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team management

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Sudden death of an athlete is the most devastating medical event in sports. While accidents account for more than 50% of these cases, sudden cardiac deaths (SCD) are less frequent (approx. 15%), but the leading medical cause of deaths. The risk depends on age, sex, ethnicity, type of sport and sport level. There are large variations in the methods of registration of SCD in recreational and competitive sports. This must be taken into account when interpreting reported incidences and causes. High data quality in registries is a prerequisite for meaningful preventive strategies (e.g. ECG screening and safety at sports facilities).
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Through continuous improvement of diagnostic accuracy of ECG criteria for athletes sensitivity as well as specificity have grown so much that foregoing this screening tool is not feasible anymore. The most updated guidelines, the so-called “International (Seattle) Criteria” globally exhibit the most important reference publication, currently. The criteria were created with the purpose that particularly “non-cardiologists” should be able to use them before clearly pathological findings lead to further follow-up examinations at a specialist. On the other hand, physiologic ECG findings should not prompt expensive further evaluations, as it used to happen quite frequently.
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Traditionally, cardiovascular screening has been recommended mostly for competitive athletes younger than 35 years. The perception that only young competitive athletes at top level are at increased risk, has changed in the last years. Theoretically, we advocate a voluntary cardiovascular screening for all athletes who exercise vigorously, independent of their competitive status, and age. Although, this should be based on an individual estimation of the athlete’s risk. Physical examination, medical history and an ECG should be the baseline investigations for all athletes.
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As soon as he prescibes medicine to an athlete, any physician is confrounted if he wants or not, and if he is aware of it or not, with the numerous and often complex rules treating with the universal fight against doping. In case of an involountary mistakee or not, the doctor can be involved in very unpleasant situations over different regulations. As ignorance is no valid defense form, it seems obvious that it is very imporant that each practitionner is informed the better possible about these legal aspects. This is the objective of the following presentation.
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There was a longstanding controversy on the role of resting ECG in the preparticipation examination in athletes, as well as in children and adolescent, in leisure time or top athletes. Besides other arguments, this was due to the limited validity, to the false positive and false negative findings often followed by a thorough clinical examination. However, recent studies from different research groups yielded a significant improvement in establishing ECG criteria in athletes discriminating normal from abnormal or pathological findings in athletes.This in addition is supported and improved by a software-based ECG device considering the new Seattle criteria. These new criteria from the Seattle conference reliably discriminate normal from abnormal findings. Frequent ECG findings in athletes, especially in those engaged in endurance sports showed sinus bradycardia, AV-block and signs of left ventricular hypertrophy.
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Created in 2008, the Cycling Anti-Doping Foundation (CADF), is a non-profit organization acting under Swiss law that became fully independent in 2013. Unique model for a sporting organization, the CADF’s role is to manage autonomously the Anti-Doping programme, on behalf of the Union Cycliste Internationale (UCI). The relationships between UCI and CADF are regulated by a contract signed by the CADF Foundation Board and UCI management. The CADF activities are conducted in compliance with the World Anti-Doping code [1], the UCI Anti-Doping rules [2].
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A career in elite sports requires a significant investment of time. Professional sportsmen, such as Swiss ice hockey players, are intensively involved in the system of high-performance sports. From junior years through to the end of a professional career, a high investment of time is necessary to develop the appropriate sporting achievements. Building an ice hockey career occurs at the same time as the school phase of vocational training. The high time-demand of sport training can affect the choices and occupational opportunities offered at this time. After the end of the professional career and hockey players are forced to enter ’normal’ working life.
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The intermittent fasting of Ramadan could affect various aspects of body physiology and biochemistry important to athletic success. Sleep time may be shortened. Disturbance of psychomotor performance, impaired vigilance and slower reactions can be observed particularly during afternoon. Food intake is limited to night-time meals. Well disciplined athletes usually maintain energy balance unless daily energy expenditures are very high. Daytime fluid depletion is inevitable if athletes exercise in the heat.
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Injury prevention is a priority in the field of sports medicine and in physical activity promotion, in particular for youth. Injuries can lead to long term handicaps and disengagement from physical activity. The follow up of young sportsmen in the canton of Geneva over the last 35 years has permitted to get an idea of the prevalence of injuries in young sportsmen and allows a comparison with the general population. It has also permitted to get an idea of the influence prevention has had on injuries.
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