Addressing Sensory Challenges in Athletes with Autism Spectrum Disorder: A Clinical Commentary.

Athletes with autism spectrum disorder (ASD) experience lesser care for injuries and athletic trainers (ATs) report feeling unprepared to provide care competently for this population. Provision of sports-related care can be impacted by sensory differences associated with ASD such as hyper-reactivity to sensation or poor integration of sensory information. An in-depth review of the literature using the Strength of Recommendation Taxonomy (SORT) guidelines was used to identify articles that address the sensory features of autism for athletic trainers with the purpose of informing athletic trainers about the sensory features of ASD and to present the most current evidence-based recommendations for providing care to athletes with ASD and other neurodivergent individuals who present with sensory differences.

Infectious Tenosynovitis of the Tibialis Anterior Due to Mycobacterium chelonae After Intravenous Heroin Injection.

Mycobacterium chelonae is a ubiquitous Gram-positive, acid-fast, non-spore-forming bacterium commonly encountered in nature associated with aquatic animals, soil, and water, including tap water. Nontuberculous mycobacterial tenosynovitis infections caused by M. chelonae in the lower extremity are uncommon, leading to a paucity of literature documenting the diagnosis and treatment of such cases.

Long-term comparison of endovascular and open repair of abdominal aortic aneurysm.

Background: Whether elective endovascular repair of abdominal aortic aneurysm reduces long-term morbidity and mortality, as compared with traditional open repair, remains uncertain.

Methods: We randomly assigned 881 patients with asymptomatic abdominal aortic aneurysms who were candidates for both procedures to either endovascular repair (444) or open repair (437) and followed them for up to 9 years (mean, 5.2).

Fascicular anatomy of human femoral nerve: implications for neural prostheses using nerve cuff electrodes.

Clinical interventions to restore standing or stepping by using nerve cuff stimulation require a detailed knowledge of femoral nerve neuroanatomy. We harvested eight femoral nerves with all distal branches and characterized the branching patterns and diameters. The fascicular representation of each distal nerve was identified and traced proximally to create fascicle maps of the compound femoral nerve in four cadaver specimens.

Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial.

Context: Limited data are available to assess whether endovascular repair of abdominal aortic aneurysm (AAA) improves short-term outcomes compared with traditional open repair.

Objective: To compare postoperative outcomes up to 2 years after endovascular or open repair of AAA in a planned interim report of a 9-year trial.

Design, Setting, And Patients: A randomized, multicenter clinical trial of 881 veterans (aged > or = 49 years) from 42 Veterans Affairs Medical Centers with eligible AAA who were candidates for both elective endovascular repair and open repair of AAA.

"Pseudostring sign" on carotid computed tomographic angiography: collateralization by vasa vasorum.

We present 3 cases of unilateral internal carotid artery (ICA) occlusions with prominent single collateralizing vessel of vasa vasorum on computed tomographic angiography. The features on axial source and 3-dimensional images of computed tomographic angiography include "pseudostring sign," serpigenous course of the vasa vasorum, eccentric dot appearance in the wall of chronically thrombosed ICA, and termination in the neck or reconstituting into the ICA at or below the skull base.

Response of plasma matrix metalloproteinase-9 to conventional abdominal aortic aneurysm repair or endovascular exclusion: implications for endoleak.

Purpose: Matrix metalloproteinases are enzymes capable of breaking down all of the components of the extracellular matrix and have been implicated in the development of aneurysm formation. Because matrix metalloproteinase-9 (MMP-9) levels are elevated in aortic aneurysmal tissue and in that patient plasma, we hypothesized that plasma MMP-9 levels should decrease significantly after conventional and endovascular infrarenal abdominal aortic aneurysm (AAA) repair but that plasma MMP-9 levels would remain elevated in patients with endoleaks.

Methods: A sandwich enzyme-linked immunosorbent assay was used to measure plasma levels of MMP-9 in patients with AAA who underwent conventional (n = 26; mean age, 71.

Analysis of initial CT findings after endovascular repair of abdominal aortic aneurysm.

Purpose: To determine the spectrum and frequency of specific computed tomographic (CT) findings in the acute period after endovascular repair of abdominal aortic aneurysm (AAA).

Materials And Methods: CT images obtained 1--3 days after endograft placement were evaluated in 88 patients. The images were analyzed for stent position, appearance of endograft components, perigraft leak, and postoperative findings including air and acute thrombus within the aneurysm and air surrounding the femoral-femoral bypass graft.

Lessons learned in adopting endovascular techniques for treating abdominal aortic aneurysm.

Hypothesis: Endovascular exclusion of abdominal aortic and common iliac aneurysms can be performed safely, and in the short term represents a feasible alternative to traditional, open aneurysm repair.

Patients And Methods: Forty-one patients were treated with endovascular grafts for 39 abdominal aortic and 2 common iliac artery aneurysms.

Results: All devices were successfully deployed.

Determinates of functional disability after complex upper extremity trauma.

This is a retrospective chart review of 71 patients who were operated on for presumed upper extremity arterial trauma between June 1992 and June 1998. Penetrating trauma occurred in 50 (70%) patients, and blunt trauma in 21 (30%). There were 2 innominate, 6 subclavian, 13 axillary, 26 brachial, 5 radial, 6 ulnar, and 6 multiple arterial injuries.

Shear force regulates matrix metalloproteinase activity in human saphenous vein organ culture.

Background: Development of vein graft intimal hyperplasia has been related both to shear force and to the activity of matrix metalloproteinases (MMPs). Little data are available regarding the effects of shear on MMP expression and activity. The aim of this study was to examine the relationship among shear force, metalloproteinase activity, and intimal thickening in human saphenous vein segments maintained in organ culture.

Aortic stent-grafts in patients with renal transplants.

Purpose: To report the endovascular treatment of abdominal aortic aneurysms (AAA) in 2 patients with pelvic renal transplants.

Methods And Results: Two men with multiple comorbidities and pelvic transplant kidneys underwent endovascular AAA repair using an aortomonoiliac system with femorofemoral bypass grafting. The arterial end-to-side anastomosis in both patients was to the external iliac artery.

All-trans-retinoic acid decreases cell proliferation and increases apoptosis in an animal model of vein bypass grafting.

Background: We have previously demonstrated a decrease in intimal hyperplasia in vein bypass grafts from animals treated with all-trans-retinoic acid (atRA). The purpose of this study was to examine the effect of atRA on proliferation and apoptosis rates in healing vein bypass grafts.

Methods: Interposition jugular vein bypass grafts were placed in the carotid artery of 30 New Zealand white rabbits.

Intraoperative carotid evaluation.

Hypothesis: Intraoperative duplex scanning can identify technical defects and increase the quality of carotid artery repair.

Design: We evaluated 100 consecutive carotid operations in 96 patients (60 men and 36 women) from 1995 to 1998. Spectral-derived peak systolic flow velocities (PSV) were graded (PSV < 100 cm/s, normal laminar flow; PSV 100-150 cm/s, mild or moderate flow disturbance; PSV > 150 cm/s, severe flow disturbance).

All-trans-retinoic acid decreases vein graft intimal hyperplasia and matrix metalloproteinase activity in vivo.

Background: Development of vein graft intimal hyperplasia has been associated with increased activity of matrix metalloproteinases (MMPs). All-trans-retinoic acid (atRA) decreases expression and activity of MMPs in tissue culture and has decreased intimal hyperplasia following arterial balloon catheter injury. We examined the effect of oral administration of atRA on intimal hyperplasia and MMP expression in an animal model of vein bypass grafting.

Metalloproteinase levels are decreased in symptomatic carotid plaques.

Background: Matrix metalloproteinase enzymes (MMP) have been identified in carotid atherosclerotic plaques, but their role in the development of clinical symptoms remains ill defined. We correlated the activity and levels of metalloproteinase enzymes and their inhibitors in human carotid plaques to ischemic neurologic events.

Methods: Carotid plaques were collected at the time of endarterectomy from 23 patients with carotid stenosis.

Pararenal aortic aneurysms: the future of open aortic aneurysm repair.

Purpose: As endovascular stent graft repair of infrarenal abdominal aortic aneurysms (AAAs) becomes more common, an increasing proportion of patients who undergo open operation will have juxtarenal aneurysms (JR-AAAs), which necessitate suprarenal crossclamping, suprarenal aneurysms (SR-AAAs), which necessitate renal artery reconstruction, or aneurysms with associated renal artery occlusive disease (RAOD), which necessitate repair. To determine the current results of the standard operative treatment of these patterns of pararenal aortic aneurysms, we reviewed the outcome of 257 consecutive patients who underwent operation for JR-AAAs (n = 122), SR-AAAs (n = 58), or RAOD (n = 77).

Methods: The patients with SR-AAAs and RAOD were younger (67.

Abdominal aortic aneurysm in high-risk patients: short- to intermediate-term results of endovascular repair.

Purpose: To assess the safety and efficacy of endovascular repair of abdominal aortic aneurysm in high-risk patients during the short to intermediate term.

Materials And Methods: Endovascular aneurysm repair was performed in 50 patients considered too high risk for conventional repair. Stent-grafts were inserted through surgically exposed femoral arteries with fluoroscopic guidance.

Cytokines that activate proteolysis are increased in abdominal aortic aneurysms.

Background: Abdominal aortic aneurysm (AAA) disease is characterized by an increase in proteolysis and loss of matrix components. The cytokines tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta), products of activated macrophages and T cells, are known to increase the production of matrix-degrading enzymes in some pathological states.

Methods And Results: Seven AAA and five control aortic tissue extracts were assayed for TNF-alpha and IL-1 beta with ELISA.

Cellular localization of matrix metalloproteinases in the abdominal aortic aneurysm wall.

Purpose: This study explores the source(s) of the matrix-degrading proteinases, matrix metalloproteinase 1 (MMP-1; interstitial collagenase), matrix metalloproteinase 3 (MMP-3; stromelysin 1), and matrix metalloproteinase 9 (MMP-9; gelatinase B), previously implicated in abdominal aortic aneurysm (AAA) development. The possible involvement of the plasmin cascade in the activation of these proteinases was also explored by examining the presence of the urokinase-type plasminogen activator (uPA) in aneurysm wall.

Methods: Immunohistochemical techniques were used to detect the presence of MMP-1, MMP-3 and MMP-9 proteins and uPA in fixed, paraffin-embedded tissue sections from AAA (n = 10) and control (n = 2) aortas.

Possible key role for plasmin in the pathogenesis of abdominal aortic aneurysms.

Background: Activation of proteolysis is characteristic of abdominal aortic aneurysm (AAA) disease, and by substrate gel enzymography with casein the most conspicuous proteinase of AAA wall has a molecular weight of approximately 80 kd. This activity has been resolved into separate metalloproteinase and serine proteinase (SP) components, by binding out the metalloproteinase by affinity to tissue inhibitor of metalloproteinases. Because plasmin plays a key role in activating members of the metalloproteinase family, the following experiments were done to test the hypothesis that the unknown SP is plasmin.