876 resultados para Radius fractures


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The purpose of the study was to investigate the effect of skate blade radius of hollow (ROH) on anaerobic performance, specifically during the acceleration and stopping phases of an on-ice skating test. Fifteen, male Junior B hockey players (mean age 19 y ± 1.46) were recruited to participate. On-icc testing required each participant to complete an on-ice anaerobic performance test [Reed Repeat Skate (RRS)) on three separate days. During each on-ice test, the participant's skate blades were sharpened to one of three, randomly assigned, ROH values (0.63 cm, 1.27 cm, 1.90 cm). Performance times were recorded during each RRS and used to calculate anaerobic variables [anaerobic power (W), anaerobic capacity (W), and fatigue index (s, %)). Each RRS was video recorded for the purpose of motion analysis. Video footage was imported into Peak Motus™ to measure kinematic variables of the acceleration and stopping phases. The specific variables calculated from the acceleration phase were: average velocity over 6 m (m/s), average stride length (m), and mean stride rate (strides/s). The specific variables calculated from the stopping phase were: velocity at initiation of stopping (rn/s), stopping distance (m), stopping time (s). A repeated measures ANOV A was used to assess differences in mean performance and kinematic variables across the three selected hollows. Further analysis was conducted to assess differences in trial by trial performance and kinematic variables for all hollows. The primary findings of the study suggested that skate blade ROH can have a significant effect on kinematic variables, namely stride length and stride rate during the acceleration phase and stopping distance and stopping time during the stopping phase of an on-ice anaerobic performance test. During the acceleration phase, no significant difdifferences were found in SR and SL across the three selected hollows. Mean SR on the 1.27 cm hollow was significantly slower than both the 0.63 cm and 1.90 cm hollows and SL was significantly longer when skating on the 1.27 cm hollow in comparison to the 1.90 cm hollow. During the stopping phase, stopping distance on the 0.63 cm hollow (4.12 m ± 0.14) was significantly shorter than both the 1.27 cm hollow (4.43 m ± 0.08) (p < 0.05) and the 1.90 cm ho])ow (4.35 m ± 0.12) (p < 0.05). Mean ST was also significantly shorter when stopping on the 0.63 cm hollow then both the 1.27 cm and 1.90 cm hollows. Trial by trial results clearly illustrated the affect of fatigue on kinematic variables; AV, SR, IV decreased from trial 1 to 6. There was no significant effect on anaerobic performance variables during the RRS. Altering the skate blade ROH has a significant and practical affect on accelerating and stopping performance will be discussed in this paper.

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An analytical model for bacterial accumulation in a discrete fractllre has been developed. The transport and accumlllation processes incorporate into the model include advection, dispersion, rate-limited adsorption, rate-limited desorption, irreversible adsorption, attachment, detachment, growth and first order decay botl1 in sorbed and aqueous phases. An analytical solution in Laplace space is derived and nlln1erically inverted. The model is implemented in the code BIOFRAC vvhich is written in Fortran 99. The model is derived for two phases, Phase I, where adsorption-desorption are dominant, and Phase II, where attachment-detachment are dominant. Phase I ends yvhen enollgh bacteria to fully cover the substratllm have accllillulated. The model for Phase I vvas verified by comparing to the Ogata-Banks solution and the model for Phase II was verified by comparing to a nonHomogenous version of the Ogata-Banks solution. After verification, a sensitiv"ity analysis on the inpllt parameters was performed. The sensitivity analysis was condllcted by varying one inpllt parameter vvhile all others were fixed and observing the impact on the shape of the clirve describing bacterial concentration verSllS time. Increasing fracture apertllre allovvs more transport and thus more accllffilliation, "Vvhich diminishes the dllration of Phase I. The larger the bacteria size, the faster the sllbstratum will be covered. Increasing adsorption rate, was observed to increase the dllration of Phase I. Contrary to the aSSllmption ofllniform biofilm thickness, the accllffilliation starts frOll1 the inlet, and the bacterial concentration in aqlleous phase moving towards the olitiet declines, sloyving the accumulation at the outlet. Increasing the desorption rate, redllces the dliration of Phase I, speeding IIp the accllmlilation. It was also observed that Phase II is of longer duration than Phase I. Increasing the attachment rate lengthens the accliffililation period. High rates of detachment speeds up the transport. The grovvth and decay rates have no significant effect on transport, althollgh increases the concentrations in both aqueous and sorbed phases are observed. Irreversible adsorption can stop accllillulation completely if the vallIes are high.

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The primary purpose of this study was to investigate the effect of skate blade shape on skating performance. A secondary purpose was to evaluate if a change in hollow shape can create additional effects on skating performance. Thirty-seven male ice hockey players (age=18 years, SD=3.4) participated. The intervention consisted of four sharpening trials assessed using three on-ice tests. Participant feedback was also assessed using a Likert scale questionnaire. Statistical analysis included within-subject repeated measures MANOVA of trial by skating variables (p≤0.05). Results revealed Contour 1 enhanced performance compared to baseline on six variables at varsity level and five variables at midget level. Contour 1 enhanced performance compared to Contour 2 on six variables at the varsity and midget levels. Contour 1 also scored highest on the feedback questionnaire. Findings of this study indicate that contouring is a necessary practice to achieve optimal skating performance.

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Thèse diffusée initialement dans le cadre d'un projet pilote des Presses de l'Université de Montréal/Centre d'édition numérique UdeM (1997-2008) avec l'autorisation de l'auteur.

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Pre-publication drafts are reproduced with permission and copyright © 2013 of the Journal of Orthopaedic Trauma [Mutch J, Rouleau DM, Laflamme GY, Hagemeister N. Accurate Measurement of Greater Tuberosity Displacement without Computed Tomography: Validation of a method on Plain Radiography to guide Surgical Treatment. J Orthop Trauma. 2013 Nov 21: Epub ahead of print.] and copyright © 2014 of the British Editorial Society of Bone and Joint Surgery [Mutch JAJ, Laflamme GY, Hagemeister N, Cikes A, Rouleau DM. A new morphologic classification for greater tuberosity fractures of the proximal humerus: validation and clinical Implications. Bone Joint J 2014;96-B:In press.]

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Introduction. L’ostéoporose est une maladie chronique habituellement asymptomatique jusqu’à ce qu’il y ait fracture de fragilisation (FF). Ces fractures engendrent des coûts importants dont une partie pourrait être évitée par la prise en charge de ces patients pour l’ostéoporose. L’implantation d’un programme de prévention des fractures subséquentes géré par des infirmières en orthopédie pourrait permettre de parer à ces problèmes. Objectifs. L’objectif principal de ce projet était de déterminer si une infirmière peut gérer de façon efficace et sécuritaire un service de liaison pour fracture. Méthode. Les décisions cliniques d’infirmières entre 2010 et 2012 pour 525 patients d’un service de liaison pour fracture à l’étude ont été évaluées par deux médecins spécialistes indépendants avec expertise dans les soins pour l’ostéoporose. Résultats. Les infirmières ont pu identifier la totalité des sujets à risque et référer 26.7% de ceux-ci à un spécialiste. L’accord entre chacun des évaluateurs et les infirmières était de >97%. Les évaluateurs ont donné les mêmes réponses à >96% pour chaque type de décision et le niveau d’accord inter-juge était presque parfait (AC1 >0.960). Aucune référence n’a été jugée inutile. Les comorbidités majeures ont toutes été prises en charge. Conclusion. L’accord élevé entre les décisions cliniques des infirmières et des médecins évaluateurs démontre que la prise en charge par une infirmière est sécuritaire et recommandable pour les patients avec FF. Ce type d’intervention pourrait contribuer à résoudre les problèmes d’accessibilité aux soins chez les patients avec fragilité osseuse, ainsi qu’à diminuer le fardeau économique que représente le traitement des FF pour la société.

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Pocos estudios han evaluado el tratamiento de las fracturas desplazadas de cuello femoral en pacientes menores de 65 años de edad, y no han sido claramente definidos los factores de riesgo para necrosis avascular o no-unión dentro de este rango de edad. Para determinar los factores asociados a la necrosis avascular de la cabeza femoral (AVN) y no-unión en pacientes menores de 65 años de edad con fracturas desplazadas del cuello femoral tratados con reducción y fijación interna, se realizó un estudio retrospectivo de 29 fracturas desplazadas del cuello femoral en 29 pacientes consecutivos tratados en una sola institución. La influencia de la edad, la energía del trauma, tipo de reducción, y el tiempo entre la fractura y el tratamiento en desarrollo de la AVN y no-unión fueron evaluados. Los pacientes que desarrollaron NAV fueron significativamente mayores y sufrieron un trauma de más baja energía que en los casos sin AVN. Ninguna variable fue asociada con la no-unión. La regresión logística determinó que sólo la edad se asoció de forma independiente a NAV. La edad es un buen predictor para el desarrollo de NAV, con un C-estadístico de 0.861, y un mejor corte-determinado en 53,5 años. Conclusión: Los pacientes de entre 53,5 y 65 años presentan un riesgo más alto de NAV. La artroplastia primaria se debe considerar en este subgrupo.

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Introducción: la medición de la densidad mineral ósea en el fémur y columna lumbar es considerada la prueba de oro para el diagnóstico de osteoporosis en mujeres postmenopáusicas, sin tener suficiente evidencia de la utilidad al medir de manera individual o simultanea el radio 33 con este mismo propósito. Metodología Se realizó un estudio de pruebas diagnósticas, valorando concordancia anidada para determinar el valor diagnóstico del radio 33 comparado con los resultados por dual fémur y columna, actualmente patrón de oro el en diagnóstico. Se incluyeron mujeres mayores de 50 años entre el periodo de 2008 y 2011. Resultados Se incluyeron 3241 osteodensitometrias de pacientes femeninas con columna AP, dual fémur, radio ultradistal y radio 33. Tomando como estándar de oro la medición en columna y/o femur, el radio-33 obtuvo una sensibilidad de 95.5% y especificidad de 91% (p= 0,000) para osteoporosis, y una sensibilidad de 76.5% y especificidad de 54.9% p=0,000 para el diagnóstico de osteopenia. El radio 33 permite diagnosticar un 35% adicional de casos que no son captados con la medición en fémur y columna lumbar. Discusión La osteodensitometría en los sitios usados comúnmente, predice únicamente el 40% del riesgo de fractura (1). Si se incluye la medición de radio 33, la sensibilidad de la osteodensitometría sube en un 35.66% adicional, logrando detectar más pacientes con este riesgo y generando un impacto en la oportunidad del tratamiento y quizás reducción en la morbi-mortalidad secundaria a fracturas en esta población susceptible.

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Resumen basado en el de la publicaci??n

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OBJECTIVES: To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. DESIGN: Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta-regression to investigate the effects of dementia and of study quality and design. DATA SOURCES: Medline, CINAHL, Embase, PsychInfo, Cochrane Database, Clinical Trials Register, and hand searching of references from reviews and guidelines to January 2005. RESULTS: 1207 references were identified, including 115 systematic reviews, expert reviews, or guidelines. Of the 92 full papers inspected, 43 were included. Meta-analysis for multifaceted interventions in hospital (13 studies) showed a rate ratio of 0.82 (95% confidence interval 0.68 to 0.997) for falls but no significant effect on the number of fallers or fractures. For hip protectors in care homes (11 studies) the rate ratio for hip fractures was 0.67 (0.46 to 0.98), but there was no significant effect on falls and not enough studies on fallers. For all other interventions (multifaceted interventions in care homes; removal of physical restraints in either setting; fall alarm devices in either setting; exercise in care homes; calcium/vitamin D in care homes; changes in the physical environment in either setting; medication review in hospital) meta-analysis was either unsuitable because of insufficient studies or showed no significant effect on falls, fallers, or fractures, despite strongly positive results in some individual studies. Meta-regression showed no significant association between effect size and prevalence of dementia or cognitive impairment. CONCLUSION: There is some evidence that multifaceted interventions in hospital reduce the number of falls and that use of hip protectors in care homes prevents hip fractures. There is insufficient evidence, however, for the effectiveness of other single interventions in hospitals or care homes or multifaceted interventions in care homes.

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This paper describes the recent developments and improvements made to the variable radius niching technique called Dynamic Niche Clustering (DNC). DNC is fitness sharing based technique that employs a separate population of overlapping fuzzy niches with independent radii which operate in the decoded parameter space, and are maintained alongside the normal GA population. We describe a speedup process that can be applied to the initial generation which greatly reduces the complexity of the initial stages. A split operator is also introduced that is designed to counteract the excessive growth of niches, and it is shown that this improves the overall robustness of the technique. Finally, the effect of local elitism is documented and compared to the performance of the basic DNC technique on a selection of 2D test functions. The paper is concluded with a view to future work to be undertaken on the technique.