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      The fittest person in the morgue? : The fittest person in the morgue?

      Histopathology

      Wiley-Blackwell

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          Updating the evidence that physical activity is good for health: an epidemiological review 2000-2003.

          Developing policy and strategic initiatives to increase population levels of physical activity (PA) requires constant referral to the epidemiological evidence base. This paper updates the evidence that PA confers a positive benefit on health, using research studies in the peer-reviewed scientific literature published between 2000-2003. Areas covered include updates in all-cause mortality and in cardiovascular disease prevention, diabetes, stroke, mental health, falls and injuries, and in obesity prevention. Recent evidence on PA and all-cause mortality replicates previous findings, and is consistent with current Australian moderate PA recommendations. Recent papers have reinforced our understanding of the cardiovascular protective effects of moderate PA, with new evidence that walking reduces the risk of CVD and, in two studies, at least as much as vigorous activity. The evidence base for protective effects of activity for women, older adults and for special populations has strengthened. Cancer prevention studies have proliferated during this period but the best evidence remains for colon cancer, with better evidence accumulating for breast cancer prevention, and uncertain or mixed evidence for the primary prevention of other cancers. Important new controlled-trial evidence has accumulated in the area of type 2 diabetes: moderate PA combined with weight loss, and a balanced diet can confer a 50-60% reduction in risk of developing diabetes among those already at high risk. Limited new evidence has accumulated for the role of PA in promoting mental health and preventing falls.
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            Prevalence of sudden cardiac death during competitive sports activities in Minnesota high school athletes.

            Reliable prevalence data would be useful in assessing the impact of sudden cardiac death in young competitive athletes on the community and designing effective preparticipation screening strategies. The frequency with which these catastrophes occur is largely unknown. We utilized a circumstance unique to Minnesota in which the precise number of participants and deaths due to cardiovascular disease could be ascertained over a substantial period of time based on a long-standing insurance program for catastrophic injury or death, mandatory for all student athletes engaged in interscholastic sports. Over the 12-year period, 1985/1986 to 1996/1997, inclusive, three sudden deaths due to cardiovascular disease occurred in competitive high school athletes (grades 10-12) during competition or practice. At autopsy, 1 each proved to be due to anomalous origin of the left main coronary artery from the right sinus of Valsalva, congenital aortic valve stenosis (with bicuspid valve) and myocarditis. All three athletes were white and male, 16 or 17 years of age; two competed in cross-country/track and one in basketball. During the study period there were 1,453,280 overall sports participations and 651,695 student athlete participants among the 27 high school sports. The calculated risk for sudden death was 1:500,000 participations and 1:217,400 participants per academic year (or 0.46/100,000, annually). Over a 3-year high school career for a student athlete the estimated risk was 1:72,500. The risk of sudden cardiac death in a population of high school student athletes was small, in the range of one in 200,000 per year, and was higher in male athletes. The rare occurrence of sudden cardiac death in competitive sports underlines the limitations implicit in structuring productive and cost-effective broad-based preparticipation screening strategies for high school athletes.
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              Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death.

              To evaluate non-atherosclerotic cardiac deaths in the UK population aged over 15 years including elderly patients and to highlight the concept of the structurally normal heart in sudden death. Pathological data were collected prospectively for sudden adult deaths referred by UK coroners. 453 cases of sudden death from 1994 to 2003 (278 men (61.4%) and 175 women (38.6%), age range 15-81 years) were reviewed. Males predominated in both age groups ( 35 years). More than half of the hearts (n = 269, 59.3%) were structurally normal. In the other 40.7%, cardiac abnormalities were noted, which included: (1) cardiomyopathies (23%) such as idiopathic fibrosis, left ventricular hypertrophy, hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic right ventricular dysplasia; (2) inflammatory disorders (8.6%) including lymphocytic myocarditis and cardiac sarcoidosis; (3) non-atheromatous abnormalities of coronary arteries (4.6%); (4) valve diseases; and (5) miscellaneous and rare causes. The concept of the structurally normal heart in sudden death and the need for histological examination to detect underlying disease is highlighted. Relatives need to be referred for cardiological and genetic screening in cases of normal hearts found at necropsy.
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                Author and article information

                Journal
                Histopathology
                Wiley-Blackwell
                03090167
                February 2012
                February 13 2012
                : 60
                : 3
                : 381-396
                Article
                10.1111/j.1365-2559.2011.03852.x
                © 2012

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