RESUMO
Background: Breast cancer surgeries affect the upper extremities and posture. This study aimed to examine the efficacy of muscle energy and Mulligan mobilization techniques on the upper extremities and posture after breast cancer surgery with axillary dissection. Methods: A total of 90 female participants who had undergone breast cancer surgery with axillary dissection were recruited and randomly assigned to three groups. Group A received a combination of the Mulligan and muscle energy techniques, while Groups B and C received either the Mulligan or muscle energy techniques for six weeks, respectively. The study measured the shoulders' range of motion, posture, and upper-extremity disabilities. Outcome measurements were taken at three different time points: baseline, post-intervention, and at eight-week follow-up. Results: All the interventions significantly improved the study outcomes. The combination of the Mulligan and muscle energy techniques was significantly better than a single intervention. Mulligan mobilization was superior to the muscle energy techniques in terms of improving the shoulders' range of motion and disability. The interventions showed a significant effect pre-post-treatment and pre-follow-up but not post-follow-up. Conclusions: The Mulligan mobilization and muscle energy techniques have been found beneficial in improving the postural changes and shoulder outcomes after breast cancer surgery with axillary dissection. The superior effectiveness of the combined interventions points out the importance of integrating multiple therapeutic approaches for optimal outcomes. Regular examination and long-term follow-up assessment are important for studying the effect of rehabilitation interventions in people after the late stages of breast surgery.
RESUMO
Two derivatization regents were reacted with bisoprolol (BIS), followed by liquid-chromatography-mass spectrometric analysis. 3-Bromomethyl-propyphenazone (BMP) and dansyl-chloride (Dns-Cl) were reacted via the secondary amino group using a catalyst to accelerate the reaction progress and completeness with minimal reaction byproducts. The sensitivity and the ionization efficiency of both BIS-methyl-propyphenazone (BIS-MP) and BIS-Dns via electrospray ionization were studied. The sensitivity of BIS-MP was superior to BIS-Dns. The derivatization procedure, extraction procedure, and LC-MS method were optimized and validated to achieve the monitoring of BIS in rat serum at a picogram scale. The calibration curve showed a regression coefficient value of 0.999 within a concentration spanning a range of 10-500 pg/mL. The detection limit and quantitation were 4 and 10 pg/mL, respectively. The intraday and inter-day precision values (% relative standard deviation) ranged from 0.53 to 6.91%, whereas the accuracy values (expressed as % error) ranged from -4.20 to -0.77%. The pharmacokinetic parameters were: 15,280 pg/mL for a maximum concentration of BIS (Cmax) at the maximum time (Tmax) of 1 h. BIS's elimination half-life (t1/2) was determined to be 3 h. The value of the area under the concentration-time curve (AUC0 - t) was 34,370 pg/mL h.