ABSTRACT
Plantar fasciitis is a common cause of heel pain in adults. The disorder classically presents with pain that is particularly severe with the first few steps taken in the morning. In general, plantar fasciitis is a self-limited condition. However, symptoms usually resolve more quickly when the interval between the onset of symptoms and the onset of treatment is shorter. Many treatment options exist, including rest, stretching, strengthening, change of shoes, arch supports, orthotics, night splints, anti-inflammatory agents and surgery. Usually, plantar fasciitis can be treated successfully by tailoring treatment to an individual's risk factors and preferences.
Subject(s)
Fasciitis/therapy , Foot Diseases/therapy , Pain Management , Adrenal Cortex Hormones/administration & dosage , Adult , Fasciitis/diagnosis , Fasciitis/rehabilitation , Female , Foot Diseases/diagnosis , Foot Diseases/rehabilitation , Humans , Injections, Intralesional , Male , Orthopedic Procedures/methods , Pain/diagnosis , Pain/rehabilitation , Physical Therapy Modalities/methods , Prognosis , Severity of Illness Index , Treatment OutcomeABSTRACT
OBJECTIVE: The goals of this study were to assess the health care available to Wisconsin high school football players and to assess high schools' compliance with safety requirements of the Wisconsin Interscholastic Athletic Association (WIAA). DESIGN: The design was a cross-sectional survey-based study. SETTING: The setting consisted of WIAA high schools. PARTICIPANTS: Athletic directors of WIAA high school football programs participated in the survey. MAIN OUTCOME MEASURES: The main outcome measures were the prevalence of medical coverage by physicians, certified athletic trainers, and ambulance personnel at football games and practice and the prevalence of compliance with WIAA requirements. RESULTS: Seventy-seven percent (302/392) of surveys were returned. Thirty-six percent of schools had a designated team physician. Eighty-seven percent had a trainer, and 86% were certified athletic trainers (Athletic Trainer Certified, ATC). At practice and scrimmage, 79% had an ambulance available or on call, 52% had a trainer present, and 28% had a physician on call. At football games, 71% had an ambulance, 67% a certified athletic trainer, 48% an emergency medical technician, and 45% a physician present. Regarding WIAA requirements, 9% had no accessible phone, 27% had no written emergency plan of action, 92% had gloves, and 92% had blood spill kits. Larger schools had better compliance with WIAA requirements than did smaller schools. CONCLUSION: Health care coverage was provided mainly by trainers and ambulance personnel, although physicians were routinely present at almost half of all games. Failure to comply with WIAA medical coverage requirements was not infrequent. This study forms the basis for an informational intervention, providing an opportunity to correct deficits.
Subject(s)
Emergency Medical Services/statistics & numerical data , Football , School Health Services/statistics & numerical data , Cardiopulmonary Resuscitation , Cross-Sectional Studies , First Aid , Health Care Surveys , Humans , WisconsinABSTRACT
Recent studies have identified a region in the rostral ventromedial medulla (RVMM) of rats that appears to be involved in cardiovascular function. Since these studies used either microinjection of lidocaine or electrical stimulation, the exact contribution of intrinsic neurons as opposed to fibers of passage could not be determined. The present study was performed to map the location of neurons in RVMM from which changes in mean arterial pressure could be elicited by the microinjection of the excitatory amino acid analogue N-methyl-D-aspartic acid (NMDA) (20 ng/50 nl), which selectively activates cell bodies in barbiturate-anesthetized rats. Microinjection of NMDA into RVMM most often (53%) elicited pressor responses (31 +/- 7 mm Hg). On the basis of these responses, RVMM was determined to encompass a large portion of the nucleus gigantocellularis 0.5-1.5 mm lateral to the midline, 0.5-3.5 mm above the ventral surface, and extending from the rostral to the caudal pole of the facial nucleus. Depressor responses (-21 +/- 3 mm Hg) were found at all levels of RVMM but were most concentrated and of the largest magnitude in the rostral and caudal poles of RVMM. Microinjection of the inhibitory neurotransmitter glycine (500 mM) was used to determine whether neurons in RVMM were contributing to the maintenance of arterial pressure. Microinjection of glycine decreased arterial pressure (-15 +/- 2 mm Hg) throughout most of RVMM. Unexpectedly, increases in mean arterial pressure (24 +/- 3 mm Hg) were elicited by microinjection of glycine into the same region in RVMM in which NMDA most frequently elicited pressor responses.(ABSTRACT TRUNCATED AT 250 WORDS)
