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Aiello F. Development of a standardised method for the analysis of mechanisms and circumstances of injury in football (PhD Academy Award). Br J Sports Med 2024; 58:289-290. [PMID: 38050031 DOI: 10.1136/bjsports-2023-107644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Francesco Aiello
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
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Lefevre N, Kassab Hassan S, Valentin E, Bohu Y, Gerometta A, Meyer A, Grimaud O, Hardy A. Validation of the Parisian Hamstring Avulsion Score (PHAS) in the Evaluation and Follow-up of Patients Operated for Proximal Hamstring Avulsion. Am J Sports Med 2024; 52:1014-1021. [PMID: 38353118 PMCID: PMC10943598 DOI: 10.1177/03635465241227434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 12/06/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND No validated score is available for the prediction of return to sport (RTS) after proximal hamstring avulsion (PHA) surgery. PURPOSE To validate a new assessment tool for patients after PHA surgery: the Parisian Hamstring Avulsion Score (PHAS). STUDY DESIGN Cohort study (Diagnosis); Level of evidence, 3. METHODS All patients at our clinic who had surgery for PHA between January 2015 and March 2018 were included in this study. A suspected clinical diagnosis of PHA was confirmed by magnetic resonance imaging. PHA was repaired by surgical reinsertion with suture anchors. Minimum postoperative follow-up was 2 years, and the PHAS, University of California, Los Angeles (UCLA), score, and Tegner score were used. The PHAS is a patient-reported outcome measure, evaluating the effect of PHA injury with 9 items. It was validated by calculating its psychometric properties, and then correlation analysis was performed to determine the relationship between the PHAS, UCLA score, and Tegner score. Cutoff values for the prediction of RTS were determined. RESULTS A prospective case series study was performed. A total of 156 patients were included. Median age (first quartile; third quartile) was 54.2 years (44.7 years; 61.3 years), and the mean ± SD time of the final follow-up was 69 ± 11.6 months. Two years after surgery, 66.7% (n = 104) of patients were able to RTS. A strong correlation was noted between all 3 scores at 1 year postoperatively. Overall internal consistency was high, with a Cronbach alpha coefficient of 0.86. The intraclass correlation coefficient was 0.96, showing excellent reliability. The minimal detectable change was 12.9. No patients reached the maximum score at 2 years. Analysis of the receiver operating characteristic curves of the 3 scores at postoperative 9 months in relation to the RTS at 1 and 2 years showed area under the curve values of >0.7, indicating significant discriminant capacity for the RTS. A PHAS cutoff value of 86 at 9 months for the prediction of RTS at postoperative 1 year had a sensitivity of 65.6% (95% CI, 53.7%-77.5%) and a specificity of 81.4% (95% CI, 69.8%-93%). CONCLUSION PHAS is a valid and reliable tool for follow-up after PHA surgery. It also offers a simple way to predict RTS.
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Affiliation(s)
| | | | | | - Yoann Bohu
- Clinique du Sport Paris V, Paris, France
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3
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Hassid BV, Warrick AE, Ray JW. Hamstring Strain Ultrasound Case Series: Dominant Semitendinosus Injuries in National Collegiate Athletic Association Division I Athletes. J Athl Train 2024; 59:270-273. [PMID: 37655822 DOI: 10.4085/1062-6050-0064.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Authors of previous studies of patients with acute hamstring strains have reported injury to the biceps femoris and semitendinosus (ST) in 50% to 100% and 0% to 30%, respectively. This retrospective case series of hamstring injuries in National Collegiate Athletic Association Division I collegiate athletes exhibited an injury pattern on ultrasound imaging that differed from what would be expected based on prior literature. We examined ultrasound images of 38 athletes with acute hamstring strains for injury location (proximal muscle, proximal myotendinous junction, midportion of muscle, distal muscle) and affected muscles (biceps femoris, ST, or semimembranosus). Twenty-six athletes (68.4%) injured the ST, and 9 athletes (23.7%) injured the biceps femoris long head. Most athletes (23, 60.5%) injured the proximal portion of the muscle or myotendinous junction. Though this study had many limitations, we demonstrated more frequent involvement of the ST and less frequent involvement of the biceps femoris than reported in the literature.
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Affiliation(s)
- Brandon V Hassid
- Department of Physical Medicine and Rehabilitation, University of California Davis School of Medicine, Sacramento
| | - Alexandra E Warrick
- Department of Physical Medicine and Rehabilitation, University of California Davis School of Medicine, Sacramento
| | - Jeremiah W Ray
- Sports Medicine, Hoag Physician Partners, Foothill Ranch, CA
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4
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Lee S, Kim S, Yi J. Shape phenotype of thigh fat and muscle and risk of major adverse cardiovascular events after fragility hip fracture. J Cachexia Sarcopenia Muscle 2024; 15:331-341. [PMID: 38129313 PMCID: PMC10834328 DOI: 10.1002/jcsm.13407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Although sarcopenia has been recognized as a predictor of mortality in elderly patients with hip fracture, the association of thigh fat and muscle with cardiovascular (CV) outcome remains unclear. We examined the impact of computed tomography (CT)-derived shape features of thigh fat and muscle on major adverse CV events (MACE) in elderly patients with hip fracture. METHODS We conducted a retrospective analysis of consecutive patients aged ≥65 years who presented with hip fracture confirmed on pelvic bone CT scan and underwent hip fracture surgery at our institution from April 2019 to December 2021. The cross-sectional area (CSA) and compactness (CM) of both the muscle and fat at the upper-thigh level were calculated from two-dimensional CT images using AVIEW Research (v1.1.38, Coreline Soft, Co. Ltd, Seoul, South Korea). The shape features of thigh fat and muscle were categorized into four groups based on the combination of CSA and CM: fat CSA (fat area [FA])/fat CM (FCM), muscle CSA (muscle area [MA])/muscle CM (MCM), FA/MCM and MA/FCM. In each of them, subjects were categorized into four subgroups: high CSA/high CM, high CSA/low CM, low CSA/high CM and low CSA/low CM. The primary outcome was MACE after 30 days of surgery, defined as a composite of all-cause death, acute myocardial infarction, stroke or hospitalization for heart failure. RESULTS Of 356 patients enrolled (median age, 82 years; 76.7% females), 72 (20.2%) had MACE over a median follow-up of 13.1 months (ranges 5.9-21.0 months). Patients with MACE had a significantly lower median FA (193.7 vs. 226.2 cm2 , P < 0.0001) and FCM (0.443 vs. 0.513, P = 0.001) compared with those without MACE, but no significant differences were found in MA, MCM and FA-MA ratio between the two groups. In a multivariate Cox regression analysis, low FA (<240.1 cm2 ) (adjusted hazard ratio [HR] 2.99, 95% confidence interval [CI] 1.39-6.44, P = 0.005) and low FCM (<0.477) (adjusted HR 2.00, 95% CI 1.10-3.63, P = 0.023) were associated with an increased risk of MACE. Among the shape phenotypes of thigh fat and muscle, the thigh fat phenotype of low FA/low FCM (adjusted HR 3.13, 95% CI 1.81-5.42, P < 0.0001 [reference, high FA/high FCM]) was found to be an independent predictor of MACE. CONCLUSIONS In elderly patients with fragility hip fracture, thigh CT-derived measures of FA and FCM may provide useful prognostic information for predicting adverse CV outcomes.
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Affiliation(s)
- Sheen‐Woo Lee
- Department of RadiologyEunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of KoreaSeoulSouth Korea
| | - Seung‐Chan Kim
- Department of Orthopedic SurgeryEunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of KoreaSeoulSouth Korea
| | - Jeong‐Eun Yi
- Division of Cardiology, Department of Internal MedicineEunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea1021 Tongil‐ro, Eunpyeong‐guSeoul03312South Korea
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Yang S, Koo B, Lee S, Jang DJ, Shin H, Choi HJ, Kim Y. Determination of Gait Events and Temporal Gait Parameters for Persons with a Knee-Ankle-Foot Orthosis. Sensors (Basel) 2024; 24:964. [PMID: 38339681 PMCID: PMC10857118 DOI: 10.3390/s24030964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
Gait event detection is essential for controlling an orthosis and assessing the patient's gait. In this study, patients wearing an electromechanical (EM) knee-ankle-foot orthosis (KAFO) with a single IMU embedded in the thigh were subjected to gait event detection. The algorithm detected four essential gait events (initial contact (IC), toe off (TO), opposite initial contact (OIC), and opposite toe off (OTO)) and determined important temporal gait parameters such as stance/swing time, symmetry, and single/double limb support. These gait events were evaluated through gait experiments using four force plates on healthy adults and a hemiplegic patient who wore a one-way clutch KAFO and a pneumatic cylinder KAFO. Results showed that the smallest error in gait event detection was found at IC, and the largest error rate was observed at opposite toe off (OTO) with an error rate of -2.8 ± 1.5% in the patient group. Errors in OTO detection resulted in the largest error in determining the single limb support of the patient with an error of 5.0 ± 1.5%. The present study would be beneficial for the real-time continuous monitoring of gait events and temporal gait parameters for persons with an EM KAFO.
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Affiliation(s)
- Sumin Yang
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (S.Y.); (B.K.); (S.L.)
| | - Bummo Koo
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (S.Y.); (B.K.); (S.L.)
| | - Seunghee Lee
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (S.Y.); (B.K.); (S.L.)
| | - Dae-Jin Jang
- Korea Orthopedics and Rehabilitation Engineering Center, Incheon 21417, Republic of Korea; (D.-J.J.); (H.S.); (H.-J.C.)
| | - Hyunjun Shin
- Korea Orthopedics and Rehabilitation Engineering Center, Incheon 21417, Republic of Korea; (D.-J.J.); (H.S.); (H.-J.C.)
| | - Hyuk-Jae Choi
- Korea Orthopedics and Rehabilitation Engineering Center, Incheon 21417, Republic of Korea; (D.-J.J.); (H.S.); (H.-J.C.)
| | - Youngho Kim
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (S.Y.); (B.K.); (S.L.)
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Han K, Gevorkyan H, Sadik Shaik J, Crauwels H, Leemereise C, Bontempo G, Win B, Chounta V, Seal C, DeMoor R, D'Amico R, Spreen WR, Ford SL. Pharmacokinetics and tolerability of cabotegravir and rilpivirine long-acting intramuscular injections to the vastus lateralis (lateral thigh) muscles of healthy adult participants. Antimicrob Agents Chemother 2024; 68:e0078123. [PMID: 38038460 PMCID: PMC10777827 DOI: 10.1128/aac.00781-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/04/2023] [Indexed: 12/02/2023] Open
Abstract
Cabotegravir + rilpivirine administered via intramuscular gluteal injections is the first complete long-acting (LA) regimen approved for maintaining HIV-1 virologic suppression. The vastus lateralis (lateral) thigh muscle could be a potential alternative site of administration in circumstances such as injection site fatigue, intolerability, or contraindication for gluteal administration. Cabotegravir and rilpivirine pharmacokinetics and participant tolerability were evaluated following single intramuscular injections to the lateral thigh. Healthy adult participants received 4 weeks of daily oral cabotegravir (30 mg) and rilpivirine (25 mg), followed by a 10- to 14-day washout and single 3 mL intramuscular injections of cabotegravir LA 600 mg and rilpivirine LA 900 mg to the lateral thigh. Safety, tolerability, and pharmacokinetics were evaluated through 52 weeks post injection. Pharmacokinetic parameters were estimated using non-compartmental analysis. Fifteen participants (female at birth, n = 6) enrolled. Median age was 33 years. Median weight was 93.6 kg. Median body mass index was 31.4 kg/m2. One participant withdrew due to pregnancy after oral dosing before receiving an injection. Plasma concentrations at Weeks 4 and 8 were 15.4- and 5.3-fold above the protein-adjusted 90% inhibitory concentration for cabotegravir and 4.7- and 2.4-fold for rilpivirine, respectively. The most common injection site reactions were pain [28/28 (100%)], induration [15/28 (54%)], and swelling [12/28 (42%)]; 94% were Grade 1 or 2. Cabotegravir and rilpivirine plasma pharmacokinetic profiles observed in this study support further evaluation of thigh administration in target populations of people living with HIV-1. Tolerability of cabotegravir + rilpivirine LA intramuscular lateral thigh injections was similar to gluteal administration.
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Affiliation(s)
- Kelong Han
- Department of Clinical Pharmacology, Modeling & Simulation, GSK, Collegeville, Pennsylvania, USA
| | - Hakop Gevorkyan
- California Clinical Trials Medical Group in affiliation with PAREXEL, Glendale, California, USA
| | - Jafar Sadik Shaik
- Department of Clinical Pharmacology & Pharmacometrics, Janssen Research & Development, Spring House, Pennsylvania, USA
| | - Herta Crauwels
- Department of Clinical Pharmacology, Janssen Research & Development, Beerse, Belgium
| | | | | | | | | | | | | | | | | | - Susan L. Ford
- Department of Clinical Pharmacology, Modeling & Simulation, GSK, Durham, North Carolina, USA
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Miyamae M, Urabe R, Nakai K. Usefulness of perforating branches of the deep femoral artery and vein as recipient vessels during free-flap reconstruction for extensive defects of the thigh. J Surg Case Rep 2023; 2023:rjad683. [PMID: 38163057 PMCID: PMC10755091 DOI: 10.1093/jscr/rjad683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024] Open
Abstract
The perforating branches of the deep femoral artery and vein are considered useful recipient vessels during free-flap reconstruction for extensive defects extending from the knee to the mid-thigh or from the lateral to the posterior region of the thigh. Despite being located deep between the adductor longus and magnus muscles, they can be easily identified, allowing for a sufficient surgical field for the vascular anastomosis. Approximately four perforators from the deep femoral artery can be found on the posterior aspect of the thigh, easily identified by dissecting the semitendinosus and biceps femoris muscles. The calibre and length of the perforators were suitable for vascular anastomosis. In this study, we present three cases of free-flap reconstruction for extensive thigh defects using perforating branches of the deep femoral artery and vein as recipient vessels.
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Affiliation(s)
- Makoto Miyamae
- Department of Plastic and Reconstructive Surgery, University of Fukui Hospital, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
| | - Ryotaro Urabe
- Department of Plastic and Reconstructive Surgery, University of Fukui Hospital, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
| | - Kunihiro Nakai
- Department of Plastic and Reconstructive Surgery, University of Fukui Hospital, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
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Bilić M, Jaman J, Gorjanc B, Žic R. Massive dedifferentiated thigh liposarcoma growing for 10 years and extending into the retroperitoneum: a case report. Case Reports Plast Surg Hand Surg 2023; 10:2285051. [PMID: 38229695 PMCID: PMC10790800 DOI: 10.1080/23320885.2023.2285051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/13/2023] [Indexed: 01/18/2024]
Abstract
Liposarcomas are rare, malignant tumors of adipocyte differentiation. Surgery is the main treatment method. We are reporting a rare case of a 65- year- old female patient with a massive dedifferentiated thigh liposarcoma that was growing for 10 years and spread to the retroperitoneum.
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Affiliation(s)
- Miro Bilić
- Department of Plastic Surgery, University Hospital "Dubrava", Zagreb, Croatia
| | - Josip Jaman
- Department of Plastic Surgery, University Hospital "Dubrava", Zagreb, Croatia
| | - Božo Gorjanc
- Department of Plastic Surgery, University Hospital "Dubrava", Zagreb, Croatia
| | - Rado Žic
- Department of Plastic Surgery, University Hospital "Dubrava", Zagreb, Croatia
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Williamson S, Somach S. Firm smooth polypoid nodule within a skin graft. JAAD Case Rep 2023; 41:49-51. [PMID: 37842155 PMCID: PMC10568224 DOI: 10.1016/j.jdcr.2023.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Affiliation(s)
- Sarah Williamson
- Department of Dermatology, MetroHealth Medical Center, Cleveland, Ohio
| | - Stephen Somach
- Department of Dermatology, MetroHealth Medical Center, Cleveland, Ohio
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10
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Ipponi E, Di Lonardo M, Bechini E, Cordoni M, Cosseddu F, Capanna R, Andreani L. Giant atypical lipomatous tumors of the thigh: a case series. Acta Biomed 2023; 94:e2023202. [PMID: 37850775 PMCID: PMC10644927 DOI: 10.23750/abm.v94i5.14275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/07/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND AND AIM Atypical Lipomatous Tumors (ALTs) are low-grade locally aggressive soft tissue tumors. Deep large sized ALTs of the thigh can cause significant functional impairment due to their mass effect. Surgical resection, which is the treatment of choice for these lesions, can be a though procedure, especially if the neoplasm comes in proximity with noble structures such as large sized arteries or nerves. The aim of our study is to assess risks and effectiveness of surgical resection, evaluating complications, local recurrences and post-operative functionality. METHODS We evaluated all the giant ALT (larger diameter of 10 cm or more) of the thigh that received surgery in our institution between 2017 and 2022. Each patient's personal data and tumor size were evaluated. The quality of surgical margins was analyzed. MRI scans were performed both pre-operatively and during patients' follow-up. Lower limb's functional status was assessed using the MSTS score before and after surgery. Intra-operative and post-operative complications were recorded, as well as local recurrences. RESULTS Twentythree cases were included in our study. Tumors' mean major diameter was 19.1cm. The mean pre-operative MSTS score was 25.9. Only one case suffered from significant post-operative complications. Only 2 of our cases (8.7%) developed a local recurrence after surgery. The mean post-operative MSTS score was 29.1 Conclusions: A careful surgical resection can be effective in treating giant ALTs of the thigh in reason of good functional outcomes, low complications risks and reasonable local recurrence rates.
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Affiliation(s)
- Edoardo Ipponi
- University of Pisa - Department of Orthopaedics and Trauma surgery.
| | | | - Elena Bechini
- University of Pisa - Department of Orthopaedics and Trauma surgery.
| | - Martina Cordoni
- University of Pisa - Department of Orthopaedics and Trauma surgery.
| | - Fabio Cosseddu
- University of Pisa - Department of Orthopaedics and Trauma surgery.
| | - Rodolfo Capanna
- University of Pisa - Department of Orthopaedics and Trauma surgery.
| | - Lorenzo Andreani
- University of Pisa - Department of Orthopaedics and Trauma surgery.
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Limaiem F, Teborbi A, Bouzidi R. Primary giant hydatid cyst of the thigh: An unusual location. Clin Case Rep 2023; 11:e8056. [PMID: 37850058 PMCID: PMC10577154 DOI: 10.1002/ccr3.8056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/30/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023] Open
Abstract
Key Clinical Message Primary hydatid cyst of the thigh is a rare condition requiring prompt recognition and accurate diagnosis for timely management and prevention of complications. Abstract Muscular hydatid cysts are rare, with a frequency ranging from 1% to 5% even in endemic areas. The clinical presentation of muscular hydatidosis is typically subtle and lacks specific features, frequently resulting in delayed diagnosis. Herein, the authors describe a case of a primary hydatid cyst located in the thigh.
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Affiliation(s)
- Faten Limaiem
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
- Pathology DepartmentMongi Slim HospitalMarsaTunisia
| | - Anis Teborbi
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
- Department of Orthopedic SurgeryMongi Slim HospitalMarsaTunisia
| | - Ramzi Bouzidi
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
- Department of Orthopedic SurgeryMongi Slim HospitalMarsaTunisia
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12
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Matsui C, Escandón JM, Mohammad A, Tanaka T, Wynn ET, Mizuno H, Roche N. Clinical applications of the chimeric anterolateral thigh (ALT) flap in head and neck reconstruction. Acta Chir Belg 2023; 123:473-480. [PMID: 35499297 DOI: 10.1080/00015458.2022.2073016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/28/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Surgical site infection (SSI) is a common complication following head and neck surgery. Dead space at the excision site can increase the risk of infection, abscess formation, and mortality. Herein, we evaluated the performance of the chimeric anterolateral thigh (ALT) flap in addressing these concerns. METHODS Patients who underwent oncologic head and neck reconstruction between October 2016 and November 2021 were divided in two groups: a normal ALT flap and a chimeric dead space filling (DSF) ALT-vastus lateralis flap group. We evaluated the postoperative outcomes. RESULTS Twenty-five patients treated with normal ALT flaps (34.7%) and 47 with DSF ALT flap group (65.2%) were included. Only one ALT per case was necessary. Most of the cases involved tongue (31.9%) and lower gingival reconstruction (27.8%). The time to harvest the DSF ALT flap was 134.3 min when compared to the normal ALT flap (116.2 min, p < .001). Vascular occlusion, flap loss, partial necrosis, and fat necrosis were not observed among the different groups. CONCLUSION The DSF process can be used as a preventive measure for SSI or vessel exposure due to radiation-induced skin damage. This flap allows same-site reconstruction if the primary tumor recurs by using the pedicle of the chimeric flap for reattachment of another free flap.
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Affiliation(s)
- Chihiro Matsui
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Joseph M Escandón
- Division of Plastic and Reconstructive Surgery, University of Rochester Medical Center, Strong Memorial Hospital, New York, NY, USA
| | - Arbab Mohammad
- Aarupadai Veedu Medical College and Hospital, Puducherry, India
| | | | - Ei Thinzar Wynn
- Department of Plastic and Reconstructive Surgery, Countess of Chester Hospital NHS Foundation Trust, Chester, UK
| | - Hiroshi Mizuno
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Nathalie Roche
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium
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Fukumoto Y, Taniguchi M, Hirono T, Yagi M, Yamagata M, Nakai R, Yamada Y, Kimura M, Ichihashi N. Association of Regional Muscle Thickness and Echo Intensity with Muscle Volume, Intramuscular Adipose Tissue, and Strength of the Quadriceps Femoris. Clin Interv Aging 2023; 18:1513-1521. [PMID: 37724172 PMCID: PMC10505373 DOI: 10.2147/cia.s424504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023] Open
Abstract
Purpose This study aimed to investigate the association of muscle thickness (MT) and echo intensity (EI) obtained at different regions along the muscle length with muscle volume (MV), intramuscular adipose tissue (IntraMAT), and muscle strength of the quadriceps femoris (QF). Patients and Methods A total of 135 community-dwelling adults (64 men and 71 women) participated in the study. Ultrasound scanning of the rectus femoris (RF) and vastus intermedius (VI) was performed at three locations (from mid- to distal thigh). The MT of the RF and VI and EI of the RF were measured. MRI-derived MV, IntraMAT, and muscle strength of the QF were measured. Results The correlation between RF-MT and RF-MV weakened as scanning approached the distal thigh, and the difference between the coefficients for the scanning locations was significant for women. However, the correlation of VI-MT with VI-MV and that of the combined MT of RF and VI with the MV of the whole QF and muscle strength were comparable among the scanning locations for both sexes. The correlation of RF-EI with the IntraMAT of the RF and the whole QF and muscle strength was also comparable among the scanning locations for both sexes. Conclusion The results of this study suggest that ultrasound measurements at the distal thigh can predict MV, IntraMAT, and muscle strength of the QF to the same degree as those at the mid-thigh.
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Affiliation(s)
- Yoshihiro Fukumoto
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahide Yagi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Momoko Yamagata
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryusuke Nakai
- Kyoto University Institute for the Future of Human Society, Kyoto, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, Kameoka, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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14
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Khan A, AlSubaie R, Aljayban AA. Hydatid Cyst of the Thigh: A Report of a Rare Case With Literature Review. Cureus 2023; 15:e46040. [PMID: 37900365 PMCID: PMC10603306 DOI: 10.7759/cureus.46040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Hydatid cyst (HC) is a parasitic infection originating from the cestode of the Taeniidae family, predominantly occurring in the liver and lungs. Muscular involvement, however, remains a rarity. This report delineates the case of a 32-year-old female from Saudi Arabia presenting with a six-month history of an enlarging mass in her left thigh accompanied by significant localized pain. The clinical features were suggestive of an abscess, yet diagnostic imaging, specifically ultrasound, uncovered the presence of multiple daughter cysts within a primary lesion. MRI confirmed a well-defined encapsulated cystic mass. With an additional backdrop of a previously treated hepatic HC and living in proximity to a domestic cat, the clinical suspicion gravitated toward echinococcosis. Following surgical excision of the cystic lesion, histopathological examination confirmed the diagnosis of an infected HC. Postoperatively, the patient displayed an uneventful recovery with no recurrence or complications. This case underscores the diagnostic challenge posed by HC, especially in non-typical locations, and the pivotal role of imaging modalities in facilitating accurate diagnosis and subsequent management.
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Affiliation(s)
- Arshadullah Khan
- Surgical Oncology and Breast Oncoplasty, Al Ahsa Hospital, Al Hofuf, SAU
| | - Renad AlSubaie
- Medicine and Surgery, King Faisal University, Al Ahsa, SAU
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15
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Yedle R, Reniguntla MK, Puttaswamy R, Puttarangappa P, Hiremath S, Nanjundappa M, Jayaraman R. Neutropenic Rat Thigh Infection Model for Evaluation of the Pharmacokinetics/Pharmacodynamics of Anti-Infectives. Microbiol Spectr 2023; 11:e0013323. [PMID: 37260385 PMCID: PMC10433970 DOI: 10.1128/spectrum.00133-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/10/2023] [Indexed: 06/02/2023] Open
Abstract
The neutropenic mouse infection model is extensively used to characterize the pharmacokinetics/pharmacodynamics (PK/PD) of anti-infective agents. However, it is difficult to evaluate agents following intravenous (i.v.) infusions using this model. Furthermore, in many drug discovery programs, lead identification and optimization is performed in rats, and pharmacology is performed in mice. Alternative models of infection are needed for robust predictions of PK/PD in humans. The rat is an alternative model of infection which can overcome the shortcomings of the mouse model. However, the rat neutropenic thigh infection (NTI) model has not been adequately characterized for evaluation of the PK/PD of anti-infectives. The aim of this study was to characterize the PK/PD of ciprofloxacin against bacterial pathogens in a rat NTI model. We studied the PK/PD relationships of ciprofloxacin against wild-type Escherichia coli, Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae in neutropenic Wistar rats following administration of 10, 30, and 100 mg/kg as single intravenous boluses and 30- and 60-min infusions. The PK/PD of ciprofloxacin against all four pathogens was AUC/MIC dependent and independent of the duration of administration at 10, 30, and 100 mg/kg. At human-equivalent rat doses, the PK/PD targets of ciprofloxacin achieved in rats for microbiological cure were similar to those reported in human patients. The neutropenic rat thigh infection model can be used to evaluate anti-infective agents intended to be administered as infusions in the clinic, and it complements the mouse model, increasing the robustness of PK/PD predictions in humans. IMPORTANCE Many antibiotics are administered as intravenous infusions in the clinic, especially in intensive care units. Anti-infective drug discovery companies develop clinical candidates that are intended to be administered as i.v. infusions in the clinic. However, there are no well-characterized models with which they can evaluate the PK/PD of the candidates following i.v. infusions. The neutropenic rat thigh infection model reported in this study helps in evaluating anti-infective agents that are intended to be administered as i.v. infusions in the clinic. The rat model is useful for simulating the clinical conditions for i.v. infusions for treatment of infections, such as acute bacterial skin and skin structure, lung, and urinary tract infections. This model is predictive of efficacy in humans and can serve as an additional confirmatory model, along with the mouse model, for determining the proof of concept and for making robust predictions of efficacy in humans.
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Affiliation(s)
- Randhir Yedle
- TheraIndx Lifesciences Pvt. Ltd., Nelamangala, Bangalore, India
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16
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Mishra JK, Sahu SA, De M, Saha A. Pedicled anterolateral thigh flap: A versatile flap for complex regional defect reconstruction. GMS Interdiscip Plast Reconstr Surg DGPW 2023; 12:Doc04. [PMID: 37577728 PMCID: PMC10413255 DOI: 10.3205/iprs000174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Objectives Soft-tissue defects of the lower abdomen, perineum, groin, and trochanteric area often involve the loss of composite tissue components and are technically challenging to reconstruct. The goals of reconstruction should include the replacement of the defect with a suitable soft-tissue flap that provides stable coverage while protecting important exposed structures. However, there are limited locations in this region for the creation of pedicled flaps for complex defect reconstruction. The pedicled anterolateral thigh (ALT) flap is considered superior to other comparable flaps due to its varying soft-tissue components and long pedicle with consistent anatomy that allow the reconstruction of locations that are difficult to reach without significant flap donor site morbidity. Herein, we present a case series of our experience of using a pedicled ALT flap to reconstruct regional defects over a range of locations. Methods The present study comprised ten patients who underwent surgical reconstruction of soft-tissue defects of the lower abdomen, groin, trochanteric, scrotal, and penoscrotal defects using a pedicled ALT flap over a two-year period. The flap was customized according to the defect when required. Results In our case series, flap loss was not observed with only a few minor complications. All patients accepted the aesthetic appearance of the flap recipient site area without requesting revision surgery. The donor site was closed primarily in half of all cases, with split skin grafting applied in the remaining patients. Graft take at the flap donor site was satisfactory in all cases. Conclusion A pedicled ALT flap is a reliable and suitable option for complex soft-tissue reconstruction for regional soft-tissue defects of the lower abdomen and perineum.
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Affiliation(s)
- Jiten Kumar Mishra
- Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Raipur, India
| | - Shamendra Anand Sahu
- Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Raipur, India
| | - Moumita De
- Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Raipur, India
| | - Aparajita Saha
- Department of Burns & Plastic Surgery, All India Institute of Medical Sciences, Raipur, India
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17
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Cameron D, Reiter DA, Adelnia F, Ubaida-Mohien C, Bergeron CM, Choi S, Fishbein KW, Spencer RG, Ferrucci L. Age-related changes in human skeletal muscle microstructure and architecture assessed by diffusion-tensor magnetic resonance imaging and their association with muscle strength. Aging Cell 2023:e13851. [PMID: 37162031 PMCID: PMC10352548 DOI: 10.1111/acel.13851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 05/11/2023] Open
Abstract
Diffusion-tensor magnetic resonance imaging (DT-MRI) offers objective measures of muscle characteristics, providing insights into age-related changes. We used DT-MRI to probe skeletal muscle microstructure and architecture in a large healthy-aging cohort, with the aim of characterizing age-related differences and comparing these to muscle strength. We recruited 94 participants (43 female; median age = 56, range = 22-89 years) and measured microstructure parameters-fractional anisotropy (FA) and mean diffusivity (MD)-in 12 thigh muscles, and architecture parameters-pennation angle, fascicle length, fiber curvature, and physiological cross-sectional area (PCSA)-in the rectus femoris (RF) and biceps femoris longus (BFL). Knee extension and flexion torques were also measured for comparison to architecture measures. FA and MD were associated with age (β = 0.33, p = 0.001, R2 = 0.10; and β = -0.36, p < 0.001, R2 = 0.12), and FA was negatively associated with Type I fiber proportions from the literature (β = -0.70, p = 0.024, and R2 = 0.43). Pennation angle, fiber curvature, fascicle length, and PCSA were associated with age in the RF (β = -0.22, 0.26, -0.23, and -0.31, respectively; p < 0.05), while in the BFL only curvature and fascicle length were associated with age (β = 0.36, and -0.40, respectively; p < 0.001). In the RF, pennation angle and PCSA were associated with strength (β = 0.29, and 0.46, respectively; p < 0.01); in the BFL, only PCSA was associated with strength (β = 0.43; p < 0.001). Our results show skeletal muscle architectural changes with aging and intermuscular differences in the microstructure. DT-MRI may prove useful for elucidating muscle changes in the early stages of sarcopenia and monitoring interventions aimed at preventing age-associated microstructural changes in muscle that lead to functional impairment.
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Affiliation(s)
- Donnie Cameron
- Norwich Medical School, University of East Anglia, Norwich, UK
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - David A Reiter
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Fatemeh Adelnia
- Department of Radiology and Radiological Sciences, Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Tennessee, Nashville, USA
| | - Ceereena Ubaida-Mohien
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Christopher M Bergeron
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Seongjin Choi
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kenneth W Fishbein
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Richard G Spencer
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
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18
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Sutherland AMT, Lynch JT, Serpell BG, Pickering MR, Newman P, Perriman DM, Kenneally-Dabrowski C. Statistical shape modelling reveals differences in hamstring morphology between professional rugby players and sprinters. J Sports Sci 2023; 41:164-171. [PMID: 37074755 DOI: 10.1080/02640414.2023.2204269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Hamstring morphology may play an important role in understanding the aetiology of hamstring injury. Currently, the methods available to capture detailed morphological data such as muscle shape have not been utilized for the hamstring muscles. The aim of this study was to examine the utility of statistical shape modelling (SSM) for describing and comparing hamstring muscle shape in rugby and sprinting athletes. Magnetic resonance images of both thighs of nine elite male rugby players and nine track and field sprinters were analysed. Images were converted to three-dimensional models enabling generation of four statistical shape models. Principal components describing the shape variation in the cohort were derived and evaluated. Six principal components were sufficient to discriminate differences in the shape of the hamstring muscles of rugby and sprinting athletes with 89% classification accuracy. Distinct shape features distinguishing rugby players from sprinters included size, curvature and axial torsion. These data demonstrate that SSM is useful for understanding hamstring muscle shape and that meaningful variation can be identified within a small sample. This method can be used in future research to enhance the anatomical specificity of musculoskeletal modelling and to understand the relationship between hamstring shape and injury.
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Affiliation(s)
- Ashlee M T Sutherland
- Faculty of Health, Discipline of Physiotherapy, University of Canberra, Bruce, ACT, Australia
| | - Joseph T Lynch
- Medical School, Australian National University, Canberra, ACT, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Woden, ACT, Australia
| | - Benjamin G Serpell
- Football Department, Brumbies Rugby, Bruce, ACT, Australia
- Football Department, Geelong Football Club, Geelong, VIC, Australia
- School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Mark R Pickering
- School of Engineering and Information Technology, University of New South Wales at the Australian Defence Force Academy, Canberra, Australia
| | - Phil Newman
- Faculty of Health, Discipline of Physiotherapy, University of Canberra, Bruce, ACT, Australia
- University of Canberra Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, Australia
| | - Diana M Perriman
- Medical School, Australian National University, Canberra, ACT, Australia
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Woden, ACT, Australia
| | - Claire Kenneally-Dabrowski
- Medical School, Australian National University, Canberra, ACT, Australia
- Centre for Sports Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
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19
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Abdi Dezfouli R, Hosseinpour A, Qorbani M, Daneshzad E. The efficacy of topical aminophylline in local fat reduction: A systematic review. Front Endocrinol (Lausanne) 2023; 14:1087614. [PMID: 36875487 PMCID: PMC9978326 DOI: 10.3389/fendo.2023.1087614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023] Open
Abstract
Background and aims Some studies have reported that the topical forms with aminophylline as the active ingredient appear to be relatively effective on local fat burning while having no/minimal side effects. This systematic review accumulates all of the data on the local fat-burning potency of aminophylline topical formulation. Methods Documents were retrieved from PubMed, Web of Science, and Scopus databases until Aug 2022. Data were extracted from clinical trials reporting the reduction in thigh or waist circumference as a result of using topical forms containing aminophylline. Screening of included studies was performed independently by two authors and the quality assessment of included studies was performed based on the Cochrane Collaboration's approach. Results Of the 802 initial studies, 5 studies were included in the systematic review. Several concentrations of aminophylline were used in different studies. Most studies administred the topical formulation on participants' one thigh, and the other thigh was considered to be the control for comparing the fat reduction amount. Except for one study, all other studies reported that all participants lost more fat on the treated area than the control groups. The amount of fat reduction differed in studies regarding their different aminophylline concentrations and administration routines. In the case of side effects, except for some studies reporting skin rashes, other studies reported no significant side effects at all. Conclusions Aminophylline topical formulation offers a safe, effective, and much less invasive alternative to cosmetic surgery for localized fat reduction. It seems that the 0.5% concentration, administered five times a week for five weeks is the most potent concentration. However, more high-quality clinical trials are needed to verify this conclusion. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022353578.
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Affiliation(s)
- Ramin Abdi Dezfouli
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hosseinpour
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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20
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Mechó S, Balius R, Bossy M, Valle X, Pedret C, Ruiz-Cotorro Á, Rodas G. Isolated Adductor Magnus Injuries in Athletes: A Case Series. Orthop J Sports Med 2023; 11:23259671221138806. [PMID: 36698789 PMCID: PMC9869219 DOI: 10.1177/23259671221138806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 01/18/2023] Open
Abstract
Background Little is known about injuries to the adductor magnus (AM) muscle and how to manage them. Purpose To describe the injury mechanisms of the AM and its histoarchitecture, clinical characteristics, and imaging features in elite athletes. Study Design Case series; Level of evidence, 4. Methods A total of 11 competitive athletes with an AM injury were included in the study. Each case was clinically assessed, and the diagnosis and classification were made by magnetic resonance imaging (MRI) according to the British Athletics Muscle Injury Classification (BAMIC) and mechanism, location, grade, and reinjury (MLG-R) classification. A 1-year follow-up was performed, and return-to-play (RTP) time was recorded. Results Different mechanisms of injury were found; most of the athletes (10/11) had flexion and internal rotation of the hip with extension or slight flexion of the knee. Symptoms consisted of pain in the posteromedial (7/11) or medial (4/11) thigh during adduction and flexion of the knee. Clinically, there was a suspicion of an injury to the AM in only 3 athletes. According to MRI, 5 lesions were located in the ischiocondylar portion (3 in the proximal and 2 in the distal myoconnective junction) and 6 in the pubofemoral portion (4 in the distal and 2 in the proximal myoconnective junction). Most of the ischiocondylar lesions were myotendinous (3/5), and most of the pubofemoral lesions were myofascial (5/6). The BAMIC and MLG-R classification coincided in distinguishing injuries of moderate and mild severity. The management was nonoperative in all cases. The mean RTP time was 14 days (range, 0-35 days) and was longer in the ischiocondylar cases than in the pubofemoral cases (21 vs 8 days, respectively). Only 1 recurrence, at <10 months, was recorded. Conclusion Posteromedial thigh pain after an eccentric contraction during forced adduction of the thigh from hip internal rotation should raise a suspicion of AM lesions. The identification of the affected portion was possible on MRI. An injury in the ischiocondylar portion entailed a longer RTP time than an injury in the pubofemoral portion.
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Affiliation(s)
- Sandra Mechó
- Department of Radiology, Hospital of Barcelona, Barcelona, Spain.,Medical Department, Football Club Barcelona, Barcelona, Spain.,Department of Surgery and Orthopedics, Autonomous University of Barcelona, Barcelona, Spain.,Sandra Mechó, MD, Department of Radiology, Hospital of Barcelona, Avinguda Diagonal 660, 08034 Barcelona, Spain () (Twitter: @mechomeca)
| | - Ramon Balius
- Catalan Sports Council, Government of Catalonia, Barcelona, Spain
| | - Mireia Bossy
- Clínica Creu Blanca, Barcelona, Spain.,Sports Medicine and Imaging Department, Clínica Diagonal, Barcelona, Spain.,Quiron Hospital, Barcelona, Spain
| | - Xavier Valle
- Medical Department, Football Club Barcelona, Barcelona, Spain.,Department of Surgery and Orthopedics, Autonomous University of Barcelona, Barcelona, Spain.,Dexeus University Hospital, Barcelona, Spain
| | - Carles Pedret
- Sports Medicine and Imaging Department, Clínica Diagonal, Barcelona, Spain
| | - Ángel Ruiz-Cotorro
- Royal Spanish Tennis Federation, Barcelona, Spain.,Clínica Mapfre de Medicina del Tenis, Barcelona, Spain
| | - Gil Rodas
- Medical Department, Football Club Barcelona, Barcelona, Spain.,Barça Innovation Hub, Football Club Barcelona, Barcelona, Spain.,Sports Medicine Unit, Sant Joan de Déu Hospital, Barcelona, Spain
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21
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Maniar N, Carmichael DS, Hickey JT, Timmins RG, San Jose AJ, Dickson J, Opar D. Incidence and prevalence of hamstring injuries in field-based team sports: a systematic review and meta-analysis of 5952 injuries from over 7 million exposure hours. Br J Sports Med 2023; 57:109-116. [PMID: 36455927 DOI: 10.1136/bjsports-2021-104936] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE This study aimed to systematically review and meta-analyse the incidence and prevalence of hamstring injuries in field-based team sports. A secondary aim was to determine the impact of other potential effect moderators (match vs training; sport; playing surface; cohort age, mass and stature; and year when data was collected) on the incidence of hamstring injury in field-based team sports. DESIGN Systematic review and meta-analysis. DATA SOURCES CINAHL, Cochrane Library, MEDLINE Complete (EBSCO), Embase, Web of Science and SPORTDiscus databases were searched from database inception to 5 August 2020. ELIGIBILITY CRITERIA Prospective cohort studies that assessed the incidence of hamstring injuries in field-based team sports. METHOD Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against predefined criteria then assessed for methodological quality using the Critical Appraisal Tool for prevalence studies. Meta-analysis was used to pool data across studies, with meta-regression used where possible. RESULTS Sixty-three articles were included in the meta-analysis, encompassing 5952 injuries and 7 262 168 hours of exposure across six field-based team sports (soccer, rugby union, field hockey, Gaelic football, hurling and Australian football). Hamstring injury incidence was 0.81 per 1000 hours, representing 10% of all injuries. Prevalence for a 9-month period was 13%, increasing 1.13-fold for every additional month of observation (p=0.004). Hamstring injury incidence increased 6.4% for every 1 year of increased average cohort age, was 9.4-fold higher in match compared with training scenarios (p=0.003) and was 1.5-fold higher on grass compared with artificial turf surfaces (p<0.001). Hamstring injury incidence was not significantly moderated by average cohort mass (p=0.542) or stature (p=0.593), was not significantly different between sports (p=0.150) and has not significantly changed over the last 30 years (p=0.269). CONCLUSION Hamstring injury represents 10% of all injuries in field-based team sports, with 13% of the athletes experiencing a hamstring injury over a 9-month period most commonly during matches. More work is needed to reduce the incidence of hamstring injury in field-based team sports. PROSPERO REGISTRATION NUMBER CRD42020200022.
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Affiliation(s)
- Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia .,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | | | - Jack Thomas Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ryan Gregory Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Argell Joseph San Jose
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Jessica Dickson
- Library and Academic Research Services, Australian Catholic University, Melbourne, Victoria, Australia
| | - David Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
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22
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Xia H, Liu G, Wu A, Zhao R, Li S, Li S, Zhou Q, Zeng Z, Chen L, Li M. Intra-muscular extraskeletal myxoid chondrosarcoma of the thigh: a case report. Int J Clin Exp Pathol 2022; 15:476-479. [PMID: 36628074 PMCID: PMC9827227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/03/2022] [Indexed: 01/12/2023]
Abstract
Soft tissue sarcomas are mesenchymal tumors that account for about 1% of all malignancies. We retrospectively analyzed a rare case of a painful intra-muscular extraskeletal myxoid chondrosarcoma in the thigh of a 35-year-old man, that had undergone excision. Histological and immunohistochemical analysis of the mass revealed extraskeletal myxoid chondrosarcoma. The patient proceeded to radiotherapy and chemotherapy after curative surgery and had a good outcome.
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Affiliation(s)
- Hongli Xia
- Department of Vascular Surgery, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Guoli Liu
- Department of Vascular Surgery, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Ansen Wu
- Department of Vascular Surgery, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Rong Zhao
- Department of Vascular Surgery, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Shihuan Li
- School of Basic Medical Sciences, Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Suqin Li
- School of Basic Medical Sciences, Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Qiaofeng Zhou
- School of Basic Medical Sciences, Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Zhi Zeng
- Department of Pathology, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Ling Chen
- Department of Pathology, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
| | - Mincai Li
- Department of Vascular Surgery, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China,School of Basic Medical Sciences, Hubei University of Science and TechnologyXianning 437100, Hubei, P. R. China
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23
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Calabrese S, Innocenti M. Superthin Flap Harvesting Procedure: Technical Note. Arch Plast Surg 2022; 49:785-786. [PMCID: PMC9747285 DOI: 10.1055/s-0042-1758634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/18/2022] [Indexed: 12/15/2022] Open
Abstract
The anterolateral thigh (ALT) flap has been extensively discussed in the literature as it allows for a wide variety and depth of tissues for complex wound coverage. Thanks to many cadaveric and angiographic studies of the subdermal plexus, it is to date ascertained that tailoring ALT thickness can be safely performed without compromising flap outcomes or causing additional morbidity. Recently, the authors applied and described a simpler, safer, and less time-consuming superthin ALT perforator (ALTP) free flap harvesting technique. The aim of this article is to show the versatility of the adipofascial flap harvested around the chosen perforators, which allowed us to safely expand the usage of ALTP superthin flaps.
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Affiliation(s)
- Sara Calabrese
- Department of Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy,Address for correspondence Sara Calabrese, MD Department of Plastic and Reconstructive Microsurgery, Careggi Universital HospitalVia Taddeo Alderotti, 56 Florence, 50139Italy
| | - Marco Innocenti
- Department of Orthoplastic Surgery, Rizzoli Institute, Bologna, Italy
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24
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Wang R, Zhou J, Yu Y, Deng J, Wu Z, Ou C, Wu Y, Yang K, Wang J. Phosphaturic mesenchymal tumor in right thigh: 2 cases report and literature review. Clin Pathol 2022; 15:2632010X221129588. [PMID: 36313588 PMCID: PMC9597019 DOI: 10.1177/2632010x221129588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/12/2022] [Indexed: 11/15/2022]
Abstract
Background Phosphaturic mesenchymal tumor (PMT) is a very rare tumor of bone and soft tissue that has no specific clinical manifestations. Here we present 2 cases of PMT in the right thigh, including comparatively adequate immunohistochemistry. Case Presentation We described 2 cases of PMT in the right thigh with manifestations of hypophosphatemia. PET-CT examination showed that both patients had lesions with increased expression of somatostatin receptors in the right thigh. Bland cells and dirty calcified stroma were exhibited under the microscope. And immunohistochemical detection of FGF-23 was positive. Conclusions PMT is a very uncommon tumor for which diagnosis and treatment are often delayed. Considering the importance of surgery for the treatment of this disease, a full understanding of its clinicopathological features will facilitate the diagnosis of this disease.
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Affiliation(s)
- Ruifeng Wang
- Department of Pathology, Xiang-ya Hospital,
Central South University, Changsha City, Hunan Province, China,Department of Pathology, School of Basic
Medicine, Central South University, Changsha City, Hunan Province, China
| | - Jiayu Zhou
- Department of Pathology, Xiang-ya Hospital,
Central South University, Changsha City, Hunan Province, China,Department of Pathology, School of Basic
Medicine, Central South University, Changsha City, Hunan Province, China
| | - Yupei Yu
- Department of Pathology, Xiang-ya Hospital,
Central South University, Changsha City, Hunan Province, China,Department of Pathology, School of Basic
Medicine, Central South University, Changsha City, Hunan Province, China
| | - Junqi Deng
- Department of Pathology, Xiang-ya Hospital,
Central South University, Changsha City, Hunan Province, China,Department of Pathology, School of Basic
Medicine, Central South University, Changsha City, Hunan Province, China
| | - Ze Wu
- Department of Pathology, Xiang-ya Hospital,
Central South University, Changsha City, Hunan Province, China
| | - Chunlin Ou
- Department of Pathology, Xiang-ya Hospital,
Central South University, Changsha City, Hunan Province, China,Department of Pathology, School of Basic
Medicine, Central South University, Changsha City, Hunan Province, China,National Clinical Research Center for Geriatric
Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yanhao Wu
- Department of Respiratory Medicine, National Key
Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya
Hospital, Central South University, Changsha, Hunan, China
| | - Keda Yang
- Department of Pathology, Xiang-ya Hospital,
Central South University, Changsha City, Hunan Province, China,Department of Pathology, School of Basic
Medicine, Central South University, Changsha City, Hunan Province, China,Keda Yang, Department of Pathology, Xiangya Hospital,
Central South University, 87 Xiangya Road, Kaifu District, Changsha 410008, China.
| | - Junpu Wang
- Department of Pathology, Xiang-ya Hospital,
Central South University, Changsha City, Hunan Province, China,Department of Pathology, School of Basic
Medicine, Central South University, Changsha City, Hunan Province, China,National Clinical Research Center for Geriatric
Disorders, Xiangya Hospital, Central South University, Changsha, China,Key Laboratory of Hunan Province in
Neurodegenerative Disorders, Xiangya Hospital, Central South University, Changsha, Hunan,
China,Ultrapathology (Biomedical electron microscopy)
Center, Department of Pathology, Xiang-ya Hospital, Central South University, Changsha City,
Hunan Province, China,Junpu Wang, Department of Pathology, Xiangya Hospital,
Central South University, 87 Xiangya Road, Kaifu District, Changsha 410008, China.
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25
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John RS, Solanki JA, Kanna VES, Ram H. Conventional fibrotomy and reconstruction with lateral thigh dermal fat pad in grade III oral submucous fibrosis patients: A case report and review of literature. Natl J Maxillofac Surg 2022; 13:S166-S169. [PMID: 36393940 PMCID: PMC9651222 DOI: 10.4103/njms.njms_167_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 02/02/2021] [Accepted: 02/26/2021] [Indexed: 01/25/2023] Open
Abstract
Oral submucous fibrosis is a chronic debilitating premalignant condition with progressive stiffening of oral mucosa ultimately ending in trismus most commonly from substance abuse. The most common etiological factor is the consumption of areca nut. Patients usually report to us when the mouth opening is almost nil. Various grafts have been used in the reconstruction of buccal defects after fiberotomy, the most popular being the buccal fat pad. We present the case of a 34-year-old man presenting with the complaint of reduced mouth opening and burning sensation in the mouth for 8 months. The patient is a poor candidate for buccal fat grafting as the patient body type being ectomorphic. The patient had a stigma of scar in the abdomen; hence, the possibility of an abdominal fat graft was out of the equation. Therefore, dermal fat is was harvested from the lateral thigh and reconstructed into the defect. The patient had a favorable outcome with good healing. Further studies are required to assess the quality, microscopic features of the adipose tissue, and the fate of dermal fat from the anterolateral thigh region.
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Affiliation(s)
- Rubin S. John
- Department of Oral and Maxillofacial Surgery, King George Medical University, Lucknow, Uttar Pradesh, India,Address for correspondence: Dr. Rubin S. John, #702, Akash Ganga Tower, New Hyderabad Colony, Hassanganj, Lucknow - 226 007, Uttar Pradesh, India. E-mail:
| | - Jaykishan A. Solanki
- Department of Oral and Maxillofacial Surgery, King George Medical University, Lucknow, Uttar Pradesh, India
| | - V. E. Shanthosh Kanna
- Department of Oral and Maxillofacial Surgery, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Hari Ram
- Department of Oral and Maxillofacial Surgery, King George Medical University, Lucknow, Uttar Pradesh, India
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26
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Augustus S, Hudson PE, Smith N. Defining movement strategies in soccer instep kicking using the relationship between pelvis and kick leg rotations. Sports Biomech 2022:1-12. [PMID: 35903959 DOI: 10.1080/14763141.2022.2106297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 07/20/2022] [Indexed: 10/16/2022]
Abstract
Growing evidence suggests skilled ball kickers use distinct pelvis and kick leg strategies to achieve successful performance. However, since the interaction between different strategies remains unexplored, the aims of this study were to a) examine relationships between pelvis and kick leg rotations in male players performing soccer instep kicks and b) classify different 'types' of kickers based on the observed movement strategies. Twenty semi-professional players performed kicks for maximal speed and accuracy, and kick leg and pelvis kinematics were analysed using 3D motion capture (1000 Hz). A strong relationship was found between change in pelvis transverse angular velocity and thigh-knee angular velocity ratio upon ball contact (r = 0.76, p < 0.001), and participants were categorised by their location on kick leg (thigh-knee) and pelvis (maintainer-reverser) continuums. Knowledge of a player's preferred strategy can inform departure from 'one size fits all' technical and conditioning training practices towards more individualised approaches. For example, pelvis maintainer-thigh dominant kickers might benefit from focus towards the concentric capabilities of the hip flexors, whereas reverser-knee dominant kickers might benefit from developing the ability to decelerate the pelvis and thigh to induce motion-dependent angular acceleration of the lower leg towards the ball.
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Affiliation(s)
- Simon Augustus
- Department of Applied and Human Sciences, Kingston University, London, UK
| | - Penny E Hudson
- Chichester Institute of Sport, University of Chichester, West Sussex, UK
| | - Neal Smith
- Chichester Institute of Sport, University of Chichester, West Sussex, UK
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27
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Morinaga S, Takeuchi A, Yamamoto N, Hayashi K, Miwa S, Igarashi K, Yonezawa H, Asano Y, Saito S, Nojima T, Tsuchiya H. Compartment-specific Clinical Outcomes in Patients With Soft Tissue Sarcomas of the Thigh. Anticancer Res 2022; 42:3143-3150. [PMID: 35641265 DOI: 10.21873/anticanres.15803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/06/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The thigh is divided into the anterior, medial, and posterior compartments, and malignant soft tissue tumours can occur in any compartment of the thigh. This study analysed the relationship between various factors, particularly tumour location and clinical outcome, in patients with primary soft tissue sarcoma of the thigh. PATIENTS AND METHODS Seventy-four patients were included in this retrospective study. The relationships between variables and prognosis were statistically analysed. RESULTS Multivariate analysis of the patient clinical data demonstrated that seromas developed more often in the medial compartment tumours and postoperative complications excluding seroma occurred more frequently in patients with two or more muscles resected or stage III tumours. A low Musculoskeletal Tumor Society score was associated with a long operative time (more than 120 min), anterior compartment tumours, and more than two muscle resections. In addition, soft tissue sarcomas in the medial compartment and stage III sarcomas were associated with a low 5-year metastasis-free survival. CONCLUSION Soft tissue sarcomas in the medial compartment were associated with postoperative seroma and metastasis, whereas sarcomas in the anterior compartment correlated with low postoperative function.
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Affiliation(s)
- Sei Morinaga
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Akihiko Takeuchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan;
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kentaro Igarashi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Hirotaka Yonezawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Yohei Asano
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Shiro Saito
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Takayuki Nojima
- Department of Diagnostic Pathology, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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28
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Fares MY, Stewart K, McBride M, Maclean J. Lower limb injuries in an english professional football club: injury analysis and recommendations for prevention. PHYSICIAN SPORTSMED 2022; 51:260-268. [PMID: 35191360 DOI: 10.1080/00913847.2022.2045176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Lower limb injuries constitute a problem in the sport of football. Our aim is to explore patterns and trends of lower limb injuries in an English professional football club. METHODS This is a descriptive epidemiological study. Reports provided by the club's physical therapy team were screened for injuries among professional football players sustained over four seasons, from 2015/2016 to 2018/2019. Data included setting of injury (in-match or training), anatomical location of injury, type of injury, number of days off and month of injury. RESULTS A total of 296 lower limb injuries were recorded in our study, with a rate of 11.14 per 1000 football hours. Injury rate during games was 51.38 per 1000 football hours, significantly greater than that during training at 3.81 per 1000 football hours (p = 0.021). The thigh was significantly the most commonly injured location at 4.67 per 1000 football hours (p < 0.001). Grade I tears were the most common injury type at 1.73 per 1000 football hours, significantly greater than grade III tears (p = 0.027), contusions (p = 0.043), fractures (p = 0.02), and lacerations (p = 0.019). Injury rates were found to be greatest during preseason and declined as season progressed. On average, an injury sidelined the affected footballer for a total of 20 days. CONCLUSION Lower limb injuries were more common during matches than training. The thigh is the most common injury location, and grade I muscle tear was the most common type of injury. Injury rates were higher early on in the season. Potential prevention strategies include spacing out competition, adopting training and exercise regimens that cater for recovery, and increasing research regarding injury mechanisms.
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Affiliation(s)
- Mohamad Y Fares
- College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Katy Stewart
- College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland, UK.,Hampden Sports Clinic, Glasgow, Scotland, UK
| | | | - John Maclean
- College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland, UK.,Hampden Sports Clinic, Glasgow, Scotland, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK
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29
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Kaufman-Janette J, Katz BE, Vijayan S, Xiang Q, Kaminer MS. Evaluation of Five Collagenase Clostridium Histolyticum-aaes Injection Techniques For the Treatment of Cellulite on the Buttock or Thigh. J Cosmet Dermatol 2022; 21:1448-1453. [PMID: 35150194 PMCID: PMC9305772 DOI: 10.1111/jocd.14842] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/18/2022] [Accepted: 02/09/2022] [Indexed: 12/03/2022]
Abstract
Background Given differences in buttock versus thigh cellulite, collagenase clostridium histolyticum‐aaes (CCH‐aaes) injection technique may impact treatment effects at these sites. Aim To evaluate efficacy and safety of 5 CCH‐aaes injection techniques. Methods A phase 2A, open‐label trial enrolled women with mild‐to‐severe cellulite (Clinician Reported Photonumeric Cellulite Severity Scale) on both buttocks or thighs. CCH‐aaes 0.84 mg was administered as 12 injections in each of two buttock or two thigh treatment areas (total dose, 1.68 mg) during three treatment sessions (Days 1, 22, 43). On Day 1, women were sequentially assigned to: Technique A = shallow injection/3 aliquots; Technique B = shallow injection/1 aliquot; Technique C = deep injection/1 aliquot; Technique D = deep and shallow injections/5 aliquots; or Technique E = shallow injection/4 aliquots. Change from baseline in Hexsel Cellulite Severity Scale (CSS) depression depth (range, 0 [no depressions] to 3 [deep depressions]) was assessed at Day 71. Safety was evaluated via adverse events. Results Sixty‐three women with buttock (n = 31) or thigh (n = 32) cellulite received ≥1 CCH‐aaes dose. For buttock cellulite, CCH‐aaes injection Technique A resulted in the greatest baseline‐adjusted improvement in CSS score on Day 71 (least‐squares mean, 1.17‐point improvement). For thigh cellulite, CSS score improvement was greatest with Technique D (least‐squares mean, 1.40‐point improvement). CCH injection Techniques A, D, and E were associated with more favorable safety profiles than Techniques B and C. Conclusion Different CCH‐aaes injection techniques are required with buttock (Technique A) versus thigh (Technique D) cellulite to optimize treatment outcomes.
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Affiliation(s)
| | - Bruce E Katz
- dermatologist in private practice in New York, NY, USA
| | - Saji Vijayan
- Research and Development Strategy at Endo Pharmaceuticals Inc., Malvern, PA, USA
| | - Qinfang Xiang
- Biometrics at Endo Pharmaceuticals Inc., Malvern, PA, USA
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30
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Memarzadeh A, Morrison AP, Merzbach V, Ferrandino M, Arora A, Claydon-Mueller LS, Khanduja V. Validating the Cambridge Protocol: Reliability of Hip Muscle Strength Measurements Using a Motorized Dynamometer and Electromyography. Sports Health 2022; 14:740-746. [PMID: 35104417 PMCID: PMC9460091 DOI: 10.1177/19417381211056869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Muscle weakness is common after injury in athletes and in the presence of hip pathology. It will cause abnormal hip biomechanics and can predict future injury. However, objective measurement of hip muscle strength is difficult to perform accurately and reliably. Therefore, it is challenging to determine when an athlete has returned to preinjury levels of strength. In addition, there is currently no standardized method of obtaining measurements, which prevents the data being compared or shared between research centers. PURPOSE The purpose of this study is to comprehensively assess the inter- and intraobserver reliability of our standardized muscle strength measurement protocol. STUDY DESIGN Descriptive laboratory study. LEVEL OF EVIDENCE Level 3, inception cohort study. METHODS A total of 16 healthy male volunteers (age = 28.3 ± 7.9 years) were recruited. Those with a previous history of hip injuries or disorders were excluded. These volunteers underwent strength testing according to the Cambridge Protocol on 4 separate occasions, performed by 2 independent assessors. Maximal voluntary contractions, fatigue torque fluctuations, and electromyography measurements were recorded. Intra- and interobserver reliability was assessed using intraclass correlation coefficient (ICC). RESULTS Good-to-excellent correlation was seen for both intra- and interobserver reliability across almost all hip movements for maximal contractions: ICC ranged 0.78 to 0.93 and 0.78 to 0.96, respectively. The standard error of the mean for all hip movements was also extremely low at 2% to 3%. CONCLUSION The Cambridge Protocol is a highly reliable method for objective measurement of hip muscle strength. We recommend future studies use this protocol, or the principles underpinning it, to enable data sharing and comparison across different studies. CLINICAL RELEVANCE This is a description and analysis of hip muscle strength measurement. If widely used, it will allow for accurate and objective strength assessment and closer monitoring of hip injuries and pathology.
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Affiliation(s)
- Arman Memarzadeh
- Trauma and Orthopaedics, Nuffield
Orthopaedic Centre, Oxford, United Kingdom,Addenbrooke’s Hospital, Cambridge,
United Kingdom,Arman Memarzadeh, MBBS,
PGCME, Department of Orthopaedics, Addenbrooke’s Hospital, Cambridge, CB2 0QQ,
UK () (Twitter: @TheKneeDoc_)
| | - Andrew Paul Morrison
- Cambridge Centre for Sport and Exercise
Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Viviane Merzbach
- Cambridge Centre for Sport and Exercise
Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Michael Ferrandino
- Cambridge Centre for Sport and Exercise
Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Arvind Arora
- Department of Trauma and Orthopaedics,
Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Leica S. Claydon-Mueller
- Faculty of Health, Education, Medicine,
and Social Care, Anglia Ruskin University, Camridge, United Kingdom
| | - Vikas Khanduja
- Cambridge University Hospital &
Mobius Health, Cambridge Nuffield Hospital, Cambridge, United Kingdom
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Oda T, Malis V, Finni T, Kinugasa R, Sinha S. Dynamics of Quadriceps Muscles during Isometric Contractions: Velocity-Encoded Phase Contrast MRI Study. Diagnostics (Basel) 2021; 11:2280. [PMID: 34943517 DOI: 10.3390/diagnostics11122280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: To quantify the spatial heterogeneity of displacement during voluntary isometric contraction within and between the different compartments of the quadriceps. Methods: The thigh muscles of seven subjects were imaged on an MRI scanner while performing isometric knee extensions at 40% maximal voluntary contraction. A gated velocity-encoded phase contrast MRI sequence in axial orientations yielded tissue velocity-encoded dynamic images of the four different compartments of the thigh muscles (vastus lateralis (VL), vastus medialis (VM), vastus intermedius (VI), and rectus femoris (RF)) at three longitudinal locations of the proximal–distal length: 17.5% (proximal), 50% (middle), and 77.5% (distal). The displacement, which is the time integration of the measured velocity, was calculated along the three orthogonal axes using a tracking algorithm. Results: The displacement of the muscle tissues was clearly nonuniform within each axial section as well as between the three axial locations. The ensemble average of the magnitude of the total displacement as a synthetic vector of the X, Y, and Z displacements was significantly larger in the VM at the middle location (p < 0.01), and in the VI at the distal location than in the other three muscles. The ensemble average of Z-axis displacement, which was almost aligned with the line of action, was significantly larger in VI than in the other three muscles in all three locations. Displacements of more than 20 mm were observed around the central aponeuroses, such as those between VI and the other surrounding muscles. Conclusions: These results imply that the quadriceps muscles act as one functional unit in normal force generation through the central aponeuroses despite complex behavior in each of the muscles, each of which possesses different physiological characteristics and architectures.
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Tsuchie H, Miyakoshi N, Nagasawa H, Nanjo H, Shimada Y. Deep Angiomyxoma of the Thigh That Is Difficult to Diagnose: A Case Report and Literature Review. Acta Med Okayama 2021; 75:653-657. [PMID: 34703050 DOI: 10.18926/amo/62780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We present an extremely rare case of deep angiomyxoma (DAM) in the thigh that was misdiagnosed as desmoid-type fibromatosis. A 40-year-old Japanese woman presented with a mass on the left thigh. The histological diagnosis by needle biopsy was desmoid-type fibromatosis; the tumor grew slowly and was resected 4 years later. The histological diagnosis from the resected tumor was DAM. As of 16 months post-surgery, the patient has not noticed any local recurrence. Although DAM in a lower extremity is extremely rare, clinicians must be aware of its possible occurrence in areas relatively close to the pelvis.
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Affiliation(s)
- Hiroyuki Tsuchie
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine
| | - Hiroyuki Nagasawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine
| | - Hiroshi Nanjo
- Department of Pathology, Akita University Graduate School of Medicine
| | - Yoichi Shimada
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine
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Arumukhom Revi D, De Rossi SMM, Walsh CJ, Awad LN. Estimation of Walking Speed and Its Spatiotemporal Determinants Using a Single Inertial Sensor Worn on the Thigh: From Healthy to Hemiparetic Walking. Sensors (Basel) 2021; 21:6976. [PMID: 34770283 DOI: 10.3390/s21216976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022]
Abstract
We present the use of a single inertial measurement unit (IMU) worn on the thigh to produce stride-by-stride estimates of walking speed and its spatiotemporal determinants (i.e., stride time and stride length). Ten healthy and eight post-stroke individuals completed a 6-min walk test with an 18-camera motion capture system used for ground truth measurements. Subject-specific estimation models were trained to estimate walking speed using the polar radius extracted from phase portraits produced from the IMU-measured thigh angular position and velocity. Consecutive flexion peaks in the thigh angular position data were used to define each stride and compute stride times. Stride-by-stride estimates of walking speed and stride time were then used to compute stride length. In both the healthy and post-stroke cohorts, low error and high consistency were observed for the IMU estimates of walking speed (MAE < 0.035 m/s; ICC > 0.98), stride time (MAE < 30 ms; ICC > 0.97), and stride length (MAE < 0.037 m; ICC > 0.96). This study advances the use of a single wearable sensor to accurately estimate walking speed and its spatiotemporal determinants during both healthy and hemiparetic walking.
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34
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Zeltzer AA, Waked K, Brussaard C, Giunta G, De Baerdemaeker R, Hamdi M. Anatomic study of the profunda artery perforators by multidetector CT scanner and clinical use of the banana-shaped flap design for breast reconstruction. J Surg Oncol 2021; 125:123-133. [PMID: 34608998 DOI: 10.1002/jso.26703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The profunda artery perforator (PAP) flap is a well-known free flap for breast reconstruction. However, a reproducible perforator mapping system has yet to be developed. METHODS The PAP perforators were localized by CTA using a novel X-Y axis system. Flap dimensions were based on the CTA images and localized PAP-perforators. Perioperative findings and postoperative outcomes were analyzed. RESULTS A total of 70 lower limbs and 180 PAP perforators were evaluated. An average of 2.78 ± 1.22 and 2.22 ± 0.96 perforators were seen, in the right and left legs, respectively, and were divided in five clusters (PAP1-PAP5) based on their location on the Y-axis. The course of the perforators was noted as well as the average diameter at the origin. The overall average diameter was 1.99 ± 0.86 mm. A banana-shaped PAP-flap was harvested in 10 patients. The mean operative time was 278 min, pedicle length 76 ± 12 mm, and mean flap weight 247 g. No major complications were seen. CONCLUSION The PAP flap can be mapped by CTA in a reproducible way. The X and Y axes are based on fixed anatomic landmarks and may form the basis for a banana-shaped flap design of the PAP-flap.
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Affiliation(s)
- Assaf A Zeltzer
- Department of Plastic and Reconstructive Surgery, University Hospital Brussels (VUB), Brussels, Belgium
| | - Karl Waked
- Department of Plastic and Reconstructive Surgery, University Hospital Brussels (VUB), Brussels, Belgium
| | - Carola Brussaard
- Department of Radiology and Medical Imaging, University Hospital Brussels (VUB), Brussels, Belgium
| | - Gabriele Giunta
- Department of Plastic and Reconstructive Surgery, University Hospital Brussels (VUB), Brussels, Belgium
| | - Randy De Baerdemaeker
- Department of Plastic and Reconstructive Surgery, University Hospital Brussels (VUB), Brussels, Belgium
| | - Moustapha Hamdi
- Department of Plastic and Reconstructive Surgery, University Hospital Brussels (VUB), Brussels, Belgium
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35
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王 扬, 华 祖, 魏 鹏, 任 甜, 徐 毅, 徐 又. [Application of free-style perforator pedicled propeller flap to repair the wound after extensive resection of skin malignant tumor on the thigh]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021; 35:1177-1181. [PMID: 34523285 PMCID: PMC8444129 DOI: 10.7507/1002-1892.202104052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/07/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore the effectiveness of free-style perforator pedicled propeller flap to repair the wound after extensive resection of skin malignant tumor on the thigh. METHODS Between December 2016 and June 2019, 12 patients with skin malignant tumor on the thigh were treated. There were 9 males and 3 females, aged from 8 to 65 years (median, 38.5 years). The etiologies included basal cell carcinoma in 3 cases, squamous cell carcinoma in 7 cases, fibrosarcoma in 1 case, and malignant melanoma in 1 case. The disease duration ranged from 5 months to 10 years (median, 7.5 years). Color Doppler ultrasound was used to detect and mark at least one perforator vessel before operation. After extensive resection, the size of wound ranged from 5.0 cm×3.5 cm to 8.5 cm×6.5 cm. In the range of 1-3 cm from the edge of the lesion, the perforator vessels were explored again from the deep surface of the deep fascia to confirm and mark. The perforator vessel with diameter greater than 0.5 mm and closest to the edge of the lesion was taken as the rotation point of the flap. According to the wound size and shape, the free-style perforator pedicled propeller flap in size of 8.0 cm×3.5 cm to 12.5 cm×6.0 cm was designed. The wound was repaired with the big blade of the flap. The donor site was closed directly with the aid of the small blade. RESULTS The distal part of the skin flap was necrosis after operation, and healed after symptomatic treatment such as dressing change; the other flaps survived successfully and the wounds healed by first intention. All incisions at the donor site healed by first intention. All patients were followed up 5-24 months (mean, 10.2 months). During the follow-up, there was no recurrence of tumor. The flap had good elasticity and texture with no obvious swelling or scar hyperplasia, and the appearance was satisfactory; the hip and knee joint activities were normal. CONCLUSION Based on the extensive skin blood supply and abundant perforator vessels of the thigh, the free-style perforator pedicled propeller flap is an ideal flap for repairing small or medium wound after extensive resection of skin malignant tumor on the thigh.
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Affiliation(s)
- 扬剑 王
- 苏州大学附属第二医院骨科(江苏苏州 215004)Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215004, P.R.China
- 宁波市第一医院修复重建外科(浙江宁波 315010)Department of Reparative and Reconstructive Surgery, Ningbo First Hospital, Ningbo Zhejiang, 315010, P.R.China
| | - 祖广 华
- 苏州大学附属第二医院骨科(江苏苏州 215004)Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215004, P.R.China
| | - 鹏 魏
- 苏州大学附属第二医院骨科(江苏苏州 215004)Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215004, P.R.China
| | - 甜甜 任
- 苏州大学附属第二医院骨科(江苏苏州 215004)Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215004, P.R.China
| | - 毅 徐
- 苏州大学附属第二医院骨科(江苏苏州 215004)Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215004, P.R.China
| | - 又佳 徐
- 苏州大学附属第二医院骨科(江苏苏州 215004)Department of Orthopaedics, the Second Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215004, P.R.China
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Abstract
RATIONALE Follicular dendritic cell sarcoma (FDCS) is an intermediate-grade malignancy originating from follicular dendritic cells. Nodal FDCS is the most common type, meaning that the extranodal type may not be recognized and could be easily misdiagnosed. Reported extranodal sites include the head and neck, retroperitoneum, spleen, liver, and gastrointestinal tract. FDCS in the soft tissue is extremely rare. PATIENT CONCERNS A 75-year-old male presented with complaints of a localized swelling and intra-muscular soft tissue mass in the left upper thigh. DIAGNOSIS The present tumor consisted of fascicular or vague storiform-arranged spindle cells with less pleomorphism and many lymphoid aggregates. Tumor cells were positive for CD21, CD35, CD68, vimentin, and EGFR. Intra-muscular FDCS was confirmed by immunohistochemical studies. INTERVENTIONS The patient received a wide marginal excision, followed by adjuvant radiotherapy. OUTCOMES Symptomatic improvements were achieved and no subsequent relapses were observed. LESSONS If the tumor arises in the extranodal sites, especially in the soft tissue, it is difficult to include FDCS in the differential diagnosis. When the immunoprofile is not consistent with that of common spindle cell tumors, immunostaining for follicular dendritic cell markers such as CD21, CD23, and CD35, as well as further immunohistochemistry for D2-40, CD68, EGFR, Epstein-Barr virus, and BRAF can be helpful for the diagnosis and subtyping of FDCS. To the best of our knowledge, the present case is the first case of intramuscular FDCS.
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Affiliation(s)
- Yong Jin Cho
- Department of Orthopedic Surgery, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Song Iy Han
- Division of Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Sung-Chul Lim
- Department of Pathology, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Lee SH, Kim HY. Comparison of Quality and Sensory Characteristics of Spent Hen and Broiler in South Korea. Animals (Basel) 2021; 11:2565. [PMID: 34573531 DOI: 10.3390/ani11092565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022] Open
Abstract
This study was conducted to compare the quality and sensory characteristics of spent hen and broiler in South Korea. The carcasses of spent hens and broilers that had been slaughtered 24 h before were used. The cooking yield and water holding capacity of broiler was significantly higher than that of spent hen (p < 0.05). The pH of broiler thigh was significantly higher than that of the other treatments (p < 0.05), while on the other hand spent hen breast had a lower value than other treatments (p < 0.05). The redness of the thigh of both types was more than that of the breast (p < 0.05). In contrast, the yellowness of the breast of the two types was more than that of the thigh of both types. The changes in organoleptic characteristics of broiler was higher than that of spent hen, and the aroma patterns detected using the electronic nose were markedly different in terms of the type of meat. Spent hens are generally considered to have lower consumption rates than broilers because they have a lower taste and aroma. Therefore, the results of this study suggest that processing or additives are required in the distribution method of spent hens.
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Torğutalp ŞŞ, Özkan Ö, Parlak Ş, Oğuz KK, Korkusuz F. Volume and T2 relaxation time measurements of quadriceps femoris and hamstring muscles are reliable and reproducible. Turk J Med Sci 2021; 51:2007-2014. [PMID: 34118802 PMCID: PMC8569770 DOI: 10.3906/sag-2101-49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/12/2021] [Indexed: 11/04/2022] Open
Abstract
Background/aim Volume and T2 relaxation time measurements of the skeletal muscle provide quantitative information. We aimed to evaluate the interobserver reliability and the intraobserver reproducibility of measurements of volumes and T2 relaxation times of the quadriceps femoris and the hamstring muscles. Materials and methods A cross-sectional reliability study was conducted on ten recreational athletes. The images of the quadriceps and the hamstring muscles of both limbs were obtained using a 3.0 Tesla magnetic resonance imaging (MRI) scanner. Two sports medicine specialists measured muscle volumes from a total of 2560 images and T2 relaxation times from a total of 40 images, and repeated this once more. The intraobserver and interobserver compliance were assessed by the intraclass correlation coefficient (ICC) and Cronbach’s alpha (α). Results Volume and T2 relaxation time of quadriceps femoris and hamstring muscle measurements with MRI had good to excellent reliability (Muscle volume; intraobserver ICCs: between 0.97 and 0.99, α: between 0.98 and 0.99 and interobserver ICCs: between 0.96 and 0.99, α: 0.99. T2 relaxation time; intraobserver ICCs: between 0.74 and 0.96, α: between 0.85 and 0.98 and interobserver ICCs: between 0.75 and 0.90, α: between 0.85 and 0.95). Conclusion Volume and T2 relaxation time measurements of the quadriceps femoris and the hamstring muscles are reliable and reproducible.
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Affiliation(s)
- Şerife Şeyma Torğutalp
- Clinic of Sports Medicine, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Ömer Özkan
- Department of Sports Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Şafak Parlak
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kader Karlı Oğuz
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Feza Korkusuz
- Department of Sports Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Pirri C, Fede C, Petrelli L, Guidolin D, Fan C, De Caro R, Stecco C. Elastic Fibres in the subcutaneous tissue: Is there a difference between superficial and muscular fascia? A cadaver study. Skin Res Technol 2021; 28:21-27. [PMID: 34420234 PMCID: PMC9907621 DOI: 10.1111/srt.13084] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/31/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND In last years the role of fascia in proprioception and pain has been confirmed in numerous papers, but the real structure of fasciae is not still entirely known. To date, many studies have evaluated the elastic fibres in arteries, ligaments, lungs, epidermis and dermis, but only two studies exist about the elastic fibres in the fasciae, and they did not distinguish between superficial (in the subcutaneous tissue) and deep/muscular fasciae. The aim of the study was to assess the percentage of elastic fibres between superficial and deep fascia. MATERIALS AND METHODS Three full thickness specimens (proximal, middle and distal respectively) were taken from each of four regions of the thigh of three non-embalmed cadavers: the anterior (Ant), the lateral (Lat), the posterior (Post) and the medial (Med) aspect. Thus, a total of 12 specimens were collected from each analysed thigh and histological Weigert Van Gieson stains was performed. Three sections per specimen were considered for the morphometric analysis. RESULTS In all the specimens the superficial and deep fasciae were clearly recognizable. The difference in percentage of elastic fibres between superficial and deep fasciae in same region for all four was highly significant (p < 0.001). They are abundant in the superficial fascia than deep fascia. CONCLUSIONS In the light of these findings is evident that the superficial (in the subcutaneous tissue) and deep fasciae have different elasticity. This difference may improve grading of fascial dysfunction in dermatological diseases as burns, scars and lymphedema to better plan treatments.
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Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Caterina Fede
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Lucia Petrelli
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Diego Guidolin
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Chenglei Fan
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
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Gadermayr M, Heckmann L, Li K, Bähr F, Müller M, Truhn D, Merhof D, Gess B. Image-to-Image Translation for Simplified MRI Muscle Segmentation. Front Radiol 2021; 1:664444. [PMID: 37492182 PMCID: PMC10365001 DOI: 10.3389/fradi.2021.664444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/30/2021] [Indexed: 07/27/2023]
Abstract
Deep neural networks recently showed high performance and gained popularity in the field of radiology. However, the fact that large amounts of labeled data are required for training these architectures inhibits practical applications. We take advantage of an unpaired image-to-image translation approach in combination with a novel domain specific loss formulation to create an "easier-to-segment" intermediate image representation without requiring any label data. The requirement here is that the task can be translated from a hard to a related but simplified task for which unlabeled data are available. In the experimental evaluation, we investigate fully automated approaches for segmentation of pathological muscle tissue in T1-weighted magnetic resonance (MR) images of human thighs. The results show clearly improved performance in case of supervised segmentation techniques. Even more impressively, we obtain similar results with a basic completely unsupervised segmentation approach.
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Affiliation(s)
- Michael Gadermayr
- Department of Information Technology and Systems Management, Salzburg University of Applied Sciences, Salzburg, Austria
- Institute of Imaging & Computer Vision, RWTH Aachen University, Aachen, Germany
| | - Lotte Heckmann
- Institute of Imaging & Computer Vision, RWTH Aachen University, Aachen, Germany
| | - Kexin Li
- Institute of Imaging & Computer Vision, RWTH Aachen University, Aachen, Germany
| | - Friederike Bähr
- Department of Neurology, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Madlaine Müller
- Department of Neurology, RWTH Aachen, University Hospital Aachen, Aachen, Germany
- Department of Neurology, Inselspital Bern, Bern, Switzerland
| | - Daniel Truhn
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany
| | - Dorit Merhof
- Institute of Imaging & Computer Vision, RWTH Aachen University, Aachen, Germany
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Burkhard Gess
- Department of Neurology, RWTH Aachen, University Hospital Aachen, Aachen, Germany
- Department of Neurology, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Bielefeld, Germany
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Taniguchi M, Hirono T, Nakayama T, Kobayashi K, Ichihashi N. Assessment of Edematous Changes Using Three-Dimensional Body Scanning and Segmental-Bioelectrical Impedance Spectroscopy. Lymphat Res Biol 2021; 19:524-530. [PMID: 33605789 DOI: 10.1089/lrb.2020.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The primary purpose of this study was to clarify the occurrence of sites of edematous changes using the measured circumferences of the thigh and lower leg via three-dimensional (3D) body scanning. The secondary purpose was to determine the relationship between the volume changes using 3D body scanning and the resistance changes as indicator of extracellular water (ECW) via segmental-bioelectrical impedance spectroscopy (S-BIS). Methods and Results: Fifteen healthy women participated. Limb circumferences were measured using 3D body scanning at 10% intervals between 50% and 80% in the thigh circumference and between 0% and 80% in the lower leg circumference. The resistance of the ECW component (RECW) and total body water (RTBW) was measured using S-BIS in the thigh and lower leg segments. These measurements were conducted at baseline and 6 hours postobservation. A paired t-test was conducted for the differences in these parameters, and the effect sizes (ESs) were calculated using Cohen's d. Correlations between changes in segmental volume and RECW were analyzed. Measurement-site circumferences and segmental volume significantly increased in the lower leg at postobservation but not in the thigh. The ES of circumference changes in the lower leg's central region were larger (ESs were 0.40-0.71 at 30%-50%) than in other regions. A significant correlation was observed between changes in segmental volume and RECW of the lower leg (ρ = -0.79, p < 0.001). Conclusions: Assessing the circumference using 3D body scanning, we found the edematous changes to be significant in the lower leg's central regions. Moreover, volumetry using 3D body scanning can detect edematous change in the lower leg.
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Affiliation(s)
- Masashi Taniguchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tetsuya Hirono
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Kotono Kobayashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Abstract
Compartment syndrome is a medical emergency and must be considered in patients who present with severe limb pain. Compartment syndrome is a clinical diagnosis, classically described as presenting with the 5 'P's (pain, pulselessness, pallor, paraesthesia, and paralysis). Apart from pain, the other findings signify acute arterial obstruction and would be late findings. We present a case of a 31-year-old male in which point of care ultrasound (POCUS) expedited this diagnosis by demonstrating a large thigh hematoma in the anterior compartment. This prompted emergent orthopedic surgery consultation, and the diagnosis of compartment syndrome was confirmed both at the bedside and in the operating room. Compartment syndrome can be a challenging diagnosis, especially early in the course of illness. While POCUS should not be used in isolation in the assessment of possible compartment syndrome, it can be used as an adjunct in the workup, especially if it identifies an underlying cause.
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Affiliation(s)
- Neil Long
- Department of Emergency Medicine, Burnaby General Hospital Burnaby, British Columbia Canada.,Department of Emergency Medicine, University of British Columbia Vancouver , British Columbia Canada
| | - Justin S Ahn
- Department of Emergency Medicine, University of British Columbia Vancouver , British Columbia Canada.,Department of Emergency Medicine, Royal Columbian Hospital New Westminster, British Columbia Canada
| | - Daniel J Kim
- Department of Emergency Medicine, University of British Columbia Vancouver , British Columbia Canada.,Department of Emergency Medicine, Vancouver General Hospital Vancouver , British Columbia Canada
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Ozturk M, Ayhan E, An I, Akman Ilik Z, Kaya Ş. Premature or nevoid sebaceous hyperplasia? Two case reports of a rare disease. J Cosmet Dermatol 2020; 20:835-837. [PMID: 33369053 DOI: 10.1111/jocd.13906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/31/2020] [Accepted: 12/10/2020] [Indexed: 11/28/2022]
Abstract
Early or familial cases of sebaceous hyperplasia (SH) with multiple lesions, thought to be associated with genetic predisposition, have been reported in young individuals. Rarely reported variants include the giant, diffuse, zosteriform, and/or linear (nevoid) form. However, premature SH, defined as benign proliferation of sebaceous glands that occurs during or after puberty, is histologically similar to SH. Whether the definitions of nevoid SH or premature SH are the same remains unclear. We report two sporadic cases of premature SH.
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Affiliation(s)
- Murat Ozturk
- Department of Dermatology, Van Training and Research Hospital, University of Health Sciences, Van, Turkey
| | - Erhan Ayhan
- Department of Dermatology, Gazi Yaşargil Training and Research Hospital, University of Health Sciences, Diyarbakır, Turkey
| | - Isa An
- Department of Dermatology, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Zehra Akman Ilik
- Department of Pathology, Van Training and Research Hospital, University of Health Sciences, Van, Turkey
| | - Şeyhmus Kaya
- Department of Pathology, University of Health Sciences Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
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Zhu L, Jiang R, Kong X, Wang X, Pei L, Deng Q, Li X. Effects of various catheter fix sites on catheter-associated lower urinary tract symptoms. Exp Ther Med 2020; 21:47. [PMID: 33273975 DOI: 10.3892/etm.2020.9478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/17/2020] [Indexed: 11/05/2022] Open
Abstract
The present study aimed to compare the effects of various catheter fix sites on catheter-associated lower urinary tract symptoms (CALUTS) in 450 patients who underwent surgical removal of upper urinary calculi 24 h earlier. All patients had 16 French Foley catheters inserted and the balloons were filled. In group A, the catheters were fixed on the top one-third of the thigh. In group B, the catheters were fixed on the abdominal wall. Patients in whom the catheters were neither fixed on the thigh nor abdominal wall were designated as controls. There were 150 patients in each group. CALUTS, such as frequency, urgency, burning during micturition, odynuria, bladder pain and other symptoms, including urethral discharge, a red and swollen external urethral orifice, catheter traction or blockage and catheter-associated discomfort were recorded. Patients in group A compared with the control group had a significantly lower incidence of frequency, urgency, odynuria, urethral discharge, catheter traction and catheter-associated discomfort (P<0.05). Patients in group B were observed to have a significantly lower incidence of urgency, urethral discharge, catheter traction and catheter-associated discomfort compared with the control group (P<0.05), but a higher incidence of odynuria, urethral pain, urethral discharge and a red and swollen external urethral orifice compared with group A (P<0.05). An additional catheter fixation site for bedridden patients was necessary and an additional fix site on the thigh was preferred to the abdominal wall, which may further reduce catheter-associated lower urinary tract symptoms.
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Affiliation(s)
- Likun Zhu
- Department of Urology Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.,Sichuan Clinical Medical Research Center for Nephropathy, Luzhou, Sichuan 646000, P.R. China
| | - Rui Jiang
- Department of Urology Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.,Sichuan Clinical Medical Research Center for Nephropathy, Luzhou, Sichuan 646000, P.R. China
| | - Xiangjun Kong
- Department of Urology Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.,Sichuan Clinical Medical Research Center for Nephropathy, Luzhou, Sichuan 646000, P.R. China
| | - Xinwei Wang
- Department of Urology Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.,Sichuan Clinical Medical Research Center for Nephropathy, Luzhou, Sichuan 646000, P.R. China
| | - Lijun Pei
- Department of Urology Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.,Sichuan Clinical Medical Research Center for Nephropathy, Luzhou, Sichuan 646000, P.R. China
| | - Qingfu Deng
- Department of Urology Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.,Sichuan Clinical Medical Research Center for Nephropathy, Luzhou, Sichuan 646000, P.R. China
| | - Xu Li
- Department of Urology Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.,Sichuan Clinical Medical Research Center for Nephropathy, Luzhou, Sichuan 646000, P.R. China
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Pasic N, Burkhart TA, Baha P, Ayeni OR, Getgood A, Degen RM. A Biomechanical Comparison of 2 Hip Capsular Reconstruction Techniques: Iliotibial Band Autograft Versus Achilles Tendon Allograft. Am J Sports Med 2020; 48:3288-3295. [PMID: 33044838 DOI: 10.1177/0363546520962071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Several techniques for hip capsular reconstruction have been described to address gross instability or microinstability due to capsular deficiency. However, objective biomechanical data to support their use are lacking. PURPOSE To compare the kinematic effect of 2 capsular reconstruction techniques (iliotibial band [ITB] graft and Achilles tendon graft). Kinematic effect encompassed rotational range of motion (ROM) as well as joint translation in the coronal, sagittal, and axial planes. STUDY DESIGN Controlled laboratory study. METHODS 8 paired, fresh-frozen hemi-pelvises (16 hips) were tested on a custom-designed joint motion simulator in the intact state and after capsulectomy. Pairs were randomly allocated to either ITB or Achilles reconstruction and retested. Testing was performed at 0°, 45°, and 90° of flexion. Internal-external rotation (IR-ER) torques and abduction-adduction torques of 3 N·m were applied to the femur via a load cell at each position, and rotational ROM and joint translation in the coronal, sagittal, and axial planes were recorded. RESULTS At 45° and 90°, there was a significant effect of the condition of the hip on the total IR-ER (P = .004, effect size [ES] = 0.305; and P < .001, ES = 0.497; respectively). At 45°, mean ± SD total rotation was significantly greater for the capsulectomy (59.7°± 15.9°) state compared with intact (53.3°± 13.2°; P = .007). At 90°, reconstruction significantly decreased total rotation to 49.0°± 18.9° compared with a mean total rotation of 52.8°± 18.7° after capsulectomy (P = .02). No difference was seen in the total abduction-adduction of the hip between conditions. Comparisons of the 2 different reconstruction techniques showed no significant differences in total IR-ER or abduction-adduction ROM or joint translation in the coronal, sagittal, or axial planes. For translation, at both 0° and 45° there was a statistically significant effect of the condition on the medial-lateral translation (P = .033; ES = 0.204). Reconstruction, independent of technique, was successful in significantly decreasing (P = .030; P = .014) the mean medial-lateral translation at 0° and 45° of hip flexion from 5.2 ± 3.8 mm and 5.6 ± 4.0 mm to 2.8 ± 1.9 mm and 3.9 ± 3.2 mm, respectively. CONCLUSION The integrity of the native hip capsule played a significant role in rotational stability, where capsulectomy significantly increased rotational ROM. Both ITB and Achilles reconstruction techniques restored normal rotational ROM of the hip at 90° of flexion as well as coronal plane stability at 0° and 45° of hip flexion. No differences were seen between ITB and Achilles reconstruction techniques. CLINICAL RELEVANCE Both capsular reconstruction techniques provide comparable joint kinematics, restoring rotation and translation to normal values with the exception of rotational ROM at 45°, which remained significantly greater than the intact state. The most significant results were the rotational stability at 90° of hip flexion and coronal plane stability at 0° and 45° of hip flexion, which were significantly improved compared with the capsulectomy state.
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Affiliation(s)
- Nicholas Pasic
- Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
| | - Timothy A Burkhart
- Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada.,Department of Mechanical and Materials Engineering, Western University, London, Ontario, Canada.,School of Kinesiology, Western University, London, Ontario, Canada
| | - Pardis Baha
- School of Kinesiology, Western University, London, Ontario, Canada
| | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Alan Getgood
- Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
| | - Ryan M Degen
- Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
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Morris RJ, Ridgway BS, Woodcock JP. The use of intermittent pneumatic compression of the thigh to affect arterial and venous blood flow proximal to a chronic wound site. Int Wound J 2020; 17:1483-1489. [PMID: 32558254 PMCID: PMC7540542 DOI: 10.1111/iwj.13418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022] Open
Abstract
Intermittent pneumatic compression of the lower limbs has been shown to have beneficial effects in patients with chronic ulceration. However, the intermittent compression cuff will normally be applied over the wound, which may produce discomfort or interfere with other treatments. Thigh-only approaches to intermittent pneumatic compression could solve this problem. This study aimed to demonstrate if such a system would have positive effects on venous and arterial blood flow distal to the compression site, but proximal to wound sites. The distal venous and arterial effects of a prototype thigh-only 3-chamber sequential intermittent pneumatic compression system were tested in 20 healthy volunteers, and 13 patients with ulcers of various aetiologies using Doppler ultrasound. The system produced hyperaemic responses in the arterial flow of both test groups. The peak venous velocity on deflation of the first and second chambers of the cuff was also greater in the patients with ulceration than in the healthy volunteers (11.6 cm/s vs 8.3 cm/s, P = .1). This work demonstrates that compression of the thigh alone can produce positive haemodynamic effects in the calves of patients with chronic wounds, and that this approach should be investigated as a therapy to improve blood flow to wound sites.
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Affiliation(s)
- Rhys John Morris
- Department of Medical Physics and Clinical EngineeringUniversity Hospital of WalesCardiffUK
| | - Bethan Sarah Ridgway
- Department of Medical Physics and Clinical EngineeringUniversity Hospital of WalesCardiffUK
| | - John Patrick Woodcock
- Department of Medical Physics and Clinical EngineeringUniversity Hospital of WalesCardiffUK
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Dooley K, Snodgrass SJ, Stanwell P, Birse S, Schultz A, Drew MK, Edwards S. Spatial muscle activation patterns during different leg exercise protocols in physically active adults using muscle functional MRI: a systematic review. J Appl Physiol (1985) 2020; 129:934-946. [PMID: 32853111 DOI: 10.1152/japplphysiol.00290.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An emerging method to measure muscle activation patterns is muscle functional magnetic resonance imaging (mfMRI), where preexercise and postexercise muscle metabolism differences indicate spatial muscle activation patterns. We evaluated studies employing mfMRI to determine activation patterns of lumbar or lower limb muscles following exercise in physically active adults. Electronic systematic searches were conducted until March 2020. All studies employing ≥1.5 Tesla MRI scanners to compare spatial muscle activation patterns at the level of or inferior to the first lumbar vertebra in healthy, active adults. Two authors independently assessed study eligibility before appraising methodological quality using a National Institutes of Health assessment tool. Because of heterogeneity, findings were synthesized without meta-analysis. Of the 1,946 studies identified, seven qualified for inclusion and pertained to hamstring (n = 5), quadriceps (n = 1) or extrinsic foot (n = 1) muscles. All included studies controlled for internal validity, with one employing assessor blinding. MRI physics and differing research questions explain study methodology heterogeneity. Significant mfMRI findings were: following Nordic exercise, hamstrings with previous trauma (strain or surgical autograft harvest) demonstrated reduced activation compared with unharmed contralateral muscles, and asymptomatic individuals preferentially activated semitendinosus; greater biceps femoris long head to semitendinosus ratios reported following 45° hip extension over Nordic exercise; greater rectus femoris activation occurred in "flywheel" over barbell squats. mfMRI parameters differ on the basis of individual research questions. Individual muscles show greater activation following specific exercises, suggesting exercise specificity may be important for rehabilitation, although evidence is limited to single cohort studies comparing interlimb differences preexercise versus postexercise.
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Affiliation(s)
- Katherine Dooley
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Suzanne J Snodgrass
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Peter Stanwell
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Samantha Birse
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, New South Wales, Australia
| | - Adrian Schultz
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, New South Wales, Australia
| | - Michael K Drew
- Department of Physical Therapies, Australian Institute of Sport, Canberra, Australia
| | - Suzi Edwards
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, New South Wales, Australia
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48
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Bharti S, Nalwa A, Rajendran M, Rao M, Elhence PA. Pilomatricoma with florid osseous metaplasia: A common tumor with rare histopathological finding. J Cutan Pathol 2020; 48:422-424. [PMID: 32621564 DOI: 10.1111/cup.13796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 06/07/2020] [Accepted: 07/01/2020] [Indexed: 11/30/2022]
Abstract
Pilomatricoma, also known as calcifying epithelioma of Malherbe, is a common benign skin adnexal tumor with differentiation toward hair cortex cells, commonly seen in head and neck region of children. It is usually solitary. Herein, we present a rare case of pilomatricoma with extensive osseous metaplasia as a thigh swelling in an adult female, considered clinically to be a sebaceous cyst. Florid osseous metaplasia is extremely rare in cases of pilomatricoma. To date, fewer than 10 cases of pilomatricoma with extensive osseous metaplasia at different sites have been reported in the English literature.
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Affiliation(s)
- Sushma Bharti
- Department of Pathology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Aasma Nalwa
- Department of Pathology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Madhubala Rajendran
- Department of Pathology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Meenakshi Rao
- Department of Pathology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
| | - Poonam Abhay Elhence
- Department of Pathology, All India Institute of Medical Sciences, Basni, Jodhpur, Rajasthan, India
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49
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Rizwan T, Ahmed J, Shaikh FH, Malik F, Ullah S. Giant Leiomyosarcoma Arising in Posterior Thigh: Management of a Rare Case. Cureus 2020; 12:e10146. [PMID: 33014644 PMCID: PMC7526762 DOI: 10.7759/cureus.10146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Leiomyosarcoma, primarily a tumor of smooth muscle origin, frequently originates from the uterus, retroperitoneum, and intra-abdominal region. Rarely, the tumor may arise from the conjunctiva, inferior vena cava, or oral cavity. Here we report a case of a 65-year-old male patient who presented with a swelling in the posterior thigh for six months. The swelling was progressively increasing in size for the last two months. Examination of thigh showed a swelling of 20×30 cm in size, which was firm, non-compressible, immobile, and not transilluminating. CT scan showed no metastasis in the liver, lung, or bone. The histopathology report showed poorly differentiated leiomyosarcoma involving the muscles of the posterior compartment of the left thigh. The tumor was resected, and the patient was referred to rehabilitation clinic. Early diagnosis of such cases is essential to improve the outcome in patients as these tumors can metastasize early.
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Affiliation(s)
- Tehlil Rizwan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Jawad Ahmed
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Fahad H Shaikh
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Farheen Malik
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Shuah Ullah
- General Surgery/Urology, Sindh Institute of Urology and Transplantation, Karachi, PAK
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50
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Heatley N, Kolson Kokohaare E, Strauss DC, Hallin M, Jones RL, Fisher C, Thway K. Epithelioid malignant peripheral nerve sheath tumor arising in schwannoma. Rare Tumors 2020; 12:2036361320950862. [PMID: 32913618 PMCID: PMC7443986 DOI: 10.1177/2036361320950862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/18/2020] [Indexed: 11/15/2022] Open
Abstract
Epithelioid malignant peripheral nerve sheath tumor (EMPNST, malignant epithelioid schwannoma) is a rare variant of malignant peripheral nerve sheath tumor that has morphologic and immunophenotypic overlap with a variety of epithelioid neoplasms. Because of its rarity it may be potentially underrecognized. We describe a case arising in the subcutis of the thigh in a 25 year-old female, and discuss the pathologic features and differential diagnosis.
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Affiliation(s)
| | | | | | - Magnus Hallin
- Sarcoma Unit, The Royal Marsden Hospital, London, UK
| | - Robin L Jones
- Sarcoma Unit, The Royal Marsden Hospital, London, UK.,The Institute of Cancer Research, London, UK
| | - Cyril Fisher
- The Institute of Cancer Research, London, UK.,Department of Musculoskeletal Pathology, Royal Orthopaedic Hospital NHS Foundation Trust, Robert Aitken Institute for Clinical Research, University of Birmingham, Birmingham, UK
| | - Khin Thway
- Sarcoma Unit, The Royal Marsden Hospital, London, UK.,The Institute of Cancer Research, London, UK
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