Incidence of injuries in high school softball and baseball players

Context:

Participation in high school sports has grown 16.1% over the last decade, but few studies have compared the overall injury risks in girls'' softball and boys'' baseball.

Objective:

To examine the incidence of injury in high school softball and baseball players.

Design:

Cohort study.

Setting:

Greenville, South Carolina, high schools.

Patients or Other Participants:

Softball and baseball players (n = 247) from 11 high schools.

Main Outcome Measure(s):

Injury rates, locations, types; initial or subsequent injury; practice or game setting; positions played; seasonal trends.

Results:

The overall incidence injury rate was 4.5/1000 athlete-exposures (AEs), with more injuries overall in softball players (5.6/1000 AEs) than in baseball players (4.0/1000 AEs). Baseball players had a higher initial injury rate (75.9/1000 AEs) than softball players (66.4/1000 AEs): rate ratio (RR) = 0.88, 95% confidence interval (CI) = 0.4, 1.7. The initial injury rate was higher than the subsequent injury rate for the overall sample (P < .0001) and for softball (P < .0001) and baseball (P < .001) players. For both sports, the injury rate during games (4.6/1000 AEs) was similar to that during practices (4.1/1000 AEs), RR = 1.22, 95% CI = 0.7, 2.2. Softball players were more likely to be injured in a game than were baseball players (RR = 1.92, 95% CI = 0.8, 4.3). Most injuries (77%) were mild (3.5/1000 AEs). The upper extremity accounted for the highest proportion of injuries (63.3%). The incidence of injury for pitchers was 37.3% and for position players was 15.3%. The rate of injury was highest during the first month of the season (7.96/1000 AEs).

Conclusions:

The incidence of injury was low for both softball and baseball. Most injuries were minor and affected the upper extremity. The injury rates were highest in the first month of the season, so prevention strategies should be focused on minimizing injuries and monitoring players early in the season.     

Prediction of core and lower extremity strains and sprains in collegiate football players: a preliminary study

Context:

Poor core stability is believed to increase vulnerability to uncontrolled joint displacements throughout the kinetic chain between the foot and the lumbar spine.

Objective:

To assess the value of preparticipation measurements as predictors of core or lower extremity strains or sprains in collegiate football players.

Design:

Cohort study.

Setting:

National Collegiate Athletic Association Division I Football Championship Subdivision football program.

Patients or Other Participants:

All team members who were present for a mandatory physical examination on the day before preseason practice sessions began (n  =  83).

Main Outcome Measure(s):

Preparticipation administration of surveys to assess low back, knee, and ankle function; documentation of knee and ankle injury history; determination of body mass index; 4 different assessments of core muscle endurance; and measurement of step-test recovery heart rate. All injuries were documented throughout the preseason practice period and 11-game season. Receiver operating characteristic analysis and logistic regression analysis were used to identify dichotomized predictive factors that best discriminated injured from uninjured status. The 75th and 50th percentiles were evaluated as alternative cutpoints for dichotomization of injury predictors.

Results:

Players with ≥2 of 3 potentially modifiable risk factors related to core function had 2 times greater risk for injury than those with <2 factors (95% confidence interval  =  1.27, 4.22), and adding a high level of exposure to game conditions increased the injury risk to 3 times greater (95% confidence interval  =  1.95, 4.98). Prediction models that used the 75th and 50th percentile cutpoints yielded results that were very similar to those for the model that used receiver operating characteristic-derived cutpoints.

Conclusions:

Low back dysfunction and suboptimal endurance of the core musculature appear to be important modifiable football injury risk factors that can be identified on preparticipation screening. These predictors need to be assessed in a prospective manner with a larger sample of collegiate football players.     

The assessment of airway maneuvers and interventions in university Canadian football, ice hockey, and soccer players

Context:

Managing an airway in an unconscious athlete is a lifesaving skill that may be made more difficult by the recent changes in protective equipment. Different airway maneuvers and techniques may be required to help ventilate an unconscious athlete who is wearing full protective equipment.

Objective:

To assess the effectiveness of different airway maneuvers with football, ice hockey, and soccer players wearing full protective equipment.

Design:

Crossover study.

Setting:

University sports medicine clinic.

Patients or Other Participants:

A total of 146 university varsity athletes, consisting of 62 football, 45 ice hockey, and 39 soccer players.

Intervention(s):

Athletes were assessed for different airway and physical characteristics. Three investigators then evaluated the effectiveness of different bag-valve-mask (BVM) ventilation techniques in supine athletes who were wearing protective equipment while inline cervical spine immobilization was maintained.

Main Outcome Measure(s):

The effectiveness of 1-person BVM ventilation (1-BVM), 2-person BVM ventilation (2-BVM), and inline immobilization and ventilation (IIV) was judged by each investigator for each athlete using a 4-point rating scale.

Results:

All forms of ventilation were least difficult in soccer players and most difficult in football players. When compared with 1-BVM, both 2-BVM and IIV were deemed more effective by all investigators for all athletes. Interference from the helmet and stabilizer were common reasons for difficult ventilation in football and ice hockey players.

Conclusions:

Sports medicine professionals should practice and be comfortable with different ventilation techniques for athletes wearing full equipment. The use of a new ventilation technique, termed inline immobilization and ventilation, may be beneficial, especially when the number of responders is limited.     

Neuroplus biofeedback improves attention,resilience, and injury prevention in elite soccer players

Performance and injury prevention in elite soccer players are typically investigated from physical‐tactical, biomechanical, and metabolic perspectives. However, executive functions, visuospatial abilities, and psychophysiological adaptability or resilience are also fundamental for efficiency and well‐being in sports. Based on previous research associating autonomic flexibility with prefrontal cortical control, we designed a novel integrated autonomic biofeedback training method called Neuroplus to improve resilience, visual attention, and injury prevention. Herein, we introduce the method and provide an evaluation of 20 elite soccer players from the Italian Soccer High Division (Serie‐A): 10 players trained with Neuroplus and 10 trained with a control treatment. The assessments included psychophysiological stress profiles, a visual search task, and indexes of injury prevention, which were measured pre‐ and posttreatment. The analysis showed a significant enhancement of physiological adaptability, recovery following stress, visual selective attention, and injury prevention that were specific to the Neuroplus group. Enhancing the interplay between autonomic and cognitive functions through biofeedback may become a key principle for obtaining excellence and well‐being in sports. To our knowledge, this is the first evidence that shows improvement in visual selective attention following intense autonomic biofeedback.     

Analysis of Injury Rates and Treatment Patterns for Time-Loss and Non-Time-Loss Injuries Among Collegiate Student-Athletes

OBJECTIVE: To compare the injury rates for time-loss and non-time-loss injuries among selected intercollegiate athletic programs and to describe the number of treatments associated with these injuries. DESIGN AND SETTING: A volunteer, cross-sectional cohort study of 50 collegiate athletic programs representing the 3 National Collegiate Athletic Association divisions, the National Association of Intercollegiate Athletics, and the National Junior College Athletic Association during the 2000-2002 academic years. SUBJECTS: Individuals listed on the team rosters for the participating institutions and representing the sports associated with the institution's athletic programs. MEASUREMENTS: The athletic training staff and students recorded the injury and treatment data for the participating institutions. The data included information for time-loss and non- time-loss injuries, daily treatments, and daily athlete-exposures. RESULTS: Non-time-loss injury rates were 3.5 (confidence interval = 3.4, 3.6) times the time-loss rate for men and 5.1 (confidence interval = 4.9, 5.2) times the time-loss rate for women. Non-time-loss injuries required more treatments over the course of the year than did time-loss injuries. For men's sports, 22% of the injuries resulted in loss of participation time, with 47% of the treatments associated with these injuries. For women's sports, 16% of the injuries and 34% of the treatments were associated with time-loss injuries. CONCLUSIONS: Throughout the sports medicine year, athletic training staff and students spent more time delivering treatments to athletes who were not missing participation time than to athletes who were missing time. A noteworthy difference in the workforce available to provide health care among the various levels of intercollegiate athletics may contribute to the frequency of injury and treatments reported.     

番禺区2006—2007年狂犬病流行病学分析

目的了解番禺区狂犬病门诊暴露人群的流行病学特征，为制定狂犬病预防策略提供科学依据。方法对2006—2007年在狂犬病预防门诊接受诊治的狂犬病门诊暴露人群进行描述性流行病学分析。结果2006—2007年番禺区共报告狂犬病暴露者19532人。两年均无因本地动物伤害而引起的狂犬病病例报告。动物伤人一年四季均可发生，其中以7～10月相对较多，第三季度共发生5574例。暴露者中男性占56．43％．女性占43．57％。所有暴露者中15～44岁占51．22％。中心城区的暴露水平较周边地区高。伤人动物以犬为主，占87．82％，受伤部位以下肢为主共10190例，占52．17％，暴露人员中以Ⅱ度暴露最多共18193例，占93．14％。结论当前控制狂犬病流行需加强养犬管理，有效地降低人群狂犬病暴露水平；加强狂犬病防治等相关知识的宣传教育．提高人群的自我保护意识等综合措施。以控制狂犬病的发生。     

急性颈髓损伤并发低钠血症的危险因素分析

目的探讨急性颈髓损伤患者并发低钠血症的危险因素。方法检测160例急性颈髓损伤患者空腹血钠指标,按照脊髓损伤程度、损伤节段、合并感染、合并颅脑外伤、年龄、病程、损伤原因等因素分组,比较上述因素对低钠血症发生率的影响。结果不同颈髓损伤程度、损伤节段、合并感染、合并颅脑外伤、年龄、病程各组别之间低钠血症发生率有显著差异（P〈0．05）,不同损伤原因各组之间低钠血症发生率无显著差异（P〉0．05）。结论急性颈髓损伤患者是否并发低钠血症的危险因素包括：脊髓损伤程度、损伤节段、合并感染、合并颅脑外伤、年龄、病程。损伤程度越重,节段越高,年龄越大,病程越长,合并有感染或者颅脑外伤的患者,并发低钠血症的发生率越高。     

Seroepidemiology of cytomegalovirus infection among children between the ages of 4 and 12 years in Taiwan.

To determine risk factors responsible for primary cytomegalovirus (CMV) infection in Taiwan, samples of blood for antibody to CMV were obtained from 362 children aged 4 to 12 years: 58% were found to be positive for anti-CMV IgG antibody. Logistic regression analysis showed that seropositivity correlated with age, method of delivery, duration of breast feeding, and younger age of mother. Neither socioeconomic status nor crowded living conditions showed significant correlation with CMV seropositivity. Primary CMV infection in Taiwan appears to be less related to socioeconomic status shown in western countries, and, since the majority of pregnant women were seropositive in Taiwan, two of the major sources of primary CMV transmission are infected breast milk and the infected genital tract.     

Molecular epidemiology of hepatitis A in St. Petersburg, Russia, 1997-2003

The molecular epidemiology of hepatitis A virus (HAV) strains circulating in the St. Petersburg and Karelia regions was studied during 1997-2003. Hepatitis A virus RNA was isolated from both clinical samples (stools or sera) and environmental samples (sewage water). RT-PCR was carried out using different primer pairs from the VP1/2A and VP1 genomic regions, the variable parts of the HAV genome. PCR products were sequenced and 306 nucleotides from the VP1/2A and 332 nucleotides from the VP1 region were used for phylogenetic analysis. The results show that the IA subtype was the most common during the follow-up period: >90% of the isolated HAV strains belonged to that subtype. The HAV strains found in intravenous drug users belonged to subtypes IA and IIIA. Only one out of a total of 88 sequenced strains was of the IB subtype. The subtypes IB and IIIA were found only in 2001-2003, which suggests that new strains were introduced into the endemic situation. The results indicate the usefulness of molecular epidemiological methods in studying changes in the circulating HAV strains and in tracing transmission routes.     

Risk Taking, Reported Injiry, and Perception of Future Injury Among Adolesecents

Investigated the relationships among self-reported injury, risktaking, and perception of injury risk in a sample of 1,426 adolescents,14 to 18 years old. Both risk taking and injury were higherin males than females across age groups. Having a friend injuredthe same way was the strongest predictor of injury, accountingfor 28% of the variance. Risk taking accounted for 4% of thevariance. Sociodemographic variables-gender, age, and race-accountedfor only 1%of the variance. Findings underscore the potentialrole of pediatric psychologists in both understanding and reducingthe incidence of adolescent injury.     

Cancer incidence and mortality in the Bucaramanga metropolitan area, 2003-2007

Introduction:

Cancer is an important cause of morbidity and mortality worldwide. Population-based cancer registries (PBCRs) make possible to estimate the burden of this condition.

Aim:

To estimate cancer incidence and mortality rates in the Bucaramanga Metropolitan Area (BMA) during 2003-2007.

Methods:

Incident cases of invasive cancer diagnosed during 2003-2007 were identified from the Bucaramanga Metropolitan Area PBCR (BMA-PBCR). Population counts and mortality were obtained from the Colombian National Administrative Department of Statistics (NADS). We estimated total and cancer-specific crude incidence and mortality rates by age group and sex, as well as age-standardized (Segi''s world population) incidence (ASIR(W)) and mortality (ASMR(W)) rates. Statistical analyses were conducted using CanReg4 and Stata/IC 10.1.

Results:

We identified 8,225 new cases of cancer excluding non-melanoma skin cancer (54.3% among women). Of all cases, 6,943 (84.4%) were verified by microscopy and 669 (8.1%) were detected only by death certificate. ASIR(W) for all invasive cancers was 162.8 per 100,000 women and 177.6 per 100,000 men. Breast, cervix, colorectal, stomach and thyroid were the most common types of cancer in women. In men, the corresponding malignancies were prostate, stomach, colorectal, lung and lymphoma. ASMR(W) was 84.5 per 100,000 person-years in women and 106.2 per 100,000 person-years in men. Breast and stomach cancer ranked first as causes of death in those groups, respectively.

Conclusion:

Overall, mortality rates in our region are higher than national estimates possibly due to limited effectiveness of secondary prevention strategies. Our work emphasizes the importance of maintaining high-quality, nationwide PBCRs.     

2007-2015年北京市密云区手足口病流行特征分析

目的 分析2007-2015年密云区手足口病流行病学特征,为调整防控措施提供科学依据.方法 采用描述性流行病学方法,对密云区2007-2015年手足口病监测数据进行分析.结果 2007-2015年密云区手足口病报告发病数及发病率每2-3年有一发病高峰,发病时间以4-9月份为主;手足口病高发地区主要为城区及城乡结合部的平原地区;患者以5岁以下儿童为主;男童病例数高于女童;EV71和CVA16为手足口病的主要致病病原体.结论 密云区手足口病报告发病数及发病率呈周期性波动趋势,幼托儿童和散居儿童为手足口病高发人群,城区及城乡结合部的平原地区是手足口病防控的重点区域.     

Markers of individual susceptibility and DNA repair rate in workers exposed to xenobiotics in a tire plant

Workers employed in tire plants are exposed to a variety of xenobiotics, such as 1,3-butadiene (BD), soots containing polycyclic aromatic hydrocarbons, and other organic chemicals (e.g., styrene). In the present study, we investigated markers of genotoxicity [chromosomal aberrations (CAs) and single-strand breaks (SSBs)] in a cohort of 110 tire plant workers engaged in jobs with different levels of xenobiotic exposure in relation to various polymorphisms in genes coding for biotransformation enzymes (CYP1A1, CYP2E1, EPHX1, GSTM1, GSTP1, and GSTT1) and in genes involved in DNA repair (XPD exon 23, XPG exon 15, XPC exon 15, XRCC1 exon 10, and XRCC3 exon 7). In addition, the expression of CYP2E1, a gene playing a key role in BD metabolism, was determined by real-time PCR in peripheral blood lymphocytes, and the capacity of lymphocytes to repair gamma-ray-induced SSBs and to convert 8-oxoguanine in HeLa cell DNA into SSBs was assessed using in vitro assays. No positive associations were detected between the CA frequency or SSB induction and levels of workplace exposure; however, a nonsignificant twofold higher irradiation-specific DNA repair rate was found among highly exposed workers. In evaluations conducted with the markers of individual susceptibility, workers with low-EPHX1-activity genotypes exhibited a significantly higher CA frequency as compared to those with medium and high-EPHX1-activity genotypes (P = 0.050). CA frequencies were significantly lower in individuals homozygous for the XPD exon 23 variant allele in comparison to those with the wild-type CC genotype (P = 0.003). Interestingly, CAs were higher in individuals with higher CYP2E1 expression levels, but the association was nonsignificant (P = 0.097). The results from this study suggest the importance of evaluating markers of individual susceptibility, since they may modulate genotoxic effects induced by occupational exposure to xenobiotics.     

Population estimates of height and weight in Great Britain at ages 11 and 15, 1983 and ages 16-19 inclusive, 1980

Height and weight tables for adults in Great Britain were published in this journal in 1985. A similarly representative sample, at ages 11 and 15, has become available as the result of a survey of schoolchildren's diets. The opportunity has been taken of linking the results of the two surveys, both of which were conducted by the Office of Population Censuses and Surveys for the Department of Health and Social Security, using the same measuring techniques. Quetelet indices have been calculated for these data at each age, using a method that depends only on knowing the means and standard deviations of the heights and weights, and on their covariance. Limits are derived within which 95% and 80% of the populations lie.     

Molecular characterization of rotavirus strains from children with diarrhea in Italy, 2007-2009

The surveillance network RotaNet-Italia was established in 2007 in order to investigate the diversity of co-circulating rotavirus strains in Italy, and to provide a baseline for future assessment of possible effects of vaccine implementation in selecting novel versus common rotavirus strains. A total of 2,645 rotavirus strains from pediatric patients with acute diarrhea were collected over three consecutive seasons from September 2006 through August 2009, and partially characterized by standardized multiplex RT-PCR. Most of strains (89.1%) belonged to genotypes G1-G4, and G9, associated with either P[8] or P[4], commonly found in humans worldwide. However, in at least 2.0% of cases, viruses exhibited either a G or P type typical of animal viral strains, suggesting gene reassortment events between rotaviruses of different origin. Mixed infections with two or more rotavirus strains were observed frequently (7.6% of patients), and depended on the frequencies of co-circulating rotaviruses of one particular genotype. The numbers and genotypes of likely natural reassortants of common genotype rotaviruses were found to be correlated with the observed numbers and genotypes of mixed infections. Large variation in the relative frequency of different rotavirus genotypes was observed between different seasons and/or areas of Italy, suggesting independent evolution or differential introduction of viral strains with respect to both time and space.     

Perceived risk, risk taking, estimation of ability and injury among adolescent sport participants

OBJECTIVE: To determine the predictive validity of perceived risk, risk taking, estimation of ability, overefficacy, and previous injuries on actual injury among adolescents in sport; and to examine sex differences on these factors. METHODS: A cohort of 260 (148 male, 112 female) soccer players aged 11 to 14 years participated in a 3-month prospective injury study. Preseason written measures included self-reported perceived risk, previous injuries, risk taking and estimation of ability. RESULTS: Low levels of perceived risk and estimation of ability were associated with a significant increase in risk of injury, with odds ratios (ORs) ranging from 3.77-7.92. Positive relationships between injury and both estimation of ability and overestimation of ability were supported. Estimation of ability was also positively related to risk taking. In this study, however, risk taking was not directly related to injury, nor were previous injuries. Girls reported higher levels of perceived risk and lower levels of risk taking than boys. However, boys and girls reported similar estimation of ability and overestimation of ability and subsequently incurred similar numbers of injuries. CONCLUSIONS: Perceived risk and estimation of ability represent significant psychological risk factors for injury in adolescent sports. Sex differences in perceived risk, risk taking, and previous injuries should be considered when developing environmental and behavioral injury-prevention programs.     

Rate and risk of anterior cruciate ligament injury among sportswomen in Slovenia

Context:

Anterior cruciate ligament (ACL)-injury rate is greater among female athletes than among male athletes.

Objective:

To investigate the rate and risk of ACL injury among Slovenian sportswomen playing professional basketball, team handball, or volleyball.

Design:

Prospective cohort study.

Setting:

The Slovenian National Organizations of basketball, team handball, and volleyball.

Patients or Other Participants:

During the 2003–2004 season, we prospectively followed 585 Slovenian sportswomen registered in the Slovenian National Organizations of basketball, team handball, and volleyball.

Main Outcome Measure(s):

We asked sportswomen and coaches to document the occurrence of every significant traumatic knee injury requiring medical attention. Injury rate and injury risk were calculated for sportswomen in each sport group. To calculate injury rate, we estimated the average exposure of each sportswoman during the research period.

Results:

During the 2003–2004 season, 585 Slovenian sportswomen sustained 12 ACL injuries. The ACL-injury risk was different in athletes participating in the various sports, with basketball players having the greatest ACL-injury risk and volleyball players having the lowest ACL-injury risk (P  =  .04). The risk of ACL injury among Slovenian sportswomen was 2.1 per 100 athletes (95% confidence interval  =  0.9, 3.2), whereas the rate of ACL injury was 0.037 per 1000 exposure hours (95% confidence interval  =  0.016, 0.06).

Conclusions:

Overall differences in injury risk were found among sports, but no differences were noted among divisions within sports. No differences for injury rate were observed between or within sports. The rate and risk of ACL injury among Slovenian sportswomen are high, with basketball players having the greatest ACL-injury risk.     

Age and Gender Differences in School-Age Children's Appraisals of Injury Risk

Objective: To examine age and gender differences in children'sperception of injury risk and to evaluate cognitive factorsthat relate to their appraisal of risk. Methods: The participants were 120 children (6 to 10 years ofage), who used a series of photographs, which depicted playactivities that varied from no to high risk, to appraise injuryrisk. Results: Children were able to distinguish varying degrees ofinjury risk. Boys rated risk as lower than girls, and 6-year-oldchildren identified fewer risk factors and did so more slowlythan 10-year-old children. For girls, perceived vulnerabilityto injury was the best predictor of injury risk ratings, whereasfor boys it was judged severity of potential injury. Conclusions: Children's appraisal of risk and age and genderdifferences in related factors highlight important componentsfor injury prevention programs.