DOCSLIB.ORG

A Review of Overtraining Syndrome- Recognizing the Signs and Symptoms

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Review of Overtraining Syndrome- Recognizing the Signs and Symptoms A Review of Overtraining Syndrome- Recognizing the Signs and Symptoms Mary Black Johnson, PhD, ATC Steven M. Thiese, MS ABSTRACT: Overtraining syndrome is Physiological Indicators stress fractures, and tendinitis conditions common in athletes. Itmanifests itselfwith Numerous physiological characteris- in the lower extremities (4, 19). It is un- both physiological and psychological tics of overtraining syndrome are docu- clear whether overuse injuries associated symptoms, and can adversely affect an mented in the literature (3,10,14; Table 1). with overtraining are the result of exces- athlete'sperformance. Thisarticle reviews In an overtrained athlete, an overactive sively high training loads or the body's the physiological andpsychological signs pituitary gland is primarily responsible for impaired ability to recover from training andsymptoms ofovertraining syndrome in physiological responses to overtraining. bouts. order to help the athletic trainer recognize Stimulation of the hypothalamus causes Still another of the body's systems the condition. With an understanding of the pituitary gland to secrete excess adre- affected by overtraining syndrome is the overtrainingsyndrome, theathletic trainer nocorticotropic hormone. This, in turn, cardiovascular system. Overtrained ath- can better aid coaches and athletes in stimulates cortisol secretion by the adrenal letes exhibit elevated exercise heart rates preventing and treating this phenomenon, cortex, which aids the body in adapting to and require longer for their heart rate to and thus maintain the athlete's optimal stress. Barron et al (2) reported that corti- return to normal following activity (4). performance level. sol levels were significantly higher in ath- Early studies found both increased (15) letes who had overtrained than in the same and decreased (25) resting blood pressure athletes afterthey had4 weeks ofrest. The in overtrained athletes. More recently, O vertraining syndrome has been re- elevation of cortisol levels in overtrained Henschen (10) reported that higher sys- ferredto as "staleness," "overreach- athletes in this study was observed imme- tolicbloodpressure was aphysiologic char- ing," and "chronic fatigue" (21). It can diately following exercise, as well at 15 acteristic of overtraining. Verma et al (24) result in mental lassitude and/or physical and 30 minutes postexercise. observed a lengthened time to return to injury and therefore a declining perfor- The humanreproductive system also basal blood pressure levels after exercise mance (21). Most simply put, overtraining is adversely affected by overtraining syn- in overtrained athletes. syndrome is the point at which an athlete drome, with luteinizing hormone (LH) Finally, overtraining can lead to de- exceeds his/hercapacityfor exercise (22). levels decreasing when the athlete is creased immunity (17). One report docu- It has both psychological and physiologi- overtrained (5,7,12). In women, LH de- ments a decrease in C-reactive protein af- cal components that shouldberecognized crease is associated with decreased per- ter intense exercise (11). An acute phase by those working with athletes. cent of body fat and associated decreased response may be exhibited in overtrained The athletic trainer is in a unique levels of estrogen. Overtraining in fe- athletes, detectable as fever, leukocytosis, position to recognize symptoms of males is often manifested by amenorrhea a drop in serum iron and zinc, and arise in overtraining. Acting as a health care (7,12). In men, decreased LH results in serum copper and erthyrocyte sedimenta- liaison, the athletic trainer can work with decreased testosterone and a resultant in- tionrate. In addition,increasedheadcolds, the physician, the coach, and the athlete ability to build muscle mass (5). allergicreactions, and otherinfections have toward returning the athlete to optimal Overtraining also affects the muscu- been associated with overtraining. performance levels. The purpose of this loskeletal system. One report documents paper is to review the physical and psy- that serum creatine kinase (CK), an enzy- Psychological Indicators chological manifestations ofovertraining matic marker of muscle tissue injury, is The psychological factors associated syndrome and to outline those signs and elevated in athletes on mornings after run- with overtraining syndrome are more dif- symptoms that could be monitored by the ning (4). The researchers hypothesized ficultto detectthanthe physiological ones athletic trainer. thattheathletewho losesweightandmuscle (9; Table 1). According to one sports girth while training is undergoing catabo- psychologist, psychological overtraining Mary Black Johnson is an assistant lism, metabolizing muscle protein stores is characterizedby sleepdisturbances (and professor in the Department of Physical for energy. The net result is a decrease in associated drowsiness), prolongedexces- Education (Athletic Training) at San Di- performance. sive weariness, chronic fatigue, and loss ego State University in San Diego, CA. The musculoskeletal system also re- of vigor (9,18,23). In addition, loss of Steven Thiese holds a master's degree sponds to overtraining with overuse inju- self-confidence, apathy, irritability, de- in athletic managementfrom the Univer- ries. The three most common overuse pression, anxiety, and confusion also are sity of Utah, SaltLake City, UT. injuries associated with overtraining are: exhibited (10,18). An overtrained athlete posterior tibialis syndrome, lower limb may exhibit emotional and motivational 352 Volume 27 a Number4 a 1992 m JournalofAthletic Training Table 1.-Physiological and Psychological evening fluid intake. The athlete may The athlete should maintain records Indicators of Overtraining Syndrome exhibit signs ofdehydration andmay drink of morning heart rate and records of fluid copious amounts of fluid after practice. and dietary intake throughout the training Physiological This athlete also may have alack ofperspi- and competitive seasons. The amount and 1. Higher restng heart rate ration during practice since the body is quality of sleep the athlete gets each night 2. Changes in normal blood pressure attempting to maintain fluid balance by should also be recorded. These records 3. Delayed return to normal heart rate retaining fluids. should be reviewed regularly by the coach 4. Elevated basal metabolic rate Another symptom ofovertraining syn- and/or the athletic trainer, as changes in 5. Elevated body temperature drome is an alteration in sleeping patterns established baseline levels of these mea- 6. Weight loss/excessive thirst (9,16,20). Sleep is how the body replen- surements could signify an increased risk 7. Impeded respiration ishes itself. If an athlete gets inadequate of overtraining for the athlete. In addition, 8. Subcostal aching sleep, the body is denied its optimal re- the athlete should be encouraged to main- 9. Bowel disorders covery time. Disruption of normal sleep tain a diary assessing his/her emotional patterns-such as time to bed and the outlook. It may be helpful to have an Psychological amount and quality of sleep-alters the objective assessment ofthe athlete's men- 1. Sleep disturbances ability ofthe body to adapt to the stress of tal outlook. This can be accomplished 2. Loss of self-confidence training. using psychological tests such as the Pro- 3. Drowsiness and apathy The final symptom is general psycho- file of Mood States (POMS) (9). 4. Irritability logical malaise (1,8,13). An alteration in These steps, at first, may appear ex- 5. Emoiol ad monvato imbaan the athlete's mood or approach to his/her cessive. It may be impractical to expect 6. Excessive, prolonged weariness sport may be a signal of staleness. An athletic trainers to monitor all athletes for 7. Lack of appetite (anorexia) inability to maintain the training schedule signs and symptoms of overtraining. In 8. Fatigue orto be psychologically prepared for com- reality, only periodic review is necessary 9. Depression petition may be apparent. to assess changes in the five areas that 10. Anxiety indicate overtraining syndrome. Addition- 11. Anger/hostility Recognition ally, the athletic trainer is in a unique posi- 12. Confusion The causes of overtraining syndrome tion to educate coaches regarding this syn- are associated with physical training and drome. Through these means, the coach competition (10; Table 2). As has been can monitor the athletes and direct their imbalance, anger, and hostility (10,18), mentioned, there are anumber ofscientific training toward eliminating andpreventing and mood swings are common (13,23). assays and measures that can indicate overtraining syndrome. Eating disorders and generalized loss of overtraining in an athlete. Many of the appetite also are observed (16). tests that can be employed are either too Prevention and Treatment expensive or too invasive to be practical. Recognizing overtraining syndrome Signs and Symptoms There are, however, several simple ways may be vital to its prevention; however, Although manifestations of over- the athletic trainer or coach can watch for recognition is only afirst step. Treating the training syndrome differ from person to signs of overtraining syndrome. syndrome involves attenuation of both person, fivemainsigns andsymptoms com- physical and psychological symptoms. monly appear in overtrained athletes. The Physical symptoms should be dealt with first is an alteration in the circulatory sys- Table 2.-Causes of Overtraining Syndrome first. This may involve a
Load more

Recommended publications
  • General Signs and Symptoms of Abdominal Diseases
    General signs and symptoms of abdominal diseases Dr. Förhécz Zsolt Semmelweis University 3rd Department of Internal Medicine Faculty of Medicine, 3rd Year 2018/2019 1st Semester • For descriptive purposes, the abdomen is divided by imaginary lines crossing at the umbilicus, forming the right upper, right lower, left upper, and left lower quadrants. • Another system divides the abdomen into nine sections. Terms for three of them are commonly used: epigastric, umbilical, and hypogastric, or suprapubic Common or Concerning Symptoms • Indigestion or anorexia • Nausea, vomiting, or hematemesis • Abdominal pain • Dysphagia and/or odynophagia • Change in bowel function • Constipation or diarrhea • Jaundice “How is your appetite?” • Anorexia, nausea, vomiting in many gastrointestinal disorders; and – also in pregnancy, – diabetic ketoacidosis, – adrenal insufficiency, – hypercalcemia, – uremia, – liver disease, – emotional states, – adverse drug reactions – Induced but without nausea in anorexia/ bulimia. • Anorexia is a loss or lack of appetite. • Some patients may not actually vomit but raise esophageal or gastric contents in the absence of nausea or retching, called regurgitation. – in esophageal narrowing from stricture or cancer; also with incompetent gastroesophageal sphincter • Ask about any vomitus or regurgitated material and inspect it yourself if possible!!!! – What color is it? – What does the vomitus smell like? – How much has there been? – Ask specifically if it contains any blood and try to determine how much? • Fecal odor – in small bowel obstruction – or gastrocolic fistula • Gastric juice is clear or mucoid. Small amounts of yellowish or greenish bile are common and have no special significance. • Brownish or blackish vomitus with a “coffee- grounds” appearance suggests blood altered by gastric acid.
    [Show full text]
  • Heart Failure
    Heart Failure Sandra Keavey, DHSc, PAC, DFAAPA Defined Heart failure (HF) is a common clinical syndrome resulting from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. HF may be caused by disease of the myocardium, pericardium, endocardium, heart valves, vessels, or by metabolic disorders Epidemiology-Magnitude Heart failure disproportionately affects the older population. Approximately 80% of all cases of heart failure in the United States occur in persons aged 65 years and older. In the older population, heart failure accounts for more hospital admissions than any other single condition. Following hospitalization for heart failure, nearly half are readmitted within 6 months. Epidemiology-Prevalence Prevalence. About 5.1 million people in the United States have heart failure. One in 9 deaths in 2009 included heart failure as contributing cause. About half of people who develop heart failure die within 5 years of diagnosis. 25% of all heart failure patients are re-admitted to the hospital within 30 days. 50% of all heart failure patients are re-admitted to the hospital within 6 months. Systolic vs Diastolic There are two common types of heart failure Systolic HF Systolic HF is the most common type of HF Now referred to as HFrEF Heart Failure reduced Ejection Fraction The heart is weak and enlarged. The muscle of the left ventricle loses some of its ability to contract or shorten. Diastolic HF Diastolic HF is not an isolated disorder of diastole; there are widespread abnormalities of both systolic and diastolic function that become more apparent with exercise.
    [Show full text]
  • Medical Terminology Abbreviations Medical Terminology Abbreviations
    34 MEDICAL TERMINOLOGY ABBREVIATIONS MEDICAL TERMINOLOGY ABBREVIATIONS The following list contains some of the most common abbreviations found in medical records. Please note that in medical terminology, the capitalization of letters bears significance as to the meaning of certain terms, and is often used to distinguish terms with similar acronyms. @—at A & P—anatomy and physiology ab—abortion abd—abdominal ABG—arterial blood gas a.c.—before meals ac & cl—acetest and clinitest ACLS—advanced cardiac life support AD—right ear ADL—activities of daily living ad lib—as desired adm—admission afeb—afebrile, no fever AFB—acid-fast bacillus AKA—above the knee alb—albumin alt dieb—alternate days (every other day) am—morning AMA—against medical advice amal—amalgam amb—ambulate, walk AMI—acute myocardial infarction amt—amount ANS—automatic nervous system ant—anterior AOx3—alert and oriented to person, time, and place Ap—apical AP—apical pulse approx—approximately aq—aqueous ARDS—acute respiratory distress syndrome AS—left ear ASA—aspirin asap (ASAP)—as soon as possible as tol—as tolerated ATD—admission, transfer, discharge AU—both ears Ax—axillary BE—barium enema bid—twice a day bil, bilateral—both sides BK—below knee BKA—below the knee amputation bl—blood bl wk—blood work BLS—basic life support BM—bowel movement BOW—bag of waters B/P—blood pressure bpm—beats per minute BR—bed rest MEDICAL TERMINOLOGY ABBREVIATIONS 35 BRP—bathroom privileges BS—breath sounds BSI—body substance isolation BSO—bilateral salpingo-oophorectomy BUN—blood, urea, nitrogen
    [Show full text]
  • Study Guide Medical Terminology by Thea Liza Batan About the Author
    Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails ­proficiency­in­communicating­with­healthcare­professionals­such­as­physicians,­nurses,­ or dentists.
    [Show full text]
  • Signs and Symptoms
    Signs and Symptoms Some abnormal heart rhythms can happen without the person knowing it, while some may cause a feeling of the heart “racing,” lightheadedness, or dizziness. At some point in life, many adults Rapid Heartbeat – Tachycardia have had short-lived heart rhythm When the heart beats too quickly changes that are not serious. (usually above 100 beats per minute), the lower chambers, or Certain heart rhythms, especially ventricles, do not have enough time those that last long enough to af - to fill with blood, so they cannot ef - fect the heart’s function, can be fectively pump blood to the rest of serious or even deadly. the body. When this happens, some Palpitation or Skipped Beat people have symptoms such as: Although it may seem as if the Skipping a beat Slow Heartbeat – Bradycardia heart missed a beat, it has really had an early heartbeat — an extra If the heartbeat is too slow (usually Beating out of rhythm below 60 beats per minute), not beat that happens before the heart Palpitations has a chance to fill with blood. enough blood carrying oxygen Fast or racing heartbeat Therefore the squeeze is empty flows through the body. The symptoms of a slow heartbeat are: and results in a pause. Shortness of breath Fatigue (feeling tired) Fluttering Chest pain A fluttering sensation (like butter - Dizziness Dizziness flies in the chest) is usually due to Lightheadedness extra or “skipped beats” that occur Lightheadedness Fainting or near fainting one right after the other, or may be Fainting or near fainting caused by other kinds of abnormal heart rhythms.
    [Show full text]
  • Arrhythmia What Is It?
    Arrhythmia What is it? Most of us have felt our heart race or skip a beat. It’s fairly normal every once and a while. But for some people, it’s a sign of arrhythmia – a disorder of your heart rate or rhythm – that needs to be checked out by a specialist. If you have an arrhythmia (there are multiple types), your heart either beats: • too fast • too slow or • with an irregular pattern Did You Know? This change in your heart rhythm is usually caused by a “glitch” Our heart beats an average of in your heart’s electrical activity, which tells the heart when to 70 to 80 times a minute and contract and pump blood to the body. Your heart doesn’t beat over 100,000 times a day! It’s with the regularity of a Swiss watch, and many factors can cause no wonder millions of people an irregularity. notice palpitations such as skipping a beat, fluttering or a Some of these factors include: racing heart. • having had a heart attack • having heart failure • blood chemistry imbalances • abnormal hormone levels • alcohol, caffeine and other substances or medicines • a variety of inherited abnormalities 8 Tips for Staying Heart Healthy with Arrhythmias Living with an arrhythmia varies tremendously from one person to the next. It will depend on the type of arrhythmia you have, how serious it is and the recommended treatment. Some people can take a single medication to correct their heart’s rhythm; others undergo electrophysiology studies or require a pacemaker or implantable defibrillator. No matter what kind of arrhythmia you have, there are things you can do to keep your heart healthy and ticking as it should.
    [Show full text]
  • GE Reflux Presentations, Complications, and Treatment
    GE Reflux Presentations, Complications, and Treatment Osama Almadhoun, MD Chief, UBMD Pediatric Gastroenterology Associate Professor, University at Buffalo Learning Objectives • Understand the difference between GER and GERD • To review the signs and symptoms related to GERD • Discuss the diagnostic and therapeutic management of GER. • Learn about indications and potential complications of Fundoplication. • Understand literature and management dilemmas for Extra- Esophageal manifestations of GER(D) GER • Passage of gastric contents into the esophagus. – Normal physiologic process, last <3 minutes. – Occur in the postprandial period and cause few or no symptoms. • Normal COMMON!!!phase in the development in infants and toddlers – 50% of infants in the first 3 mos of life – 67% of 4 month old infants – 5% of 10 to 12 month old infants. • Happy “Spitters” • No evaluation or testing is necessary Nelson et al, 1997 GERD GERD is present when the reflux of gastric contents causes troublesome symptoms and/or complications. Refractory GERD . GERD not responding to optimal treatment after 8 weeks. Regurgitation: The passage of refluxed gastric contents into the oral pharynx. Vomiting: Expulsion of the refluxed gastric contents from the mouth. Proportion (%) of children who spilled. A James Martin et al. Pediatrics 2002;109:1061-1067 Reflux Mechanism Intragastric pressure overcomes the opposition of the high- pressure zone at the distal end of the esophagus: • LES tone • Diaphragmatic crura • Intraabdominal portion of the esophagus • Angle of His Dent J et al, J Clin Invest, 1980 Mittal, R. K. et al. N Engl J Med 1997;336:924-932 Pathogenesis • Primary Mechanism • Transient lower esophageal sphincter relaxations (TLESRs) • Decrease basal LES tone GER and impaired esophageal acid clearance • Secondary Mechanism • Overfeeding, Overweight • Increased intra-abdominal pressure • Delayed Gastric Emptying • There are a number of challenges to defining GER and GERD in the pediatric population.
    [Show full text]
  • Clinical Assessment in Acute Heart Failure
    Hellenic J Cardiol 2015; 56: 285-301 Review Article Clinical Assessment in Acute Heart Failure 1 2 NIKOLAOS S. KAKOUROS , STAVROS N. KAKOUROS 1University of Massachusetts, MA, USA; 2Cardiac Department, “Amalia Fleming” General Hospital, Athens, Greece Key words: eart failure (HF) is defined as “a clear precipitant or trigger. It is very im­ Heart failure, complex clinical syn drome that portant to establish the precipitating diagnosis, physical examination, H can result from any structural or causes, which may have therapeutic and congestion. functional cardiac disorder that impairs the prognostic implications. Approximate­ ability of the ventricle to fill with, or eject ly 60% of patients with AHF have doc­ blood.” HF has an estimated overall prev­ umented CAD. Myocardial ischemia in alence of 2.6%. It is becoming more com­ the setting of acute coronary syndromes mon in adults older than 65 years, because is a precipitant or cause, particularly in of increased survival after acute myocar­ patients presenting with de novo AHF.4 dial infarction (AMI) and improved treat­ AHF is also often precipitated by medica­ ment of coronary artery disease (CAD), tion and dietary non­compliance, as well val vular heart disease and hypertension.1 as by many other conditions, which are Acute HF (AHF) is an increasingly com­ summarized in Table 1. Once the diagno­ mon cause of hospitalizations and mortality sis of AHF is confirmed, initial therapy in­ worldwide. In the majority of patients, AHF cludes removal of precipitants; if this can Manuscript received: can be attributed to worsening chronic HF, be carried out successfully, the patient’s August 25, 2014; and approximately 40­50% of this group have subsequent course may be stable.
    [Show full text]
  • Chapter 24 Abdomen Injuries
    44093_CH024_0001_0021.qxd 1/18/07 4:35 PM Page 1 SECTION 4TRAUMA Chapter 24 Abdomen Injuries Objectives Cognitive 4-8.17 Describe the epidemiology, including the morbidity/mortality and prevention strategies 4-8.1 Describe the epidemiology, including the for hollow organ injuries. (p 24.11) morbidity/mortality and prevention strategies for a patient with abdominal trauma. 4-8.18 Explain the pathophysiology of hollow organ (p 24.6, 24.7) injuries. (p 24.11) 4-8.2 Describe the anatomy and physiology of organs 4-8.19 Describe the assessment findings associated and structures related to abdominal injuries. with hollow organ injuries. (p 24.11) (p 24.6) 4-8.20 Describe the treatment plan and management of 4-8.3 Predict abdominal injuries based on blunt and hollow organ injuries. (p 24.15) penetrating mechanisms of injury. 4-8.21 Describe the epidemiology, including the (p 24.5, 24.8) morbidity/mortality and prevention strategies 4-8.4 Describe open and closed abdominal injuries. for abdominal vascular injuries. (p 24.12) (p 24.7, 24.8) 4-8.22 Explain the pathophysiology of abdominal 4-8.5 Explain the pathophysiology of abdominal vascular injuries. (p 24.12) injuries. (p 24.10) 4-8.23 Describe the assessment findings associated 4-8.6 Describe the assessment findings associated with abdominal vascular injuries. (p 24.12) with abdominal injuries. (p 24.10) 4-8.24 Describe the treatment plan and management of 4-8.7 Identify the need for rapid intervention and abdominal vascular injuries. (p 24.15) transport of the patient with abdominal injuries 4-8.25 Describe the epidemiology, including the based on assessment findings.
    [Show full text]
  • Chest Auscultation: Presence/Absence and Equality of Normal/Abnormal and Adventitious Breath Sounds and Heart Sounds A
    Northwest Community EMS System Continuing Education: January 2012 RESPIRATORY ASSESSMENT Independent Study Materials Connie J. Mattera, M.S., R.N., EMT-P COGNITIVE OBJECTIVES Upon completion of the class, independent study materials and post-test question bank, each participant will independently do the following with a degree of accuracy that meets or exceeds the standards established for their scope of practice: 1. Integrate complex knowledge of pulmonary anatomy, physiology, & pathophysiology to sequence the steps of an organized physical exam using four maneuvers of assessment (inspection, palpation, percussion, and auscultation) and appropriate technique for patients of all ages. (National EMS Education Standards) 2. Integrate assessment findings in pts who present w/ respiratory distress to form an accurate field impression. This includes developing a list of differential diagnoses using higher order thinking and critical reasoning. (National EMS Education Standards) 3. Describe the signs and symptoms of compromised ventilations/inadequate gas exchange. 4. Recognize the three immediate life-threatening thoracic injuries that must be detected and resuscitated during the “B” portion of the primary assessment. 5. Explain the difference between pulse oximetry and capnography monitoring and the type of information that can be obtained from each of them. 6. Compare and contrast those patients who need supplemental oxygen and those that would be harmed by hyperoxia, giving an explanation of the risks associated with each. 7. Select the correct oxygen delivery device and liter flow to support ventilations and oxygenation in a patient with ventilatory distress, impaired gas exchange or ineffective breathing patterns including those patients who benefit from CPAP. 8. Explain the components to obtain when assessing a patient history using SAMPLE and OPQRST.
    [Show full text]
  • Case Report Visual Disturbance As the First Symptom of Chronic Myeloid Leukemia
    [Downloaded free from http://www.meajo.org on Tuesday, March 27, 2012, IP: 41.234.93.234] || Click here to download free Android application for this journal Case Report Visual Disturbance as the first Symptom of Chronic Myeloid Leukemia Philemon K. Huang, Srinivasan Sanjay ABSTRACT Access this article online Website: Chronic myeloid leukemia (CML) is a well-studied entity and advances made in diagnosis and www.meajo.org treatment have improved the disease outcome. Patients with ophthalmic manifestation of DOI: CML have been reported to have lower 5-year survival rates. Hence, recognizing the early 10.4103/0974-9233.90143 fundus changes may improve outcome by allowing earlier diagnosis and treatment. We Quick Response Code: report a case of a previously healthy 30-year-old Myanmarese male, who presented with a minor visual disturbance, complaining of seeing a ‘black dot’ in his left visual field for the past 1 week. Fundoscopic examination revealed bilateral retinal blot hemorrhages, white- centered hemorrhage, and preretinal hemorrhage over the left fovea. The full blood count and peripheral blood film were abnormal, and bone marrow biopsy confirmed the diagnosis of CML. Cytoreduction therapy was promptly commenced and his symptoms resolved, with improvement in visual acuity. No complications were recorded at 1-year follow-up. Key words: Chronic Myeloid Leukemia, Retinal Hemorrhage, Roth Spots, Visual Disturbance INTRODUCTION CASE REPORT atients with ophthalmic manifestation of chronic myeloid A 30-year-old Myanmarese male with no medical history Pleukemia (CML) have been reported to have lower 5-year presented with a history of seeing a ‘black dot’ in his left visual survival than those without.1 However, ocular manifestations field for the past 1 week.
    [Show full text]
  • Coronary Artery Disease Management
    HealthPartners Inspire® Special Needs Basic Care Clinical Care Planning and Resource Guide CORONARY ARTERY DISEASE MANAGEMENT The following Evidence Base Guideline was used in developing this clinical care guide: National Institute of Health (NIH); American Heart Association (AHA) Documented Health Condition: Coronary Artery Disease, Coronary Heart Disease, Heart Disease What is Coronary Artery Disease? Coronary artery disease (CAD) is a disease in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen‐rich blood to your heart muscle. When plaque builds up in the arteries, the condition is called atherosclerosis (ATH‐er‐o‐skler‐O‐sis). The buildup of plaque occurs over many years. Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen‐rich blood to the heart. If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. Over time, ruptured plaque also hardens and narrows the coronary arteries. Common Causes of Coronary Artery Disease? If the flow of oxygen‐rich blood to your heart muscle is reduced or blocked, angina or a heart attack can occur. Angina is chest pain or discomfort. It may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. A heart attack occurs if the flow of oxygen‐rich blood to a section of heart muscle is cut off. If blood flow isn’t restored quickly, the section of heart muscle begins to die.
    [Show full text]