Flexor Hallucis Longus Tenolysis and Tenosynovectomy in Dancers.

The purpose of this study was to report on a series of dancers who had undergone flexor hallucis longus (FHL) tenolysis/tenosynovectomy after having failed conservative management. Institutional human subjects committee approval was obtained prior to initiating this study. This study is a retrospective case series of 58 dancers and 63 ankles who underwent FHL tenolysis/tenosynovectomy via an open posteromedial approach by a single surgeon between 1993 and 2017. All patients were interviewed and charts reviewed. Collected variables included: preoperative and postoperative pain levels, time to return to dance, and subjective satisfaction with the procedure. Age, primary dance form, and level of dance were determined. Mean preoperative pain level decreased significantly postoperatively. Mean time to return to dance was 7.1 weeks. There was a 98% (62/63) return to dance at some level while 97% (61/63) of patients returned to dance symptom-free. There were no neurovascular or other major complications. Minor complications included stiffness at follow-up (6.3%, 4/63), superficial wound infection (3.1%, 2/63), and hypertrophic scar (4.8%, 3/63). Over 97% (61/63) of dancers considered the procedure a success and 98% (62/63) of dancers would repeat the procedure. This is one of the largest series reported of isolated FHL tenolysis/tenosynovectomy in dancers who have failed nonoperative management. Satisfactory pain relief and return to dance with a low complication rate may be expected from this surgical procedure. The results of this study can be used to help dancers and their providers make informed decisions about treatment in isolated FHL tendinitis.

Close encounters of the fatal kind: Landscape features associated with central mountain caribou mortalities.

In western Canada, anthropogenic disturbances resulting from resource extraction activities are associated with habitat loss and altered predator-prey dynamics. These habitat changes are linked to increased predation risk and unsustainable mortality rates for caribou (Rangifer tarandus caribou). To inform effective habitat restoration, our goal was to examine whether specific linear disturbance features were associated with caribou predation in central mountain caribou ranges. We used predation-caused caribou mortalities and caribou GPS-collar data collected between 2008 and 2015 to assess caribou predation risk within and outside of protected areas at four spatio-temporal scales: habitat use during the (a) 30 days, (b) 7 days, and (c) 24 hours prior to caribou being killed, and (d) characteristics at caribou kill site locations. Outside of protected areas, predation risk increased closer to pipelines, seismic lines, and streams. Within protected areas, predation risk increased closer to alpine habitat. Factors predicting predation risk differed among spatio-temporal scales and linear feature types: predation risk increased closer to pipelines during the 30 and 7 days prior to caribou being killed and closer to seismic lines during the 30 days, 7 days, and 24 hours prior, but decreased closer to roads during the 30 days prior to being killed. By assessing habitat use prior to caribou being killed, we identified caribou predation risk factors that would not have been detected by analysis of kill site locations alone. These results provide further evidence that restoration of anthropogenic linear disturbance features should be an immediate priority for caribou recovery in central mountain caribou ranges.

Response of grizzly bears (Ursus arctos) to pipelines in Alberta.

This research provides the first in-depth analysis of fine-scale grizzly bear habitat selection and movement patterns in response to the linear footprints cleared for below-ground pipelines in Alberta. Using an extensive set of GPS location data from collared grizzly bears, we were able to determine that grizzly bears selected for younger pipelines (mean age since last construction~6.5 years), which are known to have a greater abundance of important bear foods. Bears also selected for wider corridors that were disturbed for construction more than once. During the spring season, sex/age class was an important predictor of grizzly bear use of pipelines, with adult female bears more likely to use these features than other sex/age classes. Examination of movement patterns revealed that pipeline density influenced grizzly bears' movement rates and path straightness, particularly in the spring, when bears moved more slowly and movement paths were more tortuous in areas with higher pipeline densities. These movement patterns are consistent with foraging behavior and further indicate that bears are not exhibiting avoidance behaviors or displacement by pipeline features, and pipelines may be functioning as seasonally important foraging areas for grizzly bears in Alberta.

Effect of "ionized" wrist bracelets on musculoskeletal pain: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: To assess objectively the perceived benefits of wearing an "ionized" wrist bracelet to treat muscle or joint pain. SUBJECTS AND METHODS: This study was performed at the Mayo Clinic in Jacksonville, Fla, in 2000 and 2001. In a randomized, double-blind design, 305 participants wore an ionized bracelet and 305 wore a placebo bracelet for 4 weeks. For each location where pain was present at baseline, participants rated the intensity of pain. Follow-up ratings were made after 1, 3, 7, 14, 21, and 28 days of wearing the bracelet. Two primary end points were defined for evaluating efficacy. The first was the change at 4-week follow-up (day 28) in the pain score at the location with the highest baseline value (maximum pain score). The second was the change at 4-week follow-up in the sum of the pain scores for all locations. RESULTS: Analysis of the data showed significant improvement in pain scores in both groups, but no differences were observed between the group wearing the placebo bracelet and the group wearing the ionized bracelet. CONCLUSION: The finding that subjective improvement in pain scores was equivalent with ionized and placebo bracelet use questions the benefit of using an ionized bracelet. New treatments in alternative medical therapy must be shown to be effective through vigorous, unbiased, objective testing before physicians acknowledge potential benefits or recommend these treatments to patients.