Ideal specialty ICU care appears to offer no survival benefit over general ICU care for select common diagnoses. Non-ideal specialty ICU care (i.e., "boarding") is associated with increased risk-adjusted mortality.
Conservation of North American grasslands is hampered by the impact of invasive herbaceous species. Selective control of these plants, although desirable, is complicated by the shared physiology and phenology of the invader and the native components of the invaded plant community. Fortunately, there is evidence that some management practices, such as prescribed fire, herbicide, and mowing, can cause differential responses in native and invasive grassland species. However, timing of treatment is critical, and fire has been shown to increase rates of invasion when implemented during the dormant season. Bothriochloa ischaemum, an introduced C4 Eurasian grass is an increasing problem in grasslands, particularly in southern and central regions of North America. To date, there has been little success in effective selective control. Two invaded grassland sites representative of Blackland Prairie and Edwards Plateau ecoregions were subjected to two growing-season prescribed fire treatments, single and double herbicide applications, and single and double mowing treatments. Mowing had no effect on either B. ischaemum or other dominant species at either site one-year posttreatment. However, growing-season fire and herbicide were both effective at reducing the abundance of B. ischaemum, with other codominant species responding either negatively to herbicide or neutrally or positively to fire. The vulnerability of B. ischaemum to growing-season fire may be associated with the ecology of its native range. The negative growth response to growingseason fire, combined with its lower implementation costs, indicates that this method warrants further investigation as a selective management tool for other problematic species in invaded grasslands.
Background Hand, foot, and mouth disease (HFMD) is an acute viral illness commonly caused by coxsackievirus A16 (CV-A16) and enterovirus 71 infections. Recently, atypical HFMD has been reported in association with CV-A6, an uncommon enterovirus strain. Objective To describe the clinical features of atypical HFMD associated with CV-A6 infection and its diagnostic laboratory evaluation. Methods Patients presenting to our institution with history and examination suggestive of atypical HFMD from January 2012 to July 2012 were identified. Morphology and distribution of mucocutaneous lesions were recorded. Enterovirus infection was assessed by reverse transcriptase polymerase chain reaction of biologic specimens. Enterovirus type was determined by viral capsid protein 1 gene sequencing. Results Two adults and 3 children with atypical HFMD were identified. Four of 5 patients exhibited widespread cutaneous lesions. In 2 patients with a prior history of atopic dermatitis, accentuation in areas of dermatitis was noted. Associated systemic symptoms prompted 4 of 5 patients to seek emergency care, and both adults were hospitalized for diagnostic evaluation. Infection with CV-A6 was confirmed in all patients. Limitations This study is a case series from a single institution. Conclusion Consideration of the expanded range of cutaneous findings in atypical HFMD caused by CV-A6 infection may assist clinicians in diagnosis and management.
The purpose of this study was to determine whether a 4-week isotonic resistance training program using Theraband elastic tubing and lightweight dumbbells would significantly increase concentric shoulder rotator strength or velocity of serve or both in a group of elite-level tennis players. Twenty-two male and female varsity college tennis players were randomly assigned to control or 4-week training groups. Subjects were pre- and posttested in concentric internal and external rotation torque using an isokinetic dynamometer. Functional performance was assessed before and after training by recording the peak and average velocities of eight maximal serves. The experimental group exhibited significant gains in internal rotation torque at both slow (120 deg/sec) and fast speeds (300 deg/sec) for total work and in peak torque to body weight ratio and torque acceleration energy at the fast speed. This group also exhibited significant gains in external rotation torque for the same parameters at fast speed. Regarding speed to serve, the experimental group exhibited significantly greater increase in peak speed (+6.0% compared with -1.8%) and average speed (+7.9% compared with -2.3%) compared with the control group. Men exhibited greater internal and external rotation torque on all parameters and in peak and mean speed of serve on both evaluations. Men also exhibited greater imbalance in external to internal rotation torque ratios. In conclusion, resistance training using Theraband tubing and lightweight dumbbells may have beneficial effects on strength and functional performance in college-level tennis players.
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