All-terrain vehicle injuries: are they dangerous? A 6-year experience at a level I trauma center after legislative regulations expired.

All-terrain vehicles (ATVs) have increased in popularity and sales since 1971. This rise in popularity led to an increase in injuries resulting in voluntary industry rider safety regulations in 1988, which expired without renewal in 1998. Our purpose was twofold, to determine the incidence and severity of ATV injuries in our patient population and what, if any impact the safety regulations had. To further characterize the risk of ATV use, we compared them to a vehicle generally recognized as dangerous, the motorcycle (MC). Our trauma registry was reviewed from January 1998 through August 2004 for ATV or MC injured. Data collected included age, gender, mortality, Injury Severity Score (ISS), helmet use, and injury distribution. These were compared to our data from the decade of regulation. There were 352 MC and 221 ATV patients. ATV injured demonstrated a higher proportion of pediatric and female patients (P < 0.001 and P < 0.01, respectively), a decrease in helmet use (8.6% vs 64.7%, P < 0.001), and increased closed head injuries (CHI) (54.2% vs 44.9%, P < 0.05) compared with MC injured. ISS and mortality were similar. The average number of patients from 1988 to 1998 was 6.9/yr compared to 31.6/yr (P < 0.001) during 1998-2004 with equal ISS. Our data show that there has been a dramatic and progressive increase in the number of ATV crashes since expiration of industry regulations. ATVs are as dangerous as MCs based on patient ISS and mortality. There are significantly more children and women injured on ATVs. The lower rate of helmet use in ATVs may account for the significantly greater incidence of CHI. These data mandate the need for injury prevention efforts for ATV riders, in particular children, through increased public awareness and new legislation.

Joseph Larner's personal odyssey: search for the cause and cure of non-insulin-dependent diabetes mellitus.

Over the last five decades, Joseph Larner has tirelessly pursued scientific studies of the mechanism of insulin action, which are now providing new insight into the cause, diagnosis, and cure of non-insulin-dependent diabetes mellitus (NIDDM). Larner demonstrated that D-chiro-inositol (D-CI) is virtually absent in the urine of patients with NIDDM. Consequently, he suggested that the insulin resistance seen in such patients is related to the absence of one of the mediators of insulin action containing D-CI. Moreover, Larner demonstrated that this D-CI deficiency and insulin resistance could be corrected by the administration of D-CI to experimental diabetic and insulin-resistant animals. From this pioneering research, the potential for therapy using D-CI in NIDDM is evident and must be evaluated expeditiously.

Adaptive clothing for persons with mobility disorders after burn injury.

Smart-looking clothes have been designed for wheelchair users. These clothes make dressing faster and easier, and the clothes fit better than the standard garments. The special features for new adaptive clothing for wheelchair users include easy handling fastenings, quick-access garment openings, conveniently placed pockets, custom-curved trousers, slacks, and jackets, custom-shaped dresses and skirts, ponchos or custom-made coats, easy-fit undergarments, and durable styled fabrics. These clothing adaptations are attractive and give the wearer and the observer the feeling that the person with the disability is not set apart by the clothing he or she wears.

New advances in electronic devices for hole detection.

Holes in surgical gloves are considered to be an important source of transmission of pathogens between surgeon and patient. Two new glove hole detectors have been devised to alert the surgeon to the presence of holes. These devices have been evaluated using six powder-free and seven powdered varieties of surgical gloves that were either dry or exposed to hydration. Eight of the 13 surgical gloves hydrated rapidly with water, altering their resistance to the conduction of electricity. Because the Barrier Integrity Monitor¿ only has a hydration monitor, 68 false positives occurred during the evaluation, indicating to the surgeon that he/she should change gloves unnecessarily because the glove had no hole. In contrast, the Surgic Alert Monitor¿ (SAM¿) had a hydration alarm as well as a glove hole detection alarm. During the 104 tests, the SAM¿ device showed no false positives. In the testing of five of the rapidly hydrating types of surgical gloves, the SAM¿ device could not reliably detect holes. On the basis of this study, the SAM¿ device, in conjunction with gloves that resist hydration, appeared to be a reliable hole detection monitor.