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1.
Rev. baiana saúde pública ; 45(Supl. Especial 2): 39-47, 2021/12/28.
Article in English | LILACS | ID: biblio-1352323

ABSTRACT

Hyperbaric Oxygen Therapy (HBOT) assumes that high pressure hyperoxygenation causes faster tissue recovery and wound healing. Lower extremity flow rates are affected by leg ulcers that change vasodilation, microcirculation resistance, and local tissue demands; how blood hyper oxygenation influences these factors is still unclear. Peripheral arterial occlusive disease (PAOD) has been mostly associated with HBOT results in the femoral artery than in other arteries. Common femoral artery (CFA) peak systolic velocities (PSV), measured pre and post HBOT, were analyzed to research HBOT hemodynamics. Sixteen patients with leg ulcers who were 65 ± 11 (SD) (38-87) years-old, had HBOT of 90 minutes at 2.6 ATA. Bilateral CFA Doppler velocity waveforms were recorded immediately pre and post HBOT. Ulcerated vs non-ulcerated peak systolic velocity (PSV) data were compared using paired t-test. CFA PSV were significantly equal in the ulcerated and non-ulcerated extremities before HBOT: 114 ± 35 (SD) cm/s vs 116 ± 41 cm/s (p = 0.87 by paired t-test). CFA PSV in the ulcerated extremity increased to 122 ± 35 cm/s after HBOT but were statistically insignificant (p =.19 by one-tailed paired t-test). On the other hand, CFA PSV decreased to 103 ± 28 cm/s (p =.049 by one-tailed paired t-test) in the non-ulcerated extremity and were significantly lower after HBOT, with 103 ± 28 cm/s vs 122 ± 35 cm/s for the ulcerated limb (p =.02 by paired t-test). Blood velocity responses post HBOT showed differences between ulcerated vs non-ulcerated extremities. The non-ulcerated extremity apparently responded to oxygenation more than the ulcerated extremity. Such observation suggests further research on hemodynamic reactions caused by HBOT.


A oxigenoterapia hiperbárica (HbOT) assume que a oxigenação de alta pressão resulta em mais celeridade na recuperação do tecido e na cicatrização de feridas. As taxas de fluxo nas extremidades inferiores são afetadas por úlceras nas pernas que alteram a vasodilatação, a resistência da microcirculação e as demandas locais de tecido; esses fatores podem ser influenciados pela hiperoxigenação sanguínea de maneiras ainda não claramente compreendidas. A doença arterial oclusiva periférica femoral (DAOP) tem sido associada a melhores resultados de HBOT quando comparada a outras artérias. As velocidades sistólicas de pico (PSV) da artéria femoral comum (CFA) medidas antes e depois da HBOT foram analisadas como parte de um projeto de pesquisa da hemodinâmica da HBOT. Dezesseis pacientes com úlceras de perna, com idade 65 ± 11 (DP), 38-87 anos, realizaram HBOT com duração de 90 minutos a 2,6 ATA. As formas de onda de velocidade do Doppler CFA bilateral foram registradas imediatamente antes e depois da HBOT. Os dados de PSV ulcerado vs. não ulcerado foram comparados usando o teste t pareado. Pre HBOT CFA PSV não foi significativamente diferente nas extremidades ulceradas e não ulceradas: 114 ± 35 (DP) cm/s vs 116 ± 41 cm/s (p = 0,87 pelo teste t pareado). O PSV pós HbOT CFA na extremidade ulcerada aumentou para 122 ± 35 cm/s, mas não atingiu significância estatística (p = 0,19 pelo teste t pareado unicaudal). Em contraste, CFA PSV na extremidade não ulcerada diminuiu para 103 ± 28 cm/s (p = 0,049 pelo teste t pareado unicaudal). O pós-HbOT CFA PSV foi significativamente menor no membro não ulcerado, 103 ± 28 cm/s vs 122 ± 35 cm/s para o membro ulcerado (p = 0,02 pelo teste t pareado). As respostas da velocidade do sangue após HbOT mostraram diferenças entre as extremidades ulceradas e não ulceradas. Aparentemente, a extremidade não ulcerada respondeu mais significativamente à oxigenação do que a extremidade ulcerada. Tal observação sugere pesquisas adicionais sobre as reações hemodinâmicas decorrentes da HbOT.


La terapia de oxígeno hiperbárico (HbOT) asume que la hiperoxigenación a alta presión da como resultado una recuperación más rápida de los tejidos y una cicatrización de heridas. Las tasas de flujo de las extremidades inferiores se ven afectadas por úlceras en las piernas que alteran la vasodilatación, la resistencia de la microcirculación y las demandas de los tejidos locales; estos factores pueden verse influenciados por la hiperoxigenación de la sangre, de formas que aún no se han entendido con claridad. La enfermedad oclusiva arterial periférica femoral (PAOD) se ha relacionado con los mejores resultados de HbOT que otras arterias. Las velocidades sistólicas máximas (PSV) de la arteria femoral común (CFA) medidas antes y después de la HbOT se analizaron como parte de un proyecto para investigar la hemodinámica de la HbOT. Dieciséis pacientes con úlceras en pierna, 65 ± 11 (DE) (38-87) años, 12 hombres, 11 diabéticos, tenían HbOT de 90 minutos a 2,6 ATA. Se registraron formas de onda de velocidad de CFA Doppler bilaterales inmediatamente antes y después de la HbOT. Se compararon los datos de la velocidad sistólica máxima (PSV) ulcerada frente a la no ulcerada mediante la prueba t pareada. Pre HbOT CFA PSV no fue significativamente diferente en las extremidades ulceradas y no ulceradas: 114 ± 35 (DE) cm/s vs 116 ± 41 cm/s (p = 0,87 por prueba t pareada). Post HbOT CFA PSV en la extremidad ulcerada aumentó a 122 ± 35 cm/s pero no alcanzó significación estadística (p =.19 por prueba t unilateral pareada). En contraste, CFA PSV en la extremidad no ulcerada disminuyó a 103 ± 28 cm/s (p =.049 por prueba t unilateral pareada). El PSV después de la HbOT CFA fue significativamente menor en la extremidad no ulcerada, 103 ± 28 cm/s frente a 122 ± 35 cm/s para la extremidad ulcerada (p = 0,02 según la prueba t pareada). Las respuestas de velocidad sanguínea post HbOT mostraron diferencias entre las extremidades ulceradas y no ulceradas. Aparentemente, la extremidad no ulcerada respondió más significativamente a la oxigenación que la extremidad ulcerada. Tal observación sugiere una mayor investigación sobre las reacciones hemodinámicas debidas a la HbOT.


Subject(s)
Femoral Artery , Hyperbaric Oxygenation , Leg , Leg Ulcer
2.
Rev. bras. ortop ; 55(6): 736-741, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1156197

ABSTRACT

Abstract Objective To describe and demonstrate the outcomes of the modified Monteiro (1991) technique for lower limb reconstruction with a fasciocutaneous flap of the distal pedicle in a series of 15 cases. Method We present the technique and outcomes from a series of 15 cases of the modified technique using a fasciocutaneous flap of the distal pedicle to repair the lower third of the leg and the foot. Results Outcomes were satisfactory since these flaps provided good cutaneous and subcutaneous tissue coverage in cases with bone exposure and skin loss. The donor area was closed 3 days after surgery with a partial skin graft to provide better graft viability. Conclusion The fasciocutaneous flap of the distal pedicle proved to be a good option for reconstruction of the middle and lower thirds of the leg, offering good bone coverage.


Resumo Objetivo Descrever e demonstrar o desfecho da técnica modificada de Monteiro (1991) para a reconstrução do membro inferior com retalho fasciocutâneo de pedículo distal numa série de 15 casos. Método Com uma série de 15 casos, apresentamos a técnica e o desfecho da técnica modificada do retalho fasciocutâneo de pedículo distal com para a reparação do terço inferior da perna e do pé. Resultados Os resultados foram satisfatórios porque os retalhos proporcionaram boa cobertura de pele e tecido celular subcutâneo nos casos de exposição óssea e perda cutânea. A área doadora foi fechada 3 dias após a cirurgia, com enxerto de pele de espessura parcial, proporcionando uma melhor viabilidade do enxerto. Conclusão O retalho fasciocutâneo de pedículo distal mostrou-se como uma boa opção para a reconstrução do terço médio e inferior da perna, oferecendo boa cobertura óssea.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Surgical Flaps , Tissue Donors , Bereavement , Skin Transplantation , Lower Extremity , Fascia , Foot , Leg
4.
Rev. habanera cienc. méd ; 19(4): e3129, ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1139177

ABSTRACT

RESUMEN Introducción: La insuficiencia venosa crónica es el conjunto de síntomas y signos derivados de una hipertensión venosa en los miembros inferiores debido a un mal funcionamiento valvular de los sistemas venosos. Se han asociado varias complicaciones a esta entidad, una de ellas es el pseudosarcoma de Kaposi, enfermedad rara y caracterizada por una proliferación reactiva vascular, con lesiones cutáneas similares a las del sarcoma de Kaposi. Objetivo: Describir el proceso diagnóstico de una paciente con pseudosarcoma de Kaposi tipo Mali unilateral como complicación de la insuficiencia venosa crónica. Presentación del caso: Se presenta una paciente femenina, piel blanca, de 51 años de edad, con lesiones cutáneas de aproximadamente 9 años de evolución, tipo placas eritematomarronáceas y papuloescamocostrosas, en el miembro inferior derecho, que progresivamente fueron extendiéndose; la paciente presentaba además insuficiencia venosa crónica. Se diagnosticó pseudosarcoma de Kaposi tipo Mali unilateral, teniendo en cuenta, fundamentalmente, los antecedentes patológicos personales, el examen clínico realizado, la biopsia de la lesión, la inmunohistoquímica para anticuerpos CD 34 y el dúplex venoso de miembro inferior derecho. Se indicó terapia compresiva de la extremidad y ungüento esteroideo en lesiones, con mejoría de estas. Conclusiones: Una de las complicaciones asociadas a la insuficiencia venosa crónica es el pseudosarcoma de Kaposi. En esta rara entidad cutánea el estudio histopatológico y la inmunohistoquímica desempeñan un papel muy importante para su correcto diagnóstico y diferenciación del sarcoma de Kaposi, principal diagnóstico diferencial a tener en cuenta(AU)


ABSTRACT Introduction: Chronic venous insufficiency is the set of symptoms and signs derived from venous hypertension in the lower limbs due to a valvular malfunction of the venous system. Several complications have been associated with this entity; one of them is Pseudo-Kaposi's sarcoma, a rare disease characterized by reactive vascular proliferation with skin lesions similar to those of Kaposi's sarcoma. Objective: To describe the diagnostic process of a patient with unilateral Mali-type Pseudo-Kaposi's sarcoma as a complication of chronic venous insufficiency. Case presentation: Fifty-one-year-old white female patient with about 9-year history of brownish erythematosus-type and squamous, crusty plaque-like skin lesions in the right lower limb that were progressively extending. The patient also presented chronic venous insufficiency. Unilateral Mali-type Pseudo-Kaposi's sarcoma was diagnosed, mainly considering the personal pathological antecedents, the clinical examination performed, the biopsy of the lesion, the immunohistochemistry for CD34 antibodies and the venous duplex imaging of the right lower limb. Compressive therapy of the limb and steroid ointment was indicated for the lesions, with improvement of the condition. Conclusions: Pseudo-Kaposi's sarcoma is one of the complications associated with chronic venous insufficiency. In this rare skin entity, the histopathological study and immunohistochemistry play a very important role in the correct diagnosis and differentiation of Kaposi's sarcoma, being this the main differential diagnosis to take into account(AU)


Subject(s)
Humans , Female , Middle Aged , Sarcoma, Kaposi/etiology , Skin Neoplasms/etiology , Venous Insufficiency/complications , Leg
5.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(2): 147-150, jun. 2020. []
Article in Spanish | LILACS, BINACIS | ID: biblio-1125552

ABSTRACT

La flegmasia cerúlea dolens es una presentación poco habitual y grave de una trombosis venosa profunda producida por una obstrucción al flujo venoso de salida de la extremidad inferior, que conlleva un alto grado de morbilidad. Este cuadro no ha sido comunicado como complicación del tratamiento definitivo de una fractura de pelvis. Consideramos que una breve descripción del tema y la presentación de un caso pueden ser útiles para el cirujano ortopédico ante una situación similar. Nivel de Evidencia: IV


Phlegmasia cerulea dolens (PCD) is an unusual and serious presentation of deep venous thrombosis (DVT) caused by an obstruction to the venous outflow of the lower limb, which is associated with significant morbidity. To our knowledge, this complication has not yet been reported as a complication of the definitive treatment of a pelvic fracture. We believe that a brief description of the subject matter and the description of the case may be useful to Orthopedic surgeons in similar situations. Level of Evidence: IV


Subject(s)
Middle Aged , Pelvis/injuries , Postoperative Complications , Acute Disease , Venous Thrombosis , Fractures, Bone , Leg/pathology , Anticoagulants/therapeutic use
6.
Arq. neuropsiquiatr ; 78(3): 139-142, Mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1098076

ABSTRACT

Abstract Many people have a habit of moving their legs and believe that this behavior is due to the restless legs syndrome (RLS), a highly prevalent neurological condition that greatly impairs the quality of life of affected individuals. This behavioral pattern, characterized by the habit of moving one's legs and feet, may be an important confounding factor in the diagnosis of RLS. Objective: To describe the main movements associated with this benign behavioral state to characterize a possible clinical condition that can contribute to the differential diagnosis of RLS. Methods: Experienced sleep specialists, who primarily see RLS patients listed the most frequent movements people without RLS report while describing their suspected RLS. We first compiled a list of the lower-limb movements described by the specialists. Then, one of the authors (KC) carried out all movements of the list on camera to obtain a video footage. This footage was sent to one of the authors, EPC, who, alongside a group of students, drew graphic representations (cartoons) of the recorded movements. Results: The panel of sleep experts described 13 leg movements commonly reported by their patients. The experts reported 11 simple movements and two combined movements. Conclusion: In this study we developed an instrument that allows us to oppose and distinguish a pathological condition (RLS) from a behavioral phenomenon. This state of behavioral leg fidgeting needs to be better characterized and may eventually be recognized as a clinical entity per se.


Resumo Muitas pessoas têm o hábito de movimentar as pernas e acreditam que esse comportamento decorre da Síndrome das Pernas Inquietas (SPI), uma condição neurológica altamente prevalente com grande impacto na qualidade de vida dos indivíduos acometidos. Esse padrão de comportamento, caracterizado pelo costume de mover as pernas e os pés, pode ser um importante fator confundidor no diagnóstico da SPI. Objetivo: Descrever os principais movimentos associados a esse estado comportamental benigno, com a finalidade de caracterizar uma eventual condição clínica que possa contribuir para o diagnóstico diferencial da SPI. Métodos: Especialistas em distúrbios do sono, que atendem principalmente pacientes com SPI, listaram os movimentos que as pessoas sem SPI reportam com maior frequência enquanto descrevem a sua suspeita de síndrome. Elaboramos uma lista de movimentos dos membros inferiores descritos pelos especialistas e um dos autores (KC) realizou esses movimentos para que fossem gravados em vídeo. Essa filmagem foi enviada ao autor EPC, que, em conjunto com um grupo de alunos, realizou a representação gráfica (cartoon) dos movimentos gravados. Resultados: Os especialistas reportaram 13 movimentos de pernas, sendo 11 movimentos simples e dois movimentos combinados. Conclusão: Neste estudo, elaboramos um instrumento que permite opor, com a finalidade de diferenciá-las, uma condição patológica (SPI) de um fenômeno comportamental. Esse estado de inquietude comportamental das pernas necessita ser mais bem caracterizado, podendo eventualmente vir a ser reconhecido como uma entidade clínica per se.


Subject(s)
Humans , Quality of Life , Restless Legs Syndrome/psychology , Cartoons as Topic , Leg , Movement
7.
Rev. Col. Bras. Cir ; 47: e20202481, 2020. tab, graf
Article in English | LILACS | ID: biblio-1136536

ABSTRACT

ABSTRACT Endovascular treatment for femoropopliteal arterial disease has made revascularization procedures less invasive, but the self-expanding stents used can suffer great wear in arteries with extreme mobility. Objective: to evaluate the prevalence of fractures in stents implanted in the femoropopliteal segment, to identify predisposing factors and consequences on arterial patency. Method: between March and June 2019, thirty patients previously operated for femoropopliteal obstruction underwent stent X-rays in anteroposterior and lateral views to detect fractures and Doppler to analyze arterial patency. Results: we observed 12 cases with fractures (33.3%): 1 type I (2.8%), 3 type II (8.3%), 5 type III (13.9%), 3 type IV (8.3%) and no type V. According to the TASC II we had 1 in group B (8.3%), 6 in group C (50%) and 5 in group D (41.6%) p <0.004. The number of stents per limb was 3.1 (± 1.3) in cases of fracture versus 2.3 (± 1.3) in cases without fracture (p = 0.08). The extension was 274.17mm (± 100.94) in cases of fracture and 230.83mm (± 135.44) in cases without fracture (p = 0.29). On Doppler we had: 17 patients (47.2%) without stenosis, 9 patients (25%) with stenosis> 50% and 10 patients (27.8%) with occlusion (p = 0.37). There was no correlation between fracture and arterial obstruction (p = 0.33). Conclusion: stent fractures are a frequent finding in the femoropopliteal area (33.3%), being more prevalent in cases of more advanced disease (C and D). There was no association between the finding of fracture and arterial obstruction.


RESUMO Os tratamentos endovasculares para a doença arterial obstrutiva fêmoro-poplítea tornaram os procedimentos de revascularização menos invasivos, porém os stents metálicos autoexpansíveis utilizados podem sofrer grande desgaste em artérias com extrema mobilidade. Objetivo: avaliar a prevalência de fraturas em stents implantados no segmento fêmoro-poplíteo, identificar fatores predisponentes e possíveis consequências sobre a patência arterial. Métodos: entre março a junho de 2019, trinta pacientes previamente operados por obstrução fêmoro-poplítea realizaram RX dos stents em incidências ântero-posterior e perfil para detectar fraturas e eco Doppler para analisar a patência arterial. Resultados: observamos 12 casos com fraturas (33,3%): 1 do tipo I (2,8%), 3 do tipo II (8,3%), 5 do tipo III (13,9%), 3 do tipo IV (8,3%) e nenhuma tipo V. Segundo a classificação TASC II, tivemos 1 no grupo B (8,3%), 6 no grupo C (50%) e 5 no grupo D (41,6%) p<0,004. O número de stents por membro foi de 3,1 (±1,3) nos casos de fratura contra 2,3 (±1,3) nos casos sem fratura (p = 0,08). A extensão tratada foi 274,17mm (±100,94) nos casos de fratura e 230,83mm (±135,44) nos casos sem fratura (p=0,29). No Doppler tivemos: 17 pacientes (47,2%) sem estenose, 9 pacientes (25%) com estenose>50% e 10 pacientes (27,8%) com oclusão (p=0,37). Não houve correlação entre fratura e obstrução arterial (p=0,33). Conclusão: as fraturas de stents são um achado frequente no setor fêmoro-poplíteo (33,3%) sendo mais prevalentes nos casos de doença mais avançada TASC II C e D. Não houve associação entre o achado de fratura e obstrução arterial.


Subject(s)
Humans , Popliteal Artery , Prosthesis Failure , Stents , Peripheral Vascular Diseases/therapy , Ultrasonography, Doppler, Color/methods , Peripheral Arterial Disease , Endovascular Procedures/methods , Prosthesis Design , Vascular Patency , Prevalence , Retrospective Studies , Risk Factors , Treatment Outcome , Peripheral Vascular Diseases/diagnostic imaging , Leg/blood supply
9.
Article in Korean | WPRIM | ID: wpr-811247

ABSTRACT

Restless legs syndrome (RLS) is a neurological sleep disorder characterized by an urge to move the legs or arms and is associated with discomfort and paresthesia in the legs. RLS is diagnosed based on the clinical symptoms, and polysomnography is performed to quantify the periodic limb movements during sleep or in patients who undergo the suggested immobilization test. Determining the cause of RLS is important for accurately diagnosing and evaluating this condition. The treatment of RLS varies according to the etiology, severity, and frequency of the patients' symptoms. Accurate identification and treatment of the cause of RLS are important in patients with secondary RLS. Iron supplementation could be useful in patients with uremia, iron deficiency, and for RLS during pregnancy. Dopamine agonists have been used as the first-line treatment for primary RLS. On the other hand, augmentation is a known adverse effect associated with the long-term use of dopamine agonists. Therefore, recent treatment guidelines recommend the administration of anticonvulsants, such as pregabalin and gabapentin, to treat RLS. Iron, opioids, or benzodiazepines may be useful in patients refractory to anticonvulsants or dopamine agonists. RLS is a chronic condition. Therefore, it is essential to establish a long-term treatment plan, considering both the efficacy and adverse effects of therapeutic agents used in patients.


Subject(s)
Analgesics, Opioid , Anticonvulsants , Arm , Benzodiazepines , Diagnosis , Dopamine Agonists , Extremities , Hand , Humans , Immobilization , Iron , Leg , Paresthesia , Polysomnography , Pregabalin , Pregnancy , Restless Legs Syndrome , Sleep Wake Disorders , Uremia
10.
Article in English | WPRIM | ID: wpr-811205

ABSTRACT

BACKGROUND: This study evaluated the efficacy of three intraoral topical anesthetics in reducing the injection needle prick pain from local anesthetic among children aged 7–11 years old.METHODS: It is a prospective, Interventional, parallel design, single-blind, randomized clinical trial in which subjects (n=90) aged 7–11 years were included in the study based on an inclusion criteria. Subjects were divided into three groups based on computer-generated randomization with an allocation ratio of 1:1:1. Groups A, B, and C received benzocaine 20% jelly (Mucopain gel, ICPA health products Ltd, Ankleshwar, India), cetacaine anesthetic liquid (Cetylite Industries, Inc, Pennsauken, NJ), and EMLA cream (2% AstraZeneca UK Ltd, Luton, UK), respectively, according to manufacturer's instructions, for 1 minute prior to local anesthetic injection. After application of topical anesthetic agent, for all the groups, baseline pre-operative (prior to topical anesthetic administration) and post-operative scores (after local anesthetic administration) of pulse rate was recorded using Pulse oximeter (Gibson, Fingertip Pulse Oximeter, MD300C29, Beijing Choice Electronic). Peri-operative (i.e., during the administration of local anesthesia) scores were recorded using Face, Legs, Activity, Cry, Consolability (FLACC) Scale, Modified Children hospital of Eastern Ontario Pain Scale (CPS) behavior rating scale, and Faces Pain Scale (FPS-R) – Revised (For self-reported pain). Direct self-reported and physiological measures were ascertained using FPS-R – Revised and Pulse oximeter, respectively, whereas CPS and FLACC scales assessed behavioral measures. To test the mean difference between the three groups, a one way ANOVA with post hoc tests was used. For statistical significance, a two-tailed probability value of P < 0.05 was considered as significant.RESULTS: The Cetacaine group had significantly lower pain scores for self-report (P < 0.001), behavioral, and physiological measures (P < 0.001) than the other two groups. However, there was no significant difference between the Benzocaine group and EMLA group during palatal injection prick.CONCLUSION: Cetacaine can be considered as an effective topical anesthetic agent compared to benzocaine 20% jelly (Mucopain gel) and EMLA cream.


Subject(s)
Anesthetics , Behavior Rating Scale , Beijing , Benzocaine , Child , Clinical Study , Heart Rate , Humans , Leg , Needles , Ontario , Palate , Prospective Studies , Random Allocation , Weights and Measures
11.
Article in English | WPRIM | ID: wpr-811186

ABSTRACT

BACKGROUND: The purpose of this study was to identify the characteristics of appendicular lean mass (ALM) associated with rheumatoid arthritis (RA) and to analyze appendicular tissue components in patients with RA.METHODS: We prospectively reviewed of patients with RA who underwent dual energy X-ray absorptiometry in a single center. From data of 28 patients, ALM was calculated. Regression analysis was used to investigate the association between ALM and RA. Using propensity score matching, patients with RA were compared to the control group from 18,698 patients of Korea National Health and Nutrition Examination Surveys data. RA and control group were matched in a 1: 5, respectively.RESULTS: In regression model, there was significantly negative association between disease activity score and ALM index in patients with RA in unadjusted (β=−0.387, 95% confidence interval [CI], −0.729 to −0.045) and model adjusted for age, sex, and body mass index (β=−0.227, 95% CI, −0.451 to −0.003). In matching with age and sex, the arms fat mass and fat fraction of RA group were significantly lower than that of control group. In matching with age, sex, and body mass index, the ALM index and legs lean mass of RA group were significantly higher than control group.CONCLUSIONS: Patients with RA have a lower ALM with higher disease activity. In addition, we found that patients with RA had different tissue component in arms and legs compared to general population.


Subject(s)
Absorptiometry, Photon , Adiposity , Arm , Arthritis, Rheumatoid , Body Composition , Body Mass Index , Humans , Korea , Leg , Propensity Score , Prospective Studies
12.
Actual. osteol ; 15(3): 192-204, Sept-Dic. 2019. graf, ilus, tab
Article in English | LILACS | ID: biblio-1104327

ABSTRACT

Blocking of the growth plate (GP) using plates with screws (tension band plating) is a modern method used to correct deformities and moderate leg length discrepancy in growing children. Determining the duration of temporary bilateral blocking without the occurrence of irreversible changes of GP is of paramount importance important. Methods: Two-month-old Californian breed male rabbits (n=30) were exposed to bilateral blocking of the distal GP of the right femur locking plates with screws for 3, 5, and 7 weeks. The fixators were removed after 5 and 7 weeks in 18 rabbits and 3 weeks after that, animals were sacri!ced. The contralateral limb was used as a control. Histological, histomorphometric, and X-ray analyses were performed. Results: During GP blocking, its height gradually decreased. This decreased was more pronounced after 7 weeks. Destructive changes progressed with an increase in the blocking duration. Three weeks after discontinuation of the bilateral blocking that lasted 5 weeks, the height of the GP signi!cantly increased 1.2 times on the lateral side and 1.9 times on the medial side (p<0.001) compared to the control. When blocking was discontinued after 7 weeks, the structure of the GP was partially restored after 3 weeks, the height of GP signi!cantly increased 1.2 times on the lateral side, and 1.07 times on the medial side (p<0.01) compared to the control. Conclusion: Restoration of the structuralfunctional features of the GP after the removal of the plates depends on the duration of temporary bilateral blocking, which must be taken into account in the clinical setting. (AU)


El bloqueo de la placa de crecimiento (PC) utilizando placas con tornillos (banda de tensión) es un método moderno utilizado para corregir deformidades y alteraciones moderadas en la longitud de las piernas en niños en crecimiento. Es de suma importancia determinar cuál debe ser la duración del bloqueo bilateral temporal sin que ocurran cambios irreversibles en la PC. Métodos: Conejos machos de raza californiana de dos meses de edad (n = 30) fueron expuestos al bloqueo bilateral de la PC distal colocando placas del fémur derecho con tornillos durante 3, 5 y 7 semanas. Los fijadores fueron retirados después de 5 y 7 semanas en 18 de los conejos, y 3 semanas después los animales fueron sacrificados. La extremidad contralateral se utilizó como control. Se realizaron análisis histológicos, histomorfométricos y de rayos X. Resultados: Durante el bloqueo de la PC, su altura disminuyó gradualmente. Esta disminución fue más pronunciada después de 7 semanas. Los cambios destructivos se incrementaron a medida aumentaba la duración del bloqueo. Tres semanas después de la interrupción del bloqueo bilateral que duró 5 semanas, la altura de la PC aumentó significativamente 1.2 veces en el lado lateral y 1.9 veces en el lado medial (p <0.001) en comparación con el control. Conclusión: La restauración de las características funcionales estructurales de la PC después de la extracción de las placas depende de la duración del bloqueo bilateral temporal, lo que debería tenerse en cuenta en el tratamiento clínico de estas alteraciones. (AU)


Subject(s)
Humans , Animals , Child , Rabbits , Limb Deformities, Congenital/therapy , Growth Plate/growth & development , Phenobarbital/administration & dosage , Rabbits/surgery , Xylazine/administration & dosage , Bone Plates , Cefazolin/administration & dosage , Child Development , Harm Reduction , Femur/cytology , Femur/growth & development , Femur/diagnostic imaging , Fixatives/analysis , Growth Plate/abnormalities , Ketamine/administration & dosage , Leg/abnormalities
13.
Rev. méd. Chile ; 147(9): 1136-1143, set. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058656

ABSTRACT

Background: High-speed resistance training programs aiming to increase muscle power have beneficial effects on balance. Aim: To compare the effect of high-speed bodyweight resistance training and normal-speed bodyweight resistance training on the static and dynamic balance in community-dwelling older women. Material and Methods: Thirty-five non-disabled community-dwelling women aged 65 to 80 years were trained for 12 weeks using a high-speed bodyweight resistance training (HS-BT) or a normal-speed bodyweight resistance training (NS-BT). At baseline and after the intervention, One Leg Stance (OLS) and Timed Up and Go (TUG) tests were measured. Participants with an attendance to training sessions of less than 70% were excluded from the final analysis. Results: Data from 26 participants were analyzed, 14 women aged 71 ± 4 years who received HS-BT and 12 women aged 73 ± 4 years who received NS-BT. After 12 weeks of training, a significant improvement in TUG was observed in women receiving HS-BT (ΔTUG −1.07 sec, p < 0.01), but without changes in the OLS test. No significant changes were observed in any of the tests in the NS-BT group. Conclusions: High-speed bodyweight resistance training for 12 weeks improved TUG in these women.


Subject(s)
Humans , Female , Aged , Aged, 80 and over , Resistance Training , Leg
14.
Rev. méd. Chile ; 147(9): 1206-1209, set. 2019. graf
Article in Spanish | LILACS | ID: biblio-1058665

ABSTRACT

Adventitial cystic disease of the popliteal artery is a rare condition of uncertain etiology, which presents as intermittent claudication of the lower extremity in middle-age patients. We report a 44-year-old man presenting with intermittent claudication of his left leg. MR angiography showed cystic parietal lesions that caused compression with partial occlusion of the left popliteal artery. Surgical resection of the affected segment was performed, with venous graft interposition. The histopathological analysis of the surgical specimen was consistent with cystic adventitial disease.


Subject(s)
Humans , Male , Adult , Middle Aged , Cysts/complications , Cysts/diagnostic imaging , Intermittent Claudication/etiology , Popliteal Artery/diagnostic imaging , Angiography , Leg
15.
An. bras. dermatol ; 94(2): 230-232, Mar.-Apr. 2019. graf
Article in English | LILACS | ID: biblio-1001135

ABSTRACT

Abstract Eccrine porocarcinoma (EPC) is a rare malignant skin tumor. The dermoscopy of invasive EPC reveals focal presence of whitish-pink, structureless areas surrounded by pinkish-white halos. In an eccrine poroma (EP), such areas present diffuse distribution in the "frog- eggs" pattern. We reported an EPC in situ that presents a transitional dermoscopy pattern between EP and invasive EPC. We found a diffuse distribution; whitish-pink, structureless areas surrounded by pinkish-white halos; a central exulceration and a polymorphic vascular pattern.


Subject(s)
Humans , Female , Aged , Sweat Gland Neoplasms/diagnostic imaging , Poroma/diagnostic imaging , Eccrine Porocarcinoma/diagnostic imaging , Sweat Gland Neoplasms/pathology , Biopsy , Dermoscopy/methods , Diagnosis, Differential , Poroma/pathology , Eccrine Porocarcinoma/pathology , Leg
16.
Dermatol. pediátr. latinoam. (En línea) ; 14(1): 12-21, mar. 2019. tab, ilus
Article in Spanish | LILACS | ID: biblio-1005430

ABSTRACT

La incontinencia pigmenti es una genodermatosis poco frecuente, de herencia dominante ligada al X, que se caracteriza por la presencia de lesiones cutáneas típicas que pueden asociarse con afectación de otros tejidos derivados del neuroectodermo. Es una enfermedad potencialmente grave, que requiere un diagnóstico precoz y un seguimiento multidisciplinario de por vida.Se presenta el caso de un paciente de sexo femenino de 6 días de vida con diagnóstico clínico y anatomopatológico de incontinencia pigmenti


Incontinentiapigmenti is a rare, X-linked dominantgenodermatosis, characterized by the presence of typical skin lesions that may be associated with involvement of other tissues derived from neuroectoderm. It is a potentially serious disease that requires early diagnosis and a multidisciplinary life-long follow up.Wereport the case of a 6 day old femalewith a clinical and anatomopathological diagnosis of incontinenciapigmenti.


Subject(s)
Humans , Incontinentia Pigmenti , Leg
17.
Ann. afr. med ; : 196-199, 2019.
Article in English | AIM | ID: biblio-1258848

ABSTRACT

Background: Amputation is one of the oldest known surgical procedures. It has been one of the modalities of applying judgment and treatment. Its method and indications has evolved over time. Modern amputation is regarded as a part of treatment rather than failure of treatment. Amputation is the removal of a limb or part of a limb through on or more bone. When through a joint is referred to as disarticulation. Data on the profile and pattern of amputation in Liberia will add to the body of knowledge. Aim and Objectives: Is to describe the pattern of limb of amputations in Liberia. Also to describe the anatomical variations of limb amputations in Liberia. Patients and Method: A retrospective study of all patients that underwent limb amputation surgeries in the John F Kennedy Memorial (JFK M), Hospital , Monrovia Liberia between January 2010 to December 2015. Results: 100 patients had limb amputations between 2010 and 2015. Males(73) to female(27) ratio were 2.4:1. The age range was 9 - 91 years. Mean age was 42.9 years. The indications for amputations were Trauma 24%, Diabetes 29%, Gangrene (6%), Chronic ulcer (25%), Tumour (5%). Below knee(47%), Above Knee(45%), Below elbow(2%), Above Elbow(2%), Knee Disarticulation(2%), and Big Toe Disarticulation(2%). Conclusion: The profile of Limb amputation in Liberia is not very different from what is obtaining in the region. However the limitations of histology and other investigative procedure have affected the accurate diagnosis of certain conditions like tumours


Subject(s)
Amputation , Leg/surgery , Liberia , Surgical Procedures, Operative , Wounds and Injuries/epidemiology , Wounds and Injuries/surgery
18.
Article in Korean | WPRIM | ID: wpr-786058

ABSTRACT

PURPOSE: This study compared the effects of Static stretching and Mulligan's Two-leg rotation about the Hamstring flexibility, Hip range of motion, and pain.METHODS: The subjects were allocated randomly into two groups: Static stretching group (n=13) and Mulligan's two leg rotation group (n=14). The study was designed with stretching protocols for four minutes and thirty seconds per day five times a week for three weeks in total. Measurements, including the Sit and reach test, Active/Passive Straight leg raise, and Visual analogue scale, were conducted before and after the intervention. The data were analyzed using a paired t-test and independent t-test.RESULTS: The flexibility of the two leg rotation group was higher than the static stretching group after the intervention. The post-sit and reach test value of the two leg rotation group was significantly higher than the pre-sit and reach test value of the static stretching group. In addition, the variance of the sit and reach test of the two leg rotation group was significantly higher than that of the static stretching group.CONCLUSION: These results showed that two leg rotation techniques have a positive effect on the changes in the sit and reach test and active straight leg raise test. Two leg rotation techniques can be recommended as a self-stretching and easier way to stabilize the lumbopelvic rhythm, reduce the stiffness of the muscle and relieve pain. This is effective in preventing muscle damage, enabling muscle relaxation and reducing the risk of injury to the spine during daily lives and in sports activities.


Subject(s)
Hip , Humans , Leg , Muscle Relaxation , Muscle Stretching Exercises , Pliability , Range of Motion, Articular , Spine , Sports , Young Adult
19.
Clinical Pain ; (2): 65-69, 2019.
Article in Korean | WPRIM | ID: wpr-811493

ABSTRACT

OBJECTIVE: This study aims to evaluate the efficacy of high-voltage microcurrent therapy in patients with herniated lumbar disc (HLD) presenting radicular or back pain.METHOD: This is a retrospective study with 33 patients who are complaining pain with HLD findings on magnetic resonance image. Microcurrent therapy was applied to leg or paralumbar area. Treatment was conducted for seven minutes with 250~1000 uA intensity as high as the patients could tolerate via stimulating probe with roller type and the frequency was 60 Hz with a sine wave pulse. The visual analogue scale (VAS) was measured just before and after the treatment.RESULTS: The degree of pain reduction (ΔVAS) was 1.6 points after treatment on average. The ΔVAS according to the diagnosis, stenosis, dermatome area, medication, pain site and caudal epidural block was not statistically significant. However, the ΔVAS according to the number of treatments (< 3, ≥ 3 times) showed a statistically significant difference (p=0.04).CONCLUSION: High-voltage microcurrent therapy may help reduce lumbar or lumbosacral radiating pain after the procedure. The effect was better when microcurrent was applied three times or more. This result suggests that the microcurrent would have cumulative effect on reducing radicular or back pain in patients with HLD.


Subject(s)
Back Pain , Constriction, Pathologic , Diagnosis , Electric Stimulation , Humans , Intervertebral Disc Displacement , Leg , Methods , Retrospective Studies , Visual Analog Scale
20.
Article in English | WPRIM | ID: wpr-773369

ABSTRACT

OBJECTIVE@#The aim of this study was to determine whether low calf circumference (CC) could predict nutritional risk and the cutoff values of CC for predicting nutritional risk in hospitalized patients aged ⪖ 80 years.@*METHODS@#A total of 1,234 consecutive patients aged ⪖ 80 years were enrolled in this study. On admission, demographic data, CC, and laboratory parameters were obtained. Patients with Nutritional Risk Screening 2002 (NRS-2002) total score ⪖ 3 were considered as having nutritional risk.@*RESULTS@#CC values were significantly lower in patients with nutritional risk compared to those in patients without nutritional risk [27.00 (24.50-31.00) vs. 31.00 (29.00-33.50], P < 0.001]. CC was negatively correlated with age and nutritional risk scores. Logistic regression analysis of nutritional risk revealed that body mass index, albumin level, hemoglobin level, cerebral infarction, neoplasms, and CC (OR, 0.897; 95% confidence interval, 0.856-0.941; P < 0.001) were independent impact factors of nutritional risk. Nutritional risk scores increased with a decrease in CC. In men, the best CC cutoff value for predicting nutritional risk according to the NRS-2002 was 29.75 cm. In women, the cutoff value was 28.25 cm.@*CONCLUSION@#CC is a simple, noninvasive, and valid anthropometric measure to predict nutritional risk for hospitalized patients aged ⪖ 80 years.


Subject(s)
Aged, 80 and over , Anthropometry , Methods , China , Female , Hospitalization , Humans , Leg , Male , Nutritional Status , Risk Assessment , Methods
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