Study on Overload Injuries during Periods of Intense Physical Activity Complemented by Isokinetic Dynamometry Evaluation.

Objective The present study aims to measure the incidence of overload injuries in training soldiers, who are subjected to intense physical exercise, and to compare it with a control group. Next, it intends to verify whether there is any relationship between overload injuries and some neuromuscular function parameters. Methods Analytical, prospective observational study. Both the observational and the control group consisted of soldiers from the Portuguese Army. Clinical evaluation was performed by medical interview in the week prior to the beginning of a military parachuting course and in the week immediately after its completion. The neuromuscular performance was assessed by isokinetic dynamometry during the medical interview. Results With 44 of the 57 military personnel in training complaining of pain, the observational group had significantly more injuries than the control group ( p < 0.001). Five complaints had traumatic origin and 39 were overload injuries. Of the 39 military personnel with overload injuries, 21 reported limited sports performance. However, isokinetic dynamometry showed no statistically significant differences in neuromuscular performance ( p = 0.223 and p = 0.229). Conclusion Military personnel in training are prone to overload injuries, with an incidence rate > 70%. The implementation of strategies for injury monitoring and prevention is critical to promote health and physical capacity.

Study on Overload Injuries during Periods of Intense Physical Activity Complemented by Isokinetic Dynamometry Evaluation / Estudo das lesões de sobrecarga durante período intenso de atividade física complementado com avaliação por dinamometria isocinética

Abstract Objective The present study aims to measure the incidence of overload injuries in training soldiers, who are subjected to intense physical exercise, and to compare it with a control group. Next, it intends to verify whether there is any relationship between overload injuries and some neuromuscular function parameters. Methods Analytical, prospective observational study. Both the observational and the control group consisted of soldiers from the Portuguese Army. Clinical evaluation was performed by medical interview in the week prior to the beginning of a military parachuting course and in the week immediately after its completion. The neuromuscular performance was assessed by isokinetic dynamometry during the medical interview. Results With 44 of the 57 military personnel in training complaining of pain, the observational group had significantly more injuries than the control group (p< 0.001). Five complaints had traumatic origin and 39 were overload injuries. Of the 39 military personnel with overload injuries, 21 reported limited sports performance. However, isokinetic dynamometry showed no statistically significant differences in neuromuscular performance (p = 0.223 and p = 0.229). Conclusion Military personnel in training are prone to overload injuries, with an incidence rate > 70%. The implementation of strategies for injury monitoring and prevention is critical to promote health and physical capacity.

Resumo Objetivo Os autores pretendem medir a incidência de lesões de sobrecarga em militares em formação, que são submetidos a exercício físico intenso, e compará-la com um grupo controle. Posteriormente, pretende-se verificar se existe alguma relação entre a ocorrência de lesões de sobrecarga e alguns parâmetros da função neuromuscular. Métodos Estudo observacional prospectivo analítico. Grupo de observação e grupo controle constituídos por militares do Exército Português. A avaliação clínica foi feita por entrevista médica na semana que antecede o início do curso de paraquedismo militar e na semana imediatamente após o final do curso. Em simultâneo com a entrevista médica, foi realizada a avaliação da performance neuromuscular através da dinamometria isocinética. Resultados Com 44 dos 57 militares em formação a referir queixas álgicas, o grupo de observação apresentou significativamente mais lesões que o grupo controle (p < 0.001). Cinco queixas foram de origem traumática e 39 foram lesões de sobrecarga. Dos 39 militares com lesões de sobrecarga, 21 referiram limitação do rendimento esportivo. No entanto, na avaliação por dinamometria isocinética, não se verificaram diferenças estatisticamente significativas na evolução da performance neuromuscular (p = 0.223 e p = 0.229). Conclusão Os militares em formação são indivíduos propensos a sofrerem lesões de sobrecarga, tendo-se obtido uma taxa de incidência de lesões de sobrecarga na ordem dos 70%. A implementação de estratégias de monitoração e prevenção das lesões são fundamentais na promoção da saúde e da capacidade física.

Remodelagem cardíaca adicional induzida pelo treinamento militar intenso em atletas de nível competitivo / Additional cardiac remodeling induced by intense military in competitive athletes

Fundamento: A remodelagem cardíaca depende da intensidade, da duração e do método de treinamento. Objetivo: Avaliar se o treinamento realizado em uma tropa especial portuguesa incrementa a remodelagem cardíaca em uma amostra de jovens que previamente praticavam esporte de competição. Métodos: Estudo prospectivo que incluiu 76 militares candidatos a tropas especiais, 45 dos quais praticavam previamente exercício físico de nível competitivo (> 10 horas por semana). Destes militares atletas, apenas 17 concluíram com sucesso o curso. A avaliação foi realizada com 6 meses de intervalo e incluiu história clínica completa, exame físico, sinais vitais, dados antropométricos e avaliação ecocardiográfica. Considerou-se significância estatística quando p < 0,05, com intervalo de confiança de 95%. Resultados: No final do curso, verificaram-se diminuição da porcentagem de massa gorda (19,1 ± 3,3% vs. 13,1 ± 3,5%; p < 0,01), aumento da porcentagem de massa muscular (41,3 ± 2,1% vs. 44,4 ± 1,8%; p < 0,01), e diminuição da pressão arterial sistólica, diastólica e frequência cardíaca. Em relação à remodelagem cardíaca, verificaram-se aumento do diâmetro diastólico do ventrículo esquerdo (49,7 ± 3,2 mm vs. 52,8 ± 3,4 mm; p < 0,01), aumento tendencial do volume do átrio esquerdo (27,3 ± 4,5 mL/m2 vs. 28,2 ± 4,1 mL/m2; p = 0,07) e aumento da massa do ventrículo esquerdo (93,1 ± 7,7g/m2 vs. 100,2 ± 11,4 g/m2; p < 0,01). As variáveis funcionais também sofreram alterações, com aumento do S' (15 (13-16) cm/s vs. 17 (16-18) cm/s; p < 0,01) e diminuição da fração de ejeção do ventrículo esquerdo (60 ± 6% vs. 54 ± 6%; p < 0,01). Conclusão: O treinamento físico militar intenso provocou remodelagem cardíaca adicional em atletas de nível competitivo, tanto estrutural como funcional

Background: Cardiac remodeling depends on the intensity, duration, and training method. Objective: To evaluate if the training performed in a Portuguese military special operations troop increases cardiac remodeling in a sample of young individuals who previously practiced competitive sports. Methods: A prospective study involving 76 military candidates for military special operations, 45 of whom previously practiced at competitive level (> 10 hours per week). Of these military athletes, only 17 successfully completed the course. The evaluation was performed at 6 months intervals and included a complete clinical history, physical examination, vital signs, anthropometric data and echocardiographic evaluation. Statistical significance was considered when p < 0.05, with a 95% confidence interval. Results: At the end of the course, there was a decrease in the percentage of fat mass (19.1 ± 3.3% vs. 13.1 ± 3.5%; p < 0.01), an increase in the percentage of lean mass (41.3 ± 2.1% vs. 44.4 ± 1.8%; p < 0.01), and decreased systolic and diastolic blood pressure and heart rate. Regarding cardiac remodeling, there was an increase in left ventricular diastolic diameter (49.7 ± 3.2 mm vs. 52.8 ± 3.4 mm; p < 0.01), an increase trend in left atrial volume (27.3 ± 4.5 mL/m2 vs. 28.2 ± 4.1 mL/m2; p = 0.07) and increased left ventricular mass (93.1 ± 7.7 g/m2 vs.100.2 ± 11.4 g/m2 ; p < 0.01). Functional variables also changed, with an increase in S' (15 (13-16) cm/s vs. 17 (16-18) cm/s; p < 0,01) and a decrease in left ventricular ejection fraction (60 ± 6% vs. 54 ± 6%; p < 0.01). Conclusion: Intense military physical training resulted in additional cardiac remodeling in athletes of competitive level, both structural and functional

Exercise-induced cardiac remodeling in athletes and in special forces soldiers. / Remodelagem cardíaca induzida pelo exercício físico em atletas de nível competitivo e militares de forças especiais.

INTRODUCTION: Exercise-induced cardiac remodeling is frequent in athletes. This adaptation is structurally manifested by an increase in cardiac dimensions and mass. Soldiers are also subject to intense physical exercise, although with different characteristics. OBJECTIVE: To compare exercise-induced cardiac remodeling in competitive athletes and in soldiers on a special forces training course. METHODS: We studied 17 soldiers (all male and Caucasian, mean age 21±3 years) who completed a special forces course and 17 basketball players (47.3% male, 64.7% Caucasian, mean age 21±3 years). Assessment included a transthoracic echocardiogram and analysis of myocardial mechanics. This assessment was performed at the beginning and end of the military course and the sports season, respectively. RESULTS: Cardiac remodeling was observed in both groups. The soldiers presented a predominantly eccentric pattern, with increased left ventricular (LV) size (49.7±3.2 vs. 52.8±3.4 mm; p<0.01), increased LV mass (93.1±7.7 vs. 100.2±11.4 g/m2; p<0.01) and decreased relative wall thickness (0.40±0.1 vs. 0.36±0.1; p=0.05). The basketball players showed a concentric pattern, with decreased LV size (52.0±4.7 vs. 50.4±4.7 mm; p=0.05), and increased relative wall thickness (0.33±0.1 vs. 0.36±0.1; p=0.05). Although there was no significant difference in LV myocardial strain in the groups separately, when compared there was a significant decrease (-20.2±1.6% vs. -19.4±2.1%; p=0.03). CONCLUSION: Cardiac remodeling was frequent, with an eccentric pattern in soldiers and a concentric pattern in basketball players. Myocardial deformation may represent a physiological adaptation to physical exercise.

Comparison of Three Criteria for Interpretation of Electrocardiogram in the Military.

BACKGROUND: Screening of competitive athletes and other individuals exposed to regular and intense physical exercise, such as military personnel, can lead to an early and preclinical identification of cardiac conditions associated with a higher risk for sudden cardiac death. The electrocardiogram (ECG) has been recommended for the precompetitive screening, but its interpretation remains controversial. The aim of this study was to compare three different standardized criteria for interpretation of athletes' ECG applied in military. METHODS: Prospective study of 1,380 consecutive healthy military, 249 (18%) also involved in competitive sport, screened with clinical history, physical examination, and ECG. The ECG was interpreted according to the European Society of Cardiology (ESC) recommendations, the Seattle Criteria (SC), and the Refined Criteria (RC). FINDINGS: Independently of the criteria used, the majority of the individuals included had ECG changes, mainly physiological: ESC 55.1%, SC 63.6%, and RC 64.4%. The rate of pathological ECGs was significantly higher with the ESC criteria when compared to SC and RC (ESC 14.8%, SC 5.0% and RC 4.5%; p < 0.001). A significant cardiac abnormality was diagnosed with additional investigations in 4 patients (Brugada syndrome Type 1, mitral valve prolapse, bicuspid aortic valve, and Wolff-Parkinson-White pattern). DISCUSSION: Electrical cardiac adaptations are frequent in military personnel, similar to competitive athletes. Some ECG changes, previously considered pathological, could in fact correspond to physiological adaptations. The refinement of the ECG interpretation in this athletic population seems to reduce the rate of false-positive cases. This may have a favorable socioeconomic impact, especially by reducing the health cost burden and number of disability days.

The use of FT-NIR for API content assay in organic solvent media: a single calibration for multiple downstream processing streams.

The use of near infrared spectroscopy (NIRS) in downstream solvent based processing steps of an active pharmaceutical ingredient (API) is reported. A single quantitative method was developed for API content assessment in the organic phase of a liquid-liquid extraction process and in multiple process streams of subsequent concentration and depuration steps. A new methodology based in spectra combinations and variable selection by genetic algorithm was used with an effective improvement in calibration model prediction ability. Root mean standard error of prediction (RMSEP) of 0.05 in the range of 0.20-3.00% (w/w) was achieved. With this method, it is possible to balance the calibration data set with spectra of desired concentrations, whenever acquisition of new spectra is no longer possible or improvements in model's accuracy for a specific selected range are necessary. The inclusion of artificial spectra prior to genetic algorithms use improved RMSEP by 10%. This method gave a relative RMSEP improvement of 46% compared with a standard PLS of full spectral length.

The use of NIR as a multi-parametric in situ monitoring technique in filamentous fermentation systems.

The use of Fourier transform near infrared (FT-NIR) spectroscopy for simultaneous determination of multiple properties in an active pharmaceutical ingredient (API) fermentation process is described, together with procedures for developing accurate NIR calibrations with a performance independent of scale and the specific bioreactor used. Measurements were made in situ, by insertion of transflection probes into pilot and industrial bioreactors providing direct contact with the fermentation culture media. The ultimate goal was to establish methods for real time process monitoring aimed at enhanced process supervision, fault detection diagnosis and control of bioreactors. The in situ acquired spectra were related to lab results of samples taken from the reactors during the course of the manufacturing process. Suitable spectral wavenumber regions were selected and calibration models based on partial least squares (PLS) were developed. The root mean square errors of prediction for API content, viscosity, nitrogen source and carbon source concentration were all within acceptable ranges as compared to the off-line lab measurements, respectively, 0.03% (w/w), 150 cp, 0.01% (w/w), and 0.4% (w/w).

Applying near-infrared spectroscopy in downstream processing: one calibration for multiple clarification processes of fermentation media.

The use of near-infrared spectroscopy (NIRS) is demonstrated in the first downstream processing (DSP) steps of an active pharmaceutical ingredient (API) manufacturing process. The first method developed was designed to assess the API content in the filtrate stream (aqueous) of a rotary drum vacuum filter. The PLS method, built after spectral preprocessing and variable selection, had an accuracy of 0.01% (w/w) for an API operational range between 0.20 and 0.45% (w/w). The robustness and extrapolation ability of the calibration was proved when samples from ultrafiltration and nanofiltration processes, ranging from 0 to 2% (w/w), were linearly predicted (R2=0.99). The development of a robust calibration model is generally a very time-consuming task, and once established it is imperative that it can be useful for a long period of time. This work demonstrates that NIR procedures, when carefully developed, can be used in different process conditions and even in different process steps of similar unit operations.

Improving drug manufacturing with process analytical technology.

Within the process analytical technology (PAT) framework, as presented in the US Food and Drug Administration guidelines, the aim is to design, develop and operate processes consistently to ensure a pre-defined level of quality at the end of the manufacturing process. Three PAT implementation scenarios can be envisaged. Firstly, PAT could be used in its most modest version (in an almost non-PAT manner) to simply replace an existing quality control protocol (eg, using near-infrared spectroscopy for an in-process quality control, such as moisture content). Secondly, the use of in-process monitoring and process analysis could be integrated to enhance process understanding and operation for an existing industrial process. Thirdly, PAT could be used extensively and exclusively throughout development, scale-up and full-scale production of a new product and process. Although the first type of implementations are well known, reports of the second and third types remain scarce. Herein, results obtained from PAT implementations of the second and third types are described for two industrial processes for preparing bulk active pharmaceutical ingredients, demonstrating the benefits in terms of increased process understanding and process control.

Evaluation of a new annular capacitance probe for biomass monitoring in industrial pilot-scale fermentations.

The four-pin electrode capacitance probe has already shown to be a valuable tool for on-line monitoring viable biomass concentration in industrial-type fermentations. A new prototype annular probe was developed and its performance in real-time monitoring the concentration of viable cells during industrial pilot-scale fermentation for the production of an Active Pharmaceutical Ingredient (API) was investigated and compared to the four-pin probe. A set of 14 fermentations was monitored on-line: four of them with the four-pin probe, the remaining with the annular probe. The performance of both the annular and the four-pin electrode probe were compared against each other and against off-line measurements (viscosity and packed mycelial volume). The prototype annular probe showed to have higher signal intensity and sensitivity than the standard four-pin probe, with higher signal-to-noise ratio. Furthermore, its new design and construction proved to be easier to handle in an industrial environment.

Deposiçäo interna de urânio inalado, considerando-se um homem referência brasileiro / Internal deposition of ihnaled uranium considering a brasilian reference man

É apresentada uma avaliação da deposição interna de urânio inalado, considerando-se os parâmetros morfológicos e fisiológicos fornecidos na literatura para uma amostra da população brasileira, e uma comparação destes resultados com aqueles obtidos com os parâmetros da ICRP 66.

Biocinética dos compostos solúveis e insolúveis de urânio em um homem referência brasileiro / Biokinetic of soluble and insoluble compounds of uranium in a brasilian reference man

É apresentada uma avaliação da deposição interna de urânio inalado, considerando-se os parâmetros morfológicos e fisiológicos fornecidos na literatura para uma amostra da população brasileira, e uma comparação destes resultados com aqueles obtidos com os parâmetros da ICRP 66.