Search Results (8)

Myocardial bridging (MB) is a congenital coronary anomaly in which a segment of an epicardial coronary artery courses intramurally beneath the myocardium for part of its length, resulting in dynamic compression during systole. Once considered a largely benign incidental finding, accumulating evidence has demonstrated MB to be a clinically significant substrate for myocardial ischemia, arrhythmia, and sudden cardiac death (SCD), particularly under conditions of elevated adrenergic drive such as vigorous physical exercise. The prevalence of MB is highly dependent on the diagnostic modality used, ranging from approximately 0.5–2.5% on coronary angiography to 15–85% on post-mortem and advanced intravascular imaging studies, reflecting a substantial detection gap- in particular on routine cardiac screening tests. This review critically examines the current evidence base regarding MB in the context of competitive and recreational sport. We address: (1) the pathophysiology of exercise-induced hemodynamic compromise in MB; (2) the limitations of existing screening modalities—including electrocardiography, echocardiography, exercise stress testing, and advanced coronary imaging in identifying athletes at risk; (3) the clinical management of symptomatic MB, encompassing pharmacological therapy, coronary revascularization strategies, and catheter-based interventions; and (4) physical activity guidance for athletes with known or suspected MB. Full article

The purpose of this study was to explore the adaptations that schools made to physical activity programs and facilities, and disparities by area urbanicity and income, during the first school year after the emergence of the COVID-19 pandemic. In a convenience sample of 132 secondary schools in Canada, school contacts responded to an annual survey in the 2020–2021 school year on changes to physical activity programs and facilities, and related staff training. Content analysis categorized open-ended text responses, and schools were compared based on area urbanicity and median income. Most schools canceled all interschool sports (88.9%) and intramurals (65.9%). New programs were added by 12.6% of schools, and about half (49%) of schools reported some continuing programs, most of which were sports programs, followed by facility and equipment access. Physical activity facilities were closed in 18.1% of schools, while 15.7% had new facilities added, and 11% temporarily converted facilities into learning spaces. Large/medium urban schools were at greater odds of having made any change to their facilities compared to schools in rural/small urban areas (odds ratio (95% confidence interval): 2.3 (1.1, 4.8)). The results demonstrate the considerable scale and nature of the restrictions in school provisions of physical activity opportunities during this period, as well as the resourcefulness of some schools in adding new programs and facilities. Full article

Background: The complications associated with Meckel’s diverticulum (MD) are well-known. However, blunt injuries regarding MD have not been widely described in the literature. This was the reason for undertaking research on MD lesions. Materials and Methods: The materials consisted of 28 cases of damage to MD after blunt trauma published during the years 1921–2022. The collected data were subjected to statistical analysis. Results: The following MD injuries have been identified, starting with the most common isolated perforation of MD, bleeding from the area of MD, perforation of MD with concomitant tearing of the mesentery intestines and bleeding, intussusception of MD, and intramural hematoma of MD with adjacent mesenteric hematoma. Most injuries were caused by a traffic accident, followed by sports, accidents at work, and then violence. Almost all the cases (27) involved men. Several possible mechanisms may contribute to post-traumatic damage to MD. First of all, they are associated with abdominal compression and a secondary increase in intra-abdominal pressure as well as with the action of shearing forces during deceleration. Conclusions: Traumatic MD injuries are differentiated and very rare. They can coexist with other serious injuries to the abdominal organs. Full article

Schools are well-positioned to provide physical activity opportunities to help youth achieve the recommended 60 or more daily minutes of moderate-to-vigorous physical activity. The Children’s Physical Activity Research Group (CPARG) at the University of South Carolina has focused on understanding physical activity in school-aged youth for 30+ years. The purpose of this article was to critically review (CPARG) contributions to the field in school settings and school-age youth. We reviewed 127 published CPARG articles from six research projects conducted between 1993–2019. The review was guided by questions in five categories: measurement of physical activity and its determinants, characteristics of physical activity behavior, correlates/determinants of physical activity, physical activity interventions, and race/ethnicity and physical activity. Results were summarized by question and synthesized across categories. CPARG contributions included assessing physical activity levels, patterns, forms, and contexts; identifying and measuring physical activity correlates/determinants; and conducting school-based physical activity interventions. Identifying multiple domains of physical activity determinants enables researchers and practitioners to select/design age-appropriate, valid, and reliable instruments to assess determinants. Focusing on determinants enables them to create effective physical activity interventions, environments, programs, and policies in schools. These efforts must address race/ethnicity differences, ensuring that measurement instruments and intervention strategies are culturally appropriate. Full article

(1) School-based physical activity programs such as intramurals provide youth with inclusive opportunities to be physically active, yet we know little about how types of intramurals (e.g., team and individual sports) may contribute to youth MVPA. This research aims to evaluate how real-world changes in types of intramurals available in schools impact youth physical activity over time. (2) This study used three years of longitudinal school- and student-level data from Ontario schools participating in year 5 (2016–2017), year 6 (2017–2018) and year 7 (2018–2019) of the COMPASS study. Data on types of intramural programs from 55 schools were obtained, baseline demographic characteristics were measured and data on physical activity and sport participation were collected on a sample of 4417 students. Hierarchical linear mixed regression models were used to estimate how changes in the type of intramurals associate with youth MVPA over time. (3) Regardless of participation, adding individual and team intramurals was significantly and positively associated with female MVPA in Y6. (4) The indirect, but positive relationship between adding individual and team intramurals and female MVPA may be explained by other characteristics of the school environment that are conducive to female MVPA. Full article

Center-based early childhood education and care (ECEC) programs are well-positioned to create positive impacts on the health and development of large numbers of young children by promoting physical activity using evidence-based programs. Studies testing physical activity programs for young children should examine the circumstances under which programs are most effective by assessing the role of contextual factors on program outcomes. The purpose of this study was to examine the moderating effects of baseline ECEC center characteristics on the relationship between the Study of Health and Activity in Preschool Environments (SHAPES) intervention and moderate-to-vigorous physical activity (MVPA). MVPA was assessed via accelerometry; center characteristics, practices, and social and physical environments were assessed by director interview and observation; and center quality was assessed using the Early Childhood Environment Rating Scale-Revised Edition. Mixed-model analyses of covariance (ANCOVAs) examined intervention effects on MVPA during the school day; interactions between baseline center variables and group assignment (intervention vs. control) tested for moderation. Two center instructional practices, two social environment characteristics, and one physical environment characteristic at baseline moderated the effects of SHAPES on MVPA outcomes. Assessing baseline practices and center characteristics may aid efforts to match centers with interventions likely to increase physical activity as well as suggest additional intervention strategies to test. Full article

An anomalous coronary artery from the opposite sinus of Valsalva (ACAOS) is a rare inherited cardiac condition with a prevalence of around 1% in the general population. ACAOS is associated with sudden cardiac death in young athletes and therefore its exclusion by means of cardiac imaging is crucial in young symptomatic individuals. With the increasing use of noninvasive imaging modalities to exclude coronary artery disease (CAD) in the middle-aged and older population, physicians are faced with an increased absolute number of patients with the incidental finding of ACAOS. However, it seems that in the middle-aged population the intrinsic risk of ACAOS moves into the background compared with the gradually increasing risk associated with CAD. The assessment of high-risk anatomical features, such as slit-like ostium, acute take-off angle, interarterial course, intramural course with elliptical vessel shape and proximal narrowing of the anomalous vessel is a cornerstone in the evaluation of patients with ACAOS. Further, downstream testing in order to evaluate haemodynamic relevance by means of perfusion imaging of anatomic high-risk features in ACAOS is critical. Perfusion can be tested with single-photon emission computed tomography (SPECT) or positron-emission tomography (PET), allowing fusion with coronary computed tomography angiography and enabling differentiation of perfusion defects from an anomalous coronary artery and from possible concomitant CAD. As to date no randomised prospective trials are available, the therapeutic approach to sports restriction and/or surgery is mainly based on experts’ opinions and recommendations with a low level of evidence, and is usually chosen on an individual case-by-case basis. A presumed prognostic benefit from surgical repair and sports restriction should be carefully balanced against the risk of surgery and possible impairment to quality of life, and patient management should be chosen only after considering symptoms, age, sports behaviour, and imaging information. Full article

Research has shown that exposure to a concussion definition (CD) increases self-reported concussion history (SRCH) immediately, however, no research has been performed that examines the effects of exposure to a CD on SRCH over time. Collegiate recreational student-athletes (RSAs) have limited access to monitoring and supervision by medical staff. As such, recognition of concussion symptoms and need for medical management oftentimes falls upon the RSA. The purpose of this study was to assess the effect of a novel questionnaire on the SRCH of RSAs. A two-part questionnaire was sent to RSAs participating is sports with a greater than average risk of concussion at a university in Arizona. Data from 171 RSAs were analyzed to assess the change in RSAs’ suspected concussion estimates pre- and post-exposure to a CD and concussion symptom worksheet, as well as over the short-term (2.5 months). Approximately one-third of RSAs reported an increase in suspected concussion estimates immediately following exposure to the questionnaire, but the change was not maintained over the short-term. The results suggest that a single exposure to a CD is ineffective at increasing short-term SRCH estimates. Full article