Propuesta para evaluación preparticipativa y seguimiento en la prescripción del ejercicio y el deporte en el entrenamiento de resistencia / A proposal for preparticipation evaluation and follow up in the prescription of exercise and sports for resistance training

Resumen El ejercicio mejora la calidad y expectativa de vida y sus beneficios superan los riesgos asociados. Sin embargo, los atletas están expuestos al riesgo de muerte cardíaca súbita, cuya prevalencia es mayor que en personas sedentarias secundario a enfermedad cardíaca silente. La evaluación preparticipativa difiere en todos los países y representa un desafío para el médico al momento de tomar decisiones para considerar apta alguna persona para la práctica de ejercicio o deporte. Existen riesgos adicionales asociados a la práctica del entrenamiento de resistencia secundario a las adaptaciones cardiovasculares generadas, como el remodelamiento cardíaco, el cual puede llegar a ser patológico e incrementar el riesgo de arritmias y conducir así a una muerte cardíaca súbita. El objetivo principal de este artículo es proponer una evaluación preparticipativa en diferentes grupos etarios con base en la evidencia actual de la literatura para detectar y prevenir enfermedades cardiovasculares que conduzcan a muerte cardíaca súbita en el atleta durante su práctica deportiva.

Abstract Exercise improves quality of life and life expectancy, and its benefits outweigh its associated risks. However, athletes are at risk for sudden cardiac death, which occurs more frequently in them than in sedentary people, secondary to silent heart disease. Preparticipation evaluation varies by country and is a challenge for physicians in deciding whether to clear an individual for exercise or sports. Resistance training carries additional risks secondary to the cardiovascular adaptations it causes, such as cardiac remodeling, which may become pathological and increase the risk of arrhythmias, thus leading to sudden cardiac death. The main objective of this article is to propose a preparticipation evaluation in different age groups, based on current evidence in the literature for detecting and preventing cardiovascular diseases which can lead to sudden cardiac death in an athlete during sports practice.

Effect of Vitamin C Supplements on Respiratory Tract Infections: A Systematic Review and Meta-Analysis.

BACKGROUND: Respiratory tract infections are a primary cause of illness and mortality over the world. OBJECTIVE: This study was aimed to investigate the effectiveness of vitamin C supplementation in preventing and treating respiratory tract infections. METHODS: We used the Cochrane, PubMed, and MEDLINE Ovid databases to conduct our search. The inclusion criteria were placebo-controlled trials. Random effects meta-analyses were performed to measure the pooled effects of vitamin C supplementation on the incidence, severity, and duration of respiratory illness. RESULTS: We found ten studies that met our inclusion criteria out of a total of 2758. The pooled risk ratio (RR) of developing respiratory illness when taking vitamin C regularly across the study period was 0.94 (with a 95% confidence interval of 0.87 to 1.01) which found that supplementing with vitamin C lowers the occurrence of illness. This effect, however, was statistically insignificant (P= 0.09). This study showed that vitamin C supplementation had no consistent effect on the severity of respiratory illness (SMD 0.14, 95% CI -0.02 to 0.30: I2 = 22%, P=0.09). However, our study revealed that vitamin C group had a considerably shorter duration of respiratory infection (SMD -0.36, 95% CI -0.62 to -0.09, P = 0.01). CONCLUSION: Benefits of normal vitamin C supplementation for reducing the duration of respiratory tract illness were supported by our meta-analysis findings. Since few trials have examined the effects of therapeutic supplementation, further research is needed in this area.

Revision of the Simulium (Simulium) melanopus species-group (Diptera: Simuliidae) in Sabah, Malaysia.

Species of the Simulium (Simulium) melanopus species-group in Sabah are taxonomically revised by examining type specimens of S. (S.) crassimanum S. (S.) laterale, and S. (S.) nigripilosum, all described from females by Edwards in 1933, and newly collected samples from the vicinity of Mt. Kinabalu. The females of these three species are redescribed, and their males and pupae are described for the first time based on adults reared from pupae. Simulium (S.) liewi Takaoka, 2007 and S. (S.) kinabaluense Smart & Clifford, 1969 are synonymized with S. (S.) crassimanum and S. (S.) laterale, respectively. Simulium (S.) cheedhangi Takaoka, Sofian-Azirun & Ya'cob, 2015 is newly recorded from Sabah. Two new related species, S. (S.) lardizabalae and S. (S.) timpohonense, are described from males reared from pupae. Keys to identify eight species of the S. melanopus species-group in Sabah are provided for females, males, pupae and mature larvae.

Use of interactive teaching methods in tobacco cessation program and examine it by using objective structured clinical exam.

BACKGROUND: Tobacco addiction is an important public health issue. It is important for health professional to counsel the tobacco users for cessation. AIM: To enhance communication skills of MBBS (Bachelor of Medicine and Bachelor of Surgery) students in counseling of tobacco users by using interactive teaching methods and examine it by using OSCE. MATERIALS AND METHODS: It was a before and after comparison study. Communication skills of students were examined by standardized patients (investigators) by objective structured clinical examination (OSCE) method before and after intervention. All the students were trained to enhance the communication skills by role play, interactive session, anecdotes. Statistical analysis was done by using Paired t-test. RESULTS: The difference in scores at all the 3 stations before and after the intervention and also global scores before and after the intervention was statistically highly significant (P = 0.0001). CONCLUSION AND RECOMMENDATION: Communication skills of students in counseling tobacco users improved after they were given role play, interactive session, anecdotes. Similar model can be used to improve the communication/counseling skills in other important health hazards.

Assessment of awareness regarding climate change in an urban community.

BACKGROUND: Climate change has emerged as one of the most devastating environmental threats. It is essential to assess the awareness regarding climate change in the general population for framing the mitigation activities. AIM: To assess the awareness regarding climate change in an urban community. SETTINGS AND DESIGN: Urban field practice area of a medical college in the Pune city. Observational study. MATERIALS AND METHODS: The cross-sectional survey was conducted in the urban adult population who had given the written consent. A pre-tested questionnaire was used for a face to face interview. Responses were evaluated. STATISTICAL ANALYSIS USED: Proportions, percentage. RESULTS: Total 733 respondents above 18 years of age were included in the present survey. 672 (91.68%) respondents commented that global climate is changing. 547 (81.40%) respondents opined that human activities are contributing to climate change. 576 (85.71%) respondents commented that climate changing based on their personal experiences. Commonest source of information about climate change was television (59.78%). Poor awareness about UNFCC, Kyoto Protocol and IPCC was found. 549 (74.90%) respondents commented that deforestation contribute most significantly towards climate change. As per 530 (72.31%) respondents water related issues are due to changing climate change. According to 529 (72.17%) respondents, direct physical hazards of extreme climatic events are most important health related impact of climate change. According to 478 (65.21%) respondents, life style changes (63.3%) would be most effective in tackling climate change and for preventing further climate change. CONCLUSION: The urban general population is aware about changing global climate. Personal efforts are more important in mitigating climate change as per the urban general population. The awareness campaigns regarding mitigation activities are recommended.