Caregiver Awareness of Safe Pitching Recommendations in Youth Fastpitch Softball Pitchers.

Background: Although fastpitch softball participation continues to rise, there is a lack of established pitch count guidelines, potentially putting young female athletes at risk of overuse injuries. In addition to coaches, caregivers' ability to recognize and employ safe pitching guidelines plays an important role in athlete safety. Purpose/Hypothesis: The purpose of this study was to assess caregivers' knowledge of their child's pitching practices and their familiarity with softball pitching recommendations. We hypothesized that caregivers would be unaware of safe pitching recommendations in youth fastpitch softball. Study Design: Cross-sectional study. Methods: A 30-question survey was distributed to caregivers of youth fastpitch softball pitchers in age groups 10U (ie, ≤10 years), 12U, 14U, 16U, and 18U. The survey included questions on the demographic characteristics of caregivers and athletes, caregivers' knowledge of safe pitching recommendations, and athletes' pitching background and throwing habits. Comparisons of responses between the age groups were conducted using the chi-square test, Fisher exact test, or 1-way analysis of variance, as appropriate. Results: A total of 115 caregivers completed the survey. Of the respondents, 84% were between 31 and 50 years, and 81.7% had a degree beyond high school. Only 28.1% of caregivers reported participating in youth sports. When asked to estimate the number of pitches they considered a safe amount during a single outing, 28.7% of caregivers (n = 33) did not provide a limit, 4.3% (n = 5) stated no limit was needed, 32.2% (n = 37) suggested 25 to 80 pitches, 21.7% (n = 25) suggested 81 to 100 pitches, 12.2% (n = 14) suggested 100 to 150 pitches, and 0.9% (n = 1) suggested that >150 pitches were acceptable. These data emphasized that only 14.8% of the caregivers were aware of any pitching guidelines. However, 93% of caregivers acknowledged that they would adhere to recommendations if guidelines were made available. Conclusion: The study findings demonstrated that a majority of caregivers are unaware of current youth fastpitch softball pitching recommendations.

Diagnosis and Management of Calcaneal Stress Fractures.

Overuse injuries, such as stress fractures, are easy to prevent, yet they are prevalent in nearly all populations. Correct diagnosis of stress fractures relies greatly on patient history and physical examination, with medical imaging used as a complementary procedure. Radiography typically is performed first, then subsequent alternative imaging modalities that provide better sensitivity and specificity are used if necessary. This article discusses stress fractures of the calcaneus, including a review of hindfoot anatomy and the gait cycle. Risk factors, prevention, and management also are reviewed.

Persistent viral shedding despite seroconversion in a kidney transplant recipient with severe extrapulmonary COVID-19.

Renal transplant (RT) recipients are at increased risk for infectious complications. The clinical course of COVID-19 has been described in several RT recipients with varying clinical outcomes. Most present with pulmonary manifestations, however extrapulmonary presentations are not uncommon. Also, the timing and efficacy of seroconversion in transplant recipients is not well known. This report describes the duration of viral shedding and timing of seroconversion in a young adult RT recipient with COVID-19 who presented with severe diarrhoea and acute kidney injury requiring dialysis. She developed anti-SARS-CoV-2 IgG antibody after 5 weeks despite persistently shedding the virus in the nasopharynx until 6 weeks after symptom onset. Further studies are needed to determine if immunosuppressed patients have prolonged viral shedding and are still contagious despite seroconversion.