Intra-Abdominal Actinomycosis: An Indolent Masquerader of Malignancy.

This report describes the case of a 54-year-old female who presented with the constitutional symptoms of lethargy, weight loss, and asthenia. She had been extensively investigated for possible gynaecological malignancy but with no definitive outcome achieved. The symptoms were persistent and, partly due to occurring during the coronavirus disease 2019 (COVID-19) pandemic, a decision was made to progress with surgical management. Following an oncology multidisciplinary meeting, a decision was made for a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Intra-operatively, there was an incidental finding of an extensive tumour infiltrating the liver, colon, anterior abdominal wall and urinary bladder. A surgical resection with ileostomy was performed on suspicion of an underlying malignancy. Unexpectedly, the histopathological diagnosis revealed actinomycosis. Following this discovery, our entire management plan was altered, and the patient was treated with a prolonged course of antibiotics and recovered well.

Current issues in the identification, assessment, and management of concussions in sports-related injuries.

The recent literature has focused on the need for appropriate identification, assessment, and management of sports-related concussion. This article addresses current issues in the prevalence and assessment of sports-related concussion. Despite a paucity of research on female athletes and youth athletes, there is evidence that female athletes are at higher risk for injury than males and that concussions may affect children and young adolescents differently than older adolescents and adults. Sideline, baseline, and postconcussion assessments have become prevalent in documenting preinjury and postinjury performance, tracking recovery rates, and assisting return-to-play decisions. New computerized assessment procedures are growing in popularity and use. Future directions in the assessment and management of sports-related concussion include increased research on prevalence rates and effects of concussions for females and youth athletes, educating parents of youth athletes as well as family physicians on the importance of baseline and postconcussion cognitive assessments, and further validation of computerized assessment measures.