1/4. Injury severity and neuropsychological and balance outcomes of four college athletes.Recent evidence suggests significant short-term neurocognitive deficits following mild traumatic brain injury (MTBI) in sports. However, sequelae of mild head injuries is complicated by many factors including a history of multiple head injuries and injury severity. Few studies have considered the influence these variables may have on proper classification of a MTBI and their meaning for return-to-play guidelines. This study presents the short-term neuropsychological and balance outcomes of four college athletes who sustained mild head injuries of different severity (grade I, grade II, grade III and multiple head injured with a grade II based on American Academy of neurology guidelines). The results demonstrated that self-report symptoms of concussion were slow to resolve in the grade III and multiple concussed individuals. For neuropsychological testing, Trails A & B, Symbol Digit Modalities Test and Digits Span Backwards were the most sensitive in identifying differences between the injuries. For balance assessments using the Neurocom Smart Balance System, the Sensory Organization Test and reaction time were also important variables in detecting differences among the various injuries. When these data are used together, it can assist physicians in determining safe return-to-play for athletes who sustain MTBI. There are contradindications in the numerous grading systems and return-to-play guidelines for MTBI. The results from this study provides new evidence which can be assimilated into a valid grading scale for MTBI sustained in sport.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Medical problems affecting musicians.The physical demands of performing on musical instruments can cause pain, sensory loss, and lack of coordination. Five cases illustrate common problems. knowledge of the interaction between the technique of playing the instrument and the particular musician can help physicians diagnose and resolve problems.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. Decreased corneal sensation as an initial feature of acanthamoeba keratitis.BACKGROUND: herpes simplex keratitis is the most common misdiagnosis in patients with acanthamoeba keratitis, which is increasing in frequency and is associated with daily wear soft contact lenses. Both entities usually present as unilateral keratitis. The manifestations of superficial acanthamoeba keratitis (i.e., unilaterality, dendriform appearance, positive response to antivirals, and decreased corneal sensation) increase the opportunity for misdiagnosis as herpes simplex keratitis. The authors have encountered six patients with acanthamoeba keratitis in whom the correct diagnosis was delayed from 2 weeks to 3 months. methods: All six patients underwent testing with the Cochet-Bonnet esthesiometer and extensive pharmacologic treatment for herpes simplex keratitis. Corneal scrapings were taken between 2 and 6 weeks after the initial examination. RESULTS: In all six patients, corneal sensation was decreased significantly. drug therapy was ineffective. Cultures were positive for Acanthamoeba. Five of six patients underwent penetrating keratoplasty. CONCLUSIONS: Decreased corneal sensation has contributed to the misdiagnosis of Acanthamoeba as herpes simplex keratitis. Misdiagnosis results in delayed treatment and worse outcome. The authors found that significantly decreased corneal sensation is a frequent finding in early acanthamoeba keratitis. Therefore, physicians should consider acanthamoeba keratitis as an alternative diagnosis in patients with presumed herpes simplex keratitis with decreased corneal sensation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. Chronic carbon monoxide exposure: a clinical syndrome detected by neuropsychological tests.Chronic exposure to carbon monoxide produces a clinical syndrome that is often overlooked because of obscure symptomatology, a range of presentations, and lack of awareness of the problem. To help physicians recognize and treat the chronic carbon monoxide exposure syndrome, the authors present its objective symptomatology, an approach to diagnosis emphasizing neuropsychological tests, a treatment protocol, and theoretical considerations for the mechanism of hyperbaric oxygen's therapeutic action. For elucidation, eight patients treated in the hyperbaric chamber at a tertiary care facility are described. diagnosis can be facilitated by recognizing the syndrome based on the patient's history, as well as physical and neuropsychological examinations, with emphasis on identifying potential sources of carbon monoxide exposure. The evaluation and treatment protocols presented, though still experimental, show promise for improving functional, cognitive, and psychiatric capacities.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |