Heiderscheit, Bryan C.; Sherry, Marc A.; Silder, Amy; Chumanov, Elizabeth S.; Thelen, Darryl G.
Synopsis Hamstring strain injuries remain a challenge for both athletes and clinicians given the high incidence rate, slow healing, and persistent symptoms. Moreover, nearly one-third of these injuries recur within the first year following a return to sport, with subsequent injuries often being more severe than the original. This high reinjury rate suggests that commonly utilized rehabilitation programs may be inadequate at resolving possible muscular weakness, reduced tissue extensibility, and/or altered movement patterns associated with the injury. Further, the traditional criteria used to determine the readiness of the athlete to return to sport may be insensitive to these persistent deficits, resulting in a premature return. There is mounting evidence that the risk of reinjury can be minimized by utilizing rehabilitation strategies that incorporate neuromuscular control exercises and eccentric strength training, combined with objective measures to assess musculotendon recovery and readiness to return to sport. In this paper, we first describe the diagnostic examination of an acute hamstring strain injury, including discussion of the value of determining injury location in estimating the duration of the convalescent period. Based on the current available evidence, we then propose a clinical guide for the rehabilitation of acute hamstring injuries including specific criteria for treatment progression and return to sport. Finally, we describe directions for future research including injury-specific rehabilitation programs, objective measures to assess reinjury risk, and strategies to prevent injury occurrence. Level of evidence: Diagnosis/therapy, level 5. PMID:20118524
Opar, David A; Williams, Morgan D; Shield, Anthony J
Hamstring strain injuries (HSIs) are common in a number of sports and incidence rates have not declined in recent times. Additionally, the high rate of recurrent injuries suggests that our current understanding of HSI and re-injury risk is incomplete. Whilst the multifactoral nature of HSIs is agreed upon by many, often individual risk factors and/or causes of injury are examined in isolation. This review aims to bring together the causes, risk factors and interventions associated with HSIs to better understand why HSIs are so prevalent. Running is often identified as the primary activity type for HSIs and given the high eccentric forces and moderate muscle strain placed on the hamstrings during running these factors are considered to be part of the aetiology of HSIs. However, the exact causes of HSIs remain unknown and whilst eccentric contraction and muscle strain purportedly play a role, accumulated muscle damage and/or a single injurious event may also contribute. Potentially, all of these factors interact to varying degrees depending on the injurious activity type (i.e. running, kicking). Furthermore, anatomical factors, such as the biarticular organization, the dual innervations of biceps femoris (BF), fibre type distribution, muscle architecture and the degree of anterior pelvic tilt, have all been implicated. Each of these variables impact upon HSI risk via a number of different mechanisms that include increasing hamstring muscle strain and altering the susceptibility of the hamstrings to muscle damage. Reported risk factors for HSIs include age, previous injury, ethnicity, strength imbalances, flexibility and fatigue. Of these, little is known, definitively, about why previous injury increases the risk of future HSIs. Nevertheless, interventions put in place to reduce the incidence of HSIs by addressing modifiable risk factors have focused primarily on increasing eccentric strength, correcting strength imbalances and improving flexibility. The response to these intervention programmes has been mixed with varied levels of success reported. A conceptual framework is presented suggesting that neuromuscular inhibition following HSIs may impede the rehabilitation process and subsequently lead to maladaptation of hamstring muscle structure and function, including preferentially eccentric weakness, atrophy of the previously injured muscles and alterations in the angle of peak knee flexor torque. This remains an area for future research and practitioners need to remain aware of the multifactoral nature of HSIs if injury rates are to decline. PMID:22239734
Wisconsin at Madison, University of
. Bilateral comparisons were made for peak knee flexion torque, angle of peak torque, and the hamstrings:quadriceps used to measure the volumes of the proximal tendon/aponeurois of the biceps femoris, with asymmetries considered indicative of scar tissue. Findings: A significantly enlarged proximal biceps femoris tendon
On the basis of research, the following characteristics appear to be important factors relative to precluding hamstring strains in sprinters: bilaterality relative to hamstring and quadricep strength development, optimum strength ratios between ipsilateral antagonists throughout the range of movement, and above-normal hip-joint flexibility. (JD)
Small, K; McNaughton, L; Greig, M; Lovell, R
The purpose of this work was to investigate the effect of multidirectional soccer-specific fatigue on hamstring muscle strength and angle of peak torque. Sixteen male semi-professional soccer players (mean+/-S.D.: age: 21.3+/-2.9 years; height 185.0+/-8.7 cm; body mass 81.6+/-6.7 kg) completed the SAFT(90), a multidirectional, intermittent 90-min exercise protocol based on data from English Championship soccer matches. Prior to exercise (t(0)), at half-time (t(45)) and post-exercise (t(105)), subjects performed three maximal dominant limb isokinetic contractions (Biodex, System 3) at 120 degrees s(-1) through a 90 degrees range for concentric and eccentric knee flexors and concentric knee extensors. Analysis of variance revealed significant time dependant reductions in gravity corrected eccentric hamstring peak torque, and consequently in the functional hamstring:quadriceps ratio (P<0.01). Eccentric hamstring peak torque decreased significantly during each half (t(0): 272.0+/-43.2; t(45): 240.4+/-43.3; t(105): 226.3+/-45.7 Nm). The functional hamstring:quadriceps ratio also decreased significantly during each half (t(0): 116.6+/-21.2; t(45): 107.1+/-17.6; t(105): 98.8+/-20.3%). There were no significant changes in concentric hamstring or quadriceps peak torque observed during SAFT(90) (P>0.05). Data analysis also revealed significant differences for Angle of Peak Torque for eccentric hamstrings (P<0.05) which was significantly higher at the end of each half (t(45): 37+/-15; t(105): 38+/-18 degrees ) than the pre-exercise value (t(0): 28+/-12 degrees ). There was a time dependant decrease in peak eccentric hamstring torque and in the functional strength ratio which may have implications for the increased predisposition to hamstring strain injury during the latter stages of match-play. PMID:18976956
Barreira, P; Drust, B; Robinson, M A; Vanrenterghem, J
Hamstring injuries constitute one of the most concerning injuries in English Premier League football, due to its high primary incidence but also its recurrence. Functional methods assessing hamstring function during high-risk performance tasks such as sprinting are vital to identify potential risk factors. The purpose of this study was to assess horizontal force deficits during maximum sprint running on a non-motorized treadmill in football players with previous history of hamstring strains as a pre-season risk-assessment in a club setting. 17 male football players from one Premier League Club were divided into 2 groups, experimental (n=6, age=24.5±2.3 years) and control (n=11, age=21.3±1.2 years), according to history of previous hamstring injury. Participants performed a protocol including a 10-s maximum sprint on a non-motorized treadmill. Force deficits during acceleration phase and steady state phases of the sprint were assessed between limbs and between groups. The main outcome measures were horizontal and vertical peak forces during the acceleration phase or steady state. There were no significant differences in peak forces between previously injured and non-injured limbs, or between groups, challenging the ideas around functional force deficits in sprint running as a diagnostic measure of hamstring re-injury risk. PMID:25700101
P. Renström; S. W. Arms; T. S. Stanwyck; R. J. Johnson; M. H. Pope
The objectives of this study were to measure strain in the ACL during simulated: (1) hamstring activity alone, (2) quadriceps activity alone, and (3) simultaneous quadriceps and hamstring activity. Seven knee speci mens removed from cadavers were studied. Heavy sutures applied to load cells were attached to the hamstring and quadriceps tendons. Loads were then applied manually (hamstrings) and\\/or with
SUN, YULIANG; WEI, SHUTAO; ZHONG, YUNJIAN; FU, WEIJIE; LI, LI; LIU, YU
ABSTRACT Purpose The potential mechanisms of hamstring strain injuries in athletes are not well understood. The study, therefore, was aimed at understanding hamstring mechanics by studying loading conditions during maximum-effort overground sprinting. Methods Three-dimensional kinematics and ground reaction force data were collected from eight elite male sprinters sprinting at their maximum effort. Maximal isometric torques of the hip and knee were also collected. Data from the sprinting gait cycle were analyzed via an intersegmental dynamics approach, and the different joint torque components were calculated. Results During the initial stance phase, the ground reaction force passed anteriorly to the knee and hip, producing an extension torque at the knee and a flexion torque at the hip joint. Thus, the active muscle torque functioned to produce flexion torque at the knee and extension torque at the hip. The maximal muscle torque at the knee joint was 1.4 times the maximal isometric knee flexion torque. During the late swing phase, the muscle torque counterbalanced the motion-dependent torque and acted to flex the knee joint and extend the hip joint. The loading conditions on the hamstring muscles were similar to those of the initial stance phase. Conclusions During both the initial stance and late swing phases, the large passive torques at both the knee and hip joints acted to lengthen the hamstring muscles. The active muscle torques generated mainly by the hamstrings functioned to counteract those passive effects. As a result, during sprinting or high-speed locomotion, the hamstring muscles may be more susceptible to high risk of strain injury during these two phases. PMID:24911288
Ross Clark; Adam Bryant; John-Paul Culgan; Ben Hartley
ObjectivesAlthough previous research shows that the hamstring length–tension relationship during eccentric contractions plays a role in hamstring injury, training methods to promote beneficial adaptations are still unclear. The purpose of this pilot study was to determine whether an eccentric hamstring specific training programme results in favourable adaptations.
Wayne Hoskins; Henry Pollard
Hamstring injuries are the most prevalent muscle injury in sports involving rapid acceleration and maximum speed running. Injury typically occurs in an acute manner through an eccentric mechanism at the terminal stages of the swing phase of gait. Biceps femoris is most commonly injured. Re-injury rates are high and management is a challenge given the complex multi-factorial aetiology. The high
Reurink, Gustaaf; Goudswaard, Gert Jan; Tol, Johannes L; Almusa, Emad; Moen, Maarten H; Weir, Adam; Verhaar, Jan A N; Hamilton, Bruce; Maas, Mario
Background Previous studies have shown that MRI of fresh hamstring injuries have diagnostic and prognostic value. The clinical relevance of MRI at return to play (RTP) has not been clarified yet. The aim of this study is to describe MRI findings of clinically recovered hamstring injuries in amateur, elite and professional athletes that were cleared for RTP. Methods We obtained MRI of 53 consecutive athletes with hamstring injuries within 5?days of injury and within 3?days of RTP. We assessed the following parameters: injured muscle, grading of injury, presence and extent of intramuscular signal abnormality. We recorded reinjuries within 2?months of RTP. Results MRIs of the initial injury showed 27 (51%) grade 1 and 26 (49%) grade 2 injuries. Median time to RTP was 28?days (range 12–76). On MRI at RTP 47 athletes (89%) had intramuscular increased signal intensity on fluid-sensitive sequences with a mean longitudinal length of 77?mm (±53) and a median cross-sectional area of 8% (range 0–90%) of the total muscle area. In 22 athletes (42%) there was abnormal intramuscular low-signal intensity. We recorded five reinjuries. Conclusions 89% of the clinically recovered hamstring injuries showed intramuscular increased signal intensity on fluid-sensitive sequences on MRI. Normalisation of this increased signal intensity seems not required for a successful RTP. Low-signal intensity suggestive of newly developed fibrous tissues is observed in one-third of the clinically recovered hamstring injuries on MRI at RTP, but its clinical relevance and possible association with increased reinjury risk has to be determined. PMID:24255767
Withrow, Thomas J.; Huston, Laura J.; Wojtys, Edward M.; Ashton-Miller, James A.
Background: The hamstring muscles are well positioned to limit both anterior tibial translation and anterior cruciate ligament strain during the knee flexion phase of a jump landing. We hypothesized that systematically increasing or decreasing hamstring tension during the knee flexion phase of a simulated jump landing would significantly affect peak relative strain in the anterior cruciate ligament. Methods: Ten cadaveric knees from four male and six female donors (mean age [and standard deviation] at the time of death, 60.3 ± 23.6 years) were mounted in a custom fixture to initially position the specimen in 25° of knee flexion and simulate axial impulsive loading averaging 1700 N to cause an increase in knee flexion. Quadriceps, hamstring, and gastrocnemius muscle forces were simulated with use of pretensioned linear springs, with the tension in the hamstrings arranged to be increased, held constant, decreased, at “baseline,” or absent during knee flexion. Impulsive loading applied along the tibia and femur was monitored with use of triaxial load transducers, while uniaxial load cells monitored quadriceps and medial and lateral hamstring forces. Relative strain in the anterior cruciate ligament was measured with use of a differential variable reluctance transducer, and tibiofemoral kinematics were measured optoelectronically. For each specimen, anterior cruciate ligament strains were recorded over eighty impact trials: ten preconditioning trials, ten “baseline” trials involving decreasing hamstring tension performed before and after three sets of ten trials conducted with increasing hamstring tension, constant hamstring tension, or no hamstring tension. Peak relative strains in the anterior cruciate ligament were normalized for comparison across specimens. Results: Increasing hamstring force during the knee flexion landing phase decreased the peak relative strain in the anterior cruciate ligament by >70% compared with the baseline condition (p = 0.005). Neither a constant hamstring muscle force nor the absence of a hamstring force significantly changed the peak strain in the anterior cruciate ligament relative to the baseline condition. Conclusions: Increasing hamstring muscle force during the knee flexion phase of a simulated jump landing significantly reduces the peak relative strain in the anterior cruciate ligament in vitro. Clinical Relevance: It may be possible to proactively limit peak anterior cruciate ligament strain during the knee flexion phase of jump landings by accentuating hip flexion, thereby increasing the tension in active hamstring muscles by lengthening them. PMID:18381320
Brukner, Peter; Nealon, Andrew; Morgan, Christopher; Burgess, Darren; Dunn, Andrew
Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme—biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence. PMID:23322894
Brukner, Peter; Nealon, Andrew; Morgan, Christopher; Burgess, Darren; Dunn, Andrew
Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme-biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence. PMID:23322894
Tsaklis, Panagiotis; Malliaropoulos, Nikos; Mendiguchia, Jurdan; Korakakis, Vasileios; Tsapralis, Kyriakos; Pyne, Debasish; Malliaras, Peter
Background Hamstring injuries are common in many sports, including track and field. Strains occur in different parts of the hamstring muscle but very little is known about whether common hamstring loading exercises specifically load different hamstring components. The purpose of this study was to investigate muscle activation of different components of the hamstring muscle during common hamstring loading exercises. Methods Twenty elite female track and field athletes were recruited into this study, which had a single-sample, repeated-measures design. Each athlete performed ten hamstring loading exercises, and an electromyogram (EMG) was recorded from the biceps femoris and semitendinosus components of the hamstring. Hamstring EMG during maximal voluntary isometric contraction (MVIC) was used to normalize the mean data across ten repetitions of each exercise. An electrogoniometer synchronized to the EMG was used to determine whether peak EMG activity occurred during muscle-tendon unit lengthening, shortening, or no change in length. Mean EMG values were compared between the two recording sites for each exercise using the Student’s t-test. Results The lunge, dead lift, and kettle swings were low intensity (<50% MVIC) and all showed higher EMG activity for semitendinosus than for biceps femoris. Bridge was low but approaching medium intensity, and the TRX, hamstring bridge, and hamstring curl were all medium intensity exercises (?50% or <80% MVIC). The Nordic, fitball, and slide leg exercises were all high intensity exercises. Only the fitball exercise showed higher EMG activity in the biceps femoris compared with the semitendinosus. Only lunge and kettle swings showed peak EMG in the muscle-tendon unit lengthening phase and both these exercises involved faster speed. Conclusion Some exercises selectively activated the lateral and medial distal hamstrings. Low, medium, and high intensity exercises were demonstrated. This information enables the clinician, strength and conditioning coach and physiotherapist to better understand intensity- and muscle-specific activation during hamstring muscle rehabilitation. Therefore, these results may help in designing progressive strengthening and rehabilitation and prevention programs. PMID:26170726
Morgan, Kristin D; Donnelly, Cyril J; Reinbolt, Jeffrey A
Approximately 320,000 anterior cruciate ligament (ACL) injuries in the United States each year are non-contact injuries, with many occurring during a single-leg jump landing. To reduce ACL injury risk, one option is to improve muscle strength and/or the activation of muscles crossing the knee under elevated external loading. This study's purpose was to characterize the relative force production of the muscles supporting the knee during the weight-acceptance (WA) phase of single-leg jump landing and investigate the gastrocnemii forces compared to the hamstrings forces. Amateur male Western Australian Rules Football players completed a single-leg jump landing protocol and six participants were randomly chosen for further modeling and simulation. A three-dimensional, 14-segment, 37 degree-of-freedom, 92 muscle-tendon actuated model was created for each participant in OpenSim. Computed muscle control was used to generate 12 muscle-driven simulations, 2 trials per participant, of the WA phase of single-leg jump landing. A one-way ANOVA and Tukey post-hoc analysis showed both the quadriceps and gastrocnemii muscle force estimates were significantly greater than the hamstrings (p<0.001). Elevated gastrocnemii forces corresponded with increased joint compression and lower ACL forces. The elevated quadriceps and gastrocnemii forces during landing may represent a generalized muscle strategy to increase knee joint stiffness, protecting the knee and ACL from external knee loading and injury risk. These results contribute to our understanding of how muscle's function during single-leg jump landing and should serve as the foundation for novel muscle-targeted training intervention programs aimed to reduce ACL injuries in sport. PMID:25218505
Hayat, Zara; Konan, Sujith; Pollock, Rob
Significantly reduced distance between the ischium and the femur can result in symptomatic hip pain as a result of impingement. We present the case of a 16-year-old boy who presented with groin pain which had been affecting him for a year and a half following an innocuous football injury. Plain radiograph revealed a chronic apophyseal avulsion fracture of the ischium with excessive callus formation. CT scan and MRI revealed that the bony protuberance was responsible for symptomatic ischiofemoral impingement. In this case, he was successfully treated with non-operative management involving slow re-introduction to exercise. An unusual example of acquired ischiofemoral impingement, unrelated to surgery or significant trauma, this case highlights the need to consider such a diagnosis in otherwise unexplained groin pain. PMID:24966262
Ardern, Clare L; Pizzari, Tania; Wollin, Martin R; Webster, Kate E
The aim of this study was to describe the isokinetic thigh muscle strength profile of professional male football players in Australia. Concentric (60° and 240°·s(-1)) and eccentric (30° and 120°·s(-1)) hamstrings and quadriceps isokinetic strength was measured with a HUMAC NORM dynamometer. The primary variables were bilateral concentric and eccentric hamstring and quadriceps peak torque ratios, concentric hamstring-quadriceps peak torque ratios, and mixed ratios (eccentric hamstring 30°·s(-1) ÷ concentric quadriceps 240°·s(-1)). Hamstring strength imbalance was defined as deficits in any 2 of: bilateral concentric hamstring peak torque ratio <0.86, bilateral eccentric hamstring peak torque ratio <0.86, concentric hamstring-quadriceps ratio <0.47, and mixed ratio <0.80. Fifty-five strength tests involving 42 players were conducted. Ten players (24%) were identified as having hamstring strength imbalance. Athletes with strength imbalance had significantly reduced concentric and eccentric bilateral hamstring peak torque ratios at all angular velocities tested; and reduced eccentric quadriceps peak torque (30°·s(-1)) in their stance leg, compared with those without strength imbalance. Approximately, 1 in 4 players had preseason hamstring strength imbalance; and all strength deficits were observed in the stance leg. Concentric and eccentric hamstrings strength imbalance may impact in-season football performance and could have implications for the future risk of injury. PMID:25426513
H Kurosawa; K Nakasita; H Nakasita; S Sasaki; S Takeda
Rupture of the hamstring tendon is a rare injury. Two cases of complete rupture of the hamstring tendons sustained while playing judo are reported. The diagnosis of a rupture of the hamstring tendons was difficult from physical examination because of severe pain on knee or hip joint movement. Magnetic resonance imaging was non-invasive and showed the lesion clearly. In one
Along with the enjoyment and the other positive benefits of sport participation, there is also the risk of injury that is elevated in contact sport. This review provides a summary of injury incidence in Australian rules football (ARF), identifies injury risk factors, assesses the efficacy of interventions to reduce injury risk and makes recommendations for future research. The most common injuries were found to be muscle strains, particularly hamstrings; joint ligament sprains, especially ankle; haematomas and concussion. The most severe joint injury was anterior cruciate ligament rupture. Mouthguards are commonly worn and have been shown to reduce orofacial injury. There is evidence that thigh pads can reduce the incidence of thigh haematomas. There is a reluctance to wear padded headgear and an attempt to assess its effectiveness was unsuccessful due to low compliance. The most readily identified risk factor was a history of that injury. There were conflicting findings as to the influence strength imbalances or deficit has on hamstring injury risk in ARF. Static hamstring flexibility was not related to risk but low hip flexor/quadriceps flexibility increased hamstring injury risk. High lower-limb and high hamstring stiffness were associated with an elevated risk of hamstring injury. Since stiffness can be modulated through strength or flexibility training, this provides an area for future intervention studies. Low postural balance ability was related to a greater risk of ankle injury in ARF, players with poor balance should be targeted for balance training. There are preliminary data signifying a link between deficiencies in hip range of motion and hip adductor strength with groin pain or injury. This provides support for future investigation into the effectiveness of an intervention for high-risk players on groin injury rate. Low cross-sectional area of core-region muscle has been associated with more severe injuries and a motor control exercise intervention that increased core muscle size and function resulted in fewer games missed due to injury. A randomized controlled trial of the effectiveness of eccentric hamstring exercise in decreasing hamstring injury rate in ARF players was unsuccessful due to poor compliance from muscle soreness; a progressive eccentric training intervention for ARF should be given future consideration. Jump and landing training reduced injury risk in junior ARF players and it would be advisable to include this component as part of a neuromuscular training intervention. A multifaceted programme of sport-specific drills for hamstring flexibility while fatigued, sport skills that load the hamstrings and high-intensity interval training to mimic match playing conditions showed some success in reducing the incidence of hamstring injuries in ARF. A countermeasure designed to reduce injury risk is more likely to be adopted by coaches and players if it also has the scope to enhance performance. PMID:23529288
de Britto, Morgana Alves; Carpes, Felipe P; Koutras, Georgios; Pappas, Evangelos
ACL tear is a major concern among athletes, coaches and sports scientists. More than taking the athlete away from training and competition, ACL tear is a risk factor for early-onset of knee osteoarthritis, and, therefore addressing strategies to avoid such injury is pertinent not only for competitive athletes, but for all physically active subjects. Imbalances in the prelanding myoelectric activity of the hamstrings and quadriceps muscles have been linked to ACL injuries. We investigated the effect of landing from different heights on prelanding myoelectric activity of the hamstrings and quadriceps muscles in recreational athletes. Thirty recreational athletes (15 male and 15 female) performed three bilateral drop jumps from two different heights; 20cm and 40cm while myoelectric activity of the vastus medialis, rectus femoris, biceps femoris and medial hamstrings were collected. When increasing the height of drop landing tasks prelanding normalized myoelectric activity of the quadriceps was increased by 15-20% but no significant changes were found for the hamstrings. Female athletes exhibited higher activity of the medial hamstrings compared to their male counterparts. We concluded that increasing the height of drop landing tasks is associated with increased myoelectric activity of the quadriceps but not the hamstrings in recreational athletes. These differences in muscle activity may be related to increased risk for ACL injury when the height is increased. Female athletes demonstrated higher recruitment of the medial hamstrings. PMID:24837628
Verrall, Geoffrey M.; Esterman, Adrian; Hewett, Timothy E.
Background: Injuries are common in contact sports like Australian football. The Australian Football League (AFL) has developed an extensive injury surveillance database that can be used for epidemiological studies. Objectives: The purpose of this study is to identify any association between the three most prevalent injuries in the AFL. Patients and Methods: From the AFL injury surveillance data 1997-2012 the injury incidence (new injuries per club per season) and the injury prevalence data (missed games per club per season) were analysed to detect the three most common injuries that would cause a player to miss a match in the AFL. The three most prevalent injuries in the AFL are hamstring strains, groin/hip/osteitis pubis injuries and Anterior Cruciate Ligament (ACL) knee injuries. Following this, further study was undertaken to detect the presence of any statistical relationship between injury incidences of the three most prevalent injuries over this sixteen year study period. Results: Statistical analysis demonstrates for any given year that there was an association between having a groin/hip/osteitis pubis injuriy and having a knee ACL injury (P < 0.05) over the entire sixteen years. In other words if the number of groin/hip/osteitis pubis injuries in any given season were higher than average (alternatively lower) then the number of knee ACL injuries were also higher than average (alternatively lower) for that same season. Hamstring injuries had the highest variance of incidence of the three most prevalent injuries. Conclusions: Analysis of the AFL injury data demonstrates an association between incidence of groin/hip/osteitis pubis injuries and incidence of knee ACL injuries for any given playing season. This finding is difficult to explain with further research being required. PMID:25520768
Begalle, Rebecca L.; DiStefano, Lindsay J.; Blackburn, Troy; Padua, Darin A.
Context Anterior tibial shear force and knee valgus moment increase anterior cruciate ligament (ACL) loading. Muscle coactivation of the quadriceps and hamstrings influences anterior tibial shear force and knee valgus moment, thus potentially influencing ACL loading and injury risk. Therefore, identifying exercises that facilitate balanced activation of the quadriceps and hamstrings might be beneficial in ACL injury rehabilitation and prevention. Objective To quantify and compare quadriceps with hamstrings coactivation electromyographic (EMG) ratios during commonly used closed kinetic chain exercises. Design Cross-sectional study. Setting Research laboratory. Patients or Other Participants Twenty-seven healthy, physically active volunteers (12 men, 15 women; age = 22.1 ± 3.1 years, height = 171.4 ± 10 cm, mass = 72.4 ± 16.7 kg). Intervention(s) Participants completed 9 separate closed chain therapeutic exercises in a randomized order. Main Outcome Measure(s) Surface electromyography quantified the activity level of the vastus medialis (VM), vastus lateralis (VL), medial hamstrings (MH), and biceps femoris (BF) muscles. The quadriceps-to-hamstrings (Q:H) coactivation ratio was computed as the sum of average quadriceps (VM, VL) EMG amplitude divided by the sum of average hamstrings (MH, BF) EMG amplitude for each trial. We used repeated-measures analyses of variance to compare Q:H ratios and individual muscle contributions across exercises (? = .05), then used post hoc Tukey analyses. Results We observed a main effect for exercise (F3,79 = 22.6, P < .001). The post hoc Tukey analyses revealed smaller Q:H ratios during the single-limb dead lift (2.87 ± 1.77) than the single-limb squat (5.52 ± 2.89) exercise. The largest Q:H ratios were observed during the transverse-lunge (7.78 ± 5.51, P < .001), lateral-lunge (9.30 ± 5.53, P < .001), and forward-lunge (9.70 ± 5.90, P < .001) exercises. Conclusions The most balanced (smallest) coactivation ratios were observed during the single-limb dead-lift, lateral-hop, transverse-hop, and lateral band-walk exercises. These exercises potentially could facilitate balanced activation in ACL rehabilitation and injury-prevention programs. They also could be used in postinjury rehabilitation programs in a safe and progressive manner. PMID:22889655
Hamilton, Bruce; Knez, Wade; Eirale, Cristiano; Chalabi, Hakim
Hamstring muscle strains are among the most common injuries in sport, but despite increasing research into the epidemiology, aetiology and management the rates of both injury and re-injury remain high. Typically, hamstring injury management is conservative, but recently the use of autologous platelet enriched plasma (PEP), has been proposed as a treatment tool which may optimise muscle regeneration and enhance clinical outcomes. Unfortunately however, there remains little scientific evidence for the clinical use of these techniques in muscle injuries. This report outlines the current clinical evidence for the use of PEP in muscle injuries. A case report of a patient with a grade II semi-membranosus muscle strain, injected with PEP while concurrently using platelet inhibitors will illustrate the clinical, radiological and theoretical challenges of this new technique. Further clinical research into the clinical utility of PEP in muscle injury is required and it is incumbent on Sports Physicians and researchers to address this research deficit, if PEP is to live up to its high public profile. PMID:20973348
Wisconsin at Madison, University of
, MUSCLE-TENDON LENGTH, MOMENT ARM H amstring muscle strains are one of the most frequent injuries scientific data to better understand injury mechanisms and differences in injury rates between muscles muscle-tendon lengths throughout the sprinting gait cycle for each speed. We tested the hypothesis
Hong, Chih-Kai; Chang, Chih-Hsun; Chiang, Chen-Hao; Jou, I-Ming; Su, Wei-Ren
Anterior cruciate ligament reconstruction using double-looped hamstring autograft is a common procedure in orthopaedic practice. However, during placement of the running, locking stitches at each end of the harvested tendons, the surgeon may face several potential obstacles, including the risk of damaging the tendon, predisposing the surgeon to needle-stick injury, and extended time consumption. We report a modified rolling hitch technique for hamstring graft preparation that is quick, cost-saving, and needleless as an alternative method. The original rolling hitch technique uses a traditional knot that attaches a rope to an object; the modified rolling hitch technique was created by adding 1 more turn before finishing with a half-hitch, which may prevent suture slippage off the tendon, thus providing sufficient fixation of the suture-tendon construct. PMID:25126495
Devereaux, M. D.; Lachmann, S. M.
In a prospective study over the two years 1981-1982, there were 1186 separate sporting injuries treated at a Sports Injury Clinic. Just over 75% of patients were aged between 16 and 25 years old, while 80% were male. Football, Rugby, Running, Squash and Rowing contributed over 70% of these injuries. The commonest injuries were to the lower limb and lumbar region. In 43% of knee injuries there was strain of the collateral ligaments, while another 26% had patello-femoral pain. Short distance running was associated with an increase in shin splints, tibial stress fractures and hamstring injuries. Long distance running was associated with an increase in ankle and foot injuries. Sports Injury Clinics can benefit the injured athlete and there appears to be a need for their development in major hospitals. Images p137-a p137-b PMID:6661608
Skotak, Maciej; Wang, Fang; Chandra, Namas
There is a great need to have in vitro cell injury model wherein a wide range of strain (?) and strain rate (??) can be precisely and independently applied. Such a model will enable exploration of various biomechanical loading conditions cells normally encounter during either blunt or blast impact-induced traumatic brain injuries (TBIs). In combination with a highly automated data acquisition and analysis system, this method can quickly generate a large data set of experimental results to yield identification of bio-mechanical and chemical sequelae following injury. A proper understanding of these sequelae will enable the discovery of the time window of opportunity available for pharmacological interventions. In this study we present such an injury model, a modified version of the Cultured Axonal Injury (CAI) device, and demonstrate its efficacy through viability of SH-SY5Y cells at different ranges of strain (0-140%) and strain rate (15-68 s?¹). We identified three different regimes in the stretch-induced dose-response of curves of SH-SY5Y cells, with a very sharp decline from live to dead in a narrow range of strain (30-55%). The effect of strain rate is minimal when the final strain in the cells was fixed at 50%. The model further shows that time-after-injury plays a vital role in the determination of recovery-deterioration pathways and the biological selection depends on the severity of initial injury. These data point out the initial strain level is vital to the cell fate and emphasize the need to study the various mechanisms triggered by different magnitudes of initial injuries. PMID:22257521
Blackburn, J. Troy; Norcross, Marc F.; Cannon, Lindsey N.; Zinder, Steven M.
Context: Greater hamstrings stiffness is associated with less anterior tibial translation during controlled perturbations. However, it is unclear how hamstrings stiffness influences anterior cruciate ligament (ACL) loading mechanisms during dynamic tasks. Objective: To evaluate the influence of hamstrings stiffness on landing biomechanics related to ACL injury. Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: A total of 36 healthy, physically active volunteers (18 men, 18 women; age = 23 ± 3 years, height = 1.8 ± 0.1 m, mass = 73.1 ± 16.6 kg). Intervention(s): Hamstrings stiffness was quantified via the damped oscillatory technique. Three-dimensional lower extremity kinematics and kinetics were captured during a double-legged jump-landing task via a 3-dimensional motion-capture system interfaced with a force plate. Landing biomechanics were compared between groups displaying high and low hamstrings stiffness via independent-samples t tests. Main Outcome Measure(s): Hamstrings stiffness was normalized to body mass (N/m·kg?1). Peak knee-flexion and -valgus angles, vertical and posterior ground reaction forces, anterior tibial shear force, internal knee-extension and -varus moments, and knee-flexion angles at the instants of each peak kinetic variable were identified during the landing task. Forces were normalized to body weight, whereas moments were normalized to the product of weight and height. Results: Internal knee-varus moment was 3.6 times smaller in the high-stiffness group (t22 = 2.221, P = .02). A trend in the data also indicated that peak anterior tibial shear force was 1.1 times smaller in the high-stiffness group (t22 = 1.537, P = .07). The high-stiffness group also demonstrated greater knee flexion at the instants of peak anterior tibial shear force and internal knee-extension and -varus moments (t22 range = 1.729–2.224, P < .05). Conclusions: Greater hamstrings stiffness was associated with landing biomechanics consistent with less ACL loading and injury risk. Musculotendinous stiffness is a modifiable characteristic; thus exercises that enhance hamstrings stiffness may be important additions to ACL injury-prevention programs. PMID:24303987
Lempainen, Lasse; Johansson, Kristian; Banke, Ingo J.; Ranne, Juha; Mäkelä, Keijo; Sarimo, Janne; Niemi, Pekka; Orava, Sakari
Summary Background: proximal hamstring tendinopathy (PHT) is a disabilitating disease often causing underperformance in the athletically demanding patients. The main symptom of PHT is lower gluteal pain especially during running or while prolonged sitting. Mainly affecting athletically active individuals, PHT is a considerable challenge for treating health care professionals. Purpose: this paper aims to concisely present the literature on PHT to guide health care professionals treating these patients and doing research on the subject. Methods: we reviewed the literature on PHT through literature search of scientific journal databases. Conclusions: as a tendinopathic pathology, it is a rather recently discovered exertion injury. As with other chronic tendon overuse injuries, current treatment strategies are unspecific with uncertain outcomes due to the unknown etiology of the tendon degeneration. Diagnostic features as well as both operative and non-operative treatments are evaluated from a clinical perspective, providing up to date information for clinicians and sports medicine therapists dealing with hamstring problems. Level of evidence: V. PMID:25878983
Evangelidis, Pavlos Eleftherios; Pain, Matthew Thomas Gerard; Folland, Jonathan
It is currently unclear how football participation affects knee-joint muscle balance, which is widely considered a risk factor for hamstrings injury. This study compared the angle-specific functional hamstring-to-quadriceps (H:Q) ratio (hamstrings eccentric torque as a ratio of quadriceps concentric torque at the same knee-joint angle) of football players with recreationally active controls. Ten male footballers and 14 controls performed maximal voluntary isometric and isovelocity concentric and eccentric contractions (60, 240 and 400° s(-1)) of the knee extensors and flexors. Gaussian fitting to the raw torque values was used to interpolate torque values for knee-joint angles of 100-160° (60° s(-1)), 105-160° (240° s(-1)) and 115-145° (400° s(-1)). The angle-specific functional H:Q ratio was calculated from the knee flexors eccentric and knee extensors concentric torque at the same velocity and angle. No differences were found for the angle-specific functional H:Q ratio between groups, at any velocity. Quadriceps and hamstrings strength relative to body mass of footballers and controls was similar for all velocities, except concentric knee flexor strength at 400° s(-1) (footballers +40%; P < 0.01). In previously uninjured football players, there was no intrinsic muscle imbalance and therefore the high rate of hamstring injuries seen in this sport may be due to other risk factors and/or simply regular exposure to a high-risk activity. PMID:25073098
Lubowitz, James H
While radiographic and histologic data show features of hamstring tendon regeneration after harvest for ligament reconstruction, we remain skeptical that hamstring regeneration is clinically meaningful. We cannot recommend reharvest for revision surgery. PMID:26048767
Smith, Cheryl A; Stauber, Franciose; Waters, Christopher; Alway, Stephen E; Stauber, William T
Transforming growth factor-beta (TGF-beta) is a multifunctional cytokine implicated in inflammatory processes, wound healing, and fibrosis. In muscle diseases (i.e., dystrophy and inflammatory myopathy) and in animal models of muscle injury (i.e., produced by cardiotoxin, laceration, and eccentric contractions), increased TGF-beta was associated with muscle fibrosis and healing. Although TGF-beta transcript abundance was increased following injury, many studies presume that TGF-beta protein was also active as evident by increases in collagen transcript abundance. The purpose was to determine whether TGF-beta protein is present and active 48 h following injury. Using female rats, muscle strains were produced by stretching (50 stretches) the plantar flexor muscles. Forty-eight hours following injury, the medial gastrocnemius was removed and compartmentalized into five equal segments. Damaged myofibers with intracellular concanavalin A staining were counted. The percentage of damaged myofibers was significantly greater in the distal-most segment. TGF-beta was assessed by using immunohistochemistry, RT-PCR, and immunoblot analysis. Immunohistochemistry revealed the presence of TGF-beta1 in areas of myofiber injury, whereas TGF-beta2 was not detected. Increases in TGF-beta1 and TGF-beta2 transcript abundance following strain injury were documented by RT-PCR analysis. Increases in TGF-beta1 and TGF-beta2 precursor abundance were observed following strain injury by using immunoblot analysis but there was no change in active TGF-beta abundance. Although there was no correlation between the amount of cellular injury and TGF-beta transcript and protein abundance, elevated levels of TGF-beta1 and TGF-beta2 precursor proteins were present in strain-injured skeletal muscles 48 h after injury. PMID:17068209
Stauber, W T; Smith, C A; Miller, G R; Stauber, F D
Recovery from chronic strain injury (50 strains daily, five times weekly for 6 weeks to hyperactive soleus muscles) was followed for 3 months in female rats after cessation of chronic hyperactivity induced by pretreatment of the plantar flexor muscles with tetanus toxin. After 6 weeks of repeated strains, muscle mass decreased by 62%, myofiber areas were reduced by 87%, and noncontractile tissue expanded dramatically by 222%. Collagen content increased by almost ninefold (control 40 +/- 3 microg/mg, chronic injury 392 +/- 53 microg/mg), whereas the molar ratio of collagen (pyridinoline) crosslinks to collagen remained the same (control 0.20 +/- 0.01, chronic injury 0.16 +/- 0.01). After 3 months of ambulation, muscle mass returned to normal but myofiber areas remained smaller by 21%, noncontractile tissue was still markedly elevated by 18% with increased collagen content (107 +/- 15 microg/mg), and the molar ratio of crosslinks to collagen increased by 75% during recovery. Thus, rat soleus muscles recovered very slowly and incompletely from chronic strain injuries that produced muscle fibrosis, highlighting the necessity of devising preventative strategies for repeated strain injuries. PMID:11102904
Rolfe, Andrew; Register, David; Levasseur, Joseph E.; Churn, Severn B.; Sun, Dong
Abstract The present study directly compares the effects of experimental brain injury in two commonly used rat strains: Fisher 344 and Sprague-Dawley. We previously found that Fisher rats have a higher mortality rate and more frequent seizure attacks at the same injury level than Sprague-Dawley rats. Although strain differences in rats are commonly accepted as contributing to variability among studies, there is a paucity of literature addressing strain influence in experimental neurotrauma. Therefore this study compares outcome measures in two rat strains following lateral fluid percussion injury. Fisher 344 and Sprague-Dawley rats were monitored for changes in physiological measurements, intracranial pressure, and electroencephalographic activity. We further analyzed neuronal degeneration and cell death in the injured brain using Fluoro-Jade-B (FJB) histochemistry and caspase-3 immunostaining. Behavioral studies using the beam walk and Morris water maze were conducted to characterize strain differences in both motor and cognitive functional recovery following injury. We found that Fisher rats had significantly higher intracranial pressure, prolonged seizure activity, increased FJB-positive staining in the injured cortex and thalamus, and increased caspase-3 expression than Sprague-Dawley rats. On average, Fisher rats displayed a greater amount of total recording time in seizure activity and had longer ictal durations. The Fisher rats also had increased motor deficits, correlating with the above results. In spite of these results, Fisher rats performed better on cognitive tests following injury. The results demonstrate that different rat strains respond to injury differently, and thus in preclinical neurotrauma studies strain influence is an important consideration when evaluating outcomes. PMID:20392137
Dollé, Jean-Pierre; Morrison, Barclay; Schloss, Rene S.; Yarmush, Martin L.
Diffuse axonal injury (DAI) is a devastating consequence of traumatic brain injury, resulting in significant axon and neuronal degeneration. Currently, therapeutic options are limited. Using our brain-on-a-chip device, we evaluated axonal responses to DAI. We observed that axonal diameter plays a significant role in response to strain injury, which correlated to delayed elasticity and inversely correlated to axonal beading and axonal degeneration. When changes in mitochondrial membrane potential (MMP) were monitored an applied strain injury threshold was noted, below which delayed hyperpolarization was observed and above which immediate depolarization occurred. When the NHE-1 inhibitor EIPA was administered before injury, inhibition in both hyperpolarization and depolarization occurred along with axonal degeneration. Therefore, axonal diameter plays a significant role in strain injury and our brain-on-a-chip technology can be used both to understand the biochemical consequences of DAI and screen for potential therapeutic agents. PMID:25101309
Anne M. Comi; Michael V. Johnston; Mary Ann Wilson
Neonatal stroke is an important cause of neurologic morbidity and cerebral palsy. Recently, we have determined that in postnatal day 12 CD1 mice unilateral carotid ligation alone results in seizures and brain injury. We have shown that, in this model, seizure scores correlate with brain injury scores. We have applied this model to another strain of mice to assess strain-related
Scott D. Mair; Anthony V. Seaber; Richard R. Glisson; William E. Garrett
We investigated the role of fatigue in muscle strain injuries using the extensor digitorum longus muscles of 48 rabbits. The muscles of the rabbits were fatigued by 25% or 50% then stretched to failure and compared with the contralateral controls. Three rates of stretch were used. The force to muscle failure was reduced in the fatigued leg in all groups
Cloots, R J H; van Dommelen, J A W; Kleiven, S; Geers, M G D
The length scales involved in the development of diffuse axonal injury typically range from the head level (i.e., mechanical loading) to the cellular level. The parts of the brain that are vulnerable to this type of injury are mainly the brainstem and the corpus callosum, which are regions with highly anisotropically oriented axons. Within these parts, discrete axonal injuries occur mainly where the axons have to deviate from their main course due to the presence of an inclusion. The aim of this study is to predict axonal strains as a result of a mechanical load at the macroscopic head level. For this, a multi-scale finite element approach is adopted, in which a macro-level head model and a micro-level critical volume element are coupled. The results show that the axonal strains cannot be trivially correlated to the tissue strain without taking into account the axonal orientations, which indicates that the heterogeneities at the cellular level play an important role in brain injury and reliable predictions thereof. In addition to the multi-scale approach, it is shown that a novel anisotropic equivalent strain measure can be used to assess these micro-scale effects from head-level simulations only. PMID:22434184
Wei, Feng; Fong, Daniel Tik-Pui; Chan, Kai-Ming; Haut, Roger C
This study presents the ankle ligament strains and ankle joint moments during an accidental injury event diagnosed as a grade I anterior talofibular ligament (ATaFL) sprain. A male athlete accidentally sprained his ankle while performing a cutting motion in a laboratory setting. The kinematic data were input to a three-dimensional rigid-body foot model for simulation analyses. Maximum strains in 20 ligaments were evaluated in simulations that investigated various combinations of the reported ankle joint motions. Temporal strains in the ATaFL and the calcaneofibular ligament (CaFL) were then compared and the three-dimensional ankle joint moments were evaluated from the model. The ATaFL and CaFL were highly strained when the inversion motion was simulated (10% for ATaFL and 12% for CaFL). These ligament strains were increased significantly when either or both plantarflexion and internal rotation motions were added in a temporal fashion (up to 20% for ATaFL and 16% for CaFL). Interestingly, at the time strain peaked in the ATaFL, the plantarflexion angle was not large but apparently important. This computational simulation study suggested that an inversion moment of approximately 23 N m plus an internal rotation moment of approximately 11 N m and a small plantarflexion moment may have generated a strain of 15-20% in the ATaFL to produce a grade I ligament injury in the athlete's ankle. This injury simulation study exhibited the potentially important roles of plantarflexion and internal rotation, when combined with a large inversion motion, to produce a grade I ATaFL injury in the ankle of this athlete. PMID:23654290
Jacobs, Craig L; Hincapié, Cesar A; Cassidy, J David
The objective of this study was to assemble and synthesize the best available literature from 2004 to 2008 on musculoskeletal injury and pain in dancers. MEDLINE and CINAHL were the primary sources of data. Indexed terms such as dance, dancer, dancing, athletic injuries, occupational injuries, sprains and strains, musculoskeletal diseases, bone density, menstruation disturbances, and eating disorders were used to search the databases. Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed for scientific merit by the best-evidence synthesis method. After screening, 19 articles were found to be scientifically admissible. Data from accepted studies were abstracted into evidence tables relating to: prevalence and associated factors; incidence and risk factors; intervention; and injury characteristics and prognosis of musculoskeletal injury and pain in dancers. Principal findings included: a high prevalence and incidence of lower extremity, hip and back injuries; preliminary evidence that psychosocial and psychological issues such as stress and coping strategies affect injury frequency and duration; history of a previous lateral ankle sprain is associated with an increased risk of ankle sprain in the contralateral ankle in dance students; fatigue may play a role in ACL injury in dancers; acute hamstring strains in dancers affect tendon more than muscle tissue, often resulting in prolonged absence from dance. It is concluded that, while there are positive developments in the literature on the epidemiology, diagnosis, prognosis, treatment, and prevention of MSK injuries and pain in dancers, much room for improvement remains. Suggestions for future research are offered. PMID:22687721
Marshall, Stephen W; Hamstra-Wright, Karrie L; Dick, Randall; Grove, Katie A; Agel, Julie
Objective: To review 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for women's softball and to identify potential areas for injury prevention initiatives. Background: The NCAA Injury Surveillance System has tracked injuries in all divisions of NCAA softball from the 1988– 1989 to the 2003–2004 seasons. This report describes what was found and why the findings are important for the safety, enhancement, and continued growth of the sport. Main Results: Across all divisions, preseason practice injury rates were more than double the regular-season practice injury rates (3.65 versus 1.68 injuries per 1000 athlete-exposures, rate ratio = 2.2, 95% confidence interval [CI] = 2.0, 2.4, P < .01). The rate of injury in a game was 1.6 times that in a practice (4.30 versus 2.67 injuries per 1000 athlete-exposures, rate ratio = 1.6, 95% CI = 1.5, 1.7). A total of 51.2% of game injuries resulted from “other-contact” mechanisms, whereas 55% of practice injuries resulted from noncontact mechanisms. In games, ankle ligament sprains and knee internal derangements accounted for 19% of injuries. Twenty-three percent of all game injuries were due to sliding, most of which were ankle sprains. In practices, ankle ligament sprains, quadriceps and hamstring strains, shoulder strains and tendinitis, knee internal derangements, and lower back strains (combined) accounted for 38% of injuries. Recommendations: Ankle ligament sprains, knee internal derangements, sliding injuries, and overuse shoulder and low back injuries were among the most common conditions in NCAA women's softball. Preventive efforts should focus on sliding technique regardless of skill level, potential equipment changes, neuromuscular training programs, position-specific throwing programs, and mechanisms of low back injury. Further research is needed on the development and effects of these preventive efforts, as well as in the area of windmill-pitching biomechanics. PMID:17710178
Larsen, Chelsea C; Troiano, Jean M; Ramirez, Rebecca J; Miller, Michael G; Holcomb, William R
Flexibility, which is the ability to move freely through a full range of motion (ROM), is desired to enhance the performance and decrease the likelihood of muscle injury. There are different techniques used to increase ROM and cryotherapy techniques to facilitation flexibility gains. However, the combination of stretching and type of cryotherapy agents are still confounding. The purpose was to determine which type of cryotherapy, crushed or wetted ice, would produce the greatest gains in hamstring ROM when followed by proprioceptive neuromuscular facilitation (PNF) stretching. Fifteen healthy subjects underwent 3 treatment conditions: crushed ice bag (crushed ice), wetted ice bag (wetted ice), and no ice bag (no ice). Subject's hamstring ROM was measured at baseline, then again after a 20-minute cryotherapy treatment session. Subjects were then stretched using a slow-reversal-hold-relax PNF technique followed by a final ROM measurement. A repeated measures analysis of variance showed significant differences between cryotherapy and measurement conditions. Post hoc testing indicated that no ice (75.49 ± 12.19° C) was significantly different from wetted ice (81.73 ± 10.34° C) and crushed ice (81.62 ± 13.19° C) at the end of the treatment session, and that no ice (85.27 ± 13.83° C) was significantly different than wetted ice (89.44 ± 11.31° C) and crushed ice (89.16 ± 13.78° C) after the stretching session. However, there were no differences between wetted ice and crushed ice. Results indicate that strength and conditioning specialists can increase ROM with both forms of ice in combination with PNF stretching more so than when using no ice at all. PMID:24378663
Lee, Rushyuan Jay; Ganley, Theodore J
The use of anterior cruciate ligament reconstruction in the pediatric and adolescent population has been increasing in recent years. Autograft hamstring graft is favored in this population, but these patients often have smaller hamstring tendons that yield smaller final graft constructs. These smaller grafts are associated with an increased need for revision surgery. We describe a technique for obtaining a larger-diameter anterior cruciate ligament graft construct from autologous hamstring graft without allograft supplementation. PMID:25473619
... happens. A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can ... suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing ...
Sedory, Edward J; McVey, Eric D; Cross, Kevin M; Ingersoll, Christopher D; Hertel, Jay
Context: An arthrogenic muscle response (AMR) of the soleus and peroneal muscles has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of AMR in muscles acting on joints proximal to unstable ankles has not been previously explored. Objective: To determine if AMR is present in the quadriceps and hamstrings muscles of those with and without unilateral CAI. Design: Case control. Setting: University research laboratory. Patients or Other Participants: Twenty subjects with unilateral CAI (12 males, 8 females: age = 19.9 ± 3.7 years; height = 170.3 ± 15.6 cm; mass = 78.0 ± 23.1 kg) and 21 controls (16 males, 5 females: age = 23.2 ± 5.4 years; height = 173.9 ± 12.7 cm; mass = 87.2 ± 24.6 kg) with no previous ankle injuries. Main Outcome Measure(s): The central activation ratio (CAR), a measure of motoneuron pool excitability during maximal voluntary isometric contraction, for the hamstrings and quadriceps muscles was measured in both limbs using the superimposed burst technique. Results: The CAI group demonstrated quadriceps CARs that were significantly larger in their involved limbs (.87 ± .09), as compared with their uninvolved limbs (.84 ± .08), whereas no significant side-to-side difference was seen in the control group (sham involved = .80 ± .11, sham uninvolved = .81 ± .11). When values from both the involved and uninvolved limbs were averaged, the hamstrings CAR was significantly lower for the CAI group (.94 ± .03) than for the control group (.96 ± .03). Conclusions: Arthrogenic inhibition of the hamstrings muscles bilaterally and facilitation of the quadriceps muscle ipsilateral to the involved limb were noted in subjects with unilateral CAI. Motoneuron pool excitability appears to be altered in muscles that act on joints proximal to the ankle in those with unilateral CAI. PMID:18059990
Jedlicka, Anne E.; Gladwell, Wesley; Marzec, Jacqui; McCaw, Zackary R.; Bienstock, Rachelle J.; Kleeberger, Steven R.
Abstract Aims: Nrf2 is a master transcription factor for antioxidant response element (ARE)-mediated cytoprotective gene induction. A protective role for pulmonary Nrf2 was determined in model oxidative disorders, including hyperoxia-induced acute lung injury (ALI). To obtain additional insights into the function and genetic regulation of Nrf2, we assessed functional single nucleotide polymorphisms (SNPs) of Nrf2 in inbred mouse strains and tested whether sequence variation is associated with hyperoxia susceptibility. Results: Nrf2 SNPs were compiled from publicly available databases and by re-sequencing DNA from inbred strains. Hierarchical clustering of Nrf2 SNPs categorized the strains into three major haplotypes. Hyperoxia susceptibility was greater in haplotypes 2 and 3 strains than in haplotype 1 strains. A promoter SNP ?103?T/C adding an Sp1 binding site in haplotype 2 diminished promoter activation basally and under hyperoxia. Haplotype 3 mice bearing nonsynonymous coding SNPs located in (1862?A/T, His543Gln) and adjacent to (1417?T/C, Thr395Ile) the Neh1 domain showed suppressed nuclear transactivation of pulmonary Nrf2 relative to other strains, and overexpression of haplotype 3 Nrf2 showed lower ARE responsiveness than overexpression of haplotype 1 Nrf2 in airway cells. Importantly, we found a significant correlation of Nrf2 haplotypes and hyperoxic lung injury phenotypes. Innovation and Conclusion: The results indicate significant influence of Nrf2 polymorphisms and haplotypes on gene function and hyperoxia susceptibility. Our findings further support Nrf2 as a genetic determinant in ALI pathogenesis and provide useful tools for investigators who use mouse strains classified by Nrf2 haplotypes to elucidate the role for Nrf2 in oxidative disorders. Antioxid. Redox Signal. 22, 325–338. PMID:25268541
Thelen, Darryl G; Lenz, Amy L; Francis, Carrie; Lenhart, Rachel L; Hernández, Antonio
The hamstrings are often associated with the development of crouch gait, a fatiguing form of walking characterized by excessive hip flexion, knee flexion and ankle dorsiflexion during stance. However, recent studies have called into question whether abnormally active hamstrings induce the limb to move into a crouch posture. The purpose of this study was to directly measure the influence of the hamstrings on limb posture during stance. Nineteen healthy young adults walked on an instrumented treadmill at their preferred speed. A 90 ms pulse train was used to stimulate the medial hamstrings during either terminal swing or loading response of random gait cycles. Induced motion was defined as the difference in joint angle trajectories between stimulated and non-stimulated strides. A dynamic musculoskeletal simulation of normal gait was generated and similarly perturbed by increasing hamstring excitation. The experiments show that hamstring stimulation induced a significant increase in posterior pelvic tilt, knee flexion and ankle dorsiflexion during stance, while having relatively less influence on the hip angular trajectory. The induced motion patterns were similar whether the hamstrings were stimulated during late swing or early stance, and were generally consistent with the direction of induced motion predicted by gait simulation models. Hence, we conclude that overactive hamstrings have the potential to induce the limb to move toward a crouch gait posture. PMID:23540723
Behrens, Martin; Mau-Moeller, Anett; Wassermann, Franziska; Bruhn, Sven
Anterior cruciate ligament (ACL) rupture ranks among the most common injuries in sports. The incidence of ACL injuries is considerably higher in females than in males and the underlying mechanisms are still under debate. Furthermore, it has been suggested that muscle fatigue can be a risk factor for ACL injuries. We investigated gender differences in hamstring reflex responses and posterior-anterior tibial translation (TT) before and after fatiguing exercise. We assessed the isolated movement of the tibia relative to the femur in the sagittal plane as a consequence of mechanically induced TT in standing subjects. The muscle activity of the hamstrings was evaluated. Furthermore, isometric maximum voluntary torque (iMVT) and rate of torque development (RTD) of the hamstrings (H) and quadriceps (Q) were measured and the MVT H/Q as well as the RTD H/Q ratios were calculated. After fatigue, reflex onset latencies were enhanced in women. A reduction of reflex responses associated with an increased TT was observed in females. Men showed no differences in these parameters. Correlation analysis revealed no significant associations between parameters for TT and MVT H/Q as well as RTD H/Q. The results of the present study revealed that the fatigue protocol used in this study altered the latency and magnitude of reflex responses of the hamstrings as well as TT in women. These changes were not found in men. Based on our results, it is conceivable that the fatigue-induced decrease in neuromuscular function with a corresponding increase in TT probably contributes to the higher incidence of ACL injuries in women. PMID:23573178
Hemanth R. Gadikota; Jia-Lin Wu; Jong Keun Seon; Karen Sutton; Thomas J. Gill; Guoan Li
Background: Anatomical reconstruction techniques that can restore normal joint kinematics without increasing surgical complications could potentially improve clinical outcomes and help manage anterior cruciate ligament injuries more efficiently.Hypothesis: Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft can more closely restore normal knee anterior-posterior, medial-lateral, and internal-external kinematics than can conventional single-bundle anterior cruciate ligament reconstruction.Study
Razi, Mohammad; Sarzaeem, Mohammad Mahdi; Kazemian, Gholam Hossein; Najafi, Farideh; Najafi, Mohammad Amin
Background: Disruption of anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. The choice of graft for (ACL) reconstruction remains controversial. This prospective, randomized clinical trial aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis (ST) grafts for ACL reconstruction over a 3-year follow-up interval. Methods: Seventy-one patients with an average age of 29± 4.5yearswere treated for torn ACL between 2008 and 2009. Forty-sixpatients underwent reconstruction with BPTB autograft, and 41 were treated with ST autograft. At the time of final follow-up, 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC (International Knee Documentation Committee) score and complications. Results: At 36thmonth of follow-up, 34 (92%) and 28 (82%) patients in BPTB and ST group, respectively had good-to-excellent IKDC score (p > 0.05). The activity levels were higher in BPTB group (p> 0.05). At 3rd yearof follow up, the Lachman test was graded normal, for 23 (62%) and 11 (32%) patients in BPTB and ST group, respectively (p=0.019). Regarding the pivot-shift test, 29 (79%) and 15 (44%) patients in patella and hamstring group, respectively had normal test at the latest follow-up (p=0.021).There were no significant differences in terms of thigh circumference difference, effusion, knee range of motion, pain and complications. Conclusion: The results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However, the two groups had comparable results in terms of activity level and knee function. PMID:25694992
Kuszewski, Micha?; Gnat, Rafa?; Sobota, Grzegorz; My?liwiec, Andrzej
The aim of the study was to explore whether passive stiffness of the hamstrings influences the strategy of maintaining postural stability. A sample of 50 subjects was selected; the final analyses were based on data of 41 individuals (33 men, 8 women) aged 21 to 29 (mean = 23.3, SD = 1.1) years. A quasi- experimental ex post facto design with repeated measures was used. Categories of independent variables were obtained directly prior to the measurement of the dependent variables. In stage one of the study, passive knee extension was measured in the supine position to assess hamstring stiffness. In stage two, the magnitude of postural sway in antero-posterior direction was measured, while varying the body position on a stabilometric platform, both with and without visual control. The margin of safety was used as a measure of postural control. The magnitude of the margin of safety increased significantly between the open-eye and closed-eye trials. However, although we registered a visible tendency for a larger increase of the margin of safety associated with lower levels of passive hamstrings stiffness, no significant differences were found. Therefore, this study demonstrated that hamstring stiffness did not influence the strategy used to maintain postural stability. PMID:25964809
Kuszewski, Micha?; Gnat, Rafa?; Sobota, Grzegorz; My?liwiec, Andrzej
The aim of the study was to explore whether passive stiffness of the hamstrings influences the strategy of maintaining postural stability. A sample of 50 subjects was selected; the final analyses were based on data of 41 individuals (33 men, 8 women) aged 21 to 29 (mean = 23.3, SD = 1.1) years. A quasi- experimental ex post facto design with repeated measures was used. Categories of independent variables were obtained directly prior to the measurement of the dependent variables. In stage one of the study, passive knee extension was measured in the supine position to assess hamstring stiffness. In stage two, the magnitude of postural sway in antero-posterior direction was measured, while varying the body position on a stabilometric platform, both with and without visual control. The margin of safety was used as a measure of postural control. The magnitude of the margin of safety increased significantly between the open-eye and closed-eye trials. However, although we registered a visible tendency for a larger increase of the margin of safety associated with lower levels of passive hamstrings stiffness, no significant differences were found. Therefore, this study demonstrated that hamstring stiffness did not influence the strategy used to maintain postural stability. PMID:25964809
Michael Jagodzinski; Vahid Behfar; Christof Hurschler; Knut Albrecht; Christian Krettek; Ulrich Bosch
Background: Press-fit fixation of patellar tendon–bone anterior cruciate ligament autografts is an interesting technique because no hardware is necessary. For hamstring tendon grafts, no biomechanical data exist of a press-fit procedure.Hypothesis: Press-fit femoral fixation of hamstring tendons is mechanically equivalent to press-fit patellar tendon–bone fixation.Study Design: Controlled laboratory study.Methods: Patellar and hamstring tendons of 30 human cadavers (age, 53.8 ±
Joseph P. Weir; Dennis A. Keefe; Jason F. Eaton; Robert T. Augustine; Dawn M. Tobin
We examined the effect of fatigue of the quadriceps muscles on coactivation of the hamstring muscles and determined if the\\u000a response is different between two isokinetic speeds in ten males and ten females with no history of knee pathology. Electromyographic\\u000a data were recorded from the vastus lateralis and biceps femoris muscles during 50 maximal knee extensions at isokinetic speeds\\u000a of
Li, Yang; Frank, Eliot H.; Wang, Yang; Chubinskaya, Susan; Huang, Han-Hwa; Grodzinsky, Alan J.
Objective Traumatic joint injury can initiate early cartilage degeneration in the presence of elevated inflammatory cytokines (e.g., TNF-? and IL-6). The positive/negative effects of post-injury dynamic loading on cartilage degradation and repair in vivo is not well-understood. This study examined the effects of dynamic strain on immature bovine cartilage in vitro challenged with TNF-? + IL-6 and its soluble receptor (sIL-6R) with/without initial mechanical injury. Methods Groups of mechanically injured or non-injured explants were cultured in TNF-? + IL-6/sIL-6R for 8 days. Intermittent dynamic compression was applied concurrently at 10%, 20%, or 30% strain amplitude. Outcome measures included sGAG loss (DMMB), aggrecan biosynthesis (35S-incorporation), aggrecanase activity (Western blot), chondrocyte viability (fluorescence staining) and apoptosis (nuclear blebbing via light microscopy), and gene expression (qPCR). Results In bovine explants, cytokine-alone and injury-plus-cytokine treatments markedly increased sGAG loss and aggrecanase activity, and induced chondrocyte apoptosis. These effects were abolished by moderate 10% and 20% strains. However, 30% strain-amplitude greatly increased apoptosis and had no inhibitory effect on aggrecanase activity. TNF+IL-6/sIL-6R downregulated matrix gene expression and upregulated expression of inflammatory genes, effects that were rescued by moderate dynamic strains but not by 30% strain. Conclusions Moderate dynamic compression inhibits the pro-catabolic response of cartilage to mechanical injury and cytokine challenge, but there is a threshold strain-amplitude above which loading becomes detrimental to cartilage. Our findings support the concept of appropriate loading for post-injury rehabilitation. PMID:24007885
Laura C. Decoster; Joshua Cleland; Carolann Altieri; Pamela J. Russell
Study Design: Systematic literature review. Objective: Investigate the literature regarding the most effective positions, techniques, and durations of stretching to improve hamstring muscle flexibility. Background: Hamstring stretching is popular among physical therapists, athletic trainers, and fitness\\/coaching professionals; however, numerous stretching methodologies have been proposed in the literature. This fact establishes a need to systematically summarize available evidence in an attempt
Jennifer E. Stevens-Lapsley; Jaclyn E. Balter; Wendy M. Kohrt; Donald G. Eckhoff
Background\\/rationale Although TKA reliably reduces pain from knee osteoarthritis, full recovery of muscle strength and physical function to normal\\u000a levels is rare. We presumed that a better understanding of acute changes in hamstrings and quadriceps muscle performance would\\u000a allow us to enhance early rehabilitation after TKA and improve long-term function.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes The purposes of this study were to (1) evaluate postoperative quadriceps
exposure on the surface. The model is based on the skin damage equation proposed by Henriques and Moritz of strain energy on skin damage is investigated. The time-dependent partial di#11;erential equations (PDEs minor damage in skin super#12;cial layer to severe dam- age in deeper layers to even fatality. Skin b
Miyagi, Ryo; Sairyo, Koichi; Sakai, Toshinori; Tezuka, Fumitake; Kitagawa, Yasuhiro; Dezawa, Akira
Apophyseal ring fracture is a unique disease in children and adolescents. Its clinical features include low back pain, sciatica, paravertebral muscle spasm and tenderness, restricted back motion, neurological symptoms, and tight hamstrings. For all athletes, body flexibility is one of the most important factors for better performance. Therefore, persistent tight hamstrings has a negative influence on athletic performance. In this report, we present two adolescent athletes with apophyseal ring fracture treated successfully by conservative treatment for severe low back pain (LBP) and leg pain, despite having persistent tight hamstrings for more than one year. Unlike herniated nucleus pulposus, bony fragments in the spinal canal never disappear. Although conservative treatment can alleviate LBP and leg pain, surgical removal of fragments is considered when symptoms such as tight hamstrings and restricted lumbar motion due to canal stenosis are found, particularly in athletes. PMID:25264071
Harukazu Tohyama; Eiji Kondo; Riku Hayashi; Nobuto Kitamura; Kazunori Yasuda
Background: Although previous studies suggested that female patients are predisposed to increase graft laxity compared with male patients after single-bundle anterior cruciate ligament reconstruction using autogenous hamstring tendons, there have been no studies specifically examining gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts.Hypotheses: (1) Female patients have significantly smaller hamstring graft diameters than
Moningka, Natasha C; Cunningham, Mark W; Sterling, Myrline; West, Crystal A; Verlander, Jill W; Croker, Byron P; Ahlgren, Joslyn; Hayward, Linda; Baylis, Chris
Exercise-induced vascular endothelial adaptations in the kidney are not well understood. Therefore, we investigated the impact of voluntary wheel running (VWR) on the abundance of endothelial nitric oxide synthase (eNOS) and extracellular superoxide dismutase (EC SOD), in kidney and lung, and other SOD isoforms and total antioxidant capacity (TAC), in kidney. We also determined whether VWR influences susceptibility to acute kidney injury (AKI). Male Sprague–Dawley and Fisher 344 rats, VWR or sedentary for 12 weeks, were subjected to AKI (uninephrectomy (UNX) and 35 min of left kidney ischaemia–24 h reperfusion, IR). We measured glomerular filtration rate (GFR) and renal plasma flow (RPF), and analysed renal structural injury. Running was comparable between strains and VWR reduced body weight. In Sprague–Dawley rats, VWR reduced eNOS and EC SOD, but increased Mn SOD in kidney. Similar changes were seen after 6 weeks of VWR in Sprague–Dawley rats. In Fisher 344 rats, VWR increased eNOS, all SOD isoforms and TAC in kidney. Both strains increased eNOS and EC SOD in lung with VWR. Compared to UNX alone, UNX-IR injury markedly reduced renal function for both strains; however, in the Sprague–Dawley rats, VWR exacerbated falls in GFR and RPF due to UNX-IR, whereas in the Fisher 344 rats, GFR was unaffected by VWR. Some indices of renal structural injury due to UNX-IR tended to be worse in SD vs. F344. Our study demonstrates that genetic background influences the effect of exercise on kidney eNOS and EC SOD, which in turn influence the susceptibility to AKI. PMID:23266936
Dauty, M; Tortellier, L; Rochcongar, P
We report isokinetic results of anterior cruciate ligament reconstruction with patellar tendon or hamstring graft from the literature analysis. The literature was defined from two search "textwords": Isokinetic and Anterior cruciate ligament reconstruction, and from three databases: Medline, Pascal, and Herasmus. Two independent physicians (Physical Medicine and Rehabilitation) carried out an analysis according to the French National Accreditation and Health Evaluation Agency recommendations. Fifty-three studies were selected: 29 reported isokinetic results after anterior cruciate ligament reconstruction with patellar tendon graft, 15 reported isokinetic results after anterior cruciate ligament reconstruction with hamstring graft, and 9 studies compared the two surgical procedures. After discussing different bias and in reference to prospective randomised and comparative studies, the anterior cruciate ligament reconstruction with patellar tendon graft involves a knee extensors deficit during several months. The hamstring surgical procedure involves a less important knee extensor deficit (from 6 to 19 % against 8 to 21 %). Knee sprain and intra-articular surgery involve a long-lasting knee extensors deficit. Anterior cruciate ligament reconstruction with hamstrings graft involves a knee flexors deficit over several months. The patellar tendon surgical procedure involves a less important knee flexors deficit (from 1 to 15 % against 5 to 17 %). In reference to isokinetic parameters, no difference between the two surgical procedures (patellar tendon graft or hamstring graft) is shown after more than twenty-four post-surgical months. PMID:16195995
Al-Johani, Ahmed H; Kachanathu, Shaji John; Ramadan Hafez, Ashraf; Al-Ahaideb, Abdulaziz; Algarni, Abdulrahman D; Meshari Alroumi, Abdulmohesn; Alanezi, Aqeel M
[Purpose] Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide. The purpose of this study was to compare exercise treatments for hamstring and quadriceps strength in the management of knee osteoarthritis. [Subjects and Methods] Forty patients with OA knee, aged 50-65 years were divided into 2 groups. The first group (57.65±4.78 years) received hot packs and performed strengthening exercises for the quadriceps and hamstring, and stretching exercises for the hamstring. The second group (58.15±5.11 years) received hot packs and performed strengthening exercises for only the quadriceps, and stretching exercise for the hamstring. Outcome measures were the WOMAC (Western Ontario and McMaster Universities OA index questionnaire), Visual Analogue Scale (VAS) assessment of pain, the Fifty-Foot Walk Test (FWS), and Handheld dynamometry. [Results] There was a significant difference between the groups. The first group showed a more significant result than the second group. [Conclusion] Strengthening of the hamstrings in addition to strengthening of the quadriceps was shown to be beneficial for improving subjective knee pain, range of motion and decreasing the limitation of functional performance of patients with knee osteoarthritis. PMID:25013274
Andreas Weiler; Manuel Richter; Gerhard Schmidmaier; Frank Kandziora; Norbert P. Südkamp
Purpose: The EndoPearl (Linvatec, Largo, FL), a biodegradable device to augment the femoral interference screw fixation of hamstring tendon grafts has been developed. The first objective of this study was to compare the initial fixation strength of quadrupled hamstring tendons and biodegradable interference screw fixation with and without the application of the EndoPearl device. The second objective was to determine
McCormick, Frank; Nwachukwu, Benedict U; Kim, Jaehon; Martin, Scott D
A paucity of literature exists on quadriceps tendon reruptures. Failed quadriceps tendon repair can cause significant morbidity and disability. Surgical management of quadriceps tendon rerupture can be challenging due to tissue degeneration, tendon retraction, muscle atrophy, and poor bone fixation. A lack of guidance in the literature exists on the appropriate surgical techniques for managing quadriceps tendon reruptures.This article describes the case of a male recreational athlete with a failed primary quadriceps tendon repair who presented 10 months after rerupture. Examination was significant for morbid obesity, assisted ambulation, and a significant defect at the superior pole of the patella on the affected side. Intraoperative findings were consistent with a 2.0- to 4.5-cm tendon defect across the extensor mechanism with complete retinaculi tears. The authors performed a novel surgical approach for revision of quadriceps tears using a bilateral hamstring autograft through a quadriceps tendon weave and a transosseous patellar repair. Tendon length was restored, and extensor mechanism tension was reapproximated. Postoperatively, the patient achieved a good outcome and had returned to full, painless, sport participation at 2-year follow-up.This surgical technique is suitable for revision quadriceps tendon repairs of large tendon gap defects, repairs desiring tendon-to-bone in-growth, and repairs requiring large-force transmission across the repair. PMID:23590798
Kim, Eun-Sang; Kim, Gyeong-Moon; Lu, Xiaobin; Hsu, Chung Y; Xu, Xiao Ming
The distribution of retrogradely and transneuronally labeled neurons in the adult rat brain and spinal cord after contusive mid-thoracic spinal cord injury (SCI) was studied using Fast Blue (FB) and the Bartha strain of pseudorabies virus (PRV), respectively. When FB was injected into the distal spinal cord at 2 days after graded SCI at the 10th vertebral level, labeled neurons were consistently found 7 days later in supraspinal areas that normally project to the spinal cord. The number of FB-labeled neurons decreased as the injury severity increased. An inverse correlation between the number of FB-labeled neurons and injury severity was seen in most investigated brain nuclei with coefficient of correlations (r) ranging from -0.84 in the red nucleus to -0.92 in the raphe nuclei. The coefficient of correlation was relatively poor in the motor cortex (r = -0.63), where a mild injury (6.25 g.cm) resulted in a 99% damage of the corticospinal tract. Such a prominent difference between the corticospinal tract and other descending pathways can be related to the difference in location of these pathways within the adult rat spinal cord. When PRV was injected into the right sciatic nerve one month after the injury, labeled cells were consistently identified 5 days later in the spinal cord rostral to the injury and in certain supraspinal regions that regulate autonomic outflow. In these nuclei, the distribution and number of PRV-labeled neurons markedly decreased after SCI as compared to the control group. In contrast, PRV-labeled neurons were inconsistently found in the supraspinal nuclei that contribute to somatic motor outflow in normal controls and no labeling was observed in these nuclei after injury. These results demonstrate that (1) a proportion of neural network across the injured spinal cord has been spared after acute contusive SCI, (2) the proportion of spared axons of a particular pathway is closely correlated to the injury severity and the position of that pathway, and (3) the transneuronal labeling method using PRV may provide a unique approach to investigate multi-synaptic neural circuitry of the central autonomic control after SCI, but its application to the somatic motor system is limited. PMID:12165138
Poul, Jan; T?ma, Jirí; Bajerová, Jaroslava
The aim of the study was to present the results of video-assisted fractional lengthening of the triceps surae muscle and the hamstrings in children with spastic cerebral palsy. In the period from September 2003 to December 2004, triceps surae muscle contractures were treated in 35 lower extremities (22 patients) and hamstring lengthening was performed in 12 knees (eight patients). The patients were between 4 and 10 years of age. Lengthening of the gastrocnemius-soleus was sufficient for achieving 10 degrees dorsiflexion of the foot in 31 of the 35 extremities. The short-term follow-up, at least 1 year after operation, did not reveal any complications. The hamstring lengthening resulted in full correction in nine knees; one endoscopic procedure required conversion to open surgery owing to bleeding. In one case, incomplete sciatic nerve palsy developed. Video-assisted gastrocnemius-soleus recession as well as video-assisted lengthening of the hamstrings proved to be fully efficient in the group reported here. PMID:18510164
A Weiler; RF Hoffmann; AC Stähelin; HJ Bail; CJ Siepe; NP Südkamp
It has recently been shown that graft fixation close to the ACL insertion site is optimal in order to increase anterior knee stability. Hamstring tendon fixation using interference screws offers this possibility and a round threaded titanium interference screw has been previously developed. The use of a round threaded biodegradable interference screw may be equivalent. In addition, to increase initial
Connors, G. Patrick
Many baseball players suffer from shoulder injuries related to the rotator cuff muscles. These injuries may be classified as muscular strain, tendonitis or tenosynovitis, and impingement syndrome. Treatment varies from simple rest to surgery, so it is important to be seen by a physician as soon as possible. In order to prevent these injuries, the…
Previous studies have highlighted the importance of the hamstrings and quadriceps muscles on knee joint mechanics and the effects of their pathologies. It is crucial that the resultant force of theses musculature be accurately represented...
Mehmet Asik; Cengiz Sen; Ibrahim Tuncay; Mehmet Erdil; Cem Avci; Omer F. Taser
In this study, mid to long-term results of anterior cruciate ligament reconstruction with hamstring tendons and Transfix technique\\u000a were evaluated. Anterior cruciate ligament (ACL) reconstruction with four-strand hamstring tendon was performed with Transfix\\u000a technique on 271 (198 males, 73 females; mean age 25.7; 17–52) patients with anterior cruciate ligament ruptures. The patients\\u000a were followed up with clinical examination, Lysholm and
Rita Y. Lam; Gabriel Y. Ng; Eric P. Chien
Lam RY, Ng GY, Chien EP. Does wearing a functional knee brace affect hamstring reflex time in subjects with anterior cruciate ligament deficiency during muscle fatigue? Arch Phys Med Rehabil 2002;83:1009-12. Objective: To evaluate the effects of wearing a functional knee brace and muscle fatigue on hamstring reflex time in subjects with anterior cruciate ligament (ACL) deficiency. Design: Repeated-measures clinical
Nyland, John A.; Caborn, David N.M.; Shapiro, Robert; Johnson, Darren L.
Objective: To assess the effects of eccentric work-induced hamstring fatigue on sagittal and transverse plane (axial) knee and ankle biodynamics and kinetics during a running crossover cut directional change (functional pivot shift). Design and Setting: A pretest-posttest, single-group intervention experimental design was employed. All data were collected in a biodynamics laboratory. Subjects: Twenty healthy athletic females were trained for 3 weeks in crossover cutting before testing. Measurements: Data were sampled during 3 unfatigued and 3 fatigued (20% eccentric isokinetic knee-flexor torque reduction) crossover cut trials. Three-dimensional kinematic and ground reaction-force data were sampled at 200 Hz and 1000 Hz, respectively, and joint moment estimates were calculated. Data were standardized to initial force-plate heelstrike for comparisons of mean differences between conditions using paired t tests with Bonferroni adjustments. Pearson product-moment correlations compared kinematic and eccentric hamstring-torque relationships. Results: During internal rotation phase 1, between heelstrike and impact absorption, mean internal rotation velocity increased by 21.2°/s ± 114°/s. During internal rotation phase II, mean peak transverse plane knee rotation during propulsion decreased by 3.1° ± 9°. During internal rotation phase II, mean peak ankle plantar flexor moment onsets occurred 12.7 ± 53 milliseconds earlier, and this activation demonstrated a moderately positive relationship with the onset of mean peak knee internal rotation during propulsion and a weak negative relationship with mean peak hamstring torque/lean body weight. Conclusions: The increased knee internal rotation velocity during phase I indicates transverse plane dynamic knee-control deficits during hamstring fatigue. Earlier peak ankle plantar-flexor moments and decreased internal rotation during phase II in the presence of hamstring fatigue may represent compensatory attempts at dynamic knee stabilization from the posterior lower leg musculature during the pivot shift portion of the crossover cut. The weak relationship between decreased hamstring torque/lean body weight and delayed knee internal rotation during propulsion further supports greater dependence on ankle plantar flexors for dynamic knee stabilization compensation ImagesFigure 1.Figure 2.Figure 3. PMID:16558556
Kimura, Akihiko [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan); Ishida, Yuko [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan); Division of Molecular Bioregulation, Kanazawa University Cancer Research Institute, Kanazawa (Japan); Wada, Takashi [Department of Gastroenterology and Nephrology, Graduate School of Medical Science and Division of Blood Purification, Kanazawa University, Kanazawa (Japan); Yokoyama, Hitoshi [Department of Gastroenterology and Nephrology, Graduate School of Medical Science and Division of Blood Purification, Kanazawa University, Kanazawa (Japan); Mukaida, Naofumi [Division of Molecular Bioregulation, Kanazawa University Cancer Research Institute, Kanazawa (Japan); Kondo, Toshikazu [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan)]. E-mail: firstname.lastname@example.org
To clarify the pathophysiological mechanism underlying acute renal injury caused by acute exposure to arsenic, we subcutaneously injected both BALB/c and C57BL/6 mice with sodium arsenite (NaAs; 13.5 mg/kg). BALB/c mice exhibited exaggerated elevation of serum blood urea nitrogen (BUN) and creatinine (CRE) levels, compared with C57BL/6 mice. Moreover, half of BALB/c mice died by 24 h, whereas all C57BL/6 mice survived. Histopathological examination on kidney revealed severe hemorrhages, acute tubular necrosis, neutrophil infiltration, cast formation, and disappearance of PAS-positive brush borders in BALB/c mice, later than 10 h. These pathological changes were remarkably attenuated in C57BL/6 mice, accompanied with lower intrarenal arsenic concentrations, compared with BALB/c mice. Among heavy metal inducible proteins including multidrug resistance-associated protein (MRP)-1, multidrug resistance gene (MDR)-1, metallothionein (MT)-1, and arsenite inducible, cysteine- and histidine-rich RNA-associated protein (AIRAP), intrarenal MDR-1, MT-1, and AIRAP gene expression was enhanced to a similar extent in both strains, whereas NaAs challenge augmented intrarenal MRP-1 mRNA and protein expression levels in C57BL/6 but not BALB/c mice. Moreover, the administration of a specific inhibitor of MRP-1, MK-571, significantly exaggerated acute renal injury in C57BL/6 mice. Thus, MRP-1 is crucially involved in arsenic efflux and eventually prevention of acute renal injury upon acute exposure to NaAs.
Lim, Kyoung-Il; Nam, Hyung-Chun; Jung, Kyoung-Sim
[Purpose] The purpose of this study was to investigate the effects of two different stretching techniques on range of motion (ROM), muscle activation, and balance. [Subjects] For the present study, 48 adults with hamstring muscle tightness were recruited and randomly divided into three groups: a static stretching group (n=16), a PNF stretching group (n=16), a control group (n=16). [Methods] Both of the stretching techniques were applied to the hamstring once. Active knee extension angle, muscle activation during maximum voluntary isometric contraction (MVC), and static balance were measured before and after the application of each stretching technique. [Results] Both the static stretching and the PNF stretching groups showed significant increases in knee extension angle compared to the control group. However, there were no significant differences in muscle activation or balance between the groups. [Conclusion] Static stretching and PNF stretching techniques improved ROM without decrease in muscle activation, but neither of them exerted statistically significant effects on balance. PMID:24648633
DePino, Glen M.; Webright, William G.; Arnold, Brent L.
Objective: Increased muscle flexibility from static stretching is supported by the literature, but limited research has assessed the duration of maintained flexibility gains in knee joint range of motion after same-day static hamstring stretching. The purpose of our study was to determine the duration of hamstring flexibility gains, as measured by an active knee-extension test, after cessation of an acute static stretching protocol. Design and Setting: All subjects performed 6 active warm-up knee extensions, with the last repetition serving as the baseline comparison measurement. After warm-up, the experimental group performed 4 30-second static stretches separated by 15-second rests. Subjects: Thirty male subjects (age = 19.8 ± 5.1 years, ht = 179.4 ± 18.7 cm, wt = 78.5 ± 26.9 kg) with limited hamstring flexibility of the right lower extremity were randomly assigned to control and experimental groups. Measurements: Postexercise active knee-extension measurements for both groups were recorded at 1, 3, 6, 9, 15, and 30 minutes. Results: Tukey post hoc analysis indicated significant improvement of knee-extension range of motion in the experimental group that lasted 3 minutes after cessation of the static stretching protocol. Subsequent measurements after 3 minutes were not statistically different from baseline. A dependent t test revealed a significant increase in knee-extension range of motion when comparing the first to the sixth active warm-up repetition. Conclusions: Our results suggest that 4 consecutive 30-second static stretches enhanced hamstring flexibility (as determined by increased knee-extension range of motion), but this effect lasted only 3 minutes after cessation of the stretching protocol. Future research should examine the effect of other stretching techniques in maintaining same-day flexibility gains. ImagesFigure 1.Figure 2. PMID:16558609
J. C. L’Insalata; Brian Klatt; Freddie H. Fu; Christopher D. Harner
Thirty patients having had anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BPTB) autograft\\u000a and thirty patients having had ACL reconstruction with hamstring (HS) autograft were enrolled. All procedures were performed\\u000a using an endoscopic technique with identical postoperative rehabilitation, such that the only variable was the type of graft\\u000a and its fixation. Lateral and 45? posteroanterior (PA) weightbearing radiographs were
Jo?wiak, M; Pietrzak, S; Tobjasz, F
A population of 920 healthy children was studied with the aim of assessing the incidence of hamstring muscle and plantar foot flexor tightness, and to correlate such symptoms with gait, posture, and low back discomfort or pain. Special attention was paid to the popliteal angle and dorsal foot flexion. The borderline values for the popliteal angle in the following age groups were, boys: 3 to 5 years, 40 degrees; 6 to 15 years, 50 degrees; and 16 to 19 years, 40 degrees; girls: 3 to 5 years, 30 degrees; 6 to 14 years, 45 degrees; 15 to 19 years, 30 degrees. The borderline values for dorsal foot flexion in the following age groups were 3 to 4 years, 7 degrees; 5 to 13 years, 10 degrees; and 14 to 19 years, 5 degrees. The results obtained indicate a natural increase in hamstring tightness, particularly shortly before the pubertal growth spurt. This seems to be linked with the natural evolution of lumbar lordosis and pelvic tilt. When hamstring tightness surpassed borderline values, dorsiflexion and lumbar lordosis decreased leading to postural deformities, bending-forward deficit, discomfort when sitting, and a shambling gait. PMID:9285439
Sinikumpu, Juha-Jaakko; Antila, Eeva; Korhonen, Jussi; Rättyä, Johanna; Serlo, Willy
Trampolines for home use have become common in Finland during the past ten years, being especially favored by children. Trampoline jumping is beneficial and constructive physical exercise, but poses a significant risk for injuries. The most common injuries include sprains and strains. During summertime, trampoline injuries account for as many as 13% of children's accidents requiring hospital care. Fractures are by far the most common trampoline injuries requiring hospital care. Injuries can be prevented by using safety nets. Only one child at a time is allowed to jump on the trampoline. PMID:22880376
Dauty, M; Collon, S
In this prevalence cohort study, injuries sustained during 15 seasons in a professional soccer team were investigated according to the different soccer seasons, number of matches per season, month the injury occurred, location, severity, playing position and the team's rank at the end of the French professional championship. Altogether, 903 injuries in 173 professional soccer players were reported. Injury incidence per 1?000?h of exposure during matches and training was 4.7±5. This incidence did not vary significantly between seasons. However, injury incidence increased after the year 2003 and constantly exceeded 4.2. In the same way, after 2002 muscle injury incidence always exceeded 2 per 1?000?h of exposure. Injury incidence peaked during the month of January. Hamstring muscle injury represented the most frequent injury. No difference in injury incidence was found according to the playing position or to the season whether the team participated or not in the European cup. No correlation was found with the team's rank at the end of the French championship. This study highlighted no significant variation on injury incidence over a 15-season period except for the muscle injury rate in high level soccer players. PMID:22052029
Baltaci, G; Un, N; Tunay, V; Besler, A; Gerceker, S
Background: The sit and reach test is the most common flexibility test used in health related fitness test batteries. Objective: To examine and compare three different sit and reach tests as a measure of hamstring flexibility in 102 female students. Method: The traditional sit and reach test, the chair sit and reach test, the back saver sit and reach test, and passive straight leg raise were administered in three trials to all 102 students (mean (SD) age 22 (1) years) on the same day. Results: A Pearson correlation coefficient analysis was significant (p<0.01) for the traditional sit and reach test with back saver sit and reach test and flexibility of hamstrings (r = 0.45 and 0.65 for left and right legs, and 0.63 and 0.53 for left and right legs respectively). Also, the back saver sit and reach test for the left (p<0.01) and right (p<0.05) leg was significantly associated with hamstring flexibility (r = 0.37 and 0.25 for the left leg and 0.50 and 0.44 for the right leg respectively). Conclusion: The results indicate that the back saver sit and reach test produces reasonably accurate and stable measures of hamstring flexibility. Moreover, it appears that this test is a safe and acceptable alternative to the traditional and chair sit and reach tests as a measure of hamstring flexibility in young women. PMID:12547745
Faber, Irene R.; Nienhuis, Bart; Rijs, Nique P. A. M.; Geurts, Alexander C. H.; Duysens, Jacques
The aim of this study was to investigate whether the modified Tardieu scale (MTS) in a semi-standing position, used for the assessment of hamstrings spasticity, was better associated with knee extension and hamstrings activity in terminal swing than the MTS in a supine position in children with cerebral palsy (CP). Seven children diagnosed with…
Orishimo, Karl F; McHugh, Malachy P
The purposes of this study were to document relative activation intensities of the hamstrings and gluteus maximus during 4 eccentric hamstring strengthening exercises and to assess the effects of a short-term strengthening program comprised of these exercises on knee flexor strength and the length-tension relationship. Twelve healthy subjects participated in this study. Electromyographic (EMG) activities from the biceps femoris, semitendinosus, and gluteus maximus were recorded as subjects performed (a) standing hip extension with elastic resistance, (b) trunk flexion in single limb stance (diver), (c) standing split (glider), and (d) supine sliding bridge (slider). Baseline isometric knee flexor strength was measured at 90, 70, 50, and 30° of flexion at the knee with the subject seated and the hip flexed to 50° from horizontal. After completing the 4-week training program, strength tests were repeated. Repeated-measures analysis of variance were used to compare EMG activity between muscles and to assess angle-specific strength improvements. Hamstring activity exceeded gluteus maximus activity for resisted hip extension, glider, and slider exercises (p < 0.001) but not for the diver (p = 0.087). Hamstring activation was greatest during the slider and resisted hip extension and lowest during the glider and the diver. Knee flexor strength improved by 9.0% (p = 0.005) but was not angle specific (training by angle p = 0.874). The short-term home training program effectively targeted the hamstrings and resulted in strength gains that were similar at short and long muscle lengths. These data demonstrate that hamstring strength can be improved using eccentrically biased unilateral exercises without the use of weights or other equipments. PMID:25226327
Comparing the PEF resistance and occurrence of sublethal injury on different strains of Escherichia coli, Salmonella Typhimurium, Listeria monocytogenes and Staphylococcus aureus in media of pH 4 and 7
G. Saldaña; E. Puértolas; N. López; D. García; I. Álvarez; J. Raso
The effect of pulsed electric fields (PEF) on the reduction of the population and on the occurrence of sublethal injury in five strains of two Gram-positive (Listeria monocytogenes and Staphylococcus aureus) and two Gram-negative (Escherichia coli and Salmonella Typhimurium) microorganisms was investigated in media of pH 4.0 and 7.0. Samples were subjected to 50 exponential waveform pulses of 15, 20,
... please visit: www.burninstitute.org Safety tipS & info Inhalation Injuries Inhalation injuries are among the most devastating types of ... injuries. • Over half of these deaths result from inhalation injuries. • Inhalation injuries increase mortality 30% to 40% ...
Mokhtar, AH.; Rahnama, N.; Yusof, A.
The study investigates the effects of the 11+ and HarmoKnee injury prevention programmes on knee strength in male soccer players. Under-21-year-old players (n=36) were divided equally into: the 11+, HarmoKnee and control groups. The programmes were performed for 24 sessions (20-25 min each). The hamstrings and quadriceps strength were measured bilaterally at 60°·s-1, 180°·s-1 and 300°·s-1. The concentric quadriceps peak torque (PT) of the 11+ increased by 27.7% at 300°·s-1 in the dominant leg (p<0.05). The concentric quadriceps PT of HarmoKnee increased by 36.6%, 36.2% and 28% in the dominant leg, and by 31.3%, 31.7% and 20.05% at 60°·s-1, 180°·s-1 and 300°·s-1 in the non-dominant leg respectively. In the 11+ group the concentric hamstring PT increased by 22%, 21.4% and 22.1% at 60°·s-1, 180°·s-1 and 300°·s-1, respectively in the dominant leg, and by 22.3%, and 15.7% at 60°·s-1 and 180°·s-1, in the non-dominant leg. In the HarmoKnee group the hamstrings in the dominant leg showed an increase in PT by 32.5%, 31.3% and 14.3% at 60°·s-1, 180°·s-1 and 300°·s-1, and in the non-dominant leg hamstrings PT increased by 21.1% and 19.3% at 60°·s-1 and 180°·s-1 respectively. The concentric hamstrings strength was significantly different between the 11+ and control groups in the dominant (p=0.01) and non-dominant legs (p=0.02). The HarmoKnee programme enhanced the concentric strength of quadriceps. The 11+ and HarmoKnee programmes are useful warm-up protocols for improving concentric hamstring strength in young professional male soccer players. The 11+ programme is more advantageous for its greater concentric hamstring strength improvement compared to the HarmoKnee programme. PMID:24795499
Guex, Kenny; Degache, Francis; Gremion, Gérald; Millet, Grégoire P
The eccentric contraction mode was proposed to be the primary stimulus for optimum angle (angle at which peak torque occurs) shift. However, the training range of motion (or muscle excursion range) could be a stimulus as important. The aim of this study was to assess the influence of the training range of motion stimulus on the hamstring optimum length. It was hypothesised that performing a single set of concentric contractions beyond optimal length (seated at 80° of hip flexion) would lead to an immediate shift of the optimum angle to longer muscle length while performing it below (supine at 0° of hip flexion) would not provide any shift. Eleven male participants were assessed on an isokinetic dynamometer. In both positions, the test consisted of 30 consecutive knee flexions at 4.19 rad · s?¹. The optimum angle was significantly shifted by ?15° in the direction of longer muscle length after the contractions at 80° of hip flexion, while a non-significant shift of 3° was found at 0°. The hamstring fatigability was not influenced by the hip position. It was concluded that the training range of motion seems to be a relevant stimulus for shifting the optimum angle to longer muscle length. Moreover, fatigue appears as a mechanism partly responsible for the observed shift. PMID:23631731
Fonda, B; Sarabon, N
The purpose of this study was to examine the effects of whole-body cryotherapy (WBC) on biochemical, pain, and performance parameters during the 5-day recovery period after damaging exercise for hamstrings. Participants completed a bout of damaging exercise for the hamstring muscles on two separate occasions (control and experimental condition) separated by 10 weeks. During the control condition, subjects received no treatment after the damaging exercise. The experimental condition consisted of WBC everyday during the recovery period. WBC included single 3-min daily exposures to low temperatures (-140 to -19 °C) in the cryo-cabin. During the recovery period, subjects were tested for biochemical markers, perceived pain sensation, and physical performance (squat jump, counter movement jump, maximal isometric torque production, and maximally explosive isometric torque production). Majority of the observed variables showed statistically significant time effects (P < 0.05) in control group, which indicates the presence of muscle damage. Significant interaction between the control and WBC condition was evident for the rate of torque development (P < 0.05). Pain measures substantially differed between the WBC and the control condition after the exercise. Results of this study are not completely supportive of the use of WBC for recovery enhancement after strenuous training. PMID:23614691
Hefzy, M S; al Khazim, M; Harrison, L
The anterior lunge exercise is a closed chain kinetic exercise that has been developed to improve the function of the lower limb and to strengthen the hamstrings and quadriceps, simultaneously. In this study, a three-dimensional biomechanical analysis of this exercise was conducted in order to understand the mechanics of this rehabilitation activity. Experimental conditions were recorded using an active optoelectronic kinematic data capture system (OPTOTRAK), two force plates (AMTI) and electromyography (EMG). Data were collected from healthy male subjects while performing several lunges. When the distance between the toe of the rear leg and the heel of the front leg (lunging distance) was maximum, a large net flexion moment was predicted in the front leg in the extented position. This moment was reversed to a large net extension moment in the flexed position. A large increase in the net extension moment in the rear leg was also predicted as the front knee was bent from 5 degrees to 90 degrees of flexion. These data suggest that quadriceps and hamstring muscles co-contraction occur during a maximum lunge in the front leg when it is in the flexed position. PMID:9731386
Dorgo, Sandor; Edupuganti, Pradeep; Smith, Darla R.; Ortiz, Melchor
In this study, we compared hamstring (H) and quadriceps (Q) strength changes in men and women, as well as changes in conventional and functional H:Q ratios following an identical 12-week resistance training program. An isokinetic dynamometer was used to assess 14 male and 14 female participants before and after the intervention, and conventional…
Delextrat, A; Baker, J; Cohen, D D; Clarke, N D
The purpose of this study was to investigate the effect of a simulated soccer test on the functional hamstrings-to-quadriceps ratio (H(ecc) :?Q(con)) in female soccer players. Fourteen amateur players (age, 26.1?±?4.6 years; height, 168?±?12?cm; body mass, 62.7?±?5.5?kg; body fat, 23.7?±?2.2%) performed the modified Loughborough Intermittent Shuttle Test (modified LIST). Isokinetic strength assessments of the hamstrings and quadriceps on the dominant and non-dominant legs at 120°/s were performed before and immediately after the modified LIST. H(ecc) :?Q(con) was calculated as the ratio of the peak eccentric torque of the hamstrings to the peak concentric torque of the quadriceps. A two-way univariate analysis of variance was used to assess the effect of time and leg dominance on H(ecc)?:?Q(con). The main results showed that the modified LIST led to a significant decrease in H(ecc)?:?Q(con) in the dominant (-14.1%) and non-dominant legs (-8.0%) (P?=?0.02). However, this decrease was not significantly different between dominant and non-dominant legs (P?=?0.42). These results reflect a greater risk of hamstrings tears and ACL sprains at the end of soccer matches. PMID:22107131
Burke, Darren G.; Rasmussen, Roy; MacKinnon, Natalie C.; Vossen, Jeffery F.; Pelham, Thomas W.
Objective: To compare the changes in hamstring length resulting from modified proprioceptive neuromuscular facilitation flexibility training in combination with cold-water immersion, hot-water immersion, and stretching alone. Design and Setting: Training-only subjects stood motionless for 10 minutes, while subjects in the cold group stood in a cold-water bath (8° ± 1°C) immersed up to the gluteal fold for 10 minutes, and subjects in the hot group stood in a hot-water bath (44° ± 1°C) immersed up to the gluteal fold for 10 minutes. All subjects exercised only the right lower limb using a modified proprioceptive neuromuscular facilitation flexibility protocol, consisting of 1 set of 4 repetitions. This procedure was followed for 5 consecutive days. Subjects: Forty-five uninjured subjects (21 women, 24 men; age range, 18–25 years) were randomly assigned to the cold, hot, or stretching-alone group. Measurements: Subjects were measured for maximum active hip flexion on the first and fifth days. Results: Group results were assessed using a 2 × 3 analysis of variance, comparing changes in hamstring length from pretest to posttest. All 3 groups had significant improvements in hamstring length (pretest to posttest) (P < .05). However, no significant differences occurred among groups. Conclusions: No advantage was apparent in using complete hot or cold immersion to increase hamstring length in healthy subjects. PMID:12937509
Lee, Jin-Hyuck; Jeong, Hye-Jin; Lee, Seok-Joo
Purpose The purpose of this study was to evaluate the quadriceps and hamstring muscle strength and hamstring-to-quadriceps (HQ) ratio, as well as the relationships of these parameters with dynamic balance, in patients with anterior cruciate ligament (ACL) rupture. Materials and Methods We compared 25 patients diagnosed with chronic unilateral ACL tears and 25 age-matched healthy volunteers. The maximal torque of the quadriceps and hamstring and dynamic balance were measured. Results Although the isokinetic maximal peak torques were about 50% lower in the quadriceps (57%, p<0.001) and hamstring (56%, p=0.001) muscles in the chronic ACL tear group than in the control group, their HQ ratios were similar (56%±17% vs. 58%±6%, p=0.591). HQ ratio was significantly correlated with anterior-posterior stability index (r=-0.511, p=0.021) and overall stability index (r=-0.476, p=0.034) in control group, but these correlations were not observed in chronic ACL tear group. Conclusions Thigh muscle strength was about 50% lower in the chronic ACL tear group than in the control group, but the HQ ratio was similar. The dynamic balance of the knee was not influenced by thigh muscle strength but was influenced by HQ ratio in healthy young individuals. However, HQ ratio was not correlated with dynamic knee balance in chronic ACL tear patients. PMID:26060609
Pollock, Noel; James, Steven L J; Lee, Justin C; Chakraverty, Robin
The commonly used muscle injury grading systems based on three grades of injury, representing minor, moderate and complete injuries to the muscle, are lacking in diagnostic accuracy and provide limited prognostic information to the clinician. In recent years, there have been a number of proposals for alternative grading systems. While there is recent evidence regarding the prognostic features of muscle injuries, this evidence has not often been incorporated into the grading proposals. The British Athletics Muscle Injury Classification proposes a new system, based on the available evidence, which should provide a sound diagnostic base for therapeutic decision-making and prognostication. Injuries are graded 0-4 based on MRI features, with Grades 1-4 including an additional suffix 'a', 'b' or 'c' if the injury is 'myofascial', 'musculo-tendinous' or 'intratendinous'. Retrospective and prospective studies in elite track and field athletes are underway to validate the classification for use in hamstring muscle injury management. It is intended that this grading system can provide a suitable diagnostic framework for enhanced clinical decision-making in the management of muscle injuries and assist with future research to inform the development of improved prevention and management strategies. PMID:25031367
... long winter off might lead to a strained calf or thigh muscle. Sprains are caused by injuries, ... splint to prevent and decrease swelling) E levation (raise the injured part so it's higher than your ...
... before. Usually, the injury is minor because your skull is hard and it protects your brain. But ... injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury. Head injuries ...
Mark A. Reed; Robert P. Naftel; Susanna Carter; Paul A. MacLennan; Gerald McGwin Jr; Loring W. Rue III
Objective. Motor vehicle collision (MVC)-related spinal injury is a severe and often permanently disabling injury. In addition, strain injuries have been reported as a common outcome of MVCs. Although advances in automobile crashworthiness have reduced both fatalities and severe injuries, the impact of varying occupant restraint systems (seatbelts and airbags) on thoracolumbar spine injuries is unknown. This study examined the
Reiner Rugulies; Niklas Krause
Work-related musculoskeletal disorders account for the largest single category of lost-time occupational injury or disease episodes in industrialized countries. In this study we analyzed the impact of the psychosocial work environment, conceptualized by the demand–control–support model, on the incidence of low back and neck injury in a cohort of 1221 public transit operators followed for 7 years and 6 months.
Magalhães, Francisco Elezier Xavier; Junior, Arlindo Rodrigues de Mesquita; Meneses, Harnold's Tyson de Sousa; Moreira Dos Santos, Rayele Pricila; Rodrigues, Ezaine Costa; Gouveia, Samara Sousa Vasconcelos; Gouveia, Guilherme Pertinni de Morais; Orsini, Marco; Bastos, Victor Hugo do Vale; Machado, Dionis de Castro Dutra
[Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care. PMID:26157261
Magalhães, Francisco Elezier Xavier; Junior, Arlindo Rodrigues de Mesquita; Meneses, Harnold’s Tyson de Sousa; Moreira dos Santos, Rayele Pricila; Rodrigues, Ezaine Costa; Gouveia, Samara Sousa Vasconcelos; Gouveia, Guilherme Pertinni de Morais; Orsini, Marco; Bastos, Victor Hugo do Vale; Machado, Dionis de Castro Dutra
[Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care.
James Robinson; Chris Huber; Paul Jaraj; Philippe Colombet; Michel Allard; Philippe Meyer
Bone tunnel enlargement following anterior cruciate ligament (ACL) reconstruction can complicate revision surgery. This study compared postoperative tibial tunnel widening in patients who underwent arthroscopically assisted, single-incision, four-strand hamstring ACL reconstruction using a poly-l-lactic acid\\/hydroxyapatite blend (PLLA+HA) bioabsorbable interference screw for tibial fixation, with those in whom a plain poly-l-lactic acid (PLLA) screw was used. Thirty-four patients (13 with PLLA+HA
Marilia Dos Santos Andrade; Claudio Andre Barbosa De Lira; Fabiana De Carvalho Koffes; Naryana Cristina Mascarin; Ana Amélia Benedito-Silva; Antonio Carlos Da Silva
The purpose of this study was to determine differences in hamstrings-to-quadriceps (H\\/Q) peak torque ratios evaluated at different angular velocities between men and women who participate in judo, handball or soccer. A total of 166 athletes, including 58 judokas (26 females and 32 males), 39 handball players (22 females and 17 males), and 69 soccer players (17 females and 52
KUMAR, DEEPAK; SUBBURAJ, KARUPPPASAMY; LIN, WILSON; KARAMPINOS, DIMITRIOS C.; MCCULLOCH, CHARLES E.; LI, XIAOJUAN; LINK, THOMAS M.; SOUZA, RICHARD B.; MAJUMDAR, SHARMILA
STUDY DESIGN Controlled laboratory study using a cross-sectional design. OBJECTIVES To analyze the relationship of quadriceps-hamstrings and medial-lateral quadriceps anatomical cross-sectional area (ACSA) ratios with knee loads during walking and articular and meniscal cartilage composition in young, healthy subjects. BACKGROUND Muscle forces affect knee loading during walking, but it is not known if muscle morphology is associated with walking mechanics and cartilage composition in young subjects. METHODS Forty-two knees from 27 young, healthy, active volunteers (age, 20-35 years; body mass index, <28 kg/m2) underwent 3-T magnetic resonance imaging (MRI) and 3-D motion capture. Standard MRI sequences were used for articular and meniscal cartilage T1rho and T2 relaxation times and for quadriceps and hamstrings muscle ACSA. Frontal plane kinetics during the stance phase of walking was calculated. Generalized estimating equation models were used to identify muscle variables that predicted MRI and gait parameters. RESULTS Quadriceps-hamstrings and medial-lateral quadriceps ACSA ratios were positively related to frontal plane loading (? = .27-.54, P?.006), global articular cartilage relaxation times (? = .22-.28, P?.041), and the medial-lateral ratio of meniscus T1rho relaxation time (? = .26-.36, P?.049). The medial-lateral quadriceps ACSA ratio was positively related to global meniscus T1rho relaxation times (? = .30, P = .046). CONCLUSION Higher quadriceps-hamstrings and medial-lateral quadriceps ACSA ratios were associated with higher frontal plane loading during walking and with articular and meniscal cartilage T1rho and T2 relaxation times. These findings highlight the relationships between different knee tissues and knee mechanics in young, healthy individuals. PMID:24175607
Keith L. Markolf; Geoffery O’Neill; Steven R. Jackson; David R. McAllister
Background: Muscle contraction can subject healing knee ligament grafts to high loads.Purpose: To directly measure the effects of quadriceps and hamstrings muscle loads on forces in the anterior cruciate ligaments and posterior cruciate ligaments.Study Design: Controlled laboratory study.Methods: Thirteen cadaveric knee specimens had load cells installed to record resultant forces in both anterior and posterior cruciate ligaments under 5 loading
Cushman, Daniel; Rho, Monica E
Study Design Case report. Background Proximal hamstring tendinopathy in runners is characterized by pain with passive hip flexion with the knee extended, active hip extension, and pain with sitting. Relatively little literature exists on the condition, and publications on nonsurgical treatment protocols are even more scarce. Surgical intervention, which comprises the majority of literature for treatment of this condition, is an option for cases that fail to respond to nonsurgical treatment. Case Description The patient was a 34-year-old, otherwise healthy male triathlete with unilateral proximal hamstring tendinopathy diagnosed by ultrasound, who had pain only with running and prolonged sitting. After he failed to respond to 4 weeks of eccentric knee flexion and lumbopelvic musculature strengthening exercises, an eccentric hip extensor strengthening program using a treadmill was initiated. This treadmill exercise was performed on a daily basis, in addition to a lumbopelvic musculature strengthening program. Outcomes The patient noted a decrease in pain within 2 weeks of initiating the new exercise, and was able to return to gradual running after 4 weeks and to speed training after 12 weeks. He returned to competition shortly thereafter and had no recurrence for 12 months after the initiation of therapy. His score on the Victorian Institute of Sport Assessment-proximal hamstring tendons improved from 23 on initial presentation to 83 at 12 weeks after the initiation of therapy. Discussion We described the management of a triathlete with subacute proximal hamstring tendinopathy, who responded well to nonsurgical treatment using eccentric hip extension strengthening using a treadmill. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2015;45(7):557-562. Epub 21 May 2015. doi:10.2519/jospt.2015.5762. PMID:25996362
Amineldin@Aminudin, Nurul Izzaty Bt.; Rambely, A. S.
This study aims to investigate the hamstring muscle activity after the surgery by carrying out an electromyography experiment on the hamstring and to compare the behavior of the ACL muscle activity between ACL patient and control subject. Electromyography (EMG) is used to study the behavior of muscles during walking activity. Two hamstring muscles involved which are semitendinosus and bicep femoris. The EMG data for both muscles were recorded while the subject did maximum voluntary contraction (MVC) and marching. The study concluded that there were similarities between bicep femoris of the ACL and control subjects. The analysis showed that the biceps femoris muscle of the ACL subject had no abnormality and the pattern is as normal as the control subject. However, ACL patient has poor semitendinosus muscle strength compared to that of control subject because the differences of the forces produced. The force of semitendinosus value for control subject was two times greater than that of the ACL subject as the right semitendinosus muscle of ACL subject was used to replace the anterior cruciate ligament (ACL) that was injured.
... Data Consumer Opinion Surveys Home / Research & Statistics Injury Statistics This is the statistic reports page for scientific ... Home Appliances, Maintenance and Construction Injury Statistics Injury Statistics September 30, 2012 Submersions Related to Non-Pool ...
A crush injury occurs when force or pressure is put on a body part. This type of injury most ... squeezed between two heavy objects. Damage related to crush injuries include: Bleeding Bruising Compartment syndrome (increased pressure ...
Laupattarakasem, Wiroon; Boonard, Manusak; Laupattarakasem, Pat; Kosuwon, Weerachai
The posterior tibial inlay technique is currently accepted as a standard operation for the posterior cruciate ligament–deficient knee. The classical technique requires a graft construct consisting of a bony part to be fitted into the posterior tibial socket. When an autogenous source is chosen, morbidity at the donor site generated by obtaining the graft with a bony part (e.g., bone–patellar tendon–bone or quadriceps tendon–bone) can be more serious than when obtaining the soft-tissue graft (e.g., hamstring). This study describes an alternative use of soft-tissue graft anchored in a bone socket at the posterior tibial margin by a transfixing cancellous screw. The graft is secured on top by a “bone washer” harvested from this bone socket to provide biological bone-tendon-bone healing. The posterior cruciate ligament remnant with integral fibers at the femur can have its tibial part revised, tensioned, and reattached concomitantly. This additional procedure is deemed to enhance joint stability and promote graft healing. PMID:23767002
Ice hockey is a popular collision sport with a growing number of female athletes participating each year. As participation among girls and women continues to increase, it will be important to recognize common injuries occurring during women's games. Despite difference in the rules that prohibit body checking in women's and girls' games, injury profiles are similar to those of their male counterparts. Concussions, contusions, acromioclavicular joint injuries, ligamentous knee injuries, and muscle strains occur during women's ice hockey games, with groin strains accounting for the most common practice injury. This article will review both injury rates and common injuries occurring in women's ice hockey, with a focus on the observed concussion rate and groin injuries. PMID:25391093
... Pediatric Injury: Condition Information Skip sharing on social media links Share this: Page Content What is pediatric injury? Pediatric injuries (or traumas) are quite diverse in their origins, severity, and effects on children. One way to understand injuries is by their ...
C hest Foot Leg Spine Wrist 20. If physical injury, type of injury: (SELEC T O NE O NLY ) A brasion T ooth (broken) Burn Fracture Sprain Burn (chem.) Laceration Strain 21. If physical injury, extent: Fatal
Dollé, Jean-Pierre; Morrison, Barclay; Schloss, Rene R.; Yarmush, Martin L.
Traumatic brain injuries are the leading cause of disability each year in the US. The most common and devastating consequence is the stretching of axons caused by shear deformation that occurs during rotational acceleration of the brain during injury. The injury effects on axonal molecular and functional events are not fully characterized. We have developed a strain injury model that maintains the three dimensional cell architecture and neuronal networks found in vivo with the ability to visualize individual axons and their response to a mechanical injury. The advantage of this model is that it can apply uniaxial strains to axons that make functional connections between two organotypic slices and injury responses can be observed in real-time and over long term. This uniaxial strain model was designed to be capable of applying an array of mechanical strains at various rates of strain, thus replicating a range of modes of axonal injury. Long term culture, preservation of slice and cell orientation, and slice-slice connection on the device was demonstrated. The device has the ability to strain either individual axons or bundles of axons through the control of microchannel dimensions. The fidelity of the model was verified by observing characteristic responses to various strain injuries which included axonal beading, delayed elastic effects and breakdown in microtubules. Microtubule breakdown was shown to be dependent on the degree of the applied strain field, where maximal breakdown was observed at peak strain and minimal breakdown is observed at low strain. This strain injury model could be a powerful tool in assessing strain injury effects on functional axonal connections. PMID:23233120
... to treat and alleviate symptoms of a strained back. Anti-inflammatory medications (such as ibuprofen) can help, and stretching and strengthening of the back muscles is important to avoid another back injury.
Welck, M J; Zinchenko, R; Rudge, B
Lisfranc injuries are commonly asked about in FRCS Orthopaedic trauma vivas. The term "Lisfranc injury" strictly refers to an injury where one or more of the metatarsals are displaced from the tarsus. The term is more commonly used to describe an injury to the midfoot centred on the 2nd tarsometatarsal joint. The injury is named after Jacques Lisfranc de St. Martin (1790-1847), a French surgeon and gynaecologist who first described the injury in 1815. 'Lisfranc injury' encompasses a broad spectrum of injuries, which can be purely ligamentous or involve the osseous and articular structures. They are often difficult to diagnose and treat, but if not detected and appropriately managed they can cause long-term disability. This review outlines the anatomy, epidemiology, classification, investigation and current evidence on management of this injury. PMID:25543185
Greco, Camila C; da Silva, Wendell L; Camarda, Sérgio R A; Denadai, Benedito S
The aim of this study was to investigate the effect of fatigue induced by an exhaustive laboratory-based soccer-specific exercise on different hamstrings/quadriceps (H:Q) ratios of soccer players. Twenty-two male professional soccer players (23·1 ± 3·4 year) performed maximal eccentric (ecc) and concentric (con) contractions for knee extensors (KE) and flexors (KF) at 60° s(-1) and 180° s(-1) to assess conventional (H(con) :Q(con)) and functional (H(ecc) :Q(con)) ratios. Additionally, they performed maximal voluntary isometric contraction for KE and KF, from which the maximal muscle strength, rate of force development (RFD) and RFD H:Q strength ratio (RFDH:Q) were extracted. Thereafter, subjects were performed an exhaustive laboratory-based soccer-specific exercise and a posttest similar to the pretest. There was significant reduction in H(con) :Q(con) (0·60 ± 0·06 versus 0·58 ± 0·06, P<0·05) and in H(ecc) :Q(con) (1·29 ± 0·2 versus 1·16 ± 0·2, P<0·01) after the soccer-specific exercise. However, no significant difference between Pre and Post exercise conditions was found for RFDH:Q at 0-50 (0·53 ± 0·23 versus 0·57 ± 0·24, P>0·05) and 0-100 ms (0·53 ± 0·17 versus 0·55 ± 0·17, P>0·05). In conclusion, H:Q strength ratios based on peak force values are more affected by fatigue than RFDH:Q obtained during early contraction phase. Thus, fatigue induced by soccer-specific intermittent protocol seems not reduce the potential for knee joint stabilization during the initial phase of voluntary muscle contraction. PMID:23216761
Robert, Henri; Bowen, Mark; Odry, Guillaume; Collette, Michel; Cassard, Xavier; Lanternier, Hubert; De Polignac, Thierry
The aim of this study was to evaluate at time-zero four tibial fixations on four major criteria: the elongation and cyclic stiffness of the hamstring graft construct under cyclic loading, the yield load and pullout stiffness under load at failure. Four fixation systems were tested: the Delta screw, the WasherLoc, the TightRope Reverse and the tape locking screw on 32 tibiae of adult pigs using 32 pairs of human semitendinosus and gracilis tendons. Two tests were performed: cyclic tests using loads at 70-220 N, to measure the elongation at the end of the cycles, followed by load-to-failure testing to measure the yield load and the cyclic stiffness. The mean elongation was 1.23 mm for the TLS, 3.81 mm for the Delta, 3.59 mm for the WasherLoc and 3.91 mm for the TightRope. The mean yield loads and SD were 1,015 ± 129 N for the TLS, 844 ± 394 N for the Delta, 511 ± 95 N for the WasherLoc and 567 ± 112 N for the TightRope. The results showed the significant superiority of TLS and Delta over WasherLoc and tibial TightRope in regard to yield load. The results showed the significant superiority of TLS over the other fixations in regard to slippage. The TLS system and the Delta screw provide a better quality of primary fixation to the tibia, but further in vitro studies are needed. PMID:24816761
There are a variety of substances you can inhale that can cause acute internal injuries. Particles in ... heart and lung diseases worse. Symptoms of acute inhalation injuries may include Coughing and phlegm A scratchy ...
Sukeik, Mohamed; Haddad, Fares S
Trampoline-related injuries have increased dramatically over the last few years. This article presents a review of the literature summarizing the different types and mechanisms of sustaining such injuries and looks at current recommendations to prevent them. PMID:21240113
... some bleeding in the brain, causing swelling. A skull fracture is when the skull cracks. Sometimes the edges ... of head injuries include bicycle or motorcycle wrecks, sports injuries, falls from windows (especially among children who ...
Hinkle, J; Betz, S
If current trends for this nation continue, by the year 2003 the number of people killed by firearms will exceed the number of people killed in motor vehicle accidents. Critical care practitioners must understand the mechanism of injury associated with firearm injuries to provide optimal care. This article reviews internal, exterior, and terminal ballistics, bullet design, wound classification, and initial assessment and treatment of firearm injuries. PMID:7743422
Selman Uranues; Abe Fingerhut
\\u000a The treatment of splenic injury has changed over the past decade from prompt splenectomy in all cases to splenic salvage when\\u000a possible. The most important factor influencing this change is the recognition of the risk of infection after splenectomy.\\u000a As patients with severe splenic injury generally have other organ injuries, have lost a lot of blood, and are usually in
Krüger-Franke, M; Siebert, C H; Pförringer, W
Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries. Images p99-a p100-a p100-b p100-c PMID:1751899
Krüger-Franke, M; Siebert, C H; Pförringer, W
Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries. PMID:1751899
Young, C C; Niedfeldt, M W
Snowboarding is a popular winter sport that involves riding a single board down a ski slope or on a half-pipe snow ramp. Compared with injuries resulting from traditional alpine skiing, snowboarding injuries occur more frequently in the upper extremities and ankles and less frequently in the knees. Different types of snowboard equipment, rider stance and snowboarding activity tend to result in different types of injury. Snowboarder's ankle, a fracture of the lateral talus, must be considered in a snowboarder with a "severe ankle sprain" that has not responded to treatment. Risk of injury may be lowered by using protective equipment, such as a helmet and wrist guards. PMID:9917579
Cheryl A. Smith; William T. Stauber
Muscle injury is a common result of muscle exertion caused by overload and over-activity. In this presentation, an attempt was made to discuss models of muscle injury which involve exertion but not excessive strain, although most functional activities of the extremities require some eccentric muscle actions. Muscle injury is characterized by cellular and extracellular matrix responses which appear to be
S. Ito; P. C. Ivancic; A. M. Pearson; Y. Tominaga; S. E. Gimenez; W. Rubin; Manohar M. Panjabi
Cervical disc injury due to frontal impact has been observed in both clinical and biomechanical investigations; however, there is a lack of data that elucidate the mechanisms of disc injury during these collisions. The goals of the current study were to determine the peak dynamic disc annular tissue strain and disc shear strain during simulated frontal impact of the whole
Michael L. Tuggy; Cora Collette Breuner
Family physicians routinely treat many athletic injuries in their clinical practice. The benefits of long-term exercise in the prevention of common illnesses such as cardiovascular disease, osteoporosis, and falls in the elderly are well established. With the increased interest in fitness in the general population, the number of people resuming more active exercise as they age is increasing. Injuries sustained
McCurdy, S A; Farrar, J A; Beaumont, J J; Samuels, S J; Green, R S; Scott, L C; Schenker, M B
We conducted a population-based telephone survey addressing farm-work-related (FWR) injuries among California farm operators. Of 1947 participants (80.4% response), 135 farm operators reported 160 FWR injuries in the preceding year, yielding a one-year cumulative incidence for any FWR injury of 6.9% (95% CI 5.8%-8.2%), or a mean 8.2 FWR injuries per 100 farmers in the preceding year (95% CI 6.8-9.7). Multiple injury events in the same individual occurred more frequently than predicted by chance. Sprains and strains (29.4%) were the most frequently reported injury and predominantly involved the back. Overexertion represented the most frequent external cause (24.2%), followed by machinery (14.3%), falls (13.0%), and animals (12.4%). Factors associated with FWR injury included white ethnicity (OR 3.19; 95% CI 1.38-7.36), increased annual hours worked on the farm, low levels of administrative work, and increased percentage of time working with livestock. FWR injury experience of California farm operators is comparable with that reported for other agricultural populations. Above-expected frequency of multiple injuries supports involvement of personal or environmental risk factors. Preventive efforts should focus on higher-risk groups and preventing overexertion and muscle strain and injury related to machinery, falls, and animals, especially livestock. PMID:15216650
Nysted, M; Drogset, J O
Objective To describe the mechanism, location and types of injury for all patients treated for trampoline?associated injuries at St Olav's University Hospital, Trondheim, Norway, from March 2001to October 2004. Materials and methods Patients were identified from a National Injury Surveillance System. All patients were asked to complete a standard questionnaire at their first visit at the hospital. Most data were recorded prospectively, but data on the mechanism of injury, the number of participants on the trampoline at the time of injury, adult supervision and whether the activity occurred at school or in another organised setting were collected retrospectively. Results A total of 556 patients, 56% male and 44% female, were included. The mean age of patients was 11 (range 1–62)?years. 77% of the injuries occurred on the body of the trampoline, including falls on to the mat, collisions with another jumper, falls on to the frame or the springs, and performing a somersault, whereas 22% of the people fell off the trampoline. In 74% of the cases, more than two people were on the trampoline, with as many as nine trampolinists noted at the time of injury. For children <11?years, 22% had adult supervision when the injury occurred. The most common types of injuries were fractures (36%) and injury to ligaments (36%). Injuries to the extremities predominated (79%), and the lower extremities were the most commonly injured part of the body (44%). A ligament injury in the ankle was the most often reported diagnosis (20%), followed by an overstretching of ligaments in the neck (8%) and a fracture of the elbow (7%). Regarding cervical injuries, two patients had cervical fractures and one patient had an atlantoaxial subluxation. Three patients with fractures in the elbow region reported an ulnar nerve neuropathy. 13% of the patients were hospitalised for a mean of 2.2?days. Conclusion Trampolining can cause serious injuries, especially in the neck and elbow areas of young children. The use of a trampoline is a high?risk activity. However, a ban is not supported. The importance of having safety guidelines for the use of trampolines is emphasised. PMID:17000711
Wisconsin at Madison, University of
% of sports medicine practice , with hamstring injuries being particularly frequent among individuals away from sport than the initial injury [9, 10]. Magnetic resonance (MR) imaging provides an objective strain injury Amy Silder & Bryan C. Heiderscheit & Darryl G. Thelen & Timothy Enright & Michael J. Tuite
Kim, Min-hee; Yoo, Won-gyu
[Purpose] This study investigated the effects of inclined treadmill walking on pelvic anterior tilt angle, hamstring muscle length, and back muscle endurance of seated workers with flat-back syndrome. [Subjects] Eight seated workers with flat-back syndrome who complained of low-back pain in the L3–5 region participated in this study. [Methods] The subjects performed a walking exercise on a 30° inclined treadmill. We measured the pelvic anterior tilt angle, hamstring muscle length, and back muscle endurance before and after inclined treadmill walking. [Results] Anterior pelvic tilt angle and active knee extension angle significantly increased after inclined treadmill walking. Trunk extensor and flexor muscle endurance times were also significantly increased compared to the baseline. [Conclusion] Inclined treadmill walking may be an effective approach for the prevention or treatment of low-back pain in flat-back syndrome. PMID:25013282
Isokinetic dynamometer evaluation of the effects of early thigh diameter difference on thigh muscle strength in patients undergoing anterior cruciate ligament reconstruction with hamstring tendon graft
K?l?nç, Bekir Eray; Kara, Adnan; Camur, Savas; Oc, Yunus; Celik, Haluk
After anterior cruciate ligament (ACL) reconstruction, which muscle groups are more affected from frequently developing thigh muscle atrophy is a matter of debate. We evaluate the effect of thigh circumference difference between patients’ knees who were administered the ACL reconstruction with hamstring tendon autograft and intact knees, on torque between the hamstring and quadriceps muscles. Fifty-five patients at least 6 months follow-up period available were included in our study. Power measurements of quadriceps and hamstring muscle groups in patients’ extremities were done by using isokinetic dynamometer. The maximum torque values at 60°/sec, 240°/sec in frequency, positions of flexion and extension were determined. In accordance with our findings it is still possible to encounter the thigh atrophy in average 28 months after ACL reconstruction surgery even under physical rehabilitation programs and appropriate follow-up. It is inevitable for the clinician to consider these changes in diagnosis and rehabilitation stages. It can’t be ignored that muscle weakness mechanisms developing in the thigh circumference vary according to the thigh muscle group and knee flexors play an important role in thigh atrophy when determining an appropriate rehabilitation program after reconstruction application. PMID:25960982
Palmer, Ty B; Akehi, Kazuma; Thiele, Ryan M; Smith, Doug B; Thompson, Brennan J
The purpose of this study was to examine the reliability of ultrasound (US) measures of cross-sectional area (CSA), muscle thickness (MT) and echo intensity (EI) of the hamstrings, with comparisons between males and females. In 20 healthy participants (10 males, 10 females), CSA, MT and EI were measured from panoramic US scans of the hamstrings on 2 separate days. The intra-class correlation coefficients and standard errors of measurement as a percentage of the mean for CSA, MT and EI ranged from 0.715 to 0.984 and from 3.145 to 12.541% in the males and from 0.724 to 0.977 and from 4.571 to 17.890% in the females, respectively. The males had greater CSAs and MTs and lower EIs than the females (p = 0.002-0.049), and significant relationships were observed between CSA and MT (r = 0.714-0.938, p ? 0.001-0.023). From an overall reliability standpoint, these findings suggest that panoramic US may be a reliable technique for examining muscle size and quality of the hamstrings in both males and females. PMID:25683219
Resorbable screws versus pins for optimal transplant fixation (SPOT) in anterior cruciate ligament replacement with autologous hamstring grafts: rationale and design of a randomized, controlled, patient and investigator blinded trial [ISRCTN17384369
Stengel, Dirk; Matthes, Gerrit; Seifert, Julia; Tober, Volker; Mutze, Sven; Rademacher, Grit; Ekkernkamp, Axel; Bauwens, Kai; Wich, Michael; Casper, Dirk
Background Ruptures of the anterior cruciate ligament (ACL) are common injuries to the knee joint. Arthroscopic ACL replacement by autologous tendon grafts has established itself as a standard of care. Data from both experimental and observational studies suggest that surgical reconstruction does not fully restore knee stability. Persisting anterior laxity may lead to recurrent episodes of giving-way and cartilage damage. This might at least in part depend on the method of graft fixation in the bony tunnels. Whereas resorbable screws are easy to handle, pins may better preserve graft tension. The objective of this study is to determine whether pinning of ACL grafts reduces residual anterior laxity six months after surgery as compared to screw fixation. Design/ Methods SPOT is a randomised, controlled, patient and investigator blinded trial conducted at a single academic institution. Eligible patients are scheduled to arthroscopic ACL repair with triple-stranded hamstring grafts, conducted by a single, experienced surgeon. Intraoperatively, subjects willing to engage in this study will be randomised to transplant tethering with either resorbable screws or resorbable pins. No other changes apply to locally established treatment protocols. Patients and clinical investigators will remain blinded to the assigned fixation method until the six-month follow-up examination. The primary outcome is the side-to-side (repaired to healthy knee) difference in anterior translation as measured by the KT-1000 arthrometer at a defined load (89 N) six months after surgery. A sample size of 54 patients will yield a power of 80% to detect a difference of 1.0 mm ± standard deviation 1.2 mm at a two-sided alpha of 5% with a t-test for independent samples. Secondary outcomes (generic and disease-specific measures of quality of life, magnetic resonance imaging morphology of transplants and devices) will be handled in an exploratory fashion. Conclusion SPOT aims at showing a reduction in anterior knee laxity after fixing ACL grafts by pins compared to screws. PMID:15723704
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... who sustain a mild traumatic brain injury (mTBI)/concussion recover completely with little or no intervention. After ... cause symptoms to recur or worsen. Why does concussion affect returning to duty? Symptoms after a concussion ...
, such a sport injury or motor vehicle accident. More common and less dramatic causes include reaching or pulling trauma to head occurred or headache is severe. This side effect will resolve in time. Most injuriesNeck Pain (Cervical Strain) COMMON CAUSES: Neck pain may be triggered by a specific event
Blemker, Silvia Salinas
Keywords: Myotendinous junction Injury Strain Muscle mechanics Micromechanics Finite element modeling to the following hypotheses: (i) the increased likelihood of injury during active lengthening of muscle fibers may fibers from injury by reducing the strains within the fiber at the MTJ. & 2011 Elsevier Ltd. All rights
Joel M. Kary
Injuries to the quadriceps muscle group occur frequently in sports and athletic activities. Muscle strains and contusions\\u000a constitute the majority of these injuries. The clinical presentation and assessment of quadriceps strains and contusions are\\u000a reviewed along with discussion of appropriate imaging used in diagnosis. Treatment protocols for acute injuries are reviewed\\u000a including rehabilitation techniques frequently utilized during recovery. Special consideration
... the Sun Eye Health News Consumer Alerts Preventing Eye Injuries Tweet Protecting your eyes from injury is ... as possible, even if the injury seems minor. Eye Injury Facts and Myths Men are more likely ...
de Candole, C A
The shock wave generated by an explosion ("blast wave") may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742
The postconcussion syndrome is a definite entity, and the patient's complaints are due to legitimate injury. The following three factors contribute to the symptomatology: 1. Headaches, caused by the associated sprain of the cervical spine with resultant radiculitis—giving rise to muscle spasm and suboccipital headaches. 2. Vertigo, due to trauma of the vestibular and labyrinthine apparatus. 3. A vasomotor imbalance and instability resulting from the reaction to “stress.” In treatment of an unconscious patient great care must be taken to prevent anoxia and to balance the fluids and electrolytes. If coma develops following brain injury, hemorrhage into the cerebellar fossa as well as above the tentorium must be considered. PMID:13304695
Yasuyuki Kawaguchi; Eiji Kondo; Nobuto Kitamura; Shuken Kai; Masayuki Inoue; Kazunori Yasuda
Purpose Authors have hypothesized that the incidence and the degree of femoral tunnel enlargement after the hamstring ACL reconstruction\\u000a may be significantly less in the anatomic double-bundle procedure than in single-bundle procedure. The purpose of this study\\u000a is to test this hypothesis.\\u000a \\u000a \\u000a \\u000a \\u000a Methods Seventy-two patients who underwent single-bundle reconstruction (Group S) and 97 patients who underwent anatomic double-bundle\\u000a reconstruction (Group D) were
McKean, Kelly A
Neurologic running injuries account for a small number of running injuries. This may be caused by misdiagnosis or underdiagnosis. Nerve injuries that have been reported in runners include injuries to the interdigital nerves and the tibial, peroneal, and sural nerves. In this article, the etiology, symptoms, diagnosis, and treatment of these injuries are reviewed. Differences between nerve injury and more common musculoskeletal injury have been presented to aid in differential diagnosis. PMID:19084775
McKean, Kelly A
Neurologic running injuries account for a small number of running injuries. This may be caused by misdiagnosis or underdiagnosis. Nerve injuries that have been reported in runners include injuries to the interdigital nerves and the tibial, peroneal, and sural nerves. In this article, the etiology, symptoms, diagnosis, and treatment of these injuries are reviewed. Differences between nerve injury and more common musculoskeletal injury have been presented to aid in differential diagnosis. PMID:18295096
Myer, Gregory D; Ford, Kevin R; Di Stasi, Stephanie L; Foss, Kim D Barber; Micheli, Lyle J; Hewett, Timothy E
Background Identifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle. Objective We evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury. Methods The ‘PFP cohort’ consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The ‘ACL cohort’ included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts. Results KAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p<0.05). Conclusions In adolescent girls aged 13.3 years, >15 Nm of knee abduction load during landing is associated with greater likelihood of developing PFP. Also, in girls aged 16.1 years who land with >25 Nm of knee abduction load during landing are at increased risk for both PFP and ACL injury. PMID:24687011
Kazemi, Mohsen; Chudolinski, Artur; Turgeon, Matt; Simon, Aaron; Ho, Eric; Coombe, Lianne
This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence. This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College. The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend to be younger than 18 years. Recent rule changes have no significant effect on head injuries. PMID:20037692
Shoulder Injuries Approved by the UHS Patient Education Committee Revised 2/13/2013 Page 1 of 2 The common types of shoulder injuries are: Sprains: overstretching or tearing a ligament that connects bone to bone Strain: overstretching of tendons or muscles Tendinitis: inflammation of a tendon Dislocation
Objective: To review the current evidence for the epidemiology of pediatric injuries in martial arts. Data sources: The relevant literature was searched using SPORT DISCUS (keywords: martial arts injuries, judo injuries, karate injuries, and taekwondo injuries and ProQuest (keywords: martial arts, taekwondo, karate, and judo), as well as hand searches of the reference lists. Main results: In general, the absolute
Kim, Tae-Woo; Kim, Yong-Wook
[Purpose] The purpose of this study was to compare the effects of an abdominal drawing-in maneuver (ADIM), measured using a pressure bio-feedback unit, on the activities of the hamstring, gluteus maximus, and erector spinae muscles during prone hip extension. [Subjects and Methods] Thirty healthy adult subjects (14 male, 16 female), were recruited. Subjects' lumbar lordosis and pelvic tilt angles were measured, and based on the results, the subjects were divided into two groups: a hyperlordotic lumbar angle (HLLA) group (n=15) and a normal lordotic lumbar angle (NLLA) group (n=15). The muscle activities of the hamstring and gluteus maximus, and of the erector spinae on the right side of the body, were recorded using surface electromyography. [Results] When performing ADIM with prone hip extension, the muscle activity of the gluteus maximus of the HLLA group significantly improved compared with that the NLLA group. [Conclusion] This study demonstrated that ADIM with prone hip extension was more effective at eliciting gluteus maximus activity in the HLLA group than in the NLLA group. Therefore, ADIM with prone hip extension may be useful for increasing the gluteus maximus activity of individuals with lumbar hyperlordosis. PMID:25729173
Kellis, Eleftherios; Karagiannidis, Evaggelos; Patsika, Glykeria
The purpose of this study was to examine the moment-arm and cross-sectional area (CSA) of the patellar tendon (PT) and the hamstrings after anterior cruciate ligament (ACL) reconstruction. The right knee of five males who underwent ACL reconstruction with a PT graft and five age-matched controls was scanned using magnetic resonance image scans. Based on three-dimensional (3D) solids of the PT, CSAs and moment-arms of semitendinous (ST), biceps femoris (BF) long head and semimembranosus (SM) were estimated. Analysis of variance indicated no significant group differences in muscle moment-arms (p>0.05). 3D moment-arms of PT, ST and BF were significantly lower than the corresponding 2D values (p < 0.05). The ACL group displayed a significantly higher maximum BF CSA, a lower ST CSA (p < 0.05) but similar PT and SM CSAs compared with controls. It is concluded that any alterations in PT properties 1 year after harvesting do not affect knee muscle moment-arms compared with age-matched controls. Moment-arm estimation differed between 3D and 2D data, although it did not affect comparisons between ACL reconstruction group and controls. Design of rehabilitation programmes should take into consideration a potential alteration in hamstring morphology following surgery with a PT graft. PMID:24460238
Ellen E. Yard; R. Dawn Comstock
This study evaluated the effects of competitive intensity, represented by the variables time in competition, phase of play, and field location, on injury severity in U.S. high school football. The injury rate was higher in competition than practice (RR?=?4.75, 95% CI: 4.34–5.20). Mild and moderate injuries were frequently lower leg\\/foot\\/ankle sprains\\/strains and concussions. Severe injuries were frequently knee Sprains\\/strains and
de Lijser, Peter
C. Jessie Jones, Roberta E. Rikli, Julie Max, and Guillermo Nofall. (1998). The Reliability and Validity of a Chair Sit-and-Reach Test as a Measure of Hamstring Flexibility in Older Adults. Research-retest reliability and the criterion validity of a newly developed chair sit-and-reach (CSR) test as a measure
Saadat, Ehsan; Curry, Emily J; Li, Xinning; Matzkin, Elizabeth G
Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simultaneous bilateral ACL tear and preferred management strategies by sports medicine orthopedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons) asking about overall number of ACL reconstructions performed, number of bilateral simultaneous ACL injuries seen and optimal management strategies of such an injury. Out of 43 responses, only 22 (51.2%) surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2%) preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar tendon autograft (58%) or hamstring autograft (41%) were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study. PMID:25568728
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Neeter, Camille; Gustavsson, Alexander; Thomeé, Pia; Augustsson, Jesper; Thomeé, Roland; Karlsson, Jon
A more sports-specific and detailed strength assessment has been advocated for patients after anterior cruciate ligament (ACL) injury and reconstruction. The purpose of this study was to develop a test battery of lower extremity strength tests with high ability to discriminate between leg power development on the injured and uninjured sides in patients after ACL injury and in patients who have undergone ACL reconstruction. Twenty-three patients were tested 6 months after ACL injury and 44 patients were tested 6 months after ACL reconstruction. Twenty-four of the 44 patients were operated on using a hamstrings graft and 20 patients were operated on using a patellar tendon graft. All the patients performed a test battery of three strength tests for each leg in a randomised order. The three strength tests were chosen to reflect quadriceps and hamstring muscular power in a knee-extension and a knee-flexion test (open kinetic chain) and lower-extremity muscular power in a leg-press test (closed kinetic chain). There was a higher sensitivity for the test battery to discriminate abnormal leg power compared with any of the three strength tests individually. Nine out of ten patients after ACL reconstruction and six out of ten of the patients after ACL injury exhibited abnormal leg power symmetry using the test battery. Thus, this test battery had high ability in terms of discriminating between the leg power performance on the injured and uninjured side, both in patients with an ACL injury and in patients who have undergone ACL reconstruction. It is concluded that a test battery consisting of a knee-extension, knee-flexion and leg-press muscle power test had high ability to determine deficits in leg power 6 months after ACL injury and reconstruction. Only a minority of the patients had restored leg muscle power. The clinical relevance is that the test battery may contribute to the decision-making process when deciding whether and when patients can safely return to strenuous physical activities after an ACL injury or reconstruction. PMID:16477472
Apple Jr., David F.
This article discusses reasons for the increase in basketball-related injuries, describes common injuries, outlines steps for diagnosis and treatment, and offers recovery and prevention strategies. (IAH)
Maquirriain, Javier; Ghisi, Juan P; Kokalj, Antonio M
Rectus abdominis muscle strains are common and debilitating injuries among competitive tennis players. Eccentric overload, followed by forced contraction of the non?dominant rectus abdominis during the cocking phase of the service motion is the accepted injury mechanism. A tennis?specific rehabilitation program emphasising eccentrics and plyometric strengthening of the abdominal wall muscles, contributes to the complete functional recovery in tennis players, and could help reduce recurrences. PMID:17957025
McKay, Brian J; Bir, Cynthia A
Anti-vehicular (AV) landmines and improvised explosive devices (IED) have accounted for more than half of the United States military hostile casualties and wounded in Operation Iraqi Freedom (OIF) (Department of Defense Personnel & Procurement Statistics, 2009). The lower extremity is the predominantly injured body region following an AV mine or IED blast accounting for 26 percent of all combat injuries in OIF (Owens et al., 2007). Detonations occurring under the vehicle transmit high amplitude and short duration axial loads onto the foot-ankle-tibia region of the occupant causing injuries to the lower leg. The current effort was initiated to develop lower extremity injury criteria for occupants involved in underbelly blast impacts. Eighteen lower extremity post mortem human specimens (PMHS) were instrumented with an implantable load cell and strain gages and impacted at one of three incrementally severe AV axial loading conditions. Twelve of the 18 PMHS specimens sustained fractures of the calcaneus, talus, fibula and/or tibia. The initiation of skeletal injury was precisely detected by strain gages and corresponded with local peak axial tibia force. Survival analysis identified peak axial tibia force and impactor velocity as the two best predictors of incapacitating injury. A tibia axial force of 5,931 N and impactor velocity of 10.8 m/s corresponds with a 50 percent risk of an incapacitating injury. The criteria may be utilized to predict the probability of lower extremity incapacitating injury in underbelly blast impacts. PMID:20058557
Marc Roig Pull; Craig Ranson
Many acute muscle strain injuries are thought to occur during the eccentric phase of sudden, forceful muscle actions. Repeated eccentric muscle actions during exercise are also thought to contribute to microscopic muscle and tendon damage, leading to chronic muscle strains, muscle rupture and tendinopathy. Conversely, eccentric training has been demonstrated to have a positive effect in the prevention of muscle
Scheusner, D. L.; Busta, F. F.; Speck, M. L.
Injury of test cultures was quantitated by differences in colony counts obtained with a complete medium and those obtained on conventional selective media. Staphylococcus aureus, Streptococcus faecalis, and several strains of Escherichia coli were injured when exposed to the quaternary ammonium compound methylalkyltrimethyl ammonium chloride. Representative hypochlorite sanitizers also caused injury of E. coli ML30. Sanitizer concentration appeared to be the main factor in the cause of death and injury, a higher concentration being needed to cause death. Increases in temperature did not result in substantial increases in injury; however, the lethal effect was greater at higher temperatures. Varying the cell concentration from 107 to 109 cells per ml did not change the fraction of cell population killed or injured. The inability or failure of common selective media to detect injured bacteria in food could have serious public health consequences. PMID:4993231
Sutherland, A G; Holmes, J D; Myers, S
This is a study of all people presenting to ski patrollers with ski and snowboard injuries during the 1995 season. There were 476 casualties of whom 396 were skiers and 57 were snowboarders. Information was collected retrospectively on the mechanism, region and injury, and also personal details of the casualties. The information was compared with the numbers of ski and snowboard injuries for the 1994 season. Injuries due to snowboarding increased in frequency, from 4 per cent in 1994 to 11 per cent in 1995. Snowboarders were younger, predominantly male, and were more often beginners than were skiers. They most commonly sustained ligament strains, dislocations and fractures, with the hand and forearm and shoulder most affected. Skiers sustained more ligament strains and soft tissue bruising, particularly of the knee and thumb. Snowboarders sustain a different pattern of injuries compared with skiers, and this has important implications for preventing accidents in the instruction of novices. PMID:8881140
Joel A Pearlman; K. G. Au Eong; Ferenc Kuhn; Dante J Pieramici
Although airbags measurably reduce the overall risk of injury to adults (including eye injury), and death from motor vehicle accidents, injuries attributed to airbag deployment have been reported. To identify reported cases of ocular trauma related to airbag deployment, a MEDLINE search from 1991 to 2000 was performed. A total of 263 injuries in 101 patients were identified. Patient demographics,
R C Cantu
Injuries to the head and neck are the most frequent catastrophic sports injury, and head injuries are the most common direct athletic cause of death. Although direct compressive forces may injure the brain, neural tissue is particularly susceptible to injury from shearing stresses, which are most likely to occur when rotational forces are applied to the head. The most common
Winwood, Paul W; Hume, Patria A; Cronin, John B; Keogh, Justin W L
This study provides the first empirical evidence of strongman training and competition injury epidemiology. Strongman athletes (n = 213) (mean ± SD: 31.7 ± 8.8 years, 181.3 ± 7.4 cm, 113.0 ± 20.3 kg, 12.8 ± 8.1 years general resistance training, and 4.4 ± 3.4 years strongman implement training) completed a self-reported, 4-page, 1-year retrospective survey of physical injuries that caused a missed or modified training session or competition. Analysis by age (?30 and >30 years), body mass (?105 and >105 kg), and competitive standard (low and high level) was conducted. Eighty-two percent of strongman athletes reported injuries (1.6 ± 1.5 training injuries per lifter per year, 0.4 ± 0.7 competition injuries per lifter per year, and 5.5 ± 6.5 training injuries per 1,000-hour training). Lower back (24%), shoulder (21%), bicep (11%), knee (11%), and strains and tears of muscle (38%) and tendon (23%) were frequent. The majority of injuries (68%) were acute and were of moderate severity (47%). Strongman athletes used self-treatment (54%) or medical professional treatment (41%) for their injuries. There were significantly more competition injuries for the ?30- than the >30-year athletes (0.5 ± 0.8 vs. 0.3 ± 0.6, p = 0.03) and >105-kg athletes compared with the ?105-kg athletes (0.5 ± 0.8 vs. 0.3 ± 0.6, p = 0.014). Although 54% injuries resulted from traditional training, strongman athletes were 1.9 times more likely to sustain injury when performing strongman implement training when exposure to type of training was considered. To reduce risk of injury and improve training practices, strongman athletes should monitor technique and progressions for exercises that increase risk of lower back, shoulder, bicep, and knee musculoskeletal injuries. Clinicians should advise athletes who use of strongman resistance training programs can increase injury risk over traditional exercises. PMID:23669816
Schneider, A S; Mayer, H M; Geißler, U; Rumpf, M C; Schneider, C
This study addresses the epidemiology of injuries in adolescent male and female soccer players in Germany. Therefore, the purpose of the study was to analyse the injuries in male and female youth soccer players in Germany. This study was designed as a cross-sectional web-based survey. From March until December 2011 we investigated 1110 soccer players (male n = 841; female n = 269) aged 12 - 19 years (15.0 ± 2.0 years) from 60 clubs in Southern Germany. A total of 664 (79 %) of the 841 boys and 67 (25 %) of the 269 girls reported being injured due to soccer. The total number of injuries was 2373. Respectively the frequency of injury was 2.85 in boys and 7.10 in girls. The lower extremities were affected in 70 % of all reported cases. Strains were the most common injuries in the lower and upper extremities (35 %). The boys reported in 51.5 % of all injuries that the injury was non-contact in nature. In contrast, 52.1 % of the injuries in girls were reported as contact injuries. Similar amounts of injuries were observed in training versus games for both genders. Prevention procedures, such as a thorough warm-up, should be implemented before every game and training to reduce the risk of injury. PMID:23446953
Kerr, Hamish A
Closed head injuries vary from the very minor to the catastrophic. It is often difficult to differentiate the severity at initial presentation. Serial assessment is very valuable. Awareness of facial injuries is aided by familiarity with facial bone anatomy and the clinical presentation of orbital, zygomatic, maxillary, and mandibular fracture. Functional injury such as concussion may coexist with other injuries. This article will discuss closed head trauma and outline specific injuries to the face, brain, skull, and its surroundings. PMID:23522509
Myer, Gregory D.; Ford, Kevin R.; Khoury, Jane; Succop, Paul; Hewett, Timothy E.
Background Prospective measures of high knee abduction moment during landing identify female athletes at high risk for non-contact anterior cruciate ligament injury. Biomechanical laboratory measurements predict high knee abduction moment landing mechanics with high sensitivity (85%) and specificity (93%). The purpose of this study was to identify correlates to laboratory-based predictors of high knee abduction moment for use in a clinic-based anterior cruciate ligament injury risk prediction algorithm. The hypothesis was that clinically obtainable correlates derived from the highly predictive laboratory-based models would demonstrate high accuracy to determine high knee abduction moment status. Methods Female basketball and soccer players (N=744) were tested for anthropometrics, strength and landing biomechanics. Pearson correlation was used to identify clinically feasible correlates and logistic regression to obtain optimal models for high knee abduction moment prediction. Findings Clinical correlates to laboratory-based measures were identified and predicted high knee abduction moment status with 73% sensitivity and 70% specificity. The clinic-based prediction algorithm, including (Odds Ratio: 95% confidence interval) knee valgus motion (1.43:1.30–1.59 cm), knee flexion range of motion (.98:0.96–1.01 deg), body mass (1.04:1.02–1.06 kg), tibia length (1.38:1.25–1.52 cm) and quadriceps to hamstring ratio (1.70:1.06–2.70) predicted high knee abduction moment status with C statistic 0.81. Interpretation The combined correlates of increased knee valgus motion, knee flexion range of motion, body mass, tibia length and quadriceps to hamstrings ratio predict high knee abduction moment status in female athletes with high sensitivity and specificity. PMID:20554101
Mininder S. Kocher; John A. Feagin
We retrospectively reviewed alpine skiing injuries at a destination ski resort during three seasons to charac terize the incidence and types of shoulder injuries. A total of 3451 injuries in 3247 patients were reviewed. The overall injury rate was 4.44 injuries per 1000 skier- days. Injuries to the upper extremity represented 29.1% (N = 1004) of all alpine ski injuries.
Reed, Christopher A.
INJURY & ILLNESS PREVENTION PLAN (IIPP) University of California Riverside (UCR) Injury & Illness Prevention Plan (IIPP) describes specific 2. Written Documents Document Location Injury and Illness Prevention Plan
Tsuboi, Toshiki; Kitamura, Koji; Nishida, Yoshihumi; Motomura, Yoichi; Takano, Tachio; Yamanaka, Tatsuhiro; Mizoguchi, Hiroshi
This paper proposes a new technology,``a bodygraphic injury surveillance system (BISS)'' that not only accumulates accident situation data but also represents injury data based on a human body coordinate system in a standardized and multilayered way. Standardized and multilayered representation of injury enables accumulation, retrieval, sharing, statistical analysis, and modeling causalities of injury across different fields such as medicine, engineering, and industry. To confirm the effectiveness of the developed system, the authors collected 3,685 children's injury data in cooperation with a hospital. As new analyses based on the developed BISS, this paper shows bodygraphically statistical analysis and childhood injury modeling using the developed BISS and Bayesian network technology.
Tiret, L; Nicaud, V; Hatton, F
An epidemiological survey carried out in 460 public and private institutions chosen at random country-wide in France made it possible to study injuries whose treatment had necessitated an anaesthetic. For 1980, the total number of anaesthetics administered for injuries was estimated at 450,600, among which 22% were applied in public teaching hospitals, 40% in non teaching hospitals, and 38% in private institutions. Of the total number of anaesthetics given, 41% were emergencies and 10% were repeat operations. The proportion of anaesthetics applied in treatment of injuries increases in the summertime and on weekends. There was a majority of male patients (61%), the most important group being those 15 to 24 years of age. Among females, the highest proportion of injuries was observed among those between 75 and 84 years of age. Fractures accounted for 58% of the injuries, open wounds for 20%, dislocations, sprains and strains for 10%. The incidence of injuries varied according to sex and age. Those exposed to the highest risk were males between 15 and 24, and females over 75. Incidence rates by sex and age were also assessed for fractures of the skull and face, upper limb, neck of the femur and lower limb. PMID:3441654
Spinal Cord Injury Prevention Tips Preventing SCI Biking prevention tips While many cycling injuries are head injuries, the ... NeurosurgeryToday.org Every year, an estimated 11,000 spinal cord injury (SCI) accidents occur in the United States. ...
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... the Job Fireworks Eye Safety The personal and economic toll of eye injuries at work is alarming. ... if the eye injury appears minor. Delaying medical attention can result in permanent vision loss or blindness. ...
Face injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, speech, breathing and your ... facial injuries. Certain diseases also lead to facial disorders. For example, nerve diseases like trigeminal neuralgia or ...
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... Anand Veeravagu More Videos New Initiative to Map Human Brain Physicians at Wiesbaden Army Health Clinic are using vision therapy to treat traumatic brain injury Traumatic Brain Injury Pentagon Roundtable Blogs DARPA's Memory Restoration Program
Fields, Karl B.
This article reviews the medical literature on head injuries in soccer and concludes that protective headgear to reduce these injuries may not be as effective as rule changes and other measures, such as padding goal posts. (IAH)
NINDS Brachial Plexus Injuries Information Page Synonym(s): Erb's Palsy Table of Contents (click to jump to sections) What are Brachial ... is being done? Clinical Trials Organizations What are Brachial Plexus Injuries? The brachial plexus is a network of ...
Drkulec, John A.; Letts, Mervyn
Objective To study injury patterns of snowboarding trauma in children. Design A retrospective case series. Setting A major pediatric trauma centre. Patients A cohort of 113 children (97 boys, 16 girls), mean age 13.9 years, who sustained 118 injuries secondary to snowboarding. Interventions All fractures were treated by immobilization in a cast; 19 children required a closed reduction. Outcome measures Sex and age of patients, mechanism of injury, injury sustained, treatments and complications. Results Falls on the outstretched hand from a loss of balance accounted for 66 (57%) of the injuries, uncontrolled falls for 42 (36%) and collisions for 5 (4%). Seventy-nine percent of the injuries were to the upper extremity, whereas 7% were to the lower extremity. Conclusions The predominance of snowboarding injuries of the upper extremity seen in children differs significantly from those in adults in whom lower extremity injuries are more common. PMID:11764877
The cause of death by fires was studied. The present results and information are, however, not enough to reduce loss of life or inhalation injury. The magnitude and type of inhalation injury for civilians and firefighters represents the most inadequately defined human element of accidental fires. Little information is available on compounds other than carbon monoxide, which are responsible for respiration injury or toxicological syndrome. Effective treatment methods for inhalation victims and studies on fatalities, inhalation injury and animals are suggested.
Andrew S. McIntosh
Impacts in sport can cause severe and fatal head, spinal and thoracic injuries. As sports have developed during the last half\\u000a century, methods have been developed to control injury risks, such as rule modifications, helmets, padded clothing and training.\\u000a The biomechanics of severe injury is well understood through investigations of motor vehicle accident trauma. Research into\\u000a sports injury can assist
Bob Winter; Hina Pattani
The annual incidence of acute spinal cord injury in the UK is 15–40 cases per million. More than half these injuries are the result of road traffic accidents, with falls, industrial accidents, sports or violence making up most of the remainder. Violent injury accounts for only a small percentage of cases in this country. The typical patient is male (male
Bob Winter; Hina Pattani
The annual incidence of acute spinal cord injury in the UK is 15–40 cases per million. More than half of these injuries are the result of road traffic accidents, with falls, industrial accidents, sports or violence making up most of the remainder. Violent injury accounts for only a small percentage of cases in the UK. The typical patient is male
Joseph Yuk Sang Ting; Sang Ting
Background: Blunt traumatic aortic injury (TAI) is clinically difficult to diagnose, as signs and symptoms are unreliable and variable. The identification of TAI may be obscured by other injuries that are more apparent. Furthermore, radiologic evaluation of the mediastinum for this injury is not well defined. Most patients with TAI die immediately. Survivors have a contained rupture which requires crucial
Joseph Yuk; Sang Ting
Background: Blunt traumatic aortic injury (TAI) is clini- cally difficult to diagnose, as signs and symptoms are unreliable and variable. The identification of TAI may be obscured by other injuries that are more apparent. Furthermore, radiologic evaluation of the mediastinum for this injury is not well defined. Most patients with TAI die immediately. Survivors have a contained rupture which requires
Dr. Leslie Nader (MSMR)
Very concise description of what constitutes a traumatic brain injury and the cost to society in hospitalizations, injuries and deaths resulting from traumatic brain injury. It also looks very concisely at new understandings of the nature of TBIs and the research being done to find better treatments.
Knutsen, Andrew K.; Ma, Ningning; Taggar, Ajay K.; Brady, Beckah D.; Cupps, Brian P.; Pasque, Michael K.
Background Global systolic strain has been described previously in patients with chronic aortic insufficiency (AI). This study explored regional differences in contractile injury. Methods Tagged magnetic resonance images of the left ventricle (LV) were acquired and analyzed to calculate systolic strain in 42 patients with chronic AI. Multiparametric systolic strain analysis was applied to relate cardiac function in AI patients to a normal strain database (N = 60). AI patients were classified as having normal or poor function based on their results. A two-way repeated-measures analysis of variance was applied to analyze regional differences in injury. Results The mean and standard deviation of raw strain values (circumferential strain, longitudinal strain, and minimum principal strain angle) are presented over the entire LV in our normal strain database. Of the 42 patients with AI, 15 could be defined as having poor function by multiparametric systolic strain analysis. In AI patients with poor function, statistical analysis showed significant differences in injury between standard LV regions (F369,44.33 = 3.47, p = 0.017) and levels (F1.49,17.88 = 4.41, p = 0.037) of the LV, whereas no significant differences were seen in the group with normal cardiac function. Conclusions Patients with poor function, as defined by multiparametric systolic strain z scores, exhibit a consistent, heterogeneous pattern of contractile injury in which the septum and posterior regions at the base are most injured. PMID:22381452
Erin D. Bigler; Stephen R. McCauley; Trevor C. Wu; Ragini Yallampalli; Sanjeev Shah; Marianne MacLeod; Zili Chu; Jill V. Hunter; Guy L. Clifton; Harvey S. Levin; Elisabeth A. Wilde
The temporal stem (TS) of the temporal lobe is a major white matter (WM) region containing several major pathways that connect\\u000a the temporal lobe with the rest of the brain. Because of its location, it may be particularly vulnerable to shear-strain effects\\u000a resulting from traumatic brain injury (TBI). A case vignette is presented in a patient with severe brain injury
Runer, A; Runer, F; Neunhäuserer, D; Ring-Dimitriou, S; Resch, H; Moroder, P
The purpose of this study was to examine the incidence and mechanisms of acute injuries in the sport of fistball. No scientific studies on injury characteristics have yet been conducted in this traditional sport game. The study was conducted prospectively over the course of 12 months. During a total of 40.308 h of sport-specific exposure, 240 players reported 492 injuries, representing an overall injury rate of 12.2 injuries/1000 h of exposure. Most injuries were classified as bagatelle injuries (67.8%). The majority of the injuries were located in the knee (23.5%) followed by the elbow (11.9%) and the hip (11.5%). Ankle injuries resulted in the longest impairment from sports participation. The most common types of injury were abrasions (38.2%), contusions (21.1%), distortions (7.5%) and muscle strains (6.9%). Wrong or insufficient equipment (15.0%) was the most commonly mentioned causes of injury. The data indicate that the injury risk in fistball is rather high; however, the sport should not be considered a high-risk sport because most of the injuries are slight and do not prevent the players from training or competition. Injury prevention strategies should include the development of fistball-specific protective equipment with focus on the knee and elbow joint. PMID:24033688
Daneshjoo, Abdolhamid; Mokhtar, Abdul Halim; Rahnama, Nader; Yusof, Ashril
Purpose We aimed to investigate the effect of FIFA 11+ (11+) and HarmoKnee injury preventive warm-up programs on conventional strength ratio (CSR), dynamic control ratio (DCR) and fast/slow speed ratio (FSR) in young male professional soccer players. These ratios are related to the risk of injury to the knee in soccer players. Methods Thirty-six players were divided into 3 groups; FIFA 11+, HarmoKnee and control (n?=?12 per group). These exercises were performed 3 times per week for 2 months (24 sessions). The CSR, DCR and FSR were measured before and after the intervention. Results After training, the CSR and DCR of knee muscles in both groups were found to be lower than the published normal values (0.61, 0.72, and 0.78 during 60°.s?1, 180°.s?1 and 300°.s?1, respectively). The CSR (60°.s?1) increased by 8% and FSR in the quadriceps of the non-dominant leg by 8% in the 11+. Meanwhile, the DCR in the dominant and non-dominant legs were reduced by 40% and 30% respectively in the 11+. The CSR (60°.s?1) in the non-dominant leg showed significant differences between the 11+, HarmoKnee and control groups (p?=?0.02). As for the DCR analysis between groups, there were significant differences in the non-dominant leg between both programs with the control group (p?=?0.04). For FSR no significant changes were found between groups. Conclusions It can be concluded that the 11+ improved CSR and FSR, but the HarmoKnee program did not demonstrate improvement. We suggest adding more training elements to the HarmoKnee program that aimed to enhance hamstring strength (CSR, DCR and FSR). Professional soccer players have higher predisposition of getting knee injuries because hamstring to quadriceps ratio were found to be lower than the average values. It seems that the 11+ have potentials to improve CSR and FSR as well as prevent knee injuries in soccer players. PMID:23226553
Takhounts, Erik G; Craig, Matthew J; Moorhouse, Kevin; McFadden, Joe; Hasija, Vikas
Rotational motion of the head as a mechanism for brain injury was proposed back in the 1940s. Since then a multitude of research studies by various institutions were conducted to confirm/reject this hypothesis. Most of the studies were conducted on animals and concluded that rotational kinematics experienced by the animal's head may cause axonal deformations large enough to induce their functional deficit. Other studies utilized physical and mathematical models of human and animal heads to derive brain injury criteria based on deformation/pressure histories computed from their models. This study differs from the previous research in the following ways: first, it uses two different detailed mathematical models of human head (SIMon and GHBMC), each validated against various human brain response datasets; then establishes physical (strain and stress based) injury criteria for various types of brain injury based on scaled animal injury data; and finally, uses Anthropomorphic Test Devices (ATDs) (Hybrid III 50th Male, Hybrid III 5th Female, THOR 50th Male, ES-2re, SID-IIs, WorldSID 50th Male, and WorldSID 5th Female) test data (NCAP, pendulum, and frontal offset tests) to establish a kinematically based brain injury criterion (BrIC) for all ATDs. Similar procedures were applied to college football data where thousands of head impacts were recorded using a six degrees of freedom (6 DOF) instrumented helmet system. Since animal injury data used in derivation of BrIC were predominantly for diffuse axonal injury (DAI) type, which is currently an AIS 4+ injury, cumulative strain damage measure (CSDM) and maximum principal strain (MPS) were used to derive risk curves for AIS 4+ anatomic brain injuries. The AIS 1+, 2+, 3+, and 5+ risk curves for CSDM and MPS were then computed using the ratios between corresponding risk curves for head injury criterion (HIC) at a 50% risk. The risk curves for BrIC were then obtained from CSDM and MPS risk curves using the linear relationship between CSDM - BrIC and MPS - BrIC respectively. AIS 3+, 4+ and 5+ field risk of anatomic brain injuries was also estimated using the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) database for crash conditions similar to the frontal NCAP and side impact conditions that the ATDs were tested in. This was done to assess the risk curve ratios derived from HIC risk curves. The results of the study indicated that: (1) the two available human head models - SIMon and GHBMC - were found to be highly correlated when CSDMs and max principal strains were compared; (2) BrIC correlates best to both - CSDM and MPS, and rotational velocity (not rotational acceleration) is the mechanism for brain injuries; and (3) the critical values for angular velocity are directionally dependent, and are independent of the ATD used for measuring them. The newly developed brain injury criterion is a complement to the existing HIC, which is based on translational accelerations. Together, the two criteria may be able to capture most brain injuries and skull fractures occurring in automotive or any other impact environment. One of the main limitations for any brain injury criterion, including BrIC, is the lack of human injury data to validate the criteria against, although some approximation for AIS 2+ injury is given based on the angular velocities calculated at 50% probability of concussion in college football players instrumented with 5 DOF helmet system. Despite the limitations, a new kinematic rotational brain injury criterion - BrIC - may offer a way to capture brain injuries in situations when using translational accelerations based HIC alone may not be sufficient. PMID:24435734
Available Strain Details Order Form for Cryoarchived Strains Strain Number: 01XB8 Common Strain Name: Brca1 floxed (FVB;129) Strain Nomenclature: FVB;129-Brca1tm1Brn/Nci Release Category (Required for MTA form): C2 , D Sample MTA for this strain Strain
Manella, Christine; Backus, Deborah
Purpose: Our study set out to measure the effect of a specific routine of massage on gait characteristics, range of motion, and spasticity in a person with incomplete spinal cord injury. Methods: This descriptive, pre–post case study, conducted at the outpatient program of a rehabilitation facility, used neuromuscular techniques in massage for a 42-year-old man with incomplete chronic C5 spinal cord injury. The massage was applied to the iliopsoas, triceps surae, and hamstring muscle groups for 3 consecutive days. Main Outcome Measures: Pre- and post-intervention testing included standard goniometric measurement of joint range of motion in the lower extremities, spasticity evaluation using the modified Ashworth scale, and evaluation of gait characteristics using GAITRite Walkway (CIR Systems, Havertown, PA, USA) pressure mapping for ambulation time, cadence, velocity, stride length, base of support, and single- and double-limb support. Results: After the therapeutic intervention, the following gait changes were demonstrated: increase in velocity and cadence of gait, decrease in ambulation time, increase in stride length, and improvements in the percentages of the swing and stance phases of the gait cycle. Conclusions: Specific application of massage therapy influenced gait speed, stride length, and swing and stance phase percentages in one person with incomplete spinal cord injury. Further study is warranted to determine the extent to which massage may affect musculoskeletal and neural impairments that limit gait in people with incomplete spinal cord injury, and the method or routine whose application will yield the most benefit. PMID:21589693
SA 2004-2005, Recordable Injuries, SELF ASSESSMENT YEAR 2 2004-2005 Total recordable injuries Cut on finger Material handler Hand sprain Custodian 1 Knee Strain Trans- portation Contused foot Table fell on knee Custodian Hernia Moving furniture carpenter Contusions Fall on stairs custodian Stitches on foot
Presents statistics on injury patterns in youth sports, recommending that physicians who care for young athletes understand the kinds of injuries likely to be sustained. Awareness of injury patterns helps medical professionals identify variables associated with injury, anticipate or prevent injuries, plan medical coverage, and compare individual…
Adirim, Terry A; Cheng, Tina L
It is estimated that 30 million children in the US participate in organised sports programmes. As more and more children participate in sports and recreational activities, there has been an increase in acute and overuse injuries. Emergency department visits are highest among the school-age to young adult population. Over one-third of school-age children will sustain an injury severe enough to be treated by a doctor or nurse. The yearly costs have been estimated to be as high as 1.8 billion US dollars. There are physical and physiological differences between children and adults that may cause children to be more vulnerable to injury. Factors that contribute to this difference in vulnerability include: children have a larger surface area to mass ratio, children have larger heads proportionately, children may be too small for protective equipment, growing cartilage may be more vulnerable to stresses and children may not have the complex motor skills needed for certain sports until after puberty. The most commonly injured areas of the body include the ankle and knee followed by the hand, wrist, elbow, shin and calf, head, neck and clavicle. Contusions and strains are the most common injuries sustained by young athletes. In early adolescence, apophysitis or strains at the apophyses are common. The most common sites are at the knee (Osgood-Schlatter disease), at the heel (Sever's disease) and at the elbow (Little League Elbow). Non-traumatic knee pain is one of the most common complaints in the young athlete. Patellar Femoral Pain Syndrome (PFPS) has a constellation of causes that include overuse, poor tracking of the patellar, malalignment problems of the legs and foot problems, such as pes planus. In the child, hip pathology can present as knee pain so a careful hip exam is important in the child presenting with an insidious onset of knee pain. Other common injuries in young athletes discussed include anterior cruciate ligament injuries, ankle sprains and ankle fractures. Prevention of sports and recreation-related injuries is the ideal. There are six potential ways to prevent injuries in general: (i) the pre-season physical examination; (ii) medical coverage at sporting events; (iii) proper coaching; (iv) adequate hydration; (v) proper officiating; and (vi) proper equipment and field/surface playing conditions. PMID:12477379
Barry P. Boden; Willie Lin; Megan Young; Frederick O. Mueller
Background: There is a paucity of comprehensive information on catastrophic wrestling injuries.Objective: Our objective was to develop a profile of catastrophic injuries in wrestling and a list of relevant risk factors.Study Design: Retrospective review.Methods: We retrospectively reviewed 35 incidents that were reported to the National Center for Catastrophic Sports Injury Research over an 18-year period from 1981 until 1999.Results: Except
Letts, R. M.; Gammon, W.
A 6-year review of auger injuries in Manitoba children revealed that 23 children sustained major injuries resulting in amputation of 17 limbs. Auger injuries are the main cause of traumatic amputation in children in Manitoba. Improved safety education for the entire farm family as well as better design of safety shields would decrease this carnage. Images FIG. 1 FIG. 3 FIG. 4 FIG. 5 FIG. 6 FIG. 9 PMID:630513
\\u000a Head injuries are common among children, and they result in a significant number of visits to emergency departments and physicians’\\u000a offices each year. In children 15yr old and under, the estimated incidence of traumatic brain injury is 180 per 100,000 children\\u000a per year, totaling more than 1 million injuries annually in the United States and accounting for more than 10%
... inside of the chest cavity. Chest injuries and disorders include Heart diseases Lung diseases and collapsed lung Pleural disorders Esophagus disorders Broken ribs Thoracic aortic aneurysms Disorders ...
Kretschmer, Thomas; Heinen, Christian W; Antoniadis, Gregor; Richter, Hans-Peter; König, Ralph W
As long as humans have been medically treated, unfortunate cases of inadvertent injury to nerves afflicted by the therapist have occurred. Most microsurgically treated iatrogenic nerve injuries occur directly during an operation. Certain nerves are at a higher risk than others, and certain procedures and regions of the body are more prone to sustaining nerve injury. A high degree of insecurity regarding the proper measures to take can be observed among medical practitioners. A major limiting factor in successful treatment is delayed referral for evaluation and reconstructive surgery. This article on iatrogenic nerve injuries intends to focus on relevant aspects of management from a nerve surgeon's perspective. PMID:19064181
Kazemi, Mohsen; Shearer, Heather; Su Choung, Young
Background Over the past decade, there has been heightened interest in injury rates sustained by martial arts athletes, and more specifically, Taekwondo athletes. Despite this interest, there is a paucity of research on pre-competition habits and training of these athletes. The purpose of this pilot study was to assess training characteristics, competition preparation habits, and injury profiles of Taekwondo athletes. Methods A retrospective survey of Canadian male and female Taekwondo athletes competing in a national tournament was conducted. Competitors at a Canadian national level tournament were given a comprehensive survey prior to competition. Items on training characteristics, diet, and injuries sustained during training and competition were included. Questionnaires were distributed to 60 athletes. Results A response rate of 46.7% was achieved. Of those that responded, 54% dieted prior to competition, and 36% dieted and exercised pre-competition. Sixty-four percent of the athletes practised between 4–6 times per week, with 54% practicing 2 hours per session. Lower limb injuries were the most common (46.5%), followed by upper extremity (18%), back (10%), and head (3.6%). The majority of injuries consisted of sprains/strains (45%), followed by contusions, fractures, and concussions. More injuries occurred during training, including 59% of first injuries. Conclusion More research needs to be conducted to further illustrate the need for appropriate regulations on weight cycling and injury prevention. PMID:15921510
... techniques that may prevent injury and disease. A spinal cord injury (SCI) can result from trauma, such as ... with daily living skills. What can persons with spinal cord injuries and their friends and families do? ? Get ...
Van Hook, James W
Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and thrombotic microangiopathies may produce acute kidney injury. Prerenal azotemia is another common cause of acute kidney injury in pregnancy. This manuscript will review pregnancy-associated acute kidney injury from a renal functional perspective. Pathophysiology of acute kidney injury will be reviewed. Specific conditions causing acute kidney injury and treatments will be compared. PMID:25264696
George C. Velmahos; Muhammad U. Butt
Cardiac and pulmonary injuries present major chal- lenges in diagnosis and treatment. Distinct differences between penetrating and blunt trauma of these or- gans exist. Outcomes for severe injuries are still grave. Organized trauma systems can provide optimal care by minimizing prehospital time, allowing easy access to imaging modalities, and offering state-of-the-art treatment strategies. A multidisciplinary approach, including surgeons, intensivists, and
Altinok, Tamer; Can, Atilla
Tracheobronchial injury is one of cases which are relatively uncommon, but must be suspected to make the diagnosis and managed immediately. In such a case, primary initial goals are to stabilize the airway and localize the injury and then determine its extend. These can be possible mostly with flexible bronchoscopy conducted by a surgeon who can repair the injury. Most of the penetrating injuries occur in the cervical region. On the other hand, most of the blunt injuries occur in the distal trachea and right main bronchus and they can be best approached by right posterolateral thoracotomy. The selection of the manner and time of approaching depends on the existence and severity of additional injuries. Most of the injuries can be restored by deploying simple techniques such as individual sutures, while some of them requires complex reconstruction techniques. Apart from paying attention to the pulmonary toilet, follow-up is crucial for determination of anastomotic technique or stenosis. Conservative treatment may be considered an option with a high probability of success in patients meeting the criteria, especially in patients with iatrogenic tracheobronchial injury. PMID:25610327
The National Center for Injury Prevention and Control (NCIPC), within the Centers for Disease Control and Prevention, established an interagency agreement with CPSC to begin collecting data on nonfatal firearm-related injuries to monitor the incidence and characteristics of perso...
Purpose – The primary purpose of this paper is to examine the kinds of injuries that preschool teachers working in Indiana, USA, believed to be the most common in their preschool (3-6 year olds) classrooms, the causes of such injuries, and the most important precautions they take to prevent them. Also examined are the measures the teachers take when an
... old injury hurts or aches An old injury swells The joint doesn’t feel normal or feels ... tissue forms. After a while, the scar tissue shrinks. This shrinking brings the ... or concrete. Run on flat surfaces. For adults: Don’t ...
... the eye nausea or vomiting after an eye injury Think Prevention! Kids who play sports should wear protective goggles or unbreakable glasses as needed. Keep chemicals and other potentially dangerous objects out of the reach of children. Reviewed by: Steven Dowshen, MD Date ... Injuries First Aid: Pinkeye Pinkeye (Conjunctivitis) Corneal Abrasions A ...
Downey, Daniel J
Rodeo is a fast-moving sport with highly talented and tough athletes. Prevalence of injury is high, especially in rough stock events, which include bareback, saddle bronc, and bull riding. In bull riding, the incidence of injury is reported at 32.2 injuries per 1000 competitor-exposures. While a number of different injuries can occur during bull riding, concussions are often the most alarming. However, they may also be the most amenable to prevention, despite resistance from rodeo cowboys and organization rulemakers to the use of protective headgear and lack of adherence to recovery guidelines. Rodeo athletes want to return to their sport despite injuries and rarely seek medical care; nonetheless, arena-side health care is still utilized and appreciated by rodeo cowboys. This article addresses the need for greater use of preventative equipment, the importance of allowing full recovery from concussions, and the need to make medical care more available to the rodeo athlete. PMID:17883969
Laraque, D; Barlow, B; Durkin, M
There are four categories of causes responsible for the majority of injuries in youth 10-19 years of age: 1) motor vehicle traffic; 2) violence (intra-familial, extra-familial, self, pregnancy-related); 3) recreational; and 4) occupational. This article presents data from the National Center for Health Statistics mortality data and the National Pediatric Trauma Registry morbidity data. Nationwide, the pediatric injury death rate is highest among adolescents 15-19 years of age. Motor vehicle-related deaths account for 41% and firearm-related deaths account for 36% of injury deaths in this age group. For youths aged 10-14 years, motor vehicle-related deaths account for 38% and; firearm-related deaths account for 26% of injury deaths. For both age groups, occupant motor vehicle-related deaths account for the majority of deaths and underscore the need for seat belt use. Using theoretical principles based on the Haddon matrix and a knowledge of adolescent development, proposed interventions to decrease injuries and deaths related to motor vehicles and firearms include graduated licensing, occupant restraint, speed limits, conflict resolution, and gun control. Occupational injuries, particularly injury associated with agricultural production, account for an estimated 100,000 injuries per year. Preventive strategies include OSHA regulations imposing standards for protective devices and further study for guidelines for adolescent work in agriculture. Injuries related to recreation include drowning and sports injuries. Preventive strategies may include proper supervision and risk reduction with respect to use of alcohol/drugs. The data presented support the use of primary prevention to achieve the most effective, safe community interventions targeting adolescents. PMID:10599188
Handl, Milan; Drzík, Milan; Cerulli, Giuliano; Povýsil, Ctibor; Chlpík, Juraj; Varga, Ferdinand; Amler, Evzen; Trc, Tomás
The study is focused on the biomechanical aspects of the anterior cruciate ligament (ACL) reconstruction procedures with an emphasis on evaluating the dynamic strain of materials commonly used for this purpose. Separate and multiple, equally tensioned strands of hamstring grafts used for the reconstruction of the ACL were biomechanically tested and compared to original ACL and bone-patellar tendon-bone (BPTB) grafts, using tissue samples from cadavers. The study was focused on measuring such material properties as the strength, stiffness, maximum load, and elongation at maximum load of the original ACL, BPTB graft, and single tendon hamstring (gracilis and semitendinosus) grafts, continued by double strands and finally by four-strand graft (STG) evaluation. Fresh-frozen cadaveric knees were used, which had been clamped and tensioned equally. The measurement was performed by drop-weight testing, using a Laser Doppler Vibrometer as a basic sensor of the dynamic movements of the gripping clamps, with parallel correlation by a piezoelectric transducer. The grafts for experiments were obtained from 21-paired knees. The measurement was performed at room temperature (21 degrees C) after 24 h of thawing at 4 degrees C. All the specimens were measured for their response to the dynamic tensile load. The maximum strength values were obtained and calculated for the appropriate section area of the specimen. The tensioned strands of the original ACL showed a maximum average load of 1,246 +/- 243 N in the section area of about 30 mm(2) (max. stress 41.3 MPa); the strands of BPTB grafts showed values of 3,855 +/- 550 N in the section area of 80 mm(2) (max. stress 40.6 MPa); the gracilis tendons showed 925 +/- 127 N in the section area of 10 mm(2) (max. stress 95.1 MPa) and the semitendinosuss yielded a result of 2,050 +/- 159 N in the area of 20 mm(2) (max. stress 88.7 MPa). Of all the materials, the original ACL have the lowest strength and stiffness in respect of their biomechanical properties. BPTB grafts showed a slightly higher value of maximum stress, while both the gracilis and semitendinosus tendons showed double the value of maximum load per section area-tensile stress. Two- and four- combined hamstring strands clamped together and equally tensioned with a drop-weight had the combined tensile strength properties of the individual strands within the estimated range of measurement errors. No significant changes in maximum loads/stresses were observed under impact loading conditions. The results of this study demonstrate that equally tensioned four-strand hamstring-tendon grafts have higher initial tensile properties than those in other varieties of samples. From a biomechanical point of view, they seem to be a reasonable alternative procedure for ACL reconstruction. PMID:16972110
Habelt, Susanne; Hasler, Carol Claudius; Steinbrück, Klaus; Majewski, Martin
In spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.88% girls. The most frequent sports injuries were football (31.13%) followed by handball (8.89%) and sports during school (8.77%). The lower extremity was involved in 68.71% of the cases. Knee problems were seen in 29.79% of the patients; 2.57% spine and 1.99% head injuries. Injuries consisted primarily of distortions (35.34%) and ligament tears (18.76%); 9,00% of all injuries were fractures. We found more skin wounds (6:1) and fractures (7:2) in male patients compared to females. The risk of ligament tears was highest during skiing. Three of four ski injuries led to knee problems. Spine injuries were observed most often during horse riding (1:6). Head injuries were seen in bicycle accidents (1:3). Head injuries were seen in male patients much more often then in female patients (21:1). Fractures were noted during football (1:9), skiing (1:9), inline (2:3), and during school sports (1:11). Many adolescents participate in various sports. Notwithstanding the methodological problems with epidemiological data, there is no doubt about the large number of athletes sustain musculoskeletal injuries, sometimes serious. In most instances, the accident does not happened during professional sports and training. Therefore, school teachers and low league trainer play an important role preventing further accidence based on knowledge of individual risk patterns of different sports. It is imperative to provide preventive medical check-ups, to monitor the sport-specific needs for each individual sports, to observe the training skills as well as physical fitness needed and to evaluation coaches education. PMID:22355484
Young, Lee Ann; Rule, Gregory T; Bocchieri, Robert T; Burns, Jennie M
Despite years of effort to prevent traumatic brain injuries (TBIs), the occurrence of TBI in the United States alone has reached epidemic proportions. When an external force is applied to the head, it is converted into stresses that must be absorbed into the brain or redirected by a helmet or other protective equipment. Complex interactions of the head, neck, and jaw kinematics result in strains in the brain. Even relatively mild mechanical trauma to these tissues can initiate a neurochemical cascade that leads to TBI. Civilians and warfighters can experience head injuries in both combat and noncombat situations from a variety of threats, including ballistic and blunt impact, acceleration, and blast. It is critical to understand the physics created by these threats to develop meaningful improvements to clinical care, injury prevention, and mitigation. Here the authors review the current state of understanding of the complex loading conditions that lead to TBI and characterize how these loads are transmitted through soft tissue, the skull and into the brain, resulting in TBI. In addition, gaps in knowledge and injury thresholds are reviewed, as these must be addressed to better design strategies that reduce TBI incidence and severity. PMID:25714862
Hume, P A; Chalmers, D J; Wilson, B D
OBJECTIVE: To examine trampoline related injuries resulting in emergency department attendance. METHODS: Cases were identified by searching free text descriptions of the circumstances of injury contained in the records of the emergency department of a large city hospital. RESULTS: 114 cases were identified for a 12 month period, giving an incidence rate of 108 per 100,000 population per year (95% confidence interval = 89 to 129) compared with 9.3 hospital admissions per 100,000 population per year (95% confidence interval = 8.3 to 10.4) for a corresponding period reported in earlier research from New Zealand. This suggested that for every one hospital admission there are approximately 12 emergency department attendances. Of the cases, 95% were aged less than 20 years. As for the earlier research, falls from the trampoline to the surrounding surface were the commonest cause of injury. In the present study, sprains and strains were the commonest type of injury (40%), and the body site most frequently involved was the lower limb (46%). CONCLUSIONS: The findings support the conclusion from earlier research that although existing trampoline standards address many of the issues relating to trampoline safety, the need remains for measures to reduce the impact of falls from the trampoline to the ground surface and to prohibit the use of trampolines as unsupervised "play equipment". PMID:9015596
Holmes, Harlan K.; Moore, T. C., Sr.
Once an installed strain gage is connected to a strain indicating device and the instrument is balanced, a subsequent change in temperature of the gage installation will generally produce a resistance change in the gage. This purely temperature-induced resistance will be registered by the indicating device as a strain and is referred to as 'apparent strain' to distinguish it from strain due to applied stress. One desirable technique for apparent strain compensation is to employ two identical gages with identical mounting procedures which are connected with a 'half bridge' configuration where gages see the same thermal environment but only one experiences a mechanical strain input. Their connection in adjacent arms of the bridge will then balance the thermally induced apparent strains and, in principle, only the mechanical strain remains. Two approaches that implement this technique are discussed.
Macedonia, Christian; Zamisch, Monica; Judy, Jack; Ling, Geoffrey
The repair of traumatic injuries to the central nervous system remains among the most challenging and exciting frontiers in medicine. In both traumatic brain injury and spinal cord injuries, the ultimate goals are to minimize damage and foster recovery. Numerous DARPA initiatives are in progress to meet these goals. The PREventing Violent Explosive Neurologic Trauma program focuses on the characterization of non-penetrating brain injuries resulting from explosive blast, devising predictive models and test platforms, and creating strategies for mitigation and treatment. To this end, animal models of blast induced brain injury are being established, including swine and non-human primates. Assessment of brain injury in blast injured humans will provide invaluable information on brain injury associated motor and cognitive dysfunctions. The Blast Gauge effort provided a device to measure warfighter's blast exposures which will contribute to diagnosing the level of brain injury. The program Cavitation as a Damage Mechanism for Traumatic Brain Injury from Explosive Blast developed mathematical models that predict stresses, strains, and cavitation induced from blast exposures, and is devising mitigation technologies to eliminate injuries resulting from cavitation. The Revolutionizing Prosthetics program is developing an avant-garde prosthetic arm that responds to direct neural control and provides sensory feedback through electrical stimulation. The Reliable Neural-Interface Technology effort will devise technologies to optimally extract information from the nervous system to control next generation prosthetic devices with high fidelity. The emerging knowledge and technologies arising from these DARPA programs will significantly improve the treatment of brain and spinal cord injured patients.
Clenney, T L; Lassen, L F
Because of the increasing popularity of recreational scuba diving, primary care physicians should be familiar with common diving injuries. One form of barotrauma, middle ear squeeze, is the most common diving injury. Other important diving injuries include inner ear barotrauma and pulmonary barotrauma. Arterial gas embolism, a potentially life-threatening form of pulmonary barotrauma, requires hyperbaric treatment. Decompression sickness is the result of bubble formation in body tissue. Symptoms of decompression sickness range from joint pain to neurologic or pulmonary problems. Recompression is the mainstay of treatment. PMID:8623700
Meyers, M C; Brown, B R; Bloom, J A
The popularity of fast pitch softball in the US and throughout the world is well documented. Along with this popularity, there has been a concomitant increase in the number of injuries. Nearly 52% of cases qualify as major disabling injuries requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75% of injuries occur during away games and approximately 31% of traumas occur during nonpositional and conditioning drills. Injuries range from contusions and tendinitis to ligamentous disorders and fractures. Although head and neck traumas account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of injuries occur when the athlete collides with another individual or object. Other factors involved include the quality of playing surface, athlete's age and experience level, and the excessive physical demands associated with the sport. Nearly 24% of injuries involve base running and are due to poor judgement, sliding technique, current stationary base design, unorthodox joint and extremity position during ground impact and catching of cleats. The increasing prevalence of overtraining syndrome among athletes has been attributed to an unclear definition of an optimal training zone, poor communication between player and coach, and the limited ability of bone and connective tissue to quickly respond to match the demands of the sport. This has led routinely to arm, shoulder and lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and time loss injuries in 45% of pitching staff during a single season. Specific attention to a safer playing environment, coaching and player education, and sport-specific training and conditioning would reduce the risk, rate and severity of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as well as minimising use of indoor facilities, is suggested to decrease the number of collision injuries. Coaches should be cognisant of overtraining, vary day-to-day training routines to decrease repetitive musculoskeletal stress, focus on motor skills with equal emphasis on speed and efficiency of movement, and use drills that reinforce sport-specific, decision making processes to minimise mental mistakes. Conditioning programs that emphasise a combination of power, acceleration, flexibility, technical skill, functional capacity and injury prevention are recommended. Due to the limited body of knowledge presently available on this sport, a greater focus on injury surveillance would provide a clearer picture of injury causation and effective management procedures, leading toward safer participation and successful player development. PMID:11219502
Ilsar, M; Chirambo, M; Belkin, M
A survey was made of 205 patients admitted to hospital for ocular trauma in Malawi in south-east Africa from January 1976 to December 1977. Results of the survey show that eye trauma is a relatively common problem in this developing country, occurring most frequently in children, young adults, and males. Most eye injuries in Malawi occurred under domestic circumstances; the major cause of ocular trauma was associated with chopping and gathering wood. Industrial injuries were rare. The most common injury was contusion and the most frequent complication was traumatic cataract. Most treated eyes retained useful vision. PMID:7059557
Available Strain Details Order Form for Cryoarchived Strains Strain Number: 01XE7 Common Strain Name: Villin-Cre, vil-Cre Fo20 Strain Nomenclature: B6.Cg-Tg(Vil-cre)20Sy/Nci Release Category (Required for MTA form): B1 , D Sample MTA for this
Available Strain Details Order Form for Live Mice Strain Number: 01XBL Common Strain Name: Myf6-ires-cre knock-in Strain Nomenclature: B6;129-Myf6tm2(cre)Mrc/Nci Release Category (Required for MTA form): C1 , D Sample MTA for this strain Animal
Michael A. Nelson; Chair Barry Goldberg; Sally S. Harris; Gregory L. Landry; David M. Orenstein; William L. Risser; Kathryn Keely; Richard Malacrea; Judith C. Young
Horseback riding accidents can cause head injuries resulting in death or permanent residual defects. These riding injuries occur most frequently in riders younger than 21 years of age.' Approximately 20% of injuries in young riders are to the central nervous system.2'3 The majority of these injuries are cerebral contusions, concussions, or skull fractures.3 Use of approved helmets has been associated
Brent M. Wiersema; Eric J. Wall; Susan L. Foad
Objective. To identify the most common mechanisms and sites of injury associated with book backpacks in school-aged children, who present to the emergency department. This should help with the devel- opment of backpack injury prevention strategies. Design. A descriptive analysis of The National Elec- tronic Injury Surveillance System (NEISS) of the US Consumer Product Safety Commission (CPSC) National Injury Information
Tuchfarber, Barbara S.; Zins, Joseph E.; Jason, Leonard A.
Childhood injury continues to be a major public health crisis in the United States, with a large percentage of injuries being preventable and controllable. This chapter provides information related to understanding child and youth injury. Studies have shown that injuries affect identifiable high-risk groups. Such host factors that put children at…
Schöffl, Volker; Heid, Andreas; Küpper, Thomas
Tendon injuries are the second most common injuries of the hand and therefore an important topic in trauma and orthopedic patients. Most injuries are open injuries to the flexor or extensor tendons, but less frequent injuries, e.g., damage to the functional system tendon sheath and pulley or dull avulsions, also need to be considered. After clinical examination, ultrasound and magnetic resonance imaging have proved to be important diagnostic tools. Tendon injuries mostly require surgical repair, dull avulsions of the distal phalanges extensor tendon can receive conservative therapy. Injuries of the flexor tendon sheath or single pulley injuries are treated conservatively and multiple pulley injuries receive surgical repair. In the postoperative course of flexor tendon injuries, the principle of early passive movement is important to trigger an “intrinsic” tendon healing to guarantee a good outcome. Many substances were evaluated to see if they improved tendon healing; however, little evidence was found. Nevertheless, hyaluronic acid may improve intrinsic tendon healing. PMID:22720265
Vachhani, Prasanti G; Copelan, Alexander; Remer, Erick M; Kapoor, Baljendra
Iatrogenic hepatopancreaticobiliary injuries occur after various types of surgical and nonsurgical procedures. Symptomatically, these injuries may lead to a variety of clinical presentations, including tachycardia and hypotension from hemobilia or hemorrhage. Iatrogenic injuries may be identified during the intervention, immediately afterwards, or have a delayed presentation. These injuries are categorized into nonvascular and vascular injuries. Nonvascular injuries include biliary injuries such as biliary leak or stricture, pancreatic injury, and the development of fluid collections such as abscesses. Vascular injuries include pseudoaneurysms, arteriovenous fistulas, dissection, and perforation. Imaging studies such as ultrasound, computed tomography, magnetic resonance imaging, and digital subtraction angiography are critical for proper diagnosis of these conditions. In this article, we describe the clinical and imaging presentations of these iatrogenic injuries and the armamentarium of minimally invasive procedures (percutaneous drainage catheter placement, balloon dilatation, stenting, and coil embolization) that are useful in their management. PMID:26038625
... but it also has a large societal and economic toll. The estimated economic cost of TBI in 2010, including direct and ... P, Miller T and associates. The Incidence and Economic Burden of Injuries in the United States. New ...
... Research Information Clinical Trials Resources and Publications Traumatic Brain Injury (TBI): Condition Information Skip sharing on social ... external force that affects the functioning of the brain. It can be caused by a bump or ...
Wampler, Charles Wilson
In the design of robotic systems that safely interact with people, it is useful to have validated criteria for measuring injury risks. To this end, some researchers have advocated the use of metrics developed for assessing ...
Exercising and playing sports can lead to a sound mind and body, but sports-related injuries can be frustrating for anyone. This very helpful site, offered as part of the Medline Plus series from the U.S. National Library of Medicine, contains dozens of fact sheets, media presentations, and other items regarding various sports injuries. Visitors who know exactly what they need can click on over to the "Related Topics" area on the right-hand side of the homepage, where they will find resources on everything from ankle injuries to general wellness. Their homepage also contains sections like "Basics", "Research", and "Multimedia & Cool Tools". Two items that are definitely worth checking out are the tennis elbow tutorial and the basic overview of sports injuries offered by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Griffing, Bill; /Fermilab
In a recent DOE Program Review, Fermilab's director presented results of the laboratory's effort to reduce the injury rate over the last decade. The results, shown in the figure below, reveal a consistent and dramatic downward trend in OSHA recordable injuries at Fermilab. The High Energy Physics Program Office has asked Fermilab to report in detail on how the laboratory has achieved the reduction. In fact, the reduction in the injury rate reflects a change in safety culture at Fermilab, which has evolved slowly over this period, due to a series of events, both planned and unplanned. This paper attempts to describe those significant events and analyze how each of them has shaped the safety culture that, in turn, has reduced the rate of injury at Fermilab to its current value.
... made of muscles and tendons. It helps your shoulder to move and stay stable. Problems with the rotator cuff are common. They include tendinitis, bursitis, and injuries such as tears. Rotator cuff tendons can become ...
Unlike the hepatic, cardiovascular, nervous, or excretory organ systems, where there .ls a strong contribution of host factors or extracellular biochemical milieu in causing organ damage, the causes of lung injuries and subsequent diseases are primarily from direct environmental ...
... Videos Infographics Hand Anatomy Find a Hand Surgeon Brachial Plexus Injury Email to a friend * required fields From * ... to name and customize your collection. DESCRIPTION The brachial plexus is a group of nerves that come from ...
Jennifer M. Medina; Tamara C. Valovich McLeod; Suzanne K. Howell; Jackie J. Kingma
There is a discrepancy between males and females in regards to lower extremity injury rates, particularly at the knee [Agel, J., Arendt, E.A., Bershadsky, B., 2005. Anterior cruciate ligament injury in National Collegiate Athletic Association basketball and soccer: a 13-year review. American Journal of Sports Medicine 33, (4) 524–530]. Gender differences in neuromuscular recruitment characteristics of the muscles that stabilize
Kemper, A R; Kennedy, E A; McNally, C; Manoogian, S J; Stitzel, J D; Duma, S M
The purpose of this study was to quantify the biomechanical response of the human thorax during dynamic shoulder belt loading representative of that seen in a severe automotive collision. Two post-mortem human surrogates (PMHSs) (one male and one female) were instrumented with 26 single-axis strain gages on the ribs, sternum, and clavicle. The thorax of each PMHS was placed on a custom spine support bracket designed to support the thorax on either side of the spinous process, thereby allowing free motion at the costovertebral joints. In addition, the support bracket raised the thorax above the flat base plate, which could otherwise constrain the deformation and motion of the posterior region of the rib cage. The thorax of each PMHS was then loaded using a custom table-top belt loading system that generated thoracic displacement rates representative of a severe automotive collision, 1.3 m/s for the male PMHS and 1.0 m/s for the female PMHS. The rib fracture timing data, determined by analyzing the strain gage time histories, showed that severe thoracic injury (AIS = 3) occurred at 16% chest compression for the male and 12% chest compression for the female. However, these values are well below the current thoracic injury criteria of 29% chest compression for the male and 23% chest compression for the female. This data illustrates that serious thoracic injury (AIS = 3) occurs at lower chest compressions than the current ATD thoracic injury criteria. Overall, this study provides critical data that can be used in the design and validation of advanced ATDs and finite element models, as well as the establishment of improved, more stringent thoracic injury criteria. PMID:21512892
Plog, Benjamin A.; Pierre, Clifford A.; Srinivasan, Vasisht; Srinivasan, Kaushik; Petraglia, Anthony L.; Huang, Jason H.
Background: Snowmobiles are increasingly popular recreational, all-terrain utility vehicles that require skill and physical strength to operate given their inherent maneuverability, acceleration, and top speed capabilities. These same characteristics increase the risk of injury with the operation of these vehicles, particularly neurological injury. We characterize our series of 107 patients involved in snowmobiling accidents. Methods: From January 2004 to January 2012, all snowmobiling-related injuries referred to our regional trauma center were reviewed. Information had been recorded in the hospital's trauma registry and medical records were retrospectively reviewed for data pertaining to the injuries, with particular emphasis on neurological injuries and any associated details. Results: A total of 107 patients were identified. Ninety percent of injured riders were male. The mean age was 34.4 years (range 10-70), with 7% younger than age 16. The mean Injury Severity Score was 12.0 ± 0.69 (range 1-34). Although not documented in all patients, alcohol use was found in 7.5% of the patients and drug use found in one patient. Documentation of helmet use was available for only 31 of the patients; of which 13% were not helmeted. Causes included being thrown, flipped, or roll-over (33%), striking a stationary object (27%), being struck by a snowmobile (9%), striking another snowmobile (5.5%) or a car, train, or truck (5.5%), being injured by the machine itself (9%), other (2%) or unspecified (18%). Head injuries occurred in 35% patients, including concussion, subarachnoid hemorrhage, subdural hematoma, contusion, and facial/skull fracture. Spinal fractures occurred in 21% of the patients. Fractures to the thoracic spine were the most common (50%), followed by the cervical (41%) and lumbar (36%) spine. There were also three brachial plexus injuries, one tibial nerve injury, and one internal carotid artery dissection. Average length of stay was 4.98 ± 0.56 days. Disposition was home (78%), home with services (12%), rehabilitation placement (9%), and one death. Details regarding other systemic injuries will also be reviewed. Conclusions: Snowmobiles are a significant source of multi-trauma, particularly neurological injury. Neurosurgeons can play key roles in advocating for neurological safety in snowmobiling. PMID:25024887
A muscle strain is the stretching or tearing of muscle fibers. A muscle strain can be caused by sports, exercise, a ... something that is too heavy. Symptoms of a muscle strain include pain, tightness, swelling, tenderness, and the ...
This article looks at healthcare professionals, in particular midwives, and considers how to maintain back health and prevent injury through principles of good practice. Knowledge of back pain, mindfulness in working conditions and modifications of current practice will reduce the risk of repetitive injury, and present management options in the short- and long term. Considerations on improving the 'working lifestyle' rather than quick fixes are ultimately the long-term goal. PMID:25597130
Zeller, T; Billing, A; Lob, G
In a retrospective study, 376 paragliding accidents have been analysed. Leg injuries were most common, but a large number of spinal injuries also occurred. The causes were either misjudgement by the pilot or the influence of weather and terrain. Improvements in the instructor's knowledge and the pilot's training could have prevented most of the accidents. Analysis of the mechanisms of the crashes and the pattern of trauma help to produce an efficient approach to diagnosis and treatment. PMID:1428338
Raghupathi, Anantha Krishnan; Kumar, Prathap
Aims Nonscaphoid fractures comprise approximately 40% of all carpal fractures. But the exact incidence of these rare injuries is still not clear. Missed or late diagnosis can lead to serious ligamentous disruption and permanent wrist dysfunction. Methods A retrospective analysis of wrist X-rays and CT scans were carried out for a period of 3 years. Incidence and associated injuries from this study was compared with literature. A total of 33 patients were included in our study. Both wrist X-rays and CT scans were reviewed individually by two authors. DASH scores were recorded for each patient. Results There were 26 male and 7 female patients. Out of 33 patients 13 (35%) were Triquetral fractures, 10 (27%) were Hamate fractures, 5 (14%) were Capitate fractures, 4 (11%) were Lunate fractures, 3 (8%) were Trapezium fractures and 2 (5%) were Pisiform fractures. There were no Trapezoid fractures in our study. Conclusion Incidence of nonscaphoid carpal fractures in our study is considerably higher when compared to literature. We propose that high index of suspicion should always be borne in mind when dealing with carpal fractures and detailed examination of wrist should be conducted even when X-rays does not show any obvious bony injuries. CT scans and other specialized images should be judiciously used in areas of suspicion for early diagnosis, to initiate immediate treatment, for early mobilisation and good functional recovery. PMID:25104893
Bridges, E; Rouah, F; Johnston, K
Objectives: To evaluate injury patterns of snowbladers and compare them with those of skiers and snowboarders. To determine possible effects of helmet use in these sports on injury to the head and neck. Methods: This prospective case series observational study was conducted by collecting the injury reports from the ski patrol during the 1999–2000 season at Mont Tremblant ski resort, Quebec. All participants in downhill winter sports who presented themselves to the ski patrol with traumatic injury related to their sport were included. A concussion was defined as any loss of consciousness, amnesia, confusion, disorientation, vertigo, or headache that resulted from injury. The ski patroller reported helmet use on the accident report at the time of injury. Results: Snowbladers present with a unique pattern of injury compared with skiers and snowboarders. The incidence of leg, knee, and ankle/foot injuries were 20.5%, 25.6%, and 10.3% respectively. Concussions represented 11% of all injuries. There was no increase in other injury, including neck injury, related to helmet use. Conclusions: Unique injury patterns in snowbladers warrant reconsideration of equipment design. Concussion is a common injury on the ski slope. Although the effects of helmet use on concussion rate are inconclusive based on this study, helmet use did not increase the rate of neck injury, even when adjusted for age. PMID:14665590
If you work in front of a computer a lot, you are probably a candidate for Repetitive-Stress Injuries (RSI). This article from TECHWR-L entitled, Avoiding Repetitive-Stress Injuries: A Guide for the Technical Communicator gives some helpful tips for preventing the aches, pains, hand problems and eye strain associated with repeated computer usage. The article discusses different mouse options, keyboard options, and other adjustments you can make to lessen your risk of RSI and make typing at the computer a little more pleasant. Additional links at the bottom provide further information on healthy computing.
Suh, Chang Min; Kim, Sung Ho; Goldsmith, Werner
Traumatic Brain Injury (TBI) due to head impact by external impactor was analyzed using Finite Element Method (FEM). Two-dimensiona modeling was performed according to Magnetic Resonance Imaging (MRI) data of Mongolian subject. Pressure variation in a cranium due to external impact was analyzed in order to simulate Nahum et al.'s cadaver test.6 And, analyzed results were compared with Nahum et al.'s experimental data.6 As results, stress and strain behaviors of the brain during impact were accorded with experimental data qualitatively even though there were some differences in quantitative values. In addition, they were accorded with other references about brain injury as well.
Wiater, J M; Bigliani, L U
Injury to the spinal accessory nerve can lead to dysfunction of the trapezius. The trapezius is a major scapular stabilizer and is composed of three functional components. It contributes to scapulothoracic rhythm by elevating, rotating, and retracting the scapula. The superficial course of the spinal accessory nerve in the posterior cervical triangle makes it susceptible to injury. Iatrogenic injury to the nerve after a surgical procedure is one of the most common causes of trapezius palsy. Dysfunction of the trapezius can be a painful and disabling condition. The shoulder droops as the scapula is translated laterally and rotated downward. Patients present with an asymmetric neckline, a drooping shoulder, winging of the scapula, and weakness of forward elevation. Evaluation should include a complete electrodiagnostic examination. If diagnosed within 1 year of the injury, microsurgical reconstruction of the nerve should be considered. Conservative treatment of chronic trapezius paralysis is appropriate for older patients who are sendentary. Active and healthy patients in whom 1 year of conservative treatment has failed are candidates for surgical reconstruction. Studies have shown the Eden-Lange procedure, in which the insertions of the levator scapulae, rhomboideus minor, and rhomboideus major muscles are transferred, relieves pain, corrects deformity, and improves function in patients with irreparable injury to the spinal accessory nerve. PMID:10613148
Hamiltonians that generally describe the effects of strain are proposed. The strain effects can be calculated easily from the unstrained potential using these Hamiltonians. These Hamiltonians are valid when the strain is spatially modulated, and are also valid when the strain exists in a magnetic field. These Hamiltonians can also be used in the improved effective mass approximation.
In Canada 30,000 people are registered as blind; in one third of these, blindness might have been avoided. Prevention is the key to reducing the number of eye injuries and blind eyes. The role of the family physician in early identification of treatable conditions and in the education of patients is discussed, but responsibility for prevention belongs to all physicians. The success of prevention is seen in the great reduction in eye injuries in industry and sports since eye protectors have been commonly used. However, many dangers to the eyes are either not recognized or are not taken seriously enough. This paper discusses some of the common causes of serious eye injuries in the home, in sports and in industry. Imagesp464-aFig. 1Fig. 2Fig. 3Fig. 4 PMID:21289691
Three patients are presented with significant flame burns, resulting from accidents occurring during 'special effects' situations in the entertainment industry. These occurred as a result of the spontaneous combustion of various materials, during events in live theatre (gun powder), a television commercial (artificial 'rocket fuel'), and a video presentation (magnesium oxide). All three patients sustained flash burns to the face and hands. One patient sustained a significant bilateral corneal injury, a gamekeeper's thumb, and a permanent continuous right-sided high frequency tinnitus, in addition to his burn injury. Photographic documentation of all three patients is presented. The total loss of time from work for all patients was 6 months. All these injuries were potentially preventable. PMID:2031675
Noel, Bruce W. (Espanola, NM); Smith, Darryl L. (Los Alamos, NM); Sinha, Dipen N. (Los Alamos, NM)
A strain gage comprising a strained-layer superlattice crystal exhibiting piezoelectric properties is described. A substrate upon which such a strained-layer superlattice crystal has been deposited is attached to an element to be monitored for strain. A light source is focused on the superlattice crystal and the light reflected from, passed through, or emitted from the crystal is gathered and compared with previously obtained optical property data to determine the strain in the element.
Noel, B.W.; Smith, D.L.; Sinha, D.N.
A strain gage comprising a strained-layer superlattice crystal exhibiting piezoelectric properties is described. A substrate upon which such a strained-layer superlattice crystal has been deposited is attached to an element to be monitored for strain. A light source is focused on the superlattice crystal and the light reflected from, passed through, or emitted from the crystal is gathered and compared with previously obtained optical property data to determine the strain in the element. 8 figs.
Ji, Songbai; Zhao, Wei; Ford, James C; Beckwith, Jonathan G; Bolander, Richard P; Greenwald, Richard M; Flashman, Laura A; Paulsen, Keith D; McAllister, Thomas W
Sports-related concussion is a major public health problem in the United States and yet its biomechanical mechanisms remain unclear. In vitro studies demonstrate axonal elongation as a potential injury mechanism; however, current response-based injury predictors (e.g., maximum principal strain, ?(ep)) typically do not incorporate axonal orientations. We investigated the significance of white matter (WM) fiber orientation in strain estimation and compared fiber strain (?(n)) with ?(ep) for 11 athletes with a clinical diagnosis of concussion. Geometrically accurate subject-specific head models with high mesh quality were created based on the Dartmouth Head Injury Model (DHIM), which was successfully validated (performance categorized as "good" to "excellent"). For WM regions estimated to be exposed to high strains using a range of injury thresholds (0.09-0.28), substantial differences existed between ?(n) and ?(ep) in both distribution (Dice coefficient of 0.13-0.33) and extent (? 5-10-fold differences), especially at higher threshold levels and higher rotational acceleration magnitudes. For example, an average of 3.2% vs. 29.8% of WM was predicted above an optimal threshold of 0.18 established from an in vivo animal study using ?(n) and ?(ep), respectively, with an average Dice coefficient of 0.14. The distribution of WM regions with high ?(n) was consistent with typical heterogeneous patterns of WM disruptions in diffuse axonal injury, and the group-wise extent at the optimal threshold matched well with the percentage of WM voxels experiencing significant longitudinal changes of fractional anisotropy and mean diffusivity (3.2% and 3.44%, respectively) found from a separate independent study. These results suggest the significance of incorporating WM microstructural anisotropy in future brain injury studies. PMID:24735430
Patient Education Institute
This patient education program discusses how spinal cord injuries are caused and their treatment options. It also includes tips on how to prevent spinal cord injuries. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.
Luff, A J; Hodgkins, P R; Baxter, R J; Morrell, A J; Calder, I
This study addresses the aetiology of perforating ocular injury in childhood and possible preventive measures. Data have been collected from the case notes of 143 patients presenting over a 10 year period to a single ophthalmic unit. Injuries occurred most often in a domestic setting (34%) or with a child at play (19%) and showed an overall four to one ratio of boys to girls. Sports injuries accounted for 15% and assault for 8% of all injuries. A changing pattern of ocular injury is evident: road traffic accidents constituted 6% of injuries, compared with 31% in a similar study published in 1976. The role of litigation is discussed, particularly with regard to firearms, which accounted for 8% of injuries. It is concluded that the most important factor in the prevention of perforating ocular trauma is parental awareness, 53% of injuries occurring with the child in a domestic setting or at play. PMID:8323341
... this? Submit What's this? Submit Button NCHS Home All Injuries Recommend on Facebook Tweet Share Compartir Data ... first-listed diagnostic categories [PDF - 58 KB] Mortality All injury deaths Number of deaths: 192,945 Deaths ...
Han, Jay S; Chopra, Anil; Carr, David
The TASER (TASER International) is an energy-conducting weapon, that is becoming more frequently used by law enforcement officials to subdue combative individuals. Though generally regarded as a safe alternative, the use of such weapons has been reported to cause serious injuries. We describe a case in which ocular injuries were sustained by impalement with a TASER dart. Emergency physicians should be aware of the potential for serious ophthalmic injuries from TASERs and how such injuries should be managed. PMID:19166645
With the new emphasis on physical fitness, musculoskeletal stress injuries are being seen with greater frequency in children and adults, and in locations that are not widely associated with stress injury. Some of the injuries continue to be mistaken for signs of more serious illnesses, such as infection and neoplasm, and this may lead to unnecessary investigative effort. This book covers both the classic stress injuries and the new manifestations.
Osman, Essam A.
Ocular trauma remains a core root of avoidable blindness worldwide. Corneal scarring, lens injury, glaucoma, vitreous hemorrhage, retinal or choroidal detachment and endophthalmitis are sequel to ocular trauma that can lead to blindness. Very few studies have been published to tackle the risk of developing post-traumatic glaucoma after open globe injuries (OGI), however, there are many articles discussing closed eye injury. This review article aims to cover the incidence, risk factors, causes and treatment of glaucoma after open globe injury.
McCue, Frank C., III; and Others
The majority of shoulder injuries occurring in throwing sports involve the soft tissue structures. Injuries often occur when the unit is overstretched to a point near its greatest length, involving the elastic tissues. The other injury mechanism involves the contractural unit of the muscle, which occurs near the midpoint of contractions, involving…
A. O. GROBBELAAR; D. A. HUDSON
Flexor tendon injuries in adults differ from those in children. 38 children (22 male and 16 female) with a mean age of 6.7 years were treated for flexor tendon injuries by primary suture and controlled mobilization between 1985 and 1992. 53 flexor tendons were injured (average 1.5 digits per patient) and the injury most commonly affected the little finger (23
Peter Kälebo; Jon Karlsson; Leif Sward; Lars Peterson
Ultrasonography was used in the diagnosis of 36 pa tients with chronic groin pain localized to the tendons of the rectus abdominis, rectus femoris, adductor mus cles, hamstring muscles, and the gluteal muscles. Ab normal findings, such as focal sonolucent areas and discontinuity of tendon fibers, that are indicative of nonhealed partial ruptures were found in 28 patients. These findings
Forward, Karen E; Seabrook, Jamie A; Lynch, Tim; Lim, Rodrick; Poonai, Naveen; Sangha, Gurinder S
BACKGROUND: Hockey is played by youth across Canada, and its popularity has increased dramatically among females in the past decade. Despite this, there has been little epidemiological research comparing the injury patterns of young female and male hockey players. OBJECTIVE: To describe and compare injuries sustained by female and male youth hockey players using the Canadian Hospitals Injury Reporting and Prevention Program database. METHODS: In the present cross-sectional, retrospective comparison study, the Canadian Hospitals Injury Reporting and Prevention Program database was used to identify all hockey-related injuries sustained by children seven to 17.5 years of age over a 15-year period (January 1995 to December 2009). Exclusion criteria included paid professional players and children with injuries sustained while playing road hockey. RESULTS: Inclusion criteria were met by 33,233 children (2637 [7.9%] females and 30,596 [92.1%] males). Compared with males, females reported proportionately more soft tissue injuries (39.8% versus 32.6%; P<0.01) and sprains/strains (21.1% versus 17.6%; P<0.01). Males experienced more fractures (27.1% versus 18.2%; P<0.01) and were most often injured through body checking (42.8% versus 25.7%; P<0.01). Females showed a trend toward increased concussion with age, and were most often injured through collisions (28.6% versus 24.6%; P<0.01). CONCLUSION: Compared with males, female hockey players sustained proportionately more soft tissue injures and sprains/strains, and showed a trend toward concussions in late adolecence. Males experienced more fractures, shoulder injuries and injuries due to body checking. Further research is required to identify risk factors for injury in female youth hockey players and to target injury prevention. PMID:25382998
Bergstrøm, K A; Askild, O; Jørgensen, N A; Ekeland, A
The goal of this study was to evaluate the Injury Severity Score (ISS) in an alpine area. Hafjell Alpine Centre was the 1994 Winter Olympic Alpine arena in Lillehammer. A total of 2,044,484 lift transportations and 183 injuries were registered in the two winter seasons 1991 and 1992. The injury rate was 1.8 injuries per 1000 skier days. The mean ISS was 3.6 per injury for this particular alpine area. Thirty-six per cent of the injured were women and 35.5% were between 15 and 19 years of age. There was no difference in mean ISS between male and female skiers, but mean ISS was higher in adolescents than in the other age groups. Injuries to the knee represented the single most frequently injured body region, but injuries to the abdomen had the highest mean ISS. Alpine skiers suffered more severe injuries than telemark and snowboard skiers. Severe injuries (ISS > 16) were recorded when unexpected objects, such as a grooming machine, a net, a root, etc., appeared on the slope. The Abbreviated Injury Scale (AIS) and ISS give us additional information about the condition of the slopes, and their use as a tool in preventing skiing injuries is recommended. PMID:10220846
N. de Vera; L. Camón; E. Martínez
Summary The cerebral ODC\\/polyamine system is disturbed by brain injury. The main modifications are important increases in ODC activity and putrescine concentration, with minor variations in spermidine and spermine concentrations. A great diversity of stimuli such as cerebral ischemia or overstimulation of the central nervous system by chemical or non-chemical agents can induce polyamine disturbances. Both the contribution of polyamines
... visit emergency departments due to serious injuries from motor vehicle accidents. Suffocation (being unable to breathe) Infants are most likely to suffocate while they sleep. Toddlers are most at risk from suffocating by choking on food or other small objects. Drowning Drowning is the ...
... fracture of the skull or bleeding, bruising or blood clots in the brain. Treatment How is a traumatic brain injury treated? ... there is a skull fracture, if there are blood clots that need to be removed from the brain or if there is too much pressure inside ...
Schwartz, Stacey Hunter
This paper reviews the Acquired Brain Injury (ABI) Program at Coastline Community College (California). The ABI Program is a two-year, for-credit educational curriculum designed to provide structured cognitive retraining for adults who have sustained an ABI due to traumatic (such as motor vehicle accident or fall) or non-traumatic(such as…
Ellis, Jessica L; Gottlieb, Jamie E
This article summarizes the current evidence and expert opinion on making return-to-play decisions after cervical spine injuries. Injuries discussed include fractures, central cord neuropraxia, stringers, disc herniations, strains, sprains, and instability. Each of these injuries may be complicated by coexistence of other conditions making return-to-play decisions more complicated. The congenital, developmental, and disease processes discussed include spear tackler's spine, congenital and developmental stenosis, Klippel-Feil syndrome, odontoid abnormalities, rheumatoid arthritis, spina bifida, and Arnold-Chiari malformations. Postsurgical considerations are also discussed. This review represents an abundant amount of expert opinion that was overwhelmingly based on case series, case reports, and biomechanical studies to support the return-to-play guidelines. PMID:17212914
In humans, a number of genetic factors have been linked to the development of fibrosis in a variety of different organs. Seeking a wider understanding of this observation in man is ethically important. There is mounting evidence suggesting that inbred mouse strains with different genetic backgrounds demonstrate variable susceptibility to a fibrotic injury. We performed a systematic review of the literature describing strain and organ specific response to injury in order to determine whether genetic susceptibility plays a role in fibrogenesis. Data were collected from studies that were deemed eligible for analysis based on set inclusion criteria, and findings were assessed in relation to strain of mouse, type of injury and organ of investigation. A total of 44 studies were included covering 21 mouse strains and focusing on fibrosis in the lung, liver, kidney, intestine and heart. There is evidence that mouse strain differences influence susceptibility to fibrosis and this appears to be organ specific. For instance, C57BL/6J mice are resistant to hepatic, renal and cardiac fibrosis but susceptible to pulmonary and intestinal fibrosis. However, BALB/c mice are resistant to pulmonary fibrosis but susceptible to hepatic fibrosis. Few studies have assessed the effect of the same injury stimulus in different organ systems using the same strains of mouse. Such mouse strain studies may prove useful in elucidating the genetic as well as epigenetic factors in humans that could help determine why some people are more susceptible to the development of certain organ specific fibrosis than others. PMID:24294831
acute inversion ankle sprains. Stress fracture interventionankle, foot (SOAP notes: foot strain) † All injury encounters include the ICD-9 codes for fracture/fracture, eight sprain/strain, four iliotibial band syndrome/patellofemoral syndrome (ITBS/PFS), one tendinitis of the foot or ankle,
Rozycki, G S; Maull, K I
During a recent 4-year period, 381 patients were admitted with injuries sustained from falls. Equal numbers of patients were less than and greater than 50 years of age and included 53 children (less than or equal to 16 years) and 214 elderly (greater than or equal to 55 years). Falls from heights occurred predominantly in young males (mean age 34.2 years), were most commonly job or recreation related and resulted in higher injury severity scores (ISS). Falls in the elderly occurred more commonly in women, typically on a flat surface, and were less severe. Despite lower mean ISS, fall victims over 55 years of age had longer hospitalizations (11.4 vs. 4.5 days) and incurred higher hospital charges compared to younger patients. There were 35 deaths (9.2%). In patients under 55 years, deaths resulted from fall-related central nervous system (CNS) injury and/or multisystem trauma. In patients over 55 years, fatalities were most commonly related to pre-existent medical conditions. Based on a review of this experience, we conclude that: (1) unlike other causes of blunt and penetrating trauma, both sexes are equally at risk from fall-related injuries but sex incidence is age related; (2) falls from heights are more common in men; (3) advanced age and pre-existing medical conditions account for the increased morbidity and mortality following falls and; (4) cost containment measures for fall-related trauma must consider not only injury severity, but the age and pre-existent medical conditions of the patient. PMID:1772536
Moffat, Craig; McIntosh, Scott; Bringhurst, Jade; Danenhauer, Karen; Gilmore, Nathan; Hopkins, Christy L.
Background: This study examined demographics, injury pattern, and hospital outcome in patients injured in winter resort terrain parks. Methods: The study included patients ?12 years of age who presented to a regional trauma center with an acute injury sustained at a winter resort. Emergency department (ED) research assistants collected patient injury and helmet use information using a prospectively designed questionnaire. ED and hospital data were obtained from trauma registry and hospital records. Results: Seventy-two patients were injured in a terrain park, and 263 patients were injured on non-terrain park slopes. Patients injured in terrain parks were more likely to be male [68/72 (94%) vs. 176/263 (67%), p<0.0001], younger in age [23 ± 7 vs. 36 ± 17, p<0.0001], live locally [47/72 (65%) vs. 124/263 (47%), p=0.006], use a snowboard [50/72 (69%) vs. 91/263 (35%), p<0.0001], hold a season pass [46/66 (70%) vs. 98/253 (39%), p<0.0001], and sustain an upper extremity injury [29/72 (40%) vs. 52/263 (20%), p<0.001] when compared to patients injured on non-terrain park slopes. There were no differences between the groups in terms of EMS transport to hospital, helmet use, admission rate, hospital length of stay, and patients requiring specialty consultation in the ED. Conclusions: Patients injured in terrain parks represent a unique demographic within winter resort patrons. Injury severity appears to be similar to those patients injured on non-terrain park slopes. PMID:20046245
Quatman, Carmen E.; Kiapour, Ali; Myer, Gregory D.; Ford, Kevin R.; Demetropoulos, Constantine K.; Goel, Vijay K.; Hewett, Timothy E.
Background Bone bruises located on the lateral femoral condyle and posterolateral tibia are commonly associated with anterior cruciate ligament (ACL) injuries and may contribute to the high risk for knee osteoarthritis after ACL injury. The resultant footprint (location) of a bone bruise after ACL injury provides evidence of the inciting injury mechanism. Purpose/Hypothesis (1) To analyze tibial and femoral articular cartilage pressure distributions during normal landing and injury simulations, and (2) to evaluate ACL strains for conditions that lead to articular cartilage pressure distributions similar to bone bruise patterns associated with ACL injury. The hypothesis was that combined knee abduction and anterior tibial translation injury simulations would demonstrate peak articular cartilage pressure distributions in the lateral femoral condyle and posterolateral tibia. The corollary hypothesis was that combined knee abduction and anterior tibial translation injury conditions would result in the highest ACL strains. Study Design Descriptive laboratory study. Methods Prospective biomechanical data from athletes who subsequently suffered ACL injuries after testing (n = 9) and uninjured teammates (n = 390) were used as baseline input data for finite element model comparisons. Results Peak articular pressures that occurred on the posterolateral tibia and lateral femoral condyle were demonstrated for injury conditions that had a baseline knee abduction angle of 5°. Combined planar injury conditions of abduction/anterior tibial translation, anterior tibial translation/internal tibial rotation, or anterior tibial translation/external tibial rotation or isolated anterior tibial translation, external tibial rotation, or internal tibial rotation resulted in peak pressures in the posterolateral tibia and lateral femur. The highest ACL strains occurred during the combined abduction/anterior tibial translation condition in the group that had a baseline knee abduction angle of 5°. Conclusion The results of this study support a valgus collapse as the major ACL injury mechanism that results from tibial abduction rotations combined with anterior tibial translation or external or internal tibial rotations. Clinical Relevance Reduction of large multiplanar knee motions that include abduction, anterior translation, and internal/external tibial motions may reduce the risk for ACL injuries and associated bone bruises. In particular, prevention of an abduction knee posture during initial contact of the foot with the ground may help prevent ACL injury. PMID:21487121
Pugh, Theresa J; Bolin, Delmas
Some 30 million Americans are involved in equestrian sports. Although there is significant literature regarding catastrophic injury, there is very little literature that addresses overuse injury and its effect on rider and horse. As the horse and rider function as a unit, overuse injuries to the rider can affect the horse's training and responsiveness. Sports physicians treating riders should understand correct posture in the saddle and its alteration by muscular imbalance and injury. This review discusses common equestrian events, and common overuse injuries in recreational and competitive riders. PMID:15509470
Chen, YungChia; Mao, Haojie; Yang, King H.; Abel, Ted; Meaney, David F.
For the past 25?years, controlled cortical impact (CCI) has been a useful tool in traumatic brain injury (TBI) research, creating injury patterns that includes primary contusion, neuronal loss, and traumatic axonal damage. However, when CCI was first developed, very little was known on the underlying biomechanics of mild TBI. This paper uses information generated from recent computational models of mild TBI in humans to alter CCI and better reflect the biomechanical conditions of mild TBI. Using a finite element model of CCI in the mouse, we adjusted three primary features of CCI: the speed of the impact to achieve strain rates within the range associated with mild TBI, the shape, and material of the impounder to minimize strain concentrations in the brain, and the impact depth to control the peak deformation that occurred in the cortex and hippocampus. For these modified cortical impact conditions, we observed peak strains and strain rates throughout the brain were significantly reduced and consistent with estimated strains and strain rates observed in human mild TBI. We saw breakdown of the blood–brain barrier but no primary hemorrhage. Moreover, neuronal degeneration, axonal injury, and both astrocytic and microglia reactivity were observed up to 8?days after injury. Significant deficits in rotarod performance appeared early after injury, but we observed no impairment in spatial object recognition or contextual fear conditioning response 5 and 8?days after injury, respectively. Together, these data show that simulating the biomechanical conditions of mild TBI with a modified cortical impact technique produces regions of cellular reactivity and neuronal loss that coincide with only a transient behavioral impairment. PMID:24994996
Lone, Reyaz A; Akbar, Bhat M; Sharma, ML; Lateef, Wani M; Ahangar, AG; Lone, GN; Dar, A M; Singh, Shyam; Shah, Mubbashir; Hussain, Zahur; Irshad, Ifat; Rasool, Fouzia
Background: Importance of repairing a diaphragmatic tear due to a missile injury cannot be overemphasized. Even a small diaphragmatic rent should be repaired because of morbidity and mortality caused by subsequent herniation and strangulation. Methods: Fifty-three cases with diaphragmatic injuries caused by penetrating missiles were studied from January 1997 to January 2007. All the patients were primarily explored either for thoracic or abdominal penetrating trauma; the diaphragmatic injury was an associated incidental intraoperative finding. Thoracotomy was performed in 18 patients, Laprotomy in 33 patients and in two patients combined thorocoabdominal approach was utilised for managing associated visceral injuries. Results: Overall mortality was 37.7%. Mortality was dependent on associated injuries of thoracic and abdominal viscera. Most patients died due to associated injuries and septicaemia. None of the patients had any sequelae of diaphragmatic repair. Conclusion: Immediate repair of diaphragmatic injury is of paramount importance to prevent subsequent complications of herniation and strangulation. PMID:21475506
A decade ago, cricket has traditionally been regarded as relatively injury free, although it has been classified as having a "moderate" injury risk. At present, cricket has evolved into shorter and more competitive versions involving greater aggression and often played for long periods of time. This has expectedly ensued in an increase in the number of cricketing injuries similar to those seen in other sports which involve running, throwing, or being hit by a hard object. However, there are some injuries to look out for especially in cricket players. In this article, we have reviewed information about cricket injuries that will help orthopaedists make the correct diagnoses and initiate appropriate treatment. Orthopaedic surgeons and physiotherapists should work as a team to detect treatable cricket injuries at an early stage and ensure that every precaution is taken to minimize the risks of injury. PMID:24890289
MCALLISTER, THOMAS W.; FORD, JAMES C.; JI, SONGBAI; BECKWITH, JONATHAN G.; FLASHMAN, LAURA A.; PAULSEN, KEITH; GREENWALD, RICHARD M.
On-field monitoring of head impacts, combined with finite element (FE) biomechanical simulation, allow for predictions of regional strain associated with a diagnosed concussion. However, attempts to correlate these predictions with in vivo measures of brain injury have not been published. This article reports an approach to and preliminary results from the correlation of subject-specific FE model-predicted regions of high strain associated with diagnosed concussion and diffusion tensor imaging to assess changes in white matter integrity in the corpus callosum (CC). Ten football and ice hockey players who wore instrumented helmets to record head impacts sustained during play completed high field magnetic resonance imaging preseason and within 10 days of a diagnosed concussion. The Dartmouth Subject-Specific FE Head model was used to generate regional predictions of strain and strain rate following each impact associated with concussion. Maps of change in fractional anisotropy (FA) and median diffusivity (MD) were generated for the CC of each athlete to correlate strain with change in FA and MD. Mean and maximum strain rate correlated with change in FA (Spearman ? = 0.77, p = 0.01; 0.70, p = 0.031), and there was a similar trend for mean and maximum strain (0.56, p = 0.10; 0.6, p = 0.07), as well as for maximum strain with change in MD (?0.63, p = 0.07). Change in MD correlated with injury-to-imaging interval (? = ?0.80, p = 0.006) but change in FA did not (? = 0.18, p = 0.62). These results provide preliminary confirmation that model-predicted strain and strain rate in the CC correlate with changes in indices of white matter integrity. PMID:21994062
McAllister, Thomas W; Ford, James C; Ji, Songbai; Beckwith, Jonathan G; Flashman, Laura A; Paulsen, Keith; Greenwald, Richard M
On-field monitoring of head impacts, combined with finite element (FE) biomechanical simulation, allow for predictions of regional strain associated with a diagnosed concussion. However, attempts to correlate these predictions with in vivo measures of brain injury have not been published. This article reports an approach to and preliminary results from the correlation of subject-specific FE model-predicted regions of high strain associated with diagnosed concussion and diffusion tensor imaging to assess changes in white matter integrity in the corpus callosum (CC). Ten football and ice hockey players who wore instrumented helmets to record head impacts sustained during play completed high field magnetic resonance imaging preseason and within 10 days of a diagnosed concussion. The Dartmouth Subject-Specific FE Head model was used to generate regional predictions of strain and strain rate following each impact associated with concussion. Maps of change in fractional anisotropy (FA) and median diffusivity (MD) were generated for the CC of each athlete to correlate strain with change in FA and MD. Mean and maximum strain rate correlated with change in FA (Spearman ? = 0.77, p = 0.01; 0.70, p = 0.031), and there was a similar trend for mean and maximum strain (0.56, p = 0.10; 0.6, p = 0.07), as well as for maximum strain with change in MD (-0.63, p = 0.07). Change in MD correlated with injury-to-imaging interval (? = -0.80, p = 0.006) but change in FA did not (? = 0.18, p = 0.62). These results provide preliminary confirmation that model-predicted strain and strain rate in the CC correlate with changes in indices of white matter integrity. PMID:21994062
Myers, A H; Baker, S P; Li, G; Smith, G S; Wiker, S; Liang, K Y; Johnson, J V
OBJECTIVES: The purpose of this study was to identify factors associated with acute low back injury among municipal employees of a large city. METHODS: For each of 200 injured case patients, 2 coworker controls were randomly selected, the first matched on gender, job, and department and the second matched on gender and job classification. In-person interviews were conducted to collect data on demographics, work history, work characteristics, work injuries, back pain, psychosocial and work organization, health behaviors, and anthropometric and ergonomic factors related to the job. Psychosocial work organization variables were examined with factor analysis techniques; an aggregate value for job strain was entered into the final model. Risk factors were examined via multivariate logistic regression techniques. RESULTS: High job strain was the most important factor affecting back injury (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.28, 3.52), and it showed a significant dose-response effect. Body mass index (OR = 1.54, 95% CI = 1.08, 2.18) and a work movement index (twisting, extended reaching, and stooping) (OR = 1.42, 95% CI = 0.97, 2.08) were also significant factors. CONCLUSIONS: Results suggest that increasing workers' control over their jobs reduces levels of job strain. Ergonomic strategies and worksite health promotion may help reduce other risk factors. PMID:10394312
Salwe, Kirtigandha; Kumar, Shrawan; Hood, Joyce
Objectives. To determine the prevalence of musculoskeletal disorders in hospital cleaners. Methods. Injury data on all hospital employees were extracted from occupational health records and compared. Additionally an interview-based modified Nordic Questionnaire (response rate 98.14%) was conducted. Results. The mean total injury rate for cleaners was 35.9?per 100?full-time equivalent (FTE), while that for other employees was 13.64 per 100?FTE. Slips/trips/falls and MMH contributed 4.39 and 2.37 per 100?FTE among cleaners and rest of the hospital employees, respectively. The most common type of injury was strain while the most common cause of injury was a striking object. Conclusion. The cleaners have higher injury rates and morbidity as compared to other employees of the hospital. The lower back was most commonly affected. PMID:21776437
Strained silicon has generated significant interest in the Si integrated circuit community in recent years due to its ability of carrier mobility enhancement. Different approaches of introducing strain are being studied. One of the approaches for introducing the strained Si channel region is to grow a graded SiGe layer on top of standard Si substrate followed by a uniform SiGe layer, and finally overgrow a thin strained Si layer. In this dissertation, we review the physics of carrier mobility enhancement due to the strain. Band gap shrinkage, band offset (misalignment) are discussed. A number of approaches of forming strain are introduced and compared. We use several characterization techniques including Raman spectroscopy, Rutherford backscattering spectrometry (RBS) and ion channeling, capacitance-voltage (C-V), pulsed metal-oxide-semiconductor (MOS) capacitor capacitance-time (C-t), and gate oxide integrity (GOI) measurements to characterize the crystalline structure, the band structure, the strain status, and oxide quality of strained silicon/relaxed SiGe samples. We are able to determine the strain of the capping Si and SiGe layers, extract the band offset of Si/SiGe interfaces, and the thickness of the strained Si. The effective carrier generation lifetime is also obtained for strained-Si/relaxed SiGe structure by Zerbst analysis of C-t measurement. From GOI statistical analysis, we found that the oxide grown on strained Si is inferior compared to regular Si samples.
Gorguner, Metin; Akgun, Metin
Inhaled substances may cause injury in pulmonary epithelium at various levels of respiratory tract, leading from simple symptoms to severe disease. Acute inhalation injury (AII) is not uncommon condition. There are certain high risk groups but AII may occur at various places including home or workplace. Environmental exposure is also possible. In addition to individual susceptibility, the characteristics of inhaled substances such as water solubility, size of substances and chemical properties may affect disease severity as well as its location. Although AII cases may recover in a few days but AII may cause long-term complications, even death. We aimed to discuss the effects of short-term exposures (minutes to hours) to toxic substances on the lungs. PMID:25610115
\\u000a Traumatic brain injury (TBI) is a serious public health problem, often referred to as a silent epidemic due to lack of public\\u000a awareness . TBI is still the leading cause of mortality and morbidity in the world for individuals under the age of 45\\u000a . In the United States alone, based on population data from 1995 to 2001, 1.4 million
With the rapid development of neuroimaging and neuroscience in the past several years, the body of research and clinical knowledge\\u000a about concussion processes in adults continues to rapidly increase. Nevertheless, many questions involving the functioning\\u000a of a human brain post-head injury and its recover remain unanswered. There is even less known about neurodynamics of concussive\\u000a processes and recovery in children,
Soccer is the most popular sport in the world, with FIFA recognising more than 265 million amateur players. Despite the fact\\u000a that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status\\u000a as the fastest growing team sport in the USA. Acute and minor injuries predominate in the
Kenneth L. Mattox
This report concentrates on the 15% of chest injuries requiring thoracotomy. Eighty-five percent of cases may be managed by a large-bore chest tube placed in the midaxillary line. The indications for thoracotomy following placement of a chest tube are immediate egress of 1,500 ml of blood, continued bleeding at a rate of more than 100 ml\\/h, and large air leaks
Introduction Acute renal failure is characterised by abrupt and sustained decline in glomerular filtration rate, which leads to accumulation of urea and other chemicals in the blood. The term acute kidney injury has been introduced to encompass a wide spectrum of acute alterations in kidney function from mild to severe. Acute kidney injury is classified according to the RIFLE criteria, in which a change from baseline serum creatinine or urine output determines the level of renal dysfunction. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent acute kidney injury in people at high risk? What are the effects of treatments for critically ill people with acute kidney injury? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 82 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: albumin supplementation plus loop diuretics (intravenous), aminoglycosides, aminophylline, amphotericin B, calcium channel blockers, contrast media, dialysis membranes, dopamine, early versus late dialysis, extended daily dialysis, fenoldopam, loop diuretics, mannitol, N-acetylcysteine, natriuretic peptides, renal replacement therapy, sodium bicarbonate-based fluids, sodium chloride-based fluids, and theophylline. PMID:21443811
Wani, Mohd Lateef; Ahangar, Ab Gani; Ganie, Farooq Ahmad; Wani, Shadab Nabi; Wani, Nasir-ud-din
Abstract Vascular injury presents a great challenge to the emergency resident because these injuries require urgent intervention to prevent loss of life or limb. Sometimes serious vascular injury presents with only subtle or occult signs or symptoms. The patient may present weeks or months after initial injury with symptoms of vascular insufficiency, embolization, pseudoaneurysm, arteriovenous fistula etc. Although the majority of vascular injuries are caused by penetrating trauma from gunshot wounds, stabbing or blast injury, the possibility of vascular injury needs to be considered in patients presenting with displaced long bone fractures, crush injury, prolonged immobilization in a fixed position by tight casts or bandages and various invasive procedures. iatrogenic vascular injuries constitute about 10% of cases in most series; however the incidence is an increasing trend because more endovascular procedures such as angioplasty and cardiac catheterization are being performed routinely. Civilian trauma is more frequently seen in young males. However, it can occur at any age due to road accidents, firearms, bomb blasts and diagnostic procedures. Most of the time, civilian trauma causes less tissue damage. There is an epidemic of vascular injuries in Kashmir valley because of problems in law and order in the past two decades. This review deals with the topic in detail. PMID:24350103
We undertook a prospective collection of data on all children below the age of 16 presenting with a history of trauma to the Accident and Emergency Department and at Haukeland University Hospital in the city of Bergen, Norway, during 1998. Our study included 7.041 new injuries, giving an annual injury incidence of 9% for preschool children, and 13% for children aged 6 to 15. Boys were injured more often than girls, and they hurt themselves equally at all age groups. Girls, however, had the lowest incidence of injury at 4-6 years of age, and two peaks at 2 and at 10-12 years of age. In the youngest children there was a predominance of head injury (51%) while in school children upper extremity injury was the commonest (46%). Most of the younger children sustained their injuries at home, while older children were injured both at home and school. Sixty percent of all medically treated patients with injuries associated with roller blade, skateboard or snowboard activities sustained a fracture. These newer sports create a new injury pattern, but soccer and bicycle injuries still predominate. On comparing our data with previous studies performed a decade ago, we found a significant decline in bicycle injuries (p=0.019), but burns are still as common (p=0.35), which suggests a need to focus more on burns prevention. PMID:11154744
Das, Nabangshu S.; Usman, Juliana; Choudhury, Dipankar; Abu Osman, Noor Azuan
Cricket has over the years gained much popularity in Asia, thus the number of cricket players has also grown in tandem. However, cricket players are not as fortunate as other athletes as they do not always have a standard cricket infrastructure to practice; therefore, the injury prevalence is expected to be high. Unfortunately, very few studies have been conducted to investigate the nature and pattern of cricket injuries prevalent to cricketers in this region. Therefore, a prospective cohort injury surveillance study was conducted during the Asian Cricket Council (ACC) Under-19 Elite Cup held in June 2013 in order to gather more data on the type of injuries sustained by cricket players. Overall, 31 injuries occurred to 28 players throughout the tournament, of which 7 injuries happened during practice sessions. The overall injury incidence rate (IIR) was 292.0 per 10,000 player hours (95% CI 176.9–407.1) and 10.4 per 10,000 balls faced and 2.6 per 1000 overs bowled delivered during batting and bowling, respectively. Injuries to the lower limb (IIR: 146; 95% CI 1.8–98.2) were the most frequent, followed by injuries to the upper limb (97.3;95% CI 30.2–164.5) and to the trunk and back (IIR: 36.5;95% CI 0.0–77.7). Sprain/strains (IIR 109.5;95% CI 38.4–180.7) to muscle/tendon and joint/ligament were the most commonly reported nature of injury. This is the first study investigating injury incidence among the players of the ACC. It provides an overview of injuries sustained by elite players' under-19 years of age from10 Asian countries. The overall IIR is similar to earlier studies conducted in well-established cricket playing nations. PMID:24927127
Das, Nabangshu S; Usman, Juliana; Choudhury, Dipankar; Abu Osman, Noor Azuan
Cricket has over the years gained much popularity in Asia, thus the number of cricket players has also grown in tandem. However, cricket players are not as fortunate as other athletes as they do not always have a standard cricket infrastructure to practice; therefore, the injury prevalence is expected to be high. Unfortunately, very few studies have been conducted to investigate the nature and pattern of cricket injuries prevalent to cricketers in this region. Therefore, a prospective cohort injury surveillance study was conducted during the Asian Cricket Council (ACC) Under-19 Elite Cup held in June 2013 in order to gather more data on the type of injuries sustained by cricket players. Overall, 31 injuries occurred to 28 players throughout the tournament, of which 7 injuries happened during practice sessions. The overall injury incidence rate (IIR) was 292.0 per 10,000 player hours (95% CI 176.9-407.1) and 10.4 per 10,000 balls faced and 2.6 per 1000 overs bowled delivered during batting and bowling, respectively. Injuries to the lower limb (IIR: 146; 95% CI 1.8-98.2) were the most frequent, followed by injuries to the upper limb (97.3;95% CI 30.2-164.5) and to the trunk and back (IIR: 36.5;95% CI 0.0-77.7). Sprain/strains (IIR 109.5;95% CI 38.4-180.7) to muscle/tendon and joint/ligament were the most commonly reported nature of injury. This is the first study investigating injury incidence among the players of the ACC. It provides an overview of injuries sustained by elite players' under-19 years of age from 10 Asian countries. The overall IIR is similar to earlier studies conducted in well-established cricket playing nations. PMID:24927127
Murty, O P
A teenager college student was fatally injured by burst tyre air pressure while waiting on a public bus stand to catch a bus to reach her college at Kuala Lumpur. She accidentally came near the wheel while boarding when tube and tyre got burst .The air pressure had blown the girl in the air and she subsequently fell on a rough surface. The iron-locking rim of the wheel acted as a missile and hit the girl. She died on her way to the hospital. A medico-legal autopsy was performed which showed extensive injuries in the cranial and chest cavity. Head had large scalp laceration with diffuse separation and gaping from in the vault region; skull bones were fractured. Chest cavity had extensive rib fractures, lacerated lungs and haemo-thorax while externally there was no obvious injury. It requires intensive care management and screening of the victims. Tyre-blast injuries are not so common. This case exposes the hazard due to burst tyre. PMID:19329081
Schulze, W; Richter, J; Schulze, B; Esenwein, S; Buttner-Janz, K
Objectives: To show trends in paragliding injuries and derive recommendations for safety precautions for paraglider pilots on the basis of accident statistics, interviews, questionnaires, medical reports, and current stage of development of paragliding equipment. Methods: All paragliding accidents in Germany have to be reported. Information on 409 accidents was collected and analysed for the period 1997–1999. Results: There was a substantial decrease in reported accidents (166 in 1997; 127 in 1998; 116 in 1999). The number of accidents resulting in spinal injuries was 62 in 1997, 42 in 1998, and 38 in 1999. The most common cause of accident was deflation of the glider (32.5%), followed by oversteering (13.9%), collision with obstacles (12.0%), take off errors (10.3%), landing errors (13.7%), misjudgment of weather conditions (4.9%), unsatisfactory preflight checks (4.9%), mid-air collisions with other flyers (2.2%), accidents during winching (2.2%), and defective equipment (0.5%). Accidents predominantly occurred in mountain areas. Fewer than 100 flights had been logged for 40% of injured pilots. In a total of 39 accidents in which emergency parachutes were used, 10 pilots were seriously injured (26%) and an additional three were killed (8%). Conclusions: Injuries in paragliding caused by unpredictable situations can be minimised by (a) using safer gliders in the beginner or intermediate category, (b) improving protection systems, such as padded back protection, and (c) improving pilot skills through performance and safety training. PMID:12351336
Risdall, Jane E.; Menon, David K.
There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilcian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad. PMID:21149359
Witiw, Christopher D; Fehlings, Michael G
Our understanding of the pathophysiological processes that comprise the early secondary phases of spinal cord injury such as spinal cord ischemia, cellular excitotoxicity, ionic dysregulation, and free-radical mediated peroxidation is far greater now than ever before, thanks to substantial laboratory research efforts. These discoveries are now being translated into the clinical realm and have led to targeted upfront medical management with a focus on tissue oxygenation and perfusion and include avoidance of hypotension, induction of hypertension, early transfer to specialized centers, and close monitoring in a critical care setting. There is also active exploration of neuroprotective and neuroregenerative agents; a number of which are currently in late stage clinical trials including minocycline, riluzole, AC-105, SUN13837, and Cethrin. Furthermore, new data have emerged demonstrating that the timing of spinal cord decompression after injury impacts recovery and that early decompression leads to significant improvements in neurological recovery. With this review we aim to provide a concise, clinically relevant and up-to-date summary of the topic of acute spinal cord injury, highlighting recent advancements and areas where further study is needed. PMID:26098670
...biological condition; behavior; community composition; ecological processes and functions; physical and chemical habitat quality or structure; and public services. (d) Establishing exposure and pathway. Except for injuries...
... is actually a break in the bone. Causes Injuries are the most common causes of foot and ankle sprains and fractures. Many fractures and sprains occur during sports. Football players are particularly vulnerable to foot and ankle ...
Chakravarthy, Bharath; Lotfipour, Shahram; Vaca, Federico E.
Traffic-related pedestrian injuries are a growing public health threat worldwide. The global economic burden of motor vehicle collisions and pedestrian injuries totals $500 billion.1 In 2004, there were 4,641 pedestrian deaths and over 70,000 injuries in the United States.2 Injury patterns vary depending on the age, gender and socioeconomic status of the individual. Children, older adults, and those of lower socioeconomic status are most affected. The burden of injury upon the individual, families and society is frequently overwhelming. Although pedestrian injuries and deaths are relatively on the decline in the United States, this is not universally true throughout the world. It requires particular attention by emergency medicine physicians, public health experts and policy makers. PMID:20440388
A postal survey was carried out of the 90 most accessible climbing walls in England, Scotland and Wales to determine the incidence and nature of injuries requiring emergency treatment associated with their use. Over a two year period, representing 1.021 million visits to the 56 walls used by more than 30 climbers per week, 55 significant injuries were recorded. The rate of injury was not related to any identified design or safety feature of the walls, although upper limb injuries were proportionally more common in walls which provided thinner fixed landing mats rather than thicker, moveable crash mats. The overall rate of injury was very low and climbers seem to modify risk taking behaviour and thus compensate for the level of safety equipment available. It may be possible to reduce the injury rate further by providing seamless ground cover with matting of adequate energy absorbency. Images Figure 1 PMID:8800849
Kos, John J.
A great deal of concern is recently being expressed relative to the playing of tackle football by adolescent Canadians. The purpose of this literature review is to try to summarize the important data from the available world literature. Very few Canadian statistics are available. Most of the data comes from United States experience. Tackle football injury is examined from various perspectives: 1. Equipment 2. Mechanisms of injury 3. Types of injury, with some emphasis on epiphyseal injury 4. Prevention 5. Comparison with other sports Although no “hard and fast” conclusion is drawn, the paper tends to show that: 1. Football is dangerous 2. Football is damaging to many body systems 3. Prevention of injury is difficult under present conditions 4. Alternate games, such as soccer and rugby seem to provide the same benefits with less catastrophic injuries
J. Andy Sullivan; Richard H. Gross; William A. Grana; Carlos A. Garcia-Moral
Soccer has rapidly gained in interest in the United States. A paucity of available data on soccer injuries led us to formulate this study to quantitate and categorize injuries acquired during a program of youth soccer (under age 19). A prospective study of 1,272 players showed an injury rate of 2.6 injuries per 100 participants. The injury rate for girls
Andrew S. Levy; Merrick J. Wetzler; Marie Lewars; William Laughlin
We evaluated the prevalence and patterns of knee injuries in 810 women collegiate rugby players. Injuries that resulted in players missing at least one game were recorded and a questionnaire was used to delineate players' rugby and knee injury history. There were 76 total knee injuries in 58,296 exposures. This resulted in a 1.3 knee injury rate per 1000 exposures.
Thomas J. Guilmette; Anthony J. Giuliano
\\u000a Among the many causes of brain injury, traumatic brain injury (TBI) is the most common cause of disability and death in young\\u000a people (Coronado et al.2006). Moreover, one of the most socially relevant and personally meaningful domains of post-injury\\u000a disability is significantly reduced work capacity and performance, often during the period of psychosocial development in\\u000a which young people are entering
Ghauri, A-J; Amissah-Arthur, K N; Rashid, A; Mushtaq, B; Nessim, M; Elsherbiny, S
Purpose Accidental sharps injuries are a potential route for transmission of blood-borne infection to healthcare workers. Ophthalmic staff in particular are at risk of sustaining such injuries due to the microsurgical nature of the speciality. Forthcoming European Union legislation aimed at reducing sharps injuries requires the development of risk-based sharps policy. The authors believe that this is the first study to assess the risks of sharps injuries and their management specific to ophthalmic practice within the European Union. Methods A retrospective review of all reported sharps injuries across three eye units in the UK over a period of 6 years was undertaken. Data were analysed to determine the circumstances surrounding the injury, occupation of the injured person, and whether appropriate actions were taken following incidents. Results A total of 68 sharps injuries were reported over the 6-year period. Nurses sustained 54.4% (n=37) of needlestick injuries, doctors 39.7% (n=27), and allied healthcare staff 5.9% (n=4). In all 51.5% (n=35) of sharps injuries occurred in the operating theatre, 30.9% (n=21) in the outpatient clinic, 13.2% (n=9) on the ophthalmic ward, and 4.4% (n=3) in unspecified locations. There was a median rate of 1.3 sharps injuries per 1000 surgical procedures per year and a range of 0.4–3.5 per 1000. Conclusions This study demonstrates the need to raise awareness of the unique risks of sharps injuries in ophthalmic practice. This is necessary in order to develop speciality-specific policy that promotes strategies to reduce such injuries, enhances the accuracy of reporting of such events, and provides guidance for appropriate management. PMID:21336251
Salminen, Simo; Kurenniemi, Marja; Råback, Mirka; Markkula, Jaana; Lounamaa, Anne
Background: Although injuries at school are an important issue in public health, environmental factors in schools and school yards have seldom been the focus of school injury research. The goal of our investigation was to examine the effect of environmental factors on school injuries. Methods: Nine comprehensive Finnish schools registered school injuries over a period of two school years. Injuries were classified as being associated with environmental factors, suspected environmental factors, and others. The consensus between two independent classifiers was 81%. Results: A total of 722 injuries were classified. In 11.6% of these injuries, the physical environment factor was evident, and in 28.1% of the injuries, physical environment was suspected of being a contributory risk factor. Thus the physical environment of the school was a contributing factor in over a third (39.7%) of injuries occurring in the school, on the school yard or during the journey to, or from school. In this study, conducted in Finland, ice on the ground was mentioned most frequently as an environmental risk factor. Conclusion: In Finland, the Nordic weather conditions are not taken into account in the school yard and playground plans as they ought to from the safety point of view. An initiative has been launched on a mandatory wintertime master plan for every school yard. PMID:24455667
Stucken, Charlton; Cohen, Steven B
Although recent advances have been made in the treatment of acromioclavicular (AC) joint injuries, they are still challenging for shoulder surgeons. There is a consensus that type I and II injuries should be treated nonoperatively, whereas acute type IV, V, and VI injuries should be treated surgically. There is no algorithm for correctly diagnosing and treating type III injuries, but the current trend is toward nonoperative treatment except for those with persistent symptoms and functional limitations after a course of conservative management. If surgery is indicated, newer anatomic techniques of reconstructing the coracoclavicular (CC) and AC ligaments are recommended. PMID:25435035
Zemper, E D
While very rare, catastrophic injuries in youth sports have a major impact on athletes and their families when they do occur. This article reviews and summarises the sparse research on direct catastrophic injuries in youth sports, a direct catastrophic sports injury being defined as a sport injury that resulted from participation in the skills of the sport, and resulted in a fatality or in a non-fatal brain or spinal cord injury, or skull or spinal fracture. While an electronic database search was completed to assemble the articles reviewed here, much of the data come from the National Center for Catastrophic Injury Research at the University of North Carolina, which has the most extensive and complete data set on this issue. This article reviews and summarises what is known about the rate of occurrence of these injuries in various youth sports, the risk factors for these injuries, injury mechanisms and what can be done to prevent them in various youth sports. PMID:19892698
Peterson, L; Schick, B
This study describes a set of empirically derived safety rules that if followed, would have prevented the occurrence of minor injuries. Epidemiologists have criticized behavioral interventions as increasing "safe" behavior but failing to demonstrate a decrease in injury. The present study documents retrospectively the link between safe behavior and injury. It demonstrates that these empirically derived rules are very similar to rules for the prevention of serious injury. The study also shows that these rules are not widely accepted and implemented by parents. Suggestions for future research in this area are advanced. PMID:8307829
Egalon, Claudio Oliveira (inventor); Rogowski, Robert S. (inventor)
A strain sensor uses an optical fiber including a strain sensitive portion and at least one strain insensitive portion. The strain sensitive portion is mounted on the surface of a structure at a location where a strain is desired to be measured. The strain insensitive portion(s) may be fused to the strain sensitive portion to transmit light therethrough, so that the resulting pattern may be detected to determine the amount of strain by comparison with a similar fiber not subjected to strain, or with the light pattern produced when the fiber is not under strain.
Peter Conrad; Y. S. Bradshaw; Rusdi Lamsudin; Naniek Kasniyah; Christine Costello
This paper examines motorcycle helmet use and injuries in a developing country with a helmet law. Data were collected by systematic street observations and interviews with motorcyclists and supplemented with motorcycle injury data from a 1 month study of all patients coming to emergency departments in Yogyakarta, Indonesia. Observations show that 89% of motorcycle drivers (N = 9242) wore helmets;
S. M. Wijeyaratne; C. Weerasinghe; M. R. N. Cassim
Unattended blunt carotid injury (BCI) has stroke high risk of stroke and screening based on injury probability is recommended. Penetrating forces are not considered high risk and concomitant BCI would go unattended. The authors report a case of a 48-year-old man who fell out of a tree on to an upright stick that penetrated his lateral neck. He presented with
Willman, Kristal Y.; Bank, David E.; Scenic, Melvin; Catwalk, David L.
Review of the cases of 95 fatal head injuries in children found that brain swelling could be detected as early as 1 hour 17 minutes postinjury using computerized topography scans. Results also suggested that a reported history of a lucid interval in a case not involving an epidural hematoma is likely to be false and the injury probably inflicted.…
Eskridge, Susan Lindsay
Knee Lower leg/ankle Foot/toes LE unspecified Other/multiple Unspecified site Systemwide/late effects TBI=Traumatic Brain Injury,Knee Lower leg/ankle 488(2.77) Foot/toes LE unspecified Other/multiple Unspecified site Systemwide/late effects TBI=Traumatic Brain Injury,
Harada, K; Asa, K; Imachi, T; Yamaguchi, Y; Yoshida, K
We here report the first case of postmortem injury caused by a centipede. An old man was found dead in his bedroom. The death was estimated to be due to intracranial hemorrhage and to have occurred two days before the police inspection. A centipede about 12 cm long emerged from a subcutaneous cavity on the victim's forearm. Obviously, the centipede had dug the cavity on the intact skin. A police inspector was bitten by the centipede, so he stepped on the centipede on the floor. The exudate from the insect was identified to be derived from the victim's blood. PMID:10432619
Patient Education Institute
This patient education program discusses rotator cuff injuries, their causes, symptoms, diagnosis, prevention, and options for their treatment including physiotherapy and surgery. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.
JAY T. BISHOFF; MOHAMAD E. ALLAF; WIM KIRKELS; ROBERT G. MOORE; LOUIS R. KAVOUSSI; FRITZ SCHRODER
PurposeBowel injury is a potential complication of any abdominal or retroperitoneal surgical procedure. We determine the incidence and assess the sequelae of laparoscopic bowel injury, and identify signs and symptoms of an unrecognized injury.
-10% of patients with closed head injury (CHI) Cervical collar placed on all trauma patients In line traction indications Hypoxia Cervical spine injury present in 1Clinical Management of Traumatic Brain Injury Janet Rossi Children's Hospital LSUHSC Neuroscience
Krishna Reddy, S.V.; Shaik, Ahammad Basha; Sreenivas, K.
We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating injuries; and Group 4 (n = 7) with patients with penile soft tissue injuries. Grading of injury was done using the American Association for the Surgery of Trauma (AAST)-Organ injury scale of penile injury. Penile injuries without urethral injuries are urological emergencies which require immediate attention. PMID:25295134
Two-thirds of Achilles tendon injuries in competitive athletes are paratenonitis and one-fifth are insertional complaints (bursitis and insertion tendinitis). The remaining afflictions consist of pain syndromes of the myotendineal junction and tendinopathies. The majority of Achilles tendon injuries from sport occur in males, mainly because of their higher rates of participation in sport, but also with tendinopathies a gender difference is probably indicated. Athletes in running sports have a high incidence of Achilles tendon overuse injuries. About 75% of total and the majority of partial tendon ruptures are related to sports activities usually involving abrupt repetitive jumping and sprinting movements. Mechanical factors and a sedentary lifestyle play a role in the pathology of these injuries. Achilles tendon overuse injuries occur at a higher rate in older athletes than most other typical overuse injuries. Recreational athletes with a complete Achilles tendon rupture are about 15 years younger than those with other spontaneous tendon ruptures. Following surgery, about 70 to 90% of athletes have a successful comeback after Achilles tendon injury. Surgery is required in about 25% of athletes with Achilles tendon overuse injuries and the frequency of surgery increases with patient age and duration of symptoms as well as occurrence of tendinopathic changes. However, about 20% of injured athletes require a re-operation for Achilles tendon overuse injuries, and about 3 to 5% are compelled to abandon their sports career because of these injuries. Myotendineal junction pain should be treated conservatively. Partial Achilles tendon ruptures are primarily treated conservatively, although the best treatment method of chronic partial rupture seems to be surgery. Complete Achilles tendon ruptures of athletes are treated surgically, because this increases the likelihood of athletes reaching preinjury activity levels and minimises the risk of re-ruptures. Marked forefoot varus is found in athletes with Achilles tendon overuse injuries, reflecting the predisposing role of ankle joint overpronation. Athletes with the major stress in lower extremities have often a limited range of motion in the passive dorsiflexion of the ankle joint and total subtalar joint mobility, which seems to be predisposing factor for these injuries. Various predisposing transient factors are found in about one-third of athletes with Achilles tendon overuse injuries; of these, traumatic factors (mostly minor injuries) predominate. The typical histological features of chronically inflamed paratendineal tissue of the Achilles tendon are profound proliferation of loose, immature connective tissue and marked obliterative and degenerative alterations in the blood vessels. These changes cause continuing leakage of plasma proteins, which may have an important role in the pathophysiology of these injuries. The chronically inflamed paratendineal tissues of the Achilles tendon do not seem to have enough capacity to form mature connective tissue. PMID:7809555
Blake, Catherine; O'Malley, Edwenia; Gissane, Conor; Murphy, John C
Objectives Hurling is a stick handling game which, although native to Ireland, has international reach and presence. The aim of this study was to report incidence and type of injuries incurred by elite male hurling players over five consecutive playing seasons. Design Prospective cohort study. Setting Male intercounty elite sports teams participating in the National GAA Injury Database, 2007–2011. Participants A total of 856 players in 25 county teams were enrolled. Primary and secondary outcomes Incidence, nature and mechanism of injury were recorded by team physicians or physiotherapists to a secure online data collection portal. Time-loss injury rates per 1000 training and match play hours were calculated and injury proportions were expressed. Results In total 1030 injuries were registered, giving a rate of 1.2 injuries per player. These were sustained by 71% (n=608) of players. Injury incidence rate was 2.99 (95% CI 2.68 to 3.30) per 1000 training hours and 61.75 (56.75 to 66.75) per 1000 match hours. Direct player-to-player contact was recorded in 38.6% injuries, with sprinting (24.5%) and landing (13.7%) the next most commonly reported injury mechanisms. Median duration of time absent from training or games, where the player was able to return in the same season, was 12?days (range 2–127?days). The majority (68.3%) of injuries occurred in the lower limbs, with 18.6% in the upper limbs. The trunk and head/neck regions accounted for 8.6% and 4.1% injuries, respectively. The distribution of injury type was significantly different (p<0.001) between upper and lower extremities: fractures (upper 36.1%, lower 1.5%), muscle strain (upper 5.2%, lower 45.8%). Conclusions These data provide stable, multiannual data on injury patterns in hurling, identifying the most common injury problems. This is the first step in applying a systematic, theory-driven injury prevention model in the sport. PMID:24948748
Berger, Lawrence R; Wallace, L J David; Bill, Nancy M
Throughout the world, injuries and violence are a leading cause of mortality and suffering among Indigenous communities. Among American Indian and Alaska Native children aged 1 to 19 years, 71% of deaths are from injuries. Motor-vehicle accidents, attempted suicide, and interpersonal violence are the most common causes of injuries in highly industrialized countries. For Indigenous populations in middle- and low-income countries, trauma caused by motor-vehicle accidents, agricultural injuries, interpersonal violence, child labor, and the ravages of war are priorities for intervention. To be effective, injury-prevention efforts should be based on scientific evidence, be developmentally and culturally appropriate, and draw on the inherent strengths of Indigenous communities. PMID:19962034
Biegalski, Michael David
Although SrTiO3 is normally not ferroelectric at any temperature, predictions that predate this thesis based on thermodynamic analysis concluded that a biaxial tensile strain of order 1% would shift the paraelectric-to-ferroelectric transition temperature (Tc) of SrTiO3 to the vicinity of room temperature. In practice, uniformly straining SrTiO3 or related perovskite ferroelectrics to such strain levels is challenging and hitherto unheard of Nonetheless, using epitaxy and the misfit strain imposed by an underlying substrate, I have strained SrTiO 3 thin films to percent levels---far beyond where they would crack in bulk. Epitaxial ferroelectric films are often grown to thicknesses greatly exceeding their critical values, resulting in undesirable relaxation toward a zero-strain state by the introduction of dislocations. Dislocation densities of ˜1011 cm-2 are common in epitaxial ferroelectric films grown on lattice-mismatched substrates, and the resulting inhomogeneous strain smears out the ferroelectric phase transition. My approach to achieving the desired high strain levels in SrTiO3 films to assess strain predictions made use of new substrates (DyScO3 and GdScO3 ) that enabled the growth of uniformly strained SrTiO3 films below, or at least far closer to, the critical thickness for relaxation. The resulting strained SrTiO3 films have better structural perfection (narrower rocking curve widths) than the best bulk SrTiO3 single crystals. These films have the narrowest rocking curves ever reported for any heteroepeitaxial oxide thin film (6.5 arcsec). Modeling of ferroelectrics under these strain levels predicts dramatic shifts in the transition temperature and enhancement of the polarization. Indeed, in our strained SrTiO3, a ferroelectric state was induced with a Tc near room temperature. These films also exhibit a peak dielectric constant near room temperature of ˜20,000, comparable to that seen at very low temperatures (˜4K) in bulk SrTiO3. Unexpectedly, the strained SrTiO3 films exhibit a frequency dependence of their dielectric constant consistent with relaxor ferroelectricity. Due to the anisotropy in the in-plane strain, the polarization develops at different temperatures along two orthogonal in-plane directions indicating an anisotropy in the dielectric properties due to the orhorhombicity of the substrate. These results, illustrate that in thin films strain is a viable alternative to the traditional method of chemical substitutions for shifting Tc by large amounts.
Goldkorn, Tzipora; Filosto, Simone
Cigarette smoke has been connected to an array of chronic lung diseases and is a major source of morbidity and mortality. Active smoking is responsible for approximately 90% of lung cancer cases. In addition, cigarette smoke is associated with other chronic pulmonary diseases such as pulmonary edema, chronic bronchitis, and pulmonary emphysema, the last two also termed chronic obstructive pulmonary disease (COPD). Lung cancer and COPD are developed very frequently in chronic cigarette smokers. It has been known for some time that lung cancer incidence increases in patients with COPD. Even the existence of some low-grade emphysema without noticeable airflow obstruction is associated with significantly elevated risk of lung cancer. These recent clinical insights demand new thinking and exploration of novel mechanistic studies to fully understand these observations. Lung injury and repair involve cell death and hyperplasia of airway epithelial cells and infiltration of inflammatory cells. All of these occur simultaneously. The mechanisms of cell death and hyperplasia in the lung constitute two sides of the coin of lung injury and repair. However, most molecular studies in airway epithelial cells center on the mechanism(s) of either cell growth and proliferation or cell death and the ceramide-generating machinery that drives aberrant induction of apoptotic cell death. Very few address both sides of the coin as an outcome of cigarette smoke exposure, which is the focus of this review. PMID:20525802
Norman A. Marcus; Edward R. Sweetser; Robert W. Benson
The sport of hot-air ballooning is generally safe, but does place its participants in certain unique circumstances which may predispose them to injury. Fractures of the ankle and compression fractures of the lumbar spine are among the most common skeletal injuries that require ortho paedic care. Attention to basket design, proper education of the passenger, and careful consid eration of
Ronald A. Furnival; Jeff E. Schunk
Background. Recent reports note a dra- matic increase in the number of pediatric trampoline injuries (PTI) during the past several years. In 1996, the US Consumer Product Safety Commission estimates that 83 000 patients received treatment for trampoline injuries in US hospital emergency departments (EDs), and that ;75% of these patients were <15 years of age. We sought to review
This guide has been developed to provide resources to teachers to address injury prevention in their classrooms. Entries in this guide represent materials which the Injury Prevention Program has identified. Chapters are divided by their target grade and age level. Curricula are listed by the youngest grade which they target. For each entry,…
Robinson, J. M.
Patients injured during sport or fitness activities can make up a significant portion of a family physician's practice. Asking certain questions while taking the history might help diagnose the injury. Components of the physical examination can also be specific to injured athletes. Specific knowledge about the injury allows more effective management. Images Figure 1 Figures 2-3 PMID:8374362
Crush injury is caused by continuous prolonged pressure on the limbs. It is found in patients extricated after being trapped for at least 4 hours. The main injury is to the muscles of the limbs. Treatment should be conservative and fasciotomy should be avoided. If fasciotomy is performed, it should be followed by radical debridement of the injured muscle in
Muhammad U Butt; Nikolaos Zacharias; George C Velmahos
Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe
Williams, Biff; Marston, Rip
Describes five common youth sport injuries: Little League elbow, swimmer's shoulder, shin splints, Osgood's Schlatters disease, and jumper's knee, also noting their corresponding causes, behavioral symptoms, treatment techniques, and prevention strategies. The information is intended to help teachers identify sports injuries more readily and…
Nas, Kemal; Yazmalar, Levent; ?ah, Volkan; Ayd?n, Abdulkadir; Öne?, Kadriye
Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients’ family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206
PTA Today, 1987
Eleven thousand eye injuries are suffered annually by 5- to-14-year-old youngsters during sports and recreational activities. Baseball-related accidents result in more eye injuries to youth than any other sport. Protective face gear is discussed and recommended. (MT)
... ligament (MCL) runs along the inside of your knee. A collateral ligament injury occurs when the ligaments are stretched or torn. ... is any damage to the bones in your knee. If you have a collateral ligament injury, you may need: Crutches to walk until the ...
... gov/BrainInjuryInSeniors . Participating Organizations • Administration on Aging • American Occupational Therapy Association • Brain Injury Association of America • Centers for Medicare and Medicaid ...
Scott E. Sinclair; Robert C. Molthen; Steve T. Haworth; Christopher A. Dawson; Christopher M. Waters
Rationale: Mechanical ventilation with large tidal volumes causes ventilator-induced lung injury in animal models. Little direct evi- dence exists regarding the deformation of airways in vivo during mechanical ventilation, or in the presence of positive end-expiratory pressure (PEEP). Objectives: To measure airway strain and to estimate airway wall tension during mechanical ventilation in an intact animal model. Methods: Sprague-Dawley rats
Dalton, H. P.; Haynes, B. W.; Stone, L. L.
Biologically active means are effective for rapidly removing scar tissue caused by burns or corrosive agents. Specially selected strain of bacteria applied to injury site releases enzymes which are active against eschar. These bacteria tend to locate between eschar and unburned tissue, thus providing optimal cell surface area arrangement for enzyme dispersal. Procedure may prove especially useful in treatment of disaster casualties under relatively primitive conditions.
Yarar, S; Rueger, J M; Schlickewei, C
Ball sports are the most frequent cause of sport injuries and 60?% of all hand injuries involve the fingers. The most common injury is closed rupture of the extensor tendon of the distal interphalangeal joint (mallet finger). Rupture of the deep flexor tendon (jersey finger) occurs particularly in contact ball sports, such as rugby. Injuries of the proximal interphalangeal and metacarpophalangeal joints are of high functional relevance. These injuries frequently represent complex lesions which are demanding both in diagnostics and therapy. Errors in diagnosis or insufficient treatment can lead to misalignment and functional impairment of the hand. This article provides an overview of the current treatment strategies and includes recommendations for the treatment of professional athletes. PMID:25869469
This strain carries a conditional allele of mdm2 that functions as a wild type allele prior to excision by the Cre recombinase. Cre-mediated deletion of exons 7-9 in vivo has been shown. This strain is useful for studying functions of Mdm2, an essential inhibitor of p53.
Puentes, John; Langet, Hélène; Herry, Christophe; Frize, Monique
Interpretation of medical infrared images is complex due to thermal noise, absence of texture, and small temperature differences in pathological zones. Acute inflammatory response is a characteristic symptom of some knee injuries like anterior cruciate ligament sprains, muscle or tendons strains, and meniscus tear. Whereas artificial coloring of the original grey level images may allow to visually assess the extent inflammation in the area, their automated segmentation remains a challenging problem. This paper presents a hybrid segmentation algorithm to evaluate the extent of inflammation after knee injury, in terms of temperature variations and surface shape. It is based on the intersection of rapid color segmentation and homogeneous region segmentation, to which a Laplacian of a Gaussian filter is applied. While rapid color segmentation enables to properly detect the observed core of swollen area, homogeneous region segmentation identifies possible inflammation zones, combining homogeneous grey level and hue area segmentation. The hybrid segmentation algorithm compares the potential inflammation regions partially detected by each method to identify overlapping areas. Noise filtering and edge segmentation are then applied to common zones in order to segment the swelling surfaces of the injury. Experimental results on images of a patient with anterior cruciate ligament sprain show the improved performance of the hybrid algorithm with respect to its separated components. The main contribution of this work is a meaningful automatic segmentation of abnormal skin temperature variations on infrared thermography images of knee injury swelling.
Practitioners of endoscopy often experience musculoskeletal pain and injury (most often in the back, neck, shoulders, hands, wrists, and thumbs) that are associated with the minute and repetitive strain that is placed on these areas during endoscopic procedures. This review of the current documentation of endoscopy-related pain and injuries among practitioners finds that such problems are widespread and specific in kind as well as strongly correlated with high procedure volume and procedure duration. Research on the nature and impact of cumulative trauma and overuse syndromes in other professions such as dentistry, pianists, production labor, and athletics is brought to bear on the work of the endoscopist. A more thorough understanding of the nature and prevalence of work-related pain and injury sustained by endoscopists should inform further development of ergonomic practices and equipment design. This article reviews current recommendations for ergonomic design in the endoscopy procedure space and finds that reported compliance with those recommendations is quite low. Strategies for the management of the risk of musculoskeletal injuries related to the practice of endoscopy include compliance with currently recommended ergonomic practices, education of trainees in ergonomic technique when practicing endoscopy, and research toward the modification and development of more ergonomic endoscopes and procedure spaces. PMID:24798940
Fuller, C; Junge, A; Dvorak, J
Objective: To identify those risk factors that have the greatest impact on the incidence of head and neck injuries in international football. Method: A case–control study of players sustaining head and neck injuries during 20 FIFA tournaments (men and women) from 1998 to 2004. Video recordings of incidents were used to identify a range of parameters associated with the incidents. Team physicians provided medical reports describing the nature of each injury. ?2 tests (p?0.01) and 95% confidence intervals were used to assess differences in distribution and incidence of injury, respectively. Results: In total, 248 head and neck injuries were recorded of which 163 were identified and analysed on video sequences. The commonest injuries were contusions (53%), lacerations (20%), and concussions (11%). The incidence of all head and neck injuries was 12.5/1000 player hours (men 12.8, women 11.5) and 3.7 for lost-time injuries (men 3.5, women 4.1). The commonest causes of injury involved aerial challenges (55%) and the use of the upper extremity (33%) or head (30%). The unfair use of the upper extremity was significantly more likely to cause an injury than any other player action. Only one injury (a neck muscle strain) occurred as a result of heading the ball throughout the 20 tournaments equivalent to 0.05 injuries/1000 player hours. Conclusions: Players' actions most likely to cause a head or neck injury were the use of the upper extremity or the head but in the majority of cases these challenges were deemed to be fair and within the laws of the game. PMID:16046353
Acute kidney injury (AKI) is a serious complication in the perioperative period, and is consistently associated with increased rates of mortality and morbidity. Two major consensus definitions have been developed in the last decade that allow for easier comparison of trial evidence. Risk factors have been identified in both cardiac and general surgery and there is an evolving role for novel biomarkers. Despite this, there has been no real change in outcomes and the mainstay of treatment remains preventive with no clear evidence supporting any therapeutic intervention as yet. This review focuses on definition, risk factors, the emerging role of biomarkers and subsequent management of AKI in the perioperative period, taking into account new and emerging strategies. PMID:24764522
Ordog, G J; Wasserberger, J; Schlater, T; Balasubramanium, S
The Taser is an electrical weapon used for immobilization. Two hundred eighteen patients who were shot by police with a Taser for violent or criminal behavior were compared to 22 similar patients shot by police with .38 Specials. The long-term morbidity rate was significantly different for "tasered" victims (0%) and for those with bullet wounds (50%) (P less than .05). The mortality rate was also significantly different between "tasered" victims (1.4%), and gunshot wound victims (50%) (P less than .05). Possible complications associated with Taser wounds included contusions, abrasions, and lacerations (38%); mild rhabdomyolysis (1%); and testicular torsion (0.5%). Although 48% of "tasered" patients required hospitalization, all but one was for a preexisting injury or toxic or psychiatric problem. We conclude that Tasers are relatively safe when compared to shooting with more conventional weapons. PMID:3800082
Al-Benna, S.; O'Boyle, C.; Holley, J.
Insertion of an intravascular catheter is one of the most common invasive procedures in hospitals worldwide. These intravascular lines are crucial in resuscitation, allow vital medication to be administered, and can be used to monitor the patients' real-time vital parameters. There is, however, growing recognition of potential risks to life and limb associated with their use. Medical literature is now replete with isolated case reports of complications succinctly described by Garden and Laussen (2004) as “An unending supply of “unusual” complications from central venous catheters.” This paper reviews complications of venous and arterial catheters and discusses treatment approaches and methods to prevent complications, based on current evidence and endeavours to provide information and guidance that will enable practitioners to prevent, recognise, and successfully treat extravasation injuries in adults. PMID:23738141
Lindsey, D; Lindsey, W E
Cactus spines produce injuries whose clinical significance is loosely in inverse proportion to the dimensions of the spine. Long and medium spines of saguaro and barrel cacti seldom result in embedded fragments, but when they do they are difficult to locate and remove. Other medium spines, those of prickly pear and cholla, are a nuisance but they can be removed readily by traction, as can the smaller spines (glochids) of the prickly pear. The very small spines (also glochids) of the polka dot or bunny's ear cactus (Opuntia microdasys) and the beavertail cactus (Opuntia basilaris) offer the most frustrating problem of all, but can be peeled off with a dried film of a professional facial gel. PMID:3390256
Guarini, Giacinta; Huqi, Alda; Capozza, Paola; Morrone, Doralisa; Donati, Francesca; Marzilli, Mario
The advent of reperfusion therapy constituted a historical change for the management of myocardial infarction (MI) patients. However, shortly after, experimental models recognized an intrinsic damage, related to reperfusion itself, which was termed as ischemiareperfusion injury (IRI). Clinical studies attribute IRI a significant burden of morbidity and mortality observed in patients undergoing successful epicardial reperfusion. Several mechanisms have been identified and, as many strategies, have been investigated to address the phenomenon. In this review we will discuss the current evidence for IRI, pharmacological and non-pharmacological preventive strategies adopted both in experimental models and in clinical practice. Finally, we will try to provide a critical appraisal to the lack of consistent benefit observed in translational medicine. PMID:23270551
Nonpowder guns (ball-bearing [BB] guns, pellet guns, air rifles, paintball guns) continue to cause serious injuries to children and adolescents. The muzzle velocity of these guns can range from approximately 150 ft/second to 1200 ft/second (the muzzle velocities of traditional firearm pistols are 750 ft/second to 1450 ft/second). Both low- and high-velocity nonpowder guns are associated with serious injuries, and fatalities can result from high-velocity guns. A persisting problem is the lack of medical recognition of the severity of injuries that can result from these guns, including penetration of the eye, skin, internal organs, and bone. Nationally, in 2000, there were an estimated 21840 (coefficient of variation: 0.0821) injuries related to nonpowder guns, with approximately 4% resulting in hospitalization. Between 1990 and 2000, the US Consumer Product Safety Commission reported 39 nonpowder gun-related deaths, of which 32 were children younger than 15 years. The introduction of high-powered air rifles in the 1970s has been associated with approximately 4 deaths per year. The advent of war games and the use of paintball guns have resulted in a number of reports of injuries, especially to the eye. Injuries associated with nonpowder guns should receive prompt medical management similar to the management of firearm-related injuries, and nonpowder guns should never be characterized as toys. PMID:15520121
Tarney, Christopher M.
Cesarean section is the most common surgery performed in the United States with over 30% of deliveries occurring via this route. This number is likely to increase given decreasing rates of vaginal birth after cesarean section (VBAC) and primary cesarean delivery on maternal request, which carries the inherent risk for intraoperative complications. Urologic injury is the most common injury at the time of either obstetric or gynecologic surgery, with the bladder being the most frequent organ damaged. Risk factors for bladder injury during cesarean section include previous cesarean delivery, adhesions, emergent cesarean delivery, and cesarean section performed at the time of the second stage of labor. Fortunately, most bladder injuries are recognized at the time of surgery, which is important, as quick recognition and repair are associated with a significant reduction in patient mortality. Although cesarean delivery is a cornerstone of obstetrics, there is a paucity of data in the literature either supporting or refuting specific techniques that are performed today. There is evidence to support double-layer closure of the hysterotomy, the routine use of adhesive barriers, and performing a Pfannenstiel skin incision versus a vertical midline subumbilical incision to decrease the risk for bladder injury during cesarean section. There is also no evidence that supports the creation of a bladder flap, although routinely performed during cesarean section, as a method to reduce the risk of bladder injury. Finally, more research is needed to determine if indwelling catheterization, exteriorization of the uterus, and methods to extend hysterotomy incision lead to bladder injury. PMID:24876830
Forks, Thomas P
It is clear from the data that hunting injuries in Mississippi mirror those which occur nationwide. The vast majority of these injuries are easily preventable by following common sense hunting safety rules. As with firearm injuries, tree stand injuries are clearly preventable by following common sense rules (Table 1). Most falls are due to poorly constructed or old wooden tree stands that come apart or become detached from the tree thereby causing the hunter to fall. All bolts and fasteners should be inspected and replaced if found to be defective prior to use of the stand. Old, broken or rotten lumber should be replaced. Tree stands should only be placed in healthy, mature trees with strong healthy limbs. Unfortunately, tree stand hunters seldom wear safety harnesses when hunting. These devices, when used properly (worm around the chest under both arms), can greatly decrease morbidity and mortality associated with falls. To minimize trauma, tree stands should be constructed no greater than 20 feet above ground level. Hunters should be cautioned to wear non-slip boots [table| see text] and to apply a non-slip covering to the floor of their tree stands prior to use of the stands. Other safety tips include the removal of all logs, stones or other obstructions from around the base of the tree. As with all hunters, tree stand hunters are advised to carry a compass, whistle, flashlight and cellular phone with them during their hunt. Hunting equipment, including bows and arrows and all firearms should never be carried up to the stand. This equipment should only be lifted or lowered to or from the stand with the use of a haul line. Hunters must remember the 10 commandments of gun safety (Table 2). Every firearm should be treated as if it were loaded. Firearms should not be pointed at anything other than the intended target and the muzzle must be controlled at all times. The action and barrel should be inspected prior to loading ammunition to ensure that they are clear of obstructions. The target must be clearly identified before discharging the firearm. All firearms must be kept separate from their ammunition and unloaded when not in use. Alcohol and any mind-altering substances (antihistamines, etc) must be strictly avoided when hunting. Hunters should avoid shooting at hard, flat surfaces in an attempt to prevent ricochets, should never pull a loaded gun toward themselves, and should never climb over a fence or other obstacle with a loaded firearm. Additional common sense safety precautions include the use of the "gun safety." The safety should be "on" at all times and switched off only when the rifle is sighted in, on the game just before discharge. This simple precaution may well prevent many of the accidental shootings that occur when firearms are dropped. When firearms are dropped, the hunter must carefully pick up the gun butt first while leaving the muzzle pointed toward the ground. Rifles should be left unloaded until game is sighted and should be loaded only in the immediate anticipation of discharging the firearm at game. Hunters are also advised to hunt in-groups and should notify family members or friends of the approximate time they anticipate entering and leaving the hunting area. Bright orange hunting vests have been shown to greatly increase the hunter's visibility and should always be worn when in the field during hunting season. Hunters are also advised to layer their clothing to prevent cold injuries. A backpack containing a flashlight, compass, prescription medications, first aid kit, cellular phone and high calorie foods should be taken into the field with the hunter. Bow hunters can drastically reduce injuries and death by following a few common sense rules (Table 3). All arrows should remain sheathed until prey is sighted at which time the arrow may be nocked to the bowstring. Bows should never be drawn until the hunter is ready to fire at the target. At all times, the bow and nocked arrow should be pointed in a safe direction. Reminding hunters of the major causes of accidents as wel
Moore, Justin Xavier; Lambert, Brice; Jenkins, Gabrielle P; McGwin, Gerald
The purpose of the present study was to investigate the epidemiology of high-heel-related injuries among a nationally representative population of women in the United States and to analyze the demographic differences within this group. The data used in the present study were collected from the Consumer Product Safety Commission's National Electronic Injury Surveillance System. A total of 3294 injuries, representing an estimated 123,355 high-heel-related injuries, were treated in emergency departments within the United States from 2002 to 2012. The overall rate of high-heel-related injuries for the study was 7.32 per 100,000 females (95% confidence interval 7.08 to 7.56). The injury rate was greatest for young adult females, with the greatest rates observed for those aged 20 to 29 years (18.38 per 100,000 females) and those aged 30 to 39 years (11.07 per 100,000 females). The results from the present study suggest that high-heel-related injuries have nearly doubled during the 11-year period from 2002 to 2012. Injuries from high heels are differential by body region, with most injuries occurring as sprains and strains to the foot and ankle. Although high heels might be stylish, from a health standpoint, it could be worthwhile for females and those interested in wearing high heels to understand the risks of wearing high-heeled shoes and the potential harm that precarious activities in high-heeled shoes can cause. The results of the present study can be used in the development of a prospective cohort study to investigate the risk of injury from high-heeled shoes, accounting for the exposure time and studying differences in demographics (e.g., age and race). PMID:25977152
Saboisky, Julian P.; Butler, Jane E.; Gandevia, Simon C.; Eckert, Danny J.
The causes of obstructive sleep apnea (OSA) are multifactorial. Neural injury affecting the upper airway muscles due to repetitive exposure to intermittent hypoxia and/or mechanical strain resulting from snoring and recurrent upper airway closure have been proposed to contribute to OSA disease progression. Multiple studies have demonstrated altered sensory and motor function in patients with OSA using a variety of neurophysiological and histological approaches. However, the extent to which the alterations contribute to impairments in upper airway muscle function, and thus OSA disease progression, remains uncertain. This brief review, primarily focused on data in humans, summarizes: (1) the evidence for upper airway sensorimotor injury in OSA and (2) current understanding of how these changes affect upper airway function and their potential to change OSA progression. Some unresolved questions including possible treatment targets are noted. PMID:22715333
Mason, Brandon; Smithey, Martha
This study examines Merton's Classical Strain Theory (1938) as a causative factor in intimate partner violence among college students. We theorize that college students experience general life strain and cumulative strain as they pursue the goal of a college degree. We test this strain on the likelihood of using intimate partner violence. Strain due to unrealistic expectations of intimate partnership and economic strain are also examined. The analysis examines the following causative factors representing strain: 1) the College Undergraduate Stress Scale (Renner & Mackin, 1998); 2) cumulative academic strain measured by college classification; 3) cumulative intimate partner strain measured as the length of time in the relationship; 4) academic strain measured by number of hours studied weekly, and 5) economic strain measured by number of hours worked weekly. Additionally, we examine the extent to which gender and race/ethnicity differentially affect intimate partner in the context of these measures of strain. The Conflict Tactics Scales II (Straus et al, 1996) are used to measure dating violence and include indicators for sexual coercion, physical aggression, injury, and psychological aggression. Data were collected from 142 students in lower-division classes from Texas Tech University. Results show that general strain and cumulative intimate partner strain increase the use of dating violence among college students. The longer dating partners are in a relationship, the higher the chances of psychological aggression, physical assault, and sexual coercion. Converse to our expectations, time spent working reduces psychological aggression due to reducing time spent together rather than reflecting economic strain. PMID:21987517
Merz, W G
Candida albicans is a major opportunistic pathogen causing a wide spectrum of disease in human beings. Methods for strain delineation of this species to assess or predict virulence or to conduct epidemiologic or pathogenetic investigations have been developed. Although factors associated with virulence have been identified, there is no rapid system to quantitate them in a clinical laboratory. Therefore, many typing methods are based on variable phenotypic characteristics within this species including morphotyping, serotyping, antibiogram, resistogram typing, biotyping, biotyping based on commercial carbon assimilation patterns, enzyme profiles, sensitivity to yeast killer toxins, and typing based on protein variability. Phenotypically defined strains generally do not correlate with the pathogenic potential of a strain with the exception of morphotyping. However, these methods can be useful in epidemiologic investigations; for example, they have revealed that most individuals harbor one strain and that infections are frequently due to an endogenous strain. Problems with these methods usually relate to their discriminatory power. When this is maximized, reproducibility (especially between laboratories) suffers. Recently, methods based on differences in DNA structure (genotyping) for strain delineation have been developed, including electrophoretic karyotyping and restriction enzyme fragment length polymorphisms. The development of a computer-assisted data bank and analysis for these genotypic strain delineators will open investigations into the pathogenesis of this infection and permit epidemiologic studies previously not possible with this important human pathogen. PMID:1977511
...categories of injury include, but are not limited to, adverse changes in: survival, growth, and reproduction; health, physiology and biological condition; behavior; community composition; ecological processes and functions; physical and chemical...
...categories of injury include, but are not limited to, adverse changes in: survival, growth, and reproduction; health, physiology and biological condition; behavior; community composition; ecological processes and functions; physical and chemical...
...categories of injury include, but are not limited to, adverse changes in: survival, growth, and reproduction; health, physiology and biological condition; behavior; community composition; ecological processes and functions; physical and chemical...
Bruner, Heather C.; Bruner, David I.
Both anaphylaxis and head injury are often seen in the emergency department, but they are rarely seen in combination. We present a case of a 30-year-old woman who presented with anaphylaxis with urticaria and angioedema following a minor head injury. The patient responded well to intramuscular epinephrine without further complications or airway compromise. Prior case reports have reported angioedema from hereditary angioedema during dental procedures and maxillofacial surgery, but there have not been any cases of first-time angioedema or anaphylaxis due to head injury. PMID:25987924
Akuffo, E O; Sylvester, P E
A clinical and pathological study of head injury and the implications in mental handicap are outlined. Non-accidental injury as a form of child abuse is suspected as contributing considerably to the cause of mental handicap in populations resident in long-stay hospital, but this is unlikely to be the best environment for such patients. A number of mentally handicapped epileptic patients who injure their heads during fits and patients who repeatedly bang their heads as a feature of self-injurious behaviour are exposed to progressive neurological deficits associated with lesions in the brain which could further impair the efficiency of brain function. PMID:6876043
Management of major limb injuries is a daunting challenge, especially as many of these patients have severe associated injuries. In trying to save life, often the limb is sacrificed. The existing guidelines on managing such trauma are often confusing. There is scope to lay down such protocols along with the need for urgent transfer of such patients to a multispecialty center equipped to salvage life and limb for maximizing outcome. This review article comprehensively deals with the issue of managing such major injuries. PMID:24511296
Howard, Andrew William
Injuries are the most common cause of death for Canadians aged one to 18 years, and 50% of injury deaths in this age group involve an automobile. Evidence suggests that 71% reduction in deaths and a 67% reduction in injuries can be achieved when child safety seats are used properly. This article reviews the recommended restraints for children by weight group and describes the proper position for children. Detailed case examples of car crashes are described to illustrate the dangers of incorrectly used or no restraint. PMID:20107592
Christensen, Doran M; Iddins, Carol J; Sugarman, Stephen L
Although the spectrum of information related to diagnosis and management of radiation injuries and illnesses is vast and as radiation contamination incidents are rare, most emergency practitioners have had little to no practical experience with such cases. Exposures to ionizing radiation and internal contamination with radioactive materials can cause significant tissue damage and conditions. Emergency practitioners unaware of ionizing radiation as the cause of a condition may miss the diagnosis of radiation-induced injury or illness. This article reviews the pertinent terms, physics, radiobiology, and medical management of radiation injuries and illnesses that may confront the emergency practitioner. PMID:24275177
Del Buono, Angelo; Florio, Antonietta; Boccanera, Michele Simone; Maffulli, Nicola
Ankle syndesmosis injuries are relatively frequent in sports, especially skiing, ice hockey, and soccer, accounting for 1 %-18 % of all ankle sprains. The evolution is unpredictable: When missed, repeated episodes of ankle instability may predispose to early degenerative changes, and frank osteoarthritis may ensue. Diagnosis is clinical and radiological, but arthroscopy may provide a definitive response, allowing one to address secondary injuries to bone and cartilage. Obvious diastasis needs to be reduced and fixed operatively, whereas less severe injuries are controversial. Nonoperative treatment may be beneficial, but it entails long rehabilitation. In professional athletes, more aggressive surgical treatment is warranted. PMID:23943273
Zhang, Ning; Fang, Marong; Chen, Haohao; Gou, Fangming; Ding, Mingxing
Because there is no curative treatment for spinal cord injury, establishing an ideal animal model is important to identify injury mechanisms and develop therapies for individuals suffering from spinal cord injuries. In this article, we systematically review and analyze various kinds of animal models of spinal cord injury and assess their advantages and disadvantages for further studies. PMID:25598784
D I Graham; J C Clark; J H Adams; T A Gennarelli
The case reports of 50 fatal head injuries caused by assault and managed at the Institute of Neurological Sciences, Glasgow, were reviewed. Fifteen cases had diffuse axonal injury. Diffuse axonal injury is a well recognised type of brain damage brought about by a head injury, usually as a result of a road traffic accident or fall from a height. It
Kevin D. Tipton
Background\\/Aims: Injuries are an unavoidable aspect of participation in physical activity. Little information about nutritional support for injuries exists. Review: Immediately following injury, wound healing begins with an inflammatory response. Excessive anti-inflammatory measures may impair recovery. Many injuries result in limb immobilization. Immobilization results in muscle loss due to increased periods of negative muscle protein balance. Oxidative capacity of muscle
Simo Salminen; Anne Lounamaa; Marja Kurenniemi
The aim of this study is to analyze the gender differences in injuries at Finnish comprehensive schools. Nine schools reported a total of 1135 injuries to the injury register over two school years. Boys (56%) were injured more often than girls, their injuries happened more often during breaks at school yard, whereas girls hurt themselves during sport lectures in the
Cook, Daniel W.
Reviewing literature on the psychological impact of spinal cord injury suggests: (a) depression may not be a precondition for injury adjustment; (b) many persons sustaining cord injury may have experienced psychological disruption prior to injury; and (c) indexes of rehabilitation success need to be developed for the spinal cord injured. (Author)
J V de Bruijn; S Keizers
Fysion Blesreg is a new system on which sports assistants (trainers, masseurs, physiotherapists and physicians) can rely for quick and straightforward registration and retrieval of personalized injury data. Registration of injury data can provide a clear picture of the injury mechanism, which in turn can lead to effective preventive measures and a decline in sports injuries. The two components of
NEW GRADUATE CERTIFICATE IN INJURY BIOMECHANICS Injury biomechanics is a well-known field made over the last half century use research data generated by workers in injury biomechanics. Wayne State University has an almost 70-year history in injury biomechanics research including development
Cary S. Keller; Frank R. Noyes; C. Ralph Buncher
In this article, the six major studies of soccer injury epidemiology are reviewed. Strengths and weaknesses of each epidemiologic design are critiqued and the crucial importance of the definition of injury is empha sized. The effect of age, sex, and intensity of play on injury rates is discussed. Our present knowledge of injury rate by anatomical site, player position, and
Bjorn Engström; Christer Johansson; Hans Tornkvist
Injuries occurring in two female elite soccer teams were recorded during 1 year. Of 41 players, 33 (80%) sus tained 78 injuries. The incidence of injury during games was 24\\/1000 hours, while the incidence during training was 7\\/1000 hours. The majority (88%) of injuries were localized to the lower extremities, with equal occur rence in the left and right legs.
Choi, Sang D
The study was designed to identify any trends of injury type as it relates to the age and trade of construction workers. The participants for this study included any individual who, while working on a heavy and highway construction project in the Midwestern United States, sustained an injury during the specified time frame of when the data were collected. During this period, 143 injury reports were collected. The four trade/occupation groups with the highest injury rates were laborers, carpenters, iron workers, and operators. Data pertaining to injuries sustained by body part in each age group showed that younger workers generally suffered from finger/hand/wrist injuries due to cuts/lacerations and contusion, whereas older workers had increased sprains/strains injuries to the ankle/foot/toes, knees/lower legs, and multiple body parts caused by falls from a higher level or overexertion. Understanding these trade-related tasks can help present a more accurate depiction of the incident and identify trends and intervention methods to meet the needs of the aging workforce in the industry. PMID:26106517
Swanberg, Jennifer E.; Clouser, Jessica M.; Westneat, Susan C.; Marsh, Mary W.; Reed, Deborah B.
Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry’s workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies and describes types of injuries experienced by workers (N = 284) and their surrounding circumstances. Results indicate that general injuries and musculoskeletal strains, sprains, and tears account for a majority of injuries among workers on thoroughbred farms. Upper limbs and extremities are most frequently injured, while direct contact with the horse accounted for over half of all injuries. No differences in the diagnoses or distribution of injury were found by ethnicity; however, Latinos were more often struck by or trampled by a horse while non-Latinos were more often injured by an insect or plant. Implications and opportunities for future research are discussed. PMID:24351785
Choi, Sang D.
The study was designed to identify any trends of injury type as it relates to the age and trade of construction workers. The participants for this study included any individual who, while working on a heavy and highway construction project in the Midwestern United States, sustained an injury during the specified time frame of when the data were collected. During this period, 143 injury reports were collected. The four trade/occupation groups with the highest injury rates were laborers, carpenters, iron workers, and operators. Data pertaining to injuries sustained by body part in each age group showed that younger workers generally suffered from finger/hand/wrist injuries due to cuts/lacerations and contusion, whereas older workers had increased sprains/strains injuries to the ankle/foot/toes, knees/lower legs, and multiple body parts caused by falls from a higher level or overexertion. Understanding these trade-related tasks can help present a more accurate depiction of the incident and identify trends and intervention methods to meet the needs of the aging workforce in the industry.
Albert, Michael; McCaig, Linda F
Data from the National Hospital Ambulatory Medical Care Survey, 2010-2011. In 2010-2011, the emergency department (ED) visit rate for motor vehicle traffic injuries was highest among persons aged 16-24 years. The rates declined with age after 16-24, with rates for those aged 0-15 similar to those 65 and over. The overall ED visit rate for motor vehicle traffic injuries was higher among non-Hispanic black persons compared with non-Hispanic white and Hispanic persons. Imaging services were ordered or provided at 70.2% of ED visits for motor vehicle traffic injuries, which was higher than for other injury-related ED visits (55.9%). About one-half of ED visits for motor vehicle traffic injuries had a primary diagnosis of sprains and strains of the neck and back, contusion with intact skin surface, or spinal disorders. In spite of improvements in motor vehicle safety in recent years, motor vehicle crashes remain a major source of morbidity and mortality in the United States (1-3). Motor vehicle-related deaths and injuries also result in substantial economic and societal costs related to medical care and lost productivity (4). This report describes the rates and characteristics of emergency department (ED) visits for motor vehicle traffic injuries during 2010-2011 based on nationally representative data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). PMID:25647474
Conard, Lisa Marie
A tool and a method for attaching a strain gauge to a test specimen by maintaining alignment of, and applying pressure to, the strain gauge during the bonding of the gauge to the specimen. The tool comprises rigid and compliant pads attached to a spring-loaded clamp. The pads are shaped to conform to the specimen surface to which the gauge is to be bonded. The shape of the pads permits the tool to align itself to the specimen and to maintain alignment of the gauge to the specimen during the bond curing process. A simplified method of attaching a strain gauge is provided by use of the tool.
Conard, Lisa Marie (Swissvale, PA)
A tool and a method for attaching a strain gauge to a test specimen by maaining alignment of, and applying pressure to, the strain gauge during the bonding of the gauge to the specimen. The tool comprises rigid and compliant pads attached to a spring-loaded clamp. The pads are shaped to conform to the specimen surface to which the gauge is to be bonded. The shape of the pads permits the tool to align itself to the specimen and to maintain alignment of the gauge to the specimen during the bond curing process. A simplified method of attaching a strain gauge is provided by use of the tool.
Stein, Deborah M; Roddy, Vincent; Marx, John; Smith, Wade S; Weingart, Scott D
Traumatic spine injuries (TSIs) carry significantly high risks of morbidity, mortality, and exorbitant health care costs from associated medical needs following injury. For these reasons, TSI was chosen as an ENLS protocol. This article offers a comprehensive review on the management of spinal column injuries using the best available evidence. Though the review focuses primarily on cervical spinal column injuries, thoracolumbar injuries are briefly discussed as well. The initial emergency department clinical evaluation of possible spinal fractures and cord injuries, along with the definitive early management of confirmed injuries, are also covered. PMID:22965323
Yulish, Michael; Pikkel, Joseph
Purpose: To document the types of ocular trauma that occurs during the olive-harvesting season in a region of the Middle East. Materials and Methods: Ophthalmic assessments of all patients were performed by one ophthalmologist. Examinations included visual acuity, slit-lamp evaluation of the anterior segment, intraocular pressure measurement and posterior segment assessment after pupil dilatation. Results: The study cohort comprised 119 patients who presented for ocular injury due to olive harvesting. Seven patients (5.9%) had severe ocular trauma. Two of these patients presented with corneal perforation, and five with retinal edema. Six patients with severe ocular injury were male. Conclusions: Ocular injuries are common when olives were harvested manually or with sticks. A preventive program to reduce injury should consider environmental and cultural factors. PMID:22837627
Gorlov, A A
The principles of modern technology in injuries prevention have been elaborated which are based on fundamentally new approaches to the interpretation of injuries and classification of prevention activities proposed by the author. It is emphasized that each type of prevention (urgent, operative, planned) corresponds to a certain technological succession of operations: selection and pickup of information, the time period and mechanism of analysis communication, etc., and also to specific goals. A model of injuries prevention system is proposed which is based on organizational structures of local councils of people's deputies and may be used for any administrative territory of the country with due regard for peculiarities and specific factors determining the level and nature of injuries. PMID:1862364
Mokra, Daniela; Kosutova, Petra
Acute respiratory distress syndrome (ARDS) and its milder form acute lung injury (ALI) may result from various diseases and situations including sepsis, pneumonia, trauma, acute pancreatitis, aspiration of gastric contents, near-drowning etc. ALI/ARDS is characterized by diffuse alveolar injury, lung edema formation, neutrophil-derived inflammation, and surfactant dysfunction. Clinically, ALI/ARDS is manifested by decreased lung compliance, severe hypoxemia, and bilateral pulmonary infiltrates. Severity and further characteristics of ALI/ARDS may be detected by biomarkers in the plasma and bronchoalveolar lavage fluid (or tracheal aspirate) of patients. Changed concentrations of individual markers may suggest injury or activation of the specific types of lung cells-epithelial or endothelial cells, neutrophils, macrophages, etc.), and thereby help in diagnostics and in evaluation of the patient's clinical status and the treatment efficacy. This chapter reviews various biomarkers of acute lung injury and evaluates their usefulness in diagnostics and prognostication of ALI/ARDS. PMID:25466727
Pierz, Joseph J
The snowmobile was developed to move people and supplies, and for emergencies in regions where heavy snow prohibited the use of conventional vehicles. Today, snowmobiling has become a popular winter sport enjoyed by more than 2 million people of all ages in North America. However, the modern snowmobile can weigh in excess of 600 pounds and travel at speeds exceeding 90 miles per hour. Each year snowmobile accidents produce approximately 200 deaths and 14,000 injuries. Excess speed, alcohol, driver inexperience, and poor judgment are the leading causes of accidents. Injuries incurred in children and adults often are extremity fractures, but can involve any organ system. Similar to motor vehicle accidents, multisystem trauma occurs frequently with head injury the leading cause of death. Reduction in injury and death rates is urgently needed and can be accomplished through education and legislation. PMID:12671482
... colleagues, with an educational grant from Pfizer Inc. University of Washington-operated SCI Clinics: Harborview Medical Center ... Spinal Cord Injury Clinic nurses: 206-744-5862 University of Washington Medical Center Rehabilitation Medicine Clinic 1959 ...
... NICHD Research Information Clinical Trials Resources and Publications Spinal Cord Injury (SCI): Condition Information Skip sharing on social ... with SCI is the lowest point on the spinal cord below which sensory feeling and motor movement diminish ...
Singh, Vibha; Malkunje, Laxman; Mohammad, Shadab; Singh, Nimisha; Dhasmana, Satish; Das, Sanjib Kumar
Objectives: The aim of this study was to evaluate the incidence and etiology of maxillofacial fractures and also to evaluate different treatment modalities. Study design: The sample consisted of 1,038 patients, with maxillofacial injuries treated at our center from June 2006 to June 2011. Cause, type, site of injury, gender, age and treatment given to them, all these parameter are evaluated. Conclusion: The results of this study exhibit that road traffic accidents is the main reason for maxilla facial injuries followed by fall from height. Maxillofacial injuries are more frequent in male than in female. The mandible was most frequently involved facial bone. The miniplate osteosynthesis was the most widespread of the fixation technique but conservative management of the fractured bone also has a significance importance in treatment modalities. PMID:23833492
Mettler, R; Biener, K
We made an anamnesis of sports related injuries for 189 members of the Swiss Wind Surfing Federation. This data enabled us to calculate an yearly incidence of 0.02 injuries per athlete. By comparison, this frequency amounts to 0.03 for tennis players, to 0.24 in football and 2.30 for competitive cyclists. Feet injuries made up for 36.5% of all cases, whereas legs were affected for 23.5%. The athlete had to stop his training for 25.2 days on average. His work had to be interrupted for 10.2 days and his mean hospital stay was of 2.0 days. One third of all injuries were due to board contact events, 20% happened on the shore and 19% were ascribed to falls on/of the mast. Bruises and other wounds were mainly due to the lack of surf-shoes and/or other protective clothing items. PMID:1685028
Minton, Sandra, Ed.
This series features nine articles and an introduction by the editor. Topics covered include biomechanics of foot, ankle, knee, hip, and back; corrective exercises; preventative approaches to dance instruction; and aerobic dance injuries. (MT)
Stein, J D; Jaeger, E A; Jeffers, J B
PURPOSE: This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed. METHODS: Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries. RESULTS: Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury. CONCLUSION: Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm. Images FIGURE 1 FIGURE 2A FIGURE 2B FIGURE 2C FIGURE 2D FIGURE 3A FIGURE 3B FIGURE 4 FIGURE 5 FIGURE 7 FIGURE 8 PMID:10703118
S W Marshall
Heat injury is a potentially lethal condition that is considered to be completely preventable. Fatal heat injury is relatively rare (0.20 per 100 000 player-seasons in US high school football) and there are very limited data on non-fatal incidence. Expert recommendations for prevention include gradual acclimatisation of youth athletes to hot conditions, reductions in activity in hot and humid conditions,
Wilhelm, Marianne; Bir, Cynthia
In today's law enforcement community, one of the most vital tools an officer can possess is personal body armor. However, a recent Department of Justice investigation has raised important questions regarding the protection actually afforded officers through the use of personal body armor, and the current test methods used to assess the armor. Test results show that most Zylon-containing vests showed deformations in excess of the 0101.04 Standard's 44 mm backface signature limit. Such increased deformation can lead to serious injuries, including backface signature injuries, which have occurred in the field. Although the vest is successful in containing the round, it is not effectively dissipating the energy enough to prevent large amounts of vest deformation at the area of impact. Therefore, open, penetrating wounds occur even though the bullet did not penetrate the vest. The objective of the current study was to further define the backface signature injury through the use of case studies and laboratory experiments. Following the case study investigation, backface signature testing was conducted using a clay medium based on the NIJ 0101.04 Standard. The final component of this research involved the use of post-mortem human specimens (PMHS) for further investigation of the backface signature injury. Although the underlying cause of backface signature injuries is unknown, energy density is likely to play a role in the mechanism. Energy density (E/a) is defined as the energy per unit area and has been previously used in less lethal skin penetration research. Further research into the underlying causes of backface signature injuries is necessary. In addition to armor testing, the study of law enforcement personnel who have been shot while wearing soft body armor is also a valuable tool for determining the effectiveness of certification standards. Finally, it is important for medical personnel to recognize the backface signature injury and document this as a type of injury separate from blunt trauma or penetrating trauma behind armor injuries. Detailed knowledge of the injury, including the depth of the wound, would be beneficial to the scientific community. PMID:17434273
Togan, Turhan; Azap, Ozlem Kurt; Durukan, Elif; Arslan, Hande
Background: Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days. Objectives: The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury. Patients and Methods: This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuria Results: Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant. Conclusions: The most common infectious episode among spinal cord injury patients was found to be urinary tract ?nfection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract ?nfection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection. PMID:25147663
Curran, Robert; Sorr, Sasha; Aquino, Eva
Wrist pain in rescuers performing chest compressions as part of cardiopulmonary resuscitation has been reported anecdotally and recently in the literature. Studies have indicated that rescuers apply as much as 644 N of force to the victim's chest with each compression, while standards require one hundred compressions per minute. Recent research suggests that forces transmitted through the rescuers’ wrists of less than 10% of those seen during the performance of chest compressions significantly strain the scapholunate ligament. Biomechanical research should be performed to further evaluate this possible correlation. Compensation for worker injury maybe involved. PMID:23723622
Siewe, J; Rudat, J; Zarghooni, K; Sobottke, R; Eysel, P; Herren, C; Knöll, P; Illgner, U; Michael, J
Boxing remains a subject of controversy and is often classified as dangerous. But the discussion is based mostly on retrospective studies. This survey was conducted as a prospective study. From October 2012 to September 2013, 44 competitive boxers were asked to report their injuries once a month. The questionnaire collected general information (training, competition) and recorded the number of bouts fought, injuries and resulting lost days. A total of 192 injuries were recorded, 133 of which resulted in interruption of training or competition. Each boxer sustained 3 injuries per year on average. The injury rate was 12.8 injuries per 1?000?h of training. Boxers fighting more than 3 bouts per year sustain more injuries (p=0.0075). The injury rate does is not a function of age (age?19 vs. >?19a, p=0.53). Injuries to the head and the upper limbs occur most frequently. The most common injuries are soft tissue lacerations and contusions. Head injuries with neurological symptoms rarely occur (4.2%). Boxing has a high injury rate that is comparable with other contact sports, but most injuries are minor. Injury frequency is not a function of whether the boxer competes in the junior or adult category. Athletes fighting many bouts per year have a greater risk of injury. PMID:25376728
Orava, S.; Puranen, J.
A series of 147 cases of exertion injuries in less than or equal to 15 years old athletes is presented. All injuries occurred during training or athletic performances without trauma and caused symptoms that prevented athletic exercises. There were 67 girls (46%) and 80 boys (54%) in the material. About 90% of them had been training for more than one year before the onset of the symptoms; 65% were interested in track and field athletics, 13% in ball games, 11% in skiing, 4% in swimming, and 3% in orienteering. The rest were interested in other sports. About 33% of the injuries were growth disturbances or osteochondroses seen also in other children. About 15% were anomalies, deformities or earlier osteochondritic changes, which caused first symptoms during the physical exercise; 50% were typical overuse injuries that may bother adult athletes, too; 43% of the injuries were localized in ankle, foot and heel, 31% in knee, 8% in back and trunk, 7% in pelvic and hip region, and the rest in other parts of the body. The injuries were generally slight, no permanent disability was noticed. Rest and conservation therapy cured most cases; operative treatment was used in only eight cases. PMID:24489
Stoner, H B; Heath, D F; Yates, D W; Frayn, K N
Attempts have been made to improve the Injury Severity Score (ISS) system of Baker et al. (1974) using plasma lactate data obtained from 277 patients shortly after injury and before treatment. The ISS is based on the Abbreviated Injury Scale (AIS) values of the individual injuries, being the sum of the squares of the values for the three most severely injured regions. Log (plasma lactate concentration) is positively related to ISS over its whole range. It was not possible to vary the AIS values, either on clinical grounds or using a computer, in such a way that the variance of the log (plasma lactate concentration) about its regression line with ISS was significantly reduced. With a score based on the sum of the squares of the AIS values for all the patient's injuries, some improvement to the AIS values could be made but it was not statistically significant. At the present time Baker's ISS method would seem to be the best way of grading injuries for acute studies. PMID:7230174
Ramcharan, Alexius; Ponnapalli, Sarma
Splenic injury is a rare but serious complication of colonoscopy. Since the mid-1970s, 68 splenic injuries during colonoscopy including our 2 cases have been described. With the increasing use of colonoscopy, endoscopists, surgeons, and radiologists are more likely to encounter this unusual complication. Any cause of increased splenocolic adhesions, splenomegaly, or underlying splenic disease might be a predisposing factor for splenic injury during colonoscopy. However, it can occur in patients without significant adhesions or underlying splenic pathology. The diagnosis is often described in the literature as delayed, because many physicians are not aware of this complication of colonoscopy. Although computerized tomography is highly sensitive, knowledge of this complication is the best tool to aid in early diagnosis. Patients with abdominal pain, hypotension, and a drop in hematocrit without rectal bleeding after colonoscopy should be suspected of having splenic injury. Early recognition and interdisciplinary management are required to assure successful management of this potentially life-threatening injury. Patients with hemodynamic instability most often undergo surgery. We present 2 cases of splenic injury secondary to colonoscopy that required splenectomy. PMID:20202406
Cross, L. L.; Meythaler, J. M.; Tuel, S. M.; Cross, A. L.
Each year about 2,000 women of childbearing age in the United States have a spinal cord injury. Only a few mostly anecdotal reports describe pregnancy after such an injury. In a retrospective study of 16 women with a spinal cord injury, half of whom have a complete injury and about half quadriplegia, 25 pregnancies occurred, with 21 carried to full term. The women delayed pregnancy an average of 6.5 years after their injury, with an average age at first pregnancy of 26.8 years. Cesarean section was necessary in 4 patients because of inadequate progress of labor. In 5 deliveries an episiotomy and local anesthesia were required, 7 required epidural anesthesia, including all cesarean sections, and 10 did not require anesthesia. Several complications have been identified in the antepartum, intrapartum, and postpartum periods including autonomic hyperreflexia, premature labor, pressure sores, urinary tract infections, abnormal presentation, and failure to progress. Ultrasonography and amniocentesis were used selectively. Women with spinal cord injuries can have healthy children, although there are significant risks and these women have special needs. PMID:1866960
Al-Hasani, Omer Hussain
Traumatic brain injury (TBI) remains an important cause of morbidity and mortality within society. TBI may result in both focal and diffuse brain injury. Diffuse traumatic axonal injury (TAI) is an important pathological substrate of TBI, and can...
Wolthuis, Esther K; Vlaar, Alexander PJ; Choi, Goda; Roelofs, Joris JTH; Juffermans, Nicole P; Schultz, Marcus J
Introduction Mechanical ventilation (MV) may cause ventilator-induced lung injury (VILI). Present models of VILI use exceptionally large tidal volumes, causing gross lung injury and haemodynamic shock. In addition, animals are ventilated for a relative short period of time and only after a 'priming' pulmonary insult. Finally, it is uncertain whether metabolic acidosis, which frequently develops in models of VILI, should be prevented. To study VILI in healthy mice, the authors used a MV model with clinically relevant ventilator settings, avoiding massive damage of lung structures and shock, and preventing metabolic acidosis. Methods Healthy C57Bl/6 mice (n = 66) or BALB/c mice (n = 66) were ventilated (tidal volume = 7.5 ml/kg or 15 ml/kg; positive end-expiratory pressure = 2 cmH2O; fraction of inspired oxygen = 0.5) for five hours. Normal saline or sodium bicarbonate were used to correct for hypovolaemia. Lung histopathology, lung wet-to-dry ratio, bronchoalveolar lavage fluid protein content, neutrophil influx and levels of proinflammatory cytokines and coagulation factors were measured. Results Animals remained haemodynamically stable throughout the whole experiment. Lung histopathological changes were minor, although significantly more histopathological changes were found after five hours of MV with a larger tidal volume. Lung histopathological changes were no different between the strains. In both strains and with both ventilator settings, MV caused higher wet-to-dry ratios, higher bronchoalveolar lavage fluid protein levels and more influx of neutrophils, and higher levels of proinflammatory cytokines and coagulation factors. Also, with MV higher systemic levels of cytokines were measured. All parameters were higher with larger tidal volumes. Correcting for metabolic acidosis did not alter endpoints. Conclusions MV induces VILI, in the absence of a priming pulmonary insult and even with use of relevant (least injurious) ventilator settings. This model offers opportunities to study the pathophysiological mechanisms behind VILI and the contribution of MV to lung injury in the absence of pre-existing lung injury. PMID:19152704
Reid, Christopher R.; McFarland, Shane M.
Injuries to the hands are common among astronauts who train for extravehicular activity (EVA). When the gloves are pressurized, they restrict movement and create pressure points during tasks, sometimes resulting in pain, muscle fatigue, abrasions, and occasionally more severe injuries such as onycholysis. A brief review of the Lifetime Surveillance of Astronaut Health's injury database reveals that 58% of total astronaut hand and arm injuries from NBL training between 1993 and 2010 occurred either to the fingernail, MCP, or fingertip. The purpose of this study was to assess the potential of using small sensors to measure force acting on the fingers and hand within pressurized gloves and other variables such as blood perfusion, skin temperature, humidity, fingernail strain, skin moisture, among others. Tasks were performed gloved and ungloved in a pressurizable glove box. The test demonstrated that fingernails saw greater transverse strain levels for tension or compression than for longitudinal strain, even during axial fingertip loading. Blood perfusion peaked and dropped as the finger deformed during finger presses, indicating an initial dispersion and decrease of blood perfusion levels. Force sensitive resistors to force plate comparisons showed similar force curve patterns as fingers were depressed, indicating suitable functionality for future testing. Strategies for proper placement and protection of these sensors for ideal data collection and longevity through the test session were developed and will be implemented going forward for future testing.
Misha D. Luyer; Wim A. Buurman; M. Hadfoune; G. Speelmans; J. Knol; J. A. Jacobs; C. H. C. Dejong; A. J. M. Vriesema; J. W. M. Greve
Probiotic therapy modulates the composition of the intestinal flora and inhibits the inflammatory response. These properties may be of benefit in the preservation of gut barrier integrity after injury or stress. In this study, we examined the effect of two Lactobacillus strains selected for their pathogen exclusion properties on intestinal barrier integrity following hemorrhagic shock. Additionally, the responsiveness of the
Cook, Thomas Bradley; Davis, Mark S.
Relatively little is known about legal entanglements and suicide risk. This matched case-control study estimated the risk of suicide associated with legal strains using online court archives, a novel source of exposure data. Court records linked to suicide deaths (N = 315), controls (N = 630), and unintentional injury and poisoning deaths (N =…
Menzer, Heather; Gill, G Keith; Paterson, Andrew
Although sports-related injuries to the thoracic spine are relatively uncommon, they are among the most feared due to the potential for catastrophic neurologic injury. The increased biomechanical support of the thoracic spine makes injuries in this region particularly rare compared with the cervical and lumbar spine. As a result, thoracic spine injuries can be missed easily, difficult to diagnose, and problematic to treat. Recognition of mechanism and awareness of injury patterns help physicians determine a diagnosis and create an index of suspicion for unstable thoracic spine injuries. Aggressive full-contact sports receive the most attention for spinal injury; however several sports with repetitive loading of the spine can cause severe injuries, including rowing, gymnastics, and golf. The goal of this article was to provide an overview of the unique anatomic and biomechanical features of the thoracic spine and to discuss some of the more common thoracic injuries that can affect athletes. PMID:25574880
Romagnoli, S; Ricci, Z
Acute kidney injury (AKI) represents 18-47% of all causes of hospital-acquired AKI and it is associated with a high incidence of morbidity and mortality especially in patients requiring dialysis. Only recently, with the application of new AKI classifications and guidelines (RIFLE, AKIN and KDIGO), a more accurate evaluation of the real incidence of kidney dysfunction in patients undergoing surgery has been detailed. In patients undergoing non-cardiac, non-vascular and non-thoracic surgery several independent preoperative and intraoperative predictors of AKI have been identified. Nonetheless, no measure for AKI prevention reached a high level of recommendation, although hemodynamic monitoring and goal-directed fluid management may limit perioperative AKI. Cardiac surgery-related AKI and cardiopulmonary bypass-related AKI have been extensively evaluated and several preventive and treatment strategies have been developed. Open and endovascular surgery-related AKI have been compared and hydration is currently the only preventive strategy with a substantial level of efficacy. In addition, AKI in thoracic surgery, overlooked in the past, has been evaluated, showing that it frequently complicates postoperative course of patients undergoing elective lung cancer resection. Multi-hit mechanisms (ischemia, inflammation, toxins) co-act on patients' predisposition (susceptibility). A multi-step approach is probably necessary to limit the incidence and the severity of postsurgery AKI patients, such as careful risk stratification, adoption of preventive measures and goal directed intraoperative algorithms. The present review will summarize the current literature about the epidemiology of postoperative AKI focusing on patient-related and technical-related risk factors, outcome and prevention strategies in different groups of surgeries. PMID:25057935
Kulkarni, Sanjay B.; Joshi, Pankaj M.; Hunter, Craig; Surana, Sandesh; Shahrour, Walid; Alhajeri, Faisal
Objective To assess treatment strategies for seven different scenarios for treating complex pelvic fracture urethral injury (PFUI), categorised as repeat surgery for PFUI, ischaemic bulbar urethral necrosis (BUN), repair in boys and girls aged ?12 years, in patients with a recto-urethral fistula, or bladder neck incontinence, or with a double block at the bulbomembranous urethra and bladder neck/prostate region. Patients and methods We retrospectively reviewed the success rates and surgical procedures of these seven complex scenarios in the repair of PFUI at our institution from 2000 to 2013. Results In all, >550 PFUI procedures were performed at our centre, and 308 of these patients were classified as having a complex PFUI, with 225 patients available for follow-up. The overall success rates were 81% and 77% for primary and repeat procedures respectively. The overall success rate of those with BUN was 76%, using various methods of novel surgical techniques. Boys aged ?12 years with PFUI required a transpubic/abdominal approach 31% of the time, compared to 9% in adults. Young girls with PFUI also required a transpubic/abdominal urethroplasty, with a success rate of 66%. In patients with a recto-urethral fistula the success rate was 90% with attention to proper surgical principles, including a three-stage procedure and appropriate interposition. The treatment of bladder neck incontinence associated with the tear-drop deformity gave a continence rate of 66%. Children with a double block at the bulbomembranous urethra and at the bladder neck-prostate junction were all continent after a one-stage transpubic/abdominal procedure. Conclusion An understanding of complex pelvic fractures and their appropriate management can provide successful outcomes. PMID:26019978
MacVittie, T J
It is apparent from preclinical and clinical research to date that continued evaluation of new and alternative treatment strategies is required to eliminate the obligate periods of neutropenia and thrombocytopenia after acute high-dose irradiation. Future treatment strategies may involve new combinations of cytokines to affect hematopoietic stem cell proliferation and "engineered" cellular grafts to provide short-term in vivo expansion of neutrophils and platelets in an effort to bridge the cytopenic gap until endogenous or transplanted stem cells regenerate the hematopoietic and immune systems. Cytokine-mobilized peripheral blood and cord blood will provide alternative sources of allogeneic stem and progenitor cells in support of primary engraftment, delayed engraftment or secondary failure of the initial graft, as well as starting populations for various ex vivo expansion protocols. Further insights into the relative quality of stem cell populations and the factors that regulate their survival and self renewal, and the identification and roles of adhesion molecules in stem cell mobilization, engraftment, and interaction with the adult marrow microenvironment will provide the basis for future treatment strategies for the radiation-induced hematopoietic syndrome. As our ability to treat the hematopoietic syndrome improves, damage to other organ systems such as the skin, lung, and/or gastrointestinal tissue will emerge as dose-limiting. At the same time, the characterization of receptors for inflammatory cytokines, cytokine receptor antagonists, and anti-endotoxin antibodies has allowed significant insights into the mechanisms and pathogenesis of sepsis. However, translation of this knowledge into a treatment modality for septic patients is precluded by the lack of any clear-cut beneficial effect from the many clinical trials. The research and clinical results presented in this volume and recent conferences reflect the body of knowledge that will lead to further developments in assessment, prophylaxis, and treatment of radiation injuries in the areas of infectious disease and the hematopoietic, gastrointestinal, and cutaneous syndromes. PMID:9368312
Jin, Guang; Arai, Ken; Murata, Yoshihiro; Wang, Sophia; Stins, Monique F.; Lo, Eng H.; van Leyen, Klaus
Background and Purpose The concept of the neurovascular unit suggests that effects on brain vasculature must be considered if neuroprotection is to be achieved in stroke. We previously reported that 12/15-lipoxygenase (12/15-LOX) is upregulated in the peri-infarct area after middle cerebral artery occlusion in mice, and 12/15-LOX contributes to brain damage after ischemia–reperfusion. The current study was designed to investigate 12/15-LOX involvement in vascular injury in the ischemic brain. Methods In cell culture, a human brain microvascular endothelial cell line was subjected to either hypoxia or H2O2-induced oxidative stress with or without lipoxygenase inhibitors. For in vivo studies, mice were subjected to 90 minutes middle cerebral artery occlusion, and the effects of either 12/15-LOX gene knockout or treatment with lipoxygenase inhibitors were compared. Expression of 12/15-LOX and claudin-5 as well as extravasation of immunoglobulin G were detected by immunohistochemistry. Edema was measured as water content of brain hemispheres according to the wet–dry weight method. Results Brain endothelial cells were protected against hypoxia and H2O2 by the lipoxygenase inhibitor baicalein. After focal ischemia, 12/15-LOX was increased in neurons and endothelial cells. The vascular tight junction protein claudin-5 underwent extensive degradation in the peri-infarct area, which was partially prevented by the lipoxygenase inhibitor baicalein. Leakage of immunoglobulin G into the brain parenchyma was significantly reduced in 12/15-LOX knockout mice as well as wild-type mice treated with baicalein. Likewise, brain edema was significantly ameliorated. Conclusion 12/15-LOX may contribute to ischemic brain damage not just by causing neuronal cell death, but also by detrimental effects on the brain microvasculature. 12/15-LOX inhibitors may thus be effective as both neuroprotectants and vasculoprotectants. PMID:18635843
Sandor, Katalin; Josephson, Anna; Svensson, Camilla I; Abrams, Mathew B.
Abstract A number of different rodent experimental models of spinal cord injury have been used in an attempt to model the pathophysiology of human spinal cord injury. As a result, interlaboratory comparisons of the outcome measures can be difficult. Further complicating interexperiment comparisons is the fact that the rodent response to different experimental models is strain-dependent. Moreover, the literature is abundant with examples in which the same injury model and strain result in divergent functional outcomes. The objective of this research was to determine whether substrain differences influence functional outcome in experimental spinal cord injury. We induced mild contusion spinal cord injuries in three substrains of Sprague-Dawley rats purchased from three different European breeders (Scanbur, Charles River, and Harlan) and evaluated the impact of injury on spontaneous locomotor function, hypersensitivity to mechanical stimulation, and bladder function. We found that Harlan rats regained significantly more hindlimb function than Charles River and Scanbur rats. We also observed substrain differences in the recovery of the ability to empty the bladder and development of hypersensitivity to mechanical stimulation. The Harlan substrain did not show any signs of hypersensitivity in contrast to the Scanbur and Charles River substrains, which both showed transient reduction in paw withdrawal thresholds. Lastly, we found histological differences possibly explaining the observed behavioral differences. We conclude that in spite of being the same strain, there might be genetic differences that can influence outcome measures in experimental studies of spinal cord injury of Sprague-Dawley rats from different vendors. PMID:23879467
Mohan, Sadanandan; Varghese, George; Kumar, Sanjay; Subramanian, Dinesh Pambungal
Penetrating facial injuries are potentially dangerous and require emergency management because of the presence of vital structures in the face and it may be life threatening especially when the injury involves airway, major blood vessels, spinal cord and cervical spines. Penetrating injuries of facial region can occur due to missile injuries, blast injuries, accidental fall on sharp objects such as sticks or glass and motor vehicle accidents etc., Indications for immediate surgical management of penetrating neck injuries include airway management and hemodynamic instability according to advanced trauma life support protocol. PMID:25937743
Hu, G; Baker, T D; Li, G; Baker, S P
Injury control is an important health issue in China, but has been less well explored than in other countries. To encourage health policy makers to give greater attention to injury control, this report highlights the great damage caused by injuries and the neglected status of injury control in China. China's situation and the experiences and lessons from industrialized countries, especially the USA, are summarized. Finally, two opportunities to improve injury control in China are identified: establishment of a mechanism for multi-department coordination and collaboration; and improvement of injury data surveillance. PMID:18388234
Scolletta, S; Taccone, F S; Donadello, K
In patients undergoing cardiac surgery, postoperative brain injury significantly contributes to increase morbidity and mortality and has negative consequences on quality of life and costs. Moreover, over the past years, compelling medical and technological improvements have allowed an even older patients' population, with several comorbidities, to be treated with cardiac surgery; however, the risk of brain injury after such interventions is also increased in these patients. With the aim of improving post-operative neurological outcome, a variety of neuromonitoring methods and devices have been introduced in clinical practice. These techniques allow the assessment of a number of parameters, such as cerebral blood flow, brain embolic events, cerebral cortical activity, depth of anesthesia and brain oxygenation. Some of them have been used to optimize the hemodynamic management of such patients and to select specific therapeutic interventions. Also, various pharmacological and non-pharmacological approaches have been proposed to minimize the incidence of brain injury in this setting. In this review we describe the risk factors and mechanisms of cerebral injury after cardiac surgery and focus on monitoring techniques and clinical strategies that could help clinicians to minimize the incidence of brain injury. PMID:25220549
Prado Júnior, J; Alves, M R; Kara José, N; Usuba, F S; Onclix, T M; Marantes, C R
The author studied 140 cases of perforating eye injury in children up to 15 years old admitted at the Clinic Hospital of the Medical College of the University of São Paulo (Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo) from January 1989 to December 1993. These cases represent 24.71% of the total of the perforating eye injuries seen during this period, showing a ratio of 76.42% of males, a ratio of 2/1 in the group from 0 to 6 years old, 7/1 in the group from 7 to 11 years old and a ratio of 3/1 in the group from 12 to 15 years old. The most common perforating eye injuries were due to sharp objects (54.71%), contusion (20%), explosions (7.85%) and flying objects (5.71%). The relation between the severity of the injury and the prognosis is emphasized. Safety precautions should be effective in order to reduce frequence and morbidity of these perforating ocular injuries. PMID:9008931
Melamed, Eitan; Blumenfeld, Amir; Kalmovich, Boaz; Kosashvili, Yona; Lin, Guy
Orthopedic injuries are predominant among combat casualties, and carry the potential for significant morbidity. An expert consensus process (Prehospital care of military orthopedic trauma: A consensus meeting, Israel Defense Forces Medical Corps, May 2003) was used to create guidelines for the treatment of these injuries by military prehospital providers. The consensus treatment guidelines developed by experienced orthopedic trauma personnel from leading trauma centers in Israel are presented in this paper. For victims with open fractures, the first priority is hemorrhage control. Splinting, irrigation, and wound care should be performed while waiting for transport, or, in any scenario, in the case of an isolated limb injury. The use of traction splints was advocated for both the rapid transport scenario (up to one hour from the time of injury to arrival at the hospital) and the delayed transport scenario. In the urban setting, traction splints may not be necessary. Any victim experiencing pelvic pain following a high-energy mechanism of injury should be presumed to have an unstable pelvic fracture, and a sheet should be tied around the pelvis. The panel agreed that field-reduction of dislocations should be avoided by the medical officer unless it is anticipated that the patient will need to go through a long evacuation chain and the medical officer is familiar with specific reduction techniques. PMID:17484359
A tool and a method are disclosed for attaching a strain gauge to a test specimen by maintaining alignment of, and applying pressure to, the strain gauge during the bonding of the gauge to the specimen. The tool comprises rigid and compliant pads attached to a spring-loaded clamp. The pads are shaped to conform to the specimen surface to which the gauge is to be bonded. The shape of the pads permits the tool to align itself to the specimen and to maintain alignment of the gauge to the specimen during the bond curing process. A simplified method of attaching a strain gauge is provided by use of the tool. 6 figs.
Elsner, Jonathan J; Gefen, Amit
Deep tissue injury (DTI) is a severe form of pressure ulcers that occur in subcutaneous tissue under intact skin by the prolonged compression of soft tissues overlying bony prominences. Pressure ulcers and DTI in particular are common in patients with impaired motosensory capacities, such as those with a spinal cord injury (SCI). Obesity is also common among subjects with SCI, yet there are contradicting indications regarding its potential influence as a risk factor for DTI in conditions where these patients sit in a wheelchair without changing posture for prolonged times. It has been argued that high body mass may lead to a greater risk for DTI due to increase in compressive forces from the bones on overlying deep soft tissues, whereas conversely, it has been argued that the extra body fat associated with obesity may reduce the risk by providing enhanced subcutaneous cushioning that redistributes high interface pressures. No biomechanical evaluation of this situation has been reported to date. In order to elucidate whether obesity can be considered a risk factor for DTI, we developed computational finite element (FE) models of the seated buttocks with 4 degrees of obesity, quantified by body mass index (BMI) values of 25.5, 30, 35 and 40kg/m(2). We found that peak principal strains, strain energy densities (SED) and von Mises stresses in internal soft tissues (muscle, fat) overlying the ischial tuberosities (ITs) all increased with BMI. With a rise in BMI from 25.5 to 40kg/m(2), values of these parameters increased 1.5 times on average. Moreover, the FE simulations indicated that the bodyweight load transferred through the ITs has a greater effect in increasing internal tissue strains/stresses than the counteracting effect of thickening of the adipose layer which is concurrently associated with obesity. We saw that inducing some muscle atrophy (30% reduction in muscle volume, applied to the BMI=40kg/m(2) model) which is also characteristic of chronic SCI resulted in further substantial increase in all biomechanical measures reflecting geometrical distortion of muscle tissue, that is, SED, tensile stress, shear stress and von Mises stress. This result highlights that obesity and muscle atrophy, which are both typical of the chronic phase of SCI, contribute together to the state of elevated tissue loads, which consequently increases the likelihood of DTI in this population. PMID:19026415
Burgess-Limerick, Robin; Peeters, Geeske
Study Design. Prospective cohort study. Objective. To determine if a job-specific pre-employment functional assessment (PEFA) predicts musculoskeletal injury risk in healthy mineworkers. Summary of Background Data. Traditional methods of pre-employment screening, including radiography and medical screenings, are not valid predictors of occupational musculoskeletal injury risk. Short-form job-specific functional capacity evaluations are increasing in popularity, despite limited evidence of their ability to predict injury risk in healthy workers. Methods. Participants were recruited from an Australian coal mine between 2002 and 2009 as part of the hiring process. At baseline, participants were screened with the JobFit System PEFA, and classified as PEFA 1 if they met job demands and PEFA>1, if not. Males who completed the PEFA and were employed were included. Injury data from company records were coded for body part, mechanism, and severity. The relationship between PEFA classification and time to first injury was analyzed using Cox proportional hazards regression with adjustments for department and post hoc stratification for time (0–1.3 yr, 1.3–6 yr). Results. Of the 600 participants (median age, 37 yr, range, 17.0–62.6 yr), 427 scored PEFA 1. One hundred ninety-six sprain/strain injuries were reported by 121 workers, including 35 back injuries from manual handling. Significant differences between PEFA groups were found in time to first injury for all injury types during the long term (any injury: adjusted hazard ratio [HR] = 2.3, 95% confidence interval [CI] = 1.4–3.9; manual handling injury: HR = 3.3, CI = 1.6–7.2; any back injury: HR = 3.3, CI = 1.6–6.6; back injuries from manual handling HR = 5.8, CI = 2.0–16.7), but not during the short term. An area under the receiver operator curve value of 0.73 (CI = 0.61–0.86) demonstrated acceptable predictive ability for back injuries from manual handling during the long term. Conclusion. JobFit System PEFAs predict musculoskeletal injury risk in healthy mineworkers after 1.3 years of employment. Future research should assess whether use of these assessments as part of a holistic risk management program can decrease workplace musculoskeletal injuries. Level of Evidence: 2 PMID:24048088
Xiang, H; Stallones, L; Smith, G
Objective: Young skiers are at increased risk for injury, however, epidemiological data on skiing related fatal injuries among child skiers are scarce. This study aimed to provide information needed to develop injury control and prevention programs. Design and setting: Study subjects came from Colorado, USA and were identified using a death certificate based surveillance system. Fatal injuries were limited to events that occurred at established commercial ski resorts in Colorado, and subjects were classified as child skiers (0–17 years) or adult skiers (?18 years). Main outcome measure: Type and external cause, time, and week day of injury, gender and residency of the decedents. Results: During the study period from 1980–2001, 149 fatal injuries associated with downhill skiing were identified; 21 (14.1%) occurred among child skiers aged ?17 years. The age of the youngest decedent was 7 years. In females the proportion of fatal injuries among child skiers was nearly three times that of adults. Traumatic brain injuries were the leading cause of death (67% of all deaths) among children, while multiple internal injuries and traumatic brain injuries accounted for almost equal proportions of fatal injuries among adults. Collision was the leading external mechanism of fatal injuries, accounting for more than two thirds of fatal injuries in both child and adult skiers. Conclusions: Traumatic brain injury was the leading cause and collision was the leading external injury mechanism of fatal injuries associated with downhill skiing among child skiers. This underscores the importance of brain injury prevention strategies, including the use of ski helmets and prevention of collisions on ski slopes. PMID:15066975
Zulkipli, Zarir Hafiz; Abdul Rahmat, Abdul Manap; Mohd Faudzi, Siti Atiqah; Paiman, Noor Faradila; Wong, Shaw Voon; Hassan, Ahamedali
This study presents an analysis of crash characteristics of motorcyclists who sustained spinal injuries in motorcycle crashes. The aim of the study is to identify the salient crash characteristics that would help explain spinal injury risks for motorcyclists. Data were retrospectively collected from police case reports that were archived at MIROS from year 2005 to 2007. The data were categorized into two subcategories; the first group was motorcycle crashes with spinal injury (case) and the second group was motorcycle crashes without spinal injury (control). A total of 363 motorcyclists with spinal injury and 873 motorcyclists without spinal injury were identified and analyzed. Descriptive analysis and multivariate analysis were performed in order to determine the odds of each characteristic in contributing to spinal injury. Single vehicle crash, collision with fixed objects and crash configuration were found to have significant influence on motorcyclists in sustaining spinal injury (p<0.05). Although relatively few than other impact configurations, the rear-end impacted motorcyclist shows the highest risk of spinal injury. Helmets have helped to reduce head injury but they did not seem to offer corresponding protection for the spine in the study. With a growing number of young motorcyclists, further efforts are needed to find effective measures to help reduce the crash incidents and severity of spinal injury. In sum, the study provides some insights on some vital crash characteristics associated with spinal injury that can be further investigated to determine the appropriate counter-measures and prevention strategies to reduce spinal injury. PMID:23036400
Levy, A S; Smith, R H
Neurologic injures are the leading cause of death and disability in skiing and snowboarding accidents, despite accounting for only a small fraction of injuries overall. Head injuries make up 3 to 15% of all skiing and snowboarding related injuries, spinal injuries account for 1 to 13%, and peripheral nerve injuries constitute less than 1% of reported injuries. Improvements in equipment and technology, especially advances in binding technology, have resulted in decreased injury rates on the slopes overall, but neurologic injury rates have not decreased, and in fact appear to be increasing as a percentage of overall injuries and in absolute numbers. With advances in technology and slope maintenance, skiers and boarders progress to higher skill levels and faster speeds more rapidly than ever before. Great efforts have been focused on reducing extremity injuries in skiers and snowboarders, but until recently very little attention has been given to neurologic injury prevention on the slopes. Hopefully with increased awareness and the growing popularity of ski/snowboard helmets, we will begin to see head injury rates (and maybe even spine injury rates) decrease among skiers and snowboarders. PMID:10946744
Scheuring, Rick; McCulloch, Pat; Van Baalen, Mary; Watson, Richard; Bowen, Steve; Blatt, Terri
There are multiple factors associated with the mechanism of injury that leads to shoulder injury requiring surgical repair. Despite the injury prevention measures taken from the 2003 Shoulder Tiger Team recommendations, shoulder injuries and subsequent shoulder surgeries remain relatively unchanged.
Crossen, Eric J; Lewis, Brenna; Hoffman, Benjamin D
Firearms are involved in the injury and death of a large number of children each year from both intentional and unintentional causes. Gun ownership in homes with children is common, and pediatricians should incorporate evidence-based means to discuss firearms and protect children from gun-related injuries and violence. Safe storage of guns, including unloaded guns locked and stored separately from ammunition, can decrease risks to children, and effective tools are available that pediatricians can use in clinical settings to help decrease children's access to firearms. Furthermore, several community-based interventions led by pediatricians have effectively reduced firearm-related injury risks to children. Educational programs that focus on children's behavior around guns have not proven effective. PMID:25646308
Grys, G; Uszy?ski, H; Sawicki, G; Or?owski, J
Remote results of hand injuries in 78 patients (93% males, 7% females) aged 16-82 (mean 39 years) were analyzed statistically and economically. Injuries sustained at work constituted 61%. All patients were operated on emergency basis, hospital stay ranged 1-93 days (mean 14 days). Further treatment on an outpatient basis lasted 4.5 months on an average. According to own 3-grade scale 24% results were rated good, 33%-fair and 43%-poor. Fifty-one per cent of patients resumed previous occupation, 17% found less demanding work and 15% were unable to work. Accident compensation fund was granted to 56% of patients. Great social cost of hand injuries is underlined in the paper. PMID:9607285
Carroll, A W; Soderstrom, C A
A new, nonpenetrating ballistic injury mechanism involving individuals protected by soft body armor is described. Experimental studies using laboratory animals have demonstrated that despite stopping missile penetration, the heart, liver, spleen, and spinal cord are vulnerable to injury. The rapid jolting force of an impacting bullet is contrasted with the usually encountered mechanisms producing blunt trauma injury. The experimental methodology used to assess a 20% increase in survival probability and an 80% decrease in the need for surgical intervention with a new soft body armor is reviewed. Five cases of ballistic assaults on law enforcement personnel protected by soft body armor are presented. Four emphasize the potentially lifesaving qualities of the armor, while the fifth indicates the need for torso encircling design. Hospitalization should follow all assaults, regardless of the innocuous appearance of the skin lesion and the apparent well being on the assaulted individual. Therapeutic guidelines for patient management are suggested. PMID:736653
Cernak, Ibolja; Wing, Ian D; Davidsson, Johan; Plantman, Stefan
Penetrating traumatic brain injury (pTBI) has been difficult to model in small laboratory animals, such as rats or mice. Previously, we have established a non-fatal, rat model for pTBI using a modified air-rifle that accelerates a pellet, which hits a small probe that then penetrates the experimental animal's brain. Knockout and transgenic strains of mice offer attractive tools to study biological reactions induced by TBI. Hence, in the present study, we adapted and modified our model to be used with mice. The technical characterization of the impact device included depth and speed of impact, as well as dimensions of the temporary cavity formed in a brain surrogate material after impact. Biologically, we have focused on three distinct levels of severity (mild, moderate, and severe), and characterized the acute phase response to injury in terms of tissue destruction, neural degeneration, and gliosis. Functional outcome was assessed by measuring bodyweight and motor performance on rotarod. The results showed that this model is capable of reproducing major morphological and neurological changes of pTBI; as such, we recommend its utilization in research studies aiming to unravel the biological events underlying injury and regeneration after pTBI. PMID:25374559
Lipscomb, H J; Dement, J M; Loomis, D P; Silverstein, B; Kalat, J
Combined data sources, including union administrative records and workers' compensation claims, were used to construct event histories for a dynamic cohort of union carpenters from Washington State during the period 1989-1992. Person-time at risk and the events of interest were stratified by age, sex, time in the union, and predominant type of carpentry work. Poisson regression techniques were used to identify subgroups at greatest risk of filing claims for a variety of musculoskeletal disorders defined by ANSI codes for body part injured and injury nature. Distinguishing different kinds of musculoskeletal disorders, even crudely with ANSI codes, led to different conclusions about the effects of the explanatory variables. Among older workers, the rates of fractures of the foot were higher, while rates of contusions of the hand and foot were lower. Women had higher rates of sprain/strains and nerve conditions of the wrist/forearm. Higher rates of injuries to the axial skeleton were seen among carpenters who did predominantly light commercial and drywall work, while piledrivers had lower rates of these injuries. Drywall workers had higher rates of sprains to the ankle/lower leg. Workers who were members of the union as long as four years had lower risks for the vast majority of musculoskeletal disorders studied. Similar patterns were seen for more serious claims that resulted in paid lost time from work. PMID:9358920
Cernak, Ibolja; Wing, Ian D.; Davidsson, Johan; Plantman, Stefan
Penetrating traumatic brain injury (pTBI) has been difficult to model in small laboratory animals, such as rats or mice. Previously, we have established a non-fatal, rat model for pTBI using a modified air-rifle that accelerates a pellet, which hits a small probe that then penetrates the experimental animal’s brain. Knockout and transgenic strains of mice offer attractive tools to study biological reactions induced by TBI. Hence, in the present study, we adapted and modified our model to be used with mice. The technical characterization of the impact device included depth and speed of impact, as well as dimensions of the temporary cavity formed in a brain surrogate material after impact. Biologically, we have focused on three distinct levels of severity (mild, moderate, and severe), and characterized the acute phase response to injury in terms of tissue destruction, neural degeneration, and gliosis. Functional outcome was assessed by measuring bodyweight and motor performance on rotarod. The results showed that this model is capable of reproducing major morphological and neurological changes of pTBI; as such, we recommend its utilization in research studies aiming to unravel the biological events underlying injury and regeneration after pTBI. PMID:25374559
Fisher, Kurt; Vuppalanchi, Raj; Saxena, Romil
Context .- Drug-induced liver injury (DILI) represents a diverse set of responses following exposure to any manufactured or naturally occurring chemical compound. Drug-induced liver injury is of major concern owing to the ever increasing number of compounds introduced into the market for treatment of various diseases as well as the increasing popularity of herbals, which lend themselves to self-medication but are not rigorously regulated. Objective .- To provide an overview of the prevalence, classification, and diagnosis of DILI with emphasis on pathogenesis and the role of a liver biopsy. To focus on the most common, emerging, and herbal agents that cause DILI with emphasis on the histologic pattern of injury observed. Data Sources .- A review of the literature was drawn from the PubMed (US National Library of Medicine) repository, textbooks, and online databases. All figures were taken from cases seen at our tertiary referral center, which is 1 of 12 participating sites in the National Institutes of Health-funded Drug-Induced Liver Injury Network. Conclusions .- Drug-induced liver injury due to prescription, over-the-counter, and herbal products is a major cause of liver disease in the United States and around the world. Diagnosis of DILI is challenging because there is no single clinical, laboratory, or histologic feature specific to DILI. Accurate diagnosis requires establishing a causal relationship with the suspected agent and excluding competing causes of liver injury. The liver biopsy is an essential component in the management of DILI by offering clues to the underlying pathogenesis, providing prognostic information, and guiding therapy. PMID:26125428
Kazim, Syed Faraz; Shamim, Muhammad Shahzad; Tahir, Muhammad Zubair; Enam, Syed Ather; Waheed, Shahan
Penetrating brain injury (PBI), though less prevalent than closed head trauma, carries a worse prognosis. The publication of Guidelines for the Management of Penetrating Brain Injury in 2001, attempted to standardize the management of PBI. This paper provides a precise and updated account of the medical and surgical management of these unique injuries which still present a significant challenge to practicing neurosurgeons worldwide. The management algorithms presented in this document are based on Guidelines for the Management of Penetrating Brain Injury and the recommendations are from literature published after 2001. Optimum management of PBI requires adequate comprehension of mechanism and pathophysiology of injury. Based on current evidence, we recommend computed tomography scanning as the neuroradiologic modality of choice for PBI patients. Cerebral angiography is recommended in patients with PBI, where there is a high suspicion of vascular injury. It is still debatable whether craniectomy or craniotomy is the best approach in PBI patients. The recent trend is toward a less aggressive debridement of deep-seated bone and missile fragments and a more aggressive antibiotic prophylaxis in an effort to improve outcomes. Cerebrospinal fluid (CSF) leaks are common in PBI patients and surgical correction is recommended for those which do not close spontaneously or are refractory to CSF diversion through a ventricular or lumbar drain. The risk of post-traumatic epilepsy after PBI is high, and therefore, the use of prophylactic anticonvulsants is recommended. Advanced age, suicide attempts, associated coagulopathy, Glasgow coma scale score of 3 with bilaterally fixed and dilated pupils, and high initial intracranial pressure have been correlated with worse outcomes in PBI patients. PMID:21887033
Chan, Matilda F.; Werb, Zena
The cornea is an excellent model system to use for the analysis of wound repair because of its accessibility, lack of vascularization, and simple anatomy. Corneal injuries may involve only the superficial epithelial layer or may penetrate deeper to involve both the epithelial and stromal layers. Here we describe two well-established in vivo corneal wound models: a mechanical wound model that allows for the study of re-epithelialization and a chemical wound model that may be used to study stromal activation in response to injury (Stepp et al., 2014; Carlson et al., 2003).
Simon, S I; Schmid-Schönbein, G W
A new method is presented to measure local cytoplasmic deformation and rate of deformation in motile active neutrophils. The deformation is expressed in terms of biomechanical strains and strain rates. For this purpose small phagocytosed latex microspheres were used as intracellular markers. Planar Lagrangian and Eulerian strains and the rate of strain were estimated from the positions of a triad of internalized markers. Principal strains, stretch ratios, and principal directions were computed. The intracellular strains were found to be large relative to the overall cell shape change. Principal cytoplasmic stretch ratios showed large extension in the direction of pseudopod formation and cell locomotion and contraction in perpendicular directions. Regional strain analysis showed contractile strains to predominate in the vicinity of the pseudopod or leading edge of motion. The transitional region between the pseudopod and the main cell body exhibited large shear strains. The posterior region, where the uropod is located, also revealed large extensions but small contractile strains. The rate of strains are relatively small, nonuniform in time, and largely independent of the strain. The method we propose to measure cytoplasmic strain can be applied to a variety of problems in cell mechanics. Images FIGURE 3 PMID:2207240
Curry, Parichat; Ramaiah, Ramesh; Vavilala, Monica S.
Injuries are a major and growing public health problem, a leading cause of death and disabilities among people aged 1–44 years around the world. Each year, 5.8 million people die from injuries, accounting for 10% of the world's deaths. Road traffic injuries (RTIs), self-inflicted injuries and violence are the top three leading causes of all injury deaths, while RTIs, falls and drowning are the top three leading causes of unintentional injury death. In many high-income countries, trends of injury death have been decreasing as a result of prevention measures. In contrast, trends in low- and middle-income countries have been rising. In this article, we review the prevention strategies for RTIs, violence, falls and drowning developed over decades to disseminate the knowledge and inform health care providers, especially acute care physicians, about the importance of injury prevention. PMID:22096775
Laurence S. Baskin; Douglas A. Canning; Howard M. Snyder; John W. Duckett
PurposeThe 2 types of urethral injury that can occur during circumcision are urethrocutaneous fistula and urethral distortion secondary to partial glans amputation. We report the surgical repair of these rare injuries.
...FRUITS, VEGETABLES AND OTHER PRODUCTS 1,2 (INSPECTION, CERTIFICATION, AND STANDARDS) United States Standards for Shelled English Walnuts (Juglans Regia) Definitions § 51.2290 Insect injury. Insect injury means that the insect, web,...
The National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC) had developed and maintains a surveillance system to understand the magnitude and characteristics of hospitalized and fatal traumatic brain injuries in the United State...
... Center Spinal Cord Injury InfoSheet 10 Level - Consumer Pain Management following Spinal Cord Injury coming from somewhere other ... pain is described as burning, cramping and constant. PAIN MANAGEMENT Pain management usually includes treatment with medications, modified ...
... medlineplus/news/fullstory_152937.html Injuries From High Heels on the Rise Most of those seeking ER ... finds. U.S. emergency rooms treated 123,355 high-heel-related injuries between 2002 and 2012, say researchers ...
... Contact the UAB-SCIMS UAB Spinal Cord Injury Model System Newly Injured Health Daily Living Consumer Groups ... University of Alabama at Birmingham Spinal Cord Injury Model System (UAB-SCIMS) maintains this Information Network as ...
... abnormal brain scan (CT or MRI) relateD injuries • Skull fracture: a break in the bones that surround ... to the head that does not penetrate the skull Penetrating Head Injury Occurs when an object goes ...
Although golf is not a rigorous sport, it has its share of injuries. Greater attention to preplay stretching and conditioning programs and to the proper mechanics of the golf swing can help prevent injuries. (Author/CB)
Yokota, M; Karis, A J; Tharion, W J
Background: Thermal safety standards for the use of chemical, biological, radiological, and nuclear (CBRN) ensembles have been established for various US occupations, but not for law enforcement personnel. Objectives: We examined thermal strain levels of 30 male US law enforcement personnel who participated in CBRN field training in Arizona, Florida, and Massachusetts. Methods: Physiological responses were examined using unobtrusive heart rate (HR) monitors and a simple thermoregulatory model to predict core temperature (Tc) using HR and environment. Results: Thermal strain levels varied by environments, activity levels, and type of CBRN ensemble. Arizona and Florida volunteers working in hot-dry and hot-humid environment indicated high heat strain (predicted max Tc>38.5°C). The cool environment of Massachusetts reduced thermal strain although thermal strains were occasionally moderate. Conclusions: The non-invasive method of using physiological monitoring and thermoregulatory modeling could improve law enforcement mission to reduce the risk of heat illness or injury. PMID:24999847
This video from CUNY Kingsborough Community College describes how to perform a gram strain. The brief demonstration is described step by step and would be easy to replicate in a laboratory setting. Running time for the video is 1:46.
These mice carry a floxed allele of Nf1 with LoxP sites in introns 30 and 32. The animals are phenotypically normal; homozygous mice are viable. This is a useful strain for the study of neurofibromatosis and other cancers associated with loss of Nf1 function.
This strain carries a chain-termination mutation in amino acid 1638 (exon 15) of the Apc gene. Mice homozygous for this mutation are embryonic lethal. Heterozygous mice develop multiple colonic polyps, gastrointestinal adenomas and adenocarcinomas. Liver metastases has been observed.
This strain carries a conditional mutation in the endogenous Rb1 gene. LoxP sites were inserted into introns surrounding exon 19 in the Rb1 locus. Removal of the region flanked by the LoxP sites results in mice with the same tumor spectrum as mice with a conventional Rb1-null mutation.
GH Yattoo; Amin Tabish
This study was conducted on patients of head injury admitted through Accident & Emergency Department of Sher-i-Kashmir Institute of Medical Sciences during the year 2004 to determine the number of head injury patients, nature of head injuries, condition at presentation, treatment given in hospital and the outcome of intervention. Traumatic brain injury (TBI) deaths were also studied retrospectively for a
Karen A. Tong; Udochuckwu E. Oyoyo; Barbara A. Holshouser; Stephen Ashwal; L. Santiago Medina
\\u000a Head injury is not a homogeneous phenomenon and has a complex clinical course. There are different mechanisms, varying severity,\\u000a diversity of injuries, secondary injuries, and effects of age or underlying disease. Classifications of injury and outcomes\\u000a are inconsistent. Differences in diagnostic procedures and practice patterns prevent direct comparison of population-based\\u000a studies. There are a variety of imaging methods that measure
Z. Lalani; K. M. Bonanthaya
Objective—To find out the incidence of associated facial injuries and injuries to the cervical spine. Design—Retrospective study. Setting—Teaching hospital, India. Subjects-536 patients treated for maxillofacial injuries between January 1992 and November 1993. Interventions—Review of hospital case notes and radiographs. Main outcome measures—Coexisting facial and cervical spine injuries, morbidity and mortality. Results—16 patients (3%) had sustained both facial and cervical spine
Thomas N. Lindenfeld; David J. Schmitt; Mary Pat Hendy; Robert E. Mangine; Frank R. Noyes
All injuries occurring over a 7-week period at a local indoor soccer arena were documented for analysis of incidence rates. All injury rates were calculated per 100 player-hours. The overall injury rates for male and fe male players were similar, 5.04 and 5.03, respectively. The lowest injury rate was found among the 19- to 24- year-old athletes and the highest
Butler, Benjamin; Bo, Chiara; Williams, Alun; Jardine, Andy; Brown, Katherine
There is a pressing need to better understand the relationship between the intensity of a blast wave and the clinical consequences for victims of an explosion. In order to quantitatively study how these factors correlate with one another, blast injury tissue models are being developed. Sections of larynx, trachea and pulmonary tissue were excised from a recently sacrificed pig and maintained on ice prior to testing. The samples were subjected to strain rates of between 0.001 s-1 and 1000 s-1 in the laboratory by using a Split Hopkinson Pressure Bar and quasi-static testing apparatus. During high strain rate testing, samples were housed in a polycarbonate chamber which permitted experimentation on tissue held in fluid. Data were analysed using 1, 2 and 3 wave analysis software in Matlab to yield information about the material properties of both undamaged and damaged tissues. In addition, macroscopic changes in tissue organization were also visualized using histopathological techniques. This work is being extended to cellular and animal models to derive more detailed information about the underlying molecular changes relating to blast-induced damage and repair. There is a pressing need to better understand the relationship between the intensity of a blast wave and the clinical consequences for victims of an explosion. In order to quantitatively study how these factors correlate with one another, blast injury tissue models are being developed. Sections of larynx, trachea and pulmonary tissue were excised from a recently sacrificed pig and maintained on ice prior to testing. The samples were subjected to strain rates of between 0.001 s-1 and 1000 s-1 in the laboratory by using a Split Hopkinson Pressure Bar and quasi-static testing apparatus. During high strain rate testing, samples were housed in a polycarbonate chamber which permitted experimentation on tissue held in fluid. Data were analysed using 1, 2 and 3 wave analysis software in Matlab to yield information about the material properties of both undamaged and damaged tissues. In addition, macroscopic changes in tissue organization were also visualized using histopathological techniques. This work is being extended to cellular and animal models to derive more detailed information about the underlying molecular changes relating to blast-induced damage and repair. The Royal British Legion Centre for Blast Injury Studies.
Frost, Joe L.
A study analyzed 82 cases of playground injuries and litigation (including 7 fatalities) in 28 states. In order of frequency, injuries happened in public schools, public parks, child care centers, apartment complexes, fast food restaurants, backyards, recreation camps, state parks, and state schools. Sixty-five percent of all injuries resulted…
Chris Baker; Howard Kadish; Jeff E Schunk
To compare historical features, clinical examination findings, and radiographic results among pediatric patients with cervical spine injury (CSI), a retrospective review of patients who were diagnosed with CSI was undertaken. Two main groups were identified: radiographically evident cervical spine injury (RESCI), and spinal cord injury without radiographic abnormality (SCIWORA). Demographic, historical, clinical, and radiographic information was obtained from patients' charts
Susan Lurie; Carlos H. Crisosto
Peaches and nectarines ripen and deteriorate quickly at ambient temperature. Cold storage is used to slow these processes and decay development. However, low temperature disorders, chilling injury classified as internal breakdown, limit the storage life of peaches and nectarines under refrigeration. The onset of chilling injury symptoms determines the postharvest storage\\/shipping potential because their development reduces consumer acceptance. Chilling injury
Erik Witvrouw; Nele Mahieu; Lieven Danneels; Peter McNair
promotes better performances and decreases the number of injuries. Stretching exercises are regularly included in warm-up and cooling-down exercises; howev- er, contradictory findings have been reported in the literature. Several authors have suggested that stretching has a beneficial effect on injury prevention. In contrast, clinical evidence suggesting that stretching before exercise does not prevent injuries has also been reported. Apparently,
WILLIAM J. MCFEELY; DENNIS I. BOJRAB; KENT G. DAVIS; DOUGLAS F. HEGYI
Airbags are clearly successful at mitigating injury severity during motor vehicle accidents. Deployment unfortunately has introduced new injury-causing mechanisms. A retrospective review of 20 patients who sustained otologic injuries resulting from airbag inflation was conducted. The most common symptoms were hearing loss in 17 (85%) and tinnitus in 17 (85%). Objective hearing loss was documented in 21 of 24 (88%)
Lloyd, Mark Sheldon
Bull fighting is a reality and the injuries sustained by the matador cause a bizarre pattern of injury that the trauma surgeon must appreciate since they are inflicted in unique circumstances. This article highlights the mechanism of a bull gore injury, the pattern of wounds, and the most appropriate management. PMID:15005936
Paul M. Keller; K. Donald Shelbourne; John R. McCarroll; Arthur C. Rettig
To evaluate the theory that isolated posterior cruciate ligament injuries do well when treated nonoperatively, we reviewed 40 patients (mean age, 33 years at fol lowup ; average interval from injury, 6 years) who com pleted a modified Noyes knee questionnaire and were reevaluated by physical examination, radiographs, and isokinetic testing. Thirty of the injuries to the posterior cruciate ligament
Ojofeitimi, S; Bronner, S; Woo, H
Hip hop dance has rapidly become a popular international art form. There is limited information on injury patterns in this population. The purpose of this study was to determine injury incidence and patterns among three groups of hip hop dancers. Three hundred and twelve intermediate, advanced, and expert hip hop dancers were recruited at battles, dance conferences, clubs, and on dance related web sites within the United States and internationally. A Web-based survey was conducted over a 6-month period. Inclusion criteria included intermediate and advanced level dancers over the age of 13. Dancers were divided into three main categories: Breakers, Popper/Lockers, and New Schoolers. Separate analysis of variances were used to compare injury pattern differences between groups. Two hundred and thirty-two dancers reported a total of 738 injuries. Five hundred and six of these (sustained by 205 dancers) were time-loss (TL) injuries. Annual injury incidence was 237% (162% involving TL). Lower extremity injuries were 52% and upper extremity injuries 32% of total injuries. Breakers had a higher injury incidence compared with Popper/Lockers, and New Schoolers. Hip hop dancers report injury rates that are higher than other dance forms but similar to gymnastics. These dancers should be educated concerning injury prevention, biomechanics, and use of protective equipment. PMID:20807386
E. Towner; J. Towner
The importance of child injuries has now been recognised as a significant public health problem internationally. The World Health Organisation (WHO) and United Nations Children's Fund (UNICEF) have recently published the first world report on child injury prevention. As infectious diseases decline, the relative importance of injury has increased, but the pace of change of global processes means that absolute
G. Matthes; U. Schmucker; E. Lignitz; M. Huth; A. Ekkernkamp; J. Seifert
Introduction The airbag is an established car safety device. However, recent studies pointed out that even the airbag might cause injuries. Nevertheless, most physicians do consider a lower risk in accident victims sustaining severe injury of the chest, when a deployed frontal airbag has been reported. We set out to verify the frequency and pattern of thoracic injury in car drivers
C. J. Inglefield; M. D’ARCANGELO; P. S. Kolhe
Many fingertip injuries in childhood involve the nail bed. Deformities of the nail are a frequent result of failure to repair the nail bed at the time of injury. Secondary correction of nail deformities seldom achieves good results. We present the results of our experience in the management of 19 children with 22 injuries involving the nail bed. All achieved
Fumio Arisawa; Kimitaka Kogure; Yasushi Tsuzuki; Tetsu Ando; Masao Sekihara; Takayuki Kori; Munenori Ide; Hiroshi Koitabashi; Hiroyuki Kuwano
With the rapidly increasing number of snowboarders, the incidence of injuries has recently become higher. From 1994 to 1995, we encountered four snowboarders with splenic injuries in one season. In three of the four patients the splenic injuries were caused by striking the abdomen with their own elbow when falling by themselves, of which emergent splenectomy was required in two
Pynn, B R; Bartkiw, T P; Clarke, H M
As basketball increases in worldwide popularity, more epidemiological data on injury rate and type will be documented. A serious ring avulsion injury (Urbaniuk Class I) is here reported in an adolescent incurred while attempting a slam dunk. The management of this injury is discussed as well as safety concerns for coaches and supervisory staff. Images Figure 1 Figure 1 Figure 2 PMID:9132219
KOBI PELEG; LIMOR AHARONSON-DANIEL; MICHAEL MICHAEL; S. C. SHAPIRA; ISRAEL TRAUMA
Acts of terror increase the demand for acute care. This article describes the pattern of injury of terror victims hospitalized at 9 acute-care hospi- tals in Israel during a 15-month period of terrorism. To characterize patients hospitalized as a result of terror injuries, we compared terror casualties with other injuries regarding severity, outcome, and service utilization. Using data from the
Kobi Peleg; Limor Aharonson-Daniel; Michael Michael; S. C Shapira
Acts of terror increase the demand for acute care. This article describes the pattern of injury of terror victims hospitalized at 9 acute-care hospitals in Israel during a 15-month period of terrorism. To characterize patients hospitalized as a result of terror injuries, we compared terror casualties with other injuries regarding severity, outcome, and service utilization. Using data from the National
Kosciulek, John F.
Examined dimensions underlying family coping with head injury. Data from 150 families with a member with a head injury identified 3 dimensions of coping: individual-to-family versus family-to-community coping; family-respite versus head-injury-focused coping; and cognitive versus behavioral coping. Findings have implications for family stress and…
Rosenbaum, Alan; And Others
Fifty-three partner-abusive men, 45 maritally satisfied, and 32 maritally discordant, nonviolent men were evaluated for past history of head injury. Logistic regressions confirmed head injury was significant predictor of being a batterer. Implications of findings for both marital aggression and posthead injury rehabilitation are discussed. (Author)
Pulos, Nicholas; Bozentka, David J
Innovations in operative techniques, biomaterials, and rehabilitation protocols have improved outcomes after treatment of flexor tendon injuries. However, despite these advances, treatment of flexor tendon injuries remains challenging. The purpose of this review is to highlight the complications of flexor tendon injuries and review the management of these complications. PMID:25934203
National Athletic Trainers' Association, Inc., Greenville, NC.
This series of newsletters and fact sheets provides information on the incidence of sport-related injuries in scholastic sports. The following topics are addressed: (1) how the National Athletic Trainers' Association (NATA) measures the number and severity of injuries; (2) facts about NATA; (3) injuries to high school football players; (4)…
Bunt, T J; Manship, L; Moore, W
Iatrogenic vascular injury may occur during peripheral revascularization procedures secondary to the application of vascular occlusive devices. This review summarizes the known mechanical causes of such injury, relates this to clamp design, and suggests methods to minimize such injury by appropriate selection and handling of vascular occlusive clamps. PMID:3889383
Andrea Ferretti; Paola Papandrea; Fabio Conteduca; Pier Paolo Mariani
The authors report a series of 52 cases of serious knee ligament injuries in volleyball players. The most frequent mechanism of injury was landing from a jump in the attack zone. Women were more affected than men. Injuries were more frequent during games than training. Volleyball must then be considered among high-risk sports according to the frequency and gravity of