scholarly journals A-147 Post-Concussive Symptoms in Adolescent Athletes with Premorbid Psychiatric History: A Matched Case–Control Study

2020 ◽  
Vol 35 (6) ◽  
pp. 941-941
Author(s):  
Presley C ◽  
Caze T ◽  
Tarkenton T ◽  
Stokes M ◽  
Miller S ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Control Sample ◽  
Psychiatric History ◽  
Adolescent Athletes ◽  
Symptom Scale ◽  
North Texas ◽  
The North ◽  
Matched Case ◽  
Domain Scores

Abstract Objective To examine sport-related concussion (SRC) symptoms in adolescent athletes with premorbid psychiatric history (PPH+) compared to a matched control sample without such history (PPH-). It was hypothesized that adolescents with PPH+ would report higher symptom severity both initially and at 3-month follow-up. Method Participants aged 13–18 (M age = 14.9) who reported a psychiatric history (N = 29) presented to clinic within 7 days of sustaining a SRC. Subjects were matched to those without premorbid psychiatric history (N = 29) by age, sex, race, sport, and time to clinic ( 1 day). All participants (N = 58) completed the Post-Concussion Symptom Scale (PCSS) at initial visit and 3-month follow-up as part of the North Texas Concussion Registry (ConTex). Independent sample T tests compared PCSS total and cognitive/fatigue, vestibular, ocular, posttraumatic migraine, and anxiety/mood domain scores between groups across time points. Results Consistent with our hypothesis, the PPH+ group reported significantly higher PCSS total (M = 41.0/132 vs. M = 27.7/132; p = .02), posttraumatic migraine domain (M = 3.5/6 vs. M = 2.5/6; p = .03), and anxiety domain (M = 1.1/6 vs. M = 0.4/6; p = .002) severity at the initial evaluation. However, there were no significant differences in PCSS total (PPH+ M = 4.1/132 vs. PPH- M = 3.3/132) or domain scores at 3-month follow-up. Conclusion(s) After matching by age, sex, race, sport, and time to clinic, adolescents with self-endorsed PPH+ reported higher total symptom, posttraumatic migraine, and anxiety domain symptom severity immediately following SRC but not at 3-month follow-up. Findings suggest that adolescents with PPH+ may experience higher subjective levels of distress following SRC, although further research is needed to understand the role of recovery in this population.

Association Between Sleep Quality and Recovery Following Sport-Related Concussion in Pediatrics

2019 ◽  
Vol 34 (11) ◽  
pp. 639-645 ◽  
Author(s):  
Jane S. Chung ◽  
Aaron J. Zynda ◽  
Nyaz Didehbani ◽  
Cason Hicks ◽  
Linda S. Hynan ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Symptom Severity ◽  
Early Recognition ◽  
Clinic Visit ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
North Texas ◽  
The North ◽  
Prolonged Recovery

Our objective was to determine the association between sleep quality, symptom severity, and recovery following sport-related concussion in pediatric athletes. A review of data from the North Texas Concussion Network Prospective Registry (ConTex) was performed. Participants were diagnosed with a sport-related concussion and were ≤18 years old. Participants were categorized based on their initial clinic visit Pittsburgh Sleep Quality Index composite score (0-21) into good sleep quality (GS≤5) and poor sleep quality (PS>5) groups. The PS group reported higher median total symptom scores at 3-month follow-up (3.0 vs 0.0, P < .01) and took more than a median of 2 weeks longer to recover compared to the GS group (35.0 days vs 20.0 days, P < .01). Poor sleep quality was strongly associated with greater symptom severity and longer time to recovery following sport-related concussion. Early recognition of concussed athletes with poor sleep quality at initial clinic visit may help predict prolonged recovery.

The Role of Premorbid Psychiatric History and Current Mood Ratings on Self-Reported Concussion Symptom Severity

2019 ◽  
Vol 34 (5) ◽  
pp. 775-775
Author(s):  
C Presley ◽  
T Tarkenton ◽  
T Meredith-Duliba ◽  
T Sabo ◽  
S Miller ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Visual Memory ◽  
Cognitive Outcomes ◽  
Adolescent And Young Adult ◽  
Psychiatric History ◽  
General Anxiety Disorder ◽  
The North ◽  
Severity Scores ◽  
Current Mood

Abstract Purpose Psychiatric history is known to be relevant to concussion outcomes, although less is known about the role of such factors or current mood ratings in adolescents. The aim of this study was to assess the role of premorbid psychiatric history (PPH) and current mood ratings (CMR) on overall sports-related concussion (SRC) symptomology and cognitive outcomes in adolescent and young adult athletes. Methods Participants age 12–25 years (M=14.8) diagnosed with SRC (n=560) were evaluated within 14 days of injury as part of the North Texas Concussion Registry (ConTex) using the Patient Health Questionnaire-8 Items (PHQ-8), General Anxiety Disorder-7 Item Scale (GAD-7), and ImPACT. Subjects were dichotomized into those with (PPH+) and without (PPH-) pre-existing reported psychiatric diagnoses, and CMR groups were determined by normal vs. elevated scores on the GAD-7 and PHQ-8. T-tests were used to compare groups. Results Significant differences in total symptom severity scores were found between both PPH (p=.01) and CMR (p<.001) groupings. PPH+ (n=27) reported significantly higher symptom scores (M=31.6) than PPH- subjects (n=316, M=20.9). Additionally, those reporting elevated CMR endorsed 2.3x higher symptom severity scores (n=48, M=42.1 vs. n=276, M=18.2). Among ImPACT cognitive scores, only Visual Memory differed between CMR groups (p=.047). Conclusion Findings suggest that PPH and elevated CMR are associated with greater self-reported symptom severity in adolescent SRC, but have little relationship to cognitive outcomes as assessed by ImPACT. Further research is needed to understand the interaction between PPH, CMR, and SRC recovery across the age spectrum.

scholarly journals Pediatric headache incidence and outcomes after sports-related concussion: Findings from the North Texas ConcussionRegistry (ConTex)

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S11.3-S12
Author(s):  
Bert B. Vargas ◽  
Elida Godbey ◽  
Stephen Bunt ◽  
Ali Shah Tejani ◽  
Munro Cullum
Keyword(s):  
Common Symptom ◽  
North Texas ◽  
Recurrent Headache ◽  
Symptom Resolution ◽  
The North ◽  
Pediatric Headache ◽  
History Of ◽  
Time Since Injury ◽  
Mean Time

IntroductionHeadache is the most common symptom reported after concussion; however, little is known about the incidence of headache and the clinical course over 3 months in pediatric patients with sports-related concussion (SRC) presenting within 30 days of injury.MethodsFour hundred twenty-five patients met inclusion criteria (patients under 18 years old limited to SRC within 30 days of injury and who also completed a 3 months follow up evaluation) and were enrolled from any 1 of 5 ConTex clinic sites.ResultsMean age was 14.3 years (range = 7–18, SD 2.2) and mean time since injury at presentation to clinic was 8.1 days (range = 0–30, SD = 6.7). Only 13.7% (n = 56) had a history of headache before their concussion. 96.5% (n = 410) of patients recalled having headache at time of injury. At initial presentation, 77.3% (n = 317) reported headache; 38.2% (n = 121) mild, 48.6% (n = 154) moderate, 13.2% (n = 42) severe (on a scale from 0-6). At 3 months follow up, 19.8% (n = 81) reported headache; 76.6% (n = 62) mild, 18.5% (n = 15) moderate, 4.9% (n = 4) severe. Among 264 that were treated with headache abortive medications, 97.7% (n = 258) used simple analgesics (NSAIDs or acetaminophen); 0.8% (n = 2) used opioids; 10.2% (n = 27) used triptans; and 5.7% (n = 15) used other non-specified treatments. 66.5% of children reported symptom resolution within 29 days (range 0–90 days, mode 17–29, n = 71, 20.2%).ConclusionsThe incidence of headache at the time of concussion is high and remains high within 30 days after injury, the majority of which were moderate in severity. By 3 months, only a minority of patients report headache, the majority of which were mild. For 86.3% of children, their first experience with recurrent headache occurred in the context of SRC. Outcomes were generally good at 3 months despite an overwhelming majority of children being treated with non-specific, simple analgesics. Most children reported symptom resolution within 29 days of injury.

scholarly journals The North Texas Concussion Registry (ConTex)

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032345 ◽  
Author(s):  
C. Munro Cullum ◽  
Stephen Bunt ◽  
Cason Hicks ◽  
Nyaz Didehbani ◽  
Shane Miller ◽  
...  
Keyword(s):  
Risk Factors ◽  
The Body ◽  
North Texas ◽  
The North ◽  
Body Of Knowledge ◽  
Longitudinal Tracking ◽  
Data Source ◽  
Assessment Metrics ◽  
Rich Data

PurposeThe North Texas Concussion Registry (ConTex) was established in 2015 as a multi-institutional collaboration intended to study risk factors, recovery patterns and clinical outcomes associated with concussion across the lifespan, with a particular emphasis on sport-related concussion.ParticipantsProspective enrolment of individuals who sustained a concussion within the past 6 months who were seen at one of four North Texas ConTex concussion clinics which employ common diagnostic criteria and assessment metrics to evaluate effects of a concussion as well as longitudinal tracking of recovery.Findings to dateThe ConTex database and multidisciplinary oversight team has been established, and over 1700 participants aged 5–88 years have been enrolled. A majority of concussions were sport-related (60%), with a mean age of 17.5 years and similar numbers of males and females. Three-month follow-up compliance has been excellent (86%), with a majority of subjects reporting good recovery by that time. ConTex has provided a rich data source for multiple research projects focused on concussion characteristics, risk factors and outcomes, and led to the development of a statewide youth concussion registry.Future plansConTex data are being analysed to add to the body of knowledge regarding concussion mechanisms, factors related to recovery and improving outcomes for concussion patients. ConTex will serve as a platform for future treatment studies and may serve as a model for other concussion surveillance programmes.

1588: The Bicalutamide Early Prostate Cancer Program: Findings of the North American Trial at 7.7 Years' Median Follow-Up

2006 ◽  
Vol 175 (4S) ◽  
pp. 511-512
Author(s):  
David G. McLeod ◽  
Ira Klimberg ◽  
Donald Gleason ◽  
Gerald Chodak ◽  
Thomas Morris ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
North American ◽  
Early Prostate Cancer ◽  
The North ◽  
Cancer Program

Autoimmune Pancreatitis – Diagnosis, Management and Longterm Follow-up

2014 ◽  
Vol 23 (2) ◽  
pp. 179-185 ◽  
Author(s):  
Suvadip Chatterjee ◽  
Kofi W. Oppong ◽  
John S. Scott ◽  
Dave E. Jones ◽  
Richard M. Charnley ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Rare Condition ◽  
Team Approach ◽  
Diagnostic Challenge ◽  
Multisystem Disorder ◽  
North East ◽  
The North ◽  
Work Up ◽  
Igg4 Level

Background & Aims: Autoimmune pancreatitis (AIP) is a fibroinflammatory condition affecting the pancreas and could present as a multisystem disorder. Diagnosis and management can pose a diagnostic challenge in certain groups of patients. We report our experience of managing this condition in a tertiary pancreaticobiliary centre in the North East of England.Methods: Patients were identified from a prospectively maintained database of patients diagnosed with AIP between 2005 and 2013. Diagnosis of definite/probable AIP was based on the revised HISORt criteria. When indicated, patients were treated with steroids and relapses were treated with azathioprine. All patients have been followed up to date.Results: Twenty-two patients were diagnosed with AIP during this period. All patients had pancreatic protocol CT performed while some patients had either MR or EUS as part of the work up. Fourteen out of 22 (64%) had an elevated IgG4 level (mean: 10.9 g/L; range 3.4 - 31 g/L). Four (18%) patients underwent surgery. Extrapancreatic involvement was seen in 15 (68%) patients, with biliary involvement being the commonest. Nineteen (86%) were treated with steroids and five (23%) required further immunosuppression for treatment of relapses. The mean follow up period was 36.94 months (range 7 - 94).Conclusion: Autoimmune pancreatitis is being increasingly recognized in the British population. Extrapancreatic involvement, particularly extrahepatic biliary involvement seems to be a frequent feature.Diagnosis should be based on accepted criteria as this significantly reduces the chances of overlooking malignancy. Awareness of this relatively rare condition and a multi-disciplinary team approach will help us to diagnose and treat this condition more efiectively thereby reducing unnecessary interventions.

Features of degenerative mitral valve prolapse in the North East of China: repair characteristics, and short-term follow-up results

2020 ◽  
Vol 68 (5) ◽  
Author(s):  
Silvia Corona ◽  
Paolo Barbier ◽  
Guangyu Liu ◽  
Osafo A. Annoh ◽  
Marcio Scorsin ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Short Term ◽  
North East ◽  
The North

Peranan Ombudsman Republik Indonesia Perwakilan Sumatera Utara Dalam Pengawasan Pelayanan Dinas Kependudukan dan Catatan Sipil Kota Medan

2019 ◽  
Vol 1 (1) ◽  
pp. 1-12
Author(s):  
Putri Ananda Sari ◽  
Abdul Kadir ◽  
Beby Mashito Batu Bara
Keyword(s):  
Service Provider ◽  
Qualitative Approach ◽  
First Report ◽  
The North ◽  
Supervision Process ◽  
The Republic ◽  
North Sumatra

This study aims to determine the role of the Ombudsman of the Republic of Indonesia in North Sumatra Representative in the Supervision of Population and Civil Registry Service in Medan City. This study uses a qualitative approach with descriptive methods describing information about the data obtained from the field in the form of written and oral data from the parties studied. Data is collected based on interviews and documentation. The results of this study indicate that the role of the Ombudsman of the Republic of Indonesia in North Sumatra was carried out in the form of external supervision. External supervision is supervision carried out by the Ombudsman of the Republic of Indonesia Representative of North Sumatra to the Medan Population and Civil Registry Service. Actions taken in the supervision process are incoming reports, follow-up of the first report and follow-up of the report. Based on the research that has been carried out, it has been concluded that the role of the Ombudsman of the Republic of Indonesia in the North Sumatra Representative in supervising the service provider of the Population and Civil Registry services is carried out in the form of external supervision. In supervising the handling of public reports of alleged poor service in the area of population administration, it has been effective, with several efforts to handle reports such as: (1) Clarification; (2) Investigation; (3) Recommendations; (4) Monitoring.

scholarly journals 472. The Utility of Infectious Diseases E-consults in the Era of COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S302-S303
Author(s):  
Hala Saad ◽  
Kruti Yagnik ◽  
Helen King ◽  
Roger Bedimo ◽  
Richard J Medford
Keyword(s):  
Health Care ◽  
Infectious Diseases ◽  
Infection Prevention ◽  
Panel Member ◽  
University Hospital ◽  
North Texas ◽  
Review Panel ◽  
The North ◽  
Time To Completion ◽  
Texas Health

Abstract Background During the COVID-19 pandemic, rapid Infectious Diseases (ID) consultation has been required to answer novel questions regarding SARS-CoV-2 testing and infection prevention. We sought to evaluate the utility of e-consults to triage and provide rapid ID recommendations to providers. Methods We performed a retrospective study reviewing ID e-consults in three institutions in the North Texas region: Clements University Hospital (CUH), Parkland Hospital and Health System (PHHS), and the VA North Texas Health Care System (VA) from March 1, 2020 to May 15, 2020. Variables collected include age, sex, ethnicity, comorbidities, time to completion, reason for consult and outcome of consult (initiation or removal of personal protective equipment (PPE) and recommendation to test or retest for COVID-19). Results We performed all analysis using R studio (Version 1.3.959). Characteristics of 198 patients included: 112(57%) male, 86(43%) female, 86(43%) Caucasian, 71(36%) Hispanic, 42(21%) African American, 6(3%) Asian and mean(sd) age of 55.1(15.9). Patient comorbidities included: 89(45%) with a heart condition, 77(39%) diabetes, 30(15%) asthma and 14(7%) liver disease. Median time to completion for all hospitals was 4 hours(h); ((CUH (4h) vs PHHS (2h), p&lt; 0.05; VA (5.5h) vs PHHS (2h) p&lt; 0.05)). Most common reasons for e-consult included: (63)32% regarding re-testing ((CUH 14(21%) vs PHHS 43(50%), p&lt; 0.05; CUH vs VA 14(27%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)), (61)31% testing ((CUH 25(37%) vs PHHS 39(45%), p&lt; 0.05; CUH vs VA 7(16%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)) and 61(31%) infection prevention (IP). Based on the e-consult recommendation, 53(27%) of patients were tested ((CUH 31(45%) vs PHHS 11(13%), p&lt; 0.05, CUH vs VA 11(25%), PHHS vs VA, p&lt; 0.05)), 45(23%) were re-tested, 44(22%) of patients had PPE started on and 19% had PPE removed ((CUH 0(0%) vs PHHS 16(19%), p&lt; 0.05; CUH vs VA 21(48%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)). Reason for Consult Conclusion E-consult services can provide prompt ID input during the COVID-19 pandemic, minimizing the risk of infection to the patient and health care workers while preserving PPE and testing supplies. Disclosures Roger Bedimo, MD, MS, Gilead Sciences (Consultant)Merck & Co. (Advisor or Review Panel member)ViiV Healthcare (Advisor or Review Panel member, Research Grant or Support)

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