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1.
Rehabil. integral (Impr.) ; 15(1): 20-29, ago. 2021. tab
Article in Spanish | LILACS | ID: biblio-1283456

ABSTRACT

INTRODUCCIÓN: Las deficiencias congénitas y adquiridas de extremidades superiores son una condición importante en la población pediátrica, existe poca información respecto de sus características clínicas, sociodemográficas y las asociadas al uso de prótesis. OBJETIVO: Describir las características clínicas y sociodemográficas de la población infantojuvenil entre 2 y 17 años con diagnóstico de deficiencia de extremidades superiores adquirida y/o congénita, pertenecientes al Instituto Teletón Santiago (IT-S). METODOLOGÍA: Estudio transversal, en población infantojuvenil entre 2 y 17 años, con diagnóstico de deficiencia de extremidades superiores, adquirida y congénita, que se atienden en el IT-S. Se realizó una revisión de fichas clínicas y encuesta para la obtención de datos de características sociodemográficas, clínicas y asociadas al uso de prótesis. RESULTADOS: Se incluyeron 215 pacientes, 93,9% de etiología congénita y 6,1% adquirida. El nivel de la deficiencia más frecuente fue parcial de mano con 51,6%, seguido del transradial con 33,1%. El 33% de los 215 pacientes estudiados tuvieron prescripción de prótesis. De los pacientes con prescripción de prótesis, 78,9% correspondía a mecánica y 18,3% a prótesis 3D. El 53,5% usaba su prótesis y el 46,4% no la usaba. Respecto a las prótesis 3D, el 84,6% no la usaban. En el nivel parcial de mano, el 83,3% no usaban su prótesis. CONCLUSIONES: Este estudio aporta datos de importancia clínica, destacando, una prescripción protésica de inicio temprano y asociada a las características clínicas de los pacientes. Así mismo, existe una alta tasa de no uso de las prótesis 3D, en el nivel parcial de mano.


INTRODUCTION: Congenital and acquired deficiencies of the upper extremities are an important condition in the pediatric population, however, there is almost no information regarding the clinical and sociodemographic characteristics and those associated with the use of prostheses. OBJECTIVE: Describe the clinical and sociodemographic characteristics of the child and adolescent population between 2 and 17 years old with a diagnosis of acquired and/or congenital upper limb deficiency, belonging to the Instituto Teletón Santiago (IT-S). METHODS: A cross-sectional study was conducted in child and adolescent population between 2 and 17 years old, with a diagnosis of acquired and/ or congenital upper limb deficiency treated in the IT-S. A review of clinical records and a survey were carried out to obtain data on sociodemographic and clinical characteristics and characteristics associated with the use of prostheses. RESULTS: 215 patients were included, 93.9% of congenital and 6.1% of acquired etiology. The most common level of deficiency was partial hand with 51.6%, followed by transradial with 33.1%. 33% of the 215 patients included had a prescription for a prosthesis. 78.9% of the patients with a prosthesis prescription had a mechanical prosthesis and 18.3% had a 3D prosthesis. 53.5% used their prosthesis and 46.4% did not use it. 84.6% of the patients with 3D prostheses did not use them and an 83.3% of the patients with a partial hand level deficiency did not use their prosthesis. CONCLUSION: This study provides data of clinical importance, highlighting an early-onset prosthetic prescription associated with the clinical characteristics of the patients. Likewise, there is a high rate of non-use of 3D prostheses at the partial hand level.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Upper Extremity/pathology , Upper Extremity Deformities, Congenital/epidemiology , Prostheses and Implants , Socioeconomic Factors , Chile , Cross-Sectional Studies , Surveys and Questionnaires , Retrospective Studies , Upper Extremity Deformities, Congenital/rehabilitation , Amputation
2.
Fisioter. Bras ; 22(3): 486-499, Jul 15, 2021.
Article in Portuguese | LILACS | ID: biblio-1290557

ABSTRACT

Uma das principais causas de morte e limitação funcional em todo o mundo é o Acidente Vascular Encefálico (AVE), causando alterações significativas sobre as atividades de vida diária do indivíduo. O AVE ocorre a partir de comprometimentos vasculares, ocasionando danos cognitivos e musculares, sendo necessário o tratamento fisioterapêutico para a recuperação da função. A realidade virtual se tornou uma aliada da fisioterapia para a recuperação de pacientes pós-AVE, como forma de tornar o tratamento mais interativo e atraente para o paciente. O presente estudo teve como objetivo verificar a eficácia do uso da realidade virtual na recuperação funcional dos membros superiores em pacientes com sequelas de AVE, por meio de uma revisão sistemática. Os estudos utilizados foram buscados em duas bases de dados, onde aqueles selecionados deveriam obedecer aos critérios de inclusão e exclusão pré-determinados. Os resultados obtidos mostraram que a realidade virtual em conjunto com a fisioterapia pode proporcionar resultados significantes para a melhora funcional do membro superior afetado, o que acarreta melhora e bem estar geral do paciente. (AU)


One of the main causes of death and functional limitation worldwide is the stroke, causing significant changes in the individual's daily activities. Stroke occurs from vascular impairments, causing cognitive and muscle damage, requiring physiotherapeutic treatment to recover function. Virtual reality has become a complement of physiotherapy for the recovery of post-stroke patients, with a way of making treatment more interactive and attractive to the patient. The present study aimed to verify the effectiveness of the use of virtual reality in the functional recovery of the upper limbs in patients with stroke sequelae, through a systematic review. The studies used were searched on two scientific bases, where those selected should obey the predetermined inclusion and exclusion criteria. The results obtained showed that virtual reality in conjunction with physical therapy can provide significant results for the functional improvement of the upper limb affected, which leads to improvement and general well-being of the patient. (AU)


Subject(s)
Humans , Paralysis , Stroke , Virtual Reality , Quality of Life , Physical Therapy Modalities , Upper Extremity
3.
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
4.
Rev. inf. cient ; 100(1): 1-6, ene.-feb. 2021. graf
Article in Spanish | LILACS | ID: biblio-1156709

ABSTRACT

RESUMEN Los aneurismas venosos, en especial de la extremidad superior, son malformaciones vasculares de baja frecuencia. Se presentó el manejo de dos pacientes del sexo femenino atendidas en el Servicio de Angiología y Cirugía Vascular del Hospital General Docente "Dr. Agostinho Neto" de la provincia Guantánamo, Cuba, a las que se les diagnosticaron aneurismas en diferentes segmentos del sistema venoso superficial de la extremidad superior, los que se resecaron quirúrgicamente y se les confirmó el diagnóstico mediante biopsia.


ABSTRACT Venous aneurysms, especially the ones located in the upper limbs, are vascular malformations with low incidence in the population. Two cases of venous aneurisms on female patients showed up at the Angiology and Vascular Surgery services at the General Teaching Hospital ¨Dr. Agostinho Neto¨ in Guantanamo, Cuba. Aneurism diagnosis was confirmed through biopsy. They were located in different segments of the superficial venous system of the upper limbs, and were surgically resected.


RESUMO Os aneurismas venosos, principalmente de membro superior, são malformações vasculares de baixa frequência. Foi apresentada a gestão de duas pacientes do sexo feminino atendidas no Serviço de Angiologia e Cirurgia Vascular do Hospital General Docente "Dr. Agostinho Neto" da província de Guantánamo, Cuba, que foram diagnosticados com aneurismas em diferentes segmentos do sistema venoso superficial do membro superior, os quais foram ressecados cirurgicamente e o diagnóstico foi confirmado por biópsia.


Subject(s)
Humans , Female , Middle Aged , Upper Extremity/injuries , Aneurysm/surgery , Aneurysm/diagnosis
5.
Clin. biomed. res ; 41(1): 53-56, 2021. ilus
Article in Portuguese | LILACS | ID: biblio-1254974

ABSTRACT

O presente estudo teve por objetivo relatar os efeitos do uso da realidade virtual não imersiva através de um jogo criado para a reabilitação de membro superior pós AVC. O mesmo foi aplicado com quatro pacientes na Unidade de Cuidados Especiais do Hospital de Clínicas de Porto Alegre, sendo realizado duas vezes ao dia durante a semana e uma vez ao dia nos finais de semana, desde a avaliação ao momento da alta hospitalar. Foi realizado a avaliação inicial e final da escala de Rankin modificada e selecionou-se as jogadas inicial e final para a verificação dos resultados. A análise dos dados foi realizada através de estatística descritiva. Os resultados demonstraram uma diminuição do tempo de execução do jogo com aumento da pontuação alcançada durante os desafios na maioria dos pacientes. Entende-se que jogos sérios podem ser utilizados como complemento na reabilitação pós-AVC. (AU)


The present study aimed to report the effects of using a non-immersive virtual reality game on patients undergoing upper limb rehabilitation after stroke. The intervention was administered to 4 patients in the Special Care Unit at Hospital de Clínicas de Porto Alegre; it was performed twice a day during the week and once a day on weekends, from baseline to discharge. The initial and final evaluations were conducted using the modified Rankin scale, and the initial and final moves were selected to check the results. Data analysis was performed using descriptive statistics. The results showed a decrease in game execution time with an increase in the score achieved during the challenges in most patients. It is believed that serious games can be used as an additional tool in post-stroke rehabilitation. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Upper Extremity , Stroke Rehabilitation , Virtual Reality
6.
Rev. Bras. Cancerol. (Online) ; 67(3): e-021168, 2021.
Article in English | LILACS | ID: biblio-1291816

ABSTRACT

Introduction: Surgical treatment after the diagnosis of breast cancer can lead to several consequences of the survivor's upper limb. Objective: Analyze the physical function of the upper limb after breast cancer surgery in Southern Brazilian survivors. Method: 82 breast cancer survivors (55±10 years) receiving hormone therapy were included. A questionnaire for general information, pain (Visual Analogue Scale), and upper limb functionality (DASH) were applied, followed by physical tests; the shoulder range of motion (goniometer), strength (dynamometer), proprioception (kinesimeter) and arm volume (perimeter of the arm). Results: No differences were found for any variable of physical function in relation to mastectomy or breast-conserving surgery. However, better scores of strength and the shoulder range of motion were found for the non-surgery arm. Linear regression demonstrated a relation between pain, strength, range of motion, proprioception, and arm volume with the disabilities of the upper limb, and when adjusted by surgery modality, shoulder range of motion, arm volume, and proprioception maintained significantly. Conclusion: Breast cancer survivors presented physical disabilities on the upper limb after surgery, regardless of the modality of surgery. Results elucidate the need for an efficient post-treatment program to prevent poor physical function after breast cancer surgery and provide better daily activities to these women.


Introdução: O tratamento cirúrgicodo câncer de mama pode levar a consequências físicas no membro superior de sobreviventes. Objetivo: Analisar a funcionalidade do membro superior após cirurgia de câncer de mama em sobreviventes do Sul do Brasil. Método: Foram avaliadas82 sobreviventes de câncer de mama (55±10 anos) em tratamento com hormonioterapia. Foi aplicado um questionário para informações gerais, dor (Escala Visual Analógica) e funcionalidade do membro superior (DASH), seguido de testes físicos; amplitude de movimento (goniômetro), força (dinamômetro), propriocepção (cinesiômetro) e volume do braço (perímetro do braço). Resultados: Não foram encontradas diferenças para nenhuma das variáveis de funcionalidade em relação à mastectomia ou cirurgia conservadora de mama. No entanto, melhores escores de força e amplitude de movimento foram apresentados no membro contralateral à cirurgia. A regressão linear demonstrou uma relação entre dor, força, amplitude de movimento, propriocepção e volume do braço com as disfunções do membro superior e, quando ajustada pela modalidade de cirurgia, apenas a amplitude de movimento, volume do braço e propriocepção mantiveram--se significativamente. Conclusão: A cirurgia do câncer de mama pode levar à pior funcionalidade no membro superior, independentemente da modalidade da cirurgia. Os resultados elucidam a necessidade de um programa eficiente de pós-tratamento para prevenir as consequências na função física do membro superior após cirurgia de câncer de mama e proporcionar melhora nas atividades de vida diária nessa população.


Introducción: El tratamiento quirúrgico después del diagnóstico de cáncer de seno puede conducir a varias consecuencias de la extremidad superior de la sobreviviente. Objetivo: Analizar la función física de la extremidad superior después de una cirugía de cáncer de mama en sobrevivientes del sur de Brasil.Método: Se incluyeron 82 sobrevivientes de cáncer de mama (55±10 años) que recibieron terapia hormonal. Se aplicó un cuestionario para información general, dolor (escala analógica visual) y funcionalidad de la extremidad superior (DASH), seguido de pruebas físicas; el rango de movimiento (goniómetro), fuerza (dinamómetro), propiocepción (kinesímetro) y volumen del brazo (perímetro del brazo). Resultados: No se encontraron diferencias para ninguna variable de la función física con respecto a someterse a una mastectomía o cirugía conservadora de seno. Sin embargo, se encontraron mejores puntajes de fuerza y rango de movimiento para el brazo no quirúrgico. La regresión lineal demostró una relación entre el dolor, la fuerza, el rango de movimiento, la propiocepción y el volumen del brazo con las discapacidades de la extremidad superior, y cuando se ajustó por la modalidad quirúrgica, el rango de movimiento, el volumen del brazo y la propiocepción se mantuvieron significativamente. Conclusión: Las sobrevivientes de cáncer de mama presentaron discapacidades físicas en la extremidad superior después de la cirugía, independientemente de la modalidad de la cirugía. Los resultados aclaran la necesidad de un programa de postratamiento eficiente para prevenir la mala función física después de la cirugía de cáncer de mama y proporcionar mejores actividades diarias a estas mujeres.


Subject(s)
Humans , Female , Middle Aged , Aged , Breast Neoplasms/rehabilitation , Upper Extremity/physiopathology , Mastectomy/rehabilitation , Pain/rehabilitation , Brazil , Breast Neoplasms/surgery , Breast Neoplasms/therapy , Survivors , Muscle Strength
7.
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
8.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(4): 369-376, dic. 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1351412

ABSTRACT

Objetivo: Utilizar la escala LRINEC en pacientes con infecciones necrosantes de miembros superiores y evaluar su correlación con la morbimortalidad ortopédica. Materiales y Métodos: Se llevó a cabo una revisión sistemática de las historias clínicas de los pacientes operados por nuestro equipo, entre el 1 de marzo de 2015 y el 1 de marzo de 2020. Se registraron los puntajes de la escala LRINEC de cada paciente operado con diagnóstico clínico y posoperatorio de infección necrosante de partes blandas, así como sus antecedentes clínicos, el microorganismo, las complicaciones y la morbimortalidad ortopédica, y otros datos clínicos importantes (tiempo de internación en terapia intensiva, necesidad de asistencia respiratoria mecánica y de diálisis, cantidad de cirugías), y se los comparó con el puntaje. Resultados: Se analizaron 4126 historias clínicas de pacientes operados por nuestro equipo. Tres tuvieron infecciones necrosantes del miembro superior. El puntaje aplicado en forma retrospectiva determinó que todos tenían una alta probabilidad de sufrir una infección necrosante. Los pacientes con puntaje más alto desarrollaron más comorbilidades ortopédicas y clínicas. Conclusiones: La escala LRINEC es un instrumento reproducible para el diagnóstico de infecciones necrosantes de partes blandas y está relacionada con el número de complicaciones y la morbilidad ortopédica, aunque no necesariamente con la cantidad de cirugías realizadas. Nivel de Evidencia: II


Objective: To use the LRINEC scoring system for necrotizing infections of the upper extremity and study its correlation with morbidity and mortality in Orthopedics patients Materials and Methods: We conducted a systematic review of the medical records of patients operated on by our team between March 1, 2015, and March 1, 2020. Data collection included the LRINEC scores of every patient who underwent surgery and had a clinical and postoperative diagnosis of necrotizing soft tissue infection, as well as their clinical history, causative organism, complications, Orthopedics-related morbidity and mortality data, and other significant clinical data (length of intensive care stay, need for mechanical respiratory assistance, need for dialysis, number of surgeries), which were then compared with their respective LRINEC score. Results: The review included 4126 medical records of patients who had undergone surgery by our team. There were three recorded cases of necrotizing infections in the upper extremity. Their LRINEC scores were retrospectively calculated and all of them showed a high risk of developing a necrotizing infection. The patients with the highest scores developed more Orthopedics and other clinical conditions. Conclusions: The LRINEC score is a reproducible method for the diagnosis of necrotizing soft tissue infections and is related to the number of complications and orthopedic conditions, although not necessarily with the number of surgeries. Level of Evidence: II


Subject(s)
Indicators of Morbidity and Mortality , Soft Tissue Infections , Fasciitis, Necrotizing , Upper Extremity
10.
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
11.
Int. j. morphol ; 38(4): 963-969, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1124883

ABSTRACT

During routine undergraduate dissections of the upper limb, variations on the usual arterial and muscular patterns were observed in a 68 year-old male cadaver. The arterial and muscular pattern found in our specimen is similar to that of some primates in the following terms. 1) Brachial artery duplicity, on the right side, with a superficial brachio-ulnoradial artery. 2) In the right upper limb, the biceps brachii muscle continued with the superficial muscles of the forearm. 3) The brachial artery on the left side, cross over in front of the median nerve, as the only artery of the arm with a network axillary pattern. 4) On both sides, the ulnar artery was superficial and originated at the elbow from superficial brachial arteries. 5) The right anterior interosseous artery intervened in the vascularization of the hand. These results suggest that this may be a case of early detention of human embryonic development and/or the persistence of phylogenetic older patterns. In the literature, we have found no reference to the presence of all these variations in the same individual. The objective of our study was to analyze these variations from an embryological and phylogenetic perspective.


Durante las disecciones de pregrado de rutina del miembro superior, se observaron variaciones en los patrones arteriales y musculares habituales en un cadáver macho de 68 años. El patrón arterial y muscular que se encuentra en nuestro espécimen es similar al de algunos primates en los siguientes términos. 1) Duplicidad de la arteria braquial, en el lado derecho, con una arteria braquioulnoradial superficial. 2) En el miembro superior derecho, el músculo bíceps braquial continuó con los músculos superficiales del antebrazo. 3) La arteria braquial en el lado izquierdo, se cruza frente al nervio mediano, como la única arteria del brazo con un patrón axilar en red. 4) En ambos lados, la arteria ulnar era superficial y se originó en el codo de las arterias braquiales superficiales. 5) La arteria interósea anterior derecha intervino en la vascularización de la mano. Estos resultados sugieren que este puede ser un caso de detención temprana del desarrollo embrionario humano y/o la persistencia de patrones filogenéticos más antiguos. En la literatura, no hemos encontrado ninguna referencia a la presencia de todas estas variaciones en el mismo individuo. El objetivo de nuestro estudio fue analizar estas variaciones desde una perspectiva embriológica y filogenética.


Subject(s)
Humans , Male , Aged , Arteries/anatomy & histology , Upper Extremity/blood supply , Anatomic Variation , Arteries/embryology , Cadaver , Upper Extremity/embryology
12.
Arch. argent. pediatr ; 118(4): e400-e404, agosto 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1118589

ABSTRACT

El exantema periflexural asimétrico de la infancia es una entidad subdiagnosticada, de etiología incierta, que afecta, predominantemente, a niñas alrededor de los dos años de edad. Se caracteriza por ser un exantema que solo afecta a un hemicuerpo y que se resuelve sin tratamiento específico.Se reportan dos casos clínicos acerca de esta entidad. El primero, referente a una niña de 14 meses con exantema papuloeritematoso de inicio en la axila siete días antes y extensión a la extremidad superior y el hemitronco ipsilateral sin otras alteraciones. El segundo, referente a una niña de 24 meses de edad con exantema papuloeritematoso pruriginoso de inicio en la extremidad inferior izquierda y la posterior extensión por el hemicuerpo izquierdo.Dadas las características del exantema y la edad de las pacientes, se diagnosticó exantema periflexural asimétrico y recibió tratamiento sintomático, con resolución del cuadro de forma espontánea


The asymmetric periflexural exanthema of childhood is an underdiagnosed entity of unknown etiology that affects, most commonly, girls around two years of age. Clinically, it affects only one side of the body and it eventually disappears without the need of any specific treatment.We report two cases of this entity. The first case is a 14-month-old female patient with an erythematosus papular eruption that initiates near the axilla and progresses, in a period of seven days, towards the ipsilateral upper limb and hemithorax, with no other alterations. The second case is a 24-month-old female with a pruriginous erythematosus papular exanthema that begins on the left lower extremity and extends throughout the left hemibody.Due to the characteristics of the exanthema and the age range of the patients, they were diagnosed with asymmetric periflexural exanthema. They both received symptomatic treatment with spontaneous resolution of the condition


Subject(s)
Humans , Female , Infant , Exanthema/diagnosis , Lower Extremity , Upper Extremity , Exanthema/therapy
13.
Rev. bras. ortop ; 55(4): 445-447, Jul.-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1138052

ABSTRACT

Abstract Objective To evaluate the biomechanical properties of the "figure-of-eight" and Kessler suture techniques for tendons. Methods Flexor tendons of porcine fingers were divided into two groups with triple central "figure of eight" sutures (six passages) and Kessler sutures (two passages) associated with simple and continuous peripheral sutures, and submitted to continuous longitudinal mechanical tests, to obtain the mechanical properties of maximum load and energy at maximum load. Results The mean maximum load and energy at maximum load in the "figure-of-8" suture were of 63.4 N and 217.3 N.mm respectively; in the Kessler suture, the values were of 34.19 N and 100.9 N.mm respectively. The statistical analysis indicated that the "figure-of-eight" suture is mechanically superior to the Kessler technique. Conclusion Under the conditions of this experiment and in the flexor tendon of porcine fingers, the triple "figure-of-eight" suture (six passages) is more resistant than the Kessler suture (two passages). The "figure-of-eight" suture with six passages enables active movement in the immediate rehabilitation of the flexor tendon repair of the finger, with little risk of rupture or suture spacing.


Resumo Objetivo Avaliar as propriedades biomecânicas dos pontos de sutura tendinosa em "oito" e de Kessler. Métodos Tendões flexores dos dedos de membros superiores de porcos foram divididos em dois grupos com suturas triplas centrais em "oito" (seis passagens) e de Kessler (duas passagens) associadas a suturas periféricas contínuas simples, e submetidos a ensaios mecânicos longitudinais contínuos, obtendo-se as propriedades mecânicas de carga máxima e de energia na carga máxima. Resultados As médias da carga máxima e da energia na carga máxima na sutura em "8" foram de 63,4 N e 217,3 Nmm, respectivamente; na sutura de Kessler, os valores foram de 34,19 N e 100,9 Nmm, respectivamente. A análise estatística indicou que o ponto em "oito" é superior mecanicamente ao ponto de Kessler. Conclusões Nas condições deste experimento e no tendão flexor de dedo de membro superior de porcos, o triplo ponto em "oito" (seis passagens) é mais resistente do que o ponto de Kessler (duas passagens). O triplo ponto em "oito", com seis passagens, permite movimentação ativa na reabilitação imediata de reparo de tendão flexor de dedo de membro superior com pouco risco de ruptura ou espaçamento na sutura.


Subject(s)
Swine , Tendon Injuries , Biomechanical Phenomena , Suture Techniques , Orthopedic Procedures , Upper Extremity , Finger Injuries
14.
Rev. chil. neuro-psiquiatr ; 58(2): 150-160, jun. 2020. tab, ilus
Article in Spanish | LILACS | ID: biblio-1115480

ABSTRACT

Resumen Introducción El accidente cerebrovascular constituye la principal causa de muerte y discapacidad en Chile. Más del 85% de los pacientes sufren hemiplejía y más del 69% discapacidad motora funcional de las extremidades superiores. Esta alteración genera impacto en el uso de la extremidad superior, afectando las diversas actividades de la vida diaria de las personas. No existen estudios que combinen terapia de biofeedback electromiográfico y activación bimanual con estimulación eléctrica funcional en sujetos secuelados de Accidente cerebrovascular (ACV). Por esto, surge el interés de determinar el efecto que tiene un protocolo de entrenamiento basado en Estimulación Eléctrica Funcional (EEF) con activación bimanual y terapia de biofeedback en la función de la extremidad superior. Metodología: 15 sujetos secuelados de ACV entre 40 y 85 años reclutados en el área de neurorrehabilitación ambulatoria de Clínica Dávila, aleatorizados en un grupo experimental y en dos grupos controles de 5 sujetos. En cada sesión el grupo experimental entrenará quince minutos de activación bimanual con electroestimulación funcional y luego un programa de entrenamiento de biofeedback de diez minutos, mientras que el grupo control 1 y control 2 entrenaron en las mismas condiciones pero con EEF placebo y BF-EMG placebo respectivamente Resultados Existieron cambios significativos en el grupo experimental luego de la intervención. Conclusión Este estudio sugiere la estimulación eléctrica funciona y biofeedback como una herramienta para la rehabilitación de la extremidad superior paréticas en sujetos secuelados de ACV.


Introduction: Stroke is the leading cause of death and disability in Chile. More than 85% of patients suffer from hemiplegia and more than 69% functional motor disability of the upper extremities. This alteration generates an impact on the use of the upper limb, affecting the various activities of people's daily lives. There are no studies that combine electromyographic biofeedback therapy and bimanual activation with functional electrical stimulation in subjects with stroke. Therefore, there is interest in determining the effect of a training protocol based on Functional Electrical Stimulation (FES) with bimanual activation and biofeedback therapy on the function of the upper limb. Methodology: 15 subjects with stroke between 40 and 85 years recruited in the outpatients neurorehabilitation program of Clínica Dávila, randomized in an experimental group and in two control groups of 5 subjects. In each session the experimental group will train fifteen minutes of bimanual activation with functional electrostimulation and then a ten-minute biofeedback training program, while the control 1 and control 2 group trained under the same conditions but with placebo FES and placebo BF-EMG respectively. Results There were significant changes in the experimental group after the intervention. Conclusion This study suggests the electrical stimulation works and biofeedback as a tool for the rehabilitation of the upper limb in subjects with stroke.


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Therapeutics , Stroke , Upper Extremity , Electric Stimulation , Neurological Rehabilitation , Hemiplegia , Longitudinal Studies , Evaluation Studies as Topic
15.
Salud trab. (Maracay) ; 28(1): 35-45, jun. 2020. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1104332

ABSTRACT

El presente artículo identificó la prevalencia de síntomas de trastornos músculo esquelético relacionados al trabajo en extremidades superiores y su relación con algunos factores de riesgo vinculados al desempeño de las tareas, factores psicosociales, sexo, edad y antigüedad laboral. Utilizando un diseño exploratorio, correlacional y una muestra por conveniencia de 45 trabajadores (hombres/mujeres). Se exploró la presencia de síntomas mediante el cuestionario nórdico estandarizado para población chilena; la repetitividad, postura forzada, fuerza y algunos factores ambientales mediante la norma técnica para identificación y evaluación de factores de riesgo de Trastornos Musculo esqueléticos relacionados con el trabajo del Ministerio de Salud chileno, los factores psicosociales mediante el cuestionario de SUSESO-ISTAS 21 versión breve, y la edad, sexo y antigüedad laboral mediante una ficha propuesta por los autores. Los resultados (año 2017) muestran que el 8 % de los trabajadores no manifestó síntomas en extremidad superior y espalda. Que 48.9% de trabajadores sintomáticos son hombres y menores de 45 años (55.6%) de antigüedad laboral inferior de 5 años (73.4%). No se observó diferencias estadísticas entre exigencia psicosocial y presencia de síntomas de Trastornos Musculo esqueléticos. No obstante el 51.6% de los trabajadores sintomáticos de Trastornos Musculo esqueléticos, tenía nivel alto de riesgo psicosocial para la dimensión doble presencia. Se concluye que para el control y la prevención Trastornos Musculo esqueléticos en el trabajo es imprescindible el conocimiento de la población laboral a proteger y adoptar un enfoque biopsicosocial amplio que genere información para actuar racionalmente y con expectativas de solución(AU)


This study measured the prevalence of musculoskeletal symptoms related to work using the upper extremities and their relationship to risk factors linked to task performance, psychosocial risk factors, sex, age and length of employment. The study design was exploratory and correlational, conducted in a convenience sample of 45 workers. The presence of symptoms was explored using the Nordic Musculoskeletal Questionnaire for a Chilean population, along with repetitiveness, forced posture, strength. Environmental factors were explored using the standard identification and evaluation of risk factors based on the Work-related Musculoskeletal Disorders inventory (TMERT in Spanish) of the Chilean Ministry of Health. Psychosocial factors were explored using the short version (21 items) of the Psychosocial Risk of the Workplace (SUSESOISTAS in Spanish) questionnaire, which explores age, sex and length of employment. Results in 2017 show that 8% of workers reported no symptoms in the upper extremity or back. In addition, 48.9% of symptomatic workers were men under 45 years of age (55.6%), with less than 5 years of employment (73.4%). No statistically significant differences were observed between psychosocial demands and presence of musculoskeletal symptoms. However, 51.6% of workers with musculoskeletal symptoms had high levels of psychosocial risk for the dual presence. We conclude that specific knowledge of the working population is essential in order to protect them and to control and prevent musculoskeletal disorders at work. In addition, a comprehensive biopsychosocial approach that generates information to act rationally and with expectations of finding solutions must be adopted(AU)


Subject(s)
Humans , Back , Occupational Risks , Risk Factors , Muscle, Skeletal/injuries , Upper Extremity , Task Performance and Analysis , Surveys and Questionnaires , Occupational Groups
16.
Fisioter. Bras ; 21(2): 164-173, Mai 16, 2020.
Article in Portuguese | LILACS | ID: biblio-1282901

ABSTRACT

Introdução: O acidente vascular encefálico (AVE) é a causa de diversas incapacidades neurológicas em adultos, o que torna necessário o melhor estudo de seu impacto na capacidade funcional. Objetivo: Avaliar a destreza motora funcional de membros superiores de hemiparéticos crônicos submetidos a Fisioterapia em Grupo no Formato de Circuito de Treinamento (FGCT), pois esta forma de tratamento tem se mostrado eficaz na melhora da capacidade funcional, o que torna necessário um estudo voltado para o membro superior. Métodos: Participaram 15 hemiparéticos em atendimento com FGCT. Foi realizada uma avaliação inicial (AV1) utilizando a escala de Ashworth Modificada, o teste de caixa de blocos, e o nine hole peg test. Após 12 semanas de intervenção com FGCT foi realizada a avaliação final (AV2) utilizando os mesmos testes. Resultados: A análise estatística considerou p > 0,05 e não revelou diferença significante entre AV1 e AV2 na dinamometria bem como no teste de caixa de blocos e nine hole peg test. Conclusão: O protocolo terapêutico não determinou a melhora da destreza motora funcional de membros superiores de hemiparéticos crônicos submetidos a fisioterapia de grupo no formato de circuito de treinamento. (AU)


Introduction: Stroke is the cause of several neurological disabilities in adults, which makes it necessary to better study the impact on functional capacity. Objective: The objective was to evaluate the motor dexterity performance of upper limbs in chronic hemiparetic submitted to Group Physiotherapy in the Training Circuit (GPTC) format, as this form of treatment has been shown to be effective in the improvement functional capacity, which makes it necessary a study aimed at the upper limb. Methods: Fifteen hemiparetic patients in our service with GPTC participated. An initial assessment (IA1) was performed using the Modified Ashworth scale, Box and Block Test (BBT), and the 9-Hole Peg Test (9-HPT). After 12 weeks of intervention with GPTC, the final evaluation (FE2) was performed using the same tests. Results: Statistical analysis considered p > 0.05 and did not reveal a significant difference between IA1 and FE2 in hand-held dynamometry as well as in the BBT and 9-HPT. Conclusion: The therapeutic protocol did not determine the improvement of the motor dexterity of upper limbs in chronic hemiparetic patients submitted to GPTC. (AU)


Subject(s)
Humans , Paresis , Physical Therapy Modalities , Upper Extremity , Motor Skills , Muscle Strength
17.
Int. j. morphol ; 38(2): 265-272, abr. 2020. tab
Article in English | LILACS | ID: biblio-1056433

ABSTRACT

In this study, we analyzed the differences in body composition among athletes during different stages of their career Forty taekwondo athletes and 10 non-athletes (20 males and 30 females) with a mean age of 18.2 years (range, 15-23 years), a mean height of 173.4 cm, and a mean body weight of 64.8 kg were studied using dual energy X-ray absorptiometry and Biodex balance system. The bone mineral density of upper and lower limbs was higher among university athletes of both sexes than in high school athletes. The lean body mass of male athletes in the university was higher than in high school male athletes. By contrast, in case of females, the opposite results were obtained for the upper and lower limbs. Elucidation of the body composition according to career and sex of taekwondo athlete is worthwhile.


En este estudio, analizamos las diferencias de la composición corporal entre los atletas durante las diferentes etapas de su carrera. Se estudiaron cuarenta atletas de taekwondo y 10 no atletas (20 hombres y 30 mujeres) edad media de 18,2 años (rango, 15-23 años), una altura media de 173,4 cm y un peso corporal medio de 64,8 kg. Se utilizaron la absorciometría de rayos X de energía dual y el sistema de equilibrio Biodex. La densidad mineral ósea de las miembros superiores e inferiores fue mayor entre los atletas universitarios de ambos sexos, que en los atletas de educación secundaria. La masa corporal magra de los atletas varones en la universidad fue mayor que en los varones de la educación secundaria. Por el contrario, en el caso de las mujeres, se obtuvieron los resultados opuestos para las miembros superiores e inferiores. En conclusión se debe considerar un análisis de la composición corporal según la carrera y el sexo del atleta de taekwondo.


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Body Composition , Martial Arts , Lower Extremity/anatomy & histology , Upper Extremity/anatomy & histology , Absorptiometry, Photon , Body Mass Index
18.
Rev. bras. ortop ; 55(2): 221-225, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1138008

ABSTRACT

Abstract Objective To compare the medial and lateral rotations of the shoulders and the distances between the coracoid process and the cubital fossa of non-athletic individuals to those of elite squash players. Method The cross-sectional study was performed between March and August 2017. Male and female non-athletes (n = 628) were selected at the Orthopedic Emergency Service of our institution. The inclusion criteria were: age between 18 and 60 years, no physical disabilities or cognitive impairments and absence of pain in the upper limbs. Elite squash players (n = 30) of various nationalities were selected at an event held in our city. All of the athletes had practiced this sport under high performance requirements for > 10 years and/or 10.000 hours, and all were asymptomatic. Demographic and clinical data were collected through interviews, while physical examinations and shoulder assessments were performed by a single orthopedic practitioner. Results If compared with non-athletes, elite squash players presented significant (p < 0.001) mean losses of 23º34' in medial rotation and significant (p < 0.003) mean gains of 10º23' in lateral rotation of the dominant shoulders. There was a significant difference (p < 0.008) between non-athletes and athletes regarding the distance between the coracoid process and the cubital fossa in the dominant arm. Conclusion Intensive squash practice causes adaptive changes that trigger glenohumeral medial rotation deficit, accompanied by significant lateral rotation gain, and can generate pathogenic alterations in the shoulder.


Resumo Objetivo Comparar as rotações medial e lateral dos ombros e as distâncias entre o processo coracoide e a fossa cubital de indivíduos não atletas e de jogadores profissionais de squash. Método O estudo transversal foi realizado entre março e agosto de 2017. Não atletas do sexo feminino e masculino (n = 628) foram selecionados no Serviço de Emergência Ortopédica da nossa instituição. Os critérios de inclusão foram: idade entre 18 e 60 anos, ausência de deficiências físicas ou cognitivas e ausência de dor nos membros superiores. Jogadores profissionais de squash (n = 30) de várias nacionalidades foram selecionados em um evento realizado em nossa cidade. Todos os atletas praticavam seu esporte em alto nível há > 10 anos e/ou 10.000 horas, e todos eram assintomáticos. Os dados demográficos e clínicos foram coletados por entrevista, enquanto os exames físicos e de ombro foram realizados por um único consultor ortopédico. Resultados Em comparação com os não atletas, os jogadores profissionais de squash apresentaram perdas médias significativas (p < 0,001) de 23º34' na rotação interna e significativos (p < 0,003) ganhos médios de 10º23' na rotação externa dos ombros dominantes. Houve diferença significativa (p < 0,008) entre não atletas e atletas quanto à distância entre o processo coracoide e a fossa cubital no braço dominante. Conclusão A participação intensiva no squash provoca alterações adaptativas que dão origem ao déficit de rotação interna glenoumeral, acompanhadas de significativo ganho de rotação externa, e podem gerar alterações patogênicas no ombro.


Subject(s)
Humans , Pain , Arm , Rotation , Shoulder Joint , Sports , Range of Motion, Articular , Upper Extremity , Athletes
19.
Rev. argent. dermatol ; 101(1): 1-10, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1092404

ABSTRACT

RESUMEN El embolismo por cristales de colesterol (ECC) es una complicación de la enfermedad arterioesclerótica en la que el desprendimiento de fragmentos de placa de ateroma, principalmente de grandes arterias, provoca oclusión de pequeños vasos. Esta entidad, también llamada ateroembolia o síndrome de los dedos del pie azules, es más frecuente en pacientes de edad avanzada y después de procedimientos invasivos intravasculares. Se manifiesta con cianosis, livedo reticularis, necrosis y úlceras asociado a manifestaciones renales y gastrointestinales. Se presenta un paciente trasplantado renal y portador de fístula arteriovenosa trombosada izquierda con ateroembolia localizada en mano homolateral.


ABSTRACT The cholesterol crystal embolism (ECC) is a complication of arteriosclerotic disease in which the detachment of fragments of atheromatous plaque mainly from large arteries, causes occlusion of small vessels. This entity, also called atheroembolism or blue toe syndrome, is more common in elderly patients and after intravascular invasive procedures. It manifests with cyanosis, livedo reticularis, necrosis and ulcers associated with renal and gastrointestinal manifestations. We present a renal transplant patient with a left thrombosed arteriovenous fistula with atheroembolism located in homolateral hand.


Subject(s)
Humans , Male , Middle Aged , Cholesterol/adverse effects , Arteriovenous Fistula/complications , Embolism, Cholesterol/physiopathology , Upper Extremity/blood supply , Skin Manifestations , Embolism, Cholesterol/diagnosis , Renal Insufficiency/complications , Ischemia/complications , Necrosis/complications
20.
Fisioter. Bras ; 21(1): 93-103, mar 8, 2020.
Article in Portuguese | LILACS | ID: biblio-1282761

ABSTRACT

Introdução: O procedimento cirúrgico é o principal tratamento para o câncer de mama e pode ser conservador ou não conservador. As técnicas cirúrgicas são propostas junto com terapias adjuvantes (radioterapia, quimioterapia e hormonioterapia). Independente dos avanços tecnológicos, esses procedimentos ainda estão associados a uma alta prevalência de complicações. Objetivo: Este estudo visa identificar os indicadores de funcionalidade e os tipos de intervenções fisioterapêuticas utilizadas para avaliação e reabilitação funcional do membro superior de mulheres pós-mastectomia. Métodos: Pesquisa bibliográfica em que foi realizada a busca em quatro bases de dados: Scielo; Pedro; Pubmed e Lilacs. Foram incluídos ensaios clínicos randomizados que abordaram algum tipo de intervenção fisioterapêutica na reabilitação da funcionalidade de membro superior de mulheres pós-mastectomia no período de 2012 a julho de 2018. Resultados: Os indicadores de funcionalidade encontrados nos artigos foram amplitude de movimento, força muscular, volume do membro, dor, funcionalidade e qualidade de vida. As intervenções fisioterapêuticas propostas pelos artigos foram: alongamentos; mobilização articular; mobilização neural; educação em saúde; massagem cicatricial; terapia miofascial; terapia convencional descongestiva; terapia vibratória; acupuntura; exercício ativo e fortalecimento muscular. Conclusão: Os resultados apresentados neste estudo evidenciam a importância da fisioterapia, tanto para identificar as possíveis complicações, quanto para o tratamento. (AU)


Introduction: The surgical procedure is the main treatment for breast cancer and may be conservative or non-conservative. Surgical techniques are proposed along with adjuvant therapies (radiotherapy, chemotherapy and hormone therapy). Regardless of technological advances, these procedures are still associated with a high prevalence of complications. Objective: This study aims to identify the indicators of functionality and the types of physiotherapeutic interventions used for evaluation and functional rehabilitation of the upper limbs of post-mastectomy women. Methods: A literature review was carried out in four databases: Scielo; Pedro; Pubmed and Lilacs. We included randomized clinical trials that addressed some type of physiotherapeutic intervention in the rehabilitation of upper limb functionality of women after mastectomy from 2012 to July 2018. Results: Functional indicators found in the articles were range of motion, muscle strength, volume of limb, pain, functionality and quality of life. The physiotherapeutic interventions proposed by the articles were: stretching; joint mobilization; neural mobilization; health education; scar massage; myofascial therapy; conventional decongestive therapy; vibratory therapy; acupuncture; active exercise and muscle strengthening. Conclusion: The results presented in this study show the importance of physical therapy, both to identify possible complications and to treat them. (AU)


Subject(s)
Humans , Breast Neoplasms , Physical Therapy Modalities , Upper Extremity , Rehabilitation , Mastectomy
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