RESUMO
Background: The Special Olympics Pennsylvania Summer Games attract over 2000 athletes each year. Volunteer medical staff ensures their safety throughout this period. However, few studies have examined the incidence of orthopedic injury and sickness in this group, especially with a large sample. Objective: Identify the incidence of orthopedic injury and Illness at the Special Olympics Pennsylvania Summer Games based on demographic criteria and identify the incidence of transports required for advanced care. Methods: Data was collected from logs provided by Special Olympics Pennsylvania. The data were analyzed and stratified by gender, age, sport, and type of encounter. We summarized the data and compared it to data from other years and the average. Results: An average of 1971 athletes competed annually. On average, 10% (N=144) of competitors required medical care. Males comprised 58.2% (N = 837) of encounters, females 33.6% (N = 483), and in 8.1% (N = 117) of encounters gender was not identified/recorded. The mean age of participants was 29 years of age (range from 10 to 83). 56.6% (N= 813) of encounters required first aid management only. Injuries made up 31.7% (N = 455) of total encounters, and 11.8% (N=169) of encounters were classified as illnesses. Basketball was the sport with the most injuries, 49.5% (N = 711). An average of 9.8 transports was required annually. Conclusions: Special Olympics athletes suffer the same injuries as regular athletes, but they are also prone to various medical disorders that regular athletes are not.
RESUMO
PURPOSE: Coronary artery aneurysms (CAA) may remain silent after Kawasaki disease (KD) until adulthood when myocardial ischemia can lead to sudden death. We postulated that there would be young adults with sudden, unexpected death due to CAA from KD who would have a state-mandated autopsy performed by the San Diego County Medical Examiner's Office (SDCMEO). METHODS: We reviewed all autopsy cases <35years of age from 1997 to 2012 at the SDCMEO with a cardiovascular cause of death (n=154). RESULTS: We found 2 cases meeting inclusion criteria. Case 1 was a 22-year-old Korean male with chronic ischemic changes due to a partially occluded and diffusely calcified 15mm aneurysm at the bifurcation of the left main coronary artery. Interview of the mother revealed that this patient had been diagnosed with KD complicated by giant aneurysms at age two years. Case 2 was a 30-year-old Hispanic male with myocardial infarction due to thrombosis of a calcified left anterior descending artery aneurysm. Histologic findings included diffuse myocardial fibrosis and a recanalized aneurysm in the right coronary artery. Interview of the family revealed a KD-compatible illness in childhood. Immunohistochemical staining showed expression of transforming growth factor ß pathway molecules in the aneurysmal arterial wall. CONCLUSIONS: In a medical examiner's office serving a population of approximately 3 million people, 2 of 154 (1.3%) cardiovascular deaths in persons <35years were attributed to cardiovascular complications of KD in childhood. Antecedent KD should be considered in the evaluation of all cases of sudden, unexpected death in young adults.