Unusual nerve injuries in recreational activities.
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The aging process predisposes man to a greater concern for and sensitivity to his health and fitness. Regular exercise can improve and maintain an individual's general health regardless of the fitness level at the onset of the exercise regimen. We have noted that age does not significantly reduce the benefits (trainability) attained from exercise; however, it does appear that a prolonged sedentary lifestyle will diminish the fitness level that can be achieved. Cardiopulmonary fitness is primarily a function of the oxygen transport system and, therefore, is monitored by determining maximal aerobic capacity (VO2max). The VO2max is a highly reproducible parameter related to cardiac output and the arteriovenous oxygen difference. Exercise conditioning can improve the VO2max by augmenting both the cardiac output and the oxygen extraction within the capillaries. Resting stroke volume is increased by a conditioning effect and resting bradycardia is common. Changes in total peripheral resistance (TPR) and blood pressure are not as readily demonstrable. To produce a conditioning effect and maintain fitness it is recommended that dynamic exercise at intensities of 60 to 90% of the maximum heart rate reserve for at least 15 minutes should be performed at least 3 days/week. The total work load (as a function of intensity and duration) appears to be the most important criterion for producing a conditioning effect. Proper testing and evaluation is necessary for a clinician in prescribing an exercise program that is safe and effective. With the middle-aged individual precautions must be taken to discern any risks for a cardiovascular event or structural injury.
Bilateral rupture of the infrapatellar tendons is a rare event in an otherwise healthy athletic individual. The event is usually quite severe and diagnosis can be readily made on a clinical examination. In the case presented here, predisposing factors consisted of an underlying patella alta and a long history of repetitive trauma to the knee. Prompt diagnosis and surgical repair will lead to a good functional result.
Lower extremity equipment-related injuries are the most significant injury group in alpine skiing. The lower extremity equipment-related injuries occurring at four Norwegian ski resorts were studied during the winter of 1985 to 1986. A total of 132 skiers with injuries were included (40% of all injured skiers) and compared with a randomly selected control population of 316 uninjured skiers. The most common lower extremity equipment-related injuries were knee sprains (56%) and lower leg fractures (14%), usually caused by no or late binding release. Significantly more lower extremity equipment-related injuries (33%) than other skiing injuries (19%) needed hospital admittance. Children below 10 years had a risk of lower leg fractures nine times that of skiers beyond 20 years. Beginners were six times more at risk for a lower extremity equipment-related injury than skiers of higher skiing abilities. The following factors were also associated with a significantly increased risk for a lower extremity equipment-related injury: less than three skiing seasons, no skiing instruction, and no self-testing of the bindings.
The current study reviews the personal characteristics of 32 consecutive admissions to a secure custody centre in one southwest Ontario jurisdiction under the Young Offenders Act. Results indicated that there was considerable variability amongst the group regarding court history and the seriousness of the charge on which committal was made. Background history data suggested that the problems of youths committed to secure custody reflect considerable difficulties within families and school. The discussion questions whether the youths in this group are better served through the dispositions emphasizing custody-deterrence or rehabilitation-treatment. Implications for young offender policy are also presented.
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In this study, the immediate effects (within 10 minutes) of age- and stage-appropriate activities and two control activities were observed in 56 dementia sufferers. Compared with the control activities, the two experimental treatment conditions elicited greater reductions in agitation and negative emotion and increases in positive emotion and duration of activity. Stage-appropriate activity was superior to age-appropriate activity in increasing positive emotion and had about the same effect in reducing negative emotion and agitation. The study also addressed the idea that people with Alzheimer's disease may regress through Piaget's stages of cognitive development and thus display the play interests associated with each stage. There was a significant relationship between cognitive level and type of Piagetian play observed; however, Piaget's descriptions of play were not entirely appropriate for persons with with Alzheimer's disease.
The purpose of this investigation was to define homogeneous personality subtypes among substance abusers treated in a long-term, inpatient, drug-free therapeutic community and to determine how the resulting typology was related to length of stay and treatment outcome. A hierarchical agglomerative cluster analysis was performed on the Millon Clinical Multiaxial Inventory (MCMI) scale scores of 235 admissions to a therapeutic community. Five cluster types emerged, which were similar to typologies found in studies with alcoholic inpatients. A concordant solution evolved when a different clustering algorithm was used with the same sample and when clustering was done with a different group of substance abusers. As hypothesized, clusters of patients with average MCMI elevations that indicated avoidant, schizoid, and antisocial qualities tended to stay in treatment fewer days and relapsed earlier during the 1-year follow-up. The implications for substance abuse treatment are discussed.
The midcycle surge of LH and FSH is critical for final oocyte maturation and ovulation. In normal women, this gonadotropin surge follows a gradual increase in estradiol levels (E) and is concomitant with a small increase in progesterone (P) levels. However, whether sex steroids alone are sufficient to induce the complex neuroendocrine interactions underlying this switch from negative to positive feedback is unknown. In this study, physiological midcycle levels of E, with and without periovulatory levels of P (E+P and E, respectively) were infused into 18 normally cycling women in their early to midfollicular phases. The resulting sex-steroid-induced gonadotropin responses were then compared with 118 spontaneous midcycle surges in 81 normal women. The sex steroid levels achieved by the infusions were within the normal ranges for the spontaneous midcycle surge. However, neither women who received E alone nor those who received E+P had LH responses that achieved those of spontaneous LH surges in the normal menstrual cycle (NMC) [82.7 +/- 16.23 IU/L E (mean +/- SEM), 69.7 +/- 12.01 IU/L E+P vs. 121.7 +/- 6.23 IU/L NMC, P < 0.05 E and P < 0.005 E+P vs. NMC]. In contrast, peak FSH levels evoked by E and P matched the spontaneous FSH peaks (19.0 +/- 2.1 IU/L E, 24.5 +/- 4.0 IU/L E+P vs. 23.3 +/- 0.9 IU/L NMC, P = 0.07 E and P = 0.71 E+P vs. NMC). In conclusion, sex steroids alone do not seem to be sufficient to stimulate the normal midcycle LH surge. We hypothesize that other ovarian factors, which are missing in the midfollicular phase, are required for the generation of the normal midcycle surge of LH.
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Environmental monitoring and public health risk assessments require methods that are rapid and quantitative with defined sensitivity and specificity thresholds. Although several molecular techniques have been developed to rapidly detect bacteria in complex matrices, the challenge to simultaneously detect and enumerate only viable cells remains a limiting factor to their routine application. This chapter describes the use of peroxidase-labeled peptide nucleic acid (PNA) probes to simultaneously detect and count live Staphylococcus aureus, a human pathogen in sea water and beach sand. Mixed bacteria from the environmental sample were immobilized on polyvinylidene difluoride membrane filters and allowed to form microcolonies during a 5-h incubation on Tryptic soy agar plates. PNA probes targeting species-specific regions of the 16S rRNA sequences of S. aureus were then used to hybridize the target bacteria in situ. Probes were detected by capturing chemiluminiscence on instant (e.g., Polaroid) films. Each viable cell (i.e., rRNA producing) is detected as a light spot from its microcolony on the film after scanning the image into a computer. This rapid in situ hybridization technique is simple and highly sensitive and could be developed into portable kits for monitoring pathogens and indicators in the environment.
With the use of nitrous oxide increasing, overuse and excessive exposure to this gas are also more prevalent. Neuropathy, expressed as amnesia, aphasia or weakness, numbness, and incoordination affecting all extremities, is the common result of frequent overexposure. For optimal dental treatment, it is recommended that both patient and dentist be aware that nitrous oxide can be an exogenous toxin, damaging to neuronal structures, if used in excess.
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OBJECTIVES: This study evaluated a health-related physical education program for fourth- and fifth-grade students designed to increase physical activity during physical education classes and outside of school. METHODS: Seven schools were assigned to three conditions in a quasi-experimental design. Health-related physical education was taught by physical education specialists or trained classroom teachers. Students from these classes were compared with those in control classes. Analyses were conducted on 955 students with complete data. RESULTS: Students spent more minutes per week being physically active in specialist-led (40 min) and teacher-led (33 min) physical education classes than in control classes (18 min; P < .001). After 2 years, girls in the specialist-led condition were superior to girls in the control condition on abdominal strength and endurance (P < .001) and cardiorespiratory endurance (P < .001). There were no effects on physical activity outside of school. CONCLUSIONS: A health-related physical education curriculum can provide students with substantially more physical activity during physical education classes. Improved physical education classes can potentially benefit 97% of elementary school students.
We compared rates of reported health symptoms among surfers in urban North Orange County (NOC) and rural Santa Cruz County (SCC), California, during 2 winters (1998 and 1999) to determine whether symptoms were associated with exposure to urban runoff. NOC participants reported almost twice as many symptoms as SCC participants during the 1998 winter. In both study years, risk increased across symptom categories by an average of 10% for each 2.5 hours of weekly water exposure. Our findings suggest that discharging untreated urban runoff onto public beaches can pose health risks.
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