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Mashup Score: 13The Challenges of Screening Master Athletes - 9 day(s) ago
In recent decades, there has been a significant increase in the number of men and women over the age of 40 participating in high-intensity endurance sports, often referred to as “master athletes.” The “State of the Running 2019” report by RunRepeat.com and the International Association of Athletics Federation covers 96% of US recreational race results, 91% of the race results from the EU, Canada, and Australia, and a big portion from Asian, Africa, and South America. According to this study, more than a million people finished a marathon in 2018 (compared to less than half million in 2001): of those, more than 40% were over 40 years old [1] (Fig. 1). Other endurance sports, such as cycling, also show a large number of adult and senior competitors. This trend towards a higher mean age of participants in strenuous sport disciplines obliges the sports cardiology community to confront new challenges.The majority of scientific studies and public health initiatives have historically focused
Source: karger.comCategories: General Medicine News, Cardiologists1Tweet
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Mashup Score: 0“Stat Rosa Pristina Nomine, Nomina Nuda Tenemus”: The Many Syndromes, Diseases, and Anatomic Structures Bearing Jean-Martin Charcot’s Name - 14 day(s) ago
Abstract. The sheer magnitude of Jean-Martin Charcot’s contributions to neurology, pathology, psychiatry, and internal medicine has allowed for the common usage of eponyms bearing the master’s name in recognition of his work. However, these are so numerous that confusion has naturally arisen concerning the exact nature of each eponym, allowing for different specialists to refer to completely different ailments or symptoms, while using the very same expression. Previous compilations of his eponyms were often incomplete. Therefore, the authors aimed to bring some clarification into the nature and origin of each known eponym with Charcot’s name.
Source: karger.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 9The Challenges of Screening Master Athletes - 15 day(s) ago
In recent decades, there has been a significant increase in the number of men and women over the age of 40 participating in high-intensity endurance sports, often referred to as “master athletes.” The “State of the Running 2019” report by RunRepeat.com and the International Association of Athletics Federation covers 96% of US recreational race results, 91% of the race results from the EU, Canada, and Australia, and a big portion from Asian, Africa, and South America. According to this study, more than a million people finished a marathon in 2018 (compared to less than half million in 2001): of those, more than 40% were over 40 years old [1] (Fig. 1). Other endurance sports, such as cycling, also show a large number of adult and senior competitors. This trend towards a higher mean age of participants in strenuous sport disciplines obliges the sports cardiology community to confront new challenges.The majority of scientific studies and public health initiatives have historically focused
Source: karger.comCategories: General Medicine News, Cardiologists1Tweet
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Mashup Score: 41Sunlight Has Cardiovascular Benefits Independently of Vitamin D - 27 day(s) ago
Abstract. Background: High blood pressure (BP) is the leading risk factor for disability adjusted life years lost globally. Epidemiological data show a correlation between increased sun exposure and reduced population BP and cardiovascular mortality. Individuals with high serum vitamin D levels are at reduced risk of hypertension, cardiovascular disease and metabolic syndrome, yet multiple trial data show that oral vitamin D supplementation has no effect on these endpoints. Sunlight is a risk factor for skin cancers, but no link has been shown with increased all-cause mortality. Cohort studies from Scandinavia show a dose-dependent fall in mortality with increased sun-seeking behaviour. Skin contains significant stores of nitrogen oxides, which can be converted to NO by UV radiation and exported to the systemic circulation. Human studies show that this pathway can cause arterial vasodilatation and reduced BP. Murine studies suggest the same mechanism may reduce metabolic syndrome. Summ
Source: karger.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 69Renal Sodium Avidity in Heart Failure - 30 day(s) ago
Abstract. Background: Increased renal sodium avidity is a hallmark feature of the heart failure syndrome. Summary: Increased renal sodium avidity refers to the inability of the kidneys to elicit potent natriuresis in response to sodium loading. This eventually causes congestion, which is a major contributor to hospital admissions and mortality in heart failure. Key Messages: Important novel concepts such as the renal tamponade hypothesis, accelerated nephron loss, and the role of hypochloremia, the sympathetic nervous system, inflammation, the lymphatic system, and interstitial sodium buffers are involved in the pathophysiology of renal sodium avidity. A good understanding of these concepts is crucially important with respect to treatment recommendations regarding dietary sodium restriction, fluid restriction, rapid up titration of guideline-directed medical therapies, combination diuretic therapy, natriuresis guided diuretic therapy, use of hypertonic saline, and ultrafiltration.
Source: karger.comCategories: General Medicine News, CardiologistsTweet
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Mashup Score: 77Venous Excess Doppler Ultrasound: A Visual Guide to Decongestion in Cardiorenal Syndrome - 1 month(s) ago
Abstract. Promptly recognizing congestion, both clinical and hemodynamic, is paramount in the management of patients with heart failure. The pathophysiology of congestion involves a complex interplay of absolute fluid gain, volume redistribution from venous capacitance beds to the central venous circulation, inadequate excretion due to renal dysfunction, salt and water retention, and endothelial dysfunction. While congestive nephropathy is gaining wider recognition as a distinct variant of hemodynamic acute kidney injury (AKI), there are limited bedside diagnostic tools for proper evaluation of these patients. In this manuscript, we describe a case of AKI where POCUS helped us diagnose clinically silent congestion as well as monitor the response to therapy. A patient with heart failure with mildly reduced ejection fraction was initially administered intravenous fluids for rise in serum creatinine attributed to volume depletion. However, POCUS demonstrated a completely different scenari
Source: karger.comCategories: General Medicine News, Critical CareTweet
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Mashup Score: 12COMPUTED TOMOGRAPHY PERFUSION IN ACUTE STROKE ASSESSMENT - 1 month(s) ago
Abstract. Background: Traditionally, non-contrast computed tomography (CT) alone was used in the initial assessment of acute ischaemic stroke patients mainly to exclude haemorrhage or alternative pathology. Summary: Late-window (beyond 6 hours) and recent large-volume endovascular mechanical thrombectomy (MT) trials integrated CT Perfusion (CTP) imaging to guide MT and/or intravenous thrombolysis (IVT) decision-making in stroke patients. Key Messages: In current clinical practice, many patients are being excluded from reperfusion therapy due to a lack of data from urgent investigations to assess cerebral vasculature and perfusion. Here, we explore the potential benefits of CTP incorporated into the initial CT protocol assessment of stroke patients.
Source: karger.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 73Sex and Socioeconomic Disparities in Dementia Risk: A Population-Attributable Fraction Analysis in Argentina - 1 month(s) ago
Abstract. Introduction: Twelve modifiable risk factors (RFs) account for 40% of dementia cases worldwide. However, limited data exist on such factors in middle- and low-income countries. We aimed to estimate the population-attributable fractions (PAFs) for the 12 RFs in Argentina, assessing changes over a decade and exploring socioeconomic and sex influences. Methods: We conducted cross-sectional analyses of the 12 RFs from Argentinian surveys conducted in 2009, 2015, and 2018, including 96,321 people. We calculated PAFs and stratified estimates based on sex and income. Results: We estimated an overall PAF of 59.6% (95% CI = 58.9–60.3%). The largest PAFs were hypertension = 9.3% (8.7–9.9%), physical inactivity = 7.4% (6.8–8.2%), and obesity = 7.4% (6.8–7.9%). Men were more impacted by excessive alcohol, while women by isolation and smoking. Lower income linked to higher PAFs in education, hypertension, and obesity. Discussion: Argentina has a higher PAF for dementia than the world popu
Source: karger.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 33Advances in Prehospital Management of Intracerebral Hemorrhage - 2 month(s) ago
Abstract. ABSTRACT Background: Spontaneous acute intracerebral hemorrhage (ICH) is associated with greater stroke-related disability and mortality. Hematoma expansion (HME), an important treatment target in acute ICH, is time-dependent, with a greater probability of hematoma growth occurring <3 hours from ICH onset. Summary: Promising treatment options to reduce HME include early intensive blood pressure (BP) reduction and the administration of hemostatic or anticoagulant reversal agents, yet large phase III clinical trials have so far failed to show overwhelming benefit for these interventions in acute ICH. Post-hoc analyses provide evidence, however, that the therapeutic benefit of such treatments is enhanced by rapid and ultra-early intervention, likely driven in large part by attenuation of early HME. Clinical trials assessing ultra-rapid treatments (<2 hours from ICH onset), including study procedures in the ambulance setting are currently underway, and demonstrate that the prehos
Source: karger.comCategories: General Medicine News, NeurologyTweet
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Mashup Score: 13
Abstract. Introduction: The ongoing OPTIMISTmain study, an international, multicenter, stepped-wedge cluster randomized trial, aims to determine effectiveness and safety of low-intensity versus standard monitoring in thrombolysis-treated patients with mild-to-moderate acute ischemic stroke (AIS). An embedded process evaluation explored integration and impact of the intervention on care processes at participating US sites. Methods: A mixed-methods approach with quantitative and qualitative data were collected between September 2021 and November 2022. Implementer surveys were undertaken at pre- and post-intervention phases to understand the perceptions of low-intensity monitoring strategy. A sample of stroke care nurses were invited to participate in semi-structured interviews at an early stage of post-intervention. Qualitative data were analyzed deductively using the normalization process theory; quantitative data were tabulated. Results: Interviews with 21 nurses at 8 hospitals have sh
Source: karger.comCategories: General Medicine News, NeurologyTweet
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