Estimated rate of agricultural injury: the Korean Farmers’ Occupational Disease and Injury Survey

Science.gov (United States)

2014-01-01

Objectives This study estimated the rate of agricultural injury using a nationwide survey and identified factors associated with these injuries. Methods The first Korean Farmers’ Occupational Disease and Injury Survey (KFODIS) was conducted by the Rural Development Administration in 2009. Data from 9,630 adults were collected through a household survey about agricultural injuries suffered in 2008. We estimated the injury rates among those whose injury required an absence of more than 4 days. Logistic regression was performed to identify the relationship between the prevalence of agricultural injuries and the general characteristics of the study population. Results We estimated that 3.2% (±0.00) of Korean farmers suffered agricultural injuries that required an absence of more than 4 days. The injury rates among orchard farmers (5.4 ± 0.00) were higher those of all non-orchard farmers. The odds ratio (OR) for agricultural injuries was significantly lower in females (OR: 0.45, 95% CI = 0.45–0.45) compared to males. However, the odds of injury among farmers aged 50–59 (OR: 1.53, 95% CI = 1.46–1.60), 60–69 (OR: 1.45, 95% CI = 1.39–1.51), and ≥70 (OR: 1.94, 95% CI = 1.86–2.02) were significantly higher compared to those younger than 50. In addition, the total number of years farmed, average number of months per year of farming, and average hours per day of farming were significantly associated with agricultural injuries. Conclusions Agricultural injury rates in this study were higher than rates reported by the existing compensation insurance data. Males and older farmers were at a greater risk of agriculture injuries; therefore, the prevention and management of agricultural injuries in this population is required. PMID:24808945

Estimated rate of agricultural injury: the Korean Farmers' Occupational Disease and Injury Survey.

Science.gov (United States)

Chae, Hyeseon; Min, Kyungdoo; Youn, Kanwoo; Park, Jinwoo; Kim, Kyungran; Kim, Hyocher; Lee, Kyungsuk

2014-01-01

This study estimated the rate of agricultural injury using a nationwide survey and identified factors associated with these injuries. The first Korean Farmers' Occupational Disease and Injury Survey (KFODIS) was conducted by the Rural Development Administration in 2009. Data from 9,630 adults were collected through a household survey about agricultural injuries suffered in 2008. We estimated the injury rates among those whose injury required an absence of more than 4 days. Logistic regression was performed to identify the relationship between the prevalence of agricultural injuries and the general characteristics of the study population. We estimated that 3.2% (±0.00) of Korean farmers suffered agricultural injuries that required an absence of more than 4 days. The injury rates among orchard farmers (5.4 ± 0.00) were higher those of all non-orchard farmers. The odds ratio (OR) for agricultural injuries was significantly lower in females (OR: 0.45, 95% CI = 0.45-0.45) compared to males. However, the odds of injury among farmers aged 50-59 (OR: 1.53, 95% CI = 1.46-1.60), 60-69 (OR: 1.45, 95% CI = 1.39-1.51), and ≥70 (OR: 1.94, 95% CI = 1.86-2.02) were significantly higher compared to those younger than 50. In addition, the total number of years farmed, average number of months per year of farming, and average hours per day of farming were significantly associated with agricultural injuries. Agricultural injury rates in this study were higher than rates reported by the existing compensation insurance data. Males and older farmers were at a greater risk of agriculture injuries; therefore, the prevention and management of agricultural injuries in this population is required.

Clinical significance of percutaneous endoscopic gastrostomy for patients with severe craniocerebral injury

Directory of Open Access Journals (Sweden)

Du Hanggen

2014-12-01

Full Text Available Objective: To investigate the application of percutaneous endoscopic gastrostomy (PEG to patients with severe craniocerebral injury for the purpose of nutritional support therapy and pulmonary infection prevention. Methods: A total of 43 patients with severe craniocerebral injury admitted to our department from January 2008 to December 2012 received PEG followed by nutritional therapy. There were other 82 patients who were prescribed nasal-feeding nutrition. Nutrition status was evaluated by comparing serum albumin levels, and the incidence of pulmonary infection 1 week before and 2 weeks after operation was identifi ed and compared. Results: Both PEG and nasal-feeding nutrition therapies have significantly levated serum albumin levels (P<0.05. Serum albumin levels before and after nutritional therapies showed no significant difference between the two groups (P>0.05. The incidence of pulmonary infection in PEG group was significantly decreased compared with that in nasal-feeding nutrition group (P<0.05. Conclusion: PEG is an effective method for severe craniocerebral injury patients. It can not only provide enteral nutrition but also prevent pulmonary infection induced by esophageal refl ux. Key words: Gastrostomy; Craniocerebral trauma; Enteral nutrition

Gastrointestinal Injuries in Blunt Abdominal Traumas.

Science.gov (United States)

Gönüllü, D; Ilgun, S; Gedik, M L; Demiray, O; Öner, Z; Er, M; Köksoy, F N

2015-01-01

To discuss the efficiency of RTS (Revised TraumaScore), ISS (Injury Severity Score), and factors that affect mortality and morbidity in gastrointestinal injuries due to blunt trauma.Method and methods: Patients with gastrointestinal injuries due to blunt trauma operated within the last six years have been studied retrospectively in terms of demographics,injury mechanism and localization, additional injuries, RTS and ISS, operative technique, morbidity, mortality and duration of hospitalization. Of the eighteen cases, cause of injury was a traffic accident for 11 (61.1%), fall from height for 5 (27%) and physical attack for 2 (11%). Among the eighteen patients,there were 21 gastrointestinal injuries (11 intestinal, 6 colon,3 duodenum, 1 stomach). 10 (55.6%) had additional intraabdominal injuries while the number for extra-abdominal injuries were 12 (66.7%). Primary suture (10), segmentary resection (9) and pyloric exclusion (2) were the operations performed for the twenty-one gastrointestinal injuries.Although statistically not significant, 13(72.2%) patients with additional injuries compared with 5 (27.8%) patients with isolated gastrointestinal injuries, were found to have lower RTS (7.087/7.841), higher ISS (19.4/12.2), longer duration of hospitalization (11.5/8.4 day) as well as higher morbidity (7/1) and mortality (2/0) rates. Comparing the RTS (7.059/7.490) of patients who have and have not developed morbidity revealed no significant difference.However, ISS (23.9/12.2) was significantly higher in patients who have developed morbidity (p=0.003). RTS (6.085 7.445) and ISS (39.5/14.6) of patients who have survived were significantly different than patients who have not(p=0.037 and p=0.023, respectively) Additional injuries in patients with gastrointestinal injury due blunt abdominal traumas increases, although not significantly, morbidity, mortality and duration of hospitalization even when operated early. High ISS is significantly related to the risk of both

Low External Workloads Are Related to Higher Injury Risk in Professional Male Basketball Games

Directory of Open Access Journals (Sweden)

Toni Caparrós, Martí Casals, Álvaro Solana, Javier Peña

2018-06-01

Full Text Available The primary purpose of this study was to identify potential risk factors for sports injuries in professional basketball. An observational retrospective cohort study involving a male professional basketball team, using game tracking data was conducted during three consecutive seasons. Thirty-three professional basketball players took part in this study. A total of 29 time-loss injuries were recorded during regular season games, accounting for 244 total missed games with a mean of 16.26 ± 15.21 per player and season. The tracking data included the following variables: minutes played, physiological load, physiological intensity, mechanical load, mechanical intensity, distance covered, walking maximal speed, maximal speed, sprinting maximal speed, maximal speed, average offensive speed, average defensive speed, level one acceleration, level two acceleration, level three acceleration, level four acceleration, level one deceleration, level two deceleration, level three deceleration, level four deceleration, player efficiency rating and usage percentage. The influence of demographic characteristics, tracking data and performance factors on the risk of injury was investigated using multivariate analysis with their incidence rate ratios (IRRs. Athletes with less or equal than 3 decelerations per game (IRR, 4.36; 95% CI, 1.78-10.6 and those running less or equal than 1.3 miles per game (lower workload (IRR, 6.42 ; 95% CI, 2.52-16.3 had a higher risk of injury during games (p < 0.01 in both cases. Therefore, unloaded players have a higher risk of injury. Adequate management of training loads might be a relevant factor to reduce the likelihood of injury according to individual profiles.

Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores.

Science.gov (United States)

Cameron, Kenneth L; Peck, Karen Y; Thompson, Brandon S; Svoboda, Steven J; Owens, Brett D; Marshall, Stephen W

2015-01-01

Activity-related patient-reported outcome measures are an important component of assessment after knee ligament injury in young and physically active patients; however, normative data for most activity scales are limited. To present reference values by sex for the Marx Activity Rating Scale (MARS) within a young and physically active population while accounting for knee ligament injury history and sex. Cross-sectional study. Level 2. All incoming freshman entering a US Service Academy in June of 2011 were recruited to participate in this study. MARS was administered to 1169 incoming freshmen (203 women) who consented to participate within the first week of matriculation. All subjects were deemed healthy and medically fit for military service on admission. Subjects also completed a baseline questionnaire that asked for basic demographic information and injury history. We calculated means with standard deviations, medians with interquartile ranges, and percentiles for ordinal and continuous variables, and frequencies and proportions for dichotomous variables. We also compared median scores by sex and history of knee ligament injury using the Kruskal-Wallis test. MARS was the primary outcome of interest. The median MARS score was significantly higher for men when compared with women (χ(2) = 13.22, df = 1, P MARS scores between men and women (χ(2) = 0.47, df = 1, P = 0.493) who reported a history of injury. Overall, median MARS scores were significantly higher among those who reported a history of knee ligament injury when compared with those who did not (χ(2) = 9.06, df = 1, P = 0.003). Assessing activity as a patient-reported outcome after knee ligament injury is important, and reference values for these instruments need to account for the influence of prior injury and sex. © 2015 The Author(s).

A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS).

Science.gov (United States)

Messier, Stephen P; Martin, David F; Mihalko, Shannon L; Ip, Edward; DeVita, Paul; Cannon, D Wayne; Love, Monica; Beringer, Danielle; Saldana, Santiago; Fellin, Rebecca E; Seay, Joseph F

2018-05-01

The National Center for Injury Prevention and Control, noting flaws in previous running injury research, called for more rigorous prospective designs and comprehensive analyses to define the origin of running injuries. To determine the risk factors that differentiate recreational runners who remain uninjured from those diagnosed with an overuse running injury during a 2-year observational period. Cohort study; Level of evidence, 2. Inclusion criteria were running a minimum of 5 miles per week and being injury free for at least the past 6 months. Data were collected at baseline on training, medical and injury histories, demographics, anthropometrics, strength, gait biomechanics, and psychosocial variables. Injuries occurring over the 2-year observation period were diagnosed by an orthopaedic surgeon on the basis of predetermined definitions. Of the 300 runners who entered the study, 199 (66%) sustained at least 1 injury, including 73% of women and 62% of men. Of the injured runners, 111 (56%) sustained injuries more than once. In bivariate analyses, significant ( P ≤ .05) factors at baseline that predicted injury were as follows: Short Form Health Survey-12 mental component score (lower mental health-related quality of life), Positive and Negative Affect Scale negative affect score (more negative emotions), sex (higher percentage of women were injured), and knee stiffness (greater stiffness was associated with injury); subsequently, knee stiffness was the lone significant predictor of injury (odds ratio = 1.18) in a multivariable analysis. Flexibility, quadriceps angle, arch height, rearfoot motion, strength, footwear, and previous injury were not significant risk factors for injury. The results of this study indicate the following: (1) among recreational runners, women sustain injuries at a higher rate than men; (2) greater knee stiffness, more common in runners with higher body weights (≥80 kg), significantly increases the odds of sustaining an overuse running

Clinical significance of changes of serum IL-6 and TNF-α levels in rat models of hypoxic-ischemia brain injury

International Nuclear Information System (INIS)

Niu Tingxian; Shi Zhiyong; Luo Jianjun

2009-01-01

Objective: To explore the clinical significance of changes of serum interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) levels in rat models of hypoxic-ischemia (HI) brain injury. Methods: Seventy five rat HI brain injury nodels were prepared with bilateral occlusion of common carotid artery for 24rs followed 2hrs later by hypoxia (breathing 8% oxygen) for 2hrs. One fifth of the animals were sacrificed at 4h, 8h, 12h, 24h and 48h later respectively, the serum and brain homogenate concentrations of IL-6 and TNF-α were determined with RIA and brain tissues were pathologically examined. Results: The concentrations of IL-6 and TNF-α were dynamically changed within 48h in serum and brain homogenate. Peak values occurred at 24h with serum and at 12h with brain homogenate. Meanwhile, levels of both cytokines were significantly higher in the models than those in controls (P<0.01 or P<0.05). Conclusion: The concentrations of IL-6 and TNF-α were dynamically(sham operation only, 15 animals) changed and might be regarded as the clinical markers of degree of HI brain injury. (authors)

Occult pneumothoraces in Chinese patients with significant blunt chest trauma: radiological classification and proposed clinical significance.

Science.gov (United States)

Lee, Ryan K L; Graham, Colin A; Yeung, Janice H H; Ahuja, Anil T; Rainer, Timothy H

2012-12-01

An occult pneumothorax (OP) is a pneumothorax not seen on a supine chest X-ray (CXR) but detected on abdominal or thoracic computed tomography (CT) scanning. With the increasing use of CT in the management of significantly injured trauma patients, more OPs are being detected. The aim of this study was to classify OPs diagnosed on thoracic CT (TCT) and correlate them with their clinical significance. Retrospective analysis of prospectively collected trauma registry data. Total 36 (N=36) consecutive significantly injured trauma patients admitted through the emergency department (ED) who sustained blunt chest trauma and underwent TCT between 1 January 2007 and 31 December 2008 were included. OP was defined as the identification (by a consultant radiologist) of a pneumothorax on TCT that had not been detected on supine CXR. OPs were classified by laterality (unilateral/bilateral) and location (apical, basal, non apical/basal). The size of pneumothoraces, severity of injury [including number of associated thoracic injuries and injury severity score (ISS)], length of hospital stay and mortality were compared between groups. The need for tube thoracostomy and clinical outcome were also analysed. Patients with bilateral OPs (N=8) had significantly more associated thoracic injuries (median: 2 vs. 1, p=0.01), higher ISS (median: 35 vs. 23, p=0.02) and longer hospital stay (median: 20 days vs. 11 days, p=0.01) than those with a unilateral OP (N=28). Basal OPs (N=7) were significantly larger than apical (N=10) and non-apical/basal Ops (N=11). Basal OPs were associated with significantly more associated thoracic injuries (median: 2 vs. 1, p=0.01), higher ISS (median: 35 vs. 25, p=0.04) and longer hospital stays (median: 23 days vs. 17 days, p=0.02) than apical Ops, which had higher ISS (median: 35 vs. 25, p=0.04) and longer hospital stays (median: 23 days vs. 15 days, p=0.02) than non-apical/basal OPs. Non-apical/basal OPs were associated with more related injuries (median: 2

Functional brain imaging to investigate the higher brain dysfunction induced by diffuse brain injury

International Nuclear Information System (INIS)

Nariai, Tadashi; Inaji, Motoki; Ohno, Kikuo; Hiura, Mikio; Ishii, Kenji; Hosoda, Chihiro

2011-01-01

Higher brain dysfunction is the major problem of patients who recover from neurotrauma the prevents them from returning to their previous social life. Many such patients do not have focal brain damage detected with morphological imaging. We focused on studying the focal brain dysfunction that can be detected only with functional imaging with positron emission tomography (PET) in relation to the score of various cognition batteries. Patients who complain of higher brain dysfunction without apparent morphological cortical damage were recruited for this study. Thirteen patients with diffuse axonal injury (DAI) or cerebral concussion was included. They underwent a PET study to image glucose metabolism by 18 F-fluorodeoxyglucose (FDG), and central benodiazepine receptor (cBZD-R) (marker of neuronal body) by 11 C-flumazenil, together with cognition measurement by WAIS-R, WMS-R, and WCST etc. PET data were compared with age matched normal controls using statistical parametric mapping (SPM)2. DAI patients had a significant decrease in glucose matabolism and cBZD-R distribution in the cingulated cortex than normal controls. Patients diagnosed with concussion because of shorter consciousness disturbance also had abnormal FDG uptake and cBZD-R distribution. Cognition test scores were variable among patients. Degree of decreased glucose metabolism and cBZD-R distribution in the dominant hemishphere corresponded well to the severity of cognitive disturbance. PET molecular imaging was useful to depict focal cortical dysfunction of neurotrauma patients even when morphological change was not apparent. This method may be promising to clarify the pathophysiology of higher brain dysfunction of patients with diffuse axonal injury or chronic traumatic encephalopathy. (author)

The CRASH trial protocol (Corticosteroid randomisation after significant head injury [ISRCTN74459797

Directory of Open Access Journals (Sweden)

2001-06-01

Full Text Available Abstract Background Worldwide, millions of people are treated each year for significant head injury. A substantial proportion die, and many more are disabled. If short term corticosteroid infusion could be reliably shown to reduce these risks by just a few percent then this might affect the treatment of a few hundred thousand patients a year, protecting thousands from death or long term disability. Study design CRASH is a large simple, placebo-controlled trial of the effects of a 48-hour infusion of corticosteroids on death and on neurological disability, among adults with head injury and some impairment of consciousness. Head injured patients with impaired consciousness who are judged to be 16 years or older are eligible if the responsible doctor is, for any reason, substantially uncertain whether or not to use corticosteroids. Organisation The CRASH trial will determine reliably the effects on death and disability of a short corticosteroid infusion following significant head injury. To detect or refute improvements of only a few percent in outcome, many thousands of acute head injury patients must be randomised between control and steroid infusions. Such large numbers will be possible only if hundreds of doctors and nurses can collaborate in the participating emergency departments. Since they are busy, and working in emergency situations, the trial involves them in almost no extra work: no special investigations or changes to usual management are required, and data collection is absolutely minimal. The trial is on-going and new collaborators are welcome. Further information about the trial is available at http://www.crash.lshtm.ac.uk

Closing the Aboriginal child injury gap: targets for injury prevention.

Science.gov (United States)

Möller, Holger; Falster, Kathleen; Ivers, Rebecca; Falster, Michael O; Clapham, Kathleen; Jorm, Louisa

2017-02-01

To describe the leading mechanisms of hospitalised unintentional injury in Australian Aboriginal children and identify the injury mechanisms with the largest inequalities between Aboriginal and non-Aboriginal children. We used linked hospital and mortality data to construct a whole of population birth cohort including 1,124,717 children (1,088,645 non-Aboriginal and 35,749 Aboriginal) born in the state of New South Wales (NSW), Australia, between 1 July 2000 and 31 December 2012. Injury hospitalisation rates were calculated per person years at risk for injury mechanisms coded according to the ICD10-AM classification. The leading injury mechanisms in both groups of children were falls from playground equipment. For 66 of the 69 injury mechanisms studied, Aboriginal children had a higher rate of hospitalisation compared with non-Aboriginal children. The largest relative inequalities were observed for injuries due to exposure to fire and flame, and the largest absolute inequalities for injuries due to falls from playground equipment. Aboriginal children in NSW experience a significant higher burden of unintentional injury compared with their non-Aboriginal counterparts. Implications for Public Health: We suggest the implementation of targeted injury prevention measures aimed at injury mechanism and age groups identified in this study. © 2016 The Authors.

Work-related injuries: injury characteristics, survival, and age effect.

Science.gov (United States)

Konstantinidis, Agathoklis; Talving, Peep; Kobayashi, Leslie; Barmparas, Galinos; Plurad, David; Lam, Lydia; Inaba, Kenji; Demetriades, Demetrios

2011-06-01

Work-related injuries impose a significant burden on society. The goal of this study was to delineate the epidemiology and the effect of age on type and mortality after occupational injuries. Patients 16 years of age or older sustaining work-related injuries were identified from the National Trauma Databank 12.0. The study population was stratified into four age groups: 16 to 35, 36 to 55, 56 to 65, and older than 65 years old. The demographic characteristics, type of injury, mechanism of injury, setting of injury, use of alcohol or other illicit drugs, and mortality were analyzed and related to age strata. Overall 67,658 patients were identified. There were 27,125 (40.1%) patients in the age group 16 to 35 years, 30,090 (44.5%) in the group 36 to 55 years, 6,618 (9.8%) in the group 56 to 65 years, and 3,825 (5.7%) older than 65 years. The injury severity increased significantly with age. Elderly patients were significantly more likely to sustain intracranial hemorrhages, spinal, and other skeletal injuries. The overall mortality was 2.9 per cent (1938) with the latter increasing significantly in a stepwise fashion with progressing age, becoming sixfold higher in patients older than 65 years (OR, 6.18; 95% CI, 4.78 to 7.80; P < 0.001). Our examination illustrates the associations between occupational injury and significant mortality that warrant intervention for mortality reduction. There is a stepwise-adjusted increase in mortality with progressing age.

Strategic Learning in Youth with Traumatic Brain Injury: Evidence for Stall in Higher-Order Cognition

Science.gov (United States)

Gamino, Jacquelyn F.; Chapman, Sandra B.; Cook, Lori G.

2009-01-01

Little is known about strategic learning ability in preteens and adolescents with traumatic brain injury (TBI). Strategic learning is the ability to combine and synthesize details to form abstracted gist-based meanings, a higher-order cognitive skill associated with frontal lobe functions and higher classroom performance. Summarization tasks were…

The impact of coagulopathy on traumatic splenic injuries.

Science.gov (United States)

Smalls, Norma; Obirieze, Augustine; Ehanire, Imudia

2015-10-01

Patients with pre-injury coagulopathy have worse outcomes than those without coagulopathy. This article investigated the risk-adjusted effect of pre-injury coagulopathy on outcomes after splenic injuries. Review of the National Trauma Data Bank from 2007 to 2010 comparing mortality and complications between splenic injury patients with and without a pre-injury bleeding disorder. Of 58,896 patients, 2% had a bleeding disorder. Coagulopathic patients had higher odds of mortality (odds ratio, 1.3), sepsis (odds ratio, 2.0), acute respiratory distress syndrome (odds ratio, 2.6), acute renal failure (odds ratio, 1.5), cardiac arrest (odds ratio, 1.5), and overall complications (odds ratio, 2.4). The higher odds of myocardial infarction did not achieve statistical significance (odds ratio, 1.6). Pre-injury coagulopathy in patients with splenic injury has a negative impact on cardiac arrest, sepsis, acute respiratory distress syndrome, acute renal failure, and mortality. The higher likelihood of myocardial infarction did not reach statistical significance. Copyright © 2015 Elsevier Inc. All rights reserved.

Expression and significance of Bax protein in model of radiation injury in mouse skin

International Nuclear Information System (INIS)

Feng Yizhong; Mo Yahong

2002-01-01

Objective: The study is to find some valuable criteria for diagnosis and treatment of radiation injury in skin. Methods: The expression of Bax protein was studied by SP immunohistochemistry in 40 cases of model of radiation injury in mouse skin. Their relationship relating to radiation dose was also investigated. Results: The expression rates of Bax were 30%, 30%, 70%, 70% in 5 Gy group, 15 Gy group, 30 Gy group, 45 Gy group respectively. There was no significant correlation between the expression of Bax and radiation groups. Conclusions: The experiment shows that radiation can increase the expression of Bax protein which might be related to poor healing in radiation skin injury

Significance of radiographic abnormalities in patients with tibial stress injuries: correlation with magnetic resonance imaging

International Nuclear Information System (INIS)

Kijowski, Richard; Choi, James; Smet, Arthur de; Mukharjee, Rajat

2007-01-01

The objective was to correlate radiographic findings with magnetic resonance imaging (MRI) findings in patients with suspected tibial stress injuries in order to determine the significance of radiographic signs of stress injury in these individuals. The study group consisted of 80 patients with suspected tibial stress injuries who underwent a radiographic and MR examination of the tibia. Nineteen patients had bilateral involvement. Thus, a total of 99 tibias were evaluated. All radiographs and MR examinations were retrospectively reviewed, 1 month apart, in consensus by two musculoskeletal radiologists. The radiographs were reviewed without knowledge of the site of the clinical symptoms. Fisher's exact tests were used to determine the association between a positive radiograph and the presence of various MRI signs of a high-grade stress injury. There was a strong association between the presence of periosteal reaction on radiographs at the site of the clinical symptoms and a Fredericson grade 4 stress injury on MRI. The presence of periosteal reaction on radiographs at the site of clinical symptoms is predictive of a high-grade stress injury by MRI criteria. (orig.)

Isolated transient loss of consciousness is an indicator of significant injury.

Science.gov (United States)

Owings, J T; Wisner, D H; Battistella, F D; Perlstein, J; Walby, W F; Tharratt, R S

1998-09-01

To determine if isolated transient loss of consciousness is an indicator of significant injury. University-based level I trauma center. Phase 1 retrospective case series of all patients with trauma admitted directly from the emergency department to the operating room or an intensive care unit who had transient loss of consciousness as their only trauma triage criterion. Phase 2 prospective case series of all trauma patients transported by emergency medical system personnel with transient loss of consciousness as their only trauma triage criterion. Emergency operation and intensive care unit admission. Phase 1: From January 1, 1992, to March 31, 1995, we admitted 10255 patients with trauma. Three hundred seven (3%) met the enrollment criteria and were admitted to the operating room (n = 168) or intensive care unit (n = 139). Of these, 58 (18.9%) were taken to the operating room emergently to manage life-threatening injuries: 11 (4%) had craniotomies and 47 (15%) had non-neurosurgical operations. Phase 2: From July 1 to December 31, 1996, 2770 trauma patients were transported to our facility; 135 (4.9%) met the enrollment criteria. Forty-one (30.4%) of these required admission, and 6 (4.4%) were taken emergently to the operating room from the emergency department (1 [1%] for a craniotomy, 3 [2.2%] for intra-abdominal bleeding, and 2 [1.5%] for other procedures). Two (1.5%) of the 135 patients died. Patients with isolated transient loss of consciousness are at significant risk of critical surgical and neurosurgical injuries. These patients should be triaged to trauma centers or hospitals with adequate imaging, surgical, and neurosurgical resources.

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.

Implementation Guidance Document: Properties and Types of Significant Photothermal Retinal Lesion Injuries

Science.gov (United States)

2017-04-17

Include area code) (703) 432-0899 Standard Form 298 (Rev. 8/98) Prescribed 1::r;< ANSI S1d. Z39.18 Adobe Professional 7 .O Properties and Types of...are above MPE yet well below an irradiance that could cause significant retinal injuries. Estimating RSI in Practice - Some Illustrative Examples

The correlation of insulin resistance with the cerebral injury and stress reaction in patients with traumatic brain injury

Directory of Open Access Journals (Sweden)

Zhan Lan

2017-04-01

Full Text Available Objective: To study the correlation of insulin resistance with the cerebral injury and stress reaction in patients with traumatic brain injury (TBI. Methods: 78 patients who were diagnosed with acute traumatic brain injury in our hospital between May 2014 and August 2016 were selected as the TBI group, and 90 healthy volunteers who received physical examination during the same period were selected as the control group. The peripheral blood was collected to detect glucose, insulin and nerve injury marker molecules, stress hormones as well as oxidative stress reaction products, and the insulin resistance index (HOMA-IR was calculated. Results: The HOMA-IR index of TBI group was significantly higher than that of control group (P<0.05; serum neuron-specific enolase (NSE, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1, S100β, myelin basic protein (MBP, glucagon, growth hormone, cortisol, malondialdehyde (MDA and 8-hydroxy-deoxyguanosine (8-OHdGlevels of TBI group were significantly higher than those of control group (P<0.05; serum NSE, UCH-L1, S100β, MBP, glucagon, growth hormone, cortisol, MDA and 8-OHdG levels of patients with high HOMA-IR were significantly higher than those of patients with low HOMA-IR (P<0.05. Conclusion: The insulin resistance increases significantly in patients with traumatic brain injury, and is closely related to the degree of cerebral injury and stress reaction.

Ski and snowboard school programs: Injury surveillance and risk factors for grade-specific injury.

Science.gov (United States)

Sran, R; Djerboua, M; Romanow, N; Mitra, T; Russell, K; White, K; Goulet, C; Emery, C; Hagel, B

2018-05-01

The objective of our study was to evaluate incidence rates and profile of school program ski and snowboard-related injuries by school grade group using a historical cohort design. Injuries were identified via Accident Report Forms completed by ski patrollers. Severe injury was defined as those with ambulance evacuation or recommending patient transport to hospital. Poisson regression analysis was used to examine the school grade group-specific injury rates adjusting for risk factors (sex, activity, ability, and socioeconomic status) and accounting for the effect of clustering by school. Forty of 107 (37%) injuries reported were severe. Adolescents (grades 7-12) had higher crude injury rates (91 of 10 000 student-days) than children (grades 1-3: 25 of 10 000 student-days; grades 4-6: 65 of 10 000 student-days). Those in grades 1-3 had no severe injuries. Although the rate of injury was lower in grades 1-3, there were no statistically significant grade group differences in adjusted analyses. Snowboarders had a higher rate of injury compared with skiers, while higher ability level was protective. Participants in grades 1-3 had the lowest crude and adjusted injury rates. Students in grades 7-12 had the highest rate of overall and severe injuries. These results will inform evidence-based guidelines for school ski/snowboard program participation by school-aged children. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The incidence of hospital-treated occupational hand injuries

DEFF Research Database (Denmark)

Skov, O

1994-01-01

Previous studies have shown that young men have the highest frequency of occupational hand injuries. This study investigated their incidence and severity in relation to age and sex. For occupational hand injuries in general the estimated incidence rate was 17.1 per 1,000 person years. The incidence...... was found to be higher among men than women in all age groups below 60 years. The incidence for minor injuries declines with increasing age, but the rates for significant injuries are independent of age. The higher incidence rate for minor injuries among young patients could be real, but it could also...

Significance of focal relaxation times in head injury

Energy Technology Data Exchange (ETDEWEB)

Inao, Suguru; Furuse, Masahiro; Saso, Katsuyoshi; Yoshida, Kazuo; Motegi, Yoshimasa; Kaneoke, Yoshiki; Izawa, Akira

1987-11-01

Serial examinations by nuclear magnetic resonance-computed tomography were carried out in 35 head-injured patients aged 7 to 77 years. The injuries were classified as cerebral contusion (nine cases), acute epidural hematoma (eight cases), acute cerebral swelling (two cases), and chronic subdural hematoma (16 cases). The results of 92 measurements were divided into two groups: acute stage (within 3 days of injury) and chronic stage (2 weeks or longer after injury). The spin-lattice relaxation times (T/sub 1/) of brain tissue adjacent to chronic subdural hematoma were evaluated pre- and postoperatively. A Fonar QED 80-alpha system was used for magnetic resonance imaging and measurement of focal T/sub 1/. The T/sub 1/ values at the region of interest were measured 3 to 5 times by the field focusing technique (468 gauss in the focused spot), and the mean value was used for evaluation. The standard T/sub 1/ values obtained from healthy subjects were 290 +- 41 msec in the cerebral cortex and 230 +- 34 msec in the white matter. Prolongation of T/sub 1/ in perifocal brain gradually shortened over time and normalized in the chronic stage. The degree of contusional edema may have been reflected in alterations in T/sub 1/. In contrast, parenchymal injury resulted in a progressive T/sub 1/ elevation, which far exceeded 500 msec in the chronic stage. Such time courses of T/sub 1/ may indicate irreversible tissue damage. There were no noticeable changes in tissue T/sub 1/ over time in patients with acute diffuse cerebral swelling or those who underwent evacuation of acute epidural or chronic subdural hematomas. The underlying pathophysiology in such situations seems to be not brain edema but cerebral hyperemia. In the presence of ischemia, the T/sub 1/ value was prolonged in the early stage, reflecting progression of is chemic edema. (Abstract Truncated)

CT evaluation of pulmonary parenchymal injury due to blunt chest trauma and its clinical significance

International Nuclear Information System (INIS)

Niimi, Hiroshi

1990-01-01

The CT findings of pulmonary parenchymal injury due to blunt chest trauma in 73 patients and their clinical significance were analyzed. CT was obtained within 6 hours after trauma. Findings were analyzed according to the number of injured segments and severity which was classified into three grades. A correlation was also made with arterial blood PaO 2 and thoracic complications. Pulmonary parenchymal injury was identified in multisegmental portions bilaterally in most cases. It was most frequently observed in the posterior portion of the lung such as segment 6. More than 50% of lesions were classified as Grade 1. Pulmonary laceration, defined as patchy density with the cavitary lesion (Grade 3), was noted in 9.2%. There was a good correlation between extent of pulmonary injury and degree of hypoxia. The correlation of pneumothorax was also found with extensive lesion and frequency of Grade 3 lesion. Cases with pulmonary laceration tend to have extensive injury, and be related to the degree of hypoxia. In conclusion, CT evaluation of pulmonary parenchymal injury is valuable not only for morphological evaluation but also for estimation of hypoxia. (author)

CT evaluation of pulmonary parenchymal injury due to blunt chest trauma and its clinical significance

Energy Technology Data Exchange (ETDEWEB)

Niimi, Hiroshi (St. Marianna University School of Medicine, Kawasaki, Kanagawa (Japan))

1990-10-01

The CT findings of pulmonary parenchymal injury due to blunt chest trauma in 73 patients and their clinical significance were analyzed. CT was obtained within 6 hours after trauma. Findings were analyzed according to the number of injured segments and severity which was classified into three grades. A correlation was also made with arterial blood PaO{sub 2} and thoracic complications. Pulmonary parenchymal injury was identified in multisegmental portions bilaterally in most cases. It was most frequently observed in the posterior portion of the lung such as segment 6. More than 50% of lesions were classified as Grade 1. Pulmonary laceration, defined as patchy density with the cavitary lesion (Grade 3), was noted in 9.2%. There was a good correlation between extent of pulmonary injury and degree of hypoxia. The correlation of pneumothorax was also found with extensive lesion and frequency of Grade 3 lesion. Cases with pulmonary laceration tend to have extensive injury, and be related to the degree of hypoxia. In conclusion, CT evaluation of pulmonary parenchymal injury is valuable not only for morphological evaluation but also for estimation of hypoxia. (author).

MR imaging of post-traumatic articular cartilage injuries confined to the femoral trochlea Arthroscopic correlation and clinical significance

International Nuclear Information System (INIS)

Huegli, Rolf W.; Moelleken, Sonja M.C.; Stork, Alexander; Bonel, Harald M.; Bredella, Miriam A.; Meckel, Stephan; Genant, Harry K.; Tirman, Phillip F.J.

2005-01-01

Objective: To assess and describe post-traumatic articular cartilage injuries isolated to the trochlear groove and provide insight into potential mechanism of injury. Materials and methods: We retrospectively evaluated MR imaging findings of all knee MRIs performed at our institution over the last 2 years (2450). Thirty patients met the criteria of a cartilage injury confined to the trochlear groove. In 15 cases, which were included in our study, arthroscopic correlation was available. Each plane was evaluated and graded for the presence and appearance of articular cartilage defects using a standard arthroscopic grading scheme adapted to MR imaging. Any additional pathological derangement was documented and information about the mechanism of injury was retrieved by chart review. Results: In all cases the cartilaginous injury was well demonstrated on MRI. In 13 patients additional pathological findings could be observed. The most frequently associated injury was a meniscal tear in nine patients. In eight cases, the arthroscopic grading of the trochlear injury matched exactly with the MRI findings. In the remaining seven cases, the discrepancy between MRI and arthroscopy was never higher than one grade. In 13 out of 15 of patients trauma mechanism could be evaluated. Twelve patients suffered an indirect twisting injury and one suffered a direct trauma to their knee. Conclusion: The findings of this study demonstrate that MR imaging allows reliable grading of isolated injury to the trochlear groove cartilage and assists in directing surgical diagnosis and treatment. These injuries may be the only hyaline cartilage injury in the knee and meniscal tears are a frequently associated finding. Therefore, it is important to search specifically for cartilage injuries of the trochlear groove in patients with anterior knee pain, even if other coexistent pathology could potentially explain the patient's symptoms

MR imaging of post-traumatic articular cartilage injuries confined to the femoral trochlea Arthroscopic correlation and clinical significance

Energy Technology Data Exchange (ETDEWEB)

Huegli, Rolf W. E-mail: rhuegli@uhbs.ch; Moelleken, Sonja M.C.; Stork, Alexander; Bonel, Harald M.; Bredella, Miriam A.; Meckel, Stephan; Genant, Harry K.; Tirman, Phillip F.J

2005-01-01

Objective: To assess and describe post-traumatic articular cartilage injuries isolated to the trochlear groove and provide insight into potential mechanism of injury. Materials and methods: We retrospectively evaluated MR imaging findings of all knee MRIs performed at our institution over the last 2 years (2450). Thirty patients met the criteria of a cartilage injury confined to the trochlear groove. In 15 cases, which were included in our study, arthroscopic correlation was available. Each plane was evaluated and graded for the presence and appearance of articular cartilage defects using a standard arthroscopic grading scheme adapted to MR imaging. Any additional pathological derangement was documented and information about the mechanism of injury was retrieved by chart review. Results: In all cases the cartilaginous injury was well demonstrated on MRI. In 13 patients additional pathological findings could be observed. The most frequently associated injury was a meniscal tear in nine patients. In eight cases, the arthroscopic grading of the trochlear injury matched exactly with the MRI findings. In the remaining seven cases, the discrepancy between MRI and arthroscopy was never higher than one grade. In 13 out of 15 of patients trauma mechanism could be evaluated. Twelve patients suffered an indirect twisting injury and one suffered a direct trauma to their knee. Conclusion: The findings of this study demonstrate that MR imaging allows reliable grading of isolated injury to the trochlear groove cartilage and assists in directing surgical diagnosis and treatment. These injuries may be the only hyaline cartilage injury in the knee and meniscal tears are a frequently associated finding. Therefore, it is important to search specifically for cartilage injuries of the trochlear groove in patients with anterior knee pain, even if other coexistent pathology could potentially explain the patient's symptoms.

Higher education does not protect against firework-related injuries: a review of the economic burden and the risk factors of firework-related injuries in the capital of Iran.

Science.gov (United States)

Saadat, S; Mafi, M; Smith, G A

2012-01-01

To examine the incidence and risk factors of firework-related injuries during the Last Wednesday Eve Festival in Tehran, Iran, with a focus on the association of socio-economic status and educational level with the use of fireworks and the incidence of firework-related injury. Cross-sectional household survey. Using a random cluster sampling approach, a household survey was conducted in Greater Tehran in April 2008. During a structured interview with an adult member of the household, questions were asked about the use of fireworks and any firework-related injuries sustained by household members during the preceding festival. Data were gathered on expenditure on fireworks, medical treatment of firework-related injuries, length of hospital stay for the treatment of these injuries, and damage to personal property by fireworks. The survey included 2456 households in Greater Tehran. At least one member of 18% of these households had used fireworks during the Last Wednesday Eve Festival in 2008. The overall incidence of firework-related injuries was 100 per 100,000 population (95% confidence interval 37-163). The use of fireworks was less common among parents and more common among male children. Individuals who used fireworks were younger than non-users. Younger age and use of fireworks were associated with firework-related injuries (P fireworks was US$1.62. Among the households that had bought fireworks, the mean expenditure was US$9.40 (standard deviation US$16.34). Thirty-two households (1.3%) reported damage to personal property due to fireworks during the festival costing US$3.30-167.20. The regional price of housing in the study area was correlated with the educational level of the head of the household. Higher educational level of the head of the household was associated with participation in firework activities by household members, expenditure on fireworks, and the amount of financial loss due to fireworks (all P Fireworks are associated with serious injuries

Bile ductal injury and ductular reaction are frequent phenomena with different significance in autoimmune hepatitis.

Science.gov (United States)

Verdonk, Robert C; Lozano, Mallaki F; van den Berg, Aad P; Gouw, Annette S H

2016-09-01

The significance of bile duct injury and ductular reaction in biopsies from autoimmune hepatitis patients is not clear. We aim to establish the prevalence and clinical relevance of both phenomena in autoimmune hepatitis. Cases of newly diagnosed, untreated autoimmune hepatitis without overlap syndrome were selected. Pretreatment and follow up biopsies were scored for inflammation, fibrosis, bile ductal injury and ductular reaction. Thirty-five cases were studied of whom 14 cases had follow up biopsies. Bile duct injury was present in 29 cases (83%), mostly in a PBC-like pattern and was not correlated with demographical or laboratory findings. Ductular reaction, observed in 25 of 35 cases (71%) using conventional histology and in 30 of 32 cases (94%) using immunohistochemistry, was correlated with portal and lobular inflammation, interface hepatitis and centrilobular necrosis as well as bile duct injury and fibrosis. In 11 of 14 cases (79%) ductular reaction remained present on post-treatment biopsy whereas bile duct injury persisted in six of 14 (43%) of cases. Bile duct injury and ductular reaction are very common in newly diagnosed autoimmune hepatitis and cannot be predicted biochemically. Bile duct injury may subside in the majority of treated AIH cases while DR tends to persist during follow up. These findings show that the two phenomena are part of the spectrum of AIH with dissimilar responses to treatment and do not necessarily point towards an overlap syndrome. Persistence of ductular reaction after treatment supports the notion that it represents a regenerative response. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Injury risk is different in team and individual youth sport.

Science.gov (United States)

Theisen, Daniel; Frisch, Anne; Malisoux, Laurent; Urhausen, Axel; Croisier, Jean-Louis; Seil, Romain

2013-05-01

This study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries. Prospective cohort follow-up. Pupils from a public sports school (12-19 years) were recruited over two separate school years (2008-2009: 42 weeks, n=199 athletes; 2009-2010: 40 weeks, n=89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire. Injury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000h, respectively), as a result of a higher incidence of both traumatic (RR=2.17; CI95%=1.75-2.70; pteam sports participation had a hazard ratio of 2.00 (CI95%=1.49-2.68; psports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR=1.072; CI95% [1.033; 1.113]; psports the number of competitions per 100 days had a protective effect (HR=0.940; CI95% [0.893; 0.989]; p=0.017). Team sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Functional Coping Dynamics and Experiential Avoidance in a Community Sample with No Self-Injury vs. Non-Suicidal Self-Injury Only vs. Those with Both Non-Suicidal Self-Injury and Suicidal Behaviour

Directory of Open Access Journals (Sweden)

Emma Nielsen

2017-05-01

Full Text Available Although emotional avoidance may be a critical factor in the pathway from psychological distress to self-injury and/or suicidality, little is known about the relative importance of differing functional coping dynamics and experiential avoidance between people with self-injury histories of differing intent (e.g., Non-Suicidal Self-Injury only vs. Non-Suicidal Self-Injury plus Suicidal Behaviour; NSSI vs. NSSI + SB. A community-based survey (N = 313; female, 81%; ages 16–49 years, M = 19.78, SD = 3.48 explored self-reported experiential avoidance and functional coping dynamics in individuals with (i no self-injury history (controls; (ii a history of NSSI only; and (iii a history of NSSI + SB. Jonckheere-Terpstra trend tests indicated that avoidance coping was higher in the NSSI and NSSI + SB groups than in controls. Emotion regulation was higher in controls than those with a history of self-injury (NSSI and NSSI + SB. Approach and reappraisal coping demonstrated significant ordered effects such that control participants were higher in these coping dynamics than those with a history of NSSI only, who, in turn, were higher than those with a history of NSSI + SB (Control > NSSI > NSSI + SB. Endorsement of the reappraisal/denial facet of experiential avoidance was most pronounced in those with a history of NSSI + SB (Control < NSSI < NSSI + SB. No significant ordered effects were observed for other dimensions of experiential avoidance. Understanding how the endorsement of functional coping dynamics and which components of experiential avoidance vary between groups with differing self-injury intent histories has important implications for treatment planning.

[Diagnostic significance of serum free DNA human telomerase reverse transcriptase quantitative determination on spinal cord injury].

Science.gov (United States)

Yang, M K; Tang, J; Xiang, Z; Zhang, X; Wang, J; Li, Z; Li, Y; Sheng, W B

2018-02-06

Objective: To investigate the relationship between the content of human telomerase reverse transcriptase (hTERT) and its clinical features in serum free DNA in patients with different degree of spinal cord injury. Methods: From December 2013 to December 2016, inpatients of the Central Hospital of Bazhong, Sichuan Province were enrolledand divided into the experimental group, the disease control group and the negative control group. For the experimental group: 46 patients with spinal cord injury were graded according to the criteria of the American Association of Spinal Cord Injury (ASIA), including 12 cases of grade A, 10 cases of grade B, 10 cases of grade C, 7 cases of grade D and 7 cases of grade E; for the disease control group: 15 patients with spinal fractures (without spinal cord injury) at the same period were included; and for the negative control group: 20 healthy adult volunteers aged 18-50 years were selected.Real-time fluorescence quantitative PCR and immunoblotting were performed to detect the content of hTERT in serum free DNA both in patients and healthy controls and to compare the difference between them. The results of the somatosensory evoked potential (SEP) of all patients were compared and analyzed.The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of hTERT content in serum free DNA in patients with spinal cord injury. Results: Comparison of serum free DNA hTERT content: in the experimental group, the serum free DNA hTERT content of grade A, B, C, D, E was (99.63±8.23), (76.24±4.37), (46.07±5.43), (16.30±0.95) and (15.74±1.12)μg/L, respectively.While it was (15.01±1.39)μg/L in the disease control group and (14.54±1.03)μg/L in the negative control group. The total difference was statistically significant between patients of each group and the control group ( F =857.917, P spinal cord injury has a certain guiding significance for the diagnosis of spinal cord injury and the degree of injury.

Telemark skiing injuries.

Science.gov (United States)

Tuggy, M L

1996-09-01

Telemark skiing has become increasingly popular over the past 5 years. Telemark skiing poses unique risks when compared to alpine skiing, because of different equipment, technique, and varied skiing environments. A retrospective survey of telemark skiers was conducted in Western Washington in 1994 to obtain skier information on ski habits, demographics, frequency and types of injury, and equipment used at time of injury. During the 5 month survey period, 118 (63%) of 187 surveys distributed at 7 sites were returned. The overall injury rate was comparable to alpine skiing injury rates at 10.7/1000 skier days. Less experienced skiers and women had higher injury rates, 20/1000 and 13.1/1000 skier days, respectively. The predominant injury sites were knee (41%), hip (13%), and thumb (8%). The knee injuries sustained by telemark skiers appear to be less severe than alpine skiers, with less duration of disability and lower surgical rates. An association was found between the use of plastic reinforced boots and significant ligamentous knee injuries when compared to skiers with leather boots (p < 0.01, chi 2 = 5.43).

Endometrial Scratch Injury Induces Higher Pregnancy Rate for Women With Unexplained Infertility Undergoing IUI With Ovarian Stimulation: A Randomized Controlled Trial.

Science.gov (United States)

Maged, Ahmed M; Al-Inany, Hesham; Salama, Khaled M; Souidan, Ibrahim I; Abo Ragab, Hesham M; Elnassery, Noura

2016-02-01

To explore the impact of endometrial scratch injury (ESI) on intrauterine insemination (IUI) success. One hundred and fifty four infertile women received 100 mg of oral clomiphene citrate for 5 days starting on day 3 of the menstrual cycle. Patients were randomized to 2 equal groups: Group C received IUI without ESI and group S had ESI. Successful pregnancy was confirmed by ultrasound. 13, 21, and 10 women got pregnant after the first, second, and third IUI trials, respectively, with 28.6% cumulative pregnancy rate (PR). The cumulative PR was significantly higher in group S (39%) compared to group C (18.2%). The PR in group S was significantly higher compared to that in group C at the second and third trials. The PR was significantly higher in group S at the second trial compared to that reported in the same group at the first trial but nonsignificantly higher compared to that reported during the third trial, while in group C, the difference was nonsignificant. Eight pregnant women had first trimester abortion with 18.2% total abortion rate with nonsignificant difference between studied groups. The ESI significantly improves the outcome of IUI in women with unexplained infertility especially when conducted 1 month prior to IUI. © The Author(s) 2015.

Frequency and significance of thoracic injuries detected on abdominal trauma CT scans

International Nuclear Information System (INIS)

Hareli, G.S.; Rhea, J.T.; Novelline, R.A.; Lawrason, N.; Sacknoff, R.; Oser, A.

1987-01-01

The authors have noted that in multiple trauma patients chest injuries inapparent on initial chest radiographs may be detected at abdominal CT. In an ongoing series of 112 patients to date, 50 chest injuries were detected in 33 patients (29%). The injuries included 15 bilateral hemothoraces, seven unilateral hemothoraces, seven posttraumatic atrelectasis, seven lung contusions, five pneumothoraces, four rib factures, two thoracic spine fractures, two chest wall emphysema, and one mediastinal emphysema. In 24 of the 33 patients (72%) the injury was not seen on the initial chest radiographs; in seven patients treatment of the chest injury was required. The authors have included screening cuts of the middle and upper chest as part of their abdominal CT protocol

Can Unshod Running Reduce Running Injuries?

Science.gov (United States)

2012-06-08

78 viii ACRONYMS FFS Forefoot Strike MFS Midfoot Strike RFS Rearfoot...differences between forefoot and rearfoot striking runners. Daoud collected the history of the 52 runners and quantified their injury rates and severity...conclusion was that the rearfoot striking runners have a significantly higher rate of repetitive stress injuries compared to forefoot runners

Significant use of diagnostic radiology for sport injuries and damages

Energy Technology Data Exchange (ETDEWEB)

Wirth, C J; Kessler, M

1983-09-01

The diagnosis of a sport injury or a sport damage is usually made by the clinical investigation. However, the X-ray examination is indispensable. In addition to standard projections further radiologic techniques such as passive motion, tomography, computed tomography, arthrography or angiography are necessary. The relevant use of these X-ray methods with regard to sports injuries or damages of the particular regions of the locomotor system are described.

Significant use of diagnostic radiology for sport injuries and damages

International Nuclear Information System (INIS)

Wirth, C.J.; Kessler, M.

1983-01-01

The diagnosis of a sport injury or a sport damage is usually made by the clinical investigation. However, the X-ray examination is indispensable. In addition to standard projections further radiologic techniques such as passive motion, tomography, computed tomography, arthrography or angiography are necessary. The relevant use of these X-ray methods with regard to sports injuries or damages of the particular regions of the locomotor system are described. (orig.)

Injury severity in ice skating: an epidemiologic analysis using a standardised injury classification system.

Science.gov (United States)

Ostermann, Roman C; Hofbauer, Marcus; Tiefenböck, Thomas M; Pumberger, Matthias; Tiefenböck, Michael; Platzer, Patrick; Aldrian, Silke

2015-01-01

Although injuries sustained during ice skating have been reported to be more serious than other forms of skating, the potential injury risks are often underestimated by skating participants. The purpose of this study was to give a descriptive overview of injury patterns occurring during ice skating. Special emphasis was put on injury severity by using a standardised injury classification system. Over a six month period, all patients treated with ice-skating-related injuries at Europe's largest hospital were included. Patient demographics were collected and all injuries categorised according to the Abbreviated Injury Scale (AIS) 2005. A descriptive statistic and logistic regression analysis was performed. Three hundred and forty-one patients (134 M, 207 F) were included in this study. Statistical analysis revealed that age had a significant influence on injury severity. People > 50 years had a higher risk of sustaining a more severe injury according to the AIS compared with younger skaters. Furthermore, the risk of head injury was significantly lower for people aged between 18 and 50 years than for people  50 years than for people aged between 18 and 50 years (p = 0.04). The severity of ice-skating injuries is associated with the patient's age, showing more severe injuries in older patients. Awareness should be raised among the public and physicians about the risks associated with this activity in order to promote further educational interventions and the use of protective gear.

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.

Chest Injuries Associated with Head Injury | Mezue | Nigerian ...

African Journals Online (AJOL)

Conclusion: Associated chest injuries result in higher mortality from head injuries. This association is more likely in the young and more productive. All patients presenting with head and spinal cord injury should be specifically and carefully evaluated for associated chest injuries. Computerized tomographic has not replaced ...

Higher dietary intake of vitamin D may influence total cholesterol and carbohydrate profile independent of body composition in men with Chronic Spinal Cord Injury.

Science.gov (United States)

Beal, Christopher; Gorgey, Ashraf; Moore, Pamela; Wong, Nathan; Adler, Robert A; Gater, David

2018-07-01

A case-control design. To determine the effects of dietary vitamin D intake on insulin sensitivity (Si), glucose effectiveness (Sg), and lipid profile in individuals with spinal cord injury (SCI). 20 male, paraplegic (T3-L1) with chronic (> one year) motor complete SCI (AIS A or B) were recruited. Three-day dietary records were analyzed for dietary vitamin D (calciferol), and participants were assigned to one of two groups, a high vitamin D intake group and a low vitamin D intake group based on the mid-point of vitamin D frequency distribution. Individuals in both groups were matched based on age, weight, time since injury and level of injury. Sg, Si and lipid profiles were measured of the two groups. The high vitamin D group had an average intake of 5.33 ± 4.14 mcg compared to low vitamin D group, 0.74 ± 0.24 mcg. None of the 20 participants met the recommended guidelines for daily vitamin D intake. The higher vitamin D group had a significantly lower (P = 0.035) total cholesterol (148.00 ± 14.12 mg/dl) than the lower vitamin D group (171.80 ± 36.22 mg/dl). Vitamin D adjusted to total dietary intake was positively correlated to improvement in Si and Sg (PD intake. However, a higher dietary intake of vitamin D may influence total cholesterol and carbohydrate profile as demonstrated by a significant decrease in total cholesterol and improvement in glucose homeostasis independent of body composition changes after SCI.

Mortality associated with traumatic injuries in the elderly: a population based study.

Science.gov (United States)

O'Neill, Stephen; Brady, Richard R; Kerssens, Jan J; Parks, Rowan W

2012-01-01

Elderly trauma is increasing in incidence and is associated with significant morbidity and mortality. The primary objective of the study was to identify factors associated with survival or mortality in the elderly following trauma. The secondary objective was to compare the epidemiology of trauma in the elderly with younger patients. A retrospective analysis was performed of data that was obtained from a prospectively collected multi-centre trauma database maintained by The Scottish Trauma Audit Group (STAG) containing details of 52,887 trauma patients admitted to 25 participating Scottish Hospitals over an 11-year period. Elderly trauma patients (aged >80 years) were separately analyzed and compared to younger trauma patients (aged 13-80). Of 52,887 trauma patients identified, 4791 were elderly (9.1%). Elderly patients had a higher absolute mortality rate following traumatic injury (9.9% versus 4%, pelderly was higher in males, following a high fall, with lower Glasgow Coma Scale (GCS), in those with higher Abbreviated Injury Scale (AIS)/Injury Severity Score (ISS), in those with concomitant injuries, hemodynamic compromise and following delayed presentation. Multiple logistic regression analysis confirmed an independent relationship between mortality and low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) in the elderly. In conclusion, trauma in elderly patients is associated with significantly higher mortality. Low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) have the strongest independent relationships with mortality after trauma in the elderly population. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Injury Patterns, Physiological Profile, and Performance in University Rugby Union.

Science.gov (United States)

Ball, Shane; Halaki, Mark; Sharp, Tristan; Orr, Rhonda

2018-01-01

Rugby union is a physically demanding collision sport with high injury rates. There is a common perception that higher training loads result in greater injury risk in field-based sports. To determine injury, anthropometric, and physical-performance characteristics in junior rugby union players and investigate the interaction between training load and injury across a competitive season. Prospective cohort study. Fifty-one players (age 19.2 ± 0.7 y) from an under-20 university rugby union team (forwards, n = 27; backs, n = 24) participated in a study conducted over a competition season. Training load, injury characteristics, anthropometry, physiological performance, and match time-loss injury incidence were observed. Backs had significantly lower body mass (ES [95% CI] = 1.6 [0.9, 2.2]), skinfold thickness (ES = 1.1 [0.5, 1.7]), strength (squat ES = 0.6 [0.0, 1.2], deadlift ES = 0.6 [0.0, 1.1], bench press ES = 0.9 [0.4, 1.5]), lower-body power (ES = 0.4 [-0.2, 1.0]), and higher maximal aerobic capacity (ES = -0.3 [-0.8, 0.3]) than forwards. Match injury incidence was 107.3 injuries/1000 player hours (forwards 91.4/1000, backs 125.5/1000) during preseason and 110.7 injuries/1000 player hours (forwards 124.1/1000, backs 95.2/1000) during in-season. Forwards showed higher incidence of joint and ligament (P = .049) and upper-limb (P = .011) injuries than backs. No significant relationship between overall training load and match injury incidence was found. However, lower match injury incidence was associated with higher weekly training volume in backs (P = .007). Positional differences in body composition, performance, injury characteristics, and match injury patterns were identified in junior university rugby union players, indicating the need for position-specific training programs to reduce risk of injury.

Youth Participation and Injury Risk in Martial Arts.

Science.gov (United States)

Demorest, Rebecca A; Koutures, Chris

2016-12-01

The martial arts can provide children and adolescents with vigorous levels of physical exercise that can improve overall physical fitness. The various types of martial arts encompass noncontact basic forms and techniques that may have a lower relative risk of injury. Contact-based sparring with competitive training and bouts have a higher risk of injury. This clinical report describes important techniques and movement patterns in several types of martial arts and reviews frequently reported injuries encountered in each discipline, with focused discussions of higher risk activities. Some of these higher risk activities include blows to the head and choking or submission movements that may cause concussions or significant head injuries. The roles of rule changes, documented benefits of protective equipment, and changes in training recommendations in attempts to reduce injury are critically assessed. This information is intended to help pediatric health care providers counsel patients and families in encouraging safe participation in martial arts. Copyright © 2016 by the American Academy of Pediatrics.

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.

Injuries in martial arts: a comparison of five styles.

Science.gov (United States)

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

2005-01-01

To compare five martial arts with respect to injury outcomes. A one year retrospective cohort was studied using an injury survey. Data on 263 martial arts participants (Shotokan karate, n = 114; aikido, n = 47; tae kwon do, n = 49; kung fu, n = 39; tai chi, n = 14) were analysed. Predictor variables included age, sex, training frequency (3 h/week), experience (or=3 years), and martial art style. Outcome measures were injuries requiring time off from training, major injuries (>or=7 days off), multiple injuries (>or=3), body region, and type of injury. Logistic regression was used to determine odds ratios (OR) and confidence intervals (CI). Fisher's exact test was used for comparisons between styles, with a Bonferroni correction for multiple comparisons. The rate of injuries, expressed as percentage of participants sustaining an injury that required time off training a year, varied according to style: 59% tae kwon do, 51% aikido, 38% kung fu, 30% karate, and 14% tai chi. There was a threefold increased risk of injury and multiple injury in tae kwon do than karate (por=18 years of age were at greater risk of injury than younger ones (p3 h/week was also a significant predictor of injury (pkarate, the risks of head/neck injury, upper extremity injury, and soft tissue injury were all higher in aikido (pinjuries were higher in tae kwon do (pkarate. Different martial arts have significantly different types and distribution of injuries. Martial arts appear to be safe for young athletes, particularly those at beginner or intermediate levels.

Nine-year study of US high school soccer injuries: data from a national sports injury surveillance programme.

Science.gov (United States)

Khodaee, Morteza; Currie, Dustin W; Asif, Irfan M; Comstock, R Dawn

2017-02-01

Research on high school soccer injury epidemiology is sparse. To describe high school soccer injury rates, trends and patterns by type of athlete exposure (AE), position and sex. This descriptive epidemiological study used data from a large national high school sports injury surveillance programme to describe rates and patterns of soccer-related injuries including concussion sustained from 2005/2006 to 2013/2014. Injury rates are calculated per 1000 AEs. Overall, 6154 soccer injuries occurred during 2 985 991 AEs; injury rate=2.06 per 1000 AEs. Injury rates were higher during competition (4.42) than practice (1.05; rate ratio (RR)=4.19; 95% CI 3.98 to 4.41), and in girls (2.33) than boys (1.83; RR=1.27, 95% CI 1.21 to 1.34). Boys' non-concussion injury rates decreased significantly (p=0.001) during the study period while reported concussion rates increased significantly (p=0.002). Girls' non-concussion rates were relatively stable and reported concussion rates increased significantly (p=0.004). Player-player contact was the injury mechanism that led to the most competition injuries (injury proportion ratio (IPR)=2.87; 95% CI 2.57 to 3.21), while non-contact injuries were the most common mechanisms among practice injuries (IPR=2.10; 95% CI 1.86 to 2.38). Recovery from concussion was >7 days in a third of the cases. Injury patterns were similar between sexes with respect to position played and location on the field at the time of injury. High school soccer injury rates vary by sex and type of exposure, while injury patterns are more similar across sexes. Reported concussion rates increased significantly over the study period in male and female athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Colon injury after blunt abdominal trauma: results of the EAST Multi-Institutional Hollow Viscus Injury Study.

Science.gov (United States)

Williams, Michael D; Watts, Dorraine; Fakhry, Samir

2003-11-01

Blunt injury to the colon is rare. Few studies of adequate size and design exist to allow clinically useful conclusions. The Eastern Association for the Surgery of Trauma Multi-institutional Hollow Viscus Injury (HVI) Study presents a unique opportunity to definitively study these injuries. Patients with blunt HVI were identified from the registries of 95 trauma centers over 2 years (1998-1999). Patients with colon injuries (cases) were compared with blunt trauma patient undergoing a negative laparotomy (controls). Data were abstracted by chart review. Of the 227,972 patients represented, 2,632 (1.0%) had an HVI and 798 had a colonic/rectal injury (0.3%). Of patients diagnosed with HVI, 30.2% had a colon injury. No physical findings or imaging modalities were able to discriminate colonic injury. Logistic regression modeling yielded no clinically useful combination of findings that would reliably predict colonic injury. In patients undergoing laparotomy, presence of colon injury was associated with a higher risk of some complications but not mortality. Colon injury was associated with increased hospital (17.4 vs. 13.1, p colon patients (92.0%) underwent laparotomy within 24 hours of injury. Colonic injury after blunt trauma is rare and difficult to diagnose. No diagnostic test or combination of findings reliably excluded blunt colonic injury. Despite the inadequacy of current diagnostic tests, almost all patients with colonic injury were taken to the operating room within 24 hours. Even with relatively prompt surgery, patients with colon injury were at significantly higher risk for serious complications and increased length of stay. In contrast to small bowel perforation, delay in operative intervention appears to be less common but is still associated with serious morbidity.

Competitive Intelligence: Significance in Higher Education

Science.gov (United States)

Barrett, Susan E.

2010-01-01

Historically noncompetitive, the higher education sector is now having to adjust dramatically to new and increasing demands on numerous levels. To remain successfully operational within the higher educational market universities today must consider all relevant forces which can impact present and future planning. Those institutions that were…

Patterns of severe injury in pediatric car crash victims: Crash Injury Research Engineering Network database.

Science.gov (United States)

Brown, J Kristine; Jing, Yuezhou; Wang, Stewart; Ehrlich, Peter F

2006-02-01

Motor vehicle crashes (MVCs) account for 50% of pediatric trauma. Safety improvements are typically tested with child crash dummies using an in vitro model. The Crash Injury Research Engineering Network (CIREN) provides an in vivo validation process. Previous research suggest that children in lateral crashes or front-seat locations have higher Injury Severity Scale scores and lower Glasgow Coma Scale scores than those in frontal-impact crashes. However, specific injury patterns and crash characteristics have not been characterized. Data were collected from the CIREN multidisciplinary crash reconstruction network (10 pediatric trauma centers). Injuries were examined with regard to crash direction (frontal/lateral), restraint use, seat location, and change in velocity at impact (DeltaV). Injuries were limited to Abbreviated Injury Scale (AIS) scores of 3 or higher and included head, thoracic, abdominal, pelvic, spine, and long bone (orthopedic) injuries. Standard age groupings (0-4, 5-9, 10-14, and 15-18 years) were used. Statistical analyses used Fisher's Exact test and multiple logistic regressions. Four hundred seventeen MVCs with 2500 injuries were analyzed (males = 219, females = 198). Controlling for DeltaV and age, children in lateral-impact crashes (n = 232) were significantly more likely to suffer severe injuries to the head and thorax as compared with children in frontal crashes (n = 185), who were more likely to suffer severe spine and orthopedic injuries. Children in a front-seat (n = 236) vs those in a back-seat (n = 169) position had more injuries to the thoracic (27% vs 17%), abdominal (21% vs 13%), pelvic (11% vs 1%), and orthopedic (28% vs 10%) regions (P < .05 for all). Seat belts were protective for pelvic (5% vs 12% unbelted) and orthopedic (15% vs 40%) injuries (odds ratio = 3, P < .01 for both). A reproducible pattern of injury is noted for children involved in lateral-impact crashes characterized by head and chest injuries. The Injury Severity

Rib fractures: comparison of associated injuries between pediatric and adult population.

Science.gov (United States)

Kessel, Boris; Dagan, Jasmin; Swaid, Forat; Ashkenazi, Itamar; Olsha, Oded; Peleg, Kobi; Givon, Adi; Alfici, Ricardo

2014-11-01

Rib fractures are considered a marker of exposure to significant traumatic energy. In children, because of high elasticity of the chest wall, higher energy levels are necessary for ribs to fracture. The purpose of this study was to analyze patterns of associated injuries in children as compared with adults, all of whom presented with rib fractures. A retrospective cohort study involving blunt trauma patients with rib fractures registered in the National Trauma Registry was conducted. Of 6,995 trauma victims who were found to suffer from rib fractures, 328 were children and 6,627 were adults. Isolated rib fractures without associated injuries occurred in 19 children (5.8%) and 731 adults (11%). More adults had 4 or more fractured ribs compared with children (P pneumothorax (P = .006), spleen, and liver injury (P < .001). Mortality rate was 5% in both groups. The incidence of associated head, thoracic, and abdominal solid organ injuries in children was significantly higher than in adults suffering from rib fractures. In spite of a higher Injury Severity Score and incidence of associated injuries, mortality rate was similar. Mortality of rib fracture patients was mostly affected by the presence of extrathoracic injuries. Copyright © 2014 Elsevier Inc. All rights reserved.

Clinical significance of bone bruises and cartilage lesions associated with anterior cruciate ligament injuries by magnetic resonance imaging and arthroscopy

International Nuclear Information System (INIS)

Nawata, Koji; Yamamoto, Kichizo; Teshima, Ryota; Suzuki, Toshiro; Yamagata, Taiji.

1995-01-01

In 85 patients with anterior cruciate ligament (ACL) rupture, we examined bone bruises retrospectively using magnetic resonance imaging (MRI). In 53 patients who underwent arthroscopy, the bone bruises were compared with the cartilage lesions. Depending on the time from their ligamentous injury to the performance of MRI, the patients were divided into three groups: the acute group (less than 1 months, n=29), the subacute group (between 1 and 12 months, n=29), and the chronic group (12 months or more, n=27). The detection rate of bone bruises by MRI was significantly higher in the acute group than in the other groups (p<0.0001). Bone bruises were always detected in the same locations of the lateral compartment of the knee joint. In four patients who observed bone bruises in the first MRI and underwent follow-up MRI 3-6 months later, bone bruises had disappeared in the follow-up MRI. In the acute group, bone bruises in the lateral femoral condyle were often found to be accompanied by cartilaginous injuries. In the subacute and chronic groups, the rate of degeneration of these cartilaginous lesions had progressed. (author)

Location of Sternal Fractures as a Possible Marker for Associated Injuries

Directory of Open Access Journals (Sweden)

Max J. Scheyerer

2013-01-01

Full Text Available Introduction. Sternal fractures often occur together with serious and life-threatening additional injuries. This retrospective study was designed to assess concomitant injuries and develop a correlation between fracture location and the severity of injury. Methods. All patients ( diagnosed with a fracture of the sternum by means of a CT scan were analysed with respect to accident circumstances, fracture morphology and topography, associated injuries, and outcome. Results. Isolated sternal fractures occurred in 9%. In all other admissions, concomitant injuries were diagnosed: mainly rip fractures (64%, injury to the head (48%, the thoracic spine (38%, lumbar spine (27%, and cervical spine (22%. Predominant fracture location was the manubrium sterni. In these locations, the observed mean ISS was the highest. They were strongly associated with thoracic spine and other chest injuries. Furthermore, the incidence of head injuries was significantly higher. ICU admission was significantly higher in patients with manubrium sterni fractures. Conclusion. Sternal fractures are frequently associated with other injuries. It appears that the fracture location can provide important information regarding concomitant injuries. In particular, in fractures of manubrium sterni, the need for further detailed clinical and radiologic workup is necessary to detect the frequently associated injuries and reduce the increased mortality.

Evaluation on vertebral endplate injury and adjacent intervertebral disk injury of patients with osteoporotic vertebral compression fractures by MRI and its clinical significance

International Nuclear Information System (INIS)

Shen Yu; Shen Huiliang; Fang Xiutong; Zhang Wenbo

2012-01-01

Objective: To investigate the relationship between vertebral endplate injury and adjacent intervertebral disk injury of patients with acute or sub-acute osteoporotic vertebral compression fractures (OVC-F) by MRI, and to provide basis for diagnosis of OVCF. Methods: The clinical data of a total of 66 patients with OVCF underwent vertebroplasty (76 fracture of vertebral bodies) were selected. The vertebral endplate injury and adjacent intervertebral disk injury of OVCF patients were detected by MRI. Results: There were 57 vertebral endplate injury in 76 fracture vertebral bodies (75% ). There were only 27 vertebral bodies with vertebral endplate injury in 57 fracture vertebral bodies with endplate injury (47% ), and 22 vertebral with superior and inferior vertebral endplate injury (39% ), and 8 vertebral bodies with inferior vertebral endplate injury (14% ). There were 48 vertebral bodies with intervertebral disc injury in 76 fracture vertebral bodies (63% ). There were 22 intervertebral disc injury located above the fracture of the lumbar spine in 48 vertebral bodies with intervertebral disc injury (45% ), and 19 fracture vertebral bodies with upper and lower intervertebral disc injury (40% ), and 7 intervertebral injuries located below the fracture of the lumbar spine (15% ). Conclusion: Vertebral endplate injury is frequently associated with the adjacent intervertebral disk injury. The clinical diagnosis and treatment should be emphasized in the fracture vertebral endplate damage and adjacent intervertebral disc injury. (authors)

Magnetic susceptibility artifacts in a diffuse brain injury and their pathological significance

International Nuclear Information System (INIS)

Taguchi, Yoshio; Miyakita, Yasuji; Matsuzawa, Motoshi; Sakakibara, Yohtaro; Takahara, Taro; Yamaguchi, Toshio

1998-01-01

In our study, FLAIR images and multishot echo planar imaging T2-weighted images (EPI T2-WI) were used in addition to conventional T1-weighted images, T2-weighted images and T2-weighted sagittal images. In this series we focused our attention on small parenchymatous lesions of a mild or moderate form of diffuse brain injury. These injuries are shown as high intensity areas on T2-weighted images (T2-high intensity lesions) but are not visualized in CT images. This series consisted of 29 patients who were diagnosed with diffuse brain injury and whose CT scans showed a Diffuse Injury I or II. Nineteen patients were studied in an acute or subacute stage. In all but 3 patients, small T2-high intensity lesions were found in the brain parenchyma. In the follow-up study brain edema was suggested because the lesions tended to be absent within 3 months in T2-weighted images and FLAIR. In 10 patients examined during a chronic stage. Small hemorrhages in patients with Diffuse Injury II were shown with variable intensities on the conventional T1- and T2-weighted images, but were visualized with low intensity in an EPI T2-WI. In diffuse brain injuries, small T2-high intensity lesions have been considered to be brain edema or ischemic insults. Our data however, suggested that microhemorrhages associated with brain edema were resent in most of the supratentorial lesions, and in more than a half of the lesions in the corpus callosum and the brain stem. These findings appear similar to contusions, which are defined as traumatic bruises of the neural parenchyma. The use of MRI has increased our understanding of in vivo pathological changes in mild or moderate forms of diffuse brain injury. (K.H.)

Injury rates of the German Women’s American Football National Team from 2009 to 2011

Directory of Open Access Journals (Sweden)

Marco Ezechieli

2012-09-01

Full Text Available American football is one of the leading causes of athletic-related injuries. Injury rates in female elite players are mostly unknown. We hypothesized that the injury rates of female was comparable to those in men’s football during practice, as well as games. From 2009 to 2011, injury data were collected from the German female national team during training camps, World Championship 2010 and International friendly matches. The injury was categorized by location on the body and recorded as fracture/dislocation, strain, concussion, contusion or other injury. Injury rates were determined based on the exposure of an athlete to a game or practice event. The injury rate was calculated as the ratio of injuries per 1000 athlete exposures (AE. The rate of injury was significantly higher during games (58.8/1000 AE than practices [16.3/1000 AE, (P<0.01]. Furthermore, the injury rate in the tryouts was significantly higher (24.05/1000 AE compared to other training sessions with the national team (11.24/1000 AE. Our findings show that the injury rates in female elite American football players can be compared to those described for male players. Higher injury rates during matches than in training should also be underlined.

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.

Muscle injury is the principal injury type and hamstring muscle injury is the first injury diagnosis during top-level international athletics championships between 2007 and 2015.

Science.gov (United States)

Edouard, Pascal; Branco, Pedro; Alonso, Juan-Manuel

2016-05-01

During top-level international athletics championships, muscle injuries are frequent. To analyse the incidence and characteristics of muscle injuries and hamstring muscle injuries (hamstring injuries) occurring during top-level international athletics championships. During 16 international championships held between 2007 and 2015, national medical team and local organising committee physicians reported daily all injuries on a standardised injury report form. Only muscle injuries (muscle tears and muscle cramps) and hamstring injuries have been analysed. 40.9% of all recorded injuries (n=720) were muscle injuries, with 57.5% of them resulting in time loss. The overall incidence of muscle injuries was higher in male athletes than female athletes (51.9±6.0 vs 30.3±5.0 injuries per 1000 registered athletes, respectively; RR=1.71; 95% CI 1.45 to 2.01). Muscle injuries mainly affected the thigh (52.9%) and lower leg (20.1%), and were mostly caused by overuse with sudden onset (38.2%) and non-contact trauma (24.6%). Muscle injury risk varied according to the event groups. Hamstring injuries represented 17.1% of all injuries, with a higher risk in male compared to female athletes (22.4±3.4 vs 11.5±2.6 injuries per 1000 registered athletes, respectively; RR=1.94; 95% CI 1.42 to 2.66). During international athletics championships, muscle injury is the principal type of injury, and among those, the hamstring is the most commonly affected, with a two times higher risk in male than female athletes. Athletes in explosive power events, male athletes and older male athletes, in specific were more at risk of muscle injuries and hamstring injuries. Injury prevention strategies should be sex-specific. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Epidemiology of occupational injury among cleaners in the healthcare sector.

Science.gov (United States)

Alamgir, Hasanat; Yu, Shicheng

2008-09-01

The cleaning profession has been associated with multiple ergonomic and chemical hazards which elevate the risk for occupational injury. This study investigated the epidemiology of occupational injury among cleaners in healthcare work settings in the Canadian province of British Columbia. Incidents of occupational injury among cleaners, resulting in lost time from work or medical care, over a period of 1 year in two healthcare regions were extracted from a standardized operational database and with person-years obtained from payroll data. Detailed analysis was conducted using Poisson regression modeling. A total of 145 injuries were identified among cleaners, with an annual incidence rate of 32.1 per 100 person-years. After adjustment for age, gender, subsector, facility, experience and employment status, Poisson regression models demonstrated that a significantly higher relative risk (RR) of all injury, musculoskeletal injury and cuts was associated with cleaning work in acute care facilities, compared with long-term care facilities. Female cleaners were at a higher RR of all injuries and contusions than male cleaners. A lower risk of all injury and allergy and irritation incidents among part-time or casual workers was found. Cleaners with >10 years of experience were at significantly lower risk for all injury, contusion and allergy and irritation incidents. Cleaners were found to be at an elevated risk of all injury categories compared with healthcare workers in general.

Analysis of fall injuries by body mass index.

Science.gov (United States)

Ren, Jun; Waclawczyk, Amanda; Hartfield, Doug; Yu, Shicheng; Kuang, Xiangyu; Zhang, Hongrui; Alamgir, Hasanat

2014-05-01

To examine the association of body mass index (BMI) and fall injuries. Data were derived from the 2010 Behavioral Risk Factor Surveillance System and included subjects aged 45 years and older from Texas. The outcome was self-reported falls that resulted in injury to the respondents. Analysis of fall injuries by BMI was conducted and standard errors, 95% confidence intervals (CIs), and coefficients of variation were reported. Complex sample multivariate Poisson regression was used to examine the association of BMI and fall injuries. A total of 18,077 subjects were surveyed in 2010, and 13,235 subjects were aged 45 years old and older. The mean BMI was higher (29.94 vs 28.32 kg/m(2)) among those who reported fall injuries compared with those who did not. The fall injuries reported by obese respondents (relative risk [RR] 1.67) were found to be significantly (P = 0.031) higher compared with normal-weight respondents in the multivariate regression. Other risk factors that had significant association with fall injuries (when adjusted for BMI) were activity limitations (RR 5.00, 95% CI 3.36-7.46) compared with no limitations, and not having formal employment (homemaker: RR 2.68, 95% CI 1.33-5.37; unable to work: RR 5.01, 95% CI 1.87-13.29; out of work and students: RR 3.21, 95% CI 1.41-7.29) compared with the employed population. There is a significant association between obesity and fall injuries in adults aged 45 years old and older in Texas. Interventions in fall prevention, although generally targeted at present to older adults, also should take into account the weight status of the subjects.

Medial joint line bone bruising at MRI complicating acute ankle inversion injury: What is its clinical significance?

International Nuclear Information System (INIS)

Chan, V.O.; Moran, D.E.; Shine, S.; Eustace, S.J.

2013-01-01

Aim: To assess the incidence and clinical significance of medial joint line bone bruising following acute ankle inversion injury. Materials and methods: Forty-five patients who underwent ankle magnetic resonance imaging (MRI) within 2 weeks of acute ankle inversion injury were included in this prospective study. Integrity of the lateral collateral ligament complex, presence of medial joint line bone bruising, tibio-talar joint effusion, and soft-tissue swelling were documented. Clinical follow-up at 6 months was carried out to determine the impact of injury on length of time out of work, delay in return to normal walking, delay in return to sports activity, and persistence of medial joint line pain. Results: Thirty-seven patients had tears of the anterior talofibular ligament (ATFL). Twenty-six patients had medial joint line bone bruising with altered marrow signal at the medial aspect of the talus and congruent surface of the medial malleolus. A complete ATFL tear was seen in 92% of the patients with medial joint line bone bruising (p = 0.05). Patients with an ATFL tear and medial joint line bone bruising had a longer delay in return to normal walking (p = 0.0002), longer delay in return to sports activity (p = 0.0001), and persistent medial joint line pain (p = 0.0003). There was no statistically significant difference in outcome for the eight patients without ATFL tears. Conclusion: Medial joint line bone bruising following an acute ankle inversion injury was significantly associated with a complete ATFL tear, longer delay in the return to normal walking and sports activity, as well as persistent medial joint line pain. Its presence should prompt detailed assessment of the lateral collateral ligament complex, particularly the ATFL

A prospective study of downhill mountain biking injuries.

Science.gov (United States)

Becker, Johannes; Runer, Armin; Neunhäuserer, Daniel; Frick, Nora; Resch, Herbert; Moroder, Philipp

2013-05-01

Downhill mountain biking (DMB) has become an increasingly popular extreme sport in the last few years with high velocities and bold manoeuvres. The goal of this study was to provide information on the pattern and causes of injuries in order to provide starting points for injury prevention measures. We performed a monthly e-mail-based prospective survey of 249 riders over one summer season ranging from April until September 2011. A total of 494 injuries occurred during the 29 401 h of downhill exposure recorded, of these 65% were mild, 22% moderate and 13% severe, of which 41% led to a total restriction greater than 28 days. The calculated overall injury rate was 16.8 injuries per 1000 h of exposure. For experts it was 17.9 injuries per 1000 h of exposure, which is significantly higher than the 13.4 for professional riders (OR 1.34; 95% CI, 1.02 to 1.75; p=0.03). A significantly higher rate of injury was reported during competition (20 per 1000 h) than during practice (13 per 1000 h) (OR 1.53; 95% CI, 1.16 to 2.01; p=0.0022). The most commonly injured body site was the lower leg (27%) followed by the forearm (25%). Most frequent injury types were abrasions (64%) and contusions (56%). Main causes of injury reported by the riders were riding errors (72%) and bad trail conditions (31%). According to our data DMB can be considered an extreme sport conveying a high risk of serious injury. Strategies of injury prevention should focus on improvements in riders' technique, checking of local trail conditions and protective equipment design.

A prospective epidemiological study of injuries in four English professional football clubs.

Science.gov (United States)

Hawkins, R D; Fuller, C W

1999-06-01

To define the causes of injuries to players in English professional football during competition and training. Lost time injuries to professional and youth players were prospectively recorded by physiotherapists at four English League clubs over the period 1994 to 1997. Data recorded included information related to the injury, date and place of occurrence, type of activity, and extrinsic Playing factors. In all, 67% of all injuries occurred during competition. The overall injury frequency rate (IFR) was 8.5 injuries/1000 hours, with the IFR during competitions (27.7) being significantly (p IFRs for youth players were found to increase over the second half of the season, whereas they decreased for professional players. There were no significant differences in IFRs for professional and youth players during training. There were significantly (p 41%), sprains (20%), and contusions (20%) represented the major types of injury. The thigh (23%), the ankle (17%), knee (14%), and lower leg (13%) represented the major locations of injury, with significantly (p 41% of all injuries. The overall level of injury to professional footballers has been showed to be around 1000 times higher times higher than for industrial occupations generally regarded as high risk. The high level of muscle strains, in particular, indicates possible weakness in fitness training programmes and use of warming up and cooling down procedures by clubs and the need for benchmarking players' levels of fitness and performance. Increasing levels of injury to youth players as a season progresses emphasizes the importance of controlling the exposure of young players to high levels of competition.

[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.

Frequency of injuries, in particular dental injuries, in ski jumping and Nordic combined.

Science.gov (United States)

Stillhard, Angela; Buschor, Cornel; Krastl, Gabriel; Kühl, Sebastian; Filippi, Andreas

This study investigates the frequency of injuries, in particular dental injuries, among ski jumpers and Nordic combined athletes. It also examines the level of knowledge regarding tooth protection and tooth rescue boxes in this population. Of the 465 sportswomen and sportsmen who took part in the study, 230 (62.5%) of the 368 ski jumpers and 56 (56.5%) of the 97 Nordic combined athletes had sustained an injury. In both disciplines injury was most likely among professionals. The survey participants reported injuries to the limbs (n = 216), head and lips (n = 273 and n = 253, respectively), torso or spine (n = 249), teeth (n = 246), nose (n = 229) and jaw (n = 26). Dental injuries were more common among professionals than either amateur or junior ski jumpers, whereas, among the Nordic combined athletes, juniors were most likely to sustain a dental injury. Overall, the frequency of dental injury was significantly (p = 0.019) higher among adults 12.7% (n = 234) than junior athletes 6.1% (n = 212). The level of awareness of mouthguards and tooth rescue boxes varied between countries. The high injury rate recorded in this study demonstrates that ski jumping contains a considerable risk of injury, including tooth damage. Consequently, it seems reasonable to inform skiing organisations, trainers and athletes about the potential benefits of mouthguards and tooth rescue boxes in order to reduce the risk of dental injury.

Incidence and injury characteristics of traumatic brain injury: Comparison between children, adults and seniors in Israel.

Science.gov (United States)

Siman-Tov, Maya; Radomislensky, Irina; Knoller, Nachshon; Bahouth, Hany; Kessel, Boris; Klein, Yoram; Michaelson, Moshe; Avraham Rivkind, Bala Miklosh; Shaked, Gad; Simon, Daniel; Soffer, Dror; Stein, Michael; Jeroukhimov, Igor; Peleg, Kobi

2016-01-01

To assess the incidence and injury characteristics of hospitalized trauma patients diagnosed with TBI. A retrospective study of all injured hospitalized patients recorded in the National Trauma Registry at 19 trauma centres in Israel between 2002-2011. Incidence and injury characteristics were examined among children, adults and seniors. The annual incidence rate of hospitalized TBI for the Israeli population in 2011 was 31.8/100,000. Age-specific incidence was highest among seniors with a dramatic decrease in TBI-related mortality rate among them. Adults, in comparison to children and seniors, had higher rates of severe TBI, severe and critical injuries, more admission to the intensive care unit, underwent surgery, were hospitalization for more than 2 weeks and were discharged to rehabilitation. After adjusting for age, gender, ethnicity, mechanism of injury and injury severity score, TBI-related in-hospital mortality was higher among seniors and adults compared to children. Seniors are at high risk for TBI-related in-hospital mortality, although adults had more severe and critical injuries and utilized more hospital resources. However, seniors showed the most significant reduction in mortality rate during the study period. Appropriate intervention programmes should be designed and implemented, targeted to reduce TBI among high risk groups.

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

Psychological injury in victims of child sexual abuse: A meta-analytic review

Directory of Open Access Journals (Sweden)

Bárbara G. Amado

2015-04-01

Full Text Available In order to assess the effects of child/adolescent sexual abuse (CSA/ASA on the victim's probability of developingsymptoms of depression and anxiety, to quantify injury in populational terms, to establish theprobability of injury, and to determine the different effects of moderators on the severity of injury, a meta-analysis was performed. Given the abundant literature, only studies indexed in the scientific databaseof reference, the Web of Science, were selected. A total of 78 studies met the inclusion criteria: they measuredCSA/ASA victimization or injury in terms of depression or anxiety symptoms, measured the effectsize or included data for computing them, and provided a description of the sample. The results showedthat CSA/ASA victims suffered significant injury, generally of a medium effect size and generalizable, victimshad 70% more probabilities of suffering from injury, and clinical diagnosis was significantly a moreadequate measure of injury than symptoms. The probability of chronic injury (dysthymia was greaterthan developing more severe injury, i.e., major depressive disorder (MDD. In the category of anxiety disorders,injury was expressed with a higher probability in specific phobia. In terms of the victim's gender,females had significantly higher rates of developing a depressive disorder (DD and/or an anxiety disorder(AD, quantified in a 42% and 24% over the baseline, for a DD and AD respectively. As for the type of abuse,the meta-analysis revealed that abuse involving penetration was linked to severe injury, whereas abusewith no contact was associated to less serious injury. The clinical, social, and legal implications of the resultsare discussed.

[Skiing and snowboarding trauma in children: epidemiology, physiopathology, prevention and main injuries].

Science.gov (United States)

Dohin, B; Kohler, R

2008-11-01

Skiing and snowboarding are leading to a risk of injuries in children. Beginners and experienced have higher risk of injuries, however, the first have less severe injuries than the latest. Risk factors of injury are: ability and experience, binding adjustment, slope characteristics, speed, collisions with objects or jumping and risky behavior of the young skiers and snowboarders. Lower limb injuries are most common in skier, especially knee sprains, conversely snowboarders present more upper limb injuries, especially wrist fractures. The frequency of head injuries does not decrease while helmet use increases but severity decreases. Despite prevention and wearing protections, the frequency of trauma does not decrease significantly, which could be in relation with higher speed and increased risky behavior. Main prevention factors are safety knowledge and safety behavior, correct binding adjustment, and use of protections.

Traumatic brain injuries in the construction industry.

Science.gov (United States)

Colantonio, Angela; McVittie, Doug; Lewko, John; Yin, Junlang

2009-10-01

This study analyses factors associated with work-related traumatic brain injury (TBI), specifically in the construction industry in Ontario, Canada. This cross-sectional study utilized data extracted from the Ontario Workplace Safety and Insurance Board (WSIB) records indicating concussion/intracranial injury that resulted in days off work in 2004-2005. Analyses of 218 TBI cases revealed that falls were the most common cause of injury, followed by being struck by or against an object. Mechanisms of injury and the temporal profile of injury also varied by age. For instance, a significantly higher proportion of injuries occurred in the mornings for young workers compared to older workers. The results of this study provide important information for prevention of TBI which suggest important age-specific strategies for workers in the construction industry.

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.

Diaphragm electromyographic activity following unilateral midcervical contusion injury in rats

Science.gov (United States)

Sieck, Gary C.

2016-01-01

Contusion-type injuries to the spinal cord are characterized by tissue loss and disruption of spinal pathways. Midcervical spinal cord injuries impair the function of respiratory muscles and may contribute to significant respiratory complications. This study systematically assessed the impact of a 100-kDy unilateral C4 contusion injury on diaphragm muscle activity across a range of motor behaviors in rats. Chronic diaphragm electromyography (EMG) was recorded before injury and at 1 and 7 days postinjury (DPI). Histological analyses assessed the extent of perineuronal net formation, white-matter sparing, and phrenic motoneuron loss. At 7 DPI, ∼45% of phrenic motoneurons were lost ipsilaterally. Relative diaphragm root mean square (RMS) EMG activity increased bilaterally across a range of motor behaviors by 7 DPI. The increase in diaphragm RMS EMG activity was associated with an increase in neural drive (RMS value at 75 ms after the onset of diaphragm activity) and was more pronounced during higher force, nonventilatory motor behaviors. Animals in the contusion group displayed a transient decrease in respiratory rate and an increase in burst duration at 1 DPI. By 7 days, following midcervical contusion, there was significant perineuronal net formation and white-matter loss that spanned 1 mm around the injury epicenter. Taken together, these findings are consistent with increased recruitment of remaining motor units, including more fatigable, high-threshold motor units, during higher force, nonventilatory behaviors. Changes in diaphragm EMG activity following midcervical contusion injury reflect complex adaptations in neuromotor control that may increase the risk of motor-unit fatigue and compromise the ability to sustain higher force diaphragm efforts. NEW & NOTEWORTHY The present study shows that unilateral contusion injury at C4 results in substantial loss of phrenic motoneurons but increased diaphragm muscle activity across a range of ventilatory and higher

Railway train versus motor vehicle collisions: a comparative study of injury severity and patterns.

Science.gov (United States)

Kligman, M D; Knotts, F B; Buderer, N M; Kerwin, A J; Rodgers, J F

1999-11-01

This study compares the demographics, injury severity, resource use, and injury patterns of patients involved in railway train-motor vehicle (RT-MV) to motor vehicle-motor vehicle (MV-MV) collisions. Retrospective trauma registry review of 74 RT-MV and 1,931 MV-MV consecutive patients, age more than 14 years, presenting to two Level I trauma centers, January of 1991 to May of 1998. Compared with MV-MV, RT-MV had significantly more males (72% vs. 54%), higher mortality (15% vs. 7%), higher Injury Severity Score (median, 20 vs. 9), longer intensive care unit length of stay (1.7 vs. 0.04 days), and longer hospital length of stay (7.5 vs. 4 days). RT-MV patients had a higher percentage of scalp/facial lacerations; intracranial hemorrhage; hemothorax and pneumothorax; fractures of the rib/sternum, upper extremity, skull, and face; and lung, splenic, and renal injuries. After adjusting for the difference in Injury Severity Score between groups, the only remaining significant group difference was the odds of a scalp/facial laceration. RT-MV collisions are a marker for more severe injuries, but not a different pattern of injury, compared with MV-MV collisions.

[Temporal and spacial expression of perlecan in dental pulp after injury].

Science.gov (United States)

Li, Qiao; Sun, Hong; Pan, Yi-huai; Liu, Chuan-tong

2014-02-01

To investigate the temporal and special expressions and functions of perlecan in dental pulp of rats after injury. Specimens of one side of maxillary molars of 24 male SD rats were collected 1,3,5,7 days after injury, and the other side were used as controls. The specimens were decalcified and embedded in paraffin, sliced by longitudinal section and stained by immunohistochemistry. The staining of perlecan and β1 integrin were examined, and the average optical density (AOD) was compared. The measurement data were analyzed by ANOVA using SPSS 19.0 software package. The staining intensity of perlecan in dental pulp in the experimental group was significantly higher compared with that of the control group. The immunolocalization of perlecan in dental pulp was gradually progressed as the inflamed tissue was progressing after injury, and its AOD was significantly higher than that of control group (F=11.104,P>0.05), especially in the group of 1 d. The staining of β1 integrin was generally enhanced in the pulp 3 d after injury, and its AOD was significantly higher than that of control group (F=124.18,P>0.05). Perlecan may play an important role in tissue defense mechanism after injury through regulating angiogenesis and inflammatory cell infiltration. Supported by Science and Technology Research Project of Department of Education of Zhejiang Province (20051196) and Wenzhou City (Y20100015).

Current pregnancy among women with spinal cord injury: findings from the US national spinal cord injury database.

Science.gov (United States)

Iezzoni, L I; Chen, Y; McLain, A B J

2015-11-01

Cross-sectional study. To examine the prevalence of pregnancy and associations with sociodemographic and clinical factors among women with spinal cord injury (SCI). US National Spinal Cord Injury Database, an SCI registry that interviews participants 1, 5 and then every 5 years post injury. Data include SCI clinical details, functional impairments, participation measures, depressive symptoms and life satisfaction. Women aged 18-49 are asked about hospitalizations in the last year relating to pregnancy or its complications. Data represent 1907 women, who completed 3054 interviews. We used generalized estimating equations to examine bivariable associations between pregnancy and clinical and psychosocial variables and to perform multivariable regressions predicting pregnancy. Across all women, 2.0% reported pregnancy during the prior 12 months. This annual prevalence differed significantly by the years elapsed since injury; the highest rate occurred 15 years post injury (3.7%). Bivariable analyses found that younger age at injury was significantly associated with current pregnancy (Ppregnancy were significantly more likely to be married or partnered, have sport-related SCI, have higher motor scores and have more positive psychosocial status scores. Multivariable analyses found significant associations between current pregnancy and age, marital status, motor score and mobility and occupation scale scores. Current pregnancy rates among reproductive-aged women with SCI are similar to rates of other US women with chronic mobility impairments. More information is needed about pregnancy experiences and outcomes to inform both women with SCI seeking childbearing and clinicians providing their care.

Effects of the new karate rules on the incidence and distribution of injuries.

Science.gov (United States)

Macan, J; Bundalo-Vrbanac, D; Romić, G

2006-04-01

To evaluate the incidence and distribution of injuries in karate before and after the implementation of new rules established by the World Karate Federation in 2000. Injury incidence was followed up during the official karate competition seasons of 1997 and 2002 in Croatia. A questionnaire was used to collect data on the age and sex of the competitor and localisation and severity of injury. Data were analysed separately for female and male competitors and age categories or = 18 years. A total of 2023.5 and 2584 minutes of active fighting (exposure time) was assessed for 1997 and 2002 respectively. The overall injury incidence rate (IR) was similar in 1997 and 2002 (10.28 and 9.82/100 exposure minutes respectively). The relative risk (RR) of injury was significantly higher in 1997 than in 2002 for competitors younger than 18 years (RR 1.55, 95% confidence interval (CI) 1.11 to 2.16). The overall RR of head injury was significantly higher in 1997 than in 2002 (RR 1.96, 95% CI 1.54 to 2.49), but the RR of leg injury was significantly lower in 1997 than in 2002 (RR 0.16, 95% CI 0.09 to 0.28). Most injuries (> 98%) were categorised as mild (grade 1) in both periods studied. The results of this study confirm the importance of the new competition rules in the distribution and prevention of injuries in martial arts. Strict judging and heavy penalties for uncontrolled blows, particularly for the youngest competitors, can significantly decrease the risk of 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...

Sex-specific differences in injury types among basketball players.

Science.gov (United States)

Ito, Eri; Iwamoto, Jun; Azuma, Koichiro; Matsumoto, Hideo

2015-01-01

The purpose of the present study was to investigate sex-specific differences in injury types among basketball players. According to our database, during the 20-year period between October 1991 and June 2011, 1,219 basketball players (640 males and 579 females) consulted our sports medicine clinic; in total, 1,414 injuries in basketball players (729 injuries in males and 685 injuries in females) were recorded. The mean age of patients was 19.6 years. The most common injury site was the knee, followed by the foot and ankle, lower back, and upper extremities. There was a higher proportion of female players presenting with a knee injury, compared with male players (50.4% vs 41.7%), and a lower proportion of female players presenting with an upper extremity injury (5.1% vs 9.7%). The proportion of anterior cruciate ligament injury in the 10-19-year-old age group was higher among female players than among male players (45.9% vs 22.1%), while the proportions of Osgood-Schlatter disease in the 10-19-year-old age group and jumper's knee (patellar and femoral tendinopathy) in the 20-29-year-old age group were higher among male players than among female players (12.5% vs 1.8% and 14.6% vs 3.7%, respectively). However, the proportions of other injuries did not differ significantly between male and female players. The present observational study, which was performed using a retrospective case-series design, showed the existence of sex-specific differences in knee injuries sustained while participating in basketball.

Temporomandibular disorders after whiplash injury

DEFF Research Database (Denmark)

Kasch, Helge; Hjorth, Tine; Svensson, Peter

2002-01-01

Aims: Whiplash injury to the neck, is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies however have examined TMD-related pain in acute whiplash...... patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Methods: Prospectively, 19 acute whiplash patients exposed...... obtained at each visit. Results: One whiplash patient and I ankle-injury patient bad jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ...

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.

Synergistic impact of acute kidney injury and high level of cervical spinal cord injury on the weaning outcome of patients with acute traumatic cervical spinal cord injury.

Science.gov (United States)

Yu, Wen-Kuang; Ko, Hsin-Kuo; Ho, Li-Ing; Wang, Jia-Horng; Kou, Yu Ru

2015-07-01

Respiratory neuromuscular impairment severity is known to predict weaning outcome among patients with cervical spinal cord injury; however, the impact of non-neuromuscular complications remains unexplored. This study was to evaluate possible neuromuscular and non-neuromuscular factors that may negatively impact weaning outcome. From September 2002 to October 2012, acute traumatic cervical spinal cord injury patients who had received mechanical ventilation for >48h were enrolled and divided into successful (n=54) and unsuccessful weaning groups (n=19). Various neuromuscular, non-neuromuscular factors and events during the intensive care unit stay were extracted from medical charts and electronic medical records. Variables presenting with a significant difference (pspinal cord injury (C1-3), lower pulse rates, and lower Glasgow Coma Scale score on admission, higher peak blood urea nitrogen, lower trough albumin, and lower trough blood leukocyte counts. Furthermore, unsuccessful weaning patients had a higher incidence of pneumonia, acute respiratory distress syndrome, shock and acute kidney injury during the intensive care unit stay. Multivariate logistic regression analysis revealed acute kidney injury and high level of cervical spinal cord injury were independent risk factors for failure of weaning. Importantly, patients with both risk factors showed a large increase in odds ratio for unsuccessful weaning from mechanical ventilation (pinjury during the intensive care unit stay and high level of cervical spinal injury are two independent risk factors that synergistically work together producing a negative impact on weaning outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

Child Injury: Does home matter?

Directory of Open Access Journals (Sweden)

Cate Cameron

2017-04-01

Through the use of comprehensive linkage of five years of state-wide administrative health data, combined with individual survey data methods, this study overcame the most significant threat to longitudinal research – loss to follow-up. Our results demonstrated that children in socio-economically deprived families have higher rates of injury, despite living in a physical environment that contains substantially fewer injury risks than their less deprived counterparts. These findings support continued efforts to implement societal-wide, long term policy and practice changes to address the socioeconomic differentials in child health outcomes.

Risk factors in iatrogenic spinal cord injury.

Science.gov (United States)

Montalva-Iborra, A; Alcanyis-Alberola, M; Grao-Castellote, C; Torralba-Collados, F; Giner-Pascual, M

2017-09-01

In the last years, there has been a change in the aetiology of spinal cord injury. There has been an increase in the number of elderly patients with spinal cord injuries caused by diseases or medical procedures. The aim of this study is to investigate the frequency of the occurrence of iatrogenic spinal cord injury in our unit. The secondary aim is to study what variables can be associated with a higher risk of iatrogenesis. A retrospective, descriptive, observational study of patients with acute spinal cord injury admitted from June 2009 to May 2014 was conducted. The information collected included the patient age, aetiology, neurological level and grade of injury when admitted and when discharged, cardiovascular risk factors, a previous history of depression and any prior treatment with anticoagulant or antiplatelet drugs. We applied a logistic regression. The grade of statistical significance was established as Pinjury was the thoracic level (48%). The main aetiology of spinal cord injury caused by iatrogenesis was surgery for degenerative spine disease, in patients under the age of 30 were treated with intrathecal chemotherapy. Iatrogenic spinal cord injury is a frequent complication. A statistically significant association between a patient history of depression and iatrogenic spinal cord injury was found as well as with anticoagulant and antiplatelet drug use prior to iatrogenic spinal cord injury.

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.

Respiratory Syncytial Virus Aggravates Renal Injury through Cytokines and Direct Renal Injury

Directory of Open Access Journals (Sweden)

Songhui Zhai

2016-09-01

Full Text Available The purpose of this study was to investigate the relationship between renal injury and reinfection that is caused by respiratory syncytial virus (RSV and to analyze the mechanism of renal injury. Rats were repeatedly infected with RSV on days 4, 8, 14, and 28, then sacrificed and examined on day 56 after the primary infection. Renal injury was examined by transmission electron microscopy and histopathology. The F protein of RSV was detected in the renal tissue by indirect immunofluorescence. Proteinuria and urinary glycosaminoglycans (GAGs, serum levels of albumin, urea nitrogen, and creatinine, secretion of cytokines, T lymphocyte population and subsets, and dendritic cell (DC activation state were examined. The results showed that renal injury was more serious in the reinfection group than in the primary infection group. At a higher infection dose, 6×106 PFU, the renal injury was more severe, accompanied by higher levels of proteinuria and urinary GAGs excretion, and lower levels of serum albumin. Podocyte foot effacement was more extensive, and hyperplasia of mesangial cells and proliferation of mesangial matrix were observed. The maturation state of DCs was specific, compared with the primary infection. There was also a decrease in the ratio of CD4+ to CD8+T lymphocytes, due to an increase in the percentage of CD8+T lymphocytes and a decrease in the percentage of CD4+T lymphocytes, and a dramatic increase in the levels of IL-6 and IL-17. In terms of the different reinfection times, the day 14 reinfection group yielded the most serious renal injury and the most significant change in immune function. RSV F protein was still expressed in the glomeruli 56 days after RSV infection. Altogether, these results reveal that RSV infection could aggravate renal injury, which might be due to direct renal injury caused by RSV and the inflammatory lesions caused by the anti-virus response induced by RSV.

High velocity missile-related colorectal injuries: In-theatre application of injury scores and their effects on ostomy rates.

Science.gov (United States)

Kaymak, Şahin; Ünlü, Aytekin; Harlak, Ali; Ersöz, Nail; Şenocak, Rahman; Coşkun, Ali Kağan; Zeybek, Nazif; Lapsekili, Emin; Kozak, Orhan

2016-03-01

Treatment of colorectal injuries (CRIs) remains a significant cause of morbidity and mortality. The aim of the present study was to analyze treatment trends of Turkish surgeons and effects of the American Association for the Surgery of Trauma (AAST), Injury Severity (ISS), and Penetrating Abdominal Trauma Index (PATI) scoring systems on decision-making processes and clinical outcomes. Data regarding high velocity missile (HVM)-related CRIs were retrospectively gathered. Four patient groups were included: Group 1 (stoma), Group 2 (no stoma in primary surgery), Group 2a (conversion to stoma in secondary surgery), and Group 2b (remaining Group 2 patients). Groups 1, 2, 2a, and 2b included 39 (66%), 20 (34%), 6 (30%), and 14 (70%) casualties, respectively. Ostomies were performed in casualties with significantly higher AAST scores (pcolon/rectum injury scores.

Descriptive Epidemiology of Musculoskeletal Injuries and Concussions in the National Football League, 2012-2014

Science.gov (United States)

Lawrence, David W.; Hutchison, Michael G.; Comper, Paul

2015-01-01

Background: The risk of all-cause injury and concussion associated with football is significant. The National Football League (NFL) has implemented changes to increase player safety warranting investigation into the incidence and patterns of injury. Purpose: To document the incidence and patterns of all-cause injury and concussions in the NFL. Study Design: Descriptive epidemiology study. Methods: Injury data were collected prospectively from official NFL injury reports over 2 regular seasons from 2012 to 2014, with identification of injury incidence rates and patterns. Concussion rate ratios were calculated using previously reported NFL rates. Results: A total of 4284 injuries were identified, including 301 concussions. The all-cause injury rate was 395.8 per 1000 athletes at risk (AAR) and concussion incidence was 27.8 per 1000 AAR. Only 2.3% of team games were injury free. Wide receivers, tight ends, and defensive backs had the highest incidence of injury and concussion. Concussion incidence was 1.61-fold higher in 2012 to 2014 compared with 2002 to 2007. The knee was injured most frequently, followed by the ankle, hamstring, shoulder, and head. Conclusion: The incidence of all-cause injury and concussion in the NFL is significant. Concussion injury rates are higher than previous reports, potentially reflecting an improvement in recognition and awareness. Injury prevention efforts should continue to reduce the prevalence of injury associated with football. PMID:26675321

Boarding Injuries: The Long and the Short of It

Directory of Open Access Journals (Sweden)

Leslie A. Fabian

2014-01-01

Full Text Available As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU length of stay (LOS, Injury Severity Score (ISS, patient treatment options, disposition, and outcome were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI, and intracranial hemorrhage (ICH were significantly more common among longboard patients than skateboarders (P<0.0001. All patients with an ISS above 15 were longboarders. Hospital and ICU LOS in days was also significantly greater for longboarders compared with skateboarders (P<0.0001. Of the three patients that died, each was a longboarder and each experienced a head injury. Longboard injuries account for a higher incidence rate of severe head injuries compared to skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population.

Penetrating Brain Injury after Suicide Attempt with Speargun

Directory of Open Access Journals (Sweden)

John Ross Williams

2014-07-01

Full Text Available Penetrating cranial injury by mechanisms other than are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here we present a case of penetrating brain injury by the low velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of lower-velocity penetrating brain injury (LVPBI, including benefit in delaying foreign body removal to allow for tamponade; the importance of history taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using DECT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher velocity forms of intracranial injury.

Sex-specific differences in injury types among basketball players

Directory of Open Access Journals (Sweden)

Ito E

2014-12-01

Full Text Available Eri Ito, Jun Iwamoto, Koichiro Azuma, Hideo MatsumotoInstitute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, JapanAbstract: The purpose of the present study was to investigate sex-specific differences in injury types among basketball players. According to our database, during the 20-year period between October 1991 and June 2011, 1,219 basketball players (640 males and 579 females consulted our sports medicine clinic; in total, 1,414 injuries in basketball players (729 injuries in males and 685 injuries in females were recorded. The mean age of patients was 19.6 years. The most common injury site was the knee, followed by the foot and ankle, lower back, and upper extremities. There was a higher proportion of female players presenting with a knee injury, compared with male players (50.4% vs 41.7%, and a lower proportion of female players presenting with an upper extremity injury (5.1% vs 9.7%. The proportion of anterior cruciate ligament injury in the 10–19-year-old age group was higher among female players than among male players (45.9% vs 22.1%, while the proportions of Osgood–Schlatter disease in the 10–19-year-old age group and jumper's knee (patellar and femoral tendinopathy in the 20–29-year-old age group were higher among male players than among female players (12.5% vs 1.8% and 14.6% vs 3.7%, respectively. However, the proportions of other injuries did not differ significantly between male and female players. The present observational study, which was performed using a retrospective case-series design, showed the existence of sex-specific differences in knee injuries sustained while participating in basketball.Keywords: sports injury, sex, anterior cruciate ligament injury, Osgood–Schlatter disease, basketball

TAEKWONDO TECHNIQUES AND COMPETITION CHARACTERISTICS INVOLVED IN TIME-LOSS INJURIES

Directory of Open Access Journals (Sweden)

Konstantinos Beis

2007-10-01

Full Text Available The purpose of this study was to assess time-loss injuries in young and adult taekwondo athletes. Participants were 2739 children (11-13 years, Junior (14-17 years and adult males and females (18 years and older competing in the national Greek championships. Injury data were collected by project staff with all diagnoses made by the tournament physician. Odds ratios were computed as well as 95% confidence intervals around the injury rates. The female Juniors had a higher time-loss injury rate (Fisher's Exact Test p = 0.033 than their adult counterparts. However, they were not at a higher risk of incurring a time-loss injury: OR = 0.143, 95% CI: 0.018-1.124. Collapsed over age, the females as a group recorded more time-loss injuries [11.36/1,000 A-E (95% CI: 6.25-16.47 versus 7.40/1,000 A-E (95% CI: 4.44-10.36], but this was not significant (OR = 0.703, 95% CI: 0.383-1.293. In the Juniors, the boys only incurred time-loss injuries to the head and neck. There was no difference in the Junior girls in the distribution of time-loss injuries across body region, although they were at higher risk of sustaining an injury to the head and neck (OR = 1.510, 95% CI: 0.422-5.402 but this was not statistically significant. Although there were no statistical differences among age groups within gender, the Junior boys and girls (11-13 years sustained more cerebral concussions. The Junior boys were at a higher risk of incurring a cerebral concussion than the boys (OR = 7.871, 95% CI: 0.917-67.583, Fisher's Exact Test p = 0.036. In the males, there was no difference between the men and Junior boys in injury rate for swing kicks compared to other techniques (OR = 2.000, 95% CI = 0.397-28.416. There also was no difference between the men and boys (OR = 4.800, 95% CI: 0.141-58.013. To help reduce the incidence of time-loss injuries in taekwondo, especially cerebral concussions, it is suggested for coaches to emphasize blocking skills. Educating referees, coaches and

Injury-related hospital admissions of military dependents compared with similarly aged nonmilitary insured infants, children, and adolescents.

Science.gov (United States)

Pressley, Joyce C; Dawson, Patrick; Carpenter, Dustin J

2012-10-01

Military deployment of one or both parents is associated with declines in school performance, behavioral difficulties, and increases in reported mental health conditions, but less is known regarding injury risks in pediatric military dependents. Kid Health Care Cost and Utilization Project 2006 (KID) was used to identify military dependents aged 0.1 year to 17 years through expected insurance payer being CHAMPUS, Tricare, or CHAMPVA (n = 12,310) and similarly aged privately insured nonmilitary in CHAMPUS, Tricare, or CHAMPVA states (n = 730,065). Mental health diagnoses per 1,000 hospitalizations and mechanisms of injury per 1,000 injury-related hospitalizations are reported. Unweighted univariate analyses used Fisher's exact, χ(2), and analysis of variance tests for significance. Odds ratios are age and sex adjusted with 95% confidence intervals. Injury-related admissions were higher in military than in nonmilitary dependents (15.5% vs. 13.2%, p sex-adjusted motor vehicle occupant and pedestrian injuries were significantly lower in all-age military dependents but not in age-stratified categories. Very young military dependents had higher all-cause injury admissions (p < 0.0001), drowning/near drowning (p < 0.0001), and intracranial injury (p < 0.0001) and showed a tendency toward higher suffocation (p = 0.055) and crushing injury (p = 0.065). Military adolescents and teenagers had higher suicide/suicide attempts (p = 0.0001) and poisonings from medicinal substances (p = 0.0001). Mental health diagnoses were significantly higher in every age category of military dependents. All-cause in-hospital mortality tended to be greater in military than in nonmilitary dependents (p = 0.052). This study suggests that military dependents are a vulnerable population with special needs and provides clues to areas where injury prevention professionals might begin to address their needs. Prognostic/epidemiologic study, level II.

Time to significant pain reduction following DETP application vs placebo for acute soft tissue injuries.

Science.gov (United States)

Yanchick, J; Magelli, M; Bodie, J; Sjogren, J; Rovati, S

2010-08-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) provide fast and effective acute pain relief, but systemic administration has increased risk for some adverse reactions. The diclofenac epolamine 1.3% topical patch (DETP) is a topical NSAID with demonstrated safety and efficacy in treatment of acute pain from minor soft tissue injuries. Significant pain reduction has been observed in clinical trials within several hours following DETP application, suggesting rapid pain relief; however, this has not been extensively studied for topical NSAIDs in general. This retrospective post-hoc analysis examined time to onset of significant pain reduction after DETP application compared to a placebo patch for patients with mild-to-moderate acute ankle sprain, evaluating the primary efficacy endpoint from two nearly identical studies. Data from two double-blind, randomized, parallel-group, placebo-controlled studies (N = 274) of safety and efficacy of the DETP applied once daily for 7 days for acute ankle sprain were evaluated post-hoc using statistical modeling to estimate time to onset of significant pain reduction following DETP application. Pain on active movement on a 100 mm Visual Analog Scale (VAS) recorded in patient diaries; physician- and patient-assessed tolerability; and adverse events. DETP treatment resulted in significant pain reduction within approximately 3 hours compared to placebo. Within-treatment post-hoc analysis based on a statistical model suggested significant pain reduction occurred as early as 1.27 hours for the DETP group. The study may have been limited by the retrospective nature of the analyses. In both studies, the DETP was well tolerated with few adverse events, limited primarily to application site skin reactions. The DETP is an effective treatment for acute minor soft tissue injury, providing pain relief as rapidly as 1.27 hours post-treatment. Statistical modeling may be useful in estimating time to onset of pain relief for comparison of topical

Paediatric ride-on mower related injuries and plastic surgical management.

LENUS (Irish Health Repository)

Laing, T A

2011-05-01

Lawnmower related injuries cause significant morbidity in children and young teenagers. The \\'ride-on\\' mowers which are more powerful than the \\'walk behind\\' mowers are becoming increasingly popular. The incidence and severity of injuries from either type of lawnmower appears to be steadily rising as is the burden placed on local plastic surgical and emergency services in managing the care of these patients. The aims of the study were to demonstrate changing trends in lawnmower-related injuries to children presenting to a single unit over a ten-year period and to identify any association between injury severity and machine subtype (\\'ride-on\\' versus \\'walk-behind\\'). Hospital databases, theatre records and medical case notes were reviewed retrospectively of all patients under the age of 16 treated for lawnmower related injuries over a 10 year period from July 1998 to June 2008. Data gathered included patient demographics, injury site and severity, management (type and number of surgical procedures), length of hospital stay and outcome. Injury severity score was also calculated for each case. Controlling for estimated regional population changes, there was a significant increase in the number of ride-on mower related accidents in the time period 2003-2008, compared to the time period 1998-2003. Ride-on injuries had significantly higher injury severity scores, longer hospital stays and were more likely to involve amputations as compared with walk-behind injuries. Children can sustain significant injuries with unsafe lawnmower use. The current study demonstrates the increasing incidence of ride-on mower related injuries in children and identifies a greater morbidity associated with such injuries. Such presentations place intense demands on local plastic surgical services.

Occult pneumomediastinum in blunt chest trauma: clinical significance.

Science.gov (United States)

Rezende-Neto, J B; Hoffmann, J; Al Mahroos, M; Tien, H; Hsee, L C; Spencer Netto, F; Speers, V; Rizoli, S B

2010-01-01

Thoracic injuries are potentially responsible for 25% of all trauma deaths. Chest X-ray is commonly used to screen patients with chest injury. However, the use of computed tomography (CT) scan for primary screening is increasing, particularly for blunt trauma. CT scans are more sensitive than chest X-ray in detecting intra-thoracic abnormalities such as pneumothoraces and pneumomediastinums. Pneumomediastinum detected by chest X-ray or "overt pneumomediastinum", raises the concern of possible aerodigestive tract injuries. In contrast, there is scarce information on the clinical significance of pneumomediastinum diagnosed by CT scan only or "occult pneumomediastinum". Therefore we investigated the clinical consequences of occult pneumomediastinum in our blunt trauma population. A 2-year retrospective chart review of all blunt chest trauma patients with initial chest CT scan admitted to a level I trauma centre. Data extracted from the medical records include; demographics, occult, overt, or no pneumomediastinum, the presence of intra-thoracic aerodigestive tract injuries (trachea, bronchus, and/or esophagus), mechanism and severity of injury, endotracheal intubation, chest thoracostomy, operations and radiological reports by an attending radiologist. All patients with intra-thoracic aerodigestive tract injuries from 1994 to 2004 were also investigated. Of 897 patients who met the inclusion criteria 839 (93.5%) had no pneumomediastinum. Five patients (0.6%) had overt pneumomediastinum and 53 patients (5.9%) had occult pneumomediastinum. Patients with occult pneumomediastinum had significantly higher ISS and AIS chest (pchest thoracostomy tube was more common (ppneumothorax. None of the patients with occult pneumomediastinum had aerodigestive tract injuries (95%CI 0-0.06). Follow up CT scan of patients with occult pneumomediastinum showed complete resolution in all cases, in average 3 h after the initial exam. Occult pneumomediastinum occurred in approximately 6% of

Effects of sports injury prevention training on the biomechanical risk factors of anterior cruciate ligament injury in high school female basketball players.

Science.gov (United States)

Lim, Bee-Oh; Lee, Yong Seuk; Kim, Jin Goo; An, Keun Ok; Yoo, Jin; Kwon, Young Hoo

2009-09-01

Female athletes have a higher risk of anterior cruciate ligament injury than their male counterparts who play at similar levels in sports involving pivoting and landing. The competitive female basketball players who participated in a sports injury prevention training program would show better muscle strength and flexibility and improved biomechanical properties associated with anterior cruciate ligament injury than during the pretraining period and than posttraining parameters in a control group. Controlled laboratory study. A total of 22 high school female basketball players were recruited and randomly divided into 2 groups (the experimental group and the control group, 11 participants each). The experimental group was instructed in the 6 parts of the sports injury prevention training program and performed it during the first 20 minutes of team practice for the next 8 weeks, while the control group performed their regular training program. Both groups were tested with a rebound-jump task before and after the 8-week period. A total of 21 reflective markers were placed in preassigned positions. In this controlled laboratory study, a 2-way analysis of variance (2 x 2) experimental design was used for the statistical analysis (P training effects on all strength parameters (P = .004 to .043) and on knee flexion, which reflects increased flexibility (P = .022). The experimental group showed higher knee flexion angles (P = .024), greater interknee distances (P = .004), lower hamstring-quadriceps ratios (P = .023), and lower maximum knee extension torques (P = .043) after training. In the control group, no statistical differences were observed between pretraining and posttraining findings (P = .084 to .873). At pretraining, no significant differences were observed between the 2 groups for any parameter (P = .067 to .784). However, a comparison of the 2 groups after training revealed that the experimental group had significantly higher knee flexion angles (P = .023

Properties and Types of Significant Thermal Skin Burn Injuries

Science.gov (United States)

2018-02-01

The deep burn category includes deep second, deep third and deep fourth-degree burns. Table 2: Burn Classification and Injury Outcome ( Rice ...Subcutaneous tissue  Entire dermis destroyed  No to low pain due to nerve destruction  Waxy white to leathery gray to charred black skin  Dry...Richard R.L. (2009) Rehabilitation of the Burned Hand. Hand Clinics, 25, 529- 541 Rice P.L. & Orgill, D.P. (2015).Classification of burns. (Ed

Properties and Types of Significant Photothermal Retinal Lesion Injuries

Science.gov (United States)

2016-09-01

19b. TELEPHONE NUMBER {Include area code) (703) 4n-os99 Reset Standard Form 298 (Rev . 8/98) PrescribM by ANSI Std Z39 18 Adobe Professional 7 .0...injuries.       Estimating RSI in Practice – Some  Illustrative  Examples  Suppose a developmental dazzling laser system is intended to cause non‐lethal

Study on the establishment of corneal alkali chemical injury on rats

Directory of Open Access Journals (Sweden)

Nan Hu

2013-06-01

Full Text Available AIM:To investigate the appropriate methods to establish corneal alkali chemical injury on rats. METHODS:The rats(n=87were randomly divided into three groups. Corneal alkali injury was induced by placing 1mol/L NaOH soaked filter paper on the limbus of right cornea for 20 seconds(group A, n=34or 40 seconds(group B, n=23, and on the central axis of the right cornea for 40 seconds(group C, n=30respectively. Corneal transparency, corneal ulceration, and corneal neovascularization were observed and recorded under slit- lamp biomicroscope on day 7 post-operation. RESULTS: Incidence of corneal ulceration, corneal perforation and positive rate of corneal fluorescein staining in limbal corneal injury groups(group A and Bwere significantly higher than that of central corneal injury group(group C(P<0.05. Incidence of corneal ulceration and corneal perforation in group B was significantly higher than group A(P<0.05. Corneal neovascularization was observed in all three groups. CONCLUSION: Corneal alkali burns induced by 3mm diameter central cornea injury are fit for the study of corneal neovascularization, while those induced by limbus injury for 20 seconds are fit for the study on limbal stem cells deficiency.

Terror attacks increases the risk of vascular injuries

Directory of Open Access Journals (Sweden)

Eitan eHeldenberg

2014-05-01

Full Text Available Objectives: Extensive literature exists about military trauma as opposed to the very limited literature regarding terror-related civilian trauma. However, terror-related vascular trauma (VT, as a unique type of injury, is yet to be addressed.Methods: A retrospective analysis of the Israeli National Trauma Registry was performed. All patients in the registry from 09/2000 to 12/2005 were included. The subgroup of patients with documented vascular trauma (VT (N=1,545 was analyzedand further subdivided into those suffering from Terror-related Vascular Trauma (TVT and Non-Terror related Vascular Trauma (NTVT. Both groups were analyzed according to mechanism of trauma, type and severity of injury and treatment.Results: Out of 2,446 terror related trauma admissions 243 sustained TVT (9.9% compared to 1302 VT patients from Non Terror trauma (1.1%. TVT injuries tend to be more complex and most patients were operated on. ICU admissions and hospitallength of stay was higher in the TVT group. Penetrating trauma was the prominent cause of injury among the TVT group. TVT group had a higher proportion of patients with severe injuries (ISS>16 and mortality. Thorax injuries were more frequent in the TVT group. Extremity injuries were the most prevalent vascular injuries in both groups; however NTVT group had more upper extremity injuries, while the TVT group had significantly more lower extremity injuries.Conclusion: Vascular injuries are remarkably more common among terror attack victims than among non-terror trauma victims and the injuries of terror casualties tend to be more complex. The presence of a vascular surgeon will ensure a comprehensive clinical care.

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

Injuries in youth football: national emergency department visits during 2001-2005 for young and adolescent players.

Science.gov (United States)

Mello, Michael J; Myers, Richard; Christian, Jennifer B; Palmisciano, Lynne; Linakis, James G

2009-03-01

Limited research exists describing youth football injuries, and many of these are confined to specific regions or communities. The authors describe U.S. pediatric football injury patterns receiving emergency department (ED) evaluation and compare injury patterns between the younger and older youth football participants. A retrospective analysis of ED data on football injuries was performed using the National Electronic Injury Surveillance System-All Injury Program. Injury risk estimates were calculated over a 5-year period (2001-2005) using participation data from the National Sporting Goods Association. Injury types are described for young (7-11 years) and adolescent (12-17 years) male football participants. There were an estimated total of 1,060,823 visits to U.S. EDs for males with football-related injuries. The most common diagnoses in the younger group (7-11 years) were fracture/dislocation (29%), sprain/strain (27%), and contusion (27%). In the older group (ages 12-17 years), diagnoses included sprain/strain (31%), fracture/dislocation (29%), and contusion (23%). Older participants had a significantly higher injury risk of injury over the 5-year study period: 11.0 (95% confidence interval [CI] = 9.2 to 12.8) versus 6.1 (95% CI = 4.8 to 7.3) per 1,000 participants/year. Older participants had a higher injury risk across all categories, with the greatest disparity being with traumatic brain injury (TBI), 0.8 (95% CI = 0.6 to 1.0) versus 0.3 (95% CI = 0.2 to 0.4) per 1,000 participants/year. National youth football injury patterns are similar to those previously reported in community and cohort studies. Older participants have a significantly higher injury risk, especially with TBI.

No strong evidence for lateralisation of word reading and face recognition deficits following posterior brain injury

DEFF Research Database (Denmark)

Gerlach, Christian; Marstrand, Lisbet; Starrfelt, Randi

2014-01-01

Face recognition and word reading are thought to be mediated by relatively independent cognitive systems lateralized to the right and left hemisphere respectively. In this case, we should expect a higher incidence of face recognition problems in patients with right hemisphere injury and a higher......-construction, motion perception), we found that both patient groups performed significantly worse than a matched control group. In particular we found a significant number of face recognition deficits in patients with left hemisphere injury and a significant number of patients with word reading deficits following...... right hemisphere injury. This suggests that face recognition and word reading may be mediated by more bilaterally distributed neural systems than is commonly assumed....

Injury rates and injury risk factors among federal bureau of investigation new agent trainees

Science.gov (United States)

2011-01-01

Background A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training. Methods Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy. Results A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity. Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents. PMID:22166096

Lawn mower injuries to the lower extremity: a 10-year retrospective review.

Science.gov (United States)

Greenhagen, Robert M; Raspovic, Katherine M; Crim, Brandon E; Ryan, Michael T; Gruen, Gary G

2013-04-01

Lawn mower injuries occur frequently in the United States and oftentimes result in extensive trauma to the lower extremities. These injuries can be quite devastating and cause there to be loss of function and amputation. The purpose of this study was to determine if there are specific factors that would help determine the best treatment protocol, patient outcomes, and prognosis after lawn mower injury to the foot and ankle. A retrospective review of medical records was performed on all patients treated at a university level 1 trauma center from 2000 to 2010. Only subjects 18 years or older who sustained an injury below the level of the knee were included for review. Seventy-three patients were included in this review. The results revealed that patients who developed a complication were significantly older than the group of patients without complications (P = .03). Digits were found to be injured most often but the odds of developing a complication were much higher if these injuries involved the plantar foot, dorsal foot, or ankle. Interestingly, patients on prolonged antibiotic therapy had a significantly higher risk of developing complications. The presence of comorbidities significantly increased the risk of complication (P = .008); the greatest risk factors were cardiovascular disease (P = .001) and diabetes (P = .06). The authors present the largest cohort of lawn mower injuries in the medical literature, which demonstrates that factors such as age, location of injury, and the presence of comorbidities influence the outcome and increase the risk of injury to the foot and ankle. These results may be useful in determining the best treatment plan possible for patients with these severe injuries. Therapeutic, Level IV, Retrospective case series.

Serum Albumin Predicts Long-Term Neurological Outcomes After Acute Spinal Cord Injury.

Science.gov (United States)

Tong, Bobo; Jutzeler, Catherine R; Cragg, Jacquelyn J; Grassner, Lukas; Schwab, Jan M; Casha, Steve; Geisler, Fred; Kramer, John L K

2018-01-01

There is a need to identify reliable biomarkers of spinal cord injury recovery for clinical practice and clinical trials. Our objective was to correlate serum albumin levels with spinal cord injury neurological outcomes. We performed a secondary analysis of patients with traumatic spinal cord injury (n = 591) participating in the Sygen clinical trial. Serum albumin concentrations were obtained as part of routine blood chemistry analysis, at trial entry (24-72 hours), 1, 2, and 4 weeks after injury. The primary outcomes were "marked recovery" and lower extremity motor scores, derived from the International Standards for the Neurological Classification of Spinal Cord Injury. Data were analyzed with multivariable logistic and linear regression to adjust for potential confounders. Serum albumin was significantly associated with spinal cord injury neurological outcomes. Higher serum albumin concentrations at 1, 2, and 4 weeks were associated with higher 52-week lower extremity motor score. Similarly, the odds of achieving "marked neurological recovery" was greater for individuals with higher serum albumin concentrations. The association between serum albumin concentrations and neurological outcomes was independent of initial injury severity, treatment with GM-1, and polytrauma. In spinal cord injury, serum albumin is an independent marker of long-term neurological outcomes. Serum albumin could serve as a feasible biomarker for prognosis at the time of injury and stratification in clinical trials.

Predictors of "occult" intra-abdominal injuries in blunt trauma patients

Directory of Open Access Journals (Sweden)

José Gustavo Parreira

Full Text Available Objective: to assess predictors of intra-abdominal injuries in blunt trauma patients admitted without abdominal pain or abnormalities on the abdomen physical examination. Methods: We conducted a retrospective analysis of trauma registry data, including adult blunt trauma patients admitted from 2008 to 2010 who sustained no abdominal pain or abnormalities on physical examination of the abdomen at admission and were submitted to computed tomography of the abdomen and/or exploratory laparotomy. Patients were assigned into: Group 1 (with intra-abdominal injuries or Group 2 (without intra-abdominal injuries. Variables were compared between groups to identify those significantly associated with the presence of intra-abdominal injuries, adopting p<0.05 as significant. Subsequently, the variables with p<0.20 on bivariate analysis were selected to create a logistic regression model using the forward stepwise method. Results: A total of 268 cases met the inclusion criteria. Patients in Group I were characterized as having significantly (p<0.05 lower mean AIS score for the head segment (1.0±1.4 vs. 1.8±1.9, as well as higher mean AIS thorax score (1.6±1.7 vs. 0.9±1.5 and ISS (25.7±14.5 vs. 17,1±13,1. The rate of abdominal injuries was significantly higher in run-over pedestrians (37.3% and in motorcyclists (36.0% (p<0.001. The resultant logistic regression model provided 73.5% accuracy for identifying abdominal injuries. The variables included were: motorcyclist accident as trauma mechanism (p<0.001 - OR 5.51; 95%CI 2.40-12.64, presence of rib fractures (p<0.003 - OR 3.00; 95%CI 1.47-6.14, run-over pedestrian as trauma mechanism (p=0.008 - OR 2.85; 95%CI 1.13-6.22 and abnormal neurological physical exam at admission (p=0.015 - OR 0.44; 95%CI 0.22-0.85. Conclusion Intra-abdominal injuries were predominantly associated with trauma mechanism and presence of chest injuries.

Injury risk in professional boxing.

Science.gov (United States)

Bledsoe, Gregory H; Li, Guohu; Levy, Fred

2005-10-01

Although a popular endeavor, boxing has fallen under increased scrutiny because of its association with traumatic brain injury. However, few studies have investigated the overall epidemiology of boxing injuries from representative samples, and no study has ever documented the incidence of injuries in female boxers. This study is a review of professional boxing data from the state of Nevada from September 2001 through March 2003. Medical and outcome data for all professional boxing matches occurring in Nevada between September 2001 and March 2003 (n = 524 matches) were analyzed on the basis of a pair-matched, case-control design. Cases were boxers who received an injury during the boxing matches. Boxers who were not injured served as control subjects. Both conditional and unconditional logistic regression models were used to assess risk factors for injury. The overall incidence rate of injury was 17.1 per 100 boxer-matches, or 3.4 per 100 boxer-rounds. Facial laceration accounted for 51% of all injuries, followed by hand injury (17%), eye injury (14%), and nose injury (5%). Male boxers were significantly more likely than female boxers to receive injuries (3.6 versus 1.2 per 100 boxer-rounds, P = 0.01). Male boxing matches also ended in knockouts and technical knockouts more often than did female matches (P boxing matches is high, particularly among male boxers. Superficial facial lacerations are the most common injury reported. Male boxers have a higher rate of knockout and technical knockouts than female boxers. Further research is necessary to determine the outcomes of injury, particularly the long-term neurologic outcome differences between sexes.

Parental distress, parenting practices, and child adaptive outcomes following traumatic brain injury.

Science.gov (United States)

Micklewright, Jackie L; King, Tricia Z; O'Toole, Kathleen; Henrich, Chris; Floyd, Frank J

2012-03-01

Moderate and severe pediatric traumatic brain injuries (TBI) are associated with significant familial distress and child adaptive sequelae. Our aim was to examine the relationship between parental psychological distress, parenting practices (authoritarian, permissive, authoritative), and child adaptive functioning 12-36 months following TBI or orthopedic injury (OI). Injury type was hypothesized to moderate the relationship between parental distress and child adaptive functioning, demonstrating a significantly stronger relationship in the TBI relative to OI group. Authoritarian parenting practices were hypothesized to mediate relationship between parental distress and child adaptive functioning across groups. Groups (TBI n = 21, OI n = 23) did not differ significantly on age at injury, time since injury, sex, race, or SES. Parents completed the Brief Symptom Inventory, Parenting Practices Questionnaire, and Vineland-II. Moderation and mediation hypotheses were tested using hierarchical multiple regression and a bootstrapping approach, respectively. Results supported moderation and revealed that higher parental psychological distress was associated with lower child adaptive functioning in the TBI group only. Mediation results indicated that higher parental distress was associated with authoritarian parenting practices and lower adaptive functioning across groups. Results suggest that parenting practices are an important area of focus for studies attempting to elucidate the relationship between parent and child functioning following TBI.

Phytophthora ramorum does not cause physiologically significant systemic injury to California bay laurel, its primary reservoir host.

Science.gov (United States)

DiLeo, M V; Bostock, R M; Rizzo, D M

2009-11-01

California bay laurel trees (Umbellularia californica) play a crucial role in the reproduction and survival of Phytophthora ramorum in coastal California forests by supporting sporulation during the rainy season and by providing a means for the pathogen to survive the dry, Mediterranean summer. While bay laurel is thus critical to the epidemiology of sudden oak death and other P. ramorum diseases in California, the relatively minor symptoms observed on this reservoir host suggest that it may not sustain ecologically significant injury itself. The long-term role that P. ramorum will play in California forests will depend in part on the extent to which this pathogen decreases the ecological fitness of bay laurel. Despite the importance of this question, no study has yet investigated in detail the physiological impact that ramorum blight imposes on bay laurel. This experimental study quantifies the impact that P. ramorum has on artificially inoculated bay laurel seedlings with measurements that integrate the full injury that infection with an oomycete may cause: photosynthetic efficiency, total photosynthetic area, and growth. Leaf area and leaf mass were not impacted significantly by infection of P. ramorum. Photosynthetic efficiency was mildly depressed in symptomatic, but not asymptomatic leaves, despite unnaturally high levels of necrosis that were imposed on the seedlings. These results demonstrate that bay laurel trees suffer only minor injury from ramorum blight beyond visible necrotic symptoms. Consequently, it is highly likely that bay laurel will continue to be widely available as a host for P. ramorum in California forests, which has long-term implications for the composition of these forests.

Caregiver burden in Danish family members of patients with severe brain injury

DEFF Research Database (Denmark)

Doser, Karoline; Norup, Anne

2016-01-01

OBJECTIVE: To investigate caregiver burden and factors associated with caregiver burden among family members of patients with severe brain injury in the chronic phase. Additionally, the study aimed at investigating differences in burden between parents and spouses. METHODS: Forty-four Danish...... caregivers of patients with severe brain injury were contacted 3-6 years post-injury and asked to complete a measure of caregiver burden. RESULTS: Medium, high and low levels of burden were observed in 45%, 16% and 39% of family members, respectively. Higher burden was seen in caregivers of patients...... with more severe injuries, who spent more time on caregiving and reported more unmet needs. Overall, spouses spent significantly more time taking care of their family member than parents and reported higher levels of burden. CONCLUSIONS: The findings emphasized the continuing consequences of brain injury...

Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit

Directory of Open Access Journals (Sweden)

Alicia M. Montalvo, Hilary Shaefer, Belinda Rodriguez, Tan Li, Katrina Epnere, Gregory D. Myer

2017-03-01

Full Text Available The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002 and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p < 0.001 than non-competitors. Athletes who reported injury also reported significantly higher values for the following risk factors: years of participation (2.7 ± 1.8 v 1.8 ± 1.5, p = 0.001, weekly athlete training hours (7.3 ± 3.8 v 4.9 ± 2.1, p = 0.020, weekly athlete-exposures (6.4 ± 3.8 v 4.7 ± 2.1, p = 0.003, height (1.72 ± 0.09 m v 1.68 ± 0.01 m, p = 0.011, and body mass (78.24 ± 16.86 kg v 72.91 ± 14.77 kg, p = 0.037. Injury rates during CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce

[Status quo and influencing factors of disabilities caused by injury in Guangdong province].

Science.gov (United States)

Dai, Jin-fang; Dong, Xiao-mei; Song, Zhuo-ping; Jiang, Ming-xu; Wang, Chang; Wang, Sheng-yong

2011-09-01

To analyze the epidemiology status and risk factors of disabilities caused by injury in Guangdong province. Stratified multi-stage cluster sampling was used to identify 1530 subjects with disabilities (among them, 415 disabilities caused by injury), in the villages or districts in the four regions of Guangzhou, Qingyuan, Zhaoqing and Huizhou in 2010. Subjects were interviewed by trained staff with self-made questionnaires about the status of the disabled, then 415 disabled caused by injury were interviewed about the process of the injury causing disability. The variables in this survey included gender, regions, rural (urban) residences, occupation, age and injury style. The difference of injury were analyzed through χ(2) test, and the influencing factors were explored through classification tree model. The top five causes of disability were road traffic injury, fall, work-related injury, medical accident, scald or burn, accounting for 32.53% (135/415), 21.45% (89/415), 12.77% (53/415), 8.43% (35/415) and 5.06% (21/415), respectively. The proportion of male was higher than female in all disabilities caused by injury (295 male, 117 female, 3 unknown). Female had higher proportion 8.55% (10/117) than male 3.05% (9/295) with the cause of scald or burn (χ(2) = 6.302, P = 0.012), the proportion of rural residents 38.89%(84/216)was also higher than urban residents 25.63% (51/199) in disabilities caused by traffic accident (χ(2) = 43.850, P work-injury mainly caused disability in 25 - 44 age group, 85.71% (30/35) medical accident and 76.20% (16/21) scald or burn mainly caused disability in 0 - 14 age group, the injury caused by the fall was 62.50% (5/8) in 65- age group. The proportions of fall in Qingyuan 29.09% (16/55) and Huizhou 28.23% (37/131) were significantly higher than that in Guangzhou 13.38% (21/157) and Zhaoqing 21.13% (15/71) (χ(2) = 11.904, P = 0.008). The proportions of work-injury in Guangzhou 19.11% (30/157) and Zhaoqing 19.72% (14/71) were

Features of fatal injuries in older cyclists in vehicle-bicycle accidents in Japan.

Science.gov (United States)

Matsui, Yasuhiro; Oikawa, Shoko; Hitosugi, Masahito

2018-01-02

The purpose of this study was to identify and better understand the features of fatal injuries in cyclists aged 75 years and over involved in collisions with either hood- or van-type vehicles. This study investigated the fatal injuries of cyclists aged 75 years old and over by analyzing accident data. We focused on the body regions to which the fatal injury occurred using vehicle-bicycle accident data from the Institute for Traffic Accident Research and Data Analysis (ITARDA) in Japan. Using data from 2009 to 2013, we examined the frequency of fatally injured body region by gender, age, and actual vehicle travel speed. We investigated any significant differences in distributions of fatal injuries by body region for cyclists aged 75 years and over using chi-square tests to compare with cyclists in other age groups. We also investigated the cause of fatal head injuries, such as impact with a road surface or vehicle. The results indicated that head injuries were the most common cause of fatalities among the study group. At low vehicle travel speeds for both hood- and van-type vehicles, fatalities were most likely to be the result of head impacts against the road surface. The percentage of fatalities following hip injuries was significantly higher for cyclists aged 75 years and over than for those aged 65-74 or 13-59 in impacts with hood-type vehicles. It was also higher for women than men in the over-75 age group in impacts with these vehicles. For cyclists aged 75 years and over, wearing a helmet may be helpful to prevent head injuries in vehicle-to-cyclist accidents. It may also be helpful to introduce some safety measures to prevent hip injuries, given the higher level of fatalities following hip injury among all cyclists aged 75 and over, particularly women.

Foot strike and injury rates in endurance runners: a retrospective study.

Science.gov (United States)

Daoud, Adam I; Geissler, Gary J; Wang, Frank; Saretsky, Jason; Daoud, Yahya A; Lieberman, Daniel E

2012-07-01

This retrospective study tests if runners who habitually forefoot strike have different rates of injury than runners who habitually rearfoot strike. We measured the strike characteristics of middle- and long-distance runners from a collegiate cross-country team and quantified their history of injury, including the incidence and rate of specific injuries, the severity of each injury, and the rate of mild, moderate, and severe injuries per mile run. Of the 52 runners studied, 36 (69%) primarily used a rearfoot strike and 16 (31%) primarily used a forefoot strike. Approximately 74% of runners experienced a moderate or severe injury each year, but those who habitually rearfoot strike had approximately twice the rate of repetitive stress injuries than individuals who habitually forefoot strike. Traumatic injury rates were not significantly different between the two groups. A generalized linear model showed that strike type, sex, race distance, and average miles per week each correlate significantly (P strike have significantly higher rates of repetitive stress injury than those who mostly forefoot strike. This study does not test the causal bases for this general difference. One hypothesis, which requires further research, is that the absence of a marked impact peak in the ground reaction force during a forefoot strike compared with a rearfoot strike may contribute to lower rates of injuries in habitual forefoot strikers.

Underestimation of Severity of Previous Whiplash Injuries

Science.gov (United States)

Naqui, SZH; Lovell, SJ; Lovell, ME

2008-01-01

INTRODUCTION We noted a report that more significant symptoms may be expressed after second whiplash injuries by a suggested cumulative effect, including degeneration. We wondered if patients were underestimating the severity of their earlier injury. PATIENTS AND METHODS We studied recent medicolegal reports, to assess subjects with a second whiplash injury. They had been asked whether their earlier injury was worse, the same or lesser in severity. RESULTS From the study cohort, 101 patients (87%) felt that they had fully recovered from their first injury and 15 (13%) had not. Seventy-six subjects considered their first injury of lesser severity, 24 worse and 16 the same. Of the 24 that felt the violence of their first accident was worse, only 8 had worse symptoms, and 16 felt their symptoms were mainly the same or less than their symptoms from their second injury. Statistical analysis of the data revealed that the proportion of those claiming a difference who said the previous injury was lesser was 76% (95% CI 66–84%). The observed proportion with a lesser injury was considerably higher than the 50% anticipated. CONCLUSIONS We feel that subjects may underestimate the severity of an earlier injury and associated symptoms. Reasons for this may include secondary gain rather than any proposed cumulative effect. PMID:18201501

Does the Reliability of Reporting in Injury Surveillance Studies Depend on Injury Definition?

Science.gov (United States)

Cross, Matthew; Williams, Sean; Kemp, Simon P T; Fuller, Colin; Taylor, Aileen; Brooks, John; Trewartha, Grant; Stokes, Keith

2018-03-01

Choosing an appropriate definition for injury in injury surveillance studies is essential to ensure a balance among reporting reliability, providing an accurate representation of injury risk, and describing the nature of the clinical demand. To provide guidance on the choice of injury definition for injury surveillance studies by comparing within- and between-team variability in injury incidence with >24-hour and >7-day time-loss injury definitions in a large multiteam injury surveillance study. Cohort study (diagnosis); Level of evidence, 2. Injury data were reported for 2248 professional rugby union players from 15 Premiership Rugby clubs over 12 seasons. Within-team percentage coefficient of variation and mean between-team standard deviation (expressed as a percentage coefficient of variation) in injury incidence rates (injuries per 1000 player match hours) were calculated. For both variables, a comparison was made between >24-hour and >7-day injury incidence rates in terms of the magnitude of the observed effects. The overall mean incidence across the population with a >24-hour time-loss injury definition was approximately double the reported incidence with the >7-day definition. There was a 10% higher between-team variation in match injury incidence rates with the >24-hour time-loss definition versus the >7-day definition. There was a likely higher degree of between-team variation in match injury incidence rates with a >24-hour time-loss definition than with a >7-day definition of injury. However, in professional sports settings, it is likely that the benefits of using a more inclusive definition of injury (improved understanding of clinical demand and the appropriate and accurate reporting of injury risk) outweigh the small increase in variation in reporting consistency.

Children and youth with 'unspecified injury to the head': implications for traumatic brain injury research and surveillance.

Science.gov (United States)

Chan, Vincy; Mann, Robert E; Pole, Jason D; Colantonio, Angela

2015-01-01

The case definition for traumatic brain injury (TBI) often includes 'unspecified injury to the head' diagnostic codes. However, research has shown that the inclusion of these codes leads to false positives. As such, it is important to determine the degree to which inclusion of these codes affect the overall numbers and profiles of the TBI population. The objective of this paper was to profile and compare the demographic and clinical characteristics, intention and mechanism of injury, and discharge disposition of hospitalized children and youth aged 19 years and under using (1) an inclusive TBI case definition that included 'unspecified injury to the head' diagnostic codes, (2) a restricted TBI case definition that excluded 'unspecified injury to the head 'diagnostic codes, and (3) the 'unspecified injury to the head' only case definition. The National Ambulatory Care Reporting System and the Discharge Abstract Database from Ontario, Canada, were used to identify cases between fiscal years 2003/04 and 2009/10. The rate of TBI episodes of care using the inclusive case definition for TBI (2,667.2 per 100,000) was 1.65 times higher than that of the restricted case definition (1,613.3 per 100,000). 'Unspecified injury to the head' diagnostic codes made up of 39.5 % of all cases identified with the inclusive case definition. Exclusion of 'unspecified injury to the head' diagnostic code in the TBI case definition resulted in a significantly higher proportion of patients in the intensive care units (p definition of TBI for the children and youth population is important, as it has implications for the numbers used for policy, resource allocation, prevention, and planning of healthcare services. This paper can inform future work on reaching consensus on the diagnostic codes for defining TBI in children and youth.

Occupational injury among full-time, part-time and casual health care workers.

Science.gov (United States)

Alamgir, Hasanat; Yu, Shicheng; Chavoshi, Negar; Ngan, Karen

2008-08-01

Previous epidemiological studies have conflicting suggestions on the association of occupational injury risks with employment category across industries. This specific issue has not been examined for direct patient care occupations in the health care sector. To investigate whether work-related injury rates differ by employment category (part time, full time or casual) for registered nurses (RNs) in acute care and care aides (CAs) in long-term facilities. Incidents of occupational injury resulting in compensated time loss from work, over a 1-year period within three health regions in British Columbia (BC), Canada, were extracted from a standardized operational database. Detailed analysis was conducted using Poisson regression modeling. Among 8640 RNs in acute care, 37% worked full time, 24% part time and 25% casual. The overall rates of injuries were 7.4, 5.3 and 5.5 per 100 person-years, respectively. Among the 2967 CAs in long-term care, 30% worked full time, 20% part time and 40% casual. The overall rates of injuries were 25.8, 22.9 and 18.1 per 100 person-years, respectively. In multivariate models, having adjusted for age, gender, facility and health region, full-time RNs had significantly higher risk of sustaining injuries compared to part-time and casual workers. For CAs, full-time workers had significantly higher risk of sustaining injuries compared to casual workers. Full-time direct patient care occupations have greater risk of injury compared to part-time and casual workers within the health care sector.

Boxing injury epidemiology in the Great Britain team: a 5-year surveillance study of medically diagnosed injury incidence and outcome.

Science.gov (United States)

Loosemore, Michael; Lightfoot, Joseph; Palmer-Green, Deborah; Gatt, Ian; Bilzon, James; Beardsley, Chris

2015-09-01

There has been no comprehensive injury report of elite-level amateur boxers in competition and training. We reviewed injuries in training and competition in the Great Britain (GB) amateur boxing squad between 2005 and 2009. Longitudinal, prospective injury surveillance over 5 years of the GB boxing squad from 2005 to 2009. 66 boxers passed through the squad. The location, region affected, description, and the duration of each injury were recorded by the team doctor and team physiotherapist. We recorded whether the injury occurred during competition or training, and also whether it was a new or a recurrent injury. The injury rate during competition was calculated as the number of injuries per 1000 h. More injuries affected the hand than any other body location. This was the case overall, in training and competition individually, and for both new and recurrent injuries. More injuries occurred during training than during competition, and most injuries were new rather than recurrent. Total injury rate during competition was 828 per 1000 h and hand injury rate in competition was 302 injuries per 1000 h. Hand injury rate in competition was significantly higher than at the other locations. The incidence of concussion is comparatively low. Injury prevention should aim to protect the hands and wrists of elite amateur boxers. 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.

Randomized controlled trial of peer mentoring for individuals with traumatic brain injury and their significant others.

Science.gov (United States)

Hanks, Robin A; Rapport, Lisa J; Wertheimer, Jeffrey; Koviak, Carole

2012-08-01

To examine the efficacy of a peer-mentoring program for persons with traumatic brain injury (TBI) and their significant others, and to determine the relationship of this mentoring program to 3 main outcomes: (1) emotional well-being; (2) post-TBI quality of life; and (3) community integration. Randomized controlled trial. Midwestern rehabilitation hospital. Persons with TBI (n=96) and significant others/caregivers (n=62). Persons with TBI and friends/caregivers who knew the person prior to their injury were randomly assigned to a treatment (mentored) or no-treatment (no mentoring) control group immediately prior to discharge from the rehabilitation unit and were mentored for up to 2 years. Peer Mentoring Questionnaire; Brief Symptom Inventory-18; Family Assessment Device; Coping Inventory for Stressful Situations; Short Michigan Alcohol Screening Test; Medical Outcomes Study 12-Item Short-Form Health Survey; and Community Integration Measure. Eighty-eight percent of individuals who were involved in the mentoring program reported positive experiences. t tests revealed that among persons with TBI, individuals who received mentoring had significantly better behavioral control and less chaos in the living environment (P=.04), lower alcohol use (P=.01), less emotion-focused (P=.04) and avoidance coping (P=.03), and good physical quality of life (P=.04) compared with those who did not receive mentoring. Among significant others, mentored individuals demonstrated greater community integration (P=.03) than the nonmentored control group. Mentoring can be an effective way to benefit mood and healthy coping after TBI, and it can help to prevent maladaptive behaviors, such as substance abuse and behavioral dyscontrol, in the living situation. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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.

Is Level of Injury a Determinant of Quality of Life Among Individuals with Spinal Cord Injury? A Tertiary Rehabilitation Center Report

Directory of Open Access Journals (Sweden)

Seyed Amir Hossein Tavakoli

2016-03-01

Full Text Available Objectives: The role of injury-related variables in determining health-related quality of life (HRQOL among Iranian persons with spinal cord injury (SCI has not yet been fully described. In this study, we compared HRQOL between individuals with injury at cervical level and those with injury at thoracolumbar sections and evaluated the discriminating value of injury level as a determinant of HRQOL among Iranian people with SCI. Methods: Individuals with SCI, who were referred to Brain and Spinal Cord Injury Research Center, were invited to participate in this investigation. HRQOL was assessed using the Short Form (SF-36 questionnaire to determine the quality of life (QOL in eight domains: physical functioning (PF, role limitation due to physical problems (RP, bodily pain (BP, general health (GH, vitality (VT, social functioning (SF, role limitation due to emotional problems (RE, and mental health (MH. Results: Ninety patients with paraplegia and 94 quadriplegic patients participated in this investigation. The mean score of PF domain was significantly lower in patients with injury at cervical level (p < 0.0001. There was no significant difference in other domains of SF-36 between subjects with paraplegia and quadriplegia (p = 0.670, 0.700, 0.910, 0.710, 0.730, 0.290 and 0.850 for RP, RE, VT, MH, SF, BP and GH, respectively. Similarly, the mean physical component summary (PCS score was significantly higher among individuals with injury at thoracolumbar sections (p < 0.0001. The mean mental component summary (MCS score did not differ between the two groups (p = 0.720. Conclusions: Patients with SCI at the cervical level have similar mental health compared to those with injury at thoracolumbar sections, which shows proper mental adaptability in quadriplegic individuals. Injury level can be used as a major determinant of the physical component of QOL among people with SCI.

Unintentional Injuries in Preschool Age Children: Is There a Correlation With Parenting Style and Parental Attention Deficit and Hyperactivity Symptoms.

Science.gov (United States)

Acar, Ethem; Dursun, Onur Burak; Esin, İbrahim Selcuk; Öğütlü, Hakan; Özcan, Halil; Mutlu, Murat

2015-08-01

Unintentional injuries are the leading cause of death among children. Previous research has shown that most of the injuries occur in and around the home. Therefore, parents have a key role in the occurrence and prevention of injuries. In this study, we examined the relationship among home injuries to children and parental attention deficit hyperactivity disorder (ADHD) symptoms, parental attitudes, and children's behavioral problems.Forty children who were admitted to the emergency department because of home injuries constitute the study group. The control group also consisted of 40 children, who were admitted for mild throat infections. The parents filled out questionnaires assessing parental ADHD, child behavioral problems, and parenting attitudes.Scores were significantly higher for both internalizing disorders and externalizing disorders in study groups. We also found that ADHD symptoms were significantly higher among fathers of injured children compared with fathers of control groups. Democratic parenting was also found to correlate with higher numbers of injuries.Parenting style, as well as the psychopathology of both the parents and children, is important factors in children's injuries. A child psychiatrist visit following an emergency procedure may help to prevent further unintentional injuries to the child.

Does the Reliability of Reporting in Injury Surveillance Studies Depend on Injury Definition?

Science.gov (United States)

Cross, Matthew; Williams, Sean; Kemp, Simon P.T.; Fuller, Colin; Taylor, Aileen; Brooks, John; Trewartha, Grant; Stokes, Keith

2018-01-01

Background: Choosing an appropriate definition for injury in injury surveillance studies is essential to ensure a balance among reporting reliability, providing an accurate representation of injury risk, and describing the nature of the clinical demand. Purpose: To provide guidance on the choice of injury definition for injury surveillance studies by comparing within- and between-team variability in injury incidence with >24-hour and >7-day time-loss injury definitions in a large multiteam injury surveillance study. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Injury data were reported for 2248 professional rugby union players from 15 Premiership Rugby clubs over 12 seasons. Within-team percentage coefficient of variation and mean between-team standard deviation (expressed as a percentage coefficient of variation) in injury incidence rates (injuries per 1000 player match hours) were calculated. For both variables, a comparison was made between >24-hour and >7-day injury incidence rates in terms of the magnitude of the observed effects. Results: The overall mean incidence across the population with a >24-hour time-loss injury definition was approximately double the reported incidence with the >7-day definition. There was a 10% higher between-team variation in match injury incidence rates with the >24-hour time-loss definition versus the >7-day definition. Conclusion: There was a likely higher degree of between-team variation in match injury incidence rates with a >24-hour time-loss definition than with a >7-day definition of injury. However, in professional sports settings, it is likely that the benefits of using a more inclusive definition of injury (improved understanding of clinical demand and the appropriate and accurate reporting of injury risk) outweigh the small increase in variation in reporting consistency. PMID:29581994

INJURIES IN QUIDDITCH: A DESCRIPTIVE EPIDEMIOLOGICAL STUDY.

Science.gov (United States)

Pennington, Rachel; Cooper, Ashley; Edmond, Evan; Faulkner, Alastair; Reidy, Michael J; Davies, Peter S E

2017-10-01

Quidditch is a fast growing, physically intense, mixed-gender full-contact sport. Originally adapted from Harry Potter novels, quidditch was first played in 2005 in the USA but is now played worldwide. It is essential to elucidate patterns of injury for the safety and growth of the sport of quidditch. It also provides a unique opportunity to study injury patterns in mixed-gender full-contact sport, an area of increasing importance with the developing culture of transition from single-gender to mixed-gender sports. The purpose of this investigation was to examine the types of injuries sustained while playing quidditch in terms of their incidence, anatomical distribution and severity, and gender distribution. An anonymous self-reporting questionnaire was distributed to all active quidditch players in the UK. Data collection included player demographics, type of injury, mechanism of injury, player position, experience and treatment required, relating to the previous 12 months. A total of 348 participants of 684 eligible athletes responded to the questionnaire representing a 50.87% response rate. There were 315 injuries reported by 180 athletes in total, with an overall incidence of 4.06 injuries per 1,000 hours. A statistically significantly different rate of concussion was observed with female athletes sustaining more concussion than males (p=0.006). The overall rate of concussion was 0.651/1000hrs in males and 1.163/1000hrs in females (0.877/1000 hours overall). This study provides the first quantitative description of injury rates in quidditch. The overall injury rates are no higher than those reported in other recreational contact sports. Female athletes were found to have a higher rate of concussion, which needs further investigation. These findings are relevant to players concerned about safety in quidditch and to governing bodies regarding governance of the sport. 3b.

Fractures and dislocations of the hand in polytrauma patients: Incidence, injury pattern and functional outcome.

Science.gov (United States)

Ferree, Steven; van der Vliet, Quirine M J; van Heijl, Mark; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco

2017-04-01

Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. A single centre retrospective cohort study was performed at a level 1 trauma centre. Polytrauma was defined as patients with an Injury Severity Score of 16 or higher. Fractures and dislocations to the hand were determined. All eligible polytrauma patients with hand injuries were included and a Quick Disability of Arm, Shoulder and Hand questionnaire (QDASH) and Patient-Rated Wrist/Hand Evaluation (PRWHE) were administered. Patients were contacted 1-6 years after trauma. In a cohort of 2046 polytrauma patients 72 patients (3.5%) suffered a hand injury. The functional outcome scores of 52 patients (72%) were obtained. The Metacarpal (48%) and carpal (33%) bones were the most frequently affected. The median QDASH score for all patients with hand injury was 17 (IQR 0-31) and the PRWHE 14 (IQR 0-41). Patients with a concomitant upper extremity injury (p=0.002 for PRWHE, p0.006 for QDASH) and those with higher ISS scores (p=0.034 for PRWHE, QDASH not significant) had worse functional outcome scores. As an example, of the 5 patients with the worst outcome scores 3 suffered an isolated phalangeal injury, all had concomitant upper extremity injury or neurological injuries (3 plexus injuries, 1 severe brain injury). The incidence of hand injuries in polytrauma patients is 3.5%, which is relatively low compared to a general trauma population. Metacarpal and carpal bones were most frequently affected. The functional extremity specific outcome scores are highly influenced by concomitant injuries (upper extremity injuries, neurological injuries and higher ISS). Copyright © 2017 Elsevier Ltd. All

Surgical therapy for craniocerebral firearm injury.

Science.gov (United States)

Wei, Liang-Feng; Wang, Shou-Sen; Jing, Jun-Jie; Zheng, Zhao-Cong; Gao, Jin-Xi; Liu, Zheng; Wang, Ru-Mi

2013-01-01

The current study aims to explore the clinical characteristics of craniocerebral firearm injury and to improve the diagnosis and treatment of this condition. Data from 56 patients with craniocerebral firearm injury were analyzed retrospectively for projectile types, traumatic conditions, and treatment approaches. 43 patients exhibited intracranial foreign body residence. Of them, 40 were subjected to complete foreign body removal and 2 to partial removal, leaving 1 without receiving removal treatment. 54 patients (96.4%) survived and 2 (3.6%) died. Of the survivors, 36 (64.3%) recovered well, 15 (26.8%) were moderately disabled, 2 (3.6%) were severely disabled, and 1 (1.8%) lapsed into vegetative state. Patients receiving debridement within 8 h after injury had a significantly higher recovery rate than those receiving such treatment after 8 h (82.1% vs. 26.7%; P debridement as early as possible, reasonably deciding on the operative mode and approach for intracranial residing foreign body removal, and increasing vigilance regarding concomitant injuries are the keys to the improvement of the overall treatment of craniocerebral firearm injury.

[Lightning strikes and lightning injuries in prehospital emergency medicine. Relevance, results, and practical implications].

Science.gov (United States)

Hinkelbein, J; Spelten, O; Wetsch, W A

2013-01-01

Up to 32.2% of patients in a burn center suffer from electrical injuries. Of these patients, 2-4% present with lightning injuries. In Germany, approximately 50 people per year are injured by a lightning strike and 3-7 fatally. Typically, people involved in outdoor activities are endangered and affected. A lightning strike usually produces significantly higher energy doses as compared to those in common electrical injuries. Therefore, injury patterns vary significantly. Especially in high voltage injuries and lightning injuries, internal injuries are of special importance. Mortality ranges between 10 and 30% after a lightning strike. Emergency medical treatment is similar to common electrical injuries. Patients with lightning injuries should be transported to a regional or supraregional trauma center. In 15% of all cases multiple people may be injured. Therefore, it is of outstanding importance to create emergency plans and evacuation plans in good time for mass gatherings endangered by possible lightning.

Arthroscopic knee surgery does not modify hyperalgesic responses to heat injury

DEFF Research Database (Denmark)

Werner, Mads U; Duun, Preben; Kraemer, Otto

2003-01-01

contralateral to the surgical side. Ibuprofen and acetaminophen were given for 2 days before the first burn injury and again from the time of surgery. In the controls, the two burn injuries were separated by 7 days. Sensory variables included cumulated pain score during induction of the burn (visual analog...... scale), secondary hyperalgesia area, and mechanical and thermal pain perception and pain thresholds assessed before and 1 h after the burn injury. RESULTS: The heat injuries induced significant increases in pain perception (P pain thresholds (P pain...... thresholds were higher during the second burn injury in patients (P pain to heat injury (P > 0.8), secondary hyperalgesia areas (P > 0.1), mechanical and thermal pain perception (P > 0.1), or mechanical and thermal pain...

Comparison of isolated and concomitant liver injuries: is hepatic trauma entirely responsible for the outcome?

Science.gov (United States)

Yazici, P; Aydin, U; Sozbilen, M

2010-01-01

This study was undertaken to examine both isolated and concomitant liver injuries to clarify the role of liver trauma on outcome. This retrospective study was a review of all abdominal trauma patients who presented with liver injuries, with or without concomitant injury at Ege University School of Medicine over a 3-year period. Presentation, injury grade, management, and outcomes were analyzed. Patients with isolated hepatic injury (Group A) were compared with patients who had concomitant hepatic injury (liver and spleen/small bowel) (Group B). Significance was set at 95% confidence intervals. Of 368 patients, 80 (21%) presented with liver injury. Of these, the aetiology was as follows: 53 (66.2%) blunt injury, 19 (23%) penetrating injury, and 8 (10%) gun shot trauma. There were 38 patients in Group A and 42 in Group B. Of these 42 patients, 19 were diagnosed with serious types of injury ; eight thoracic, three open long bone fracture, one intra-cardiac, one intracranial. Six additional patients were observed with injuries to large abdominal vessels. Eleven patients (28.9%) with isolated hepatic injury were managed non-operatively. Mortality, intensive care unit and hospital length of stay, and transfusion requirements were significantly higher in Group B. Only the number of transfused blood units and the grade of liver injury were found to be effective on outcome whereas stepwise regression analysis revealed that injury type (penetrating) and blood transfusion were predictive for mortality. This study highlighted that although isolated liver injury results in good outcome with non-operative management, concomitant injuries to the liver lead to a higher failure and mortality rate. However, liver injury itself is rarely responsible for death.

Snowboarding and ski boarding injuries in Niigata, Japan.

Science.gov (United States)

Sakamoto, Yuko; Sakuraba, Keishoku

2008-05-01

The purpose of this study was to compare the injury patterns and incidence of snowboarding and ski boarding injuries with that of alpine skiing in 2000 to 2005, as there are few previous studies comparing these 3 sports, especially in Asia. The injury patterns are different among the 3 snow sports. Descriptive epidemiology study. The subjects were alpine skiers (1240 cases), snowboarders (2220 cases), and ski boarders (132 cases) who were injured in 2 ski resorts located in Niigata prefecture in Japan and visited the authors' clinics in these ski resorts between 2000 and 2005. On visiting the clinics, patients completed a questionnaire reviewing the circumstances surrounding the injury event, and physicians documented the diagnosis. The injury rate, which was based on all purchased lift tickets, in snowboarding decreased gradually, although it was still 2 times higher than that of alpine skiing. Snowboarding and ski boarding had a higher fracture and dislocation rate. Both sports also had a 4 times higher rate of injuries because of jumping. The characteristics of ski boarding were a lower head and neck injury rate and collision injury rate than those of the other 2 snow sports, as well as a 2 times higher rate of fractures compared with alpine skiing injuries and a 1.4 times higher incidence than that of snowboarding injuries. Of the fractures caused by ski boarding accidents, 39.6% affected the lower leg bones. Injury prevention strategies should focus on jumps for snowboarders and ski boarders.

Musculoskeletal injuries in break-dancers.

Science.gov (United States)

Cho, Chul Hyun; Song, Kwang Soon; Min, Byung Woo; Lee, Sung Moon; Chang, Hyuk Won; Eum, Dae Seup

2009-11-01

Since no epidemiologic studies have been reported about musculoskeletal injuries in break-dancers, there are no data on the rates and patterns of musculoskeletal injuries in this population that clinicians can use to find ways to decrease injury rate. We believe that the incidence of injuries in break-dancers is higher than assumed and that injury rates and patterns differ between professional and amateur dancers. Descriptive epidemiologic study. Of a total of 42 study subjects, 23 were professional dancers and 19 were amateur dancers. Injury frequency, site and type, along with the presence of supervised training, the use of protective devices and warm-up exercises done were recorded. Of the 42 study subjects, excluding two amateur dancers, 40 (95.2%) had had musculoskeletal injuries at more than one site. The mean number of sites per dancer was 4.60. The frequency of injury depended on the site and was as follows: wrist (69.0%), finger (61.9%), knee (61.9%), shoulder (52.4%), lumbar spine (50.0%), elbow (42.9%), cervical spine (38.1%), ankle (38.1%), foot (28.6%) and hip (16.7%). Sprain, strain and tendinitis were the most common injuries, accounting for the most cases. Of the 42 dancers, 13 (31%) had had fractures or dislocations. Eight (19.1%) learned break-dancing under supervised instruction, 17 (40.5%) used protective devices and 28 (66.7%) performed warm-up exercises before dancing. There were significant differences in age, dance career length, amount of dance training, mean number of injury sites and the presence of supervised training between professionals and amateurs (Pnature of the activities that result in both unusual and common injuries in break-dancers and educate them about safety. Careful screening, instruction and supervised training of break-dancers will help to prevent injuries.

Determining the Prevalence and Assessing the Severity of Injuries in Mixed Martial Arts Athletes

Science.gov (United States)

2009-01-01

Background Mixed martial arts (MMA) is currently the fastest growing sport in the United States and has recently surpassed boxing as the most popular full contact sport. Due to the physical nature of the sport, MMA is associated with various types of injuries. Objective The purpose of this study was aimed at identifying prevalence and assessing the severity, location, and type of injuries in MMA athletes sustained during MMA related activities in the twelve month period prior to the survey. Methods A total of fifty-five subjects between the ages of 18 to 39 participated in the study. Participants were given a two-part questionnaire to collect demographic and injury data. Results Two hundred seven injuries were reported in the study. Low belt ranks had significantly more injuries more than any other belt rank, resulting in more than two times higher injury rate. Professional fighters had significantly more injuries than amateur fighters, resulting in three times higher injury rate. The most common body region injured was the head/neck/face (38.2%), followed by the lower extremities (30.4%), upper extremities (22.7%), torso (8.2%), and groin (0.5%). Injuries to the nose (6.3%), shoulder (6.3%), and toe (6.3%) were the most common. The most common type of injury was contusions (29.4%), followed by strains (16.2%), sprains (14.9%), and abrasions (10.1%). Conclusion Injury prevention efforts should consider the prevalence and distribution of injuries and focus on reducing or preventing injuries to the head/neck/face in MMA related activities. Preventative measures should focus on improving protective equipment during training, and possible competition rule modifications to further minimize participant injury. PMID:21509103

Epidemiology of work-related injuries requiring hospitalization among sawmill workers in British Columbia, 1989-1997.

Science.gov (United States)

Alamgir, Hasanat; Demers, Paul A; Koehoorn, Mieke; Ostry, Aleck; Tompa, Emile

2007-01-01

This study describes hospitalized injuries among workers in British Columbia lumber industry. Between April 1989 and December 1997, from the hospital records of 5,745 male sawmill workers were analyzed for the present study. Work relatedness was determined using either ICD-9 external cause of injury codes, which have a digit-indicating place of occurrence, or a payment field, which can identify workers compensation agency. Poisson regression models were used to analyze differences in hospitalization rates across race, job category, age group, and calendar year. The crude and adjusted rate ratios were calculated along with the 95% confidence intervals (CIs). During the follow-up period, there were 164 work related hospitalization resulting in a rate for work-related hospitalization of 5.38 per 1,000 person years. The higher rates by nature of injury were for dislocation, sprains & strains, open wounds, and fracture of upper limbs. During the study period, the higher rates of injury by causes were machinery related, falls, and struck against. In the multivariate models, there were no statistically significant relationship of injury risk with age and race. In respect to occupation, compared to foremen/supervisor, other sawmills' workers did not have significantly elevated risk of injury. The trend analyses found a significant negative trend (P = 0.004) of injury risk over the whole study period. Knowing the causes and nature of injury and their related risk factors are helpful to employers, compensation officials, and other stakeholders to target preventive measures.

A review of epidemiological injury studies in the oil- and gas offshore industry

DEFF Research Database (Denmark)

Jensen, Olaf; Laursen, Lise Hedegaard

2014-01-01

papers in PubMed, Cochrane, EMBASE, Google Scholar and Web of Science databases that were published on or before January 1st 2000. Results: i) The fatal injury incidence rates in the USA are significantly higher than for all other industries; ii) The incidence rates of lost time injuries have been...

Tackle-related injury rates and nature of injuries in South African Youth Week tournament rugby union players (under-13 to under-18): an observational cohort study.

Science.gov (United States)

Burger, Nicholas; Lambert, Mike I; Viljoen, Wayne; Brown, James C; Readhead, Clint; Hendricks, Sharief

2014-08-12

The tackle situation is most often associated with the high injury rates in rugby union. Tackle injury epidemiology in rugby union has previously been focused on senior cohorts but less is known about younger cohorts. The aim of this study was to report on the nature and rates of tackle-related injuries in South African youth rugby union players representing their provinces at national tournaments. Observational cohort study. Four South African Youth Week tournaments (under-13 Craven Week, under-16 Grant Khomo Week, under-18 Academy Week, under-18 Craven Week). Injury data were collected from 3652 youth rugby union players (population at risk) in 2011 and 2012. Tackle-related injury severity ('time-loss' and 'medical attention'), type and location, injury rate per 1000 h (including 95% CIs). Injury rate ratios (IRR) were calculated and modelled using a Poisson regression. A χ(2) analysis was used to detect linear trends between injuries and increasing match quarters. The 2012 under-13 Craven Week had a significantly greater 'time-loss' injury rate when compared with the 2012 under-18 Academy Week (IRR=4.43; 95% CI 2.13 to 9.21, p<0.05) and under-18 Craven Week (IRR=3.52; 95% CI 1.54 to 8.00, p<0.05). The Poisson regression also revealed a higher probability of 'overall' ('time-loss' and 'medical attention' combined) and 'time-loss' tackle-related injuries occurring at the under-13 Craven Week. The proportion of 'overall' and 'time-loss' injuries increased significantly with each quarter of the match when all four tournaments were combined (p<0.05). There was a difference in the tackle-related injury rate between the under-13 tournament and the two under-18 tournaments, and the tackle-related injury rate was higher in the final quarter of matches. Ongoing injury surveillance is required to better interpret these findings. Injury prevention strategies targeting the tackle may only be effective once the rate and nature of injuries have been accurately determined

Tackle-related injury rates and nature of injuries in South African Youth Week tournament rugby union players (under-13 to under-18): an observational cohort study

Science.gov (United States)

Burger, Nicholas; Lambert, Mike I; Viljoen, Wayne; Brown, James C; Readhead, Clint; Hendricks, Sharief

2014-01-01

Objectives The tackle situation is most often associated with the high injury rates in rugby union. Tackle injury epidemiology in rugby union has previously been focused on senior cohorts but less is known about younger cohorts. The aim of this study was to report on the nature and rates of tackle-related injuries in South African youth rugby union players representing their provinces at national tournaments. Design Observational cohort study. Setting Four South African Youth Week tournaments (under-13 Craven Week, under-16 Grant Khomo Week, under-18 Academy Week, under-18 Craven Week). Participants Injury data were collected from 3652 youth rugby union players (population at risk) in 2011 and 2012. Outcome measures Tackle-related injury severity (‘time-loss’ and ‘medical attention’), type and location, injury rate per 1000 h (including 95% CIs). Injury rate ratios (IRR) were calculated and modelled using a Poisson regression. A χ2 analysis was used to detect linear trends between injuries and increasing match quarters. Results The 2012 under-13 Craven Week had a significantly greater ‘time-loss’ injury rate when compared with the 2012 under-18 Academy Week (IRR=4.43; 95% CI 2.13 to 9.21, p<0.05) and under-18 Craven Week (IRR=3.52; 95% CI 1.54 to 8.00, p<0.05). The Poisson regression also revealed a higher probability of ‘overall’ (‘time-loss’ and ‘medical attention’ combined) and ‘time-loss’ tackle-related injuries occurring at the under-13 Craven Week. The proportion of ‘overall’ and ‘time-loss’ injuries increased significantly with each quarter of the match when all four tournaments were combined (p<0.05). Conclusions There was a difference in the tackle-related injury rate between the under-13 tournament and the two under-18 tournaments, and the tackle-related injury rate was higher in the final quarter of matches. Ongoing injury surveillance is required to better interpret these findings. Injury prevention strategies

The association between hip and groin injuries in the elite junior football years and injuries sustained during elite senior competition.

Science.gov (United States)

Gabbe, B J; Bailey, M; Cook, J L; Makdissi, M; Scase, E; Ames, N; Wood, T; McNeil, J J; Orchard, J W

2010-09-01

To establish the relationship between the history of hip and groin injuries in elite junior football players prior to elite club recruitment and the incidence of hip and groin injuries during their elite career. Retrospective cohort study. Analysis of existing data. 500 Australian Football League (AFL) players drafted from 1999 to 2006 with complete draft medical assessment data. Previous history of hip/groin injury, anthropometric and demographic information. The number of hip/groin injuries resulting in > or =1 missed AFL game. Data for 500 players were available for analysis. 86 (17%) players reported a hip/groin injury in their junior football years. 159 (32%) players sustained a hip/groin injury in the AFL. Players who reported a previous hip or groin injury at the draft medical assessment demonstrated a rate of hip/groin injury in the AFL >6 times higher (IRR 6.24, 95% CI 4.43 to 8.77) than players without a pre-AFL hip or groin injury history. This study demonstrated that a hip or groin injury sustained during junior football years is a significant predictor of missed game time at the elite level due to hip/groin injury. The elite junior football period should be targeted for research to investigate and identify modifiable risk factors for the development of hip/groin injuries.

Overuse Injuries in Professional Ballet: Injury-Based Differences Among Ballet Disciplines.

Science.gov (United States)

Sobrino, Francisco José; de la Cuadra, Crótida; Guillén, Pedro

2015-06-01

Despite overuse injuries being previously described as the most frequent in ballet, there are no studies on professional dancers providing the specific clinical diagnoses or type of injury based on the discipline. Overuse injuries are the most frequent injuries in ballet, with differences in the type and frequency of injuries based on discipline. Cross-sectional study; Level of evidence, 3. This was a descriptive cross-sectional study performed between January 1, 2005, and October 10, 2010, on injuries occurring in professional dancers from leading Spanish dance companies who practiced disciplines such as classical, neoclassical, contemporary, and Spanish ballet. Data, including type of injury, were obtained from specialized medical services at the Trauma Service, Fremap, Madrid, Spain. A total of 486 injuries were evaluated, a significant number of which were overuse disorders (P ballet (82.60%). Injuries were more frequent among female dancers (75.90%) and classical ballet (83.60%). A statistically significant prevalence of patellofemoral pain syndrome was found in the classical discipline (P = .007). Injuries of the adductor muscles of the thigh (P = .001) and of the low back facet (P = .02) in the Spanish ballet discipline and lateral snapping hip (P = .02) in classical and Spanish ballet disciplines were significant. Overuse injuries were the most frequent injuries among the professional dancers included in this study. The prevalence of injuries was greater for the most technically demanding discipline (classical ballet) as well as for women. Patellofemoral pain syndrome was the most prevalent overuse injury, followed by Achilles tendinopathy, patellar tendinopathy, and mechanical low back pain. Specific clinical diagnoses and injury-based differences between the disciplines are a key factor in ballet.

Functional Brain Connectivity during Multiple Motor Imagery Tasks in Spinal Cord Injury

Directory of Open Access Journals (Sweden)

Alkinoos Athanasiou

2018-01-01

Full Text Available Reciprocal communication of the central and peripheral nervous systems is compromised during spinal cord injury due to neurotrauma of ascending and descending pathways. Changes in brain organization after spinal cord injury have been associated with differences in prognosis. Changes in functional connectivity may also serve as injury biomarkers. Most studies on functional connectivity have focused on chronic complete injury or resting-state condition. In our study, ten right-handed patients with incomplete spinal cord injury and ten age- and gender-matched healthy controls performed multiple visual motor imagery tasks of upper extremities and walking under high-resolution electroencephalography recording. Directed transfer function was used to study connectivity at the cortical source space between sensorimotor nodes. Chronic disruption of reciprocal communication in incomplete injury could result in permanent significant decrease of connectivity in a subset of the sensorimotor network, regardless of positive or negative neurological outcome. Cingulate motor areas consistently contributed the larger outflow (right and received the higher inflow (left among all nodes, across all motor imagery categories, in both groups. Injured subjects had higher outflow from left cingulate than healthy subjects and higher inflow in right cingulate than healthy subjects. Alpha networks were less dense, showing less integration and more segregation than beta networks. Spinal cord injury patients showed signs of increased local processing as adaptive mechanism. This trial is registered with NCT02443558.

Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia, Is Associated with Higher Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population.

Science.gov (United States)

Rau, Cheng-Shyuan; Wu, Shao-Chun; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun; Kuo, Pao-Jen; Hsieh, Ching-Hua

2017-11-03

.3-fold higher odds of mortality, respectively, than patients with NDN. After adjusting for confounding factors, including sex and age, pre-existing co-morbidities, existence of different kinds of intracerebral hemorrhage, and injury severity, patients with SIH still had 6.6-fold higher odds of mortality than those with NDN; however, DH did not present significantly higher adjusted mortality odds. SIH and DH presented different effects on outcomes after TBI. The results also suggested that the pathophysiological effect associated with SIH was different from that of DH. Conclusions : This study demonstrated that patients with SIH and DH had significantly higher mortality than patients with NDN. However, the adjusted mortality was significantly higher only in the selected propensity score-matched patients with SIH and not in those with DH.

Physical Activity-Related Injury Profile in Children and Adolescents According to Their Age, Maturation, and Level of Sports Participation.

Science.gov (United States)

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

Physical activity (PA) is beneficial, enhancing healthy development. However, one-third of school-age children practicing sports regularly suffer from an injury. These injuries are associated with sex, chronological age, and PA level. To identify the importance of age, PA level, and maturity as predictors of injury in Portuguese youth. Descriptive epidemiological study. Level 3. Information about injury and PA level was assessed via 2 questionnaires (LESADO RAPIL II) from 647 subjects aged 10 to 17 years. Maturity offset according to Mirwald (time before or after peak height velocity) and Tanner-Whitehouse III bone age estimates were used to evaluate maturation. Binary logistic regression and gamma regression were used to determine significant predictors of injury and injury rate. Injury occurrence was higher for both sexes in recreational, school, and federated athletes (athletes engaged in sports that are regulated by their respective federations, with formal competition). These injuries also increased with age in boys and in the higher maturity offset group in girls. Injury rate was higher for both sexes in the no sports participation group. Early-maturing girls, with higher bone age and lower maturity offset, showed higher injury rate. Injuries in Portuguese youth were related to PA level, age, and biological maturation. Recreational, school, and federated athletes had more injury ocurrences while subjects with no sports participation had higher injury risk. Older subjects had more injuries. Early-maturing girls that had just passed peak height velocity may be particularly vulnerable to risk of sports injury because of the growing process. Increased knowledge about injury with specific PA exposure data is important to an overall risk management strategy. This study has deepened the association between injury and biological maturation variables.

Assessing injury severity in bicyclists involved in traffic accidents to more effectively prevent fatal bicycle injuries in Japan.

Science.gov (United States)

Gomei, Sayaka; Hitosugi, Masahito; Ikegami, Keiichi; Tokudome, Shogo

2013-10-01

The objective of this study was to clarify the relationship between injury severity in bicyclists involved in traffic accidents and patient outcome or type of vehicle involved in order to propose effective measures to prevent fatal bicycle injuries. Hospital records were reviewed for all patients from 2007 to 2010 who had been involved in a traffic accident while riding a bicycle and were subsequently transferred to the Shock Trauma Center of Dokkyo Medical University Koshigaya Hospital. Patient outcomes and type of vehicle that caused the injury were examined. The mechanism of injury, Abbreviated Injury Scale (AIS) score, and Injury Severity Score (ISS) of the patient were determined. A total of 115 patients' records were reviewed. The mean patient age was 47.1 ± 27.4 years. The average ISS was 23.9, with an average maximum AIS (MAIS) score of 3.7. The ISS, MAIS score, head AIS score, and chest AIS score were well correlated with patient outcome. The head AIS score was significantly higher in patients who had died (mean of 4.4); however, the ISS, MAIS score, and head AIS score did not differ significantly according to the type of vehicle involved in the accident. The mean head AIS scores were as high as 2.4 or more for accidents involving any type of vehicle. This study provides useful information for forensic pathologists who suspect head injuries in bicyclists involved in traffic accidents. To effectively reduce bicyclist fatalities from traffic accidents, helmet use should be required for all bicyclists.

Seizure-related injuries in children and adolescents with epilepsy.

Science.gov (United States)

Lagunju, IkeOluwa A; Oyinlade, Alexander O; Babatunde, Olubusayo D

2016-01-01

Children with epilepsy are reported to be at a greater risk of injuries compared with their peers who do not have epilepsy. We set out to determine the frequency and pattern of seizure-related injuries in children with epilepsy seen at the University College Hospital (UCH), Ibadan, Nigeria. Consecutive cases of epilepsy seen at the pediatric neurology clinic of the UCH, Ibadan over a period of 6months were evaluated for injuries in the preceding 12months using a structured questionnaire. These were compared with age- and sex-matched controls. A total of 125 children with epilepsy and 125 age- and sex-matched controls were studied. Injuries occurred more frequently in children with epilepsy than in their peers (p=0.01, OR 1.935, 95% CI 1.142-3.280). Epilepsy was generalized in 80 (64.0%), and localization-related in 45 (36.0%). Idiopathic epilepsy accounted for 74 (59.2%), and the remaining 51 (40.8%) had remote symptomatic epilepsy. Fifty-seven (45.6%) children had suffered seizure-related injuries with multiple injuries in 31 (24.8%). The most frequent were skin/soft tissue lacerations (26.4%), injuries to the tongue and soft tissues of the mouth (19.2%), minor head injuries (15.2%), and dental injuries with tooth loss (8.0%). There was a statistically significant association between seizure frequency and seizure-related injuries (p=0.002). Children on polytherapy had a significantly higher frequency of seizure-related injuries (pEpilepsy is a major risk factor for injuries in childhood. High seizure frequency increases the risk of multiple injuries in children with epilepsy. Copyright © 2015 Elsevier Inc. All rights reserved.

Spinal injuries in snowboarders: risk of jumping as an integral part of snowboarding.

Science.gov (United States)

Yamakawa, H; Murase, S; Sakai, H; Iwama, T; Katada, M; Niikawa, S; Sumi, Y; Nishimura, Y; Sakai, N

2001-06-01

The purpose of this study was to clarify the occurrence rate and characteristics of spinal injuries caused by snowboarding that were sustained at the Okumino skiing area in Gifu Prefecture, Japan, from 1988 to 2000. This study was a retrospective review of 13,490 cases of snowboard- or ski-related injury treated at Sumi Memorial Hospital over this period. A total of 7,188 patients sustained snowboard-related injuries, and 238 of these had spinal injuries caused by snowboarding (3.3%), whereas 6,302 patients sustained ski-related injuries, and 86 of these had spinal injuries caused by skiing (1.4%). Although there were no significant differences in the difficulty of slope, location of vertebral fracture, or spinal cord injury between snowboarders and skiers, the incidence of transverse process fractures was significantly higher in snowboard-related than in skiing-related injury (p jumping than beginners (p skiing resulted from a simple fall. Spinal injuries sustained while snowboarding are increasing considerably in incidence and are characterized as complex injuries. We must educate young snowboarders of the risk of this sport, to prevent these serious injuries.

Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience.

Science.gov (United States)

Veysi, Veysi T; Nikolaou, Vassilios S; Paliobeis, Christos; Efstathopoulos, Nicolas; Giannoudis, Peter V

2009-10-01

A review of prospectively collected data in our trauma unit for the years 1998-2003 was undertaken. Adult patients who suffered multiple trauma with an Injury Severity Score (ISS) of >/=16, admitted to hospital for more than 72 hours and with sustained blunt chest injuries were included in the study. Demographic details including pre-hospital care, trauma history, admission vital signs, blood transfusions, details of injuries and their abbreviated injury scores (AIS), operations, length of intensive care unit and hospital stays, Injury Severity Score (ISS) and mortality were analysed. Fulfilling the inclusion criteria with at least one chest injury were 1,164 patients. The overall mortality reached 18.7%. As expected, patients in the higher AIS groups had both a higher overall ISS and mortality rate with one significant exception; patients with minor chest injuries (AIS(chest) = 1) were associated with mortality comparable to injuries involving an AIS(chest) = 3. Additionally, the vast majority of polytraumatised patients with an AIS(chest) = 1 died in ICU sooner than patients of groups 2-5.

Badminton injuries.

Science.gov (United States)

Krøner, K; Schmidt, S A; Nielsen, A B; Yde, J; Jakobsen, B W; Møller-Madsen, B; Jensen, J

1990-01-01

In a one year period, from 1 January 1986 to 31 December 1986, 4303 patients with sports injuries were treated at Aarhus Amtssygehus and Aarhus Kommunehospital. The mean age was 21.6 years (range 7-72 years) and 2830 were men. Two hundred and seventeen badminton injuries occurred in 208 patients (136 men) with a mean age of 29.6 years (range 7-57 years), constituting 4.1 percent of all sport injuries in Aarhus. Joints and ligaments were injured in 58.5 percent of the patients, most frequently located in the lower limb and significantly more often among patients younger than 30 years of age. Muscle injury occurred in 19.8 percent of the patients. This type of injury was significantly more frequent among patients older than 30 years of age. Most injuries were minor. However, 6.8 percent of the patients were hospitalized and 30.9 percent received additional treatment by a physician. As the risk of injury varies with age, attempts to plan training individually and to institute prophylactic measures should be made. PMID:2078802

Blunt Cardiac Injury in the Severely Injured - A Retrospective Multicentre Study.

Directory of Open Access Journals (Sweden)

Marc Hanschen

Full Text Available Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients.In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009, characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6, the revised injury severity score (RISC allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6 (2.3% of patients.Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%. The overall mortality rate was 13.9%, minor cardiac injury (AIS 1 and severe cardiac injury (AIS 2-6 are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6 is associated with a higher mortality (OR 2.79 and 4.89, respectively as compared to the predicted average mortality (OR 2.49 of the study collective.Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients' outcome is dependent on the severity of cardiac injury.

Injury risk functions for frontal oblique collisions.

Science.gov (United States)

Andricevic, Nino; Junge, Mirko; Krampe, Jonas

2018-03-09

The objective of this article was the construction of injury risk functions (IRFs) for front row occupants in oblique frontal crashes and a comparison to IRF of nonoblique frontal crashes from the same data set. Crashes of modern vehicles from GIDAS (German In-Depth Accident Study) were used as the basis for the construction of a logistic injury risk model. Static deformation, measured via displaced voxels on the postcrash vehicles, was used to calculate the energy dissipated in the crash. This measure of accident severity was termed objective equivalent speed (oEES) because it does not depend on the accident reconstruction and thus eliminates reconstruction biases like impact direction and vehicle model year. Imputation from property damage cases was used to describe underrepresented low-severity crashes-a known shortcoming of GIDAS. Binary logistic regression was used to relate the stimuli (oEES) to the binary outcome variable (injured or not injured). IRFs for the oblique frontal impact and nonoblique frontal impact were computed for the Maximum Abbreviated Injury Scale (MAIS) 2+ and 3+ levels for adults (18-64 years). For a given stimulus, the probability of injury for a belted driver was higher in oblique crashes than in nonoblique frontal crashes. For the 25% injury risk at MAIS 2+ level, the corresponding stimulus for oblique crashes was 40 km/h but it was 64 km/h for nonoblique frontal crashes. The risk of obtaining MAIS 2+ injuries is significantly higher in oblique crashes than in nonoblique crashes. In the real world, most MAIS 2+ injuries occur in an oEES range from 30 to 60 km/h.

Unintentional injuries among Chinese children with different types and severity of disability.

Science.gov (United States)

Zhu, Huiping; Xiang, Huiyun; Xia, Xin; Yang, Xia; Li, Dan; Stallones, Lorann; Du, Yukai

2014-01-01

Little research has been done in China to study injury in individuals with disability. We investigated the impact of type and severity of disability on injury among children with disability in Hubei Province of China. A sample of 1201 children with disability were matched with 1201 healthy children on gender, age, and neighborhood. Disability type and severity were determined using the Chinese national standards. Caregivers were interviewed face-to-face about nonfatal unintentional injuries suffered by the child in the past 12 months before the interview. Univariate χ(2) test and logistic regression models were used to investigate association between disability type/severity and nonfatal unintentional injuries. Injury rate among children with disability was significantly higher than that among children without disability (10.2% vs. 4.4%; P disability and injury varied by type and severity of disability. The magnitude of the association between the presence or absence of disability in children and their risk of injury was large and significant, regardless of the type or severity of the children's disabilities. Copyright © 2014 Elsevier Inc. All rights reserved.

Correlation between crash avoidance maneuvers and injury severity sustained by motorcyclists in single-vehicle crashes.

Science.gov (United States)

Wang, Chen; Lu, Linjun; Lu, Jian; Wang, Tao

2016-01-01

In order to improve motorcycle safety, this article examines the correlation between crash avoidance maneuvers and injury severity sustained by motorcyclists, under multiple precrash conditions. Ten-year crash data for single-vehicle motorcycle crashes from the General Estimates Systems (GES) were analyzed, using partial proportional odds models (i.e., generalized ordered logit models). The modeling results show that "braking (no lock-up)" is associated with a higher probability of increased severity, whereas "braking (lock-up)" is associated with a higher probability of decreased severity, under all precrash conditions. "Steering" is associated with a higher probability of reduced injury severity when other vehicles are encroaching, whereas it is correlated with high injury severity under other conditions. "Braking and steering" is significantly associated with a higher probability of low severity under "animal encounter and object presence," whereas it is surprisingly correlated with high injury severity when motorcycles are traveling off the edge of the road. The results also show that a large number of motorcyclists did not perform any crash avoidance maneuvers or conducted crash avoidance maneuvers that are significantly associated with high injury severity. In general, this study suggests that precrash maneuvers are an important factor associated with motorcyclists' injury severity. To improve motorcycle safety, training/educational programs should be considered to improve safety awareness and adjust driving habits of motorcyclists. Antilock brakes and such systems are also promising, because they could effectively prevent brake lock-up and assist motorcyclists in maneuvering during critical conditions. This study also provides valuable information for the design of motorcycle training curriculum.

Injury Pattern in Icelandic Elite Male Handball Players.

Science.gov (United States)

Rafnsson, Elis Thor; Valdimarsson, Örnólfur; Sveinsson, Thorarinn; Árnason, Árni

2017-10-10

To examine the incidence, type, location, and severity of injuries in Icelandic elite male handball players and compare across factors like physical characteristics and playing position. Prospective cohort study. The latter part of the preseason and the competitive season of Icelandic male handball. Eleven handball teams (185 players) from the 2 highest divisions in Iceland participated in the study. Six teams (109 players) completed the study. Injuries were recorded by the players under supervision from their team physiotherapists or coaches. Coaches recorded training exposure, and match exposure was obtained from the Icelandic and European Handball Federations. The players directly recorded potential risk factors, such as age, height, weight, previous injuries, and player position. Injury incidence and injury location and number of injury days. Recorded time-loss injuries were 86, of which 53 (62%) were acute and 33 (38%) were due to overuse. The incidence of acute injuries was 15.0 injuries/1000 hours during games and 1.1 injuries/1000 hours during training sessions. No significant difference was found in injury incidence between teams, but number of injury days did differ between teams (P = 0.0006). Acute injuries were most common in knees (26%), ankles (19%), and feet/toes (17%), but overuse injuries occurred in low back/pelvic region (39%), shoulders (21%), and knees (21%). Previous knee injuries were the only potential risk factor found for knee injury. The results indicate a higher rate of overuse injuries in low back/pelvic region and shoulders than in comparable studies.

Dual hit lipopolysaccharide & oleic acid combination induced rat model of acute lung injury/acute respiratory distress syndrome

Directory of Open Access Journals (Sweden)

T N Hagawane

2016-01-01

Results: It was noted that the respiratory rate, and tumour necrosis factor-α (TNF-α levels were significantly higher at 4 h in the dual hit group as compared to LPS, OA and control groups. Interleukin-6 (IL-6 levels were significantly higher in the dual hit group as compared to LPS at 8 and 24 h, OA at 8 h and control (at all time intervals group. IL-1β levels were significantly higher in LPS and dual hit groups at all time intervals, but not in OA and control groups. The injury induced in dual hit group was earlier and more sustained as compared to LPS and OA alone. Interpretation & conclusions: The lung pathology and changes in respiration functions produced by the dual hit model were closer to the diagnostic criteria of ALI/ARDS in terms of clinical manifestations and pulmonary injury and the injury persisted longer as compared to LPS and OA single hit model. Therefore, the ARDS model produced by the dual hit method was closer to the diagnostic criteria of ARDS in terms of clinical manifestations and pulmonary injury.

The Effects of Motorcycle Helmet Legislation on Craniomaxillofacial Injuries.

Science.gov (United States)

Adams, Nicholas S; Newbury, Patrick A; Eichhorn, Mitchell G; Davis, Alan T; Mann, Robert J; Polley, John W; Girotto, John A

2017-06-01

Motorcycle helmet legislation has been a contentious topic for over a half-century. Benefits of helmet use in motorcycle trauma patients are well documented. In 2012, Michigan repealed its universal motorcycle helmet law in favor of a partial helmet law. The authors describe the early clinical effects on facial injuries throughout Michigan. Retrospective data from the Michigan Trauma Quality Improvement Program trauma database were evaluated. Included were 4643 motorcycle trauma patients presenting to 29 Level I and II trauma centers throughout Michigan 3 years before and after the law repeal (2009 to 2014). Demographics, external cause of injury codes, International Classification of Diseases, Ninth Revision diagnosis codes, and injury details were gathered. The proportion of unhelmeted trauma patients increased from 20 percent to 44 percent. Compared with helmeted trauma patients, unhelmeted patients were nearly twice as likely to sustain craniomaxillofacial injuries (relative risk, 1.90), including fractures (relative risk, 2.02) and soft-tissue injuries (relative risk, 1.94). Unhelmeted patients had a lower Glasgow Coma Scale score and higher Injury Severity Scores. Patients presenting after helmet law repeal were more likely to sustain craniomaxillofacial injuries (relative risk, 1.46), including fractures (relative risk, 1.28) and soft-tissue injuries (relative risk, 1.56). No significant differences were observed for age, sex, Injury Severity Score, or Glasgow Coma Scale score (p > 0.05). This study highlights the significant negative impact of relaxed motorcycle helmet laws leading to an increase in craniomaxillofacial injuries. The authors urge state and national legislators to reestablish universal motorcycle helmet laws.

Influence of long-term drinking alcohol on the cytokines in the rats with endogenous and exogenous lung injury.

Science.gov (United States)

Liu, Y D; Liu, W; Liu, Z

2013-02-01

Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) are syndromes of acute respiratory failure. Exploration of the impacts of long-term drinking alcohol on the cytokines of rats with endogenous and exogenous lung injuries. Through giving the model rats long-term drinking alcohol or water, we acquired the changes of the cytokines in the serum and bronchoalveolar lavage fluid (BALF) of these rats with lung injuries due to different incentives. The partial pressure of oxygen in rats with lung damage after long-term drinking alcohol were significantly lower than those drinking water group (p exogenous lung injury were higher than those of rats with endogenous lung injury (p endogenous lung injury were higher than those with exogenous lung injury (p exogenous lung injury. The expression of TNF-α, IL-6 and IL-10 are different according to the different ways that lead to the acute lung injury.

Windsurfing vs kitesurfing: Injuries at the North Sea over a 2-year period.

Science.gov (United States)

van Bergen, Christiaan J A; Commandeur, Joris P; Weber, Rik I K; Haverkamp, Daniel; Breederveld, Roelf S

2016-12-18

To analyze all windsurfing and kitesurfing (kiteboarding) injuries presented at our coastal hospital over a 2-year period. Twenty-five windsurfers (21 male; aged 31 ± 8 years) and 32 kitesurfers (23 male; aged 29 ± 11 years) presented at our hospital during the 2-year study period. Various injury data were recorded, including transport to hospital and treatment. After a median follow-up of 16 mo (range, 7-33 mo), 18 windsurfers (72%) and 26 kitesurfers (81%) completed questionnaires on the trauma mechanisms, the use of protective gear, time spent on windsurfing or kitesurfing, time to return to sports, additional injuries, and chronic disability. Most patients sustained minor injuries but severe injuries also occurred, including vertebral and tibial plateau fractures. The lower extremities were affected the most, followed by the head and cervical spine, the upper extremities, and the trunk. The injury rates were 5.2 per 1000 h of windsurfing and 7.0 per 1000 h of kitesurfing ( P = 0.005). The injury severity was the same between groups ( P = 1.0). Less than 30% of the study population used protective gear. Kitesurfers had a higher number of injuries, and required transport by ambulance, inpatient hospital stay and operative treatment more often than windsurfers, but these differences were not statistically significant ( P > 0.05). The median time to return to windsurfing and kitesurfing was 5 and 4 wk, respectively ( P = 0.79). Approximately one-third of the patients in each group experienced chronic symptoms. Kitesurfing results in a significantly higher injury rate than windsurfing in the same environmental conditions but the severity of the injuries does not differ.

A prospective investigation of injury incidence and injury risk factors among Army recruits in military police training.

Science.gov (United States)

Knapik, Joseph J; Graham, Bria; Cobbs, Jacketta; Thompson, Diane; Steelman, Ryan; Jones, Bruce H

2013-01-17

United States Army military police (MP) training is a 19-week course designed to introduce new recruits to basic soldiering skills, Army values and lifestyle, and law enforcement skills and knowledge. The present investigation examined injury rates and injury risk factors in MP training. At the start of training, 1,838 male and 553 female MP recruits were administered a questionnaire containing items on date of birth, height, weight, tobacco use, prior physical activity, injury history, and menstrual history. Injuries during training were obtained from electronic medical records and the training units provided data on student graduation and attrition. Successfully graduating from the course were 94.3% of the men and 83.7% of the women. Experiencing at least one injury during training were 34.2% of the men and 66.7% of the women (risk ratio (women/men) = 1.95, 95% confidence interval = 1.79-2.13). Recruits were at higher injury risk if they reported that they were older, had smoked in the past, or had performed less frequent exercise or sports prior to MP training. Men were at higher injury risk if they reported a prior injury and women were at higher risk if they reported missing at least six menstrual cycles in the last year or had previously been pregnant. The present investigation was the first to identify injury rates and identify specific factors increasing injury risk during MP training.

Management of Severe Perineal Injuries in Major Pelvic Fractures

Directory of Open Access Journals (Sweden)

A Jangjoo

2009-01-01

Full Text Available Introduction: Significant perineal injuries and major pelvic fractures resulting from blunt trauma manifest a high-energy injury. Open pelvic fractures (with perineal injury are associated with higher mortality rates of 40 to 60 %. Methods: This study was a review of patients with multiple traumas comprising of major pelvic fracture and severe perineal injuries (Shahid Kamyab hospital in Mashhad from 2002- 2005. A total of 11 patients, with pelvic fracture and perineal injuries (injury to urethra and anal canal were entered in the study. The data was gathered by a checklist and analyzed with SPSS software. Results: The population under study included 11 patients (9 male, 2 female with a mean age of 35years. Cause of trauma in all patients was motor vehicle accidents. All of the patients in the first 6 hours of admission received at least 4 liters of serum ringer lactate and 3 units of packed cells. The mean of packed cell received was 8 units and one patient needed 21 units of packed cells. All of patients were taken to the operating room for diverting colostomy, distal rectal washout, cystostomy and radical debridment and irrigation of devitalized tissue. Good results were achieved in 9 patients and there was one case of mortality and one morbidity (ARF. Conclusion: Open pelvic fractures and perineal injuries are associated with higher mortality rates. Prompt diagnosis and proper treatment (reanimation, colostomy, cystostomy, debridment and irrigation is the key to success.

Martial arts injuries.

Science.gov (United States)

Pieter, Willy

2005-01-01

To review the current evidence for the epidemiology of pediatric injuries in martial arts. The relevant literature was searched using SPORT DISCUS (keywords: martial arts injuries, judo injuries, karate injuries, and taekwondo injuries and ProQuest (keywords: martial arts, taekwondo, karate, and judo), as well as hand searches of the reference lists. In general, the absolute number of injuries in girls is lower than in boys. However, when expressed relative to exposure, the injury rates of girls are higher. Injuries by body region reflect the specific techniques and rules of the martial art. The upper extremities tend to get injured more often in judo, the head and face in karate and the lower extremities in taekwondo. Activities engaged in at the time of injury included performing a kick or being thrown in judo, while punching in karate, and performing a roundhouse kick in taekwondo. Injury type tends to be martial art specific with sprains reported in judo and taekwondo and epistaxis in karate. Injury risk factors in martial arts include age, body weight and exposure. Preventive measures should focus on education of coaches, referees, athletes, and tournament directors. Although descriptive research should continue, analytical studies are urgently needed.

Splenectomy exacerbates lung injury after ischemic acute kidney injury in mice

Science.gov (United States)

Andrés-Hernando, Ana; Altmann, Christopher; Ahuja, Nilesh; Lanaspa, Miguel A.; Nemenoff, Raphael; He, Zhibin; Ishimoto, Takuji; Simpson, Pete A.; Weiser-Evans, Mary C.; Bacalja, Jasna

2011-01-01

Patients with acute kidney injury (AKI) have increased serum proinflammatory cytokines and an increased occurrence of respiratory complications. The aim of the present study was to examine the effect of renal and extrarenal cytokine production on AKI-mediated lung injury in mice. C57Bl/6 mice underwent sham surgery, splenectomy, ischemic AKI, or ischemic AKI with splenectomy and kidney, spleen, and liver cytokine mRNA, serum cytokines, and lung injury were examined. The proinflammatory cytokines IL-6, CXCL1, IL-1β, and TNF-α were increased in the kidney, spleen, and liver within 6 h of ischemic AKI. Since splenic proinflammatory cytokines were increased, we hypothesized that splenectomy would protect against AKI-mediated lung injury. On the contrary, splenectomy with AKI resulted in increased serum IL-6 and worse lung injury as judged by increased lung capillary leak, higher lung myeloperoxidase activity, and higher lung CXCL1 vs. AKI alone. Splenectomy itself was not associated with increased serum IL-6 or lung injury vs. sham. To investigate the mechanism of the increased proinflammatory response, splenic production of the anti-inflammatory cytokine IL-10 was determined and was markedly upregulated. To confirm that splenic IL-10 downregulates the proinflammatory response of AKI, IL-10 was administered to splenectomized mice with AKI, which reduced serum IL-6 and improved lung injury. Our data demonstrate that AKI in the absence of a counter anti-inflammatory response by splenic IL-10 production results in an exuberant proinflammatory response and lung injury. PMID:21677145

Injury rates in martial art athletes: anthropometric parameters and training volume, but not foot morphology indexes, are predictive risk factors for lower limb injuries.

Science.gov (United States)

Vitale, Jacopo A; Bassani, Tito; Galbusera, Fabio; Bianchi, Alberto; Martinelli, Nicolò

2017-09-22

Previous studies attempted to identify possible risk factors for acute and overuse injuries in several sports disciplines such as running, gymnastics or team sports. Given the lack of scientific works focused on risk factors for lower limb injuries in martial arts, the present study was aimed to investigate foot anatomy, anthropometric measures, and other background information as possible risk factors of injury in barefoot athletes practicing judo, karate, kung fu, thai boxe, or aikido. In addition, the injury rates were evaluated in relation with the different martial art styles. One group of 130 martial artists was retrospectively evaluated. Data of three foot morphological variables were collected: navicular height (NH), navicular drop (ND) and the rear foot (RF). In addition, each participant filled an interview questionnaire providing the following information: age, sex, body weight, height, BMI, hours of training per week, the kind of injury occurred to the lower limbs in the preceding year. Of 130 subjects, 70 (53.8%) did not sustain injuries, 35 (27.0%) suffered an acute injury and the remaining 25 (19.2%) reported an overuse injury. No significant differences were observed in the injury rates in relation to style and kind of martial art. Age, training volume and BMI were found as significant predictors of injury, while NH, ND and RF were not able to predict acute or overuse injury at lower limbs. The injury rates were similar in karate, judo, kung fu, aikido, and thai boxe. The foot morphology variables were not related with the presence or absence of acute and overuse injuries. Conversely, older and heavier martial artists, performing more hours of barefoot training, are at higher risk of acute and overuse injury. Athletic trainers should strongly take into account the present information in order to develop more accurate and specific injury prevention programs for martial artists.

Characterization of American Football Injuries in Children and Adolescents.

Science.gov (United States)

Smith, Patrick J; Hollins, Anthony M; Sawyer, Jeffrey R; Spence, David D; Outlaw, Shane; Kelly, Derek M

2018-02-01

As a collision sport, football carries a significant risk of injury, as indicated by the large number of pediatric football-related injuries seen in emergency departments. There is little information in the medical literature focusing on the age-related injury patterns of this sport. Our purpose was to evaluate the types of football-related injuries that occur in children and adolescents and assess which patient characteristics, if any, affect injury pattern. Retrospective chart review was performed of football-related injuries treated at a level 1 pediatric referral hospital emergency department and surrounding urgent care clinics between January 2010 and January 2014. Patients with e-codes for tackle football selected from the electronic medical record were divided into 4 age groups: younger than 8 years old, 8 to 11, 12 to 14, and 15 to 18 years. Data collected included diagnosis codes, procedure codes, and hospital admission status. Review identified 1494 patients with 1664 football-related injuries, including 596 appendicular skeleton fractures, 310 sprains, 335 contusions, 170 closed head injuries, 62 dislocations, 9 spinal cord injuries, and 14 solid organ injuries. There were 646 (43.2%) athletes with upper extremity injuries and 487 (32.6%) with injuries to the lower extremity. Hospital admissions were required in 109 (7.3%) patients. Fracture was the most common injury in all four patient age groups, but occurred at a lower rate in the 15 to 18 years old age group. The rate of soft tissue injury was higher in the 15 to 18 years old age group. The rate of closed head injury, which included concussions, was highest in the younger than 8 years old age group. Age does influence the rates of certain football-related injuries in children and adolescents. Fractures decrease with increasing age, while the rate of soft tissue trauma increases with increasing age. Younger patients (younger than 8 y old) trended toward higher rates of closed head injury compared

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.

Injuries in team sport tournaments during the 2004 Olympic Games.

Science.gov (United States)

Junge, Astrid; Langevoort, Gijs; Pipe, Andrew; Peytavin, Annie; Wong, Fook; Mountjoy, Margo; Beltrami, Gianfranco; Terrell, Robert; Holzgraefe, Manfred; Charles, Richard; Dvorak, Jiri

2006-04-01

Several authors have analyzed the incidence of injuries in a given sport, but only a few have examined the exposure-related incidence of injuries in different types of sports using the same methodology. Analysis of the incidence, circumstances, and characteristics of injuries in different team sports during the 2004 Olympic Games. Cohort study; Level of evidence, 2. During the 2004 Olympic Games, injuries in 14 team sport tournaments (men's and women's soccer, men's and women's handball, men's and women's basketball, men's and women's field hockey, baseball, softball, men's and women's water polo, and men's and women's volleyball) were analyzed. After each match, the physician of the participating teams or the official medical representative of the sport completed a standardized injury report form. The mean response rate was 93%. A total of 377 injuries were reported from 456 matches, an incidence of 0.8 injuries per match (95% confidence interval, 0.75-0.91) or 54 injuries per 1000 player matches (95% confidence interval, 49-60). Half of all injuries affected the lower extremity; 24% involved the head or neck. The most prevalent diagnoses were head contusion and ankle sprain. On average, 78% of injuries were caused by contact with another player. However, a significantly higher percentage of noncontact (57%) versus contact injuries (37%) was expected to prevent the player from participating in his or her sport. Significantly more injuries in male players (46%) versus female players (35%) were expected to result in absence from match or training. The incidence, diagnosis, and causes of injuries differed substantially between the team sports. The risk of injury in different team sports can be compared using standardized methodology. Even if the incidence and characteristics of injuries are not identical in all sports, prevention of injury and promotion of fair play are relevant topics for almost all team sports.

Long-term outcome after whiplash injury. A 2-year follow-up considering features of injury mechanism and somatic, radiologic, and psychosocial findings.

Science.gov (United States)

Radanov, B P; Sturzenegger, M; Di Stefano, G

1995-09-01

With the increased incidence of whiplash injury following the introduction of compulsory car seat belts, a large number of reports have dealt with the aftermath of this condition. Previous studies, however, focused on somatic symptoms on the one hand or considered only psychological or neuropsychological variables on the other hand, often in loosely defined or selected groups of patients. No study so far has analyzed the long-term outcome in a nonselected group of patients using a clear injury definition considering patient history; somatic, radiologic, and neuropsychological findings; and features of the injury mechanisms assessed soon after trauma and during follow-up. the present investigation was designed to assess these combined factors. According to a strict definition of whiplash injury, we assessed a consecutive nonselected sample of 117 patients with recent injury who had similar sociocultural and educational backgrounds. The patients had been in automobile crashes and were all equally covered by accident insurance according to the country-wide scheme. Initial examination was performed 7.2 +/- 4.2 days after trauma, and follow-up examinations 3, 6, 12, and 24 months later. At baseline, features of injury mechanism, subjective complaints, and different aspects of patient history were documented and cervical spine X rays performed. At all examinations patients underwent neurologic examination and cognitive and psychosocial factor assessment. At 2 years, patients were divided into symptomatic and asymptomatic groups and then compared with regard to the initial findings. In addition, symptomatic patients who were disabled at the 2-year follow-up examination and symptomatic patients not disabled (that is, they were able to work at the pretraumatic level) were compared regarding initial and 2-year findings. At 2 years, 18% of patients still had injury-related symptoms. With regard to baseline findings the following significant differences were found: Symptomatic

Pediatric martial arts injuries presenting to Emergency Departments, United States 1990-2003.

Science.gov (United States)

Yard, Ellen E; Knox, Christy L; Smith, Gary A; Comstock, R Dawn

2007-08-01

Although an estimated 6.5 million United States (US) children aged 6-17 practiced a martial art in 2004, there have been no nationally representative studies comparing pediatric injuries among the three most popular disciplines, karate, taekwondo, and judo. Describe pediatric martial arts injuries presenting to a representative sample of US Emergency Departments (EDs) from 1990 to 2003. We reviewed all martial arts injuries captured by the US Consumer Product Safety Commission's (CPSC), National Electronic Injury Surveillance System (NEISS). An estimated 128,400 children injuries from 1990 to 2003. Injured tended to be male (73.0%) and had a mean age of 12.1 years. Most injuries were attributed to karate (79.5%). The most common mechanism of injury was being kicked (25.6%), followed by falling (20.6%) and kicking (18.0%). The majority of injuries occurred to the lower leg/foot/ankle (30.1%) and hand/wrist (24.5%). The most common injury diagnoses were sprains/strains (29.3%), contusions/abrasions (27.8%), and fractures (24.6%). Participants in judo sustained significantly higher proportions of shoulder/upper arm injuries than karate (IPR=4.31, 95% CI: 2.84-6.55) or taekwondo (IPR=9.75, 95% CI: 3.53-26.91) participants. There were also higher proportions of neck injuries sustained by judo participants compared to karate (IPR=4.73, 95% CI: 1.91-11.70) or taekwondo (IPR=4.17, 95% CI: 1.02-17.06) participants. Pediatric martial arts injuries differ by discipline. Understanding these injury patterns can assist with the development of discipline-specific preventive interventions.

Blunt gastric injuries.

Science.gov (United States)

Oncel, Didem; Malinoski, Darren; Brown, Carlos; Demetriades, Demetrios; Salim, Ali

2007-09-01

Gastric rupture after blunt abdominal trauma is a rare injury with few reports in the literature. The purpose of this study was to review our experience with blunt gastric injuries and compare outcomes with small bowel or colon injuries. All patients with hollow viscus perforations after blunt abdominal trauma from 1992 to 2005 at our level I trauma center were reviewed. Of 35,033 blunt trauma admissions, there were 268 (0.7%) patients with a total of 319 perforating hollow viscus injuries, 25 (0.07%) of which were blunt gastric injuries. When compared with the small bowel or colon injuries, the blunt gastric injury group had a higher Injury Severity Score (22 versus 17, P = 0.04), more patients with a chest Abbreviated Injury Score greater than 2 (36% versus 12%, P < 0.01), and a shorter interval from injury to laparotomy (221 versus 366 minutes, P = 0.017). Multivariate analysis identified five independent risk factors for mortality: age older than 55 years, head Abbreviated Injury Score greater than 2, chest Abbreviated Injury Score greater than 2, the presence of hypotension on admission, and Glasgow Coma Scale 8 or less. The results of this study suggest that mortality in patients with blunt hollow viscus injuries can be attributed to concurrent head and chest injuries, but not the specific hollow viscus organ that is injured.

Work-related ocular injuries in Johor Bahru, Malaysia

Directory of Open Access Journals (Sweden)

Nyo Nyo Min

2016-03-01

Full Text Available AIM:To describe the epidemiology of work-related ocular injuries and its visual outcome in tertiary hospital in southern Malaysia. METHODS:Retrospective review of medical records of patients diagnosed as work-related ocular injuries who attended to the eye casualty of Hospital Sultan Ismail in Johor Bahru, Malaysia from Jan. 2011 to Dec. 2013. Data for clinical presentation, types of injuries, use of eye protective device(EPDand visual outcome were collected using a standardized proforma.RESULTS: A total of 935 ocular injuries attended to Hospital Sultan Ismail during 3y period. Among them 440 cases were work-related ocular injuries and included in the study. There was significant male preponderance(98.19%and commonest age group affected was 21 to 30y(45%. The most common type of injury was superficial injuries(70.91%, followed by chemical(11.13%, open globe(8.41%, closed globe(6.83%and thermal(2.72%. Although Malays are commonly involved in work-related ocular injury accounted for 78.47%, two-thirds of open globe injuries were seen in foreign workers. Only 59 patients(13.41%reported that they wore EPD at the time of incident. Generally, 89.86%(n=399had good vision, 5.45%(n=24had moderate vision and 3.86%(n=17poor vision. Visual outcome related to specific types of injuries showed that poor outcome was higher in open globe injuries groups compared with closed globe injuries \\〖odd ratio(OR=3.33, 95% confidence interval(CI=0.68 to 16.33\\〗. Overall hospital attendance rate of work-related ocular trauma ranged from 20.7 to 51.9 per 1000 new cases and decline of approximately 1.5% per year(PCONCLUSION: Work-related ocular trauma is important cause of ocular morbidity in working forces particularly young men. Malay males between 21 to 40y have higher risk. Majority of work-related ocular trauma seen in our hospital are generally of superficial injuries and potentially preventable. This study indicates they need to improve safety measures to

Traumatic colon injuries -- factors that influence surgical management.

Science.gov (United States)

Jinescu, G; Lica, I; Beuran, M

2013-01-01

This study sought to evaluate current trends in surgical management of colon injuries in a level I urban trauma centre, in the light of our increasing confidence in primary repair. Our retrospective study evaluates the results of 116 patients with colon injuries operated at Bucharest Clinical Emergency Hospital, in the light of some of the most commonly cited factors which could influence the surgeon decision-making process towards primary repair or colostomy. Blunt injuries were more common than penetrating injuries (65% vs. 31%). Significant other injuries occurred in 85 (73%) patients. Primary repair was performed in 95 patients (82%). Fecal diversion was used in 21 patients(18%). Multiple factors influence the decision-making process: shock, fecal contamination, associated injuries and higher scores on the Abdominal Trauma Index (ATI) and Colon Injury Scale (CIS). Colon related intra-abdominal complications occurred in 7% of patients in whom the colon injury was closed primarily and in 14% of patients in whom a stoma was created, ATI having a predictive role in their occurrence. The overall mortality rate was 19%. Primary repair of colon injuries, either by primary suture or resection and anastomosis, is a safe method in the management of the majority of colonic injuries. Colostomy is preferred for patients with ATI ≥ 30 and CIS ≥ 4. Surgical judgment remains the final arbiter in decision making. Celsius.

Blunt Cardiac Injury in Trauma Patients with Thoracic Aortic Injury

Directory of Open Access Journals (Sweden)

Rathachai Kaewlai

2011-01-01

Full Text Available Trauma patients with thoracic aortic injury (TAI suffer blunt cardiac injury (BCI at variable frequencies. This investigation aimed to determine the frequency of BCI in trauma patients with TAI and compare with those without TAI. All trauma patients with TAI who had admission electrocardiography (ECG and serum creatine kinase-MB (CK-MB from January 1999 to May 2009 were included as a study group at a level I trauma center. BCI was diagnosed if there was a positive ECG with either an elevated CK-MB or abnormal echocardiography. There were 26 patients (19 men, mean age 45.1 years, mean ISS 34.4 in the study group; 20 had evidence of BCI. Of 52 patients in the control group (38 men, mean age 46.9 years, mean ISS 38.7, eighteen had evidence of BCI. There was a significantly higher rate of BCI in trauma patients with TAI versus those without TAI (77% versus 35%, P<0.001.

Clinical Findings in Patients with Splenic Injuries: Are Injuries to the Left Lower Chest Important?

Directory of Open Access Journals (Sweden)

Schneir, Aaron

2001-07-01

Full Text Available The purpose of this study was to describe the clinical findings in patients with splenic injury and to determine if isolated left lower chest injury may be the single clinical indicator of splenic injury. The medical records of all adult blunt trauma patients with splenic injury over a 14 month period were reviewed. Significant left lower chest injury was considered present if the patient had left sided pleuritic chest pain with tenderness to ribs 7-12 or if these ribs were visualized as fractured on any imaging study. Patients were considered to have clinical findings suggestive of splenic injury if they had pre-hospital or emergency department hypotension, abdominal pain or tenderness, a Glasgow coma scale < 15, or gross hematuria. Ninety patients had splenic injury. Thirty-nine (43%. 95% CI 33, 54% patients had significant left lower chest injury. In five (6%. 95% CI 2, 12% patients, injury to this portion of the chest was the single indicator of splenic injury. Nearly half the patients with splenic injury will have significant injury to the left lower chest and this finding may be the only indicator of splenic injury.

An Epidemiological Comparison of Elbow Injuries Among United States High School Baseball and Softball Players, 2005-2006 Through 2014-2015.

Science.gov (United States)

Pytiak, Andrew V; Kraeutler, Matthew J; Currie, Dustin W; McCarty, Eric C; Comstock, R Dawn

Pitching is a common mechanism of injury in baseball, with known risk factors for elbow injuries among adolescent pitchers. Elbow injury rates and mechanisms will differ between high school baseball and softball players. Descriptive epidemiology study. Level 3. Baseball- and softball-related injury data from the 2005-2006 through 2014-2015 academic years were collected from the High School Reporting Information Online (RIO) Internet-based data collection tool. Athlete-exposure (AE) and injury data were collected by certified athletic trainers. Rate ratios (RRs) were calculated comparing injury rates in the 2 populations. Injury proportion ratios (IPRs) comparing elbow injuries in pitchers and nonpitchers were calculated as the proportion of all elbow injuries in pitchers divided by the proportion of all elbow injuries in nonpitchers. A total of 214 elbow injuries in male baseball players occurred over 2,327,774 AEs, for an overall elbow injury rate of 0.92 per 10,000 AEs. A total of 75 elbow injuries were reported in female softball players over 1,731,644 AEs, for an overall rate of 0.43 per 10,000 AEs. The rate of elbow injury was significantly higher for baseball than softball (RR, 2.12; 95% CI, 1.64-2.77). A significantly greater proportion of elbow injuries in baseball were pitching-related compared with those from softball, with 50.2% occurring while pitching in baseball versus 11.0% in softball (IPR, 4.58; 95% CI, 2.35-8.93). If all injuries occurring during pitching were removed from both sports, the difference in elbow injury rate for baseball and softball would no longer be significant (RR, 1.19; 95% CI, 0.88-1.62). The rate of elbow injuries is significantly higher in baseball than softball. This is attributable to differences in rates of pitching-related injuries between these 2 groups. These results demonstrate that overhand pitching increases risk of elbow injury in high school athletes.

Injury risk in Danish youth and senior elite handball using a new SMS text messages approach.

Science.gov (United States)

Moller, Merete; Attermann, Jorn; Myklebust, Grethe; Wedderkopp, Niels

2012-06-01

To assess the injury incidence in elite handball, and if gender and previous injuries are risk factors for new injuries. Cohort study of 517 male and female elite handball players (age groups under (u)16, u-18 and senior). Participants completed a web survey establishing injury history, demographic information and sports experience, and provided weekly reports of time-loss injuries and handball exposure for 31 weeks by short message service text messaging (SMS). Injuries were further classified by telephone interview. The weekly response rate ranged from 85% to 90% illustrating the promise of the SMS system as a tool in injury surveillance. Of 448 reported injuries, 165 injuries (37%) were overuse injuries and 283 (63%) traumatic injuries. Knee (19%) and ankle (29%) were the most common traumatic injuries. The injury incidence during match play was 23.5 (95% CI 17.8 to 30.4), 15.1 (95% CI 9.7 to 22.2), 11.1 (95% CI 7.0 to 16.6) injuries per 1000 match hours among senior, u-18 and u-16 players, respectively. U-18 male players had an overall 1.76 (95% CI 1.10 to 2.80) times higher risk of injury compared to females. Having had two or more previous injuries causing absence from handball for more than 4 weeks increased the risk of new injury in the u-16 group (IRR: 1.79 (95% CI 1.03 to 3.11)-2.23 (95% CI 1.22 to 4.10)). The incidence of time-loss injuries in elite handball was higher during match play than previously reported in recreational handball. Previous injuries were a risk factor for new injuries among u-16 players. Male players had a significant higher injury rate in the u-18 group.

CT-based injury classification

International Nuclear Information System (INIS)

Mirvis, S.E.; Whitley, N.O.; Vainright, J.; Gens, D.

1988-01-01

Review of preoperative abdominal CT scans obtained in adults after blunt trauma during a 2.5-year period demonstrated isolated or predominant liver injury in 35 patients and splenic injury in 33 patients. CT-based injury scores, consisting of five levels of hepatic injury and four levels of splenic injury, were correlated with clinical outcome and surgical findings. Hepatic injury grades I-III, present in 33 of 35 patients, were associated with successful nonsurgical management in 27 (82%) or with findings at celiotomy not requiring surgical intervention in four (12%). Higher grades of splenic injury generally required early operative intervention, but eight (36%) of 22 patients with initial grade III or IV injury were managed without surgery, while four (36%) of 11 patients with grade I or II injury required delayed celiotomy and splenectomy (three patients) or emergent rehospitalization (one patient). CT-based injury classification is useful in guiding the nonoperative management of blunt hepatic injury in hemodynamically stable adults but appears to be less reliable in predicting the outcome of blunt splenic injury

A systematic review on the influence of pre-existing disability on sustaining injury.

Science.gov (United States)

Yung, A; Haagsma, J A; Polinder, S

2014-01-01

To systematically review studies measuring the influence of pre-existing disability on the risk of sustaining an injury. Systematic review. Electronic databases searched included Medline (Pubmed), ProQuest, Ovid and EMBASE. Studies (1990-2010) in international peer-reviewed journals were identified with main inclusion criteria being that the study assessed involvement of injury sustained by persons with and without pre-existing disability. Studies were collated by design and methods, and evaluation of results. Twenty-two studies met the inclusion criteria of our review. All studies found that persons with disabilities were at a significantly higher risk of sustaining injuries than those without. Persons with disability had a 30-450% increased odds (odds ratio 1.3-5.5) of sustaining injury compared to persons without disability. Among persons with pre-existing disability, the high risk groups of sustaining an injury are children and elderly. People with disabilities experience a higher risk to sustain an injury in comparison to the healthy population. There is a high need for large epidemiological studies of injury among persons with disability, to better address these unique risk profiles in order to prevent additional disability or secondary conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Weight-training injuries. Common injuries and preventative methods.

Science.gov (United States)

Mazur, L J; Yetman, R J; Risser, W L

1993-07-01

The use of weights is an increasingly popular conditioning technique, competitive sport and recreational activity among children, adolescents and young adults. Weight-training can cause significant musculoskeletal injuries such as fractures, dislocations, spondylolysis, spondylolisthesis, intervertebral disk herniation, and meniscal injuries of the knee. Although injuries can occur during the use of weight machines, most apparently happen during the aggressive use of free weights. Prepubescent and older athletes who are well trained and supervised appear to have low injury rates in strength training programmes. Good coaching and proper weightlifting techniques and other injury prevention methods are likely to minimise the number of musculoskeletal problems caused by weight-training.

Disabling injuries of the cervical spine in Argentine rugby over the last 20 years.

Science.gov (United States)

Secin, F P; Poggi, E J; Luzuriaga, F; Laffaye, H A

1999-02-01

To investigate the incidence and risk factors of disabling injuries to the cervical spine in rugby in Argentina. A retrospective review of all cases reported to the Medical Committee of the Argentine Rugby Union (UAR) and Rugby Amistad Foundation was carried out including a follow up by phone. Cumulative binomial distribution, chi 2 test, Fisher test, and comparison of proportions were used to analyse relative incidence and risk of injury by position and by phase of play (Epi Info 6, Version 6.04a). Eighteen cases of disabling injury to the cervical spine were recorded from 1977 to 1997 (0.9 cases per year). The forwards (14 cases) were more prone to disabling injury of the cervical spine than the backs (four cases) (p = 0.03). Hookers (9/18) were at highest risk of injury (p < 0.01). The most frequent cervical injuries occurred at the 4th, 5th, and 6th vertebrae. Seventeen of the injuries occurred during match play. Set scrums were responsible for most of the injuries (11/18) but this was not statistically significant (p = 0.44). The mean age of the injured players was 22. Tetraplegia was initially found in all cases. Physical rehabilitation has been limited to the proximal muscles of the upper limbs, except for two cases of complete recovery. One death, on the seventh day after injury, was reported. The forwards suffered a higher number of injuries than the backs and this difference was statistically significant. The chance of injury for hookers was statistically higher than for the rest of the players and it was particularly linked to scrummaging. However, the number of injuries incurred in scrums was not statistically different from the number incurred in other phases of play.

[Protective effect of compound bismuth and magnesium granules on aspirin-induced gastric mucosal injury in rats].

Science.gov (United States)

Mu, F H; Hu, F L; Wei, H; Zhang, Y Y; Yang, G B; Lei, X Y; Yang, Y P; Sun, W N; Cui, M H

2016-02-01

To investigate the protective effect of compound bismuth and magnesium granules on aspirin-induced gastric mucosal injury in rats and its possible mechanism. Acute gastric mucosal injury model was developed with intraperitoneal injection of aspirin in Wistar rats. The rats were divided into normal control group, injury group, sucralfate protection group, compound bismuth and magnesium granules protection group and its herbal components protection group(each group 12 rats). In the protection groups, drugs as mentioned above were administered by gavage before treated with intraperitoneal injection of aspirin. To evaluate the extent of gastric mucosal injury and the protective effect of drugs, gastric mucosal lesion index, gastric mucosal blood flow, content of gastric mucosal hexosamine, prostaglandins (PG), nitric oxide(NO), tumor necrosis factor (TNF), and interleukin (IL) -1, 2, 8 were measured in each group, and histological changes were observed by gross as well as under microscope and electron microscope. Contents of hexosamine, NO, and PG in all the protection groups were significantly higher than those in the injury group (all Pcompound bismuth and magnesium granules group was significantly higher than that in the sucralfate group ((11.29±0.51) vs(10.80±0.36)nmol/ml, Pcompound bismuth and magnesium granules group were significantly lower than those in the sucralfate group ((328.17±6.56) vs(340.23±8.05)pg/ml, PCompound bismuth and magnesium granules and its herbal components may have significant protective effect on aspirin-induced gastric mucosal injury.

Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey

Directory of Open Access Journals (Sweden)

Setel Philip

2005-01-01

Full Text Available Abstract Background Injuries are becoming a major health problem in developing countries. Few population based studies have been carried out in African countries. We examined the pattern of nonfatal injuries and associated risk factors in an urban and rural setting of Tanzania. Methods A population-based household survey was conducted in 2002. Participants were selected by cluster sampling. A total of 8,188 urban and 7,035 rural residents of all ages participated in the survey. All injuries reported among all household members in the year preceding the interview and resulting in one or more days of restricted activity were included in the analyis. Results A total of 206 (2.5% and 303 (4.3% persons reported to have been injured in the urban and rural area respectively. Although the overall incidence was higher in the rural area, the incidence of major injuries (≥ 30 disability days was similar in both areas. Males were at a higher risk of having an injury than females. Rural residents were more likely to experience injuries due to falls (OR = 1.6; 95% CI = 1.1 – 2.3 and cuts (OR = 4.3; 95% CI = 3.0 – 6.2 but had a lower risk of transport injuries. The most common causes of injury in the urban area were transport injuries and falls. In the rural area, cuts and stabs, of which two thirds were related to agriculture, formed the most common cause. Age was an important risk factor for certain types of injuries. Poverty levels were not significantly associated with experiencing a nonfatal injury. Conclusion The patterns of injury differ in urban and rural areas partly as a reflection of livelihoods and infrastructure. Rural residents are at a higher overall injury risk than urban residents. This may be important in the development of injury prevention strategies.

Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes.

Science.gov (United States)

Mitani, Yasuhiro

2017-01-01

[Purpose] To investigate the gender-related differences in lower limb alignment, range of joint motion, and history of lower limb sports injuries in Japanese university athletes. [Subjects and Methods] The subjects were 224 Japanese university athletes (154 males and 70 females). The quadriceps angle (Q-angle), arch height index, and ranges of internal and external rotation of the hip joints were measured. History of lower limb sports injury was surveyed using a questionnaire. [Results] Females had a significantly higher Q-angle and hip joint internal rotation angle and a significantly lower arch height index than males. The survey revealed that a significantly higher proportion of females had a history of lower limb sports injuries, and that the proportion of those with a history of foot/ankle injuries was particularly high. [Conclusion] These results suggested that females experience more lower limb sports injuries than males, and that a large proportion of these injuries involve the foot/ankle. Reduced lower limb alignment and increased range of joint motion in females may be risk factors for injury because they lead to increased physical stress being exerted on the lower legs during sporting activities.

Airbag deployment-related eye injuries.

Science.gov (United States)

Koisaari, Tapio; Leivo, Tiina; Sahraravand, Ahmad; Haavisto, Anna-Kaisa; Sulander, Pekka; Tervo, Timo M T

2017-07-04

We studied the correlation between airbag deployment and eye injuries using 2 different data sets. The registry of the Finnish Road Accident (FRA) Investigation Teams was analyzed to study severe head- and eyewear-related injuries. All fatal passenger car or van accidents that occurred during the years 2009-2012 (4 years) were included (n = 734). Cases in which the driver's front airbag was deployed were subjected to analysis (n = 409). To determine the proportion of minor, potentially airbag-related eye injuries, the results were compared to the data for all new eye injury patients (n = 1,151) recorded at the Emergency Clinic of the Helsinki University Eye Hospital (HUEH) during one year, from May 1, 2011, to April 30, 2012. In the FRA data set, the unbelted drivers showed a significantly higher risk of death (odds ratio [OR] = 5.89, 95% confidence interval [CI], 3.33-10.9, P = 2.6E-12) or of sustaining head injuries (OR = 2.50, 95% CI, 1.59-3.97, P = 3.8E-5). Only 4 of the 1,151 HUEH patients were involved in a passenger car accident. In one of the crashes, the airbag operated, and the belted driver received 2 sutured eye lid wounds and showed conjunctival sugillation. No permanent eye injuries were recorded during the follow-up. The calculated annual airbag-related eye injury incidence was less than 1/1,000,000 people, 4/100,000 accidents, and 4/10,000 injured occupants. Airbag-related eye injuries occurred very rarely in car accidents in cases where the occupant survived and the restraint system was appropriately used. Spectacle use did not appear to increase the risk of eye injury in restrained occupants.

Corpus callosum lesions after closed head injury in children: MRI, clinical features and outcome

International Nuclear Information System (INIS)

Mendelsohn, D.B.; Bruce, D.

1992-01-01

Thirty-four children who sustained moderate to severe closed head injury underwent magnetic resonance imaging (MRI). Eight (24%) had MRI evidence of corpus callosum injury, most commonly within the posterior body and splenium. In contradistinction to reports in adults, there was no definite relationship between callosal injury and lower initial Glasgow Coma Scale scores, nor was there a significantly higher incidence of primary brain-stem lesions, diffuse axonal shear injury or intraventricular hemorrhage. In none of these 8 children did the initial admission computed tomography show evidence of callosal injury. Callosal injuries on MRI are not necessarily a poor prognostic finding, the majority of the 8 children showing good functional recovery. (orig.)

Injuries among talented young dancers: findings from the U.K. Centres for Advanced Training.

Science.gov (United States)

Steinberg, N; Aujla, I; Zeev, A; Redding, E

2014-03-01

The aim of the present study was to characterize the injuries of young dancers attending Centres for Advanced Training. 806 dancers, ages 10-18 years responded to surveys regarding their biological profile, dance experience and injury history, and were examined for their anthropometric profile. Of the 806 dancers, 347 reported an injury. Based on 4 age groups, the total hours of practice per week increased significantly with increasing age. Incidence of injuries per 1000 h of dance practice for dancers ages 11-12 were found to be significantly higher compared to the incidence for dancers ages 13-18 (p<0.05). Foot and ankle and other lower extremities were the most common injury location, and muscle injuries were the most common type of injury. Total months in CAT training (OR=1.044, 95% CI=1.014-1.075) and hours per week in creative style practice (OR=1.282, 95% CI=1.068-1.539) were found to be significantly associated with injuries. In conclusion, both young and mature dancers are exposed to extensive risk of injury. The intensity of training (such as number of months and number of hours of training per week) is important factor that should be taken into account in order to decrease future injuries among young dancers. © Georg Thieme Verlag KG Stuttgart · New York.

Injury Characteristics of Low-Energy Lisfranc Injuries Compared With High-Energy Injuries.

Science.gov (United States)

Renninger, Christopher H; Cochran, Grant; Tompane, Trevor; Bellamy, Joseph; Kuhn, Kevin

2017-09-01

Lisfranc injuries result from high- and low-energy mechanisms though the literature has been more focused on high-energy mechanisms. A comparison of high-energy (HE) and low-energy (LE) injury patterns is lacking. The objective of this study was to report injury patterns in LE Lisfranc joint injuries and compare them to HE injury patterns. Operative Lisfranc injuries were identified over a 5-year period. Patient demographics, mechanism of injury, injury pattern, associated injuries, missed diagnoses, clinical course, and imaging studies were reviewed and compared. HE mechanism was defined as motor vehicle crash, motorcycle crash, direct crush, and fall from greater than 4 feet and LE mechanism as athletic activity, ground level twisting, or fall from less than 4 feet. Thirty-two HE and 48 LE cases were identified with 19.3 months of average follow-up. There were no differences in demographics or missed diagnosis frequency (21% HE vs 18% LE). Time to seek care was not significantly different. HE injuries were more likely to have concomitant nonfoot fractures (37% vs 6%), concomitant foot fractures (78% vs 4%), cuboid fractures (31% vs 6%), metatarsal base fractures (84% vs 29%), displaced intra-articular fractures (59% vs 4%), and involvement of all 5 rays (23% vs 6%). LE injuries were more commonly ligamentous (68% vs 16%), with fewer rays involved (2.7 vs 4.1). LE mechanisms were a more common cause of Lisfranc joint injury in this cohort. These mechanisms generally resulted in an isolated, primarily ligamentous injury sparing the lateral column. Both types had high rates of missed injury that could result in delayed treatment. Differences in injury patterns could help direct future research to optimize treatment algorithms. Level III, comparative series.

Morbidity associated with golf-related injuries among children: findings from a pediatric trauma center.

Science.gov (United States)

Vitale, Melissa A; Mertz, Kristen J; Gaines, Barbara; Zuckerbraun, Noel S

2011-01-01

To describe injuries due to golf-related activities among pediatric patients requiring hospital admission. We conducted a retrospective analysis of all sports-related injuries from 2000 to 2006 using a level 1 trauma center database. Of 1005 children admitted with sports-related injuries, 60 (6%) had golf-related injuries. The mean injury severity score was significantly higher for golf-related injuries (11.0) than that for all other sports-related injuries (6.8). Most golf-related injuries occurred in children younger than 12 years (80%), at home (48%), and by a strike from a club (57%) and resulted in trauma to the head or neck (68%). Golf-related injuries, although an infrequent cause of sports-related injuries, have the potential to result in severe injuries, especially in younger children. Preventive efforts should target use of golf clubs by younger children in the home setting.

Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes.

Science.gov (United States)

Gilbert, Frances C; Burdette, G Trey; Joyner, A Barry; Llewellyn, Tracy A; Buckley, Thomas A

Concussions have been associated with elevated musculoskeletal injury risk; however, the influence of unreported and unrecognized concussions has not been investigated. The purpose of this study was to examine the association between concussion and lower extremity musculoskeletal injury rates across a diverse array of sports among collegiate student-athletes at the conclusion of their athletic career. The hypothesis was that there will be a positive association between athletes who reported a history of concussions and higher rates of lower extremity injuries. Cross-sectional study. Level 3. Student-athletes (N = 335; 62.1% women; mean age, 21.2 ± 1.4 years) from 13 sports completed a reliable injury history questionnaire. Respondents indicated the total number of reported, unreported, and potentially unrecognized concussions as well as lower extremity injuries including ankle sprains, knee injuries, and muscle strains. Chi-square analyses were performed to identify the association between concussion and lower extremity injuries. There were significant associations between concussion and lateral ankle sprain ( P = 0.012), knee injury ( P = 0.002), and lower extremity muscle strain ( P = 0.031). There were also significant associations between reported concussions and knee injury ( P = 0.003), unreported concussions and knee injury ( P = 0.002), and unrecognized concussions and lateral ankle sprain ( P = 0.001) and lower extremity muscle strains ( P = 0.006), with odds ratios ranging from 1.6 to 2.9. There was a positive association between concussion history and lower extremity injuries (odds ratios, 1.6-2.9 elevated risk) among student-athletes at the conclusion of their intercollegiate athletic careers. Clinicians should be aware of these elevated risks when making return-to-participation decisions and should incorporate injury prevention protocols.

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.

Acute kidney injury is independently associated with higher mortality after cardiac surgery

DEFF Research Database (Denmark)

Kandler, Kristian; Jensen, Mathias E; Nilsson, Jens C

2014-01-01

OBJECTIVES: To investigate the incidence of acute kidney injury after cardiac surgery and its association with mortality in a patient population receiving ibuprofen and gentamicin perioperatively. DESIGN: Retrospective study with Cox regression analysis to control for possible preoperative......, intraoperative and postoperative confounders. SETTING: University hospital-based single-center study. PARTICIPANTS: All patients who underwent coronary artery bypass grafting ± valve surgery during 2012. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Acute surgery within 24 hours of coronary angiography.......21-4.51, p = 0.011) and 5.62 (95% CI: 2.42-13.06), psurgery developed AKI in this contemporary cohort. Furthermore, acute kidney injury was an independent...

Dismounted Complex Blast Injury.

Science.gov (United States)

Andersen, Romney C; Fleming, Mark; Forsberg, Jonathan A; Gordon, Wade T; Nanos, George P; Charlton, Michael T; Ficke, James R

2012-01-01

The severe Dismounted Complex Blast Injury (DCBI) is characterized by high-energy injuries to the bilateral lower extremities (usually proximal transfemoral amputations) and/or upper extremity (usually involving the non-dominant side), in addition to open pelvic injuries, genitourinary, and abdominal trauma. Initial resuscitation and multidisciplinary surgical management appear to be the keys to survival. Definitive treatment follows general principals of open wound management and includes decontamination through aggressive and frequent debridement, hemorrhage control, viable tissue preservation, and appropriate timing of wound closure. These devastating injuries are associated with paradoxically favorable survival rates, but associated injuries and higher amputation levels lead to more difficult reconstructive challenges.

Pain perception in self-injurious patients with borderline personality disorder.

Science.gov (United States)

Russ, M J; Roth, S D; Lerman, A; Kakuma, T; Harrison, K; Shindledecker, R D; Hull, J; Mattis, S

1992-09-15

Pain ratings during the cold pressor test were significantly lower in female inpatients with borderline personality disorder who report that they do not experience pain during self-injury (BPD-NP group, n = 11), compared with similar patients who report that they do experience pain during self-injury (BPD-P group, n = 11), and normal female subjects (n = 6). Pain ratings were not significantly different in the BPD-P and normal control groups. Self-report ratings of depression, anger, anxiety, and confusion were significantly lower, and ratings of vigor significantly higher following the cold pressor test in the BPD-NP group, but not in the BPD-P group. Only anxiety was significantly lower in the normal control group following the cold pressor test. The implications and limitations of these preliminary findings are discussed.

VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration.

Science.gov (United States)

Shireman, Paula K; Rasmussen, Todd E; Jaramillo, Carlos A; Pugh, Mary Jo

2015-02-03

Limb injuries comprise 50-60% of U.S. Service member's casualties of wars in Afghanistan and Iraq. Combat-related vascular injuries are present in 12% of this cohort, a rate 5 times higher than in prior wars. Improvements in medical and surgical trauma care, including initial in-theatre limb salvage approaches (IILS) have resulted in improved survival and fewer amputations, however, the long-term outcomes such as morbidity, functional decline, and risk for late amputation of salvaged limbs using current process of care have not been studied. The long-term care of these injured warfighters poses a significant challenge to the Department of Defense (DoD) and Department of Veterans Affairs (VA). The VA Vascular Injury Study (VAVIS): VA-DoD Extremity Injury Outcomes Collaborative, funded by the VA, Health Services Research and Development Service, is a longitudinal cohort study of Veterans with vascular extremity injuries. Enrollment will begin April, 2015 and continue for 3 years. Individuals with a validated extremity vascular injury in the Department of Defense Trauma Registry will be contacted and will complete a set of validated demographic, social, behavioral, and functional status measures during interview and online/ mailed survey. Primary outcome measures will: 1) Compare injury, demographic and geospatial characteristics of patients with IILS and identify late vascular surgery related limb complications and health care utilization in Veterans receiving VA vs. non-VA care, 2) Characterize the preventive services received by individuals with vascular repair and related outcomes, and 3) Describe patient-reported functional outcomes in Veterans with traumatic vascular limb injuries. This study will provide key information about the current process of care for Active Duty Service members and Veterans with polytrauma/vascular injuries at risk for persistent morbidity and late amputation. The results of this study will be the first step for clinicians in VA and

[Frequency, nature and distribution of school sport injuries at different types of schools].

Science.gov (United States)

Greier, K; Riechelmann, H

2012-12-01

A high percentage of all sports injuries occur during school sports. It was analysed whether there are differences in frequency, nature and distribution of school sport injuries at two different types of schools. School sport injuries of all secondary modern schools (n = 106) and in lower classes of grammar Schools (n = 17) in the federal state of Tyrol, Austria, from the ten school years 2001/02 to 2010/11 were analysed. All physical injuries occurring during school sports and resulting in the consultation of a medical doctor and therefore being reported to the general accident department (Allgemeine Unfallversicherungsanstalt [AUVA]) were assessed. During the evaluation period an average number of 32,935 (±1584) school children attended the two types of schools in Tyrol per year. The average incidence of school sports injuries in this ten-year period in both types of schools was 36.4/1,000 (mean) with a standard deviation of 4.4/1,000 per school child per year. The incidence increased from 30.3 in the school year 2001/02 to 40.4 in the school year 2010/11 (r = 0.91; b = 1.34; p school sport injuries at secondary modern schools (37.4 ± 4.9 per 1,000 school children per year) was higher than at the lower classes of grammar schools (32.9 ± 4.0 per 1,000 school children per year; relative risk 1.138; 95% CI = 1.09-1.19; p = 1.8 × 10-8). In addition, the sports injuries of the school year 2010/11 were analysed in detail and a comparison was made between the two types of schools. The distribution pattern of school sports injuries did not show any significant differences between both school types. At the secondary modern schools, as well as in the lower classes of grammar schools, injuries to the upper extremities prevailed (>50%). Ball sports were responsible for every second injury. Secondary modern school pupils had a significantly higher risk of suffering a school sports injury than pupils in the lower classes of grammar schools. The injury pattern did not show

RISUS study: Rugby Injury Surveillance in Ulster Schools.

Science.gov (United States)

Archbold, H A P; Rankin, A T; Webb, M; Nicholas, R; Eames, N W A; Wilson, R K; Henderson, L A; Heyes, G J; Bleakley, C M

2017-04-01

To examine injury patterns in adolescent rugby players and determine factors associated with injury risk. Prospective injury surveillance study. N=28 Grammar Schools in Ulster, Ireland (2014-2015 playing season). 825 adolescent rugby players, across in 28 school first XV rugby squads; mean age 16.9 years. Injuries were classified by body part and diagnosis, and injury incidence using injuries per 1000 match hours of exposure. HRs for injury were calculated through Cox proportional hazard regression after correction for influential covariates. A total of n=426 injuries were reported across the playing season. Over 50% of injuries occurred in the tackle situation or during collisions (270/426), with few reported during set plays. The 3 most common injury sites were head/face (n=102, 23.9%), clavicle/shoulder (n=65, 15.3%) and the knee (n=56, 13.1%). Sprain (n=133, 31.2%), concussion (n=81, 19%) and muscle injury (n=65, 15.3%) were the most common diagnoses. Injury incidence is calculated at 29.06 injuries per 1000 match hours. There were no catastrophic injuries. A large percentage of injuries (208/424) resulted in absence from play for more than 28 days. Concussion carried the most significant time out from play (n=33; 15.9%), followed by dislocations of the shoulder (n=22; 10.6%), knee sprains (n=19, 9.1%), ankle sprains (n=14, 6.7%), hand/finger/thumb (n=11; 5.3%). 36.8% of participants in the study (304/825) suffered at least one injury during the playing season. Multivariate models found higher risk of injury (adjusted HR (AHR); 95% CI) with: higher age (AHR 1.45; 1.14 to 1.83), heavier weight (AHR 1.32; 1.04 to 1.69), playing representative rugby (AHR 1.42; 1.06 to 1.90) and undertaking regular strength training (AHR 1.65; 1.11 to 2.46). Playing for a lower ranked team (AHR 0.67; 0.49 to 0.90) and wearing a mouthguard (AHR 0.70; 0.54 to 0.92) were associated with lower risk of injury. There was a high incidence of severe injuries, with concussion, ankle and

Ultrasonic character istics and clinical significance of umbilical cord blood flow in acute fetal distress

Directory of Open Access Journals (Sweden)

Wei Dai, Yin Xu

2016-11-01

Full Text Available Objective: To study ultrasonic characteristics of umbilical cord blood flow in acute fetal distress and its correlation with umbilical artery blood gas parameters, oxidative stress parameters, neonatal brain injury and myocardial injury. Methods: The pregnant women delivered in Department of Obstetrics of our hospital were chosen during the period from May 2012 to August 2015. The pregnant women with acute fetal distress were included in the distress group, and the healthy pregnant women with no acute fetal distress were included in the control group. The resistance index (RI, pulsatility index (PI and systolic/diastolic (S/D ratio of umbilical artery were measured at 24–30 weeks, 31–36 weeks and 37–41 weeks of pregnancy. After delivery, umbilical artery blood was taken for analysis of blood gas and determination of oxidative stress parameters. The venous blood of newborns was taken to measure the myocardial injury and brain injury parameters. Results: At 24–30 weeks, 31–36 weeks and 37–41 weeks of pregnancy, RI, S/D and PI in pregnant women of distress group were significantly higher than those in control group. The pH, contents of arterial partial pressure of oxygen, vitamin C, vitamin E, superoxide dismutase and glutathione peroxidase in umbilical artery blood in pregnant women of distress group was significantly lower than those in control group and negatively correlated with the umbilical artery RI, PI and S/D. The contents of partial pressure of carbon dioxide in artery, lactic acid and malondialdehyde in pregnant women of distress group were significantly higher than those in control group and positively correlated with the umbilical artery RI, PI and S/D. The contents of lactate dehydrogenase, hydroxybutyrate dehydrogenase, creatine kinase, creatine kinase-MB, S100B, neuron-specific enolase, creatine kinase-BB and Tau in newborns' venous blood in distress group were significantly higher than those in control group and

Temporomandibular disorders after whiplash injury: a controlled, prospective study.

Science.gov (United States)

Kasch, Helge; Hjorth, Tine; Svensson, Peter; Nyhuus, Lone; Jensen, Troels S

2002-01-01

Whiplash injury to the neck is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies, however, have examined TMD-related pain in acute whiplash patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Prospectively, 19 acute whiplash patients exposed to a motor vehicle accident involving a rear collision participated in a study of TMD. The control group consisted of 20 age- and gender-matched ankle-injury patients. Participants were seen within 4 weeks and again at 6 months post-injury. The masticatory system was examined in accordance with the research diagnostic criteria. Participants underwent structured interviews, filled out the McGill Pain Questionnaire (MPQ), and had their masticatory system examined by a trained dentist, blinded to their diagnosis. Pain detection threshold (PDT) to pressure stimuli, and maximal voluntary occlusal force (MVOF) were obtained at each visit. One whiplash patient and 1 ankle-injury patient had jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ, TMD symptoms and signs, MVOF and PDT were not significantly different in whiplash-injury and ankle-injury patients after 4 weeks and 6 months. TMD pain after whiplash injury and ankle injury is rare, suggesting that whiplash injury is not a major risk factor for the development of TMD problems. Further studies are needed to identify which other factors may contribute to TMD pain.

A Long-Gap Peripheral Nerve Injury Therapy Using Human Skeletal Muscle-Derived Stem Cells (Sk-SCs: An Achievement of Significant Morphological, Numerical and Functional Recovery.

Directory of Open Access Journals (Sweden)

Tetsuro Tamaki

Full Text Available Losses in vital functions of the somatic motor and sensory nervous system are induced by severe long-gap peripheral nerve transection injury. In such cases, autologous nerve grafts are the gold standard treatment, despite the unavoidable sacrifice of other healthy functions, whereas the prognosis is not always favorable. Here, we use human skeletal muscle-derived stem cells (Sk-SCs to reconstitute the function after long nerve-gap injury. Muscles samples were obtained from the amputated legs from 9 patients following unforeseen accidents. The Sk-SCs were isolated using conditioned collagenase solution, and sorted as CD34+/45- (Sk-34 and CD34-/45-/29+ (Sk-DN/29+ cells. Cells were separately cultured/expanded under optimal conditions for 2 weeks, then injected into the athymic nude mice sciatic nerve long-gap model (7-mm bridging an acellular conduit. After 8-12 weeks, active cell engraftment was observed only in the Sk-34 cell transplanted group, showing preferential differentiation into Schwann cells and perineurial/endoneurial cells, as well as formation of the myelin sheath and perineurium/endoneurium surrounding regenerated axons, resulted in 87% of numerical recovery. Differentiation into vascular cell lineage (pericyte and endothelial cells were also observed. A significant tetanic tension recovery (over 90% of downstream muscles following electrical stimulation of the sciatic nerve (at upper portion of the gap was also achieved. In contrast, Sk-DN/29+ cells were completely eliminated during the first 4 weeks, but relatively higher numerical (83% vs. 41% in axon and functional (80% vs. 60% in tetanus recovery than control were observed. Noteworthy, significant increase in the formation of vascular networks in the conduit during the early stage (first 2 weeks of recovery was observed in both groups with the expression of key factors (mRNA and protein levels, suggesting the paracrine effects to angiogenesis. These results suggested that the

A Long-Gap Peripheral Nerve Injury Therapy Using Human Skeletal Muscle-Derived Stem Cells (Sk-SCs): An Achievement of Significant Morphological, Numerical and Functional Recovery.

Science.gov (United States)

Tamaki, Tetsuro; Hirata, Maki; Nakajima, Nobuyuki; Saito, Kosuke; Hashimoto, Hiroyuki; Soeda, Shuichi; Uchiyama, Yoshiyasu; Watanabe, Masahiko

2016-01-01

Losses in vital functions of the somatic motor and sensory nervous system are induced by severe long-gap peripheral nerve transection injury. In such cases, autologous nerve grafts are the gold standard treatment, despite the unavoidable sacrifice of other healthy functions, whereas the prognosis is not always favorable. Here, we use human skeletal muscle-derived stem cells (Sk-SCs) to reconstitute the function after long nerve-gap injury. Muscles samples were obtained from the amputated legs from 9 patients following unforeseen accidents. The Sk-SCs were isolated using conditioned collagenase solution, and sorted as CD34+/45- (Sk-34) and CD34-/45-/29+ (Sk-DN/29+) cells. Cells were separately cultured/expanded under optimal conditions for 2 weeks, then injected into the athymic nude mice sciatic nerve long-gap model (7-mm) bridging an acellular conduit. After 8-12 weeks, active cell engraftment was observed only in the Sk-34 cell transplanted group, showing preferential differentiation into Schwann cells and perineurial/endoneurial cells, as well as formation of the myelin sheath and perineurium/endoneurium surrounding regenerated axons, resulted in 87% of numerical recovery. Differentiation into vascular cell lineage (pericyte and endothelial cells) were also observed. A significant tetanic tension recovery (over 90%) of downstream muscles following electrical stimulation of the sciatic nerve (at upper portion of the gap) was also achieved. In contrast, Sk-DN/29+ cells were completely eliminated during the first 4 weeks, but relatively higher numerical (83% vs. 41% in axon) and functional (80% vs. 60% in tetanus) recovery than control were observed. Noteworthy, significant increase in the formation of vascular networks in the conduit during the early stage (first 2 weeks) of recovery was observed in both groups with the expression of key factors (mRNA and protein levels), suggesting the paracrine effects to angiogenesis. These results suggested that the human Sk

Acute respiratory distress syndrome assessment after traumatic brain injury

Directory of Open Access Journals (Sweden)

Shahrooz Kazemi

2016-01-01

Full Text Available Background: Acute respiratory distress syndrome (ARDS is one of the most important complications associated with traumatic brain injury (TBI. ARDS is caused by inflammation of the lungs and hypoxic damage with lung physiology abnormalities associated with acute respiratory distress syndrome. Aim of this study is to determine the epidemiology of ARDS and the prevalence of risk factors. Methods: This prospective study performed on patients with acute traumatic head injury hospitalization in the intensive care unit of the Shohaday-e Haftom-e-Tir Hospital (September 2012 to September 2013 done. About 12 months, the data were evaluated. Information including age, sex, education, employment, drug and alcohol addiction, were collected and analyzed. The inclusion criteria were head traumatic patients and exclusion was the patients with chest trauma. Questionnaire was designed with doctors supervision of neurosurgery. Then the collected data were analysis. Results: In this study, the incidence of ARDS was 23.8% and prevalence of metabolic acidosis was 31.4%. Most injury with metabolic acidosis was Subarachnoid hemorrhage (SAH 48 (60% and Subdural hemorrhage (SDH was Next Level with 39 (48% Correlation between Glasgow Coma Scale (GCS and Respiratory Distress Syndrome (ARDS were significantly decreased (P< 0.0001. The level of consciousness in patients with skull fractures significantly lower than those without fractures (P= 0.009 [(2.3±4.6 vs (4.02±7.07]. Prevalence of metabolic acidosis during hospitalization was 80 patients (31.4%. Conclusion: Acute respiratory distress syndrome is a common complication of traumatic brain injury. Management and treatment is essential to reduce the mortality. In this study it was found the age of patients with ARDS was higher than patients without complications. ARDS risk factor for high blood pressure was higher in men. Most victims were pedestrians. The most common injury associated with ARDS was SDH. Our analysis

Protein profiling in serum after traumatic brain injury in rats reveals potential injury markers.

Science.gov (United States)

Thelin, Eric Peter; Just, David; Frostell, Arvid; Häggmark-Månberg, Anna; Risling, Mårten; Svensson, Mikael; Nilsson, Peter; Bellander, Bo-Michael

2018-03-15

The serum proteome following traumatic brain injury (TBI) could provide information for outcome prediction and injury monitoring. The aim with this affinity proteomic study was to identify serum proteins over time and between normoxic and hypoxic conditions in focal TBI. Sprague Dawley rats (n=73) received a 3mm deep controlled cortical impact ("severe injury"). Following injury, the rats inhaled either a normoxic (22% O 2 ) or hypoxic (11% O 2 ) air mixture for 30min before resuscitation. The rats were sacrificed at day 1, 3, 7, 14 and 28 after trauma. A total of 204 antibodies targeting 143 unique proteins of interest in TBI research, were selected. The sample proteome was analyzed in a suspension bead array set-up. Comparative statistics and factor analysis were used to detect differences as well as variance in the data. We found that complement factor 9 (C9), complement factor B (CFB) and aldolase c (ALDOC) were detected at higher levels the first days after trauma. In contrast, hypoxia inducing factor (HIF)1α, amyloid precursor protein (APP) and WBSCR17 increased over the subsequent weeks. S100A9 levels were higher in hypoxic-compared to normoxic rats, together with a majority of the analyzed proteins, albeit few reached statistical significance. The principal component analysis revealed a variance in the data, highlighting clusters of proteins. Protein profiling of serum following TBI using an antibody based microarray revealed temporal changes of several proteins over an extended period of up to four weeks. Further studies are warranted to confirm our findings. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

Predicting significant torso trauma.

Science.gov (United States)

Nirula, Ram; Talmor, Daniel; Brasel, Karen

2005-07-01

Identification of motor vehicle crash (MVC) characteristics associated with thoracoabdominal injury would advance the development of automatic crash notification systems (ACNS) by improving triage and response times. Our objective was to determine the relationships between MVC characteristics and thoracoabdominal trauma to develop a torso injury probability model. Drivers involved in crashes from 1993 to 2001 within the National Automotive Sampling System were reviewed. Relationships between torso injury and MVC characteristics were assessed using multivariate logistic regression. Receiver operating characteristic curves were used to compare the model to current ACNS models. There were a total of 56,466 drivers. Age, ejection, braking, avoidance, velocity, restraints, passenger-side impact, rollover, and vehicle weight and type were associated with injury (p < 0.05). The area under the receiver operating characteristic curve (83.9) was significantly greater than current ACNS models. We have developed a thoracoabdominal injury probability model that may improve patient triage when used with ACNS.

Influence of practice time on surfing injuries

Directory of Open Access Journals (Sweden)

Natacha Verônica Bazanella

Full Text Available Abstract Introduction: studying the influence of surfing on the prevalence of injuries may contribute to prevention. Objective: to analyze the influence of time practicing sports and the occurrence of previous surgery on the profile and prevalence of injuries caused by surfing. Methods: Sixty-six Brazilian surfers (26.16 ± 0.73 years old participated in this study. Anthropometric data, physical activity level, surfing practice time and the prevalence of injuries (type of injury, anatomical region affected, and mechanism of injury were evaluated. To assess which of the studied variables exerted significant influence on the mean number of injuries, a Poisson log-linear model was adjusted through R software (p < 0.05. Results: most surfers were classified as eutrophic (73%, very active (60.6%, had an average practice time of 10.1 ± 1 years, and were not members of a surfing federation (74%. It was also observed that 90.9% of participants reported injuries caused by surfing and 44.9% affected the lower limbs. The majority of these injuries affected the integumentary system (46.6%. The main mechanism of injury was impact with the board or seabed (40.4%. Furthermore, it was found that surfing federation members presented an average of 58.4% more injuries than non-members (p = 0.007. Surfers who had undergone previous surgeries showed an average number of injuries that was 56.9% higher than other surfers (p = 0.012. In addition, it was found that for each extra year of surfing, the average number of injuries increased by 2.5% (p = 0.0118. Conclusion: the average number of injuries increased with increment in time practicing the sport, previous surgery and membership in a surfing federation.

Injuries in Rugby Union football.

Science.gov (United States)

Davies, J E; Gibson, T

In a prospective study of 185 players attached to 10 British rugby clubs, 151 injuries were recorded among 98 of them (53%) during a single season. Forwards sustained significantly more injuries than backs. The standard of rugby, players' body weights, degree of fitness, and presence of joint hypermobility did not affect the risk of injury. The leg was the most common site of injury. Head and neck injuries were significantly more common when play was static and on wet pitches. Scrummaging accounted for no neck injuries. Almost half the injuries occurred during the last quarter of games. Foul play might have caused as many as 47 (31%) of all reported injuries. Complete eradication of deliberately dangerous play would considerably reduce the high incidence of injuries in this sport.

A profile of injury in Fiji: findings from a population-based injury surveillance system (TRIP-10).

Science.gov (United States)

Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Herman, Josephine; McCaig, Eddie; Ameratunga, Shanthi

2012-12-12

Over 90% of injury deaths occur in low-and middle-income countries. However, the epidemiological profile of injuries in Pacific Islands has received little attention. We used a population-based-trauma registry to investigate the characteristics of all injuries in Viti Levu, Fiji. The Fiji Injury Surveillance in Hospitals (FISH) database prospectively collected data on all injury-related deaths and primary admissions to hospital (≥ 12 hours stay) in Viti Levu during 12 months commencing October 2005. The 2167 injury-related deaths and hospitalisations corresponded to an annual incidence rate of 333 per 100,000, with males accounting for twice as many cases as females. Almost 80% of injuries involved people aged less than 45 years, and 74% were deemed unintentional. There were 244 fatalities (71% died before admission) and 1994 hospitalisations corresponding to crude annual rates of 37.5 per 100,000 and 306 per 100,000 respectively. The leading cause of fatal injury was road traffic injury (29%) and the equivalent for injury admissions was falls (30%). The commonest type of injury resulting in death and admission to hospital was asphyxia and fractures respectively. Alcohol use was documented as a contributing factor in 13% of deaths and 12% of admissions. In general, indigenous Fijians had higher rates of injury admission, especially for interpersonal violence, while those of Indian ethnicity had higher rates of fatality, especially from suicide. Injury is an important public health problem that disproportionately affects young males in Fiji, with a high proportion of deaths prior to hospital presentation. This study highlights key areas requiring priority attention to reduce the burden of potentially life-threatening injuries in Fiji.

Fishing gear-related injury in California marine wildlife.

Science.gov (United States)

Dau, Brynie Kaplan; Gilardi, Kirsten V K; Gulland, Frances M; Higgins, Ali; Holcomb, Jay B; Leger, Judy St; Ziccardi, Michael H

2009-04-01

We reviewed medical records from select wildlife rehabilitation facilities in California to determine the prevalence of injury in California Brown Pelicans (Pelecanus occidentalis), gulls (Larus spp.), and pinniped species (Zalophus californianus, Mirounga angustirostris, and Phoca vitulina) due to fishing gear entanglement and ingestion from 2001 to 2006. Of 9,668 Brown Pelican, gull, and pinniped cases described during the 6-yr study period (2001-06), 1,090 (11.3%) were fishing gear-related. Pelican injuries caused by fishing gear were most common in the Monterey Bay region, where 59.6% of the pelicans rescued in this area and admitted to a rehabilitation center were injured by fishing gear over the 6-yr period. The highest prevalence of fishing gear-related injury in gulls was documented in the Los Angeles/Orange County region (16.1%), whereas the highest prevalences in pinnipeds were seen in the San Diego region (3.7%). Despite these higher prevalences of gull and pinniped fishing gear-related injuries in these specific regions, there was no statistical significance in these trends. Juvenile gulls and pinnipeds were more commonly injured by fishing gear than adults (gulls: P = 0.03, odds ratio = 1.29; pinnipeds: P = 0.01, odds ratio = 2.07). Male pinnipeds were twice as likely to be injured by fishing gear as females (P gear-related injury cases that were successfully rehabilitated and released (percentage of cases successfully rehabilitated to the point of release out of the total number of fishing gear-related injury cases) was high in all three species groups (pelicans: 63%; gulls: 54%; pinnipeds: 70%). Fishing gear-related injuries in Brown Pelicans and gulls were highest in the fall, but there was only a significant difference between seasons for fishing gear-related injuries in pelicans. Fishing gear-related injuries in pinnipeds most commonly occurred in summer; however, a statistical difference was not detected between seasons for pinnipeds. Derelict

Interval training elicits higher enjoyment versus moderate exercise in persons with spinal cord injury.

Science.gov (United States)

Astorino, Todd A; Thum, Jacob S

2018-01-01

High intensity interval training (HIIT) is a robust and time-efficient approach to improve multiple health indices including maximal oxygen uptake (VO 2 max). Despite the intense nature of HIIT, data in untrained adults report greater enjoyment of HIIT versus continuous exercise (CEX). However, this has yet to be investigated in persons with spinal cord injury (SCI). To examine differences in enjoyment in response to CEX and HIIT in persons with SCI. Repeated measures, within-subjects design. University laboratory in San Diego, CA. Nine habitually active men and women (age = 33.3 ± 10.5 years) with chronic SCI. Participants performed progressive arm ergometry to volitional exhaustion to determine VO 2 peak. During subsequent sessions, they completed CEX, sprint interval training (SIT), or HIIT in randomized order. Physical activity enjoyment (PACES), affect, rating of perceived exertion (RPE), VO 2 , and blood lactate concentration (BLa) were measured. Despite a higher VO 2 , RPE, and BLa consequent with HIIT and SIT (P HIIT (107.4 ± 13.4) and SIT (103.7 ± 12.5) compared to CEX (81.6 ± 25.4). Fifty-five percent of participants preferred HIIT and 45% preferred SIT, with none identifying CEX as their preferred exercise mode. Compared to CEX, brief sessions of submaximal or supramaximal interval training elicit higher enjoyment despite higher metabolic strain. The long-term efficacy and feasibility of HIIT in this population should be explored considering that it is not viewed as more aversive than CEX.

Characteristics of helmet or knit cap use in head injury of snowboarders.

Science.gov (United States)

Fukuda, Osamu; Hirashima, Yutaka; Origasa, Hideki; Endo, Shunro

2007-11-01

The rate of head injury is 1.86-6 times higher for snowboarding than for skiing. Detailed data about the usefulness of a helmet or knit cap for protecting against serious head injuries have not been reported. The present study evaluated the use of a helmet or knit cap for preventing head injuries. Questionnaire data were collected from 1,190 consecutive patients in a hospital during the 1999/2000-2002/2003 winter seasons at Uonuma ski resort, Niigata, Japan. Patients were divided into the helmet, knit cap, and no cap groups. Upper technical level was highest and jumping as the cause of injury was most frequent in the helmet group. After adjustment for other confounders, there was a significant negative association between the occurrence of serious head injury during snowboarding and female sex (adjusted odds ratio 0.55, 95% confidence interval 0.421-0.718, p jumping (adjusted odds ratio 2.25, 95% confidence interval 1.48-3.43, p = 0.0001). Among snowboarding maneuvers, only jumping showed a significant negative association between wearing of a helmet or knit cap and the occurrence of serious head injury (p = 0.036). Snowboarders who wear helmets might attempt dangerous maneuvers causing injuries. Wearing of a helmet or knit cap protected against serious head injuries on jumping. Every snowboarder should wear a helmet or knit cap on jumping to prevent head injury.

Significance of magnetic resonance imaging in the diagnosis of vertebral artery injury associated with blunt cervical spine trauma

International Nuclear Information System (INIS)

Yokota, Hiroyuki; Atsumi, Takahiro; Araki, Takashi; Fuse, Akira; Sato, Hidetaka; Kawai, Makoto; Yamamoto, Yasuhiro

2007-01-01

Vertebral artery injury associated with non-penetrating cervical trauma is rare. We report 11 cases of vertebral artery injury diagnosed with magnetic resonance imaging (MRI) after blunt trauma to the cervical spine and discuss about the importance of MRI in the diagnosis of this injury. Seven cases were caused by motor vehicle accidents, three by diving accidents, and one by static compression of the neck. All of the patients had documented cervical spine fractures and dislocations. In three patients, the diagnosis of complete occlusion of the vertebral artery was made on the basis of MRI and digital subtraction angiography (DSA). In the other patients, mural injuries of the vertebral artery were demonstrated with DSA. These 11 patients presented with acute, nonspecific changes in neurological status. Two had infarctions of the cerebellum and brainstem. None were treated with anticoagulants. All of them survived and were discharged to other hospitals for physical and occupational therapy. Although DSA remains the gold standard for diagnosing vertebral artery injuries, MRI is a newer modality for assessing cervical cord injury, and it may be useful for evaluating the presence of vertebral injury after blunt cervical spine trauma. (author)

Head injury as a PTSD predictor among Oklahoma City bombing survivors.

Science.gov (United States)

Walilko, Timothy; North, Carol; Young, Lee Ann; Lux, Warren E; Warden, Deborah L; Jaffee, Michael S; Moore, David F

2009-12-01

The aim of the Oklahoma City (OKC) bombing retrospective review was to investigate the relationship between physical injury, environmental contributors, and psychiatric disorders such as posttraumatic stress disorder (PTSD) in an event-based, matched design study focused on injury. The 182 selected participants were a random subset of the 1,092 direct survivors from the OKC bombing. Only 124 of these 182 cases had a full complement of medical/clinical data in the OKC database. These 124 cases were assessed to explore relationships among PTSD diagnoses, levels of blast exposure, and physical injuries. Associations among variables were statistically tested using contingency analysis and logistic regression. Comparison of the PTSD cases to symptoms/diagnoses reported in the medical records reveals a statistically significant association between PTSD and head/brain injuries associated with head acceleration. PTSD was not highly correlated with other injuries. Although blast pressure and impulse were highly correlated with head injuries, the correlation with PTSD was not statistically significant. Thus, a correlation between blast pressure and PTSD may exist, but higher fidelity pressure calculations are required to elucidate this potential relationship. This study provides clear evidence that head injury is associated with subsequent PTSD, giving caregivers' information on what physical injuries may suggest the development of psychologic disorders to aid them in developing a profile for the identification of future survivors of terrorist attacks and Warfighters with brain injuries and potential PTSD.

Motorized dirt bike injuries in children.

Science.gov (United States)

Ramakrishnaiah, Raghu H; Shah, Chetan; Parnell-Beasley, Donna; Greenberg, Bruce S

2013-04-01

The number of dirt bike injuries in children in the United States is increasing and poses a public health problem. The purpose of our study was to identify the imaging patterns of dirt bike injuries in children and associations with morbidity and mortality. The study included 85 children (83 boys, 2 girls) dirt bike injury treated at a tertiary care pediatric hospital. Imaging studies and hospital medical records were reviewed. Outcomes were classified into the following categories: short-term disability, long-term disability or no follow-up available. Imaging studies were reviewed for head, torso, and extremity injuries. One-tailed z test for two proportions was used to determine significant differences between various proportions. Chi-square test with Yates correction was used to determine the significance of long-term disability with injury type. Long bone fractures were the most common injuries. Lower extremity fractures accounted for 79% of extremity fractures and were significantly more common than upper extremity fractures (p = 0.001). Head injuries included fractures (n = 9), brain contusion (n = 5), and meningeal hemorrhage (n = 2). Head injury was associated with long-term disability (p < 0.0001). All torso injuries were solitary. Long-term disability was associated with head injuries but not with torso or extremity injuries. Lower extremity injuries were significantly more common than upper extremity injuries. Torso solid organ injuries were uniformly solitary. Published by Elsevier Inc.

Comparative outcome of bomb explosion injuries versus high-powered gunshot injuries of the upper extremity in a civilian setting.

Science.gov (United States)

Luria, Shai; Rivkin, Gurion; Avitzour, Malka; Liebergall, Meir; Mintz, Yoav; Mosheiff, Ram

2013-03-01

Explosion injuries to the upper extremity have specific clinical characteristics that differ from injuries due to other mechanisms. To evaluate the upper extremity injury pattern of attacks on civilian targets, comparing bomb explosion injuries to gunshot injuries and their functional recovery using standard outcome measures. Of 157 patients admitted to the hospital between 2000 and 2004, 72 (46%) sustained explosion injuries and 85 (54%) gunshot injuries. The trauma registry files were reviewed and the patients completed the DASH Questionnaire (Disabilities of Arm, Shoulder and Hand) and SF-12 (Short Form-12) after a minimum period of 1 year. Of the 157 patients, 72 (46%) had blast injuries and 85 (54%) had shooting injuries. The blast casualties had higher Injury Severity Scores (47% vs. 22% with a score of > 16, P = 0.02) and higher percent of patients treated in intensive care units (47% vs. 28%, P = 0.02). Although the Abbreviated Injury Scale score of the upper extremity injury was similar in the two groups, the blast casualties were found to have more bilateral and complex soft tissue injuries and were treated surgically more often. No difference was found in the SF-12 or DASH scores between the groups at follow up. The casualties with upper extremity blast injuries were more severely injured and sustained more bilateral and complex soft tissue injuries to the upper extremity. However, the rating of the local injury to the isolated limb is similar, as was the subjective functional recovery.

Clinical implications of bile duct injury after transcatheter arterial chemoembolization

International Nuclear Information System (INIS)

Wang Maoqiang; Tang Wenjie; Lin Hanying; Ye Huiyi; Dai Guanghai; Wang Zhiqiang

2005-01-01

Objective: To evaluate the incidence, risk factors , and clinical course of bile duct injury after transcatheter arterial chemoembolization (TACE) for treatment of hepatic malignancy. Methods: A total of 1240 consecutive patients with hepatic malignancies underwent 2680 TACE procedures. None of these patients were found to have any radiographic evidence of biliary abnormalities pre-TACE. Eighteen patients developed bile duct injuries at 3 weeks to 3 months after TACE. A retrospective review of medical records and imaging studies were carried out to evaluate the occurrence of TACE-induced bile duct injury, the clinical outcome, and the statistical significance of potential predisposing factors. Results: The TACE-induced bile duct injuries occurred in 13 of 148 patients with liver metastatic tumors (8.8%), 5 of 1092 patients with HCC (0.5%). Biliary injuries, including focal (n=4) and multiple intrahepatic bile duct dilatation (n=8), and cystic lesion or biloma (n=6), were identified on the follow-up imaging studies after TACE. Three patients with multiple bile duct injuries had mild jaundice at the presentation, two of them responded well to the conservative treatment, one died of irreversible deterioration of liver function at 2 weeks after the onset of jaundice. Four patients with a large biloma had associated serious bacterial infections; 3 of which were treated with percutaneous catheter drainage and antibiotics, 2 of them died of purulent peritonitis due to rupture of the cystic lesions and 1 cured with antibiotic. The remaining 11 patients were asymptomatic. The mortality related to the biliary injury occurred in 3 patients (16.7%). The incidences of bile duct injury were higher in patients with metastatic tumors in non-cirrhotic livers than in patients with hepatocellular carcinoma associated with cirrhosis (P<0.01), higher in patient with hypovascular lesions (P<0.01), and higher in patients using an emulsion of lipiodol-platinum for selective embolization

Equestrian injuries: incidence, injury patterns, and risk factors for 10 years of major traumatic injuries.

Science.gov (United States)

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

2007-05-01

Horseback riding is more dangerous than motorcycle riding, skiing, football, and rugby. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with severe equestrian trauma. All patients with major equestrian injuries (injury severity score > or = 12) admitted between 1995 and 2005 were reviewed. A 46-question survey outlining potential rider, animal, and environmental risk factors was administered. Among 7941 trauma patients, 151 (2%) were injured on horseback (mean injury severity score, 20; mortality rate, 7%). Injuries included the chest (54%), head (48%), abdomen (22%), and extremities (17%). Forty-five percent required surgery. Survey results (55%) indicated that riders and horses were well trained, with a 47% recidivism rate. Only 9% of patients wore helmets, however, 64% believed the accident was preventable. Chest trauma previously has been underappreciated. This injury pattern may be a result of significant rider experience. Helmet and vest use will be targeted in future injury prevention strategies.

How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis.

Science.gov (United States)

Hsieh, Ting-Min; Tsai, Tsung-Cheng; Liu, Yueh-Wei; Hsieh, Ching-Hua

2016-07-21

High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher's exact or Pearson's chi-square tests were used to compare categorical data, unpaired Student's t-test was used to analyze normally distributed continuous data, and Mann-Whitney's U test was used to compare non-normally distributed data. In this study, the majority (76%, 101/133) of high-grade BHSI were due to motorcycle crashes. Car occupants had a significantly higher injury severity score (ISS; 26.8 ± 10.9 vs. 20.7 ± 10.4, respectively, p = 0.005) and organ injured score (OIS; 3.8 ± 1.0 vs. 3.4 ± 0.6, respectively, p = 0.033), as well as a significantly longer hospital length of stay (LOS; 21.2 days vs. 14.6 days, respectively, p = 0.038) than did motorcyclists. Car occupants with high-grade BHSI also had worse clinical presentations than their motorcyclist counterparts, including a significantly higher incidence of hypotension, hyperpnea, tube thoracostomy, blood transfusion >4 units, LOS in intensive care unit >5 days, and complications. However, there were no differences in the percentage of angiography or laparotomy performed or mortality rate between these two groups of patients. This study demonstrated that car occupants with high-grade BHSI were injured more severely, had a higher incidence of worse clinical presentation, had a longer hospital LOS, and had a higher incidence of complications than motorcyclists. The results also

How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis

Directory of Open Access Journals (Sweden)

Ting-Min Hsieh

2016-07-01

Full Text Available Background: High-grade blunt hepatic and/or splenic injuries (BHSI remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. Methods: High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher’s exact or Pearson’s chi-square tests were used to compare categorical data, unpaired Student’s t-test was used to analyze normally distributed continuous data, and Mann–Whitney’s U test was used to compare non-normally distributed data. Results: In this study, the majority (76%, 101/133 of high-grade BHSI were due to motorcycle crashes. Car occupants had a significantly higher injury severity score (ISS; 26.8 ± 10.9 vs. 20.7 ± 10.4, respectively, p = 0.005 and organ injured score (OIS; 3.8 ± 1.0 vs. 3.4 ± 0.6, respectively, p = 0.033, as well as a significantly longer hospital length of stay (LOS; 21.2 days vs. 14.6 days, respectively, p = 0.038 than did motorcyclists. Car occupants with high-grade BHSI also had worse clinical presentations than their motorcyclist counterparts, including a significantly higher incidence of hypotension, hyperpnea, tube thoracostomy, blood transfusion >4 units, LOS in intensive care unit >5 days, and complications. However, there were no differences in the percentage of angiography or laparotomy performed or mortality rate between these two groups of patients. Conclusions: This study demonstrated that car occupants with high-grade BHSI were injured more severely, had a higher incidence of worse clinical presentation, had a longer hospital LOS, and had a

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.

A profile of Injury in Fiji: findings from a population-based injury surveillance system (TRIP-10

Directory of Open Access Journals (Sweden)

Wainiqolo Iris

2012-12-01

Full Text Available Abstract Background Over 90% of injury deaths occur in low-and middle-income countries. However, the epidemiological profile of injuries in Pacific Islands has received little attention. We used a population-based-trauma registry to investigate the characteristics of all injuries in Viti Levu, Fiji. Method The Fiji Injury Surveillance in Hospitals (FISH database prospectively collected data on all injury-related deaths and primary admissions to hospital (≥12 hours stay in Viti Levu during 12 months commencing October 2005. Results The 2167 injury-related deaths and hospitalisations corresponded to an annual incidence rate of 333 per 100,000, with males accounting for twice as many cases as females. Almost 80% of injuries involved people aged less than 45 years, and 74% were deemed unintentional. There were 244 fatalities (71% died before admission and 1994 hospitalisations corresponding to crude annual rates of 37.5 per 100,000 and 306 per 100,000 respectively. The leading cause of fatal injury was road traffic injury (29% and the equivalent for injury admissions was falls (30%. The commonest type of injury resulting in death and admission to hospital was asphyxia and fractures respectively. Alcohol use was documented as a contributing factor in 13% of deaths and 12% of admissions. In general, indigenous Fijians had higher rates of injury admission, especially for interpersonal violence, while those of Indian ethnicity had higher rates of fatality, especially from suicide. Conclusions Injury is an important public health problem that disproportionately affects young males in Fiji, with a high proportion of deaths prior to hospital presentation. This study highlights key areas requiring priority attention to reduce the burden of potentially life-threatening injuries in Fiji.

Prevalence of traumadc dental Injuries among new orthodondc ...

African Journals Online (AJOL)

The prevalence of dental trauma was significantly higher in males (p<0.05) and most frequently observed In patients aged 6 to 10 years. Falls was the commonest cause of dental traumatic Injuries among the patients (37.5%). The most common type of trauma to the teeth was enamel fracture (46. 9%) followed by avulslon ...

Concomitant hollow viscus injuries in patients with blunt hepatic and splenic injuries: an analysis of a National Trauma Registry database.

Science.gov (United States)

Swaid, Forat; Peleg, Kobi; Alfici, Ricardo; Matter, Ibrahim; Olsha, Oded; Ashkenazi, Itamar; Givon, Adi; Kessel, Boris

2014-09-01

Non-operative management has become the standard approach for treating stable patients sustaining blunt hepatic or splenic injuries in the absence of other indications for laparotomy. The liberal use of computed tomography (CT) has reduced the rate of unnecessary immediate laparotomies; however, due to its limited sensitivity in the diagnosis of hollow viscus injuries (HVI), this may be at the expense of a rise in the incidence of missed HVI. The aim of this study was to assess the incidence of concomitant HVI in blunt trauma patients diagnosed with hepatic and/or splenic injuries, and to evaluate whether a correlation exists between this incidence and the severity of hepatic or splenic injuries. A retrospective cohort study involving blunt trauma patients with splenic and/or liver injuries, between the years 1998 and 2012 registered in the Israel National Trauma Registry. The association between the presence and severity of splenic and/or liver injuries and the incidence of HVI was examined. Of the 57,130 trauma victims identified as suffering from blunt torso injuries, 2335 (4%) sustained hepatic injuries without splenic injuries (H group), 3127 (5.4%) had splenic injuries without hepatic injuries (S group), and 564 (1%) suffered from both hepatic and splenic injuries (H+S group). Overall, 957 patients sustained 1063 HVI. The incidence of HVI among blunt torso trauma victims who sustained neither splenic nor hepatic injuries was 1.5% which is significantly lower than in the S (3.1%), H (3.1%), and H+S (6.7%) groups. In the S group, there was a clear correlation between the severity of the splenic injury and the incidence of HVI. This correlation was not found in the H group. The presence of blunt splenic and/or hepatic injuries predicts a higher incidence of HVI, especially if combined. While in blunt splenic injury patients there is a clear correlation between the incidence of HVI and the severity of splenic injury, such a correlation does not exist in patients

Molecular mechanisms of cognitive dysfunction following traumatic brain injury

Science.gov (United States)

Walker, Kendall R.; Tesco, Giuseppina

2013-01-01

Traumatic brain injury (TBI) results in significant disability due to cognitive deficits particularly in attention, learning and memory, and higher-order executive functions. The role of TBI in chronic neurodegeneration and the development of neurodegenerative diseases including Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic Lateral Sclerosis (ALS) and most recently chronic traumatic encephalopathy (CTE) is of particular importance. However, despite significant effort very few therapeutic options exist to prevent or reverse cognitive impairment following TBI. In this review, we present experimental evidence of the known secondary injury mechanisms which contribute to neuronal cell loss, axonal injury, and synaptic dysfunction and hence cognitive impairment both acutely and chronically following TBI. In particular we focus on the mechanisms linking TBI to the development of two forms of dementia: AD and CTE. We provide evidence of potential molecular mechanisms involved in modulating Aβ and Tau following TBI and provide evidence of the role of these mechanisms in AD pathology. Additionally we propose a mechanism by which Aβ generated as a direct result of TBI is capable of exacerbating secondary injury mechanisms thereby establishing a neurotoxic cascade that leads to chronic neurodegeneration. PMID:23847533

Molecular mechanisms of cognitive dysfunction following traumatic brain injury.

Science.gov (United States)

Walker, Kendall R; Tesco, Giuseppina

2013-01-01

Traumatic brain injury (TBI) results in significant disability due to cognitive deficits particularly in attention, learning and memory, and higher-order executive functions. The role of TBI in chronic neurodegeneration and the development of neurodegenerative diseases including Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic Lateral Sclerosis (ALS) and most recently chronic traumatic encephalopathy (CTE) is of particular importance. However, despite significant effort very few therapeutic options exist to prevent or reverse cognitive impairment following TBI. In this review, we present experimental evidence of the known secondary injury mechanisms which contribute to neuronal cell loss, axonal injury, and synaptic dysfunction and hence cognitive impairment both acutely and chronically following TBI. In particular we focus on the mechanisms linking TBI to the development of two forms of dementia: AD and CTE. We provide evidence of potential molecular mechanisms involved in modulating Aβ and Tau following TBI and provide evidence of the role of these mechanisms in AD pathology. Additionally we propose a mechanism by which Aβ generated as a direct result of TBI is capable of exacerbating secondary injury mechanisms thereby establishing a neurotoxic cascade that leads to chronic neurodegeneration.

Organizational injury rate underreporting: the moderating effect of organizational safety climate.

Science.gov (United States)

Probst, Tahira M; Brubaker, Ty L; Barsotti, Anthony

2008-09-01

The goals of this study were (a) to assess the extent to which construction industry workplace injuries and illness are underreported, and (b) to determine whether safety climate predicts the extent of such underreporting. Data from 1,390 employees of 38 companies contracted to work at a large construction site in the northwestern United States were collected to assess the safety climate of the companies. Data from the Occupational Safety and Health Administration (OSHA) logs kept by the contractors allowed for calculation of each company's OSHA recordable injury rate (i.e., the reported injury rate), whereas medical claims data from an Owner-Controlled Insurance Program provided the actual experienced rate of injuries for those same companies. While the annual injury rate reported to OSHA was 3.11 injuries per 100 workers, the rate of eligible injuries that were not reported to OSHA was 10.90 injuries per 100 employees. Further, organizations with a poor safety climate had significantly higher rates of underreporting (81% of eligible injuries unreported) compared with organizations with a positive safety climate (47% of eligible injuries unreported). Implications for organizations and the accuracy of the Bureau of Labor Statistics's national occupational injury and illness surveillance system are discussed.

Miners’ return to work following injuries in coal mines

Directory of Open Access Journals (Sweden)

Ashis Bhattacherjee

2016-12-01

Full Text Available Background: The occupational injuries in mines are common and result in severe socio-economical consequences. Earlier studies have revealed the role of multiple factors such as demographic factors, behavioral factors, health-related factors, working environment, and working conditions for mine injuries. However, there is a dearth of information about the role of some of these factors in delayed return to work (RTW following a miner’s injury. These factors may likely include personal characteristics of injured persons and his or her family, the injured person’s social and economic status, and job characteristics. This study was conducted to assess the role of some of these factors for the return to work following coal miners’ injuries. Material and Methods: A study was conducted for 109 injured workers from an underground coal mine in the years 2000–2009. A questionnaire, which was completed by the personnel interviews, included among others age, height, weight, seniority, alcohol consumption, sleeping duration, presence of diseases, job stress, job satisfaction, and injury type. The data was analyzed using the Kaplan-Meier estimates and the Cox proportional hazard model. Results: According to Kaplan-Meier estimate it was revealed that a lower number of dependents, longer sleep duration, no job stress, no disease, no alcohol addiction, and higher monthly income have a great impact on early return to work after injury. The Cox regression analysis revealed that the significant risk factors which influenced miners’ return to work included presence of disease, job satisfaction and injury type. Conclusions: The mine management should pay attention to significant risk factors for injuries in order to develop effective preventive measures. Med Pr 2016;67(6:729–742

Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

International Nuclear Information System (INIS)

Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon; Bae, Sang Jin

2004-01-01

We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance (ρ > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury

Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

Energy Technology Data Exchange (ETDEWEB)

Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)

2004-12-15

We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance ({rho} > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury.

Risk factors of significant pain syndrome 90 days after minor thoracic injury: trajectory analysis.

Science.gov (United States)

Daoust, Raoul; Emond, Marcel; Bergeron, Eric; LeSage, Natalie; Camden, Stéphanie; Guimont, Chantal; Vanier, Laurent; Chauny, Jean-Marc

2013-11-01

The objective was to identify the risk factors of clinically significant pain at 90 days in patients with minor thoracic injury (MTI) discharged from the emergency department (ED). A prospective, multicenter, cohort study was conducted in four Canadian EDs from November 2006 to November 2010. All consecutive patients aged 16 years or older with MTI were eligible at discharge from EDs. They underwent standardized clinical and radiologic evaluations at 1 and 2 weeks, followed by standardized telephone interviews at 30 and 90 days. A pain trajectory model characterized groups of patients with different pain evolutions and ascertained specific risk factors in each group through multivariate analysis. In this cohort of 1,132 patients, 734 were eligible for study inclusion. The authors identified a pain trajectory that characterized 18.2% of the study population experiencing clinically significant pain (>3 of 10) at 90 days after a MTI. Multivariate modeling found two or more rib fractures, smoking, and initial oxygen saturation below 95% to be predictors of this group of patients. To the authors' knowledge, this is the first prospective study of trajectory modeling to detect risk factors associated with significant pain at 90 days after MTI. These factors may help in planning specific treatment strategies and should be validated in another prospective cohort. © 2013 by the Society for Academic Emergency Medicine.

Analysis of factors related to military training injury and the effect of self-rescue and buddy rescue on the final result of the injury in tank crew of the armored forces

Directory of Open Access Journals (Sweden)

Rong-bin ZHOU

2011-09-01

Full Text Available Objective To analyze the factors related to military training injury and the effect of self-rescue and buddy rescue on the result of the injury in the soldiers.Methods All data were statistically classified with cluster sampling according to the diagnosis standard of Chinese PLA for analysis.Investigation was conducted in 1028 soldiers of the armored forces with questionnaire,and non-condition logistic regression analysis was applied.Results The total incidence of military training injury was 40.2%.Of all the injured soldiers,36.80% of them served for one year only,and the incidence of injury was obviously higher than those who had served in armed forces for 2 or 3 years.Unconditioned regression analysis revealed that the main causes related to military training injury in the soldiers were as follows: the items of training,the terrain feature,motion sickness,self-rescue and buddy rescue training,and whether the action consistent with the standards.The rehabilitation rate within one month was significantly higher in those who underwent self-rescue or buddy rescue(93.8% and 94.2%,respectively than those who did not undergo self-rescue or buddy rescue(76.3%,76.7%,respectively,P < 0.001.Conclusions The incidence of military training injury in the armored forces is high.It should be emphysized that soldiers with one year of military service should be partioularly taken care to prevent from injuries.Many factors may influence the military training injury,and protective measures should be taken.Those who have the knowledge of self-rescue or undergo buddy rescue will have higher rehabilitation rate within one month.

[Biomechanical significance of the acetabular roof and its reaction to mechanical injury].

Science.gov (United States)

Domazet, N; Starović, D; Nedeljković, R

1999-01-01

The introduction of morphometry into the quantitative analysis of the bone system and functional adaptation of acetabulum to mechanical damages and injuries enabled a relatively simple and acceptable examination of morphological acetabular changes in patients with damaged hip joints. Measurements of the depth and form of acetabulum can be done by radiological methods, computerized tomography and ultrasound (1-9). The aim of the study was to obtain data on the behaviour of acetabular roof, the so-called "eyebrow", by morphometric analyses during different mechanical injuries. Clinical studies of the effect of different loads on acetabular roof were carried out in 741 patients. Radiographic findings of 400 men and 341 women were analysed. The control group was composed of 148 patients with normal hip joints. Average age of the patients was 54.7 years and that of control subjects 52.0 years. Data processing was done for all examined patients. On the basis of our measurements the average size of female "eyebrow" ranged from 24.8 mm to 31.5 mm with standard deviation of 0.93 and in men from 29.4 mm to 40.3 mm with standard deviation of 1.54. The average size in the whole population was 32.1 mm with standard deviation of 15.61. Statistical analyses revealed high correlation coefficients between the age and "eyebrow" size in men (r = 0.124; p 0.05). The examination of the size of collodiaphysial angle and length of "eyebrow" revealed that "eyebrow" length was in inverse proportion to the size of collodiaphysial angle (r = 0.113; p 0.05) and female (r = 0.005; p > 0.05) patients. The "eyebrow" length was proportionally dependent on the size of the shortened extremity in all examined subjects. This dependence was statistically significant both in female (r = 0.208; p < 0.05) and male (r = 0.193; p < 0.05) patients. The study revealed that fossa acetabuli was forward and downward laterally directed. The size, form and cross-section of acetabulum changed during different

A Brief Analysis of Traditional Chinese Medical Elongated Needle Therapy on Acute Spinal Cord Injury and Its Mechanism

Directory of Open Access Journals (Sweden)

Mengxuan Du

2013-01-01

Full Text Available Acute spinal cord injury is one of the most common and complicated diseases among human spinal injury. We aimed to explore the effect of point-through-point acupuncture therapy with elongated needles on acute spinal cord injury in rabbits and its possible mechanism. Adult rabbits were randomly divided into a model group, elongated needle therapy group, and blank group. Immunohistochemical staining showed that the protein levels of Fas and caspase-3 in the model group were significantly higher than those in the blank group at each time point (P<0.05 and significantly lower than those in the elongated needle therapy group on the 3rd and 5th days after operation (P<0.05. RT-PCR showed that Fas and caspase-3 mRNA levels in the model group and elongated needle therapy group were significantly higher than those in the blank group (P<0.05, 0.01. The mRNA levels of Fas and caspase-3 in the elongated needle therapy group were significantly lower than those in model group on the 3rd day (P<0.05, 0.01. Therefore, we confirmed that elongated needle therapy has an obvious effect on acute spinal cord injury in rabbits. Its mechanism is made possible by inhibiting the expression of the Fas→caspase-3 cascade, thereby inhibiting cell apoptosis after spinal cord injury.

The 1982 epidemic--roller skating injuries.

Science.gov (United States)

Bunker, T. D.

1983-01-01

A series of 100 roller skating injuries is presented. Roller skating injuries have been occurring at a higher rate than the previously reported skateboarding epidemic of 1977. The severity of injury has been lower, 32% fractures and dislocations occurring whilst roller skating, compared to 60% whilst skateboarding. In particular a striking reduction is seen in ankle fractures. Fifty questionnaires detailing method of injury were analysed. Images p205-a Fig. 1 Fig. 2 PMID:6652406

A Prospective Epidemiological Study of Injuries in Japanese National Tournament-Level Badminton Players From Junior High School to University.

Science.gov (United States)

Miyake, Eiji; Yatsunami, Mitsunobu; Kurabayashi, Jun; Teruya, Koji; Sekine, Yasuhiro; Endo, Tatsuaki; Nishida, Ryuichiro; Takano, Nao; Sato, Seiko; Jae Kyung, Han

2016-03-01

Injury prevention programs have recently been created for various sports. However, a longitudinal study on badminton injuries, as assessed by a team's dedicated medical staff, at the gymnasium has not been performed. We aimed to perform the first such study to measure the injury incidence, severity and type as the first step in creating a badminton injury prevention program. A prospective, longitudinal survey was conducted between April 2012 and March 2013 with 133 national tournament-level badminton players from junior high school to university in Japan with the teams' physical therapists at the gymnasium. Injury incidence was measured as the injury rate (IR) for every 1,000 hour (1000 hour) and IR for every 1,000 athlete exposures (1000 AE). Severity was classified in 5 levels by the number of days the athlete was absent from practice or matches. Injury types were categorized as trauma or overuse. Practice (IR) (1,000 hour) was significantly higher in female players than in male players; the rates increased with increasing age. IR (1,000 AE) was significantly higher in matches than in practice in both sexes of all ages, except for female junior high school students and injuries were most frequent for high school students in matches. The majority of the injuries were slight (83.8%); overuse injuries occurred approximately 3 times more than trauma. This is the first study in which medical staff assessed injuries in badminton, providing value through benchmark data. Injury prevention programs are particularly necessary for female university students in practice and high school students in matches.

Pediatric scalds: do cooking-related burns have a higher injury burden?

Science.gov (United States)

Bachier, Marielena; Hammond, Sarah E; Williams, Regan; Jancelewicz, Timothy; Feliz, Alexander

2015-11-01

Pediatric scald burns result in frequent emergency room visits and hospitalizations. We investigated whether cooking-related burns produce greater morbidity requiring more extensive care than noncooking burns. We performed a 6-y review at our free-standing children's hospital. Children aged cooking versus noncooking burns. The Mann-Whitney U test, a chi-square test, and the negative binomial were used to compare continuous, categorical, and count data between groups. Bivariate analysis was performed to identify risk factors among patients with adverse outcomes. We identified 308 patients; 262 (85%) cooking and 46 (15%) noncooking burns. Most patients were African-American males, with public insurance, and a median age of 2 y. Cooking burns preferentially occurred over the head, neck, and upper body; noncooking burns were distributed over the lower body (P  0.11). In subgroup analysis, semisolid and grease burns resulted in increased rates of wound contractures and/or limited mobility when compared with noncooking burns (P = 0.05 and P = 0.008, respectively). Patients with complications were more likely to have third degree burns and required more consults, longer hospitalization, and more surgical debridements and clinic visits. Most accidental scald burns occurred in young children during food preparation. Greater long-term morbidity was found in patients with semisolid and grease burns. This subset of children has a higher injury burden and requires extensive care in the acute and long-term setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Effect of tanshinone combined with valsartan therapy on the renal injury and endothelial injury in patients with hypertensive nephropathy

Directory of Open Access Journals (Sweden)

Wen-Tao Ma1

2017-04-01

Full Text Available Objective: To study the effect of tanshinone combined with valsartan therapy on the renal injury and endothelial injury in patients with hypertensive nephropathy. Methods: A total of 72 patients with hypertensive nephropathy who were treated in our hospital between January 2013 and April 2016 were selected and randomly divided into the control group (n=36 who received conventional treatment + valsartan therapy and the observation group (n=36 who received conventional treatment + tanshinone combined with valsartan therapy, and both therapies lasted for 2 weeks. Before treatment and after 2 weeks of treatment, automatic biochemical analyzer was used to determine the renal function indexes in peripheral blood, enzyme-linked immunosorbent assay (ELISA was used to determine the levels of endothelial injury markers and inflammatory cytokines in peripheral blood, and RIA method was used to determine the serum levels of oxidative stress indexes. Results: Before treatment, the differences in the peripheral blood renal function indexes and endothelial injury markers as well as the serum inflammatory factors and oxidative stress indexes were not statistically significant between two groups of patients. After 2 weeks of treatment, peripheral blood renal function indexes Scr and BUN levels as well as urine mAlb level of observation group were lower than those of control group, and endothelial injury indexes E-selectin and ET levels were lower than those of control group while NOS and CGRP levels were higher than those of control group; serum inflammatory cytokines IL-1, IL-6, CRP and TNF-α levels of observation group were lower than those of control group, and oxidative stress index GSH-Px level was higher than that of control group while MDA and AOPP levels were lower than those of control group. Conclusion: Tanshinone combined with valsartan can reduce the renal injury and endothelial injury in patients with hypertensive nephropathy, and the specific

Effects of abdominal lavage fluid from rats with radiation injury and combined radiation-burn injury on growth of hematopoietic progenitor cells

International Nuclear Information System (INIS)

Su, Y.-P.; Cheng, T.-M.; Guo, C.-H.; Liu, X.-H.; Qu, J.-F.

2003-01-01

Full text: Objective: To observe the effects of abdominal lavage fluid from rats with radiation injury, burn injury and combined radiation-burn injury on growth of hematopoietic progenitor cells. Methods Rats were irradiated with a single dose of 12 Gy γ-ray of 60Co, combined with 30% of total body surface area (TBSA) generated under a 5 KW bromo-tungsten lamp for 25 s. Lavage fluid from the peritoneum was collected 3, 12, 24, 48 and 72 hours after injury. Then the lavage fluid was added to the culture media of erythrocyte progenitor cells (CFU-E, BFE-E) or of granulocyte-macrophage progenitor cells (CFU-GM) at 40 mg/ml final concentration. Results The formed clones of CFU-E, BFU-E and CFU-GM of the lavage fluid from rats with radiation injury or combined radiation-burn injury at 3h, 12h, 24h, 48h and 72h time points were significantly higher than those from normal. They reached their peaks at 24h after injury (215.7%, 202.3%, or 241.2% from burned rats and 188.1%, 202.3% or 204.6% from rats inflected with combined radiation-burn injury as compared with those from normal rats). However, few CFU-E, BFU-E or CFU-GM clones were found after addition of lavage fluid from irradiated rats. Conclusion Peritoneal lavage fluid from rats with burn injury or combined radiation-burn injury enhances the growth of erythrocytes and granulocyte progenitor cells. On the contrary, the lavage fluid from irradiated rats shows inhibitory effects

Seat belt injuries and sigmoid colon trauma.

OpenAIRE

Eltahir, E M; Hamilton, D

1997-01-01

Colonic seat belt injuries are rare but carry higher mortality rates than small bowel injuries. The case of a 44 year old man is described who had severe sigmoid colon compression injury from his seat belt a few days after a road traffic accident.

Cumulative effective dose associated with radiography and CT of adolescents with spinal injuries.

Science.gov (United States)

Lemburg, Stefan P; Peters, Soeren A; Roggenland, Daniela; Nicolas, Volkmar; Heyer, Christoph M

2010-12-01

The purpose of this study was to analyze the quantity and distribution of cumulative effective doses in diagnostic imaging of adolescents with spinal injuries. At a level 1 trauma center from July 2003 through June 2009, imaging procedures during initial evaluation and hospitalization and after discharge of all patients 10-20 years old with spinal fractures were retrospectively analyzed. The cumulative effective doses for all imaging studies were calculated, and the doses to patients with spinal injuries who had multiple traumatic injuries were compared with the doses to patients with spinal injuries but without multiple injuries. The significance level was set at 5%. Imaging studies of 72 patients (32 with multiple injuries; average age, 17.5 years) entailed a median cumulative effective dose of 18.89 mSv. Patients with multiple injuries had a significantly higher total cumulative effective dose (29.70 versus 10.86 mSv, p cumulative effective dose to multiple injury patients during the initial evaluation (18.39 versus 2.83 mSv, p cumulative effective dose. Adolescents with spinal injuries receive a cumulative effective dose equal to that of adult trauma patients and nearly three times that of pediatric trauma patients. Areas of focus in lowering cumulative effective dose should be appropriate initial estimation of trauma severity and careful selection of CT scan parameters.

Characteristics and contributing factors related to sports injuries in young volleyball players.

Science.gov (United States)

Vanderlei, Franciele Marques; Bastos, Fabio Nascimento; Tsutsumi, Gustavo Yuki Cantalejo; Vanderlei, Luiz Carlos Marques; Netto Júnior, Jayme; Pastre, Carlos Marcelo

2013-10-14

The participation of young in volleyball is becoming increasingly common, and this increased involvement raises concerns about the risk of installation of sports injuries. Therefore, the objectives the study were identify the characteristics of sports injuries in young volleyball players and associate anthropometric and training variables with contributing factors for injuries. A total of 522 volleyball players participating in the High School Olympic Games of the State of São Paulo (Brazil) were interviewed. A reported condition inquiry was used to gather information on injuries, such as anatomic site affected, mechanism and moment of injury, as well as personal and training data. The level of significance was set at 5%. A 19% frequency of injuries was found. Higher age, weight, height, body mass index and training duration values were associated with the occurrence of injuries. The most affected anatomic site was the ankle/foot complex (45 injuries, 36.3%). Direct contact and contactless mechanisms were the main causes of injuries (61 injuries; 49.2% and 48 injuries; 38.7%, respectively). Training was the moment in which most injuries occurred (93 injuries; 75%), independently of personal and training characteristics. Injuries affected the ankle/foot complex with a greater frequency. Direct contact and contactless mechanisms were the most frequently reported and injuries occurred mainly during training sessions. Personal and training characteristics were contributing factors for the occurrence of injuries.

Penetrating injuries to the duodenum: An analysis of 879 patients from the National Trauma Data Bank, 2010 to 2014.

Science.gov (United States)

Phillips, Bradley; Turco, Lauren; McDonald, Dan; Mause, Alison; Walters, Ryan W

2017-11-01

Despite wide belief that the duodenal Organ Injury Scale has been validated, this has not been reported in the published literature. Based on clinical experience, we hypothesize that the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) for duodenal injuries can independently predict mortality. Our objectives were threefold: (1) describe the national profile of penetrating duodenal injuries, (2) identify predictors of morbidity and mortality, and (3) validate the duodenum AAST-OIS as a statistically significant predictor of mortality. Using the Abbreviated Injury Scale 2005 and International Classification of Diseases-9th Rev.-Clinical Modification (ICD-9-CM) E-codes, we identified 879 penetrating duodenal trauma patients from the National Trauma Data Bank between 2010 and 2014. We controlled patient-level covariates of age, biological sex, systolic blood pressure (SBP), Glasgow Coma Scale (GCS) score, pulse, Injury Severity Score (ISS), and Organ Injury Scale (OIS) grade. We estimated multivariable generalized linear mixed models to account for the nesting of patients within trauma centers. Our results indicated an overall mortality rate of 14.4%. Approximately 10% of patients died within 24 hours of admission, of whom 76% died in the first 6 hours. Patients averaged approximately five associated injuries, 45% of which involved the liver and colon. Statistically significant independent predictors of mortality were firearm mechanism, SBP, GCS, pulse, ISS, and AAST-OIS grade. Specifically, odds of death were decreased with 10 mm Hg higher admission SBP (13% decreased odds), one point higher GCS (14.4%), 10-beat lower pulse (8.2%), and 10-point lower ISS (51.0%). This study is the first to report the national profile of penetrating duodenal injuries. Using the National Trauma Data Bank, we identified patterns of injury, predictors of outcome, and validated the AAST-OIS for duodenal injuries as a statistically significant predictor of morbidity

The NLstart2run study: Training-related factors associated with running-related injuries in novice runners.

Science.gov (United States)

Kluitenberg, Bas; van der Worp, Henk; Huisstede, Bionka M A; Hartgens, Fred; Diercks, Ron; Verhagen, Evert; van Middelkoop, Marienke

2016-08-01

The incidence of running-related injuries is high. Some risk factors for injury were identified in novice runners, however, not much is known about the effect of training factors on injury risk. Therefore, the purpose of this study was to examine the associations between training factors and running-related injuries in novice runners, taking the time varying nature of these training-related factors into account. Prospective cohort study. 1696 participants completed weekly diaries on running exposure and injuries during a 6-week running program for novice runners. Total running volume (min), frequency and mean intensity (Rate of Perceived Exertion) were calculated for the seven days prior to each training session. The association of these time-varying variables with injury was determined in an extended Cox regression analysis. The results of the multivariable analysis showed that running with a higher intensity in the previous week was associated with a higher injury risk. Running frequency was not significantly associated with injury, however a trend towards running three times per week being more hazardous than two times could be observed. Finally, lower running volume was associated with a higher risk of sustaining an injury. These results suggest that running more than 60min at a lower intensity is least injurious. This finding is contrary to our expectations and is presumably the result of other factors. Therefore, the findings should not be used plainly as a guideline for novices. More research is needed to establish the person-specific training patterns that are associated with injury. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effect of Kaempferol Pretreatment on Myocardial Injury in Rats.

Science.gov (United States)

Vishwakarma, Anamika; Singh, Thakur Uttam; Rungsung, Soya; Kumar, Tarun; Kandasamy, Arunvikram; Parida, Subhashree; Lingaraju, Madhu Cholenahalli; Kumar, Ajay; Kumar, Asok; Kumar, Dinesh

2018-01-20

The present study was undertaken to evaluate the effect of kaempferol in isoprenaline (ISP)-induced myocardial injury in rats. ISP was administered subcutaneously for two subsequent days to induce myocardial injury. Assessment of myocardial injury was done by estimation of hemodynamic functions, myocardial infarcted area, cardiac injury markers, lipid profile, oxidative stress, pro-inflammatory cytokines and histopathology of heart and liver. Rats pretreated with kaempferol showed reduction in the myocardial infarcted area and heart rate. However, no improvement was observed in change in body weight, mean arterial, systolic and diastolic blood pressure. Kaempferol showed significant decrease in serum LDH, CK-MB, troponin-I and lipid profile. However, highest dose of kaempferol did not reduce the serum triglyceride level. Further, antioxidant enzymes, SOD and catalase, were also higher. However, reduced glutathione, serum SGOT and creatinine did not show any improvement. Kaempferol showed reduction in MDA level. Kaempferol at highest dose showed reduction in pro-MMP-2 expression and MMP-9 level. mRNA expression level of TNF-α was not different in kaempferol-pretreated myocardial injured rats with ISP-alone group. Pretreatment with kaempferol at highest dose showed mild mononuclear infiltration and degenerative changes in heart tissue section of myocardial injured rats. Rats pretreated with kaempferol at higher concentration showed normal cordlike arrangement of hepatocytes with moderate swelling of hepatocytes (vacuolar degeneration) around the central vein. Study suggests that kaempferol attenuated lipid profile, infarcted area and oxidative stress in ISP-induced myocardial injury in rats.

Callus formation in bone fractures combined with brain injury in rat

Directory of Open Access Journals (Sweden)

Yu-Ping Chen

2017-01-01

Full Text Available Objective: The objective of this study was to determine the speed of bony union and the serum levels of biomarkers in the setting of bone fractures combined with brain injury. Materials and Methods: In this study, Sprague–Dawley rats were randomized into four groups: sham, brain injury, bone fracture, and bone fracture plus brain injury groups. The serum levels of biochemical markers, namely, nerve growth factor (NGF, Wnt-3a, Dickkopf-related protein-1, receptor-activator of NF-κB ligand, and adrenocorticotropic hormone (ACTH, were measured on the days 1, 3, 7, and 14 following injury. Bony union was evaluated using radiographs every week for 6 weeks. Results: Compared with the brain injury group and bone fracture group, the radiographs of the bone fracture plus brain injury group revealed enhanced callus formations in week 2. From week 3, the callus formation did not differ significantly among the groups. The serum levels of the biomarkers varied at different time points. The serum levels of NGF on days 1 and 3, Wnt-3a on days 3 and 14, and ACTH on days 1, 3, and 7 were significantly higher in the bone fracture plus brain injury group than in the bone fracture group. Conclusions: Brain injury increases callus formation in simultaneous bone fracture. Considering the time point, early NGF, Wnt-3a, and ACTH elevation might be associated with early callus formation enhancement. The results indicate that these brain injury-induced biomarkers might play crucial role in accelerating bone healing.

Overuse Injuries in Professional Ballet

Science.gov (United States)

Sobrino, Francisco José; de la Cuadra, Crótida; Guillén, Pedro

2015-01-01

Background Despite overuse injuries being previously described as the most frequent in ballet, there are no studies on professional dancers providing the specific clinical diagnoses or type of injury based on the discipline. Hypothesis Overuse injuries are the most frequent injuries in ballet, with differences in the type and frequency of injuries based on discipline. Study Design Cross-sectional study; Level of evidence, 3. Methods This was a descriptive cross-sectional study performed between January 1, 2005, and October 10, 2010, on injuries occurring in professional dancers from leading Spanish dance companies who practiced disciplines such as classical, neoclassical, contemporary, and Spanish ballet. Data, including type of injury, were obtained from specialized medical services at the Trauma Service, Fremap, Madrid, Spain. Results A total of 486 injuries were evaluated, a significant number of which were overuse disorders (P ballet (82.60%). Injuries were more frequent among female dancers (75.90%) and classical ballet (83.60%). A statistically significant prevalence of patellofemoral pain syndrome was found in the classical discipline (P = .007). Injuries of the adductor muscles of the thigh (P = .001) and of the low back facet (P = .02) in the Spanish ballet discipline and lateral snapping hip (P = .02) in classical and Spanish ballet disciplines were significant. Conclusion Overuse injuries were the most frequent injuries among the professional dancers included in this study. The prevalence of injuries was greater for the most technically demanding discipline (classical ballet) as well as for women. Patellofemoral pain syndrome was the most prevalent overuse injury, followed by Achilles tendinopathy, patellar tendinopathy, and mechanical low back pain. Clinical Relevance Specific clinical diagnoses and injury-based differences between the disciplines are a key factor in ballet. PMID:26665100

Concussions and Head Injuries in English Community Rugby Union Match Play.

Science.gov (United States)

Roberts, Simon P; Trewartha, Grant; England, Michael; Goodison, William; Stokes, Keith A

2017-02-01

Previous research has described general injury patterns in community-level rugby union, but specific information on time-loss head injuries has not been reported. To establish the incidence and nature of significant time-loss head injuries in English community rugby match play, and to identify the injury risk for specific contact events. Descriptive epidemiology study. Over 6 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), 76 (2011-2012), 50 (2012-2013), 67 (2013-2014), and 58 (2014-2015) English community rugby clubs (Rugby Football Union levels 3-9) over a total of 175,940 hours of player match exposure. Club injury management staff reported information for all head injuries sustained during match play whereby the player was absent for 8 days or greater. Clubs were subdivided into semiprofessional (mean player age, 24.6 ± 4.7 years), amateur (24.9 ± 5.1 years), and recreational (25.6 ± 6.1 years) playing levels. Contact events from a sample of 30 matches filmed over seasons 2009-2010, 2010-2011, and 2011-2012 provided mean values for the frequency of contact events. The overall incidence for time-loss head injuries was 2.43 injuries per 1000 player match hours, with a higher incidence for the amateur (2.78; 95% CI, 2.37-3.20) compared with recreational (2.20; 95% CI, 1.86-2.53) ( P = .032) playing level but not different to the semiprofessional (2.31; 95% CI, 1.83-2.79) playing level. Concussion was the most common time-loss head injury, with 1.46 per 1000 player match hours. The tackle event was associated with 64% of all head injuries and 74% of all concussions. There was also a higher risk of injuries per tackle (0.33 per 1000 events; 95% CI, 0.30-0.37) compared with all other contact events. Concussion was the most common head injury diagnosis, although it is likely that this injury was underreported. Continuing education programs for medical staff and players are essential for the improved identification and management of

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.

A Comparison of Women's Collegiate and Girls' High School Volleyball Injury Data Collected Prospectively Over a 4-Year Period.

Science.gov (United States)

Reeser, Jonathan C; Gregory, Andrew; Berg, Richard L; Comstock, R Dawn

2015-01-01

There is a relative paucity of research examining the sport-specific injury epidemiology of high school and collegiate volleyball athletes. Moreover, differences in study methodology frequently limit our ability to compare and contrast injury data collected from selected populations. There are differences between the injury patterns characteristic of high school and collegiate female volleyball athletes. Retrospective clinical review. Level 3. We statistically analyzed injury incidence and outcome data collected over a 4-year interval (2005-2006 to 2008-2009) by 2 similar injury surveillance systems, the National Collegiate Athletic Association's Injury Surveillance System (NCAA ISS) and the High School Reporting Injuries Online (HS RIO). We compared diagnoses, anatomic distribution of injuries, mechanisms of injury, and time lost from training or competition between high school and collegiate volleyball athletes. The overall volleyball-related injury rate was significantly greater among collegiate athletes than among high school athletes during both competition (injury rate ratio, 2.9; 95% CI, 2.5-3.4) and practice (injury rate ratio, 3.5; 95% CI, 3.1-3.9). Collegiate athletes had a higher rate of ankle sprain, knee injury, and shoulder injury. Concussions represented a relatively high percentage of injuries in both populations (5.0% of total NCAA ISS injuries vs 4.8% of total HS RIO injuries, respectively). The data suggest that although similar, there were distinct differences between the injury patterns of the 2 populations. Compared with high school volleyball players, collegiate athletes have a higher rate of acute time loss injury as well as overuse time loss injury (particularly patellar tendinosis). Concussions represented a significant and worrisome component of the injury pattern for both study populations. The injury data suggest that important differences exist in the injury patterns of female high school compared with collegiate volleyball athletes

Telemark skiing injuries: an 11-year study.

Science.gov (United States)

Made, C; Borg, H; Thelander, D; Elmqvist, L G

2001-11-01

This study evaluated telemark injuries in a Swedish ski area in terms of injury ratio, location, and causes over time. During the seasons of 1989-2000 all injured telemark skiers ( n=94) who attended the medical center in Tärnaby, Sweden, within 48 h after the accident were registered and asked to fill in an injury form. A control group of noninjured telemark skiers were interviewed in the season of 1999-2000. The most common cause of injury was fall (70%) and the injury ratio was 1.2. There was a higher proportion of beginners in the injured population, and they had a fall/run ratio of 0.7, compared with 0.3 for average and advanced skiers. Ankle/foot injuries were most common (28% of injuries) followed by knee (20%) and head/neck (17%). The ankle/foot injuries decreased from 35% to 22% in the seasons 1989-1995 to 1995-2000. Beginners had more ankle/foot injuries than skilled participants. The severity of ankle/foot injuries classified as the Abbreviated Injury Scale group 2 or higher decreased from 33% to 21% during the study period. Twenty-seven percent used plastic and 73% leather boots. We found no association between boot material and ankle/foot injuries. The proportion of high boots with two or more buckles was 51%. High boots appeared to be protective against ankle/foot injuries. The proportion of high boots increased from 24% to 67% during the study period. Thus ankle/foot injuries were the most common injury location, but have decreased over time. The severity of these injuries has also decreased. A possible explanation could be the increased use of high boots.

The Effect of Naloxone on Plasma ET-1 and CGRP Levels in Patients with Traumatic Brain Injury

International Nuclear Information System (INIS)

Zhang Chunyin; Guang Ming; Cai Liang; Chen Boxun; Gan Xilun

2009-01-01

To investigate the effect of naloxone on the changes of plasma ET-1 and CGRP levels in patients with traumatic brain injury, ninety patients with traumatic brain injury were randomly divided into naloxone treated group and conventionally treated group (both n=45). The plasma levels of ET-1 and CGRP in both groups before and after treatment and in 30 healthy controls were measured by RIA. The results showed that the plasma levels of ET-1 were significantly increased in the patient before treatment and decreased markedly after treatment in both groups. The magnitude of decrease of the plasma ET-1 levels in the naloxone treated group was significantly higher than that in the conventionally treated group (P<0.01). The plasma levels of CGRP were significantly decreased in the patients before treatment and increased markedly after treatment in both groups. The magnitude of increase of the plasma CGRP levels in the naloxone treated group was significantly higher than that in the conventionally treated group (P<0.01). The plasma ET-1 levels in patients with traumatic brain injury was remarkably increased and markedly decreased after treatment with naloxone. The plasma CGRP levels in patients with traumatic brain injury was remarkably decreased and markedly increased after treatment with naloxone. Naloxone has a favorable effect on patient with traumatic brain injury, it may protect the neural cells and improve their living quality. (authors)

Mountain biking injuries: an update.

Science.gov (United States)

Kronisch, Robert L; Pfeiffer, Ronald P

2002-01-01

This article reviews the available literature regarding injuries in off-road bicyclists. Recent progress in injury research has allowed the description of several patterns of injury in this sport. Mountain biking remains popular, particularly among young males, although sales and participation figures have decreased in the last several years. Competition in downhill racing has increased, while cross-country racing has decreased somewhat in popularity. Recreational riders comprise the largest segment of participants, but little is known about the demographics and injury epidemiology of noncompetitive mountain cyclists. Most mountain bikers participating in surveys reported a history of previous injuries, but prospective studies conducted at mountain bike races have found injury rates of bike racing the risk of injury may be higher for women than men. Minor injuries such as abrasions and contusions occur frequently, but are usually of little consequence. Fractures usually involve the torso or upper extremities, and shoulder injuries are common. Head and face injuries are not always prevented by current helmet designs. Fatal injuries are rare but have been reported. Improvements in safety equipment, rider training and racecourse design are suggested injury prevention measures. The authors encourage continued research in this sport.

Pressure Injury Knowledge in Critical Care Nurses.

Science.gov (United States)

Miller, Donna M; Neelon, Lisa; Kish-Smith, Kathleen; Whitney, Laura; Burant, Christopher J

The purpose of this study was to identify pressure injury knowledge in critical care nurses related to prevention and staging following multimodal education initiatives. Postintervention descriptive study. The sample comprised 32 RNs employed in medical intensive care/coronary intensive care or surgical intensive care units. The study setting was a 237-bed Veterans Affairs acute care hospital in the Midwestern United States. Critical care RNs were asked to participate in this project over a 3-week period following a multimodal 2-year education initiative. Nurses completed the paper version of the 72-item Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) to determine pressure injury knowledge level. Calculated mean cumulative scores and subscores for items related to prevention and staging, respectively. Pearson correlations were used to examine associations between nursing staff characteristics and the PZ-PUKT prevention and staging scores. The cumulative score on the PZ-PUKT was 51.66 (72%); nurses with 5 to 10 years' experience had a higher mean score than nurses with experiences of 20 years or more (mean ± SD = 54.25 ± 4.37 vs 49.5 ± 7.12), but the difference was not statistically significant. Nurses scored higher on the staging system-related items as compared to the prevention-related items (81% vs 70%). Nurses achieved higher staging subscale scores if they were younger (r =-0.41, P < .05), had less experience (r =-0.43, P < .05), and if they worked in the medical intensive care unit (r = 0.37, P < .05). Study findings indicate gaps in knowledge related to pressure injury practice; participants had greater knowledge of staging rather than prevention. Cumulative and subscale findings can be used to direct educational efforts needed to improve and maintain an effective pressure injury prevention program.

Lightning injury: a review.

Science.gov (United States)

Ritenour, Amber E; Morton, Melinda J; McManus, John G; Barillo, David J; Cancio, Leopoldo C

2008-08-01

Lightning is an uncommon but potentially devastating cause of injury in patients presenting to burn centers. These injuries feature unusual symptoms, high mortality, and significant long-term morbidity. This paper will review the epidemiology, physics, clinical presentation, management principles, and prevention of lightning injuries.

Expressed Emotion, Shame, and Non-Suicidal Self-Injury.

Science.gov (United States)

Hack, Jessica; Martin, Graham

2018-04-30

A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male). We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed Emotion (EE) than non-injurers ( t (254) = −3.24, p = 0.001), linear contrasts explaining 6% of between-groups variability ( F (2, 254) = 7.36, p = 0.001, η² = 0.06). Differences in EE between current and past self-injurers were not significant. Overall shame accounted for 33% of between-groups variance ( F (2, 252) = 61.99, p < 0.001, η² = 0.33), with linear contrasts indicating self-injurers experienced higher levels compared to non-injurers ( t (252) = −8.23, p < 0.001). Current self-injurers reported higher overall shame than past self-injurers ( t (252) = 6.78, p < 0.001). In further logistic regression, emotional involvement and overall shame were the only significant predictors of self-injury status. With every one-unit increase in emotional involvement, odds of currently engaging in self-injury decreased by a factor of 0.860. Conversely, a one-unit increase in overall shame was associated with an increase in the odds of being a current self-injurer by a factor of 1.05. The findings have important treatment implications for engaging key family members in intervention and prevention efforts.

Expressed Emotion, Shame, and Non-Suicidal Self-Injury

Directory of Open Access Journals (Sweden)

Jessica Hack

2018-04-01

Full Text Available A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male. We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed Emotion (EE than non-injurers (t(254 = −3.24, p = 0.001, linear contrasts explaining 6% of between-groups variability (F(2, 254 = 7.36, p = 0.001, η2 = 0.06. Differences in EE between current and past self-injurers were not significant. Overall shame accounted for 33% of between-groups variance (F(2, 252 = 61.99, p < 0.001, η2 = 0.33, with linear contrasts indicating self-injurers experienced higher levels compared to non-injurers (t(252 = −8.23, p < 0.001. Current self-injurers reported higher overall shame than past self-injurers (t(252 = 6.78, p < 0.001. In further logistic regression, emotional involvement and overall shame were the only significant predictors of self-injury status. With every one-unit increase in emotional involvement, odds of currently engaging in self-injury decreased by a factor of 0.860. Conversely, a one-unit increase in overall shame was associated with an increase in the odds of being a current self-injurer by a factor of 1.05. The findings have important treatment implications for engaging key family members in intervention and prevention efforts.

Brand preferences of underage drinkers who report alcohol-related fights and injuries.

Science.gov (United States)

Roberts, Sarah P; Siegel, Michael B; DeJong, William; Naimi, Timothy S; Jernigan, David H

2015-04-01

A significant body of research has demonstrated an association between adolescent alcohol consumption and subsequent fights and injuries. To date, however, no research has identified which brands are associated with alcohol-related fights and injuries among underage drinkers. We aimed to: (1) report the prevalence of alcohol-related fights and injuries among a national sample of underage drinkers in the U.S. and (2) describe the relationship between specific alcohol brand consumption and these alcohol-related negative consequences. We recruited 1,031 self-reported drinkers (ages 13-20 years) via an internet panel maintained by Knowledge Networks to complete an online survey. Respondents reported their past-month overall and brand-specific alcohol consumption, risky drinking behavior, and past-year alcohol-related fights and injuries. Over one-quarter of the respondents (26.7%, N = 232) reported at least one alcohol-related fight or injury in the past year. Heavy episodic drinkers were over six times more likely to report one of these negative alcohol-related consequences (AOR: 6.4, 95% CI: 4.1-9.9). Respondents of black race and those from higher-income households were also significantly more likely to report that experience (AOR: 2.2, 95% CI: 1.3-3.7; AOR: 1.8, 95% CI: 1.1-3.0 and 1.1-3.2, respectively). We identified eight alcohol brands that were significantly associated with alcohol-related fights and injuries. CONCLUSIONS/IMPORTANCE: Alcohol-related fights and injuries were frequently reported by adolescent respondents. Eight alcohol brands were significantly more popular among drinkers who experienced these adverse consequences. These results point to the need for further research on brand-specific correlates of underage drinking and negative health outcomes.

A Comparison between Australian Football League (AFL Injuries in Australian Indigenous versus Non-indigenous Players

Directory of Open Access Journals (Sweden)

Jessica Orchard

2013-09-01

Full Text Available It has previously been shown that being of aboriginal descent is a risk factor for hamstring injuries in Australian football. The aim of this study was to review the Australian Football League (AFL injury database to determine whether there were any injuries where indigenous players had different relative risks to non-indigenous players. Analysis was conducted using data from the AFL injury database, which included data from 4,492 players over 21 years (1992–2012, covering 162,683 player-matches at AFL level, 91,098 matches at lower levels and 328,181 weeks (possible matches of exposure. Compared to non-indigenous players, indigenous players had a significantly higher risk of hamstring injuries (RR 1.52, 95% CI 1.32–1.73 and calf strains (RR 1.30, 95% CI 1.00–1.69. Conversely, indigenous players had a significantly lower risk of lumbar/thoracic spine injuries (RR 0.61, 95% CI 0.41–0.91, groin strains/osteitis pubis (RR 0.75, 95% CI 0.58–0.96 and Achilles tendon injuries (RR 0.32, 95% CI 0.12–0.86. The results for the above injuries were also significant in terms of games missed. There was no difference between overall risk of injury (RR 1.03, 95% CI 0.96–1.10 or missed games (RR 1.00, 95% CI 0.97–1.04. This suggests that indigenous AFL players have the same overall number of injuries and missed games, but a slightly different injury profile.

Boxing-related head injuries.

Science.gov (United States)

Jayarao, Mayur; Chin, Lawrence S; Cantu, Robert C

2010-10-01

Fatalities in boxing are most often due to traumatic brain injury that occurs in the ring. In the past 30 years, significant improvements in ringside and medical equipment, safety, and regulations have resulted in a dramatic reduction in the fatality rate. Nonetheless, the rate of boxing-related head injuries, particularly concussions, remains unknown, due in large part to its variability in clinical presentation. Furthermore, the significance of repeat concussions sustained when boxing is just now being understood. In this article, we identify the clinical manifestations, pathophysiology, and management of boxing-related head injuries, and discuss preventive strategies to reduce head injuries sustained by boxers.

High incidence of injury at the Sochi 2014 Winter Paralympic Games: a prospective cohort study of 6564 athlete days.

Science.gov (United States)

Derman, W; Schwellnus, M P; Jordaan, E; Runciman, P; Van de Vliet, P; Blauwet, C; Webborn, N; Willick, S; Stomphorst, J

2016-09-01

To describe the epidemiology of injuries at the Sochi 2014 Winter Paralympic Games. A total of 547 athletes from 45 countries were monitored daily for 12 days during the Sochi 2014 Winter Paralympic Games (6564 athlete days). Daily injury data were obtained from teams with their own medical support (32 teams, 510 athletes) and teams without their own medical support (13 teams, 37 athletes) through electronic data capturing systems. There were 174 total injuries reported, with an injury incidence rate (IR) of 26.5 per 1000 athlete days (95% CI 22.7% to 30.8%). There was a significantly higher IR recorded in alpine skiing/snowboarding (IR of 41.1 (95% CI 33.7% to 49.6%) p=0.0001) compared to cross-country skiing/biathlon, ice sledge hockey or wheelchair curling. Injuries in the shoulder region were the highest single-joint IR (IR of 6.4 (95% CI 4.6% to 8.6%)), although total upper and lower body IR were similar (IR 8.5 vs 8.4 (95% CI 6.4% to 11.1%)). Furthermore, the IR of acute injuries was significantly higher than other types of injury onset (IR of 17.8 (95% CI 14.7% to 21.4%)). In a Winter Paralympic Games setting, athletes report higher injury incidence than do Olympic athletes or athletes in a Summer Paralympic Games setting. The highest incidence of injury was reported in the alpine skiing/snowboarding sporting category. There was a similar incidence of injury in the upper and lower limbs. The joint with the greatest rate of injury reported was the shoulder joint. Our data can inform injury prevention programmes and policy considerations regarding athlete safety in future Winter Paralympic Games. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Post-traumatic acute kidney injury: a cross-sectional study of trauma patients.

Science.gov (United States)

Lai, Wei-Hung; Rau, Cheng-Shyuan; Wu, Shao-Chun; Chen, Yi-Chun; Kuo, Pao-Jen; Hsu, Shiun-Yuan; Hsieh, Ching-Hua; Hsieh, Hsiao-Yun

2016-11-22

The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System. Patients with direct renal trauma were excluded from this study. Two-sided Fisher's exact or Pearson's chi-square tests were used to compare categorical data, unpaired Student's t-test was used to analyze normally distributed continuous data, and Mann-Whitney's U test was used to compare non-normally distributed data. Propensity score matching with a 1:1 ratio with logistic regression was used to evaluate the effect of shock on AKI. Patients with AKI presented with significantly older age, higher incidence rates of pre-existing comorbidities, higher odds of associated injures (subdural hematoma, intracerebral hematoma, intra-abdominal injury, and hepatic injury), and higher injury severity than patients without AKI. In addition, patients with AKI had a longer hospital stay (18.3 days vs. 9.8 days, respectively; P < 0.001) and intensive care unit (ICU) stay (18.8 days vs. 8.6 days, respectively; P < 0. 001), higher proportion of admission into the ICU (57.7% vs. 19.0%, respectively; P < 0.001), and a higher odds ratio (OR) of short-term mortality (OR 39.0; 95% confidence interval, 24.59-61.82; P < 0.001). However, logistic regression analysis of well-matched pairs after propensity score matching did not show a significant influence of shock on the occurrence of AKI. We believe that early and aggressive resuscitation, to avoid prolonged untreated shock, may help to prevent the occurrence

A cross-sectional study of elite adult Irish dancers: biopsychosocial traits, pain, and injury.

Science.gov (United States)

Cahalan, Roisin; Purtill, Helen; O'Sullivan, Peter; O'Sullivan, Kieran

2015-03-01

Despite its growing popularity, scant research exists concerning musculoskeletal pain and injury in Irish dancing (ID). This study aimed to record the biopsychosocial characteristics of elite adult Irish dancers and to investigate potential relationships between these characteristics and musculoskeletal pain and injury. One hundred and four professional Irish dancers, elite competitive Irish dancers, and dancers in full time education studying ID completed a questionnaire providing data on dance and activity levels, physical and psychological health, and pain and injury history. Of these subjects, 84 underwent 1. a physical screening of lower limb flexibility, which involved balance and endurance; 2. a number of functional tests; and 3. anthropometric, biomechanical, and anatomical assessments. Subjects were divided into "significantly injured (SI)" and "not significantly injured (NSI)" categories based on the severity and impact of self-reported pain and injury. Thirty-three (31.7%) subjects were classified as SI and 71 (68.3%) as NSI. The factors significantly associated with being SI were female sex (p = 0.036), higher number of subjective general health (p = 0.001) and psychological (p = 0.036) complaints, low mood (p = 0.01), heightened catastrophizing (p = 0.047), and failure always to complete a warm-up (p = 0.006). A self-reported injury rate of 76.9% over the previous 5 years was reported. The mean number of injuries sustained to all body parts over the previous 5 years was 1.49, with a mean of 126.1 days lost annually to injury. Foot and ankle injuries were most prevalent. It was concluded that there is a significant level of musculoskeletal pain and injury in elite adult ID. A complex combination of biopsychosocial factors appears to be associated with pain and injury.

Running injuries - changing trends and demographics.

Science.gov (United States)

Fields, Karl B

2011-01-01

Running injuries are common. Recently the demographic has changed, in that most runners in road races are older and injuries now include those more common in master runners. In particular, Achilles/calf injuries, iliotibial band injury, meniscus injury, and muscle injuries to the hamstrings and quadriceps represent higher percentages of the overall injury mix in recent epidemiologic studies compared with earlier ones. Evidence suggests that running mileage and previous injury are important predictors of running injury. Evidence-based research now helps guide the treatment of iliotibial band, patellofemoral syndrome, and Achilles tendinopathy. The use of topical nitroglycerin in tendinopathy and orthotics for the treatment of patellofemoral syndrome has moderate to strong evidence. Thus, more current knowledge about the changing demographics of runners and the application of research to guide treatment and, eventually, prevent running injury offers hope that clinicians can help reduce the high morbidity associated with long-distance running.

Interactive eBooks in educating patients and their families about head injury regardless of age.

Science.gov (United States)

Sahyouni, Ronald; Mahmoodi, Amin; Mahmoodi, Amir; Huang, Melissa; Tran, Diem Kieu; Chen, Jefferson W

2017-05-01

Traumatic Brain Injury (TBI) is a common and debilitating injury that is particularly prevalent in patients over 60. Given the influence of head injury on dementia (and vice versa), and the increased likelihood of ground-level falls, elderly patients are vulnerable to TBI. Educational interventions can increase knowledge and influence preventative activity to decrease the likelihood of further TBI. We sought to determine the efficacy of interactive tablet-based educational interventions in elderly patients on self-reported knowledge. Patients and family members, ages 20-90, presenting to a NeuroTrauma clinic completed a pre-survey to assess baseline TBI or concussion knowledge, depending on their diagnosis. Participants then received an interactive electronic book (eBook), or a text-based pamphlet with identical information, and completed a post-survey to test interim knowledge improvement. All participants (n=180), regardless of age, had significantly higher post-survey scores (peBook (n=39) scored lower than their younger counterparts despite higher pre-survey scores (peBook (n=20, 90) significantly improved on the post-survey (peBook (p<0.01, 95% CI). We demonstrated that interactive educational interventions are effective in the elderly TBI population. Enhanced educational awareness in the elderly population, especially patients at risk or with prior TBI, may prevent further head injury by educating patients on the importance of avoiding further head injury and taking precautionary measures to decrease the likelihood of further injury. Copyright © 2017 Elsevier B.V. All rights reserved.

Abdominal trauma in infants and children: prompt identification and early management of serious and life-threatening injuries. Part II: Specific injuries and ED management.

Science.gov (United States)

Rothrock, S G; Green, S M; Morgan, R

2000-06-01

Evaluation of children with suspected abdominal trauma could be a difficult task. Unique anatomic and physiologic features render vital sign assessment and the physical examination less useful than in the adult population. Awareness of injury patterns and associations will improve the early diagnosis of abdominal trauma. Clinicians must have a complete understanding of common and atypical presentations of children with significant abdominal injuries. Knowledge of the utility and limitations of available laboratory and radiologic adjuncts will assist in accurately identifying abdominal injury. While other obvious injuries (eg, facial, cranial, and extremity trauma) can distract physicians from less obvious abdominal trauma, an algorithmic approach to evaluating and managing children with multisystem trauma will improve overall care and help to identify and treat abdominal injuries in a timely fashion. Finally, physicians must be aware of the capabilities of their own facility to handle pediatric trauma. Protocols must be in place for expediting the transfer of children who require a higher level of care. Knowledge of each of these areas will help to improve the overall care and outcome of children with abdominal trauma.

Miners' return to work following injuries in coal mines.

Science.gov (United States)

Bhattacherjee, Ashis; Kunar, Bijay Mihir

2016-12-22

The occupational injuries in mines are common and result in severe socio-economical consequences. Earlier studies have revealed the role of multiple factors such as demographic factors, behavioral factors, health-related factors, working environment, and working conditions for mine injuries. However, there is a dearth of information about the role of some of these factors in delayed return to work (RTW) following a miner's injury. These factors may likely include personal characteristics of injured persons and his or her family, the injured person's social and economic status, and job characteristics. This study was conducted to assess the role of some of these factors for the return to work following coal miners' injuries. A study was conducted for 109 injured workers from an underground coal mine in the years 2000-2009. A questionnaire, which was completed by the personnel interviews, included among others age, height, weight, seniority, alcohol consumption, sleeping duration, presence of diseases, job stress, job satisfaction, and injury type. The data was analyzed using the Kaplan-Meier estimates and the Cox proportional hazard model. According to Kaplan-Meier estimate it was revealed that a lower number of dependents, longer sleep duration, no job stress, no disease, no alcohol addiction, and higher monthly income have a great impact on early return to work after injury. The Cox regression analysis revealed that the significant risk factors which influenced miners' return to work included presence of disease, job satisfaction and injury type. The mine management should pay attention to significant risk factors for injuries in order to develop effective preventive measures. Med Pr 2016;67(6):729-742. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Life expectancy in elderly patients following burns injury.

Science.gov (United States)

Sepehripour, Sarvnaz; Duggineni, Sirisha; Shahsavari, Somaya; Dheansa, Baljit

2018-05-18

Burn injuries commonly occur in vulnerable age and social groups. Previous research has shown that frailty may represent a more important marker of adverse outcome in healthcare rather than chronological age (Roberts et al., 2012). In this paper we determined the relationship between burn injury, frailty, co-morbidities and long-term survival. Retrospective data collection from patients aged 75 with burns injuries, treated and discharged at Queen Victoria Hospital. The Clinical Frailty Scale (Rockwood et al., 2005) was used to calculate frailty at the time of admission. The expected mortality age (life expectancy) of deceased patients was obtained from two survival predictors. The data shows a statistically significant correlation between frailty score and complications and a statistically significant correlation between total body surface area percentage and complications. No significant difference was found between expected and observed age of death or life expectancy amongst the deceased (p value of 0.109). Based on the data from our unit, sustaining a burn as an elderly person does not reduce life expectancy. Medical and surgical complications, immediate, early and late, although higher with greater frailty and TBSA of burn, but do not adversely affect survival in this population. Copyright © 2018 Elsevier Ltd. All rights reserved.

Examining the Prevalence and Predictors of Injury from Adolescent Dating Violence

Science.gov (United States)

Tharp, Andra Teten; Reyes, H. Luz McNaughton; Foshee, Vangie; Swahn, Monica H.; Hall, Jeffrey E.; Logan, Joseph

2018-01-01

Medical needs of youth who experience dating violence are not well understood because of limited past research examining the prevalence and predictors of injuries and medical help seeking. To address these gaps, the current study described the prevalence and predictors of injuries from dating violence from grades 8 through 12 in a large sample of youth. Results indicate that one third to one half of youth who experienced any physical and/or sexual dating violence also sustained an injury. Prevalence of injury was highest in the 8th grade and was significantly higher for females than for males across grades 8 through 11. Youth who experienced greater amounts of violent victimization in their relationships (physical, sexual, and psychological) were at highest risk for injury. Results also suggest that victims at highest risk for injury are girls, white youth, those experiencing multiple types of violence, and those who also engage in perpetration. Given the high prevalence of injury among youth who report dating violence, healthcare professionals may be in a unique position to screen and counsel youth about dating violence. Because the highest prevalence of injury occurred before high school, prevention programs should start early and selected prevention may be used for youth at highest risk for injury. PMID:29593374

Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

Directory of Open Access Journals (Sweden)

Sungmin Lee

2017-02-01

Full Text Available Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS. Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA were analyzed at the census tract level (n = 264. Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.

Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers.

Science.gov (United States)

Lee, Sungmin; Lee, Chanam; Rodiek, Susan

2017-02-08

Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.

Post-Traumatic Hypoxia Is Associated with Prolonged Cerebral Cytokine Production, Higher Serum Biomarker Levels, and Poor Outcome in Patients with Severe Traumatic Brain Injury

Science.gov (United States)

Yan, Edwin B.; Satgunaseelan, Laveniya; Paul, Eldho; Bye, Nicole; Nguyen, Phuong; Agyapomaa, Doreen; Kossmann, Thomas; Rosenfeld, Jeffrey V.

2014-01-01

Abstract Secondary hypoxia is a known contributor to adverse outcomes in patients with traumatic brain injury (TBI). Based on the evidence that hypoxia and TBI in isolation induce neuroinflammation, we investigated whether TBI combined with hypoxia enhances cerebral cytokine production. We also explored whether increased concentrations of injury biomarkers discriminate between hypoxic (Hx) and normoxic (Nx) patients, correlate to worse outcome, and depend on blood–brain barrier (BBB) dysfunction. Forty-two TBI patients with Glasgow Coma Scale ≤8 were recruited. Cerebrospinal fluid (CSF) and serum were collected over 6 days. Patients were divided into Hx (n=22) and Nx (n=20) groups. Eight cytokines were measured in the CSF; albumin, S100, myelin basic protein (MBP) and neuronal specific enolase (NSE) were quantified in serum. CSF/serum albumin quotient was calculated for BBB function. Glasgow Outcome Scale Extended (GOSE) was assessed at 6 months post-TBI. Production of granulocye macrophage-colony stimulating factor (GM-CSF) was higher, and profiles of GM-CSF, interferon (IFN)-γ and, to a lesser extent, tumor necrosis factor (TNF), were prolonged in the CSF of Hx but not Nx patients at 4–5 days post-TBI. Interleukin (IL)-2, IL-4, IL-6, and IL-10 increased similarly in both Hx and Nx groups. S100, MBP, and NSE were significantly higher in Hx patients with unfavorable outcome. Among these three biomarkers, S100 showed the strongest correlations to GOSE after TBI-Hx. Elevated CSF/serum albumin quotients lasted for 5 days post-TBI and displayed similar profiles in Hx and Nx patients. We demonstrate for the first time that post-TBI hypoxia is associated with prolonged neuroinflammation, amplified extravasation of biomarkers, and poor outcome. S100 and MBP could be implemented to track the occurrence of post-TBI hypoxia, and prompt adequate treatment. PMID:24279428

Analysis of injuries in long-distance triathletes.

Science.gov (United States)

Egermann, M; Brocai, D; Lill, C A; Schmitt, H

2003-05-01

Triathlon is an individual sport consisting of three disciplines - swimming, cycling and running. Triathlon has changed from a novel appearance to a very popular Olympic sport within the last fifteen years. Nevertheless, there is not sufficient data about injuries in triathlon. The aim of this retrospective survey was to investigate the incidence of injuries according to class of injuries, anatomical sites and disciplines. Relations to age, sex, performance level, training habits and medical care were analysed. Questionnaires were sent to all German speaking participants of the Ironman Europe 2000. With a response rate of 35 %, 656 questionnaires met the inclusion criteria. At least one injury was experienced by 74.8 % (95 %-CI: 71.3-78.1) of all respondents during their active time in triathlon. 51.1 % (95 %-CI: 47.2-55.0) suffered one or more contusion/skin-abrasions, 33.1 % (95 %-CI: 29.5-36.8) muscle-/tendon-injuries, 29.0 % (95 %-CI: 25.5-32.6) ligament-/capsule-injuries and 11.9 % (95 %-CI: 9.5-14.6) fractures. Most of the injuries happened during cycling (54.8 % [95 %-CI: 51.9-57.8]) within training sessions. 18.7 % (95 %-CI: 16.4-21.2) of all injuries occurred while the athletes were competing. Considering the low number of competition hours per year, the incidence of injuries during competition was higher than during training session. Significant relations were found considering the age, performance level and weekly training hours of the triathletes. Older athletes sustained more fractures (p = 0.024), high performance athletes suffered more contusions/abrasions (p = 0.003) and muscle-tendon-injuries (p = 0.001) and athletes with a large number of weekly training hours suffered more muscle-tendon-injuries (p = 0.014). To summarize, injuries in triathlon seem to be related to age, performance level and weekly training hours, but not to sex, presence of training coach and medical care.

A Comparison of Women’s Collegiate and Girls’ High School Volleyball Injury Data Collected Prospectively Over a 4-Year Period

Science.gov (United States)

Reeser, Jonathan C.; Gregory, Andrew; Berg, Richard L.; Comstock, R. Dawn

2015-01-01

Background: There is a relative paucity of research examining the sport-specific injury epidemiology of high school and collegiate volleyball athletes. Moreover, differences in study methodology frequently limit our ability to compare and contrast injury data collected from selected populations. Hypothesis: There are differences between the injury patterns characteristic of high school and collegiate female volleyball athletes. Study Design: Retrospective clinical review. Level of Evidence: Level 3. Methods: We statistically analyzed injury incidence and outcome data collected over a 4-year interval (2005-2006 to 2008-2009) by 2 similar injury surveillance systems, the National Collegiate Athletic Association’s Injury Surveillance System (NCAA ISS) and the High School Reporting Injuries Online (HS RIO). We compared diagnoses, anatomic distribution of injuries, mechanisms of injury, and time lost from training or competition between high school and collegiate volleyball athletes. Results: The overall volleyball-related injury rate was significantly greater among collegiate athletes than among high school athletes during both competition (injury rate ratio, 2.9; 95% CI, 2.5-3.4) and practice (injury rate ratio, 3.5; 95% CI, 3.1-3.9). Collegiate athletes had a higher rate of ankle sprain, knee injury, and shoulder injury. Concussions represented a relatively high percentage of injuries in both populations (5.0% of total NCAA ISS injuries vs 4.8% of total HS RIO injuries, respectively). Conclusion: The data suggest that although similar, there were distinct differences between the injury patterns of the 2 populations. Compared with high school volleyball players, collegiate athletes have a higher rate of acute time loss injury as well as overuse time loss injury (particularly patellar tendinosis). Concussions represented a significant and worrisome component of the injury pattern for both study populations. Clinical Relevance: The injury data suggest that important

Clinical analysis of firework-related ocular injuries during Spring Festival 2009.

Science.gov (United States)

Jing, Yuan; Yi-qiao, Xing; Yan-ning, Yang; Ming, Ai; An-huai, Yang; Lian-hong, Zhou

2010-03-01

To document the clinical features, management and visual outcome of fireworks-related ocular injuries during the Spring Festival. A retrospective analysis of all patients with fireworks-related ocular injuries attending the Department of Ophthalmology in Renmin Hospital of Wuhan University from January 20 to February 10, 2009. Age, gender, laterality, type of fireworks, location of incident, initial best-corrected visual acuity (BCVA), diagnosis, management, and final BCVA at last follow-up were documented. Relevant clinical features and visual outcome were evaluated. We observed 25 eyes in 24 patients. Injuries were more frequent in children (ten, 41.7%), males (19, 79.2%), and as open globe injury (15, 62.5%). The most common pyrotechnical products causing accidents were firecrackers (12, 50%). Rural residents had significantly higher rates of injury compared to urban residents (P = 0.023). Of 25 eyes, the most common injuries were corneal/scleral/corneoscleral open globe trauma (15, 60%), traumatic cataract (14, 56%), vitreous hemorrhage (seven, 28%) and retinal detachment (seven, 28%). Most eyes (23, 92%) received surgical intervention, including one (4%) eye enucleation. Vitrectomy was the most surgical treatment. After management, visual outcomes showed statistically significant improvement (P = 0.008). Initial BCVA correlated strongly with final BCVA (P = 0.010). Fireworks-related ocular injuries occur mainly in children, males and rural settings, are frequently severe and visually devastating. Therefore, preventive measures should be strengthened, including public education and legal restriction on the sale and use of fireworks.

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

Nonfatal Injuries to Law Enforcement Officers: A Rise in Assaults.

Science.gov (United States)

Tiesman, Hope M; Gwilliam, Melody; Konda, Srinivas; Rojek, Jeff; Marsh, Suzanne

2018-04-01

Limited studies exist that describe nonfatal work-related injuries to law enforcement officers. The aim of this study is to provide national estimates and trends of nonfatal injuries to law enforcement officers from 2003 through 2014. Nonfatal injuries were obtained from the National Electronic Injury Surveillance System-Occupational Supplement. Data were obtained for injuries treated in U.S. emergency departments from 2003 to 2014. Nonfatal injury rates were calculated using denominators from the Current Population Survey. Negative binomial regression was used to analyze temporal trends. Data were analyzed in 2016-2017. Between 2003 and 2014, an estimated 669,100 law enforcement officers were treated in U.S. emergency departments for nonfatal injuries. The overall rate of 635 per 10,000 full-time equivalents was three times higher than all other U.S. workers rate (213 per 10,000 full-time equivalents). The three leading injury events were assaults and violent acts (35%), bodily reactions and exertion (15%), and transportation incidents (14%). Injury rates were highest for the youngest officers, aged 21-24 years. Male and female law enforcement officers had similar nonfatal injury rates. Rates for most injuries remained stable; however, rates for assault-related injuries grew among law enforcement officers between 2003 and 2011. National Electronic Injury Surveillance System-Occupational Supplement data demonstrate a significant upward trend in assault injuries among U.S. law enforcement officers and this warrants further investigation. Police-citizen interactions are dynamic social encounters and evidence-based policing is vital to the health and safety of both police and civilians. The law enforcement community should energize efforts toward the study of how policing tactics impact both officer and citizen injuries. Published by Elsevier Inc.

The Clinical Significance of the MIF Homolog D-Dopachrome Tautomerase (MIF-2) and its Circulating Receptor (sCD74) in Burn Injury

Science.gov (United States)

Kim, Bong-Sung; Stoppe, Christian; Grieb, Gerrit; Leng, Lin; Sauler, Maor; Assis, David; Simons, David; Boecker, Arne Hendrick; Schulte, Wibke; Piecychna, Marta; Hager, Stephan; Bernhagen, Jürgen; Pallua, Norbert; Bucala, Richard

2016-01-01

Background We reported earlier that the cytokine macrophage migration inhibitory factor (MIF) is a potential biomarker in burn injury. In the present study, we investigated the clinical significance in severely burned patients of expression levels the newly discovered MIF family member D-dopachrome tautomerase (DDT or MIF-2) and their common soluble receptor CD74 (sCD74). Methods DDT and sCD74 serum levels were measured 20 severely burned patients and 20 controls. Serum levels were correlated to the abbreviated burn severity index (ABSI) and TBSA followed by receiver operating characteristic (ROC) analysis. Data were supported by gene expression dataset analysis of 31 burn patients and 28 healthy controls. Results CD74 and DDT were increased in burn patients. Furthermore, CD74 and DDT also were elevated in septic non-survivors when compared to survivors. Serum levels of DDT showed a positive correlation with the ABSI and TBSA in the early stage after burn injury, and the predictive character of DDT was strongest at 24 hrs. Serum levels of CD74 only correlated with the ABSI five days post-injury. Conclusions DDT may assist in the monitoring of clinical outcome and prediction of sepsis during the early post-burn period. sCD74 and MIF, by contrast, have limited value as an early predictor of death due to their delayed response to burn injury. PMID:27209369

Patterns in deer-related traffic injuries over a decade: the Mayo clinic experience

Directory of Open Access Journals (Sweden)

Smoot Dustin L

2010-08-01

Full Text Available Abstract Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC. We characterized injury patterns between motorcycle/all-terrain vehicles (MCC and automobile (MVC crashes related to dMVC (deer motor vehicle crash with the hypotheses that MCC will present with higher Injury Severity Score (ISS and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS. Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5 and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained.

Characteristics and contributing factors related to sports injuries in young volleyball players

Science.gov (United States)

2013-01-01

Background The participation of young in volleyball is becoming increasingly common, and this increased involvement raises concerns about the risk of installation of sports injuries. Therefore, the objectives the study were identify the characteristics of sports injuries in young volleyball players and associate anthropometric and training variables with contributing factors for injuries. Methods A total of 522 volleyball players participating in the High School Olympic Games of the State of São Paulo (Brazil) were interviewed. A reported condition inquiry was used to gather information on injuries, such as anatomic site affected, mechanism and moment of injury, as well as personal and training data. The level of significance was set at 5%. Results A 19% frequency of injuries was found. Higher age, weight, height, body mass index and training duration values were associated with the occurrence of injuries. The most affected anatomic site was the ankle/foot complex (45 injuries, 36.3%). Direct contact and contactless mechanisms were the main causes of injuries (61 injuries; 49.2% and 48 injuries; 38.7%, respectively). Training was the moment in which most injuries occurred (93 injuries; 75%), independently of personal and training characteristics. Conclusion Injuries affected the ankle/foot complex with a greater frequency. Direct contact and contactless mechanisms were the most frequently reported and injuries occurred mainly during training sessions. Personal and training characteristics were contributing factors for the occurrence of injuries. PMID:24124803

Playground slide-related injuries in preschool children: increased risk of lower extremity injuries when riding on laps.

Science.gov (United States)

Jennissen, Charles A; Koos, Maggie; Denning, Gerene

2018-04-10

The purpose of this study was to better understand the factors associated with playground slide-related injuries in preschool children and to test the hypothesis that riding on laps increases the likelihood of lower extremity injuries. Playground slide-related injuries (product code 1242) in children ≤5 years of age treated in emergency departments from 2002 to 2015 were identified (N = 12,686) using the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS). Descriptive and comparative analyses, including chi-square testing and binary logistic regression, were performed. Based on NEISS stratified national sampling estimates, over 350,000 children ≤5 years of age were injured on slides from 2002 to 2015. Overall, 59% of the children were male, and 65% were white. Almost 60% of injuries occurred in parks or other public areas. The most frequent diagnosis was a fracture (36%); lacerations were 19% of the injuries. A higher proportion of musculoskeletal injuries were seen in toddlers < 3 years old as compared to those 3-5 years of age (p < 0.001). Injuries to the lower extremities increased in frequency as age decreased, whereas injuries to the upper extremities and head/neck/face were more common in older preschoolers. Children < 3 years of age were 12 times more likely to be identified from narratives as being on another person's lap at the time of injury. Children identified as being on a lap had an increased odds of injury to the lower extremity than to other body parts (OR 43.0, 95% confidence interval (CI) 32.0-58.0), and of lower leg/ankle fracture than fractures elsewhere (OR 49.5, 95% CI 31.7-77.4). Decreasing age was associated with a higher likelihood of being identified as sliding down on another person's lap and a higher likelihood of lower extremity injuries. Healthcare providers should be mindful of the potential for these slide-related injuries as they can result in a toddler's fracture of

Effects of age and insulin-like growth factor-1 on rat neurotrophin receptor expression after nerve injury.

Science.gov (United States)

Luo, T David; Alton, Timothy B; Apel, Peter J; Cai, Jiaozhong; Barnwell, Jonathan C; Sonntag, William E; Smith, Thomas L; Li, Zhongyu

2016-10-01

Neurotrophin receptors, such as p75(NTR) , direct neuronal response to injury. Insulin-like growth factor-1 receptor (IGF-1R) mediates the increase in p75(NTR) during aging. The aim of this study was to examine the effect of aging and insulin-like growth factor-1 (IGF-1) treatment on recovery after peripheral nerve injury. Young and aged rats underwent tibial nerve transection with either local saline or IGF-1 treatment. Neurotrophin receptor mRNA and protein expression were quantified. Aged rats expressed elevated baseline IGF-1R (34% higher, P = 0.01) and p75(NTR) (68% higher, P < 0.01) compared with young rats. Post-injury, aged animals expressed significantly higher p75(NTR) levels (68.5% above baseline at 4 weeks). IGF-1 treatment suppressed p75(NTR) gene expression at 4 weeks (17.2% above baseline, P = 0.002) post-injury. Local IGF-1 treatment reverses age-related declines in recovery after peripheral nerve injuries by suppressing p75(NTR) upregulation and pro-apoptotic complexes. IGF-1 may be considered a viable adjuvant therapy to current treatment modalities. Muscle Nerve 54: 769-775, 2016. © 2016 Wiley Periodicals, Inc.

EPIDEMIOLOGY OF KNEE INJURIES AMONG US HIGH SCHOOL ATHLETES, 2005/06–2010/11

Science.gov (United States)

Swenson, David M.; Collins, Christy L.; Best, Thomas M.; Flanigan, David C.; Fields, Sarah K.; Comstock, R. Dawn

2012-01-01

Purpose US high school athletes sustain millions of injuries annually. Detailed patterns of knee injuries, among the most costly sports injuries, remain largely unknown. We hypothesize that patterns of knee injuries in US high school sports differ by sport and gender. Methods US High school sports-related injury data were collected for 20 sports using the National High School Sports-Related Injury Surveillance System, High School RIO™. Knee injury rates, rate ratios, and injury proportion ratios were calculated. Results From 2005/06–2010/11, 5,116 knee injuries occurred during 17,172,376 athlete exposures (AEs) for an overall rate of 2.98 knee injuries per 10,000 AEs. Knee injuries were more common in competition than practice (RR 3.53, 95% CI 3.34–3.73). Football had the highest knee injury rate (6.29 per 10,000 AEs) followed by girls’ soccer (4.53) and girls’ gymnastics (4.23). Girls had significantly higher knee injury rates than boys in gender-comparable sports (soccer, volleyball, basketball, baseball/softball, lacrosse, swimming and diving, and track and field) (RR 1.52, 95% CI 1.39–1.65). The most commonly involved structure was the MCL (reported in 36.1% of knee injuries), followed by the patella/patellar tendon (29.5%), ACL (25.4%), meniscus (23.0%), LCL (7.9%), and PCL (2.4%). Girls were significantly more likely to sustain ACL injuries in gender-comparable sports (RR 2.38, 95% CI 1.91–2.95). Overall, 21.2% of knee injuries were treated with surgery; girls were more often treated with surgery than boys in gender-comparable sports (IPR 1.30, 95% CI 1.11–1.53). Conclusions Knee injury patterns differ by sport and gender. Continuing efforts to develop preventive interventions could reduce the burden of these injuries. PMID:23059869

Isolated traumatic brain injury and venous thromboembolism.

Science.gov (United States)

Van Gent, Jan-Michael; Bandle, Jesse; Calvo, Richard Y; Zander, Ashley L; Olson, Erik J; Shackford, Steven R; Peck, Kimberly A; Sise, C Beth; Sise, Michael J

2014-08-01

Traumatic brain injury (TBI) is considered an independent risk factor of venous thromboembolism (VTE). However, the role of TBI severity in VTE risk has not been determined. We hypothesized that increased severity of brain injury in patients with isolated TBI (iTBI) is associated with an increased incidence of VTE. The records of patients admitted from June 2006 to December 2011 were reviewed for injury data, VTE risk factors, results of lower extremity surveillance ultrasound, and severity of TBI. Patients were identified by DRG International Classification of Diseases-9th Rev. codes for TBI, and only those with a nonhead Abbreviated Injury Scale (AIS) score of 1 or lower, indicating minimal associated injury, were included. The association of iTBI and VTE was determined using a case-control design. Among iTBI patients, those diagnosed with VTE (cases) were matched for age, sex, and admission year to those without VTE (controls). Data were analyzed using conditional logistic regression. There were 345 iTBI patients: 41 cases (12%) and 304 controls (88%). A total of 151 controls could not be matched to an appropriate case and were excluded. Of the remaining 153 controls, 1 to 16 controls were matched to each of the 41 VTE cases. Compared with the controls, the cases had a higher mean head-AIS score (4.4 vs. 3.9, p = 0.001) and overall Injury Severity Score (20.4 vs. 16.8, p = 0.001). Following adjustment for all factors found to be associated with VTE (ventilator days, central line placement, operative time > 2 hours, chemoprophylaxis, history of VTE, and history of cancer), the cases were significantly more likely to have a greater head injury severity (head-AIS score ≥ 5; odds ratio, 5.25; 95% confidence interval, 1.59-17.30; p = 0.006). The incidence of VTE in iTBI patients was significantly associated with the severity of TBI. VTE surveillance protocols may be warranted in these high-risk patients, as early detection of VTE could guide subsequent therapy

Self-injury and externalizing pathology: a systematic literature review.

Science.gov (United States)

Meszaros, Gergely; Horvath, Lili Olga; Balazs, Judit

2017-05-03

During the last decade there is a growing scientific interest in nonsuicidal self-injury (NSSI). The aim of the current paper was to review systematically the literature with a special focus on the associations between self-injurious behaviours and externalizing psychopathology. An additional aim was to review terminology and measurements of self-injurious behaviour and the connection between self-injurious behaviours and suicide in the included publications. A systematic literature search was conducted on 31st December 2016 in five databases (PubMed, OVID Medline, OVID PsycINFO, Scopus, Web of Science) with two categories of search terms (1. nonsuicidal self-injury, non-suicidal self-injury, NSSI, self-injurious behaviour, SIB, deliberate self-harm, DSH, self-injury; 2. externalizing disorder, attention deficit hyperactivity disorder, ADHD, conduct disorder, CD, oppositional defiant disorder, OD, ODD). Finally 35 papers were included. Eleven different terms were found for describing self-injurious behaviours and 20 methods for measuring it. NSSI has the clearest definition. All the examined externalizing psychopathologies had strong associations with self-injurious behaviours according to: higher prevalence rates in externalizing groups than in control groups, higher externalizing scores on the externalizing scales of questionnaires, higher symptom severity in self-injurious groups. Eight studies investigated the relationship between suicide and self-injurious behaviours and found high overlap between the two phenomena and similar risk factors. Based on the current findings the association between externalizing psychopathology and self-injurious behaviours has been proven by the scientific literature. Similarly to other reviews on self-injurious behaviours the confusion in terminology and methodology was noticed. NSSI is suggested for use as a distinct term. Further studies should investigate the role of comorbid conditions in NSSI, especially when internalizing

Mechanisms of ACL injury in professional rugby union: a systematic video analysis of 36 cases.

Science.gov (United States)

Montgomery, Connor; Blackburn, Jeff; Withers, Daniel; Tierney, Gregory; Moran, Cathal; Simms, Ciaran

2016-12-30

The mechanisms of ACL injury in rugby are not well defined. To describe the mechanisms of ACL injury in male professional rugby players using systematic video analysis. 36 cases from games played in top professional leagues and international matches were analysed. 5 analysts independently assessed all videos to record the estimated frame/time of initial ground contact, frame/time of ACL tear and a range of play specific variables. This included contact versus non-contact ACL injuries, injury timing, joint flexion angles and foot contact with the ground. 37 side-stepping manoeuvres from a control game were analysed to allow comparison of non-injury versus injury situations. 57% of ACL injuries occurred in a contact manner. 2 main scenarios were identified: (1) offensive running and (2) being tackled, indicating that the ball carrier might be at higher risk of ACL injury. The majority of non-contact ACL injuries resulted from a side-stepping manoeuvre. In most non-contact cases, initial ground contact was through heel strike. Statistical assessment of heel strike at initial ground contact versus non-heel strike cases showed a significant difference in injury versus non-injury outcomes, with heel strike associated with higher injury risk. Non-contact ACL injuries had lower median knee flexion angles and a more dorsiflexed ankle when compared with a control group (10° vs 20°, p≤0.001 and 10° vs 0°, p=0.033 respectively). Over half of ACL injuries in rugby in our analysis resulted from a contact mechanism. For non-contact injuries, lower knee flexion angles and heel-first ground contact in a side-stepping manoeuvre were associated with ACL injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Injury prevention in Australian Indigenous communities.

Science.gov (United States)

Ivers, Rebecca; Clapham, Kathleen; Senserrick, Teresa; Lyford, Marilyn; Stevenson, Mark

2008-12-01

Injury prevention in Indigenous communities in Australia is a continuing national challenge, with Indigenous fatality rates due to injury three times higher than the general population. Suicide and transport are the leading causes of injury mortality, and assault, transport and falls the primary causes of injury morbidity. Addressing the complex range of injury problems in disadvantaged Indigenous communities requires considerable work in building or enhancing existing capacity of communities to address local safety issues. Poor data, lack of funding and absence of targeted programs are some of the issues that impede injury prevention activities. Traditional approaches to injury prevention can be used to highlight key areas of need, however adaptations are needed in keeping with Indigenous peoples' holistic approach to health, linked to land and linked to community in order to address the complex spiritual, emotional and social determinants of Indigenous injury.

Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football

DEFF Research Database (Denmark)

Clausen, Mikkel Bek; Tang, L; Zebis, M K

2016-01-01

with low KOOS subscale scores (Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P time-loss knee...... questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (... as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P time-loss knee injury was also significantly increased in players...

Injuries in Spanish female soccer players

Directory of Open Access Journals (Sweden)

Juan Del Coso

2018-04-01

Full Text Available Background: Epidemiologic research to learn the incidence, type, location, and severity of female soccer injuries and the risk factors for sustaining a sport injury is the first step in developing preventive policies. The aim of this study was to analyze the incidence of injuries in the population of female soccer players in Spain. Methods: The injuries incurred by 25,397 female soccer players were registered by the medical staff of the Spanish Football Federation during 1 season. A standardized medical questionnaire was used to classify the injury according to type, severity, location, and injury mechanism. A total of 2108 injuries was reported with an incidence of 0.083 injuries per player per season. Most injuries were in the lower limbs (74.0%, mainly affecting knee (30.4% and ankle joints (17.9%. Results: The proportion of injuries derived from contact with another player was higher during matches (33.7% than during training (11.4%; p  0.05. Conclusion: Most female soccer injuries were located at the knee and ankle; the injury mechanism determined the playing time lost; and the player's age did not affect injury characteristics. Keywords: Ankle, Epidemiology, Knee, Sport injuries, Women

[Trampoline injuries in children].

Science.gov (United States)

Sinikumpu, Juha-Jaakko; Antila, Eeva; Korhonen, Jussi; Rättyä, Johanna; Serlo, Willy

2012-01-01

Trampolines for home use have become common in Finland during the past ten years, being especially favored by children. Trampoline jumping is beneficial and constructive physical exercise, but poses a significant risk for injuries. The most common injuries include sprains and strains. During summertime, trampoline injuries account for as many as 13% of children's accidents requiring hospital care. Fractures are by far the most common trampoline injuries requiring hospital care. Injuries can be prevented by using safety nets. Only one child at a time is allowed to jump on the trampoline.

Natural history of nonoperative management for grade 4 and 5 liver and spleen injuries in children.

Science.gov (United States)

Yang, Jeannie C; Sharp, Susan W; Ostlie, Daniel J; Holcomb, George W; St Peter, Shawn D

2008-12-01

Nonoperative management is standard treatment of blunt liver or spleen injuries. However, there are few reports outlining the natural history and outcomes of severe blunt hepatic and splenic trauma. Therefore, we reviewed our experience with nonoperative management of grade 4 or 5 liver and spleen injuries. A retrospective analysis was performed on patients with grade 4 or 5 (high-grade) blunt liver and/or spleen injuries from April 1997 to July 2007 at our children's hospital. Demographics, hospital course data, and follow-up data were analyzed. There were 74 high-grade injuries in 72 patients. There were 30 high-grade liver and 44 high-grade spleen injuries. Two patients had both a liver and splenic injury. High-grade liver injuries had a significantly longer length of intensive care and hospital stay compared to high-grade spleen injuries. There were also a significantly higher number of transfusions, radiographs, and total charges in the high-grade liver injuries when compared to the high-grade splenic injuries. The only mortality from solid organ injury was a grade 4 liver injury with portal vein disruption. In contrast, there was only one complication from a high-grade splenic injury-a pleural effusion treated with thoracentesis. There were 5 patients with complications from their liver injury requiring 18 therapeutic procedures. Three patients (10%) with liver injury required readmission as follows: one 5 times, one 3 times, and another one time. Patients with high-grade liver injuries have a longer recovery, more complications, and greater use of resources than in patients with similar injuries to the spleen.

Heelys injuries in children.

Science.gov (United States)

Oh, D; Arjandas, M; Lim, K B L; Lee, E H

2006-05-01

Heelys, a type of shoes with stealth wheels, are extremely popular among children in Singapore. The widespread availability of cheap imitations has led to a proliferation of young users. Coupled with a total lack of safety equipment and instructions, these shoes can lead to significant injuries. The purpose of this study was to examine the incidence and type of injuries sustained by children using Heelys. During a seven-month period from February to August 2004, all children treated at the Paediatric Orthopaedic Department of the KK Women's and Children's Hospital, were asked if the injury was sustained while "heeling". All the patients were reviewed by the authors. A total of 37 patients with significant injuries sustained while "heeling" were identified. Their radiographs and clinical charts were reviewed. The patients and/or their parents were also interviewed to obtain additional information. Upper limb injuries were by far the most common. Distal radius fractures and elbow injuries predominated. None of the children used safety gear. "Heeling" can lead to serious injuries despite the relatively low velocity involved. Children and their parents need to be educated on the use of safety gear.

Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups.

Science.gov (United States)

Schneider, S; Seither, B; Tönges, S; Schmitt, H

2006-04-01

To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups. The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18-79. 3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups. Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.

Prevalence, patterns, and correlates of equestrian injuries in Malaysia: A cross-sectional study.

Science.gov (United States)

Majeedkutty, Nizar A; Khairulanuar, Nor A B

2017-01-01

Equestrian sport carries with it an implicit risk of injury. Despite the frequency of injuries in equestrian sports, there is no published study on injuries of equestrian athletes in Malaysia. The objective of this study was to determine the prevalence of injuries and its correlates among horseback riders. A web-based standardized questionnaire was used to collect data for this cross-sectional survey. Horseback riders aged 18 years and above were included in the study. Out of 169 participants, 93 were females and 76 were males. The correlation of injuries to gender, age, level of experience, exercise habits, use of safety measures, and type of equestrian sport were determined. Chi-square test was performed to test for statistical significance. The prevalence was high with 85.8% of the participants reporting symptoms and characteristics of injuries in the past 12 months. The most frequently perceived symptoms reported were in the upper extremities (43.4%) followed by lower extremities (40.7%), head injury (8.3%) and injuries of upper and lower back (3.4%). There was a higher prevalence of injury among female participants (55.03%) than males (42.60%). A significant correlation was found between gender and prevalence of injuries. About 70% of the riders sustained soft tissue injuries. Fifty-five percent of the injured were involved in recreational riding. The most common mechanism of injury was a fall from a horse. Sixty percent of the injured riders did not seek medical attention after being injured, and physiotherapy consultation was even lower with 10.3%. The high prevalence of injuries and low rate of medical consultation emphasize the need for education programs on safety in Malaysia. Sessions should be held to improve coaching for riders and instructors, and their knowledge of the nature of the horse, mechanisms of injuries, horse handling, and riding skills to help them host safe equestrian activities.

Acute electrical injury: A systematic review

Directory of Open Access Journals (Sweden)

Noor-Ahmad Latifi

2017-01-01

>Conclusions: High-voltage injury leads to greater morbidity and mortality than low-voltage one. Lightening has mortality of about 32%, higher rates of complications and specialty long-term complications. Strict multi-specialty treatment and rehabilitations are required for proper treatment of electrical injuries.

Mole gun injury.

Science.gov (United States)

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.

Societal cost of traumatic brain injury: A comparison of cost-of-injuries related to biking with and without helmet use.

Science.gov (United States)

Costa, Camille K; Dagher, Jehane H; Lamoureux, Julie; de Guise, Elaine; Feyz, Mitra

2015-01-01

The goal of this study is to determine if a difference in societal costs exists from traumatic brain injuries (TBI) in patients who wear helmets compared to non-wearers. This is a retrospective cost-of-injury study of 128 patients admitted to the Montreal General Hospital (MGH) following a TBI that occurred while cycling between 2007-2011. Information was collected from Quebec Trauma Registry. The independent variables collected were socio-demographic, helmet status, clinical and neurological patient information. The dependent variables evaluated societal costs. The median costs of hospitalization were significantly higher (p = 0.037) in the no helmet group ($7246.67 vs. $4328.17). No differences in costs were found for inpatient rehabilitation (p = 0.525), outpatient rehabilitation (p = 0.192), loss of productivity (p = 0.108) or death (p = 1.000). Overall, the differences in total societal costs between the helmet and no helmet group were not significantly different (p = 0.065). However, the median total costs for patients with isolated TBI in the non-helmet group ($22, 232.82) was significantly higher (p = 0.045) compared to the helmet group ($13, 920.15). Cyclists sustaining TBIs who did not wear helmets in this study were found to cost society nearly double that of helmeted cyclists.

Exercise promotes motor functional recovery in rats with corticospinal tract injury: anti-apoptosis mechanism

Directory of Open Access Journals (Sweden)

Ting-ting Hou

2015-01-01

Full Text Available Studies have shown that exercise interventions can improve functional recovery after spinal cord injury, but the mechanism of action remains unclear. To investigate the mechanism, we established a unilateral corticospinal tract injury model in rats by pyramidotomy, and used a single pellet reaching task and horizontal ladder walking task as exercise interventions postoperatively. Functional recovery of forelimbs and forepaws in the rat models was noticeably enhanced after the exercises. Furthermore, TUNEL staining revealed significantly fewer apoptotic cells in the spinal cord of exercised rats, and western blot analysis showed that spinal cord expression of the apoptosis-related protein caspase-3 was significantly lower, and the expression of Bcl-2 was significantly higher, while the expression of Bax was not signifiantly changed after exercise, compared with the non-exercised group. Expression of these proteins decreased with time after injury, towards the levels observed in sham-operated rats, however at 4 weeks postoperatively, caspase-3 expression remained significantly greater than in sham-operated rats. The present findings indicate that a reduction in apoptosis is one of the mechanisms underlying the improvement of functional recovery by exercise interventions after corticospinal tract injury.

Cognitive and motor abilities of young children and risk of injuries in the home.

Science.gov (United States)

Ehrhardt, Jennifer; Xu, Yingying; Khoury, Jane; Yolton, Kimberly; Lanphear, Bruce; Phelan, Kieran

2017-02-01

Residential injury is a leading cause of morbidity and mortality in US children. Rates and types of injury vary by child age but little is known about injury risk based on child cognitive and motor abilities. The objective of this study was to determine whether cognitive or motor development in young children is associated with residential injury. We employed data from Health Outcomes and Measures of the Environment (HOME) Study. Parent report of medically attended injury was obtained at regular intervals from 0 to 42 months. Child development was assessed at 12, 24 and 36 months using Bayley Scales of Infant and Toddler Development, 2nd edition, which generates both mental developmental index (MDI) and a psychomotor developmental index (PDI). Injury risk was modelled using multivariable logistic regression as function of child's MDI or PDI. Effects of MDI and PDI on injury risk were examined separately and jointly, adjusting for important covariates. Children with cognitive delay (MDI cognitive delay (OR=3.7, 95% CI 1.4 to 10.5, p=0.012). There was no significant association of PDI with injury. There was, however, significant interaction of MDI and PDI (p=0.02); children with cognitive delay but normal motor development were at significantly higher risk of injury than children with normal cognitive and motor development (OR=9.6, 95% CI 2.6 to 35.8, p=0.001). Children with cognitive delays, especially those with normal motor development, are at elevated risk for residential injuries. Injury prevention efforts should target children with developmental delays. NCT00129324; post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Protective Effects of Erythropoietin and N-Acetylcysteine on Methotrexate-Induced Lung Injury in Rats

Directory of Open Access Journals (Sweden)

Hasan Kahraman

2013-03-01

Full Text Available Objective: Methotrexate (MTX is known to have deleterious side effects on lung tissue. We aimed to investigate the effects of erythropoietin (EPO and N-acetyl-cysteine (NAC on MTX-induced lung injury in rats. Study Design: Animal experiment. Material and Methods: Twenty-six female Sprague-Dawley rats were divided into 4 groups. Sham group, 0.3 mL saline; MTX group, 5 mg/kg MTX; EPO group, 5mg/kg MTX and 2000 IU/kg EPO; NAC group, 5 mg/kg MTX and 200 mg/kg NAC were administered once daily for 4 consecutive days. Malondialdehyde (MDA, superoxide dismutase (SOD, catalase (CAT and inflammation and congestion scores in lung tissues were evaluated. Results: In MTX group MDA were significantly higher, CAT and SOD were significantly lower than in sham, EPO and NAC groups (p0.005. In group MTX both scores were significantly higher than in sham (p<0.005. The congestion score of group MTX was significantly higher than those of group EPO and NAC (p<0.005. Conclusion: EPO and NAC have significant preventive effects on MTX-induced lung injury in rats. Decreased antioxidant capacity and increased MDA level may cause the oxidative damage in MTX group. Also, higher antioxidant capacity and lower MDA level may be a response to oxidative stress in EPO and NAC groups.

Childhood and adolescent injuries in elementary schools in north-western Uganda: extent, risk and associated factors.

Science.gov (United States)

Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif

2012-01-01

Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural-urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.

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

Directory of Open Access Journals (Sweden)

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.

Changing pattern and outcome of pediatric chest injuries in urban Syria.

Science.gov (United States)

Darwish, Bassam; Mahfouz, Mohammad Z; Al-Nosairat, Saeed; Izzat, Mohammad Bashar

2018-01-01

Background Pediatric chest injuries were infrequent in our practice, but the outbreak of the Syrian crisis resulted in an increase in number and a change in the pattern of thoracic trauma incidents. We compared our experience of pediatric chest injuries before and during the crisis. Methods We reviewed the records of 256 children aged 12.8 ± 5 years who were admitted to our hospital with the diagnosis of chest trauma over a 12-year period. Collected data included mechanism of injury, associated injuries, method of management, length of hospital stay, complications, and mortality. Results The incidence of pediatric chest injuries increased significantly following the outbreak of the crisis, and penetrating injuries prevailed, mainly due to shrapnel, bullets, and stab wounds. Forty percent of patients with blunt injuries and 20% of those with penetrating injuries were managed conservatively, whereas urgent thoracotomies were indicated in 10%, mostly in patients with penetrating injuries. Associated injuries were more frequent in patients with blunt injuries and resulted in a longer hospital stay and an increased mortality rate. The overall mortality rate was 7.8% and it was higher in children younger than 7 years of age and in patients who had been subjected to blunt injuries. Conclusions There has been a recent substantial upsurge in the incidence of pediatric thoracic trauma, with a predominance of penetrating injuries. Most patients could be managed nonoperatively, but a small subset required an open thoracotomy. The presence of associated injuries constitutes the main determinant of prognosis in this group of patients.

Emergent risk factors associated with eyeball loss and ambulatory vision loss after globe injuries.

Science.gov (United States)

Hyun Lee, Seung; Ahn, Jae Kyoun

2010-07-01

The objective of this study was to evaluate risk factors associated with eyeball loss and ambulatory vision loss on emergent examination of patients with ocular trauma. We reviewed the medical records of 1,875 patients hospitalized in a single tertiary referral center between January 2003 and December 2007. Emergent examinations included a history of trauma, elapsed time between injury and hospital arrival, visible intraocular tissues, and initial visual acuity (VA) using a penlight. The main outcome measures were ocular survival and ambulatory vision survival (>20/200) at 1 year after trauma using univariate and multivariate regression analysis. The ocular trauma scores were significantly higher in open globe injuries than in closed globe injuries (p eyeball loss. Elapsed time more than 12 hours and visible intraocular tissues were the significant risk factors associated with ambulatory vision loss. The most powerful predictor of eyeball loss and ambulatory vision loss was eyeball rupture. In closed globe injuries, there were no significant risk factors of eyeball loss, whereas initial vision less than LP and the presence of relative afferent pupillary defect were the significant risk factors associated with ambulatory vision loss. An initial VA less than LP using a penlight, a history of golf ball injury, and elapsed time more than 12 hours between ocular trauma and hospital arrival were associated with eyeball loss and ambulatory vision loss. Physicians should bear these factors in mind so that they can more effectively counsel patients with such injuries.

Prognostic significance of blood-brain barrier disruption in patients with severe nonpenetrating traumatic brain injury requiring decompressive craniectomy.

Science.gov (United States)

Ho, Kwok M; Honeybul, Stephen; Yip, Cheng B; Silbert, Benjamin I

2014-09-01

The authors assessed the risk factors and outcomes associated with blood-brain barrier (BBB) disruption in patients with severe, nonpenetrating, traumatic brain injury (TBI) requiring decompressive craniectomy. At 2 major neurotrauma centers in Western Australia, a retrospective cohort study was conducted among 97 adult neurotrauma patients who required an external ventricular drain (EVD) and decompressive craniectomy during 2004-2012. Glasgow Outcome Scale scores were used to assess neurological outcomes. Logistic regression was used to identify factors associated with BBB disruption, defined by a ratio of total CSF protein concentrations to total plasma protein concentration > 0.007 in the earliest CSF specimen collected after TBI. Of the 252 patients who required decompressive craniectomy, 97 (39%) required an EVD to control intracranial pressure, and biochemical evidence of BBB disruption was observed in 43 (44%). Presence of disruption was associated with more severe TBI (median predicted risk for unfavorable outcome 75% vs 63%, respectively; p = 0.001) and with worse outcomes at 6, 12, and 18 months than was absence of BBB disruption (72% vs 37% unfavorable outcomes, respectively; p = 0.015). The only risk factor significantly associated with increased risk for BBB disruption was presence of nonevacuated intracerebral hematoma (> 1 cm diameter) (OR 3.03, 95% CI 1.23-7.50; p = 0.016). Although BBB disruption was associated with more severe TBI and worse long-term outcomes, when combined with the prognostic information contained in the Corticosteroid Randomization after Significant Head Injury (CRASH) prognostic model, it did not seem to add significant prognostic value (area under the receiver operating characteristic curve 0.855 vs 0.864, respectively; p = 0.453). Biochemical evidence of BBB disruption after severe nonpenetrating TBI was common, especially among patients with large intracerebral hematomas. Disruption of the BBB was associated with more severe

Golf-related injuries treated in United States emergency departments.

Science.gov (United States)

Walsh, Brittany A; Chounthirath, Thiphalak; Friedenberg, Laura; Smith, Gary A

2017-11-01

This study investigates unintentional non-fatal golf-related injuries in the US using a nationally representative database. This study analyzed golf-related injuries treated in US hospital emergency departments from 1990 through 2011 using the National Electronic Injury Surveillance System database. Injury rates were calculated using golf participation data. During 1990 through 2011, an estimated 663,471 (95% CI: 496,370-830,573) individuals ≥7years old were treated in US emergency departments for golf-related injuries, averaging 30,158 annually or 12.3 individuals per 10,000 golf participants. Patients 18-54years old accounted for 42.2% of injuries, but injury rates per 10,000 golf participants were highest among individuals 7-17years old (22.1) and ≥55years old (21.8) compared with 18-54years old (7.6). Patients ≥55years old had a hospital admission rate that was 5.01 (95% CI: 4.12-6.09) times higher than that of younger patients. Injured by a golf club (23.4%) or struck by a golf ball (16.0%) were the most common specified mechanisms of injury. The head/neck was the most frequently injured body region (36.2%), and sprain/strain (30.6%) was the most common type of injury. Most patients were treated and released (93.7%) and 5.9% required hospitalization. Although golf is a source of injury among all age groups, the frequency and rate of injury were higher at the two ends of the age spectrum. Given the higher injury and hospital admission rates of patients ≥55years, this age group merits the special attention of additional research and injury prevention efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Injury in elite New Zealand cricketers 2002-2008: descriptive epidemiology.

Science.gov (United States)

Frost, Warren Leonard; Chalmers, David John

2014-06-01

To describe the incidence, prevalence, nature and severity of injury to elite New Zealand cricketers for the 2002/2003 to 2007/2008 seasons. Prospective cohort. Elite cricket in New Zealand. 248 elite male cricketers. Incidence and prevalence rates. The overall match injury incidence rate for the international competition (51.6 injuries per 10 000 player-hours; 95% CI 40.1 to 65.3) was almost twice that of the domestic competition (27.2; 23.5 to 31.4). The prevalence rate for the international competition (12%; 11.3% to 12.8%) was significantly higher than that for the domestic competition (9.7%; 9.4% to 10.1%). Overall, 79.5% of injuries occurred in matches and 48.7% of all injuries were sustained while bowling. The lower limb was the body region most commonly injured (43.5%), the most common specific diagnosis was hamstring strains/tears (11.1%) and the injuries contributing the highest proportion of match days lost were stress fractures to the low back (22%). The findings of this study support ongoing injury surveillance in New Zealand and other test cricket playing nations for the purpose of describing injury and monitoring the effect of interventions over time. 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.

Craniomaxillofacial Trauma: Synopsis of 14,654 Cases with 35,129 Injuries in 15 Years

Science.gov (United States)

Kraft, Anna; Abermann, Elisabeth; Stigler, Robert; Zsifkovits, Clemens; Pedross, Florian; Kloss, Frank; Gassner, Robert

2011-01-01

Craniomaxillofacial (CMF) trauma occurs in isolation or in combination with other serious injuries, including intracranial, spinal, and upper- and lower-body injuries. It is a major cause of expensive treatment and rehabilitation requirements, temporary or lifelong morbidity, and loss of human productivity. The aim of this study was to evaluate patterns of CMF trauma in a large patient sample within a 15-year time frame. Between 1991 and 2005, CMF trauma data were collected from 14,654 patients with 35,129 injuries at the Department of Cranio-Maxillofacial and Oral Surgery in Innsbruck, assessing a plethora of parameters such as injury type and mechanism as well as age and gender distribution over time. Three main groups of CMF trauma were evaluated: facial bone fractures, dentoalveolar trauma, and soft tissue injuries. Statistical comparisons were carried out using a chi-square test. This was followed by a logistic regression analysis to determine the impact of the five main causes for CMF injury. Older people were more prone to soft tissue lesions with a rising risk of 2.1% per year older, showing no significant difference between male and female patients. Younger patients were at higher risk of suffering from dentoalveolar trauma with an increase of 4.4% per year younger. This number was even higher (by 19.6%) for female patients. The risk of sustaining facial bone fractures increased each year by 4.6%. Male patients had a 66.4% times higher risk of suffering from this type of injury. In addition, 2550 patients (17.4%) suffered from 3834 concomitant injuries of other body parts. In summary, we observed changing patterns of CMF trauma over the last 15 years, paralleled by advances in refined treatment and management options for rehabilitation and reconstruction of patients suffering from CMF trauma. PMID:23449961

Association of Socio-economic Status with Injuries in Children Andadolescents:the CASPIAN-IV Study

Directory of Open Access Journals (Sweden)

Roya Kelishadi

2016-05-01

Full Text Available Background:Childhood and adolescence injuries are still frequently occuring in developing countries. This study aims to assess the association  of socio-economic status (SES with injuriesin Iranian children and adolescents. Materials and Methods: This multicentricsurvey was part of a national surveillance program, which was conducted in 2011-2012 amongst 14,880 students aged6-18 years. Participants were randomly selected from urban and rural areas of 30 provinces in Iran. Socio- economic status (SES of participants was categorized to “low”, “middle” ,and “high” by using principle component analysis method by considering parental job and education as well as family assets. Prevalence, types and places of injuries were based on the questionnaire of the World Health Organization- Global School-based student Health Survey (WHO-GSHS.Multivariate modelwas used for comparison of variables between SES groups. Results: Overall, 13486 out of 14880 invited students (response rate: 90.6% participated in this study.Their mean (SD age was12.47 (3.36 years.Boys and urban residents constituted the majority of participants (50.8% and 75.6%, respectively. Compared with low SES group, oddsof sport injury was higher in students with middle (OR=1.44; 95%CI: 0.92-2.26 and highSES (OR=1.96; 95%CI: 1.27-3.01. Compared to participants withlow SES,odds of home injuries was significantly lower in high SES group (OR=0.78; 95%CI: 0.64-0.95. Conclusion: This study revealedconsiderable differences in injuries of children and adolescents according to their SES, with higher prevalence of home injuries in low SES families and higher prevalence of sport injuries in middle and high SES levels. When implementing injury prevention programs, such differences should be taken into account.