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Tuomo Visuri - One of the best experts on this subject based on the ideXlab platform.
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incidence and risk factors of acute traumatic primary patellar dislocation
Medicine and Science in Sports and Exercise, 2008Co-Authors: Petri Sillanpaa, Tuomo Iivonen, Tuomo Visuri, Ville M Mattila, Harri PihlajamäkiAbstract:Purpose: The purpose of this study was to investigate incidence, nature, and risk factors of primary traumatic patellar dislocations. Methods: We identified acute first-time traumatic patellar dislocations from a national hospital discharge register. Patients with previous patellar dislocations, subluxations, or knee traumas were excluded. The sample consisted of 128,714 Finnish male Conscripts (median age 20). Background risk factor data were obtained from a Finnish Conscript service database. The dislocators were observed during their service period for a short-term outcome. Results: From the 128,714 male Conscripts, 278 had patellar dislocations, and 72 were classified as having sustained first-time traumatic patellar dislocations. The 128,436 nondislocators served as a control group. The incidence of acute traumatic primary patellar dislocations among male Conscripts was 77.4 (95% CI: 61.1-96.8) per 100,000 persons per year. The male patients with traumatic primary patellar dislocations were taller (P = 0.03) and weighed more (P = 0.02) than the controls. Hemarthrosis was present in all patients, and when MRI or open surgery was performed, medial retinacular disruption and medial patellofemoral ligament (MPFL) injury were identified. Patients' return to military service was unrelated to the choice of treatment. Conclusion: Primary patellar dislocation is not a negligible cause of morbidity among young male adults. It can be concluded that hemarthrosis and MPFL rupture are the definite signs of an acute traumatic primary patellar dislocation. Height and weight were significant risk factors, whereas poor physical performance was not associated with primary patellar dislocation.
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Patellar dislocation in army Conscripts.
Military Medicine, 2002Co-Authors: Heikki Mäenpää, Tuomo VisuriAbstract:: Between 1990 and 1996, 119 Finnish male Conscripts underwent operative treatment for patellar dislocation. There were 68 Conscripts (58%) with primary and 51 Conscripts (42%) with recurrent patellar dislocation. Sixty-five (55%) dislocations occurred during military service, 40 (34%) occurred during sports activities, and 14 (11%) occurred during leisure time. The most common cause of injury was military training at battle exercises (n = 30). The typical injury mechanism was knee valgus rotation on fixed foot and tibia (97 Conscripts, 82%). Surgical procedures performed were open in 75 Conscripts (63%) and arthroscopically assisted in 44 Conscripts (37%). Twenty-three (19%) redislocations occurred during follow-up (mean, 6 years; range, 3-9 years). The subjective outcome of treatment was excellent in 23 (19%), good in 42 (35%), moderate in 44 (37%), and poor in 10 (9%) Conscripts. The most common residual complaint was patellofemoral pain (25 Conscripts, 21%). Only 42 (35%) Conscripts were able to finish their military service normally; fitness classification was decreased in 16 Conscripts (13%), and 61 (52%) were temporarily exempted from military service (class E). The results of operative treatment did not differ significantly in Conscripts with primary and recurrent dislocation, except for the time of first recurrence, which was significantly longer in Conscripts with primary than with recurrent dislocation (27 versus 9 months). Patellar dislocation is the most common form of severe knee injury among Conscripts and significantly hampers military service. Operative treatment yields only satisfactory results. Preventive measurements should be considered. A suggested algorithm for the treatment and classification of acute and recurrent patellar dislocation among military Conscripts is presented.
Harri Pihlajamäki - One of the best experts on this subject based on the ideXlab platform.
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Trends in musculoskeletal disorders and related health care utilization among Conscripts in Finland, 1967-2006.
Military Medicine, 2012Co-Authors: Heikki Frilander, Harri Pihlajamäki, Helena Miranda, Pertti Mutanen, Tuija Martelin, Eira Viikari-junturaAbstract:ABSTRACTObjectives: The aim was to investigate time trends in musculoskeletal disorders (MSDs) among Finnish Conscripts over a period of 40 years. Methods: A nationally representative health examination survey (the Health 2000 study) was carried out in 2000–2001 among 10,000 adult Finns. All 18- to 50-year-old men were further sampled (n = 2674) and those with completion of the 6 to 12 month compulsory service were included. (n = 2296). Time trends in consultations because of MSDs during service and findings at call-up examinations were analysed. Results: From 1967 to 2006 altogether 4872 MSD-related consultations were done, most commonly because of problems in the ankle or foot, knee, or back. The proportion of Conscripts visiting military health care because of MSDs increased 1.6-fold (from 44 to 72%). The average number of MSD-related consultations per Conscript tripled. The proportion of Conscripts with ≥6 consultations increased 5-fold and those seeking care for multisite symptoms increased 10-fold. ...
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Predictors of low back pain in physically active Conscripts with special emphasis on muscular fitness
The Spine Journal, 2012Co-Authors: Henri Taanila, Ville M Mattila, Harri Pihlajamäki, Jaana H Suni, Olli Ohrankammen, Petteri Vuorinen, Jari ParkkariAbstract:Abstract Background context Association between low physical fitness and low back pain (LBP) is contradictory in previous studies. Purpose The objective of the present prospective cohort study was to investigate the predictive associations of various intrinsic risk factors in young Conscripts for LBP, with special attention to physical fitness. Study design A prospective cohort study. Patient sample A representative sample of Finnish male Conscripts. In Finland, military service is compulsory for male citizens and 90% of young men enter into the service. Outcome measures Incidence of LBP and recurrent LBP prompting a visit at the garrison health clinic during 6-month military training. Methods Four successive cohorts of 18- to 28-year-old male Conscripts (N=982) were followed for 6 months. Conscripts with incidence of LBP were identified and treated at the garrison clinic. Predictive associations between intrinsic risk factors and LBP were examined using multivariate Cox proportional hazard models. Results The cumulative incidence of LBP was 16%, the incidence rate being 1.2 (95% confidence interval [CI], 1.0–1.4) per 1,000 person-days. Conscripts with low educational level had increased risk for incidence of LBP (hazard ratio [HR], 1.6; 95% CI, 1.1–2.3). Conscripts with low dynamic trunk muscle endurance and low aerobic endurance simultaneously (ie, having coimpairment) at baseline also had an increased risk for incidence of LBP. The strongest risk factor was coimpairment of trunk muscular endurance in tests of back lift and push-up (HR, 2.8; 95% CI, 1.4–5.9). Conclusions The increased risk for LBP was observed among young men who had a low educational level and poor fitness level in both muscular and aerobic performance.
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neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service a population based randomised study
BMC Medicine, 2011Co-Authors: Jari Parkkari, Ville M Mattila, Henri Taanila, Jaana H Suni, Olli Ohrankammen, Petteri Vuorinen, Pekka Kannus, Harri PihlajamäkiAbstract:The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service. The trial design was a population-based, randomised study. Two successive cohorts of male Conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospectively for one 6-month term to determine the baseline incidence of injury. After this period, two new successive cohorts in the same four companies were randomised into two groups and followed prospectively for 6 months. Military service is compulsory for about 90% of 19-year-old Finnish men annually, who comprised the cohort in this study. This randomised, controlled trial included 968 Conscripts comprising 501 Conscripts in the intervention group and 467 Conscripts in the control group. A neuromuscular training programme was used to enhance Conscripts' motor skills and body control, and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries. The main outcome measures were acute injuries of the lower and upper limbs. In the intervention groups, the risk for acute ankle injury decreased significantly compared to control groups (adjusted hazards ratio (HR) = 0.34, 95% confidence interval (95% CI) = 0.15 to 0.78, P = 0.011). This risk decline was observed in Conscripts with low as well as moderate to high baseline fitness levels. In the latter group of Conscripts, the risk of upper-extremity injuries also decreased significantly (adjusted HR = 0.37, 95% CI 0.14 to 0.99, P = 0.047). In addition, the intervention groups tended to have less time loss due to injuries (adjusted HR = 0.55, 95% CI 0.29 to 1.04). A neuromuscular training and injury prevention counselling programme was effective in preventing acute ankle and upper-extremity injuries in young male army Conscripts. A similar programme could be useful for all young individuals by initiating a regular exercise routine. ClinicalTrials.gov identifier number NCT00595816 .
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incidence and risk factors of acute traumatic primary patellar dislocation
Medicine and Science in Sports and Exercise, 2008Co-Authors: Petri Sillanpaa, Tuomo Iivonen, Tuomo Visuri, Ville M Mattila, Harri PihlajamäkiAbstract:Purpose: The purpose of this study was to investigate incidence, nature, and risk factors of primary traumatic patellar dislocations. Methods: We identified acute first-time traumatic patellar dislocations from a national hospital discharge register. Patients with previous patellar dislocations, subluxations, or knee traumas were excluded. The sample consisted of 128,714 Finnish male Conscripts (median age 20). Background risk factor data were obtained from a Finnish Conscript service database. The dislocators were observed during their service period for a short-term outcome. Results: From the 128,714 male Conscripts, 278 had patellar dislocations, and 72 were classified as having sustained first-time traumatic patellar dislocations. The 128,436 nondislocators served as a control group. The incidence of acute traumatic primary patellar dislocations among male Conscripts was 77.4 (95% CI: 61.1-96.8) per 100,000 persons per year. The male patients with traumatic primary patellar dislocations were taller (P = 0.03) and weighed more (P = 0.02) than the controls. Hemarthrosis was present in all patients, and when MRI or open surgery was performed, medial retinacular disruption and medial patellofemoral ligament (MPFL) injury were identified. Patients' return to military service was unrelated to the choice of treatment. Conclusion: Primary patellar dislocation is not a negligible cause of morbidity among young male adults. It can be concluded that hemarthrosis and MPFL rupture are the definite signs of an acute traumatic primary patellar dislocation. Height and weight were significant risk factors, whereas poor physical performance was not associated with primary patellar dislocation.
Kiviranta Ilkka - One of the best experts on this subject based on the ideXlab platform.
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Regular physical exercise before entering military service may protect young adult men from fatigue fractures
'Springer Science and Business Media LLC', 2019Co-Authors: Pihlajamäki Harri, Parviainen Mickael, Kyröläinen Heikki, Kautiainen Hannu, Kiviranta IlkkaAbstract:Abstract Background Bone stress fractures are overuse injuries commonly encountered in sports and military medicine. Some fatigue fractures lead to morbidity and loss of active, physically-demanding training days. We evaluated the incidence, anatomical location, risk factors, and preventive measures for fatigue fractures in young Finnish male Conscripts. Methods Five cohorts of 1000 men performing military service, classified according to birth year (1969, 1974, 1979, 1984, 1989), were analysed. Each Conscript was followed for his full military service period (180 days for Conscripts with rank and file duties, 270 days for those with special training, 362 days for officers and highly trained Conscripts). Data, including physical activity level, were collected from a standard pre-information questionnaire and from the garrisons’ healthcare centre medical reports. Risk factor analysis included the Conscripts’ service class (A, B), length of military service, age, height, weight, body mass index, smoking, education, previous diseases, injuries, and subjective symptoms, as well as self-reports of physical activity before entering the service using a standard military questionnaire. Results Fatigue fractures occurred in 44 (1.1%) of 4029 men, with an incidence of 1.27 (95% confidence interval: 0.92–1.70) per 1000 follow-up months, and mostly (33/44, 75%) occurred at the tibial shaft or metatarsals. Three patients experienced two simultaneous stress fractures in different bones. Most fatigue fractures occurred in the first 3 months of military service. Conscripts with fatigue fractures lost a total of 1359 (range 10–77) active military training days due to exemptions from duty. Conscripts reporting regular (> 2 times/week) physical activity before entering the military had significantly fewer (p = 0.017) fatigue fractures. Regular physical activity before entering the service was the only strong explanatory, protective factor in the model [IRR = 0.41 (95% CI: 0.20 to 0.85)]. The other measured parameters did not contribute significantly to the incidence of stress fractures. Conclusion Regular and recurrent high-intensity physical activity before entering military service seems to be an important preventive measure against developing fatigue fractures. Fatigue fractures should be considered in Conscripts seeking medical advice for complaints of musculoskeletal pain, and taken into consideration in planning military and other physical training programs
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Regular physical exercise before entering military service may protect young adult men from fatigue fractures
'Springer Science and Business Media LLC', 2019Co-Authors: Pihlajamäki Harri, Parviainen Mickael, Kyröläinen Heikki, Kautiainen Hannu, Kiviranta IlkkaAbstract:BackgroundBone stress fractures are overuse injuries commonly encountered in sports and military medicine. Some fatigue fractures lead to morbidity and loss of active, physically-demanding training days. We evaluated the incidence, anatomical location, risk factors, and preventive measures for fatigue fractures in young Finnish male Conscripts.MethodsFive cohorts of 1000 men performing military service, classified according to birth year (1969, 1974, 1979, 1984, 1989), were analysed. Each Conscript was followed for his full military service period (180days for Conscripts with rank and file duties, 270days for those with special training, 362days for officers and highly trained Conscripts). Data, including physical activity level, were collected from a standard pre-information questionnaire and from the garrisons' healthcare centre medical reports. Risk factor analysis included the Conscripts' service class (A, B), length of military service, age, height, weight, body mass index, smoking, education, previous diseases, injuries, and subjective symptoms, as well as self-reports of physical activity before entering the service using a standard military questionnaire.ResultsFatigue fractures occurred in 44 (1.1%) of 4029 men, with an incidence of 1.27 (95% confidence interval: 0.92-1.70) per 1000 follow-up months, and mostly (33/44, 75%) occurred at the tibial shaft or metatarsals. Three patients experienced two simultaneous stress fractures in different bones. Most fatigue fractures occurred in the first 3months of military service. Conscripts with fatigue fractures lost a total of 1359 (range 10-77) active military training days due to exemptions from duty. Conscripts reporting regular (>2 times/week) physical activity before entering the military had significantly fewer (p=0.017) fatigue fractures. Regular physical activity before entering the service was the only strong explanatory, protective factor in the model [IRR=0.41 (95% CI: 0.20 to 0.85)]. The other measured parameters did not contribute significantly to the incidence of stress fractures.ConclusionRegular and recurrent high-intensity physical activity before entering military service seems to be an important preventive measure against developing fatigue fractures. Fatigue fractures should be considered in Conscripts seeking medical advice for complaints of musculoskeletal pain, and taken into consideration in planning military and other physical training programs.Peer reviewe
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Incidence and risk factors of exercise-related knee disorders in young adult men
'Springer Science and Business Media LLC', 2017Co-Authors: Pihlajamäki, Harri K, Kautiainen Hannu, Parviainen, Mickael C, Kiviranta IlkkaAbstract:Abstract Background Musculoskeletal disorders and injuries are common causes of morbidity and loss of active, physically demanding training days in military populations. We evaluated the incidence, diagnosis, and risk factors of knee disorders and injuries in male Finnish military Conscripts. Methods The study population comprised 5 cohorts of 1000 men performing their military service, classified according to birth year (1969, 1974, 1979, 1984, and 1989). Follow-up time for each Conscript was the individual Conscript’s full, completed military service period. Data for each man were collected from a standard pre-information questionnaire used by defense force healthcare officials and from all original medical reports of the garrison healthcare centers. Background variables for risk factor analysis included the Conscripts’ service data, i.e., service class (A, B), length of military service, age, height, weight, body mass index (BMI), underweight, overweight, obesity, smoking habit, education, diseases, injuries, and subjective symptoms. Results Of the 4029 Conscripts, 853 visited healthcare professionals for knee symptoms during their military service, and 103 of these had suffered a knee injury. Independent risk factors for the incidence of knee symptoms were: older age; service class A; overweight (BMI 25.0–29.9 kg/m2); smoking habit; comprehensive school education only; and self-reported previous symptoms of the musculoskeletal, respiratory, and gastrointestinal system. The majority of visits to garrison healthcare services due to knee symptoms occurred during the first few months of military service. Knee symptoms were negatively correlated with self-reported mental and behavioral disorders. Conclusions The present study highlights the frequency of knee disorders and injuries in young men during physically demanding military training. One-fifth of the male Conscripts visited defense force healthcare professionals due to knee symptoms during their service period. Independent risk factors for the incidence of knee symptoms during military service were age at military service; military service class A; overweight; smoking habit; comprehensive school education only; and self-reported previous symptoms of the musculoskeletal system, respiratory system, or gastrointestinal system. These risk factors should be considered when planning and implementing procedures to reduce knee disorders and injuries during compulsory military service
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Incidence and risk factors of exercise-related knee disorders in young adult men
'Springer Science and Business Media LLC', 2017Co-Authors: Pihlajamäki, Harri K, Kautiainen Hannu, Parviainen, Mickael C, Kiviranta IlkkaAbstract:Background: Musculoskeletal disorders and injuries are common causes of morbidity and loss of active, physically demanding training days in military populations. We evaluated the incidence, diagnosis, and risk factors of knee disorders and injuries in male Finnish military Conscripts. Methods: The study population comprised 5 cohorts of 1000 men performing their military service, classified according to birth year (1969, 1974, 1979, 1984, and 1989). Follow-up time for each Conscript was the individual Conscript's full, completed military service period. Data for each man were collected from a standard pre-information questionnaire used by defense force healthcare officials and from all original medical reports of the garrison healthcare centers. Background variables for risk factor analysis included the Conscripts' service data, i.e., service class (A, B), length of military service, age, height, weight, body mass index (BMI), underweight, overweight, obesity, smoking habit, education, diseases, injuries, and subjective symptoms. Results: Of the 4029 Conscripts, 853 visited healthcare professionals for knee symptoms during their military service, and 103 of these had suffered a knee injury. Independent risk factors for the incidence of knee symptoms were: older age; service class A; overweight (BMI 25.0-29.9 kg/m(2)); smoking habit; comprehensive school education only; and self-reported previous symptoms of the musculoskeletal, respiratory, and gastrointestinal system. The majority of visits to garrison healthcare services due to knee symptoms occurred during the first few months of military service. Knee symptoms were negatively correlated with self-reported mental and behavioral disorders. Conclusions: The present study highlights the frequency of knee disorders and injuries in young men during physically demanding military training. One-fifth of the male Conscripts visited defense force healthcare professionals due to knee symptoms during their service period. Independent risk factors for the incidence of knee symptoms during military service were age at military service; military service class A; overweight; smoking habit; comprehensive school education only; and self-reported previous symptoms of the musculoskeletal system, respiratory system, or gastrointestinal system. These risk factors should be considered when planning and implementing procedures to reduce knee disorders and injuries during compulsory military service.Peer reviewe
Benjamin Livshits - One of the best experts on this subject based on the ideXlab platform.
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Conscript specifying and enforcing fine grained security policies for javascript in the browser
IEEE Symposium on Security and Privacy, 2010Co-Authors: Leo A Meyerovich, Benjamin LivshitsAbstract:Much of the power of modern Web comes from the ability of a Web page to combine content and JavaScript code from disparate servers on the same page. While the ability to create such mash-ups is attractive for both the user and the developer because of extra functionality, code inclusion effectively opens the hosting site up for attacks and poor programming practices within every JavaScript library or API it chooses to use. In other words, expressiveness comes at the price of losing control. To regain the control, it is therefore valuable to provide means for the hosting page to restrict the behavior of the code that the page may include. This paper presents Conscript, a client-side advice implementation for security, built on top of Internet Explorer 8. Conscript allows the hosting page to express fine-grained application-specific security policies that are enforced at runtime. In addition to presenting 17 widely-ranging security and reliability policies that Conscript enables, we also show how policies can be generated automatically through static analysis of server-side code or runtime analysis of client-side code. We also present a type system that helps ensure correctness of Conscript policies. To show the practicality of Conscript in a range of settings, we compare the overhead of Conscript enforcement and conclude that it is significantly lower than that of other systems proposed in the literature, both on micro-benchmarks as well as large, widely-used applications such as MSN, GMail, Google Maps, and Live Desktop.
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IEEE Symposium on Security and Privacy - Conscript: Specifying and Enforcing Fine-Grained Security Policies for JavaScript in the Browser
2010 IEEE Symposium on Security and Privacy, 2010Co-Authors: Leo A Meyerovich, Benjamin LivshitsAbstract:Much of the power of modern Web comes from the ability of a Web page to combine content and JavaScript code from disparate servers on the same page. While the ability to create such mash-ups is attractive for both the user and the developer because of extra functionality, code inclusion effectively opens the hosting site up for attacks and poor programming practices within every JavaScript library or API it chooses to use. In other words, expressiveness comes at the price of losing control. To regain the control, it is therefore valuable to provide means for the hosting page to restrict the behavior of the code that the page may include. This paper presents Conscript, a client-side advice implementation for security, built on top of Internet Explorer 8. Conscript allows the hosting page to express fine-grained application-specific security policies that are enforced at runtime. In addition to presenting 17 widely-ranging security and reliability policies that Conscript enables, we also show how policies can be generated automatically through static analysis of server-side code or runtime analysis of client-side code. We also present a type system that helps ensure correctness of Conscript policies. To show the practicality of Conscript in a range of settings, we compare the overhead of Conscript enforcement and conclude that it is significantly lower than that of other systems proposed in the literature, both on micro-benchmarks as well as large, widely-used applications such as MSN, GMail, Google Maps, and Live Desktop.
Bryan Ford - One of the best experts on this subject based on the ideXlab platform.
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Conscript your friends into larger anonymity sets with javascript
Workshop on Privacy in the Electronic Society, 2013Co-Authors: Henry Corrigangibbs, Bryan FordAbstract:We present the design and prototype implementation of Conscript, a framework for using JavaScript to encourage casual Web users to participate in an anonymous communication system. When a Web user visits a cooperative Web site, the site serves a JavaScript application that instructs the browser to create and submit "dummy" messages into the anonymity system. Users who want to send non-dummy messages through the anonymity system use a browser plug-in to replace these dummy messages with real messages. Creating such Conscripted anonymity sets can increase the anonymity set size available to users of remailer, e-voting, and verifiable shuffle-style anonymity systems. We outline Conscript's architecture, we address a number of potential attacks against Conscript, and we discuss the ethical issues related to deploying such a system. Our implementation results demonstrate the practicality of Conscript: a workstation running our prototype Conscript JavaScript client generates a dummy message for a mix-net in 81 milliseconds and it generates a dummy message for a DoS-resistant DC-net in 156 milliseconds.
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Conscript Your Friends into Larger Anonymity Sets with JavaScript
arXiv: Cryptography and Security, 2013Co-Authors: Henry Corrigan-gibbs, Bryan FordAbstract:We present the design and prototype implementation of Conscript, a framework for using JavaScript to allow casual Web users to participate in an anonymous communication system. When a Web user visits a cooperative Web site, the site serves a JavaScript application that instructs the browser to create and submit "dummy" messages into the anonymity system. Users who want to send non-dummy messages through the anonymity system use a browser plug-in to replace these dummy messages with real messages. Creating such Conscripted anonymity sets can increase the anonymity set size available to users of remailer, e-voting, and verifiable shuffle-style anonymity systems. We outline Conscript's architecture, we address a number of potential attacks against Conscript, and we discuss the ethical issues related to deploying such a system. Our implementation results demonstrate the practicality of Conscript: a workstation running our Conscript prototype JavaScript client generates a dummy message for a mix-net in 81 milliseconds and it generates a dummy message for a DoS-resistant DC-net in 156 milliseconds.
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WPES - Conscript your friends into larger anonymity sets with JavaScript
Proceedings of the 12th ACM workshop on Workshop on privacy in the electronic society - WPES '13, 2013Co-Authors: Henry Corrigan-gibbs, Bryan FordAbstract:We present the design and prototype implementation of Conscript, a framework for using JavaScript to encourage casual Web users to participate in an anonymous communication system. When a Web user visits a cooperative Web site, the site serves a JavaScript application that instructs the browser to create and submit "dummy" messages into the anonymity system. Users who want to send non-dummy messages through the anonymity system use a browser plug-in to replace these dummy messages with real messages. Creating such Conscripted anonymity sets can increase the anonymity set size available to users of remailer, e-voting, and verifiable shuffle-style anonymity systems. We outline Conscript's architecture, we address a number of potential attacks against Conscript, and we discuss the ethical issues related to deploying such a system. Our implementation results demonstrate the practicality of Conscript: a workstation running our prototype Conscript JavaScript client generates a dummy message for a mix-net in 81 milliseconds and it generates a dummy message for a DoS-resistant DC-net in 156 milliseconds.