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1.
rev. cuid. (Bucaramanga. 2010) ; 12(3): 1-14, 20210821.
Article in Spanish | LILACS, BDENF, COLNAL | ID: biblio-1343574

ABSTRACT

Introducción: En el sector sanitario es común la ejecución de actividades de pie; sin embargo, es un tema poco atendido, a pesar de los efectos negativos que se pueden generar en la salud de los trabajadores. Objetivo: Analizar la variación de dolor musculoesqueléticos en las extremidades inferiores y espalda baja, y la variación de volumen en las piernas presentados en trabajadores sanitarios que realizan sus actividades de pie durante una jornada laboral. Materiales y métodos: Estudio transversal donde se registró la percepción de dolor musculoesquelético de los segmentos corporales: espalda baja y el lado derecho e izquierdo de: muslo-cadera, rodilla, pierna y tobillo-pie y se midió la circunferencia para calcular su volumen de las piernas con la cinta métrica Gulick II a 21 trabajadores del sector sanitario. Los registros y mediciones se realizaron durante la primera y la última hora de una jornada laboral de 8 horas. Resultados: En todos los segmentos corporales la percepción de dolor musculoesquelético y el volumen en ambas piernas aumentó al final de la jornada laboral respecto al inicio. Los segmentos corporales muslo-cadera izquierda, tobillo-pie derecho y el volumen en ambas piernas aumentaron significativamente. Discusión: Los resultados obtenidos son similares a estudios con diseños experimentales, con la diferencia que nuestro estudio se desarrolló en condiciones reales sin control de variables. Conclusiones: Este estudio muestra cómo actividades del sector sanitario ejecutadas durante tiempos prolongados de pie pueden ocasionar en los trabajadores dolor musculoesqueléticos en las extremidades inferiores y la espalda baja, así como un aumento en el volumen de las piernas.


Introduction: In the health care sector, the execution of standing activities is common; however, it is an issue that receives little attention, despite the negative effects that can be generated in the health of workers. Objective: To analyze the variation of musculoskeletal pain in the lower extremities and lower back, and the variation of volume in the legs in health care workers who perform their activities while standing during a working day. Materials and methods: A cross-sectional study in which the perception of musculoskeletal pain was recorded in the following body segments: lower back and right and left side of the thigh-hip, knee, leg and ankle-foot, and the circumference was measured to calculate the volume of the legs with the Gulick II tape measure in 21 health care sector workers. Recordings and measurements were taken during the first and last hour of an 8-hour workday. Results: In all body segments the perception of musculoskeletal pain and the volume in both legs increased at the end of the working day compared to the beginning. The body segments left thigh-hip, right ankle-foot and the volume in both legs increased significantly. Discussion: The results obtained are similar to studies with experimental designs, with the difference that our study was developed under real conditions without variables control. Conclusions: This study shows how activities in the health care sector executed during prolonged standing times can cause musculoskeletal pain in the lower extremities and lower back in workers, as well as an increase in the legs volume.


Introdução: No setor de saúde, a execução de atividades em pé é comum; entretanto, é uma questão que recebe pouca atenção, apesar dos efeitos negativos que podem gerar sobre a saúde dos trabalhadores. Objetivo: Analisar a variação da dor musculoesquelética nos membros inferiores e lombar, e a variação do volume das pernas nos profissionais de saúde que realizam suas atividades em pé durante uma jornada de trabalho. Materiais e métodos: Estudo transversal no qual foi registrada a percepção da dor musculoesquelética nos segmentos do corpo: região lombar e lado direito e esquerdo da coxa-quadril, joelho, perna e tornozelo-pé, e a circunferência foi medida para calcular o volume das pernas com a fita métrica Gulick II em 21 trabalhadores do setor de saúde. Os registros e medições foram feitos durante a primeira e última hora de um dia de trabalho de 8 horas. Resultados: Em todos os segmentos do corpo, a percepção da dor musculoesquelética e o volume em ambas as pernas aumentou no final do dia de trabalho em comparação com o início. Os segmentos do corpo coxa-quadril esquerdo, tornozelo-pé direito e o volume em ambas as pernas aumentaram significativamente. Discussão: Os resultados obtidos são semelhantes aos estudos com desenhos experimentais, com a diferença de que nosso estudo foi realizado em condições reais sem controle de variáveis. Conclusões: Este estudo mostra como as atividades no setor de saúde realizadas durante períodos prolongados de permanência em pé podem causar dores musculoesqueléticas nos membros inferiores e a região lombar, bem como um aumento no volume das pernas.


Subject(s)
Humans , Male , Female , Occupational Health , Low Back Pain , Lower Extremity , Musculoskeletal Pain , Standing Position
2.
Int. j. med. surg. sci. (Print) ; 8(2): 1-9, jun. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1284417

ABSTRACT

Background:Lumbar sympathectomy through radio ablation is a useful treatment of peripheral ischemia. However, clinical efficacy with respect to lower limb ulcers is not adequately established in the Indian population. The study was conducted to evaluate the role of radiofrequency ablation (RFA) of the lumbar sympathetic ganglia in healing of ischemic ulcers of the lower limb.Method:The prospective study with 63 patients registered in the General surgery department with lower limb ischemic ulcers between December 2017­ July2019 were treated with RFA. Patients with cardiopulmonary disease, pregnant, congenital malformation, or skin infection at the site of intervention, or suffering from bleeding disorders, were excluded from the study. Clinical investigation of the wound was performed, and demographic data was collected. Comparative reduction in wound size was assessed through Friedman`s ANOVA (P<0.001). Difference in pain score, hospital stay, and walking distance were evaluated using Wilcoxon matched pair test (P<0.001), Unpaired t-test, and Paired t-test (P<0.05).Result:Majority of the patients were male (n=40) with a mean age of 60.93 SD14.34 years. Significant reduction in wound size, pain scores and hospital stay were observed post procedure(P<0.001). Number of RFA sessions was significantly associated with the size of the ulcer and Fontaine's classification 2 and 3 (P<0.0001).Conclusion:RFA of lumbar sympathetic ganglia is a potential treatment modality for lower limb ischemic ulcers.


Antecedentes: La simpatectomía lumbar a través de la ablación por radiofrecuencia es un tratamiento útil de la isquemia periférica. Sin embargo, la eficacia clínica con respecto a las úlceras en las extremidades inferiores no está adecuadamente establecida en la población india. El estudio se llevó a cabo para evaluar el papel de la ablación por radiofrecuencia (RFA) de los ganglios simpáticos lumbares en la curación de las úlceras isquémicas de la extremidad inferior. Método: El estudio prospectivo con 63 pacientes registrados en el departamento de cirugía general con úlceras isquémicas de las extremidades inferiores entre diciembre de 2017 y julio de 2019 fueron tratados con RFA. Los pacientes con enfermedad cardiopulmonar, malformación embarazada, congénita o infección de la piel en el lugar de la intervención, o que sufren de trastornos hemorrágicos, fueron excluidos del estudio. Se realizó una investigación clínica de la herida y se recopilaron datos demográficos. La reducción comparativa en el tamaño de la herida se evaluó a través del ANOVA de Friedman (P<0.001).Resultado: La diferencia en la puntuación del dolor, la estancia en el hospital y la distancia a pie se evaluaron mediante la prueba de par coincidente de Wilcoxon (P<0.001), la prueba t no emparejada y la prueba t emparejada (P<0.05). La mayoría de los pacientes eran varones (n-40) con una edad media de 60,93 SD14,34 años. Se observó una reducción significativa en el tamaño de la herida, las puntuaciones de dolor y la estancia hospitalaria (P<0.001). El número de sesiones de RFA se asoció significativamente con el tamaño de la úlcera y las clasificaciones 2 y 3 de Fontaine (P<0.0001).Conclusión: LA RFA de los ganglios simpáticos lumbares puede constituir una opción terapéutica para las úlceras isquémicas de las extremidades inferiores.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Ulcer/therapy , Lower Extremity , Radiofrequency Ablation/methods , Ganglia, Sympathetic , Ischemia/therapy , Prospective Studies , Analysis of Variance , India
3.
Cambios rev. méd ; 20(1): 87-93, 30 junio 2021. ilus.
Article in Spanish | LILACS | ID: biblio-1292972

ABSTRACT

INTRODUCCIÓN. Los defectos de la fosa poplítea suponen un desafío reconstructivo para el cirujano plástico, dada la relación íntima de esta área con la articulación de la rodilla y la neurovasculatura vital subyacente. El propósito de éste informe fie compartir la experiencia en la utilización de un colgajo fasciocutaneode la arteria safena. CASO CLÍNICO. Paciente de 5 años de edad que sufrió quemadura térmica en miembros inferiores con dos años y medio de evolución, ameritó injertos, presentó contractura por tejido cicatricial en fosa poplítea, dificultó la deambulación y desarrollo neuro osteomuscular. Se realizó reconstrucción de la fosa poplítea con colgajo fasciocutáneo de la arteria safena. RESULTADOS. El colgajo fasciocutáneo de la arteria safena dio cobertura al defecto en fosa poplítea izquierda tras retiro del tejido cicatricial que producía contractura, limitaba la marcha y el desarrollo neuro osteo-muscular. Seis meses postquirúrgicos brindó cobertura cutánea definitiva y estable en el área crítica, que permitió la deambulación con movimientos de extensión y flexión de rodilla conservados. DISCUSIÓN. Este colgajo al igual que en otros estudios que respaldan su ejecución brindó excelentes resultados en defectos de partes blandas a nivel de la articulación de la rodilla. CONCLUSIÓN. El colgajo fasciocutáneo de la arteria safena demostró utilidad para la reconstrucción del defecto de la fosa poplítea, posibilitó una cobertura definitiva, funcional y estética, restableció los ángulos de movilidad y favoreció el desarrollo pondoestatural del paciente.


INTRODUCTION. Defects of the popliteal fossa pose a reconstructive challenge for the plastic surgeon, because of the intimate relation of this area with the knee joint and the near vital neurovasculature; the purpose of this report was to share the experience of using a fasciocutaneous flap of the saphenous artery. CLINICAL CASE. A 5 year old patient who suffered thermal burn in lower limbs with two and a half years of evolution, he nedeed grafts and presented tissue contracture because the scar in the popliteal fossa hindered ambulation and neuro-osteomuscular growth. Reconstruction of the popliteal fossa was made it with a fasciocutaneous flap of the saphenous artery. RESULTS. The fasciocutaneous flap of the saphenous artery covered the defect in the left popliteal fossa after removal of the scar tissue that caused contracture, limited to walk and growth. Six months after surgery the flap provided definitive and secure skin coverage in the critical area, which allowed to walk with preserved knee extension and flexion movements. DISCUSSION. This flap was useful for the recons-truction of the defect of the popliteal fossa and provided excellent results in soft tissue defects in this area of the knee joint. CONCLUSION. The fasciocutaneous flap of the saphenous artery proved useful for the reconstruction of the popliteal fossa defect, it permited a definitive, functional and esthetic coverage, reestablished the angles of mobility and helped with the patient growth


Subject(s)
Humans , Male , Child, Preschool , Arteries , Regeneration , Surgical Flaps , Burns , Lower Extremity/injuries , Pediatrics , Child Development , Skin Transplantation , Motor Skills Disorders , Knee , Knee Joint
4.
Rev. inf. cient ; 100(3): e3433, 2021. graf
Article in Spanish | LILACS | ID: biblio-1289634

ABSTRACT

RESUMEN Introducción: Los trabajadores de la salud se enfrentan permanentemente a labores complejas que afectan la región lumbar y miembros inferiores. Objetivo: Identificar la prevalencia de enfermedad osteomioarticular lumbosacras y miembros inferiores en auxiliares de enfermería Método: Se realizó un estudio epidemiológico, descriptivo y transversal en una muestra de 46 auxiliares del Distrito 18D04 de salud de Tungurahua, Ecuador. El instrumento aplicado fue un cuestionario para indagar variables sociodemográficas, antigüedad en el sector, horarios, tipos y tiempo de exposición a las labores habituales. Se utilizó la prueba estadística Chi-cuadrado, la paramétrica de correlación de Pearson y la prueba t de Student. Resultados: El 85 % de los estudiados presentó enfermedades lumbosacras y miembros inferiores durante el tiempo de trabajo, se apreció que el 39 % ha tenido una baja temporal al trabajo entre 1-3 días. Se identificó que la carga de peso es realizada por un 37 % y caminatas prolongadas en un 33 %. El 67 % tenía entre 11 y 40 años de trabajo y el resto menos de 10 años en el sector. El 54 % padeció enfermedades pertenecientes a miembros inferiores y un 46 % a lumbosacras. Conclusiones: El padecimiento de enfermedad osteomioarticular lumbosacras y miembros inferiores está relacionado con la edad y con padecerlas en los últimos doce meses, estas han provocado ausentismo laboral. No se comprobó una relación estadísticamente significativa con el padecimiento de enfermedad osteomioarticular con la antigüedad en el sector, las jornadas de trabajo y las actividades que más desarrollan.


ABSTRACT Introduction: Health care workers are constantly confronted with complex tasks that affect the lumbar region and lower limbs. Objective: To identify the prevalence of lumbosacral and lower limb osteomyoarticular pathologies in nursing assistants. Method: An epidemiological, descriptive and cross-sectional study was carried out in the 18D04 health district of Tungurahua, Ecuador. A total of 46 nursing assistants were selected in this study. We aimed a questionnaire to assess the sociodemographic variables, seniority in the health sector, time schedules, modes and time of exposure to the usual work. Chi-square test, Pearson's parametric correlation test, and the Student's t-test were used. Results: Most nursing assistants, the 85%, were diagnosed with lumbosacral and lower limb pathologies, and 39% took a temporary absence from work between 1-3 days. It was found that 37 % performed the heavy load work and 33% performed prolonged walks. The 67% had between 11 and 40 years of work and the rest had less than 10 years in the health sector. Fifty-four percent suffered from lower limb pathologies and 46% from lumbosacral pathologies. Conclusions: Lumbosacral and lower limb osteomyoarticular pathology is related to age, and their suffering in the last 12 months has led to a level of absenteeism in the workplace. There was no an important relationship, statistically, between osteomyoarticular pathology and seniority in the sector, working hours and the activities most frequently performed.


RESUMO Introdução: Os trabalhadores da saúde enfrentam constantemente tarefas complexas que afetam a região lombar e membros inferiores. Objetivo: Identificar a prevalência de doenças osteomioarticulares lombossacrais e de membros inferiores em auxiliares de enfermagem. Método: Estudo epidemiológico, descritivo e transversal em uma amostra de 46 auxiliares do Distrito Sanitário 18D04 de Tungurahua, Equador. O instrumento aplicado foi um questionário para investigar variáveis sociodemográficas, antiguidade no setor, horário, tipos e tempo de exposição a tarefas normais. Foram utilizados o teste estatístico Qui-quadrado, correlação paramétrica de Pearson e teste t de Student. Resultados: 85% dos estudados apresentaram doenças lombossacrais e de membros inferiores durante o tempo de trabalho, observou-se que 39% tiveram afastamento temporário do trabalho entre 1-3 dias. Identificou-se que a descarga de peso é realizada por 37% e as caminhadas prolongadas por 33%. 67% tinham entre 11 e 40 anos de trabalho e o restante menos de 10 anos no setor. 54% sofreram doenças pertencentes aos membros inferiores e 46% lombossacral. Conclusões: O sofrimento da doença osteomioarticular lombossacral e de membros inferiores está relacionado à idade e com o sofrimento nos últimos doze meses, estes têm causado absenteísmo ao trabalho. Não foi verificada relação estatisticamente significativa entre o sofrimento de doença osteomioarticular e o tempo de permanência no setor, a jornada de trabalho e as atividades que mais desenvolvem.


Subject(s)
Humans , Female , Middle Aged , Bone Diseases/epidemiology , Low Back Pain/epidemiology , Lower Extremity , Joint Diseases/epidemiology , Muscular Diseases/epidemiology , Nursing Assistants , Burnout, Professional , Epidemiology, Descriptive , Cross-Sectional Studies
5.
Rev. bras. ortop ; 56(3): 275-280, May-June 2021. graf
Article in English | LILACS | ID: biblio-1288680

ABSTRACT

Abstract Most shoulder injuries occur due to repetitive overhead movements. Before studying the treatment of these shoulder injuries, it is paramount that health professionals have an understanding of the etiology of and the underlying mechanisms for shoulder pathologies. The act of overhead throwing is an eloquent full-body motion that requires tremendous coordination from the time of force generation to the end of the pitch. The shoulder is a crucial component of the upper-body kinetic chain, as it transmits force created in the lower body to the arm and hand to provide velocity and accuracy to the pitch.


Resumo A maioria das lesões do ombro ocorre devido aos movimentos repetitivos acima do nóvel da cabeça. Antes de estudar o tratamento dessas lesões, é fundamental que os profissionais de saúde tenham um entendimento da etiologia e dos mecanismos que causam essas patologias. O ato do arremesso acima do nóvel da cabeça exige considerável coordenação de todo o corpo, desde o momento de geração de força até o final do arremesso. O ombro é um componente crucial da cadeia cinética da extremidade superior, por transmitir a força gerada na extremidade inferior para o braço e mão para produzir velocidade e precisão no lançamento da bola.


Subject(s)
Humans , Athletic Injuries , Shoulder , Therapeutics , Lower Extremity , Upper Extremity , Joint Instability
6.
Rev. cuba. angiol. cir. vasc ; 22(1): e296, ene.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1251679

ABSTRACT

Introducción: La enfermedad arterial periférica de miembros inferiores se considera un problema de salud por presentar elevadas tasas de morbi-mortalidad y de amputaciones no traumáticas. En ocasiones se desconoce su presencia en los adultos de la población general. Objetivo: Evaluar mediante pesquiza la presencia de la enfermedad arterial periférica de miembros inferiores en personas mayores de 50 años de la población. Métodos: Estudio descriptivo y analítico en 235 personas mayores de 50 años de diferentes municipios de la capital. El diagnóstico de la enfermedad arterial se realizó por examen físico y estudio hemodinámico. Se analizaron variables sociodemográficas y algunos factores de riego cardiovasculares. Se trabajó con un nivel de confiabilidad del 95 por ciento. Resultados: Predominaron el sexo femenino (68,1 por ciento), la piel blanca (53,2 por ciento) y el grupo etáreo entre 50 y 69 años (68,1 por ciento). Hubo mayor frecuencia de la enfermedad en el sexo masculino (70,5 por ciento). El 55,7 por ciento presentó macroangiopatía diabética. Las prevalencias encontradas para la enfermedad arterial periférica y para los factores de riesgo fueron de 51,9 por ciento y de 91,5 por ciento, respectivamente. El 64,7 por ciento de las personas presentaban tres o más factores. La hipertensión (χ 2 = 23,66; p = 0,0000; OR: 3,88) y la obesidad (χ 2 = 8,74; p < 0,001; OR: 1,38) estuvieron asociadas con la enfermedad arterial periférica. Conclusiones: Las personas mayores de 50 años de edad, del sexo masculino y con más de tres factores de riesgo tienen un riesgo elevado de presentar una enfermedad arterial periférica de miembros inferiores(AU)


Introduction: Lower limb peripheral artery disease is considered a health problem because it has high rates of morbidity-mortality and non-traumatic amputations. Its presence in adults in the general population is sometimes unknown. Objective: Assess by investigation the presence of peripheral artery disease of lower limbs in people of the population over 50 years. Methods: Descriptive and analytical study in 235 people over 50 years from different municipalities of the capital. The diagnosis of arterial disease was made by physical examination and hemodynamic study. Sociodemographic variables and some cardiovascular risk factors were analyzed. The reliability level was of 95 percent. Results: Female sex (68.1 percent), white skin (53.2 percent) and the age group between 50 and 69 years (68.1 percent) predominated. There was a higher frequency of the disease in the male sex (70.5 percent). 55.7 percent had diabetic macroangiopathy. The prevalences found for peripheral artery disease and risk factors were 51.9 percent and 91.5 percent, respectively. 64.7 percent of people had three or more factors. Hypertension (χ 2 = 23.66; p = 0.0000; OR: 3.88) and obesity (χ 2 = 8,74; p < 0,001; OR: 1,38) were associated with peripheral artery disease. Conclusions: People over 50 years of age, males and with more than three risk factors have a high risk of developing peripheral lower limb artery disease(AU)


Subject(s)
Humans , Male , Female , Lower Extremity , Peripheral Arterial Disease , Amputation, Traumatic
7.
Dement. neuropsychol ; 15(2): 275-280, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1286201

ABSTRACT

ABSTRACT. An amputation is an irreversible event that causes social, psychological, and functional consequences that reduces the quality of life of the amputee. Phantom pain generally is reported by 50 to 80% of amputees. Objective: To describe the pain and phantom sensation and quality of life among lower-limb amputees. Methods: This was a cross-sectional study carried out in the region of Juiz de Fora, state of Minas Gerais, Brazil. Inclusion criteria were being a patient in one of two hospitals in the region at the time of the interview and having at least one lower-limb amputation. A total of 20 amputees were included in the analysis. The interview questionnaire had items adapted from the Groningen Questionnaire Problems After Leg Amputation - describing the frequency and discomfort of phantom pain and sensation, causes and the level of the amputation, as well as the WHOQOL-BREF, for assessing quality of life. Results: Most participants were women (55%) and had a mean age of 55.6 years (SD=14.8). Femoral amputation was the most prevalent (65%), and diabetes (40%) was the main reason for amputation. 29% of amputees classified the phantom pain as moderate or severe, and 15% claimed daily frequency of this phenomenon. As for phantom pain, only 6% stated daily frequency. The mean quality of life was 4.1 (SD=1.1, five score means very satisfied), the physical domain of quality of life had the lowest mean (3.4, SD=0.7). Conclusions: Phantom sensation and pain were prevalent among lower-limb amputees who were, in general, less satisfied with their physical domain of quality of life.


RESUMO. A amputação é um procedimento irreversível que gera consequências sociais, psicológicas e funcionais. A dor do membro fantasma ocorre entre 50 e 80% dos amputados, apresentando implicações na qualidade de vida. Objetivo: Avaliar a sensação, dor fantasma e qualidade de vida entre pacientes amputados. Métodos: Trata-se de um estudo transversal retrospectivo realizado na região de Juiz de Fora, Minas Gerais, Brasil. Os critérios de inclusão foram possuir pelo menos uma amputação de membro inferior e ser paciente de um dos hospitais referência para região. Vinte participantes foram incluídos nas análises. O questionário da pesquisa consistiu em itens, adaptados do Groningen Questionnaire Problems After Leg Amputation, que descrevem frequência e incômodo da sensação fantasma, dor fantasma, causas e nível da amputação, e questões sobre os tratamentos além do questionário qualidade de vida WHOQOL-BREF. Resultados: A maioria dos participantes era do sexo feminino (55%) com idade média de 55,6 (DP=14,8) anos. A maior frequência de amputação foi transfemural (65%), e o principal motivo da amputação foi o diabetes mellitus (40%). Com relação ao incômodo da sensação fantasma, 29% a classificou como moderado ou severa, e 15% alegou frequência diária desse fenômeno. Quanto {a dor fantasma, apenas 6% afirmou frequência diária. A qualidade de vida média dos participantes foi de 4,1 (DP=1,1) em 5 (cinco significa muito satisfeito), de acordo com a primeira questão do WHOQOL-BREF; o domínio físico apresentou a menor média 3,4 (DP=0,7). Conclusão: A sensação e dor fantasmas foram prevalentes nos entrevistados que apresentaram menor satisfação com o domínio físico da qualidade de vida.


Subject(s)
Humans , Quality of Life , Phantom Limb , Lower Extremity , Amputation
8.
Rev. bras. ortop ; 56(2): 192-197, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1251333

ABSTRACT

Abstract Objective To evaluate the use of a propeller flap to cover soft-tissue injuries in the lower limb. Materials and Methods A retrospective study, with review of medical records, and a convenience sample of 14 patients operated between July 2018 and June 2019. The following clinical aspects were evaluated: sex; age group; type of injury; cause of the injury; initial diagnosis; affected location; techniques for incision and identification; surgical planning; flap design; postoperative period; result of the propeller flap; and complications. Results The sample was composed of male patients (100%), with a mean age of 36.4 years, and 92.7% of the injuries resulted from motorcycle accidents, mostly on the right side (71.4%). The surgical planning of the propeller flap followed the same procedure in all cases. Immediate postsurgical complications were present in 35.7% of the cases, and they included excessive bleeding (14.3%), partial necrosis (14.3%), and flap dehiscence (7.1%). In total, 13 patients had excellent coverage, and only 1 had flap loss. Conclusion The propeller-flap technique to cover lesions in the lower limb proved to be a good alternative in most cases evaluated, with a good surgical result, although complications were observed in some cases.


Resumo Objetivo Avaliar o uso de retalho em hélice para cobertura de lesões de partes moles em membro inferior. Métodos Estudo retrospectivo, de revisão de prontuários e amostra de conveniência, com 14 pacientes operados entre julho de 2018 e junho de 2019. Foram avaliados os seguintes aspectos clínicos: sexo; faixa etária; tipo de lesão; causa da lesão; diagnóstico inicial; local acometido; técnica de incisão e identificação; planejamento cirúrgico; desenho do retalho; pós-operatório; resultado do retalho em hélice; e complicações. Resultados A amostra era composta por pacientes do sexo masculino (100%), com idade média de 36,4 anos, e 92,7% das lesões eram decorrentes de acidente motociclístico, a maioria do lado direito (71,4%). O planejamento cirúrgico do retalho em hélice seguiu o mesmo procedimento em todos os casos. As complicações pós-cirúrgicas imediatas estavam presentes em 35,7%, e incluíram sangramento excessivo (14,3%), necroses parciais (14,3%), e deiscência do retalho (7,1%). No total, 13 pacientes apresentaram ótima cobertura, e em apenas 1 houve perda do retalho. Conclusão A técnica do retalho em hélice para a cobertura de lesões em membro inferior mostrou-se uma boa alternativa na maioria dos casos avaliados, com um bom resultado cirúrgico, embora tenham sido observadas complicações em alguns casos.


Subject(s)
Humans , Male , Adult , Middle Aged , Postoperative Period , Motorcycles , Accidents , Retrospective Studies , Soft Tissue Injuries , Lower Extremity , Perforator Flap
9.
Rev. Soc. Argent. Diabetes ; 55(1): 4-12, ene. - abr. 2021. tab, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1248267

ABSTRACT

Introducción: el examen del pie es fundamental en pacientes con diabetes mellitus (DM). La correcta evaluación del pie en el paciente que concurre a control diabetológico es clave para establecer factores de riesgo para el desarrollo de úlceras, detectar lesiones, tomar medidas preventivas, realizar una derivación temprana y educar en cuidados del pie. Objetivos: en este estudio se examinaron los pies de personas con DM durante la Campaña de Concientización y Prevención del Pie Diabético el 1º de noviembre de 2019 con el fin de evaluar la presencia de síntomas y signos relacionados con neuropatía, enfermedad vascular periférica, y prevalencia de los mismos, y conocer el riesgo. Materiales y métodos: se analizaron 165 pacientes en cuatro centros: Sanatorio Güemes (Servicio de Diabetes y Endocrinología), PREDIGMA (Centro de Medicina Preventiva, Posadas, Misiones), Hospital Central de San Isidro, Nexo Centro Médico (Ciudad de Junín) y Hospital Municipal de General Viamonte (Provincia de Buenos Aires). Resultados: se encontró que el 43,6% presentaba algún síntoma en miembros inferiores y hasta el 57% alteración en las pruebas de tamizaje de neuropatía diabética o enfermedad arterial periférica, con mayor prevalencia a mayor tiempo de evolución de la DM. Los signos más frecuentemente hallados en el examen físico fueron: piel seca (71,5%), distrofia ungueal (60,6%) o alteración de la almohadilla plantar (52,1%). Las comorbilidades más frecuentes fueron: hipertensión (74,5%) y dislipemia (73,3%). La mediana de hemoglobina glicosilada fue de 7,40% (6,70-8,10), mayor en personas con antecedentes de retinopatía (7,8%; p<0,01) y en pacientes que refirieron tener calambres (7,85 a 7,30; p=0,03) o ardor (8,0 vs 7,3; p<0,01). El porcentaje de pacientes con pie de alto riesgo por antecedentes, inspección o tamizaje de neuropatía o enfermedad vascular representó desde el 40% en aquellos con DM de menos de cinco años de evolución hasta el 86% en quienes tenían más de 20 años. Conclusiones: el elevado porcentaje de pacientes con pie de riesgo identificado en este estudio sugiere que, además del correcto examen físico, se requiere la toma de conductas por parte del médico tratante, como la indicación de plantillas o calzado adecuado, así como una fluida derivación al técnico en ortesis, traumatólogo o fisiatra.


Introduction: foot examination is essential in patients with diabetes mellitus (DM). The correct evaluation of the foot in the patient who attends diabetes control is key to establish risk factors for the development of ulcers, detect injuries, take preventive measures, make an early referral and educate in foot care. Objectives: in this study, the feet of people with DM were examined during the Diabetic Foot Awareness and Prevention Campaign on November 1, 2019 in order to assess the presence of symptoms and signs related to neuropathy, peripheral vascular disease, prevalence of the same and know the risk. Materials and methods: 165 patients were analyzed in four centers: Sanatorio Güemes (Diabetes and Endocrinology Service), PREDIGMA (Preventive Medicine Center, Posadas, Misiones), Central Hospital of San Isidro, Nexo Medical Center (Junín City) and Hospital Municipal of General Viamonte (Province of Buenos Aires). Results: it was found that 43.6% had some symptoms in the lower limbs and up to 57% had an alteration in the screening tests for diabetic neuropathy or peripheral arterial disease, with a higher prevalence the longer the evolution of DM. The most frequent signs found in the physical examination were: dry skin (71.5%), nail dystrophy (60.6%) or alteration of the foot pad (52.1%). The lost frequent comorbidities were: hypertension (74.5%) and dyslipidemia (73.3%). The median glycated hemoglobin was 7.40% (6.70-8.10), higher in people with a history of retinopathy (7.8%; p <0.01) and in patients who reported having cramps (7, 85 to 7.30; p = 0.03) or burning (8.0 vs 7.3; p <0.01). The percentage of patients with high-risk foot due to antecedents, inspection or screening for neuropathy or vascular disease represented from 40% in those with DM of less than five years of evolution to 86% in those who were older than 20 years. Conclusions: this high percentage of patients with foot at risk identified in this study suggests that, in addition to the correct physical examination, the attending physician requires the taking of behaviors, such as the indication of appropriate footwear or insoles, as well as a fluid referral to the orthotic technician, orthopedic surgeon, or physiatrist.


Subject(s)
Humans , Diabetes Mellitus , Physical Examination , Diabetic Foot , Lower Extremity , Diabetic Neuropathies
10.
Rev. colomb. cir ; 36(1): 161-164, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1150547

ABSTRACT

Introducción. El síndrome de atrapamiento poplíteo es una entidad infrecuente, cuya incidencia oscila entre 0,17 y 3,5 %, representando una de las principales causas de isquemia en miembros inferiores en adultos jóvenes. Suele manifestarse con claudicación intermitente (69 %) o isquemia aguda (26 %), siendo muy rara su presentación con isquemia crítica de miembros inferiores. Caso clínico. Paciente de 30 años quien presentó úlcera subungueal en primer dedo de pie derecho con dolor intenso. En la exploración física no se palpaban pulsos distales y se observó palidez cutánea intensa y frialdad. Se realizó arteriografía donde se observó defecto de repleción de bordes regulares y desplazamiento medial de la arteria poplítea. La resonancia magnética mostró una inserción anómala del gastrocnemio medial, con lo que se hizo diagnóstico de síndrome de atrapamiento poplíteo tipo I. Mediante abordaje posterior se realizó reconstrucción vascular con injerto venoso y sección tendinosa del gastrocnemio medial. En el postoperatorio inmediato el paciente recupera pulso pedio y en el seguimiento a un año el paciente no presenta clínica de isquemia de miembros inferiores, encontrándose el baipás permeable. Discusión. A pesar de su baja incidencia, es importante incluir el síndrome de atrapamiento poplíteo en el diagnóstico diferencial de isquemia en miembros inferiores en adultos jóvenes. Su presentación con isquemia crítica es excepcional, encontrando muy pocos casos publicados en la literatura. La reconstrucción arterial precoz mediante injerto o plastia con material autólogo constituye el tratamiento de elección


Introduction. The popliteal entrapment syndrome is an infrequent entity, whose incidence ranges between 0.17 and 3.5%, representing one of the main causes of lower limb ischemia in young adults. It usually manifests with intermittent claudication (69%) or acute ischemia (26%), being very rare its presentation with critical ischemia of the lower limbs.Clinical case. A 30-year-old patient with a history of smoking, with no other risk factors, who presented with a subungual ulcer on the first right toe. On physical examination, distal pulses are not palpated, intense skin paleness and coldness are observed. Magnetic resonance imaging showed an anomalous insertion of the medial gastrocnemius with extrinsic compression of the popliteal artery, confirming a diagnosis of popliteal entrapment syndrome type I. Vascular reconstruction with venous graft and tendon section of the medial gastrocnemius was performed through a posterior approach. In the immediate postoperative period, the patient recovers a pediatric pulse and in the one-year follow-up the patient does not present symptoms of lower limb ischemia, finding the bypass patent. Discussion. Despite its low incidence, it is important to include popliteal impingement syndrome in the differential diagnosis of lower limb ischemia in young adults. Its presentation with critical ischemia is exceptional, finding very few cases published in the literature. Early arterial reconstruction by graft or plasty with autologous material is the treatment of choice


Subject(s)
Humans , Ischemia , Popliteal Artery , Vascular Surgical Procedures , Lower Extremity
11.
Article in Chinese | WPRIM | ID: wpr-879278

ABSTRACT

Lower extremity movement is a complex and large range of limb movement. Arterial stents implanted in lower extremity are prone to complex mechanical deformation, so the stent is required to have high comprehensive mechanical properties. In order to evaluate the mechanical property of different stents, in this paper, finite element method was used to simulate and compare the mechanical properties of six nitinol stents (Absolute Pro, Complete SE, Lifestent, Protégé EverFlex, Pulsar-35 and New) under different deformation modes, such as radial compression, axial compression/tension, bending and torsion, and the radial support performance of the stents was verified by experiments. The results showed that the comprehensive performance of New stent was better than other stents. Among which the radial support performance was higher than Absolute Pro and Pulsar-35 stent, the axial support performance was better than Complete SE, Lifestent and Protégé EverFlex stent, the flexibility was superior to Protégé Everflex stent, and the torsion performance was better than Complete SE, Lifestent and Protégé Everflex stent. The TTR2 type radial support force tester was used to test the radial support performance of 6 types, and the finite element analysis results were verified. The mechanical properties of the stent are closely related to the structural size. The result provides a reference for choosing a suitable stent according to the needs of the diseased location in clinical applications.


Subject(s)
Alloys , Femoral Artery , Finite Element Analysis , Lower Extremity , Mechanical Phenomena , Prosthesis Design , Stents , Stress, Mechanical
12.
Article in Chinese | WPRIM | ID: wpr-878939

ABSTRACT

The evaluation standard of LEAD animal model was established according to the understanding of the etiology and pathogenesis of diabetic lower extremity vascular disease based on Chinese and Western medicine. The consistency between the existing LEAD animal model and the clinical characteristics of traditional Chinese and Western medicine was analyzed and evaluated. The advantages and disadvantages of the existing model were compared,the application scope of different models was considered,and the possible improvement methods of the existing model were proposed,so as to provide impetus for the improvement of LEAD animal model.We should reflect more characteristics of traditional Chinese medicine syndromes in the process of model improvement and development,making the LEAD animal model to get closer to clinical features of traditional Chinese and Western medicine.


Subject(s)
Animals , China , Diabetes Mellitus/drug therapy , Drugs, Chinese Herbal , Lower Extremity , Medicine , Medicine, Chinese Traditional
13.
Article in Chinese | WPRIM | ID: wpr-879423

ABSTRACT

OBJECTIVE@#To compared with the modified Robert Jones bandage of 3M elastic bandage, to evaluate the fitness, convenience, safety and comfort of the modular combination lower limb elastic compression device.@*METHODS@#Forty healthy adult college students, including 28 males and 12 females, aged 16 to 25 (20.3±2.2) years old and weighing 40 to 81 (60.4±20.2) kg, were randomly divided into two groups with 40 samples in each group. According to the body surface parameters of Chinese lower limbs and guided by the concept of modularization, a group of modular combined lower limb elastic compression device was designed. Each module was combined to evaluate the fitness of the modular combined compression device in thelength and circumference of the lower limbs. The left and right lower limbs were randomly paired and divided into groups, with 40 samples in each group. The convenience of the operation time, adjustment times and required time were compared between two groups. The safety of the two groups after 24 hours of application of pressure injury was compared. The subjective pain feeling changes within 24 hours were recorded by visual analogue scale (VAS) to evaluate the comfort.@*RESULTS@#The device was composed of several elastic compression outer lining modules with different length and width of 15 cm, an inner lining module for buffering, positioning and attaching the main body, and an elastic ankle compression module. The length of the elastic compression outer lining module covers the circumference of the human lower limbs. The length of a single outer lining module increased from 15 cm to 80 cm every 5 cm interval, and the length of a single inner lining module increased from 62 cm to 83 cm every 3 cm interval. After the modules were selected and combined, the length and circumference of the lower limbs can reach 100% fitness. The operation time of the first placement(118.23±7.33) s and re operation(60.08±5.88) s of experimental group were significantly shorter than those of control group (164.68±8.93) s and re operation (131.23±7.91) s. The adjustment times (3) and operation time (3.50±0.71) s of experimental group were significantly shorter than those of control group(11)and operation time(139.00±5.66) s (@*CONCLUSION@#The modular combined elastic compression device has good fitness, better placement and flexible adjustment, convenience and safety, and better comfort than modified Robert Jones bandage of 3M elastic bandage.


Subject(s)
Adolescent , Adult , Compression Bandages , Female , Humans , Lower Extremity , Male , Pain Measurement , Pressure , Treatment Outcome , Young Adult
14.
Article in Chinese | WPRIM | ID: wpr-879395

ABSTRACT

Femorotibial mechanical axis (FTMA) is one of important factors influencing clinical effect after total knee arthroplasty (TKA). It is generally believed that the range of lower limb alignment after TKA is controlled within neutral FTMA ± 3 °, which has more advantages in improving joint function, prolonging prosthesis survival rate and reducing revision rate, and obtain better clinical results. Therefore, neutral FTMA is also considered to be the gold standard for TKA. However, with the application of computer-assisted surgery and other technologies, the alignment of FTMA is more accurate than before, but the clinical effect after surgery has not significantly improved. Some scholars have begun to question the necessity of neutral alignment of FTMA, and proposed alignment methods such as kinematics and retained residual deformity, which could achieve better clinical effects. In recent years, it has been reported that FTMA might not be the most important factor influencing postoperative clinical effects, and it is suggested that the arrangement and measurement of lower limbs and the effects on adjacent joint functions could affect clinical effect after TKA. The paper reviews neutral FTMA alignment is still an important factor for success of TKA. After a thorough evaluation according to the patient's condition, it should be appropriately applied in the case of neutral FTMA alignment; the operator should explore other factors which affect clinical outcome after TKA, and improve it to achieve the best therapeutic effect.


Subject(s)
Arthroplasty, Replacement, Knee , Biomechanical Phenomena , Humans , Knee Joint/surgery , Knee Prosthesis , Lower Extremity , Osteoarthritis, Knee/surgery , Prosthesis Failure , Surgery, Computer-Assisted
15.
Rev. cuba. invest. bioméd ; 39(4): e567, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156454

ABSTRACT

Introducción: El baloncesto es objeto de múltiples estudios que incluye la valoración mediante tecnologías actuales como la bioimpedancia. Objetivo: Comparar los índices de asimetría (IA) de las extremidades superiores e inferiores en jugadores de baloncesto universitario por nivel deportivo. Método: Se evaluaron 24 jugadores de baloncesto de diferente nivel competitivo, representativo 1) universitario (n = 12) y 2) facultad (n = 12). Se determinó la circunferencia de brazos y piernas, además de masa magra y grasa por bioimpedancia. Se determinó el índice de asimetría de los miembros inferiores y superiores y se compararon por nivel deportivo. Resultados: La comparación de los índices de asimetría entre brazos y piernas en el grupo total identificó diferencias estadísticamente significativas (p < 0,05) en lo referente a la masa grasa, con mayor adiposidad en extremidades superiores, y un índice de asimetría de -10,8. Cuando se compararon las mismas variables en función del nivel deportivo, los jugadores representantes de la universidad mostraron mayores valores (p < 0,05) en el índice de asimetría de la masa total, circunferencias, masa magra y masa grasa. Las comparaciones intergrupales señalan diferencias en los índices de asimetría del brazo vs. la pierna en masa magra para ambos grupos (p < 0,05) mientras que los de la facultad mostraron diferencia también para grasa con índice de asimetría de 18,3 (p < 0,05). Conclusiones: Indistintamente del nivel deportivo, existen diferentes niveles del índice de asimetría entre extremidades superiores e inferiores en el componente de masa grasa, aunque menores valores del índice de asimetría fueron característicos de los individuos de mayor nivel deportivo(AU)


Introduction: Basketball has been the object of many studies, including assessments based on current technologies such as bioimpedance. Objective: Compare the asymmetry indices (AI) for upper and lower limbs in university basketball players. Methods: An evaluation was conducted of 24 basketball players from different competitive levels, representing 1) the university (n = 12) and 2) the school (n = 12). Determination was made of arm and leg circumference, as well as lean mass and fat by bioimpedance. The lower and upper limb asymmetry index was estimated and compared between the competitive levels. Results: Comparison of the arms and legs asymmetry indices in the total group revealed statistically significant differences (p < 0.05) as to fat mass, with greater adiposity in the upper limbs and an asymmetry index of 10.8. Comparison of the same variables between the sports levels found that players representing the university displayed higher values (p < 0.05) in the asymmetry index for total mass, circumferences, lean mass and fat mass. Comparison between the groups found differences in the arm vs. leg asymmetry indices for lean mass in both groups (p < 0.05), whereas the school players also showed differences for fat, with an asymmetry index of 18.3 (p < 0.05). Conclusions: Regardless of the sports level, different asymmetry indices are found between upper and lower limbs as to fat mass, though smaller asymmetry index values were characteristic of individuals from a higher sports level(AU)


Subject(s)
Humans , Male , Adult , Basketball/physiology , Electric Impedance , Lower Extremity/physiology , Upper Extremity/physiology , Universities/ethics
16.
Rev. cuba. ortop. traumatol ; 34(2): e302, jul.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156593

ABSTRACT

RESUMEN Introducción: La cobertura de dispositivos ortopédicos expuestos y las infecciones en el hueso con colgajos es un tema controvertido. No existe un consenso claro sobre el tratamiento de esta complicación. En los últimos años se aprecia una tendencia a mantener el material de osteosíntesis y a controlar la infección aportando tejido bien vascularizado en forma de colgajo muscular o fasciocutáneo. Objetivo: Evaluar el éxito reconstructivo con colgajos de defectos de partes blandas en miembros que han precisado de una osteosíntesis, en función de la presencia de infección y el estado de los dispositivos de implante en el momento de la reconstrucción. Métodos: Estudio retrospectivo de una serie de 15 casos con un defecto de partes blandas en las extremidades inferiores secundario a la implantación de dispositivos ortopédicos en el hueso. Todos los casos recibieron cobertura con un colgajo muscular o fasciocutáneo con o sin retirada de los implantes. Se estudió la presencia o ausencia de infección previa a la reconstrucción (signos clínicos, resultado del cultivo microbiológico y exposición del material ortopédico), la retirada o mantenimiento del implante durante la reconstrucción, y la presencia de complicaciones posoperatorias. Se relacionaron estas variables con el éxito reconstructivo posoperatorio. El análisis de las variables se realizó con los estadísticos chi cuadrado, Wilcoxon y U de Mann Whitney, según el tipo de variable, y para una significación de 0,05. Resultados: La frecuencia de éxito reconstructivo fue mayor en aquellos pacientes con cultivo negativo sin exposición de material óseo (p = 0,038). Se encontró menor tasa de complicaciones en los pacientes que presentaban infección antes de la reconstrucción (p = 0,039), y en aquellos con cultivo positivo y exposición del material previos a la cirugía, cuyos implantes habían sido retirados durante la reconstrucción (p = 0,032). Conclusiones: El aporte de tejido bien vascularizado en forma de colgajo permite el mantenimiento del material ortopédico con una frecuencia de éxito de 66,67 %, y resultados favorables de mediano a largo plazo. La exposición y el resultado del cultivo son indicadores predictivos de los resultados de la cirugía(AU)


ABSTRACT Introduction: The covering of exposed orthopedic devices and bone infections with flaps are a controversial issue. There is no clear consensus concerning the treatment of this complication. In recent years, there has been a trend to maintain the osteosynthesis material and to control the infection by providing well vascularized tissue in the form of a muscular or fasciocutaneous flap. Objective: To assess the reconstructive success with flaps of soft tissue defects in limbs that have required osteosynthesis, based on the presence of infection and the status of the implant devices at the time of reconstruction. Methods: Retrospective study of a series of 15 cases with soft tissue defect in the lower limbs after implantation of orthopedic devices to the bone. All the cases were covered with muscle or fasciocutaneous flap, with or without removal of the implants. The presence or absence of infection prior to reconstruction (clinical signs, results of microbiological culture, and exposure of the orthopedic material), removal or maintenance of the implant during reconstruction, and the presence of postoperative complications were studied. These variables were associated with postoperative reconstructive success. The analysis of the variables was performed using the chi-square, as well as Wilcoxon and Mann Whitney U tests, according to the type of variable, and for a significance of 0.05. Results: The frequency of reconstructive success was higher in those patients with negative culture and without exposure of bone material (P=0.038). A lower rate of complications was found in patients with infection before reconstruction (P=0.039), and in those with positive culture and exposure of the material prior to surgery, whose implants had been removed during reconstruction (P=0.032). Conclusions: The provision of well vascularized tissue in the form of flap allows maintenance of the orthopedic material with a success rate of 66.67%, as well as favorable outcomes in the mid to long terms. The results of exposure and culture are predictive indicators of surgery outcomes(AU)


Subject(s)
Humans , Arthroplasty/adverse effects , Surgical Flaps/transplantation , Lower Extremity/surgery , Fracture Fixation, Internal/adverse effects , Retrospective Studies
17.
Rev. cuba. angiol. cir. vasc ; 21(3): e191, sept.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156382

ABSTRACT

Introducción: La enfermedad isquémica del corazón y la enfermedad arterial periférica de miembros inferiores mantienen su vigencia como problemas de salud por presentar elevadas tasas de prevalencias y ser causas principales de morbi-mortalidad. Objetivo: Identificar la presencia de la enfermedad arterial periférica de miembros inferiores. Métodos: Se realizó un estudio descriptivo, ambispectivo y analítico en 167 pacientes con cardiopatía isquémica, dispensarizados en un área de salud del municipio San Miguel del Padrón, de la provincia La Habana. La edad promedio del grupo fue de 64 ± 8 años (rango: 39-81). El período de investigación abarcó tres años y finalizó en 2017. Las variables de estudio fueron: edad, sexo, factores de riesgo (tabaquismo, obesidad, dislipidemia, hipertensión arterial), índice de presiones tobillo brazo, presencia de la enfermedad arterial periférica de miembros inferiores y su severidad. Resultados: Se encontraron 43 pacientes cardiópatas con enfermedad arterial periférica de miembros inferiores para una prevalencia porcentual de 26 por ciento. El 60,5 por ciento (n = 26) del total era sintomáticos, con igual frecuencia para el estadio y la severidad moderada de la enfermedad (51,2 por ciento). Los factores de riesgo más frecuentes fueron la hipertensión arterial (83,7 por ciento) y el tabaquismo (81,4 por ciento), los cuales resultaron asociados significativamente (p < 0,05) con la presencia de la enfermedad arterial periférica de miembros inferiores. Conclusiones: La enfermedad arterial periférica es común en los pacientes con cardiopatía isquémica, asociada fuertemente con la hipertensión arterial y el tabaquismo(AU)


Introduction: Ischemic heart disease and lower limb´s peripheral artery disease are still health problems because they have high prevalence rates and are major causes of morbidity and mortality. Objective: Identify the presence of lower limb´s peripheral artery disease in patients with ischemic heart disease. Methods: A descriptive, ambispective and analytical study was carried out in 167 patients with ischemic heart disease who were classified in a health area of San Miguel del Padrón municipality, Havana province. The average age of the group was 64 ± 8 years (range: 39-81). The research period spanned three years and ended in 2017. The study variables were: age, sex, risk factors (smoking, obesity, dyslipidemia, high blood pressure), ankle arm pressure index, presence of lower limb´s peripheral artery disease and its severity. Results: 43 patients suffering a cardiopathy with lower limb´s peripheral artery disease were found for a percentage prevalence of 26 percent. 60.5 percent (n = 26) of the total were symptomatic, with equal frequency for the stage and moderate severity of the disease (51.2 percent). The most common risk factors were high blood pressure (83.7 percent) and smoking habit (81.4 percent), which were significantly associated (p< 0.05) with the presence of lower limb´s peripheral artery disease. Conclusions: Peripheral artery disease is common in patients with ischemic heart disease, and it is strongly associated with high blood pressure and smoking habit(AU)


Subject(s)
Humans , Male , Female , Risk Factors , Lower Extremity , Peripheral Arterial Disease , Prevalence
18.
Rev. cuba. med. mil ; 49(4): e826, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156508

ABSTRACT

Introducción: Las investigaciones sobre la incidencia de la masa muscular apendicular en la fuerza muscular en poblaciones sanas y clínicas es escasa, lo cual dificulta la práctica clínica y prescripción del ejercicio a los profesionales de la salud. Objetivo: Determinar la relación entre la masa muscular de miembros inferiores y la repetición máxima en sentadilla media en sujetos capacitados en el entrenamiento de la fuerza con sobrecargas. Métodos: Estudio descriptivo-correlacional con una muestra a conveniencia conformada por diez hombres (edad 17,40 ± 2,32 años, talla 172,10 ± 5,76 cm y una masa corporal de 79,13 ± 19,54 kg), se evaluó la fuerza máxima a través de un test de repetición máxima en el ejercicio sentadilla media, y la masa muscular de miembros inferiores fue estimada a través de una ecuación predictiva. Se utilizó el paquete estadístico PSPP (nivel de confianza del 95 por ciento y un p-valor de 0,05) para el análisis estadístico se aplicó las pruebas de normalidad (Shapiro-Wilk) y el coeficiente correlacional de Pearson. Resultados: La masa muscular de miembros inferiores y la repetición máxima en sentadilla media presentaron una distribución normal (p > 0,05), mientras que la relación entre la masa muscular de miembros inferiores y la repetición máxima en la sentadilla media fue negativa y no significativa (r = -0,45; p > 0,05). Conclusión: La masa muscular de miembros inferiores se relaciona de forma negativa y no significativa con la repetición máxima en sentadilla media en sujetos capacitados en el entrenamiento de la fuerza con sobrecargas(AU)


Introduction: Research on the incidence of appendicular muscle mass in muscle strength in healthy and clinical populations is scarce, making it difficult to practice and prescribe exercise for health professionals. Objective: Determine the relationship between lower limb muscle mass and maximum repetition in half squat in subjects trained in strength training with overloads. Methods: Descriptive-correlational study with a sample of ten men's convenience (age 17,40 ± 2,32 years, a size of 172,10 ± 5,76 cm and a body mass of 79,13 ± 19,54 kg), the maximum strength was evaluated through a maximum repetition test in the half squat exercise, and the muscle mass of lower limbs was estimated through a predictive equation. The PSPP statistical package (95 percent confidence level and a p-value of 0,05) was used for statistical analysis using the normality tests (Shapiro-Wilk) and Pearson correlational coefficient. Results: The muscle mass of lower limbs and the maximum repetition in half squat was presented a normal distribution (p > 0,05), while the relationship between the muscle mass of lower limbs and the maximum repetition in the half squat was negative and not significant (r = -0,45; p > 0,05). Conclusion: The muscle mass of lower limbs is negatively and not significantly related to the maximum repetition in half squat in subjects trained in strength training with overloads(AU)


Subject(s)
Humans , Lower Extremity/anatomy & histology , Exercise Test/methods , Muscle Strength , Epidemiology, Descriptive
19.
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
20.
Rev. bras. ortop ; 55(5): 629-636, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144223

ABSTRACT

Abstract Objective To analyze the epidemiological profile and evolution of 20 patients diagnosed with upper- and lower-limb schwannomas. Methods A group of patients was defined for a retrospective evaluation comprising the period between February 2002 and June 2018, in which we studied and evaluated 20 medical records of patients undergoing surgery due to schwannoma; the diagnosis was confirmed by an anatomopathological examination. Results Male and female patients were equally affected. The average age was 50.85 years, ranging from 12 to 77 years. There was a predominance of the upper limb and of the flexor face. The most affected nerve was the ulnar nerve. In total, 6 (30%) patients had transient postoperative complications. No cases of tumor recurrence were identified. Conclusion Schwannoma is a rare and difficult-to-diagnose lesion. It should always be considered as a hypothesis when facing a soft-tissue tumor affecting the limbs. The Tinel sign should be regarded, given its higher correlation with complications. The patients should be informed of the possible postoperative complications, which are frequent but usually transient.


Resumo Objetivo Analisar o perfil epidemiológico e a evolução de 20 pacientes diagnosticados com schwannoma nos membros superiores e inferiores. Métodos Definiu-se um grupo de pacientes para avaliação retrospectiva, compreendendo o período entre fevereiro de 2002 e junho de 2018, no qual foram estudados e avaliados 20 prontuários de pacientes submetidos a procedimento cirúrgico devido a schwannoma; a confirmação diagnóstica foi feita pelo exame anatomopatológico. Resultados Tanto os pacientes do sexo masculino quanto do feminino foram igualmente acometidos, e a média de idade foi de 50,85 anos, variando de 12 a 77 anos. Houve predomínio do membro superior e da face flexora. O nervo mais acometido foi o ulnar, e 6 (30%) pacientes apresentaram complicações pós-operatórias transitórias. Não foi identificado nenhum caso de recidiva tumoral. Conclusão O schwannoma é uma lesão rara e de difícil diagnóstico. Deve sempre ser considerada como hipótese quando se estiver diante de um tumor de partes moles acometendo os membros. O sinal de Tinel deve ser levado em consideração por conta de sua maior correlação com as complicações. Os pacientes devem ser informados quanto às possíveis complicações pós-operatórias, que são frequentes, mas, geralmente, transitórias.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Peripheral Nervous System Neoplasms/epidemiology , Peripheral Nerves , Lower Extremity , Upper Extremity , Neurilemmoma/epidemiology , Peripheral Nervous System Neoplasms/surgery , Peripheral Nervous System Neoplasms/diagnosis , Postoperative Complications , Retrospective Studies , Neurilemmoma/surgery , Neurilemmoma/diagnosis
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