Autonomic response to exercise as measured by cardiovascular variability

Motivation. There is growing interest in the use of cardiovascular variability indicators as measures of autonomic activity, even though reported results are not always comparable or as expected. This review aims to determine the consistency of results reported on the autonomic response to physical exercise as measured by heart rate variability, blood pressure variability and baroreceptor sensitivity. Method. An Ovid MEDLINE Database search for the period 1950 - March 2008 produced 46 articles for review. The published articles that evaluate the effect of exercise on the autonomic nervous system (ANS) are summarised in three categories: the response of the ANS during a bout of exercise, directly after exercise (recovery measurements), and after a long-term exercise programme. Results. Articles on the effect of training on the ANS as measured by cardiovascular variability indicators show increased variability, decreased variability, and no change in variability. Conclusion. Findings in this review emphasise that standardisation and refinement of these measuring tools are essential to produce results that can be repeated and used as reference. Standardisation is essential as these measurements are increasingly employed in studies regarding investigations of central autonomic regulation, those exploring the link between psychological pro cesses and physiological functioning, and those indicating ANS activity in response to exercise, training and overtraining. This review shows that important aspects are inter-individual differences, duration and intensity of the exercise programme, and choice and specific implementation of variability analysis techniques. South African Journal of Sports Medicine Vol. 20 (4) 2008: pp. 102-10

Delayed onset muscle soreness: No pain, no gain? The truth behind this adage

The purpose of this article is to provide brief insight into delayed onset muscle soreness (DOMS), a phenomenon that is often experienced by recreational and elite athletes. The negative implications of DOMS include pain, decreased motivation to continue training, and decreased performance. While performance issues may be more relevant to the elite athlete, pain and decreased motivation are  particularly relevant to recreational athletes wishing to sustain a regular level of physical activity. The article is aimed at general practitioners (GPs) who may encounter athletes presenting with DOMS, and who will benefit from understanding the proposed mechanisms, signs and symptoms of the condition. Numerous researchers have hypothesised that certain interventions may prevent or minimise the symptoms thereof, and all GPs could benefit from understanding the available options for athletes, and the scientific evidence that supports these options.Keywords: delayed onset muscle soreness, mechanism, symptoms, treatment, athletes, managemen

Evidence-based prescription for cyclo-oxygenase-2 inhibitors in sports injuries

Healthcare professionals are increasingly under pressure to return athletes to play in the shortest possible time. There is limited choice in providing treatment that speeds up tissue repair, while simultaneously maintaining good quality of healing. Inflammation forms a fundamental part in the process of tissue repair. However, excessive inflammation may cause more pain, and limit functional restoration. Although the use of anti-inflammatory treatment in the form of a cyclo-oxygenase-2 inhibitor (coxibs) has been widely recognised as being effective, the potential detrimental effect on tissue repair, as described mainly in animal model studies, needs to be taken into account. The side-effects profile on the gastrointestinal tract favour coxibs over non-traditional NSAIDs. The possible effects on the renal and cardiovascular systems also need to be considered. The prescription of coxibs should be pathology and situation specific. There are no clear guidelines on the correct time of administration and the duration of the course, but it seems that the literature is in agreement that they should be administered for a limited time at the lowest effective dose possible.Keywords: cyclo-oxygenase-2 inhibitors (coxibs), sports injuries, treatmen

Shouldering the blame for impingement: the rotator cuff continuum

The aim of this article was to summarise recent research on shoulder impingement and rotator cuff pathology. A continuum model of rotator cuff pathology is described, and the challenges of accurate clinical diagnosis, imaging and best management discussed.Keywords: shoulder impingement syndrome, subacromial impingement syndrome, rotator cuff, tendinopathy, rehabilitatio

Detection of spatiotemporal variation in ranavirus distribution using eDNA

Amphibian population declines have been associated with emerging diseases including ranaviruses, which can cause mass die‐offs across entire amphibian communities. Understanding and mitigating disease spread requires knowledge of spatial and temporal patterns of pathogen distribution, but also how environmental factors influence pathogen occurrence. We applied environmental DNA (eDNA) detection tools to survey spatial and temporal distributions of ranaviruses by sampling 103 waterbodies in southeastern Ontario, Canada and assessed the role of abiotic factors as predictors of pathogen occurrence. Ten waterbodies sampled during June–August (>30 km between sites) revealed that ranavirus was marginally more prevalent (p = .055) during the latter part of the summer. Ninety‐three sites sampled at a finer scale (<10 km between sites) exhibited seasonal variability in ranavirus detection (site prevalence: 56% May; 66% July). Occupancy modeling revealed that wetland size and elevation influenced ranavirus occurrence while sampling date and water temperature influenced probability of detection. These findings indicate that biotic factors, such as host density and alternative hosts, should be investigated further as likely determinants of ranavirus prevalence across the landscape. Further, these results highlight the sensitivity of eDNA for detecting widespread presence of ranavirus and that abiotic factors may have a limited role in determining its prevalence and infectivity

Solar UV Doses of Young Americans and Vitamin D3 Production

Background: Sunlight contains ultraviolet B (UVB) radiation (290–315 nm) that affects human health in both detrimental (skin cancers) and beneficial (vitamin D3) ways. Serum 25-hydroxyvitamin D concentrations from young Americans (≤ 19 years) show that many have deficient (< 50 nmol/L, 20 ng/mL) or insufficient (< 75 nmol/L, 30 ng/mL) vitamin D levels, indicating that they are not getting enough sun exposure. Those findings are in conflict with some calculated, published values that suggest people make “ample” vitamin D3 (~ 1,000 IU/day) from their “casual,” or everyday, outdoor exposures even if they diligently use sunscreens with sun protection factor (SPF) 15

Identifying risk factors that contribute to acute mountain sickness

Background. Acute mountain sickness (AMS) is an ever-increasing burden on the health sector. With reported incidences of greater than 50%, coupled with the fact that recreational activities at high altitude are gaining increasing popularity, more persons are developing AMS. Physicians are therefore increasingly faced with the task of managing and preventing AMS.Objectives. The pathophysiology of AMS is poorly understood, with little understanding of risk factors for the development of AMS. This research aimed to identify epidemiological and physiological risk factors for development of AMS.Methods. This study is a questionnaire-based study conducted in London and at Everest Base Camp, in which 116 lowlanders were invited to participate and fill in a questionnaire to identify potential risk factors in their history that may have contributed to development of or protection against AMS.Results. A total of 89 lowlanders enrolled in the study. Thirty-seven of the participants had AMS at  Everest Base Camp, giving a prevalence of 42%. Of the demographic variables, only weight and body  mass index (BMI) were statistically significantly associated with AMS, with those who weighed less or had a lower BMI more likely to get AMS. Previous high-altitude experience was also associated with AMS, with those who had such experience less likely to get AMS.Conclusion. Predicting AMS and furthering our understanding of the pathophysiology of AMS will be of tremendous benefit. Further research is needed in this regard

Sternal stress fracture in a gymnast: A case report and literature review

No Abstract

Spatial stimulation of the electrosensory system of mormyrid electric fish

Spatial stimulation of the electrosensory system of mormyrid electric fis

Clinical characteristics of pertussis-associated cough in adults and children: a diagnostic systematic review and meta-analysis

Background: Pertussis (whooping cough) is a highly infective cause of cough that causes significant morbidity and mortality. Existing case definitions include paroxysmal cough, whooping and post-tussive vomiting but diagnosis can be difficult. We determined the diagnostic accuracy of clinical characteristics of pertussis-associated cough. Methods: We systematically searched CINAHL, Embase, Medline and SCI-EXPANDED/CPCI-S up to June 2016. Eligible studies compared clinical characteristics in those positive and negative for Bordetella pertussis infection, confirmed by laboratory investigations. Two authors independently completed screening, data extraction and quality and bias assessments. For each characteristic RevMan was used to produce descriptive forest plots. We used the bivariate meta-analysis method to generate pooled estimates of sensitivity and specificity. Results: Of 1969 identified papers, 53 were included. Forty-one clinical characteristics were assessed for diagnostic accuracy. In adult patients, paroxysmal cough and absence of fever had a high sensitivity (93.2%, CI 83.2-97.4 and 81.8%, CI 72.2-88.7 respectively) and low specificity (20.6%, CI 14.7-28.1 and 18.8%, CI 8.1-37.9 respectively), whereas post-tussive vomiting and whooping had low sensitivity (32.5%, CI 24.5-41.6 and 29.8%, CI 8.0-45.2 respectively) and high specificity (77.7%, CI 73.1-81.7 and 79.5%, CI 69.4-86.9 respectively). Post-tussive vomiting in children is moderately sensitive (60.0%, CI 40.3-77.0) and specific 66.0%, CI 52.5-77.3). Conclusions: In adult patients the presence of whooping or post-tussive vomiting should rule in a possible diagnosis of pertussis, whereas the lack of a paroxysmal cough or the presence of fever should rule it out. In children, post-tussive vomiting is much less helpful as a clinical diagnostic test