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[Fatal soccer injury as an unfortunate sequela of collision].

The tragic death of a 26-year old hobby soccer player is described, who had a collision with the opposing goalie and suffered from a fracture of the left lateral process of the atlas, an extensive subarachnoid haemorrhage, tamponade of the third and fourth cerebral ventricles, bleeding into both lateral cerebral ventricles, infratentorial and supratentorial cerebral oedema. Furthermore, a survey of the literature concerning acute death in soccer is presented.

Adult↗

[Figure skating in high performance sports].

A top performance figure skater is compleled to expose his postural and locomotor system to maximum stress. To achieve the high level of performance that is expected from him, his training schedule must be most exacting. Parallel to this there is an enhanced risk of a sports accident and of damage to health conditioned by sports activities. We report on the results of a study conducted with 67 active and former top performance figure skaters in respect of joint mobility of the lower extremities, sports injuries and damage caused by sports. The type and rate of incidence of sports injuries and sports damage are described and compared with epidemiological data of the average population, the hobby figure skater, and related types of sports.

Adolescent↗

[Fatigue fracture of the femoral neck in a recreational runner. A case report].

A report about a hobby runner's femoral neck fatigue fracture is presented. Femoral neck fatigue fractures are rare injuries. Young soldiers occasionally are involved. The under-evaluation of pains in the inguinal region delies the diagnosis. The femoral neck breaks under cyclic load. Therefore the operative treatment is necessary though the injury could be treated conservatively during early stage.

Adult↗

[Maculopathy caused by Nd:YAG laser accident].

BACKGROUND: Since the construction of the first laser in the sixties and the extended use in medicine, technology and hobby the number of accidents has increased. Appreciated to therapy concepts are missing at the time. PATIENT: A 19 year-old-man was hit by the impulse of an military hand-held rangefinder (Nd:YAG with a wavelength of 1064 nm) on the right eye. The visual acuity dropped to 1/35 and a central scotoma with metamorphopsia occurred immediatly after the accident. The ophthalmological findings showed a distinct submacular hemorrhage. The therapy with Prednisolon intravenous and daily parabulbar, vitamin C, indomethacin systemical and lokal application resulted in an increase of visual acuity up to 0.4 and a reduction of central scotoma from 8 degrees to 2 degrees. CONCLUSION: Systemical and local use of antiphlogistic and antiinflamatoric substances may partially reduce the vision limitating scar formation. Application of antioxidants to neutralize the toxic radicals that arise by tissue decay should be given additionally to the cyclopegic medication. Special attention should be payed to the prevention of such laser accidents.

Accidents, Occupational↗

[The solitary pulmonary histoplasmoma].

A 63-year-old man who grows orchids as a hobby, fell ill with weakness and pain in his hips and legs 2 months after his latest trip to South America (Ecuador). The WBC count was 9900/microliters with unremarkable differential count while blood sedimentation rate was raised to 60/100 mm. The chest X-ray demonstrated in the right upper lobe a well-circumscribed coin lesion (3 cm diameter) of soft-tissue density, uncalcified and without cavitation. Computed tomography in addition revealed an enlarged lymph-node at the lower hilar pole, but no mediastinal lymphoma. Bronchoscopy demonstrated narrowing of a subsegmental ostium of the 6th segment on the right. An attempt at transbronchial biopsy failed. As a peripheral bronchial carcinoma was suspected, a posterolateral thoracotomy was performed (4 months after the trip to Ecuador). Rapid histological examination was negative for tumour and the lesion was therefore enucleated. Histologically (Grocott silver staining) a histoplasmoma was diagnosed. Several serum samples were positive for precipitating (M-band) and complement-binding antibodies (titre 12 days preoperatively was 1:16). The postoperative course was without complication. No anti-histoplasma antibodies were demonstrable 1 year postoperatively.

Antibodies, Fungal↗

Membrane recruitment of coatomer and binding to dilysine signals are separate events.

It has previously been shown that transport of newly synthesized proteins and the structure of the Golgi complex are affected in the Chinese hamster ovary cell line ldlF, which bears a temperature-sensitive mutation in the Coat protein I (COPI) subunit epsilon-COP (Guo, Q., Vasile, E., and Krieger, M. (1994) J. Cell Biol. 125, 1213-1224; Hobbie, L., Fisher, A. S., Lee, S., Flint, A., and Krieger, M. (1994) J. Biol. Chem. 269, 20958-20970). Here, we pinpoint the site of the secretory block to an intermediate compartment between the endoplasmic reticulum (ER) and the Golgi complex and show that the distributions of ER-Golgi recycling proteins, such as KDEL receptor and p23, as well as resident Golgi proteins, such as mannosidase II, are accordingly affected. At the nonpermissive temperature, neither the stability of the COPI complex nor its recruitment to donor Golgi membranes is affected. However, the binding of coatomer to the dilysine-based ER-retrieval motif is impaired in the absence of epsilon-COP, suggesting that dilysine signal binding is not the major means of COPI recruitment. Because expression of the exogenous chimera of epsilon-COP and green fluorescent protein in ldlF cells at nonpermissive temperature rapidly restores the wild type properties, epsilon-COP is likely to play an important role in the cargo selection events mediated by COPI.

ADP-Ribosylation Factors↗

Assessing the classification of work-relatedness of fatal incidents: a comparison between Australia, New Zealand and the United States.

As part of a larger study comparing work-related fatal injury of workers in Australia, New Zealand and the United States, an assessment was made of the similarities and differences between the three countries in identifying fatal incidents as work-related or not. The researchers in each country independently classified 333 brief scenarios, describing a variety of fatal incidents, into one of nine categories related to work: worker, bystander, commuter, volunteer, student, suicide, other, unknown and none of the above. Complete agreement with the classification was moderate (62%), but agreement when classifying scenarios as working, not working or unknown was much higher (full agreement for 80% of scenarios; Kappa = 0.71). Only 5% of scenarios were classified differently by all three countries. Other main findings of the study were that there is variation between countries in the interpretation of what is and what is not work-related, and variation in the amount or type of information required to make a definitive classification. Common circumstances described in the scenarios for which there was some disagreement in classification included domestic violence incidents at work, volunteer workers, business trips, social functions connected to work, hobby farmers and some possible bystander incidents that occurred on farms or on the road. The results suggest that, even without the use of standard definitions, comparisons between the datasets of the countries involved in this study can be made with reasonable confidence. However, they also emphasise the importance of minimising ambiguity in the definitions used, and of understanding the manner in which the definitions are applied, when comparing results between studies.

Accidents, Occupational↗

The development and overwintering survival of free-living larvae of Haemonchus contortus in Sweden.

Five complimentary studies were undertaken with the overall aim to examine the ability of free-living stages of Haemonchus contortus to over-winter and tolerate cold stress. Two studies deal with the development and long-term survival of eggs and infective larvae of two geographically different isolates (Kenya and Sweden). Eggs and larvae were monitored in climatic chambers at temperatures that fluctuated daily between -1 degrees C and 15 degrees C, or at constant temperatures of 5 degrees C and 15 degrees C. The development from egg to larvae was dependent on temperatures over 5 degrees C. The long time survival was favoured at lower temperatures. Furthermore, the overwintering capacity of the free-living stages of these isolates was estimated under Swedish field conditions. Two groups of lambs were experimentally infected with different isolates, and kept separated on previously ungrazed plots. In early May the following year, two parasite-naive tracer lambs were turned out on each of the plots to estimate the pick up of overwintered larvae. This experiment was replicated in central and southern Sweden. In addition, two experiments were performed in 2003 on pasture previously grazed by naturally infected sheep. One trial was on a pasture in southern Sweden grazed by a commercial flock, where extreme numbers of H. contortus were found towards the end of the grazing season 2002. The other study was on a pasture plot in central Sweden grazed by a hobby flock in 2002, where three of six lambs died due to haemonchiasis. Overwintered H. contortus was recorded on three of four experimental sites. Worm burdens were in all instances extremely low. No differences in development and survival were found between the isolates. Consequently, overwintering on pasture is of no practical significance in the transmission of H. contortus between grazing-seasons in Sweden.

Animals↗

Evidence for a dose-response relationship between occupational noise and blood pressure.

In this study, we investigated the role of occupational noise exposure and blood pressure among workers at 2 plants. A noise-exposed plant (plant 1, > or = 89 dBA) and a less-noise-exposed plant (plant 2, < or = 83 dBA) were chosen. Exposure was based on department-wide average noise measures; on the basis of job location and adjusting for layoffs during their employment at the plant, a cumulative time-weighted average noise level was calculated for each worker. The study population comprised 329 males in plant 1 and 314 males in plant 2. Their ages ranged from 40 to 63 y (mean ages = 49.6 and 48.7, respectively), and they had worked at least 15 y at the plant. The clinical examination was administered prior to the workday and measured height, weight, pulse, and blood pressure. In addition, we noted medical and personal-habits histories, including alcohol intake and cigarette smoking patterns. We used a questionnaire to determine in-depth occupation, military history, noisy hobbies, and family history of hypertension. When individuals who took blood-pressure medication were removed from the analysis, t tests for differences in average blood pressure between plants showed a mean systolic blood pressure of 123.3 mm Hg in plant 1 versus 120.8 mm Hg in plant 2 (p = .06) and a mean diastolic blood pressure of 80.3 mm Hg versus 77.8 mm Hg in Plant 1 and 2, respectively (p = .014). On the basis of data from the combined plants, multivariate analysis revealed that age, body mass index, cumulative noise exposure, current use of blood pressure medications, and alcohol intake were significant predictors for systolic blood pressure. Cumulative noise exposure was a significant predictor of diastolic blood pressure in plant 1 but not in plant 2, possibly reflecting a threshold effect.

Adult↗

Long-term effects of heart transplantation: the gap between physical performance and emotional well-being.

The purpose of our study was to assess physical and emotional factors in heart transplant patients. A prospective design was used to compare patients' physical symptoms, emotional complaints, and restrictions at admission to the waiting list, immediately after, and 1 and 5 years after heart transplantation. Thirty-three patients were included (30 male, 3 female) in the study. Their mean age at admission was 48 +/- 10.2 years. Of these, 23 suffered from cardiomyopathy, 8 from coronary heart disease, and 2 from valvular insufficiency. At admission, the patients suffered from symptoms of cardiac insufficiency, and were restricted in sports, gardening, hobbies, sexual life, job, food-intake, and mobility. More than three-fourths rated their physical and emotional status as moderate to poor. Emotionally, they suffered from irritability, restlessness, depression, psychic lability, lowered drive, lack of social contact, low self-esteem, and anxiety. At the end of rehabilitation (4-8 weeks after the operation), all physical and emotional complaints, as well as restrictions had significantly decreased (p < 0.0001 to p < 0.001), except for trembling, numbness of hands/feet, and food-intake. One year postoperatively, patients reported even fewer physical complaints (p < 0.01). Three-fourths rated their physical and emotional status good or excellent. Five years postoperatively--in contrast to physical status, restrictions, and physical complaints--the emotional complaints had increased significantly (p < 0.0001). Patients reported excellent physical performance up to 5 years postoperatively. On the other hand, the study revealed that their emotional well-being had significantly deteriorated from 1 to 5 years postoperatively. Attention should, therefore, not only be paid to the good physical health of the survivors, but also to the worsening of their emotional status.

Adaptation, Psychological↗

Positive experiences and the relationship between stress and asthma in children.

UNLABELLED: Ninety children aged 6 to 13 y and suffering from chronic asthma were included in a prospective follow-up study lasting 18 mo in order to assess whether life events involving substantial positive effects on the child can protect against the increased risk associated with stressful life events. The main outcome measures included positive life events, positive long-term experiences, severely negative life events, chronic psychosocial stress and new asthma exacerbation. The results showed that, provided they occurred in close proximity to severely negative life events, positive life events, generally related to the child's own achievements, afforded protection against the increased risk of a new asthma exacerbation precipitated by severe events in children whose lives were marked by low to medium levels of chronic stress. No such effect was found in children exposed to high chronic stress nor did long-term positive experiences, such as when the child has a rewarding hobby, affect the asthma risk. CONCLUSION: Life events with a definite positive effect can counteract the increased risk of an asthma exacerbation precipitated by a severely negative life event, provided the chronic stress is only of low to medium level. Because this protective influence does not apply where there is high chronic stress, reducing this condition must be seen as a priority in children suffering from asthma, as these children are also more vulnerable to negative life events precipitating asthma exacerbation.

Adolescent↗

Work resumption and leisure activities after cardiac rehabilitation: the development of criteria to measure social recovery.

In a multicentered trial, the authors investigated 280 cardiac patients to determine the level of recovery of their social life after they had completed a physical training program. Data on work and leisure activities (sports, hobbies, social contacts, and odd jobs) were obtained immediately before and after rehabilitation and again 12 months later by means of semistructured interviews and an inventory of leisure activities. For the analysis of leisure variables, they developed a classification procedure to assign patients to one of five categories indicating an unchanged good outcome, significant recovery, nonparticipation, significant deterioration, or an unchanged poor outcome. The results after rehabilitation showed that some patients had benefited more than others. In addition, improvement or deterioration in one aspect of social recovery appeared to be independent from other aspects. Further systematic research is needed to determine which factors influence the amount of benefit derived from rehabilitation.

Adaptation, Psychological↗

Association between impairments, self-care ability and social activities 1 year after stroke.

PURPOSE: To explore how motor and cognitive impairments relate to physical activities of daily living (PADL) and social activities after stroke. METHOD: The data related to 65 patients (mean age 74.4 years, 43% females), assessed 1 year after stroke by means of the Sødring Motor Evaluation of Stroke patients and the Assessment of Stroke and other Brain damage instruments. The self-care and social activities scales applied were the Barthel ADL Index and the Frenchay Activities Index (FAI). The association between impairment variables on the one hand and PADL and FAI scores on the other was estimated using Kendall rank correlations. RESULTS: Arm motor function correlated most strongly with the Barthel score (tau = 0.76), and visuospatial function came second (tau = 0.58). Factor analysis of the FAI produced three subscales: a 'domestic' factor most strongly related to arm motor function (tau = 0.49); 'outdoor' related to visuospatial ability (tau = 0.48); and 'hobby' which had no significant correlates. CONCLUSION: In the chronic phase of stroke, self-care and involvement in social activities relate most strongly to arm motor function and visuospatial ability. Outdoor activities depend mainly on visuospatial function.

Activities of Daily Living↗

Presence of pro-tobacco messages on the Web.

Ignored in the finalized Master Settlement Agreement (National Association of Attorneys General, 1998), the unmonitored, unregulated World Wide Web (Web) can operate as a major vehicle for delivering pro-tobacco messages, images, and products to millions of young consumers. A content analysis of 318 randomly sampled pro-tobacco Web sites revealed that tobacco has a pervasive presence on the Web, especially on e-commerce sites and sites featuring hobbies, recreation, and "fetishes." Products can be ordered online on nearly 50% of the sites, but only 23% of the sites included underage verification. Further, only 11% of these sites contain health warnings. Instead, pro-tobacco sites frequently associate smoking with "glamorous" and "alternative" lifestyles, and with images of young males and young (thin, attractive) females. Finally, many of the Web sites offered interactive site features that are potentially appealing to young Web users. Recommendations for future research and counterstrategies are discussed.

Adolescent↗

Two-stage evaluation of exposure to mercury and biomarkers of neurotoxicity at a hazardous waste site.

Communities surrounding the Rocky Mountain Arsenal (RMA), a Superfund site in Colorado, were studied in order to determine whether exposures to mercury were greater among persons who resided there than among residents of a comparison area 12-15 miles distant. From a census-based stratified random sample, 469 persons were interviewed and urine samples were obtained for biomonitoring. Mercury was detected in urine from 32 (6.8%) of the 469 persons sample at a detection limit of 5 ppb. Trace levels of mercury (detectable, but nonquantifiable) were found in 80 (17.1%) of the persons sampled. Neither the frequency of detection, the arithmetic mean, nor the geometric mean value for urine mercury was found to be statistically different when persons living near the site were compared to persons from the more distant comparison area. The risk of mercury exposure associated with demographic variables, residence, occupation, hobbies, dietary habits, water supply, housing, and activity patterns was evaluated. In the second stage of the evaluation, the Neurobehavioral Core Test Battery (NCTB) is being used to assess individual functional deficits and nervous system disorders associated with exposure to mercury and other neurotoxic chemicals.

Adolescent↗

Occupation related fire fighter hearing loss.

A noise exposure survey and audiometric assessment of 750 Los Angeles City fire fighters carried out to study the impact of fire service noise exposure on fire fighter hearing loss revealed evidence of excess hearing loss at the 3000Hz, 4000Hz, and 6000Hz test frequencies. Fire fighter medical history and life-style data did not point to a significant impact of hobbies and diseases on hearing threshold changes. The hearing loss observed at the test frequencies was, in relation to age, in excess of a general national population. This increased hearing loss with age for fire fighters suggests occupational overexposure to noise. A hearing conservation program for the fire service is therefore recommended.

Adult↗

Characteristics of women with vulvar pain disorders: responses to a Web-based survey.

This article presents data contributed by 428 highly educated, internet-savvy women who frequented various vulvar pain discussion lists. The age range was in the reproductive years and older and over 90% were Caucasians. No country of origin was given. They had a number of distressing symptoms, including vulvar pain at rest and with contact, burning, itching, redness, and inflammation. Most felt that they had either vulvar vestibulitis, vulvodynia, or both, although they had other vulvar conditions as well. Many felt that yeast infections, stress, antibiotics, infections, and chemicals played a contributing role. There were a number of comorbidities, including irritable bowel syndrome, fibromyalgia, and interstitial cystitis. Sexual abuse was not a major issue. The vulvar pain destroyed or altered then sex lives, lowered their self-esteem, and affected their relationships. Often, they relied upon understanding partners, support groups, and hobbies but not the medical profession for comfort.

Adaptation, Psychological↗

Yersinia-induced apoptosis in vivo aids in the establishment of a systemic infection of mice.

Pathogenic Yersinia cause a systemic infection in mice that is dependent on the presence of a large plasmid encoding a number of secreted virulence proteins called Yops. We previously demonstrated that a plasmid-encoded Yop, YopJ, was essential for inducing apoptosis in cultured macrophages. Here we report that YopJ is a virulence factor in mice and is important for the establishment of a systemic infection. The oral LD50 for a yopJ mutant Yersinia pseudotuberculosis increases 64-fold compared with wild-type. Although the yopJ mutant strain is able to reach the spleen of infected mice, the mutant strain seldom reaches the same high bacterial load that is seen with wild-type Yersinia strain and begins to be cleared from infected spleens on day 4 after infection. Furthermore, when in competition with wild-type Yersinia in a mixed infection, the yopJ mutant strain is deficient for spread from the Peyer's patches to other lymphoid tissue. We also show that wild-type Yersinia induces apoptosis in vivo of Mac-1(+) cells from infected mesenteric lymph nodes or spleens, as measured by quantitative flow cytometry of TUNEL (Tdt-mediated dUTP-biotin nick-end labeling)-positive cells. The levels of Mac-1(+), TUNEL+ cells from tissue infected with the yopJ mutant strain were equivalent to the levels detected in cells from uninfected tissue. YopJ is necessary for the suppression of TNF-alpha production seen in macrophages infected with wild-type Yersinia, based on previous in vitro studies (Palmer, L.E., S. Hobbie, J.E. Galan, and J.B. Bliska. 1998. Mol. Microbiol. 27:953-965). We conclude here that YopJ plays a role in the establishment of a systemic infection by inducing apoptosis and that this is consistent with the ability to suppress the production of the proinflammatory cytokine tumor necrosis factor alpha.

Animals↗