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Da Roza T.,University of Porto | Brandao S.,Centro Hospitalar Of Sao Joao Epe | Mascarenhas T.,University of Porto | Jorge R.N.,University of Porto | Duarte J.A.,University of Porto
Clinical Journal of Sport Medicine | Year: 2015

Objectives: The aim of this study was to investigate in young nulliparous female trampolinists the hypothetical associations between the level of athletic performance and the volume of training with urine leakage. Design: Cross-sectional cohort study. Setting: Professional trampolinists. Participants: Twenty-two female athletes participating in a trampoline national championship were included in this study. Assessment of Risk Factors: The associations for player-related performance variables were evaluated using Spearman rank correlation and Kruskal-Wallis H test verified the differences between the tertiles. Main Outcome Measures: Rate of urinary incontinence (UI) among young athletes and the relationship with the athletic performance. Screening was performed through a questionnaire. This included the demographic sample characterization, the assessment of training volume, and the athletes' ranking in the championship. Additionally, it included the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-UI-SF) to assess the leakage. Results: About 72.7% of the participants reported that they experienced urine leakage during trampoline practice and described that the episodes of leakage started after the beginning of the trampoline. Significant associations between the athletic performance and the training volume were observed with the severity of incontinence. Dividing the sample in tertiles of training volume, it was observed that the third tertile was the one with greatest impact of incontinence on their quality of life (ICIQ score). Conclusions: The results confirm a high frequency of UI in young trampolinists and reveal a clear identification of the athletes' ranking and the training volume as risk factors to develop and worsen urine loss. Clinical Relevance: Special attention from team physicians and trainers is required for this athletes' problem that is often hidden by shame. In addition, female athletes practicing high-impact sports should be informed about the risk to develop pelvic floor muscles dysfunction and should be encouraged to seek help from health professionals to minimize or even eliminate the urine incontinence. © 2014 Wolters Kluwer Health, Inc. All rights reserved.

Magalhaes-Ribeiro C.,University of Porto | Freitas J.,Centro Hospitalar Of Sao Joao Epe
Revista Portuguesa de Cardiologia | Year: 2016

Syncope is a common but concerning event in young athletes. Although mostly due to benign reflex causes, syncope may be arrhythmic and precede sudden cardiac death. Efforts must therefore be made to distinguish post-exertional syncope from syncope during exercise, which can be an ominous sign of a possible underlying heart disease, such as hypertrophic cardiomyopathy. Prevention requires cooperation between physician and athlete, in order to identify individuals at risk and to protect them from sudden death. Solving this diagnostic dilemma may lead to recommendations for athletes to be cleared to play or disqualified from competitive sports, and presents challenging and controversial decisions to the health care provider that can prove difficult to implement. Although exercise contributes to physical and psychological well-being, there are insufficient data to indicate whether an athlete with hypertrophic cardiomyopathy diagnosed after a syncopal episode can safely resume competitive physical activity. The purpose of this study was to review the literature on syncope in young athletes and its relationship to individuals with hypertrophic cardiomyopathy, in order to enable accurate assessment of prognosis and the possibility of resuming competitive sports. © 2016 Sociedade Portuguesa de Cardiologia.

Osorio F.,Centro Hospitalar Of Sao Joao Epe | Tosti A.,University of Miami
Dermatology Online Journal | Year: 2012

Pili annulati is a rare hair shaft abnormality and, as far as we know, there are no published data on pili annulati's racial distribution. To our knowledge, this is the first case reported in an African-American patient. © 2012 Dermatology Online Journal.

Da Roza T.,University of Porto | Brandao S.,Centro Hospitalar Of Sao Joao Epe | Mascarenhas T.,Centro Hospitalar Of Sao Joao Epe | Jorge R.N.,University of Porto | Duarte J.A.,University of Porto
International Journal of Sports Medicine | Year: 2015

The purpose of this study was to determine the influence of different levels of regular physical exercise on the frequency of urinary incontinence in young nulliparous women from the northern region of Portugal. Participants (n=386) self-reported demographic variables, frequency, and time spent practicing organized exercise per week, as well as completed the International Consultation on Incontinence Questionnaire-Short Form. The level of exercise was calculated based on the time (in minutes) usually spent per week in organized exercise. 19.9% of Portuguese nulliparous women reported incontinence symptoms. Considering the distribution of urinary incontinence among the different quartiles of organized exercise, women from the 4thquartile (those who train for competitive purposes) demonstrated highest relative frequency (p=0.000) and a 2.53 greater relative risk to develop (95% CIs,1.3-2.7) incontinence compared to women from the 1st quartile (inactive). Women who practice exercise for recreational purposes (2nd and 3rd quartiles) did not show significant differences in the urinary incontinence prevalence and relative risk of developing it compared to women from the 1st quartile. The results showed that women participating in organized exercise involving high volume training for competition are potentially at risk of developing urinary incontinence, although organized exercise undertaken without the intent to compete seems to be safe for maintaining urinary continence. © Georg Thieme Verlag KG Stuttgart - New York.

Papoutsaki M.,A. Syggros Hospital | Osorio F.,Centro Hospitalar Of Sao Joao Epe | Morais P.,Centro Hospitalar Of Sao Joao Epe | Morais P.,University of Porto | And 5 more authors.
BioDrugs | Year: 2013

Psoriasis is a chronic inflammatory disorder of the skin and joints. Although rarely life threatening, psoriasis can significantly impair quality of life (QOL) and cause considerable physical and psychological distress. Between 6 and 42% of patients with psoriasis develop psoriatic arthritis, which is characterized by stiffness, pain, swelling and tenderness of the joints. Nail psoriasis is highly prevalent in both plaque-type psoriasis and psoriatic arthritis and is found in approximately 50% of patients with psoriasis and in 80% of patients with psoriatic arthritis. Infliximab, a chimeric human-murine monoclonal antibody directed against tumour necrosis factor α, is approved in the USA and EU for the treatment of plaque psoriasis and psoriatic arthritis at a recommended dosage of 5mg/kg administered by intravenous infusion at 0, 2 and 6 weeks, then every 8 weeks thereafter. The EXPRESS and EXPRESS II trials demonstrated that infliximab is efficacious as induction andmaintenance therapy in the treatment of moderate to severe plaque psoriasis and also improved health-related QOL. Infliximab is also efficacious in the treatment of psoriatic arthritis, as shown in the IMPACT and IMPACT II studies. Infliximab is generally well tolerated, with a similar adverse event profile in both psoriasis and psoriatic arthritis. The use of infliximab in three case reports is presented. The patients are similar to those normally seen by clinicians, and include a male patient with plaque psoriasis and a history of severe psoriatic arthritis who was corticosteroid dependent and in whom other systemic treatments were not effective or were not able to be used. This patient showed a rapid response to infliximab with no skin lesions or arthritis after 7 weeks' treatment. Infliximab was also safe and effective in the treatment of a female patient with plaque and nail psoriasis and a history of psoriatic arthritis. Importantly, this case report supports the efficacy of infliximab in psoriatic nail disease in the context of severe skin and joint involvement. Case 3 describes a young male patient with moderate plaque-type psoriasis associated with severe nail involvement and early signs of psoriatic arthritis. Treatment with infliximab improved nail psoriasis and appears to be an effective biological treatment for nail psoriasis. Importantly, ultrasound was able to diagnose joint involvement, as seen from the proliferative synovitis in the distal interphalangeal joint and mild enthesitis, despite there being no clinical evidence of psoriatic arthritis. This case report highlights the importance of early screening. If such abnormalities are detected early on in the course of psoriasis, cliniciansmay be able to predict which patients are more likely to develop psoriatic arthritis, and therefore offer effective and long-term treatment that may reduce the disability and impairment of daily activities that can be associated with psoriatic arthritis. Adis © 2013 Springer International Publishing AG.

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