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There were no deaths from Bosniak IIF or III renal cysts regardless of management approach. Moderate to severe complications are frequent in patients managed by surgery.

ObjectiveTo identify differences and gaps in the recommendations to patients for the management of sport-related concussion among family physicians (FPs), emergency physicians (ERs) and paediatricians (Peds).DesignA self-administered multiple-choice survey, which had been validated for content validity.SettingToronto East General Hospital and Markham Stouffville Hospital, both in Ontario, Canada.Subjects270 physicians were invited to participate; 104 surveys were completed (39%).InterventionThe survey link was emailed to FPs, ERs and Peds from the above hospitals. Data were analysed using SPSS. Frequencies and percentages were calculated with cross-tabulation of data by specialty.Outcome MeasuresKey survey questions identified sources of concussion management information, usefulness of concussion diagnosis strategies, and whether physicians use common terminology when explaining cognitive rest strategies to patients after a sport-related concussion.ResultsFor making a diagnosis of concussion, 54% of FPs, 86% of ERs and 78% of Peds never used the SCAT2; 49% of FPs, 57% of ERs and 36% of Peds always advised cognitive rest, the mainstay of early management for post-concussion symptoms; 65% of FPs, 71% of ERs and 55% of Peds always advised physical rest; and 49% of FPs, 52% of ERs and 27% of Peds reported no knowledge of any consensus statements on concussion in sport.ConclusionsWe identified large gaps in the implementation of recommendations for sport-related concussion patients. Although some physicians are recommending physical and cognitive rest, a large proportion fail to consistently advise this strategy. Better knowledge translation efforts should target all three groups of physicians.AcknowledgementsThank you to Babak Aliarzadeh for the statistical analysis. Special thanks go to Paul Krueger, Leigh Hayden and the other 18 participants in the validation of our survey.Competing interestsNone.

Objective To determine whether the proportion of sport-related concussion (SRC) cases among student athletes that resulted in a relapse of their symptoms due to premature return to play (RTP) or premature return to learn (RTL) has changed compared with a prior (2006 to 2011) study.Design Retrospective cohort study of electronic medical record charts from a 5-year period (2011 to 2016) compared with previous data.Setting A sport and exercise medicine physician's office-based practice in Ontario.Participants Two-hundred forty-one students who had 258 distinct cases of SRC diagnosed. Main outcome measuresPremature RTP and RTL were defined as chart records documenting the relapse, recurrence, or worsening of concussion symptoms that accompanied the patient's RTP or RTL.This article has been peer reviewed. Cet article a fait l'objet d'une révision par des pairs.