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  • ISSN: 2379-0571
    Volume 3, Issue 1
    Short Communication
    Roger Lyon*, Xue Cheng Liu and Brian Curtin
    Abstract: We compared clinical findings of children who received surgical treatment or nonsurgical treatment for Osteochondritis Dissecans (OCD). A chart review was done on seventy-eight patient’s ages 9-17 years of age who were diagnosed with OCD from 2004 to 2008. Patients were categorized into three groups: surgical intervention with grafting, surgical intervention without grafting and non-surgical treatment. Patients were evaluated based on lesion location and stability, symptoms before treatment, joint effusion, and the D’ Aubigné and Postel functional score. The most common sites of involvement in all three groups were the medial and lateral femoral condyles. In the group receiving surgical intervention with grafting, 50% of the lesions were stable. In the group receiving surgical intervention without grafting, 78% of the lesions were stable, and 100% of the lesions were stable in the non-surgical group. Symptoms of locking/catching/giving out were present in 45%, 32%, and 26% of patients in the surgical intervention with grafting group, surgical intervention without grafting group, and non-surgical treatment group, respectively. Joint effusions were present prior to treatment in 10% of patients in the surgical intervention with grafting group, in 3%of patients in the surgical intervention without grafting group, and in no participants of the non-surgical treatment group. The average preoperative D’Aubigné and Postel mean scores for the surgical intervention with grafting group, the surgical intervention without grafting group, and the non-surgical treatment group was 15.1, 15.8, and 17.1, respectively. At six months post-operatively, the surgical intervention with grafting group D’Aubigné and Postel mean score was 17.2, while the surgical intervention without grafting group D’Aubigné and Postelmean score was 17.4.This study reports clinical findings in juvenile patients with OCD who received surgical treatment with grafting, surgical treatment without grafting, or nonsurgical treatment.
    Ann Glang*, Melissa Mc Cart, Michael C. Koester, David Kracke, James Chesnutt, Sue Hayes, Sondra Marshall, Kyle Stanfield and Viviane Ugalde
    Abstract: Although Oregon was one of the first states in the country to pass laws about managing sports concussion, dissemination and implementation of those laws has taken a concerted effort by a multidisciplinary group across the state. The Oregon Concussion Awareness and Management Program (OCAMP) were created to develop and implement protocols for effective concussion education and management for high school athletes, administrators, coaches, and medical providers across the state of Oregon. Since 2007, OCAMP has developed policy and practice guidelines for implementation of the state’s concussion laws. The OCAMP website provides information about implementation of the two laws, with current information about concussion management for school administrators, directors of youth sports organizations, youth, parents, educators, and coaches.
    Since its inception, OCAMP has worked closely with the Oregon School Activities Association (OSAA), athletic trainers, and medical providers to support the safe return to play of student athletes following concussion. OCAMP has worked closely with the Oregon Departments of Education’s Traumatic Brain Injury Educational Consulting Teams to provide a seamless return to school activities for students. This team of statewide educators works with local schools to support all students with brain injury, including concussion.
    Future initiatives including working with local high schools to develop written concussion management policies and a formalized Concussion Management Team, providing training for educators on managing concussion in the classroom, and supporting youth sports organizations in implementing best practices in concussion management.
    Case Report
    Theresa Rohr-Kirchgraber*, Kelsey Black and Christina Pedro
    Abstract: Women and girls are experiencing concussions at a significantly higher rate and severity than boys and men. So why are concussions so narrowly synonymous with football? Evidence suggests females experience more severe concussions subjectively and objectively than males in the same sport. Despite this evidence, concussed females are still being overlooked and undertreated.
    A 59-year-old female with previous traumatic brain injuries had a helmeted fall from her horse complicated by loss of consciousness, intraventricular hemorrhage, closed orbital fracture, and pneumothorax. Upon hospital discharge she was released to resume all activities in 1 week.
    On her one-week outpatient follow-up, her concussive symptoms remained with double vision, instability, severe headaches with reading, inability to concentrate and short-term memory loss.
    The approach to management of a concussive patient such as a 17-year-old football player with a similar presentation would most likely be completely different. A conversation would have been had with the patient about brain rest: not returning to work, not watching thought-provoking television shows, staying away from reading and her cell phone. This patient was an older female who sustained a head injury in a non-traditional way. Perhaps that is why she was not advised. Females may be at greater risk for concussion than males and higher concussion rates are trending among women. A concussion should be considered in all who have sustained a head injury, regardless of the gender or how the injury occurred and appropriate management is needed.
    Flavia Del Grosso* and Pietro Nannelli
    Abstract: Craneo-occlusal balance can improve sport performance. Does this also apply to swimming?
    Two competitive swimmers wore occlusal splints (Serranus: individual oral appliance) during training and competitions, in an attempt to improve their performance.
    The athletes wore the appliance during one season (2013-2014), and we observed their swimming technique, run tests, took videos and photos.
    Tests carried out showed an improvement in propulsive efficiency and a decrease of lactic acid parameters. Coaches observed an improvement in the swimmers’ performance, both during training and during races.
    Research Article
    Anna E. Stanhewicz*, Lacy M. Alexander and W. Larry Kenney
    Abstract: We performed a pilot study to test the hypothesis that chronic oral ingestion of sapropterin augments reflex cutaneous vasodilation in aged men and women. Healthy older [74±4 years; n=4] men and women ingested 400mg sapropterin or placebo twice daily for four weeks in a randomized, double-bind crossover design. Following each treatment, subjects returned to the lab for testing. One intradermal microdialysis fiber was placed in the forearm skin for local delivery of lactated Ringers solution. Red cell flux was measured at each site by laser-Doppler flow metry (LDF) as reflex vasodilation was induced using a water-perfused suit. At 1°C rise in oral temperature, mean body temperature was clamped and 20mM L-NAME was perfused through the microdialysis fiber to quantify nitric oxide-dependent vasodilation. Cutaneous vascular conductance was calculated (CVC=LDF/MAP) and expressed as a percentage of maximum [% CVCmax; 28mM sodium nitroprusside and local heat, 43°C]. Sapropterin increased reflex vasodilation (sapropterin: 57±4 vs. placebo: 46±4 %CVCmax; p<0.001). NO-dependent vasodilation was greater following sapropterin treatment, however the difference was not statistically significant (sapropterin: 26±8 vs. placebo: 10±5%; p = 0.07). These data suggest that chronic sapropterin augments reflex vasodilation in aged human skin and may be a viable intervention to increase skin blood flow during hyperthermia in older adults.
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