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PubMed1999

Snow-related recreational injuries in children: assessment of morbidity and management strategies.

PURPOSE: The aim of this study was to investigate the causes, clinical course, and financial impact of snow-related sport injuries in children. METHODS: Reports of snow-related injuries (skiing, toboganning, snowboarding) occurring in 147 consecutive children (< or =16 years of age) admitted from 1991 through 1997 were collected prospectively and assessed retrospectively. During the last year of the study, outpatients treated and released from the emergency department (1996 through 1997) were examined in parallel (n = 101). Total financial impact was determined from the aggregate hospital, rehabilitation, and societal costs. RESULTS: One hundred thirty-seven patients (M:F, 2:1; mean age, 13 yrs) were admitted (toboggan [n = 74], ski [n = 59], snowboard [n = 16]), of which 66% occurred at licensed resorts, and 33% at parks or private property. There was one death. Although the pattern of injury was similar in all groups (head greater than long bone greater than intraabdominal injuries), mean injury severity scores (ISS) were significantly higher for snowboard injuries. Seventy-five percent of patients required at least one operation. Postdischarge, 15% of patients required institutional care. Of the 101 ambulatory patients (ski [n = 48], toboggan [n = 35], snowboard [n = 18]), 65% were injured at licensed resorts, and 56% required outpatient rehabilitation or home care. The per-patient costs were: hospital treatment, $27,936; outpatient services, $15,243; lost parental income, $1,500. CONCLUSIONS: Snow sport injuries, particularly snowboarding, cause severe childhood morbidity. Helmet usage, training requirements, and regulation of licensed resorts may reduce the morbidity and staggering costs.

Adolescent↗
PubMedDate not supplied

Eye injuries in athletics and recreation.

Sports-related eye injuries represent a significant eye health hazard worldwide. In the USA, it is estimated that eye injuries from sports account for more than 100,000 physician visits per year at the cost of greater than $175 million. The sports responsible for the greatest number of injuries are baseball, ice hockey, and racquet sports. In the USA there are over 189 million participants in these sports with a disproportionate number (one-third) of injuries involving the pediatric population. The most common injuries are abrasions and contusions, followed by more serious injuries, including hyphema. Substantial reduction in the incidence of eye injuries through prevention has been demonstrated in the sport of hockey which can serve as a model for other sports. Specific criteria for protective eyewear must be developed. Polycarbonate plastic lenses and frames which are sturdy and impact resistant provide optimal protection. Lensless goggles, street wear and spectacle correction glasses do not provide adequate eye protection. The ophthalmologist's role in preventing sports-related eye injuries includes addressing particular sports participants needs, identifying one-eyed athletes, and informing patients of the need for protective eyewear.

Athletic Injuries↗
PubMed2002

Quantitative risk assessment of human infection from Escherichia coli O157 associated with recreational use of animal pasture.

A quantitative microbial risk assessment incorporating Monte Carlo simulations is described which estimates the probability of Escherichia coli O157 infection of humans by visiting pasture previously grazed by cattle. The risk assessment is performed for a number of scenarios including a variation in the grazing period prior to the human visit, the duration of visit (8-h day or 24-h camp) and the level of E. coli O157 shed by the cattle. Assuming the cattle have been on the field for 28 days, followed directly by a human visit, and the proportion of animals shedding the organism are as described in previous surveys 5 +/- 1% (Synge, B.A., Gunn, G.J., Ternent, H.E., Hopkins, G.F., Thomson-Carter, F., Foster, G., Chase-Topping, M., McKendrick, I., 2001). Prevalence and factors affecting the shedding of verocytotoxin producing Escherichia coli O157 in beef cattle in Scotland. In: Concerted Action CT98-3935 Veroctotoxigenic E. coli in Europe, 5. Epidemiology of Verocytotoxigenic E. coli, Dublin, pp. 98-103.), a probability of infection of 0.1% is attained for 8- and 24-h periods when the cattle are shedding approximately 10(3) and 10(4) CFU g(-1), respectively. Monte Carlo simulations demonstrated that risk mitigation strategies of removing cattle from the pasture 4 weeks prior to the human visit in addition to physical removal of faeces showed significant reductions in potential infection rates.

Animals↗
PubMed2002

Synaptotagmin I and IV are differentially regulated in the brain by the recreational drug 3,4-methylenedioxymethamphetamine (MDMA).

3,4-Methylenedioxymethamphetamine (MDMA or Ecstasy) is a widely abused drug. In brains of mice exposed to MDMA, we recently detected altered expression of several cDNAs and genes by using the differential display polymerase chain reaction (PCR) method. Expression of one such cDNA, which exhibited 98% sequence homology with the synaptic vesicle protein synaptotagmin IV, decreased 2 h after MDMA treatment. Herein, the effect of MDMA on expression of both synaptotagmin I and IV was studied in detail, since the two proteins are functionally interrelated. PCR analyses (semi-quantitative and real-time) confirmed that upon treatment with MDMA, expression of synaptotagmin IV decreased both in the midbrain and frontal cortex of mice. Decreases in the protein levels of synaptotagmin IV were confirmed by Western immunoblotting with anti-synaptotagmin IV antibodies. In contrast, the same exposure to MDMA increased expression of synaptotagmin I in the midbrain, a region rich in serotonergic neurons, but not in the frontal cortex. This differential expression was confirmed at the protein level with anti-synaptotagmin I antibodies. MDMA did not induce down- or up-regulation of synaptotagmin IV and I, respectively, in serotonin transporter knockout mice (-/-) that are not sensitive to MDMA. Therefore, psychoactive drugs, such as MDMA, appear to modulate expression of synaptic vesicle proteins, and possibly vesicle trafficking, in the brain.

Animals↗
PubMed1999

Injuries in a 1-day recreational cycling tour: Bike New York.

STUDY OBJECTIVE: To describe injuries during a 1-day urban cycling tour. METHODS: During the May 1996 "Bike New York" tour, we monitored EMS calls to identify injuries in a cohort of helmeted cyclists shielded from traffic. We collected demographic information from entry records, injury data from ambulance call reports, and follow-up on transported patients from telephone interviews with emergency physicians. Data were summarized using proportions, relative risks (RRs), 95% confidence intervals (CIs), and chi2 RESULTS: Approximately 28,000 cyclists participated, of which 23,502 (84%) were officially registered. Sixty-eight percent of registered bicyclists were male, and 92% were between 18 and 55 years old. Of the 140 EMS calls made during the tour, 136 (97%) involved participants; this yielded an injury incidence of 5 per 1,000 riders, or 12 to 13 per 100,000 person-miles. Injury was more common among younger cyclists (RR=1.4 for age </=35 years versus age >35 years; 95% CI, 1.0 to 2.0; P <.05), and possibly women (RR=1.3; 95% CI,.9 to 1.8; P =.11). Injuries were mostly minor, but there were 7 concussions and 6 clavicle fractures; none of the 140 injuries was fatal. Thirty-eight calls resulted in ED transport, and 5 of these patients were admitted. Although EMS units were evenly distributed along the route, most EMS calls occurred in only 3 of the 7 zones (P <.001). CONCLUSION: Injuries during the largest 1-day US cycling tour were uncommon. More data are needed to determine the relative importance of injury risk factors. Data collection during mass events may help guide distribution of EMS personnel.

Adolescent↗
PubMed2000

Anabolic-androgenic steroid use disorders among a sample of Australian competitive and recreational users.

Illicit anabolic-androgenic steroid (AAS) use, for body building and body image purposes, is increasing internationally. This study describes the prevalence and symptoms of AAS use disorders obtained using a semi-structured interview among a mixed-gender sample of 100 current Australian users, that were recruited from a variety of sources. The median age of the sample was 27 years and 94% were male. The full range of DSM IV symptoms of AAS abuse and dependence were reported and over three quarters (78%) of the sample exhibited at least one symptom of abuse or dependence on AAS. A total of 23% of the participants qualified for a diagnosis of AAS dependence using DSM IV criteria and a further 25% met criteria for AAS abuse. There were no gender differences in AAS abuse or dependence diagnoses. The only variable related to an AAS substance use disorder was reporting the experience of AAS-related aggression, which may be a useful clinical indicator of the disorder.

Adolescent↗