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Modern Treatment of Asymptomatic Carotid Stenosis —The Importance of Both Medical Therapy and Carotid Endarterectomy
Each year there are approximately 700  000 new ischemic strokes in the US, and 10% to 15% of them are caused by thromboembolism from a previously asymptomatic carotid stenosis (ACS). Three large randomized clinical trials, published in the 1990s and early 2000s, have demonstrated a significant benefit of carotid endarterectomy (CEA) i n preventing stroke in patients with severe ACS compared with medical therapy alone. They showed a 50% relative risk reduction in 5-year stroke rate and an approximately 1% per year absolute stroke risk reduction. Over the course of the past 2 decades, there has been significant improvement...
Source: JAMA Surgery - June 8, 2022 Category: Sports Medicine Source Type: research

Herculean mistake: mephentermine associated cardiomyopathy.
Authors: Singal AK, Deepti S, Sharma G, Kothari SS Abstract Case presentation: A 32-year-old professional bodybuilder presented with acute decompensated heart failure. He gave a history of anabolic androgenic steroids (AAS) use for >2 years and mephentermine use for the preceding 3 months.Management: Transthoracic echocardiography showed severe left ventricular (LV) dysfunction with a large pedunculated, mobile thrombus attached to the ventricular apex. The patient had an embolic stroke during the hospital stay, with complete neurological recovery. Following the cessation of mephentermine use, there was a stea...
Source: The Physician and Sportsmedicine Online - May 16, 2020 Category: Sports Medicine Tags: Phys Sportsmed Source Type: research

Ischaemia-reperfusion injury and hyperbaric oxygen pathways: a review of cellular mechanisms.
Authors: Francis A, Baynosa R Abstract Ischaemia-induced tissue injury has wide-ranging clinical implications including myocardial infarction, stroke, compartment syndrome, ischaemic renal failure and replantation and revascularization. However, the restoration of blood flow produces a 'second hit' phenomenon, the effect of which is greater than the initial ischaemic event and characterizes ischaemia-reperfusion (IR) injury. Some examples of potential settings of IR injury include: following thrombolytic therapy for stroke, invasive cardiovascular procedures, solid organ transplantation, and major trauma resuscitat...
Source: Diving and Hyperbaric Medicine - June 24, 2017 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Internal carotid artery dissection and delayed stroke following rugby tackle - a case report
This report will offer a unique and interesting insight into the patient's perspective of this injury – both at the time the actual stroke occurred and his subsequent rehabilitation journey. It will also discuss that whilst much publicity and training is offered around the assessment and management of head injuries and/or concussion, the possible intracerebral consequence of neck trauma sustained in contact sports seems to be less well publicised. This mechanism of injury should be considered in the emergency department as in this case the ‘typical clinical presentation’ of an extradural haematoma turned ...
Source: British Journal of Sports Medicine - October 31, 2016 Category: Sports Medicine Authors: Cowlin, D., Dickinson, M., Sultan, S. Tags: Poster presentations Source Type: research

The Significance of Preoperative Impaired Sensorium on Surgical Outcomes in Nonemergent General Surgical Operations
ImportanceWith an aging population, preoperative assessment of the frail older adult requires evaluation beyond simply accounting for chronic diseases. Impaired cognition is a recognized characteristic of the frail older adult.ObjectiveTo examine the effect of preoperative impaired sensorium (IS) on general surgical outcomes.Design, Setting, and ParticipantsRetrospective cohort study using data between January 2005 and December 2010 at academic and community hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program. Patients undergoing nonemergent general surgical operations ...
Source: JAMA Surgery - November 19, 2014 Category: Sports Medicine Source Type: research