The purpose of the study was to evaluate the capacity of an expanded set of force steadiness tasks to explain the variance in the time it takes young men and women to complete the grooved pegboard test. In a single experimental session, 30 participants (mean ± SD) (24.2 ± 4.0 yr; 15 women) performed the grooved pegboard test, two tests of hand speed, measurements of muscle strength, and a set of submaximal, steady contractions. The steadiness tasks involved single and double actions requiring isometric contractions in the directions of wrist extension, a pinch between the index finger and thumb, and index finger abduction. Time to complete the grooved pegboard test ranged from 41.5 to 67.5 s. The pegboard times (53.9 ± 6.2 s) were not correlated with any of the strength measurements or the reaction time test of hand speed. A stepwise, multiple-regression analysis indicated that much of the variance (R(2) = 0.70) in pegboard times could be explained by a model that comprised two predictor variables derived from the steadiness tasks: time to match the target during a rapid force-matching task and force steadiness (coefficient of variation for force) during a single-action task. Moreover, the pegboard times were significantly faster for women (51.7 ± 6.8 s) than men (56.1 ± 4.9 s). Participants with slower pegboard times seemed to place a greater emphasis on accuracy than speed as they had longer times to match the target during the rapid force-matching task and exhibited superior force steadiness during the single-action task.

Summary We report the first known case of envenomation following snake bite by a king cobra in the UK. The patient required tracheal intubation and ventilation. Treatment with king cobra antivenom resulted in anaphylaxis (bronchospasm and hypotension), requiring adrenaline infusion. The patient's trachea was extubated 11 h after administration of antivenom.

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Case: A 43-year-old man suffered an irreducible posterolateral knee dislocation while snowboarding with associated tears of the anterior cruciate, posterior cruciate, medial collateral, and posterolateral corner ligaments. Two closed reduction attempts failed, and magnetic resonance imaging revealed incarcerated soft tissue from a tertiary gastrocnemius muscle head. The patient underwent open reduction and repair/reconstruction of his multiligamentous knee injury. At the 6-year follow-up, the patient did not have pain or instability and returned to recreational activities. Conclusions: This case demonstrates that a tertiary gastrocnemius muscle head, the most common anatomical variation, may complicate the closed reduction of an irreducible posterolateral knee dislocation.

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