Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 9 de 9
Filtrar
Más filtros

Métodos Terapéuticos y Terapias MTCI
Bases de datos
País/Región como asunto
Tipo del documento
Intervalo de año de publicación
1.
Arch Orthop Trauma Surg ; 143(9): 5701-5706, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37219597

RESUMEN

INTRODUCTION: Climbing up and down stairs with crutches is a particular challenge. The current study evaluates a commercially available insole orthosis device for weighing an affected limb and for biofeedback training of gait. This study was done on healthy, asymptomatic individuals before applying to the intended postoperative patient. The outcomes should demonstrate whether a continuous real-time biofeedback (BF) system is more effective on stairs than the current protocol involving a bathroom scale. MATERIALS AND METHODS: 59 healthy test subjects received both crutches and an orthosis and learned to apply a 3-point gait with a partial load of 20 kg using a bathroom scale. Thereafter, the participants were asked to complete an up-and-down course, first without (control group) and then with (test group) an audio-visual real-time biofeedback (BF). Compliance was evaluated using an insole pressure measurement system. RESULTS: Using the conventional therapy technique, 36.6% of the steps up and 39.1% of the steps down in the control group were loaded with < 20 kg. By activating continuous biofeedback, steps with < 20 kg could be increased significantly to 61.1% upstairs (p < 0.001) and 66.1% downstairs (p < 0.001). All subgroups profited from the BF system, independent of age, gender, side relieved, dominant or non-dominant side. CONCLUSIONS: Traditional training without biofeedback led to poor performance for partial weight bearing on stairs, even among young and healthy individuals. However, continuous real-time biofeedback clearly improved compliance, indicating its potential to enhance training and support future research in patient populations.


Asunto(s)
Biorretroalimentación Psicológica , Soporte de Peso Parcial , Humanos , Soporte de Peso , Biorretroalimentación Psicológica/métodos , Marcha , Aparatos Ortopédicos
2.
Thorax ; 77(9): 900-912, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-34848555

RESUMEN

BACKGROUND: Risk factors for severe COVID-19 include older age, male sex, obesity, black or Asian ethnicity and underlying medical conditions. Whether these factors also influence susceptibility to developing COVID-19 is uncertain. METHODS: We undertook a prospective, population-based cohort study (COVIDENCE UK) from 1 May 2020 to 5 February 2021. Baseline information on potential risk factors was captured by an online questionnaire. Monthly follow-up questionnaires captured incident COVID-19. We used logistic regression models to estimate multivariable-adjusted ORs (aORs) for associations between potential risk factors and odds of COVID-19. RESULTS: We recorded 446 incident cases of COVID-19 in 15 227 participants (2.9%). Increased odds of developing COVID-19 were independently associated with Asian/Asian British versus white ethnicity (aOR 2.28, 95% CI 1.33 to 3.91), household overcrowding (aOR per additional 0.5 people/bedroom 1.26, 1.11 to 1.43), any versus no visits to/from other households in previous week (aOR 1.31, 1.06 to 1.62), number of visits to indoor public places (aOR per extra visit per week 1.05, 1.02 to 1.09), frontline occupation excluding health/social care versus no frontline occupation (aOR 1.49, 1.12 to 1.98) and raised body mass index (BMI) (aOR 1.50 (1.19 to 1.89) for BMI 25.0-30.0 kg/m2 and 1.39 (1.06 to 1.84) for BMI >30.0 kg/m2 versus BMI <25.0 kg/m2). Atopic disease was independently associated with decreased odds (aOR 0.75, 0.59 to 0.97). No independent associations were seen for age, sex, other medical conditions, diet or micronutrient supplement use. CONCLUSIONS: After rigorous adjustment for factors influencing exposure to SARS-CoV-2, Asian/Asian British ethnicity and raised BMI were associated with increased odds of developing COVID-19, while atopic disease was associated with decreased odds. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04330599).


Asunto(s)
COVID-19 , COVID-19/epidemiología , Estudios de Cohortes , Humanos , Estudios Longitudinales , Masculino , Estudios Prospectivos , Factores de Riesgo , SARS-CoV-2 , Reino Unido/epidemiología
3.
Clin Nutr ; 37(5): 1448-1455, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-28866140

RESUMEN

BACKGROUND & AIMS: Surgical trauma leads to an inflammatory response that causes surgical morbidity. Reduced antioxidant micronutrient (AM)a levels and/or excessive levels of Reactive Oxygen Species (ROS)b have previously been linked to delayed wound healing and presence of chronic wounds. We aimed to evaluate the effect of pre-operative supplementation with encapsulated fruit and vegetable juice powder concentrate (JuicePlus+®) on postoperative morbidity and Quality of Life (QoL)c. METHODS: We conducted a randomised, double-blind, placebo-controlled two-arm parallel clinical trial evaluating postoperative morbidity following lower third molar surgery. Patients aged between 18 and 65 years were randomised to take verum or placebo for 10 weeks prior to surgery and during the first postoperative week. The primary endpoint was the between-group difference in QoL over the first postoperative week, with secondary endpoints being related to other measures of postoperative morbidity (pain and trismus). RESULTS: One-hundred and eighty-three out of 238 randomised patients received surgery (Intention-To-Treat population). Postoperative QoL tended to be higher in the active compared to the placebo group. Furthermore, reduction in mouth opening 2 days after surgery was 3.1 mm smaller (95% CI 0.1, 6.1), the mean pain score over the postoperative week was 8.5 mm lower (95% CI 1.8, 15.2) and patients were less likely to experience moderate to severe pain on postoperative day 2 (RR 0.58, 95% CI 0.35, 0.95), comparing verum to placebo groups. CONCLUSION: Pre-operative supplementation with a fruit and vegetable supplement rich in AM may improve postoperative QoL and reduce surgical morbidity and post-operative complications after surgery. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01145820; Registered June 16, 2010.


Asunto(s)
Suplementos Dietéticos , Jugos de Frutas y Vegetales , Atención Perioperativa/métodos , Complicaciones Posoperatorias/dietoterapia , Complicaciones Posoperatorias/epidemiología , Adolescente , Adulto , Anciano , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polvos , Calidad de Vida , Resultado del Tratamiento , Reino Unido/epidemiología , Adulto Joven
4.
Clin Oral Implants Res ; 27(6): 701-6, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26178580

RESUMEN

OBJECTIVES: Maxillary sinus augmentation procedures with bone replacement grafts aimed to increase bone height in the posterior maxilla. During healing, bone particles are partially resorbed and replaced by the patient's own bone. Vitamin D plays an essential role in calcium homeostasis and is critical for bone formation and remodeling. MATERIALS AND METHODS: This randomized, double-blind, placebo-controlled clinical investigation studied whether oral supplementation with vitamin D3 (5000 IU) combined with calcium (600 mg) impacts bone formation and remodeling after maxillary sinus augmentation compared to a placebo medication containing calcium alone (n = 10/group). Bone cores were harvested at the time of implant placement (6-8 months) for histological analysis. RESULTS: Serum 25-hydroxyvitamin D (25-OHD) levels were comparable between both groups at the baseline (P = nonsignificant [n.s.]). Vitamin D3+ calcium supplementation improved significantly serum 25-OHD levels (placebo vs. vitamin D3 group: 25-OHD ng/ml: 31.13 ± 7.06 vs. 61.11 ± 20.42, P ≤ 0.01); however, no statistically significant difference in bone formation or graft resorption was detected between groups. However, in the vitamin D3 group, a significant association was found between increased vitamin D levels and number of bone-resorbing osteoclasts around graft particles suggesting that local bone remodeling might be more pronounced when serum vitamin D levels were improved (r = 0.92, P ≤ 0.05). CONCLUSIONS: Vitamin D3+ calcium supplementation improves serum vitamin D levels and potentially impacts local bone remodeling on a cellular level. However, no statistically significant difference in bone formation or graft resorption was detected between groups.


Asunto(s)
Remodelación Ósea/efectos de los fármacos , Colecalciferol/administración & dosificación , Osteogénesis/efectos de los fármacos , Elevación del Piso del Seno Maxilar , Densidad Ósea , Calcio/administración & dosificación , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vitamina D/sangre
5.
Artículo en Inglés | MEDLINE | ID: mdl-22762920

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the applicability and limitations of a novel atraumatic extraction system. STUDY DESIGN: Seventy-two patients with severely decayed teeth or root remnants not suitable for forceps extraction were consecutively recruited and had 111 teeth extracted with the use of a novel atraumatic vertical extraction system (Benex). Various patient, tooth, and procedure data were recorded and analyzed. RESULTS: Overall, 92 out of 111 teeth (83%) were successfully extracted. The success rate was higher in single-rooted teeth (89%) and lower in multirooted teeth (43%), with a risk ratio for failure of multirooted versus single-rooted teeth of 5.2 (95% confidence interval 2.5-10.7). The majority of failures were characterized by insufficient retention of the screw and/or root fracture, which mainly occurred as a result of caries in the root canal, misplacement/misalignment of the screw by the surgeon, or a fracture of the root in response to drilling and/or moderate input of traction force. CONCLUSIONS: The Benex extractor system may be successfully used for atraumatic tooth extraction. The system has a higher success rate with single-rooted teeth compared with multirooted teeth. Extraction failure is mostly associated with insufficient retention or misplacement of the screw and root fracture.


Asunto(s)
Extracción Dental/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anestesia Local , Caries Dental/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Extracción Dental/instrumentación , Raíz del Diente/cirugía , Resultado del Tratamiento
6.
J Bone Miner Res ; 24(5): 935-42, 2009 May.
Artículo en Inglés | MEDLINE | ID: mdl-19113911

RESUMEN

A higher calcium intake is still the primary recommendation for the prevention of osteoporosis, whereas vitamin D deficiency is often not addressed. To study the relative importance of dietary calcium intake and serum 25-hydroxyvitamin D [25(OH)D] status in regard to hip BMD, 4958 community-dwelling women and 5003 men >/=20 yr of age from the U.S. NHANES III population-based survey were studied. Calcium supplement users and individuals with a prior radius or hip fracture were excluded. We calculated standardized means for BMD by quartiles of sex-specific calcium intake for three 25(OH)D categories (<50, 50-74, and 75+ nM) among men and women, separately controlling for other important predictors of BMD. A higher calcium intake was significantly associated with higher BMD (p value for trend: p = 0.005) only for women with 25(OH)D status <50 nM, whereas calcium intake beyond the upper end of the lowest quartile (>566 mg/d) was not significantly associated with BMD at 25(OH)D concentrations >50 nM. Among men, there was no significant association between a higher calcium intake beyond the upper end of the lowest quartile (626 mg/d) and BMD within all 25(OH)D categories. Among both sexes, BMD increased stepwise and significantly with higher 25(OH)D concentrations (<50, 50-74, 75+ nM; p value for trend: women < 0.0001; men = 0.0001). Among men and women, 25(OH)D status seems to be the dominant predictor of BMD relative to calcium intake. Only women with 25(OH)D concentrations <50 nM seem to benefit from a higher calcium intake.


Asunto(s)
Densidad Ósea/fisiología , Calcio de la Dieta/administración & dosificación , Vitamina D/análogos & derivados , Adulto , Anciano , Anciano de 80 o más Años , Dieta/estadística & datos numéricos , Femenino , Cadera/fisiología , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Vitamina D/sangre
7.
Am J Clin Nutr ; 82(3): 575-80, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16155270

RESUMEN

BACKGROUND: Vitamin D has been shown to have immunomodulatory effects in in vitro and in animal studies. However, data from clinical studies of inflammatory diseases are scarce. OBJECTIVE: The purpose of this study was to evaluate the association between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and gingival inflammation. DESIGN: We analyzed data from 77,503 gingival units (teeth) in 6700 never smokers aged 13 to >90 y from the third National Health and Nutrition Examination Survey. Multiple logistic regression models adjusted for subject- and site-specific covariates included age, sex, race-ethnicity, income, body mass index, diabetes, use of oral contraceptives and hormone replacement therapy among women, intake of vitamin C, missing teeth, full crown coverage, presence of calculus, frequency of dental visits, and dental examiner and survey phase. Generalized estimating equations were used to account for correlated observations within subjects. RESULTS: Compared with sites in subjects in the lowest 25(OH)D quintile, sites in subjects in the highest 25(OH)D quintile were 20% (95% CI: 8%, 31%) less likely to bleed on gingival probing (P for trend < 0.001). The association appeared to be linear over the entire 25(OH)D range, was consistent across racial or ethnic groups, and was similar among men and women as well as among users and nonusers of vitamin and mineral supplements. CONCLUSIONS: Vitamin D may reduce susceptibility to gingival inflammation through its antiinflammatory effects. Gingivitis may be a useful clinical model to evaluate the antiinflammatory effects of vitamin D.


Asunto(s)
Hemorragia Gingival/epidemiología , Gingivitis/epidemiología , Deficiencia de Vitamina D/complicaciones , Vitamina D/análogos & derivados , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Hemorragia Gingival/sangre , Hemorragia Gingival/etiología , Gingivitis/sangre , Gingivitis/etiología , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Estado Nutricional , Enfermedades Periodontales/sangre , Enfermedades Periodontales/epidemiología , Enfermedades Periodontales/etiología , Índice Periodontal , Radioinmunoensayo , Estados Unidos/epidemiología , Vitamina D/sangre , Deficiencia de Vitamina D/sangre
8.
JAMA ; 293(18): 2257-64, 2005 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-15886381

RESUMEN

CONTEXT: The role and dose of oral vitamin D supplementation in nonvertebral fracture prevention have not been well established. OBJECTIVE: To estimate the effectiveness of vitamin D supplementation in preventing hip and nonvertebral fractures in older persons. DATA SOURCES: A systematic review of English and non-English articles using MEDLINE and the Cochrane Controlled Trials Register (1960-2005), and EMBASE (1991-2005). Additional studies were identified by contacting clinical experts and searching bibliographies and abstracts presented at the American Society for Bone and Mineral Research (1995-2004). Search terms included randomized controlled trial (RCT), controlled clinical trial, random allocation, double-blind method, cholecalciferol, ergocalciferol, 25-hydroxyvitamin D, fractures, humans, elderly, falls, and bone density. STUDY SELECTION: Only double-blind RCTs of oral vitamin D supplementation (cholecalciferol, ergocalciferol) with or without calcium supplementation vs calcium supplementation or placebo in older persons (> or =60 years) that examined hip or nonvertebral fractures were included. DATA EXTRACTION: Independent extraction of articles by 2 authors using predefined data fields, including study quality indicators. DATA SYNTHESIS: All pooled analyses were based on random-effects models. Five RCTs for hip fracture (n = 9294) and 7 RCTs for nonvertebral fracture risk (n = 9820) met our inclusion criteria. All trials used cholecalciferol. Heterogeneity among studies for both hip and nonvertebral fracture prevention was observed, which disappeared after pooling RCTs with low-dose (400 IU/d) and higher-dose vitamin D (700-800 IU/d), separately. A vitamin D dose of 700 to 800 IU/d reduced the relative risk (RR) of hip fracture by 26% (3 RCTs with 5572 persons; pooled RR, 0.74; 95% confidence interval [CI], 0.61-0.88) and any nonvertebral fracture by 23% (5 RCTs with 6098 persons; pooled RR, 0.77; 95% CI, 0.68-0.87) vs calcium or placebo. No significant benefit was observed for RCTs with 400 IU/d vitamin D (2 RCTs with 3722 persons; pooled RR for hip fracture, 1.15; 95% CI, 0.88-1.50; and pooled RR for any nonvertebral fracture, 1.03; 95% CI, 0.86-1.24). CONCLUSIONS: Oral vitamin D supplementation between 700 to 800 IU/d appears to reduce the risk of hip and any nonvertebral fractures in ambulatory or institutionalized elderly persons. An oral vitamin D dose of 400 IU/d is not sufficient for fracture prevention.


Asunto(s)
Fracturas Óseas/prevención & control , Vitamina D/uso terapéutico , Anciano , Colecalciferol/uso terapéutico , Suplementos Dietéticos , Ergocalciferoles/uso terapéutico , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Vitamina D/administración & dosificación
9.
Neuropsychologia ; 42(5): 563-8, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-14725794

RESUMEN

Intrinsic alertness designates the internal (cognitive) control of wakefulness and arousal; typical tasks to assess optimal levels of intrinsic alertness are simple reaction time (RT) measurements without preceding warning stimuli. Until now, cerebral networks subserving alertness after visual and somatosensory stimulation have been reported. Studies concerning other intensity aspects of alertness like sustained attention and vigilance, on the other hand, have been performed in the auditory modality, too. In a 15O-butanol PET-activation study in 10 right-handed young healthy male volunteers an intrinsic alertness network was studied for the auditory modality. In contrast with a sensorimotor control condition we found an extended predominantly right-hemisphere network similar to those reported for other sensory modalities including frontal, cingular, inferior parietal, temporal and thalamic structures, when subjects waited for and rapidly responded to a 1000 Hz tone signal by pressing a response key with the right-hand thumb. There were, however, some differences in the topography of the frontal, temporal and thalamic activations between auditory and visual stimulation which are discussed with respect to similar results for auditory vigilance and auditory selective attention tasks reported in the literature.


Asunto(s)
Atención/fisiología , Percepción Auditiva/fisiología , Corteza Cerebral/fisiología , Red Nerviosa/fisiología , Detección de Señal Psicológica/fisiología , Tomografía Computarizada de Emisión , Estimulación Acústica , Adulto , Mapeo Encefálico , Corteza Cerebral/anatomía & histología , Circulación Cerebrovascular , Dominancia Cerebral/fisiología , Humanos , Masculino , Desempeño Psicomotor/fisiología , Tiempo de Reacción
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA