Category: Injury & Trauma

Categories : Injury & TraumaTags :

Elite Athletes Have an Osteoarthritis Risk from Sports-related Injuries

On By ModernMedia
Photo by Quino Al on Unsplash

Elite retired sportspeople who had experienced a sports-related injury had a higher chance of knee and hip osteoarthritis when compared with the general population, according to a two-part study reported in the British Journal of Sports Medicine.

One in four retired Olympians reported a diagnosis of osteoarthritis, researchers have found. The athletes – who had competed at an Olympic level in 57 sports including athletics, rowing and skiing – also had an increased risk of lower back pain overall, and shoulder osteoarthritis after a shoulder injury.

Researchers hope the findings will help develop new approaches in injury prevention for the benefit of athletes now and in retirement.

The study is the largest international survey of its kind, and the first to observe the consequences of osteoarthritis and pain in different joints from retired elite athletes across different summer and winter Olympic sports.

Researchers surveyed 3357 retired Olympians aged around 45 on injuries and the health of their bones, joints, muscles and spine. They were also asked if they were currently experiencing joint pain, and if they had an osteoarthritis diagnosis. A comparison group of 1735 people aged around 41 from the general population completed the same survey.

Researchers used statistical models to compare the prevalence of spine, upper limb and lower limb osteoarthritis and pain in retired Olympians with the general population.

The team considered factors that could influence the risk of pain and osteoarthritis such as injury, recurrent injury, age, sex and obesity.

They found that the knee, lumbar spine and shoulder were the most injury prone areas for Olympians. These were also among the most common locations for osteoarthritis and pain.

After a joint injury the Olympians were more likely to develop osteoarthritis than someone sustaining a similar injury in the general population, the research found

The sportspeople also had an increased risk of shoulder, knee, hip and ankle and upper and lower spine pain after injury, although this did not differ with the general population.

Dr Debbie Palmer, of the University of Edinburgh’s Moray House School of Education and Sport, said: “High performance sport is associated with an increased risk of sport-related injury and there is emerging evidence suggesting retired elite athletes have high rates of post-traumatic osteoarthritis.

“This study provides new evidence for specific factors associated with pain and osteoarthritis in retired elite athletes across the knee, hip, ankle, lumbar and cervical spine, and shoulder, and identifies differences in their occurrence that are specific to Olympians.”

Researchers say the study may help people make decisions about recovery and rehabilitation from injuries in order to prevent recurrences, and to inform prevention strategies to reduce the risk and progression of pain and OA in retirement.

Source: University of Edinburgh

Categories : Injury & TraumaTags :

Medical Glue Inspired by Marine Animals could Stop Haemorrhages

On By ModernMedia
Red blood cells
Source: Pixabay

Every year around two million people die worldwide from haemorrhage, which accounts for more than 30% of trauma deaths. Medical glue, often used to stop the bleeding, is ineffective if the site is too wet or if the site can’t be compressed. But marine animals like mussels and flatworms are able to bond to surfaces underwater, inspiring researchers to develop a medical adhesive, which they describe in Nature Communications.

“When applied to the bleeding site, the new adhesive uses suction to absorb blood, clear the surface for adhesion, and bond to the tissue providing a physical seal. The entire application process is quick and pressure-free, which is suitable for non-compressible haemorrhage situations, which are often life-threatening,” says lead author Guangyu Bao, a recently graduated PhD student under the supervision of Professor Jianyu Li of Department of Mechanical Engineering.

Testing out the their new technology, the researchers found that the adhesive promotes blood coagulation. The adhesive can also be removed without causing re-bleeding or even left inside the body to be absorbed. “Our material showed much better-improved safety and bleeding control efficiency than other commercial products. Beyond bleeding control, our material could one day replace wound sutures or deliver drugs to provide therapeutic effects,” said senior author Professor Jianyu Li.

Source: McGill University

Categories : Injury & Trauma PaediatricsTags :

e-Scooter Injuries among Children on The Increase

On By ModernMedia
Photo by Kelly Sikkema on Unsplash

Standing electric scooters, typically termed e-scooters, have been increasing in popularity over the past decade. According to a new research abstract presented during the 2022 American Academy of Pediatrics National Conference & Exhibition, e-scooter injuries among children are becoming much more common and increasingly severe.

The authors found hundreds of e-scooter injuries in the US between 2011-2020. The rate of hospital admittance for patients increased from fewer than 1 out of every 20 e-scooter injuries in 2011 to 1 out of every 8 requiring admittance into a hospital for care in 2020.

“The number of annual e-scooter injuries has increased from 2011 to 2020, likely due in some part to the rise in popularity of rideshare e-scooter apps,” said lead author Harrison Hayward, MD, Emergency Medicine fellow at Children’s National Hospital. “Our study has characterised the spectrum of injuries that occur in children, which helps emergency room doctors prepare for taking care of them and helps parents and families to practice better safety.”

Researchers examined a national database of paediatric e-scooter injuries that were seen in emergency departments at over 100 US hospitals from 2011–2020 to find out what kinds of injuries children were sustaining and if any trends existed. Over 10% of all patients had a head injury, including a concussion, skull fractures, and internal bleeding. The most common injuries were arm fractures (27%), followed by minor abrasions (22%) and lacerations needing stitches (17%). The average age was 11.1 years and 59% of patients were male. Admittance to a hospital rose from 4.2% in 2011 to 12.9% in 2020.

“Parents whose children are riding e-scooters need to know how best to be safe. To that end, helmets are a must, since over 10% of the reported cases were head injuries,” said Dr Hayward. “Children should absolutely be wearing helmets while riding an e-scooter. Research has broadly demonstrated that helmets save lives for bicycle riders, and we should think similarly about e-scooters.”

Source: American Academy of Pediatrics

Categories : Injury & Trauma PaediatricsTags :

Behavioural Problems in Kids after Traumatic Brain Injuries

On By ModernMedia
Boy hanging from tree
Photo by Annie Spratt on Pexels

Kids who experience a traumatic brain injury (TBI), even a mild one, have more emotional and behavioural problems than kids who do not, according to a study published in NeuroImage.

“These hits to the head are hard to study because much of it depends on recall of an injury since the impacts do not all require a visit to a doctor,” said study first author Daniel Lopez, a PhD candidate at Del Monte Institute for Neuroscience. “But being able to analyse longitudinal data from a large cohort and ask important questions like this gives us valuable information into how a TBI, even a mild one, impacts a developing brain.”

Researchers used MRI and behavioural data collected from thousands of children who participated in the Adolescence Brain Cognitive Development (ABCD) Study. They revealed children with a mild TBI experienced a 15-percent increased risk of an emotional or behavioural problem. The risk was the highest in children around ten years old. Researchers found that children who had a significant hit to the head but did not meet diagnostic criteria for a mild TBI also had an increased risk of these behavioural and emotional problems.

The University of Rochester Medical Center is one of 21 research sites collecting data for the National Institutes of Health ABCD Study. Since 2017, 340 children have been part of the 10-year study that is following 11 750 children through early adulthood. It looks at how biological development, behaviours, and experiences impact brain maturation and other aspects of their lives, including academic achievement, social development, and overall health.

Researchers hope future ABCD Study data will better reveal the impact these head hits have on mental health and psychiatric problems. “We know some of the brain regions associated with increased risk of mental health problems are impacted during a TBI,” said Ed Freedman, PhD, associate professor of Neuroscience and co-principal investigator of the ABCD Study at the University of Rochester. Freedman also led this study. “With more time and data, we hope to gain a better understanding of the long-term impact of even a mild TBI.”

Source: University of Rochester Medical Center

Categories : General Interest Injury & TraumaTags :

Oldest Known Successful Amputation Dates Back 31 000 Years

On By ModernMedia
Mariano, Public domain, via Wikimedia Commons

At a site in Borneo, archaeologists have unearthed the oldest case of surgical amputation to date, a remarkable feat of prehistoric medical practice.

Published in Nature, the researchers describe the skeletal remains of a young adult found in a cave in Borneo, who had part of the left lower leg and left foot amputated, probably as a child, at least 31 000 years ago. The person lived for at least another six to nine years after the procedure, surviving into adulthood where they died from an unknown cause, possibly in their 20s.

The prehistoric surgery is a remarkable feat; preventing infections is difficult even in modern surgical amputations.

Study co-lead author, Dr Melandri Vlok, at University of Sydney said the find is “incredibly exciting and unexpected.”

“The discovery implies that at least some modern human foraging groups in tropical Asia had developed sophisticated medical knowledge and skills long before the Neolithic farming transition,” said bioarchaeologist Dr Vlok, an expert in ancient skeletons.

The skeleton of the young adult was carefully buried within LiangTebo cave – located Borneo in East Kalimantan, in a limestone karst area home to some of the world’s earliest dated rock art.

The bones were uncovered by archaeologists just days before borders closed for the COVID pandemic in March 2020. Dr Vlok was invited to study the bones when they were brought back to Australia.

“No one told me they had not found the left foot in the grave,” Dr Vlok said. “They kept it hidden from me to see what I would find.”

As Dr Vlok laid the bones out, the left leg looked withered, and was the size of a child’s, but the individual was an adult. She unwrapped the part of the leg that contained the stump and noticed the cut was clean, well healed and had no evidence of any infection. “The chances the amputation was an accident was so infinitely small,” Dr Vlok said. “The only conclusion was this was stone age surgery.”

Dr Vlok ran to the office to tell her research colleagues what she had found. “I told them I thought it looked like a surgical amputation,” she said. “It wasn’t until then that they said they already knew the foot was missing.” Dr Vlok had just confirmed their suspicions. The foot was never placed in the grave to begin with.

An accident in difficult terrain

While the cause for the amputation was unclear, the individual also had a very well healed neck fracture and trauma to their collar bone that may have occurred during the same event, said Dr Vlok.

“An accident, such as a rock fall may have caused the injuries, and it was clearly recognised by the community that the foot had to be taken off for the child to survive,” she said.

The location of the cave is surrounded by extremely rugged terrain, and accessing the site was challenging, making the individual’s survival after the the surgery even more remarkable. The finding will provide even more insight into prehistoric medicine, the researchers said.

Source: University of Sydney

Categories : Ageing Injury & TraumaTags :

A Biomarker for Male Hip Fracture Risk

On By ModernMedia
Photo by Mehmet Turgut Kirkgoz on Unsplash

In new research published in the Journal of Bone and Mineral Research, elevated blood levels of a certain chemokine, or small signalling protein, that promotes osteoclast formation were linked with a higher risk of hip fracture in men.

To maintain bone health, a balanced activity of various bone cell types including bone-forming osteoblasts and bone-resorbing osteoclasts has to take place. When osteoclasts dominate without adequate bone formation to compensate, osteoporosis results.

The study included 55 men and 119 women who had experienced a hip fracture an average of 6.3 years after their blood was collected. The participants were matched individually to controls who did not develop hip fractures.

The researchers found higher levels of the chemokine CXCL9 in the pre-fracture blood samples of men with subsequent hip fractures compared with their non-fracture controls. In women, the researchers saw no such.

“The unexpected difference in the results between men and women in our study may be explained by how changes in sex hormone levels during aging could influence the level and effects of CXCL9 differently in older men and women,” explained corresponding author Woon-Puay Koh, MBBS, PhD, from the National University of Singapore (NUS).

“Our findings open the exciting possibility that early interventions targeting CXCL9 or CXCL9-CXCR3 signalling could be beneficial in preventing hip fractures in older men,” added co-corresponding author Christoph Winkler, PhD, also from NUS.

Source: Wiley

Categories : Injury & TraumaTags :

Repeated Concussions can Result in Skull Thickening

On By ModernMedia
MRI images of the brain
Photo by Anna Shvets on Pexels

Published in the journal Scientific Reports, a study led by Associate Professor Bridgette Semple from Monash University, found that repeated concussions resulted in thicker, denser bones in the skull.

Although bones are considered a mostly structural component of the human body, bones are in fact active living tissues that can respond to applied mechanical forces. For example, martial arts training, with its kicks, punches and throws, has been shown to increase bone mineral density in the arms, legs and spines of practitioners.

At present, it is unclear whether this thickening of the skull is beneficial or detrimental: theoretically, a thicker skull is a stronger skull, suggesting that this may be the bone’s attempt to protect the brain from subsequent impacts.

“This is a bit of a conundrum,” Assoc Prof Semple said. “As we know, repeated concussions can have negative consequences for brain structure and function. Regardless, concussion is never a good thing.”

The team hopes that the microstructural skull alterations caused by concussion are now considered by researchers in the field to better understand how concussions affect the whole body.

A form of mild traumatic brain injury, concussion have been linked to long-term neurological consequences if they happen repetition.

While most studies focus on its effect on the brain and its function, they largely ignore the overlying skull bones.

Study collaborator Professor Melinda Fitzgerald, from Curtin University and the Perron Institute in Western Australia, has previously shown that repeated concussive impacts lead to subtle problems with memory, and evidence of brain damage.

In this new study, high-resolution neuroimaging and tissue staining techniques were used in a pre-clinical animal model, and revealed an increase in bone thickness and density, in close proximity to the site of injury.

“We have been ignoring the potential influence of the skull in how concussive impacts can affect the brain,” Associate Professor Semple said. “These new findings highlight that the skull may be an important factor that affects the consequences of repeated concussions for individuals.”

Future studies are planned, with collaborator and bone expert Professor Natalie Sims from St Vincent’s Institute of Medical Research in Melbourne, to understand if a thickened skull resulting from repeated concussions alters the transmission of impact force through the skull and into the vulnerable brain tissue underneath.

Source: Monash University

Categories : Diet and Nutrition Injury & TraumaTags :

Increased Risk of Hip Fractures for Women on Vegetarian Diets

On By ModernMedia
Source: Unsplash

Middle-aged women on vegetarian diets have a significantly higher risk of hip fractures than those on diets that include fish or meat, according to a long-term study publish in BMC Central. This risk remained even after accounting for the differences in available nutrient intake and body mass index.

Hip fractures greatly impact quality of life and and health outcomes, and carry a significant financial burden, with an average of $44 000 estimated to spent in the 12 months following a hip fracture. The growing trends of meat-free diets have prompted concern over their impact on hip fracture rates.

While increased intake of vegetable proteins has been associated with lower hip fracture risk, vegetarian diets have also been characterised by lower dietary intakes of nutrients that boost bone mineral density (BMD) and which are more abundant in animal products. Examples include total protein, calcium, vitamin D, vitamin B12, and ω-3 fatty acids, though the relationship with BMD is complex.

The researchers drew on data from the United Kingdom Women’s Cohort Study (UKWCS), and included 26 318 participants aged 35–69 who were classed into regular meat-eaters (> 5 servings/week), occasional meat-eaters (< 5 servings/week), pescatarians (eating fish but no meat) and vegetarians.

On average, vegetarians and pescetarians had a lower BMI (23.3 for both) than regular meat-eaters (25.2). At recruitment, regular meat-eaters had the highest prevalence of CVD, cancer, or diabetes (10.2%), and vegetarians the lowest (5.8%). A higher proportion of vegetarians reported never drinking alcohol. Regular meat-eaters reported the highest absolute dietary intakes of protein, vitamin D, and vitamin B12, whilst vegetarians reported the lowest. Calcium intakes were similar across the diet groups.

Before adjustments, compared with regular meat-eaters, vegetarians (hazard ratio 1.40) but not occasional meat-eaters (1.03) or pescatarians (1.04) had a greater hip fracture risk. Adjustment for confounders slightly attenuated these associations in the adjusted model, but the higher risk in vegetarians remained and was statistically significant: vegetarians 1.33; occasional meat-eaters 1.00; pescatarians 0.97.

However, even after adjustment for factors such as reported differences in nutrient intake and lower BMI, which is a known risk factor in hip fractures, the relative risk difference remained. This suggests that other, as yet unknown, factors related to the diets may be involved.

Categories : Ageing Injury & TraumaTags :

Psychological Resilience Aids Faster Return to Walking after Hip Fracture

On By ModernMedia
Carers help an old man to walk
Photo by Kampus Productions on Pexels

In a study of 210 community-dwelling older adults who had surgery following hip fracture, participants who reported feeling high levels of psychological resilience were later able to walk faster and longer than those feeling less resilient. The results, published in the Journal of the American Geriatrics Society, will help the development of interventions such as targeted exercise programmes.

Walking capacity is a critically important outcome following hip fracture, in that it serves both as a surrogate measure of functional ability and physical health more globally, as well as a predictor of future survival, institutionalisation, social interaction and community engagement. Moreover, poor recovery after hip fracture causes considerable suffering for patients and imposes a financial burden on the social and health care sector. In 29%–50% of cases, older adults with hip fracture do not reach their pre-fracture levels of functioning a year after the fracture. Poorer pre-fracture function, greater cognitive impairment, greater co-morbidity burden, poorer social support, and poorer nutrition, have been identified as predictors for diminished post-fracture recovery.

Psychological resilience was measured through a questionnaire provided at the start of the study, and they assessed walking capacity at the start as well as 16 weeks later.

“We believe these results support opportunities to improve walking capacity following hip fracture in older adults by devising multicomponent interventions combining targeted exercise with psychological resilience-enhancing programmes,” said corresponding author Richard H. Fortinsky, PhD, of the University of Connecticut School of Medicine and the UConn Center of Aging.

Source: Wiley

Categories : Injury & TraumaTags :

Neural Plastic Changes can Help in Cervical Spinal Cord Injuries

On By ModernMedia
MRI images of the brain
Photo by Anna Shvets on Pexels

By studying damage involving the connection between the brain’s hemispheres, researchers are finding new ways to leverage neural plasticity to promote functional recovery after a spinal cord injury.

In a study published in JCI Insight, the team of researchers used models in the lab to investigate a unilateral spinal cord injury similar to Brown-Sequard Syndrome, a rare neurological condition where damage to the spinal cord in a person results in weakness or paralysis on one side of the body and a loss of sensation on the opposite side.

Assistant Professor Wei Wu at Indiana University School of Medicine, said that the spinal cord injury model damaged the connection between the left hemisphere of the brain and the right side of the body, leading to significant loss of function in the right forelimb.

“The skilled function of upper limbs is very important for the quality of life in the patients with cervical spinal cord injury, but such functional recovery is very difficult to achieve in the severe injury,” said Asst Prof Wu, first author of the paper. “We found that the intact corticospinal system in the opposite side of the brain and spinal cord can be modulated to at least partially take over the control of the forelimb that is damaged by the spinal cord injury, resulting in a forelimb functional improvement.”

Since each hemisphere controls the opposite side of the body, researchers discovered a spontaneous shift of the neural circuits after injury from the left hemisphere to the right. Although there are connections between the right hemisphere of the brain and the right side of the body through some relayed pathways after injury, Asst Prof Wu said that’s not sufficient to support the motor recovery.

Using optogenetics to stimulate the right hemisphere of the brain, the researchers modulated the motor cortex. Additional neural circuits were shifted from the left side to the right side of the brain to dramatically increase and improve forelimb function.

“New circuits in the whisker, jaw forelimb and neck areas in the right hemisphere of the brain are recruited to control the right forelimb,” Asst Prof Wu said. “Interestingly, the beneficial neural plastic changes emerge both in the brain and the distal spinal cord after the optogenetic neuromodulation was applied on the motor cortex.”

Asst Prof Wu said results of the study showed significant improvement to the forelimb; however, there are still many challenges ahead, since complete digital recovery was not achieved.

The research team will continue explore this transhemispheric neural reorganisation to further improve the functional recovery after the spinal cord injury, Asst Prof Wu said. He hopes that these findings will be applied to treatments for spinal cord injuries.

Source: Indiana University School of Medicine