The effect of leg strength on the incidence of lower extremity overuse injuries during military training.

This study examined the effects of strength, aerobic fitness, and activity profile on the incidence of overuse injuries, particularly stress fractures, during military training. A total of 136 military recruits were followed during 9 weeks of basic training. Maximal strength and aerobic fitness were determined by a one-repetition maximum leg press and a 2,000-m run, respectively. An activity profile was determined by the recruit's activity history. Twelve recruits (8.8%) were diagnosed with stress fractures. Recruits who were 1 SD below the population mean in both absolute (98.4 +/- 36.6 kg) and relative strength (1.72 +/- 0.61 kg/kg of body weight) had a five times greater risk for stress fracture (p < 0.05) than stronger recruits. Poor aerobic fitness did not appear to be related to any increased incidence of stress fracture. It appears that recruits with lower body strength levels, within 1 SD of the population mean, have a reduced incidence of stress fractures during military training.

[Primary quality control in Israel Air Force clinics].

The practice of primary medicine within a military framework differs from that in the civilian environment in: accessibility, its consumers, obligations of the providers, involvement of the funder (the commanders), and ability to define and enforce professional guide lines. These differences influence the scope of medical service, as well as affect the methods and results of quality control. A system of quality control evaluation and feedback of military primary care in 16 Israel Air Force clinics was carried out by a team of experienced physicians using peer group review and according to a specially prepared protocol. Emphasis was placed on medical record assessment using obligatory markers of adequate medical evaluation and treatment. Identification of the population at risk, further medical training, and medical administration with a direct effect on the quality of medical treatment were also evaluated. 2 quality control surveys with feedback were carried out 6 months apart. The overall mean score was 81.66 +/- 7.16% at the first evaluation, increasing to 88.60 +/- 7.46% at the second (p < 0.01). The greatest improvements were in follow-up of population at risk (increasing from 68.4% to 86.4%, p < 0.025), training of medical teams, (from 75.7% to 87.5%, p < 0.05) and patient case management (from 79.4% to 85.1%, N.S.). Categories in which there was no improvement were medical records, recovery of old medical files and patient education. The categories in which there was improvement had a common denominator: "recognition of importance" and "provision of patterns" by headquarters. The quality control system was designed for routine use, and not as a research project.(ABSTRACT TRUNCATED AT 250 WORDS)

[Mallory-Weiss syndrome in children]. / Sindrom Mallori-Veissa u detei.

The article analyzes an experience with treatment of 18 children with the Mallory-Weiss syndrome. Six children were operated upon, one of them died. Questions of pathogenesis of this syndrome in children practice are considered on the basis of anatomo-physiological properties of the child's organism. Attention was paid to the diagnostic and medical role of endoscopy. The tactics of treatment of this disease is recommended based on reference of the blood loss degree and findings of the endoscopic examination.

Zinc metabolism in patients treated with captopril versus enalapril.

Several zinc parameters were assessed in 13 patients with essential hypertension who were chronically taking only captopril (six subjects) or enalapril (seven subjects), as well as in six untreated hypertensives, and nine healthy controls. Serum zinc levels were comparable in all groups. Twenty-four-hour urinary zinc excretion was significantly increased in the captopril-treated patients compared with the other three groups. The zinc:creatinine ratio in 24-hour urine was significantly increased in both captopril and enalapril groups, but was significantly greater in the former. Although plasma zinc concentrations were comparable in all groups, red blood cell (RBC) zinc values were significantly decreased in the captopril group compared with the other three groups. We conclude that (1) although both captopril and enalapril produce renal zinc loss, this loss is far greater in patients receiving captopril; and (2) captopril administration over 3 months or more generates RBC zinc depletion.

[Chronic acalculous cholecystitis in children]. / Khronicheskii beskamennyi kholetsistit u detei.

Based upon literature data and an analysis of immediate and remote results of treatment of 50 children with acalculous cholecystitis the authors point to the advisability of operative interventions in patients with organic disturbances of the bile outflow. An analysis of the clinical picture, effects of the conservative therapy and results of subsidiary investigations enabled the authors to establish indications to surgery. The surgical methods must be determined by the character of pathology of the gallbladder, bile ducts and concomitant diseases. The immediate and long-term results of the surgical treatment of chronic cholecystitis resulting from organic disturbances of bile excretion confirm expediency of active surgical tactics in the presence of indications and of strict dispensary observation after operations for this disease.

[Surgical treatment of developmental defects of the biliary tract in children]. / Khirurgicheskoe lechenie porokov razvitiia zhelchevyvodiashchikh putei u detei.

Analysis of the surgical treatment of 212 children is given. The patients were divided into 3 groups: 158 children with atresia of bile ducts, 29 children with abnormality of the cervix-duct segment of the gall bladder and 25 children with cystic transformation of the choledochus. Indications for the operation were as follows: stable mechanical jaundice, recurrent pain syndrome in deformity of the gall bladder and alternating jaundice with a formation present in the subhepatic space. The successful treatment was found to depend on early detection of the defect and rational choice of the operation method.

[Congenital cystic transformation of the common bile duct in children]. / Vrozhdennaia kistoznaia transformatsiia obshchego zhelchnogo protoka u detei.

By now the world literature counts 955 observations on congenital cystic enlargement of the common bile duct. The authors add 14 own observations of this rather rare pathology. Preoperative diagnosis is still difficult. The intravenous cholegraphy remains the best diagnostic procedure. The choledochocystoduodenostomy is justified by its usefulness and is the most frequently used. The late results of the treatment are good. An unfavourable prognosis is present only in cases with preoperative chronic hepatitis, cholangitis or pancreatitis, as these diseases are likely to aggravate later on.

[Subcutaneous injuries of the duodenum in children]. / Podkozhnye povrezhdeniia dvenadtsatiperstnoi kishki u detei

In Child Surgery clinics of the Leningrad City since 1955 to 1974 eight children, aged from 3 to 15 years, were operated upon for this kind of trauma. The diagnosis of duodenal injuries intraoperatively is based on the presence of retroperitoneal hematoma, emphysema in the retroperitoneal space, yellow-green staining of the posterior peritoneal leaf.