Biomedical subjects

Andrew W Nichols

Publications and source records attributed to Andrew W Nichols.

4 recordsLinked to original sources

PubMed2006

Complementary and alternative medicine usage by intercollegiate athletes.

OBJECTIVE: The purpose of this study is to determine the prevalence and types of provider-delivered complementary and alternative medicine (CAM) used by intercollegiate student athletes attending a Division I NCAA University. DESIGN AND SETTING: Survey methodology within a group of intercollegiate student athletes at a Division I NCAA university during the fall semester of 2004. PARTICIPANTS: All incoming and returning intercollegiate student athletes were invited to participate. Surveys were completed by 309 (122 women, 187 men) of 482 (64.1%) student athletes representing 20 sports (11 women's, 9 men's teams). MAIN OUTCOME MEASUREMENTS: A 28-item reliable and valid survey instrument that measured the use of provider delivered CAM and allopathic medical care was administered. Data were analyzed using descriptive statistics, chi2 tests, and logistic regressions. RESULTS: Fifty-six percent of subjects reported using CAM within the past 12 months, including a significantly higher percentage of women (67%) than men (49%) (P < 0.01). Massage was the most commonly used type (38%), followed by chiropractic (29%), Lomilomi (14%), and acupuncture (12%). CAM usage overall did not differ significantly by sport, year in college, nor ethnicity. Hawaiian, Samoan, and Tongan subjects were more likely to use the Hawaiian-originated forms of CAM. Sixty percent of respondents have a regular medical doctor, eighty percent of which are family practitioners. Forty-two percent of subjects were referred to a medical specialist within the previous three years. CONCLUSIONS: CAM usage is common among collegiate student athletes and rates are higher than in adults nationwide and within the state of Hawai'i. This study and future investigations will increase the awareness of CAM use patterns by collegiate athletes, and hopefully improve allopathic physicians' abilities to provide optimal athletic health care.

Adult↗

PubMed2006

Selective serotonin reuptake inhibitors and rhabdomyolysis after eccentric exercise.

PURPOSE: The purpose of this report was to review three cases of clinically significant rhabdomyolysis that developed in research subjects after completing an eccentric exercise protocol. All three cases occurred in subjects who reported use of selective serotonin reuptake inhibitors (SSRI). METHODS: Sixty-three subjects enrolled in the study. Subjects performed 15 sets of 15 repetitions of maximal eccentric contractions of the elbow flexors. Subjects were then monitored on a daily basis for development of delayed onset muscle soreness (DOMS). Subjects received either microcurrent electrical neuromuscular stimulation (MENS) or sham treatment. RESULTS: Three subjects developed clinically significant rhabdomyolysis after performing this exercise protocol. Affected subjects were the only subjects who reported use of SSRI during the study period. CONCLUSION: This report raises suspicion of SSRI use as a predisposing factor to muscle injury after eccentric exercise.

Adult↗

PubMed2005

A comparison of a preparticipation evaluation history form and a symptom-based concussion survey in the identification of previous head injury in collegiate athletes.

OBJECTIVE: The purpose of this study was to compare the incidence of prior head injury reported on preparticipation physical evaluation (PPE) history forms with a retrospective symptom-based survey. DESIGN: A comparison of 2 retrospective survey instruments. SETTING: NCAA Division I varsity athletic program. PARTICIPANTS: A total of 93 male and 79 female athletes participating in intercollegiate contact/collision sports. MAIN OUTCOME MEASURES: Athletes were administered a concussion symptom survey (CSS) with questions about symptom incidence after head injury. These responses were compared with answers given about previous concussion/head injury on the university's PPE history form. The numbers of positive responses were analyzed using descriptive statistics, and differences between the PPE medical history form and the concussion symptom survey were assessed using chi analysis. Factor analysis was performed to assess for possible variance structure between reported symptoms. RESULTS: Seventy-one percent of athletes reporting symptoms consistent with concussion were not identified as having a history of head injury on the PPE medical history form. The most common symptom on the CSS was headache, which accounted for 46 (56.1%) positive responses. CONCLUSIONS: The CSS revealed greater numbers of athletes experiencing symptomatic head injuries than the screening questions on the PPE history form. Screening for signs and symptoms of concussion may enhance the sensitivity of the PPE in detecting a prior history of concussion.

Adolescent↗

PubMed2005

Complications associated with the use of corticosteroids in the treatment of athletic injuries.

BACKGROUND: The potent anti-inflammatory pharmacologic effects of the corticosteroids (cortisone and synthetic derivatives) has led to their extensive usage in the management of rheumatologic diseases and athletic musculoskeletal injuries. The efficacy and risks of locally injected or systemically administered corticosteroids in the treatment of athletic injuries are unclear. OBJECTIVE: To review critically the medical literature and determine complications and risks associated with corticosteroid treatment of athletic injuries. DATA SOURCES: A search of 3 databases-MEDLINE, CINAHL, and Cochrane Clinical Trial Register-was performed using the OVID interface for all years between 1966 and 2003. The search first combined all references under the medical subject headings adrenal cortex hormones, glucocorticoids, and glucocorticoids, synthetic. A second search combined all references under the medical subject headings athletic injuries, sprains and strains, tendon injuries, shoulder injuries, rotator cuff disease, tennis elbow, and lateral epicondylitis. The references identified by these 2 searches were intersected and limited to human only to produce 130 articles. Relevant review articles were scanned, references reviewed, and additional articles retrieved for consideration of inclusion. STUDY SELECTION: For inclusion in this critical review, articles must meet the following criteria: (1) subjects were human, (2) subjects had athletic-related injuries, and (3) subjects received corticosteroid treatment. Ultimately, 43 studies met inclusion criteria. DATA EXTRACTION AND SYNTHESIS: Selected articles were then categorized as to whether the primary focus was usage/efficacy of corticosteroid injection therapy, occurrence of complications of corticosteroid injection therapy, or usage or complications of systemic corticosteroid therapy. MAIN RESULTS: Twenty-five selected studies primarily examined the usage/efficacy of corticosteroid injections in the treatment of various athletic injuries. Of the 983 total subjects who received corticosteroid injections among these studies, only minor complications of treatment were reported. Eighteen selected studies primarily described complications of corticosteroid injections in the treatment of athletic injuries. Of these, tendon and fascial ruptures were the predominant complications reported. The search identified no articles that addressed the usage of or complications of systemic corticosteroids in the treatment of athletic injuries, although tibial stress fracture and multifocal osteonecrosis occurred in individuals being treated for nonathletic injury conditions. CONCLUSIONS: This critical review reveals that the existing medical literature does not provide precise estimates for complication rates following the therapeutic use of injected or systemic corticosteroids in the treatment of athletic injuries. Tendon and fascial ruptures are often reported complications of injected corticosteroids, whereas tibial stress fractures and multifocal osteonecrosis were described with systemic corticosteroids.

Administration, Oral↗