Effect of mouthguards on dental injuries and concussions in college basketball.

PURPOSE: Dental injuries can be permanent and disfiguring. They are also universally expensive to treat. Many dentists, sports physicians, and athletic trainers recommend mouthguards for athletes participating in certain competitive sports, including men's college basketball, because of a common perception that mouthguards afford protection from dental injuries, and even some concussions. However, there are few reliable reports of the incidence of dental injuries and concussions in men's college basketball, and good evidence that mouthguards reduce the risk of these injuries in this population of athletes is notably lacking. This study prospectively recorded dental injuries and concussions among 50 men's Division I college basketball teams during one competitive season, then compared injury rates between mouthguard users and nonusers. METHODS: During the 1999 to 2000 basketball season, athletic trainers from 50 men's Division I college basketball programs used an Internet Web site to submit weekly reports of the number of athlete exposures, mouthguard users, concussions, oral soft tissue injuries, dental injuries, and dentist referrals. RESULTS: Response rate was 86%. There were 70,936 athlete exposures. Athletes using custom-fitted mouthguards accounted for 8663 exposures. Injury rates were expressed as number of injuries per 1000 athlete exposures. There were no significant differences between mouthguard users and nonusers in rates of concussions (0.35 vs 0.55) or oral soft tissue injuries (0.69 vs 1.06). Mouthguard users had significantly lower rates of dental injuries (0.12 vs 0.67; P < 0.05) and dentist referrals (0.00 vs 0.72; P < 0.05) than nonusers. CONCLUSION: Custom-fitted mouthguards do not significantly affect rates of concussions or oral soft tissue injuries, but can significantly reduce the morbidity and expense resulting from dental injuries in men's Division I college basketball.

Physiological effects of exercise on the cardiopulmonary system.

The cardiopulmonary adaptations made to dynamic and static exercise show the amazing ability of the human body to alter physiological processes in order to meet metabolic demands. A remarkable partnership that allows individuals to maximize their abilities and obtain goals exists between the cardiovascular and pulmonary systems. The adaptations of the cardiopulmonary system depend heavily on the intensity, duration, frequency, and type of exercise being performed. Although most of this article examined dynamic and static exercise separately, the majority of individuals train using a combination of these two modes. The overall adaptations will vary with the chosen degree of each exercise mode. An appropriate exercise program allows for improvements in the cardiopulmonary system that help develop and maintain fitness levels.

Exercise considerations in coronary artery disease, peripheral vascular disease, and diabetes mellitus.

Physical inactivity is a risk factor for cardiovascular disease. Regular aerobic and resistance training increases exercise capacity and plays a role both in the primary and secondary prevention of cardiovascular disease. Patients with coronary artery disease, peripheral vascular disease, or diabetes mellitus must be considered individually when prescribing exercise because their clinical status can vary greatly. In addition, a majority of these patients have multiple comorbid disorders such as renal, neurologic, and retinal disease that may affect their ability to exercise safely. Therefore, a preparticipation medical evaluation is required. An exercise prescription should be tailored to each person's unique set of circumstances and reflect an effort to maximize the anticipated benefits while minimizing the risks.

Effects of seawater acidification on cell cycle control mechanisms in Strongylocentrotus purpuratus embryos.

Previous studies have shown fertilization and development of marine species can be significantly inhibited when the pH of sea water is artificially lowered. Little mechanistic understanding of these effects exists to date, but previous work has linked developmental inhibition to reduced cleavage rates in embryos. To explore this further, we tested whether common cell cycle checkpoints were involved using three cellular biomarkers of cell cycle progression: (1) the onset of DNA synthesis, (2) production of a mitotic regulator, cyclin B, and (3) formation of the mitotic spindle. We grew embryos of the purple sea urchin, Strongylocentrotus purpuratus, in seawater artifically buffered to a pH of ∼7.0, 7.5, and 8.0 by CO(2) infusion. Our results suggest the reduced rates of mitotic cleavage are likely unrelated to common cell cycle checkpoints. We found no significant differences in the three biomarkers assessed between pH treatments, indicating the embryos progress through the G(1)/S, G(2)/M and metaphase/anaphase transitions at relatively similar rates. These data suggest low pH environments may not impact developmental programs directly, but may act through secondary mechanisms such as cellular energetics.

Survival in nuclear waste, extreme resistance, and potential applications gleaned from the genome sequence of Kineococcus radiotolerans SRS30216.

Kineococcus radiotolerans SRS30216 was isolated from a high-level radioactive environment at the Savannah River Site (SRS) and exhibits gamma-radiation resistance approaching that of Deinococcus radiodurans. The genome was sequenced by the U.S. Department of Energy's Joint Genome Institute which suggested the existence of three replicons, a 4.76 Mb linear chromosome, a 0.18 Mb linear plasmid, and a 12.92 Kb circular plasmid. Southern hybridization confirmed that the chromosome is linear. The K. radiotolerans genome sequence was examined to learn about the physiology of the organism with regard to ionizing radiation resistance, the potential for bioremediation of nuclear waste, and the dimorphic life cycle. K. radiotolerans may have a unique genetic toolbox for radiation protection as it lacks many of the genes known to confer radiation resistance in D. radiodurans. Additionally, genes involved in the detoxification of reactive oxygen species and the excision repair pathway are overrepresented. K. radiotolerans appears to lack degradation pathways for pervasive soil and groundwater pollutants. However, it can respire on two organic acids found in SRS high-level nuclear waste, formate and oxalate, which promote the survival of cells during prolonged periods of starvation. The dimorphic life cycle involves the production of motile zoospores. The flagellar biosynthesis genes are located on a motility island, though its regulation could not be fully discerned. These results highlight the remarkable ability of K radiotolerans to withstand environmental extremes and suggest that in situ bioremediation of organic complexants from high level radioactive waste may be feasible.

Back injuries in the pediatric athlete.

Pediatric and adolescent athletes presenting with back pain are much more likely to have a pathologic cause for their symptoms than are adult patients. For this reason, it is important for those caring for younger athletes to maintain a high index of suspicion for some of the more common pathologic causes of back pain in this population. Diagnostic evaluation should be undertaken more quickly in pediatric and adolescent athletes. Sports-related diagnoses that must be considered include disc-related back pain, atypical Scheuermann's kyphosis, spondylolysis, and spondylolisthesis. Patients of this age may also present with conditions not associated with activity, including discitis, classic Scheuermann's disease, rheumatologic disease, and spinal tumors. History and physical exam provide valuable information to help guide further diagnostic studies which, in turn, will determine necessary treatment. No definitive studies are available regarding the diagnosis and treatment of spondylolysis and spondylolisthesis. Health professionals need to consider the expertise of a local radiologist when deciding upon diagnostic imaging procedures. The athlete's age and sport played can contribute to the appropriate treatment plan.

Eye injuries in women's lacrosse players.

OBJECTIVE: To determine the prevalence of eye injuries among intercollegiate women's lacrosse players as well as the level of play, specific play settings, and particular mechanisms associated with these injuries. DESIGN: Anonymous, retrospective, survey. SETTING: Intercollegiate lacrosse tournament. PARTICIPANTS: Collegiate and postcollegiate women's lacrosse players. MAIN OUTCOME MEASURES: Self-reports of eye injuries, injury circumstances, treatment received, playing time missed, and continuing problems were recorded. RESULTS: Surveys were collected from 667 players from 34 teams (83% of players listed on rosters). A total of 125 injuries were reported among 84 players (12.6%). Injuries occurred equally in high school and college. Athletes were injured most frequently in games (41 injuries) and practices (38 injuries), with 17 players injured during the off-season. Several mechanisms of injury were noted. Fifty-three women sustained injuries requiring medical attention. Of those athletes injured, 23 missed 1-5 days and 9 players missed more than 5 days. Four athletes (4.8%) reported residual problems from an eye injury sustained while playing lacrosse. CONCLUSIONS: Eye injuries are occurring more frequently than current surveillance data suggest. Because injuries are seen at all levels of play, in many different situations, and by multiple mechanisms, mandatory eyewear is needed to prevent serious eye injuries in women's lacrosse.

Comparison of reporting systems to determine concussion incidence in NCAA Division I collegiate football.

OBJECTIVE: To determine the incidence of concussion during the 2001 Division I-A college football season through utilization of the Internet. DESIGN: Prospective Internet survey. SETTING: Internet Web site. PARTICIPANTS: Head athletic trainers from Division I-A collegiate football programs. MAIN OUTCOME MEASURES: During the 2001-2002 football season, head athletic trainers from 87 Division I-A football programs agreed to use an Internet Web site to submit weekly data on the number of athlete exposures and concussions. RESULTS: A total of 373 concussions were reported over the course of a season in both practices and games combined. Of these concussions, 256 (68.6%) occurred during games, and 117 (31.4%) occurred during practice. The injury rate per 1,000 athletic exposures was 5.56 in games and 0.25 in practices. There were 230 grade 1 (61.7%), 134 grade 2 (35.9%), and 9 grade 3 (2.4%) concussions reported. There was a significant (p < 0.01) difference found between the total concussion injury rate and game concussion injury rate when comparing the Internet and the NCAA injury data collection methods. CONCLUSIONS: The results of this study suggest an underreporting of concussions using the NCAA Injury Surveillance System and demonstrate that the Internet is a simple and effective tool for data collection.