Advances in the study of ischemic cerebrovascular disease and restless legs syndrome / 中国医师杂志

Restless legs syndrome (RLS) and ischemic cerebrovascular disease (ICVD) are two common disorders in neurology departments that place a significant economic burden on patients′ families and society. In recent years, increasing attention has been paid to the relationship between the two, but there is no clear-cut conclusion that RLS may be both a consequence of ICVD and associated with an increased risk of developing ICVD and poor functional outcome. This article summarizes the latest research findings on ICVD and RLS in China and abroad, with a view to providing a better understanding of their interaction and pathophysiological mechanisms, as well as providing some references for the early prevention and treatment of ischemic cerebrovascular events and rehabilitation.

Recent advance in risk factors related to restless leg syndrome / 中华神经医学杂志

Restless legs syndrome (RLS) is a common sensorimotor disorder. Although it does not pose a threat to life, it seriously affects the quality of life of patients. RLS pathogenesis is still unclear, and its incidence is associated with a variety of risk factors, including genetic factors and non-genetic factors. Genetic factors involve more than 20 risk genes, such as meis homeobox 1 ( MEIS1), BTB domain containing 9 ( BTBD9), mitogen-activated protein kinase kinase 5 ( MAP2K5), and protein tyrosine phosphatase receptor type Db ( PTPRD). Non-genetic factors include regional age, gender, obesity, medical related diseases, neuropsychiatric diseases and drugs. This paper reviews the recent advance in risk factors and related pathogenesis of RLS to provide references for early prevention and treatment of the disease.

The effect of compression stockings on the complaints well-being and sleep quality of pregnant women with restless legs syndrome: a randomized controlled study

SUMMARY OBJECTIVE: The aim of this study was to determine the effect of compression stockings on complaints, well-being, and sleep quality in pregnant women with restless legs syndrome. METHODS: This randomized placebo-controlled study was conducted on 63 pregnant women (placebo group [PG]=31; experimental group [EG]=32) at the Perinatology Outpatient Clinic of a Health Research and Application Centre in Turkey. Pregnant women in the experimental group wore compression stockings when they got up in the morning for 3 weeks and took them off at bedtime. Placebo group women wore a placebo stocking. Data were collected using the restless legs syndrome Severity Rating Scale, the Pittsburgh Sleep Quality Index, the World Health Organization-5 Well-Being Index, and the Application Satisfaction Form on the 22nd day of the first interview. Statistical significance was accepted as p<0.05. RESULTS: Post-test mean scores of both the experimental group and placebo group in the restless legs syndrome Severity Rating Scale (post-test:;8.87±5.27, 12.19±5.60; pre-test:;21.28±5.63, 21.0±5.61; p<0.05), the Pittsburgh Sleep Quality Index (post-test:;5.34±3.28, 6.12±3.12; pre-test:;10.15±4.23, 9.61±4.59; p<0.05), and Well-Being Index (post-test:;18.06±4.59, 19.00±4.47; pre-test:;12.71±5.85, 15.09±5.62; p<0.05) showed recovery according to the pre-tests. However, the post-test restless legs syndrome Severity Rating Scale of the experimental group was lower than that of the placebo group (p<0.05). The effect of their application started in 3.93±1.74 days on average in the experimental group, while it started in 5.09±1.55 days in the placebo group (p<0.05). CONCLUSION: Both applications reduced the severity of restless legs syndrome in pregnant women and increased sleep quality and well-being. However, compression stockings were more effective in reducing restless legs syndrome severity. Nurses can use compression and placebo stockings in the care of pregnant women with restless legs syndrome. Clinical Trial Registration Number: NCT05795868.

Prevalence rate and influencing factors of restless leg syndrome in maintenance hemodialysis patients in Anhui province / 中华肾脏病杂志

Objective:To explore the prevalence rate of restless leg syndrome (RLS) and its related influencing factors in patients with maintenance hemodialysis (MHD) in Anhui province.Methods:It was a cross-sectional study, including regular MHD patients in blood purification centers of 27 hospitals in southern, central and northern Anhui province from January to March 2020. The investigation included general demographic characteristics, primary diseases, complications, dialysis-related conditions and drug use. According to the presence or absence of RLS, the patients were divided into RLS group and non-RLS group, and the differences of clinical data between the two groups were compared. Logistic regression analysis method was used to analyze the influencing factors of RLS.Results:The study included 3 025 MHD patients, aged (54.8±12.8) years old, with 1 819 males (60.1%) and 1 206 females (39.9%). The dialysis age was (5.5±3.8) years. The prevalence rates of RLS in MHD patients were 8.8% (265/3 025), of which 13.7% (77/561), 7.7% (88/1 145) and 7.6% (100/1 319) in southern, central and northern Anhui province, respectively. The prevalence rates of RLS in MHD patients in secondary and tertiary hospitals were 9.5% (55/577) and 8.6% (210/2 448), respectively. Proportion of hypertension, dialysis age, intact parathyroid hormone, alkaline phosphatase, 25(OH)D3, and proportions of secondary hyperparathyroidism, erythropoietin use, iron supplements, active vitamin D use, calcimimetic use, dialysis blood flow <250 ml/min and low-flux dialyzers in RLS group were higher than those in non-RLS group, while hemoglobin level and proportions of non-calcium-phosphorus binders and high-flux dialyzers were lower than those in non-RLS group (all P<0.05). Multivariate logistic regression analysis results showed that long dialysis age ( OR=1.188, 95% CI 1.031-1.369, P=0.017) and high alkaline phosphatase ( OR=1.007, 95% CI 1.001-1.013, P=0.047) were correlated with a higher risk of RLS in MHD patients. Conclusions:The prevalence rate of RLS in MHD patients in Anhui province is 8.8%. The prevalence rates of RLS in MHD patients in southern, central and northern Anhui province are 13.7%, 7.7% and 7.6%, respectively. The prevalence rate of RLS in secondary and tertiary hospitals are 9.5% and 8.6%, respectively. Long dialysis age and high alkaline phosphatase are associated with a high risk of RLS in MHD patients.

Acupuncture treatment for a patient with panic disorder / 全日本鍼灸学会雑誌

[Introduction] We report our experience with a patient with panic disorder (PD) , which suggests the importance of building a trusting relationship between the patient and the acupuncturist.[Case] A 69-year-old woman with PD presented to our acupuncture clinic with anxiety and difficulty breathing. Her symptoms appeared six months prior, and later, she presented to the emergency department of A Hospital with dyspnea and nausea. Shehad a significant medical history of RLS and rheumatoid arthritis. She was diagnosed with PD at the Department of Oriental Medicine of the same hospital. Her symptoms improved with herbal remedies; however, anxiety and difficulty breathing persisted. Her symptoms at the first acupuncture visit were dyspnea, chest tightness, and anxiety regarding seizures that occurred once or twice a week. She also experienced insomnia and nocturnal hot flashes in her legs. She had no panic attacks or prevailing anxiety, and her neurological and cardiovascular parameters were normal. During the treatment period of 91 days, 14 acupuncture and moxibustion treatments were performed once a week. GV20, PC6, HT7, ST36, SP6, LV3, GB20, BL13, BL15, LI4, BL23, and BL33 were used for mood symptoms, and KI9, BL57, and KI3 were used for toe symptoms. After the second visit, BL10, GB21, and SL14 were performed for neck and shoulder symptoms, and Ex-LE10 and plantar nerve acupuncture were performed for coldness in the lower extremities. Moxibustion was applied to SP6, KI3, and LV3.[Course] After the initiation of acupuncture, anxiety and difficulty breathing were almost resolved by the second treatment session; however, insomnia and hot flashes in the lower extremities worsened in the seventh round of treatment. The patient had also hoped for the resolution of the insomnia-related symptoms using acupuncture. However, since acupuncture was ineffective, we explained the need for specialized treatment and referred her case to a psychiatrist. She was diagnosed with restless leg syndrome, and treatment was initiated using pramipexole, which improved hersymptoms.[Discussion] In this case, acupuncture and moxibustion treatment were effective for the symptoms associated with panic disorder. Additionally, the importance of providing opportunities for appropriate medical consultations as needed was demonstrated.

Analysis on influencing factors of leg work-related musculoskeletal disorders among shipbuilding workers / 中国职业医学

{L-End}Objective To investigate the current status and influencing factors of leg work-related musculoskeletal disorders (WMSDs) in shipbuilding workers. {L-End}Methods A total of 3 393 shipbuilding workers from Guangdong Province, Liaoning Province, Shandong Province, and Beijing City were selected as the research subjects using the convenience sampling method. The Chinese Version of the Musculoskeletal Disorders Questionnaire was used to investigate the prevalence of leg WMSDs in the past year. A multivariate logistic regression model was used to analyze the influencing factors of leg WMSDs. {L-End}Results The prevalence of leg WMSDs in the research subjects was 11.3% (382/3 393). The result of multivariate logistic regression showed that the risk of leg WMSDs was higher in workers with a length of service >10 years than those with a length of service <5 years (P<0.05). Workers with frequent used of vibration tools at work had higher the risk of leg WMSDs (all P<0.05). Workers who did the same work every day, had insufficient rest time, had a shortage of department staff, and those who often repeated the same leg movements had a higher risk of leg WMSDs (all P<0.05). The risk of leg WMSDs in workers who sometimes stand for a long time was lower than that in workers who rarely stand for a long time (P<0.01). {L-End}Conclusion Length of service, rarely long-standing work, use of vibration tools at work, daily engagement in the same work, in-adequate rest time, shortage of department staff, and frequent repetition of the same leg movements are all influencing factors for leg WMSDs in shipbuilding workers.

Correlation between peripheral blood neutrophil-to-lymphocyte ratio and restless legs syndrome in patients undergoing hemodialysis / 中国基层医药

Objective:To correlate peripheral blood neutrophil-to-lymphocyte ratio with the occurrence of restless legs syndrome (RLS) in patients undergoing maintenance hemodialysis (MHD).Methods:This is a cross-sectional study. A total of 203 patients who underwent long-term MHD at the Blood Purification Center, Department of Nephrology, The First Affiliated Hospital of Xiamen University from May to June 2021 were included in this study. The counts of peripheral blood neutrophils and lymphocytes were determined and the neutrophil-to-lymphocyte ratio was calculated. These patients were divided into a RLS group and a non-RLS group according to whether they developed RLS. RLS-related factors were evaluated using face-to-face interview questionnaires. Various clinical and laboratory parameters were analyzed. The influential factors of RLS in patients undergoing MHD were analyzed through univariate regression analysis and multivariate logistic regression analysis.Results:A total of 203 patients undergoing MHD were enrolled, 30 individuals were determined as current RLS cases (14.78%). The levels of NLR and PTH in the RLS group were 4.86 (3.39, 5.82) L/L and 244.50 (143.25, 406.50) ng/L, respectively, which were significantly higher than those in the normal group [3.51 (2.60, 5.24) L/L, 147.00 (94.80, 263.50) ng/L, Z = -3.38, -2.64, both P < 0.05]. Univariate logistic regression analysis showed that NLR, PTH, uric acid, and neutrophil count were correlated with RLS (Wald χ2 = 7.96, 4.99, 4.76, 8.33, all P < 0.05). NLR was the independent risk factor of RLS (Wald χ2 = 6.14, P < 0.05) in multivariate models adjusting for confounding factor. Conclusion:The prevalence of RLS is high in patients undergoing MHD. RLS is assicuated with NLR among patients undergoing MHD after adjusting for confounding factor. RLS is likely associated with systemic inflammatory diseases.

Sleep disorders in multiple sclerosis: a case-control study using the São Paulo Epidemiologic sleep study (Episono) database / Alterações de sono em esclerose múltipla: um estudo caso-controle utilizando o banco de dados do São Paulo Epidemiologic Sleep Study (Episono)

Abstract Background Sleep disorders such as obstructive sleep apnea and restless legs syndrome are prevalent in the general population and patients with chronic diseases such as multiple sclerosis (MS). Objectives This study compared the prevalence of sleep disorders complaints, fatigue, depression, and chronotype of adult patients with multiple sclerosis (PwMS) to a representative sample of São Paulo city residents. Methods A comparative study was made between PwMS and volunteers from the São Paulo Epidemiologic Sleep Study (Episono) study. We compared the scores of sleep questionnaires using the multivariate analysis of variance (MANOVA) test to evaluate the effects and analysis of variance (ANOVA) as a follow-up test. Covariates were age, sex, and physical activity. The Pearson correlation test was performed to measure the correlation between Expanded Disability Status Scale (EDSS) and the scores of the sleep questionnaires. Finally, we applied propensity score matching to reduce bias in estimating differences between the two groups. Analyses were performed using Stata 14 (StataCorp, College Station, TX, USA) and IBM SPSS Statistics for Windows version 22.0 (IBM Corp., Armonk, NY, USA). Results The Episono group had worse sleep quality, and more excessive daytime sleepiness than PwMS. Obstructive sleep apnea and restless legs syndrome were more frequent in the Episono group. There was no difference in chronotype between the two groups, with morning and intermediate preference. There was no correlation between EDSS and sleep complaints. Fatigue was intensively present among PwMS. Conclusions Disease Modifying Drug (DMD)-treated PwMS had a lower frequency of sleep complaints, no difference in chronotype, and a higher prevalence of fatigue than a sample of São Paulo city residents. The immunomodulatory drugs commonly used to treat MS may have contributed to these findings.

Resumo Antecedentes Os distúrbios do sono são prevalentes na população em geral e em pacientes com doenças crônicas, como a esclerose múltipla (EM). Objetivos No presente estudo, comparamos a prevalência de queixas de distúrbios do sono, fadiga, depressão e cronotipo de pacientes adultos com EM com uma amostra representativa dos moradores da cidade de São Paulo. Métodos Estudo comparativo entre pacientes com EM e voluntários saudáveis do estudo São Paulo Epidemiologic Sleep Study Episono. Comparamos as pontuações dos questionários de sono usando o teste de análise de variância multivariada (MANOVA, na sigla em inglês) para avaliar os efeitos e o teste de análise de variância (ANOVA, na sigla em inglês) como um teste de acompanhamento. As covariáveis usadas foram idade, gênero e atividade física. O teste de correlação de Pearson foi aplicado para medir a correlação entre o Expanded Disability Status Scale (EDSS) e os escores dos questionários de sono. Por fim, aplicamos o Propensity Score Matching para reduzir o viés na estimativa das diferenças entre os dois grupos. Resultados O grupo Episono apresentou pior qualidade do sono e mais sonolência excessiva diurna do que os pacientes com EM. A apneia obstrutiva do sono e a síndrome das pernas inquietas foram mais frequentes no grupo Episono. Não houve diferença no cronotipo entre os dois grupos, com predomínio matutino e intermediário. Os pacientes com EM apresentaram mais fadiga do que o grupo controle. Conclusões Pacientes com EM tratados apresentaram menor frequência de queixas de sono, sem diferença no cronotipo, com maior prevalência de fadiga do que uma amostra de moradores da cidade de São Paulo. Os medicamentos imunomoduladores comumente usados para tratar EM podem ter contribuído para estes achados.

Coexistence of restless legs syndrome and multiple sclerosis aggravates anxiety and depression / A coexistência da síndrome das pernas inquietas e esclerose múltipla agrava ansiedade e depressão

ABSTRACT Background: Among the comorbidities that accompany multiple sclerosis (MS), restless legs syndrome (RLS) is one of the most common. Anxiety and depression are common psychological comorbidities that impact the quality of life of patients with MS (PwMS), as well as patients with RLS. Objective: To investigate the psychiatric burden of MS and RLS coexistence, we conducted a nationwide, multicenter and cross-sectional survey. Methods: Participants were assessed by using demographic and clinical parameters along with the Hamilton Anxiety and Hamilton Depression Scales (HAM-A and HAM-D). Results: Out of the 1,068 participants, 173 (16.2%) were found to have RLS [RLS(+)] and 895 (83.8%) did not [RLS(-)]. The mean scores for HAM-A and HAM-D were significantly higher among RLS(+) subjects than among RLS(-) subjects (p<0.001 for all variables). Conclusions: According to our data, the presence of RLS in PwMS may increase the occurrence of both anxiety and depression symptoms. Awareness and treatment of RLS in PwMS could possibly reduce the symptoms of psychiatric comorbidities originating from RLS.

RESUMO Antecedentes: Considerando-se as comorbidades que acompanham a esclerose múltipla (EM), a síndrome das pernas inquietas (SPI) é uma das mais comuns, e ansiedade e depressão são comorbidades psicológicas comuns que afetam a qualidade de vida de pacientes com EM, bem como de pacientes com SPI. Objetivo: Investigar a carga psiquiátrica da coexistência de EM e SPI por meio de uma pesquisa nacional, multicêntrica e transversal. Métodos: Os participantes foram avaliados por parâmetros demográficos e clínicos, além da versão turca das escalas de ansiedade e depressão de Hamilton (HAM-A e HAM-D). Resultados: Dos 1.068 participantes, 173 (16,2%) apresentaram SPI [SPI (+)] e 895 (83,8%) não [SPI (-)]. As pontuações médias no HAM-A e no HAM-D foram significativamente maiores em indivíduos com SPI (+) do que naqueles com SPI (-) (p <0,001 para todas as variáveis). Conclusões: De acordo com nossos dados, a presença de SPI na EM pode aumentar a ocorrência de sintomas de ansiedade e depressão. A conscientização e o tratamento da SPI na EM podem reduzir os sintomas de comorbidades psiquiátricas originadas da SPI.

Single nucleotide polymorphisms in risk genes of restless legs syndrome: a Meta-analysis / 中华行为医学与脑科学杂志

Objective:To investigate the correlation between single nucleic acid polymorphisms (SNPs) of MEIS1, BTBD9, MAP2K5, PTPRD and restless leg syndrome (RLS).Methods:By searching the literatures published before March 1, 2021 at home and abroad, case-control studies on risk genes associated with RLS were collected, and the Review Manager 5.3 and Stata 15.1 softwares were used for statistical analysis.Results:A total of 8 studies were included, with a total of 7 824 cases and 14 645 controls.Meta analysis results showed that the SNPs locus of the risk gene associated with RLS was MEIS1 rs2300478( OR=1.68, 95% CI: 1.59-1.78), BTBD9 rs9296249( OR=1.62, 95% CI: 1.47-1.77), BTBD9 rs9357271( OR=1.49, 95% CI: 1.44-1.55), MAP2K5 rs12593813( OR=1.44, 95% CI: 1.36-1.53), MAP2K5 rs11635424( OR=1.47, 95% CI: 1.34-1.60)and PTPRD rs1975197( OR=1.34, 95% CI: 1.21-1.49). Conclusion:MEIS1 rs2300478, BTBD9 rs9296249, BTBD9 rs9357271, MAP2K5 rs12593813, MAP2K5 rs11635424 and PTPRD rs1975197 are the risk loci of RLS.

A Case Report of Painful Legs and Moving Toes Syndrome and Painful Arms and Moving Fingers Syndrome with Severe Blood Stasis and Panic Disorder Successfully Treated with Tokakujokito-Based Kampo Prescriptions / 日本東洋医学雑誌

The patient was a 47-year-old woman. Four years previously, she began to suffer from left lower leg pain and numbness, and involuntary movements. She received further examination in the department of neurology at other hospitals, but had an uncertain etiology and was provisionally diagnosed with restless legs syndrome. She was treated with Western medicine such as gabapentin and gabapentin enacarbil, but they were ineffective. She subsequently visited our hospital and was hospitalized. She was diagnosed with painful legs and moving toes syndrome, and painful arms and moving fingers syndrome after further examination. We prescribed tokakujokito because she had severe blood stasis and panic disorder on Kamp medical findings. As a result, her left lower leg numbness disappeared and pain was reduced. We report a case of a patient who could not be effectively treated using Western medicine and was successfully treated with tokakujokito-based Kampo prescriptions.

One case of Creutzfeldt-Jakob disease with restless leg syndrome as the first symptom and literature analysis / 中国基层医药

Objective:To analyze the clinical features and auxiliary examination results of sporadic Creutzfeldt-Jakob disease (sCJD) with restless leg syndrome (RLS) as the first symptom.Methods:The clinical features and auxiliary examination results of one case of sCJD who received treatment in Sichuan Mianyang 404 Hospital were analyzed based on relevant literature.Results:A 59-year-old woman of Han nationality who had sCJD with restless leg-like manifestation of the left lower limb for 18 days was included in this study. The patient was first treated in orthopedic department, but her symptom did not improve after treatment. Twenty days later, she was transferred to neurology department for further treatment. Her daily life and activities were not affected. Head magnetic resonance imaging, electroencephalography, cerebrospinal fluid routine examination and biochemical test results were normal. Five days later, the patient had mild left-sided ataxia, which then progressed rapidly, followed by right-sided ataxia, left-leg spasticity and adduction, involuntary movement, myoclonia, cognitive decline, akinetic mutism, repeated hyperthermia, repeated complex partial seizures. Two weeks later, head magnetic resonance imaging examination revealed hyperintense signal of the cingulate gyrus, frontal cortex and right island cortex on DWI, with cerebellar atrophy and three-phase electroencephalography wave. Four weeks later, CSF14-3-3 protein was positive, and no related genetic mutation in the prion protein gene was found. The duration from onset to death was about 8 months.Conclusion:sCJD is a common subtype of prion protein disease, and the condition can be stabilized for more than 1 month after the onset of RLS. There is no specificity in early clinical and auxiliary examinations, and neither dobutazine treatment nor neurotrophic treatment is effective. The disease progresses rapidly after 1 month, head MRI and EEG reexamination can reveal clues, and CSF14-3-3 protein can assist clinical diagnosis.

Association of single nucleotide polymorphisms of PTPRD and restless legs syndrome：a Meta-analysis / 中风与神经疾病杂志

@#The aim of the study is to investigate the association of rs1975197 and rs4626664 of PTPRD and restless legs syndrome （RLS）.Methods We retrieved 4 studies on rs1975197 and 5 studies of rs4626664 and extracted basic information of each study following inclusion and exclusion criteria. Meta-analysis was used to analyze odds ratio（OR）and 95% confidence intervals（CI）.Forest plots were used to assess heterogeneity visually.If heterogeneity existed，subgroup analysis would be used. Funnel plots was used to assess publication bias visually.Results As for rs1975197，T allele could increase the risk of RLS in Caucasian（OR=1.43，95%CI 1.13～1.80）.However，there were no statistically significant of rs4626664 observed in neither overall analysis nor subgroup analysis.Conclusion T allele of rs1975197 of PTPRD increases the risk of RLS in Caucasian using Meta-Analysis，suggesting a race specificity of PTPRD with RLS. More and larger case-control studies including different races need to be launched for investigating the association of PTPRD with RLS.

Sensilla of the Western Flower Thrips, Frankliniella occidentalis (Pergande) (Thysanoptera, Thripidae)

ABSTRACT The sensilla of insects play important roles in odor, taste, the feeling environment, and some sensory functions, which are closely associated with insect host locating, feeding, habitat searching, courtship, mating, and oviposition. In this study, we used a scanning electron microscope to observe the external morphology of nymph and adult Frankliniella occidentalis sensilla on antennae, compound eyes, legs, mouthparts, wings and tail. The results show that three main types of sensilla are located on the antennae: sensilla trichodea, sensilla chaetica, and sensilla basiconica. Among them, sensilla trichodea are the most abundant, followed by sensilla chaetica. Sensilla basiconica on antennae are divided into seven sub-styles, including longer sensilla (L-sensilla basiconica, long sensilla basiconica), shorter sensilla (angle sensilla basiconica, bud sensilla basiconica), and thicker and bigger sensilla (stick sensilla basiconica, fork sensilla basiconica, and finger sensilla basiconica). Only two fork sensilla basiconica were found, located on the dorsal part of the first flagellum subsegment and the ventral part of the second flagellum subsegment, respectively. Seven sensillum types were found on the legs: sensilla trichodea, sensilla chaetica, sensilla basiconica, sensilla ear washing buob-shaped, mamillary sensilla, sensilla campaniform, and Böhm bristle. About 60% of them are sensilla chaetica. Only one sensillum type was found on compound eyes: sensilla chaetica. In addition, some sensillum types were also found on the mouthparts, wings and tail, respectively. In the study, we observed the type, morphology, and distribution of sensilla on antennae, legs, compound eyes, and other regions of nymph and adult F. occidentalis, forming a base for future electrophysiological and behavior experiments on F. occidentalis.

From garrincha's legs to neymar's legs: the genu varum and valgum in soccer. historical overview and update / Das pernas de garrincha às de neymar: os genu varum e valgum no futebol. panorama histórico e atualização

ABSTRACT The presence of abnormalities in knee alignment (genu varum and genu valgum) is extremely common in soccer. It can occur in the junior league / youth academy and perpetuate itself throughout the professional career. The consequences of years of high-level sports practice in players with genu varum / genu valgum can be harmful to the knees. By observing football matches of the present and the past, the authors of the article noted that great Brazilian soccer players were, or are, affected by the malalignment of the knees: Garrincha (the most famous), Leandro, Dunga, Romário, Rivaldo and Neymar. This study aims to discuss the relationship between high-performance sport and the development of these orthopedic deformities, serving as a tool for updating the trauma-orthopedic knee subspecialty. Level of Evidence III, Retrospective comparative study.

RESUMO A presença de anormalidades no alinhamento dos joelhos (geno varo e geno valgo) é extremamente comum no futebol. Seu aparecimento pode ocorrer quando os jogadores estão nas categorias de base e se perpetuar durante a carreira profissional. As consequências de anos de prática esportiva em alto nível em jogadores com geno varo/geno valgo podem ser deletérias aos joelhos. A partir da observação de jogos de futebol do presente e do passado, os autores do artigo notaram que grandes nomes brasileiros deste esporte foram ou são acometidos pelo desalinhamento dos joelhos: Garrincha - o mais famoso -, Leandro, Dunga, Romário, Rivaldo e Neymar. O presente estudo tem como objetivo discutir a relação entre o esporte de alto rendimento e o desenvolvimento dessas deformidades ortopédicas, servindo como ferramenta de atualização da subespecialidade traumato-ortopédica do joelho. Nível III de Evidência, Estudo Retrospectivo Comparativo.

Is restless legs syndrome in Parkinson disease patients associated with any specific factor? / A síndrome das pernas inquietas nos pacientes com doença de Parkinson está associada a algum fator específico?

ABSTRACT Background: Restless legs syndrome or Willis-Ekbom disease is a disorder characterized by unpleasant sensations associated with the need to mobilize the lower limbs. In Parkinson disease patients, restless legs syndrome is associated with worse quality of life and excessive sleepiness. Regarding other factors, results of different studies are controversial. Objective: To determine the factors associated with the restless legs syndrome presence in Parkinson disease patients. Methods: A cross-sectional study was conducted in 88 consecutive Parkinson disease patients from the outpatient clinic for 21 months. Participants underwent a clinical interview, assessment based on standardized scales (Epworth Sleepiness Scale, Parkinson Disease Questionnaire - 39, Pittsburgh Sleep Quality Index, International Restless Legs Syndrome Study Group rating scale), and video-polysomnography. Results: Out of the 88 participants, 25 had restless legs syndrome. In the multivariate analysis, restless legs syndrome in Parkinson disease has been associated with the symptom of smell loss and quality of sleep and life. In the univariate analysis, restless legs syndrome in Parkinson disease has occurred more frequently in women with higher frequency of insomnia, constipation, and anosmia than in the group without restless legs syndrome. Conclusion: Restless legs syndrome is a prevalent condition in patients with Parkinson disease and is associated with specific characteristics in this group of patients.

RESUMO Introdução: A síndrome das pernas inquietas, ou doença de Willis-Ekbom, é um transtorno caracterizado por sensações de desconforto associadas à necessidade de movimentar os membros inferiores. Nos pacientes com doença de Parkinson, a síndrome das pernas inquietas está associada a uma qualidade de vida inferior e sonolência excessiva. Em relação a outros fatores, resultados de diferentes estudos mostraram resultados controversos. Objetivo: Determinar os fatores associados à presença da síndrome das pernas inquietas nos pacientes com doença de Parkinson. Métodos: Um estudo transversal foi conduzido com 88 pacientes com doença de Parkinson, consecutivos, acompanhados em ambulatório especializado, durante 21 meses. Participantes passaram por uma entrevista clínica, avaliação por meio de escalas padronizadas (Escala de Sonolência de Epworth, Questionário de Qualidade de Vida da Doença de Parkinson, Índice de Qualidade de Sono de Pittsburgh, Escala de Gravidade Internacional da Síndrome das Pernas Inquietas) e videopolissonografia. Resultados: Do total de 88 participantes, 25 tinham síndrome das pernas inquietas. Na análise multivariada, a síndrome das pernas inquietas na doença de Parkinson esteve associada à perda de olfato, assim como à qualidade de vida e ao sono. Na análise univariada, a síndrome das pernas inquietas na doença de Parkinson ocorreu mais frequentemente em mulheres, com maior frequência de insônia, constipação e anosmia, do que no grupo sem síndrome das pernas inquietas. Conclusão: A síndrome das pernas inquietas é uma condição prevalente na doença de Parkinson e está associada a características específicas neste grupo de pacientes.

The effect of aerobic combined stretching exercise training on restless legs syndrome, quality of life in hemodialysis patients / 中国实用护理杂志

Objective:To investigate the effects of aerobic combined stretching exercise during dialysis on the severity of restless legs syndrome(RLS), quality of life and sleep quality in hemodialysis (HD) patients.Methods:A total of 63 HD patients with RLS who were admitted to the Hemodialysis Center, Renmin Hospital of Wuhan University from March 2018 to March 2019 were selected as research objects. According to the random number table method, they were divided into the observation group (32 cases) and the control group (31 cases). Patients in the control group were given conventional nursing methods while patients in the observation group were given the aerobic combined stretching exercise during dialysis. The International Restless Legs Syndrome Rating Scale (IRLS) Kidney Disease Quality of Life, (KDQOL-36 TM), Pittsburgh Sleep Quality Index(PSQI) and blood chemistry were used to evaluate the effect of exercise on HD patients with RLS. Results:After intervention, the observation group ′s IRLS scores was 12.19±4.48, lower than the control group (17.87±3.91), the difference was statistically significant ( t value was 3.021, P<0.05). The scores of physical health, mental health, kidney burden, symptoms and discomfort, effects of kidney disease in KDQOL-36 TM of the observation group were 44.56±6.64, 46.12±4.95, 19.92±15.91, 87.59±5.65, 64.55±13.20, higher than the control group (37.43±4.81, 41.81±4.87,12.10±14.87, 78.83±7.96, 55.45±15.52), the differences were statistically significant ( t values were -5.027--2.015, P<0.05). The PSQI total score was 8.94±2.54, lower than that of the control group (13.13±1.31), the difference was statistically significant ( t value was 8.271, P<0.05). The blood phosphorus was (1.80±0.48) mmol/L in the observation group, lower than (2.04±0.34) mmol/L in the control group, and hemoglobin, blood calcium [(105.31±13.58) g/L, (2.26±0.20) mg/L] were higher than those in the control group[(99.52±8.21) g/L, (2.05±0.29) mg/L], the differences were statistically significant ( t values were 2.275, -2.042, -3.325, P<0.05). Conclusions:The aerobic combined stretching exercise during dialysis relieves the symptom of RLS, improves the sleeping quality and quality of life.

Research progress on the mechanisms of restless legs syndrome in patients with Parkinson's disease / 中华老年医学杂志

Parkinson's disease(PD)and restless legs syndrome(RLS)are relatively common movement disorders.There has been much debate over whether an etiological link exists between these two diseases and whether they share common pathophysiological mechanisms.PD and RLS may co-occur and respond well to dopaminergic agents, suggesting there is underlying dopamine dysfunction in both conditions.Despite the overlapping clinical features, the mechanisms underlying idiopathic RLS and RLS associated with PD may differ.In this article, we review studies related to the epidemiology, pathophysiology and genetics of PD with concurrent RLS, in order to provide evidence for exploring the link between RLS and PD.

Accuracy of dexmedetomidine titration in diagnosis of restless legs syndrome / 中华麻醉学杂志

The medical records of patients of both sexes with sleep disorders treated with multimodal sleep therapy for which patient controlled sleep with dexmedetomidine was the main method, aged≥18 yr, with body mass index of 18-30 kg/m 2, from February 2019 to January 2021, were collected.Dexmedetomidine 60 ml/h (4 μg/ml) was intravenously infused until non-rapid eye movement (NREM) Ⅲ phase was reached or the consumption of dexmedetomidine reached 1 μg/kg.Whether dexmedetomidine induced restless legs syndrome (RLS) was judged according to the Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition). When the titration was stopped and on the next day after emergence from anesthesia, clinical diagnosis was performed according to Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition) to determine whether RLS was combined or not.Kappa consistency analysis was used to assess the consistency between dexmedetomidine titration and the Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 Edition) in diagnosis of RLS.The sensitivity and specificity of diagnosis of RLS by dexmedetomidine titration were calculated.A total of 39 patients were included and 8 patients had RLS symptoms which were judged accroding to dexmedetomidine titration.The results of Kappa consistency test showed that there was a strong consistency between dexmedetomidine titration and Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition) (Kappa value 1.0, P<0.01). The sensitivity and specificity of dexmedetomidine titration in judging RLS were 100%.In conclusion, dexmedetomidine titration can accurately judge RLS.

Research progress of single nucleotide polymorphisms of risk gene of restless legs syndrome / 中华神经科杂志

Restless legs syndrome (RLS) is a kind of common diseases of the nervous system, of which adult prevalence rate is from 1% to 15%. The etiology, pathogenesis and related gene therapy of RLS are not fully understood. Studies have shown that RLS may be associated with the polymorphism of some risk genes. Genome-wide association studies have revealed a total of seven risk sites to date, including MEIS1, BTBD9, MAP2K5/SKOR1, PTPRD, TOX3, NOS1 and 2p14 intergenic regions. This article reviewed the research progress of single nucleotide polymorphisms in RLS risk genes in recent years.