scholarly journals Symptom cluster is associated with prolonged return-to-play in symptomatic athletes with acute respiratory illness (including COVID-19): a cross-sectional study—AWARE study I

2021 ◽  
pp. bjsports-2020-103782
Author(s):  
Martin Schwellnus ◽  
Nicola Sewry ◽  
Carolette Snyders ◽  
Kelly Kaulback ◽  
Paola Silvia Wood ◽  
...  
Keyword(s):  
Online Survey ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Respiratory Illness ◽  
Symptom Cluster ◽  
Return To Play ◽  
Whole Body ◽  
Multiple Model ◽  
Acute Respiratory Illness ◽  
Cross Sectional

BackgroundThere are no data relating symptoms of an acute respiratory illness (ARI) in general, and COVID-19 specifically, to return to play (RTP).ObjectiveTo determine if ARI symptoms are associated with more prolonged RTP, and if days to RTP and symptoms (number, type, duration and severity) differ in athletes with COVID-19 versus athletes with other ARI.DesignCross-sectional descriptive study.SettingOnline survey.ParticipantsAthletes with confirmed/suspected COVID-19 (ARICOV) (n=45) and athletes with other ARI (ARIOTH) (n=39).MethodsParticipants recorded days to RTP and completed an online survey detailing ARI symptoms (number, type, severity and duration) in three categories: ‘nose and throat’, ‘chest and neck’ and ‘whole body’. We report the association between symptoms and RTP (% chance over 40 days) and compare the days to RTP and symptoms (number, type, duration and severity) in ARICOV versus ARIOTH subgroups.ResultsThe symptom cluster associated with more prolonged RTP (lower chance over 40 days; %) (univariate analysis) was ‘excessive fatigue’ (75%; p<0.0001), ‘chills’ (65%; p=0.004), ‘fever’ (64%; p=0.004), ‘headache’ (56%; p=0.006), ‘altered/loss sense of smell’ (51%; p=0.009), ‘Chest pain/pressure’ (48%; p=0.033), ‘difficulty in breathing’ (48%; p=0.022) and ‘loss of appetite’ (47%; p=0.022). ‘Excessive fatigue’ remained associated with prolonged RTP (p=0.0002) in a multiple model. Compared with ARIOTH, the ARICOV subgroup had more severe disease (greater number, more severe symptoms) and more days to RTP (p=0.0043).ConclusionSymptom clusters may be used by sport and exercise physicians to assist decision making for RTP in athletes with ARI (including COVID-19).

scholarly journals Lower Extremity Musculoskeletal Screening Tool Practices Among Athletic Trainers in Secondary School and Collegiate Settings

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Megan Fowler ◽  
Elizabeth Neil ◽  
Cameron Powden
Keyword(s):  
Secondary School ◽  
Lower Extremity ◽  
Injury Risk ◽  
Online Survey ◽  
Screening Tool ◽  
Athletic Trainers ◽  
Screening Tools ◽  
Return To Play ◽  
Post Injury ◽  
Cross Sectional

Purpose: Musculoskeletal (MSK) screening tools can allow athletic trainers (AT) to focus prevention efforts by providing patient risk information. The purpose of this study is to examine lower extremity MSK screening tool practices and perceptions of ATs in traditional settings. Methods: A cross-sectional online survey was distributed to 4,937 full- and part-time collegiate and secondary school ATs randomly selected by the NATA. MSK screening tools were grouped into 7 categories: Range of Motion (ROM), Strength, Balance, Drop and Jump Landing (D/J Land), Double- and Single-Leg Hopping (D/S Hop), Movement Quality (MQual), and Injury History (History). For each screening tool category, questions assessed MSK screening tool usage, the perceived effectiveness of MSK screening tools to provide relevant injury risk and return to play (RTP) information, and MSK screening tools effect on decisions to implement prevention programs. Results: A total of 372 participants (female=215(48.4%), male=152(34.2%), age=35±10 years, experience=12±10 years, secondary school=194(52.2%), collegiate=178(47.8%)) completed the survey. Participants within our study indicated the used of the following screening tools categories in clinical practice: ROM=339(91.1%), Strength=342(91.9%), Balance=238(64.0%), D/J-Landing=134(36.0%), D/S-Hopping=233(62.6%), MQual=212(57.0%), History=316(85.0%), and None=18(4.8%). Conclusions: ATs in traditional settings indicate that they primarily use ROM, Strength, and History screening tools to gather information concerning LE injury risk and RTP. Implementation of screening tools most frequently occurred post-injury. Lastly, it seemed that intervention prescriptions were consistent regardless of screening tool used, suggesting blanket interventions prescription. This may have been do feelings of moderate effectiveness of these tools to determine injury risk.

scholarly journals Conjunctivitis and other ocular findings in patients with COVID-19 infection

2021 ◽  
Vol 41 (5) ◽  
pp. 280-284
Author(s):  
Haider Aswad Layikh ◽  
Zainab Adel Hashim ◽  
Alyaa A. Kadum
Keyword(s):  
Viral Infection ◽  
Care Center ◽  
Severe Disease ◽  
Respiratory Illness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Ocular Findings ◽  
Standard Deviation Range ◽  
Severity Of The Disease ◽  
Novel Coronavirus

BACKGROUND: COVID-19 is an acute respiratory illness caused by a novel coronavirus (SARS-CoV-2). COVID-19 that might affect the eye in the form of conjunctivitis and other ocular features. OBJECTIVES: Assess the frequency and clinical profile of conjunctivitis and other ocular findings in Iraqi patients with confirmed COVID-19 infection. DESIGN: Analytical cross-sectional study. SETTING: Secondary care center. PATIENTS AND METHODS: This study involved patients diagnosed with SARS-CoV-2 viral infection of variable disease severity from June 2020 to December 2020. Ocular history and the severity of SARS-CoV-2 viral infection was assessed for all of the patients. MAIN OUTCOME MEASURES: Frequency of conjunctival inflammation and other ocular findings in patients with coronavirus infection. SAMPLE SIZE: 186 patients. RESULTS: The patients had a mean (standard deviation, range) age of 44.4 (18.8, 18–78) years. Conjunctivitis was present in 25 patients (13.4%). There was no significant association between prevalence of conjunctivitis and patient gender ( P =.868). However, conjunctivitis was significantly associated with the severity of the disease ( P =.018): the rate of conjunctivitis was significantly higher in cases with severe disease (28%) in comparison with those with mild to moderate clinical presentation (9.3%). The natural course of conjunctivitis seemed to be mild with no effect on visual acuity and no short-term complications. CONCLUSION: Conjunctivitis can occur in patients with SARS-CoV-2 viral infection, and could be a presenting sign. Conjunctivitis is more common in cases of severe COVID-19 infection and since it could be a presenting sign it might be of benefit in the early diagnosis and treatment of COVID-19. LIMITATION: Single-center study, safety limitations in the examination of the patients. CONFLICT OF INTEREST: None.

scholarly journals The Self-Efficacy of Certified Athletic Trainers in Assessing and Managing Sport-Related Concussions

2018 ◽  
Vol 53 (10) ◽  
pp. 983-989 ◽  
Author(s):  
Jennifer L. Savage ◽  
Tracey Covassin
Keyword(s):  
High School ◽  
Self Efficacy ◽  
Online Survey ◽  
Athletic Trainers ◽  
School Setting ◽  
Cross Sectional Study ◽  
The Self ◽  
Return To Play ◽  
Cross Sectional ◽  
Certified Athletic Trainers

Context:  Diagnostic and return-to-play assessments of athletes with sport-related concussions (SRCs) have changed dramatically over the past decade. Currently, SRC assessment and management has taken a multifaceted approach, with new SRC measures being developed yearly. However, to date, no researchers have examined certified athletic trainers' (ATs') self-efficacy in assessing and managing a patient with an SRC. Objective:  To examine the self-efficacy of ATs in assessing and managing athletes with SRCs, with a secondary purpose of examining job setting (high school and college). Design:  Cross-sectional study. Setting:  Web-based questionnaire. Patients or Other Participants:  A total of 94 ATs (high school setting = 54.3%, n = 51; collegiate setting = 45.7%, n = 43) completed an online survey, for a response rate of 9.2%. Main Outcome Measure(s):  The survey contained 3 primary subsections: demographics, self-efficacy in assessing SRCs, and self-efficacy in managing SRCs. Possible self-efficacy ratings for SRC assessment and management in the survey ranged from 0 to 100. Multivariate analyses of variance were performed to identify differences in the self-efficacy of high school and collegiate ATs in assessing and managing athletes with SRCs. Results:  The self-efficacy of all 94 participants in their assessment of SRCs was 60.34 ± 14.5 and in their management of SRCs was 55.30 ± 14.1. Collegiate ATs reported higher self-efficacy in the assessment of SRCs using balance (P &lt; .001) and the King-Devick test (P = .04), and their responses approached significance for vestibular-ocular motor screening (P = .05). Additionally, their self-efficacy in the management of SRCs was greater using balance (P &lt; .001) and vestibular-ocular therapy (P = .01) compared with high school ATs. Conclusions:  Athletic trainers had moderate self-efficacy regarding their assessment and management of SRCs. Collegiate ATs had higher self-efficacy in newer SRC assessment and management tools than high school ATs.

scholarly journals A Cross-Sectional Surveillance Study of Acute Respiratory Illness (ARI) in Pregnant Women

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S573-S573
Author(s):  
Anne Hause ◽  
Vasanthi Avadhanula ◽  
Maurizio Maccato ◽  
Phillip Pinell ◽  
Nanette Bond ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Respiratory Illness ◽  
Surveillance Study ◽  
Acute Respiratory Illness ◽  
Cross Sectional

scholarly journals 104 Management of sports-related concussion in UK emergency departments: a multi-centre study

2020 ◽  
Vol 37 (12) ◽  
pp. 822.2-822
Author(s):  
Haroon Rashid ◽  
Nick Dobbin ◽  
Smarak Mishra
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Return To Play ◽  
Cross Sectional ◽  
Multi Centre Study ◽  
North West ◽  
The North ◽  
Consensus Statements

Aims/Objectives/BackgroundIt is necessary for those working in emergency departments to have adequate knowledge and delivery of current sport-related concussion (SRC) management protocols including identifying patients with concussion, managing their symptoms, giving appropriate advice with regards to return to play and referring those at risk of further injuries to an appropriate service.This study aimed to establish the current practice, knowledge base and views towards SRC management of emergency department clinicians who have trained or are currently training in emergency medicine in the North West of England.Methods/DesignThis study was a multi centre, cross sectional study of 111 emergency department clinicians (EDCs) working across 15 centres in the North West of England A 21 item online survey was issued. The key questions focused on the advice given to patients on discharge, the importance of cognitive and physical rest, and knowledge of GRTP.Results/ConclusionsApproximately, 37% of the population responded to the invitation, with 111 responses included in this study. Only 27% of total respondents were aware of the Consensus Statements of Concussion in Sport guidelines, whilst 45% were unaware of any SRC guidelines. 57% of respondents had heard of a graded return to play (GRTP) protocol. Physical rest following an SRC was advised by 95% of respondents with 61% advising concomitant cognitive rest and 42% of respondents providing specific written advice. 90% of clinicians had not received any SRC training.There is a lack of knowledge amongst EDCs in the North West of England in managing and providing discharge advice according to recommendations for patients with SRC. This is likely a consequence of the limited training that these clinicians have received in managing SRC and suggests further work needs to be undertaken to educate EDCs on current SRC management guidance to ensure appropriate care and discharge advice is given to patients.

scholarly journals Necrotizing Fasciitis: Diagnostic Challenges in a Mute Bedridden Patient with Atypical Laboratory Parameters

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Ghan-Shyam Lohiya ◽  
Lilia Tan-Figueroa ◽  
Vijay Krishna ◽  
Sunita Lohiya
Keyword(s):  
Necrotizing Fasciitis ◽  
Pressure Ulcers ◽  
Subcutaneous Tissue ◽  
Respiratory Illness ◽  
Whole Body ◽  
Acute Respiratory Illness ◽  
Laboratory Parameters ◽  
Serious Infections ◽  
Leg Amputation ◽  
Bedridden Patient

A 27-year-old mute bedridden patient required parenteral corticosteroids and antibiotics, and hospitalization for an acute respiratory illness. After 2 days, staff noted a ~0.3 cm blister on the patient’s right heel. Within 19 hours, blistering increased and the foot became partly gangrenous. The patient developed high fever (40.3°C), and leukocytosis (count:13×109/L; was6.5×109/Lten days earlier). Necrotizing fasciitis (NF) was diagnosed and treated with emergency leg amputation. Histopathology revealed necrosis of fascia, muscle, subcutaneous tissue, and skin. In bedridden patients, corticosteroids may particularly facilitate serious infections, and initial NF blistering may be mistaken for pressure ulcers. Vigilant and frequent whole body monitoring is necessary for all patients incapable of verbalizing their symptoms.

scholarly journals Outbreak of severe acute respiratory infection in Southern Province, Sri Lanka in 2018: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040612
Author(s):  
Sky Vanderburg ◽  
Gaya Wijayaratne ◽  
Nayomi Danthanarayana ◽  
Jude Jayamaha ◽  
Bhagya Piyasiri ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Active Surveillance ◽  
Respiratory Illness ◽  
Respiratory Viruses ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Acute Respiratory Illness ◽  
Sectional Study ◽  
Cross Sectional ◽  
Southern Province

ObjectivesTo determine aetiology of illness among children and adults presenting during outbreak of severe respiratory illness in Southern Province, Sri Lanka, in 2018.DesignProspective, cross-sectional study.Setting1600-bed, public, tertiary care hospital in Southern Province, Sri Lanka.Participants410 consecutive patients, including 371 children and 39 adults, who were admitted with suspected viral pneumonia (passive surveillance) or who met case definition for acute respiratory illness (active surveillance) in May to June 2018.ResultsWe found that cocirculation of influenza A (22.6% of cases), respiratory syncytial virus (27.8%) and adenovirus (AdV) (30.7%; type B3) was responsible for the outbreak. Mortality was noted in 4.5% of paediatric cases identified during active surveillance. Virus type and viral coinfection were not significantly associated with mortality.ConclusionsThis is the first report of intense cocirculation of multiple respiratory viruses as a cause of an outbreak of severe acute respiratory illness in Sri Lanka, and the first time that AdV has been documented as a cause of a respiratory outbreak in the country. Our results emphasise the need for continued vigilance in surveying for known and emerging respiratory viruses in the tropics.

scholarly journals COVID-19 vaccination and breakthrough infections among healthcare workers: an online survey

2021 ◽  
Vol 8 (11) ◽  
pp. 5435
Author(s):  
Ramesh Masthi ◽  
Gowri Hebbar
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Online Survey ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Appropriate Behavior ◽  
Frontline Workers ◽  
Care Workers

Background: COVID-19 vaccinations were started in India among health care workers in January, 2021. These vaccinations provide protective immunity against the infection but may not completely exclude the possibility of contracting the infection. The objective was to assess the risk of contracting COVID-19 disease following vaccination; to describe the adherence to COVID appropriate behavior by vaccinated individuals.Methods: A cross-sectional study was conducted using an online questionnaire. The subjects selected were health care workers, medical students and other frontline workers. The sample size was 393. The risk of COVID-19 following vaccination was assessed against various factors like age, type of vaccination, status of vaccination, pre-existing comorbidities etc.Results: Out of the 393 vaccinated subjects, 57 (14.5%) acquired COVID-19 breakthrough infection. Majority of these individuals (75.4%) experienced mild symptoms. All vaccinated individuals were protected from severe COVID-19 disease. Most vaccinated individuals continued to strictly adhere to COVID appropriate behavior i.e., masks (97.0% and 98.0%), sanitized hands (93.0% and 98.0%) and maintain social distanced (91.6% and 86%) in both fully and partially vaccinated groups following vaccination.Conclusions: One tenth of the subjects were infected with COVID-19 following vaccination. Most experienced mild symptoms and risk of severe disease was significantly reduced.  There was no significant association between the type of vaccine administered and risk of infection.

scholarly journals Changes in Substance Use and Mental Health Burden among Women during the Second Wave of COVID-19 in Germany

2021 ◽  
Vol 18 (18) ◽  
pp. 9728
Author(s):  
Henrike Schecke ◽  
Madeleine Fink ◽  
Alexander Bäuerle ◽  
Eva-Maria Skoda ◽  
Adam Schweda ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Psychological Distress ◽  
Online Survey ◽  
Mental Health Problems ◽  
Severe Disease ◽  
Generalized Anxiety ◽  
Cross Sectional ◽  
Health Burden ◽  
Second Wave

Unlike men, who are disproportionately affected by severe disease progression and mortality from COVID-19, women may be more affected by the economic, social and psychological consequences of the pandemic. Psychological distress and mental health problems are general risk factors for increases in the use of alcohol and other substances as a dysfunctional coping mechanism. Methods: An analysis was carried out of the female subset (n = 2153) of a population-based, cross-sectional online survey (October–December 2020), covering the “second wave” of the COVID-19 pandemic in Germany. Results: Among women, 23% increased their alcohol use, 28.4% increased their nicotine use and 44% increased their illicit substance use during the COVID-19 pandemic. Twenty percent reported major depressive symptoms and 23.4% symptoms of generalized anxiety. Generalized anxiety proved to be a significant predictor of increases in alcohol and nicotine use in logistic regression. Discussion: The mental health burden remained high during the second wave of COVID-19 and alcohol, nicotine and other substance use increased. However, the association between mental health and substance use was weak. Psychological distress does not seem to be the main motivator of substance use.

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