Application of "eliminating stagnation and bloodletting/fire needling" in treatment of jingjin diseases / 中国针灸

Based on the development of conditions, the etiology and pathogenesis of jingjin (muscle region of meridian) diseases are summarized as 3 stages, i.e. stagnation due to over-exertion at early stage, manifested by tendon-muscle contracture and tenderness; cold condition due to stagnation, interaction of stasis and cold, resulting in clustered nodules at the middle stage; prolonged illness and missed/delayed treatment, leading to tendon-muscle contracture and impairment of joint function at the late stage. It is proposed that the treatment of jingjin diseases should be combined with the characteristic advantages of fire needling and bloodletting technique, on the base of "eliminating stagnation and bloodletting/fire needling". This combined therapy warming yang to resolve stasis and dispels cold to remove nodules, in which, eliminating the stagnation is conductive to the tissue regeneration, and the staging treatment is delivered in terms of the condition development at different phases.

Collagen I and III ratios and tenacity of rats muscle injured and treated with platelet-rich plasma / Relaciones de colágeno I y III y tenacidad del músculo de rata lesionado y tratado con plasma rico en plaquetas

SUMMARY: Severe muscle injuries are common in accidents and have a delayed recovery of muscle integrity. In these cases, muscle suture surgery is the standard treatment. However, Platelet Rich Plasma (PRP), has been widely used in orthopedic injuries due to its growth factors. Thus, the objective of the study will be to analyze the association of suture and PRP techniques in the collagen and tenacity of the injured muscle. Were used seventy rats, divided into five groups: control (C), injury control (CI), injury and suture (IS), injury and PRP (IP), injury, suture, and PRP (ISP). Were sectioned approximately 50 % of the width and 100 % of the thickness of the gastrocnemius muscle. The homologous PRP was applied 24h after the injury. On the 7th day after the injury, the animals were euthanized and their muscles subjected to mechanical testing to measure tenacity or collagen analysis to calculate the ratio between type I and III collagen. The results show a significant decrease (p <0.05) in the values of the relationship between collagens in all injured groups (CI, IS, IP, ISP) compared to group C. In injured groups, the tenacity was significantly (p <0.05) reduced compared to the control group, with no observed difference between treatments and injured groups. The amount of collagen in the injured area has increased, but it did not affect the tenacity of the muscles, which was reduced.

RESUMEN: Las lesiones musculares graves son comunes durante los accidentes y la integridad del músculo está sujeta a una larga recuperación. En esos casos la cirugía, para la sutura del músculo, es el tratamiento común, no obstante el plasma rico en plaquetas (PRP) ha sido utilizado recientemente en lesiones ortopédicas, debido a sus factores del crecimiento. El objetivo del estudio fue analizar la asociación de las técnicas de sutura y PRP en la histología y tenacidad de músculo lesionado. Fueron utilizadas 70 ratas distribuidas en cinco grupos: control (C), control lesión (CL), lesión y sutura (LS), lesión y PRP (LPRP), lesión, sutura y PRP (LSPRP). Aproximadamente en la lesión, el 50 % de la longitud y el 100 % del espesor del músculo gastrocnemio fueron seccionados. El PRP homólogo fue aplicado 24 horas después de la lesión. En el 7º día después de la lesión los animales fueron eutanasiados y las muestras fueran sometidas al ensayo mecánico para la medición de la tenacidad y análisis del colágeno, para realizar el cálculo de la relación entre los colágenos I y III. Los resultados demostraron una reducción significativa (p<0,05) en los valores de la relación entre los colágenos en todos los grupos lesionados en relación al grupo C. La tenacidad fue (p<0,05) reducida significativamente en los grupos lesionados en relación al grupo control, sin diferencia entre los tratados. En la lesión muscular hubo disminución de los valores de colágeno, aunque en los tratamientos se observó elevación de la cantidad de colágeno en la área lesionada, esta no tuvo efecto en la tenacidad de los músculos que fue disminuida en la lesión.

Segurança no uso da eletroestimulação neuromuscular em pacientes graves: revisão sistemática / Safety of neuromuscular electrical stimulation among critically ill patients: systematic review

RESUMO Objetivo: Revisar as evidências sobre segurança da eletroestimulação neuromuscular quando utilizada em unidade de terapia intensiva. Métodos: Revisão sistemática, sendo a busca realizada nas bases de dados MEDLINE (acessado via PubMed), PEDro, Cochrane CENTRAL e EMBASE, além de busca manual de referências em estudos randomizados. Foram incluídos ensaios clínicos randomizados que comparassem aplicação da eletroestimulação neuromuscular com grupo controle ou placebo em unidades de terapia intensiva, e que contivessem informações sobre segurança da técnica nos desfechos, sendo considerado como segurança dados de variáveis hemodinâmicas e informações sobre efeitos adversos. Resultados: Os artigos foram analisados por dois revisores independentes, e a análise dos dados foi descritiva. A busca inicial encontrou 1.533 artigos; destes, foram incluídos somente 4 ensaios clínicos randomizados. Dois estudos avaliaram segurança por meio das variáveis hemodinâmicas, e somente um deles mostrou aumento nas frequências cardíacas, respiratória e lactato, porém sem relevância clínica. Os outros dois estudos avaliaram a segurança por meio do relato de efeitos adversos; um expôs que 15% dos pacientes apresentaram sensação de picada, sem alteração clinicamente relevante; o outro relatou apenas que um paciente sofreu queimadura superficial por configuração incorreta dos parâmetros. Conclusão: A eletroestimulação neuromuscular é uma técnica segura para ser aplicada em pacientes graves, porém deve ser aplicada por profissional treinado e utilizando parâmetros corretos, baseados em evidências.

ABSTRACT Objective: To review the evidence on the safety of neuromuscular electrical stimulation when used in the intensive care unit. Methods: A systematic review was conducted; a literature search was performed of the MEDLINE (via PubMed), PEDro, Cochrane CENTRAL and EMBASE databases, and a further manual search was performed among the references cited in randomized studies. Randomized clinical trials that compared neuromuscular electrical stimulation to a control or placebo group in the intensive care unit and reporting on the technique safety in the outcomes were included. Hemodynamic variables and information on adverse effects were considered safety parameters. Articles were independently analyzed by two reviewers, and the data analysis was descriptive. Results: The initial search located 1,533 articles, from which only four randomized clinical trials were included. Two studies assessed safety based on hemodynamic variables, and only one study reported an increase in heart rate, respiratory rate and blood lactate, without clinical relevance. The other two studies assessed safety based on reported adverse effects. In one, 15% of patients described a prickling sensation, without any clinically relevant abnormalities. In the other, one patient suffered a superficial burn due to improper parameter configuration. Conclusion: Neuromuscular electrical stimulation is safe for critically ill patients; however, it should be applied by duly trained professionals and with proper evidence-based parameters.

Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation

ABSTRACTINTRODUCTION: Hydatid cysts are rarely detected in muscle tissue (0.7-0.9%), even in endemic countries. The aim of this study was to present information regarding the clinical manifestations, diagnosis, and management of muscle echinococcosis.METHODS: Twenty-two patients with hydatid cysts in the muscle were followed from January 2006 through December 2014.RESULTS: Twenty-four sites of muscle involvement were observed in the 22 patients. Fifteen (68%) of our patients were women, while seven (32%) were men. The mean age was 28.1 ± 15.4 (6-61) years. The most frequent locations were the thigh (27.2%) and the paravertebral region (13.6%). Most patients reported a painless slow-growing mass with normal overlying skin. Most (90.2%) cases were treated by surgical excision and fine-needle aspiration.CONCLUSIONS: Primary muscle hydatid cyst should be considered in the differential diagnosis in cystic masses of the muscular system without pain and localized enlargement of soft tissue, especially in endemic areas. Hydatid cyst should be investigated using serological tests and imaging modalities. If possible, total surgical excision of hydatid cyst in the muscle should be performed.

Las plaquetas con fines terapéuticos en lesiones del Sistema osteomioarticular / Platelets for therapeutic purposes in SOMA injuries

La utilización de las plaquetas con fines terapéuticos ha cobrado gran interés en los últimos años por las grandes propiedades que presentan como reparadoras de tejidos. Además de su papel en la coagulación y la hemostasia, las plaquetas contienen gránulos alfa con varias moléculas (factores de crecimiento) que son secretadas tras su activación. Se realizó una revisión bibliográfica, donde se exponen las principales propiedades y funciones de las plaquetas que le confieren propiedades terapéuticas en diferentes lesiones del sistema osteomioarticular. Se presentan además sus componentes y funciones. Se llega a conclusiones destacando la utilidad de las plaquetas con fines terapéuticos en pacientes con afecciones ortopédicas.

The use of platelets for therapeutic purposes has gained great interest in recent years by their large properties as tissue repair. Besides its role in clotting and hemostasis, platelet alpha granules contain several molecules (growth factors) that are secreted upon activation. A literature review was performed to present the main features and functions of platelets that give them therapeutic properties in different injuries of the osteomioarticular system. Its components and functions are also presented here. Platelets usefulness for therapeutic purposes in patients with orthopedic conditions is highlighted.

Association between the use of a baby's bottle and pacifier and the absence of breastfeeding in the second six months of life / Associação entre o uso de mamadeira e de chupeta e a ausência de amamentação no segundo semestre de vida

Introduction: The World Health Organization recommends breastfeeding for two years or more and advises against bottle feeding and pacifier use. Objective: Investigate the association between bottle feeding and pacifier use, and breastfeeding in the second half-year of life. Methods: Survey in a municipality of Rio de Janeiro state, in 2006, interviewing those responsible for 580 children aged 6-11 months. Bottle feeding and pacifier use, and variables which in the bivariate analysis were associated with the outcome 'absence of breastfeeding' (≥ 0.20), were selected for multiple analysis. Adjusted prevalence ratios were obtained by a Poisson regression model. Results: 40% of the children 6-11 months were not being breastfed, 47% used a pacifier and 57% used a bottle. Pacifier use (PR = 3.245; CI95%: 2.490-4.228) and bottle feeding (PR = 1.605; CI95%: 1.273-2.023) were shown to be strongly associated with the outcome, and also with: mother's low schooling (PR = 0.826; CI95%: 0.689-0.990); low birth weight (PR = 1.488; CI95%: 1.159-1.910); mother not being the baby carer (PR = 1.324; CI95%: 1.080-1.622); and increasing age of the baby in days (PR = 1.004; CI95%: 1.002-1.006). Conclusions: The use of pacifiers and bottles can reduce continued breastfeeding. Stronger discouragement of these artifacts should be adopted in public health policies. .

A OMS preconiza a amamentação por 2 anos ou mais e contraindica o uso de chupeta e mamadeira. O objetivo deste estudo foi investigar a associação entre esse uso e o aleitamento materno no 2º semestre de vida, por meio de inquérito. Foi conduzido em município do estado do Rio de Janeiro, em 2006, entrevistando acompanhantes de 580 crianças de 6 a 11 meses. O uso da chupeta e da mamadeira e variáveis, que na análise bivariada se associaram ao desfecho "ausência do aleitamento materno" (≥ 0,20), foram selecionadas para análise múltipla. Razões de prevalência ajustadas foram obtidas por modelo de regressão de Poisson com variância robusta. Não estavam sendo amamentadas 40% das crianças de 6 a 11 meses, 47% usavam chupeta e 57% mamadeira. O uso de chupeta (RP = 3,245; IC95%: 2,490-4,228) e da mamadeira (RP = 1,605; IC95%: 1,273-2,023) mostraram-se fortemente associados ao desfecho, além da: baixa escolaridade materna (RP = 0,826; IC95%: 0,689-0,990), baixo peso ao nascer (RP = 1,488; IC95%: 1,159-1,910), mãe não ser o acompanhante do bebê (RP = 1,324; IC95%: 1,080-1,622), e idade crescente do bebê em dias (RP = 1,004; IC95%: 1,002-1,006). O uso de chupetas e mamadeiras pode prejudicar a amamentação continuada. O desestímulo a estes artefatos deve ser reforçado no âmbito das políticas públicas de nutrição e saúde.

Sarcopenia en pacientes con y sin insuficiencia renal crónica: diagnóstico, evaluación y tratamiento / Sarcopenia in patients with and without chronic renal insufficiency: diagnosis, evaluation and treatment

Se define sarcopenia como la pérdida de masa y función musculares, no sólo por disminución del tamaño sino también del número de fibras musculares. Altamente prevalente en el adulto mayor, aparece también en pacientes con enfermedades crónicas. En la insuficiencia renal crónica (IRC) contribuyen a su aparición la enfermedad crónica per se, la edad avanzada, el sedentarismo habitual, sumado a múltiples factores que deterioran el estado nutricional, tales como reducción de la ingesta asociada o no a drogas anorexígenas, inflamación crónica, déficit de hormonas anabólicas, bajos niveles de vitamina D, resistencia insulínica y disminución de gelsolina (proteína clave en el ensamblaje y desensamblaje de filamentos de actina). La presencia de sarcopenia correlaciona con mayor mortalidad, discapacidad y aumento del riesgo de caídas. El diagnóstico se basa en medir la fuerza muscular y el rendimiento físico; para lo primero se utiliza el dinamómetro, y para lo segundo la medida de la velocidad de la marcha (registra el tiempo necesario para caminar una distancia determinada) y el test ôTime Up and Goõ (evalúa el tiempo para levantarse, recorrer 3 metros y volver a sentarse). En pacientes con IRC, una adecuada ingesta proteica, sumado a actividad física (particularmente ejercicios de resistencia) mejoran el rendimiento físico, la aptitud respiratoria y la sobrevida en general, y reducen la mortalidad cardiovascular. Asimismo, el ejercicio aumenta elcontenido muscular de IGF-1, y del ARNm para factor de crecimiento tipo insulina II, la capacidad oxidativa muscular y el número de células satélites necesarias para regenerar las fibras musculares.

Sarcopenia is defined as the loss of muscle mass and function, not only due to muscle fiber decrease in size but also in number. Highly prevalent in older adults, it also appears in patients with chronic diseases. In the chronic renal failure (CRF), the facts that contribute to its appearance are: chronic disease per se, advanced age, sedentary lifestyle, added to multiple factors which deteriorate the nutritional status such as reduction of in-take associated or not to anorexic drugs, chronic inflammation, anabolic hormone deficit, vitamin D low levels, insulin resistance and gelsolin decrease ( key protein in the assembly and disassembly of actin filaments). Presence of sarcopenia correlates with greater mortality, disability and falls risk increase. Diagnosis is based on measuring muscle strength and physical performance, for the first one a dynamometer is used, and for the second one: walking speed measurement (records the needed period of time to walk a determined distance) and the test ôTime Up and Goõ (which evaluates the needed period of time to stand up, walk 3 meters and sit down again). In patients with CRF, an appropriate protein ingestion, added to physical activity, (specially resistance exercises) improve physical performance, respiratory aptitude and survival in general, and reduce cardiovascular mortality. Additionally, exercise increases IGF-1 muscle content, as well as the mRNA for insulin-like growth factor type II, muscle oxidative capacity and the number of required satellite cells to regenerate muscle fibers.

Comparación entre inmersión en agua fría y terapia pasiva para disminuir el dolor muscular de inicio tardío: CAT / Cold-water immersion versus passive therapy to decrease delayed onset muscular soreness: a CAT

Introducción El dolor muscular de inicio tardío o Delayed Onset Muscular Soreness (DOMS) corresponde a una condición músculo-esquelética dolorosa, que se produce comúnmente entre 24 a 48 horas, y hasta las 72 horas, posteriores a la realización de actividad física poco habitual o ejercicios físicos de alta intensidad que impliquen una actividad muscular excéntrica. En el campo de la rehabilitación física la inmersión en agua fría corresponde a una de las intervenciones más utilizadas en la medicina deportiva, orientada principalmente a minimizar el dolor muscular de inicio tardío y promover la recuperación después del ejercicio. Objetivo Comprobar la validez y aplicabilidad de los resultados en relación a la efectividad de la inmersión en agua fría posterior al ejercicio de alta intensidad y responder la siguiente interrogante: en sujetos que realizan actividad física de forma regular, ¿puede la inmersión en agua fría comparada con la terapia pasiva (reposo) disminuir el dolor muscular de inicio tardío? MétodosSe analizó el artículo “Inmersión en agua fría (crioterapia) para prevenir y tratar el dolor muscular posterior al ejercicio”, revisión sistemática Cochrane, de Bleakley et al (2012). Resultados La inmersión en agua fría podría disminuir el dolor muscular de inicio tardío posterior al ejercicio de alta intensidad a las 24 horas posteriores a la intervención, diferencia media estandarizada -0,55 (IC: 95 por ciento; -0,84 a -0,27), 48 horas diferencia media estandarizada -0,66 (IC: 95 por ciento; -0,97 a -0,35), 72 horas diferencia media estandarizada -0,93 (IC: 95 por ciento; -1,36 a -0,51) y hasta 96 horas de seguimiento diferencia media estandarizada -0,58 (IC: 95 por ciento; -1,00 a -0,16). Conclusión A pesar de las limitaciones metodológicas presentes en los estudios incluidos en la revisión sistemática analizada, se encuentra razonable recomendar la inmersión en agua fría (crioterapia)

Introduction Late onset muscle soreness, also known as delayed onset muscle soreness, is a painful musculoskeletal condition that may occur 24-48 and up to 72 hours after the completion of unusual physical or high intensity exercise involving eccentric muscle activity. In the field of physical rehabilitation, immersion in cold water is a common intervention mainly used in sports medicine, to minimize delayed onset muscle soreness and promote recovery after exercise. ObjectiveTo assess the validity and applicability of the results regarding the effectiveness of immersion in cold water after high intensity exercise and answer the following question: In subjects who exercise regularly, can cold-water immersion compared to passive therapy (rest) reduce late-onset muscle soreness? Methods The article "Cold Water Immersion (cryotherapy) for preventing and treating muscle soreness after exercise," a Cochrane systematic review authored by Bleakley et al (2012), was analyzed. ResultsImmersion in cold water can decrease delayed onset of muscle pain after high intensity exercise. Twenty-four hours after the intervention, the mean standardized difference was -0.55 (95 percent CI: -0.84 to -0.27); 48 hours after, the mean standardized difference was -0.66 (95 percent CI: -0.97 to -0.35); 72 hours after, the mean standardized difference was -0.93 (95 percent CI: -1.36 to -0.51) and up to 96 hours after, mean standardized difference was -0.58 (95 percent CI: -1.00 to -0.16). Conclusion Despite the methodological limitations present in the studies included in the systematic review analyzed, we found the recommendation for cold water immersion (cryotherapy) reasonable in individuals with late muscle pain caused by high intensity sports.

Assessment of proprioceptive exercises in the treatment of rotator cuff disorders in nursing professionals: a randomized controlled clinical trial / Avaliação dos exercícios proprioceptivos no tratamento dos distúrbios do manguito rotador em profissionais de enfermagem: um estudo clínico controlado e randomizado

BACKGROUND: Shoulder pain in nursing professionals may lead to limitations in occupational and daily activities and consequently interfere with quality of life. OBJECTIVE: To compare the effects of two physical therapy programs which differed in the proprioceptive exercises used on the nursing professionals with rotator cuff disorder, according to quality of life, work satisfaction indicators, and pain intensity. METHOD: This study was an experimental, randomized, prospective, comparative trial with quantitative data analysis. The data sampling was carried out between the months of June 2010 and July 2011 by means of a questionnaire containing socio-demographic and professional information, the Western Ontario Rotator Cuff Index (WORC), the Occupational Stress Indicator (OSI), and the Visual Numeric Scale (VNS). Based on randomization, subjects were divided into two groups. Group 1 (control) was submitted to stretching and strengthening exercises and cryotherapy. Group 2 (experimental) was treated with the same protocol as the control group, with the addition of proprioception exercises. The data was analyzed by means of the Statistical Package for the Social Science version 16.0 for Windows. RESULTS: After physical therapy intervention, significant reduction in pain levels occurred in both groups, with a significant improvement in quality of life for Group 2. No changes were observed in the work satisfaction indicators after the two types of physical therapy interventions. CONCLUSIONS: The proprioceptive exercises were important in the treatment of musculoskeletal disorders, however the results did not allow us to determine which treatment was the most effective as there was no significant difference between groups.

CONTEXTUALIZAÇÃO: A dor no ombro em profissionais de enfermagem pode acarretar limitação das atividades diárias e ocupacionais e interferir na qualidade de vida. OBJETIVO: Comparar o efeito da aplicação de dois programas fisioterapêuticos diferenciados pelos exercícios de propriocepção em trabalhadores de enfermagem com desordem do manguito rotador, segundo indicadores de qualidade de vida, satisfação no trabalho e intensidade da dor. MÉTODO: Trata-se de um estudo experimental, randomizado, prospectivo, comparativo, com análise quantitativa dos dados. A coleta de dados foi realizada no período de junho de 2010 a julho de 2011, por meio de um questionário sociodemográfico e profissional, questionário Western Ontario Rotador Cuff Index (WORC), Escala de Satisfação no Trabalho (Occupational Stress Indicator) e Escala Visual Numérica (EVN) para intensidade da dor. Após randomização, os sujeitos foram alocados em dois grupos. No Grupo 1 (controle), foram aplicados exercícios de alongamento, fortalecimento e crioterapia. No Grupo 2 (experimental), foram realizados os mesmos exercícios que no Grupo 1 acrescidos de exercícios proprioceptivos. Os dados foram analisados por meio do Statistical Package for the Social Science, versão 16.0 para Windows. RESULTADOS: Após os tratamentos fisioterapêuticos, houve melhora significativa da dor nos sujeitos dos dois grupos e da qualidade de vida nos trabalhadores do Grupo 2. Não houve alteração dos indicadores de satisfação no trabalho nos dois grupos. CONCLUSÕES: Os exercícios proprioceptivos foram importantes no tratamento dos distúrbios osteomusculares. No entanto, os resultados não permitiram inferir a melhor efetividade deles em relação ao outro tratamento, pois não houve diferença significativa entre os grupos. Ensaio clínico registrado no ClinicalTrials.gov NCT01465932.

Arnica montana e desordens musculares mastigatórias / Arnica montana and disorders masticatory muscle

As desordens musculares geralmente estão presentes na Disfunção Temporomandibular (DTM). Sua principal sintomatologia é dor, edema, proveniente de injúria tecidual e inflamação. O tratamento das DTMs consiste em tratamento suporte para alívio da sintomatologia e “definitivo” para eliminar as causas e fatores que são perpetuantes. O uso de antiinflamatórios (AINEs), relaxantes musculares, placas oclusais, fitoterápicos com ação antiinflamatória como Arnica Montana são indicados como tratamento suporte. A Arnica montana tem sido usada para redução de inflamação e dor causada por entorse, contusões e ferimentos. Sua principal ação é inibição da ativaçãodo fator de transcrição celular NF- қB.

Recurrent diabetic myonecrosis: A rare complication of a common disease.

Spontaneous aseptic diabetic muscle infarction (DMI) is one of the rare complications of diabetes. We report a case of type 2 diabetes mellitus with advanced microvascular complications presenting with severe muscular pain. She was diagnosed as DMI on the basis of clinical presentation, radiological and histopathological investigations. She was managed conservatively. During 18 months of follow up, she had good improvement but subsequently other muscle groups were involved suggesting recurrent DMI.

Incidencia de lesiones deportivas en un equipo de futbol profesional / Sports injury incidence in a professional soccer team

Se evaluaron 267 jugadores de futbol profesional del Monagas Sport Club de Primera División, durante cinco temporadas (diez torneos cortos), comprendidas entre 2005 y 2010. Se estudiaron las diversas lesiones producidas en este deporte. El promedio de edad de los jugadores correspondió a 24,64 años, oscilando las edades entre 16 y 36 años. En las cinco temporadas de estudio, las horas de exposición fueron 3136 horas de partidos y 70689 horas de entrenamientos. La incidenciade lesiones encontradas en este estudio fue de 3,81 por cada 1000 horas de exposición por jugador. Las lesiones musculares representaron el mayor porcentaje 41,1%, siendo la extremidad inferior mayormente afectada. La mayoría de las lesiones ocurrieron durante el entrenamiento, siendo la defensa la más susceptible a presentar una lesión 41,1%. Se destaca la diferencia entre lesión aguda y por sobrecarga; se agruparon de acuerdo a su severidad en cuatro grupos, manteniendo la prevalencia las lesiones moderadas (grado II) 58,6%. El tratamiento médico prevalece sobre el quirúrgico. De acuerdo a las condiciones deportivas del grupo estudiadojunto a los resultados obtenidos de este estudio, se establecen conclusiones que servirán para regir directivasen el campo de la prevención de lesiones.

267 professional soccer players of Monagas Sport Club First Division were evaluated, for five seasons between (ten short tournament) 2005 and 2010. We studied the different injuries that take place in this sport. The averageage of players was 24.64 years, ranging between the ages of 16 and 36 years. In the five seasons of study, exposure times were 3136 hours of games and 70,689 hours of training. The incidence of lesions found in this study was 3.81 per 1000 hours of exposure per player. Muscle injury represented the highest percentage 41.1%, being the most affected the lower extremity. Most injuries occurred during training, the defense being the most susceptible to a lesion 41.1%. It highlights the difference between acute and overuse injuries were grouped according to their severity into four groups, keeping the prevalence of moderate injuries (grade II) 58.6%. The medical treatment outweighs the surgery. According to the conditions of the studied group, with the results of this study, findings will set guidelines to govern in the field of injury prevention.

Critical illness myopathy

Critical illness myopathy [CIM] is a syndrome of widespread muscle weakness and neurological dysfunction which can develop in critically ill patients receiving intensive care. CIM are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy and its causes are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome usually developing in patients after a brief period of stay in the Intensive Care Unit [ICU]. This case report aims to analyze the Clinical feature, diagnosis and treatment of CIM of 60 years old male case with Chronic Obstructive Lung disease [COPD] admitted to the intensive care. Health professionals working at critical care unit should be aware that any ICU patient may develop CIM

Statin-Induced myopathy: a clinical perspective

Statins are at the forefront of treatments for hyperlipidemia, coronary artery disease and stroke. Patients may not adhere to Statins therapy due to hepatic or neuromuscular side effects that include neuropathy and myopathy. The latter include myalgia, lassitude, fatigue, proximal muscle weakness with or without elevated creatine kinase [CK] or myoglobinuria. Studies suggest that these symptoms are under reported and may occur in as much as 5% or more. This article reviews the definition, incidence, possible mechanisms, risk factors, clinical presentation and suggested management of Statin-induced myopathy

Síndrome lumbociático de etiología distinta a hernia discal / Etiology of lumbosciatic syndrome different from lumbar herniated disk

La causa más frecuente de lumbociática es la hernia de disco y la patología asociada de estenosis foraminal, espondilolistesis y entesopatía de la articulación facetaria, incluyendo quistes sinoviales. Existen una serie de condiciones que pueden presentar un cuadro clínico similar, y el problema es detectar estas causas infrecuentes en un universo muy grande de pacientes con patología discal. Esto crea una situación potencialmente peligrosa, en la cual se podría interpretar la sintomatología secundaria, por ejemplo a un tumor, como producida por una hernia discal, por otro lado asintomática. En base a una historia clínica cuidadosa y al uso racional de los exámenes complementarios, se puede sospechar aquellos casos que pudieran albergar esta patología de baja incidencia, pero de gran importancia clínica. Se revisan las causas más importantes que pueden provocar un síndrome lumbociático y que deben incluirse en el diagnóstico diferencial, como el síndrome piriforme, tumores intradurales y del nervio ciático y fístulas durales.

The most frequent etiology of sciatic pain is herniation of the nucleus pulposus and associated entesopathic diseases, including synovial cysts. There are several conditions that can present with a similar clinical picture, and the clinician is confronted with the problem of detecting this infrequent occurrences. This creates a potentially dangerous condition of thinking that an asymptomatic disc herniation is causing the symptoms that are originated higher by a tumor for example. With a careful history and judicious use of ancillary examinations, specially NMR, most of the cases can be suspected. The principal causes of non-discal sciatica are reviewed, including piriform syndrome, tumors of the spine and sciatic nerve, and dural fistulae.

[Comparison of effectiveness and durability of two stretching methods [Hold-Relax, Static Stretching] for treatment of hamstring muscle tightness]

It is quite obvious that stretching techniques enhance the joint range of motion. However the permanency of these techniques after the treatment period remains questionable. So this randomized clinical trial was done to determine and compare the permanency of Hold-Relax and static Stretching techniques on extensibility of short hamstring during 4 weeks. Twenty non-athlete girls with 18-26 years old with bilateral hamstring muscles shortness [SLR /= 0.05]. These findings revealed that there is no clear difference in terms of effects and permanency between the two techniques, so the results of our study enable clinicians to provide the more simple technique in their stretching activities that is [static stretch]

The relationship between music and muscoloskeletal chronic pain

Musculoskeletal chronic pain causes suffering and influences an individual's quality of life, functioning, and independence. The purpose of this descriptive, comparative, and correlational study was to examine the effect of music on the intensity of musculoskeletal chronic pain among women with musculoskeletal chronic pain, and identify symbolic themes similarities and aesthetic reactions caused by mental images after listening to three music pieces (Bolero, Lohengrin, and Mix). Data were collected from 90 women suffering from specific chronic musculoskeletal pain (fibromyalgia, repetitive strains injuries, and spinal column diseases) using the Numerical Rating Scale. Differences in perceptions of pain were measured before and after classical music listening (Bolero - M. Ravel, Lohengrin - R. Wagner, and Mix - classical various). Drawing and verbal reports were also recorded to characterize mental images. Results of t-tests indicated that women in the three groups had less pain after listening to the music pieces (p< 0.001). Symbolic and aesthetically significant differences among the three musical pieces were also observed. The mix has shown lower results in mental image quantity in relation to Ravel and Wagner's music, both symbolically and aesthetically, with predominance of descriptive images. These findings indicate that music is an effective nursing intervention that can be used to relieve musculoskeletal chronic pain.

Terapia por microcorrentes no tratamento da ruptura muscular parcial do reto femural / Microcurrent Therapy in Treating Partial Muscular Rupture of the Rectus Femoris

Este artigo tem por objetivo analisar o efeito da terapia por microcorrentes no processo agudo da ruptura muscular parcial do reto femural. Os dados da pesquisa de campo foram descritos com base na escala visual analógica, mediante a utilizacao de dois grupos de sujeitos, um grupo de controle e outro grupo placebo. Na análise comparativa dos resultados entre os grupos experimentais verificou-se que o grupo de pacientes submetidos à terapia por microcorrentes elétricas obteve uma substancial analgesia em relacao aos dados obtidos com os sujeitos do grupo placebo

Amyloidotic muscle pseudohypertrophy: case report

The authors report one case of amyloidosis associated with muscular pseudohypertrophy in a 46-year-old woman, who developed weakness, macroglossia and muscle hypertrophy associated with primary systemic amyloidosis. Electromyography showed a myopathic pattern and bilateral carpal tunnel syndrome. The muscle biopsy presented with a type I and II fiber hypertrophy and infiltration of amyloid material in the interstitious space and artery walls. She underwent bone marrow transplantation with stabilization and subjective improvement of the clinical picture