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Allergic and Immunologic Reactions
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Saira N. Agarwala, Aspen R. Trautz, Sylvia Hsu
Management: EI is generally managed by controlling the underlying cause. In the case of TB-associated EI, patients should be started on standard TB treatment for either latent or active disease. In drug-associated EI, withdrawal of the medication can lead to resolution. Supportive care for the lesions can be provided with mild pain medications and other treatments to support healing, such as leg elevation.
Bones and fractures
Published in Henry J. Woodford, Essential Geriatrics, 2022
Often, there is classical leg shortening and external rotation but an undisplaced or impacted fracture may only cause pain on attempted weight-bearing. Around 1% of initial X-rays do not show a fracture that later becomes apparent (e.g. by becoming displaced).104 MRI scanning can increase the fracture detection rate. A 4.4% prevalence of hip or pelvic fracture has been found by MRI scanning patients who attended an emergency department with hip pain but with no fracture seen on initial X-ray.105 In another study of people aged 70 and over with negative X-rays but a high clinical suspicion of fracture (persisting pain, unable to weight bear and pain on straight leg raising or hip rotation) MRI scanning detected a proximal femoral fracture in 21 of 25 (84%) people, with a further three having pelvic fractures.106 CT imaging or isotope bone scans are alternative, but less sensitive detection techniques. Another option is to simply repeat the hip X-ray after 24 to 48 hours.
Prenatal Care
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Gabriele Saccone, Kerri Sendek
Leg cramps are reported to occur in 34% of pregnant women in the mid-trimester [136, 137]. Magnesium lactate or citrate chewable tablets 5 mmol in the morning and 10 mmol in the evening for 3 weeks are associated with one-third of women not having persistent leg cramps compared to 94% of placebo controls having persistent cramps. A multivitamin with a mineral supplement might decrease leg cramps, but it is unclear which one of the 12 ingredients (or combination) is beneficial. Sodium chloride is associated with a slight reduction, although consideration must be given to the potential effect on blood pressure. Calcium supplements do not decrease leg cramps compared to placebo. However, it is unclear whether any of the interventions studied (i.e., oral magnesium, oral calcium, oral vitamin B, or oral vitamin C) provide an effective treatment for leg cramps due to poor study design and trials being too small to address the question satisfactorily.
Cardiovascular responses to hot skin at rest and during exercise
Published in Temperature, 2023
Ting-Heng Chou, Edward F. Coyle
We have discussed that skin blood flow usually does not rise continuously during prolonged exercise or during exercise in the heat, and skin blood flow does not temporally relate to stroke volume during exercise. The next question is whether increases in cutaneous venous volume are associated with reduced stroke volume during exercise? Some data suggest that venous volume can affect stroke volume during exercise. Patients with congenital absence of venous valves showed considerably lower stroke volume during exercise in the sitting position than in the supine position, and the difference was significantly larger than in normal subjects [160]. Patients with large varicose veins showed higher stroke volume and cardiac output during submaximal exercise in a sitting position when the legs were bandaged compared to those not bandaged [161]. Bandaging the legs also raised stroke volume in normal subjects during prolonged exercise in a neutral environment, however, it did not prevent the gradual decreases in stroke volume as exercise duration increased [162]. These studies demonstrated that reducing venous volume in the lower limbs elevates stroke volume during upright exercise, suggesting that an increase in cutaneous blood volume can cause a decrease in stroke volume. The following question is, does an increase in cutaneous venous volume actually occur during exercise in the heat?
Using an external focus of attention for gait retraining in runners: A case report
Published in Physiotherapy Theory and Practice, 2023
Sara Skammer, Justin Halvorson, James Becker
The participant in this case report was a 22-year-old female collegiate track and field athlete (mass: 54.9 kg, height: 1.62 m) who competed in steeplechase during the outdoor season and 3K for the indoor season. Prior to participating in this assessment and retraining, all procedures were explained to the participant and she provided written informed consent allowing the anonymous use of her data and treatment outcomes for publication. At the time of evaluation, the participant was running 6 days per week, covering a total of approximately 50 km. This training included two high-intensity interval sessions each week, with the remainder being runs at an easy pace (3.74 m/s). The athlete had a history of bone stress injuries in the left leg, having sustained a stress fracture in the left tibia 2 years prior to initial assessment and a stress reaction in the same limb in the 2 months prior to initial assessment. These injuries were treated through a combination of reduced weight bearing, rehabilitation exercises, and therapeutic modalities. The participant also completed an alternating walk–run progression to slowly return to activity. Additionally, the athlete presented with relative energy deficiency as characterized by low energy availability, low bone mineral density, and menstrual dysfunction (Tosi, Maslyanskaya, Dodson, and Coupey, 2018). This condition explains, in part, why the athlete seemed to be prone to stress fractures and historically has had difficulty recovering from them. The athlete was also taking vitamin D and calcium supplements.
Training and competition injury epidemiology in professional basketball players: a prospective observational study
Published in The Physician and Sportsmedicine, 2023
Victor Moreno-Pérez, Javier Ruiz, Jairo Vazquez-Guerrero, Gil Rodas, Juan Del Coso
Basketball is among the team sports with the highest rate of injury incidence [7]. Previous reports showed an overall incidence of between 7.0 and 19.1 injuries per 1000 hours of basketball play [8–10]. However, injury incidence is highly different between training and competition due to the differences in the physical demands of each context [11]. Injury incidence during basketball training is between 2.0–9.6 injuries per 1000 hours of basketball play and can reach 46.8–47.3 injuries per 1000 hours of basketball play during games [10,12]. Injury incidence is higher as the level of the player increases due to greater movement intensities and the increase in body contact [13]. Overall, the incidence of acute injuries is higher than overuse injuries [10]. The lower leg is the most common body site for basketball-specific injuries, and ankle sprains and muscle strains are usually the most frequently occurring types of acute injuries [9,12]. A high proportion of acute injuries does not entail time loss from competition [14] and the mean return to play is usually less than 10 days [9]. On the other hand, patellofemoral tendinopathies and other overuse knee injuries are less frequent [10], but they are related to a greater number of days missed [15].