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79 records · Page 5Linked to original sources
PubMed1994

Horseback riding injuries among children and young adults.

BACKGROUND: Horseback riding injuries are responsible for an estimated 2300 hospital admissions annually among persons younger than 25 years of age in the United States, but injury rates, patterns of injury, and risk factors for this population have not been well studied. METHODS: Study participants were selected from a list provided by a national mail-order company that sells riding equipment. A total of 557 persons younger than 25 years of age who rode horses at least six times a year completed survey questionnaires. RESULTS: Among the study participants, 34 (6.1%) had been hospitalized at least once because of a riding injury and 153 (27.5%) had been treated by a physician within the previous 2 years for such an injury. The overall injury rate was 0.6 per 1000 riding hours. Among those injured, sprains or strains (41.8%), lacerations or bruises (40.0%), and fractures or dislocations (33.3%) were the most common types of injury. A total of 27.5% of those injured sustained concussions or other head injuries. Riding 15 to 24 hours per month (odds ratio [OR] = 2.04), being female (OR = 1.81), and riding English style (OR = 1.77) were the characteristics most strongly correlated with injury. CONCLUSIONS: Horseback riding injuries among participants in this study tended to be serious. Family physicians should inform their patients who ride horses about the risks associated with equestrian activities and should emphasize helmet use.

Adolescent↗
PubMed1994

Desiccated thyroid in a nutritional supplement.

Nutritional or vitamin supplements, which are largely unregulated by the Food and Drug Administration (FDA) and are sold in health food stores and through mail-order catalogs, may contain various combinations and doses of vitamins, minerals, herbs, chemicals, and animal tissues. Some of the products marketed as nutritional supplements contain desiccated porcine or bovine thyroid. A patient came to our family practice center with resting tachycardia, amenorrhea, and weight loss. She had been taking a nutritional supplement containing desiccated thyroid for 3 months. Laboratory studies confirmed the presence of hyperthyroidism. The daily recommended and consumed dose of the product she had been taking exceeded the normal replacement dose by two to three times. There is potential for harm in the unregulated availability and distribution of desiccated thyroid to the public.

Adult↗
PubMedDate not supplied

Helmets and horseback riders.

To determine patterns of helmet use and attitudes toward helmets among horseback riders, we analyzed a subset of data (n = 1,834) from a cross-sectional mail survey of horseback riders conducted from July to December 1991. Riders were randomly selected from the mailing list of a national mail-order company that sells horseback-riding equipment. Of 900 English-style riders, 517 (57.5%) wore helmets on their last ride, compared with only 81 of 684 (11.8%) Western-style riders. Among 546 riders who did not own helmets, their most commonly cited reasons included believing that helmets were unnecessary (43.8%) or uncomfortable (29.9%). Of the 1,263 helmet owners, nearly 62% had one or more complaints about helmets, but 41.1% of owners reported that their helmet had prevented at least one head injury. Increasing helmet use will require major educational efforts with horseback riders and design changes by manufacturers.

Adolescent↗
PubMed1998

Patient education programs and continuance with estrogen replacement therapy: evaluation of the women's health exchange.

OBJECTIVE: This study examined the impact of the Women's Health Exchange (WHE), a program aimed at educating women about menopause and estrogen replacement therapy, on patient continuance with Estraderm, a transdermal estrogen replacement medication. DESIGN: The prescription database of Express Scripts, Inc., a pharmacy benefits management company serving a large, nationwide insured population, was used for the study. All study subjects had one or more claims for Estraderm between 2/1/95 and 8/31/95. The intervention group consisted of 299 WHE enrollees, and the control group comprised a random sample of 1,513 patients who had not enrolled in WHE. RESULTS: A multivariate Cox regression model found that older age, longer prior length of Estraderm use, progestin use, and patronage of a mail-order pharmacy were associated with increased continuance. Controlling for these factors and for HMO enrollment and copay amount, the likelihood of discontinuing Estraderm was significantly lower for WHE enrollees compared to non-WHE enrollees. Sensitivity analyses tested the effects of preexisting differences between the WHE and control group subjects on study findings. Even when WHE enrollees were compared with control subjects having similar medication costs, disease severity, or continuance with chronic medications, WHE enrollment was associated with an increased length of Estraderm therapy. CONCLUSIONS: These findings suggest that patient education programs may improve continuance with transdermal hormone replacement therapy for patients with a prescription benefit.

Administration, Cutaneous↗