SummaryReasons for performing study: To improve the understanding of exercise related sudden death in Thoroughbred racehorses.

This descriptive study has provided a useful resource for further case-control studies to investigate risk factors for retirement from racing due to tendon injury. This is the first step toward the development of management tools to reduce the incidence of tendon injury related retirement in Hong Kong.

Objective To determine the incidence and risk factors of falling among amputees during the postoperative time on the surgical ward. Design Retrospective cohort. Setting Three tertiary acute care hospitals. Patients Subjects aged 18 years or older undergoing either a primary or revision amputation at the transtibial, knee disarticulation, or transfemoral levels. Subjects were excluded if they underwent bilateral amputations. A total of 466 charts were identified, and 370 subjects were included in the analysis. Main Outcome Measurements All outcome measurements were devised before data collection. The primary outcome variable was the presence of at least one fall. Details regarding falls, including the date, time, and location of the first fall, were recorded. In addition, the total number of falls and any associated injuries were documented. Secondary outcome variables included type and number of medical comorbidities, cognitive deficits, and regular use of specific medications. Results Sixty‐one of 370 subjects fell at least once, giving an incidence of 16.5% (95% confidence interval [95% CI] 12.7%‐20.3%). No difference was noted between the fall and no fall groups for gender, mean age, number of regular medications, and number of medical comorbidities. The fall group demonstrated a significantly longer length of stay (difference of means 32.5 days, 95% CI 17.4‐47.5, P < .001). Injuries were sustained in 60.7% of those who fell. Multiple logistic regression analysis identified the major risk factors for falling as dysvascular etiology (odds ratio [OR] 2.418, 95% CI 1.043‐5.606), transtibial level (OR 2.127, 95% CI 1.050‐4.309), and right‐sided amputation (OR 1.933, 95% CI 1.073‐3.483). Conclusions Falls and associated injuries occur commonly in the postoperative lower limb amputee on the surgical ward. Risk factors for falling include dysvascular etiology, transtibial level, and right‐sided amputation. Further studies are required to characterize the mechanisms of falling in this patient population and to develop appropriate fall‐prevention strategies.

No abstract

Insulin administration can increase muscle glycogen by utilising hyperinsulinaemic clamps prior to sports events or during the recovery phases, and increase muscle size by its chalonic action to inhibit protein breakdown. In order to control insulin abuse in equine sports, a method to detect effectively the use of insulins in horses would be required. Besides the readily available human insulin and its synthetic analogues, structurally similar insulins from other species can also be used as doping agents. This study describes a method for the simultaneous detection of bovine, porcine and human insulins, as well as the synthetic analogues Humalog (Lilly) and Novolog (Novo Nordisk) in equine plasma. Insulins were isolated from equine plasma by immunoaffinity purification, followed by centrifugal filtration, and analysed by nano-liquid chromatography-tandem mass spectrometry (LC/MS/MS). Insulin and analogues were detected and confirmed by comparing their retention times and major product ions. All five insulins (human insulin, Humalog, Novolog, bovine insulin and porcine insulin), which are exogenous in the horse, could be detected and confirmed at 0.05ng/mL. This method was successful in confirming the presence of human insulin in plasma collected from horses up to 4h after having been administered a single low dose of recombinant human insulin (Humulin R, Eli Lilly). To our knowledge, this is the first identification of exogenous insulin from post-administration horse plasma samples.