RESUMO
An epidemiological analysis was carried out of 1,126 sports injuries covered by German occupational accident insurance at a small regional hospital over a period of six years, of which 86.6% were allotted to the sport at schools. The types of sport most frequently involved were general fitness sports (n = 486), soccer (n = 137), volleyball (n = 126), gymnastics (n = 125) and basketball (n = 121). In the general fitness sports (n = 228 women/girls, n = 258 men/boys), bruising injuries dominated (47%), followed by sprains (29%), mostly involving the upper extremities (53%). In soccer injuries (proportion of woman = 15%), bruising and injuries to the lower extremities ranked first. Falls (33%) and sprains (31%) were the most common gymnastics injuries. Injuries to the upper extremities were most common in volleyball and basketball with 72% and 68% respectively. The distribution of these sports injuries more or less mirrors the distribution of sports disciplines at schools and institutions like the Federal Border Police. Sporting activity here should include preventive elements such a proprioceptive training.
Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Traumatismos em Atletas/epidemiologia , Hospitais de Distrito/estatística & dados numéricos , Seguro de Acidentes/estatística & dados numéricos , Medição de Risco/métodos , Estudantes/estatística & dados numéricos , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Prevalência , Fatores de RiscoRESUMO
BACKGROUND: Venous leg ulceration results from chronic venous insufficiency of the lower extremities. We recently showed that matrix metalloproteinase (MMP) -2 plays a major part in the pathogenesis of venous leg ulcers. In vitro activation of recombinant MMP-2 is controlled by the activity of the urokinase-type plasminogen activator (uPA), which acts as a fibrin-independent plasminogen activator. The activity of MMP-2 is potentiated by binding of uPA to the uPA receptor (uPAR). OBJECTIVES: We aimed to clarify the role of plasminogen activation in venous leg ulcers. METHODS: The expression of uPA, uPAR, the tissue-type plasminogen activator, and plasminogen activator inhibitor (PAI) -1 and PAI-2 was investigated using reverse transcription followed by polymerase chain reaction and Western blotting. RESULTS: These provided direct evidence of elevated expression of uPA and uPAR at the mRNA and protein levels in venous leg ulcers, in comparison with healthy skin. By immunohistochemistry, elevated expression of uPA and uPAR was detected. Fibrin zymography showed significantly elevated endogenous uPA activity in venous leg ulcers in comparison with healthy controls. CONCLUSIONS: Our findings indicate venous leg ulcers to be characterized by elevated plasminogen activation, suggesting that this enzyme cascade plays a crucial part in maintaining proteolytic activity in venous leg ulcers.
Assuntos
Ativadores de Plasminogênio/fisiologia , Úlcera Varicosa/fisiopatologia , Idoso , Capilares/metabolismo , Feminino , Fibrinólise , Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Inibidor 2 de Ativador de Plasminogênio/metabolismo , RNA Mensageiro/genética , Receptores de Superfície Celular/genética , Receptores de Superfície Celular/metabolismo , Receptores de Ativador de Plasminogênio Tipo Uroquinase , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Pele/irrigação sanguínea , Ativador de Plasminogênio Tipo Uroquinase/genética , Ativador de Plasminogênio Tipo Uroquinase/metabolismo , Úlcera Varicosa/enzimologiaRESUMO
Densitometric analysis shows an accelerated healing rate and a significantly diminished lesional fibrinolytic activity in patients with venous leg ulcers treated topically with the fibrin-stabilising factor XIII compared with controls.
