Collegiate Wrestler With a Bicuspid Aortic Valve and Aortic Dilation.

Bicuspid aortic valve and aortopathy are generally considered contraindications to isometric exercise. For athletes with mild disease at low risk of adverse events, a shared decision-making approach for continued sports participation is reasonable. We present a case of a collegiate wrestler with bicuspid aortic valve and aortopathy to illustrate shared decision making. (Level of Difficulty: Intermediate.).

Antibiotic precautions in athletes.

CONTEXT: Antibiotics are the mainstay of treatment for bacterial infections in patients of all ages. Athletes who maximally train are at risk for illness and various infections. Routinely used antibiotics have been linked to tendon injuries, cardiac arrhythmias, diarrhea, photosensitivity, cartilage issues, and decreased performance. EVIDENCE ACQUISITION: Relevant articles published from 1989 to 2012 obtained through searching MEDLINE and OVID. Also, the Food and Drug Administration website was utilized. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 3. RESULTS: The team physician should consider alternative medications in place of the "drug of choice" when adverse drug effects are a concern for an athlete's health or performance. If alternative medications cannot be selected, secondary preventative measures, including sunscreen or probiotics, may be needed. CONCLUSION: Physicians choose medications based on a variety of factors to help ensure infection resolution while limiting potential side effects. Extra precautions are indicated when treating athletes with certain antibiotics.

Nonprescription pain medication use in collegiate athletes: a comparison of samples.

BACKGROUND: Despite recent research, nonprescription pain medication use among collegiate athletes across all divisions of the National Collegiate Athletic Association (NCAA) is still not well understood. HYPOTHESIS: Non-Division I-A NCAA athletes have a different usage pattern of nonprescription pain medication than NCAA Division I-A football athletes. METHODS: A modified version of a nonprescription medication usage survey that had been used with Division I-A football athletes was distributed to Division II and Division III athletes during pre-participation exams. The statistics were analyzed by calculating the z-ratio for the significance of the difference between 2 independent proportions. RESULTS: A total of 198 athletes from 16 different sports were surveyed. It was found that 62% of athletes used nonprescription medications for sports-related pain, which was significantly lower than previous findings for Division I-A football athletes: 12% reported taking more than the recommended dose; 1.5% reported taking nonprescription pain medication for > 10 consecutive days; and 38% reported that they read the label the first time they took a new nonprescription pain medication. These results, when compared with findings on Division I-A football athletes, demonstrated that Division II and III athletes are less likely to take more than the recommended dose of nonprescription pain medications and are less likely to use the medications for > 10 consecutive days-characteristics that are used to define misuse. Similar results were found when comparing Division I-A football athletes with non-Division I-A football athletes. CONCLUSIONS: Athletes from NCAA Division II and Division III sports appear to use nonprescription pain medication for sports-related pain less often and have lower rates of misuse than do Division I-A football athletes. Division I-A football athletes may be more likely to misuse nonprescription pain medication than non-Division I-A athletes. Special attention should be paid to this population to help reduce adverse event risks.

The home visit experience: a medical student's perspective.

Incorporating home care education into the medical school curriculum is essential for providing a learning experience not duplicated elsewhere. Students rotating through family medicine write a reflection paper on their experiences. The papers about home visits from July 2000 to June 2004 were analyzed by a constant comparison technique developing seven themes: student paradigm shift in their understanding of causes vs. efects of disease, misconceptions about treatment, access to care, a return to the roots of medicine, quality of family caregiving, broader implications of providing care, and controversial issues. The students'papers demonstrate the unique environment of home visits.