Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
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To investigate the incidence and assess the outcomes of cardiac arrest occurring in the context of participation in marathon or half-marathon races. ⋯ Among 10.9 million registered race participants there were 40 cardiac arrests in marathons and 19 in half marathons (overall incidence, 0.54 per 100,000; 95% confidence interval [CI], 0.41-0.70). The mean age of runners with cardiac arrest was 42 (SD 13) years and 86% were men. The incidence per 100,000 was higher in marathons (1.01; 95% CI, 0.72-1.38) than in half marathons (0.27; 95% CI, 0.17-0.43; and among men (0.90; 95% CI, 0.67-1.18) than among women (0.16; 95% CI, 0.07-0.31). More runners died than survived the cardiac arrest (42 [71%] vs 17[29%]); the incidence of sudden death was 0.39 per 100,000 participants (95% CI, 0.28-0.52). The mean age of the nonsurvivors was younger than that of the survivors (39 vs 49 years; P = 0.002). Complete clinical information on cause of death was available for 23 runners. The most common confirmed or possible cause of death was hypertrophic cardiomyopathy (15 cases, of whom 9 had an additional clinical factor). Among the 8 survivors with complete information, ischemic heart disease was the cause of cardiac arrest in 5. The survivors were older than nonsurvivors (53 vs 40 years), had completed more long-distance races, and were more likely to have known cardiac risk factors. The strongest predictors of survival were initiation of cardiopulmonary resuscitation by bystanders (P = 0.01) and an underlying diagnosis other than hypertrophic cardiomyopathy (P = 0.01) CONCLUSIONS:: The incidence of cardiac arrest and sudden death per 100,000 runner hours was 0.2 and 0.14. Risk factors for cardiac arrest were full marathon and male sex. Younger age and no previous knowledge of cardiovascular risk were associated with sudden death.
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Comment
Is there evidence in favor of surgical interventions for the subacromial impingement syndrome?
To investigate the effectiveness of surgical and postsurgical interventions for the subacromial impingement syndrome (SIS). ⋯ Studies of surgical interventions in subacromial impingement syndrome suggested that no technique is convincingly better than another or than conservative interventions. Evidence from the few better quality studies suggested that injections of platelet-leukocyte gel given postoperatively were effective in the short term for lessening pain and improving shoulder function, and that radio-frequency-based plasma microtenotomy was not more effective than arthroscopic subacromial decompression for improving any outcome measure.
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To evaluate the effectiveness of a neuromuscular warm-up program in preventing acute knee injury in adolescent female football (soccer) players. ⋯ A short weekly neuromuscular exercise program reduced the rate of ACL injuries among adolescent female football (soccer) players. Those who were compliant with the intervention had fewer severe knee injuries and fewer injuries overall.
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To describe the incidence and risk factors for high ankle sprains (ie, syndesmosis injuries) among National Collegiate Athletic Association (NCAA) football players. ⋯ Our data suggest a significantly higher incidence of syndesmosis injuries during games, during running plays, and to running backs and interior defensive linemen. The wide range in time lost from participation for complete syndesmosis injuries underscores the need for improved understanding of injury mechanism and classification of injury severity such that prevention, safe return to play protocols, and outcomes can be further improved.