Intrinsic Sinus Node/Atrioventricular Node Dysfunction Requiring Pacemaker Implantation: Role of Former Professional Sport Activity.

BACKGROUND: Sinus bradycardia and first degree or second degree Mobitz type I atrioventricular (AV) block in an athlete are considered adaptive and reversible phenomena; however, some evidence suggests that they may persist after detraining and become pathological. The aim of the study was to investigate the characteristics of a group of former professional athletes who required pacemaker (PM) implantation for intrinsic (idiopathic) sinus node (SN) dysfunction or AV block in comparison to control groups of sedentary individuals. METHODS: We included all patients who underwent PM implantation during 2022. Three groups were compared: group 1 including 18 former professional athletes who received a PM for SN dysfunction/AV block in the absence of heart disease; group 2 including the first 20 sedentary individuals without heart disease who underwent PM implantation; and group 3 including all other 323 patients who received PM, the majority with underlying heart diseases. RESULTS: Compared to the non-athlete control group 2, the mean age at diagnosis and at the time of PM implantation of former professional athletes did not show statistically significant differences. However, subgroup analysis revealed significant differences depending on the type of sports discipline: the age at diagnosis and at PM implantation was significantly lower in former endurance athletes than former strength/mixed athletes, control non-athletes, and all other patients. Moreover, former endurance professional athletes exhibited a higher prevalence of second or third degree AV block (78%) as the reason for PM implantation compared to power/mixed athletes (44%). The other clinical characteristics, including echocardiographic parameters, did not differ between former athletes and non-athletes. CONCLUSIONS: Former professional endurance athletes with idiopathic SN dysfunction/AV block manifested the disease earlier in the life course compared to former power/mixed athletes and non-athletes. This suggests that bradycardia/AV block caused by intense and prolonged endurance sports may not always be benign and adaptive phenomena.

Nociceptors: Their Role in Body's Defenses, Tissue Specific Variations and Anatomical Update.

The human body is constantly under the influence of numerous pathological factors: both external and internal. These factors can be potentially harmful and are perceived as such with a specialized nervous system subunit: the nociceptive system. The functional unit of the nociceptive system is the nociceptor. Recent studies have shown that nociceptors play a crucial role in maintaining of defensive homeostasis (responsive, immune, behavioral). Nociceptors respond to potentially harmful stimuli within viscera, bones, muscles, skin and specialized sensory organs. They function as complex predictors of harm through formation of pain stimulus. Their function and structures vary within different tissues. This variability reflects the anatomical and pathological peculiarities of varying tissues. Nociceptors play a significant role in adaptive, protective and behavioral reactions. Their functional capabilities and vast spread throughout the body make them the main units of the body's defense system, allowing us to interact with the inner and outer environments.

Markers of muscle damage and strength performance in professional football (soccer) players during the competitive period.

BACKGROUND: The present study investigated the impact of competitive soccer on the short-term changes in isometric strength of the adductor muscle group during the competitive season. METHODS: In this cohort study we evaluated the association between a serum marker of muscle damage [creatine phosphokinase (CPK)] and isometric strength of the adductor muscles of the hip in 30 professional football players (age: 26.7±2.9 years) during two seasons of the national top-level championship. Serum CPK level was determined the day before the match, 12-20, 36-48, 60-72 h after the match. The maximum voluntary isometric contraction force of the adductor muscles complex was determined immediately after having taken blood samples. RESULTS: There was evidence of a statistically significant positive association between age, body mass index (BMI), percentage of body fat, and muscle strength, and between weight and muscle strength. There was evidence of a statistically significant negative association between the level of CPK and the maximum isometric strength of the adductors of soccer players. Changes in CPK levels were associated with the muscle strength recovery trend (P<0.001). The strength/CPK ratio at different time points had a U-shaped curve. CONCLUSIONS: Exercise induced muscle damage significantly affects the strength of the adductor muscle group of professional soccer players during the competitive period. The lower the CPK level, the greater the athletes' strength at a given time point. Also, the greater the decrease in CPK level, the greater the rate of strength restoration.

Current and emerging methods for treatment of hemoglobin related cutaneous discoloration: A literature review.

BACKGROUND: Currently, there is no available medication for immediate correction of bruise discoloration. Instead, makeup, cosmetic powders, concealers, and various traditional herbal remedies are used to mask discoloration. These approaches have no influence on the pathology behind the discoloration. The purpose of this study was to explore existing methods and current trends in correction of hemoglobin related cutaneous discoloration. METHODS: This paper describes the treatment methodologies available for proposed correction of hemoglobin related cutaneous discoloration. A thorough literature review was conducted to assess current knowledge of available treatments for bruise discoloration. RESULTS: current cosmetics being marketed under the names "Bleacher bruises," "Bleaching agents" and "Blood bleachers" addressing bruise related discoloration do not offer targeted pathological treatment. Several methods for immediate discoloration of the skin and nail plate in the area of bruising and hematoma were found, yet no method offered sufficient clinical data in support of its efficacy and safety. The intricate mechanisms of discoloration associated with hemoglobin extravascular deterioration are not targeted by any treatment method. Only one paper outlining the clinical application of bleaching agents was found. CONCLUSION: The primary blood pigments responsible for the discoloration in bruises include methemoglobin, oxyhemoglobin, carbohymoglobin, verdoglobin, biliverdin, and bilirubin. No existing method targets the degradation of hemoglobin in the area of ecchymosis. The efficacy of existing patented methods remains questionable and unsupported clinically. Future research should focus on developing a drug targeting hemoglobin derivatives, preventing discoloration at an early stage.

The Role of Mitochondria in Piperine Mediated Cardioprotection in Isoproterenol Induced Myocardial Ischemia.

BACKGROUND: Several pharmacological therapeutic interventions are being used as therapeutic agents against myocardial infarction/ischemia (MI) but their usage is constrained by toxicity and nonselective pharmacological actions. Our preliminary report depicted the cardioprotective effect of piperine against isoproterenol (ISO)-induced MI. AIM: Current study determined the protective efficacy of piperine by modulating mitochondrial function in rat models of isoproterenol (ISO)-induced myocardial ischemia. METHODS: The above aim was achieved by analyzing mitochondrial antioxidant status, mitochondrial calcium, mitochondrial enzyme activity, ATP level, and apoptosis. Ultra-structural alterations in heart tissue were determined by TEM analysis. RT-PCR studies and Western blotting were executed to determine apoptotic and proapoptotic gene expression, and apoptotic protein expression, respectively. RESULTS: The results elucidate that piperine pre-treatment prevents ISO induced alterations in the mitochondrial antioxidant status, Krebs cycle as well as mitochondrial respiratory chain enzyme activities (MRCEs). ISO induced ultrastructural changes of heart mitochondria were significantly reduced in the group that received piperine pretreatment followed by ISO injection. Piperine maintains mitochondrial calcium homeostasis and inhibits ISO-induced myocardial apoptosis. A significant increase in the expression levels of proapoptotic genes such as Bax, caspases (caspase 9, caspase 3), and cytochrome-c with a concomitant decrease in Bcl-2 expression (anti-apoptotic gene) was observed in ISO injected group compared to the control group. The group that received the piperine pretreatment followed by ISO administration showed a significant decrease in the expression profile of proapoptotic genes with a concomitant increase in the anti-apoptotic gene expression than the ISO injected group. Apoptotic protein expressions including Bax, cytochrome-c, caspase-3, and cleaved PARP were upregulated & Bcl-2 was downregulated with ISO treatment, whereas piperine pre-treatment prevented these changes in apoptotic protein expressions during ISO-induced myocardial cell damage. CONCLUSION: Current results demonstrate the efficacy of piperine for attenuating ISO-induced myocardial ischemia by enhancing mitochondria function. This study described that piperine could be used as a nutritional intervention against ISO-induced myocardial ischemia.

Asymptomatic Degenerative Changes in the Lumbar Spine Among Professional Soccer Players.

STUDY DESIGN: Cross-sectional study. OBJECTIVE: The aim of this study was to evaluate the actual prevalence of degenerative spinal changes and their association with age in a cohort of professional soccer players. SUMMARY OF BACKGROUND DATA: Presently, there are data that athletes have more degenerative changes than nonathletes; however, the research examining the prevalence of degenerative spinal conditions among professional elite soccer players is scarce. METHODS: Professional male soccer players were included in the study (n = 40, average age 26,6 ±â€Š4,5 years, average height 18 ±â€Š0.07 m, weight 76.7 ±â€Š7.1 kg). Lumbosacral spine MRI scanning at the L1-S1 level has been performed. Two radiologists with at least 7 years of experience of working with athletes evaluated all images independently of each other. RESULTS: 92.5% (n = 37) of soccer players had ≥1 spinal degenerative condition. Thirty-five percent (n = 14) of players had three to five, and 50% (n = 20) had six or more conditions. The average age of players who had six or more conditions was significantly higher than those who had zero to five or three to five conditions-28.1 ±â€Š4.8 years versus 25.1 ±â€Š3.6 years (P = 0.029), and 24.8 ±â€Š3.6 years, respectively.Kruskal-Wallis test has shown no association between the number of degenerative conditions and weight (P = 0.98) as well as body mass index (P = 0.99). The age was associated with degenerative changes (P = 0.008).Disc desiccation was the most common pathologic condition, which was found in 82.5% of athletes. Facet joint arthropathy and spondylosis were present in 70, and 50% of the studied lumbar spine MRI scans, respectively. The spondylolysis prevalence of 20% was noted. CONCLUSION: Elite professional soccer players demonstrate a high prevalence of asymptomatic degenerative lumbar spinal degenerative changes, which are significantly associated with age. These conditions might lead to the development of symptomatic lower back pain, given the high-intensity exercise required in professional soccer. It is presently unclear what measures might be applied for the primary prevention of these degenerative spinal conditions.Level of Evidence: 4.

The prevalence of non-contact muscle injuries of the lower limb in professional soccer players who perform Salah regularly: a retrospective cohort study.

BACKGROUND: The present study assessed the prevalence of non-contact muscle injuries of the lower limbs, including hamstring injuries, in professional Russian soccer players who regularly perform Salah, an obligatory Muslim prayer performed 5 times a day. METHODS: Using a retrospective cohort study design, 68 professional male soccer players (excluding goalkeepers), 34 of whom were Muslims regularly performing Salah (exposure group) and 34 were randomly chosen non-Muslim players (control group), were included in the study. The groups were similar in their playing leagues, field positions, age (27 ± 3.1 vs 28 ± 4.2 years), and body mass index (22 ± 1.2 vs 23 ± 0.92 kg/m2). RESULTS: The incidence of hamstring injury was significantly lower in the exposure group (2 vs 14, p = 0.0085). A declining trend for the number of muscle injuries (either hamstring or not) was observed in the exposure group (11 vs 27, p = 0.0562). Two players in the exposure group and 11 in the control group (p = 0.0115, OR 0.1307, 95% CI 0.0276 to 0.5698) suffered a hamstring injury, with no statistically significant difference in the occurrence of other injuries. The total amount of the training and play days missed because of hamstring and other muscle injuries was significantly lower in the exposure group (24 vs 213 days, p = 0.0043, and 200 vs 344 days, p = 0.0066, respectively). CONCLUSION: The prevalence of non-contact muscle injuries, including hamstring injuries, was lower in professional Russian soccer players who regularly performed Salah.

Nordic Walking as an effective physical activity for weight loss among overweight young adults in high schools.

BACKGROUND: Overweight and obesity, low physical activity and lack of motivation to exercise are common among young adults. Thus, the objective of the study is to evaluate the efficiency of Nordic Walking for weight loss and improvement of functional and physiological state in young adults with overweight and obesity. METHODS: The study enrolled 77 students from Sechenov University with overweight and obesity aged from 17 to 23 years. Forty students in the main group completed an individual 9-months Nordic Walking exercise program. Thirty-seven students in the control group were engaged in physical training within the curriculum of the university. The components of body composition, level of physical working capacity and psycho-emotional status were studied. RESULTS: The final tests showed significant excessive body weight loss in students in the main group due to fat mass reduction by 18%; increase of physical working capacity by 22.5%; improvement of emotional stability by 22% and self-confidence level growth by 24%. CONCLUSIONS: Nordic Walking is an effective type of physical training with high motivational component for excessive body weight loss in young adults. It is proved by significant improvement of the majority of morphofunctional and psychological parameters in students in the main group. Nordic Walking can be used in physical education program at high schools for pupils and students with overweight and obesity. The materials of the article are of practical value for PT tutors, advisors on healthy way of life and public health, specialists in physical rehabilitation, general practice doctors.

Atrial Fibrillation in Athletes-Features of Development, Current Approaches to the Treatment, and Prevention of Complications.

Atrial fibrillation (AF) is one of the most common types of cardiac arrhythmias. This review article highlights the problem of the development of atrial fibrillation in individuals engaged in physical activity and sports. Predisposing factors, causes, and development mechanisms of atrial fibrillation in athletes from the perspective of the authors are described. Methods of treatment, as well as prevention of thromboembolic complications, are discussed. Directions for further studies of this problem and prevention of complications are proposed.

The Dependence of Running Speed and Muscle Strength on the Serum Concentration of Vitamin D in Young Male Professional Football Players Residing in the Russian Federation.

Background: Vitamin D insufficiency is prevalent among athletes, and it can negatively affect physical performance. At the same time, most of the available data were obtained from untrained individuals of various ages, and published studies performed in athletes led to contradictory conclusions. Methods: This cohort prospective study examined the serum concentration of 25-hydroxycalciferol (25(OH)D) and its association with running speed and muscle power in 131 young football players (mean age 15.6 ± 2.4 years). Results: 25(OH)D levels were below reference in 42.8% (serum 25(OH)D <30 ng/mL) and above reference in 30.5% of the participants (serum 25(OH)D 61-130 ng/mL). A comparison of the results of 5, 15, and 30 m sprint tests and the standing long jump test found no statistically significant differences between the two groups. Athletes from the 25(OH)D-insufficient group were treated with 5000 IU cholecalciferol supplement daily for 60 days. After the treatment, the 25(OH)D concentration increased by 79.2% and was within reference in 84% of the treated athletes (serum 25(OH)D 30-60 ng/mL). Testing was repeated after the end of treatment, and a statistically significant increase in the results of the 5, 15, and 30 m sprint tests was observed (Cohen's d was 0.46, 0.33, and 0.34, respectively), while the results of the standing long jump test remained unchanged. Body height, body weight, and lean body mass of the football players also increased. Conclusions: These findings indicate that there is likely no correlation between serum levels of 25(OH)D, muscle power, and running speed in young professional football players, and the changes observed post-treatment might have been caused by changes in the anthropometric parameters. During the study, all the anthropometric parameters changed, but the amount of lean body mass only correlated with the results of the 5 m sprint.

Degree of vision impairment influence the fight outcomes in the Paralympic judo: a 10-year retrospective analysis.

BACKGROUND: In the International Blind Sports Federation (IBSA) judo Sports Classes B1, B2, and B3 compete against each other within weight- and gender-specific categories. B1 athletes are totally blind, whereas B2 and B3 are partially sighted. The aim of this study was to examine the impact of the degree of vision impairment on fight outcomes. METHODS: We analyzed 1936 fights from official competitions and compare win ratio in fights between discordant Sports Classes. RESULTS: B1 won B2 ratio was 34.8%, B1 won B3 ratio was 36.5%, B2 won B3 ratio = 50.6%. The B1 percent of IBSA judo athletes decreased from 25.9% in 2007 to 19.4% in 2016, while the total number of participants increased over this period. CONCLUSIONS: These findings confirm that blind athletes have fewer chances to win a fight in IBSA Judo and become a member of National Team. Loss of vision functions affects movement coordination, balance, and emotional state, which are important for martial arts and may explain why B1 athletes are more likely to lose competitions against either B2 or B3. Creation of the evidence-based and sport-specific classification system and/or improvement of the technical rules are necessary for fair IBSA Judo competitions.

Cobalt in athletes: hypoxia and doping - new crossroads.

Cobalt is an essential trace element that is known to mimic hypoxia and hypoxic training. Inorganic Co compounds are capable of Hypoxia-inducible factor-1 (HIF-1) activation, resulting in up-regulation of gene expression including erythropoietin (Epo). Experimental studies have demonstrated that Co treatment may increase hypoxic tolerance of different tissues, improve muscle metabolism and exercise performance. Other mechanisms may also involve modulation of steroid hormone and iron metabolism. Based on these experimental studies, in 2017 inorganic cobalt compounds were added into the World Anti-Doping Agency (WADA) prohibited list as doping agents. However, the existing data on beneficial effects of cobalt on exercise performance in athletes are scarce. Similarly, only experimental studies demonstrated exercise-induced decrease in tissue Co levels, whereas human data are inconsistent. In addition, multiple studies have demonstrated that excessive Co intake may be toxic due to prooxidant, proinflammatory, and proapoptotic activity. Therefore, monitoring of Co deficiency and overload is required to prevent potential health hazards in athletes. At the same time, modulation of Co status should be performed through supplementation avoiding excessive doses of inorganic cobalt that are used for doping and are accompanied by adverse health effects of metal toxicity.