Effects of nutritional and hydration strategies during ultramarathon events between finishers and non-finishers: A systematic review protocol.

Ultramarathon running is a sport that is growing in popularity. Competing in an ultramarathon event is physiologically taxing on the human body, and it should not be surprising that not all individuals who enroll for an event ultimately finish. While many factors can contribute to this phenomenon, it is likely that nutritional and hydration strategies play a large role between finishing and not finishing an ultramarathon. No published paper has systematically reviewed the effects of nutritional and hydration strategies during ultramarathon events between finishers and non-finishers. This paper details our intended protocol with the following steps that create the flow of the systematic review: 1) Determine the review question and Participant, Intervention, Comparator, Outcome, Study Design (PICOS) criteria; 2) Create inclusion and exclusion criteria; 3) Create and follow a search strategy; 4) Document sources that are included and excluded according to the pre-determined eligibility criteria; 5) Assess final sources for risk of bias; 6) Extract pertinent data from final full-text articles and synthesize the information; and 7) Disseminate findings of the systematic review.

Cardiac Structure and Function in Adults with Down Syndrome.

Various factors may alter the risk for cardiovascular disease in adults with Down syndrome (Ds), yet few studies have examined differences in cardiac physiology in this population. Previous research suggested lower systolic and diastolic function, but inconsistent methodologies and younger samples warrant research in adults with Ds. Our aim is to compare the cardiac structure and function of adults with Ds to age- and sex-matched adults without Ds. Echocardiography was used to assess systolic function, diastolic function, and cardiac structure in n = 19 adults (Ds n = 9, control n = 10). Regarding cardiac structure, adults with Ds had increased left ventricular posterior wall thickness at end-systole compared to adults without Ds (p = 0.007). Regarding systolic and diastolic function, adults with Ds were found to have lower septal peak systolic annular velocity (S') (p = 0.026), lower lateral and septal mitral annular early diastolic velocity (E') (p = 0.007 and p = 0.025, respectively), lower lateral peak mitral annular late diastolic velocity (A') (p = 0.027), and higher lateral and septal mitral annular early systolic velocity to diastolic velocity ratios (E/e') (p = 0.001 and p = 0.001, respectively). Differences in both cardiac structure and function were found when comparing adults with Ds to matched adults without Ds. Most of the differences were indicative of worse diastolic function.