Current Trends in Ultramarathon Running.

Exercise is universally recognized for its health benefits and distance running has long been a popular form of exercise and sport. Ultramarathons, defined as races longer than a marathon, have become increasingly popular in recent years. The diverse ultramarathon distances and courses provide additional challenges in race performance and medical coverage for these events. As the sport grows in popularity, more literature has become available regarding ultramarathon-specific illnesses and injuries, nutrition guidelines, psychology, physiologic changes, and equipment. This review focuses on recent findings and trends in ultramarathon running.

Epidemiology of Shoulder Dislocation Treated at Emergency Departments in the United States Between 1997 and 2021.

Background: The exact incidence of shoulder dislocation in the general population of the United States (US) has yet to be well studied. Purpose: To establish the current incidence and patterns of shoulder dislocations in the US, especially regarding sports-related activity. Study Design: Descriptive epidemiology study. Methods: This was a retrospective analysis of shoulder dislocations encountered in emergency departments in the US between 1997 and 2021 as recorded in the National Electronic Injury Surveillance System (NEISS). Data were further analyzed according to patient age, sex, and sports participation. Information from the United States Census Bureau was used to determine the overall incidence of dislocations. Results: A total of 46,855 shoulder dislocations were identified in the NEISS database, representing a national estimate of 1,915,975 dislocations (mean 25.2 per 100,000 person-years). The mean patient age was 35.3 years. More than half of the dislocations (52.5%) were sports-related, and basketball (16.4%), American football (15.6%), and cycling (9%) were the sports most commonly associated with dislocation. Most dislocations (72.1%) occurred in men. This disparity by sex was more significant for sports-related dislocations (86.1% in men) than nonsports-related dislocations (56.7% in men; P < .001). With sports-related dislocations, people <21 years experienced a significantly higher proportion versus those >39 years (44.6% vs 14.9%; P < .001), while the opposite distribution was seen with nonsports-related dislocations (<21 years: 12% vs >39 years: 51.7%; P < .001). Women outnumbered men with shoulder dislocation among people >61 years. Conclusion: Sports-related shoulder dislocations were more common among younger and male individuals than older and female individuals. Contact sports such as basketball and American football were associated with more shoulder dislocations compared with noncontact sports.

Phenotypic and molecular differences between rats selectively bred to voluntarily run high vs. low nightly distances.

The purpose of the present study was to partially phenotype male and female rats from generations 8-10 (G8-G10) that had been selectively bred to possess low (LVR) vs. high voluntary running (HVR) behavior. Over the first 6 days with wheels, 34-day-old G8 male and female LVRs ran shorter distances (P < 0.001), spent less time running (P < 0.001), and ran slower (P < 0.001) than their G8 male and female HVR counterparts, respectively. HVR and LVR lines consumed similar amounts of standard chow with or without wheels. No inherent difference existed in PGC-1α mRNA in the plantaris and soleus muscles of LVR and HVR nonrunners, although G8 LVR rats inherently possessed less NADH-positive superficial plantaris fibers compared with G8 HVR rats. While day 28 body mass tended to be greater in both sexes of G9-G10 LVR nonrunners vs. G9-G10 HVR nonrunners (P = 0.06), body fat percentage was similar between lines. G9-G10 HVRs had fat mass loss after 6 days of running compared with their prerunning values, while LVR did not lose or gain fat mass during the 6-day voluntary running period. RNA deep sequencing efforts in the nucleus accumbens showed only eight transcripts to be >1.5-fold differentially expressed between lines in HVR and LVR nonrunners. Interestingly, HVRs presented less Oprd1 mRNA, which ties in to potential differences in dopaminergic signaling between lines. This unique animal model provides further evidence as to how exercise may be mechanistically regulated.

Epidemiology of Clavicle Fractures Sustained at a Colorado Ski Resort.

BACKGROUND: Although clavicle fractures are a common sports injury, there are limited studies on the incidence and causes of clavicle fractures among winter sports athletes. PURPOSE: To evaluate the characteristics and injury mechanisms associated with clavicle fractures among patients evaluated at a Colorado ski resort. STUDY DESIGN: Descriptive epidemiology study. METHODS: This was a retrospective descriptive analysis of patients with clavicle fractures at the Denver Health Winter Park Medical Center during the 2012-2013 to 2016-2017 ski seasons. Chart review was performed on the patient cohort to confirm clavicle fracture diagnosis and to evaluate factors associated with clavicle fracture. RESULTS: A total of 393 clavicle fractures (6.2% of total clinic visits) occurred during the study period, corresponding to an overall clavicle fracture incidence of 8.4 per 100,000 participant-visits. The mean patient age was 26.4 years (range, 5-73 years). The majority were middle-third fractures (85.5%), occurring mainly in men (87.3%). More than half of the fractures were comminuted (54.5%) and occurred in snowboarders (55.0%). The most common mechanism of injury was a fall onto snow while skiing or snowboarding (92.4%). Women sustained more clavicle fractures while skiing compared with snowboarding (82.0% vs 18.0%; P < .001), while men sustained more fractures while snowboarding compared with skiing (60.3% vs 39.7%; P < .001). CONCLUSION: Clavicle fractures are relatively common, but there are scant incidence data for clavicle fractures in mountain sports. Consistent with prior studies, clavicle fractures were more common in younger patients and men. The most common anatomic fracture location was the midclavicle. A greater proportion of clavicle fractures among men were sustained during snowboarding and among women during skiing.

Frequency of Continuous Renal Replacement Therapy Use Early in Coronavirus Disease 2019 Pandemic.

OBJECTIVES: A subset of patients with coronavirus disease 2019 develop renal failure and require continuous renal replacement therapy. We reviewed the available literature to understand the frequency of continuous renal replacement therapy use among patients with coronavirus disease 2019 who required intensive care. DATA SOURCES: The authors reviewed PubMed and Google Scholar for published studies and MedRxiv.com for unpublished studies. STUDY SELECTION: Observational and randomized studies that report the frequency of continuous renal replacement therapy use in adult patients with coronavirus disease 2019. DATA EXTRACTION: Data from the eligible studies were extracted independently by two authors into Microsoft Excel. DATA SYNTHESIS: We identified 12 eligible studies (eight published, four unpublished). We found that up to 20% of patients admitted to ICUs may require continuous renal replacement therapy. CONCLUSIONS: Given the high utilization of continuous renal replacement therapy by critically ill patients with coronavirus disease 2019, there may be an urgent need to mobilize inpatient dialysis resources to cope with the anticipated increase in the demand.