Professional Sports Persons Should Drink More Water

Top sports persons must always perform to their maximum capacity, making them the most vulnerable to the effects of dehydration. Now, a new study conducted by researchers from the Universidad de Castilla la Mancha (UCLM) reveals that 91% of professional basketball, volleyball, handball and football players are dehydrated when they begin their training sessions.

“Dehydration negatively affects sporting performance, even when the level of dehydration is low (such as a 2% loss of body weight through perspiration)”, UCLM researcher and author of the article Ricardo Mora-RodrГ­guez explained to SINC.

Many studies have tested dehydration in outdoor sports, but little scientific information is available on indoor sports. This new study, which has been published in the European Journal of Sport Science, calculates the loss of body fluids and salts on behalf of professional basketball, volleyball, handball and indoor football players.

“Despite being indoor sports, the pace these professionals play at makes them sweat a great deal”, Mora-RodrГ­guez added. In this sense, it is worth highlighting indoor football players, who lose approximately 1.8 litres per hour through perspiration.

The researchers analysed how sports persons replenish lost body fluids by drinking liquids between workouts and the degree of dehydration “inherited” from the previous day that they begin their training sessions with.

Four professional men’s sports teams were studied (Benetton de Treviso basketball and volleyball teams, the Ciudad Real handball team and the Boomerang indoor football team), from which 43 players re-hydrated, recovering 63% of the fluid they had lost through perspiration. As a result, their level of dehydration remained below 2%.

How to sweat 1.4 litres per hour

According to urine specific gravity data, 91% of the players began their training sessions “slightly dehydrated”. Furthermore, total sodium losses through perspiration amounted to an average of 1.3 grams per person.

“Professional indoor sports persons sweat profusely when playing their sports (1.4 litres/hour on average), but their rehydration habits prevent them from reaching levels of dehydration that would affect their sporting performance,” the research underlined.

The authors insist how important it is to recover body fluids and sodium after training sessions.

Sources: Plataforma SINC, AlphaGalileo Foundation.

Does Stage T3a Renal Cell Carcinoma Embrace A Homogeneous Group Of Patients?

UroToday- Much has been made of the deficiencies associated with the current TNM staging system for renal cell carcinoma (RCC) in contemporary literature. Many recent publications have suggested that tumor size may be more important than traditional factors that suggest biologic aggressiveness of a tumor (and thus increased stage), such as perinephric fat invasion. Conflicting reports have surfaced that suggest that larger tumors that are organ confined (T2) may have a worse prognosis than those that demonstrate perinephric fat invasion (T3a). Moreover, oncocytomas, which are benign tumors without metastatic potential, can demonstrate evidence of perinephric fat invasion. Is perinephric fat invasion more a consequence of concentric growth of a peripheral tumor rather than a measure of tumor virulence? Here, Gofrit and colleagues examine their experience with patients treated surgically for RCC to address this question.

The authors examine the outcome of 237 patients treated surgically for RCC. Of these 78% were treated with radical nephrectomy and 22% were treated with nephron sparing. Mean age was 61.1 years and 19.4% were T3a according to the 2002 TNM staging system. With a median of 8 years of follow-up 48 patients (20.5%) had evidence of recurrence at a median of 21.5 months. In their multivariate analysis that examined clinicopathologic variables that predicted prognosis, the authors found that the symptoms, performance status, high tumor grade, the presence of sarcomatoid dedifferentiation and tumor size were all significant predictors of an adverse outcome. The distinction between T2 and T3a was not significant in predicting risk of recurrence. The authors then proposed a new staging system that was based on tumor size and eliminated perinephric fat as a classification. T1a was tumors 4 cm or less, T1b was tumors 4-7 cm, T2a was tumors 7-10 cm, T2b was tumors >10cm, and T3a was used to classify those tumors with venous invasion. Statistical goodness of fit testing then demonstrated that the proposed system was more predictive of outcome than the 2002 TNM staging system.

The authors conclude that tumor size may be a more important variable in predicting patient outcome than the presence of perinephric fat invasion and that perinephric fat invasion should be removed from future staging systems. Instead, staging for tumors that do not invade the venous system should be based solely on tumor size.

Gofrit ON, Shapiro A, Pizov G, Landau EH, Katz R, Zorn KC, Pode D

J Urol. 177(5):1682-86, May 2007.

Reported by Urotoday Contributing Editor Christopher G. Wood, MD.

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Sleep Disturbance Increases Spontaneous Pain In Women

Sleep continuity disturbance impairs endogenous pain-inhibitory function and increases spontaneous pain in women. This supports a possible pathophysiologic role of sleep disturbance in chronic pain, according to a study published in the April 1st issue of the journal SLEEP.

The study, conducted by Michael T. Smith, PhD, and colleagues at John’s Hopkins University, focused on 32 healthy females, who were studied polysomnographically for seven nights. On the first two nights, the subjects slept undisturbed for eight hours. Then, the women were assigned to one of three groups: “Control”, “Forced Awakening” (FA) and “Restricted Sleep Opportunity” (RSO). From nights three-to-five, the “Control” group continued to sleep undisturbed, while the “Forced Awakening” group underwent eight forced awakenings, one per hour, and the “Restricted Sleep Opportunity” group received partial sleep deprivation by delayed bedtime. On night six, both the FA and RSO groups underwent 36 hours of total sleep deprivation, followed by 11-hour recovery sleep.

In an assessment of the subjects’ completion of twice-daily psychophysical assessments of mechanical pain thresholds and pain inhibition, it was discovered that the FA group demonstrated an increase in spontaneous pain, while neither the “Control” nor the RSO group showed changes in pain inhibition or spontaneous pain during partial sleep deprivation.

“This study finds that fragmented sleep profiles, akin to individuals suffering from middle of the night insomnia, health care workers on call, and parents caring for infants,
alter natural systems that regulate and control pain, and can lead to spontaneous painful symptoms,” said Smith. “Our research shows that disrupted sleep, marked by multiple prolonged awakenings, impairs natural pain control mechanisms that are thought to play a key role in the development, maintenance, and exacerbation of chronic pain.”

Recent studies associate lack of sleep with serious health problems such as an increased risk of depression, obesity, cardiovascular disease and diabetes.

Experts recommend that adults get between seven and eight hours of sleep each night to maintain good health and optimum performance.

Those who think they might have a sleep disorder are urged to discuss their problem with their primary care physician, who will issue a referral to a sleep specialist.

SLEEP is the official journal of the Associated Professional Sleep Societies, LLC, a joint venture of the American Academy of Sleep Medicine (AASM) and the Sleep Research Society.

SleepEducation, a Web site maintained by the AASM, provides information about the various sleep disorders that exist, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

District Court Clears The Way For Antitrust Case

The National Athletic Trainers’ Association (NATA) Fair Practice Initiative has scored a key victory in the fight to protect the athletic training profession. By an opinion entered on September 9, 2008, the Federal District Court in Dallas, Texas, denied the American Physical Therapy Association’s (APTA) motion to dismiss the lawsuit and rejected APTA’s request to transfer the case from Dallas to Virginia.

NATA President Marje Albohm, MS, ATC, said the ruling sends an important message to athletic trainers. “This reaffirms our position that athletic trainers are fully qualified, skilled health care providers who have the right to practice to the full extent allowed by our state laws and national certification,” Albohm said. “I am pleased about the Court’s opinion.”

The Court’s decision clears the way for NATA to proceed with its antitrust case. NATA expects that discovery will soon commence. At the same time, Albohm reiterates NATA’s continued willingness to meet with APTA.

“The Court’s favorable ruling does not change NATA’s commitment to productive conversation between NATA and APTA,” Albohm said. “Athletic trainers have always been leaders in teamwork. We simply want to protect our right to practice those skills we are qualified to provide.”

Also in its Sept. 9 ruling, the Court decided the Orthopaedic Section of APTA is not subject to jurisdiction in Texas. NATA is now evaluating its next steps for that portion of the case.

The Fair Practice Initiative was launched in February after APTA and its Orthopaedic Section took actions to unfairly restrict athletic trainers from practicing manual therapy.

National Athletic Trainers’ Association (NATA) – Health Care for Life & Sport

Athletic trainers are unique health care professionals who specialize in the prevention, diagnosis, treatment and rehabilitation of injuries and illnesses. The National Athletic Trainers’ Association represents and supports 30,000 members of the athletic training profession. NATA advocates for equal access to athletic trainers for patients and clients of all ages and supports H.R. 1846. Only 42 percent of high schools have access to athletic trainers. NATA members adhere to a code of ethics.

National Athletic Trainers’ Association

No Difference In Sleep Of OSA Patients Studied In A Hospital Vs. A Hotel-Based Sleep Center

A study published in the April 15 issue of the Journal of Clinical Sleep Medicine (JCSM) finds no significant difference in sleep parameters associated with the first-night effect in patients undergoing sleep studies in a hotel and a hospital-based sleep laboratory.

Kimberly N. Hutchison, MD, of Vanderbilt University Medical Center in Nashville, Tenn., reviewed polysomnograms, or sleep tests, completed in their hotel-based and hospital-based sleep laboratories over a two-year period. All patients were undergoing evaluation for obstructive sleep apnea (OSA). Dr. Hutchison and her colleagues compared the sleep architecture changes associated with the first-night effect in the two groups.

According to the results, no significant differences were detected between the two groups in sleep onset latency, sleep efficiency, REM sleep latency, total amount of slow wave sleep, and total stage 1 sleep. There was also no difference detected in arousal index between the two groups.

“Hotel-based sleep laboratories are growing. It is not known how this new environment will affect clinical studies,” said Dr. Hutchison. “This study is meaningful because it suggests that the increased comfort and familiarity offered by a hotel setting doesn’t necessarily change the sleep architecture, at least in our patient subgroup (patients referred for suspected sleep apnea). Perhaps our patients are more familiar with a hospital rather than a hotel!”

OSA is a sleep-related breathing disorder that causes your body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs. It is estimated that four percent of men and two percent of women have OSA, and millions more remain undiagnosed.

On average, most adults need seven to eight hours of nightly sleep to feel alert and well-rested.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good night’s sleep:
Follow a consistent bedtime routine.

Establish a relaxing setting at bedtime.

Get a full night’s sleep every night.

Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.

Do not bring your worries to bed with you.

Do not go to bed hungry, but don’t eat a big meal before bedtime either.

Avoid any rigorous exercise within six hours of your bedtime.

Make your bedroom quiet, dark and a little bit cool.

Get up at the same time every morning.

First introduced as a treatment option for sleep apnea in 1981, CPAP is the most common and effective treatment for OSA. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.


CPAP Central sleepeducation/CPAPCentral), a Web site created by the AASM, provides the public with comprehensive, accurate and reliable information about CPAP. CPAP Central includes expanded information about OSA and CPAP, including how OSA is diagnosed, the function of CPAP, the benefits of CPAP and an overview of what to expect when beginning CPAP, the position of experts on CPAP, and tools for success. CPAP Central also features an interactive slide set that educates the public about the warning signs of OSA.

Those who think they might have OSA, or another sleep disorder, are urged to consult with their primary care physician or a sleep specialist.

JCSM is the official publication of the AASM. It contains published papers related to the clinical practice of sleep medicine, including original manuscripts such as clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports.

More information about OSA is available from the AASM at sleepeducation/Disorder.aspx?id=7.

SleepEducation, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

Article, entitled, “Analysis of Sleep Parameters in Patients with Obstructive Sleep Apnea Studied in a Hospital vs. a Hotel-Based Sleep Center”

SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies and the world’s largest annual gathering of sleep scientists and sleep medicine
professionals, will take place in Baltimore, Maryland, from June 9-12, 2008. SLEEP 2008 will bring together an international body of 5,000 leading researchers and
clinicians, who will present and discuss over 1,100 new findings and medical developments related to sleep and sleep disorders. More details, including the program
schedule and a list of invited lecturers, are available at sleepmeeting/.

Source: Jim Arcuri

American Academy of Sleep Medicine

‘Conversation’ With People Living In Extreme Poverty

This year’s theme of the ‘Rajendrapur Conversation’ organised by the Brooks World Poverty Institute (BWPI) at The University of Manchester will be global warming and will take place from 24 to 28 January.

It will provide a unique opportunity for the poor of Dhaka to discuss their experiences and ideas on adapting cities to climate change with world renowned experts.

It will result in an action plan and a series of pilot projects to be announced at the International Conference on Urban Poverty and Climate Change in Dhaka on January 28.

The wider aim of the annual conversation, which in subsequent years will be held in other developing countries, is to create a strategic global partnership between poor people and leading poverty research institutions.

It has been timed to coincide with the World Economic Forum in Davos in an attempt to divert attention to the needs of the poor.

Professor Tony Addison, BWPI Executive Director said: “There needs to be a sense of urgency about this. The world knows that action is needed now to help people in developing countries affected by climate change and to stem the North’s impact on them by reducing carbon emissions.

“We hope that world leaders gathering in Davos this week, who are focusing predominantly on the global financial crisis, will consider the economic impact on the world’s poor and see that we need to act now.”

He added: “Our urban focus is important. Most of the adaptation research in Bangladesh has been carried out in rural areas, but we need to look at ways in which the lives of people in towns and cities can be improved, as the population continues to shift there in huge numbers to escape the flood-swept rural areas.”

One of the projects to be discussed at the 4-day conversation is the introduction of a huge barge to the market area of Dhaka to enable trading to continue during floods, preventing the ruin of poor people’s livelihoods.

The BWPI team is working in partnership on the conversation with Dhaka-based BRAC, the world’s largest and most successful NGO, which works with 110 million people across Bangladesh, Africa and Afghanistan on projects to lift them out of poverty.

Professor David Hulme, Associate Director of BWPI said: “Our partnership with BRAC is critical to the success of the conversation. We’re sitting down and listening to poor people, bringing their knowledge together with our expertise in poverty research and architecture alongside BRAC’s expertise and phenomenal on-the-ground experience.

“Our engagement with poor people from the outset means that their knowledge and their preferences will help shape the projects designed to improve their lives. In the past, poverty researchers have been guilty of exploring solutions that they believe will work for the poor, rather than listening to what poor people really want,’ he said.

With 153 million people, Bangladesh is the world’s most densely populated country and because it is one vast flat river delta, it is the most vulnerable place on earth to rising sea levels and extreme weather caused by climate change.

More than half of its population lives in poverty and scientists at NASA have predicted that the country will be completely submerged by 2100.

The first Rajendrapur Conversation takes place between January 24 to 27, followed by the International Conference on Urban Poverty and Climate Change on January 28 in Dhaka.


Source: Michael Addelman

University of Manchester

Seniors Demand Clear Retirement Income Policy From Government, Australia

Older Australians have demanded a clear retirement income policy from government to provide them with certainty in their later years.

Addressing a super industry conference in Brisbane today, National Seniors Australia chief executive, Michael O’Neill, said the federal government had much going on in the way of reviews but no apparent overarching strategy.

“Older Australians are nervous. As their retirement plans unraveled during the global financial crisis, many were forced to keep working.

“Now they’re facing a spate of reforms that threaten, once again, to shift the goal posts.

“The Henry tax review, the Cooper superannuation review, even aged care reform, will have implications on retirement income planning but there isn’t a retirement income policy that pulls all these strands together,” he said.

“Unfortunately, government and bureaucrats have little sense of how difficult it is, after years of careful planning, to adjust to sudden policy changes on the cusp of retirement.

“Growing life expectancies mean many Australians could find themselves living 30 years out of the workforce. It just won’t do to say to retirees five years in: Oh, by the way, now you have to pay for your aged care, and that tax offset has been phased out.

“A clearly articulated retirement incomes policy that crosses several portfolios would go a long way in providing certainty to older Australians.

“National Seniors welcomes the creation of fairer and simpler financial systems but we want to know how it all ties together and what the ultimate goal is,” he said.

O’Neill was addressing the 2011 SPAA SMSF National Conference. SPAA is the peak body for professional advisors within the Self Managed Super Fund industry.


National Seniors Australia

Value Of Calcium And Vitamin D Supplements For Older Women

What benefits are there for older women if they take Calcium and Vitamin D supplements? A new study found that a woman’s risk of having a hip fracture goes down, but her risk of other types of fractures remain the same. Researchers also found that the supplements did not alter a post-menopausal woman’s risk of developing colorectal cancer.

The research was carried out by the Women’s Health Initiative, USA.

The study, of 36,000 menopausal women, found a 1% improvement in bone density as a result of taking Calcium and Vitamin D supplements for 7 years. Hip fractures went down 29% (for women over 60 it was 29%).

The study found the benefits were only there for women who took their supplements regularly, at least four days out of every five.

BVA Warns Against Kneejerk Reaction To TB Report, UK

The British Veterinary Association (BVA) has warned against a kneejerk reaction to today’s report on tackling bovine tuberculosis (TB), which concludes that badger culling is unlikely to be a cost-effective way of helping control cattle TB in Britain.

The report “The duration of the effects of repeated widespread badger culling on cattle TB following the cessation of culling” analyses data from the Randomised Badger Culling Trial (RBCT) undertaken between 1998 and 2005 by Defra. It found that incidence of bovine TB in cattle reduced during culling but that the reductions subsequently declined after its cessation.

Commenting, Professor Bill Reilly, President of the BVA, said:

“This paper clearly demonstrates that badger culling did have an impact on the incidence of bovine TB in cattle, which is a very positive outcome.

“The Randomised Badger Culling Trial (RBCT) was undertaken in very specific circumstances and it could be misleading to extrapolate the findings to any future control programme.

“What we can learn from this paper is that any future badger cull, such as the proposed cull in West Wales, must be only one part of a package of control measures and take account of the findings resulting from the RBCT.

“The report, based on a single trial, concludes that badger culling is not cost-effective, but the cost of TB to farmers and the government is already incredibly high. Investment now could reduce the costs in the much longer term.

“The BVA warns against a kneejerk reaction to this paper that would rule out badger culling in the future. Bovine TB is devastating both livestock and wildlife and a range of control measures, including targeted badger culling, must be employed if we are to tackle the disease in the long term.”


1. The report “The duration of the effects of repeated widespread badger culling on cattle TB following the cessation of culling” by Helen E. Jenkins, Rosie Woodroffe, and Christl A. Donnelly is published on PLoS ONE

2. The BVA policy on bovine TB

British Veterinary Association

Discovery Of New Strain Of MRSA

Scientists have identified a new strain of methicillin-resistant Staphylococcus aureus (MRSA) which occurs both in human and dairy cow populations.

The study, led by Dr Mark Holmes at the University of Cambridge, identified the new strain in milk from dairy cows while researching mastitis (a bacterial infection which occurs in the cows’ udders).

The new strain’s genetic makeup differs greatly from previous strains, which means that the ‘gold standard’ molecular tests currently used to identify MRSA – a polymerase chain reaction technique (PCR) and slide agglutination testing – do not detect this new strain. The research findings are published in the journal The Lancet Infectious Diseases.

Dr Laura GarcГ­a-Alvarez, first author of the paper, who discovered the new strain while a PhD student at the University of Cambridge’s Veterinary School, said: “To find the same new strain in both humans and cows is certainly worrying. However, pasteurization of milk will prevent any risk of infection via the food chain. Workers on dairy farms may be at higher risk of carrying MRSA, but we do not yet know if this translates into a higher risk of infection. In the wider UK community, less than 1% of individuals carry MRSA – typically in their noses – without becoming ill.”

The scientists discovered the antibiotic resistant strain while researching S. aureus, a bacterium known to cause bovine mastitis. Despite the strain being able to grow in the presence of antibiotics, when they attempted to use the standard molecular tests available – which work by identifying the presence of the gene responsible for methicillin resistance (the mecA gene) – the tests came back negative for MRSA.

When Dr Matt Holden and a research team at the Wellcome Trust Sanger Institute sequenced the entire genome (decoding all of the genes in the bacteria’s DNA) they realised that the new strain possessed unconventional DNA for MRSA. They found that the new strain does have a mecA gene but with only 60% similarity to the original mecA gene. Unfortunately, this results in molecular tests (which identify MRSA by the presence of the mecA gene) giving a false negative for this strain of MRSA.

Subsequent research revealed that the new strain was also present in humans. During the study, the new strain was found in samples from Scotland, England and Denmark (some from screening tests and others from people with MRSA disease). It has since been identified in Ireland and Germany. Additionally, by testing archived S. aureus samples, the researchers have also identified a recent upward trend in the prevalence of the antibiotic resistant bacteria.

Dr Mark Holmes said: “The majority of MRSA testing in British hospitals is performed by seeing if the bacteria will grow in the presence of antibiotics, typically oxacillin and cefoxitin, rather than methicillin – which is now no longer manufactured. This type of testing detects both the new MRSA and conventional MRSA.

“However, it is important that any of the MRSA testing that is based on detection of the mecA gene – i.e. PCR based testing, or slide agglutination testing – be upgraded to ensure that the tests detect the new mecA gene found in the new MRSA. We have already been working with public health colleagues in the UK and Denmark to ensure that testing in these countries now detects the new MRSA.”

The new research also raises questions about whether cows could be a reservoir for the new strains of MRSA.

Dr Holmes added: “Although there is circumstantial evidence that dairy cows are providing a reservoir of infection, it is still not known for certain if cows are infecting people, or people are infecting cows. This is one of the many things we will be looking into next.

“Although our research suggests that the new MRSA accounts for a small proportion of MRSA – probably less than 100 isolations per year in the UK, it does appear that the numbers are rising. The next step will be to explore how prevalent the new strain actually is and to track where it is coming from. If we are ever going to address the problem with MRSA, we need to determine its origins.”

Scientists at the Health Protection Agency (HPA) co-authored this paper, providing the analysis of the human samples of the new strain. Dr Angela Kearns, head of the HPA’s Staphylococcus Reference Laboratory said: “There are numerous strains of MRSA circulating in the UK and the rest of Europe. Even though this new strain is not picked up by the current molecular tests, they do still remain effective for the detection of over 99 per cent of MRSAs. This new strain can be picked up by another type of test, which has shown to be effective in trials in the UK and elsewhere in Europe.

“This is a very interesting find and the HPA is currently involved in further research to screen a wider population of MRSA samples to ascertain how prevalent it is. It’s important to remember MRSA is still treatable with a range of antibiotics and the risk of becoming infected with this new strain is very low.”

With funding from the Medical Research Council, the researchers will next be undertaking prevalence surveys in people and in dairy cattle in the UK to determine how much new MRSA is present in these populations. They will also be performing an epidemiological study on farms to identify any factors that may be associated with infection by the new MRSA, to look for further new MRSA strains, and to explore the potential risks of the new strain to farm workers.

The paper:
‘Meticillin-resistant Staphylococcus aureus with a novel mecA homologue emerging in human and bovine populations in the UK and Denmark: a descriptive study’ was published by The Lancet Infectious Diseases on Friday, 03 June.

Genevieve Maul

University of Cambridge