[Sports Injuries and Illnesses of the German National Team during the 2016 Olympic Summer Games in Rio de Janeiro]. / Verletzungen und Erkrankungen der Deutschen Mannschaft bei den Olympischen Sommerspielen 2016 in Rio de Janeiro.

Background This article aims to survey and describe the injuries and illnesses of the German Team during the 2016 Olympic Games in Rio de Janeiro. Methods Through an electronic documentation system, injuries and illnesses requiring treatment were recorded and evaluated. An injury or illness was defined as any physical symptom that required medical attention and impaired participation in training and/or competition. The classification distinguished between type of injury (acute or overload), region and type of illness (infections, skin, allergy, etc.). Results A total of 808 treatments were performed on the German team during Rio 2016. Out of 283 musculoskeletal-related treatments, 160 were performed on the lower limb. 70 treatments addressed back problems. 164 treatments were performed due to upper respiratory tract infections. When extrapolated to 1000 athletes, 617 treatments were required due to illness while 672 treatments addressed musculoskeletal problems. The number of treatments for injuries and illness is almost identical. In addition to less severe problems, the following serious injuries occurred: lethal traumatic brain injury, acute thigh compartment syndrome, ACL tear with a medial meniscal lesion and antero-lateral instability, isolated ACL tear, stress fracture of the base of the third metatarsal bone, acute lateral ankle instability, AC joint dislocation, and infected bursa prepatellaris. CONCLUSIONS: The documentation system is reliable for "injury and illness surveillance" at multi-sport events. Treatment numbers are consistent with the 2012 Summer Games in London, so a reliable strategy can be assumed. In addition to illnesses predominantly affecting the upper respiratory tract, the system also recorded serious musculoskeletal injuries, which implicates the need for an interdisciplinary setup of the medical team. The methods used for data collection currently do not allow for the identification of risk factors for injuries and illness and should therefore be extended in the future.

The cardio-metabolic risk of moderate and severe obesity in children and adolescents.

OBJECTIVE: To compare the cardio-metabolic risk profile between moderately obese and severely obese children and adolescents. STUDY DESIGN: Cross-sectional study involving 463 obese 6- to 19-year-olds who were referred to an inpatient weight-loss program. Anthropometric data were assessed and fasting blood samples were analyzed for lipid and glucose metabolism, adipokines, and inflammatory markers. Moderately obese individuals (percentiles corresponding to body mass index ≥ 30 to 35 kg/m(2) at age 18 years) and severely obese individuals (percentiles corresponding to body mass index ≥ 35 kg/m(2) at age 18 years) were defined by sex and age-specific cut-offs according to the International Obesity Task Force. RESULTS: The prevalence of the metabolic syndrome was three times higher in severely obese individuals compared with those who are moderately obese. Mean values for proinsulin, insulin, homeostatic model assessment-insulin resistance, triglycerides, and interleukin-6 were 30%-50% higher in severe obesity compared with moderate obesity. Concentrations of leptin and high-sensitive C-reactive protein were about 1.5-fold higher, adiponectin levels were 12% lower, and resistin levels 10% higher in severely obese individuals compared with moderately obese (all P < .001). CONCLUSION: Severely obese individuals have a markedly more unfavorable cardio-metabolic risk profile than those who are moderately obese. The results of this study underscore the substantial effect of severe obesity on health and highlights that these children need to receive particular attention regarding obesity treatment.

Blood volume and hemoglobin mass in endurance athletes from moderate altitude.

PURPOSE: To determine whether total hemoglobin (tHb) mass and total blood volume (BV) are influenced by training, by chronic altitude exposure, and possibly by the combination of both conditions. METHODS: Four groups (N = 12, each) either from locations at sea level or at moderate altitude (2600 m) were investigated: 1) sea-level control group (UT-0 m), 2) altitude control group (UT-2600 m), 3) professional cyclists from sea level (C-0 m), and 4) professional cyclists from altitude (C-2600 m). All subjects from altitude were born at about 2600 m and lived all their lives (except during competitions at lower levels) at this altitude. tHb and BV were determined by the CO-rebreathing method. RESULTS: VO2max (mL x kg(-1) x min(-1)) was significantly higher in UT-0 m (45.3 +/- 3.2) than in UT-2600 m (39.6 +/- 4.0) but did not differ between C-0 m (68.2 +/- 2.7) and C-2600 m (69.9 +/- 4.4). tHb (g x kg(-1)) was affected by training (UT-0 m: 11.0 +/- 1.1, C-0 m: 15.4 +/- 1.3) and by altitude (UT-2600 m: 13.4 +/- 0.9) and showed both effects in C-2600 m (17.1 +/- 1.4). Because red cell volume showed a behavior similar to tHb and because plasma volume was not affected by altitude but by training, BV (mL x kg(-1)) was increased in C-0 m (UT-0 m: 78.3 +/- 7.9; C-0 m: 107.0 +/- 6.2) and in UT-2600 m (88.2 +/- 4.8), showing highest values in the C-2600 m group (116.5 +/- 11.4). CONCLUSION: In endurance athletes who are native to moderate altitude, tHb and BV were synergistically influenced by training and by altitude exposure, which is probably one important reason for their high performance.