scholarly journals Clinical patterns, recovery time and prolonged impact of COVID-19 illness in international athletes: the UK experience

2021 ◽  
pp. bjsports-2021-104392
Author(s):  
James H Hull ◽  
Moses Wootten ◽  
Moiz Moghal ◽  
Neil Heron ◽  
Rhodri Martin ◽  
...  
Keyword(s):  
Sport Participation ◽  
Clinical Presentation ◽  
Return To Sport ◽  
Respiratory Illness ◽  
Symptom Duration ◽  
Time Loss ◽  
Predominant Symptom ◽  
The Uk ◽  
Prevalent Symptom ◽  
Antibody Tests

ObjectivesTo report COVID-19 illness pattern, symptom duration and time loss in UK elite athletes.MethodsObservational, clinical and database review of athletes with symptomatic COVID-19 illness managed within the UK Sports Institutes. Athletes were classified as confirmed (positive SARS-CoV-2 PCR or antibody tests) or probable (consistent clinical features) COVID-19. Clinical presentation was characterised by the predominant symptom focus (eg, upper or lower respiratory illness). Time loss was defined as days unavailable for full sport participation and comparison was made with a 2016–2019 respiratory illness dataset from the same surveillance system.ResultsBetween 24 February 2020 and 18 January 2021, 147 athletes (25 Paralympic (17%)) with mean (SD) age 24.7 (5.2) years, 37% female, were diagnosed with COVID-19 (76 probable, 71 confirmed). Fatigue was the most prevalent symptom (57%), followed by dry cough (50%) and headache (46%). The median (IQR) symptom duration was 10 (6–17) days but 14% reported symptoms >28 days. Median time loss was 18 (12–30) days, with 27% not fully available >28 days from initial date of infection. This was greater than our historical non-COVID respiratory illness comparator; 6 days, 0–7 days (p<0.001) and 4% unavailable at 28 days. A lower respiratory phenotype (ie, including dyspnoea±chest pain±cough±fever) was present in 18% and associated with a higher relative risk of prolonged symptoms risk ratio 3.0 (95% CI: 1.4 to 6.5) and time loss 2.1 (95% CI: 1.2 to 3.5).ConclusionsIn this cohort, COVID-19 largely resulted in a mild, self-limiting illness. The presence of lower respiratory tract features was associated with prolonged illness and a delayed return to sport.

Acute respiratory illness and return to sport: a systematic review and meta-analysis by a subgroup of the IOC consensus on ‘acute respiratory illness in the athlete’

2021 ◽  
pp. bjsports-2021-104719
Author(s):  
Carolette Snyders ◽  
David B Pyne ◽  
Nicola Sewry ◽  
James H Hull ◽  
Kelly Kaulback ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Return To Sport ◽  
Respiratory Illness ◽  
Diagnostic Methods ◽  
Symptom Duration ◽  
Acute Respiratory Illness ◽  
Time Loss ◽  
Anatomical Classification ◽  
The Mean

ObjectiveTo determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in >1 day lost from training/competition, and symptom duration (days) of ARill in athletes.DesignSystematic review and meta-analysis.Data sourcesPubMed, EBSCOhost, Web of Science, January 1990–July 2020.Eligibility criteriaOriginal research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (%) of time loss >1 day after ARill or symptom duration (days) of ARill.Results767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (%) of time loss >1 day after ARill was 20.4% (95% CI 15.3% to 25.4%). The mean symptom duration for all ARill was 7.1 days (95% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens).ConclusionsIn 80% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS.PROSPERO registration numberCRD42020160479.

scholarly journals Predictive Role of Symptom Duration Before the Initial Clinical Presentation of Adolescents With Capitellar Osteochondritis Dissecans on Preoperative and Postoperative Measures: A Systematic Review

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711882505 ◽  
Author(s):  
Christopher Cheng ◽  
Matthew D. Milewski ◽  
Jeffrey J. Nepple ◽  
Hannah S. Reuman ◽  
Carl W. Nissen
Keyword(s):  
Systematic Review ◽  
Osteochondritis Dissecans ◽  
Surgical Procedure ◽  
Clinical Presentation ◽  
Return To Sport ◽  
Chief Complaint ◽  
Postoperative Outcomes ◽  
Symptom Duration ◽  
Cochrane Central Register ◽  
Young Athletes

Background: Osteochondritis dissecans (OCD) of the capitellum is an increasingly recognized disease affecting young athletes. Because lesion progression is common, early identification is potentially beneficial for an athlete’s treatment and recovery. However, there is currently no analysis available that evaluates the impact of symptom duration on preoperative and postoperative outcomes. Purpose/Hypothesis: The purpose of this study was to perform a systematic review of surgically treated OCD lesions to examine the effect of symptom duration before the initial presentation on preoperative and postoperative outcomes. We hypothesized that a longer symptom duration would correlate with more severe preoperative signs and symptoms and poorer postoperative outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: Ovid MEDLINE, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and the Database of Abstracts of Reviews of Effects were queried for studies evaluating symptom duration before the clinical presentation of capitellar OCD and surgical outcomes. A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: A total of 23 studies reporting outcomes in 258 patients (mean patient age, 14.4 ± 1.5 years) were analyzed. Locking as a chief complaint predominated in a greater proportion of patients who presented with a longer history of OCD symptoms ( P = .007). A longer symptom duration also correlated with a longer time to return to sport ( P = .008) and older age ( P < .001). Range of motion limitations as both a chief complaint and a physical examination finding correlated with a longer symptom duration ( P = .014 and .001, respectively). Symptom duration did not show a relationship with most postoperative outcomes, including the return-to-sport rate ( P = .172), which ranged from 70.7% to 91.1% depending on the surgical procedure performed. No significant difference was observed between symptom duration and the surgical procedure performed ( P = .376). Conclusion: Advanced OCD lesions were observed in patients with a longer symptom duration. However, treatment specifics rather than symptom duration correlated best with return to sport for patients with advanced OCD lesions requiring surgery. The earlier detection of capitellar OCD may be valuable in reducing the severity of lesions, the time to return to sport, and potential need for surgery in young athletes.

Covid-19: A review of its clinical features, effects on gastrointestinal system and possibility of faecal transmission

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 623-627
Author(s):  
Kanishk K Adhit ◽  
Anjankar Ashish P ◽  
Siddhaarth K
Keyword(s):  
Clinical Presentation ◽  
Throat Swab ◽  
Respiratory Illness ◽  
Review Article ◽  
Gastrointestinal System ◽  
Rt Pcr ◽  
Significant Evidence ◽  
Stool Samples ◽  
High Possibility ◽  
Positive Results

In China, Wuhan in the province of China, COVID-19 a patient suffering from pneumonia was tested and to identify the cause, the throat swab of the patient was tested. On 7th January 2020 WHO declared the identification as COVID-19. And then it was proclaimed as a pandemic. It classically causes a respiratory illness presenting as a mild cough, fever and . However, several investigators have advocated the involvement of the gastrointestinal tract and liver in COVID-19 infection similar to other infections. Further research studies have shown results that are expanding the possibility of transmission because RT-PCR assessment has shown significant evidence for the presence of virus not only in samples but also in stool samples. Studies have shown that virus in stool samples have got positive results even after the illness has resolved, and two respiratory tests were done 24 hours after COVID-19 being tested negative. The review article the different findings of the clinical presentation of COVID-19. It sheds light on the effects of COVID-19 in the gastrointestinal system along with the reasons for the high possibility of transmission of COVID-19 through the route.

scholarly journals Essentials for Best Practice: Treatment Approaches for Athletes With Eating Disorders

2018 ◽  
Vol 12 (4) ◽  
pp. 495-507 ◽  
Author(s):  
Jenny H. Conviser ◽  
Amanda Schlitzer Tierney ◽  
Riley Nickols
Keyword(s):  
Eating Disorders ◽  
Emotional Regulation ◽  
Best Practice ◽  
Sport Participation ◽  
Emotional Health ◽  
Multidisciplinary Treatment ◽  
Return To Sport ◽  
Multidisciplinary Care ◽  
Return To Play ◽  
Treatment Team

Eating disorders (EDs) and disordered-eating behaviors (DEBs), pose a high risk of morbidity and mortality, threatening physical health, emotional health, and overall quality of life. Unfortunately, among athletes, prevalence rates continue to increase. This document summarizes the challenges of establishing and navigating the multidisciplinary care needed to effectively treat EDs and DEBs among athletes. The benefits of timely and frequent communication within the multidisciplinary treatment team (MDTT) are emphasized and discussed. Authors advise who should be selected as members of the MDTT and suggest that all personnel, including athletic coaches, athletic trainers, physical therapists, and certified fitness professionals be ED-informed and ED-sensitive. Vital components of care are noted including use of a variety of evidence-based psychotherapeutic modalities, interventions which target emotional regulation, and prioritize values based compassionate care. Authors caution that performance decrements and medical/physiological changes are not always easily observable in individuals with EDs and DEBs and therefore, attuned, consistent, and ongoing monitoring is needed. Consensus regarding previously established parameters for return to play and careful titration of physical activity throughout the ED recovery process are suggested as important for preserving health, preventing re-injury, or relapse and facilitating successful return to sport participation.

Measuring Physical Activity and Sports Participation After Autologous Cartilage Implantation: A Systematic Review

2014 ◽  
Vol 23 (3) ◽  
pp. 171-181 ◽  
Author(s):  
Andre Filipe Santos-Magalhaes ◽  
Karen Hambly
Keyword(s):  
Physical Activity ◽  
Sport Participation ◽  
Rating Scale ◽  
Evidence Synthesis ◽  
Return To Sport ◽  
Sports Participation ◽  
International Knee Documentation Committee ◽  
Primary Treatment ◽  
Functional Score ◽  
Sport And Exercise

Context:The assessment of physical activity and return to sport and exercise activities is an important component in the overall evaluation of outcome after autologous cartilage implantation (ACI).Objective:To identify the patient-report instruments that are commonly used in the evaluation of physical activity and return to sport after ACI and provide a critical analysis of these instruments from a rehabilitative perspective.Evidence Acquisition:A computerized search was performed in January 2013 and repeated in March 2013. Criteria for inclusion required that studies (1) be written in English and published between 1994 and 2013; (2) be clinical studies where knee ACI cartilage repair was the primary treatment, or comparison studies between ACI and other techniques or between different ACI generations; (3) report postoperative physical activity and sport participation outcomes results, and (4) have evidence level of I–III.Evidence Synthesis:Twenty-six studies fulfilled the inclusion criteria. Three physical activity scales were identified: the Tegner Activity Scale, Modified Baecke Questionnaire, and Activity Rating Scale. Five knee-specific instruments were identified: the Lysholm Knee Function Scale, International Knee Documentation Committee Score Subjective Form, Knee Injury and Osteoarthritis Outcome Score, Modified Cincinnati Knee Score, and Stanmore-Bentley Functional Score.Conclusions:Considerable heterogeneity exists in the reporting of physical activity and sports participation after ACI. Current instruments do not fulfill the rehabilitative needs in the evaluation of physical activity and sports participation. The validated instruments fail in the assessment of frequency, intensity, and duration of sports participation.

Aeromedical Implications of Cerebral Cavernomas

2021 ◽  
Vol 92 (2) ◽  
pp. 120-123
Author(s):  
Tania Jagathesan ◽  
Michael OBrien
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Civil Aviation ◽  
Complication Rates ◽  
Cerebral Cavernous Malformations ◽  
Cavernous Malformations ◽  
Medical Certification ◽  
The Uk ◽  
Age Range ◽  
The Brain

BACKGROUND: Cavernomas, cavernous angiomas, or cerebral cavernous malformations are clusters of endothelium-lined blood vessels usually found in the brain. With the increasing use of radiological imaging, these are being detected incidentally in asymptomatic aircrew. The UK Civil Aviation Authority (CAA) experience of cavernomas is described and the aeromedical concerns, that is, the risk of epilepsy, hemorrhage, and the development of a neurological deficit, are considered.METHODS: A search of the CAA database between 1990 and 2020 was performed for the term cavernoma. The gender, age at diagnosis, class of certification held, clinical presentation, location, and size of the lesion were noted. A PubMed literature review for papers with complications of cavernoma was performed.RESULTS: Six cases of cavernoma have been declared to the CAA: five professional pilots and one private pilot. Five were men and one was a woman. The age range was between 38 and 60 yr, with a mean of 48 yr. Two cases presented with clinical symptoms and four were asymptomatic. Complication rates for seizure and hemorrhage were extracted from the published literature together with the significance of other factors such as cavernoma size, family history, multiplicity, and the development of new lesions.DISCUSSION: A policy for the medical certification of aircrew with cavernomas that have presented with clinical symptoms and those that are detected incidentally is proposed.Jagathesan T, OBrien M. Aeromedical implications of cerebral cavernomas. Aerosp Med Hum Perform. 2021; 92(2):120123.

The effect of the COVID-19 pandemic on non-elective otolaryngology admissions and a positive change in clinical practice

2021 ◽  
Vol 103 (7) ◽  
pp. 496-498 ◽  
Author(s):  
B Wright ◽  
C McKenna ◽  
CEE Reddy
Keyword(s):  
Clinical Practice ◽  
Northern Ireland ◽  
Adverse Events ◽  
Respiratory Illness ◽  
Positive Change ◽  
Peritonsillar Abscess ◽  
Outpatient Basis ◽  
Large Numbers ◽  
The Uk

As the COVID-19 pandemic progressed across the UK and Northern Ireland in March 2020, our otolaryngology department began to make preparations and changes in practice to accommodate for potentially large numbers of patients with COVID-19 related respiratory illness in the hospital. We retrospectively reviewed the number of non-elective admissions to our department between the months of January and May in 2019 and 2020. A significant reduction in admissions of up to 94% during the months of the pandemic was observed. Our practice shifted to manage patients with epistaxis and peritonsillar abscess on an outpatient basis, and while prospectively collecting data on this, we did not observe any significant adverse events. We view this as a positive learning point and change in our practice as a result of the COVID-19 pandemic.

scholarly journals Information given by websites selling home self-sampling COVID-19 tests: an analysis of accuracy and completeness

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042453
Author(s):  
Sian Taylor-Phillips ◽  
Sarah Berhane ◽  
Alice J Sitch ◽  
Karoline Freeman ◽  
Malcolm James Price ◽  
...  
Keyword(s):  
Best Practice ◽  
Venous Blood ◽  
Test Accuracy ◽  
Cross Sectional ◽  
Predictive Values ◽  
Online Sales ◽  
Online Purchase ◽  
The Uk ◽  
Antibody Tests ◽  
Intended Use

ObjectivesTo assess the accuracy and completeness of information provided by websites selling home self-sampling and testing kits for COVID-19.DesignCross-sectional observational study.SettingAll websites (n=27) selling direct to user home self-sampling and testing kits for COVID-19 (41 tests) in the UK (39 tests) and USA (two tests) identified by a website search on 23 May 2020.Main outcome measuresThirteen predefined basic information items to communicate to a user, including who should be tested, when and how testing should be done, test accuracy, and interpretation of results.ResultsMany websites did not provide the name or manufacturer of the test (32/41; 78%), when to use the test (10/41; 24%), test accuracy (12/41; 29%), and how to interpret results (21/41; 51%). Sensitivity and specificity were the most commonly reported test accuracy measures (either reported for 27/41 [66%] tests): we could only link these figures to manufacturers’ documents or publications for four (10%) tests. Predictive values, most relevant to users, were rarely reported (five [12%] tests reported positive predictive values). For molecular virus tests, 9/23 (39%) websites explained that test positives should self-isolate, and 8/23 (35%) explained that test negatives may still have the disease. For antibody tests, 12/18 (67%) websites explained that testing positive does not necessarily infer immunity from future infection. Seven (39%) websites selling antibody tests claimed the test had a CE mark, when they were for a different intended use (venous blood rather than finger-prick samples).ConclusionsAt the point of online purchase of home self-sampling COVID-19 tests, users in the UK are provided with incomplete, and, in some cases, misleading information on test accuracy, intended use, and test interpretation. Best practice guidance for communication about tests to the public should be developed and enforced for online sales of COVID-19 tests.

scholarly journals Return to Sport and Activity after Total Ankle Arthroplasty and Arthrodesis: A Systematic Review

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0027
Author(s):  
William L. Johns ◽  
Christopher Sowers ◽  
Kempland C. Walley ◽  
J. Ben Jackson ◽  
David B. Thordarson ◽  
...  
Keyword(s):  
Surgical Management ◽  
Sport Participation ◽  
Sport Activity ◽  
Return To Sport ◽  
Participation Rate ◽  
Ankle Arthrodesis ◽  
Cochrane Library ◽  
Activity Participation ◽  
Activity Levels ◽  
Sports Activity

Category: Ankle Arthritis; Ankle; Other Introduction/Purpose: There is no consensus regarding participation in sports and recreational activities following total ankle replacement (TAR) and ankle arthrodesis (AA). Better understanding on this topic will allow orthopaedic foot and ankle surgeons to set evidence-based goals and expectations with their patients in regards to postoperative activity recommendations and quality of life. We aimed to summarize the evidence on return to sport and activity after surgical management with either TAR or AA for ankle osteoarthritis (OA). Methods: A literature search of PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane Library databases was performed in January 2020. The bibliographies of all relevant publications were searched for further applicable studies. Included studies were required to report sport and activity outcomes in patients undergoing TAR and AA, with primary outcomes being percentage of sport participation and level of sport participation. Excluded studies were non-English and did not assess level of sport activity after TAR or AA. Results: Twelve studies met inclusion criteria for analysis. There were 1,270 ankle procedures, of which 923 TAR and 347 AA were performed. Mean reported patient age was 59.2 years old and mean BMI was 28 kg/m2. Mean follow-up was 43 months. Fifty-four percent of patients were active in sports preoperatively compared to 63.7% postoperatively (Figure 1). Mean preoperative activity participation rate was 41% in the TAR cohort, but improved to 59% after TAR, whereas preoperative activity participation rate of 73% was similar to postoperative rate of 70% in the AA cohort. The most common sports in TAR and AA groups were swimming, hiking, cycling, and skiing. Conclusion: Participation in sports activity is nearly 10% improved after surgical management of ankle OA. The existing literature demonstrated a large improvement in pre-to postoperative activity levels after TAR, with minimal change in activity after AA, however, AA patients were more active at baseline. The most frequent postoperative sports activities after surgical management of ankle OA are: swimming, hiking, cycling, and skiing. Despite preoperative participation in high-impact sports such as tennis, soccer, and running, these were consistently limited after surgery. This review of the literature will equip patients and physicians with the knowledge to appropriately establish realistic expectations for postoperative physical activity and return to sport goals. [Table: see text]

The Clinical Presentation of Oral Potentially Malignant Disorders

2016 ◽  
Vol 5 (1) ◽  
pp. 52-57
Author(s):  
Neal J Mccormick ◽  
Peter J Thomson ◽  
Marco Carrozzo
Keyword(s):  
Oral Cancer ◽  
Clinical Presentation ◽  
Screening Programme ◽  
Survival Rates ◽  
Oral Potentially Malignant Disorders ◽  
Clinical Appearance ◽  
Potentially Malignant Disorders ◽  
Potentially Malignant ◽  
The Uk ◽  
Dental Appointments

Early detection of oral cancer improves survival rates significantly, however, the incidence of oral cancer has continued to rise in the UK – between 2002–2012, it increased by more than 30%.1 There is currently no national screening programme for oral cancer, so undertaking a full examination of the oral mucosa during routine dental appointments is vital. Although strong evidence is still lacking, oral cancer is thought to be preceded by oral potential malignant disorders (OPMDs) or oral precancerous diseases. These mainly present as white/red lesions within the mouth and their clinical appearance can be challenging to diagnose accurately, which can lead to them being misdiagnosed as negligible problems. Dentists must keep up to date with OPMDs detection and ensure they are capable of correctly recognising lesions that carry a potential risk. This paper aims to provide a brief overview on OPMDs, highlighting potentially malignant disorders as they may present to the practitioner, showing their typical clinical appearance, and suggesting differential diagnosis and clinical management in dental practice.

Sign in / Sign up

Export Citation Format

Share Document