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1.
Trials ; 22(1): 850, 2021 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-34838094

RESUMO

BACKGROUND: A commonly applied control condition in trials evaluating complex interventions in rehabilitation research is "usual care." The main challenge is to ensure that the control group receives genuine usual care as delivered in everyday clinical practice. The assessment interviews and dialogues with the data collectors may influence the control group participants' reflections on their condition and adjustments. This represents a threat to the internal validity of the trial. Thus, the aim of this study was to explore the perceived study-induced influence of assessment interviews on the adjustment of the members of a control group in a randomized clinical trial. The aim of the trial was to test a dialogue-based psychosocial intervention aiming at promoting the psychosocial well-being and adjustment of stroke survivors. METHODS: Fifteen participants in the control group of a multicenter stroke rehabilitation trial participated in narrative semi-structured interviews. Ricoeur's interpretation theory guided the analysis. RESULTS: The perceived study-induced influence of the assessment interviews on the adjustment process of members of the control group varied considerably. The results demonstrated that the assessment interviews facilitated some participants' feelings of control and their ability to cope. Other participants' statements indicate that they relied on their existing personal capacity to cope and adjust and that the assessment interviews did not make any difference either on their coping ability or on their process of adjustment. Five themes were identified that described the perceived study-induced influence of the assessment interviews in the control group. The themes illustrated that the assessments served as a safety net, enhanced awareness and understanding, encouraged seeking support, allowed the opportunity to vent disappointment, or did not make any difference either way. CONCLUSIONS: RCT assessment interviews may influence the adjustment process and represent a serious problem in measuring interventions over time in trials of complex interventions in rehabilitation research. To uphold rigor and stringency, the usual care control conditions should be thoroughly assessed and described. Informing participants only about the treatment they were allocated to receive might counteract the potential to dilute the difference between the two arms of the trial. TRIAL REGISTRATION: ClinicalTrials.gov NCT02338869. Registered on October 4, 2014.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Adaptação Psicológica , Grupos Controle , Humanos , Qualidade de Vida , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia
2.
Psychiatr Danub ; 33(3): 314-319, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795172

RESUMO

BACKGROUND: A low-grade inflammation is presumed to be related to the etiopathogenesis of major depressive disorder (MDD) and bipolar disorder. Tumor necrosis factor (TNF) superfamily members have roles in the pathogenesis of neuropsychiatric disorders because of the relationship with inflammation and neurogenesis. The aim of this study was to investigate the serum TNF-related weak inducer of apoptosis (TWEAK) and TNF-related apoptosis-inducing ligand (TRAIL) levels in patients with bipolar depression (BD), MDD and a healthy control (HC) group to determine any differences between MDD and BD in terms of inflammation biomarkers. SUBJECTS AND METHODS: After a 12-hour overnight fast, 5 milliliter (mL) samples of fasting blood were obtained from the participants. The TWEAK and TRAIL plasma levels were calculated using ELISA kits. RESULTS: The TWEAK levels were found to be higher in the BD group than in the HC group (p=0.03). No statistically significant differences were determined between the BD vs MDD and MDD vs HC groups (p=0.17, p=0.37, respectively). There were no statistically significant differences between the three groups (BD vs HC; BD vs MDD; MDD vs HC) in terms of TRAIL levels (p=0.21). CONCLUSION: To the best of our knowledge, this study is the first to have explored TWEAK levels in patients with BD. The higher TWEAK levels in BD than in the control group is compatible with the inflammation hypothesis of BD. Limitations of the study were the differences in medications of the patient groups and that it was a cross-sectional study. There is a need for further longitudinal studies with larger sample size and medication-free patients.


Assuntos
Transtorno Bipolar , Citocina TWEAK/sangue , Transtorno Depressivo Maior , Ligante Indutor de Apoptose Relacionado a TNF/sangue , Grupos Controle , Estudos Transversais , Depressão , Humanos
3.
J Headache Pain ; 22(1): 140, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34800970

RESUMO

BACKGROUND: Health care costs of migraine constitute a major issue in health economics. Several publications analyzed health care costs for adult migraine patients, based on questionnaires or secondary (health insurance) data. Although migraine often starts already in primary school age, data on migraine related costs in children is scarce. In this paper we aimed to assess the migraine-related health care costs in 6 to 11 year old children in Germany. METHODS: Using claims data of a large German health insurer (BARMER), overall annual health care costs of 6 to 11 year old children with a diagnosis of migraine in 2017 (n = 2597) were compared to a control group of 6 to 11 year old children without a headache diagnosis between 2013 and 2017 (n = 306,926). The association of migraine and costs was modeled by generalized linear regression (Gamma regression) with adjustment for sex, age and comorbidities. RESULTS: Children with migraine caused considerably higher annual per capita health care costs than children without a headache diagnosis (migraine group: € 1018, control group: € 618). Excess costs directly related to migraine amounted to € 115. The remaining excess costs were related to comorbidities, which were more frequent in the migraine group. Mental and behavioural disorders constituted the most expensive comorbidity, accounting for € 105 of the € 400 annual excess costs in the migraine group. CONCLUSION: 6 to 11 year old children with a migraine diagnosis cause significant direct and comorbidity related excess costs in the German health care system.


Assuntos
Custos de Cuidados de Saúde , Transtornos de Enxaqueca , Adulto , Criança , Grupos Controle , Alemanha/epidemiologia , Cefaleia , Humanos , Seguro Saúde , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/epidemiologia
4.
Ann Parasitol ; 67(2): 265-273, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34597499

RESUMO

Toxocara spp. (T. canis and T. cati in particular) are the major etiological nematodes that have contributed to visceral larval migrans (VLM). So to show the ability of T. cati to produce such migration in the rats as experimental model and detection through histopathological observations to detect larval migratory patterns. Adult females T. cati were collected from naturally infected feral cats. Eight rats, Rattus norvegicus had acted as a model for experimental infection, each receiving an infectious dose of about 1000 infective T. cati eggs, while 2 rats served as non-infected control group. Two infected rats were sacrificed and examined at 7, 14, 21, and 28 day post infection (dpi) and tissue samples were taken for digestioning order to recover migrated larvae and for histopathological examination. In vitro embryonation of T. cati eggs was successfully carried out, although the percentage of embryonation was 10%, prepared inoculums were also infective to rats. Larvae recovered from the lungs at 7 and 14 dpi and were also present at 21, and 28 dpi. The larvae of T. cati were present in the intestines at 14, and 21 dpi. There were no larvae or less than one larva per gram found in other studied tissues. Histopathological changes in different organs were observed. Generally speaking, a multi-tissue response can be defined as the histopathological response of T. cati larval migration. The migratory larvae of T. cati can cause severe histopathological alterations in various tissues and organs of infected animals, within the current study shows that the lungs are a favorable site of migration for these larvae. T. cati is a zoonotic parasite that is underestimated.


Assuntos
Toxocara canis , Toxocara , Animais , Gatos , Grupos Controle , Feminino , Larva , Ratos
5.
J Affect Disord ; 295: 1161-1168, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34706429

RESUMO

OBJECTIVES: Metabolic syndrome (MetS) is highly prevalent among patients with bipolar disorder (BD). The aims of this cross-sectional study were to determine the prevalence of MetS in Dutch BD subjects and compare it with a control group, to examine the association of demographic and clinical characteristics with MetS in BD, and to determine the extent to which metabolic dysregulation is treated in those patients. METHODS: 493 Dutch adult patients (≥ 18 years) with BD receiving psychotropic drugs and 493 matched control subjects were compared using data from the biobank Lifelines. We determined MetS according to the National Cholesterol Education Program Adult Treatment Panel III-Adapted (NCEP ATP III-A) criteria. The difference in the prevalence of MetS and the associations with characteristics were analyzed with logistic regression. RESULTS: BD subjects (30.6%) showed a significantly higher prevalence of MetS compared to the control group (14.2%) (p < .001, OR:2.67, 95% CI:1.94-3.66). Univariate analysis showed that smoking, body mass index (BMI) and antidepressant drug use were associated with MetS. Multivariate analysis showed that smoking (OR:2.01) was independently associated with MetS in BD. For hypertension, hyperglycemia and lipid disorder pharmacological treatment was provided to respectively 69.5%, 24% and 18.4% of the BD subjects in our sample. LIMITATIONS: Duration of illness of BD subjects was unknown. CONCLUSIONS: This study demonstrated a higher prevalence of MetS in Dutch BD subjects compared to persons without BD. In addition, a remarkable undertreatment of some of the components of MetS was found.


Assuntos
Transtorno Bipolar , Síndrome Metabólica , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/epidemiologia , Estudos de Coortes , Grupos Controle , Estudos Transversais , Humanos , Síndrome Metabólica/epidemiologia , Países Baixos/epidemiologia , Prevalência
6.
Am J Sports Med ; 49(13): 3602-3612, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34652224

RESUMO

BACKGROUND: Return to sports (RTS) and patient-reported outcomes (PROs) for high-level athletes after bilateral hip arthroscopy have not been well established. PURPOSE: (1) To report minimum 2-year PROs and RTS rates in high-level athletes who underwent staged bilateral primary hip arthroscopies and (2) to compare clinical results against a propensity-matched control group of high-level athletes who underwent unilateral primary hip arthroscopy. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data were prospectively collected and retrospectively reviewed for high-level athletes (professional, college, or high school) who underwent staged bilateral hip arthroscopy for femoroacetabular impingement syndrome between September 2009 and October 2018. Inclusion criteria were preoperative and minimum 2-year follow-up for modified Harris Hip Score, Non-arthritic Hip Score, Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and visual analog scale for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center-edge angle <18°), and previous ipsilateral hip surgery/conditions. Rates of achieving the minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement satisfaction threshold were recorded in addition to RTS. These athletes were then propensity matched in a 1:3 ratio to high-level athletes who underwent unilateral arthroscopy for comparison. Outcomes were compared among the first hip of the study group, the second hip of the study group, and the control group. RESULTS: A total of 74 high-level athletes who underwent bilateral hip arthroscopy met the inclusion criteria, and follow-up was available for 68 (91.9%) at 58.9 ± 24.5 months (mean ± SD). Athletes undergoing bilateral hip arthroscopy returned to sports at a high rate (81.7%), demonstrated significant improvements in all recorded PROs, and achieved the MCID and PASS for the HOS-SSS at rates of 80.9% and 64.7%, respectively. PROs, RTS rate, and rates of achieving the MCID and PASS for the HOS-SSS were similar when the bilateral study group was compared with the unilateral control group (P > .05). CONCLUSION: High-level athletes who undergo staged bilateral primary hip arthroscopy for femoroacetabular impingement syndrome may expect favorable PROs and RTS rates at minimum 2-year follow-up. These results were comparable with those of a propensity-matched control group of high-level athletes who underwent unilateral primary hip arthroscopy.


Assuntos
Artroscopia , Impacto Femoroacetabular , Atletas , Benchmarking , Estudos de Coortes , Grupos Controle , Impacto Femoroacetabular/cirurgia , Seguimentos , Articulação do Quadril/cirurgia , Humanos , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Volta ao Esporte , Resultado do Tratamento
7.
Am J Sports Med ; 49(12): 3261-3269, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34468218

RESUMO

BACKGROUND: Labral reconstruction has shown promise for the treatment of irreparable labral tears in high-level athletes. The literature is scarce regarding outcomes and timing of return to sports (RTS) in these patients. PURPOSE: (1) To report minimum 2-year patient-reported outcome (PRO) scores and RTS characteristics for high-level athletes undergoing primary labral reconstruction for irreparable labral tears and (2) to compare clinical results with a matched control group of athletes undergoing labral repair. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data were prospectively collected and retrospectively reviewed for high school, college, and professional athletes who underwent a primary arthroscopic labral reconstruction between January 2010 and June 2018. Minimum 2-year PROs were compared for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and Hip Outcome Score-Sport Specific Subscale (HOS-SSS), as well as the visual analog scale (VAS) pain score, patient satisfaction, and RTS. The percentages of patients achieving the Patient Acceptable Symptom State (PASS) and minimal clinically important difference (MCID) for the mHHS (PASS, >74 points; MCID, >8 points) and HOS-SSS (PASS, >75 points; MCID, >6 points) were also recorded. These patients were propensity score matched in a 1:3 ratio to other high-level athletes undergoing labral repair. RESULTS: A total of 17 high-level athletes with primary arthroscopic labral reconstruction were included with a median follow-up time of 37.1 months (95% CI, 37.2-60.3 months). They demonstrated significant improvement from preoperatively to the latest follow-up for mHHS, NAHS, HOS-SSS, and VAS for pain (P < .05). Further, patients achieved PASS/MCID for mHHS at high rates (PASS, 84.2%; MCID, 68.4%). Athletes were able to return to sport-specific training at a median of 3.33 months (95% CI, 3.07-4.71 months) and RTS at a median of 6.2 months (95% CI, 5.08-11.98 months). Fourteen (82.4%) of reconstructions and 29 (82.8%) of repairs either returned to sport or decided not to do so for reasons unrelated to the hip. PROs, RTS rate, and PASS/MCID rates were similar between the labral reconstruction group and a control labral repair group (P > .05). CONCLUSION: Primary arthroscopic labral reconstruction for irreparable labral tears was associated with significant improvement in PROs and high rates of RTS in high-level athletes. These results were comparable with those of a control group of athletes undergoing labral repair.


Assuntos
Impacto Femoroacetabular , Volta ao Esporte , Artroscopia , Atletas , Benchmarking , Estudos de Coortes , Grupos Controle , Impacto Femoroacetabular/cirurgia , Seguimentos , Articulação do Quadril , Humanos , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Resultado do Tratamento
8.
Am J Sports Med ; 49(13): 3582-3591, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34591692

RESUMO

BACKGROUND: Outcomes of revision hip arthroscopy in the athletic population have not been well established. PURPOSE: (1) To report clinical outcomes for high-level athletes undergoing revision hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS) or labral tears and (2) to compare these outcomes against a propensity-matched group of high-level athletes undergoing primary hip arthroscopy. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data for professional, college, and high school athletes were prospectively collected and retrospectively reviewed between January 2012 and October 2018. Patients were included if they underwent revision or primary hip arthroscopy and had preoperative and minimum 2-year patient-reported outcome (PRO) scores for modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. The findings and outcomes of revision athletes were compared with a propensity-matched control group of high-level athletes undergoing primary hip arthroscopy. RESULTS: A total of 32 hips (29 patients) undergoing revision hip arthroscopy and 92 hips (88 patients) undergoing primary hip arthroscopy were included in our final analysis with a median follow-up time of 29.5 months (95% CI, 27.2-32.1 months) and 36.5 months (95% CI, 33.5-37.7 months), respectively. Athletes undergoing revision surgery showed significant improvement in all recorded PRO measurements and achieved patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) for mHHS at high rates (80.6% and 83.9%, respectively). When compared with a propensity-matched primary control group, patients undergoing revision surgery demonstrated lower preoperative and postoperative scores for mHHS, NAHS, and HOS-SSS, but the magnitude of improvement in functional scores was similar between groups. Athletes undergoing revision surgery achieved PASS for HOS-SSS at lower rates than the control group (P = .005), and they were less likely to attempt to return to sport compared with the control group (62.5% vs 87.0%; P < .01). CONCLUSION: Revision hip arthroscopy is a viable treatment option to improve PROs in high-level athletes at minimum 2-year follow-up. The study group showed significant improvement in functional scores and a high rate of successful outcomes. They experienced similar magnitude of improvement as that of a propensity-matched control group; however, they achieved lower postoperative PRO scores and attempted to return to sport at lower rates.


Assuntos
Artroscopia , Impacto Femoroacetabular , Atividades Cotidianas , Atletas , Estudos de Coortes , Grupos Controle , Impacto Femoroacetabular/cirurgia , Seguimentos , Articulação do Quadril/cirurgia , Humanos , Projetos de Pesquisa , Estudos Retrospectivos , Resultado do Tratamento
9.
Artigo em Inglês | MEDLINE | ID: mdl-34501658

RESUMO

BACKGROUND: Coordination and reaction time are relevant aspects of a sport's competitive performance within teams. The aim of this study was to explore if a group of futsal players, in a laboratory context, would present better results from actions where vision is prevalent compared to a control group without contact with futsal or any other sport. METHODS: The digital system of the COI- SV software was used; six tests were selected, related to coordination ("Eye/hand coordination"; "Coordination and identification") and reaction time ("Anticipation Time"; "Peripheral response"; "reaction time"; "Visual memory"). RESULTS: Of all the tests performed, only in the anticipation time test did the futsal players obtain better results than the control group. The average time of the failures was lower in relation to the control group. In the others, no differences were found between the two groups. CONCLUSIONS: The futsal players did not perform better than the control group in most of the tests carried out, except in the "anticipation time". Therefore, visual training maybe necessary to improve visual skills and sports performance.


Assuntos
Desempenho Atlético , Grupos Controle , Memória , Tempo de Reação , Visão Ocular
10.
Transplant Proc ; 53(7): 2180-2187, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34429190

RESUMO

BACKGROUND: Postmortal organ donor rates remain low in Germany, whereas donor age has been increasing considerably in the last decades. As a consequence of low donation rates older and more marginal donor kidneys are accepted for transplantation. However, procured kidneys from very old a/o marginal donors may be considered as not suitable for transplantation as a single organ and subsequently be discarded. However, dual transplantation of both kidneys from such donors may provide an opportunity to nevertheless use these organs for renal transplantation, thereby providing the twofold nephron mass as a single kidney transplantation. METHODS: We compared in this retrospective analysis the outcome of 10 recipients of a dual kidney transplantation (DKT) with 40 matched recipients of a single kidney transplantation (SKT). Recipients were matched for donor and recipient age (ie, a maximum age difference of ±10 years in a ratio of 1:4 for DKT vs SKT recipients). In addition, a second SKT control group of 10 SKT recipients being transplanted immediately before each DKT recipient with a kidney from a donor aged ≥65 years was used for comparison. All renal transplant recipients were observed for up to 3 years or until July 31, 2020. RESULTS: Mean donor and recipient age was 77.2 ± 4.6/75.1 ± 6.6/82.1 ± 7.9 and 66.4 ± 5.8/66.1 ± 6.0/64.8 ± 8.4 for SKT group 1/SKT group 2/DKT, respectively. Procurement serum creatinine concentrations were significantly higher in the DKT group in comparison to the SKT control group 1 (P = .019) as was the rate of transplant artery atherosclerosis (P = .021). Furthermore, Kidney Donor Profile Index, and Kidney Donor Risk Index were significantly higher (P = .0138/P = .064, and P < .001/P = .038) in the DKT group than in SKT group 1 and 2. Rates of acute rejection and delayed graft function were not significantly different between groups, though biopsy-proven acute rejection was numerically higher in the SKT groups. Patient survival and overall and death-censored graft survival rates were also not significantly different between groups, although they tended to be higher after DKT. CONCLUSIONS: DKT provides an opportunity to successfully use postmortal kidneys even from donors aged >80 years and a Kidney Donor Profile Index ≥95% for renal transplantation. DKT may thereby increase the available pool of donors to better serve patients with end-stage renal disease on the waiting list.


Assuntos
Transplante de Rim , Grupos Controle , Sobrevivência de Enxerto , Humanos , Rim , Transplante de Rim/efeitos adversos , Estudos Retrospectivos , Doadores de Tecidos , Resultado do Tratamento
11.
Rev Bras Enferm ; 74Suppl 2(Suppl 2): e20200984, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34231781

RESUMO

OBJECTIVE: To investigate possible differences in plasma and erythrocyte concentrations of selenium among elderly with and without a diagnosis of Alzheimer's disease (AD). METHODS: Cross-sectional study, performed with an elderly group with Alzheimer's disease, diagnosed by a geriatric doctor, and compared to an elderly group without the disease, equaling gender, education, and age. Atomic absorption spectrophotometry determined plasma and erythrocyte concentrations of total selenium (Set). RESULTS: The mean age was 74.41±7.1 years in the Alzheimer's disease group and 71.46±5.1 years among the control group. The Alzheimer's disease group presented lower plasma concentrations (mean of 45.29±14.51 µg/dL vs. 55.14±14.01 µg/dL; p=0.004), and erythrocyte Set (median of 56.36 µg/L vs. 76.96 µg/L; p<0.001). The logistic regression model indicated an association between erythrocyte Set concentrations and diagnosis of Alzheimer's disease (p=0.028). CONCLUSION: Elderly with Alzheimer's disease present lower selenium concentrations in the evaluated organic compartments.


Assuntos
Doença de Alzheimer , Selênio , Idoso , Idoso de 80 Anos ou mais , Grupos Controle , Estudos Transversais , Eritrócitos , Humanos
12.
Artigo em Inglês | MEDLINE | ID: mdl-34204017

RESUMO

This randomized, double-blind and controlled clinical trial investigates how a diode laser lingual frenectomy can improve obstructive sleep apnea syndrome (OSAS) in pediatric patients. BACKGROUND: Several authors have shown that a short lingual frenulum causes a reduction in incoming air flow and the relationship between OSAS and a short lingual frenulum. METHODS: Thirty-two pediatric patients were equally randomly divided into a Study Group (SG) and a Control Group (CG). On each SG patient a polysomnography 1 (PSG1) and a lingual frenectomy were performed using a diode laser via Doctor Smile Wiser technology, power 7 W. After three months, a new polysomnography (PSG2) was performed to evaluate the lingual frenectomy efficacy in pediatric patients. The pain was assessed by a numerical rating scale (NRS) before and after surgery. The CG followed the same protocol without a lingual frenectomy but myofunctional and speech therapy were conducted to qualitatively and quantitatively improve the lingual functionality. In the SG, eight subjects (50%) had severe OSAS and eight had moderate (50%) while in the CG, three subjects had severe OSAS (18.8%) and thirteen had moderate (81.2%). RESULTS: In the SG, 93.8% were classified as mild OSAS and 6.2% as moderate. In contrast, in the CG, 18.75% were classified as mild OSAS, 62.5% as moderate and 18.75% as severe. CONCLUSION: The study demonstrates how a lingual laser frenectomy can improve OSAS in pediatric patients.


Assuntos
Freio Lingual , Apneia Obstrutiva do Sono , Criança , Grupos Controle , Método Duplo-Cego , Humanos , Lasers Semicondutores/uso terapêutico , Freio Lingual/cirurgia , Apneia Obstrutiva do Sono/cirurgia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34208162

RESUMO

Women with excessive gestational weight gain are at increased risk of postpartum weight retention and potentially also unfavorable body composition. Insight into the lifestyle behaviors that play a role in the evolution of postpartum weight and body composition among these women could aid identification of those at highest risk of long-term adverse outcomes. This secondary analysis of the INTER-ACT randomized controlled trial investigates control group data only (n = 524). The evolution of weight retention, percentage loss of gestational weight gain, fat percentage, waist circumference, and associated lifestyle behaviors between 6 weeks and 12 months postpartum were assessed using mixed model analyses. At six weeks postpartum, every sedentary hour was associated with 0.1% higher fat percentage (P = 0.01), and a higher emotional eating score was associated with 0.2% higher fat percentage (P < 0.001) and 0.3 cm higher waist circumference (P < 0.001). Increase in emotional eating score between 6 weeks and 6 months postpartum was associated with a 0.4 kg (P = 0.003) increase in postpartum weight retention from six months onwards. Among women with overweight, an increase in the uncontrolled eating score between 6 weeks and 6 months postpartum was associated with a 0.3 kg higher postpartum weight retention (P = 0.04), and 0.3% higher fat percentage (P = 0.006) from six months onwards. In conclusion, sedentary and eating behaviors play important roles in postpartum weight and body composition of women with excessive gestational weight gain and should therefore be incorporated as focal points in lifestyle interventions for this population.


Assuntos
Ganho de Peso na Gestação , Complicações na Gravidez , Composição Corporal , Índice de Massa Corporal , Peso Corporal , Grupos Controle , Feminino , Humanos , Estilo de Vida , Obesidade , Sobrepeso , Período Pós-Parto , Gravidez
14.
Artigo em Inglês | MEDLINE | ID: mdl-34065329

RESUMO

The study aimed to investigate the psychological and physiological effects of forest therapy programs on adolescents under probation. Fifty probationary teenagers from the Ministry of Gyeonggi Justice Compliance Support Center participated in the study. The study explored the effectiveness of a nonrandomized control group pretest-posttest design forest therapy program. The forest therapy program was conducted for two days and one night for the experimental groups (N = 33), who participated in the forest therapy program, and the control group (N = 17), who received two days of attendance center orders program in the lecture room of the Ministry of Gyeonggi Justice Compliance Support Center. As a result, adolescents under probation who participated in forest therapy programs had a beneficial effect on psychological well-being (K-WBMMS) and HRV's HF (high frequency) and LF/HF (A ratio of Low Frequency to High Frequency) compared to those who received the general attendance center orders program. These results support that forest therapy programs play a positive role in the psychological and physiological effects of probationary adolescents and can affect the diversity of rehabilitation programs for probationary adolescents.


Assuntos
Florestas , Adolescente , Grupos Controle , Humanos
15.
Am J Sports Med ; 49(9): 2309-2320, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34166113

RESUMO

BACKGROUND: While platelet-rich plasma (PRP) has been widely studied for musculoskeletal disorders, few studies to date have reported its use for adhesive capsulitis (AC). Fully characterized and standardized allogenic PRP may provide clues to solve the underlying mechanism of PRP with respect to synovial inflammation and thus may clarify its clinical indications. PURPOSE: To clinically evaluate the safety and efficacy of a fully characterized pure PRP injection in patients with AC and to assess the effects of pure PRP on synoviocytes with or without inflammation in vitro. STUDY DESIGN: Controlled laboratory study and cohort study; Level of evidence, 3. METHODS: For the clinical analysis, a total of 15 patients with AC received an ultrasonography-guided intra-articular PRP injection and were observed for 6 months. Pain, range of motion (ROM), muscle strength, shoulder function, and overall satisfaction in the patients were evaluated using questionnaires at 1 week as well as at 1, 3, and 6 months after the PRP injection and results were compared with the results of a propensity score-matched control group that received a corticosteroid injection (40 mg triamcinolone acetonide). For the in vitro analysis, synoviocytes were cultured with or without interleukin-1ß (IL-1ß) and PRP. The gene expression of proinflammatory and anti-inflammatory cytokines as well as matrix enzymes and their inhibitors was evaluated. RESULTS: At 6-month follow-up, pure PRP significantly decreased pain and improved ROM, muscle strength, and shoulder function to levels comparable with those after a corticosteroid injection. All pain values, strength measurements, and functional scores significantly improved up to 6 months in the PRP group, but these measures improved up to 3 months and then were decreased at 6 months in the corticosteroid group. ROM was significantly improved in the 2 groups at 6 months compared with baseline. Allogenic PRP did not cause adverse events. For the in vitro findings, PRP induced inflammation but significantly improved the IL 1ß-induced synovial inflammatory condition by decreasing proinflammatory cytokines such as IL-1ß, tumor necrosis factor-α, IL-6, cyclooxygenase-2, and microsomal prostaglandin E synthase-1 and decreased matrix enzymes (matrix metalloproteinase-1, -3, and -13 as well as a disintegrin and metalloproteinase with thrombospondin motifs-4 and -5) and further increasing anti-inflammatory cytokines such as vasoactive intestinal peptide. CONCLUSION: This study showed that PRP decreased pain and improved shoulder ROM and function to an extent comparable with that of a corticosteroid in patients with AC. Allogenic pure PRP acted in a pleiotropic manner and decreased proinflammatory cytokines only in the inflammatory condition. CLINICAL RELEVANCE: Allogenic PRP could be a treatment option for the inflammatory stage of AC.


Assuntos
Bursite , Plasma Rico em Plaquetas , Corticosteroides/uso terapêutico , Bursite/tratamento farmacológico , Estudos de Coortes , Grupos Controle , Humanos , Injeções Intra-Articulares , Pontuação de Propensão , Resultado do Tratamento
16.
Semin Arthritis Rheum ; 51(4): 775-785, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34146952

RESUMO

OBJECTIVES: To assess how patient characteristics and study design influence the effectiveness of control interventions in hand OA trials. METHODS: The study protocol was registered in PROSPERO (CRD42020163473). Two authors independently searched four electronic databases from their inception to December 31, 2019. Randomized and non-randomized controlled hand OA trials were included if pain intensity was assessed using a validated scale. We allocated control groups into one of the following: placebo, add-on treatment, no treatment, or active treatment. The standardized mean differences (d) of pain, as well as subjective function and hand strength, were pooled with 95% confidence intervals (CI) and 90% prediction intervals using random-effects models. Meta-regression and post-hoc subgroup analyses were performed to investigate which factors potentially impacted placebo analgesia and between-study heterogeneity. RESULTS: Thirty-one placebo, 11 add-on, 12 no-treatment, and 10 active-treatment controls were included in meta-analyses. Effective pain relief was observed in placebo (d = -0.50, 95% CI -0.63 to -0.37), add-on (d = -0.35, 95% CI -0.59 to -0.12), and active-treatment (d = -0.92, 95% CI -1.35 to -0.48) groups. In subjective function, these treatments had smaller but beneficial effects; hand strength, contrastingly, was not improved. Placebo effects were larger when flare designs were used (d = -0.96) and more homogeneous when minimum pain thresholds were set (d = -0.46, 90% prediction intervals -0.79 to -0.14). CONCLUSION: Placebo, add-on, and active control treatments were more effective than the no treatment control in relieving hand pain and improving subjective function. By choosing minimum pain thresholds and flare requirements at patient enrollment, moderate pain relief may be replicated among control participants in future randomized placebo-controlled trials.


Assuntos
Osteoartrite , Dor , Grupos Controle , Mãos , Humanos , Osteoartrite/tratamento farmacológico , Dor/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
Rev. bras. med. esporte ; 27(2): 174-178, Apr.-June 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1280067

RESUMO

ABSTRACT Introduction: High-performance athletes often undergo periods of exhaustive training and insufficient recovery, which can lead to decreased performance, but it is not clear whether there are any differences between the sexes in the level of habitual physical activity, sedentary time or sleep quantity and quality in young highly trained badminton athletes. Objectives: The aim of this study was to compare the habitual physical activity (PA), sedentary time and sleep quantity and quality of highly trained young male and female badminton athletes and non-athletes. Methods: Twenty-seven young badminton athletes and twenty-one non-athletes (control group) were recruited. Sleep duration and quality (total time in bed, total sleep time, wake after sleep onset, sleep efficiency and latency), total counts, vigorous activity time and sedentary time were measured using a tri-axial accelerometer. Results: Male athletes spent less sedentary time (p=0.028), more time in vigorous activity (p=0.016) and had higher total counts (p<0.001) than the male control group. There were no significant differences in sedentary time (p=0.702) or vigorous activity time (p=0.205) between the female athletes and non-athletes, but the female athletes accumulated higher total counts than the female control group (p=0.003). There were no significant differences between the sexes or groups for time in bed, total sleep time, sleep efficiency, wake after sleep onset and latency (p> 0.05). Conclusion: Among males but not females, young highly trained badminton athletes had less sedentary time and more time in vigorous activity than the non-athletes, however, there were no significant differences between the sexes or groups in sleep quantity and quality. Level of evidence III; Case-control study .


RESUMEN Introducción: Los atletas de alto rendimiento con frecuencia son sometidos a períodos de entrenamiento exhaustivo y recuperación insuficiente, lo que puede llevar a una disminución del desempeño, pero no está claro si hay diferencia entre los sexos en cuanto al nivel de actividad física habitual, tiempo sedentario, cantidad y calidad del sueño en jóvenes atletas de bádminton altamente entrenados. Objetivos: El objetivo de este estudio fue comparar la actividad física habitual (AF), el tiempo de sedentarismo y la duración y calidad del sueño en jóvenes atletas de bádminton altamente entrenados y de no atletas, del sexo femenino y masculino. Métodos: Fueron reclutados veintisiete jóvenes atletas de bádminton y veintiuno no atletas (grupo control). La duración y la calidad del sueño (tiempo total en la cama, tiempo total de sueño, vigilia después del inicio del sueño, eficiencia y latencia del sueño), counts totales, el tiempo en actividad vigorosa y el tiempo de sedentarismo fueron medidos con un acelerómetro triaxial. Resultados: Los atletas del sexo masculino tuvieron menos tiempo de sedentarismo (p = 0,028), más tiempo de actividad vigorosa (p = 0,016) y mayor cantidad de counts totales (p <0,001) que el grupo control masculino. No hubo diferencias significativas en el tiempo de sedentarismo (p = 0,702) o tiempo de actividad vigorosa (p = 0,205), entre las atletas y no atletas, pero las atletas del sexo femenino acumularon mayor cantidad de counts totales que el grupo control femenino (p = 0,003). No hubo diferencias significativas entre los sexos o grupos para tiempo en la cama, tiempo total de sueño, eficiencia del sueño, vigilia después del inicio del sueño y latencia (p> 0,05). Conclusiones: Entre hombres, pero no entre mujeres, los jóvenes atletas de bádminton altamente entrenados tuvieron menor tiempo de sedentarismo y mayor tiempo en actividades vigorosas que los no atletas; entretanto, no hubo diferencia significativa entre los sexos o grupos en la cantidad y calidad del sueño. Nivel de evidencia III; Estudio de caso control .


RESUMO Introdução: Atletas de alto rendimento com frequência são submetidos a períodos de treinamento exaustivo e recuperação insuficiente, o que pode levar à diminuição do desempenho, mas não está claro se há diferença entre os sexos quanto ao nível de atividade física habitual, tempo sedentário, quantidade e qualidade do sono em jovens atletas de badminton altamente treinados. Objetivos: O objetivo deste estudo foi comparar a atividade física habitual (AF), o tempo de sedentarismo e a duração e qualidade do sono em jovens atletas de badminton altamente treinados e de não atletas, do sexo masculino e feminino. Métodos: Vinte e sete jovens atletas de badminton e vinte e um não atletas (grupo controle) foram recrutados. A duração e a qualidade do sono (tempo total na cama, tempo total de sono, vigília após o início do sono, eficiência e latência do sono), counts totais, tempo em atividade vigorosa e tempo de sedentarismo foram medidos com um acelerômetro triaxial. Resultados: Atletas do sexo masculino tiveram menos tempo de sedentarismo (p = 0,028), mais tempo de atividade vigorosa(p = 0,016) e maior quantidade de counts totais (p < 0,001) do que o grupo controle masculino. Não houve diferença significante no tempo de sedentarismo (p = 0,702) ou tempo de atividade vigorosa (p = 0,205) entre as atletas e não atletas, mas as atletas do sexo feminino acumularam maior quantidade de counts totais que o grupo controle feminino (p = 0,003). Não houve diferença significante entre os sexos ou grupos para tempo na cama, tempo total de sono, eficiência do sono, vigília após o início do sono e latência (p> 0,05). Conclusões: Entre homens, mas não entre mulheres, os jovens atletas de badminton altamente treinados tiveram menor tempo de sedentarismo e maior tempo em atividades vigorosas do que os não atletas; entretanto, não houve diferença significante entre os sexos ou grupos na quantidade e qualidade do sono. Nível de evidência III; Estudo de caso controle .


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Sono/fisiologia , Exercício Físico/fisiologia , Esportes com Raquete/fisiologia , Desempenho Atlético/fisiologia , Esportes com Raquete/estatística & dados numéricos , Fatores Sexuais , Grupos Controle , Desempenho Atlético/estatística & dados numéricos
18.
Ann Palliat Med ; 10(5): 5289-5298, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33977734

RESUMO

BACKGROUND: In severe chronic obstructive pulmonary disease (COPD), interval training (IT) can be performed with oxygen support, which provides beneficial effect on metabolic processes, tissue perfusion, and peripheral muscle function. METHODS: A prospective cohort study with matched controls was performed on patients in Budapest at the Department of Pulmonary Rehabilitation of the National Koranyi Institute of Pulmonology between January 1, 2020 and March 1, 2020. After a complex condition assessment, both case and control patients participated in a 3-week long complex pulmonary rehabilitation (PR) program that included individual training, education, nutrition, and psychological counseling. Anthropometric and functional data of patients were recorded at both the beginning and end of the PR program. Our research aimed to assess the effect of non-invasive ventilation (NIV) in patients with severe COPD who underwent IT. RESULTS: A total of 18 [male/female: 10 (55.6%)/8 (44.4%)] patients were enrolled in our study. IT with NIV significantly improved the patients' 6-minute walking distance (6MWD) (m) [216.0 (211.5-233.7) vs. 274.0 (247.5-313.5); P<0.001] and quality of life [COPD Assessment Test (CAT): 29.0 (26.9-32.0) vs. 15.0 (13.5-17.5); P<0.001], [modified Medical Research Council (mMRC): 2.0 (1.5-2.0) vs. 1.0 (1.0-2.0); P=0.009]; in addition, there was a significant increase in inspiratory vital capacity (IVC) (ref%) [65.0 (63.0-69.0) vs. 74.7 (70.5-75.0); P=0.015], in chest kinematics (cm) [3.0 (2.5-4.0) vs. 5.5 (4.0-6.5); P<0.001], work rate (Watt) [25.0 (24.0-27.0) vs. 36.0 (35.0-38.0); P<0.001], volume of oxygen consumption [VO2/kg (mL/kg/min): 8.8 (8.5-9.2) vs. 10.3 (10.2-10.7); P<0.001], and Body-mass index, airflow Obstruction, Dyspnea, and Exercise (BODE) index [5.0 (5.0-6.7) vs. 4.0 (3.0-5.0); P=0.006], while the results of the control group were non-significant [6MWD, maximal inspiratory pressure (MIP), CAT, mMRC, BODE index]. CONCLUSIONS: In severe COPD, IT with NIV is well tolerated during PR, it has a significant beneficial effect on the quality of life, improves exercise capacity and respiratory functions, decreases dynamic hyperinflation and dyspnea.


Assuntos
Ventilação não Invasiva , Doença Pulmonar Obstrutiva Crônica , Grupos Controle , Dispneia , Feminino , Humanos , Masculino , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/terapia , Qualidade de Vida
20.
BMC Med Res Methodol ; 21(1): 99, 2021 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-33957892

RESUMO

BACKGROUND: Sample size calculation is a key point in the design of a randomized controlled trial. With time-to-event outcomes, it's often based on the logrank test. We provide a sample size calculation method for a composite endpoint (CE) based on the geometric average hazard ratio (gAHR) in case the proportional hazards assumption can be assumed to hold for the components, but not for the CE. METHODS: The required number of events, sample size and power formulae are based on the non-centrality parameter of the logrank test under the alternative hypothesis which is a function of the gAHR. We use the web platform, CompARE, for the sample size computations. A simulation study evaluates the empirical power of the logrank test for the CE based on the sample size in terms of the gAHR. We consider different values of the component hazard ratios, the probabilities of observing the events in the control group and the degrees of association between the components. We illustrate the sample size computations using two published randomized controlled trials. Their primary CEs are, respectively, progression-free survival (time to progression of disease or death) and the composite of bacteriologically confirmed treatment failure or Staphylococcus aureus related death by 12 weeks. RESULTS: For a target power of 0.80, the simulation study provided mean (± SE) empirical powers equal to 0.799 (±0.004) and 0.798 (±0.004) in the exponential and non-exponential settings, respectively. The power was attained in more than 95% of the simulated scenarios and was always above 0.78, regardless of compliance with the proportional-hazard assumption. CONCLUSIONS: The geometric average hazard ratio as an effect measure for a composite endpoint has a meaningful interpretation in the case of non-proportional hazards. Furthermore it is the natural effect measure when using the logrank test to compare the hazard rates of two groups and should be used instead of the standard hazard ratio.


Assuntos
Projetos de Pesquisa , Simulação por Computador , Grupos Controle , Humanos , Modelos de Riscos Proporcionais , Tamanho da Amostra
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