The impact of major league baseball on the incidence of operative hand and facial trauma at a level 1 trauma center

BACKGROUND: Professional affiliation between medical centers and professional sports teams can be mutually beneficial in the provision of healthcare and marketing strategy. Anecdotal evidence suggests a link between trauma volume and sporting events; however, there is limited data. This study aims to characterize the incidence of operative hand and facial trauma during professional baseball home games. METHODS: A retrospective review of surgical cases for traumatic hand or facial injuries at a level 1 center between 1999 and 2012 was performed. Demographic information including date of injury, admission status, and operative repair were collected. Patients were grouped based on whether their trauma occurred on the date of a home game. RESULTS: Operative hand and facial trauma occurred at a rate of 33.4 injuries per 100 days with home games, compared to 22.2 injuries per 100 days (incidence rate ratios, 1.50; 95% confidence interval, 1.34–1.69). When home games were played, patients were more likely to present as a result of motorcycle accidents (3.1% vs. 1.5%; P=0.04) or bicycle accidents (5.0% vs. 2.6%; P=0.01). Other mechanisms of trauma were not statistically different. There was an increase incidence of injuries during home games in August; weekly variability showed an increased incidence during the weekends. CONCLUSIONS: There was an increased rate of operative hand and facial injuries on dates with professional home games. The incidence of injuries during home games was higher in the late summer and on the weekends. Further analysis may allow improved resource allocation and strategies for injury prevention and treatment.

Methacholine Challenge Test as an Adjunctive Investigative Tool in Patients with Asthma-Like Symptoms: The Sabah Experience

Introduction: Patients with asthma-like symptoms pose a diagnostic dilemma when physical examination is normal. The usual practice in Malaysia would be to give empirical asthma treatment. Bronchial challenge test (BCT) is widely used in many countries to diagnose asthma objectively but it is not widely available in Malaysia. Objective: To describe our experience with BCT using methacholine at Queen Elizabeth Hospital as a supporting tool in the investigation of patients with asthma-like symptoms. Methodology: Review of case notes of patients who underwent BCT from July 2008 till April 2009. BCT was performed via dosimeter technique. Results were classified as high hyper responsiveness if the provocative dose of methacholine required to achieve 20% fall in FEV1 (PD20) was less than or equal to 0.125 μmol, moderate hyper responsiveness if PD20 was between 0.125 to 1.99 μmol or mild hyper responsiveness if PD20 was between 2.00 to 6.6 μmol. PD20 of more than 6.6 μmol constitutes a negative MCT. Results: 29 patients had BCT during the study period. 19 cases were included in this review. The age ranged from 13 to 70 years old. There were 12 males and 7 females. Duration of symptoms ranged from 2 weeks to 23 years. BCT was positive (mild or moderate hyper responsiveness) in 10 out of 19 patients. No patient had high bronchial hyper responsiveness. Conclusions: BCT is a useful adjunctive tool in the investigation of patients presenting with asthma-like symptoms. This test obviates empirical asthma treatment. BCT should be made available in all major hospitals in Malaysia.

The role of FDG-PET in the management of non-small cell lung carcinoma

<p><b>INTRODUCTION</b>Positron emission tomography (PET) using 18F-2-fluoro-2 deoxy-D-glucose (FDG) has been widely investigated and used in the non-invasive imaging of malignancy. Non-small cell lung carcinoma (NSCLC) is one of the most common and best validated indications for an FDG-PET scan. This review examines the roles of FDG-PET in the management of NSCLC and attempts to identify emerging uses and possible future developments.</p><p><b>MATERIALS AND METHODS</b>Literature review of English language literature indexed on Medline.</p><p><b>RESULTS</b>There is strong evidence to support the clinical efficacy and cost effectiveness of FDG-PET in the characterisation of solitary pulmonary nodules and in the staging of NSCLC. In addition, there are emerging uses in radiotherapy planning, monitoring of treatment response and prognostication.</p><p><b>CONCLUSIONS</b>FDG-PET plays an integral role in the management of NSCLC and it is likely to expand as evidence supporting additional roles in the management of NSCLC becomes available.</p>