Epidemiology of hamstring injuries in 538 cases from an FC Barcelona multi sports club.

OBJECTIVES: Hamstring injuries are the most common muscle injuries in team sports. The aims of this study were to describe the epidemiology of hamstring muscle injuries in the professional and amateur sport sections of a multi-sport club Football Club Barcelona (FCB) and to determine any potential correlation between return-to-play (RTP) and injury location, severity of connective tissue damage, age, sex, and athlete's level of competition. METHODS: This descriptive epidemiological study with data collected from September 2007 to September 2017 stored in the FCB database. The study included non-contact hamstring injuries sustained during training or competition. RESULTS: A total of 538 hamstring injuries were reported in the club's database, of which 240 were structurally verified by imaging as hamstring injuries. The overall incidence for the 17 sports studied was 1.29 structurally verified hamstring injuries per 100 athletes per year. The muscle most commonly involved in hamstring injuries was the biceps femoris, and the connective tissue most frequently involved was the myofascial. There was no evidence of a statistically significant association between age and RTP after injury, and no statistically significant difference between sex and RTP. However, the time loss by professionals was shorter than for amateurs, and proximal hamstring injuries took longer RTP than distal ones. CONCLUSION: In the 17 sports practiced at multi-sport club, the incidence of hamstring injury was 1.29 per 100 athletes per year. Players from sports in which high-speed sprinting and kicking are necessary, and amateurs, were at higher risk of suffering a hamstring injury. In addition, proximally located hamstring injuries involving tendinous connective tissue showed the longest RTP time. Age did not seem to have any influence on RTP. Documenting location and the exact tissue involved in hamstring injuries may be beneficial for determining the prognosis and RTP.

Apophysitis Among Male Youth Soccer Players at an Elite Soccer Academy Over 7 Seasons.

BACKGROUND: Apophyseal injuries are common in children and adolescent athletes. These injuries are believed to be caused by repetitive overloading, which can create inflammatory and degenerative conditions in growing bone prominences. However, their prevalence, diagnosis, and treatment in young soccer players have been understudied. PURPOSE: To evaluate characteristics of apophyseal injuries in adolescent athletes at an elite soccer academy. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: All apophyseal injuries between July 2008 and June 2015 were evaluated. For each injury, the authors recorded the type and location, age of the player, injury date, imaging modalities, and time absent from training/competition. RESULTS: Over the 7 seasons of this study, 210 apophyseal injuries were documented, including 172 simple apophyseal injuries and 38 apophyseal avulsion fractures. The rate of apophyseal injuries was 0.35 per 1000 hours of training exposure. A total of 196 (93.3%) cases were primary injuries, and the rest (6.7%) were reinjuries. Ultrasonography was the most commonly used imaging modality for diagnosis (172 cases; 81.9%). The most common location of apophyseal injuries was the anterior inferior iliac spine (AIIS). Return to sport was faster in athletes with apophyseal injury at the ischiopubic ramus, those with simple apophyseal injuries, and younger athletes. CONCLUSION: The most common location for apophyseal injury among soccer players was the AIIS. Return to training and competition differed according to injury location, type of apophyseal injury, and age.

Prevalence and predisposition to deep vein thrombosis in professional male soccer players

The long recovery time required after deep venous thrombosis (DVT), or other serious manifestations of venous thromboembolic disease, can lead to a reduction in sporting condition and economic losses. Neither are such events always free of clinical sequelae.ObjectiveThis study examines the prevalence of DVT in male, professional soccer players in Spain.MethodsA questionnaire on DVT events experienced by players in the ongoing 2015-16 season, and the previous 10 seasons, was sent to the medical services of all first and second division clubs in Spain. The genetic predisposition of those who suffered an event was investigated using the inCode thrombus test, as well as in 73 players who experienced no such event.ResultsFour subjects were diagnosed with DVT via clinical history and ultrasound or D-dimer determination. This associated prevalence (1.2/1000) is higher than reported (1/10,000) for this age group in the general population (18-35 years). All four affected players carried a risk allele (A1) at the ABO locus, three were homozygous for the risk allele of FactorXIII, and one was heterozygous for a risk allele of FactorXII. Among the 73 players who experienced no DVT, 3 high risk genetic variants associated with thromboembolic events were detected in 7 players (9.6%), either in the SERPINA_A10, FactorV, FactorXII, or FactorXIII genes.ConclusionDVT prevalence in professional soccer players is higher than expected for the same age segment, and highlights how genetic predisposition towards thromboembolic processes and sport-associated environmental risk factors work in tandem in the DVT appearance. (AU)

Dolor agudo en fosa ilíaca derecha. Un nuevo algoritmo de diagnóstico basado en árboles de clasificación y red neuronal artificial / Diagnosis of pain in the right iliac fossa. A new diagnostic score based on Decision-Tree and Artificial Neural Network Methods

Introducción: El dolor en fosa ilíaca derecha (FID) sigue planteando problemas diagnósticos. El objetivo de este estudio es la elaboración de un modelo diagnóstico de dolor en FID basado en árboles de clasificación (CHAID) y en una red neuronal artificial (RNA). Métodos: Estudio prospectivo de 252 pacientes que acudieron al hospital por presentar dolor en FID. Se recogieron datos demográficos, clínicos, exploración física y analíticos. Se clasificaron en 4 grupos: dolor simple en FID (dFID), apendicitis aguda (AA), dolor abdominal sin proceso inflamatorio (DASPI) y dolor abdominal con proceso inflamatorio (DACPI). Se construyó un modelo de árbol de clasificación tipo Chi-Square Automatic Interaction Detection (CHAID) y un modelo de RNA. Se evaluaron también los modelos clásicos (Alvarado [ALS], Appendicitis Inflammatory Response [AIR] y Fenyö-Lindberg FLS]). Se evaluó la discriminación mediante curvas ROC (ABC [IC 95%]) y porcentaje de correcta clasificación (PCC). Resultados: El 53% eran varones. Edad media 33,3±16 años. El grupo más numeroso fue el de dFID (45%), AA (37%), DASPI (12%) y DACPI (6%). Discriminación de ALS (0,82 [0,76-0,87]), AIR (0,83 [0,77-0,88]) y FLS (0,88 [0,84-0,92]). El CHAID determina 10 grupos de decisión: 3 con probabilidad altas para dFID, 3 altas para AA y 4 especiales sin diagnóstico predominante. PCC de RNA y CHAID con el 75 y 74,2%, respectivamente. Conclusiones: La metodología basada en árboles de clasificación tipo CHAID permite establecer un modelo diagnóstico basado en cuatro grupos de dolor en FID y genera reglas de decisión que pueden ayudarnos en el diagnóstico de procesos con dolor en FID

Introduction: Pain in the right iliac fossa (RIF) continues to pose diagnostic challenges. The objective of this study is the development of a RIF pain diagnosis model based on classification trees of type CHAID (Chi-Square Automatic Interaction Detection) and on an artificial neural network (ANN). Methods: Prospective study of 252 patients who visited the hospital due to RIF pain. Demographic, clinical, physical examination and analytical data were registered. Patients were classified into 4 groups: NsP (nonspecific RIFP group), AA (acute appendicitis), NIRIF (RIF pain with no inflammation) and IRIF (RIF pain with inflammation). A CHAID-type classification tree model and an ANN were constructed. The classic models (Alvarado [ALS], Appendicitis Inflammatory Response [AIR] and Fenyö-Linberg [FLS]) were also evaluated. Discrimination was assessed using ROC curves (AUC [95% CI]) and the correct classification rate (CCR). Results: 53% were men. Mean age 33.3±16 years. The largest group was the NsP (45%), AA (37%), NRIF (12%) and IRIF (6%). The analytical model results were: ALS (0.82 [0.76-0.87]), AIR (0.83 [0.77-0.88]) and FLS (0.88 [0.84-0.92]). CHAID determined 10 decision groups: 3 with high probability for NsP, 3 high for AA and 4 special groups with no predominant diagnosis. CCR of ANN and CHAID were 75% and 74.2%, respectively. Conclusions: The methodology based on CHAID-type classification trees establishes a diagnostic model based on four pain groups in RIF and generates decision rules that can help us in the diagnosis of processes with RIF pain

Diagnosis of pain in the right iliac fossa. A new diagnostic score based on Decision-Tree and Artificial Neural Network Methods. / Dolor agudo en fosa ilíaca derecha. Un nuevo algoritmo de diagnóstico basado en árboles de clasificación y red neuronal artificial.

INTRODUCTION: Pain in the right iliac fossa (RIF) continues to pose diagnostic challenges. The objective of this study is the development of a RIF pain diagnosis model based on classification trees of type CHAID (Chi-Square Automatic Interaction Detection) and on an artificial neural network (ANN). METHODS: Prospective study of 252 patients who visited the hospital due to RIF pain. Demographic, clinical, physical examination and analytical data were registered. Patients were classified into 4 groups: NsP (nonspecific RIFP group), AA (acute appendicitis), NIRIF (RIF pain with no inflammation) and IRIF (RIF pain with inflammation). A CHAID-type classification tree model and an ANN were constructed. The classic models (Alvarado [ALS], Appendicitis Inflammatory Response [AIR] and Fenyö-Linberg [FLS]) were also evaluated. Discrimination was assessed using ROC curves (AUC [95% CI]) and the correct classification rate (CCR). RESULTS: 53% were men. Mean age 33.3±16 years. The largest group was the NsP (45%), AA (37%), NRIF (12%) and IRIF (6%). The analytical model results were: ALS (0.82 [0.76-0.87]), AIR (0.83 [0.77-0.88]) and FLS (0.88 [0.84-0.92]). CHAID determined 10 decision groups: 3 with high probability for NsP, 3 high for AA and 4 special groups with no predominant diagnosis. CCR of ANN and CHAID were 75% and 74.2%, respectively. CONCLUSIONS: The methodology based on CHAID-type classification trees establishes a diagnostic model based on four pain groups in RIF and generates decision rules that can help us in the diagnosis of processes with RIF pain.

Hipercolesterolemia familiar en deportistas de alto rendimiento: una serie de casos clínicos y una breve revisión / Hipercolesterolèmia familiar en esportistes d'alt nivell: una sèrie de casos clínics i una breu revisió / Familiar hypercholesterolemia in high performance athletes: A case series and short clinical review

No disponible

Incidencia de la hiponatremia y de sus causas en pacientes neurológicos / Incidence of hyponatremia and its causes in neurological patients

Introducción La hiponatremia se considera el trastorno electrolítico más frecuentemente hallado entre pacientes hospitalizados y parece ser un factor pronóstico en dicha hospitalización. Métodos Se realizó un estudio prospectivo observacional en pacientes ingresados de forma consecutiva en el Hospital del Mar de Barcelona, durante un período de 3 meses. Se realizó un ionograma en sangre y orina, así como la osmolalidad en plasma y orina, al ingreso y tras 3–5 días en aquellos que presentaban hiponatremia. Resultados De los 130 pacientes incluidos, 19 (14,6%) presentaron hiponatremia. Las causas de hiponatremia fueron las siguientes: administración de sueros hipotónicos, 4 (21%); medicación antihipertensiva, 4 (21%); síndrome de secreción inadecuada de hormona antidiurética, 4 (21%); síndrome pierde sal cerebral, 2 (10%); estado edematoso causado por hepatopatía, uno (5%), pérdidas digestivas, 2 (10%), cardiopatia hipertensiva, 1 (5%) y 1 paciente sin diagnóstico etiológico (5%). La mortalidad fue de uno (5%) y 0 (0%) entre los pacientes con y sin hiponatremia, respectivamente. Conclusión La hiponatremia es un trastorno común entre pacientes neurológicos hospitalizados, y la falta de diagnóstico podría ser interpretada como un empeoramiento del cuadro neurológico (AU)

Introduction Hyponatremia is considered the most frequent electrolyte disorder found in hospitalized patients and seems to be a prognostic factor during hospitalization. Methods A prospective observational study was carried out in consecutive neurological patients admitted to our hospital over a 3-month period. Blood and urinary ionogram and osmolality were determined at entry and 3–5 days after admission in all patients with hyponatremia. Results Of the 130 patients admitted, 19 (14.6%) had hyponatremia. The causes of hyponatremia were as follows: inappropriate fluid replacement in 4 patients (21%), antihypertensive drugs in 4 (21%), syndrome of inappropriate secretion of antidiuretic hormone in 4 (21%), cerebral salt wasting syndrome in 2 (10%), and edematous status caused by liver disease in one and digestive loss in one (5%) each. Mortality was one (5%) and 0 (0%) among patients with and without hyponatremia, respectively.Conclusion Hyponatremia is common in hospitalized neurological patients and can be misdiagnosed as a worsening of the main illness (AU)

[Incidence of hyponatremia and its causes in neurological patients]. / Incidencia de la hiponatremia y de sus causas en pacientes neurológicos.

INTRODUCTION: Hyponatremia is considered the most frequent electrolyte disorder found in hospitalized patients and seems to be a prognostic factor during hospitalization. METHODS: A prospective observational study was carried out in consecutive neurological patients admitted to our hospital over a 3-month period. Blood and urinary ionogram and osmolality were determined at entry and 3-5 days after admission in all patients with hyponatremia. RESULTS: Of the 130 patients admitted, 19 (14.6%) had hyponatremia. The causes of hyponatremia were as follows: inappropriate fluid replacement in 4 patients (21%), antihypertensive drugs in 4 (21%), syndrome of inappropriate secretion of antidiuretic hormone in 4 (21%), cerebral salt wasting syndrome in 2 (10%), and edematous status caused by liver disease in one and digestive loss in one (5%) each. Mortality was one (5%) and 0 (0%) among patients with and without hyponatremia, respectively. CONCLUSION: Hyponatremia is common in hospitalized neurological patients and can be misdiagnosed as a worsening of the main illness.

Prevalencia del consumo de fármacos psicoactivos en una población de obesos / Prevalence of psychoactive drug consumption in an obese population

Objetivo Determinar la prevalencia de consumo de psicofármacos en una población de obesos. Material y métodos Recogimos datos procedentes de las historias clínicas de pacientes diagnosticados de obesidad y visitados por el Servicio de Endocrinología y Nutrición y por el Servicio de Psiquiatría del Hospital del Mar en el periodo comprendido entre junio del 2005 y mayo del 2006.Material y métodos Las variables recopiladas fueron datos antropométricos, epidemiológicos y toxicológicos. También investigamos la frecuencia de patología concomitante. Resultados El consumo de fármacos psicoactivos en los pacientes con obesidad fue del 37%, siendo los más utilizados los antidepresivos (27%), los ansiolíticos, los sedantes y los hipnóticos y los antiepilépticos. Además, el 15% de los pacientes estaba recibiendo tratamiento con 2 o más psicofármacos, siendo la combinación más frecuente la asociación de antidepresivos con antiepilépticos. Conclusiones La prevalencia de consumo de fármacos psicoactivos en nuestra muestra fue superior a los datos de prevalencia observados en la población general. En el caso de los antidepresivos, el consumo fue 3 veces superior respecto a la población general (AU)

Objective To establish the prevalence of psychoactive drug consumption in an obese population. Material and methods We collected data from the clinical records of obese patients attending the Endocrinology and Nutrition Department and Psychiatry Department of Hospital del Mar between June 2005 and May 2006 (n=259). We recorded anthropometric, epidemiological and toxicological data. We also investigated the prevalence of concomitant diseases in this population. Results Psychoactive drugs were consumed by 37% of obese patients, mainly antidepressants (27%), anxiolytics, sedatives and hypnotics, and anticonvulsants. Moreover, 15% of all patients received combination treatment with two or more psychoactive drugs, mostly the association of an antidepressant and an antiepileptic drug. Conclusion The prevalence of psychoactive drug consumption in our sample was higher than prevalence data observed in the general population, with antidepressant consumption being three-fold higher (AU)

[Prevalence of psychoactive drug consumption in an obese population]. / Prevalencia del consumo de fármacos psicoactivos en una población de obesos.

OBJECTIVE: To establish the prevalence of psychoactive drug consumption in an obese population. MATERIAL AND METHODS: We collected data from the clinical records of obese patients attending the Endocrinology and Nutrition Department and Psychiatry Department of Hospital del Mar between June 2005 and May 2006 (n=259). We recorded anthropometric, epidemiological and toxicological data. We also investigated the prevalence of concomitant diseases in this population. RESULTS: Psychoactive drugs were consumed by 37% of obese patients, mainly antidepressants (27%), anxiolytics, sedatives and hypnotics, and anticonvulsants. Moreover, 15% of all patients received combination treatment with two or more psychoactive drugs, mostly the association of an antidepressant and an antiepileptic drug. CONCLUSION: The prevalence of psychoactive drug consumption in our sample was higher than prevalence data observed in the general population, with antidepressant consumption being three-fold higher.