Artificial Intelligence in Sports Medicine: Reshaping Electrocardiogram Analysis for Athlete Safety-A Narrative Review.

Artificial Intelligence (AI) is redefining electrocardiogram (ECG) analysis in pre-participation examination (PPE) of athletes, enhancing the detection and monitoring of cardiovascular health. Cardiovascular concerns, including sudden cardiac death, pose significant risks during sports activities. Traditional ECG, essential yet limited, often fails to distinguish between benign cardiac adaptations and serious conditions. This narrative review investigates the application of machine learning (ML) and deep learning (DL) in ECG interpretation, aiming to improve the detection of arrhythmias, channelopathies, and hypertrophic cardiomyopathies. A literature review over the past decade, sourcing from PubMed and Google Scholar, highlights the growing adoption of AI in sports medicine for its precision and predictive capabilities. AI algorithms excel at identifying complex cardiac patterns, potentially overlooked by traditional methods, and are increasingly integrated into wearable technologies for continuous monitoring. Overall, by offering a comprehensive overview of current innovations and outlining future advancements, this review supports sports medicine professionals in merging traditional screening methods with state-of-the-art AI technologies. This approach aims to enhance diagnostic accuracy and efficiency in athlete care, promoting early detection and more effective monitoring through AI-enhanced ECG analysis within athlete PPEs.

Delayed Diagnosis of Clostridium difficile Colitis in a 48-Year-Old Woman with a Homozygous Mutation of the UGT1A1 Gene While on Chemotherapy for Colorectal Carcinoma.

BACKGROUND There are many causes of chronic colitis and diarrhea, including the effects of chemotherapy. Mutations in the UGT1A1 gene can be associated with increased toxicity from irinotecan-based chemotherapy. This report is of a case of delayed diagnosis of Clostridium difficile (C. difficile) colitis in a 48-year-old woman with a homozygous mutation of the UGT1A1 gene treated with chemotherapy for colorectal carcinoma. CASE REPORT A 48-year-old woman with a low-differentiated colonic adenocarcinoma was treated after surgery with irinotecan, 5 fluorouracil, and panitumumab and had a history of chronic and severe diarrhea. Genetic testing identified a mutation in the UGT1A1 gene associated with increased toxicity to irinotecan, and the EIA tests performed for evaluation of C. difficile toxins A and B showed repeatedly negative results. Replacement of irinotecan with oxaliplatin did not have significant therapeutic results, but these were achieved by the administration of active antibiotics against C. difficile (metronidazole, vancomycin, and fidaxomicin). CONCLUSIONS This report has shown that in complex cases where patients are treated with chemotherapy and have increased susceptibility to drug toxicity, chronic diarrhea may still have an infectious cause. Only when the diagnosis is correctly made can the patient be appropriately treated.

Preparticipation medical evaluation for elite athletes: EFSMA recommendations on standardised preparticipation evaluation form in European countries.

Sports medicine is a medical specialty that supports the performance of professional and amateur athletes while maintaining their health. Sports medicine professionals need to ensure the safe participation of athletes in sports activities achieved through a periodical preparticipation evaluation (PPE) and a regular medical monitoring of the athletes' health in accordance with the latest recommendations regarding health condition and medical history, physical working capacity, training period and programme, recovery, nutrition, use of supplements, injuries prevention and safe return to play. In order to harmonise these national variations in the content and application of the PPE, the EFSMA Scientific and Educational Commission proposes a 'gold standard' for elite athletes across Europe. Important objectives of PPE are early detection and prevention of severe complications during sports activities both in leisure time and competitive sports. The PPE should entail the following diagnostic components: health status, anthropometry, functional and exercise capacity. It is of utmost importance to develop and implement preventive strategies such as the PPE. Besides monitoring the health status of athletes, the PPE plays an important role in the selection process, bringing valuable information for coaches and supporting a personalised treatment approach. Screening of athletes through a standardised digital PPE could be beneficial for a better understanding of the impact of long-term physical activity. Furthermore, PPE leads the scientific community to a way of working closer together in the interest of the athletes.