Acute and Subacute Clinical Markers After Sport-Related Concussion

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S16.1-S16
Author(s):  
Maria Julieta Russo ◽  
Fernando Salvat ◽  
Gustavo Sevlever ◽  
Ricardo F. Allegri
Keyword(s):  
Symptom Assessment ◽  
Cross Sectional Study ◽  
Rugby Union ◽  
Clinical Markers ◽  
Cross Sectional ◽  
Sports Concussion ◽  
Persistent Symptoms ◽  
Traumatic Amnesia ◽  
Assessment And Treatment ◽  
Memory Concerns

ObjectiveThis study aimed to determine the association of a range of off-field symptoms reported by athletes retrospectively with on-field concussion signs and in-office symptoms among rugby union players.BackgroundPlayers with sports concussion experience multiple symptoms. Understanding the association between these symptoms and clinical markers of concussion would facilitate a targeted approach to symptom assessment and treatment.Design/MethodsCross-sectional study. We consecutively enrolled 92 adult rugby union players, within the first 72 hours after sport concussion. Ten symptoms assessed using a retrospective symptoms interview were examined for their association with observed concussion signs and post-concussion symptoms using the Post-Concussion Symptoms Scale (PCSS).ResultsOdds ratios revealed that athletes who was overtly symptomatic based on retrospective concussion interview at the time of the concussion were over 2.6 times more likely (p = 0.047) to have exhibited post-traumatic amnesia when compared with athletes who was asymptomatic. There were no differences between groups in terms of on-field loss of consciousness or confusion. Off-field symptoms reported by athlete were associated with symptoms reporting on the Beck Depression Inventory (OR 2.8; 95% CI 1.14–6.88), headache (OR 4.9; 95% CI 1.92–12.79), memory concerns (OR 3.15; 95% CI 1.06–9.34), pressure in head (OR 2.8; 95% CI 1.03–8.08), and visual disturbances (OR 3.9; 95% CI 1.05–14.50) within the first 72 hours after concussion.ConclusionsSymptomatic concussed rugby athletes have increased odds for sustaining on-field concussion signs that can be observed by others and persistent symptoms within the first 72 hours after concussion. Information from the on-field and off-field assessment is essential in understanding the severity of sports concussion.

scholarly journals Quality of life in multiple sclerosis: The differential impact of motor and cognitive fatigue

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199604
Author(s):  
Sabina David Ruban ◽  
Claudia Christina Hilt ◽  
Thor Petersen
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Short Form ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cognitive Fatigue ◽  
Cross Sectional ◽  
Impact Scale ◽  
Assessment And Treatment

Background Multiple sclerosis is a chronic disease leading to reduced quality of life. Objectives To investigate whether motor and cognitive fatigue impact differently on aspects of quality of life among patients with multiple sclerosis, independently from bodily disability. Methods 79 patients with multiple sclerosis from Aalborg University Hospital, Denmark were included in an observational, cross-sectional study. Each subject completed two separate questionnaires regarding fatigue (Fatigue Scale for Motor and Cognitive Functions and Modified Fatigue Impact Scale) and one regarding quality of life (Short Form 36). Disability was measured with the Expanded Disability Status Scale (EDSS)-scores obtained from patient records. Results All fatigue scores were significantly correlated to all areas of quality of life (p < 0,05). This remained significant after adjustment for age, disease duration and EDSS-score. When looking at each type of fatigue separately, cognitive fatigue correlated mainly with mental health aspects of quality of life and motor fatigue with physical health areas of quality of life. Conclusion Increased motor and cognitive fatigue lead to a differential reduction in physical and mental quality of life, independently of bodily disability. This underlines the importance of proper assessment and treatment of fatigue among patients with multiple sclerosis.

Measurement of Empathy Levels in Undergraduate Paramedic Students

2013 ◽  
Vol 28 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Brett Williams ◽  
Mal Boyle ◽  
Tracy Earl
Keyword(s):  
Medical Condition ◽  
Cross Sectional Study ◽  
First Year ◽  
Significant Variable ◽  
Health Provider ◽  
Patient Relationship ◽  
Publication Type ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Assessment And Treatment

AbstractIntroductionParamedics rely on establishing a health provider-patient relationship with patients that promotes two-way communication, patient satisfaction, and facilitates appropriate patient assessment and treatment. Paramedics also must have an ability to empathize with patients and their family members in order to develop a successful health provider-patient relationship. The objective of this study was to assess paramedics’ empathy and attitudes toward patients with specific conditions.MethodsThis was a cross-sectional study using a convenience sample of first-, second-, and third-year, Australian undergraduate paramedic students. Student empathy levels were assessed using two standardized self-reporting instruments: the Jefferson Scale of Physician Empathy (JSPE) Health Professional (HP) version and the Medical Condition Regard Scale (MCRS).ResultsA total of 94 paramedic students participated in the study. The JSPE demonstrated that male paramedic students had higher mean empathy scores than did female paramedic students (113.25 and 107.5, respectively; P = .042). The JSPE empathy level scores were lowest among first-year paramedic students (mean = 107.53); age was not found to be a significant variable on empathy scores. The Medical Condition Regard Scale revealed lowest scores in compassion towards substance abuse (mean = 46.42).ConclusionsThe results of this study provide the discipline of paramedic health care with useful data, and provide students, academics, and other educators with important information regarding the improvement of the health provider-patient relationship and paramedic education curriculum development.WilliamsB, BoyleM, EarlT. Measurement of empathy levels in undergraduate paramedic students. Prehosp Disaster Med. 2013;28(2):1-5.

scholarly journals Cognition, functionality and symptoms in patients under home palliative care

2018 ◽  
Vol 64 (10) ◽  
pp. 922-927
Author(s):  
Maria Aparecida Scottini ◽  
Rachel Duarte Moritz ◽  
José Eduardo de Siqueira
Keyword(s):  
Home Care ◽  
Severe Pain ◽  
Symptom Assessment ◽  
Cross Sectional Study ◽  
Assessment System ◽  
Cross Sectional ◽  
Palliative Home Care ◽  
Student’S T ◽  
State Examination

SUMMARY OBJECTIVE: Evaluating the degree of cognition, functionality, presence of symptoms and medications prescribed for patients under palliative home care. METHOD: Descriptive, cross-sectional study where 55 patients under palliative home care were interviewed. Cognition was evaluated using the Mini-Mental state examination (MM), with patients being separated into two groups: with preserved cognitive ability (MM>24), or altered (MM <24). The functionality was verified by the Palliative Performance Scale (PPS) and the patients were divided into two groups: PPS≤50 and PPS≥60. The symptoms presence was evaluated by ESAS (Edmonton Symptom Assessment System) being considered as mild (ESAS 1-3), moderate (ESAS 4-6) or severe (ESAS 7-10) symptoms. Medications prescribed to control the symptoms were registered. Statistical analysis used Student's t test (p <0.05). RESULTS: Most of the 55 patients were women (63.6%), 70.9% of these had MM> 24, 83.6% had PPS <50 and 78.2% presented chronic non-neoplastic degenerative disease. There was a significant relationship between PPS≤50 and MM≤24. Symptoms were present in 98% of patients. Asthenia was more frequently reported and was not treated in 67% of the cases. Severe pain was present in 27.3%: 46% without medication and 13% with medication, if necessary. Most patients with severe dyspnea used oxygen. CONCLUSIONS: Most of the analysed patients had their cognition preserved, presented low functionality and 98% reported the presence of symptoms. Severe pain was present in almost 1/3 of the patients without effective treatment. Re-evaluate palliative home care is suggested to optimize patient's quality of life.

scholarly journals BRain health and healthy AgeINg in retired rugby union players, the BRAIN Study: study protocol for an observational study in the UK

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017990 ◽  
Author(s):  
Valentina Gallo ◽  
Damien McElvenny ◽  
Catherine Hobbs ◽  
Donna Davoren ◽  
Huw Morris ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Rugby Union ◽  
Healthy Ageing ◽  
Current Evidence ◽  
London School ◽  
Cross Sectional ◽  
Potential Health ◽  
Age Related ◽  
Rugby Players

IntroductionRelatively little is known about the long-term health of former elite rugby players, or former sportspeople more generally. As well as the potential benefits of being former elite sportspersons, there may be potential health risks from exposures occurring during an individual’s playing career, as well as following retirement. Each contact sport has vastly different playing dynamics, therefore exposing its players to different types of potential traumas. Current evidence suggests that these are not necessarily comparable in terms of pathophysiology, and their potential long-term adverse effects might also differ. There is currently limited but increasing evidence that poorer age-related and neurological health exists among former professional sportsmen exposed to repetitive concussions; however the evidence is limited on rugby union players, specifically.Methods and analysisWe present the protocol for a cross-sectional study to assess the association between self-reported history of concussion during a playing career, and subsequent measures of healthy ageing and neurological and cognitive impairment. We are recruiting a sample of approximately 200 retired rugby players (former Oxford and Cambridge University rugby players and members of the England Rugby International Club) aged 50 years or more, and collecting a number of general and neurological health-related outcome measures though validated assessments. Biomarkers of neurodegeneration (neurofilaments and tau) will be also be measured. Although the study is focusing on rugby union players specifically, the general study design and the methods for assessing neurological health are likely to be relevant to other studies of former elite sportspersons.Ethics and disseminationThe study has been approved by the Ethical Committee of London School of Hygiene and Tropical Medicine (reference: 11634-2). It is intended that results of this study will be published in peer-reviewed medical journals, communicated to participants, the general public and all relevant stakeholders.

scholarly journals Relationship between the stuttering severity index and speech rate

2003 ◽  
Vol 121 (2) ◽  
pp. 81-84 ◽  
Author(s):  
Claudia Regina Furquim de Andrade ◽  
Luciana Maluf Cervone ◽  
Fernanda Chiarion Sassi
Keyword(s):  
Speech Rate ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Important Variable ◽  
Index Test ◽  
Cross Sectional ◽  
Important Indicator ◽  
Fluency Disorders ◽  
Assessment And Treatment ◽  
Developmental Stuttering

CONTEXT: The speech rate is one of the parameters considered when investigating speech fluency and is an important variable in the assessment of individuals with communication complaints. OBJECTIVE: To correlate the stuttering severity index with one of the indices used for assessing fluency/speech rate. DESIGN: Cross-sectional study. SETTING: Fluency and Fluency Disorders Investigation Laboratory, Faculdade de Medicina da Universidade de São Paulo. PARTICIPANTS: Seventy adults with stuttering diagnosis. MAIN MEASUREMENTS: A speech sample from each participant containing at least 200 fluent syllables was videotaped and analyzed according to a stuttering severity index test and speech rate parameters. RESULTS: The results obtained in this study indicate that the stuttering severity and the speech rate present significant variation, i.e., the more severe the stuttering is, the lower the speech rate in words and syllables per minute. DISCUSSION AND CONCLUSION: The results suggest that speech rate is an important indicator of fluency levels and should be incorporated in the assessment and treatment of stuttering. This study represents a first attempt to identify the possible subtypes of developmental stuttering. DEFINITION: Objective tests that quantify diseases are important in their diagnosis, treatment and prognosis.

scholarly journals Analysis of cell-mediated immunity in people with long Covid.

2021 ◽  
Author(s):  
Nerea Montes ◽  
Èlia Domènech ◽  
Silvia Guerrero ◽  
B&aacuterbara Oliv&aacuten-Bl&aacutezquez ◽  
Rosa Magallón-Botalla
Keyword(s):  
Nk Cells ◽  
Immune Cell ◽  
Nk Cell ◽  
Humoral Response ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cell Mediated Immunity ◽  
Specific Cell ◽  
Cross Sectional ◽  
Persistent Symptoms

Introduction: The objective of this study is to analyse the specific immune response against SARS-CoV-2 in those affected by Long Covid (LC), attributable to T cells (cell-mediated immunity) and to carry out a parallel analysis of the humoral response and lymphocyte typing. Methodology: Descriptive cross-sectional study of 74 patients with LC for at least 4 months since diagnosis. The collected data were: information on the COVID-19 episode and the persistent symptoms, medical history and a specific cell-mediated immunity to SARS-CoV-2 through flow cytometry, assessing the release of interferon-gamma (IFN-Ɣ) by T4 lymphocytes, T8 lymphocytes and NK cells. Descriptive and comparative analyses were carried out. Results: Patients with LC had negative serology for Covid-19 in 89% of cases but 96% showed specific cellular immunity to SARS-CoV-2 an average of 9.5 months after infection: 89% of this response corresponded to T8 lymphocytes, 58% to NK cells, and 51% to T4 lymphocyte (20% negligibly positive). Most of them had altered immune cell typing and we found that T4 lymphocyte counts were low in 34% of cases and NK cell high in 64%. Macrophage populations were detected in the peripheral blood of 7% of them. Patients displayed a higher percentage of illnesses related to ″abnormal″ immune responses, either preceding SARS-CoV-2 infection (43%) or following it in 23% of cases. Conclusion: The immune system appears to have an important involvement in the development of LC and viral persistence could be the cause or consequence of it. Further analysis with a control group should be performed.

scholarly journals Long COVID Occurrence in COVID-19 Survivors

2022 ◽  
Author(s):  
Aya Sugiyama ◽  
Kei Miwata ◽  
Yoshihiro Kitahara ◽  
Mafumi Okimoto ◽  
Kanon Abe ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Work Performance ◽  
Large Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Persistent Symptoms ◽  
Stigma And Discrimination ◽  
Hiroshima Prefecture ◽  
Taste Disorders ◽  
Independent Risk Factors

Abstract This cross-sectional study aimed to investigate the post-acute consequences of COVID-19. We conducted a self-administered questionnaire survey on sequelae, psychological distress (K6), impairments in work performance (WFun), and COVID-19–related experiences of stigma and discrimination in two designated COVID-19 hospitals in Hiroshima Prefecture, Japan, between August 2020 and March 2021. The prevalence of sequelae were calculated by age and COVID-19 severity. Factors independently associated with sequelae or psychological distress were identified using logistic regression analysis. Among 127 patients who had recovered from COVID-19, 52.0% had persistent symptoms at a median of 29 days [IQR 23–128] after COVID-19 onset. Among patients with mild COVID-19, 50.5% had sequelae. The most frequent symptoms were olfactory disorders (15.0%), taste disorders (14.2%), and cough (14.2%). Multivariate analysis showed that age was an independent risk factor for sequelae (adjusted odds ratios [AOR] for ≥60 years vs. <40 years 3.84, p=0.0139). Possible psychological distress was noted in 30.7% (17.9% of males and 45.0% of females). Female sex and the presence of sequelae were independent risk factors for psychological distress. Of all participants 29.1% had possible impairments in work performance. Experiences of stigma and discrimination were reported by 43.3% of participants. This study revealed the significant impacts of Long COVID on health in local communities. A large-scale, long-term cohort study is desired.

scholarly journals 0596 Providers Rarely Assess Obstructive Sleep Apnea Symptoms Among Patients with Chronic Obstructive Pulmonary Disease

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A228-A228
Author(s):  
L M Donovan ◽  
T Keller ◽  
N H Stewart ◽  
L J Spece ◽  
D H Au ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Symptom Assessment ◽  
Cross Sectional Study ◽  
Mixed Effects ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Care Clinic ◽  
General Internal ◽  
Obstructive Sleep

Abstract Introduction Professional societies recommend providers assess sleep symptoms in COPD, but it is unclear if this occurs. We aimed to evaluate OSA symptom assessment and documentation among patients with COPD, and the patient and provider characteristics associated with this assessment. Methods We conducted a cross-sectional study of adults aged ≥40 years with clinically diagnosed COPD and no prior diagnosis of OSA. We selected patients receiving care at two academic general internal medicine clinics between 6/1/2011 - 6/1/2013. We abstracted charts to assess how often OSA symptoms such as snoring, somnolence, witnessed apneas, or gasping/choking arousals were documented as present or absent. We performed multivariable mixed-effects logistic regression to assess associations of patient and primary care provider (PCP) factors with assessment of OSA symptoms. Patient factors included demographics, body mass index, comorbidities, healthcare utilization, and severity of COPD, and PCP factors including demographics, degree, and years of experience. Results Of 523 patients with COPD, only 26 (5.0%) had documentation of OSA symptom assessment within a one-year period. In mixed effects models, only referral to general pulmonary clinic was associated with the assessment of OSA symptoms (OR: 4.56, 95% CI 1.28-15.52). Among the 26 individuals who had OSA symptoms assessed, 9 (34.6%) reported snoring, 15 (57.7%) reported daytime somnolence, 2 (7.7%) reported gasping/choking arousals, and 5 (19.2%) reported witnessed apneas. Among those assessed for OSA symptoms, providers referred 11 (42.3%) for formal sleep consultation. Conclusion Providers rarely document OSA symptoms for patients with COPD in primary care clinic, but assessment is greater among those with pulmonary specialty consultation. Given time constraints in primary care, external facilitation of sleep symptom assessment may improve symptom recognition and receipt of appropriate services. Support NIH 5K23HL111116-05, VA Center of Innovation for Veteran-Centered and Value-Driven Care.

scholarly journals Comfort level of caregivers of cancer patients receiving palliative care

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Maisa Vitória Gayoso ◽  
Marla Andréia Garcia de Avila ◽  
Thays Antunes da Silva ◽  
Rúbia Aguiar Alencar
Keyword(s):  
Palliative Care ◽  
Functional Status ◽  
Cancer Patients ◽  
Symptom Assessment ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Comfort Level ◽  
Cross Sectional ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale

ABSTRACT Objective: To verify the association between the level of comfort of the caregiver and socio-demographic variables related to caregiving, and the patient’s functional status and symptoms. Method: Cross-sectional study with non-probabilistic intentional sample. The instruments Palliative Performance Scale (score 0 to 100%), Edmonton Symptom Assessment Scale (symptom scores from zero to ten) and Holistic Comfort Questionnaire (total score ranging from 49 to 294 and mean score from 1 to 6) were used. The relationship between comfort scores and independent variables was calculated by multiple linear regression. Results: Fifty informal caregivers participated in the study - 80% were female, 32% were 60 years old or older, 36% were children of the patient, 58% had paid work and 60% did not have help in the care. The mean overall comfort was 4.52 points. A better functional status of the patients was associated with higher levels of comfort of the caregivers. Older caregivers who received helped in the care activities presented higher comfort scores. Conclusion: The level of comfort of caregivers of cancer patients receiving palliative care was associated with socio-demographic variables and patients’ functional status and symptoms.

Sign in / Sign up

Export Citation Format

Share Document