Assuntos
Anticorpos Antifosfolipídeos/imunologia , Lúpus Eritematoso Sistêmico/diagnóstico , Tromboembolia/prevenção & controle , Varfarina/administração & dosagem , Adulto , Fatores Etários , Relação Dose-Resposta a Droga , Esquema de Medicação , Medicina Baseada em Evidências , Medicina de Família e Comunidade , Feminino , Seguimentos , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/imunologia , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Índice de Gravidade de Doença , Tromboembolia/tratamento farmacológico , Tromboembolia/etiologia , Resultado do TratamentoRESUMO
OBJECTIVES: Oral creatine is the most widely used nutritional supplement among athletes. Our purpose was to investigate whether creatine supplementation increases maximal strength and power in healthy adults. STUDY DESIGN: Meta-analysis of existing literature. DATA SOURCES: We searched MEDLINE (1966-2000) and the Cochrane Controlled Trials Register (through June 2001) to locate relevant articles. We reviewed conference proceedings and bibliographies of identified studies. An expert in the field was contacted for sources of unpublished data. Randomized or matched placebo controlled trials comparing creatine supplementation with placebo in healthy adults were considered. OUTCOMES MEASURED: Presupplementation and postsupplementation change in maximal weight lifted, cycle ergometry sprint peak power, and isokinetic dynamometer peak torque were measured. RESULTS: Sixteen studies were identified for inclusion. The summary difference in maximum weight lifted was 6.85 kg (95% confidence interval [CI], 5.24-8.47) greater after creatine than placebo for bench press and 9.76 kg (95% CI, 3.37-16.15) greater for squats; there was no difference for arm curls. In 7 of 10 studies evaluating maximal weight lifted, subjects were young men (younger than 36 years) engaged in resistance training. There was no difference in cycle ergometer or isokinetic dynamometer performance. CONCLUSIONS: Oral creatine supplementation combined with resistance training increases maximal weight lifted in young men. There is no evidence for improved performance in older individuals or women or for other types of strength and power exercises. Also, the safety of creatine remains unproven. Therefore, until these issues are addressed, its use cannot be universally recommended.
Assuntos
Creatina/administração & dosagem , Suplementos Nutricionais , Músculo Esquelético/efeitos dos fármacos , Resistência Física/efeitos dos fármacos , Levantamento de Peso/fisiologia , Administração Oral , Adolescente , Adulto , Peso Corporal , Estudos de Casos e Controles , Intervalos de Confiança , Relação Dose-Resposta a Droga , Esquema de Medicação , Ergometria , Humanos , Masculino , Pessoa de Meia-Idade , Probabilidade , Valores de Referência , Sensibilidade e Especificidade , Esportes/fisiologia , Resultado do TratamentoRESUMO
The Achilles tendon, the largest tendon in the body, is vulnerable to injury because of its limited blood supply and the combination of forces to which it is subjected. Aging and increased activity (particularly velocity sports) increase the chance of injury to the Achilles tendon. Although conditions of the Achilles tendon are occurring with increasing frequency because the aging U.S. population is remaining active, the diagnosis is missed in about one fourth of cases. Injury onset can be gradual or sudden, and the course of healing is often lengthy. A thorough history and specific physical examination are essential to make the appropriate diagnosis and facilitate a specific treatment plan. The mainstay of treatment for tendonitis, peritendonitis, tendinosis, and retrocalcaneobursitis is ice, rest, and nonsteroidal anti-inflammatory drugs, but physical therapy, orthoties, and surgery may be necessary in recalcitrant cases. In patients with tendon rupture, casting or surgery is required. Appropriate treatment often leads to full recovery.
