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1.
Foot Ankle Surg ; 28(8): 1293-1299, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35773179

RESUMO

BACKGROUND: A bio-integrative fiber-reinforced implant (OSSIOfiber® Hammertoe Fixation Implant, OSSIO Ltd., Caesarea, Israel) for proximal interphalangeal joint (PIPJ) correction-arthrodesis showed partial bio-integration at 1-year follow-up (1FU) in a previous study. The study was prolonged to assess the bio-integration at 2-year-follow-up (2FU). METHODS: Twenty-four patients with proximal interphalangeal joint (PIPJ) correction-arthrodesis using the fiber-reinforced implant and analysed at 1FU, completed 2FU. Follow-up included clinical examination, patient reported outcomes, radiographs, MRI and bio-integration scoring. Results were compared between the 1FU and 2FU (paired t-test). RESULTS: Radiographs confirmed fusion in 96 % (n = 23) at 2FU (1FU, 92 % (n = 22)). Implant was no longer visible in 21 % (n = 5), partially visible in 33 % (n = 8), and fully visible in 46 % (n = 11)(1FU, fully visible 100 % (n = 24)). The border between implant and surrounding bone was scored not visible in 88 % (n = 21) and partially visible in 12 % (n = 3) (1FU, border partially visible 100 % (n = 24)). There were no cyst formation or fluid accumulation findings 1FU/2FU. Mild bone edema was detected in 4 % (n = 1) (1FU, 29 % (n = 7)). None of the edema findings were considered as adverse implant related. The mean bio-integration score was 9.71 ± 0.69 at 2FU (1FU, 7.71 ± 0.46). The parameters of border between implant and bone and bone edema further improved at the 2FU compared to the 1FU, total bio-integration score was also higher at 2FU than 1FU (each p < 0.05). CONCLUSIONS: This study demonstrates 96 % PIPJ fusion rate and increased bio-integration from 1FU to 2FU, reaching advanced bio-integration of the fiber-reinforced implant at 2FU.


Assuntos
Síndrome do Dedo do Pé em Martelo , Humanos , Síndrome do Dedo do Pé em Martelo/cirurgia , Artrodese/métodos , Articulação do Dedo do Pé/cirurgia , Próteses e Implantes , Radiografia
2.
Foot Ankle Surg ; 28(4): 418-423, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34247921

RESUMO

BACKGROUND: A new bio-integrative fiber-reinforced implant (OSSIOfiber® Hammertoe Fixation Implant, OSSIO Ltd., Caesarea, Israel) was developed for proximal interphalangeal joint (PIPJ) correction-arthrodesis. The main purpose of this clinical study was to assess implant bio-integration at 1-year follow-up. METHODS: Twenty-four patients, previously treated for a Hammertoe deformity using the bio-integrative, fiber-reinforced implant, were enrolled in this follow-up study. One-year follow-up included clinical examination, patient reported outcomes, radiographs, Magnetic Resonance Imaging (MRI) and bio-integration scoring. RESULTS: Proximal interphalangeal joint (PIPJ) radiographic fusion rate was 92% (n = 22). MRI was analyzed for 24 (100%) patients. In 100% of patients (n = 24), the border between implant and surrounding tissue was scored as partially visible. There were no cyst formation or fluid accumulation findings. Mild bone edema was detected in 29% (n = 7) and is attributed to the chronic distribution of forces due to chronic abnormal gait and pasture. None of the edema findings were considered as adverse implant-related finding. The mean bio-integration score was 7.71 ± 0.46. CONCLUSIONS: This study demonstrates safe bio-integration of the newly developed fiber-reinforced implant at 1-year follow-up without negative side effects.


Assuntos
Síndrome do Dedo do Pé em Martelo , Artrodese/métodos , Seguimentos , Síndrome do Dedo do Pé em Martelo/cirurgia , Humanos , Próteses e Implantes , Articulação do Dedo do Pé/cirurgia
3.
BMC Geriatr ; 21(1): 356, 2021 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-34112098

RESUMO

BACKGROUND: Social isolation is an increasing concern for older adults who live in the community. Despite some availability of social support programs to address social isolation, their effectiveness is not routinely measured. This study aimed to evaluate an innovative excursion-based program offering unique social experiences to older adults receiving aged care services. METHODS: This six-month before and after mixed-methods study evaluated the outcomes of an Australian excursion-based program which offered social and physical outings to bring older adults receiving aged care services into the wider community. The study combined two parts: Part 1 was a pre-post survey assessing the quality of life of older adults who received the excursion-based program for 6 months (n = 56; two time-points, analysed using signed rank test) and Part 2 involved qualitative in-depth, semi-structured interviews (n = 24 aged care staff, older adults and carers; analysed using thematic analysis). RESULTS: Older adults experienced a significant increase in quality of life scores (p < 0.001) between baseline and 6 months. Interviews confirmed these observations and suggested that benefits of participation included increased opportunities for social participation, psychological wellbeing, physical function, and carer respite. Interviews also revealed being in a group setting, having tailored, convenient and accessible activities, alongside supportive staff were key drivers in improving the wellbeing of participants. CONCLUSIONS: Participating in an excursion-based community program may improve wellbeing in older adults. Aging policy should focus on prioritizing initiatives that promote social connectivity with the wider community and assist in improving outcomes for older adults.


Assuntos
Qualidade de Vida , Apoio Social , Idoso , Austrália , Humanos , Participação Social , Inquéritos e Questionários
4.
Br J Sports Med ; 55(4): 191-197, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33184113

RESUMO

All sport events have inherent injury and illness risks for participants. Healthcare services for sport events should be planned and delivered to mitigate these risks which is the ethical responsibility of all sport event organisers. The objective of this paper was to develop consensus-driven guidelines describing the basic standards of services necessary to protect athlete health and safety during large sporting events. By using the Knowledge Translation Scheme Framework, a gap in International Federation healthcare programming for sport events was identified. Event healthcare content areas were determined through a narrative review of the scientific literature. Content experts were systematically identified. Following a literature search, an iterative consensus process was undertaken. The outcome document was written by the knowledge translation expert writing group, with the assistance of a focus group consisting of a cohort of International Federation Medical Chairpersons. Athletes were recruited to review and provide comment. The Healthcare Guidelines for International Federation Events document was developed including content-related to (i) pre-event planning (eg, sport medical risk assessment, public health requirements, environmental considerations), (ii) event safety (eg, venue medical services, emergency action plan, emergency transport, safety and security) and (iii) additional considerations (eg, event health research, spectator medical services). We developed a generic standardised template guide to facilitate the planning and delivery of medical services at international sport events. The organisers of medical services should adapt, evaluate and modify this guide to meet the sport-specific local context.


Assuntos
Atletas , Consenso , Atenção à Saúde/normas , Segurança , Esportes , Serviços Médicos de Emergência/organização & administração , Serviços Médicos de Emergência/normas , Grupos Focais , Humanos , Agências Internacionais , Internacionalidade , Saúde Pública , Medição de Risco/métodos
5.
J Sports Sci ; 39(9): 1046-1054, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33432889

RESUMO

Football boots are marketed with emphasis on a single key performance characteristic (e.g. speed). Little is known on how design parameters impact players' performance. This study investigated the impact of boot design on performance maintenance and perceived foot comfort during a 90-minute match simulation drill. Eleven male university football players tested two commercially available "sprint boots" known to generate significantly different plantar pressures (high=Boot H and low=Boot L) . Players completed a modified Soccer-specific Aerobic Field Test on a 3G pitch. Heart rate, rated perceived exertion and perceived foot discomfort were assessed for each 15-min interval. Power generation was assessed pre- and post-match simulation. A significantly higher mean heart rate was seen for Boot L in the 60th-75th and 75th-90th minute intervals (P = 0.017, P = 0.012 respectively). Perceived exertion did not differ between boots (P ≥ 0.302). Power generation significantly decreased in Boot H between pre- and post-match (P = 0.042). Both boots increased discomfort with significantly more plantar discomfort felt in the last 30 min in Boot H (75th min: P = 0.037; 90th min: P = 0.048). The results imply that a comfortable boot design may improve maintenance of performance during match-play.


Assuntos
Desenho de Equipamento , , Desempenho Físico Funcional , Sensação , Sapatos , Futebol , Humanos , Masculino , Adulto Jovem , Desempenho Atlético/fisiologia , Estudos Cross-Over , Desenho de Equipamento/efeitos adversos , Pé/fisiologia , Frequência Cardíaca/fisiologia , Esforço Físico/fisiologia , Pressão , Distribuição Aleatória , Sensação/fisiologia , Sapatos/efeitos adversos , Futebol/fisiologia , Fatores de Tempo
6.
J Strength Cond Res ; 35(10): 2720-2727, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34324460

RESUMO

ABSTRACT: Wilson, LJ, Dimitriou, L, Hills, FA, Gondek, MB, van Wyk, A, Turek, V, Rivkin, T, Villiere, A, Jarvis, P, Miller, S, Turner, A, and Cockburn, E. Cold water immersion offers no functional or perceptual benefit compared to a sham intervention during a resistance training program. J Strength Cond Res 35(10): 2720-2727, 2021-Cold water immersion (CWI) is regularly used by athletes as a postexercise recovery strategy, but relatively little is understood about potential training adaptations associated with habitual use. The aim of this study was to investigate the influence of repeated CWI or a sham intervention on adaptations to a lower body resistance training program. Thirteen men (26 ± 6 years; 83.6 ± 15.7 kg) familiar with resistance training were allocated into a CWI (10 minutes at 10° C) or sham group and completed 2 × 4-week blocks of lower body resistance training. Subjects completed a total of 16 training sessions (2 × session·week-1), with each session immediately followed by their allocated recovery intervention. Measures of perceptual markers, muscle function, and muscle architecture were recorded at baseline, midpoint, and post-training. Data were analyzed using factorial analysis of variances. The training program resulted in significant increases in muscle fibre pennation angle (p = 0.009), isometric peak force (p = 0.018), and 1/4 squat (p < 0.001) with no differences between groups (all p > 0.05). There were no differences in perceptual responses between groups. Despite the popularity of CWI as a postexercise recovery intervention, the findings from the present study demonstrated no functional or perceptual benefit compared with a sham intervention during progressive strength and power training. Furthermore, there was no detrimental impact of CWI on morphological adaptations after 16 exposures. These findings are important for athletes and practitioners wishing to use CWI as an acute recovery strategy after training, without blunting potential training adaptations.


Assuntos
Treinamento Resistido , Adaptação Fisiológica , Temperatura Baixa , Humanos , Imersão , Masculino , Fibras Musculares Esqueléticas , Músculo Esquelético , Água
7.
Br J Sports Med ; 53(17): 1117-1125, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30877137

RESUMO

OBJECTIVE: To identify changes in International Federations' priorities and the barriers to implementing athlete and global health initiatives. Results should influence the work of the International Federation medical committees, the IOC and the Association of Summer Olympic International Federation. METHODS: The 28 Summer and 7 Winter International Federations participating in the most recent Olympic Games (2016; 2018) were surveyed to (i) identify the importance of 27 health topics, (ii) assess their progress on implementation health-related programmes and (iii) the barriers to implementation of these programmes. We compared International Federations' activities in 2016 and 2017. RESULTS: The response rate was 83%. Health topics which most International Federations regarded as important and in which the International Federations felt insufficiently active were 'team physician certification', 'prevention of harassment and abuse', 'eating disorders/disordered eating', 'mental health' and 'injury surveillance'. Compared with 2016, there was a decrease in International Federations' activities in 'injury surveillance', 'nutritional supplements' and 'hyperandrogenism'. The main barrier to implementing health-related programmes was 'International Federation political support/willingness', followed by 'knowledge'. 'Time' and 'coach support' were more often reported than 'finances', or 'IOC or Association of Summer Olympic International Federations partnership'. CONCLUSION: If International Federations are going to promote health of athletes and global health promotion through physical activity (sport), International Federation leadership must change their focus and provide greater political support for related initiatives. Improving coach and athlete knowledge of the health issues could also facilitate health programme delivery. Time constraints could be mitigated by sharing experiences among the International Federations, Association of Summer Olympic International Federations and the IOC. International Federations should focus on those health-related topics that they identified as being important, yet rate as having insufficient activity.


Assuntos
Promoção da Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde , Agências Internacionais , Esportes , Saúde Global , Implementação de Plano de Saúde , Humanos , Inquéritos e Questionários
8.
Analyst ; 143(8): 1862-1869, 2018 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-29543293

RESUMO

Radioluminescence microscopy is an emerging modality that can be used to image radionuclide probes with micron-scale resolution. This technique is particularly useful as a way to probe the metabolic behavior of single cells and to screen and characterize radiopharmaceuticals, but the quality of the images is critically dependent on the scintillator material used to image the cells. In this paper, we detail the development of a microscopy dish made of a thin-film scintillating material, Lu2O3:Eu, that could be used as the blueprint for a future consumable product. After developing a simple quality control method based on long-lived alpha and beta sources, we characterize the radioluminescence properties of various thin-film scintillator samples. We find consistent performance for most samples, but also identify a few samples that do not meet the specifications, thus stressing the need for routine quality control prior to biological experiments. In addition, we test and quantify the transparency of the material, and demonstrate that transparency correlates with thickness. Finally, we evaluate the biocompatibility of the material and show that the microscopy dish can produce radioluminescent images of live single cells.


Assuntos
Microscopia/instrumentação , Cintilografia , Linhagem Celular Tumoral , Humanos , Análise de Célula Única
9.
Undersea Hyperb Med ; 45(3): 287-295, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30028915

RESUMO

INTRODUCTION: Decompression sickness (DCS) is manifested by the quantity and location of bubbles in body tissues after reduction in ambient pressures. Models have been formulated to explain why bubbles form, but none provide satisfactory explanations as to why the findings of DCS occur as they do. This first of a three-part series explains why and at what sites DCS occurs. MATERIALS AND METHODS: Over a 50-year span and 500 cases of DCS we have managed, it has become apparent that almost all "unexplained" DCS (i.e., cases with no obvious explanation as to how/why they occurred) have physiological explanations. The vagaries of the physiology of tissue perfusion and the physics of gradients as a cause of autochthonous bubble formation were analyzed. FINDINGS: Perfusion is highly variable, with so-called "fast" tissues (i.e., tissues with a rapid rate of saturation) requiring a constant blood supply, "intermediate" tissues requiring a blood supply proportional to needs, and "slow" tissues having minimal perfusion requirements. The 5-liter blood volume in a vascular system with greater than a 20-liter capacity requires careful regulation. Disruptions in the regulation and/or overwhelming gradients explain why DCS occurs. CONCLUSIONS: Our Gradient-Perfusion Model provides an explanation as to why disordering events account for almost all cases of unexplained DCS. We propose that this latter term be discarded and "disordering events" be sought for DCS cases that have no obvious explanations.


Assuntos
Doença da Descompressão/etiologia , Modelos Cardiovasculares , Fluxo Sanguíneo Regional/fisiologia , Volume Sanguíneo/fisiologia , Doença da Descompressão/fisiopatologia , Gases/sangue , Humanos , Pulmão/fisiologia , Especificidade de Órgãos/fisiologia
10.
Undersea Hyperb Med ; 45(3): 297-305, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30028916

RESUMO

Introduction: In Part 1 of this three-part series, we provided an explanation as to why and at what sites decompression sickness (DCS) occurs, using the Gradient-Perfusion Model (GPM). In this part, we provide information to substantiate the concept and present clinical cases that were initially labeled as "unexplained DCS," but later disordering events were identified to explain the clinical presentations. Materials and Methods: Among 500 cases of DCS we have managed for over 50 years, a cohort of these patients was initially diagnosed as unexplained DCS. However, some have shown that disordering events are the likely cause of their DCS. Results: By pairing the tissue involved with the patient's dive history, a gradient-perfusion imbalance connection was identified. In all serious (Type 2) presentations of DCS, alterations in perfusion of the fast tissues were able to account for the clinical findings. The consequences demonstrated that the gradients overwhelmed the ability of altered perfusion to offgas/offload the inert gas. Pain-only and peripheral neuropathy presentations involved both intermediate and slowly perfused tissues. Rather than perfusion, gradient limitations were the reasons for the clinical presentations of these patients. Conclusions: The GPM accounts for signs and symptom presentations in DCS. This provides the basis for appropriate treatments and logical recommendations for return to diving. We recommend that the label "unexplained DCS" be discontinued and that the GPM be used to determine the cause. Once the cause is established, "DCS due to disordered decompression" becomes the appropriate term.


Assuntos
Doença da Descompressão/etiologia , Modelos Cardiovasculares , Fluxo Sanguíneo Regional/fisiologia , Adulto , Idoso , Lesões Encefálicas Traumáticas/complicações , Reanimação Cardiopulmonar , Doença da Descompressão/fisiopatologia , Doença da Descompressão/terapia , Desidratação/complicações , Mergulho/efeitos adversos , Mergulho/fisiologia , Evolução Fatal , Feminino , Humanos , Hipestesia/etiologia , Deslocamento do Disco Intervertebral/complicações , Pulmão/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Gases Nobres/sangue , Especificidade de Órgãos , Paraplegia/etiologia , Vértebras Torácicas , Inconsciência/etiologia , Manobra de Valsalva , Doenças Vestibulares/etiologia , Doenças Vestibulares/terapia , Adulto Jovem
11.
Undersea Hyperb Med ; 45(3): 307-311, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30028917

RESUMO

INTRODUCTION: Decompression sickness (DCS) has been associated with unusual circumstances such as breath-hold diving, shallow depths, and short bottom times. We report a case of DCS with an extraordinary cause and course. MATERIALS AND METHODS: A 72-year-old healthy Hispanic female was referred to our 24/7 Hyperbaric Medicine Unit for emergency hyperbaric oxygen recompression treatment (HBO2 RCT) after developing lower-extremity paralysis following a hyperbaric air exposure in a homemade hyperbaric chamber. RESULTS: After an uneventful exposure to hyperbaric air at a maximum 72-foot depth (3.2 ATA, 32.3 psig), the patient had the delayed onset of abdominal pain and paraplegia after eating a meal. After HBO2 RCT in accordance with our management algorithm, the patient had a full recovery. CONCLUSIONS: This patient's presentation and course corresponded to what we label as "disordered decompression" and conformed to our Gradient Perfusion Model. With a finite blood volume and the need to perfuse two "intermediate" tissues simultaneously, we postulate that a "steal" syndrome arose to cause the abdominal and paralysis symptoms.


Assuntos
Dor Abdominal/etiologia , Doença da Descompressão/etiologia , Oxigenoterapia Hiperbárica/efeitos adversos , Paresia/etiologia , Dor Abdominal/diagnóstico por imagem , Dor Abdominal/terapia , Idoso , Doença da Descompressão/terapia , Ingestão de Alimentos , Feminino , Humanos , Oxigenoterapia Hiperbárica/métodos , Paresia/terapia
12.
Clin Orthop Relat Res ; 475(10): 2588-2596, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28616759

RESUMO

BACKGROUND: Large Achilles tendon defects pose a treatment challenge. The standard treatment with a turndown flap requires a large extensile incision, puts the sural nerve at risk, and demands slow, careful rehabilitation. Dual allograft semitendinosus reconstruction is a new clinical alternative that has the theoretical advantages of a smaller incision, less dissection, and a stronger construct that may allow for faster rehabilitation. QUESTIONS/PURPOSES: In a cadaver biomechanical model, we compared the dual allograft semitendinosus reconstruction with the myofascial turndown in terms of (1) mechanical strength and resistance to deformation and (2) failure mechanisms in reconstruction of large segmental Achilles defects. METHODS: An 8-cm segmental Achilles defect was created in 18 cadaveric lower extremities, nine matched pairs without defect or previous surgery (mean age, 78.4 years; range, 60-97 years; three female and six male pairs). Femoral neck densitometry to determine bone mineral density found that all specimens except two were osteopenic or osteoporotic. Specimens in each pair were assigned to allograft or turndown reconstruction. The constructs were mounted on a load frame and differential variable reluctance transducers were applied to measure deformation. Specimens were preconditioned and then loaded axially. Tensile force and proximal and distal construct deformation were measured at clinical failure, defined as 10 mm of displacement, and at ultimate failure, defined as failure of the reconstruction. Failure mechanism was recorded. RESULTS: Tensile strength at time zero was higher in the allograft versus the turndown construct at clinical failure (156.9 ± 29.7 N versus 107.2 ± 20.0 N, respectively; mean difference, -49.7 N; 95% CI, -66.3 to -33.0 N; p < 0.001) and at ultimate failure (290.9 ± 83.2 N versus 140.7 ± 43.5 N, respectively; mean difference, -150.2 N; 95% CI, -202.9 to -97.6 N; p < 0.001). Distal construct deformation was lower in the turndown versus the allograft construct at clinical failure (1.6 ± 1.0 mm versus 4.7 ± 0.7 mm medially and 2.2 ± 1.0 mm versus 4.8 ± 1.1 mm laterally; p < 0.001). Semitendinosus allograft failure occurred via calcaneal bone bridge fracture in eight of nine specimens. All myofascial turndowns failed via suture pullout through the fascial tissue at its insertion. CONCLUSION: In this comparative biomechanical study, dual semitendinosus allograft reconstruction showed greater tensile strength and construct deformation compared with myofascial turndown in a cadaveric model of large Achilles tendon defects. CLINICAL RELEVANCE: Further study of dual semitendinosus allograft for treatment of severe Achilles tendon defects with cyclic loading and investigation of clinical results will better elucidate the clinical utility and indications for this technique.


Assuntos
Tendão do Calcâneo/cirurgia , Tendões dos Músculos Isquiotibiais/transplante , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Tendão do Calcâneo/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Aloenxertos , Fenômenos Biomecânicos , Cadáver , Feminino , Tendões dos Músculos Isquiotibiais/fisiopatologia , Humanos , Técnicas In Vitro , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/efeitos adversos , Estresse Mecânico , Retalhos Cirúrgicos/efeitos adversos , Técnicas de Sutura , Resistência à Tração
13.
Undersea Hyperb Med ; 44(1): 45-55, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28768085

RESUMO

As the population gets older, coupled with increased awareness of good health practices and the recognition that fitness contributes to participation in activities generally appropriate for younger individuals, decisions need to be made about what are appropriate activities for the older-aged scuba (self-contained underwater breathing apparatus) diver. It is essential to appreciate the distinction between chronological and physiological age. Three factors, namely fitness, comorbidities, and mobility and strength are fundamental when making decisions about participation in activities in general as well as in scuba diving for older adults. There is almost always a time to call it quits for everything.


Assuntos
Fatores Etários , Envelhecimento/fisiologia , Mergulho/fisiologia , Nível de Saúde , Aptidão Física , Atividades Cotidianas , Comorbidade , Tomada de Decisões , Humanos , Longevidade , Força Muscular , Doenças do Sistema Nervoso , Fumar , Previdência Social , Esteroides/administração & dosagem , Caminhada/fisiologia
14.
J Foot Ankle Surg ; 56(1): 3-7, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27989342

RESUMO

We compared the pullout strength of a suture-based anchor versus a bioabsorbable anchor in the distal fibula and calcaneus and evaluated the relationship between bone mineral density and peak load to failure. Eight paired cadaveric specimens underwent a modified Broström procedure and Achilles tendon reattachment. The fibula and calcaneus in the paired specimens received either a suture-based anchor or a bioabsorbable suture anchor. The fibular and calcaneal specimens were loaded to failure, defined as a substantial decrease in the applied load or pullout from the bone. In the fibula, the peak load to failure was significantly greater with the suture-based versus the bioabsorbable anchors (133.3 ± 41.8 N versus 76.8 ± 35.3 N; p = .002). No significant difference in load with 5 mm of displacement was found between the 2 groups. In the calcaneus, no difference in the peak load to failure was found between the 2 groups, and the peak load to failure with 5 mm of displacement was significantly lower with the suture-based than with the bioabsorbable anchors (52.2 ± 9.8 N versus 75.9 ± 12.4 N; p = .003). Bone mineral density and peak load to failure were significantly correlated in the fibula with the suture-based anchor. An innovative suture-based anchor had a greater peak load to failure compared with a bioabsorbable anchor in the fibula. In the calcaneus, the load at 5 mm of displacement was significantly lower in the suture-based than in the bioabsorbable group. The correlation findings might indicate the need for a cortical bone shelf with the suture-based anchor. Suture-based anchors could be a viable alternative to bioabsorbable anchors for certain foot and ankle procedures.


Assuntos
Implantes Absorvíveis , Tendão do Calcâneo/cirurgia , Calcâneo/cirurgia , Âncoras de Sutura , Resistência à Tração , Adulto , Articulação do Tornozelo/cirurgia , Fenômenos Biomecânicos , Cadáver , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Sutura
15.
J Sports Sci ; 34(17): 1627-36, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26699792

RESUMO

This study aimed to examine player perceptions and biomechanical responses to tennis surfaces and to evaluate the influence of prior clay court experience. Two groups with different clay experiences (experience group, n = 5 and low-experience group, n = 5) performed a 180° turning movement. Three-dimensional ankle and knee movements (50 Hz), plantar pressure of the turning step (100 Hz) and perception data (visual analogue scale questionnaire) were collected for two tennis courts (acrylic and clay). Greater initial knee flexion (acrylic 20. 8 ± 11.2° and clay 32.5 ± 9.4°) and a more upright position were reported on the clay compared to the acrylic court (P < 0.05). This suggests adaptations to increase player stability on clay. Greater hallux pressures and lower midfoot pressures were observed on the clay court, allowing for sliding whilst providing grip at the forefoot. Players with prior clay court experience exhibited later peak knee flexion compared to those with low experience. All participants perceived the differences in surface properties between courts and thus responded appropriately to these differences. The level of previous clay court experience did not influence players' perceptions of the surfaces; however, those with greater clay court experience may reduce injury risk as a result of reduced loading through later peak knee flexion.


Assuntos
Extremidade Inferior/fisiologia , Percepção/fisiologia , Tênis/fisiologia , Adaptação Fisiológica , Adulto , Tornozelo/fisiologia , Fenômenos Biomecânicos , Pé/fisiologia , Fricção , Humanos , Joelho/fisiologia , Movimento , Pressão , Propriedades de Superfície
16.
Undersea Hyperb Med ; 43(6): 641-648, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28768391

RESUMO

INTRODUCTION: In 2002 Fife and Strauss (Fife, et al. Wound Rep Reg, 10:198-207; Strauss, et al. Foot Ankle Intl, 23:933-937) studied the predictability of transcutaneous oxygen measurements (TCOMs) for healing diabetic foot ulcers (DFUs). This paper analyzes the validity of the two studies and combines their information to predict which DFU will heal with adjunctive hyperbaric oxygen (HBO2) treatments. METHODS: A statistical review of the Fife and Strauss papers was performed. The numbers presented in the papers were subjected to analyses to compare like by like data as well as test for p-values and odds ratios for predicting healing of DFUs with HBO2. RESULTS: In the Strauss paper 143 subjects were studied in retrospective and prospective series. In those TCOMs which exceed 200 mmHg with HBO2 healing occurred in 87.5% even if the room air TCOM was ⟨ 30 mmHg (p ⟨ 0.001). The Fife paper studied retrospectively a subset of 221 patients who had TCOMs with HBO2. Failure rates for healing decreased progressively from 35.7% to 14.3%, with TCOMs grouped in 100-mmHg increments from 200 mmHg to 699 mmHg. This resulted in absence of statistical significance for any 100-mmHg range over 200 mmHg with HBO2 due to the small number of subjects for each 100-mmHg grouping. CONCLUSIONS: Although differences exist between the study designs, each complements the other. If TCOMs exceed 200 mmHg with HBO2, both authors observed that almost 90% of DFUs healed regardless of the room air readings when HBO2 was used as an adjunct to management.


Assuntos
Pé Diabético/sangue , Pé Diabético/terapia , Oxigenoterapia Hiperbárica , Cicatrização , Monitorização Transcutânea dos Gases Sanguíneos , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes , Estudos Retrospectivos
17.
J Environ Health ; 78(4): 14-7, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26638670

RESUMO

Restroom internal door handles have the potential to become contaminated by pathogenic bacteria, particularly because frequent breakdowns occur in hand hygiene. Cleaning these door handles periodically could reduce this cross-contamination risk. The sustained effect following cleaning with chlorhexidine could be beneficial in restroom facilities as cleaning episodes are of necessity at time intervals. The cleaning efficacies and residual effects of Sani Cloth CHG 2% wipes were investigated in a double-blinded randomized crossover controlled trial in a school setting. No significant difference occurred in initial cleaning efficacy; however, following a six-hour period of use by pupils of the restroom facilities, the internal door handles wiped with Sani-Cloth CHG 2% wipes were significantly less contaminated than those with the control wipe (14% v. 32%, p = .02). Cleaning with Sani-Cloth CHG 2% wipes demonstrated significant improvements in the continuous cleanliness of restroom door handles during use with this simple and inexpensive technique.


Assuntos
Clorexidina/farmacologia , Desinfetantes/farmacologia , Instituições Acadêmicas , Banheiros , Estudos Cross-Over , Método Duplo-Cego
18.
Inorg Chem ; 53(5): 2491-500, 2014 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-24527942

RESUMO

The synthesis optimization and scale-up of the benchmarked microporous zirconium terephthalate UiO-66(Zr) were investigated by evaluating the impact of several parameters (zirconium precursors, acidic conditions, addition of water, and temperature) over the kinetics of crystallization by time-resolved in situ energy-dispersive X-ray diffraction. Both the addition of hydrochloric acid and water were found to speed up the reaction. The use of the less acidic ZrOCl2·8H2O as the precursor seemed to be a suitable alternative to ZrCl4·xH2O, avoiding possible reproducibility issues as a consequence of the high hygroscopic character of ZrCl4. ZrOCl2·8H2O allowed the formation of smaller good quality UiO-66(Zr) submicronic particles, paving the way for their use within the nanotechnology domain, in addition to higher reaction yields, which makes this synthesis route suitable for the preparation of UiO-66(Zr) at a larger scale. In a final step, UiO-66(Zr) was prepared using conventional reflux conditions at the 0.5 kg scale, leading to a rather high space-time yield of 490 kg m(-3) day(-1), while keeping physicochemical properties similar to those obtained from smaller scale solvothermally prepared batches.


Assuntos
Cloretos/química , Ácidos Ftálicos/síntese química , Difração de Raios X , Zircônio/química , Modelos Moleculares , Ácidos Ftálicos/química , Porosidade
19.
J Appl Biomech ; 30(5): 637-42, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25011002

RESUMO

It has previously been shown that a loaded warm-up may improve power performances. We examined the acute effects of loaded dynamic warm-up on change of direction speed (CODS), which had not been previously investigated. Eight elite badminton players participated in three sessions during which they performed vertical countermovement jump and CODS tests before and after undertaking the dynamic warm-up. The three warm-up conditions involved wearing a weighted vest (a) equivalent to 5% body mass, (b) equivalent to 10% body mass, and (c) a control where a weighted vest was not worn. Vertical jump and CODS performances were then tested at 15 seconds and 2, 4, and 6 minutes post warm-up. Vertical jump and CODS significantly improved following all warm-up conditions (P < .05). Post warm-up vertical jump performance was not different between conditions (P = .430). Post warm-up CODS was significantly faster following the 5% (P = .02) and 10% (P < .001) loaded conditions compared with the control condition. In addition, peak CODS test performances, independent of recovery time, were faster than the control condition following the 10% loaded condition (P = .012). In conclusion, the current study demonstrates that a loaded warm-up augmented CODS, but not vertical jump performance, in elite badminton players.


Assuntos
Desempenho Atlético/fisiologia , Educação Física e Treinamento/métodos , Esportes com Raquete/fisiologia , Teste de Esforço , Humanos , Masculino , Adulto Jovem
20.
Sports Med ; 54(5): 1163-1178, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38280179

RESUMO

BACKGROUND: Historically, kinematic measures have been compared across injured and non-injured groups of runners, failing to take into account variability in kinematic patterns that exist independent of injury, and resulting in false positives. Research led by gait patterns and not pre-defined injury status is called for, to better understand running-related injury (RRI) aetiology and within- and between-group variability. OBJECTIVES: Synthesise evidence for the existence of distinct kinematic sub-groups across a population of injured and healthy runners and assess between-group variability in kinematics, demographics and injury incidence. DATA SOURCES: Electronic database search: PubMed, Web of Science, Cochrane Central Register of Controlled Trials (Wiley), Embase, OVID, Scopus. ELIGIBILITY CRITERIA: Original, peer-reviewed, research articles, published from database start to August 2022 and limited to English language were searched for quantitative and mixed-methods full-text studies that clustered injured runners according to kinematic variables. RESULTS: Five studies (n = 690) were included in the review. All studies detected the presence of distinct kinematic sub-groups of runners through cluster analysis. Sub-groups were defined by multiple differences in hip, knee and foot kinematics. Sex, step rate and running speed also varied significantly between groups. Random injury dispersal across sub-groups suggests no strong evidence for an association between kinematic sub-groups and injury type or location. CONCLUSION: Sub-groups containing homogeneous gait patterns exist across healthy and injured populations of runners. It is likely that a single injury may be represented by multiple movement patterns, and therefore kinematics may not predict injury risk. Research to better understand the underlying causes of kinematic variability, and their associations with RRI, is warranted.


Assuntos
Traumatismos em Atletas , Marcha , Corrida , Humanos , Traumatismos em Atletas/epidemiologia , Fenômenos Biomecânicos , Incidência , Corrida/lesões , Corrida/fisiologia
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