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1.
Brain ; 147(7): 2530-2541, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38620012

RESUMO

The acquisition of reading modifies areas of the brain associated with vision and with language, in addition to their connections. These changes enable reciprocal translation between orthography and the sounds and meaning of words. Individual variability in the pre-existing cerebral substrate contributes to the range of eventual reading abilities, extending to atypical developmental patterns, including dyslexia and reading-related synaesthesias. The present study is devoted to the little-studied but highly informative ticker-tape synaesthesia, in which speech perception triggers the vivid and irrepressible perception of words in their written form in the mind's eye. We scanned a group of 17 synaesthetes and 17 matched controls with functional MRI, while they listened to spoken sentences, words, numbers or pseudowords (Experiment 1), viewed images and written words (Experiment 2) or were at rest (Experiment 3). First, we found direct correlates of the ticker-tape synaesthesia phenomenon: during speech perception, as ticker-tape synaesthesia was active, synaesthetes showed over-activation of left perisylvian regions supporting phonology and of the occipitotemporal visual word form area, where orthography is represented. Second, we provided support to the hypothesis that ticker-tape synaesthesia results from atypical relationships between spoken and written language processing: the ticker-tape synaesthesia-related regions overlap closely with cortices activated during reading, and the overlap of speech-related and reading-related areas is larger in synaesthetes than in controls. Furthermore, the regions over-activated in ticker-tape synaesthesia overlap with regions under-activated in dyslexia. Third, during the resting state (i.e. in the absence of current ticker-tape synaesthesia), synaesthetes showed increased functional connectivity between left prefrontal and bilateral occipital regions. This pattern might reflect a lowered threshold for conscious access to visual mental contents and might imply a non-specific predisposition to all synaesthesias with a visual content. These data provide a rich and coherent account of ticker-tape synaesthesia as a non-detrimental developmental condition created by the interaction of reading acquisition with an atypical cerebral substrate.


Assuntos
Imageamento por Ressonância Magnética , Leitura , Percepção da Fala , Sinestesia , Humanos , Masculino , Feminino , Adulto , Percepção da Fala/fisiologia , Adulto Jovem , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Pessoa de Meia-Idade , Fala/fisiologia , Dislexia/fisiopatologia , Dislexia/diagnóstico por imagem
2.
J Proteome Res ; 23(8): 3404-3417, 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39042361

RESUMO

Collagen from paleontological bones is an important organic material for isotopic measurement, radiocarbon analysis, and paleoproteomic analysis to provide information on diet, dating, taxonomy, and phylogeny. Current paleoproteomic methods are destructive and require from a few milligrams to several tens of milligrams of bone for analysis. In many cultures, bones are raw materials for artifacts that are conserved in museums, which hampers damage to these precious objects during sampling. Here, we describe a low-invasive sampling method that identifies collagen, taxonomy, and post-translational modifications from Holocene and Upper Pleistocene bones dated to 130,000 and 150 BC using dermatological skin tape discs for sampling. The sampled bone micropowders were digested following our highly optimized enhanced filter-aided sample preparation protocol and then analyzed by MALDI FTICR MS and LC-MS/MS for identifying the genus taxa of the bones. We show that this low-invasive sampling does not deteriorate the bones and achieves results similar to those obtained by more destructive sampling. Moreover, this sampling method can be carried out at archeological sites or in museums.


Assuntos
Osso e Ossos , Colágeno , Fósseis , Paleontologia , Proteômica , Osso e Ossos/química , Proteômica/métodos , Paleontologia/métodos , Animais , Colágeno/química , Colágeno/análise , Arqueologia/métodos , Manejo de Espécimes/métodos , Cromatografia Líquida/métodos , Espectrometria de Massas em Tandem/métodos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Processamento de Proteína Pós-Traducional , Humanos
3.
Small ; : e2403350, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38988140

RESUMO

Conventional adhesives experience reduced adhesion when exposed to aqueous environments. The development of underwater adhesives capable of forming strong and durable bonds across various wet substrates is crucial in biomedical and engineering domains. Nonetheless, limited emphasis placed on retaining high adhesion strengths in different saline environments, addressing challenges such as elevated osmotic pressure and spontaneous dimensional alterations. Herein, a series of ionogel-based underwater adhesives are developed using a copolymerization approach that incorporates "dynamic complementary cross-linking" networks. Synergistic engineering of building blocks, cross-linking networks, pendant groups and counterions within ionogels ensures their adhesion and cohesion in brine spanning a wide salinity range. A high adhesion strength of ≈3.6 MPa is attained in freshwater. Gratifyingly, steady adhesion strengths exceeding 3.3 MPa are retained in hypersaline solutions with salinity ranging from 50 to 200 g kg-1, delivering one of the best-performing underwater adhesives suitable for diverse saline solutions. A combination of outstanding durability, reliability, deformation resistance, salt tolerance, and self-healing properties showcases the "self-contained" underwater adhesion. This study shines light on the facile fabrication of catechol-free ionogel-based adhesives, not merely boosting adhesion strengths in freshwater, but also broadening their applicability across various saline environments.

4.
Ann Surg Oncol ; 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38965099

RESUMO

BACKGROUND: The PREVENT randomized control trial monitored progression to chronic breast cancer-related lymphedema (cBCRL) following intervention for subclinical breast cancer-related lymphedema (sBCRL) assessed by bioimpedance spectroscopy (BIS) versus tape-measure (TM). This multi-institutional trial demonstrated a 92% risk reduction of developing cBCRL. This secondary analysis reviews the timing of sBCRL and cBCRL following breast cancer (BC) treatment. PATIENTS AND METHODS: Women at risk of cBCRL (n = 919) were screened regularly up to 36 months after BC treatment using either BIS or TM. Following diagnosis of sBCRL, patients underwent a 4-week compression sleeve intervention. The time in months from BC treatment to detection was reviewed at 3-month intervals. RESULTS: In total 209 patients developed sBCRL (BIS: n = 89, TM: n = 120) and were eligible for intervention. 30 progressed to cBCRL postintervention (BIS: 7, TM: 23). More than half of patients had measurements consistent with sBCRL within 9 months of BC treatment. Patients continued to have initial detections of sBCRL, regardless of screening method, with rates remaining consistent in years two and three (p > 0.242) post surgery. Additionally, 39 patients progressed to cBCRL without developing sBCRL or receiving intervention across the 3-year period. CONCLUSIONS: The timing of sBCRL detection demonstrates that patients continue to be at risk years after treatment and may continue to progress to cBCRL years after surgery. Early detection of sBCRL allows for early intervention decreasing the likelihood of progression to cBCRL. Patients should continue to be monitored for a minimum of 3 years following completion of cancer treatment. Specifically, careful targeted monitoring over the initial 9-month period is important.

5.
Exp Dermatol ; 33(8): e15154, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39082307

RESUMO

The composition of human skin microbiome profoundly impacts host skin health and disease. However, the relationship between skin homeostasis or the development of skin diseases and daily changes in skin microbial composition is poorly understood. Longitudinal samplings at more frequent intervals would address this issue, while conventional sampling methods have technical difficulties, leading to limitations in sampling opportunities. Here, we developed a simple and stable tape-stripping method regardless of the operator's skill. Our method enables skin microbial sampling within 30 seconds and taking multiple skin microbial samples from the same body site. The amount of microbial DNA among multiple sampling sites could be measured within 13.5%. The sequencing results of multiple sampling showed high consistency, Pearson's correlation coefficient between multiple samples of 0.98. Furthermore, these results were comparable to those collected by the conventional swabbing method. These results demonstrate that our tape-stripping method enables simple microbiome collection and highly reliable quantitative skin microbiome analysis. These features of our method would lead to a further understanding of skin disease development or diagnosis of skin conditions in clinical research by increasing the opportunities for microbial sampling.


Assuntos
Microbiota , Pele , Humanos , Pele/microbiologia , Manejo de Espécimes/métodos , DNA Bacteriano/análise , Fita Cirúrgica
6.
Allergy ; 79(1): 80-92, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37577841

RESUMO

BACKGROUND: Our knowledge of etiopathogenesis of atopic dermatitis (AD) is largely derived from skin biopsies, which are associated with pain, scarring and infection. In contrast, tape-stripping is a minimally invasive, nonscarring technique to collect skin samples. METHODS: To construct a global AD skin transcriptomic profile comparing tape-strips to whole-skin biopsies, we performed RNA-seq on tape-strips and biopsies taken from the lesional skin of 20 moderate-to-severe AD patients and the skin of 20 controls. Differentially expressed genes (DEGs) were defined by fold-change (FCH) ≥2.0 and false discovery rate <0.05. RESULTS: We detected 4104 (2513 Up; 1591 Down) and 1273 (546 Up; 727 Down) DEGs in AD versus controls, in tape-strips and biopsies, respectively. Although both techniques captured dysregulation of key immune genes, tape-strips showed higher FCHs for innate immunity (IL-1B, IL-8), dendritic cell (ITGAX/CD11C, FCER1A), Th2 (IL-13, CCL17, TNFRSF4/OX40), and Th17 (CCL20, CXCL1) products, while biopsies showed higher upregulation of Th22 associated genes (IL-22, S100As) and dermal cytokines (IFN-γ, CCL26). Itch-related genes (IL-31, TRPV3) were preferentially captured by tape-strips. Epidermal barrier abnormalities were detected in both techniques, with terminal differentiation defects (FLG2, PSORS1C2) better represented by tape-strips and epidermal hyperplasia changes (KRT16, MKI67) better detected by biopsies. CONCLUSIONS: Tape-strips and biopsies capture overlapping but distinct features of the AD molecular signature, suggesting their respective utility for monitoring specific AD-related immune, itch, and barrier abnormalities in clinical trials and longitudinal studies.


Assuntos
Dermatite Atópica , Humanos , Dermatite Atópica/diagnóstico , Dermatite Atópica/genética , Transcriptoma , Pele/patologia , Epiderme/patologia , Biópsia
7.
Allergy ; 79(6): 1548-1559, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38477552

RESUMO

BACKGROUND: Skin tape-strips and biopsies are widely used methods for investigating the skin in atopic dermatitis (AD). Biopsies are more commonly used but can cause scarring and pain, whereas tape-strips are noninvasive but sample less tissue. The study evaluated the performance of skin tape-strips and biopsies for studying AD. METHODS: Whole-transcriptome RNA-sequencing was performed on paired tape-strips and biopsies collected from lesional and non-lesional skin from AD patients (n = 7) and non-AD controls (n = 5). RNA yield, mapping efficiency, and differentially expressed genes (DEGs) for the two methods (tape-strip/biopsy) and presence of AD (AD/non-AD) were compared. RESULTS: Tape-strips demonstrated a lower RNA yield (22 vs. 4596 ng) and mapping efficiency to known genes (28% vs. 93%) than biopsies. Gene-expression profiles of paired tape-strips and biopsies demonstrated a medium correlation (R2 = 0.431). Tape-strips and biopsies demonstrated systematic differences in measured expression levels of 6483 genes across both AD and non-AD samples. Tape-strips preferentially detected many itch (CCL3/CCL4/OSM) and immune-response (CXCL8/IL4/IL5/IL22) genes as well as markers of epidermal dendritic cells (CD1a/CD207), while certain cytokines (IL18/IL37), skin-barrier genes (KRT2/FLG2), and dermal fibroblasts markers (COL1A/COL3A) were preferentially detected by biopsies. Tape-strips identified more DEGs between AD and non-AD (3157 DEGs) then biopsies (44 DEGs). Tape-strips also detected higher levels of bacterial mRNA than biopsies. CONCLUSIONS: This study concludes that tape-strips and biopsies each demonstrate respective advantages for measuring gene-expression changes in AD. Thus, the specific skin layers and genes of interest should be considered before selecting either method.


Assuntos
Dermatite Atópica , Pele , Humanos , Dermatite Atópica/genética , Dermatite Atópica/patologia , Biópsia , Pele/patologia , Pele/metabolismo , Feminino , Análise de Sequência de RNA , Masculino , Perfilação da Expressão Gênica , Transcriptoma , Adulto , Fita Cirúrgica , Pessoa de Meia-Idade
8.
Allergy ; 79(6): 1516-1530, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38375886

RESUMO

INTRODUCTION: Tape-strips, a minimally invasive method validated for the evaluation of several skin diseases, may help identify asthma-specific biomarkers in the skin of children with allergic asthma. METHODS: Skin tape-strips were obtained and analyzed with RNA-Seq from children with moderate allergic asthma (MAA) (n = 11, mean age 7.00; SD = 1.67), severe allergic asthma (SAA) (n = 9, mean age 9.11; SD = 2.37), and healthy controls (HCs) (n = 12, mean age 7.36; SD = 2.03). Differentially expressed genes (DEGs) were identified by fold change ≥2 with a false discovery rate <0.05. Transcriptomic biomarkers were analyzed for their accuracy in distinguishing asthma from HCs, their relationships with asthma-related outcomes (exacerbation rate, lung function-FEV1, IOS-R5-20, and lung inflammation-FeNO), and their links to skin (barrier and immune response) and lung (remodeling, metabolism, aging) pathogenetic pathways. RESULTS: RNA-Seq captured 1113 in MAA and 2117 DEGs in SAA. Epidermal transcriptomic biomarkers for terminal differentiation (FLG/filaggrin), cell adhesion (CDH19, JAM2), lipid biosynthesis/metabolism (ACOT2, LOXL2) were significantly downregulated. Gene set variation analysis revealed enrichment of Th1/IFNγ pathways (p < .01). MAA and SAA shared downregulation of G-protein-coupled receptor (OR4A16, TAS1R3), upregulation of TGF-ß/ErbB signaling-related (ACVR1B, EGFR, ID1/2), and upregulation of mitochondrial-related (HIGD2A, VDAC3, NDUFB9) genes. Skin transcriptomic biomarkers correlated with the annualized exacerbation rate and with lung function parameters. A two-gene classifier (TSSC4-FAM212B) was able to differentiate asthma from HCs with 100% accuracy. CONCLUSION: Tape-strips detected epithelial barrier and asthma-associated signatures in normal-appearing skin from children with allergic asthma and may serve as an alternative to invasive approaches for evaluating asthma endotypes.


Assuntos
Asma , Biomarcadores , Perfilação da Expressão Gênica , Transcriptoma , Humanos , Asma/genética , Asma/diagnóstico , Asma/metabolismo , Criança , Masculino , Feminino , Proteínas Filagrinas , Epiderme/metabolismo , Pré-Escolar , Pele/metabolismo , Pele/patologia
9.
Chemistry ; 30(35): e202401240, 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38632105

RESUMO

A triply linked dicarbacorrole dimer (7) was synthesized from a new meso-meso singly linked dicarbacorrole dimer precursor (6) via an oxidative fusion reaction by 2,3-dichloro-5,6-dicyano-p-benzoquinone (DDQ) in the presence of trifluoromethanesulfonic acid (TfOH). Single crystal X-ray structure of 7 adopts a flat conformation with a length as ca. 15.946 Šand a width as 6.903 Å, which can be regarded as a short carbaporphyrinoid tape. Two coordinated Cu ions keeps the +3 oxidation state in 7, as confirmed by NMR spectroscopy, single crystal X-ray diffraction and X-ray photoelectron spectroscopy (XPS). This is in sharp contrast to the Osuka's triply linked tetrapyrrolic corrole dimers, where the inner 3NH form is not stable and thus can only act as a divalent ligand. Due to the non-aromatic nature of dicarbacorrole macrocycle, the largely decreased HOMO-LUMO gap and red-shifted absorption of 7 are best ascribed to the strong electronic interaction between two dipyrromethene-type chromophores. To our knowledge, this is the first fully fused carbaporphyrinoid dimer with ß-ß, meso-meso, ß-ß triply linkages prepared to date.

10.
Am J Obstet Gynecol ; 230(3): 308-314.e5, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38036163

RESUMO

OBJECTIVE: This study aimed to assess the risk of stress urinary incontinence recurrence and reoperation after a midurethral sling procedure in women with subsequent childbirth and to assess the effect of delivery mode on this risk. DATA SOURCES: An electronic database search was performed using MEDLINE with the OvidSP interface and PubMed, Embase, Web of Science, and the Cochrane Library up to September 20, 2023. STUDY ELIGIBILITY CRITERIA: This study included experimental and nonexperimental studies, composed of randomized controlled and observational (case-control, cohort, and cross-sectional) studies assessing the risk factors for stress urinary incontinence recurrence and reoperation after childbirth in women who had previously undergone a midurethral sling procedure for stress urinary incontinence. METHODS: Analysis was performed using RevMan (version 5.3; Cochrane Collaboration, Oxford, United Kingdom). Quantitative synthesis was used if the included studies were sufficient in numbers and homogeneity. The overall certainty of the evidence was assessed using criteria recommended by the Grading of Recommendations Assessment, Development, and Evaluation Working Group. RESULTS: A total of 2001 studies were identified, of which 6 were eligible for analysis, composed of 381 patients who had at least 1 childbirth after a midurethral sling procedure (study group) and 860 patients who underwent a midurethral sling without having a subsequent childbirth (control group). All included studies were observational, the patients' mean age at the time of the midurethral sling procedure ranged from 34 to 36 years, and the mean time from midurethral sling procedure to delivery ranged from 21 to 31 months. No difference in stress urinary incontinence recurrence (relative risk, 0.1.02; 95% confidence interval, 0.78-1.33) or reoperation (relative risk, 1.37; 95% confidence interval, 0.87-2.17) was found between the study and control groups. The average follow-up time among the included studies of this comparison was 9.8 years (range, 2-18). Furthermore, the mode of delivery (vaginal vs cesarean) did not seem to affect the risk of stress urinary incontinence recurrence. CONCLUSION: Subsequent pregnancy and childbirth did not increase the risk of stress urinary incontinence recurrence or reoperation after a midurethral sling procedure.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse , Gravidez , Humanos , Feminino , Pré-Escolar , Incontinência Urinária por Estresse/cirurgia , Incontinência Urinária por Estresse/etiologia , Slings Suburetrais/efeitos adversos , Estudos Transversais , Reoperação , Fatores de Risco , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Observacionais como Assunto
11.
BJOG ; 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38812080

RESUMO

Serious concerns have been raised over the safety of vaginal mesh tapes for stress urinary incontinence (SUI). Autologous rectus fascial sling and the more recent 'sling on a string' through a laparotomy are gaining popularity as native tissue options for SUI. We describe a novel technique of laparoscopic mid-urethral autologous rectus fascial sling for SUI. Ten patients underwent this new technique safely. At 12 months, all patients reported cure of SUI with normal voiding. The advantages of this technique include the minimal access approach, introduction of the sutures under laparoscopic guidance, and avoidance of over-tightening of the sling.

12.
BJOG ; 131(8): 1146-1153, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38126201

RESUMO

OBJECTIVE: To evaluate rates of subjective and objective cure, treatment satisfaction, pain, and the correlation between cure and body mass index (BMI), at 10 and 20 years after tension-free vaginal tape (TVT) surgery. DESIGN: Retrospective cohort study. SETTING: Multicentre study including 19 units in Norway. POPULATION: Women undergoing TVT surgery for stress urinary incontinence (SUI) during 2001-2006 (20-year cohort) and 2011-2012 (10-year cohort). METHODS: The Norwegian Female Incontinence Registry was used to identify women eligible for the study, who answered validated questionnaires about urinary incontinence, pain and satisfaction. MAIN OUTCOME MEASURES: Subjective cure of SUI (with stress index of <3, range 0-12), objective cure (<3 g on stress test) and persisting pain and satisfaction after TVT (scored on a five-point Likert scale). RESULTS: In total, 1210 of 1903 (64%) patients responded. The subjective cure rate was 68% after 10 years, versus 59% after 20 years, and did not significantly differ after adjusting for age, BMI, parity and preoperative stress index (adjusted OR 1.27, 95% CI 0.82-1.94). The objective cure rate was 100% versus 93% (P < 0.001), with 89% versus 76% reporting subjective satisfaction (P < 0.001), and with 4.7% versus 2.7% reporting persisting pain (P < 0.001), after 10 versus 20 years, respectively. Women in obesity classes I and II, compared with women of normal weight, had an increased risk of not being subjectively cured (crude OR 2.02, 95% CI 1.42-2.90; OR 2.95, 95% CI 1.60-5.46, respectively). CONCLUSIONS: Tension-free vaginal tape (TVT) provided high rates of subjective and objective cure at 10 and 20 years after surgery, with no significant difference between the two cohorts. Although 3%-5% of women experienced persisting pain, most women were satisfied with TVT surgery. Obesity was associated with a lower cure rate.


Assuntos
Índice de Massa Corporal , Satisfação do Paciente , Slings Suburetrais , Incontinência Urinária por Estresse , Humanos , Feminino , Estudos Retrospectivos , Incontinência Urinária por Estresse/cirurgia , Pessoa de Meia-Idade , Noruega , Resultado do Tratamento , Idoso , Dor Pós-Operatória/etiologia , Adulto , Inquéritos e Questionários
13.
J Am Acad Dermatol ; 90(4): 749-758, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38049071

RESUMO

BACKGROUND: Hidradenitis suppurativa (HS) has a high unmet need for better treatments. Biopsies are considered the gold standard for studying molecular alterations in skin. A reproducible, minimally invasive approach is needed for longitudinal monitoring in trials and in pediatric populations. OBJECTIVE: To determine whether skin tape strips can detect molecular alterations in HS and identify biomarkers of disease activity. METHODS: We performed RNA sequencing on tape strips collected from lesional and healthy-appearing (nonlesional) HS skin (n = 22) and healthy controls (n = 21). We correlated the expression of skin biomarkers between tape strips and a previously published gene-signature of HS biopsies. RESULTS: Tape strips detected upregulation of known HS biomarkers (eg, Interleukin[IL]-17A) in nonlesional and/or lesional skin and also identified novel clinically actionable targets, including OX40 and JAK3. The expression of Th17 and tumor necrosis factor-α pathways were highly correlated between tape strips and biopsies. HS clinical severity was significantly associated with expression of biomarkers (eg tumor necrosis factor-α , IL-17 A/F, OX40, JAK1-3, IL-4R) in HS lesional and/or nonlesional skin. LIMITATIONS: Sample size. Tape stripping is limited in depth. CONCLUSION: This study validates tape strips as a minimally-invasive approach to identify cutaneous biomarkers in HS. This provides a novel avenue for monitoring treatment efficacy and a potential step toward individualized therapy in HS.


Assuntos
Hidradenite Supurativa , Criança , Humanos , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/genética , Hidradenite Supurativa/tratamento farmacológico , Fator de Necrose Tumoral alfa/uso terapêutico , Pele/patologia , Biomarcadores/metabolismo , Regulação para Cima
14.
Neurourol Urodyn ; 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38873955

RESUMO

INTRODUCTION: There have been concerns around the use of synthetic mesh for stress urinary incontinence (SUI) surgery with a renewed interest in the use of autologous tissues. Recently, an autologous transobturator sling (aTOT) has been described, but the comparative data with synthetic transobturator sling (sTOT) is limited. The objective of this systematic review and meta-analysis was to assess the outcome of aTOT and compare it with sTOT. METHODS: A systematic search of PubMed, Scopus, and Web of Science databases was performed and all articles available up to December 31, 2023 were screened. Studies reporting on the outcomes of aTOT and those comparing aTOT with sTOT were included. This review was performed as per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS: Eleven studies evaluating 323 patients that met the criteria were included in the final analysis, of which 6 were single arm (155 patients) and 5 were comparative. In single-arm studies, the pooled success rate, defined as negative cough stress test at 12 months follow-up was 96.8%, 3.8% had postoperative urinary retention, 6.1% had graft site-related complications and 7.6% required additional intervention for persistent SUI. The overall complication rate was 20.6% and there were no Clavien III-V complications. aTOT had similar success and complication rates when compared with sTOT but had a significantly longer operative time (weighted mean difference: 22.35 min, p < 0.00001) and superior sexual function outcomes. CONCLUSIONS: aTOT, at short-term follow-up (12 months), has similar efficacy and complication rates when compared to sTOT. However, given that the data is limited and not of very good quality, and the fact that long-term follow-up is not available, further studies are required to better define the role of aTOT in the management of female patients with SUI.

15.
Neurourol Urodyn ; 43(4): 925-934, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38426785

RESUMO

AIMS: To assess and compare 30-day perioperative adverse events following suburethral sling surgery using synthetic mesh, autologous rectus fascia, and autologous fascia lata in women. METHODS: This was a retrospective cohort study of patients who underwent fascial or synthetic sling placement for stress urinary incontinence between 2008 and 2021 using the American College of Surgeons' National Surgical Quality Improvement Program database. Current Procedural Terminology codes were used to identify patients undergoing each type of sling procedure. Multivariable regression analysis with stepwise regression was used to assess the odds of composite adverse events (e.g., urinary tract infection, surgical site infection, pulmonary embolism, and other reportable events) between cohorts. RESULTS: Of the 41 533 female patients who underwent isolated suburethral sling placement without concurrent procedures, 41 292 (99.4%) received a synthetic mesh sling, and 241 (0.6%) received an autologous facial sling. In the fascial sling cohort, 160 (66.4%) underwent rectus fascia harvest and 81 (33.6%) underwent fascia lata harvest. Sling surgeries involving autologous fascia were associated with increased odds of adverse events compared to those involving synthetic mesh, even after adjusting for confounders (adjusted odds ratio [aOR]: 3.63, 95% confidence interval [CI]: 2.56-5.15). Compared to fascial slings from rectus fascia, slings from fascia lata were associated with increased odds of composite adverse events (aOR: 2.11, 95% CI: 1.03-4.04). However, with the exclusion of urinary tract infections, the adverse event rate was similar between slings using the two fascial harvest techniques (aOR: 1.93, 95% CI: 0.81-4.63). CONCLUSIONS: In this retrospective database study, suburethral sling surgeries using autologous fascia were independently associated with a 3.6-fold increase in odds of 30-day perioperative adverse events compared to sling surgeries using synthetic mesh.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse , Humanos , Feminino , Estudos Retrospectivos , Fascia Lata , Telas Cirúrgicas , Incontinência Urinária por Estresse/cirurgia , Sistema de Registros
16.
Skin Res Technol ; 30(3): e13655, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38481085

RESUMO

BACKGROUND: The stratum corneum (SC), the outermost layer of the skin epidermis, acts as an effective bi-directional barrier, preventing water loss (inside-outside barrier) and entry of foreign substances (outside-inside barrier). Although transepidermal water loss (TEWL) is a widely-used measure of barrier function, it represents only inside-outside protection. Therefore, we aimed to establish a non-invasive method for quantitative evaluation of the outside-inside barrier function and visually present a skin barrier model. MATERIALS AND METHODS: Skin barrier damage was induced by applying a closed patch of 1% sodium dodecyl sulfate to the forearms of eight participants; they were instructed to apply a barrier cream on a designated damaged area twice daily for 5 days. The SC barrier was evaluated by measuring TEWL and fluorescein sodium salt penetration rate before, immediately after, and 5 days after damage. The penetration rate was assessed using tape-stripping (TS) technique and fluorescence microscopy. RESULTS: The rates of fluorescein sodium salt penetration into the lower layers of SC differed significantly based on the degree of skin barrier damage. The correlation between penetration rate and TEWL was weak after two rounds of TS and became stronger after subsequent rounds. Five days after skin barrier damage, the penetration rate of all layers differed significantly between areas with and without the barrier cream application. CONCLUSION: Our findings demonstrated that the penetration rate was dependent on skin barrier conditions. The penetration rate and corresponding fluorescence images are suitable quantitative indicators that can visually represent skin barrier conditions.


Assuntos
Dermatopatias , Perda Insensível de Água , Humanos , Fluoresceína/metabolismo , Fluoresceína/farmacologia , Epiderme/metabolismo , Pele/metabolismo , Dermatopatias/metabolismo , Água/metabolismo , Emolientes/farmacologia
17.
BMC Musculoskelet Disord ; 25(1): 480, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890668

RESUMO

Taping is increasingly used to manage proprioceptive deficits, but existing reviews on its impact have shortcomings. To accurately assess the effects of taping, a separate meta-analyses for different population groups and tape types is needed. Therefore, both between- and within-group meta-analyses are needed to evaluate the influence of taping on proprioception. According to PRISMA guidelines, a literature search was conducted across seven databases (Web of Science, PEDro, Pubmed, EBSCO, Scopus, ERIC, SportDiscus, Psychinfo) and one register (CENTRAL) using the keywords "tape" and "proprioception". Out of 1372 records, 91 studies, involving 2718 individuals, met the inclusion criteria outlined in the systematic review. The meta-analyses revealed a significant between and within-group reduction in repositioning errors with taping compared to no tape (Hedge's g: -0.39, p < 0.001) and placebo taping (Hedge's g: -1.20, p < 0.001). Subgroup and sensitivity analyses further confirmed the reliability of the overall between and within-group analyses. The between-group results further demonstrated that both elastic tape and rigid tape had similar efficacy to improve repositioning errors in both healthy and fatigued populations. Additional analyses on the threshold to detection of passive motion and active movement extent discrimination apparatus revealed no significant influence of taping. In conclusion, the findings highlight the potential of taping to enhance joint repositioning accuracy compared to no tape or placebo taping. Further research needs to uncover underlying mechanisms and refine the application of taping for diverse populations with proprioceptive deficits.


Assuntos
Fita Atlética , Propriocepção , Humanos , Propriocepção/fisiologia
18.
BMC Musculoskelet Disord ; 25(1): 244, 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38539120

RESUMO

BACKGROUND: Kinesiology Taping(KT) is commonly used as a physical therapy to prevent exercise-induced fatigue. This study aims to evaluate the immediate effects of KT on muscle strength, static balance, and proprioception after eccentric muscle fatigue on ankle. METHODS: Twenty healthy male university students were recruited. The experimental protocol was structured into four sessions, each separated by a one-week washout period to prevent carryover effects. Participants were randomly allocated to one of four intervention conditions in each session, ensuring no participant received the same intervention twice. These conditions were: no taping(NT),sham taping(ST),athletic taping(AT),and kinesiology taping(KT).Taping was applied immediately following an eccentric muscle fatigue protocol targeting the ankle, and assessments were conducted in the order of proprioception, muscle strength and static balance. Isometric muscle strength and proprioception were evaluated using the Biodex isokinetic system. Static balance was measured using the TecnoBody balance platform. RESULTS: KT had a significantly higher plantarflexion/dorsiflexion peak torque, dorsiflexion average peak torque, and plantarflexion/dorsiflexion average power at 60°/s compared with NT and ST in terms of isometric muscle strength (p < 0.05).Furthermore, the plantarflexion peak torque of KT was significantly greater than AT at 60°/s[p = 0.005,95% confidence interval(CI) = 3.39 to 18.20] and 180°/s[p = 0.006,95%CI(2.62,21.98)]. In terms of proprioception, KT showed a lower absolute error in 25° plantarflexion and 10° dorsiflexion compared to NT, ST and AT. For static balance with eyes-open and eyes-closed conditions, AT and KT had a lower total sway area than NT and ST (p < 0.05). Additionally, a significant difference in total sway length with eyes-open condition was observed between AT and KT[p < 0.001,95%CI(-431.81,-168.25)];total sway area and the center of pressure(COP) velocity in the mediolateral(ML) and anteroposterior(AP) directions with eyes-closed condition were significantly lower in AT compared to KT. CONCLUSION: This study suggests that KT is more effective than other taping conditions in improving muscle strength and proprioception after eccentric muscle fatigue on ankle. However, AT is more helpful in increasing static postural control ability after ankle muscle fatigue than KT. TRIAL REGISTRATION: This study was registered with www.chictr.org.cn (registration number: ChiCTR2300068278) on 13/2/2023.


Assuntos
Tornozelo , Fita Atlética , Humanos , Masculino , Fadiga Muscular/fisiologia , Estudos Cross-Over , Propriocepção/fisiologia , Equilíbrio Postural/fisiologia , Força Muscular/fisiologia
19.
Arthroscopy ; 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-39047990

RESUMO

PURPOSE: To compare outcomes after anterior cruciate ligament reconstruction (ACLR) with bone marrow aspirate concentrate (BMAC), demineralized bone matrix (DBM), and suture tape augmentation (STA) vs. ACLR without biologic augmentation or STA. METHODS: A prospective randomized controlled trial at a single institution was performed to compare ACLR with BMAC, DBM, and STA (Group A) vs. ACLR without biologic or STA (Group NA). One hundred patients were required. Skeletally mature patients <25 years old received quadriceps tendon autografts, while patients ≥25 years old received allograft ACLR with an all-inside technique. Concomitant meniscal pathologies were included. Primary outcomes compared were range-of-motion (ROM), limb symmetry, and patient-reported outcomes (PROs). Secondary outcomes included radiographic outcomes and surgical complications. Univariate and mixed-model regression analysis were used to compare outcomes. RESULTS: Fifty-nine patients were included (Group A: 29 patients, 11 females, 38%; Group NA: 30 patients, 15 females, 50%). Early range-of-motion at 6 weeks (125° vs 109° flexion, p<0.0001) and limb symmetry testing at 12 weeks (80.6 % vs. 36.7% [Delta 43.9%], p<0.001) were significantly improved in Group A. At two years, International Knee Documentation (IKDC) scores were similar (91.1 ± 12.7 vs. 85.3 ± 10.8, p=0.109). Knee Injury and Osteoarthritis and Outcome Score (KOOS) Quality of Life (QOL) scores were significantly enhanced in Group A (85.2 ± 20.9 vs. 72.1 ± 20.4, p=0.042). Twenty-two patients (12 Group A, 10 Group NA) underwent CT scans at 6-months to compare bone tunnel healing. Overall, the mean increase in bone tunnel diameter was significantly smaller in Group A vs. NA. No difference in graft re-ruptures or re-operations was observed. Seven of 59 patients (11.9%) underwent re-operation for stiffness (A: 3 (10%) vs. NA: 4 (13%), p=1.0). CONCLUSION: There were no differences in IKDC scores between groups at 2-year follow-up. Functional outcomes including early range-of-motion and limb symmetry were significantly improved in patients who received ACLR with BMAC, DBM, and STA. ACLRACLR.ACLR.

20.
Arch Gynecol Obstet ; 309(3): 1119-1125, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-37695373

RESUMO

OBJECTIVE: To inquire whether obesity is a risk factor of peri- and post-operative complications following Mid-urethral sling (MUS) surgeries for SUI repair using the Clavien-Dindo classification system (CDcs). METHODS: This retrospective cohort included 304 women who undergone a MUS in a 1000 beds tertiary University medical center between the years 2012-2018. Univariate analysis was conducted to compare clinical and operative traits by BMI group and to examine associations of obesity and complications rates and severity according to the CDcs. Multivariate analysis was conducted to assess the risk for post-operative complications and adjust to potential confounders. RESULTS: The study group included 106 (34.9%) women with BMI 30 or higher and the comparison group included 198 (65.1%) women with BMI lower than 30. In the study group we found a significantly higher prevalence of hypertension (P = 0.019), previous abdominal surgeries (P = 0.012) including cesarean section (P = 0.025), previous pelvic floor surgeries (P = 0.005) and pelvic organ prolapse (P = 0.02). In the control group we found a significantly higher rates of concomitant hysterectomy which performed during the MUS (P = 0.005). Obesity was not associated with increased rates of peri and post-operative complications (P = 0.973). CONCLUSIONS: In our study, obesity was not associated with peri- and post-operative complications following MUS.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse , Gravidez , Feminino , Humanos , Masculino , Incontinência Urinária por Estresse/cirurgia , Incontinência Urinária por Estresse/complicações , Slings Suburetrais/efeitos adversos , Estudos Retrospectivos , Cesárea , Procedimentos Cirúrgicos Urológicos , Obesidade/complicações , Obesidade/epidemiologia , Fatores de Risco , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento
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