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Journal of Personalized Medicine Dec 2023Pregnant women may experience pain and discomfort during pregnancy, especially in areas such as the lower back and pelvic girdle. Pain in pregnancy is associated with... (Review)
Review
Pregnant women may experience pain and discomfort during pregnancy, especially in areas such as the lower back and pelvic girdle. Pain in pregnancy is associated with poor quality of life, and because it is a common occurrence, pregnant women may be offered several resources to prevent discomforts throughout pregnancy, such as engaging in physical activity. This study was a meta-analysis of randomised controlled trials (prospectively registered in Prospero, registration number: CRD42023451320) aimed to assess the effects of physical activity during pregnancy on maternal pain and discomfort. We analysed 16 randomised clinical trials. The results of these analyses indicate that women who performed physical activity had significantly less intensity of pain (z = <2.69, = <0.007; SMD = -0.66, 95% CI = -1.13, -0.18, I = <91%, P = <0.001) and a reduction observed in the disability questionnaire (z = <2.37, = <0.02; SMD = -0.80, 95% CI = -1.47, -0.14, I = <91%, P = <0.001), and overall reduced general pain (z = <3.87, = <0.001; SMD = -0.56, 95% CI = -0.84, -0.27, I = <86%, P = <0.001) than women who did not practice physical activity during pregnancy. In conclusion, physical activity during pregnancy could effectively help to diminish pain intensity, reduce disability due to pain, and generally reduce pain.
PubMed: 38248744
DOI: 10.3390/jpm14010044 -
Journal of Orthopaedic Trauma Sep 2023To identify factors associated with the development of fracture-related infection (FRI) in patients who have undergone operative fixation of their fracture.
OBJECTIVES
To identify factors associated with the development of fracture-related infection (FRI) in patients who have undergone operative fixation of their fracture.
DESIGN
Retrospective study.
SETTING
Academic medical center.
PATIENTS/PARTICIPANTS
Patients with peripheral extremity long-bone fractures and shoulder and pelvic girdle fractures who underwent operative repair. This included patients who had undergone fixation inside and outside of our institution.
INTERVENTION
Chi-square, Fisher exact testing, analysis of variance (ANOVA), and t tests were used for analysis of data, as appropriate. Binomial logistic regression analysis was performed to determine risk factors of FRI.
MAIN OUTCOME MEASUREMENTS
Demographics, fracture location, injury mechanism, open wound status, and wound complication type.
RESULTS
One hundred ninety-three patients comprised the FRI cohort. Of those with confirmed signs of FRI, 36 (18.7%) had wound breakdown to bone or implant, 120 (62.1%) had a sinus track, and 170 patients (88.1%) had the confirmed presence of microorganisms in deep tissue samples obtained during operative intervention. Factors associated with development of an FRI were as follows: higher BMI; being of Black and Hispanic race; higher American Society of Anesthesiologists class; history of tobacco, alcohol, and drug use; and fractures of the lower extremity (foot, tibia, and femur/pelvis). The results of binary logistic regression demonstrated that treatment at an urban level I trauma center and drug use positively predicted the development of FRI.
CONCLUSION
Our results demonstrate that higher BMI; being of Black or Hispanic race; higher American Society of Anesthesiologists; history of tobacco, alcohol, and drug use; and fractures of the foot, tibia, and femur/pelvis are all factors associated with development of FRI.
LEVEL OF EVIDENCE
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Topics: Humans; Retrospective Studies; Fractures, Bone; Lower Extremity; Tibia; Ethanol
PubMed: 37587567
DOI: 10.1097/BOT.0000000000002615 -
Cureus Dec 2023During pregnancy, there are notable alterations in biomechanics, hormones, and vascular functioning, which frequently result in a range of musculoskeletal ailments,...
During pregnancy, there are notable alterations in biomechanics, hormones, and vascular functioning, which frequently result in a range of musculoskeletal ailments, including back pain, leg cramps, and pelvic girdle discomfort. The significance of pregnancy-related musculoskeletal problems on women's daily functioning and general well-being is highlighted by their widespread occurrence worldwide, necessitating heightened focus and implementation of effective therapeutic approaches. The main aims of this study were to assess the effectiveness of prenatal exercises in musculoskeletal discomfort and investigate the association between post-intervention levels of discomfort and certain demographic factors. A quantitative technique was used in this study, utilizing a pre-experimental design conducted for three months. A total of 60 primigravida mothers were selected as participants through purposive sampling. The study was conducted in a Maternity Tertiary Care Center located in Tamil Nadu. The intervention encompassed the provision of antenatal exercises, specifically focusing on abdominal tightness, pelvic tilting, and foot and ankle movements. The researcher demonstrated the exercises for 20 minutes, and afterward, mothers were asked to perform the activities themselves. The process was monitored and observed for two weeks. The findings were statistically significant, suggesting a noteworthy decrease in musculoskeletal disorders following the implementation of the intervention. The statistical analysis revealed a significant degree of significance ( = 0.001), confirming the efficacy of the exercises. Before the implementation of the intervention, a significant proportion of mothers, namely, 45 (75%) reported experiencing moderate back pain. However, following the intervention, this percentage notably fell to 33.34% (20). The incidence of moderate pelvic pain decreased from 80% (48) to 30% (18), and a comparable pattern was observed in the reduction of leg cramps. Additionally, the research identified significant associations between the improvements and a range of demographic and obstetric factors, including the level of education, occupation, family structure, age at marriage, and weight of the mother. The results highlight the significance of incorporating antenatal exercises as a regular component of prenatal care to minimize musculoskeletal discomfort, hence promoting the overall health and well-being of expectant mothers.
PubMed: 38226104
DOI: 10.7759/cureus.50494 -
Human Molecular Genetics Jul 2023Limb-girdle muscular dystrophy R7 (LGMDR7) is an autosomal recessive hereditary muscular dystrophy caused by mutations in titin-cap (TCAP). Here, we summarized the...
Limb-girdle muscular dystrophy R7 (LGMDR7) is an autosomal recessive hereditary muscular dystrophy caused by mutations in titin-cap (TCAP). Here, we summarized the clinical characteristics and TCAP mutations in a Chinese cohort of 30 patients with LGMDR7. The onset age of Chinese patients was 19.89 ± 6.70 years old, which is later than European and South Asian patients (P < 0.05). Clinically speaking, 20.0% of patients presented with predominant distal weakness, and 73.3% of patients presented with predominant pelvic girdle weakness. Radiological study revealed semitendinosus and magnus adductor were severely involved in Chinese LGMDR7 patients. Rectus femoris, vastus lateralis, vastus intermedius, soleus and tibialis anterior were moderately to severely involved. The most prevalent mutation in this cohort is c.26_33dupAGGTGTCG, while c.165dupG and c.110 + 5G > A are unique in Chinese population as two of the common mutations. Besides, variant c.26_33dupAGGGTGTCG might be a founder mutation in Asian patients. Internal nuclei, lobulated fibers, and scattered rimmed vacuoles were typical morphological changes in Chinese LGMDR7 patients. This is the largest LGMDR7 cohort in the Chinese population and in the world. This article also expands the clinical, pathological, mutational and radiological spectrum of patients with LGMDR7 in China and in the world.
Topics: Adolescent; Adult; Humans; Young Adult; East Asian People; Muscle, Skeletal; Muscular Dystrophies, Limb-Girdle; Mutation
PubMed: 37216648
DOI: 10.1093/hmg/ddad090 -
Journal of Anatomy Apr 2024Piatnitzkysauridae were Jurassic theropods that represented the earliest diverging branch of Megalosauroidea, being one of the earliest lineages to have evolved moderate...
Piatnitzkysauridae were Jurassic theropods that represented the earliest diverging branch of Megalosauroidea, being one of the earliest lineages to have evolved moderate body size. This clade's typical body size and some unusual anatomical features raise questions about locomotor function and specializations to aid in body support; and other palaeobiological issues. Biomechanical models and simulations can illuminate how extinct animals may have moved, but require anatomical data as inputs. With a phylogenetic context, osteological evidence, and neontological data on anatomy, it is possible to infer the musculature of extinct taxa. Here, we reconstructed the hindlimb musculature of Piatnitzkysauridae (Condorraptor, Marshosaurus, and Piatnitzkysaurus). We chose this clade for future usage in biomechanics, for comparisons with myological reconstructions of other theropods, and for the resulting evolutionary implications of our reconstructions; differential preservation affects these inferences, so we discuss these issues as well. We considered 32 muscles in total: for Piatnitzkysaurus, the attachments of 29 muscles could be inferred based on the osteological correlates; meanwhile, in Condorraptor and Marshosaurus, we respectively inferred 21 and 12 muscles. We found great anatomical similarity within Piatnitzkysauridae, but differences such as the origin of M. ambiens and size of M. caudofemoralis brevis are present. Similarities were evident with Aves, such as the division of the M. iliofemoralis externus and M. iliotrochantericus caudalis and a broad depression for the M. gastrocnemius pars medialis origin on the cnemial crest. Nevertheless, we infer plesiomorphic features such as the origins of M. puboischiofemoralis internus 1 around the "cuppedicus" fossa and M. ischiotrochantericus medially on the ischium. As the first attempt to reconstruct muscles in early tetanurans, our study allows a more complete understanding of myological evolution in theropod pelvic appendages.
Topics: Animals; Phylogeny; Biological Evolution; Lower Extremity; Hindlimb; Dinosaurs; Muscle, Skeletal
PubMed: 38037880
DOI: 10.1111/joa.13983 -
Seminars in Nuclear Medicine May 2024Polymyalgia rheumatica (PMR) is an inflammatory disorder usually diagnosed in patients older than 50 years of age. It is characterized by sudden onset pain and prolonged... (Review)
Review
Polymyalgia rheumatica (PMR) is an inflammatory disorder usually diagnosed in patients older than 50 years of age. It is characterized by sudden onset pain and prolonged morning stiffness in the scapular and/or pelvic girdle, sometimes debilitating and accompanied by constitutional symptoms such as weight loss. In approximately 20% of the cases, it is linked to giant cell arteritis (GCAV) representing a disease continuum. The diagnosis is mainly clinical and noninvasive imaging such as ultrasound of joints may be helpful. In atypical PMR cases, whole body imaging using [F]FDG-PET/CT may be useful. First, to confirm or rule out the diagnosis of PMR, secondly, to assess the coexistence of a GCA, and thirdly to establish the differential diagnosis with other types of arthritides encountered in this age group, such as elderly-onset rheumatoid arthritis, spondyloarthropathies, crystal-induced arthropathies or the rare remittent seronegative symmetrical synovitis with pitting edema. Relatively typical patterns of [F]FDG-PET/CT are well known, based on the clinical distribution of the disease (eg, scapular and pelvic girdle, interspinous bursae, sterno-costoclavicular joints, entheses), especially the hypermetabolism at the interspinous lumbar bursae that has shown the best post-test likelihood ratio in a meta-analysis. This article focuses on the differential diagnosis and on the visual and semi-quantitative tools that can be used to guide to the correct diagnosis of PMR as an add-on to the clinical picture. Further, we briefly discuss the options that can improve molecular imaging in the future for inflammatory rheumatisms in elderly.
Topics: Polymyalgia Rheumatica; Humans; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography
PubMed: 38030423
DOI: 10.1053/j.semnuclmed.2023.10.003 -
Cureus Nov 2023Pelvic girdle pain (PGP) during pregnancy is a major source of stress for mothers. This review summarizes studies on the effectiveness of functional stability exercises... (Review)
Review
Pelvic girdle pain (PGP) during pregnancy is a major source of stress for mothers. This review summarizes studies on the effectiveness of functional stability exercises (FSEs) in preventing PGP during pregnancy. FSE is a rising area of study in maternal health, focusing on core muscle groups and addressing the biomechanical changes during pregnancy. Although data shows that FSE may relieve PGP and improve the quality of life in pregnant women, the research landscape is defined by limitations and differences in intervention parameters among studies, resulting in contradictory conclusions. As a result, the efficacy of FSE in pregnant women with PGP remains inconclusive. This review can help comprise the existing research on FSE alleviating PGP in pregnancy to provide full knowledge on the topic, analyze long-term effects, and develop practice guidelines. While FSE shows promise, treating the multidimensional nature of PGP in pregnancy requires a comprehensive approach to therapy that incorporates several therapeutic modalities.
PubMed: 38098896
DOI: 10.7759/cureus.48769 -
Arquivos Brasileiros de Cardiologia 2023Emery-Dreifuss muscular dystrophy is a rare hereditary neuromuscular disease. Its manifestations begin primarily in childhood. The most frequent manifestations are...
Emery-Dreifuss muscular dystrophy is a rare hereditary neuromuscular disease. Its manifestations begin primarily in childhood. The most frequent manifestations are progressive muscle weakness, atrophy that usually begins in the scapula-vertebral region, extending later to the pelvic girdle, and spinal stiffness. Patients can also manifest cardiac involvement as palpitations, syncope, exercise intolerance, congestive heart failure, and variable heart rhythm disturbances. 1 - 3 The presence and severity of these manifestations can vary according to the individual and the disease's subtypes. 2 Cardiac involvement is the most worrisome feature of this disease, and there are some reports of the need for heart transplantation in this dystrophy. 4.
Topics: Humans; Cardiac Rehabilitation; Muscular Dystrophy, Emery-Dreifuss; Arrhythmias, Cardiac; Heart Failure; Heart Transplantation
PubMed: 37466619
DOI: 10.36660/abc.20220560 -
BMC Public Health Jan 2024A physically active lifestyle is beneficial during pregnancy. However, little is known about physical activity (PA) behaviour and psychosocial factors in women during... (Randomized Controlled Trial)
Randomized Controlled Trial
The effect of exercise training and motivational counselling on physical activity behaviour and psychosocial factors in pregnant women: secondary analyses of the FitMum randomised controlled trial investigating prenatal physical activity.
BACKGROUND
A physically active lifestyle is beneficial during pregnancy. However, little is known about physical activity (PA) behaviour and psychosocial factors in women during and after pregnancy. This study examined exercise behavioural regulation, exercise self-efficacy, health-related quality of life, sickness absence and musculoskeletal pain in pregnant women offered either structured supervised exercise training, motivational counselling on PA, or standard prenatal care in the FitMum randomised controlled trial.
METHODS
Two hundred and eighteen healthy inactive pregnant women were randomised to structured supervised exercise training (n = 87), motivational counselling on PA (n = 86) or standard prenatal care (n = 45). The women answered the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2), the Pregnancy Exercise Self-Efficacy Scale (P-ESES-DK) and the Short Form 36 Health Survey Questionnaire (SF-36) at baseline (gestational age (GA) of max 15 weeks), GA 28 and 34 weeks, and one year after delivery. Sickness absence and low back and/or pelvic girdle pain were likewise reported in questionnaires at baseline and GA 28 weeks.
RESULTS
Participants offered structured supervised exercise training or motivational counselling on PA had higher autonomous motivation for exercise during pregnancy compared with participants receiving standard prenatal care (e.g., difference in intrinsic regulation at GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 0.39 [0.16; 0.64], p < 0.001). Participants offered structured supervised exercise training also had higher exercise self-efficacy during pregnancy (e.g., GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 6.97 [2.05; 12.02], p = 0.005). All participants reported high exercise self-efficacy at baseline and medium exercise self-efficacy during pregnancy and one year after delivery. No differences were found between groups in health-related quality of life, sickness absence or low back and/or pelvic girdle pain during pregnancy. No group differences were found one year after delivery.
CONCLUSION
Structured supervised exercise training and motivational counselling on PA had important effects on autonomous exercise motivation during pregnancy. Exercise self-efficacy was also increased with structured supervised exercise training compared to standard prenatal care. No group differences in health-related quality of life, sickness absence, or pain were found during and after pregnancy. No effects were found one year post-delivery after intervention cessation.
TRIAL REGISTRATION
The study was approved by the Danish National Committee on Health Research Ethics (#H-18011067) and the Danish Data Protection Agency (#P-2019-512). The study adheres to the principles of the Helsinki declaration. Written informed consent was obtained at inclusion.
Topics: Pregnancy; Female; Humans; Infant; Pregnant Women; Quality of Life; Pelvic Girdle Pain; Exercise; Exercise Therapy; Motivational Interviewing
PubMed: 38178045
DOI: 10.1186/s12889-023-17525-3 -
Revista Da Associacao Medica Brasileira... 2023
Topics: Pregnancy; Female; Humans; Acupuncture Therapy; Pain; Pregnancy Complications
PubMed: 37556620
DOI: 10.1590/1806-9282.2023S101