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Biomedical subjects

J A Lombardo

Publications and source records attributed to J A Lombardo.

At least 19 recordsLinked to original sources
PubMed1999

Steroids and steroid-like compounds.

Athletes have been searching for an "edge" in competition as long as there has been a reward for success. Anabolic-androgenic steroids have been the most popular of these ergogenic aids when winning is the only goal. The authors present a concise review of these substances, their prevalence, efficacy, adverse effects, and legality. This article also presents a steroid user profile and discusses physician perception and management of a patient who uses these drugs. The popular precursors of testosterone, dehydroepiandrosterone, and androstenedione are discussed with a review of the limited available data on these substances.

Adolescent↗
PubMed1998

Drug programs.

Drug programs can be a positive method to assist athletes in the decision-making process concerning drug use. The keys to a successful drug program include the following: (1) inclusion of all involved parties in the development and administration of the program, (2) a reliable testing program that is sensitive for the drugs banned, (3) a disciplinary program that is consistent, (4) an evaluation and treatment program to prevent recurrence of the behavior or one that will treat the disease, and (5) the maintenance of confidentiality that will foster the confidence and support of all involved parties in the program.

Delivery of Health Care↗
PubMed1998

Mild brain trauma in sports. Diagnosis and treatment guidelines.

Much has been written about the evaluation and management of mild brain trauma in sports. No less than 10 different 'guidelines' have been proposed and published to aid the clinician in the diagnosis of the condition. Too often, these guidelines have creating confusion instead of promoting an understanding of the spectrum of brain injury. As the understanding of the basic science of mild brain injury evolves, so must the approach to the concussed athlete. This article presents an up-to-date and clinically useful approach to the management of the athlete with a mild brain injury. The definition of 'concussion' is discussed and clarified and pertinent epidemiological data which highlight the importance of management skills as applied to athletes in a wide variety of sports are also reviewed. There is really no such thing as a 'mild concussion' if one considers the rare but catastrophic outcome of the second impact syndrome. For this reason, we review and expand upon the mechanisms of injury and pathophysiology. The accurate diagnosis of mild brain injury requires considerable experience, a high index of suspicion, a careful history and a series of examinations of the athlete, and a working knowledge of the athlete's personality and the likelihood of minimising their symptoms. The value of orientation questions pertinent to the athlete is now well established. Any focal neurological deficit or the deterioration of an athlete's condition warrants immediate hospitalisation, brain imaging and neurosurgical consultation. More commonly, athletes present with a brief alteration of consciousness, headache and amnesia and require careful examination and observation before returning to competition. The astute clinician will always err on the side of conservative management. The complete resolution of all symptoms before a return to play is imperative. Computerised tomography is very sensitive in the imaging of mild brain injuries. Neuropsychological testing is also very sensitive in the evaluation of brain injuries in athletes, and may become more clinically useful in the future.

Adolescent↗
PubMed1996

Resistance training-induced increases in muscle mass and performance in ponies.

The purpose of this study was to determine whether 8 wk of progressive resistance exercise training would produce increases in strength and changes in foreleg muscle characteristics indicative of hypertrophy in ponies. Two mature 3- to 6-yr-old, male ponies (188 +/- 16 kg) were taught to carry sheets of lead over their saddle region (wither) while walking on a level treadmill at 1.9 m.s-1. This initial familiarization period was followed by 8 wk of training (3 d per wk), in which the ponies performed a series of progressive sets of weight carrying to fatigue. Each workout started with a 2-min walk at 1.9 m.s-1 followed by sets of weight carrying. The ponies carried 44.5 kg for the first set with increases of 22.3 kg per set until fatigue. Weights were applied and then removed for 60-90 s between sets using a chain hoist and sling apparatus. Measurements of forelimb girth, body weight, and total weight carried were recorded at each workout session. Ultrasound measurement of the diameters of the superdigital flexor muscles and muscle biopsies were performed before and after the 8-wk training period. Eight weeks of resistance training resulted in significant increases in peak weight carried (260%, P < 0.05) and total weight carried (1525%, P < 0.05) during each workout. Forelimb girth increased 12 +/- 1% (P < 0.05) with a corresponding 19 +/- 3% (P < 0.05) increase in muscle cross-sectional diameter. There were no changes (P > 0.05) in Type I muscle fiber area; however, there was a nonsignificant 26% increase in Type IIA+IIB fiber area. These data suggest that 8 wk of progressive resistance exercise training increase strength and cause changes in muscle size and characteristics consistent with hypertrophy.

Animals↗
PubMed1995

Psychiatric effects and psychoactive substance use in anabolic-androgenic steroid users.

The purpose of this study was to assess the psychiatric effects of anabolic-androgenic steroid (AAS) use and assess the frequency of other psychoactive substance use in a population of AAS users compared with non-AAS-using weight-lifter controls. One hundred sixty-four subjects were administered a demographic survey, including psychiatric history, substance use history, AAS use history, and medical history. Psychiatric diagnoses were made and psychological testing was performed. User categories were determined by history and urine testing. The user categories did not differ significantly on psychological testing. Past AAS users had a higher incidence of psychiatric diagnosis than the nonuser and current user groups. Hypomania was correlated with AAS use, and major depression with AAS discontinuation. Present psychoactive substance abuse or dependence was relatively low across all user categories. AAS dependence was seen in 12.9% of current users and 15.2% of past users of AAS. In conclusion, AAS use may lead to psychiatric disorders in certain individuals. Concurrent use of psychoactive drugs other than AAS does not appear to be common in intensively training weight lifters and bodybuilders.

Adult↗
PubMed1995

Stress fracture of index metacarpal in an adolescent tennis player.

Stress fractures are common injuries in sports medicine clinics. The few reported cases of stress fractures of the metacarpal bones have been associated with overuse, athletic or occupational techniques, and equipment problems. We describe a stress fracture of the index metacarpal in an adolescent tennis player. An increase in training intensity, combined with a recent change in stroke biomechanics and racket grip, were thought to be predisposing factors for this fracture. A similar mechanism and location of injury has been previously described, suggesting a common mechanism. Relative rest, a change in racket grip, and appropriate physical therapy facilitated a quick return to asymptomatic tennis. A brief review of metacarpal stress fractures is presented.

Adolescent↗
PubMed1995

Occipital neuralgia in a football player: a case report.

Occipital neuralgia, a painful condition thought to be caused by nerve entrapment, has been described in the general population. Athletes, particularly those who participate in collision sports, such as football, may be predisposed to this condition. An illustrative case is presented along with discussion of the differential diagnosis and treatment of this type of headache.

Adult↗
PubMed1993

The adolescent basketball player.

Adolescent basketball players can be viewed in two ways, as a unique population requiring special attention for their unique problems or as a similar group sharing the same problems as their adult counterparts. Attention should be paid to issues related to adolescence in general including changes in body size, growth of the musculoskeletal system, and hormonal changes that contribute to changes in behavior, emotions, and maturity. Attention to the particular needs of the adolescent basketball player may help prevent problems or lead to early recognition and intervention.

Adolescent↗
PubMed1992

Substance abuse.

The three types of drugs commonly used in sports--therapeutic drugs, performance-enhancing drugs, and recreational drugs--have been discussed and presented in a way that should be helpful to health care providers dealing with athletes. The goal of this article has been not only to present information concerning drugs but also to raise the awareness level so that abuse of all types of drugs will be considered by athletic trainers, physicians, and health care providers when they deal with athletes. The role of the physician in the area of drug abuse is no different than the physician's role in dealing with any health problem, diagnosis, and management. The responsibility of the physician who deals with athletes always has been, is, and always will be the health and safety of the athlete.

Adrenal Cortex Hormones↗
PubMed1992

[Anabolic steroids in athletes].

The use of anabolic-androgenic steroids (AS) to enhance appearance as well as physical/physiological capacities has increased dramatically over the past four decades in all age groups from early adolescence to adulthood. Although higher AS use rates are reported by elite and competitive athletes, a significant number of recreational athletes appear to be using AS. The scientific literature is inconsistent and at times at odds with the conventional wisdom and empirical experiences of the athletic community regarding the ergogenic effects of AS. However, individuals experienced in weight training, with an adequate diet, and who continue training during AS administration seem to consistently increase their strength and lean mass over what would have been expected from training alone. Previous research documenting deleterious but transient and mostly asymptomatic acute changes in physiology, risk factors and behavior has been inconclusive regarding the long term health impact. The abuse of AS constitutes a special challenge to society. AS are not euphorigenic or mood altering immediately following administration, as are other illicit drugs; the appetite for AS has been created predominantly by our societal fixations on winning and physical appearance. Consequently any successful intervention in this area must go beyond education, law enforcement and drug testing, and attempt to change a social environment which currently encourages the use of AS.

Anabolic Agents↗
PubMed1991

The preparticipation evaluation.

The preparticipation evaluation (PPE) is the first step toward meeting the responsibility of maintaining the health and safety of the athlete. The ideal timing for the PPE is 6 weeks prior to the competitive season to allow adequate time for treatment and rehabilitation of problems. It is suggested that a complete screening evaluation be performed prior to entrance into a new level of school with annual limited reevaluations thereafter. The annual reevaluation should focus on the medical history with the physical examination emphasizing the cardiovascular system and interim injuries and medical problems. Currently, there are no data to support routine screening laboratory, radiographic, or cardiovascular testing in the asymptomatic athlete with an unremarkable history and normal examination. Two different methods for performing the PPE can be used (station-type mass screening and office setting), with each having its own distinct advantages and disadvantages. The most important and difficult decision for the physician screening young athletes is determining clearance for activity. Guidelines based on the demands of the sport and specific medical problems have been established; however, the physician's clinical judgement should be used in interpreting these recommendations for each individual athlete. The PPE is an excellent opportunity for the physician to positively influence the health care and safety of a local sports program. Through genuine interest, thorough evaluation, and knowledgeable counseling, the athlete will develop confidence in the evaluating physician. This confidence can translate into a good relationship and hopefully this interaction will encourage the athlete to trust the physician's judgement and seek early evaluation and treatment for problems that arise.

Health Status↗
PubMed1989

The effects of anabolic steroids and strength training on the human immune response.

The immune response was assessed in 13 competitive bodybuilders self-administering anabolic-androgenic steroids and ten competitive bodybuilders not administering these drugs. Laboratory assessment included the number and relative distribution of T-cells, T-helper/inducer cells, T-cytotoxic/suppressor cells, activated T-cells, lymphocyte transformation to the mitogens, pokeweed mitogen (PWM), phytohemagglutinin (PHA), Concanavalin-A (CON-A), Staphylococcus aureus Cowan strain I (SAC), serum immunoglobulins, and natural killer (NK) activity. There were no significant differences in T-cell subsets among steroid users and non-users, but lymphocyte transformation studies revealed that the anabolic-androgenic steroid-using group had enhanced proliferative ability to the B-cell mitogen, SAC, in comparison to non-bodybuilding controls. NK activity was significantly (P less than 0.05) augmented in the anabolic-androgenic steroid users but not in the non-using bodybuilders. Serum immunoglobulin levels, in particular IgA, were significantly (P less than 0.017) lower in the steroid-using group. Four of 13 steroid users and three of eight non-steroid-using bodybuilders had detectable antinuclear antibodies. These studies indicate that 1) anabolic-androgenic steroid use as practiced by contemporary athletes is a potent modulator of immune responsiveness and 2) autoantibodies are prevalent in strength-trained men even in the absence of anabolic steroid use.

Anabolic Agents↗
PubMed1984

Pre-participation physical evaluation.

The pre-participation physical evaluation is an integral part of any sports or activity program. There are many alternative methods for completing this evaluation, using varying degrees of frequency and thoroughness. A practical approach to the pre-participation physical evaluation is presented for use in an office as well as in a mass-screening situation.

Humans↗