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Soccer players sidelining MIs
Rachel Worsley AMATEUR soccer players in their 40s and 50s struggle to identify some cardiac symptoms and tend to put off seeking medical attention even when they experience chest pain , researchers have found .
An Australian study of 153 ‘ masters ’ age ( over 35 ) players found one in five experienced prodromal symptoms , such as unexplained tightness in the chest in the past 12 months , but only a quarter of these players went on to seek advice from a doctor .
The players participating in the online survey ( mean age 49.3 and mainly men ) included those competing at masters A and B grade level , as well as social players .
The survey showed only a third of players were confident they could recognise signs of an MI in other players , and half did not think they would recognise symptoms in themselves .
In addition , about one-third of the players said they would be embarrassed to present to ED if they turned out not to be having a cardiac event .
More than 80 % recognised signs such as chest pain and shortness of breath as typical of an MI , but fewer than 40 % were aware of less typical signs , such as jaw pain and nausea .
Concerningly , the authors said , 60 % of players inaccurately considered that the earliest warning signs before a heart attack happened within minutes to hours , whereas signs could be present for weeks .
“ Confusion regarding possible MI symptoms and failure to recognise prodromal symptoms could cause delay in seeking help ,” the researchers , from University of Sydney and Royal North Shore Hospital , wrote in the Internal Medicine Journal .
When players were asked about what they would do if they experienced chest pain while on the field , about half said they would keep playing while waiting for symptoms to pass .
The senior author , cardiologist
Professor Geoffrey Tofler , said players needed education on symptom recognition and management of cardiac events .
“ These instructions should be made available to players electronically and onsite through posters . This will be vital to taking prompt action and increasing the rate of survival .” Intern Med J 2021 ; 11 Dec .
Call for national CMV screening plan
Heather Saxena A NATIONWIDE strategy to screen newborns for congenital CMV is needed as the current approach is inadequate and delays care , doctors warn .
Writing in the Medical Journal of Australia , they recommend targeted screening , based on a failed newborn sensorineural hearing test .
The test should be carried out within 21 days of birth to distinguish between congenital and acquired CMV , say the two paediatricians and surgeon .
Currently , fewer than 2 % of infected infants are diagnosed in Australia , and both clinicians and policymakers have limited awareness of the infection , say the group from Perth Children ’ s Hospital .
“ Congenital CMV infection is a significant , if poorly recognised , public health issue ,” said Dr Allison Reid and colleagues , from the University of WA .
“[ The ] narrow window , limited congenital CMV awareness and lack of a comprehensive approach across Australia mean most cases go undiagnosed .
“ For symptomatic children , this may represent a lifelong disability of unknown cause .”
Universal screening was hard to
One-third of players were embarrassed to go to ED in case of a false alarm .
justify because of the high rate of asymptomatic babies , they said , but a targeted approach — currently being trialled in WA — could lift diagnosis rates and improve care .
The WA trial used saliva PCR testing and confirmed positive cases via urine samples to avoid false positives from maternal CMV contamination via breastfeeding . Med J Aust 2022 ; 7 Mar .
How does Nuvaxovid compare ?
Antony Scholefield THE first safety data for Novavax ’ s COVID-19 vaccine have been analysed , showing more cases of fatigue and headache than after Pfizer ’ s Comirnaty but fewer injection-site reactions .
More than 35,000 doses of the protein subunit vaccine , Nuvaxovid , have gone into arms since it received TGA and ATAGI approval in January .
The Federal Government estimated that between 45,000 and 180,000 Australians were waiting for Novavax because of their safety concerns about both mRNA COVID-19 vaccines and Astra- Zeneca ’ s vaccine , Vaxzevria .
Of the first 867 patients surveyed about adverse events after the new vaccine , 38 % reported at least one — most commonly fatigue ( 28 %) — followed by injection-site reactions ( 24 %), headache ( 22 %) and muscle pain ( 19 %). More than two patients in every 100 reported seeing a doctor or going to hospital after their vaccination , compared with fewer than one after a first dose of Comirnaty and slightly more than one for first doses of Moderna ’ s Spikevax and Vaxzevria .
The data , released in March , were collected by active surveillance program AusVaxSafety , co-ordinated by the National Centre for Immunisation Research and Surveillance in Sydney .