Short-term and long-term alterations of condylar position after bilateral sagittal split ramus osteotomy for mandibular setback: A preliminary before-after clinical trial.

Background: Because of the importance of the condyle, it is crucial to document all changes in its position after orthognathic surgery. Since previous studies in this regard are mostly controversial and limited by two-dimensional radiography technique, this study was conducted. Materials and Methods: This prospective clinical trial was performed on 102 measurements (17 patients, 2 condyles each, and 3 time points). Cone-beam computerized tomography imaging was done for 17 skeletal Class-III patients (10 females and 7 males, mean age, 24.05 ± 4.78 years) undergoing fixed orthodontic treatment, at three time points T0 (before surgery), T1 (immediately after surgery), and T2 (8 months after surgery). Condylar positions were measured. Position changes were evaluated during the course of the study. They were also compared between right/left sides and between men and women. Tests in use were repeated-measures one- and two-way analysis of variance and paired t-tests (α =0.05, α =0.017). Results: Alterations in various anatomical condyle parameters over the 8-month course of the study did not reach the level of significance (P ≥ 0.078). At all intervals, mean anterior-posterior index (API) remained between -12 and +12 (indicative of central position of the condyle in the glenoid fossa). Between men and women, left superior joint space, left anterior joint space, and left API differed (P ≤ 0.05). Left condyle mean superior joint space and anterior joint space were greater in men compared to women in all the three intervals; left condyle mean API was greater in women compared to men (more posterior in men, P ≤ 0.05). Conclusion: Condyles might not change significantly after 8 months post-surgery. However, small changes might be observed, and these changes might differ between the left and right sides and between males and females.

A Bibliometric Analysis of the Top Cited Articles in Sports and Exercise Medicine.

BACKGROUND: Although citation analysis is common in many areas of medicine, there is a lack of similar research in sports and exercise medicine. PURPOSE: To identify and examine the characteristics of the 100 top cited articles in the field of sports and exercise medicine in an effort to determine what components make an article highly influential. STUDY DESIGN: Cross-sectional study. METHODS: The Web of Science, Scopus, and PubMed databases were used to determine the 100 top cited articles from 46 journals in the field of sports and exercise medicine. Each of the 100 articles was then analyzed by 2 independent reviewers, and results were compared. Basic information was collected, including journal title, country of origin, and study type. Different categories were compared using descriptive statistics of counts or percentages. RESULTS: The 100 top cited articles were published in 15 of the 46 identified sports and exercise medicine journals, with the most prolific being Medicine and Science in Sports and Exercise (n = 49), American Journal of Sports Medicine (n = 18), and Sports Medicine (n = 7). In terms of country of origin, the top 3 contributors were the United States (n = 65), Canada (n = 9), and Sweden (n = 8). The most commonly researched anatomic areas were the knee (n = 15) and the brain (n = 3). Narrative reviews were the most common study type (n = 38), and only a single study on the 100 top cited articles list used a randomized controlled trial design. The most prevalent fields of study were exercise science (55% of articles) and well-being (16% of articles). CONCLUSION: Narrative reviews from the United States and published in English-language journals were the most likely to be highly cited. In addition, the knee was a common anatomic area of study on the top cited list of research in sports and exercise medicine.

Contrast Baths, Intramuscular Hemodynamics, and Oxygenation as Monitored by Near-Infrared Spectroscopy.

CONTEXT:: Contrast baths (CB) is a thermal treatment modality used in sports medicine, athletic training, and rehabilitation settings. Proposed physiological effects of CB include increasing tissue blood flow and oxygenation and decreasing tissue swelling and edema to promote better healing, improved limb function, and quicker recovery. OBJECTIVE:: To investigate the physiological effects of CB on the intramuscular hemodynamics and oxygenation of the lower leg muscles using near-infrared spectroscopy (NIRS), an optical method for monitoring changes in tissue oxygenated (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb) as well as tissue oxygen saturation index (TSI%). DESIGN:: Descriptive laboratory study. PATIENTS OR OTHER PARTICIPANTS:: Ten healthy men and women with a mean age of 29 (range = 17 ± 42) years, mean body mass index of 24.6 ± 3.2, and mean adipose tissue thickness of 6.4 ± 2.2 mm. INTERVENTION(S):: Conventional CB (10-minute baseline, 4 : 1-minute hot : cold ratio) was applied to the left lower leg. MAIN OUTCOME MEASURE(S):: Changes in chromophore concentrations of O2Hb, HHb, tHb, and TSI% of the gastrocnemius muscle were monitored during 10 minutes of baseline measurement, a 30-minute CB protocol, and 10 minutes of recovery using a spatially resolved NIRS. RESULTS:: After a 30-minute CB protocol, increases ( P < .05) in tissue O2Hb (7.4 ± 4 µM), tHb (7.6 ± 6.1 µM), and TSI% (3.1% ± 2.3%) were observed as compared with baseline measures. CONCLUSIONS:: Application of CB induced a transient change in the hemodynamics and oxygenation of the gastrocnemius muscle in healthy individuals. The effect of CB application in improving tissue hemodynamics and oxygenation may, therefore, support the therapeutic benefits of CB in the treatment of muscle injuries.

Zika and Rio Olympic Games.

Zika virus (ZIKV) is an arthropod-borne virus that is mainly transmitted via a bite from a female mosquito of the Aedes species. However, ZIKV can be transmitted sexually or via blood. Due to the recent ZIKV outbreak in South and Central America, many national and international organizations are concerned about the safety of athletes, coaches, staff, and spectators during the Olympic and Paralympic Games. Infected individuals are generally asymptomatic or have mild symptoms. However, ZIKV infection can potentially cause serious complications such as Guillain-Barre syndrome and congenital defects. Preferred diagnosis is based on real-time reverse-transcription polymerase chain reaction from blood and urine. Currently, there is no treatment or immunization available for ZIKV infection, and disease control is limited to preventing mosquito bites.

Analysis of the Factors Affecting Surgical Success of Implants Placed in Iranian Warfare Victims.

OBJECTIVE: The aim was to evaluate the survival time and success rates of dental implants in warfare victims and factors that affect implant success. SUBJECTS AND METHODS: This retrospective study involved 250 Iranian warfare victims who received dental implants from 2003 to 2013. Patients' demographic characteristics, as well as the brand, diameter, length, location and failure rate of the implants were retrieved from patients' dental records and radiographs. The associations between these data and the survival rate were analyzed. Statistical analysis was carried out with χ2 and log-rank tests. RESULTS: Overall, out of the 1,533 dental implants, 61 (4%) failed. The maxillary canine area had the highest failure rate [9 of 132 implants (6.8%)], while the mandibular incisor region had the least number of failures [3 of 147 implants (2.0%)] and the longest survival time (approximately 3,182 days). Maxillary canine areas had the shortest survival (about 2,996 days). The longest survival time was observed in implants with 11 mm length (3,179.72 ± 30.139 days) and 3.75-4 mm diameter (3,131.161 ± 35.96 days), and the shortest survival was found in implants with 11.5 mm length (2,317.79 ± 18.71 days) and 6.5 mm diameter (2,241.45 ± 182.21 days). Moreover, implants with 10 mm length (10.7%) and 5.5-6 mm diameter (22.2%) had the highest failure rate; however, the least failure rate occurred when the implants were 11.5 mm in length (1.9%) and 3-3.5 mm in diameter (3.1%). CONCLUSIONS: The brand, length and diameter of implants affected the survival time, failure rate and time to failure. The location of the implant was not statistically significant regarding the mentioned factors, although it has clinical significance.

Subcutaneous and Intramuscular Hemodynamics and Oxygenation After Cold-Spray Application as Monitored by Near-Infrared Spectroscopy.

CONTEXT: Vapocoolant spray, commonly known as cold spray (CS), is a cryotherapy modality used in sports medicine, athletic training, and rehabilitation settings. Proposed physiologic effects of cryotherapy modalities include reductions in tissue blood flow, oxygenation, and cell metabolism in addition to attenuation of pain perception attributed to reduced superficial nerve conduction velocity. OBJECTIVE: To examine the effects of CS on subcutaneous and intramuscular blood flow and oxygenation on the thigh muscle using near-infrared spectroscopy, an optical method to monitor changes in tissue oxygenated (O2Hb), deoxygenated (HHb), and total (tHb) hemoglobin. DESIGN: Cross-sectional study. SETTING: Muscle Biophysics Laboratory. PATIENTS OR OTHER PARTICIPANTS: Participants were 13 healthy adults (8 men, 5 women; age = 37.4 ± 6 years, body mass index = 27.4 ± 2.6, adipose tissue thickness = 7.2 ± 1.8 mm). INTERVENTION(S): Conventional CS was applied to the vastus medialis muscles. MAIN OUTCOME MEASURE(S): Changes in chromophore concentrations of O2Hb, HHb, and tHb at superficial and deep layers were monitored for 5 minutes using a 2-channel near-infrared spectroscopy. RESULTS: Thirty seconds after CS application, we observed a decrease from baseline in O2Hb and tHb only in the superficial layer that was maintained for 3 minutes. CONCLUSIONS: Application of CS induced a transient change in blood flow and oxygenation of the superficial tissues with no change in deeper tissues over the healthy vastus medialis muscle. The limited physiologic effect of CS on the superficial hemodynamics and oxygenation of limb muscles may limit the therapeutic benefit of this cryotherapy modality to a temporary analgesic effect, a hypothesis that warrants a clinical trial on traumatized muscles.

Suffolk Show 2011: prehospital medical coverage in a mass-gathering event.

INTRODUCTION: Despite their popularity and unique characteristics, county shows, also known as agricultural fairs, are amongst the least-studied mass-gathering events. Suffolk Show is one of the biggest such events in the UK, attracting tens of thousands of people annually over a 2-day period. In addition to trade stands and livestock displays, the 2011 show included top international show jumping and other sport activities. Problem Due to the range of activities and large number of attendees of different ages and medical backgrounds, combined with a lack of objective data about medical contacts made during these events, medical officers and local emergency services find planning an appropriate level of medical coverage for county shows particularly challenging. This study involved analyzing the characteristics of medical contacts during a major county show and assessing the level of medical coverage provided. METHODS: Data collected from St John Ambulance (SJA) and British Red Cross standard medical records of all contacts on the show ground over the two days were analyzed in terms of demographics, presenting complaints, medical history, and discharge destination. The Event Safety Guide by the Health and Safety Executive (HSE) was the agreed standard for the level of medical coverage. RESULTS: More than 90,000 people visited the show, with a total of 180 medical contacts recorded. Patient presentation rate (per 1,000 attendees) was 2.0 and the transport to hospital rate (per 1,000 attendees) was 0.1. Of the 112 cases handled by SJA, 74 (66%) were women and 49 (44%) were 18-64 years of age. Wounds, lacerations and abrasions made up 26 (23.2%) of all presentations to SJA, followed by foot and lower limb blisters at 20 (17.8%). Hypertension was the most common medical history in presentations to SJA (11 cases, 10%), followed by asthma in 7 (6%). CONCLUSION: The majority of presentations were due to minor injuries or ailments. An understanding of the event characteristics, demographics, and nature of medical contacts will provide organizers, medical officers, and local emergency services with information about the level of coverage and resources required. This data can further help advance knowledge of mass-gathering medicine across the various types of events.

A systematic review of tissue engineered meniscus: cell-based preclinical models.

Meniscal injuries are one of the common sports injuries and their natural healing is limited. Removal of injured meniscus alters knee biomechanics and predisposes patients to osteoarthritis. Tissue engineered meniscus provides a novel approach for the treatment of severe meniscus injury. The aim of this review is to review preclinical studies that used cell based approaches for tissue engineered meniscus. Studies were assessed for inclusion following a search in PubMed, UK PubMed central and Embase. All preclinical studies that used cell based approaches for meniscus regeneration were included in the study. Nineteen articles that used cellular approaches were reviewed. The cell types used were mesenchymal stem cells (derived from bone marrow or synovium), meniscal fibrochondrocytes, chondrocytes and bone marrow stromal cells. One study used xenogeneic bone marrow derived mesenchymal stem cells. Sixteen out of nineteen studies showed better tissue regeneration with cell based approaches when compared to acellular controls. The review included preclinical studies. The diversity of the studies made it impossible to adhere to full guidelines or perform a meta-analysis. Overall,experiments have demonstrated superior tissue integration and favourable biochemical properties of the regenerated tissues compared to acellular techniques. Few approaches however, have measured the chondroprotective ability at preclinical testing.