ACUTE EFFECTS OF MUSCLE ENERGY TECHNIQUE AND JOINT MOBILIZATION ON SHOULDER TIGHTNESS IN YOUTH THROWING ATHLETES: A RANDOMIZED CONTROLLED TRIAL.

BACKGROUND: Posterior shoulder tightness (PST), defined as limited glenohumeral (GH) horizontal adduction and internal rotation motion, is a common occurrence in overhead athletes, particularly baseball and softball players, as a result of the extreme forces on the GH joint and the high number of throwing repetitions. Despite clinical evidence suggesting the use of joint mobilizations and muscle energy techniques (MET) for treating PST, there currently are no data examining the overall effectiveness of joint mobilizations and MET to determine optimal treatment for posterior shoulder tightness. PURPOSE: To compare the acute effectiveness of MET and joint mobilizations for reducing posterior shoulder tightness, as measured by passive GH horizontal adduction and internal rotation ROM, among high school baseball and softball players. STUDY DESIGN: Randomized controlled study. METHODS: Forty-two asymptomatic high school baseball and softball players were randomly assigned to one of three groups (14 MET, 14 joint mobilization, 14 control). Glenohumeral passive adduction and internal rotation ROM were measured in all participants in a pre-test post-test fashion. Between testing, the joint mobilization group received one application of GH posterior joint mobilizations. The MET group received one cycle of MET applied to the GH horizontal abductors. The control group received no intervention. Posttests measures were completed immediately following intervention or a similar amount of time resting for the control group and then again 15 minutes later. RESULTS: One-way analyses of covariance showed that the MET group had significantly more horizontal adduction ROM post-treatment compared to the control group (p = 0.04). No significant differences existed between groups in horizontal adduction (p > 0.16) or internal rotation (p>.28) or at the 15-minute posttests (p > 0.70). CONCLUSION: The results of this study indicate the application of MET to the horizontal abductors provides acute improvements to GH horizontal adduction ROM in high school baseball and softball players, while joint mobilizations provide no improvements. LEVEL OF EVIDENCE: 1.

HIV and viral hepatitis coinfection analysis using surveillance data from 15 US states and two cities.

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.

Comparison of Individual and Area Level Factors Between HIV-Infected Cisgender and Transgender Individuals in Florida (2006-2014).

This descriptive study compares individual- and area-level factors among HIV-infected transgender and cisgender individuals in Florida using data from the Florida Department of Health HIV/AIDS surveillance system (2006-2014). Of those individuals diagnosed with HIV, 7 (0.01 %) identified as transgender males, 142 (0.3 %) as transgender females, 12,497 (25.7 %) as cisgender females, and 35,936 (74.0 %) as cisgender males. Transgender females resided in rural and urban areas, were disproportionately non-Hispanic black, and were more likely than cisgender women to be diagnosed with AIDS within 3 months of their HIV diagnosis. Results suggest HIV screening and outreach efforts should be enhanced for transgender women.

Understanding the relationship between schematic beliefs, bullying, and unusual experiences in 8-14 year olds.

BACKGROUND: Cognitive models of adult psychosis propose that negative schematic beliefs (NSBs) mediate the established association between victimisation and psychotic symptoms. In childhood, unusual, or psychotic-like, experiences are associated with bullying (a common form of victimisation) and NSBs. This study tests the mediating role of NSBs in the relationship between bullying and distressing unusual experiences (UEDs) in childhood. METHOD: Ninety-four 8-14 year olds referred to community Child and Adolescent Mental Health Services completed self-report assessments of UEDs, bullying, and NSBs about the self (NS) and others (NO). RESULTS: Both NS and NO were associated with bullying (NS: r=.40, P<.001; NO: r=.33, P=.002), and with UEDs (NS: r=.51, P<.001; NO: r=.43, P<.001). Both NS and NO significantly mediated the relationship between bullying and UEDs (NS: z=3.15, P=.002; NO: z=2.35, P=.019). CONCLUSIONS: Children's NSBs may mediate the adverse psychological impact of victimisation, and are appropriate treatment targets for young people with UEDs. Early educational intervention to reduce negative appraisals of the self and others may increase resilience to future adverse experiences and reduce later mental health risk.

A preliminary investigation of schematic beliefs and unusual experiences in children.

BACKGROUND: In cognitive models of adult psychosis, schematic beliefs about the self and others are important vulnerability and maintaining factors, and are therefore targets for psychological interventions. Schematic beliefs have not previously been investigated in children with distressing unusual, or psychotic-like, experiences (UEDs). The aim of this study was firstly to investigate whether a measure of schematic beliefs, originally designed for adults with psychosis, was suitable for children; and secondly, to examine the association of childhood schematic beliefs with internalising and externalising problems and with UEDs. METHOD: Sixty-seven children aged 8-14 years, with emotional and behavioural difficulties, completed measures of UEDs, internalising (depression and anxiety), and externalising (conduct and hyperactivity-inattention) problems, together with the Brief Core Schema Scales (BCSS). RESULTS: The BCSS was readily completed by participants, and scale psychometric properties were good. Children tended to view themselves and others positively. Internalising and externalising problems and UEDs were all associated with negative schematic beliefs; effect sizes were small to medium. CONCLUSIONS: Schematic beliefs in young people can be measured using the BCSS, and negative schematic beliefs are associated with childhood psychopathology and with UEDs. Schematic beliefs may therefore form a useful target in psychological interventions for young people with UEDs.

Genetic studies in autistic disorder and chromosome 15.

Autistic disorder (AD) is a developmental disorder affecting social interactions, communication, and behavior. AD is a disease of complex genetic architecture. It is postulated that several genes contribute to the underlying etiology of AD. Chromosome 15 is of particular interest due to numerous reports of AD in the presence of chromosomal abnormalities, located mainly in the 15q11-q13 region. There are also a number of plausible candidate genes in this area, including the gamma-aminobutyric acidA (GABA(A)) receptor gene complex. We have undertaken a study of this region of chromosome 15 in a data set of 63 multiplex families (with 2 or more AD affected individuals per family). We found evidence in support of linkage to the 15q11-q13 region, as well as evidence of increased recombination in this region. These findings provide further support for the involvement of chromosome 15q11-q13 in the genetic etiology of AD.

Analysis of linkage disequilibrium in gamma-aminobutyric acid receptor subunit genes in autistic disorder.

Autistic disorder (AD) is a neurodevelopmental disorder characterized by abnormalities in behavior, communication, and social interactions and functioning. Recently, Cook et al. reported significant linkage disequilibrium with an AD susceptibility locus and a marker, GABRB3 155CA-2, in the gamma-aminobutyric acid(A) (GABA(A)) receptor beta3-subunit gene on chromosome 15q11-q13. This linkage disequilibrium was detected using a multiallelic version of the transmission/disequilibrium test (TDT) in a sample of nuclear families having at least one child with autistic disorder. In an attempt to replicate this finding we tested for linkage disequilibrium with this marker, as well as with three additional markers in and around the GABA(A) receptor beta3-subunit gene, in an independent, clinically comparable set of AD families. Unlike Cook et al., we failed to detect significant linkage disequilibrium between GABRB3 155CA-2 and AD in our sample. We did, however, find suggestive evidence for linkage disequilibrium with a marker, GABRB3, approximately 60 kb beyond the 3' end of beta3-subunit gene. This finding lends support for previous reports implicating the involvement of genes in this region with AD. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:43-48, 2000

Autistic disorder and chromosome 15q11-q13: construction and analysis of a BAC/PAC contig.

Autistic disorder (AD) is a neurodevelopmental disorder that affects approximately 2-10/10,000 individuals. Chromosome 15q11-q13 has been implicated in the genetic etiology of AD based on (1) cytogenetic abnormalities; (2) increased recombination frequency in this region in AD versus non-AD families; (3) suggested linkage with markers D15S156, D15S219, and D15S217; and (4) evidence for significant association with polymorphisms in the gamma-aminobutyric acid receptor subunit B3 gene (GABRB3). To isolate the putative 15q11-q13 candidate AD gene, a genomic contig and physical map of the approximately 1.2-Mb region from the GABA receptor gene cluster to the OCA2 locus was generated. Twenty-one bacterial artificial chromosome (BAC) clones, 32 P1-derived artificial chromosome (PAC) clones, and 2 P1 clones have been isolated using the markers D15S540, GABRB3, GABRA5, GABRG3, D15S822, and D15S217, as well as 34 novel markers developed from the end sequences of BAC/PAC clones. In contrast to previous findings, the markers D15S822 and D15S975 have been localized within the GABRG3 gene, which we have shown to be approximately 250 kb in size. NotI and numerous EagI restriction enzyme cut sites were identified in this region. The BAC/PAC genomic contig can be utilized for the study of genomic structure and the identification and characterization of genes and their methylation status in this autism candidate gene region on human chromosome 15q11-q13.

Reduction of MTT by glutathione S-transferase.

The reduction of the tetrazolium salt 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) to a blue formazan product is widely used for assaying cell survival and proliferation. The reduction reaction is catalyzed by dehydrogenases localized in the mitochondria of viable cells. As part of an analysis of the ability of glutathione S-transferase (GST) enzymes to protect cells from electrophilic compounds, we found extremely high background levels of the formazan product produced by cells that overexpressed the mouse GST P1-1 enzyme. Further analysis with purified GST enzymes confirmed the ability of these enzymes to reduce MTT in vitro. These data suggest that cytotoxicity assays using MTT should be interpreted with caution, especially when studying the effects of compounds that can influence GST expression.

Identification of a recombination event narrowing the Lafora disease gene region.

Patients affected with progressive myoclonus epilepsy of the Lafora type present during late adolescence with a characteristic EEG pattern and Lafora bodies seen on skin biopsy. The critical region for the Lafora gene has been localised to chromosome 6q24 flanked by the dinucleotide repeat markers D6S292 and D6S420. This study for linkage of markers from the candidate gene region was performed in a previously unpublished family affected with Lafora disease. EEG and skin biopsy evaluation for Lafora bodies were performed on five of eight family members followed for seizure activity. Haplotype and linkage analysis of DNA from five family members were carried out using the nine dinucleotide repeat markers reported in the common region of homozygosity by Serratosa et al in 1995. The present study of an additional family affected by Lafora disease has narrowed the 17 cM critical region for the Lafora disease gene on chromosome 6q24 to a 4 cM region flanked by markers D6S308 and D6S311.

Comparison of SSCP analysis and CFLP analysis for mutation detection in the human iduronate 2-sulfatase gene.

Scanning methodologies are used for the identification of DNA fragments that differ from the normal nucleotide sequence. Fragments that produce abnormal band patterns are sequenced for characterization of the exact mutation. Factors considered in choosing a scanning methodology include reproducibility, sensitivity, and time. In the present study, we compared single-stranded conformational polymorphism (SSCP) and Cleavase fragment length polymorphism (CFLP) methodologies for mutation scanning of exon VIII in the iduronate 2-sulfatase (IDS) gene. Mutations of the IDS gene result in an X-linked lysosomal storage disease, Hunter syndrome. These six known mutations analyzed by the two methods included a one base pair deletion, a one base pair insertion, and four point mutations. SSCP analysis detected all of the mutations and CFLP analysis detected three of the six mutations. We concluded that SSCP analysis was preferable to CFLP analysis for scanning exon VIII in the IDS gene for mutations.

Tensile properties of the superior glenohumeral and coracohumeral ligaments.

Recent evidence has shown that the superior glenohumeral ligament (SGHL) and coracohumeral ligament (CHL) are important static stabilizers. To clarify the function of these two ligaments, we studied their tensile properties with bone-ligament-bone complexes from fresh-frozen shoulders, 10 SGHLs and 10 CHLs. Each ligament's cross-sectional area was measured, and uniaxial tensile testing of each complex was performed. The stiffness, ultimate load, percent elongation, and energy absorbed to failure of each bone-ligament-bone complex were derived from its load-elongation curve. The cross-sectional area of the coracohumeral ligament was significantly greater than that of the superior glenohumeral ligament of their midportions (CHL, 53.7 +/- 3.2 mm2 vs. SGHL, 11.3 +/- 1.6 mm2, p < 0.05). Results also reveal significant differences between the tensile properties for the two ligaments, with the coracohumeral ligament possessing greater stiffness (CHL, 36.7 +/- 5.9 N/mm vs. SGHL, 17.4 +/- 1.5 N/mm, p < 0.05) and ultimate load (CHL, 359.8 +/- 40.3 N vs. SGHL, 101.9 +/- 11.5 N, p < 0.05) than the superior glenohumeral ligament. Our findings confirm that the coracohumeral ligament is an important capsuloligamentous structure of the glenohumeral joint.

The "arthroscopic impingement test".

Arthroscopic acromioplasty is an effective technique to treat refractory impingement syndrome of the shoulder; however, it is a technically demanding procedure and failure due to inadequate acromial resection has been reported. The purpose of this study was to describe a more reliable technique of arthroscopic acromioplasty ("arthroscopic impingement test") that allows determination of subacromial space available (SSA) during shoulder flexion after acromioplasty. During a 2-year period, 70 consecutive patients (group I) underwent arthroscopic acromioplasty by a conventional technique and 50 consecutive patients (group II) underwent the modified technique. Both groups were comparable in terms of age, gender, chronicity of symptoms, incidence of workman's compensation cases, side of surgery, and operative findings. In group I, four patients (6%) failed due to inadequate acromioplasty and at time of revision were found to have 0 mm SSA at 120 degrees flexion (contact of cuff on acromion). After revision acromioplasty, SSA at 120 degrees flexion was measured as > 3 mm, and impingement symptoms resolved postoperatively. In group II, there were no failures and SSA after initial acromioplasty was found to average 13 mm at 0 degree 10 mm at 45 degrees, 8 mm at 90 degrees, and 6 mm at 120 degrees flexion. In four cases, the "arthroscopic impingement test" determined that there was inadequate SSA at 120 degrees (< 3 mm) after initial acromioplasty, and these were revised by further acromioplasty at time of surgery. It was concluded that the "arthroscopic impingement test" improves reliability of arthroscopic acromioplasty by verifying adequate acromial resection in a position of impingement.

Combined medium to determine deoxyribonuclease activity and phenylalanine deamination by Enterobacteriaceae.

A combination medium has been developed to aid in the identification of Serratia and urease-negative Providencia recovered from clinical specimens.