Recurrence rate of basal cell carcinoma among different micrographic surgery techniques: systematic review with meta-analysis.

In high-risk basal cell carcinomas (BCCs), micrographic surgery (MS) has high tissue preservation and low recurrence rates. The Mohs technique is the most commonly used technique, with limited use of other MS techniques. No studies have been designed to compare the MS methods. This review aimed to assess BCC recurrence rates of different MS techniques. A systematic review and meta-analysis were conducted to search for related studies in PubMed, LILACS, EMBASE, SCOPUS, WEB OF SCIENCE, CINHAL and COCHRANE until March 2021. Randomized clinical trials (RCTs) and observational studies involving patients with BCC and indications for different MS techniques were included. Study selection and data extraction were performed independently by three peer reviewers, as was the risk of bias assessment using the Joanna Briggs Institute tool. Pooled estimates were assessed using the random-effects model (Logit), and heterogeneity was assessed by the chi-squared test (χ2 ). Stata Software version 17.0 was used for analysis. Eighteen studies were included, two RCTs and sixteen observational studies. The overall recurrence rate was 2% (95% CI, 1.0-3.0%; χ2 = 46.2; P = 0.00; 18 studies, 10 424 BCCs). In studies using the Mohs technique, the recurrence rate was 3.0% (95% CI, 1.0-5.0%; χ2 = 11.0; P = 0.00; 6 studies; 1,582 BCCs), with the Munich technique 3.0% (95% CI, 2.0-5.0%; χ2 = 0.0; no heterogeneity; 3 studies; 404 BCCs), with Tubingen technique 1% (95% CI, 1.0-2.0%; χ2 = 12.1; P = 0.00; 8 studies; 8374 BCCs) and with the Muffin technique 0.0% (95% CI, 0.0-6.0%; 1 study; 64 BCCs). Relapse rates between MS techniques were low and appeared to be similar. However, the design of this review and the absence of primary studies that directly compare the techniques do not allow us to assert the superiority between them.

Treadmill training in Parkinson's patients after deep brain stimulation: Effects on gait kinematic.

OBJECTIVE: The purpose of this study was to evaluate the effect of treadmill training with body weight support on gait kinematics parameters in patients with PD using DBS. DESIGN: Twelve patients completed the protocols (age: 60.9±10.6 years; disease duration: 20±7 years; and time since DBS surgery: 20±4 months). The same set of patients underwent two trainings protocols and four gait analyses (before and after each training). They received eight weeks of treadmill training without body weight support (16 sessions) in conjunction with physiotherapy program followed by six weeks of wash out period, followed by eight weeks of body-weight-supported treadmill training in conjunction with a same physiotherapy program. The Gait Kinematic Analysis involved eight infrared cameras that detected 19 reflective spherical markers attached in limb lower of patients. Statistical analysis used the Wilcoxon test (p≤0.05). RESULTS: Both the training no showed significant differences in linear variables. As the angular variables, only training with support showed significant increase of ranges of motion: pelvis tilt, obliquity and rotation amplitude; hip adduction-abduction and rotation amplitude; percentage of peak flexion in swing phase; foot progression amplitude. CONCLUSION: The body weight supported treadmill training may promote increase of mobility of lower limbs during gait and it could be a targeted intervention for PD patients treated with DBS.

Correlation of postural balance and knee muscle strength in the sit-to-stand test among women with and without postmenopausal osteoporosis.

UNLABELLED: The task of standing up from a chair forms a part of daily life for all independent individuals. However, this task becomes more difficult with advancing age. Women with postmenopausal osteoporosis presented diminished knee extensor and flexor muscle strength. There was a weak correlation between knee muscle strength (greater with extensor strength) and postural balance during the act of standing up. INTRODUCTION: This study aims to evaluate postural balance during the transition from sitting to standing and its relationship with knee extensor and flexor strength among women with and without postmenopausal osteoporosis. METHODS: Assessments were made on 126 women (aged 55-65 years), divided into osteoporosis and control groups according to lumbar bone density. Their balance during the task of standing up from a chair was evaluated using the Balance Master® device. Knee muscle strength was evaluated using an isokinetic dynamometer (Biodex®), in concentric/concentric mode, at a velocity of 60°/s. Spearman's correlation between the variables of muscle strength and postural balance was evaluated. Subsequently, to evaluate the association of each balance variable with the group and with muscle strength, multiple linear regression models were fitted. The significance level was set at 0.05. RESULTS: There was a difference in knee muscle strength between the groups (P < 0.05). However, independent of the muscle strength values, there were no differences in relation to weight transfer times (P = 0.556) or center of gravity sway velocity (P = 0.952). Transfer time diminished with increasing extensor strength (P = 0.025). The center of gravity sway velocity tended to increase with increasing extensor strength (P = 0.013) and was the same in the two groups (P = 0.264). CONCLUSION: Women with postmenopausal osteoporosis presented diminished knee extensor and flexor muscle strength. There was a weak correlation between knee muscle strength (greater with extensor strength) and postural balance during the act of standing up.