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Breath-Hold Diving Injuries - A Primer for Medical Providers. 憋气式潜水伤害--医务人员入门指南》。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-05-01 DOI: 10.1249/JSR.0000000000001168
Elaine Yu, Juan M Valdivia-Valdivia, Fernando Silva, Peter Lindholm

Abstract: Breath-hold divers, also known as freedivers, are at risk of specific injuries that are unique from those of surface swimmers and compressed air divers. Using peer-reviewed scientific research and expert opinion, we created a guide for medical providers managing breath-hold diving injuries in the field. Hypoxia induced by prolonged apnea and increased oxygen uptake can result in an impaired mental state that can manifest as involuntary movements or full loss of consciousness. Negative pressure barotrauma secondary to airspace collapse can lead to edema and/or hemorrhage. Positive pressure barotrauma secondary to overexpansion of airspaces can result in gas embolism or air entry into tissues and organs. Inert gas loading into tissues from prolonged deep dives or repetitive shallow dives with short surface intervals can lead to decompression sickness. Inert gas narcosis at depth is commonly described as an altered state similar to that experienced by compressed air divers. Asymptomatic cardiac arrhythmias are common during apnea, normally reversing shortly after normal ventilation resumes. The methods of glossopharyngeal breathing (insufflation and exsufflation) can add to the risk of pulmonary overinflation barotrauma or loss of consciousness from decreased cardiac preload. This guide also includes information for medical providers who are tasked with providing medical support at an organized breath-hold diving event with a list of suggested equipment to facilitate diagnosis and treatment outside of the hospital setting.

摘要:憋气潜水员(又称自由潜水员)有可能受到不同于水面游泳者和压缩空气潜水员的特殊伤害。通过同行评审的科学研究和专家意见,我们为医疗服务提供者在现场处理屏气潜水伤害制定了一份指南。长时间呼吸暂停和摄氧量增加引起的缺氧会导致精神状态受损,表现为不自主运动或完全丧失意识。继发于气腔塌陷的负压气压创伤可导致水肿和/或出血。气室过度膨胀继发的正压气压创伤可导致气体栓塞或空气进入组织和器官。长时间深潜或反复浅潜且浮出水面的时间间隔短,导致惰性气体进入组织,可引起减压病。惰性气体深度麻醉通常被描述为一种类似于压缩空气潜水员所经历的改变状态。在呼吸暂停期间,无症状的心律失常很常见,通常在恢复正常通气后不久就会逆转。舌咽部呼吸方法(充气和排气)会增加肺过度充气气压创伤或因心脏前负荷降低而失去知觉的风险。本指南还包括为在有组织憋气潜水活动中负责提供医疗支持的医疗服务提供者提供的信息,以及一份建议设备清单,以方便在医院环境之外进行诊断和治疗。
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引用次数: 0
Every Picture Tells A Story: Managing Exertional Heatstroke with Rotating Ice Water Towels. 每张图片都在讲述一个故事用旋转冰水毛巾处理劳累性中暑。
IF 1.7 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-05-01 DOI: 10.1249/JSR.0000000000001165
William O Roberts

Abstract: A 23-year-old woman completing her first marathon collapsed near the finish line at 4 hours 6 min with a rectal temperature of 41.8°C. She was in good health before the race with no recent illness, had completed a full training program, and was taking no medications or supplements. On the initial exam, she was unconscious with a response to painful stimulus, spontaneous breathing, rapid pulse, eyes closed, fully dilated pupils, poor muscle tone, and pale skin that was warm to touch. The medical team initiated whole-body cooling using rapidly rotating ice water towels and ice packs placed in the neck, axilla, and groin. She developed echolalia during active cooling. About 20 minutes into the cooling procedure, she "woke up," was able to answer questions coherently, and her pupils were normal size and reactive. She was discharged home with instructions to follow-up in 2 d for evaluation and blood chemistry testing.

摘要:一名首次参加马拉松比赛的 23 岁女性于 4 小时 6 分钟时在终点线附近晕倒,直肠温度为 41.8°C。赛前她健康状况良好,近期没有生病,完成了完整的训练计划,没有服用任何药物或补充剂。初步检查时,她昏迷不醒,对疼痛刺激有反应,自主呼吸,脉搏加快,双眼紧闭,瞳孔完全散大,肌肉张力差,皮肤苍白,触摸时发热。医疗小组开始使用快速旋转的冰水毛巾和冰袋进行全身降温,并将冰袋放置在颈部、腋窝和腹股沟处。在主动降温过程中,她出现了回声。降温过程进行了大约 20 分钟后,她 "醒了过来",能够连贯地回答问题,瞳孔大小正常,反应灵敏。她出院回家,医生嘱咐她两天后复诊,进行评估和血液化学检测。
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引用次数: 0
Oxygen Straight to the Brain: An Overview of Hyperbaric Oxygen Therapy for a Variety of Brain Morbidities. 氧气直达大脑:治疗各种脑部疾病的高压氧疗法概述。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-04-01 DOI: 10.1249/jsr.0000000000001158
Terrance Leighton, Edgar VanHorne, Dale Parsons
Hyperbaric oxygen therapy as a treatment for conditions like traumatic brain injury, posttraumatic stress disorder, and migraines would seem intuitive, given its effect on condition-related ischemia and inflammation. However, hyperbaric therapeutic impacts for these in acute and chronic, or prolonged symptoms are elusive. This narrative review of hyperbaric's utility provided in sections per disease renders first a review of conventional pathological mechanisms and then articulates hyperbaric treatment targets versus their respective impacts. Multiple challenges exist using hyperbaric oxygen therapy for each morbidity, even in tertiary and adjunctive treatments. An almost universal shortfall across studies includes a lack of consistent, appropriate patient selection criteria intersected with delivery timing of therapy to symptomatic target, necessary to provide a higher fidelity in treatment metrics. Further research into these respective conditions is needed along with a revisitation of hyperbaric oxygen therapy's application to their conventional pathological mechanisms, lending new perspective to their employment and efficacy.
高压氧疗法可治疗脑外伤、创伤后应激障碍和偏头痛等疾病,鉴于其对与疾病相关的缺血和炎症的影响,高压氧疗法似乎很直观。然而,高压氧对这些急性、慢性或长期症状的治疗效果却难以捉摸。本报告按疾病分节叙述高压氧的作用,首先回顾传统病理机制,然后阐明高压氧治疗目标及其各自的影响。对每种疾病使用高压氧治疗都存在多重挑战,即使是在三级和辅助治疗中也是如此。各项研究中几乎普遍存在的不足包括缺乏一致、适当的患者选择标准,以及向症状目标提供治疗的时机,而这是提供更高保真治疗指标所必需的。需要对这些病症进行进一步研究,同时重新审视高压氧疗法在其传统病理机制中的应用,为其应用和疗效提供新的视角。
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引用次数: 0
Dive Hazards: Barotrauma, Flora, Fauna, Equipment, and Free Diving. 潜水危险:气压创伤、植物群、动物群、设备和自由潜水。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-04-01 DOI: 10.1249/jsr.0000000000001159
Jonathan Bailey, Collin Hu, Brian Merrigan, Steve Gillis
Present-day diving comes in various forms, from utilizing sophisticated diving equipment to relying solely on one's ability to hold their breath. The diver and physician must be aware of the many common medical conditions and environmental considerations of this unique activity. While barotrauma remains the most common dive-related injury, injuries and accidents also are related to diving equipment-related accidents and exposure to marine flora and fauna. In addition, breath-hold diving, which includes free diving, snorkeling, and tasks, is an activity humans have done for thousands of years for recreation or survival. This article will update the dangers of diving and methods to prevent or treat injuries.
当今的潜水形式多种多样,有利用先进潜水设备的,也有完全依靠个人憋气能力的。潜水员和医生必须了解这种独特活动的许多常见疾病和环境因素。虽然气压创伤仍然是最常见的潜水相关伤害,但伤害和事故也与潜水设备相关事故和接触海洋动植物有关。此外,憋气潜水(包括自由潜水、浮潜和任务潜水)是人类数千年来为娱乐或生存而进行的活动。本文将介绍潜水的最新危险以及预防或治疗伤害的方法。
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引用次数: 0
Swimming-Induced Pulmonary Edema: Evaluation, Diagnosis, and Treatment. 游泳引起的肺水肿:评估、诊断和治疗。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-04-01 DOI: 10.1249/jsr.0000000000001157
Stephen Steele, Sunny Brahmbhatt, Devak Patel
Swimming-induced pulmonary edema (SIPE) is a rare but life-threatening acute illness that can occur in otherwise healthy athletes and individuals. Also known as immersion pulmonary edema, SIPE presents in swimmers, snorkelers, and SCUBA divers. It occurs in persons under heavy exertion in cold water temperatures, leading to coughing, shortness of breath, and sometimes blood-tinged sputum. Under these conditions, there is increased pulmonary vascular pressure, which may ultimately lead to pulmonary edema. This article synthesizes the latest data on the prevalence, pathophysiology, etiology, risks, short- and long-term complications, and the efficacy of supportive medical treatment interventions.
游泳诱发肺水肿(SIPE)是一种罕见但危及生命的急性疾病,可发生在原本健康的运动员和个人身上。SIPE 也称为浸入性肺水肿,主要发生在游泳者、浮潜者和水肺潜水员身上。在低水温环境下,体力消耗较大的人会出现这种情况,导致咳嗽、气短,有时还会出现带血的痰。在这些情况下,肺血管压力会升高,最终可能导致肺水肿。本文综述了有关肺水肿的发病率、病理生理学、病因学、风险、短期和长期并发症以及支持性医疗干预措施疗效的最新数据。
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引用次数: 0
Mass Participation and Tournament Event Management for the Team Physician: A Consensus Statement (2022 Update). 队医的大众参与和赛事活动管理:共识声明(2022 年更新)》。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-04-01 DOI: 10.1249/jsr.0000000000001160
Stanley A Herring, W Ben Kibler, Margot Putukian, Cheri Blauwet, Lori A Boyajian-O'Neill, Joel Boyd, R Rob Franks, Peter A Indelicato, Lance E LeClere, Catherine Logan, Francis G O'Connor, Jason Matuszak, William O Roberts, Robert E Sallis
Mass participation events include endurance events (e.g., marathon, triathlon) and/or competitive tournaments (e.g., baseball, tennis, football (soccer) tournaments). Event management requires medical administrative and participant care planning. Medical management provides safety advice and care at the event that accounts for large numbers of participants, anticipated injury and illness, variable environment, repeated games or matches, and mixed age groups of varying athletic ability. This document does not pertain to the care of the spectator.
大众参与活动包括耐力赛(如马拉松、铁人三项)和/或竞技锦标赛(如棒球、网球、足球锦标赛)。活动管理需要医疗管理和参与者护理规划。医疗管理为赛事提供安全建议和护理,以应对大量参与者、预期伤病、多变的环境、重复的游戏或比赛以及不同运动能力的混合年龄组。本文件与观众护理无关。
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引用次数: 0
First Rib Fracture Presenting as Chest Pain in a Collegiate Basketball Player: A Case Report. 一名大学篮球运动员以胸痛为表现的第一肋骨骨折:病例报告。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-03-01 DOI: 10.1249/JSR.0000000000001143
Jeremy Loescher, Joshua Blomgren, Kathleen Weber
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引用次数: 0
Bias and Conflict of Interest in the Underreporting of Sexual Abuse in Competitive Sports: A Literature Review. 竞技体育性虐待报告不足中的偏见和利益冲突:文献综述。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-03-01 DOI: 10.1249/JSR.0000000000001146
Abhishek Chandra, Jack Goldstein, Krystina Peters, William O Roberts, David J Satin

Abstract: The prevalence of sexual abuse in competitive sports is increasing worldwide and requires a united call to action. The underreporting of such abuses gained media attention resulting from recent high-profile cases. In this article, we report the results of a systematic literature review, identifying root causes of underreporting sexual abuse in competitive sports. We identify that biases and conflicts of interest work against effective reporting of abuse by athletes at the individual, organizational, and cultural levels. We offer conflict of interest and bias mitigation approaches from the social science, law, business, research, and diagnostic error literature that may apply. Competitive sports organizations may use this analysis to identify barriers and improve the effective reporting of sexual abuse.

摘要:竞技体育中的性虐待现象在世界范围内日益普遍,需要各方联合呼吁采取行动。最近一些备受瞩目的案件导致对此类性虐待行为的报告不足,引起了媒体的关注。在本文中,我们报告了系统性文献综述的结果,找出了竞技体育中性虐待报告不足的根本原因。我们发现,偏见和利益冲突在个人、组织和文化层面上阻碍了运动员对性虐待行为的有效报告。我们提供了社会科学、法律、商业、研究和诊断错误文献中可能适用的利益冲突和偏见缓解方法。竞技体育组织可以利用这一分析来识别障碍并改进性虐待的有效报告。
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引用次数: 0
Initial Assessment and Management of Select Musculoskeletal Injuries: A Team Physician Consensus Statement. 特定肌肉骨骼损伤的初步评估和处理:队医共识声明》。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-03-01 DOI: 10.1249/JSR.0000000000001151
Stanley A Herring, W Ben Kibler, Margot Putukian, Lori A Boyajian-O'Neill, Cindy J Chang, R Rob Franks, Mark Hutchinson, Peter A Indelicato, Francis G O'Connor, Amy Powell, Ryan Roach, Marc Safran, Siobhan M Statuta, Karen Sutton

Abstract: Musculoskeletal injuries occur frequently in sport during practice, training, and competition. Injury assessment and management are common responsibilities for the team physician. Initial Assessment and Management of Musculoskeletal Injury-A Team Physician Consensus Statement is title 23 in a series of annual consensus documents written for the practicing team physician. This statement was developed by the Team Physician Consensus Conference, an annual project-based alliance of six major professional associations. The goal of this document is to help the team physician improve the care and treatment of the athlete by understanding the initial assessment and management of selected musculoskeletal injuries.

摘要:在体育运动中,肌肉骨骼损伤经常发生在练习、训练和比赛期间。损伤评估和处理是队医的共同职责。肌肉骨骼损伤的初步评估和处理--队医共识声明》是为执业队医撰写的年度共识文件系列中的第 23 篇。该声明由团队医师共识会议(Team Physician Consensus Conference)制定,该会议是由六大专业协会组成的基于项目的年度联盟。本文件的目的是帮助队医了解选定肌肉骨骼损伤的初步评估和管理,从而改善对运动员的护理和治疗。
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引用次数: 0
Penetrating Flank Injury in an Adolescent Due to Exercise Resistance Band Malfunction. 运动阻力带故障导致一名青少年侧腹穿透性损伤。
IF 1.8 4区 医学 Q3 SPORT SCIENCES Pub Date : 2024-03-01 DOI: 10.1249/JSR.0000000000001145
Anthony Ruzga, Adam Gorra
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引用次数: 0
期刊
Current sports medicine reports
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