Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 20.738
Filtrar
1.
Appl Ergon ; 98: 103555, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34425517

RESUMO

PURPOSE: Although firefighters are required to perform various high-intensity critically essential tasks, the influence of neuromuscular function on firefighter occupational performance is unclear. The primary aim of the current study was to identify the key neuromuscular determinants of stair climb (SC) performance in firefighters. METHODS: Leg extension isometric peak torque (PT), peak power (PP), torque steadiness at 10% (Steadiness10%) and 50% (Steadiness50%) of PT, fatigability following 30 repeated isotonic concentric contractions at 40% of PT, percent body fat (%BF), and a weighted and timed SC task were examined in 41 (age: 32.3 ± 8.2 yrs; %BF: 24.1 ± 7.9%) male career firefighters. RESULTS: Faster SC times (74.7 ± 13.4 s) were associated with greater PT and PP, less fatigability, younger age, and lower %BF (r = -0.530-0.629; P ≤ 0.014), but not Steadiness10% or Steadiness50% (P ≥ 0.193). Stepwise regression analyses indicated that PP and Steadiness50% were the strongest predictors of SC time (R2 = 0.442, P < 0.001). However, when age and %BF were included in the model, these variables became the only significant predictors of SC time (R2 = 0.521, P < 0.001) due to age and %BF being collectively associated with all the neuromuscular variables (excluding Steadiness10%). CONCLUSIONS: Lower extremity neuromuscular function, specifically PP and steadiness, and %BF are important modifiable predictors of firefighter SC performance, which becomes increasingly important in aging firefighters.


Assuntos
Bombeiros , Adulto , Envelhecimento , Humanos , Extremidade Inferior , Masculino , Força Muscular , Torque , Adulto Jovem
2.
BMJ Case Rep ; 14(11)2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725062

RESUMO

Substernal goitre is characterised by compressive symptoms of the airway and oesophagus. Chronic, progressive symptoms usually result in surgical removal. We report a rare presentation of substernal goitre in a male in his early 70s who suffered from severe bilateral lower extremity (LE) lymphoedema, resulting in immobility and nursing home placement, and left upper extremity lymphoedema. Our initial assessment led to a filariasis work-up, which was negative, due to the patient's prior 2-year residence in India and service overseas. Chest CT scan revealed an incidental substernal goitre extending posterior to the left innominate vein and aortic arch to the level of the left mainstem bronchus. The patient underwent a left hemithyroidectomy via cervical excision and sternotomy and had an uneventful recovery with resolution of lymphoedema and mobility. Despite extensive literature regarding clinical presentations of substernal goitre, severe lymphoedema of the LE is not a well-established association.


Assuntos
Bócio Subesternal , Edema/etiologia , Bócio Subesternal/complicações , Bócio Subesternal/diagnóstico por imagem , Bócio Subesternal/cirurgia , Humanos , Extremidade Inferior/diagnóstico por imagem , Extremidade Inferior/cirurgia , Masculino , Estudos Retrospectivos , Tireoidectomia
3.
Cir Cir ; 89(S1): 14-19, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34762627

RESUMO

INTRODUCTION: Lower limb high-flow arteriovenous malformations (AVM) are a rare pathology with a chronic and progressive evolution. Development in imaging and treatment has helped to improve outcome. OBJECTIVE: We report a case treated with multi-session endovascular embolization therapy with favorable results. CASE REPORT: A 44-year-old man referred with a complex high-flow lower limb AVM, previously treated with covered stents and a bypass. Six endovascular interventions were performed, combining different embolization methods. CONCLUSION: Endovascular treatment is a safe and effective option for high-flow AVMs. Embolization should be done carefully to prevent complications that could threaten the patient's limb or life.


Assuntos
Malformações Arteriovenosas , Embolização Terapêutica , Procedimentos Endovasculares , Adulto , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/cirurgia , Humanos , Extremidade Inferior , Masculino , Resultado do Tratamento
4.
Behav Neurol ; 2021: 3010555, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34804258

RESUMO

Background: Structural integrity of the ipsilesional corticospinal tract (CST) is important for upper limb motor recovery after stroke. However, additional neuromechanisms associated with motor function poststroke are less well understood, especially regarding the lower limb. Objective: To investigate the neural basis of upper/lower limb motor deficits poststroke by correlating measures of motor function with diffusion tensor imaging-derived indices of white matter integrity (fractional anisotropy (FA), mean diffusivity (MD)) in primary and secondary motor tracts/structures. Methods: Forty-three individuals with chronic stroke (time poststroke, 64.4 ± 58.8 months) underwent a comprehensive motor assessment and MRI scanning. Correlation and multiple regression analyses were performed to examine relationships between FA/MD in a priori motor tracts/structures and motor function. Results: FA in the ipsilesional CST and red nucleus (RN) was positively correlated with motor function of both the affected upper and lower limb (r = 0.36-0.55, p ≤ 0.01), while only ipsilesional RN FA was associated with gait speed (r = 0.50). Ipsilesional CST FA explained 37.3% of the variance in grip strength (p < 0.001) and 31.5% of the variance in Arm Motricity Index (p = 0.004). Measures of MD were not predictors of motor performance. Conclusions: Microstructural integrity of the ipsilesional CST is associated with both upper and lower limb motor function poststroke, but appears less important for gait speed. Integrity of the ipsilesional RN was also associated with motor performance, suggesting increased contributions from secondary motor areas may play a role in supporting chronic motor function and could become a target for interventions.


Assuntos
Tratos Piramidais , Acidente Vascular Cerebral , Estudos Transversais , Imagem de Tensor de Difusão , Humanos , Extremidade Inferior/diagnóstico por imagem , Imageamento por Ressonância Magnética , Tratos Piramidais/diagnóstico por imagem , Núcleo Rubro/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem
5.
J Coll Physicians Surg Pak ; 31(12): 1455-1458, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34794287

RESUMO

OBJECTIVE: To evaluate the effect of obesity on percutaneous thrombectomy (PT) results for the management of lower limb deep vein thrombosis (DVT). STUDY DESIGN: Retrospective cohort study. PLACE AND DURATION OF STUDY: Department of Cardiology, Avcilar Hospital, Istanbul, Turkey, between August 2020 and January 2021. METHODOLOGY: Patients who underwent PT for lower limb DVT were included. Patients' demographic characteristics, operative parameters, and postoperative outcomes were recorded in prospective manner. Patients were divided into two groups, as patients with body mass index (BMI) <30 kg/m2 (Group 1) and patients with BMI ≥30 kg/m2 (Group 2). The two groups were compared according to patient demographic properties, intraoperative results, and postoperative outcomes. RESULTS: Eventually, 62 patients were enrolled into the non-obese group and 30 patients had BMI ≥30 Kg/m2. Comparison of the groups demonstrated that the mean operation time and the mean fluoroscopy time were significantly higher in obese patients (121.5 min vs. 134.5, p = 0.017 and 19.8 min vs. 25.9 min, p = 0.006, respectively). In addition, the mean hospitalisation period and the mean ICU stay were significantly longer in patients with ≥30 kg/m2 (p = 0.025 and p = 0.007). Postoperative visual analog scale (VAS) score in the first hour was significantly higher in obese patients (2.4 vs. 3.0, p = 0.008). The presence of obesity did not have a significant effect on success and complication rates following PT (p = 0.368 and p = 0.646). CONCLUSION: Obesity prolonged operation time and fluoroscopy time during PT. Additionally, obesity was associated with significantly longer hospitalisation period, and ICU stay, and higher VAS score in the first hour following PT. Key Words: Complication, Deep vein thrombosis, Obesity, Percutaneous thrombectomy, Success, VAS score.


Assuntos
Trombose Venosa , Humanos , Extremidade Inferior/cirurgia , Obesidade/complicações , Estudos Prospectivos , Estudos Retrospectivos , Trombectomia , Resultado do Tratamento
6.
J Coll Physicians Surg Pak ; 31(12): 1478-1481, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34794291

RESUMO

OBJECTIVE: To compare the clinical application effects of peripherally inserted central catheter (PICC) and deep venous catheters placed through the lower limbs in adults with malignancy obviating the use of upper limb PICC. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Oncology, Beijing Shijingshan Hospital, Capital Medical University, Beijing, China between February 2017 and February 2019. METHODOLOGY: The patients enrolled in this study were assigned to PICC under ultrasound guidance group and deep venous catheterisation group. The inclusion criteria were patients with advanced malignant tumor after bilateral breast cancer lymphadenectomy or superior vena cava obstruction syndrome; bedridden patients; and patients without mental disorders; who could understand the content of this study and agreed to participate in this study. Patients with high-risk thrombosis and venous thrombosis of lower limbs were excluded. The success rate of one-time catheterisation, the length of catheterisation puncture time, the number of catheterisations, and the occurrence of catheter-related complications of the two groups were compared. RESULTS: Ultrasound-guided PICC through the lower limbs had a higher success rate than deep venous catheterization (84.6% vs. 42.9%, p=0.046). The average length of puncture time in adults with PICC through the lower limbs under ultrasound guidance was shorter than that in the femoral vein group (24.69 ± 4.35 vs. 29.14 ± 6.02, p=0.038). No catheter-related infection was found in the two groups of patients. CONCLUSION: The indications for PICC through the lower limbs in adults include patients with advanced malignant tumor after bilateral breast cancer lymphadenectomy or superior vena cava obstruction syndrome, and mainly bedridden patients. This technique has certain advantages over deep venous catheterisation and is an effective choice for venous access. Key Words: Lower limb PICC, Deep venous catheterisation, Advanced malignant tumor, Bedridden.


Assuntos
Cateterismo Venoso Central , Cateterismo Periférico , Cateteres Venosos Centrais , Adulto , Cateterismo Venoso Central/efeitos adversos , Cateterismo Periférico/efeitos adversos , Humanos , Extremidade Inferior , Veia Cava Superior
7.
Sensors (Basel) ; 21(21)2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34770281

RESUMO

Foot strike detection is important when evaluating a person's gait characteristics. Accelerometer and gyroscope signals from smartphones have been used to train artificial intelligence (AI) models for automated foot strike detection in able-bodied and elderly populations. However, there is limited research on foot strike detection in lower limb amputees, who have a more variable and asymmetric gait. A novel method for automated foot strike detection in lower limb amputees was developed using raw accelerometer and gyroscope signals collected from a smartphone positioned at the posterior pelvis. Raw signals were used to train a decision tree model and long short-term memory (LSTM) model for automated foot strike detection. These models were developed using retrospective data (n = 72) collected with the TOHRC Walk Test app during a 6-min walk test (6MWT). An Android smartphone was placed on a posterior belt for each participant during the 6MWT to collect accelerometer and gyroscope signals at 50 Hz. The best model for foot strike identification was the LSTM with 100 hidden nodes in the LSTM layer, 50 hidden nodes in the dense layer, and a batch size of 64 (99.0% accuracy, 86.4% sensitivity, 99.4% specificity, and 83.7% precision). This research created a novel method for automated foot strike identification in lower extremity amputee populations that is equivalent to manual labelling and accessible for clinical use. Automated foot strike detection is required for stride analysis and to enable other AI applications, such as fall detection.


Assuntos
Amputados , Idoso , Inteligência Artificial , Árvores de Decisões , Humanos , Extremidade Inferior , Memória de Curto Prazo , Estudos Retrospectivos
8.
Sensors (Basel) ; 21(21)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34770451

RESUMO

Human movement patterns were shown to be as unique to individuals as their fingerprints. However, some movement characteristics are more important than other characteristics for machine learning algorithms to distinguish between individuals. Here, we explored the idea that movement patterns contain unique characteristics that differentiate between individuals and generic characteristics that do not differentiate between individuals. Layer-wise relevance propagation was applied to an artificial neural network that was trained to recognize 20 male triathletes based on their respective movement patterns to derive characteristics of high/low importance for human recognition. The similarity between movement patterns that were defined exclusively through characteristics of high/low importance was then evaluated for all participants in a pairwise fashion. We found that movement patterns of triathletes overlapped minimally when they were defined by variables that were very important for a neural network to distinguish between individuals. The movement patterns overlapped substantially when defined through less important characteristics. We concluded that the unique movement characteristics of elite runners were predominantly sagittal plane movements of the spine and lower extremities during mid-stance and mid-swing, while the generic movement characteristics were sagittal plane movements of the spine during early and late stance.


Assuntos
Corrida , Fenômenos Biomecânicos , Humanos , Extremidade Inferior , Masculino , Movimento , Coluna Vertebral
9.
Sensors (Basel) ; 21(21)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34770468

RESUMO

The position calibration of inertial measurement units (IMUs) is an important part of human motion capture, especially in wearable systems. In realistic applications, static calibration is quickly invalid during the motions for IMUs loosely mounted on the body. In this paper, we propose a dynamic position calibration algorithm for IMUs mounted on the waist, upper leg, lower leg, and foot based on joint constraints. To solve the problem of IMUs' position displacement, we introduce the Gauss-Newton (GN) method based on the Jacobian matrix, the dynamic weight particle swarm optimization (DWPSO), and the grey wolf optimizer (GWO) to realize IMUs' position calibration. Furthermore, we establish the coordinate system of human lower limbs to estimate each joint angle and use the fusion algorithm in the field of quaternions to improve the attitude calibration performance of a single IMU. The performances of these three algorithms are analyzed and evaluated by gait tests on the human body and comparisons with a high-precision IMU-Mocap reference device. The simulation results show that the three algorithms can effectively calibrate the IMU's position for human lower limbs. Additionally, when the degree of freedom (DOF) of a certain dimension is limited, the performances of the DWPSO and GWO may be better than GN, when the joint changes sufficiently, the performances of the three are close. The results confirm that the dynamic calibration algorithm based on joint constraints can effectively reduce the position offset errors of IMUs on upper or lower limbs in practical applications.


Assuntos
Marcha , Extremidade Inferior , Fenômenos Biomecânicos , Calibragem , Organotiofosfatos
10.
BMC Nephrol ; 22(1): 376, 2021 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-34763669

RESUMO

BACKGROUND: There have been cases of minimal change disease (MCD) reported following previous vaccines. During the COVID-19 era, only 3 cases of new-onset MCD and a case of MCD relapse were reported following the Pfizer-BioNTech COVID-19 vaccine. We herein report the first case of MCD after receiving the Moderna COVID-19 vaccine. CASE PRESENTATION: A 43-year-old man presented to hospital 3 weeks after receiving the first dose of the Moderna vaccine, with both bilateral lower extremities and scrotal edema. He initially developed a sudden-onset bilateral lower extremities swelling on day 7 post-vaccine. He, then, developed dyspnea and scrotal swelling over a time span of 2 weeks. On physical examination, his blood pressure was 150/92 mmHg. There was a decreased air entry at lung bases, bilateral lower extremities and scrotal edema. Labs revealed hypoalbuminemia, hyperlipidemia and 15 g of proteinuria. His immunologic and serologic work up was negative. Renal biopsy showed concomitant MCD and IgA nephropathy. Patient was treated with oral steroids and had a good response; his edema resolved, serum albumin improved, and proteinuria decreased to 1 g within 2 weeks of treatment. CONCLUSIONS: To the best of our knowledge, MCD has not been previously reported after receiving the Moderna COVID-19 vaccine. It remains unclear whether the COVID-19 mRNA vaccines are associated with the development of MCD, or it coincided with the mass vaccination. Further studies are needed to determine the incidence of MCD post COVID-19 vaccines and the underlying pathophysiology of glomerular injury post vaccination.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Edema/etiologia , Extremidade Inferior , Nefrose Lipoide/induzido quimicamente , Escroto , Adulto , Dispneia/etiologia , Glomerulonefrite por IGA/induzido quimicamente , Glomerulonefrite por IGA/complicações , Glomerulonefrite por IGA/patologia , Humanos , Hipoalbuminemia/etiologia , Masculino , Nefrose Lipoide/complicações , Nefrose Lipoide/patologia , SARS-CoV-2
11.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(11): 1380-1383, 2021 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-34779162

RESUMO

Objective: To analyze the characteristics of patients with secondary lower limb deformity of spina bifida based on the QIN Sihe Orthopedic Surgery Case Data, and provide the references for clinical research, diagnosis, and treatment. Methods: A clinical data of 1 012 patients with secondary lower limb deformity of spina bifida between October 12, 1986 and December 31, 2020 selected from QIN Sihe Orthopedic Surgery Case Data was retrospectively analyzed. Among them, 231 cases (22.83%) had undergone orthopedic surgery for lower extremity deformities in other hospitals. The gender, age at surgery, indicators related to spina bifida (deformity side, comorbidity, sensory disturbance level), and information related to surgery (operating time, surgical site, postoperative fixation method) were analyzed. Results: Of the 1012 patients, 457 were males and 555 were females. The age was 3-51 years at the time of surgery, with a median of 18.0 years; among them, the 15-30 years old group had the most patients, accounting for 53.16%. Most deformities involved both lower limbs (652 cases, 64.43%). There were 111 cases of ulcers in the weight-bearing area of the foot, 265 cases of gatism, 554 cases of sensory disturbance, and 85 cases of abnormal hair on the waist. From 2010 to 2019, there were significantly more patients undergoing surgery than before 2010, reaching 61.17%. Sensory disturbances mostly occurred in the ankle and foot. A total of 1 149 sites were treated with surgery, of which the most ankle joint deformities were corrected by surgery, accounting for 84.33%. The main fixation methods after orthopedic surgery were external fixation, including Ilizarov external fixation (442 cases), combined external fixation (315 cases), and plaster fixation (189 cases). Conclusion: Spina bifida can be secondary to severe deformities of the lower limbs, mainly in the ankles. Common complications include ulcers in the weight-bearing area, dysfunction of urine and feces, and sensory disturbances; external fixation is the main method of fixation after surgery.


Assuntos
Ortopedia , Disrafismo Espinal , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Fixação de Fratura , Humanos , Extremidade Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Disrafismo Espinal/complicações , Disrafismo Espinal/cirurgia , Adulto Jovem
12.
J Pak Med Assoc ; 71(11): 2596-2603, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34783743

RESUMO

OBJECTIVE: To explore the current evidences on effects of trigger point dry needling as a treatment strategy on pain and range of motion among subjects with lower extremity myofascial trigger areas. METHODS: The systematic review was conducted at the University Institute of Physical Therapy, Lahore, Pakistan, from February to August 2019, and comprised search of studies on Cochrane Library, PubMed, SPORTDiscus and PEDro databases published in the English language from 2000 to July 2019. The search terms used were 'Dry needling', 'Trigger points', 'Myofascial trigger points', 'Trigger area', 'Acupuncture therapy', 'Lower extremity' and 'Acupuncture'. Cochrane Risk of Bias tool was used to assess the randomised and non-randomised controlled trials. Methodological assessment was performed using Physiotherapy Evidence Database 10-point scale. Data synthesis was performed through vote counting method. RESULTS: Of the 564 articles initially found, 30(5.3%) were shortlisted for full-text assessment. Of them, 10(33.3%) were selected for final assessment; with 7(70%) scoring high and 3(30%) fair on the PEDro scale. All the 10(100%) studies documented improvement in the pain over time with dry needling strategy. None of the studies targeted any other outcome, like anxiety and sleep disturbances, related with myofascial trigger points. CONCLUSIONS: On basis of the best evidences available, dry needling seemed to be effective in pain reduction related to lower extremity myofascial trigger points. Evidence also suggested that there was not much positive effect of myofascial trigger point dry needling on depression, anxiety, muscular strength and quality of life.


Assuntos
Agulhamento Seco , Síndromes da Dor Miofascial , Humanos , Extremidade Inferior , Síndromes da Dor Miofascial/terapia , Qualidade de Vida , Pontos-Gatilho
13.
J Invasive Cardiol ; 33(11): E910-E915, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34735354

RESUMO

BACKGROUND: Deep vein thrombosis (DVT) is often seen in patients with acute pulmonary embolism (PE). Risk stratification of PE patients is useful in predicting mortality risk and hospital course. However, rates or predictors of DVT or proximal DVT (popliteal, femoral, common femoral, or iliac thrombosis) have not been studied in the highest-risk patients who receive catheter-directed therapy (CDT) for their PE. A single-center retrospective analysis of patients referred for CDT for confirmed PE was conducted to evaluate rates and predictors of DVT or proximal DVT and the impact on short-term outcomes. In 137 consecutive patients undergoing CDT for PE with available lower-extremity ultrasound, the rates of DVT and proximal DVT in PE patients receiving CDT were 76.6% and 65.0%, respectively. Rates of DVT (P=.68) and proximal DVT (P=.72) did not differ between high-risk or non-high risk PE patients. The only significant factor associated with presence of concomitant DVT was previous DVT (P=.045). The presence of a concomitant DVT or proximal DVT was not associated with an increase in all-cause mortality or hospitalization at 30 days or 1 year compared with an absence of concomitant DVT or proximal DVT. The results of this study suggest that patients with PE clinically requiring CDT have high rates of concomitant DVT and proximal DVT, prior DVT predicts concomitant DVT, and the presence of DVT is not associated with additional risk in this already high-risk population of patients.


Assuntos
Embolia Pulmonar , Trombose Venosa , Cateteres , Humanos , Extremidade Inferior , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/epidemiologia , Embolia Pulmonar/etiologia , Estudos Retrospectivos , Fatores de Risco , Trombose Venosa/diagnóstico , Trombose Venosa/epidemiologia , Trombose Venosa/etiologia
14.
Cien Saude Colet ; 26(10): 4591-4602, 2021 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34730646

RESUMO

This paper aimed to assess the factors related to the physical capacity of upper and lower limbs in quilombola older adults. This is a cross-sectional, analytic study performed with elderly residents in the quilombola community Caiana dos Crioulos, Alagoa Grande, Paraíba, Brazil. The researched dependent variables were the physical capacity of upper and lower limbs. It was performed the Spearman correlation and multiple and linear simple regression (95% CI; p<0.05). This work was performed per Resolution 466/2012 from National Health Council. Forty-three older adults were assessed. The bivariate analyses showed a positive correlation between handgrip strength (HGS) and physical activity (PA), between HGS and arm muscle circumference (AMC), and an inverse correlation between Short Physical Performance Battery (SPPB) and age. The multiple-model for HGS was significantly correlated with age, AMC, and years of study (R2=0.374; p<0.05). Regarding the SPPB, it showed a significant correlation with age (R2=0.2524; p=0.001). Therefore, the muscle mass reserve, years of study, and age were factors related to the physical capacity among quilombola older adults. The strict compliance of these aspects and the early intervention can preserve physical capacity and ensure the productive inclusion and economic autonomy so much sought in the communities' social agenda.


Assuntos
Exercício Físico , Força da Mão , Idoso , Brasil , Estudos Transversais , Humanos , Extremidade Inferior
15.
Saudi Med J ; 42(11): 1247-1251, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732559

RESUMO

OBJECTIVES: To examine the effects of desflurane and cerium oxide (CO) on lung tissue following ischemia-reperfusion injury (IRI). METHODS: Experiments were conducted in Gazi University Animal Laboratory, Ankara, Turkey. Thirty rats were divided into 5 groups: control (C), IRI, IRI-CO, IRI-desflurane (IRID), IRI-CO-desflurane (IRICOD). Cerium oxide was given intraperitoneally. Lower extremity IRI was induced. Desflurane was applied during IRI. Lung histopathological examinations and serum biochemical analyses were performed. RESULTS: Serum nitric oxide (NO) and malondialdehyde (MDA) levels were higher in group IRI (p=0.006) than in group C (p=0.001). Serum MDA and NO levels were significantly lower in groups IRICO and IRICOD than in group IRI. Significantly greater alveolar wall thickening and neutrophil infiltration were recorded in group IRI than in group C. Co-administration of desflurane and CO significantly decreased alveolar wall thickening and neutrophil infiltration compared to group IRI. Total lung injury scores were significantly lower in groups IRID, IRICO, and IRICOD than in group IRI. CONCLUSION: Intraperitoneal CO with desflurane, reduced oxidative stress and corrected the damage in lung. Cerium oxide given before and desflurane given during IRI have been shown to have protective effects on lung damage in rats.


Assuntos
Anestesia , Lesão Pulmonar , Traumatismo por Reperfusão , Animais , Cério , Desflurano , Extremidade Inferior , Ratos , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/prevenção & controle
16.
J Wound Care ; 30(11): 896-902, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34747210

RESUMO

OBJECTIVES: This study is aimed at assessing the safety and effectiveness of an advanced flowable wound matrix (FWM) in the treatment of hard-to-heal vascular leg ulcers that often involve deep structures, are irregular and/or tunnelled or excavated. METHODS: Records of patients seen at our Vascular Surgery Unit, at the University of Campania 'Luigi Vanvitelli', for hard-to-heal vascular leg ulcers between January 2018 and January 2020 were retrospectively reviewed. For each wound aetiology, area and complications were recorded and evaluated. Every patient received one or more applications of FWM and was followed up. RESULTS: A total of 22 patients (18 female/four male), mean age 63±8.5 years, were treated. The initial wound area ranged from 4-58cm2. After wound bed preparation, FWM was applied. Treatment was well tolerated and effective-rate of complications was low, graft take was very satisfactory, and no graft loss, rejection or superimposed infections were observed. Healing time was short: 85% of ulcers healed after 12 weeks. Most importantly, there was a decrease in the rate and level of amputations as compared with standard wound care. CONCLUSIONS: The data presented indicate that FWM is an option for the treatment of hard-to-heal vascular leg ulcers, particularly for those with an irregular cavity. DECLARATION OF INTEREST: The authors have no conflicts of interest.


Assuntos
Úlcera da Perna , Úlcera , Idoso , Feminino , Humanos , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Cicatrização
17.
J Wound Care ; 30(11): 916-921, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34747216

RESUMO

OBJECTIVE: Lower extremity ulcers (LEUs) are associated with a decline in patients' quality of life (QoL). Better healthcare availability in remote regions, facilitated by telemedicine (TM), may improve patient wellbeing. The aim of this study was to compare the QoL of patients treated via synchronous video TM with that of patients treated with standard face-to-face (FTF) care. METHOD: The study was performed in a large health services provider in Israel (Maccabi Healthcare Services). TM was used in four remote locations; the FTF method was applied in two regional clinics. The treatment protocol was performed by a nurse and supervised by the regional physician in both treatment modes. A validated Wound-QoL questionnaire in Hebrew was used to assess patient outcomes. RESULTS: A total of 83 patients were treated via TM and 94 patients were treated FTF. The mean QoL for patients treated via TM was 0.546±0.249 compared with 0.507±0.238 for the FTF group. A similarity relating to outcomes in both treatment methods was demonstrated by a difference of 0.039 (95% confidence interval -0.33-0.111) and p=0.291. The probability of the difference being within the limits of the interval in a replicated study was 83.4%. The equivalence/non-inferiority was established within the accepted Δ=0.12 range. CONCLUSION: The results indicated no reduced QoL for patients with LEUs treated with telemedicine versus with standard FTF care. DECLARATION OF INTEREST: The authors have no conflicts of interest.


Assuntos
Úlcera da Perna , Telemedicina , Humanos , Úlcera da Perna/terapia , Extremidade Inferior , Qualidade de Vida , Úlcera
18.
Orthopade ; 50(11): 900-909, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34735595

RESUMO

The rehabilitation of patients with an amputation is challenging and an example of an interdisciplinary team approach. Knowledge of the principal surgical techniques and the needs for a good prosthetic fitting is mandatory for the team members. According to the ideas of International Classification of Functioning, Disabilities and Handicaps the goal of the rehabilitation is to achieve the highest possible participation in private, work and social life of the patient. Within the team a clear definition of responsibilities is necessary, as well as an intensive communication structure. The patient himself plays a major role. This rehabilitation is complex, in terms of both personal and resource use. Depending on the level of amputation, the usual rehabilitation times range between 4 to 12 weeks for the lower extremity; for the arms, the time varies greatly from person to person. Longer rehabilitation times seem to ensure better treatment outcomes in the long term.


Assuntos
Membros Artificiais , Atividades Cotidianas , Amputação , Humanos , Extremidade Inferior , Resultado do Tratamento
19.
Sensors (Basel) ; 21(19)2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34640779

RESUMO

Early and self-identification of locomotive degradation facilitates us with awareness and motivation to prevent further deterioration. We propose the usage of nine squat and four one-leg standing exercise features as input parameters to Machine Learning (ML) classifiers in order to perform lower limb skill assessment. The significance of this approach is that it does not demand manpower and infrastructure, unlike traditional methods. We base the output layer of the classifiers on the Short Test Battery Locomotive Syndrome (STBLS) test used to detect Locomotive Syndrome (LS) approved by the Japanese Orthopedic Association (JOA). We obtained three assessment scores by using this test, namely sit-stand, 2-stride, and Geriatric Locomotive Function Scale (GLFS-25). We tested two ML methods, namely an Artificial Neural Network (ANN) comprised of two hidden layers with six nodes per layer configured with Rectified-Linear-Unit (ReLU) activation function and a Random Forest (RF) regressor with number of estimators varied from 5 to 100. We could predict the stand-up and 2-stride scores of the STBLS test with correlation of 0.59 and 0.76 between the real and predicted data, respectively, by using the ANN. The best accuracies (R-squared values) obtained through the RF regressor were 0.86, 0.79, and 0.73 for stand-up, 2-stride, and GLFS-25 scores, respectively.


Assuntos
Locomoção , Aprendizado de Máquina , Estudos de Viabilidade , Extremidade Inferior , Medição de Risco
20.
Artigo em Inglês | MEDLINE | ID: mdl-34639656

RESUMO

Currently, sports activities require a high reaction speed, coordination, and balance, highlighting the relationship between proprioceptive control, visual control, and hand-eye coordination in youth. The present research assessed the proprioceptive control, reaction speed, and lower limb balance of youth from five different schools to identify the level of physical preparation of children in this direction. This prospective study was conducted between 1 January 2020 and 29 February 2020. A total of 107 healthy children (33 females and 74 males) with appropriate medical conditions, aged between 14 and 15 years, from five Romanian schools were included in the experiment. All children were assessed for visual control and reaction speed with the ruler drop test, and for lower limb balance, the standing stork test was used. Statistical analysis included descriptive statistics, data series distribution, and comparison of means and medians using specific statistical programs. Comparison of medians highlighted significant statistical differences in the standing stork test with eyes closed and the dominant leg compared with the nondominant leg (p = 0.0057). Males were compared to females at the nondominant leg (p = 0.0179); closed eyes were compared with opened eyes for the nondominant leg (p = 0.0175 and 0.0006) for the ruler drop test comparing the dominant hand with the nondominant hand (p = 0.0212). Children who engage in sports activities better integrated sensory information in motor action execution based on reaction speed and coordination with the nondominant hand.


Assuntos
Perna (Membro) , Equilíbrio Postural , Adolescente , Criança , Feminino , Humanos , Extremidade Inferior , Masculino , Estudos Prospectivos , Estudantes
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...