Angry posture.

Postural abnormalities can affect the emotions and vice-versa. The aim of the present study was to investigate the existence of a relationship between subjective anger and body posture in 28 women, aged between 20 and 39 years, with a normal body mass index (or underweight) and an absence of neurological, psychiatric or musculoskeletal disorders. The postural parameters photographed were the inclination of the shoulders, protrusion of the head, hyperextension of the knees and shoulder elevation. The degree of anger was rated by analogue scales representing current and usual anger. The results indicated that a relationship exists between current anger and the inclination of the shoulders (p = 0.03), protrusion of the head (p = 0.05) and hyperextension of the knees (p = 0.05). Correlations were found between usual anger, shoulder elevation (p = 0.05) and hyperextension of the knees (p = 0.05). In conclusion, posture is associated with emotions, and usual anger can lead to shoulder protraction.

Resultados quirúrgicos de los pacientes con hemorragia subaracnoidea aneurismática que recibieron atenciónprotocolizada en el Hospital Hermanos Ameijeiras / Surgical results of patients with aneurismatic subarachnoid hemorrhage treated by protocolized approach in “Hermanos Ameijeiras” Hospital

Objetivo: Valorar las características basales de una serie de pacientes con hemorragia subaracnoidea aneurismática y el impacto sobrelos resultados quirúrgicos de un protocolo de manejo dinámico basado fundamentalmente en el ultrasonido Doppler transcraneal.Métodos: Se realizó un estudio descriptivo longitudinal en 233 pacientes con hemorragia subaracnoidea aneurismática operados en el Hospital Hermanos Ameijeiras durante el período 2006–2010 y evaluados posoperatoriamente por un año.Resultados: La edad media fue 49,19 años. El sexo femenino representó el 66 (Por ciento). Al ingreso, 58,4 (Por ciento) de los casos fueron grado 1 de laescala modificada de la FMSN. El estado preoperatorio evolucionó a 69,5 (Por ciento)en grado 1. El grado 3 de Fisher predominó y se asoció a la presencia de vasospasmo. El 28,8 (Por ciento) de los casos presentó vasospasmo angiográfico, elevándose el diagnóstico al 49,4 (Por ciento) con el DopplerTranscraneal, en el 25,8 (Por ciento) se hizo sintomático y el 15,9 (Por ciento) desarrolló déficit isquémico. El 73,4 (Por ciento) tuvieron aneurismas únicos de la circulación anterior. El 79,4 (Por ciento) de los aneurismas midieron entre 4–10 mm. La evolución fue favorable en el 93 (Por ciento) y la mortalidad fue de 4,29 (Por ciento). Los resultados al alta se relacionaron significativamente con: el estado al ingreso y preoperatorio, la escala de Fisher, el número de aneurismas, vasospasmo y resangramiento. Las complicaciones médicas y quirúrgicas más frecuentes fueron el vasospasmo, elresangramiento, el infarto cerebral, las infecciones urinarias, la hidrocefalia y la ruptura transoperatoria.Conclusiones: Los resultados fueron propicios comparados con la literatura especializada. Se evidenció la utilidad del manejo protocolizado y el uso de Doppler Transcraneal en estos pacientes(AU)

Objective: To assess basal characteristics and surgical outcome in patients with aneurismatic subarachnoid hemorrhage managed with one dynamic protocol based mostly on transcranial Doppler ultrasound.Methods: A descriptive longitudinal study was carried out in 233 patients with aneurismatic subarachnoid hemorrhages, who received neurosurgical clipping in the years 2006–2010 and were followed during one year.Results: Mean age was 49.19 years. Female were 66 (Per cent). At the admission, 58.4 (Per cent) of cases were in grade 1 according to the modified scale of World Federation of Neurosurgical Societies (WFNS). Preoperatively 69.5 (Per cent) of patients become grade 1. Patients were mostly Fisher 3 according to CT scan results, and this was statistically associated with vasospasm. Angiographic vasospasm was present in 28.8 (Per cent) of the cases, but increased to 49.4 (Per cent) by using transcranial Doppler. In 25.8 (Per cent) of cases vasospasm was symptomatic, and 15.9 (Per cent) develop delayed ischemic deficit. Single aneurysms on the anterior Willis circle were most relevant statistically and accounted for 73.4 (per cent) of the cases. Aneurysms were mostly of relatively small size, and in 79.4 (Per cent) of the patients they ranged between 4 and 10 mm. Outcome was favorable in 93 (Per cent), and mortality was 4.29 (Per cent). Outcome was significant associated with: neurological status at the admission, Fisher scale, numbers of aneurysms, vasospasm, and re–bleeding. Most frequents surgical and medical complications were vasospasm, re–bleeding, cerebral infarct urinary infection, hydrocephalus and intraoperative rupture.Conclusions: Compared with several series from specialized literature, outcome in this series was good. These suggest the utility of one dynamic protocol based on transcranial Doppler in patients with aneurismatic subarachnoid hemorrhage(AU)

Momento quirúrgico apoyado con doppler transcraneal en pacientes con hemorragia subaracnoidea aneurismática / Surgical timing supported by transcranial doppler in patients with subarachnoid hemorrhage from aneurisms rupture

Introducción: La cirugía de la hemorragia subaracnoidea aneurismática (HSA) realizada en las primeras 72 horas es beneficiosa. Cuando los casos arriban transcurrido este período el mejor momento quirúrgico es controversial. Objetivo. Evaluar la influencia sobre los resultados de la cirugía en la HSA de un protocolo para decidir el momento quirúrgico apoyado en el monitoreo con Doppler transcraneal (DTC). Material y Método: Se comparan los resultados quirúrgicos al alta y al año de seguimiento según la escala de Glasgow para resultados (EGR), en una serie de 233 casos con HSA rotos operados Enero de 2006 - Diciembre de 2010 y seguidos hasta Enero de 2012, en los que la cirugía en el período intermedio se decidió teniendo en cuenta las velocidades de flujo de los segmentos proximales del polígono de Willis registradas por DTC, con los de un grupo control histórico operado Diciembre de 1983 - Diciembre de 2005 sin la ayuda de dicho monitoreo. Resultados: La mortalidad al alta y al año en la serie de estudio fue de 4,3 y 4,5 por ciento y en el grupo control 7 y 7,7 por ciento respectivamente. Se observaron resultados satisfactorios (grados 4 y 5 en EGR) en el 93,1 al alta y 92,8 por ciento al año en la serie de estudio. Entre los controles históricos estos índices fueron 85,6 y 88,1 por ciento respectivamente (p = 0,004 y p = 0,036). Conclusiones: Los resultados del tratamiento microquirúrgico de la HSA se benefician con la atención protocolizada y la consideración de los resultados del DTC para seleccionar el momento quirúrgico.

Background: Aneurysmal subarachnoid hemorrhage (SAH) surgery, practiced in the first 72 hours is beneficial. The optimal surgical timing, for microsurgical clipping of ruptured intracranial aneurysms, remains controversial when patients arrive between 4 and 14 days. Some surgeons favor a prompt operation regardless the timing. Other ones prefer to wait 2 weeks. Most patients in developing countries are taken to neurosurgical attention late, which not permit an early surgery. Object. To evaluate the surgical outcome in a series of patients with subarachnoid hemorrhage (SAH) managed according to a dynamic protocol. Methods: The authors evaluated surgical outcome by means of Glasgow Outcome Scale (GOS) score in a series of 233 patients with SAH who received neurosurgical clipping in the years 2006-2010 and were followed until January 2012, whose surgical timing was decided according to transcranial Doppler (TD) monitoring. These outcomes were compared with results in a series of 445 historic controls operated 1983-2005. Results: Series mortality at the discharge and at the year were 4.3 and 4.5 percent, and 7 and 7.7 percent in the control group respectively. Series show good outcomes (grade 4 and grade 5 in GOS score) in 93.1 at the discharge and 92.8 percent at the year. Among the historic controls cases with good outcome were 85.6 and 88.1 percent respectively (p = 0.004 y p = 0.036). Conclusions: Surgical outcomes of SAH can be favored by the impact of protocolized attention and TD to decide the best surgical timing in SAH.

Comparative study of stretching modalities in healthy women: heating and application time.

A lack of muscle flexibility affects the functionality of the human body, making it difficult to carry out certain activities of daily living. The aim of the present study was to compare the technique of passive static stretching on hamstring muscles in isolation, or combined with heating techniques and different application times. Fifty women were randomly assigned to 5 groups (n = 10 each): The Microwave Diathermy Group had the hamstrings heated by microwave before stretching; Treadmill Group, in which warm-up walking was performed before stretching; 30-Second Group, in which 30 s of stretching was performed; 10-Minute Group, which involved stretching for 10 min and Control Group. In all groups, the leg extension range of motion was assessed, and the flexibility by the third finger-ground test was performed before and after application. The individuals in the experimental groups performed three stretching sessions on three consecutive days. All statistical analysis was performed with p ≤ 0.05. The results showed that all treatments were effective compared to the control group. The Treadmill Group and the 10-Minute group were superior for an acute effect (soon after the stretch--related to a decreased muscular viscoelasticity). The 10-Minute Group was the most effective for the chronic effect (long lasting--related to increased numbers of sarcomeres). A 10-minute stretch, when performed over four subsequent days, is suggested for faster increase in flexibility. The results could suggest a systemic warming (such as the one provided by a treadmill workout) before stretching for an acute gain of flexibility in the same day. It was possible to identify the inefficiencies associated with the use of microwaves in terms of stretching to gain flexibility. In fact, the values recorded were similar to stretching without any heat at all.

Differences and similarities in postural alterations caused by sadness and depression.

The present study investigated the existence of a relationship between depression and body posture in 40 women, aged between 20 and 30 years, who had normal body mass indices (or were underweight) and absence of neurological, psychiatric, or musculoskeletal disorders. The aim of the present study was to investigate the existence of a relationship between sadness, depression and the posture represented by the angle of Tales, head inclination, shoulder inclination, and forward head and shoulder protrusion. The degree of depression was rated on analogue scales representing current and usual depression and current and usual sadness and by the Beck Depression Inventory. The results indicated that a relationship exists between: Beck depression and the angle of Tales (p = 0.01), current depression and inclination of the head (p = 0.05) and inclination of the shoulders (p = 0.006), and usual depression and protrusion of the shoulder (p = 0.02). Inclination of the shoulders is associated with current sadness (p = 0.03; r = 0.443) and usual sadness (p = 0.04; r = 0.401). Usual sadness is also associated with protrusion of the shoulder (p = 0.05; r = 0.492). No associations were found with protrusion of the head and the emotional variables assessed. The conclusion was that depression and sadness might possibly change posture. Consequently, postural assessment and treatment may assist in diagnosing and treating depression.

Biomechanical assessment of human posture: a literature review.

INTRODUCTION: Postural deviations have been linked to a series of different kinds of pain and dysfunction. However, posture is not an easy subject to study, mainly because postural assessments are still scientifically inaccurate, such as photography, or expensive, such as MRI, whereas others, such as X-ray, involve radiation problems. The aim of this literature review was to search for new scientific methods for assessing posture and to discuss which among both new and old methods are best for scientific and clinical objectives. MATERIALS AND METHODS: The Medline and Lilacs databases were searched for the period 2003 to 2013 with the use of the following keywords: "posture" and "postural." RESULTS: A total of 452 articles that assessed posture in some way were found. Twenty-two articles were selected, and 11 relevant types of technologies were described. DISCUSSION: The relevant technologies discussed were force plate; pictures; goniometers, inclinometers, tape, and other devices; 3D analysis; 3D X-ray; sensors; electromyography; Kinect; magnetic resonance imaging; 4D computed tomography; and infrared. CONCLUSION: There is enough technology to make a very good quantitative evaluation possible. For example, the 3D MRI or the 4D CT can register static and dynamic posture. Other cheaper solutions may use combined and synchronized equipments. However, these synchronizations still require validation.

A review of the utilization of baropodometry in postural assessment.

Postural deviations have been linked to a series of different kinds of pain and dysfunction. Since the human foot is the basis of support and propulsion for gait, and baropodometric analysis assesses dysfunctions of the feet, it may be valuable in terms of postural assessment. Therefore, the aim of this literature review was to investigate which studies have used this baropodometric equipment and how the equipment was used, as well as to discuss the scientific problems and solutions associated with the study and clinical practice of baropodometry. Twenty-eight of the 48 articles found in the Pubmed and Lilacs databases were used. The baropodometer has the potential to provide excellent research in the postural field and related areas. However, baropodometry requires standardization and an improved calibration system. Further significant scientific papers, using properly calibrated equipment, are important in order to improve the quality of the technique and display evidence of its clinical and scientific value.

Photographic analysis of human posture: a literature review.

INTRODUCTION: The study of posture is not an easy task, mainly because postural assessment is still scientifically inaccurate. Photographs of bipedalism in the frontal and sagittal planes are one of the most widely used methods for this assessment. The aim of this literature review was to determine which anatomical markers authors of scientific papers have taken to minimize the chances of error in measurements. MATERIALS AND METHODS: The Medline and Lilacs databases were searched for the period from 2002 to 2012, with the following keywords: "postura"; "posture" and "postural." DISCUSSION: A number of studies have shown a reasonable correlation between radiographic measurements and the placement of markers. It appears possible to use photography as a form of scientific assessment since the anatomical landmarks are well chosen. CONCLUSION: The markers that were suggested in this review: malleolus; posterior calcaneal tuberosity; fibular head; tibial tuberosity; greater trochanter of the femur; anterior angle and/or posterior lateral edge of the acromion; spinous processes (particularly C7); inferior angle of the scapula; sternum manubrium; mental protuberance; and the intertragic notch. Iliac spines, both anterior superior and posterior superior, should only be used with lean subjects.

The immediate effects of modified Yoga positions on musculoskeletal pain relief.

Many musculoskeletal pains are related to poor posture. Thus, the aim of the present study was to assess the efficiency of a single session of two modified Yoga positions with 110 subjects and their 147 pain-related complaints. The participants were divided into two groups: The Yoga Group, which received treatment of two 20-min postures and the Control Group, which received a placebo treatment of 15 min with a turned off ultrasound. All volunteers experienced some pain before treatment and were assessed before and after treatment using the analog pain scale. A score of 0 indicated no pain whereas 10 was the maximum degree of pain on the scale. The difference before and after treatment was compared between the groups with a p-value of 0.0001, as measured by the Student's t-test. It is possible to conclude that one therapy session is effective in the treatment of various musculoskeletal problems.

Can sadness alter posture?

The present study investigated the existence of a relationship between subjective sadness and body posture in 28 women, aged between 20 and 39 years, who had a normal body mass indices (or were underweight) and an absence of neurological, psychiatric or musculoskeletal disorders. The postural parameter photographed was protraction of the shoulder. The degree of sadness was rated by analog scales representing current and usual sadness. The results indicated that a relationship exists between protraction of the shoulder and usual sadness (p = 0.05). However, there was no relationship between current sadness and the shoulder position. In conclusion, the usual sadness can lead to shoulder protraction.

Gigant transethmoidal meningoencephalocele operated by full endonasal endoscopic approach: case report.

Intranasal meningoencephaloceles have historically been managed by neurosurgeons, although their main clinical manifestations are rhinological. Recent advances in endoscopic skull base surgery has significantly improved the treatment of these lesions and consequently diminished appreciable surgical morbidity. We report an ethmoidal meningoencephalocele case operated on by endonasal endoscopic approach for removal of the lesion and reconstructing the associated skull base. From this experience, we conclude that removal of the lesion and watertight closure of the skull base irrespective of the size of the mass and anterior skull base defect are the operation's most important aspects.