Athletes participating in contact sports such as ice hockey are exposed to a high risk of suffering a concussion. We determined whether recent rule changes regulating contact to the head introduced in 2010-11 and 2011-12 have been effective in reducing the incidence of concussion in the National Hockey League (NHL). A league with a longstanding ban on hits contacting the head, the Ontario Hockey League (OHL), was also studied. A retrospective study of NHL and OHL games for the 2009-10 to 2011-12 seasons was performed using official game records and team injury reports in addition to other media sources. Concussion incidence over the 3 seasons analyzed was 5.23 per 100 NHL regular season games and 5.05 per 100 OHL regular season games (IRR 1.04; 95% CI 1.01, 1.50). When injuries described as concussion-like or suspicious of concussion were included, incidences rose to 8.8 and 7.1 per 100 games respectively (IRR 1.23; 95% CI 0.81, 1.32). The number of NHL concussions or suspected concussions was lower in 2009-10 than in 2010-11 (IRR 0.61; 95% CI 0.45, 0.83), but did not increase from 2010-11 to 2011-12 (IRR 1.05; 95% CI 0.80, 1.38). 64.2% of NHL concussions were caused by bodychecking, and only 28.4% of concussions and 36.8% of suspected concussions were caused by illegal incidents. We conclude that rules regulating bodychecking to the head did not reduce the number of players suffering concussions during NHL regular season play and that further changes or stricter enforcement of existing rules may be required to minimize the risk of players suffering these injuries.
Anterior temporal resection may effectively relieve therapy-resistant seizures in children and give social, psychological and economic benefits. Epidemiological and prognostic data demonstrate that this is an under-utilised procedure: although an estimated 677 Ontario children per year would be candidates for anterior temporal resection, only 18 were performed in a 12 month period.
Adolescence, spanning 15-19 years of age, is a time of developmental transition from childhood to adult life. The spectrum of cancers affecting this age group reflects a similar transition. The common malignant diseases of childhood - leukemias, lymphomas, tumors of the central nervous system and embryonal solid tumors (such as nephroblastoma and neuroblastoma) - are replaced in relative frequency by sarcomas of bone and soft tissue, and tumors of the male and female genital tracts. Moreover, the epithelial tumors (carcinomas), so prevalent in adults, occur (albeit at much lower frequencies) in adolescents. Within individual tumor types, biological features may be distinctive in this age group. Examples are the high prevalence of poor prognostic determinants in acute lymphoblastic leukemia and histologically higher grade forms of astrocytic/glial tumors. Particular challenges in addressing the common tumors of adolescence include the development of better categorization, especially of soft tissue sarcomas, and exploring these diseases in this age group within the developing world where most adolescents reside.
The diagnoses of 40,000 consecutively accessioned oral biopsies from the Oral Pathology Diagnostic Service, University of Western Ontario, London, Canada, were reviewed. All odontogenic neoplasm, neoplasm-like lesions (tumors), and true cysts of the oral tissues and jaws were listed. Clinical data were reviewed, and microscopic diagnoses were confirmed for cases in which diagnoses were ambiguous. Records of all cases were examined to identify distant referrals that were not representative of the study population. Of a total of 445 (1.11%) odontogenic tumors, 392 (0.98%) were lesions from patients in the usual local drawing area of the biopsy service; 53 were referred from distant centers. From the local population, odontomas were by far the most common tumor (51.53%) followed by ameloblastomas (13.52%) and peripheral odontogenic fibromas (8.93%). Locally, radicular (periapical) cysts were the most common odontogenic cyst (65.15%) followed by the dentigerous cyst (24.08%) and the odontogenic keratocyst (4.88%). The most common nonodontogenic cyst was the nasopalatine duct cyst that accounted for 73.43% of this subset of cysts. Surprisingly few studies of this type are available, especially for odontogenic tumors. These data are important to assess geographic differences in the incidence of lesions and to allow clinicians to make realistic judgments in counseling patients before biopsy about the probability of diagnosis and risks associated with nonspecific clinical or radiographic lesions.