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1.
Unfallchirurg ; 123(2): 89-96, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-31970427

RESUMO

The treatment of flexor tendon injuries is still challenging, especially in the region of the narrow annular ligaments and tendon sheaths of the 3­segment fingers and the thumb (zone 2). In the course of time, the primary suture of the flexor tendons has prevailed over traditional recommendations for a secondary tendon replacement after healing of the wound. Improvements regarding suture techniques and materials and, above all the follow-up treatment, have been crucial for better results and remarkable changes in flexor tendon surgery. The suture techniques are determined by the location of the injury but the experience and preferences of the surgeon are also important. Although no technique was found to be optimal, published research and clinical experiences provide important indications for the presumption of successful treatment. To achieve this an early functionally active protocol should be implemented. The tendon suture should enable this by having a high primary strength and therefore at least a 4-strand core suture technique with a ring suture should be given preference. Further important prerequisites for success are the undisturbed gliding of the repaired tendon in its "bed" paying special attention to the annular ligaments and preservation of the blood supply to the tendons.


Assuntos
Traumatismos dos Tendões , Fenômenos Biomecânicos , Dedos , Humanos , Técnicas de Sutura , Suturas , Traumatismos dos Tendões/terapia , Tendões
2.
J Physiol Anthropol ; 39(1): 1, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31952553

RESUMO

BACKGROUND: Dermatoglyphics has been used widely in fields of medicine as a non-invasive diagnostic tool and an early assessment of risk for certain medical conditions. It reflects disturbances in fetal development during early prenatal weeks 14-22 when fingerprints develop. Dermatoglyphic asymmetry has been used to measure developmental instability during a specific period of human fetal development. Thus, the present study was planned to investigate whether digital and palmar dermatoglyphics of chronic kidney disease of unknown origin (CKDu) patients in Sri Lanka are different from healthy people. METHODS: A case control study was carried out among CKDu patients (90 males, 90 females) from a CKDu endemic area and gender-matched two control groups; one group from a CKDu endemic region (90 males, 90 females) and another group from a CKDu non-endemic region (90 males, 90 females). Dermatoglyphics were obtained using photographic methods. Both qualitative and quantitative dermatoglyphic variables were defined and analyzed according to standard criteria. Both directional (DA) and fluctuating asymmetry (FA) were assessed. RESULTS: Several qualitative dermatoglyphic variables had significant association with CKDu. The triradii a1 variable was less evident in palms of CKDu cases in both genders when compared to both control groups. The FA of pattern discordance (right vs left hands) between CKDu cases and control group were significant in several digits. The FA of the ridge count was found significant in several digits, and also significant for A-B ridge count and total ridge count. CONCLUSION: Based on these results, it is proposed that the mechanisms responsible for the development of CKDu might be associated with those responsible for FA observed in CKDu patients. Accordingly, a diagnostic tool based on FA could be developed for predicting risk prior to the development of CKDu.


Assuntos
Dermatoglifia , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Dedos/anatomia & histologia , Humanos , Masculino , Pessoa de Meia-Idade , Sri Lanka/epidemiologia
3.
Sud Med Ekspert ; 62(6): 47-52, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825333

RESUMO

The authors have analyzed the data base of L.P. Astanin (1951) by 19 macro- and microscopic signs of the proximal phalanx of the V finger of the left hand of 40 Russian women aged 18-85. With the increase of years, the external parameters of the proximal phalanx change insufficiently, the medullary cavity increases, and the compact substance area decreases due to the erosion of bone lamellas. The total number of vascular channels changes insufficiently, but their average sizes dramatically increase due to resorption. The majority of the studied age-related markers are correlation-dependent on each other. Three diagnostic models with significant indices of determination (R2=0.719-0.804) have been calculated using multiple regression analysis in a stepwise manner. By the verification results, the diagnostic models can be used in forensic medical practice.


Assuntos
Determinação da Idade pelo Esqueleto , Falanges dos Dedos da Mão , Dedos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Osso e Ossos , Feminino , Falanges dos Dedos da Mão/crescimento & desenvolvimento , Humanos , Pessoa de Meia-Idade , Federação Russa , Adulto Jovem
6.
Rev Fac Cien Med Univ Nac Cordoba ; 76(4): 257-260, 2019 12 11.
Artigo em Espanhol | MEDLINE | ID: mdl-31833751

RESUMO

INTRODUCTION: The Achenbach syndrome was described in the '50s by the German physician Walter Achenbach and corresponds to an entity characterized by the appearance of ecchymosis or purpura and even bruises on the fingers and sometimes on the feet. It courses benignly and is self-limited. METHODS: We present the case of a 60-year-old woman who was diagnosed with this syndrome after performing laboratory tests, antibodies and images without finding alterations in them, with improvement after receiving analgesia and physical means. RESULTS: The Achenbach syndrome continues to be an unknown entity, with few reports in the literature. Up to the year 2 016, 12 case reports had been identified worldwide, concluding that it is a pathology that mainly affects women between the fifth and sixth decade of life. CONCLUSION: Although this nosological entity is benign and its pathophysiology is not entirely clear, it is important that during the initial approach it is consulted for similar episodes in the past and if it is an acute event, look for other alterations such as delay in capillary refill, coldness distal, absence of pulses and thus discarding acute ischemic pathology with diagnostic exams.


Assuntos
Dedos , Dermatoses da Mão/diagnóstico , Hematoma/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome
7.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(4): 163-166, oct.-dic. 2019. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-184305

RESUMO

Los trastornos relacionados con mutaciones del gen IRF6, comprenden desde una afectación casi asintomática con la única presencia de hoyuelos labiales que son la manifestación más sutil del síndrome de van der Woude, hasta manifestaciones congénitas graves que incluyen anomalías faciales, musculoesqueléticas y genitourinarias que corresponden al síndrome de pterigium poplíteo. Pese a que existe cierta relación fenotipo-genotipo entre las mutaciones del gen IRF6, estas tienen una penetrancia incompleta y una expresión variable, inter e intrafamiliar


The disorders related to IRF6 encompass a spectrum from an almost asymptomatic affectation, with the only presence of isolated lip pits, which are a mild presentation of van der Woude syndrome, to the presence in the other extreme, of congenital manifestations that include facial anomalies, musculoskeletal and genitourinary malformations, corresponding to popliteal pterygium syndrome. Although there is a certain phenotype-genotype relationship between mutations of the IRF6 gene, such mutations have incomplete penetrance and variable inter-and intra-familial expression


Assuntos
Humanos , Feminino , Gravidez , Adulto , Anormalidades Múltiplas/diagnóstico , Fenda Labial/diagnóstico , Dedos/anormalidades , Sindactilia/diagnóstico , Mutação , Fenda Labial/genética , Deformidades Congênitas das Extremidades Inferiores/diagnóstico , Feto/anormalidades
8.
Zhonghua Shao Shang Za Zhi ; 35(11): 821-823, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775473

RESUMO

Scar contracture after burn on the back of hand can easily lead to the limitation of flexion function of fingers, which seriously affects daily life activities. Generally, comprehensive rehabilitation treatment is adopted for scar contracture on the back of hand, among which wearing braces is an effective treatment method. However, some braces will limit the normal finger joints or must wait until all the affected fingers heal before they can be worn, and the wearing operation is quite complicated. In order to solve these problems, the author designed and made a finger flexion band, which was used to stretch the patients with limited flexion of finger caused by scar contracture after burn on the back of hand, and achieved good therapeutic effect. According to the measured hand size, the finger flexion band is cut and spliced from the fabric commonly used in daily life. The finger flexion band is designed with finger sleeve, which will not limit the normal finger joints, can interfere with the healed finger in advance, fix the corresponding fingers better, and improve the treatment comfort, especially for children who do not cooperate with the braces wearing. This finger flexion band is simple to make, cheap, convenient to use, and suitable for clinical promotion.


Assuntos
Queimaduras/reabilitação , Cicatriz/reabilitação , Contratura/reabilitação , Traumatismos da Mão/reabilitação , Aparelhos Ortopédicos , Dedos , Humanos
9.
Medicine (Baltimore) ; 98(45): e17853, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702646

RESUMO

BACKGROUND: The recommended chest compression technique for a single rescuer performing infant cardiopulmonary resuscitation is the two-finger technique. For 2 rescuers, a two-thumb-encircling hands technique is recommended. Several recent studies have reported that the two-thumb-encircling hands technique is more effective for high-quality chest compression than the two-finger technique for a single rescuer performing infant cardiopulmonary resuscitation. We undertook a systematic review and meta-analysis of infant manikin studies to compare two-thumb-encircling hands technique with two-finger technique for a single rescuer. METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library for eligible randomized controlled trials published prior to December 2017, including cross-over design studies. The primary outcome was the mean difference in chest compression depth (mm). The secondary outcome was the mean difference in chest compression rate (counts/min). A meta-analysis was performed using Review Manager (version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). RESULTS: Six studies that had reported data concerning both chest compression depth and chest compression rate were included. The two-thumb-encircling hands technique was associated with deeper chest compressions compared with two-finger technique for mean chest compression depth (mean difference, 5.50 mm; 95% confidence interval, 0.32-10.69 mm; P = .04), but no significant difference in the mean chest compression rate (mean difference, 7.89 counts/min; 95% confidence interval, to 0.99, 16.77 counts/min; P = .08) was noted. CONCLUSION: This study indicates that the two-thumb-encircling hands technique is a more appropriate technique for a single rescuer to perform high-quality chest compression in consideration of chest compression depth than the two-finger technique in infant manikin studies.


Assuntos
Reanimação Cardiopulmonar/métodos , Parada Cardíaca/terapia , Feminino , Dedos , Humanos , Lactente , Masculino , Manequins , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Sud Med Ekspert ; 62(5): 33-38, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31626192

RESUMO

The possibilities of determining the sex and age group of an adult on the basis of frequency analysis of combinations of dermatoglyphic signs are presented. The study established new, highly informative dermatoglyphic markers of general physiological traits, with a multiplicity of differences from 5 to 59 (p<0.05) in alternative comparison groups formed by sex and age groups of 18 to 35 years and 36 to 77 years. It was found that the combination of acquired signs of raised skin (white lines and scars) is more informative if compared to the combination of congenital signs (types of patterns, outlines of papillary ridges). Depending on the number of fingers studied, the total occurrence of informative combinations can be 37.8 - 64.4% (one finger) to 96.9% (5 fingers of one hand). The result opens up the prospect for the application of a dermatoglyphic research method in the identification of persons from fragmented human remains and fingerprints found at the scene of an accident.


Assuntos
Dermatoglifia , Dedos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa , Pele , Adulto Jovem
13.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 36(10): 993-995, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31598943

RESUMO

OBJECTIVE: To explore the genetic etiology of a pedigree affected with tricho-rhino-phalangeal syndrome. METHODS: Next-generation sequencing (NGS) using a gene panel for hereditary osteopathies was carried out for the proband. Suspected mutation was validated in the proband and her parents by Sanger sequencing. RESULTS: A heterozygous frameshift variation c.1995dupA (p.Gly666Argfs*20) of the TRPS1 gene was detected in the proband but not in her parents. CONCLUSION: The novel c.1995dupA (p.Gly666Argfs*20) mutation of the TRPS1 gene probably underlies the disease in the proband.


Assuntos
Proteínas de Ligação a DNA/genética , Dedos/anormalidades , Mutação da Fase de Leitura , Doenças do Cabelo/genética , Síndrome de Langer-Giedion/genética , Nariz/anormalidades , Fatores de Transcrição/genética , Feminino , Humanos , Linhagem
14.
J Drugs Dermatol ; 18(10): 1047, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31603633

RESUMO

To the Editor: Acrodermatitis continua of Hallopeau (ACH) is a relatively rare chronic disorder with clinical findings of pustules and erythematous plaques on the digits.1 Although it is a variant of pustular psoriasis, it can be resistant to multiple lines of therapy. We describe for the first time a patient with recalcitrant ACH successfully treated with brodalumab, an interleukin-17 receptor A (IL-17RA) blocking antibody.


Assuntos
Acrodermatite/tratamento farmacológico , Anticorpos Monoclonais/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Acrodermatite/imunologia , Anticorpos Monoclonais Humanizados , Esquema de Medicação , Resistência a Medicamentos , Dedos , Humanos , Masculino , Pessoa de Meia-Idade , Receptores de Interleucina-17/antagonistas & inibidores , Receptores de Interleucina-17/imunologia , Resultado do Tratamento
15.
Niger J Clin Pract ; 22(10): 1356-1364, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607724

RESUMO

Aims: The study aimed to assess the percentage difference of hand dimensions and their correlation with grip and pinch strength among school children in Saudi Arabia. Materials and Methods: Anthropometric measurements, hand dimensions, grip, and pinch strength measurements were obtained from 200 healthy schoolchildren in both genders aged 6-16 years. A Jamar electronic handgrip dynamometer was used to measure handgrip strength in kg. Pinch dynamometer was used to measure the two-point pinch strength, three-point pinch strength and lateral pinch strength in kg. Hand circumference was measured following hand arch at the maximum palm level. Hand span from the tip of the thumb to the tip of the little finger with the hand opened as broad as possible. Hand length from the tip of the middle finger to the midline of the distal wrist crease. Palm length from the distal wrist crease to the base of the middle finger. Results: The percentage of difference of hand dimensions between both the genders was statistically significant. Both handgrip and pinch strength were significantly correlated with anthropometric measurements and hand dimensions. Body mass index had mild correlation with both handgrip strength and pinch strength (P < 0.05). Age, hand circumference, hand span, hand length and palm length had moderate to strong correlation with both grip and pinch strength (P < 0.01). Conclusion: The current study provides a source of perspective reference values in clinical settings for hand dimensions. The present study showed significant correlations with handgrip and pinch grip strengths among schoolchildren in Saudi Arabia.


Assuntos
Força da Mão/fisiologia , Mãos/anatomia & histologia , Força de Pinça/fisiologia , Adolescente , Fatores Etários , Antropometria , Estatura , Índice de Massa Corporal , Criança , Feminino , Dedos/fisiologia , Humanos , Masculino , Valores de Referência , Arábia Saudita
16.
Nature ; 574(7777): 249-253, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31578523

RESUMO

The integrity of the mammalian epidermis depends on a balance of proliferation and differentiation in the resident population of stem cells1. The kinase RIPK4 and the transcription factor IRF6 are mutated in severe developmental syndromes in humans, and mice lacking these genes display epidermal hyperproliferation and soft-tissue fusions that result in neonatal lethality2-5. Our understanding of how these genes control epidermal differentiation is incomplete. Here we show that the role of RIPK4 in mouse development requires its kinase activity; that RIPK4 and IRF6 expressed in the epidermis regulate the same biological processes; and that the phosphorylation of IRF6 at Ser413 and Ser424 primes IRF6 for activation. Using RNA sequencing (RNA-seq), histone chromatin immunoprecipitation followed by sequencing (ChIP-seq) and assay for transposase-accessible chromatin using sequencing (ATAC-seq) of skin in wild-type and IRF6-deficient mouse embryos, we define the transcriptional programs that are regulated by IRF6 during epidermal differentiation. IRF6 was enriched at bivalent promoters, and IRF6 deficiency caused defective expression of genes that are involved in the metabolism of lipids and the formation of tight junctions. Accordingly, the lipid composition of the stratum corneum of Irf6-/- skin was abnormal, culminating in a severe defect in the function of the epidermal barrier. Collectively, our results explain how RIPK4 and IRF6 function to ensure the integrity of the epidermis and provide mechanistic insights into why developmental syndromes that are characterized by orofacial, skin and genital abnormalities result when this axis goes awry.


Assuntos
Diferenciação Celular , Células Epidérmicas/citologia , Epiderme/fisiologia , Fatores Reguladores de Interferon/metabolismo , Proteínas Serina-Treonina Quinases/metabolismo , Transdução de Sinais , Anormalidades Múltiplas/genética , Animais , Fenda Labial/genética , Fissura Palatina/genética , Cistos/genética , Embrião de Mamíferos/citologia , Embrião de Mamíferos/embriologia , Embrião de Mamíferos/metabolismo , Células Epidérmicas/metabolismo , Epiderme/embriologia , Anormalidades do Olho/genética , Feminino , Dedos/anormalidades , Regulação da Expressão Gênica , Fatores Reguladores de Interferon/deficiência , Fatores Reguladores de Interferon/genética , Joelho/anormalidades , Articulação do Joelho/anormalidades , Lábio/anormalidades , Metabolismo dos Lipídeos/genética , Deformidades Congênitas das Extremidades Inferiores/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fosforilação , Fosfosserina/metabolismo , Proteínas Serina-Treonina Quinases/genética , Sindactilia/genética , Anormalidades Urogenitais/genética
17.
Nature ; 573(7773): 175-176, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31506618
18.
Muscle Nerve ; 60(6): 752-757, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31509255

RESUMO

INTRODUCTION: Andersen-Tawil syndrome (ATS) is characterized by a triad of periodic paralysis, ventricular arrhythmias, and dysmorphism. However, patients often lack one or more of these features. METHODS: Clinical and neurophysiological features were reviewed of five members in two families with heterozygous mutations in KCNJ2 (R218Q and R67W). RESULTS: Only one patient had all features of the triad of ATS. One patient had low-set ears, and the others had minor anomalies. Bidirectional ventricular tachycardias were seen in two patients. Two patients (R67W) never had episodes of paralysis. The long exercise test was abnormal in three patients with episodes of paralysis, but normal in two without paralytic episodes. DISCUSSION: ATS patients without skeletal muscle symptoms can have normal neurophysiological examinations. They can show variability in phenotype or the severity of arrhythmias. Such variability among patients who share the same gene mutations may result in underdiagnosis of ATS.


Assuntos
Síndrome de Andersen/fisiopatologia , Adolescente , Síndrome de Andersen/genética , Anormalidades Craniofaciais/genética , Anormalidades Craniofaciais/fisiopatologia , Eletrocardiografia , Eletromiografia , Teste de Esforço , Feminino , Dedos/anormalidades , Humanos , Masculino , Pessoa de Meia-Idade , Paralisia/genética , Paralisia/fisiopatologia , Fenótipo , Canais de Potássio Corretores do Fluxo de Internalização/genética , Taquicardia Ventricular/genética , Taquicardia Ventricular/fisiopatologia , Complexos Ventriculares Prematuros/genética , Complexos Ventriculares Prematuros/fisiopatologia , Adulto Jovem
19.
J Drugs Dermatol ; 18(9): 943-945, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31524993

RESUMO

Raynaud's phenomenon is an exaggerated physiological response of blood vessels in the distal extremities to emotional stress and cold. It can be idiopathic or secondary to a connective tissue disorder, such as scleroderma or systemic lupus erythematosus. Treatment for Raynaud's phenomenon consists primarily of lifestyle modifications; if unsuccessful, pharmacotherapy with dihydropyridine calcium channel blockers can be added. Botulinum toxin (BTX-A) is a neurotoxic protein produced by Clostridium botulinum spores. While most widely known for its cosmetic use, BTX-A has many therapeutic utilities due to its ability to inhibit multiple neurotransmitters. In this report, we present a patient with Raynaud's phenomenon refractory to standard therapies whose symptoms resolved after treatment with BTX-A. Follow-up with the patient after one and five years showed no relapse or recurrence of symptoms. J Drugs Dermatol. 2019;18(9):943-945.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Neurotoxinas/administração & dosagem , Doença de Raynaud/tratamento farmacológico , Pele/patologia , Resistência a Medicamentos , Feminino , Dedos , Humanos , Injeções Subcutâneas , Necrose/tratamento farmacológico , Necrose/etiologia , Doença de Raynaud/complicações , Pele/efeitos dos fármacos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
20.
Acta Psychol (Amst) ; 199: 102900, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31400650

RESUMO

There are many similarities and differences between the human hands and feet. On a psychological level, there is some evidence from clinical disorders and studies of tactile localisation in healthy adults for deep functional connections between the hands and feet. One form these connections may take is in common high-level mental representations of the hands and feet. Previous studies have shown that there are systematic, but distinct patterns of confusion found between both the fingers and toes. Further, there are clear individual differences between people in the exact patterns of mislocalisations. Here, we investigated whether these idiosyncratic differences in tactile localisation are shared between the fingers and toes, which may indicate a shared high-level representation. We obtained confusion matrices showing the pattern of mislocalisation on the hairy skin surfaces of both the fingers and toes. Using a decoding approach, we show that idiosyncratic differences in individuals' pattern of confusions are shared across the fingers and toes, despite different overall patterns of confusions. These results suggest that there is a common representation of the fingers and toes.


Assuntos
Dedos/fisiologia , Lateralidade Funcional/fisiologia , Dedos do Pé/fisiologia , Tato/fisiologia , Adulto , Feminino , Humanos , Masculino , Estimulação Física/métodos
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