Does Night Training Load Affect Sleep Patterns and Nocturnal Cardiac Autonomic Activity in High-Level Female Soccer Players?

Purpose: To analyze whether exercise training conducted at night disturbs sleep and affects nocturnal cardiac autonomic control in high-level female athletes. Methods: A total of 18 high-level female soccer players (mean [SD] age 20.4 [2.1] y) wore actigraphs and heart-rate (HR) monitors during night sleep throughout night training days (n = 8) and resting days (n = 8), for 3 consecutive weeks. This was a longitudinal study that measured internal training load, sleep, nocturnal cardiac autonomic activity, and well-being ratings prior to training sessions. Results: Training load varied across training days (eg, training impulse range, mean [SD]; effect size, ES [95% confidence interval]: 72.9 [18.8] to 138.4 [29.6] a.u.; F4,62 = 32.331; ηp2=.673 [.001-.16], large effect; P < .001). However, no differences in subjective well-being ratings were observed, although ES was large. Total sleep time (training days vs resting days: 07:17 [00:47] h vs 07:51 [00:42] h; ES = 0.742 [0.59-0.92], P = .005; moderate effect) and sleep-onset time (00:58 [00:19] h vs 00:44 [00:16] h; ES = 0.802 [0.68-0.94], P = .001; moderate effect) were negatively affected after night training. In addition, small effects were detected for wake-up time, time in bed, and sleep latency (P > .05). No differences were detected in HR variability during sleep (range of lnRMSSD: 4.3 [0.4] to 4.5 [0.4] ln[ms] vs 4.6 [0.3] to 4.5 [0.4] ln[ms]; F3,52 = 2.148; P > .05; ηp2=.112 [.01-.25], medium effect), but HR during sleep was significantly higher after training days (range of HR: 56 [4] to 63 [7] beats/min vs 54 [4] to 57 [6] beats/min; F2,32 = 15.956; P < .001; ηp2=.484 [.20-.63], large effect). Conclusion: Overall, the results indicate that exercise training conducted at night may disturb sleep and affect HR, whereas limited effects can be expected in HR variability assessed during sleep in high-level female soccer players.

Prevalence of paroxysmal atrial fibrillation in a population assessed by continuous 24-hour monitoring. / Prevalência da fibrilhação auricular paroxística numa população avaliada por monitorização contínua de 24 horas.

INTRODUCTION: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice and a major cause of morbidity, due to the associated risk of stroke. However, since it is often paroxysmal, it is commonly underdiagnosed and undertreated. OBJECTIVES: The primary objective of this prospective study was to determine the prevalence of paroxysmal atrial fibrillation (PAF) in patients aged 40 and above in a population who underwent continuous 24-hour electrocardiographic monitoring. The secondary objectives were to determine the overall prevalence of AF/atrial flutter (AFL) regardless of the type and to compare the population with AF with the general population and patients with PAF with patients with AF. RESULTS: A total of 4843 consecutive patients were analyzed, 58% women, 26.2% aged 70-79 years (n=1269), 25.9% (n=1252) aged 60-69 years, and 19.0% (n=923) aged 50-59 years; the others were aged either >80 years (n=712, 14.7%) or <50 years (n=686, 14.2%). At least one episode of PAF was detected in 123 patients, a prevalence of 2.5% (95% CI: 2.1-3.0). The prevalence of persistent AF throughout the monitoring period was 9.4% (95% CI: 8.6-10.2) (n=454). Additionally, 39 cases of typical AFL were detected, but in 23 of them (sustained or paroxysmal) this appeared isolated, a prevalence of 0.8% (95% CI: 0.6-1.1). The overall prevalence of AF/AFL was thus 12.4%. The presence of some type of AF/AFL was significantly correlated with male gender (p<0.001), age (especially in the 70-79 and >80 age-groups) (p<0.001) and hypertension (p<0.001). This group had a significantly higher prevalence of previous stroke (56 patients [9.3%], p=0.001) and acute myocardial infarction (5.3%, p<0.001). Comparing the population with PAF and/or paroxysmal AFL (PAF/PAFL) to those with persistent AF (during 24-hour monitoring), significant differences were found: a higher prevalence of PAF/PAFL in younger individuals (40-49, 50-59 and 60-69 age-groups) and lower in older individuals (70-79 and >80 age-groups) (p<0.001), higher prevalence of history of stroke (p=0.024), and lower levels of hypertension (p<0.001). Only 12.8% of patients with PAF were taking anticoagulant drugs. CONCLUSIONS: The prevalence of PAF found in a population referred for continuous 24-hour electrocardiographic monitoring for diverse reasons was 2.5% and the overall AF/AFL prevalence was 12.4%. PAF was more prevalent in younger patients. Patients with PAF showed a significantly lower prevalence of hypertension and significantly higher rates of stroke. Systematically detecting patients with PAF is a major public health concern, since early diagnosis is essential to identify candidates for oral anticoagulation and catheter ablation, which is frequently curative when applied at this stage.

Injuries in Portuguese Amateur Youth Football Players: A Six Month Prospective Descriptive Study.

INTRODUCTION: This study analyzed the incidence and characteristics of injuries sustained by amateur youth football players in Portugal during season 2015 - 2016. MATERIAL AND METHODS: This is an observational descriptive study. We analyzed Portuguese youth football players' injuries over six months of a season. A total of 529 players were divided according to their age in two groups (Under-17 and Under-19). Data on injuries were collected. RESULTS: Throughout all 62 062.0 hours of exposure recorded, 248 injuries were reported in 173 different players. The average incidence of injury was 3.87 (95% CI = 2.81; 4.94) per 1000 hours of football exposure. There was a significantly higher average incidence of injury during matches - 14.22 (95% CI = 10.35; 18.09) per 1000 hours of exposure - when compared to the average incidence of injury during training - 2.06 (95% CI = 1.22; 2.90) per 1000 hours of exposure. This significance was also observed when the comparison was made within each age group. A traumatic mechanism was involved in 76.6% of all the injuries, while overuse was reported in 12.9%. The most common type was the injury that affected muscles and tendons (52.8%). The body location most commonly affected by injuries was the thigh (24.6%). DISCUSSION: Even though is essential a better characterization of Portuguese athletes of younger age groups such as those discussed in this study, the results of the studied population are in agreement with the existing literature. However, this study provides more information that may be important to better target the Portuguese athletes' training for injury prevention. CONCLUSION: This study provides descriptive data on injuries developed in a subpopulation of Portuguese amateur youth football players that could represent a focus for future prevention.

Introdução: Este estudo foi projetado com o intuito de analisar a incidência e as características das lesões desenvolvidas pelos jovens jogadores portugueses de futebol amador durante a época de 2015 - 2016. Material e Métodos: Trata-se de um estudo observacional descritivo. Foram analisadas as lesões de jovens atletas durante seis meses de uma época. Um total de 529 jogadores foi dividido em dois grupos, atendendo à sua idade (Sub-17 e Sub-19). Os dados foram colectados semanalmente pelo responsável por cada equipa. Resultados: Ao longo de 62 062,0 horas de exposição registadas, foram reportadas 248 lesões em 173 jogadores. A incidência de lesão média foi de 3,87 (95% CI = 2,81; 4,94) por 1000 horas de exposição a futebol. A incidência de lesão média durante os jogos ­ 14,22 (95% CI = 10,35; 18,09) por 1000 horas de exposição ­ foi significativamente superior à incidência de lesão média durante os treinos ­ 2,06 (95% CI = 1,22; 2,90) por 1000 horas de exposição. Esta significância foi também observada quando feita a comparação dentro de cada grupo etário (Sub-17 e Sub-19). O mecanismo traumático esteve envolvido em 76,6% das lesões, enquanto que o mecanismo de sobre-utilização foi causa de 12,9% das lesões. As lesões mais frequentemente observadas foram as que envolveram músculos e tendões (52,8%). A coxa foi a localização mais comum das lesões (24,6%). Discussão: Apesar de ser essencial uma melhor caracterização dos atletas Portugueses de grupos etários mais novos como os abordados neste estudo, os resultados da população estudada vão de encontro ao que existe na literatura mundial. No entanto, este estudo é mais uma fonte de informação que poderá ser importante para melhor direcionar o treino dos atletas portugueses para a prevenção de lesões. Conclusão: Este estudo fornece informação descritiva das lesões ocorridas numa sub-população de jovens jogadores portugueses de futebol amador, podendo representar um foco para futura prevenção.

Musculoskeletal Injuries in Competitive Rowers.

INTRODUCTION: The objective of this study was the assessment of the injuries occurred over the competitive rowing lifetime of Portuguese senior rowers. MATERIAL AND METHODS: We sent a questionnaire to all Portuguese senior rowers medalled in the national championships during the 2013-2014 season. We analysed biometric variables, anatomic location, type and circumstances of injury occurrence, type of treatment provided and time of inactivity. For statistical analysis we used parametric and non-parametric statistics with 95% confidence levels (p < 0.05). RESULTS: The questionnaire was answered by 18 of the 18 female and 74 of the 77 male rowers. Females had significantly lower ages, heights and weights and rowed more often sculling boats (p < 0.05). The number of years of practice, as well as the number of injuries per rower was similar, for both females and males. The mean age at the first injury was significantly lower in females (p < 0.001), who also had more progressive lesions than acute ones, although not significantly. In both, the most frequent anatomical location and type of injury were the lumbar region and muscular pathology, with a higher occurrence in winter and spring, during land training. Femalessustained longer periods of inactivity, but not significantly. DISCUSSION: The results that were different from those reported by other authors may be related with differences in the studied populations or with other factors that need to be clarified. CONCLUSION: The injuries sustained by the Portuguese competitive rowers, probably associated with a lower competitive exposure of our athletes, were less severe than those generally reported in the literature.

Introdução: O objetivo deste estudo foi a avaliação das lesões ocorridas ao longo da vida desportiva de remadores de competição seniores portugueses. Material e Métodos: Enviámos um questionário a todos os remadores seniores medalhados nos campeonatos nacionais na época de 2013-2014. Analisámos variáveis biométricas, localização anatómica, tipo e circunstâncias de ocorrência de lesões, tratamentos efetuados e tempos de inatividade. Para análise estatística utilizámos métodos paramétricos e não paramétricos com níveis de confiança de 95% (p < 0,05). Resultados: Responderam 18 dos 18 remadores femininos e 74 dos 77 masculinos. Os femininos apresentaram idades, estaturas e pesos significativamente mais baixos e remaram mais parelhos (p < 0,05). O número de anos de prática e de lesões por remador foram semelhantes, entre femininos e masculinos. A idade média da primeira lesão foi significativamente mais precoce nos femininos (p < 0,001), nos quais se registaram mais lesões progressivas do que agudas, embora de forma não significativa. Tanto nos femininos como nos masculinos, a localização anatómica e o tipo de lesão mais frequentes foram a região lombar e a contratura muscular, com maior ocorrência no inverno e na primavera, em terra, durante os treinos. A inatividade por lesão foi superior nos femininos, embora de forma não significativa. Discussão: Os resultados que diferiram dos reportados por outros autores podem estar relacionados com diferenças nas populações estudadas ou com outros fatores que necessitam de ser esclarecidos. Conclusão: As lesões dos remadores de competição portugueses, associadas provavelmente a um nível competitivo menos expressivo dos nossos atletas, foram menos graves do que as geralmente referidas na literatura.

Cardiac Fabry's disease: an unusual cause of left ventricular hypertrophy.

BACKGROUND: A 64-year-old male was observed as an outpatient with atypical, non-exercise-induced chest pain and palpitations. He had arterial hypertension and marked concentric left ventricular hypertrophy. After 2.5 years of antihypertensive drug therapy the patient's blood pressure had returned to normal, but his left ventricular hypertrophy was unchanged. INVESTIGATIONS: Electrocardiography, transthoracic echocardiography, myocardial perfusion scintigraphic imaging, measurement of alpha-galactosidase A activity, gene sequencing, brain MRI, carotid artery ultrasonography, biochemical renal evaluation and cardiac Doppler tissue imaging. DIAGNOSIS: Cardiac Fabry's disease. MANAGEMENT: Losartan, hydrochlorothiazide, low-dose aspirin and bisoprolol. The patient is expected to begin enzyme replacement therapy.

Modelling long-term heart rate variability: an ARFIMA approach.

Long-term heart rate variability (HRV) series can be described by time-variant autoregressive modelling. HRV recordings show dependence between distant observations that is not negligible, suggesting the existence of long-range correlations. In this work, selective adaptive segmentation combined with fractionally integrated autoregressive moving-average models is used to capture long memory in HRV recordings. This approach leads to an improved description of the low- and high-frequency components in HRV spectral analysis. Moreover, it is found that in the 24-h recording of a case report, the long-memory parameter presents a circadian variation, with different regimes for day and night periods.