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[PMID]:28743162
[Au] Autor:Cahn DB; Handorf EA; Ghiraldi EM; Ristau BT; Geynisman DM; Churilla TM; Horwitz EM; Sobczak ML; Chen DYT; Viterbo R; Greenberg RE; Kutikov A; Uzzo RG; Smaldone MC
[Ad] Endereço:Department of Urology, Einstein Healthcare Network, Philadelphia, Pennsylvania.
[Ti] Título:Contemporary use trends and survival outcomes in patients undergoing radical cystectomy or bladder-preservation therapy for muscle-invasive bladder cancer.
[So] Source:Cancer;123(22):4337-4345, 2017 Nov 15.
[Is] ISSN:1097-0142
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The current study was performed to examine temporal trends and compare overall survival (OS) in patients undergoing radical cystectomy (RC) or bladder-preservation therapy (BPT) for muscle-invasive urothelial carcinoma of the bladder. METHODS: The authors reviewed the National Cancer Data Base to identify patients with AJCC stage II to III urothelial carcinoma of the bladder from 2004 through 2013. Patients receiving BPT were stratified as having received any external-beam radiotherapy (any XRT), definitive XRT (50-80 grays), and definitive XRT with chemotherapy (CRT). Treatment trends and OS outcomes for the BPT and RC cohorts were evaluated using Cochran-Armitage tests, unadjusted Kaplan-Meier curves, adjusted Cox multivariate regression, and propensity score matching, using increasingly stringent selection criteria. RESULTS: A total of 32,300 patients met the inclusion criteria and were treated with RC (22,680 patients) or BPT (9620 patients). Of the patients treated with BPT, 26.4% (2540 patients) and 15.5% (1489 patients), respectively, were treated with definitive XRT and CRT. Improved OS was observed for RC in all groups. After adjustments with more rigorous statistical models controlling for confounders and with more restrictive BPT cohorts, the magnitude of the OS benefit became attenuated on multivariate (any XRT: hazard ratio [HR], 2.115 [95% confidence interval [95% CI], 2.045-2.188]; definitive XRT: HR, 1.870 [95% CI, 1.773-1.972]; and CRT: HR, 1.578 [95% CI, 1.474-1.691]) and propensity score (any XRT: HR, 2.008 [95% CI, 1.871-2.154]; definitive XRT: HR, 1.606 [95% CI, 1.453-1.776]; and CRT: HR, 1.406 [95% CI, 1.235-1.601]) analyses. CONCLUSIONS: In the National Cancer Data Base, receipt of BPT was associated with decreased OS compared with RC in patients with stage II to III urothelial carcinoma. Increasingly stringent definitions of BPT and more rigorous statistical methods adjusting for selection biases attenuated observed survival differences. Cancer 2017;123:4337-45. © 2017 American Cancer Society.
[Mh] Termos MeSH primário: Carcinoma de Células de Transição/mortalidade
Carcinoma de Células de Transição/cirurgia
Cistectomia
Neoplasias Musculares/mortalidade
Neoplasias Musculares/cirurgia
Tratamentos com Preservação do Órgão
Neoplasias da Bexiga Urinária/mortalidade
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Músculos Abdominais/patologia
Neoplasias Abdominais/mortalidade
Neoplasias Abdominais/secundário
Neoplasias Abdominais/cirurgia
Adulto
Idoso
Carcinoma de Células de Transição/patologia
Quimiorradioterapia
Cistectomia/métodos
Cistectomia/mortalidade
Cistectomia/estatística & dados numéricos
Cistectomia/tendências
Bases de Dados Factuais
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias Musculares/secundário
Invasividade Neoplásica
Estadiamento de Neoplasias
Tratamentos com Preservação do Órgão/mortalidade
Tratamentos com Preservação do Órgão/estatística & dados numéricos
Tratamentos com Preservação do Órgão/tendências
Análise de Sobrevida
Resultado do Tratamento
Neoplasias da Bexiga Urinária/patologia
[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:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1002/cncr.30900


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[PMID]:29049215
[Au] Autor:Kim SH; Park KN; Kwon OY
[Ad] Endereço:aDepartment of Physical Therapy, College of Health Science, Yonsei University, Maeji-ri, Heungeop-myeon, Wonju-si, Gangwon-do bDepartment of Physical Therapy, College of Medical Science, Jeonju University cLaboratory of Kinetic Ergocise based on Movement Analysis, Department of Physical Therapy, College of Health Science, Yonsei University, Maeji-ri, Heungeop-myeon, Wonju-si, Gangwon-do, South Korea.
[Ti] Título:Pain intensity and abdominal muscle activation during walking in patients with low back pain: The STROBE study.
[So] Source:Medicine (Baltimore);96(42):e8250, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nonspecific low back pain (LBP) is a common musculoskeletal problem that is intensified during physical activity. Patients with LBP have been reported to change their abdominal muscle activity during walking; however, the effects of pain intensity, disability level, and fear-avoidance belief on this relationship have not been evaluated. Thus, we compared abdominal muscle activity in patients with LBP and asymptomatic controls, and assessed the impact of pain intensity, disability level, and fear-avoidance belief.Thirty patients with LBP divided into groups reporting low (LLBP) and high-pain intensity low back pain (HLBP), and 15 participants without LBP were recruited. LBP patients' self-reported pain intensity, disability, and fear-avoidance belief were recorded. To examine abdominal muscle activity (rectus abdominis [RA], internal [IO], and external oblique [EO] muscles) during walking, all subjects walked at a self-selected speed. Abdominal muscle activity (RA, IO, and EO) was compared among groups (LLBP, HLBP, and controls) in different phases of walking (double support vs swing). Relationships between abdominal muscle activity and clinical measures (pain intensity, disability, fear-avoidance belief) were analyzed using partial correlation analysis.Right IO muscle activity during walking was significantly decreased in LLBP and HLBP compared with controls in certain walking phase. Partial correlation coefficients showed significant correlations between fear-avoidance belief and right EO activity (r = .377, P < .05) and between disability index and left IO activity (r = .377, P < .05) in patients with LBP. No significant difference was found in abdominal muscle activity in walking between patients with LLBP and HLBP (P > .05).This study demonstrated decreased IO muscle activity during certain walking phases in LLBP and HLBP compared with asymptomatic participants. Although altered IO muscle activity during walking was observed in patients with LBP, no changes were found with other abdominal muscles (EO, RA). Thus, these results provide useful information about abdominal muscle activity during walking in patients with LBP.
[Mh] Termos MeSH primário: Músculos Abdominais/fisiopatologia
Aprendizagem da Esquiva/fisiologia
Medo/fisiologia
Dor Lombar/fisiopatologia
Caminhada/fisiologia
[Mh] Termos MeSH secundário: Adulto
Estudos de Casos e Controles
Estudos Transversais
Feminino
Seres Humanos
Dor Lombar/psicologia
Masculino
Contração Muscular/fisiologia
Medição da Dor/métodos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[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.0000000000008250


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[PMID]:28888083
[Au] Autor:Sato M; Hara M; Uchida O
[Ad] Endereço:Department of Anesthesiology, Chiba Children's Hospital, Chiba, Japan.
[Ti] Título:An antero-lateral approach to ultrasound-guided lumbar plexus block in supine position combined with quadratus lumborum block using single-needle insertion for pediatric hip surgery.
[So] Source:Paediatr Anaesth;27(10):1064-1065, 2017 10.
[Is] ISSN:1460-9592
[Cp] País de publicação:France
[La] Idioma:eng
[Mh] Termos MeSH primário: Músculos Abdominais
Agulhas
[Mh] Termos MeSH secundário: Criança
Seres Humanos
Plexo Lombossacral
Bloqueio Nervoso
Decúbito Dorsal
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170910
[St] Status:MEDLINE
[do] DOI:10.1111/pan.13208


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[PMID]:28735829
[Au] Autor:Cruz-Díaz D; Bergamin M; Gobbo S; Martínez-Amat A; Hita-Contreras F
[Ad] Endereço:Department of Health Sciences, Faculty of Health Sciences, University of Jaén, E-23071 Jaén, Spain. Electronic address: dcruz@ujaen.es.
[Ti] Título:Comparative effects of 12 weeks of equipment based and mat Pilates in patients with Chronic Low Back Pain on pain, function and transversus abdominis activation. A randomized controlled trial.
[So] Source:Complement Ther Med;33:72-77, 2017 Aug.
[Is] ISSN:1873-6963
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pilates method has been recommended for patients with chronic low back pain (CLBP) and the activation of transversus abdominis has been deemed to play an important role in the improvement of these patients. Nevertheless, the evidence of the activation of TrA in Pilates practitioners remains unclear. OBJECTIVE: To assess the effectiveness of 12 weeks of Pilates practice in disability, pain, kinesiophobia and transversus abdominis activation in patients with chronic nonspecific Low Back Pain. DESIGN: A randomized controlled trial was carried out. METHODS: A single-blind randomized controlled trial with repeated measures at 6 and 12 weeks was carried out. A total of ninety eight patients with low back pain were included and randomly allocated to a Pilates Mat group (PMG) equipment based with apparatus Pilates (PAG) or control group (CG). Roland Morris Disability Questionnaire (RMDQ), visual analog scale (VAS) Tampa Scale of Kinesiophobia (TSK), and transversus abdominis (TrA) activation assessed by real time ultrasound measurement (US) were assessed as outcome measures. RESULTS: Improvement were observed in both intervention groups in all the included variables at 6 and 12 weeks (p<0.001). Faster enhancement was observed in the equipment based Pilates group (p=0.007). CONCLUSIONS: Equipment based and mat Pilates modalities are both effective in the improvement of TaA activation in patients with CLBP with associate improvement on pain, function and kinesiophobia. Significant differences were observed after 12 weeks of intervention in PMG and PAG with faster improvement in PAG suggesting that, feedback provided by equipment could help in the interiorization of Pilates principles.
[Mh] Termos MeSH primário: Músculos Abdominais/fisiologia
Dor Crônica/terapia
Técnicas de Exercício e de Movimento/métodos
Terapia por Exercício
Medo
Dor Lombar/terapia
Atividade Motora
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Dor Crônica/psicologia
Avaliação da Deficiência
Equipamentos e Provisões
Feminino
Seres Humanos
Dor Lombar/psicologia
Masculino
Meia-Idade
Contração Muscular
Dor
Método Simples-Cego
Ultrassonografia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170725
[St] Status:MEDLINE


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[PMID]:28667050
[Au] Autor:Jackson WF; Boerman EM
[Ad] Endereço:Department of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan jacks783@msu.edu.
[Ti] Título:Regional heterogeneity in the mechanisms of myogenic tone in hamster arterioles.
[So] Source:Am J Physiol Heart Circ Physiol;313(3):H667-H675, 2017 Sep 01.
[Is] ISSN:1522-1539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Myogenic tone is an important feature of arterioles and resistance arteries, but the mechanisms responsible for this hallmark characteristic remain unclear. We used pharmacological inhibitors to compare the roles played by phospholipase C (PLC; 10 µM U73122), inositol 1,4,5-trisphosphate receptors (IP Rs; 100 µM 2-aminoethoxydiphenylborane), protein kinase C (10 µM bisindolylmaleimide I), angiotensin II type 1 receptors (1 µM losartan), Rho kinase (10 nM-30 µM Y27632 or 300 nM H1152), stretch-activated ion channels (10 nM-1 µM Gd or 5 µM spider venom toxin GsMTx-4) and L-type voltage-gated Ca channels (0.3-100 µM diltiazem) in myogenic tone of cannulated, pressurized (80 cmH O), second-order hamster cremaster or cheek pouch arterioles. Effective inhibition of either PLC or IP Rs dilated cremaster arterioles, inhibited Ca waves, and reduced global Ca levels. In contrast, cheek pouch arterioles did not display Ca waves and inhibition of PLC or IP Rs had no effect on myogenic tone or intracellular Ca levels. Inhibition of Rho kinase dilated both cheek pouch and cremaster arterioles with equal efficacy and potency but also reduced intracellular Ca signals in both arterioles. Similarly, inhibition of mechanosensitive ion channels with Gd or GsMTx-4 produced comparable dilation in both arterioles. Inhibition of L-type Ca channels with diltiazem was more effective in dilating cremaster (86 ± 5% dilation, = 4) than cheek pouch arterioles (54 ± 4% dilation, = 6, < 0.05). Thus, there are substantial differences in the mechanisms underlying myogenic tone in hamster cremaster and cheek pouch arterioles. Regional heterogeneity in myogenic mechanisms could provide new targets for drug development to improve regional blood flow in a tissue-specific manner. Regional heterogeneity in the mechanisms of pressure-induced myogenic tone implies that resistance vessels may be able to alter myogenic signaling pathways to adapt to their environment. A better understanding of the spectrum of myogenic mechanisms could provide new targets to treat diseases that affect resistance artery and arteriolar function.
[Mh] Termos MeSH primário: Músculos Abdominais/irrigação sanguínea
Arteríolas/fisiologia
Sinalização do Cálcio
Bochecha/irrigação sanguínea
Mecanotransdução Celular
Vasoconstrição
Vasodilatação
[Mh] Termos MeSH secundário: Animais
Arteríolas/efeitos dos fármacos
Arteríolas/metabolismo
Pressão Sanguínea
Canais de Cálcio Tipo L/metabolismo
Sinalização do Cálcio/efeitos dos fármacos
Relação Dose-Resposta a Droga
Técnicas In Vitro
Receptores de Inositol 1,4,5-Trifosfato/metabolismo
Masculino
Mecanotransdução Celular/efeitos dos fármacos
Mesocricetus
Microcirculação
Especificidade de Órgãos
Proteína Quinase C/metabolismo
Fatores de Tempo
Fosfolipases Tipo C/metabolismo
Resistência Vascular
Vasoconstrição/efeitos dos fármacos
Vasoconstritores/farmacologia
Vasodilatação/efeitos dos fármacos
Vasodilatadores/farmacologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Calcium Channels, L-Type); 0 (Inositol 1,4,5-Trisphosphate Receptors); 0 (Vasoconstrictor Agents); 0 (Vasodilator Agents); EC 2.7.11.13 (Protein Kinase C); EC 3.1.4.- (Type C Phospholipases)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170702
[St] Status:MEDLINE
[do] DOI:10.1152/ajpheart.00183.2017


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[PMID]:28625452
[Au] Autor:De Oliveira GS
[Ad] Endereço:School of Medicine, Brown University, Providence, USA; Department of Anesthesiology, Rhode Island Hospital, Providence, RI, USA; Department of Surgery, Alpert School of Medicine, Brown University, Providence, RI, USA; Department of Health Services Research, School of Public Health, Providence, RI, USA. Electronic address: gildasio.deoliveira@lifespan.org.
[Ti] Título:Tranversus abdoimis plane (TAP) block with morphine: Local, systemic or no effect?
[So] Source:J Clin Anesth;40:72-73, 2017 08.
[Is] ISSN:1873-4529
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Analgesia Controlada pelo Paciente
Morfina
[Mh] Termos MeSH secundário: Músculos Abdominais
Analgésicos Opioides
Anestésicos Locais
Seres Humanos
Bloqueio Nervoso
Medição da Dor
Dor Pós-Operatória
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); 76I7G6D29C (Morphine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE


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[PMID]:28610880
[Au] Autor:Park SY; Park JS; Choi GS; Kim HJ; Moon S; Yeo J
[Ad] Endereço:Colorectal Cancer Center, Kyungpook National University Medical Center, School of Medicine, Kyungpook National University, Daegu, Korea.
[Ti] Título:Comparison of Analgesic Efficacy of Laparoscope-Assisted and Ultrasound-Guided Transversus Abdominis Plane Block after Laparoscopic Colorectal Operation: A Randomized, Single-Blind, Non-Inferiority Trial.
[So] Source:J Am Coll Surg;225(3):403-410, 2017 Sep.
[Is] ISSN:1879-1190
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transversus abdominis plane (TAP) block has been used as a component of multimodal analgesia after abdominal operation. We introduced a new laparoscope-assisted TAP (LTAP) block technique using intraperitoneal injection and compared its analgesic effect with that of an ultrasound-guided TAP (UTAP) block in terms of postoperative pain control. STUDY DESIGN: A prospective, randomized, single-blinded non-inferiority clinical trial was conducted with patients undergoing elective laparoscopic colectomy for colon cancer. Eighty patients were randomly assigned (1:1 ratio) to the UTAP and LTAP groups. At the end of the operation, opioid consumption and numeric rating scores (NRS; 0 [no pain] to 10 [worst pain]) of pain were recorded at 2, 6, 24, and 48 hours postoperatively and were compared between the groups. The primary end point was pain NRS during rest at 24 hours after operation. RESULTS: Thirty-eight patients in the LTAP group and 35 patients in the UTAP group completed the study protocol. We found no significant difference in mean ± SD pain NRS during rest at 24 hours between the LTAP group (3.90 ± 1.7) and the UTAP group (4.5 ± 1.9). The mean difference in pain NRS during rest at 24 hours was 0.57 (95% CI -0.26 to 1.41). Because the lower boundary of a 95% CI for the differences in pain NRS was > -1, non-inferiority was established. There was no significant difference between the groups in NRS pain during rest, NRS pain on movement, and postoperative morphine consumption during the 48 hours after operation. CONCLUSIONS: These results show our new LTAP block technique was non-inferior to the ultrasound-guided technique in providing a TAP block after laparoscopic colorectal operation.
[Mh] Termos MeSH primário: Músculos Abdominais/inervação
Colectomia
Laparoscopia
Bloqueio Nervoso/métodos
Dor Pós-Operatória/prevenção & controle
Ultrassonografia de Intervenção
[Mh] Termos MeSH secundário: Adulto
Idoso
Procedimentos Cirúrgicos Eletivos
Feminino
Seres Humanos
Injeções Intraperitoneais
Masculino
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Estudos Prospectivos
Método Simples-Cego
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE


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[PMID]:28538578
[Au] Autor:Light D; Kundu N; Djohan R; Quintini C; Gandhi N; Gastman BR; Drake R; Siemionow M; Zins JE
[Ad] Endereço:Cleveland, Ohio From the Department of Plastic Surgery, Dermatology and Plastic Surgery Institute, the Department of Hepatobiliary and Transplant Surgery, Digestive Disease Institute, and the Department of Abdominal Diagnostic Radiology, Imaging Institute, Cleveland Clinic; and the Department of Anatomic Studies, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
[Ti] Título:Total Abdominal Wall Transplantation: An Anatomical Study and Classification System.
[So] Source:Plast Reconstr Surg;139(6):1466-1473, 2017 Jun.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Candidates for multivisceral transplantation present with complex defects often beyond traditional reconstructive options. In this study, the authors describe a dissection technique for a total abdominal wall vascularized composite flap. In addition, the authors suggest a classification system for complex abdominal wall defects. METHODS: Forty fresh, cadaveric hemiabdomens were dissected, with care taken to preserve the iliofemoral, deep circumflex iliac, superficial circumflex iliac, deep inferior epigastric, and superficial inferior epigastric arteries and corresponding veins. Perfusion patterns of the flaps were then studied using computed tomographic angiography. RESULTS: The deep circumflex iliac, superficial circumflex iliac, deep inferior epigastric, and superficial inferior epigastric arteries were identified along a 5-cm cuff of the iliofemoral artery centered on the inguinal ligament. Perfusion with an intact deep circumflex iliac artery yielded improvement in lateral perfusion based on computed tomographic angiography. CONCLUSIONS: The authors propose an algorithm for abdominal wall reconstruction based on defect size and abdominal wall perfusion, and their technique for harvesting a total vascularized composite abdominal wall flap for allotransplantation. Total abdominal wall transplantation should be considered in the subset of patients already receiving visceral organ transplants who also have concomitant abdominal wall defects.
[Mh] Termos MeSH primário: Parede Abdominal/anatomia & histologia
Parede Abdominal/irrigação sanguínea
Retalho Miocutâneo/transplante
Procedimentos Cirúrgicos Reconstrutivos/métodos
[Mh] Termos MeSH secundário: Músculos Abdominais/irrigação sanguínea
Músculos Abdominais/transplante
Parede Abdominal/cirurgia
Adulto
Cadáver
Dissecação
Feminino
Seres Humanos
Masculino
Meia-Idade
Retalho Miocutâneo/irrigação sanguínea
Medição de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170525
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003327


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[PMID]:28504068
[Au] Autor:Oliveira CB; Negrão Filho RF; Franco MR; Morelhão PK; Araujo AC; Pinto RZ
[Ti] Título:Psychometric Properties of the Deep Muscle Contraction Scale for Assessment of the Drawing-in Maneuver in Patients With Chronic Nonspecific Low Back Pain.
[So] Source:J Orthop Sports Phys Ther;47(6):432-441, 2017 Jun.
[Is] ISSN:1938-1344
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Study Design A prospective cohort study. Background Motor control dysfunctions have been commonly reported in patients with chronic nonspecific low back pain (LBP). Physical therapists need clinical tools with adequate psychometric properties to assess such patients in clinical practice. The deep muscle contraction (DMC) scale is a clinical rating scale for assessing patients' ability to voluntarily contract deep abdominal muscles. Objectives To investigate the intrarater reliability, floor and ceiling effects, internal and external responsiveness, and correlation analysis (with ultrasound measures) of the DMC scale in patients with chronic nonspecific LBP undergoing a lumbar stabilization exercise program. Methods Sixty-two patients with chronic nonspecific LBP were included. At baseline, self-report questionnaires were administered to patients and a trained assessor evaluated abdominal muscle recruitment with the DMC scale and ultrasound imaging. Four ratios of the change in abdominal muscle thickness between the resting and contracted states were calculated through the ultrasound measures. After 1 week, the same ultrasound measures and DMC scale were collected again for the reliability analysis. The proportions of patients with the lowest and highest scores on the DMC scale were calculated to investigate floor and ceiling effects. All patients underwent a lumbar stabilization program, administered twice a week for 8 weeks. After the treatment period, all measures were collected again, with the addition of the global perceived effect scale, to assess the internal and external responsiveness of the measures. Correlation coefficients between ultrasound ratios and DMC scale total and subscale scores were also calculated. Results The intrarater reliability of the DMC scale and the 4 ratios of abdominal muscle thickness varied from moderate to excellent. The DMC scale showed no floor or ceiling effects. Results for internal responsiveness of the DMC scale showed large effect sizes (2.26; 84% confidence interval [CI]: 2.06, 2.45), whereas the external responsiveness was below the proposed threshold (area under the curve = 0.54; 95% CI: 0.39, 0.68). Fair and significant correlations between some ultrasound ratios and DMC subscales were found. Conclusion The DMC scale was demonstrated to be a reliable tool, with no ceiling and floor effects, and to detect change in the ability to contract the deep abdominal muscles after a lumbar stabilization exercise program, but with low accuracy for estimating patient-perceived clinical outcome. J Orthop Sports Phys Ther 2017;47(6):432-441. doi:10.2519/jospt.2017.7140.
[Mh] Termos MeSH primário: Músculos Abdominais/diagnóstico por imagem
Dor Lombar/diagnóstico
Contração Muscular
[Mh] Termos MeSH secundário: Músculos Abdominais/fisiopatologia
Adulto
Dor Crônica
Técnicas e Procedimentos Diagnósticos
Terapia por Exercício
Feminino
Seres Humanos
Dor Lombar/fisiopatologia
Dor Lombar/psicologia
Dor Lombar/terapia
Masculino
Meia-Idade
Variações Dependentes do Observador
Estudos Prospectivos
Psicometria
Reprodutibilidade dos Testes
Índice de Gravidade de Doença
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170802
[Lr] Data última revisão:
170802
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE
[do] DOI:10.2519/jospt.2017.7140


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[PMID]:28446462
[Au] Autor:Fischereder M; Michalke B; Schmöckel E; Habicht A; Kunisch R; Pavelic I; Szabados B; Schönermarck U; Nelson PJ; Stangl M
[Ad] Endereço:Medizinische Klinik und Poliklinik IV, Renal Division, Klinikum der Ludwig Maximilians Universitaet, Munich, Germany; Michael.fischereder@med.uni-muenchen.de.
[Ti] Título:Sodium storage in human tissues is mediated by glycosaminoglycan expression.
[So] Source:Am J Physiol Renal Physiol;313(2):F319-F325, 2017 Aug 01.
[Is] ISSN:1522-1466
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The current paradigm regarding sodium handling in animals and humans postulates that total body sodium is regulated predominately via regulation of extracellular volume. Active sodium storage independent of volume retention is thought to be negligible. However, studies in animals, hypertensive patients, and healthy humans suggest water-free storage of sodium in skin. We hypothesized that tissue sodium concentrations ([Na] ) found in humans vary and reflect regulation due to variable glycosaminoglycan content due to variable expression of XYLT-1. Twenty seven patients on dialysis and 21 living kidney transplant donors free of clinically detectable edema were studied. During surgery, abdominal skin, muscle, and arteries were biopsied. [Na] was determined by inductively coupled plasma-optical emission spectrometry, semiquantitative glycosaminoglycan content with Alcian stain, and XYLT-1 expression by real-time PCR. [Na] of arteries were ranging between 0.86 and 9.83 g/kg wet wt and were significantly higher in arteries (4.52 ± 1.82 g/kg) than in muscle (2.03 ± 1.41 g/kg; < 0.001) or skin (3.24 ± 2.26 g/kg wet wt; = 0.038). For individual patients [Na] correlated for skin and arterial tissue ( = 0.440, = 0.012). [Na] also correlated significantly with blinded semiquantitative analysis of glycosaminoglycans staining ( = 0.588, = 0.004). In arteries XYLT-1 expression was also correlated with [Na] ( = 0.392, = 0.003). Our data confirm highly variable [Na] in human skin and muscle and extend this observation to [Na] in human arteries. These data support the hypothesis of water-independent sodium storage via regulated glycosaminoglycan synthesis in human tissues, including arteries.
[Mh] Termos MeSH primário: Músculos Abdominais/química
Artérias Epigástricas/química
Glicosaminoglicanos/análise
Nefropatias/metabolismo
Pele/química
Sódio/análise
[Mh] Termos MeSH secundário: Adulto
Idoso
Biópsia
Estudos de Casos e Controles
Linhagem Celular
Feminino
Fibroblastos/enzimologia
Seres Humanos
Nefropatias/diagnóstico
Nefropatias/terapia
Masculino
Meia-Idade
Osmose
Pentosiltransferases/genética
Pentosiltransferases/metabolismo
Diálise Renal
Espectrofotometria/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glycosaminoglycans); 9NEZ333N27 (Sodium); EC 2.4.2.- (Pentosyltransferases); EC 2.4.2.26 (UDP xylose-protein xylosyltransferase)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1152/ajprenal.00703.2016



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