AMSSM position statement update: blood-borne pathogens in the context of sports participation.

This American Medical Society for Sports Medicine position statement update is directed towards healthcare providers of patients involved in sport and exercise. There have been significant advances in clinical and scientific research in the understanding of blood-borne pathogens (BBPs), and this update incorporates these advancements. This document is intended as a general guide to clinical practice based on the current state of the evidence, while acknowledging the need for modification as new knowledge becomes available. Confirmed transmission of BBPs during sport is exceedingly rare. There are no well-documented reports of HIV, HCV or HDV transmission during sport. There is also no evidence for universal testing for BBPs as a specific requirement for participation in sports. Competitive athletes and non-athletes should follow appropriate general public health agency recommendations for screening for BBPs, considering their individual risk factors and exposures. Standard (universal) precautions must be followed by those providing care to athletes. Exercise and athletic participation can help promote a healthy lifestyle for persons living with BBPs. Those with acute symptomatic BBP infection should limit exercise intensity based on their current health status. Education is the key tool for preventing BBP transmission. Research gaps include evaluation of the prevalence of BBP infections in competitive athletes, the effects of long-term, intense training on infected athletes and the effects of BBP treatment therapies on performance.

AMSSM Position Statement Update: Blood-Borne Pathogens in the Context of Sports Participation.

This AMSSM position statement update is directed toward health care providers of patients involved in sport and exercise. There have been significant advances in clinical and scientific research in the understanding of blood-borne pathogens (BBPs), and this update incorporates these advancements. This document is intended as a general guide to clinical practice based on the current state of evidence, while acknowledging the need for modification as new knowledge becomes available. Confirmed transmission of BBPs during sport is exceedingly rare. There are no well-documented reports of HIV, hepatitis C virus, or hepatitis D virus transmission during sport. There is also no evidence for universal testing for BBPs as a specific requirement for participation in sports. Competitive athletes and nonathletes should follow appropriate general public health agency recommendations for screening for BBPs, considering their individual risk factors and exposures. Standard (universal) precautions must be followed by those providing care to athletes. Exercise and athletic participation can help promote a healthy lifestyle for persons living with BBPs. Those with acute symptomatic BBP infection should limit exercise intensity based on their current health status. Education is the key tool for preventing BBP transmission. Research gaps include evaluation of the prevalence of BBP infections in competitive athletes, the effects of long-term, intense training on infected athletes, and the effects of BBP treatment therapies on performance.

Terlipressin facilitates gastric and autonomic system dysfunctions in liver cirrhosis.

BACKGROUND/AIMS: The aim of this study was to evaluate gastric myoelectric activity and autonomic activity in patients with esophageal varices treated by an analogue of vasopressin. METHODOLOGY: Included in this study are 20 patients divided into two groups: Group A: 10 patients treated with terlipressin (the bleeding from oesophageal varices) and Group B: 10 healthy persons matched with age and gender. The studies were performed before and after intravenous administration of vasopressin (VP) analogue. In both groups the fasting plasma levels of vasopressin, adrenaline and noradrenaline were measured by immunochemistry. RESULTS: In group A disturbances of gastric myoelectric activity with high timing of dysrhythmic pattern were observed before VP. VP administration further increased the timing of gastric dysrhythmia from 35 ± 16 to 41 ± 13%, and decreased PDF from 1.4 ± 0.6cpm to 1.19 ± 0.6cpm, PDP from 1891 ± 851µV2 to 718 ± 678µV2. VP induced an increase in SDANN, lnLF, nLF (p<0.05) as well as a decrease in SDNN, pNN50, lnHF (p<0.05). Although there was no retching or vomiting, 80% of patients presented with nausea and exhibited a significant increase in plasma levels of VP, adrenaline and noradrenaline after administration of VP analogue. CONCLUSIONS: VPinduced gastroparesis is characterized by suppressed slow wave amplitude and with increase of their frequency. The existing parasympathetic impairment and increased sympathetic drive of the autonomic system is responsible for vasopressin-induced gastric dysrrhythmia and its clinical consequences.