Mild Traumatic Brain Injury and Post-concussion Syndrome: Treatment and Related Sequela for Persistent Symptomatic Disease.

Sport-related concussion typically resolves within a few weeks of the injury; however, persistent symptoms have been reported to occur in 10% to 15% of concussions. These ongoing symptoms can cause significant disability and be frustrating for the patient and family. In addition, factors other than brain injury can cause complications for these patients, such as adjustment disorder or exacerbation of preexisting conditions such as depression or migraine. Individuals with prolonged symptoms of concussion may be classified as having post-concussion syndrome. A careful and thoughtful evaluation is important, as the clinician must determine whether these prolonged symptoms reflect brain injury pathophysiology versus another process. Although there have been numerous studies on the acute management of concussion, much less is available on the treatment of persistent disease. This review will provide an evaluation approach for the patient with prolonged concussion symptoms and review recent literature on treatment strategies.

Effect of morning school schedule on sleep and anthropometric variables in adolescents: a follow-up study.

The aim of this study was to assess whether the shift from afternoon to morning classes reduces the duration of sleep and whether this reduction has any relation to body fat measurements. This is a follow-up study in which students (n = 379), 12.4 (SD(+/-)0.7) yrs old, were evaluated before and after the school schedule shift, with a 1-yr interval between the first and second data collections. Adolescents were divided into two groups: an afternoon-morning group (students who shifted from afternoon to morning classes) and an afternoon-afternoon group (students who remained in afternoon classes). The morning schedule of classes lasted from 07:30 and 12:00?h, and the afternoon schedule of classes lasted from 13:00 and 17:30?h. Self-reported bedtime, wake-up time, and time-in-bed were obtained. Body mass index, waist circumference, and body fat percentage were obtained by direct measures. The results showed a reduction of time-in-bed during weekdays for those students who changed to the morning session (p < .001). Analysis of covariance (ANCOVA) for repeated measures of anthropometric differences between afternoon-afternoon and afternoon-morning groups showed no effect of the school schedule change on weight gain. In conclusion, the time-in-bed reduction in the period analyzed cannot be considered to be a mediating factor to modifications in overweight anthropometric indicators.

[Maternal breast-feeding: changes occurred in the father's conjugal life]. / Aleitamento materno: mudanças ocorridas na vida conjugal do pai.

It is a qualitative study with the objective of identifying the man's perception regarding the changes that took place in his marital relationship during the child's breast-feeding. The data were collected through interview with 13 fathers. The results indicate that men develop attitudes and feelings relative to the son and the wife; they recognize that the alterations in their marital relationship are more evident during the first three months of the child's life and they try to understand or to demonstrate indifference towards the changes. Although breastfeeding results in modifications in the spouses' relationship, the fathers do not consider them as something negative in their lives.

A study in a community in Brazil in which cutaneous larva migrans is endemic.

BACKGROUND: Cutaneous larva migrans (CLM) is a common but neglected parasitic skin disease in impoverished communities of the developing world. METHODS: To describe the clinical features and the morbidity associated with CLM, active-case finding was performed during rainy and dry seasons in a rural community in the state of Alagoas, Northeast Brazil. RESULTS: A total of 62 individuals received a diagnosis for CLM, and among them there were a total of 75 larval tracks. The number of tracks per person ranged from 1 to 3. Children <9 years old were affected significantly more often than other age groups (P<.001). Children had their lesions mainly on the buttocks, genitals, and hands, whereas in older patients, the majority of lesions were located on the feet. Twenty-four percent of the 75 lesions were superinfected. Bacterial superinfection was more common among children. All but 1 patient complained about itching, and 84% of the 62 patients complained about sleep disturbances. Itching was classified as being severe by 61% of patients. Approximately 40% of the 62 patients had attempted to treat their creeping eruption previously. Larvae moved forward 2.7 mm per day. There was a significant correlation between the length of the track and the duration of infestation ( rho =.53; P<.0001). CONCLUSIONS: CLM is a common parasitic skin disease in this rural community, with different topographic patterns of lesions in children and adults. CLM is associated with considerable morbidity. The length of the track can be used to estimate the duration of infestation.