Costeffectiveness of analytic strategies for venous thromboembolism a planned out evaluate

The objective of this study is to determine the relative efficacy of an intravenous therapy for post-concussive headaches in a pediatric population, as compared to oral therapy.
Post traumatic headache is extremely common in the acute and chronic phases after concussion. To date, there is still not significant evidence-based treatment protocols defined for treatment.
Pediatric patients who were treated for post-concussive headaches at an outpatient infusion clinic from 2016 to 2018 were selected for inclusion in the study. Clinic visits before and after infusions were reviewed to determine changes in headache score (HA), symptom severity score (SSS), and self-reported symptom relief. The control group received only oral therapy for their headaches. The infusion consisted of parenteral ketorolac, compazine, diphenhydramine, and a normal saline bolus (20 mg/kg). Of the 95 patients who were treated in clinic, 53 patients were selected for a retrospective chart review.
Following infusion therapy, overall infusion therapy may have a shorter time to headache abortion than oral therapy based on pharmacokinetics. Further, some physicians are unwilling to allow an athlete to return to play while taking suppressive medication. Future studies may show that an infusion could allow a more rapid return to play and resolution of symptoms.
The purpose of this study is to expose the prevalence of mild traumatic brain injuries among high school football players and to explore the possibility of implementing eye tracking performance as an objective way to assess cases of potential concussion.
Concussions are one of the most common forms of traumatic brain injury (TBI). Unfortunately, current research suggests that mild TBIs cannot always be accurately diagnosed via routine neurologic examination. Also, most evaluations, such as ImPACT, are survey-style assessments that are time intensive and subjective. Lack of an objective method to rapidly assess concussions on the field raises concern for second-impact syndrome (SIS), which can lead to permanent brain damage or even fatality.
This multi-part study included a population of 849 high school athletes in from Lubbock, TX. Student athletes filled out a baseline concussion survey, then assessed their eye tracking performance with the EyeGuide Focus, a 10-second test that involves visually trackiween the concussed, baseline, and follow-up scores, eye-tracking promises to be a quick and efficient tool to assess sports-related concussions.
To highlight a multidisciplinary approach to the diagnosis and management of unilateral abducens palsy after a sports-related concussion.
Mild traumatic brain injury (TBI) often leads to disruptions in visual functioning, affecting convergence, saccades, smooth pursuit, and accommodation. More severe TBI injuries may result in structural injuries to the ocular muscles, nerves, or the brain itself.
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Case We present the case of a 33-year-old male with unilateral abducens nerve palsy after a sports-related concussion with loss of consciousness and multiple hemorrhagic contusions. The patient's visual symptoms manifested several days after the injury. With a multi-disciplinary evaluation involving specialists representing neurosurgery, endovascular neurology and neuro-ophthamology, unenhanced magnetic resonance imaging revealed multiple foci of intraparenchymal microhemorrhages and siderosis consistent with diffuse axonal injury (DAI), and an incidental parasagittal cavernoma. The delayed development of a sixth nerve palsy raised our suspicion for secondary axotomy, as has been described following TBI. While the probability of recovery is high, close follow up is imperative to address evolution of the patient's symptoms. In this case, the patient developed imbalance and headaches in association with his visual symptoms. For the imbalance we use physical therapy with therapists trained in vestibular therapy and for the visual symptoms we use vision therapy with trained optometrists.
Delayed post-traumatic abducens palsy is concerning for DAI and secondary axotomy. Multidisciplinary assessment imparts the ability to evaluate for all possible causes and provide additional specialized care for recovery.
Delayed post-traumatic abducens palsy is concerning for DAI and secondary axotomy. Multidisciplinary assessment imparts the ability to evaluate for all possible causes and provide additional specialized care for recovery.
To quantify the head impact biomechanics, by impact mechanism, of female high school lacrosse players during games using an instrumented mouthguard.
There is growing concern for the neurologic effects of repetitive head impacts in sports, which have been linked with several short-term neurophysiologic deficits. Girls' lacrosse represents a popular but understudied sport with regard to head impact exposure and current debate exists as to the need for enhanced protective equipment.
A female high school varsity lacrosse team wore the Stanford Instrumented Mouthguard during competitive games for the 2019 season. Video footage was reviewed to confirm head impact events and remove false-positive recordings. For each impact event, the mechanism was coded as stick contact, player contact, fall, or ball contact. Head impact rates were calculated per athlete exposure (AE, defined as a single player participating in a single game).
Sensor data were recorded for 15 female varsity lacrosse players for 14 games andin the highest peak linear and angular kinematics, which may help explain why they are the most common cause of head injury in female lacrosse. By quantifying the head impact exposure, kinematics and mechanisms in female high school lacrosse, targeted injury preventions can be developed, such as rule changes and protective equipment.
The objective of this study was to examine the association between insurance status and prevalence of follow up care at a tertiary referral center compared to the emergency department.
Concussions are extremely common in today's society, affecting patients of all demographic backgrounds. There is concern that public insurance status may affect follow up care at tertiary treatments centers compared to children with private insurance, as evidenced by Copley et al. who documented insurance disparities between children presenting to a sports medicine clinic with orthopedic injuries verses concussion.
We compared insurance status of patients presenting to our pediatric concussion clinic to the insurance status of patients diagnosed with concussion at the emergency department of our tertiary hospital. From 2018 to 2019, 725 patients received an ICD-10 diagnosis code for concussion in our clinic. Patients were excluded if insurance status was not available for the clinic visit (4), or if they were lost to follnic. As a result, children with public insurance may have prolonged recovery and more significant symptoms burden compared to children with private insurance.
The objective of this study was to examine the association between sport/non-sport concussions as well as age and time to recovery after concussion diagnosis in children and adolescents.
There is an ongoing debate between policy makers and medical specialists on when is the appropriate time to allow children to begin playing contact sports. This dilemma is important because sports are incredibly prevalent in our child and adolescent population today. There is still significant debate if age at time of concussion diagnosis is associated with long term affects and time to recovery.
Of the 725 patients who received a diagnosis of concussion at Children's of Alabama (COA) from 2018 to 2019, 350 patients were included for retrospective cohort review based on documented recovery data defined as follow up appointment PRN (as needed) or begin return to play protocol. 221 patients were lost to follow up while 7 were excluded for concomitant skull fracture. Recovery time, patient demographic data, symptoms severime to recovery as there was no difference in the 2 age groups. This data, along with the NCAA-DOD Care Consortium showing repetitive head injury during early adolescence is unrelated to brain health as measured by specific outcome measures, has the potential to provide valuable information for future policy on child and adolescent sports.
To identify differences in symptoms following sports-related concussion (SRC) on natural grass vs artificial turf in youth and adolescent football players.
There is continued interest in reducing risk of SRC in football, with playing surface being one potentially modifiable factor. It is estimated that 15-30% of concussions result from helmet-to-ground contact, and some studies have suggested a higher incidence of SRC on grass in competitive contact sports compared to turf. https://www.selleckchem.com/products/mst-312.html To our knowledge, our study is the first to investigate reported post-concussive symptoms after SRC as they relate to playing surface.
Data were prospectively collected from the North Texas Concussion Registry (ConTex), a longitudinal multi-institutional concussion database. We selected male football players between the ages of 10 and 24 who sustained a helmet-to-ground SRC (GCS 13-15) on either grass or turf. Pre-injury information and post-concussive symptoms (Graded Symptom Checklist from the SCAT-5) were collected at an initial iC on grass vs turf is important, as competitive playing surface is a modifiable risk factor.
Youth and adolescent football players who sustain SRC on grass report higher post-concussive symptom severity and burden. Elucidating differential effects of SRC on grass vs turf is important, as competitive playing surface is a modifiable risk factor.
To determine if concussed adolescents with positive cervical findings on examination provided with early cervical treatment demonstrate recovery time and incidence of persistent post-concussive symptoms (PPCS, recovery = 30 days) comparable to those without cervical findings.
Cervical impairments resulting from concussive injury are historically associated with longer recovery times. Concomitant cervical injuries may result in symptoms that overlap with concussion, including headache, dizziness, tinnitus, sleep disturbances, and blurred vision. Current recommendations include assessment of the cervical spine; however, there is limited evidence for the effect of immediate cervical intervention on recovery.
Retrospective case-controlled study. Patients included adolescents with acute concussion presenting with (n = 132, 14.99 ± 1.9 years, 58% male, 5.70 ± 3.3 days since injury) and without (n = 138, 14.85 ± 1.8 years, 65% male, 6.13 ± 3.4 days since injury) cervical findings on physical exam. Patients wert symptoms (39% vs 35%,
= 0.511).
In this group of adolescents, cervical impairment managed early after concussion was not associated with prolonged recovery. Early management of cervical impairments may reduce the development of PPCS. Prospective evaluation is warranted.
In this group of adolescents, cervical impairment managed early after concussion was not associated with prolonged recovery. Early management of cervical impairments may reduce the development of PPCS. Prospective evaluation is warranted.