Dehydration, Cramping, and Exertional Rhabdomyolysis: A Case Report with Suggestions for Recovery

2007 ◽  
Vol 16 (3) ◽  
pp. 244-259 ◽  
Author(s):  
Michelle Cleary ◽  
Daniel Ruiz ◽  
Lindsey Eberman ◽  
Israel Mitchell ◽  
Helen Binkley
Keyword(s):  
High School ◽  
Differential Diagnosis ◽  
Previous History ◽  
Football Player ◽  
Return To Play ◽  
Initial Assessment ◽  
Severe Dehydration ◽  
Exertional Rhabdomyolysis ◽  
Hospitalization Period ◽  
Return To Activity

Objective:We present a case of severe dehydration, muscle cramping, and rhabdomyolysis in a high school football player followed by a suggested program for gradual return to play.Background:A 16-year-old male football player (body mass = 69.1 kg, height = 175.3 cm) reported to the ATC after the morning session on the second day of two-a-days complaining of severe muscle cramping.Differential Diagnosis:The initial assessment included severe dehydration and exercise-induced muscle cramps. The differential diagnosis was severe dehydration, exertional rhabdomyolysis, or myositis. CK testing revealed elevated levels indicating mild rhabdomyolysis.Treatment:The emergency department administered 8 L of intravenous (IV) fluid within the 48-hr hospitalization period, followed by gradual return to activity.Uniqueness:To our knowledge, no reports of exertional rhabdomyolysis in an adolescent football player exist. In this case, a high school quarterback with a previous history of heat-related cramping succumbed to severe dehydration and exertional rhabdomyolysis during noncontact preseason practice. We provide suggestions for return to activity following exertional rhabdomyolysis.

scholarly journals Isolated Axillary Nerve Injury in an Elite High School American Football Player: A Case Report

2019 ◽  
Vol 11 (6) ◽  
pp. 550-553
Author(s):  
Daniel T. Probst ◽  
Susan E. Mackinnon ◽  
Heidi Prather
Keyword(s):  
High School ◽  
Case Report ◽  
Nerve Injury ◽  
Football Player ◽  
Axillary Nerve ◽  
American Football ◽  
Return To Play ◽  
Nerve Injuries ◽  
Nerve Transfers ◽  
American Football Player

An elite high school American football athlete sustained a traumatic, isolated, axillary nerve injury. Axillary nerve injuries are uncommon, but serious injuries in American football. With the advent of nerve transfers and grafts, these injuries, if diagnosed in a timely manner, are treatable. This case report discusses the multidisciplinary approach necessary for the diagnosis and treatment of an elite high school American football player who presented with marked deltoid atrophy. The athlete’s injury was diagnosed via electrodiagnostic testing and he underwent a medial triceps nerve to axillary nerve transfer. After appropriate postsurgical therapy, the athlete was able to return to American football the subsequent season and continue performing at an elite level. This case report reviews the evaluation and modern treatment for axillary nerve injuries in the athlete, including nerve transfers, nerve grafts, and return to play.

Return to Activity Considerations in a Football Player Predisposed to Exertional Heat Illness: A Case Study

2007 ◽  
Vol 16 (3) ◽  
pp. 260-270 ◽  
Author(s):  
Eric Emmanuel Coris ◽  
Stephen Walz ◽  
Jeff Konin ◽  
Michele Pescasio
Keyword(s):  
Sports Medicine ◽  
Football Player ◽  
Return To Play ◽  
Heat Illness ◽  
Competitive Sport ◽  
Exertional Heat Illness ◽  
The Third ◽  
Return To Activity ◽  
Medicine Team

Context:Heat illness is the third leading cause of death in athletics and a leading cause of morbidity and mortality in exercising athletes. Once faced with a case of heat related illness, severe or mild, the health care professional is often faced with the question of when to reactivate the athlete for competitive sport. Resuming activity without modifying risk factors could lead to recurrence of heat related illness of similar or greater severity. Also, having had heat illness in and of itself may be a risk factor for future heat related illness. The decision to return the athlete and the process of risk reduction is complex and requires input from all of the components of the team. Involving the entire sports medicine team often allows for the safest, most successful return to play strategy. Care must be taken once the athlete does begin to return to activity to allow for re-acclimatization to exercise in the heat prior to resumption particularly following a long convalescent period after more severe heat related illness.

Assessing the diagnostic capabilities of the app DemDx in an acute care setting (Preprint)

2018 ◽  
Author(s):  
Cian Murphy
Keyword(s):  
Differential Diagnosis ◽  
Care Setting ◽  
Medical Student Education ◽  
Initial Assessment ◽  
Junior Doctors ◽  
Doctor Who ◽  
Clinical Accuracy ◽  
Education Tool ◽  
Clinical Records ◽  
Diagnostic Capabilities

UNSTRUCTURED DemDx is a differential diagnosis app for students and junior doctors. Starting with a patient’s presenting complaint the app goes through a step-by-process through history, examination and investigation findings to an increasingly refined differential diagnosis list until a single most likely diagnosis is reached. The aim of this project was to assess the accuracy of DemDx in an Emergency Department (ED) setting. Anonymised clinical records for 100 patients were retrospectively obtained from the ED in Beth Israel, Boston, USA. This contained the differential diagnoses from the clerking doctor, who performed the initial assessment (D1). The discharge diagnosis was used as the gold standard diagnosis (D2). D1 agreed with D2 in 74.44% of cases while DemDx agreed with D2 in 85.56% of cases (p=0.0003716). When the first, and thus most likely, differential was taken from D1 and DemDx, they agreed with D2 in 20 and 18.8% of cases, respectively (p=0.1428). This demonstration of the clinical accuracy of the app highlights how it can be a useful medical student education tool.

scholarly journals Machine learning approach for differentiating cytomegalovirus esophagitis from herpes simplex virus esophagitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jung Su Lee ◽  
Jihye Yun ◽  
Sungwon Ham ◽  
Hyunjung Park ◽  
Hyunsu Lee ◽  
...  
Keyword(s):  
Machine Learning ◽  
Differential Diagnosis ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Previous History ◽  
Clinical Factor ◽  
Endoscopic Images ◽  
Simplex Virus

AbstractThe endoscopic features between herpes simplex virus (HSV) and cytomegalovirus (CMV) esophagitis overlap significantly, and hence the differential diagnosis between HSV and CMV esophagitis is sometimes difficult. Therefore, we developed a machine-learning-based classifier to discriminate between CMV and HSV esophagitis. We analyzed 87 patients with HSV esophagitis and 63 patients with CMV esophagitis and developed a machine-learning-based artificial intelligence (AI) system using a total of 666 endoscopic images with HSV esophagitis and 416 endoscopic images with CMV esophagitis. In the five repeated five-fold cross-validations based on the hue–saturation–brightness color model, logistic regression with a least absolute shrinkage and selection operation showed the best performance (sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the receiver operating characteristic curve: 100%, 100%, 100%, 100%, 100%, and 1.0, respectively). Previous history of transplantation was included in classifiers as a clinical factor; the lower the performance of these classifiers, the greater the effect of including this clinical factor. Our machine-learning-based AI system for differential diagnosis between HSV and CMV esophagitis showed high accuracy, which could help clinicians with diagnoses.

Coaches attitudes about returning to play in youth and varsity sports post- COVID-19

2021 ◽  
Vol 18 (2) ◽  
pp. 292-330
Author(s):  
Joe Deutsch ◽  
Roman Waldera
Keyword(s):  
High School ◽  
Statistical Significance ◽  
Research Result ◽  
Return To Play ◽  
Chi Square ◽  
School Sport ◽  
High School Sport ◽  
Face To Face Instruction ◽  
Athletic Leaders ◽  
Sport Coaches

BACKGROUND: One industry affected by the COVID-19 mandated social distancing policies is sport. In the wake of pressures to return to some normalcy, sport leagues have begun a return to play, many of which include regulations additional to the typical athlete and fan experience. Youth, Middle School, and High School sport leagues are of specific interest in America given the currently inconclusive national plan for returning to face-to-face instruction of students at schools. PURPOSE: The current goal is to identify the perceptions and experiences of current sport professionals throughout the country regarding a return to play. METHODS: The participants of this study were 181 Youth and High School Sport Coaches of various sports. The sample contained males (n = 123) and females (n = 58). The age of respondents ranged from 20 or more years of age. A return to play questionnaire was created and used to collect data for this study. The survey consisted of 12 yes or no questions regarding a return to play during the pandemic, with an opportunity for an open-ended explanation for each. Statistical methods employed to conduct data analysis included frequencies to determine percentages. A crosstabs analysis and Pearson Chi-Square tests of association were utilized to identify statistical significance within the variables. FINDING: No statistically significant association was found at the p ≤ .05 level between age or years of coaching experience and any response to a yes/no question. Percentages for high school coaches who responded "Yes" to each question are presented. Due to the wide variety of responses in these open-ended explanations, statistical expressions were not conducted, and an inclusive list of explanations for each question is provided. CONCLUSION: While the research result is unclear, the information obtained from coaches in the current study presents a small illustration of the current perceptions of athletic leaders in this region regarding the return to play of youth sport coaches and their respective schools' policies.

Return-to-play probabilities following new versus recurrent ankle sprains in high school athletes

2014 ◽  
Vol 17 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Jennifer M. Medina McKeon ◽  
Heather M. Bush ◽  
Ashley Reed ◽  
Angela Whittington ◽  
Timothy L. Uhl ◽  
...  
Keyword(s):  
High School ◽  
Return To Play ◽  
Ankle Sprains ◽  
High School Athletes

Complex Lateral Meniscus Tear in a High School Football Player

2009 ◽  
Vol 14 (1) ◽  
pp. 39-40
Author(s):  
Aaron MacDonald ◽  
Darren Johnson ◽  
Barton Branam ◽  
Michael Krueger
Keyword(s):  
High School ◽  
Lateral Meniscus ◽  
Football Player ◽  
Meniscus Tear ◽  
High School Football

Assessment of Mild Head Injury Using Measures of Balance and Cognition: A Case Study

1997 ◽  
Vol 6 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Bryan L. Riemann ◽  
Kevin M. Guskiewicz
Keyword(s):  
Head Injury ◽  
Sports Medicine ◽  
Athletic Trainers ◽  
Head Injuries ◽  
Football Player ◽  
Athletic Participation ◽  
Return To Play ◽  
Mild Head Injury ◽  
Collegiate Football

Mild head injury (MHI) represents one of the most challenging neurological pathologies occurring during athletic participation. Athletic trainers and sports medicine personnel are often faced with decisions about the severity of head injury and the timing of an athlete's return to play following MHI. Returning an athlete to competition following MHI too early can be a catastrophic mistake. This case study involves a 20-year-old collegiate football player who sustained three mild head injuries during one season. The case study demonstrates how objective measures of balance and cognition can be used when making decisions about returning an athlete to play following MHI. These measures can be used to supplement the subjective guidelines proposed by many physicians.

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