The Protective Effect of Neuromuscular Training on the Medial Tibial Stress Syndrome in Youth Female Track-and-Field Athletes: A Clinical Trial and Cohort Study.

CONTEXT: Few reports have analyzed the effects of neuromuscular (NM) training programs on the injury incidence among youth female track-and-field athletes. OBJECTIVE: To determine the effects of NM training on reducing lower limb injury incidence and to establish its effects on countermovement jump performance, balance, 30-m sprint, and joint position sense in youth female track-and-field athletes. DESIGN: Single-blind, randomized controlled clinical trial. SETTING: Sports research laboratory. PARTICIPANTS: Twenty-two female athletes were allocated into 2 groups: Conventional (CONV) training (n = 11; age = 15.3 [2.1] y) and NM training (n = 11; age = 15.0 [2.7] y). INTERVENTIONS: Interventions were performed during the preseason of 6 weeks. The CONV training included anaerobic, strength, and aerobic training. The NM training consisted of a multicomponent program that integrated jumps, landings, and running with strength, endurance, agility, balance, and CORE training. MAIN OUTCOME MEASURES: A follow-up of the cohorts was carried out through the evaluation of lower limb injuries (main outcome) during a regular season (weeks 7-18). Secondary outcomes were measured before and after the intervention: Y-balance test, active joint repositioning, ground reaction force, and countermovement jump height. RESULTS: The injury incidence rate was 17.89 injuries per 1000 hours athlete-exposure in CONV training, and 6.58 in NM training (relative risk = 0.38; 95% confidence interval,  0.18 to 0.82; P = .044). Particularly, the medial tibial stress syndrome incidence rate was 5.96 injuries per 1000 hours athlete-exposure in CONV training and 0.82 in NM training (relative risk = 0.17; 95% confidence interval, 0.02 to 1.12; P = .012). In addition, a significant training × time interaction was noted, favoring improvements in 30-m sprint and countermovement jump height after NM. CONCLUSION: The NM training may improve youth female athlete's physical fitness and reduce their injury relative risk of medial tibial stress syndrome injury.

Dissecção aguda de aorta: relato de caso / Acute aortic dissection: case report

JUSTIFICATIVA E OBJETIVOS: A dissecção aguda da aorta (DAA) é uma emergência que exige diagnóstico imediato, bem como terapêutica agressiva, sem os quais a mortalidade é expressiva.O objetivo deste estudo foi apresentar um caso considerado atípico, tendo em vista não corresponder às características epidemiológicas apresentadas na literatura, além de quadro clínico com sintomatologia prolongada e predomínio de queixas extratorácicas. RELATO DO CASO: Paciente do sexo masculino, 36 anos, sem fatores de risco para a dissecção aórtica com história de dor torácica com duração de 5 dias, que evoluiu com parestesia e paresia de membro inferior. Feito o diagnóstico de DAA e, após ser instituído a terapêutica, o paciente evoluiu com remissão completa dos sintomas,voltando a deambular normalmente. CONCLUSÃO: O relato reforça a recomendação de que diante do quadro de dor torácica é necessário considerar a possibilidade de DAA.

BACKGROUND AND OBJECTIVES: Acute aortic dissection (AAD) is a emergency that requires immediate diagnosis and aggressive therapy, without which mortality is significant. The aim of this study was to present an atypical case, not corresponding to the epidemiological characteristics presented in the literature,with clinical symptoms prolonged and predominance of extrathoracic manifestations. CASE REPORT: Male patient, 36 years old, without risk factorsfor aortic dissection and history of chest pain lasting 5 days, which progressed to numbness and paralysis of the lower limb. Once the AAD diagnosis was established and after therapy, the patient presented a complete remission of symptoms, getting back towalking normally. CONCLUSION: The report reinforces the recommendation that we must consider AAD in front of chest pain.