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3.
BMJ Open ; 14(5): e078114, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38729754

RESUMO

INTRODUCTION: Lymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb/midline region and an increased risk of infection. Lymphoedema is often associated with mental and physical problems limiting quality of life. The first choice of treatment is a conservative treatment, consisting of exercises, skin care, lymph drainage and compression. Reconstructive lymphatic surgery is also often performed, that is, lymphovenous anastomoses, lymph node transfer or a combination. However, robust evidence on the effectiveness of reconstructive lymphatic surgery is missing. Therefore, the objective of this trial is to investigate the added value of reconstructive lymphatic surgery to the conservative treatment in patients with lymphoedema. METHODS AND ANALYSIS: A multicentre randomised controlled and pragmatic trial was started in March 2022 in three Belgian university hospitals. 90 patients with arm lymphoedema and 90 patients with leg lymphoedema will be included. All patients are randomised between conservative treatment alone (control group) or conservative treatment with reconstructive lymphatic surgery (intervention group). Assessments are performed at baseline and at 1, 3, 6, 12, 18, 24 and 36 months. The primary outcome is lymphoedema-specific quality of life at 18 months. Key secondary outcomes are limb volume and duration of wearing the compression garment at 18 months. The approach of reconstructive lymphatic surgery is based on presurgical investigations including clinical examination, lymphofluoroscopy, lymphoscintigraphy, lymph MRI or CT angiography (if needed). All patients receive conservative treatment during 36 months, which is applied by the patient's own physical therapist and by the patient self. From months 7 to 12, the hours a day of wearing the compression garment are gradually decreased. ETHICS AND DISSEMINATION: The study has been approved by the ethical committees of University Hospitals Leuven, Ghent University Hospital and CHU UCL Namur. Results will be disseminated via peer-reviewed journals and presentations. TRIAL REGISTRATION NUMBER: NCT05064176.


Assuntos
Linfedema , Qualidade de Vida , Humanos , Linfedema/terapia , Linfedema/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Ensaios Clínicos Pragmáticos como Assunto , Bélgica , Estudos Multicêntricos como Assunto , Perna (Membro)
4.
J Drugs Dermatol ; 23(5): 380, 2024 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-38709685

RESUMO

Wound repair of the pretibial and forearm regions presents a challenge during dermatologic surgery as these areas are under significant tension and exhibit increased skin fragility. Various methodologies have been proposed for the closure and repair of such wounds, however, the use of the bilayered suture technique may be simpler and more effective than other techniques such as the pinch stitch, pully stitch, slip-knot stitch, pulley set-back dermal suture, horizontal mattress suture, pully stitch, and tandem pulley stitch. Our objective was to describe a novel method for the repair of pretibial and forearm wounds following Mohs micrographic surgery utilizing bilayered closure followed by tissue adhesive application.  J Drugs Dermatol. 2024;23(5):380.     doi:10.36849/JDD.7139  .


Assuntos
Antebraço , Cirurgia de Mohs , Neoplasias Cutâneas , Técnicas de Sutura , Cicatrização , Humanos , Cirurgia de Mohs/efeitos adversos , Cirurgia de Mohs/métodos , Antebraço/cirurgia , Neoplasias Cutâneas/cirurgia , Adesivos Teciduais , Perna (Membro)/cirurgia , Masculino , Feminino
5.
PLoS One ; 19(5): e0298257, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38771839

RESUMO

OBJECTIVES: The main purpose of this research study was to compare mean modified straight-leg raise test (mSLR) and hamstring muscle length (HL) between chronic non-specific low back pain (LBP) and healthy subjects to understand the possibility of neuropathic causes in LBP population as it may impact the diagnosis and treatment of LBP. Another purpose was to compare mean mSLR between those with lumbar nerve root impingement and those without as determine by magnetic resonance imaging (MRI). METHODS: The design of the study is cross sectional and included 32 subjects with ages ranging from 18-50 years old. Clinical exam objective measures were collected such as patient questionnaires, somatosensory tests, HL range of motion, and a mSLR test, and were compared to the findings from a structural lumbar spine MRI. RESULTS: There were no significant differences in mean HL angulation and mSLR angulation between LBP and healthy subjects (p>0.05). There was no significant difference in mean HL by impingement by versus no impingement (38.3±15.6 versus 44.8±9.4, p = 0.08, Cohen's d = 0.50). On the other hand, there was a significant difference in mean mSLR angulation by impingement (57.6.3±8.7 versus 63.8±11.6, p = 0.05, Cohen's d = 0.60). CONCLUSIONS: The mSLR test was found to be associated with lumbar nerve root compression, regardless of the existence of radiating leg symptoms, and showed no association solely with the report of LBP. The findings highlight the diagnostic dilemma facing clinicians in patients with chronic nonspecific LBP with uncorrelated neuroanatomical image findings. Clinically, it may be necessary to reevaluate the common practice of exclusively using the mSLR test for patients with leg symptoms. This study may impact the way chronic LBP and neuropathic symptoms are diagnosed, potentially improving treatment methods, reducing persistent symptoms, and ultimately improving disabling effects.


Assuntos
Músculos Isquiossurais , Dor Lombar , Imageamento por Ressonância Magnética , Humanos , Dor Lombar/fisiopatologia , Dor Lombar/diagnóstico , Dor Lombar/diagnóstico por imagem , Adulto , Estudos Transversais , Masculino , Feminino , Pessoa de Meia-Idade , Músculos Isquiossurais/fisiopatologia , Músculos Isquiossurais/diagnóstico por imagem , Adolescente , Adulto Jovem , Imageamento por Ressonância Magnética/métodos , Amplitude de Movimento Articular/fisiologia , Perna (Membro)/fisiopatologia , Perna (Membro)/diagnóstico por imagem
6.
Tomography ; 10(5): 773-788, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38787019

RESUMO

Background: The purpose of this study was to investigate the dependence of Intravoxel Incoherent Motion (IVIM) parameters measured in the human calf on B0. Methods: Diffusion-weighted image data of eight healthy volunteers were acquired using five b-values (0-600 s/mm2) at rest and after muscle activation at 0.55 and 7 T. The musculus gastrocnemius mediale (GM, activated) was assessed. The perfusion fraction f and diffusion coefficient D were determined using segmented fits. The dependence on field strength was assessed using Student's t-test for paired samples and the Wilcoxon signed-rank test. A biophysical model built on the three non-exchanging compartments of muscle, venous blood, and arterial blood was used to interpret the data using literature relaxation times. Results: The measured perfusion fraction of the GM was significantly lower at 7 T, both for the baseline measurement and after muscle activation. For 0.55 and 7 T, the mean f values were 7.59% and 3.63% at rest, and 14.03% and 6.92% after activation, respectively. The biophysical model estimations for the mean proton-density-weighted perfusion fraction were 3.37% and 6.50% for the non-activated and activated states, respectively. Conclusions: B0 may have a significant effect on the measured IVIM parameters. The blood relaxation times suggest that 7 T IVIM may be arterial-weighted whereas 0.55 T IVIM may exhibit an approximately equal weighting of arterial and venous blood.


Assuntos
Imagem de Difusão por Ressonância Magnética , Músculo Esquelético , Humanos , Imagem de Difusão por Ressonância Magnética/métodos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Masculino , Adulto , Feminino , Perna (Membro)/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Campos Magnéticos , Movimento (Física) , Voluntários Saudáveis , Adulto Jovem
7.
Sensors (Basel) ; 24(9)2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38732868

RESUMO

This paper presents the design, development, and validation of a novel e-textile leg sleeve for non-invasive Surface Electromyography (sEMG) monitoring. This wearable device incorporates e-textile sensors for sEMG signal acquisition from the lower limb muscles, specifically the anterior tibialis and lateral gastrocnemius. Validation was conducted by performing a comparative study with eleven healthy volunteers to evaluate the performance of the e-textile sleeve in acquiring sEMG signals compared to traditional Ag/AgCl electrodes. The results demonstrated strong agreement between the e-textile and conventional methods in measuring descriptive metrics of the signals, including area, power, mean, and root mean square. The paired data t-test did not reveal any statistically significant differences, and the Bland-Altman analysis indicated negligible bias between the measures recorded using the two methods. In addition, this study evaluated the wearability and comfort of the e-textile sleeve using the Comfort Rating Scale (CRS). Overall, the scores confirmed that the proposed device is highly wearable and comfortable, highlighting its suitability for everyday use in patient care.


Assuntos
Eletrodos , Eletromiografia , Têxteis , Dispositivos Eletrônicos Vestíveis , Humanos , Eletromiografia/métodos , Eletromiografia/instrumentação , Masculino , Adulto , Feminino , Músculo Esquelético/fisiologia , Perna (Membro)/fisiologia
8.
J Med Invest ; 71(1.2): 177-178, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38735717

RESUMO

Vitiligo is an acquired chronic depigmenting disorder of the skin and is characterized by the destruction of melanocytes. One of the clinical features of vitiligo is that damage to normal skin frequently results in the formation of depigmented macules, which is known as Köebner's phenomenon (KP). Here, we presented a case of vitiligo, in which depigmented macules followed the course of a dilated varicose vein. Dilatation of blood vessels was considered to contribute to the development of the vitiliginous lesions as a trigger for KP. Any kind of skin injury can trigger KP, but this is only the second case in which a dilated blood vessel caused KP in vitiligo. J. Med. Invest. 71 : 177-178, February, 2024.


Assuntos
Perna (Membro) , Varizes , Vitiligo , Humanos , Vitiligo/patologia , Varizes/etiologia , Varizes/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Masculino , Feminino , Adulto
9.
BMJ Open ; 14(5): e085044, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38719285

RESUMO

BACKGROUND: Venous access in patients with obesity presents significant challenges. The success of central venous catheterisation largely depends on the cross-sectional area (CSA) of the internal jugular vein (IJV). While techniques like the Trendelenburg position have been traditionally used to increase IJV CSA, recent studies suggest its ineffectiveness in patients with obesity. Conversely, the potential of the effect of passive leg raising (PLR) has not been thoroughly investigated in this group of patients. METHODS: This protocol outlines a planned randomised controlled trial to evaluate the effect of PLR on the CSA of the IJV in patients with obesity slated for central venous catheterisation. The protocol involves dividing 40 participants into two groups: one undergoing PLR and another serving as a control group without positional change. The protocol specifies measuring the CSA of the IJV via ultrasound as the primary outcome. Secondary outcomes will include the success rates of right IJV cannulation. The proposed statistical approach includes the use of t-tests to compare the changes in CSA between the two groups, with a significance threshold set at p<0.05. ETHICS APPROVAL: This study has been approved by the Institutional Review Board of Shanghai Tongren Hospital. All the participants will provide informed consent prior to enrolment in the study. Regarding the dissemination of research findings, we plan to share the results through academic conferences and peer-reviewed publications. Additionally, we will communicate our findings to the public and professional communities, including patient advocacy groups. TRIAL REGISTRATION NUMBER: ChiCTR: ChiCTR2400080513.


Assuntos
Cateterismo Venoso Central , Veias Jugulares , Perna (Membro) , Obesidade , Humanos , Veias Jugulares/diagnóstico por imagem , Obesidade/terapia , Cateterismo Venoso Central/métodos , Perna (Membro)/irrigação sanguínea , Perna (Membro)/diagnóstico por imagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Posicionamento do Paciente/métodos , Ultrassonografia , Adulto , Feminino , Masculino
10.
BMC Musculoskelet Disord ; 25(1): 391, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38762469

RESUMO

BACKGROUND: Pain is common in individuals with cerebral palsy (CP) and the most reported pain site is the foot/lower leg. We analyzed the prevalence of pain in the foot/lower leg and the associations with age, sex, gross motor function, and clinical findings in individuals with CP. METHOD: This was a cross-sectional register-study, based on data reported to the Swedish Cerebral Palsy Follow-up Program (CPUP). All participants in CPUP, four years-of-age or older, were included. Pearson chi-square tests and logistic regression were used to analyze the prevalence and degree of pain in the foot/lower leg. RESULTS: In total, 5,122 individuals were included from the CPUP database: 58% were males and 66% were under 18 years-of-age. Overall, 1,077 (21%) reported pain in the foot/lower leg. The odds ratios (ORs) of pain were higher in females (OR 1.31, 95% confidence interval (CI) 1.13-1.53), individuals who could ambulate (Gross Motor Function Classification System Level I (OR 1.84, CI 1.32-2.57) and II (OR 2.01, CI 1.46-2.79) compared to level V), and in individuals with decreased range of motion of the ankle (dorsiflexion 1-10 degrees (OR 1.43, CI 1.13-1.83) and ≤ 0 degrees (OR 1.46, CI 1.10-1.93) compared to ≥ 20 degrees). With increasing age the OR of pain increased (OR 1.02, CI 1.01-1.03) as well as the reported pain intensity (p < 0.001). CONCLUSIONS: Pain in the foot and lower leg appears to be a significant problem in individuals with CP, particularly in those who walk. As with pain in general in this population, both pain intensity and frequency increase with age. The odds of pain in the foot and lower leg were increased in individuals with limited dorsiflexion of the ankle. Given the cross-sectional design causality cannot be inferred and it is unknown if pain causes decreased range of motion of the ankle or if decreased range of motion causes pain. Further research is needed on causal pathways and importantly on prevention.


Assuntos
Paralisia Cerebral , Perna (Membro) , Sistema de Registros , Humanos , Paralisia Cerebral/epidemiologia , Paralisia Cerebral/complicações , Paralisia Cerebral/fisiopatologia , Masculino , Feminino , Estudos Transversais , Adulto , Adolescente , Criança , Adulto Jovem , Suécia/epidemiologia , Pré-Escolar , Prevalência , Pé/fisiopatologia , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/diagnóstico , Dor/etiologia , Medição da Dor
11.
J Bodyw Mov Ther ; 38: 8-12, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38763619

RESUMO

OBJECTIVE: Long-term assessments of lower leg muscle forces in ambulant patients with distal myopathies. METHODS AND MATERIALS: Over a five-year period, we measured involuntary, nerve-stimulated, isometric torques of the ankle dorsiflexors in a group of ambulant patients with myopathies and compared results with voluntary Manual Muscle Tests (MMT). RESULTS: From ten recruited patients, five could finish the five-year protocol. Twenty-seven force measurements sessions (one per year; 1,5 hours duration each) were performed. These patients exhibited low, stable torques or increased minimally (0.2 Newtonmeter, versus 0.1 Nm, ns; 0.7 vs. 1.0, ns; 3.4 vs. 3.5, ns; 0.2 vs. 0.1, ns; 0.8 vs. 1.5, P 0.0004 initial values vs. 5-year values, [norm: 3.9-5.7 Nm]). A 6th patient, eliciting low torque values (0.1 Nm) early passed away. Contraction times inversely correlated with MMT. MMT provided similar overall force abilities. CONCLUSIONS: Long-term monitoring of lower leg muscle forces in ambulant patients is limited by the patient's health status. In a small group of patients, stimulated lower leg forces did not worsen over many years relative to their diagnosed myopathies. Tracking involuntary forces, could be a useful monitoring providing phenotypic information, in addition to MMT. Future devices should be small and be simply self-applying, designed for subjects' domestic use and web-based data transfer. CLINICALTRIALS: gov NCT00735384.


Assuntos
Músculo Esquelético , Torque , Humanos , Masculino , Músculo Esquelético/fisiologia , Músculo Esquelético/fisiopatologia , Pessoa de Meia-Idade , Feminino , Adulto , Doenças Musculares/fisiopatologia , Seguimentos , Perna (Membro)/fisiopatologia , Perna (Membro)/fisiologia , Contração Isométrica/fisiologia , Força Muscular/fisiologia , Idoso , Contração Muscular/fisiologia
12.
Acta Psychol (Amst) ; 246: 104258, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38670042

RESUMO

BACKGROUND: In daily life and sports activities, the regulation of muscle force and timing is often not controlled independently, rather the appropriate amount of force is controlled simultaneously with appropriate timing. However, which of the two variables, force or timing, is more difficult to control remains unclear. OBJECTIVE: We aimed to investigate the difficulty in the accurate control of force and timing, simultaneously. By setting target levels for force and timing interval, with both target lines presented, none of them presented, or only one of the target lines for force or timing interval presented, we directly examined and identified which variable is more important. METHODS: Participants were asked to produce periodic isometric knee extension force using their right leg. The following four tasks were established: 20 %MVF-1000 ms task (20 % maximum voluntary force [MVF] at 1000 ms intervals), 20 %MVF-2000 ms task (20 % MVF at 2000 ms intervals), 40 %MVF-1000 ms task (40 % MVF at 1000 ms intervals), and 40 %MVF-2000 ms task (40 % MVF at 2000 ms intervals). Moreover, the participants performed four tasks under the following four conditions based on target line presentation: Both variables condition (force and interval lines presented), force condition (only force line presented), interval condition (only interval line presented), and no variable condition (neither force nor interval lines presented). The recorded force data were analyzed. RESULTS: Regarding the force factor, the error of the interval and no variable conditions was greater than that of the both variables and force conditions. As for the interval factor, the error was greater when the target interval line was not presented (force and no variable conditions) than when it was presented (both variables and interval conditions), and it exceeded the target interval in the 1000 ms task, whereas it was shorter than the target interval in the 2000 ms task. Except for the force condition, the force factor showed significantly greater absolute errors when the target level was set as 100 %, compared to the interval factor. CONCLUSIONS: The control of force was found to be more difficult than that of timing, based on aspects relating to accuracy and reproducibility.


Assuntos
Contração Isométrica , Humanos , Contração Isométrica/fisiologia , Masculino , Adulto Jovem , Adulto , Músculo Esquelético/fisiologia , Perna (Membro)/fisiologia , Feminino , Desempenho Psicomotor/fisiologia , Fatores de Tempo
13.
Eur J Radiol ; 175: 111449, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38604093

RESUMO

PURPOSE: Calf muscles play an important role in marathon race, and the incidence of injury is high in this process. This study prospectively quantified diffusion tensor metrics, muscle fat fraction (MFF) and cross-sectional area (CSA) of calf muscles induced by endurance exercise in amateur marathoners, and the potential mechanisms underlying the changes in these parameters were analyzed. METHOD: In this prospective study, 35 marathoners (27 males, 8 females; mean age (standard deviation, SD), 38.92 (4.83) years) and 26 controls (18 males, 8 females; mean age (SD), 38.35 (6.75) years) underwent magnetic resonance imaging (MRI) from September 2022 to March 2023. The diffusion tensor eigenvalues (λ1, λ2, λ3), radial diffusivity (RD), fractional anisotropy (FA), MFF and CSA of calf muscles were compared between marathoners and controls. A binary logistic regression model with gender correction was performed analyze the relationship between marathon exercise and DTI parameters, CSA and MFF of calf muscles. RESULTS: Interobserver agreement was good (κ = 0.71). The results of binary logistic regression model with gender correction showed that the regression coefficients of FA values in anterior group of calf (AC), soleus (SOL), medial gastrocnemius (MG) and lateral gastrocnemius (LG) were negative, and the odds ratios (OR) were 0.33, 0.45, 0.35, 0.05, respectively (P < 0.05). The OR of RD in SOL and λ2 in external group of calf (EC) were relatively higher, 3.74 and 3.26, respectively (P < 0.05). CSA was greater in SOL of marathoners, with an OR value of 1.00(P < 0.05). The MFF in AC and LG was lower in marathoners and OR of two indexes were -0.69 and -0.59, respectively (P < 0.05). CONCLUSIONS: Diffusion tensor imaging (DTI) combined with chemical shift-encoded sequence can noninvasively detect and quantify the adaptive changes of calf muscle morphology, microstructure and tissue composition induced by long-term running training in amateur marathoners.


Assuntos
Imagem de Tensor de Difusão , Corrida de Maratona , Músculo Esquelético , Humanos , Imagem de Tensor de Difusão/métodos , Masculino , Feminino , Músculo Esquelético/diagnóstico por imagem , Adulto , Estudos Prospectivos , Corrida de Maratona/fisiologia , Perna (Membro)/diagnóstico por imagem , Adaptação Fisiológica
14.
Am J Cardiol ; 220: 56-66, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38580040

RESUMO

Peripheral artery disease (PAD) is associated with impaired blood flow in the lower extremities and histopathologic changes of the skeletal calf muscles, resulting in abnormal microvascular perfusion. We studied the use of convolution neural networks (CNNs) to differentiate patients with PAD from matched controls using perfusion pattern features from contrast-enhanced magnetic resonance imaging (CE-MRI) of the skeletal calf muscles. We acquired CE-MRI based skeletal calf muscle perfusion in 56 patients (36 patients with PAD and 20 matched controls). Microvascular perfusion imaging was performed after reactive hyperemia at the midcalf level, with a temporal resolution of 409 ms. We analyzed perfusion scans up to 2 minutes indexed from the local precontrast arrival time frame. Skeletal calf muscles, including the anterior muscle, lateral muscle, deep posterior muscle group, and the soleus and gastrocnemius muscles, were segmented semiautomatically. Segmented muscles were represented as 3-dimensional Digital Imaging and Communications in Medicine stacks of CE-MRI perfusion scans for deep learning (DL) analysis. We tested several CNN models for the 3-dimensional CE-MRI perfusion stacks to classify patients with PAD from matched controls. A total of 2 of the best performing CNNs (resNet and divNet) were selected to develop the final classification model. A peak accuracy of 75% was obtained for resNet and divNet. Specificity was 80% and 94% for resNet and divNet, respectively. In conclusion, DL using CNNs and CE-MRI skeletal calf muscle perfusion can discriminate patients with PAD from matched controls. DL methods may be of interest for the study of PAD.


Assuntos
Meios de Contraste , Imageamento por Ressonância Magnética , Músculo Esquelético , Redes Neurais de Computação , Doença Arterial Periférica , Humanos , Doença Arterial Periférica/fisiopatologia , Doença Arterial Periférica/diagnóstico por imagem , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/métodos , Perna (Membro)/irrigação sanguínea , Fluxo Sanguíneo Regional/fisiologia , Aprendizado Profundo
15.
Medicine (Baltimore) ; 103(14): e37731, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38579061

RESUMO

RATIONALE: A hostile iliac access route is an important consideration when enforcing endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA). Herein, we report a case of AAA with unilateral external iliac artery occlusion, for which bifurcated EVAR was successfully performed using a single femoral and brachial artery access. PATIENT CONCERNS: A 76-year-old man who had undergone surgery for lung cancer 4.5 years prior was diagnosed AAA by computed tomography (CT). DIAGNOSIS: Two and a half years before presentation, CT revealed an infrarenal 48 mm AAA, which had enlarged to 57 mm by 2 months preoperatively. CT identified occlusion from the right external iliac artery to the right common femoral artery, with no observed ischemic symptoms in his right leg. The right external iliac artery, occluded and atrophied, had a 1 to 2 mm diameter. INTERVENTION: Surgery was commenced with the selection of a Zenith endovascular graft (Cook Medical) with an extended body length. Two Gore Viabahn VBX balloon expandable endoprosthesis (VBX; W.L. Gore & Associate) were delivered from the right axilla as the contralateral leg. OUTCOMES: CT scan on the 2nd day after surgery revealed no endoleaks. LESSONS: While the long-term results remain uncertain, this method may serve as an option for EVAR in patients with unilateral external iliac artery occlusion.


Assuntos
Aneurisma da Aorta Abdominal , Implante de Prótese Vascular , Procedimentos Endovasculares , Aneurisma Ilíaco , Masculino , Humanos , Idoso , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Prótese Vascular , Implante de Prótese Vascular/métodos , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/cirurgia , Axila/cirurgia , Perna (Membro)/cirurgia , Procedimentos Endovasculares/métodos , Stents , Resultado do Tratamento , Aneurisma Ilíaco/cirurgia
16.
J Diabetes ; 16(5): e13556, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38664878

RESUMO

AIMS: The adverse effects of sedentary behavior on obesity and chronic diseases are well established. However, the prevalence of sedentary behavior has increased, with only a minority of individuals meeting the recommended physical activity guidelines. This study aimed to investigate whether habitual leg shaking, a behavior traditionally considered unfavorable, could serve as an effective strategy to improve energy metabolism. MATERIALS AND METHODS: A randomized crossover study was conducted, involving 15 participants (mean [SD] age, 25.4 [3.6]; mean [SD] body mass index, 22 [3]; 7 women [46.7%]). The study design involved a randomized sequence of sitting and leg shaking conditions, with each condition lasting for 20 min. Energy expenditure, respiratory rate, oxygen saturation, and other relevant variables were measured during each condition. RESULTS: Compared to sitting, leg shaking significantly increased total energy expenditure [1.088 kj/min, 95% confidence interval, 0.69-1.487 kj/min], primarily through elevated carbohydrate oxidation. The average metabolic equivalent during leg shaking exhibited a significant increase from 1.5 to 1.8. Leg shaking also raised respiratory rate, minute ventilation, and blood oxygen saturation levels, while having no obvious impact on heart rate or blood pressure. Electromyography data confirmed predominant activation of lower leg muscles and without increased muscle fatigue. Intriguingly, a significant correlation was observed between the increased energy expenditure and both the frequency of leg shaking and the muscle mass of the legs. CONCLUSIONS: Our study provides evidence that habitual leg shaking can boost overall energy expenditure by approximately 16.3%. This simple and feasible approach offers a convenient way to enhance physical activity levels.


Assuntos
Estudos Cross-Over , Metabolismo Energético , Perna (Membro) , Humanos , Feminino , Adulto , Masculino , Adulto Jovem , Comportamento Sedentário , Taxa Respiratória , Frequência Cardíaca/fisiologia
17.
Ann Anat ; 254: 152262, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38582236

RESUMO

BACKGROUND: The perforator flap has garnered significant interest since its inception due to its advantage of not needing a vascular network at the deep fascial level. Perforator flaps are commonly utilized in different flap transplant surgeries, and the thigh flap is presently the most widely used perforator flap. Is it possible for the calf to replace the thigh as a more suitable site for harvesting materials? Currently, there is a lack of relevant anatomical research. This study aims to address this question from an anatomical and imaging perspective. METHODS: This study used cadavers to observe the branches and courses of perforators on the calf and the distribution of skin branches using microdissection techniques, digital X-ray photography, and micro-computed tomography techniques. RESULTS: The perforators had three main branches: the vertical cutaneous branch, the oblique cutaneous branch, and the superficial fascial branch. The superficial fascial branch traveled in the superficial fascia and connected with the nearby perforators. The vertical and oblique cutaneous branches entered the subdermal layer and connected with each other to create the subdermal vascular network. CONCLUSIONS: We observed an intact calf cutaneous branch chain between the cutaneous nerve and the perforator of the infrapopliteal main artery at the superficial vein site. Utilizing this anatomical structure, the calfskin branch has the potential to serve as a substitute for thigh skin flap transplantation and may be applied to perforator flap transplantation in more locations.


Assuntos
Cadáver , Perna (Membro) , Retalho Perfurante , Humanos , Retalho Perfurante/irrigação sanguínea , Perna (Membro)/irrigação sanguínea , Perna (Membro)/anatomia & histologia , Masculino , Pele/irrigação sanguínea , Pele/anatomia & histologia , Feminino , Idoso , Microtomografia por Raio-X
18.
MMW Fortschr Med ; 166(7): 25, 2024 04.
Artigo em Alemão | MEDLINE | ID: mdl-38637376
19.
J Biomech ; 167: 112076, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38583376

RESUMO

Given the known deficits in spatiotemporal aspects of gait for people with Parkinson's disease (PD), we sought to determine the underlying gait abnormalities in limb and joint kinetics, and examine how deficits in push-off and leg swing might contribute to the shortened step lengths for people with PD. Ten participants with PD and 11 age-matched control participants walked overground and on an instrumented treadmill. Participants with PD then walked on the treadmill with a posteriorly directed restraining force applied to 1) the pelvis to challenge push-off and 2) the ankles to challenge leg swing. Spatiotemporal, kinematic, and force data were collected and compared between groups and conditions. Despite group differences in spatiotemporal measures during overground walking, we did not observe these differences when the groups walked on a treadmill at comparable speeds. Nevertheless, the hip extension impulse appeared smaller in the PD group during their typical walking. When challenging limb propulsion, participants in the PD group maintained step lengths by increasing the propulsive impulse. Participants with PD were also able to maintain their typical step length against resistance intended to impede swing limb advancement, and even increased step lengths with cuing. The presence of reduced hip extension torque might be an early indicator of gait deterioration in this neurodegenerative disease. Our participants with PD were able to increase hip extension torque in response to needed demands. Additionally, participants with PD were able to increase limb propulsion and leg swing against resistance, suggesting a reserve in limb mechanics.


Assuntos
Doenças Neurodegenerativas , Doença de Parkinson , Humanos , Caminhada/fisiologia , Marcha/fisiologia , Perna (Membro)/fisiologia , Fenômenos Biomecânicos , Velocidade de Caminhada/fisiologia
20.
Clin Biomech (Bristol, Avon) ; 114: 106237, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38599131

RESUMO

BACKGROUND: Perceived instability is a primary symptom among individuals with chronic ankle instability. However, the relationship between joint kinematics during landing remains unclear. Therefore, we investigated the relationships between landing kinematics and perceived instability in individuals with chronic ankle instability. METHODS: In 32 individuals with chronic ankle instability, we recorded ankle, knee, and hip joint angles during a single-leg drop landing. Joint angle waveforms during 200 ms before and after initial contact were summarized into single values using two methods: peak joint angles and principal component scores via principal component analysis. Using Spearman's rank correlation coefficient (ρ), we examined the relationships of peak joint angles and principal component scores with the Cumberland Ankle Instability Tool score, with a lower score indicating a greater perceived instability (α = 0.05). FINDINGS: The second principal component scores of ankle angle in the horizontal and sagittal planes significantly correlated with the Cumberland Ankle Instability Tool score (Horizontal: ρ = 0.507, P = 0.003; Sagittal: ρ = -0.359, P = 0.044). These scores indicated the differences in the magnitude of angles before and after landing. Significant correlations indicated a greater perceived instability correlated with smaller internal rotation and plantarflexion before landing and smaller external rotation and dorsiflexion after landing. In contrast, no peak joint angles correlated with the Cumberland Ankle Instability Tool score (P > 0.05). INTERPRETATION: In individuals with chronic ankle instability, ankle movements during landing associated with perceived instability may be a protective strategy before landing and potentially cause ankle instability after landing.


Assuntos
Tornozelo , Instabilidade Articular , Humanos , Fenômenos Biomecânicos , Perna (Membro) , Amplitude de Movimento Articular , Articulação do Tornozelo , Articulação do Joelho
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