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BACKGROUND: Rates of shoulder and elbow pathology are well documented among competitive baseball players in the United States; however, little is known about the prevalence of these pathologies in the Dominican Republic (DR). PURPOSE: To report the epidemiology of shoulder and elbow pathology among participants at a Major League Baseball scouting event in Santo Domingo, DR. STUDY DESIGN: Retrospective descriptive study. LEVEL OF EVIDENCE: 3. METHODS: All pitchers and position players who attended the 2021 scouting event were reviewed. Those with complete medical history, physical examination, imaging series, and radiology reports were included. All participants underwent shoulder and elbow radiography, while pitchers also underwent magnetic resonance imaging (MRI). All pathologic findings on imaging studies were recorded and compared among position players and pitchers. RESULTS: Seventy-five participants (average age, 17.9 years) were reviewed (42 position players, 33 pitchers); 72% and 32% had ≥1 abnormal finding on elbow and shoulder radiographs, respectively. Position players had significantly higher numbers of elbow radiographic findings compared with pitchers (81% vs 57.6%, P = 0.03) but similar numbers on shoulder radiograph (28.6% vs 33.3%, P = 0.66). Position players had high numbers of acromioclavicular separation (14.3%) and little leaguer's shoulder (14.3%) on shoulder radiograph, with olecranon osteophytes (23.8%) and medial epicondyle nonunions (11.9%) prevalent on elbow radiograph. Pitchers had high numbers of rotator cuff pathology (93.9%), labral tears (75.8%), and Bennett lesions (51.5%). On elbow imaging, pitchers had high numbers of ulnar collateral ligament (UCL) abnormalities (81.8%), olecranon osteophytes (69.7%), osteochondral lesions (18.2%), and medial epicondyle nonunions (12.1%). Two pitchers had complete UCL disruption (6.1%), while 8 had partial tears (24.2%). CONCLUSION: Dominican baseball prospects had high numbers of asymptomatic shoulder and elbow pathology on imaging studies. Knowledge of the prevalence of these pathologies can guide injury prevention programs in Dominican youth baseball.

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The interconnected nature of surface and subsurface karst environments allows easy disturbance to their aquifers and specialized ecosystems from anthropogenic impacts. The karst disturbance index is a holistic tool used to measure disturbance to karst environments and has been applied and refined through studies in Florida and Italy, among others. Through these applications, the karst disturbance index has evolved into two commonly used methods of application; yet, the karst disturbance index is still susceptible to evaluation and modification for application in other areas around the world. The geographically isolated and highly vulnerable municipality of Arecibo, Puerto Rico's karst area provides an opportunity to test the usefulness and validity of the karst disturbance index in an island setting and to compare and further refine the application of the original and modified methods. This study found the both methods of karst disturbance index application resulted in high disturbance scores (Original Method 0.54 and Modified Method 0.69, respectively) and uncovered multiple considerations for the improvement of the karst disturbance index. An evaluation of multiple methods together in an island setting also resulted in the need for adding additional indicators, including Mogote Removal and Coastal Karst. Collectively, the results provide a holistic approach to using the karst disturbance index in an island karst setting and suggest a modified method by which scaling and weighting may compensate for the difference between the original and modified method scores and allow interested stakeholders to evaluate disturbance regardless of his or her level of expertise.

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INTRODUCCIÓN: La diarrea es la segunda causa de morbilidad y mortalidad en niños menores de 5 años en Honduras. El objetivo de este estudio fue determinar los agentes etiológicos virales, bacterianos y parasitarios en niños con diarrea no sanguino lenta de 2 barrios marginales de Comayagüela, Honduras. METODOLOGÍA: Estudio de casos y controles realizado del 1er de marzo al 31 de agosto 2004 en los centros de Salud de Las Crucitas y El Carrizal, en 151 niños de 6 meses a 5 años de edad con diarrea aguda que acudieron por demanda espontanea; con los correspondientes 151 controles apareados por edad, sexo y vecindario, una vez obtenido el consentimiento informado. Las muestras de heces se procesaron por virus, bacterias y parásitos utilizando métodos convencionales en el laboratorio. El análisis estadístico además de la prueba exacta de Fisher. RESULTADOS: Se encontró una asociación significativa entre los niños infectados por Cryptosporidium spp. y Adenovirus y los episodios de diarrea aguda, comparada con los no infectados por esos agentes patógenos (OR=9.31, 95%CI=1.24 - 69.97; OR = 5.47, 95%CI=1.51 – 19.80, respectivamente); los 8 pacientes infectados con Rotavirus tenían un cuadro diarreico agudo evidente (prueba exacta de Fisher p<0.01). CONCLUSIONES: Las infecciones por Adenovirus, Rotavirus y Cryptosporidium spp. se asociaron fuertemente con diarrea aguda no sanguinolenta en niños en Honduras...

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INTRODUCCIÓN: La diarrea es la segunda causa de morbilidad y mortalidad en niños menores de 5 años en Honduras. El objetivo de este estudio fue determinar los agentes etiológicos virales, bacterianos y parasitarios en niños con diarrea no sanguino lenta de 2 barrios marginales de Comayagüela, Honduras. METODOLOGÍA: Estudio de casos y controles realizado del 1er de marzo al 31 de agosto 2004 en los centros de Salud de Las Crucitas y El Carrizal, en 151 niños de 6 meses a 5 años de edad con diarrea aguda que acudieron por demanda espontanea; con los correspondientes 151 controles apareados por edad, sexo y vecindario, una vez obtenido el consentimiento informado. Las muestras de heces se procesaron por virus, bacterias y parásitos utilizando métodos convencionales en el laboratorio. El análisis estadístico además de la prueba exacta de Fisher. RESULTADOS: Se encontró una asociación significativa entre los niños infectados por Cryptosporidium spp. y Adenovirus y los episodios de diarrea aguda, comparada con los no infectados por esos agentes patógenos (OR=9.31, 95%CI=1.24 - 69.97; OR = 5.47, 95%CI=1.51 – 19.80, respectivamente); los 8 pacientes infectados con Rotavirus tenían un cuadro diarreico agudo evidente (prueba exacta de Fisher p<0.01). CONCLUSIONES: Las infecciones por Adenovirus, Rotavirus y Cryptosporidium spp. se asociaron fuertemente con diarrea aguda no sanguinolenta en niños en Honduras...(AU)

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BACKGROUND: Despite the widespread availability of oral rehydration therapy, diarrheal illness remains a major cause of morbidity and mortality around the world. Previous studies have shown individualized homeopathic therapy to be effective in treating childhood diarrhea, but this approach requires specialized training. OBJECTIVE: A homeopathic combination medicine, if effective, could be used by health personnel on a widespread basis. METHODS: A double-blind randomized controlled trial was conducted in Honduras to evaluate the effectiveness of a homeopathic combination therapy to treat acute diarrhea in children. A total of 292 children with acute diarrhea was recruited; 145 were randomized to the experimental group and 147 to the placebo group. Tablets containing a combined preparation of the five most common single homeopathic remedies used to treat diarrhea or placebo were administered by a parent after each unformed stool. Children were followed up daily for 7 days or until symptoms resolved, whichever occurred first. Time until resolution of symptoms, daily rate of unformed stools, and total number of unformed stools were compared between the two groups. RESULTS: There was no significant difference in the likelihood of resolution of diarrheal symptoms between the treatment and placebo groups (hazard ratio = 1.02, 95% confidence interval: 0.79-1.32), with a median time until resolution of 3 days for both groups. Children in the treatment group had an average of 2.6 unformed stools per day compared to 2.8 among those in the placebo group; this difference was not significant (p = 0.43). The median number of unformed stools was 7 among children in the treatment group and 8 among those in the placebo group (p = 0.41). DISCUSSION: The homeopathic combination therapy tested in this study did not significantly reduce the duration or severity of acute diarrhea in Honduran children. Further study is needed to develop affordable and effective methods of using homeopathy to reduce the global burden of childhood diarrhea.

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