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A&A Practice Jun 2024The parasternal blocks cannot cover the T7 and lower anterior and lateral branches of the thoracoabdominal nerves. In the open heart surgeries, chest drainage tubes are...
The Medipol Combination: Novel Rectointercostal Fascial Plane Block and Pectointercostal Fascial Plane Block for Postoperative Analgesia Management After Cardiac Surgery: A Report of 15 Cases.
The parasternal blocks cannot cover the T7 and lower anterior and lateral branches of the thoracoabdominal nerves. In the open heart surgeries, chest drainage tubes are generally outside the target of the parasternal blocks. Recently, Tulgar et al described a novel interfascial plane block technique named "recto-intercostal fascial plane block" (RIFPB). RIFPB is performed between the rectus abdominis muscle and the sixth to seventh costal cartilages. RIFPB targets the anterior and lateral cutaneous branches of the T6-T9 thoracoabdominal nerves. In this clinical report, we want to share our experiences about pectointercostal plane block and RIFPB combination (Medipol Combination) after cardiac surgery.
Topics: Humans; Nerve Block; Pain, Postoperative; Male; Cardiac Surgical Procedures; Middle Aged; Female; Aged; Anesthetics, Local; Adult; Pain Management
PubMed: 38836555
DOI: 10.1213/XAA.0000000000001794 -
Clinical Interventions in Aging 2024Muscle ultrasound has emerged as a promising method in the diagnostic work-up of sarcopenia. The objective of this scoping review was to explore the validity of muscle... (Review)
Review
PURPOSE
Muscle ultrasound has emerged as a promising method in the diagnostic work-up of sarcopenia. The objective of this scoping review was to explore the validity of muscle ultrasound against the latest sarcopenia definitions among older adults.
METHODS
We adhered to the PRISMA guidelines for scoping reviews. A systematic search of databases was performed by two independent reviewers. All articles comparing the performance of ultrasound to an internationally acknowledged sarcopenia definition among older adults (≥60 years) and published between 2019/01/01 (the year updated sarcopenia definitions were introduced) and 2023/11/15 were included. Data were extracted and collated by muscle and muscle parameters.
RESULTS
Out of 2290 articles screened, six studies comprising 24 validity tests among a total of 1619 older adults (mean age 74.1 years, 52.2% female) were included. The validity tests investigated the rectus femoris (n = 7), biceps brachii (n = 5), gastrocnemius medialis (n = 4), tibialis anterior (n = 4), soleus (n = 3), and rectus abdominis (n = 1). The parameter muscle thickness (MT) (n = 14) was most commonly measured. The latest European and Asian sarcopenia definitions (EWGSOP2, AWGS2) were applied as reference standards in four validity tests each. None of the studies used the Sarcopenia Definition and Outcome Consortium (SDOC) criteria. The highest area under the curve AUC (0.92, 95% confidence interval [CI] 0.89-0.94) was found for the muscle thickness of the rectus femoris muscle. Due to substantial heterogeneity among the studies, pooling of data using a meta-analytic approach was not feasible.
CONCLUSION
Limited number of studies have examined the validity of muscle ultrasound for diagnosing sarcopenia based on recent definitions among older adults. Thereby, muscle thickness of the rectus femoris showed promising results regarding validity. Further studies are needed to investigate the validity of key muscles and to validate muscle ultrasound among older hospitalized patients.
Topics: Humans; Sarcopenia; Ultrasonography; Aged; Muscle, Skeletal; Female; Male; Reproducibility of Results
PubMed: 38831963
DOI: 10.2147/CIA.S463917 -
Radiology Case Reports Aug 2024The Spigelian hernia is a abdominal wall hernia that originates from a discontinuity of the Spigelian fascia located lateral to the rectus abdominis muscle. It can be...
The Spigelian hernia is a abdominal wall hernia that originates from a discontinuity of the Spigelian fascia located lateral to the rectus abdominis muscle. It can be acquired in adults or congenital in newborns. In very rare cases in male it can be associated with cryptorchidism, in which case it is known as "Spigellian-Cryptorchidism Syndrome". It can be clinically highlighted with abdominal swelling wall along the semilunar line and intestinal obstruction. The diagnosis, as in all pediatric emergencies, must be timely and the method of choice is ultrasound which allows a rapid localization of the hernia breach and herniated structures. The treatment of choice is surgical with herniopexy and repositioning of the testicle into the scrotal sac, or orchipessy in cases of testicular necrosis. We describe ultrasound characteristics of Spigellian-cryptorchidism syndrome presenting with acute intestinal obstruction in a newborn.
PubMed: 38827042
DOI: 10.1016/j.radcr.2024.04.080 -
Journal of Musculoskeletal & Neuronal... Jun 2024To verify the relationship between the indicators of components of lumbar motor control and determine the factors related to the indicators to each of these components.
OBJECTIVES
To verify the relationship between the indicators of components of lumbar motor control and determine the factors related to the indicators to each of these components.
METHODS
Twenty-five healthy university students were included in the study. The lumbar spine and hip kinematic parameters of posterior/anterior pelvic tilt (mobility and smoothness), ball catching (reactivity), and forward/backward rocking (adaptive stability) were measured as indicators of lumbar motor control. Lumbar proprioception, trunk muscle strength, and lower trunk muscle thickness were also measured. Kinematic parameters of the lumbar spine and hip were measured using a small accelerometer. The data verified the relevance of indicators of lumbar motor control and the relationship with relevant factors.
RESULTS
No significant correlations were found for most lumbar motor control indicators. Lumbar proprioception and rectus abdominis muscle thickness were identified as relevant indicators of lumbar motor control.
CONCLUSIONS
Each component of lumbar motor control is independent and must be evaluated for the component whose function is required. Additionally, some components of lumbar motor control are associated with lumbar proprioception and rectus abdominis muscle thickness; thus, evaluation of these components is necessary when evaluating lumbar motor control.
Topics: Humans; Male; Female; Young Adult; Proprioception; Lumbar Vertebrae; Biomechanical Phenomena; Adult; Muscle Strength; Postural Balance; Lumbosacral Region; Muscle, Skeletal
PubMed: 38825996
DOI: No ID Found -
International Journal of Surgery Case... Jul 2024Herein, we present an unexpected rectus sheath hematoma (RSH) complication due to chronic COVID-19 related cough and prolonged anticoagulation therapy. COVID-19 usually...
INTRODUCTION AND IMPORTANCE
Herein, we present an unexpected rectus sheath hematoma (RSH) complication due to chronic COVID-19 related cough and prolonged anticoagulation therapy. COVID-19 usually presents with respiratory symptoms, such as cough. Anticoagulants are used in severe cases of COVID-19 as well as in mechanical heart valve replacement to prevent thrombosis. However, there is a high risk of bleeding.
CASE PRESENTATION
We report a rare case of a 74-year-old woman who presented with a COVID-19 related cough persistent over two months, and was also undertaking warfarin daily for 10 years due to mechanical mitral valve replacement. Computed Tomography (CT) scan revealed retroperitoneal and rectus sheath hematoma (RSH) as well as rectus abdominis muscle rupture. She had hemorrhagic shock due to rapid hematoma expansion to the right and left flank as well as to the back. Thus, she required an emergency surgery in which the hematoma was excised and the rectus abdominis muscle was sutured. The patient was discharged and has completely recovered.
CLINICAL DISCUSSION
Many factors and mechanisms contribute to the formation of the RSH and the rupture of rectus abdominis muscle, including severe cough and anticoagulants.
CONCLUSION
Although the use of anticoagulants is necessary for patients who underwent mechanical valve replacement or for COVID-19 patients as a prophylaxis of thrombotic complication, RSH should be kept in mind and carefully monitored as it may require surgical intervention in severe cases.
PubMed: 38810295
DOI: 10.1016/j.ijscr.2024.109628 -
Journal of Anatomy May 2024Previous studies have poorly described the initial development process of the tendinous intersections of the rectus abdominis muscle (RAM). The present study aimed to...
Previous studies have poorly described the initial development process of the tendinous intersections of the rectus abdominis muscle (RAM). The present study aimed to observe the formation of tendinous intersections in the RAM during the early fetal period using diffusion tensor imaging (DTI). Fifteen human fetal specimens (crown-rump length [CRL]: 39.5-93.7 mm) were selected. Three-dimensional measurements revealed that Zone-4 (i.e., the zone between the pubic symphysis and the caudal base of the umbilical ring in the RAM) had a smaller width and was thicker than Zone-1 and Zone-2 (i.e., the zones between the costal arch and the cranial base of the umbilical ring) and Zone-3 (i.e., the zone at the umbilical ring). Characteristics of tendinous intersections in the RAM during the early fetal period were assessed according to number, size, type, laterality, and sex. The mean number of tendinous intersections on both sides was 3.1 (range: 2.0-4.0), and 21% of specimens had only two tendinous intersections, which was higher than that reported in previous adult studies. The present data suggest that the formation of tendinous intersections was still in progress in specimens with two tendinous intersections in the RAM and that the third tendinous intersection was formed in Zone-2. Ordinal logistic regression via generalized estimating equations revealed that the odds for a higher type of tendinous intersections in Zone-1 and Zone-2 were significantly higher than those in Zone-4 (adjusted odds ratio: 14.85, 8.84). The odds for the presence of incomplete types (tendinous intersections that could not completely transverse the RAM) in Zone-3 were significantly higher than those in Zone-1 (adjusted odds ratio: 7.4). The odds for missing tendinous intersections in Zone-4 were significantly higher than those in Zone-1 (adjusted odds ratio: 20.5). These zonal differences in the formation of tendinous intersections were consistent with those observed in previous adult studies. In this study, DTI detected tendinous intersections in a sample with a CRL of 45.8 mm (approximately 11 weeks of gestation), which is earlier than that in previous histological findings, indicating that the RAM does not have mature tendinous intersections until the 17th week of gestation. In conclusion, DTI could detect the premature differentiation of tendinous intersection formation. Our data may aid in elucidating the developmental processes of tendinous intersections in the RAM.
PubMed: 38808647
DOI: 10.1111/joa.14064 -
World Journal of Psychiatry May 2024Rectus abdominis separation (DRA) affects pelvic stability and body image. No studies have explored the effects of manual massage on early postpartum DRA and postpartum...
BACKGROUND
Rectus abdominis separation (DRA) affects pelvic stability and body image. No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression.
AIM
To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women.
METHODS
Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023. The patients were divided into the Group S (35 cases, biomimetic electrical stimulation treatment) and Group L (35 cases, biomimetic electrical stimulation combined with manual massage treatment). Baseline data, the edinburgh postpartum depression scale (EPDS) score, and the visual analog scale (VAS) scores for rectus abdominis distance, waist circumference, and lower back pain before and after treatment were compared.
RESULTS
No significant differences were found in the baseline data, rectus abdominis distance, waist circumference, and VAS and EPDS scores between the two groups before treatment ( > 0.05). After treatment, the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S ( < 0.05). Furthermore, lower back pain (VAS score) and the EPDS score in Group L were significantly lower than those in Group S ( < 0.05).
CONCLUSION
Manual massage can significantly reduce early postpartum DRA, waist circumference, and back pain and improve the patient's mental state and postpartum depression.
PubMed: 38808091
DOI: 10.5498/wjp.v14.i5.678 -
Journal of Xenobiotics May 2024Glyphosate, a widely used herbicide, is linked to a plethora of deleterious effects in both clinical and preclinical studies. Nevertheless, the effects of its main...
Glyphosate, a widely used herbicide, is linked to a plethora of deleterious effects in both clinical and preclinical studies. Nevertheless, the effects of its main metabolite, aminomethylphosphonic acid (AMPA), whose half-life in soil is even longer than that of glyphosate, have been little explored. On this basis, as a first approach, in this work, we report that intraperitoneal (i.p.) administration of AMPA or glyphosate (at 10, 56, and 100 mg/kg) decreased, to a similar extent, plasma cholinesterase (ChE) activity in acutely exposed rats. Moreover, we designed an experimental protocol to analyze and compare the effects of AMPA and glyphosate on human plasma ChE activity; this protocol consisted of adding these compounds to human plasma to subsequently test the effects of this plasma on the contraction to acetylcholine (ACh) in the frog rectus abdominis muscle (an indirect estimate of ChE activity). Accordingly, this muscular contraction to ACh was evaluated before and after pre-incubation of ACh with (i) plasma alone, (ii) plasma with AMPA, and (iii) plasma with glyphosate. Our results indicate that AMPA, like glyphosate, decreased ChE activity in the plasma of rats (when given i.p.) and humans (when added in vitro), suggesting that both xenobiotics may exert similar toxicological effects.
PubMed: 38804288
DOI: 10.3390/jox14020035 -
Techniques in Coloproctology May 2024Loop ileostomy is a common surgical procedure but is associated with complications such as outlet obstruction (OO), parastomal hernia (PH), and high-output stoma (HOS)....
BACKGROUND
Loop ileostomy is a common surgical procedure but is associated with complications such as outlet obstruction (OO), parastomal hernia (PH), and high-output stoma (HOS). This study aimed to identify risk factors for these complications, as well as their causal relationships.
METHODS
The study included 188 consecutive patients who underwent loop ileostomy between April 2016 and September 2021. Clinical factors and postoperative stoma-related complications (OO, HOS, and PH) were analyzed retrospectively. Stoma-related factors were evaluated using specific measurements from computed tomography (CT) scans. The incidence, clinical course, and risk factors for the stoma-related complications were investigated.
RESULTS
OO was diagnosed in 28 cases (15.7%), PH in 60 (32%), and HOS in 57 (31.8%). A small longitudinal stoma diameter at the rectus abdominis level on CT and a right-sided stoma were significantly associated with OO. Creation of an ileostomy for anastomotic leakage was independently associated with HOS. Higher body weight and a large longitudinal stoma diameter at the rectus abdominis level on CT were significantly associated with PH. There was a significant relationship between the occurrence of OO and HOS. However, the association between OO and PH was marginal.
CONCLUSION
This study identified key risk factors for OO, HOS, and PH as complications of loop ileostomy and their causal relationships. Our findings provide insights that may guide the prevention and management of complications related to loop ileostomy.
Topics: Humans; Ileostomy; Female; Male; Risk Factors; Middle Aged; Retrospective Studies; Aged; Postoperative Complications; Tomography, X-Ray Computed; Surgical Stomas; Intestinal Obstruction; Adult; Incisional Hernia; Aged, 80 and over; Anastomotic Leak; Incidence; Rectus Abdominis
PubMed: 38801595
DOI: 10.1007/s10151-024-02926-2 -
Anatomy & Cell Biology May 2024Transversus abdominis release (TAR) is a myofascial release technique which helps in surgical repair of large ventral abdominal wall defects. In this procedure, the...
Transversus abdominis release (TAR) is a myofascial release technique which helps in surgical repair of large ventral abdominal wall defects. In this procedure, the medial margin of muscular part of transversus abdominis (TA) is of great importance. Hence, the authors sought to describe the extent of medial margin of TA muscle. The surgical steps of TAR were performed in 10 formalin-fixed cadavers and distance between medial margin of TA muscle, lateral margin of rectus abdominis, to linea alba at five anatomical levels were documented respectively. The distance between the inferior epigastric vessels and the medial border of TA muscle was also noted. The TA muscle was within the posterior rectus sheath in all cadavers, at the xiphisternum (R, 61.6 mm; L, 58.9 mm), and at midway between xiphisternum and umbilicus (R, 25.4 mm; L, 27.1 mm). The TA muscle exited the posterior rectus sheath between this point and the umbilicus. The mean incongruity at the next three levels were -24.6 mm, -24.9 mm, and -22.9 mm respectively on the right and -21.4 mm, -19.9 mm, and -18.9 mm respectively on the left. The mean distance between the medial border of TA and inferior epigastric vessels was 18.9 mm on the right and 17.2 mm on the left. The muscular part of TA was incorporated within the posterior rectus sheath above the umbilicus, and it completely exited the rectus sheath at the umbilicus. This is contrary to the traditional understanding of posterior rectus sheath formation.
PubMed: 38797746
DOI: 10.5115/acb.23.305