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1.
In Vivo ; 36(1): 384-390, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34972739

RESUMO

BACKGROUND/AIM: Open surgical reduction/fixation of thoracolumbar fractures results in significant soft-tissue trauma and related complications. Minimally-invasive technical developments could deliver similar radiological outcomes, while avoiding the related complications. We evaluated radiological and perioperative outcomes in thoracolumbar fractures by using a novel minimally-invasive device. PATIENTS AND METHODS: Twenty-six patients with 29 thoracolumbar fractures using the NForce device were analyzed. Postoperative reduction and alignment were assessed by radiographic measurement of the local kyphosis angle (LKA) up until a follow-up period of 9 months. RESULTS: Postoperative imaging revealed an average reduction of traumatic kyphosis of 8.25° (±7.72°) with an average postoperative LKA of 3.24° (±8.97°). The highest degree of reduction was 27.39°. The mean LKA had increased to 5.08° (±5.17°) at 3 months postoperative, 5.43° (±4.32°) at 6 months and 6.21° (±3.82°) at 9 months. CONCLUSION: The minimally invasive NForce system is effective in performing anatomic percutaneous reduction/fixation.


Assuntos
Fraturas da Coluna Vertebral , Vértebras Torácicas , Fixação Interna de Fraturas , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Estudos Retrospectivos , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/lesões , Vértebras Torácicas/cirurgia , Resultado do Tratamento
2.
Br J Radiol ; 95(1129): 20210019, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34797695

RESUMO

OBJECTIVE: This study was designed to assess the accuracy of unenhanced 3T MRI supplemented with dedicated true plane reformats of 3D T2 Dual Echo Steady State (DESS), in assessing tears of scapholunate, lunotriquetral ligaments and triangular fibrocartilage complex, using arthroscopy as gold-standard. METHODS: In a retrospective cohort review, patients who underwent wrist arthroscopy and MRI over 2 years (n=46) were identified. Dedicated axial and coronal reformats were obtained from 3D T2 DESS sequence for assessing intrinsic ligaments and triangular fibrocartilage (TFCC). At arthroscopy, tears were classified using Geissler's classification and compared to MRI findings. RESULTS: The sensitivity of unenhanced 3T MRI in detecting scapholunate ligament tears was 87%, specificity was 90% and negative predictive value of 93%. The lunate triquetral ligament was assessed with a high specificity (97%) and negative predictive value (93%), sensitivity was 63%. TFCC tears were assessed with a sensitivity of 100%. The overall diagnostic accuracy of unenhanced 3T MRI of wrist in detecting ligament tears was 91%. CONCLUSION: 3T wrist MRI with dedicated reformats from 3D T2 DESS has a high diagnostic accuracy in assessing acute intrinsic ligament and TFCC injuries. High strength 3T MRI with good technical quality isotropic 3D T2 DESS is critical for accurate wrist ligament assessment. Negative predictive values of 3T MRI of 95% can lead to reduced need for diagnostic arthroscopy of the wrist. ADVANCES IN KNOWLEDGE: This study assesses the diagnostic performance of unenhanced 3T MRI with 3D T2 DESS in assessing traumatic wrist ligament tears. The accuracy of T2 DESS in wrist imaging has not been previously reported.


Assuntos
Ligamentos Articulares/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Articulação do Punho/diagnóstico por imagem , Artroscopia , Humanos , Ligamentos Articulares/lesões , Estudos Retrospectivos , Fibrocartilagem Triangular/diagnóstico por imagem , Fibrocartilagem Triangular/lesões , Traumatismos do Punho/diagnóstico por imagem
3.
J Clin Neurosci ; 95: 188-197, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34929644

RESUMO

OBJECTIVE: The aim of this retrospective cohort study was to study the impact of age on in-hospital complications and mortality following surgery for Ankylosing Spondylitis (AS) associated spine fractures. METHODS: We extracted data from the Nationwide Inpatient Sample (NIS) database (1998-2018) using ICD-9/10 codes. Patients with a primary diagnosis of AS associated spine fractures who underwent fusion surgery were included. Complications and in-hospital mortality were analyzed. RESULTS: A total cohort of 8526 patients was identified. Overall, the median age of the cohort was 69 years. AS associated fractures were equally distributed among cervical and thoracolumbar regions. Overall, complications were noted in 48% of patients and pulmonary complications were the most common (32%) followed by renal (13%) and infection (12%). Complications were seen in 57.3% of patients ≥ 70 years of age compared to 38.4% of patients < 70 years of age (p < .0001). Also, 9.9 % of patients ≥ 70 years of age had in-hospital mortality compared to 3.1 % of patients < 70 years of age (p < .0001). Based on surgical approaches, elderly patients (≥70 years) who underwent anterior, posterior, and anterior + posterior approaches had 19.8%, 7.4% and 16.4% in-hospital mortality compared to 5.3%, 2.2% and 7.4% respectively for patients < 70 years. CONCLUSIONS: Elderly patients (≥70 years of age) were 3.2 times more likely to have in-hospital mortality and higher complications compared to younger patients (57% vs. 38%). Cervical compared to thoracolumbar fractures and anterior compared to posterior surgical approaches were associated with higher complications and in-hospital mortality.


Assuntos
Fraturas da Coluna Vertebral , Espondilite Anquilosante , Idoso , Vértebras Cervicais/lesões , Mortalidade Hospitalar , Humanos , Estudos Retrospectivos , Fraturas da Coluna Vertebral/cirurgia , Espondilite Anquilosante/complicações
4.
J Pediatr Orthop ; 42(1): e45-e49, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34608037

RESUMO

BACKGROUND: Facet fractures have been reported in a total of 6 young athletes in 4 previous publications. These injuries were not diagnosed on magnetic resonance imaging (MRI) or radiographs, and were identified on computed tomography (CT). Our purpose was to report a series of athletes with operatively managed facet fractures. This may be an under-recognized diagnosis. METHODS: Retrospective review of pediatric patients with operatively managed isolated lumbar or sacral facet fractures from 3 tertiary pediatric hospitals from 2014 to 2019. Clinical records and imaging studies were reviewed. RESULTS: Ten patients with symptomatic lumbar or sacral facet fractures met inclusion criteria (mean age at presentation; 13.3±2.1 years, 70% Female). All patients reported competitive participation in sports. On physical examination, 10/10 (100%) of patients had lower back pain that was exacerbated with lumbar spine extension. Limited CT scans demonstrated facet fractures in 10/10 (100%) patients not detected on plain film or MRI. All patients experienced significant relief of pain following excision of the facet fracture fragment. At time of first postoperative visit, 9/10 (90%) patients were pain free while one had generalized back pain thought to be related to fibromyalgia and not facet pathology. At time of last follow-up, 2/10 (20%) of patients reported nonspecific back pain that was not localized in the area of the facet fracture, while 80% (8/10) remained pain free. All patients 100% (10/10) returned to full participation to sports. There were no complications noted in this series. Average follow-up was 27 months (range: 1 to 68 mo). CONCLUSIONS: Athletes with localized back pain exacerbated by spine extension may have a facet fracture. As facet fractures are usually not identified with radiographs or MRI, a limited CT scan should be considered in the evaluation of pediatric athletes with localized back pain exacerbated by extension. In this series, surgical excision of facet fracture fragments was safe and provided predictable pain relief.


Assuntos
Sacro , Fraturas da Coluna Vertebral , Atletas , Criança , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Masculino , Estudos Retrospectivos , Sacro/diagnóstico por imagem , Sacro/lesões , Sacro/cirurgia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia
5.
Facial Plast Surg Clin North Am ; 30(1): 31-45, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34809885

RESUMO

The bony orbit is commonly involved in athletic injuries. Evaluation should include a comprehensive history and ocular examination. Computed tomography imaging is the gold standard for diagnostic testing. Urgent surgical intervention for orbital floor fractures should occur after "white eye" trapdoor fractures or if oculocardiac response occurs. Most orbital fractures do not require urgent intervention and repair can be completed within 2 weeks of injury. There are many approaches to repair orbital fractures, and consideration of techniques depends on the unique fracture pattern. Intraoperative computed tomography has become frequently used and can lead to increased identification of plate malpositioning intraoperatively.


Assuntos
Traumatismos em Atletas , Fraturas Orbitárias , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/cirurgia , Ossos Faciais , Humanos , Órbita/lesões , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/cirurgia , Tomografia Computadorizada por Raios X
6.
Exp Neurol ; 347: 113899, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34678230

RESUMO

BACKGROUND AND PURPOSE: Traumatic brain injury (TBI) destroys white matter, and this destruction is aggravated by secondary neuroinflammatory reactions. Although white matter injury (WMI) is strongly correlated with poor neurological function, understanding of white matter integrity maintenance is limited, and no available therapies can effectively protect white matter. One candidate approach that may fulfill this goal is cannabinoid receptor 2 (CB2) agonist treatment. Here, we confirmed that a selective CB2 agonist, JWH133, protected white matter after TBI. METHODS: The motor evoked potentials (MEPs), open field test, and Morris water maze test were used to assess neurobehavioral outcomes. Brain tissue loss, WM damage, Endoplasmic reticulum stress (ER stress), microglia responses were evaluated after TBI. The functional integrity of WM was measured by diffusion tensor imaging (DTI) and transmission electron microscopy (TEM). Primary microglia and oligodendrocyte cocultures were used for additional mechanistic studies. RESULTS: JWH133 increased myelin basic protein (MBP) and neurofilament heavy chain (NF200) levels and anatomic preservation of myelinated axons revealed by DTI and TEM. JWH133 also increased the numbers of oligodendrocyte precursor cells and mature oligodendrocytes. Furthermore, JWH133 drove microglial polarization toward the protective M2 phenotype and modulated the redistribution of microglia in the striatum. Further investigation of the underlying mechanism revealed that JWH133 downregulated phosphorylation of the protein kinase R (PKR)-like endoplasmic reticulum (ER) kinase (PERK) signaling pathway and its downstream signals eukaryotic translation initiation factor 2 α (eIF2α), activating transcription factor 4 (ATF4) and Growth arrest and DNA damage-inducible protein (GADD34); this downregulation was followed by p-Protein kinase B(p-Akt) upregulation. In primary cocultures of microglia and oligodendrocytes, JWH133 decreased phosphorylated PERK expression in microglia stimulated with tunicamycin and facilitated oligodendrocyte survival. These data reveal that JWH133 ultimately alleviates WMI and improves neurological behavior following TBI. However, these effects were prevented by SR144528, a selective CB2 antagonist. CONCLUSIONS: This work illustrates the PERK-mediated interaction between microglia and oligodendrocytes. In addition, the results are consistent with recent findings that microglial polarization switching accelerates WMI, highlighting a previously unexplored role for CB2 agonists. Thus, CB2 agonists are potential therapeutic agents for TBI and other neurological conditions involving white matter destruction.


Assuntos
Canabinoides/farmacologia , Receptor CB2 de Canabinoide/agonistas , Receptor CB2 de Canabinoide/metabolismo , Transdução de Sinais/fisiologia , Substância Branca/metabolismo , eIF-2 Quinase/biossíntese , Animais , Agonistas de Receptores de Canabinoides/farmacologia , Agonistas de Receptores de Canabinoides/uso terapêutico , Canabinoides/uso terapêutico , Células Cultivadas , Modelos Animais de Doenças , Potencial Evocado Motor/efeitos dos fármacos , Potencial Evocado Motor/fisiologia , Masculino , Microglia/efeitos dos fármacos , Microglia/metabolismo , Ratos , Ratos Sprague-Dawley , Substância Branca/diagnóstico por imagem , Substância Branca/efeitos dos fármacos , Substância Branca/lesões , eIF-2 Quinase/antagonistas & inibidores
7.
Ulus Travma Acil Cerrahi Derg ; 28(1): 120-123, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34967437

RESUMO

Trans-sectional injuries of trachea are quite rare and can be extremely challenging for anesthesiologists to deal with. About 25% of post-traumatic deaths are due to thoracic traumas in which blunt injuries take a rather small place within and the resultant damage of respiratory tract is quite rare with an incidence of 0.5-2%. A recent review from a single trauma center revealed an incidence of 0.4% for tracheobronchial injury (TBI) due to blunt thoracic injuries. Most of the patients having tracheal transection lose their lives on the field due to loss of airway. Patients mostly present with a large spectrum of clinical features varying from hoarseness to respiratory collapse; though subcutaneous emphysema is the most common presenting sign which should remind possible TBI. Emergent surgery is preferred seldomly; such in cases of partial damage or because of late diagnosis, due to favorable outcome of conservative approach. Herein, we report the management of a case on TBI due to blunt thoracic trauma, experiencing difficult ventilation despite tracheal intubation. Fiber-optic bronchoscope (FOB) seems obligatory to visualize site and severity of injury and to ensure safe airway during procedures such as the neck exploration, primary end-to-end anastomosis of the trachea, tracheostomy, diversion pharyngostomy, and feeding jejunostomy.


Assuntos
Traumatismos Torácicos , Ferimentos não Penetrantes , Humanos , Intubação Intratraqueal , Traumatismos Torácicos/cirurgia , Traqueia/lesões , Traqueia/cirurgia , Traqueostomia , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/cirurgia
8.
J Exp Med ; 219(1)2022 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-34846534

RESUMO

Muscle regeneration is the result of the concerted action of multiple cell types driven by the temporarily controlled phenotype switches of infiltrating monocyte-derived macrophages. Pro-inflammatory macrophages transition into a phenotype that drives tissue repair through the production of effectors such as growth factors. This orchestrated sequence of regenerative inflammatory events, which we termed regeneration-promoting program (RPP), is essential for proper repair. However, it is not well understood how specialized repair-macrophage identity develops in the RPP at the transcriptional level and how induced macrophage-derived factors coordinate tissue repair. Gene expression kinetics-based clustering of blood circulating Ly6Chigh, infiltrating inflammatory Ly6Chigh, and reparative Ly6Clow macrophages, isolated from injured muscle, identified the TGF-ß superfamily member, GDF-15, as a component of the RPP. Myeloid GDF-15 is required for proper muscle regeneration following acute sterile injury, as revealed by gain- and loss-of-function studies. Mechanistically, GDF-15 acts both on proliferating myoblasts and on muscle-infiltrating myeloid cells. Epigenomic analyses of upstream regulators of Gdf15 expression identified that it is under the control of nuclear receptors RXR/PPARγ. Finally, immune single-cell RNA-seq profiling revealed that Gdf15 is coexpressed with other known muscle regeneration-associated growth factors, and their expression is limited to a unique subpopulation of repair-type macrophages (growth factor-expressing macrophages [GFEMs]).


Assuntos
Perfilação da Expressão Gênica/métodos , Fator 15 de Diferenciação de Crescimento/genética , Inflamação/genética , Peptídeos e Proteínas de Sinalização Intercelular/genética , Macrófagos/metabolismo , Regeneração/genética , Animais , Diferenciação Celular/genética , Células Cultivadas , Fator 15 de Diferenciação de Crescimento/metabolismo , Inflamação/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Células Musculares/metabolismo , Músculos/lesões , Músculos/metabolismo , Músculos/fisiopatologia , Células Mieloides/metabolismo , RNA-Seq/métodos
9.
Urol Clin North Am ; 49(1): 161-173, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34776049

RESUMO

Percutaneous nephrolithotomy (PCNL) remains the treatment of choice for large and complex renal stones. The technological advances over the past several decades gave birth to different varieties of minimally invasive PCNLs, including the mini-PCNL, ultra-mini PCNL, super mini-PCNL, and micro-PCNL, with indications being extended to stones even larger than 20 mm. This article provides an update of all these available techniques of miniaturized PCNL along with its anatomic and physiologic impact. This should assist urologists in providing a personalized approach to the patient based on various patient- and stone-related factors to provide the best of all available technology for treatment.


Assuntos
Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/instrumentação , Nefrolitotomia Percutânea/métodos , Animais , Cicatriz/etiologia , Humanos , Rim/lesões , Miniaturização , Nefrolitotomia Percutânea/efeitos adversos , Complicações Pós-Operatórias/etiologia , Guias de Prática Clínica como Assunto , Ferida Cirúrgica/etiologia
10.
Biochim Biophys Acta Mol Basis Dis ; 1868(1): 166287, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34626772

RESUMO

Oxidative stress and lipid peroxidation are major causes of skin injury induced by ultraviolet (UV) irradiation. Ferroptosis is a form of regulated necrosis driven by iron-dependent peroxidation of phospholipids and contributes to kinds of tissue injuries. However, it remains unclear whether the accumulation of lipid peroxides in UV irradiation-induced skin injury could lead to ferroptosis. We generated UV irradiation-induced skin injury mice model to examine the accumulation of the lipid peroxides and iron. Lipid peroxides 4-HNE, the oxidative enzyme COX2, the oxidative DNA damage biomarker 8-OHdG, and the iron level were increased in UV irradiation-induced skin. The accumulation of iron and lipid peroxidation was also observed in UVB-irradiated epidermal keratinocytes without actual ongoing ferroptotic cell death. Ferroptosis was triggered in UV-irradiated keratinocytes stimulated with ferric ammonium citrate (FAC) to mimic the iron overload. Although GPX4 protected UVB-injured keratinocytes against ferroptotic cell death resulted from dysregulation of iron metabolism and the subsequent increase of lipid ROS, keratinocytes enduring constant UVB treatment were markedly sensitized to ferroptosis. Nicotinamide mononucleotide (NMN) which is a direct and potent NAD+ precursor supplement, rescued the imbalanced NAD+/NADH ratio, recruited the production of GSH and promoted resistance to lipid peroxidation in a GPX4-dependent manner. Taken together, our data suggest that NMN recruits GSH to enhance GPX4-mediated ferroptosis defense in UV irradiation-induced skin injury and inhibits oxidative skin damage. NMN or ferroptosis inhibitor might become promising therapeutic approaches for treating oxidative stress-induced skin diseases or disorders.


Assuntos
Glutationa/genética , Ferro/metabolismo , Estresse Oxidativo/genética , Fosfolipídeo Hidroperóxido Glutationa Peroxidase/genética , Pele/metabolismo , 8-Hidroxi-2'-Desoxiguanosina/farmacologia , Aldeídos/farmacologia , Animais , Ciclo-Oxigenase 2/genética , Dano ao DNA/efeitos dos fármacos , Dano ao DNA/efeitos da radiação , Compostos Férricos/farmacologia , Ferroptose/efeitos dos fármacos , Ferroptose/efeitos da radiação , Humanos , Queratinócitos/efeitos dos fármacos , Queratinócitos/efeitos da radiação , Peroxidação de Lipídeos/efeitos dos fármacos , Peroxidação de Lipídeos/efeitos da radiação , Peróxidos Lipídicos/farmacologia , Camundongos , Mononucleotídeo de Nicotinamida/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/efeitos da radiação , Compostos de Amônio Quaternário/farmacologia , Pele/efeitos dos fármacos , Pele/lesões , Pele/patologia , Raios Ultravioleta/efeitos adversos
11.
J Med Virol ; 94(1): 7-10, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34506635

RESUMO

Hepatitis, a significant cause of mortality worldwide, results in around 1.34 million deaths each year globally. Africa is not exempt from the plague of Hepatitis. Around 100 million estimated individuals are infected with Hepatitis B or C. Egypt has the highest prevalence of cases of Hepatitis followed by Cameroon and Burundi. The continent is severely affected by the onset of the COVID-19 pandemic, as the virus has added an additional burden on the already fragile continent. With the pandemic, it is presumable that Hepatitis like other viral diseases will pose a threat to collapsing healthcare system. Therefore, for Africa to become more resilient in the face of such menaces, including Hepatitis, further prevention policies are required to be implemented.


Assuntos
COVID-19/epidemiologia , Acesso aos Serviços de Saúde , Hepatite B Crônica/epidemiologia , Hepatite C Crônica/epidemiologia , Países em Desenvolvimento , Egito/epidemiologia , Hepacivirus/patogenicidade , Vírus da Hepatite B/patogenicidade , Hepatite B Crônica/prevenção & controle , Hepatite B Crônica/terapia , Hepatite C Crônica/prevenção & controle , Hepatite C Crônica/terapia , Humanos , Fígado/lesões , Fígado/patologia , Fígado/virologia , Prevalência , SARS-CoV-2
12.
JAMA Netw Open ; 4(12): e2138801, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34910152

RESUMO

Importance: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease; understanding ALS risk factors is a critical public health issue. Objectives: To evaluate the incidence of and mortality from ALS in National Football League (NFL) athletes and to describe characteristics associated with ALS within this cohort. Design, Setting, and Participants: This population-based cohort study included all 19 423 NFL athletes who debuted between 1960 and 2019 and played 1 or more professional game. It was conducted between October 3, 2020, and July 19, 2021. Exposure: Participation in the NFL, including playing 1 or more professional games. Main Outcomes and Measures: Cases of ALS and death information were identified based on public records from NFL statistics aggregators, news reports, obituaries, and National Death Index results. The standardized incidence ratio and the standardized mortality ratio were calculated based on data acquired from surveillance studies of ALS accounting for age, sex, and race. Secondary analyses examined the association of body mass index, NFL career duration, race, birth location, and markers of fame, using a nested case-control design, matching athletes with ALS to athletes without ALS, by NFL debut year. Results: A total of 19 423 male former and current NFL players (age range, 23-78 years) were included in this cohort study and were followed up for a cumulative 493 168 years (mean [SD] follow-up, 30.6 [13.7] years). Thirty-eight players received a diagnosis of ALS, and 28 died during the study time frame, representing a significantly higher incidence of ALS diagnosis (standardized incidence ratio, 3.59; 95% CI, 2.58-4.93) and mortality (standardized mortality ratio, 3.94; 95% CI, 2.62-5.69) among NFL players compared with the US male population, adjusting for age and race. Among NFL athletes, nested-case-control analyses found that those who received a diagnosis of ALS had significantly longer careers (mean [SD] duration, 7.0 [3.9] years) than athletes without ALS (mean [SD] duration, 4.5 [3.6] years; odds ratio, 1.2; 95% CI, 1.1-1.3). There were no differences in ALS status based on proxies of NFL fame, body mass index, position played, birth location, or race. Conclusions and Relevance: The age-, sex-, and race-adjusted incidence of and mortality from ALS among all NFL players who debuted between 1960 and 2019 were nearly 4 times as high as those of the general population. Athletes with a diagnosis of ALS had longer NFL careers than those without ALS, suggesting an association between NFL duration of play and ALS. The identification of these risk factors for ALS helps to inform the study of pathophysiological mechanisms responsible for this fatal neurodegenerative disease.


Assuntos
Esclerose Amiotrófica Lateral/etiologia , Atletas , Futebol Americano , Adulto , Idoso , Esclerose Amiotrófica Lateral/epidemiologia , Traumatismos em Atletas/complicações , Estudos de Casos e Controles , Traumatismos Craniocerebrais/complicações , Seguimentos , Futebol Americano/lesões , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34948565

RESUMO

Groin injuries are one of the most prevalent in male soccer players, especially due to the hip adductor muscles' weakness which is considered as a risk factor in these injuries. The Copenhagen adduction (CA) exercise has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics of adductor muscles have not been studied yet. This study aimed to analyze the effects of the CA exercise on the muscle thickness of the adductors. Twelve male U-17 soccer players were randomized into two groups: the control group with no intervention and the experimental group with an intervention based on an eight-week training with CA exercise. The muscle thickness of adductors was measured before and after the intervention using ultrasound imaging. A significant increase in muscle thickness was found in both control (p = 0.002) and experimental group (p < 0.001), but the experimental group did not show additional effects in comparison with the control group. In conclusion, an 8-week CA exercise intervention does not increase the muscle thickness of adductors in U-17 soccer players more than their regular training.


Assuntos
Traumatismos em Atletas , Futebol , Exercício Físico , Humanos , Masculino , Força Muscular , Músculo Esquelético/lesões , Fatores de Risco
14.
Gac Sanit ; 35 Suppl 2: S216-S220, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34929815

RESUMO

OBJECTIVE: The purpose of this study will be to review several studies regarding the repair or treatment of perineal tears after vaginal delivery. This is expected to be an update for a midwife in daily caring. METHODS: Two electronic databases (PubMed and Sciencedirect) were searched to locate relevant literature about perineal tears/wound/laceration/trauma that is published in 2016-2021. 124 Pubmed articles and 452 ScienceDirect articles filtered successfully. The articles that have been obtained will be evaluated based on the inclusion criteria in this study. We summarize place and date, objective, design, samples, the measurement used, and research results. RESULTS: 9 articles were found that matched the inclusion criteria. Three articles examined the effect of the type of suture on perineal pain, and another 6 discussed therapy to reduce the adverse effects of perineal tears. The therapies used are far-infrared radiation therapy, capacitive-resistive radiofrequency therapy, pelvic floor muscle training in early postpartum, cold therapy, and treatment with TheresienOl (natural oil). CONCLUSION: Sutures and technique/suturing second-degree perineal tears or a postpartum episiotomy can affect perineal pain. Cold gel pad therapy and treatment with natural oil on perineal wounds can affect perineal pain and wound healing.


Assuntos
Lacerações , Tocologia , Complicações do Trabalho de Parto , Parto Obstétrico , Episiotomia , Feminino , Humanos , Lacerações/terapia , Complicações do Trabalho de Parto/terapia , Períneo/lesões , Períneo/cirurgia , Gravidez
15.
Int J Mol Sci ; 22(24)2021 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-34948144

RESUMO

Central and peripheral nerve injuries can lead to permanent paralysis and organ dysfunction. In recent years, many cell and exosome implantation techniques have been developed in an attempt to restore function after nerve injury with promising but generally unsatisfactory clinical results. Clinical outcome may be enhanced by bio-scaffolds specifically fabricated to provide the appropriate three-dimensional (3D) conduit, growth-permissive substrate, and trophic factor support required for cell survival and regeneration. In rodents, these scaffolds have been shown to promote axonal regrowth and restore limb motor function following experimental spinal cord or sciatic nerve injury. Combining the appropriate cell/exosome and scaffold type may thus achieve tissue repair and regeneration with safety and efficacy sufficient for routine clinical application. In this review, we describe the efficacies of bio-scaffolds composed of various natural polysaccharides (alginate, chitin, chitosan, and hyaluronic acid), protein polymers (gelatin, collagen, silk fibroin, fibrin, and keratin), and self-assembling peptides for repair of nerve injury. In addition, we review the capacities of these constructs for supporting in vitro cell-adhesion, mechano-transduction, proliferation, and differentiation as well as the in vivo properties critical for a successful clinical outcome, including controlled degradation and re-absorption. Finally, we describe recent advances in 3D bio-printing for nerve regeneration.


Assuntos
Axônios , Exossomos/transplante , Traumatismos dos Nervos Periféricos , Impressão Tridimensional , Nervo Isquiático , Tecidos Suporte/química , Animais , Axônios/metabolismo , Axônios/patologia , Humanos , Traumatismos dos Nervos Periféricos/metabolismo , Traumatismos dos Nervos Periféricos/patologia , Traumatismos dos Nervos Periféricos/terapia , Nervo Isquiático/lesões , Nervo Isquiático/metabolismo , Nervo Isquiático/patologia
16.
J Healthc Eng ; 2021: 1152368, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34956554

RESUMO

Because of the intense competition, table tennis requires players to bear a strong physiological load, which increases the risk of sports injury. Anterior cruciate ligament (ACL) is an important structure of the knee joint to maintain forward stability and rotational stability and is also a common sports injury in table tennis players. ACL has poor self-repair ability after injury. Therefore, the purpose of this study is to provide a more comprehensive, reliable, and representative theoretical basis for the diagnosis and rehabilitation of anterior cruciate ligament injury in table tennis players, and three-dimensional reconstruction of ACL using dual-source computed tomography (DSCT) combined with deep learning was conducted. For this purpose, a number of table tennis players with ACL injuries were collected, and each patient underwent arthroscopic anterior cruciate ligament reconstruction. DSCT scanning was performed on several knee joints, the 3D model of the knee joint was reconstructed using a CT image postprocessing workstation, and the medial wall of the femoral lateral condyle was reconstructed, as well as the reconstructed single tract of bony canal, tibial plateau, and bony canal. Then, the Lysholm score was used to score the cases, with scores greater than 75 as the excellent group and below 75 as the poor group. The relative positions of the central points of the femoral and tibial canals were marked and measured. The results were as follows: 3D-CT reconstruction could clearly reflect the situation after anterior cruciate ligament reconstruction. In clinic, it is used to evaluate the relationship between bone tunnel location and graft shape so as to guide the surgeon to improve the operation.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos em Atletas , Aprendizado Profundo , Tênis , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/cirurgia , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/cirurgia , Humanos , Imageamento Tridimensional , Articulação do Joelho , Tênis/lesões , Tomografia Computadorizada por Raios X
17.
Ann Agric Environ Med ; 28(4): 654-658, 2021 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-34969225

RESUMO

INTRODUCTION AND OBJECTIVE: Vertebral compression fractures (VCFs), which are a complication of osteoporosis, often cause diagnostic and therapeutic difficulties. The aim of this study was to find association between the characteristics of VCFs and the symptomatic status of patients. MATERIAL AND METHODS: The study involved a total of 437 women with diagnosed postmenopausal osteoporosis (193 with at least one compression fracture and 244 without VCFs). To identify VCFs, all patients underwent morphometry using dual-energy X-ray absorptiometry. Based on the history of VCFs, subjects were divided into two groups: with symptomatic (n=59) and asymptomatic (n=134) VCFs. RESULTS: Each patient had, on average, 2.03 ± 1.50 VCFs. Patients with VCFs were older [p<0.001] and shorter [p<0.001] than those without VCFs. VCFs located in the thoracic spine and the lumbar spine occurred with similar frequency (p=0.112). Multiple fractures in both spine segments (50.13%) were more frequent than fractures limited to only one section of the spine, either thoracic (22.76%) or lumbar (27.11%). The decreasing number of subjects was exponentially associated with the increasing number of VCFs (p<0.001). Symptomatic patients compared to asymptomatic patients had a higher serum concentration of 25-hydroxyvitamin D, and lower serum activity of alkaline phosphatase (p<0.01; p<0.005, respectively). In the lumbar spin, the risk of symptomatic VCFs was more than twofold higher compared to asymptomatic VCFs (p <0.001, OR=2.57, 95% CI: 1.57-4.19). Symptomatic status depended on the number of lumbar VCFs (p<0.001, OR=2.47, 95% CI: 1.68-3.63), as well as higher T-score L1-L4 (p=0.009, OR=1.43, 95% CI: 1.09-1.88). CONCLUSIONS: Patients' symptomatic status depends on the location and number of VCFs, as well as T-score L1-L4.


Assuntos
Fraturas por Compressão , Fraturas da Coluna Vertebral , Densidade Óssea , Feminino , Fraturas por Compressão/epidemiologia , Fraturas por Compressão/etiologia , Humanos , Vértebras Lombares/lesões , Polônia/epidemiologia , Pós-Menopausa , Estudos Retrospectivos , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/etiologia
18.
Cells ; 10(12)2021 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-34943914

RESUMO

Liver fibrosis is a complex process characterized by the excessive accumulation of extracellular matrix (ECM) and an alteration in liver architecture, as a result of most types of chronic liver diseases such as cirrhosis, hepatocellular carcinoma (HCC) and liver failure. Maresin-1 (MaR1) is derivative of ω-3 docosahexaenoic acid (DHA), which has been shown to have pro-resolutive and anti-inflammatory effects. We tested the hypothesis that the application of MaR1 could prevent the development of fibrosis in an animal model of chronic hepatic damage. Sprague-Dawley rats were induced with liver fibrosis by injections of diethylnitrosamine (DEN) and treated with or without MaR1 for four weeks. In the MaR1-treated animals, levels of AST and ALT were normalized in comparison with DEN alone, the hepatic architecture was improved, and inflammation and necrotic areas were reduced. Cell proliferation, assessed by the mitotic activity index and the expression of Ki-67, was increased in the MaR1-treated group. MaR1 attenuated liver fibrosis and oxidative stress was induced by DEN. Plasma levels of the pro-inflammatory mediators TNF-α and IL-1ß were reduced in MaR1-treated animals, whereas the levels of IL-10, an anti-inflammatory cytokine, increased. Interestingly, MaR1 inhibited the translocation of the p65 subunit of NF-κB, while increasing the activation of Nrf2, a key regulator of the antioxidant response. Finally, MaR1 treatment reduced the levels of the pro-fibrotic mediator TGF-ß and its receptor, while normalizing the hepatic levels of IGF-1, a proliferative agent. Taken together, these results suggest that MaR1 improves the parameters of DEN-induced liver fibrosis, activating hepatocyte proliferation and decreasing oxidative stress and inflammation. These results open the possibility of MaR1 as a potential therapeutic agent in fibrosis and other liver pathologies.


Assuntos
Ácidos Docosa-Hexaenoicos/farmacologia , Inflamação/patologia , Cirrose Hepática/metabolismo , Cirrose Hepática/prevenção & controle , Fator 2 Relacionado a NF-E2/metabolismo , NF-kappa B/metabolismo , Estresse Oxidativo , Animais , Apoptose/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Ciclo Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Citocinas/sangue , Dietilnitrosamina , Ácidos Docosa-Hexaenoicos/administração & dosagem , Matriz Extracelular/efeitos dos fármacos , Matriz Extracelular/metabolismo , Inflamação/sangue , Inflamação/complicações , Mediadores da Inflamação/sangue , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Fígado/efeitos dos fármacos , Fígado/lesões , Fígado/patologia , Cirrose Hepática/sangue , Cirrose Hepática/complicações , Masculino , Tamanho do Órgão/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Ratos Sprague-Dawley , Receptores Citoplasmáticos e Nucleares/metabolismo
19.
J Hand Surg Asian Pac Vol ; 26(4): 734-737, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34789112

RESUMO

Avulsions of the flexor digitorum profundus (FDP) tendon and phalanx fractures are both common injuries for rugby players, but these concurrent injuries in the same finger have not been previously described. This case describes a 20-year-old female rugby player who sustained a right ring finger comminuted, mildly displaced middle phalanx fracture. The patient was evaluated by a hand surgeon 3 weeks after the injury, and non-operative management with a splint was elected. One week later, upon further examination, the patient demonstrated persistent inability to flex the distal interphalangeal joint (DIPJ) of the ring finger. Ultrasound was inconclusive but an MRI demonstrated avulsion of the FDP tendon from the distal phalanx, consistent with a jersey finger injury. The patient subsequently underwent open repair of the FDP tendon. This case illustrates the importance of careful physical exam and index of suspicion for coexisting injuries.


Assuntos
Traumatismos dos Dedos , Falanges dos Dedos da Mão , Futebol Americano , Traumatismos dos Tendões , Adulto , Feminino , Traumatismos dos Dedos/diagnóstico por imagem , Traumatismos dos Dedos/cirurgia , Falanges dos Dedos da Mão/diagnóstico por imagem , Falanges dos Dedos da Mão/lesões , Falanges dos Dedos da Mão/cirurgia , Humanos , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/cirurgia , Tendões , Adulto Jovem
20.
BMC Musculoskelet Disord ; 22(1): 958, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789227

RESUMO

BACKGROUND: Despite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare. The current prospective cohort study aims to evaluate potential risk-factors, propose a criteria-based conservative rehabilitation protocol and assess return-to-play outcomes among professional youth soccer players suffering from long-standing pubic-related groin pain. METHODS: Male soccer players with long-standing (> 6 weeks) pubic-related groin pain from a professional soccer club's youth academy were analyzed for possible risk factors such as age, team (U12 - U23), younger/older age group within the team, position and preinjury Functional movement score. All injured players received a conservative, standardized, supervised, criteria-based, 6-level rehabilitation program. Outcome measures included time to return to play, recurrent groin pain in the follow-up period and clinical results at final follow-up two years after their return to play. RESULTS: A total of 14 out of 189 players developed long-standing pubic-related groin pain in the 2017/2018 season (incidence 7.4%). The average age of the players at the time of the injury was 16.1 ± 1.9 years. Risk factor analysis revealed a significant influence of the age group within the team (p = .007). Only players in the younger age group were affected by long-standing pubic-related groin pain, mainly in the first part of the season. Injured players successfully returned to play after an average period of 135.3 ± 83.9 days. Only one player experienced a recurrence of nonspecific symptoms (7.1%) within the follow-up period. The outcome at the 24-month follow-up was excellent for all 14 players. CONCLUSIONS: Long-standing pubic-related groin pain is an overuse entity with a markedly high prevalence in youth soccer players, resulting in a relevant loss of time in training and match play. In particular, the youngest players in each team are at an elevated risk. Applying a criteria-based rehabilitation protocol resulted in an excellent return-to-play rate, with a very low probability of recurrence. TRIAL REGISTRATION: The trial was retrospectively registered under DRKS00016510 in the German Clinical Trials Register on 19.04.2021.


Assuntos
Traumatismos em Atletas , Futebol , Adolescente , Idoso , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/epidemiologia , Virilha/lesões , Humanos , Masculino , Dor , Estudos Prospectivos , Volta ao Esporte , Fatores de Risco
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