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Sports Hernia

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181. The NFL Orthopaedic Surgery Outcomes Database (NO-SOD): The Effect of Common Orthopaedic Procedures on Football Careers. (PubMed)

athletes and to compare respective prognoses and effects on careers.Case series; Level of evidence, 4.Athletes in the NFL undergoing procedures for anterior cruciate ligament (ACL) tears, Achilles tendon tears, patellar tendon tears, cervical disc herniation, lumbar disc herniation, sports hernia, knee articular cartilage repair (microfracture technique), forearm fractures, tibial shaft fractures, and ankle fractures were identified through team injury reports or other public records. Game (...) and performance statistics during the regular season were collected before and after surgery. Statistical analysis was performed with significance accepted as P < .05.A total of 559 NFL athletes were included. Overall, 79.4% of NFL athletes returned to play after an orthopaedic procedure. Forearm open reduction and internal fixation (ORIF), sports hernia repair, and tibia intramedullary nailing (IMN) led to significantly higher return-to-play (RTP) rates (90.2%-96.3%), while patellar tendon repair led

2016 American Journal of Sports Medicine

182. Patient Modesty: Volume 73

there are those militant providers that insist on them. Here is an example: . Then we come to find after an evidence based review, these things provide no benefit and are a matter of ritual (women's pelvic exam and sports hernia check). Give the patient the option of skipping these. Explicitly ask, right one is about to preform a GE if the patient wants to skip it. The problem is that they know they can skip them, the first clue is that other providers skip them. The next issue is dealing with the past (...) in a sports league. Over drinks they would discuss pts openly with names - "Mrs. Johnson and her" A few of us that overheard switched from this large (6 physician) practice to smaller ones. How do you complain about this and get results? Interesting study: http://rutgerssocialcognitionlab.weebly.com/uploads/1/3/9/7/13979590/moss-racusin_phelan__rudman_2010.pdf "In sum, our findings demonstrate that men encounter prejudice when they behave atypically, and raise the possibility that men may avoid behaving

2015 Bioethics Discussion Blog

183. Patient Modesty: Volume 70

calls for an anogenital examination for a (wellness) physical when a patient is requesting a "modesty wellness physical." The SOP for a modesty wellness physical" can include alternatives such as PSA testing or ultrasound to assess prostate health, urine and blood tests for genital health, self reporting for hernia, etc. I think that the ACA will help with some of these issues. Another issue is requiring pelvic exams for oral contraceptives. Under the ACA's anti-fraud provisions, this can

2015 Bioethics Discussion Blog

184. Patient Modesty: Volume 71

versed in the laws surrounding informed consent. The problem is that the law is routinely ignored, see . Informed consent includes offering a patient EVERY option whether reasonable or not, even if not covered by insurance. Dr. Sherman has also written about . One has to wonder IF anyone who ever objected to the hernia check (whether it be sports or employment) was offered radiology or was the issue just coerced with threats of denial of validating the form? My point is that providers can justify (...) is not acting in his own best interests. However, many other societies prioritize beneficence over autonomy." Continued... At , said... Part 2: Even justice conflicts with autonomy. A patient is never offered an MRI (or other radiology) when they object to a "hernia exam." Every physician would argue that the test is too expensive, too overly used which in turns lessens availability and raises healthcare costs (justice) and exposes the patient to needless radiation (beneficence/non-maleficence

2015 Bioethics Discussion Blog

186. TEP Versus Open Minimal Suture Repair for the Sportsman's Groin

for the treatment of Sportsman´s hernia/athletic pubalgia. The primary endpoint is patient being free from intractable groin pain during sports activity or daily work four weeks after surgery. Condition or disease Intervention/treatment Phase Hernia Procedure: Total ExtraPeritoneal Procedure: Open minimal suture repair Not Applicable Detailed Description: The prevalence of chronic groin pain in athletes and physically active adults is between 5 and 10 % (1-3). The groin area is vulnerable in contact sports (...) mesh placed in the preperitoneal space behind the pubic symphysis and posterior inguinal canal (11). The aim of this randomized study is to compare the effectiveness of OMR technique in local or spinal anesthesia to TEP technique in general anesthesia for treatment of Sportsman´s hernia/athletic pubalgia with the primary endpoint; patients being totally free from groin pain during sports activity four weeks after surgery. Study Design Go to Layout table for study information Study Type

2014 Clinical Trials

187. Reinforcement of the Abdominal Wall After Breast Reconstruction With the Pedicled TRAM-flap

site morbidity [ Time Frame: 24 months ] Bulge Definition: visible abdominal contour abnormality, without the presence of a fascial defect, with or without the need for surgical correction. Assessed after 3-4, 12 and 24 months by clinical examination and after 12 and 24 months by CT scanning including the Valsalva maneuver Hernia Definition: abdominal wall bulge with the presence of a palpable fascial defect and/or a fascial defect found during an additional correcting surgical procedure or by CT (...) scanning. Assessed after 3-4, 12 and 24 months by clinical examination and after 12 and 24 months by CT scanning including the Valsalva maneuver Abdominal donor site correction procedure (within 24 months) Pain/ discomfort Assessed after 3-4, 12 and 24 months by DoloTest® Study specific questionnaire regarding postoperative assessment of abdominal pain/ discomfort including effect on daily life activities and ability to perform sport Aesthetics at the abdominal wall [ Time Frame: 24 months ] Study

2014 Clinical Trials

188. Groin defects seen at extra-peritoneal laparoscopic dissection during surgical treatment of athletic pubalgia. (PubMed)

. In addition to these defects, five patients (12.5%) had additional unilateral femoral hernias, whereas no patient had solitary femoral hernia defects.AP is a new diagnostic entity with poorly understood etiology. It mostly affects young active adults, often involved in competitive sports and surgical methods may be most effective at achieving the cure. In our experience all of the patients presented with groin defects, though not all were the same. It is our belief that these defects, although likely (...) Groin defects seen at extra-peritoneal laparoscopic dissection during surgical treatment of athletic pubalgia. Recently new disease process, often referred to as athletic pubalgia (AP), has been acknowledged by the medical community. The patients suffering from this ailment present with unilateral or bilateral chronic groin pain associated with physical activity without a clear diagnosis of a groin hernia. Though physical therapy and medical treatments are considered first line remedies, some

2014 Surgical endoscopy

190. Patient Modesty: Volume 65

, M.D. @ 181 Comments: At , said... From PT writing to Volume 64 at the time of closure. ..Maurice. Paul You forgot to mention mass school physicals and sports physicals that males have endured not to mention unnecessary female observers during military induction physicals. This is all before males actually enter the health care system with real medical problems. PT At , Anonymous said... It is sad about how male patient modesty is often disregarded. It seems like the medical industry respects

2014 Bioethics Discussion Blog

192. Gastrointestinal Complications

. In contrast to constipation or impaction, an intestinal obstruction is a partial or complete occlusion of the bowel lumen by a process other than fecal impaction. Intestinal obstructions can be classified by the following three means: The type of obstruction. The obstructing mechanism. The part of the bowel involved. Structural disorders, such as intraluminal and extraluminal bowel lesions caused by primary or metastatic tumor, postoperative adhesions, volvulus of the bowel, or incarcerated hernia, affect (...) . Anorexia. Immobility. Antidepressants. Inability to increase intra-abdominal pressure Emphysema. Any neuromuscular impairment of the diaphragm or abdominal muscles. Massive abdominal hernias. Atony of muscles Malnutrition. Cachexia, anemia, or carcinoma.* Senility. Environmental factors Inability to get to the bathroom without assistance. Unfamiliar or hurried environment. Excess heat leading to dehydration. Change in bathroom habits (e.g., use of a bedpan). Lack of privacy. Narrowing of colon lumen

2012 PDQ - NCI's Comprehensive Cancer Database

194. Osteitis Pubis (Overview)

, a blood culture Imaging studies that may be helpful include the following: Plain radiography Bone scanning (technetium-99m) Single-photon emission computed tomography (SPECT) Magnetic resonance imaging (MRI) Computed tomography (CT) Other studies that may be considered are as follows: Aspiration of the pubic symphysis for culture, when the patient is febrile but blood cultures are negative Herniography, when a sports hernia is a strong consideration Treatment Rest and time are the primary healing (...) Musculoskelet Rehabil . 2012 Jan 1. 25(4):225-30. . Garvey JF, Read JW, Turner A. Sportsman hernia: what can we do?. Hernia . 2010 Feb. 14(1):17-25. . Lloyd-Smith R, Clement DB, McKenzie DC, Taunton JE. A survey of overuse and traumatic hip and pelvic injuries in athletics. Phys Sportsmed . 1985. 18(10):131-41. Westlin N. Groin pain in athletes from southern Sweden. Sports Med Arthroscopy Rev . 1997. 5:280-4. Holt MA, Keene JS, Graf BK, Helwig DC. Treatment of osteitis pubis in athletes. Results

2014 eMedicine.com

195. Osteitis Pubis (Overview)

, a blood culture Imaging studies that may be helpful include the following: Plain radiography Bone scanning (technetium-99m) Single-photon emission computed tomography (SPECT) Magnetic resonance imaging (MRI) Computed tomography (CT) Other studies that may be considered are as follows: Aspiration of the pubic symphysis for culture, when the patient is febrile but blood cultures are negative Herniography, when a sports hernia is a strong consideration Treatment Rest and time are the primary healing (...) Musculoskelet Rehabil . 2012 Jan 1. 25(4):225-30. . Garvey JF, Read JW, Turner A. Sportsman hernia: what can we do?. Hernia . 2010 Feb. 14(1):17-25. . Lloyd-Smith R, Clement DB, McKenzie DC, Taunton JE. A survey of overuse and traumatic hip and pelvic injuries in athletics. Phys Sportsmed . 1985. 18(10):131-41. Westlin N. Groin pain in athletes from southern Sweden. Sports Med Arthroscopy Rev . 1997. 5:280-4. Holt MA, Keene JS, Graf BK, Helwig DC. Treatment of osteitis pubis in athletes. Results

2014 eMedicine.com

196. Neutrophilia (Overview)

can occur. Neutrophilia in severe burns is accompanied by a shift to the left in the differential and the presence of degenerative forms, including toxic granulation and Dohle bodies. Postoperatively, neutrophilia occurs for 12-36 hours as a result of tissue injury–related increases in adrenocortical hormones. Leukocytosis can also occur in intestinal obstruction and strangulated hernia. Neutrophil activation during cardiopulmonary bypass (CPB) surgery may occur because of the release (...) -reactive protein and erythrocyte sedimentation rate could be helpful. In hematologic diseases, it is so important to take a peripheral blood smear to assess the abnormal shape of the cells. Bone marrow study is of great value to rule out some malignancies. Previous References Syu GD, Chen HI, Jen CJ. Differential Effects of Acute and Chronic Exercise on Human Neutrophil Functions. Med Sci Sports Exerc . 2011 Nov 29. . Gratacap RL, Rawls JF, Wheeler RT. Mucosal candidiasis elicits NF-?B activation

2014 eMedicine.com

197. Upper Respiratory Tract Infection (Diagnosis)

. Myositis or pericarditis may result from viral infection. Hyperglycemia may occur during a URI in patients with diabetes. Rib fracture may be seen following an episode of severe coughing, such as that associated with whooping cough. Hernia may develop following an episode of severe coughing. Cutaneous complications such as rash, cellulitis, and toxic shock syndrome may occur with group A streptococcus. This pathogen can also be associated with glomerulonephritis, acute rheumatic fever, and PANDAS (...) , as many as 20% have permanent hearing loss or other long-term sequelae. [ ] Complications from pertussis More than half of infants younger than 12 months who contract pertussis require hospitalization, especially those who are younger than 6 months. Complications of pertussis in hospitalized infants include the following [ ] : Apnea (50%) Pneumonia (20%) Seizures (1%) Encephalopathy (0.3%) Death (1%) In addition, severe cough may result in rib fractures, hernia, incontinence, or subconjunctival

2014 eMedicine.com

198. Pneumothorax (Follow-up)

. . . Peuker E. Case report of tension pneumothorax related to acupuncture. Acupunct Med . 2004 Mar. 22(1):40-3. . . Whale C, Hallam C. Tension pneumothorax related to acupuncture. Acupunct Med . 2004 Jun. 22(2):101; author reply 101-2. . Zhao DY, Zhang GL. [Clinical analysis on 38 cases of pneumothorax induced by acupuncture or acupoint injection]. Zhongguo Zhen Jiu . 2009 Mar. 29(3):239-42. . Dalton AM, Hodgson RS, Crossley C. Bochdalek hernia masquerading as a tension pneumothorax. Emerg Med J . 2004

2014 eMedicine Surgery

199. Nerve Entrapment Syndromes (Follow-up)

to ensure clearance of other iliacus fascial bands. In spite of the incision on the inguinal ligament (on its lateral side), hernia is extremely rare after this procedure. Recurrence of symptoms can be treated with transection of the nerve. After freeing the nerve at the ASIS and proximally toward the pelvis, gentle downward traction is applied and the neurectomy is done proximally. This allows the proximal stump to retract proximally into deep tissues. This is thought to decrease painful neuroma (...) management of cubital tunnel syndrome: an 8-year prospective study. Neurology . 1993 Sep. 43(9):1673-7. . Fernández-de-Las-Peñas C, Cleland J, Palacios-Ceña M, Fuensalida-Novo S, Pareja JA, Alonso-Blanco C. The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function, Cervical Range of Motion, and Pinch Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial. J Orthop Sports Phys Ther . 2017 Mar. 47 (3):151-161. . Pirela-Cruz MA, Omer GF. Surgical exposure of the peripheral

2014 eMedicine Surgery

200. Cancer and Rehabilitation (Overview)

roles and mobility were notable problems in 26% of patients. Other patients reported that fatigue and deconditioning interfered with their functional performance and mobility. Psychological integration of the new situation into personal relations and coping with daily life were also problematic. As a result of their survey, VanHarten et al proposed a community pilot program for patients with cancer. Components of the program included the following: Fitness and sports activities Relaxation exercises (...) exercise, sports, psychoeducation, and information. Measurements were performed before and after 6 weeks of rehabilitation to assess symptom-limited bicycle ergometry performance, muscle force, and QOL (on the RAND-36 instrument, Rotterdam Symptom Checklist [RSCL], and Multidimensional Fatigue Inventory [MFI]). Statistically significant improvements were found in symptom-limited bicycle ergometry performance, muscle force, and several domains of the QOL instruments (RAND-36, RSCL, and MFI

2014 eMedicine.com

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