Comparing Time to Recovery Between Initial and Repeat Concussion in Athletes.

Objective: Compare time to recovery between initial and repeat concussions.

Design: Retrospective review of electronic medical record.

Setting: An interdisciplinary concussion clinic.

Orthostatic Vital Signs After Sport-Related Concussion: A Cohort Study.

Background: The 6th International Consensus Statement on Concussion in Sport guidelines identified that measuring autonomic nervous system dysfunction using orthostatic vital signs (VSs) is an important part of the clinical evaluation; however, there are limited data on the frequency of autonomic nervous system dysfunction captured via orthostatic VSs after concussion.

Purpose: To compare orthostatic changes in heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) between athletes with acute sport-related concussion (SRC) and control athletes.

Study Design: Cross-sectional study; Level of evidence, 3.

Headache Characteristics of Pediatric Sport-Related Concussion.

Background: Headache is among the most common symptoms following concussion, yet headache after concussion (HAC) remains poorly characterized. This study describes headache characteristics over the first four weeks following pediatric sport-related concussion.

Methods: This is a retrospective case series of 87 athletes (mean: 14.

The Evaluation and Management of Concussion to Optimize Safe Recovery.

Concussion is a mild traumatic brain injury causing temporary neurologic dysfunction. Symptoms following concussion are variable and generally are expected to resolve within about 1 month, but some patients experience persistent and prolonged symptoms. An early return to safe, symptom-limited activity is now favored, using targeted rehabilitation and treatments.

Recommendations for Medical Discharge Documentation and Academic Supports for University Students Recovering From Concussion.

Objective: This study sought to (1) collate the experiences of university students with concussion history and academic stakeholders through interviews and (2) develop concussion management recommendations for institutions of higher learning using a multidisciplinary Delphi procedure.

Setting: Remote semistructured interviews and online surveys.

Participants: The first aim of this study included undergraduate university students with concussion history who did not participate in varsity athletics ( n = 21; 57.

Anesthesia provider performance in the first two years of merit-based incentive payment system: Shifts in reporting and predictors of receiving bonus payments.

Study Objective: The Merit-Based Incentive Payment System (MIPS) program was intended to align CMS quality and incentive programs. To date, no reports have described anesthesia clinician performance in the first two years of the program.

Design: Observational retrospective cohort study.

Factor Structure for the Sport Concussion Assessment Tool Symptom Scale in Adolescents After Concussion.

Objective: To examine the factor structure of the Sport Concussion Assessment Tool-5 (SCAT5) symptom scale in adolescents on their initial presentation to a concussion clinic within the typical recovery period after concussion (ie, <30 days). We hypothesize that the SCAT5 symptoms represent various clinically meaningful groups. A secondary purpose was to examine the effects of sex on the factor structure of the SCAT5 symptom scale.

Does Exercise Increase Vestibular and Ocular Motor Symptom Detection After Sport-Related Concussion?

Background And Purpose: Postconcussive vestibular and ocular motor symptoms are common and contribute to longer recovery. The Vestibular/Ocular Motor Screening (VOMS) is used to detect such symptoms, but a VOMS performed at rest may miss symptoms that are only provoked by exertion. Supervised exercise challenges (SECs) have been shown to detect concussion-related symptoms provoked by physical exertion.

Do male and female adolescents report symptoms differently after concussion?

We investigated sex-based differences in the presence and severity of aggregated symptom indicators as well as individual concussion symptoms. A cross-sectional examination of sex differences in symptoms reported by adolescents upon initial concussion evaluation at a concussion clinic. Nine hundred and eighty-six adolescents completed the Sport Concussion Assessment Tool (SCAT5) symptom checklist.

Symptom Provocation During Aerobic and Dynamic Supervised Exercise Challenges in Adolescents With Sport-Related Concussion.

Context: Supervised exercise challenges (SECs) have been shown to be safe and beneficial in the early symptomatic period after concussion. Thus far, most in-clinic SECs studied have included a form of basic aerobic exercise only. An SEC that also includes dynamic forms of exercise mimics all steps of a standard return-to-play progression and may enhance the detection of concussion symptoms to guide in-clinic management decisions.

Radio-Frequency Coil Array for Improved Concurrent Transcranial Magnetic Stimulation and Functional Magnetic Resonance Imaging.

Purpose: To perform concurrent TMS-fMRI on difficult targets, such as the occipital lobe.

Methods: a 3-channel flexible, thin RF coil was constructed that allows for whole head image coverage without impeding TMS placement. A custom MR-safe patient table which mates with typical 3T MR scanners was constructed for the purpose of face-down subject positioning to allow for access to posterior TMS targets.

A Model for Sustaining and Investing in Immunization Information Systems: Authors.

In the past three years, Scientific Technologies Corporation electronically sent one-hundred fifty million retail pharmacy patient immunization events to state and community public health immunization information systems. Today, as a conservative estimate, over 85% of the U.S.

A Demand for Data to Improve Outcomes Creates the Why to Move to Third Generation Immunization Information Systems.

Investments over the past two decades to collect and store immunization events established a national population health data asset. The ability to track vaccine usage and storage has increased accountability, lowered wastage, protected valuable resources, and provided the correct vaccines at the right time. Sixty-four immunization registries support the current immunization ecosystem, yet all investments to date have been through state and federal funding.

Use of Supervised Exercise During Recovery Following Sports-Related Concussion.

Objective: To assess the safety of supervised exercise (SE) in acute sport-related concussion (SRC) and its influence on recovery.

Design: Retrospective cohort study.

Setting: University SRC clinic at a tertiary care center.

Effects of tobacco control policy on cardiovascular morbidity and mortality in Russia.

Background: According to the Global Adult Tobacco Survey carried out in Russia in 2009, the country had one of the highest smoking prevalence rates in Europe. In response to this health and economic burden, Russia implemented a comprehensive Tobacco Control Law (TCL) in 2013, which has been associated with a 21.5% relative decline in adult smoking prevalence in 2016 compared with 2009.

The Power of Consumer Activism and the Value of Public Health Immunization Registries in a Pandemic: Preparedness for Emerging Diseases and Today's Outbreaks.

Public Health immunization registries and the immunization ecosystem have evolved over the past two decades to become significant population health data assets. Clinical providers and pharmacists are reporting the immunizations given to their patients to public health registries in 49 states and all territories, creating consolidated immunization event patient records. Most of these immunization events are reported through the provider's Electronic Health Record system (EHR), Pharmacy Management System (PMS), online, or through data uploads.

Quality Reporting: Understanding National Priorities, Identifying Local Applicability.

Since the 1990s, the use of quality measures in healthcare has grown exponentially. Practices must maintain current knowledge of measures that affect their clinicians locally and understand how assessment of these medical professionals affects the priorities and quality activities of practices and facilities. Because quality measures are increasingly used by hospital administrators, health plans, and payers, practices are being asked to shoulder the additional burdens of collecting and reporting data to various entities.

A Multifaceted Approach to Reduction of Catheter-Associated Urinary Tract Infections in the Intensive Care Unit With an Emphasis on "Stewardship of Culturing".

BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications. OBJECTIVE To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture.

Observations Illustrating the Use of Health Informatics to Link Public Health Immunization Registries and Pharmacies to Increase Adult Immunization Rates and Improve Population Health Outcomes.

The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages health information exchange between clinical care and public health through Meaningful Use measures. Meaningful Use specifically identifies objectives to support a number of public health programs including immunizations, cancer registries, syndromic surveillance, and disease case reports. The objective is to improve public and population health.

Drug-induced immune-mediated thrombocytopenia in the intensive care unit.

A 62-year-old woman with prosthetic mitral valve was admitted for explant of an infected prosthetic knee. Perioperatively, she was bridged with heparin and started on empiric vancomycin and piperacillin-tazobactam. Platelet counts dropped precipitously within 2 days reaching a nadir of 6000/μL, without any bleeding.