ABSTRACT
SYNOPSIS: Mild traumatic brain injury is a major global public health concern. While most people recover within days to months, 1 in 5 people with mild traumatic brain injury report persistent, disabling symptoms that interfere with participation in work, school, and sport. People with injuries to regions other than the head may report similar symptoms. The biopsychosocial model of health explains this phenomenon in terms of factors associated with recovery that are not biomedical. Important psychosocial factors include poor recovery expectations and pretraumatic and posttraumatic psychological symptoms. Recent clinical practice guidelines recommend that clinicians examine all relevant biopsychosocial factors that may contribute to persistent postconcussive symptoms and consider them when helping their patients make health-management decisions. However, because clinical training continues to prioritize biomedical symptoms, clinicians may not feel confident in the psychosocial domain. Our objective is to provide 3 recommendations for clinicians to assess psychosocial factors in patients after concussion, and to argue a case for clinicians to improve their skills in assessing psychosocial factors. J Orthop Sports Phys Ther 2019;49(11):842-844. Epub 1 Jun 2019. doi:10.2519/jospt.2019.8849.
Subject(s)
Brain Concussion/psychology , Brain Concussion/therapy , Post-Concussion Syndrome/psychology , Post-Concussion Syndrome/therapy , Humans , Neuropsychological Tests , Recovery of Function , Referral and ConsultationABSTRACT
Horseshoe kidneys (HSK) represent an interesting surprise during anatomical dissections directed towards teaching of the urinary system. Clinically, the HSK limits access into the retroperitoneal space due to its location, orientation, and positioning of the ureters. In addition, its highly variable arterial and venous patterns provide great difficulties for surgeons during aortic aneurysm correction, and more recently, HSK transplantation. This case is a morphological study of a noticeably different HSK from the perspective of location, arterial blood supply, and venous drainage, which is further solidified by an embryological review. The debate is opened for further exploration into the theories associated with HSK ascent, its vasculature patterns, and the need for precise diagnostic imaging to serve preoperative planning
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