Sideline Management of Joint Dislocations.

Athletes can sustain a large variety of injuries from simple soft tissue sprains to complex fractures and joint dislocations. This article reviews and provides the most recent information for sports medicine professionals on the management of simple and complex joint dislocations, i.e., irreducible and/or associated with a fracture, from the sidelines without the benefit of imaging. For each joint, the relevant anatomy, common mechanisms, sideline assessment, reduction techniques, initial treatment, and potential complications will be discussed, which allow for the safe and prompt return of athletes to the field of play.

Global spread of mobile antimicrobial drug resistance determinants in human and animal Escherichia coli and Salmonella strains causing community-acquired infections.

BACKGROUND: Antimicrobial drugs used in human infection treatment and animal husbandry may select for drug-resistant bacterial pathogens, which are increasingly observed worldwide. We sought to examine the extent to which identical mobile drug resistance elements are shared across common pathogens isolated from human and animal sources. METHODS: We compared the distribution of one class of mobile elements--integrons and gene cassettes--among uropathogenic Escherichia coli isolates, Salmonella enterica serovar Typhimurium isolates from human diarrhea cases, and E. coli and Salmonella isolates from nonhuman sources in the United States. The sequences of the gene cassettes were also compared with those deposited in GenBank. RESULTS: Class 1 integrons were detected in 68 (49%) of 139 uropathogenic E. coli isolates, 16 (72%) of 22 human and animal Salmonella isolates, and 120 (28%) of 436 nonhuman E. coli isolates. The most prevalent cassettes were those encoding aminoglycoside adenyltransferase A (aadA) and dihydrofolate reductase A (dfrA). Sequences of aadA1, dfrA12-orfF-aadA2, and dfrA17-aadA5 gene cassettes from 35 urinary tract infection E. coli isolates and of aadA2 and aadA12 gene cassettes from 7 Salmonella isolates were 100% identical to the corresponding cassette sequences from food animal E. coli isolates and those deposited in GenBank from a wide variety of bacteria isolated from animal hosts from distinct regions of the world. CONCLUSION: Common community-acquired human drug-resistant infections are caused by bacterial strains that harbor mobile drug resistance determinants of identical sequences that are found in diverse bacterial species from varied animal sources worldwide.