Stress fractures of the navicular.
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Adolescent↗
Biomedical subjects
R Quirk
Publications and source records attributed to R Quirk.
Metatarsalgia.
Metatarsalgia, or pain in the metatarsal region of the foot, is a common orthopaedic problem, but is generally less well understood than pain in the toes, ankle or heel. The cause of metatarsal pain is often less apparent than in other regions of the foot, and in many cases plain X-rays are of no help. Morton's neuroma, a common cause of severe metatarsalgia, can usually only be diagnosed from the history and clinical examination. The key to diagnosis in the metatarsal region is to have a clear knowledge of the most likely conditions.
Diagnosis, Differential↗
Common foot and ankle injuries in dance.
Classical ballet is a popular but physically demanding activity. Minor injuries become increasingly common as the dancer encounters the greater workload of professional dancing. The doctor must have a basic knowledge of ballet technique and an understanding of the mental approach of dancers to accurately diagnose and effectively treat their injuries. The practice of dancing on the toes, the exaggerated turn out of the feet, and the extreme flexibility of the hips and spine all lead to unusual injuries. With informed conservative treatment, most ballet injuries will heal, but surgery is occasionally required.
Achilles Tendon↗
Stress fractures.
Stress fractures are now common. They are often missed because the doctor fails to keep the possible diagnosis in mind, or believes that a plain X-ray can exclude these fractures. A bone scan gives the diagnosis. Treatment is by rest in most cases, but stress fractures of the navicular sometimes require surgery.
Athletic Injuries↗
Phenylpropanolamine and caffeine use among diet center clients.
We surveyed phenylpropanolamine (PPA) use and overuse among 309 diet center clients. Fifty-one percent of all subjects surveyed reported using PPA drugs: 44 percent used cold medicines and 16 percent used diet aids. Twenty-two percent of diet aid users and 7 percent of cold medicine users reported that they deliberately used more than the dosage recommended to improve efficacy. Among diet aid users, 59 percent also regularly consumed caffeine. Despite package warnings, individuals who had been told by their doctors that they were hypertensive used PPA products as often as normotensive individuals. PPA, the fifth most frequently used drug in the USA, is contained in over-the-counter (OTC) diet aids as well as OTC and prescription cold medicines. Severe adverse drug reactions (ADRs) including hypertensive crisis, stroke and death have been attributed to PPA products. Clinical studies have shown that using greater than recommended doses of PPA and using PPA in combination with caffeine may increase the risk of ADRs. Overweight patients may be particularly at risk for ADRs to PPA because they are likely to be hypertensive and to use diet aids. We recommend informing diet center clients of the potential dangers of consuming PPA products, especially more than the recommended dose, in the presence of hypertension, and when other sympathomimetic drugs are being taken.
Adult↗
The effects of phenylpropanolamine on human sympathetic nervous system function.
Phenylpropanolamine (PPA) is a sympathomimetic agent, very similar in structure to amphetamine. In the United States, it is present in over 130 medications, primarily anorectic agents and cough and cold remedies, many available without a prescription. The effects of PPA on blood pressure (BP) remain controversial and its mechanisms of action unknown. We studied acute (1 and 2 hours) and 2-week effects of a daily dose of 75 mg of sustained release PPA administered to 14 normal volunteers. Measurements of heart rate, BP, and plasma catecholamines (CA) were made with the subject in the supine and standing positions, and upon gripping a hand dynamometer for 5 minutes. Although systolic BP across all postures and sampling times was significantly higher when subjects were taking PPA in comparison to placebo (F = 5.95, p = 0.03), in no subject did the increase in BP reach hypertensive or clinically significant levels and no substantial changes in CA levels were found. Our study population was relatively young and normotensive; even such a small BP increase may pose greater problems for hypertensive, obese subjects likely to be users of diet aids. Strenuous isometric exercise did not cause any greater increase in BP or CA after subjects took PPA versus placebo. PPA blood levels 24 hours after the last of 14 daily doses were similar to levels 1 and 2 hours after an initial dose. We conclude from these data that recommended doses of PPA have only minimal sympathetic nervous system (SNS) and cardiovascular effects in young, healthy, normotensive populations at the times and dose studied.
Adult↗
Stress fractures of the foot.
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Athletic Injuries↗
Injuries in classical ballet.
The specialised medical knowledge about dancers' injuries is negligible compared with that which surrounds sports medicine. The author discusses his experience in the management of more than 2000 injuries sustained by dancers of classical ballet.
Adolescent↗
Ballet injuries: the Australian experience.
There is a distinct difference between ballet injuries and sports injuries in general, and the sports medicine physician needs to study the technique of dance and the specific injuries that it may produce in order to treat dancers effectively. In Australia, which is typical of other countries where ballet is performed, ballet injuries include strained lumbar muscles, sprained ankle, Achilles tendinitis, clicking hip, jumper's knee, chondromalacia, stress fractures, patellar subluxation, and other knee and tendon problems.
Australia↗
Talar compression syndrome in dancers.
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Adolescent↗