The efficacy of PRP in the treatment of tendinopathies has been already studied both in in vitro and in clinical studies. This paper describes the local and the systemic effects of US-guided ...autologous PRP (Platelet Rich Plasma) injections in chronic tendinopathies in sportspersons.
Fifteen patients (13 male, 2 female) between 17 and 68 years old, affected by chronic tendinopathies at different sites were treated with an echographically guided injection of autologous PRP within the pathological area of the tendons. VISA score and MRI data were collected pre interventions and after 90 days and 24 months from treatment. Changes in different inteleukins (ILs), tumour necrosis factor α (TNF α), interferon γ, vascular endothelial growth factor (VEGF), endothelial growth factor (EGF), chemokine (C-C motif) ligand 2 (CCL2), were analysed at four time points in the peripheral blood of five patients.
After 90 days the VISA score significantly improved from 36±12 (range 21-64) to 74±17 (range 40-92). Reduction of irregularities was found in 80% of the tendons. After 24 months patients reported an average VISA score of 73±16 (range 42-100). No changes in IL, TNF α and interferon γ were observed. VEGF, EGF and CCL2 decreased progressively from 30m to 3 h after the treatment and returned to near the baselines after 24 h.
PRP injection allow an improvement of the clinical symptomatology, which is well maintained at least for two years from treatment. The PRP-based local therapy could influence systems homeostasis and antidoping evaluations, but, in our opinion, it doesn't represent a doping substance in itself.
Recent studies have investigated the importance of recovery strategies after training session, including hydrotherapy and cryotherapy. However, only a few studies have focused on cold-water immersion ...(CWI) treatments in team sport disciplines. The present study investigates the effects of CWI and contrast-water therapy (CWT) on the performance of young male soccer players during a week of training.
Eighteen young soccer players participated in the present study (age 15.5±1.0 years, weight 61.8±3.0 Kg, height 175.5±4.0 cm and training experience 8.1±1.0 years). They were involved in a four-day study with recovery using CWI or with CWT after each training session by using performance tests and small-sided games. We measured uric acid concentration, leukocytes, haemoglobin, reticulocytes and creatine kinase changes in the blood, axillary temperature, rating of perceived exertion after a training session, heart rate during exercise, performance tests (counter movement jump, repeated sprint ability and 5' shuttle run).
No significant difference were reported between groups when different physiological tests were used; CWI and CWT did not negatively influence the performances of the athletes. The principal effect of CWI was a reduced perception of fatigue after the training session. The use of active recovery protocols based on cold water or cold/thermoneutral water did not induce modifications of inflammatory and haematological markers in young soccer players.
The beneficial effect of a reduced perception of fatigue can improve training and competitions in young soccer players.
Little information is available about the long‐term outcome of renal transplantation in patients with systemic vasculitis (SV). We compared the outcomes of 19 renal transplant recipients with SV with ...those of 38 controls matched for time of transplantation, age, gender and source of donor. The mean post‐transplant follow‐up was 58 ± 57 months for vasculitic patients and 61 ± 49 months for controls. The actuarial 10‐year patient survival was 87% in vasculitic patients and 90% in controls, death‐censored graft survival were 84% and 100%, respectively. The risks of acute and chronic rejection, and arterial hypertension were not significantly different between the two groups. Infection was significantly more frequent in vasculitic patients (74% vs. 34%; p = 0.01). Seven patients (36.8%) had a recurrence of vasculitis in mean 45 months after renal transplant (0.076/patients/year). After recurrence, one patient had an irreversible humoral rejection, another died from hemophagocytosis and another restarted dialysis 1 year later. Long‐term patient and renal allograft survival in vasculitic patients was good. Although graft function recovered in most relapsers after reinforcement of immunosuppression, one patient died and two lost graft function.
In 19 renal transplant recipients with systemic vasculitis, graft and patient survival was good, despite seven patients having recurrent vasculitis.
Summary
The role of reticulocytes (Ret) in sports medicine became important when the count of immature erythrocytes has been introduced in protocols used and officially approved for antidoping ...purposes. The use of modern automated analysers, which allow the easy count and the description of characteristics of reticulocytes, increased the possible use of these parameters in sports medicine. We studied the behaviour of Ret and immature reticulocyte fraction (IRF) in top‐level athletes practising rugby, ski, soccer and cyclism, throughout a competitive season. We aimed at increasing the knowledge of physiological characteristics of these sportsmen and supplying valuable suggestions to trainers and sports physicians. We observed a stability of Ret counts, also during training and competitions, although some modifications, namely decrease during competitions periods in cyclists, and in rugby and soccer players, occurred. No significant correlation was found between Ret count and Hb in each sport discipline. IRF values tend to be high in athletes owing to continuous bone marrow stimulation linked to haemolysis, typical of sports activities. We confirm the validity of the use of Ret counts for antidoping purposes and also for evaluating health status and iron metabolism of sportsmen.
Bone metabolism markers in sports medicine Banfi, Giuseppe; Lombardi, Giovanni; Colombini, Alessandra ...
Sports medicine (Auckland),
2010-Aug-01, Letnik:
40, Številka:
8
Journal Article
Recenzirano
Bone mass can be viewed as the net product of two counteracting metabolic processes, bone formation and bone resorption, which allow the skeleton to carry out its principal functions: mechanical ...support of the body, calcium dynamic deposition and haemopoiesis. Besides radiological methods, several blood and urinary molecules have been identified as markers of bone metabolic activity for estimating the rates and direction of the biological activities governing bone turnover. The advantages for the use of bone metabolism markers are that they are potentially less dangerous than radiological determinations, are more sensitive to changes in bone metabolism than radiological methods and are easily collected and analysed. The disadvantages are that they have high biological variability. Physical exercise is a known source of bone turnover and is recommended for preventing osteoporosis and bone metabolism problems. There are numerous experiments on bone metabolism markers after acute exercise, but not after long-term training and during or after a whole competition season. Moreover, few studies on bone metabolism markers have evaluated their performance in elite and top-level athletes, who have a higher bone turnover than sedentary individuals. Despite discrepant results among studies, most have shown that short exercise is insufficient for modifying serum concentrations of bone metabolism markers. Marker variations are more evident after several hours or days after exercise, bone formation markers are more sensitive than bone resorption markers, and stimulation of osteoblast and/or osteoclast functions is exercise dependent but the response is not immediate. The response depends on the type of exercise; the markers seem to be less sensitive to resistance exercise and the intensity of exercise is not discriminate. Comparisons between trained subjects and untrained controls have demonstrated the influence of exercise on bone turnover. During training, carboxy-terminal collagen cross-links (CTx), a bone resorption marker, was shown to be less sensitive than amino-terminal cross-linking telopeptide of type I collagen (NTx) and urinary pyridinolines, which were sensitive to anaerobic exercise. Whereas, the bone formation markers, bone alkaline phosphatase (BAP) and osteocalcin (OC) changed after 1 month and 2 months of an exercise programme, respectively. After 2 months, while BAP normalized, it was found to be sensitive to aerobic exercise and OC was found to be sensitive to anaerobic exercise. After prolonged training and competition, bone formation markers are found to change in sedentary subjects enrolled in a physical activity programme. Professional athletes show changes in bone formation markers depending on programme intensity, whereas bone resorption appears to stabilize. Crucial for long-term training, are the characteristics of exercise (e.g. weight-bearing, impact).
Saliva represents a low stress, not-invasively collected matrix that allows steroid hormone monitoring in athletes by reflecting type, intensity and duration of exercise. Whole body cryotherapy (WBC) ...consists of short whole-body exposures to extremely cold air (-110° to -140°C) which, despite being initially used to treat inflammatory diseases, is currently acquiring increasing popularity in sports medicine. Cryostimulation practice is now widely accepted as an effective treatment to accelerate muscle recovery in rugby players. The aim of this work was to study the changes of steroid hormones in saliva of rugby players after both 2 and 14 consecutive WBC sessions, in order to investigate the effects of the treatment on their salivary steroid hormonal profile. Twenty-five professional rugby players, belonging to the Italian National Team, underwent a 7-day cryotherapy protocol consisting of 2 daily sessions. Saliva samples were taken in the morning prior to the start of the WBC, in the evening after the end of the second WBC, and in the morning of the day after the last WBC session. The samples were analyzed for cortisol, DHEA, testosterone and estradiol using competitive enzyme-linked immunosorbent assays. Cortisol and DHEA showed a reduction already after the 2 WBC sessions of the first day; after 14 consecutive WBC sessions cortisol, DHEA, and estradiol levels decreased, while testosterone increased as did the testosterone to cortisol ratio. These results were confirmed by the fact that the majority of subjects showed variations exceeding the critical difference (CD). In conclusion, we found that WBC acutely affects the salivary steroid hormone profile, and the results are evident already after only one twice-daily session. Most significantly, after one-week of consecutive twice-daily WBC sessions, all the hormones were modified. This is the first experimental report that links changes in the hormonal asset to WBC.
Sex hormones play a role in pain perception, a key variable in evaluating the progression and treatment of osteoarthritis. The aim of this study was to determine the relationship between salivary ...concentrations of four steroid hormones and functional/clinical outcomes after hip and knee arthroplasty. Saliva samples were collected from 24 otherwise healthy patients with osteoarthritis before surgery, on admission to rehabilitation, and at hospital discharge. Salivary concentrations of testosterone, 17β-estradiol, dehydroepiandrosterone (DHEA), and cortisol were immunoassayed. Changes in hormone levels were compared with clinical outcomes, as assessed by functional independence measure (FIM®), Barthel Index (BI), and visual analog scale for pain (VAS) scores. Changes in testosterone levels were significantly inversely correlated with VAS (r= -0.53, p=0.043) and FIM® and BI scores in all patients (r= -0.30, p= 0.043, and r= -0.35, p=0.031, respectively). The testosterone to cortisol ratio was inversely correlated with BI scores in all patients (r= -0.30, p=0.040), and in the men (r= -0.55, p=0.005) and the women (r= -0.28, p=0.042) when analyzed separately. Changes in salivary testosterone concentrations closely correlated with clinical outcome measurements for total hip and knee arthroplasty. Clinical outcome after arthroplasty was generally better among the men.
Reticulocytes are the transitional cells from erythroblasts to mature erythrocytes. Reticulocytes are present in blood for a period of 1-4 days and can be recognized by staining with supravital dyes, ...such as new methylene blue, or fluorescent markers, which couple residual nucleic acid molecules, a hallmark of the immature forms of erythrocytes. Although reticulocytes could be counted through a microscope (there is a standard of International Committee for Standardisation in Haematology for manual counting), this method is reported to be time consuming, inaccurate and imprecise. The integration of the reticulocyte count in automated haematology systems allowed the widespread use of these parameters, although the lack of calibration material and different markers, technologies and software used in automated systems could engender discrepancies among data obtained from different analytical systems.The importance of reticulocytes in sports medicine derives from their sensitivity, the highest among haematology parameters, in identifying the bone marrow stimulation, especially when recombinant human erythropoietin is fraudulently used. Automated systems are also able to supply information on volume, density and the haemoglobin content of reticulocytes. Some of the related parameters are also used in algorithms for identifying abnormal stimulation of bone marrow as reticulocytes haematocrit. The pre-analytical variability of reticulocytes (transportation, storage, biological variability) should be taken into account in sports medicine also. Reticulocytes remain stable for almost 24 hours at 4 degrees C from blood drawing, they are affected by transportation, and biological variability is not high in general. It could be remarked, however, that the intra-individual variability is high when compared with other haematological parameters such as haemoglobin and haematocrit. The intervals of data reported in athletes are very similar to reference intervals characterizing the general population.The reticulocyte count shows some modifications after training and during the competition season. The variability induced by exercise cannot be overlooked since the so-called haematological passport, a personal athlete's document in which haemoglobin and other parameters are registered, may be introduced by sports federations. Exposure to naturally high altitude and 'living high-training low' programmes determined contentious results on reticulocytes. Simulated high altitude induced by intermittent hypobaric hypoxia does not modify reticulocytes, despite an increase in erythropoietin serum concentration. The variability among athletes competing in different sport disciplines is apparently limited. The knowledge of the behaviour of reticulocytes in training and competitions is crucial for defining their role in an antidoping control context. It is important for sport physicians and clinical pathologists to know the reticulocyte variability in the general population and in athletes, the pre-analytical warnings, the different methodologies for counting reticulocytes and the derived parameters automatically available, and, finally, the possible influence of training, competitions, type of sport and altitude.
The OPG-RANK-RANKL system is a new family of bone metabolism biomarkers belonging to the immune system. In this study, were evaluated these biomarkers in professional rugby players after a ...single-bout of training session.
The study has been performed on 30 professional male rugby players during a training camp of the Italian National Team, in July, before the start of the competitive season. Blood drawings were performed before and after training in the same day. Levels of soluble OPG, RANKL RANK in serum specimens were measured by commercially available according to the manufacturers' protocols.
All the bone markers examined displayed no significative changes after training session.
Short exercise is insufficient for modifying serum concentrations of these osteoimmunologic markers, as previously indicated for commonly used bone metabolism markers. Future studies will be conducted over an entire competition season in order to define a common profile of bone markers in rugby players.
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