Relación entre dimensiones antropométricas de tronco y valores de espirometría / Association between anthropometric dimensions of trunk and spirometry indices

Los objetivos del presente estudio fueron primero evaluar la asociación de dimensiones antropométricas de tórax y tronco con índices espirométricos, segundo, ajustar una ecuación de predicción con dimensiones antropométricas de tronco y tercero, comparar nuestro modelo predictivo con dos ecuaciones diagnósticas. Se evaluaron 59 estudiantes universitarios entre 20 y 40 años, de ambos sexos, sin hábito tabáquico. Las variables consideradas fueron: edad, sexo, peso, estatura, diámetro transverso de tórax, diámetro anteroposterior de tórax, perímetro de tórax, altura de tórax, altura de tronco, flujo espiratorio máximo (FEM), volumen espiratorio forzado en el primer segundo (VEF1) y capacidad vital forzada (CVF). Se utilizó el análisis de regresión múltiple para estimar los valores espirométricos en función de las variables demográficas y antropométricas. La CVF y el VEF1 tienen asociación lineal directa con el diámetro transverso de tórax, altura de tórax, perímetro de tórax y altura de tronco. Se ajustó una ecuación de regresión lineal múltiple que indicó que es posible estimar la CVF y el VEF11 en función de la altura de tronco y el perímetro de tórax para ambos sexos. Estas variables son capaces de explicar el 74 % de los valores de CVF y el 68 % de los valores de VEF1. Al comparar los valores obtenidos por nuestras ecuaciones predictivas con las ecuaciones de referencia nacional observamos que nuestros resultados son más cercanos a los de Quanjer et al. (2012) que a los de Knudson et al. (1983). La altura de tronco y el perímetro de tórax tienen asociación directa con el VEF1 y CVF y son buenos predictores del VEF1 y CVF en estudiantes universitarios. Nuestros valores estimados son más cercanos a las ecuaciones de Quanjer et al. (2012) en comparación a las estimaciones de Knudson (1983).

SUMMARY: The purposes of the present study were first to evaluate the association between anthropometric dimensions of the thorax and trunk with spirometric indices, second, to fit a prediction equation with anthropometric dimensions of the trunk, and third, to compare our predictive model with two diagnostic equations. Fifty-nine university students between 20 and 40 years old, of both sexes and non-smokers were recruited. Variables considered were age, sex, weight, height, chest transverse diameter, chest anteroposterior diameter, chest perimeter, chest height, trunk height, maximum expiratory flow (PEF), forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC). Multiple regression analysis was used to estimate spirometric values based on demographic and anthropometric variables. FVC and FEV1 have a direct linear association with chest transverse diameter, chest height, chest circumference, and trunk height. A multiple linear regression equation was fitted, indicating that it is possible to estimate FVC and FEV1 as a function of trunk height and chest girth for both sexes. These variables can explain 74% of the FVC values and 68% of the FEV1 values. Comparing the values obtained by our predictive equations with the national reference equations, we observe that our results are closer to those of Quanjer et al. (2012) than to those of Knudson et al. (1983). Trunk height and chest circumference have a direct association with FEV1 and FVC and are good predictors of FEV1 and FVC in university students. Our estimated values are closer to Quanjer et al. (2012) than Knudson et al. (1983) prediction equations.

Effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury / 浙江大学学报·医学版

OBJECTIVES@#To investigate the effect of torso training on unstable surface on lower limb motor function in patients with incomplete spinal cord injury.@*METHODS@#A total of 80 patients with incomplete spinal cord injury caused by thoracolumbar fracture admitted in Ningbo Yinzhou No.2 Hospital from April 2020 to December 2021 were randomly divided into control group and study group, with 40 cases in each group. In addition to routine training, the control group received torso training on stable surface and the study group received torso training on unstable surface. The gait, lower limb muscle strength, balance function, lower limb function, mobility and nerve function of the two groups were compared.@*RESULTS@#After treatment, the stride length, stride frequency and comfortable walking speed improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05). The muscle strength of quadriceps femoris, gluteus maximus, hamstring, anterior tibialis and gastrocnemius were improved in the two groups (all P<0.05), and the improvements in study group were more significant (all P<0.05); the total trajectories of static eye opening and static eye closing gravity center movement in the two groups were significantly shorter (all P<0.05), and the improvements in the study group were more significant (all P<0.05). The dynamic stability limit range and the American Spinal Injury Association (ASIA) lower extremity motor score, Berg balance scale, modified Barthel index scale in the two groups were significantly higher (all P<0.05), and these scores in study group were significantly higher than those in the control group (all P<0.05). Both groups showed a significant improvement in ASIA grade (all P<0.05), and the improvement in the study group was significantly better (P<0.05).@*CONCLUSIONS@#Torso training on unstable surface can effectively improve the gait and lower limb muscle strength of patients with incomplete spinal cord injury and improve the lower limb motor function.

Poor Trunk Flexibility is Associated with Cardiovascular Risk Factors

Abstract Background: Poor flexibility is a predictor of reduced physical activity. The association between trunk flexibility and cardiovascular risk factors (CVRFs) is not well understood. Objective: To identify the prevalence of CVRFs and their association with trunk flexibility in individuals participating in a community-based health education program. Methods: Volunteers (51 men, 48 women) aged 20-85 years old, participants in a community-based health education program in the city of Santo Antônio de Goiás, Brazil, were selected for this study. Anthropometric measures including body mass, height, body mass index (BMI), waist circumference (WC) and waist/height ratio (WHtR) were evaluated. Physical activity level was evaluated based on leisure activity participation, and trunk flexibility was evaluated by the sit and reach test. Data distribution was assessed using the Shapiro-Wilk test; Pearson's chi-square or Fisher's exact and Student t tests were performed for comparisons. To analyze the association between trunk flexibility and concomitant CVRFs, Spearman's correlation test and linear regression were employed. Statistical significance was defined as p < 0.05. Results: 7.2% of the volunteers had no CVRF, 10.3% had only one CVRF and 82.5% had two or more CVRFs, with no differences between sexes. Increased abdominal adiposity, as assessed by WHtR (p = 0.0097), and systemic arterial hypertension (p = 0.0003) were the most prevalent CVRFs, with differences between age groups. A strong negative correlation was found between mean trunk flexibility and the number of concomitant CVRFs (r = -0.96, p < 0.0028). Conclusion: The strong negative correlation between trunk flexibility and concomitant CVRF indicates an increased risk for cardiovascular events. Therefore, trunk flexibility measurement may be an additional tool for health promotion and prevention of cardiovascular and associated diseases in community health programs.

Postura, mobilidade diafragmática e função pulmonar em crianças e adolescentes obesos Autores Patrícia Clara Pereira dos Santos / Posture, diaphragmatic mobility and pulmonary function in obese children and adolescents

Introdução: A sobrecarga corporal devida à obesidade contribui no surgimento de alterações no sistema musculoesquelético e respiratório. Objetivo: Analisar as evidências científicas referentes à influência da obesidade sobre a postura do tronco, a resposta cinético-funcional do diafragma e a função pulmonar em crianças e adolescentes. Métodos: Trata-se de uma revisão de literatura, utilizando as bases de dados Medline, Cochrane, Embase, Lilacs e Web of Sciences, nos idiomas inglês, português e espanhol, nos últimos 10 anos. Foram utilizados os descritores: "obesidade', "postura", "diafragma", "função pulmonar", "adolescentes", "adultos jovens". Os critérios de exclusão foram: estudos que abordaram distúrbios neuromusculares associados, cifoescoliose, fibrose cística, enfisema pulmonar, asma e DPOC e artigos não disponíveis na íntegra. Resultados: Foram identificados 226 estudos, porém 10 foram analisados. Os resultados apontaram que a postura do tronco nos obesos é hipercifótica, hiperlordótica e com anteversão pélvica, além de apontar indícios de repercussão na dinâmica respiratória, com redução da mobilidade do diafragma e dos volumes e capacidades pulmonares. Conclusão: A obesidade contribui para a ocorrência de hipercifose, hiperlordose e anteversão da pelve, bem como na diminuição da atividade do diafragma e função pulmonar. (AU)

Lipoblastoma de extremidades y tronco: recurrencia local y complicaciones después de la resección marginal. Estudio multicéntrico / Limb and trunk lipoblastoma: Local recurrence and complications after marginal resection. A multicenter study

Objetivo: El lipoblastoma es una neoplasia benigna poco común que puede presentarse como un tumor localizado o difuso (lipoblastomatosis). Debido a su rareza, se han publicado, en su mayoría, solo reportes de casos. El objetivo de este estudio fue determinar la tasa de recurrencia local y las complicaciones después de la resección marginal de lipoblastomas ubicados en extremidades y tronco. Materiales y métodos: Se realizó una revisión retrospectiva multicéntrica de los registros de pacientes pediátricos sometidos a extirpación quirúrgica de lipoblastomas en cuatro instituciones, entre 2008 y 2018. Se registraron las siguientes variables: datos demográficos, método diagnóstico, volumen de la lesión, tipo de biopsia, complicaciones, recurrencia y necesidad de procedimientos adicionales. Resultados: Durante el período de estudio, 17 pacientes cumplieron los criterios de inclusión para la evaluación. La media de la edad era de 3.9 años y el 65% eran varones. Las ubicaciones más frecuentes fueron: muslos (n = 9), columna lumbar (n = 2) y glúteos (n = 2). El volumen de masa preoperatorio medio fue de 305,5 cm3 (rango: 10,2-1745,8). La duración media del seguimiento fue de 2.8 años (rango: de 8 meses a 5.6 años). Hubo una recurrencia (5,9%) y una cicatriz retraída en el área glútea como complicación. Ninguno requirió una nueva intervención. Conclusión: La resección quirúrgica marginal de lipoblastomas localizados en el dorso o las extremidades genera una baja tasa de recurrencia a los 2.8 años de seguimiento y mínimas complicaciones. Nivel de Evidencia: IV

Objectives: Lipoblastoma is a rare benign neoplasm that resembles white fat and can occur as a localized (lipoblastoma) or diffuse (lipoblastomatosis) tumor. Due to its rarity, the literature is mostly limited to case reports. The purpose of this study was to determine the local recurrence rate and complications after marginal resection of lipoblastomas located in the extremities or the back. Materials and methods: We performed a multicenter retrospective review of the records of pediatric patients who had undergone surgical excision of lipoblastomas at 4 tertiary care institutions from 2008 to 2018. We recorded the demographic data, diagnostic method, the volume of the lesion, type of biopsy, complications, recurrence, and the need for additional procedures. Results: Throughout the study, 17 patients met the inclusion criteria for evaluation. The average patient age was 3.9 years, and 65% were male. The most common locations included thighs (N 9), low back region (N 2), and buttocks (N 2). The mean preoperative mass volume was 305.5 cm3(range: 10.2 cm3 - 1745.8 cm3). The mean duration of follow-up was 2.8 years (range: 8 months to 5.6 years). One patient experienced recurrence (5.9%). One patient had a retracted skin scarring in the gluteal area. Conclusion: Marginal surgical resection of lipoblastomas located in the back or extremities showed a low recurrence rate at 2.8 years of follow-up and minimal complications. Level of Evidence: IV

Atypical and unusual clinical presentation of atopic dermatitis: A case report / Apresentação clínica atípica e incomum de dermatite atópica: relato de caso

Atopic Dermatitis, also called atopic eczema, is a complex systemic inflammatory disease with heterogeneous clinical morphologies. Common features are eczematous lesions, intense pruritus and chronic or relapsing disease course. Eczematous lesions typically show an age-related distribution. However, this disease can present different phenotypes, like follicular/papular dermatitis and prurigo nodularis. We reported a male, 22 years old, phototype IV, African descent, with personal and familial history of atopy. He reported pruritus, xerosis and lesions on skin since he was 2 years-old, with relapsing and chronic course. Clinical examination showed disseminated perifollicular accentuation and rough follicular papules. Extensor surfaces of the legs showed excoriated papules and nodules, beside generalized post-inflammatory hypopigmentation. He had lichenified plaques on the back, neck, hands and foot. Skin biopsy showed spongiosis, parakeratosis and irregular acanthosis at the epidermis. The diagnosis was late and occurred only in adulthood. Due to the extensive and relapsing presentation, he received Cyclosporin 3 mg/Kg/day, associated to steroids and emollients, with improvement of pruritus, xerosis and lechinification. But he maintained perifollicular accentuation. The patient presented common features of Atopic Dermatitis, like chronic and relapsing lesions, history of atopic, dry skin, pruritus, and early disease onset. However, atypical morphologies were presented, exemplified by prurigo nodularis and follicular/papular dermatitis. Other relevant finding it was the fact that the lesions occurred outside the classic areas, with prevalence on extensor surfaces and trunk. These atypical morphologies and unusual location of lesions are prevalent on adults with high phototypes, as seen in this case. It is essential to identify these challenging phenotypes, because the diagnosis of Atopic Dermatitis is clinical. Given the diversity of clinical presentation and difficult to recognize some cases, this article will contribute to demonstrate atypical manifestations and common features in non-white patients, facilitating correct diagnosis and early treatment.

A dermatite atópica, também chamada de eczema atópico, é uma doença inflamatória sistêmica complexa, com morfologias clínicas heterogêneas. As características comuns são lesões eczematosas, prurido intenso e curso crônico ou recidivante. Lesões eczematosas geralmente mostram uma distribuição relacionada à idade. No entanto, essa doença pode apresentar diferentes fenótipos, como dermatite folicular/papular e prurigo nodular. Relatamos um homem, 22 anos, fototipo IV, afrodescendente, com história pessoal e familiar de atopia. Referia prurido, xerose e lesões na pele desde os 2 anos, com recidiva e curso crônico. O exame clínico mostrou acentuação perifolicular disseminada e pápulas foliculares ásperas. As superfícies extensoras das pernas apresentavam pápulas e nódulos escoriados, além de hipopigmentação pós-inflamatória generalizada. Notaram-se placas liquenificadas no dorso, pescoço, mãos e pés. A biópsia de pele demonstrou espongiose, paraqueratose e acantose irregular na epiderme. O diagnóstico foi tardio e ocorreu apenas na idade adulta. Devido ao quadro clínico extenso e recidivante, recebeu Ciclosporina 3 mg/Kg/dia, associada a esteroides e emolientes, com melhora de prurido, xerose e liquenificação, mas manteve a acentuação perifolicular. O paciente apresentava características comuns de dermatite atópica, como lesões crônicas e recidivantes, história de atopia, pele seca, prurido e início precoce da doença, no entanto, foram apresentadas morfologias atípicas, exemplificadas por prurigo nodular e dermatite folicular/papular. Outro achado relevante foi o fato das lesões localizarem-se em áreas não clássicas da doença, com predomínio nas superfícies extensoras e tronco. Essas morfologias atípicas e localizações incomuns são prevalentes em adultos com fototipos elevados, como visto neste caso. É essencial identificar esses fenótipos desafiadores, porque o diagnóstico de dermatite atópica é clínico. Devido à diversidade de apresentações clínicas e dificuldade de reconhecimento de alguns casos, este artigo contribuirá para demonstrar manifestações atípicas e características comuns em pacientes não brancos.

Research Progress on Individual Identification by Frontal Sinus Imaging / 法医学杂志

Frontal sinus imaging is an important research object in forensic individual identification due to the highly specific irregular air cavity shape of frontal sinus, the stability of its shape after maturity, and the wide clinical application of radiology technology. The use of frontal sinus imaging for individual identification has significance in the court. When the application of traditional individual identification methods such as fingerprint identification and DNA analysis are limited or cannot be effectively carried out, or when the corresponding dental records are lacking and in other special cases, individual identification with frontal sinus imaging comparison is an effective alternative. Various types of image data can be used for individual identification with frontal sinus, mainly based on artificial visual comparing. With limitations such as, high professional requirements, low efficiency and small application range, the methods cannot be used in mass disasters. In recent years, some computer image recognition techniques have been used in identification of frontal sinus imagings and can significantly improve the efficiency of recognition. Difficulties such as low manual recognition efficiency may be overcomed. This study summarizes the reports on forensic individual identification using frontal sinus imaging, to review the research progress on individual identification with frontal sinus imaging, to provide a reference for further research on frontal sinus imaging, and to provide ideas for exploration and establishment of a faster, more efficient and more accurate individual identification system.

Vertical Mandibular and Trunk Symmetry in Indonesian Orthodontic Patients

Abstract Objective: To analyze differences in vertical mandibular and trunk symmetry in orthodontic patients. Material and Methods: This was a cross-sectional study of 129 growing orthodontic patients who sought orthodontic treatment at the Dental Hospital Universitas Sumatera Utara, Indonesia. Mandibular symmetry index was observed with pre-treatment panoramic radiography based on Kjellberg's technique and trunk symmetry was evaluated based on questionnaires and visual observation. Vertical mandibular asymmetry was decided if the index of asymmetry was lower than 93.7%. The bivariate analysis used the chi-squared and Fisher's exact tests, with a significance level of 5%. Results: There was a significant association between vertical mandibular and trunk symmetry (p<0.05). The prevalence odds ratio for the association with vertical mandibular asymmetry was 3.007 (95% CI = 1.016-8.905) for trunk asymmetry. Conclusion: The necessity to consider trunk symmetry could be included in orthodontics treatment of any malocclusion with vertical mandibular asymmetry that might require a multidisciplinary approach in the future.

Responsiveness of upper limb scales and trunk control for the evolution of patients with duchenne muscular dystrophy / Responsividade de escalas de membro superior e controle de tronco na evolução de pacientes com distrofia muscular de duchenne

ABSTRACT Objective: To verify the interval of responsiveness to the scales Segmental Assessment of Trunk Control (SATCo-BR), Performance of Upper Limbs (PUL), and Jebsen Taylor Test (JTT) in patients with Duchenne Muscular Dystrophy (DMD). Methods: We assessed patients with DMD aged 6 to 19 years old and with mini-mental (MMSE) score above 10 points. The assessments were performed individually, in a single session. The upper limb function was performed by PUL and JTT, and trunk control by SATCo-BR. Assessments were repeated six and 12 months after the initial assessment. The repeated-measures analysis of variance model and Bonferroni's multiple comparison method were employed as post hoc analysis; when the ANOVA assumptions were not met, the Friedman test was applied. Results: The sample consisted of 28 patients evaluated in three moments (initial, and six and 12 months after the beginning). There was a time effect for the Upper Limb function performance in the total JTT, and for the subtests, except for subtests 1 and 6, which did not show a difference between the different moments. There was also a time effect for the score of total PUL, proximal PUL, intermediate PUL, and distal PUL. In the SATCo-BR, this effect was observed between the initial and 6 months, and between the initial and 12 months. Conclusions: The JTT, PUL, and SATCo-BR scales can detect changes over time, and they showed responsiveness to detect the evolution of the disease in the 6-month interval.

RESUMO Objetivo: Verificar o intervalo de tempo para a responsividade das escalas Segmental Assessment of Trunk Control (SATCo-BR), Performance of Upper Limb (PUL) e o Teste de Função Manual de Jebsen Taylor (TJT) em pacientes com distrofia muscular de Duchenne (DMD). Métodos: Foram avaliados pacientes com DMD nas idades entre 6 e 19 anos, e com escore do Mini Exame do Estado Mental (MEEM) a partir de 10 pontos. As avaliações foram realizadas individualmente, em uma única sessão: a função de membro superior (MS) ocorreu pela PUL e TJT; e da do controle de tronco, pela SATCo-BR. As avaliações foram repetidas após seis e 12 meses da avaliação inicial. Foi empregado o modelo de análise de variância com medidas repetidas e o método de comparações múltiplas de Bonferroni, como análise post hoc; quando os pressupostos da ANOVA não foram atendidos, foi aplicado o teste de Friedman. Resultados: A amostra foi composta por 28 pacientes avaliados em três momentos (inicial, após seis meses e após 12 meses). Houve efeito do tempo no desempenho da função Membro Superior no TJT total e nos subtestes, exceto nos subtestes 1 e 6, que não apresentaram diferença nas avaliações entre os diferentes momentos. Houve efeito do tempo para o escore da PUL total, PUL proximal, PUL intermediário e PUL distal. No SATCo-BR, esse efeito foi entre o inicial e após seis meses, e entre o inicial e após 12 meses. Conclusões: As escalas TJT, PUL e SATCo-BR são capazes de detectar alterações ao longo do tempo, e apresentam responsividade para detectar a evolução da doença em intervalo de 6 meses.

Analysis on the route of conception vessel and governor vessel in / 中国针灸

On the base of the analysis on the original text in

Experimental research on characteristics of temperature field distribution of mild moxibustion and sparrow-pecking moxibustion / 中国针灸

OBJECTIVE@#To explore the temperature field distribution and variation rules during treatment with mild moxibustion and sparrow-pecking moxibustion of TCM.@*METHODS@#Six healthy subjects were selected. Mild moxibustion and sparrow-pecking moxibustion were exerted at Zusanli (ST 36) respectively, for 25 min. Using infrared thermal imaging instrument, the temperature field distribution was measured during moxibustion at Zusanli (ST 36). The simulated thermometer was adopted to measure the temperature field distribution during moxibustion at the imitated cortex. At 20 min of mild moxibustion and sparrow-pecking moxibustion, the temperature field distribution generated by moxibustion was observed at the imitated cortex and Zusanli (ST 36) separately. The temperature values were collected at the sites 0.7, 2.1 and 3.5 cm far from the center of the moxibustion-exerted places successively, and then the characteristics of temperature field distribution and variation rules were compared between different moxibustion methods at the imitated cortex and Zusanli (ST 36).@*RESULTS@#At 20 min of mild moxibustion and sparrow-pecking moxibustion at Zusanli (ST 36), the temperature field distribution focused on the center of moxibustion-exerted site and the temperature was reduced to all directions and illustrated as a curved surface graph, whereas, the temperature field distribution at the imitated cortex was consistent with that at Zusanli (ST 36). With mild moxibustion, the temperature field was distributed uniformly along the longitudinal temperature gradient; whereas, with sparrow-pecking moxibustion, the longitudinal temperature of the temperature field was greatly different, in which, the maximum temperature and the average temperature were higher than those with mild moxibustion respectively and the first time up to the peak value of sparrow-pecking moxibustion was shorter than that with mild moxibustion. The thermal transfer was presented at the non-moxibustion exerted areas during the moxibustion experiment at Zusanli (ST 36).@*CONCLUSION@#A distance feature is presented in the temperature field measured by simulated thermometer and generated under suspension moxibustion at Zusanli (ST 36). The warm stimulation effect of sparrow-pecking moxibustion is much more obvious at the moxibustion-exerted center as compared with mild moxibustion and the area of warm stimulation generated by sparrow-pecking moxibustion is more concentrated as compared with mild moxibustion. The radiation energy produced by suspension moxibustion is scattered and attenuated in skin tissue, resulting in a certain temperature gradient in the temperature field. The warm stimulation generated at skin surface by moxibustion has a warming-dredging effect.

Relação entre o desempenho no teste de salto vertical em água e a velocidade de arremesso da bola em jogadores de polo aquático / Relationship between water vertical jump test and ball speed in the throw to the goal in water polo players

Considerando as técnicas fundamentais do polo aquático (PAq), o objetivo deste estudo foi verificar a existência de relação entre a velocidade da bola após o arremesso à gol (VB) e a altura alcançada em teste vertical realizado dentro da água (HEB) por jogadores recreacionais de PAq. Participaram 13 jogadores de PAq do sexo masculino (idade: 30,4 ± 6,5 anos, massa corporal de 81,4 ± 9,9 kg, estatura de 1,78 ± 0,05 m e envergadura de 1,81 ± 0,06 m). VB foi mensurada com radar e HEB com videogrametria. Resultados: VB foi de 15,8 ± 1,4 m∙s -1 e HEB foi de 128,0 ± 12,0 cm. Encontrou-se correlação positiva, forte e significativa (r = 0,71 e p = 0,004) entre a VB e a HEB. Jogadores recreacionais adultos de polo aquático tem desempenho no teste de velocidade da bola e no de salto vertical na água próximos ou abaixo daquele apresentado por jogadoras de elevado nível de desempenho e atletas mais jovens de bom desempenho.(AU)

Considering the fundamental techniques of water polo (WP), the aim of this study was to verify the existence of a relationship between the speed of the ball in the throw to the goal (SB) and the height reached in vertical test performed in water (HEB) by WP players. Thirteen WP male players participated (age: 30.4 ± 6.5 years, body mass 81.4 ± 9.9 kg, height 1.78 ± 0.05 m and wingspan of 1.81 ± 0, 06 m). SB was measured with radar and HEB with videogrammetry. Results: SB was 15.8 ± 1.4 m∙s -1 and HEB was 128.0 ± 12.0 cm. Positive, strong and significant correlation (r = 0.71 and p = 0.004) between SB and HEB was found. Adult male recreational water polo players perform the throw to the goal and the vertical jump near or below that of high-performance female players and younger but high-level athletes.(AU)

Exploring of the Mechanism of Rib Fracture Caused by Landing on Different Parts of the Trunk after Falls from Height Using Finite Element Method / 法医学杂志

Objective To study the mechanism of rib fracture caused by landing on different parts of the trunk using finite element method, and to provide some new techniques and new ideas for the reconstruction of the whole process of falls from height. Methods The finite element method was used to study the rib fracture of human security model THUMS4.0 caused by landing on different parts of the trunk. Then the model was compared with actual cases and the mechanism of rib fracture caused by falls from height was analyzed from a biomechanical point of view. Results There were some differences in the stress and strain distribution as well as the rib fracture sites when different parts touched the ground. Ribs on both sides of the body were fractured when the front of the trunk touched the ground, and the fractures were mainly located in the junction of the ribs and costal cartilage and the midaxillary line area. When the right anterior part of the trunk touched the ground, rib fracture occurred first on the side that touched the ground, and rib fractures were mainly located in the area from the right midaxillary line to the posterior axillary line, and junction of ribs on both sides and costal cartilage. When the back of the trunk touched the ground, the fracture sites were mainly located on the back of the ribs on both sides. When the right posterior part of the trunk touched the ground, multiple rib fractures were likely to occur in the parts that touched the ground. The plastic strains were mainly concentrated at the fracture sites, while the von Mises stresses were not only concentrated at the fracture sites, but also at other sites. Conclusion There are some differences in rib fracture location sites and injury mechanisms when different parts of the trunk touch the ground.

Comparación entre los melanomas de cabeza y cuello con los de tronco y extremidades / Comparison between head and neck melanomas with trunk and extremity melanomas

Antecedentes: los melanomas en cabeza y cuello (MCC) han sido asociados con factores pronósticos diferentes de aquellos en otras localizaciones. Objetivo: comparar características demográficas, clínicas y resultados del tratamiento quirúrgico de pacientes con MCC y pacientes con melanomas en tronco y extremidades (MTE). Material y métodos: se llevó a cabo una revisión retrospectiva de las historias clínicas de pacientes operados por melanoma entre enero de 2012 y diciembre de 2017. Quince pacientes (22,3%) tuvieron MCC y 52 (77,7%) MTE. Resultados: ambos grupos tuvieron edad similar (63,8 ± 21,1 versus 58,5 ± 16), pero los MCC mostraron una tendencia con predominio masculino (80% versus 61,3%). Los MCC tuvieron menor espesor tumoral que los MTE (2,07 versus 5,5 mm) y mayor porcentaje de melanoma in situ, 5 (33,3%) versus 8 (15,3%), pero requirieron vaciamientos ganglionares más a menudo (33% versus 25%) así como reconstrucción del defecto primario con colgajos locales y miocutáneos. Durante el seguimiento, en el grupo de MCC, dos pacientes desarrollaron recidivas locales que fueron extirpadas, y otros tres desarrollaron metástasis a distancia en pulmón, intestino delgado y abdomen y fallecieron por la enfermedad; en el grupo de MTE un paciente tuvo recidiva local y cinco fallecieron de metástasis sistémicas. El tamaño de la muestra no permitió aplicar pruebas de significación entre las diferencias encontradas. Conclusión: los MCC se presentan en un amplio rango de edad y estadios, y tuvieron algunas diferencias clínicas con el MTE. Los defectos producidos por la extirpación de la lesión primaria requieren procedimientos reconstructivos más complejos la mayoría de las veces y se aconseja un abordaje multidisciplinario.

Background: Head and neck melanomas (HNMs) have been associated with prognostic factors different from those on other locations. Objective: The goal of the present study was to compare the demographic and clinical characteristics and the outcomes of surgical treatment between patients with HNM and those with trunk and extremity melanoma (TEM). Material and methods: The clinical records of patients undergoing surgery for melanoma between October 2014 and April 2018 were retrospectively reviewed. Fifteen patients (22.3%) had HNM and 52 (77.7) presented TEM. Results: There were no differences in age between both groups (63.8 ± 21.1 versus 58.5 ± 16), but there was a trend toward higher percentage of men in the HNM group (80% versus 61.3%). Patients with HNM had lower tumor thickness than those with TEM (2.07 versus 5.5 mm), higher incidence of melanoma in situ [5 (33.3%) versus 8 (15.3%)]; lymph node resection was more common (33% versus 25%) as well as reconstruction of the primary defect with local and musculocutaneous flaps. During follow-up, two patients in the HNM group developed local recurrences that were excised and three presented distant metastases in the lung, small bowel and abdomen and finally died due to the disease. In the TEM group, one patient had local recurrence and five died due to systemic metastases. The sample size was not sufficient to assess statistically significant differences. Conclusion: Head and neck melanomas occur in a wide age range and stages and has some clinical differences with TEM. The defects produced after the excision of the primary lesion often require more complex procedures and should be managed with a multidisciplinary approach.

Effect of horse riding equipment in activity of trunk and lower limb muscles in equine-assisted therapy

Equine-assisted therapy uses the horse in rehabilitation and/or education of people, such as Down syndrome(SD), cerebral palsy(PC)and intellectual disability(DI). In context, the rehabilitation program and horse riding equipment should be usedaccording to the specific characteristics of each individual, becoming an ally in the quest for excellence in equine-assisted therapy programs. The aim was to evaluate the effect of riding equipment used in equine-assisted therapy on the muscular activityof trunk and lower limb of individuals with SD, PC and DI. The study included 15 individuals equally assigned to each group: SD, PC and DIwith a mean age of 16.2 (±1.10), 16 (±1.22)e 16 (±0) years,respectively. The analysis of muscle activity was performed through surface electromyography, using four variations of horse riding equipment: saddle with and without feet supported on the stirrups and blanket with and without feet supported on the stirrups. Sigma Stat 3.5®software was used for statistical analysis.The Shapiro Wilk's test was used for normality of the data, the Bartlett test for homogeneity of the variances and the Kruskal-Wallis test for repeated measures with no normal distribution.Statistically significant differences were observed forp<0.05.The SDgroup presented a greater muscular activity of trunk and lower limbs with blanket equipment without the feet supported in the stirrups (H = 15.078, p = 0.002), as in the DI group (H=8.302, p = 0.040), while inPCgroup was the saddle with feet supported in the stirrups (H=11.137,p = 0.011). The choice of riding equipment used in equine-assisted therapy interferes differently in the pattern of muscular activation of the trunk and the lower limbs, according to the pathological processes of the practitioners. It should be an important aspect to consider when planninga treatment.

Isokinetic evaluation of the trunk muscle strength in housewives with fibromyalgia: a cross-sectional study

Abstract Background: It is known that physical activity and muscular performance are reduced in fibromyalgia (FM) syndrome. This study aims to compare the performance of trunk muscles in women with FM and healthy controls and evaluate the correlation between trunk muscle strength and FM severity. Methods: Forty-six patients with FM and 42 age- and body mass index-matched healthy housewives without FM were included in the FM and control groups, respectively. The Fibromyalgia Impact Questionnaire (FIQ) was used for the assessment of FM severity. The pain intensity was evaluated using the visual analogical scale (VAS). An isokinetic dynamometer was used to measure the isokinetic trunk muscle strength. The peak torque (PT) values were recorded. The psychological status of the patients was evaluated using the Beck Depression Inventory. Results: There was no statistically significant difference in terms of age, BMI, and BDI scores in two groups (p > 0.05, for all). The isokinetic trunk extensor PT values were significantly lower in the FM group (p = 0.002 for 60°/s, and p < 0.001 for 90°/s and 120°/s) than control group. There was a statistically significant negative correlation between FIQ score and isokinetic extensor muscle parameters. Conclusion: The results indicate that trunk extensor muscles were significantly weaker in FM patients. Trunk extensor muscle strength decreased as FM severity increased in FM patients.(AU)

Trastornos músculo-esqueléticos como factor de riesgo ergonómico en trabajadores de la Empresa Eléctrica de Riobamba / Musculoskeletal disorders as an ergonomic risk factor in workers of Riobamba's Electric Company

Introducción: los trastornos músculo-esqueléticos ocupacionales en el sector laboral eléctrico han generado gran interés a nivel mundial desde hace décadas. Objetivo: la presente investigación tuvo como objetivo aportar conocimientos acerca de la frecuencia de afecciones músculo-esqueléticas relacionadas con factores de riesgo ergonómicos, en trabajadores de la Empresa Eléctrica de Riobamba. Metodología: se llevó a cabo un estudio descriptivo y transversal con enfoque cuali-cuantitativo, lo cual permitió analizar el objeto de estudio en su contexto real. La muestra estuvo constituida por 271 trabajadores, con edades de 22 a 58 años. La información obtenida se contrastó con estudios relacionados, encontrados a partir del uso de motores de gestión informativa convencionales y la revisión documental in situ. Resultados: la mayoría de los sujetos estudiados (63%) desarrolló algún trastorno músculo esquelético. Predominó el sexo masculino (65%) y el lumbago representó la afección más frecuente (30%). El segmento anatómico más afectado fue el tronco (17%). Conclusiones: el lumbago resultó ser una condición frecuente que afectó mayormente a trabajadores del sexo masculino y que se desempeñaban como linieros. Por la importancia de los resultados encontrados se sugirió a la Empresa reforzar las intervenciones preventivas y de vigilancia epidemiológica para evitar y detectar tempranamente los trastornos músculo-esqueléticos en sus empleados.