In summary, laparoscopy in PAT may have an important role in a selected subgroup of patients, with surgeon expertise also an important factor. Laparoscopy has screening, diagnostic and therapeutic roles, particularly where diaphragm injury is suspected. It is extremely sensitive in determining need for laparotomy but detects hollow visceral injuries less reliably. It has potential as a therapeutic tool in centres with appropriate expertise. The development of specific guidelines or protocols may increase the value of laparoscopy in trauma but this would require more evidence of a higher quality.

These findings illustrate injury patterns in Gaelic football using a prospective methodology, over 4 consecutive seasons. Comparison with published literature suggests that Gaelic football match play injury risk is greater than soccer but less than rugby union.

Microdiffusion methods for determinations of minute amounts of ammonia, urea, carbon dioxide, the halogens etc., are now established in many laboratories. A general account of apparatus and several applications have been given elsewhere [Conway, 1939]. Recent extensions include submicro-determinations of total N by Needham & Boell [1939], as well as a further very accurate submicro-total N method by Tompkins & Kirk [1942], also amideand nitrate-N etc. by Borsook & IDubnoff [1939], quantitative acetone determination by Werch [1940] and an accurate acetone method using bisulphite absorption by Winnick [1941; 1942], who has also extended the technique to lactic acid and threonine estimations. As shown elsewhere micro-NH3 determinations by the microdiffusion technique can be brought to any desirable level of accuracy. Recoveries are better than with aeration methods, the apparatus required,is simpler and large numbers of determinations can be carried out in one series. Using the standard unit and 0-2 ml. of the NH3-containing fluid the full absorption time at room temperature is 45 min., but with rocking this can be reduced to 10 min. Such times arise out of the principles discussed and the experimental results described. (Borsook & Dubnoff [1939] have erred in claiming an absorption time of 90 min. as an advance on the microdiffusion technique.) The present study is directed especially to the removal of certain objections to the clinical use of the microdiffusion method for urea, but has also a more general application for concentrations of NH3 beyond a certain level. The blood urea method as originally described [Conway, 1933] had the disadvantage for clinical use, as commented on by Lee & Widdowson [1937], that the upper limit was 100 mg. urea/100 ml. Occasional blood ureas exceed this figure, though as pointed out

Rehabilitation of ACLR patients may be complete when they achieve isokinetic knee-extension peak torque of 260% (±40%) body mass, SL CMJ performance of >17 cm (±4 cm), and reach-limb symmetry measures of >90% in both strength and jump outcomes. The outcomes in the control group can inform return-to-play criteria for young adult male multidirectional field-sport athletes after ACLR.

ObjectivesHurling is a stick handling game which, although native to Ireland, has international reach and presence. The aim of this study was to report incidence and type of injuries incurred by elite male hurling players over five consecutive playing seasons.DesignProspective cohort study.SettingMale intercounty elite sports teams participating in the National GAA Injury Database, 2007–2011.ParticipantsA total of 856 players in 25 county teams were enrolled.Primary and secondary outcomesIncidence, nature and mechanism of injury were recorded by team physicians or physiotherapists to a secure online data collection portal. Time-loss injury rates per 1000 training and match play hours were calculated and injury proportions were expressed.ResultsIn total 1030 injuries were registered, giving a rate of 1.2 injuries per player. These were sustained by 71% (n=608) of players. Injury incidence rate was 2.99 (95% CI 2.68 to 3.30) per 1000 training hours and 61.75 (56.75 to 66.75) per 1000 match hours. Direct player-to-player contact was recorded in 38.6% injuries, with sprinting (24.5%) and landing (13.7%) the next most commonly reported injury mechanisms. Median duration of time absent from training or games, where the player was able to return in the same season, was 12 days (range 2–127 days). The majority (68.3%) of injuries occurred in the lower limbs, with 18.6% in the upper limbs. The trunk and head/neck regions accounted for 8.6% and 4.1% injuries, respectively. The distribution of injury type was significantly different (p<0.001) between upper and lower extremities: fractures (upper 36.1%, lower 1.5%), muscle strain (upper 5.2%, lower 45.8%).ConclusionsThese data provide stable, multiannual data on injury patterns in hurling, identifying the most common injury problems. This is the first step in applying a systematic, theory-driven injury prevention model in the sport.