Inflammatory biomarkers and psychological variables to assess quality of life in patients with inflammatory bowel disease: a cross-sectional study.

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic gastrointestinal condition. While inflammatory biomarkers are valuable for diagnosing and monitoring the disease, their correlation with patients' quality of life (QoL) is not well-established. PURPOSE: This study aims to investigate the correlations between inflammatory biomarkers and the quality of life (QoL) variables of individuals diagnosed with IBD in clinical remission. METHODS: The sample of this cross-sectional study included 74 patients (80% women; 45 ± 11 years old) diagnosed with IBD. Outcome variables included faecal calprotectin (FC), C-reactive protein (CRP), cortisol levels from hair samples, and anxiety and depression assessed using the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), alongside QoL evaluated with the Inflammatory Bowel Disease Questionnaire 32 (IBDQ-32). Bivariate correlations were calculated using the Pearson correlation coefficient, and stepwise linear regression analyses were conducted to identify independent factors contributing to IBDQ-32 scores. RESULTS: The IBDQ-32 did not significantly correlate with any biomarkers. However, it exhibited a large and statistically significant negative correlation with HADS-A (r = -0.651) and HADS-D (r = -0.611) scores (p < 0.001). Stepwise linear regression analyses indicated that HADS-A was a significant and independent predictor for IBDQ-32 scores (Adjusted R2 = 0.41, ß = -0.65, p < 0.001). CONCLUSIONS: Inflammatory markers such as CRP, FC, or cortisol in hair do not play a decisive role in assessing the QoL of IBD patients. These findings emphasize the significance of considering psychological factors in evaluating and managing QoL in IBD patients in order to identify severity, suggesting that instruments like HADS should be integral to comprehensive patient assessments.

Influence of Physical Activity and Cup Orientation on Metal Ion Release and Oxidative Stress in Metal-on-Metal and Ceramic-on-Metal Total Hip Arthroplasty.

BACKGROUND: Metal-on-metal (M-M) total hip arthroplasty (THA) has shown adverse reactions to metal debris, abnormal soft-tissue reactions, and high blood metal ion levels. This study aims to: (1) assess whether the toxicity of high levels of ions is related to altered oxidative stress and (2) evaluate tribological factors related to increased blood levels of chromium (Cr) and cobalt (Co) ions. METHODS: A cross-sectional analytical descriptive study was conducted on 75 patients. A total of 25 underwent M-M THA, 25 ceramic-on-metal (C-M) THA, and 25 were on the THA waiting list. Ion metallic levels in blood, oxidative stress, physical activity, and implant position were compared. RESULTS: In the M-M group, Co and Cr levels were significantly higher than those found in the C-M group and the control group (p < 0.01). We found no differences in terms of oxidative stress between the groups. Also, we did not find a correlation between metal blood levels and oxidative stress indicators, the physical activity of the patients or the position of the implants between groups. CONCLUSIONS: The use of M-M bearing surfaces in THA raises the levels of metals in the blood without modifying oxidative stress regardless of the physical activity levels of the patients. Therefore, although patients with M-M bearings require close monitoring, it does not seem necessary to recommend the restriction of physical activity in patients with M-M or C-M arthroplasties.

The dose-dependent effects of transcutaneous electrical nerve stimulation for pain relief in individuals with fibromyalgia: a systematic review and meta-analysis.

ABSTRACT: Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological modality widely used to manage pain; however, its effectiveness for individuals with fibromyalgia (FM) has been questioned. In previous studies and systematic reviews, variables related to dose of TENS application have not been considered. The objectives of this meta-analysis were (1) to determine the effect of TENS on pain in individuals with FM and (2) determine the dose-dependent effect of TENS dose parameters on pain relief in individuals with FM. We searched the PubMed, PEDro, Cochrane, and EMBASE databases for relevant manuscripts. Data were extracted from 11 of the 1575 studies. The quality of the studies was assessed using the PEDro scale and RoB-2 assessment. This meta-analysis was performed using a random-effects model that, when not considering the TENS dosage applied, showed that the treatment had no overall effect on pain (d+ = 0.51, P > 0.050, k = 14). However, the moderator analyses, which were performed assuming a mixed-effect model, revealed that 3 of the categorical variables were significantly associated with effect sizes: the number of sessions ( P = 0.005), the frequency ( P = 0.014), and the intensity ( P = 0.047). The electrode placement was not significantly associated with any effect sizes. Thus, there is evidence that TENS can effectively reduce pain in individuals with FM when applied at high or at mixed frequencies, a high intensity, or in long-term interventions involving 10 or more sessions. This review protocol was registered at PROSPERO (CRD42021252113).

Minimally Invasive Myomectomy: An Overview on the Surgical Approaches and a Comparison with Mini-Laparotomy.

Uterine fibroids (UFs) are the most common benign solid tumors of the female genital tract manageable by surgical of pharmacological approach. When the medical management is ineffective or surgery is primarily requested, several surgical approaches can be used. Among these, minimally invasive surgery might be preferred. Myomectomy is the standard surgical treatment when fertility sparing is claimed. It can be performed via laparoscopy, robotic surgery and hysteroscopy and the choice depend on UFs features and surgeon's skill. Alongside these minimally invasive options, mini-laparotomy has been proposed as a less invasive surgical approach comparable to the well-established minimally invasive options. The aim of this review is to describe the most recent advances in minimally invasive techniques to perform myomectomy, comparing them with mini-laparotomy approach.

Non-pharmacological pain control in outpatient hysteroscopies.

Outpatient hysteroscopy has become the standard technique for gynaecological exploration of the uterine cavity. The most common reason for failure of the procedure is pain. During the last decade many studies were carried out to improve the equipment as well as the procedural technical aspects. Even so, hysteroscopy is still painful for many patients. Pharmacological pain control has been widely used for hysteroscopy, but these modalities can be invasive, have side effects and are contraindicated in many women. This review examines current literature on non-pharmacological interventions (pressure, stretching, heat, electricity, music and hypnosis) on the pain experienced during outpatient hysteroscopy.

Home-exercise Childhood Obesity Intervention: A Randomized Clinical Trial Comparing Print Versus Web-based (Move It) Platforms.

PURPOSE: To compare the impact of adhering to a Mediterranean diet plus mixed physical exercise program (Move-It) implemented by means of printed instructions or via a web-platform (with or without e-mail support) on body composition, physical fitness, and blood pressure. DESIGN AND METHODS: Randomized clinical trial. Fifty-two overweight or obese Spanish children and adolescents were randomly assigned to the print-based (n = 18), Move-It (n = 18), or Move-It plus support (n = 16) intervention groups. Two-way mixed ANOVA tests were used to compare any changes between the groups in terms of percentage body fat, physical fitness (VO2peak), handgrip strength, and systolic and diastolic blood pressure. The measurements were taken before and after a three-month mixed-exercise (aerobic and resistance) and Mediterranean-diet program which was either implemented by means of printed instructions or via a web-platform (with or without e-mail support). RESULTS: No statistical differences were found between groups. However, the results highlighted significant improvements in body fat percentage metrics over time for all three groups (print-based: -1.8%, 95%CI -3.3% to -0.3%; Move-It: -1.8%, 95%CI -3.3% to -0.3%; Move-It plus support: -2.0%, 95%CI -3.7% to -0.4%, P < 0.05). We also observed a tendency towards improvement in the VO2peak, handgrip strength, and blood pressure variable values 10 min after the exercise-stress test in these three groups. CONCLUSIONS: The program improved the body composition, regardless of the way it is implemented. PRACTICE IMPLICATIONS: A mixed physical exercise program lasting for three months, combined with a Mediterranean diet, improves the body composition of children and adolescents with overweight/obesity.

Transcutaneous Nerve Stimulation for Pain Relief During Office Hysteroscopy: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the pain-relieving effect of transcutaneous electrical nerve stimulation (TENS) during office-based hysteroscopy without sedation. METHODS: We conducted a randomized, double-blind, placebo-controlled trial. Participants were randomly assigned to the active TENS, placebo TENS, or control group. The active TENS intervention consisted of a varying high-frequency (80-100 Hz), 400-microseconds, individually adjusted, high-intensity TENS application with two self-adhesive electrodes placed parallel to the spinal cord at the T10-L1 and S2-S4 levels. In the placebo group, participants were connected to the TENS unit but delivering no electrical stimulation. The primary outcome was self-reported pain intensity (0-100 mm) measured on a visual analog scale at several stages (entry, contact, biopsy, and residual). The minimum clinically relevant difference for the visual analog scale has been previously reported as 10 mm. Sample size was calculated to provide 80% power to show a 10-mm difference (α=0.0125) in the primary outcome. Secondary outcomes included duration of the procedure, vital parameters, vasovagal symptoms, and participant satisfaction index (0-10 rating scale). RESULTS: A total of 138 women (46 per group) participated in the study between January 2016 and April 2016. No differences were found between groups regarding age, weight, body mass index, parity status, menopausal status, or previous hysteroscopy status. Visual analog scale scores highlighted a decrease in pain in the active TENS group compared with the placebo group (entry: -11 mm, 95% confidence interval [CI] -17 to -5; contact: -21.9 mm, 95% CI -30 to -13.9; biopsy: -30.5 mm, 95% CI -47.1 to -13.8, P<.001). Moreover, the reduction in pain reached the minimum clinically relevant difference. Regarding satisfaction, results also revealed differences between active TENS and placebo groups (1.3, 95% CI 0.5-2.2, P=.001). CONCLUSION: Transcutaneous electrical nerve stimulation reduces pain and increases patient satisfaction during office hysteroscopy without sedation. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT02647008.

Effects of unstable shoes on trunk muscle activity and lumbar spine kinematics.

BACKGROUND: In patients with neuromuscular disease and a forced vital capacity (FVC) of <30% of the predictive value, scoliosis correction operation was Background. An unstable shoe was developed as a walking device to strengthen the lower extremity muscles and reduce joint loading. A large number of studies have reported increased electromyographic (EMG) activity throughout the gait cycle in most of the lower limb muscles, and significant kinematic changes in the lower extremity. However, no studies have investigated the effects of wearing unstable shoes on spine kinematics and trunk muscle activity during gait. AIM: To compare trunk muscle activity and lumbar spine range of motion (ROM) during gait using an unstable shoe and a conventional stable control shoe. DESIGN: Cross-sectional study. SETTING: A Biomechanics laboratory. POPULATION: Forty-eight healthy voluntary participants (24.5±5.6 years and 22.7±6.8 kg/m2). METHODS: Subjects underwent gait analysis while simultaneously collecting surface EMG data of erector spinae (ES) and rectus abdominis (RA) and lumbar spine sagittal plane ROM while treadmill walking wearing regular shoes and unstable shoes. RESULTS: The results showed that the unstable shoes resulted in significantly higher ES and RA EMG muscle activity levels in all gait phases compared to control shoes (P<0.001). In addition, the unstable shoe condition showed a significantly higher mean (mean difference: 3.1º; 95% CI 2.2º to 4º) and maximum (mean difference: 4.5º; 95% CI 2.6º to 6.5º) lumbar spine extension values (P<0.001). CONCLUSIONS: Unstable shoes increase trunk muscle activity (ES, RA) and lumbar lordosis during gait compared to control shoes. CLINICAL REHABILITATION IMPACT: Based on these findings, the use of unstable shoes may have potential implications in promoting spine tissue health, particularly in strengthening trunk muscles in healthy population or in low back pain treatment.

Competitive active video games: Physiological and psychological responses in children and adolescents.

BACKGROUND: Recent strategies to reduce sedentary behaviour in children include replacing sedentary screen time for active video games. Active video game studies have focused principally on the metabolic consumption of a single player, with physiological and psychological responses of opponent-based multiplayer games to be further evaluated. OBJECTIVE: To determine whether adding a competitive component to playing active video games impacts physiological and psychological responses in players. METHODS: Sixty-two healthy Caucasian children and adolescents, nine to 14 years years of age, completed three conditions (8 min each) in random order: treadmill walking, and single and opponent-based Kinect active video games. Affect, arousal, rate of perceived exertion, heart rate and percentage of heart rate reserve were measured for each participant and condition. RESULTS: Kinect conditions revealed significantly higher heart rate, percentage of heart rate reserve, rate of perceived exertion and arousal when compared with treadmill walking (P<0.001). Opponent-based condition revealed lower values for the rate of perceived exertion (P=0.02) and higher affect (P=0.022) when compared with single play. CONCLUSION: Competitive active video games improved children's psychological responses (affect and rate of perceived exertion) compared with single play, providing a solution that may contribute toward improved adherence to physical activity.

HISTORIQUE: Parmi les récentes stratégies en vue de réduire les comportements sédentaires chez les enfants, soulignons le remplacement du temps d'écran sédentaire par des jeux vidéo actifs. Les études sur ce type de jeux ont surtout porté sur la consommation métabolique en mode solo. Les réponses physiologiques et psychologiques de jeux en mode multijoueur comportant des adversaires n'ont pas encore été évaluées. OBJECTIF: Déterminer si l'ajout d'un élément compétitif aux jeux vidéo actifs influe sur les réponses physiologiques et psychologiques chez les joueurs. MÉTHODOLOGIE: Soixante-deux enfants et adolescents blancs en bonne santé de neuf à 14 ans ont effectué trois conditionnements de huit minutes chacun, dans un ordre aléatoire : marche sur tapis roulant et jeux vidéo actifs Kinect en mode solo et multijoueur (Microsoft Corporation, États-Unis). Les chercheurs ont mesuré l'affect, l'éveil, le taux d'effort perçu, la fréquence cardiaque et le pourcentage de réserve de fréquence cardiaque de chaque participant et de chaque conditionnement. RÉSULTATS: Le conditionnement Kinect a suscité une augmentation significative de la fréquence cardiaque, du pourcentage de réserve de fréquence cardiaque, d'effort perçu et d'éveil par rapport à la marche sur tapis roulant (P<0,001). Le conditionnement contre un adversaire révélait des valeurs plus faibles de taux d'effort perçu (P=0,02) et un affect plus élevé (P=0,022) que le jeu en mode solo. CONCLUSION: Les jeux vidéo actifs compétitifs donnent de meilleures réponses psychologiques chez les enfants (affect et taux d'efforts perçu) que le jeu en mode solo. Cette solution pourrait contribuer à une meilleure adhérence à l'activité physique.

Correlation between the level of physical activity as measured by accelerometer and the Harris Hip Score.

BACKGROUND: The most widely used method to assess the outcome of total hip arthroplasty (THA) is the Harris Hip Score (HHS). Patients' expectations about the benefits of hip arthroplasty are increasing and are no longer limited to pain reduction. Patients believe they will be able to do recreational activity and sport after surgery. It is also essential to assess the level of physical activity after arthroplasty insofar as it is associated with early failure of the components. The purpose of this study is to explore correlation of the HHS with physical activity in patients with THA. METHODS: This is a cross-sectional study on 47 patients with THA. Correlation of HHS with the results of physical activity obtained objectively using accelerometer worn for a week and subjectively using the IPAQ questionnaire and the UCLA scale. FINDING: There was no correlation between the HHS and the activity measured using accelerometers, or with the IPAQ activity questionnaire. The HHS reported moderately significant correlations with the UCLA scale. CONCLUSIONS: The HHS may not be as discriminatory as other instruments at assessing patient activity levels after THA.