Publications by authors named "Scott Horn"

18 Publications

  • Page 1 of 1

Contrast flow patterns based on needle tip position during cervical transforaminal epidural injections.

PM R 2021 Mar 26. Epub 2021 Mar 26.

Department of Orthopaedic Surgery, Stanford University, Virginia Beach, Virginia, USA.

Background: Few studies have evaluated the effect of final needle position on contrast flow patterns during the performance of cervical transforaminal epidural steroid injections (TFESIs).

Objective: To analyze fluoroscopically guided cervical TFESI contrast flow patterns based upon final needle tip position.

Design: Retrospective, observational in vivo study.

Setting: Outpatient private practice physical medicine and rehabilitation spine clinic.

Participants: One hundred consecutive patients undergoing cervical TFESIs.

Interventions: Cervical TFESIs.

Main Outcome Measures: Categories of contrast flow patterns including epidural, intraforaminal, "sufficient to inject," and "predominantly epidural and/or intraforaminal," based upon final needle tip position.

Results: Two independent observers reviewed images from 100 consecutive patients and classified injectate flow patterns stratified by needle tip position. The interrater reliability for all categories of interest was moderate, with kappa values from 0.61 to 0.76. More medially placed needles (middle third and lateral third of the articular pillars) resulted in higher rates of epidural contrast flow (75%; 95% confidence interval [CI]: 56%-94%; and 60%; 95% CI: 47%-73%) compared to needles placed lateral to the articular pillars (26%; 95% CI: 8%-44%), and higher rates of "predominantly epidural and/or intraforaminal" flow patterns with needles placed in the middle one third (75%; 95% CI: 56%-94%) and lateral one third of the articular pillars (47%; 95% CI: 34%-60%) compared to flow patterns when needles were placed lateral to the articular pillars (17%; 95% CI: 2%-32%). No needles were placed in the medial third of the articular pillars.

Conclusions: More medially placed needle tips result in more optimal flow patterns during cervical TFESIs. The importance of this finding is unknown as clinical outcomes were not measured.
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March 2021

Modification of the Cervical Transforaminal Epidural Steroid Injection Technique Based Upon the Anatomic Angle of the Superior Articular Process on MRI.

Pain Med 2020 10;21(10):2090-2099

PM&R Section, Department of Orthopaedic Surgery and Neurosurgery, Stanford University, Redwood City, California, USA.

Objective: A modification of the conventional technique for cervical transforaminal epidural steroid injection (CTFESI) has been developed. This technique may, theoretically, decrease the likelihood of the needle encountering the vertebral artery and spinal nerve. The approach uses angle measurements of the superior articular process ventral surface from the patient's axial MRI as a guide for fluoroscopic set-up and needle trajectory. This report aims to compare contrast flow patterns of the modified approach with those of the conventional technique.

Design: Retrospective chart review and prospective blinded analysis of contrast flow patterns. Setting. Outpatient interventional physiatry practice.

Methods: A retrospective blinded qualitative review of fluoroscopic images was performed to compare contrast flow patterns of CTFESIs performed using the modified approach with those using the conventional technique. A detailed description of the modified approach is provided in this report.

Results: Ninety-seven CTFESI procedures were used for flow analysis. The modified approach resulted in a statistically significant greater percentage of injections with epidural flow: 69% [95% CI = 57-82%] modified approach vs. 42% [95% CI = 28-56%] conventional approach. The modified technique also showed a statistically significant higher percent of injections categorized as having an ideal flow pattern, that of predominate epidural and/or intraforaminal flow: 65% [95% CI = 52-78%] vs. 27% [95% CI = 14-40%].

Conclusions: A modification of the conventional CTFESI technique, developed for the purpose of improved safety, may provide superior contrast flow patterns when compared to the conventional approach.
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October 2020

Staying ahead of the curve: Early lessons from a New York City Otolaryngology Department's organizational response to the coronavirus pandemic.

Laryngoscope Investig Otolaryngol 2020 Jun 19;5(3):401-403. Epub 2020 May 19.

Department of Otolaryngology-Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA.

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June 2020

Incidence of Extravascular Perivertebral Artery Contrast Flow During Cervical Transforaminal Epidural Injections.

Pain Med 2020 09;21(9):1753-1758

Department of Orthopaedic Surgery, Stanford University, Redwood City, California.

Background: During a cervical transforaminal epidural injection, injectate flows along the path of least resistance. Given the proximity of the vertebral artery to the intervertebral foramen, injected contrast may flow along the external wall of the artery. The incidence of this contrast flow pattern during cervical transforaminal epidural injections is unknown.

Purpose: To determine the incidence of extravascular perivertebral artery contrast flow patterns during cervical transforaminal epidural injections.

Study Design/setting: Retrospective, observational, in vivo study.

Patient Sample: Patients receiving cervical transforaminal epidural injections at a single outpatient spine clinic.

Outcome Measures: The presence or absence of extravascular perivertebral artery contrast flow.

Methods: The saved images from 100 consecutive patients were reviewed by two independent observers and classified with or without extravascular perivertebral artery contrast flow. The incidence was determined and kappa was used to examine inter-rater reliability. All disagreements were reviewed, and the final classification was determined by consensus.

Results: The inter-rater reliability was moderate, with a kappa value of 0.69. The incidence of extravascular perivertebral artery contrast flow patterns was 49% by consensus. No statistically significant differences in incidence were present when comparing three different final needle tip positions.

Conclusions: During a cervical transforaminal epidural injection, an extravascular perivertebral artery contrast flow pattern is frequently encountered. This includes flow along the exiting nerve and then around the vertebral artery, as suggested by this study. Although this contrast pattern does not represent an intravascular injection into the vertebral artery, practitioners should remain cautious to exclude intravascular needle placement before injecting medication.
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September 2020

The Utility of Determining the Fluoroscopic Contralateral Oblique Angle Measurement During Cervical Interlaminar Epidural Steroid Injections for Use in Repeat Injections.

PM R 2019 05 11;11(5):566-568. Epub 2019 Feb 11.

Division of PM&R, Jordan-Young Institute, Virginia Beach, VA.

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May 2019

Is a History of Severe Episodic Low Back Pain an Indicator of a Discogenic Etiology?

Pain Med 2018 07;19(7):1334-1339

Department of Orthopaedic Surgery, Stanford School of Medicine, Redwood City, California, USA.

Objective: To determine if a history of severe episodic low back pain (LBP) correlates with positive discography.

Methods: A retrospective chart review identified patients undergoing discography from January 2012 through February 2016. The review determined if the patient's LBP began or continued with severe disabling episodes (lasting a minimum of two days). A gradual onset or initiating event with continuous symptoms was considered a nonepisodic history. Patients were excluded for unclear record, workers' compensation, litigation, prior lumbar surgery, radiologic instability, or indeterminate discography.

Results: Seventy-eight patients underwent discography. Thirty-nine patients were included, 31 of which had positive discograms. Eight had negative discograms. Nineteen patients had a history of episodic LBP, and 20 had no history of episodic LBP. Of those 19 with a history of episodic LBP, 18 had positive discography and one had negative discography. Of those with no history of episodic LBP, 13 had positive discography and seven had negative discography. Using the historical finding of severe episodic LBP as a test for discogenic source of LBP, the sensitivity is 58% (95% confidence interval [CI] = 41-75%) and the specificity is 88% (95% CI = 65-100%). The likelihood ratio is 4.7 (95% CI = 0.72-30). The positive predictive value (PPV) is 95% (95% CI = 72-100%). The PPV is based upon a prevalence of 79% (discogram positive) in our sample of patients considering fusion surgery. The diagnostic confidence odds are 18.2, with a diagnostic confidence of 95%.

Conclusions: A positive history of severe episodic LBP may be a strong indicator for a discogenic etiology.
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July 2018

Response to Drs. Gill and Simopoulos.

Pain Med 2017 11;18(11):2257-2259

APM Spine and Sports Physicians, Virginia Beach, Virginia, USA.

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November 2017

Fundamental Host Range of Leptoypha hospita (Hemiptera: Tingidae), a Potential Biological Control Agent of Chinese Privet.

Environ Entomol 2016 08 20;45(4):897-908. Epub 2016 Jun 20.

Chinese Academy of Sciences, Beijing, China 100101

Chinese privet, Ligustrum sinense Lour., is an invasive shrub within riparian areas of the southeastern United States. Biological control is considered the most suitable management option for Chinese privet. The potential host range of the lace bug, Leptoypha hospita Drake et Poor, was evaluated on the basis of adult feeding and oviposition, combined oviposition-nymphal development no-choice tests, nymphal development no-choice tests, multiple generation comparison on Forestiera pubescens Nutt. and L. sinense no-choice tests, and multiple-choice tests with 45 plant species in 13 families. No-choice tests showed that the host range of L. hospita was restricted to the tribe Oleeae. In adult feeding and oviposition no-choice tests, the bug fed and oviposited significantly more on Chinese privet than all other test plant species except for three native Forestiera spp., two nonnative Syringa spp., and another exotic Ligustrum sp. Among those, only F. pubescens supported complete development in numbers comparable to Chinese privet. However, when reared for multiple generations lace bugs reared on F. pubescens were smaller and had lower fecundity than those reared on L. sinense, suggesting F. pubescens is not an optimal host. In multiple-choice tests, L. hospita displayed a strong preference for feeding and ovipositing on Chinese privet over other test plant species, with the exception of the closely related nonnative Syringa spp. and its congenic species Ligustrum vulgare. The results of this study suggest that the risk to nontarget plant species in North America is minimal, and L. hospita would be a promising candidate for Chinese privet biological control.
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August 2016

Influence of Trap Distance From a Source Population and Multiple Traps on Captures and Attack Densities of the Redbay Ambrosia Beetle (Coleoptera: Curculionidae: Scolytinae).

J Econ Entomol 2016 Apr 6;109(3):1196-1204. Epub 2016 Apr 6.

The redbay ambrosia beetle, Xyleborus glabratus Eichhoff, is the principal vector of laurel wilt disease in North America. Lures incorporating essential oils of manuka plants ( Leptospermum scoparium J. R. Forster & G. Forster) or cubeb seeds ( Piper cubeba L.f.) are the most effective in-flight attractants to date. Using grids of traps baited with these essential oil lures, we evaluated 1) the effect of trap distance from a source beetle population on beetle captures, 2) the feasibility of trapping out low-density beetle populations, and 3) the effect of trap spacing on beetle captures. In the first experiment, increasing trap distance up to 300 m from a source X. glabratus population had little effect on beetle captures. In a second experiment conducted in a study area with very low beetle densities, trapping for 5 mo prior to deploying freshly cut, uninfested redbay bolts had no effect on subsequent attack densities. In a third experiment, numbers of X. glabratus captured in traps in the center of a grid of nine traps spaced 1 or 5 m apart were compared with lone baited or unbaited traps 30 m away. Relative to the more distant traps, the grid of baited traps neither increased captures in the unbaited center trap nor decreased captures in the baited center trap, regardless of spacing. The results suggest that the effective trapping distance of essential oil lures for X. glabratus is <1 m, and that newer, more attractive lures will be needed to be useful in managing X. glabratus populations.
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April 2016

Reliability and Accuracy of MRI Laminar Angle Measurements to Determine Intra-Procedural Contralateral Oblique View Angle for Cervical or Thoracic Interlaminar Epidural Steroid Injections.

Pain Med 2016 09 6;17(9):1628-33. Epub 2016 Jan 6.

*APM Spine and Sports Physicians, Virginia Beach, Virginia, USA.

Background And Objective: Contralateral oblique (CLO) angle view has been a useful addition to standard views in fluoroscopically guided interlaminar epidural injections. Determination of the appropriate CLO angle is paramount in the usefulness of this technique. Using MRI laminar angle measurements as a pre-procedural guide for the intra-procedural fluoroscopic CLO angle has been proposed. The purpose of this study was to help determine if using axial MRI laminar measurements prior to a cervical or thoracic epidural steroid injection would be useful in predicting the appropriate fluoroscopic CLO angle.

Study Design: A retrospective review was performed for patients who underwent cervical or thoracic interlaminar injections. In the performance of interlaminar injections, the authors had routinely determined the true fluoroscopic contra-lateral oblique angle after epidural access was confirmed, for use during any potential future injections. The fluoroscopic CLO angle measurements were obtained from a chart review and compared blindly to each patient's MRI axial laminar angle measurements.

Results: 34 injections were included. Inter-rater reliability comparing the two authors' MRI angle measurements was considered fair, ICC = 0.395. Accuracy was only 57% comparing MRI laminar angle measurements to within five degrees of the true fluoroscopic CLO angle as determined during the injection procedure. Accuracy by ICC showed only fair agreement, 0.47 and 0.22, for the two authors.

Conclusions: The findings of this study indicate fair inter-rater reliability in manual measurements of laminar angle on axial MRI images. MRI laminar angle measurements do not appear to be highly accurate in determining the appropriate fluoroscopic CLO angle.
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September 2016

The Incidence of Intradiscal, Intrathecal, and Intravascular Flow During the Performance of Retrodiscal (Infraneural) Approach for Lumbar Transforaminal Epidural Steroid Injections.

Pain Med 2016 08 24;17(8):1416-22. Epub 2015 Dec 24.

*APM Spine and Sports Physicians, Norfolk, Virginia, USA.

Background: Lumbar transforaminal epidural steroid injections (TFESIs) are often used in the treatment of radicular pain. In light of safety concerns, many practitioners have proposed adopting the retrodiscal (infraneural) approach with the needle tip positioned into Kambin's triangle. With this technique, the needle may inadvertently be directed too far ventrally and enter the intervertebral disc. In addition, the risk of subarachnoid or subdural extra-arachnoid injection may be higher with this technique as well.

Objective: To determine the incidence of inadvertent intradiscal, intrathecal, and vascular injections during the performance of retrodiscal TFESI.

Study Design: Retrospective review

Methods: Retrospective review of all retrodiscal approach TFESIs performed from July 2012 to August 2014 by two of the authors (DL and SH).

Results: A total of 257 retrodiscal transforaminal injections were performed. There were no neurologic complications. There were no cases of discitis. Inadvertent intradiscal injections occurred in 12/257 injections, 4.7% (95% CI 2.1-7.3%). Intrathecal injections occurred in 8/257 injections, 3.1% (95% CI 0.99- 5.23%). Three were subarachnoid (SA), four were subdural extra-arachnoid (SDXA), and one was both SA and SDXA. Vascular injections occurred in 17/257, 6.6% (95% CI 3.6-9.6%).

Conclusion: This retrospective review demonstrates that a relatively high rate of inadvertent intradiscal injections occurs in the performance of the retrodiscal approach for TFESI. This has significant implications in terms of the potential risk of disc injury induced by the needle puncture. The high incidence of intrathecal injections may also be of great concern depending upon the injectate delivered.
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August 2016

Intradiscal Platelet-Rich Plasma Injection for Chronic Discogenic Low Back Pain: Preliminary Results from a Prospective Trial.

Pain Med 2016 06 26;17(6):1010-22. Epub 2015 Dec 26.

*APM Spine and Sports Physicians, Norfolk, Virginia.

Background: Platelet-rich plasma (PRP) has been found to be effective for a variety of musculoskeletal conditions. The treatment of discogenic pain with PRP is under investigation.

Objective: To assess changes in pain and function in patients with discogenic low back pain after an intradiscal injection of PRP.

Study Design: Prospective trial.

Methods: Patients were diagnosed with discogenic low back pain by clinical means, imaging, and exclusion of other structures. Provocation discography was used in a minority of the patients. Patients underwent a single treatment of intradiscal injection of PRP at one or multiple levels.

Main Outcome Measures: Patients were considered a categorical success if they achieved at least 50% improvement in the visual analog score and 30% decrease in the Oswestry Disability Index at 1, 2, and 6 months post-treatment.

Results: 22 patients underwent intradiscal PRP. Nine patients underwent a single level injection, ten at 2 levels, two at 3 levels, and one at 5 levels. Categorical success rates were as follows: 1 month: 3/22 = 14% (95% CI 0% to 28%), 2 months: 7/22 = 32% (95% CI 12% to 51%), 6 months: 9/19 = 47% (95% CI 25% to 70%).

Conclusion: This trial demonstrates encouraging preliminary 6 month findings, using strict categorical success criteria, for intradiscal PRP as a treatment for presumed discogenic low back pain. Randomized placebo controlled trials are needed to further evaluate the efficacy of this treatment.
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June 2016

Safeguards to prevent neurologic complications after epidural steroid injections: consensus opinions from a multidisciplinary working group and national organizations.

Anesthesiology 2015 May;122(5):974-84

From the Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (J.P.R., N.S.R.); Northwestern University Feinberg School of Medicine, Chicago, Illinois (H.T.B.); EvergreenHealth, Kirkland, Washington (P.D., R.B.); Vanderbilt University School of Medicine, Nashville, Tennessee (M.H.); University of California San Diego, San Diego, California (M.W.); Washington University School of Medicine, St. Louis, Missouri (K.D.R.); Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (R.W.R.); Interventional Spine Specialists, Kenner, Louisiana (C.A.); Rush Medical College, Chicago, Illinois (A.B.); Ahwatukee Sports and Spine, Phoenix, Arizona (D.S.K.); University of Newcastle, Newcastle, Australia (N.B.); University of Saskatchewan, Saskatoon, Saskatchewan, Canada (D.R.F.); Southside Pain Solutions, Danville, Virginia (E.F.); APM Spine and Sports Physicians, Virginia Beach, Virginia (S.H.); Mayo Clinic Florida, Jacksonville, Florida (J. Stone); Virginia Mason Medical Center, Seattle, Washington (K.V.); Neuroimaging and Interventional Spine Services, LLC, Ridgefield, Connecticut (G.L.); NewSouth NeuroSpine, Flowood, Mississippi (J. Summers); Danbury Hospital, Danbury, Connecticut (D.K.); University of North Carolina School of Medicine, Winston Salem, North Carolina (D.O.); and Medical College of Wisconsin/Froedtert Hospital, Milwaukee, Wisconsin (S.T.).

Background: Epidural corticosteroid injections are a common treatment for radicular pain caused by intervertebral disc herniations, spinal stenosis, and other disorders. Although rare, catastrophic neurologic injuries, including stroke and spinal cord injury, have occurred with these injections.

Methods: A collaboration was undertaken between the U.S. Food and Drug Administration Safe Use Initiative, an expert multidisciplinary working group, and 13 specialty stakeholder societies. The goal of this collaboration was to review the existing evidence regarding neurologic complications associated with epidural corticosteroid injections and produce consensus procedural clinical considerations aimed at enhancing the safety of these injections. U.S. Food and Drug Administration Safe Use Initiative representatives helped convene and facilitate meetings without actively participating in the deliberations or decision-making process.

Results: Seventeen clinical considerations aimed at improving safety were produced by the stakeholder societies. Specific clinical considerations for performing transforaminal and interlaminar injections, including the use of nonparticulate steroid, anatomic considerations, and use of radiographic guidance are given along with the existing scientific evidence for each clinical consideration.

Conclusion: Adherence to specific recommended practices when performing epidural corticosteroid injections should lead to a reduction in the incidence of neurologic injuries.
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May 2015

Intradiskal methylene blue treatment for diskogenic low back pain.

PM R 2014 Nov 26;6(11):1030-7. Epub 2014 Apr 26.

APM Spine and Sports Physicians, Virginia Beach, VA(‡).

Background: Low back pain is a leading cause of pain and disability. The intervertebral disk has been identified as the most common source of chronic low back pain. Although prior treatments directed at intervertebral disks have been disappointing, recent studies show promising improvement of pain and function after a single intradiskal injection of methylene blue.

Objective: To assess changes in pain and function in patients with diskogenic low back pain, diagnosed by diskography, after an intradiskal injection of methylene blue.

Study Design: Prospective trial.

Methods: Patients diagnosed with diskogenic pain by diskography underwent a single treatment of intradiskal injection of methylene blue, determined by prior provocation diskography.

Main Outcome Measures: Pain and function measurements were completed at baseline and 1, 2, and 6 months after treatment. Treatment was considered a categorical success based on a 30% improvement in pain according to a visual analog scale (VAS) and function on the Oswestry Disability Index (ODI). Treatment was considered a categorical failure if less than 30% improvement in pain and function was achieved or if the patient pursued other invasive treatment options during the trial period.

Results: Sixteen patients received the intradiskal methylene blue injection. Eleven patients received a single-level injection, 4 patients received a 2-level injection, and one patient received injections at 3 levels. For the VAS, at 1, 2, and 6 months after the injection, the categorical success rates were 25%, 21%, and 25%, respectively. For the ODI, at 1, 2 and 6 months after the injection, the categorical success rates were 25%, 21%, and 33%, respectively. The overall categorical success rates at 1, 2, and 6 months after the injection were 19%, 21%, and 25%, respectively.

Conclusion: This small trial did not demonstrate overall clinical success of intradiskal methylene blue injection for patients diagnosed with diskogenic pain by diskography.
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November 2014

The biology and preliminary host range of Megacopta cribraria (Heteroptera: Plataspidae) and its impact on kudzu growth.

Environ Entomol 2012 Feb;41(1):40-50

Department of Entomology, University of Georgia, Athens, GA 30602, USA.

The bean plataspid, Megacopta cribraria (F.), recently was discovered in the United States feeding on kudzu, Pueraria montana Lour. (Merr.) variety lobata (Willd.), an economically important invasive vine. We studied its biology on kudzu and its impact on kudzu growth. We also tested its ability to use other common forest legumes for oviposition and development. Flight intercept traps operated from 17 May 2010 to 31 May 2011 in a kudzu field near Athens, GA showed three peaks of adult flight activity suggesting there are two generations per year on kudzu. Vine samples examined for eggs from April 2010 to April 2011 and June to October 2011 showed two periods of oviposition activity in 2010, which coincided with the peaks in adult activity. In 2011, the second period of oviposition began on or before 24 June and then egg abundance declined gradually thereafter until late August when we recovered <2 eggs/0.5 m of vine. Samples of the five nymphal instars and adults on vines did not show similar trends in abundance. Adults did not lay eggs on the various legume species tested in 2010 in a no-choice test possibly because the cages were too small. In the 2011 field host range experiments conducted in a kudzu field by using 12 legume species, M. cribraria preferentially oviposited on kudzu over soybean, Glycine max Merrill., but they still laid 320 eggs per plant on soybean. Lespedeza hirta (L.) Hornem. and Lespedeza cuneata (Dum. Cours.) G. Don had 122.2 and 108.4 eggs per plant, respectively. Kudzu and soybean were the only species M. cribraria completed development on. Plots protected from M. cribraria feeding by biweekly insecticide applications had 32.8% more kudzu biomass than unprotected plots. Our results show that M. cribraria has a significant impact on kudzu growth and could help suppress this pest weed.
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February 2012

Efficacy of two insecticides for protecting loblolly pines (Pinus taeda L.) from subcortical beetles (Coleoptera: Curculionidae and Cerambycidae).

Pest Manag Sci 2012 Jul 22;68(7):1048-52. Epub 2012 Feb 22.

University of Georgia, Athens, GA, USA.

Background: Tests were conducted on two insecticides (carbaryl and bifenthrin) for excluding subcortical beetles (Coleoptera: Curculionidae and Cerambycidae) from loblolly pine trees (Pinus taeda L.). Two trap designs (single- and double-pane windows) and two trapping heights (1.5 and 4 m) were also evaluated for maximizing beetle catches.

Results: In July 2009, 15 loblolly pine trees were double girdled and were either left unsprayed or sprayed with carbaryl or bifenthrin. A total of 28 473 bark beetles were caught in window traps, including Ips avulsus Eichoff, I. grandicollis (Eichhoff), I. calligraphus (Germar) and Dendroctonus terebrans (Olivier). Both insecticides significantly reduced colonization of the trees by bark and woodboring beetles by 300-400%, with no differences in efficacy observed between the two insecticides. About 59% more I. avulsus were caught in double- than in single-pane window traps, with no differences for any other species. Traps at 4 m caught more I. avulsus and I. grandicollis (290 and 153% respectively), while traps at 1.5 m caught more D. terebrans (215%).

Conclusions: Either bifenthrin or carbaryl can be used to exclude subcortical beetles from loblolly pine trees. Trapping data reflect known vertical partitioning on the bole by these insects. Double-pane traps were slightly more effective than single-pane traps in catching subcortical beetles.
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July 2012

Effect of trap type, trap position, time of year, and beetle density on captures of the redbay ambrosia beetle (Coleoptera: Curculionidae: Scolytinae).

J Econ Entomol 2011 Apr;104(2):501-8

USDA Forest Service, Southern Research Station, Forestry Sciences Laboratory, 320 Green St., Athens, GA 30602-2044, USA.

The exotic redbay ambrosia beetle, Xyleborus glabratus Eichhoff (Coleoptera: Curculionidae: Scolytinae), and its fungal symbiont Raffaellea lauricola Harrington, Fraedrich, and Aghayeva are responsible for widespread redbay, Persea borbonia (L.) Spreng., mortality in the southern United States. Effective traps and lures are needed to monitor spread of the beetle and for early detection at ports-of-entry, so we conducted a series of experiments to find the best trap design, color, lure, and trap position for detection of X. glabratus. The best trap and lure combination was then tested at seven sites varying in beetle abundance and at one site throughout the year to see how season and beetle population affected performance. Manuka oil proved to be the most effective lure tested, particularly when considering cost and availability. Traps baited with manuka oil lures releasing 5 mg/d caught as many beetles as those baited with lures releasing 200 mg/d. Distributing manuka oil lures from the top to the bottom of eight-unit funnel traps resulted in similar numbers of X. glabratus as a single lure in the middle. Trap color had little effect on captures in sticky traps or cross-vane traps. Funnel traps caught twice as many beetles as cross-vane traps and three times as many as sticky traps but mean catch per trap was not significantly different. When comparing height, traps 1.5 m above the ground captured 85% of the beetles collected but a few were caught at each height up to 15 m. Funnel trap captures exhibited a strong linear relationship (r2 = 0.79) with X. glabratus attack density and they performed well throughout the year. Catching beetles at low densities is important to port of entry monitoring programs where early detection of infestations is essential. Our trials show that multiple funnel traps baited with a single manuka oil lure were effective for capturing X. glabratus even when no infested trees were visible in the area.
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April 2011

Self-reported anabolic-androgenic steroids use and musculoskeletal injuries: findings from the center for the study of retired athletes health survey of retired NFL players.

Am J Phys Med Rehabil 2009 Mar;88(3):192-200

Department of Physical Medicine and Rehabilitation, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Objective: The relationship between musculoskeletal injuries and anabolic-androgenic steroids is not well understood. The purpose of our study was to investigate the association between self-reported anabolic-androgenic steroids use and the prevalence of musculoskeletal injuries in a unique group of retired professional football players.

Design: A general health questionnaire was completed by 2552 retired professional football players. Survey data were collected between May 2001 and April 2003. Results of self-reported musculoskeletal injuries were compared with the use of anabolic-androgenic steroids using frequency distributions and chi2 analyses.

Results: Of the retired players, 9.1% reported using anabolic-androgenic steroids during their professional career. A total of 16.3% of all offensive line and 14.8% of all defensive line players reported using anabolic-androgenic steroids. Self-reported anabolic-androgenic steroids use was significantly associated (P < 0.05) with the following self-reported, medically diagnosed, joint and cartilaginous injuries in comparison with the nonanabolic-androgenic steroids users: disc herniations, knee ligamentous/meniscal injury, elbow injuries, neck stinger/burner, spine injury, and foot/toe/ankle injuries. There was no association between anabolic-androgenic steroids use and reported muscle/tendon injuries.

Conclusions: Our findings demonstrate that an association may exist between anabolic-androgenic steroids use and the prevalence of reported musculoskeletal injury sustained during a professional football career, particularly ligamentous/joint-related injuries. There may also be an associated predisposition to selected types of injuries in anabolic-androgenic steroids users.
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March 2009