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1.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(10. Vyp. 2): 80-88, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33205935

RESUMO

Disturbances in sleep and wakefulness are important symptoms of Parkinson's disease (PD) and are associated with negative effects on patients' quality of life. The analysis of literature on the relationship between RLS and PD revealed three main hypotheses explaining the relatively high incidence of RLS in PD: (1) RLS can be considered as an early (prodromal) manifestation or a predictor of PD that can outpace its main symptoms by several years (by analogy with conduct disorder during sleep with REM); (2) the high incidence of RLS in the advanced stage of PD may be associated with augmentation of previously latent RLS symptoms during prolonged dopaminergic therapy of PD; (3) a significant proportion of RLS cases in PD patients are not «classical¼ RLS, but represent, for example, manifestations of motor or non-motor fluctuations or a special form of stereotypy in the legs. Further research is needed to determine if any of these statements are true.


Assuntos
Doença de Parkinson , Síndrome das Pernas Inquietas , Humanos , Perna (Membro) , Doença de Parkinson/complicações , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/epidemiologia , Qualidade de Vida , Síndrome das Pernas Inquietas/epidemiologia , Síndrome das Pernas Inquietas/etiologia , Sono
5.
Science ; 370(6514): 364-368, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33060364

RESUMO

The heart consumes circulating nutrients to fuel lifelong contraction, but a comprehensive mapping of human cardiac fuel use is lacking. We used metabolomics on blood from artery, coronary sinus, and femoral vein in 110 patients with or without heart failure to quantify the uptake and release of 277 metabolites, including all major nutrients, by the human heart and leg. The heart primarily consumed fatty acids and, unexpectedly, little glucose; secreted glutamine and other nitrogen-rich amino acids, indicating active protein breakdown, at a rate ~10 times that of the leg; and released intermediates of the tricarboxylic acid cycle, balancing anaplerosis from amino acid breakdown. Both heart and leg consumed ketones, glutamate, and acetate in direct proportionality to circulating levels, indicating that availability is a key driver for consumption of these substrates. The failing heart consumed more ketones and lactate and had higher rates of proteolysis. These data provide a comprehensive and quantitative picture of human cardiac fuel use.


Assuntos
Ácidos Graxos/metabolismo , Insuficiência Cardíaca/metabolismo , Miocárdio/metabolismo , Acetatos/metabolismo , Idoso , Glicemia/metabolismo , Ciclo do Ácido Cítrico , Feminino , Ácido Glutâmico/metabolismo , Glutamina/metabolismo , Humanos , Cetonas/metabolismo , Perna (Membro)/irrigação sanguínea , Masculino , Metabolômica , Pessoa de Meia-Idade , Contração Miocárdica , Proteólise
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4858-4862, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019078

RESUMO

This paper presents an algorithm that makes novel use of distance measurements alongside a constrained Kalman filter to accurately estimate pelvis, thigh, and shank kinematics for both legs during walking and other body movements using only three wearable inertial measurement units (IMUs). The distance measurement formulation also assumes hinge knee joint and constant body segment length, helping produce estimates that are near or in the constraint space for better estimator stability. Simulated experiments have shown that inter-IMU distance measurement is indeed a promising new source of information to improve the pose estimation of inertial motion capture systems under a reduced sensor count configuration. Furthermore, experiments show that performance improved dramatically for dynamic movements even at high noise levels (e.g., σdist = 0.2 m), and that acceptable performance for normal walking was achieved at σdist = 0.1 m. Nevertheless, further validation is recommended using actual distance measurement sensors.


Assuntos
Extremidade Inferior , Dispositivos Eletrônicos Vestíveis , Fenômenos Biomecânicos , Perna (Membro) , Caminhada
7.
Angiol Sosud Khir ; 26(3): 116-121, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063758

RESUMO

Presented herein is original experience in using a technique of arterialization in patients with critical lower limb ischaemia on the background of diffuse multilevel occlusive lesions of femoral, crural arteries and arteries of the foot in 214 patients. We used a new method of treatment by means of oxygenation of the sural group of muscles and the foot through the small saphenous vein and indirect communicating veins. This method does not require destruction of the valvular apparatus of the communicants themselves, promoting opening of previously not functioning ones, as well as appears to be a powerful stimulus for the development of collateral circulation of the extremity. Alterations introduced into the design characteristics of a valvulotome make it possible to avoid lateral injury of the venous wall in the area of confluence of tributaries, preventing incomplete resection of the valve. The method expands the boundaries of operability of patients with the absence of the receiving arterial bed of the calf and foot. It may be combined with arterial primary and repeat reconstructions in patients with depleted receiving channel of the calf as an effective additional path of outflow. It also makes it possible to lower the level of amputation in the developed necrosis of the distal part of the foot. Based on clinical laboratory and instrumental findings, the patients were diagnosed by the aetiological factor of the occlusive process and its extension, substantiating the indications for operative treatment with the use of one or another venous basin. Comparative assessment of reversion of arterial blood flow through the great saphenous vein, small saphenous vein, and posterior tibial vein, according to the findings of bioelectromagnetic diagnosis of reactivity of tissues demonstrated that the most effective method was that of arterialization thought the small saphenous vein. With the help of the questionnaire of quality of life in patients with performed arterialization of the calf and foot through the small saphenous vein for critical lower limb ischaemia we obtained 5-year remote results. Upon completion of this period, 87.3% of the limbs were saved and composite measures of the patients' quality of life proved to be high, ranging from 53 to 69 points.


Assuntos
Doenças Vasculares Periféricas , Qualidade de Vida , Humanos , Isquemia/diagnóstico , Isquemia/etiologia , Isquemia/cirurgia , Perna (Membro) , Veia Safena
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3969-3972, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018869

RESUMO

The assessment of lower limb oedema almost always involves measuring leg volume, and the gold-standard for this is the water displacement technique. As it is not very practical to use in a clinical routine, physicians prefer indirect methods such as anthropometric or bioimpedance measurements. In the case of "non-pitting" leg oedema, i.e. where the presence of oedema is not obvious, it may be challenging to estimate changes in leg volume using these methods separately. The combination of these two methods, however, gives interesting results, such as a new composite parameter that is much more robust and efficient than commonly used parameters.Clinical Relevance- This study demonstrates the benefit of using a composite anthropometric-impedimetric parameter to predict water displacement variations in the leg over the course of a day, rather than using parameters based solely on anthropometry or impedance. Our new parameter (C²-A²)/R0 showed a robust r² value of 61%, which is more than twice the r² values obtained using other simple or composite parameters.


Assuntos
Perna (Membro) , Água , Antropometria , Edema/diagnóstico , Humanos , Extremidade Inferior , Análise Espectral
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3981-3984, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018872

RESUMO

Remote monitoring of fluid status via calf bioimpedance measurements could improve the experience of patients with congestive heart failure and reduce readmission rates. Most measurements today use conventional Ag/AgCl electrodes and a short inter-electrode spacing, resulting in current flowing primarily near the electrodes, preventing deeper current penetration and in turn accurate volume estimation. Textile band electrodes may more evenly distribute current throughout the calf. In the present study, simulations were conducted to investigate the impact of inter-electrode spacing/placement and fat tissue on bioimpedance using both Ag/AgCl electrodes and textile band electrodes. Simulation results showed that increasing the inter-electrode spacing can improve current distribution in the tissue, but there are still errors that increase with fat thickness (14.3% error at 10 cm spacing down to 1.7% error at 20 cm spacing for a "nominal" fat thickness, vs. -0.3% and -0.5% error for band electrodes). Band electrodes most closely matched the expected resistance and seem the most suitable regardless of inter-electrode spacing.


Assuntos
Perna (Membro) , Músculos , Anisotropia , Impedância Elétrica , Eletrodos , Humanos
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4243-4247, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018933

RESUMO

A growing body of evidence has highlighted that inertial sensor data can increase the sensitivity and clinical utility of the Y Balance Test, a commonly used clinical dynamic balance assessment. While early work has demonstrated the value of a single lumbar worn inertial sensor in quantifying dynamic balance control, no research has investigated if alternative (shank) or combined (lumbar and shank) sensor mounting locations may improve the assessments discriminant capabilities. Determining the optimal sensor set-up is crucial to ensuring minimal cost and maximal utility for clinical users The aim of this cross-sectional study was to investigate if single or multiple inertial sensors, mounted on the lumbar spine and/or shank could differentiate young (18-40 years [n = 41]) and middle-aged (40-65 years [n = 42]) adults, based on dynamic balance performance. Random-forest classification highlighted that a single lumbar sensor could classify age-related differences in performance with an accuracy of 79% (sensitivity = 81%; specificity = 78%). The amalgamation of shank and lumbar data did not significantly improve the classification performance (accuracy = 73-77%; sensitivity = 71-76%; specificity = 73-78%). Jerk magnitude root-mean-square consistently demonstrated predictor importance across the three reach directions: posteromedial (rank 1), anterior (rank 3) and posterolateral (rank 6).


Assuntos
Perna (Membro) , Região Lombossacral , Estudos Transversais , Vértebras Lombares , Modalidades de Fisioterapia
12.
Zhen Ci Yan Jiu ; 45(9): 740-5, 2020 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-32959558

RESUMO

OBJECTIVE: To observe changes of microcirculation in the superficial regions of acupoints of the three Yin meridians of foot during the menstrual cycle in young college students, so as to provide experimental evidence for explaining the saying of traditional Chinese medicine that acupoints reflect the state of physiological and pathological activities of the internal organs. METHODS: Ninety healthy female volunteer college students were recruited in the present study. The subjects were asked to take a supine position on an examination couch to expose the Yuan-primary acupoints Taixi (KI3), Taibai (SP3) and Taichong (LR3), and Xi-cleft acupoints Shuiquan (KI5), Diji (SP8) and Zhongdu (LR6) which are related to the uterus of the three Yin meridians of foot, the crossing acupoints of the three Yin meridians of foot Sanyinjiao (SP6), non-specific acupoint of the Spleen meridian Xuehai (SP10), non-related meridian acupoint Xuanzhong (GB39) and non-meridian-non-acupoint (being at the same level of GB39, between the Stomach and Gallbladder meridians on the lateral aspect of the lower leg). The laser speckle blood flow imaging technique was used to detect the state of microcirculation (average blood perfusion volume) during menstrual, follicular, ovulatory and luteal phases. RESULTS: The average blood perfusion volume (ABPV) of the right SP8 region was significantly lower in the menstrual phase than in the ovulation and luteal phases (P<0.05), and in the follicular phase than in the ovulation phase (P<0.05). In the left LR6 region, the ABPV was obviously lower in the menstrual period than in the follicular, ovulation and luteal phases (P<0.05). In the SP8, SP6, KI3 and KI5 regions, the ABPV was significantly higher in each of the 4 phases on the left side than on the right side (P<0.05). In the right GB39, the ABPV in each of the 4 phases was apparently higher on the right side than on the left side (P<0.05). In the SP10 region, the ABPV was considerably higher on the left side than on the right side in the ovulation period (P<0.05). The ABPV of SP3 in the menstrual phase and that of the non-acupoint in the luteal phase were significantly higher on the right side than on the left side (P<0.05). CONCLUSION: The blood perfusion of microcirculation in the superficial tissues of Xi-cleft acupoints SP8 and LR6 is obviously lower in the menstrual phase than in both of the ovulation and luteal phases in healthy young college students, which may specifically reflect the periodical activities of the uterus in the physiological state, and provide a basis of acupoint selection for menstrual healthy care.


Assuntos
Pontos de Acupuntura , Meridianos , Feminino , Humanos , Perna (Membro) , Menstruação , Microcirculação
13.
Geriatr Gerontol Int ; 20(10): 943-950, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32886830

RESUMO

AIM: To re-evaluate the suitability of calf circumference as a surrogate marker of low muscle mass measured by both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). We also examined the effects of obesity and age on low muscle mass screening using calf circumference. METHODS: In total, 1239 adults participated in this cross-sectional study. We measured the maximum calf circumference in a standing position and appendicular skeletal muscle mass (ASM) using BIA and DXA. We defined low muscle mass based on the Asian Working Group for Sarcopenia 2019 consensus. RESULTS: Calf circumference was positively correlated with BIA-measured ASM/height2 (men: r = 0.81, women: r = 0.73) and DXA-measured ASM/height2 (men: r = 0.78, women: r = 0.76). In the subgroup analyses by obesity and age, calf circumference was also positively correlated with ASM/height2 . The optimal calf circumference cut-offs for low muscle mass screening measured by BIA and DXA were 35 cm (sensitivity 91%, specificity 84%) and 36 cm (sensitivity 82%, specificity 80%) for men, and 33 cm (sensitivity 82%, specificity 84%) and 34 cm (sensitivity 85%, specificity 72%) for women, respectively. CONCLUSIONS: Calf circumference is positively correlated with BIA- and DXA-measured muscle mass regardless of obesity and age and is a simple and accurate surrogate marker of muscle mass for diagnosing sarcopenia. Geriatr Gerontol Int 2020; 20: 943-950.


Assuntos
Perna (Membro)/fisiologia , Músculo Esquelético/fisiologia , Sarcopenia/diagnóstico , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Composição Corporal , Índice de Massa Corporal , Estudos Transversais , Impedância Elétrica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Sensibilidade e Especificidade
14.
J Cancer Res Ther ; 16(4): 900-902, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32930137

RESUMO

Objective: Aggressive fibromatosis (AF), also called desmoid tumor, is an uncommon soft-tissue neoplasm. Characteristically, it expands locally without metastatic potential. However, its tendency of relapse after curative resections has been well documented. Effective treatment options have been limited and there is a clear need for novel treatment strategies. Methods: We used combination therapy including multikinase tyrosine kinase inhibitor for treating AF. Results: We presented a case of an extra-abdominal AF who was successfully treated with meloxicam and sorafenib combination in our clinic. She tolerated this therapy well with only mild side effects. To our knowledge, this is the first case report of an extra-abdominal AF with a major partial response to sorafenib and meloxicam combination. Conclusion: Due to the favorable toxicity profile of sorafenib and meloxicam, this combination might be an effective treatment option for patients with locally aggressive and inoperable AF.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fibromatose Agressiva/tratamento farmacológico , Neoplasias Musculares/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Feminino , Fibromatose Agressiva/diagnóstico por imagem , Fibromatose Agressiva/patologia , Humanos , Perna (Membro)/patologia , Imagem por Ressonância Magnética/métodos , Meloxicam/administração & dosagem , Neoplasias Musculares/diagnóstico por imagem , Neoplasias Musculares/patologia , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/patologia , Inibidores de Proteínas Quinases/administração & dosagem , Sorafenibe/administração & dosagem , Resultado do Tratamento
15.
J Stroke Cerebrovasc Dis ; 29(10): 105147, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912540

RESUMO

Hypertrophic olivary degeneration (HOD) is a rare phenomenon that occurs after various insults to the Guillain-mollaret triangle (GMT). HOD is unique because the degeneration of inferior olivary nucleus becomes hypertrophic rather than atrophic. In this study, a 31-year-old woman developed HOD after pontine cavernoma surgery had been performed. The clinical manifestation was involuntary intorsion of right lower extremity during walking, which has not been reported in the literature. The woman also presented with palatal tremor, the most classic symptom of HOD. HOD's imaging trait include olive hypertrophy with increased T2 signal intensity on MRI, which are corresponding to the pathological findings. HOD is a self-limiting disease and excessive treatments are unnecessary.


Assuntos
Distonia/etiologia , Pé/inervação , Perna (Membro)/inervação , Doenças Neurodegenerativas/etiologia , Procedimentos Neurocirúrgicos/efeitos adversos , Núcleo Olivar/patologia , Palato/inervação , Tremor/etiologia , Adulto , Distonia/fisiopatologia , Feminino , Humanos , Hipertrofia , Degeneração Neural , Doenças Neurodegenerativas/diagnóstico por imagem , Doenças Neurodegenerativas/patologia , Doenças Neurodegenerativas/fisiopatologia , Núcleo Olivar/diagnóstico por imagem , Núcleo Olivar/fisiopatologia , Tremor/fisiopatologia
17.
Medicine (Baltimore) ; 99(39): e22450, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991481

RESUMO

RATIONALE: There is still a lack of case reports about tactile vibration feedback devices for the treatment of transtibial amputees so far. This case report aims to introduce a tactile vibration feedback device designed to improve the balance and walking function of the transtibial amputee. PATIENT CONCERNS: The amputee was a 20-year-old man with right transtibial amputation in a car accident four years ago. DIAGNOSE: The clinical diagnosis of him was "Right transtibial amputation," and the rehabilitation diagnosis was "Motor dysfunction (Balance function abnormality and Gait abnormality)." INTERVENTIONS: The patient was reminded to adjust their posture in time via the tactile vibration feedback device. OUTCOMES: The balance and walking function of the volunteer transtibial amputee was improved. CONCLUSION: The tactile vibration feedback device has the potential to improve the balance and walking function of the transtibial amputee after installation. Potential fields that can be recommended for future research include intelligent prosthetics, feedback training, motor function, prosthetic acceptance, compliance, social communication, and the quality of life.


Assuntos
Amputados/reabilitação , Membros Artificiais , Retroalimentação Sensorial , Equilíbrio Postural , Dispositivos Eletrônicos Vestíveis , Humanos , Perna (Membro) , Masculino , Vibração , Adulto Jovem
18.
Rev Col Bras Cir ; 47: e20202481, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32965301

RESUMO

OBJECTIVE: Endovascular treatment for femoropopliteal arterial disease has made revascularization procedures less invasive, but the self-expanding stents used can suffer great wear in arteries with extreme mobility. To evaluate the prevalence of fractures in stents implanted in the femoropopliteal segment, to identify predisposing factors and consequences on arterial patency. METHOD: between March and June 2019, thirty patients previously operated for femoropopliteal obstruction underwent stent X-rays in anteroposterior and lateral views to detect fractures and Doppler to analyze arterial patency. RESULTS: we observed 12 cases with fractures (33.3%): 1 type I (2.8%), 3 type II (8.3%), 5 type III (13.9%), 3 type IV (8.3%) and no type V. According to the TASC II we had 1 in group B (8.3%), 6 in group C (50%) and 5 in group D (41.6%) p <0.004. The number of stents per limb was 3.1 (± 1.3) in cases of fracture versus 2.3 (± 1.3) in cases without fracture (p = 0.08). The extension was 274.17mm (± 100.94) in cases of fracture and 230.83mm (± 135.44) in cases without fracture (p = 0.29). On Doppler we had: 17 patients (47.2%) without stenosis, 9 patients (25%) with stenosis> 50% and 10 patients (27.8%) with occlusion (p = 0.37). There was no correlation between fracture and arterial obstruction (p = 0.33). CONCLUSION: stent fractures are a frequent finding in the femoropopliteal area (33.3%), being more prevalent in cases of more advanced disease (C and D). There was no association between the finding of fracture and arterial obstruction.


Assuntos
Procedimentos Endovasculares/métodos , Doença Arterial Periférica , Doenças Vasculares Periféricas/terapia , Artéria Poplítea , Falha de Prótese , Stents , Ultrassonografia Doppler em Cores/métodos , Humanos , Perna (Membro)/irrigação sanguínea , Doenças Vasculares Periféricas/diagnóstico por imagem , Prevalência , Desenho de Prótese , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Grau de Desobstrução Vascular
20.
Dtsch Arztebl Int ; 117(24): 405-411, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32865491

RESUMO

BACKGROUND: Many people have leg-length discrepancies of greater or lesser severity. No evidence-based studies on the need for treatment are currently available. METHODS: This review is based on publications retrieved by a selective search in the PubMed database, as well as on published recommendations from Germany and abroad and on the authors' own clinical experience. RESULTS: If the two legs are of different lengths, this is generally because one leg is too short. It is debated whether leg-length discrepancy causes pain or long-term musculoskeletal disturbances. A direct connection to back pain is questionable, but a mildly elevated incidence of knee arthritis seems likely. The evidence base on the indications for treatment of leg-length discrepancy is poor; only informal consensus recommendations are available. There are a wide variety of conservative and surgical treatment options. The final extent of a leg-length discrepancy first noted during the growing years can be estimated with predictive algorithms to within 2 cm. The treatments that can be considered include a shoe insert, a high shoe, or an orthosis, surgically induced slowing of growth by blockade of the epiphyseal plates around the knee joint, or leg lengthening with osteotomy and subsequent distraction of the bone callus with fully implanted or external apparatus. Changes in leg length exert marked mechanical stress on the soft tissues. If the predicted leg-length discrepancy exceeds 5 cm, initial leg-lengthening treatment can already be considered during the patient's growing years. CONCLUSION: It must be discussed with each patient individually whether the treatment should be conservative or surgical. The extent of the discrepancy is not the sole determining factor for the mode of treatment. The decision to treat is always elective.


Assuntos
Desigualdade de Membros Inferiores , Perna (Membro) , Alemanha , Humanos , Perna (Membro)/anatomia & histologia , Próteses e Implantes , Resultado do Tratamento
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