Knowledge and Attitudes Towards Fluid Hydration of Athletes by Jamaican Track and Field High-school Coaches

ABSTRACT Objective: To determine whether or not Jamaican coaches' knowledge and practices of fluid replacement are on par with that of the National Athletic Association's and the American College of Sports Medicine Standards. Methods: A descriptive survey of 90 high-school track and field coaches in Jamaica was conducted. Coaches were given a 29-item survey questionnaire which adapted the content from previous surveys and also based on the National Athletic Trainers' Association guidelines for fluid replacement and information sources of fluid replacement. A pass score of 80% was employed. Results: Approximately 26.6% of participants passed the knowledge-based assessment with the minimum requirement of 80% and 73.4% of participants had an unacceptable level of knowledge about fluid replacement and hydration. Only 26 (28.9%) coaches received training in fluid replacement therapy. Most of them therefore relied on reading materials ranging from magazines to journals, or learnt it on the job from other coaches. Conclusion: Findings suggest that the level of knowledge in Jamaican track and field high-school coaches about fluid replacement and hydration is very poor. However, their attitudes towards fluid replacement and hydration are very good, and this will facilitate their acceptance and adoption of correct fluid replacement guidelines. Tapping into this positive attitude and implementing workshops, seminars and onsite promotion should improve the coaches' knowledge significantly.

Accuracy of Magnetic Resonance Arthrography in Detecting Rotator Cuff Tears / Precisión de la artrografía por resonancia magnética en la detección de desgarros del manguito rotador

ABSTRACT Objective: Shoulder pain, a common cause of productivity loss and health-related expense, is commonly due to rotator cuff tears. Magnetic resonance (MR) imaging with intra-articular gadolinium, MR arthrography, is accepted internationally as an excellent modality for evaluating the rotator cuff. Ultrasound is cheaper and only slightly less sensitive in detecting rotator cuff tears, but MR is superior in detecting ancillary lesions. Magnetic resonance arthrography was introduced at the University Hospital of the West Indies (UHWI), Jamaica, in July 2003. This study aimed to evaluate our experience with MR arthrography and assess its accuracy. Methods: A retrospective study was carried out. All MR arthrography cases performed at UHWI between July 2003 and July 2006 were reviewed. Medical records were reviewed to determine surgical correlation. Results: A total of 140 MR arthrograms were performed; 55% of the patients were female. Ages ranged from the second to the ninth decade, having a distribution approaching but not attaining a normal distribution (p = 0.03) with clustering in the middle years. Magnetic resonance arthrography demonstrated torn rotator cuffs in 40 patients, none of whom was under the age of 40 years (p < 0.001). Fifteen patients had surgery which confirmed torn rotator cuffs in all 15. Conclusion: Magnetic resonance arthrography was found to be accurate in detecting rotator cuff tears. It should be considered in the evaluation of patients with suspected rotator cuff tears. For patients under the age of 40 years, sonography could be used as an alternative.

RESUMEN Objetivo: El dolor en el hombro, el cual es causa común de pérdida de productividad y gastos relacionados con la salud, se debe comúnmente a desgarros del manguito rotador. La imagen por resonancia magnética (IRM) con gadolinio intra-articular - conocida como artrografía RM - se acepta internacionalmente como una excelente modalidad para evaluar el manguito rotador. El ultrasonido es más barato y sólo ligeramente menos sensible a la hora de detectar desgarros del manguito rotador, pero la RM es superior en la detección de lesiones secundarias. La artrografía por resonancia magnética se introdujo en el Hospital Universitario de West Indies (HUWI), Jamaica, en julio de 2003. Este estudio tuvo como objetivo evaluar nuestra experiencia con la artrografía RM y evaluar su precisión. Métodos: Se realizó un estudio retrospectivo. Se revisaron todos los casos de artrografías RM realizadas en HUWI entre julio de 2003 y julio de 2006. Se revisaron las historias clínicas a fin de determinar la correlación quirúrgica. Resultados: Un total de 140 artogramas RM fueron realizados. El 55% de los pacientes eran mujeres. Las edades variaron del segundo al noveno decenio, con una distribución que se acercaba pero no llevaba a alcanzar una distribución normal (p = 0.03), concentrándose en los años intermedios. La artrografía de resonancia magnética mostró desgarros de los manguitos rotadores en 40 pacientes, ninguno de los cuales tenía menos de 40 años (p < 0.001). Quince pacientes tuvieron cirugía que confirmaba desgarros de los manguitos rotadores en los 15. Conclusión: Se halló que la artrografía por resonancia magnética era exacta a la hora de detectar los desagarros del manguito rotador. Debe considerarse en la evaluación de pacientes con sospecha de desgarros del manguito rotador. Para los pacientes menores de 40 años de edad, la sonografía podría ser utilizada como alternativa.

Eryngial (trans-2-dodecenal), a bioactive compound from Eryngium foetidum: its identification, chemical isolation, characterization and comparison with ivermectin in vitro.

Methanol-water (4:1, v/v) crude extracts (50 mg mL(-1)) of 25 Jamaican medicinal plants were screened in vitro for anthelmintic activity using infective third-stage larvae of Strongyloides stercoralis. The most effective extract was further chemically scrutinized to isolate and identify the source of the bioactivity, and the efficacy of this compound was compared with ivermectin. Eosin exclusion (0.1 mg mL(-1)) served as the indicator of mortality in all bioassays. A crude extract of Eryngium foetidum (Apiaceae) was significantly (Probit Analysis, P<0.05) more potent than the other plant extracts, taking 18.9 h to kill 50% (LT50) of the larvae. Further, the petrol extract of E. foetidum was significantly more effective (Probit Analysis, P<0.05) at killing the larvae (LT50, 4.7 h) than either its methanol-water or dichloromethane extract. The latter two effected less than 1% larval mortality after 120 h. With bioassay-driven column chromatography of the petrol extract, trans-2-dodecenal (eryngial) was identified and chemically isolated as the main anthelmintic compound in E. foetidum. There was a significant difference between the 24 h LD50 values (mm) of trans-2-dodecenal (0.461) and ivermectin (2.251) but there was none between the 48 h LD50 values (mm): trans-2-dodecenal (0.411) and ivermectin (0.499) in vitro.

Injuries in elite Jamaican netballers / Heridas en los voleibolistas jamaicanos de élite

OBJECTIVES: The purpose of this study is to identify the nature, spectrum and frequency of injuries among national netballers in Jamaica. METHODS: A retrospective study utilizing a questionnaire was used to gather the necessary information among netball players over a five-year period spanning two world cups. A 31-item questionnaire on player's profile, protective equipment, site of injury and associated factors of injury was completed by a study population recruited from players who had represented Jamaica at the senior level, under 21 or under 16 age groups between 2003 and 2007. Statistical analysis was done using the SPSS version 12. RESULTS: Most of the injuries were confined to the ankle and knee, with the playing surface and poor landing technique the main reasons for the injuries. CONCLUSIONS: There are wide variations in training, players' fitness, levels of coaching and the standards of playing courts, all of which might have contributed to players' injuries.

OBJETIVOS: El propósito de este studio es identificar la natural, el espectro y la frecuencia de las heridas entre los voleibolistas nacionales de Jamaica. MÉTODOS: Por medio de un cuestionario, se realizó un estudio retrospectivo entre los jugadores de voleibol a fin de obtener la información necesaria, el cual cubrió un período de cinco años. Un cuestionario de 31 items sobre el perfil del jugador, el equipo de protección, el lugar de la herida y los factors asociados con la herida, fue respondido por una población de estudio, reclutada de jugadores que habían representado a Jamaica en la categoría de mayores, correspondiente a los grupos de menos de 21 años y menos de 16 años de edad. El análisis estadístico se realizó usando la versión 12 del SPSS. RESULTADOS: La mayoría de las heridas estuvieron confinadas al tobillo y las rodillas, siendo la superficie del terreno de juego y la pobre técnica de aterrizaje, las razones principales de las heridas. CONCLUSIONES: Existe una amplia gama de variaciones en el entrenamiento, el estar en forma (fitness), los niveles de coaching, y las normas de las canchas de juego, todas las cuales pudieron haber contribuido a que los jugadores sufrieran heridas.

Injuries in elite Jamaican netballers.

OBJECTIVES: The purpose of this study is to identify the nature, spectrum and frequency of injuries among national netballers in Jamaica. METHODS: A retrospective study utilizing a questionnaire was used to gather the necessary information among netball players over a five-year period spanning two world cups. A 31-item questionnaire on player's profile, protective equipment, site of injury and associated factors of injury was completed by a study population recruited from players who had represented Jamaica at the senior level, under 21 or under 16 age groups between 2003 and 2007. Statistical analysis was done using the SPSS version 12. RESULTS: Most of the injuries were confined to the ankle and knee, with the playing surface and poor landing technique the main reasons for the injuries. CONCLUSIONS: There are wide variations in training, players' fitness, levels of coaching and the standards of playing courts, all of which might have contributed to players' injuries.

Posterior ankle impingement in fast bowlers in cricket.

OBJECTIVE: To determine common features of posterior ankle impingement in fast bowlers in the West Indies and to compare modes of treatment with respect to return to play without pain. METHODS: Retrospective analysis of ankle impingement injuries treated in fast bowlers in the West Indies. RESULTS: Six fast bowlers had evidence of os trigonum in the front foot only. Pain was felt on forced plantar flexion and dorsiflexion on front foot landing; no pain was felt with running. Four had large os trigonum on radiographs, and one was only detectable on Magnetic Resonance (MRI) Imaging. The condition resolved in two bowlers with low workloads who had injections with steroid. The remainder had surgical excision which led to recovery. CONCLUSION: This injury is being seen increasingly in fast bowlers. Steroid injections are useful in bowlers with low workloads but surgical excision is recommended in bowlers with heavy workloads. Further investigation is required in the biomechanics of bowling to determine the cause for the increase in this condition.

Posterior ankle impingement in fast bowlers in cricket / Pinzamiento posterior del tobillo en lanzadores de críquet rápidos

OBJECTIVES: To determine common features of posterior ankle impingement in fast bowlers in the West Indies and to compare modes of treatment with respect to return to play without pain. METHODS: Retrospective analysis of ankle impingement injuries treated in fast bowlers in the West Indies. RESULTS: Six fast bowlers had evidence of os trigonum in the front foot only. Pain was felt on forced plantar flexion and dorsiflexion on front foot landing; no pain was felt with running. Four had large os trigonum on radiographs, and one was only detectable on Magnetic Resonance (MRI) Imaging. The condition resolved in two bowlers with low workloads who had injections with steroid. The remainder had surgical excision which led to recovery. CONCLUSION: This injury is being seen increasingly in fast bowlers. Steroid injections are useful in bowlers with low workloads but surgical excision is recommended in bowlers with heavy workloads. Further investigation is required in the biomechanics of bowling to determine the cause for the increase in this condition.

OBJETIVO: Determinar rasgos comunes del pinzamiento posterior del tobillo en lanzadores rápidos de West Indies, y comparar modos de tratamiento dirigidos a que puedan volver a jugar sin dolor. MÉTODO: Análisis retrospectivo del tratamiento de lesiones por pinzamiento del tobillo en lanzadores rápidos de West Indies. RESULTADOS: Seis lanzadores rápidos presentaban evidencia de os trigonum en el pie delantero solamente. Sentían dolor en la flexión plantar forzada y dorsiflexión al aterrizar con el pie delantero; no sentían ningún dolor al correr. Cuatro tenían os trigonum grandes según podía observarse en las radiografías, y un os trigonum era sólo detectable mediante imagen por resonancia magnética (IRM). La condición se resolvió en dos lanzadores con baja carga de trabajo, que recibieron inyecciones de esteroides. El resto recibió una escisión quirúrgica que condujo finalmente a la recuperación. CONCLUSIÓN: Este tipo de lesión viene observándose cada vez más en lanzadores rápidos. Las inyecciones de esteroide son útiles en lanzadores con baja carga de trabajo, pero en el caso de aquellos con alta carga de trabajo, se recomienda la escisión quirúrgica. Se requiere más investigación de la biomecánica del lanzamiento en el críquet a fin de determinar la causa del aumento de esta condición.

Bilateral psoas abscesses and vertebral osteomyelitis in a patient with sickle cell disease.

The authors present a case of a patient with sickle-ß thalassaemia (Sß(0) Thal) who had bilateral psoas abscesses on a background of splenectomy in early childhood. The patient also turned out to have vertebral osteomyelitis and hydronephrosis on the side of the larger abscess. The only organism recovered from the patient was a Bacteroides species. The patient was managed with percutaneous drainage and intravenous antibiotics and made a full recovery.

Injuries in West Indies cricket 2003-2004.

OBJECTIVE: To analyse injuries in West Indies Cricket and compare them with those of other cricket playing nations. METHODS: Injuries between June 2003 and December 2004 were surveyed prospectively in all major matches of the West Indies Cricket Board. RESULTS: Most injuries occurred in the West Indies Test and one day international teams. Mean match injury incidence was 48.7 per 10,000 player-hours in Test cricket, and 40.6 per 10,000 player-hours in one day international cricket, with injury prevalence of 11.3% and 8.1% respectively. In domestic cricket, the match injury incidence was 13.9 per 10,000 player-hours for first class cricket, and 25.4 per 10,000 player-hours in one day domestic competitions. There were more injuries on tour for the West Indies team than at home. The batsmen and fast bowlers sustained 80% of injuries, with many leading to long absence from the game, although many of these injuries were sustained while fielding. Most injuries were of the phalanges (22%) and the lumbar spine (20%) sustained mainly while fielding (including catching) and fast bowling respectively. CONCLUSIONS: Injuries in West Indies cricket may be reduced by (a) early detection and management of injuries on tour, (b) attention to fielding and catching techniques, and (c) monitoring of young fast bowlers.

Methods for injury surveillance in international cricket.

BACKGROUND: The varying methods of cricket injury surveillance projects have made direct comparison of published studies in this field impossible. METHODS: A consensus regarding definitions and methods to calculate injury rates in cricket was sought between researchers in this field. This was arrived at through a variety of face-to-face meetings, email communication and draft reviews between researchers from six of the major cricket-playing nations. RESULTS: It is recommended that a cricket injury is defined as any injury or other medical condition that either: (a) prevents a player from being fully available for selection for a major match or (b) during a major match, causes a player to be unable to bat, bowl or keep wicket when required by either the rules or the team's captain. Recommended definitions for injury incidence (for matches, training sessions and seasons) and injury prevalence are also provided. It is proposed that match injury incidence is calculated using a denominator based on a standard time estimated for player exposure in matches, for the purposes of simplicity. This will allow all injury surveillance systems, including those with limited resources, to make calculations according to a standard definition. CONCLUSION: The consensus statement presented provides a standard which, if followed, allows meaningful comparison of injury surveillance data from different countries and time periods, which will assist in the possible identification of risk factors for injury in cricket.

Methods for injury surveillance in international cricket.

BACKGROUND: The varying methods of cricket injury surveillance have made direct comparison of published studies in this field impossible. METHODS: A consensus regarding definitions and methods to calculate injury rates in cricket was sought between researchers in this field. This was arrived at through a variety of face to face meetings, email communication, and draft reviews between researchers from six of the major cricket playing nations. RESULTS: It is recommended that a cricket injury is defined as any injury or other medical condition that either (a) prevents a player from being fully available for selection for a major match or (b) during a major match, causes a player to be unable to bat, bowl, or keep wicket when required by either the rules or the team's captain. Recommended definitions for injury incidence (for matches, training sessions, and seasons) and injury prevalence are also provided. It is proposed that match injury incidence is calculated using a denominator based on a standard time estimated for player exposure in matches, for the purposes of simplicity. This will allow all injury surveillance systems, including those with limited resources, to make calculations according to a standard definition. CONCLUSION: The consensus statement presented provides a standard which, if followed, allows meaningful comparison of injury surveillance data from different countries and time periods, which will assist in the possible identification of risk factors for injury in cricket.

Acute haematogenous anaerobic osteomyelitis in sickle cell disease. A case report and review of the literature.

Patients with sickle cell disease are more susceptible to acute anaerobic osteomyelitis due to focal gut mucosal ischaemia, translocation of bacteria, and seeding in infarcted bone marrow. Modulation of the immune system is also present. The isolation of anaerobic organisms requires a high index of suspicion, correct specimen collection procedures and meticulous specimen handling. Bacteroides is the predominant organism isolated. Intra-osseous gas in the bone may be seen within four days and radiographs are therefore useful earlier than with aerobic osteomyelitis. Surgical débridement and intravenous antibiotics are the mainstay of treatment with the erythrocyte sedimentation rate being relied on heavily to guide conversion to oral antibiotics. Coexistence of septic arthritis is more common with anaerobic osteomyelitis.

Acute haematogenous anaerobic osteomyelitis in sickle cell disease. A case report and review of the literature

Patients with sickle cell disease are more susceptible to acute anaerobic osteomyelitis due to focal gut mucosal ischaemia, translocation of bacteria, and seeding in infarcted bone marrow. Modulation of the immune system is also present. The isolation of anaerobic organisms requires a high index of suspicion, correct specimen collection procedures and meticulous specimen handling. Bacteroides is the predominant organism isolated. Intra-osseous gas in the bone may be seen within four days and radiographs are therefore useful earlier than with aerobic osteomyelitis. Surgical débridement and intravenous antibiotics are the mainstay of treatment with the erythrocyte sedimentation rate being relied on heavily to guide conversion to oral antibiotics. Coexistence of septic arthritis is more common with anaerobic osteomyelitis

Dissipation of chlorpyrifos from tap, river and brackish waters in glass aquaria.

Persistence of Dursban 2E formulation of chlorpyrifos was studied in aerated and unaerated tap, river and brackish water, under laboratory conditions. Adsorption of residues onto a glass surface over 12-24 h was 12%. The half-lives of the residues in aerated and unaerated (data in parenthesis) tap, river and brackish waters were 23 and (403) h, 3.2 and (60) h, and 5.8 and 232 h, respectively. The kinetics of dissipation of residues from aerated and unaerated tap, river and brackish waters suggested a linear relationship for most of the data sets, and could not be ascribed to distinct first- or second-order models.

Toxicity, bioaccumulation and tissue partitioning of dieldrin by the shrimp, Macrobrachium faustinum de Sassure, in fresh and brackish waters of Jamaica.

The 2-week no observed effect (NOEC) and lowest observed effect (LOEC) concentrations of dieldrin were determined for Macrobrachium faustinum de Sassure in fresh and brackish waters. LOEC1,10,50,95 values in fresh water were 0.001, 0.003, 0.011 and 0.058 microg l(-1), respectively, and in brackish water, 0.00006, 0.00027, 0.00165, and 0.0172 microg l(-1), respectively. The 96-hr LC10, LC50 and LC95 values were 0.029, 0.123 and 0.771 microg l(-1), respectively. It is proposed that NOEC and LOEC be redefined to take into account the percentage of individuals affected, the severity of symptoms and the recovery of poisoned individuals. Two new terms are proposed--Median Observable Effect Concentration (MOEC) for pronounced toxic symptoms in most individuals but mortality in <50%, and Pronounced Observed Effect Concentration (POEC), which inflicts mortality in >50% individuals. Bioaccumulation of dieldrin by M. faustinum from surrounding fresh and brackish waters were rapid and fairly uniform for the first 48 h when the bioconcentration equilibrium (14.4 +/- 0.42 ng g(-1) at 0.001 microg l(-1) and 42.5 +/- 1.72 ng g(-1) at 0.01 phi g l(-1)) was achieved. Relative partitioning of residues (ng g(-1) wet wt.), after 24h exposure to 0.001 microg l(-1) of dieldrin in fresh water, in the different tissues was hepatopancreas > gonads > gills > large claws > muscle and exoskeleton. Shrimp which had accumulated 10.5 +/- 0.52 ng g(-1) dieldrin in fresh and brackish water, eliminated only about 52% of the residues after eight days in uncontaminated water.

Bioaccumulation, elimination, and tissue distribution of chlorpyrifos by red hybrid Tilapia in fresh and brackish waters.

Bioaccumulation, degradation, elimination and tissue partitioning of chlorpyrifos (Dursban 25E) was studied under static conditions for 3-4 days, in fresh (FW) and brackish (BW) waters by two methods: in the renewal method, fish were transferred every 24 h to FW or BW aquaria containing 0.05 mg l(-1) of the insecticide; in the spiking method, the original concentration of 0.005 mg l(-1) was spiked every 8 h. Samples of fish and water were collected at regular intervals and residues determined gas chromatographically. In the renewal experiments with 0.05 mg l(-1), bioconcentration reached its peak within 8 h of exposure in FW (1.25 mg l(-1)) and within 1 h in BW (0.95 mg g(-1)); in spiking experiments with 0.005 mg l(-1), these peaks were attained in 48 h in FW (3.8 mg g(-1)) and 8-24 h in BW (1.67 mg g(-1)). Thereafter, the concentrations declined. The concentrations of an unidentified metabolite were generally but not always correlated with that of the parent compound. Upon exposure of contaminated fish to uncontaminated waters, 72% was eliminated within the first 12 h and 4% later in 60 h in FW, and only 23% in 1 h and another 21% in the following 60 h in BW. Concentration of the metabolite was very high during the elimination. In the renewal experiment with 0.05 mg l(-1) of chlorpyrifos, tissue distribution was much higher in FW than in BW, while the reverse was true in spiking experiments with 0.005 mg l(-1) of the chemical. Testis, heart and brain had the highest levels of residues, followed by ovaries and other tissues.

Hand infections in Jamaica

Empirical antibiotic treatment for hand infections is changing to single antibiotic therapy against Staphylococcus aureus in immunocompetent patients. Fifty-one patients treated surgically for hand infections were reviewed to assess the nature of infection in terms of site, organism, mechanism of injury, and antibiotic sensitivity of the organisms. Twenty-three per cent of patients had diabetes mellitus and were noted to be older than non-diabetics. Eighty-four per cent of non-diabetic patients had single organism infections, 59 involving S aureus. Fifty per cent of diabetic patients had multi-organism infection caused by gram positive and gram negative organisms. Patients stuck with a piece of wood also had multi-organism infections. Double antibiotic therapy is therefore advocated for patients with diabetes mellitus and all patients who had hand infections as a result of being stuck with a piece of wood. All others should have single antibiotic therapy with amoxycillin and clavulanic acid.

Hand infections in Jamaica.

Empirical antibiotic treatment for hand infections is changing to single antibiotic therapy against Staphylococcus aureus in immunocompetent patients. Fifty-one patients treated surgically for hand infections were reviewed to assess the nature of infection in terms of site, organism, mechanism of injury, and antibiotic sensitivity of the organisms. Twenty-three per cent of patients had diabetes mellitus and were noted to be older than non-diabetics. Eighty-four per cent of non-diabetic patients had single organism infections, 59% involving S aureus. Fifty per cent of diabetic patients had multi-organism infection caused by gram positive and gram negative organisms. Patients stuck with a piece of wood also had multi-organism infections. Double antibiotic therapy is therefore advocated for patients with diabetes mellitus and all patients who had hand infections as a result of being stuck with a piece of wood. All others should have single antibiotic therapy with amoxycillin and clavulanic acid.