Background: Preliminary evidence indicates that prophylactic-dose thromboprophylaxis may be inadequate to control the increased risk of venous thromboembolism (VTE) in patients hospitalized for coronavirus disease 2019 (COVID-19) infection. Additionally, it remains unclear whether the D-dimer measurement is useful for VTE risk stratification among COVID-19 patients. This study aimed to offer benchmark data on the incidence of VTE and to examine the difference in D-dimer levels among anticoagulated COVID-19 patients with and without VTE incident. Methods: A comprehensive literature review of PubMed from inception to May 2020 was performed for original studies that reported the frequency of VTE and death among COVID-19 patients who received thromboprophylaxis on hospitalization. The endpoints included VTE (a composite of pulmonary embolism (PE) or deep vein thrombosis (DVT)), PE, DVT, and mortality. Results: A total of 11 cohort studies were included. Among hospitalized COVID-19 patients, 23.9% (95% confidence interval (CI), 16.2% to 33.7%; I2 = 93%) developed VTE despite anticoagulation. PE and DVT were detected in 11.6% (95% CI, 7.5% to 17.5%; I2 = 92%) and 11.9% (95% CI, 6.3% to 21.3%; I2 = 93%) of patients, respectively. Patients in the intensive care unit (ICU) had a higher risk for VTE (30.4% )95% CI, 19.6% to 43.9%)) than those in the ward (13.0% (95% CI, 5.9% to 26.3%)). The mortality was estimated at 21.3% (95% CI, 17.0% to 26.4%; I2 = 53%). COVID-19 patients who developed VTE had higher D-dimer levels than those who did not develop VTE (mean difference, 2.05 µg/mL; 95% CI, 0.30 to 3.80 µg/mL; P = 0.02). Conclusions: The heightened and heterogeneous risk of VTE in COVID-19 despite prophylactic anticoagulation calls into research on the pathogenesis of thromboembolic complications and strategy of thromboprophylaxis and risk stratification. Prominent elevation of D-dimer may be associated with VTE development and can be used to identify high-risk subsets.

Purpose. The aim of this study was to evaluate the associations between anaerobic performance (AnP), applicable field tests, and the functional classification levels in female wheelchair basketball athletes. Methods. Female wheelchair basketball athletes (N = 23; Category A, n = 9; Category B, n = 14) from the Canadian national team were evaluated using field tests and the 30-second Wingate Anaerobic Test. Measures of peak power output (PP), time to achieve peak power (tPP), mean power output (MP), and a fatigue index (FI) were used to assess AnP. A test battery evaluating seven wheelchair basketball skills was applied. Student's t test was used to identify differences between the two main functional categories (A and B). Spearman's rank correlation coefficient and Pearson's product-moment correlation coefficient were calculated to determine the significance of all relationships between the parameters of AnP, the results of the field tests, and the eight functional classification levels of the athletes (1.0-4.5 pts.). Results. In all analyzed parameters, except for the field test measuring shooting skills, the results of AnP were significantly higher for Category B players. Significant relationships were observed between athletes' classification level and AnP and the field tests except for tPP, the 5 m sprint, and the shooting test. The strongest association was observed for MP and PP, MP and FI, PP and FI (p = 0.001). Conclusions. Strong associations were found between the functional classification level and AnP of the female wheelchair basketball athletes. The strongest correlation was confirmed between MP, PP, and the field test measuring the two-handed chest pass, suggesting that this test can be used to indirectly assess the anaerobic performance of female wheelchair basketball athletes.

Purpose. the purpose of this study was to analyze scientific evidence on the effects that Nordic Walking (NW) has on the human body. Basic procedures. A comprehensive search of computer databases (MEDLINE/PubMed, cINAHL, and SPORtDiscus) was conducted to identify relevant English and Polish studies on NW that were published from 1995 to 2009 and based on scientific research. Main findings. A total of 26 studies met the inclusion criteria. the majority of studies (12) discussed physiological issues, eleven studies were dedicated to NW as a form of rehabilitation (including one case study), and three studies focused on biomechanical issues present in NW. Conclusions. Not all of the widely promoted benefits of NW were confirmed in the results of the found scientific studies. Often analyzed issues did not provide sufficient explanation. there is a large discrepancy in the results of physiological responses during NW in a variety of conditions (on a treadmill with/without grade; field -uphill/downhill/horizontal level terrain). the results of studies analyzing the effects of NW training as a form of rehabilitation particularly in the areas of cardiology confirmed the positive aspects of including NW towards a patient's rehabilitation after acute coronary syndrome, with intermittent claudication, and after coronary artery disease, or after myocardial infarction. contrary to popular belief and previously done studies, recent research has shown that NW does not reduce the loading of the knee joint.

Emerging evidence has underscored the potential usefulness of red blood cell distribution width (RDW) measurement in predicting the mortality and disease severity of COVID‐19. This study aimed to assess the association of the plasma RDW levels with adverse prognosis in COVID‐19 patients. A comprehensive literature search from inception to September 2020 was performed to harvest original studies reporting RDW on admission and clinical outcomes among patients hospitalized with COVID‐19. RDW levels were compared between cases (patients who died or developed more severe symptoms) and controls (patients who survived or developed less severe symptoms). A total of 14,866 subjects from 10 studies were included in the meta‐analysis. Higher levels of RDW were associated with adverse outcomes in COVID‐19 patients (mean differences = 0.72; 95% CI = 0.47–0.97; I2 = 89.51%). Deceased patients had higher levels of RDW compared to patients who survived (mean differences = 0.93; 95% CI = 0.63–1.23; I2 = 85.58%). Severely ill COVID‐19 patients showed higher levels of RDW, as opposed to patients classified to have milder symptoms (mean differences = 0.61; 95% CI = 0.28–0.94; I2 = 82.18%). Elevated RDW levels were associated with adverse outcomes in COVID‐19 patients. This finding warrants further research on whether RDW could be utilized as a simple and reliable biomarker for predicting COVID‐19 severity and whether RDW is mechanistically linked with COVID‐19 pathophysiology.

Traditional Chinese medication (TCM) has analgesic and anti-inflammatory effects in patients with knee osteoarthritis (OA). We conducted the first systematic review of the best quantitative and qualitative evidence currently available in order to evaluate the effectiveness of TCM in relieving pain in knee OA. A comprehensive literature search was conducted using three English and four Chinese biomedical databases from their inception through March 1, 2015. We included randomized controlled trials of TCM for knee OA with intervention durations of at least two weeks. The effects of TCM on pain and other clinical symptoms were measured with the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The total effectiveness rate, which was used to assess overall pain, physical performance and wellness, was also measured. Two researchers independently extracted data on study design, population characteristics, duration, intervention, outcomes, risk of bias, and primary results. We performed a random-effects meta-analysis when appropriate. We also explored factors that could explain the heterogeneity by conducting subgroup and meta-regression analyses. Twenty-three studies, totaling 2362 subjects, met the eligibility criteria. Treatments were formulated with an average of 8 Chinese herbs and were prescribed based on the traditional Chinese diagnostic method of syndrome differentiation. The mean treatment duration was seven weeks, with oral administration occurring one to three times a day. Compared with non-steroidal anti-inflammatory drugs and intra-articular hyaluronate injections, 18 of the studies showed significantly improved VAS pain scores (Mean Difference [MD] = 0.56; 95% confidence interval [CI], 0.18 to 0.94; p = 0.004), six of the studies showed significantly improved WOMAC pain subscale scores (MD = 2.23; 95% CI, 0.56 to 3.91; p = 0.009), and 16 of the trials showed significantly improved total effectiveness rates (risk ratio = 1.12; 95% CI, 1.05 to 1.19; p = 0.0003). In addition, TCM showed a lower risk of adverse events than standard western treatments. This evidence suggests that TCM is safe and effective for improving pain, function, and wellness in treatments of knee OA. However, there is inherent clinical heterogeneity (diverse TCM formulations, controls, and treatment regimens) among the included trials. Despite these limitations, the potential analgesic effects of TCM warrant further methodologically rigorous research to determine the clinical implications of TCM on pain management in knee OA.

The aim of this study was to evaluate relationships between anaerobic performance, field tests, game performance and anthropometric variables of sitting volleyball players. Twenty elite Polish sitting volleyball players were tested using the 30 s Wingate Anaerobic Test for arm crank ergometer and participated in six physical field tests. Heights in position to block and to spike, as well as arm reach were measured. Players were observed during the game on the court in terms of effectiveness of the serve, block, attack, receive and defense. Pearson analysis and the Spearman’s rank correlation coefficient were used. The strongest correlations were found between the chest pass test and mean power and peak power (r=.846; p=.001 and r=.708; p=.0005, respectively), and also between the T-test and peak power (r= −.718; p=.001). Mean power correlated with the 3 m test (r= −.540; p=.014), the 5 m test (r= −.592; p=.006), and the T-test (r= −.582; p=.007). Peak power correlated with the 3 m test (r= −.632; p=.003), the 5 m test (r= −.613; p=.004), speed & agility (r= −.552; p=.012) and speed & endurance (r=−.546; p=.013). Significant correlations were observed between anthropometric parameters and anaerobic performance variables (p≤.001), and also between anthropometric parameters and field tests (p≤.05). Game performance and physical fitness of sitting volleyball players depended on their anthropometric variables: reach of arms, the position to block and to spike. The chest pass test could be used as a non-laboratory field test of anaerobic performance of sitting volleyball players.

Wheelchair basketball is an adaptive Paralympic sport and wheelchair basketball players are under classification in sport. Coaches are looking for useful assessment tools (field-based tests) to evaluate players’ anaerobic performance (anaerobic capacity). The aim of this study was to assess the validity of field-based tests for anaerobic performance evaluation for two functional categories of wheelchair basketball players and to create a calculator to predict mean or peak power on the basis of the selected field-based test results. Sixty-one elite male wheelchair basketball players performed the Wingate Anaerobic Test and the following field-based tests: 3 m sprint, 5 m sprint, 10 m sprint, 20 m sprint, basketball chest pass test, medicine ball (3 kg) chest pass test, bilateral handgrip, 3-6-9 m drill test, 30-s sprint test, agility drill test and 10 × 5 m sprint test. The participants were divided into two functional categories: A (classes from 1.0 to 2.5; n = 29) and B (classes from 3.0 to 4.5; n = 32) according to the International Wheelchair Basketball Federation rules. The large effect size (Cohen’s d > 0.5) was found in four tests (3 m sprint, 5 m sprint, basketball chest pass test, medicine ball chest pass test; ES 0.90, 0.53, –0.96, –1.05). There were differences between category A and category B players regarding mean power, peak power and relative peak power. Peak power correlated with four tests, while mean power correlated with eight out of eleven tests. The formulas for estimating peak power or mean power in category A and B players were created separately. All the analyses confirmed that 3 m sprint, 5 m sprint, 10 m sprint, 20 m sprint, agility drill test, bilateral handgrip, 3-6-9 m drill test, 30-s sprint test, basketball chest pass test and medicine ball chest pass test are valid for non-laboratory anaerobic performance evaluation. Using the four formulas as a tool to predict mean or peak power on the basis of the selected field-based test results and functional categories will be helpful and will allow coaches and players to prepare pre-season, post-season and in-season conditioning exercises in wheelchair basketball.

Background Secondary hospitals play an important, yet overlooked, role in reflecting public health status, both locally and nationally. Relatively few reports analysing the causes of secondary hospital admissions exist, which is especially unfortunate in the case of developing countries, considering the huge numbers of admissions and people at risk. In developing countries like South Africa, the quality of records varies among institutions. Some hospitals have computerised data, while others may keep no records whatsoever. A major problem facing the quality of hospital records is the constant shortage of staff in rural and urban hospitals. Thorough documentation is essential in providing an invaluable database for researchers, but morbidity statistics are unfortunately scarce. GF Jooste Hospital in Manenberg is the busiest hospital in Cape Town-serving 1.1 million people, with 224 beds and over 12 000 admissions annually. Budgetary constraints in the South African public health sector means that providing healthcare services at higher levels than necessary is too costly. Because hospitals consume the largest share of the public healthcare budget, they have been the focus in cost cutting. In particular, the budgets of referral (tertiary or teaching) hospitals have been trimmed in order to promote primary and secondary care. It is imperative to identify those services that are required most at secondary hospitals in order to improve budgeting and, more appropriately, train doctors and medical students for the job at hand. Identifying the morbidity profile of the population for which the hospital caters can aid the optimal utilisation of the available resources, as well as focusing the continuing medical education of hospital physicians. We determined disease patterns of admissions over a three-year period (2001-2003), primarily as insight towards optimal hospital resource management. Methods A retrospective study examined ward records, totalling 36 657 admissions, from which a random sample (N=608) was selected. A stratified sample (N=462) was constructed, considering the relative proportions admitted to the wards. The International Statistical Classification of Diseases (ICD) directed diagnosis sorting. Disease prevalence was expressed as the percentage of patients allocated to each ICD category among those admitted to the hospital and respective wards and, additionally, the percentage of diagnoses for each ICD subcategory among patients assigned to each major category. Results Trauma (represented by ICD categories S/T 23% and V/X/Y 16%), specifically assault-related, was most prevalent. This was followed by circulatory diseases (22%) and infectious diseases (19%), dominated by HIV (61%) and associated diseases like TB (57%). The age of the patients ranged from 13 to 87 (mean: 40 years), with the 20 to 30-year-olds predominating. Surgical patients were younger (mean: 35 years) than medical (mean: 45 years). In the medical wards, infectious (39% in men; 38% in women) and circulatory aetiologies (39% and 41% in men ...