Donald M. Christie

Atypical pneumonia in active patients: clues, causes, and return to play.

Atypical pneumonias can affect young, otherwise healthy individuals who have close contact with one another, such as athletes in team sports. Symptoms, which often progress gradually, may mimic an upper respiratory tract infection. Mycoplasma, chlamydia, and legionella organisms, along with certain viruses, are the usual atypical pneumonia agents, and antimicrobial therapies are recommended. Because complications, though rare, can be protracted, affect athletic performance, and result in sudden death, return-to-play guidelines should be cautious and patient- and sport-specific.

Managing atrial fibrillation in active patients and athletes

Atrial fibrillation in young or middle-aged active patients can often be managed with medication. Evaluation should address associated conditions and predisposing factors such as idiopathic hypertrophic subaortic stenosis, Wolff-Parkinson-White syndrome, congenital heart disease, hyperthyroidism, excess alcohol or other drug use, and exercise-induced catecholamine release. Diagnostic studies may include an ECG, 24-hour Holter or event monitoring, exercise treadmill testing, stress echocardiography, electrophysiologic studies, and laboratory testing. Electrocardioversion provides rapid, predictable treatment, but ablation therapy is sometimes needed.

Fatter Bellies Signal Lower Cardiovascular Fitness

Waist circumference is positively associated with increased risk of disorders such as type 2 diabetes mellitus and cardiovascular disease, and one Canadian study demonstrated that high cardiorespiratory fitness (CRF) has been associated with lower waist circumferences for a given body mass index (BMI). CRF may mediate health risks associated with elevated BMI via a reduction in abdominal adipose tissue, according to a study from the Cooper Clinic in Dallas. Patients were 293 healthy white men (age range, 30 to 76 years; BMI range, 21.2 to 34.9 kg/m) examined at the clinic. Participants were nonsmokers who did not have diabetes or had not experienced a heart attack, stroke, or cancer. Patients were classified into either

Children Getting Fatter Faster

‘Best of the Literature’ presents summaries of sports medicine-related articles culled from more than 30 medical journals. Experts comment on what the new findings add to current medical thinking and on the implications for practice.

Lifestyle Changes Prevent Type 2 Diabetes

‘Best of the Literature’ presents summaries of sports medicine—related articles culled from more than 30 medical journals. Experts comment on what the new findings add to current medical thinking and on the implications for practice.

Ventricular tachycardia in a marathoner

In brief Young marathoners who run 60 miles per week may appear to be in great shape. But episodes of palpitations and light-headedness may signify a cardiovascular problem. Tests can reveal just how deceiving appearances can be.