The Case for Mandatory Mouth Protectors

Abstract

Osteochondral lesions of the knee is a common disorder in adolescents, although it may present in children and adults. Despite the fact that the disorder was discovered more than a century ago, no specific causes have been identified, although relationships with ischemia, irregular ossification of epiphyseal cartilage, genetic influences, trauma, and endocrine disorders have been postulated. Taking a thorough history and performing a thorough physical examination will facilitate diagnosis of this condition. Radiographic and magnetic resonance imaging are useful diagnostic tools that aid in the evaluation. A comprehensive knowledge of the relevant anatomy and clinical progression of osteochondral lesions allows for a better understanding of the classification systems and, ultimately management of this disorder. The size, location, and stability of the lesion, as well as the patient's age, are crucial in determining optimal treatment. The spectrum of injury ranges from small, stable lesions, which can be treated nonoperatively, to unstable or displaced lesions, which may require surgical management. Surgical options include drilling of subchondral bone, curettage and microfracture, refixation of detached lesions, autologous osteochondral autograft procedures (eg, mosaicplasty, osteochondral autograft transfer system), autologous chondrocyte implantation, and osteochondral allograft resurfacing. This article provides a basic approach to the evaluation and management of osteochondral lesions, as well as indications for surgery.     

Ⅲ期褥疮治疗方法的探讨

目的 :探索褥疮治疗的新途径。方法 :对于Ⅲ期褥疮病人 ,先用MEBO换药 ,每日 2次 ,约 7天～ 1 0天创面新鲜 ,肉芽坚实 ,即改行皮瓣修复法。对不同部位的褥疮采用不同的皮瓣修复。结果 :1 2例病人 ,有 1例病人并发皮瓣下积液 ,经引流后愈合 ,余 1 1例均一期愈合。 9例随访 6个月～ 3年 ,一例死于原发病 ,8例未复发。结论 :对于Ⅲ期褥疮用MEBO换药后 ,即改行皮瓣修复术 ,可大大缩短病程 ,减少工作量 ,且节约费用 ,适于基层医院开展。     

湿润烧伤膏治疗褥疮的临床体会

目的：探索湿润烧伤膏治疗褥疮的临床经验。方法：本组３１例褥疮病人全部采用湿润烧伤膏治疗,根据创面情况分别采用湿性暴露方法和湿性包扎方法。结果：本组３１例,痊愈２２例,好转９例,总有效率达１００％。结论：临床观察证实,湿润烧伤膏可促进褥疮自行愈合。     

压疮护理小组在危重症患儿压疮预防中的效果分析

目的回顾性分析压疮护理小组在危重症患儿压疮预防中的应用效果。方法将2016年2月—2017年10月郑州大学附属儿童医院儿童重症监护室收治的200例危重症患儿按照护理方法分为观察组(100例)与对照组(100例),其中对照组患儿采用的是常规护理模式,观察组患儿在常规护理的基础上,压疮护理小组又给予了专业的压疮预防护理,对比观察两组患儿的压疮发病率及患儿或其家属对护理的满意度。结果观察组患儿中出现Ⅰ期压疮者4例、Ⅱ期压疮者1例、压疮发病率为5.0%,对照组患儿中出现Ⅰ期压疮者5例、Ⅱ期压疮者6例、Ⅲ期压疮者10例、压疮发病率为21.0%,两组对比采用2行×4列表资料的卡方检验,X~2=15.154, P=0.002,P 0.01,差异具有统计学意义;观察组中患儿或其家属对护理服务非常满意者39例、满意者57例、不满意者4例、满意度为96. 0%,对照组中患儿或其家属对护理服务非常满意者30例、满意者55例、不满意者15例、满意度为85.0%,两组对比采用2行×3列表资料的卡方检验,X~2=7.578, P=0. 023,P0.05,差异具有统计学意义。结论危重症患儿采用压疮护理小组的专业压疮预防护理方案,可有效预防压疮的发生,提高护理满意度,值得临床推广应用。     

Grain Foods and Health: A Primer for Clinicians

Abstract

Preventing many chronic diseases in North America requires substantial changes in dietary habits. Achieving a better balance of grain-based foods through the inclusion of whole grains is one scientifically supported dietary recommendation. Epidemiological and other types of research continue to document health benefits for diverse populations who have adequate intakes of both folic acid-fortified grain foods and whole grains. Folic acid fortification of grains is associated with reduced incidence of neural tube and other birth defects and may be related to decreased risk of other chronic disease. Whole grain intake is associated with reduced risk of chronic disease. Specifically, there is a decreased risk of obesity, coronary heart disease, hypertension, stroke, metabolic syndrome, type 2 diabetes, and some cancers observed among the highest whole grain eaters compared with those eating little or no whole grains. Nationally promulgated dietary recommendations such as those in the US Dietary Guidelines or by health promotion organizations such as the American Heart Association have incorporated the science on whole grains, recommending that consumers increase their whole grain intake. The US Dietary Guidelines state that consumers select half of the recommended bread and cereal servings as whole grain. Thus, the recommendations recognize the importance of adequate folic acid intake from refined, fortified grains to reduce the risk of birth defects and other disorders and to reflect the existing science on whole grains. The association between whole grains and decreased chronic disease is not surprising because whole grains are a source of vitamins, minerals, fatty acids, antioxidants, and other phytochemicals and dietary fiber. Each of these components can act singly or in tandem to contribute to specific health-maintaining and disease-preventing mechanisms. Health professionals should be aware of these benefits and advocate these dietary strategies to help prevent chronic disease and to improve overall health.     

Mouth guards for the prevention of injuries in contact sports

There has been a significant increase in the number of individuals participating in contact sports. As a result, every effort must be made to provide the athletes with protection against mouth injuries. In this review the use, construction and benefits of mouthguards in all sports has been described. There is unanimous opinion attesting to the benefits of such protective devices and in those sports where the athlete is required to wear a mouth guard, a dramatic decrease in the number and severity of injuries has been reported. Custom-fitted mouth guards should be used in many sports that do not already have a compulsory rule requiring their use. Physicians, dentists, trainers and coaches need to be educated on the data supporting the benefits described. Studies on performance enhancement as a result of mandibular orthopaedic repositioning appliances have also been reviewed. Long term studies are required to assess the claims of ergogenic enhancement utilising proper study design. Current evidence exists relating to the effects of psychological phenomena on athletic performance, and it is believed the placebo effect contributes to the findings of performance improvement.     

Soft Contact Lenses for Sports

Good vision is essential in sports, but many athletes go without correction because the solution is worse than the problem. This study shows that soft contact lenses correct more than vision.     

Mouth Protectors in Junior Football Players

This study tested Sta-Guard and Proform mouth protectors that were worn by 280 football players aged 9 to 12 years. Laboratory studies were also conducted to test tensile and tear strength, dynamic modulus and resilience, and hardness. The players received new mouth guards every two weeks for 12 weeks and reported any problems with gagging, taste, speech, feel, and durability. Ninety percent of the boys preferred the Sta-Guard mouth protector, stating that it was softer, more resilient, and more comfortable than the Proform mouth guard.     

洁治中咬合块辅助张口的护理

目的观察口腔咬合块在洁治护理中辅助张口的应用效果。方法应用咬合块为100例需要洁治的患者进行护理,对其使用效果进行问卷调查。结果使用咬合块后,洁治中患者持续张口困难改善,关节、肌肉放松。结论咬合块适用于洁治中辅助张口的护理。     

Soft tissue angiofibroma: a case report

Soft tissue angiofibroma is a recently described neoplasm that typically presents as a slowly growing, painless mass in the soft tissues of the lower extremities. Cytogenetic and molecular studies have identified a recurrent t(5;8) translocation. Treatment is simple excision. Existing data suggest that this tumor is benign and has a low rate of local recurrence. The radiologic and pathologic differential diagnoses for this lesion include both benign and malignant lesions, including plantar fibromatosis, tenosynovial giant cell tumor, fibroma of tendon sheath, epithelioid sarcoma, and low-grade myxofibrosarcoma. Proper identification of this benign lesion through radiologic and pathologic correlation is important to prevent misdiagnosis of a low-grade sarcoma.     

MEBO治疗压疮20例临床护理体会

目的:探讨应用湿润烧伤膏(MEBO)治疗压疮的护理效果.方法:将40例压疮患者随机分成实验组(MEBO组)和对照组.实验组用MEBO治疗,对照组予以生理盐水冲洗创面,利凡诺纱布、凡士林纱布等常规换药,结合神灯照射(烤灯)创面治疗,观察并比较两组患者压疮愈合情况和压疮护理时间.结果:在相同观察时间内两组患者压疮治疗总有效率比较(P<0.01)有统计学意义,实验组治疗优于对照组;两组患者满意度比较,P<0.01,实验组优于对照组.结论:MEBO治疗压疮操作简便,压疮创面生理性愈合效果好,值得推广应用.     

Interventional Radiology for Treating Soft Tissue Sarcomas

The role of interventional radiology for soft tissue sarcomas is only occasionally addressed in the literature. However, different techniques such as embolization, selective chemotherapy, chemoembolization, and acrylic cement osteoplasty can be helpful with the primary tumor, recurrences, and metastases. This article discusses these techniques and their complications in treatment of soft tissue sarcomas.     

Effects of Intraoral Mouth Guards on Ventilation

Orthoses can be used inside downhill ski boots to aid in parallel skiing. Small degrees of imbalance become significant when they affect the skier's posture and ability to turn. The author explains how orthoses, cants between the boot and the ski, and posts correct biomechanical deformities including tibial varus and valgus, subtalar varus, forefoot varus and valgus, and leg-length discrepancies. He advises skiers whose feet hurt to find a good podiatrist and a reliable ski boot fitter.