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1.
Danilo de Oliveira Silva Fernando Henrique Magalhães Nathálie Clara Faria Deisi Ferrari Marcella Ferraz Pazzinatto Evangelos Pappas Fábio Mícolis de Azevedo 《Archives of physical medicine and rehabilitation》2017,98(1):114-119
Objective
To determine the association between the amplitude of vastus medialis (VM) Hoffmann reflex (H-reflex) and pain level, self-reported physical function, and chronicity of pain in women with patellofemoral pain (PFP).Design
Cross-sectional study.Setting
Laboratory of biomechanics and motor control.Participants
Women diagnosed with PFP (N=15) aged 18 to 35 years.Interventions
Not applicable.Main Outcome Measures
Data on worst pain level during the previous month, self-reported physical function, and symptom duration (chronicity) were collected from the participants. Maximum evoked responses were obtained by electrical stimulation applied to the femoral nerve and peak-to-peak amplitudes of normalized maximal H-reflexes (maximal Hoffmann reflex/maximal motor wave ratios) of the VM were calculated. A Pearson product-moment correlation matrix (r) was used to explore the relations between the amplitude of VM H-reflex and worst pain during the previous month, self-reported function, and chronicity of pain.Results
Strong negative correlations were found between the amplitude of VM H-reflex and worst pain in the previous month (r=?.71; P=.003) and chronicity (r=?.74; P=.001). A strong positive correlation was found between the amplitude of VM H-reflex and self-reported physical function (r=.62; P=.012).Conclusions
The strong and significant relations reported in this study suggest that women with PFP showing greater VM H-reflex excitability tend to have lower pain, better physical function, and more recent symptoms. Therefore, rehabilitation strategies designed to increase the excitability of the monosynaptic stretch reflex should be considered in the treatment of women with PFP if their effectiveness is demonstrated in future studies. 相似文献2.
Tomás Coloma Martínez Enrique Lluch Rafael Torres-Cueco Daniel Pecos-Martín Jenny McConnell 《Journal of manipulative and physiological therapeutics》2018,41(9):780-788
Objective
The objective of this study was to examine the intra- and intertester reliability, concurrent criterion-related validity, and responsiveness to treatment of the “figure-of-four” position.Methods
A total of 52 asymptomatic male soccer players participated in this study. The intraclass correlation coefficient (2, 1) was used to determine intra- and intertester reliability of the figure-of-four position. Pearson product moment correlation coefficients examining the association between the figure-of-four position and goniometric measurements of hip extension and external rotation were used to establish concurrent validity. To evaluate responsiveness to treatment, the figure-of-four position was assessed by a blinded examiner before and immediately after the application of a stretching technique or control intervention.Results
Excellent reliability (intraclass correlation coefficient > 0.75) was obtained for both intra- and intertester reliability of the figure-of-four position. Overall, the figure-of-four position and goniometric measurements of both hip extension and external rotation were significantly correlated. However, no significant treatment effects were observed for the figure-of-four position.Conclusion
The results of this study demonstrated that the figure-of-four position is a reliable and valid way to obtain information on tightness of anterior hip joint structures in male soccer players. However, responsiveness to treatment of the figure-of-four position should be questioned. 相似文献3.
Isabelle Pagé Michael Swain Arnold Wong Alexander Breen Diana De Carvalho Martin Descarreaux Martha Funabashi Gregory Kawchuk 《Journal of manipulative and physiological therapeutics》2018,41(9):734-752
Objective
The purpose of this study was to describe the correlations between individual characteristics and spinal stiffness as measured with different spinal stiffness measurement devices in individuals with and without back pain.Methods
A secondary analysis of 3 adult data sets obtained using 3 different devices, in 2 spinal regions, from a total of 5 separate cross-sectional studies was conducted. Differences in spinal stiffness between men and women and in the strength of correlations among spinal stiffness and age and anthropometric characteristics were evaluated using either the t test for independent samples, Pearson’s correlation coefficient, or Kendall’s τ rank correlation coefficient.Results
As expected, results varied between data sets; however, few factors had consistent correlations. Specifically, spinal stiffness was significantly lower in women than men in all 3 data sets. Height was positively correlated with spinal stiffness across all data sets. Although weight was correlated with thoracic stiffness, its correlation with lumbar stiffness varied. In 2 data sets, body mass index was inversely associated with lumbar spinal stiffness, whereas results from the thoracic spine region revealed a positive correlation. The results for 1 data set suggest that physiological measurement evaluating body weight distribution may also affect spinal stiffness; however, the specific correlation remains unclear.Conclusion
Despite data set differences, significant correlations were observed, indicating that participants’ characteristics appear to affect spinal stiffness measurement. 相似文献4.
Casey S. Okamoto Andrew S. Dunn Bart N. Green Lance R. Formolo David Chicoine 《Journal of manipulative and physiological therapeutics》2017,40(5):358-364
Objective
Back pain is more prevalent in the obese, but whether back pain severity is directly correlated to obesity in veterans is unknown. We sought to determine if there was a correlation between body composition and low back pain severity in a sample of veterans. The hypothesis was that veterans with higher body mass index values would report higher low back pain severity scores.Methods
This study was a retrospective chart review of 1768 veterans presenting to a Veterans Affairs chiropractic clinic with a chief complaint of low back pain between January 1, 2009 and December 31, 2014. Spearman’s rho was used to test for correlation between body composition as measured by body mass index and low back pain severity as measured by the Back Bournemouth Questionnaire.Results
On average, the sample was predominantly male (91%), older than 50, and overweight (36.5%) or obese (48.9%). There was no correlation between body mass index and Back Bournemouth Questionnaire scores, r = .088, p < .001.Conclusions
The majority of veterans with low back pain in this sample were either overweight or obese. There was no correlation between body composition and low back pain severity in this sample of veterans. 相似文献5.
Monique Silva Rezende Ana Luiza Marsengo Amanda Apolinário Vânia Tie Koga Ferreira Elaine Caldeira de Oliveira Guirro 《Journal of manipulative and physiological therapeutics》2017,40(4):241-245
Objective
The purpose of this study was to correlate upper limb volume and arterial and venous blood flow velocity in breast cancer survivors.Methods
A cross-sectional study was conducted on 30 women with lymphedema and a mean age of 55.60 years (standard deviation = 8.12). For the assessment of upper limb volume, perimetry was performed with measures at 6 points on the limb, which were mathematically calculated as volume. The blood flow velocity of the axillary and brachial arteries and veins were assessed by Doppler ultrasound with a probe at 4 MHz. In the statistical analysis, a Shapiro-Wilk test determined a non-normal data distribution. Spearman correlation coefficients (ρ) were calculated to determine the association between the variables blood flow velocity and lymphedema volume.Results
We identified significant and positive associations between all variables correlated with limb volume: blood flow velocity of the axillary artery (ρ = 0.381, P = .041), axillary vein (ρ = 0.383, P = .039), brachial artery (ρ = 0.375, P = .044), and the brachial vein (ρ = 0.373, P = .045).Conclusion
There is a positive association between limb volume and blood flow velocity in the upper limbs of women with lymphedema secondary to breast cancer treatment. 相似文献6.
Sean P. Wilson Taher Vohra McKenna Knych Jared Goldberg Christopher Price Sean Calo Meredith Mahan Joseph Miller 《The American journal of emergency medicine》2017,35(5):701-703
Introduction
Delay in current nucleic acid amplification testing for Neisseria gonorrhoeae and Chlamydia trachomatis has led to recommendations for presumptive treatment in patients with concern for infection and unreliable follow-up. In the urban setting, it is assumed that many patients have unreliable follow-up, therefore presumptive therapy is thought to be used frequently. We sought to measure the frequency of disease and accuracy of presumptive treatment for these infections.Methods
This was an observational cohort study performed at an urban academic Level 1 trauma center ED with an annual census of 95,000 visits per year. Testing was performed using the APTIMA Unisex swab assay (Gen-Probe Incorporated, San Diego, CA). Presumptive therapy was defined as receiving treatment for both infections during the initial encounter without confirmation of diagnosis.Results
A total of 1162 patients enrolled. Infection was present in 26% of men, 14% of all women and 11% of pregnant women. Despite high frequency of presumptive treatment, > 4% of infected patients in each category went untreated.Conclusion
Inaccuracy of presumptive treatment was common for these sexually transmitted infections. There is an opportunity to improve diagnostic accuracy for treatment. 相似文献7.
Leonardo Shigaki Edgar Ramos Vieira André Wilson de Oliveira Gil Cynthia Gobbi Alves Araújo Mariana Zingari Carmargo Leandro Amaral Sturion Marcio Roǵerio de Oliveira Rubens A. da Silva 《Journal of manipulative and physiological therapeutics》2017,40(4):284-292
Objective
The purpose of this study was to assess the effect of holding an external load on the standing balance of younger and older adults with and without chronic low back pain (CLBP).Methods
Twenty participants with and 20 without CLBP participated in the study. Each group contained 10 younger (50% men) and 10 older adults (50% men). Participants were instructed to look straight ahead while standing on a force platform during two 120-second trials with and without holding an external load (10% of body mass). The center of pressure area, mean velocity, and mean frequency in the anteroposterior and mediolateral directions were measured.Results
Older adults had worse standing balance than younger adults did (P < .001, d = 0.20). There were no significant balance differences between participants with and without CLBP within age groups during standing balance condition. However, holding the external load significantly increased postural instability for both age groups and CLBP status, with mean effect size across center of pressure variables of d = 0.82 for older participants without CLBP and d = 2.65 for younger participants without CLBP. These effects for people with CLBP were d = 1.65 for subgroup of older and d = 1.60 for subgroup of younger participants.Conclusion
Holding an external load of 10% of body mass increased postural instability of both younger and older adults with and without CLBP. 相似文献8.
Nathan F. Jarman Toby Brooks C. Roger James Troy Hooper Mark Wilhelm Jean-Michel Brismée Manuel A. Domenech Stanley J. Kotara Phillip S. Sizer 《PM & R》2017,9(10):969-975
Background
Deep neck flexor (DNF) muscles stabilize the neck and contribute to head acceleration control. The function of DNF in cervical spine dynamic stabilization has not been examined in athletes of any age group, including adolescents. This investigation was necessary prior to studying the DNF muscles’ role in cervical spine injury patterns.Objectives
The objectives of this study were (1) to determine average Deep Neck Flexor Endurance Test (DNFET) time scores in high school?aged and university-aged subjects (aged 14-22 years); and (2) to establish the relationship between gender and age for adolescent DNFET time scores.Design
Cross-sectional design.Setting
Public high school and private university.Participants
A total of 81 (40 male, 41 female) healthy high school and collegiate athletes.Intervention
DNFET time scores (in seconds) were collected and means values were calculated. Interrater reliability was established using the first 15 university-aged subjects enrolled in the study.Main Outcomes
Mean DNFET time (seconds) scores.Results
The DNF muscle endurance interrater reliability coefficient of reproducibility for 4 allied health clinicians was intraclass correlation coefficient (2,4) 0.712 (confidence interval, 0.24-0.85). The mean (± standard deviation) DNFET time score for females was 31.86 (±8.53) seconds versus 35.57 (±10.43) seconds for males. The DNFET performance demonstrated a significant but fair correlation with age (r = 0.401, P = .0001). No significant performance differences were found between male and female subjects in the 14- to 17-year-old group (U = 187.0, P = .285), the 18- to 22-year-old group (U = 145.0, P = .215), or the total male versus female subject groups (U = 653.0, P = .083).Conclusion
Our study establishes a normative data set available for the DNFET in the adolescent population. The fair correlation between DNFET time scores and age is consistent with other studies. These findings serve as a basis for clinician testing, objectifying, and monitoring DNF dysfunction in an adolescent athletic population.Level of Evidence
II 相似文献9.
Sean D. Rundell Adam P. Goode Pradeep Suri Patrick J. Heagerty Bryan A. Comstock Janna L. Friedly Laura S. Gold Zoya Bauer Andrew L. Avins Srdjan S. Nedeljkovic David R. Nerenz Larry Kessler Jeffrey G. Jarvik 《Archives of physical medicine and rehabilitation》2017,98(1):43-50
Objective
To examine if a comorbid diagnosis of knee or hip osteoarthritis (OA) in older adults with new back pain visits is associated with long-term patient-reported outcomes and back-related health care use.Design
Prospective cohort study.Setting
Three integrated health systems forming the Back pain Outcomes using Longitudinal Data cohort.Participants
Participants (N=5155) were older adults (≥65y) with a new visit for back pain and a complete electronic health record data.Interventions
Not applicable; we obtained OA diagnoses using diagnostic codes in the electronic health record 12 months prior to the new back pain visit.Main Outcome Measures
The Roland-Morris Disability Questionnaire (RDQ) and the EuroQol-5D (EQ-5D) were key patient-reported outcomes. Health care use, measured by relative-value units (RVUs), was summed for the 12 months after the initial visit. We used linear mixed-effects models to model patient-reported outcomes. We also used generalized linear models to test the association between comorbid knee or hip OA and total back-related RVUs.Results
Of the 5155 participants, 368 (7.1%) had a comorbid knee OA diagnosis, and 94 (1.8%) had a hip OA diagnosis. Of the participants, 4711 (91.4%) had neither knee nor hip OA. In adjusted models, the 12-month RDQ score was 1.23 points higher (95% confidence interval [CI], 0.72–1.74) for patients with knee OA and 1.26 points higher (95% CI, 0.24–2.27) for those with hip OA than those without knee or hip OA, respectively. A lower EQ-5D score was found among participants with knee OA (.02 lower; 95% CI, ?.04 to ?.01) and hip OA diagnoses (.03 lower; 95% CI, ?.05 to ?.01) compared with those without knee or hip OA, respectively. Comorbid knee or hip OA was not significantly associated with total 12-month back-related resource use.Conclusions
Comorbid knee or hip OA in older adults with a new back pain visit was associated with modestly worse long-term disability and health-related quality of life. 相似文献10.
Michal Laufer-Perl Ofer Havakuk Yacov Shacham Arie Steinvil Sivan Letourneau-Shesaf Ehud Chorin Gad Keren Yaron Arbel 《The American journal of emergency medicine》2017,35(2):201-205
Background
Sex differences in heart diseases, including acute coronary syndrome, congestive heart failure, and atrial fibrillation, have been studied extensively. However, data are lacking regarding sex differences in pericarditis and myopericarditis patients.Objectives
The purpose of the study was to evaluate whether there are sex differences in pericarditis and myopericarditis patients as well.Methods
We performed a retrospective, single-center observational study that included 200 consecutive patients hospitalized with idiopathic pericarditis or myopericarditis from January 2012 to April 2014. Patients were evaluated for sex differences in prevalence, clinical presentation, laboratory variables, and outcome. We excluded patients with a known cause for pericarditis.Results
Among 200 consecutive patients, 55 (27%) were female. Compared with men, women were significantly older (60 ± 19 years vs 46 ± 19 years, P < .001) and had a higher rate of chronic medical conditions. Myopericarditis was significantly more common among men (51% vs 25%, P = .001). Accordingly, men had significantly higher levels of peak troponin (6.8 ± 17 ng/mL vs 0.9 ± 2.6 ng/mL, P < .001), whereas women presented more frequently with pericardial effusion (68% vs 45%, P = .006). Interestingly, women had a significantly lower rate of hospitalization in the cardiology department (42% vs 63%, P = .015). Overall, there were no significant differences in ejection fraction, type of treatment, complications, or in-hospital mortality.Conclusions
Most patients admitted with acute idiopathic pericarditis are male. In addition, men have a higher prevalence of myocardial involvement. Significant sex differences exist in laboratory variables and in hospital management; however, the outcome is similar and favorable in both sexes. 相似文献11.
S. Jun Son Hyunsoo Kim Matthew K. Seeley J. Ty Hopkins 《Archives of physical medicine and rehabilitation》2017,98(1):25-35
Objectives
To examine the effect of experimental knee pain on perceived knee pain and gait patterns and to examine the efficacy of transcutaneous electrical nerve stimulation (TENS) on perceived knee pain and pain-induced knee gait mechanics.Design
Crossover trial.Setting
Biomechanics laboratory.Participants
Recreationally active, individuals without musculoskeletal pain aged 18 to 35 years (N=30).Interventions
Thirty able-bodied individuals were assigned to either a TENS (n=15) or a placebo (n=15) group. All participants completed 3 experimental sessions in a counterbalanced order separated by 2 days: (1) hypertonic saline infusion (5% NaCl); (2) isotonic saline infusion (0.9% NaCl); and (3) control. Each group received sensory electrical stimulation or placebo treatment for 20 minutes, respectively.Main Outcome Measures
Perceived pain was collected every 2 minutes using a 10-cm visual analog scale (VAS) for 50 minutes and analyzed using a mixed model analysis of covariance with repeated measures. Gait analyses were performed at baseline, infusion, and treatment. Sagittal and frontal knee angles and internal net joint torque across the entire stance were analyzed using a functional data analysis approach.Results
Hypertonic saline infusion increased perceived pain (4/10cm on a VAS; P<.05) and altered right knee angle (more flexion and less abduction; P<.05) and internal net joint torque (less extension and greater abduction; P<.05) across various stance phases. TENS treatment reduced perceived pain and improved right sagittal gait abnormalities as compared with placebo treatment (P<.05).Conclusions
This pain model increases perceived pain and induces compensatory gait patterns in a way that indicates potential quadriceps weakness. However, TENS treatment effectively reduces perceived pain and restores pain-induced gait abnormalities in sagittal knee mechanics. 相似文献12.
Lidiane L. Florencio Gabriela N. Ferracni Thais C. Chaves María Palacios-Ceña Carlos Ordás-Bandera José G. Speciali Debora Belilaqua Grossi César Fernández-de-las-Peñas 《Journal of manipulative and physiological therapeutics》2018,41(9):762-770
Objective
The purpose of this study was to investigate the correlation between head and neck posture and superficial neck flexor and extensor activity during performance of the craniocervical flexion test (CCFT) in women with migraine and healthy controls.Methods
Fifty-two women with episodic migraine, 16 with chronic migraine, and 23 healthy controls participated. Head and neck posture were determined by assessing the craniovertebral (CV) angle and cervical lordosis angle. Surface electromyography signals were recorded bilaterally from sternocleidomastoid, anterior scalene, splenius capitis, and upper trapezius muscles as participants performed the CCFT. Differences in electromyogram activity and posture among groups were compared with analyses of variance. Correlations between posture and electromyogram activity were analyzed with the Pearson correlation coefficient.Results
Both migraine groups had a significant increase in splenius capitis muscle activity, when acting as an antagonist, at the last stage of CCFT (F = 4.687; P = .012) compared with controls. No differences among groups were observed for head and neck posture. No significant correlation was found in the episodic migraine group. Moderate correlations between the CV angle and upper trapezius activity at the majority stages of the CCFT (-0.61 < r < -0.65, all P < .05) were observed within the chronic migraine group: the more extended the head posture, the higher the activity of the upper trapezius muscle. The CV angle also was correlated with upper trapezius muscle activity at the first stage of the CCFT and with splenius capitis muscle activity at the last stages (-0.42 < r < -0.52; P < .05).Conclusion
An extended (forward) head posture was moderately correlated with an increased in electrical activity of superficial neck extensor muscles, particularly the upper trapezius, when acting as an antagonist, during the performance of the CCFT in women with chronic but not episodic migraine. 相似文献13.
Mehmet Ali Aslaner Mustafa Boz Ali Çelik Asliddin Ahmedali Sercan Eroğlu Nalan Metin Aksu Serkan Emre Eroğlu 《The American journal of emergency medicine》2017,35(1):71-76
Objectives
Altered mental status (AMS) is a challenging diagnosis in older patients and has a large range of etiologies. The aim of this study was to investigate the nature of such etiologies for physicians to be better aware of AMS backgrounds and hence improve outcomes and mortality rates.Methods
This prospective observational study was conducted at 4 emergency departments. Patients 65 years and older who presented to the emergency department with acute AMS (≤1 week), with symptoms ranging from comas and combativeness, were eligible for inclusion in this study. The outcomes, etiologies, Richmond Agitation and Sedation Scale scores, and the presence of delirium were recorded.Results
Among 822 older patients with AMS, infection (39.5%) and neurological diseases (36.5%) were the most common etiologies. The hospital admission and mortality rates were 73.7% (n = 606) and 24.7% (n = 203), respectively. The mortality rate rose if AMS persisted for more than 3 days. Delirium was observed in 55.7% of the patients; these individuals had higher durations of AMS than those without delirium (median, 24 hours; interquartile range, 3-48 hours; median 6 hours, interquartile range, 3-48 hours, respectively; P = .010). Notably, delirium was observed in more than two-thirds of neurological patients.Conclusions
The most common causes of AMS were infection and neurological diseases. Delirium was associated with AMS in nearly half the patients. Moreover, the rates of hospitalization and mortality remained high. 相似文献14.
David M. Nestler Waqas I. Gilani Ryan T. Anderson M. Fernanda Bellolio Megan E. Branda Annie LeBlanc Sean Phelan Ronna L. Campbell Erik P. Hess 《The American journal of emergency medicine》2017,35(1):29-35
Objectives
Despite a high prevalence of coronary heart disease in both genders, studies show a gender disparity in evaluation whereby women are less likely than men to undergo timely or comprehensive cardiac investigation. Using videographic analysis, we sought to quantify gender differences in provider recommendations and patient evaluations.Methods
We analyzed video recordings from our Chest Pain Choice trial, a single center patient-level randomized trial in which emergency department patients with chest pain being considered for cardiac stress testing were randomized to shared decision-making or usual care. Patient-provider interactions were video recorded. We compared characteristics and outcomes by gender.Results
Of the 204 patients enrolled (101 decision aid; 103 usual care), 120 (58.8%) were female. Of the 75 providers evaluated, 20 (26.7%) were female. The mean (SD) pretest probability of acute coronary syndrome was lower in women [3.7% (2.2) vs 6.7% (4.4), P = .0002]. There was no gender effect on duration of discussion, clinician recommendations, OPTION scores, patient perceptions, or eventual patient dispositions. When the clinician and patient gender matched, OPTION scores were lower (interaction P = .002), and patients were less likely to find the information to be very helpful (interaction P = .10).Conclusions
Despite a lower pretest probability of acute coronary syndrome in women, we did not observe any significant gender disparity in how patients were managed and evaluated. When the patients' and providers' gender matched, the provider involved them less in the decision making process, and the information provided was less helpful than when the genders did not match. 相似文献15.
Hyun Joo Kim Shin Hyung Kim Ji Young Min Wyun Kon Park 《The American journal of emergency medicine》2017,35(10):1430-1434
Introduction
Size 9 and 8 airways for men and women, respectively, have been proposed as most appropriate based on endoscopy. However, a limitation of this guideline is that ventilation was not assessed.Methods
In this retrospective review of prospectively collected data, 149 patients requiring tracheal intubation for general anesthesia were included. The adequacy for manual and pressure-controlled mechanical ventilation and views at the distal end of each airway was assessed using a fiber-optic bronchoscope with various airway sizes (7, 8, 9, 10, and 11).Results
For men, size 9, 10, and 11 airways permitted clear manual and adequate mechanical ventilation; size 7 and 8 airways caused partially obstructed manual and inadequate mechanical ventilation. On endoscopy, size 7 and 8 airways caused complete obstruction by the tongue; size 10 and 11 airways either touched or passed beyond the tip of the epiglottis. For women, the size 7 airway caused partially obstructed manual and inadequate mechanical ventilation; size 9 and 10 airways provided clear manual and adequate mechanical ventilation. The size 8 airway permitted clear manual ventilation, though mechanical ventilation was inadequate in one patient. On endoscopy, the size 7 airway caused complete obstruction in > 50% of women; size 9, 10, and 11 airways either touched or passed beyond the tip of the epiglottis.Conclusions
With respect to adequate ventilation in conjunction with an acceptable endoscopic view, size 9 and size 8 oropharyngeal airways appear to be the most appropriate sizes for clinical use in men and women, respectively. 相似文献16.
Kyoung Min You Chiwon Lee Woon Yong Kwon Jung Chan Lee Gil Joon Suh Kyung Su Kim Min Ji Park Sungwan Kim 《The American journal of emergency medicine》2017,35(2):292-298
Purpose
We performed this study to investigate whether real-time tidal volume feedback increases optimal ventilation and decreases hyperventilation during manikin-simulated cardiopulmonary resuscitation (CPR).Basic procedures
We developed a new real-time tidal volume monitoring device (TVD) which estimated tidal volume in real time using a magnetic flowmeter. The TVD was validated with a volume-controlled mechanical ventilator with various tidal volumes. We conducted a randomized, crossover, manikin-simulation study in which 14 participants were randomly divided into a control (without tidal volume feedback, n = 7) and a TVD group (with real-time tidal volume feedback, n = 7) and underwent manikin simulation. The optimal ventilation was defined as 420-490 mL of tidal volumes for a 70-kg adult manikin. After 2 weeks of the washout period, the simulation was repeated via the participants' crossover.Main findings
In the validation study, 97.6% and 100% of the difference ratios in tidal volumes between the mechanical ventilator and TVD were within ±1.5% and ±2.5%, respectively. During manikin-simulated CPR, TVD use increased the proportion of optimal ventilation per person. Its median values (range) of the control group and the TVD group were 37.5% (0.0-65.0) and 87.5% (65.0-100.0), respectively, P < .001). TVD use also decreased hyperventilation. The proportions of hyperventilation in the control group and the TVD group were 25.0% vs 8.9%, respectively (P < .001).Principal conclusions
Real-time tidal volume feedback using the new TVD guided the rescuers to provide optimal ventilation and to avoid hyperventilation during manikin-simulated CPR. 相似文献17.
18.
Kyoung-Chul Cha Yong Won Kim Hyung Il Kim Oh Hyun Kim Yong Sung Cha Hyun Kim Kang Hyun Lee Sung Oh Hwang 《The American journal of emergency medicine》2017,35(1):117-121
Objectives
We analyzed chest computed tomographic scan to evaluate parenchymal lung injury and its clinical significance in patients who received standard cardiopulmonary resuscitation and were resuscitated from cardiac arrest.Methods
We enrolled nontraumatic out-of-hospital cardiac arrest patients older than 19 years who had been admitted to the emergency department in cardiac arrest and successfully resuscitated after cardiopulmonary resuscitation. Chest computed tomography was obtained immediately after return of spontaneous circulation (ROSC). To allocate the area of lung contusion, we divided both hemithoraces into 3 regions longitudinally, and each part was subdivided into 4 segments except the lower part of the left lung. To stratify the severity of lung contusion, each segment was scored depending on the area of lung contusion. Oxygen index (OI) was measured at the time of ROSC, 24, 48, and 72 hours and 1 week after cardiac arrest.Results
Lung contusion was developed in 37 (41%) patients and median lung contusion score (LCS) was 17 (12-26). Lung contusion was not associated with hospital mortality (P = .924) or length of intensive care unit stay (P = .446). The OI at the time of ROSC was lower in patients with LCS greater than 23 than that in patients with LCS less than or equal to 23 (126 [93-224] vs 278 [202-367]; P = .008); however, the OI at the other timelines was not different between patients with LCS greater than 23 and patients with LCS less than or equal to 23.Conclusion
Extensive lung contusion is associated with a lower oxygenation index at the time of ROSC, but did not affect the resuscitation outcome. 相似文献19.
Amir H. Kahlaee Leila Ghamkhar Amir M. Arab 《Journal of manipulative and physiological therapeutics》2017,40(2):106-117
Objective
The purpose of this study was to compare the effect of abdominal hollowing (AH) and abdominal bracing (AB) maneuvers on the activity pattern of lumbopelvic muscles during prone hip extension (PHE) in participants with or without nonspecific chronic low back pain (CLBP).Methods
Twenty women with or without CLBP participated in this cross-sectional observational study. The electromyographic activity (amplitude and onset time) of the contralateral erector spinae (CES), ipsilateral erector spinae (IES), gluteus maximus, and biceps femoris muscles was measured during PHE with and without abdominal maneuvers. A 3-way mixed model analysis of variance and post hoc tests were used for statistical analysis.Results
Between-group comparisons showed that the CES onset delay during PHE alone was greater (P = .03) and the activity level of IES, CES, and biceps femoris in all maneuvers (P < .05) was higher in patients with CLBP than in asymptomatic participants. In asymptomatic participants, PHE + AH significantly decreased the signal amplitude (AMP) of IES (P = .01) and CES (P = .02) muscles. In participants with CLBP, IES muscle AMP was lower during PHE + AH compared with PHE + AB and PHE alone. With regard to onset delay, the results also showed no significant difference between maneuvers within either of the 2 groups (P > .05).Conclusions
Performance of the AH maneuver decreased the erector spinae muscle AMP in both groups, and neither maneuver altered the onset delay of any of the muscles in either group. The low back pain group showed higher levels of activity in all muscles (not statistically significant in gluteus maximus during all maneuvers). The groups were similar according to the onset delay of any of the muscles during either maneuver. 相似文献20.
Nooraldeen Al-Dury Araz Rawshani Johan Israelsson Anneli Strömsöe Solveig Aune Jens Agerström Thomas Karlsson Annica Ravn-Fischer Johan Herlitz 《The American journal of emergency medicine》2017,35(12):1839-1844