scholarly journals An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise Associated Muscle Cramps

2021 ◽  
Author(s):  
Kevin C. Miller ◽  
Brendon P. McDermott ◽  
Susan W. Yeargin ◽  
Aidan Fiol ◽  
Martin P. Schwellnus
Keyword(s):  
Risk Factors ◽  
Patient Specific ◽  
Evidence Based ◽  
Prevention Strategies ◽  
Extrinsic Factors ◽  
Physically Active ◽  
Muscle Cramps ◽  
Evidence Based Treatment ◽  
Treatment And Prevention ◽  
Exercise Associated Muscle Cramps

ABSTRACT Exercise-associated muscle cramps (EAMC) are common and frustrating for athletes and the physically active. We critically-appraised the EAMC literature to provide evidence-based treatment and prevention recommendations. While the pathophysiology of EAMC appears controversial, recent evidence suggests EAMC are due to a confluence of unique intrinsic and extrinsic factors rather than a singular etiology. The treatment of acute EAMC continues to include self-application or clinician-guided gentle static stretching until EAMC abatement. Once the painful EAMC are alleviated, clinicians can continue treatment on the sidelines by focusing on patient-specific risk factors that the clinician believes may have contributed to the genesis of EAMC. For EAMC prevention, clinicians should first perform a thorough medical history followed by identification of the patients' unique risk factors that could have coalesced to elicit EAMC. Individualizing EAMC prevention strategies will likely be more effective than generalized advice (e.g., drink more fluids).

Introduction

2016 ◽  
pp. 2-8
Author(s):  
Daniel R. Strunk ◽  
Robert J. DeRubeis
Keyword(s):  
Risk Factors ◽  
Mood Disorders ◽  
Cross Cultural ◽  
Comprehensive Treatment ◽  
Evidence Based ◽  
Personal Factors ◽  
Evidence Based Treatment ◽  
Treatment And Prevention

This volume provides what we believe to be the most comprehensive treatment of the range of mood disorders to date. In this introductory chapter, we present the organization and overarching themes of the volume. The volume’s coverage of mood disorders includes historical, cross-cultural, developmental, neuroscientific, etiological, and therapeutic issues. Following this introduction (Section I), Section II provides coverage of the phenomenology, classification, and assessment of mood disorders. A key theme of the section, the heterogeneity of mood disorders, is then carried through the volume. Section III addresses key etiologic, vulnerability and risk factors. Section IV covers key interpersonal and intra-personal factors, with several chapters focusing on neurobiological features. Section V examines variants of mood disorders as well as key sub-populations. Section VI addresses common comorbidities. Finally, Section VII surveys the wide array of commonly used and evidence-based treatment and prevention approaches.

Nonsuicidal Self-Injury Among Youth

2018 ◽  
Author(s):  
Adam Bryant Miller ◽  
Maya Massing-Schaffer ◽  
Sarah Owens ◽  
Mitchell J. Prinstein
Keyword(s):  
Risk Factors ◽  
Applied Research ◽  
Evidence Based ◽  
Prevalence Rates ◽  
Evidence Based Treatment ◽  
The Past ◽  
Self Injury ◽  
Assessment Techniques ◽  
Basic And Applied Research ◽  
Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is direct, intentional harm to one’s own body performed without the intent to die. NSSI has a marked developmental onset reaching peak prevalence in adolescence. NSSI is present in the context of multiple psychological disorders and stands alone as a separate phenomenon. Research has accumulated over the past several decades regarding the course of NSSI. While great advances have been made, there remains a distinct need for basic and applied research in the area of NSSI. This chapter reviews prevalence rates, correlates and risk factors, and leading theories of NSSI. Further, it reviews assessment techniques and provides recommendations. Then, it presents the latest evidence-based treatment recommendations and provides a case example. Finally, cutting edge research and the next frontier of research in this area are outlined.

Outcomes of Management of Proximal Humeral Fractures with Patient-Specific, Evidence-Based Treatment Algorithms

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Christian Spross ◽  
Vilijam Zdravkovic ◽  
Melanie Manser ◽  
Jan Marino Farei-Campagna ◽  
Matthijs Jacxsens ◽  
...  
Keyword(s):  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Patient Specific ◽  
Evidence Based ◽  
Treatment Algorithms ◽  
Evidence Based Treatment

scholarly journals 584. Use of Multi-Disciplinary Prevention Rounds to Reduce Central Line-Associated Bloodstream Infections in a Neonatal Intensive Care Unit

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S275-S276
Author(s):  
Matthew Linam ◽  
Jessica Wright ◽  
Kum Kim ◽  
Cara Van Treek ◽  
Patrick Spafford
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Central Venous Line ◽  
Patient Specific ◽  
Successful Implementation ◽  
Evidence Based ◽  
Clabsi Rate

Abstract Background Despite successful implementation of evidence-based prevention bundles, central line-associated bloodstream infections (CLABSIs) continue to occur in neonatal intensive care units (NICUs). We hypothesized that multi-disciplinary prevention rounds may be able to further reduce CLABSIs. Methods We implemented bedside rounds in a 39-bed tertiary NICU in November 2018 with the focus of reducing CLABSIs. Standardized rounds for all patients with a central venous line (CVL) occurred 2–3 times/week on weekdays during either the day or evening shifts. Rounds included NICU nursing leadership, the Hospital Epidemiologist and the patient’s nurse. Questions focused on the CVL maintenance bundle, reducing line access, and patient-specific CLABSI risk factors. Best practices were reinforced and solutions for identified risk factors were developed. Recommendations were communicated to the physician, as appropriate. Prevention rounds data were collected. Nurses and providers in the NICU were surveyed about their perceptions of the rounds. CLABSIs were identified by Infection Prevention using standard definitions. Results The average daily NICU census was 35.6, with an average of 14 patients with CVLs/day. The average duration of rounds was 45 minutes. Recommendations to physicians, such as changing medications from intravenous to oral or line removal, were accepted 85% of the time. 74.5% of nurses and 87.5% of providers thought that prevention rounds had at least some impact on CLABSI prevention. Nurse and provider responses to the perceived impact of CLABSI prevention rounds are in Tables 1 and 2, respectively. In the 12 months prior to starting prevention rounds, the CLABSI rate was 1.53 /1000 line days and the CLABSI rate for the 6 months after starting rounds was 0.99/1,000 line days, a 65% decrease. Conclusion CLABSI prevention rounds helped reinforce evidence-based prevention practices, identified patient-specific risk factors and improved physician-nurse communication. CLABSIs in NICU were reduced. Disclosures All authors: No reported disclosures.

scholarly journals Toward Effective Early Intervention and Prevention Strategies for Major Affective Disorders: A Review of Antecedents and Risk Factors

2000 ◽  
Vol 45 (4) ◽  
pp. 340-348 ◽  
Author(s):  
Anne Duffy
Keyword(s):  
Risk Factors ◽  
Early Intervention ◽  
Family History ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Relevant Literature ◽  
Positive Family History ◽  
Prevention Strategies ◽  
Sociological Factors ◽  
Treatment And Prevention

Objective: To review critically the literature pertaining to riskfactors and antecedent symptoms and syndromes in order to determine an empirically based strategy for early treatment and prevention of major mood episodes. Method: The relevant literature is summarized, with particular emphasis on early-onset (child and adolescent) mood disorders. Results: A complex interaction between biological, psychological, and sociological factors contributes to the development of a major mood disorder. Having a positive family history of mood disorder (bipolar and unipolar) and being female (unipolar) are the strongest, most reliable risk factors. There is continuity between adolescent and adult mood disorders, and subsyndromal mood disturbance in adolescents has clinical and public health significance. However, more longitudinal study is required to reliably map the course and predictive importance of mood disorders in very young children. Conclusions: Substantial evidence supports the effectiveness of early intervention and prevention efforts in children at risk for mood disorders (identified as having affected family members) and in adolescents manifesting significant mood symptoms and syndromes (especially if associated with a positive family history). However, the current level of understanding regarding the etiological significance and mechanism of risk factors associated with mood disorders does not support broad community-based primary prevention strategies in unselected populations.

Substance misuse and older people: a question of values

2015 ◽  
Author(s):  
Ilana Crome
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Prescription Drugs ◽  
Substance Misuse ◽  
Evidence Based ◽  
Younger Adults ◽  
Evidence Based Treatment ◽  
Treatment Regimes ◽  
Key Points ◽  
Physical Disorders

Key points• Substances are drugs that alter mental state and are potentially addictive.• Substance abuse is not confined to the younger population; it is also prevalent in older people—alcohol and prescription drugs are the most commonly misused in this population.• The possibility of substance misuse should not be dismissed because of the patient’s age.• Recommended alcohol limits are likely to be lower than for younger adults.• Risk factors differ for older people, e.g. bereavement, retirement, loneliness, boredom.• Substance misuse is often accompanied by other mental and physical disorders.• Older people can improve with treatment so should be comprehensively assessed and offered evidence-based treatment regimes that are adjusted to take their special needs into account.

scholarly journals Evidence-Based Treatment of Delirium in Patients With Cancer

2012 ◽  
Vol 30 (11) ◽  
pp. 1206-1214 ◽  
Author(s):  
William Breitbart ◽  
Yesne Alici
Keyword(s):  
Adverse Outcomes ◽  
Evidence Based ◽  
Close Monitoring ◽  
Evidence Based Treatment ◽  
Patients With Cancer ◽  
Treatment And Prevention ◽  
Hospital Stays ◽  
Prolonged Hospital ◽  
Care Costs

Delirium is the most common neuropsychiatric complication seen in patients with cancer, and it is associated with significant morbidity and mortality. Increased health care costs, prolonged hospital stays, and long-term cognitive decline are other well-recognized adverse outcomes of delirium. Improved recognition of delirium and early treatment are important in diminishing such morbidity. There has been an increasing number of studies published in the literature over the last 10 years regarding delirium treatment as well as prevention. Antipsychotics, cholinesterase inhibitors, and alpha-2 agonists are the three groups of medications that have been studied in randomized controlled trials in different patient populations. In patients with cancer, the evidence is most clearly supportive of short-term, low-dose use of antipsychotics for controlling the symptoms of delirium, with close monitoring for possible adverse effects, especially in older patients with multiple medical comorbidities. Nonpharmacologic interventions also appear to have a beneficial role in the treatment of patients with cancer who have or are at risk for delirium. This article presents evidence-based recommendations based on the results of pharmacologic and nonpharmacologic studies of the treatment and prevention of delirium.

scholarly journals Triathlon-related musculoskeletal injuries: a study on a Portuguese Triathlon Championship

2020 ◽  
Vol 66 (11) ◽  
pp. 1536-1541
Author(s):  
Beatriz Minghelli ◽  
Catarina Jesus ◽  
Ilvanda Martins ◽  
Joana Jesus
Keyword(s):  
Risk Factors ◽  
Statistical Significance ◽  
Measurement Instrument ◽  
Mechanism Of Injury ◽  
Prevention Strategies ◽  
Specific Training ◽  
Extrinsic Factors ◽  
Training Frequency ◽  
High Prevalence

SUMMARY BACKGROUND: A triathlon consists of 3 modalities: swimming, cycling and running. Its higher training frequency, the environmental factors and extrinsic factors (technique and equipment) may lead to injuries. This study aimed to determine injury epidemiology in triathletes, as well as their type, location, mechanism of injury, and risk factors. METHODS: The sample was constituted of 174 triathletes who participated in the Triathlon Club Portuguese Championship, being 131 (75.3%) male, aged 18 to 70 years old (36.09±11.03). The measurement instrument was a questionnaire concerning the characterization of the population and aspects related to the modality and injuries. RESULTS: One hundred and twenty (69%) athletes reported one injury since the beginning of their practice, and 95 (54.6%) had an injury in the previous year, with a total of 130 injuries. There were 2.39 injuries per 1,000 hours of triathlon training. The most common injuries were muscle contusion (31.5%) and inflammatory injuries (19.2%), located in the knee (22.3%) and the leg (18.5%). Overtraining (43.1%) was the mechanism that led to the highest occurrence of injuries. Fourteen (10.8%) injuries occurred during swimming, 23 (17.7%) during cycling, and 93 (71.5%) during running. No statistical significance was observed between the risk factors analyzed and the occurrence of injuries. CONCLUSIONS: Triathlon practice is associated with a high prevalence of injuries, being contusions, knee, and overtraining the most common type, location, and mechanism of injury respectively. It is necessary to create injury prevention strategies, including specific training and suitable materials for use by athletes.

Prevention and Management of Obstetric Perineal Lacerations

2018 ◽  
Author(s):  
Helai Hesham ◽  
Lori R Berkowitz
Keyword(s):  
Risk Factors ◽  
Pelvic Floor ◽  
Key Words ◽  
Evidence Based ◽  
Operative Delivery ◽  
Prevention Strategies ◽  
Perineal Lacerations ◽  
Vaginal Deliveries ◽  
Perineal Massage

Vaginal deliveries vary widely in the trauma they may introduce to the pelvic floor as does the management of such trauma. Labor, operative deliveries, lacerations, and episiotomies all present unique risk factors for both acute and long-term pelvic floor complications. Of these risk factors, perineal lacerations are the most commonly encountered event that women experience during vaginal childbirth. This review attempts to analyze obstetric perineal lacerations, their management, and potential prevention strategies to enhance pelvic floor health. With standardized management based on evidence based strategies and care during both delivery and postpartum, clinicians can decrease higher order lacerations and their possible sequela. This review contains 12 figures, 1 table and 36 references Key Words: episiotomy, laceration, laceration repair, obstetric, operative delivery, perineal massage, prevention, pudendal block

scholarly journals The EdUReP Model for Nonsurgical Management of Tendinopathy

2005 ◽  
Vol 85 (10) ◽  
pp. 1093-1103 ◽  
Author(s):  
Todd E Davenport ◽  
Kornelia Kulig ◽  
Yogi Matharu ◽  
Cesar E Blanco
Keyword(s):  
Mechanical Loading ◽  
Functional Limitation ◽  
Educational Interventions ◽  
Evidence Based ◽  
Prevention Strategies ◽  
Evidence Based Treatment ◽  
Nonsurgical Management ◽  
Cellular Changes ◽  
Abrupt Changes

AbstractTendinopathy is a common and substantial source of morbidity worldwide. Various anatomical and functional predispositions combine with abrupt changes in mechanical loading to cause characteristic histological maladaptations in tendons. The nature and latency of cellular changes in tendinopathy makes many common treatments lessthan-optimal options. This Perspective presents the EdUReP model for nonsurgical management of tendinopathy, a model that considers sources of pathology at the cellular, anatomical, and functional levels. The EdUReP model addresses possible sources of symptoms at the levels of pathology, impairment, functional limitation, and disability through Educational interventions, periods of tendon Unloading and controlled Reloading, and implementation of Prevention strategies. The EdUReP model is an evidence-based treatment construct that aims to reduce functional limitation and disability through amelioration of tissue pathology.

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