The athlete and HIV.

Physicians are called upon to provide information and guidance concerning HIV and AIDS. Education and prevention are important elements in halting this dreaded disease. Athletes are at risk for exposure to HIV because of close contact and the potential for bleeding and resulting exposure. The risk of actual transmission is more potential than real. Precautions should always be taken so that athletes and those caring for them can minimize risks of exposure and transmission. To date, no conclusive case of HIV transmission has been reported in the athletic arena. Although this is reassuring, universal precautions should always be employed.

Concussions in athletics: guidelines for return to sport.

Physicians are required to make determinations that affect the health and well-being of their patients on a daily basis. None of these judgements may have as profound an impact as the decisions rendered for athletes who have suffered a concussion. Concussions occur with regularity in sports and vary in severity and appropriate management. Guidelines should be followed and used as a tool to allow safe return to competitive endeavors in the athletic arena. Following guidelines will decrease the likelihood of worsening the condition with potentially fatal consequences.

The female athlete.

Although there are many similarities between men and women involved in sport activities, certain issues are unique to the female athlete. This article presents and brings to light some of the more important concerns that are specific to women engaged in sports.

Concussion in sport: diagnosis, management, return to competition.

Concussions can occur in any sports activity. Although no standards for grading and managing concussions exist, many sets of guidelines have been proposed. Therefore, physicians should be familiar with at least one set to assist in diagnosing and managing concussions.

Concussions in sports: guidelines for return to competition.

Concussion is the most common head injury in sports. The injury ranges from a simple "ding" to prolonged loss of consciousness with amnesia. Proper grading of the severity of the injury is necessary to establish a protocol for deciding when to allow an athlete to return to his or her sport. This approach to concussions will minimize the risk of further, even fatal, complications.

Sacroiliac sprain: an overlooked cause of back pain.

Since sacroiliac sprain syndrome is not a common disorder, it may be overlooked as a cause of low back pain. Even though the sacroiliac joint is very strong, it can incur painful injury. The diagnosis of sacroiliac sprain syndrome requires more than just tenderness on palpation of the sacroiliac area. Certain maneuvers, such as Patrick's test and the sacroiliac compression test, are useful in establishing the diagnosis. Proper treatment consists of bed rest, heat, nonsteroidal anti-inflammatory drugs and muscle relaxants. Physical therapy and manipulation may also help. In recalcitrant cases, injection of the sacroiliac joint with a corticosteroid and a local anesthetic can be effective.

Jejuno-jejunal intussusception in a hemophiliac: a case report.

Reported is a case of jejuno-jejunal intussusception with an intramural hematoma as a lead point, occurring in a hemophiliac after blunt trauma to the abdomen. Exploratory laparotomy was performed, the jejunal hematoma was evacuated, and the intussusception was reduced. No similar case was found in the literature.

Forearm vasoreactivity in type 1diabetic subjects.

This study compared forearm vasoreactivity in 15 Type I diabetic subjects with 15 healthy controls. The groups were matched for age, exercise capacity, and the absence of other cardiovascular risk factors. Vasoreactivity was measured using strain gauge plethysmography, at rest, after arterial occlusion (OCC), and following OCC coupled with handgrip exercise (ROCC). Forearm blood flows were significantly elevated between conditions 2.58 +/- 0.37ml/100mltissue at rest to 26.80 +/- 6.56 after OCC and 32.80 +/- 8.26ml/100mltissue following ROCC in Type I diabetic subjects. There were no differences in forearm blood flow between groups for any of the conditions. These data indicate the degree of forearm blood flow is directly related to the intensity of the vasodilatory stimulus. However, our study did not reveal evidence of impaired vasodilatory capacity in Type I diabetic subjects compared to controls in the absence of other risk factors.

Modifiable high-risk behaviors for cardiovascular disease among family physicians in the United States. A national Survey.

OBJECTIVES: To study the prevalence of modifiable high-risk behaviors that contribute to mortality and morbidity from cardiovascular disease among family physicians in the United States, to examine whether these prevalence rates would differ across geographic regions of the United States, and to determine whether a family history of coronary artery disease differentiated physicians who engage in these high-risk behaviors from those who do not. DESIGN: A mailed self-report survey. SETTING: Family physician members of the American Board of Family Practice. PARTICIPANTS: The survey was mailed to 1500 randomly selected members of the American Board of Family Practice. RESULTS: The response was 62%. The results showed that 97% of the physicians were nonsmokers, 54% engaged in exercise regularly, 36% considered themselves overweight, and 91% knew their lipid profile. Of the respondents, 63% reported having a family physician, 78% reported visiting their physician as needed, and 41% reported having had a physician visit in the past year. Forty-one percent of the physicians reported having a family history of coronary artery disease. There were no notable differences regarding the prevalence of these behaviors across the 5 geographic areas or between respondents with a family history of coronary artery disease and those without such a history. CONCLUSION: Our results suggest that the respondents as a group engage in health practices that help to prevent cardiovascular disease. However, the frequency of exercise among these physicians is below the recommended level, and efforts should be made in promoting exercise among this population.