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Anatomical Record (Hoboken, N.J. : 2007) Apr 2017The human pelvis is often described as an evolutionary compromise (obstetrical dilemma) between the requirements of efficient bipedal locomotion and safe parturition of... (Review)
Review
The human pelvis is often described as an evolutionary compromise (obstetrical dilemma) between the requirements of efficient bipedal locomotion and safe parturition of a highly encephalized neonate, that has led to a tight fit between the birth canal and the head and body of the foetus. Strong evolutionary constraints on the shape of the pelvis can be expected under this scenario. On the other hand, several studies have found a significant level of pelvic variation within and between human populations, a fact that seems to contradict such expectations. The advantages of a narrow pelvis for locomotion have recently been challenged, suggesting that the tight cephalo-pelvic fit might not stem from the hypothesized obstetrical dilemma. Moreover, the human pelvis appears to be under lower constraints and to have relatively higher evolvability than other closely related primates. These recent findings substantially change the way in which we interpret variation in the human pelvis, and help make sense of the high diversity in pelvic shape observed within and among modern populations. A lower magnitude of covariance between functionally important regions ensured that a wide range of morphological variation was available within populations, enabling natural selection to generate pelvic variation between populations living in different environments. Neutral processes such as genetic drift and differential migration also contributed to shaping modern pelvic diversity during and after the expansion of humans into and across the various continents. Anat Rec, 300:687-697, 2017. © 2017 Wiley Periodicals, Inc.
Topics: Biological Evolution; Climate; Humans; Individuality; Pelvic Bones; Pelvis
PubMed: 28297180
DOI: 10.1002/ar.23542 -
European Journal of Surgical Oncology :... Nov 2022In the pelvis, anatomic complexity and difficulty in visualization and access make surgery a formidable task. Surgeons are prone to work-related musculoskeletal injuries...
In the pelvis, anatomic complexity and difficulty in visualization and access make surgery a formidable task. Surgeons are prone to work-related musculoskeletal injuries from the frequently poor design and flow of their work environment. This is exacerbated by the strain of surgery in the pelvis. These injuries can result in alterations to a surgeons practice, inadvertent patient injury, and even early retirement. Human factors examines the relationships between the surgeon, their instruments and their environment. By bridging physiology, psychology, and ergonomics, human factors allows a better understanding of some of the challenges posed by pelvic surgery. The operative approach involved (open, laparoscopic, robotic, or perineal) plays an important role in the relevant human factors. Improved understanding of ergonomics can mitigate these risks to surgeons. Other human factors approaches such as standardization, use of checklists, and employing resiliency efforts can all improve patient safety in the operating theatre.
Topics: Humans; Ergonomics; Surgeons; Operating Rooms; Pelvis; Laparoscopy
PubMed: 35012835
DOI: 10.1016/j.ejso.2021.12.468 -
Abdominal Radiology (New York) Aug 2022Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are... (Review)
Review
Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are most common in high-grade lymphomas, especially diffuse large B-cell lymphoma. Complications may occur as the initial manifestation of lymphoma, during treatment course, or late following complete disease remission. Most complications are associated with worse prognosis and increased mortality. Imaging is essential in evaluation of disease extent and diagnosis of complications. Therefore, radiologists should be familiar with the clinical context and imaging features of abdominal and pelvic lymphoma complications. We provide a comprehensive, organ system-based approach, and clinical and imaging review of complications of abdominal and pelvic lymphoma along with radiologic images of illustrated cases of the most commonly encountered complications.
Topics: Abdomen; Abdominal Neoplasms; Humans; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Pelvis; Prognosis
PubMed: 35690955
DOI: 10.1007/s00261-022-03567-5 -
International Braz J Urol : Official... 2022
Topics: Humans; Pelvis
PubMed: 35373953
DOI: 10.1590/S1677-5538.IBJU.2022.03.04 -
BioMed Research International 2022This study was aimed at investigating the effect of pelvic tilt taping on muscle strength, pelvic inclination, and gait function in patients with stroke. (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of Pelvic Stabilization Training with Lateral and Posterior Tilt Taping on Pelvic Inclination, Muscle Strength, and Gait Function in Patients with Stroke: A Randomized Controlled Study.
BACKGROUND
This study was aimed at investigating the effect of pelvic tilt taping on muscle strength, pelvic inclination, and gait function in patients with stroke.
METHODS
A total of 60 patients with stroke were included in our study and randomly divided into three groups: the posterior pelvic tilt taping (PPTT, = 20), the lateral pelvic tilt taping (LPPP) with PPTT (LPPP+PPTT, = 20), and the control ( = 20) groups. All participants performed pelvic stabilization exercises consisting of 6 movements: supine, side lying, quadruped, sitting, squatting, and standing (30 min/day, five days/week, for six weeks). PPTT to correct anterior pelvic tilt was applied to the LPTT+PPTT and PPTT groups, and lateral pelvic tilt taping was additionally applied to the LPTT+PPTT group. LPTT was performed to correct the pelvis tilted to the affected side, and PPTT was performed to correct the anterior pelvic tilt. The control group did not undergo taping. A hand-held dynamometer was used to measure the hip abductor muscle strength. In addition, a palpation meter and 10-meter walk test were used to assess pelvic inclination and gait function.
RESULTS
Muscle strength was significantly stronger in the LPTT+PPTT group than in the other two groups ( = 0.01). The anterior pelvic tilt was significantly improved in the taping group compared to the control group ( < 0.001), and the lateral pelvic tilt was significantly improved in the LPTT+PPTT group compared to the other two groups ( < 0.001). Significantly greater improvements in gait speed were observed in the LPTT+PPTT group than in the other two groups ( = 0.02).
CONCLUSIONS
PPPT can significantly affect pelvic alignment and walking speed in patients with stroke, and the additional application of LPTT can further strengthen these effects. Therefore, we suggest using taping as an auxiliary therapeutic-intervention method in postural control training.
Topics: Humans; Pelvis; Posture; Gait; Stroke; Muscle Strength
PubMed: 37333857
DOI: 10.1155/2022/9224668 -
Journal of Medicine and Life 2015Pelvic exenteration remains one of the most destructive surgical procedures in gynecologic oncology, performed in patients with locally advanced malignancies who were... (Review)
Review
Pelvic exenteration remains one of the most destructive surgical procedures in gynecologic oncology, performed in patients with locally advanced malignancies who were considered for a long time as unresectable. However, for these patients, an aggressive surgical approach seems to be the only potential curative solution. This is a literature review of the most important studies, which analyzes the benefits and the secondary risks of this demanding procedure.
Topics: Female; Genital Neoplasms, Female; Humans; Pelvic Exenteration; Pelvis
PubMed: 25866569
DOI: No ID Found -
Pain Physician Sep 2023Endometriosis is a chronic common condition affecting 10% of reproductive-aged women globally. It is caused by the growth of endometrial-like tissue outside the uterine... (Review)
Review
BACKGROUND
Endometriosis is a chronic common condition affecting 10% of reproductive-aged women globally. It is caused by the growth of endometrial-like tissue outside the uterine cavity and leads to chronic pelvic pain, affecting various aspects of a woman's physical, mental, emotional, and social well-being. This highlights the importance of an understanding of the potential involvement of the nervous system and involved nerves as well as an effective multidisciplinary pain management.
OBJECTIVES
Our aim was to assess the current understanding of pain mechanisms in endometriosis and the effectiveness of different interventional pain management strategies.
STUDY DESIGN
Literature review.
METHODS
A search was conducted using multiple databases, including Google Scholar, MEDLINE (Ovid), PubMed, and Embase. We used keywords such as "endometriosis," "pain," pelvic pain, "management," and "anaesthesia" along with Boolean operators and MeSH terms. The search was limited to English language articles published in the last 15 years.
RESULTS
Nerve involvement is a well-established mechanism for pain generation in patients with endometriosis, through direct invasion, irritation, neuroangiogenesis, peripheral and central sensitization, and scar tissue formation. Endometriosis may also affect nerve fibers in the pelvic region, causing chronic pelvic pain, including sciatic neuropathy and compression of other pelvic nerves. Endometriosis can cause sciatica, often misdiagnosed due to atypical symptoms. Interventional pain management techniques such as superior hypogastric plexus block, impar ganglion block, S3 pulsed radiofrequency, myofascial pain trigger point release, peripheral nerve hydrodissection, and neuromodulation have been used to manage persistent and intractable pain with positive patient outcomes and improved quality of life.
LIMITATIONS
The complex and diverse clinical presentations of endometriosis make it challenging to compare the effectiveness of different pain management techniques.
CONCLUSION
Endometriosis is a complex condition causing various forms of pain including nerve involvement, scar tissue formation, and bowel/bladder symptoms. Interventional pain management techniques are effective for managing endometriosis-related pain.
KEY WORDS
Endometriosis, chronic pain, therapeutic interventions, interventional techniques, pain injections, visceral pain, peripheral pain.
Topics: Adult; Female; Humans; Chronic Disease; Cicatrix; Endometriosis; Pain Management; Pelvic Pain; Pelvis; Quality of Life
PubMed: 37774202
DOI: No ID Found -
Philosophical Transactions of the Royal... Mar 2015The pelvis performs two major functions for terrestrial mammals. It provides somewhat rigid support for muscles engaged in locomotion and, for females, it serves as the... (Comparative Study)
Comparative Study Review
The pelvis performs two major functions for terrestrial mammals. It provides somewhat rigid support for muscles engaged in locomotion and, for females, it serves as the birth canal. The result for many species, and especially for encephalized primates, is an 'obstetric dilemma' whereby the neonate often has to negotiate a tight squeeze in order to be born. On top of what was probably a baseline of challenging birth, locomotor changes in the evolution of bipedalism in the human lineage resulted in an even more complex birth process. Negotiation of the bipedal pelvis requires a series of rotations, the end of which has the infant emerging from the birth canal facing the opposite direction from the mother. This pattern, strikingly different from what is typically seen in monkeys and apes, places a premium on having assistance at delivery. Recently reported observations of births in monkeys and apes are used to compare the process in human and non-human primates, highlighting similarities and differences. These include presentation (face, occiput anterior or posterior), internal and external rotation, use of the hands by mothers and infants, reliance on assistance, and the developmental state of the neonate.
Topics: Adaptation, Biological; Animals; Biological Evolution; Female; History, Ancient; Humans; Labor Presentation; Midwifery; Parturition; Pelvis; Pregnancy; Primates; Species Specificity
PubMed: 25602069
DOI: 10.1098/rstb.2014.0065 -
Medical Physics Apr 2022Diffusion MRI has enormous potential and utility in the evaluation of various abdominal and pelvic disease processes including cancer and noncancer imaging of the liver,...
Diffusion MRI has enormous potential and utility in the evaluation of various abdominal and pelvic disease processes including cancer and noncancer imaging of the liver, prostate, and other organs. Quantitative diffusion MRI is based on acquisitions with multiple diffusion encodings followed by quantitative mapping of diffusion parameters that are sensitive to tissue microstructure. Compared to qualitative diffusion-weighted MRI, quantitative diffusion MRI can improve standardization of tissue characterization as needed for disease detection, staging, and treatment monitoring. However, similar to many other quantitative MRI methods, diffusion MRI faces multiple challenges including acquisition artifacts, signal modeling limitations, and biological variability. In abdominal and pelvic diffusion MRI, technical acquisition challenges include physiologic motion (respiratory, peristaltic, and pulsatile), image distortions, and low signal-to-noise ratio. If unaddressed, these challenges lead to poor technical performance (bias and precision) and clinical outcomes of quantitative diffusion MRI. Emerging and novel technical developments seek to address these challenges and may enable reliable quantitative diffusion MRI of the abdomen and pelvis. Through systematic validation in phantoms, volunteers, and patients, including multicenter studies to assess reproducibility, these emerging techniques may finally demonstrate the potential of quantitative diffusion MRI for abdominal and pelvic imaging applications.
Topics: Abdomen; Artifacts; Diffusion Magnetic Resonance Imaging; Humans; Male; Pelvis; Reproducibility of Results
PubMed: 34554579
DOI: 10.1002/mp.15246 -
Canadian Association of Radiologists... Nov 2023The Canadian Association of Radiologists (CAR) Endometriosis Working Group was tasked with providing guidance and benchmarks to ensure the quality of technique and... (Review)
Review
The Canadian Association of Radiologists (CAR) Endometriosis Working Group was tasked with providing guidance and benchmarks to ensure the quality of technique and interpretation for advanced imaging modalities associated with diagnosing endometriosis. This practice statement provides an overview of the state of the art of advanced pelvic ultrasound in the diagnosis and mapping of pelvic endometriosis. While acknowledging that advanced pelvic ultrasound in some practices falls within the scope of clinical colleagues rather than imaging departments, the statement seeks to guide radiologists interested in implementing these techniques into their practice for patients referred for evaluation and diagnosis of endometriosis. The statement covers indications, some components of the ultrasound assessment and technique, reporting, and recommendations for starting an ultrasound endometriosis evaluation program.
Topics: Female; Humans; Canada; Endometriosis; Pelvis; Sensitivity and Specificity; Ultrasonography
PubMed: 37042803
DOI: 10.1177/08465371231165986