Maturation Selection Biases and Relative Age Effect in Italian Soccer Players of Different Levels.

Soccer is a sport practiced all over the world, in which players are expected to show specific physical and technical skills. Soccer academies look for young talented individuals to develop promising players. Although several parameters could affect the players' performance, the relative age effect (RAE) and the maturity status appeared debated. Therefore, this study compared the differences in RAE and biological maturity among the players of two Italian soccer teams of different levels and to understand their interaction effects with the competition level on youth players' physical characteristics and abilities. One hundred and sixty-two young soccer players from the U12 to U15 age categories of the elite (n = 98) and non-elite (n = 64) teams were recruited. The prevalence of maturity status and RAE was observed. Many anthropometric parameters, BIA vectors, and motor tests (CMJ, Sprint, RSA) were carried out. The maturity status had a greater effect on several anthropometric characteristics and on 15 m sprint, while it affected the CMJ only in U12 (F = 6.187, p ≤ 0.01). Differently, the RAE seemed to priorly affect the U13 and U15 categories in body composition, whereas its effect appeared on the 15-m sprint (F(3, 45) = 4.147, p ≤ 0.01) and the RSA (F(3, 45) = 3.179, p ≤ 0.05) in the U14 category. In addition, early matured players or those who were born in the first six months presented cellular characteristics similar to adult elite players. Soccer professionals should be encouraged to monitor the maturity status to better interpret changes in the physical performance of young soccer players to guide adequate training plans.

Assessment of Body Composition and Physical Performance of Young Soccer Players: Differences According to the Competitive Level.

Soccer is a multifactorial sport, in which players are expected to possess well developed physical, psychological, technical, and tactical skills. Thus, the anthropometric and fitness measures play a determinant role and could vary according to the competitive level. Therefore, the present study aimed to verify differences in body composition and physical performance between two soccer team. 162 young soccer players (from the Under 12 to Under 15 age categories; age: 13.01 ± 1.15 years) of different competitive levels (elite­n = 98 and non-elite­n = 64) were recruited. Anthropometric characteristics (height, weight, lengths, widths, circumferences, and skinfold thicknesses (SK)), bioelectrical impedance, physical performance test as countermovement jump (CMJ), 15 m straight-line sprints, Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo), and 20 + 20 m repeated-sprint ability (RSA)) were carried out. In addition, Body mass index (BMI), body composition parameters (percentage of fat mass (%F), Fat mass (FM, kg), and Fat-free mass (FFM, kg)) and the areas of the upper arm, calf and thigh were calculated, and the Bioelectric Impedance Vector Analysis (BIVA) procedures were applied. In addition, a linear discriminant analysis was assessed to determine which factors better discriminate between an elite and non-elite football team. Many differences were observed in body composition between and within each football team's category, especially in triceps SK (p < 0.05), %F (p < 0.05), and all performance tests (p < 0.01). The canonical correlation was 0.717 (F(7,128) = 19.37, p < 0.0001), and the coefficients that better discriminated between two teams were 15 m sprint (−2.39), RSA (1−26), suprailiac SK (−0.5) and CMJ (−0.45). Elite soccer team players present a better body composition and greater physical efficiency. In addition, BIVA outcome could be a relevant selection criterion to scout among younger soccer players.

Do Knee Bracing and Delayed Weight Bearing Affect Mid-Term Functional Outcome after Anterior Cruciate Ligament Reconstruction?

Purpose The aim of this study was to assess the effect of knee bracing and timing of full weight bearing after anterior cruciate ligament reconstruction (ACLR) on functional outcomes at mid-term follow-up. Methods We performed a retrospective study on 41 patients with ACLR. Patients were divided in two groups: ACLR group, who received isolated ACL reconstruction and ACLR-OI group who received ACL reconstruction and adjunctive surgery. Information about age at surgery, bracing, full or progressive weight bearing permission after surgery were collected for the two groups. Subjective IKDC score was obtained at follow-up. Statistical analysis was performed to compare the two groups for IKDC score. Subgroup analysis was performed to assess the effect of postoperative regimen (knee bracing and weight bearing) on functional outcomes. Results The mean age of patients was 30.8 ± 10.6 years. Mean IKDC score was 87.4 ± 13.9. The mean follow-up was 3.5 ± 1.8 years. Twenty-two (53.7%) patients underwent ACLR only, while 19 (46.3%) also received other interventions, such as meniscal repair and/or collateral ligament suture. Analysis of overall data showed no differences between the groups for IKDC score. Patients in the ACLR group exhibited a significantly better IKDC score when no brace and full weight bearing after 4 weeks from surgery was prescribed in comparison with patients who worn a brace and had delayed full weight bearing. No differences were found with respect to the use of brace and postoperative weight bearing regimen in the ACLR-OI group. Conclusion Brace and delayed weight bearing after ACLR have a negative influence on long-term functional outcomes. Further research is required to explore possible differences in the patients operated on ACLR and other intervention with respect to the use of a brace and the timing of full weight bearing to identify optimal recovery strategies. Level of Evidence Level III, retrospective observational study.

Early subclinical ventricular dysfunction in patients with insulin resistance.

AIMS: The aim of our study was to evaluate the relationship between insulin resistance and the detection of precocious echocardiographic signs of heart failure in patients with cardiovascular risk factors. METHODS: We enrolled 34 consecutive patients with cardiovascular risk factors. All patients underwent coronary angiography, echocardiography, and laboratory tests. Exclusion criteria were diabetes (fasting glucose greater than 126 mg/dl or treatment with insulin or oral hypoglycemic agents), coronary artery disease, creatinine above 1.5 mg/dl, left-ventricular hypertrophy, valvular heart disease, ejection fraction below 50%, atrial fibrillation, or other severe arrhythmia. The presence of insulin resistance was assessed by using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Ventricular function was investigated by echocardiography. RESULTS: Distinguishing patients with insulin resistance, based on the median value of HOMA-IR (<4.06 and >4.06), we observed that in the group with higher levels of HOMA-IR, there were echocardiographic signs of subclinical ventricular dysfunction statistically more frequent (E/A in group with HOMA <4.06: 1.159 + 0.33 vs. group with HOMA >4.06: 0.87 + 0.29, P = 0.0136; E/E': 6.42 + 4 vs. 15.52 + 3.26, P = 0.001; Tei index: 0.393 + 0.088 vs. 0.489 + 0.079, P = 0.0029; S wave: 0112 + 0.015 vs. 0.114 + 0.027, P = 0.0001; ejection fraction 59.11 + 4.75 vs. 58.88 + 6.81, P = 0.9078). Grade II diastolic dysfunction was observed in 5 patients, grade I in 12 patients, and 17 patients had normal diastolic function. On multivariate analysis, HOMA-IR (P = 0.0092), hypertension (P = 0.0287), waist circumference (P = 0.0009), high-density lipoprotein (P = 0.0004), and fasting blood glucose (P = 0.0003) were variables independently associated with diastolic dysfunction. On analysis of covariance, we found that the variables that influence diastolic dysfunction are HOMA-IR, waist circumference, BMI, and age, and that the only variable that influences Tei index is HOMA-IR. CONCLUSION: Insulin resistance is frequently associated with subclinical left-ventricular dysfunction. Patients with cardiovascular risk factors and increased HOMA-IR levels, although without diabetes mellitus, overt coronary artery disease, or hypertensive cardiomyopathy, may represent a target population for screening programs, recommended changes in lifestyle, and possibly the use of pharmacological interventions to prevent the onset of heart failure.

Role of curcumin in idiopathic pulmonary arterial hypertension treatment: a new therapeutic possibility.

The idiopathic pulmonary arterial hypertension is a complex disease that mainly affects pulmonary arterial circulation. This undergoes a remodeling with subsequent reduction of flow in the small pulmonary arteries. Because of this damage an increased vascular resistance gradually develops, and over time it carries out in heart failure. The inflammatory process is a key element in this condition, mediated by various cytokines. The inflammatory signal induces activation of NF-κB, and prompts TGF-ß-related signaling pathway. Clinical evolution leads to progressive debilitation, greatly affecting the patient quality of life. The actual therapeutic approaches, are few and expensive, and include systemic drugs such as prostanoids, phosphodiesterase inhibitors and antagonists of endothelin-1 (ERBs). Some researchers have long investigated the anti-inflammatory effects of curcumin. It shows a role for inactivation of NF-κB-mediated inflammation. On the basis of these findings we propose a potential role of curcumin and its pharmacologically fit derivatives for treatment of idiopathic pulmonary arterial hypertension.