Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Neurology
Total Results:
22994
Mental health symptoms and disorders in Paralympic athletes: a narrative review
OBJECTIVES/OBJECTIVE:This narrative review summarises the literature on the mental health of Paralympic athletes, explores possible reasons for the paucity of research in this area and suggests directions for future research. METHODS:A systematic search of PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Scopus, and Cochrane databases was conducted using search terms related to disability, sport and mental health. RESULTS:The search yielded 665 publications. Of these, 129 were duplicates, resulting in 536 publications identified for initial screening. A total of 72 publications were to be relevant at initial screening. Only seven publications addressed Paralympic athletes specifically. Of these papers, three included measures of depression and three included measures of anxiety. In the studies that were not concerned with mental health symptoms or disorders, the focus of enquiry included identity and self, stress, and well-being. CONCLUSION/CONCLUSIONS:Most of the studies reviewed are small in scale, and there are almost no comparative data on Paralympic versus Olympic athletes. There is a paucity of data on rates of mental health symptoms and disorders in this population and the factors that might contribute to poor mental health among elite athletes with disabilities. We propose that stereotypes about people with disabilities-and the disability rights movement's rightful reaction to these stereotypes-have created barriers to mental health research among Paralympic athletes. There is a need for enquiry into the differential stressors experienced by Paralympic athletes, including trauma, transition out of sport, sport and personhood, and the potential for disability sport to promote psychological health.
PMID: 31097461
ISSN: 1473-0480
CID: 4174132
A Decision Algorithm Is Not Superior to Clinician Judgment to Determine Need for Peripheral vs Central Venous Catheterization
BACKGROUND:Venous access, via a midline peripheral catheter (midline) or a peripherally inserted central catheter, is used regularly in the neurointensive care unit as a means for prolonged infusion of drugs or medications. There is little research on how to choose the appropriate access device to use in this setting. The aim of this study is to trial an algorithm to assist clinicians in determining which device to use, as a way to reduce patient complications such as central line-associated bloodstream infection and deep vein thrombosis. METHODS:This quality improvement initiative included both retrospective and prospective data. A retrospective chart review was performed, and data were analyzed for variables associated with decision making between the 2 access devices. An algorithm was developed to assist clinicians with deciding between midline access and peripherally inserted central catheter access. RESULTS:A total of 325 charts were reviewed (126 retrospective and 109 prospective). Results show no significant differences in the demographic characteristics of either group. Before intervention, clinicians chose the correct access device 86% of the time, whereas after the intervention, clinicians chose the correct device 78% of the time (P = .06). CONCLUSION/CONCLUSIONS:The results of this study indicate that the quality improvement intervention and algorithm decision-making tool did not improve accuracy of use of access devices.
PMID: 30964845
ISSN: 1945-2810
CID: 4095572
Management of mental health emergencies in elite athletes: a narrative review
Mental health emergencies require a rapid, effective response. We searched the literature on mental health emergencies in athletes and found five papers. None of these addressed elite athletes. Nonetheless, common mental health emergencies may present in the sports environment and may place the athlete and others at risk. Sports teams and organisations should anticipate which emergencies are likely and how medical and support staff can best respond. Responses should be based on general non-sporting guidelines. We stress the importance of clinicians following standard procedures.
PMID: 31097462
ISSN: 1473-0480
CID: 4174142
Wake up call for collegiate athlete sleep: narrative review and consensus recommendations from the NCAA Interassociation Task Force on Sleep and Wellness
Sleep is an important determinant of collegiate athlete health, well-being and performance. However, collegiate athlete social and physical environments are often not conducive to obtaining restorative sleep. Traditionally, sleep has not been a primary focus of collegiate athletic training and is neglected due to competing academic, athletic and social demands. Collegiate athletics departments are well positioned to facilitate better sleep culture for their athletes. Recognising the lack of evidence-based or consensus-based guidelines for sleep management and restorative sleep for collegiate athletes, the National Collegiate Athletic Association hosted a sleep summit in 2017. Members of the Interassociation Task Force on Sleep and Wellness reviewed current data related to collegiate athlete sleep and aimed to develop consensus recommendations on sleep management and restorative sleep using the Delphi method. In this paper, we provide a narrative review of four topics central to collegiate athlete sleep: (1) sleep patterns and disorders among collegiate athletes; (2) sleep and optimal functioning among athletes; (3) screening, tracking and assessment of athlete sleep; and (4) interventions to improve sleep. We also present five consensus recommendations for colleges to improve their athletes' sleep.
PMID: 31097460
ISSN: 1473-0480
CID: 4174122
Human Fibrinogen for Maintenance and Differentiation of Induced Pluripotent Stem Cells in Two Dimensions and Three Dimensions
Human fibrin hydrogels are a popular choice for use as a biomaterial within tissue engineered constructs because they are biocompatible, nonxenogenic, autologous use compatible, and biodegradable. We have recently demonstrated the ability to culture induced pluripotent stem cell (iPSC)-derived retinal pigment epithelium on fibrin hydrogels. However, iPSCs themselves have relatively few substrate options (e.g., laminin) for expansion in adherent cell culture for use in cell therapy. To address this, we investigated the potential of culturing iPSCs on fibrin hydrogels for three-dimensional applications and further examined the use of fibrinogen, the soluble precursor protein, as a coating substrate for traditional adherent cell culture. iPSCs successfully adhered to and proliferated on fibrin hydrogels. The two-dimensional culture with fibrinogen allows for immediate adaption of culture models to a nonxenogeneic model. Similarly, multiple commercially available iPSC lines adhered to and proliferated on fibrinogen coated surfaces. iPSCs cultured on fibrinogen expressed similar levels of the pluripotent stem cell markers SSea4 (98.7% ± 1.8%), Oct3/4 (97.3% ± 3.8%), TRA1-60 (92.2% ± 5.3%), and NANOG (96.0% ± 3.9%) compared with iPSCs on Geltrex. Using a trilineage differentiation assay, we found no difference in the ability of iPSCs grown on fibrinogen or Geltrex to differentiate to endoderm, mesoderm, or ectoderm. Finally, we demonstrated the ability to differentiate iPSCs to endothelial cells using only fibrinogen coated plates. On the basis of these data, we conclude that human fibrinogen provides a readily available and inexpensive alternative to laminin-based products for the growth, expansion, and differentiation of iPSCs for use in research and clinical cell therapy applications. Stem Cells Translational Medicine 2019;8:512-521.
PMCID:6525556
PMID: 30768863
ISSN: 2157-6580
CID: 5592992
Should there be less emphasis on levodopa-induced dyskinesia in Parkinson's disease?
PMID: 30983023
ISSN: 1531-8257
CID: 4095882
Castleman Disease Presenting with Pseudotumour Cerebri and Myasthenia Gravis: A Case Report and Literature Review [Case Report]
Castleman disease (CD) is a rare lymphoproliferative disorder that may present with various autoimmune, inflammatory, or neurologic syndromes. This is a case of a 21-year-old woman who presented with signs and symptoms of pseudotumour cerebri (PTC) who subsequently developed myasthenia gravis (MG), and was incidentally found to have a large mass in the posterior mediastinum. Upon resection, the mass was classified as unicentric CD involved with follicular dendritic cell sarcoma. Following treatment with IVIG in the setting of progressive weakness and dyspnea, she has had complete symptom resolution while maintained on a low dose of pyridostigmine for the last two years. There are 13 cases of MG and five cases of optic disc edema described as PTC associated with CD in the literature, but to our knowledge, this is the sole case reported of the intersection of all three conditions in one patient. Increased serum levels of interleukin-6 and vascular endothelial growth factor may provide clues as to the association of CD with these neurologic syndromes.
PMCID:6619924
PMID: 31312243
ISSN: 0165-8107
CID: 5524332
A catalog of genetic loci associated with kidney function from analyses of a million individuals
Chronic kidney disease (CKD) is responsible for a public health burden with multi-systemic complications. Through trans-ancestry meta-analysis of genome-wide association studies of estimated glomerular filtration rate (eGFR) and independent replication (n = 1,046,070), we identified 264 associated loci (166 new). Of these, 147 were likely to be relevant for kidney function on the basis of associations with the alternative kidney function marker blood urea nitrogen (n = 416,178). Pathway and enrichment analyses, including mouse models with renal phenotypes, support the kidney as the main target organ. A genetic risk score for lower eGFR was associated with clinically diagnosed CKD in 452,264 independent individuals. Colocalization analyses of associations with eGFR among 783,978 European-ancestry individuals and gene expression across 46 human tissues, including tubulo-interstitial and glomerular kidney compartments, identified 17 genes differentially expressed in kidney. Fine-mapping highlighted missense driver variants in 11 genes and kidney-specific regulatory variants. These results provide a comprehensive priority list of molecular targets for translational research.
PMID: 31152163
ISSN: 1546-1718
CID: 3936112
Mental health in elite athletes: International Olympic Committee consensus statement (2019)
Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
PMID: 31097450
ISSN: 1473-0480
CID: 4174062
Breaking a taboo: why the International Olympic Committee convened experts to develop a consensus statement on mental health in elite athletes [Editorial]
PMID: 31097449
ISSN: 1473-0480
CID: 4174052
