The Physician and sportsmedicine
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Objective: Individuals with rheumatoid arthritis (RA) have increased risk of cardiovascular disease (CVD). Lifestyle factors such as prolonged sedentary behavior (SB) and reduced physical activity (PA) may heighten the risk of CVD. The objective of the study was to investigate the role of SB and PA as predictors for long-term CVD risk in RA patients. ⋯ Increased daily PA, at all intensities, was inversely associated with 10-year CVD risk (p< 0.01). In the fully adjusted regression model, associations between 10-year CVD risk and SB (β = 0.31, R2 = 0.27, p< 0.01), very light PA (β = -0.19, R2 = 0.26, p< 0.01), light PA (β = -0.16, R2 = 0.25, p< 0.01), and moderate-to-vigorous PA (β = -0.15, R2 = 0.25, p< 0.01) remained significant. Conclusions: Strategies for decreasing SB and increasing PA should be explored with individuals with RA in order to decrease long-term CVD risk.
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Objective: Ambulatory surgical centers (ASC's) have emerged as an alternative to the traditional hospital- based outpatient department (HOPD). We aim to determine the effect of surgical setting on adverse events following anterior cruciate ligament reconstruction (ACLR). Methods: The Humana Claims Database was queried for all patients undergoing ACLR in the HOPD or ASC setting, using the PearlDiver supercomputer. ⋯ On logistic regression, ASC was associated with decreased risk for deep vein thrombosis (.87, .83-.93) and pulmonary embolism (.85, .78-.95). Conclusion: ACLR performed in ASC is associated with reduced risk of venous thromboembolism and no difference in surgical morbidity and readmissions versus ACLR performed in HOPD. Development of a standardized algorithm for patient selection in the ASC setting is needed to preserve acceptability of ASC-based ACLR in cost-savings and patient safety models.
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Meta Analysis Comparative Study
Shock-wave therapy versus corticosteroid injection on lateral epicondylitis: a meta-analysis of randomized controlled trials.
Background: Shock-wave (SW) therapy has been widely promoted and proven to be effective in ameliorating symptoms of lateral epicondylitis (LE) during recent years. Corticosteroid (CS) injection is another common treatment of LE, and several researches have documented its significant effect in the treatment of LE. Despite this, few studies have focused on comparing the use of SW and CS in the treatment of LE. ⋯ A significant difference in VAS score (SMD = 1.13, Cl 0.72-1.55 P < 0.00001, I2 = 0) was noted between the SW group and the CS group. Furthermore, Significant difference was also seen in the term of grip strength (including HGS and GSS scoring system) (SMD = -1.42, Cl -1.85--0.98 P < 0.00001, I2 = 0). Conclusions: In light of the better improvement in the terms of VAS and grip strength with follow-up more than 12 weeks, we assume that SW may be a superior alternative for the treatment of LE.
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Background: Although football is one of the most popular collegiate sports, the epidemiology of and risk factors for shoulder and elbow injuries in this population not been recently described. We aimed to characterize this incidence in National Collegiate Athletic Association (NCAA) football players, determine risk factors, and establish outcomes after injury. Methods: All shoulder and elbow injuries in men's football occurring during the 2009-2010 through 2013-2014 academic years were retrospectively identified in the NCAA Injury Surveillance Program database. ⋯ Competition had an eight times higher incidence than did practice. Tackling and blocking were the most common mechanisms, while AC separation and shoulder instability were the most common injuries. This epidemiology may help players, coaches, trainers, and governing bodies target injury-prevention programs and assess improvement over time.
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Objectives: This study sought to determine whether shortened recovery periods between regularly scheduled Sunday NFL games and Thursday Night Football games significantly increased the incidence of injury in NFL players. Methods: NFL injury reports and injury reserve data were collected for every NFL player, on all 32 NFL teams, for each week during the regular season, for the 2012-2013, 2013-2014, 2014-2015, 2015-2016, and 2016-2017 NFL seasons. Injuries were defined as any reported injury, not previously documented in an injury report prior to said injury. ⋯ The relative risk of injury during Thursday Night Football games was calculated to be 0.97 compared to Sunday and Monday night games. Therefore, the rate of injury during Thursday Night Football games was significantly less than the rate of injury during Sunday and Monday night games, despite the lack of additional recovery time. Conclusion: This study suggests that eliminating Thursday Night Football is unlikely to improve the statistical injury rate among NFL players.