Higher incidence of major complications after splenic embolization for blunt splenic injuries in elderly patients.

Science.gov (United States)

Wu, Shih-Chi; Fu, Chih-Yuan; Chen, Ray-Jade; Chen, Yung-Fang; Wang, Yu-Chun; Chung, Ping-Kuei; Yu, Shu-Fen; Tung, Cheng-Cheng; Lee, Kun-Hua

2011-02-01

Nonoperative management (NOM) of blunt splenic injuries has been widely accepted, and the application of splenic artery embolization (SAE) has become an effective adjunct to NOM. However, complications do occur after SAE. In this study, we assess the factors leading to the major complications associated with SAE. Focusing on the major complications after SAE, we retrospectively studied patients who received SAE and were admitted to 2 major referral trauma centers under the same established algorithm for management of blunt splenic injuries. The demographics, angiographic findings, and factors for major complications after SAE were examined. Major complications were considered to be direct adverse effects arising from SAE that were potentially fatal or were capable of causing disability. There were a total of 261 patients with blunt splenic injuries in this study. Of the 261 patients, 53 underwent SAE, 11 (21%) of whom were noted to have 12 major complications: 8 cases of postprocedural bleeding, 2 cases of total infarction, 1 case of splenic abscess, and 1 case of splenic atrophy. Patients older than 65 years were more susceptible to major complications after SAE. Splenic artery embolization is considered an effective adjunct to NOM in patients with blunt splenic injuries. However, risks of major complications do exist, and being elderly is, in part, associated with a higher major complication incidence. Copyright © 2011 Elsevier Inc. All rights reserved.

Return to competition, re-injury, and impact on performance of preseason shoulder injuries in Major League Baseball pitchers.

Science.gov (United States)

Makhni, Eric C; Lee, Randall W; Nwosu, Ekene O; Steinhaus, Michael E; Ahmad, Christopher S

2015-07-01

Major league baseball (MLB) pitchers are vulnerable to overuse injury of the upper extremity, especially in the shoulder. Injuries sustained in the preseason may have negative impact on performance following return. The goal of this study was to document the frequency of preseason shoulder injury in these athletes, as well as risk for re-injury and impact on performance following return from injury. A comprehensive search of MLB injury information from 2001 to 2010 of public databases yielded a cohort of MLB pitchers who sustained preseason shoulder injuries. These databases were utilized to obtain information regarding return to MLB competition, re-injury, and performance following return from injury. All performance metrics were compared to those of an age-matched control cohort. A total of 74 pitchers were identified who sustained a preseason shoulder injury. Only 39 (53%) returned that same season to pitch in the MLB competition. Of those that returned, nearly 50% of players were re-designated on the Disabled List during the return season. There was a decline in performance in earned run average and batting average against in the year of return. Compared to age-matched control pitchers, those with preseason shoulder injury had lower performance metrics across a number of outcomes. Preseason shoulder injury in MLB pitchers has the potential to result in high re-injury rates and decreased subsequent performance.

Understanding suicide and disability through three major disabling conditions: Intellectual disability, spinal cord injury, and multiple sclerosis.

Science.gov (United States)

Giannini, Margaret J; Bergmark, Brian; Kreshover, Samantha; Elias, Eileen; Plummer, Caitlin; O'Keefe, Eileen

2010-04-01

Disability is not a category of disease but rather relates to the physical, sensory, cognitive, and/or mental disorders that substantially limit one or more major life activities. These functional limitations have been found to be predictive of suicide, with psychiatric comorbidities increasing the risk for suicide. Enormous gaps exist in the understanding of the relationship between disability and suicide. We reviewed the current literature addressing the prevalence of and risk factors for suicide among persons with three major disabling conditions and identify priorities for future research. We performed a literature review investigating the relationship between three major disabilities (intellectual disability, spinal cord injury, multiple sclerosis) and suicide. To ensure thorough evaluation of the available literature, we searched PubMed, the Cochrane Library, and Google Scholar with terms including "suicide," "disability," "intellectual disability," "spinal cord injury," "multiple sclerosis," and permutations thereof. By this method we evaluated 110 articles and included 21 in the review. Suicide rates are significantly higher among persons with multiple sclerosis and spinal cord injury than in the general population. A more nuanced picture of suicide rates and risk factors exists for the intellectual disability population, in which it appears that rates of suicide risk factors are higher than among the general population while suicide rates may be lower. The highest rates of suicide are reported among study populations of persons with multiple sclerosis, followed by persons with spinal cord injury, and then individuals with intellectual disability. Suicide among persons with disabilities is a complex and pressing public health concern. Urgent research priorities include (1) valid estimates of suicide rates among persons with disabilities by age cohort; (2) assessment of the predictive importance of suicide risk factors; and (3) determination of best

Collections of laws and ordinances concerning radiation injury prevention as of July 24, 1981

International Nuclear Information System (INIS)

Tsuruta, Takao

1981-01-01

There are laws, government and ministerial ordinances and notifications, each of them bears a definite role, and the contents of the legal regulation on a certain range of matter are determined by their close interrelation and mutual supplementation. Many laws and ordinances concerning atomic energy also form a legal system under such mutual relation. The Atomic Energy Act is positioned at its top, and the main part related to radiation injury prevention comprises a law, two ordinances, a regulation and a notification. Such relationship of individual laws and ordinances is mostly shown in lower rank laws and ordinances. In Chapter 1 of this book, the Atomic Energy Act and the government ordinance concerning the definition of nuclear fuel materials, nuclear raw materials, nuclear reactors and radiation are described. In Chapter 2, the law concerning prevention of radiation injuries due to radiactive isotopes and others, the ordinances and eight notifications closely related to them are collected. In Chapter 3, other related laws and ordinances are gathered. To understand the laws and ordinances synthetically and systematically, the provisions of different laws and ordinances, which are mutually related, are arranged together showing their relation. (Kako, I.)

Sibling experiences after a major childhood burn injury.

Science.gov (United States)

Lehna, Carlee

2010-01-01

The purpose of this research project was to understand, primarily from the sibling perspective, the effect of a child's major burn injury on his or her sibling. A mixed method qualitative dominant design was implemented using the life story method for the qualitative portion. Additionally, the Sibling Relationship Questionnaire -Revised (SRQ-R) was used as a structured interview guide and for calculating scoring data to explore sibling relationship factors of warmth/closeness, rivalry, conflict, and relative status/power. Participants from 22 family cases (one or multiple family members) and 40 individuals were interviewed. To capture impact on the family over time, interviews began a minimum of two years post-burn. The central thematic pattern for the sibling relationship in families having a child with a major burn injury was that of normalization. Two components of normalization were described: areas of normalization and the process of adjustment. Areas of normalization were found in play and other activities, in school and work, and in family relations with siblings. The process of adjustment was varied and often gradual, involved school and work re-entry, and in some instances, seemed to change life perspective. Clinical implications in providing family-centered care can focus on promoting normalization by assessing and supporting siblings who may only be occasionally seen in the hospital or clinic.

First rib fractures as an indicator of injury severity in major trauma

OpenAIRE

Sammy, I.A.; Chatha, H.; Lecky, F.; Bouamra, O.; Fragoso Iniguez, M.; Sattout, A.; Hickey, M.

2016-01-01

Introduction First rib fractures are traditionally considered indicators of increased morbidity and mortality in major trauma. However, this relationship has not been definitively proven. With an increase in computed tomography in major trauma, and the likely increase in detection of first rib fractures, this study re-evaluates whether first rib fractures are an indicator of injury severity. Discussion This study suggests that major trauma patients with first rib fractures have increased ISS ...

Sports injuries in Saudi Arabia.

Science.gov (United States)

Sadat-Ali, M; Sankaran-Kutty, M

1985-03-01

Saudi Arabia has now a wealth of sporting facilities of which the youth of the country is making full use. A prospective study of sports related injuries was conducted during the twelve months of 1983. We present an analysis of 846 such injuries seen at the King Fahd University Hospital, Al Khobar. These injuries formed 8.36% of those who attended after an accident for emergency treatment, of which 63% were under 20 years. The majority was sustained during soccer games. The most frequent site of injury was the knee. We believe that specialised Sports Injury Clinics, initially based at the University Hospitals should be established here, to give guidance and education concerning avoidance of injuries, and for the treatment and follow-up of those injured and enable them to return to sports early.

Ambulatory cell phone injuries in the United States: an emerging national concern.

Science.gov (United States)

Smith, Daniel C; Schreiber, Kristin M; Saltos, Andreas; Lichenstein, Sarah B; Lichenstein, Richard

2013-12-01

Over the past 15 years, the use of cell phones has increased 8-fold in the United States. Cell phone use has been shown to increase crash risks for drivers, but no systematic analyses have described injuries related to ambulatory cell phone use. The purpose of this study is to describe and quantitate injuries and deaths among persons using cell phones while walking. We searched the National Electronic Injury Surveillance System (NEISS) for emergency department (ED) reports of injuries related to phone use. The cases that returned were screened initially using words that would eliminate cases unlikely to be related to cell phone use and walking, possibly linked to distraction. The resulting cases were randomized and evaluated for consistency with predetermined case definitions by two authors blinded to the dates of the incidents. Cases that were disagreed upon were evaluated in a second screening by both authors for final case determination. National ED visit rates were estimated based on NEISS sampling methods. Annual variations were analyzed using linear regression with a restricted maximum likelihood approach. Our screening process identified 5,754 possible cases that occurred between 2000 and 2011, and 310 were agreed on as cases of cell-phone-induced distraction. The majority of the patients were female (68%) and 40 years of age or younger (54%). The primary mechanism of injury was a fall (72%), and most patients were treated and released from the ED (85%). No patients died from their injuries while they were in the ED. Linear modeling by year revealed a statistically significant increase in distraction injury rates over the years of study (pcell phone use has been increasing. More research is needed to determine the risks associated with walking and talking on a cell phone and to develop strategies for intervention. Cell phone use continues to increase both at home and outdoor environments. The use of smart phones, with their more enticing features, increases

Self-reported and reported injury patterns in contemporary dance students.

Science.gov (United States)

Baker, Jo; Scott, Daniel; Watkins, Katherine; Keegan-Turcotte, Sheramy; Wyon, Matthew

2010-03-01

Injury is a major concern among dancers, as currently rates are reported as being high. The purpose of the present study was to assess the incidence and details of injuries across an academic year at a full-time contemporary dance school. A questionnaire was distributed to 57 dancers at the end of their first academic year. Reported injury information was also retrieved from a database as collected from a physiotherapist over the same period. Differences were found between the reported and self-reported information, particularly with reference to shin injuries. The majority of injuries occurred in November and May, noted to be close to assessment periods. Injury rates in contemporary dance are high; notably, 89% of dancers reported one or more injuries. This problem is particularly evident in the lower limb. Med Probl Perform Art 2010; 25:10-15.

Stigma perspective of siblings of children with a major childhood burn injury.

Science.gov (United States)

Lehna, Carlee

2013-10-01

To understand the stigma perspective of siblings of children with major burn injury. A mixed method, qualitative-dominant study was conducted. The life story method was used for the qualitative portion. Only narratives from those family members describing the sibling's appearance change were used (N = 18 participants). Stigma experienced by siblings was first described by parents or noninjured siblings; they described how the sibling with changed appearance was stared at, ridiculed, or teased when they entered a new social situation. Only when specifically asked did the children with burn injury talk about their problems, saying, "This always happens when I go somewhere new." Children with changed appearance focused on normalizing their lives in a positive way. Oftentimes, it was a parent or noninjured sibling who would describe manifestations of stigma and ways they tried to protect the child with burn injury. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Major lower extremity lawn mower injuries in children.

Science.gov (United States)

Dormans, J P; Azzoni, M; Davidson, R S; Drummond, D S

1995-01-01

Between 1983 and 1993, 16 children with 18 lower extremity power lawn mower-related injuries were treated at Children's Hospital of Philadelphia. Eleven of 16 patients (69%) were bystanders or nonoperators. The average age at injury was 4 years 9 months. Length of follow-up averaged 3 years 10 months. There was an average of 4.9 procedures per patient. Fourteen of the 18 limbs injured required eventual amputation (78%). We propose a new classification of lawn mower injuries in children. The most common injury (16 of 18 limbs) was a shredding type injury and was either intercalary or distal. The second was a paucilaceration type (two of 18 limbs). Of the four salvaged limbs, there were two shredding type injuries, and on most recent follow-up are considered to have poor results. The two patients with the paucilaceration type injuries and limb salvage are considered to have excellent results. All patients with a shredding type injury ultimately required amputation or had poor results with the salvaged limb. Limb salvage surgery was associated with prolonged hospitalizations, a higher incidence of surgical problems, a longer treatment course, and more complications than early ablative procedures.

Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application

NARCIS (Netherlands)

Valle, Xavier; Alentorn-Geli, Eduard; Tol, Johannes L.; Hamilton, Bruce; Garrett, William E.; Pruna, Ricard; Til, Lluís; Gutierrez, Josep Antoni; Alomar, Xavier; Balius, Ramón; Malliaropoulos, Nikos; Monllau, Joan Carles; Whiteley, Rodney; Witvrouw, Erik; Samuelsson, Kristian; Rodas, Gil

2017-01-01

Muscle injuries are among the most common injuries in sport and continue to be a major concern because of training and competition time loss, challenging decision making regarding treatment and return to sport, and a relatively high recurrence rate. An adequate classification of muscle injury is

Ten years of major equestrian injury: are we addressing functional outcomes?

OpenAIRE

Ball, Jill E; Ball, Chad G; Mulloy, Robert H; Datta, Indraneel; Kirkpatrick, Andrew W

2009-01-01

Abstract Background Horseback riding is considered more dangerous than motorcycle riding, skiing, automobile racing, football and rugby. The integral role of rehabilitation therapy in the recovery of patients who have sustained a major horse-related injury is previously not described. The goals of this paper were to (1) define the incidence and pattern of severe equestrian trauma, (2) identify the current level of in-patient rehabilitation services, (3) describe functional outcomes for patien...

Traumatic aortic injury score (TRAINS): an easy and simple score for early detection of traumatic aortic injuries in major trauma patients with associated blunt chest trauma.

Science.gov (United States)

Mosquera, Victor X; Marini, Milagros; Muñiz, Javier; Asorey-Veiga, Vanesa; Adrio-Nazar, Belen; Boix, Ricardo; Lopez-Perez, José M; Pradas-Montilla, Gonzalo; Cuenca, José J

2012-09-01

To develop a risk score based on physical examination and chest X-ray findings to rapidly identify major trauma patients at risk of acute traumatic aortic injury (ATAI). A multicenter retrospective study was conducted with 640 major trauma patients with associated blunt chest trauma classified into ATAI (aortic injury) and NATAI (no aortic injury) groups. The score data set included 76 consecutive ATAI and 304 NATAI patients from a single center, whereas the validation data set included 52 consecutive ATAI and 208 NATAI patients from three independent institutions. Bivariate analysis identified variables potentially influencing the presentation of aortic injury. Confirmed variables by logistic regression were assigned a score according to their corresponding beta coefficient which was rounded to the closest integer value (1-4). Predictors of aortic injury included widened mediastinum, hypotension less than 90 mmHg, long bone fracture, pulmonary contusion, left scapula fracture, hemothorax, and pelvic fracture. Area under receiver operating characteristic curve was 0.96. In the score data set, sensitivity was 93.42 %, specificity 85.85 %, Youden's index 0.79, positive likelihood ratio 6.60, and negative likelihood ratio 0.08. In the validation data set, sensitivity was 92.31 % and specificity 85.1 %. Given the relative infrequency of traumatic aortic injury, which often leads to missed or delayed diagnosis, application of our score has the potential to draw necessary clinical attention to the possibility of aortic injury, thus providing the chance of a prompt specific diagnostic and therapeutic management.

Contemporary Cardiovascular Concerns after Spinal Cord Injury: Mechanisms, Maladaptations, and Management.

Science.gov (United States)

Phillips, Aaron A; Krassioukov, Andrei V

2015-12-15

Cardiovascular (CV) issues after spinal cord injury (SCI) are of paramount importance considering they are the leading cause of death in this population. Disruption of autonomic pathways leads to a highly unstable CV system, with impaired blood pressure (BP) and heart rate regulation. In addition to low resting BP, on a daily basis the majority of those with SCI suffer from transient episodes of aberrantly low and high BP (termed orthostatic hypotension and autonomic dysreflexia, respectively). In fact, autonomic issues, including resolution of autonomic dysreflexia, are frequently ranked by individuals with high-level SCI to be of greater priority than walking again. Owing to a combination of these autonomic disturbances and a myriad of lifestyle factors, the pernicious process of CV disease is accelerated post-SCI. Unfortunately, these secondary consequences of SCI are only beginning to receive appropriate clinical attention. Immediately after high-level SCI, major CV abnormalities present in the form of neurogenic shock. After subsiding, new issues related to BP instability arise, including orthostatic hypotension and autonomic dysreflexia. This review describes autonomic control over the CV system before injury and the mechanisms underlying CV abnormalities post-SCI, while also detailing the end-organ consequences, including those of the heart, as well as the systemic and cerebral vasculature. The tertiary impact of CV dysfunction will also be discussed, such as the potential impediment of rehabilitation, and impaired cognitive function. In the recent past, our understanding of autonomic dysfunctions post-SCI has been greatly enhanced; however, it is vital to further develop our understanding of the long-term consequences of these conditions, which will equip us to better manage CV disease morbidity and mortality in this population.

Oesophageal Injury During AF Ablation: Techniques for Prevention

Science.gov (United States)

Romero, Jorge; Avendano, Ricardo; Grushko, Michael; Diaz, Juan Carlos; Du, Xianfeng; Gianni, Carola; Natale, Andrea

2018-01-01

Atrial fibrillation remains the most common arrhythmia worldwide, with pulmonary vein isolation (PVI) being an essential component in the treatment of this arrhythmia. In view of the close proximity of the oesophagus with the posterior wall of the left atrium, oesophageal injury prevention has become a major concern during PVI procedures. Oesophageal changes varying from erythema to fistulas have been reported, with atrio-oesophageal fistulas being the most feared as they are associated with major morbidity and mortality. This review article provides a detailed description of the risk factors associated with oesophageal injury during ablation, along with an overview of the currently available techniques to prevent oesophageal injury. We expect that this state of the art review will deliver the tools to help electrophysiologists prevent potential oesophageal injuries, as well as increase the focus on research areas in which evidence is lacking. PMID:29636969

Injury Rehabilitation Overadherence: Preliminary Scale Validation and Relationships With Athletic Identity and Self-Presentation Concerns

Science.gov (United States)

Podlog, Leslie; Gao, Zan; Kenow, Laura; Kleinert, Jens; Granquist, Megan; Newton, Maria; Hannon, James

2013-01-01

Context: Evidence suggests that nonadherence to rehabilitation protocols may be associated with worse clinical and functional rehabilitation outcomes. Recently, it has been recognized that nonadherence may not only reflect a lack of rehabilitation engagement but that some athletes may “overadhere” to their injury-rehabilitation regimen or risk a premature return to sport. Presently, no measure of overadherence exists, and correlates of overadherence and risking a premature return to sport remain uncertain. Objective: To provide initial validation of a novel injury-rehabilitation overadherence measure (study 1) and to examine correlates of overadherence and risking a premature return to sport (study 2). Design: Cross-sectional study. Setting: High school athletes (study 1) and collegiate athletes (study 2). Patients or Other Participants: In study 1, 118 currently injured US adolescent athletes competing in a range of high school sports participated. In study 2, 105 currently injured collegiate athletes (National Collegiate Athletic Association Divisions I–III) volunteered. Main Outcome Measure(s): The Rehabilitation Overadherence Questionnaire was a novel instrument developed to assess injured athletes' tendency toward overadherence behaviors and beliefs. We used an adapted version of the Injury Psychological Readiness to Return to Sport Scale to assess the tendency to risk a premature return to sport. Results: In study 1, the construct validity of the overadherence measure was supported using principal axis factoring. Moreover, bivariate correlation and regression analyses indicated that self-presentation concerns and athletic identity were positive predictors of adolescent rehabilitation overadherence and a premature return to sport. Study 2 provided support for the 2-factor structure of the overadherence measure found in study 1 via confirmatory factor analysis. Further support for the relationship among self-presentation concerns, athletic identity, and

Fetal and neonatal brain injury: mechanisms, management, and the risks of practice

National Research Council Canada - National Science Library

Stevenson, David K; Benitz, William E; Sunshine, Philip

2003-01-01

..., imaging studies, and laboratory measurements can identify the timing and severity of the injury event. Despite these advances, fetal and neonatal brain injury remains a major concern with devastating consequences. It is hoped that this definitive account will provide the clinician not only with a better understanding of the mechanisms involved but also with...

Ethnic disparities in traumatic brain injury care referral in a Hispanic-majority population.

Science.gov (United States)

Budnick, Hailey C; Tyroch, Alan H; Milan, Stacey A

2017-07-01

Functional outcomes after traumatic brain injury (TBI) can be significantly improved by discharge to posthospitalization care facilities. Many variables influence the discharge disposition of the TBI patient, including insurance status, patient condition, and patient prognosis. The literature has demonstrated an ethnic disparity in posthospitalization care referral, with Hispanics being discharged to rehabilitation and nursing facilities less often than non-Hispanics. However, this relationship has not been studied in a Hispanic-majority population, and thus, this study seeks to determine if differences in neurorehabilitation referrals exist among ethnic groups in a predominately Hispanic region. This study is a retrospective cohort that includes 1128 TBI patients who presented to University Medical Center El Paso, Texas, between the years 2005 and 2015. The patients' age, sex, race, residence, admission Glasgow Coma Scale (GCS), GCS motor, Injury Severity Score (ISS), hospital and intensive care unit length of stay (LOS), mechanism of injury, and discharge disposition were analyzed in univariate and multivariate models. Our study population had an insurance rate of 55.5%. Insurance status and markers of injury severity (hospital LOS, intensive care unit LOS, ISS, GCS, and GCS motor) were predictive of discharge disposition to rehabilitation facilities. The study population was 70% Hispanic, yet Hispanics were discharged to rehabilitation facilities (relative risk: 0.56, P: 0.001) and to long-term acute care/nursing facilities (relative risk: 0.35, P < 0.0001) less than non-Hispanics even after LOS, ISS, ethnicity, insurance status, and residence were adjusted for in multivariate analysis. This study suggests that patients of different ethnicities but comparable traumatic severity and insurance status receive different discharge dispositions post-TBI even in regions in which Hispanics are the demographic majority. Copyright © 2017 Elsevier Inc. All rights

The impact of a massive transfusion protocol (1:1:1) on major hepatic injuries: does it increase abdominal wall closure rates?

Science.gov (United States)

Ball, Chad G; Dente, Christopher J; Shaz, Beth; Wyrzykowski, Amy D; Nicholas, Jeffrey M; Kirkpatrick, Andrew W; Feliciano, David V

2013-10-01

Massive transfusion protocols (MTPs) using high plasma and platelet ratios for exsanguinating trauma patients are increasingly popular. Major liver injuries often require massive resuscitations and immediate hemorrhage control. Current published literature describes outcomes among patients with mixed patterns of injury. We sought to identify the effects of an MTP on patients with major liver trauma. Patients with grade 3, 4 or 5 liver injuries who required a massive blood component transfusion were analyzed. We compared patients with high plasma:red blood cell:platelet ratio (1:1:1) transfusions (2007-2009) with patients injured before the creation of an institutional MTP (2005-2007). Among 60 patients with major hepatic injuries, 35 (58%) underwent resuscitation after the implementation of an MTP. Patient and injury characteristics were similar between cohorts. Implementation of the MTP significantly improved plasma: red blood cell:platelet ratios and decreased crystalloid fluid resuscitation (p = 0.026). Rapid improvement in early acidosis and coagulopathy was superior with an MTP (p = 0.009). More patients in the MTP group also underwent primary abdominal fascial closure during their hospital stay (p = 0.021). This was most evident with grade 4 injuries (89% vs. 14%). The mean time to fascial closure was 4.2 days. The overall survival rate for all major liver injuries was not affected by an MTP (p = 0.61). The implementation of a formal MTP using high plasma and platelet ratios resulted in a substantial increase in abdominal wall approximation. This occurred concurrently to a decrease in the delivered volume of crystalloid fluid.

[Hypoxic brain injuries notified to the Danish Patient Insurance Association during 1992-2004. Secondary publication

DEFF Research Database (Denmark)

Bock, J.; Christoffersen, J.K.; Hedegaard, M.

2008-01-01

We investigated the files of the Danish Patient Insurance Association for newborns suffering from hypoxic brain injuries. From 1992 to 2004, a total of 127 approved claims concerning peripartum hypoxic injury were registered. Thirty-eight newborns died and the majority of the 89 surviving children...

Analysis of 127 peripartum hypoxic brain injuries from closed claims registered by the Danish Patient Insurance Association

DEFF Research Database (Denmark)

Bock, J.; Christoffersen, J.K.; Hedegaard, M.

2008-01-01

: The authors retrospectively investigated peripartum hypoxic brain injuries registered by the Danish Patient Insurance Association. RESULTS: From 1992 to 2004, 127 approved claims concerning peripartum hypoxic brain injuries were registered and subsequently analysed. Thirty-eight newborns died, and a majority...

Surgical intervention for paediatric liver injuries is almost history - a 12-year cohort from a major Scandinavian trauma centre.

Science.gov (United States)

Koyama, Tomohide; Skattum, Jorunn; Engelsen, Peder; Eken, Torsten; Gaarder, Christine; Naess, Pål Aksel

2016-11-29

Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. Patients trauma registry and medical records. A total of 66 children were included. The majority was severely injured as reflected by a median injury severity score of 20.5 (mean 22.2). NOM was attempted in 60 (90.9%) patients and was successful in 57, resulting in a NOM success rate of 95.0% [95% CI 89.3 to 100]. Only one of the three NOM failures was liver related, occurred in the early part of the study period, and consisted in operative placement of drains for bile leak. Two (3.0%) patients underwent angiographic embolization (AE). Complications occurred in 18 (27.3% [95 % CI 16.2 to 38.3]) patients. Only 2 (3.0%) patients had liver related complications, in both cases bile leak. Six (9.1%) patients underwent therapeutic laparotomy for non-liver related injuries. Two (3.0%) patients died secondary to traumatic brain injury. This single institution paediatric liver injury cohort confirms high attempted NOM and NOM success rates even in patients with high grade injuries and multiple accompanying injuries. AE can be a useful NOM adjunct in the treatment of paediatric liver injuries, but is seldom indicated. Moreover, bile leak is the most common liver-related complication and the need for liver-related surgery is very infrequent. NOM is the treatment of choice in almost all liver injuries in children, with operative management and interventional radiology very infrequently indicated.

Epidemiology and predictors of cervical spine injury in adult major trauma patients: a multicenter cohort study.

Science.gov (United States)

Hasler, Rebecca M; Exadaktylos, Aristomenis K; Bouamra, Omar; Benneker, Lorin M; Clancy, Mike; Sieber, Robert; Zimmermann, Heinz; Lecky, Fiona

2012-04-01

Patients with cervical spine injuries are a high-risk group, with the highest reported early mortality rate in spinal trauma. This cohort study investigated predictors for cervical spine injury in adult (≥ 16 years) major trauma patients using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Univariate and multivariate logistic regression analyses were used to determine predictors for cervical fractures/dislocations or cord injury. A total of 250,584 patients were analyzed. Median age was 47.2 years (interquartile range, 29.8-66.0) and Injury Severity Score 9 (interquartile range, 4-11); 60.2% were male. Six thousand eight hundred two patients (2.3%) sustained cervical fractures/dislocations alone. Two thousand sixty-nine (0.8%) sustained cervical cord injury with/without fractures/dislocations; 39.9% of fracture/dislocation and 25.8% of cord injury patients suffered injuries to other body regions. Age ≥ 65 years (odds ratio [OR], 1.45-1.92), males (females OR, 0.91; 95% CI, 0.86-0.96), Glasgow Coma Scale (GCS) score sports injuries (OR, 3.51; 95% CI, 2.87-4.31), road traffic collisions (OR, 3.24; 95% CI, 3.01-3.49), and falls >2 m (OR, 2.74; 95% CI, 2.53-2.97) were predictive for fractures/dislocations. Age sports injuries (OR, 4.42; 95% CI, 3.28-5.95), road traffic collisions (OR, 2.58; 95% CI, 2.26-2.94), and falls >2 m (OR, 2.24; 95% CI, 1.94-2.58) were predictors for cord injury. 3.5% of patients suffered cervical spine injury. Patients with a lowered GCS or systolic blood pressure, severe facial fractures, dangerous injury mechanism, male gender, and/or age ≥ 35 years are at increased risk. Contrary to common belief, head injury was not predictive for cervical spine involvement.

MAJOR INJURIES MUSCULOSKELETALS IN YOUNG ATHLETES BASKETBALL

Directory of Open Access Journals (Sweden)

José Simão Rodrigues Filho

2012-11-01

Full Text Available The growth of participation of youth in sports is accompanied by an increase in the number of musculoskeletal injuries, especially in contact sports. Basketball gained prominence among contact sports not only for its plastic and beauty of their games, but because it is a sport that demands much of its practitioners, and in the case of young athletes, this requirement can endanger children and adolescents are not properly monitored for health professionals sports. In this study we can see that the ankle is the most affected, followed by knee and fingers and wrists. The mechanisms of injury most frequently reported were sprains, after the bruises and fractures. Highlight for disturbances dorsolumbar, pointed out by many authors. The prevention programs and pre-competition oriented properly treated as paramount by all the authors investigated, in order to reduce the number of injuries in young athletes.

A matter of life or limb? A review of traumatic injury patterns and anesthesia techniques for disaster relief after major earthquakes.

Science.gov (United States)

Missair, Andres; Pretto, Ernesto A; Visan, Alexandru; Lobo, Laila; Paula, Frank; Castillo-Pedraza, Catalina; Cooper, Lebron; Gebhard, Ralf E

2013-10-01

All modalities of anesthetic care, including conscious sedation, general, and regional anesthesia, have been used to manage earthquake survivors who require urgent surgical intervention during the acute phase of medical relief. Consequently, we felt that a review of epidemiologic data from major earthquakes in the context of urgent intraoperative management was warranted to optimize anesthesia disaster preparedness for future medical relief operations. The primary outcome measure of this study was to identify the predominant preoperative injury pattern (anatomic location and pathology) of survivors presenting for surgical care immediately after major earthquakes during the acute phase of medical relief (0-15 days after disaster). The injury pattern is of significant relevance because it closely relates to the anesthetic techniques available for patient management. We discuss our findings in the context of evidence-based strategies for anesthetic management during the acute phase of medical relief after major earthquakes and the associated obstacles of devastated medical infrastructure. To identify reports on acute medical care in the aftermath of natural disasters, a query was conducted using MEDLINE/PubMed, Embase, CINAHL, as well as an online search engine (Google Scholar). The search terms were "disaster" and "earthquake" in combination with "injury," "trauma," "surgery," "anesthesia," and "wounds." Our investigation focused only on studies of acute traumatic injury that specified surgical intervention among survivors in the acute phase of medical relief. A total of 31 articles reporting on 15 major earthquakes (between 1980 and 2010) and the treatment of more than 33,410 patients met our specific inclusion criteria. The mean incidence of traumatic limb injury per major earthquake was 68.0%. The global incidence of traumatic limb injury was 54.3% (18,144/33,410 patients). The pooled estimate of the proportion of limb injuries was calculated to be 67.95%, with a

Crash test rating and likelihood of major thoracoabdominal injury in motor vehicle crashes: the new car assessment program side-impact crash test, 1998-2010.

Science.gov (United States)

Figler, Bradley D; Mack, Christopher D; Kaufman, Robert; Wessells, Hunter; Bulger, Eileen; Smith, Thomas G; Voelzke, Bryan

2014-03-01

The National Highway Traffic Safety Administration's New Car Assessment Program (NCAP) implemented side-impact crash testing on all new vehicles since 1998 to assess the likelihood of major thoracoabdominal injuries during a side-impact crash. Higher crash test rating is intended to indicate a safer car, but the real-world applicability of these ratings is unknown. Our objective was to determine the relationship between a vehicle's NCAP side-impact crash test rating and the risk of major thoracoabdominal injury among the vehicle's occupants in real-world side-impact motor vehicle crashes. The National Automotive Sampling System Crashworthiness Data System contains detailed crash and injury data in a sample of major crashes in the United States. For model years 1998 to 2010 and crash years 1999 to 2010, 68,124 occupants were identified in the Crashworthiness Data System database. Because 47% of cases were missing crash severity (ΔV), multiple imputation was used to estimate the missing values. The primary predictor of interest was the occupant vehicle's NCAP side-impact crash test rating, and the outcome of interest was the presence of major (Abbreviated Injury Scale [AIS] score ≥ 3) thoracoabdominal injury. In multivariate analysis, increasing NCAP crash test rating was associated with lower likelihood of major thoracoabdominal injury at high (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7-0.9; p NCAP side-impact crash test rating is associated with a lower likelihood of major thoracoabdominal trauma. Epidemiologic study, level III.

Chest Injuries Associated with Head Injury

African Journals Online (AJOL)

Traumatic brain injury (TBI) is a common cause of mortality and severe morbidity. Although there have been significant advances in management, associated severe injuries, in particular chest injuries, remain a major challenge. Extracranial injuries, especially chest injuries increase mortality in patients with TBI in both short.

Chest and spine radiography abnormality in blunt chest trauma correlated with major vessel injury in an unselected patient population

International Nuclear Information System (INIS)

Fernandez, G.; Kadir, S.; Encarnacion, C.

1989-01-01

To assess the true incidence of major vessel injury, the authors retrospectively reviewed all arch aortograms obtained for blunt chest trauma (BCT) during a 24-month period beginning December 1986. Aortograms were correlated with preangiographic chest radiographic and operative findings. The goals of this review were to examine the usefulness of commonly employed screening criteria for aortography and determine whether thoracic spine fractures imply a decreased likelihood of aortic injury. One hundred twenty aortograms were obtained during this period. The incidence of aortic laceration was 6.7%, and 7.5% had brachiocerebral vascular injury. Only 51% of chest radiographs were suggestive of vascular injury. Two patients with subtle radiographic findings had aortic laceration. One patient with a burst fracture of T-4 had aortic laceration. The results of this review indicate the incidence of great vessel injury is as high as that of injury to the aorta itself and that the presence of spine fractures does not exclude vascular injury

Firework injuries at a major trauma and burn center: A five-year prospective study.

Science.gov (United States)

Wang, Cheng; Zhao, Ran; Du, Wei-Li; Ning, Fang-Gang; Zhang, Guo-An

2014-03-01

In China, fireworks are an integral part of the celebration of the annual Spring Festival, but the number of injuries associated with their private use seen in emergency rooms increases dramatically. To raise awareness and help guide future prevention practices in this city, we investigated the epidemiology of firework-related injuries presented at our trauma and burn center in Beijing during the Spring Festivals of 2007-2011. Patients were interviewed using a pre-coded questionnaire to elicit information regarding age, gender, causes, injured body part, type of injury, diagnosis, and disposition. From 2007 to 2011, during the Spring Festivals 734 patients with fire-work related injuries were seen at our trauma and burn center in Beijing, the median patients of the five year were 140(136-150). The mean age of the patients was 26±15.3 years (range, 1-95 years). Of the 734 patients, the highest proportion of injuries were the 5-14 year-old age group The majority of the patients were male (87.9%), the overall male:female ratio was 7.41:1, and males were predominant in all age groups. For all 5 years, the incidence of firework-related injuries during the Spring Festival Holidays peaked specifically on the first, fifth, and last days, respectively. Injuries were mainly due to improper handling (415/610, 68.0%) or setting off illegal fireworks (195/610, 32.0%). The most frequently injured body parts were the hands and fingers (32.0%), head or face except eyes (28.3%), and trunk (22.4%). Burns were the most common type of injury (65.7%), most of the burned patients (437/453) were between 1% and 10%, and the most common region burned were hands and fingers (218/754). Contusions or lacerations were the second common type of injury (34.3%). Most of the patients (642, 87.5%) were treated and released, while 37 (5%) were treated and transferred, and 55 (7.5%) were admitted for advanced treatment. The private use of fireworks during the Spring Festival Holidays is associated

Rear impact whiplash neck injury reduction technology; Jidosha komen shototsu ni okeru muchiuchisho teigen gijutsu

Energy Technology Data Exchange (ETDEWEB)

Watanabe, Y.; Ichikawa, H.; Kayama, O. [Nissan Motor Co. Ltd., Tokyo (Japan)

1999-11-01

Even though whiplash neck injuries suffered in low-speed rear impacts are one of the major concern in traffic accidents, the mechanism of the injuries is not fully understood at present. Hence, the countermeasures have not been clear, yet. The bio-mechanical research was done to understand the injuries and three different modes of occupant's motion related to the mechanism were found. Based on this research, Nissan Active Head Restraint has been developed to reduce whiplash neck injuries in low-speed rear impacts. (author)

Traumatic brain injury in children in Denmark: a national 15-year study

DEFF Research Database (Denmark)

Engberg, A; Teasdale, T W

1998-01-01

Demographic trends are reported concerning three types of traumatic brain injury (concussions, cranial fractures, and intracranial contusions/haemorrhages) among children in Denmark of ages up to and including 14 years, for a fifteen year period from 1979 through 1993. The data were derived from...... a national computer-based hospitalization register and include 49,594 children, of whom 60% were boys and 89% had suffered a concussion. Virtually all injuries were the result of accidents. A major finding was that there has been a general decline in the incidence of traumatic brain injuries, especially...

Heading for a fall? Management of head injury in infants.

LENUS (Irish Health Repository)

Williamson, M

2010-09-01

Head injury is one of the commonest reasons for infants (< 1 year) to attend the Emergency Department (ED). Clinical management varies considerably and concern about non accidental injury results in a high admission rate in some hospitals. Information was obtained on 103 children under one year of age presenting to the ED with head injury in a prospective study. The average age was 6.7 months and 57% of patients were male. Twenty eight babies had skull x rays with 1 skull fracture diagnosed. None required CT brain scan. Ninety eight (94%) were discharged home from the ED. There were no unplanned returns, readmissions or adverse events. The incidence of traumatic brain injury in children under one year of age presenting with head injury is low and the majority can be safely discharged home.

Identification of the constituents of tar vapors injurious to plants and the differentiation of their effect from acute injuries caused by other fumes

Energy Technology Data Exchange (ETDEWEB)

Ewert, R

1916-01-01

The types of injuries that plants may incur from exposure to air pollution, as well as some factors that must be considered when diagnosing pollution damage to vegetation are discussed. The pollutants of major concern and their effects on plants are summarized. They include: sulfur dioxide, hydrochloric acid, ammonia, anthracene, and acridines.

Barriers to return to work after burn injuries.

Science.gov (United States)

Esselman, Peter C; Askay, Shelley Wiechman; Carrougher, Gretchen J; Lezotte, Dennis C; Holavanahalli, Radha K; Magyar-Russell, Gina; Fauerbach, James A; Engrav, Loren H

2007-12-01

To identify barriers to return to work after burn injury as identified by the patient. A cohort study with telephone interview up to 1 year. Hospital-based burn centers at 3 national sites. Hospitalized patients (N=154) meeting the American Burn Association criteria for major burn injury, employed at least 20 hours a week at the time of injury, and with access to a telephone after discharge. Patients were contacted via telephone every 2 weeks up to 4 months, then monthly up to 1 year after discharge. A return to work survey was used to identify barriers that prevented patients from returning to work. A graphic rating scale determined the impact of each barrier. By 1 year, 79.7% of patients returned to work. Physical and wound issues were barriers early after discharge. Although physical abilities continued to be a significant barrier up to 1 year, working conditions (temperature, humidity, safety) and psychosocial factors (nightmares, flashbacks, appearance concerns) became important issues in those with long-term disability. The majority of patients return to work after a burn injury. Although physical and work conditions are important barriers, psychosocial issues need to be evaluated and treated to optimize return to work.

Thoracic epidural analgesia reduces myocardial injury in ischemic patients undergoing major abdominal cancer surgery

Directory of Open Access Journals (Sweden)

Mohamad MF

2017-04-01

Full Text Available Mohamad Farouk Mohamad,1 Montaser A Mohammad,1 Diab F Hetta,1 Eman Hasan Ahmed,2 Ahmed A Obiedallah,3 Alaa Ali M Elzohry1 1Department of Anesthesia, ICU and Pain Relief, 2Department of Clinical Pathology, South Egypt Cancer Institute, 3Department of Internal Medicine, Faculty of Medicine, Assiut University, Arab Republic of Egypt Background and objectives: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery.Patients and methods: One hundred and twenty patients (American Society of Anesthesiologists grade II and III of either sex were scheduled for elective upper gastrointestinal cancer surgeries. Patients were allocated randomly into two groups (60 patients each to receive, besides general anesthesia: continuous intra and postoperative intravenous (IV infusion with fentanyl for 72 h postoperatively (patient controlled intravenous analgesia [PCIA] group or continuous intra and postoperative epidural infusion with bupivacaine 0.125% and fentanyl (PCEA group for 72 h postoperatively. Perioperative hemodynamics were recorded. Postoperative pain was assessed over 72 h using visual analog scale (VAS. All patients were screened for occurrence of myocardial injury (MI by electrocardiography, echocardiography, and cardiac troponin I serum level. Other postoperative complications as arrhythmia, deep venous thrombosis (DVT, pulmonary embolism, pneumonia, and death were recorded.Results: There was a significant reduction in overall adverse cardiac events (myocardial injury, arrhythmias, angina, heart failure and nonfatal cardiac arrest in PCEA group in comparison to PCIA group. Also, there was a significant reduction in dynamic VAS pain score in group PCEA in comparison

Surgical management and outcome of blunt major liver injuries: experience of damage control laparotomy with perihepatic packing in one trauma centre.

Science.gov (United States)

Lin, Being-Chuan; Fang, Jen-Feng; Chen, Ray-Jade; Wong, Yon-Cheong; Hsu, Yu-Pao

2014-01-01

This retrospective study aimed to assess the clinical experience and outcome of damage control laparotomy with perihepatic packing in the management of blunt major liver injuries. From January 1998 to December 2006, 58 patients of blunt major liver injury, American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) equal or greater than III, were operated with perihepatic packing at our institute. Demographic data, intra-operative findings, operative procedures, adjunctive managements and outcome were reviewed. To determine whether there was statistical difference between the survivor and non-survivor groups, data were compared by using Mann-Whitney U test for continuous variables, either Pearson's chi-square test or with Yates continuity correction for contingency tables, and results were considered statistically significant if phepatic artery ligation (n=11) and 7 patients required post-laparotomy hepatic transarterial embolization. Of the 58 patients, 28 survived and 30 died with a 52% mortality rate. Of the 30 deaths, uncontrolled liver bleeding in 24-h caused 25 deaths and delayed sepsis caused residual 5 deaths. The mortality rate versus OIS was grade III: 30% (6/20), grade IV: 54% (13/24), and grade V: 79% (11/14), respectively. On univariate analysis, the significant predictors of mortality were OIS grade (p=0.019), prolonged initial prothrombin time (PT) (p=0.004), active partial thromboplastin time (APTT) (p<0.0001) and decreased platelet count (p=0.005). The mortality rate of surgical blunt major liver injuries remains high even with perihepatic packing. Since prolonged initial PT, APTT and decreased platelet count were associated with high risk of mortality, we advocate combination of damage control resuscitation with damage control laparotomy in these major liver injuries. Copyright © 2013 Elsevier Ltd. All rights reserved.

Use of a Novel Accounting and Grouping Method for Major Trunk Injury-Analysis of Data from a Statewide Trauma Financial Survey.

Science.gov (United States)

Joubert, Kyla D; Mabry, Charles D; Kalkwarf, Kyle J; Betzold, Richard D; Spencer, Horace J; Spinks, Kara M; Porter, Austin; Karim, Saleema; Robertson, Ronald D; Sutherland, Michael J; Maxson, Robert T

2016-09-01

Major trunk trauma is common and costly, but comparisons of costs between trauma centers (TCs) are rare. Understanding cost is essential to improve quality, manage trauma service lines, and to facilitate institutional commitment for trauma. We have used results of a statewide trauma financial survey of Levels I to IV TC to develop a useful grouping method for costs and clinical characteristics of major trunk trauma. The trauma financial survey collected billing and clinical data on 75 per cent of the state trauma registry patients for fiscal year 2012. Cost was calculated by separately accounting for embedded costs of trauma response and verification, and then adjusting reasonable costs from the Medicare cost report for each TC. The cost-to-charge ratios were then recalculated and used to determine uniform cost estimates for each patient. From the 13,215 patients submitted for the survey, we selected 1,094 patients with major trunk trauma: lengths of stay ≥ 48 hours and a maximum injury of AIS ≥3 for either thorax or abdominal trauma. These patients were then divided into three Injury Severity Score (ISS) groups of 9 to 15, 16 to 24, or 25+ to stratify patients into similar injury groups for analysis of cost and cost drivers. For abdominal injury, average total cost for patients with ISS 9 to 15 was $17,429. Total cost and cost per day increased with severity of injury, with $51,585 being the total cost for those with ISS 25. Similar trends existed for thoracic injury. Use of the Medicare cost report and cost-to-charge ratios to compute uniform costs with an innovative grouping method applied to data collected across a statewide trauma system provides unique information regarding cost and outcomes, which affects quality improvement, trauma service line management, and decisions on TC participation.

The effects of social concern goals on the value of learning and on the intentions of medical students to change their majors.

Science.gov (United States)

Park, Soowon; Cho, Seunghee; Lee, Jun-Young

2017-01-01

In the process of developing a professional medical expertise, goals can become a psychological impetus and act as a source of retaining an individual's persistency. Therefore, the goals of medical students should be considered when designing a curriculum for health professions. The purpose of this study was to examine relative effects of goal categories on the value of learning and intention to change one's major. Data were obtained from the Korea Education Longitudinal Study, which included 1938 representative Korean college freshmen majoring in medicine, engineering, natural science and humanities. They answered a survey questionnaire about goal categories (i.e., social concern, affiliation, self-growth, leisure, wealth, and fame), the value of learning, and intention to change one's major. For medical students, social concern goals were positively related to the value of learning and negatively related to the intention to change one's major. Social concern goals decreased the intention to change one's major directly, and also indirectly through increased value of learning. Providing context for enhancing medical students' social concern goals is necessary in a medical training curriculum, not only for the students' professional development but also for improving society. GCT: Goal contents theory GPA: Grade point average KELS: Korea education longitudinal study SDLA: Self-directed learning abilities SDT: Self-determination theory.

Epidemiological Review of Injury in Pre-Professional Ballet Dancers.

Science.gov (United States)

Caine, Dennis; Goodwin, Brett J; Caine, Caroline G; Bergeron, Glen

2015-12-01

The objective of this study was to provide an epidemiological review of the literature concerning ballet injuries affecting pre-professional ballet dancers. The literature search was limited to published peer-reviewed reports and involved an extensive examination of Scopus, SPORTDiscus, and CINAHL. The following search terms were used in various combinations: ballet, injury, epidemiology, risk factor, pre-professional, and intervention. Additional citations were located using the ancestry approach. Unlike some other athletic activities that have been the focus of recent intervention research, there is a paucity of intervention and translational research in pre-professional ballet, and sample sizes have often been small and have not accounted for the multivariate nature of ballet injury. Exposure-based injury rates in this population appear similar to those reported for professional ballet dancers and female gymnasts. A preponderance of injuries affect the lower extremity of these dancers, with sprains and strains being the most frequent type of injury reported. The majority of injuries appear to be overuse in nature. Injury risk factors have been tested in multiple studies and indicate a variety of potential injury predictors that may provide useful guidance for future research.

Preliminary Study on Non-Fatal Occupational Injury among Operational Workers in Malaysia Palm Oil Mill

Directory of Open Access Journals (Sweden)

Ruslan Rumaizah

2017-01-01

Full Text Available Non-fatal occupational injury had becoming major global concern and its consequences to safety and health would be heavily burdening. The aim of this preliminary study was to investigate the distribution of non-fatal occupational injury among specific group of workers in palm oil mill and to acknowledge potential factors of injury causation. A questionnaire survey was designed to assess injury involvement during the employment period among operational workers of palm oil mill located in Southern Peninsular Malaysia. Thirty three (n= 33 workers volunteered and completed the questionnaire. Prevalence of injury among palm oil mill workers was 39.4% with sprain and burn were the common types of injury reported. Press Plant workers reported to have high cases of injuries. Majority of workers (78.8% stated noise was the main hazard in the palm oil mill, followed by heat hazard. Press Plant was identified as one of the specific risk group in palm oil mill based on the rate of injury occurrences reported by the workers. Exposure to noise hazard was estimated to be one of the potential factors of injury causation and further study should be made to measure the risk of hazard.

Outcome measurements in major trauma--results of a consensus meeting.

Science.gov (United States)

Ardolino, A; Sleat, G; Willett, K

2012-10-01

The NHS Outcomes Framework for England has identified recovery from major injury as an important clinical area. At present, there are no established outcome indicators. As more patients survive major trauma, outcomes will need to be measured in terms of morbidity and not mortality alone. To make recommendations for a selection of outcome measures that could be integrated into National Clinical Audit data collection and form part of clinical governance requirements for Regional Trauma Networks (RTNs) and measures by which RTNs are held to account by government. Specific focus was given to acute care and rehabilitation for both adults and children. A Multiprofessional, multidisciplinary expert group reviewed the current evidence on outcome measures for major trauma in the adult and children's populations, informed by a systematic review carried out jointly by the Trauma Audit and Research Network (TARN) and the Cochrane Injuries Group. A structured discussion covered functional and quality of life outcome measures as well as patient experience and indicators such as return to work, education and social dependency. For the adult population the group agreed with the in-hospital performance and hospital discharge measures recommended in the TARN and Cochrane systematic review. Concerning longer-term outcome indicators, the group suggested the use of the Glasgow Outcome Scale - Extended (GOS-E) and European Quality of Life 5D (EQ-5D) with consideration to be given to the World Health Organisation Quality of Life survey (WHO-QoL). For patients who had ongoing inpatient rehabilitation needs the group thought the measurement of the Rehabilitation Complexity Scale (RCS) and Functional Independence Measure (FIM) were important in total brain injury and, the American Spinal Injury Association Impairment Scale (ASIA) and Spinal Cord Independence Measure (SCIM) in spinal cord injury. For children the group recommended the use of the King's Outcome Scale for Childhood Head Injury

Injury timing alters metabolic, inflammatory and functional outcomes following repeated mild traumatic brain injury.

Science.gov (United States)

Weil, Zachary M; Gaier, Kristopher R; Karelina, Kate

2014-10-01

Repeated head injuries are a major public health concern both for athletes, and members of the police and armed forces. There is ample experimental and clinical evidence that there is a period of enhanced vulnerability to subsequent injury following head trauma. Injuries that occur close together in time produce greater cognitive, histological, and behavioral impairments than do injuries separated by a longer period. Traumatic brain injuries alter cerebral glucose metabolism and the resolution of altered glucose metabolism may signal the end of the period of greater vulnerability. Here, we injured mice either once or twice separated by three or 20days. Repeated injuries that were separated by three days were associated with greater axonal degeneration, enhanced inflammatory responses, and poorer performance in a spatial learning and memory task. A single injury induced a transient but marked increase in local cerebral glucose utilization in the injured hippocampus and sensorimotor cortex, whereas a second injury, three days after the first, failed to induce an increase in glucose utilization at the same time point. In contrast, when the second injury occurred substantially later (20days after the first injury), an increase in glucose utilization occurred that paralleled the increase observed following a single injury. The increased glucose utilization observed after a single injury appears to be an adaptive component of recovery, while mice with 2 injuries separated by three days were not able to mount this response, thus this second injury may have produced a significant energetic crisis such that energetic demands outstripped the ability of the damaged cells to utilize energy. These data strongly reinforce the idea that too rapid return to activity after a traumatic brain injury can induce permanent damage and disability, and that monitoring cerebral energy utilization may be a tool to determine when it is safe to return to the activity that caused the initial

Etiology of Infectious Complications and Antibiotic-Resistance of Major Causative Agents in Victims with Severe Injury

Directory of Open Access Journals (Sweden)

T. A. Vasina

2007-01-01

Full Text Available Objective: to analyze the spectrum of major pathogens of infectious complications in patients with concomitant injury.Materials and methods. 560 biological samples taken from 331 patients were bacteriologically studied. A significant reduction in the isolation frequency of Pseudomonas aeruginosa and an increase in etiological role of Staphylococcus aureus were ascertained in victims with severe injury and concomitant infectious complications during long-term 1982—1984 and 2002—2004 follow-ups.Results. The significant pathogens of infectious complications in concomitant injuries are Staphylococcus aureus, Klebsiella and Escherichia coli. Vancomycin, imipenem/cilastatin, and amikacin are shown to be the most effective drugs for early antibiotic therapy. Thus, the findings reflect structural changes in the leading causative agents of infectious complications in victims with severe injury. If their principal pathogen was Pseudomonas aeruginosa in the 1990s, Staphylococcus aureus and representatives in the colibacillus group prevail today. This supports and generates a need for continuous microbiological monitoring of the causative agents of pyoin-flammatory complications in intensive care units wherein patients with immunosuppression are also present. Pathogen monitoring makes it possible to apply of a well-grounded and rational package of preventive and therapeutic measures and to perform early target antibiotic therapy. 

Trampolines revisited: a review of 114 pediatric recreational trampoline injuries.

Science.gov (United States)

Woodward, G A; Furnival, R; Schunk, J E

1992-05-01

A search of the medical literature failed to reveal any articles that discuss pediatric injuries acquired on privately owned recreational trampolines. This study was undertaken to quantify and qualify pediatric injuries from recreational trampoline use. A group of 114 patients who presented to the Emergency Department at Primary Children's Medical Center in Salt Lake City, Utah, with injuries directly related to use of a trampoline are discussed. There was a 1.2:1 male-female ratio. The average age was 8.0 years. Forty-eight percent of the patients were injured on their family's trampoline, with the remainder injured on a friend's, neighbor's, relative's, or gymnasium's equipment. The majority of injuries involved group use of the trampoline and the youngest person in a group was most often the injured participant. Extremity injuries were seen in 55% of the patient and head or neck injuries in 37%. Seventy-five percent of the patients required radiographs, 23% hospitalization, and 17% operative intervention. The history of the trampoline and medical literature discussions concerning injuries and safety are reviewed.

Analysis of National Major Work Safety Accidents in China, 2003-2012.

Science.gov (United States)

Ye, Yunfeng; Zhang, Siheng; Rao, Jiaming; Wang, Haiqing; Li, Yang; Wang, Shengyong; Dong, Xiaomei

2016-01-01

This study provides a national profile of major work safety accidents in China, which cause more than 10 fatalities per accident, intended to provide scientific basis for prevention measures and strategies to reduce major work safety accidents and deaths. Data from 2003-2012 Census of major work safety accidents were collected from State Administration of Work Safety System (SAWS). Published literature and statistical yearbook were also included to implement information. We analyzed the frequency of accidents and deaths, trend, geographic distribution and injury types. Additionally, we discussed the severity and urgency of emergency rescue by types of accidents. A total of 877 major work safety accidents were reported, resulting in 16,795 deaths and 9,183 injuries. The numbers of accidents and deaths, mortality rate and incidence of major accidents have declined in recent years. The mortality rate and incidence was 0.71 and 1.20 per 10(6) populations in 2012, respectively. Transportation and mining contributed to the highest number of major accidents and deaths. Major aviation and railway accidents caused more casualties per incident, while collapse, machinery, electrical shock accidents and tailing dam accidents were the most severe situation that resulted in bigger proportion of death. Ten years' major work safety accident data indicate that the frequency of accidents and number of eaths was declined and several safety concerns persist in some segments.

An inferential and descriptive statistical examination of the relationship between cumulative work metrics and injury in Major League Baseball pitchers.

Science.gov (United States)

Karakolis, Thomas; Bhan, Shivam; Crotin, Ryan L

2013-08-01

In Major League Baseball (MLB), games pitched, total innings pitched, total pitches thrown, innings pitched per game, and pitches thrown per game are used to measure cumulative work. Often, pitchers are allocated limits, based on pitches thrown per game and total innings pitched in a season, in an attempt to prevent future injuries. To date, the efficacy in predicting injuries from these cumulative work metrics remains in question. It was hypothesized that the cumulative work metrics would be a significant predictor for future injury in MLB pitchers. Correlations between cumulative work for pitchers during 2002-07 and injury days in the following seasons were examined using regression analyses to test this hypothesis. Each metric was then "binned" into smaller cohorts to examine trends in the associated risk of injury for each cohort. During the study time period, 27% of pitchers were injured after a season in which they pitched. Although some interesting trends were noticed during the binning process, based on the regression analyses, it was found that no cumulative work metric was a significant predictor for future injury. It was concluded that management of a pitcher's playing schedule based on these cumulative work metrics alone could not be an effective means of preventing injury. These findings indicate that an integrated approach to injury prevention is required. This approach will likely involve advanced cumulative work metrics and biomechanical assessment.

Analysis of National Major Work Safety Accidents in China, 2003–2012

Science.gov (United States)

YE, Yunfeng; ZHANG, Siheng; RAO, Jiaming; WANG, Haiqing; LI, Yang; WANG, Shengyong; DONG, Xiaomei

2016-01-01

Background: This study provides a national profile of major work safety accidents in China, which cause more than 10 fatalities per accident, intended to provide scientific basis for prevention measures and strategies to reduce major work safety accidents and deaths. Methods: Data from 2003–2012 Census of major work safety accidents were collected from State Administration of Work Safety System (SAWS). Published literature and statistical yearbook were also included to implement information. We analyzed the frequency of accidents and deaths, trend, geographic distribution and injury types. Additionally, we discussed the severity and urgency of emergency rescue by types of accidents. Results: A total of 877 major work safety accidents were reported, resulting in 16,795 deaths and 9,183 injuries. The numbers of accidents and deaths, mortality rate and incidence of major accidents have declined in recent years. The mortality rate and incidence was 0.71 and 1.20 per 106 populations in 2012, respectively. Transportation and mining contributed to the highest number of major accidents and deaths. Major aviation and railway accidents caused more casualties per incident, while collapse, machinery, electrical shock accidents and tailing dam accidents were the most severe situation that resulted in bigger proportion of death. Conclusion: Ten years’ major work safety accident data indicate that the frequency of accidents and number of eaths was declined and several safety concerns persist in some segments. PMID:27057515

A booming economy means a bursting trauma system: association between hospital admission for major injury and indicators of economic activity in a large Canadian health region.

Science.gov (United States)

Roberts, Derek J; Das, Debanjana; Mercado, Michelle; Vis, Christine; Kortbeek, John B; Kirkpatrick, Andrew W; Ball, Chad G

2014-05-01

Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 16-year period using linear regression. An increased risk of injured patient admissions was associated with rising mean gross domestic product (GDP [millions of chained 2002 dollars]) (.36 person increase per 100,000 population/$1,000 increase in GDP; P = .001) and annual gasoline prices (.47 person increase per 100,000 population/cent increase in gasoline price; P = .001). Recreation-related vehicle injuries were also associated with economic affluence. The risk of trauma patient mortality with increasing mean annual GDP (P = .72) and gasoline prices (P = .32) remained unchanged. Hospital admissions for major injury, but not trauma patient mortality, were associated with economic activity in a large Canadian health care region. Copyright © 2014 Elsevier Inc. All rights reserved.

'Do as we say, not as we do:' a cross-sectional survey of injuries in injury prevention professionals.

Science.gov (United States)

Ezzat, Allison; Brussoni, Mariana; Schneeberg, Amy; Jones, Sarah J

2014-06-01

As the leading cause of death and among the top causes of hospitalisation in Canadians aged 1-44 years, injury is a major public health concern. Little is known about whether knowledge, training and understanding of the underlying causes and mechanisms of injury would help with one's own prevention efforts. Based on the Theory of Planned Behaviour, we hypothesised that injury prevention professionals would experience fewer injuries than the general population. An online cross-sectional survey was distributed to Canadian injury prevention practitioners, researchers and policy makers to collect information on medically attended injuries. Relative risk of injury in the past 12 months was calculated by comparing the survey data with injury incidence reported by a comparable subgroup of adults from the (Canadian Community Health Survey (CCHS)) from 2009 to 2010. We had 408 injury prevention professionals complete the survey: 344 (84.5%) women and 63 (15.5%) men. In the previous 12 months, 86 individuals reported experiencing at least one medically attended injury (21,235 people per 100,000 people); with sports being the most common mechanism (41, 33.6%). Fully 84.8% individuals from our sample believed that working in the field had made them more careful. After accounting for age distribution, education level and employment status, injury prevention professionals were 1.69 (95% CI 1.41 to 2.03) times more likely to be injured in the past year. Despite their convictions of increasing their own safety behaviour and that of others, injury prevention professionals' knowledge and training did not help them prevent their own injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Traffic Accidents in Kosovo – A Major Concern for Kosovo

Directory of Open Access Journals (Sweden)

Merita Muharremi

2017-03-01

Full Text Available The number of traffic c accidents in Kosovo is increasing rapidly from year to year. As a result of traffi c accidents the number of injured and deaths has increased. During the period of January-December 2016 there were 18541 accidents, which resulted in 110 casualties (Kosovo Police Annual Reports. Campaigns undertaken by the Government of Kosovo, Ministry of Infrastructure and Transport and the Kosovo Police, as well as various video-spots intended to raise awareness of the dangers of traffic c accidents have not accomplished the expected results and did not reduce the number of accidents. Therefore, we can conclude that the number of accidents taking place in Kosovo is concerning. Despite the best efforts of relevant institutions, despite the increased engagement to pass legislation, which would be in line with the European standards, and despite substantial improvements and major investments on the infrastructure, and despite all the measures taken, reducing the number of road accidents remains a significant challenge. With this paper, I will try to draw attention to the actions, measures and activities that I consider the relevant institutions of Kosovo should focus on in order to prevent and to reduce the high number of traffic accidents.

Transcriptional Changes in the Mouse Retina after Ocular Blast Injury: A Role for the Immune System.

Science.gov (United States)

Struebing, Felix L; King, Rebecca; Li, Ying; Chrenek, Micah A; Lyuboslavsky, Polina N; Sidhu, Curran S; Iuvone, P Michael; Geisert, Eldon E

2018-01-01

Ocular blast injury is a major medical concern for soldiers and explosion victims due to poor visual outcomes. To define the changes in gene expression following a blast injury to the eye, we examined retinal ribonucleic acid (RNA) expression in 54 mouse strains 5 days after a single 50-psi overpressure air wave blast injury. We observe that almost 40% of genes are differentially expressed with a false discovery rate (FDR) of immune system are activated. Accompanied by lymphocyte invasion into the inner retina, blast injury also results in progressive loss of visual function and retinal ganglion cells (RGCs). Collectively, these data demonstrate how systems genetics can be used to put meaning to the transcriptome changes following ocular blast injury that eventually lead to blindness.

Injury prevention: a strategic priority for environmental health?

Science.gov (United States)

Stone, D H; Morris, G P

2010-10-01

Injury results from the acute transfer of energy (or the acute lack of a vital element) from the environment to human tissue. It is thus, ipso facto, an 'environmental health' issue par excellence. This paper argues that injury consequently deserves consideration as a major strategic priority by environmental health professionals. Two international agreements concerning children's health and the environment have major implications for safety. The Children's Environmental Health Action Plan for Europe (CEHAPE) and the European Environmental Health Strategy make reference to the need for improved evidence and greater co-operation between the environmental and health sectors. CEHAPE is particularly relevant to safety as it focuses on four regional priority goals, the second of which refers to the prevention and reduction of health consequences from injuries by promoting safe, secure and supportive human settlements for all children. The natural strategic 'home' for injury prevention may therefore lie within environmental health, a domain from which it has generally been excluded. In support of this assertion, Scotland's recent policy initiative on the environment and human health 'Good Places, Better Health' is cited, where injury in children up to 8 years of age is one of four child health priorities being tackled during its initial implementation. An important test of the initiative may be its capacity to inform policy, practice and research in the field of injury prevention and safety promotion. If successful, it will help to validate the environmental health approach to a field that remains relatively neglected by public agencies, policy makers, practitioners and researchers. Copyright © 2010 The Royal Institute of Public Health. All rights reserved.

Quality of Life Following Brain Injury: Perspectives from Brain Injury Association of America State Affiliates

Science.gov (United States)

Degeneffe, Charles Edmund; Tucker, Mark

2012-01-01

Objective: to examine the perspectives of brain injury professionals concerning family members' feelings about the quality of life experienced by individuals with brain injuries. Participants: participating in the study were 28 individuals in leadership positions with the state affiliates of the Brain Injury Association of America (BIAA). Methods:…

Craniomaxillofacial falling bullet injuries and management.

Science.gov (United States)

Shuker, Sabri T; Sadda, Raid

2010-07-01

The purpose of this study was to bring attention to craniocerebral maxillofacial perforating/penetrating injuries due to AK-47 Kalashnikov falling bullets (FBs); these dangerous injuries to both civilians and soldiers are rare. A review of the literature shows no reports on AK-47 FBs leading to double craniocerebral perforation and settling into the maxillofacial region. The number of victims, the AK-47's availability, the associated morbidity and mortality rates, and the rarity of cases prompted this article. The treatment of injuries to the craniocerebral facial clinical profile due to FBs is challenging, and an understanding of the neurosurgical and maxillofacial management of these low-velocity FB injuries is required. We treated 11 cases due to AK-47 rifle FBs and 1 due to anti-aircraft Dashka 12.7-mm FBs. Craniocerebral facial injuries were treated and lodged bullets removed from different challenging locations in the base of the skull, without increasing morbidity and with avoidance of unnecessary surgical trauma to the affected area by the bullets. The required identification of such injuries can be difficult, and the removal of the lodged bullet to prevent secondary complications and reduce the chance of secondary infection can be graver than in other parts of the body. AK-47 FBs are a major public health concern internationally and require serious attention in terms of protection and management for civilians and soldiers in uniform. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Scarf-related injuries at a major trauma center in northern India

Directory of Open Access Journals (Sweden)

Pritish Singh

2017-04-01

Conclusion: Scarf-related injuries constitute a sizable proportion of trauma, with varying degrees of severity. Devastating consequences in significant proportion of cases dictate the call for a prevention plan comprising both educational and legislative measures. Urgent preventive measures targeting scarf-related injuries will help reduce mortality and morbidity.

Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know.

Science.gov (United States)

Jaschke, Werner; Schmuth, Matthias; Trianni, Annalisa; Bartal, Gabriel

2017-08-01

For a long time, radiation-induced skin injuries were only encountered in patients undergoing radiation therapy. In diagnostic radiology, radiation exposures of patients causing skin injuries were extremely rare. The introduction of fast multislice CT scanners and fluoroscopically guided interventions (FGI) changed the situation. Both methods carry the risk of excessive high doses to the skin of patients resulting in skin injuries. In the early nineties, several reports of epilation and skin injuries following CT brain perfusion studies were published. During the same time, several papers reported skin injuries following FGI, especially after percutaneous coronary interventions and neuroembolisations. Thus, CT and FGI are of major concern regarding radiation safety since both methods can apply doses to patients exceeding 5 Gy (National Council on Radiation Protection and Measurements threshold for substantial radiation dose level). This paper reviews the problem of skin injuries observed after FGI. Also, some practical advices are given how to effectively avoid skin injuries. In addition, guidelines are discussed how to deal with patients who were exposed to a potentially dangerous radiation skin dose during medically justified interventional procedures.

Injuries in Competitive Dragon Boating.

Science.gov (United States)

Mukherjee, Swarup; Leong, Hin Fong; Chen, Simin; Foo, Yong Xiang Wayne; Pek, Hong Kiat

2014-11-01

Dragon boating is a fast-growing team water sport and involves forceful repetitive motions that predispose athletes to overuse injuries. Despite the rising popularity of the sport, there is a lack of studies on injury epidemiology in dragon boating. To investigate the injury epidemiology in competitive dragon boating athletes. Descriptive epidemiological study. A total of 95 dragon boaters (49 males, 46 females) representing their respective universities took part in this study. Data were collected retrospectively using a reliable and valid self-report questionnaire. The study period was from August 2012 to July 2013. A total of 104 musculoskeletal injuries were reported (3.82 injuries/1000 athlete-exposures), 99% of which occurred during training. The most commonly injured regions were the lower back (22.1%), shoulder (21.1%), and wrist (17.3%). The majority of injuries were due to overuse (56.3%), and incomplete muscle-tendon strain was the most prevalent type of injury (50.5%). The time loss from injuries varied. In addition, a significant majority of the dragon boating athletes incurred nonmusculoskeletal injuries, with abrasions (90.5%), blisters (78.9%), and sunburns (72.6%) being the most common. Competitive dragon boating has a moderately high injury incidence, and there seems to be a direct relationship between exposure time and injury rate. A majority of the injuries are overuse in nature, and the body parts most actively involved in paddling movement are at higher risk of injuries. The high incidence of nonmusculoskeletal injuries in dragon boaters suggested that these injuries are likely outcomes of participation in the sport.

Strengthening Injury Surveillance System in Iran

Institute of Scientific and Technical Information of China (English)

Seyed Abbas Motevalian; Mashyaneh Haddadi; Hesam Akbari; Reza Khorramirouz; Soheil Saadat; Arash Tehrani; Vafa Rahimi-Movaghar

2011-01-01

Objective:To strengthen the current Injury Surveillance System (IS System) in order to better monitor injury conditions,improve protection ways and promote safety.Methods:At first we carried out a study to evaluate the frameworks of IS System in the developed countries.Then all the available documents from World Health OrganizationEastern Mediterranean Regional Organization,as well as Minister of Health and Medical Education concerning Iran were reviewed.Later a national stakeholder's consultation was held to collect opinions and views.A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance.Results:The evaluation of the current IS System revealed many problems,mainly presented as lack of accurate pre- and post-hospital death registry,need of precise injury data registry in outpatient medical centers,incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry.The five main characteristics of current IS System including flexibility,acceptability,simplicity,usefulness and timeliness were evaluated as moderate by experts.Contusions:Major revisions must be considered in the current IS System in Iran.The following elements should be added to the questionnaire:identifier,manner of arrival to the hospital,situation of the injured patient,consumption of alcohol and opioids,other involved participants in the accident,intention,severity and site of injury,side effects of surgery and medication,as well as one month follow-up results.Data should be collected from 10％ of all hospitals in Iran and analyzed every 3 months.Simultaneously data should be online to be retrieved by researches.

Musculoskeletal injuries among Malaysian badminton players.

Science.gov (United States)

Shariff, A H; George, J; Ramlan, A A

2009-11-01

The purpose of this study was to investigate the pattern of musculoskeletal injuries sustained by Malaysian badminton players. This is a retrospective case notes review of all badminton players who attended the National Sports Institute (NSI) Clinic, Kuala Lumpur, Malaysia, and were diagnosed with musculoskeletal injuries. In a two and a half year period, from January 2005 to June 2007, 469 musculoskeletal injuries were diagnosed among badminton players at the NSI Clinic. The mean age of the players who attended the clinic was 19.2 (range 13-52) years. Approximately 60 percent of the injuries occurred in players younger than 20 years of age. The majority of injuries (91.5 percent) were categorised as mild overuse injury and mostly involved the knee. The majority of the injuries sustained by badminton players in this study were due to overuse, primarily in the knee. The majority of the injuries were diagnosed in younger players and occurred during training/practice sessions. There was no difference in terms of incidence and types of injuries between the genders.

Crash protectiveness to occupant injury and vehicle damage: An investigation on major car brands.

Science.gov (United States)

Huang, Helai; Li, Chunyang; Zeng, Qiang

2016-01-01

This study sets out to investigate vehicles' crash protectiveness on occupant injury and vehicle damage, which can be deemed as an extension of the traditional crash worthiness. A Bayesian bivariate hierarchical ordered logistic (BVHOL) model is developed to estimate the occupant protectiveness (OP) and vehicle protectiveness (VP) of 23 major car brands in Florida, with considering vehicles' crash aggressivity and controlling external factors. The proposed model not only takes over the strength of the existing hierarchical ordered logistic (HOL) model, i.e. specifying the order characteristics of crash outcomes and cross-crash heterogeneities, but also accounts for the correlation between the two crash responses, driver injury and vehicle damage. A total of 7335 two-vehicle-crash records with 14,670 cars involved in Florida are used for the investigation. From the estimation results, it's found that most of the luxury cars such as Cadillac, Volvo and Lexus possess excellent OP and VP while some brands such as KIA and Saturn perform very badly in both aspects. The ranks of the estimated safety performance indices are even compared to the counterparts in Huang et al. study [Huang, H., Hu, S., Abdel-Aty, M., 2014. Indexing crash worthiness and crash aggressivity by major car brands. Safety Science 62, 339-347]. The results show that the rank of occupant protectiveness index (OPI) is relatively coherent with that of crash worthiness index, but the ranks of crash aggressivity index in both studies is more different from each other. Meanwhile, a great discrepancy between the OPI rank and that of vehicle protectiveness index is found. What's more, the results of control variables and hyper-parameters estimation as well as comparison to HOL models with separate or identical threshold errors, demonstrate the validity and advancement of the proposed model and the robustness of the estimated OP and VP. Copyright © 2015 Elsevier Ltd. All rights reserved.

Strengthening Injury Surveillance System in Iran

Directory of Open Access Journals (Sweden)

Motevalian Seyed Abbas

2012-02-01

Full Text Available 【Abstract】Objective: To strengthen the current Injury Surveillance System (IS System in order to better monitor injury conditions, improve protection ways and promote safety. Methods: At first we carried out a study to evaluate the frameworks of IS System in the developed countries. Then all the available documents from World Health Organization, Eastern Mediterranean Regional Organization, as well as Minister of Health and Medical Education concerning Iran were reviewed. Later a national stakeholder抯 consultation was held to collect opinions and views. A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance. Results: The evaluation of the current IS System revealed many problems, mainly presented as lack of accurate pre- and post-hospital death registry, need of precise injury data registry in outpatient medical centers, incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry. The five main characteristics of current IS System including flexibility, acceptability, simplicity, usefulness and timeliness were evaluated as moderate by experts. Conclusions: Major revisions must be considered in the current IS System in Iran. The following elements should be added to the questionnaire: identifier, manner of arrival to the hospital, situation of the injured patient, consumption of alcohol and opioids, other involved participants in the accident, intention, severity and site of injury, side effects of surgery and medication, as well as one month follow-up results. Data should be collected from 10% of all hospitals in Iran and analyzed every 3 months. Simultaneously data should be online to be retrieved by researches. Key words: Wounds and injuries; Population surveillance; Registries; Iran

Effects of a lighter, smaller football on Acute match injuries in adolescent female football

DEFF Research Database (Denmark)

Zebis, Mette K.; Thorborg, Kristian; Andersen, Lars L.

2018-01-01

BACKGROUND: The high injury incidence during match-play in female adolescent football is a major concern. In football, males and females play matches with the same football size. No studies have investigated the effect of football size on injury incidence in female adolescent football. Thus......, the aim of the present study was to investigate the effects of introducing a lighter, smaller football on the injury pattern in female adolescent football. METHODS We conducted a pilot cluster randomized controlled trial including 26 football teams representing 346 adolescent female football players (age...... 15-18 years). The teams were randomized to a new lighter, smaller football (INT, N.=12 teams) or a traditional FIFA size 5 football (CON, N.=14 teams) during a full match-season. Acute time-loss injuries and football-exposure during match-play were reported weekly by text-message questions...

State-of-the-Art Techniques in Treating Peripheral Nerve Injury.

Science.gov (United States)

Kubiak, Carrie A; Kung, Theodore A; Brown, David L; Cederna, Paul S; Kemp, Stephen W P

2018-03-01

Peripheral nerve injuries remain a major clinical concern, as they often lead to chronic disability and significant health care expenditures. Despite advancements in microsurgical techniques to enhance nerve repair, biological approaches are needed to augment nerve regeneration and improve functional outcomes after injury. Presented herein is a review of the current literature on state-of-the-art techniques to enhance functional recovery for patients with nerve injury. Four categories are considered: (1) electroceuticals, (2) nerve guidance conduits, (3) fat grafting, and (4) optogenetics. Significant study results are highlighted, focusing on histologic and functional outcome measures. This review documents the current state of the literature. Advancements in neuronal stimulation, tissue engineering, and cell-based therapies demonstrate promise with regard to augmenting nerve regeneration and appropriate rehabilitation. The future of treating peripheral nerve injury will include multimodality use of electroconductive conduits, fat grafting, neuronal stimulation, and optogenetics. Further clinical investigation is needed to confirm the efficacy of these technologies on peripheral nerve recovery in humans, and how best to implement this treatment for a diverse population of nerve-injured patients.

The clinical profile of musculoskeletal injuries in children attending a major hospital in Delhi, India.

Science.gov (United States)

Sural, Sumit; Verma, Anu

2015-03-01

Children are vulnerable to musculoskeletal injuries both at home and on the street for various reasons. Morbidity and disabilities resulting from these, mostly preventable, injuries, make them a burden to their families and society. The role of various factors associated with injuries is often not documented. This prospective study, done on 100 children aged up to 12 years with musculoskeletal trauma, analysed in details, the various modes of injuries. One in every five patient was a child below 12 years of age. Boys were injured more than girls. Injuries, especially fractures, were most common in the extremities, the upper limb more commonly injured than the lower limb. Most of the injuries occurred at home. The most common mode of injuries was falls that happened while playing both within and outside the home, followed by road traffic accidents. Most injuries occurred during daytime. Injuries in children were found to be preventable. Small interventions while constructing homes can contribute tremendously to injury prevention and control in children. Parental awareness about the various modes of injury, role of supervised playing and their responsibility towards injury prevention can play a key role in reducing the morbidity associated with childhood fractures.

Injury prevention in football

African Journals Online (AJOL)

other sports,[1,2] and youth football players are no exception to this. ... at risk of sports injury because of high levels of exposure at a time of major physiological change.[4] The ..... As part of injury prevention, adequate injury management and.

Alpine ski and snowboarding traumatic injuries: incidence, injury patterns, and risk factors for 10 years.

Science.gov (United States)

McBeth, Paul B; Ball, Chad G; Mulloy, Robert H; Kirkpatrick, Andrew W

2009-05-01

Alpine skiing and snowboarding are popular winter sports in Canada. Every year participation in these activities results in traumatic injury. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with ski and snowboarding injuries. A comprehensive 10-year retrospective review of Alpine ski and snowboarding injuries from 1996 to 2006 was conducted. The Alberta Trauma Registry was used as the primary source of data. A total of 196 patients (56.6% skiers, 43.4% snowboarders) were identified as having major traumatic injuries (Injury Severity Score, >or=12). Forty-three patients required intensive care unit support. The majority of injuries were related to falls and collisions with natural objects. Head injuries were most common, followed by chest, spinal, and extremity trauma. Seventy-nine patients required emergency surgery. Skiing and snowboarding represent activities with high potential for traumatic injury. Safety initiatives should be developed to target this population.

Major League Baseball pitch velocity and pitch type associated with risk of ulnar collateral ligament injury.

Science.gov (United States)

Keller, Robert A; Marshall, Nathan E; Guest, John-Michael; Okoroha, Kelechi R; Jung, Edward K; Moutzouros, Vasilios

2016-04-01

The number of Major League Baseball (MLB) pitchers requiring ulnar collateral ligament (UCL) reconstructions is increasing. Recent literature has attempted to correlate specific stresses placed on the throwing arm to risk for UCL injury, with limited results. Eighty-three MLB pitchers who underwent primary UCL reconstruction were evaluated. Pitching velocity and percent of pitch type thrown (fastball, curve ball, slider, and change-up) were evaluated 2 years before and after surgery. Data were compared with control pitchers matched for age, position, size, innings pitched, and experience. The evaluation of pitch velocity compared with matched controls found no differences in pre-UCL reconstruction pitch velocities for fastballs (91.5 vs. 91.2 miles per hour [mph], P = .69), curveballs (78.2 vs. 77.9 mph, P = .92), sliders (83.3 vs. 83.5 mph, P = .88), or change-ups (83.9 vs. 83.8 mph, P = .96). When the percentage of pitches thrown was evaluated, UCL reconstructed pitchers pitch significantly more fastballs than controls (46.7% vs. 39.4%, P = .035). This correlated to a 2% increase in risk for UCL injury for every 1% increase in fastballs thrown. Pitching more than 48% fastballs was a significant predictor of UCL injury, because pitchers over this threshold required reconstruction (P = .006). MLB pitchers requiring UCL reconstruction do not pitch at higher velocities than matched controls, and pitch velocity does not appear to be a risk factor for UCL reconstruction. However, MLB pitchers who pitch a high percentage of fastballs may be at increased risk for UCL injury because pitching a higher percent of fastballs appears to be a risk factor for UCL reconstruction. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Laboratory Animal Workers' Attitudes and Perceptions Concerning Occupational Risk and Injury.

Science.gov (United States)

Steelman, Eric D; Alexander, Jeffrey L

2016-01-01

Little is known regarding the risk perceptions and attitudes of laboratory animal care workers toward biologic safety. The purpose of this descriptive study was to assess the attitudes and perceptions of laboratory animal workers toward occupational and injury risk. Subscribers to the CompMed and TechLink listservs (n = 4808) were surveyed electronically, and 5.3% responded; data from 215 respondents were included in the final analysis. Primary variables of interest included AALAS certifications status, level of education, and responses to Likert-scale questions related to attitudes and perceptions of occupational risk and injury. Nonparametric (χ(2)) testing and measures of central tendency and dispersion were used to analyze and describe the data. According to 88.6% of respondents, biologic safety training is provided with information about zoonotic diseases of laboratory animals. Level of education was significantly related to perception of importance regarding wearing personal protective equipment. Participants indicated that appropriate support from coworkers and management staff is received, especially when performance and perception are hindered due to stress and fatigue. Laboratory animal staff are susceptible to injury and exposure to dangerous organisms and toxic substances. For this reason, to maximize safety, yearly biologic safety training should be provided, the importance of protective equipment adherence strengthened, and the culture of safety made a priority within the institution.

Snowboarding injuries, a four-year study with comparison with alpine ski injuries.

Science.gov (United States)

Davidson, T M; Laliotis, A T

1996-03-01

Snowboarding is a rapidly growing winter sport. Its unorthodox maneuvers and young participants raise many safety concerns. We examined injury patterns in recreational snowboarders, comparing these patterns with those found in alpine skiers. Snowboarding and skiing injury patterns differed significantly (P knee (17% versus 39%) or thumb (2% versus 4%) injuries than skiers. For snowboarders, wrist injuries were most common in beginners (30%), knee injuries in low intermediates (28%), ankle injuries in intermediates (17%), and shoulder or clavicle injuries in advanced snowboarders (14%). Most snowboarders (90%) wore soft-shelled boots, 73% of lower extremity injuries occurred to the lead-foot side, and 73% of wrist injuries occurred during backward falls; 67% of knee injuries occurred during forward falls. Of all injuries, 8% occurred while loading onto or unloading from a ski lift. The sport of snowboarding brings with it a different set of injuries from those seen in alpine skiing. The data focus attention on improvements such as wrist guards or splints, releasable front-foot bindings, and better instruction for beginner snowboarders to improve the safety of this sport. Finally, the data confirm that snowboarders and skiers may be safely combined on the same slopes.

Imaging of acute traumatic injuries of the thoracic aorta

International Nuclear Information System (INIS)

Wintermark, Max; Wicky, Stefan; Schnyder, Pierre

2002-01-01

Blunt traumatic aortic injuries are a major concern in the settings of high-speed deceleration accidents, since they are associated with a very high mortality rate; however, with prompt diagnosis and surgery, 70% of the patients with a blunt aortic lesion who reach the hospital alive will survive. This statement challenges the emergency radiologist in charge to evaluate the admission radiological survey in a severe chest trauma patient. With a 95% negative predictive value for the identification of blunt traumatic aortic lesions, plain chest film represents an adequate screening test. If aortography remains the gold standard, it tends, at least in hemodynamically stable trauma patients, to be replaced by spiral-CT angiography (SCTA), which demonstrates a 96.2% sensitivity, a 99.8% specificity, and a 99.7% accuracy. In unstable patients, trans-esophageal echography (TEE) plays a major diagnostic role. Knowledge of advantages and pitfalls of these imaging techniques, as reviewed in this article, will help the emergency radiologist to choose the appropriate algorithm in the diagnosis of traumatic aortic injury, for each trauma patient. (orig.)

Opinion Leaders See Rising College Costs as Major Concern.

Science.gov (United States)

Chronicle of Higher Education, 1988

1988-01-01

A recent survey of federal government officials, corporate leaders in charge of personnel and research, and journalists found dramatically different views in some areas, but agreement in concern about college costs, financing, and lack of government spending for research. Most felt college is a fair value for the cost. (MSE)

Whiplash injuries.

Science.gov (United States)

Malanga, Gerard; Peter, Jason

2005-10-01

Whiplash injuries are very common and usually are associated with rear-end collisions. However, a whiplash injury can be caused by any event that results in hyperextension and flexion of the cervical spine. These injuries are of serious concern to all consumers due to escalating cost of diagnosis, treatment, insurance, and litigation. Most acute whiplash injury cases respond well to conservative treatments, which result in resolution of symptoms usually within weeks to a few months after the injury occurred. Chronic whiplash injuries often are harder to diagnose and treat and often result in poor outcomes. Current research shows that various structures in the cervical spine receive nociceptive innervation and potentially may be the cause of chronic pain symptoms. One potential pain generator showing promise is the facet or zygapophyseal joints. Various researchers have proven that these joints are injured during whiplash injuries and that diagnosis and temporary pain relief can be obtained with facet joint injections. The initial evaluation of any patient should follow an organized and stepwise approach, and more serious causes of neck pain must first be ruled out through the history, physical examination, and diagnostic testing. Treatment regimens should be evidence-based, focusing on treatments that have proven to be effective in treating acute and chronic whiplash injuries.

Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application.

Science.gov (United States)

Valle, Xavier; Alentorn-Geli, Eduard; Tol, Johannes L; Hamilton, Bruce; Garrett, William E; Pruna, Ricard; Til, Lluís; Gutierrez, Josep Antoni; Alomar, Xavier; Balius, Ramón; Malliaropoulos, Nikos; Monllau, Joan Carles; Whiteley, Rodney; Witvrouw, Erik; Samuelsson, Kristian; Rodas, Gil

2017-07-01

Muscle injuries are among the most common injuries in sport and continue to be a major concern because of training and competition time loss, challenging decision making regarding treatment and return to sport, and a relatively high recurrence rate. An adequate classification of muscle injury is essential for a full understanding of the injury and to optimize its management and return-to-play process. The ongoing failure to establish a classification system with broad acceptance has resulted from factors such as limited clinical applicability, and the inclusion of subjective findings and ambiguous terminology. The purpose of this article was to describe a classification system for muscle injuries with easy clinical application, adequate grouping of injuries with similar functional impairment, and potential prognostic value. This evidence-informed and expert consensus-based classification system for muscle injuries is based on a four-letter initialism system: MLG-R, respectively referring to the mechanism of injury (M), location of injury (L), grading of severity (G), and number of muscle re-injuries (R). The goal of the classification is to enhance communication between healthcare and sports-related professionals and facilitate rehabilitation and return-to-play decision making.

Injuries in epilepsy: a review of its prevalence, risk factors, type of injuries and prevention

Directory of Open Access Journals (Sweden)

Jose Tellez-Zenteno

2009-12-01

Full Text Available Currently, there is intense clinical research into various aspects of the medical risks relating to epilepsy, including total and cause-specific mortality, accidents and injuries in patients with epilepsy and mortality related with seizures. Seizures occurring in precarious situations and resulting in injuries are still an important concern for patients with epilepsy, their employers and their caregivers. Submersion injuries, motor vehicle accidents, burns, and head injuries are among the most feared epilepsy-related injuries. These concerns seem valid because the hallmark of epilepsy, episodic impairment of consciousness and motor control, may occur during interictal EEG epileptiform discharges, even in the absence of a clinical seizure. In addition, psychomotor comorbidity and side effects of antiepileptic drugs may contribute to the risk of injuries in patients with epilepsy. Published risk factors for injuries include the number of antiepileptic drugs, history of generalized seizures, and seizure frequency. In general, epidemiological information about incidence of injuries has been conflicting and sparse. In general, studies focusing on populations with more severe forms of epilepsy tend to report substantially higher risks of injuries than those involving less selected populations. On the other hand, studies based on non-selected populations of people with epilepsy have not shown an increased frequency of injuries in people with epilepsy compared with the general population. Some studies have shown that patients with epilepsy are more frequently admitted to the hospital following an injury. Possible explanations include: more cautious attitude of clinicians toward injuries occurring in the setting of seizures; hospitalization required because of seizures and not to the injuries themselves; and hospitalization driven by other issues, such as comorbidities, which are highly prevalent in patients with epilepsy. Potentially the high rate of

Preventing playground injuries.

Science.gov (United States)

Fuselli, Pamela; Yanchar, Natalie L

2012-06-01

With concerns increasing around childhood obesity and inactivity, playgrounds offer a chance for children to be active. But playgrounds also have risks, with injuries from falls being the most common. Research has shown that playground injuries can be reduced by lowering the heights of play equipment and using soft, deep surfaces to cushion falls. The Canadian Standards Association has published voluntary standards for playgrounds to address these risks for several years. Parents can further reduce injury risks by following simple playground strategies. This statement outlines the burden of playground injuries. It also provides parents and health care providers with opportunities to reduce injury incidence and severity through education and advocacy, and to implement evidence-informed safety standards and safer play strategies in local playgrounds. This document replaces a previous Canadian Paediatric Society position statement published in 2002.

Needlestick injuries in veterinary medicine.

Science.gov (United States)

Weese, J Scott; Jack, Douglas C

2008-08-01

Needlestick injuries are an inherent risk of handling needles during the course of veterinary practice. While significant effort has been expended to reduce needlestick injuries in human medicine, a relatively lax approach seems to be prevalent in veterinary medicine. It appears that needlestick injuries are very common among veterinary personnel and that serious adverse effects, while uncommon, do occur. Clients may also receive injuries in clinics during the course of animal restraint, and at home following prescription of injectable medications or fluids. Because of occupational health, personal health, and liability concerns, veterinary practices should review the measures they are taking to reduce the likelihood of needlestick injuries and develop written needlestick injury avoidance protocols.

Urological injuries following trauma

International Nuclear Information System (INIS)

Bent, C.; Iyngkaran, T.; Power, N.; Matson, M.; Hajdinjak, T.; Buchholz, N.; Fotheringham, T.

2008-01-01

Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated

Urological injuries following trauma

Energy Technology Data Exchange (ETDEWEB)

Bent, C. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)], E-mail: clare.bent@bartsandthelondon.nhs.uk; Iyngkaran, T.; Power, N.; Matson, M. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom); Hajdinjak, T.; Buchholz, N. [Department of Urology, Barts and The London NHS Trust, London (United Kingdom); Fotheringham, T. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)

2008-12-15

Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated.

Upper extremity golf injuries.

Science.gov (United States)

Cohn, Michael A; Lee, Steven K; Strauss, Eric J

2013-01-01

Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury.

Urological injuries following trauma.

Science.gov (United States)

Bent, C; Iyngkaran, T; Power, N; Matson, M; Hajdinjak, T; Buchholz, N; Fotheringham, T

2008-12-01

Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated.

Management of pediatric splenic injuries in Canada.

Science.gov (United States)

McDonald, Lindsay A; Yanchar, Natalie L

2012-03-01

Nonoperative management (NOM) of blunt splenic injuries has become the standard of care in hemodynamically stable children. This study compares the management of these injuries between pediatric and nonpediatric hospitals in Canada. Data were obtained from the Canadian Institute of Health Information trauma database on all patients aged 2 to 16 years, admitted to a Canadian hospital with a diagnosis of splenic injury between May 2002 and April 2004. Variables included age, sex, associated major injuries, splenic procedures, intensive care unit (ICU) admissions, blood transfusions, and length of stay. Hospitals were coded as pediatric or nonpediatric. Univariate analysis and logistic regression were used to determine associations between hospital type and outcomes. Of 1284 cases, 654 were managed at pediatric hospitals and 630 at nonpediatric centers. Patients at pediatric centers tended to be younger and more likely to have associated major injuries. Controlling for covariates, including associated major injuries, patients managed at pediatric centers were less likely to undergo splenectomy compared with those managed at nonpediatric centers (odds ratio [OR], 0.2; 95% confidence interval, 0.1-0.4). The risk of receiving blood products, admission to the ICU, and staying in hospital for more than 5 days was associated only with having associated major injuries. Even in the presence of other major injuries, successful NOM of blunt splenic injuries occurs more frequently in pediatric hospitals in Canada. This has policy relevance regarding education of adult surgeons about the appropriateness of NOM in children and developing guidelines on appropriate regional triaging of pediatric patients with splenic injury in Canada. Copyright © 2012 Elsevier Inc. All rights reserved.

Fatal injuries in the United States construction industry involving cranes 1984-1994.

Science.gov (United States)

Suruda, A; Liu, D; Egger, M; Lillquist, D

1999-12-01

There is little published information concerning the epidemiology of injuries in the construction industry involving cranes other than for electrical injury from power line contact. For the 11-year period of 1984 through 1994, the US Occupational Safety and Health Administration (OSHA) investigated 502 deaths in 479 incidents involving cranes in the construction industry. Electrocution was the largest category, with 198 deaths (39%) reported. Other major categories were assembly/dismantling (58 deaths, 12%), boom buckling (41 deaths, 8%), crane upset/overturn (37 deaths, 7%), and rigging failure (36 deaths, 7%). The majority of the deaths during assembly/dismantling involved removal of the boom pins from lattice boom cranes. Only 34% of the construction firms employing the fatally injured workers had ever been inspected by OSHA. OSHA cited the employer for safety violations in 436 deaths (83%). Additional worker training, increased OSHA inspections, and crane inspection programs could prevent many crane-related deaths.

Four-wheeled walker related injuries in older adults in the Netherlands.

Science.gov (United States)

van Riel, K M M; Hartholt, K A; Panneman, M J M; Patka, P; van Beeck, E F; van der Cammen, T J M

2014-02-01

With ageing populations worldwide, mobility devices are used more than ever. In the current literature there is no consensus whether the available mobility devices safely improve the mobility of their users. Also, evidence is lacking concerning the risks and types of injuries sustained while using a four-wheeled walker. To assess injury risks and injury patterns in older adults (≥65 years) who presented at Emergency Departments (ED) in the Netherlands with an injury due to using a four-wheeled walker. In this study, the Dutch Injury Surveillance System was used to obtain a national representative sample of annual ED visits in the Netherlands in the adult population (≥65 years) sustaining an injury while using a four-wheeled walker. The numbers of four-wheeled walker users in the Netherlands were obtained from the national insurance board. The numbers of ED visits were divided by the numbers of four-wheeled walker users to calculate age- and sex-specific injury risks. Annually 1869 older adults visited an ED after sustaining an injury while using a four-wheeled walker. Falls were the main cause of injury (96%). The injury risk was 3.1 per 100 users of four-wheeled walkers. Women (3.5 per 100 users) had a higher risk than men (2.0 per 100 users). Injury risk was the highest in women aged 85 years and older (6.2 per 100 users). The majority of injuries were fractures (60%) with hip fracture (25%) being the most common injury. Nearly half of all four-wheeled walker related injuries required hospitalisation, mostly due to hip fractures. Healthcare costs per injury were approximately €12 000. This study presents evidence that older adults experiencing a fall while using a four-wheeled walker are at high risk to suffer severe injuries.

The Role of Self-Esteem on Vocational Rehabilitation of People with Spinal Cord Injury

Directory of Open Access Journals (Sweden)

Seyed J Sadrossadat

2007-09-01

Full Text Available Rehabilitation is the ongoing management of injuries and disabilities after an accident. It will help people to maximize the individuals` recovery through the relearning of skills or teaching of strategies to compensate for changed abilities. Self-esteem may be one major factor related to the manner in which people with Spinal Cord Injury (SCI respond to rehabilitation. Following a short discussion on related concepts this article will report a study and conclude that, pertaining to vulnerabilities in self-esteem, the second year following SCI may be just as critical a time period as the initial one after the injury.  If replicated, this finding is of potential importance in the rehabilitation field. For example, the majority of psychological services are currently available at the acute stage of injury. People with SCI are most often discharged from hospital when they are physiologically stable and physically deemed ready for the discharge. It is precisely at this point, however, that people with new SCI may have many questions and concerns their new role in the community. The current study suggests that perhaps practitioners need to make a more concerted effort in dealing with the psychological effects of SCI when difficulties may arise in the community.

Patterns of Injuries After Road Traffic Crashes Involving Bodabodas

African Journals Online (AJOL)

2010-01-12

Jan 12, 2010 ... Globally, trauma resulting from road traffic crashes is a major cause of death and disability with majority occur- ... Bodabodas are a major form of transport in the city of. Kampala and in other towns in East Africa. .... Injury Control Injury Surveillance Reports (2000 – 2003). Injury Control Centre, Kampala. 4.

Injuries in Cricket.

Science.gov (United States)

Pardiwala, Dinshaw N; Rao, Nandan N; Varshney, Ankit V

Cricket is a popular global sport that requires a combination of physical fitness, skill, and strategy. Although a noncontact sport, overuse and impact injuries are common since players engage in a wide range of physical activities, including running, throwing, batting, bowling, catching, and diving. Significant or match time-loss injuries are defined as those that either prevent a player from being fully available for selection in a major match, or during a major match, cause a player to be unable to bat, bowl, or keep wicket when required by either the rules or the team's captain. This review describes the various region-wise injuries sustained in cricket along with their epidemiology, biomechanics, treatment, and prevention. Data were collected from peer-reviewed articles (obtained via PubMed search) published through November 2016 that involved the medical, biomechanical, and epidemiological aspects of cricket injuries. Clinical review. Level 4. Cricket was one of the first sports to publish recommended methods for injury surveillance in 2005 from England, South Africa, Australia, the West Indies, and India. While the incidence of injuries is about the same, the prevalence of injuries has increased due to game format changes, increasing number of matches played, and decreased rest between matches. Bowling (41.3%), fielding, and wicket keeping (28.6%) account for most injuries. Acute injuries are most common (64%-76%), followed by acute-on-chronic (16%-22.8%) and chronic ones (8%-22%). The most common modern-day cricket injury is hamstring strain, and the most severe is lumbar stress fracture in young fast bowlers. With improved understanding of the scientific and medical aspects of cricket, along with advances in surgical and nonsurgical treatment techniques, the time to return to play has shortened considerably. While the prevalence of cricket injuries has increased, their severity has decreased over the past decades.

Musculoskeletal disease and injury, now and in the future. Part 1: fractures and fatalities.

Science.gov (United States)

Clegg, P D

2011-11-01

Orthopaedic injury is common in the racing Thoroughbred and is a cause of both economic loss to the industry, as well as being an obvious welfare issue. Fatal injuries sustained during racing are an obvious major concern and it is important that all is done to reduce their frequency. As a consequence of the importance of these causes of horse morbidity and mortality, the Horserace Betting Levy Board in the UK has invested considerable resources into research in recent years in this area in an attempt to decrease the frequency of such injuries. This review summarises current knowledge relating to epidemiological investigations relating to fractures, falling and fatalities in the racing Thoroughbred. Studies identify the importance of track surface conditions, the importance of pre-existing orthopaedic pathology, as well as issues relating to the horse's past training and racing experience as important determinants of both injury and death. Such findings can now be used to develop interventions to reduce racehorse injury and death for the benefit of both the industry and the horse. © 2011 EVJ Ltd.

Geriatric fall-related injuries.

African Journals Online (AJOL)

Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk fac- tors for falls including home hazards is essential for prevention of geriatric fall-related injuries. Keywords: Accidental fall, geriatrics, injury, trauma registry. DOI: http://dx.doi.org/10.4314/ahs.v16i2.24.

Injuries in Irish dance.

Science.gov (United States)

Stein, Cynthia J; Tyson, Kesley D; Johnson, Victor M; Popoli, David M; d'Hemecourt, Pierre A; Micheli, Lyle J

2013-12-01

Irish dance is growing in popularity and competitiveness; however, very little research has focused specifically on this genre of dance. The purpose of this study was to analyze the types of dance injuries incurred by Irish dancers. A chart review was performed to identify all injuries associated with Irish dance seen in the sports medicine or orthopaedic clinics at the investigators' hospital over an 11-year period. "Injury" was defined as any dance-related pain or disorder that led to evaluation in the clinics. Survey data were also collected from study participants. Ultimately, 255 patients from over 30 different schools of dance were seen with injuries directly related (726 clinic visits) or partially related (199 visits) to Irish dance. Participants ranged in age from 4 to 47, with 95% (243/255) under the age of 19. These 255 patients received 437 diagnoses. Almost 80% of the injuries (348/437) were attributable to overuse, and 20.4% were acute and traumatic injuries (89/437). Ninety-five percent (95.9%) of injuries involved the hip or lower extremity. The most common sites were the foot (33.2%), ankle (22.7%), knee (19.7%), and hip (14.4%). Typical diagnoses were tendon injury (13.3%), apophysitis (11.4%), patellofemoral pain and instability (10.8%), stress injury (10.1%), and muscle injury (7.8%). The majority of traumatic injuries were seen in clinic within 3 weeks, but less than a quarter of overuse injuries were seen that quickly. The most common treatment, prescribed to 84.3% of patients, was physical therapy and home exercises, and the majority of dancers (64.3%) were able to return to full dance activity after injury.

Modified Pectoralis Major Tendon Transfer for Reanimation of Elbow Flexion as a Salvage Procedure in Complete Brachial Plexus Injury: A Case Report

Directory of Open Access Journals (Sweden)

S Taran

2013-03-01

Full Text Available Traumatic brachial plexus injuries rarely recover spontaneously and if the window period for neurotisation has elapsed, the only option for restoration of function lies in a salvage procedure. Many such salvage procedures have been described in the literature with variable functional results. We report the case of a 16-year-old boy who presented after unsuccessful treatment for a complete brachial plexus injury; we performed a pectoralis major tendon transfer to attain elbow flexion. Postoperatively, the elbow was splinted with flexion at 100°. After 4 weeks of immobilization the splint was removed and the patient could actively flex his elbow from 30° to 100°.

Community integration after burn injuries.

Science.gov (United States)

Esselman, P C; Ptacek, J T; Kowalske, K; Cromes, G F; deLateur, B J; Engrav, L H

2001-01-01

Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.

Penetrating abdominal injury and peritonitis: A rare case of birth Injury

Directory of Open Access Journals (Sweden)

Patankar Shreeprasad

2008-01-01

Full Text Available The incidence of birth injuries has decreased considerably because of the identification of risk factors at an earlier stage and taking the decision for caesarian section (LSCS at proper time. Fractures, nerve palsies and central nervous system injuries comprise the majority of "birth injuries." In this study, we report a newborn that had a birth injury during LSCS. The baby sustained a penetrating abdominal injury by the knife of the surgeon, while performing LSCS. The bowel was injured at two sites, proximal jejunum and descending colon. The baby developed meconeum spillage and peritonitis. Exploratory laprotomy was done and the injuries were identified. The injured portions were resected and bowel continuity was reestablished. The baby had an uneventful recovery.

Burn injuries related to motorcycle exhaust pipes: a study in Greece.

Science.gov (United States)

Matzavakis, Ioannis; Frangakis, Constantine E; Charalampopoulou, Ava; Petridou, Eleni

2005-05-01

To identify measures that should reduce the incidence of burn injuries resulting from motorcycle exhaust pipes through epidemiological analysis of such injuries. During a 5-year period, 251 persons who suffered burn injuries related to motorcycle exhaust pipes have contacted four major hospitals belonging to the Emergency Department Injury Surveillance System (EDISS) operating since 1996 in Greece. These burn injuries were studied in relation to person, environment and vehicle characteristics. The estimated countrywide incidence of burns from motorcycle exhaust pipes was 17 per 100,000 person-years (208 per 100,000 motorcycle-years). The incidence was two times higher for children than for older persons and among the latter it was 60% higher among females than among males. Most of burn injuries (70.5%) concerned motorcycle passengers, mainly when getting on or off motorcycle, with peak incidence during summer. The most frequent location of burn wounds was below the knee and particularly the right leg. It was estimated that the risk of motorcycle exhaust pipe burns when wearing shorts could be reduced by 46% through wearing long pants. Among the victims 65.3% experienced second degree burns. Motorcycle exhaust burns could be substantially reduced by systematically wearing long pants, by incorporating in the design of motorcycles external thermo resistant shields with adequate distance to the exhaust pipe, and by avoiding riding with children on motorcycles.

[Injury pattern caused by aggressive inline skating].

Science.gov (United States)

Hilgert, R E; Besch, L; Behnke, B; Egbers, H-J

2004-12-01

In order to evaluate the special injury pattern of aggressive inline skating, a field study was conducted in a local, non-commercial skate park equipped with all the typical features like ramps, halfpipes, gully areas. 66 unselected aggressive inline skaters were randomly enrolled and interviewed concerning their skating habits and their skating injury history. Average age was 15 (10 to 41) years, skating was performed since 2.1 (0.1 to 6) years, as aggressive skating since 1.3 (0.1 to 4) years. Medical treatment in a doctor's practice or in a hospital had been necessary in 66 cases, averaging 1.4 times per skater and year, averaging one injury per 586 hours of aggressive skating. The injury pattern reflected the regions typically injured in fitness skating, too, with a higher percentage of injuries concerning knee, tibia and ankle region. The use of protective devices varied from 41 % (wrist guards) to 94 % (knee pads), with an average of 69 %. Only 32 % of skaters wore all protective devices. As the personal thrill is an important motivation for aggressive skating, safer skating campaigns are quite unlikely to decrease the risk of injury in aggressive skaters.

Safety concerns in composite manufacturing and machining

Science.gov (United States)

Asmatulu, Eylem; Alonayni, Abdullah; Alamir, Mohammed

2018-03-01

Because of the superior properties, composites have been used in many industrial applications, including aerospace, wind turbines, ships, cars, fishing rods, storage tanks, swimming pool panels, and baseball bats. Each application may require different combinations of reinforcements and matrices, which make the manufacturing safety even more challenging while working on these substances. In this study, safety issues in composite manufacturing and machining were investigated in detail, and latest developments were provided for workers. The materials most frequently used in composite manufacturing, such as matrix (polyester, vinylester, phenolic, epoxies, methyl ethyl ketone peroxide, benzoil peroxide, hardeners, and solvents), and reinforcement materials (carbon, glass and Kevlar fibers, honeycomb and foams) can be highly toxic to human body. These materials can also be very toxic to the environment when dumped out uncontrollably, creating major future health and environmental concerns. Throughout the manufacturing process, workers inhale vapors of the liquid matrix, hardeners and solvents / thinners, as well as reinforcement materials (chopped fibers and particles) in airborne. Milling, cutting and machining of the composites can further increase the toxic inhalations of airborne composite particles, resulting in major rashes, irritation, skin disorders, coughing, severe eye and lung injury and other serious illnesses. The major portions of these hazardous materials can be controlled using appropriate personal protective equipment for the chemicals and materials used in composite manufacturing and machining. This study provides best possible safety practices utilized in composite manufacturing facilities for workers, engineers and other participants.

Genitalia burn: accident or violence? Concerns that transcend injury treatment

Directory of Open Access Journals (Sweden)

Ana Lúcia Ferreira

2014-06-01

Full Text Available OBJECTIVE: To describe a case of genital burn which raised the suspicion of maltreatment (sexual abuse and neglect by lack of supervision.CASE DESCRIPTION: An infant was taken to the Emergency Room of a pediatric hospital with an extensive burn in the vulva and perineum. The mother claimed the burn had been caused by a sodium-hydroxide-based product. However, the injury severity led to the suspicion of sexual abuse, which was then ruled out by a multidisciplinary team, based on the consistent report by the mother. Besides, the lesion type matched those caused by the chemical agent involved in the accident and the family context was evaluated and considered adequate. The patient had a favorable outcome and was discharged after four days of hospitalization. Outpatient follow-up during six months after the accident enabled the team to rule out neglect by lack of supervision.COMMENTS: Accidents and violence are frequent causes of physical injuries in children, and the differential diagnosis between them can be a challenge for healthcare workers, especially in rare clinical conditions involving patients who cannot speak for themselves. The involvement of a multidisciplinary trained team helps to have an adequate approach, ensuring child protection and developing a bond with the family; the latter is essential for a continued patient follow-up.

Pectoralis Major Repair With Unicortical Button Fixation And Suture Tape

OpenAIRE

Sanchez, Anthony; Ferrari, Marcio B.; Frangiamore, Salvatore J.; Sanchez, George; Kruckeberg, Bradley M.; Provencher, Matthew T.

2017-01-01

Although injuries of the pectoralis major muscle are generally uncommon, ruptures of the pectoralis major are occasionally seen in younger, more active patients who participate in weightlifting activities. These injuries usually occur during maximal contraction of the muscle, while in extension and external rotation. In the case of a rupture, operative treatment is advocated especially in young, active patients regardless of the chronicity of the injury. Various surgical techniques for reatta...

The management of complex pancreatic injuries.

Science.gov (United States)

Krige, J E J; Beningfield, S J; Nicol, A J; Navsaria, P

2005-08-01

Major injuries of the pancreas are uncommon, but may result in considerable morbidity and mortality because of the magnitude of associated vascular and duodenal injuries or underestimation of the extent of the pancreatic injury. Prognosis is influenced by the cause and complexity of the pancreatic injury, the amount of blood lost, duration of shock, speed of resuscitation and quality and nature of surgical intervention. Early mortality usually results from uncontrolled or massive bleeding due to associated vascular and adjacent organ injuries. Late mortality is a consequence of infection or multiple organ failure. Neglect of major pancreatic duct injury may lead to life-threatening complications including pseudocysts, fistulas, pancreatitis, sepsis and secondary haemorrhage. Careful operative assessment to determine the extent of gland damage and the likelihood of duct injury is usually sufficient to allow planning of further management. This strategy provides a simple approach to the management of pancreatic injuries regardless of the cause. Four situations are defined by the extent and site of injury: (i) minor lacerations, stabs or gunshot wounds of the superior or inferior border of the body or tail of the pancreas (i.e. remote from the main pancreatic duct), without visible duct involvement, are best managed by external drainage; (ii) major lacerations or gunshot or stab wounds in the body or tail with visible duct involvement or transection of more than half the width of the pancreas are treated by distal pancreatectomy; (iii) stab wounds, gunshot wounds and contusions of the head of the pancreas without devitalisation of pancreatic tissue are managed by external drainage, provided that any associated duodenal injury is amenable to simple repair; and (iv) non-reconstructable injuries with disruption of the ampullary-biliary-pancreatic union or major devitalising injuries of the pancreatic head and duodenum in stable patients are best treated by

Blast-induced traumatic brain injury: a new trend of blast injury research.

Science.gov (United States)

Zhao, Yan; Wang, Zheng-Guo

2015-01-01

Blast injury has become the major life- and function-threatening injuries in recent warfares. There is increased research interest in the mental disorders caused by blast-induced traumatic brain injury (bTBI), which has been proved as one of the "signature wounds" in modern battlefield. We reviewed the recent progresses in bTBI-related researches and concluded that the new era of blast injury research has shifted from the traditional physical impairments to cognitive dysfunctional/mental disorders that are proved to be more related to the outcome of combat casualty care.

Football injury: a literature review *

Science.gov (United States)

Kos, John J.

1979-01-01

A great deal of concern is recently being expressed relative to the playing of tackle football by adolescent Canadians. The purpose of this literature review is to try to summarize the important data from the available world literature. Very few Canadian statistics are available. Most of the data comes from United States experience. Tackle football injury is examined from various perspectives: 1. Equipment 2. Mechanisms of injury 3. Types of injury, with some emphasis on epiphyseal injury 4. Prevention 5. Comparison with other sports Although no “hard and fast” conclusion is drawn, the paper tends to show that: 1. Football is dangerous 2. Football is damaging to many body systems 3. Prevention of injury is difficult under present conditions 4. Alternate games, such as soccer and rugby seem to provide the same benefits with less catastrophic injuries

Specific injuries induced by the practice of trampoline, tumbling and acrobatic gymnastics.

Science.gov (United States)

Grapton, Xavier; Lion, Alexis; Gauchard, Gérome C; Barrault, Denys; Perrin, Philippe P

2013-02-01

The recreational and competitive practice of acrobatic sports, that is, trampoline, tumbling and acrobatic gymnastics (ACRO), is growing rapidly around the world. Many studies described the injuries affecting young artistic gymnasts, but only few concerned acrobatic sports. During a 5-year period, 357 traumatic events were collected in young acrobats practicing trampoline, tumbling or ACRO. Accident characteristics, level of expertise and training, injury location (upper limb, spine and lower limb), type of tissue injured (bone, cartilage, muscle, ligament and tendon) and provoking factors (intrinsic/behavioural and extrinsic) were investigated. Acrobats of national and international levels were mostly injured. Injuries occurring in acrobatic sports concerned predominantly the lower limbs and concerned in this body part mainly damages to ligaments. Forearm and knee injuries were preferentially related to trampoline. Ankle injuries were preferentially related to tumbling. Wrist injuries were preferentially related to ACRO. Upper limb bone damage and upper limb tendon damage were preferentially related to trampoline and ACRO, respectively. Intrinsic/behavioural factors were the main injury determinant in the three acrobatic sports. The main injuries in acrobatic sports (i.e. lower limbs) are similar to those observed in artistic gymnastics. Specific injuries may result from falls and incomplete and/or erroneous figure's landing and may also depend to the type of the landing surface. II.

Are first rib fractures a marker for other life-threatening injuries in patients with major trauma? A cohort study of patients on the UK Trauma Audit and Research Network database.

Science.gov (United States)

Sammy, Ian Ayenga; Chatha, Hridesh; Lecky, Fiona; Bouamra, Omar; Fragoso-Iñiguez, Marisol; Sattout, Abdo; Hickey, Michael; Edwards, John E

2017-04-01

First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted. Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research Network. The prevalence of life-threatening injuries was compared in patients with first rib fractures and those with other rib fractures. Multivariate logistic regression was performed to determine the association between first rib fractures, injury severity, polytrauma and mortality. There were 1683 patients with first rib fractures and 8369 with fractures of other ribs. Life-threatening intrathoracic and extrathoracic injuries were more likely in patients with first rib fractures. The presence of first rib fractures was a significant predictor of injury severity (Injury Severity Score >15) and polytrauma, independent of mechanism of injury, age and gender with an adjusted OR of 2.64 (95% CI 2.33 to 3.00) and 2.01 (95% CI 1.80 to 2.25), respectively. Risk-adjusted mortality was the same in patients with first rib fractures and those with other rib fractures (adjusted OR 0.97, 95% CI 0.79 to 1.19). First rib fractures are a marker of life-threatening injuries in major trauma, though they do not independently increase mortality. Management of patients with first rib fractures should focus on identification and treatment of associated life-threatening injuries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) [year]. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Throwing Injuries of the Shoulder.

Science.gov (United States)

McCue, Frank C., III; and Others

The majority of shoulder injuries occurring in throwing sports involve the soft tissue structures. Injuries often occur when the unit is overstretched to a point near its greatest length, involving the elastic tissues. The other injury mechanism involves the contractural unit of the muscle, which occurs near the midpoint of contractions, involving…

Mountain biking injuries requiring trauma center admission: a 10-year regional trauma system experience.

Science.gov (United States)

Kim, Peter T W; Jangra, Dalbhir; Ritchie, Alec H; Lower, Mary Ellen; Kasic, Sharon; Brown, D Ross; Baldwin, Greg A; Simons, Richard K

2006-02-01

Mountain biking has become an increasingly popular recreational and competitive sport with increasingly recognized risks. The purpose of this study was to review a population based approach to serious injuries requiring trauma center admission related to mountain biking, identify trends and develop directions for related injury prevention programs. Three trauma centers in the Greater Vancouver area exclusively serve a major mountain bike park and the North Shore Mountains biking trails. The Trauma Registries and the patient charts were reviewed for mountain bike injuries from 1992 to 2002. The data were analyzed according to demographics, distribution, and severity of injuries, and need for operative intervention. Findings were reviewed with injury prevention experts and regional and national mountain-biking stakeholders to provide direction to injury prevention programs. A total of 1,037 patients were identified as having bicycling-related injuries. Of these, 399 patients sustained 1,092 injuries while mountain biking. There was a threefold increase in the incidence of mountain biking injuries over a 10-year period. Young males were most commonly affected. Orthopedic injuries were most common (46.5%) followed by head (12.2%), spine (12%), chest (10.3%), facial (10.2%), abdominal (5.4%), genitourinary (2.2%), and neck injuries (1%). High operative rate was observed: 38% of injuries and 66% of patients required surgery. One patient died from his injuries. Injury prevention programs were developed and successfully engaged the target population. Mountain biking is a growing cause of serious injuries. Young males are principally at risk and serious injuries result from intended activity and despite protective equipment. Injury prevention programs were developed to address these concerns.

Sport injuries of the cervical spine

International Nuclear Information System (INIS)

Bargon, G.

1981-01-01

The article reports on injuries of the cervical spine occurring during sports activities. An attempt is made to reconstruct the movements which led to the cervical spine injuries in question. In two cases of accidents occuring during bathing, one football accident and a toboggan accident, the injuries concerned point to hyperextension of the cervical spine as cause of the injury. In another football accident and a riding accident, the changes observed allow us to conclude that the movement leading to the injury must have been a hyperflexion. One accident occurring while jumping on the trampolin resulted in an injury of the upper cervical spine pointing to the action of a compressive force on the cervical spine in addition to the force resulting in hyperflexion. (orig.) [de

Sport injuries of the cervical spine

Energy Technology Data Exchange (ETDEWEB)

Bargon, G

1981-03-01

The article reports on injuries of the cervical spine occurring during sports activities. An attempt is made to reconstruct the movements which led to the cervical spine injuries in question. In two cases of accidents occuring during bathing, one football accident and a toboggan accident, the injuries concerned point to hyperextension of the cervical spine as cause of the injury. In another football accident and a riding accident, the changes observed allow us to conclude that the movement leading to the injury must have been a hyperflexion. One accident occurring while jumping on the trampolin resulted in an injury of the upper cervical spine pointing to the action of a compressive force on the cervical spine in addition to the force resulting in hyperflexion.

Novel variants in the PRDX6 Gene and the risk of Acute Lung Injury following major trauma

Directory of Open Access Journals (Sweden)

Localio A Russell

2011-05-01

Full Text Available Abstract Background Peroxiredoxin 6 (PRDX6 is involved in redox regulation of the cell and is thought to be protective against oxidant injury. Little is known about genetic variation within the PRDX6 gene and its association with acute lung injury (ALI. In this study we sequenced the PRDX6 gene to uncover common variants, and tested association with ALI following major trauma. Methods To examine the extent of variation in the PRDX6 gene, we performed direct sequencing of the 5' UTR, exons, introns and the 3' UTR in 25 African American cases and controls and 23 European American cases and controls (selected from a cohort study of major trauma, which uncovered 80 SNPs. In silico modeling was performed using Patrocles and Transcriptional Element Search System (TESS. Thirty seven novel and tagging SNPs were tested for association with ALI compared with ICU at-risk controls who did not develop ALI in a cohort study of 259 African American and 254 European American subjects that had been admitted to the ICU with major trauma. Results Resequencing of critically ill subjects demonstrated 43 novel SNPs not previously reported. Coding regions demonstrated no detectable variation, indicating conservation of the protein. Block haplotype analyses reveal that recombination rates within the gene seem low in both Caucasians and African Americans. Several novel SNPs appeared to have the potential for functional consequence using in silico modeling. Chi2 analysis of ALI incidence and genotype showed no significant association between the SNPs in this study and ALI. Haplotype analysis did not reveal any association beyond single SNP analyses. Conclusions This study revealed novel SNPs within the PRDX6 gene and its 5' and 3' flanking regions via direct sequencing. There was no association found between these SNPs and ALI, possibly due to a low sample size, which was limited to detection of relative risks of 1.93 and above. Future studies may focus on the role of

Impact of Acute Kidney Injury in Patients Hospitalized With Pneumonia.

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Chawla, Lakhmir S; Amdur, Richard L; Faselis, Charles; Li, Ping; Kimmel, Paul L; Palant, Carlos E

2017-04-01

Pneumonia is a common cause of hospitalization and can be complicated by the development of acute kidney injury. Acute kidney injury is associated with major adverse kidney events (death, dialysis, and durable loss of renal function [chronic kidney disease]). Because pneumonia and acute kidney injury are in part mediated by inflammation, we hypothesized that when acute kidney injury complicates pneumonia, major adverse kidney events outcomes would be exacerbated. We sought to assess the frequency of major adverse kidney events after a hospitalization for either pneumonia, acute kidney injury, or the combination of both. We conducted a retrospective database analysis of the national Veterans Affairs database for patients with a admission diagnosis of International Classification of Diseases-9 code 584.xx (acute kidney injury) or 486.xx (pneumonia) between October 1, 1999, and December 31, 2005. Three groups of patients were created, based on the diagnosis of the index admission and serum creatinine values: 1) acute kidney injury, 2) pneumonia, and 3) pneumonia with acute kidney injury. Patients with mean baseline estimated glomerular filtration rate less than 45 mL/min/1.73 m were excluded. The primary endpoint was major adverse kidney events defined as the composite of death, chronic dialysis, or a permanent loss of renal function after the primary discharge. The observations of 54,894 subjects were analyzed. Mean age was 68.7 ± 12.3 years. The percentage of female was 2.4, 73.3% were Caucasian, and 19.7% were African-American. Differences across the three diagnostic groups were significant for death, 25% decrease in estimated glomerular filtration rate from baseline, major adverse kidney events following admission, and major adverse kidney events during admission (all p pneumonia + acute kidney injury group (51% died and 62% reached major adverse kidney events). In both unadjusted and adjusted time to event analyses, patients with pneumonia + acute kidney injury

Early postoperative alterations of ventilation parameters after tracheostomy in major burn injuries

Directory of Open Access Journals (Sweden)

Mailänder, Peter

2010-01-01

Full Text Available Purpose: In patients with major burn injuries mechanical ventilation is often required for longer periods. Tracheostomy (TS plays an integral role in airway management. We investigated the effect of TS on ventilation parameters within 8 hours after TS. Materials: A retrospective analysis of severely burned patients admitted to the burn unit of a German University Hospital was performed. Ventilation parameters 8 hours before and after TS were registered. Results: A retrospective analysis of 20 patients which received surgical TS was performed. Mean age was 52±19 years. Mean abbreviated burned severity index (ABSI was 8.3±2.2. A mechanical ventilation was required for 14.3±4.8 days. TS was performed on day 7±4. Inspiratory oxygen concentration (FiO2 (p<0.001, peak inspiratory pressure (p<0.001, positive end-expiratory pressure (p=0.003 and pulmonary resistance (p<0.001 were reduced significantly after TS. The arterial partial pressure of oxygen/FiO2-ratio increased significantly after TS (p<0.001. Conclusions: We demonstrate that TS reduces invasiveness of ventilation in severely burned patients and by this can optimize lung protective ventilation strategy.

The international spinal cord injury pain basic data set.

Science.gov (United States)

Widerström-Noga, E; Biering-Sørensen, F; Bryce, T; Cardenas, D D; Finnerup, N B; Jensen, M P; Richards, J S; Siddall, P J

2008-12-01

To develop a basic pain data set (International Spinal Cord Injury Basic Pain Data Set, ISCIPDS:B) within the framework of the International spinal cord injury (SCI) data sets that would facilitate consistent collection and reporting of pain in the SCI population. International. The ISCIPDS:B was developed by a working group consisting of individuals with published evidence of expertise in SCI-related pain regarding taxonomy, psychophysics, psychology, epidemiology and assessment, and one representative of the Executive Committee of the International SCI Standards and Data Sets. The members were appointed by four major organizations with an interest in SCI-related pain (International Spinal Cord Society, ISCoS; American Spinal Injury Association, ASIA; American Pain Society, APS and International Association for the Study of Pain, IASP). The initial ISCIPDS:B was revised based on suggestions from members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA and APS Boards, and the Neuropathic Pain Special Interest Group of the IASP, individual reviewers and societies and the ISCoS Council. The final ISCIPDS:B contains core questions about clinically relevant information concerning SCI-related pain that can be collected by health-care professionals with expertise in SCI in various clinical settings. The questions concern pain severity, physical and emotional function and include a pain-intensity rating, a pain classification and questions related to the temporal pattern of pain for each specific pain problem. The impact of pain on physical, social and emotional function, and sleep is evaluated for each pain.

Mind the gap: 11 years of train-related injuries at the Royal London Hospital Major Trauma Centre.

Science.gov (United States)

Virdee, J; Pafitanis, G; Alamouti, R; Brohi, K; Patel, H

2018-06-18

Introduction This study presents an extensive retrospective database of patients with polytrauma following train-related injuries and highlights the key lessons learnt in this rare clinical presentation. Materials and methods We retrospectively collected data from 127 patients who presented to Royal London Hospital after sustaining train related trauma. We analysed demographics, accident report data, aetiologies and clinical management interventions. All data were screened and injuries were mapped to various anatomical regions. The revised trauma score, injury severity score and new injury severity scores were used to quantify injury extent. Results Mean patient age was 41 years (range 16-81 years) with a 73% to 27% male to female ratio. Deliberate injuries occurred in 71% of patients, with accidental injury accounting for 29%. The mean new injury severity score was 26.48 (range 1-75), with the most common injuries sustained to the chest and the extremities. Pneumothorax, haemothorax or tension pneumothorax occurred in 44% of patients, with 11% suffering a flail chest injury. Traumatic amputations occurred in 33% of patients and 56% of patients required admission to intensive care. Total mortality rates were 19%, with 12% of patients dying at day 0 and 18% at day 7, respectively. Conclusions This study demonstrated the significant impact of train-related polytrauma and provided a comprehensive injury patterns. It was observed that deliberate polytrauma is related to psychiatric deliberate harm but there is no significant difference in the patterns of injuries between accidental and deliberately caused injuries. Overall injuries to the thorax and extremities were the most severe, demonstrating the highest mean injury scores.

Swedish dairy farmers' perceptions of animal-related injuries.

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Lindahl, Cecilia; Lundqvist, Peter; Norberg, Annika Lindahl

2012-01-01

Animal-related injuries are among the most common occupational injuries in agriculture. Despite the large number of documented animal-related injuries in dairy farming, the issue has received relatively limited attention in the scientific literature. The farmers' own perspectives and views on risks and safety during livestock handling and what they think are effective ways of preventing injuries are valuable for the future design of effective interventions. This paper presents results from a qualitative study with the aim to investigate Swedish dairy farmers' own experience of animal-related occupational injuries, as well as their perceptions of and attitudes towards them, including risk and safety issues, and prevention measures. A total of 12 dairy farmers with loose housing systems participated in the study. Data collection was conducted by means of semistructured in-depth interviews. Three main themes with an impact on risks and safety when handling cattle were identified: the handler, the cattle, and the facilities. They all interact with each other, influencing the potential risks of any work task. Most of the farmers believed that a majority of the injuries can be prevented, but there are always some incidents that are impossible to foresee. In conclusion, this study indicates that Swedish dairy farmers are aware of the dangers from working with cattle. However, even though safety is acknowledged by the farmers as an important and relevant issue, in the end safety is often forgotten or not prioritized. One concern is that farmers are willing to take calculated risks to save money or time. In situations where they work alone with high stress levels and under economic distress, safety issues are easily given low priority.

Shoulder Injury Incidence Rates in NASA Astronauts

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Laughlin, Mitzi S.; Murray, Jocelyn D.; Foy, Millennia; Wear, Mary L.; Van Baalen, Mary

2014-01-01

Evaluation of the astronaut shoulder injury rates began with an operational concern at the Neutral Buoyancy Laboratory (NBL) during Extravehicular Activity (EVA) training. An astronaut suffered a shoulder injury during an NBL training run and commented that it was possibly due to a hardware issue. During the subsequent investigation, questions arose regarding the rate of shoulder injuries in recent years and over the entire history of the astronaut corps.

Motorcycle helmet type and the risk of head injury and neck injury during motorcycle collisions in California.

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Erhardt, Taryn; Rice, Thomas; Troszak, Lara; Zhu, Motao

2016-01-01

The use of novelty motorcycle helmets is often prompted by beliefs that wearing a standard helmet can contribute to neck injury during traffic collisions. The goal of this analysis was to examine the association between helmet type and neck injury risk and the association between helmet type and head injury. Data were collected during the investigation of motorcycle collisions of any injury severity by the California Highway Patrol (CHP) and 83 local law enforcement agencies in California between June 2012 and July 2013. We estimated head injury and neck injury risk ratios from data on 7051 collision-involved motorcyclists using log-binomial regression. Helmet type was strongly associated with head injury occurrence but was not associated with the occurrence of neck injury. Rider age, rider alcohol use, and motorcycle speed were strong, positive predictors of both head and neck injury. Interventions to improve motorcycle helmet choice and to counteract misplaced concerns surrounding neck injury risk are likely to lead to reductions in head injury, brain injury, and death. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lawnmower injuries in children.

LENUS (Irish Health Repository)

Nugent, Nora

2012-02-03

OBJECTIVE: Power lawnmowers can pose significant danger of injury to both the operator and the bystander, from direct contact with the rotary blades or missile injury. Our objective was to review our experience with paediatric lawnmower-associated trauma, and the safety recommendations available to operators of power lawnmowers. METHODS: The patient cohort comprised paediatric (<16 years of age) patients treated for lawnmower-associated trauma, by the plastic surgery service, between 1996 and 2003. These patients were identified retrospectively. Age at the time of injury, location and extent of bony and soft tissue injuries sustained, treatment instituted and clinical outcome were recorded. Brochures and instruction manuals of six lawnmower manufacturers were reviewed, and safety recommendations noted. RESULTS: Fifteen patients were identified. The majority of injuries occurred from direct contact with the rotary blades (93%); the remaining child sustained a burn injury. Fourteen children (93%) required operative intervention. Seven patients (46%) sustained injuries resulting in amputation, two of whom had major limb amputations. All children, except the burns patient, underwent wound debridement and received antibiotic therapy. Reconstructive methods ranged from primary closure to free tissue transfer. Many patients required multiple procedures. In all instruction manuals, instructions to keep children and pets indoors or out of the yard when mowing were found. CONCLUSIONS: Lawnmower injuries can be devastating, particularly in children. Many victims have lasting deformities as a result of their injuries. Awareness of and stringent adherence to safety precautions during use of power lawnmowers can prevent many of these accidents.

Mole gun injury.

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Pistré, V; Rezzouk, J

2013-09-01

A mole gun is a weapon, which is used to trap and kill moles. This report provides an overview of the state of knowledge of mole gun injuries, comparable to blast injuries caused by fireworks, explosive or gunshot. Over a 2-year period, the authors reported their experience with ten hand injuries caused by mole gun. Radial side of the hand was often concerned, particularly the thumb. The authors explain their choices in the management of such lesions. Surgery was performed primarily and a large debridement currently seemed to offer the best outcome for the patient. Blast, crush, burns and lacerations may explain the higher rate of amputation to the digits. A long period of physiotherapy, specifically of the hand, was needed before the patient could return to work. This ballistic hand trauma encountered by surgeons requires knowledge and understanding of these injuries. It should be in accordance with firearms law because of severe injuries encountered and possible lethal wounds. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Factors influencing psychological, social and health outcomes after major burn injuries in adults: cohort study protocol.

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Druery, Martha; Newcombe, Peter A; Cameron, Cate M; Lipman, Jeffrey

2017-06-17

The goal of burn care is that 'the quality of the outcome must be worth the pain of survival'. More research is needed to understand how best to deliver care for patients with burns to achieve this aim. Loss of independence, function as well as loss of income for patients with burns and carers cause a significant burden at both individual and societal levels. Much is being done to advance knowledge in the clinical care field; however, there has been a paucity of research exploring psychosocial outcomes. This paper describes the study background and methods, as implemented in an Australian cohort study of psychosocial outcomes after major burn injuries. In this inception cohort study, a target sample of 230 participants, aged 18 years or over, admitted to a single statewide burns centre with a burn injury are identified by hospital staff for inclusion. Baseline survey data are collected either in person or by telephone within 28 days of the injury and participants then followed up with telephone interviews at 3, 6 and 12 months postburn. Injury and burns treatment information is collected from medical records. Social support is measured as a predictor variable using the Multidimensional Scale of Perceived Social Support. Outcome data are collected via standardised measures in the domains of Quality of Life (SF-12, EQ-5D, BSHS-B), depression (PHQ-9), post-traumatic stress disorder (PCL-C, PAS), community integration (CIQ-R) and Quality-Adjusted Life Years (EQ-5D). Additional survey questions measure life satisfaction, return to work and public services utilisation at 12 months postinjury. Data analysis methods will include analysis of variance, Pearson correlation and hierarchical multiple regression analyses. Hospital-based and University of Queensland Human Research Ethics Committees have approved the protocol. Results from the study will be disseminated at national and international conferences, in peer-reviewed journals and in a doctoral thesis. Australia New

Trampoline-related injury in children.

Science.gov (United States)

Shankar, Amitabh; Williams, Kim; Ryan, Mary

2006-09-01

To quantify and describe trampoline-related injuries in children attending an urban pediatric emergency department. Retrospective cohort study of consecutive patients attending a children's emergency department with trampoline-related injuries over a 3-month period (May-July 2005). One hundred and sixty-eight children were treated for trampoline-related injuries during the period reviewed. Sixty-three percent were girls. Their age ranged between 4 months and 16 years (mean, 10.4 years [SD, 3 years and 10 months]). Lower limb injuries (51%) were more common overall. The most common injuries were to the ankle (31%), followed by foot (9.2%), and neck (8.4%). Sprain or soft tissue injuries (68%) were the most common type of injury, followed by fracture (12.2%). The most common mechanism of injury was inversion of the ankle on a trampoline (18.4%). Trampoline-related injuries represented 2.5% of morbidity from accidental trauma in children presenting to emergency department in our study. The rate and severity of injury has become a significant public health concern. It appears that current preventative strategies are inadequate in making children's carers aware of the potential risks of trampoline use, particularly when used recreationally.

Test-retest reliability at the item level and total score level of the Norwegian version of the Spinal Cord Injury Falls Concern Scale (SCI-FCS).

Science.gov (United States)

Roaldsen, Kirsti Skavberg; Måøy, Åsa Blad; Jørgensen, Vivien; Stanghelle, Johan Kvalvik

2016-05-01

Translation of the Spinal Cord Injury Falls Concern Scale (SCI-FCS), and investigation of test-retest reliability on item-level and total-score-level. Translation, adaptation and test-retest study. A specialized rehabilitation setting in Norway. Fifty-four wheelchair users with a spinal cord injury. The median age of the cohort was 49 years, and the median number of years after injury was 13. Interventions/measurements: The SCI-FCS was translated and back-translated according to guidelines. Individuals answered the SCI-FCS twice over the course of one week. We investigated item-level test-retest reliability using Svensson's rank-based statistical method for disagreement analysis of paired ordinal data. For relative reliability, we analyzed the total-score-level test-retest reliability with intraclass correlation coefficients (ICC2.1), the standard error of measurement (SEM), and the smallest detectable change (SDC) for absolute reliability/measurement-error assessment and Cronbach's alpha for internal consistency. All items showed satisfactory percentage agreement (≥69%) between test and retest. There were small but non-negligible systematic disagreements among three items; we recovered an 11-13% higher chance for a lower second score. There was no disagreement due to random variance. The test-retest agreement (ICC2.1) was excellent (0.83). The SEM was 2.6 (12%), and the SDC was 7.1 (32%). The Cronbach's alpha was high (0.88). The Norwegian SCI-FCS is highly reliable for wheelchair users with chronic spinal cord injuries.

Epidemiology of Nonfatal Injuries among Schoolchildren

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ALBashtawy, Mohammed; Al-Awamreh, Khetam; Gharaibeh, Huda; Al-Kloub, Manal; Batiha, Abdul-Monim; Alhalaiqa, Fadwa; Hamadneh, Shereen

2016-01-01

Nonfatal injuries are considered as one of the major public health hazards affecting schoolchildren, and the majority of these injuries occur at school or in the home. A cross-sectional study was conducted over a period of 3 months, March-May 2015. The participants were 4,355 Jordanian schoolchildren in Grades 7-12. The Pearson ?[superscript 2]…

Major workplace related accidents in Singapore: A major trauma centre's experience.

Science.gov (United States)

Ng, Zhi Xu; Teo, Li Tserng; Go, Karen T S; Yeo, Yen Teng; Chiu, Ming Terk

2010-12-01

Major workplace related accidents pose a significant healthcare resource challenge in Singapore. Our study looks at the epidemiology of patients who were admitted for workplace related accidents, in a single institution, with an Injury Severity Score of >9. There were 196 cases of major workplace related accidents admitted between January 2006 and December 2007. The median age of patients admitted was 37 years with a large percentage being males (95.4%) and non-residents (57.1%). The most common ethnic group was Chinese (53.1%) followed by Indians (23.5%). The most common mechanism of injury was fall from height (66.3%) followed by injuries as a result of falling objects at work (21.9%). The percentage of patients who required surgical intervention was 69.9%. Patients admitted for major workplace related accidents had a median length of stay of 5 days in the hospital, a median length of 24 days of medical leave (ML), certifying them unfit for duty and the average cost of stay for each patient was S$11,000. We have a better understanding of the epidemiology and socio-economic impact of workplace related accidents through this study. Workplace related accidents result in significant number of man-days lost from work and monetary cost to employers, medical insurance and the hospital. With an improved understanding, we propose methods to prevent and reduce such accidents in future. A direct consequence of which will be the possible reduction of hospitalisation costs and better allocation of healthcare resources in the future.

Collection of laws and ordinances concerning regulation of atomic energy, 1989 edition. 1989 ed.

International Nuclear Information System (INIS)

1989-01-01

The collection of the laws and ordinances concerning the regulation of atomic energy, 1989 edition, was published by the Nuclear Safety Bureau, Science and Technology Agency. First, the abbreviated expressions of 56 laws and ordinances are shown. The contents are divided into Part 1: Fundamental laws and ordinances, Part 2: Regulation of nuclear source materials, nuclear fuel materials and nuclear reactors, Part 3: Prevention of radiation injuries due to radioactive isotopes and others, and Part 4: Related laws and ordinances. In Part 1, Atomic Energy Fundamental Act, Act of Institution of Atomic Energy Commission and Nuclear Safety Commission of Japan, Law Concerning the Technical Standard for Prevention of Radiation Injuries and 9 others are included. In Part 2, Law Concerning Regulation of Nuclear Source Materials, Nuclear Fuel Materials and Nuclear Reactors and 45 others are included. In Part 3, Law Concerning Prevention of Radiation Injuries Due to Radioisotopes and Others and 25 others are included. In Part 4, Electricity Enterprises Act, Road Transport and Vehicles Act, Ships' Safety Law, Labor Safety and Hygiene Law, Japan Atomic Energy Research Institute Law and 29 others are included. The contents are those as of November 30, 1988. (Kako, I.)

Impact of adverse pancreatic injury at surgical procurement upon islet isolation outcome.

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Andres, Axel; Kin, Tatsuya; O'Gorman, Doug; Bigam, David; Kneteman, Norman; Senior, Peter; Shapiro, Am James

2014-11-01

The consequence of a pancreas injury during the procurement for islet isolation purpose is unknown. The goal of this work was to assess the injuries of the pancreata procured for islet isolation, and to determine their effect on the islet yield. Between January 2007 and October 2013, we prospectively documented every injury of the pancreata processed in our centre for islet isolation. Injuries involving the main duct were classified as major, the others as minor. Donors' characteristics and islet yields were compared between the groups of injuries. A pancreas injury was identified in 42 of 452 pancreata received for islet isolation (9.3%). In 15 cases, the injury was major (3.3% of all pancreata). Although a minor injury did not affect the islet yield, a major injury was significantly associated with unfavourable outcomes (postpurification mean islet equivalent of 364 ± 181, 405 ± 190 and 230 ± 115 × 10(3) for absence of injury, minor injury and major injury, respectively). A major injury was significantly more prevalent in lean and short donors. We recommend assessing the quality of the pancreas in the islet isolation centre before starting the isolation procedure. Each centre should determine its own policy based on its financial resources and on the wait list. © 2014 Steunstichting ESOT.

Clothing Flammability and Burn Injuries: Public Opinion Concerning an Overlooked, Preventable Public Health Problem.

Science.gov (United States)

Frattaroli, Shannon; Spivak, Steven M; Pollack, Keshia M; Gielen, Andrea C; Salomon, Michele; Damant, Gordon H

2016-01-01

The objective of this study was to describe knowledge of clothing flammability risk, public support for clothing flammability warning labels, and stronger regulation to reduce the risk. As part of a national survey of homeowners about residential sprinkler systems, the authors included questions about clothing flammability. The authors used an online web panel to sample homeowners and descriptive methods to analyze the resulting data. The sample included 2333 homeowners. Knowledge of clothing flammability and government oversight of clothing flammability risk was low. Homeowners were evenly split about the effectiveness of current standards; however, when presented with clothing-related burn injury and death data, a majority (53%) supported stricter standards. Most homeowners (64%) supported warning labels and indicated that such labels would either have no effect on their purchasing decisions (64%) or be an incentive (24%) to purchase an item. Owners of sprinkler-equipped homes were more likely to support these interventions than owners of homes without sprinkler systems. Public knowledge about clothing flammability risks is low. Most homeowners supported clothing labels to inform consumers of this risk and increased government intervention to reduce the risk.

The Infant and Young Child with Spina Bifida: Major Medical Concerns.

Science.gov (United States)

Shaer, Catherine M.

1997-01-01

This review of medical concerns in dealing with spina bifida examines neurologic and neurosurgical issues, learning issues, urological dysfunction, orthopedic issues, bowel control, latex allergy, and prenatal diagnosis and prevention. (JDD)

The incidence and nature of injuries in South African rugby players in the rugby Super 12 competition.

Science.gov (United States)

Holtzhausen, Louis J; Schwellnus, Martin P; Jakoet, Ismail; Pretorius, A L

2006-12-01

There are sparse scientific data concerning the aetiology and incidence of injuries in the Super 12 rugby competition. Aim. The aim of the study was to document the incidence, nature and risk factors associated with injuries during a Super 12 rugby competition. Injuries, defined as injuries preventing playing or training, or requiring medical treatment, were recorded in a cohort of 75 South African Super 12 players over one season. Injury severity was graded according to sessions missed: minor (1 - 3 missed), intermediate (4 - 9) and severe (> 9). During the tournament, a total of 740 player game hours and 4 900 player training hours were recorded. The overall incidence of injuries was 55.4 injuries/1,000 player game hours, and 4.3 injuries/1,000 player training hours. The most common injury types were: ligament sprains (25.8%), musculotendinous strains/tears (24.2%). The most common injured sites were: pelvis, hip (19.3%), head and knee (12.9% each). The tackle caused 40.3%, and rucks and mauls 11.3% of injuries. Injuries sustained during training accounted for 34%, and chronic overuse injuries 9.7% of injuries. There is a high injury rate during a Super 12 rugby competition. However, the majority of injuries were minor injuries. The most dangerous phase of play was the tackle. Training in tackling and rucking techniques, and rule enforcement are therefore recommended to reduce risk of injury. Injuries tended to occur late in games and early in the season, suggesting lack of physical conditioning and fatigue as possible causes of injury.

Pain is the Greatest Preoperative Concern for Patients and Parents Before Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

Science.gov (United States)

Chan, Priscella; Skaggs, David L; Sanders, Austin E; Villamor, Gabriela A; Choi, Paul D; Tolo, Vernon T; Andras, Lindsay M

2017-11-01

Prospective cross-sectional study. To evaluate patients' and parents' concerns so they can be addressed with appropriate preoperative counseling. Despite much research on outcomes for posterior spinal fusion (PSF) in adolescent idiopathic scoliosis (AIS), little is available about preoperative fears or concerns. Patients with AIS undergoing PSF, their parents, and surgeons were prospectively enrolled and asked to complete a survey on their fears and concerns about surgery at their preoperative appointment. Forty-eight patients and parents completed surveys. Four attending pediatric spine surgeons participated and submitted 48 responses. Mean age of patients was 14.2 years. On a scale of 0 to 10, mean level of concern reported by parents (6.9) was higher than that reported by patients (4.6). Surgeons rated the procedure's complexity on a scale of 0 to 10 and reported a mean of 5.2. Neither patients' nor parents' level of concern correlated with the surgeons' assessment of the procedure's complexity level (R = 0.19 and 0.12, P = 0.20 and P = 0.42, respectively). Top three concerns for patients were pain (25%), ability to return to activities (21%), and neurologic injury (17%). Top three concerns for parents were pain (35%), neurologic injury (21%), and amount of correction (17%). Top three concerns for surgeons were postoperative shoulder balance (44%), neurologic injury (27%), and lowest instrumented vertebrae selection (27%). Patients reported the same concerns 23% of the time as parents, and 17% of the time as surgeons. Parents and surgeons reported the same concerns 21% of the time. Pain was the greatest concern for both patients and parents but was rarely listed as a concern by surgeons. Parent and patient level of concern did not correlate to the surgeon's assessment of the procedure's complexity. Neurologic injury was a top concern for all groups, but otherwise there was little overlap between physician, patient, and parent concerns. 3.

Nasal avulsion injuries.

Science.gov (United States)

Denneny, J C

1987-11-01

The nose is the most frequently traumatized portion of the human face. High-speed motor vehicle accidents and interpersonal violence commonly produce bony pyramid and septal damage and occasional minor soft-tissue damage. Major soft-tissue injuries are much less commonly encountered. Avulsion injuries of this type may involve skin only or the bony and cartilaginous framework as well. The severity of these injuries can range from total avulsion to minor skin loss and anywhere within the spectrum between. My experience is reviewed, management guidelines and options are detailed, and selected cases are presented.

Risk Stratification for Ulnar Collateral Ligament Injury in Major League Baseball Players: A Retrospective Study From 2007 to 2014.

Science.gov (United States)

DeFroda, Steven F; Kriz, Peter K; Hall, Amber M; Zurakowski, David; Fadale, Paul D

2016-02-01

Ulnar collateral ligament (UCL) injury has become increasingly common in Major League Baseball (MLB) players in recent years. There is a significant difference in preinjury fastball velocity between MLB pitchers with tears and matched controls without UCL injury. Pitchers with injuries are throwing harder and getting injured earlier in their MLB careers. Cohort study; Level of evidence, 3. From 2007 to 2014, a total of 170 documented UCL injuries (156 pitchers, 14 position players) occurred in MLB. Inclusion criteria for this study consisted of any player who tore his UCL in MLB during this time frame. There were 130 regular-season tears (April-September). From this group, 118 players who pitched more than 100 innings prior to tear were matched to subjects with no tear and were compared using a logistic regression analysis. A subgroup of "early tear" players who threw less than 100 career innings (n = 37) was also identified and compared with the larger tear group using a logistic regression analysis. Of the 130 tears that occurred during the regular season, a significantly larger number (62%) occurred in the first 3 months (P = .011). The rate of UCL tears per MLB player (P = .001) was statistically significant. In the group of 118 matched tears, the mean fastball velocity was greater in the tear group (91.7 mph) compared with the control group (91.0 mph; P = .014). Furthermore, relief pitchers made up a greater percentage of the early tear group (<100 innings) compared with the later tear group (P = .011). Sixteen of the 170 UCL tears (9.4%) were recurrent tears, with 5 of 16 experiencing both tear and retear within the past 4 years. There is a statistically significant difference in the mean fastball velocity of pitchers who injure their UCL. Small increases in pitcher fastball velocity are a main contribution to the increased rate of tear in MLB. In addition, there has been an increased incidence of injury in the first 3 months of the season. Finally, early

Morbidity and injury recurrence in victims of firearm injuries.

Science.gov (United States)

Ponzer, S; Bergman, B; Brismar, B

1996-01-01

Civilian violence has become an increasing problem in the industrial world. Gunshot wounds, fatal or non-fatal, are often considered as acute trauma episodes. However, our previous study, based on 820 firearm injuries, showed that this group of patients was characterized by a high mortality rate and a pronounced involvement in criminality when compared to a control group. The aim of this study was to determine the general morbidity in the same group of firearm victims. Our hypotheses were that these patients consume a considerable amount of hospital care due to recurring trauma episodes and that their general morbidity is raised. Information was collected concerning all episodes of in-patient care for victims of firearm injuries from 1972-1992 in Stockholm, Sweden. The victims were compared with a sex- and age-matched control group. During the study period, 69.9% of the 820 firearm victims were treated for other reasons than gunshot injuries, compared to 45.5% of the 820 controls. The former group was hospitalized 3,703 times and the latter on 1,512 occasions. The firearm injury group showed an higher morbidity in almost all diagnostic subgroups according to ICD-9. The trauma recurrence rate was high and suicide, homicide and assault were relatively more common in this group. We suggest that the gunshot episode may be regarded as one expression of a "chronic trauma syndrome'. Patients exhibiting this "syndrome' are characterized by recurrent episodes of trauma, a risk-taking and destructive behavior, high morbidity and mortality as well as anti-social traits. Medical, social and legal complications are common making these patients extremely costly for society and their identification a matter of concern. It is probable that this "syndrome' also exists in other groups of trauma patients. Since hospitalization affords a unique opportunity of reaching patients who have a "chronic trauma syndrome' risk profile, we believe, that these patients should not only be treated

[Forensic analysis of injuries in dentistry].

Science.gov (United States)

Heltai, Nóra; Baráth, Zoltán; Kereszty, Éva M

2016-03-13

Documentation and evaluation of dental injuries in forensic medicine are rather problematic. It needs a professional work up why dental injuries are out of focus, and how the diagnosis, pattern and treatment are influenced by novel approaches of dentistry. The aims of the authors were to characterize dental injuries, to compare their own findings to literature data concerning the type and characteristics of injuries, and propose a diagnostic workflow. Expert's reports between 2009 and 2013 at the Department of Forensic Medicine, University of Szeged were reviewed. Review of about 7000 reports revealed only 20 cases with dental injury, which is in contrast with literature data indicating a significantly higher frequency of dental injuries. Although the number of "dental cases" was low, there were several additional cases where the trauma probably affected the teeth but the injury was not documented. In future more attention is needed in forensic evaluation of the mechanism, therapeutic strategy and prognosis of dental injuries.

Etiology and mechanisms of ulnar and median forearm nerve injuries

Directory of Open Access Journals (Sweden)

Puzović Vladimir

2015-01-01

Full Text Available Bacgraund/Aim. Most often injuries of brachial plexus and its branches disable the injured from using their arms and/or hands. The aim of this study was to investigate the etiology and mechanisms of median and ulnar forearm nerves injuries. Methods. This retrospective cohort study included 99 patients surgically treated in the Clinic of Neurosurgery, Clinical Center of Serbia, from January 1st, 2000 to December 31st, 2010. All data are obtained from the patients' histories. Results. The majority of the injured patients were male, 81 (81.8%, while only 18 (18.2% were females, both mainly with nerve injuries of the distal forearm - 75 (75.6%. Two injury mechanisms were present, transection in 85 patients and traction and contusion in 14 of the patients. The most frequent etiological factor of nerve injuries was cutting, in 61 of the patients. Nerve injuries are often associated with other injuries. In the studied patients there were 22 vascular injuries, 33 muscle and tendon injuries and 20 bone fractures. Conclusion. The majority of those patients with peripheral nerve injuries are represented in the working age population, which is a major socioeconomic problem. In our study 66 out of 99 patients were between 17 and 40 years old, in the most productive age. The fact that the majority of patients had nerve injuries of the distal forearm and that they are operated within the first 6 months after injury, promises them good functional prognosis.

Injuries in professional Rugby Union.

Science.gov (United States)

Targett, S G

1998-10-01

To document injury rates in professional rugby players in the Rugby Super 12 competition and to act as a pilot study for future studies of rugby injuries. Prospective longitudinal study encompassing the 1997 Super 12 rugby season. A New Zealand Super 12 rugby squad. 25 professional rugby players (replacement players were used for unavailable players, so although 30 different players were used during the season, there were only 25 in the squad at any one time). An "injury" was defined as something that prevented a player from taking part in two training sessions, from playing the next week, or something requiring special medical treatment (suturing or special investigations). An injury was "significant" if it prevented the player from being able to play one week after sustaining it (that is, if it made the player miss the next match). The overall injury rate was 120/1000 player hours. The rate of significant injuries was 45/1000 player hours. Those playing the position of "forward" had a higher overall injury rate than other players, but there was no difference in significant injury rate between the forwards and the backs. Injuries that caused players to miss game time occurred almost exclusively during the pre-season program or in the final third of the season. The majority of injuries were musculo-tendinous sprains or strains. The phase of play responsible for the majority of injuries was the tackle. The most frequently injured body part was the head and face. No catastrophic injuries occurred during the study period. Injury rates increase with increasing grade of rugby, injury rates in the Super 12 competition being higher than in first grade rugby. There is very little quality data on rugby injuries, and the few studies available use different methods of data collection and injury definition. There is a pressing need for the collection of accurate ongoing epidemiological data on injuries in rugby.

Rupture of the pectoralis major muscle in a paratrooper.

Science.gov (United States)

Komurcu, Mahmut; Yildiz, Yavuz; Ozdemir, M Taner; Erler, Kaan

2004-01-01

Rupture of the pectoralis major muscle is a very rare injury. Excessive contraction of muscle fibers during certain forms of sports, such as weightlifting and bench pressing, is the most common cause. Among the 150 reported cases in the literature, in only 1 case did the injury happen during the landing phase of parachuting. Here we report a case of pectoralis major muscle rupture caused by a different mechanism than published previously. A paratrooper was injured during a tactical jump out of an aircraft after becoming entangled with the risers. The mechanism of injury was excessive traction and malpositioning of his shoulder when the parachute deployed. A three-phase conservative treatment regimen was performed and results were assessed by dynamometry. The patient was satisfied with the treatment and the dynamometric results were good at 9 mo after injury and at the end of a 20-mo follow-up period. We suggest that three-phase rehabilitation can be an effective treatment option for pectoralis major muscle rupture in selected patients. Prevention of this type of altitude injury would be possible by applying the fundamentals of parachuting.

Monitoring injury in the New Zealand adventure tourism sector: an operator survey.

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Bentley, Tim A; Page, Stephen; Edwards, Joanna

2008-01-01

Client safety is a major risk management concern for the commercial adventure tourism sector in New Zealand. This study built on previous exploratory analyses of New Zealand adventure tourism safety, including industry surveys conducted by these authors in 1999 and 2003. The aims of the study were to provide a continuation of injury monitoring across the sector through data collected from self-reported injury incidence by industry operators and to compare findings with those from other primary and secondary research studies conducted by the authors. A postal questionnaire was used to survey all identifiable New Zealand adventure tourism operators during 2006. The questionnaire asked respondents about their recorded client injury experience, perceptions of client injury risk factors, and safety management practices. Some 21 adventure tourism activities were represented among the responding sample (n = 127), with most operations being very small in terms of staff numbers, although responding operators catered to nearly 1 million clients in total annually. Highest ranked risk factors for client injury included clients not following instructions; level of client skill, ability, and fitness; and changeable/unpredictable weather conditions. Highest client injury was reported for horse riding, ecotourism, and white water rafting sectors, although serious underreporting of minor injuries was evidenced across the sector. Slips, trips, and falls were the most frequently reported injury mechanism, while safety management measures were inconsistently applied across the sector. The industry should address reporting culture issues and safety management practices generally. Specifically, the industry should consider risk management that focuses on minor (eg, falls) as well as catastrophic events.

TREATMENT OF BLUNT LIVER INJURIES IN CHILDREN

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Ana Kostić

2003-04-01

Full Text Available Liver is the largest parenchymatous organ, well vascularized, weighing approximately 1.8-3.0% of the whole body weight. Among all abdominal traumas liver injuries account for 25%. For more serious liver injuries the mortality is around 40% in children below 10 years of age. For lesions of the juxtahepatic veins (three major hepatic veins or the retrohepatic portion of v. cava or for complex, combined intraabdominal injuries, the mortality is even up to 70%.This work analyzed the period 1988-2000 during which there were 19 children admitted and treated for blunt liver injuries at the Clinic of Pediatric Surgery and Orthopedics in Nis; I, II and III scale injuries prevailed (17 cases; 89.4%. These injuries were surgically treated for the most part (17 cases; 89.4%. In 7 children (36.8% there were combined injuries. The lethality was 26.3%-5 cases, with three major complications: two intrahepatic hematomas and one biliary fistula associated with biliary peritonitis and biloma formation.

Firework-related childhood injuries in Greece: a national problem.

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Vassilia, Konte; Eleni, Petridou; Dimitrios, Trichopoulos

2004-03-01

During a 5-year period, out of 110066 children with injuries recorded in the Greek Emergency Department Injury Surveillance System (EDISS), 91 had firework-related injuries. Descriptive analyses and the Barrell matrix were used to determine risk factors and extrapolated national firework childhood injury figures were calculated. The estimated annual incidence of childhood firework injuries treated in the emergency departments of hospitals countrywide, was 7 per 100000 children years. Seventy percent of injuries concerned older children (10-14 years), mostly boys with self-inflicted injuries, whereas girls suffered injuries as bystanders. A sharp peak in spring was noted, when the Greek Orthodox Easter is celebrated. Illicitly sold fireworks caused most injuries, but in eight instances homemade firecrackers were responsible.

School Response to Self-Injury: Concerns of Mental Health Staff and Parents

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Kelada, Lauren; Hasking, Penelope; Melvin, Glenn A.

2017-01-01

Nonsuicidal self-injury (NSSI) among adolescents poses a significant problem for schools, adolescents, and their families. However, appropriate guidelines for addressing NSSI, including when to disclose the behavior to parents, are currently lacking. The present study aimed to understand how school mental health staff and parents of secondary…

Financial Aspects of Bile Duct Injuries.

Science.gov (United States)

Palaz Alı, Ozgkıour; Ibis, Abdil Cem; Gurtekin, Basak

2017-11-04

BACKGROUND Major bile duct injury is the most worrisome complication of cholecystectomy. There is no detailed data about the incidence or treatment-related costs of bile duct injuries in Turkey. We aimed to determine prevalence and therapeutic costs of patients with major biliary duct injuries managed in our department, and further estimate a projection of these parameters at the national level. MATERIAL AND METHODS All patients admitted due to bile duct injury during cholecystectomy from 2011 to 2014 were included. Healthcare costs were calculated by summing of their all treatment-related costs in Istanbul Medical Faculty. We collected 2014-2015 data on number of patients diagnosed with cholecystitis in Turkey, the number of cholecystectomies, and the number of the interventions performed following these initial surgeries, which were obtained from the Turkish Social Security Institution. RESULTS Forty-nine patients were enrolled and bilioenteric diversion was performed in 39 patients: 20.4% of patients had Bismuth II, 38.8% had Bismuth III, and 40.8% had Bismuth IV biliary stricture. Comparison of stricture types with total costs, days of hospitalization, and outpatient clinic costs revealed significant differences. Mean total cost of corrective surgeries was 9199 TRY. We estimated that 1.5% to 2.4% of patients who underwent cholecystectomy in Turkey have bile duct injury (including 0.3% with major bile duct injury). CONCLUSIONS New preventive strategies should be used to avoid bile duct injuries, which have a huge financial impact on the national economy.

Hydrogen gas reduces hyperoxic lung injury via the Nrf2 pathway in vivo

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Kawamura, Tomohiro; Wakabayashi, Nobunao; Shigemura, Norihisa; Huang, Chien-Sheng; Masutani, Kosuke; Tanaka, Yugo; Noda, Kentaro; Peng, Ximei; Takahashi, Toru; Billiar, Timothy R.; Okumura, Meinoshin; Toyoda, Yoshiya; Kensler, Thomas W.

2013-01-01

Hyperoxic lung injury is a major concern in critically ill patients who receive high concentrations of oxygen to treat lung diseases. Successful abrogation of hyperoxic lung injury would have a huge impact on respiratory and critical care medicine. Hydrogen can be administered as a therapeutic medical gas. We recently demonstrated that inhaled hydrogen reduced transplant-induced lung injury and induced heme oxygenase (HO)-1. To determine whether hydrogen could reduce hyperoxic lung injury and investigate the underlying mechanisms, we randomly assigned rats to four experimental groups and administered the following gas mixtures for 60 h: 98% oxygen (hyperoxia), 2% nitrogen; 98% oxygen (hyperoxia), 2% hydrogen; 98% balanced air (normoxia), 2% nitrogen; and 98% balanced air (normoxia), 2% hydrogen. We examined lung function by blood gas analysis, extent of lung injury, and expression of HO-1. We also investigated the role of NF-E2-related factor (Nrf) 2, which regulates HO-1 expression, by examining the expression of Nrf2-dependent genes and the ability of hydrogen to reduce hyperoxic lung injury in Nrf2-deficient mice. Hydrogen treatment during exposure to hyperoxia significantly improved blood oxygenation, reduced inflammatory events, and induced HO-1 expression. Hydrogen did not mitigate hyperoxic lung injury or induce HO-1 in Nrf2-deficient mice. These findings indicate that hydrogen gas can ameliorate hyperoxic lung injury through induction of Nrf2-dependent genes, such as HO-1. The findings suggest a potentially novel and applicable solution to hyperoxic lung injury and provide new insight into the molecular mechanisms and actions of hydrogen. PMID:23475767

Study on the trend and disease burden of injury deaths in Chinese population, 2004-2010.

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Lijuan Zhang

Full Text Available Injuries are a growing public health concern in China, accounting for more than 30% of all Person Years of Life Lost (PYLL due to premature mortality. This study analyzes the trend and disease burden of injury deaths in Chinese population from 2004 to 2010, using data from the National Disease Surveillance Points (DSPs system, as injury deaths are classified based on the International Classification of Disease-10(th Revision (ICD-10. We observed that injury death accounted for nearly 10% of all deaths in China throughout the period 2004-2010, and the injury mortality rates were higher in males than those in females, and higher in rural areas than in urban areas. Traffic crashes (33.79-38.47% of all injury deaths and suicides (16.20-22.01% were the two leading causes of injury deaths. Alarmingly, suicide surpassed traffic crashes as the leading cause of injury mortality in rural females, yet adults aged 65 and older suffered the greatest number of fatal falls (20,701 deaths, 2004-2010. The burden of injury among men (72.11% was about three times more than that of women's (28.89%. This study provides indispensible evidence that China Authority needs to improve the surveillance and deterrence of three major types of injuries: Traffic-related injury deaths should be targeted for injury prevention activities in all population, people aged 65+ should be encouraged to take individual fall precautions, and prevention of suicidal behavior in rural females should be another key priority for the government of China.

Chronic consequences of acute injuries: worse survival after discharge.

Science.gov (United States)

Shafi, Shahid; Renfro, Lindsay A; Barnes, Sunni; Rayan, Nadine; Gentilello, Larry M; Fleming, Neil; Ballard, David

2012-09-01

The Trauma Quality Improvement Program uses inhospital mortality to measure quality of care, which assumes patients who survive injury are not likely to suffer higher mortality after discharge. We hypothesized that survival rates in trauma patients who survive to discharge remain stable afterward. Patients treated at an urban Level I trauma center (2006-2008) were linked with the Social Security Administration Death Master File. Survival rates were measured at 30, 90, and 180 days and 1 and 2 years from injury among two groups of trauma patients who survived to discharge: major trauma (Abbreviated Injury Scale score ≥ 3 injuries, n = 2,238) and minor trauma (Abbreviated Injury Scale score ≤ 2 injuries, n = 1,171). Control groups matched to each trauma group by age and sex were simulated from the US general population using annual survival probabilities from census data. Kaplan-Meier and log-rank analyses conditional upon survival to each time point were used to determine changes in risk of mortality after discharge. Cox proportional hazards models with left truncation at the time of discharge were used to determine independent predictors of mortality after discharge. The survival rate in trauma patients with major injuries was 92% at 30 days posttrauma and declined to 84% by 3 years (p > 0.05 compared with general population). Minor trauma patients experienced a survival rate similar to the general population. Age and injury severity were the only independent predictors of long-term mortality given survival to discharge. Log-rank tests conditional on survival to each time point showed that mortality risk in patients with major injuries remained significantly higher than the general population for up to 6 months after injury. The survival rate of trauma patients with major injuries remains significantly lower than survival for minor trauma patients and the general population for several months postdischarge. Surveillance for early identification and treatment of

Chest injuries associated with earthquakes: an analysis of injuries sustained during the 2008 Wen-Chuan earthquake in China.

Science.gov (United States)

Hu, Jia; Guo, Ying-Qiang; Zhang, Er-Yong; Tan, Jin; Shi, Ying-Kang

2010-08-01

The goal of this study was to analyze the patterns, therapeutic modalities, and short-term outcomes of patients with chest injuries in the aftermath of the Wen-Chuan earthquake, which occurred on May 12, 2008 and registered 8.0 on the Richter scale. Of the 1522 patients who were referred to the West China Hospital of Sichuan University from May 12 to May 27, 169 patients (11.1%) had suffered major chest injuries. The type of injury, the presence of infection, Abbreviated Injury Score (AIS 2005), New Injury Severity Score (NISS), treatment, and short-term outcome were all documented for each case. Isolated chest injuries were diagnosed in 129 patients (76.3%), while multiple injuries with a major chest trauma were diagnosed in 40 patients (23.7%). The mean AIS and the median NISS of the hospitalized patients with chest injuries were 2.5 and 13, respectively. The mortality rate was 3.0% (5 patients). Most of the chest injuries were classified as minor to moderate trauma; however, coexistent multiple injuries and subsequent infection should be carefully considered in medical response strategies. Coordinated efforts among emergency medical support groups and prior training in earthquake preparedness and rescue in earthquake-prone areas are therefore necessary for efficient evacuation and treatment of catastrophic casualties.

Different tissue type categories of overuse injuries to cricket fast ...

African Journals Online (AJOL)

Background. Cricket fast bowlers have a high incidence of injury and have been the subject of previous research investigating the effects of previous injury, workload and technique. Bone stress injuries are of particular concern as they lead to prolonged absences from the game, with younger bowlers appearing to be at ...

Soccer injuries in children

International Nuclear Information System (INIS)

Paterson, Anne

2009-01-01

Soccer is the most popular sport in the world, with FIFA recognising more than 265 million amateur players. Despite the fact that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status as the fastest growing team sport in the USA. Acute and minor injuries predominate in the statistics, with contusions and abrasions being the most commonly recorded. As would be expected, the majority of soccer injuries are to the lower limbs, with serious truncal and spinal trauma being rare. This article examines the type and anatomic location of injuries sustained by children and adolescents who play soccer, and the main mechanisms whereby such injuries occur. The risk factors underpinning injury occurrence are considered, along with injury avoidance tactics. (orig.)

Soccer injuries in children

Energy Technology Data Exchange (ETDEWEB)

Paterson, Anne [Royal Belfast Hospital for Sick Children, Radiology Department, Belfast (United Kingdom)

2009-12-15

Soccer is the most popular sport in the world, with FIFA recognising more than 265 million amateur players. Despite the fact that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status as the fastest growing team sport in the USA. Acute and minor injuries predominate in the statistics, with contusions and abrasions being the most commonly recorded. As would be expected, the majority of soccer injuries are to the lower limbs, with serious truncal and spinal trauma being rare. This article examines the type and anatomic location of injuries sustained by children and adolescents who play soccer, and the main mechanisms whereby such injuries occur. The risk factors underpinning injury occurrence are considered, along with injury avoidance tactics. (orig.)

Soccer injuries in children.

Science.gov (United States)

Paterson, Anne

2009-12-01

Soccer is the most popular sport in the world, with FIFA recognising more than 265 million amateur players. Despite the fact that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status as the fastest growing team sport in the USA. Acute and minor injuries predominate in the statistics, with contusions and abrasions being the most commonly recorded. As would be expected, the majority of soccer injuries are to the lower limbs, with serious truncal and spinal trauma being rare. This article examines the type and anatomic location of injuries sustained by children and adolescents who play soccer, and the main mechanisms whereby such injuries occur. The risk factors underpinning injury occurrence are considered, along with injury avoidance tactics.

Laboratory Animal Workers’ Attitudes and Perceptions Concerning Occupational Risk and Injury

OpenAIRE

Steelman, Eric D; Alexander, Jeffrey L

2016-01-01

Little is known regarding the risk perceptions and attitudes of laboratory animal care workers toward biologic safety. The purpose of this descriptive study was to assess the attitudes and perceptions of laboratory animal workers toward occupational and injury risk. Subscribers to the CompMed and TechLink listservs (n = 4808) were surveyed electronically, and 5.3% responded; data from 215 respondents were included in the final analysis. Primary variables of interest included AALAS certificati...

Pectoralis Major Repair With Unicortical Button Fixation And Suture Tape.

Science.gov (United States)

Sanchez, Anthony; Ferrari, Marcio B; Frangiamore, Salvatore J; Sanchez, George; Kruckeberg, Bradley M; Provencher, Matthew T

2017-06-01

Although injuries of the pectoralis major muscle are generally uncommon, ruptures of the pectoralis major are occasionally seen in younger, more active patients who participate in weightlifting activities. These injuries usually occur during maximal contraction of the muscle, while in extension and external rotation. In the case of a rupture, operative treatment is advocated especially in young, active patients regardless of the chronicity of the injury. Various surgical techniques for reattachment of the avulsed tendon have been described, but bone tunnel and suture anchor repair techniques are most widely used. In this Technical Note, we present our preferred technique for acute pectoralis major rupture repair involving use of cortical buttons for tendon stump-to-bone fixation.

The reported thoracic injuries in Homer's Iliad

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Apostolaki Mary

2010-11-01

Full Text Available Abstract Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%, the stones (7.4%, the arrow (5.5% and the sword (5.5%. We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim, medium (those which cause the victim to abandon the battlefield, and severe (those which cause death of the victim. According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95% and the remaining 8 an Achaean (21.05%. The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield.

The reported thoracic injuries in Homer's Iliad.

Science.gov (United States)

Apostolakis, Efstratios; Apostolaki, Georgia; Apostolaki, Mary; Chorti, Maria

2010-11-19

Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%), the stones (7.4%), the arrow (5.5%) and the sword (5.5%). We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim), medium (those which cause the victim to abandon the battlefield), and severe (those which cause death of the victim). According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95%) and the remaining 8 an Achaean (21.05%). The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield.

Traumatic brain injury in children in Denmark: A national 15-year study

International Nuclear Information System (INIS)

Engberg, Aase; Teasdale, Thomas W.

1998-01-01

Demographic trends are reported concerning three types of traumatic brain injury (concussions, cranial fractures, and intracranial contusions/ haemorrhages) among children in Denmark of ages up to and including 14 years, for a fifteen year period from 1979 through 1993. The data were derived from a national computer-based hospitalization register and include 49,594 children, of whom 60% were boys and 89% had suffered a concussion. Virtually all injuries were the result of accidents. A major finding was that there has been a general decline in the incidence of traumatic brain injuries, especially for boys from 5 to 14 years old, suggesting a degree of success in preventive measures, particularly regarding road safety. The incidence of fatal cases of intracranial contusions/haemorrhages approximately halved over the 15 year period. However, as a proportion of all diagnosed cases, mortality from intracranial contusions/haemorrhages remained fairly constant at about 22%, perhaps because there have been no markedly successful innovations in acute care. Among children surviving a intracranial contusions/haemorrhages, rather considerable numbers were found to have been awarded disability pension at ages under 30

Management of Laryngotracheal and Tracheobronchial Injuries

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Hamid Reza Davari

2010-09-01

Full Text Available Laryngotracheal and tracheobronchial injuries are uncommon,and their successful diagnosis and management often require ahigh level of expertise. This paper aimed at retrospectiveanalysis of a thoracic surgeon's experience in the diagnosisand management of traumatic injuries to the larynx, tracheaand major bronchi. Forty one patients with major airwaytrauma were managed from March 1994 to November 2008.Their demographic characteristics including age, gender,mechanisms and locations of injuries, associated other organinjuries as well as surgical airway managements and the outcomeswere recorded. Seven patients had re-implantation ofthe main bronchus, and one patient had a repair of the rightupper lobe bronchus with concomitant bilobectomy. In casesof tracheal injury, 16 patients had a primary repair of trachea.However, seven patients with tracheal injury first conservativeapproaches, but 4 of them were later subjected to sleeve resectionof trachea. In patients with laryngotracheal injuries, and ina patient with thermal injury, Montgomery T-Tube was usedwith or without repair and/or reconstruction. Four patients died,but no significant morbidity was seen in others. The analysis ofthe cases suggests that laryngotracheal and tracheobronchialinjuries require early correct diagnosis, skillful management,and prompt individualized surgical airway repair.

Edaravone prevents lung injury induced by hepatic ischemia-reperfusion.

Science.gov (United States)

Uchiyama, Munehito; Tojo, Kentaro; Yazawa, Takuya; Ota, Shuhei; Goto, Takahisa; Kurahashi, Kiyoyasu

2015-04-01

Lung injury is a major clinical concern after hepatic ischemia-reperfusion (I/R), due to the production of reactive oxygen species in the reperfused liver. We investigated the efficacy of edaravone, a potent free-radical scavenger, for attenuating lung injury after hepatic I/R. Adult male Sprague-Dawley rats were assigned to sham + normal saline (NS), I/R + NS, or I/R + edaravone group. Rats in the I/R groups were subjected to 90 min of partial hepatic I/R. Five minutes before reperfusion, 3 mg/kg edaravone was administered to the I/R + edaravone group. After 6 h of reperfusion, we evaluated lung histopathology and wet-to-dry ratio. We also measured malondialdehyde (MDA), an indicator of oxidative stress, in the liver and the lung, as well as cytokine messenger RNA expressions in the reperfused liver and plasma cytokine concentrations. Histopathology revealed lung damages after 6 h reperfusion of partial ischemic liver. Moreover, a significant increase in lung wet-to-dry ratio was observed. MDA concentration increased in the reperfused liver, but not in the lungs. Edaravone administration attenuated the lung injury and the increase of MDA in the reperfused liver. Edaravone also suppressed the reperfusion-induced increase of interleukin-6 messenger RNA expressions in the liver and plasma interleukin-6 concentrations. Edaravone administration before reperfusion of the ischemic liver attenuates oxidative stress in the reperfused liver and the subsequent lung injury. Edaravone may be beneficial for preventing lung injury induced by hepatic I/R. Copyright © 2015 Elsevier Inc. All rights reserved.

Quality of life after major trauma with multiple rib fractures.

Science.gov (United States)

Marasco, Silvana; Lee, Geraldine; Summerhayes, Robyn; Fitzgerald, Mark; Bailey, Michael

2015-01-01

Rib fractures are a common injury presenting to major trauma centres and community hospitals. Aside from the acute impact of rib fracture injury, longer-term morbidity of pain, disability and deformity have been described. Despite this, the mainstay of management for the vast majority of rib fracture injuries remains supportive only with analgesia and where required respiratory support. This study aimed to document the long-term quality of life in a cohort of major trauma patients with rib fracture injury over 24 months. Retrospective review (July 2006-July 2011) of 397 major trauma patients admitted to The Alfred Hospital with rib fractures and not treated with operative rib fixation. The main outcome measures were quality of life over 24 months post injury assessed using the Glasgow Outcome Scale Extended and SF12 health assessment forms and a pain questionnaire. Assessment over 24 months of major trauma patients with multiple rib fractures demonstrated significantly lower quality of life compared with published Australian norms at all time points measured. Return to work rates were poor with only 71% of those who were working prior to their accident, returning to any work. This study demonstrates a significant reduction in quality of life for rib fracture patients requiring admission to hospital, which does not return to the level of Australian norms for at least two years. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

A twin study of body dysmorphic concerns.

Science.gov (United States)

Monzani, B; Rijsdijk, F; Anson, M; Iervolino, A C; Cherkas, L; Spector, T; Mataix-Cols, D

2012-09-01

Dysmorphic concern refers to an excessive preoccupation with a perceived or slight defect in physical appearance. It lies on a continuum of severity from no or minimal concerns to severe concerns over one's appearance. The present study examined the heritability of dysmorphic concerns in a large sample of twins. Twins from the St Thomas UK twin registry completed a valid and reliable self-report measure of dysmorphic concerns, which also includes questions about perceived body odour and malfunction. Twin modelling methods (female twins only, n=3544) were employed to decompose the variance in the liability to dysmorphic concerns into additive genetic, shared and non-shared environmental factors. Model-fitting analyses showed that genetic factors accounted for approximately 44% [95% confidence intervals (CI) 36-50%] of the variance in dysmorphic concerns, with non-shared environmental factors and measurement error accounting for the remaining variance (56%; 95% CI 50-63%). Shared environmental factors were negligible. The results remained unchanged when excluding individuals reporting an objective medical condition/injury accounting for their concern in physical appearance. Over-concern with a perceived or slight defect in physical appearance is a heritable trait, with non-shared environmental factors also playing an important role in its causation. The results are relevant for various psychiatric disorders characterized by excessive concerns in body appearance, odour or function, including but not limited to body dysmorphic disorder.

Needs and Concerns of Male Combat Veterans with Mild Traumatic Brain Injury

Science.gov (United States)

2013-01-01

is bothering me . . . . I bought an old house and I’ve been remodeling it. And I found some old dressers from an old house, I’ve been refin- ishing...EW, Tong EC, Yip SC, Lui WF, Lam CS. Health services needs and quality of life assessment of individuals with brain injuries: a pilot cross -sectional

Alpine ski sport injuries in Swedish Lapland

OpenAIRE

Made, Curt

2009-01-01

Downhill skiing is associated with recreation, youth, speed, aerials and crowded courses which carry increased risk of injuries. The aim of this study was to evaluate downhill sport injuries in a Swedish ski resort. Material and methodsIn a case-control study ongoing 1989/90–2006/07, 3,696 injured skiers were registered. After informed consent the injured were assessed by a physician and asked to answer a questionnaire concerning skier, skiing and injury. ResultsAfter three years 481 injured ...

75 FR 56975 - Injurious Wildlife Species; Review of Information Concerning a Petition To List All Live...

Science.gov (United States)

2010-09-17

..., amphibians, and reptiles are the only organisms that can be added to the injurious wildlife list. The lists... Petition To List All Live Amphibians in Trade as Injurious Unless Free of Batrachochytrium dendrobatidis... Wildlife Service (Service), are reviewing a petition to list, under the Lacey Act, all live amphibians or...

Direct catastrophic injury in sports.

Science.gov (United States)

Boden, Barry P

2005-11-01

Catastrophic sports injuries are rare but tragic events. Direct (traumatic) catastrophic injury results from participating in the skills of a sport, such as a collision in football. Football is associated with the greatest number of direct catastrophic injuries for all major team sports in the United States. Pole vaulting, gymnastics, ice hockey, and football have the highest incidence of direct catastrophic injuries for sports in which males participate. In most sports, the rate of catastrophic injury is higher at the collegiate than at the high school level. Cheerleading is associated with the highest number of direct catastrophic injuries for all sports in which females participate. Indirect (nontraumatic) injury is caused by systemic failure as a result of exertion while participating in a sport. Cardiovascular conditions, heat illness, exertional hyponatremia, and dehydration can cause indirect catastrophic injury. Understanding the common mechanisms of injury and prevention strategies for direct catastrophic injuries is critical in caring for athletes.

Trend of mortality rate and injury burden of transport accidents, suicides, and falls.

Science.gov (United States)

Kim, Ki Sook; Kim, Soon Duck; Lee, Sang Hee

2012-01-01

Recently injury has become a major world-wide health problem. But studies in Korea about injuries were very few. Thus, this study was conducted to analyze the trend of major injuries from 1991 to 2006 and to provide basic data for preventing injuries. This study was based on the National Statistical Office data from 1991 to 2006 and calculated to estimate the burden of major injuries by using the standard expected years of life lost (SEYLL) and total lost earnings equation. For transport accidents, mortality, SEYLL and total lost earnings were increased from 1991 to 1996 and decreased from 2000 to 2006. On the other hand, for suicides, these were increased gradually. Since 2003, falls were included in ten leading causes of death. This study showed that injury causes major social and economical losses. We could reduce injury related premature death through active interest in injury prevention program.

Landing-related ankle injuries do not occur in plantarflexion as once thought: a systematic video analysis of ankle injuries in world-class volleyball.

Science.gov (United States)

Skazalski, Christopher; Kruczynski, Jacek; Bahr, Martin Aase; Bere, Tone; Whiteley, Rod; Bahr, Roald

2018-01-01

Ankle injuries are prevalent in elite volleyball and suggested to result from player contact at the net. Traditionally, ankle sprains are thought to happen in a plantarflexed position, but case studies suggest plantarflexion may not be involved. Describe the injury situations and mechanisms of ankle injuries in world-class volleyball based on systematic video analysis of injuries reported through the Fédération Internationale de Volleyball (FIVB) Injury Surveillance System. Videos of 24 injuries from major FIVB tournaments were included for analysis (14 men, 10 women). Five analysts reviewed the videos to determine specific situations and mechanisms leading to injuries. The majority of injuries occurred during two volleyball situations, blocking (n=15) and attacking (n=6). Injuries to blockers were the result of landing on an opponent (n=11) or teammate (n=4). Attacking injuries most frequently occurred when a back-row player landed on a front-row teammate (n=4 of 6). When landing on an opponent under the net, the attacker landed into the opponent's court in 11 of 12 situations but without violating the centre line rule. Injuries mostly resulted from rapid inversion without any substantial plantarflexion. The majority of injuries occur while blocking, often landing on an opponent. The attacker is overwhelmingly to blame for injuries at the net secondary to crossing the centre line. Injuries while attacking often result from a back-row player landing on a front-row teammate. Landing-related injuries mostly result from rapid inversion with the absence of plantarflexion. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Spinal Cord Injury Rehabilitation in Nepal

OpenAIRE

Nabina Shah; Binav Shrestha; Kamana Subba

2013-01-01

Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the...

Injuries in synchronized skating.

Science.gov (United States)

Dubravcic-Simunjak, S; Kuipers, H; Moran, J; Simunjak, B; Pecina, M

2006-06-01

Synchronized skating is a relatively new competitive sport and data about injuries in this discipline are lacking. Therefore the purpose of this study was to investigate the frequency and pattern of acute and overuse injuries in synchronized skaters. Before and during the World Synchronized Skating Championship 2004, a questionnaire inquiring about the frequency of injuries in this skating discipline was given to 23 participating teams. A total of 514 women and 14 men senior skaters completed the questionnaires (100 % response). Two hundred and eighteen (42.4 %) female and 6 (42.9 %) male skaters had suffered from acute injuries during their synchronized skating career. As some skaters had suffered from more than one injury, the total number of acute injuries in females was 398 and in males 14. In female skaters 19.8 % of acute injuries were head injuries, 7.1 % trunk, 33.2 % upper, and 39.9 % lower extremity injuries. In male skaters 14.3 % were head injuries, 28.6 % upper, and 57.1 % lower extremity injuries, with no report of trunk injuries. Sixty-nine female and 2 male skaters had low back problems and 112 female and 2 male skaters had one or more overuse syndromes during their skating career. Of 155 overuse injuries in female skaters, 102 (65.8 %) occurred during their figure skating career, while 53 injuries (34.2 %) only occurred when they skated in synchronized skating teams. In male skaters, out of 5 overuse injuries, 4 (80 %) occurred in their figure skating career, while 1 (20 %) occurred during their synchronized skating career. Out of the total of 412 injuries, 338 (82 %) occurred during on-ice practice, while 74 (18 %) happened during off-ice training. Ninety-one (26.9 %) acute injures occurred while practicing individual elements, and 247 (73.1 %) on-ice injuries occurred while practicing different team elements. We conclude that injuries in synchronized skating should be of medical concern due to an increasing number of acute injuries, especially

EYE TRAUMA. OPEN GLOBE INJURY MANAGEMENT

Directory of Open Access Journals (Sweden)

Mojca Globočnik Petrovič

2004-05-01

Full Text Available Background. Ocular trauma is important cause of blindness. Birmingham Eye Trauma Terminology allows us to use a standardized eye injury terminology which permits an unambigous interpretation. The Eye Injury Registry enables the analysis of medical, epidemyologic and social data.The most frequent ocular injury ocular contusion has a relatively good prognosis. An adequate primary ocular repair and correct timing of pars plana vitrectomy are very important in open globe injury management. There still exist some controversial issues concerning the role of posterior segment surgery in open globe injuries. These include timing of surgery, prophylactic scleral buckle placement and a proper use of systemic and intravitreal antibiotics.Conclusions. With adequate primary ocular repair, the use of systemic, intravitreal antibiotics, scleral buckling and proper timing for pars plana vitrectomy the prognosis for ocular trauma cases can be better.

Injuries in women's basketball.

Science.gov (United States)

Trojian, Thomas H; Ragle, Rosemary B

2008-03-01

Women's basketball has changed over time. It is a faster paced game than it was 30 years ago. Greatplayers, like Anne Meyers,who was the first, and only, woman to be signed to an NBA contract, would agree today's game is different. The game is played mostly "below the rim" but with players like Candice Parker, Sylvia Fowles and Maya Moore able to dunk the ball, the game is still changing. The one thing that remains constant in basketball, especially women's basketball, is injury. The majority of injuries in women's basketball are similar to those in men's basketball. Studies at the high school and college level show similar injury rates between women and men. ACL injuries are one exception, with female athletes having atwo to four times higher rate ofACL injuries. In this article, we review the common injuries in women's basketball. We discuss treatment issues and possible preventive measures.

Penetrating abdominal injury cases admitted in University of Benin ...

African Journals Online (AJOL)

The incidence of penetrating abdominal injuries especially through gunshot injuries is on the increase and is a major cause of morbidity and mortality in our community. Control measures and ways of reducing morbidity and mortality are suggested. Keywords: penetrating abdominal injuries, gun shot injuries. Annals of ...

Driving, brain injury and assistive technology.

Science.gov (United States)

Lane, Amy K; Benoit, Dana

2011-01-01

Individuals with brain injury often present with cognitive, physical and emotional impairments which impact their ability to resume independence in activities of daily living. Of those activities, the resumption of driving privileges is cited as one of the greatest concerns by survivors of brain injury. The integration of driving fundamentals within the hierarchical model proposed by Keskinen represents the complexity of skills and behaviors necessary for driving. This paper provides a brief review of specific considerations concerning the driver with TBI and highlights current vehicle technology which has been developed by the automotive industry and by manufacturers of adaptive driving equipment that may facilitate the driving task. Adaptive equipment technology allows for compensation of a variety of operational deficits, whereas technological advances within the automotive industry provide drivers with improved safety and information systems. However, research has not yet supported the use of such intelligent transportation systems or advanced driving systems for drivers with brain injury. Although technologies are intended to improve the safety of drivers within the general population, the potential of negative consequences for drivers with brain injury must be considered. Ultimately, a comprehensive driving evaluation and training by a driving rehabilitation specialist is recommended for individuals with brain injury. An understanding of the potential impact of TBI on driving-related skills and knowledge of current adaptive equipment and technology is imperative to determine whether return-to-driving is a realistic and achievable goal for the individual with TBI.

Injury incidence in hip hop dance.

Science.gov (United States)

Ojofeitimi, S; Bronner, S; Woo, H

2012-06-01

Hip hop dance has rapidly become a popular international art form. There is limited information on injury patterns in this population. The purpose of this study was to determine injury incidence and patterns among three groups of hip hop dancers. Three hundred and twelve intermediate, advanced, and expert hip hop dancers were recruited at battles, dance conferences, clubs, and on dance related web sites within the United States and internationally. A Web-based survey was conducted over a 6-month period. Inclusion criteria included intermediate and advanced level dancers over the age of 13. Dancers were divided into three main categories: Breakers, Popper/Lockers, and New Schoolers. Separate analysis of variances were used to compare injury pattern differences between groups. Two hundred and thirty-two dancers reported a total of 738 injuries. Five hundred and six of these (sustained by 205 dancers) were time-loss (TL) injuries. Annual injury incidence was 237% (162% involving TL). Lower extremity injuries were 52% and upper extremity injuries 32% of total injuries. Breakers had a higher injury incidence compared with Popper/Lockers, and New Schoolers. Hip hop dancers report injury rates that are higher than other dance forms but similar to gymnastics. These dancers should be educated concerning injury prevention, biomechanics, and use of protective equipment. © 2010 John Wiley & Sons A/S.

Ice hockey injuries.

Science.gov (United States)

Benson, Brian W; Meeuwisse, Willem H

2005-01-01

This article reviews the distribution and determinants of injuries reported in the pediatric ice hockey literature, and suggests potential injury prevention strategies and directions for further research. Thirteen electronic databases, the ISI Web of Science, and 'grey literature' databases were searched using a combination of Medical Subject Headings and text words to identify potentially relevant articles. The bibliographies of selected studies were searched to identify additional articles. Studies were selected for review based on predetermined inclusion and exclusion criteria. A comparison between studies on this topic area was difficult due to the variability in research designs, definition of injury, study populations, and measurements used to assess injury. The majority of injuries were sustained during games compared with practices. The two most commonly reported injuries were sprains/strains and contusions. Players competing at the Minor hockey, High School, and Junior levels of competition sustained most of their injuries to the upper extremity, head, and lower extremity, respectively. The primary mechanism of injury was body checking, followed by stick and puck contact. The frequency of catastrophic eye injuries has been significantly reduced with the world-wide mandation of full facial protection for all Minor hockey players. Specific hockey-related injury risk factors are poorly delineated and rarely studied among pediatric ice hockey players leaving large gaps in the knowledge of appropriate prevention strategies. Risk management strategies should be focused at avoiding unnecessary foreseeable risk, and controlling the risks inherent to the sport. Suggestions for injury prevention and future research are discussed.

Moderate to severe injuries in football: a one-year prospective study of twenty-four female and male amateur teams.

Science.gov (United States)

Lion, Alexis; Theisen, Daniel; Windal, Thierry; Malisoux, Laurent; Nührenbörger, Christian; Huberty, Robert; Urhausen, Axel; Seil, Romain

2014-01-01

This study aimed to realize a prospective follow-up of the injuries occurring in female and male football players involved in the highest league in the Grand-Duchy of Luxembourg. Data concerning anthropometric characteristics and football activities were gathered in 125 female and 243 male football players via questionnaires at the beginning of the study. Then, a follow-up of moderate to severe injuries (> 15 days of interruption in football practice) was performed throughout the season 2013-2014. Sixteen injuries (injury incidence = 0.7 injuries/1000 h of exposure) were observed in 13 female football players (10.4%). These injuries concerned mainly the knee (n = 7; 43.7%), with capsules and ligaments being the most often concerned tissues (n = 7; 43.7%). In male football players, 41 severe injuries (injury incidence = 0.6 injuries/1000 h of exposure) were observed in 36 players (14.8%). These injuries concerned mainly the thighs (n = 12; 29.3%) and the muscles and tendons were the most often concerned tissues (n = 18; 43.9%). Injuries in football are predominantly located at the lower limbs, particularly the knees in female football players. The predominant muscle and tendon lesions of the thighs occurring in males could reveal that physical preparation is insufficient or inadequate for a number of players. Regarding these results, it is necessary to implement an injury prevention strategy. The "FIFA 11+" programme could be used as the basic method, but should be personalized according to sex. The injury collection methodology could be optimized with the use of an electronic database, such as the Training and Injury Prevention Platform for Sports (TIPPS). Beside the systematic recording of injury data (as well as the training load) by the players or the medical staff, this system allows to share of important information between stakeholders, follow-up the players, provide risk factor warnings and increase the awareness of the injury problem.

Major ocular trauma in Taiwan: 2002-2004 versus 2012-2014.

Science.gov (United States)

Chang, Yi-Sheng; Teng, Yu-Ti; Huang, Yi-Hsun; Liu, Mei-Ling; Hung, Jia-Horung; Hsu, Sheng-Min; Huang, Fu-Chin; Shih, Min-Hsiu; Chen, Wan-Ju; Lai, Chun-Chieh; Hsiao, Shu-Fang; Wang, Shih-Hao; Tseng, Sung-Huei

2018-05-04

We investigated the temporal changes in major eye injuries in Taiwan by reviewing the medical records of all patients with ocular trauma hospitalized at the National Cheng Kung University Hospital during 2002-2004 and 2012-2014. A total of 169 eyes (161 patients) during 2002-2004 and 121 eyes (120 patients) during 2012-2014 were enrolled (mean ± SD age: 41.9 ± 20.8 years in 2002-2004, and 51.8 ± 19.3 years in 2012-2014). Males accounted for ~75% of patients. The most frequent injury-causing object was metallic material (~24%), and blunt traumas were most frequently attributable to traffic accidents and falls. The most common locations of injuries for males and females were the workplace and home, respectively. Open-globe injuries occurred in ~70% of eyes, requiring primary repair, cataract extraction, and/or intraocular lens implantation. The frequencies of fall injury, lacrimal system laceration, lens injury, corneal/scleral foreign bodies, and use of intracameral antibiotics increased from 2002-2004 to 2012-2014, while those of closed-globe injury, vitreous haemorrhage, optic nerve injury, and medical treatment decreased. The final visual acuity remained poor (≤20/200) in >1/3 of injured eyes. Despite therapeutic advancements, major eye injuries still pose a high risk for poor visual outcome.

Prevalence of work-related injuries among workers of bottling ...

African Journals Online (AJOL)

Prevalence of work-related injuries among workers of bottling industries in Benin city, ... job descriptions and activities which constitute health hazards for the individual. ... with the major work-related injuries and illness being physical injuries.

Lower extremity injuries in runners. Advances in prediction.

Science.gov (United States)

Macera, C A

1992-01-01

Recreational and competitive running is practised by many individuals to improve cardiorespiratory function and general well-being. The major negative aspect of running is the high rate of injuries to the lower extremities. Several well-designed population-based studies have found no major differences in injury rates between men and women; no increasing effect of age on injuries; a declining injury rate with more years of running experience; no substantial effect of weight or height; an uncertain effect of psychological factors; and a strong effect of previous injury on future injuries. Among the modifiable risk factors studied, weekly distance is the strongest predictor of future injuries. Other training characteristics (speed, frequency, surface, timing) have little or no effect on future injuries after accounting for distance run. More studies are needed to address the effects of appropriate stretching practices and abrupt change in training patterns. For recreational runners who have sustained injuries, especially within the past year, a reduction in running to below 32 km per week is recommended. For those about to begin a running programme, moderation is the best advice. For competitive runners, great care should be taken to ensure that prior injuries are sufficiently healed before attempting any racing event, particularly a marathon.

Cartilage Injuries in the Adult Knee

Science.gov (United States)

Moyad, Thomas F.

2011-01-01

Cartilage injuries are frequently recognized as a source of significant morbidity and pain in patients with previous knee injuries. The majority of patients who undergo routine knee arthroscopy have evidence of a chondral defect. These injuries represent a continuum of pathology from small, asymptomatic lesions to large, disabling defects affecting a major portion of one or more compartments within the knee joint. In comparison to patients with osteoarthritis, individuals with isolated chondral surface damage are often younger, significantly more active, and usually less willing to accept limitations in activities that require higher impact. At the present time, a variety of surgical procedures exist, each with their unique indications. This heterogeneity of treatment options frequently leads to uncertainty regarding which techniques, if any, are most appropriate for patients. The purpose of this review is to describe the workup and discuss the management techniques for cartilage injuries within the adult knee. PMID:26069581

Radiation injury

International Nuclear Information System (INIS)

Hubner, K.F.

1988-01-01

Radiation accidents and incidents continue to be of great interest and concern to the public. Issues such as the threat of nuclear war, the Chernobyl reactor accident, or reports of sporadic incidences of accidental radiation exposure keep this interest up and maintain a high level of fear among the public. In this climate of real concern and radiation phobia, physicians should not only be prepared to answer questions about acute or late effects of ionizing radiation, but also be able to participate in the initial assessment and management of individuals who have been exposed to ionizing radiation or contaminated with radioactive material. Some of the key facts about radiation injury and its medical treatment are discussed by the author

Current controversies in the interpretation of non-accidental head injury

International Nuclear Information System (INIS)

Jaspan, Tim

The field of non-accidental injury (NAI) has been the subject of a number of theories and hypotheses of variable merit. Concerning injuries that occur within the intracranial compartment, much research has been undertaken to investigate the cause of SDH and parenchymal brain injury. Much, however, remains contentious, particularly regarding the medicolegal aspects of suspected child abuse. Issues that present the greatest challenges will be addressed. (orig.)

Current controversies in the interpretation of non-accidental head injury

Energy Technology Data Exchange (ETDEWEB)

Jaspan, Tim [Imaging Centre, University Hospital, Nottingham (United Kingdom)

2008-06-15

The field of non-accidental injury (NAI) has been the subject of a number of theories and hypotheses of variable merit. Concerning injuries that occur within the intracranial compartment, much research has been undertaken to investigate the cause of SDH and parenchymal brain injury. Much, however, remains contentious, particularly regarding the medicolegal aspects of suspected child abuse. Issues that present the greatest challenges will be addressed. (orig.)

Injuries in mountain biking.

Science.gov (United States)

Gaulrapp, H; Weber, A; Rosemeyer, B

2001-01-01

Despite still growing attraction mountain biking as a matter of sports traumatology still lacks relevant data based on large cross-sectional surveys. To obtain an overview of risk factors, types, and main body sites of injuries occurring in mountain biking we assessed the results of a questionnaire answered by 3873 athletes. A total of 8133 single lesions were reported by 3474 athletes, 36% of whom regularly participated in competitions. The incidence of injuries in mountain biking is comparable to that in other outdoor sports, the majority of injuries being minor. Mountain biking athletes were found to have an overall injury risk rate of 0.6% per year and 1 injury per 1000 h of biking. The main risk factors included slippery road surface, cyclist's poor judgement of the situation, and excessive speed, representing personal factors that could be altered by preventive measures. Of all injuries 14% were due to collision with some part of the bike, especially the pedals and the handlebar. While 75% of the injuries were minor, such as skin wounds and simple contusions, 10% were so severe that hospitalization was required. A breakdown of the injuries according to body site and frequency of occurrence is presented.

Rupture of the pectoralis major: a case report and review.

Science.gov (United States)

Hasegawa, Kohei; Schofer, Joel M

2010-02-01

Rupture of the pectoralis major muscle is a rare clinical entity that is becoming more common due to the increasing popularity of weightlifting and recreational sports. Due to the rarity of this condition, it may be missed at initial presentation and inappropriately treated, potentially leading to increased disability. This case highlights the mechanism of injury, clinical features, diagnosis, and treatment of rupture of the pectoralis major. The patient was a 31-year-old male bodybuilder who presented to the Emergency Department with acute pain and swelling in the left axilla after performing a bench press with a 400-pound barbell. The diagnosis of pectoralis major rupture was suspected and confirmed by magnetic resonance imaging, and early surgical repair was performed. The most common mechanism of injury is excessive tension on a maximally contracted pectoralis major muscle. Weightlifting, specifically bench pressing, is a common cause. The diagnosis can usually be made based on a patient's history and physical examination, but shortly after injury, the diagnosis may be obscured by severe pain and swelling. Magnetic resonance imaging is the imaging modality of choice when the diagnosis remains unclear, and can avoid surgical delays. Early diagnosis and treatment within 3 to 8 weeks after the injury has the advantage of avoiding adhesions and muscle atrophy, and can prevent a delayed return to normal activities. Given the trend toward improved results with early surgical repair of complete rupture, it is important to raise awareness about pectoralis major muscle injury among Emergency Physicians to prevent missed or delayed diagnosis and repair. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Common Injuries in Professional Football Quarterbacks.

Science.gov (United States)

Kirsch, Jacob M; Burrus, M Tyrrell; Bedi, Asheesh

2018-03-01

Professional football quarterbacks are at particular risk for upper extremity injuries due to the physical demands of their position coupled with the inherent risks associated with professional football. This review sought to evaluate current clinical literature to better characterize the injury profile unique to this athletic population. Shoulder injuries are the most prevented upper extremity injury among professional football quarterbacks. The quarterback position is disproportionately impacted by shoulder injuries when compared to professional athletes at other positions. Moreover, contrary to other professional throwing athletes, the majority of upper extremity injuries in the professional quarterback result from direct contact as opposed to the throwing motion. The injury profile among professional quarterbacks is unique compared to other positions and other overhead professional throwing athletes. Overall, a paucity of high quality clinical evidence exists to support the management of injuries in this elite population.

Posterior urethral injuries associated with pelvic injuries in young adults: computerized finite element model creation and application to improve knowledge and prevention of these lesions.

Science.gov (United States)

Bréaud, J; Baqué, P; Loeffler, J; Colomb, F; Brunet, C; Thollon, L

2012-05-01

Young adult males involved in motorcycle accidents are particularly at risk for posterior urethral injury whenever pelvic injury occurs. Posterior urethral injuries remain problematic because their diagnosis may be missed, and during the initial treatment response the urethral injury can be aggravated by urethral catheterization. Few anatomical and clinical tools exist that establish a correlation between injuries and fractures of the pelvic ring and the risk of posterior urethral injury. Based on experience with traffic accident modeling, a computerized finite element model was conceived integrating the specific anatomic structures concerned. This model was extrapolated from a CAT scan of a young adult. The anatomic structures concerned in urethral and pelvic ring trauma (PRT) were isolated, placed in 3D and given biomechanical properties. The model was verified according to available experiments on PRT. To apply the model, we recreated a lateral impact mechanism on the pelvic ring. Stretching between the prostatic and membranous portions of the urethra (before and after visualization of a pelvic fracture) as well as timing of injury was studied. The model's application permitted us to analyze precisely the link between lateral impact trauma of the pelvic ring and lesions of the posterior urethra and to identify an urethra stretching prior to visualization of a pelvic fracture. Utilization of the model with other mechanisms of injury should allow for better comprehension of this associated trauma, improved prevention, iatrogenic aggravation of, and care for, these serious injuries. © Springer-Verlag 2011

Anterior cruciate ligament and meniscal injuries in sports: incidence, time of practice until injury, and limitations caused after trauma.

Science.gov (United States)

Astur, Diego Costa; Xerez, Marcos; Rozas, João; Debieux, Pedro Vargas; Franciozi, Carlos Eduardo; Cohen, Moises

2016-01-01

To analyze the incidence of ACL and meniscal injuries in a population of recreational and elite athletes from Brazil and the relation of these injuries with their sports activities. This was a prospective observational study of 240 patients with ACL and/or meniscal injuries submitted to surgical treatment. Data of patients and sport modality, as well as Tegner score were registered in the first clinical evaluation. The patients were divided into three groups: (1) isolated rupture of the ACL; (2) ACL injury associated with meniscal injury; (3) isolated menisci injury. The majority of the patients belonged to group 1 (44.58%), followed by group 2 (30.2%) and 3 (25%). Most patients were soccer players. The mean time from sport practice to injury in group 1 was 17.81 years. In group 2, it was 17.3 years, and in group 3, 26.91 years. Soccer athletes presented ACL injury in 0.523/1000 h of practice and meniscal injury in 0.448/1000 h of practice. Before the injury, the mean Tegner score obtained for groups 1, 2, and 3 were 7.18, 7.34, and 6.53, respectively. After knee injury, those values were 3.07, 3.18, and 2.87, respectively. Soccer was the sport that caused the majority of lesions, regardless the group. Furthermore, patients from groups 1 and 2 had less time of practice prior to the injury (17.81 and 17.3 years) than the patients of group 3 (26.91 years). Women presented a higher risk to develop ACL and meniscal injuries in 1000 h of game/practice. Running, volleyball, and weightlifting are in ascending order of risk for ACL and/or meniscal injury. Regarding the return to sport practice, the efficiency of all athletes was impaired because of the injury.

Anterior cruciate ligament and meniscal injuries in sports: incidence, time of practice until injury, and limitations caused after trauma

Directory of Open Access Journals (Sweden)

Diego Costa Astur

Full Text Available ABSTRACT OBJECTIVE: To analyze the incidence of ACL and meniscal injuries in a population of recreational and elite athletes from Brazil and the relation of these injuries with their sports activities. METHODS: This was a prospective observational study of 240 patients with ACL and/or meniscal injuries submitted to surgical treatment. Data of patients and sport modality, as well as Tegner score were registered in the first clinical evaluation. The patients were divided into three groups: (1 isolated rupture of the ACL; (2 ACL injury associated with meniscal injury; (3 isolated menisci injury. RESULTS: The majority of the patients belonged to group 1 (44.58%, followed by group 2 (30.2% and 3 (25%. Most patients were soccer players. The mean time from sport practice to injury in group 1 was 17.81 years. In group 2, it was 17.3 years, and in group 3, 26.91 years. Soccer athletes presented ACL injury in 0.523/1000 h of practice and meniscal injury in 0.448/1000 h of practice. Before the injury, the mean Tegner score obtained for groups 1, 2, and 3 were 7.18, 7.34, and 6.53, respectively. After knee injury, those values were 3.07, 3.18, and 2.87, respectively. CONCLUSION: Soccer was the sport that caused the majority of lesions, regardless the group. Furthermore, patients from groups 1 and 2 had less time of practice prior to the injury (17.81 and 17.3 years than the patients of group 3 (26.91 years. Women presented a higher risk to develop ACL and meniscal injuries in 1000 h of game/practice. Running, volleyball, and weightlifting are in ascending order of risk for ACL and/or meniscal injury. Regarding the return to sport practice, the efficiency of all athletes was impaired because of the injury.

Snowboarding injuries. An overview.

Science.gov (United States)

Bladin, C; McCrory, P

1995-05-01

Over the last 10 years, snowboarding has become established as a popular and legitimate alpine sport. However, at present, there are few epidemiological studies examining the spectrum of injuries associated with this new sport. Snowboarders are typically male (male: female ratio of 3:1) and in their early twenties. They have an injury rate of 4 to 6 per 1000 visits, which is comparable to that which occurs with skiing. However, in contrast to skiing, in which only 34% of those injured are beginners, the majority (60%) of snowboarders injured are beginners. This is a reflection of the participant profile of this developing sport. 57% of injuries occur in the lower limbs, and 30% in the upper limbs. The most common injuries are simple sprains (31 to 53%), particularly of the ankles (23 to 26%) and knees (12 to 23%), followed by fractures (24 to 27%) and contusions (12%). Compared with skiing injuries, snowboarders have 2.4 times as many fractures, particularly of the upper limbs (constituting 21 vs 35% of upper limb injuries), fewer knee injuries (23 vs 44% of lower limb injuries), but more ankle injuries (23 vs 6% of lower limb injuries). Snowboarding knee injuries are less severe than those associated with skiing. Fracture of the lateral process of the talus is an unusual and uncommon snowboarding injury that can be misdiagnosed as a severe ankle sprain. Ankle injuries are more common with soft shell boots, whereas knee injuries and distal tibia fractures are more common with hard shell boots.(ABSTRACT TRUNCATED AT 250 WORDS)

[Gymnastic school sport injuries--aspects of preventive measures].

Science.gov (United States)

Knobloch, K; Jagodzinski, M; Haasper, C; Zeichen, J; Krettek, C

2006-06-01

Gymnastic school sport injuries account for a significant morbidity and mortality among children and adolescents. Preventive issues may be derived from a thorough in-depth analysis of the pattern and circumstances of gymnastic injuries. During a school year among 3993 schools in 43 889 classes with 993 056 pupils 2234 school sport injuries have been reported to the Gemeinde Unfall Versicherung (GUV) Niedersachsen, Germany. Gymnastic sport injuries account for 18 % (403 accidents), which is second after ball sports injuries. Regarding the distribution of the gymnastic disciplines, vault was the major discipline with 34 %, followed by floor exercise (21.3 %), mini- and competition trampoline (16.8 %), and parallel bars (8.2 %). The analysis of the type of injury during vault accidents revealed contusion (31 %) as the predominant injury, followed by sprains (15.4 %), and fractures (15.4 %). Floor exercise injuries distributed among distorsions (26.7 %), contusions (18.6 %), muscle tears (14 %). Back injuries especially of the cervical and thoracic spine, accounted for 40 % of all their injuries. Minor head injuries account for 4.7 % of all floor exercise injuries. Mini-trampoline injuries distribute among contusions (30 %), fractures (22.5 %), distorsions (7.5 %). 21.8 % collisions were noted against a box in comparison to 6.8 % in case of the horse. Gymnast injuries account for a significant number of all school sport related injuries. Vault and floor exercise account for the vast majority of all injuries, with alarming high numbers of spine injuries during floor exercise and mini-trampoline. A preservation of a high level of attention during a sport lesson, safety measures including appropriate mats and landing zones are mandatory to reduce injuries. Muscle injuries and ankle sprains can be prevented by a prospective proprioceptive training intervention to be implemented in school sports.

Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention)

Energy Technology Data Exchange (ETDEWEB)

Goffette, Pierre P. [Department of Medical Imaging, Saint-Luc University Hospital-Louvain Medical School, Brussels (Belgium); Laterre, Pierre-Francois [Department of Emergency and Critical Care, Saint-Luc University Hospital-Louvain Medical School, Brussels (Belgium)

2002-05-01

The nonoperative management (NOM) of abdominal trauma has gained increasing acceptance over the past decade. This approach has been extended to severe trauma patients previously considered as candidates for surgery. Consequently, the incidence of delayed and uncommonly encountered complications has increased. Causes of delayed complications are multiple and include: (a) abnormal or insufficient injury healing process; (b) retention of necrotic tissue; (c) secondary infection of initially sterile collections; and (d) underestimation of injury severity. The purpose of this review article is to explain the role of various imaging modalities in detecting post-traumatic delayed complications and to highlight the usefulness of minimally invasive techniques, including laparoscopy, biliary endoscopy, therapeutic angiography and image-guided drainage. Subsequent complications, which do not necessarily negatively influence the final outcome, are often predictable, virtually obligatory consequences of the successful NOM of high-grade or complex abdominal injuries. Between 50 and 60% of those patients with grade-IV or grade-V liver or splenic lacerations require some type of interventional treatment; therefore, indiscriminate discharge of patients with solid organ injury managed conservatively may be potentially harmful. As the incidence of complications is higher for more severe grade-IV or grade-V liver, spleen, or kidney injuries, scheduled follow-up CT scans may be rational in this subset of patients to identify potential complications amenable to early application of interventional techniques. Follow-up CT scans are unnecessary in stable adults or children with low-grade injury. Delayed splenic or hepatic rupture is one of the major concerns because this type of complication remains difficult to predict and historically often requires emergent surgery. (orig.) (orig.)

Are first rib fractures a marker for other life-threatening injuries in patients with major trauma? A cohort study of patients on the UK Trauma Audit and Research Network database

OpenAIRE

Sammy, Ian Ayenga; Chatha, Hridesh; Lecky, Fiona; Bouamra, Omar; Fragoso-I?iguez, Marisol; Sattout, Abdo; Hickey, Michael; Edwards, John E

2017-01-01

Background: First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted.\\ud \\ud Methods: Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research N...

Myocardial injury after surgery is a risk factor for weaning failure from mechanical ventilation in critical patients undergoing major abdominal surgery.

Directory of Open Access Journals (Sweden)

Shu Li

Full Text Available Myocardial injury after noncardiac surgery (MINS is a newly proposed concept that is common among adults undergoing noncardiac surgery and associated with substantial mortality. We analyzed whether MINS was a risk factor for weaning failure in critical patients who underwent major abdominal surgery.This retrospective study was conducted in the Department of Critical Care Medicine of Peking University People's Hospital. The subjects were all critically ill patients who underwent major abdominal surgery between January 2011 and December 2013. Clinical and laboratory parameters during the perioperative period were investigated. Backward stepwise regression analysis was performed to evaluate MINS relative to the rate of weaning failure. Age, hypertension, chronic renal disease, left ventricular ejection fraction before surgery, Acute Physiologic and Chronic Health Evaluation II score, pleural effusion, pneumonia, acute kidney injury, duration of mechanical ventilation before weaning and the level of albumin after surgery were treated as independent variables.This study included 381 patients, of whom 274 were successfully weaned. MINS was observed in 42.0% of the patients. The MINS incidence was significantly higher in patients who failed to be weaned compared to patients who were successfully weaned (56.1% versus 36.5%; P<0.001. Independent predictive factors of weaning failure were MINS, age, lower left ventricular ejection fraction before surgery and lower serum albumin level after surgery. The MINS odds ratio was 4.098 (95% confidence interval, 1.07 to 15.6; P = 0.04. The patients who were successfully weaned had shorter hospital stay lengths and a higher survival rate than those who failed to be weaned.MINS is a risk factor for weaning failure from mechanical ventilation in critical patients who have undergone major abdominal surgery, independent of age, lower left ventricular ejection fraction before surgery and lower serum albumin levels after

Original Research Variations in injury characteristics among ...

African Journals Online (AJOL)

injury in paediatric trauma patients evaluating pre-hospital and in-hospital ... All patients that present to the emergency ... males suffered the majority of deaths for both PHD and .... true magnitude and aetiology of injury in any environment.

Injuries of the Medial Clavicle: A Cohort Analysis in a Level-I-Trauma-Center. Concomitant Injuries. Management. Classification.

Science.gov (United States)

Bakir, Mustafa Sinan; Merschin, David; Unterkofler, Jan; Guembel, Denis; Langenbach, Andreas; Ekkernkamp, Axel; Schulz-Drost, Stefan

2017-01-01

Introduction: Although shoulder girdle injuries are frequent, those of the medial clavicle are widely unexplored. An applied classification is less used just as a standard management. Methods: A retrospective analysis of medial clavicle injuries (MCI) during a 5-year-term in a Level-1-Trauma-Center. We analyzed amongst others concomitant injuries, therapy strategies and the classification following the AO standards. Results: 19 (2.5%) out of 759 clavicula injuries were medial ones (11 A, 6 B and 2 C-Type fractures) thereunder 27,8% were displaced and thus operatively treated Locked plate osteosynthesis was employed in unstable fractures and a reconstruction of the ligaments at the sternoclavicular joint (SCJ) in case of their disruption. 84,2% of the patients sustained relevant concomitant injuries. Numerous midshaft fractures were miscoded as medial fracture, which limited the study population. Conclusions: MCI resulted from high impact mechanisms of injury, often with relevant dislocation and concomitant injuries. Concerning medial injury's complexity, treatment should occur in specialized hospitals. Unstable fractures and injuries of the SCJ ligaments should be considered for operative treatment. Midshaft fractures should be clearly distinguished from the medial ones in ICD-10-coding. Further studies are required also regarding a subtyping of the AO classification for medial clavicle fractures including ligamental injuries. Celsius.

Urinary biomarkers TIMP-2 and IGFBP7 early predict acute kidney injury after major surgery.

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Ivan Gocze

Full Text Available To assess the ability of the urinary biomarkers IGFBP7 (insulin-like growth factor-binding protein 7 and TIMP-2 (tissue inhibitor of metalloproteinase 2 to early predict acute kidney injury (AKI in high-risk surgical patients.Postoperative AKI is associated with an increase in short and long-term mortality. Using IGFBP7 and TIMP-2 for early detection of cellular kidney injury, thus allowing the early initiation of renal protection measures, may represent a new concept of evaluating renal function.In this prospective study, urinary [TIMP-2]×[IGFBP7] was measured in surgical patients at high risk for AKI. A predefined cut-off value of [TIMP-2]×[IGFBP7] >0.3 was used for assessing diagnostic accuracy. Perioperative characteristics were evaluated, and ROC analyses as well as logistic regression models of risk assessment were calculated with and without a [TIMP-2]×[IGFBP7] test.107 patients were included in the study, of whom 45 (42% developed AKI. The highest median values of biomarker were detected in septic, transplant and patients after hepatic surgery (1.24 vs 0.45 vs 0.47 ng/l²/1000. The area under receiving operating characteristic curve (AUC for the risk of any AKI was 0.85, for early use of RRT 0.83 and for 28-day mortality 0.77. In a multivariable model with established perioperative risk factors, the [TIMP-2]×[IGFBP7] test was the strongest predictor of AKI and significantly improved the risk assessment (p<0.001.Urinary [TIMP-2]×[IGFBP7] test sufficiently detect patients with risk of AKI after major non-cardiac surgery. Due to its rapid responsiveness it extends the time frame for intervention to prevent development of AKI.

Parental safety concerns--a barrier to sport and physical activity in children?

Science.gov (United States)

Boufous, Soufiane; Finch, Caroline; Bauman, Adrian

2004-10-01

To examine the extent to which parents and carers perceive injury and safety risks as serious enough to prevent or discourage their children, aged 5-12 years, from participating in sports/physical activity and to identify factors that influence these perceptions. An analysis of the 2001 New South Wales Child Health Survey. More than one-quarter of parents/ carers of active children aged 5-12 years reported discouraging or preventing children from playing a particular sport (34.7% for boys and 16.6% for girls) because of injury and safety concerns. In boys, the most frequently discouraged sport was rugby league (23.2%), followed by rugby union (7.5%) and Australian rules football (2.8%). Among girls, the most frequently discouraged activities were rollerblading (2.7%), rugby league (2.3%) and soccer (2.1%). Multivariate analysis shows that factors independently associated with parents' decision to prevent/discourage their child from engaging in sport/physical activity include their child's age and gender, language spoken at home, presence of disability, and the respondent's relation to the child. Efforts need to be made to modify some sports/ activities, such as football codes, in order to minimise injury and to ensure that children continue enjoying their favourite activity well into adulthood. Guidelines designed to promote physical activity among children and young adolescents need to take into account parental concerns regarding the associated risk of injury.

Skateboarding injuries: An updated review.

Science.gov (United States)

Shuman, Kristin M; Meyers, Michael C

2015-07-01

This in-depth literature review shows that skateboarding has experienced intermittent periods of popularity, with an estimated 6-15 million skateboarders in the US currently involved at all levels of recreational play and competition. Head trauma accounts for ∼ 3.5-13.1% of all skateboarding injuries. Injury occurs most often to the upper extremity (55-63%), whereas thoracoabdominal and spine injuries account for 1.5-2.9% of all trauma and lower extremity injuries occur 17-26% of the time. Few fatal injuries (1.1%) have been reported, oftentimes resulting from traumatic head injuries incurred from collisions with motor vehicles. Although skateparks may be perceived as a safer alternative to street skateboarding, injuries still occur when the skateboarder collides with an object or falls from the board. Factors leading to trauma include fatigue and overuse, age and skill level, inadequate medical care, environmental conditions, equipment concerns, lack of fitness and training, and the detrimental behavior of the competitor. Although not all skateboarding injuries are avoidable, numerous opportunities exist to instill safety involving education, instruction, and supervision and the proper use of protective gear to reduce predisposition to trauma. Future research recommendations include a more standardized data collection system, as well as an increased focus on kinetic analysis of the sport. Legislation involving helmet laws and the increased investment in a safer environment for the skateboarder may also assist in reducing injury in this sport.

Sports injuries in Saudi Arabia.

OpenAIRE

Sadat-Ali, M; Sankaran-Kutty, M

1985-01-01

Saudi Arabia has now a wealth of sporting facilities of which the youth of the country is making full use. A prospective study of sports related injuries was conducted during the twelve months of 1983. We present an analysis of 846 such injuries seen at the King Fahd University Hospital, Al Khobar. These injuries formed 8.36% of those who attended after an accident for emergency treatment, of which 63% were under 20 years. The majority was sustained during soccer games. The most frequent site...

Staircase falls: High-risk groups and injury characteristics in 464 patients

NARCIS (Netherlands)

Boele van Hensbroek, P.; Mulder, S.; Luitse, J. S. K.; van Ooijen, M. R.; Goslings, J. C.

2009-01-01

Introduction: Few data are available about the epidemiology and injury characteristics in staircase falls. The available literature mainly concerns children and autopsy studies. Objective: To describe the epidemiology and injury characteristics of staircase falls, and to identify high-risk groups

Retrospective Review of Pectoralis Major Ruptures in Rodeo Steer Wrestlers

Directory of Open Access Journals (Sweden)

Breda H. F. Lau

2013-01-01

Full Text Available Background. Pectoralis major tendon ruptures have been reported in the literature as occupational injuries, accidental injuries, and sporting activities. Few cases have been reported with respect to rodeo activities. Purpose. To describe a series of PM tendon ruptures in professional steer wrestlers. Study Design. Case series, level of evidence, 4. Methods. A retrospective analysis of PM ruptures in a steer wrestling cohort was performed. Injury data between 1992 and 2008 were reviewed using medical records from the University of Calgary Sport Medicine Center. Results. Nine cases of pectoralis major ruptures in professional steer wrestlers were identified. Injuries occurred during the throwing phase of the steer or while breaking a fall. All athletes reported unexpected or abnormal behavior of the steer that contributed to the mechanism of injury. Seven cases were surgically repaired, while two cases opted for nonsurgical intervention. Eight cases reported successful return to competition following the injury. Conclusion. Steer wrestlers represent a unique cohort of PM rupture case studies. Steer wrestling is a demanding sport that involves throwing maneuvers that may predispose the muscle to rupture. All cases demonstrated good functional outcomes regardless of surgical or non-surgical treatment.

Major trauma from suspected child abuse: a profile of the patient pathway.

Science.gov (United States)

Davies, Ffion C; Lecky, Fiona E; Fisher, Ross; Fragoso-Iiguez, Marisol; Coats, Tim J

2017-09-01

Networked organised systems of care for patients with major trauma now exist in many countries, designed around the needs of the majority of patients (90% adults). Non-accidental injury is a significant cause of paediatric major trauma and has a different injury and age profile from accidental injury (AI). This paper compares the prehospital and inhospital phases of the patient pathway for children with suspected abuse, with those accidentally injured. The paediatric database of the national trauma registry of England and Wales, Trauma Audit and Research Network, was interrogated from April 2012 (the launch of the major trauma networks) to June 2015, comparing the patient pathway for cases of suspected child abuse (SCA) with AI. In the study population of 7825 children, 7344 (94%) were classified as AI and 481 (6%) as SCA. SCA cases were younger (median 0.4 years vs 7 years for AI), had a higher Injury Severity Score (median 16vs9 for AI), and had nearly three times higher mortality (5.7%vs2.2% for AI). Other differences included presentation to hospital evenly throughout the day and year, arrival by non-ambulance means to hospital (74%) and delayed presentation to hospital from the time of injury (median 8 hours vs 1.8 hours for AI). Despite more severe injuries, these infants were less likely to receive key interventions in a timely manner. Only 20% arrived to a designated paediatric-capable major trauma centre. Secondary transfer to specialist care, if needed, took a median of 21.6 hours from injury(vs 13.8 hours for AI). These data show that children with major trauma that is inflicted rather than accidental follow a different pathway through the trauma system. The current model of major trauma care is not a good fit for the way in which child victims of suspected abuse present to healthcare. To achieve better care, awareness of this patient profile needs to increase, and trauma networks should adjust their conventional responses. © Article author

Injuries in an Extreme Conditioning Program

OpenAIRE

Aune, Kyle T.; Powers, Joseph M.

2016-01-01

Background: Extreme conditioning programs (ECPs) are fitness training regimens relying on aerobic, plyometric, and resistance training exercises, often with high levels of intensity for a short duration of time. These programs have grown rapidly in popularity in recent years, but science describing the safety profile of these programs is lacking. Hypothesis: The rate of injury in the extreme conditioning program is greater than the injury rate of weightlifting and the majority of injuries occ...

Understanding unintentional childhood home injuries: pilot surveillance data from Karachi, Pakistan.

Science.gov (United States)

Zia, Nukhba; Khan, Uzma R; Razzak, Junaid A; Puvanachandra, Prasanthi; Hyder, Adnan A

2012-01-19

Childhood injuries, an important public health issue, globally affects more than 95% of children living in low-and middle-income countries. The objective of this study is to describe the epidemiology of childhood unintentional injuries in Karachi, Pakistan with a specific focus on those occurring within the home environment. This was a secondary analysis of a childhood unintentional injury surveillance database setup in the emergency department of the Aga Khan Hospital, Karachi, Pakistan for 3 months. The data was collected by interviewing caretakers of children under 12 years of age presenting with an unintentional injury to the emergency departments of the four major tertiary care hospitals of Karachi, Pakistan. The surveillance included 566 injured children of which 409 (72%) injuries had taken place at/around home. Of 409 children, 66% were males and mostly between 5 and 11 years of age. Injuries commonly occurred during play time (51%). Fall (59%), dog bites (11%) and burns (9%) were the commonest mechanisms of injury. The majority of the children (78%) were directly discharged from the emergency room with predicted short term disability (42%). There were 2 deaths in the emergency department both due to falls. Childhood injury surveillance system provides valuable in-depth information on child injuries. The majority of these unintentional childhood injuries occur at home; with falls, dog bites and burns being the most common types of unintentional childhood home injuries. Specific surveillance systems for child injuries can provide new and valuable information for countries like Pakistan.

Lead toxicity: current concerns.

OpenAIRE

Goyer, R A

1993-01-01

Over the 20-year period since the first issue of Environmental Health Perspectives was published, there has been considerable progress in the understanding of the potential toxicity of exposure to lead. Many of these advances have been reviewed in published symposia, conferences, and review papers in EHP. This brief review identifies major advances as well as a number of current concerns that present opportunities for prevention and intervention strategies. The major scientific advance has be...

Effects of low-dose IV ketamine on peripheral and central pain from major limb injuries sustained in combat.

Science.gov (United States)

Polomano, Rosemary C; Buckenmaier, Chester C; Kwon, Kyung H; Hanlon, Alexandra L; Rupprecht, Christine; Goldberg, Cynthia; Gallagher, Rollin M

2013-07-01

Examine response patterns to low-dose intravenous (IV) ketamine continuous infusions on multiple pain outcomes, and demonstrate effectiveness, safety, and tolerability of ketamine administration on general wards. Retrospective case series of consecutive patients given low-dose IV ketamine continuous infusions. Walter Reed Army Medical Center, Washington, DC. Nineteen eligible inpatients with neuropathic pain from major limb injuries sustained in combat with inadequate pain control from multimodal analgesia. A 3-day IV infusion of ketamine at doses ≤ 120 μg/kg/h. Daily present (PPI), average (API), and worst (WPI) pain intensity (0-10), global pain relief (GPR) (1 "no relief" to 5 "complete relief"), daily assessments of adverse events, and daily opioid requirements measured during therapy. A significant reduction in PPI (P pain (PLP) (N = 10; P = 0.0436) were observed. Mean percent increase in overall GPR was better for those reporting GPR scores ≤ 3 (N = 13) in the first 24 hours of therapy (P = 0.0153). While not significant, mean opioid requirement (IV morphine equivalents) decreased from 129.9 mgs ± 137.3 on day 1 to 112.14 ± 86.3 24 hours after therapy. Low-dose ketamine infusions for complex combat injury pain were safe and effective, and demonstrated response patterns over time and by baseline pain score stratification and presence or absence of PLP. Wiley Periodicals, Inc.

The Epidemiology of Hip and Groin Injuries in Professional Baseball Players.

Science.gov (United States)

Coleman, Struan H; Mayer, Stephanie W; Tyson, Jared J; Pollack, Keshia M; Curriero, Frank C

2016-01-01

Injuries of the hip and groin among professional baseball players can result in a significant number of disabled list days. The epidemiology of these injuries has not been delineated. The purpose of this study is to describe the incidence, mechanism, type, and rehabilitation course of hip and groin injuries among Major League Baseball (MLB) and Minor League Baseball (MiLB) players. The MLB injury database for hip and groin injuries from 2011-2014 was analyzed. Occurrence of injuries was assessed based on level of play, field location, activity during which the injury occurred, mechanism of injury, and days missed. The treatment was recorded as nonoperative or surgical. The subsequent rehabilitation and return to play were recorded. Chi-square tests were used to test the hypothesis of equal proportions between the various categories of hip and groin characteristics. From 2011-2014, 1823 hip and groin injuries occurred among MLB and MiLB players, which accounted for approximately 5% of all injuries. Of these, 1514 (83%) occurred among MiLB players and 309 (17%) among MLB players; 96% of injuries were extra-articular. Among all players, a noncontact mechanism during defensive fielding was the most common activity causing injury (74%), and infielders experienced the most hip and groin injuries (34%). The majority of extra-articular injuries were treated nonoperatively (96.2%), resulting in an average of 12 days missed. Intra-articular pathology more commonly required surgery, and resulted in an average of 123 days missed. Hip and groin injuries can be debilitating and result in a significant number of days missed. Intra-articular pathology and athletic pubalgia were usually treated surgically, while the majority of extra-articular hip injuries were treated successfully with nonoperative modalities. Correct diagnosis and appropriate treatment can lead to a high rate of return to play for professional baseball players with injuries to the hip and groin.

Injury experience in coal mining, 1990

Energy Technology Data Exchange (ETDEWEB)

None

1991-01-01

This Mine Safety and Health Administration (MSHA) informational report reviews in detail the occupational injury and illness experience of coal mining in the United States for 1990. Data reported by operators of mining establishments concerning work injuries are summarized by work location, accident classification, part of body injured, nature of injury, occupation, and anthracite or bituminous coal. Related information on employment, worktime, and operating activity also is presented. Data reported by independent contractors performing certain work at mining locations are depicted separately in this report. For ease of comparison between coal mining and the metal and nonmetal mineral mining industries, summary reference tabulations are included at the end of both the operator and the contractor sections of this report.

Injury experience in coal mining, 1992

Energy Technology Data Exchange (ETDEWEB)

Reich, R.B.; Hugler, E.C.

1994-05-01

This Mine Safety and Health Administration (MSHA) informational report reviews in detail the occupational injury and illness experience of coal mining in the United States for 1992. Data reported by operators of mining establishments concerning work injuries are summarized by work location, accident classification, part of body injured, nature of injury, occupation, and anthracite or bituminous coal. Related information on employment, worktime, and operating activity also is presented. Data reported by independent contractors performing certain work at mining locations are depicted separately in this report. For ease of comparison between coal mining and the metal and nonmetal mineral mining industries, summary reference tabulations are included at the end of both the operator and the contractor sections of this report.

Sports-related injuries in athletes with disabilities.

Science.gov (United States)

Fagher, K; Lexell, J

2014-10-01

The number of athletes with disabilities participating in organized sports and the popularity of the Paralympic Games is steadily increasing around the world. Despite this growing interest and the fact that participation in sports places the athlete at risk for injury, there are few studies concerning injury patterns, risk factors, and prevention strategies of injuries in disabled athletes. In this systematic literature search and critical review, we summarize current knowledge of the epidemiology of sports-related injuries in disabled athletes and describe their characteristics, incidence, prevalence, and prevention strategies. The outcomes of interest were any injury, either an acute trauma or an overuse event. PubMed, EMBASE, CINAHL, and Google Scholar were systematically searched and 25 of 605 identified studies met the inclusion criteria. Lower extremity injuries were more common in walking athletes, whereas upper extremity injuries were more prevalent in wheelchair athletes. The methodologies and populations varied widely between the studies. Few studies were sports or disability specific, which makes it difficult to determine specific risk factors, and few studies reported injury severity and prevention of injuries. Further longitudinal, systematic sports and disability specific studies are needed in order to identify and prevent injuries in athletes with disabilities. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Organized sports participation and the association with injury in paediatric patients with haemophilia.

Science.gov (United States)

McGee, S; Raffini, L; Witmer, C

2015-07-01

With the wide availability of factor and the routine use of prophylaxis boys with haemophilia are now able to participate in regular physical activity, including organized sports. Current guidelines vary regarding specific recommendations for sports participation and concerns remain regarding safety. To determine if participation in organized sports is associated with an increased risk for injury in paediatric subjects with haemophilia. Retrospective single-centre cohort study from January 1, 2008 to December 31, 2010 in male subjects ages 10-18 years with a factor VIII (FVIII) or FIX level sports was recorded. 48 male subjects with a mean age of 14.3 ± 2.6 years (range: 10-18.8) were included; 64.6% (31/48) FVIII deficiency, 54.2% (26/48) severe haemophilia, 18.8% (9/48) moderate and 27.1% (13/48) mild. The majority [62.5% (30/48)] of subjects participated in at least one season of organized sport. There were 77 injuries in 36/48 (75%) subjects. The mean number of injuries per subject was 1.6 ± 1.5. There was no statistical difference in the mean number of injuries (P = 0.44) or target joint formation (P = 0.52) between the subjects who participated in organized sports compared to those who did not. In this study, participation in organized sports by boys with haemophilia, ages 10-18 years, is common and not associated with an increased number of injuries or the development of a target joint. As injuries occurred equally in both groups, concerted efforts should be directed at reducing injuries in all patients. © 2015 John Wiley & Sons Ltd.

Upper extremity weightlifting injuries: Diagnosis and management.

Science.gov (United States)

Golshani, Kayvon; Cinque, Mark E; O'Halloran, Peter; Softness, Kenneth; Keeling, Laura; Macdonell, J Ryan

2018-03-01

Common upper extremity injuries in resistance training athletes include muscle strains, ligament sprains, pectoralis major tendon ruptures, distal biceps tendon ruptures, and chronic shoulder pain and capsulolabral injuries. While each injury is unique in its specific anatomic location and mechanism, each is preventable with proper exercise technique, safety and maintenance of muscle balance. Conservative treatment is the therapeutic modality of choice and these injuries generally resolve with workout modification, appropriate recovery, anti-inflammatory medication, and physical therapy. If conservative treatment fails, surgical intervention is often successful and can return the weightlifter to a level of performance near their pre-injury level.

Role of p53–fibrinolytic system cross-talk in the regulation of quartz-induced lung injury

International Nuclear Information System (INIS)

Bhandary, Yashodhar P.; Shetty, Shwetha K.; Marudamuthu, Amarnath S.; Fu, Jian; Pinson, Barbara M.; Levin, Jeffrey; Shetty, Sreerama

2015-01-01

Silica is the major component of airborne dust generated by wind, manufacturing and/or demolition. Chronic occupational inhalation of silica dust containing crystalline quartz is by far the predominant form of silicosis in humans. Silicosis is a progressive lung disease that typically arises after a very long latency and is a major occupational concern with no known effective treatment. The mechanism of silicosis is not clearly understood. However, silicosis is associated with increased cell death, expression of redox enzymes and pro-fibrotic cytokines and chemokines. Since alveolar epithelial cell (AEC) death and disruption of alveolar fibrinolysis is often associated with both acute and chronic lung injuries, we explored whether p53-mediated changes in the urokinase-type plasminogen activator (uPA) system contributes to silica-induced lung injury. We further sought to determine whether caveolin-1 scaffolding domain peptide (CSP), which inhibits p53 expression, mitigates lung injury associated with exposure to silica. Lung tissues and AECs isolated from wild-type (WT) mice exposed to silica exhibit increased apoptosis, p53 and PAI-1, and suppression of uPA expression. Treatment of WT mice with CSP inhibits PAI-1, restores uPA expression and prevents AEC apoptosis by suppressing p53, which is otherwise induced in mice exposed to silica. The process involves CSP-mediated inhibition of serine-15 phosphorylation of p53 by inhibition of protein phosphatase 2A-C (PP2A-C) interaction with silica-induced caveolin-1 in AECs. These observations suggest that changes in the p53–uPA fibrinolytic system cross-talk contribute to lung injury caused by inhalation of silica dust containing crystalline quartz and is protected by CSP by targeting this pathway. - Highlights: • Chronic exposure to quartz dusts is a major cause of lung injury and silicosis. • The survival of patients with silicosis is bleak due to lack of effective treatments. • This study defines a new role of

Heavy drinking and alcohol-related injuries in college students

Directory of Open Access Journals (Sweden)

Lucía Moure-Rodríguez

2014-09-01

Conclusion: We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern.

Characteristics of injuries among young cross-country skiers.

Directory of Open Access Journals (Sweden)

Boguszewski Dariusz

2011-08-01

Full Text Available The aim of this study was to develop information about injuries in cadet and junior cross-country skiers. Material and methods. Fifty female (n=21 and male (n=29 competitors from Podhale were in research group. Skiers completed questionnaire. The questions concerned the location of injuries, types of injuries, methods of treatments and rehabilitation and recovery exercises. Results. The most frequent injury in the research group was bruises, cuts and sprains and muscle strain. Few people had suffered broken bones and muscle ruptures. The most of the skiers suffered knee injuries. As a treatment PRICEMM procedure has been introduced. The main method of recovery was rest from training. Conclusions. No correlation was found epidemiology of injuries and the treatment, gender, age, level of sport and the number of starts of the season. Sports training and recovery should be similar In each group (female and male competitors. Players starting considerably more likely to devote less time to treatment and improvement of injury.

Major international sport profiles.

Science.gov (United States)

Patel, Dilip R; Stier, Bernhard; Luckstead, Eugene F

2002-08-01

Sports are part of the sociocultural fabric of all countries. Although different sports have their origins in different countries, many sports are now played worldwide. International sporting events bring athletes of many cultures together and provide the opportunity not only for athletic competition but also for sociocultural exchange and understanding among people. This article reviews five major sports with international appeal and participation: cricket, martial arts, field hockey, soccer, and tennis. For each sport, the major aspects of physiological and biomechanical demands, injuries, and prevention strategies are reviewed.

Classification and coding of commercial fishing injuries by work processes: an experience in the Danish fresh market fishing industry

DEFF Research Database (Denmark)

Jensen, Olaf Chresten; Stage, Søren; Noer, Preben

2005-01-01

BACKGROUND: Work-related injuries in commercial fishing are of concern internationally. To better identify the causes of injury, this study coded occupational injuries by working processes in commercial fishing for fresh market fish. METHODS: A classification system of the work processes was deve......BACKGROUND: Work-related injuries in commercial fishing are of concern internationally. To better identify the causes of injury, this study coded occupational injuries by working processes in commercial fishing for fresh market fish. METHODS: A classification system of the work processes...... to working with the gear and nets vary greatly in the different fishing methods. Coding of the injuries to the specific working processes allows for targeted prevention efforts....

Moral Injury, Spiritual Care and the Role of Chaplains: An Exploratory Scoping Review of Literature and Resources.

Science.gov (United States)

Carey, Lindsay B; Hodgson, Timothy J; Krikheli, Lillian; Soh, Rachel Y; Armour, Annie-Rose; Singh, Taranjeet K; Impiombato, Cassandra G

2016-08-01

This scoping review considered the role of chaplains with regard to 'moral injury'. Moral injury is gaining increasing notoriety. This is due to greater recognition that trauma (in its various forms) can cause much deeper inflictions and afflictions than just physiological or psychological harm, for there may also be wounds affecting the 'soul' that are far more difficult to heal-if at all. As part of a larger research program exploring moral injury, a scoping review of literature and other resources was implemented utilising Arksey and O'Malley's scoping method (Int J Soc Res Methodol 8(1):19-32, 2005) to focus upon moral injury, spirituality (including religion) and chaplaincy. Of the total number of articles and/or resources noting the term 'moral injury' in relation to spiritual/religious issues (n = 482), the results revealed 60 resources that specifically noted moral injury and chaplains (or other similar bestowed title). The majority of these resources were clearly positive about the role (or the potential role) of chaplains with regard to mental health issues and/or moral injury. The World Health Organization International Classification of Diseases: Australian Modification of Health Interventions to the International Statistical Classification of Diseases and related Health problems (10th revision, vol 3-WHO ICD-10-AM, Geneva, 2002), was utilised as a coding framework to classify and identify distinct chaplaincy roles and interventions with regard to assisting people with moral injury. Several recommendations are made concerning moral injury and chaplaincy, most particularly the need for greater research to be conducted.

Gymnastics injuries and imaging in children

Energy Technology Data Exchange (ETDEWEB)

Keller, Marc S. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

2009-12-15

Injuries of children participating in gymnastics are seen less often than in more popular sports. Patterns of injury are predictable based upon sex, age and level of intensity of training and competition. More injuries are seen in girls than in boys, and the great majority of early adolescents who compete have wrist pain. Some otherwise quiescent congenital spine anomalies may be uncovered by the stress of gymnastics maneuvers and present with low back pain. In addition to diagnosis of injuries, imaging can be used to guide analgesic and anti-inflammatory therapy in some injured athletes. Parents whose children wish to participate in gymnastics should understand that fewer injuries occur in the child enjoying recreational gymnastics than in competing gymnasts. More gymnastics injuries are found in very competitive athletes training at higher levels. (orig.)

Gymnastics injuries and imaging in children

International Nuclear Information System (INIS)

Keller, Marc S.

2009-01-01

Injuries of children participating in gymnastics are seen less often than in more popular sports. Patterns of injury are predictable based upon sex, age and level of intensity of training and competition. More injuries are seen in girls than in boys, and the great majority of early adolescents who compete have wrist pain. Some otherwise quiescent congenital spine anomalies may be uncovered by the stress of gymnastics maneuvers and present with low back pain. In addition to diagnosis of injuries, imaging can be used to guide analgesic and anti-inflammatory therapy in some injured athletes. Parents whose children wish to participate in gymnastics should understand that fewer injuries occur in the child enjoying recreational gymnastics than in competing gymnasts. More gymnastics injuries are found in very competitive athletes training at higher levels. (orig.)

Burn injury in kitchen workers: a cause for prevention.

Science.gov (United States)

Riina, L H; Simpson, R L; Gudjonsson, O; Glickman, L T; Harris, S U; Johnson, D; Ginocchio, M

2000-01-01

Preventable thermal injuries in professional kitchen workers have been identified, and we have introduced a protective garment. Because of the nature of their occupation, kitchen workers are prone to thermal injuries. It has been our experience that the majority of these injuries are scald injuries on the ankles and dorsum of the feet. We propose that a protective garment, such as a waterproof shoe and garter, could reduce the incidence of these injuries.

Hepatoprotective effect of fermented ginseng and its major constituent compound K in a rat model of paracetamol (acetaminophen)-induced liver injury.

Science.gov (United States)

Igami, Kentaro; Shimojo, Yosuke; Ito, Hisatomi; Miyazaki, Toshitsugu; Kashiwada, Yoshiki

2015-04-01

This work aimed at evaluating the effect of fermented ginseng (FG) and fermented red ginseng (FRG) against rat liver injury caused by paracetamol (acetaminophen (APAP)). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the serum and histopathological changes in the liver were analysed to determine the degree of liver injury. Deoxyribonucleic acid (DNA) microarray analysis was performed to compare gene expression levels altered in the rat livers. Phosphorylated Jun-N-terminal kinase (JNK) in human hepatocellular carcinoma (HepG2) cells were detected using western blot analysis to investigate the anti-inflammatory activity of compound K. Pretreatment with FG, containing compound K at high concentration, attenuated AST as well as ALT levels in rats, while no obvious effect was observed in the group that received FRG, whose content of compound K was lower than that of FG. In addition, the results of our histopathological analysis were consistent with changes in the serum biochemical analysis. DNA microarray analysis indicated that JNK- and glutathione S-transferase (GST)-related genes were involved in the hepatotoxicity. Notably, compound K, a major ginsenoside in FG, inhibited the phosphorylation of JNK in HepG2 cells. FG was shown to possess hepatoprotective activity against paracetamol (APAP)-induced liver injury better than FRG. Compound K might play an important role for an anti-inflammatory activity of FG by inhibiting JNK signalling in the liver. © 2014 Royal Pharmaceutical Society.

Social media in health--what are the safety concerns for health consumers?

Science.gov (United States)

Lau, Annie Y S; Gabarron, Elia; Fernandez-Luque, Luis; Armayones, Manuel

Recent literature has discussed the unintended consequences of clinical information technologies (IT) on patient safety, yet there has been little discussion about the safety concerns in the area of consumer health IT. This paper presents a range of safety concerns for consumers in social media, with a case study on YouTube. We conducted a scan of abstracts on 'quality criteria' related to YouTube. Five areas regarding the safety of YouTube for consumers were identified: (a) harmful health material targeted at consumers (such as inappropriate marketing of tobacco or direct-to-consumer drug advertising); (b) public display of unhealthy behaviour (such as people displaying self-injury behaviours or hurting others); (c) tainted public health messages (i.e. the rise of negative voices against public health messages); (d) psychological impact from accessing inappropriate, offensive or biased social media content; and (e) using social media to distort policy and research funding agendas. The examples presented should contribute to a better understanding about how to promote a safe consumption and production of social media for consumers, and an evidence-based approach to designing social media interventions for health. The potential harm associated with the use of unsafe social media content on the Internet is a major concern. More empirical and theoretical studies are needed to examine how social media influences consumer health decisions, behaviours and outcomes, and devise ways to deter the dissemination of harmful influences in social media.

Ankle ligament injuries

Directory of Open Access Journals (Sweden)

Per A.F.H. Renström

1998-06-01

Full Text Available Acute ankle ligament sprains are common injuries. The majority of these occur during athletic participation in the 15 to 35 year age range. Despite the frequency of the injury, diagnostic and treatment protocols have varied greatly. Lateral ligament complex injuries are by far the most common of the ankle sprains. Lateral ligament injuries typically occur during plantar flexion and inversion, which is the position of maximum stress on the anterotalofibular liagment (ATFL. For this reason, the ATFL is the most commonly torn ligament during an inversion injury. In more severe inversion injuries the calcaneofibular (CFL, posterotalofibular (PTFL and subtalar ligament can also be injured. Most acute lateral ankle ligament injuries recover quickly with nonoperative management. The treatment program, called "functional treatment," includes application of the RICE principle (rest, ice, compression, and elevation immediately after the injury, a short period of immobilization and protection with an elastic or inelastic tape or bandage, and early motion exercises followed by early weight bearing and neuromuscular ankle training. Proprioceptive training with a tilt board is commenced as soon as possible, usually after 3 to 4 weeks. The purpose is to improve the balance and neuromuscular control of the ankle. Sequelae after ankle ligament injuries are very common. As much as 10% to 30% of patients with a lateral ligament injury may have chronic symptoms. Symptoms usually include persistent synovitis or tendinitis, ankle stiffness, swelling, and pain, muscle weakness, and frequent giving-way. A well designed physical therapy program with peroneal strengthening and proprioceptive training, along with bracing and/or taping can alleviate instability problems in most patients. For cases of chronic instability that are refractory to bracing and external support, surgical treatment can be explored. If the chronic instability is associated with subtalar instability

Nonoperative management of pancreatic injuries in pediatric patients

International Nuclear Information System (INIS)

Cigdem, M.K.; Senturk, S.; Onen, A.; Siga, M.; Akay, H.; Otcu, S.

2011-01-01

Nonoperative management of minor pancreatic injury is the generally accepted approach. However, the management of major pancreatic injury remains controversial in pediatric patients. The aim of the present study was to determine the safety and efficacy of nonoperative management of pancreatic injury in pediatric patients. Between 2003 and 2009, 31 patients, 28 male and 3 female, with pancreatic injury due to blunt abdominal trauma were treated in our clinic. All patients were evaluated by ultrasonography, computed tomography (CT), and evaluation of serum amylase levels. Patients with ongoing hemodynamic instability after resuscitation or signs of bowel perforation underwent immediate laparotomy, and the remaining patients were conservatively treated. Conservative treatment consisted of nasogastric tube replacement, total parenteral nutrition, monitoring of amylase levels, and serial clinical examination. The most common mechanism of injury was a fall (35.4%). Ten patients (32.2%) had associated extraabdominal injuries, and 18 patients (58.1%) had associated abdominal injuries. The spleen was the most common site of intra-abdominal injury that was associated with pancreatic trauma. Initial amylase levels were normal in 5 patients, whose CT scans revealed pancreatic injury. Twenty-five patients (80.6%) were conservatively treated. Six patients (19.4%) required surgical intervention because of a hollow viscus or diaphragmatic injury and hemodynamic instability. A pseudocyst developed in 11 of the 25 patients who were nonoperatively treated; 6 patients required intervention for the pseudocyst (percutaneous drainage and cystogastrostomy). No patient succumbed to injury. The majority of the pancreatic injuries in pediatric patients can be successfully treated conservatively, unless there is hemodynamic instability and a hollow viscus injury. The most common complication is a pseudocyst. (author)

Pattern of injuries from motorcycle accidents in Abia State, Nigeria ...

African Journals Online (AJOL)

Background: Motorcycle accidents are very common and cause major injuries. The Abia State government banned commercial motorcyclists from operating in the major cities of the state in July, 2009. Objectives: To determine the influence of this ban on the cause and pattern of injuries due to road traffic accidents. Design: ...

Pediatric soup scald burn injury: etiology and prevention.

Science.gov (United States)

Palmieri, Tina L; Alderson, Tyrone S; Ison, Dahlia; O'Mara, Michael S; Sharma, Raj; Bubba, Anthony; Coombs, Elena; Greenhalgh, David G

2008-01-01

One of the leading causes of scald burn injury in children is from hot soup, particularly prepackaged instant soups. The purpose of this study was to determine the demographic, socioeconomic, and situational factors that contribute to the incidence of scald burns in children. A 20-item questionnaire was given to the caregiver of children who were treated for scald burn injury at a pediatric burn center from July 2006 to March 2007. Questions included demographics (child age, gender, siblings, ethnicity), socioeconomic status (income, education), factors contributing to the injury (type of soup, child supervision, type of container), and location of injury. The mean age of the 78 children sustaining burn injury and completing the survey was 4.8 +/- 0.6 years. The majority of patients were girls (51%), and the most frequently involved ethnic group was Hispanic (44%). Households had a mean of 3.0 +/- 0.3 children in residence, and an income of less than $29,000/year (59%). The highest educational level achieved was high school for 73% of the parents. Prepackaged soup (65%) with a narrow base heated directly in the original container (46%) using the microwave (51%) was implicated in the majority of burns. Soup scald burns, especially from prepackaged instant soups, appear to predominate in lower income families with multiple children. The majority of injuries occur when the caregiver heats the soup in the original container using the microwave. Prevention of these types of injuries will require a two-pronged approach: educating families with multiple children and changing the soup packaging.

Damage control in vascular injury

NARCIS (Netherlands)

Leenen, L. P.H.

2017-01-01

The highest goal in damage control surgery is to stop the bleeding. Major injuries to the vessels therefore pose the major challenge in the damage control approach. Optimal care can be provided in combination with receiving and treatment rooms with CT, operative and endovascular capabilities. For

Occupational injury disparities in the US hotel industry.

Science.gov (United States)

Buchanan, Susan; Vossenas, Pamela; Krause, Niklas; Moriarty, Joan; Frumin, Eric; Shimek, Jo Anna M; Mirer, Franklin; Orris, Peter; Punnett, Laura

2010-02-01

Hotel employees have higher rates of occupational injury and sustain more severe injuries than most other service workers. OSHA log incidents from five unionized hotel companies for a three-year period were analyzed to estimate injury rates by job, company, and demographic characteristics. Room cleaning work, known to be physically hazardous, was of particular concern. A total of 2,865 injuries were reported during 55,327 worker-years of observation. The overall injury rate was 5.2 injuries per 100 worker-years. The rate was highest for housekeepers (7.9), Hispanic housekeepers (10.6), and about double in three companies versus two others. Acute trauma rates were highest in kitchen workers (4.0/100) and housekeepers (3.9/100); housekeepers also had the highest rate of musculoskeletal disorders (3.2/100). Age, being female or Hispanic, job title, and company were all independently associated with injury risk. Sex- and ethnicity-based disparities in injury rates were only partially due to the type of job held and the company in which the work was performed. Copyright 2009 Wiley-Liss, Inc.

The challenges of injuries and trauma in Pakistan: an opportunity for concerted action.

Science.gov (United States)

Hyder, A A; Razzak, J A

2013-08-01

Injuries and trauma are a major cause of mortality and morbidity in low and middle income countries (LMICs). In Pakistan, a low income South Asian developing country, they are among the top ten contributors to disease burden and causes of disabilities, with the majority of the burden falling on younger people in the population. This burden of injuries comes with a high social and economic cost. Several distal and proximal determinants, such as poverty, political instability, frequent natural disasters, and the lack of legislation and enforcement of preventive measures, make the Pakistani population susceptible to injuries. Historically, there has been a low level of investment in the prevention of injuries in Pakistan. Data is limited and while a public sector surveillance project has been initiated in one major urban centre, the major sources of information on injuries have been police and hospital records. Given the cost-effectiveness of injury prevention programs and their success in other LMICs, it is essential that the public sector invest in injury prevention through improving national policies and creating a strong evidence-based strategy while collaborating with the private sector to promote injury prevention and mobilizing people to engage in these programs. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

A Commentary on Real-Time Biofeedback to Augment Neuromuscular Training for ACL Injury Prevention in Adolescent Athletes

Directory of Open Access Journals (Sweden)

Adam W. Kiefer

2015-03-01

Full Text Available Anterior cruciate ligament injury and the associated long-term sequelae, such as immediate reductions in physical inactivity, increased adiposity and increased risk of osteoarthritis throughout adulthood, are a major health concern for adolescent athletes. Current interventions for injury prevention may have limited effectiveness, are susceptible to issues of compliance and have not achieved the widespread acceptance necessary to promote full adoption. Neuromuscular training (NMT is a well-established training intervention introduced to affect change in modifiable biomechanical risk factors to reduce the risk of injury in these athletes. Despite moderate success, neuromuscular training is still limited by its reliance on subjective feedback and after the fact (i.e., offline objective feedback techniques. The purpose of this commentary is to discuss technological tools that could be used to enhance and objectify targeted biofeedback interventions to complement NMT. Electromyography, force plates, motion sensors, and camera-based motion capture systems are innovative tools that may have realistic feasibility for integration as biofeedback into NMT programs to improve training outcomes. Improved functional deficit identification and corrective analysis may further improve and optimize athletic performance, and decrease the risk of sports-related injury during sport performance.

Management of war-related vascular injuries: experience from the second gulf war.

Science.gov (United States)

Jawas, Ali; Abbas, Alaa K; Nazzal, Munier; Albader, Marzoog; Abu-Zidan, Fikri M

2013-07-01

To study the biomechanism, pattern of injury, management, and outcome of major vascular injuries treated at Mubarak Al-Kabeer Teaching Hospital, Kuwait during the Second Gulf War. This is a descriptive retrospective study. War-related injured patients who had major vascular injuries and were treated at Mubarak Al-Kabeer Teaching Hospital from August 1990 to September 1991 were studied. Studied variables included age, gender, anatomical site of vascular injury, mechanism of injury, associated injuries, type of vascular repair, and clinical outcome. 36 patients having a mean (SD) age of 29.8 (10.2) years were studied. 32 (89%) were males and 21 (58%) were civilians. Majority of injuries were caused by bullets (47.2%) and blast injuries (47.2%). Eight patients (22%) presented with shock.There were 31 arterial injuries, common and superficial femoral artery injuries were most common (10/31). Arterial repair included interposition saphenous vein graft in seven patients, thrombectomy with end-to-end / lateral repair in twelve patients, vein patch in two patients, and arterial ligation in four patients. Six patients had arterial ligation as part of primary amputation. 3/21 (14.3%) patients had secondary amputation after attempted arterial vascular repair of an extremity. There were a total of 17 venous injuries, 13 managed by lateral suture repair and 4 by ligation. The median (range) hospital stay was 8 (1-76) days. 5 patients died (14%). Major vascular injuries occurred in 10% of hospitalized war-related injured patients. Our secondary amputation rate of extremities was 14%. The presence of a vascular surgeon within a military surgical team is highly recommended. Basic principles and techniques of vascular repair remain an essential part of training general surgeons because it may be needed in unexpected wars.

Pattern of Eye Injuries in Children in Benin City, Nigeria ...

African Journals Online (AJOL)

Pattern of Eye Injuries in Children in Benin City, Nigeria. ... Open Access DOWNLOAD FULL TEXT ... Majority of the eye injuries were lacerations (50%). ... It is also important to educate parents and caregivers on the likely risk of injury that ...

Prevalence and injury profile in Portuguese children and adolescents according to their level of sports participation.

Science.gov (United States)

Costa E Silva, Lara; Fragoso, Isabel; Teles, Júlia

2018-03-01

It is becoming increasingly apparent that sports can present danger in the form of injuries. The extent of this problem calls for preventive actions based on epidemiological research. Two questionnaires (LESADO and RAPIL II) were distributed in four schools to 651 subjects aged between 10 and 18 years, involved in different levels of physical activity (PA) - recreative sports, school sports, federated sports and no sports participation (except physical education classes). Bone age was evaluated through Tanner-Whitehouse III method and anthropometric measures according to ISAK. From 247 subjects (37.9%) it was reported a sports injury during the previous six months. The most injured body areas were lower limbs (53.8%), followed by upper limbs (29.0%) and the type of injuries found was strains (33.7%), sprains (27.1%) and fractures (23.1%). The most frequent causes were direct trauma (51.9%), indirect trauma (29.5%) and overuse (12.7%). A high percentage was relapses and chronic injuries (40.9%). The OR for age group ≥16 years was 2.26 suggesting that those ≥16 years were 2.26 times more likely to have an injury than the younger subjects and concerning the PA level, school and federated sports subjects were 4.21 and 4.44 times more likely to have an injury than no sports participation subjects. Sports injuries in school age subjects were predominantly minor conditions where sprains and strains were the major injuries. They resulted mostly of trauma situations and lower and upper limbs were the most affected areas. Injury occurrence increased with age and was higher in school and federated athletes.

Bilirubin nanoparticle preconditioning protects against hepatic ischemia-reperfusion injury.

Science.gov (United States)

Kim, Jin Yong; Lee, Dong Yun; Kang, Sukmo; Miao, Wenjun; Kim, Hyungjun; Lee, Yonghyun; Jon, Sangyong

2017-07-01

Hepatic ischemia-reperfusion injury (IRI) remains a major concern in liver transplantation and resection, despite continuing efforts to prevent it. Accumulating evidence suggests that bilirubin possesses antioxidant, anti-inflammatory and anti-apoptotic properties. However, despite obvious potential health benefits of bilirubin, its clinical applications are limited by its poor solubility. We recently developed bilirubin nanoparticles (BRNPs) consisting of polyethylene glycol (PEG)-conjugated bilirubin. Here, we sought to investigate whether BRNPs protect against IRI in the liver by preventing oxidative stress. BRNPs exerted potent antioxidant and anti-apoptotic activity in primary hepatocytes exposed to hydrogen peroxide, a precursor of reactive oxygen species (ROS). In a model of hepatic IRI in mice, BRNP preconditioning exerted profound protective effects against hepatocellular injury by reducing oxidative stress, pro-inflammatory cytokine production, and recruitment of neutrophils. They also preferentially accumulated in IRI-induced inflammatory lesions. Collectively, our findings indicate that BRNP preconditioning provides a simple and safe approach that can be easily monitored in the blood like endogenous bilirubin, and could be a promising strategy to protect against IRI in a clinical setting. Copyright © 2017 Elsevier Ltd. All rights reserved.

Karate injuries in children and adolescents.

Science.gov (United States)

Zetaruk, M N; Violan, M A; Zurakowski, D; Micheli, L J

2000-05-01

To identify risk factors for injury and to establish safety guidelines for children in Uechi-Ryu karate. A 1-year retrospective survey of injuries. A private karate school (Uechi-Ryu style) in Plymouth, MA. A total of 68 athletes (age 6-16 years; mean age 10 years) who participated in karate during the 1995-1996 season. None. The presence or absence of injury, with grading of injuries as major, moderate or minor. The types of injuries and body region involved were also analyzed. Twenty eight percent of athletes sustained at least one injury. All injuries were minor, with no time off from training required. The injuries consisted primarily of bruises (11 of 19). Other injuries included mild sprains or strains (5 of 19) and having their 'wind knocked out' (3 of 19). Most injuries were localized to the extremities. Logistic regression analysis identified risk factors for injury. Risk of injury increased with number of years of training (odds ratio 2.95; 95% confidence interval 1.81-4.82; PKarate is a relatively safe sport for children and adolescents when properly taught. Risk of injury increases with experience; therefore, greater supervision is required of higher ranks. Injury increases with weekly training; however, 3 h a week or less appears to be associated with a low risk of significant injury in this age group.

Penetrating spinal injuries and their management

Directory of Open Access Journals (Sweden)

A Kumar

2011-01-01

Full Text Available Penetrating spinal trauma due to missile/gunshot injuries has been well reported in the literature and has remained the domain of military warfare more often. Civic society′s recent upsurge in gunshot injuries has created a dilemma for the treating neurosurgeon in many ways as their management has always involved certain debatable and controversial issues. Both conservative and surgical management of penetrating spinal injuries (PSI have been practiced widely. The chief neurosurgical concern in these types of firearm injuries is the degree of damage sustained during the bullet traversing through the neural tissue and the after-effects of the same in long term. We had an interesting case of a penetrating bullet injury to cervical spine at C2 vertebral level. He was operated and the bullets were removed from posterior midline approach. Usually, the management of such cases differs from region to region depending on the preference of the surgeon but still certain common principles are followed world over. Thus, we realized the need to review the literature regarding spinal injuries with special emphasis on PSI and to study the recent guidelines for their treatment in light of our case.

All-terrain vehicles (ATVs) on the road: a serious traffic safety and public health concern.

Science.gov (United States)

Denning, Gerene; Jennissen, Charles; Harland, Karisa; Ellis, David; Buresh, Christopher

2013-01-01

On-road all-terrain vehicle (ATV) crashes are frequent occurrences that disproportionately impact rural communities. These crashes occur despite most states having laws restricting on-road ATV use. A number of overall risk factors for ATV-related injuries have been identified (e.g., lack of helmet, carrying passengers). However, few studies have determined the relative contribution of these and other factors to on-road crashes and injuries. The objective of our study was to determine whether there were differences between on- and off-road ATV crashes in their demographics and/or mechanisms and outcomes of injuries. Data were derived from our statewide ATV injury surveillance database (2002-2009). Crash location and crash and injury mechanisms were coded using a modification of the Department of Transportation (DOT) coding system. Descriptive analyses and statistical comparisons (chi-square test) of variables were performed. Multivariate logistic regression analysis was used to determine relative risk. 976 records were included in the final analysis, with 38 percent of the injured individuals from on-road crashes. Demographics were similar for crashes at each location, with approximately 80 percent males, 30 percent under the age of 16, and 15 percent passengers. However, females and youths under 16 were over 4 times more likely to be passengers (P ≤ 0.0001), regardless of crash location. Compared to those off-road, on-road crash victims were approximately 10 times more likely to be involved in a vehicle-vehicle collision (P road crashes were also twice as likely to test positive for alcohol as those off-road (P road victims were only half as likely to be helmeted (P road crashes involved a collision with another vehicle, suggesting that ATVs on the road represent a potential traffic safety concern. Of note, helmets were associated with reduced risk for the number and severity of brain injuries, providing further support for the importance of helmet use. Finally

Evaluation of nature and extent of injuries during Dahihandi festival.

Science.gov (United States)

Nemade, P; Wade, R; Patwardhan, A R; Kale, S

2012-01-01

Injuries related to the Hindu festival of Dahihandi where a human pyramid is formed and a pot of money kept at a height is broken, celebrated in the state of Maharashtra, have seen a significant rise in the past few years. The human pyramid formed is multi-layered and carries with it a high risk of injury including mortality. To evaluate the nature, extent and influencing factors of injuries related to Dahihandi festival. We present a retrospective analysis of patients who presented in a tertiary care center with injuries during the Dahihandi festival in the year 2010. 124 patients' records were evaluated for timing of injury, height of the Dahihandi pyramid, position of the patient in the multi-layered pyramid, mode of pyramid collapse and mechanism of an injury. A binary regression logistic analysis for risk factors was done at 5% significance level. Univariate and multi-variate binary logistic regression of the risk factors for occurrence of a major or minor injury was done using Minitab™ version 16.0 at 5% significance. Out of 139 patients presented to the center, 15 were not involved directly in the formation of pyramid, rest 124 were included in the analysis. A majority of the patients were above 15 years of age [110 (83.6%)]. 46 (37.1%) patients suffered major injuries. There were 39 fractures, 3 cases of chest wall trauma with 10 cases of head injuries and 1 death. More than half of the patients [78 (56.1%)] were injured after 1800 hours. 73 (58.9%) injured participants were part of the pyramid constructed to reach the Dahihandi placed at 30 feet or more above the ground. 72 (51.8%) participants were part of the middle layers of the pyramid. Fall of a participant from upstream layers on the body was the main mechanism of injury, and majority [101 (81.5%)] of the patients suffered injury during descent phase of the pyramid. There is a considerable risk of serious, life-threatening injuries inherent to human pyramid formation and descent in the Dahihandi

STUDY OF ANTERIOR CRUCIATE LIGAMENT INJURY AND ITS MANAGEMENT

Directory of Open Access Journals (Sweden)

Tummala Venkata

2016-03-01

Full Text Available BACKGROUND The anterior cruciate ligament is the weaker of the two cruciate ligaments stabilizing the knee joint, and therefore gets torn easier than the posterior cruciate ligament. OBJECTIVE To determine pattern of anterior cruciate ligament injury and its management in a tertiary care center. MATERIALS AND METHODS A prospective study was carried out for two years, 28 patients with ACL injury were included. A detailed history regarding the pattern of injury was noted and ACL reconstruction was done using BT Bautograft with mini-arthrotomy and arthroscopic assisted ACL reconstruction. RESULTS The mean age of the study subjects was 30.6±7.3 years & majority were males. Majority of the ACL injury was sports related & was on the right knee. 64% underwent arthroscopic assisted ACL reconstruction & majority of them had normal range of motion of the knee. CONCLUSION Our present study concludes that most common age group involved was 20-30 years & ACL injury was more common among males. Patients with an early ACL reconstruction were more satisfied with the end result. Also, ACL reconstruction techniques using BTB auto graft leads to good ligamentous stability and function of the knee.

Nutrition, Illness, and Injury in Aquatic Sports

NARCIS (Netherlands)

Pyne, D.B.; Verhagen, E.A.L.M.; Mountjoy, M.

2014-01-01

In this review, we outline key principles for prevention of injury and illness in aquatic sports, detail the epidemiology of injury and illness in aquatic athletes at major international competitions and in training, and examine the relevant scientific evidence on nutrients for reducing the risk of

One Stage Emergency Pancreatoduodenectomy for Isolated Injury to Pancreatic Head Following Blunt Abdominal Trauma: Case Report and Review of Literature

OpenAIRE

Sumanta Kumar Ghosh

2013-01-01

Major pancreatic injury following blunt abdominal trauma by itself is a relatively rare occurrence, and in vast majority of cases (95%) it is associated with injury to adjacent major vessels and organs; thus making isolated major pancreatic injury even rarer. While most pancreatic injuries are managed by simple measures like debridement and drainage, complex proximal injury poses surgical challenge regarding surgical skill and judgement. Disproportionate approach at any stage of management ...

Injuries in Children with Extra Physical Education in Primary Schools

DEFF Research Database (Denmark)

Rexen, Christina; Andersen, Lars Bo; Ersbøll, Annette Kjær

2014-01-01

(1) Examine the influence of extra physical education (EPE) on the number of musculoskeletal injuries in public schools accounting for organized sports participation (OSP) outside school. (2) Examine the major injury subgroup: growth-related overuse (GRO) through the overuse-related injury group....

Injury experience in stone mining, 1992

Energy Technology Data Exchange (ETDEWEB)

1994-05-01

This Mine Safety and Health Administration (MSHA) informational report reviews in detail the occupational injury and illness experience of stone mining in the United States for 1992. Data reported by operators of mining establishments concerning work injuries are summarized by work location, accident classification, part of body injured, nature of injury, occupation, and principal type of mineral. Related information on employment, worktime, and operating activity also is presented. Data reported by independent contractors performing certain work at mining locations are depicted separately in this report. For ease of comparison with other metal and nonmetallic mineral mining industries and with coal mining, summary reference tabulations are included at the end of both the operator and the contractor sections of this report.

Recruitment of Intracavernously Injected Adipose-Derived Stem Cells to the Major Pelvic Ganglion Improves Erectile Function in a Rat Model of Cavernous Nerve Injury

Science.gov (United States)

Fandel, Thomas M.; Albersen, Maarten; Lin, Guiting; Qiu, Xuefeng; Ning, Hongxiu; Banie, Lia; Lue, Tom F.; Lin, Ching-Shwun

2011-01-01

Background Intracavernous (IC) injection of stem cells has been shown to ameliorate cavernous-nerve (CN) injury-induced erectile dysfunction (ED). However, the mechanisms of action of adipose-derived stem cells (ADSC) remain unclear. Objectives To investigate the mechanism of action and fate of IC injected ADSC in a rat model of CN crush injury. Design, setting, and participants Sprague-Dawley rats (n = 110) were randomly divided into five groups. Thirty-five rats underwent sham surgery and IC injection of ADSC (n = 25) or vehicle (n = 10). Another 75 rats underwent bilateral CN crush injury and were treated with vehicle or ADSC injected either IC or in the dorsal penile perineural space. At 1, 3, 7 (n = 5), and 28 d (n = 10) postsurgery, penile tissues and major pelvic ganglia (MPG) were harvested for histology. ADSC were labeled with 5-ethynyl-2-deoxyuridine (EdU) before treatment. Rats in the 28-d groups were examined for erectile function prior to tissue harvest. Measurements IC pressure recording on CN electrostimulation, immunohistochemistry of the penis and the MPG, and number of EdU-positive (EdU+) cells in the injection site and the MPG. Results and limitations IC, but not perineural, injection of ADSC resulted in significantly improved erectile function. Significantly more EdU+ ADSC appeared in the MPG of animals with CN injury and IC injection of ADSC compared with those injected perineurally and those in the sham group. One day after crush injury, stromal cell-derived factor-1 (SDF-1) was upregulated in the MPG, providing an incentive for ADSC recruitment toward the MPG. Neuroregeneration was observed in the group that underwent IC injection of ADSC, and IC ADSC treatment had beneficial effects on the smooth muscle/collagen ratio in the corpus cavernosum. Conclusions CN injury upregulates SDF-1 expression in the MPG and thereby attracts intracavernously injected ADSC. At the MPG, ADSC exert neuroregenerative effects on the cell bodies of injured nerves

Intravital and post-mortem CT examinations of cerebral gunshot injuries

International Nuclear Information System (INIS)

Schumacher, M.; Oehmichen, M.; Koenig, H.G.; Einighammer, H.; Koeln Univ.; Tuebingen Univ.; Duesseldorf Univ.

1983-01-01

The value of CT was assessed in 24 patients who died of cerebral gun-shot injuries and in two patients with more recent injuries in order to reconstruct the mode of injury and for adding forensic information. The post-mortem and intravital appearances are described and are compared with ultrasound rotation compound scans of the isolated brains. CT showed good agreement with pathological findings. Ultrasound produced images with an accuracy between CT and photographs of the brain specimen. Both methods are regarded as valuable additions to the pathological and forensic information concerning gunshot injuries. (orig.) [de

Heading and head injuries in soccer.

Science.gov (United States)

Kirkendall, D T; Jordan, S E; Garrett, W E

2001-01-01

In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

A new classification for cervical vertebral injuries: influence of CT

International Nuclear Information System (INIS)

Daffner, R.H.; Brown, R.R.; Goldberg, A.L.

2000-01-01

Objective. Computed tomography (CT) has been demonstrated to be superior to radiography in identifying cervical vertebral injuries. However, many of these injuries may not be clinically significant, and require only minimal symptomatic and supportive treatment. It is therefore imperative that radiologists and spine surgeons have criteria for distinguishing between those injuries requiring surgical stabilization and those that do not. The authors propose a new classification of cervical vertebral injuries into two categories: major and minor.Design and patients. A data base, acquired on 1052 separate cervical injuries in 879 patients seen between 1983 and 1998, was reviewed. Four categories of injury based on mechanism [hyperflexion (four variants), hyperextension (two variants), rotary (two variants), and axial compression (five variants)] were identified. ''Major'' injuries are defined as having either radiographic or CT evidence of instability with or without associated localized or central neurologic findings, or have the potential to produce the latter. ''Minor'' injuries have no radiographic and/or CT evidence of instability, are not associated with neurologic findings, and have no potential to cause the latter.Results and conclusions. Cervical injury should be classified as ''major'' if the following radiographic and/or CT criteria are present: displacement of more than 2 mm in any plane, wide vertebral body in any plane, wide interspinous/interlaminar space, wide facet joints, disrupted posterior vertebral body line, wide disc space, vertebral burst, locked or perched facets (unilateral or bilateral), ''hanged man'' fracture of C2, dens fracture, and type III occipital condyle fracture. All other types of fractures may be considered ''minor''. (orig.)

Burden of motorcycle-related injury in Malaysia

OpenAIRE

Rahman, Nik Hisamuddin NA; Baharuddin, Kamarul A; Mohamad, Syarifah Mastura S

2015-01-01

Background Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country. Methods The cross-sectiona...

Concerns in assessing radiological releases to a major estuary

International Nuclear Information System (INIS)

Foldesi, Leslie P.

1989-01-01

Full text: In the State of Virginia, the James River flows into the Chesapeake Bay and from the mouth of the James River to the fall line the river is under the influence of tidal forces. There are several centers of commerce along the river including an international port of call at the mouth of the James. Associated with the centers of commerce are potential sources of radioactive materials for being released to the river. Two hundred miles inland, the Babcock and Wilcox nuclear fuels processing plants are situated along-side the James River, which has been known to flood its banks quickly in the mountainous regions of Virginia. Storage tanks have been swept downstream from this facility in a previous flood. Fortunately, the tanks were not destroyed. Another source of a possible release is the Suny Nuclear Power Station located on the James River about fifty miles from the Chesapeake Bay. In the cities of Norfolk and Newport News, shipyards are fueling and defueling the Navy's nuclear powered fleet. In addition, many of the Navy's ships are carrying nuclear weapons. These activities may also result in an inadvertent release. In assessing the radiological release from any one of the previously mentioned activities, it is obvious that dilution of the material released into the river is a major factor in dose assessment, as well as the fact that the water is brackish and not suitable as a source of potable water. However, dilution in this case may not be the simple solution. We also have to remember that this estuary is under tidal effects, which means that the materials may not be going out to sea to be further diluted as quickly as we would like to think. It may be possible that the material will be carried up river as far as the fall line and deposited, or deposited along the river's banks. From Virginia's experience with the pesticide, Kepone, materials may be deposited along the estuary and enter the food chain thereby necessitating the limitation of taking

Concerns in assessing radiological releases to a major estuary

Energy Technology Data Exchange (ETDEWEB)

Foldesi, Leslie P [Virginia Department of Health, Bureau of Radiological Health, Richmond, VA (United States)

1989-09-01

Full text: In the State of Virginia, the James River flows into the Chesapeake Bay and from the mouth of the James River to the fall line the river is under the influence of tidal forces. There are several centers of commerce along the river including an international port of call at the mouth of the James. Associated with the centers of commerce are potential sources of radioactive materials for being released to the river. Two hundred miles inland, the Babcock and Wilcox nuclear fuels processing plants are situated along-side the James River, which has been known to flood its banks quickly in the mountainous regions of Virginia. Storage tanks have been swept downstream from this facility in a previous flood. Fortunately, the tanks were not destroyed. Another source of a possible release is the Suny Nuclear Power Station located on the James River about fifty miles from the Chesapeake Bay. In the cities of Norfolk and Newport News, shipyards are fueling and defueling the Navy's nuclear powered fleet. In addition, many of the Navy's ships are carrying nuclear weapons. These activities may also result in an inadvertent release. In assessing the radiological release from any one of the previously mentioned activities, it is obvious that dilution of the material released into the river is a major factor in dose assessment, as well as the fact that the water is brackish and not suitable as a source of potable water. However, dilution in this case may not be the simple solution. We also have to remember that this estuary is under tidal effects, which means that the materials may not be going out to sea to be further diluted as quickly as we would like to think. It may be possible that the material will be carried up river as far as the fall line and deposited, or deposited along the river's banks. From Virginia's experience with the pesticide, Kepone, materials may be deposited along the estuary and enter the food chain thereby necessitating the limitation of taking

Traumatic Brain Injury Pathophysiology and Treatments: Early, Intermediate, and Late Phases Post-Injury

Science.gov (United States)

Algattas, Hanna; Huang, Jason H.

2014-01-01

Traumatic Brain Injury (TBI) affects a large proportion and extensive array of individuals in the population. While precise pathological mechanisms are lacking, the growing base of knowledge concerning TBI has put increased emphasis on its understanding and treatment. Most treatments of TBI are aimed at ameliorating secondary insults arising from the injury; these insults can be characterized with respect to time post-injury, including early, intermediate, and late pathological changes. Early pathological responses are due to energy depletion and cell death secondary to excitotoxicity, the intermediate phase is characterized by neuroinflammation and the late stage by increased susceptibility to seizures and epilepsy. Current treatments of TBI have been tailored to these distinct pathological stages with some overlap. Many prophylactic, pharmacologic, and surgical treatments are used post-TBI to halt the progression of these pathologic reactions. In the present review, we discuss the mechanisms of the pathological hallmarks of TBI and both current and novel treatments which target the respective pathways. PMID:24381049

Trampoline Park and Home Trampoline Injuries.

Science.gov (United States)

Kasmire, Kathryn E; Rogers, Steven C; Sturm, Jesse J

2016-09-01

Trampoline parks, indoor recreational facilities with wall-to-wall trampolines, are increasing in number and popularity. The objective was to identify trends in emergency department visits for trampoline park injuries (TPIs) and compare TPI characteristics with home trampoline injuries (HTIs). Data on trampoline injuries from the National Electronic Injury Surveillance System from 2010 to 2014 were analyzed. Sample weights were applied to estimate yearly national injury trends; unweighted cases were used for comparison of injury patterns. Estimated US emergency department visits for TPI increased significantly, from 581 in 2010 to 6932 in 2014 (P = .045), whereas HTIs did not increase (P = .13). Patients with TPI (n = 330) were older than patients with HTI (n = 7933) (mean 13.3 vs 9.5 years, respectively, P trampoline parks and homes. Compared with HTIs, TPIs were less likely to involve head injury (odds ratio [OR] 0.64; 95% confidence interval [CI], 0.46-0.89), more likely to involve lower extremity injury (OR 2.39; 95% CI, 1.91-2.98), more likely to be a dislocation (OR 2.12; 95% CI, 1.10-4.09), and more likely to warrant admission (OR 1.76; 95% CI, 1.19-2.61). TPIs necessitating hospital admission included open fractures and spinal cord injuries. TPI mechanisms included falls, contact with other jumpers, and flips. TPI patterns differed significantly from HTIs. TPIs are an emerging concern; additional investigation and strategies are needed to prevent injury at trampoline parks. Copyright © 2016 by the American Academy of Pediatrics.

Australian trampoline injury patterns and trends.

Science.gov (United States)

Ashby, Karen; Pointer, Sophie; Eager, David; Day, Lesley

2015-10-01

To examine national trampoline injury patterns and trends in the context of improved product safety standards and trampoline design modifications. Review of National Hospital Morbidity data. There were an average 1,737 trampoline injuries reported nationally each year from 2002 to 2011. Both injury frequency and rate grew. Statistically significant rate increases were observed among all age groups, although both are highest among children aged 5-9 years. From 2008/09 there is a possible decreasing trend among the 5-9 age group. Falls predominate and 81% of falls result in fracture. Non-fall injuries increased annually as a proportion of all hospitalised injury although they did not comprise more than 2.4% in any one year. History provides no evidence of an observable effect of voluntary Australian Standards for trampoline safety on population rates for trampoline injury. The major design modification--netted enclosures--could contribute to the risk of injury by leading parents to falsely believe that a netted enclosure eradicates the risk of injury. © 2015 Public Health Association of Australia.

Injuries in an Extreme Conditioning Program.

Science.gov (United States)

Aune, Kyle T; Powers, Joseph M

2016-10-19

Extreme conditioning programs (ECPs) are fitness training regimens relying on aerobic, plyometric, and resistance training exercises, often with high levels of intensity for a short duration of time. These programs have grown rapidly in popularity in recent years, but science describing the safety profile of these programs is lacking. The rate of injury in the extreme conditioning program is greater than the injury rate of weightlifting and the majority of injuries occur to the shoulder and back. Cross-sectional study. Level 4. This is a retrospective survey of injuries reported by athletes participating in an ECP. An injury survey was sent to 1100 members of Iron Tribe Fitness, a gym franchise with 5 locations across Birmingham, Alabama, that employs exercises consistent with an ECP in this study. An injury was defined as a physical condition resulting from ECP participation that caused the athlete to either seek medical treatment, take time off from exercising, or make modifications to his or her technique to continue. A total of 247 athletes (22%) completed the survey. The majority (57%) of athletes were male (n = 139), and 94% of athletes were white (n = 227). The mean age of athletes was 38.9 years (±8.9 years). Athletes reported participation in the ECP for, on average, 3.6 hours per week (± 1.2 hours). Eighty-five athletes (34%) reported that they had sustained an injury while participating in the ECP. A total of 132 injuries were recorded, yielding an estimated incidence of 2.71 per 1000 hours. The shoulder or upper arm was the most commonly injured body site, accounting for 38 injuries (15% of athletes). Athletes with a previous shoulder injury were 8.1 times as likely to injure their shoulder in the ECP compared with athletes with healthy shoulders. The trunk, back, head, or neck (n = 29, 12%) and the leg or knee (n = 29, 12%) were the second most commonly injured sites. The injury incidence rate among athletes with study estimates the incidence of

Involvement of immune-related factors in diclofenac-induced acute liver injury in mice

International Nuclear Information System (INIS)

Yano, Azusa; Higuchi, Satonori; Tsuneyama, Koichi; Fukami, Tatsuki; Nakajima, Miki; Yokoi, Tsuyoshi

2012-01-01

Drug-induced liver injury (DILI) is a major safety concern in drug development and clinical drug therapy. However, the underlying mechanism of DILI is little known. It is difficult to predict DILI in humans due to the lack of experimental animal models. Diclofenac, a non-steroidal anti-inflammatory drug rarely causes severe liver injury in human, but there is some evidence for immunoallergic idiosyncratic reactions. In this study, the mechanism of diclofenac-induced liver injury in mice was investigated. First, we established the dosing condition for liver injury in normal mice. Plasma ALT and AST levels were significantly increased in diclofenac-administered (80 mg/kg, i.p.) mice in a dose- and time-dependent manner. Among several interleukins (ILs) and chemokines, mRNA expression of helper T (Th) 17 cell-mediated factors, such as retinoid orphan receptor (ROR)-γt, and signal transducers and activators of transcription factor (STAT) 3 in the liver, and the plasma IL-17 level were significantly increased. Neutralization of IL-17 tended to suppress the hepatotoxicity of diclofenac, suggesting that IL-17 was partly involved. Gadolinium chloride (GdCl 3 ) administration demonstrated that Kupffer cells are not likely to be involved in diclofenac hepatotoxicity. Hepatic expressions of IL-1β mRNA and plasma IL-1β were significantly increased soon after the diclofenac administration. Then, the results of an in vivo neutralization study of IL-1β suggested that IL-1β was involved early in the time of pathogenesis of the diclofenac-induced liver injury. In conclusion, we firstly developed a diclofenac-induced acute liver injury model in normal mice, and the involvement of IL-17 and IL-1β was clarified.

Aetiology and treatment outcome of severe traumatic brain injuries ...

African Journals Online (AJOL)

Background: Severe traumatic brain injury (TBI) is a major challenge to the patient, the relatives, the care givers, and the society in general. The primary and secondary injuries, and the high metabolism are formidable stages of the injury, each capable of taking the life of the patient. The objectives were to determine the ...

Trampolines in New Zealand: a decade of injuries.

OpenAIRE

Chalmers, D J; Hume, P A; Wilson, B D

1994-01-01

Despite international concern about the safety of trampolines, they have become increasingly popular in New Zealand. While internationally attention has centred on a relatively few cases of catastrophic cervical spine injury, little research effort has been directed at placing these incidents in a wider context. To redress this, a descriptive epidemiological study of trampoline-related injury in New Zealand was undertaken. National hospitalization and mortality data for a 10-year period revea...

CD34+ mesenchymal cells are a major component of the intestinal stem cells niche at homeostasis and after injury.

Science.gov (United States)

Stzepourginski, Igor; Nigro, Giulia; Jacob, Jean-Marie; Dulauroy, Sophie; Sansonetti, Philippe J; Eberl, Gérard; Peduto, Lucie

2017-01-24

The intestinal epithelium is continuously renewed by intestinal epithelial stem cells (IESCs) positioned at the base of each crypt. Mesenchymal-derived factors are essential to maintain IESCs; however, the cellular composition and development of such mesenchymal niche remains unclear. Here, we identify pericryptal CD34 + Gp38 + αSMA - mesenchymal cells closely associated with Lgr5 + IESCs. We demonstrate that CD34 + Gp38 + cells are the major intestinal producers of the niche factors Wnt2b, Gremlin1, and R-spondin1, and are sufficient to promote maintenance of Lgr5 + IESCs in intestinal organoids, an effect mainly mediated by Gremlin1. CD34 + Gp38 + cells develop after birth in the intestinal submucosa and expand around the crypts during the third week of life in mice, independently of the microbiota. We further show that pericryptal CD34 + gp38 + cells are rapidly activated by intestinal injury, up-regulating niche factors Gremlin1 and R-spondin1 as well as chemokines, proinflammatory cytokines, and growth factors with key roles in gut immunity and tissue repair, including IL-7, Ccl2, Ptgs2, and Amphiregulin. Our results indicate that CD34 + Gp38 + mesenchymal cells are programmed to develop in the intestine after birth to constitute a specialized microenvironment that maintains IESCs at homeostasis and contribute to intestinal inflammation and repair after injury.

Physiotherapy after traumatic brain injury: a systematic review of the literature.

Science.gov (United States)

Hellweg, Stephanie; Johannes, Sönke

2008-05-01

At present there are no standardized recommendations concerning physiotherapy of individuals with traumatic brain injury (TBI) resulting in a high variability of methods and intensity. The aim of this literature review is to develop recommendations concerning physiotherapy in the post-acute phase after TBI on the basis of scientific evidence. literature review: data bases: PubMed, PEDro, OT-Seeker, Cochrane and Cinahl. brain injury (in PEDro, OT-Seeker, Cochrane), brain injury AND physical therapy (in PubMed and Cinahl). Fourteen studies met the inclusion criteria and were grouped into sub-groups: sensory stimulation, therapy intensity, casting/splinting, exercise or aerobic training and functional skill training. While for sensory stimulation evidence could not be proven, a strong evidence exists that more intensive rehabilitation programmes lead to earlier functional abilities. The recommendation due to casting for the improvement of passive range of motion is a grade B, while only a C recommendation is appropriate concerning tonus reduction. Strong evidence exists that intensive task-orientated rehabilitation programmes lead to earlier and better functional abilities. Although some recommendations for the effectiveness of physical therapy interventions could be expressed, there are many questions concerning the treatment of humans with TBI which have not been investigated so far. Especially on the level of activity and participation only a few studies exist.

Malpractice claims related to recurrent laryngeal nerve injury: Forensic remarks regarding 15 cases

Directory of Open Access Journals (Sweden)

A. Verzeletti

2016-12-01

Full Text Available Malpractice claims concerning recurrent laryngeal nerve (RLN injuries are often related to thyroid surgery, but they can also involve surgeons of different specialties. Our survey was made considering expert opinions on claims for medical malpractice evaluated at Brescia Institute of Forensic Medicine in Italy during the period 1992–2012. Fifteen cases concerned RLN injury. Malpractice was identified in 10 cases, according to the following conditions: low pre and intra-operative risk of nerve injury, no documentation showing that the nerve was isolated and preserved despite the existence of potential risk factors. An accurate, well written and complete surgical report is the main tool for the expert examination in malpractice claims.

Diagnostic and treatment challenges in traumatic brain injury patients with severe neuropsychiatric symptoms: insights into psychiatric practice.

Science.gov (United States)

Lauterbach, Margo D; Notarangelo, Paula L; Nichols, Stephen J; Lane, Kristy S; Koliatsos, Vassilis E

2015-01-01

Traumatic brain injury (TBI) causes a variety of neuropsychiatric problems that pose diagnostic and treatment challenges for providers. In this report, we share our experience as a referral neuropsychiatry program to assist the general psychiatrist when adult TBI patients with psychiatric symptoms present for evaluation and treatment. We completed a retrospective study of patients with moderate-to-severe TBI and severe neuropsychiatric impairments. We collected information on demographics, nature of injury, symptomatology, diagnoses, and treatments. Data analysis indicates that mood stabilization was a key concern, often requiring aggressive pharmacological management. Cognitive dysfunction was a problem for the majority of patients, but was only medicated in a third, due to poor efficacy or behavioral side effects. The co-occurrence of multiple TBI-related symptoms and diagnoses in this patient cohort emphasizes the need for individualized psychopharmacological approaches and interventions.

Major influence of interobserver reliability on polytrauma identification with the Injury Severity Score (ISS): Time for a centralised coding in trauma registries?

Science.gov (United States)

Maduz, Roman; Kugelmeier, Patrick; Meili, Severin; Döring, Robert; Meier, Christoph; Wahl, Peter

2017-04-01

The Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) find increasingly widespread use to assess trauma burden and to perform interhospital benchmarking through trauma registries. Since 2015, public resource allocation in Switzerland shall even be derived from such data. As every trauma centre is responsible for its own coding and data input, this study aims at evaluating interobserver reliability of AIS and ISS coding. Interobserver reliability of the AIS and ISS is analysed from a cohort of 50 consecutive severely injured patients treated in 2012 at our institution, coded retrospectively by 3 independent and specifically trained observers. Considering a cutoff ISS≥16, only 38/50 patients (76%) were uniformly identified as polytraumatised or not. Increasing the cut off to ≥20, this increased to 41/50 patients (82%). A difference in the AIS of ≥ 1 was present in 261 (16%) of possible codes. Excluding the vast majority of uninjured body regions, uniformly identical AIS severity values were attributed in 67/193 (35%) body regions, or 318/579 (55%) possible observer pairings. Injury severity all too often is neither identified correctly nor consistently when using the AIS. This leads to wrong identification of severely injured patients using the ISS. Improving consistency of coding through centralisation is recommended before scores based on the AIS are to be used for interhospital benchmarking and resource allocation in the treatment of severely injured patients. Copyright © 2017. Published by Elsevier Ltd.

Trends in childhood injury mortality in South African population ...

African Journals Online (AJOL)

Trends in major causes of injury mortality and the proportion of total deaths attributable to injuries trom 1968·to 1985 tor white, coloured and Asian children < 15 years in the RSA were examined. There were 937 injury deaths in 1968 and 853 in 1985 but no clear trends in overall mortality rates were observed. There were ...

Rethinking Heat Injury in the SOF Multipurpose Canine: A Critical Review.

Science.gov (United States)

Baker, Janice L; Hollier, Paul J; Miller, Laura; Lacy, Ward A

2012-01-01

Heat injury is a significant concern of the Special Operations Forces Multipurpose Canine (SOF MPC). The unique athletic abilities and working environment of the SOF MPC differ from that of companion dogs or even conventional military working dogs. This should be considered in the prevention, diagnosis, and treatment of heat injury of the SOF MPC. A critical review of the literature on canine heat injury as it pertains to working dogs demonstrates limited scientific evidence on best practices for immediate clinical management of heat injury in SOF MPCs. A majority of management guidelines for heat injury in veterinary reference books and journals are based on review articles or professional opinion of the author vs. evidence from original research. In addition, guidelines are written primarily for companion animal populations vs. SOF MPCs and focus on measures to be undertaken in a clinical setting vs. point of injury. The phenomenon of ?circular referencing? is also prevalent in the heat injury literature. Current guidelines supported by review articles and textbooks often provide no citation or cite other review articles for clinical standards such as normal temperature ranges, treatment methods, and recurrence of heat injury. This ?circular referencing? phenomenon misrepresents anecdotal evidence and professional opinion as scientifically validated, reinforcing concepts and recommendations that are not truly supported by the evidence. Further study is needed to fully understand heat injury in SOF MPCs and how this applies to prevention, diagnosis and treatment guidelines. In order to provide SOF canine programs with best clinical advice and care, SOF Veterinarians must make clinical judgments based on evaluation of the most accurate and valid information possible. Clinical guidelines are fluid and should be reviewed regularly for relevance to the defined population in question. Clinical Guidelines should also be utilized as guiding principles in conjunction with

MANAGEMENT OF SPLENIC INJURY AFTER BLUNT INJURY TO ABDOMEN

Directory of Open Access Journals (Sweden)

J. Bharath Prakash Reddy

2016-07-01

Full Text Available BACKGROUND The spleen is an important organ in the body’s immune system. It is the most frequently injured organ in blunt abdominal trauma. 1 Over the past several decades, diagnosis and management of splenic trauma has been evolved. The conservative, operative approach has been challenged by several reports of successful non-operative management aided by the power of modern diagnostic imaging. The aim of our prospective study was to compare non-operative management with surgery for cases of splenic injury. METHODS We conducted a prospective study of patients admitted with blunt splenic injury to our regional hospital over a three-year period (2012-2015. Haemodynamic status upon admission, FAST examination, computed tomography 2 grade of splenic tear, presence and severity of associated injuries have been taken into account to determine the treatment of choice. Therapeutic options were classified into non-operative and splenectomy. RESULTS Over a 3-year period, 24 patients were admitted with blunt splenic injury. Sixteen patients were managed operatively and eight patients non-operatively. 3,4 Non-operative management failed in one patient due to continued bleeding. The majority of grades I, II, and III splenic injuries were managed non-operatively and grades IV and V were managed operatively. Blood transfusion requirement was significantly higher among the operative group, but the operative group had a significantly longer hospital stay. Among those managed non-operatively (median age 24.5 years, a number of patients were followed up with CT scans with significant radiation exposure and unknown longterm consequences. CONCLUSION In our experience, NOM is the treatment of choice for grade I, II and III blunt splenic injuries. Splenectomy was the chosen technique in patients who met exclusion criteria for NOM, as well as for patients with grade IV and V injury.

Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System.

Science.gov (United States)

Bere, Tone; Kruczynski, Jacek; Veintimilla, Nadège; Hamu, Yuichiro; Bahr, Roald

2015-09-01

Little is known about the rate and pattern of injuries in international volleyball competition. To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior). The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions. Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Treatment Protocol for High Velocity/High Energy Gunshot Injuries to the Face

Science.gov (United States)

Peled, Micha; Leiser, Yoav; Emodi, Omri; Krausz, Amir

2011-01-01

Major causes of facial combat injuries include blasts, high-velocity/high-energy missiles, and low-velocity missiles. High-velocity bullets fired from assault rifles encompass special ballistic properties, creating a transient cavitation space with a small entrance wound and a much larger exit wound. There is no dispute regarding the fact that primary emergency treatment of ballistic injuries to the face commences in accordance with the current advanced trauma life support (ATLS) recommendations; the main areas in which disputes do exist concern the question of the timing, sequence, and modes of surgical treatment. The aim of the present study is to present the treatment outcome of high-velocity/high-energy gunshot injuries to the face, using a protocol based on the experience of a single level I trauma center. A group of 23 injured combat soldiers who sustained bullet and shrapnel injuries to the maxillofacial region during a 3-week regional military conflict were evaluated in this study. Nine patients met the inclusion criteria (high-velocity/high-energy injuries) and were included in the study. According to our protocol, upon arrival patients underwent endotracheal intubation and were hemodynamically stabilized in the shock-trauma unit and underwent total-body computed tomography with 3-D reconstruction of the head and neck and computed tomography angiography. All patients underwent maxillofacial surgery upon the day of arrival according to the protocol we present. In view of our treatment outcomes, results, and low complication rates, we conclude that strict adherence to a well-founded and structured treatment protocol based on clinical experience is mandatory in providing efficient, appropriate, and successful treatment to a relatively large group of patients who sustain various degrees of maxillofacial injuries during a short period of time. PMID:23449809

Chirurgica Taurina: a 10-year experience of bullfight injuries.

Science.gov (United States)

Rudloff, Udo; Gonzalez, Victor; Fernandez, Eduardo; Holguin, Esteban; Rubio, Gustavo; Lomelin, Jorge; Dittmar, Michael; Barrera, Rafael

2006-10-01

Despite recent efforts to improve medical treatment for injured bullfighters, including the foundation of a scientific society for bullfight injuries, serious injuries, in particular in villages and smaller arenas, still do occur. We are not aware of any series in the English literature that aimed to study the specific mechanisms, types, and outcomes of these injuries. A review of the trauma registry of injured bullfighters who suffered any type of trauma during bullfighting and received emergency therapy by the Surgical Trauma Services between 1994 and 2004 at the Plaza de Toros Nuevo Progreso, Guadalajara, Mexico. In all, 68 out of 750 bullfighters (9.06%) required emergency assistance during bullfighting. Trauma to the upper and lower extremity was most common (66%), followed by injuries to the inguinal (8%) and perineal area (7%). Extremity injuries included penetrating wounds requiring operative debridement in 64% of cases, articular dislocations in 4%, closed fractures in 4%, and open fractures in 1% of cases. Major vascular injuries occurred in 5% of the cases. Penetrating inguinal and penetrating perineal injuries were associated with major vascular injuries to the femoral vessels, necessitating operative repair in 33% of the cases. A considerable risk of serious, life-threatening injuries is inherent to bullfighting. Penetrating inguinal and perineal trauma with injury to the femoral vessels represents a specific, potentially fatal injury. A low threshold for exploration of these penetrating injuries in injured bullfighters is associated with a favorable outcome. Appreciation of the unique mechanisms and types of injuries related to bullfighting should lead to target intervention and help the evolvement of improved emergency treatment in organized bullfighting.

A new classification for cervical vertebral injuries: influence of CT

Energy Technology Data Exchange (ETDEWEB)

Daffner, R.H.; Brown, R.R.; Goldberg, A.L. [Department of Diagnostic Radiology, Allegheny University Hospitals, Allegheny General, Pittsburgh, PA (United States)

2000-03-30

Objective. Computed tomography (CT) has been demonstrated to be superior to radiography in identifying cervical vertebral injuries. However, many of these injuries may not be clinically significant, and require only minimal symptomatic and supportive treatment. It is therefore imperative that radiologists and spine surgeons have criteria for distinguishing between those injuries requiring surgical stabilization and those that do not. The authors propose a new classification of cervical vertebral injuries into two categories: major and minor.Design and patients. A data base, acquired on 1052 separate cervical injuries in 879 patients seen between 1983 and 1998, was reviewed. Four categories of injury based on mechanism [hyperflexion (four variants), hyperextension (two variants), rotary (two variants), and axial compression (five variants)] were identified. ''Major'' injuries are defined as having either radiographic or CT evidence of instability with or without associated localized or central neurologic findings, or have the potential to produce the latter. ''Minor'' injuries have no radiographic and/or CT evidence of instability, are not associated with neurologic findings, and have no potential to cause the latter.Results and conclusions. Cervical injury should be classified as ''major'' if the following radiographic and/or CT criteria are present: displacement of more than 2 mm in any plane, wide vertebral body in any plane, wide interspinous/interlaminar space, wide facet joints, disrupted posterior vertebral body line, wide disc space, vertebral burst, locked or perched facets (unilateral or bilateral), ''hanged man'' fracture of C2, dens fracture, and type III occipital condyle fracture. All other types of fractures may be considered ''minor''. (orig.)

Coagulopathy and transfusion requirements in war related penetrating traumatic brain injury. A single centre study in a French role 3 medical treatment facility in Afghanistan.

Science.gov (United States)

Bordes, J; Joubert, C; Esnault, P; Montcriol, A; Nguyen, C; Meaudre, E; Dulou, R; Dagain, A

2017-05-01

Traumatic brain injury associated coagulopathy is frequent, either in isolated traumatic brain injury in civilian practice and in combat traumatic brain injury. In war zone, it is a matter of concern because head and neck are the second most frequent site of wartime casualty burden. Data focusing on transfusion requirements in patients with war related TBI coagulopathy are limited. A descriptive analysis was conducted of 77 penetrating traumatic brain injuries referred to a French role 3 medical treatment facility in Kabul, Afghanistan, deployed on the Kabul International Airport (KaIA), over a 30 months period. On 77 patients, 23 died during the prehospital phase and were not included in the study. Severe traumatic brain injury represented 50% of patients. Explosions were the most common injury mechanism. Extracranial injuries were present in 72% of patients. Traumatic brain injury coagulopathy was diagnosed in 67% of patients at role 3 admission. Red blood cell units (RBCu) were transfused in 39 (72%) patients, French lyophilized plasma (FLYP) in 41 (76%), and fresh whole blood (FWB) in 17 (31%). The results of this study support previous observations of coagulopathy as a frequent complication of traumatic brain injury. The majority of patients with war related penetrating traumatic brain injury presented with extracranial lesions. Most of them required a high level of transfusion capacity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hamstring Injury After Swimming in a Patient With Multiple Hereditary Osteochondromatosis.

Science.gov (United States)

Dönmez, Gürhan; Özçakar, Levent; Korkusuz, Feza

2016-09-01

Reported here is a 20-year-old male suffered a hamstring strain after a prolonged bout of swimming. After ultrasound imaging, the patient's injury was considered to be the result of nearby osteochondromas. Case reports have been previously published concerning anterior cruciate ligament injury, rotator cuff tears, subacromial impingement, or femoroacetabular impingement in multiple osteochondromatosis. However, to the best of our knowledge, this is the first reported case of a hamstring injury secondary to an osteochondroma.

Dirt bikes injuries in children.

Science.gov (United States)

Abdelgawad, A A; Maxfield, D; Tran, S; Mclean, S; Kanlic, E M

2013-12-01

Dirt bike riding is becoming a more popular recreational activity among children. Injuries associated with this recreational activity did not gain attention in the medical literature. The purpose of this study is to assess orthopedic injuries associated with dirt bike riding. We retrospectively studied injuries occurring in children less than 18 years old, while riding dirt bikes, that required admission to the trauma department in our level one trauma center during the period 2000-2010. There were 24 admissions (23 patients). The mean age was 13. Fourteen patients had brain injuries. Six patients had abdominal injuries. One patient died shortly after arriving to the emergency department. Fourteen patients had face and neck injuries. The average injury severity score was 8.5. Thirteen patients' admissions (54 %) had orthopedic fractures. Five of 13 patients (38 %) suffered more than one fracture. Eight patients needed orthopedic intervention (seven of these were in operating room under general anesthesia and one in the emergency department under conscious sedation). Femur fracture was the most common cause for performing surgery in this group of patients. Riding dirt bikes is not a safe recreational activity. Orthopedic injuries constitute a major component of the injuries affecting children riding dirt bikes. Orthopedic surgeons (being responsible for treating most of these children) have the obligation to warn the community against the possible dangers facing children who ride dirt bikes.

Biomechanical and physiological demands of kitesurfing and epidemiology of injury among kitesurfers.

Science.gov (United States)

Bourgois, Jan G; Boone, Jan; Callewaert, Margot; Tipton, Michael J; Tallir, Isabel B

2014-01-01

Kitesurfing is a relatively new extreme water sport that is considered a high-risk sport and has rising popularity. Kitesurfing combines aspects of several water sports, including surfing, windsurfing, and wakeboarding. With a large controllable kite and a small board, kitesurfers travel over the water surface with speeds of up to 35 knots. The vertical lift of the kite makes it possible to perform jumps up to 15 m high and 30 m long, while doing different manoeuvres in the air. Few scientific data are available concerning the biomechanical and physiological demands of kitesurfing and the epidemiology of kitesurfing injury, and research methods used are often questionable. During kitesurfing, considerable stress is placed on the musculoskeletal and physiological systems, and the possibility of injury or fatality is an inherent part of participation. The lower back and thigh muscles are often perceived as being highly stressed, while abdominal muscles, knees, and feet are common sites of pain or discomfort. During kitesurfing, both aerobic and anaerobic metabolism contribute to energy delivery. It is reported in the literature that kitesurfing injuries are mainly acute, due to accidents or trauma. Non-competitive kitesurfing resulted in an overall injury rate of 5.9-7.0 injuries per 1,000 kitesurfing hours. It seems that the risk of injury increases dramatically in competitive kitesurfing. However, contradictory results have been found. Lower extremities were the most common major site of injuries, followed by upper extremities, trunk, and head. Most accidents during kitesurfing reported in the literature were attributed to the inability to detach the kite from the harness. Due to technical innovations, recent studies report uncontrolled actions and unsuccessful tricks and jumps with poor landings as the main mechanisms of injuries. The main purpose of the present paper is to critically analyse the current relevant scientific literature on the biomechanical and

Biomarkers of drug-induced vascular injury

International Nuclear Information System (INIS)

Brott, D.; Gould, S.; Jones, H.; Schofield, J.; Prior, H.; Valentin, J.P; Bjurstrom, S.; Kenne, K.; Schuppe-Koistinen, I.; Katein, A.; Foster-Brown, L.; Betton, G.; Richardson, R.; Evans, G.; Louden, C.

2005-01-01

In pre-clinical safety studies, drug-induced vascular injury is an issue of concern because there are no obvious diagnostic markers for pre-clinical or clinical monitoring and there is an intellectual gap in our understanding of the pathogenesis of this lesion. While vasodilatation and increased shear stress appear to play a role, the exact mechanism(s) of injury to the primary targets, smooth muscle and endothelial cells are unknown. However, evaluation of novel markers for potential clinical monitoring with a mechanistic underpinning would add value in risk assessment and management. This mini review focuses on the progress to identify diagnostic markers of drug-induced vascular injury. Von Willebrand factor (vWF), released upon perturbation of endothelial cells, is transiently increased in plasma prior to morphological evidence of damage in dogs or rats treated with vascular toxicants. Therefore, vWF might be a predictive biomarker of vascular injury. However, vWF is not an appropriate biomarker of lesion progression or severity since levels return to baseline values when there is morphological evidence of injury. A potential mechanistically linked biomarker of vascular injury is caveolin-1. Expression of this protein, localized primarily to smooth muscle and endothelial cells, decreases with the onset of vascular damage. Since vascular injury involves multiple mediators and cell types, evaluation of a panel rather than a single biomarker may be more useful in monitoring early and severe progressive vascular injury

Comparison of clinically suspected injuries with injuries detected at whole-body CT in suspected multi-trauma victims

International Nuclear Information System (INIS)

Shannon, L.; Peachey, T.; Skipper, N.; Adiotomre, E.; Chopra, A.; Marappan, B.; Kotnis, N.

2015-01-01

thoracic region in 62% (103/165) cases. Of the 278 thoracic injuries, there were abdominal/pelvic region injuries in 37% (103/278) and injuries to the neck in 19% (52/278) cases. Of the 158 head injuries, there were neck injuries in 22% (34/158) cases. Conclusion: Clinical suspicion of injury correlates poorly with findings at WBCT, with a high proportion of uninjured body areas. The number of unsuspected injuries found at WBCT was low, but the majority of these were serious injuries, possibly masked by distracting injury to other body areas. The use of a WBCT protocol is recommended for suspected polytrauma, but regular monitoring of WBCT findings and regular feedback of the results to emergency physicians is suggested to help inform their selection of patients for trauma WBCT. - Highlights: • Clinical suspicion of injury correlates poorly with findings at Trauma WBCT. • Clinically unsuspected injuries found at Trauma WBCT are uncommon. • The majority of unsuspected injuries in this study were serious injuries, possibly masked by other distracting injuries. • Patterns of injury between certain body areas have been found. • Regular monitoring and feedback of the findings of WBCT to emergency physicians is advised.

[Sport-medical aspects concerning Asian martial arts Aikidô and Ving Tsun].

Science.gov (United States)

Adler, D; Majerle, S; Schmidt, M; von Salis-Soglio, G

2010-03-01

Asian martial arts became very popular in Germany during the last years, nevertheless there are only few clinical inquiries concerning sportorthopaedic or -traumatological aspects. In this study we analyzed the risk and the prevalence of sport-injuries and sport-damages in Aikidô and Ving Tsun. 19 Aicidôca and 24 Ving Tsun athletes were to undergo broad survey and sport-orthopedic inspection. In this process an especially adapted examination-sheet after Baumann was used. 68.4 % of the Aikidoca and 79.2 % of the Ving Tsun athletes reported injuries, whereupon soft injuries dominated, severe injuries like luxations, ligamental und muscular ruptures appeared infrequently, the incidence of fractures was 1 % resp. 0.2 %. 37 % resp. 33.3 % of all injuries where related to the lower limb, 14.8 % resp. 16.7 % to the head and neck. Disorders dominated with 60 % resp. 50 % in the range of the knees. Persistent sport-damages could not be found in the clinical examinations. There is even just a low risk for severe sport-injuries and sport-damages while intensely practicing martial arts Aikidô and Ving Tsun for years. In the range of prevention the consequent use of protective gear (specificly bump cap and footwear) is important. Georg Thieme Verlag KG Stuttgart, New York.

Hypopituitarism after acute brain injury.

Science.gov (United States)

Urban, Randall J

2006-07-01

Acute brain injury has many causes, but the most common is trauma. There are 1.5-2.0 million traumatic brain injuries (TBI) in the United States yearly, with an associated cost exceeding 10 billion dollars. TBI is the most common cause of death and disability in young adults less than 35 years of age. The consequences of TBI can be severe, including disability in motor function, speech, cognition, and psychosocial and emotional skills. Recently, clinical studies have documented the occurrence of pituitary dysfunction after TBI and another cause of acute brain injury, subarachnoid hemorrhage (SAH). These studies have consistently demonstrated a 30-40% occurrence of pituitary dysfunction involving at least one anterior pituitary hormone following a moderate to severe TBI or SAH. Growth hormone (GH) deficiency is the most common pituitary hormone disorder, occurring in approximately 20% of patients when multiple tests of GH deficiency are used. Within 7-21 days of acute brain injury, adrenal insufficiency is the primary concern. Pituitary function can fluctuate over the first year after TBI, but it is well established by 1 year. Studies are ongoing to assess the effects of hormone replacement on motor function and cognition in TBI patients. Any subject with a moderate to severe acute brain injury should be screened for pituitary dysfunction.

The impact of the business cycle on occupational injuries in the UK.

Science.gov (United States)

Davies, Rhys; Jones, Paul; Nuñez, Imanol

2009-07-01

This paper investigates the cyclical fluctuations in rates of workplace injury for the UK from 1986 to 2005. Time series analysis shows that, in aggregate terms, the rate of minor injuries is pro-cyclical whilst the rate of major injury is not affected by the level of economic activity. Analysis by sector reveals that cyclical fluctuations are sharper in the construction and manufacturing sectors. Using panel data, we find that fluctuations in both the rates of minor and major injury are related to the level of new hiring and the ratio of actual to usual hours worked. However, only minor injuries are related to variables that control for workers' bargaining power. The analysis demonstrates the importance of both compositional effects and individual reporting behaviour to understanding cyclical variations in workplace injury rates.

Drug-induced liver injuries

African Journals Online (AJOL)

2011-06-02

Jun 2, 2011 ... liver failure in the developed world and a prominent aetiological factor ... most drugs is not known and several epidemiological studies have had major ... eosinophilia, are also pointers towards the cause of the injury and are.

Therapeutic approaches for spinal cord injury

Directory of Open Access Journals (Sweden)

Alexandre Fogaça Cristante

2012-10-01

Full Text Available This study reviews the literature concerning possible therapeutic approaches for spinal cord injury. Spinal cord injury is a disabling and irreversible condition that has high economic and social costs. There are both primary and secondary mechanisms of damage to the spinal cord. The primary lesion is the mechanical injury itself. The secondary lesion results from one or more biochemical and cellular processes that are triggered by the primary lesion. The frustration of health professionals in treating a severe spinal cord injury was described in 1700 BC in an Egyptian surgical papyrus that was translated by Edwin Smith; the papyrus reported spinal fractures as a ''disease that should not be treated.'' Over the last biological or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at minimum, allow for partial functional recoveries for these patients, which could improve their quality of life.

Status of musculoskeletal injury articles published in the major journals of radiology in China and comparison with abroad during the last decade

International Nuclear Information System (INIS)

Ding Jianping; Li Yuqing; Zhang Zekun; Yu Baohai; Liu Yicun; Peng Zhigang; Zhang Min; Wang Dongmei; Cao Hongwei; Jiang Xuexiang

2008-01-01

Objective: To investigate the status of musculoskeletal articles and musculoskeletal injury articles published in the major journals of radiology in China and compare with abroad during the last decade. Methods: Statistic analysis and comparison were done with musculoskeletal injury articles published in the major journals of radiology in China and abroad. The number, category, exam methods, study region and study contents were analyzed respectively. The journals in China included Chinese Journal of Radiology, Journal of Clinical Radiology and Journal of Practical Radiology. The journals at abroad included Radiology, the American Journal of Roentgenology (AJR), the British Journal of Radiology (B JR ) and Skeletal Radiology. Results: The rate of musculoskeletal articles among the treatise articles was 13.0% (827/6352) in China and 10.4% (900/8659) in three kinds of compressive journals at abroad. The rate of musculoskeletal injury articles in musculoskeletal articles was 21.5% (178/827) in China and 10.8% (97/900) abroad. Among the review articles, the rate was 9.9% (73/741) and 13.7% (10/73)in China, respectively, while that was 4.3% (34/783)and 23.5% (8/34), respectively abroad. Among the case reports, the rate was 17.0% (675/3971) and 3.4% (23/675) in China respectively, while that was 8.8% (177/2019) and 14.7% (26/177), respectively abroad. The rate of exam methods which only used X-ray plain film in injury articles was 11.7% (26/222), mainly CT was 42.8% (95/222) and mainly MR was 27% (60/222) in China, while that was 10.9% (32/295), 9.8% (29/295) and 32.5% (96/295), respectively in four kinds of journals at abroad. The combination examination was 16.2% (36/222) in China and 42.0% (124/295) at abroad respectively. The other was 2.3% (5/222) in China and 4.8% (14/295) at abroad. As for the study region, the rate of vertebrate column was 22.5% (50/222), knee joint was 21.1% (47/222), cranial and facial bones was 15.3% (34/222), hip joint was 7.2% (16

Ocular injuries and eye care seeking patterns following injuries among cocoa farmers in Ghana.

Science.gov (United States)

Bert, Boadi-Kusi Samuel; Rekha, Hansraj; Percy, Mashige Khathutshelo

2016-03-01

The work environment of cocoa farmers exposes them to several ocular hazards that predispose them to eye diseases and injuries. However, the extent of ocular injuries and health seeking patterns following these injuries are unknown among cocoa farmers in Ghana. To determine the prevalence of ocular injuries and health seeking behaviour following injury among cocoa farmers in Ghana. Five hundred and fifty six participants were recruited through simple random sampling using a multistage approach from four cocoa growing districts in Ghana. A structured questionnaire was used to collect relevant information such as demography, ocular hazards and injuries experienced. An ocular examination was also conducted to assess the eye health of the participants. Descriptive and regression statistics were used to analyze the data. The rate of ocular injuries was calculated by using the number of injuries reported that resulted in lost work time/days divided by the number of worker years at risk of injury (sum of years worked in cocoa farms for all the participants). The rate of ocular injuries was 11.3/1000 worker years (95% CI: 9.4 - 31) which led to lost work time of 37.3/1000 worker years (95% CI: 34.1 - 40.8). The major causes of ocular injury were plants/branches (n=73, 51.1%), chemicals (n=27, 18.9%), cocoa pod/husk (n=14, 9.8%) and occurred mostly during weeding, harvesting and chemical spraying. Few (n=34, 6.1%) participants reported the use of ocular protection. Fifty-five (38.5%) participants visited the local chemical shops, while 37 (25.9%) visited hospitals/clinics for ocular treatment of their injuries. There is a high rate of ocular injuries among cocoa farmers who make insufficient use of appropriate eye care services. There is the need for eye health education among cocoa farmers in Ghana.

An analysis on compensation of claims regarding to personal Injury ...

African Journals Online (AJOL)

Road accident is a major contributor in personal injury cases. The plaintiff or accident victims are entitled to compensation from injuries. This study aims to analyse the amount of damages received compared to the amount of damages in personal injury guideline from Completion of the Review of the Compendium of ...

Severe Juxtahepatic Venous Injury: Survival after Prolonged Hepatic Vascular Isolation Without Shunting

Directory of Open Access Journals (Sweden)

J. E. J. Krige

1990-01-01

Full Text Available Survival following major juxtahepatic venous injury is rare in blunt liver trauma despite the use of intracaval shunting. Prolonged liver arterial inflow control, total hepatic venous isolation and lobectomy without shunting was used in a patient to repair a combined vena caval and hepatic venous injury after blunt liver injury. An extended period of normothermic hepatic ischemia was tolerated. Early recognition of retrohepatic venous injury and temporary liver packing to control bleeding and correct hypovolemia are essential before caval occlusion. Hepatic vascular isolation without shunting is an effective simple alternative technique allowing major venous repair in complex liver trauma.

Methods for injury surveillance in international cricket

African Journals Online (AJOL)

vents a player from being fully available for selection for a major match or 2) during a major match, causes a play- er to be unable .... who is replaced by the twelfth man for his fielding tasks nly (but who is ..... The major bias is that the injury rate ...

Pilot cluster randomised controlled trial of flooring to reduce injuries from falls in wards for older people.

Science.gov (United States)

Drahota, Amy Kim; Ward, Derek; Udell, Julie E; Soilemezi, Dia; Ogollah, Reuben; Higgins, Bernard; Dean, Taraneh P; Severs, Martin

2013-09-01

falls disproportionately affect older people, who are at increased risk of falls and injury. This pilot study investigates shock-absorbing flooring for fall-related injuries in wards for frail older people. we conducted a non-blinded cluster randomised trial in eight hospitals in England between April 2010 and August 2011. Each site allocated one bay as the 'study area', which was randomised via computer to intervention (8.3-mm thick Tarkett Omnisports EXCEL) or control (2-mm standard in situ flooring). Sites had an intervention period of 1 year. Anybody admitted to the study area was eligible. The primary outcome was the fall-related injury rate. Secondary outcomes were injury severity, fall rate and adverse events. during the intervention period, 226 participants were recruited to each group (219 and 223 were analysed in the intervention and control group, respectively). Of 35 falls (31 fallers) in the intervention group, 22.9% were injurious, compared with 42.4% of 33 falls (22 fallers) in the control group [injury incident rate ratio (IRR) = 0.58, 95% CI = 0.18-1.91]. There were no moderate or major injuries in the intervention group and six in the control group. The fall IRR was 1.07 (95% CI = 0.64-1.81). Staff at intervention sites raised concerns about pushing equipment, documenting one pulled back. future research should assess shock-absorbing flooring with better 'push/pull' properties and explore increased faller risk. We estimate a future trial will need 33,480-52,840 person bed-days per arm.

Blunt carotid and vertebral artery injuries.

Science.gov (United States)

Arthurs, Zachary M; Starnes, Benjamin W

2008-11-01

The recognition and treatment of blunt cerebrovascular injuries has dramatically evolved over the past two decades. As imaging technology has improved both with respect to the image quality and acquisition times, its use has become a fundamental diagnostic tool in blunt trauma evaluation. The single greatest radiological advance in the past quarter century has been the refinement and increasing use of computed tomographic imaging for the diagnosis of surgical disease. Paralleling advances in noninvasive imaging, a heightened awareness of blunt cerebrovascular injuries has emerged, and the first screening protocols were developed at high volume trauma centres. Through aggressive screening, these injuries have increasingly been recognised before devastating neurological ischaemia and adverse neurocognitive outcomes. The mainstay of treatment for these injuries is antithrombotic therapy. However, all blunt cerebrovascular injuries require short and long-term follow-up. While the majority of injuries will resolve with medical management, a proportion will require further intervention in order to reduce the risk of subsequent stroke.

93 Aetiological spectrum, injury characteristics and treatment ...

African Journals Online (AJOL)

Abstract: Head injury is considered as a major health problem that is a ... Road traffic accidents (RTAs) were the most common cause of injury accounting for .... Student t-test was used to test for significance of associations between the predictor and ..... Mwang'ombe, N.J. & Kiboi, J. (2001) Factors influencing the outcome of ...

Profile of thoracic injury at College of Medical Sciences Teaching Hospital

Directory of Open Access Journals (Sweden)

D Chapagain

2014-01-01

Full Text Available Objectives: Thoracic injury is a challenge to the thoracic surgeon practicing in developing countries. This prospective study was conducted to see the mode of injury, injury types and overall outcome of thoracic injury in our settings. Materials and methods: This prospective study was conducted in 100 thoracic injury patients between December 2011 to June 2012. The demographic features, type of the trauma, radiological assessment, associated organ injuries, management of the injury, surgical interventions, morbidity, mortality, length of hospital stay were analysed. Results: In this study the ages ranged from 7 to 84 years. There were 73 (73% males and 27 (27% females. The majority of patients (83% were injured during the evening and night time. The majority of patients 92(92% sustained blunt chest injuries. The mechanism of injury was not significantly associated with length of hospital stay (P > 0.05 and mortality (P > 0.05.Road traffic accident was the most common cause of injuries affecting 68(68% of patients followed by fall injury of 19(19%. Rib fractures, haemothorax, pneumothorax and lung contusion were the most common type of injuries accounting for 83.0%, 57%,34% and 33% respectively. Associated extra-thoracic injuries were noted in 64.0% of patients. 45(45% of the cases of haemothorax, pneumotharax and haemopneumothorax were treated by tube thoracotomy. Four patients (04% had undergone thoracotomy. There were 09(09% patients of flail chest and treated conservatively. Fourty six patients (46% were admitted in the ICU. Eleven (11% patients were treated with ventilator support. Seventeen (17% patients had complication. The overall length of hospital stay ranged from 0 to 25 days. Conclusion: Road traffic accidents and fall from height are the major public health problems. Preventive measures at reducing road traffic accidents and timely management with closed tube thoracotomy are the main factors to be considered in the thoracic

Prevention of childhood injuries

African Journals Online (AJOL)

road traffic crashes, drowning, burns, poisoning or falls), has become a major ... hugely on childhood health in terms of disability and, depending on their cause ... SA, children continue to be threatened by injuries of various kinds, although this ...

Tracheobronchial injuries in blunt chest trauma

Directory of Open Access Journals (Sweden)

vahid Montazeri

2004-01-01

Full Text Available Introduction: Tracheobronchial injuries are uncommon but potentially fatal complication of blunt thoracic trauma harboring a high morbidity and mortality if not diagnosed early . A recent series gleaning cases from four major Trauma Center in Los Angeles nine cases in a seven- year period , but the incidence of these injuries has been increasing recently. This has been attributed to improvement in hospital care and advanced Trauma Centers and earlier diagnosis of such injuries. Disruption of tight main bronchus is more common, such injuries are often associated with rib or clavicular fractures. Findings: Clinical and paraclinical data gathered from records of three patients referred with tracheobronchial injuries during the recent ten years have been reviewed .These include clinical manifestations, diagnostic findings, treatment modality and clinical course. The outcome has been satisfactory in all three patients who have undergone operation 2-5 hours after sustaining the injury. We have not had any mortality. Conclusion: These results are similar to those of other series emphasizing over early diagnosis and treatment of such injuries .

A comparison of Gaelic football injuries in males and females in primary care.

LENUS (Irish Health Repository)

Crowley, J

2011-10-01

The Ladies Gaelic Football Association has a playing population of 150,000 of which 33% are adults. A number of studies have been published on rates of injury among male athletes but none on female athletes in Gaelic football. A retrospective review of insurance claims, submitted under the Gaelic Athletic Association Player Insurance Injury Scheme. 405 injuries were recorded, 248 [107 (70%) male, 141 (58%) female] to the lower limb, 91 [33 (21%) male, 58 (23%) female] to the upper limb. The majority of lower limb injuries [56 (52%) male, 56 (40%) female] were to muscle. Almost a third of upper limb injuries were fractures [10 (30.3%) male, 33 (57%) female]. injuries\\/1000 hours playing was 8.25 for men and 2.4 for women. The injury rate in ladies Gaelic football was found to be significantly lower than in men\\'s Gaelic football. Lower limb injuries accounted for the majority of injuries in both sports.

A review of issues and concerns of family members of adult burn survivors.

Science.gov (United States)

Sundara, Diana C

2011-01-01

The purpose of this review is to synthesize what is known about the issues and concerns of families of adult burn survivors from research and clinical articles written between 1973 and 2009. Electronic database searching, ancestry searching, and electronic hand searching were performed to identify relevant articles. Seventeen research studies and 14 clinical articles were identified. Families are often in crisis immediately after the injury. This crisis involves strong emotions, some of which may persist over time. Throughout the course of hospitalization, family issues include worries about their loved one's physical appearance, logistical concerns, and the transition to home. For partners, role changes and sexual concerns may be of particular importance. Extended family, friends, the burn team, and other families affected by a burn injury are important sources of support for family members. Few studies have been conducted beyond the time of hospitalization. Clinical articles have identified issues not present in the research literature. Further research is needed that focuses more closely on families and their experiences both in and out of the hospital. Implications for burn care providers based on the findings of this review are discussed.

Injuries in Professional Male Soccer Players in the Netherlands: A Prospective Cohort Study

NARCIS (Netherlands)

Stubbe, J.H.; Beijsterveldt, A.M. van; Knaap, S. van der; Stege, J.; Verhagen, E.; Mechelen, W. van; Backx, F.J.G.

2015-01-01

Context : Injuries are a major adverse event in a soccer player's career. Reducing injury incidence requires a thorough knowledge of the epidemiology of soccer injuries. Objective : To investigate the incidence and characteristics of injuries in the Dutch premier soccer league. Design : Cohort

Injuries in Professional Male Soccer Players in the Netherlands: A Prospective Cohort Study

NARCIS (Netherlands)

Stubbe, J.H.; van Beijsterveldt, A.M.M.C.; van der Knaap, S.; Stege, J.; Verhagen, E.A.L.M.; van Mechelen, W.; Backx, F.J.G.

2015-01-01

Context: Injuries are a major adverse event in a soccer player's career. Reducing injury incidence requires a thorough knowledge of the epidemiology of soccer injuries. Objective: To investigate the incidence and characteristics of injuries in the Dutch premier soccer league. Design: Cohort study.

Nosographic profile of soccer injuries according to the age group

Directory of Open Access Journals (Sweden)

Karoline Pegoraro Silveira

2013-05-01

Full Text Available Soccer is one of the world’s most popular team sports and corresponds to one ofthe leading causes of sports injuries (SI. This study aimed to analyze the nosographic profile of the sports injuries common to soccer, according to theage group: childhood, youth and adulthood. We selected 209 soccer players, from amateurs to professional players of a sports club from Campo Grande/MS.Participants were divided into four age groups: G1 (childhood, G2 (juvenile,G3 (teenagers and G4 (adults. To obtain information about the injuries, we used a morbidity survey. Generally, 74 athletes reported sports injuries, with register of 92 SI. Concerning injury types, muscle injuries totalized 43.47%, followed by joint damage (34.78% and tendon injury (14.13%, respectively (p 0.05. A higher proportion of registers involved medical-therapeutic approach and asymptomatic return. The evidence shows a higher rate of muscle and joint injuries by contact in the lower limbs in soccer practitioners, regardless of age group. The practice of training seemsto be the main cause of injuries in adolescents and adults.

Traumatic injuries to the anterior teeth of Nigerian urban public ...

African Journals Online (AJOL)

Falls (78.4%) and luxation/enamel fracture (31.9%) accounted for the majority of the injuries. Upper jaw (86.6%) and upper central incisors (75.5%) suffered traumatic anterior injuries most often. Conclusion: Within the limitations of the study, traumatic dental injuries were fairly common and it is suggested that preventive ...

Extensive cortical rewiring after brain injury.

Science.gov (United States)

Dancause, Numa; Barbay, Scott; Frost, Shawn B; Plautz, Erik J; Chen, Daofen; Zoubina, Elena V; Stowe, Ann M; Nudo, Randolph J

2005-11-02

Previously, we showed that the ventral premotor cortex (PMv) underwent neurophysiological remodeling after injury to the primary motor cortex (M1). In the present study, we examined cortical connections of PMv after such lesions. The neuroanatomical tract tracer biotinylated dextran amine was injected into the PMv hand area at least 5 months after ischemic injury to the M1 hand area. Comparison of labeling patterns between experimental and control animals demonstrated extensive proliferation of novel PMv terminal fields and the appearance of retrogradely labeled cell bodies within area 1/2 of the primary somatosensory cortex after M1 injury. Furthermore, evidence was found for alterations in the trajectory of PMv intracortical axons near the site of the lesion. The results suggest that M1 injury results in axonal sprouting near the ischemic injury and the establishment of novel connections within a distant target. These results support the hypothesis that, after a cortical injury, such as occurs after stroke, cortical areas distant from the injury undergo major neuroanatomical reorganization. Our results reveal an extraordinary anatomical rewiring capacity in the adult CNS after injury that may potentially play a role in recovery.

A PROSPECTIVE STUDY ON SPLENIC INJURY

Directory of Open Access Journals (Sweden)

Palanivel Rajagopal

2017-04-01

Full Text Available BACKGROUND An injured spleen is a well-known entity to those involved in trauma care. The majority of individual with a splenic injury now receive nonoperative intervention and therapy. This shift from operative to nonoperative treatment over the past several decades is a tremendous success story in which clinical judgment and reason triumphed over standard surgical dogma. In emergency room, restoration of airway, breathing and circulation should be focussed on. A careful history is the most important one. Nevertheless, the severity of the splenic injury plays a dominant part in determining whether nonoperative management is appropriate or-if-not-whether splenorrhaphy or splenectomy will be the more appropriate surgical option. As a general rule, younger, healthier patients with lower grade splenic injuries and fewer associated injuries and comorbidities are usually managed nonoperatively or with splenic repair, whether unstable, actively bleeding patients with more severe splenic trauma and/or multiple associated injuries require splenectomy. The aim of the study is to evaluate- 1. The impact of blunt or penetrating abdominal trauma on spleen. 2. Various modes of injury. 3. Various modes of clinical presentation of cases. 4. The value of various available investigations employed. 5. The various methods of treatment. 6. The morbidity and mortality. MATERIALS AND METHODS This study was a prospective study of 20 cases of splenic injury admitted in the triage ward of Mahatma Gandhi Memorial Government Medical College Hospital, Trichy, over a period of 2 years from December 2014 to December 2016. Once the patient is admitted, the name, age, sex and mode of injury are noted. The time interval between splenic injury and admission and time interval between admission to hospital and surgery are recorded. After resuscitating the patient, all patients were subjected to careful clinical examination. RESULTS The total number of patients who had sustained

Hand Injuries by the Killer Kite Manja and Their Management.

Science.gov (United States)

Mir, Mohd Altaf; Ali, Adil Mahmud; Yaseen, Mohd; Khan, Arshad Hafeez

2017-05-01

Although hand injuries due to kite strings seem to be trivial, these injuries could be serious enough to lose the function of hand. This case series in the division of Plastic and Reconstructive Surgery of our institution from August 2014 to January 2016 evaluated the clinic-etiological profile, severity and management of hand injuries due to kite strings assessed clinically and radiologically. Eleven patients reported kite related injuries during two years, and 5 presented during 17 months. Of 11 patients, 8 were male and 3 were female with a M:F ratio of 2.66:1. The majority of patients presented with the mean age of 19.9±4.27 years. Eight patients presented acutely to the emergency while 3 believed the injury to be trivial and had delayed presentation. Injuries in the right hand were 8 and 3 in the left hand. Seven patients had injuries in zone II of the hand while 4 presented with zone III injuries. Total number of injured digits was 14 (1.4±1.11), total number of injured tendons was 26 (2.36±2.18), only one patient had nerve injury (mean=0.09), and no patient had any major vessel injury. So strict attention to safety measures and parental/guardian supervision while flying kites can avoid many preventable injuries to life and limb and also let the sport be an enjoyable and safe.

Injury experience in metallic mineral mining, 1991

Energy Technology Data Exchange (ETDEWEB)

1993-10-01

This Mine Safety and Health Administration (MSHA) informational report reviews in detail the occupational injury and illness experience of metallic mineral mining in the United States for 1991. Data reported by operators of mining establishments concerning work injuries are summarized by work location, accident classification, part of body injured, nature of injury, occupation, and principal type of mineral. Related information on employment, worktime, and operating activity also is presented. Data reported by independent contractors performing certain work at mining locations are depicted separately in this report. For ease of comparison with other metal and nonmetallic mineral mining industries and with coal mining, summary reference tabulations are included at the end of both the operator and the contractor sections of this report.

Injury experience in metallic mineral mining, 1992

Energy Technology Data Exchange (ETDEWEB)

1994-05-01

This Mine Safety and Health Administration (MSHA) informational report reviews in detail the occupational injury and illness experience of metallic mineral mining in the United States for 1992. Data reported by operators of mining establishments concerning work injuries are summarized by work location, accident classification, part of body injured, nature of injury, occupation, and principal type of mineral. Related information on employment, worktime, and operating activity also is presented. Data reported by independent contractors performing certain work at mining locations are depicted separately in this report. For ease of comparison with other metal and nonmetallic mineral mining industries and with coal mining, summary reference tabulations are included at the end of both the operator and the contractor sections of this report.

Investigation of military training injuries in a special force corps in 2011

Directory of Open Access Journals (Sweden)

Gang ZHAO

2013-09-01

Full Text Available Objective　To investigate the incidence, related influencing factors and predilection sites of training injuries in a special force corps for providing a basis of effective prevention of the injuries. Methods　Four hundred and sixty-four officers and soldiers were randomly selected by lottery method from a special force corps in May 2011, and the training injuries as well as their related information was investigated by a questionnaire method. The medical records of the 464 subjects from May 2010 to May 2011 were reviewed. The collected data were statistically analyzed using SPSS 19.0 software. Results　Of the 464 subjects, 165(35.6% never experienced injuries, and 299(64.4% were injured due to training in the last one year. A total of 505 person-time injuries occurred in 464 subjects, and the incidence of injury was 109 per 100 person-year. The major risk factors for training injuries included above average age, fondness of multiple sports, greater labor force, or higher frequency of sport exercises before enlistment, poor sleep or diet caused by training burden, and higher SCL-90 somatization score. The major protective factors comprised of higher military rank, lower-intensity training, higher education level, higher labor frequency before enlistment, higher SCL-90 phobic anxiety score, higher SCL-90 depression score, SCL-90 spirit score, and higher satisfaction degree on training program. The major sites of training injuries were lower extremities and lower back (accounting for 73.0%. Most injuries occurred below the knee (accounting for 49.0%, including the foot (6.5%, ankle (13.6%, leg(7.3% and knee (21.6%, followed by the lower back (accounting for 20.7%. Conclusions　The risk factors of military training injuries involve various aspects, and continuous high intensive and highly difficult training items are the main reason of training injuries, and the lower extremities and lower back are the major locations. Psychological factors are

Studying gender and injuries: a comparative analysis of the literatures on women's injuries in sport and work.

Science.gov (United States)

Theberge, N

2012-01-01

This article provides a review and analysis of the literatures on the gendering of injuries in sport and in work. It argues that, while research on women's work-related injuries has considered the interaction of biological and social bases of risk, research on women's injuries in sport has concentrated to a greater extent on biological risk factors alone. The difference in emphasis between these two literatures has, in turn, provoked contrasting responses to these sets of research. While bringing women into the discussion of work-related injuries is seen as an advance, the profiling of women's sport-related injuries has been viewed with alarm by critics, who see this as a return to historical notions of women's frailty. The analysis suggests that contrasts between these bodies of research derive from differences in the social organisation of sport and work and the broader literatures on health and safety in each setting. The article highlights the importance of conceptualisations of gender in research agenda devoted to understanding health-related concerns. The analysis presented here has important relevance to ergonomics because of the need to better understand how gender is implicated in ergonomics research and practice.

Hepatic enzymes have a role in the diagnosis of hepatic injury after blunt abdominal trauma.

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Tan, Ker-Kan; Bang, Shieh-Ling; Vijayan, Appasamy; Chiu, Ming-Terk

2009-09-01

Delayed diagnosis of patients with severe liver injuries is associated with an adverse outcome. As computed tomographic (CT) scan is not always available in the management of blunt abdominal trauma worldwide, the present study was undertaken to determine the accuracy of selected haematological markers in predicting the presence of hepatic injury and its severity after blunt abdominal trauma. A retrospective review of all patients with blunt abdominal trauma presented to our institution over a 3-year period was performed. Patients were excluded if they suffered penetrating injuries, died in the emergency department or if the required blood tests were not performed within 24h of the accident. The grading of the hepatic injury was verified using CT scans or surgical findings. Ninety-nine patients with blunt abdominal trauma had the required blood tests performed and were included in the study. The median injury severity score was 24 (range 4-75). Fifty-five patients had hepatic injuries, of which 47.3% were minor (Grades I and II) while 52.7% had major hepatic injuries (Grades III-V). There were no patients with Grade VI injuries. A raised ALT was strongly associated with presence of hepatic injuries (OR, 109.8; 95% CI, 25.81-466.9). This relation was also seen in patients with raised AST>2 times (OR, 21.33; 95% CI, 7.27-62.65). This difference was not seen in both bilirubin and ALP. ALT>2 times normal was associated with major hepatic injuries (OR, 7.15; 95% CI, 1.38-37.14; p=0.012) while patients with simultaneous raised AST>2 times and ALT>2 times had a stronger association for major hepatic injuries (OR, 8.44; 95% CI, 1.64-43.47). Abnormal transaminases levels are associated with hepatic injuries after blunt abdominal trauma. Patients with ALT and AST>2 times normal should be assumed to possess major hepatic trauma and managed accordingly. Patients with normal ALT, AST and LDH are unlikely to have major liver injuries.

The full spectrum of handlebar injuries in children: a decade of experience.

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Nataraja, R M; Palmer, C S; Arul, G S; Bevan, C; Crameri, J

2014-04-01

Traumatic paediatric handlebar injury (HBI) is known to occur with different vehicles, affect different body regions, and have substantial associated morbidity. However, previous handlebar injury research has focused on the specific combination of abdominal injury and bicycle riding. Our aim was to fully describe the epidemiology and resultant spectrum of injuries caused by a HBI. Retrospective data analysis of all paediatric patients (trauma registry over a 10-year period. Primary outcome was the HBI, its location and management. The effects of patient age, vehicle type, the impact region, and Injury Severity Score (ISS) were also evaluated. HBI patients were compared against a cohort injured while riding similar vehicles, but not having sustained a HBI. 1990 patients were admitted with a handlebar-equipped vehicle trauma; 236 (11.9%) having sustained a HBI. HBI patients were twice as likely to be aged between 6 and 14 years old compared with non-HBI patients (OR 2.2; 95% CI 1.5-3.2). 88.6% of the HBI patients sustained an isolated injury, and 45.3% had non-abdominal handlebar impact. There were no significant differences in median ISS (p=0.4) or need for operative intervention (OR 1.1; 95% CI 0.9-1.5) between HBI and non-HBI patients. HBI patients had a significantly longer LOS (1.8 days vs. 1.2 days; p=0.001), and more frequently required a major operation (OR 3.4; 95% CI 2.2-5.4). The majority of splenic, renal and hepatic injuries were managed conservatively. Although the majority of paediatric HBI is associated with both intra-abdominal injury and bicycle riding, it produces a spectrum of potentially serious injuries and patients are more likely to undergo major surgery. Therefore these patients should always be treated with a high degree of suspicion. Copyright © 2013. Published by Elsevier Ltd.

Outcomes Following Traumatic Grain Elevator Injuries.

Science.gov (United States)

Tolefree, Sydnei; Truong, Anthony; Ward, Jeanette; Dong, Fanglong; Ablah, Elizabeth; Haan, James

2017-01-01

The absence of a comprehensive database of grain elevator-associated injuries hinders accurate evaluation of injury prevalence and may lead to discordant information about injury frequencies. The main purpose of this study was to identify the most common mechanisms of injury related to grain elevator events. Comparisons of hospital outcomes between patients who sustained traumatic injuries associated with grain elevators at Occupational Safety and Health Administration (OSHA)-regulated industrial sites versus those on OSHA-exempt farming operations were also made. A retrospective review was conducted of all patients' presenting with grain elevator-related injuries at a level-1 trauma center between January 1, 2003, and December 31, 2013. Data collected included demographics, mechanism of injury, injury severity, hospitalization details, and discharge disposition. Data were summarized, and comparisons were made between the groups. All patients (N = 18) in the study were male, with a mean age of 37 years. Falls and being caught in equipment each accounted for 27.8% of injuries. Among the 18 patients, there were a total of 37 injuries. The majority of injuries were either lower extremity (29.7%) or chest injuries (21.6%). The average hospital length of stay was 4 ± 4.5 days, and one patient required mechanical ventilation. There were no reported deaths. The literature reports entrapments as the leading cause of grain elevator-related injuries; however, this study found that falls and being caught in equipment were the most common mechanisms of injury. This suggests that a greater emphasis should be placed on fall prevention and equipment safety.

The epidemiology of schoolboy rugby injuries.

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Roux, C E; Goedeke, R; Visser, G R; van Zyl, W A; Noakes, T D

1987-03-07

During one 18-week season, in which players from 26 high schools played 3,350 rugby matches, 495 injuries prevented players from participating in rugby for at least 1 week; 71% occurred during matches and 29% during practices. Injury was more common during the first 4 weeks of the season and again in the same time period after the mid-season vacation. At all ages, A-team players suffered the greatest number of injuries. The safest playing positions were tight-forward and scrum-half; the most dangerous loose-forward and in the back-line excluding the scrum-half. Overall, eightmen were the most often injured players. Of all injuries 55% occurred while the player was tackling or being tackled and 18% during the loose scrum/maul. The lower limb (37%), the head and neck (29%) and the upper limb (20%) were most commonly injured, and fractures (27%), ligament/tendon injuries (25%) and muscle injuries (17%) were commonest. However, concussion injuries were underreported in 19 of the 26 schools. This study shows: that monitoring rugby injuries through correspondence results in underreporting of injuries; that rugby injuries show specific trends with age, team level, playing position, time of the season and phase of play; and that players in the different positions suffer specific injuries in predictable phases of the game. Speed of play may be the most important aetiological factor in the majority of rugby injuries.

Injuries of the Portal Vein in Patients With Blunt Abdominal Trauma

Science.gov (United States)

Kremer, B.; Lloyd, D. M.; Meyer-Pannwitt, U.

1993-01-01

Between January 1987 and September 1991, 68 severely traumatized patients underwent emergency laparotomy because of blunt abdominal trauma. Intraoperatively, 54.4% of the patients had a major injury to one organ, 23.5% had injuries to two organs, 16.2% had injuries to three organs and 5.9% to four or more organs. Additionally, in 11.8% of these cases (n = 8) a major vascular injury (portal vein n = 5, vena cava n = 2, mesenteric root n = 1) was found. Injuries to the portal vein were always associated with complete rupture of the pancreas, requiring distal pancreatic resection in four cases and a duodenum preserving resection of the head of the pancreas in one. In two of these patients the portal vein had to be reconstructed with a Goretex prosthetic graft. Mortality was 14.7% for the whole group (n = 68) and 0% for patients with additional portal venous injuries. PMID:8489966

Visitor injuries in Hawai'i.

Science.gov (United States)

Ho, Hao Chih; Speck, Cora S R; Kumasaki, Jennifer

2009-12-01

Over seven million tourists visit the Hawaiian Islands each year. Popular visitor activities such as surfing, scuba diving, ocean kayaking, parasailing, bicycle tours and hiking each have risks of serious injury. This study reviews visitors' activities that led to serious injuries requiring treatment at the state's only trauma center while vacationing in Hawai'i. A retrospective electronic medical record review was conducted of all visitor and resident trauma patients admitted to The Queen's Medical Center (QMC) from January 2002-December 2006. Patient demographics, injury type and severity, mechanism of injury, and discharge status were collected and analyzed. A total of 8244 patients were admitted to QMC for major traumatic injuries over the five year study period. Of these, 466 (5.7%) were visitors. The most common mechanisms of visitor injuries were falls (23.6%), water-related injuries (22.8%), motor vehicle crashes (18.7%), motorcycle, moped, and recreational vehicle crashes (12.2%), assaults (7.3%), and bicycle crashes (4.0%). A disproportionate number of visitors sustained serious injuries while engaging in water-related activities: Visitors account for only 12.6% of the population on any given day, yet comprise 44.2% of the total admissions for Hawai'i's water-related injuries. Head and spine injuries make up over two-thirds (68.2%) of these water-related visitor injuries. As a general category, falls were responsible for the highest number of visitor trauma admissions. Of the recreational activities leading to high numbers of trauma admissions, water-related activities are the leading causes of serious injuries among visitors to Hawai'i. Water-related injury rates are significantly higher for Hawai'i's visitors than residents. Water safety education for visitors should be developed in multiple languages to educate and protect Hawai'i's visitors and visitor industry.

Ischaemia-reperfusion injury: a major protagonist in kidney transplantation.

Science.gov (United States)

Ponticelli, Claudio

2014-06-01

Ischaemia-reperfusion injury (IRI) is a frequent event in kidney transplantation, particularly when the kidney comes from a deceased donor. The brain death is usually associated with generalized ischaemia due to a hyperactivity of the sympathetic system. In spite of this, most donors have profound hypotension and require administration of vasoconstrictor agents. Warm ischaemia after kidney vessels clamping and the cold ischaemia after refrigeration also reduce oxygen and nutrients supply to tissues. The reperfusion further aggravates the state of oxidation and inflammation created by ischaemia. IRI first attacks endothelial cells and tubular epithelial cells. The lesions may be so severe that they lead to acute kidney injury (AKI) and delayed graft function (DGF), which can impair the graft survival. The unfavourable impact of DGF is worse when DGF is associated with acute rejection. Another consequence of IRI is the activation of the innate immunity. Danger signals released by dying cells alarm Toll-like receptors that, through adapter molecules and a chain of kinases, transmit the signal to transcription factors which encode the genes regulating inflammatory cells and mediators. In the inflammatory environment, dendritic cells (DCs) intercept the antigen, migrate to lymph nodes and present the antigen to immunocompetent cells, so activating the adaptive immunity and favouring rejection. Attempts to prevent IRI include optimal management of donor and recipient. Calcium-channel blockers, l-arginine and N-acetylcysteine could obtain a small reduction in the incidence of post-transplant DGF. Fenoldopam, Atrial Natriuretic Peptide, Brain Natriuretic Peptide and Dopamine proved to be helpful in reducing the risk of AKI in experimental models, but there is no controlled evidence that these agents may be of benefit in preventing DGF in kidney transplant recipients. Other antioxidants have been successfully used in experimental models of AKI but only a few studies of poor

Involvement of immune-related factors in diclofenac-induced acute liver injury in mice.

Science.gov (United States)

Yano, Azusa; Higuchi, Satonori; Tsuneyama, Koichi; Fukami, Tatsuki; Nakajima, Miki; Yokoi, Tsuyoshi

2012-03-11

Drug-induced liver injury (DILI) is a major safety concern in drug development and clinical drug therapy. However, the underlying mechanism of DILI is little known. It is difficult to predict DILI in humans due to the lack of experimental animal models. Diclofenac, a non-steroidal anti-inflammatory drug rarely causes severe liver injury in human, but there is some evidence for immunoallergic idiosyncratic reactions. In this study, the mechanism of diclofenac-induced liver injury in mice was investigated. First, we established the dosing condition for liver injury in normal mice. Plasma ALT and AST levels were significantly increased in diclofenac-administered (80 mg/kg, i.p.) mice in a dose- and time-dependent manner. Among several interleukins (ILs) and chemokines, mRNA expression of helper T (Th) 17 cell-mediated factors, such as retinoid orphan receptor (ROR)-γt, and signal transducers and activators of transcription factor (STAT) 3 in the liver, and the plasma IL-17 level were significantly increased. Neutralization of IL-17 tended to suppress the hepatotoxicity of diclofenac, suggesting that IL-17 was partly involved. Gadolinium chloride (GdCl₃) administration demonstrated that Kupffer cells are not likely to be involved in diclofenac hepatotoxicity. Hepatic expressions of IL-1β mRNA and plasma IL-1β were significantly increased soon after the diclofenac administration. Then, the results of an in vivo neutralization study of IL-1β suggested that IL-1β was involved early in the time of pathogenesis of the diclofenac-induced liver injury. In conclusion, we firstly developed a diclofenac-induced acute liver injury model in normal mice, and the involvement of IL-17 and IL-1β was clarified. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Injury rates and profiles of elite competitive weightlifters.

Science.gov (United States)

Calhoon, G; Fry, A C

1999-07-01

To determine injury types, natures, anatomical locations, recommended amount of time missed, and injury rates during weightlifting training. We collected and analyzed medical injury records of resident athletes and during numerous training camps to generate an injury profile. Elite US male weightlifters who were injured during training at the United States Olympic Training Centers. United States Olympic Training Center weightlifting injury reports from a 6-year period were analyzed. Data were expressed as percentages and were analyzed via x(2) tests. The back (primarily low back), knees, and shoulders accounted for the most significant number of injuries (64.8%). The types of injuries most prevalent in this study were strains and tendinitis (68.9%). Injuries of acute (59.6%) or chronic (30.4%) nature were significantly more common than recurrent injuries and complications. The recommended number of training days missed for most injuries was 1 day or fewer (90.5%). Injuries to the back primarily consisted of strains (74.6%). Most knee injuries were tendinitis (85.0%). The majority of shoulder injuries were classified as strains (54.6%). Rates of acute and recurring injuries were calculated to be 3.3 injuries/1000 hours of weightlifting exposure. The injuries typical of elite weightlifters are primarily overuse injuries, not traumatic injuries compromising joint integrity. These injury pattems and rates are similar to those reported for other sports and activities.

Site and Type Assessments of Sports Injuries in Archers

Directory of Open Access Journals (Sweden)

Gizem Kocaman

2018-03-01

Conclusion: Most archers are injured in the shoulder, neck and back areas. These injuries are mostly seen as muscle pain. The vast majority of injuries occur in training. In archers, shoulder, neck, and back areas should be more strengthened to reduce injuries. Extra warm-up programmes special to muscles in these sections should be especially applied in trainings and competitions. Shooting techniques are to be correctly applied.

Therapeutic Sleep for Traumatic Brain Injury

Science.gov (United States)

2017-06-01

AWARD NUMBER: W81XWH-16-1-0166 TITLE: Therapeutic Sleep for Traumatic Brain Injury PRINCIPAL INVESTIGATOR: Ravi Allada CONTRACTING...1. REPORT DATE June 2017 2. REPORT TYPE Annual 3. DATES COVERED 1June2016 - 31May2017 4. TITLE AND SUBTITLE Therapeutic Sleep for Traumatic Brain ...proposal will test the hypothesis that correcting sleep disorders can have a therapeutic effect onTraumatic Brain Injury (TBI) The majority of TBI

Acute spinal injury after centrifuge training in asymptomatic fighter pilots.

Science.gov (United States)

Kang, Kyung-Wook; Shin, Young Ho; Kang, Seungcheol

2015-04-01

Many countries have hypergravity training centers using centrifuges for pilots to cope with a high gravity (G) environment. The high G training carries potential risk for the development of spinal injury. However, no studies evaluated the influence of centrifuge training on the spines of asymptomatic fighter pilots on a large scale. Study subjects were 991 male fighter pilots with high G training at one institution. Subject variables included information about physical characteristics, flight hours of pilots prior to the training, and G force exposure related factors during training. The two dependent variables were whether the pilots developed acute spinal injury after training and the severity of the injury (major/minor). The incidence of acute spinal injury after high G training was 2.3% (23 of 991 subjects). There were 19 subjects who developed minor injury and 4 subjects who developed a herniated intervertebral disc, which is considered a major injury. In multivariate analysis, only the magnitude of G force during training was significantly related to the development of acute spinal injury. However, there was no significant factor related to the severity of the injury. These results suggest that high G training could cause negative effects on fighter pilots' spines. The magnitude of G force during training seemed to be the most significant factor affecting the occurrence of acute spinal injury.

Injuries and medical issues in synchronized Olympic sports.

Science.gov (United States)

Mountjoy, Margo

2009-01-01

Spectators of the Olympic Games can enjoy a wide variety of sports, including strength, team, timed, endurance, and artistic sports. In the Olympic program, there are two synchronized events: synchronized diving and synchronized swimming. The precision of the synchronization of the athlete's movements and skills is an added feature of entertainment. Synchronized athletes have additional training requirements to perfect the synchronization of their skills. The physical demands on the athlete from the repetition of training required for the perfection of synchronization result in injuries unique to these sports. Although both traumatic and overuse injuries occur, overuse injuries are more common. As these disciplines are artistic, judged sports, these athletes also are susceptible to eating disorders and the female athlete triad. This article reviews the training regimen of these athletes and outlines the injuries and health concerns that are common in the synchronized sports.

Injuries in Japanese Mini-Basketball Players During Practices and Games

Science.gov (United States)

Kuzuhara, Kenji; Shibata, Masashi; Uchida, Ryo

2016-01-01

Context: Mini-basketball is one of the most popular junior sports in Japan. Mini-basketball–related injuries may increase because of early specialization. However, no reports have been published to date concerning basketball injuries in children younger than 12 years of age. Objective: To prospectively study the incidence, sites, types, and mechanisms of injuries in mini-basketball teams. Design: Descriptive epidemiology study. Setting: Mini-basketball teams in Kobe, Japan. Patients or Other Participants: A total of 95 players in 7 community-based mini-basketball club teams (age range, 9 through 12 years). Main Outcome Measure(s): Data on all practice and game injuries for the 2013–2014 season were collected using an injury report form. Injury rates were calculated according to site, type, and mechanism. Results: The overall injury rate was 3.83 per 1000 athlete-hours (AHs). The game injury rate (12.92/1000 AHs) was higher than the practice injury rate (3.13/1000 AHs; P basketball players. The high practice injury rate in this study may be due to specific factors related to growth, such as individual differences in height, or to skills, such as inexperience in ball handling. PMID:27922287

Injury experience in sand and gravel mining, 1991

Energy Technology Data Exchange (ETDEWEB)

1993-10-01

This Mine Safety and Health Administration (MSHA) informational report reviews in detail the occupational injury and illness experience of sand and gravel mining in the United States for 1991. Data reported by operators of mining establishments concerning work injuries are summarized by work location, accident classification, part of body injured, nature of injury, and occupation. Related information on employment, worktime, and operating activity also is presented. Data reported by independent contractors performing certain work at mining locations are depicted separately in this report. For ease of comparison with other metal and nonmetallic mineral mining industries and with coal mining, summary reference tabulations are included at the end of both the operator and the contractor sections of this report.

Ganga hospital open injury score in management of open injuries.

Science.gov (United States)

Rajasekaran, S; Sabapathy, S R; Dheenadhayalan, J; Sundararajan, S R; Venkatramani, H; Devendra, A; Ramesh, P; Srikanth, K P

2015-02-01

Open injuries of the limbs offer challenges in management as there are still many grey zones in decision making regarding salvage, timing and type of reconstruction. As a result, there is still an unacceptable rate of secondary amputations which lead to tremendous waste of resources and psychological devastation of the patient and his family. Gustilo Anderson's classification was a major milestone in grading the severity of injury but however suffers from the disadvantages of imprecise definition, a poor interobserver correlation, inability to address the issue of salvage and inclusion of a wide spectrum of injuries in Type IIIb category. Numerous scores such as Mangled Extremity Severity Score, the Predictive Salvage Index, the Limb Salvage Index, Hannover Fracture Scale-97 etc have been proposed but all have the disadvantage of retrospective evaluation, inadequate sample sizes and poor sensitivity and specificity to amputation, especially in IIIb injuries. The Ganga Hospital Open Injury Score (GHOIS) was proposed in 2004 and is designed to specifically address the outcome in IIIb injuries of the tibia without vascular deficit. It evaluates the severity of injury to the three components of the limb--the skin, the bone and the musculotendinous structures separately on a grade from 0 to 5. Seven comorbid factors which influence the treatment and the outcome are included in the score with two marks each. The application of the total score and the individual tissue scores in management of IIIB injuries is discussed. The total score was shown to predict salvage when the value was 14 or less; amputation when the score was 17 and more. A grey zone of 15 and 16 is provided where the decision making had to be made on a case to case basis. The additional value of GHOIS was its ability to guide the timing and type of reconstruction. A skin score of more than 3 always required a flap and hence it indicated the need for an orthoplastic approach from the index procedure. Bone

Effects of a lighter, smaller football on acute match injuries in adolescent female football: a pilot cluster-randomized controlled trial.

Science.gov (United States)

Zebis, Mette K; Thorborg, Kristian; Andersen, Lars L; Møller, Merete; Christensen, Karl B; Clausen, Mikkel B; Hölmich, Per; Wedderkopp, Niels; Andersen, Thomas B; Krustrup, Peter

2018-05-01

The high injury incidence during match-play in female adolescent football is a major concern. In football, males and females play matches with the same football size. No studies have investigated the effect of football size on injury incidence in female adolescent football. Thus, the aim of the present study was to investigate the effects of introducing a lighter, smaller football on the injury pattern in female adolescent football. We conducted a pilot cluster randomized controlled trial including 26 football teams representing 346 adolescent female football players (age 15-18 years). The teams were randomized to a new lighter, smaller football (INT, N.=12 teams) or a traditional FIFA size 5 football (CON, N.=14 teams) during a full match-season. Acute time-loss injuries and football-exposure during match-play were reported weekly by text-message questions and verified subsequently by telephone interview. In total, 46 acute time-loss injuries were registered (5 severe injuries), yielding an incidence rate of 15.2 injuries per 1000 hours of match-play (95% CI: 8.5-27.2) in INT and 18.6 injuries per 1000 hours of match-play (95% CI: 14.0-24.8) in CON. The estimated 22% greater injury incidence rate risk (IRR: 1.22 [95% CI: 0.64-2.35]) in the CON group was not significant. With an IRR of 1.22, a future RCT main study would need to observe 793 acute time-loss injuries during match-play, in order to have a power of 80%. A large-scaled RCT is required to definitively test for beneficial or harmful effects of a lighter, smaller football in adolescent female football.

Missile injuries of the brain

International Nuclear Information System (INIS)

Kazmi, S.A.M.; Ashraf, A.T.; Qureshi, N.A.

2001-01-01

Data was analyzed relating to a consecutive series of 16 patients of penetrating brain injuries received at forward defense lines. Characteristics studied were the cause of injury, level of consciousness and various neurological deficits presented on initial examination, CT scan findings, the surgical procedures performed and the final outcome after one year of follow-up. One out of 16 patients, died due to severe associated injuries to abdominal viscera and major vessels. Meningitis occurred in one patient during the immediate postoperative period. All patients with motor weakness speech deficits and incontinence showed significant improvement. Hearing loss of one ear persisted in one patient. Two patients developed delayed onset seizures. It is concluded that, patients with penetrating brain injuries should be evacuated to the tertiary care neurosurgical centres as soon as possible. In operation only obviously necrotic brain and easily accessible metal and bone pieces should be removed. There is no need to explore the normal brain as it would only result in increased neurological deficits. The patients with such injuries should receive broad-spectrum antibiotics to prevent the infective complications. (author)

Spinal-cord injuries in Australian footballers, 1960-1985.

Science.gov (United States)

Taylor, T K; Coolican, M R

1987-08-03

A review of 107 footballers who suffered a spinal-cord injury between 1960 and 1985 has been undertaken. Since 1977, the number of such injuries in Rugby Union, Rugby League and Australian Rules has increased, from an average of about two injuries a year before 1977 to over eight injuries a year since then. Rugby Union is clearly the most dangerous game, particularly for schoolboys; all of the injuries in schoolboy games for this code have occurred since 1977. This study has shown that collision at scrum engagement, and not at scrum collapse, is the way in which the majority of scrum injuries are sustained. These injuries are largely preventable, and suggestions for rule changes are made. Half the injured players recovered to Frankel grades D or E. The financial entitlements of those injured were grossly inadequate; this warrants action. A national register for spinal-cord injuries from football should be established to monitor the effects of desirable rule changes in Rugby Union and Rugby League.

Injuries in an Extreme Conditioning Program

Science.gov (United States)

Aune, Kyle T.; Powers, Joseph M.

2016-01-01

Background: Extreme conditioning programs (ECPs) are fitness training regimens relying on aerobic, plyometric, and resistance training exercises, often with high levels of intensity for a short duration of time. These programs have grown rapidly in popularity in recent years, but science describing the safety profile of these programs is lacking. Hypothesis: The rate of injury in the extreme conditioning program is greater than the injury rate of weightlifting and the majority of injuries occur to the shoulder and back. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: This is a retrospective survey of injuries reported by athletes participating in an ECP. An injury survey was sent to 1100 members of Iron Tribe Fitness, a gym franchise with 5 locations across Birmingham, Alabama, that employs exercises consistent with an ECP in this study. An injury was defined as a physical condition resulting from ECP participation that caused the athlete to either seek medical treatment, take time off from exercising, or make modifications to his or her technique to continue. Results: A total of 247 athletes (22%) completed the survey. The majority (57%) of athletes were male (n = 139), and 94% of athletes were white (n = 227). The mean age of athletes was 38.9 years (±8.9 years). Athletes reported participation in the ECP for, on average, 3.6 hours per week (± 1.2 hours). Eighty-five athletes (34%) reported that they had sustained an injury while participating in the ECP. A total of 132 injuries were recorded, yielding an estimated incidence of 2.71 per 1000 hours. The shoulder or upper arm was the most commonly injured body site, accounting for 38 injuries (15% of athletes). Athletes with a previous shoulder injury were 8.1 times as likely to injure their shoulder in the ECP compared with athletes with healthy shoulders. The trunk, back, head, or neck (n = 29, 12%) and the leg or knee (n = 29, 12%) were the second most commonly injured sites. The

Kidney injury in cirrhosis

DEFF Research Database (Denmark)

Møller, Søren; Krag, Aleksander; Bendtsen, Flemming

2014-01-01

Acute kidney injury (AKI) is frequent in patients with cirrhosis. AKI and hyponatraemia are major determinants of the poor prognosis in advanced cirrhosis. The hepatorenal syndrome (HRS) denotes a functional and potential reversible impairment of renal function. Type 1 HRS, a special type of AKI...

Injuries among World Cup ski and snowboard athletes.

Science.gov (United States)

Flørenes, T W; Nordsletten, L; Heir, S; Bahr, R

2012-02-01

There is little information available on injuries to World Cup skiers and snowboarders. The aim of this study was to describe and compare the injury risk to World Cup athletes in alpine skiing, freestyle skiing, snowboarding, ski jumping, Nordic combined and cross country skiing. We performed retrospective interviews with the International Ski Federation (FIS) World Cup athletes from selected nations during the 2006-2007 and 2007-2008 winter seasons and recorded all acute injuries occurring during the seasons. We interviewed 2121 athletes and recorded 705 injuries. There were 520 (72%) time-loss injuries and 196 (28%) severe injuries (absence >28 days). In freestyle skiing, alpine skiing and snowboarding, there were 27.6, 29.8 and 37.8 time-loss and 14.4, 11.3 and 13.8 severe injuries per 100 athletes per season, respectively. In Nordic combined, ski jumping and cross country skiing, there were 15.8, 13.6 and 6.3 time-loss and 3.3, 5.6 and 0.7 severe injuries per 100 athletes per season, respectively. In conclusion about 1/3 of the World Cup alpine, freestyle and snowboard athletes sustain a time-loss injury each season, while the risk is low in the Nordic disciplines. A particular concern was the high proportion of severe injuries observed among alpine, freestyle and snowboard athletes, which is in contrast to most other sports. © 2010 John Wiley & Sons A/S.

PROSPECTIVE EPIDEMIOLOGICAL STUDY OF BASKETBALL INJURIES DURING ONE COMPETITIVE SEASON: ANKLE SPRAINS AND OVERUSE KNEE INJURIES

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Elke Cumps

2007-06-01

Full Text Available This prospective cohort study aims to assess the overall incidence of acute and overuse basketball injuries and identifies risk factors associated with ankle sprains and knee overuse injuries. In total, 164 senior players (23.7 years ± 7.0 of all levels of play, and including both men and women, participated voluntarily during one season. A total of 139 acute and 87 overuse injuries were reported, resulting in an overall injury incidence of 9.8 (8.5 to 11.1 per 1,000 hours. The incidence of acute injuries was 6.0/1,000 hours. Ankle sprains (n = 34 accounted for most acute injuries, and 52.9% of all players with ankle sprains reported a previous ankle sprain. Relative Risks (RR and Odds Ratio (OR with their 95% Confidence Intervals (CI were calculated to determine significant differences. Landing on an opponent's foot was the major inciting event, significantly more so than non contact mechanisms (RR=2.1 [95% CI: 1.0-4.2]. Acute knee injuries resulted in the highest playing absence (7 weeks 2 days ± 9 weeks 1 day. Overuse injury incidence was 3.8/1,000 hours. The knee (1.5/1,000 hours was the most common site. Forward players sustained less knee overuse injuries than players of all other playing positions, and significantly less than center players (OR=0.5 [95% CI: 0.2-0.9]. This study showed that ankle sprains and overuse knee injuries are the most common injuries in basketball, both accounting for 14.8%. Injury prevention programmes however should not concentrate on those injuries only, but might one to consider that acute knee injuries, in spite of the fact that they occur less frequently, also merit further research.

Pattern of Injuries from Road Traffic Accidents Presented at a Rural Teaching Institution of Karachi.

Science.gov (United States)

Shamim, Muhammad

2017-08-01

The aim of the study is to study the pattern of injuries from road traffic accidents presented at the emergency department of a rural teaching institution in Karachi. This descriptive case series was conducted prospectively in the Emergency Department of Fatima Hospital and Baqai Medical University from 1 January 2012 to 21 March 2013. There were 385 patients in the series. All of the patients with recent injuries from road traffic accidents were included. Cases with injuries more than 72 h old were excluded. The majority of patients had lower limb injuries 172 (44.7%), followed by head and neck injuries 107 (27.8%), multiple injuries 62 (16.1%), upper limb injuries 22 (5.7%), abdominoperineal injuries 19 (5%), and chest injuries 3 (0.8%). Majority (229, 59.5%) of patients were given first aid treatment and discharged, while 151 (39.3%) patients were either admitted or referred to better equipped hospitals. Three patients were brought dead, and two patients left against medical advice. The lower limb injuries were the commonest road traffic accidental injuries, followed by head and neck injuries, multiple injuries, upper limb injuries, abdominoperineal injuries, and chest injuries.

Pediatric trampoline injuries.

Science.gov (United States)

Hurson, Conor; Browne, Katherine; Callender, Orla; O'Donnell, Turlough; O'Neill, Anthony; Moore, David P; Fogarty, Esmond E; Dowling, Francis E

2007-01-01

The recreational use of trampolines has increased dramatically during the last 10 years. There has been a striking increase in the number of children presenting to fracture clinics with injuries associated with trampoline use. This increase in trampoline injuries has been reported in North America, but there has been a paucity of research in this area in Europe. We prospectively recorded details of patients presenting to our institution, Our Lady's Children's Hospital, Crumlin (Dublin, Ireland), during the busy summer months of June, July, and August 2005. Details recorded included type and mechanism of injury, the mode of referral, treatment, inpatient days, outpatient visits, specific details relating to trampoline safety, and an analysis of the cost of medical care. There were 101 patients treated for trampoline-related injuries in 3 months from June to August 2005. This represented 1.5% of the total attendances to the emergency department. The average age was 8.5 years (range, 1.4-17.4 years). There were 55 fractures, 38 soft tissue injuries, 5 head injuries, and 5 neck injuries, with an average Pediatric Trauma Score of 11.4. Fifty seven percent (58/101) of patients were on the trampoline with at least 1 other person. Twenty patients (19.8%) were admitted to hospital requiring 71 inpatient days. Twelve patients were treated in theatre. There were 163 fracture clinic visits, 212 x-rays, and 2 magnetic resonance imaging scans. Trampolines are a high-risk activity with the potential for significant orthopaedic injury. In Ireland, we have recently seen a dramatic increase in pediatric trampoline-related injuries mirroring the trend in the United States during the last 10 to 15 years. We found that more than 1 individual on a trampoline is a major risk factor for injury, where the lightest person is 14 times more likely to be injured than the heavier. The lighter person also has a greater chance of being injured with smaller numbers on the trampoline. We reiterate

The epidemiology of injury in skateboarding.

Science.gov (United States)

Hunter, Jamie

2012-01-01

The purpose of this report is to review the available literature to provide an epidemiological overview of skateboarding injuries, as well as to suggest possible areas for future research. A literature search was performed with the databases of PubMed, Sport Discus, Google and Google Scholar using the search terms 'skateboard', 'skateboarding', 'injury' and 'injuries', with all articles published in refereed journals in the English language being considered. An ancestry approach was also used. Articles from non-juried journals were also infrequently included to provide anecdotal information on the sport. Comparison of study results was compromised by the diversity of different study populations and variability of injury definitions across studies. The majority of injuries affect young males although conflicting arguments arise over the issues of age and experience in relation to injury severity. Most injuries are acutely suffered, and the most commonly affected body part was the wrist and forearm, with lower leg and ankle injuries also common. The incidence was relatively high but reports on severity differed. Clear conclusions could not be drawn on environmental location and risk factors. Most injuries tend to occur from a loss of balance leading to a fall, in more recent times due to a failed trick. Research on injury prevention is not conclusive although protective equipment and skatepark use are recommended. Further research using more rigorous study designs is required to gain a clearer picture of the incidence and determinants of injury, and to identify risk factors and viable injury countermeasures. Copyright © 2012 S. Karger AG, Basel.

Nosographic profile of soccer injuries according to the age group

Directory of Open Access Journals (Sweden)

Karoline Pegoraro Silveira

2013-04-01

Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2013v15n4p476 Soccer is one of the world’s most popular team sports and corresponds to one ofthe leading causes of sports injuries (SI. This study aimed to analyze the nosographic profile of the sports injuries common to soccer, according to the age group: childhood, youth and adulthood. We selected 209 soccer players, from amateurs to professional players of a sports club from Campo Grande/MS. Participants were divided into four age groups: G1 (childhood, G2 (juvenile,G3 (teenagers and G4 (adults. To obtain information about the injuries, we used a morbidity survey. Generally, 74 athletes reported sports injuries, with register of 92 SI. Concerning injury types, muscle injuries totalized 43.47%, followed by joint damage (34.78% and tendon injury (14.13%, respectively (p 0.05. A higher proportion of registers involved medical-therapeutic approach and asymptomatic return. The evidence shows ahigher rate of muscle and joint injuries by contact in the lower limbs in soccer practitioners, regardless of age group. The practice of training seems to be the main cause of injuries in adolescents and adults.

Surveillance of construction worker injuries: the utility of trade-specific analysis.

Science.gov (United States)

Hunting, K L; Welch, L S; Nessel-Stephens, L; Anderson, J; Mawudeku, A

1999-07-01

Construction is a dangerous industry, with high rates of both fatal and nonfatal injuries. To learn more about the causes of nonfatal construction worker injuries, and to identify injury cases for further work site-based investigations or prevention programs, we established an emergency department-based surveillance program in November 1990. This article describes circumstances of injury, diagnoses, and demographic characteristics of injured construction workers for 2,791 cases identified through mid-August, 1997. Lacerations and strains and sprains were the most frequent diagnoses; cutting and piercing objects were the leading causes of injury among all construction workers, followed by falls and overexertion. Because of the variety of work performed in this industry, more detailed injury descriptions, by trade, are most useful for thinking about injury prevention. To illustrate this, we profile injury patterns among workers from four specific trades: carpenters, electricians, plumbers, and ironworkers. Areas of concern highlighted by the trade-specific analyses include eye injuries among plumbers; falls from ladders among electricians and plumbers; slips, trips, and falls on the same level among ironworkers; electrical exposure among electricians; and, amputations among carpenters.

Crossbow injury to the neck | Omura | South African Journal of Surgery

African Journals Online (AJOL)

Crossbow injuries are uncommon among penetrating trauma. The tendency for a crossbow bolt to remain in situ appears to limit catastrophic haemorrhage despite the involvement of major vessels.1 Here we report our experience with an injury to the left internal jugular vein by a crossbow bolt. The injury was successfully ...

Spinal Cord Injury Rehabilitation in Nepal

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Nabina Shah

2013-06-01

Full Text Available Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the establishment of the various hospitals with rehabilitation units, rehabilitation centres and physical therapy units in different institutions. However, the spinal cord injury rehabilitation setting and scenario is different in Nepal from those in the developed countries since spinal cord injury rehabilitation care has not been adequately incorporated into the health care delivery system nor its importance has been realized within the medical community of Nepal. To name few, lack of human resource for the rehabilitation care, awareness among the medical personnel and general population, adequate scientific research evidence regarding situation of spinal injury and exorbitant health care policy are the important hurdles that has led to the current situation. Hence, it is our responsibility to address these apparent barriers to successful implementation and functioning of rehabilitation so that those with spinal injury would benefit from enhanced quality of life. Keywords: rehabilitation; spinal injury.

Work injury trends during the last three decades in the construction industry

DEFF Research Database (Denmark)

Lander, Flemming; Nielsen, Kent Jacob; Lauritsen, Jens M

2016-01-01

were calculated. Employment levels in the construction sector were used as an indicator of fluctuations in the business cycle since 1980. Results: Through the last three decades the overall trend of work-related injuries was unchanged. For some subgroups of injuries, such as major injuries and injuries...... were significantly related to the business cycle, where the risk of injuries was higher during economic booms than during recessions. Further, periods with economic booms are positively related to the rate of minor injuries and injuries due to all other work activities than the use of power tools...

No Relationship between Hamstring Flexibility and Hamstring Injuries in Male Amateur Soccer Players

NARCIS (Netherlands)

Van Doormaal, Mitchell C M; Van Der Horst, Nick; Backx, Frank J G; Smits, Dirk Wouter; Huisstede, Bionka M A

2017-01-01

BACKGROUND: In soccer, although hamstring flexibility is thought to play a major role in preventing hamstring injuries, the relationship between hamstring flexibility and hamstring injuries remains unclear. PURPOSE: To investigate the relationship between hamstring flexibility and hamstring injuries

Sport-Related Structural Brain Injury: 3 Cases of Subdural Hemorrhage in American High School Football.

Science.gov (United States)

Yengo-Kahn, Aaron M; Gardner, Ryan M; Kuhn, Andrew W; Solomon, Gary S; Bonfield, Christopher M; Zuckerman, Scott L

2017-10-01

The risk of sport-related concussion (SRC) has emerged as a major public health concern. In rare instances, sport-related head injuries can be even more severe, such as subdural hemorrhage, epidural hemorrhage, or malignant cerebral edema. Unlike SRCs, sport-related structural brain injury (SRSBI) is rare, may require neurosurgical intervention, and can lead to permanent neurologic deficit or death. Data characterizing SRSBI are limited, and many have recognized the need to better understand these catastrophic brain injuries. The goal of the current series is to describe, in detail, the presentation, management, and outcomes of examples of these rare injuries. During the fall of 2015, three high school football players presented with acute subdural hemorrhages following in-game collisions and were treated at our institution within a span of 2 months. For the 2 athletes who required surgical intervention, a previous SRC was sustained within 4 weeks before the catastrophic event. One year after injury, 2 players have returned to school, though with persistent deficits. One patient remains nonverbal and wheelchair bound. None of the athletes has returned to sports. Acute subdural hemorrhage resultant from an in-game football collision is rare. The temporal proximity of the reported SRSBIs to recent SRCs emphasizes the importance of return-to-play protocols and raises questions regarding the possibility of second impact syndrome. Although epidemiologic conclusions cannot be drawn from this small sample, these cases provide a unique opportunity to demonstrate the presentation, management, and long-term outcomes of SRSBI in American high school football. Copyright © 2017 Elsevier Inc. All rights reserved.

An autopsy study of 74 cases of cut throat injuries

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Dinesh Rao

2015-12-01

Full Text Available The present prospective autopsy study was carried out during the period July 2009 to May 2012 in Kingston, Jamaica. A total of 74 cases of cut throat injury were studied. All the cut throat injuries irrespective of those directly or indirectly contributing to the death were studied. Males dominated the list of victims, contributing to 71.62% (n = 53. Majority of those were in the age group 21–30 (n = 25 and 31–40 (n = 26 which contributed to 33.78% and 35.13% respectively. Majority of the cases were homicides contributing to 97.29% (n = 72 of cases, only 2.7% were suicides and accidental cut throat were never reported. Males dominated the homicides category contributing to 72.22% (n = 52 of the cases. Gang and relationship crisis (homosexual and heterosexual were the major motivating factors, each contributing to 39.19% (n = 29 and 32.43% (n = 24 of the cases, respectively. The disease suffered by individuals were the least motivating factors contributing to 1.35% of cases (n = 01. The most common cause of death was exsanguinations in 49.95% (n = 34 of cases followed closely by asphyxia due to aspiration of blood i.e. 36.49% (n = 27 of cases and air embolism was the least cause of death, contributing to 4.05% (n = 03 of cases. Cut throat injury was associated with other injuries like gunshot wound, chop wounds and stab wounds in 13.52% of (n = 10 autopsies. Chop injuries contributed to maximum number of other injuries in homicides (n = 46. The most preferred place for the crime was an open field or farm (n = 26. Majority of the cut throat wounds were situated in zone II level contributing to 66.21% (n = 49 of cases. Majority of the wounds were directed from left to right in 75.68% (n = 56 of cases and the cervical vertebra was affected in 8.11% (n = 06 of cases. Major weapon of choice was machete contributing to 83.78% (n = 62 of injuries. The low income group was the most affected group contributing to 91

Protective effects of incensole acetate on cerebral ischemic injury.

Science.gov (United States)

Moussaieff, Arieh; Yu, Jin; Zhu, Hong; Gattoni-Celli, Sebastiano; Shohami, Esther; Kindy, Mark S

2012-03-14

The resin of Boswellia species is a major anti-inflammatory agent that has been used for centuries to treat various conditions including injuries and inflammatory conditions. Incensole acetate (IA), a major constituent of this resin, has been shown to inhibit NF-κB activation and concomitant inflammation, as well as the neurological deficit following head trauma. Here, we show that IA protects against ischemic neuronal damage and reperfusion injury in mice, attenuating the inflammatory nature of ischemic damage. IA given post-ischemia, reduced infarct volumes and improved neurological activities in the mouse model of ischemic injury in a dose dependent fashion. The protection from damage was accompanied by inhibition of TNF-α, IL-1β and TGF-β expression, as well as NF-κB activation following injury. In addition, IA is shown to have a therapeutic window of treatment up to 6h after ischemic injury. Finally, the protective effects of IA were partially mediated by TRPV3 channels as determined by the TRPV3 deficient mice and channel blocker studies. This study suggests that the anti-inflammatory and neuroprotective activities of IA may serve as a novel therapeutic treatment for ischemic and reperfusion injury, and as a tool in the ongoing research of mechanisms for neurological damage. Published by Elsevier B.V.

Diagnostic and treatment challenges in traumatic brain injury patients with severe neuropsychiatric symptoms: insights into psychiatric practice

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Lauterbach MD

2015-07-01

Full Text Available Margo D Lauterbach,1 Paula L Notarangelo,1 Stephen J Nichols,2 Kristy S Lane,1 Vassilis E Koliatsos11The Neuropsychiatry Program at Sheppard Pratt, Sheppard Pratt Health System, Baltimore, MD, 2Department of Emergency Medicine, The University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USAAbstract: Traumatic brain injury (TBI causes a variety of neuropsychiatric problems that pose diagnostic and treatment challenges for providers. In this report, we share our experience as a referral neuropsychiatry program to assist the general psychiatrist when adult TBI patients with psychiatric symptoms present for evaluation and treatment. We completed a retrospective study of patients with moderate-to-severe TBI and severe neuropsychiatric impairments. We collected information on demographics, nature of injury, symptomatology, diagnoses, and treatments. Data analysis indicates that mood stabilization was a key concern, often requiring aggressive pharmacological management. Cognitive dysfunction was a problem for the majority of patients, but was only medicated in a third, due to poor efficacy or behavioral side effects. The co-occurrence of multiple TBI-related symptoms and diagnoses in this patient cohort emphasizes the need for individualized psychopharmacological approaches and interventions.Keywords: traumatic brain injury, neurobehavioral, treatment

Neutrophil depletion reduces edema formation and tissue loss following traumatic brain injury in mice

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Kenne Ellinor

2012-01-01

Full Text Available Abstract Background Brain edema as a result of secondary injury following traumatic brain injury (TBI is a major clinical concern. Neutrophils are known to cause increased vascular permeability leading to edema formation in peripheral tissue, but their role in the pathology following TBI remains unclear. Methods In this study we used controlled cortical impact (CCI as a model for TBI and investigated the role of neutrophils in the response to injury. The outcome of mice that were depleted of neutrophils using an anti-Gr-1 antibody was compared to that in mice with intact neutrophil count. The effect of neutrophil depletion on blood-brain barrier function was assessed by Evan's blue dye extravasation, and analysis of brain water content was used as a measurement of brain edema formation (24 and 48 hours after CCI. Lesion volume was measured 7 and 14 days after CCI. Immunohistochemistry was used to assess cell death, using a marker for cleaved caspase-3 at 24 hours after injury, and microglial/macrophage activation 7 days after CCI. Data were analyzed using Mann-Whitney test for non-parametric data. Results Neutrophil depletion did not significantly affect Evan's blue extravasation at any time-point after CCI. However, neutrophil-depleted mice exhibited a decreased water content both at 24 and 48 hours after CCI indicating reduced edema formation. Furthermore, brain tissue loss was attenuated in neutropenic mice at 7 and 14 days after injury. Additionally, these mice had a significantly reduced number of activated microglia/macrophages 7 days after CCI, and of cleaved caspase-3 positive cells 24 h after injury. Conclusion Our results suggest that neutrophils are involved in the edema formation, but not the extravasation of large proteins, as well as contributing to cell death and tissue loss following TBI in mice.

Fairness and nanotechnology concern.

Science.gov (United States)

McComas, Katherine A; Besley, John C

2011-11-01

Research suggests that fairness perceptions matter to people who are asked to evaluate the acceptability of risks or risk management. Two separate national random surveys (n = 305 and n = 529) addressed Americans' concerns about and acceptance of nanotechnology risk management in the context of the degree to which they view scientists and risk managers as fair. The first survey investigated general views about scientists across four proposed dimensions of fairness (distributional, procedural, interpersonal, and informational). The results show that respondents who believe that the outcomes of scientific research tend to result in unequal benefits (distributional fairness) and that the procedures meant to protect the public from scientific research are biased (procedural fairness) were more concerned about nanotechnology. Believing scientists would treat them with respect (interpersonal fairness) and ensure access to information (informational fairness) were not significant predictors of concern. The second study also looked at these four dimensions of fairness but focused on perceptions of risk managers working for government, universities, and major companies. In addition to concern, it also examined acceptance of nanotechnology risk management. Study 2 results were similar to those of study 1 for concern; however, only perceived informational fairness consistently predicted acceptance of nanotechnology risk management. Overall, the study points to the value of considering fairness perceptions in the study of public perceptions of nanotechnology. © 2011 Society for Risk Analysis.

Treatment of penetrating hepatic injuries: a retrospective analysis of 50 patients.

Science.gov (United States)

Gonullu, D; Koksoy, F N; Ilgun, S; Demiray, O; Yucel, O; Yucel, T

2009-01-01

The aim of this study was to determine the possibility of non-operative treatment via retrospective analysis of our patients. Fifty patients with penetrating hepatic injuries were examined retrospectively with respect to trauma scores, associated injuries, complications, and mortality parameters. Thirteen injuries were caused by firearms, whereas 37 injuries were caused by stab wounds. Forty-three patients (86%) underwent laparotomy and 7 patients (14%) were monitored by CT and clinical findings (nonoperative group, NO group). The laparotomies were evaluated as non-therapeutic in 11 patients (22%) (NTL group) and therapeutic in 32 patients (64%) (TL group). The morbidity and mortality rates were 40 and 10%, respectively. RTS and ISS scores of the nonsurviving and the surviving patients were significantly different. The rates of major venous, grade IV-V hepatic injuries, and gunshot wounds were significantly higher in the nonsurviving patients when compared to the surviving patients. Major venous and grade IV-V hepatic injuries were the primary factors determining mortality and these injuries generally occurred as a result of firearm injuries. NTL occurring at a rate of 22% would decrease to 2% if 'RTS <7' criteria was added to the hemodynamic instability and/or peritoneal irritation findings determining surgical candidacy. Copyright 2009 S. Karger AG, Basel.

Radiology and injury in sport

International Nuclear Information System (INIS)

Bowerman, J.W.

1985-01-01

The material available was grouped according to body regions and sport types. The first part contains data on radiography of the injured parts of the body and is intended to be a guide in the radiographic part of the diagnosis and treatment of the injured person. It also contains data on diagnostic pitfalls and recommendations for a comprehensive clarification of X-ray findings after an injury. The second part describes the sport types and hazards. Where possible, the injuries were documented by case studies and literature on the types of injury. The third part contains a collection of X-ray pictures with examples of various injuries. The presentation corresponds to the one of an up-to-date major text book on skeleton radiology. The pictures are presented as a series of problems for the reader to test his/her own diagnostic capabilities before he/she will read the solution to each example. With 411 figs [de

[Skiing injuries in school sport and possibilioties to prevent them].

Science.gov (United States)

Greier, K

2011-12-01

Tyrol (Austria) is one of the regions which pioneered skiing. Skiing is considered as a national sport and is deeply rooted within the school system. Thus most pupils partake in skiing courses in this period. It is clear that such a large group of pupils also leads to a significant number of skiing injuries. Preventive issues may be derived from an analysis of the pattern and circumstances of skiing injuries. During a period of ten years (2000 - 2009) 1522 school sports injuries have been reported to the health insurance agency (Allgemeine Unfallversicherungsanstalt) from all secondary schools in Tyrol. The major disciplines were ski (48 %, n = 734) ice skateing (23 %, n = 349) and snowboard injuries (21 %, n = 315), followed by tobogganing (6 %, n = 91), cross-country skiing (1 %, n = 17) and other wintersports (1 %, n = 16). Fractures (31 %) dominated in skiing, followed by contusions (23 %), and sprains (22 %). In the analysis of the distribution of injuries during alpine skiing accidents, lower extremity injuries (39 %) dominated followed by upper extremity injuries (34 %). Head and spine injuries (13 %) were rare. Analysing the circumstances of the injuries, most injuries during skiing occurred without person to person collision (82 %), 81 % either shortly before lunch-break or in the afternoon. Skiing injuries account for a significant proportion of all school sport-related injuries in Tyrol. Lower extremity injuries account for the vast majority of all injuries. Overestimation and overtiredness may be responsible for skiing sport injuries. Preventive measures such as a fitness training (e. g., skiing exercises) prior to skiing courses, appropriate breaks and proper protective gear (i. e., helmet and spine protector) may reduce the injury rate in skiing school sport. © Georg Thieme Verlag KG Stuttgart · New York.

Upper extremity injuries associated with strength training.

Science.gov (United States)

Haupt, H A

2001-07-01

Most injuries sustained during strength training are mild strains that resolve with appropriate rest. More severe injuries include traumatic shoulder dislocations, tendon ruptures of the pectoralis major, biceps, and triceps; stress fractures of the distal clavicle, humerus, radius, and ulna; traumatic fractures of the distal radius and ulna in adolescent weightlifters; and compressive and stretch neuropathies. These more severe injuries are usually the result of improperly performing a strength training exercise. Educating athletes regarding proper strength-training techniques serves to reverse established injury patterns and to prevent these injuries in the first place. Recognizing the association of anabolic steroid use to several of the injury patterns further reinforces the need for medical specialists to counsel athletes against their use. With the increasing use of supplements such as creatine, the incidence and nature of strength-training injuries may change further. Greater emphasis on the competitive performance of younger athletes undoubtedly will generate enthusiasm for strength training at earlier ages in both sexes. The importance of proper supervision of these young athletes by knowledgeable persons will increase. As the popularity of strength training grows, there will be ample opportunity to continue to catalog the injury patterns associated with this activity.

Forensic medical study on morphology and formative mechanism of blunt head injury

Directory of Open Access Journals (Sweden)

LI Hong-wei

2012-12-01

Full Text Available 【Abstract】 Objective: To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods: The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries. Results: Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant (106, 52.5%, followed by suicide (49, 24.3% and accident (44, 21.8%. The majority of suicide-induced death were by falling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants. Conclusion: Studies on the morphology and its forma-tive rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury. Key words: Brain; Head injuries, closed; Cranioce-rebral trauma; Forensic medicine

Injuries of the chestFNx01

Directory of Open Access Journals (Sweden)

Deodhar S

1979-01-01

Full Text Available Thirty cases of chest injuries were admitted in the Department of Surgery, K.E.M. Hospital, Bombay. These injuries seem to be fairly common. Detailed examination at the time of admission is necessary to assess the clinical presentation and the presence of major complications. Institution of intra-peritoneal drainage, restoration of negative intra-pleural pressure and active respiratory physiotherapy constitute an important part of the treatment. The literature on this subject is briefly reviewed

Sports injuries in physical education teacher education students.

Science.gov (United States)

Goossens, L; Verrelst, R; Cardon, G; De Clercq, D

2014-08-01

Sports injuries could be highly detrimental to the career of a physical education teacher education (PETE) student. To enable the development of future sports injury prevention programs, sports injuries in 128 first-year academic bachelor PETE students were registered prospectively during one academic year. Common risk factors for sports injuries, taken from the literature, were also evaluated by means of logistic regression analysis. We found an incidence rate of 1.91 and an injury risk of 0.85, which is higher than generally found in a sports-active population. Most injuries involved the lower extremities, were acute, newly occurring injuries, and took place in non-contact situations. More than half of all injuries lead to an inactivity period of 1 week or more and over 80% of all injuries required medical attention. A major part of these injuries happened during the intracurricular sports classes. Few differences were seen between women and men. A history of injury was a significant risk factor (P = 0.018) for the occurrence of injuries, and performance of cooling-down exercises was significantly related to a lower occurrence of ankle injuries (P = 0.031). These data can inform future programs for the prevention of sports injuries in PETE students. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Importance of proper initial treatment of moderate and major burns

Directory of Open Access Journals (Sweden)

Vulović Dejan

2008-01-01

Full Text Available Background/Aim. Burns are common injuries with frequency depending on human factors, development of protection, industry and traffic, eventual wars. Organized treatment of major burn injuries has tremendous medical, social and economic importance. The aim of this study was to analyze initial treatment of major and moderate burns, to compare it with the current recommendations and to signify the importance of organized management of burns. Methods. In a prospective study 547 adult patients with major burns were analyzed, covering a period of eight years, with the emphasis on the initial hospital admission and emergency care for burns greater than 10% of total body surface area (TBSA. Results. In the different groups of major burns, the percentage of hospital admission was: 81.5 in burns greater than 10% TBSA, 37.7 in burns of the functional areas, 54.5 in the III degree burns, 81.6 in electrical burns, 55.9 in chemical burns, 61.9 in inhalation injury, 41.0 in burns in patients with the greater risk and 100 in burns with a concomitant trauma. In the group of 145 patients with burns greater than 10% TBSA, intravenous fluids were given in 87 patients, analgesics in 45, corticosteroids in 29, antibiotics in 23 and oxygen administration in 14. In the same group, wound irrigation was done in 14.4%, removing of the clothing and shoes in 29.6%, elevation of the legs in 8.9% and prevention of hypothermia in 7.6% of the victims. There were no initial estimations of burn extent (percentage of a burn, notes about the patient and injury and tetanus immunizations. Conclusion. Based on these findings, it is concluded that there should be much more initial hospital admissions of major burns, and also, necessary steps in the emergency care of burns greater than 10% TBSA should be taken more frequently. On the other side, unnecessary or wrong steps should be avoided in the initial burn treatment.

Point-of-Care Ultrasound for Pulmonary Concerns in Remote Spaceflight Triage Environments.

Science.gov (United States)

Johansen, Benjamin D; Blue, Rebecca S; Castleberry, Tarah L; Antonsen, Erik L; Vanderploeg, James M

2018-02-01

With the development of the commercial space industry, growing numbers of spaceflight participants will engage in activities with a risk for pulmonary injuries, including pneumothorax, ebullism, and decompression sickness, as well as other concomitant trauma. Medical triage capabilities for mishaps involving pulmonary conditions have not been systematically reviewed. Recent studies have advocated the use of point-of-care ultrasound to screen for lung injury or illness. The operational utility of portable ultrasound systems in disaster relief and other austere settings may be relevant to commercial spaceflight. A systematic review of published literature was conducted concerning the use of point-of-care pulmonary ultrasound techniques in austere environments, including suggested examination protocols for triage and diagnosis. Recent studies support the utility of pulmonary ultrasound examinations when performed by skilled operators, and comparability of the results to computed tomography and chest radiography for certain conditions, with important implications for trauma management in austere environments. Pulmonary injury and illness are among the potential health risks facing spaceflight participants. Implementation of point-of-care ultrasound protocols could aid in the rapid diagnosis, triage, and treatment of such conditions. Though operator-dependent, ultrasound, with proper training, experience, and equipment, could be a valuable tool in the hands of a first responder supporting remote spaceflight operations.Johansen BD, Blue RS, Castleberry TL, Antonsen EL, Vanderploeg JM. Point-of-care ultrasound for pulmonary concerns in remote spaceflight triage environments. Aerosp Med Hum Perform. 2018; 89(2):122-129.

A systematic review and comprehensive classification of pectoralis major tears.

Science.gov (United States)

ElMaraghy, Amr W; Devereaux, Moira W

2012-03-01

Reported descriptions of pectoralis major (PM) injury are often inconsistent with the actual musculotendinous morphology. The literature lacks an injury classification system that is consistently applied and accurately reflects surgically relevant anatomic injury patterns, making meaningful comparison of treatment techniques and outcomes difficult. Published cases of PM injury between 1822 and 2010 were analyzed to identify incidence and injury patterns and the extent to which these injuries fit into a classification category. Recent work outlining the 3-dimensional anatomy of the PM muscle and tendon, as well as biomechanical studies of PM muscle segments, were reviewed to identify the aspects of musculotendinous anatomy that are clinically and surgically relevant to injury classification. We identified 365 cases of PM injury, with 75% occurring in the last 20 years; of these, 83% were a result of indirect trauma, with 48% occurring during weight-training activities. Injury patterns were not classified in any consistent way in timing, location, or tear extent, particularly with regard to affected muscle segments contributing to the PM's bilaminar tendon. A contemporary injury classification system is proposed that includes (1) injury timing (acute vs chronic), (2) injury location (at the muscle origin or muscle belly, at or between the musculotendinous junction and the tendinous insertion, or bony avulsion), and (3) standardized terminology addressing tear extent (anterior-to-posterior thickness and complete vs incomplete width) to more accurately reflect the musculotendinous morphology of PM injuries and better inform surgical management, rehabilitation, and research. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Hypopituitarism in Traumatic Brain Injury

DEFF Research Database (Denmark)

Klose, Marianne; Feldt-Rasmussen, Ulla

2015-01-01

While hypopituitarism after traumatic brain injury (TBI) was previously considered rare, it is now thought to be a major cause of treatable morbidity among TBI survivors. Consequently, recommendations for assessment of pituitary function and replacement in TBI were recently introduced. Given...

Pediatric Injuries at an Annual Motocross Competition: Rates and Severity.

Science.gov (United States)

Williams, Brendan A; McFadden, James P; Teurlings, Tyler L; Blakemore, Laurel C

Pediatric motocross injuries occur frequently and with significant associated morbidity; however, data are limited regarding injury occurring during competition. North Central Florida hosts an annual motocross competition with numerous pediatric competitors. We sought to evaluate the rate and severity of injuries sustained at this event over a multiyear period. Our primary hypothesis was that motocross injury rates and severity in competition exceed that of other competitive sports in this age group. A retrospective review was performed to identify pediatric patients (17 and younger) presenting to a single Level 1 Trauma Center as a result of injury sustained at an annual motocross competition from 2009 to 2012. Demographic, diagnostic, and treatment data were collected including injuries, procedural interventions, and length of hospital stay. Rate, type, and severity of injury were evaluated and compared with established norms of other competitive sports in a similar age group. Over a 4-year period, 51 pediatric motocross competitors sustained 75 injuries. Injured riders were 14.2±2.51 years (range, 8 to 17 y) old and 92% (47/51) male. Forty (78%) patients sustained at least 1 orthopaedic injury and 17 (33%) patients suffered polytrauma. The majority of injuries occurred in the upper extremity (36%). Twenty-four (47%) patients required procedural intervention, 15 of which were operative. Thirty-nine (76%) patients necessitated surgical specialty care. Average injury severity score was 6.5 (1 to 75) and 1 death occurred. The injury rate for pediatric motocross riders in this study was 19.9 injuries per 1000 competitors. High rates of injury occur among pediatric patients in competitive motocross, exceeding those seen in other competitive sports in a comparable age group. Significant morbidity and at least 1 fatality were demonstrated in the group studied. The majority of patients suffer at least 1 orthopaedic injury and nearly all patients require pediatric

The Role of Hope in Spinal Cord Injury Rehabilitation.

Science.gov (United States)

Heinemann, Allen; And Others

Hope has motivational importance to individuals who have suffered a major physical loss. Theories of adjustment to a spinal cord injury take one of three approaches: (1) premorbid personality, which highlights the individual's past experiences, personal meanings, and body image; (2) typologies of injury reactions, which range from normal to…

[Severe trampoline injuries and their risk factors among children and the young].

Science.gov (United States)

Sinikumpu, Juha-Jaakko; Salokorpi, Niina; Suo-Palosaari, Maria; Pesälä, Juha; Serlo, Willy

2016-01-01

Although the majority of trampoline injuries in children are minor, severe injuries occur as well. We have analyzed the risk factors, treatment and outcome of severe trampoline injuries treated in the Oulu University Hospital in children and the young between April and November 2105. There was a total of eight severe injuries. Five injuries involved a danger of death. Almost all severe trampoline injuries resulted from an unsuccessful trick. A safety net was in use in half of the cases. All cervical spine injuries would have been avoided provided that the children would have refrained from doing a somersault on the trampoline.

The contemporary management of penetrating splenic injury.

Science.gov (United States)

Berg, Regan J; Inaba, Kenji; Okoye, Obi; Pasley, Jason; Teixeira, Pedro G; Esparza, Michael; Demetriades, Demetrios

2014-09-01

Selective non-operative management (NOM) is standard of care for clinically stable patients with blunt splenic trauma and expectant management approaches are increasingly utilised in penetrating abdominal trauma, including in the setting of solid organ injury. Despite this evolution of clinical practice, little is known about the safety and efficacy of NOM in penetrating splenic injury. Trauma registry and medical record review identified all consecutive patients presenting to LAC+USC Medical Center with penetrating splenic injury between January 2001 and December 2011. Associated injuries, incidence and nature of operative intervention, local and systemic complications and mortality were determined. During the study period, 225 patients experienced penetrating splenic trauma. The majority (187/225, 83%) underwent emergent laparotomy. Thirty-eight clinically stable patients underwent a deliberate trial of NOM and 24/38 (63%) were ultimately managed without laparotomy. Amongst patients failing NOM, 3/14 (21%) underwent splenectomy while an additional 6/14 (42%) had splenorrhaphy. Hollow viscus injury (HVI) occurred in 21% of all patients failing NOM. Forty percent of all NOM patients had diaphragmatic injury (DI). All patients undergoing delayed laparotomy for HVI or a splenic procedure presented symptomatically within 24h of the initial injury. No deaths occurred in patients undergoing NOM. Although the vast majority of penetrating splenic trauma requires urgent operative management, a group of patients does present without haemodynamic instability, peritonitis or radiologic evidence of hollow viscus injury. Management of these patients is complicated as over half may remain clinically stable and can avoid laparotomy, making them potential candidates for a trial of NOM. HVI is responsible for NOM failure in up to a fifth of these cases and typically presents within 24h of injury. Delayed laparotomy, within this limited time period, did not appear to increase

Boda-boda injuries a health problem and a burden of disease in ...

African Journals Online (AJOL)

Background: Injury and deaths due to road traffic crashes are a major public health problem in developing countries. Boda bodas (motorcycles) are a practical and a sought after economic activity in Uganda's capital and cities. The injuries related to boda bodas contribute significantly to the number road traffic injuries seen ...

Analisys of pectoralis major tendon in weightlifting athletes using ultrasonography and elastography.

Science.gov (United States)

Pochini, Alberto de Castro; Ferretti, Mario; Kawakami, Eduardo Felipe Kin Ito; Fernandes, Artur da Rocha Corrêa; Yamada, Andre Fukunishi; Oliveira, Gabriela Clemente de; Cohen, Moisés; Andreoli, Carlos Vicente; Ejnisman, Benno

2015-01-01

To evaluate tendinopathy of the pectoralis major muscle in weightlifting athletes using ultrasound and elastography. This study included 20 patients, 10 with rupture of the pectoralis major muscle and 10 control patients. We evaluated pectoralis major muscle contralateral tendon with ultrasonographic and elastography examinations. The ultrasonographic examinations were performed using a high-resolution B mode ultrasound device. The elastography evaluation was classified into three patterns: (A), if stiff (more than 50% area with blue staining); (B), if intermediate (more than 50% green); and (C), if softened (more than 50% red). Patients' mean age was 33±5.3 years. The presence of tendinous injury measured by ultrasound had a significant different (p=0.0055), because 80% of cases had tendinous injury versus 10% in the Control Group. No significant differences were seen between groups related with change in elastography (p=0.1409). Long-term bodybuilders had ultrasound image with more tendinous injury than those in Control Group. There was no statistical significance regarding change in tendon elasticity compared with Control Group.

Analisys of pectoralis major tendon in weightlifting athletes using ultrasonography and elastography

International Nuclear Information System (INIS)

Pochini, Alberto de Castro; Ferretti, Mario; Kawakami, Eduardo Felipe Kin Ito; Fernandes, Artur da Rocha Corrêa; Yamada, Andre Fukunishi; Oliveira, Gabriela Clemente de; Cohen, Moisés; Andreoli, Carlos Vicente; Ejnisman, Benno

2015-01-01

To evaluate tendinopathy of the pectoralis major muscle in weightlifting athletes using ultrasound and elastography. This study included 20 patients, 10 with rupture of the pectoralis major muscle and 10 control patients. We evaluated pectoralis major muscle contralateral tendon with ultrasonographic and elastography examinations. The ultrasonographic examinations were performed using a high-resolution B mode ultrasound device. The elastography evaluation was classified into three patterns: (A), if stiff (more than 50% area with blue staining); (B), if intermediate (more than 50% green); and (C), if softened (more than 50% red). Patients’ mean age was 33±5.3 years. The presence of tendinous injury measured by ultrasound had a significant different (p=0.0055), because 80% of cases had tendinous injury versus 10% in the Control Group. No significant differences were seen between groups related with change in elastography (p=0.1409). Long-term bodybuilders had ultrasound image with more tendinous injury than those in Control Group. There was no statistical significance regarding change in tendon elasticity compared with Control Group

Analisys of pectoralis major tendon in weightlifting athletes using ultrasonography and elastography

Energy Technology Data Exchange (ETDEWEB)

Pochini, Alberto de Castro [Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP (Brazil); Ferretti, Mario [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Kawakami, Eduardo Felipe Kin Ito; Fernandes, Artur da Rocha Corrêa; Yamada, Andre Fukunishi; Oliveira, Gabriela Clemente de; Cohen, Moisés; Andreoli, Carlos Vicente; Ejnisman, Benno [Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP (Brazil)

2015-07-01

To evaluate tendinopathy of the pectoralis major muscle in weightlifting athletes using ultrasound and elastography. This study included 20 patients, 10 with rupture of the pectoralis major muscle and 10 control patients. We evaluated pectoralis major muscle contralateral tendon with ultrasonographic and elastography examinations. The ultrasonographic examinations were performed using a high-resolution B mode ultrasound device. The elastography evaluation was classified into three patterns: (A), if stiff (more than 50% area with blue staining); (B), if intermediate (more than 50% green); and (C), if softened (more than 50% red). Patients’ mean age was 33±5.3 years. The presence of tendinous injury measured by ultrasound had a significant different (p=0.0055), because 80% of cases had tendinous injury versus 10% in the Control Group. No significant differences were seen between groups related with change in elastography (p=0.1409). Long-term bodybuilders had ultrasound image with more tendinous injury than those in Control Group. There was no statistical significance regarding change in tendon elasticity compared with Control Group.

Mitigating the risk of musculoskeletal injury: A systematic review of the most effective injury prevention strategies for military personnel.

Science.gov (United States)

Wardle, Sophie L; Greeves, Julie P

2017-11-01

To update the current injury prevention strategy evidence base for making recommendations to prevent physical training-related musculoskeletal injury. We conducted a systematic review to update the evidence base on injury prevention strategies for military personnel. Literature was systematically searched and extracted from five databases, and reported according to PRISMA guidelines. Sixty one articles meeting the inclusion criteria and published during the period 2008-2015 were selected for systematic review. The retrieved articles were broadly categorised into six injury prevention strategies; (1) conditioning, (2) footwear modifications, (3) bracing, (4) physical activity volume, (5) physical fitness, and (6) leadership/supervision/awareness. The majority of retrieved articles (n=37 (of 61) evaluated or systematically reviewed a conditioning intervention of some nature. However, the most well-supported strategies were related to reducing physical activity volume and improving leadership/supervision/awareness of injuries and injury prevention efforts. Several injury prevention strategies effectively reduce musculoskeletal injury rates in both sexes, and many show promise for utility with military personnel. However, further evaluation, ideally with prospective randomised trials, is required to establish the most effective injury prevention strategies, and to understand any sex-specific differences in the response to these strategies. Copyright © 2017. Published by Elsevier Ltd.

[An overview of snow-boarding injuries].

Science.gov (United States)

Biasca, N; Battaglia, H; Simmen, H P; Disler, P; Trentz, O

1995-01-01

Snowboarding is increasing dramatically in popularity in Switzerland as well as other countries. Work aimed at improving the design of the boards and of the boots and bindings has also increased rapidly during recent years. Most injured snowboarders are fit young men and boys who describe themselves as beginners and have had a minimal amount of instruction at an officially approved training centre. Appropriate snowboard training has mostly been quite inadequate, and protective devices (e.g. waterproofed support gloves). The anatomical distribution and the types of injuries sustained in snowboarding differ from those in alpine skiing. The wrist (and forearm) and the ankle are the most frequent locations of injuries (23%) as against the knee and thumb in alpine skiing. Sprains and strains were the most frequent types of injuries (46%), followed by fractures (28%) and contusions (13.5%). The snowboard injury rate was higher than in alpine skiing (1.7-8/1000 snowboard days versus 2-4/1000 ski days). Falling forward on the slope was the major mechanism of injury (80%), and torsion the next most frequent (20%). Snowboarding injuries were sustained most often on ice and hardpacked snow, compared with soft powder snow for alpine skiing injuries. Appropriate preseason conditioning, snowboarding lessons from a certified instructor, appropriate selection of rigorously tested equipment and use of protective devices are the main steps that must be taken to prevent injuries.

The diagnosis and management of children with blunt injury of the chest.

Science.gov (United States)

Sartorelli, Kennith H; Vane, Dennis W

2004-05-01

Thoracic trauma remains a major source of morbidity and mortality in injured children, and is second only to brain injuries as a cause of death. The presence of a chest injury increases an injured child's mortality by 20-fold. Greater than 80% of chest injuries in children are secondary to blunt trauma. The compliant chest wall in children makes pulmonary contusions and rib fractures the most common chest injuries in children. Injuries to the great vessels, esophagus, and diaphragm are rare. Failure to promptly diagnose and treat these injuries results in increased morbidity and mortality.

Associated injuries, management, and outcomes of blunt abdominal aortic injury.

Science.gov (United States)

de Mestral, Charles; Dueck, Andrew D; Gomez, David; Haas, Barbara; Nathens, Avery B

2012-09-01

Blunt abdominal aortic injury (BAAI) is very rare, and current literature is limited to case series of single-center experience. Through an analysis of the National Trauma Data Bank, the largest aggregation of United States trauma registry data, our aim was to characterize the associated injury pattern, contemporary management, and in-hospital outcomes of patients with BAAI. We used a nested case-control design. The overall cohort consisted of adult patients (age ≥ 16 years) severely injured (Injury Severity Score ≥ 16) after blunt trauma who were treated at a level 1 or 2 trauma center in years 2007 to 2009. Cases were patients with BAAI and were frequency-matched by age group and mechanism to randomly selected controls at a one-to-five ratio. Multivariable matched analysis (conditional logistic regression) was used to derive adjusted measures of association between BAAI and adjacent arterial, intra-abdominal, and bony injuries. We identified 436 patients with BAAI from 180 centers. The mean Injury Severity Score was 35 ± 14, and most patients were injured in motor vehicle crashes (84%). Multivariable analysis showed injury to the thoracic aorta, renal and iliac artery, small bowel, colon, liver, pancreas, and kidney, as well as lumbar spine fractures were independently associated with BAAI. A total of 394 patients (90%) were managed nonoperatively, and 42 (10%) underwent repair. Of these 42 patients, 29 (69%) underwent endovascular repair, with 11 patients undergoing open aortic repair and two extra-anatomic bypasses. Median time from admission to repair was 1 day (interquartile range, 1-2 days). Overall mortality was 29%. A total of 271 (69%) patients managed nonoperatively survived to hospital discharge. The index of suspicion for BAAI should be raised in severely injured patients by the presence of injuries to the lumbar spine, bowel, retroperitoneal organs, and adjacent major arteries. Although endovascular repair is the most common intervention, most

76 FR 29756 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review

Science.gov (United States)

2011-05-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review The meeting announced below concerns Centers for Agricultural Disease and Injury Research, Education, and Prevention...

Improving Prevention, Early Recognition and Management of Acute Kidney Injury after Major Surgery: Results of a Planning Meeting with Multidisciplinary Stakeholders

Directory of Open Access Journals (Sweden)

Matthew T James

2014-08-01

Full Text Available Purpose of review: Acute kidney injury (AKI is common after major surgery, and is associated with morbidity, mortality, increased length of hospital stay, and high health care costs. Although recent guidelines for AKI provide recommendations for identification of patients at risk, monitoring, diagnosis, and management of AKI, there is lack of understanding to guide successful implementation of these recommendations into clinical practice. Sources of information: We held a planning meeting with multidisciplinary stakeholders to identify barriers, facilitators, and strategies to implement recommendations for prevention, early identification, and management of AKI after major surgery. Barriers and facilitators to knowledge use for peri-operative AKI prevention and care were discussed. Findings: Stakeholders identified barriers in knowledge (how to identify high-risk patients, what criteria to use for diagnosis of AKI, attitudes (self-efficacy in preventive care and management of AKI, and behaviors (common use of diuretics, non-steroidal anti-inflammatory drugs, withholding of intravenous fluids, and competing time demands in peri-operative care. Educational, informatics, and organizational interventions were identified by stakeholders as potentially useful elements for future interventions for peri-operative AKI. Limitation: Meeting participants were from a single centre. Implications: The information and recommendations obtained from this stakeholder's meeting will be useful to design interventions to improve prevention and early care for AKI after major surgery.

Injury Profile in Women Shotokan Karate Championships in Iran (2004-2005)

Science.gov (United States)

Halabchi, Farzin; Ziaee, Vahid; Lotfian, Sarah

2007-01-01

The aims of this paper were to record injury rates among Iranian women competitive Shotokan karate athletes and propose possible predisposing factors. A prospective recording of the injuries resulting from all matches in 6 consecutive women national Shotokan Karate Championships in all age groups in Iran (season 2004-2005) was performed. Data recorded included demographic characteristics (Age and Weight), athletic background (rank, years of experience, time spent training and previous injuries), type, location and reason for the injury, and the result of the match. Results indicate 186 recorded injuries from a total of 1139 bouts involving 1019 athletes, therefore there were 0.163 injury per bout [C.I. 95%: 0.142-0.184] and 183 injuries per 1000 athletes [C.I. 95%: 159-205]. Injuries were most commonly located in the head and neck (55.4%) followed by the lower limb (21%), upper limb (12.9%) and trunk (10.8%). Punches (48. 4%) were associated with more injuries than kicks (33.3%). The injuries consisted of muscle strain and contusion (81, 43.6%), hematoma and epistaxis (49, 26.3%), lacerations and abrasions (28, 15. 1%), concussion (13, 7%), tooth avulsion or subluxation (3, 1.6%), joint dislocation (3, 1.6%) and fractures (3, 1.6%). In conclusion, as the majority of injuries are minor, and severe or longstanding injuries are uncommon, it can be argued that shotokan karate is a relatively safe for females, despite its image as a combat sport, where ostensibly the aim appears to injure your opponent. Further research is needed to evaluate the effective strategies to minimize the risk of injuries. Key points 186 injuries were recorded during women competitions. Incidence rates of 0.163 injury per bout and 183 injuries per 1000 athletes were calculated. The injuries were most commonly located in the head and neck. Muscle strain and contusion, hematoma and epistaxis constitute the majority of injuries. PMID:24198704

Psychological distress and user experiences with health care provision in persons living with spinal cord injury for more than 20 years

DEFF Research Database (Denmark)

Jakimovska, V M; Kostovski, E; Biering-Sørensen, F

2017-01-01

were cases according to the GHQ-20. The cases did not differ from non-cases concerning demography, time since injury, injury aetiology, injury severity, marital status or employment status. The regression analysis revealed that cases were associated (P

Factors associated with developmental concern and intent to access therapy following discharge from the NICU.

Science.gov (United States)

Pineda, Roberta G; Castellano, Alison; Rogers, Cynthia; Neil, Jeffrey J; Inder, Terrie

2013-01-01

To determine factors associated with mothers' concern about infant development and intent to access therapy services following neonatal intensive care unit (NICU) discharge. Infant medical factors, magnetic resonance imaging results, neurobehavior at term, maternal factors, and maternal perceptions about developmental concern and intent to access therapy at NICU discharge were prospectively collected in 84 infants born premature (concern and intent to access therapy at NICU discharge. Decreased developmental concern was reported by mothers with more children (P = .007). Infant stress signs (P = .038), higher maternal education (P = .047), reading books (P = .030), and maternal depression (P = .018) were associated with increased developmental concern. More maternal education was associated with more intent to access services (P = .040). Maternal factors, rather than infant factors, had important associations with caregiver concern. In contrast, abnormal term neurobehavior and/or the presence of cerebral injury were not associated with caregiver concern about development.