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1.
Clin Rehabil ; 37(1): 86-97, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35786028

RESUMO

OBJECTIVE: To determine the effect of foot orthoses on pain, disability and foot functionality in patients with Systemic Lupus Erythematosus. DESIGN: Randomized clinical trial. SETTING: University Podiatric Clinical Area. SUBJECTS: Patients with systemic lupus erythematosus. INTERVENTIONS: Patients were randomly assigned to either group A, which received custom-made functional foot orthoses, or group B, which received flat cushioning insoles, for three months. MAIN MEASURES: The primary outcome was foot pain, measured by 11-point numeric pain rating scale. Foot functionality and foot-related disability were evaluated using the foot function index, the Manchester foot pain and disability, at the beginning and at days 90. RESULTS: Sixty-six participants (age 47.3 ± 11.9 years) suffering from foot pain, received either the custom-made foot orthoses (N = 33) or the flat cushioning insoles (N = 33). For the analysis of the data, only participants who had finished the follow-up period (90 days) were included. None statistically significant difference between groups were found. In group A, all variables showed statistically significant differences when comparing the initial and final measurements. Pain showed 6.8 ± 1.6 and 4.2 ± 2.9 in group A, at baseline and at 90 days, respectively, group B showed 6.5 ± 1.5 and 4.7 ± 3.0 at baseline and at 90 days, respectively. CONCLUSION: Both groups showed a reduction in foot pain. This study suggests that not only controlling the foot function, but providing cushioning to the foot, may have positive effects to manage foot pain in patients with systemic lupus erythematosus.


Assuntos
Órtoses do Pé , Lúpus Eritematoso Sistêmico , Humanos , Adulto , Pessoa de Meia-Idade , Manejo da Dor , Dor , Sapatos , Lúpus Eritematoso Sistêmico/complicações , Resultado do Tratamento
2.
Clin Rehabil ; 37(1): 60-71, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35801287

RESUMO

OBJECTIVE: Loss of proprioception and balance disorders are commonly observed in patients with knee osteoarthritis. In this study, we aimed to investigate the effects of balance and proprioception exercises in patients with knee osteoarthritis. DESIGN: A single-center randomized trial with three parallel arms. SETTING: A tertiary health care facility in Turkey. PARTICIPANTS: Female patients with knee osteoarthritis aged 40-70 years. INTERVENTIONS: Ten-week exercise program in Biodex training, classical balance training and isometric strengthening groups. MAIN MEASURES: Dynamic balance (overall stability index and the modified Clinical Test of Sensory Interaction and Balance), pain (visual analogue scale), physical function (30-s chair stand test and 40-meter fast-paced walk test) and quality of life (Knee Injury and Osteoarthritis Outcome Score). RESULTS: Eighty-nine patients enrolled in the study. The Biodex training group, the classical training group, and the control group had overall stability index values of 1.0 ± 0.07, 1.4 ± 0.07 and 1.4 ± 0.07, and the Modified Clinical Test of Sensory Interaction and Balance - Condition-3 values of 0.7 ± 0.04, 0.9 ± 0.04 and 0.9 ± 0.04 respectively, at the end of treatment. In terms of pain scores on movement, each group showed significant improvement compared to their baseline, and the classical balance training group had better scores than the control group. No other significant difference was found between the groups. Physical function and quality of life outcomes showed significant main effects only in the time factor. CONCLUSIONS: Balance and proprioception exercises may have positive effects on dynamic balance and pain. The effects on physical function and quality of life should be investigated in further studies with larger sample.


Assuntos
Osteoartrite do Joelho , Humanos , Feminino , Qualidade de Vida , Terapia por Exercício , Propriocepção , Dor , Resultado do Tratamento
3.
Clin Podiatr Med Surg ; 40(1): 39-54, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36368847

RESUMO

LisFranc injuries in the active, athletic, and military populations can be devastating injuries. There has been much debate over open reduction and internal fixation versus arthrodesis as primary treatment in these injuries. This article aims to present the existing evidence-based medicine to help guide appropriate treatment in this population. With the introduction of flexible fixation, the variety of ways to address these injuries surgically has expanded.


Assuntos
Traumatismos do Pé , Fraturas Ósseas , Humanos , Redução Aberta , Fixação Interna de Fraturas , Artrodese , Traumatismos do Pé/diagnóstico por imagem , Traumatismos do Pé/cirurgia , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Atletas , Resultado do Tratamento
4.
Clin Podiatr Med Surg ; 40(1): 75-96, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36368849

RESUMO

There are many factors to consider when treating an Achilles tendon rupture in the acute and chronic/neglected settings. For acute rupture, operative and nonoperative management contribute to a good prognosis with low associated risks. Patient or injury characteristics can assist in the shared decision-making about treatment. In chronic rupture, MRI may help to determine rupture location, gap distance, and tissue material available for repair. Various surgical approaches are used for chronic rupture repair. Treatment of the Achilles tendon rupture generates many interesting and complex discussions on the optimal management.


Assuntos
Tendão do Calcâneo , Traumatismos do Tornozelo , Procedimentos Cirúrgicos Reconstrutivos , Traumatismos dos Tendões , Humanos , Tendão do Calcâneo/cirurgia , Tendão do Calcâneo/lesões , Ruptura/diagnóstico por imagem , Ruptura/cirurgia , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/cirurgia , Traumatismos do Tornozelo/cirurgia , Resultado do Tratamento
5.
Interv Cardiol Clin ; 12(1): 141-153, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36372458

RESUMO

The use of coronary physiology allows for rational decision making at the time of PCI, contributing to better patient outcomes. Yet, coronary physiology is only one aspect of optimal revascularization. State-of-the-art PCI must also consider other important aspects such as intracoronary imaging guidance and specific procedural expertise, as tested in the SYNTAX II study. In this review, we highlight the technical aspects pertaining to the use of physiology as used in that trial and offer a glimpse into the future with emerging physiologic metrics, including functional coronary angiography, which have already established themselves as useful indices to guide decision making.


Assuntos
Doença da Artéria Coronariana , Intervenção Coronária Percutânea , Humanos , Intervenção Coronária Percutânea/métodos , Ponte de Artéria Coronária/métodos , Doença da Artéria Coronariana/cirurgia , Resultado do Tratamento , Angiografia Coronária
6.
Thorac Surg Clin ; 33(1): 19-24, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36372529

RESUMO

The rapid adoption of robotic-assisted thoracic surgery has led to increased interest in the management of complications. Overall rates of complication during robotic-assisted thoracic surgery are low. Reported complications include pulmonary vascular injury; great vessel injury; thoracic duct injury; erroneous transection; tracheobronchial injury; and esophageal, diaphragmatic, and abdominal organ injury. A robotic thoracic surgeon should understand and have a management plan for any potential complication. When a complication occurs, the priority is to stabilize the patient. Then, after stabilization, an assessment of the situation will determine whether the procedure can be continued robotically or whether conversion to thoracotomy or sternotomy is required.


Assuntos
Procedimentos Cirúrgicos Robóticos , Cirurgia Torácica , Humanos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Toracotomia/efeitos adversos , Cirurgia Torácica Vídeoassistida
7.
Thorac Surg Clin ; 33(1): 51-60, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36372533

RESUMO

Performing robotic thoracic lung resection is becoming an option for patients with complex thoracic disease. The robotic-assisted approach has similar survival with decreased postoperative pain, morbidity, and hospital length of stay compared with the open approach in pneumonectomy, bronchoplasty, and arterioplasty. Appropriate patient selection based on medical and surgical history combined with surgeon experience is imperative for an excellent outcome. This article will discuss the use of the robot in pneumonectomy, arterioplasty, and bronchoplasty to provide information about the technical approach and postoperative management.


Assuntos
Neoplasias Pulmonares , Procedimentos Cirúrgicos Robóticos , Robótica , Humanos , Neoplasias Pulmonares/cirurgia , Estudos Retrospectivos , Pneumonectomia , Pulmão , Cirurgia Torácica Vídeoassistida , Resultado do Tratamento
8.
Thorac Surg Clin ; 33(1): 71-79, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36372535

RESUMO

Robot-assisted thoracoscopic surgery for the treatment of thoracic outlet syndrome and chest wall lesions are burgeoning topics on thoracic surgery. Following publication of the Society of Vascular Surgeons expert statement in 2016, the diagnosis and management of thoracic outlet syndrome is favorably evolving. Robot-assisted first rib resection is a novel approach to the surgical management of thoracic outlet syndrome that may have advantages compared with traditional open surgical approaches. Robot-assisted chest wall resection is technically feasible for a variety of chest wall conditions and may also have advantages compared with thoracotomy approaches.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Síndrome do Desfiladeiro Torácico , Parede Torácica , Humanos , Parede Torácica/cirurgia , Costelas/cirurgia , Síndrome do Desfiladeiro Torácico/cirurgia , Cirurgia Torácica Vídeoassistida , Resultado do Tratamento
9.
Thorac Surg Clin ; 33(1): 61-69, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36372534

RESUMO

Robotic tracheobronchoplasty (TBP) is a new surgical approach to treat tracheobronchomalacia (TBM), and is based on open TBP, which has undergone various technical iterations since the 1950s. The robotic approach to TBM may allow for more patients to undergo TBP, and in retrospective series has demonstrated equivalent outcomes compared to open TBP if not superior in terms of postoperative complications. Long-term data are eagerly awaited, and we describe our approach in this article.


Assuntos
Procedimentos Cirúrgicos Robóticos , Traqueobroncomalácia , Humanos , Estudos Retrospectivos , Resultado do Tratamento , Traqueobroncomalácia/cirurgia , Complicações Pós-Operatórias
10.
Clin Sports Med ; 42(1): 1-24, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375863

RESUMO

Rotator cuff tears are common and multifactorial in etiology. Natural history studies suggest that following initiation of a tear, rotator cuff disease may advance along a continuum of tear enlargement and symptom progression, muscular degeneration and fatty infiltration, and glenohumeral arthritis. Patient- and tear-specific features influence both the risk of clinical progression and the potential for tendon healing following a repair. General guidelines regarding management of rotator cuff tears are influenced by a patient's symptoms, risk of clinical progression, and potential for biologic healing.


Assuntos
Lacerações , Lesões do Manguito Rotador , Humanos , Lesões do Manguito Rotador/cirurgia , Manguito Rotador/cirurgia , Resultado do Tratamento , Ruptura/cirurgia , Artroscopia
11.
Clin Sports Med ; 42(1): 141-155, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375866

RESUMO

With an increasing incidence of rotator cuff repairs (RCRs), and by extension, RCR failures, surgeons must be facile in the diagnosis and management of this complication. A detailed history and physical exam as well as familiarity with the patient-specific, anatomic, and technical variables that increase a patient's risk of RCR failure is critical. Modifiable factors should be addressed prior to revision RCR and non-modifiable factors should be examined as they may disqualify an individual from a revision attempt. A methodical surgical approach is critical. In general, outcomes following revision RCR are typically favorable although inferior than those following primary RCR.


Assuntos
Lesões do Manguito Rotador , Manguito Rotador , Humanos , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia , Artroscopia , Artroplastia , Resultado do Tratamento
12.
Clin Sports Med ; 42(1): 95-107, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375873

RESUMO

Arthroscopic augmentation of massive and irreparable rotator cuff tears proves to be a valid and evidence-based treatment option to maximize healing and patient outcomes following rotator cuff repair. Integration of acellular dermal allografts as augment or interposition grafts demonstrates definitive benefit in patients with high risk of retear or individuals with severely retracted tears, respectively. Furthermore, these allografts have demonstrated benefit when used for superior capsular repair for chronic, atrophied tears in young, active patients who do not want to proceed with a reverse total shoulder replacement.


Assuntos
Produtos Biológicos , Lesões do Manguito Rotador , Humanos , Manguito Rotador/cirurgia , Produtos Biológicos/uso terapêutico , Resultado do Tratamento , Lesões do Manguito Rotador/cirurgia , Artroscopia
13.
Clin Sports Med ; 42(1): 69-79, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375871

RESUMO

Unique biomechanical factors in the overhead and throwing athlete lead to a spectrum of rotator cuff pathology, usually with progressive lateralization of the supraspinatus footprint. Initial comprehensive nonoperative management is indicated for all athletes. Progression to arthroscopic debridement, repair of concomitant injuries, and possible rotator cuff repair with a transosseous equivalent technique are the current management strategies for athletes when nonoperative management fails.


Assuntos
Lesões do Manguito Rotador , Humanos , Lesões do Manguito Rotador/diagnóstico , Lesões do Manguito Rotador/cirurgia , Artroscopia/métodos , Manguito Rotador/cirurgia , Atletas , Resultado do Tratamento
14.
Clin Sports Med ; 42(1): 157-173, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375867

RESUMO

Most massive rotator cuff tears (MCTs) are often successfully treated with nonoperative treatment; however, various surgical treatment options are available if conservative management fails. Several joint preserving techniques for MCT are commonly used, but the options are limited if an MCT is irreparable. Reverse total shoulder arthroplasty (RTSA) is gaining popularity over hemiarthroplasty as a treatment option for irreparable MCT, especially if glenohumeral degenerative changes are present. RTSA has been shown to have improved functional outcomes and range of motion postoperatively, particularly in the elderly and patients with pseudoparalysis.


Assuntos
Artroplastia do Ombro , Hemiartroplastia , Lesões do Manguito Rotador , Articulação do Ombro , Humanos , Idoso , Lesões do Manguito Rotador/cirurgia , Articulação do Ombro/cirurgia , Resultado do Tratamento , Amplitude de Movimento Articular
15.
Gastrointest Endosc Clin N Am ; 33(1): 15-28, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375879

RESUMO

Endoscopic submucosal dissection (ESD) is a technically complex and still evolving procedure. As a result, there are many advances in the technology and tools available to assist the endoscopist. This article delves into the various tools developed for ESD including electrosurgical knives, caps, injection agents, and traction devices. The authors discuss tools available as well as their respective pros, cons, and technical considerations for use. Overall, the choice of tools depends on a multitude of factors from availability, cost, lesion characteristics, and the endoscopist's familiarity and proficiency.


Assuntos
Dissecação , Ressecção Endoscópica de Mucosa , Humanos , Dissecação/métodos , Endoscopia Gastrointestinal , Resultado do Tratamento
16.
Gastrointest Endosc Clin N Am ; 33(1): 155-168, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375880

RESUMO

Colorectal cancer is the third most common cancer worldwide and the fourth leading cause of cancer-related deaths in the world, second in the United States. Although most lesions are managed surgically especially when they have already invaded into the submucosal layer, endoscopic full-thickness resection (EFTR) has become an emerging technique that can serve as a safe and effective alternative management for locally invasive gastrointestinal cancers. This article discusses the indications and various techniques and limitations of nontunneled EFTRs of gastrointestinal cancer and reviews the current literature on the outcomes of EFTR.


Assuntos
Ressecção Endoscópica de Mucosa , Neoplasias Gastrointestinais , Humanos , Estudos Retrospectivos , Resultado do Tratamento , Ressecção Endoscópica de Mucosa/métodos , Neoplasias Gastrointestinais/cirurgia
17.
Gastrointest Endosc Clin N Am ; 33(1): 143-154, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375878

RESUMO

The concept of third space endoscopy is based on the principle that the deeper layers of the gastrointestinal tract can be accessed by tunneling in the submucosal space and maintaining the integrity of the overlying mucosa. The mucosal flap safety valve enabled endoscopists to use submucosal space securely. The era of third space endoscopy started with peroral endoscopic myotomy for treatment of achalasia and has expanded to treat various other gastrointestinal disorders, such as mucosal lesions, submucosal tumors, extraluminal tumors, and refractory gastroparesis, Zenker diverticulum, and restoration of the completely obstructed esophageal lumen. Third space endoscopy rapidly emerged as a minimally invasive alternative to conventional surgery. Many studies discovered that this technique is safe and effective with excellent outcomes. Our review focused on the indications, techniques, clinical management, and adverse events of submucosal tunneling techniques for tumor resection.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Ressecção Endoscópica de Mucosa , Acalasia Esofágica , Neoplasias Esofágicas , Neoplasias Gástricas , Humanos , Ressecção Endoscópica de Mucosa/métodos , Membrana Mucosa/patologia , Membrana Mucosa/cirurgia , Endoscopia Gastrointestinal , Resultado do Tratamento , Neoplasias Esofágicas/etiologia , Neoplasias Gástricas/cirurgia
18.
Clin Sports Med ; 42(1): 53-68, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375870

RESUMO

Symptomatic rotator cuff pathology is a common musculoskeletal issue with evolving surgical indications. Most of the patients undergo some form of nonoperative treatment before considering surgical intervention. Understanding and optimizing nonoperative treatment modalities is an essential key to successful treatment. This article contains a review of the current literature regarding the risks, benefits, and alternatives of the most common injections used in the treatment of rotator cuff pathology. Injection options covered include corticosteroids, biologics including platelet-rich plasma and stem cells, hyaluronic acid, and nonsteroidal anti-inflammatory drugs.


Assuntos
Produtos Biológicos , Plasma Rico em Plaquetas , Lesões do Manguito Rotador , Humanos , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/terapia , Produtos Biológicos/uso terapêutico , Resultado do Tratamento
19.
Gastrointest Endosc Clin N Am ; 33(1): 99-125, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375890

RESUMO

Third space endoscopy or submucosal endoscopy using a mucosal flap valve allows secure access to the submucosal and deeper layers of the gastrointestinal tract without the risk of a full-thickness perforation. This allows the performance of submucosal tunneling and myotomy for spastic segments of the gastrointestinal tract. Per oral endoscopic myotomy (POEM) has been described for the treatment of achalasia cardia and other spastic esophageal disorders and is widely implemented. Endoscopic pyloromyotomy (G-POEM) has been performed for the treatment of refractory gastroparesis. Z-POEM for Zenker's diverticulum, D-POEM for epiphrenic diverticulum, and per-rectal endoscopic myotomy for treatment of Hirschsprung's disease are described..


Assuntos
Acalasia Esofágica , Miotomia , Cirurgia Endoscópica por Orifício Natural , Humanos , Canal Anal , Espasticidade Muscular , Acalasia Esofágica/cirurgia , Boca/cirurgia , Resultado do Tratamento
20.
Gastrointest Endosc Clin N Am ; 33(1): 55-66, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36375886

RESUMO

Endoscopic submucosal dissection (ESD) is well-accepted endoscopic resection modality for esophageal lesions with benefits in certain situations. ESD offers potential cure for early esophageal cancer and detailed pathologic information for risk stratification. Techniques are mostly standardized, and the use of traction method is encouraged. Indication and proper techniques of ESD in esophageal disease and clinical outcomes will be discussed in this article with pearls for care planning and management during periprocedural period.


Assuntos
Adenocarcinoma , Esôfago de Barrett , Ressecção Endoscópica de Mucosa , Neoplasias Esofágicas , Humanos , Ressecção Endoscópica de Mucosa/métodos , Esôfago de Barrett/cirurgia , Esôfago de Barrett/patologia , Esofagoscopia/métodos , Adenocarcinoma/patologia , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/patologia , Resultado do Tratamento
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