Effectiveness of Screening for Household Gun Ownership in an Urban Primary Care Clinic.

Gun-related suicide and homicide are leading causes of death among children. Little is known about the effectiveness of screening for gun ownership in primary care. We examined positive gun ownership screens over a 2.5-year period in a pediatric primary care clinic. The main outcome was a positive screen for gun ownership. The main predictors included insurance type, neighborhood median income, number of clinic visits, and other social needs. Of 19 163 patients, 474 (2.5%) screened positive for gun ownership. Patients with private insurance and from higher income neighborhoods had 2 to 3 times higher odds of a positive screen. Patients with more visits and with food insecurity had approximately 2 to 4 times the odds of a positive screen for household gun ownership. In conclusion, the rate of positive gun ownership screens was very low and far below known gun ownership rates. Improved screening methods could better identify opportunities for gun safety advocacy.

Adherence to guidelines for cardiovascular screening in current high school preparticipation evaluation forms.

We compared the content of the cardiac screening questions on US state high school athletic association preparticipation evaluation forms with current consensus recommendations. We reviewed the high school athletic association's approved, recommended, or required sports preparticipation form from each of the 50 US states and the District of Columbia, and compared the content of the personal and family history components with current recommendations for cardiac screening questions. We found that 85% of the preparticipation forms in current use contain all elements of the formerly recommended guidelines, but only 17% contain all elements of the new consensus guidelines. We conclude that although there appears to be some improvement in the content of the preparticipation forms in current use compared with previous studies, the vast majority of these forms are incomplete compared with current consensus guidelines.

Glutamine: the nonessential amino acid for performance enhancement.

Glutamine is a popular dietary supplement consumed for purported ergogenic benefits of increased strength, quicker recovery, decreased frequency of respiratory infections, and prevention of overtraining. From a biochemical standpoint, glutamine does play a physiologic role in each of these areas, but it remains only one of a host of factors involved. This review examines the effects of glutamine on exercise and demonstrates a lack of evidence for definitive positive ergogenic benefits as a result of glutamine supplementation.

Erythropoietin in sports: a new look at an old problem.

Erythropoietin (EPO) is found naturally in the human body and has been commercially available as recombinant human EPO (rEPO) for almost 20 years. Although the positive benefits of rEPO cannot be denied for those who suffer from anemia, athletes have also used the drug as an ergogenic aid. It has replaced conventional "blood doping" as the drug of choice to improve performance in contests requiring aerobic potential. Testing for the drug in the past has proven difficult due to several factors. The similarities in structure and metabolism of EPO and rEPO allow those who choose to abuse rEPO to avoid detection. Due to the inherent danger of abusing rEPO and its analogues, the various governing bodies of international sports continue to improve testing methods for this illegal substance.

Medicolegal issues and ergogenic aids: trade, tragedy, and public safety, the example of ephedra and the Dietary Supplement Health and Education Act.

On February 6, 2004, the US Food and Drug Administration banned dietary supplements containing ephedrine alkaloids (ephedra) pending Congressional review. The ban culminates a 7-year regulatory process, the first of its kind under the Dietary Supplement Health and Education Act (DSHEA). This paper reviews that process, and the governing rules of DSHEA, within the contexts of modern science and the history of food and drug legislation. The example of ephedra reflects a longstanding conflict between trade and safety and suggests inherent weaknesses within DSHEA that place the public at risk.