Retorno ao esporte após tratamento cirúrgico de pubeíte em jogadores de futebol profissional

OBJECTIVE:to evaluate the return to sport after surgical treatment for pubalgia among 30 professional soccer players and describe the surgical technique used.METHOD:this case series was evaluated by means of a questionnaire and physical examination on 30 male professional soccer players of mean age 24.4 years (range: 18-30). The mean duration of the symptoms was 18.6 months (range: 13-28). The diagnosis was made through clinical investigation, special maneuvers and complementary examinations, by the same examiner. All the patients underwent surgical treatment after conservative treatment failed; all procedures were performed by the same surgeon using the same technique. Nonparametric comparisons were made to investigate the time taken to recover after the surgery, for the patients to return to their sport.RESULTS:five patients evolved with hematoma, with the need to remove the stitches three weeks after the operation because of a small dehiscence at the site of the operative wound. The wound healed completely in all these cases by five weeks after the surgery. Four patients presented dysuria in the first week, but improved in the second postoperative week. The mean time taken to return to training was around eight weeks (range: seven-nine). All the players returned to competitive soccer practice within 16 weeks. When asked about their degree of satisfaction after the operation (satisfied or dissatisfied), taking into consideration their return to the sport, there was 100% satisfaction, and they returned to professional practice at the same competitive level as before the injury. This degree of satisfaction continued to the last assessment, which was made after 36 months of postoperative follow-up.CONCLUSION:the surgical technique presented in this case series, with trapezoidal resection of the pubic symphysis in association with bilateral partial tenotomy of the long adductor, was a fast and effective procedure with a low rate of postoperative complications. It was shown to be an excellent treatment option for refractory cases, with a return to sports activity among professional soccer players.OBJETIVO:avaliar o retorno ao esporte após tratamento cirúrgico da pubeíte em 30 jogadores de futebol profissional e descrever a técnica cirúrgica empregada.MÉTODO:série de casos por meio de questionário e exame físico em 30 jogadores de futebol profissional. Atletas masculinos, com idade média de 24,4 anos (18 a 30). A duração média dos sintomas foi de 18,6 meses (13 a 28). O diagnóstico foi feito por meio de investigação clínica, manobras especiais e exames complementares por um mesmo examinador. Todos os pacientes foram submetidos ao tratamento cirúrgico após falha do tratamento conservador, pelo mesmo cirurgião e com a mesma técnica. A comparação não paramétrica foi efetuada para investigar o tempo de recuperação após a cirurgia para retorno ao esporte.RESULTADOS:cinco pacientes evoluíram com hematoma e foi necessária a retirada dos pontos com três semanas por causa de pequena deiscência no local da ferida operatória. Houve cicatrização completa da ferida em todos esses casos após cinco semanas. Quatro pacientes apresentaram disúria na primeira semana, porém melhoraram na segunda semana pós-operatória. O tempo médio para retorno aos treinos ocorreu em torno de oito semanas (sete a nove). Todos os atletas retornaram à prática de futebol competitivo em até 16 semanas. Quando interrogados sobre o grau de satisfação no pós-operatório (satisfeito ou insatisfeito), levando em consideração o retorno ao esporte, houve 100% de satisfação e retorno à prática profissional no mesmo nível competitivo prévio à lesão. Esse grau de satisfação persistiu até a última avaliação após 36 meses de seguimento pós-operatório.CONCLUSÃO:a técnica cirúrgica apresentada nesta série de casos com ressecção trapezoidal da sínfise púbica associada a tenotomia parcial bilateral do adutor longo é um procedimento rápido, efetivo e com baixo índice de complicações pós-operatórias. Revela-se uma excelente opção de tratamento para os casos refratários e retorno à atividade esportiva em jogadores de futebol profissional.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Common injuries in athletes' knee: experience of a specialized center

OBJECTIVE:The present cross-sectional study aims to identify the most common knee injuries in athletes cared at a Specialized Outpatient Clinics.METHOD:Analysis of patients cared at the Knee Outpatient Clinics of a Sports Trauma Center, divided by gender, age and diagnosed injury.RESULTS:Initially 440 patients were divided into 33 types of sports; after excluding the less statistically significant practices, nine sports remained. The most frequently performed sports were football with almost 50% of total patients presenting anterior cruciate ligament (ACL) injury, and road runs with great frequency of meniscal injury. There was no correlation of the disorder with the type of sports performed but a correlation was found with patient's age/gender.CONCLUSION:The complete ACL rupture was the most common injury found in football, basketball and volleyball players, followed by meniscal injury in street runners.Level of Evidence IV, Study Transversal.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of Orthopedics and TraumatologyUniversidade Federal de São Paulo (UNIFESP) Department of Orthopedics and TraumatologyUNIFESP, EPM, Department of Orthopedics and TraumatologyUNIFESP, Department of Orthopedics and TraumatologySciEL

Evaluation of the patellar height in athletes with diagnosed with chronic tendinopathy of the knee extensor mechanism

OBJECTIVES: To carry out a radiographic evaluation of patellar height in athletes diagnosed with chronic tendinopathy of the knee extensor mechanism; METHODS: Radiographic assessments were carried out on 65 patients (110 knees) aged between 15 and 40 years, who practiced different kinds of sports, some with of chronic tendinopathy of the knee extensor mechanism (jumper's knee) and others without. The athletes were divided into two groups: those with diagnosed jumper's knee (group 1:38 athletes - 56 knees) and a control group (group 2:27 athletes - 54 knees). In group 1, 18 of the athletes presented the condition in both knees on examination. The height of the patella was measured using the Insall-Salvati and Blackburne-Peel x-ray methods. CONCLUSION: The presence of a high patella in the group of athletes with chronic tendinopathy of the knee extensor mechanism was significantly higher than in the control group.OBJETIVO: Avaliar radiograficamente a altura patelar de atletas com diagnóstico de tendinopatia crônica do aparelho extensor do joelho (TCAE). MÉTODOS: Na amostra foram avaliados radiograficamente 65 pacientes (110 joelhos) com idade entre 15 e 40 anos e de diferentes modalidades esportivas com e sem diagnóstico de tendinopatia crônica do aparelho extensor do joelho (jumper's knee). Os atletas foram divididos em dois grupos: aqueles com diagnóstico de TCAE (grupo 1: 38 atletas - 56 joelhos) e um grupo que denominamos de controle (grupo 2: 27 atletas - 54 joelhos). RESULTADOS: No grupo 1 tivemos 18 atletas que apresentavam a doença bilateralmente na ocasião dos exames. Para a medida da altura patelar utilizamos os índices radiográficos de Insall e Salvati e Blackburne e Peel. CONCLUSÃO: A presença de patela alta no grupo de atletas com tendinopatia crônica do aparelho extensor do joelho foi significante maior do que a observada no grupo controle.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Supra and intracondylar open fracture of the femur in a motocross athlete: case report

The authors report the case of a patient (amateur motocross competitor) who suffered a fall during a motocross competition resulting in a supra and intracondylar open fracture in the right femur.Os autores apresentam o relato de um caso de uma paciente (atleta amador de motocross) que sofreu uma queda durante uma competição e teve fratura supra e intracondiliana exposta de fêmur direito.Universidade Federal de São Paulo (UNIFESP) Departamento de Ortopedia e Traumatologia Centro de Traumatologia do EsporteHospital e Maternidade Assunção Departamento de Ortopedia e TraumatologiaUNIFESP, Depto. de Ortopedia e Traumatologia Centro de Traumatologia do EsporteSciEL

A INTENÇÃO DE LEALDADE À UNIVERSIDADE A PARTIR DA ANÁLISE DO PERFIL DE ALUNOS DO CURSO DE ADMINISTRAÇÃO DE UMA UNIVERSIDADE PÚBLICA

Universidades cada vez mais necessitam ter um gerenciamento profissional, especialmente, objetivando o atendimento às necessidades dos alunos. A lealdade de alunos pode contribuir para a existência de benefícios pessoais, sociais e institucionais. Entretanto, algumas características interferem na lealdade daqueles que buscam serviços na área de educação. Buscando conhecer as características que influenciam na lealdade de alunos universitários, o presente artigo buscou realizar uma pesquisa descritiva e quantitativa com alunos do curso de Administração de uma universidade pública no sul do Brasil. Os resultados indicam que alunos em geral sentem-se leais, e nesta pesquisa as mulheres. Alunos de maior idade tendem e ser mais leais, assim como aqueles que estudaram em escolas públicas e nasceram em outra cidade. A lealdade varia em relação a semestres que o aluno estava cursando

Lipossarcoma of the knee in a tennis player: case report

Lipossarcoma is an uncommon malignant tumor. It originates in the mesenchymal cells, and is the most common of the soft tissue sarcomas. The authors report a case of a 40 year-old male tennis player with lipossarcoma in the posterior right knee and distal thigh region.O lipossarcoma é uma neoplasia rara, originária de células mesenquimais primitivas e, entre os sarcomas, é o tipo histológico mais frequente. Os autores relatam o caso de um lipossarcoma localizado em região de joelho e coxa posterior distal direita de um paciente de 40 anos, jogador de tênis.Universidade Federal de São Paulo (UNIFESP) Departamento de Ortopedia e TraumatologiaUNIFESP, Depto. de Ortopedia e TraumatologiaSciEL

VARIAÇÃO ESPACIAL DOS ATRIBUTOS FÍSICOS E ESTOQUES DE CARBONO DO SOLO EM PLANTIO DE Schizolobium amazonicum NA AMAZÔNIA

Tree plantations provide an increase in soil carbon stocks, but studies involving native Amazonian species are incipient. The objective was to evaluate the spatial variation of physical attributes and soil organic carbon stock in a paricá plantation. In the study area, soil samples were collected at depths of 0 to 20 cm and 20 to 40 cm and the parameters analyzed were: soil texture, macroporosity, microporosity, soil bulk density, mechanical soil resistance to penetration, and soil organic carbon content and stocks. The data were interpolated by the inverse of the square of the distance. The spatial variation of soil physical attributes at planting was influenced by texture. There was a low range of spatial variation in soil organic carbon content and stocks. Paricá planting was efficient in fixing soil carbon at depth.Plantios de árvores proporcionam aumento dos estoques de carbono do solo, mas estudos envolvendo espécies nativas da Amazônia são incipientes. Objetivou-se avaliar a variação espacial dos atributos físicos e estoque de carbono orgânico no solo em plantio de paricá. Na área de estudo, coletaram-se amostras de solo nas profundidades de 0 a 20 cm e de 20 a 40 cm e os parâmetros analisados foram: textura do solo, macroporosidade, microporosidade, densidade aparente do solo, resistência mecânica do solo à penetração, teores e os estoques de carbono orgânico do solo. Interpolou-se os dados pelo inverso do quadrado da distância. A variação espacial dos atributos físicos do solo no plantio foi influenciada pela textura. Houve baixa amplitude da variação espacial dos teores e estoques de carbono orgânico do solo. O plantio de paricá apresentou eficiência na fixação de carbono no solo em profundidade. Palavras-chave: silvicultura; sequestro de carbono; física do solo; mudança climática.   Spatial variation of physical attributes and soil carbon stocks in a Schizolobium amazonicum plantation in the amazon   ABSTRACT: Tree plantations provide an increase in soil carbon stocks, but studies involving native Amazonian species are incipient. The objective was to evaluate the spatial variation of physical attributes and soil organic carbon stock in a paricá plantation. In the study area, soil samples were collected at depths of 0 to 20 cm and 20 to 40 cm and the parameters analyzed were: soil texture, macroporosity, microporosity, soil bulk density, mechanical soil resistance to penetration, and soil organic carbon content and stocks. The data were interpolated by the inverse of the square of the distance. The spatial variation of soil physical attributes at planting was influenced by texture. There was a low range of spatial variation in soil organic carbon content and stocks. Paricá planting was efficient in fixing soil carbon at depth. Keywords: silviculture; carbon sequestration; soil physics; climate change

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049