Association of TNF-α -308G > A polymorphism with susceptibility to tendinopathy in athletes: a case-control study.

BACKGROUND: High levels of the tumor necrosis factor alpha (TNF-α) induce apoptosis and pro-inflammatory effects for primary degeneration of tendon and development of tendinopathy. The aim of this study was to investigate the association between the TNF-α polymorphisms and tendinopathy in athletes. METHODS: Two hundred and seventy athletes (135 tendinopathy cases and 135 controls) were included and genotyped (TNF-α -1031T > C; -857 C > T; -308G > A) using TaqMan validated assays. The association of the polymorphisms with tendinopathy was evaluated by a multivariate logistic regression model, using odds ratios (OR) and 95 % confidence intervals (CI). RESULTS: The variant allele - 308 A was significantly associated with patellar (OR: 1.9; 95 % CI: 1.01-3.6) or Achilles tendinopathies (OR: 2.7; 95 % CI: 1.1-6.7). No significant differences were found in allele or genotype distributions of the - 1031T > C and - 857 C > T polymorphisms between cases and controls. TNF-α TCA haplotype was associated with increased tendinopathies risk, either considering all cases (OR: 2.6, 95 % CI: 1.3-5.3), patellar (OR: 3.3, 95 % CI: 1.5-7.3), rotator cuff (OR: 3.1, 95 % CI: 1.4-7.2) or Achilles tendinopathies (OR: 3.8, 95 % CI: 1.1-12.7). CONCLUSIONS: These results suggest that the TNF-α polymorphisms could influence the susceptibility to developing tendinopathy among athletes. Knowledge of the TNF-α polymorphisms associated to tendinopathy in athletes can further understanding of the inflammatory role in the early stages of the disease and contribute for sports injury surveillance programmes, in which athletes with TNF-α TCA haplotype could be early subjected to cryotherapy after training and competition to avoid tendinopathy development.

Mouthguard use and attitudes regarding dental trauma among elite cross-country mountain biking and field hockey athletes.

BACKGROUND/AIMS: Cross-country mountain biking and field hockey are two Olympic sports that pose a potential risk for dentofacial trauma. However, mouthguard use is not mandatory in either of these sports and knowledge about tooth rescue among athletes is often neglected. The aim of this cross-sectional epidemiological survey was to evaluate the prevalence of sports-related dentofacial injuries, mouthguard use, and attitudes regarding tooth rescue among cross-country mountain biking and field hockey athletes participating at pre-Olympic competitions held in Rio de Janeiro, Brazil. MATERIALS AND METHODS: A convenience sample of 217 athletes from 33 countries participating in cross-country mountain biking (n = 82; mean age = 30.96 ± 8.52 years) and field hockey (n = 135; mean age = 19.72 ± 2.46 years) pre-Olympic competitions were examined clinically, and they answered a questionnaire regarding previous history of sports-related dentofacial injuries, attitudes toward mouthguard use, and tooth rescue. RESULTS: There were 120 (55.30%) males and 97 (44.70%) females who participated in the study. The prevalence of facial trauma was higher in mountain biking (54.88%) than in field hockey (26.66%, P < .001). Fracture was the most prevalent facial injury in mountain biking (80%), while laceration was the most prevalent in field hockey (30.55%). Extensive dental injuries occurred more often in mountain biking (47.37%) than in hockey (12.50%). The teeth most often affected were the maxillary central incisors in both mountain biking (57.89%) and field hockey (93.75%). Mouthguard use was more frequent among field hockey athletes (41.48%) than in mountain biking (1.22%, P < .001). The overall knowledge about tooth rescue was low, and most of the athletes in both sports did not know what to do in case of an avulsed tooth. CONCLUSIONS: Prevalence of dentofacial injuries among XCO-MTB and field hockey athletes participating at this pre-Olympic event was high. The majority of the athletes in this study did not use mouthguards and were unaware of recommendations in the case of an avulsed tooth.

Musculoskeletal injuries in athletes from five modalities: a cross-sectional study.

BACKGROUND: Musculoskeletal injuries (MSK-I) are a serious problem in sports medicine. Modifiable and non-modifiable factors are associated with susceptibility to these injuries. Thus, the aim of this study was to describe the prevalence of and identify the factors associated with MSK-I, including tendinopathy and joint and muscle injuries, in athletes. METHODS: In this cross-sectional observational study, 627 athletes from rugby (n = 225), soccer (n = 172), combat sports (n = 86), handball (n = 82) and water polo (n = 62) were recruited at different sports training centres and competitions. Athlete profiles and the prevalence of MSK-I were assessed using a self-reported questionnaire. Only previous MSK-I with imaging confirmation and/or a positive physical exam by a specialized orthopaedist were considered. The association of the epidemiological, clinical and sports profiles of athletes with MSK-I was evaluated by a logistic regression model. RESULTS: The mean age was 25 ± 6 years, and 60% of the athletes were male. The epidemiological, clinical and sports profiles of the athletes were different for the five sport groups. The MSK-I prevalence among all athletes was 76%, with 55% of MSK-I occurring in a joint, 48% occurring in a muscle and 30% being tendinopathy, and 19% of athletes had three investigated injuries. The MSK-I prevalence and injury locations were significantly different among sport groups. There was a predominance of joint injury in combat sports athletes (77%), muscle injury in handball athletes (67%) and tendinopathy in water polo athletes (52%). Age (≥30 years) was positively associated with joint (OR = 5.2 and 95% CI = 2.6-10.7) and muscle (OR = 4.9 and 95% CI = 2.4-10.1) injuries and tendinopathy (OR = 4.1 and 95% CI = 1.9-9.3). CONCLUSION: There is a high prevalence of tendinopathy and joint and muscle injuries among rugby, soccer, combat sports, handball and water polo athletes. The analysis of associated factors (epidemiological, clinical and sports profiles) and the presence of MSK-I in athletes suggests an approximately 4-5-fold increased risk for athletes ≥30 years of age. The identification of modifiable and non-modifiable factors can contribute to implementing surveillance programmes for MSK-I prevention.

Avaliação isocinética da força muscular em atletas profissionais de futebol feminino / Isokinetic assessment of muscle strength in female professional soccer athletes

Força muscular é uma variável comprovadamente importante de ser avaliada não somente para obter bom desempenho na prática de esportes, como também para identificar indivíduos que possam estar em um grupo de risco para lesões musculoesqueléticas. Poucos estudos descrevem valores de força para diferentes articulações em atletas de elite do futebol feminino. O objetivo deste estudo é descrever esses valores. Para isso, 23 atletas da seleção brasileira de futebol feminino, em preparação para as Olimpíadas de 2004, foram avaliadas nos movimentos de flexo-extensão de tronco, rotação interno-externa do quadril e flexo-extensão dos joelhos no dinamômetro isocinético Cybex 6000 (Lumex Inc. Ronkonkoma, NY). Foram encontrados os valores médios de torque máximo, expressos em Nm: rotação interna do quadril: 23,1; rotação externa do quadril: 25,6; flexão de tronco: 213,2; extensão de tronco: 267,7; extensão de joelho: 181,4; flexão de joelho: 102,0. Os valores encontrados devem ser considerados quando o indivíduo testado equivaler ao grupo estudado.

T has been proved that muscle strength is an important variable to be assessed not only to achieve good performance in sports practice, but also to identify deficits which might put the athlete in a group of higher musculoskeletal injury risk. Few studies to date describe strength values of different joints of elite female soccer players. The objective of this study is to describe those values. For that purpose, twenty-three athletes from the Brazilian national female soccer team, in preparation for the Olympic Games of 2004, were evaluated on an isokinetic dynamometer Cybex 6000 for the following movements: trunk flexion and extension, ,internal and external hip rotation, and knee flexion and extension. The following averages for maximum torque in Nm were found: trunk flexion: 213.2; trunk extension: 267.7; internal hip rotation: 23.1; external hip rotation: 25.6; knee flexion:102.0; knee extension: 181.4. There was no significant difference between the dominant and non-dominant sides. The values found should be considered when the tested individual has similarities with the studied group here.

Queimaduras e hábitos solares em um grupo de atletas brasileiros / Sunburns and sun habits in a group of Brazilian athletes

INTRODUÇÃO E OBJETIVOS: As queimaduras solares são consideradas o principal fator de risco ambiental para o melanoma, principalmente quando antes dos 20 anos de idade. Atletas profissionais são, em sua maioria, jovens que se expõem ao sol com bastante intensidade, tanto em suas atividades quanto no lazer, tornando-se um grupo susceptível às queimaduras. O estudo visa avaliar os conhecimentos e hábitos de proteção solar de um grupo de atletas brasileiros. MÉTODOS: Cento e quinze atletas brasileiros, durante os XIV Jogos Pan-Americanos, responderam a um questionário sobre queimaduras solares nos treinamentos e lazer, fototipo, uso de filtros solares (UFS) e conhecimento da importância de se proteger do sol (IPS) e local da prática (outdoor x indoor). RESULTADOS: A maioria era outdoor (73 por cento) e 59 por cento possuíam fototipo claro (I, II ou III). Quanto ao seu local de prática, os outdoor apresentaram índices superiores de queimaduras solares, IPS e UFS durante seus treinamentos, enquanto no lazer os grupos não se diferenciaram. Divididos por fototipo, os grupos de atletas mais claros apresentaram mais queimaduras solares, tanto em treinamentos quanto no lazer. Na análise multivariada para avaliação de risco de queimaduras solares, os fototipos claros e a IPS demonstraram-se estatisticamente significativos. CONCLUSÕES: Esportes realizados ao ar livre geram mais queimaduras solares nos atletas que os praticam. Entretanto, quando em tempo de lazer, atletas outdoor e indoor possuem hábitos solares semelhantes, mostrando que neste momento formam um grupo homogêneo com relação à fotoexposição. Atletas com fototipos claros são mais propensos a queimaduras, tanto no lazer quanto nos treinamentos. As taxas de uso de filtros solares são inferiores ao desejado. É necessário estimular a fotoproteção nos atletas, tanto nas suas atividades desportivas quanto no lazer.

BACKGROUND AND OBJECTIVES: To evaluate the knowledge and sun protection habits of a group of Brazilian athletes. Sunburns are considered the main environmental risk factor for melanoma, especially before the age of 20. Most of professional athletes are young individuals intensively exposed to sunlight in their activities and leisure as well, being therefore susceptible to sunburns. METHODS: During the XIV Pan-American Games, 115 Brazilian athletes answered to a questionnaire on sunburn during training and leisure; phototype; use of sunscreen (USS); importance of sun protection (ISP) and place of practice (indoors x outdoors). RESULTS: The majority was outdoor (73 percent), and 59 percent had light phototype (I, II or III). Comparing the athletes by their practicing place, outdoors presented higher rates of sunburn episodes, ISP and USS during their training periods, while in leisure the groups did not show any difference. Grouped by phototypes, athletes with lighter skin complexion presented more sunburn episodes in both training and leisure. In multivariate analysis for sunburn risk, light phototypes and ISP were statistically significant. CONCLUSIONS: Outdoor sports modalities give origin to more sunburn in their athletes. However, during leisure, both outdoor and indoor athletes present similar sun habits, evidencing that in this moment they form a homogeneous group regarding sun light exposure. Athletes with lighter phototypes are more prone to sunburns in both leisure and training. The rates of sunscreen use are lower than the recommendation. Sun protection should be stimulated in both sports and leisure activities in Brazilian athletes.

INTRODUCCION Y OBJETIVOS: Las quemaduras solares son consideradas el principal factor de riesgo ambiental para el melanoma, principalmente cuando ocurre antes de los 20 años de edad. Atletas profesionales son, en su mayoría, jóvenes que se exponen al sol con bastante intensidad tanto en sus actividades como en el ocio, convirtiéndose en un grupo susceptible a las quemaduras. El estudio tiene como objetivo evaluar los conocimientos y hábitos de protección solar de un grupo de atletas brasileños. MÉTODOS: Ciento quince atletas brasileños, durante los XIV Juegos Panamericanos, respondieron a un cuestionario sobre quemaduras solares en los entrenamientos y durante el ocio, fototipo, uso de filtros solares (UFS) y conocimiento de la importancia de protegerse del sol (IPS) y local de la práctica (outdoor x indoor). RESULTADOS: La mayoría era outdoor (73 por ciento) y 59 por ciento poseía fototipo claro (I, II o III). En relación al local de práctica, los outdoor presentaron índices superiores de quemaduras solares, IPS y UFS durante sus entrenamientos, mientras que en el ocio los grupos no se diferenciaron. Divididos por fototipo, los grupos de atletas más claros presentaron más quemaduras solares tanto en entrenamientos como en el ocio. En el análisis multivariado para la evaluación de riesgo de quemaduras solares, los fototipos claros y la IPS se demostraron significativos estadísticamente hablando. CONCLUSIONES: Deportes realizados al aire libre generan más quemaduras solares en los atletas que los que los practican. Sin embargo, tratándose de tiempo de ocio, atletas outdoor e indoor poseen hábitos solares semejantes, mostrando que en este momento forman un grupo homogéneo con relación a la fotoexposición. Atletas con fototipos claros son más propensos a quemaduras tanto en el ocio como en los entrenamientos. Las tasas de uso de filtros solares son inferiores a lo deseado. Es necesario estimular la fotoprotección en los atletas, tanto en...

Luxaçäo congênita de quadril: avaliaçäo dos resultados com seguimento médio de cinco anos e dez meses

Os autores apresentam os resultados da avaliaçäo de 29 casos de luxaçäo congênita de quadril (com um tempo médio de seguimento de cinco anos e 10 meses), tratados de acordo com uma filosofia uniforme, consistindo de reduçäo concêntrica, mobilizaçäo precoce em dupla abduçäo e estabilizaçäo na posiçäo de carga nos casos de perdas tardias da reduçäo, utilizando o realinhamento distal pela osteotomia femoral. As acetabuloplastias eram reservadas para as displasias acetabulares, em crianças com mais de quatro anos de idade. Apesar de o tempo de seguimento ser relativamente curto, foi concluído ser esta rotina eficaz, dando 89% do resultados clínicos considerados como bons e excelentes e 79,3% dos casos classificados nos grupos I e II de Severin, quanto ao aspecto radiográfico final