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  1 / 8601 MEDLINE  
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[PMID]:28745397
[Au] Autor:Hagey TJ; Uyeda JC; Crandell KE; Cheney JA; Autumn K; Harmon LJ
[Ad] Endereço:BEACON Center for Evolution in Action, Michigan State University, East Lansing, Michigan 48824.
[Ti] Título:Tempo and mode of performance evolution across multiple independent origins of adhesive toe pads in lizards.
[So] Source:Evolution;71(10):2344-2358, 2017 10.
[Is] ISSN:1558-5646
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Understanding macroevolutionary dynamics of trait evolution is an important endeavor in evolutionary biology. Ecological opportunity can liberate a trait as it diversifies through trait space, while genetic and selective constraints can limit diversification. While many studies have examined the dynamics of morphological traits, diverse morphological traits may yield the same or similar performance and as performance is often more proximately the target of selection, examining only morphology may give an incomplete understanding of evolutionary dynamics. Here, we ask whether convergent evolution of pad-bearing lizards has followed similar evolutionary dynamics, or whether independent origins are accompanied by unique constraints and selective pressures over macroevolutionary time. We hypothesized that geckos and anoles each have unique evolutionary tempos and modes. Using performance data from 59 species, we modified Brownian motion (BM) and Ornstein-Uhlenbeck (OU) models to account for repeated origins estimated using Bayesian ancestral state reconstructions. We discovered that adhesive performance in geckos evolved in a fashion consistent with Brownian motion with a trend, whereas anoles evolved in bounded performance space consistent with more constrained evolution (an Ornstein-Uhlenbeck model). Our results suggest that convergent phenotypes can have quite distinctive evolutionary patterns, likely as a result of idiosyncratic constraints or ecological opportunities.
[Mh] Termos MeSH primário: Evolução Molecular
Lagartos/genética
Seleção Genética
Dedos do Pé/fisiologia
[Mh] Termos MeSH secundário: Animais
Lagartos/anatomia & histologia
Lagartos/fisiologia
Modelos Genéticos
Dedos do Pé/anatomia & histologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1111/evo.13318


  2 / 8601 MEDLINE  
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[PMID]:29384887
[Au] Autor:Lu H; Chen LF; Chen Q; Shen H; Liu Z
[Ad] Endereço:Department of Hand Surgery.
[Ti] Título:A rare large cutaneous chondroid syringoma involving a toe: A case report.
[So] Source:Medicine (Baltimore);97(5):e9825, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Chondroid syringoma (CS) occurs mostly on the face and neck, and rarely occurs in the toe. Malignant CS is invasive, grows quickly, and has a high recurrence rate. The presence of a bilobed CS in 1 toe has never been reported in the literature. PATIENT CONCERNS: A 72-year-old male patient presented with a mass in a third toe of his right foot. The mass had slowly grown in 2 years. He felt mild pain and the mass occupied most of the tip of the toe. DIAGNOSES: Radiographs showed a large soft-tissue mass in the third toe of his right foot without any bone destruction. Ultrasonogram showed 2 partly fused hypoechoic masses within the lesion. The mass was therefore diagnosed as a benign CS. INTERVENTIONS: We amputated the toe with the mass under local anesthesia. The postoperative pathohistological examinations confirmed that the lesion was a bipartite CS exhibiting active cellular proliferation. OUTCOMES: Two years after surgery, there was no tumor recurrence. LESSONS: CS can also present as multiple adjacent masses. Complete surgical resection and long-term follow-up are essential.
[Mh] Termos MeSH primário: Adenoma Pleomorfo/diagnóstico por imagem
Adenoma Pleomorfo/patologia
Neoplasias das Glândulas Sudoríparas/diagnóstico por imagem
Neoplasias das Glândulas Sudoríparas/patologia
Dedos do Pé
[Mh] Termos MeSH secundário: Adenoma Pleomorfo/cirurgia
Idoso
Seres Humanos
Masculino
Radiografia
Neoplasias das Glândulas Sudoríparas/cirurgia
Ultrassonografia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009825


  3 / 8601 MEDLINE  
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[PMID]:29390534
[Au] Autor:Liu H; Song K; Zhang M; Dong X; Liu S; Wang Y
[Ad] Endereço:Department of Plastic Surgery, Peking Union Medical College Hospital.
[Ti] Título:Toe keloid after nail extraction treated with surgical excision: A case report.
[So] Source:Medicine (Baltimore);96(51):e9373, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: In this study, a case of toe keloid after nail extraction is presented, in which the keloids on both toes were resected by surgical excision. Keloids (from the Greek word meaning "crab's claw") are fibrous growths that extend beyond the original area of injury to involve the adjacent normal skin. In general, keloid tendencies appear to be regionally isolated to keloid-prone areas, such as the chest, ears, and deltoid regions, whereas the hands and feet are usually spared, which is why this case is meaningful. PATIENT CONCERNS: A 20-year-old Chinese man had paronychia on both halluxes when he was 16 years old. He underwent a nail extraction at the age of 17. The nails of both halluxes were removed by nail extraction. This operation was successful, and the postoperative course was uneventful. After 6 months, the scars of the nail extraction on both sides began to exhibit hyperplasia and became red and swollen with itching. Later, the scar expanded and eroded the tissue beyond the matrix unguis. The whole matrix unguis was destroyed, and the nails were distorted. The scars began to ulcerate after 2 years. The patient used potassium permanganate to clean his wounds, but the keloid scars did not improve. DIAGNOSES: The patient was diagnosed as toe keloid based on his history and symptoms. The biopsy result supported our diagnoses. INTERVENTIONS: The toe keloids were effectively cured by surgical excision and skin flap transplantation combined with postoperative irradiation and hyperbaric oxygen (HBO) treatment. OUTCOMES: No recurrence was detected during the period from 6 to 24 months of follow-up after the surgery. LESSONS: In this case, the trauma of the nail extraction was likely the key cause of the keloid. However, the patient was also predisposed to keloids, as we observed keloids on his chest. In general, keloid tendencies appear to be regionally isolated to keloid-prone areas such as the chest, ears, and deltoid regions, whereas the hands and feet are usually spared, which is why this case is meaningful.
[Mh] Termos MeSH primário: Queloide/cirurgia
Paroniquia/cirurgia
Complicações Pós-Operatórias/cirurgia
Dedos do Pé/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Queloide/etiologia
Masculino
Transplante de Pele
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009373


  4 / 8601 MEDLINE  
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[PMID]:28466970
[Au] Autor:Alanazy MH; Alfurayh NA; Almweisheer SN; Aljafen BN; Muayqil T
[Ad] Endereço:Department of Internal Medicine, Division of Neurology, King Saud University Medical City and College of Medicine, King Saud University, PO Box 7805, Riyadh, 11472, Saudi Arabia.
[Ti] Título:The conventional tuning fork as a quantitative tool for vibration threshold.
[So] Source:Muscle Nerve;57(1):49-53, 2018 Jan.
[Is] ISSN:1097-4598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: This study was undertaken to describe a method for quantifying vibration when using a conventional tuning fork (CTF) in comparison to a Rydel-Seiffer tuning fork (RSTF) and to provide reference values. METHODS: Vibration thresholds at index finger and big toe were obtained in 281 participants. Spearman's correlations were performed. Age, weight, and height were analyzed for their covariate effects on vibration threshold. Reference values at the fifth percentile were obtained by quantile regression. RESULTS: The correlation coefficients between CTF and RSTF values at finger/toe were 0.59/0.64 (P = 0.001 for both). Among covariates, only age had a significant effect on vibration threshold. Reference values for CTF at finger/toe for the age groups 20-39 and 40-60 years were 7.4/4.9 and 5.8/4.6 s, respectively. Reference values for RSTF at finger/toe for the age groups 20-39 and 40-60 years were 6.9/5.5 and 6.2/4.7, respectively. DISCUSSION: CTF provides quantitative values that are as good as those provided by RSTF. Age-stratified reference data are provided. Muscle Nerve 57: 49-53, 2018.
[Mh] Termos MeSH primário: Exame Neurológico/instrumentação
Limiar Sensorial/fisiologia
Vibração
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Estatura/fisiologia
Peso Corporal/fisiologia
Feminino
Dedos/inervação
Dedos/fisiologia
Seres Humanos
Masculino
Meia-Idade
Valores de Referência
Reprodutibilidade dos Testes
Dedos do Pé/inervação
Dedos do Pé/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171212
[Lr] Data última revisão:
171212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1002/mus.25680


  5 / 8601 MEDLINE  
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[PMID]:28459164
[Au] Autor:Nouman M; Leelasamran W; Chatpun S
[Ad] Endereço:1 Institute of Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
[Ti] Título:Effectiveness of Total Contact Orthosis for Plantar Pressure Redistribution in Neuropathic Diabetic Patients During Different Walking Activities.
[So] Source:Foot Ankle Int;38(8):901-908, 2017 Aug.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Using a total contact orthosis (TCO) is an effective method to offload in diabetic patients with foot neuropathy. However, the redistribution of peak plantar pressure is mostly observed during level walking, which may differ from other walking activities. The aim of this study was to investigate the plantar pressure from 4 regions of the foot during different walking activities (level walking, ramp ascending, ramp descending, stair ascending, and stair descending) in neuropathic diabetic patients with and without a TCO. METHODS: Sixteen neuropathic diabetic patients aged 40 to 60 years with calluses and hallux valgus were included in this study and were provided with TCOs made up of multifoam, Plastazote, and microcellular rubber. The plantar pressure and contact area with the TCO and without the TCO were recorded using the Pedar X system during different walking activities. RESULTS: A significant reduction of plantar pressure during different walking activities at the toes and forefoot regions was observed while walking with the TCO compared with walking without the TCO (control condition). Plantar pressure increased at the midfoot region when walking with the TCO, and no significant difference was observed at the hindfoot region between the control and TCO conditions. Furthermore, maximum contact area was observed during level walking with the TCO compared with other walking activities. CONCLUSION: The TCO significantly reduced and redistributed the peak plantar pressure from the sites where the ulceration rate is higher at the toes and forefoot compared with the other regions of the foot. LEVEL OF EVIDENCE: Therapeutic level II, lesser quality randomized controlled trial.
[Mh] Termos MeSH primário: Braquetes/normas
Pé Diabético/fisiopatologia
Neuropatias Diabéticas/fisiopatologia
/fisiologia
Antepé Humano/fisiopatologia
Hallux Valgus/fisiopatologia
Aparelhos Ortopédicos/normas
Dedos do Pé/fisiopatologia
Caminhada/fisiologia
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Pé Diabético/terapia
Seres Humanos
Pressão
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1177/1071100717704427


  6 / 8601 MEDLINE  
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[PMID]:29049244
[Au] Autor:Piette N; Zambelli PY; N'Dele D
[Ad] Endereço:Pediatric Orthopedics and Traumatology Unit, Lausanne University Hospital, Lausanne, Switzerland.
[Ti] Título:Isolated heptadactylia: A case report of central polydactyly of the foot.
[So] Source:Medicine (Baltimore);96(42):e8324, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Heptadactylia is a rare congenital disorder from the polydactyly family. Polydactyly is generally classified into 3 major groups: preaxial (medial ray), postaxial (lateral ray), and central polydactyly. Most common cases are related to preaxial or postaxial polydactyly. The rarity of central polydactyly can be explained in 3 ways. First, central polydactyly with duplication appearing on metatarsal is pretty uncommon. Second, the duplication appears isolated on the foot. Polydactyly is mostly associated with other physical defects or others duplications. Last, the duplication of the digital rays does not appear once but twice concerning all the digital rays and makes 7 functional toes appear. We describe this malformation with supporting iconography and radiography as well as its surgical management and functional results. PATIENT CONCERNS: We analyzed an original case of isolated heptadactylia on the foot of a 14-month-old girl. The supernumerary toes made it impossible for the child to wear standard shoes and her parents were worried about this problem. DIAGNOSES: Clinical foot examination and radiographs revealed the presence of 7 complete rays. Every toe was composed of phalanx and metatarsal ray. There was no other congenital deformity. INTERVENTIONS: Decision was made to resect the second and third rays (the two most misaligned toes in our consideration). The first stage of surgery was the ray resection and the second stage was the reconstruction of the intermetatarsal ligament to achieve a good functional and cosmetic results. OUTCOMES: After wound healing, the child was able to walk alone while wearing normal shoes. LESSONS: We demonstrated that treatment of foot polydactyly requires careful preoperative assessment, including radiographs and photography. A good clinical evaluation of the medial polydactyly improves type-specific recognition which may enhance the accuracy of surgical treatment. Polydactyly is frequently associated with other malformations. We recommend performing a general clinical examination to exclude concomitant malformations. We recommend surgical treatment around the onset of walking.
[Mh] Termos MeSH primário: Polidactilia/cirurgia
Dedos do Pé/anormalidades
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Lactente
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008324


  7 / 8601 MEDLINE  
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[PMID]:29040330
[Au] Autor:Uritani D; Fukumoto T; Myodo T; Fujikawa K; Usui M; Tatara D
[Ad] Endereço:Department of Physical Therapy, Faculty of Health Science, Kio University, Nara, Japan.
[Ti] Título:The association between toe grip strength and osteoarthritis of the knee in Japanese women: A multicenter cross-sectional study.
[So] Source:PLoS One;12(10):e0186454, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We evaluated the relationship between altered foot function and knee osteoarthritis through a specific comparison of toe grip strength in older women with and without knee osteoarthritis. Participants were 120 women with knee osteoarthritis (OA group) and 108 healthy community-dwelling women with no history of knee pain and lower limb surgery (control group). The following factors and outcome variables were included in our analysis: measured toe grip strength, isometric knee extension strength, the timed Up-and-Go, and the WOMAC scale. Between-group differences were compared using unpaired t-tests for descriptive characteristics and outcome measures. Pearson's correlation coefficients between toe grip strength and age, body mass index, and other outcome measures were calculated. Multiple logistic regression analysis was used to evaluate the independence of toe grip strength and knee osteoarthritis. Compared to the control group, participants in the OA group were older, heavier, and had a higher body mass index. Toe grip strength and isometric knee extension strength were lower and the timed Up-and-Go longer for the OA group than the control group. Toe grip strength was correlated with age negatively and isometric knee extension strength positively in the OA group and to age and the timed Up-and-Go negatively, and isometric knee extension strength positively in the control group. Multiple logistic regression analysis revealed that body mass index, isometric knee extensor strength, and toe grip strength were independently associated with knee osteoarthritis. Our findings indicate a probable association between altered forefoot function and the incidence or progression of knee osteoarthritis. Increasing toe grip strength might provide a practical intervention for patients with knee osteoarthritis.
[Mh] Termos MeSH primário: Articulação do Joelho/fisiopatologia
Força Muscular/fisiologia
Osteoartrite do Joelho/diagnóstico
Dor/fisiopatologia
Dedos do Pé/fisiologia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Grupo com Ancestrais do Continente Asiático
Índice de Massa Corporal
Estudos de Casos e Controles
Estudos Transversais
Feminino
Seres Humanos
Vida Independente
Contração Isométrica/fisiologia
Articulação do Joelho/patologia
Modelos Logísticos
Osteoartrite do Joelho/etnologia
Osteoartrite do Joelho/patologia
Osteoartrite do Joelho/fisiopatologia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171018
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186454


  8 / 8601 MEDLINE  
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[PMID]:29016641
[Au] Autor:Chu Q; Yan Z; Zhang J; Usman T; Zhang Y; Liu H; Wang H; Geng A; Liu H
[Ad] Endereço:Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, P. R. China.
[Ti] Título:Association of SNP rs80659072 in the ZRS with polydactyly in Beijing You chickens.
[So] Source:PLoS One;12(10):e0185953, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Beijing You chicken is a Chinese native breed with superior meat quality and a unique appearance. The G/T mutation of SNP rs80659072 in the Shh long-range regulator of GGA2 is highly associated with the polydactyly phenotype in some chicken breeds. In the present study, this SNP was genotyped using the TaqMan detection method, and its association with the number of toes was analyzed in a flock of 158 birds of the Beijing You population maintained at the Beijing Academy of Agriculture and Forestry Sciences. Furthermore, the skeletal structure of the digits was dissected and assembled in 113 birds. The findings revealed that the toes of Beijing You chickens were rich and more complex than expected. The plausible mutation rs80659072 in the zone of polarizing activity regulatory sequence (ZRS) in chickens was an essential but not sufficient condition for polydactyly and polyphalangy in Beijing You chickens. Several individuals shared the T allele but showed normal four-digit conformations. However, breeding trials demonstrated that the T allele could serve as a strong genetic marker for five-toe selection in Beijing You chickens.
[Mh] Termos MeSH primário: Proteínas Aviárias/genética
Galinhas/genética
DNA/genética
Polidactilia/genética
Dedos do Pé/fisiopatologia
[Mh] Termos MeSH secundário: Agricultura
Alelos
Animais
Cruzamento
Feminino
Genótipo
Seres Humanos
Masculino
Carne
Mutação
Polidactilia/fisiopatologia
Polidactilia/veterinária
Polimorfismo de Nucleotídeo Único
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Avian Proteins); 9007-49-2 (DNA)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185953


  9 / 8601 MEDLINE  
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[PMID]:28953920
[Au] Autor:Hagey TJ; Harte S; Vickers M; Harmon LJ; Schwarzkopf L
[Ad] Endereço:BEACON Center for Evolution in Action, Michigan State University, East Lansing, Michigan, United States of America.
[Ti] Título:There's more than one way to climb a tree: Limb length and microhabitat use in lizards with toe pads.
[So] Source:PLoS One;12(9):e0184641, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ecomorphology links microhabitat and morphology. By comparing ecomorphological associations across clades, we can investigate the extent to which evolution can produce similar solutions in response to similar challenges. While Anolis lizards represent a well-studied example of repeated convergent evolution, very few studies have investigated the ecomorphology of geckos. Similar to anoles, gekkonid lizards have independently evolved adhesive toe pads and many species are scansorial. We quantified gecko and anole limb length and microhabitat use, finding that geckos tend to have shorter limbs than anoles. Combining these measurements with microhabitat observations of geckos in Queensland, Australia, we observed geckos using similar microhabitats as reported for anoles, but geckos with relatively longer limbs were using narrower perches, differing from patterns observed in anoles and other lizards. We also observed arboreal geckos with relatively shorter proximal limb segments as compared to rock-dwelling and terrestrial geckos, similar to patterns observed for other lizards. We conclude that although both geckos and anoles have adhesive pads and use similar microhabitats, their locomotor systems likely complement their adhesive pads in unique ways and result in different ecomorphological patterns, reinforcing the idea that species with convergent morphologies still have idiosyncratic characteristics due to their own separate evolutionary histories.
[Mh] Termos MeSH primário: Ecossistema
Lagartos/anatomia & histologia
Dedos do Pé/fisiologia
[Mh] Termos MeSH secundário: Animais
Lagartos/fisiologia
Queensland
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184641


  10 / 8601 MEDLINE  
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[PMID]:28795968
[Au] Autor:Xu Z; Xu T; Zhao P; Ma R; Zhang M; Zheng J
[Ad] Endereço:From the *Department of Anesthesiology, the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and †Department of Anesthesiology & Pediatric Clinical Pharmacology Laboratory, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
[Ti] Título:Differential Roles of the Right and Left Toe Perfusion Index in Predicting the Incidence of Postspinal Hypotension During Cesarean Delivery.
[So] Source:Anesth Analg;125(5):1560-1566, 2017 Nov.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Aortocaval compression by the gravid uterus, low baseline vasomotor tone, and spinal anesthesia-related sympathetic blockade contribute to spinal anesthesia-induced hypotension during cesarean delivery. The finger perfusion index (PI) can predict spinal hypotension by reflecting baseline vasomotor tone, but cannot directly reflect aortocaval compression by the gravid uterus. This study aimed to examine whether baseline toe PIs predict the incidence of maternal hypotension and reflect aortocaval compression by the gravid uterus during cesarean delivery under spinal anesthesia. METHODS: One hundred parturients undergoing elective cesarean delivery were enrolled. The relationship between baseline toe PI and the incidence of hypotension after induction of spinal anesthesia was quantified using area under the receiver operator curves, and results compared for the right and left toe PIs. RESULTS: The area under the receiver operator curves for left and right toe baseline PIs were 0.81 (95% confidence interval, 0.71-0.88) and 0.76 (95% confidence interval, 0.66-0.84), respectively. After induction of spinal anesthesia, the toe PIs did not change in parturients with hypotension, but increased significantly among those who did not develop hypotension. CONCLUSIONS: Our study demonstrated that baseline toe PIs were inversely associated with the incidence of postspinal hypotension during cesarean delivery. Continuous monitoring of toe PIs during induction of spinal anesthesia might help to predict the development of postspinal hypotension and reflect the aortocaval compression by the gravid uterus.
[Mh] Termos MeSH primário: Anestesia Obstétrica
Raquianestesia
Pressão Sanguínea
Cesárea
Hipotensão/etiologia
Monitorização Intraoperatória/métodos
Dedos do Pé/irrigação sanguínea
[Mh] Termos MeSH secundário: Adulto
Anestesia Obstétrica/efeitos adversos
Raquianestesia/efeitos adversos
Área Sob a Curva
Cesárea/efeitos adversos
Procedimentos Cirúrgicos Eletivos
Feminino
Seres Humanos
Hipotensão/diagnóstico
Hipotensão/fisiopatologia
Modelos Logísticos
Análise Multivariada
Valor Preditivo dos Testes
Gravidez
Curva ROC
Fluxo Sanguíneo Regional
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002393



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