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To describe and compare the epidemiology of competition injuries in unarmed combat sports (ie, boxing, judo, taekwondo and wrestling) in three consecutive Olympic Games.

Prospective cohort study using injury data from the IOC injury surveillance system and exposure data from official tournament records at three consecutive Olympic Games (ie, Beijing 2008, London 2012 and Rio de Janeiro 2016). Competition injury incidence rates per 1000 min of exposure (IIR

) were calculated with 95% CIs using standard formulae for Poisson rates.

The overall IIR

was 7.8 (95% CI 7.0 to 8.7). The IIR

in judo (9.6 (95% CI 7.8 to 11.7)), boxing (9.2 (95% CI 7.6 to 10.9)) and taekwondo (7.7 (95% CI 5.6 to 10.5)) were significantly higher than in wrestling (4.8 (95% CI 3.6 to 6.2)). The proportion of injuries resulting in >7 days absence from competition or training was higher in wrestling (39.6%), judo (35.9%) and taekwondo (32.5%) than in boxing (21.0%). There was no difference in injury risk by sex, weight category or tournament round, but athletes that lost had significantly higher IIR

compared with their winning opponents (rate ratio 3.59 (95% CI 2.68 to 4.79)).

Olympic combat sport athletes sustained, on average, one injury every 2.1 hours of competition. The risk of injury was significantly higher in boxing, judo and taekwondo than in wrestling. About 30% of injuries sustained during competition resulted in >7 days absence from competition or training. There is a need for identifying modifiable risk factors for injury in Olympic combat sports, which in turn can be targeted by injury prevention initiatives to reduce the burden of injury among combat sport athletes.

7 days absence from competition or training. read more There is a need for identifying modifiable risk factors for injury in Olympic combat sports, which in turn can be targeted by injury prevention initiatives to reduce the burden of injury among combat sport athletes.The COVID-19 pandemic has created a public health crisis. Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary.The recovery process of COVID-19 patients is unclear. Some recovered patients complain of continued shortness of breath. Vasculopathy has been reported in COVID-19, stressing the importance of probing pulmonary microstructure and function at the alveolar-capillary interface. While computed tomography (CT) detects structural abnormalities, little is known about the impact of disease on lung function. 129Xe magnetic resonance imaging (MRI) is a technique uniquely capable of assessing ventilation, microstructure, and gas exchange. Using 129Xe MRI, we found that COVID-19 patients show a higher rate of ventilation defects (5.9% versus 3.7%), unchanged microstructure, and longer gas-blood exchange time (43.5 ms versus 32.5 ms) compared with healthy individuals. These findings suggest that regional ventilation and alveolar airspace dimensions are relatively normal around the time of discharge, while gas-blood exchange function is diminished. This study establishes the feasibility of localized lung function measurements in COVID-19 patients and their potential usefulness as a supplement to structural imaging.

Natriuretic peptides are an important prognostic marker in patients with heart failure (HF). However, little is known regarding their prognostic significance in patients with atrial fibrillation (AF) without HF and natriuretic peptides levels are underused in these patients in daily practice.

The Fushimi AF Registry is a community-based prospective survey of patients with AF in Fushimi-ku, Kyoto, Japan. We investigated patients with AF without HF (defined as prior HF hospitalisation, New York Heart Association functional class≥2 or left ventricular ejection fraction<40%) using the data of B-type natriuretic peptide (BNP, n=388) or N-terminal pro-B-type natriuretic peptide (NT-proBNP, n=771) at enrolment. BNPs were converted to NT-proBNP using a conversion formula. We divided the patients according to quartiles of NT-proBNP levels and compared the backgrounds and outcomes.

Of 1159 patients (mean age 72.1±10.2 years, median CHA

DS

-VASc score 3 and oral anticoagulant (OAC) prescription 671 (56%)), the median NT-proBNP level was 488 (IQR 169-1015) ng/L. Patients with high NT-proBNP levels were older, had higher CHA

DS

-VASc scores and had more OAC prescription (all p<0.001). Kaplan-Meier curves demonstrated that NT-proBNP levels were significantly associated with higher incidences of stroke/systemic embolism, all-cause death and HF hospitalisation during a median follow-up period of 5.0 years (log rank, all p<0.001). Multivariable Cox regression analyses revealed that NT-proBNP levels were an independent predictor of adverse outcomes even after adjustment by various confounders.

NT-proBNP levels are a significant prognostic marker for adverse outcomes in patients with AF without HF and may have clinical value.

UMIN000005834.

UMIN000005834.

To describe annual incidence and temporal trends (2002-2014) in incidence of long-term outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics, by age, gender, geographical remoteness and socioeconomic status (SES).

This is a retrospective cohort study. Cases were identified using the QAS OHCA Registry and were linked with entries in the Queensland Hospital Admitted Patient Data Collection and the Queensland Registrar General Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence. Inclusion criteria were adult (18+ years) residents of Queensland who suffered OHCA of presumed cardiac aetiology and survived to hospital admission. Analyses were undertaken by three mutually exclusive outcomes (1) survival to less than 30 days (Surv<30 days); (2) survival from 30 to 364 days (Surv30-364 days); and (3) survival to 365 days or more (Surv365+ days). Incidence rates were calculated for each year by gender, age, remoteness and SES.

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