Epidemiology of injuries in First Division Spanish football

Abstract The aim was to examine the injuries sustained by Spanish football players in the First Division and to compare injury-related variables in the context of both competition and training. The injury data were prospectively collected from 16 teams (427 players) using a specific web-based survey during the 2008/2009 season. A total of 1293 injuries were identified (145 were recurring injuries). The overall injury incidence was 5.65 injuries per 1000 h of exposure. Injuries were much more common during competition than during training (43.53 vs. 3.55 injuries per 1000 h of exposure, P menor que 0.05). Most of the injuries (89.6%) involved the lower extremities, and overuse (65.7%) was the main cause. Muscle and tendon injuries were the most common types of injury (53.8%) among the players. The incidence of training injuries was greater during the pre-season and tended to decrease throughout the season, while the incidence of competition injuries increased throughout the season (all P menor que 0.05). In conclusion, the results of this study suggest the need for injury prevention protocols in the First Division of the Spanish Football League to reduce the number of overuse injuries in the muscles and tendons in the lower extremities. In addition, special attention should be paid during the pre-season and the competitive phase II (the last four months of the season) in order to prevent training and competition injuries, respectively.

Doubling the width of the platform of the San Pedro bridge in Spain

The San Pedro Bridge has six spans and is 750 m (2460 ft) long, 88 m (290 ft) high, 12 m (39 ft) wide, and curved with a radius of 700 m (2300 ft). It was built in 1993 using the cantilever method. Its super - structure is a prestressed concrete box girder with main spans of 150 m (490 ft). In 2008 and 2009, the width of the platform was enlarged to 23 m (75 ft) using five movable sets of scaffolding. The bridge remained open to traffic during construction. The original platform was widened 6 m (20 ft) on each side by connecting a new lightweight concrete cantilever to the original upper slab. These cantilevers were supported by steelstruts. The tie into the upper slab was made with new transverse post-tensioned tendons. The original superstructure was strengthened to resist the additional dead load of the expansion and live loads of the extra traffic. An additional new central web and a composite concrete-steel section were constructed and connected to the concrete box and central web using vertical high-strength post-tensioning bars. Also, external post-tensioning cables were implemented. It was also necessary to strengthen the connection of the original concrete box section to the piers. Detailed calculations were performed to evaluate the load distribution transmitted to the piers by the webs and by the original inclined concrete walls of the box girder. Finally, a detailed second-order-analysis of the complete structure was made to guarantee the resistance of the piers compared with actual loads

Nociceptin/orphanin FQ-induced nociceptive responses through substance P release from peripheral nerve endings in mice

We have studied the in vivo signaling mechanisms involved in nociceptin/orphanin FQ (Noci)-induced pain responses by using a flexor-reflex paradigm. Noci was 10,000 times more potent than substance P (SP) in eliciting flexor responses after intraplantar injection into the hind limb of mice, but the action of Noci seems to be mediated by SP. Mice pretreated with an NK1 tachykinin receptor antagonist or capsaicin, or mice with a targeted disruption of the tachykinin 1 gene no longer respond to Noci. The action of Noci appears to be mediated by the Noci receptor, a pertussis toxin-sensitive G protein–coupled receptor that stimulates inositol trisphosphate receptor and Ca2+ influx. These findings suggest that Noci indirectly stimulates nerve endings of nociceptive primary afferent neurons through a local SP release.

Biomechanics of the movable pretarsal adhesive organ in ants and bees

Hymenoptera attach to smooth surfaces with a flexible pad, the arolium, between the claws. Here we investigate its movement in Asian weaver ants (Oecophylla smaragdina) and honeybees (Apis mellifera).  When ants run upside down on a smooth surface, the arolium is unfolded and folded back with each step. Its extension is strictly coupled with the retraction of the claws. Experimental pull on the claw-flexor tendon revealed that the claw-flexor muscle not only retracts the claws, but also moves the arolium. The elicited arolium movement comprises (i) about a 90° rotation (extension) mediated by the interaction of the two rigid pretarsal sclerites arcus and manubrium and (ii) a lateral expansion and increase in volume. In severed legs of O. smaragdina ants, an increase in hemolymph pressure of 15 kPa was sufficient to inflate the arolium to its full size. Apart from being actively extended, an arolium in contact also can unfold passively when the leg is subject to a pull toward the body.  We propose a combined mechanical–hydraulic model for arolium movement: (i) the arolium is engaged by the action of the unguitractor, which mechanically extends the arolium; (ii) compression of the arolium gland reservoir pumps liquid into the arolium; (iii) arolia partly in contact with the surface are unfolded passively when the legs are pulled toward the body; and (iv) the arolium deflates and moves back to its default position by elastic recoil of the cuticle.

Retinoids down-regulate telomerase and telomere length in a pathway distinct from leukemia cell differentiation

Human telomerase, a cellular reverse transcriptase (hTERT), is a nuclear ribonucleoprotein enzyme complex that catalyzes the synthesis and extension of telomeric DNA. This enzyme is specifically activated in most malignant tumors but is usually inactive in normal somatic cells, suggesting that telomerase plays an important role in cellular immortalization and tumorigenesis. Terminal maturation of tumor cells has been associated with the repression of telomerase activity. Using maturation-sensitive and -resistant NB4 cell lines, we analyzed the pattern of telomerase expression during the therapeutic treatment of acute promyelocytic leukemia (APL) by retinoids. Two pathways leading to the down-regulation of hTERT and telomerase activity were identified. The first pathway results in a rapid down-regulation of telomerase that is associated with retinoic acid receptor (RAR)-dependent maturation of NB4 cells. Furthermore, during NB4 cell maturation, obtained independently of RAR by retinoic X receptor (RXR)-specific agonists (rexinoids), no change in telomerase activity was observed, suggesting that hTERT regulation requires a specific signaling and occurs autonomously. A second pathway of hTERT regulation, identified in the RAR-responsive, maturation-resistant NB4-R1 cell line, results in a down-regulation of telomerase that develops slowly during two weeks of all-trans retinoic acid (ATRA) treatment. This pathway leads to telomere shortening, growth arrest, and cell death, all events that are overcome by ectopic expression of hTERT. These findings demonstrate a clear and full dissociation between the process of tumor cell maturation and the regulation of hTERT mRNA expression and telomerase activity by retinoids. We propose telomerase expression as an efficient and selective target of retinoids in the therapy of tumors.

The notion of the Cambrian pananimalia genome.

The toil by photosynthesizing cyanobacteria and blue-green algae of nearly three billion years appeared to have finally resulted in the sufficient accumulation of molecular oxygen. So, the stage was set for the emergence, at the ocean bottom, of diverse animals that were consumers of molecular oxygen. It now appears that this Cambrian explosion, during which nearly all the extant animal phyla have emerged, was of an astonishingly short duration, lasting only 6-10 million years. Inasmuch as only a 1% DNA base sequence change is expected in 10 million years under the standard spontaneous mutation rate, I propose that all those diverse animals of the early Cambrian period, some 550 million years ago, were endowed with nearly identical genomes, with differential usage of the same set of genes accounting for the extreme diversities of body forms. Some of the more pertinent genes that are thought to be included in the Cambrian pananimalia genome are as follows. (i) A gene for lysyloxidase that, in the presence of molecular oxygen, crosslinked collagen triple helices to produce ligaments and tendons, thus contributing to the stout bodies of the Cambrian animals. (ii) Genes for hemoglobin; these internal transporters of molecular oxygen are today seen sporadically in members of diverse animal phyla. (iii) The Pax-6 gene for eye formation; the eyes of a ribbon worm to a human are organized by this gene. In animals without eyes, the same gene organizes other sensory systems and organs. (iv) A series of Hox genes for the anterior-posterior (cranio-caudal) body plans: these genes are also present in all phyla of the kingdom Animalia.

Aplicação de gelatina obtida de subproduto animal como substituto parcial de gordura em spread de chocolate

O objetivo do presente estudo foi verificação da viabilidade da aplicação de gelatina de pés de frango em spread de chocolate como substituto parcial de gordura. Inicialmente apresentou-se uma revisão de literatura sobre os principais aspectos que envolvem a pesquisa. Após relatou-se a metodologia de extração e caracterização físico-química da gelatina obtida de pés de frango por meio de análises de composição centesimal, de cor, força de gel e análise de perfil de textura (TPA). Posteriormente abordou-se os efeitos da aplicação de gelatina como substituto de gordura nas propriedades físico-químicas e reológicas de spread de chocolate. Por último investigou-se a influência da concentração de gelatina e substituição de gordura na espalhabilidade, estabilidade (shelf life), custos e propriedades sensoriais dos spreads de chocolate. Para tanto, foi utilizado planejamento experimental Central Composto Rotacional e metodologia de superfície de resposta. Os resultados da extração de gelatina de subproduto de frango indicaram que as peles e tendões dos pés de frango possuem rendimento (7,83 %) e conteúdo mineral (1,92 %), apresentando alto teor proteico (84,96 %) próximo das gelatinas comerciais. Em concentração de 6,67 % a gelatina demonstrou elevada força de gel (294,78 g), comportando-se na análise de perfil de textura como um sólido. Os dados relacionados às formulações de spread de chocolate demonstraram que tanto o nível de substituição de gordura quanto a concentração de gelatina exerceram efeitos significativos (p<0,05) sobre a cor, volume, densidade e comportamento reológico dos produtos, exceto a atividade de água que foi influenciada apenas pelo primeiro fator. Sob a perspectiva reológica apenas a amostra com maior nível de substituição de gordura foi classificada como pseudoplástica. A gelatina contribuiu no aumento do teor proteico das formulações. A consistência foi significativamente (p<0,05) influenciada pelas propriedades da fase de gelatina, apresentando ampla faixa de plasticidade nas diferentes temperaturas (10, 20 e 30 °C). A consistência dos spreads aumentou em todas as temperaturas durante os 90 dias de armazenamento. Observou-se por meio da análise sensorial que os fatores em estudo provocaram alterações nos atributos sensoriais do produto suficiente para a percepção dos provadores. A formulação com 75 % de substituição de gordura seguida pelas formulações com 50 % e 0,8 % de concentração de gelatina apresentaram a maior aceitabilidade. Com o máximo de substituição de gordura chegou-se a 53 % de redução de custos. Contudo, os resultados obtidos sugerem que a aplicação de gelatina de pés de frango pode ser vantajosa, já que contribuiu com a formulação de spreads de chocolate menos calóricos e com propriedades físico-químicas e sensoriais adequadas para uma possível comercialização.

Efeito da aplicação do ultrassom terapêutico durante 4 e 5 minutos por área do transdutor no processo de reparação de tendão de ratos

O objetivo deste estudo foi avaliar o efeito dos tempos de aplicação 3, 4 e 5 minutos por ERA do ultrassom terapêutico (UST) na organização das fibras de colágeno em lesão do tendão do calcâneo de ratos. Foram utilizados quarenta ratos machos Wistar, dos quais 32 sofreram tenotomia total do tendão do calcâneo e foram divididos em 5 grupos: GC, sem tenotomia e tratamento; GT, com tenotomia e sem tratamento; UST3, UST4 e UST5 submetidos à tenotomia e tratados com UST nos tempos de 3, 4 e 5 minutos por área de radiação efetiva respectivamente. Os animais foram submetidos à primeira aplicação do UST foi 24 horas após a cirurgia de tenotomia. A irradiação ultrassônica foi aplicada com os seguintes parâmetros: 1 MHz, modo pulsado com 20% do ciclo de trabalho (2 ms de emissão / 8 ms de intervalo), frequência de 100 Hz, 0,5 W / cm² de intensidade e ERA de 0,5 cm². A aplicação foi realizada 1x/dia. Os animais foram sacrificados após a 10ª sessão de tratamento, no 12º dia pós-operatório. Os tendões foram retirados cirurgicamente para análise da organização das fibras colágenas através do método de birrefringência (retardo óptico - OR). As fibras colágenas mostraram melhor agregação e organização no grupo UST3, UST4 e UST5 quando comparado ao GT (p<0.05) e o UST5 apresentou melhor resposta na comparação intergrupos. Conclui-se que o UST, aplicado no tempo de 5 minutos por área de radiação efetiva, apresentou a melhor dose-resposta quanto à organização das fibras colágenas no reparo tecidual de tendões de ratos

Macroglossia como manifestação de amiloidose : caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Using percentiles to diagnose familial hypercholesterolemia in Portugal

Aims: Familial hypercholesterolemia (FH) is a genetic disorder of lipid metabolism, clinically characterised by high levels of low-density lipoprotein cholesterol (LDL-C) that leads to cholesterol accumulation in tendons and arteries, premature atherosclerosis and increased risk of premature coronary heart disease. In 1999, the Portuguese FH Study was established at the National Institute of Health to identify the genetic cause of hypercholesterolemia in individuals with a clinical diagnosis of FH and to perform an epidemiologic study to determine the prevalence and distribution of FH in Portugal. In the last 16 years, a genetic defect was identified in 749 patients, representing 3. 7 % of the cases estimated to exist in Portugal. Index patients were included in this study using the Simon Broome (SB) criteria. However, there are different FH clinical criteria to diagnose index cases. Since there are no clinical criteria to identify relatives with FH, the aim of this work was to investigate if a diagnostic tool based on population specific 95 th percentile improves the clinical identification of Portuguese FH patients comparing with SB criteria.

Caractérisation tridimensionnelle de l’amplitude articulaire de l’épaule

L’épaule est l’articulation la plus mobile et la plus instable du corps humain dû à la faible quantité de contraintes osseuses et au rôle des tissus mous qui lui confèrent au moins une dizaine de degrés de liberté. La mobilité de l’épaule est un facteur de performance dans plusieurs sports. Mais son instabilité engendre des troubles musculo-squelettiques, dont les déchirures de la coiffe des rotateurs sont fréquentes et les plus handicapantes. L’évaluation de l’amplitude articulaire est un indice commun de la fonction de l’épaule, toutefois elle est souvent limitée à quelques mesures planaires pour lesquelles les degrés de liberté varient indépendamment les uns des autres. Ces valeurs utilisées dans les modèles de simulation musculo-squelettiques peuvent amener à des solutions non physiologiques. L’objectif de cette thèse était de développer des outils pour la caractérisation de la mobilité articulaire tri-dimensionnelle de l’épaule, en passant par i) fournir une méthode et son approche expérimentale pour évaluer l’amplitude articulaire tridimensionnelle de l’épaule incluant des interactions entre les degrés de liberté ; ii) proposer une représentation permettant d’interpréter les données tri-dimensionnelles obtenues; iii) présenter des amplitudes articulaires normalisées, iv) implémenter une amplitude articulaire tridimensionnelle au sein d’un modèle de simulation numérique afin de générer des mouvements sportifs optimaux plus réalistes; v) prédire des amplitudes articulaires sécuritaires et vi) des exercices de rééducation sécuritaires pour des patients ayant subi une réparation de la coiffe des rotateurs. i) Seize sujets ont été réalisé séries de mouvements d’amplitudes maximales actifs avec des combinaisons entre les différents degrés de liberté de l’épaule. Un système d’analyse du mouvement couplé à un modèle cinématique du membre supérieur a été utilisé pour estimer les cinématiques articulaires tridimensionnelles. ii) L’ensemble des orientations définies par une séquence de trois angles a été inclus dans un polyèdre non convexe représentant l’espace de mobilité articulaire prenant en compte les interactions entre les degrés de liberté. La combinaison des séries d’élévation et de rotation est recommandée pour évaluer l’amplitude articulaire complète de l’épaule. iii) Un espace de mobilité normalisé a également été défini en englobant les positions atteintes par au moins 50% des sujets et de volume moyen. iv) Cet espace moyen, définissant la mobilité physiologiques, a été utilisé au sein d’un modèle de simulation cinématique utilisé pour optimiser la technique d’un élément acrobatique de lâcher de barres réalisée par des gymnastes. Avec l’utilisation régulière de limites articulaires planaires pour contraindre la mobilité de l’épaule, seulement 17% des solutions optimales sont physiologiques. En plus, d’assurer le réalisme des solutions, notre contrainte articulaire tridimensionnelle n’a pas affecté le coût de calculs de l’optimisation. v) et vi) Les seize participants ont également réalisé des séries d’amplitudes articulaires passives et des exercices de rééducation passifs. La contrainte dans l’ensemble des muscles de la coiffe des rotateurs au cours de ces mouvements a été estimée à l’aide d’un modèle musculo-squelettique reproduisant différents types et tailles de déchirures. Des seuils de contrainte sécuritaires ont été utilisés pour distinguer les amplitudes de mouvements risquées ou non pour l’intégrité de la réparation chirurgicale. Une taille de déchirure plus grande ainsi que les déchirures affectant plusieurs muscles ont contribué à réduire l’espace de mobilité articulaire sécuritaire. Principalement les élévations gléno-humérales inférieures à 38° et supérieures à 65°, ou réalisées avec le bras maintenu en rotation interne engendrent des contraintes excessives pour la plupart des types et des tailles de blessure lors de mouvements d’abduction, de scaption ou de flexion. Cette thèse a développé une représentation innovante de la mobilité de l’épaule, qui tient compte des interactions entre les degrés de liberté. Grâce à cette représentation, l’évaluation clinique pourra être plus exhaustive et donc élargir les possibilités de diagnostiquer les troubles de l’épaule. La simulation de mouvement peut maintenant être plus réaliste. Finalement, nous avons montré l’importance de personnaliser la rééducation des patients en termes d’amplitude articulaire, puisque des exercices passifs de rééducation précoces peuvent contribuer à une re-déchirure à cause d’une contrainte trop importante qu’ils imposent aux tendons.

External perturbation of the trunk in standing humans differentially activates components of the medial back muscles

During voluntary arm movements, the medial back muscles are differentially active. It is not known whether differential activity also occurs when the trunk is perturbed unpredictably, when the earliest responses are initiated by short-latency spinal mechanisms rather than voluntary commands. To assess this, in unpredictable and self-initiated conditions, a weight was dropped into a bucket that was held by the standing subject (n = 7). EMG activity was recorded from the deep (Deep MF), superficial (Sup MF) and lateral (Lat MF) lumbar multifidus, the thoracic erector spinae (ES) and the biceps brachii. With unpredictable perturbations, EMG activity was first noted in the biceps brachii, then the thoracic ES, followed synchronously in the components of the multifidus. During self-initiated perturbations, background EMG in the Deep MF increased two- to threefold, and the latency of the loading response decreased in six out of the seven subjects. In Sup MF and Lat MF, this increase in background EMG was not observed, and the latency of the loading response was increased. Short-latency reflex mechanisms do not cause differential action of the medial back muscles when the trunk is loaded. However, during voluntary tasks the central nervous system exerts a 'tuned response', which involves discrete activity in the deep and superficial components of the medial lumbar muscles in a way that varies according to the biomechanical action of the muscle component.

MR morphometry of posterior tibialis muscle in adult acquired flat foot

We conducted magnetic resonance imaging of the posterior tibial (PT) and flexor digitorum longus (FDL) muscle bellies in 12 patients undergoing surgical treatment for unilateral posterior tibial tendon (PTT) dysfunction. All patients had atrophy of the PT muscle compared to the normal leg (mean 10.7%, p=0.008). In those patients with a complete rupture of PTT there was replacement of the PT muscle by fatty infiltration. Conversely, the FDL muscle showed a compensatory hypertrophy (mean 17.2%, p

Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task

Study Design. Cross-sectional study. Objective. This study compared neck muscle activation patterns during and after a repetitive upper limb task between patients with idiopathic neck pain, whiplash-associated disorders, and controls. Summary of Background Data. Previous studies have identified altered motor control of the upper trapezius during functional tasks in patients with neck pain. Whether the cervical flexor muscles demonstrate altered motor control during functional activities is unknown. Methods. Electromyographic activity was recorded from the sternocleidomastoid, anterior scalenes, and upper trapezius muscles. Root mean square electromyographic amplitude was calculated during and on completion of a functional task. Results. A general trend was evident to suggest greatest electromyograph amplitude in the sternocleidomastoid, anterior scalenes, and left upper trapezius muscles for the whiplash-associated disorders group, followed by the idiopathic group, with lowest electromyographic amplitude recorded for the control group. A reverse effect was apparent for the right upper trapezius muscle. The level of perceived disability ( Neck Disability Index score) had a significant effect on the electromyographic amplitude recorded between neck pain patients. Conclusions. Patients with neck pain demonstrated greater activation of accessory neck muscles during a repetitive upper limb task compared to asymptomatic controls. Greater activation of the cervical muscles in patients with neck pain may represent an altered pattern of motor control to compensate for reduced activation of painful muscles. Greater perceived disability among patients with neck pain accounted for the greater electromyographic amplitude of the superficial cervical muscles during performance of the functional task.

Unravelling the complexity of muscle impairment in chronic neck pain

Exercise interventions are deemed essential for the effective management of patients with neck pain. However, there has been a lack of consensus on optimal exercise prescription, which has resulted from a paucity of studies to quantify the precise nature of muscle impairment, in people with neck pain. This masterclass will present recent research from our laboratory, which has utilized surface electromyography to investigate cervical flexor muscle impairment in patients with chronic neck pain. This research has identified deficits in the motor control of the deep and superficial cervical flexor muscles in people with chronic neck pain, characterized by a delay in onset of neck muscle contraction associated with movement of the upper limb. In addition, people with neck pain demonstrate an altered pattern of muscle activation, which is characterized by reduced deep cervical flexor muscle activity during a low load cognitive task and increased activity of the superficial cervical flexor muscles during both cognitive tasks and functional activities. The results have demonstrated the complex, multifaceted nature of cervical muscle impairment, which exists in people with a history of neck pain. In turn, this has considerable implications for the rehabilitation of muscle function in people with neck pain disorders. (C) 2004 Elsevier Ltd. All rights reserved.