The global COVID-19 pandemic has changed our lifestyles. Self-constrained life, as a part of the “stay-home”approach to combatting COVID-19, has also changed the incidence of diseases. The number of patients withischemic heart disease and heart failure requiring treatment has decreased. It is well known that exercise can prevent and improve many lifestyle-related diseases. In competitive athletes, it is also known that exercise can altercardiac function for physiological adaptation. This section will review the relationship between exercise and thecardiovascular system.

The world of sports injuries includes traumatic injuries and overuse syndrome.Typical traumatic injuries are sprains (ligament injuries), including ankle sprains and anterior cruciate ligament(ACL) knee injuries. If primary treatment of sprains is not performed properly, secondary injury caused by jointinstability often occurs, which can lead to osteoarthritis.Examples of overuse syndrome include tennis elbow and jumper’s knee. Overuse syndrome involves the inflammation of the surrounding enthesis. Improper treatment of such cases can lead to chronic enthesopathy.What is important in treating sports injuries is not only evaluating and treating the condition itself but alsomaintaining the overall physical stature of the athlete. Such care must involve both the treatment of the conditionand the prevention of recurrence.The knowledge acquired in sports medicine, including treatment methods and strategies for improving physicalfunction, can be widely applied in general medical care. This is the significance of sports orthopedics.

The year 2020 was to be the year of the Tokyo Olympics, but the event was postponed due to controlling thetransmission of COVID-19, and now the battle against COVID-19 is underway for the 2021 Olympics. There is nodoubt that not only top athletes aiming for the Olympics but also the entire nation is becoming more interested inbecoming involved in sports and improving their health. Conventional sports theory has developed without muchconceptualization of gender differences between men and women, which has led to many problems that need to beaddressed medically. In the field of gynecology, the importance of lifelong health care for women also calls for amedical approach to maintaining women’s health in sports. In this paper, I would like to discuss the particularitiesof women’s health problems among athletes and consider care for their lifelong health. The American College ofSports Medicine lists (1) low energy availability with or without disordered eating, (2) menstrual dysfunction, and(3) low bone mineral density as the most common health problems among female athletes and refers to these as “thefemale athlete triad”. Stress fractures have been linked to this triad.In the case of bone loss and amenorrhea caused by low energy availability, the important treatment is to increase energy intake, reduce energy consumption by training, and increase available energy. Hormone therapyshould be considered if correcting energy deficiency does not work or if weight gain is difficult due to the natureof the competition. Oral contraceptives/low dose estrogen progestin and progestin are not banned substances, sothey can be used by athletes. When considering prescribing a drug, physicians can check the Global DRO JAPANwebsite to ensure that the drug is not prohibited.

Sports psychiatry was first introduced in the medical literature at the end of the 1980s. This relatively newacademic field has two aims: 1) to prevent and treat mental problems in athletes and 2) to apply physical exerciseand sports to psychiatric practice as a treatment. Although elite athletes tend to be regarded as very mentally toughindividuals, they are at great risk of developing some mental disorders, such as depression and eating disorders.It has been reported that athletes competing in individual sports are more prone to depressive symptoms than athletes competing in team sports. Eating disorders often occur in aesthetic sports (e.g., figure skating and rhythmicgymnastics), endurance sports (e.g., marathons), and weight-class sports (e.g., wrestling and boxing). In additionto these common mental disorders, athletes are faced with sport-specific mental problems, such as overtrainingsyndrome, muscle dysmorphia, and doping. Although it is now accepted that mental disorders can also occur inelite athletes, for many athletes themselves, mental disorders are still associated with increased (self-) stigma.Therefore, destigmatization is one of the major issues that sports psychiatry should tackle. In this paper, theauthors introduced recent topics in sports psychiatry.

スポーツによって身体活動量が増加すると，活動量に見合った適切なエネルギー・各栄養素の摂取量を考慮することが必要になる．また，厳しいトレーニングを実施するエリートアスリートでは怪我や疾病を予防するために，特定の栄養素の過不足に留意する必要がある．とくに，アスリートの慢性的な摂取エネルギー不足は将来にわたっての疾病に関わることが明らかとなり，大きな問題である．一方，トレーニングや試合スケジュールに合わせた栄養素の摂取の工夫について研究が進んでおり，パフォーマンスを向上させる目的のサプリメントの開発も盛んである．サプリメントの使用にあたってはドーピングコントロールとの関係やジュニア選手への教育不足など問題点も多い．今後，スポーツ現場での栄養摂取はより，個人への対応を必要とし，多くのエビデンスの蓄積が望まれる．

もやもや病が原因で 3 度の脳出血を繰り返した 30 代の女性．両側の上側頭回と片側の大脳基底核部の障害によって，左片麻痺と高次脳機能障害に加えて聴覚失認を呈した．聴覚失認の診断には，画像診断による脳損傷部の検索，聴性脳幹反応などの機能的聴力検査，失語症や注意障害との鑑別を必要とした．また，リハビリテーションによって，家庭生活が可能なレベルまで改善した症例を経験したので，その経過について報告する．