Injuries and deaths associated with off-road recreational vehicles among children in Manitoba.

Injuries and deaths associated with off-road recreational vehicles are of increasing concern in North America. We reviewed all hospital admissions and deaths attributed to these vehicles in Manitoba from April 1979 to April 1985 among children 16 years of age or younger. Of the 693 hospital admissions and deaths 480 were associated with motorbikes, snowmobiles or all-terrain vehicles (ATVs). The incidence of injuries resulting from snowmobile and dirtbike accidents remained stable over the study period; however, there was an almost exponential increase in the number of admissions because of ATV-related injuries. There were 21 deaths during the study period. Preventive measures through legislation are necessary to reduce the numbers of injuries and deaths; these include mandatory registration, licensing and enhanced safety regulations.     

The Influence of Snowmobile Trails on Coyote Movements during Winter in High-Elevation Landscapes

Competition between sympatric carnivores has long been of interest to ecologists. Increased understanding of these interactions can be useful for conservation planning. Increased snowmobile traffic on public lands and in habitats used by Canada lynx (Lynx canadensis) remains controversial due to the concern of coyote (Canis latrans) use of snowmobile trails and potential competition with lynx. Determining the variables influencing coyote use of snowmobile trails has been a priority for managers attempting to conserve lynx and their critical habitat. During 2 winters in northwest Wyoming, we backtracked coyotes for 265 km to determine how varying snow characteristics influenced coyote movements; 278 km of random backtracking was conducted simultaneously for comparison. Despite deep snow (>1 m deep), radio-collared coyotes persisted at high elevations (>2,500 m) year-round. All coyotes used snowmobile trails for some portion of their travel. Coyotes used snowmobile trails for 35% of their travel distance (random: 13%) for a mean distance of 149 m (random: 59 m). Coyote use of snowmobile trails increased as snow depth and penetrability off trails increased. Essentially, snow characteristics were most influential on how much time coyotes spent on snowmobile trails. In the early months of winter, snow depth was low, yet the snow column remained dry and the coyotes traveled off trails. As winter progressed and snow depth increased and snow penetrability increased, coyotes spent more travel distance on snowmobile trails. As spring approached, the snow depth remained high but penetrability decreased, hence coyotes traveled less on snowmobile trails because the snow column off trail was more supportive. Additionally, coyotes traveled closer to snowmobile trails than randomly expected and selected shallower snow when traveling off trails. Coyotes also preferred using snowmobile trails to access ungulate kills. Snow compaction from winter recreation influenced coyote movements within an area containing lynx and designated lynx habitat.     

Displacement of Mountain Caribou From Winter Habitat by Snowmobiles

Abstract: Mountain caribou are an ecotype of woodland caribou (Rangifer tarandus caribou) that live in subalpine forests in southeastern British Columbia, Canada, extending into northern Idaho and Washington, USA. These caribou are listed as Threatened in Canada, Endangered in the United States, and are the subject of recovery planning efforts in both countries. Many areas of mountain caribou winter habitat experience intensive use by recreational snowmobilers. During 4 surveys, we recorded caribou on all 4 census blocks with little or no snowmobile activity (x̄ density = 0.41 caribou/km²), but during 3 of 4 years, we observed no caribou on the census block with intensive snowmobile activity. The year we observed caribou on the snowmobile block, most were using areas inaccessible to snowmobiles. We used a Resource Selection Function (RSF) based on radiotelemetry data for the area to compare habitat quality among the different census blocks. The absence of caribou from the intensive snowmobile area during most years could not be explained by differences in habitat quality. The RSF predicted that the intensive snowmobile area could support 53-96 caribou (95% CI). We conclude that intensive snowmobiling has displaced caribou from an area of suitable habitat. We recommend that snowmobile activity be restricted from all or most high-quality mountain caribou habitat as part of the recovery planning process.     

The Effect of Snowmobile Trails on Coyote Movements Within Lynx Home Ranges

Abstract: Coyotes (Canis latrans) and Canada lynx (Lynx canadensis) are sympatric throughout much of the lynx's southern range. Researchers and managers have suggested that the presence of compacted snowmobile trails may allow coyotes to access lynx habitat from which they were previously excluded by deep, unconsolidated snow. This could then allow coyotes to more effectively compete with lynx for snowshoe hares (Lepus americanus), the lynx's primary prey. We investigated how coyotes interacted with compacted snowmobile trails by conducting carnivore track surveys and by snow tracking adult coyotes (4 M, 8 F) in areas of western Montana, USA, with both documented lynx presence and recreational snowmobile use. Coyotes remained in lynx habitat having deep snow throughout the winter months. They used compacted snowmobile trails for 7.69% of their travel distance and traveled on them for a median distance of 124 m. Coyotes used compacted forest roads (5.66% of total travel) and uncompacted forest roads (4.62% of total travel) similarly. Coyotes did not travel closer to compacted snowmobile trails than random expectation (coyote x̄ distance from compacted trails = 368 m, random expectation = 339 m) and the distance they traveled from these trails did not vary with daily, monthly, or yearly changes in snow supportiveness or depth. However, they strongly selected for naturally shallower and more supportive snow surfaces when traveling off compacted snowmobile trails. Coyotes were primarily scavengers in winter (snowshoe hare kills composed 3% of coyote feed sites) and did not forage closer to compacted snowmobile trails than random expectation. The overall influence of snowmobile trails on coyote movements and foraging success during winter appeared to be minimal on our study area. The results of this study will allow land managers to better assess the effects of snow-compacting activities on coyotes and lynx.     

Effects of winter recreation on northern ungulates with focus on moose (Alces alces) and snowmobiles

Winter recreation can displace ungulates to poor habitats, which may raise their energy expenditure and lower individual survivorship, causing population declines. Winter recreation could be benign, however, if animals habituate. Moreover, recreation creates trails. Traveling on them could reduce energy expenditure, thereby increasing ungulate survivorship and generating population benefits. Balancing recreation use with wildlife stewardship requires identifying when these effects occur. This task would be simpler if guidelines existed to inform assessments. We developed and tested such guidelines using two approaches. First, we synthesized literature describing the effects of winter recreation—motorized and nonmotorized—on northern ungulates. This synthesis enabled formulating six guidelines, while exposing two requiring further attention (ungulate habituation and displacement). Second, we tested these two guidelines and evaluated the others by quantifying the behavioral responses of moose to snowmobiles, in two areas of south-central Alaska, differing by snowmobile predictability. For each location, we modeled moose preferences during the snowmobile period using different combinations of eight variables—static (elevation and slope), biotic (habitat and cover), and anthropogenic (distance to roads, railroads, snowmobile trails, and trail density). We identified the model with the most support and used it to estimate parameter coefficients for pre- and post-recreation periods. Changes in coefficients between periods indicated snowmobile effects on moose. Overall, we produced and evaluated six guidelines describing when winter recreation is potentially detrimental to ungulates as follows: (1) when unpredictable, (2) spanning large areas, (3) long in duration, (4) large spatial footprint, (5) nonmotorized, and (6) when animals are displaced to poor quality habitats.     

Missed injuries of the spinal cord.

Damage to the spinal cord had not been recognised initially in 15 patients out of a consecutive series of 353 admitted over a decade to the National Spinal Injuries Centre with paralysis due to trauma to the cord. In some patients the missed diagnosis led to mismanagement and a greater neurological deficit. Missed injuries of the spinal cord are seen in patients with multiple injuries and head injuries and in those without any paralysis. Various radiological errors contribute to the failure to recognise the vertebral injury. In addition to causing severe disability to the victim these missed and mismanaged injuries of the spinal cord cost the National Health Service large sums in compensation. A careful evaluation of the history of each accident, with greater awareness of the potential of certain types of accidents to cause spinal cord injury, should reduce the incidence of missed injuries of the spinal cord.     

急性脊髓损伤的药物治疗进展概况

脊髓损伤(spinal cord injury,SCI)是临床上常见的一种创伤性疾病。随着社会的发展呈现上升的趋势,其来源主要有交通事故,工伤,坠落伤,暴力伤,运动损伤,积累性损伤等。传统的手术治疗是围绕脊柱的骨性结构进行椎管减压、脊柱稳定性的重建,并不能解决瘫痪的主要原因-脊髓损伤问题,预后并不理想。近年来国内外学者都在对SCI进行深入研究,想要找到SCI的根本机制,从而能针对性的研究出能改变SCI患者预后的药物。本文就对脊髓损伤目前的常用治疗药物做一篇综述。     

Eye injuries associated with war games

War games, an outdoor activity combining recreation, military maneuvers and fantasy, are becoming a popular recreational sport. Increasing numbers of players are suffering eye injuries. In the last year 26 cases of serious eye injuries were reported to Canadian ophthalmologists; in 15 eyes vision was reduced to 6/24 or less. Although eyeguards are provided, all the injuries had occurred when the participants were not wearing them. Methods of preventing eye injuries in war games are discussed.     

Epidemiology of Spinal Cord Injuries and Risk Factors for Complete Injuries in Guangdong,China: A Retrospective Study

Background

Spinal cord injuries are highly disabling and deadly injuries. Currently, few studies focus on non-traumatic spinal cord injuries, and there is little information regarding the risk factors for complete injuries. This study aims to describe the demographics and the injury characteristics for both traumatic and non-traumatic spinal cord injuries and to explore the risk factors for complete spinal cord injuries.

Methods

A retrospective study was performed by reviewing the medical records of 3,832 patients with spinal cord injuries who were first admitted to the sampled hospitals in Guangdong, China. The demographics and injury characteristics of the patients were described and compared between the different groups using the chi-square test. Logistic regression was conducted to analyze the risk factors for complete spinal cord injuries.

Results

The proportion of patients increased from 7.0% to 14.0% from 2003 to 2011. The male-to-female ratio was 3.0∶1. The major cause of spinal cord injuries was traffic accidents (21.7%). Many of the injured were workers (36.2%), peasants (22.8%), and unemployed people (13.9%); these occupations accounted for 72.9% of the total sample. A multivariate logistic regression model revealed that the OR (95% CI) for male gender compared to female gender was 1.25 (1.07–1.89), the OR (95%CI) for having a spinal fracture was 1.56 (1.35–2.60), the OR (95%CI) for having a thoracic injury was 1.23 (1.10–2.00), and the OR (95%CI) for having complications was 2.47 (1.96–3.13).

Conclusion

The proportion of males was higher than the proportion of females. Workers, peasants and the unemployed comprised the high-risk occupational categories. Male gender, having a spinal fracture, having a thoracic injury, and having complications were the major risk factors for a complete injury. We recommend that preventive measures should focus on high-risk populations, such as young males.     

Spinal injuries due to front-end bale loaders.

Of 22 patients admitted to Plains Health Centre, Regina, from January 1979 to April 1986 with spinal injuries due to farming accidents, 7 had injuries related to tractor-mounted front-end bale loaders. In contrast, none of the 12 patients admitted with farm-related spinal injuries from 1974 through 1978 had injuries related to bale loaders. All seven injuries occurred when a front-end loader was used to move a large, round hay bale. In each case when the loader arms were raised past the horizontal plane the bale rolled back onto the unprotected tractor operator. There were five thoracic injuries, one cervical injury and one lumbar injury. All seven bony injuries healed. Four of the patients had permanent neurologic sequelae; two of the four had paraplegia. All seven patients suffered disability that impaired work performance; all five farmers suffered some loss of income. None of these injuries would have occurred if available safety equipment had been in place.     

Amyloidosis in paraplegia correlation with decubitus ulcers

Six patients died with amyloidosis and four patients are living with amyloidosis out of 1,000 with spinal cord injuries who were studied.No correlation was found between Congo red retention and the length of time since injury or the site of the spinal cord lesion. However, it is felt that the longer decubitus ulcer persists, the greater is the probability of amyloidosis. It is believed that decubitus ulcers with secondary osteomyelitis are of primary importance as etiologic factors in amyloidosis associated with spinal cord injuries, and that pyelonephritis plays a very minor secondary role.     

Control of defecation in patients with spinal injuries by stimulation of sacral anterior nerve roots.

OBJECTIVE--To observe the effects of stimulation of the sacral anterior roots on anorectal and low colonic pressures and to programme implanted stimulators to produce defecation. DESIGN--Prospective study of 12 consecutive patients. SETTING--Spinal injuries unit and university gastrointestinal physiology department. PATIENTS--12 Patients with complete supraconal spinal cord lesions. Their injuries had been sustained at least two years before the study. INTERVENTIONS--A Brindley-Finetech intradural sacral anterior root stimulator was implanted in all patients. Three months postoperatively the stimulator settings were adjusted after measurement of simultaneous anorectal and low colonic pressures. MAIN OUTCOME MEASURES--Full defecation. RESULTS--Six patients achieved complete rectal evacuation of faeces using the implant and subsequently did not require manual help for defecation. For all but one of the patients the total time taken to complete defecation was reduced, and all were free from constipation, the most prevalent gastrointestinal symptom in patients with spinal injuries. CONCLUSIONS--Sacral anterior root stimulators can be programmed to achieve complete unassisted defecation and can considerably improve the quality of life of patients with spinal injuries.     

Serious head injury in sport.

Of 1900 head injuries serious enough to be admitted to the neurosurgical unit in Glasgow over a five year period, 52 (2.7%) were due to "sport." Golf, horse-riding, and Association football were the sports most commonly linked with serious head injury. Golfing injuries were all compound depressed fractures, and all these patients made a good recovery; horse-riding produced more severe injuries, three of the eight patients being left with residual disability. Much attention has been directed to preventing repeated minor head injury in boxing, but this study emphasises the need for preventing both the primary head injury and secondary complications associated with other sports.     

Brown Bear Den Habitat and Winter Recreation in South-Central Alaska

ABSTRACT Increasing demand for backcountry recreation opportunities during winter (e.g., snowshoeing, helicopter-assisted skiing, snowmobiling) in steep, high-elevation terrain has elevated concern about disturbance to brown bears (Ursus arctos) denning on the Kenai Peninsula, Alaska, USA. To help identify areas where such conflicts might occur, we developed a spatially explicit model to predict potential den habitat. The model indicated brown bears selected locations for den sites with steep slopes, away from roads and trails. Den sites were associated with habitat high in elevation and away from potential human contact. We then compared areas with the highest probability of providing den habitat with patterns of snowmobile and nonmotorized recreation on a portion of the Kenai Peninsula. We found limited overlap between the 2 recreation activities and potential den habitat for brown bears. At the landscape scale, however, backcountry skiing overlapped more high-quality den habitat than did snowmobile riding. Our results may be used by land management agencies to identify potential conflict sites and to minimize the potential effects of recreation activities on brown bears in dens.     

Snowmobile-related deaths in Ontario: a 5-year review.

OBJECTIVES: To investigate the demographic characteristics and circumstances surrounding fatal snowmobile accidents in Ontario, to examine the risk factors and to observe any fatality trends over the study period. DESIGN: Case series. PATIENTS: All 131 people who died accidentally while operating a snowmobile in Ontario from 1985-86 to 1989-90. Records were obtained from the chief coroner''s office; registration data were obtained from the Ministry of Transportation. RESULTS: Although the absolute number of deaths increased each year, owing to a rapid increase in the number of registered snowmobiles, the risk of death from snowmobile accidents remained relatively constant. Deaths occurred most frequently in northeastern Ontario. Youths and men predominated among the victims. Fatal accidents occurred more often on lakes (in 66% of the cases in which this information was known) than on roads (in 26%) or trails (in 8%). Weekend fatalities predominated, and deaths occurred most often during times of suboptimal lighting (from 4 pm to 8 am). The driver was killed in 84% of the cases in which the person''s role was known. Alcohol use before death was implicated in 69% of the cases, the level exceeding the Ontario legal limit in 59%. CONCLUSION: Snowmobile-related deaths result from factors that are generally avoidable. Strategies need to be instituted to reduce the rate of these events.     

Functional recovery of paraplegic rats and motor axon regeneration in their spinal cords by olfactory ensheathing glia

Axonal regeneration in the lesioned mammalian central nervous system is abortive, and this causes permanent disabilities in individuals with spinal cord injuries. In adult rats, olfactory ensheathing glia (OEG) transplants successfully led to functional and structural recovery after complete spinal cord transection. From 3 to 7 months post surgery, all OEG-transplanted animals recovered locomotor functions and sensorimotor reflexes. They presented voluntary hindlimb movements, they supported their body weight, and their hindlimbs responded to light skin contact and proprioceptive stimuli. In addition, relevant motor axons (corticospinal, raphespinal, and coeruleospinal) regenerated for long distances within caudal cord stumps. Therefore, OEG transplantation provides a useful repair strategy in adult mammals with traumatic spinal cord injuries. Our results with these cells could lead to new therapies for the treatment of spinal cord lesions in humans.     

Injuries in Rugby Union football.

In a prospective study of 185 players attached to 10 British rugby clubs, 151 injuries were recorded among 98 of them (53%) during a single season. Forwards sustained significantly more injuries than backs. The standard of rugby, players'' body weights, degree of fitness, and presence of joint hypermobility did not affect the risk of injury. The leg was the most common site of injury. Head and neck injuries were significantly more common when play was static and on wet pitches. Scrummaging accounted for no neck injuries. Almost half the injuries occurred during the last quarter of games. Foul play might have caused as many as 47 (31%) of all reported injuries. Complete eradication of deliberately dangerous play would considerably reduce the high incidence of injuries in this sport.     

Traumatic injuries of the spinal cord in the cervical segment

A group of 1000 patients treated for traumatic injuries to the spinal cord in cervical segment was analysed. These patients were hospitalized at the Department of Rehabilitation in Konstancin in 1967-1987. The most frequent causes of spine injuries, level and degree of lesions to the spinal cord, techniques of conservative treatment and surgeries and results of therapy are discussed. Significant neurological improvement was observed in 62% of the treated patients. An improvement depended on the degree of lesion to the spinal cord, time and method of therapy, mechanism of trauma, and to some extent patients' age. Finally, hospitalization duration was analysed which greatly depend on the degree of lesions to the spinal cord.     

Evaluation of Avulsion-Induced Neuropathology in Rat Spinal Cords with 18F-FDG Micro-PET/CT

Brachial plexus root avulsion (BPRA) leads to dramatic motoneuron death and glial reactions in the corresponding spinal segments at the late stage of injury. To protect spinal motoneurons, assessment of the affected spinal segments should be done at an earlier stage of the injury. In this study, we employed ¹⁸F-FDG small-animal PET/CT to assess the severity of BPRA-induced cervical spinal cord injuries. Adult Sprague-Dawley rats were randomly treated and divided into three groups: Av+NS (brachial plexus root avulsion (Av) treated with normal saline), Av+GM1 (treated with monosialoganglioside), and control. At time points of 3 day (d), 1 week (w), 2 w, 4 w and 8 w post-injury, ¹⁸F-FDG micro-PET/CT scans and neuropathology assessments of the injured spinal roots, as well as the spinal cord, were performed. The outcomes of the different treatments were compared. The results showed that BPRA induced local bleeding and typical Wallerian degeneration of the avulsed roots accompanied by ¹⁸F-FDG accumulations at the ipsilateral cervical intervertebral foramen. BPRA-induced astrocyte reactions and overexpression of neuronal nitric oxide synthase in the motoneurons correlated with higher ¹⁸F-FDG uptake in the ipsilateral cervical spinal cord during the first 2 w post-injury. The GM1 treatment reduced BPRA-induced astrocyte reactions and inhibited the de novo nNOS expressions in spinal motoneurons. The GM1 treatment also protected spinal motoneurons from avulsion within the first 4 w post-injury. The data from this study suggest that ¹⁸F-FDG PET/CT could be used to assess the severity of BPRA-induced primary and secondary injuries in the spinal cord. Furthermore, GM1 is an effective drug for reducing primary and secondary spinal cord injuries following BPRA.     

Effect of Microcirculation Reserves on Spinal Cord Recovery after Injury

Local capillary blood flow was studied in and around the spinal cord compression focus in humans with spinal injuries in the acute and early periods of the trauma. The effect of the capillary blood flow in the perimedullary network in the region of spinal cord compression on the degree of motor and sensory disturbances was analyzed. The relationship of the increase in capillary blood flow after spinal cord decompression with increases in leg muscle strength and pain threshold was determined.