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PubMedDate not supplied

Treatment of isolated medial collateral ligament injuries in athletes with early functional rehabilitation. A five-year follow-up study.

A prospective study was designed to provide 5-year followup of the treatment of isolated grade III sprains of the medial collateral ligament with early functional rehabilitation in 35 athletes. After injury, patients were placed in lateral hinged braces to provide valgus support without restricting flexion or extension of the knee. Treatment was initiated with range of motion exercises performed in a whirlpool or swimming pool. Patients were then started on quadriceps setting and leg raises. When 90 degrees of flexion was present, resistive exercises were added. Upon recovery, patients were allowed to return to unrestricted sports. Followup consisted of both questionnaires and physical examination and was graded on the 50-point Hospital for Special Surgery scale. Mean followup was 5.3 years (range, 2.5 to 8); mean Hospital for Special Surgery knee rating score was 45.9 points (range, 41 to 50). These results are comparable with those achieved with surgery or immobilization by earlier investigators. Thus, early functional rehabilitation treatment of complete medial collateral ligament sprains produces results comparable with those achieved with surgery or immobilization while minimizing treatment-related morbidity and allowing more rapid return to sports participation.

Adolescent↗
PubMedDate not supplied

Subtalar subluxation in ballet dancers.

Ankle injuries frequently occur in dancers. Among these injuries, only a few cases of talar subluxation have been reported in the literature. In our series, we diagnosed and treated 25 subtalar subluxations over a 1-year period in the Ballet Béjart Lausanne company. The subluxations occurred after a grand plie on pointes or at the landing of a jump on demi-pointes, without any mechanism of ankle sprain. The dancer usually noted a sudden and sharp pain in the talonavicular joint and hindfoot with a feeling of "forward displacement" of the foot. At palpation, the talonavicular ligament, the anterior talofibular ligament, and the posteromedial part of the subtalar joint were painful. A limitation of the ankle extension and a clear hypomobility of the subtalar joint were noted. Under the effect of shearing forces on the midtarsal joint, a posteromedial subtalar subluxation occurred. Treatment consisted of a manipulation that reduced the subluxation. Continuous taping, which locks the talonavicular joint in the anterior direction, was recommended for 6 weeks. Dancing could be resumed in a swimming pool after 2 weeks, and on the ground after 3 to 4 weeks. We found that subluxation could recur, and that it could eventually become chronic.

Adult↗
PubMed2004

Knowledge and attitude towards HIV/AIDS among Iranian students.

BACKGROUND: Young people are of particular importance in state policies against Acquired Immunodeficiency Syndrome (AIDS). We intended to assess the knowledge and attitude of high school students regarding AIDS in Iran. METHODS: Through a cluster-sampling, 4641 students from 52 high schools in Tehran were assessed by anonymous questionnaires in February 2002. RESULTS: The students identified television as their most important source of information about AIDS. Only a few students answered all the knowledge questions correctly, and there were many misconceptions about the routes of transmission. Mosquito bites (33%), public swimming pools (21%), and public toilets (20%) were incorrectly identified as routes of transmission. 46% believed that Human Immunodeficiency Virus positive (HIV positive) students should not attend ordinary schools. Most of the students wanted to know more about AIDS. In this study knowledge level was associated with students' attitudes and discipline (p < 0.001). CONCLUSION: Although the knowledge level seems to be moderately high, misconceptions about the routes of transmission were common. There was a substantial intolerant attitude towards AIDS and HIV positive patients. We recommend that strategies for AIDS risk reduction in adolescents be developed in Iranian high schools.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Methodological aspects of a GIS-based environmental health inspection program used in the Athens 2004 Olympic and Para Olympic Games.

BACKGROUND: The use of geographical information system (GIS) technologies in public health surveillance is gradually gaining momentum around the world and many applications have already been reported in the literature. In this study, GIS technology was used to help county departments of Public Health to implement environmental health surveillance for the Athens 2004 Olympic and Para Olympic Games. METHODS: In order to assess the workload in each Olympic county, 19 registry forms and 17 standardized inspection forms were developed to register and inspect environmental health items requiring inspection (Hotels, restaurants, swimming pools, water supply system etc), respectively. Furthermore, related databases were created using Epi Info 2002 and a geographical information system (GIS) were used to implement an integrated Environmental Health inspection program. The project was conducted in Athens by the Olympic Planning Unit (OPU) of the National School of Public Health, in close cooperation with the Ministry of Health and Social Solidarity and the corresponding departments of Public Health in all municipalities that were scheduled to host events during the Athens 2004 Olympic and Para Olympic games. RESULTS: A total of 44,741 premises of environmental health interest were geocoded into GIS databases and several electronic maps were developed. Using such maps in association with specific criteria, we first identified the maximum workload required to execute environmental health inspections in all premises within the eleven Olympic County Departments of Public Health. Six different scenarios were created for each county, based on devised algorithms in order to design the most effective and realistic inspection program using the available inspectors from each municipality. Furthermore, GIS applications were used to organize the daily inspection program for the Olympic games, provide coloured displays of the inspection results and link those results with the public health surveillance of specific cases or outbreak investigation. CONCLUSION: Our computerised program exhibited significant efficiency in facilitating the prudent use of public health resources in implementing environmental health inspections in densely populated urban areas as well as in rural counties. Furthermore, the application of simple algorithms in integrating human and other resources provided tailored and cost-effective applications to different public health agencies.

Accidents↗
PubMed1989

Ruptured S1-S2 disc presenting with S2 radiculopathy.

We report the case of a 61-year-old man in whom numbness developed on the right side of the penis, scrotum, and perineum after he jumped into a swimming pool. Magnetic resonance imaging and a computed tomographic scan disclosed a lesion at S1-S2 impinging on the right S2 nerve root. At surgery, ruptured disc material originating in an area normally occupied by the fixed fibrocartilaginous plate was identified and excised. Postoperatively, the numbness resolved. We discuss a possible cause of the rupturing of the sacral disc and recommended treatment by laminectomy and excision, as in other cases of ruptured disc at other levels of the spinal column.

Humans↗
PubMed1999

Reactive airways dysfunction and systemic complaints after mass exposure to bromine.

Occasionally children are the victims of mass poisoning from an environmental contaminant that occurs due to an unexpected common point source of exposure. In many cases the contaminant is a widely used chemical generally considered to be safe. In the following case, members of a sports team visiting a community for an athletic event were exposed to chemicals while staying at a local motel. Bromine-based sanitizing agents and other chemicals such as hydrochloric acid, which were used in excess in the motel's swimming pool, may have accounted for symptoms experienced by the boy reported here and at least 16 other adolescents. Samples of pool water contained excess bromine (8.2 microg/mL; ideal pool bromine concentration is 2-4 microg/mL). Symptoms and signs attributable to bromine toxicity included irritative skin rashes; eye, nose, and throat irritation; bronchospasm; reduced exercise tolerance; fatigue; headache; gastrointestinal disturbances; and myalgias. While most of the victims recovered within a few days, the index case and several other adolescents had persistent or recurrent symptoms lasting weeks to months after the exposure.

Bromine↗
PubMed1996

High-intensity physical training in adults with asthma. A 10-week rehabilitation program.

Twenty-six adults (23 to 58 years) with mild to moderate asthma underwent a 10-week supervised rehabilitation program, with emphasis on physical training. In the first 2 weeks, they exercised daily in an indoor swimming pool (33 degrees C) and received education about asthma, medication, and principles of physical training. In the following 8 weeks, they exercised in the pool twice a week. Every training session lasted 45 min. The training sessions were made as suitable as possible for the individual subjects, in order to minimize "drop outs" from the program. The aim of the study was to evaluate the efficacy of the rehabilitation program and to determine if inactive asthmatic adults can exercise at high intensity. The rehabilitation program was preceded by a 6-min submaximal cycle ergometry test, a 12-min walking test, spirometry, and a methacholine provocation test. The subjects also responded to a five-item questionnaire related to anxiety about exercise, breathlessness, and asthma symptoms using a visual analogue scale. All subjects were able to perform physical training at a very high intensity, to 80 to 90% of their predicted maximal heart rate. No asthmatic attacks occurred in connection with the training sessions. Twenty-two of the 26 subjects completed the rehabilitation program, felt confident with physical training, and planned to continue regular physical training after the 10-week program. Improvements in cardiovascular conditioning, measured as a decreased heart rate at the same load on the cycle ergometer (average of 12 beats/min), and as a longer distance at the 12-min walking test (average of 111 m), were observed during the program. FEV1 increased significantly from 2.2 to 2.5 L. Forced expiratory flow at 25% of vital capacity also increased slightly but significantly. Methacholine provocation dose causing a fall in FEV1 by 20% was unchanged. Seventeen subjects had a peak expiratory flow reduction of more than 15% after the preprogram ergometry test and were classified as having exercise-induced asthma (EIA). Only three of these subjects had EIA after 10 weeks. The asthmatic subjects were less afraid of experiencing breathlessness during exercise and less anxious about exercising at a high intensity after 10 weeks (p < 0.05). The asthma symptoms abated significantly during the rehabilitation program and the subjects needed less acute asthma care after the rehabilitation program. The results indicate that asthmatic persons benefit from a rehabilitation period, including physical training. Rehabilitation programs are therefore of value as a supplement to conventional pharmacologic treatment of asthma. This rehabilitation program can be adapted for use in clinical practice.

Adult↗
PubMed1997

Pulmonary tuberculosis associated with invasive pseudallescheriasis.

A 54-year-old woman with pulmonary tuberculosis developed pneumonia caused by Scedosporium apiospermum, the asexual stage of the fungus Pseudallescheria boydii. Mycobacterium tuberculosis and P boydii were cultured in BAL fluid. The patient cleaned swimming pools in a spa health resort and was highly exposed to fungal conidia. She was successfully treated with antituberculosis drugs, miconazole nitrate and ketoconazole, leading to remission of her pulmonary infection. Invasive pulmonary pseudallescheriasis associated with tuberculosis is an unusual finding, especially in an immunocompetent individual.

Antifungal Agents↗
PubMed1982

Can pulmonary barotrauma cause cerebral air embolism in a non-diver?

It is generally assumed that only the diver exiting a compressed air environment is at risk for the complications of systemic air embolism following pulmonary barotrauma. We present a case of sudden death following a swimming pool dive, with evidence supporting a diagnosis of fatal systemic air embolism.

Adult↗
PubMed2004

Intracellular multiplication of Legionella species and the influence of amoebae on their intracellular growth in human monocytes: mono mac 6 cells and Acanthamoeba castellanii as suitable in vitro models.

Legionellae are important etiological agents of pneumonia. Legionella pneumophila (predominantly serogroup 1) is detected in most cases of legionellosis; other species only occasionally cause infections, predominantly in immunocompromized patients. Aquiferous technical systems are the primary source of infection (air-conditioning systems, refrigerators, showers, whirlpools, springs, taps, moisturizing equipment, medical nebulizers, and swimming pools). Legionellae are present in the water in these systems, within the amoebae, flagellates, and ciliates in which they replicate. After inhalation of contaminated aerosols, the bacteria multiply intracellularly within alveolar macrophages. The ability to multiply within monocytic host cells is usually considered to correspond to pathogenicity. The mechanisms of intracellular replication have been only partially characterized. Analysis of the molecular pathogenesis of Legionella infection, both in the pathogen itself and in the host cell, is the subject of current research and may lead to new options in prophylaxis and treatment. We have established the human Mono Mac 6 cell line (MM6) instead of the previously used histiocytic lymphoma cell line U 937 or the promyelocytic leukemia cell line HL-60 to investigate the intracellular replication of legionellae and the molecular pathogenesis of Legionella infection within human monocytic host cells. MM6 cells represent a more mature macrophage-like cell line that expresses phenotypic and functional properties of mature monocytes and that does not need to be stimulated by phorbol esters or 1,25-dihydroxyvitamin D3. A good correlation between the prevalence of a given Legionella species and its intracellular multiplication in MM6 cells could be demonstrated.In addition to Legionella, MM6 cells were found to support the intracellular growth of Mycobacterium tuberculosis and Chlamydia pneumoniae, two other important bacterial agents involved in induction of pneumonia. Therefore, the MM6 model might be adaptable to investigations of the molecular pathogenesis of other intracellular bacteria that can replicate within human monocytes and induce disease.

Acanthamoeba↗
PubMed1984

Shoulder-out immersion in pregnant women.

In the laboratory, water immersion or lower body positive pressure produces significant diuresis and natriuresis. Shoulder-out immersion appeared to induce significant diuresis and natriuresis in 42 pregnant women who were exercising in swimming pools. Lower body positive pressure (pressure calf sleeves) or Hubbard tanks (bathtubs) was not associated with increased renal function. In selected pregnant women with abnormal water distribution, shoulder-out immersion may prove to be effective therapy.

Blood Pressure↗
PubMed2003

Exploration of a variation of the bottle buoyancy technique for the assessment of body composition.

Hydrostatic weighing has long been recognized as a reliable and valid method for the assessment of body composition. An alternative method known as bottle buoyancy (BB) was introduced by Katch, Hortobagyi, and Denahan in 1989. The purpose of this clinical investigation was to determine the accuracy of the BB technique using an 11-L container. Sixteen individuals (8 men, 8 women) were weighed hydrostatically using a chair/scale and the BB technique. The overall intraclass correlation coefficient for the two techniques was 0.9537. A 2-variable ANOVA was significant for gender but not for technique, and there was no interaction between variables. Thus, the BB technique appears to be an accurate substitute for the chair/scale technique for hydrostatic weighing. The BB method does not involve elaborate equipment and is portable. It could be improved with the use of multiple bottles of various volumes or a calibrated bottle to minimize the number of trials needed for accurate measurements. BB is a valuable, simple clinical tool for assessing body composition based on the principles of hydrostatic weighing and can be performed in any high school, college, or community swimming pool.

Adult↗
PubMed1976

Effect of cold-exposure on serum thyrotrophin levels in man.

Serum TSH levels were measured after exposing male volunteers to cold, or successively to warmth and to cold, causing clear changes in body temperature. Very moderately heated Finnish sauna bath increased body temperature to about an average of 39 degrees C, and cooling in a relatively warm swimming pool (+25 to +28 degrees C, 30 min) decreased body temperature to below 35 degrees C after sauna, and to about 33 degrees C without sauna. In both cases a slight but significant initial increase of serum TSH was demonstrated. No changes in serum T3 or ETR were seen. The results suggest that a similar mechanism of initial TSH response may exist in humans as has previously been demonstrated in rats.

Adult↗
PubMed1987

[Evaluation of diving stress implication of analysis of work loads].

An investigation was conducted on the actual diving conditions of 2,996 divers in Japan except those engaged in fishery. Results of analysis made on the diving profiles and actual working conditions showed that some of their jobs required heavy load and that the burden was excessively large. Little study has been made for the proper evaluation of diving stress or work loads, but it has been assumed from these limited studies that the load is not so heavy. The load has been generally estimated to be about 1.8l/min STPD of oxygen consumption (VO2) during 40 l/min STPD of expiratory gas volume/min (VE). In our examination of their actual diving work, their work load was far greater than our expectation. It was in practice not only difficult to obtain the actual VO2 but also very difficult to determine their actual fatigue. Instead of these, it is necessary to establish an adequate index for evaluating diving work load. Studies have been made in our laboratory since 1981 and regression equations have been finally obtained, by which load during diving work can be determined using heart rate as index. Seven healthy males were chosen as subjects of the present study having a mean age of 34.4 yr and a mean diving history of 7.3 yr. First, performance time was acquired in each subject by bicycle ergometer exercise and the maximalen oxygen consumption (VO2-max) was obtained. In the second step, VO2-max was obtained by using the regulator apparatus for breathing during SCUBA diving. This value was 86.1% of the first step. The third step was made in a swimming pool.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2003

Prevention of drowning in infants, children, and adolescents.

Drowning is a leading cause of injury-related death in children. In 2000, more than 1400 US children younger than 20 years drowned. Most (91%) of these deaths were unintentional and were not related to boating. For each drowning death, it is estimated that at least 1 to 4 children suffer a serious nonfatal submersion event, many of which leave children with permanent disabilities. Environmental strategies, such as installation of 4-sided fences around swimming pools, and behavioral strategies, such as increased supervision of children while around water, are needed to prevent these tragedies.

Adolescent↗
PubMedDate not supplied

[Knowledge and practice of adolescents in the prevention of sexually transmitted diseases].

This study aims at evaluating the knowledge of adolescents regarding the prevention and transmission of DST's, HIV/AIDS. It was carried out in a school in the city of Canoas/RS. 121 students, with age between 12-19 participated in the study. According to the interviews 22.3% said that their sexual life starts at the age between 12 and 16. Student's knowledge regarding the transmission of DST's is evident, since 79% of the students pointed out that those diseases are transmitted through sexual contact if there is no use of condoms. However some myths and stereotypes related to these disease were also identified. 16.3% of the adolescents believe that contamination can occur in bathrooms, swimming pools and saunas.

Adolescent↗
PubMedDate not supplied

[Nosocomial and community outbreak of epidemic keratoconjunctivitis in Navarra in 1996].

BACKGROUND: Epidemic keratoconjunctivitis is an acute, generally bilateral infection, that appears sporadically or in outbreaks from a source of common infection which may be a visit to the ophthalmologist or a swimming pool. Keratitis may evolve to form sub-epithelial injuries in the cornea lasting as much as several months. METHODS: Description of an outbreak of epidemic keratoconjunctivitis that took place in Navarra (Spain) between April and August 1996 and which affected at least 266 people. RESULTS: The epidemiological research highlights the existence of two ophthalmologist consulting rooms as the transmission mechanism for the infection in 46 of the 116 patients researched. The spread of the infection in the environment of the patients was recorded in 119 cases, 62 of which are considered secondary cases. The aetiological diagnosis of the outbreak was carried out 11 days after the start of the microbiological research, isolating adenovirus in conjunctival samples of 8 of the 19 patients researched. CONCLUSIONS: The preventive measures taken to control the outbreak and their effectiveness was highlighted by the gradual reduction in cases.

Adenovirus Infections, Human↗
PubMed2001

Discovery, distribution, and abundance of the newly introduced mosquito Ochlerotatus japonicus (Diptera: Culicidae) in Connecticut, USA.

The earliest documented specimen of an exotic east Asian mosquito Ochlerotatus (Finlaya) japonicis japonicus (Theobald) in the Western Hemisphere is reported along with the results of a state wide survey to determine the distribution and abundance of this mosquito in Connecticut. Ochlerotatus japonicus was collected from 87 locations in eight counties. It is established throughout the state and occurs in a variety of natural and artificial container habitats including discarded tire casings, bird baths, wooden barrels, porcelain bath tubs (used for watering animals), plastic milk cartons, toys, vinyl tarpaulins (covering wood piles and swimming pools), exposed rock holes in stream beds, tree holes, subterranean catch basins, surface water rain pools, and spring-fed depressions. Larvae were particularly common in containers with water, decaying leaves, and algae, in shaded and sunlit areas and, in rock-pool habitats along streambeds, in association with Ochlerotatus atropalpus (Coquillett). Adult females were collected in sod grass-infused gravid and CO2- baited light traps, from early June through October, with peak collections in September. Biting females were collected by human bait method augmented with CO2, verifying its capacity to feed on humans. The ovitraps used in this study were not effective for recovering this species. Our results suggest that Oc. japonicus was introduced into Connecticut between 1992 and 1998. Because of the ability of Oc. japonicus to transmit West Nile virus, and because of the recent detection of this virus in field-collected specimens, the introduction of Oc. japonicus is considered a significant public health development.

Animals↗