High cost of high school football injuries

This study examines year-to-year (1965, 1976 to 1977) and state-to-state (six western United States) cost variations in relation to injury site, severity, and repetition of high school football injuries. Data were collected from the files of the largest single insurer of secondary school students in these states. Analysis was made through a specially programmed Qantel 1300 computer. The average claim cost in 1965 was $34.72 in 1976 was $149.93, and, in 1977, it was $177.95. The average cost was lowest in Utah and highest in California. In the 1976 to 1977 season, 3,501 claims from 15,252 players were reported. Over 25% of the claims filed were from players who had more than come claim per season. Relatively minor injuries (sprains, strains, contusions, and abrasions) accounted for 72.3% of all injuries but only 42.4% of medical costs. Lower extremity injuries accounted for one-third of the injuries and one-half of the costs. Knee injuries alone accounted for 12.7% of all injuries and 31.8% of all medical costs paid by the insurance company. It is proposed that trainers and coaches not only know how to care for minor injuries but also that they are more rigid in their criteria for fitness, agility, stamina, and psychologic factors so that players predisposed to injury and repeated injuries will not contribute to the escalating medical costs of high school football injuries.     

Acute gastric dilatation with infarction and perforation. Report of fatal outcome in patient with anorexia nervosa

This is a report of a 22-year-old woman with treated anorexia nervosa who died of complications of acute gastric dilatation-that is, infarction and perforation with severe and irreversible shock. Binge eating and drinking, precipitated by emotional crises, contributed to her acute gastric dilatation. This complication of anorexia nervosa has been previously reported, but, unlike the others, this case ended fatally. The literature is reviewed.     

Neurogenic pulmonary edema in fatal and nonfatal head injuries

Impaired pulmonary function is a frequent but poorly understood complication of acute head injury (HI). A potential early contributor to the pulmonary dysfunction seen in HI patients is neurogenic pulmonary edema (NPE). We hypothesized that NPE would occur early after HI and that it would have a continuum of clinical severity depending on the severity of the HI and associated intracranial hypertension. A large autopsy data base and inpatient HI data base were used to search for cases of NPE. Patients in the autopsy data base were stratified according to injury type and whether they died at the scene or within 96 hours of injury. There were significant (p < 0.0001, analysis of variance) elevations in lung weights in patients dying at the scene and within 96 hours from HI, compared with those dying from other noncentral nervous system injuries. No other organs studied showed significant weight increases. The incidence of NPE in isolated HI patients dying at the scene was 32%. In patients with isolated HI dying within 96 hours, the incidence of NPE was 50%. We found an inverse correlation (r = 0.62; p < 0.0014) between the initial cerebral perfusion pressure and the PaO2/FIO2 ratio despite a normal-appearing chest x-ray film. We conclude that NPE occurs frequently in HI patients. The process of edema formation begins early in the clinical course and is isolated to the lung.(ABSTRACT TRUNCATED AT 250 WORDS)     

Drug detection and trauma cause--a case control study of fatal injuries

This article describes how pure Ty-VLPs (virus-like particles) can be prepared from hybrid Ty-VLPs. Many different hybrid Ty-VLPs have been produced and may be easily purified. Since the sedimentation properties of different hybrid Ty-VLPs are similar, a simple purification process can be used for any VLP. This fast, versatile, and easy process allows for the production of a variety of recombinant proteins.     

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.     

In vivo blocking of L-selectin rescues BALB/c mice from fatal Leishmania major infection

Susceptibility and resistance to experimental Leishmania major (L. major) infection in mice are associated with a Th2- or Th1-type response, respectively. We have previously shown that immunological events occurring within the first 24 h after infection in the lymph node (LN) draining the site of parasite challenge are critical for the development of either type of T-cell responses. In the present study we manipulated these events by preventing the entry of naive lymphocytes into the draining LN by injecting BALB/c mice with a single dose of the anti-L-selectin mAb MEL-14 one day prior to infection with L. major. In contrast to control BALB/c mice, in MEL-14 treated animals the primary lesion healed 12 weeks after infection. The parasite load in the spleen and lymph nodes of MEL-14 treated mice was significantly reduced. The healing was found to be associated with an increased production of IFN-gamma and with a decrease in IL-4 production by LN cells. We observed a dramatic decrease in cellularity in the draining LN in Mel-14 treated L. major-infected mice within the first week of infection. Moreover, the cells in the LN of MEL-14 treated mice were highly enriched in activated cells as well as in cell influx in the draining LN after local L. major infection of BALB/c mice prevents fatal disease. The data suggest the MEL-14-induced enrichment of the draining LN in memory and activated cells is fundamental for the initiation of a protective Th1-type response.     

Contrasting reduced overshadowing and blocking.

Preexposure of a cue without an outcome (X-) prior to compound pairings with the outcome (XZ→O) can reduce overshadowing of a target cue (Z). Moreover, pairing a cue with an outcome (X→O) before compound training can enhance its ability to compete with another cue (i.e., blocking). Four experiments were conducted in a conditioned bar-press suppression preparation with rats to determine whether spacing of the X- or X→O trials would differentially affect reduced overshadowing and blocking. Experiment 1a showed that reduced overshadowing was larger with massed trials than with spaced trials. Experiment 1b found that blocking was larger with spaced trials than with massed trials. Experiments 2a and 2b indicated that these effects of trial spacing were both mediated by the associative status of the context at test. The results are interpreted in the framework of contemporary learning theories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol in fatal and nonfatal injuries: a comparison of coroner and emergency room data from the same county

Although alcohol is thought to be associated with severity of injury, relatively little data are available that compares alcohol's involvement in injury cases treated in the emergency room (ER) with coroner cases of injury fatality, both coming from the same county. Data from a probability sample of casualty patients 18 years and older treated at the University of Mississippi Medical Center ER in Jackson during a 6-month period (n = 275) are compared with data from coroner reports of all fatalities from unnatural causes among those 18 and older in the same county during a 1-year period surrounding the 6 months of data collection in the ER (n = 222). The two samples are compared on demographic characteristics, cause of injury, place of injury, and alcohol use before the event. A significantly larger proportion of the coroner sample was positive for alcohol (57%) and intoxicated (36%), compared with the proportion of those in the ER sample breathalyzed within 6 hr of injury, and reporting no drinking after the event who were positive (15%) and intoxicated (6%). Differences were most pronounced for motor vehicle accidents and fires. Violence-related injuries were more likely in the coroner sample (32%) than in the ER sample (16%), and they were more likely to involve alcohol at levels of intoxication. Those in the coroner sample were also more likely to be alcohol-positive for injuries occurring in all places except the home of another and the workplace. Using logistic regression, gender (male) and site (coroner) were predictive of a positive blood alcohol across all causes of injury combined. Gender (female), being alcohol-positive and site (coroner) were significantly predictive of motor vehicle accidents. Alcohol was not found to be a significant predictor for falls, other accidents, or injuries resulting from violence. Data suggest that alcohol's association with severity of injury varies by cause of injury.     

Trends in rates of occupational fatal injuries in the United States (1983-92)

Recent advancements in laparoscopic surgery have made laparoscopic splenectomy possible. We retrospectively compared the outcomes of laparoscopic versus open splenectomy in patients with idiopathic thrombocytopenic purpura (ITP) or beta-thalassemia. From July 1993 to July 1997, 52 patients (ITP, 43 cases; beta-thalassemia, 9 cases) underwent either laparoscopic (30 patients, 9 men, 21 women; average age, 36.9 years) or conventional open splenectomy (22 patients, 5 men, 17 women; average age, 34.3 years). The two groups were similar in terms of sex, age, diagnosis, duration of disease, preoperative platelet count, and spleen size. The mean surgical time, estimated amount of blood loss, duration of postoperative recovery, analgesic usage, and complications were compared between the two groups. Laparoscopic splenectomy was successful in 29 (97%) of the 30 patients. The mean surgical time in the laparoscopy group was longer than in the open splenectomy group (190.6 vs 113.9 minutes, p < 0.01). The laparoscopy group had earlier postoperative oral intake (15.2 vs 52.6 hours, p < 0.01), less usage of analgesics (meperidine 50 mg/unit, 1.1 vs 2.8 units, p < 0.01) and a shorter postoperative hospital stay (4.1 vs 6.8 days, p < 0.01). The estimated blood loss, incidence of accessory spleen, surgical complication rate, and recurrence rate of thrombocytopenia were similar in the two groups. Our findings show that laparoscopic splenectomy in patients with ITP or beta-thalassemia is as safe as the open approach. While laparoscopy required a longer surgical time, the recovery period was shorter, analgesic use was less, and physical discomfort was less severe.     

Severe cervical spinal cord injuries related to rugby union and league football in New South Wales, 1984-1996

OBJECTIVE: To determine the frequency and circumstances of serious cervical cord injuries associated with rugby union and league football in New South Wales. DESIGN: Retrospective review of patients with rugby football-related cervical spinal cord injuries. SETTING: The two central spinal units in NSW, from January 1984 to July 1996. OUTCOME MEASURES: Admission to spinal units; injury resulting in permanent tetraplegia. RESULTS: During the review period, 115 rugby football players (56 union and 59 league) were admitted to the spinal units because of cervical spinal cord injuries. 49 patients had resultant permanent neurological deficits (complete tetraplegia [quadriplegia])--26 associated with rugby union and 23 with rugby league. Two patients died of injury sequelae within two weeks of admission. There was no significant change in the rate of football-related admissions to spinal units for either code. There was a small decline in the number (from 15 in 1984 to 1987 to 7 in 1992 to 1996) and incidence (from 1.2 to 0.5 per 10,000 participants) of patients with tetraplegia associated with rugby union. When this decline was tested as a trend over the years, it was found to be statistically significant (P = 0.06). No significant trend was found in the tetraplegia data associated with rugby league. Cervical spinal cord injuries leading to complete tetraplegia were most commonly associated with scrum-like plays in union and with tackles in league. CONCLUSION: Serious cervical spinal injuries associated with both codes of rugby continue to occur in NSW. Rugby football in its various forms is still an inherently dangerous game.     

A within and between modality analysis of blocking.

Ran 4 groups of 6 homing pigeons to examine the role of modality relationships in blocking. In the within-modality condition Ss were pretrained on a line-tilt discrimination prior to line-tilt plus wavelength compound training. In the between-modality condition, auditory pretraining was followed by compounding with the same color cues. All Ss in pretrained conditions were run until they reached a criterion based on the proportion of responses emitted to the positive stimulus. Comparison of wavelength generalization gradients produced by Ss in pretrained conditions to those produced by Ss which received only compound training revealed that both pretraining conditions attenuated the development of control by wavelength cues (i.e., blocking occurred). Since the between- vs within-modality comparison was not significant, it appears that modality relationships are not critical for blocking. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of hippocampal lesions in overshadowing and blocking procedures.

The effects of ibotenic acid lesions of the hippocampus on overshadowing and blocking were examined in a Pavlovian appetitive conditioning experiment with rats. In a standard test of performance to the overshadowed or blocked target stimulus, sham-lesioned rats displayed both of these stimulus-selection phenomena. Rats with hippocampal lesions showed normal blocking, but no overshadowing. Subsequent inhibitory learning about the target stimulus was slower after overshadowing or blocking procedures than after a control procedure in sham-lesioned rats, but not in lesioned rats. These results suggest that exposure to these procedures can induce hippocampally mediated losses in conditioned stimulus associability (learning rate parameter), even when those losses are not a major determinant of the stimulus-selection effects themselves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Surgical therapy of frequent hand injuries. 1: Fractures and capsular ligament injuries

The hand is often involved in accidents and injuries. Most of these injuries can be treated adequately by the physician providing initial care. This paper gives the reader an outline of the most common hand injuries with the aim of facilitating recognition of the involvement of functional structures and thus ensure proper treatment or referral to the specialist. If a good functional results is to be achieved, misalignments in the longitudinal and transverse axes or torsional misalignments must be avoided. Fixation procedures facilitate provision of early-functional aftercare. In the event of injuries to the capsular ligament, a differentiation between complete and incomplete ruptures is of decisive importance for the further treatment.     

Temporal encoding as a determinant of blocking.

A blocking paradigm with rats was used to evaluate whether different temporal information is encoded in simultaneous rather than forward associations. During Phase 1, the blocking CS was simultaneously or forward paired with a unconditioned stimulus/stimuli (UCS). During Phase 2, the pretrained CS occurred in compound with a novel target CS that was paired in a simultaneous or forward manner with the UCS. Forward pretraining resulted in more blocking of a forward than a simultaneously trained target CS, and simultaneous pretraining resulted in more blocking of a simultaneously than a forward trained target CS. Thus, greater blocking occurred when the blocking and blocked CSs had the same temporal relation to the UCS. The results support the temporal coding hypothesis and question the necessity of predictive information in blocking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benchmark for the blocking of sociometric data.

Presents well-documented data to illustrate blocking with the globally best goodness-of-fit value. Blockmodeling and structural equivalence summarize the global pattern of relations and roles among actors. Using R–2 (W. H. Panning; see record 1984-11284-001) as the goodness-of-fit measure, the optimal and near-optimal solutions for the 14 individuals in the Bank Wiring Room dataset of F. J. Roethisberger and W. J. Dickson (1939) are presented. With this benchmark solution, new and existing algorithms can be evaluated for their ability to generate optimal clusters. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)