RESUMO
Background and objective: The prevention, diagnosis, and management of non-contact musculoskeletal soft tissue injuries (NCMSTIs) related to participation in sports are key components of sport and exercise medicine. Epidemiological data have demonstrated the existence of interindividual differences in the severity of NCMSTIs, indicating that these injuries occur as a consequence of both extrinsic and intrinsic factors, including genetic variations. Subjects and methods: We have collected data on NCMSTIs suffered by 73 elite players of White, black African and Hispanic ethnicity of European football over the course of three consecutive seasons. We have also examined eight single nucleotide polymorphisms (SNPs) in genes related to tissue recovery and tissue repair in blood drawn from the players and correlated our findings with type and severity of injuries in each ethnic group. Results: The frequency of the SNPs varied among the three ethnic sub-groups (p < 0.0001). Among Whites, a significant relationship was observed between ligament injuries and ELN (p = 0.001) and between tendinous injuries and ELN (p = 0.05) and IGF2 (p = 0.05). Among Hispanics, there was a significant relation between muscle injuries and ELN (p = 0.032) and IGF2 (p = 0.016). Conclusions: Interracial genotypic differences may be important in the study of NCMSTIs. A genetic profile based on SNPs may be useful tool to describe each individual's injuribility risk and provide specific treatment and preventive care for football players (AU)
Fundamento y objetivo: La prevención, el diagnóstico y el tratamiento de las non-contact musculoskeletal soft tissue injuries(NCMSTI, «lesiones musculoesqueléticas producidas por el mecanismo de no contacto») son factores clave en el deporte y en la medicina deportiva. La interacción entre factores extrínsecos e intrínsecos, incluyendo en estos últimos los factores genéticos, es determinante en la causalidad de las NCMSTI. Sujetos y métodos: Se han recogido las lesiones sufridas por 73 jugadores de fútbol profesional de diferentes razas (caucásicos, africanos subsaharianos e hispánicos), ocurridas durante 3 temporadas consecutivas. Se analizó la presencia de single nucleotide polymorphisms (SNP, «polimorfismos genéticos de un solo nucleótido») en un conjunto de genes relacionados con la reparación y la regeneración del tejido a partir de sangre obtenida de los jugadores, y se correlacionó con el tipo y grado de lesión en cada grupo racial. Resultados: La frecuencia de aparición de los SNP varía en las 3 poblaciones estudiadas (p < 0,0001). En cuanto a la población caucásica, se observa una relación estadísticamente significativa entre lesiones ligamentosas y ELN (p = 0,001) y entre lesión tendinosa y ELN (p = 0,05) e IGF2 (p = 0,05). En cuanto a la población hispánica, existe una relación estadísticamente significativa entre la lesión muscular y ELN (p = 0,032) e IGF2 (p = 0,016). Conclusiones: Las diferencias genotípicas interraciales pueden ser importantes en el estudio de las NCMSTI. Un perfil genético basado en los SNP podría ser una herramienta útil para describir el riesgo individual de un individuo a lesionarse y poder aplicar de esta manera los tratamientos preventivos adecuados (AU)
Assuntos
Humanos , Masculino , Adulto , Polimorfismo de Nucleotídeo Único , Polimorfismo de Nucleotídeo Único/genética , Sistema Musculoesquelético/lesões , Músculo Esquelético/lesões , Medicina Esportiva/métodos , Futebol/lesões , Futebol/estatística & dados numéricos , Fenômenos Fisiológicos Musculoesqueléticos , Regeneração Tecidual Guiada/tendências , Distribuição por Etnia , Entorses e Distensões/genética , Entorses e Distensões/terapia , DNA/genéticaRESUMO
Fundamento y objetivo: Evaluar la eficacia y seguridad de la toxina botulínica en la hipertonía esfinteriana en pacientes con lesión medular (LM). Pacientes y método: Ensayo clínico no controlado en varones con hipertonía esfinteriana secundaria a LM. Se aplicaron 100 U de Botox® vía transperineal en esfínter uretral externo guiado con electromiografía y ecografía transrectal. Se determinaron los siguientes parámetros: volumen urinario residual (VR), presión uretral máxima de cierre (PUMc), volumen de micción (M) y porcentaje de micción (MP). Se valoró la incidencia de disfunción eréctil mediante cuestionario International Index of Erectil Function (IIEF-5 items). Resultados: Se incluyeron 19 varones, con una media de edad de 40 años (extremos 22-56). El tiempo medio de seguimiento fue de 546 días (20 meses). Se realizó una infiltración cada 6 meses de promedio, con una media de 2,7 infiltraciones por paciente (extremos 1-7). El VR disminuyó 59,3ml (p=0,03), la micción aumentó 52ml (p=0,018) y el MP mejoró el 17,2% (p=0,011), mientras que los cambios en PUMc no fueron significativos. No empeoró la disfunción eréctil presentada ya previamente (IIEF-5: 11,4 a 13). Conclusión: La infiltración con toxina botulínica aplicada a esfínter uretral externo vía transperineal parece ser una eficaz y segura opción terapéutica (AU)
Background: To assess the efficacy and safety of botulinum toxin for sphincter hypertonia in patients with spinal cord injury (SCI). Patients and methods: Non-control clinical trial on men with neurogenic detrussor-sphincter dyssynergia (DSD) due to SCI. 100 IU of Botox® were injected through the transperineal way on external urethral sphincter under electromyography and transrectal ultrasound guidance. The following parameters were determined: post-void residual (PVR), maximum urethral pressure (MUP), miction volume (M) and miction percentage (MP). The incidence of erectile dysfunction was evaluated using the International Index of Erectile Function questionnaire (IIEF-5 items). Results: 19 men with an average age of 40years (ED 22-56) were included. The average time of monitoring was 546days (20 months). As an average, an infiltration was done every 6 months, with an average of 2.7 infiltrations per patient (1-7). PVR dropped by 59.3ml, p=0.03; miction raised to 52ml, p=0.018; MP was improved by 17.2%, p=0.011. Changes on MUP were not significant. Erectile dysfunction was not worse than the initial one (IIEF-5: 11.4 to 13). Conclusion: The infiltration of the toxin into the sphincter through the transperineal way seems to be an effective and safe therapeutic option (AU)
Assuntos
Humanos , Masculino , Toxinas Botulínicas/uso terapêutico , Retenção Urinária/terapia , Uretra , Traumatismos da Medula Espinal/complicaçõesRESUMO
BACKGROUND: To assess the efficacy and safety of botulinum toxin for sphincter hypertonia in patients with spinal cord injury (SCI). PATIENTS AND METHODS: Non-control clinical trial on men with neurogenic detrussor-sphincter dyssynergia (DSD) due to SCI. 100 IU of Botox® were injected through the transperineal way on external urethral sphincter under electromyography and transrectal ultrasound guidance. The following parameters were determined: post-void residual (PVR), maximum urethral pressure (MUP), miction volume (M) and miction percentage (MP). The incidence of erectile dysfunction was evaluated using the International Index of Erectile Function questionnaire (IIEF-5 items). RESULTS: 19 men with an average age of 40 years (ED 22-56) were included. The average time of monitoring was 546 days (20 months). As an average, an infiltration was done every 6 months, with an average of 2.7 infiltrations per patient (1-7). PVR dropped by 59.3 ml, p=0.03; miction raised to 52 ml, p=0.018; MP was improved by 17.2%, p=0.011. Changes on MUP were not significant. Erectile dysfunction was not worse than the initial one (IIEF-5: 11.4 to 13). CONCLUSION: The infiltration of the toxin into the sphincter through the transperineal way seems to be an effective and safe therapeutic option.
