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International Journal of Environmental... Feb 2023(1) Background: Optimal neuromuscular, Lumbo-Pelvic-Hip Complex, and lower extremity control are associated with decreased risk factors for secondary anterior cruciate... (Observational Study)
Observational Study
(1) Background: Optimal neuromuscular, Lumbo-Pelvic-Hip Complex, and lower extremity control are associated with decreased risk factors for secondary anterior cruciate ligament (ACL) injury. This study aimed to analyze any asymmetries and malalignments in the Lumbo-Pelvic-Hip Complex and the lower limbs at 6 months after ACL reconstruction (ACLR). (2) Methods: We conducted an exploratory retrospective observational single-center study in patients during the outpatient postoperative rehabilitation program at ICOT (Latina, Italy). From January 2014 to June 2020, 181 patients were recruited, but only 100 patients (86 male 28 ± 0.6 years, 178 ± 0.5 height; 14 female 24 ± 2.0 years, 178 ± 3.0 height) were eligible for the inclusion criteria and studied 6 months after ACL reconstruction surgery. (3) Statistical analysis: Student's -tests and Pearson's product-moment correlation coefficient were used to determine significant differences between affected and non-affected limbs and variables' association. (4) Results: The study shows a decrease in neuromuscular control of the Lumbo-Pelvic-Hip Complex and dynamic adaptive valgus of the knee at 6 months after ACLR (mean difference between pathological and healthy limb of dynamic adaptive valgus was -10.11 ± 8.19° 95% CI -14.84 to -9.34; mean value was 16.3 ± 6.8° 95% CI 14.04 to 18.55 for healthy limb and 4.2 ± 3.1° 95% CI 3.15 to 5.21 for pathological limb, < 0.0001). The results also showed a relationship between dynamic adaptive valgus and contralateral pelvic drop (r = 0.78, 95% CI 0.62 to 0.88, magnitude of correlation very large). (5) Conclusions: The analysis showed an associative correlation between decreased postural control of the pelvic girdle and dynamic adaptive valgus of the knee in 38% of patients; this study highlights the usefulness of the Single-Leg Squat Test (SLST) as a clinical/functional assessment to evaluate the rehabilitation process and as a preventive tool to reduce the risk of second ACL injuries during the return to sport.
Topics: Female; Humans; Male; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Knee Joint; Lower Extremity; Retrospective Studies
PubMed: 36833752
DOI: 10.3390/ijerph20043063 -
Cureus Jan 2023Fetus in fetu (FIF) is a rare congenital anomaly of asymmetric monozygotic twins, where the parasitic twin develops abnormally inside the body of the host twin. In most...
Fetus in fetu (FIF) is a rare congenital anomaly of asymmetric monozygotic twins, where the parasitic twin develops abnormally inside the body of the host twin. In most cases, it is incorporated into the sibling's abdomen, which frequently presents as a retroperitoneal mass. Currently, at least 200 cases have been reported worldwide, being this the first case in Nicaragua. We describe a case of a male newborn, born via cesarean section, with a history of multiple congenital malformations observed via ultrasound examination. At birth, a mass is observed on its dorsum that impresses a skull, but without the presence of bones, with three limbs, two upper and one lower, with an outline located transversely on the pelvic girdle and the presence of two male genitalia with agenesis of the testicles and an accessory kidney. A preoperative diagnosis of FIF and spinal dysraphism was made by computed tomography (CT) and magnetic resonance imaging (MRI). They shared a spinal cord and had the presence of an open spinal defect type meningocele with aberrant roots. After the diagnosis and discussion, the multidisciplinary team proceeded to surgery to perform the separation of the twin (FIF). The subsequent anatomopathological examination revealed that the fetus was anencephalic and had reliable FIF characteristics. The resection was performed followed by the closure of the 430 mL meningocele and complete separation of the spine and the parasitic twin. We present the first case of fetus in fetu in Nicaragua.
PubMed: 36819441
DOI: 10.7759/cureus.33835 -
BMC Pregnancy and Childbirth Feb 2023Self-efficacy, one's ability to deal with pain, disability, and other symptoms through self-management techniques, positively affect the quality of life in patients with...
BACKGROUND
Self-efficacy, one's ability to deal with pain, disability, and other symptoms through self-management techniques, positively affect the quality of life in patients with chronic diseases. Pregnancy-related back pain is a common musculoskeletal disorder pre- and postnatally. Hence, the study aimed to determine whether self-efficacy is associated with the development of back pain during pregnancy.
METHODS
Between February 2020 and February 2021, a prospective case-control study was performed. Women with back pain were included. The self efficacy was assessed by the Chinese version of the General Self-efficacy Scale (GSES). Pregnancy-related back pain was measured using a self-reported scale. No regression from pregnancy-related back pain is defined as a recurrent or persistent pain score ≥ 3 over a week around 6 months postpartum. Women experiencing back pain during pregnancy are classified according to whether having a regression. This problem can be divided into pregnancy-related low back pain (LBP) and posterior girdle pain (PGP). The differences in variables were compared between groups.
RESULTS
A total of 112 subjects have completed the study finally. These patients were followed up with an average of 7.2 months after childbirth ranging from six to 8 months. 31 subjects (27.7%) of the included women did not report regression 6 months postpartum. The mean self efficacy was 25.2 (SD:10.6). Patients with no regression tended to be older (LBP:25.9 ± 7.2 vs.31.8 ± 7.9, P = 0.023; PGP: 27.2 ± 7.9 vs. 35.9 ± 11.6, P < 0.001*), have a lower self efficacy (LBP:24.2 ± 6.6 vs.17.7 ± 7.1, P = 0.007; PGP: 27.6 ± 6.8 vs. 22.5 ± 7.0, P = 0.010), and need high daily physical demand in their vocations (LBP:17.4% vs. 60.0%, P = 0.019; PGP: 10.3% vs. 43.8%, P = 0.006) when compared to those with regression. Multivariate logistic analysis shows that risk factors for no regression from pregnancy-related back pain included LBP (OR = 2.36, 95%CI = 1.67-5.52, P < 0.001), pain ratings of the onset of back pain during pregnancy≥3(OR = 2.23, 95%CI = 1.56-6.24, P = 0.004), low self efficacy (OR = 2.19, 95%CI = 1.47-6.01, P < 0.001), and high daily physical demand in their vocations (OR = 2.01, 95%CI = 1.25-6.87, P = 0.001).
CONCLUSIONS
Low self efficacy makes the women experience about two-fold risk to experience no regression from pregnancy-related back pain. Evaluation for self efficacy is simple enough to be used to improve perinatal health.
Topics: Pregnancy; Humans; Female; Low Back Pain; Pelvic Girdle Pain; Self Efficacy; Quality of Life; Case-Control Studies; Pregnancy Complications; Back Pain
PubMed: 36810019
DOI: 10.1186/s12884-023-05393-z -
Homo : Internationale Zeitschrift Fur... Apr 2023Discussions of the evolution of sexual dimorphism in torso shape and the pectoral region assume that this dimorphism exists independently of body size. We test this... (Comparative Study)
Comparative Study
Discussions of the evolution of sexual dimorphism in torso shape and the pectoral region assume that this dimorphism exists independently of body size. We test this assumption in two human populations and further examine what is needed to understand sexual dimorphism in the pectoral region. Modern human males have broad shoulders and narrow hips relative to females, lending males a more triangular torso. The wider female pelvis is commonly attributed to obstetric pressures while the broader male pectoral girdle has been argued to be an adaptation that improves hunting or intrasexual competition. While sexual dimorphism in the pelvic girdle is known to exist after adjusting for body size across human populations, most studies of sexual dimorphism in the pectoral girdle have not adjusted the data to account for sexual size dimorphism or compared different ancestral groups. The aforementioned hypotheses explaining sexual dimorphism in the clavicle and scapula as products of natural selection are predicated on the untested assumption that sex differences do not scale with body size. This study tests this assumption by comparing various measurements of the pectoral girdle, the pelvic girdle, and six pectoral-pelvic indices of black and white South Africans of known sex and height to test whether the sexes and ancestral groups will differ in these values after adjusting for differences in body size. Comparisons of ancestral groups reveal that white South Africans have larger pectoral and pelvic dimensions than black South Africans, but that blacks have larger index values than whites. Regardless of differences in ancestry and body size, males have significantly broader pectoral regions as indicated by comparisons of both individual pectoral measurements and pectoral-pelvic indices. This pattern of sexual dimorphism is reversed in the pelvic region where females have larger skeletal elements. In addition to finding both absolute and relative differences in mean values for the pectoral and pelvic skeleton, females and males and blacks and whites differ in the scaling relationship of these traits, suggesting different allometric trajectories for these bones that may be explained by their distinct evolutionary functions, their adaptations to specific environments, or by changes in lengths due to age. These results suggest that sexual dimorphism in the pectoral region is not a product of scaling and that differences in this region reflect adaptive forces acting in unique ways on each sex, consistent with the assumptions of earlier evolutionary explanations.
Topics: Female; Humans; Male; Black People; Sex Characteristics; Pelvic Bones; White People; South Africa; Bones of Upper Extremity; Race Factors; Sex Factors; Body Height; Biological Evolution
PubMed: 36628541
DOI: 10.1127/homo/2023/1486 -
Neurourology and Urodynamics Jun 2023To describe the methods for the in-person assessment of the RISE FOR HEALTH (RISE) study, a population-based multicenter prospective cohort study designed to identify...
OBJECTIVES
To describe the methods for the in-person assessment of the RISE FOR HEALTH (RISE) study, a population-based multicenter prospective cohort study designed to identify factors that promote bladder health and/or prevent lower urinary tract symptoms in adult women, conducted by the Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS).
METHODS AND RESULTS
A subset of RISE participants who express interest in the in-person assessment will be screened to ensure eligibility (planned n = 525). Eligible consenting participants are asked to complete 15 physical assessments in addition to height and weight, to assess pelvic floor muscle function, musculoskeletal (MSK) status, and pain, and to provide urogenital microbiome samples. Pelvic floor muscle assessments include presence of prolapse, strength, levator attachment integrity (tear) and myofascial pain. MSK tests evaluate core stability, lumbar spine, pelvic girdle and hip pain and function. Participants are asked to complete the Short Physical Performance Battery to measure balance, lower extremity strength, and functional capacity. All participants are asked to provide a voided urine sample and a vaginal swab for microbiome analyses; a subset of 100 are asked to contribute additional samples for feasibility and validation of a home collection of urinary, vaginal, and fecal biospecimens.
RESULTS
Online and in-person training sessions were used to certify research staff at each clinical center before the start of RISE in-person assessments. Standardized protocols and data collection methods are employed uniformly across sites.
CONCLUSIONS
The RISE in-person assessment is an integral portion of the overall population-based RISE study and represents an innovative approach to assessing factors hypothesized to promote bladder health and/or prevent lower urinary tract symptoms. Data collected from this assessment will be used to prioritize future research questions and prevention strategies and interventions. This description of the assessment methods is intended to provide methodologic transparency and inform other researchers who join efforts to understand and improve bladder health.
Topics: Adult; Humans; Female; Prospective Studies; Pelvic Floor; Urinary Bladder; Lower Urinary Tract Symptoms; Pain
PubMed: 36573845
DOI: 10.1002/nau.25108 -
Journal of Clinical Medicine Dec 2022(1) Background: The objective was to compare the exploration of chronic pelvic pain syndrome (CPPS) patients in different locations and establish the role of physical...
(1) Background: The objective was to compare the exploration of chronic pelvic pain syndrome (CPPS) patients in different locations and establish the role of physical examination in CPPS patients. (2) Methods: We reviewed clinical data from 107 female patients with CPPS unresponsive to conventional therapies at Puerta de Hierro University Hospital Madrid, Spain, from May 2018 to June 2022. Patients were classified into three groups: (a) pelvic pain; (b) anorectal pain; or (c) vulvar/perineal pain. (3) Results: Although the demographics of patients with CPPS were different, their physical examinations were strikingly similar. Our study observed a comorbidity rate of 36% and 79% of central sensitization of pain. Seventy-one percent of patients had vulvar allodynia/hyperalgesia. Pain on examination was identified in any pelvic floor muscle, in any pelvic girdle structure, and neuropathic pain in 98%, 96%, and 89%, respectively. Patients with vulvar and perineal pain were more different from the other groups; these patients were younger and had fewer comorbidities and less central sensitization, less anorectal pain, more pain during intercourse, and greater nulliparity ( = 0.022; = 0.040; = 0.048; = 0.000; = 0.006; = 0.005). (4) Conclusions: The findings of this study are related to the understanding of the pathophysiology of CPPS. The physical examination confirms the central sensitization of female patients with CPPS, helps us to determine the therapeutic management of the patient, and can be considered as a prognostic factor of the disease.
PubMed: 36556104
DOI: 10.3390/jcm11247490 -
Journal of Clinical Medicine Dec 2022Polymyalgia rheumatica (PMR) is an inflammatory rheumatism of the shoulder and pelvic girdles. In 16 to 21% of cases, PMR is associated with giant cell arteritis (GCA)... (Review)
Review
Polymyalgia rheumatica (PMR) is an inflammatory rheumatism of the shoulder and pelvic girdles. In 16 to 21% of cases, PMR is associated with giant cell arteritis (GCA) that can lead to severe vascular complications. Ruling out GCA in patients with PMR is currently a critical challenge for clinicians. Two GCA phenotypes can be distinguished: cranial GCA (C-GCA) and large vessel GCA (LV-GCA). C-GCA is usually suspected when cranial manifestations (temporal headaches, jaw claudication, scalp tenderness, or visual disturbances) occur. Isolated LV-GCA is more difficult to diagnose, due to the lack of specificity of clinical features which can be limited to constitutional symptoms and/or unexplained fever. Furthermore, many studies have demonstrated the existence-in varying proportions-of subclinical GCA in patients with apparently isolated PMR features. In PMR patients, the occurrence of clinical features of C-GCA (new onset temporal headaches, jaw claudication, or abnormality of temporal arteries) are highly predictive of C-GCA. Additionally, glucocorticoids' resistance occurring during follow-up of PMR patients, the occurrence of constitutional symptoms, or acute phase reactants elevation are suggestive of associated GCA. Research into the predictive biomarkers of GCA in PMR patients is critical for selecting PMR patients for whom imaging and/or temporal artery biopsy is necessary. To date, Angiopoietin-2 and MMP-3 are powerful for predicting GCA in PMR patients, but these results need to be confirmed in further cohorts. In this review, we discuss the diagnostic challenges of subclinical GCA in PMR patients and will review the predictive factors of GCA in PMR patients.
PubMed: 36556036
DOI: 10.3390/jcm11247412 -
Journal of Developmental Biology Dec 2022Pelvic girdles, fins and claspers are evolutionary novelties first recorded in jawed vertebrates. Over the course of the evolution of chondrichthyans (cartilaginous...
Pelvic girdles, fins and claspers are evolutionary novelties first recorded in jawed vertebrates. Over the course of the evolution of chondrichthyans (cartilaginous fish) two trends in the morphology of the pelvic skeleton have been suggested to have occurred. These evolutionary shifts involved both an enlargement of the metapterygium (basipterygium) and a transition of fin radial articulation from the pelvic girdle to the metapterygium. To determine how these changes in morphology have occurred it is essential to understand the development of extant taxa as this can indicate potential developmental mechanisms that may have been responsible for these changes. The study of the morphology of the appendicular skeleton across development in chondrichthyans is almost entirely restricted to the historical literature with little contemporary research. Here, we have examined the morphology and development of the pelvic skeleton of a holocephalan chondrichthyan, the elephant shark (), through a combination of dissections, histology, and nanoCT imaging and redescribed the pelvic skeleton of (NHMUK PV P 9269), a stem holocephalan. To put our findings in their evolutionary context we compare them with the fossil record of chondrichthyans and the literature on pelvic development in elasmobranchs from the late 19th century. Our findings demonstrate that the pelvic skeleton of initially forms as a single mesenchymal condensation, consisting of the pelvic girdle and a series of fin rays, which fuse to form the basipterygium. The girdle and fin skeleton subsequently segment into distinct components whilst chondrifying. This confirms descriptions of the early pelvic development in sharks from the historical literature and suggests that chimaeras and elasmobranchs share common developmental patterns in their pelvic anatomy. Alterations in the location and degree of radial fusion during early development may be the mechanism responsible for changes in pelvic fin morphology over the course of the evolution of both elasmobranchs and holocephalans, which appears to be an example of parallel evolution.
PubMed: 36547475
DOI: 10.3390/jdb10040053 -
Cureus Nov 2022We present a unique case of a 75-year-old Caucasian female who presented with a two-month history of unrelenting proximal muscle pain and stiffness in the neck,...
We present a unique case of a 75-year-old Caucasian female who presented with a two-month history of unrelenting proximal muscle pain and stiffness in the neck, shoulders, and pelvic girdle that lasted for 45 minutes each morning upon waking. Due to clinical suspicion of polymyalgia rheumatica (PMR), the patient was started on the standard therapy of low-dose glucocorticoid therapy and was noted to have a dramatic improvement in terms of pain, strength, mobility, and range of motion. Current literature shows high variability in the standard response time to treatment. Typical resolution of symptoms occurs within a span of one day to months. The case presented in our study shows symptom resolution as well as marked improvement in muscle strength and mobility within 12 hours. The purpose of this case report is to provide additional information for physicians when considering symptom-resolution time related to low-dose glucocorticoid therapy and PMR. Additionally, we briefly explore the literature on the correlation between giant cell arteritis (GCA) and glucocorticoid therapy for PMR as well as the data associated with adjuvant therapy using immunomodulatory treatment.
PubMed: 36483895
DOI: 10.7759/cureus.31159 -
Anatomical Record (Hoboken, N.J. : 2007) Jun 2023This article presents a detailed comparative analysis of the bone microstructure of three extant species of South American turtles. The main histological characteristics...
Comparative postcranial osteohistology and bone histovariability of aquatic and terrestrial turtles: the case of the South American Phrynops hilarii, Hydromedusa tectifera (Pleurodira, Chelidae), and Chelonoidis chilensis (Cryptodira, Testudinidae).
This article presents a detailed comparative analysis of the bone microstructure of three extant species of South American turtles. The main histological characteristics of postcranial bones are identified, as well as the intraskeletal, ontogenetic and interspecific variation between aquatic and terrestrial species. For this purpose, thin sections of postcranial bones (seventh cervical vertebra, coracoid, scapula, humerus, radius, ulna, ischium, ilium, pubis, femur, tibia, and fibula) of juvenile and adult specimens of aquatic (Phrynops hilarii and Hydromedusa tectifera) and terrestrial (Chelonoidis chilensis) turtles were analyzed. Bone histology revealed an intraskeletal variation of the microanatomical and microstructural organization in these turtles. The cortical bone is composed of poorly vascularized lamellar and parallel-fibered bone tissue interrupted with lines of arrested growth (LAGs), reflecting a cyclical slow growth rate throughout these turtles' life. Although in the adult specimens a growth rate decrease was observed, none of them have reached somatic maturity. The juvenile and the adult of Chelonoidis chilensis, unlike the aquatic species studied, presented a higher vascularization in their bones, which could imply a faster growth rate in this land specie. The number of LAGs was higher in the stylopodial and zeugopodial bones, which would make these elements suitable for approximate age estimations. Pectoral and pelvic girdle bones also exhibited a good record of LAGs. The information here obtained on extant species represents a powerful tool for the interpretation of paleobiological traits present in closely related fossil forms.
Topics: Animals; Turtles; Cortical Bone; Tibia; Humerus; South America
PubMed: 36469456
DOI: 10.1002/ar.25131