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1.
Curr Sports Med Rep ; 20(8): 389-394, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34357884

RESUMO

ABSTRACT: Ten percent of all premature deaths and 117 billion dollars in annual health care costs are attributable to physical inactivity in America. The positive impact exercise can have on overall health is irrefutable. While it is the responsibility of health care providers to assess and counsel for exercise, there are logistical, structural, and educational barriers preventing this counseling. A physical activity consultation clinic led by primary care sports medicine physicians would allow for focused exercise counseling by appropriately trained providers to motivated patients. While previously there have been many institutional and logistical barriers to establishing such a clinic, the COVID-19 pandemic has created a window of opportunity for doing so within a large academic medical center. This article reviews the importance of exercise on overall health, outlines the barriers for establishing a clinical experience dedicated to counseling for physical activity, and details how overcoming those barriers was facilitated by the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , Doença Crônica/prevenção & controle , Aconselhamento , Exercício Físico , Promoção da Saúde/métodos , Pandemias , Medicina Esportiva , Humanos , SARS-CoV-2 , Estados Unidos/epidemiologia
2.
J Addict Dis ; : 1-11, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34281482

RESUMO

Kratom is a substance similar to opioids that is often used for its euphoric effects, however it can be obtained legally in most of the United States. The substance is often not assessed on routine urine drug screen, however it is estimated that millions of people engage in kratom use each year and level of use is rising. Given the increasing prevalence of kratom use, and its potentially lethal consequences, it is imperative that primary care physicians be familiar with this substance and have a framework to approach identification and treatment of individuals with kratom use disorder. This manuscript offers a review of the epidemiology and pharmacology of kratom, along with guidance for care of individuals with kratom use disorder in the primary care setting.

3.
Endocrinol Diabetes Metab ; 4(2): e00188, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33855200

RESUMO

Aims: To assess the knowledge of certified athletic trainers (ATs) on the presenting signs and symptoms of type 1 diabetes (T1D). Methods: We conducted a 31-question survey of secondary school ATs recruited from the National Athletic Training Association that established demographic information, knowledge of presenting signs and symptoms of T1D, and previous personal or professional exposure to individuals with T1D. We report descriptive statistics and univariate analyses evaluating the characteristics associated with T1D knowledge. We then report a multivariable model incorporating age, gender, years of experience and education level with T1D knowledge as the dependent variable. Results: 128 participants (92f:34m) met inclusion criteria and were included in this study. The majority of participants correctly identified frequent thirst (96.1%, n = 123) and frequent urination (85.9%, n = 110) as common presenting signs and symptoms of T1D, while fewer participants identified weight gain (58.6%, n = 75) or joint pain (39.1%, n = 50) as incorrect presenting signs and symptoms of T1D. Participants with over ten years of experience or previous exposure to individuals with T1D had increased T1D knowledge. Participants with advanced education (Master's degree or Doctorate) had no statistically significant difference in T1D knowledge compared to those with a Bachelor's degree. The only factor that demonstrated a significant association with T1D knowledge on multivariable analysis was the female gender. Conclusions: Educational awareness campaigns of T1D symptoms to reduce the rate of DKA at diagnosis of T1D have never included ATs. This study illustrates the importance of targeting future educational interventions on newly trained ATs.

4.
J Fam Pract ; 70(2): 80;82;84;85, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33760897

RESUMO

A number of factors-including patient age and risk for recurrence-influence treatment choices. Here's a closer look at what to consider.


Assuntos
Tomada de Decisão Clínica , Luxação do Ombro/reabilitação , Luxação do Ombro/cirurgia , Humanos , Modalidades de Fisioterapia , Volta ao Esporte
5.
J Fam Pract ; 69(8): E1-E8, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33175927

RESUMO

Although low back pain in children and teens is usually benign, recognizing red flags that indicate the need for imaging, referral, bracing, or surgery is critical.


Assuntos
Dor Lombar/etiologia , Adolescente , Criança , Pré-Escolar , Terapia por Exercício/métodos , Terapia por Exercício/normas , Terapia por Exercício/tendências , Feminino , Humanos , Dor Lombar/fisiopatologia , Masculino , Modalidades de Fisioterapia/normas , Modalidades de Fisioterapia/tendências
7.
J Phys Act Health ; 17(2): 230-235, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31855850

RESUMO

BACKGROUND: Few adults in the United States obtain sufficient physical activity (PA) despite knowledge of the associated health benefits. The current feasibility study examined the feasibility of a novel modified sports intervention designed to promote enjoyment and sustained PA in sedentary adults. METHODS: The US adults (N = 22, mean age 39.2 y, male/female percentage 54.5/45.5) in Central Pennsylvania participated in the PlayFit sports program for 60-minute sessions, 2 to 3 times per week, over the course of 10 weeks and 24 game sessions; completing 198 person sessions collectively. Primary outcomes were PA (accelerometry) and intervention satisfaction. RESULTS: Percentage of time in moderate to vigorous activity ranged from 35.0% (volleyball) to 91.2% (ultimate frisbee). Percentage of time spent in vigorous activity ranged from 0.0% (volleyball) to 29.5% (team handball). Satisfaction, based on a 10-point scale with 10 being the most satisfied, ranged from 7.7 (kickball) to 8.7 (floor hockey and soccer). On average, all sports were rated highly, with the majority rated >8.5 and one rated <8.0. Percentage of time spent in the moderate to vigorous range was lower in men than in women (73.2% vs 80.0%, P = .01), but did not differ by age or body mass index. CONCLUSIONS: PlayFit is a promising first step in exploring the potential of modified sports programs to enhance population PA levels.


Assuntos
Acelerometria/métodos , Exercício Físico/fisiologia , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino
8.
Orthop J Sports Med ; 7(10): 2325967119876865, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31637270

RESUMO

Background: The literature demonstrates a high prevalence of asymptomatic knee and hip findings on magnetic resonance imaging (MRI) in athletes. Baseball pitchers are shown to have a high prevalence of asymptomatic shoulder MRI findings, but the incidence of asymptomatic shoulder MRI findings has not been systematically evaluated in nonthrowing contact athletes. Purpose/Hypothesis: The purpose of this study was to determine the prevalence of shoulder abnormalities in asymptomatic professional and collegiate hockey players. We hypothesized that, similar to overhead throwing athletes, ice hockey players will have a high prevalence of asymptomatic MRI findings, including labral, acromioclavicular (AC), and rotator cuff pathology on MRI. Study Design: Cross-sectional study; Level of evidence, 4. Methods: A total of 25 asymptomatic collegiate and professional hockey players (50 shoulders) with no history of missed games or practice because of shoulder injury, pain, or dysfunction underwent bilateral shoulder noncontrast 3.0-T MRI. MRIs were read blinded by 2 board-certified radiologists at 2 separate time points, 3 months apart, to determine the prevalence of abnormalities of the joint fluid, bone marrow, rotator cuff tendon, biceps tendon, labrum, AC joint, and glenohumeral joint. Interrater and intrareader reliability was determined, and regression analysis was performed to identify the prevalence and relationship to stick-hand dominance. Results: Labral abnormalities were seen in 25% of the shoulders. AC joint abnormalities and rotator cuff findings were noted in 8% and 6% of shoulders, respectively. One shoulder was noted to have a biceps tendon abnormality, and 1 shoulder demonstrated glenohumeral joint chondral findings. Interrater reliability coefficients were 0.619 for labral abnormalities. Intrareader reliability kappa coefficients were 0.493 and 0.718 for both readers, respectively, for labral abnormalities. Regression analysis was performed and revealed that the overall shoulder pathology was more common in the nondominant stick hand (top stick hand) (coefficient -0.731; P = .021). Conclusion: Professional and collegiate ice hockey players had an overall prevalence of labral abnormalities in 25% of their shoulders, with findings more often found in the nondominant stick hand. Rotator cuff abnormalities were uncommon in ice hockey players. These findings differ significantly from published reports examining professional baseball players and other overhead sports athletes.

9.
Surg Obes Relat Dis ; 15(6): 979-984, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31378282

RESUMO

BACKGROUND: Weight loss through bariatric surgery improves short-term knee pain and symptoms in patients with osteoarthritis. There is little research regarding whether patients maintain symptomatic improvement in long-term follow-up after bariatric surgery. OBJECTIVES: We hypothesized that bariatric surgery is a reliable method of maintaining weight loss in these patients with continued improvements in knee pain and symptoms at 5-year follow-up compared with baseline. SETTING: University hospital. METHODS: A 5-year prospective observational study was performed in patients with symptoms and radiographic evidence of knee osteoarthritis who were undergoing bariatric surgery. The Western Ontario and McMaster Universities Index of Osteoarthritis and Knee Osteoarthritis Outcome Score Surveys were administered at baseline, 6 months, 12 months, 2 years, and 5 years. Patients who met all inclusion criteria and followed up at baseline, 6 months, 1 year, and 5 years were included in the study (n = 13). Statistical analysis was performed using Student t and Wilcoxon signed rank tests. RESULTS: Patients on average maintained a percent total weight loss of 22.3% at 5-year follow-up (P < .0001). There was a statistically significant improvement from baseline in all subscales-pain, stiffness, and physical function-as measured by Western Ontario and McMaster Universities at 6 months, 1 year, and 5 years. A statistically significant change in pain (P = .0005) and function/activities of daily living (P = .0088) was maintained at 5-year follow-up as measured by the Knee Osteoarthritis Outcome Score. CONCLUSIONS: Bariatric surgery is a reliable method to maintain weight loss, reduce pain and stiffness, and improve function in patients with knee osteoarthritis at 5-year follow-up.


Assuntos
Artralgia , Cirurgia Bariátrica/estatística & dados numéricos , Obesidade , Osteoartrite do Joelho , Artralgia/complicações , Artralgia/fisiopatologia , Humanos , Articulação do Joelho/fisiopatologia , Obesidade/complicações , Obesidade/cirurgia , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Estudos Prospectivos , Resultado do Tratamento , Perda de Peso
10.
Sports Health ; 11(1): 64-68, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30289744

RESUMO

BACKGROUND:: Pediatric sports specialization, defined as intense year-round training in a single sport as a result of excluding other sports for more than 8 months per year, is common in the United States. There are demonstrated physical and social risks to early pediatric sports specialization (defined as before age 12 years). While thought to be needed to acquire appropriate experience and excel in a given sport, there remains little information on when athletes at the highest levels of their sport specialized. This study aimed to define when professional and collegiate ice hockey players specialized. HYPOTHESIS:: Early sports specialization before age 12 years will not be common among elite-level (professional and collegiate) ice hockey players. STUDY DESIGN:: Retrospective cross-sectional survey study. LEVEL OF EVIDENCE:: Level 3. METHODS:: Male professional and collegiate ice hockey players within 1 National Hockey League organization and 2 National Collegiate Athletic Association (NCAA) organizations who were 18 years of age or older completed a survey at training camp detailing their history of sports participation and specialization. RESULTS:: A total of 91 athletes participated in the study (mean age, 22.8 years; range, 18-39 years). The mean age at the start of any sports participation was 4.5 years, and the mean age of sports specialization was 14.3 years. The mean age of specialization in the professional group, the NCAA Division I group, and the NCAA Division III group was 14.1, 14.5, and 14.6 years, respectively. CONCLUSION:: Early pediatric sports specialization is not common in elite-level (professional and collegiate) ice hockey players. CLINICAL RELEVANCE:: Early pediatric sports specialization before age 12 years is not necessary for athletic success in professional and collegiate ice hockey. This study provides further evidence supporting the recommendations of the American Medical Society for Sports Medicine, American Academy of Pediatrics, and American Orthopaedic Society for Sports Medicine against early sports specialization.


Assuntos
Desempenho Atlético , Hóquei , Especialização , Adolescente , Adulto , Fatores Etários , Criança , Estudos Transversais , Humanos , Masculino , Condicionamento Físico Humano , Estudos Retrospectivos , Estados Unidos , Adulto Jovem
11.
Am J Sports Med ; 47(4): 982-990, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29630388

RESUMO

BACKGROUND: The incidence of shoulder and elbow injuries among adolescent baseball players is on the rise. These injuries may lead to surgery or retirement at a young age. PURPOSE: To identify independent risk factors for elbow and shoulder injuries in adolescent baseball players. A secondary aim was to determine whether the literature supports the Major League Baseball and USA Baseball Pitch Smart guidelines. STUDY DESIGN: Systematic review. METHODS: A systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing MEDLINE, SPORTDiscus, and Web of Science. Because of study heterogeneity, a quantitative synthesis was not performed. A qualitative review was performed on 19 independent risk factors for elbow and shoulder injuries in adolescent baseball players. Level of evidence was assigned per the Oxford Centre for Evidence-Based Medicine Working Group, and risk of bias was graded per the Newcastle-Ottawa Scale. RESULTS: Twenty-two articles met criteria for inclusion. Of the 19 independent variables that were analyzed, age, height, playing for multiple teams, pitch velocity, and arm fatigue were found to be independent risk factors for throwing arm injuries. Pitches per game appears to be a risk factor for shoulder injuries. Seven independent variables (innings pitched per game, showcase participation, games per year, training days per week, pitch type, shoulder external rotation, and shoulder total range of motion) do not appear to be significant risk factors. The data were inconclusive for the remaining 6 variables (weight, months of pitching per year, innings or pitches per year, catching, shoulder horizontal adduction, and glenohumeral internal rotation deficit). CONCLUSION: The results from this study demonstrate that age, height, playing for multiple teams, pitch velocity, and arm fatigue are clear risk factors for throwing arm injuries in adolescent baseball players. Pitches per game appears to be a risk factor for shoulder injuries. Other variables are either inconclusive or do not appear to be specific risk factors for injuries.


Assuntos
Beisebol/lesões , Cotovelo/lesões , Lesões do Ombro/etiologia , Adolescente , Fatores Etários , Braço/fisiologia , Estatura , Comportamento Competitivo/fisiologia , Cotovelo/fisiopatologia , Humanos , Fadiga Muscular/fisiologia , Amplitude de Movimento Articular , Fatores de Risco , Rotação , Ombro/fisiopatologia , Lesões do Ombro/fisiopatologia
12.
Perm J ; 22: 17-211, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30005723

RESUMO

CONTEXT: Adolescent obesity and sports-related concussion are rising in prevalence, yet there is minimal research exploring the relationship between these two conditions. OBJECTIVE: To assess the impact of body mass index (BMI) percentile on duration of recovery and reported symptoms after sports-related concussion in adolescents. DESIGN: Retrospective chart review at a regional concussion program located at an academic medical center. Medical records of all patients aged 13 to 18 years treated from March 2006 through January 2012 were reviewed. Two hundred fifty-two patients met the inclusion criteria of sports-related concussion and having BMI data. MAIN OUTCOME MEASURES: Outcome variables included reported emotional symptoms, sleep-related symptoms, physical symptoms (headache), and time to recovery after a concussion. Explanatory variables in this analysis were BMI percentile and sex. RESULTS: More male patients were obese and overweight than were females (42% vs 27%, p = 0.02). There was no statistically significant difference in recovery time between obese and overweight patients and others. Obese and overweight patients were more likely than healthy-weight patients to report symptoms of irritability (p = 0.05) and impulsivity (p = 0.01), and less likely to report headache (p = 0.03). CONCLUSION: After concussion, irritability and impulsivity may be more likely than headaches in overweight and obese patients. There was no difference in recovery time between obese and healthy-weight teens. These findings may have importance in the evaluation, treatment, and anticipatory guidance of patients with concussions.


Assuntos
Índice de Massa Corporal , Síndrome Pós-Concussão/etiologia , Adolescente , Feminino , Humanos , Masculino , Obesidade Pediátrica/complicações , Síndrome Pós-Concussão/patologia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fatores Sexuais
13.
Sports Health ; 10(1): 31-34, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29059531

RESUMO

CONTEXT: The use of creatine as a dietary supplement has become increasingly popular over the past several decades. Despite the popularity of creatine, questions remain with regard to dosing, effects on sports performance, and safety. EVIDENCE ACQUISITION: PubMed was searched for articles published between 1980 and January 2017 using the terms creatine, creatine supplementation, sports performance, and dietary supplements. An additional Google search was performed to capture National Collegiate Athletic Association-specific creatine usage data and US dietary supplement and creatine sales. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: Short-term use of creatine is considered safe and without significant adverse effects, although caution should be advised as the number of long-term studies is limited. Suggested dosing is variable, with many different regimens showing benefits. The safety of creatine supplementation has not been studied in children and adolescents. Currently, the scientific literature best supports creatine supplementation for increased performance in short-duration, maximal-intensity resistance training. CONCLUSION: While creatine appears to be safe and effective for particular settings, whether creatine supplementation leads to improved performance on the field of play remains unknown.


Assuntos
Desempenho Atlético , Creatina/farmacologia , Suplementos Nutricionais , Creatina/efeitos adversos , Humanos , Treinamento de Força
14.
Prev Med Rep ; 8: 273-278, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29255662

RESUMO

Fewer adults meet guidelines for aerobic physical activity, and many report a lack of enjoyment as a barrier. This survey was designed to determine the interest of primary care patients in participating in program designed to maximize enjoyment. Primary care patients (n = 540) in Central Pennsylvania reported their interest in participating in a "a regular fitness program where people your own age played games, such as softball, floor hockey and soccer, that were made to be easier to play and less competitive." Mean age was 58.4 years (SD = 16.5, range = 18-98). More than one-third (37.0%), including 59.6% of those under age 50, were interested in the modified sports fitness program. After adjusting for confounders, patients under age 40 were 5.9 (95% CI: 2.6-13.9) times as interested (v. age > 70) and non-white patients were 3.4 (95% CI: 1.3-8.5) times interested. Female patients and those with hypertension, high cholesterol or obesity were equally interested. A fitness program that consists of modified sports may be of interest to most primary care patients under age 50. Patients' initial interest appears high enough to warrant further development and testing.

15.
Clin Pediatr (Phila) ; 56(14): 1280-1285, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29073787

RESUMO

Sleep disturbance is a common problem following concussion. A retrospective chart review was conducted at a regional concussion clinic on patients 13 to 18 years of age between 2005 and 2011. Statistical analysis evaluated sleep disturbance and duration of concussion, as well as the use and effectiveness of melatonin. A total of 417 patients met inclusion criteria. One hundred twenty-three (34%) reported disturbance in sleep. There was no difference in sleep disturbance based on age, gender, or past number of concussions. Sleep disturbance was associated with a 3- to 4-fold increase in recovery time. Non-sport-related concussions were more likely to be associated with sleep disturbance compared to sport-related concussions (45% vs 29%, P = .01). Melatonin improved sleep disturbance in 67% of the patients. Evaluating sleep disorders following concussion is an important part of the assessment. These findings will help clinicians provide anticipatory guidance and treatment for adolescents recovering from concussion.


Assuntos
Concussão Encefálica/complicações , Depressores do Sistema Nervoso Central/uso terapêutico , Melatonina/uso terapêutico , Recuperação de Função Fisiológica/fisiologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/tratamento farmacológico , Adolescente , Concussão Encefálica/fisiopatologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Transtornos do Sono-Vigília/fisiopatologia , Tempo , Resultado do Tratamento
16.
Phys Ther Sport ; 25: 76-83, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28188077

RESUMO

Athletic participation growth has resulted in increased exposures and neuromusculoskeletal (NMSK) non-contact injuries. Based on current evidence, the primary objective of this literature review is to create a preliminary evidence-based NMSK exercise guideline, addressing these intrinsic modifiable risk factors. Systematic searches were conducted September 2014 prior to data extraction utilizing CINAHL Plus (1995 to September 2014), MEDLINE (1995 to September 2014), and Academic Search Premier (1995 to September 2014). A priori defined inclusion criteria were applied and included the following: (i) full text, (ii) published in English, (iii) peer-reviewed articles addressing injury risk of non-contact lower extremity injury, (iv) identified specific exercises aimed at reducing injury risk of non-contact lower extremity injury, were the key data extraction points of interest. 3163 potential articles were identified from the initial search, 3120 excluded with reason based on the exclusion criteria. Exclusion criteria was applied in the form of an eight item list summarized in table 2, 43 articles remained after search criteria were applied. Novel to the current body of knowledge, this review identified nine intrinsic modifiable risk factors of the NMSK system that were used as a foundation to create the exercise guideline consisting of 30 exercise techniques.


Assuntos
Traumatismos em Atletas/prevenção & controle , Terapia por Exercício/métodos , Medicina Baseada em Evidências , Humanos , Guias de Prática Clínica como Assunto
17.
Am J Sports Med ; 45(3): 725-732, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27159297

RESUMO

BACKGROUND: The Functional Movement Screen (FMS) is utilized by professional and collegiate sports teams and the military for the prevention of musculoskeletal injuries. HYPOTHESIS: The FMS demonstrates good interrater and intrarater reliability and validity and has predictive value for musculoskeletal injuries. STUDY DESIGN: Systematic review and meta-analysis. METHODS: A systematic review and meta-analysis were conducted using a computerized search of the electronic databases MEDLINE and ScienceDirect in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Extracted relevant data from each included study were recorded on a standardized form. The Cochran Q statistic was utilized to evaluate study heterogeneity. Pooled quantitative synthesis was performed to measure the intraclass correlation coefficient (ICC) for interrater and intrarater reliability, along with 95% CIs, and odds ratios with 95% CIs for the injury predictive value for a score of ≤14. RESULTS: Eleven studies for reliability, 5 studies for validity, and 9 studies for the injury predictive value were identified that met inclusion and exclusion criteria; of these, 6 studies for reliability and 9 studies for the injury predictive value were pooled for quantitative synthesis. The ICC for intrarater reliability was 0.81 (95% CI, 0.69-0.92) and for interrater reliability was 0.81 (95% CI, 0.70-0.92). The odds of sustaining an injury were 2.74 times with an FMS score of ≤14 (95% CI, 1.70-4.43). Studies for validity demonstrated flaws in both internal and external validity of the FMS. CONCLUSION: The FMS has excellent interrater and intrarater reliability. Participants with composite scores of ≤14 had a significantly higher likelihood of an injury compared with those with higher scores, demonstrating the injury predictive value of the test. Significant concerns remain regarding the validity of the FMS.


Assuntos
Traumatismos em Atletas/prevenção & controle , Teste de Esforço/métodos , Sistema Musculoesquelético/lesões , Medição de Risco/métodos , Traumatismos em Atletas/diagnóstico , Humanos , Movimento , Reprodutibilidade dos Testes
18.
Sports Med Arthrosc Rev ; 24(3): 123-9, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27482778

RESUMO

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.


Assuntos
Concussão Encefálica/complicações , Concussão Encefálica/terapia , Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/etiologia , Dissonias/etiologia , Dissonias/terapia , Cefaleia/etiologia , Humanos , Transtornos do Humor/etiologia , Transtornos do Humor/terapia , Síndrome Pós-Concussão/etiologia , Síndrome Pós-Concussão/terapia , Volta ao Esporte , Retorno ao Trabalho
20.
BMJ Case Rep ; 20162016 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-26933185

RESUMO

We present the case of a 28-year-old man with a growing mass in his right popliteal fossa causing pain on exertion. The differential diagnosis included Baker's cyst, entrapment syndrome of the popliteal artery, as well as a benign or malignant neoplasm. An ultrasound was non-specific. Follow-up MRI of the knee demonstrated cystic adventitial disease (CAD). With only about 500 cases reported in the literature since its discovery in 1947, CAD is a rare entity. The disease is characterised by mucinous or gelatinous cysts in the arterial or venous adventitia. The disease is predominantly seen in the popliteal artery and typically affects otherwise healthy males in the fourth to fifth decade of life. It presents clinically as intermittent exertional claudication. Examination of our case and a review of the literature will highlight the importance of considering CAD in patients who report of a popliteal mass and intermittent claudication.


Assuntos
Túnica Adventícia/patologia , Joelho/patologia , Artéria Poplítea/patologia , Cisto Popliteal/diagnóstico por imagem , Adulto , Atletas , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino
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