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British Journal of Sports Medicine Sep 2016The modern-day athlete participating in elite sports is exposed to high training loads and increasingly saturated competition calendar. Emerging evidence indicates that...
The modern-day athlete participating in elite sports is exposed to high training loads and increasingly saturated competition calendar. Emerging evidence indicates that inappropriate load management is a significant risk factor for acute illness and the overtraining syndrome. The IOC convened an expert group to review the scientific evidence for the relationship of load-including rapid changes in training and competition load, competition calendar congestion, psychological load and travel-and health outcomes in sport. This paper summarises the results linking load to risk of illness and overtraining in athletes, and provides athletes, coaches and support staff with practical guidelines for appropriate load management to reduce the risk of illness and overtraining in sport. These include guidelines for prescription of training and competition load, as well as for monitoring of training, competition and psychological load, athlete well-being and illness. In the process, urgent research priorities were identified.
Topics: Acute Disease; Athletes; Athletic Injuries; Athletic Performance; Biomarkers; Cumulative Trauma Disorders; Diet, Healthy; Evidence-Based Medicine; Female; Health Promotion; Humans; Immune System; Male; Physical Education and Training; Practice Guidelines as Topic; Professional Practice; Return to Sport; Risk Factors; Sports Medicine; Stress, Psychological; Terminology as Topic; Travel; Workload
PubMed: 27535991
DOI: 10.1136/bjsports-2016-096572 -
Der Internist Oct 2021
Topics: Acute Disease; Humans; Pancreatitis, Chronic
PubMed: 34586450
DOI: 10.1007/s00108-021-01168-w -
The New England Journal of Medicine Mar 2018Comparative clinical effects of balanced crystalloids and saline are uncertain, particularly in noncritically ill patients cared for outside an intensive care unit (ICU). (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Comparative clinical effects of balanced crystalloids and saline are uncertain, particularly in noncritically ill patients cared for outside an intensive care unit (ICU).
METHODS
We conducted a single-center, pragmatic, multiple-crossover trial comparing balanced crystalloids (lactated Ringer's solution or Plasma-Lyte A) with saline among adults who were treated with intravenous crystalloids in the emergency department and were subsequently hospitalized outside an ICU. The type of crystalloid that was administered in the emergency department was assigned to each patient on the basis of calendar month, with the entire emergency department crossing over between balanced crystalloids and saline monthly during the 16-month trial. The primary outcome was hospital-free days (days alive after discharge before day 28). Secondary outcomes included major adverse kidney events within 30 days - a composite of death from any cause, new renal-replacement therapy, or persistent renal dysfunction (defined as an elevation of the creatinine level to ≥200% of baseline) - all censored at hospital discharge or 30 days, whichever occurred first.
RESULTS
A total of 13,347 patients were enrolled, with a median crystalloid volume administered in the emergency department of 1079 ml and 88.3% of the patients exclusively receiving the assigned crystalloid. The number of hospital-free days did not differ between the balanced-crystalloids and saline groups (median, 25 days in each group; adjusted odds ratio with balanced crystalloids, 0.98; 95% confidence interval [CI], 0.92 to 1.04; P=0.41). Balanced crystalloids resulted in a lower incidence of major adverse kidney events within 30 days than saline (4.7% vs. 5.6%; adjusted odds ratio, 0.82; 95% CI, 0.70 to 0.95; P=0.01).
CONCLUSIONS
Among noncritically ill adults treated with intravenous fluids in the emergency department, there was no difference in hospital-free days between treatment with balanced crystalloids and treatment with saline. (Funded by the Vanderbilt Institute for Clinical and Translational Research and others; SALT-ED ClinicalTrials.gov number, NCT02614040 .).
Topics: Acute Disease; Adult; Aged; Cross-Over Studies; Electrolytes; Emergency Service, Hospital; Emergency Treatment; Female; Fluid Therapy; Hospitalization; Humans; Isotonic Solutions; Kidney Diseases; Male; Middle Aged; Renal Replacement Therapy; Ringer's Lactate; Sodium Chloride
PubMed: 29485926
DOI: 10.1056/NEJMoa1711586 -
The Lancet. Respiratory Medicine Jun 2021
Topics: Acute Disease; COVID-19; Humans; Phenotype; SARS-CoV-2
PubMed: 34089668
DOI: 10.1016/S2213-2600(21)00242-3 -
Critical Care Clinics Apr 2016Acute mesenteric ischemia (AMI) is a rare disease that most commonly affects the elderly. The vague symptoms often lead to delayed diagnosis and consequent high... (Review)
Review
Acute mesenteric ischemia (AMI) is a rare disease that most commonly affects the elderly. The vague symptoms often lead to delayed diagnosis and consequent high mortality. Physical exam and laboratory findings lack the sensitivity and specificity to exclude AMI, but computed tomography angiography can rapidly and accurately confirm the diagnosis. Survival improves with prompt restoration of perfusion and resection of nonviable bowel. Advances in imaging, operative techniques, and critical care have led to a steady decline in overall mortality; however, long-term survival is limited because of the comorbidities in this patient group.
Topics: Acute Disease; Humans; Intestines; Mesenteric Ischemia; Tomography, X-Ray Computed
PubMed: 27016159
DOI: 10.1016/j.ccc.2015.11.001 -
Revue Medicale Suisse Nov 2022
Topics: Humans; Pancreatitis; Acute Disease; Fluid Therapy; Resuscitation
PubMed: 36382984
DOI: 10.53738/REVMED.2022.18.804.2187 -
Lancet (London, England) Jan 2021
Topics: Acute Disease; Enteral Nutrition; Humans; Pancreatitis
PubMed: 33485449
DOI: 10.1016/S0140-6736(21)00093-3 -
Lancet (London, England) Jan 2021
Topics: Acute Disease; Humans; Pancreatitis
PubMed: 33485451
DOI: 10.1016/S0140-6736(21)00092-1 -
MMW Fortschritte Der Medizin May 2022
Review
Topics: Acute Disease; Blood Glucose; Humans; Hyperglycemia
PubMed: 35513666
DOI: 10.1007/s15006-022-0993-x -
MMW Fortschritte Der Medizin Feb 2023
Topics: Humans; Acute Disease; Nasal Lavage; Sinusitis
PubMed: 36759459
DOI: 10.1007/s15006-023-2345-x