MRSA Infections

mrsa infection anatomy

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Methicillin-Resistant Staphylococcus aureus (S. Aureaus), or MRSA, is a bacterium that creates skin infections and other types of infections. The first time that MRSA was seen in US hospitals during the 1970s. Recently, there is a new strain of MRSA know as Community Acquired Methicillin-Resistant Staphylococcus aureus, or CA-MRSA, has left hospitals and began to spread in the community.

This is the strain that is prevalent among athletes. The difference between CA-MRSA and Healthcare-Associated MRSA (HA-MRSA) is in their effects. CA-MRSA usually creates skin infections while HA-MRSA causes bloodstream, urinary tract and surgical site infections. This make CA-MRSA less dangerous than HA-MRSA. Another difference is that CA-MRSA is more vulnerable to antimicrobial.

Symptoms

Signs of infections are :

  • Redness

  • Warmth, Swelling

  • Pus

  • Pain at sites where there are skin wounds

  • Abrasions or cuts

MRSA has the ability to spread to other organs in the body and when that happens, symptoms are more severe.

At this stage, symptoms are :

  • Fever

  • Chills

  • Low blood pressure

  • Joint pain

  • Severe headaches

  • Shortness of breath

  • An extensive rash over the body

These more advanced systemic symptoms require immediate medical attention.

Treatment

The 1st choice for treating MRSA skin infection is to use an antibiotic that has been created to kill bacteria with mild side effects. Most early infections with no widespread symptoms can be treated with oral antibiotics. Because of the nature of this decease and antibiotic options, many patients think they’re « cured » after only a few doses and decide by themselves to stop taking the prescribed drugs. However, MRSA is able to re-infect the patient and become resistant to antibiotics used previously.

For moderate to severe infections, treatment may be with intravenous antibiotics.

These infections associated with deep abscesses or boils require open surgical drainage in addition to antibiotic therapy. Most infections resolve in 7-10 days with an adequate treatment despite the fact that a deep abscess can take up to 4 weeks to eradicate the infection by resolving the abscess cavity.

Early identification and treatment of MRSA infections decrease the amount of playing time lost and decrease the chance that the infection will become severe. Skin may be protected by protective clothing or gear designed to prevent skin abrasions or cuts.

Prevention

mrsa infection anatomy

It’s necessary that athletes have good personal hygiene but it must be added that athletes and visitors to athletes facilities must also keep their hands clean by washing them often with soap and water or using an alcohol-based hand rub. The minimum is to have clean hands before and after sports and activities. For example when we use weight training equipment that is shared by all gym members, it’s important to have clean hands after using toilette or when someone is injured taking care the wounds (including changing bandage).

Ordinary and antimicrobial soaps are effective for washing hands. It’s noted that liquid soap is a better option because it’s not possible to share this type of soap compared to bar soap. Alcohol-based hand sanitizer that contain at least 60% alcohol are the perfect choice.

Athletes should shower immediately after exercise and shouldn’t share soap and towels. Washing all uniforms and clothes after each use is important. Athlete should avoid sharing items that are in contact with the skin and avoid sharing personal items as they contact the skin. Fortunately, most surfaces don’t provoke a risk of spreading staph and MRSA.

Athletes who have had MRSA

Several high school, college and professional athletes have contracted MRSA infections. There have already been epidemics among athletes on the same team. A study published in « The New England Journal of Medicine » shows an infection MRSA among St. Louis Rams professional football franchise (USA) athletes. During a single season, MRSA infections were found among 5 of 58 Rams athletes (9 percents) that was tested. All infections developed on areas of the body that are common places for turf injury.

Stats

  • Today, MRSA accounts for about 50-70% of the S. Aureus infections that are present in healthcare facilities across the world.

  • Statistics fro the Kaiser foundation in 2007 indicated that approximately 1.2 million hospitalized patients contract MRSA infections.

  • Serious MRSA infection is still predominantly related to exposure in the healthcare setting, where approximately 85 percent of all serious MRSA infections occur.

  • Fortunately, in children under 18 years old, mortality rates are much lower (1%), even though the number of hospitalized children with MRSA has almost tripled since 2002.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Heat Illness

heat illness

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Every summer, hundreds of people experience sun-related illnesses and heat. Being prepared and hydrated avoids theses situations.

Why

When an athlete exercises, his/her body temperature increase and the body sweats to cool the body. During this process, body fluids and electrolytes are lost. If the boy is not recharged with fluids and electrolytes, it’s dehydration and it increase the risk of heat illness as a heat stroke.

Symptoms

Symptoms are :

  • Chills

  • Dark colored urine

  • Dry mouth

  • Headaches

  • Thirst

  • Weakness

If the heat illness progress, there are more serious symptoms like :

  • Difficulty breathing

  • Body temperature increasing to dangerous levels

  • Muscle cramps

  • Nausea

  • Tingling of the limbs

  • Death

How to prevent

The most effective treatments for heat illness are :

  • Proper training for the heat

  • Fluid replacement before, during, and after exertion

  • Appropriate clothing (light colored, loose fitting and limited to one layer)

  • Early recognition via direct monitoring of athlete by other players, coaches and medical staff

  • Monitoring the intensity of physical activity appropriate for fitness and how an athlete has acclimated to conditions.

  • If possible, having an athletic trainer on site during events and practices to properly prevent and treat heat illnesses.

In situations where the training program is intense or during a trip in a hot climate, an athlete should limit the intensity and duration of the training session. Thereafter, the athlete will increase the training’s intensity for a period of 7-14 days to allow to the body, the time to adjust to the climate and environmental conditions. For athletes with respiratory, gastrointestinal or other diseases, they should especially evaluate these new conditions.

When an athlete should hydrate

hydrate

It’s necessary to hydrate before, during and after a training session. Drinking 47cl (16 ounces) of water is recommended 1 hour before exercises. Hydration should continue with 11-23cl (4-8 ounces) of water every 15-20 minutes throughout the effort

There is a trick to track the hydration’s level is to weigh before and after a physical activity. If the athlete is lighter after a physical activity, this means that there a deficit of fluids (indicated by weight loss) and it’s necessary to recharge them. For the next physical activity, it will be essential to drink more to evaluate the losses (perspiration). An athlete who loses more than 2-3% of his/her bodyweight during exercise may decrease the performance and the body’s physiological function.

If the athlete is heavier after a physical activity, it means that there is a surplus of fluids (indicated by gain weight). For the next physical activity, it will be essential to drink less to evaluate the surplus.

How to treat it

When you see signs of heat illness or heat stroke, it may be an imminent danger of death. It’s necessary that a person immediately call for medical assistance while you’re cooling the person at risk.

Treatment included :

  • Getting the athlete to a shaded area

  • If it heat stroke, cool the athlete rapidly using cold water immersion. If immersion is not available you may use spray from a hose, cold water sponging, or placing cold towels over the entire body

  • Monitoring body temperature

  • Providing cool beverage if possible (i.e., if the athlete doesn’t have altered consciousness).

  • Getting medical assistance as soon as possible.

Heat exhaustion is a type of heat illness that can happen after several days of exposure to high temperature and improper or unbalanced fluid recharging.

Statistics

  • Heat stroke is a type of serious illness related to heat. It can cause death to athletes and this is probably the leading cause of athlete death during the months of July and August.

  • The body produces 1.8 liters (a half of gallon) of perspiration to cool the body every hour. If there are not enough fluids or the heat is overwhelming the body, the person may develop heat-related illness.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here.

Concussion

concussion
A blow to the head that makes the brain hit the skull

What’s up ? This is THE stephane ANDRE. With my training, I’m interessed in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

A concussion is a traumatic brain injury that alters mental state or creates others symptoms. Many people think they have no concussion because they have not lost consciousness. You must know that it’s possible to have a concussion without losing consciousness. Often football or rugby players say : « I just got my bell rung » when they have been hit on the head that makes the ears rings, but these symptoms are often consistent with concussion.

Signs

  • Balance problems

  • Difficulty communicating, concentrating

  • Dizziness

  • Drowsiness

  • Fatigue

  • Feeling emotional

  • Feeling mentally foggy

  • Headache

  • Irritability

  • Memory difficulties

  • Nausea

  • Nervousness

  • Numbness or tingling

  • Sadness

  • Sensitivity to light or noise

  • Sleeping more than usual or difficulty falling asleep

  • Visual problems (blurry or double vision)

  • Vomiting

Diagnostic

diagnostic

As soon as a concussion is suspected, a trained coach, certified athletic trainer or the team physician should immediately perform an initial « sideline » evaluation, including :

  • Symptoms list review

  • Focused neurological exam

  • Focused orientation exam that tests short-term memory recall such as the event, play, opponent, score or last meal.

  • Focused orientation exam that tests long-term recall such as name, birth date, place of birth.

  • Assessment of athlete’s ability to stay attentive to a complex task such as reciting months backwards.

If a person is suspected of having a concussion and there is no diagnosis, a concussion may place an athlete at risk of developing second impact syndrome. It’s a potentially fatal injury that occurs when an athlete suffers a second head injury before the old head injury has completely healed.

Second impact syndrome

Second impact syndrome is a potentially fatal injury that occurs when an athlete suffers a second head injury before the old head injury has been fully healed. Unfortunately, it’s complicated to know if the brain has been healed from the first injury. Even after all symptoms resolved, it’s possible that the healing isn’t complete and that it increases the risk to the brain of having the second impact syndrome. Neurocognitive testing can help doctors or physician decide when the athlete can return to the competition in the best conditions.

Neurocognitive testing

Neurocognitive testing

Neurocognitive testing is a questionnaire (usually on the computer) that athletes do that deals with several areas of brain function, including memory, problem solving, reaction times, brain processing speed and post-concussion symptoms. It’s most valid if the athlete has a pre-injury baseline test on file to compare the post concussion test. This information can be really helpful for the doctor or physician to decide when the athlete can return to the competition.

When to return to the competition

All athletes suffer concussion (whatever the gravity) should pass an evaluation by a qualified health care provider before returning to the competition. Athletes should return to competition after they have been completely cleared of all concussion symptoms and have no symptoms during and after physical tests.

Baseline testing is important for assessing concussion symptoms after an incident. The baseline testing often includes neurocognitive tests, symptom checklists, sideline assessment tools such as the Sideline Concussion Assessment Tool and balance testing.

Statistics

  • Athletes who have already had a concussion are more likely to have another concussion.

  • Children and teenagers are more likely to have concussion and take longer to heal than adults.

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-Steph