Temporal Considerations in Brain Metastases Radiation Therapy: The Intersection of Chronobiology and Patient Profiles.

The circadian system, a vital temporal regulator influencing physiological processes, has implications for cancer development and treatment response. Our study assessed circadian timing's impact on whole-brain radiotherapy outcomes in brain metastases for personalized cancer therapy insights. The aim of the study was to evaluate circadian influence on radiation treatment timing and its correlation with clinical outcomes and to identify patient populations benefiting from interventions synchronizing circadian rhythms, considering subgroup differences and potential disparities. An IRB-approved retrospective analysis of 237 patients undergoing whole-brain radiotherapy for brain metastases (2017-2021), receiving over 80% of treatments in the morning or afternoon, was performed. Survival analyses utilized Kaplan-Meier curves. This was a single-institution study involving patients receiving whole-brain radiotherapy. Demographic, disease, and socioeconomic parameters from electronic medical records were collected. Morning treatment (n = 158) showed a trend toward improved overall survival vs. afternoon (n = 79); the median survival was 158 vs. 79 days (p = 0.20, HR = 0.84, CI95% 0.84-0.91). Subgroup benefits for morning treatment in females (p = 0.04) and trends in controlled primary disease (p = 0.11) and breast cancer metastases (p = 0.08) were observed. Black patients exhibited diminished circadian influence. The present study emphasized chronobiological factors' relevance in brain metastases radiation therapy. Morning treatment correlated with improved survival, particularly in specific subgroups. Potential circadian influence disparities were identified, laying a foundation for personalized cancer therapy and interventions synchronizing circadian rhythms for enhanced treatment efficacy.

Physician Perceptions on Cancer Screening for LGBTQ+ Patients.

The LGBTQ+ community experiences cancer disparities due to increased risk factors and lower screening rates, attributable to health literacy gaps and systemic barriers. We sought to understand the experiences, perceptions, and knowledge base of healthcare providers regarding cancer screening for LGBTQ+ patients. A 20-item IRB-approved survey was distributed to physicians through professional organizations. The survey assessed experiences and education regarding the LGBTQ+ community and perceptions of patient concerns with different cancer screenings on a 5-point Likert scale. Complete responses were collected from 355 providers. Only 100 (28%) reported past LGBTQ+-related training and were more likely to be female (p = 0.020), have under ten years of practice (p = 0.014), or practice family/internal medicine (p < 0.001). Most (85%) recognized that LGBTQ+ subpopulations experience nuanced health issues, but only 46% confidently understood them, and 71% agreed their clinics would benefit from training. Family/internal medicine practitioners affirmed the clinical relevance of patients' sexual orientation (94%; 62% for medical/radiation oncology). Prior training affected belief in the importance of sexual orientation (p < 0.001), confidence in understanding LGBTQ+ health concerns (p < 0.001), and willingness to be listed as "LGBTQ+-friendly" (p = 0.005). Our study suggests that despite a paucity of formal training, most providers acknowledge that LGBTQ+ patients have unique health needs. Respondents had a lack of consensus regarding cancer screenings for lesbian and transgender patients, indicating the need for clearer screening standards for LGBTQ+ subpopulations and educational programs for providers.

Bellagio II Report: Terrestrial Applications of Space Medicine Research.

AbstractINTRODUCTION: For over 50 yr, investigators have studied the physiological adaptations of the human system during short- and long-duration spaceflight exposures. Much of the knowledge gained in developing health countermeasures for astronauts onboard the International Space Station demonstrate terrestrial applications. To date, a systematic process for translating these space applications to terrestrial human health has yet to be defined.METHODS: In the summer of 2017, a team of 38 international scientists launched the Bellagio ll Summit Initiative. The goals of the Summit were: 1) To identify space medicine findings and countermeasures with highest probability for future terrestrial applications; and 2) To develop a roadmap for translation of these countermeasures to future terrestrial application. The team reviewed public domain literature, NASA databases, and evidence books within the framework of the five-stage National Institutes of Health (NIH) translation science model, and the NASA two-stage translation model. Teams then analyzed and discussed interdisciplinary findings to determine the most significant evidence-based countermeasures sufficiently developed for terrestrial application.RESULTS: Teams identified published human spaceflight research and applied translational science models to define mature products for terrestrial clinical practice.CONCLUSIONS: The Bellagio ll Summit identified a snapshot of space medicine research and mature science with the highest probability of translation and developed a Roadmap of terrestrial application from space medicine-derived countermeasures. These evidence-based findings can provide guidance regarding the terrestrial applications of best practices, countermeasures, and clinical protocols currently used in spaceflight.Sides MB, Johnston SL III, Sirek A, Lee PH, Blue RS, Antonsen EL, Basner M, Douglas GL, Epstein A, Flynn-Evans EE, Gallagher MB, Hayes J, Lee SMC, Lockley SW, Monseur B, Nelson NG, Sargsyan A, Smith SM, Stenger MB, Stepanek J, Zwart SR; Bellagio II Team. Bellagio II report: terrestrial applications of space medicine research. Aerosp Med Hum Perform. 2021; 92(8):650669.

Implementing Culinary Medicine Training: Collaboratively Learning the Way Forward.

There is a documented substantial gap between the level of nutrition education for medical trainees and the need to provide nutrition counseling. Culinary medicine offers a solution, but there are multiple barriers and no guides to implementation. This article identifies core components and strategies to overcome barriers on the basis of experiences of multiple institutions. The outline forms a foundation to be built upon by future collaborators to empower more widespread implementation of culinary medicine education and improve medical nutrition education and ultimately, patient outcomes.

Epidemiology of skateboarding-related injuries sustained by children and adolescents 5-19 years of age and treated in US emergency departments: 1990 through 2008.

BACKGROUND: The goal was to examine the patterns and trends of skateboarding-related injuries sustained by children and adolescents in the United States. METHODS: A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System for children and adolescents 5-19 years of age treated in emergency departments for injuries associated with skateboards from 1990 through 2008. RESULTS: An estimated 1 226 868 children/adolescents (95 % CI: 948 733-1 505 003) were treated in emergency departments for skateboarding-related injuries from 1990 through 2008, an average of 64,572 cases per year. From 1990 through 1994, the annual rate of injuries per 10,000 children/adolescents significantly decreased overall and for males (overall: 72.9 %, P = 0.014; males: 73.9 %, P = 0.011; females: 63.6 %, P = 0.062). From 1994 to 2008, annual rates of injuries per 10,000 children/adolescents significantly increased overall and for both males and females (overall: 378.9 %, P < 0.001; males: 393.4 %, P < 0.001; females: 283.3 % P < 0.001). From 1990 to 1994 the annual rate of injuries per 10,000 children/adolescents significantly decreased for all age groups (5-10 years: 69.9 %, P = 0.043; 11-14 years: 80.6 %, P = 0.017; 15-19 years: 64.2 %, P = 0.024), and then significantly increased from 1994 to 2008 (5-10 years: 164.5 %, P < 0.001; 11-14 years: 587.0 %, P < 0.001; 15-19 years: 407.9 %, P < 0.001). Most patients were male (89.0 %), injured at home (37.3 %) or in the street and/or highway (29.3 %), and were not hospitalized (96.9 %). Patients 11-14 years of age constituted 44.9 % of cases. The most commonly injured body regions were the upper (44.1 %) and lower (31.7 %) extremities. Fractures and dislocations were the most common diagnoses (32.1 %). Children/adolescents 11-14 years of age were hospitalized more often than younger or older children/adolescents. Lower extremity injuries increased with age, while face and head or neck injuries decreased with age. CONCLUSIONS: Skateboarding continues to be an important source of injury for children and adolescents. Further research, using more rigorous study designs, is required develop a broad perspective of the incidence and determinants of injury, and to further identify risk factors and viable injury countermeasures while simultaneously promoting participation in skateboarding.

Dance-related injuries in children and adolescents treated in US emergency departments in 1991-2007.

BACKGROUND: Dancing is one of the most physically strenuous activities on the musculoskeletal system. As other literature has previously described, the types, sites, and rates of dance-related injuries are similar to those suffered by athletes in traditional sports. METHODS: A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System from 1991-2007. Sample weights were used to calculate national estimates of dance-related injuries. Trend significance of the numbers and age-adjusted rates of dance-related injuries over time was analyzed using linear regression. RESULTS: An estimated 113,084 children and adolescents 3-19 years of age were treated in US emergency departments for dance-related injuries. Classical dance (ballet, jazz, tap, modern) accounted for 55.0% of dance-related injuries. Adolescents 15-19 years of age constituted 40.4% of the dance-related injury cases. The majority of injuries (58.1%) occurred to the lower extremities. Sprains or strains were the most common injury (52.4%) and falls were the most common mechanism of injury (44.8%). CONCLUSIONS: Dance-related injuries have distinct injury patterns and mechanisms of injury. Injury patterns differ by types of dance and by age. Further research is needed to identify injury prevention strategies specific to these age groups.

Water tubing-related injuries treated in US emergency departments, 1991-2009.

BACKGROUND: The objective was to describe the patterns and mechanisms of water tubing-related injuries treated in U.S. emergency departments. METHODS: The National Electronic Injury Surveillance System was used to examine cases of water tubing-related injuries. Sample weights were used to calculate national estimates of water tubing-related injuries. Analyses were conducted in 2010. RESULTS: From 1991-2009 an estimated 69,471 injuries were treated in US emergency departments for water tubing-related injuries. The annual number of cases increased 250% over the 19-year study period (P < .001). Sprains and strains accounted for the largest portion of injuries (27.2%). The head was the most frequently injured body part (27.5%). Children and adolescents ≤ 19 years were more likely to be injured by contact with another person (OR: 2.47; 95% CI = 1.61-3.80) and were more likely to sustain injuries to the head (OR: 2.61; 95% CI = 2.01-3.38) compared with adults. Adults ≥ 20 years, were more likely than individuals ≤ 19 years to sustain sprains and strains (OR: 2.11; 95% CI = 1.64-2.71) and were most commonly injured by impact with the water (54.6%). CONCLUSIONS: Patterns of water tubing-related injuries differ for children and adults. Research is needed to determine how best to reduce these injuries.

Track-related injuries in children and adolescents treated in US emergency departments from 1991 through 2008.

BACKGROUND: Track is a popular sport among children and adolescents. Track participants have a high rate of injury, often from overuse. PURPOSE: To determine national patterns of track-related injuries among children and adolescents aged 10 to 18 years treated in US emergency departments. STUDY DESIGN: Descriptive epidemiologic study. METHODS: A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients aged 10 to 18 years from 1991 through 2008. Sample weights were used to calculate national estimates of track-related injuries based on 4496 actual cases. Bivariate comparisons between categorical variables were assessed with odds ratios and 95% CIs. Trend significance of the numbers and rates of track-related injuries over time was analyzed using linear regression. RESULTS: From 1991 through 2008, an estimated 159 663 patients aged 10 to 18 years were treated for track-related injuries in US emergency departments, with an average of 8870 cases per year. The overall number of cases increased 36.3%, from 7702 injuries in 1991 to 10 496 injuries in 2008 (P = 0.039). Boys were more likely to sustain pelvic injuries and girls were more likely to sustain ankle injuries. Body parts injured varied by the specific track activity or event performed; hurdling was more likely to result in an injury to the upper extremities and to the head, whereas sprinting was more likely to result in an injury to the pelvis or upper leg. CONCLUSION: There are several age-, sex-, and activity-specific patterns of track-related injuries. Given the increased participation and corresponding increase in track-related injuries, more research is needed to determine how best to prevent these injuries.

Running-related injuries in school-age children and adolescents treated in emergency departments from 1994 through 2007.

Running for exercise is a popular way to motivate children to be physically active. Running-related injuries are well studied in adults but little information exists for children and adolescents. Through use of the National Electronic Injury Surveillance System database, cases of running-related injuries were selected by using activity codes for exercise (which included running and jogging). Sample weights were used to calculate national estimates. An estimated 225 344 children and adolescents 6 to 18 years old were treated in US emergency departments for running-related injuries. The annual number of cases increased by 34.0% over the study period. One third of the injuries involved a running-related fall and more than one half of the injuries occurred at school. The majority of injuries occurred to the lower extremities and resulted in a sprain or strain. These findings emphasize the need for scientific evidence-based guidelines for pediatric running. The high proportion of running-related falls warrants further research.

Exertional heat-related injuries treated in emergency departments in the U.S., 1997-2006.

BACKGROUND: Exertional heat-related injuries are a risk to all physically active individuals in warm or hot environments. Unlike classic heat-related injury, exertional heat-related injuries do not require extreme ambient temperatures to cause injury. Still, exertional heat-related injuries, including heat cramps, heat syncope, heat exhaustion, heat stress, and heat stroke, can result in injuries causing a range of outcomes from minimal discomfort to death. PURPOSE: The purpose of this paper was to describe the epidemiology of exertional heat-related injuries treated in U.S. emergency departments. METHODS: A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission for all ages from 1997 through 2006. Data provided by the National Electronic Injury Surveillance System were used to calculate national estimates of exertional heat-related injuries. Trends of exertional heat-related injuries over time were analyzed using linear regression. RESULTS: Nationally, an estimated 54,983 (95% CI=39995, 69970) patients were treated in U.S. emergency departments for exertional heat-related injuries from 1997 to 2006. The number of exertional heat-related injuries increased significantly from 3192 in 1997 to 7452 in 2006 (p=0.002), representing a 133.5% increase. The overall exertional heat-related injury rate per 100,000 U.S. population more than doubled from 1.2 in 1997 to 2.5 in 2006 (p=0.005). Patients aged ≤19 years accounted for the largest proportion of exertional heat-related injuries (47.6%). The majority of exertional heat-related injuries were associated with performing a sport or exercising (75.5%) and yard work (11.0%). The majority of patients (90.4%) were treated and released from the emergency department. Patients aged ≤19 years sustained a larger proportion of sports and recreation exertional heat-related injuries, whereas patients aged 40-59 years and ≥60 years sustained a larger proportion of exertional heat-related injuries from yard work. CONCLUSIONS: This study confirms that although there is a risk of exertional heat-related injury among all physically active individuals, sports pose a specific risk for people of all ages especially among children and adolescents playing football. Many "everyday" activities such as yard work and home maintenance also pose risks of exertional heat-related injury, particularly to those aged ≥40 years. Further research on risk factors of exertional heat-related injuries during home maintenance and yard work as well as appropriate prevention practices is needed.

Mountain biking-related injuries treated in emergency departments in the United States, 1994-2007.

BACKGROUND: Injury research on mountain biking has been mostly limited to examining professional riders and off-road biking. Mountain bikes represent the largest segment of bike sales in the United States. Recreational mountain bike use is popular and understudied. PURPOSE: To describe the scope, distribution, and trends of mountain bike-related injuries treated in US emergency departments. STUDY DESIGN: Descriptive epidemiologic study. METHODS: A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients aged ≥ 8 years from 1994 through 2007. Sample weights provided by the system were used to calculate national estimates of mountain bike-related injuries based on 4624 cases. Bivariate comparisons between categorical variables were assessed with injury proportion ratios and 95% confidence intervals. RESULTS: Nationwide, an estimated 217 433 patients were treated for mountain bike-related injuries in US emergency departments from 1994 to 2007, an average of 15 531 injuries per year. The annual number of injuries decreased 56%, from a high of 23 177 in 1995 to 10 267 in 2007 (P < .001). The most common injuries were upper extremity fractures (10.6%) and shoulder fractures (8.3%). Patients aged 14 to 19 years sustained a greater proportion of traumatic brain injuries (8.4%) than did patients aged 8 to 13 years and ≥ 20 years combined (4.3%). A greater proportion of female riders (6.1%) than male riders (4.5%) were hospitalized. CONCLUSION: Mountain bike-related injuries decreased from 1994 to 2007. Upper extremity fractures were the most common injury. Girls and women may be more likely than boys and men to sustain more severe injuries requiring hospitalization. Despite the decline over the past decade, more can be done to improve safety and reduce injuries in this popular recreational activity.

Football-related injuries among 6- to 17-year-olds treated in US emergency departments, 1990-2007.

Football is one of the most popular youth sports in the United States despite the high rate of injuries. Previously published studies have investigated football-related injuries that occurred in organized play but have excluded those that occurred during unorganized play. Through use of the National Electronic Injury Surveillance System database, cases of football-related injuries were identified for analysis. Sample weights were used to calculate national estimates. An estimated 5 252 721 children and adolescents 6 to 17 years old were treated in US emergency departments for football-related injuries. The annual number of cases increased by 26.5% over the 18-year study period. The 12- to 17-year-old age group accounted for 77.8% of all injuries and had nearly twice the odds of sustaining a concussion. The findings suggest the need for increased prevention efforts to lower the risk of football-related injury in children and adolescents.

Basketball-related injuries in school-aged children and adolescents in 1997-2007.

OBJECTIVE: The objective was to determine national patterns of basketball-related injuries treated in emergency departments in the United States among children and adolescents <20 years of age. METHODS: A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission, from 1997 to 2007. Sample weights provided by the Consumer Product Safety Commission were used to calculate national estimates of basketball-related injuries. Trend significance of the numbers and rates of basketball-related injuries over time was analyzed by using linear regression. RESULTS: An estimated 4 128 852 pediatric basketball-related injuries were treated in emergency departments. Although the total number of injuries decreased during the study period, the number of traumatic brain injuries (TBIs) increased by 70%. The most common injury was a strain or sprain to the lower extremities (30.3%), especially the ankle (23.8%). Boys were more likely to sustain lacerations and fractures or dislocations. Girls were more likely to sustain TBIs and to injure the knee. Older children (15-19 years of age) were 3 times more likely to injure the lower extremities. Younger children (5-10 years of age) were more likely to injure the upper extremities and to sustain TBIs and fractures or dislocations. CONCLUSIONS: Although the total number of basketball-related injuries decreased during the 11-year study period, the large number of injuries in this popular sport is cause for concern.

Household cleaning product-related injuries treated in US emergency departments in 1990-2006.

OBJECTIVE: The goal was to examine comprehensively the patterns and trends of household cleaning product-related injuries among children treated in US emergency departments. METHODS: Through use of the National Electronic Injury Surveillance System database, cases of unintentional, nonfatal, household cleaning product-related injuries were selected by using product codes for drain cleaners, ammonia, metal polishes/tarnish removers, turpentine, dishwasher detergents, acids, swimming pool chemicals, oven cleaners, pine oil cleaners/disinfectants, laundry soaps/detergents, toilet bowl products, abrasive cleaners, general-purpose household cleaners, noncosmetic bleaches, windshield wiper fluids, caustic agents, lye, wallpaper cleaners, room deodorizers/fresheners, spot removers, and dishwashing liquids. Products were categorized according to major toxic ingredients, mode of action, and exposure. RESULTS: An estimated 267 269 children

Pediatric and adolescent sledding-related injuries treated in US emergency departments in 1997-2007.

OBJECTIVES: The objectives were to examine comprehensively the patterns and to estimate the rates of sledding-related injuries among children and adolescents treated in US emergency departments between 1997 and 2007. METHODS: Through the use of the National Electronic Injury Surveillance System database, cases of sledding-related injuries were selected by using diagnosis codes for sleds. Sample weights were used to calculate national estimates. US Census Bureau data were used to calculate injury rates per 100,000 individuals

Pediatric mobility aid-related injuries treated in US emergency departments from 1991 to 2008.

OBJECTIVES: Although mobility aids such as crutches, walkers, and wheelchairs are typically beneficial, they can be associated with injury. The objective of this study was to describe the incidence, patterns, and trends of pediatric mobility aid-related injuries to children and adolescents who were aged < or = 19 years and treated in US emergency departments between 1991 and 2008. METHODS: A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System database for children and adolescents who were aged < or = 19 years. Sample weights were used to calculate national estimates of mobility aid-related injuries on the basis of 2301 actual cases. RESULTS: An estimated 63 309 cases of children and adolescents who were aged < or = 19 years were treated in US emergency departments for mobility aid-related injuries. Approximately 70% of mobility aid- related injuries occurred while patients were using wheelchairs. Children who were aged 2 to 10 years were more likely to sustain injuries while using walkers and wheelchairs, injure their heads, and sustain traumatic brain injuries. Children who were aged 11 to 19 years were more likely to sustain injuries while using crutches, injure their lower extremities, and sustain sprains and strains. Injuries involving wheelchairs were more likely to be traumatic brain injuries and result in hospitalization. Injuries involving crutches were more likely to involve misuse and be triggered by stairs or curbs. CONCLUSIONS: Injuries related to crutches, walkers, and wheelchairs have distinct injury patterns, mechanisms of injury, and trigger factors. Injury patterns between younger and older children were different. Additional research is needed to identify effective injury prevention strategies for the pediatric population.

Hot tub, whirlpool, and spa-related injuries in the U.S., 1990-2007.

BACKGROUND: Recreational use of hot tubs, whirlpools, and spas has increased within the past 3 decades. Injuries due to hot tubs, whirlpools, and spas can affect people of all ages and can result in serious disabilities. PURPOSE: This study examines nonfatal hot tub, whirlpool, and spa-related injuries on a national level. METHODS: The National Electronic Injury Surveillance System database was used to examine cases of nonfatal hot tub, whirlpool, and spa-related injuries treated in U.S. emergency departments from January 1, 1990, through December 31, 2007. Analysis was conducted from November 2008 to March 2009. RESULTS: An estimated 81,597 patients, aged <1-102 years, were treated in U.S. emergency departments for hot tub, whirlpool, and spa-related injuries, with the number increasing 160% over the 18-year study period (p<0.001). Nearly 73% of injuries occurred in patients aged >or=17 years. Lacerations were the most common diagnosis (27.8%) and accounted for 58% of all head injuries. Slips and falls were the most common mechanism of injury (47.6%); were more likely to result in an injury to the trunk than other body parts (OR=2.49, 95% CI=1.83, 3.39); and were more likely to result in concussions and fractures/dislocations than any other diagnosis (OR=7.813, 95% CI=2.194, 27.823 and OR=3.017, 95% CI=2.057, 4.425, respectively). CONCLUSIONS: Given the increase in hot tub, whirlpool, and spa ownership and the 160% increase in injuries during the study period, more research is needed to identify the cause of the increase in hot tub, whirlpool, and spa-related injuries and what injury-prevention solutions and policies may be appropriate.

Pediatric burn injuries treated in US emergency departments between 1990 and 2006.

OBJECTIVE: The goal was to examine comprehensively the patterns and trends of burn-related injuries in children, adolescents, and young adults treated in US emergency departments between 1990 and 2006. METHODS: Through use of the National Electronic Injury Surveillance System database, cases of nonfatal burn-related injuries were selected by using diagnosis codes for burns (scalds, thermal, chemical, radiation, electrical, and not specified). Sample weights were used to calculate national estimates. US Census Bureau data were used to calculate injury rates per 10000 individuals

Rock climbing injuries treated in emergency departments in the U.S., 1990-2007.

BACKGROUND: Rock climbing is an increasingly popular sport in the U.S., with approximately nine million participants annually. The sport holds an inherent risk of falls and stress-related injuries. As indoor climbing facilities become more common, more people are participating in the sport. PURPOSE: The objective of this study is to describe the prevalence, characteristics, and trends of rock climbing-related injuries treated in U.S. emergency departments from 1990 through 2007. METHODS: A retrospective analysis was conducted using data from the National Electronic Injury Surveillance System (NEISS) of the U.S. Consumer Product Safety Commission for all ages from 1990 through 2007. Sample weights provided by NEISS were used to calculate national estimates of rock climbing-related injuries. Trend significance of the number of rock climbing-related injuries over time was analyzed using linear regression. Analysis was conducted in 2008. RESULTS: An estimated 40,282 patients were treated in emergency departments for rock climbing-related injuries in the U.S. over the 18-year period. Patients aged 20-39 years accounted for more than half of all injuries. Fractures, sprains, and strains accounted for the largest portion of injuries (29.0% and 28.6%, respectively). The lower extremities were the most frequently injured body part, accounting for 46.3% of all injuries; ankle injuries accounted for 19.2%. Men were more likely to sustain lacerations (OR=1.65; 95% CI=1.03, 2.67) and fractures (OR=1.54; 95% CI=1.10, 2.17), whereas women were more likely to sustain a sprain or strain (OR=1.68; 95% CI=1.13, 2.51). Overexertion injuries were more likely to occur to the upper extremities (OR=5.32; 95% CI=1.99, 14.23). Falls were responsible for three quarters of all injuries (77.5%). Overall, 11.3% of patients were hospitalized. CONCLUSIONS: Our results indicate that the most common rock climbing-related injuries are to the lower extremities and are fractures, sprains, and strains. More research is needed to determine how rock-climbers' characteristics, climbing setting, style of climbing, and use of safety equipment and training may affect their risk for certain injury patterns.

Physical education class injuries treated in emergency departments in the US in 1997-2007.

OBJECTIVE: The goal was to describe the epidemiological features of physical education (PE)-related injuries treated in US emergency departments. METHODS: A retrospective analysis was conducted with data for children and adolescents (5-18 years of age) from the National Electronic Injury Surveillance Study of the US Consumer Product Safety Commission, from 1997 through 2007. Sample weights provided by the National Electronic Injury Surveillance System were used to calculate national estimates of PE-related injuries. Trend significance of the number of PE-related injuries over time was analyzed by using linear regression analysis. RESULTS: An estimated 405305 children and adolescents were treated in emergency departments for PE-related injuries. The annual number of cases increased 150% during the study period (P = .001). Nearly 70% of PE-related injuries occurred during 6 activities, that is, running, basketball, football, volleyball, soccer, and gymnastics. Boys' injuries were more likely to involve the head, to be diagnosed as a laceration or fracture, to be attributable to contact with a person or structure, and to occur during group activities. Girls' injuries were more likely to involve the lower extremities, to be strains and sprains, to be acute noncontact injuries, and to occur during individual activities. CONCLUSION: More research is needed to identify the cause of the increase in PE-related injuries, to examine the gender difference in PE-related injuries, and to determine appropriate injury prevention solutions and policies.