The effect of protective headgear on head injuries and concussions in adolescent football (soccer) players.

OBJECTIVE: To examine the effects of protective headgear in adolescent football (soccer) players. DESIGN: Cross-sectional study. SETTING: Oakville Soccer Club, Oakville, Canada. PARTICIPANTS: Football players aged 12-17 years. INTERVENTION: A questionnaire examining the 2006 football season using self-reported symptoms. MAIN OUTCOME MEASURES: The number of concussions experienced during the current football season, the duration of symptoms, injuries to the head and face and any associated risk factors for these injuries. RESULTS: In the population studied, 47.8% had experienced symptoms of a concussion during the current football year. 26.9% of athletes who wore headgear (HG) and 52.8% of those who did not wear headgear (No-HG) had concussions. Approximately 4 out of 5 athletes in each group did not realize they had suffered a concussion. More than one concussion was experienced by 50.0% of the concussed HG athletes and 69.3% of the concussed No-HG group. 23.9% of all concussed players experienced symptoms for at least 1 day or longer. Variables that increased the risk of suffering a concussion during the 2006 football year included being female and not wearing headgear. Being female and not wearing football headgear increased the risk of suffering an abrasion, laceration or contusion on areas of the head covered by football headgear. CONCLUSION: Adolescent football players experience a significant number of concussions. Being female may increase the risk of suffering a concussion and injuries on the head and face, while the use of football headgear may decrease the risk of sustaining these injuries.

Neck injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and American football.

OBJECTIVE: To examine the number and rate of neck injuries in the community as a whole for ice hockey, soccer, and American football by analysing data from patients presenting to emergency departments in the United States from 1990 to 1999. METHODS: Data compiled for the US Consumer Product Safety Commission were used to generate estimates for the total number of neck injuries and the more specific diagnoses of neck fractures, dislocations, contusions, sprains, strains, and lacerations occurring nationally from 1990 to 1999. These data were combined with yearly participation figures to generate rates of injury presenting to emergency departments for each sport. RESULTS: There were an estimated 5038 neck injuries from ice hockey, 19,341 from soccer, and 114 706 from American football. These could be broken down as follows: 4964 contusions, sprains, or strains from ice hockey, 17,927 from soccer, and 104 483 from football; 105 neck fractures or dislocations from ice hockey, 214 from soccer, and 1588 from football; 199 neck lacerations for ice hockey, 0 for soccer, and 621 for football. The rates for total neck injuries and combined neck contusions, sprains, or strains were higher for football than for ice hockey or soccer in all years for which data were available. CONCLUSION: The rate of neck injury in the United States was higher in football than in ice hockey or soccer in the time period studied.

Mass casualties and triage at a sporting event.

When a sports medicine doctor provides coverage for a sporting event with a large number of athletes and spectators, he or she should always be aware that the potential for a large number of injuries exists. In the event of a mass casualty incident that overwhelms the available medical resources, he or she may be the most qualified professional present to triage and organise patient care. Certain basic rules of triage in a disaster situation should be followed, the goal being to save as many lives as possible. Special circumstances, such as crush injuries, lightning strikes, and blast injuries, may affect the triage and initial care of injured patients.

Concussions among university football and soccer players: a pilot study.

OBJECTIVE: A pilot study to examine the incidence and characteristics of concussions for one season of university football and soccer. DESIGN: Retrospective survey. PARTICIPANTS: 60 football and 70 soccer players reporting to 1998 fall training camp. Of these, 44 football and 52 soccer players returned a completed questionnaire. MAIN OUTCOME MEASURES: Based on self-reported symptoms, calculations were made to determine the number of concussions experienced during the previous season, the duration of symptoms, the time for return to play and any associated risk factors for concussions. RESULTS: Of all the athletes who returned completed questionnaires, 34.1% of the football players and 46.2% of the soccer players had experienced symptoms of a concussion during the previous season. Only 16.7% of the concussed football players and 29.2% of the concussed soccer players realized they had suffered a concussion. All of the concussed football players and 75.0% of the concussed soccer players experienced more than one concussion during the season. The symptoms from the concussion lasted for at least 1 day in 28.6% of the football players and 18.1% of the soccer players. Variables that increased the odds of suffering a concussion during the previous season for football and soccer players included a past history of a recognized concussion. CONCLUSION: More university soccer players than football players may be experiencing sport related concussions. Variables that seem to increase the odds of suffering a concussion during the previous season for football and soccer players include a history of a recognized concussion. Despite being relatively common, many players may not recognize the symptoms of a concussion.

Recommendations for grading of concussion in athletes.

Mild sports-related concussions, in which there is no loss of consciousness, account for >75% of all sports-related brain injury. Universal agreement on concussion definition and severity grading does not exist. Grading systems represent expertise of clinicians and researchers yet scientific evidence is lacking. Most used loss of consciousness and post-traumatic amnesia as markers for grading concussion. Although in severe head injury these parameters may have been proven important for prognosis, no study has done the same for sport-related concussion. Post-concussion symptoms are often the main features to help in the diagnosis of concussion in sport. Neuropsychological testing is meant to help physicians and health professionals to have objective indices of some of the neurocognitive symptoms. It is the challenge of physicians, therapists and coaches involved in the care of athletes to know the symptoms of concussion, recognise them when they occur and apply basic neuropsychological testing to help detect this injury. It is, therefore, recommended to be familiar with one grading system and use it consistently, even though it may not be scientifically validated. Then good clinical judgement and the ability to recognise post-concussion signs and symptoms will assure that an athlete never returns to play while symptomatic.

How can hyperbaric oxygen contribute to treatment?

Hyperbaric oxygen (HBO2) is used in a sports medicine setting to reduce hypoxia and edema and appears to be particularly effective for treating crush injuries and acute traumatic peripheral ischemias. When used clinically, HBO2 should be considered as an adjunctive therapy as soon as possible after injury diagnosis. Treatment pressures for acute traumatic peripheral ischemia range from 2.0 to 2.5 atmospheres absolute (ATA), with a minimum of 90 minutes for each treatment. Some professional and amateur athletes use HBO2 to aid endurance performance or to speed recovery from exercise-related fatigue; however, research does not yet support these uses. Clinicians and athletes should keep in mind that HBO2 is a medical treatment with associated risks.

Concussions during the 1997 Canadian Football League season.

OBJECTIVE: To examine the incidence and characteristics of concussions for one season in the Canadian Football League (CFL). DESIGN: Retrospective survey. PARTICIPANTS: 289 players reporting to CFL training camp. Of these, 154 players had played in the CFL during the 1997 season. MAIN OUTCOME MEASURES: Based on self-reported symptoms, calculations were made to determine the number of concussions experienced during the previous season, the duration of symptoms, the time for return to play after concussion, and any associated risk factors for concussions. RESULTS: Of all the athletes who played during the 1997 season, 44.8% experienced symptoms of a concussion. Only 18.8% of these concussed players recognized they had suffered a concussion. 69.6% of all concussed players experienced more than one episode. Symptoms lasted at least 1 day in 25.8% of cases. The odds of experiencing a concussion increased 13% with each game played. A past history of a loss of consciousness while playing football and a recognized concussion while playing football were both associated with increased odds of experiencing a concussion during the 1997 season. CONCLUSION: Many players experienced a concussion during the 1997 CFL season, but the majority of these players may not have recognized that fact. Players need to be better informed about the symptoms and effects of concussions.

Effects of hyperbaric oxygen on aerobic performance in a normobaric environment.

The purpose was to examine the acute effects of a hyperbaric oxygen (HBO2) treatment on a) recovery following prolonged exercise and b) aerobic performance in a trained population. Subjects were six male and six female, trained runners with mean Vo2max values of 64.6 +/- 5.6 and 51.9 +/- 6.6 ml x kg(-1) x min(-1), respectively. Subjects performed four exercise-HBO2 conditions in random order: a) control, b) exercise-no HBO2, c) no exercise-HBO2; and d) exercise-HBO2. Exercise was a 90-min run at 75-80% of Vo2max x HBO2 treatments consisted of breathing 95% O2 at 2.5 atm abs for 90 min. At the end of each condition, aerobic performance was assessed with a VO2max test and by the oxygen cost of running on a treadmill at three submaximal velocities. Recovery was not enhanced following a single HBO2 treatment at 2.5 atm abs for 90 min, nor did it alter submaximal or maximal running performance.

Fever duration in hospitalized acute pyelonephritis patients.

PURPOSE: To study persistence of fever in treated pyelonephritis with respect to guidelines recommending investigation and modification of therapy after 2 to 3 days of fever. PATIENTS AND METHODS: A retrospective chart review was made of 70 patients hospitalized for febrile pyelonephritis at a community hospital in Canada. RESULTS: Median duration of fever was 34 hours; persistence of fever at 48 and 72 hours was 26% and 13%, respectively. No patients had complications such as intrarenal or perirenal abscess. Prolonged fever was independently associated with increasing baseline creatinine (P = 0.0001), younger age (P = 0.027), and increasing total leukocyte count (P = 0.026). Results of ultrasonography and intravenous urograms were not predictors of fever duration. CONCLUSION: Fever in treated pyelonephritis can take 4 days to resolve, and routine urologic investigation after 2 to 3 days of fever may be unwarranted.

Assessing the ability of chemical similarity measures to discriminate between active and inactive compounds.

A method for assessing the biological discriminating power of chemical similarity measures is presented. The main concern of this work was to develop an objective way of evaluating different similarity measures in terms of how well they distinguished between active and inactive compounds. In addition, we have explored the level of similarity required for optimal separation and commented on its implications for work in the field of chemical diversity studies. The results for one simple similarity measure showed that statistically significant separation could be achieved, and indicated a reasonable similarity value for future work.

Finding and filling protein cavities using cellular logic operations.

A method for solid-filling protein cavities is presented. The method uses a pattern-recognition technique based on cellular logic operations to distinguish between convex and concave regions of a protein. In doing this it solid fills protein cavities and automatically defines a boundary between cavity and exterior free space. The operations used to fill the cavities also can be used to process the filler to filter out small-scale features. So far the main use of the method has been in visualizing protein active sites for docking. The method can be used to find cavities of a given size range and could be used to find novel protein binding sites.