physicians have not yet attained the diagnostic quality in the shoulder they possess about the knee. The success of treatment of the impingement syndrome is directly proportional to the accuracy of diagnosis. This improved diagnostic ability will occur when the mechanism of injury is correlated to the tissue involved and the differential diagnosis of shoulder pain in the athlete is complete.

Acromioclavicular Joint↗

Quadrilateral space syndrome.

This uncommon syndrome is caused by compression of the posterior humeral circumflex artery and axillary nerve or one of its major branches in the quadrilateral space. Forward flexion and/or abduction and external rotation of the humerus aggravate the symptoms. Discrete point tenderness is always found posteriorly in the quadrilateral space. Patients with appropriate history and physical findings should have a subclavian arteriogram done by the Seldinger technique. A positive arteriogram reveals occlusion of the posterior humeral circumflex artery with the arm in abduction and external rotation. Patients with sufficient symptoms not responding to conservative treatment and having a positive subclavian arteriogram and local tenderness over the quadrilateral space should be considered for surgical decompression. A posterior approach is recommended. Of the 18 patients operated on, eight have had dramatic and complete relief, eight have been improved, and two have shown no improvement.

Adult↗

Osteolysis of the distal part of the clavicle in male athletes.

Osteolysis of the distal part of the clavicle was diagnosed in forty-six men, none of whom had a history of acute injury to the acromioclavicular area. All patients were athletes and forty-five lifted weights as part of their training. Pain and tenderness at the acromioclavicular joint associated with radiographic signs of osteoporosis, loss of subchondral bone detail, and cystic changes in the distal part of the clavicle were present in varying degrees. Joint scintigraphy showed increased activity in the distal part of the clavicle in all patients. Resection of the distal end of the clavicle in twenty-one patients, four with bilateral procedures, resulted in relief of symptoms in the nineteen who were followed. All but five of these patients were able to continue their sports activities and weight-training. The twenty-five patients who were not operated on also had improvement, but only after cessation or change of their sports activity and avoidance of weight-training.

Adult↗

Nontraumatic osteomyelitis of the patella.

Nontraumatic, hemotogenous osteomyelitis is a childhood disease uncommonly encountered and rare in the patella. The initial signs are usually intraarticular, because of the sterile effusion. The primary pathology in the patella is easy to overlook. The infection generally does not penetrate the joint cavity and most cases can be treated conservatively, or by local debridement. Arthrotomy is not necessary and could involve the joint with the infection.

Child↗