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Scientific Reports Jun 2023Previous research on the effects of body mass on the pelvic girdle focused mostly on adult females and males. Because the ontogenetic plasticity level in the pelvis...
Previous research on the effects of body mass on the pelvic girdle focused mostly on adult females and males. Because the ontogenetic plasticity level in the pelvis remains largely unknown, this study investigated how the association between body mass index (BMI) and pelvic shape changes during development. It also assessed how the large variation in pelvic shape could be explained by the number of live births in females. Data included CT scans of 308 humans from infancy to late adulthood with known age, sex, body mass, body stature, and the number of live births (for adult females). 3D reconstruction and geometric morphometrics was used to analyze pelvic shape. Multivariate regression showed a significant association between BMI and pelvic shape in young females and old males. The association between the number of live births and pelvic shape in females was not significant. Less plasticity in pelvic shape in adult females than during puberty, perhaps reflects adaptation to support the abdominopelvic organs and the fetus during pregnancy. Non-significant susceptibility to BMI in young males may reflect bone maturation accelerated by excessive body mass. Hormonal secretion and biomechanical loading associated with pregnancy may not have a long-term effect on the pelvic morphology of females.
Topics: Adult; Male; Pregnancy; Female; Humans; Infant; Pelvis; Lower Extremity; Body Mass Index; Body Size; Puberty
PubMed: 37322042
DOI: 10.1038/s41598-023-36703-2 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Jun 2023The patient was a 55-year-old man who was admitted to hospital with "progressive myalgia and weakness for 4 months, and exacerbated for 1 month". Four months ago, he...
The patient was a 55-year-old man who was admitted to hospital with "progressive myalgia and weakness for 4 months, and exacerbated for 1 month". Four months ago, he presented with persistent shoulder girdle myalgia and elevated creatine kinase (CK) at routine physical examination, which fluctuated from 1 271 to 2 963 U/L after discontinuation of statin treatment. Progressive myalgia and weakness worsened seriously to breath-holding and profuse sweating 1 month ago. The patient was post-operative for renal cancer, had previous diabetes mellitus and coronary artery disease medical history, had a stent implanted by percutaneous coronary intervention and was on long-term medication with aspirin, atorvastatin and metoprolol. Neurological examination showed pressure pain in the scapularis and pelvic girdle muscles, and V- grade muscle strength in the proximal extremities. Strongly positive of anti-HMGCR antibody was detected. Muscle magnetic resonance imaging (MRI) T2-weighted image and short time inversion recovery sequences (STIR) showed high signals in the right vastus lateralis and semimembranosus muscles. There was a small amount of myofibrillar degeneration and necrosis, CD4 positive inflammatory cells around the vessels and among myofibrils, MHC-Ⅰ infiltration, and multifocal lamellar deposition of C5b9 in non-necrotic myofibrils of the right quadriceps muscle pathological manifestation. According to the clinical manifestation, imageological change, increased CK, blood specific anti-HMGCR antibody and biopsy pathological immune-mediated evidence, the diagnosis of anti-HMGCR immune-mediated necrotizing myopathy was unequivocal. Methylprednisolone was administrated as 48 mg daily orally, and was reduced to medication discontinuation gradually. The patient's complaint of myalgia and breathlessness completely disappeared after 2 weeks, the weakness relief with no residual clinical symptoms 2 months later. Follow-up to date, there was no myalgia or weakness with slightly increasing CK rechecked. The case was a classical anti-HMGCR-IMNM without swallowing difficulties, joint symptoms, rash, lung symptoms, gastrointestinal symptoms, heart failure and Raynaud's phenomenon. The other clinical characters of the disease included CK as mean levels >10 times of upper limit of normal, active myogenic damage in electromyography, predominant edema and steatosis of gluteus and external rotator groups in T2WI and/or STIR at advanced disease phase except axial muscles. The symptoms may occasionally improve with discontinuation of statins, but glucocorticoids are usually required, and other treatments include a variety of immunosuppressive therapies such as methotrexate, rituximab and intravenous gammaglobulin.
Topics: Male; Humans; Middle Aged; Autoantibodies; Myositis; Autoimmune Diseases; Muscle, Skeletal; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Necrosis; Muscular Diseases
PubMed: 37291935
DOI: 10.19723/j.issn.1671-167X.2023.03.025 -
Journal of Physiotherapy Jul 2023What is the effect of a 12-week, home-based, abdominal exercise program containing head lifts and abdominal curl-ups on inter-recti distance (IRD) in women with... (Randomized Controlled Trial)
Randomized Controlled Trial
Curl-up exercises improve abdominal muscle strength without worsening inter-recti distance in women with diastasis recti abdominis postpartum: a randomised controlled trial.
QUESTION
What is the effect of a 12-week, home-based, abdominal exercise program containing head lifts and abdominal curl-ups on inter-recti distance (IRD) in women with diastasis recti abdominis (DRA) 6 to 12 months postpartum? What is the effect of the program on: observed abdominal movement during a curl-up; global perceived change; rectus abdominis thickness; abdominal muscle strength and endurance; pelvic floor disorders; and low back, pelvic girdle and abdominal pain?
DESIGN
This was a two-arm, parallel-group, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis.
PARTICIPANTS
Seventy primiparous or multiparous women 6 to 12 months postpartum, having a single or multiple pregnancy following any mode of delivery, with a diagnosis of DRA (IRD > 28 mm at rest or > 25 mm during a curl-up).
INTERVENTION
The experimental group was prescribed a 12-week standardised exercise program including head lifts, abdominal curl-ups and twisted abdominal curl-ups 5 days a week. The control group received no intervention.
OUTCOME MEASURES
The primary outcome measure was change in IRD measured with ultrasonography. Secondary outcomes were: observed abdominal movement during a curl-up; global perceived change; rectus abdominis thickness; abdominal muscle strength and endurance; pelvic floor disorders; and low back, pelvic girdle and abdominal pain.
RESULTS
The exercise program did not improve or worsen IRD (eg, MD 1 mm at rest 2 cm above the umbilicus, 95% CI -1 to 4). The program improved rectus abdominis thickness (MD 0.7 mm, 95% CI 0.1 to 1.3) and strength (MD 9 Nm, 95% CI 3 to 16) at 10 deg; its effects on other secondary outcomes were trivial or unclear.
CONCLUSION
An exercise program containing curl-ups for women with DRA did not worsen IRD or change the severity of pelvic floor disorders or low back, pelvic girdle or abdominal pain, but it did increase abdominal muscle strength and thickness.
REGISTRATION
NCT04122924.
Topics: Pregnancy; Female; Humans; Rectus Abdominis; Pelvic Floor Disorders; Abdominal Muscles; Postpartum Period; Exercise Therapy; Diastasis, Muscle; Abdominal Pain
PubMed: 37286390
DOI: 10.1016/j.jphys.2023.05.017 -
Medical Principles and Practice :... 2023The present study aims to investigate whether the dimple of Venus affects the anatomy of spinopelvic junction.
OBJECTIVES
The present study aims to investigate whether the dimple of Venus affects the anatomy of spinopelvic junction.
SUBJECTS AND METHODS
Inclusion criteria were having a lumbar MRI examination in the last 1 year, being older than 18 years of age and being able to radiologically evaluate the whole vertebral colon and pelvic girdle. Exclusion criteria were having congenital diseases of the pelvic girdle/hip/vertebral column and history of fracture or previous surgery in the same anatomic regions. The patients' demographic data and low back pain were noted. At radiological examination, the pelvic incidence angle was measured by lateral lumbar X-ray. The facet joint angle, tropism, facet joint degeneration, intervertebral disc degeneration, and intervertebral disc herniation at the level of L5-S1 were examined on lumbar MRIs.
RESULTS
We included 134 male and 236 female patients with a mean age of 47.86 ± 14.50 years and 48.49 ± 13.49 years, respectively. We found that the patients with the dimple of Venus had higher pelvic incidence angle (p < 0.001) and more sagittally oriented facet joint (right facet joint p = 0.017, left facet joint p = 0.001) compared to those without the dimple of Venus. There was no statistically significant relationship between low back pain and the presence of the dimple of Venus.
CONCLUSIONS
The dimple of Venus affects the anatomy of the spinopelvic junction and is associated with an increased pelvic incidence angle and a more sagittally oriented facet joint angle.
Topics: Adult; Female; Humans; Male; Middle Aged; Intervertebral Disc Displacement; Low Back Pain; Lumbar Vertebrae; Zygapophyseal Joint
PubMed: 37285829
DOI: 10.1159/000531413 -
Cureus May 2023Background Sex estimation of unidentified incomplete skeletons poses a challenge to paleoanthropologists and forensic experts. The sacrum is a part of the axial skeleton...
Background Sex estimation of unidentified incomplete skeletons poses a challenge to paleoanthropologists and forensic experts. The sacrum is a part of the axial skeleton and contributes to the formation of the pelvic girdle. It is a significant bone for the identification of the sex in the human skeletal system due to associated functional differences of the pelvic bones in males and females. However, there is a lack of cognizance of different morphometric parameters of the sacrum which may be crucial for determining sex, particularly when a part of the bone is available. This study aimed to recognize the best morphometric parameters for the identification of the sex of the sacrum even when fragmented bones were available and compare the various parameters for sexual dimorphism in different populations. Methodology The study was conducted on 110 dry adult human sacra in the anatomy department. Out of these, 42 sacra were female and 68 were male. Morphometric measurements were performed with the help of a digital vernier caliper. Statistical analysis was performed using SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). Morphometric measurements of male and female sacra were compared using Student's t-test. The receiver operating characteristic (ROC) curve analysis was performed to establish the most appropriate cut-off values for each parameter. Results The mean sacral length measured from the promontory to the apex of the sacrum was higher in males compared to females (p < 0.001), whereas the sacral index was higher in female sacra in comparison to male sacra (p < 0.001). Furthermore, the mean height of the first posterior sacral foramina (PSF) was higher in male sacra bilaterally (p < 0.05). On ROC analysis, the area under the curve was 0.994 for the sacral index and 0.862 for the sacral length. Conclusions In this study, the sacral index was noted to be the most important morphometric parameter for the identification of the sex of the sacra. Additionally, the height of the S2 body, the height of the first anterior sacral foramina, and the height of the first PSF can be contemplated with an accuracy of 60-70% if only a part of the sacrum is available for determining the sex. Hence, this study emphasizes the significance of morphometric parameters of the sacrum in the determination of sex, especially in forensic cases when the skull and pelvis are fragmented or unavailable.
PubMed: 37284374
DOI: 10.7759/cureus.38629 -
Sao Paulo Medical Journal = Revista... 2023The Pregnancy Mobility Index (PMI) was developed to assess mobility in pregnant women in the Netherlands. At present, no similar questionnaire is available in Brazil.
BACKGROUND
The Pregnancy Mobility Index (PMI) was developed to assess mobility in pregnant women in the Netherlands. At present, no similar questionnaire is available in Brazil.
OBJECTIVE
The present study aimed to translate, cross-culturally adapt, and evaluate the psychometric properties of a Brazilian PMI.
DESIGN AND SETTING
The present study was a validation study conducted at the Universidade Federal do Paraná and a public maternity ward in Curitiba, Brazil.
METHODS
Text translation and cross-cultural adaptation followed international guidelines. Construct validity, internal consistency, and inter- and intra-rater reliability tests included 97 women. The Pelvic Girdle Questionnaire, Multidimensional Pain Evaluation Scale, Schober's test, and lumbar spine range of motion assessment were administered on the first day. Intra-rater reliability (n = 19) was measured after 15 days. Exploratory factor analysis was performed, and the correlation matrix was analyzed using Pearson's coefficient.
RESULTS
Pregnant women (88%) understood the cultural adaptation process. The internal consistency was high (Cronbach's alpha > 0.90), construct validity was moderate, with significant correlation between lumbar spine range of motion (r = 0.283-0.369) and Schober's test (r = -0.314), and high correlation between the Multidimensional Pain Evaluation Scale (r = -0.650 and -0.499) and Pelvic Girdle Questionnaire (r = -0.737). Intra- and inter-rater reliabilities were excellent (intraclass correlation coefficient = 0.932 and 0.990, respectively).
CONCLUSION
The Brazilian version of the PMI was successfully translated with excellent reliability and moderate-to-high construct validity. It is an important tool for assessing mobility in pregnant women.
CLINICAL TRIAL
RBR-789tps (Validation study), https://ensaiosclinicos.gov.br/rg/RBR-789tps.
Topics: Pregnancy; Humans; Female; Brazil; Cross-Cultural Comparison; Psychometrics; Reproducibility of Results; Pain
PubMed: 37162035
DOI: 10.1590/1516-3180.2022.0279.R1.19122022 -
BMC Sports Science, Medicine &... Apr 2023In Latin American dance sport (LD), the shoulder girdle and the torso area are particularly stressed due to the dance style specific requirements. The aim of the study...
BACKGROUND
In Latin American dance sport (LD), the shoulder girdle and the torso area are particularly stressed due to the dance style specific requirements. The aim of the study was to define differences in various dance specific upper body postures in Latin American dancers and to show gender-specific differences.
METHODS
Three dimensional back scans were performed in n = 49 dancers (28 f/21 m). Five typical trunk positions in Latin American dance (habitual standing and 4 dance specific positions, P1-P5) were compared with each other. Statistical differences were calculated using the Man-Whitney U test, Friedmann test, Conover-Iman test and a Bonferroni-Holm correction.
RESULTS
Significant gender differences were found in P2, P3 and P4 (p ≤ 0.01-0.001). In P5, the frontal trunk decline, the axis deviation, the standard deviation of the rotation, the kyphosis angle and the shoulder as well as the pelvic rotation were also significantly different. The comparison of the postures showed significant differences between postures 1-5 (p ≤ 0.01-0.001) in the males, (scapular height, right and left scapular angles and pelvic torsion). Similar results were observed for the female dancers, with only the parameters of frontal trunk decline with the lordosis angle as well as the right and left scapular angles being non-significant.
CONCLUSIONS
This study is an approach to better understand the involved muscular structures in LD. Performing LD changes the static parameters of the upper body statics. Further projects are needed to analyse the field of dance even more thoroughly.
PubMed: 37098589
DOI: 10.1186/s13102-023-00672-w -
Cureus Apr 2023Polymyalgia rheumatica (PMR) is a systemic rheumatic inflammatory disease of adults presenting with symmetrical proximal muscle stiffness and pain predominantly...
Polymyalgia rheumatica (PMR) is a systemic rheumatic inflammatory disease of adults presenting with symmetrical proximal muscle stiffness and pain predominantly involving the shoulders, neck, and pelvic girdle. The coronavirus disease of 2019 (COVID-19) presented as a pandemic causing worldwide morbidity and mortality in large numbers. Rapid scientific research expedited preventative vaccine development and has helped tremendously in cutting down severe illness, hospitalizations, and death from COVID-19, with the messenger ribonucleic acid (mRNA) vaccines outperforming the others. We present two cases that showcase the incidence of polymyalgia rheumatica after receiving COVID-19 vaccination. Patient 1 is a 69-year-old female who developed arm and thigh stiffness a week before the second dose while receiving her primary Moderna vaccine series. She had an elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), so she was started on low-dose steroids, which were weaned down over a five-month period. Three weeks after receiving her Moderna booster, she had a recurrence of the classic polymyalgia rheumatica symptoms and elevated ESR. She responded to prednisone 15 mg with a successful taper over eight months. Patient 2 is a 74-year-old male who received his primary series and booster through Pfizer-BioNTech. Prior to the booster, he was treated for COVID-19 with monoclonal antibody therapy. He presented to the office with hip and shoulder pain and stiffness along with an elevated C-reactive protein. Consequently, he received 20 mg of prednisone but needed to increase his dose to 25 mg total to help with the control of his inflammation. The goal of this article is to prompt physicians about the possibility of PMR incidence after patients receive vaccinations for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PMR can be debilitating to the quality of life of patients. Knowing this association allows for more timely and competent treatment. PMR following SARS-CoV-2 vaccinations is continuously being observed in the medical field. Increased knowledge may help prevent the recurrence with subsequent doses. Further studies on the follow-up of such cases and the effect on subsequent immunization would be helpful.
PubMed: 37091488
DOI: 10.7759/cureus.37782 -
International Journal of Surgery Case... May 2023Primary hyperparathyroidism is the third most common endocrine disorder after diabetes and thyroid disease. Nevertheless, a pathological fracture revealing primary...
INTRODUCTION
Primary hyperparathyroidism is the third most common endocrine disorder after diabetes and thyroid disease. Nevertheless, a pathological fracture revealing primary hyperparathyroidism is not commonly described.
CASE PRESENTATION
We present the case of a 30-year-old male patient who was admitted with a subtrochanteric pathologic fracture of her left femur after a trivial fall. Due to suspicion of bone metastases, a thoraco-abdomino-pelvic CT scan was requested. It revealed multiple irregular circumscribed lytic bone lesions in the ribs, the right scapula, the dorsal spine, and the pelvic girdle; bilateral renal lithiasis; and a nodule contiguous to the left posterior thyroid lobe. A surgical biopsy of the bone lesion was performed. Histopathological examination confirmed the diagnosis of primary hyperparathyroidism with a brown tumor. Laboratory tests showed increased both calcium and PTH levels. The patient underwent cephalomedullary nail fixation with bipolar locking. After that, a parathyroidectomy was performed. At six months' follow-up, the functional result was satisfactory.
CLINICAL DISCUSSION
Primary hyperparathyroidism is the most common cause of hypercalcemia. It occurs as a result of a parathyroid adenoma in 80 % of cases. Definitive diagnosis should be made by clinical history, radiological findings and confirmed by biochemical tests including serum parathyroid hormone (PTH), alkaline phosphatase, calcium, phosphate, and vitamin D levels.
CONCLUSION
This case report emphasizes the need of including brown tumors in the differential diagnosis of multifocal osteolytic bone lesions, in order to ensure appropriate treatment.
PubMed: 37062190
DOI: 10.1016/j.ijscr.2023.108158