Epidemiological Analysis of 245 Patients with Athletic Pubalgia / Análise epidemiológica de 245 pacientes com pubalgia atlética

Abstract Objective To analyze the clinicoepidemiological characteristics of pubalgia in athletes and to define the epidemiological profile of patients complaining of lower abdomen and groin pain at a specialized center. Methodology We conducted a retrospective study based on a case series to evaluate the epidemiological profile of 245 athletes with pubalgia reported in their medical records from October 2015 to February 2018. The selected sample underwent a clinical evaluation, and the results were recorded through the application of a questionnaire. Results The sample consisted of 245 patients aged between 14 and 75 years. Soccer and running were the most prevalent sports. Most subjects (58%) trained or played sports 3 or more days a week. After evaluating specific sports movements, symptoms worsened in 24% of the patients when changing direction; in 23%, when kicking; in 22%, during sprints and speed training; in 17%, during long runs; and in 14%, when jumping. Pain during intercourse was reported by 13% of the patients. For most subjects (80%), the inguinal region, the adductor muscles, and the pubis (midline) were the main pain sites. The tests involving adductor contraction against resistance with an extended knee was positive in 77.6% of the patients, and the one involving simultaneous hip and abdomen flexion against resistance was positive in 76.7% of the sample. Conclusion The present study has demonstrated the predominance of pubalgia in male patients who play soccer and practice running. In most cases (80%), pain occurred in the inguinal region, the adductor muscles, and the pubis. Confirmation of the clinical diagnosis took more than six months for most patients.

Resumo Objetivo Analisar as características clínico-epidemiológicas da pubalgia do atleta, e definir o perfil epidemiológico dos pacientes com queixa de dor na região baixa do abdômen e virilha avaliados em um centro especializado. Metodologia Realizou-se um estudo retrospectivo de uma série de casos, no qual se avaliou o perfil epidemiológico de 245 pacientes esportistas com pubalgia, registrados em prontuário, entre outubro de 2015 e fevereiro de 2018. A amostra selecionada foi submetida a uma avaliação clínica, e os resultados foram documentados a partir da aplicação de um questionário. Resultados A amostra estudada foi de 245 pacientes com idades que variavam entre 14 e 75 anos. O futebol e a corrida foram os esportes mais prevalentes, e 58% treinavam ou praticavam esporte 3 ou mais dias por semana. Após a avaliação dos movimentos esportivos específicos, foi observada piora dos sintomas em 24% com a troca de direção; em 23%, nos chutes; em 22%, nos sprints e treinos de velocidade; em 17%, nas corridas longas; e em 14%, nos saltos. Dor durante o ato sexual foi relatado em 13% dos pacientes. A maior parte dos pacientes (80%) relatou que a região inguinal, os adutores e o púbis (linha média) eram os principais sítios da dor. O teste de contração dos adutores contra resistência com joelho em extensão foi positivo em 77,6% dos pacientes avaliados, e o teste de Flexão simultânea do Quadril + Abdômen contra resistência foi positivo em 76.7% dos pacientes. Conclusão O presente estudo demonstrou o predomínio dessa lesão nos pacientes do sexo masculino praticantes de futebol e de corrida. A dor, na maioria dos casos (80%), estava presente na região inguinal, nos adutores e no púbis. A maioria dos pacientes demorou mais de seis meses para ter o diagnóstico clínico confirmado.

neurosciences in Averroes' "principles of medicine"

One of the fundamental advances of the transition of the Middle Ages to the Renaissance was the rediscovery of the Greek philosophers. Among the greatest representatives of this epoch we find the Cordovan doctor and philosopher Averroes [Ibn Rushd] who, with his commentaries on the works of Aristotle, brought a new philosophical vision to Western Europe. His contribution to medicine has been overshadowed to some extent by this great work of philosophy. Our intention is to evaluate, in the context of the neurosciences, the vision of health and sickness that he left us in his book "The Book of the Principles of Medicine. The organisation of the Kulliyat is based on Aristotelian concepts. Averroes regarded the nervous system not as single entity but rather as a complex of various elements. The anatomy of the nervous system is studied in two parts: the encephalus and the periphery. Both the encephalic nervous system and the sensory organs are regarded as heterogeneous organs. Averroes structures the anatomical order without taking into account the local movements of the living body. The mission of the senses is to maintain contact between external reality and the structure of the organism. This requires an external process, a point of union and an internal process. The ultimate goal is the preservation of health in a balanced disposition and the cure of disease in the organism in disequilibrium