There is a major trade-off between improvements in longevity, general health, fitness and quality of life due to regular intense physical activity on the one hand and possible cardiac risks on the other hand, whether for participants in leisure time sports activities or for highly trained athletes. Cardiac complications and sudden death in sports, even though rare, but dramatic, events, are mainly observed in those suffering from inherited, often latent diseases with a strong genetic background, unknown to the subjects. Sedentary lifestyle together with more than one risk factor may also contribute to cardiac events in persons beginning to exercise for the first time or recommencing intense physical activities after a long pause. Manifestations of inherited cardiac diseases with a typical genetic component may occur in children or adolescents, but also in adults. For many inherited cardiac diseases there is a large body of knowledge on the genetic origin, therefore, genetic testing may be a valuable tool for diagnosis and prevention of underlying diseases, especially as genetic testing has become much cheaper over the last few years. The present paper describes cardiac diseases with genetic disposition and related genetic testing and presents recommendations for genetic examinations. Testing should be of benefit for sportsmen and women but also for family members to prevent fatal cardiac events. These recommendations will consider benefits for the sports person, and ethical reflections as well.

Aplasia cutis congenita (ACC) has been observed after fetal exposure to the antithyroid drug methimazole (MMI), but not reported after propylthiouracil (PTU), the current antithyroid drug of choice during pregnancy. This occurrence has implications for patient information and causal research

Background: Virtual simulation modalities have been implemented widely since the onset of the severe acute respiratory syndrome coronavirus 2 pandemic restrictions in March 2020, as educators face persistent restrictions to face-to-face education of medical students and healthcare professionals.There is paucity of published data regarding the benefits and barriers of distance and avatar simulation training modalities.Methods: Following a 2-day virtual pediatric simulation competition facilitated by Netzwerk Kindersimulation e.V., using remote human avatars and distance simulation, we conducted a multicenter survey to explore the advantages and challenges of avatar and distance simulation among participants. We used a modified Delphi approach to draft and develop the 32-item online questionnaire with 7-point Likert-like scales (7 being the highest rating).Results: Twenty participants answered our questionnaire. Respondents indicated both a high overall satisfaction (median of 5.0 [Q25–Q75: 4.0–6.0] ) for avatar and distance simulation 6.0 (5.0–6.0), respectively, as well as a high achieved psychological safety with both simulation types (5.0 [4.0–6.0] vs. 5.0 [4.0–6.0]). The most frequently reported profits of avatar and distance simulation included the elimination of travel distances, associated lower costs, less time spent attending the education activity, and effective communication and leadership training, especially with avatar simulation. Most often named challenges were technical problems, limited reception of non-verbal cues and a spatial distance from the team/educator.Discussion: Based on the results of this pilot study, avatar and distance simulation can be employed successfully and appear to be good supplements to face-to-face simulation. Other studies are warranted to further explore the effectiveness of various types of virtual simulation compared to conventional presential simulation. We suggest using avatar-based simulation for targeted communication and leadership skills training and the application of distance simulation to bring simulation experts virtually to remote places where educator resources are lacking.

Scant data have been published on the oxygenation and safety measures required for the aeromedical transport of infants. Current guidelines recommend avoidance of air travel for infants younger than 1 week of age and avoidance of ascent to moderate (2500 m) to high (≥2500 m) altitude until 6 weeks of age in healthy full-term infants.^1,2 In situ flight research shows that there is an increased risk of hypoxemia in preterm infants and in those with respiratory disease, but not in healthy full-term infants who are older than 6 months of age.^3-5 We report the findings of a study examining the effect of hypobaric hypoxia during aeromedical transport in infants younger than 6 months of age.