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BACKGROUND: There is conflicting evidence regarding the presence and magnitude of exercise-induced muscle damage (EIMD) following low-load resistance training with blood flow restriction (LL+BFR), which may be related to the protocol implemented or exercise volume. Therefore, the purpose of this investigation was to examine the effects of a 75 repetition (BFR-75) (1×30, 3×15) and four sets to volitional failure (BFR-4x) protocols on indices of EIMD among untrained men. METHODS: Twelve males with no history of lower-body resistance training during the previous six months volunteered for this investigation. One leg was randomly assigned to BFR-75, and the other to BFR-4x. Participants performed isokinetic, unilateral, concentric-eccentric, leg extension muscle actions at 30% of maximal strength with BFR. Indices of EIMD (limb circumference, perceived muscle soreness, pain pressure threshold [PPT], passive range of motion, and maximal strength [MVIC]) were recorded before exercise and 0, 24, 48, 72, and 96-hours post-exercise for each protocol. RESULTS: There were no significant changes (P>0.05) in limb circumference, PPT, passive range of motion, or MVIC. For both BFR-75 and BFR-4x, perceived muscle soreness increased (P<0.001) similarly 24- (2.5±1.7 AU) and 48-hours (1.9±1.7 AU) post-exercise. CONCLUSIONS: There was an increase in muscle soreness 24-48 hours post-exercise for both conditions, which may be due to metabolic stress, but this did not affect the force-generating capacity of the muscle (MVIC), suggesting minimal EIMD. The conflicting evidence of EIMD following LL+BFR may be related to differences in restriction time or overall exercise time.
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Homoleptic complexes [Fe(4bt)3](ClO4)2 (1), [Fe(2bt)3](ClO4)2 (2), and [Fe(3tpH)3](ClO4)2 (3) were obtained by a reaction between the Fe(II) precursor salt and the corresponding thiazole-based bidentate ligand (L = 4bt = 4,4'-bithiazole, 2bt = 2,2'-bithiazole, 3tpH = 3-(thiazol-2-yl)pyrazole). X-ray crystal structure determination revealed crystallization of solvent-free complex 1, a solvate 2·MeOH, and a co-crystal 3·2(3tpH). The crystal packing of all these complexes is dominated by one-dimensional interactions between the [Fe(L)3]2+ cations. These interactions are stronger in 2·MeOH and 3·2(3tpH), leading to cooperative and slightly hysteretic transitions between the high-spin and low-spin electronic configurations at â¼235 K and 159 K, respectively. In contrast, weaker intermolecular interactions in 1 result in a gradual spin crossover above 300 K, with the maximum fraction of the HS state â¼25% achieved at 400 K. Complexes 2 and 3·2(3tpH) exhibit light-induced excited spin state trapping (LIESST) under irradiation with white light or a 532 nm laser at 5 K. After the photoexcitation, the trapped metastable HS state relaxes to the ground LS state with the average relaxation temperature of 81 K and 68 K, respectively. Examination of the relaxation dynamics by optical absorption spectroscopy on a single crystal of 3·2(3tpH) revealed the sigmoidal shape of the relaxation curves at lower temperatures, attributed to cooperative effects, as well as a plateau at â¼10% of the HS fraction at intermediate temperatures, hinting at a more complex mechanism for the relaxation of the LIESST phase in this material.
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PURPOSE: To determine the effect of playing patient-selected music intraoperatively on patient self-reported anxiety and the amount of sedative administered during cataract surgery. SETTING: Yale New Haven Hospital health system, New Haven, Connecticut. DESIGN: Prospective, randomized, controlled clinical trial. METHODS: Patients were randomized to either a music group or a control group, which had no music played. Patients were blinded to the purpose of the study. On postoperative day 1, patients were consented to participate in the study and asked to complete a 6-question Likert-style survey (modified from the State-Trait Anxiety Inventory) assessing anxiety at baseline and during surgery. Patients' intraoperative and postoperative vitals were recorded. The medication, dosage, and number of sedative injections given were also recorded. Paired t tests were used to assess for significant differences between the 2 groups. RESULTS: 107 patients (mean age 71.2 years) were enrolled in the study. There was no significant difference in baseline anxiety between the 2 groups. Patients randomized to the music group had significantly lower total self-reported anxiety (mean 5.98) than the control group (mean 7.13, P = .006). Moreover, patients exposed to music felt significantly less frightened, nervous, and confused during surgery ( P = .002, .007, and 0.017, respectively). There was no significant difference between the groups in number and dosage of sedatives given. CONCLUSIONS: Playing patient-selected music during cataract surgery is an effective way to decrease anxiety. Music directly affects patient experience and is an inexpensive, low-risk method of reducing patient anxiety during surgery.
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Ansiedade , Musicoterapia , Humanos , Estudos Prospectivos , Idoso , Masculino , Feminino , Ansiedade/prevenção & controle , Musicoterapia/métodos , Facoemulsificação , Implante de Lente Intraocular , Inquéritos e Questionários , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/uso terapêutico , Extração de CatarataRESUMO
BFR) applied during sprint interval training (SIT) on performance and neuromuscular function. METHODS: Fifteen men completed a randomized bout of SIT with CBFR, IBFR, and without BFR (No-BFR), consisting of 2, 30-s maximal sprints on a cycle ergometer with a resistance of 7.5% of body mass. Concentric peak torque (CPT), maximal voluntary isometric contraction (MVIC) torque, and muscle thickness (MT) were measured before and after SIT, including surface electromyography (sEMG) recorded during the strength assessments. Peak and mean revolutions per minute (RPM) were measured during SIT and power output was examined relative to physical working capacity at the fatigue threshold (PWCFT). RESULTS: CPT and MVIC torque decreased from pre-SIT (220.3±47.6 Nm and 355.1±72.5 Nm, respectively) to post-SIT (147.9±27.7 Nm and 252.2±45.5 Nm, respectively, all P<0.05), while MT increased (1.77±0.31 cm to 1.96±0.30 cm). sEMG mean power frequency decreased during CPT (-12.8±10.5%) and MVIC (-8.7±10.2%) muscle actions. %PWCFT was greater during No-BFR (414.2±121.9%) than CBFR (375.9±121.9%). CONCLUSION: SIT with or without BFR induced comparable alterations in neuromuscular fatigue and sprint performance across all conditions, without affecting neuromuscular function.
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Treinamento Intervalado de Alta Intensidade , Músculo Esquelético , Humanos , Masculino , Eletromiografia , Contração Isométrica/fisiologia , Fadiga Muscular , Músculo Esquelético/fisiologia , Fluxo Sanguíneo Regional/fisiologia , TorqueRESUMO
Objective. Surface mechanomyography (sMMG) can measure oscillations of the activated muscle fibers in three axes (i.e.X,Y, andZ-axes) and has been used to describe motor unit activation patterns (X-axis). The application of blood flow restriction (BFR) is common in exercise studies, but the cuff may restrict muscle fiber oscillations. Therefore, the purpose of this investigation was to examine the acute effects of submaximal, fatiguing exercise with and without BFR on sMMG amplitude in theX,Y, andZ-axes among female participants.Approach. Sixteen females (21 ± 1 years) performed two separate exercise bouts to volitional exhaustion that consisted of unilateral, submaximal (50% maximal voluntary isometric contraction [MVIC]) intermittent, isometric, leg extensions with and without BFR. sMMG was recorded and examined across percent time to exhaustion (%TTE) in 20% increments. Separate 2-way repeated measures ANOVA models were constructed: (condition [BFR, non-BFR]) × (time [20, 40, 60, 80, and 100% TTE]) to examine absolute (m·s-2) and normalized (% of pretest MVIC) sMMG amplitude in theX-(sMMG-X),Y-(sMMG-Y), andZ-(sMMG-Z) axes.Main results. The absolute sMMG-X amplitude responses were attenuated with the application of BFR (mean ± SD = 0.236 ± 0.138 m·s-2) relative to non-BFR (0.366 ± 0.199 m·s-2, collapsed across time) and for sMMG-Y amplitude at 60%-100% of TTE (BFR range = 0.213-0.232 m·s-2versus non-BFR = 0.313-0.445 m·s-2). Normalizing sMMG to pretest MVIC removed most, but not all the attenuation which was still evident for sMMG-Y amplitude at 100% of TTE between BFR (72.9 ± 47.2%) and non-BFR (98.9 ± 53.1%). Interestingly, sMMG-Z amplitude was not affected by the application of BFR and progressively decreased across %TTE (0.332 ± 0.167 m·s-2to 0.219 ± 0.104 m·s-2, collapsed across condition.)Significance. The application of BFR attenuated sMMG-X and sMMG-Y amplitude, although normalizing sMMG removed most of this attenuation. Unlike theXandY-axes, sMMG-Z amplitude was not affected by BFR and progressively decreased across each exercise bout potentially tracking the development of muscle fatigue.
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Fadiga Muscular , Treinamento Resistido , Humanos , Feminino , Fadiga Muscular/fisiologia , Exercício Físico/fisiologia , Contração Isométrica/fisiologia , Fluxo Sanguíneo Regional , Modalidades de Fisioterapia , Músculo Esquelético/fisiologia , Eletromiografia , Treinamento Resistido/métodosRESUMO
ABSTRACT: Wizenberg, AM, Gonzalez-Rojas, D, Rivera, PM, Proppe, CE, Laurel, KP, Stout, JR, Fukuda, DH, Billaut, F, Keller, JL, and Hill, EC. Acute effects of continuous and intermittent blood flow restriction on sprint interval performance and muscle oxygen responses. J Strength Cond Res 37(10): e546-e554, 2023-This investigation aimed to examine the acute effects of continuous and intermittent blood flow restriction (CBFR and IBFR, respectively) during sprint interval training (SIT) on muscle oxygenation, sprint performance, and ratings of perceived exertion (RPE). Fifteen men (22.6 ± 2.4 years; 176 ± 6.3 cm; 80.0 ± 12.6 kg) completed in random order a SIT session with CBFR, IBFR (applied during rest), and no blood flow restriction (NoBFR). Each SIT session consisted of two 30-second all-out sprint tests separated by 2 minutes. Peak power (PP), total work (TW), sprint decrement score (S dec ), RPE, and muscle oxygenation were measured during each sprint. A p value ≤0.05 was considered statistically significant. PP decreased to a greater extent from sprint 1 to sprint 2 during CBFR (25.5 ± 11.9%) and IBFR (23.4 ± 9.3%) compared with NoBFR (13.4 ± 8.6%). TW was reduced similarly (17,835.6 ± 966.2 to 12,687.2 ± 675.2 J) from sprint 1 to sprint 2 for all 3 conditions, but TW was lower (collapsed across time) for CBFR (14,320.7 ± 769.1 J) than IBFR (15,548.0 ± 840.5 J) and NoBFR (15,915.4 ± 771.5 J). There were no differences in S dec (84.3 ± 1.7%, 86.1 ± 1.5%, and 87.2 ± 1.1% for CBFR, IBFR, and NoBFR, respectively) or RPE, which increased from sprint 1 (8.5 ± 0.3) to sprint 2 (9.7 ± 0.1). Collective muscle oxygenation responses increased across time and were similar among conditions, whereas increases in deoxy[heme] and total[heme] were greatest for CBFR. Applying BFR during SIT induced greater decrements in PP, and CBFR resulted in greater decrements in work across repeated sprints. The larger increases in deoxy[heme] and total[heme] for CBFR suggested it may induce greater metabolite accumulation than IBFR and NoBFR when combined with SIT.
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Treinamento Intervalado de Alta Intensidade , Músculos , Humanos , Masculino , Heme , Oxigênio , Descanso , Adulto JovemRESUMO
PURPOSE: To study the relationship between female authorship and editorial board membership in 3 ophthalmology journals from 2012 to 2021. DESIGN: Cross-sectional and trend study. METHODS: The prevalence of female first, senior authorship, and editorial board members were examined in Ophthalmology, JAMA Ophthalmology, and American Journal of Ophthalmology. Gender-API assigned gender to authors based on name and country. Editorial board (EB) information was manually extracted and grouped for comparison among leadership positions. Gender data collected on authorship and EB membership were compared. The proportion of women in EB positions was identified: editor-in-chief, mid-level editors, and consulting editors. Relationship between female authorship and editorial board membership was analyzed. RESULTS: Women published fewer articles as first (1547/4267) and senior (1165/4267) authors than did men. The proportion of women in senior authorship significantly increased from 2012 to 2021 (23.4% to 30.5%, P = .0046). Across EB, a significant increase in female members (13.9% to 34.6%, P = .0006) was observed. There was a significant correlation (P < .0001) between female EB members and female authors (r = 0.74, 95% CI = 0.51-0.87) for all journals. The odds of female first authorships were 1.89 (95% CI = 1.65-2.17) times higher for articles with female senior authors than for male senior authors (P < .0001). CONCLUSION: Female senior authorship significantly increased over the last decade. Journals with a higher representation of female EB members also had a higher representation of female authorship. This study found a positive association between first and senior female authorship; however, the gender gap persists. Continued efforts to reach equity in publications and EB representation are necessary.
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OBJECTIVES: The purpose of this investigation was to examine the acute effects of low-load blood flow restriction (LLBFR) and low-load (LL) resistance exercise on muscle excitation, neuromuscular efficiency, and average torque. METHODS: Eleven men (age±SD=22±3yrs) randomly performed LLBFR and LL that consisted of 30 unilateral leg extensions at 30% of one-repetition maximum while surface electromyography (sEMG) and torque were simultaneously assessed. Polynomial regression analyses and slope comparisons were performed to examine patterns of responses and rates of change. RESULTS: sEMG amplitude increased for LLBFR (9 of 11) and LL (8 of 11) and between composite responses (R2=0.939-0.981). For LLBFR, sEMG amplitude increased to a greater extent for 5 of the 11 individual and for the composite responses. Similarly, neuromuscular efficiency decreased for LLBFR (8 of 11) and LL (5 of 11) as well as the composite responses r2=0.902-0.929, but the decrease was larger for LLBFR than LL for the individual (4 of 11) responses. For average submaximal concentric torque, there were individual increases, decreases, and no changes for the composite responses (R2=0.198-0.325). CONCLUSION: LLBFR elicited greater fatigue-induced increases in muscle excitation and decreases in neuromuscular efficiency than LL, but neither LLBFR nor LL affected average submaximal concentric torque.
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Músculo Esquelético , Treinamento Resistido , Humanos , Masculino , Eletromiografia , Exercício Físico/fisiologia , Músculo Esquelético/fisiologia , Torque , Adulto Jovem , AdultoRESUMO
OBJECTIVE: To assess the clinical effectiveness of fluticasone furoate nasal spray (FFNS) versus placebo on nasal symptoms and safety in children with perennial allergic rhinitis (AR). METHODS: A comprehensive review was conducted with data obtained from Medline and Embase databases up to April 2023. The population of interest was patients aged 2-12 years with perennial AR. The selection was limited to randomized controlled trials (RCTs), comparing FFNS with placebo. Outcomes of interest included the reflective total nasal symptoms scores (rTNSS) and safety. To assess the minimal clinically important difference for rTNSS, the Cohen's guideline was used. If the pooled standardized mean difference (SMD) and the lower limit of the 95 percent confidence interval (CI) exceeded the threshold of -0.20, effects were considered clinically significant. RESULTS: Three RCTs (959 pediatric patients) were selected. One study evaluated the short-term use of FFNS, another evaluated the long-term use of FFNS, and another evaluated both the short-term and long-term use of FFNS. FFNS produced a statistically significant reduction over placebo in rTNSS (SMD -0.18; 95 percent CI -0.35 to -0.01, p = 0.03) in long-term treatment studies, but not in short-term treatment studies. However, since the mean reduction did not reach the minimum clinically important difference (SMD -0.20), these results were considered clinically not relevant. Safety outcomes with FFNS were similar to placebo. CONCLUSIONS: The currently available evidence suggests that FFNS, 110 µg once daily, compared to placebo, does not produce a meaningful clinical effect on nasal symptom in children with perennial AR.
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Antialérgicos , Rinite Alérgica Perene , Humanos , Criança , Sprays Nasais , Rinite Alérgica Perene/tratamento farmacológico , Androstadienos/efeitos adversos , Resultado do Tratamento , Antialérgicos/uso terapêuticoRESUMO
PURPOSE: To describe the gender trends in ophthalmology primary practice areas using the American Board of Ophthalmology (ABO) diplomates. DESIGN: A trend study plus a cross-sectional study of the ABO's database. METHODS: The de-identified records of all (N = 12,844) ABO-certified ophthalmologists between 1992 and 2020 were obtained. The year of certification, gender, and self-reported primary practice for each ophthalmologist was recorded. Subspecialty was defined as the self-reported primary practice emphasis. Practice trends of the entire population and the subpopulation of subspecialists were explored based on gender and were then visualized using tables and graphs and analyzed using the χ2 or Fisher exact test. RESULTS: A total of 12,844 board-certified ophthalmologists were included. Nearly half (47%) reported a subspecialty as their primary practice area (n = 6042), of whom the majority were male (65%, n = 3940). In the first decade, men outnumbered women reporting subspecialty practices by more than 2:1. Over time, the number of women subspecialists increased whereas the number of men remained stable, such that by 2020 women comprised almost half of new ABO diplomates reporting subspecialty practice. When all subspecialists were compared within gender, there was not a significant difference (P = .15) between the percentage of male (46%) and female (48%) ophthalmologist reporting a subspecialty practice. However, a significantly greater proportion of women than men reported primary practice in pediatrics (20.1% vs 7.9%, P < .001) and glaucoma (21.8% vs 16.0%, P < .0001). Alternatively, a significantly greater proportion of men reported primary practice in vitreoretinal surgery (47.2% vs 22.0%, P < .0001). There was no significant difference between the proportion of men and women reporting cornea (P = .15) or oculoplastics (P = .31). CONCLUSIONS: The number of women in ophthalmology subspecialty practice has increased steadily over the past 30 years. Men and women subspecialize at the same rate, but significant differences exist between the types of ophthalmology practiced by each gender.
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Oftalmologistas , Oftalmologia , Humanos , Masculino , Feminino , Criança , Estados Unidos , Estudos Transversais , Certificação , AutorrelatoRESUMO
Díaz-Loving et al. (1986) diseñaron la Escala Multi- dimensional de Empatía (EASE), un instrumento culturalmente válido para población mexicana inspirado en la estructura conceptual del Índice de Reactividad Interpersonal (IRI) (Davis, 1980). En esta investigación presentamos evidencias de validez y confiabilidad de la Escala Corta de Empatía (ECE), una versión breve de la EASE aplicada a 674 participantes (50.8 % mujeres, 49.2 % hombres) mexicanos (M = 22.8 años, de = 9.2), además del IRI, preguntas de conductas prosociales y el Inventario de Personalidad de diez ítems como criterios externos de validez. El análisis factorial exploratorio mostró tres factores malestar personal, toma de perspectiva y compasión con niveles de confiabilidad adecuados. El análisis factorial confirmatorio verificó la estructura con indicadores de bondad de ajuste aceptables, obteniendo evidencias de equivalencia estructural para mujeres y hombres. Las relaciones de los tres factores de ECE con prosocialidad, personalidad y sexo proporcionan criterios de validez externa del instrumento.
The Multidimensional Empathy Scale (EASE), a culturally valid instrument for the Mexican population inspired by the conceptual structure of the Interpersonal Reactivity Index (IRI), from 1980, was designed in 1986. The article presents evidence of the validity and reliability of the short empathy scale (ECE), a short version of the EASE, applied to 674 Mexican partici- pants (50.8 % women, 49.2 % men; M = 22.8 years, sd = 9.2). They also answered questions on prosocial behaviors and the 10-item Personality Inventory as an external validity criterion. The exploratory factor analysis showed three factors (personal discomfort, perspective-taking, and compassion) with adequate levels of reliability. The confirmatory factor analysis verified the structure with acceptable goodness-of-fit indicators, obtaining evidence of structural equivalence for women and men. The relationships of the three ECE factors with prosociality, personality, and sex provide evidence of validity.
Diaz Loving et al. (1986) desenharam a Escala de Empatia Multidimensional (EASE), um instrumento cultu- ralmente válido para a população mexicana inspirado na estrutura conceitual do Índice de Reatividade Interpessoal (IRI) (Davis, 1980). Apresentamos evidências de validade e confiabilidade da escala curta de empatia (ECE), uma versão breve do EASE, aplicada a 674 participantes mexicanos (50.8 % mulheres, 49.2 % homens) (M = 22.8 anos, dP = 9.2). Além do IRI, rea- lizamos perguntas sobre comportamento pró-social e aplicamos o Inventário de Personalidade de 10 itens como critérios de validade externa. A análise fatorial exploratória mostrou três fatores (desconforto pessoal, tomada de perspectiva e compaixão) com níveis adequa- dos de confiabilidade. A análise fatorial confirmatória verificou a estrutura com indicadores de qualidade de ajuste aceitáveis, obtendo evidências de equivalência estrutural para mulheres e homens. As relações dos três fatores da ECE com pró-socialidade, personalidade e gênero fornecem critérios de validade externa para o instrumento.
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HumanosRESUMO
Applying blood flow restriction (BFR) during resistance exercise is a potent stimulus of muscular adaption, but there is little direct comparison of its effect on neuromuscular function. The purpose of this investigation was to compare surface electromyography amplitude and frequency responses during a 75 (1 × 30, 3 × 15) repetition bout (BFR-75) of BFR to 4 sets to failure (BFR-F). Twelve women (mean ± SD age = 22 ± 4 years; body mass = 72 ± 14.4 kg; height = 162.1 ± 4.0 cm) volunteered for the investigation. One leg was randomly assigned to complete BFR-75 and the other to BFR-F. Each leg performed isokinetic, unilateral, concentric-eccentric, leg extension at 30% of maximal strength while surface electromyographic (sEMG) data was recorded. More repetitions (p = 0.006) were completed during set 2 for BFR-F (21.2 ± 7.4) than BFR-75 (14.7 ± 1.2), but there were no other between condition differences for set 1 (29.8 ± 0.9 vs 28.9 ± 10.1), set 3 (14.4 ± 1.4 vs 17.1 ± 6.9), or set 4 (14.8 ± 0.9 vs 16.3 ± 7.0). Collapsed across condition, normalized sEMG amplitude increased (p = 0.014, 132.66 ± 14.03% to 208.21 ± 24.82%) across the first three sets of exercise then plateaued, while normalized sEMG frequency decreased (p = 0.342, 103.07 ± 3.89% to 83.73 ± 4.47%) across the first two sets then plateaued. The present findings indicated that BFR-75 and BFR-F elicited similar acute neuromuscular fatigue responses. The plateau in amplitude and frequency suggested that maximal motor unit excitation and metabolic buildup may be maximized after two to three sets of BFR-75 and BFR-F.
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ABSTRACTThere is conflicting evidence regarding the prevalence and magnitude of exercise-induced muscle damage (EIMD) following low-load resistance exercise with blood flow restriction (LL + BFR) that may be related to exercise protocols. The purpose of this investigation was to examine the effects of 75-repetition (BFR-75) (1 × 30, 3 × 15) and 4 sets to failure (BFR-4x) protocols on indices of EIMD among untrained women. Thirteen women completed this investigation. One leg was randomly assigned to BFR-75 and the other to BFR-4x. Each leg performed isokinetic, unilateral, concentric-eccentric, leg extension muscle actions at 30% of maximal strength. Indices of EIMD (muscle soreness, range of motion [ROM], limb circumference, pain pressure threshold [PPT], and maximal voluntary isometric contraction [MVIC]) were recorded before exercise, 0-, 24-, 48-, 72-, and 96-hours post-exercise. There were no changes for ROM, circumference, or PPT. Muscle soreness increased similarly in both conditions 0-, 24-, and 48-hours post-exercise and MVIC increased 24-, 48-, 72-, and 96-hours post-exercise. These findings suggested BFR-75 and BFR-4x were not associated with EIMD and elicited similar physiological responses. The increases in muscle soreness may be due to metabolic stress associated with LL + BFR protocols apart from EIMD.
HighlightsThere was no evidence of significant exercise-induced muscle damage following low-load resistance exercise with blood flow restriction completed failure and non-failure.Muscle function was not impaired 24-96â h post-exercise for either protocol.Low-load resistance exercise with blood flow restriction using a 75-repetition and 4 sets to volitional failure protocol resulted in similar physiological responses to exercise.There may be higher levels of metabolic stress which may increase muscle soreness following low-load resistance exercise with blood flow restriction.
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Mialgia , Treinamento Resistido , Humanos , Feminino , Terapia de Restrição de Fluxo Sanguíneo , Músculo Esquelético , Contração Isométrica , Perna (Membro) , Fluxo Sanguíneo Regional/fisiologia , Treinamento Resistido/métodosRESUMO
Retinal vasculitis (RV) refers to an entity in which the retinal vasculature is inflamed, frequently with indications of inflammation elsewhere in the eye. Non-infectious RV can be idiopathic or associated with systemic disease, ocular conditions, and malignancy. It can also be classified based on the vessel affected: artery, vein, or both. Due to the lack of strong evidence-based treatment trials and algorithms for RV, physicians must often rely on their experience, which creates great variability in treating this entity. This article provides an overview of various treatment modalities used in the management of non-infectious RV, with a focus on immunomodulatory therapies. We outline a potential stepwise approach of starting with steroids to control the acute inflammation and subsequently changing to immunomodulatory therapy (IMT) for long-term treatment.
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OBJECTIVE: The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children. METHODS: A cross-sectional survey was conducted in parents 6-18-month-old children who attended well-child outpatient clinics from two health systems (public employee-based insurance and private health care) in Guatemala City from November 2017 through August 2018. Parental demographics, household characteristics, food insecurity, vaccine hesitancy using the WHO SAGE Vaccine Hesitancy Scale, and information on parental use of social media platforms and vaccine information sources were collected. RESULTS: Five hundred-three parents were surveyed, most of them mothers. Only 9 parents reported they had previously refused a vaccine for their child: 8 (3.2 %) from private clinics and 1 (0.4 %) from the public clinic (p = 0.02). Significantly more children attending private clinics (226, 90.4 %) were shown to have a delay in any of their vaccines scheduled for the first 2 years of life compared to those in the public clinic (169, 66.8 %; p < 0.01). Children of parents having a college degree (84.5 vs 70.1 %; p < 0.001), earning more than US$ 1,000 per month (81.5 vs 70.7 %; p < 0.001), and having a computer at home (81.4 vs 70.2; p = 0.007) were more likely to have any delays in the scheduled vaccines. Parents seeking care at private clinics were 1.14 times more at risk of delaying a vaccine compared to those at the public clinic, adjusted for other covariates (p = 0.03, 95 % CI: 1.01, 1.28). CONCLUSIONS: In Guatemala, children receiving immunizations at private clinics were significantly more likely than those attending public clinics to be delayed in their immunization schedule and to remain more days without the recommended protection, especially for third doses of the primary vaccine series.
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Vacinação , Vacinas , Feminino , Humanos , Lactente , Guatemala , Estudos Transversais , Imunização , Pais , Atitude , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
The purpose of this investigation was to examine neuromuscular function, muscle fatigue, rating of perceived exertion (RPE), and muscle swelling between isokinetic and isotonic leg extensions with blood flow restriction (BFR). Fourteen (21 ± 2years; 160cm ± 3.8; 61kg ± 9.1) trained women performed 75 (1 × 30,3 × 15) submaximal (30% of maximal strength), unilateral, isokinetic and isotonic leg extensions with BFR (60% of total arterial occlusion pressure). Before and after exercise, subjects performed maximal voluntary isometric contractions (MVIC) and muscle thickness (MT) was assessed with ultrasound. RPE was recorded across all sets and surface electromyography (EMG) was assessed during the MVIC muscle actions. Separate repeated measures ANOVAs were used to examine MVIC, MT, RPE and neuromuscular function. There were greater reductions in MVIC torque and EMG mean power frequency following isotonic (46.2 ± 17.1%; 16.4 ± 7.9%) than isokinetic (17.9 ± 10.9%;6.5 ± 6.3%). RPE was also higher during isotonic (7.5 ± 2.2), than isokinetic (5.7 ± 1.9). There were no differences in EMG amplitude or MT increases (20 ± 2.1%) between conditions. Isotonic BFR elicited greater fatigue-induced decreases in muscular strength and greater RPE than isokinetic BFR, but similar MT and muscle excitation responses for both conditions. Therefore, both isokinetic and isotonic may induce similar acute physiological responses, but isotonic BFR was associated with greater muscle fatigue and perceived effort.HighlightsExercise modality affects the fatigue and perceptual responses when applying blood flow restriction.Despite greater utility, isotonic blood flow restriction was associated greater fatigue and perceived effort.Isotonic and isokinetic blood flow restriction elicited comparable neural changes.
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Fadiga Muscular , Músculo Esquelético , Humanos , Feminino , Músculo Esquelético/fisiologia , Fadiga Muscular/fisiologia , Eletromiografia , Hemodinâmica , Exercício Físico/fisiologia , Contração Isométrica/fisiologia , Fluxo Sanguíneo Regional/fisiologia , TorqueRESUMO
The extent to which culture moderates the effects of need for approval from others on a person's handling of interpersonal conflict was investigated. Students from 24 nations rated how they handled a recent interpersonal conflict, using measures derived from face-negotiation theory. Samples varied in the extent to which they were perceived as characterised by the cultural logics of dignity, honour, or face. It was hypothesised that the emphasis on harmony within face cultures would reduce the relevance of need for approval from others to face-negotiation concerns. Respondents rated their need for approval from others and how much they sought to preserve their own face and the face of the other party during the conflict. Need for approval was associated with concerns for both self-face and other-face. However, as predicted, the association between need for approval from others and concern for self-face was weaker where face logic was prevalent. Favourable conflict outcome was positively related to other-face and negatively related to self-face and to need for approval from others, but there were no significant interactions related to prevailing cultural logics. The results illustrate how particular face-threatening factors can moderate the distinctive face-concerns earlier found to characterise individualistic and collectivistic cultural groups.
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Comparação Transcultural , Relações Interpessoais , Humanos , Conflito Psicológico , Negociação , IndividualidadeAssuntos
Neurocirurgia , Humanos , Países em Desenvolvimento , Procedimentos Neurocirúrgicos , ViolênciaRESUMO
Introduction: Soft tissue sarcomas make up 7%-15% of childhood solid tumours. The aetiology of this disease is unknown. It is a fast-growing, painless tumour; histologically similar to adult fibrosarcoma, but having a lesser risk of metastasis and a better prognosis. The treatment is aimed towards localised intervention; complete surgical resection is the appropriate treatment as long as it can be performed. Case report: An 11 years old female was referred for resection of a soft tissue tumour on the right elbow with significant peripheral vascularisation. Tumour resection was scheduled, with the placement of a partial thickness skin graft, and a piece was sent to pathology; a histological type consistent with paediatric fibrosarcoma was obtained with margins less than 1 mm from the lesion. Therefore, the patient was referred to the paediatric oncology unit. Further studies with positron emission tomography were requested, in which no evidence of macroscopic anatomy-metabolic tumour activity was found. Subsequently, treatment was started by paediatric oncology with 2 sessions of chemotherapy and 20 sessions of radiotherapy with sufficient progress; finally, assessment by plastic and reconstructive surgery was performed and an adequate quality of graft was observed, without the need for any other intervention by their service. Conclusion: The involvement of the vascular surgeon in performing the tumour resection permitted the preservation of the best circulation to the extremity, thereby, avoiding amputation. The difficult decision made by the reconstructive surgeon to place a partial thickness graft over the surgical site, and to start radiotherapy/chemotherapy by paediatric oncology, were key to the success in achieving the patient's satisfactory progress.