Do depressive symptoms predict the incidence of myocardial infarction independent of hopelessness?

Depression and hopelessness predict myocardial infarction (MI), but it is unclear whether depression and hopelessness are independent predictors of MI incidents. Hopelessness, depression, and MI incidence rate 18 years later were measured in 2005 men. Cox regressions were conducted with hopelessness and depression serving as individual predictors of MI. Another Cox model examined whether the two predictors predict MI when adjusting for each other. Depression and hopelessness predicted MI in independent regressions but when adjusting for each other, hopelessness, but not depression, predicted MI incidents. Thus, these results suggest that depression and hopelessness are not independent predictors of MI

Eating behaviours, menstrual history and the athletic career : a retrospective survey from adolescence to adulthood in female endurance athletes

Aim To evaluate differences in menstrual and pubertal history and trends in eating behaviours among women with and without a competitive sports background. Additionally, we investigated if menstrual history and eating behaviours are associated with sports career-related factors.Methods This retrospective study was conducted on 100 women with a competitive endurance sports background and their age-matched, gender-matched and municipality-matched controls (n=98). Data were collected using a questionnaire using previously validated instruments. Generalised estimating equations were used to calculate associations of menstrual history and eating behaviours with outcome variables (career length, participation level, injury-related harms and career termination due to injury).Results Athletes reported higher rates of delayed puberty and menstrual dysfunction than controls. No differences between the groups were observed in the Eating Disorder Examination Questionnaire short form (EDE-QS) scores at any age. Previous disordered eating (DE) was associated with current DE in both groups. Among athletes, higher EDE-QS scores during the sports career were associated with a shorter career (B=-0.15, 95% CI -0.26 to -0.05). Secondary amenorrhoea was associated with lower participation level (OR 0.51, 95% CI 0.27 to 0.95), injury-related harms during the career (OR 4.00, 95% CI 1.88 to 8.48) and career termination due to injury (OR 1.89, 95% CI 1.02 to 3.51).Conclusion The findings indicate that DE behaviours and menstrual dysfunction, specifically secondary amenorrhoea, have a disadvantageous relationship with a sports career in women competing in endurance sports. DE during the sports career is associated with DE after the career.Peer reviewe

The prevalence of cardiac complications and their impact on outcomes in patients with non-traumatic subarachnoid hemorrhage.

Subarachnoid hemorrhage (SAH) is a serious condition, and a myocardial injury or dysfunction could contribute to the outcome. We assessed the prevalence and prognostic impact of cardiac involvement in a cohort with SAH. This is a prospective observational multicenter study. We included 192 patients treated for non-traumatic subarachnoid hemorrhage. We performed ECG recordings, echocardiographic examinations, and blood sampling within 24 h of admission and on days 3 and 7 and at 90 days. The primary endpoint was the evidence of cardiac involvement at 90 days, and the secondary endpoint was to examine the prevalence of a myocardial injury or dysfunction. The median age was 54.5 (interquartile range [IQR] 48.0-64.0) years, 44.3% were male and the median World Federation of Neurological Surgeons (WFNS) score was 2 (IQR 1-4). At day 90, 22/125 patients (17.6%) had left ventricular ejection fractions ≤ 50%, and 2/121 patients (1.7%) had evidence of a diastolic dysfunction as defined by mitral peak E-wave velocity by peak e' velocity (E/e') > 14. There was no prognostic impact from echocardiographic evidence of cardiac complications on neurological outcomes. The overall prevalence of cardiac dysfunction was modest. We found no demographic or SAH-related factors associated with 90 days cardiac dysfunction

Self-Reported Restrictive Eating, Eating Disorders, Menstrual Dysfunction, and Injuries in Athletes Competing at Different Levels and Sports

The purpose of this study was to investigate the prevalence of self-reported restrictive eating, current or past eating disorder, and menstrual dysfunction and their relationships with injuries. Furthermore, we aimed to compare these prevalences and associations between younger (aged 15-24) and older (aged 25-45) athletes, between elite and non-elite athletes, and between athletes competing in lean and non-lean sports. Data were collected using a web-based questionnaire. Participants were 846 female athletes representing 67 different sports. Results showed that 25%, 18%, and 32% of the athletes reported restrictive eating, eating disorders, and menstrual dysfunction, respectively. Higher rates of lean sport athletes compared with non-lean sport athletes reported these symptoms, while no differences were found between elite and non-elite athletes. Younger athletes reported higher rates of menstrual dysfunction and lower lifetime prevalence of eating disorders. Both restrictive eating (OR 1.41, 95% CI 1.02-1.94) and eating disorders (OR 1.89, 95% CI 1.31-2.73) were associated with injuries, while menstrual dysfunction was associated with more missed participation days compared with a regular menstrual cycle (OR 1.79, 95% CI 1.05-3.07). Our findings indicate that eating disorder symptoms and menstrual dysfunction are common problems in athletes that should be managed properly as they are linked to injuries and missed training/competition days

Sports and exercise medicine clinic in public hospital settings : a real-life concept and experiences of the treatment of the first 1151 patients

Objective Physical exercise has been shown to have a variety of health-promoting effects, including improvements in cardiorespiratory and muscular fitness, symptoms and risk factors such as LDL and HDL cholesterol, triglyceride and glycosylated hemoglobin concentrations. Regular physical exercise may slow down or even reverse the progression of various non-communicable diseases (NCDs). Despite the overwhelming evidence, physical exercise is not comprehensively used as a treatment component either in primary care or in hospital settings. Methods The outpatient Sports and Exercise Medicine Clinic (SEMC) is the first specialized clinic in Finland to use physical exercise as a part of the public health care system. Patients needing specialist attention due to NCDs, usually combined with sedentary lifestyles, are referred to the clinic. Results The prerequisites for patient referral are the known efficacy of physical exercise intervention in the treatment of disease and the need for sports and exercise medicine expertise. The focus of the clinic is to implement physical activity into daily life with other health-promoting habits such as diet, rest and the reduction of substance use. In addition, SEMC promotes the inclusion of physical exercise in several local treatment guidelines in the hospital district. The advisory treatment protocol of SEMC consists of a baseline evaluation, face-to-face visits with a physician and/or physiotherapist at 3, 6 and 9–12 months, and contacts via phone between hospital visits. Laboratory tests, body composition, walking tests, and measurements of muscle strength and balance are performed at baseline, and body composition and physical tests are repeated after 6 and 9–12 months. Conclusions At the core of the treatment is individualization, using motivational interviewing, considering the patients’ personal interests and resources, and encouraging the patient to be an active member of our multi-professional team. We reported the first results in the SEMC with future development plans for the clinic.peerReviewe

Increased risk of respiratory viral infections in elite athletes:a controlled study

Abstract Background: Respiratory symptoms are commonly recognised in elite athletes. The occurrence, etiology and clinical presentation of the illnesses in athletes is unclear. Methods: We performed a prospective controlled study of respiratory viral infections in Team Finland during Nordic World Ski Championships 2019. There were 26 athletes and 36 staff members. Nasal swabs were taken at the onset of a symptom and on days 1, 7, and 13 during the follow-up of 14 days. Respiratory viruses were searched for by 3 different molecular multiplex tests. Fifty-two matched control subjects were studied in Finland during the same period. Results: Ten out of 26 (38%) athletes, 6 out of 36 (17%) staff, and 3 out of 52 (6%) control subjects experienced symptoms of respiratory infection (p = 0.0013). The relative risks for acquiring symptomatic infection were 6.7 (95% confidence interval [CI], 2.1–21.0) of athletes and 2.9 (95% CI, 0.84–10.0) of the staff as compared to the controls. Asymptomatic infections were identified in 8%, 22%, and 19%, respectively (p = 0.30). The etiology of respiratory infections was detected in 84% of the cases. Conclusion: The athletes had a 7-fold increase in the risk of illness compared to normally exercising control subjects

Self-Reported Restrictive Eating, Eating Disorders, Menstrual Dysfunction, and Injuries in Athletes Competing at Different Levels and Sports

The purpose of this study was to investigate the prevalence of self-reported restrictive eating, current or past eating disorder, and menstrual dysfunction and their relationships with injuries. Furthermore, we aimed to compare these prevalences and associations between younger (aged 15–24) and older (aged 25–45) athletes, between elite and non-elite athletes, and between athletes competing in lean and non-lean sports. Data were collected using a web-based questionnaire. Participants were 846 female athletes representing 67 different sports. Results showed that 25%, 18%, and 32% of the athletes reported restrictive eating, eating disorders, and menstrual dysfunction, respectively. Higher rates of lean sport athletes compared with non-lean sport athletes reported these symptoms, while no differences were found between elite and non-elite athletes. Younger athletes reported higher rates of menstrual dysfunction and lower lifetime prevalence of eating disorders. Both restrictive eating (OR 1.41, 95% CI 1.02–1.94) and eating disorders (OR 1.89, 95% CI 1.31–2.73) were associated with injuries, while menstrual dysfunction was associated with more missed participation days compared with a regular menstrual cycle (OR 1.79, 95% CI 1.05–3.07). Our findings indicate that eating disorder symptoms and menstrual dysfunction are common problems in athletes that should be managed properly as they are linked to injuries and missed training/competition days.peerReviewe

Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity

This study aimed to investigate the associations of competitive sport participation in adolescence and age at menarche (AAM) with body composition, femoral neck bone mineral density (BMD), physical performance, and physical activity (PA) in middle-aged women. 1098 women aged 47–55 years formed the sample of this retrospective study. Participants self-reported their PA level at age 13–16 years and AAM. The protocol also included dual-energy X-ray absorptiometry, physical performance tests, and accelerometer-measured PA. Participants were divided into three groups according to their PA level at the age of 13–16 (no exercise, regular PA, and competitive sport) and according to their AAM (≤12, 13, and ≥14 years). After adjusting for potential confounding factors, participation in competitive sport at age 13–16 was associated with higher midlife lean mass and BMD, and better physical performance compared to groups with no exercise or regular PA. Individuals with AAM ≥ 14 years had lower midlife BMI and fat mass than participants in the other AAM groups and pre- and perimenopausal women with AAM ≥ 14 years had lower BMD than those with AAM ≤ 12. The findings indicate that participation in competitive sport in adolescence is associated with healthier body composition, higher BMD, and better physical performance in midlife, but BMD might be impaired if menarche occurs late.peerReviewe

Associations of cardiorespiratory fitness, body composition, and blood pressure with arterial stiffness in adolescent, young adult, and middle-aged women

Few studies have investigated whether higher cardiorespiratory fitness (CRF) or favourable body composition are related to lower arterial stiffness in women. We therefore investigated the associations of CRF, body fat percentage (BF%), fat free mass index (FFMI), and mean arterial pressure (MAP) with arterial stiffness in 146 women aged 16–58 years. CRF was assessed by a maximal exercise test with respiratory gas analysis either on a cycle ergometer or a treadmill. Aortic pulse wave velocity (PWVao), augmentation index (AIx%), and MAP were assessed by a non-invasive oscillometric device and BF% and FFMI by a bioelectrical impedance or DXA device. CRF was inversely associated with PWVao (β =  − 0.004, 95% CI − 0.005 to − 0.002) and AIx% (β =  − 0.075, 95% CI − 0.102 to − 0.048) and these associations remained similar after adjustment for BF% or MAP, but not after the adjustment for age. FFMI was inversely associated with PWVao (β =  − 0.010, 95% CI − 0.019 to − 0.002) and MAP directly associated with PWVao (β = 0.005, 95% CI 0.003 to 0.006) and AIx% (β = 0.092, 95% CI 0.069 to 0.116) and the associations with PWVao also remained after further adjustments for BF% and age. In conclusion, a higher FFMI and a lower MAP were independently associated with lower arterial stiffness.peerReviewe

Menstrual dysfunction and body weight dissatisfaction among Finnish young athletes and non‐athletes

To determine the prevalence of menstrual dysfunction (MD; i.e. oligomenorrhea or amenorrhea) and attitudes towards body weight among athletes and non‐athletes, we studied a cohort of athletes and non‐athletes, in adolescence (14–16 years) and subsequently in young adulthood (18–20 years). We further studied the differences between athletes reporting MD and eumenorrheic athletes at both time periods and identified physical and behavioural characteristicsthat might predict MD in young adulthood. Data were collected using questionnaires, accelerometers, and a pre‐participation screening. In adolescence, the athletes reported current primary amenorrhea more often than the non‐athletes (4.7% vs. 0%, p=0.03). In young adulthood, athletes reported MD more frequently than non‐athletes (38.7% vs. 5.6%, p<0.001). Athletes had less desire than non‐athletes to lose weight at both time points, and in adolescence athletes were more satisfied with their weight. However, about one fifth of the athletes and about 40% of the non‐athletes experienced body weight dissatisfaction at both time points. In adolescence, athletes reporting MD had lower BMI than eumenorrheic athletes. In young adulthood, athletes with MD were more physically active than eumenorrheic athletes. The only longitudinal predictor of MD in young adulthood was MD in adolescence.Our findings indicate that MD is relatively frequent among young Finnish athletes. However, athletes appear to have a smaller tendency to experience body weight dissatisfaction than their non‐athletic peers. MD seems to track from adolescence to adulthood, suggesting that there is a need to focus on possible causes at the earliestfeasible phaseof an athlete’s career.peerReviewe