Vestibular and Balance Dysfunction Following Sport-Related Concussion

2019 ◽  
Vol 4 (6) ◽  
pp. 1349-1363
Author(s):  
Jamie M. Bogle
Keyword(s):  
Public Health ◽  
Multidisciplinary Team ◽  
Return To Sport ◽  
Return To Play ◽  
Health Concern ◽  
Balance Function ◽  
Public Health Concern ◽  
Gaze Stability ◽  
Significant Public Health Concern ◽  
Significant Public Health

Purpose Sport-related concussion is a significant public health concern that requires a multidisciplinary team to appropriately manage. Athletes often report dizziness and imbalance following concussion, and these symptoms can predict increased time to recover. Vestibular diagnostic evaluations provide important information regarding the athlete's oculomotor, gaze stability, and balance function in order to identify deficits for rehabilitation. These measures also describe objective function helpful for determining when an athlete is ready to return to play. The purpose of this clinical focus article is to provide background on the current understanding of the effects of concussion on the peripheral and central vestibular system, as well as information on a protocol that can be used for acute concussion assessment. Case studies describing 3 common postconcussion presentations will highlight the usefulness of this protocol. Conclusion Sport-related concussion is a highly visible disorder with many symptoms that may be evaluated in the vestibular clinic. A thoughtful protocol evaluating the typical presentation of these patients may help guide the multidisciplinary team in determining appropriate management and clearance for return to sport.

scholarly journals A Novel Phenotypic Method To Screen for Plasmid-Mediated Colistin Resistance among Enterobacteriales

2019 ◽  
Vol 57 (5) ◽  
Author(s):  
Drew T. Bell ◽  
Yehudit Bergman ◽  
Abida Q. Kazmi ◽  
Shawna Lewis ◽  
Pranita D. Tamma ◽  
...  
Keyword(s):  
Public Health ◽  
Sensitivity And Specificity ◽  
Health Concern ◽  
Colistin Resistance ◽  
Public Health Concern ◽  
Significant Public Health Concern ◽  
Phenotypic Method ◽  
Significant Public Health ◽  
Clinical Pathogens

ABSTRACT Plasmid-mediated colistin resistance (PMCR), a consequence of the mcr genes, is a significant public health concern given its potential to easily spread among clinical pathogens. Recently, it was discovered that MCR enzymes require zinc for activity. Thus, we modified the colistin broth-disk elution (CBDE) test to screen for plasmid-mediated colistin resistance (PMCR) genes based on any reduction of colistin MIC in the presence of EDTA. Eighty-five isolates of the order Enterobacteriales (12 mcr positive) were tested by CBDE ± EDTA. The sensitivity and specificity of the EDTA-CBDE method to detect PMCR compared to the molecular genotype results were 100% and 95.8%, respectively. Isolates positive by the EDTA-CBDE test should be further evaluated to confirm the presence of mcr genes.

Impact of the Opioid/Fentanyl Epidemic on the Toxicology Laboratory’s Workload: The CMCVAMC Experience

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S90-S90
Author(s):  
Jeffrey Petersen ◽  
Thomas George ◽  
Darshana Jhala
Keyword(s):  
Public Health ◽  
Clinical Care ◽  
Health Concern ◽  
Fiscal Year ◽  
Opioid Epidemic ◽  
Public Health Concern ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Gas Chromatography Mass Spectroscopy

Abstract Introduction Opiates have long been used by both the population at large and the veteran population as a drug of abuse. However, recently, fentanyl—a synthetic opioid—has risen in prominence in this opioid drug abuse epidemic as a drug used by suppliers to “cut” heroin, to masquerade for another opiate, or for direct usage. As this is a recent phenomenon, the new increasing need to test for fentanyl for clinical reasons has a major impact on the toxicology laboratory’s workload. Method Quality assurance/improvement data were obtained to determine the number of fentanyl tests by gas chromatography/mass spectroscopy (GC/MS) performed by the toxicology laboratory since quarter 1 of 2011 (October-December 2010) to quarter 1 of 2018 (October-December 2017). The numbers of tests required for clinical care in each quarter were tabulated and compared in a graph. Quarters for each year begin and end in October. Results The total number of GC/MS tests for fentanyl needed for clinical care has been drastically increasing recently. From 2011 to 2015, the yearly number of tests clinically needed has ranged from 83 to 92. In 2016, the total number of clinically needed tests for fentanyl spiked to 167 and by fiscal year 2017 included 1,108 fentanyl GC/MS tests. The last examined quarter (quarter 1 of fiscal year 2018) included 527 tests, which is more than the highest number from 2017 (377 in quarter 4 of 2017). Conclusion The increasing use of fentanyl in the opioid epidemic appears to have played a role in significantly increasing the clinical need to test for fentanyl by GC/MS, increasing the volume by over 10 to 15 times. The role of fentanyl in the opioid epidemic remains a significant public health concern.

scholarly journals Medications against drugs: Development of medications to prevent and treat substance use disorders

2021 ◽  
Author(s):  
Ivan Dario Montoya
Keyword(s):  
Public Health ◽  
Substance Use ◽  
Health Concern ◽  
Public Health Concern ◽  
Safety And Efficacy ◽  
Significant Public Health Concern ◽  
Scientific Approach ◽  
Challenges And Opportunities ◽  
Significant Public Health ◽  
New Compounds

Substance use disorder (SUD) is a significant public health concern. Unfortunately, there are few safe and effective medications to treat SUD and efficacy is suboptimal. There are important financial and scientific obstacles to develop new compounds, but recent advances in the discovery of new brain receptors and neurocircuits are offering opportunities to develop new pharmacotherapies. A systematic scientific approach to develop medications is required to demonstrate their safety and efficacy, bring it to market, and prescribe it to patients. The purpose of this manuscript is to provide a general overview of the challenges and opportunities in medications development for SUD, describe the phased approach of this development, the medications approved, and those that appear most promising.

scholarly journals Therapeutic options and challenges for substances of abuse

2007 ◽  
Vol 9 (4) ◽  
pp. 431-445 ◽  
Keyword(s):  
Public Health ◽  
United States ◽  
Substance Use ◽  
The United States ◽  
Health Concern ◽  
Pharmacological Treatments ◽  
Public Health Concern ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Substances Of Abuse

Addiction to substances continues to be a significant public health concern in the United States. The following review of current pharmacological treatments discusses a range of substances: nicotine, alcohol, cocaine, and opioids. The goal is to provide an overview of currently available and new pharmacological treatments for substance use disorders, while also addressing the pharmacotherapeutic challenges remaining. The significant advances in pharmacotherapy have had limited utilization, however. For example, naltrexone for alcoholism is infrequently prescribed, buprenorphine for opiates still has relatively few qualified prescribers, and stimulants have no Food and Drug Administration-approved pharmacotherapy. These pharmacotherapies are needed, with the rate of even the relatively uncommon abuse of opiates now rising sharply.

scholarly journals Towards a Greater Understanding of Suicidal Behaviour and Its Prevention

2018 ◽  
Vol 15 (8) ◽  
pp. 1629 ◽  
Author(s):  
Merike Sisask ◽  
Kairi Kõlves
Keyword(s):  
Public Health ◽  
Suicidal Behaviour ◽  
Health Concern ◽  
Public Health Concern ◽  
Significant Public Health Concern ◽  
Significant Public Health

Suicidal behaviour continues to be an important topic of research and significant public health concern globally [1–3].[...]

Introduction

2021 ◽  
pp. 1-14
Author(s):  
Jonathan S. Abramowitz ◽  
Dean McKay ◽  
Eric A. Storch
Keyword(s):  
Public Health ◽  
Functional Impairment ◽  
Health Concern ◽  
Clinical Implications ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Past Half Century ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Past Half

Obsessive-compulsive disorder (OCD) was once considered a rare and untreatable condition. Over the past half-century, however, a dramatic surge in research has led not only to a clearer understanding of this problem but also to the realization that it is fairly common and impairing, afflicting up to about 3% of the population. When the prevalence and functional impairment are considered together with the anxiety and distress that individuals with this OCD experience, one recognizes that this condition represents a significant public health concern. With this in mind, the present volume focuses on advances and emerging clinical implications in the field of OCD and related disorders with respect to assessment, treatment, treatment augmentation, and basic science.

Disease outbreaks caused by steppe-type rabies viruses in China

2014 ◽  
Vol 143 (6) ◽  
pp. 1287-1291 ◽  
Author(s):  
Y. FENG ◽  
W. WANG ◽  
J. GUO ◽  
ALATENGHELI ◽  
Y. LI ◽  
...  
Keyword(s):  
Fluorescent Antibody ◽  
Disease Outbreaks ◽  
Antibody Test ◽  
Domestic Animal ◽  
Health Concern ◽  
Rt Pcr ◽  
Public Health Concern ◽  
The North ◽  
Significant Public Health Concern ◽  
Significant Public Health

SUMMARYWhile rabies is a significant public health concern in China, the epidemiology of animal rabies in the north and northwest border provinces remains unknown. From February 2013 to March 2014, seven outbreaks of domestic animal rabies caused by wild carnivores in Xinjiang (XJ) and Inner Mongolia (IM) Autonomous Regions, China were reported and diagnosed in brain samples of infected animals by the fluorescent antibody test (FAT) and RT–PCR. Ten field rabies viruses were obtained. Sequence comparison and phylogenetic analysis based on the complete N gene (1353 bp) amplified directly from the original brain tissues showed that these ten strains were steppe-type viruses, closely related to strains reported in Russia and Mongolia. None had been identified previously in China. The viruses from XJ and IM clustered separately into two lineages showing their different geographical distribution. This study emphasizes the importance of wildlife surveillance and of cross-departmental cooperation in the control of transboundary rabies transmission.

Surgical Treatment Of Obesity

2018 ◽  
Author(s):  
Luise Pernar ◽  
Malcolm K. Robinson
Keyword(s):  
Weight Loss ◽  
Weight Loss Surgery ◽  
The United States ◽  
Health Concern ◽  
Public Health Concern ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Treatment Of Obesity ◽  
Hunger Sensation ◽  
Surgical Treatment Of Obesity

Obesity is associated with numerous comorbidities and shortens life expectancy. Currently, over one third of adults in the United States are obese, making management of obesity a significant public health concern. Given the modest benefits of behavior change alone, weight loss surgery has become a popular tool in the treatment of obesity. Numerous studies have documented the benefits of weight loss surgery in promoting weight loss and resolution of comorbidities. The hormonal and physiologic changes that are induced by some weight loss procedures are not yet fully elucidated, but it is thought that changes in hunger sensation and metabolism drive the observed effects. This review contains 4 figures, 2 videos, 3 tables and 60 references Key words: bypass, obesity, sleeve gastrectomy, surgery, weight loss

scholarly journals Increasing herd immunity with influenza revaccination

2015 ◽  
Vol 144 (6) ◽  
pp. 1267-1277 ◽  
Author(s):  
E. Q. MOORING ◽  
S. BANSAL
Keyword(s):  
Public Health ◽  
Vaccine Coverage ◽  
Herd Immunity ◽  
Population Level ◽  
Health Concern ◽  
Contact Network ◽  
Large Contribution ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Influenza Transmission

SUMMARYSeasonal influenza is a significant public health concern globally. While influenza vaccines are the single most effective intervention to reduce influenza morbidity and mortality, there is considerable debate surrounding the merits and consequences of repeated seasonal vaccination. Here, we describe a two-season influenza epidemic contact network model and use it to demonstrate that increasing the level of continuity in vaccination across seasons reduces the burden on public health. We show that revaccination reduces the influenza attack rate not only because it reduces the overall number of susceptible individuals, but also because it better protects highly connected individuals, who would otherwise make a disproportionately large contribution to influenza transmission. We also demonstrate that our results hold on an empirical contact network, in the presence of assortativity in vaccination status, and are robust for a range of vaccine coverage and efficacy levels. Our work contributes a population-level perspective to debates about the merits of repeated influenza vaccination and advocates for public health policy to incorporate individual vaccine histories.

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