Common mental disorders among Irish jockeys: prevalence and risk factors

OBJECTIVE

Jockeys compete in a sport, horseracing, renowned for its physical and psychological demands. Previous research has identified that common mental disorders (CMDs) may be prevalent among this unique population of athletes. The aim of the present study was to further explore the prevalence of CMDs among jockeys and to test for associations with potential risk factors.

METHODS

An anonymous survey was distributed to professional jockey online. Self-report screening tools for four CMDs (psychological distress, depression, generalized anxiety, and adverse alcohol use) were included alongside predictor variables from questionnaires assessing for burnout, career satisfaction, social support, and the contemplation of retirement. Binary logistic regression was used to explore associations between CMDs (present versus not present) and risk factors. Eighty-four professional jockeys completed the questionnaire (response rate = 52%).

RESULTS

In total, 79% of jockeys met the threshold for at least one CMD. Prevalence (%) of CMD varied as follows: adverse alcohol (61%), depression (35%), generalized anxiety (27%), and psychological distress (19%). Burnout, career (dis)satisfaction, lower levels of social support, and the contemplation of retirement increased the odds of meeting the criteria for CMDs.

CONCLUSION

The findings indicate that jockeys report CMD symptoms at comparable rates to athletes in other sports. The study was the first to highlight potential risk factors as predictors of CMDs among jockeys, including burnout, career satisfaction, and the current contemplation of retirement. Screening tools for the risk factors demonstrated may, therefore, provide useful in the early identification of CMDs among jockeys. The development of jockey-specific assessment tools, education programmes, and interventions may help better understand and support the mental health of jockeys.

Identification of peripheral vascular disease with real-time ultrasonic imaging

Real-time ultrasonic imaging can provide useful clinical information in subjects with peripheral vascular disease. This report outlines the technique of imaging the extracranial arterial system and arterial segments that supply the lower extremities. It describes our interpretation of the ultrasonic image as it relates to the pathology of fatty streaks, smooth and complex plaques, occlusions and thrombus formations. Our experience consists of in excess of 2700 patients who were evaluated with real-time ultrasonic imaging in conjunction with noninvasive functional studies over 4 1/2 years. In our hands, real-time ultrasonic imaging performed in conjunction with functional noninvasive studies plays a more important role in the management of patients with cerebrovascular disease than in lower extremity vascular disease.

Clinical sequelae in patients with asymptomatic carotid bruits

Noninvasive vascular laboratory evaluations were performed on 163 patients who presented with asymptomatic carotid bruits. Of these, 57 patients were identified as having a solely transmitted murmur. The remaining 106 patients had carotid disease. Based on hemodynamic criteria, 77 patients had compensated disease and 29 had uncompensated disease. These patients were followed for from 1 to 56 months (mean 31). Patients in the uncompensated group developed symptoms attributable to the extracranial territory at a higher rate than did patients in the compensated group, with differences continuing for 36 months. At 18 months the accumulated symptom rate for the uncompensated group (24.0%) was over twice that for the compensated group (11.4%). Patients in the uncompensated group also had a higher mortality rate. Differences occurred after 12 months and continued through 36 months. Of the 23 patients who died, 19 (82%) died due to cardiac disease, two due to cerebrovascular accidents, and two due to neoplastic disease. In view of the results of this study, a careful examination of patients with asymptomatic cervical bruits is warranted. This evaluation should take the form of a noninvasive vascular laboratory evaluation, which can help determine the proper course of patient management by measuring functional deficit and estimating anatomic severity.

Fatal human infection with mesocercariae of the trematode Alaria americana

A fatal human infection with mesocercafiae of Alaria americana is described. Several thousand mesocercariae were estimated to be present in the peritoneal cavity, bronchial aspirate, brain, heart, kidney, liver, lungs, lymph nodes, pancreas, retroperitoneal adipose tissue, spinal cord, spleen, and stomach. Nine days from the onset of symptoms death resulted from asphyxiation due to extensive pulmonary hemorrhage probably caused by immun-mediated mechanisms. Circumstances suggest the victim probably ate inadequately cooked frog legs while hiking. Mesocercariae penetrated through the stomach wall and spread to the various organs both directly and via and circulatory system.