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Biomedical subjects

D T Foster

Publications and source records attributed to D T Foster.

8 recordsLinked to original sources

Management of sports-induced skin wounds.

Skin wounds are common in sports but are rarely documented by the certified athletic trainer. The literature is unclear about wound types, and none of the articles reviewed reported frequencies. The purpose of this paper is to discuss the frequency of common athletic skin wounds and their specific management. Management of skin wounds can sometimes be problematic. Hydrogen peroxide has been used on wounds since 1947, yet some researchers report that hydrogen peroxide and iodophor solution can delay or interfere with wound healing, or cause damage to the wounded area if use is intense and prolonged. Occlusive dressings have been reported to have considerable advantage in maintaining a moist wound bed and in decreasing healing time. Infection rates beneath occlusive dressings, however, are similar to those associated with other types of dressings. Complications to wounds, with or without the use of occlusive dressings, such as keloids and seborrheic dermatitis, occur in low frequencies. Due to a lack of specific information about sports-induced skin wounds and their management, we recommend that standardized documentation for common wounds be developed along with further study of techniques for management.

Journal Article↗

Clinical teaching roles of athletic trainers.

Studies of clinical teaching roles have not appeared in the athletic training literature. The purposes of this study were to: 1) describe clinical teaching roles of Midwest ATCs, and 2) determine the effect of educational preparation on teaching activities and opinions of ATCs. A three-part questionnaire was returned by 154 ATCs (78%) in NATA District 5. The questionnaire included demographic, teaching, and opinion items. More than 50% of the ATCs were teacher-certified and the majority had a master's or higher degree. Most ATCs clinically supervised between one to eight students who received clinical instruction about 20 hours weekly. The ATCs who taught clinically either presented information or directed tasks from five to six Role Delineation Domains. They used three or more teaching methods and six or more audiovisual aids with their presentations. The ATCs saw the importance of clinical education and the responsibility to present clinical information, and expressed positive opinions about academic preparation for clinical teaching. Those with teaching degrees felt more prepared to teach (p<.05) than did nonteachers. Teachers conducted clinical teaching activities similar to nonteachers. We concluded that less experienced athletic trainers feel educationally prepared and enjoy clinical teaching as much as their more experienced peers. The ATCs with a teaching background presented a broader content through more mature teaching methods than did nonteachers. It appeared that adequate preparation for teaching and the attainment of an advanced degree may inspire confidence in clinical teaching. These attributes may become important characteristics to look for when recruiting clinical instructors.

Journal Article↗

Iowa wrestling study: weight loss and urinary profiles of collegiate wrestlers.

A longitudinal study was conducted with various members of the 1975 University of Iowa NCAA championship wrestling team to determine if excessive weight loss, accompanied by signs of dehydration, occurred at the college level of competition. Body weight changes from September to December indicated a mean loss of 6%, while skinfold totals (6 sites) changed from a mean of 58 mm to 37 mm. During a four-month period, mean weight losses of 10.2, 9.5, 8.0, 7.5 and 7.0 lbs occurred in intervals of 12, 4, 3, 2 and 1 day, respectively. Basal urines analyzed throughout the season usually contained 2-3 times the potassium excreted before the season started. Analyses of urines at various intervals during a 2-day time period prior to weigh-in showed a .003 increase in specific gravity, 160 mosm/1 increase in osmolarity, .10 decrease in pH, 45.3 mEq/1 decrease in Na+ concentration, and a 71.3 mEq/1 increase in K+ concentration which suggested that the wrestlers were dehydrated prior to competition. Total urinary electrolyte loss during the 2 days amounted to 3.7% of estimated total body Na+ stores and 3.0% of total body K+ stores. These data were similar to what had been reported for Iowa high school finalists and indicated that collegiate wrestlers were also competing while in a dehydrated state.

Body Weight↗

Local survey of optometrists about dilated funduscopic examinations for patients with diabetes: making use of phone book yellow-page listings.

The risk of blindness from retinopathy and macular edema is significantly greater in people with diabetes than in the general public. Annual dilated funduscopic examinations are recommended for early detection and treatment before these problems become serious and threaten vision. Yet national health survey data indicate that only about half of patients with diabetes obtain an annual dilated funduscopic examination. This study surveyed optometrists listed in the NYNEX Yellow Pages (for the Bronx, NY) to assess their knowledge, attitudes, and practices related to dilated funduscopic examinations for patients with diabetes. Over half of the optometry practices in the survey indicated that dilated funduscopic examinations were available at a relatively modest cost. However, the optometrists reported that less than one fourth of the patients they saw with diabetes had knowledge about the purpose of an annual dilated examination. Optometrists are readily available through yellow-page listings. Their role as primary eye care providers in retinopathy screening may increase with managed care.

Diabetic Retinopathy↗

Head and neck injuries in college football: an eight-year analysis.

The present study documented head and neck injuries in a study group of 342 college football players at a single institution for a period of 8 years. All freshmen players were screened for evidence of: (1) past history of head and neck injuries, and (2) abnormalities of the cervical spine on physical examination and x-ray film. By recording all head injuries and those neck injuries with time loss, incidence rates and patterns of injury incurred in college competition were determined. A total of 175 head and neck injuries were sustained by 100 players over the 8 year period. Those players with abnormal findings on screening examination were twice as likely to have a head or neck injury at some point in their college careers as those players with a normal screening examination. The greater the degree of abnormality on freshman screening examination, the more severe the neck injury in college was likely to be. Twenty-nine percent of all players in the study group sustained a head or neck injury during their college careers. The probability of a subsequent head or neck injury escalated sharply following a single incident. The overall incidence of injury was found to have been dramatically reduced over the 8 years. Influential factors such as legislative rule changes, medical status of recruits, and general coaching philosophies are discussed with regard to injury reduction and prevention of head and neck injuries in college football.

Adult↗

Prepatellar bursitis in wrestlers.

As part of a larger retrospective study examining all knee injuries sustained by the University of Iowa wrestling team over 6 years, prepatellar bursitis was found to be the most frequent injury and, therefore, was examined in depth. Of the 136 wrestlers studied, 13 developed an initial case of prepatellar bursitis. This represented 21% of all initial episodes of knee injuries. Five of these wrestlers had no recurrences, but the other eight together had 20 recurrences. Median time lost for the initial injury was only 4 days, but recurrences and surgeries added significantly to the total time lost. There were only two cases of septic prepatellar bursitis, but there have been six cases (in four wrestlers) in the three seasons since the end of the larger study period. The infecting organism in all but one case was Staphylococcus aureus and was penicillin-resistant in all but one. There was no clinical evidence of infection in 50% of the cases, emphasizing the need to do a Gram's stain and culture (and, therefore, an aspiration) on all cases of prepatellar bursitis. The prognosis appeared better if the wrestler had no previous history of bursitis, suggesting that pathologic changes in the bursal wall may impair its defense mechanisms. In sharp contrast to all other knee injuries, most prepatellar bursitis cases occurred in the off-season. Most developed insidiously, but direct impact during a takedown maneuver is suspected as being the most frequent cause.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

Patterns of knee injuries in wrestling: a six year study.

Data on knee injuries sustained by the University of Iowa wrestling team over a 6 year period were compiled. There were a total of 136 wrestlers during this time. Fifty-one different wrestlers sustained 136 injuries (64 knees). Multiple parameters were examined for each injury, including date of injury; days lost; diagnosis; side injured; mechanism; occurrence during competition or practice; whether the wrestler was in control, "on the bottom," or both wrestlers standing; type of move being made at the time of injury; how far into a match or practice the injury happened; initial versus recurrent injury; principal form of management; weight-bearing status; and presence of knee pads. Each wrestler's weight class, years of experience, rank on the team, lead leg, and compliance were noted. We found an incidence of 30 knee injuries per 100 wrestlers per year. There were 11.5 knee injuries per 100 wrestlers per year requiring a week or greater time loss. This comprises over one third of all serious wrestling injuries. Exposure data revealed injury rates in matches to be almost 40 times those of practice. Wrestlers with previous knee injuries were at high risk for reinjury. Early season competition is an extremely high risk period. The most frequent injuries were prepatellar bursitis, lateral and medial sprains, and lateral and medial meniscal tears. We noted a relatively higher rate of lateral versus medial meniscal tears compared to other sports and a somewhat common presentation of a meniscal tear resulting from minimal trauma. The lead leg was injured most often. The takedown was the most frequent situation where any injury occurred. Defensive wrestlers appeared to be at higher risk during takedowns. The wrestler "underneath" was also injured more often. Compliance correlated with decreased recurrence of injury. Approximately 50% of wrestlers were found to be noncompliant with medical recommendations. Junior varsity wrestlers lost significantly more time than varsity wrestlers with equivalent injuries. There was no correlation of injury rate with weight class, period of match, timing in practice, or years of experience.

Athletic Injuries↗

Quality assessment of athletic trainers.

This paper reports the first published assessment of the quality of services provided by athletic trainers. Medical coverage for the 1985 Junior Olympic Games was provided by certified athletic trainers (ATC), physicians, and other health care personnel. This study assessed the services of the 30 attending ATCs who managed 121 significant injuries. Standard injury information was collected by the ATCs and separately collected by their physicians. Nine months after the Games, phone interviews were conducted with the injured participants and assessment questionnaires were given to the attending physicians. Results revealed that young, injured, Junior Olympic participants generally did not inform their parents about their injuries or medical contact while at the Games. Athletes and physicians overwhelmingly agreed that they were positively impressed with the capabilities of the ATCs with whom they had contact. About 70% recovered from the symptoms and limitations of injury, as determined by the athlete, within the month following the Games. About 17% sustained some type of injury recurrence to the same body part, and at 9 months about 97% of the athletes had fully recovered from their injuries. These data not only indicate that athletic trainers can accurately identify minor athletic injury but signify the importance of long-term followup in our athletic populations. Multisport events, such as the Junior Olympic Games, impose considerable problems to a communication effort. The athletic trainer, as an ever-present figure in collegiate and professional circles, can be the central focus of an adequate communication effort regarding the patient care of other athletic populations.

Athletic Injuries↗