11 research outputs found
Medical conditions and illness in elite football players during international competition
No full textIncludes bibliographical references (leaves 121-128).Background: Previous clinical research of football players participating in international tournaments has mainly focussed on documentation of injuries and risk factors for injury. However, despite anecdotal evidence that medical symptomatology, illness and medical complaints are common during travel to international competitions, the epidemiology of medical conditions before, during or after elite level football tournaments, has not been well documented. Objective: The aims of the research presented in this dissertation were: 1) to determine the prevalence of medical conditions in elite football players 2) to determine the incidence and nature of medical conditions and illness in the elite football players participating in an international tournament (2009 FIFA Confederations Cup tournament) and 3) to provide data for the medical planning and management of elite football players during future events. Methods: The first component of this dissertation consisted of a comprehensive review of the current literature describing the prevalence and incidence of medical conditions and illness in athletes. The original research component of this dissertation consisted of two parts, and both studies were conducted during the FIFA Confederations Cup tournament, which was held in South Africa in June 2009. All the players in the 8 participating teams (23 players per team – a total of 184 players) were approached by the FIFA Medical Assessment and Research Centre (F-MARC) through their team physicians and invited to participate as research subjects in the studies. Part 1 (descriptive cross-sectional study): Prior to the tournament, all the players completed a previously validated medical history and illness questionnaire. Furthermore, the questionnaire contained sections on player demographics, training history, medication and supplement use, life-style history, family history of atopy, current and past history of medical conditions and detailed sections pertaining to upper respiratory tract infections (URTI), allergies, asthma, exercise associated muscle cramping (EAMC) and history of previous surgery. Part 2 (prospective cohort study): During the 15 days of the tournament each team physician was requested to complete a daily injury, medical illness and treatment log for each player. Finally, data on the environmental conditions at each venue were collected, as recorded by the South African Weather Service. Results: The main findings in part 1 of this study were: 1) exercise associated muscle cramping (EAMC) was the most prevalent medical condition reported, with 64 (46%) of the players reporting a history of EAMC, 2) the prevalence of allergy was 27 (20%) and asthma 6 (4%), 3) the prevalence of dermatological conditions was 16 (12%), 4) the prevalence of gastro-intestinal conditions was 10 (7%) and central nervous system conditions was 6 (4%), 5) URTI one week before the tournament was reported by 7 (5%) of the players, 6) 68 (49%) of the players reported a history of previous surgery and 7) 72 (52%) of the players reported the use of supplements or vitamins and 11 (8%) the use of medication. Knee surgery was the most common anatomical area operated with 33 (24%) of the players reporting previous knee surgery. This was followed by a much lower prevalence of ankle surgery, 8 (6%). In part 2 of the study, a total of 56 injuries and 35 illnesses were recorded during the tournament. The main findings in this study were: 1) an overall injury rate of 64.4 injuries per 1000 match hours or 2.1 injuries per match, 2) an overall rate of 2.7 injuries and 1.7 illnesses per 100 player days, 3) that 0.88 days were lost per injury and 0.46 days were lost per illness, 4) the lower limb was the most commonly injured body part, 5) 11 (20%) of the injuries reported were to the thigh, 6) 15 (44%) of the injuries reported were due to a contusion, 6) 13 (37%) of the illnesses reported were due to ENT conditions, and 7) 7 (20%) were due to respiratory tract symptoms. Summary and conclusion: Illness and injury are common during an international football tournament. The pattern of injury was similar to that previously reported. However, the novel finding of this dissertation was that illness is a significant component to the medical care to a travelling team and needs to be considered by team physicians managing the medical needs of elite football teams
Upper respiratory tract symptoms and allergies in Ironman triathletes
No full textIncludes bibliographical references (leaves 69-77).Triathletes, in particular Ironman triathletes, undergo intense training and compete in a very physically demanding race. Medical conditions in the pre-race period in these triathletes have not been well documented, but there is evidence form other endurance sports that symptoms of respiratory tract infection are particularly common. However, the prevalence, causes and consequences of these symptoms have not been studied in Ironman triathletes. The aims of this study were: 1) to determine the incidence of respiratory tract symptoms (RTS) in triathletes preparing for an Ironman Triathlon, 2) to establish the factors associated with the development of these RTS, and 3) to determine the effects of the RTS on pre-race training and race performance. Methods: In this cross-sectional descriptive study, 304 triathletes entering the 2006 Ironman triathlon in South Africa were recruited as subjects. All the subjects completed a validated questionnaire in the 1-3 days before the race (during registration). The questionnaire contained sections on demographics, training and previous competitions, common general medical conditions that they may have experienced, and a detailed section pertaining to RTS and allergies, including use of medication. Data on race performance was collected after completion of the race. Subjects were divided into the following groups, based on their self-reported history of RTS in the 6 weeks period prior to the race: no RTS, all RTS, only upper respiratory tract symptoms (URTS), lower respiratory tract and/or systemic symptoms (LRT +SS)
The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial
No full textBackground In patients with heart failure, beta-blochade has improved morbidity and left-ventricular function, but the impact on survival is uncertain. We investigated the efficacy of bisoprolol, a beta(1) selective adrenoceptor blocker in decreasing all-cause mortality in chronic heart failure. Methods In a multicentre double-blind randomised placebo-controlled trial in Europe, we enrolled 2647 symptomatic patients in New York Heart Association class III or IV, with left-ventricular ejection fraction of 35% or less receiving standard therapy with diuretics and inhibitors of angiotensin-converting enzyme. We randomly assigned patients bisoprolol 1.25 mg (n=1327) or placebo (n=1320) daily, the drug being progressively increased to a maximum of 10 mg per day. Patients were followed up for a mean of 1.3 years. Analysis was by intention to treat. Findings CIBIS-II was stopped early, after the second interim analysis, because bisoprolol showed a significant mortality benefit. All-cause mortality was significantly lower with bisoprolol than on placebo (156 [11.8%] vs 228 [17.3%] deaths with a hazard ratio of 0.66 (95% CI 0.54-0.81, p<0.0001). There were significantly fewer sudden deaths among patients on bisoprolol than in those on placebo (48 [3.6%] vs 83 [6.3%] deaths), with a hazard ratio of 0.56 (0.39-0.80, p=0.0011). Treatment effects were independent of the severity or cause of heart failure. Interpretation beta-blocker therapy had benefits for survival in stable heart-failure patients. Results should not, however, be extrapolated to patients with severe class IV symptoms and recent instability because safety and efficacy has not been established in these patients
Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)
No full textBackground Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II). Methods Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K. Results Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results. Interpretation Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This 'win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure. (C) 2001 The European Society of Cardiology
The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial
No full textBackground: In patients with heart failure, beta-blochade has improved morbidity and left-ventricular function, but the impact on survival is uncertain. We investigated the efficacy of bisoprolol, a beta(1) selective adrenoceptor blocker in decreasing all-cause mortality in chronic heart failure.
Methods: In a multicentre double-blind randomised placebo-controlled trial in Europe, we enrolled 2647 symptomatic patients in New York Heart Association class III or IV, with left-ventricular ejection fraction of 35% or less receiving standard therapy with diuretics and inhibitors of angiotensin-converting enzyme. We randomly assigned patients bisoprolol 1.25 mg (n=1327) or placebo (n=1320) daily, the drug being progressively increased to a maximum of 10 mg per day. Patients were followed up for a mean of 1.3 years. Analysis was by intention to treat.
Findings: CIBIS-II was stopped early, after the second interim analysis, because bisoprolol showed a significant mortality benefit. All-cause mortality was significantly lower with bisoprolol than on placebo (156 [11.8%] vs 228 [17.3%] deaths with a hazard ratio of 0.66 (95% CI 0.54-0.81, p<0.0001). There were significantly fewer sudden deaths among patients on bisoprolol than in those on placebo (48 [3.6%] vs 83 [6.3%] deaths), with a hazard ratio of 0.56 (0.39-0.80, p=0.0011). Treatment effects were independent of the severity or cause of heart failure.
Interpretation: beta-blocker therapy had benefits for survival in stable heart-failure patients. Results should not, however, be extrapolated to patients with severe class IV symptoms and recent instability because safety and efficacy has not been established in these patients
