Nota: Estes posicionamentos se prestam a informar e não a substituir o julgamento clínico do médico que, em última análise, deve determinar o tratamento apropriado para seus pacientes.
The purpose of this study was to investigate the relative age effect and the age of peak performance of women's football players who participated in the Olympic Games from 1996 to 2016. Methods: Birth dates, playing positions, and nationality of all players registered in women's football competition in the Olympic Games (1996 to 2016) were collected. All data used in this study were obtained from the official website of the Federation Internationale de Football Association (www.fifa.com). The sample size of the study comprised 1,203 players. Results: We found an average age of 25.1 ± 4.0 years old and a significant increase of 1.4 years in the average age from 1996 (25.0 ± 3.9 years old) to 2016 (26.4 ± 3.7 years old) (p < 0.001). The comparison of the players' age between playing positions reveals that the goalkeepers are the oldest players (26.2 ± 4.4 years) and the forwards are the youngest players (24.4 ± 3.8 years) (p < 0.001). The RAE for women's football players showed neither effect over the years nor in different playing positions. Conclusion: We found an aging trend in women's football in the past two decades and different ages of peak performance among the playing positions. The current findings provide valuable information to coaches and professionals to program long-term training and to promote athletes' progression towards their performance targets.
No abstract
Background Sporadic Adrenal Medullary hyperplasia (AMH) has been little described in the literature, being most often diagnosed during a genetic syndrome screening or the evaluation of an adrenal incidentaloma. Case report A 51-year-old female patient presented with progressive attacks of tachycardia, headache, nausea and mild paroxysmal hypertension, which started in December 2020. She had a history of smoking and she also presented Takotsubo syndrome in 2018. She denied other comorbidities. In March 2021, she was submitted to laboratorial testing which demonstrated indeterminate plasma fractionated metanephrines by HPLC/MS: metanephrines 0.3 nmol/L (n< 0.5) and normetanephrines 1.2 nmol/L (n< 0.9) and normal serum chromogranin A level: 82 ng/mL (n<93) by Directed Proteomic. Urinary metanephrines were collected in a spot sample after an adrenergic crisis episode, confirming the biochemical diagnosis: metanephrines 255 mcg/g creatinine (n 30-165), normetanephrine 824 mcg/g creatinine (n 105-375), total 1119 mcg/g creatinine (n 150- 510) by HPLC. She was submitted to an abdominal MRI, which showed bilateral adrenal thickening with medullary predominance with hyperintense sign on T2-weighted images. It was also performed a mIBG I 131 spect and a PET-CT DOTATATO-Galium 68 without abnormal uptakes. A genetic panel by NextGeneration Sequence (NGS) was also carried out for pheochromocytoma/paraganglioma (PHEO/PGL) without pathological findings. The patient underwent laparoscopic left adrenalectomy after the use of alpha and beta blockade for one month, with pathological findings suggestive of adrenal medullary hyperplasia. However, she remained symptomatic after surgery. Once again, new urinary metanephrines in a spot sample were collected after an adrenergic crisis: metanephrines 188 mcg/g creatinine (n 30-165), normetanephrines 1229 mcg/g creatinine (n 105-375), total 1417 mcg/g creatinine (n 150-510) by HPLC, which demonstrated remaining cathecolamine excess. She underwent a contralateral laparoscopic adrenalectomy without surgical complications. An anatomopathological analysis was performed in both adrenals, which confirmed bilateral adrenal medullary hyperplasia without associated PHEO. The patient showed improvement in adrenergic symptoms and normalization of plasma fractionated metanephrines levels postoperatively, currently using hydrocortisone and fludrocortisone for the treatment of adrenal insufficiency. Conclusion Adrenal Medullary hyperplasia is a rare condition, which usually presents in a milder form and is often associated with pheochromocytoma or genetic syndromes. However it should be considered in symptomatic patients without a personal or family history of PHEO/PGL, allowing an early diagnosis and treatment. Presentation: No date and time listed
As arritmias raras constituem um grupo de doenças cardíacas com participação relevante no cenário da morte súbita cardíaca (MSC) em jovens. Dentre elas, as canalopatias (síndrome do QT longo, síndrome de Brugada, taquicardia ventricular polimórfica catecolaminérgica, síndrome do QT curto) e algumas arritmias primárias raras (repolarização precoce maligna, síndrome do prolapso mitral maligno e Torsades de pointes deflagrado por extrassístole de acoplamento ultracurto) têm características bem definidas e padrão hereditário. O conhecimento de seus principais critérios diagnósticos e seu manejo inicial é cada vez mais necessário na prática clínica, na tentativa de aumentar seu alcance diagnóstico e reduzir eventos tanto para os pacientes como seus familiares, sendo este o objetivo principal desta revisão.
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