Muscle injuries associated with soccer

Skeletal muscle has a high potential for regeneration and healing. After injuries to this tissue the treatment should focus on the limitation of the injury and optimization of the inherent regeneration capacity. This article discusses the prevalence of muscle injuries in soccer including diagnoses and complications, data from basic science, and therapeutic possibilities.     

Common soccer injuries. Diagnosis, treatment and rehabilitation

Motoneurons that supply the clearnose skate's hypobranchial musculature, via the occipital nerve and first seven ventral spinal nerve roots, are located within a column that extends from a level just caudal to the obex through the corresponding rostral spinal cord segments. Individual muscle motoneuron pools within the column are considerably intermingled and overlap. Comparisons with tetrapods, particularly mammals, where the hypobranchial musculature is greatly modified, reveal general conserved features. The motor column's multisegmental organization is retained although, in mammals, the column begins rostrally at medullary levels, where hypobranchial muscle motoneurons are intimately associated with motoneurons to lingual muscles, and it is restricted caudally to fewer spinal cord segments. In addition, despite an intermingling of motoneurons that supply individual hypobranchial muscles there is a shared rostrocaudal sequence of the motor pools. Rostral most hypobranchial motoneurons supply the most ventral and anterior muscles (i.e., m. coracomandibularis, and likely m. coracohyoideus, of skate and the suprahyoid musculature, m. geniohyoideus, of tetrapods). Caudal hypobranchial motoneurons supply the skate's mm. coracohyomandibularis, coracoarcualis communis and coracobranchialis and the tetrapod's entire infrahyoid muscle complex. The intermingling of multisegmental motoneuron populations innervating different hypobranchial muscles might be attributed to intermixing of premuscle mesoderm derived from several postotic somites but the musculotopic organization along the rostrocaudal axis indicates that pre- and posthyoid muscle mesoderm may partially keep its identity during its migration to the floor of the pharynx and oral cavity.     

How can injuries be prevented in the World Cup soccer athlete?

In order to prevent soccer injuries, different risk factors have to be identified as intrinsic (e.g., joint stability or muscle imbalance) and extrinsic (e.g., equipment, turf, and rules risk factors). Some preventive measures are discussed in this article, such as shin guards, prophylactic braces and taping (or both), and proprioceptive training.     

Pediatric lap belt injuries: care and prevention

Motor vehicle collisions are the leading cause of death from injury during childhood. As children outgrow their toddler car seats, they are often restrained by two-point lap belts, which are fashioned for adult body proportions. Those children restrained by two-point lap belts are at risk for intraabdominal and spinal injury during an auto collision. This article explores the mechanisms of injury and identification of "lap belt syndrome." Aspects of nursing care and prevention strategies will be discussed. A case study illustrates and summarizes the cogent aspects of lap belt related injury and child/family care.     

Pediatric wheelchair athletics: sports injuries and prevention

Two hundred and forty-seven competitors at the 1990 Junior National Wheelchair Games (USA) were surveyed for general information, training techniques, and injury patterns. Eighty-three athletes (34%) responded to the retrospective survey. Injuries were reported by 97% of those participating in track, 22% of the field participants, and 91% of the swimming competitors. A wide variety of injuries was reported ranging from minor bruises, blisters and abrasions to more serious problems (bladder infections, hyperthermia, and soft tissue injuries). While information-reporting biases may be inherent in this type of study, these data are significant in that they are the first obtained for this specific pediatric population via a systemic scientific approach and not from merely anecdotal information.     

Ureteral injuries associated with gynecologic surgery: prevention and management

Gynecologic surgery is responsible for most of the ureteral injuries that occur. The "easy" operation--the "simple" abdominal hysterectomy--and not the technically difficult pelvic one, is responsible for most ureteral injuries. Total abdominal hysterectomy accounts for almost 50% of the genitourinary fistulas and perhaps 80-99% of all surgical ureteral injuries. This problem will persist until a most important surgical axiom is applied routinely during the accomplishment of all pelvic operations: With all dissections, the contiguous structures subject to injury must be exposed. This step not only will avoid injuries to the ureter but also will facilitate an equally important aspect, that is, urinary tract injuries must be recognized at the time of operation. With recognition and adequate repair, problems such as fistula formation and serious morbidity (and litigation) can be avoided almost entirely. Because the gnecologic surgeon frequently will find that urologic consultation is not available at the time of urinary tract injury, he or she must be aware of and familiar with the various ureteral reconstructive procedures that may be required. The gynecologic surgeon must devote time and study to the management of urinary tract injuries before their occurrence. All pelvic surgeons eventually will encounter ureteral problems. The methods of bladder mobilization and ureteroneocystostomy should be within the ability of all who operate within the pelvis. When extensive damage has occurred and a urologist is not available, the gynecologist who is unfamiliar with the more demanding techniques (that is, ureteroureterostomy, bladder flaps, ileal conduits) should avoid additonal damage to the urinary tract and accomplish a simple catheter ureterostomy, deffering the definitive repair for a urologist.     

Complacency, misdirection, and effective prevention of children's injuries.

Injuries are the leading killer of children in the US, yet most parents, communities, and legislatures remain uncommitted to effective injury prevention. Possible reasons for this complacency are described, and effective methods, likely targets, and useful tactics for prevention are reviewed. The greatest challenges to injury preventionists are to persuade those who remain uninformed concerning the importance of injury prevention, to redirect those efforts currently devoted to ineffective interventions, to continue to evaluate and implement effective preventive interventions, and to search for improved prevention strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute injuries in soccer, ice hockey, volleyball, basketball, judo, and karate: analysis of national registry data

OBJECTIVE: To determine the acute injury profile in each of six sports and compare the injury rates between the sports. DESIGN: Analysis of national sports injury insurance registry data. SETTING: Finland during 1987-91. SUBJECTS: 621,691 person years of exposure among participants in soccer, ice hockey, volleyball, basketball, judo, or karate. MAIN OUTCOME MEASURES: Acute sports injuries requiring medical treatment and reported to the insurance company on structured forms by the patients and their doctors. RESULTS: 54,186 sports injuries were recorded. Injury rates were low in athletes aged under 15, while 20-24 year olds had the highest rates. Differences in injury rates between the sports were minor in this adult age group. Overall injury rates were higher in sports entailing more frequent and powerful body contact. Each sport had a specific injury profile. Fractures and dental injuries were most common in ice hockey and karate and least frequent in volleyball. Knee injuries were the most common cause of permanent disability. CONCLUSIONS: Based on the defined injury profiles in the different sports it is recommended that sports specific preventive measures should be employed to decrease the number of violent contacts between athletes, including improved game rules supported by careful refereeing. To prevent dental injuries the wearing of mouth guards should be encouraged, especially in ice hockey, karate, and basketball.     

Causes of ear trauma in Kenyan patients

Ear trauma is one of the most important epidemiological factors in causation of deafness. The causation of otologic trauma in eighty three patients is analysed. The triad of pain, hearing loss and tinnitus comprised the most frequent presenting complaints. Physical assault was the most common causation in 49.4% of the cases, road traffic accidents in 19.3% and self-inflicted injury in 15.6%. Law enforcement agencies constituted the most prominent factor in assault cases. Iatrogenic trauma was confined to 13.3% who were all below ten years of age. Road traffic accidents and violence from law enforcers were significant contributors to severe otologic damage as defined by dead ears and cerebrospinal otorrhoea.     

Chronicle of a Kenyan mission

The mission of the Christ United Methodist Church of the Deaf has been to provide a cross-cultural experience with deaf and hearing impaired persons from other countries. In this way, deaf members from the United States not only give of themselves in ministry and in service, but also share and gain invaluable insight into the lives of the deaf all over the world.     

On the prevention of accidents and injuries. A comparative analysis of conceptual frameworks

The meaning of prevention has changed as new applications of the concept have appeared. Ideas presented in eleven different conceptual frameworks are compared. Identification of the frameworks took place through searches in databases and relevant literature. Five are general by nature, while six relate to injuries and accidents. All are supported by just a few parameters, the time dimension being the most prominent. Compatibility was established on three additional dimensions: level (individual, organizational or societal); direction ("bottom-up" or "top-down"); and in relation to the trichotomy "host-agent-environment". An attempt to synthesize all these dimensions into one general model of accident and injury prevention is presented.     

Bacterial meningitis in a rural Kenyan hospital

In a prospective study to investigate mortality and antibiotic resistance in meningitis patients, thirty two meningitis cases were seen over a three month period. Mean age was 11.3 years (range one month-60 years). Cerebrospinal fluid cultures were positive in 26 patients (81.3%). S.pneumoniae was responsible for 15 cases (46.9%), followed by H.influenzae in seven (21.9%). Salmonella infection was seen in two patients, and E.coli and N.meningitidis in one each. Twelve patients (37.5%) died during hospitalisation with most of the deaths occurring within 48 hours after admission. No patients presented with atypical signs of meningitis. No significant differences were found between delay and outcome. Malaria parasites were found in blood of thirteen patients (41%), but did not contribute to higher mortality. Three of H.influenzae isolates (42.9%) were resistant to ampicillin and penicillin. Reduced sensitivity to penicillin was found in two (13.3%) of S.pneumoniae isolates.     

Photocoagulation in the prevention of retinal detachment in perforating injuries of the eye caused by warfare

Main indications for application of photocoagulation in the prevention of retinal detachment in penetrating eye war injuries were presented. Photocoagulation was performed when intrabulbar foreign body was present, before its extraction and in the cases of traumatic ruptures of sectorial traumatic tractional retinal detachment. Modified photocoagulation by argon laser, with linked spots in two rows was used since it was shown to be clinically the most suitable.     

Childhood burn injuries: circumstances of occurrences and their prevention in Ribeir?o Preto, Brazil

The objectives of this study were to verify which circumstances are present in burn accidents of patients under 12 years of age and to gather information to ground strategies to prevent those accidents. Parents or guardians of 26 patients aged under 12 years, admitted to the burns unit of the Clinical Hospital of Ribeir?o Preto Medical School, Brazil, were interviewed, from March 1996 to March 1997. Fifty percent of the injured children were under 3 years of age and had suffered a scald. The kitchen and the backyard were identified as the places where the majority of accidents (84.6%) happened. At least one parent was present in 80.7% of cases. The results speak for the necessity of implementation of programs to prevent burn accidents, focusing on the domestic setting, chiefly activities in the kitchen.     

High school football injuries: prevention of injury to the central nervous system

Injuries to the head, neck, and spinal cord of high school athletes account for over 90% of the fatalities directly related to football. Preseasonal and seasonal guidelines that have proven to be helpful in the prevention of these injuries are presented.     

Management of psychiatric problems in a Kenyan mission hospital

Many psychiatric conditions are found in the rural general hospital in Kenya and are recognisable and manageable along standard Western lines. An essential element in management is the training of the nursing staff. The psychiatric patient should be actively managed and can benefit from the unsophisticated treatment possible at the mission hospital.     

An objective approach to antivenom therapy and assessment of first-aid measures in snake bite

Treatment of systemic envenoming in snake-bite victims has, in the past, depended almost entirely on the individual clinician's experience in assessing the severity of envenoming. The efficacy of treatment is obviously related to the neutralizing potency of the antivenom used, the route by which it is administered and the dose. The development of enzyme immunoassays has permitted a more scientific appraisal, allowing estimation of circulating specific venom and antivenom concentrations at any time after the bite in the patient's blood. It is therefore possible to measure accurately the efficacy of antivenom in the neutralization and clearance of venom antigen. In Brazil, it appears that clinicians treat patients with excessive amounts of highly efficient antivenoms and this results in an unacceptably high incidence of reactions. In Sri Lanka, the use of imported, Indian antivenom is relatively ineffective in neutralizing the venoms of Sri Lankan snakes, demonstrating the real problem of venom variability within individual species. In West Africa, the improved clearance of venom following treatment of Echis victims with a monospecific as opposed to a polyspecific antivenom has been demonstrated, and new, smaller fragment, Fab antivenoms have been developed and are now under clinical assessment. Such clinically-based immunological studies should result in more efficient and controlled use of expensive antivenoms for treatment of systemic envenoming and the accurate assessment of newly designed products. Such studies also emphasise the importance of individual countries producing their own antivenoms for treatment of systemic envenoming. Likewise, the use of such objective systems now enables the use of first-aid measures such as tourniquets to be properly assessed.