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.     

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.     

Longitudinal Assessment of Noncontact Anterior Cruciate Ligament Injury Risk Factors During Maturation in a Female Athlete: A Case Report

Objective:

To present a unique case of a young pubertal female athlete who was prospectively monitored for previously identified anterior cruciate ligament (ACL) injury risk factors for 3 years before sustaining an ACL injury.

Background:

In prospective studies, previous investigators have examined cross-sectional measures of anatomic, hormonal, and biomechanical risk factors for ACL injury in young female athletes. In this report, we offer a longitudinal example of measured risk factors as the participant matured.

Differential Diagnosis:

Partial or complete tear of the ACL.

Measurements:

The participant was identified from a cohort monitored from 2002 until 2007. No injury prevention training or intervention was included during this time in the study cohort.

Findings:

The injury occurred in the year after the third assessment during the athlete''s club basketball season. Knee examination, magnetic resonance imaging findings, and arthroscopic evaluation confirmed a complete ACL rupture. The athlete was early pubertal in year 1 of the study and pubertal during the next 2 years; menarche occurred at age 12 years. At the time of injury, she was 14.25 years old and postpubertal, with closing femoral and tibial physes. For each of the 3 years before injury, she demonstrated incremental increases in height, body mass index, and anterior knee laxity. She also displayed decreased hip abduction and knee flexor strength, concomitant with increased knee abduction loads, after each year of growth.

Conclusions:

During puberty, the participant increased body mass and height of the center of mass without matching increases in hip and knee strength. The lack of strength and neuromuscular adaptation to match the increased demands of her pubertal stature may underlie the increased knee abduction loads measured at each annual visit and may have predisposed her to increased risk of ACL injury.     

Epidemic of adenovirus-induced respiratory illness among US military recruits: epidemiologic and immunologic risk factors in healthy, young adults.

Adenovirus (Ad)-induced acute respiratory illnesses resurged among civilian adults and selected military training populations in the United States during the late 1990s. We examined the epidemiologic and immunologic correlates of Ad-induced respiratory illnesses during a large outbreak at an Army basic training installation in southeast United States during a 9-day period in November 1997. A total of 79 recruits hospitalized with acute respiratory illnesses were evaluated during the outbreak period; confirmation of Ad infection by isolation of Ad-like cytopathic agents from throat cultures was detected in 71 (90%) of these patients. Serotyping of 19 (27%) of these 71 isolates identified the etiologic agent to be Ad type 4 (Ad4). In addition, 30 (81%) of 37 patients in whom paired sera were collected demonstrated significant increases (i.e., 4-fold or higher) in serum anti-Ad4 neutralizing antibodies. Anti-Ad4 immunity in new recruits was found to be very low (15 to 22%). A case-control study involving 66 of the 79 hospitalized cases and 189 non-ill controls from the same units was conducted. A lower risk of hospitalization for acute respiratory illnesses was documented for female recruits (odds ratio[OR] = 0.47, P <.05) whereas, a higher risk was noted for smokers (OR = 1.89, P <.05). Unit (training company) attack rates as high as 8 to 10% per week were documented and the outbreak quickly subsided after live, oral Ad types 4 and 7 vaccination was resumed in November 1997. Re-establishment of a military Ad vaccination program is critical for control of Ad-induced acute respiratory illnesses.     

Dental Injuries in Intermediate and High School Athletes: A 15-Year Study at Punahou School

OBJECTIVE: To determine the rate, type, and severity of dental injuries recorded for intermediate and high school interscholastic athletic participants. DESIGN AND SETTING: A longitudinal study (1988-2003) of intermediate and high school athletes utilizing the same certified athletic trainers to evaluate and record all injury data. SUBJECTS: Sports participation included 123 teams in 19 female, 18 male, and 2 coed sports. Of 2445 Punahou School intermediate and high school students, on average, 1340 students (623 females, 717 males) annually participated in interscholastic athletics. MEASUREMENTS: Dental injuries were defined as injuries to the jaw, teeth, and oral soft tissue (lip, mouth, cheek, and tongue). Soft tissue injuries requiring physician or dentist referral were recorded. Other soft tissue injuries were treated as skin abrasions and were not recorded. Actual days lost from activity were recorded. The estimated injury rate was determined (injuries/1000 athlete-sessions). Mouth-guard use was recorded. RESULTS: During the 15-year study, 19 492 injuries were reported, with 56 (0.2%) recorded as dental injuries (23 tooth, 20 jaw, and 13 soft tissue). Injury rates were highest for girls' wrestling (0.243, confidence interval = 0-2.3), boys' judo (0.189, confidence interval = 0-3.6), and boys' soccer (0.127, confidence interval = 0.4-1.4). The football injury rate was 0.029 (confidence interval = 0.04-0.29), with no tooth injuries. CONCLUSIONS: The incidence and injury rate of dental injuries was extremely low for all reported sports. A universal definition of dental injuries must be established to facilitate injury data collection and analysis.     

Childhood unintentional injuries: factors predicting injury risk among preschoolers

OBJECTIVE: To examine the relationships between maternal perceptions of risk, stress, social support, safety-proofing behaviors, supervision practices and unintentional injuries to children under 5 years old. METHODS: Household interviews were conducted with 159 mothers who had a preschool-age child. The secondary data were part of a population-based study that collected self-report data and home observational data. Diaries were used for collecting prospective injury data. RESULTS: White children whose mothers were unemployed and whose homes needed repair were reported to be at higher injury risk than other children. Predicting a higher injury risk were children's behavioral characteristics as well as their being older than 2.5 years. Maternal social support, stress, and coping variables were not related to injury risk. Maternal perceptions of risk variables interacted with maternal safety behavior variables when predicting injury risk. CONCLUSIONS: Childhood injuries are predicted by a set of interrelated sociodemographic, cognitive, behavioral, and child-related factors.     

Trends and factors associated with insomnia and sleep apnea in all United States military service members from 2005 to 2014

Sleep disorders are a critical issue for the military, as they impact operational readiness, personnel health, wellbeing and health‐care costs. The incidence of insomnia and obstructive sleep apnea (OSA) are increasing in the United States civilian population, and rates in military personnel exceed those of civilians. Using a comprehensive database, rates of medical encounters for insomnia and OSA were investigated and their associations with various demographic factors examined in the total US military population [1,381,406 ± 25,123, mean ± standard deviation (SD) personnel per year] from 2005 to 2014. Encounters for insomnia increased from 16 of 1000 in 2005 to 75 of 1000 in 2014 (372%). Encounters for OSA increased from 44 of 1000 in 2005 to 273 of 1000 in 2014 (517%). Those experiencing the greatest increases in insomnia included women, individuals ≥40 years of age, blacks, senior enlisted personnel and Army personnel compared to other military services. Those experiencing the greatest rates of OSA included men, individuals ≥40 years of age, blacks, senior officers and Army personnel. Rates of insomnia and OSA increased linearly over time (R² = 0.95–0.99; P < 0.01) for every subpopulation except those aged <20 years. In response to this epidemic‐like increase in sleep disorders, their prevention, identification and aggressive treatment should become a health‐care priority of the US military.     

Pattern and risk factors for childhood injuries in Dar es Salaam,Tanzania

BackgroundInjuries contribute to morbidity and mortality in children. This study was carried out to describe the pattern of childhood injuries and associated risk factors in Dar es Salaam, Tanzania.MethodsThis case control study was conducted in six selected health facilities in Dar es Salaam, Tanzania. Data were collected using a structured questionnaire. Cases and controls were children below 18 years who had suffered injuries and those without injury associated condition respectively.ResultsA total of 492 cases and 492 controls were included in the study, falls (32%), burns (26%), Road Traffic Injuries (14%) and cuts (10%) were the major types of injuries identified. Younger parents/guardians {Adjusted odds ratio (AOR)= 1.4; 95% CI: 1.4 -3.6}, more than six people in the same house (AOR= 1.8; 95% CI: 1.3–2.6), more than three children in the house {AOR= 1.4; 95% CI (1.0–2.0)}, absence of parent/guardian at time of injury occurrence (AOR= 1.6; 95% CI: 1.1–2.3), middle socio-economic (AOR=1.6; 95%CI: 1.1–2.4) and low socio-economic status (AOR= 1.5; 95% CI: 1.0–2.1) were independent risk factors for childhood injury.ConclusionFalls, burns and road traffic injuries were the main injury types in this study. Inadequate supervision, overcrowding, lower socio-economic status and low maternal age were significant risk factors for childhood injuries.     

Incidence and risk factors associated with urinary tract infection in diabetic patients with and without asymptomatic bacteriuria

In order to compare the incidence of symptomatic urinary tract infection (UTI) in diabetic patients with and without asymptomatic bacteriuria (ASB), and to identify other risk factors for these infections, 289 females and 168 males were studied over a 12-month period. Symptomatic UTI occurred in 69.2% of patients with ASB (67.6% female and 76.5% male) versus 9.8% without ASB (14.9% female and 2.6% male). ASB and urinary incontinence were associated with symptomatic UTI in both women and men. Other risk factors included previous antimicrobial treatment and macrovascular complications in women and obesity and prostatic syndrome in men. The presence of ASB was found to be the major risk factor for developing symptomatic urinary tract infection. Further prospective randomized clinical trials of diabetic patients with risk factors for UTI who are receiving or not receiving treatment may be considered.     

Work stressors,depressive symptoms and sleep quality among US Navy members: a parallel process latent growth modelling approach across deployment

The present study examined whether work stressors contribute to sleep problems and depressive symptoms over the course of deployment (i.e. pre‐deployment, post‐deployment and 6‐month reintegration) among US Navy members. Specifically, we examined whether depressive symptoms or sleep quality mediate the relationships between work stressors and these outcomes. Participants were 101 US Navy members who experienced an 8‐month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Using piecewise latent growth models, we found that increased work stressors were linked to increased depressive symptoms and decreased sleep quality across all three deployment stages. Further, increases in work stressors from pre‐ to post‐deployment contributed to poorer sleep quality post‐deployment via increasing depressive symptoms. Moreover, sleep quality mediated the association between increases in work stressors and increases in depressive symptoms from pre‐ to post‐deployment. These effects were maintained from post‐deployment through the 6‐month reintegration. Although preliminary, our results suggest that changes in work stressors may have small, but significant implications for both depressive symptoms and quality of sleep over time, and a bi‐directional relationship persists between sleep quality and depression across deployment. Strategies that target both stress and sleep could address both precipitating and perpetuating factors that affect sleep and depressive symptoms.     

Incidence,temporal trends and potential risk factors for aseptic loosening following primary unicompartmental knee arthroplasty: A meta-analysis of 96,294 knees

BackgroundAseptic loosening (AL) is among the major reasons for revision of failed primary unicompartmental knee arthroplasty (UKA). There is an ongoing temporal increase in the use of UKA with a resultant increase in the revision burden. We aimed to evaluate the incidence of, temporal trends and risk factors for AL.MethodsLongitudinal studies reporting the incidence of AL following primary UKA were sought from MEDLINE, Embase, Web of Science and Cochrane Library up to 6th April 2020. Incidence and relative risks (RR) (with 95% confidence intervals) were calculated.ResultsWe identified 62 studies for inclusion. Overall, 96,294 primary UKA procedures accounting for 1752 AL cases were included. AL incidence ranged from 0.00% to 22.70% over a 7.7 year weighted mean follow-up. The pooled random effects incidence (95% CI) was 1.77% (1.34–2.25) in the same follow-up period. The annual rate of AL was 0.10% (0.02–0.22). AL incidence increased with length of follow-up, but there was a temporal decrease from the 1970s onwards. Tibial loosening was more common than femoral component loosening: incidence (95% CI) of 1.63% (0.96–2.44) and 0.58% (0.20–1.09) respectively over a weighted follow-up of 6.6 years. Fixed bearing implant design and cemented fixation were both associated with increased AL risk, whereas robotic-assisted surgery was associated with decreased risk.ConclusionThe overall incidence of AL following primary UKA is primarily driven by tibial component loosening and there is a temporal decline in rates. The use of mobile bearing, uncemented implants inserted with robotic assisted surgery may reduce the risk of AL.