scholarly journals Nonpharmacological Treatment of Persistent Postconcussion Symptoms in Adults

2021 ◽  
Vol 4 (11) ◽  
pp. e2132221
Author(s):  
Hana Malá Rytter ◽  
Heidi J. Graff ◽  
Henriette K. Henriksen ◽  
Nicolai Aaen ◽  
Jan Hartvigsen ◽  
...  
Keyword(s):  
Nonpharmacological Treatment ◽  
Postconcussion Symptoms

Symptom Factors and Neuropsychological Performance in Collegiate Athletes with Chronic Concussion Symptoms

2020 ◽  
Author(s):  
Erin Guty ◽  
Kaitlin Riegler ◽  
Jessica Meyer ◽  
Alexa E Walter ◽  
Semyon M Slobounov ◽  
...  
Keyword(s):  
Executive Functioning ◽  
Student Athletes ◽  
Memory Performance ◽  
Collegiate Athletes ◽  
Cognitive Outcomes ◽  
Depression Symptoms ◽  
Memory Functioning ◽  
Postconcussion Symptoms ◽  
Symptom Predictors ◽  
Time Since Injury

Abstract Objective The present study explored the relationship between specific types of postconcussion symptoms and cognitive outcomes in student–athletes with chronic concussion symptoms. Method Forty student–athletes with chronic concussion symptoms were given a battery of neuropsychological tests and rated themselves on a variety of postconcussion symptoms, which included the following factors derived from prior work: Physical, Sleep, Cognitive, Affective, and Headache. Cognitive outcomes included performance on composites for the memory and attention/executive functioning speed tests, respectively. The following covariates were also explored: Sex, depression symptoms, number of previous concussions, and time since injury. Results Headache was the only individual symptom factor that significantly (p < .05) predicted worse attention/executive functioning performance. None of the symptom factors were significantly related to memory performance over and above the variable of time since injury, such that longer time since injury was related to worse memory performance. Conclusion Comparable to work examining symptom predictors of cognitive outcomes in acutely concussed samples, headache predicted worse attention/executive functioning performance. Additionally, we found that the longer athletes had been symptomatic since injury, the “worse” their memory functioning. Understanding how headache and the length of time an individual is symptomatic are related to cognitive outcomes can help inform treatment and recommendations for athletes with prolonged symptom recovery.

scholarly journals New 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline

Hypertension ◽  
2019 ◽  
Vol 73 (1) ◽  
pp. 142-147 ◽  
Author(s):  
Armando J. Martínez-Rueda ◽  
Antonio Olivas-Martínez ◽  
Olynka Vega-Vega ◽  
Jorge I. Fonseca-Correa ◽  
Ricardo Correa-Rotter
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Mexico City ◽  
Pharmacological Treatment ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Nonpharmacological Treatment ◽  
City Population

The new American College of Cardiology/American Heart Association 2017 Hypertension Guidelines lower the threshold to define hypertension, thus increasing its prevalence. The impact on populations and health systems is poorly understood. We included data from 990 subjects aged 20 to 64 years from the SALMEX cohort (Salt in Mexico; Mexico City) and determined the prevalence of hypertension and requirement for pharmacological treatment according to both Joint National Committee on the Prevention, Detection, and Treatment of High Blood Pressure 7 and American College of Cardiology/American Heart Association 2017 guidelines. The data obtained were extrapolated to sex- and age-adjusted Mexico City population, and annual costs of medical follow-up were calculated. The new definition increased the prevalence of hypertension among SALMEX cohort from 16.2% to 37.4% (18%–39.3% after adjusting to Mexico City population). The proportion of subjects that require pharmacological and nonpharmacological treatment increased from 17.7% to 19.0% and from 17.7% to 37.4%, respectively (19.4%–21.8% for pharmacological and 19.4%–39.3% for nonpharmacological treatment, after adjusting to Mexico City population). Annual costs of medical follow-up for subjects with hypertension in Mexico City would increase an estimated $59 278 928. The requirement to initiate pharmacological treatment was similar when assessed by Framingham risk score with lipids or with body mass index compared with the Atherosclerotic Cardiovascular Disease score, with correlation κ indexes of 0.981 and 0.972, respectively. On the basis of these results, Framingham body mass index represents an attractive and potentially cost-effective alternative to assess cardiovascular risk. In conclusion, the adoption of the new guidelines in Mexican population has implications not only on its prevalence but also on medical follow-up costs. A pharmacoeconomic model is required to assess the actual financial impact.

scholarly journals Clinical effects of nonpharmacological treatment of ADHD

2021 ◽  
Author(s):  
Matheus Almeida Ribeiro da Cunha ◽  
João Gustavo dos Anjos Morais Oliveira ◽  
Gabriela Sarno Brandão ◽  
Ana Flávia Paiva Bandeira Assis ◽  
Leonardo Mattos Santos ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Pharmacological Treatment ◽  
Methodological Quality ◽  
Pharmacological Therapy ◽  
Pharmacological Intervention ◽  
Clinical Effects ◽  
Nonpharmacological Treatment ◽  
Hyperactivity Disorder ◽  
School Of Medicine

Background: Though pharmacotherapy of Attention Deficit Hyperactivity Disorder (ADHD) is widespread, some patients suffer with side effects or do not improve with it. Objectives: Evaluate clinical outcomes of non-pharmacological therapy on ADHD. Design and Setting: This is a literature review, produced in Bahiana School of Medicine and Public Health. Methods: Articles published between 2011 and 2021 were taken from PubMed, using the following search: (“Non-pharmacological treatment” OR “Non- pharmacological therapy” OR “Non-pharmacological intervention” OR “Non-drug treatment” OR “Non-drug therapy” OR “Adjuvant treatment” OR “Adjuvant therapy”) AND (“ADHD” OR “Attention Deficit-Hyperactivity Disorder”). Studies that did not match this review’s objectives were excluded. Results: 20 of the 57 articles found, were selected. Reviews that approach treatment in general indicate non-pharmacological therapy specially when there are obstacles to use of drugs, but highlight the lack of studies with methodological quality in this field. Clinical studies indicate reduction of symptoms through neurofeedback, transcranial magnetic stimulation, and aerobic exercises. One of the interventions with the most articles was nutritional supplementation, though most of them did not find significant improvement. Conclusions: Non-pharmacological treatment of ADHD is a relevant alternative, especially when there is no response to medication, but studies with better methodological quality are necessary.

The Structure of Postconcussion Symptoms on the Neurobehavioral Symptom Inventory

2015 ◽  
Vol 30 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Rodney D. Vanderploeg ◽  
Marc A. Silva ◽  
Jason R. Soble ◽  
Glenn Curtiss ◽  
Heather G. Belanger ◽  
...  
Keyword(s):  
Symptom Inventory ◽  
Postconcussion Symptoms

scholarly journals Relationship Between Stress, Coping, and Postconcussion Symptoms in a Healthy Adult Population

1998 ◽  
Vol 13 (5) ◽  
pp. 415-424 ◽  
Author(s):  
M. M. Machulda ◽  
T. F. Bergquist ◽  
V. Ito ◽  
S. Chew
Keyword(s):  
Healthy Adult ◽  
Adult Population ◽  
Stress Coping ◽  
Postconcussion Symptoms

Sex-based differences in outcomes for adult patients presenting to the emergency department with a concussion

2021 ◽  
pp. 1-10
Author(s):  
Brian H. Rowe ◽  
Esther H. Yang ◽  
Lindsay A. Gaudet ◽  
Leeor Eliyahu ◽  
Daniela R. Junqueira ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Motor Vehicle ◽  
Adult Population ◽  
Treatment Options ◽  
Multivariate Logistic Regression Model ◽  
Adult Women ◽  
Multivariate Logistic Regression ◽  
Persistent Symptoms ◽  
Postconcussion Symptoms

OBJECTIVE Patients with concussion frequently present to the emergency department (ED). Studies of athletes and children indicate that concussion symptoms are often more severe and prolonged in females compared with males. Given infrequent study of concussion symptoms in the general adult population, the authors conducted a sex-based comparison of patients with concussion. METHODS Adults (≥ 17 years of age) presenting with concussion to one of three urban Canadian EDs were recruited. Discharged patients were contacted by telephone 30 and 90 days later to capture the extent of persistent postconcussion symptoms using the Rivermead Post Concussion Symptoms Questionnaire (RPQ). A multivariate logistic regression model for persistent symptoms that included biological sex was developed. RESULTS Overall, 250 patients were included; 131 (52%) were women, and the median age of women was significantly higher than that of men (40 vs 32 years). Women had higher RPQ scores at baseline (p < 0.001) and the 30-day follow-up (p = 0.001); this difference resolved by 90 days. The multivariate logistic regression identified that women, patients having a history of sleep disorder, and those presenting to the ED with concussions after a motor vehicle collision were more likely to experience persistent symptoms. CONCLUSIONS In a community concussion sample, inconsequential demographic differences existed between adult women and men on ED presentation. Based on self-reported and objective outcomes, work and daily activities may be more affected by concussion and persistent postconcussion symptoms for women than men. Further analysis of these differences is required to identify different treatment options and ensure adequate care and management of injury.

Racial and Ethnic Disparities in Peripheral Artery Disease

2021 ◽  
Vol 128 (12) ◽  
pp. 1913-1926 ◽  
Author(s):  
Eddie L. Hackler ◽  
Naomi M. Hamburg ◽  
Khendi T. White Solaru
Keyword(s):  
Peripheral Artery Disease ◽  
Black Americans ◽  
Ethnic Disparities ◽  
Lower Extremity Amputation ◽  
Treatment Modalities ◽  
Racial And Ethnic Disparities ◽  
Peripheral Artery ◽  
Nonpharmacological Treatment ◽  
Artery Disease ◽  
Extremity Amputation

Peripheral artery disease is an obstructive, atherosclerotic disease of the lower extremities causing significant morbidity and mortality. Black Americans are disproportionately affected by this disease while they are also less likely to be diagnosed and promptly treated. The consequences of this disparity can be grim as Black Americans bear the burden of lower extremity amputation resulting from severe peripheral artery disease. The risk factors of peripheral artery disease and how they differentially affect certain groups are discussed in addition to a review of pharmacological and nonpharmacological treatment modalities. The purpose of this review is to highlight health care inequities and provide a review and resource of available recommendations for clinical management of all patients with peripheral artery disease.

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