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Liu RKK, Howell DR, Pierpoint LA, Little CC, Spittler J, Khodaee M, Provance A. SalterHarris fractures in paediatric skiers and snowboarders. Res Sports Med 2023:1-8. [PMID: 37221842 DOI: 10.1080/15438627.2023.2216823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The incidence of paediatric fractures among winter sport athletes is not adequately studied. Our objective was to categorize fractures that occurred in paediatric skiers and snowboarders at a single ski resort. X-rays of 756 skiers/snowboarders aged 3-17 diagnosed with a fracture were categorized using the Salter-Harris (SH) classification. SH fractures were seen in 158 (21%) patients, with 123 (77%) being Type II. There were no significant differences between patients with a SH fracture and patients with a non-SH fracture for age, sex, snowboarding or skiing, mechanism of injury, terrain or the resort conditions on the day of injury. The most common mechanism of injury was falling onto snow while collisions resulted in more severe injuries. Compared to fractures without growth plate involvement, a higher proportion of SH fractures were seen in the humerus, radius, fibula and thumb; a lower proportion of SH fractures were observed at the tibia and clavicle.
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Affiliation(s)
| | - David R Howell
- Department of Orthopedics, Children's Hospital Colorado Sports Medicine Center, Aurora, CO, USA
| | - Lauren A Pierpoint
- Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Casey C Little
- School of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Jack Spittler
- Department of Family Medicine, University of Colorado, Aurora, CO, USA
| | - Morteza Khodaee
- Department of Family Medicine, University of Colorado, Aurora, CO, USA
| | - Aaron Provance
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT, USA
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Abstract
BACKGROUND Acromioclavicular joint (ACJ) injuries are among the most common injuries in contact and non-contact sports. As winter sports become more popular, there has been an increase in shoulder injuries among recreational skiers and snowboarders. METHODS This was a retrospective analysis of all patients who presented to the Denver Health Winter Park Medical Center with ACJ injury from 2012 to 2017. We examined the incidence of ACJ injuries, the injury mechanism, demographics, and type of ACJ injuries among skiers and snowboarders treated at the clinic. RESULTS A total of 341 ACJ injuries (6.7% of total visits) were encountered during the study period. The majority of ACJ injures were type I (41.3%) and mainly occurred in men (86.5%). Most (96.8%) of the cases were primary ACJ injuries on the right shoulder (56.9%). The average age of patients with ACJ injuries was 30.0 years (range 10-72). More than half (62.2%) of ACJ injuries occurred while snowboarding. The most common mechanism of injury (93.5%) was fall to the snow while skiing/snowboarding. Women were more likely to have a type I ACJ injury than men (80.4% vs 35.4%; P < 0.001). Women with ACJ injuries were more likely to suffer the injury while skiing than snowboarding (71.7% vs 28.3%; P < 0.001), compared to men who were more likely to suffer the injury while snowboarding than skiing (67.5% vs 32.5%; P < 0.001). CONCLUSIONS Most of the ACJ injuries were type I and occurred mostly in men. Snowboarders were more likely to have an ACJ injury than skiers. LEVEL OF EVIDENCE Level IV, Epidemeiology Study.
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Affiliation(s)
- Naomi Kelley
- University of Colorado School of Medicine, Denver, CO
| | - Lauren Pierpoint
- Center for Outcomes-Based Orthopedic Research, Steadman Philippon Research Institute, Vail, Co
| | - Jack Spittler
- Department of Family Medicine and Orthopedics, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Morteza Khodaee
- Department of Family Medicine and Orthopedics, University of Colorado School of Medicine, Denver, Colorado, USA
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Oberle L, Spittler J, Khodaee M. Segmental clavicle fracture following a road bike injury. BMJ Case Rep 2022; 15:e251659. [PMID: 36692531 PMCID: PMC9445796 DOI: 10.1136/bcr-2022-251659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Lauren Oberle
- Family Medicine, UCLA Medical School, Los Angeles, California, USA
| | - Jack Spittler
- Family Medicine and Orthopaedics, University of Colorado Denver School of Medicine, Denver, Colorado, USA
| | - Morteza Khodaee
- Family Medicine and Orthopaedics, University of Colorado Denver School of Medicine, Denver, Colorado, USA
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Sidhar K, Baugh CM, Wilson JC, Spittler J, Walker GA, Armento AM, Howell DR. Socioeconomic status and injury history in adolescent athletes: Lower family affluence is associated with a history of concussion. J Clin Transl Res 2022; 8:292-298. [PMID: 35975186 PMCID: PMC9373721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 10/26/2022] Open
Abstract
Background While healthcare and health outcome disparities have been studied across a variety of different injuries, their relation to concussion incidence and management are relatively understudied. Aim The aim of this study was to evaluate the association between history of concussion or musculoskeletal injury, and family affluence and/or school-level measures of socioeconomic status. Methods We conducted a cross-sectional study of adolescent athletes in a local school district. Adolescent athletes (n = 192; mean age = 15.3, SD = 1.6 years; 49% female), who presented for a pre-participation physical evaluation reported concussion and injury history, and family affluence scale (FAS) scores. We also examined the percent of students on free/reduced lunch at each school compared to state averages. Independent variables, individual FAS score and school-based marker of socioeconomic status, were compared between those with and without a history of concussion and time-loss musculoskeletal injury. Results Of the participants, 40 (21%) reported a history of concussion. Athletes with a concussion history had significantly lower FAS scores than athletes without a history of concussion (mean difference = 0.7, 95%CI = 0.1, 1.4; P = 0.027). There was no significant difference in FAS scores between those with and without a history of time-loss musculoskeletal injury (mean difference = 0.0, 95% CI = -0.5, 0.5; P = 0.97). Athletes with a history of concussion had a higher proportion of a prior time-loss musculoskeletal injury (68% vs. 32%; P < 0.001). After adjusting for age, school free-reduced lunch rate, and history of musculoskeletal injury, a lower FAS score was associated with concussion history (adjusted odds ratio = 0.79; 95% CI = 0.64, 0.96; P = 0.019). Concussion and musculoskeletal injury were not associated with school-level markers of socioeconomic status. Conclusion Lower individual measures, but not school-level measures, of socioeconomic status were associated with a history of concussion in our sample of adolescent athletes. Relevance for Patients Enhance providers' understanding of how socioeconomic factors may impact concussion history and empower providers to adequately screen for and provide concussion education to mitigate disparities.
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Affiliation(s)
- Kartik Sidhar
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Christine M. Baugh
- 3Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,4Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Julie C. Wilson
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA,5Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jack Spittler
- 6Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gregory A. Walker
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Aubrey M. Armento
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - David R. Howell
- 1Sports Medicine Center, Children’s Hospital Colorado, Aurora, CO, USA,2Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA,Corresponding author: David R. Howell, Sports Medicine Center, Children’s Hospital Colorado; Department of Orthopedics, University of Colorado School of Medicine. Address: 13123 E. 16th Avenue, B060 Aurora, CO 80045. Tel: +1 7207771502. E-mail:
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Khodaee M, Irion B, Spittler J, Saeedi A, Hoffman MD. Characteristics of runners meeting acute kidney injury criteria following a 161‐km ultramarathon. Translational Sports Med 2021. [DOI: 10.1002/tsm2.276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Morteza Khodaee
- Department of Family Medicine & Orthopedics University of Colorado School of Medicine Denver USA
| | - Bjørn Irion
- Western Orthopedics and Sports Medicine Grand Junction CO USA
| | - Jack Spittler
- Department of Family Medicine & Orthopedics University of Colorado School of Medicine Denver USA
| | - Anahita Saeedi
- Department of Biostatistics School of Public Health & Health Sciences University of Massachusetts Amherst MA USA
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Sidhar K, Spittler J. 55 Year Old Male With Chronic Groin Pain After Work Related Hamstring Injury. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000763980.59139.b0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Oberle L, Pierpoint L, Spittler J, Khodaee M. Epidemiology of Clavicle Fractures Sustained at a Colorado Ski Resort. Orthop J Sports Med 2021; 9:23259671211006722. [PMID: 34026919 PMCID: PMC8120545 DOI: 10.1177/23259671211006722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/25/2021] [Indexed: 12/26/2022] Open
Abstract
Background Although clavicle fractures are a common sports injury, there are limited studies on the incidence and causes of clavicle fractures among winter sports athletes. Purpose To evaluate the characteristics and injury mechanisms associated with clavicle fractures among patients evaluated at a Colorado ski resort. Study Design Descriptive epidemiology study. Methods This was a retrospective descriptive analysis of patients with clavicle fractures at the Denver Health Winter Park Medical Center during the 2012-2013 to 2016-2017 ski seasons. Chart review was performed on the patient cohort to confirm clavicle fracture diagnosis and to evaluate factors associated with clavicle fracture. Results A total of 393 clavicle fractures (6.2% of total clinic visits) occurred during the study period, corresponding to an overall clavicle fracture incidence of 8.4 per 100,000 participant-visits. The mean patient age was 26.4 years (range, 5-73 years). The majority were middle-third fractures (85.5%), occurring mainly in men (87.3%). More than half of the fractures were comminuted (54.5%) and occurred in snowboarders (55.0%). The most common mechanism of injury was a fall onto snow while skiing or snowboarding (92.4%). Women sustained more clavicle fractures while skiing compared with snowboarding (82.0% vs 18.0%; P < .001), while men sustained more fractures while snowboarding compared with skiing (60.3% vs 39.7%; P < .001). Conclusion Clavicle fractures are relatively common, but there are scant incidence data for clavicle fractures in mountain sports. Consistent with prior studies, clavicle fractures were more common in younger patients and men. The most common anatomic fracture location was the midclavicle. A greater proportion of clavicle fractures among men were sustained during snowboarding and among women during skiing.
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Affiliation(s)
- Lauren Oberle
- Department of Family Medicine and Orthopedics, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Lauren Pierpoint
- Center for Outcomes-Based Orthopaedic Research, Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Jack Spittler
- Department of Family Medicine and Orthopedics, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Morteza Khodaee
- Department of Family Medicine and Orthopedics, University of Colorado School of Medicine, Denver, Colorado, USA
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Abstract
PURPOSE Urine dipstick analysis (UDA) is a useful tool in clinical practices. Abnormalities in UDA parameters have been observed as a result of extreme exercise. The exact incidence of UDA abnormalities, particularly proteinuria, as the result of running ultramarathons is unknown. The purpose of this study was to estimate the incidence of proteinuria and to identify the characteristics of those with proteinuria. METHODS We conducted a prospective observational study using urine samples from volunteer athletes before and immediately after the Leadville Trail 100 Run in August 2014. There were 33 runners with both pre-race and post-race samples and a total of 70 provided post-race samples. Demographic information was collected as a part of a larger study. RESULTS At least one abnormality was demonstrated in 89% of post-race urine samples. Twenty-one (30%) runners had post-race proteinuria (≥1+). Serum creatine kinase concentration (CK) was the only variable that was significantly correlated with the incidence of proteinuria in a multiple logistic regression model. CONCLUSION A majority of runners developed abnormalities in their UDA. Proteinuria was common and found to be associated with serum CK concentration.
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Affiliation(s)
- Morteza Khodaee
- Department of Family Medicine & Orthopedics, University of Colorado School of Medicine , Denver, CO, USA
| | - Anahita Saeedi
- Department of Biostatistics, Shahid Beheshti University , Tehran, Iran
| | - Bjørn Irion
- Western Orthopedics and Sports Medicine , Grand Junction, CO, USA
| | - Jack Spittler
- Department of Family Medicine & Orthopedics, University of Colorado School of Medicine , Denver, CO, USA
| | - Martin D Hoffman
- Department of Physical Medicine and Rehabilitation, University of California Davis , Sacramento, CA, USA
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Abstract
Paddle sports continue to be popular forms of outdoor recreation in the United States and around the world. This includes not only the more traditional sports of rafting, kayaking, and canoeing but also the newer and growing sport of stand-up paddle boarding. Because these sports are based in an aquatic environment, and frequently whitewater, there are unique, significant risks of injury. Overall, injuries in paddling sports are mostly musculoskeletal and are both acute and chronic in nature. Some injuries, such as environmental and head injuries, are especially problematic because they can lead to serious morbidity and mortality, most importantly drowning. This review describes the epidemiology, type, and location of injuries across paddle sports. It not only focuses on whitewater injuries but also includes information on injuries sustained in other aquatic paddling environments.
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Affiliation(s)
- Jack Spittler
- Departments of Family Medicine and Orthopedics, University of Colorado, Aurora, CO
| | - Ryan Gillum
- Department of Family Medicine, St. Mary's Hospital, Grand Junction, CO
| | - Kristen DeSanto
- Strauss Health Sciences Library, University of Colorado Anschutz Medical Campus, Aurora, CO
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Brennan FH, Rao AL, Myers RA, Ferderber M, Marcussen B, Mansfield L, Miller EM, Spittler J, Sylvester J. Suggested Curricular Guidelines for Musculoskeletal and Sports Medicine in Family Medicine Residency Training. Curr Sports Med Rep 2020; 19:180-188. [DOI: 10.1249/jsr.0000000000000713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Exercise is universally recognized for its health benefits and distance running has long been a popular form of exercise and sport. Ultramarathons, defined as races longer than a marathon, have become increasingly popular in recent years. The diverse ultramarathon distances and courses provide additional challenges in race performance and medical coverage for these events. As the sport grows in popularity, more literature has become available regarding ultramarathon-specific illnesses and injuries, nutrition guidelines, psychology, physiologic changes, and equipment. This review focuses on recent findings and trends in ultramarathon running.
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Affiliation(s)
- Jack Spittler
- UCH-A.F. Williams Family Medicine Center at Stapleton, Denver, CO
| | - Lauren Oberle
- University of Colorado-Denver, Anschutz Medical Campus, Denver, CO
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12
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Khodaee M, Spadafore S, Spittler J. Painful, swollen elbow. J Fam Pract 2020; 69:311-313. [PMID: 32724913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Was a recent procedure responsible for this patient's pain?
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Affiliation(s)
- Morteza Khodaee
- Department of Family Medicine & Orthopedics, University of Colorado School of Medicine, Denver, USA.
| | - Stephen Spadafore
- Department of Family Medicine & Orthopedics, University of Colorado School of Medicine, Denver, USA
| | - Jack Spittler
- Department of Family Medicine & Orthopedics, University of Colorado School of Medicine, Denver, USA
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13
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Neuman M, Spittler J. Photo Rounds: Painful facial blisters, fever, and conjunctivitis. J Fam Pract 2018; 67:573-575. [PMID: 30216398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Following Tx for facial blisters, our patient returned with what appeared to be viral conjunctivitis. Further evaluation revealed a missed tip-off to the proper Dx.
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Affiliation(s)
| | - Jack Spittler
- University of Colorado Family Medicine, Denver, USA.
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14
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Buck K, Spittler J, Reed A, Khodaee M. Psychological Attributes of Ultramarathoners. Wilderness Environ Med 2018; 29:66-71. [PMID: 29336959 DOI: 10.1016/j.wem.2017.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 07/11/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION As the popularity of ultramarathon participation increases, there still exists a lack of understanding of the unique psychological characteristics of ultramarathon runners. The current study sought to investigate some of the psychological and behavioral factors that are involved in ultramarathon running. METHODS We obtained information from participants of the Bear Chase Trail Race via an online survey. This race is a single-day, multidistance race consisting of a 10 k, half marathon, 50 k, 50 mi, and 100 k run in Lakewood, Colorado, at a base altitude of 1680 m with total altitude in climbs ranging from 663 to 2591 m. We correlated information from the Exercise Addiction Inventory and the Patient Health Questionnaire-2 and demographic information with race finish times. RESULTS Out of 200 runners who started the race, 98 (48%) completed the survey. Over half of the runners were men (61.2%), and the average age was 39.0 years (SD±8.9; range 21-64 years). A number of respondents (20%) screened positive for exercise addiction concerns. Approximately 20% of our sample screened positive for depressive symptoms (Patient Health Questionnaire-2 score >3). The majority of participants reported receiving strong social support from current partners with regard to their ultramarathon running training time and goals. CONCLUSIONS Although only a screening, the number of positive screens on the Exercise Addiction Inventory suggests use of screening measures with an ultramarathon running population. Athletes with positive screening tests should be fully evaluated for depression and exercise addiction because this would enable appropriate athlete support and treatment referral.
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Affiliation(s)
- Katherine Buck
- Family Medicine Residency Program, John Peter Smith Hospital, Fort Worth, TX (Dr Buck).
| | - Jack Spittler
- Department of Family Medicine, University of Colorado School of Medicine, Denver, CO (Drs Spittler, Reed, and Khodaee)
| | - Alex Reed
- Department of Family Medicine, University of Colorado School of Medicine, Denver, CO (Drs Spittler, Reed, and Khodaee)
| | - Morteza Khodaee
- Department of Family Medicine, University of Colorado School of Medicine, Denver, CO (Drs Spittler, Reed, and Khodaee)
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Lyon C, Spencer E, Spittler J, Desanto K. Clinical Inquiries: How do hyaluronic acid and corticosteroid injections compare for knee OA relief? J Fam Pract 2018; 67:E13-E14. [PMID: 29309475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Inconsistent evidence shows a small amount of pain relief early (one week to 3 months) with corticosteroid (CS) injections and an equally small improvement in pain relief and function later (3 to 12 months) with hyaluronic acid (HA) injections (strength of recommendation [SOR]: B, meta-analysis of a randomized controlled trial and inconsistent RCTs). Guidelines state that CS injections can be considered for symptomatic knee osteoarthritis, but that insufficient evidence exists to recommend HA injections (SOR: B, evidence-based guidelines).
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Affiliation(s)
- Corey Lyon
- University of Colorado Family Medicine Residency, Denver, CO, USA
| | - Emily Spencer
- University of Colorado Family Medicine Residency, Denver, CO, USA
| | - Jack Spittler
- University of Colorado Family Medicine Residency, Denver, CO, USA
| | - Kristen Desanto
- University of Colorado Health Sciences Library, Aurora, CO, USA
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Abstract
Water polo is a unique team sport combining swimming sprints and eggbeater kicking, frequent overhead movements and throwing, and regular physical contact with minimal protective equipment. Accordingly, a wide variety of training methods attempt to enhance all of these skill sets. This usually includes some combination of aerobic/anaerobic fitness (via swimming), sport-specific skills, strengthening, and nutrition. In addition, injuries in water polo are somewhat diverse. Physical contact is responsible for the majority of acute injuries, most frequently being injuries to the head and face. The high prevalence of shoulder pain in water polo is likely related to increased shoulder mobility and subsequent instability and stress on shoulder structures, yet the underlying causation is not certain. The unique aspect of shoulder injuries occurring in water polo players is that they may be due to a combination of swimming-related overuse conditions, overhead throwing, and acute trauma-related conditions. Although there is generally minimal evidence-based information available, this article attempts to highlight the current knowledge that we have in regard to water polo injuries and training methods.
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Affiliation(s)
- Jack Spittler
- 1University of Colorado School of Medicine, Department of Family Medicine, Primary Care Sports Medicine, Denver, CO; 2Rose Family Medicine Residency, Denver, CO
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17
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Khodaee M, Edelman GT, Spittler J, Wilber R, Krabak BJ, Solomon D, Riewald S, Kendig A, Borgelt LM, Riederer M, Puzovic V, Rodeo S. Medical Care for Swimmers. Sports Med Open 2016; 2:27. [PMID: 27512647 PMCID: PMC4960281 DOI: 10.1186/s40798-016-0051-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/07/2016] [Indexed: 12/25/2022]
Abstract
Swimming is one of the most popular sports worldwide. Competitive swimming is one of the most watched sports during the Olympic Games. Swimming has unique medical challenges as a result of a variety of environmental and chemical exposures. Musculoskeletal overuse injuries, overtraining, respiratory problems, and dermatologic conditions are among the most common problems swimmers encounter. Although not unique to swimming, overtraining is a serious condition which can have significant negative impact on swimmers' health and performance. This review article is an attempt to discuss various issues that a medical team should consider when caring for swimmers.
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Affiliation(s)
- Morteza Khodaee
- Department of Family Medicine, University of Colorado School of Medicine, Denver, CO USA
| | - George T Edelman
- Edelman Spine & Orthopaedic Physical Therapy, Dover, DE USA ; Department of Physical Therapy, University of Delaware, Newark, DE USA
| | - Jack Spittler
- Department of Family Medicine, University of Colorado School of Medicine, Denver, CO USA
| | - Randall Wilber
- United State Olympic Committee, Colorado Springs, CO USA
| | - Brian J Krabak
- Rehabilitation, Orthopedics and Sports Medicine, University of Washington and Seattle Children's Sports Medicine, Seattle, WA USA
| | | | - Scott Riewald
- Winter Sports, United States Olympic Committee, Colorado Springs, CO USA
| | - Alicia Kendig
- United State Olympic Committee, Colorado Springs, CO USA
| | - Laura M Borgelt
- Department of Clinical Pharmacy and Family Medicine, University of Colorado Skaggs School of Pharmacy and School of Medicine, Aurora, CO USA
| | - Mark Riederer
- Department of Pediatrics and Orthopaedic Surgery, University of Michigan, Ann Arbor, MI USA
| | - Vladimir Puzovic
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Scott Rodeo
- Sports Medicine and Shoulder Service, Orthopaedic Surgery, The Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY USA ; Tissue Engineering, Regeneration, and Repair Program, The Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY USA
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Khodaee M, Jones D, Spittler J. Obturator Internus and Obturator Externus Strain in a High School Quarterback. Asian J Sports Med 2015; 6:e23481. [PMID: 26448844 PMCID: PMC4594131 DOI: 10.5812/asjsm.23481] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/08/2014] [Accepted: 11/08/2014] [Indexed: 11/16/2022] Open
Abstract
Introduction: Buttock pain is a relatively common complaint among adolescent athletes and can have a very broad differential diagnosis. Case Presentation: The authors present a previously unreported case of acute obturator internus and obturator externus strain in an adolescent male American football player. The diagnosis was made by MRI. The patient was treated with relative rest, physical therapy, and gradual return to physical activities as tolerated. Conclusions: Despite rarity of the hip external rotator muscles strains, it should be considered in the differential diagnosis of athletes with proximal posterior thigh and buttock pain.
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Affiliation(s)
- Morteza Khodaee
- Department of Family Medicine, University of Colorado School of Medicine, Denver, USA
- Corresponding author: Morteza Khodaee, Department of Family Medicine, University of Colorado School of Medicine, 80238, Denver, USA. Tel: +1-7208489056, Fax: +1-7208489050, E-mail:
| | - Daniel Jones
- Department of Family Medicine, University of Colorado School of Medicine, Denver, USA
| | - Jack Spittler
- Department of Family Medicine, University of Colorado School of Medicine, Denver, USA
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Khodaee M, Spittler J, VanBaak K, Changstrom BG, Hill JC. Effects of Running an Ultramarathon on Cardiac, Hematologic, and Metabolic Biomarkers. Int J Sports Med 2015; 36:867-71. [PMID: 26134662 DOI: 10.1055/s-0035-1550045] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Serum biomarkers fluctuate as a result of running marathons, but their changes during ultramarathons have not been adequately studied. We collected blood samples from 20 participants before and 21 participants after the 161-km ultramarathon in Leadville, Colorado in August 2013. Using a portable analyzer, we measured cardiac troponin I (cTnl), hematologic, and metabolic biomarkers. Out of 10 runners for whom we collected both pre- and post-race samples, 8 were able to successfully complete the race. Mean cTnl increased from 0.001 to 0.047 ng/mL (p=0.005). Mean sodium decreased from 141 to 138 mmol/L (p <0.01). However, all runners had a sodium of ≥135 mmol/L post-race (reference range 138-146 mmol/L). Mean creatinine increased from 0.93 to 1.17 mg/dL (p <0.05). Only one out of 10 runners had an abnormal creatinine level of 1.8 mg/dL post-race (reference range 0.6-1.3 mg/dL). The other parameters did not reach statistical significance. Analyzing the samples from 21 runners after the race revealed that runners who finished the race in faster time had higher cTnl levels compared to those who finished the race close to the 30-hour cut-off finish time (P=0.005). Running an ultramarathon caused significant changes in cardiac and metabolic parameters. Ultramarathon running intensity and finish time may have effects on post-race cTnl level.
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Affiliation(s)
- M Khodaee
- Family Medicine, University of Colorado Denver School of Medicine, Denver, United States
| | - J Spittler
- Family Medicine, University of Colorado Denver School of Medicine, Denver, United States
| | - K VanBaak
- Family Medicine, University of Colorado Denver School of Medicine, Denver, United States
| | - B G Changstrom
- Department of Family Medicine and Community Health, University of Minnesota School of Medicine, Minneapolis, United States
| | - J C Hill
- Family Medicine, University of Colorado Denver School of Medicine, Denver, United States
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Miller L, Spittler J, Khodaee M, Bravman JT, Lyon C, Hoffecker L. FPIN's Clinical Inquiries. Management of acute achilles tendon rupture. Am Fam Physician 2015; 91:794-800. [PMID: 26034858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Luke Miller
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Jack Spittler
- University of Colorado School of Medicine, Aurora, CO, USA
| | | | | | - Corey Lyon
- University of Colorado School of Medicine, Aurora, CO, USA
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VanBaak KD, Spittler J, Irion B, Hoffman MD, Khodaee M. Weight Change and Hydration Status During a 161-km Ultramarathon. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478505.83465.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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22
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Khodaee M, Amir M, Spittler J, Abdollahi M. Multiple painless cutaneous nodules. Indian J Dermatol 2015; 60:206-8. [PMID: 25814721 PMCID: PMC4372925 DOI: 10.4103/0019-5154.152541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Spittler J, Hill J. Why Does My Ankle Hurt When I Run 100 Miles? Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000493587.20257.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Spittler J, Khodaee M, Hill JC, Hoffman MD. Impact of Foot Strike Pattern and Shoe Type on Ultramarathon Performance and Stress Fracture. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000495801.63926.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Khodaee M, Spittler J, Hill JC, Hoffman MD. IMPACT OF INJURY PATTERN DURING TRAINING ON ULTRAMARATHON PERFORMANCE. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Khodaee M, Spittler J, Basset P, Vanbaak K, Hill JC, San Millán I, Hoffman MD. REASONS FOR INABILITY TO COMPLETE ULTRAMARATHONS: A MULTICENTER STUDY. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Spittler J, Khodaee M. Bilateral Hand Weakness and Numbness. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000400661.38080.3e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Giaccone G, Rajan A, Carter C, Kelly R, Berman A, Spittler J, Espinoza-Delgado I, Lee M, Trepel J, Loehrer P. Phase II study of the histone deacetylase inhibitor belinostat in thymic malignancies. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.7589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7589 Background: Thymic malignancies are rare tumors. Chemotherapy is used for advanced disease. There is no established role of second-line therapy in patients with refractory or recurrent disease. Belinostat is an HDAC inhibitor with activity in cutaneous and peripheral T cell lymphoma and is being investigated in several solid tumors. One prolonged minor response (31 m) was seen in a phase I study of this agent in a patient with thymoma. Methods: Patients with recurrent thymoma or thymic carcinoma, progressing after platinum-based chemotherapy were eligible. They were also required to have measurable disease, PS 0–2 and normal organ functions. Belinostat was given iv at 1.0 g/m2 on days 1–5 of a 21-day cycle until disease progression or intolerable side effects. Correlative markers of activity in blood and tumor were performed. Results: From December 07 to December 08, 22 patients have been accrued from 2 institutions; 12 patients were males, median age 52 (23–72), 14 thymomas and 8 thymic carcinomas, mean number of prior regimens 3.5 (1–10), 16 prior tumor resection and 3 myasthenia gravis. A median of 4 cycles have been given (1–15+). Treatment was well tolerated, with nausea being the most common side effect and well controlled with prophylactic antiemetics. 21 patients are evaluable for response: 2 had a partial response (9+, 9+ m), 13 stable disease (3–11+ m) and 6 progression. No responses were seen in 8 evaluable patients with thymic carcinomas. Acetylated lysine and tubulin were analyzed in lymphocytes and monocytes by multiparameter flow cytometry. An increase of protein acetylation (2–10 fold) over baseline was observed at 1 hour post-infusion on day 3 of the first cycle in all patients analyzed. Other correlative markers are being investigated. Conclusions: The thymoma cohort has been expanded to the second stage of the study. Belinostat has activity in patients with recurrent or refractory thymoma. No significant financial relationships to disclose.
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Affiliation(s)
- G. Giaccone
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - A. Rajan
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - C. Carter
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - R. Kelly
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - A. Berman
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - J. Spittler
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - I. Espinoza-Delgado
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - M. Lee
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - J. Trepel
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
| | - P. Loehrer
- National Cancer Institute, Bethesda, MD; Indiana University Medical Center, Indianapolis, IN
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Roesch D, Shi M, Shalkey V, Spittler J, Sandberg K, Umans J, Miodovnik M. 419: Gestational changes in renal electrolyte transporters may increase lithium toxicity. Am J Obstet Gynecol 2007. [DOI: 10.1016/j.ajog.2007.10.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Comoy E, Bonnevalle C, Métais A, Auvré F, Letessier F, Lamoury F, Spittler J, Dormont D, Deslys JP. [Disinfection of gas-permeable contact lenses against prions]. J Fr Ophtalmol 2003; 26:233-9. [PMID: 12746598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Potential iatrogenic transmission from patients incubating Creutzfeldt-Jakob disease, especially variant CJD, is a major public health issue. Because the ocular route is very efficient for contamination with prions, re-use of rigid contact lenses in ophthalmology constitutes a potential problem. We therefore evaluated the anti-prion activity of different protocols available for disinfection of lenses. These treatments decreased the infectivity retained on the surface of experimentally contaminated lenses by a factor of at least 10 million. They thus represent an important factor in protecting against possible prion infection via the ocular route.
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Affiliation(s)
- E Comoy
- Département de Recherche Médicale/Direction des Sciences du Vivant, CEA, Fontenay-aux-Roses Cedex.
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Spittler J, Brouillard C, Stamm A. Manufacturing of Tablets Designed to Obtain a Cleaning/Disinfecting and Storage Solution for Contact Lenses. Drug Dev Ind Pharm 1988. [DOI: 10.3109/03639048809151881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tempe M, Jonvel P, Spittler J, Andermann G. Stability study of idoxuridine in gels by very high speed liquid chromatography. J Pharm Belg 1985; 40:222-8. [PMID: 4067807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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