Recovery and Return to Activity Following Exertional Heat Stroke: Considerations for the Sports Medicine Staff

2007 ◽  
Vol 16 (3) ◽  
pp. 163-181 ◽  
Author(s):  
Brendon P. McDermott ◽  
Douglas J. Casa ◽  
Susan W. Yeargin ◽  
Matthew S. Ganio ◽  
Lawrence E. Armstrong ◽  
...  
Keyword(s):  
Data Extraction ◽  
Heat Stroke ◽  
Data Sources ◽  
Exertional Heat Stroke ◽  
Data Synthesis ◽  
Residual Symptoms ◽  
Study Selection ◽  
Initial Care ◽  
Type Data ◽  
Return To Activity

Objective:To describe the current scientific evidence of recovery and return to activity following exertional heat stroke (EHS).Data Sources:Information was collected using MEDLINE and SPORTDiscus databases in English using combinations of key words, exertional heat stroke, recovery, rehabilitation, residual symptoms, heat tolerance, return to activity, and heat illness.Study Selection:Relevant peer-reviewed, military, and published text materials were reviewed.Data Extraction:Inclusion criteria were based on the article’s coverage of return to activity, residual symptoms, or testing for long-term treatment. Fifty-two out of the original 554 sources met these criteria and were included in data synthesis.Data Synthesis:The recovery time following EHS is dependent on numerous factors, and recovery length is individually based and largely dependent on the initial care provided.Conclusion:Future research should focus on developing a structured return-to-activity strategy following EHS.

Predisposing Risk Factors on Susceptibility to Exertional Heat Illness: Clinical Decision-Making Considerations

2007 ◽  
Vol 16 (3) ◽  
pp. 204-214 ◽  
Author(s):  
Michelle Cleary
Keyword(s):  
Relative Risk ◽  
High Risk ◽  
Data Extraction ◽  
Heat Stroke ◽  
Data Sources ◽  
Heat Illness ◽  
Potential Health ◽  
Data Synthesis ◽  
Exertional Heat Illness ◽  
Type Data

Objective:To present strategies for identifying predisposing conditions, susceptibility, and incidence reduction for the most common exertional heat illnesses (EHI): heat cramps, heat exhaustion, and most importantly, heat stroke.Data Sources:A comprehensive literature review of MEDLINE and 1996 to 2006, including all retrospective, controlled studies of EHI risk using the following keywords: exertional heat illness risk, exertional heat stroke risk, and exercise-induced dehydration risk. Search limits included the following: English language, published in the last 10 years, clinical trial, meta-analysis, practice guideline, randomized controlled trial, review, and humans. A manual review was conducted of relevant position statements and book chapters including the reference lists.Data Extraction:To evaluate the quality of the empirical studies to be included in this review, each study must have scored at least 17/22 or 77% of items included when reporting a randomized trial using the CONSORT checklist.Data Synthesis:Many cases of EHI are preventable and can be successfully treated if the ATC® identifies individuals at increased relative risk and implement appropriate prevention strategies. The ability to objectively identify individuals at increased relative risk of EHI and to provide appropriate monitoring is critical in EHI prevention and reduction of repeated incidents of EHI.Conclusions:For any heat illness prevention program to be effective, greater attention and continued observation is needed for athletes at high risk for EHI. For many athletic teams or programs, because of the sheer numbers and associated catastrophic injury potential, health care professionals must implement a system by which high-risk individuals are monitored during activity with the highest level of vigilance for prevention of EHI.

scholarly journals Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020 ◽  
Vol 9 (4) ◽  
pp. e000843
Author(s):  
Kelly Bos ◽  
Maarten J van der Laan ◽  
Dave A Dongelmans
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Data Extraction ◽  
Data Sources ◽  
Cochrane Library ◽  
High Quality ◽  
Data Synthesis ◽  
Study Selection ◽  
Personal Opinion ◽  
User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

Effectiveness of Physical Therapy Treatments on Lateral Epicondylitis

2008 ◽  
Vol 17 (2) ◽  
pp. 119-136 ◽  
Author(s):  
Mohamed Kohia ◽  
John Brackle ◽  
Kenny Byrd ◽  
Amanda Jennings ◽  
William Murray ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Treatment Options ◽  
Lateral Epicondylitis ◽  
Data Sources ◽  
Cochrane Library ◽  
Future Research ◽  
Data Synthesis ◽  
Study Selection ◽  
Type Data ◽  
Therapy Interventions

Objective:To analyze research literature that has examined the effectiveness of various physical therapy interventions on lateral epicondylitis.Data Sources:Evidence was compiled with data located using the PubMed, EBSCO, The Cochrane Library, and the Hooked on Evidence databases from 1994 to 2006 using the key words lateral epicondylitis, tennis elbow, modalities, intervention, management of, treatment for, radiohumeral bursitis, and experiment.Study Selection:The literature used included peer-reviewed studies that evaluated the effectiveness of physical therapy treatments on lateral epicondylitis. Future research is needed to provide a better understanding of beneficial treatment options for people living with this condition.Data Synthesis:Shockwave therapy and Cyriax therapy protocol are effective physical therapy interventions.Conclusions:There are numerous treatments for lateral epicondylitis and no single intervention has been proven to be the most efficient. Therefore, future research is needed to provide a better understanding of beneficial treatment options for people living with this condition.

Isoniazid-Associated Psychosis: Case Report and Review of the Literature

1993 ◽  
Vol 27 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Karen A. Pallone ◽  
Morton P. Goldman ◽  
Matthew A. Fuller
Keyword(s):  
Case Report ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Data Sources ◽  
Review Of The Literature ◽  
Data Synthesis ◽  
Medline Search ◽  
Study Selection ◽  
Language Literature

Objective To describe a case of isoniazid-associated psychosis and review the incidence of this adverse effect. Data Sources Information about the patient was obtained from the medical chart. A MEDLINE search of the English-language literature published from 1950 to 1992 was conducted and Index Medicus was manually searched for current information. Study Selection All case reports describing isoniazid-associated psychosis were reviewed. Data Extraction Studies were evaluated for the use of isoniazid, symptoms of psychosis, onset of symptoms, and dosage of isoniazid. Data Synthesis The case report is compared with others reported in the literature. The incidence of isoniazid-associated psychosis is rare. Conclusions The mechanism of isoniazid-associated psychosis is uncertain. It appears that isoniazid was associated with the psychosis evident in our patient and in the cases reviewed.

Development of Information Regarding Susceptibility to Heat Illness Using the Cooperative Extension Agency Model in Kentucky

2007 ◽  
Vol 16 (3) ◽  
pp. 277-281 ◽  
Author(s):  
Carl G. Mattacola ◽  
Lori L. Rice
Keyword(s):  
Cooperative Extension ◽  
Data Extraction ◽  
Scientific Information ◽  
Heat Stroke ◽  
Interdisciplinary Approach ◽  
Reading Level ◽  
Data Synthesis ◽  
Research Findings ◽  
Type Data ◽  
Grade Reading Level

Context:Dissemination of information regarding the latest research findings in rehabilitative health care is often limited to professional journals.Objective:The purpose of the paper is to describe opportunities to better distribute scientific information to wider swaths than normally contained within a readership of a journal, to describe a process to deliver important information via the Cooperative Extension Service, and provide an example of such an informational brochure.Design:An interdisciplinary approach was developed to provide access to a larger cohort of individuals the latest research findings regarding heat and hydration.Data Extraction:CINAHL, Medline, and Sport Discus were reviewed from 1966 to 2006 using the terms Heat, Hydration, Rhabdomyolysis, Rehabilitation, Heat Exhaustion, Heat Stroke, and Dehydration.Data Synthesis:We found substantial information describing recommendations for preventing, recognizing, and treating illness due to variance in heat and hydration. The information was succinctly summarized, converted to a 7th grade reading level, and shared with a larger audience via a unique model available through Cooperative Extension Agencies.Conclusion:Providing scientific information via a Cooperative Extension Model enables sharing of information from experts to communities. This methodology increases the distribution of the latest scientific knowledge to broader audiences.

Defining and Measuring Functional Limitations and Disability in the Athletic Shoulder

2001 ◽  
Vol 10 (3) ◽  
pp. 221-231 ◽  
Author(s):  
Douglas R. Keskula ◽  
Jason Lott
Keyword(s):  
Outcome Measures ◽  
English Language ◽  
Functional Limitations ◽  
Self Report ◽  
Data Sources ◽  
Measurement Properties ◽  
Data Synthesis ◽  
Shoulder Dysfunction ◽  
Study Selection ◽  
Type Data

Objective:To define, identify, and briefly describe functional outcome measures for assessing functional limitations and disability in athletes with shoulder conditions.Data Sources:The MEDLINE and CINAHL databases were searched for English-language articles published from 1982 to 2000, using the termsfunctional outcomes, shoulder, questionnaires, disability,andfunctional limitations,among others.Study Selection:The authors identified disease-specific self-report questionnaires that assess functional limitations and disability in patients with shoulder dysfunction.Data Synthesis:When describing outcome measures, the authors considered the items to be assessed, the measurement properties, and the practicality of the test. They categorized the available measures designed to assess patients with shoulder instability or general shoulder conditions.Conclusions:The ability to define and measure function is a fundamental consideration in managing athletes with shoulder dysfunction. The measures described might be useful in assessing functional limitations and disability in such athletes.

Etiology of Patellar Tendinopathy in Athletes

2005 ◽  
Vol 14 (3) ◽  
pp. 259-272 ◽  
Author(s):  
Sheri A. Hale
Keyword(s):  
Clinical Management ◽  
Data Sources ◽  
Patellar Tendinopathy ◽  
Extrinsic Factors ◽  
Data Synthesis ◽  
Medline Search ◽  
Complex Process ◽  
Study Selection ◽  
Joint Dynamics ◽  
Type Data

Objective:To review the etiology of patellar tendinopathy as it relates to clinical management of chronic patellar-tendon disease in athletes.Data Sources:Information was gathered from a MEDLINE search of literature in English using the key wordspatellar tendinitis, patellar tendonitis, patellar tendinosis, patellar tendinopathy,andjumper’s knee.Study Selection:All relevant peer-reviewed literature in English was reviewed.Data Synthesis:The etiology of patellar tendinopathy is multifactorial, incorporating both intrinsic and extrinsic factors. Age, muscle flexibility, training program, and knee-joint dynamics have all been associated with patellar tendinopathy. The roles of gender, body morphology, and patellar mobility in patellar tendinopathy are unclear.Conclusions:The pathoetiology of patellar tendinopathy is a complex process that results from both an inflammatory response and degenerative changes. There is a tremendous need for research to improve our understanding of the pathoetiology of patellar tendinopathy and its clinical management.

Mental Tools for Thinking About DNA Technologies in New Ways

2002 ◽  
Vol 126 (3) ◽  
pp. 263-265
Author(s):  
Robert Root-Bernstein ◽  
Michele Root-Bernstein
Keyword(s):  
Creative Thinking ◽  
Data Extraction ◽  
Data Sources ◽  
Biomedical Science ◽  
Biomedical Sciences ◽  
Data Synthesis ◽  
Recognition Pattern ◽  
The Arts ◽  
Study Selection ◽  
Pattern Forming

Abstract Objective.—To investigate the nature of creative thinking in biomedical science with specific applications to molecular pathologies and DNA technologies. Data Sources.—Accounts of breakthroughs and inventions contained in autobiographies, biographies, interviews, and archival sources. Study Selection.—Discoveries that have altered, or may yet alter, basic textbook accounts of biomedical sciences for which appropriate data sources exist. Data Extraction.—Approximately 1000 data sources were analyzed, both within appropriate sciences and in other creative fields, such as the arts. Data Synthesis.—The current analysis is based on a framework described in our previous book, Sparks of Genius, which outlines a general approach to understanding creative thinking. Conclusions.—Creative thinking in all disciplines depends on a common mental “toolkit” that consists of 13 fundamental tools: observing, imaging, abstracting, pattern recognition, pattern forming, analogizing, body thinking, empathizing, dimensional thinking, modeling, playing, transforming, and synthesizing. Scientists recognize and solve problems by observing data that break the patterns established by theories; exploring a system by creating an abstract model with which they can play; and transforming data into feelings, sounds, and other forms that create surprising analogies to already-understood principles. The result of such personal thinking is knowledge combined with sensation and emotion—feeling and understanding synthesized into complete awareness. We illustrate some of these modes of thinking with reference to recent breakthroughs in DNA-related areas and suggest ways in which the use of “tools for thinking” can increase the probability of making further discoveries in the biomedical sciences.

Identification of Risk Factors for Exertional Heat Illness: A Brief Commentary on Genetic Testing

2007 ◽  
Vol 16 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Sheila Muldoon ◽  
Rolf Bunger ◽  
Patricia Deuster ◽  
Nyamkhishig Sambuughin
Keyword(s):  
Risk Factors ◽  
Genetic Testing ◽  
Sports Medicine ◽  
Data Extraction ◽  
Data Sources ◽  
Hereditary Diseases ◽  
Heat Illness ◽  
Data Synthesis ◽  
Exertional Heat Illness ◽  
Type Data

Objective:This commentary discusses known links between Exertional Heat Illness (EHI), Malignant Hyperthermia (MH), and other hereditary diseases of muscle. Genetic and functional testing is also evaluated as measures of fitness to return to duty/play.Data Sources:Reviews and research articles from Sports Medicine, Applied Physiology, and Anesthesiology.Data Extraction:Detailed comparisons of existing literature regarding clinical cases of EHI and MH and the potential utility of genetic testing, specifically the ryanodine receptor (RYR1) gene and other genes related to disorders of skeletal muscle.Data Synthesis:EHI is a complex disorder wherein physiological, environmental, and hereditary factors interact to endanger an individual’s ability to maintain thermal homeostasis.Conclusions:Individuals’ genetic background is likely to play an important role, particularly when EHI recurs. Recurrent EHI has been associated with MH and other genetic disorders, highlighting the importance of identification and exclusion of individuals with known high risk factors.

FDA Policy on Unapproved Drug Products: Past, Present, and Future

2005 ◽  
Vol 39 (7-8) ◽  
pp. 1260-1264 ◽  
Author(s):  
Renu Chhabra ◽  
Mary E Kremzner ◽  
Brenda J Kiliany
Keyword(s):  
Data Extraction ◽  
Drug Regulation ◽  
Data Sources ◽  
Federal Regulations ◽  
Data Synthesis ◽  
Safety And Efficacy ◽  
Drug Products ◽  
The Past ◽  
Study Selection ◽  
History Of

OBJECTIVE To review the history of drug regulation by the Food and Drug Administration (FDA) as it relates to unapproved drugs and FDA policy, along with the FDA's efforts to avoid future incidents by amending and enforcing those policies that are already in place. DATA SOURCES Data from FDA history documents, FDA guidances, Code of Federal Regulations Title 21, and presentations by the FDA's Office of Compliance were gathered. STUDY SELECTION AND DATA EXTRACTION All information identified from the data sources was evaluated, and all information deemed relevant was included for this review. DATA SYNTHESIS Contrary to popular belief, there are drugs on the market that have not been evaluated for safety or efficacy by the FDA. For almost a century, the FDA has taken action against public health threats posed by unapproved drug products, and today's drugs and vaccines are required to demonstrate both safety and efficacy prior to marketing. The FDA has taken great strides to ensure the welfare of Americans by reacting to disasters that have occurred in the past and being proactive by setting regulations that will prevent such catastrophes from occurring in the future. CONCLUSIONS The FDA recognizes that drug regulation is an ongoing process and that, although we have come a long way, there is still much to be done.

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