Association between thermal responses, medical events, performance, heat acclimation and health status in male and female elite athletes during the 2019 Doha World Athletics Championships

Please read abstract in the article.The World Athletics Health and Science Department.http://bjsm.bmj.comhj2022Sports Medicin

Asymptomatic dengue infection rate : a systematic literature review

Objectives: Dengue infection is spreading worldwide. The clinical spectrum is broad and includes asymptomatic infections. This review provides an overview of the different proportions of asymptomatic infections described in epidemiological studies according to definitions, study designs, and detection methods. Methods: Medline and Embase databases were searched without restriction of date or language. Studies were included if they reported data on the incidence or prevalence of asymptomatic dengue infections. The data were summarized and classified according to the definitions of the term 'asymptomatic'. Results: A total of 74 studies were included. The mean proportion of asymptomatic infections among dengue-infected persons was 54% in 50 included studies. The prevalence of dengue infections detected in healthy persons was 0.2% in 24 included studies. The term 'asymptomatic' has been used to refer to 'clinically undetectable infection', but also to 'undiagnosed infection' or 'mild infection'. Only 8% were clinically undetectable laboratory-confirmed dengue infections. Conclusion: The proportion of asymptomatic dengue infections varied greatly. Studies proving data on clinically undetectable laboratory-confirmed dengue infections were very few, but provided consistent results of low proportions of asymptomatic infections. These data challenge the assumption that the majority of dengue cases are asymptomatic.</p

Comparing the effects of self-selected music versus predetermined music on patient anxiety prior to gynaecological surgery: a study protocol for a randomised controlled trial

International audienceBackgroundPatients undergoing gynaecological surgery are known to experience anxiety. While the use of music selected by patients based on their personal taste has hardly been evaluated, a recent study suggests that musical preferences significantly alter the anxiolytic and relaxing effects of music. Our study aims to determine whether self-selected music decreases patient anxiety prior to gynaecological surgery, as compared with predetermined music from a software programme such as MUSIC CARE®.MethodsThe study will consist of a clinical trial comparing the effects of self-selected music versus predetermined music on patient anxiety prior to gynaecological surgery. A minimum of 170 patients will be randomised in a 1:1 ratio. Inclusion criteria will be: women aged 18–55 years, awaiting scheduled gynaecological surgery under general/local anaesthesia or under sedation; having created a personal 20-min playlist; and not having received anxiolytic drugs prior to surgery. The primary outcome will be the difference between the preoperative anxiety score taken 15 to 20 min before the music-listening session and the preoperative anxiety score taken shortly after the session, as measured with the STAI for state anxiety.DiscussionThis study should help to identify more effective non-medical treatments for preoperative anxiety, as well as to adapt music therapy to the cultural context of patients

Running Endurance in Women Compared to Men: Retrospective Analysis of Matched Real-World Big Data

International audienceBackground and ObjectiveTo determine whether the gap in endurance performance between men and women is reduced as distances increase, i.e. if there is a sex difference in endurance, one can analyse the performance of elite runners, all participants, or one can pair women and men during short-distance events and examine the difference over longer distances. The first two methods have caveats, and the last method has never been performed with a large dataset. This was the goal of the present study.MethodsA dataset including 38,860 trail running races from 1989 to 2021 in 221 countries was used. It provided information on 1,881,070 unique runners, allowing 7251 pairs of men and women with the same relative level of performance to be obtained, i.e. the same percentage of the winner time of the considered race on short races (25–45 km-effort) that were compared during longer races (45–260 km-effort). The effect of distance on sex differences in average speed was determined using a gamma mixed model.ResultsThe gap between sexes decreased as distance increases, i.e. men's speed decreased by 4.02% (confidence interval 3.80–4.25) for every 10 km-effort increase, whereas it decreased by 3.25% (confidence interval 3.02–3.46) for women. The men-women ratio decreases from 1.237 (confidence interval 1.232–1.242) for a 25 km-effort to 1.031 (confidence interval 1.011–1.052) for a 260 km-effort. This interaction was modulated by the level of performance, i.e. the greater the performance level of the runner, the lower the difference in endurance between sexes.ConclusionsThis study shows for the first time that the gap between men and women shrinks when trail running distance increases, which demonstrates that endurance is greater in women. Although women narrow the performance gap with men as race distance increases, top male performers still outperform the top women

Rehabilitation program combining physical exercise and heart rate variability biofeedback in hematologic patients: a feasibility study

International audienceAbstract Purpose Hematologic patients have a poorer health-related quality of life due to the disease and its treatments. Non-pharmacological interventions represent an opportunity in tertiary cancer prevention to manage persistent symptoms and support patients in their return to active daily living. This interventional study aimed to evaluate the feasibility of a program combining physical exercise (PE) and heart rate variability biofeedback (HRVB) in hematologic patients. Method Hematologic patients in remission within 6 months participated in a 12-week rehabilitation program including 24 supervised sessions of PE associated with 10 supervised sessions of HRVB and daily home-based practice of paced breathing. We assessed patient adherence, fatigue, physical function, and heart rate variability. Results Twenty patients were included, 17 completed the protocol and 3 dropped out due to disease progression or time constraints; no adverse events or incidents were reported. Participation rates were 85% for PE and 98% for HRVB-supervised sessions. Significant improvements of physical capacity (6-min walk test, p  0.05). Conclusion A rehabilitation program combining PE and HRVB is feasible in hematologic patients and effective on physical function. Further research with a larger sample size is needed to investigate effectiveness on patients’ autonomic functions and their impacts on symptomatology

Adapted physical activity and cardiac coherence in hematologic patients (APACCHE): study protocol for a randomized controlled trial

International audienceBackground: Hematologic malignancies and their treatments are recognized for their significant long-term adverse effects on health-related quality of life. As a part of cancer treatment, physical exercise is known to improve physical functioning, but there are still questions regarding its impact on psychological and emotional functioning. Nonetheless, heart rate variability biofeedback (HRVB) is recognized for its positive effects on autonomic nervous system balance and emotional self-regulation. The Adapted Physical Activity and Cardiac Coherence in Hematologic Patients (APACCHE) protocol is a randomized, controlled superiority trial designed to evaluate the effects of HRBV training combined with an adaptive physical activity (APA) program compared to APA alone on the post-treatment quality of life of adult hematologic patients. Methods: Seventy patients aged 18-70 years, with various forms of hematological malignancies, in posttreatment remission within six months prior to beginning the study and who have been prescribed APA by a hematologist, will be randomly allocated in a 1:1 ratio to two 12-week treatment groups: HRVB + APA versus APA alone. APA sessions will consist of aerobic and resistance training for 1-h twice weekly. The HRVB training will consist of controlled breathing exercises with biofeedback of heart rate variability for 10 sessions and will include a daily home-based practice. The primary outcome will be to evaluate health-related quality of life (QLQ-C30, SF-36). The secondary outcomes will be to evaluate fatigue (MFI-20); anxiety and depression (HADS); clinical status with blood pressure, progression-free survival, overall survival, and body mass index; heart rate variability level and cardiac coherence score. All of these assessments will be evaluated initially (T1), 6 weeks after (T2), at the end of the 12 weeks (T3), and then at a 12-week post-intervention follow-up (T4)

: Exploitation des données de l’enquête transversale ERPPS-2021 à La Réunion

La Réunion est un territoire exposé depuis plusieurs décennies à une transition démographique, épidémiologique et nutritionnelle. D’après l’enquête santé européenne 2019 réalisée chez les personnes vivant à domicile (≥ 15 ans), 23-% de la population réunionnaise adulte présenterait un excès de sédentarité. Dans la perspective d’actions territorialisée basées sur la réduction des facteurs de risque, le comportement sédentaire apparaît comme un facteur modifiable de première importance. Notre objectif est de rechercher les déterminants individuels, sociaux et environnementaux de la sédentarité chez les Réunionnais.es de 15 ans et plus.La réponse à cet objectif s’appuie sur une approche méthodologique pluridisciplinaire combinant l’analyse statistique en santé et l’analyse spatiale. Les données utilisées sont celles de l’enquête régionale sur les pratiques physiques et sportives à La Réunion réalisée en septembre-décembre 2021 (ERPPS-2021), enrichies de bases environnementales (Filosofi, BD TOPO IGN, Base Permanente des Equipements, etc.).Cette enquête téléphonique transversale ponctuelle a fait l’objet d’un échantillonnage aléatoire à partir de la base de sondage Fidéli (Insee).Les analyses statistiques portent sur 2010 participants issus des 4 microrégions de l'île. L'exploitation des données déclaratives (comportements de santé, facteurs psychosociaux, conditions de vie et de travail, caractéristiques socio-économiques du lieu de résidence) et spatiales (facteurs environnementaux) est en cours.Il s’agit d’une approche originale, fondée sur des données probantes, à la frontière de l’épidémiologie sociale et de la géographie de la santé, qui laisse entrevoir des pistes en prévention primaire des maladies chroniques liées au mode de vie

Prevalence and risk factors of Mycoplasma genitalium infection in patients attending a sexually transmitted infection clinic in Reunion Island: a cross-sectional study (2017–2018)

International audienceBackground: Mycoplasma genitalium (MG) is an emerging sexually transmitted infection (STI) for whose management remains controversial. We aimed to assess the prevalence and risk factors of MG infection in patients attending an STI clinic in Reunion Island. Methods: Between January 2017 and December 2018, all patients attending the Saint-Pierre STI clinic in Reunion Island were screened for MG, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Urogenital, pharyngeal and/or anal samples were collected based on sexual behaviour and analysed by triplex PCR. Risk factors were identified using a Poisson regression for binary outcome. Results: Among 2069 screened subjects, the overall prevalence of MG was 4.88% [95% Confidence Interval (CI) 3.98-5.93]. The prevalence of urogenital MG was 4.38%, with women being more affected than men (5.33% vs 3.22%, prevalence ratio (PR) 1.66, p = 0.02). The prevalence of anal MG was 3.06% and that of pharyngeal MG was 0.61%, with men being more affected in both cases. Infection with MG was independently associated with multiple partners (6-10 partners: adjusted prevalence ratio-aPR 2.55, p 10 partners: aPR 4.33, p < 0.004), previous history of STI (aPR 1.89, p = 0.026), non-use of condoms (aPR 2.56, p < 0.003) and co-infection with CT (aPR 2.56, p < 0.017). Conclusion: Compared to other countries, the prevalence of MG is high in Reunion Island, especially in women aged under 25 years, and co-infection with CT is common. Routine MG screening and treatment should be performed in at-risk women and co-infection with MG should be considered when deciding on treatment for CT, particularly in regions where azithromycin is still in use

Health Impacts of the COVID-19 Lockdown Measure in a Low Socio-Economic Setting: A Cross-Sectional Study on Reunion Island

International audienceIn March 2020, the French government implemented nationwide measures to reduce social contact and slow the progression of the emerging coronavirus responsible for COVID-19, the most significant being a complete home lockdown that lasted 8 weeks. Reunion Island is a French overseas department marked by large social inequalities. We draw the hypothesis that distancing and lockdown measures may have contributed to an increase in the social inequalities in health (SIH) on Reunion Island. The aim of our study was to describe the SIH during lockdown in the Reunionese population. We implemented a cross-sectional telephone survey conducted between 13 May and 22 July 2020, using a retrospective data collection on the lockdown period. A total of 892 adult participants (≥18 years) were recruited in the 114 large Reunionese neighborhoods using the quota method within the national "White Pages" telephone directory. Degraded psychological states, an increase in addictive behaviors, difficulties in accessing food, a decrease in physical activity, delayed medical appointments, violence against women, and health problems in children were driven by the socioeconomic characteristics of the population, most often to the disadvantage of social groups exposed to poor living conditions. These results suggest that the COVID-19 lockdown contributed to an increase in SIH

Investigation of Dengue Infection in Asymptomatic Individuals during a Recent Outbreak in La Réunion

International audienceThe number of dengue cases has increased dramatically over the past 20 years and is an important concern, particularly as the trends toward urbanization continue. While the majority of dengue cases are thought to be asymptomatic, it is unknown to what extent these contribute to transmission. A better understanding of their importance would help to guide control efforts. In 2019, a dengue outbreak in La Reunion resulted in more than 18,000 confirmed cases. Between October 2019 and August 2020, 19 clusters were investigated in the south, west, and east of the island, enabling the recruitment of 605 participants from 368 households within a 200 m radius of the home of the index cases (ICs). No active asymptomatic infections confirmed by RT-PCR were detected. Only 15% were possible asymptomatic dengue infections detected by the presence of anti-dengue IgM antibodies. Only 5.3% of the participants had a recent dengue infection confirmed by RT-PCR. Although the resurgence of dengue in La Réunion is very recent (2016), the rate of anti-dengue IgG positivity, a marker of past infections, was already high at 43% in this study. Dengue transmission was focal in time and space, as most cases were detected within a 100-m radius of the ICs, and within a time interval of less than 7 days between infections detected in a same cluster. No particular demographic or socio-cultural characteristics were associated with dengue infections. On the other hand, environmental risk factors such as type of housing or presence of rubbish in the streets were associated with dengue infections