RESUMO
Shoulder instability is a common shoulder injury, and patients present with plastic deformation of the glenohumeral capsule. Gene expression analysis may be a useful tool for increasing the general understanding of capsule deformation, and reverse-transcription quantitative polymerase chain reaction (RT-qPCR) has become an effective method for such studies. Although RT-qPCR is highly sensitive and specific, it requires the use of suitable reference genes for data normalization to guarantee meaningful and reproducible results. In the present study, we evaluated the suitability of a set of reference genes using samples from the glenohumeral capsules of individuals with and without shoulder instability. We analyzed the expression of six commonly used reference genes (ACTB, B2M, GAPDH, HPRT1, TBP and TFRC) in the antero-inferior, antero-superior and posterior portions of the glenohumeral capsules of cases and controls. The stability of the candidate reference gene expression was determined using four software packages: NormFinder, geNorm, BestKeeper and DataAssist. Overall, HPRT1 was the best single reference gene, and HPRT1 and B2M composed the best pair of reference genes from different analysis groups, including simultaneous analysis of all tissue samples. GenEx software was used to identify the optimal number of reference genes to be used for normalization and demonstrated that the accumulated standard deviation resulting from the use of 2 reference genes was similar to that resulting from the use of 3 or more reference genes. To identify the optimal combination of reference genes, we evaluated the expression of COL1A1. Although the use of different reference gene combinations yielded variable normalized quantities, the relative quantities within sample groups were similar and confirmed that no obvious differences were observed when using 2, 3 or 4 reference genes. Consequently, the use of 2 stable reference genes for normalization, especially HPRT1 and B2M, is a reliable method for evaluating gene expression by RT-qPCR.
Assuntos
Expressão Gênica , Luxação do Ombro/genética , Adolescente , Adulto , Feminino , Humanos , Masculino , Reação em Cadeia da Polimerase em Tempo Real , Adulto JovemRESUMO
Objetivo: O objetivo desta revisão é descrever os achados publicados sobre o manejo no tratamento de pacientes após primeiro episódio de luxação traumática anterior do ombro. Métodos: Elaboramos uma busca ampla na literatura por meio de filtros e estratégia de associação boleana dos termos ?primeiro episódio luxação ombro? e ?tratamento para a identificação de estudos?. Incluímos as bases de dados LILACS e Medline. A partir da identificação consensual dos estudos, procedeu-se a leitura integral de todos os artigos selecionados e subsequente análise dos estudos. Resultados: Através da busca sistematizada nas bases de dados previamente citadas foram encontrados 262 estudos com os termos selecionados. Destes, foram utilizados no desenvolvimento deste artigo de revisão 66 estudos, sendo 64 da base Medline e 2 trabalhos pertencentes a LILACS. Conclusão: A literatura disponível suporta o tratamento cirúrgico precoce após o primeiro episódio de luxação traumática do ombro para jovens atletas do sexo masculino envolvidos em atividades físicas altamente exigentes. No entanto, novos ensaios clínicos de boa qualidade, comparando o tratamento cirúrgico versus não cirúrgico de lesões bem definidas, são necessários, especialmente para as categorias de pacientes que têm um menor risco de recorrência.
Assuntos
Humanos , Masculino , Feminino , Adulto , Luxação do Ombro/terapia , Tratamento Primário/métodosRESUMO
The authors describe the case of an athlete from the Brazilian national men's basketball team (sub-16) who reported pain in the right iliac region at the end of the season. Clinical and imaging exams revealed an iliac bone stress fracture. A conservative treatment of removing the load from the fracture in combination with physical therapy was chosen. The athlete improved satisfactorily and returned to the sport at the same level as prior to the injury after 14 weeks of treatment.
Assuntos
Basquetebol/lesões , Fraturas de Estresse/etiologia , Ílio/lesões , Adolescente , Fraturas de Estresse/terapia , Humanos , MasculinoRESUMO
Anterior traumatic dislocation is a common problem faced by orthopedic surgeons. After the first episode of shoulder dislocation, a combination of lesions can lead to chronic instability. The management in treatment of young athletes after the first acute anterior shoulder dislocation is controversial. The available literature supports early surgical treatment for young male athletes engaged in highly demanding physical activities after the first episode of traumatic dislocation of the shoulder. This is because of the best functional results and lower recurrence rates obtained with this treatment in this population. However, further clinical trials of good quality comparing surgical versus nonsurgical treatment for well-defined lesions are needed, especially for categories of patients who have a lower risk of recurrence.
RESUMO
A powerlifting athlete ruptured his left tendon of the pectoralis major muscle while attempting to lift 160 kg in a Brazilian bench press championship. The injury seemed to occur in the concentric phase of exercise; however, the more common mechanism of rupture is during the eccentric phase. The tendon was reinserted to the humerus 3 weeks later with screws and washers. The athlete returned to competitive activities after 5 months. One year later he lifted 170 kg and won the national championship.