Analysis of a Division I Sports Medicine Program's COVID-19 Protocol: Identifying Factors that Predict Testing Demands and Positive Rates During a Pandemic

OBJECTIVE

To determine factors indicating testing frequency and positive test results in a Division I sports department intrapandemic.

DESIGN

Retrospective analysis.

SETTING

A single Division I collegiate sports department.

PATIENTS

All student-athlete (n = 437), student staff (n = 89), and adult staff (n = 202) members of the sports department. Total cohort (n = 728).

INTERVENTIONS

The authors analyzed the independent variables of local positive rates, sport characteristics, and campus events for impact on the volume of the departmental testing and positive rates.

MAIN OUTCOME MEASURES

Measured dependent variables of the volume of departmental testing and positive rates were analyzed.

RESULTS

Positive predictive rates (PPRs) largely differed from local, off-campus rates in timing and duration (59.52%: P < 0.05). Overall, 20633 tests were administered with 201 positive results (0.97% PPR). Student-athlete numbers were highest in all categories, followed by adult then student staff. Greater proportions of contact sports became positive (53.03%: P < 0.001) and all-male sports (47.69%: P < 0.001). No comparative difference was seen for teams using fomites (19.15%: P = 0.403). Spring sports teams had the lowest percentage of the team positive (22.22%: P < 0.001). Winter sports had the highest PPR (1.15%), all occurring during team-controlled activities. Playing sports indoors did not increase inside team-controlled activity positive rates ( P = 0.066).

CONCLUSIONS

Longitudinal changes in local, off-campus infection rates partially affected sports departmental positive results while testing rates were more influenced by sport and university schedule. Testing resources should be directed toward high-risk sports, which included contact sports (football, basketball, and soccer), all-male teams, both Winter and indoor sports inside team-controlled activities, and sports with long periods of time outside team-controlled activities.

Rhabdomyoma (Adult Type) of the Sublingual Region

A case of sublingual rhabdomyoma (adult type) in a 40-year-old man is reported. A review of the world literature revealed 28 acceptable previous cases.

Absence of histopathological changes of ileum and colon in functional chronic diarrhea associated with bile acid malabsorption, assessed by SeHCAT test: a prospective study

OBJECTIVES

Chronic diarrhea of unknown origin is often associated with bile acid malabsorption, the pathogenetic role of which is uncertain. The aim of this study was to identify morphological abnormalities in the ileal and colonic mucosa in patients with this disorder.

METHODS

We performed a prospective and blinded histopathological study (between June 1991 and November 1992) of endoscopic biopsies of the distal ileum and colon of 23 patients suffering from chronic diarrhea of unknown origin. In 14, the SeHCAT (75-selena-homo-cholic acid taurine) test was abnormal owing to bile acid malabsorption; in the other nine, the diarrhea control group, the test results were normal. A detailed evaluation of surface epithelium, immune response and inflammatory changes was made.

RESULTS

in two patients and two controls, mild villous atrophy was observed; there was also slight inflammation of the ileal and colonic mucosa occurring with the same frequency in both groups. A slight replacement of goblet cells was more evident in the diarrhea control group.

CONCLUSIONS

Chronic diarrhea of unknown origin associated with bile acid malabsorption does not involve specific morphological changes of ileal or colonic mucosa, and its pathogenesis must be looked for in dysfunction of the ileum and/or colon.

Pineal germinoma with massive supratentorial extension. Case report

An uncommon case of huge pineal germinoma without associated ventricular enlargement is presented. The tumor extended supratentorially in dumb-bell form to affect both cerebral hemispheres, simulating a glioma at neuroradiological examinations. Subtotal removal through a bilateral parieto-occipital approach plus radiation therapy were followed by relief of symptoms for over one year since surgery. The misleading patterns of the tumor and the delayed onset of symptoms in our case are outlined.

High grade astrocytoma with spontaneous meningeal and cranial invasion

Unusual features of a Grade IV cerebral astrocytoma (glioblastoma) are presented; infiltration of the dura mater and destruction of the overlying calvarium. The meningeal fibroblastic reaction and the blood supply recruitment of the tumor from the external carotid system are also described. The literature dealing with biologically “aggressive” tumors of the glial series displaying direct invasion of the cranial extraneural structures is summarized.

Microsurgical removal of paraventricular cavernous angiomas. Report of two cases

Two cases of paraventricular cavernous angiomas are presented. In one, the cavernous angioma was found in the right wall of the fourth ventricle, and in the other in the right thalamus encroaching upon the third ventricle. Both patients had onset of symptoms suggesting a tumor. Good results were obtained by the microsurgical approach to these malformations. The computerized tomography findings typical of cavernous angiomas are reviewed

Cerebral cavernous angiomas in children

Five cases of cerebral cavernous angiomas in children are presented. Three children had seizures as the sole manifestation of the lesion, and two had intracerebral bleeding. These malformations are encountered more commonly in adults in the third to fifth decade, and are found most frequently in the white matter of the cerebral hemispheres. Intracranial bleeding, seizures, headaches, and slowly developing focal signs are the usual presenting complaints. In childhood, seizures are the initial symptom of the malformation in many cases. The value of computerized tomography (CT) in the detection of such malformations is stressed, and CT findings that are characteristic of cavernous angiomas are described.