Objective: Up to one-third of children with concussion have persistent postconcussion symptoms lasting beyond 4 weeks. Females have been shown to have prolonged concussion recovery compared with males. This study examined characteristics in pediatric athletes with concussion to investigate the underlying factors that may contribute to this difference and their relation to recovery trajectories in females compared with males. Design: A retrospective cohort study of pediatric patients with sports-related concussion (SRC). Setting: A subspecialty pediatric concussion program. Subjects: One hundred ninety-two records were reviewed, 75 females and 117 males, ages 7 to 18 years old. Assessment of Risk Factors: Sex of patient, time to presentation to specialty care after injury, presence of vision, and vestibular deficits on initial clinical examination. Main Outcome Measures: The main outcome of interest was time to clinical recovery, defined by resolution of symptoms, recovery of physical examination deficits, including vision and vestibular examination, recovery of neurocognitive function, and return to school, exercise, and sport. Results: Pediatric females, on average, presented later to specialty care for evaluation after SRC than males. Females also took longer to recover on 5 markers of recovery: time to return to school without accommodations, time to return to noncontact exercise, time to return to full sport, time to recovery of neurocognitive function on computerized testing, and time to clinical recovery of vision and vestibular deficits on examination including smooth pursuits, saccades, gaze stability, near point of convergence, and balance. These sex-based differences in recovery disappeared when controlling for time to presentation to specialty care. Conclusions: In this cohort of pediatric patients, ages 7 to 18 years old with SRC, females took longer to recover than males. Our results indicate, however, that a modifiable extrinsic factor, time to presentation to specialty care, may contribute to this difference in recovery between the sexes.

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Our incidence of IAFE was 16%, showing that IAFE occurs quite commonly in hip arthroscopy. Patients with IAFE had a greater increase in pain scores from baseline throughout the PACU stay. None of our patients required interventions. These findings suggest that even a small amount of new fluid in the peritoneum may be associated with a worse postoperative experience. This study brings awareness to a common yet potentially life-threatening complication of hip arthroscopy and highlights a unique and meaningful way that anesthesiologists in the perioperative setting can use POCUS to rapidly identify and guide management of these patients. Further studies with a larger sample size are needed to identify surgical and patient risk factors.

Background:Youth sports specialization has become more prevalent despite consequences such as increased injury rates and burnout. Young athletes, coaches, and parents continue to have misconceptions about the necessity of sports specialization, giving athletes the encouragement to focus on a single sport at a younger age.Purpose:To characterize the motivations for specialization and determine when elite athletes in various individual and team sports made the decision to specialize.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A Likert-style survey was developed and distributed to athletes from two National Collegiate Athletic Association (NCAA) Division I institutions. The survey’s Flesch-Kincaid grade level was 6.3. Statistical analysis was performed via the Student t test, where a P value less than .05 was considered significant.Results:A total of 303 athletes with a mean ± SD age of 19.9 ± 1.52 years across 19 sports were surveyed; 94.7% of specialized athletes had previously played another organized sport prior to college, and 45% of athletes had played multiple sports up to age 16 years. The mean age of specialization was 14.9 years, with a significant difference between athletes competing in team (15.5 years) and individual (14.0 years) sports (P = .008). Males in individual sports specialized earlier than those in team sports (P ≤ .001). Nearly one-fifth (17.4%) of athletes reported specializing at age 12 years or earlier. Personal interest, skill level, time constraints, and potential scholarships were the most important reasons for specialization overall. For individual sports, the motivations for specialization were similar, but collegiate (P < .001) or professional (P < .001) ambitions were significantly larger contributing factors.Conclusion:Early sports specialization is uncommon among NCAA Division I athletes for most team sports, whereas individual sports tend to have athletes who specialize earlier and are more motivated by professional and collegiate goals. This study characterized the timing of specialization among elite athletes, providing a basis for understanding the motivations behind youth sports specialization. Physicians should be prepared to discuss the misconception that early sports specialization is necessary or common among most team-focused collegiate-level athletes. Knowing the motivations for sports specialization will guide clinicians in their discussions with youth athletes.