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1.
Praxis (Bern 1994) ; 109(10): 812-823, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32752958

RESUMO

Ultrasound of the Hip (Adapted According to SGUM Guidelines) Abstract. This review paper explains the simplified ultrasound anatomy of the hip. The adapted basic standard planes are described in detail according to SGUM guidelines and illustrated with a selection of high-resolution ultrasound images. A profound knowledge of the sonographic anatomy is essential for the detection of pathologies.


Assuntos
Quadril , Quadril/anatomia & histologia , Quadril/diagnóstico por imagem , Humanos , Ultrassonografia
2.
Rev. bras. cir. plást ; 35(2): 243-248, apr.-jun. 2020. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-1103839

RESUMO

A pele de tilápia possui microbiota não infecciosa e estrutura morfológica semelhante à pele humana. Estudos clínicos fase II, ainda não publicados, mostraram resultados promissores na sua utilização para tratamento de queimaduras. Nos protocolos destes estudos, pacientes com lesões em áreas de dobras de pele, como genitais e região inguinal, foram excluídos, pois achava-se que o biomaterial não aderiria apropriadamente, resultando em um grau de cicatrização inferior. Relato de caso de paciente do sexo feminino, 18 anos, sem comorbidades, com queimaduras de segundo grau profundo em abdômen, região inguinal, parte da genitália e metade superior de ambas as coxas, envolvendo 13,5% da área total da superfície corporal. A pele de tilápia foi aplicada nas lesões levando a uma reepitelização completa com 16 dias de tratamento. Não foram observados efeitos colaterais. A pele de tilápia traz, portanto, a promessa de um produto inovador, de fácil aplicação e alta disponibilidade, que pode se tornar a primeira pele animal nacionalmente estudada e registrada pela Agência Nacional de Vigilância Sanitária, para uso no tratamento de queimaduras. Este relato de caso contribui para reduzir as limitações em relação às áreas anatômicas apropriadas para a aplicação da pele de tilápia, uma vez que, mesmo com a necessidade de reposição de pele, foram obtidos bons resultados com aplicação na genitália e região inguinal.


Tilapia skin has a non-infectious microbiota and a morphological structure similar to human skin. Phase II clinical studies, not yet published, have shown promising results in their use for the treatment of burns. In the protocols of these studies, patients with lesions in areas of skin folds, such as genitals and inguinal regions, were excluded, as it was thought that the biomaterial would not adhere properly, resulting in a lower degree of healing. Case report of a female patient, 18 years old, without comorbidities, with deep second-degree burns in the abdomen, inguinal region, part of the genitalia and upper half of both thighs, involving 13.5% of the total body surface area. Tilapia skin was applied to the lesions leading to a complete re-epithelialization with 16 days of treatment. No side effects were observed. Tilapia skin, therefore, brings the promise of an innovative product, easy to apply, and highly available, which can become the first animal skin nationally studied and registered by the Agência Nacional de Vigilância Sanitária, for use in the treatment of burns. This case report contributes to reduce the limitations concerning the anatomical areas appropriate for the application of tilapia skin, since, even with the need for skin replacement, good results were obtained with application to the genitalia and inguinal region.


Assuntos
Humanos , Feminino , Adolescente , História do Século XXI , Terapêutica , Transplante Autólogo , Curativos Biológicos , Queimaduras , Relatos de Casos , Condutas Terapêuticas , Tilápia , Ciclídeos , Abdome , Estudo Clínico , Genitália , Quadril , Terapêutica/métodos , Transplante Autólogo/métodos , Transplante Autólogo/reabilitação , Curativos Biológicos/normas , Queimaduras/terapia , Condutas Terapêuticas/efeitos adversos , Condutas Terapêuticas/normas , Tilápia/anatomia & histologia , Ciclídeos/anatomia & histologia , Genitália/anatomia & histologia , Abdome/anatomia & histologia , Quadril/anatomia & histologia
3.
J Sports Sci ; 38(7): 787-794, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32131691

RESUMO

This study identified key somatic and demographic characteristics that benefit all swimmers and, at the same time, identified further characteristics that benefit only specific swimming strokes. Three hundred sixty-three competitive-level swimmers (male [n = 202]; female [n = 161]) participated in the study. We adopted a multiplicative, allometric regression model to identify the key characteristics associated with 100 m swimming speeds (controlling for age). The model was refined using backward elimination. Characteristics that benefited some but not all strokes were identified by introducing stroke-by-predictor variable interactions. The regression analysis revealed 7 "common" characteristics that benefited all swimmers suggesting that all swimmers benefit from having less body fat, broad shoulders and hips, a greater arm span (but shorter lower arms) and greater forearm girths with smaller relaxed arm girths. The 4 stroke-specific characteristics reveal that backstroke swimmers benefit from longer backs, a finding that can be likened to boats with longer hulls also travel faster through the water. Other stroke-by-predictor variable interactions (taken together) identified that butterfly swimmers are characterized by greater muscularity in the lower legs. These results highlight the importance of considering somatic and demographic characteristics of young swimmers for talent identification purposes (i.e., to ensure that swimmers realize their most appropriate strokes).


Assuntos
Destreza Motora/fisiologia , Natação/fisiologia , Adolescente , Aptidão , Braço/anatomia & histologia , Distribuição da Gordura Corporal , Tamanho Corporal , Criança , Comportamento Competitivo , Feminino , Quadril/anatomia & histologia , Humanos , Perna (Membro)/anatomia & histologia , Masculino , Músculo Esquelético/anatomia & histologia , Ombro/anatomia & histologia , Adulto Jovem
4.
J Sports Sci ; 38(7): 827-837, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32149566

RESUMO

Purpose: This study determined the impact of menstrual status on bone tissue in elite post-pubertal female soccer players over an entire season.Methods: Fifty-one elite female soccer players participated. At baseline, forty-one were assigned to the low hormonal androgenic profile (low-HAPL) and 10 to the high hormonal androgenic profile (high-HAPL).Results: An 8-month training program led to increased bone mineral density content (p<0.05). The low-HAPL athletes improved the Narrow neck average cortical thickness (ACT) by 1.4% and reduced the corresponding Buckling ratio (BR) by 2.6%, thus decreasing the fracture risk (p<0.05). The high-HAPL athletes decreased the Narrow neck ACT by 5.4% and increased the BR by 2.6%, increasing fracture risk (p<0.05). Differences were assigned as being "very likely beneficial" for the low-HAPL athletes, supported by very large (d=3.41) and large (d=1.58) effect sizes for the Narrow neck ACT and BR, respectively.Conclusion: A season of soccer training has induced bone geometry improvements in adolescent females. Bone health parameters improved in the two clusters. However, high-HAPL athletes decreased its resistance to loading compare to low-HAPL athletes. Even if female players do not present clinical symptoms related to their hormonal status, sport medicine physicians should pay attention to their structural bone fragility.


Assuntos
Densidade Óssea/fisiologia , Hormônio Foliculoestimulante/sangue , Hormônios Esteroides Gonadais/sangue , Hormônio Luteinizante/sangue , Menstruação/fisiologia , Condicionamento Físico Humano , Futebol/fisiologia , Adolescente , Biomarcadores/sangue , Estudos Transversais , Feminino , Quadril/anatomia & histologia , Humanos , Adulto Jovem
5.
Apunts, Med. esport (Internet) ; 55(205): 5-20, ene.-mar. 2020. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-192333

RESUMO

Femoroacetabular impingement (FAI) is a common injury in basketball, having a difficult therapeutic approach because it requires an extended period of time to be resolved once it appears. Therefore, preventing the onset of this condition seems critical in maintaining athletes' health, and availability to compete. Because reducing training and competition volume in a professional team context is complex, the exercises presented here offer a good option for managing injured players without compromising their availability during the season. However, offseason and preseason periods are key to developing, protecting and strengthening the injured joint and its functionality for the competitive season


No disponible


Assuntos
Humanos , Atletas , Corrida , Imobilização/métodos , Impacto Femoroacetabular/terapia , Basquetebol/lesões , Terapia por Exercício , Quadril/anatomia & histologia , Quadril/fisiopatologia , Diagnóstico Precoce
6.
BMC Bioinformatics ; 21(Suppl 2): 86, 2020 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-32164524

RESUMO

BACKGROUND: The current study's purpose is to compare hip structural analysis variables in a group of postmenopausal women with sarcopenia and another group of postmenopausal women with normal skeletal muscle mass index. To do so, the current study included 8 postmenopausal women (whose ages ranged between 65 and 84 years) with sarcopenia and 60 age-matched controls (with normal skeletal muscle mass index (SMI)). Body composition and bone parameters were evaluated by dual-energy X-ray absorptiometry (DXA). RESULTS: Weight, lean mass, body mass index, femoral neck cross-sectional area (FN CSA), FN section modulus (Z), FN cross sectional moment of inertia (CSMI), intertrochanteric (IT) CSA, IT Z, IT CSMI, IT cortical thickness (CT), femoral shaft (FS) CSA, FS Z and FS CSMI were significantly greater (p < 0.05) in women with normal SMI compared to women with sarcopenia. In the whole population, SMI was positively associated with IT CSA, IT Z, IT CSMI, IT CT, FS CSA, FS Z, FS CSMI, FS CT but negatively correlated to IT buckling ratio (BR) and FS BR. CONCLUSION: The current study suggests that sarcopenia has a negative effect on hip bone strength indices in postmenopausal women.


Assuntos
Quadril/diagnóstico por imagem , Sarcopenia/patologia , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Peso Corporal , Densidade Óssea , Estudos de Casos e Controles , Feminino , Colo do Fêmur/diagnóstico por imagem , Quadril/anatomia & histologia , Humanos , Líbano , Pós-Menopausa
7.
Sports Biomech ; 19(2): 258-270, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30004294

RESUMO

Female gymnasts have been evidenced to experience sport-specific growth, of which broad shoulders and narrow hips are common characteristics. In addition to being a central component of handstand performance, postural control mechanisms, including whole-body and lumbo-pelvic stability, have been identified as risk factors for overuse spinal pathology. The study aimed to develop a fundamental understanding of musculoskeletal growth and postural control responses of female artistic gymnasts in order to extend longitudinal insights into overuse spinal pathology risk. Whole-body anthropometric measures were collected for 12 competitive female gymnasts (age at recruitment: nine to 15 years) at three time points across a 12 month period. Musculoskeletal growth was partially defined as the rate of bicristal-to-biacromial breadth ratio development, and informed shoulder- and pelvis-dominant growth sub-groups. Kinematic and kinetic indicators of postural control were determined for a total of 700 handstand trials. The shoulder-dominant (gymnastics-specific) growth group was found to have significantly greater biomechanical risk for general stability (p < 0.001) than the pelvis-dominant group. Significantly greater lumbo-pelvic risk was demonstrated for the pelvis-dominant group (p < 0.001). Extended idiosyncratic examination of proportional sport-specific growth measures alongside multi-faceted risk monitoring was advocated for the effective development of future overuse pathology prevention protocols.


Assuntos
Ginástica/fisiologia , Desenvolvimento Musculoesquelético/fisiologia , Equilíbrio Postural/fisiologia , Adolescente , Antropometria , Fenômenos Biomecânicos , Índice de Massa Corporal , Criança , Transtornos Traumáticos Cumulativos/fisiopatologia , Feminino , Ginástica/lesões , Quadril/anatomia & histologia , Quadril/crescimento & desenvolvimento , Humanos , Estudos Longitudinais , Vértebras Lombares/lesões , Pelve/anatomia & histologia , Pelve/crescimento & desenvolvimento , Fatores de Risco , Ombro/anatomia & histologia , Ombro/crescimento & desenvolvimento
8.
Radiol Oncol ; 53(2): 256-264, 2019 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-30969940

RESUMO

Background The aim of the study was investigate the impact of body-mass factors (BMF) on setup displacement during pelvic radiotherapy in patients with lower abdominal cancers. Patients and methods The clinical data of a training cohort composed of 60 patients with gynecological, rectal, or prostate cancer were analyzed. The daily alignment data from image-guided radiotherapy (IGRT) were retrieved. Setup errors for were assessed by systematic error (SE) and random error (RE) through the superior-inferior (SI), anterior-posterior (AP), and medial-lateral (ML) directions. Several BMFs and patient-related parameters were analyzed with binary logistic regression and receiver-operating characteristic curves. A scoring system was proposed to identify those with greater setup displacement during daily treatment. The results were validated by another cohort. Results A large hip lateral diameter correlated with a greater SI-SE and AP-SE, whereas a large umbilical AP diameter correlated with a greater ML-SE and ML-RE. A higher SI-RE was associated with a large hip circumference. The positive predictors for setup uncertainty were chosen to dichotomize patients into groups at high risk and low risk for setup displacement. Based on the scoring system, the adequate treatment margins for the SI direction in the high-and low-risk groups were 5.4 mm and 3.8 mm, whereas those for the ML direction were 8.2 mm and 4.2 mm, respectively. The validated cohort showed a similar trend. Conclusions Large BMFs including hip lateral diameter, hip circumference, and umbilical AP diameter are associated with greater setup uncertainty. Based on the scores, IGRT or required treatment margins can be adapted for patients with high risk features.


Assuntos
Neoplasias dos Genitais Femininos/radioterapia , Neoplasias da Próstata/radioterapia , Erros de Configuração em Radioterapia , Radioterapia Guiada por Imagem , Neoplasias Retais/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Feminino , Neoplasias dos Genitais Femininos/diagnóstico por imagem , Quadril/anatomia & histologia , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Neoplasias da Próstata/diagnóstico por imagem , Curva ROC , Planejamento da Radioterapia Assistida por Computador , Neoplasias Retais/diagnóstico por imagem , Incerteza , Circunferência da Cintura
9.
Nutr Hosp ; 36(1): 133-141, 2019 Mar 07.
Artigo em Espanhol | MEDLINE | ID: mdl-30834766

RESUMO

Introduction: Introduction: recent studies warn of changes in dietary habits and an increase in overweight children as possible risk factors for early hypertension. Objectives: to know the prevalence of normotension, rehypertension and hypertension in the children studied, and to evaluate its possible association with diet and anthropometric indicators. Methods: a cross-sectional study was carried out within the Project "Anthropometry and Child Nutrition of Valencia" (ANIVA), where diet, blood pressure, and anthropometry were evaluated in 652 children between six and nine years old. The World Health Organization (WHO) criteria to identify normotensive, prehypertensive and hypertensive were applied. Results: there is a higher prevalence of normotensive (83.9%, p < 0.05). The prevalence of prehypertensive and hypertensive patients is 8.1% and 8.0%, respectively. Boys have higher levels of hypertension (8.4%), while girls have a higher prevalence of prehypertension (9.3%). In boys, significantly higher values are identified for the weight, height and hip circumference. Girls present significantly higher percentage of fat mass, bicipital fold, suprailiac fold, and heart rate. Significant correlations were found between the anthropometric indicators and blood pressure by sex, highlighting the waist circumference-blood pressure correlation in boys. Significant differences are observed between the nutrients ingested in the diet and blood pressure. Conclusions: a prevalence of hypertension of 8% in children aged 6-9 years of the province of Valencia is identified. The blood pressure values increase according to the body mass index, percentage of fat mass, waist circumference and the set of folds. A dietary pattern associated with hypertension in children is identified.


Assuntos
Antropometria , Dieta , Hipertensão/epidemiologia , Adiposidade , Estatura , Peso Corporal , Criança , Estudos Transversais , Comportamento Alimentar , Feminino , Quadril/anatomia & histologia , Humanos , Masculino , Sobrepeso/epidemiologia , Pré-Hipertensão/epidemiologia , Prevalência , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia
10.
Clinics (Sao Paulo) ; 74: e560, 2019 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-30892414

RESUMO

OBJECTIVE: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.


Assuntos
Cirurgia Bariátrica , Composição Corporal , Dieta Redutora/métodos , Obesidade Mórbida/dietoterapia , Perda de Peso/fisiologia , Fatores Etários , Índice de Massa Corporal , Diabetes Mellitus/dietoterapia , Diabetes Mellitus/fisiopatologia , Feminino , Quadril/anatomia & histologia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/anatomia & histologia , Obesidade Mórbida/cirurgia , Cuidados Pré-Operatórios/métodos , Estudos Prospectivos , Fatores Sexuais , Circunferência da Cintura
11.
Plast Reconstr Surg ; 143(3): 513e-517e, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30817643

RESUMO

BACKGROUND: Asymmetry of the hips and its implication in body contouring procedures has not yet been reported. Hip asymmetry is common in the general population and may account for uneven abdominoplasty scar and the apparent discrepancies in volume following liposuction of the hips and flanks. The goal of this study was to determine the presence of hip asymmetry in women presenting for abdominal contouring surgery. METHODS: Analysis of preoperative photographs of 100 female patients was performed by three independent plastic surgeons. They were asked to evaluate for hip asymmetry and, when present, determine which side was higher. Adobe Photoshop was also used to objectively measure hip asymmetry. Patients were women with no known history of hip abnormalities; age ranged from 17 to 64 years and the body mass index ranged from 16 to 47 kg/m(2). RESULTS: All three plastic surgeon reviewers found that the majority of patients had hip asymmetry, with raters 1, 2, and 3 documenting discrepancies in hip height in 88, 60, and 76 percent of patients, respectively. The interrater reliability was 0.713. Chi-square statistical analysis suggested that the raters were not statistically different from one another (p = 0.086). The objective analysis found asymmetry in 82 percent of patients. CONCLUSIONS: The results showed that the majority of patients who present for abdominal contouring surgery have asymmetric hips. Patients are usually unaware of the unevenness of their own hips; however, they often notice postoperative discrepancies in scar height after abdominoplasty or volume differences after liposuction.


Assuntos
Contorno Corporal/efeitos adversos , Cicatriz/etiologia , Quadril/anatomia & histologia , Lipoabdominoplastia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Adolescente , Adulto , Contorno Corporal/métodos , Cicatriz/diagnóstico por imagem , Feminino , Quadril/diagnóstico por imagem , Humanos , Lipoabdominoplastia/métodos , Pessoa de Meia-Idade , Satisfação do Paciente , Fotografação , Complicações Pós-Operatórias/diagnóstico por imagem , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
12.
Int J Numer Method Biomed Eng ; 35(5): e3183, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30701692

RESUMO

Multiscale models of bone remodelling which incorporate clinically important features at a wide range of spatial scales are computationally intractable. In addition, there is a large gap in existing bone remodelling literature which deals with Haversian-level cortical bone remodelling behaviour and its effect on whole organ bone strength. In this study, we present an integration between continuum mechanics and surrogate modelling as an efficient circumvention to the problem of intractability, linked with an intricate 3D cortical bone remodelling algorithm which captures realistic microanatomical features at the Haversian level. The surrogate model predicted clear differentiation in long-term bone strength changes in clinically significant cases with extremely high computational efficiency.


Assuntos
Remodelação Óssea , Quadril/fisiologia , Modelos Biológicos , Algoritmos , Simulação por Computador , Colo do Fêmur/anatomia & histologia , Colo do Fêmur/fisiologia , Osteon , Quadril/anatomia & histologia , Humanos , Modelos Estatísticos , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/fisiologia , Estresse Mecânico
13.
Nutr. hosp ; 36(1): 133-141, ene.-feb. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-183199

RESUMO

Introducción: estudios recientes alertan de cambios en los hábitos alimentarios y de un aumento del sobrepeso en niños como posibles factores de riesgo de una hipertensión temprana. Objetivos: conocer la prevalencia de normotensión, prehipertensión e hipertensión en los niños estudiados y valorar su posible asociación con la dieta e indicadores antropométricos. Métodos: se realizó un estudio transversal dentro del Proyecto "Antropometría y Nutrición Infantil de Valencia" (ANIVA), donde se valoró dieta, presión arterial y antropometría en 652 niños/as de entre seis y nueve años. Se aplicaron los criterios de la Organización Mundial de la Salud (OMS) para identificar normotensos, prehipertensos e hipertensos. Resultados: existe una mayor prevalencia de normotensos (83,9%, p < 0,05). La prevalencia de prehipertensos e hipertensos es de un 8,1% y 8,0%, respectivamente. Los niños presentan mayores niveles de hipertensión (8,4%), mientras que las niñas presentan mayor prevalencia de prehipertensión (9,3%). En los niños se identifican valores significativamente mayores en el peso, la altura y la circunferencia de cadera. Las niñas presentan signifi cativamente mayor porcentaje de masa grasa, pliegue bicipital, pliegue suprailiaco y frecuencia cardiaca. Se encontraron correlaciones significativas entre los indicadores antropométricos y la presión arterial por sexo, destacando la correlación perímetro de cintura-presión arterial en los niños. Se observan diferencias significativas entre los nutrientes ingeridos en la dieta y la presión arterial. Conclusiones: se identifica una prevalencia de hipertensión del 8% en niños de 6-9 años de la provincia de Valencia. Los valores de presión arterial aumentan en función del índice de masa corporal, el porcentaje de masa grasa, el perímetro de cintura y el conjunto de los pliegues. Se identifi ca un patrón dietético asociado a la hipertensión en niños


Introduction: recent studies warn of changes in dietary habits and an increase in overweight children as possible risk factors for early hypertension. Objectives: to know the prevalence of normotension, prehypertension and hypertension in the children studied, and to evaluate its possible association with diet and anthropometric indicators. Methods: a cross-sectional study was carried out within the Project "Anthropometry and Child Nutrition of Valencia" (ANIVA), where diet, blood pressure, and anthropometry were evaluated in 652 children between six and nine years old. The World Health Organization (WHO) criteria to identify normotensive, prehypertensive and hypertensive were applied. Results: there is a higher prevalence of normotensive (83.9%, p < 0.05). The prevalence of prehypertensive and hypertensive patients is 8.1% and 8.0%, respectively. Boys have higher levels of hypertension (8.4%), while girls have a higher prevalence of prehypertension (9.3%). In boys, significantly higher values are identified for the weight, height and hip circumference. Girls present significantly higher percentage of fat mass, bicipital fold, suprailiac fold, and heart rate. Significant correlations were found between the anthropometric indicators and blood pressure by sex, highlighting the waist circumference-blood pressure correlation in boys. Significant differences are observed between the nutrients ingested in the diet and blood pressure. Conclusions: a prevalence of hypertension of 8% in children aged 6-9 years of the province of Valencia is identified. The blood pressure values increase according to the body mass index, percentage of fat mass, waist circumference and the set of folds. A dietary pattern associated with hypertension in children is identified


Assuntos
Humanos , Masculino , Feminino , Criança , Antropometria , Dieta , Hipertensão/epidemiologia , Adiposidade , Estatura , Peso Corporal , Estudos Transversais , Comportamento Alimentar , Quadril/anatomia & histologia , Sobrepeso/epidemiologia , Pré-Hipertensão/epidemiologia , Fatores de Risco , Prevalência , Fatores Sexuais , Espanha/epidemiologia
14.
J Am Acad Orthop Surg ; 27(10): e451-e461, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30640742

RESUMO

The diagnosis of hip pain can be difficult to isolate because the discomfort can originate from several locations and compensatory pain patterns. Pain generators can include the intra- and extra-articular hip structures, the lumbar spine, the pelvic floor, or a combination of these. It can also be referred as pain from the bowel, bladder, or reproductive organs. Injections into and around the hip have become an important part of both diagnostic and nonsurgical treatment algorithm for hip pain. The proximity of the hip to important neurovascular structures, lack of palpable anatomic landmarks, and deep location of targets can make use of ultrasonography-guided injections ideal. These injections have been growing in popularity in the orthopedic community because ultrasonography allows for a real-time visualization of dynamic anatomy without any radiation exposure to the patient and physician. The use of ultrasonography has allowed for in-office image guidance with improved accuracy for more targeted and advanced procedures. The patient's response to these injections can help guide patient selection for surgery and allow for better pain control of the soft-tissue pathology that often accompanies intra-articular pathology. This article highlights the diagnostic and therapeutic value of ultrasonography-guided hip injections for an orthopedic practice. The focus is on sonographic anatomy, introduction to technique, common indications, and pearls and pitfalls of these procedures.


Assuntos
Quadril/anatomia & histologia , Quadril/diagnóstico por imagem , Injeções Intra-Articulares/métodos , Manejo da Dor/métodos , Dor/tratamento farmacológico , Ultrassonografia de Intervenção/métodos , Articulação do Quadril/anatomia & histologia , Articulação do Quadril/diagnóstico por imagem , Humanos , Ortopedia/métodos
15.
J Robot Surg ; 13(1): 61-67, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29693206

RESUMO

Performing surgical procedures often requires a surgeon to develop a skill to create 3-dimensional (3D) mental model on patient's anatomy. Question remains whether the touching on the 3D printed model can facilitate learning of patient anatomy than viewing the rendered virtual on-screen model. The printed and the virtual 3D model were developed from CT films taken from a 4-year-old girl, who had dysplasia of the hip in the left hip. Eleven subjects were called to report measures on six key anatomical features on the hips. The reporting time and the accuracy were compared between the two models, along with the gaze characteristics of subjects while inspecting the models. The variables were analysed using a 2 × 2 within subject ANOVA to examine the difference between viewing the models (on-screen vs. printed-out) and the side of the hip (right vs. left). Interacting with the printed 3D model required shorter times and yielded more accurate visual judgments than viewing the virtual models on most of the anatomical features. Subjects performed a fewer number of fixations but with a longer mean fixation duration when interacting the printed than inspecting the virtual on-screen 3D model. Results confirmed the value of the printed 3D model on improving the clinical judgement on patient anatomy. Confidence in collecting information from the physical world and the cross-model sensor integration may explain why participants performed better with the printed model compared to the virtual model.


Assuntos
Quadril/anatomia & histologia , Modelos Anatômicos , Impressão Tridimensional , Cirurgiões/psicologia , Tomografia Computadorizada por Raios X , Adulto , Competência Clínica , Feminino , Quadril/diagnóstico por imagem , Luxação do Quadril/patologia , Humanos , Imageamento Tridimensional , Masculino , Treinamento por Simulação , Realidade Virtual , Adulto Jovem
16.
J Sports Sci ; 37(11): 1197-1204, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30526374

RESUMO

This study determined the most effective field method for quantifying fat-free mass (FFM) in elite youth male soccer players compared to dual X-ray absorptiometry (DXA) values and to develop prediction equations for FFM based on anthropometric variables. Forty-one male elite-standard youth soccer players, ages 16.2-18.0 years, undertook FFM assessments including bioelectrical impedance analysis, and different skinfold-based prediction equations. DXA provided a criterion measure of FFM. Correlation coefficients, bias, limits of agreement, and differences were used as validity measures, and regression analyses to develop soccer-specific prediction equations. Slaughter et al (1988), Durnin and Wormersley (1974), and Sarria et al (1998) equations showed the lowest biases, and no significant, standardized, and substantial differences against DXA. The new youth soccer-specific anthropometric equation explained 91% of the DXA-derived FFM variance using three circumferences, eight skinfolds, and one bone breadth. All field methods compared in this study may not be adequate for estimating FFM in elite youth male soccer players, except the equations of Slaughter et al (1988), Durnin and Wormersley (1974), and Sarria et al (1998). We recommend the use of the new soccer-specific equation proposed in this study as a valid alternative to DXA to quantify FFM among elite youth male players.


Assuntos
Distribuição da Gordura Corporal/métodos , Distribuição da Gordura Corporal/estatística & dados numéricos , Índice de Massa Corporal , Futebol/fisiologia , Absorciometria de Fóton , Adolescente , Braço/anatomia & histologia , Composição Corporal , Estudos Transversais , Impedância Elétrica , Quadril/anatomia & histologia , Humanos , Perna (Membro)/anatomia & histologia , Masculino , Análise de Regressão , Reprodutibilidade dos Testes , Pregas Cutâneas , Circunferência da Cintura
17.
PLoS One ; 13(11): e0202785, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30388100

RESUMO

Given GDF5 involvement in hip development, and osteoarthritis (OA) and developmental hip dysplasia (DDH) risk, here we sought to assess the role(s) of GDF5 and its regulatory sequence on the development of hip morphology linked to injury risk. The brachypodism (bp) mouse, which harbors a Gdf5 inactivating mutation, was used to survey how Gdf5 loss of function impacts the development of hip morphology. Two transgenic Gdf5 reporter BAC lines were used to assess the spatiotemporal expression of Gdf5 regulatory sequences. Each BAC line was also used to assess the functional roles of upstream and downstream sequence on hip morphology. bp/bp mice had shorter femora with smaller femoral heads and necks as well as larger alpha angles, smaller anterior offsets, and smaller acetabula, compared to bp/+ mice (p<0.04). Regulatory sequences downstream of Gdf5 drove strong prenatal (E17) expression and low postnatal (6 months) expression across regions of femoral head and acetabulum. Conversely, upstream regulatory sequences drove very low expression at E17 and no detectable expression at 6 months. Importantly, downstream, but not upstream Gdf5 regulatory sequences fully restored all the key morphologic features disrupted in bp/bp mice. Hip morphology is profoundly affected by Gdf5 absence, and downstream regulatory sequences mediate its effects by controlling Gdf5 expression during development. This downstream region contains numerous enhancers harboring risk variants related to hip OA, DDH, and dislocation. We posit that subtle alterations to morphology driven by changes in downstream regulatory sequence underlie this locus' role in hip injury risk.


Assuntos
Regulação da Expressão Gênica no Desenvolvimento , Fator 5 de Diferenciação de Crescimento/genética , Quadril/anatomia & histologia , Quadril/crescimento & desenvolvimento , Animais , Deleção de Genes , Masculino , Camundongos Endogâmicos BALB C , Mutação , Sequências Reguladoras de Ácido Nucleico
18.
Eur J Radiol ; 108: 92-98, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30396677

RESUMO

The purpose of this prospective study was to ascertain the degree of variation of semi-quantitative and permeability parameters on DCE-MRI of normally appearing striated muscles. Dynamic contrast-enhanced MRI of the right hip was performed in 20 women and 24 men. Mean age was 39.1 ± 12.4 years. Two regions of interest (ROI) were drawn in twelve muscles of anterior, medial and gluteal compartments: a free-form ROI covering the largest muscle section and a smaller elliptical ROI. Semi-quantitative and permeability parameters were calculated using the extended Tofts model. Statistical analysis was performed with a linear mixed model to assess perfusion parameters variation. Intra- and inter-observer agreements were assessed. The intra-observer agreement was considered to be good for free-form ROI (minimum Intra-Class Coefficient (ICC) = 0.72) and moderate for elliptical ROI (minimum ICC = 0.51), while the inter-observer agreement was considered to be bad in both cases (minimum ICC = 0.11). There was a high inter-individual variation in most of the perfusion parameters evaluated. The average coefficients of variation were: Time To Peak = 9%, Area Under the Curve = 44%, Ve = 61%, Kep = 90%, Initial Slope = 99%, and Ktrans = 128%. A considerable variation in resting muscle perfusion parameters was seen. This could lead to errors in the analysis of muscle DCE-MRI studies or oncologic/non oncologic studies using muscle as a referential. Further studies targeted on acquisition protocols and post-processing software are necessary to improve the performance of muscle MR perfusion.


Assuntos
Quadril/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Adulto , Meios de Contraste , Feminino , Quadril/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Músculo Esquelético/diagnóstico por imagem , Variações Dependentes do Observador , Estudos Prospectivos , Reprodutibilidade dos Testes , Software
19.
IEEE Trans Neural Syst Rehabil Eng ; 26(10): 2026-2032, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30281466

RESUMO

In this paper, we present a new perspective to design an unpowered exoskeleton for metabolic rate reduction in running. According to our studies on human biomechanics, it was observed that having a torsional spring that applies torque as a linear function of the difference between two hips angles ( -angle), compared with a local spring which applies torque as a function of hip angle ( -angle), provides a better condition for hip moment compensation and, consequently, metabolic rate reduction. Accordingly, a new type of unpowered exoskeleton device for realization of this idea was designed, and a prototype of this exoskeleton was constructed. This exoskeleton was tested on 10 healthy active subjects for running at 2.5 m s-1. In this experiment, 8.0 ± 1.5% (mean ± s.e.m.) metabolic rate reduction (compared with the no-exoskeleton case) was achieved.


Assuntos
Metabolismo Energético , Exoesqueleto Energizado , Corrida/fisiologia , Adulto , Fenômenos Biomecânicos , Desenho de Equipamento , Voluntários Saudáveis , Quadril/anatomia & histologia , Quadril/fisiologia , Humanos , Masculino , Aparelhos Ortopédicos , Consumo de Oxigênio/fisiologia , Torque , Caminhada/fisiologia , Adulto Jovem
20.
Am J Sports Med ; 46(6): 1294-1305, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29585730

RESUMO

BACKGROUND: Musculoskeletal hip/groin screening tests are commonly performed to detect at-risk individuals. Bony hip morphology is considered a potential intrinsic risk factor but has not been examined prospectively. PURPOSE: To evaluate the association between intrinsic risk factors identified from musculoskeletal and radiographic screening tests and hip/groin injuries leading to time loss from training and/or match play in professional male soccer players. STUDY DESIGN: Prospective cohort study; Level of evidence, 2. METHODS: Male professional soccer players, aged ≥18 years, underwent screening specific for hip/groin pain during 2 consecutive seasons of the Qatar Stars League. The screening battery included pain provocation, range of motion, and strength tests as well as a hip radiographic examination. The radiographic examination included an anteroposterior pelvic view and 45° Dunn view, with bony hip morphology determined using quantitative methods. Time-loss (≥1 day) hip/groin injuries and individual player exposure (training and match play) were recorded prospectively, and injuries were categorized as adductor-related, inguinal-related, iliopsoas-related, pubic-related, or hip-related groin pain, or "other," as recommended in the Doha agreement. We calculated hazard ratios (HRs) from univariate and multivariate Cox regression models to assess the relationship between potential risk factors and hip/groin injuries. RESULTS: There were 438 players, completing 609 player seasons, and 113 hip/groin injuries that met the criteria for inclusion, with 85 injuries categorized as adductor-related. The proportion of players with bony morphological variants was the following: cam, 71%; pincer, 5%; and acetabular dysplasia, 13%. Previous hip/groin injuries (HR, 1.8; 95% CI, 1.2-2.7) and eccentric adduction strength were associated with the risk of hip/groin injuries. Higher (>1 SD above the mean) than normal eccentric adduction strength was associated with an increased risk for all hip/groin injuries (HR, 1.6; 95% CI, 1.0-2.5). Lower (<1 SD below the mean) than normal eccentric adduction strength was associated with an increased risk for adductor-related injuries (HR, 1.7; 95% CI, 1.0-3.0). No other musculoskeletal screening test or bony hip morphology variables were associated with the injury risk. CONCLUSION: Previous groin injuries and eccentric adduction strength were associated with the risk of groin injuries. However, these associations were not strong enough to identify an "at-risk" individual, and therefore, musculoskeletal screening tests were not useful to dictate individualized prevention strategies. Bony hip morphology was not associated with the risk of groin injuries.


Assuntos
Virilha/lesões , Quadril/anatomia & histologia , Futebol/lesões , Adolescente , Adulto , Artralgia/etiologia , Quadril/diagnóstico por imagem , Lesões do Quadril/diagnóstico , Humanos , Masculino , Força Muscular/fisiologia , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/lesões , Estudos Prospectivos , Radiografia , Amplitude de Movimento Articular , Fatores de Risco , Coxa da Perna , Adulto Jovem
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