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1.
Abstract

This study examined whether urine dipstick testing might be useful to predict the development of acute kidney injury after an ultramarathon. Participants in the 2011 161-km Western States Endurance Run underwent post-race blood and urine dipstick analyses. Of the 310 race finishers, post-race urine dipstick testing was completed on 152 (49%) and post-race blood also was obtained from 150 of those runners. Based on “injury” and “risk” criteria for acute kidney injury of blood creatinine 2.0 and 1.5 times estimated baseline, respectively, 4% met the criteria for injury and an additional 29–30% met the criteria for risk of injury. Those meeting the injury criteria had higher creatine kinase concentrations (P < 0.001) than those not meeting the criteria. Urine dipstick tests that read positive for at least 1+ protein, 3+ blood, and specific gravity ≥ 1.025 predicted those meeting the injury criteria with sensitivity of 1.00 (95% confidence interval [CI] 0.54–1.00), specificity of 0.76 (95% CI 0.69–0.83), positive predictive value of 0.15 (95% CI 0.06–0.30), negative predictive value of 1.00 (95% CI 0.97–1.00), and likelihood ratio for a positive test of 4.2. We conclude that urine dipstick testing was successfully able to identify those individuals meeting injury criteria for acute kidney injury with excellent sensitivity and specificity.  相似文献   

2.
The angiogenesis-signalling pathway is a physiological response after mechanical loading to promote matrix remodelling and thereby maintain tissue homeostasis. Studies have shown increased expression of angiogenic molecules in response to loading and in ruptured ligaments. Recently, polymorphisms within the vascular endothelial growth factor A (VEGFA) and kinase insert-domain receptor (KDR) genes were associated with risk of anterior cruciate ligament (ACL) ruptures and Achilles tendinopathy in Caucasian study groups. A case-control genetic association study was conducted on 100 controls and 98 participants with surgically-diagnosed ACL ruptures; of which 51 participants reported non-contact mechanism of injury (NON). All participants were genotyped for five functional polymorphisms: VEGFA (rs699947, rs1570360, rs2010963) and KDR (rs2071559, rs1870377). Haplotypes were inferred. In the male participants, the KDR rs2071559 AG genotype was significantly over-represented (P = 0.048, OR: 1.90, 95% CI: 1.00–3.59) in the controls. Furthermore, the GG genotype was significantly under-represented in the male controls compared to the male ACL group (P = 0.018, OR: 2.77, 95% CI: 1.17–6.55) and the male NON subgroup (P = 0.013, OR: 3.26, 95% CI: 1.24–8.58). Haplotype analysis implicated the KDR gene in all participants and in male participants separately. Collectively, these results implicate the angiogenesis-signalling pathway as a potentially key biological pathway contributing to ACL injury susceptibility.  相似文献   

3.
Purpose: The aim of this study was to analyse the relationship between absolute and acute:chronic workload ratios and non-contact injury incidence in professional football players and to assess their predictive ability. Methods: Elite football players (n?=?130) from five teams competing in European domestic and confederation level competitions were followed during one full competitive season. Non-contact injuries were recorded and using session rate of perceived exertion (s-RPE) internal absolute workload and acute:chronic (A:C) workload ratios (4-weeks, 3-weeks, 2-weeks and week-to-week) were calculated using a rolling days method. Results: The relative risk (RR) of non-contact injury was increased (RR?=?1.59, CI95%: 1.18–2.15) when a cumulative 4-week absolute workload was greater than 10629 arbitrary units (AU) in comparison with a workload between 3745 and 10628?AU. When the 3-week absolute workload was more than 8319?AU versus between 2822 and 8318?AU injury risk was also increased (RR=?1.46, CI95% 1.08–1.98). Injury incidence was higher when the 4-week A:C ratio was <0.85 versus >0.85 (RR?=?1.31, CI95%: 1.02–1.70) and with a 3-week A:C ratio >1.30 versus <1.30 (RR?=?1.37, CI95%: 1.05–1.77). Importantly, none of the A:C workload combinations showed high sensitivity or specificity. Conclusions: In elite European footballers, using internal workload (sRPE) revealed that cumulative workloads over 3 and 4 weeks were associated with injury incidence. Additionally, A:C workloads, using combinations of 2, 3 and 4 weeks as the C workloads were also associated with increased injury risk. No A:C workload combination was appropriate to predict injury.  相似文献   

4.
This study investigated the impact of in-season national team duty on injury rates and player availability in a professional soccer club. Time-loss injuries and exposure time during club and national team duties were recorded prospectively over 5 seasons (2009–2014). A time-loss injury was sustained by 37.7% of squad members participating in national duty, all injuries occurring in match-play. The incidence (per 1000 h exposure) for national team player match-play injuries did not differ (P = 0.608) to that for all players in club competitions: 48.0 (95% CI 20.9–75.5) vs. 41.9 (95% CI 36.5–47.4), incidence rate ratio = 1.2 (CI: 0.8–2.4). The majority (58%) of national team injuries resulted in a layoff ≤1 week. Of all working days lost to injury generally, 5.2% were lost through injury on national duty. Injury incidence in the week following national duty was comparable (P = 0.818) in players participating or not: 7.8 (95% CI 3.6–12.0) vs. 7.1 (95% CI: 4.6–9.6), incidence rate ratio = 1.1 (CI: 0.7–2.7). While approximately 40% of participating players incurred a time-loss injury on national duty, no training injuries were sustained and injuries made up a negligible part of overall club working days lost to injury. Following duty, players had a similar injury risk to peers without national obligations.  相似文献   

5.
ABSTRACT

Current evidence suggests that chronic inflammation contributes to the development of coronary artery disease (CAD). Interestingly, exercise may constitute a method of reducing inflammation in this patient population. As such, this systematic review and meta-analysis examined the evidence generated by randomised studies that investigated the effect of exercise on inflammatory biomarkers in CAD. Literature was sought from various sources. Outcomes were pooled in a random-effects model to calculate standardised mean differences (SMD) with 95% confidence intervals (CI). Twenty-five studies were reviewed; post-intervention C-reactive protein (SMD: ?0.55 (95% CI: ?0.93, ?0.16), P = 0.005), fibrinogen (SMD: ?0.52 (95% CI: ?0.74, ?0.29, P = <0.00001)), and von Willebrand factor (SMD: ?1.57 (95% CI: ?2.23, ?0.92), P = <0.00001) values were significantly lower in exercise groups compared to controls. In addition, qualitative analyses identified evidence that supports a beneficial effect of exercise on these acute-phase reactants. However, the impact of exercise on anti–inflammatory cytokines, adhesion molecules, and chemokines is equivocal, which may be attributed to a paucity of research. Nevertheless, the findings of this review suggest that exercise induces an anti–inflammatory effect in CAD patients. Although, the quality of evidence needs to be improved by further randomised studies with high methodological qualities and large sample sizes.  相似文献   

6.
Wrist-based accelerometers are increasingly used to assess physical activity (PA) in population-based studies; however, cut-points to translate wrist-based accelerometer counts into PA intensity categories are still needed. The purpose of this study was to determine wrist-based cut-points for moderate- and vigorous-intensity ambulatory PA in adults for the Actical accelerometer. Healthy adults (n = 24) completed a four-phase treadmill exercise protocol (1.9, 3.0, 4.0 and 5.2 mph) while wearing an Actical accelerometer on their wrist. Metabolic equivalent of task (MET) levels were assessed by indirect calorimetry. Receiver operating characteristics (ROC) curves were generated to determine accelerometer counts that maximised sensitivity and specificity for classification of moderate (≥3 METs) and vigorous (>6 METs) ambulatory activity. The area under the ROC curves to discriminate moderate- and vigorous-intensity ambulatory activity were 0.93 (95% confidence interval [CI]: 0.90–0.97; P < 0.001) and 0.96 (95% CI: 0.94–0.99; P < 0.001), respectively. The identified cut-point for moderate-intensity ambulatory activity was 1031 counts per minute, which had a corresponding sensitivity and specificity of 85.6% and 87.5%, respectively. The identified cut-point for vigorous intensity ambulatory activity was 3589 counts per minute, which had a corresponding sensitivity and specificity of 88.0% and 98.7%, respectively. This study established intensity-specific cut-points for wrist-based wear of the Actical accelerometer which are recommended for quantification of moderate- and vigorous-intensity ambulatory activity.  相似文献   

7.
BackgroundFor the past 30 years, the hamstring (H)-to-quadriceps (Q) (H:Q) torque ratio has been considered an important index of muscle strength imbalance around the knee joint. The purpose of this systematic review was to examine the value of H:Q torque ratio as an independent risk factor for hamstring and anterior cruciate ligament (ACL) injuries.MethodsDatabase searches were performed to identify all relevant articles in PubMed, MEDLINE, Cochrane Library, and Scopus. Prospective studies evaluating the conventional (concentric H:Q), functional (eccentric H: concentric Q), and mixed (eccentric H at 30°/s: concentric Q at 240°/s) H:Q ratios as risk factors for occurrence of hamstring muscle strain or ACL injury were considered. Risk of bias was assessed using the Quality In Prognosis Studies tool.ResultsEighteen included studies reported 585 hamstrings injuries in 2945 participants, and 5 studies documented 128 ACL injuries in 2772 participants. Best evidence synthesis analysis indicated that there is very limited evidence that H:Q strength ratio is an independent risk factor for hamstring and ACL injury, and this was not different between various ratio types. Methodological limitations and limited evidence for ACL injuries and some ratio types might have influenced these results.ConclusionThe H:Q ratio has limited value for the prediction of ACL and hamstring injuries. Monitoring strength imbalances along with other modifiable factors during the entire competitive season may provide a better understanding of the association between H:Q ratio and injury.  相似文献   

8.
The most frequently occurring contact events in rugby union are the tackle and ruck. The ability repeatedly to engage and win the tackle and ruck has been associated with team success. To win the tackle and ruck, players have to perform specific techniques. These techniques have not been studied at the highest level of rugby union. Therefore, the purpose of this study was to identify technical determinants of tackle and ruck performance at the highest level of rugby union. A total of 4479 tackle and 2914 ruck events were coded for the Six Nations and Championship competitions. Relative risk ratio (RR), the ratio of the probability of an outcome occurring when a characteristic was observed (versus the non-observed characteristic), was determined using multinomial logistic regression. Executing front-on tackles reduced the likelihood of offloads and tackle breaks in both competitions (Six Nations RR 3.0 Behind tackle, 95% confidence interval [95% CI]: 1.9–4.6, effect size [ES] = large, P < 0.001); Championship RR 2.9 Jersey tackle, 95% CI: 1.3–6.4, ES = moderate, P = 0.01). Fending during contact increased the chances of offloading and breaking the tackle in both competitions (Six Nations RR 4.5 Strong, 95% CI: 2.2–9.2, ES = large, P = P < 0.001; Championship RR 5.1 Moderate, 95% CI: 3.5–7.4, ES = large, P < 0.001). For the ruck, actively placing the ball increased the probability of maintaining possession (Six Nations RR 2.2, 95% CI: 1.1–4.3, ES = moderate, P = 0.03); Championship RR 4.0, 95% CI: 1.3–11.8, ES = large, P = 0.01). The techniques identified in this study should be incorporated and emphasised during training to prepare players for competition. Furthermore, these techniques need to be added to coaching manuals for the tackle and ruck.  相似文献   

9.
The present investigation was carried out to examine the incidence and pattern of injuries in adolescent multisport athletes from youth sports academy. Injury data were prospectively collected from 166 athletes during the seasons from 2009 to 2014. A total of 643 injuries were identified, 559 (87.0%) were time-loss injuries. The overall injury incidence was 5.5 (95% confidence interval CI: 5.1–6.0), the incidence of time-loss injuries was 4.8 (95% CI: 4.4–5.2), the incidence of growth conditions was 1.2 (95% CI: 1.0–1.4) and incidence of serious injuries was 0.6 (95% CI: 0.5–0.8) per 1000?h of exposure. The prevalence of overuse injuries was 50.3%. Growth conditions represented 20.0%. Most of the injuries (67.0%) involved the lower extremities, and both foot and ankle were the most predominant injured body parts (22.0%). Knee injuries were mostly from overuse (50 vs. 23, p?=?.02), whereas foot and ankle injuries resulted from an acute mechanism (94 vs. 31, p?<?.0001). Minor and moderate injuries accounted for 87.0%. Muscle, tendon and osteochondrosis injuries accounted for 52.0% of all injuries. Comparing groups, squash sport was having the highest injury incidence (8.5 injuries per athlete). Higher exposure was associated with greater overuse relative risk (RR?=?1.03, 95% CI: 1.01–1.014, p?<?.001). In conclusion, the results of this study identified a high incidence of injuries in this youth sports population. Striking was the prevalence of overuse injuries of 50%, which suggests the need for injury prevention protocols for adolescent highly trained athletes.  相似文献   

10.
PurposeThe study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders.MethodsWe systematically searched PubMed, Web of Science, and MEDLINE for studies on injury incidence published from inception to April 2020. Injury data were extracted, alongside information on injury location, severity, type, cause, and sport discipline. Incidence of injuries was presented per 1000 athlete-days, with 95% confidence intervals (95%CIs).ResultsThe search identified 462 articles, and 22 were included in our review. The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days (95%CI: 2.97–4.01). Lower extremity had the highest injury incidence (1.54 per 1000 athlete-days, 95%CI: 1.24–1.84). Incidence rates of slight, mild, moderate, and severe injuries were 0.26, 0.31, 0.57, and 0.59 per 1000 athlete-days, respectively. Contusion had the highest incidence rate (1.82 per 1000 athlete-days, 95%CI: 1.01–2.63). The most common cause of injury was contact trauma (3.20 per 1000 athlete-days, 95%CI: 1.32–5.08). Freestyle skiing had the highest incidence rate (6.83 per 1000 athlete-days, 95%CI: 4.00–9.66), and Nordic skiing had the lowest rate (2.70 per 1000 athlete-days, 95%CI: 1.94–3.46).ConclusionProfessional skiers and snowboarders have a substantial risk of sustaining injuries. Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.  相似文献   

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