All studies of sport-related concussion use symptom reports to define recovery. A minority of studies used multiple measures of outcome or had clearly defined recovery criteria, the most common being a combination of a self-reported symptom checklist and a computerised neurocognitive test. Future studies ideally should define recovery a priori using objective physiological measures in addition to symptom reports.

Background Vitamin D is hypothesized to reduce risk for tooth loss via its influence on bone health, inflammation, and the immune response. We examined the association between plasma 25-hydroxyvitamin D (25[OH]D) concentrations and the prevalence and 5-year incidence of tooth loss in a cohort of postmenopausal women. Methods Participants underwent oral examinations at study baseline (1997–2000) and follow-up (2002–2005) to determine the number of missing teeth and the 5-year incidence of tooth loss, respectively. At both visits women self-reported reasons for each missing tooth. At baseline, 152 women reported no history of tooth loss and 628 were categorized as reporting a history of tooth loss due to periodontal disease (n=70) or caries (n=558) (total n=780). At follow-up, 96, 376, 48, and 328 women were categorized into the aforementioned categories as reasons for incident tooth loss (total n=472). Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for tooth loss by category of baseline 25(OH)D (nmol/L) concentrations. Models were adjusted for age, income, smoking status, frequency of dental visits, waist circumference and recreational physical activity. P for trend was estimated using continuous concentrations of 25(OH)D. Results Among women with 25(OH)D ≥50 (adequate vitamin D status) compared to <50 nmol/L (deficient/inadequate), the adjusted ORs (95% CI) was 1.24 [0.82–1.87], p-trend=0.049 for the history (prevalence) of tooth loss due to periodontal disease or caries and 1.07 [0.62–1.85], p-trend=0.111 for the incidence of tooth loss due to periodontal disease or caries. No statistically significant association was observed between 25(OH)D and the history or incidence of tooth loss due to periodontal disease. An increased odds of the history of tooth loss due to caries was observed with increasing concentrations of 25(OH)D (p-trend=0.045), but was not confirmed in prospective analyses. Conclusion In this cohort of postmenopausal women, the data do not support an association between vitamin D status and tooth loss.

Tranexamic acid (TXA) is an effective agent used for reducing perioperative blood loss and decreasing the potential for postoperative hemarthrosis. We hypothesized that patients who had received intraoperative TXA during total ankle arthroplasty (TAA) would have a reduction in postoperative drain output, thereby resulting in a reduced risk of postoperative hemarthrosis and lower wound complication rates. A retrospective review was conducted on 50 consecutive patients, 25 receiving TXA (TXA-TAA) and 25 not receiving TXA (No TXA-TAA), who underwent an uncemented TAA between September 2011 and December 2015. Demographic characteristics, drain output, preoperative and postoperative hemoglobin levels, operative and postoperative course, and minor and major wound complications of the patients were reviewed. Drain output was significantly less in the TXA-TAA group compared to that in the No TXA-TAA group (71.6 ± 60.3 vs 200.2 ± 117.0 mL, respectively, P < .0001). The overall wound complication rate in the No TXA-TAA group was higher (20%, 5/25) than that in the TXA-TAA group (8%, 2/25) (P = .114). The mean change in preoperative to postoperative hemoglobin level was significantly less in the TXA-TAA group compared to that in the No TXA-TAA group (1.5 ± 0.6 vs 2.0 ± 0.4 g/dL, respectively, P = .01). TXA is an effective hemostatic agent when used during TAA. TXA reduces perioperative blood loss, hemarthrosis, and the risk of wound complications.

No abstract