Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
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Exercise-associated hyponatremia (EAH) is a potentially fatal fluid imbalance largely resulting from sustained fluid intake beyond the capacity for fluid excretion during endurance exercise. Common symptoms include vomiting, confusion, altered mental status, and seizures; however, these symptoms can also be seen with hypernatremic encephalopathy, making measurement of plasma sodium concentration imperative when athletes present with these symptoms. Recent evidence supports the inappropriate secretion of the antidiuretic hormone, arginine vasopressin (AVP), as the primary pathophysiological mechanism underlying the development of dilutional EAH. ⋯ The prompt administration of an intravenous (IV) bolus of hypertonic saline in the field or hospital setting can be lifesaving once EAH is documented. Conversely, oral sodium supplementation will not prevent the development of EAH encephalopathy if exuberant fluid intake combined with non-osmotic secretion of AVP occurs during prolonged physical activity. As a result, the seemingly paradoxical use of sodium supplementation as the most effective practical management therapy (IV bolus) and ineffective preventive strategy can be reconciled through a more complete understanding of the pathophysiological mechanisms underlying EAH.
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Randomized Controlled Trial
The efficacy of prolotherapy for lateral epicondylosis: a pilot study.
To assess whether prolotherapy, an injection-based therapy, improves elbow pain, grip strength, and extension strength in patients with lateral epicondylosis. ⋯ Prolotherapy with dextrose and sodium morrhuate was well tolerated, effectively decreased elbow pain, and improved strength testing in subjects with refractory lateral epicondylosis compared to Control group injections.
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To examine functional brain activation patterns before and after postconcussive symptoms (PCS) resolution. ⋯ The results demonstrate the feasibility of using fMRI to detect an underlying pathology in symptomatic concussed athletes with normal structural imaging results and its potential to document recovery. Such information may be of considerable value for clinical judgment and patient management.
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To determine the prevalence of misrepresentation of publications and national presentations claimed in applications to the Maine Medical Center (MMC) Primary Care Sports Medicine Fellowship Program from 2001 through 2004. ⋯ Applicants to the Maine Medical Center Sports Medicine Fellowship Program were found to have high rates of misrepresentation in their citations of both publications and presentations.