 | | The Effect of Exercise Training on Blood Lipids: A systematic review | The Effect of Exercise Training on Blood Lipids: A systematic review
The Effect of Exercise Training on Blood Lipids: A systematic review
Summary: The Effect of Exercise Training on Blood Lipids
Exercise training (ExTr) improves lipid markers such as total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, and very low-density lipoprotein (VLDL). A systematic review and meta-analysis of 148 randomized controlled trials (RCTs) showed significant but modest improvements in these lipid markers with aerobic (AT), resistance (RT), and combined training (CT). The study found CT to be optimal for managing dyslipidemia. Meta-regression indicated that each additional weekly aerobic session and minute of training further improved TC and HDL levels. The analysis confirmed sufficient data to support the benefits of ExTr on lipid profiles.
Journal: Sports Medicine 2024
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| | HIV and Aids Part 2 | HIV and Aids Part 2
Overview
HIV (Human Immunodeficiency Virus) is a virus transmitted through sexual contact, shared needles, and from mother to child during childbirth or breastfeeding. It belongs to the Retroviridae family. All patients who are diagnosed with HIV should be initiated on ART as soon as possible.
HIV can also lead to complications like dementia and chronic diarrhea with weight loss (HIV wasting syndrome).
Exceptions to this include patients presenting with cryptococcal meningitis (CM) or central nervous system tuberculosis (tuberculous meningitis (TBM) or tuberculoma).
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| | HIV and Aids Part 1 | HIV and Aids Part 1
Overview
HIV (Human Immunodeficiency Virus) is a virus transmitted through sexual contact, shared needles, and from mother to child during childbirth or breastfeeding. It belongs to the Retroviridae family. Symptoms vary depending on the stage of infection and these include: - Acute stage, which resembles the flu, with fever, malaise, and a generalized rash;
- Asymptomatic stage which generally, has no symptoms.
- Lymphadenopathy, which presents with swelling of lymph nodes, which can be a primary symptom.
- AIDs, which is the advanced stage marked by severe infections or cancers.
HIV can also lead to complications like dementia and chronic diarrhea with weight loss (HIV wasting syndrome).
Sharespike Knowledge Studio | 3 | | R485.00 | |
| | Ebola Virus Infection | Ebola Virus Infection
Overview
Ebola virus is one of at least 30 known viruses capable of causing viral hemorrhagic fever syndrome. The genus Ebolavirus currently is classified into 5 separate species: Sudan ebolavirus, Zaire ebolavirus, Tai Forest (Ivory Coast) ebolavirus, Reston ebolavirus, and Bundibugyo ebolavirus. The outbreak of Ebola virus disease in West Africa from 2014 to 2016, involving Zaire ebolavirus, was the largest outbreak of Ebola virus disease in history.
As of September 17, 2019, an active outbreak of Ebola virus disease in the Democratic Republic of the Congo (DRC) had resulted in 3,034 confirmed and 111 probable cases of Ebola virus disease, including 2,103 attributable deaths. An experimental vaccine has been credited with limiting the outbreak’s scope.
| 3 | | R500.00 | |
| | Impact of isolated lumbar extension strength training on reducing nonspecific low back pain, disability, and improving function: a systematic review and meta-analysis | Impact of isolated lumbar extension strength training on reducing nonspecific low back pain, disability, and improving function: a systematic review and meta-analysis
Impact of isolated lumbar extension strength training on reducing nonspecific low back pain, disability, and improving function: a systematic review and meta-analysis
Overview This systematic review and meta-analysis examined the effects of isolated lumbar extension (ILEX) strength training on nonspecific low back pain. The study included 8 randomized trials with 381 participants. ILEX was found to significantly reduce pain intensity, making it a valuable intervention for pain management. However, its impact on disability and physical functionality was less consistent and not significantly different from control groups. While ILEX showed moderate effects on strength, these were not consistently supported across all studies. Clinically, ILEX is effective for pain reduction but should be combined with pelvic stabilization techniques for better outcomes. Journal Nature Portfolio Scientific Reports Volume 15 Issue 1
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| | The Associations Between Sedentary Behaviour and Neck Pain | The Associations Between Sedentary Behaviour and Neck Pain
The Associations Between Sedentary Behaviour and Neck Pain
Overview Research shows a strong link between prolonged sitting and increased neck pain risk, particularly from computer and mobile phone use. Neck pain, a common musculoskeletal disorder, affects about 70% of people globally at least once in their life. The risk is rising due to modern lifestyles and work habits. From 2006 to 2016, disability from neck pain increased by 21.9%, impacting physical function, quality of life, and work efficiency, with high medical and social costs. This study assessed the relationship between daily sedentary behaviour and neck pain risk, examining different populations by age, sex, occupation, and lifestyle. It concluded that longer sedentary periods significantly increase neck pain risk. Preventative measures for high-risk groups, such as females and employees, are necessary. Public health initiatives should aim to reduce sedentary behaviours and promote physical activity to improve neck health and combat the global prevalence of neck pain.
Journal BMC Public Health | 3 | | R495.00 | |
| | Physically Active Lifestyle Attenuates Impairments on Lung Function and Mechanics in Hypertensive Older Adults | Physically Active Lifestyle Attenuates Impairments on Lung Function and Mechanics in Hypertensive Older Adults
Physically Active Lifestyle Attenuates Impairments on Lung Function and Mechanics in Hypertensive Older Adults
Overview Physical activity attenuates hypertension in older adults, but its impact on pulmonary function and mechanics in hypertensive older adults is unknown. The study seeks to understand whether a physically active lifestyle can improve respiratory capacity, the mechanical efficiency of the lungs, and, consequently, the quality of life of these individuals, comparing data between groups of active and sedentary hypertensive older adults.
This is a cross-sectional study. 731 older adults were evaluated, stratified into two initial groups: hypertensive older adults (HE; n = 445) and non-hypertensive older adults (NHE; n = 286). For a secondary analysis, we used the International Physical Activity Questionnaire to sub-stratify HE and NHE into four groups: physically inactive hypertensive (PIH; n = 182), active hypertensive (AH; n = 110), physically inactive non-hypertensive (PINH; n = 104), and active non-hypertensive (ANH; n = 65). Lung function was measured by spirometry, and lung mechanics were assessed by impulse oscillometry.
It was concluded that hypertension is associated with impaired lung function and mechanics in older adults, and a physically active lifestyle attenuates these dysfunctions.
Journal
Advances in Respiratory Medicine Volume 92 Issue 4
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| | Can Foot Orthoses Benefit Symptomatic Runners? Mechanistic and Clinical Insights Through a Scoping Review | Can Foot Orthoses Benefit Symptomatic Runners? Mechanistic and Clinical Insights Through a Scoping Review
Can Foot Orthoses Benefit Symptomatic Runners? Mechanistic and Clinical Insights Through a Scoping Review
Overview Running is a popular sport with many health benefits, but it often results in musculoskeletal overuse injuries. Foot orthoses (FOs) are commonly prescribed by clinicians to manage these injuries. However, most studies on FOs focus on uninjured or mixed populations of runners, leaving a gap in understanding their impact on symptomatic runners. This scoping review aimed to evaluate how FOs affect biomechanics, neuromuscular function, pain, and disability in symptomatic runners. After reviewing 30 studies (involving 730 symptomatic runners), the findings suggest that FOs reduce pain and overuse injury symptoms both immediately and long-term. They also influence foot mechanics by decreasing foot/ankle eversion and altering plantar pressure distribution. The effectiveness of FOs depends on specific features of the orthosis. The review recommends further research to standardize FO descriptions and explore how different FO types and participant characteristics (e.g., foot morphology) influence outcomes. It also suggests that FOs are more effective when combined with a broader treatment plan, though more research is needed to optimize their role in treating running injuries.
Journal: Sports Medicine 2024 Volume 10 Issue 1 | 3 | | R485.00 | |
| | Influence of pain neuroscience education and exercises for the management of neck pain: A meta-analysis of randomized controlled trials | Influence of pain neuroscience education and exercises for the management of neck pain: A meta-analysis of randomized controlled trials
Influence of pain neuroscience education and exercises for the management of neck pain: A meta-analysis of randomized controlled trials
Overview It is elusive to combine pain neuroscience education with exercises to treat neck pain, and this meta-analysis aims to study the efficacy of pain neuroscience education plus exercises for the treatment of neck pain. Several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systemically searched from inception to August 2023, and we included the randomized controlled trials (RCTs) assessing the effect of pain neuroscience education plus exercises on the relief of neck pain.
It was concluded that pain neuroscience education plus exercises is effective for the relief of neck pain.
Journal Medicine Volume 103 Issue 48
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| | Is Dry Needling Effective When Combined with Other therapies for Myofascial Trigger Points Associated with Neck Pain Symptom | Is Dry Needling Effective When Combined with Other therapies for Myofascial Trigger Points Associated with Neck Pain Symptom
Is Dry Needling Effective When Combined with Other therapies for Myofascial Trigger Points Associated with Neck Pain Symptom
Overview
Neck pain is the fourth ranked condition in number of years lived with disability and has a lifetime prevalence of 70% and a point prevalence of 20% in the general population. Physical therapy is often considered the first treatment option for people with neck pain. Different therapeutic strategies, e.g., cervical spine mobilizations and manipulations thoracic manipulations, therapeutic exercise or education, have shown to be effective for the treatment of neck pain. However, evidence supporting the use of other therapies proposed for the management of neck pain, such as dry needling, is still limited.
It is important to note that clinicians do not usually treat patients with neck pain with just one isolated intervention, and multimodal approaches are generally advocated. In fact, clinical practice guidelines for physical therapy management of people with neck pain recommend a combination of manual therapy combined with exercise as a potential therapeutic strategy for this population
This study concluded that Low-to-moderate evidence suggests a positive effect to the combination of dry needling with other interventions for improving pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion in people with neck pain associated with TrPs at short-term. No midterm or long-term effects were observed.
Journal
Hindawi Pain Research and Management Volume 2021, Article ID 8836427 – 24 pages
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| | Effectiveness of Dry Needling in Improving Pain and Function in Comparison with Other Techniques in Patients with Chronic Neck Pain: A Systematic Review and Meta-Analysis | Effectiveness of Dry Needling in Improving Pain and Function in Comparison with Other Techniques in Patients with Chronic Neck Pain: A Systematic Review and Meta-Analysis
Effectiveness of Dry Needling in Improving Pain and Function in Comparison with Other Techniques in Patients with Chronic Neck Pain: A Systematic Review and Meta-Analysis
Overview
The purpose of this systematic review and meta-analysis was to assess the short-, mid-, and long-term effectiveness of dry needling in improving pain and functional capacity of patients with chronic neck pain. Neck pain is suffered by at least 30% of adults worldwide with a prevalence of 24439 to 61512 cases per 100000 population. Chronic symptoms are developed by 44% of the patients and this condition is as important as lumbar pain in prevalence and duration. When the problem turns chronic, there is an elevated economic and healthcare cost Myofascial pain syndrome is defined as a set of autonomic, motor, and sensory signs and symptoms provoked by myofascial trigger points (MTPs). It often contributes to the appearance of mechanical neck pain, and it is associated with the chronification of the symptoms. All the studies reported improvements in cervical pain and/or disability, regardless of the protocol followed and the muscles targeted. No serious adverse effects were reported. Dry needling showed to be more effective when compared with other therapies in both women and men, without differences by sex. When the analysis was carried out by age, patients over 40 years old benefitted more than those below 40 years old. Our meta-analysis supports the use of dry needling to improve pain and functional capacity in patients with chronic neck pain at short- and mid-term interval.
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| | Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Young Adult Male Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial | Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Young Adult Male Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial
Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Young Adult Male Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial
Overview
Patellofemoral pain syndrome (PFPS) is referred to as peripatellar or retropatellar pain, which is characterized by alterations in the physical and biomechanical features of the patellofemoral joint. The most excruciating discomfort is experienced when sitting or kneeling for extended periods of time with bent knees and climbing or descending stairs. The severity of the articular lesion is the single most essential element in investigating the extent of flexion that is required for activities. However, a prior study found no differences in muscle strength gains of quadriceps muscles at different knee angles in people with patellofemoral pain syndrome (PFPS). The object of this study is to confirm the effects of patellar taping and electromyographic biofeedback (EMG-BF)-guided isometric quadriceps strengthening at different knee angles (e.g., 30°, 60°, and 90° of knee flexion) on quadriceps strength and functional performance in people with PFPS were compared in this single-blind randomized controlled parallel trial. The findings indicated that individuals who trained their quadriceps at a 60° knee angle had significantly stronger quadriceps muscles than individuals who trained at 30° or 90° of knee flexion.
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| | Influence of Blood Flow restriction Training on the Aerobic Capacity: A systematic review and meta-analysis | Influence of Blood Flow restriction Training on the Aerobic Capacity: A systematic review and meta-analysis
Influence of Blood Flow restriction Training on the Aerobic Capacity: A systematic review and meta-analysis
Overview
Blood flow restriction training (also known as KAATSU training) uses professional equipment to apply pressure to the base of the limbs to limit the blood flow at the distal end of the limbs during exercise, thereby stimulating muscle growth and improving muscle strength with a low exercise intensity. This study aimed to conduct a meta-analysis on the effects of blood flow restriction training on aerobic capacity. Methods: A systematic review and quantitative evidence synthesis (QES) was used to examine the effects of blood flow restriction training on the aerobic capacity. In addition, the effect of high intensity exercise is achieved with only a low-intensity load under blood flow restriction training, which has the advantages of low intensity, high frequency, and fast recovery. It was founded that blood flow restriction training promoted the improvement in aerobic capacity. Blood flow restriction training, which is a low intensity exercise, significantly affected aerobic capacity. Twelve blood flow restriction training sessions a week achieved significantly better results than a frequency of two to four training sessions per week. A daily blood flow restriction training session of 6 to 30 min significantly improved aerobic capacity.
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| | Acute and Short-Term Effects of Dry Needling in Patients with Chronic Nonspecific Low Back Pain and Hamstring Tightness: A Pilot Study | Acute and Short-Term Effects of Dry Needling in Patients with Chronic Nonspecific Low Back Pain and Hamstring Tightness: A Pilot Study
Acute and Short-Term Effects of Dry Needling in Patients with Chronic Nonspecific Low Back Pain and Hamstring Tightness: A Pilot Study
Overview
Low back pain (LBP) is one of the common health conditions, with a prevalence of 1.4–20% in developed countries and a global prevalence of 9.4%. In Iran, the prevalence of LBP is higher than average, and about 27% of Iranian adults suffer from chronic LBP. LBP leads to higher years lived with disability than other conditions globally. In most cases, no underlying pathological condition can be found as the cause of LBP, called nonspecific LBP.
Muscle tightness contributes to musculoskeletal conditions. Previous studies have found that hamstring tightness is a contributing factor to LBP. Tightness of hamstring muscles in patients with LBP influences lumbar pelvic rhythm and is associated with severe lumbar pain and changes in the sagittal curvature of spine. Therefore, physiotherapy interventions are often applied to target hamstring muscle tightness in patients with LBP. Dry needling (DN) is one of the physiotherapy interventions, which has been utilized in patients with LBP.
This pilot study supports the use of DN in patients with LBP and hamstring tightness.
Journal
Hindawi The Scientific World Journal Volume 2021, Article ID 7259956, 6 pages | 3 | | R485.00 | |
| | 12 weeks high intensity interval training versus moderate intensity continuous training in chronic low back pain subjects: a randomised single-blinded feasibility study | 12 weeks high intensity interval training versus moderate intensity continuous training in chronic low back pain subjects: a randomised single-blinded feasibility study
12 weeks high intensity interval training versus moderate intensity continuous training in chronic low back pain subjects: a randomised single-blinded feasibility study
Overview Currently, very little is known about the effects of an endurance high intensity interval training in chronic low back pain patients. Therefore, the feasibility and safety of the HIIT has to be assessed first before it can be integrated safely into research and daily practice it can be integrated safely into research and daily practice. This study aims to answers the question if high intensity interval training and moderate intensity continuous training (MICT) have comparable adherence and feasibility. After the study it was concluded that there were no differences in adherence rates. HIIT is as feasible as MICT in non-specific chronic low back pain and can be used in future larger trials to deepen the knowledge about HIIT in this specific population.
Journal Archives of Physiotherapy
Citation Cerini T, Hilfiker R, Riegler TF, Felsch QTM. 12 weeks high intensity interval training versus moderate intensity continuous training in chronic low back pain subjects: a randomised single-blinded feasibility study. Arch Physiother. 2022 May 2;12(1):12. doi: 10.1186/s40945-022-00136-3. | 3 | | R465.00 | |
| | The Relationship Between Additional Heads of the Quadriceps Femoris, the Vasti Muscles, and the Patellar Ligament | The Relationship Between Additional Heads of the Quadriceps Femoris, the Vasti Muscles, and the Patellar Ligament
The Relationship Between Additional Heads of the Quadriceps Femoris, the Vasti Muscles, and the Patellar Ligament
Overview
The quadriceps femoris consists of four muscles: the rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis. However, the effect of additional quadriceps femoris heads on the vasti muscles and patellar ligaments is unknown. The quadriceps femoris muscle (QF) is important in locomotion; the rectus femoris (RF) swings the leg forward when a step is taken. During walking or running, quadriceps muscles such as the vastus medialis (VM) stabilize the patella and knee joint. The QF is important in sport owing to its potential for injury, which can be painful and debilitating.
The aims of the present study are to determine the relationship between additional quadriceps femoris heads and the vasti muscles and patellar ligaments and to review the morphology of the vastus lateralis, vastus medialis, and vastus intermedius.
Journal
Hindawi BioMed Research International
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| | Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation | Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation
Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation
Overview
The poor physical health of people with mental illness has long been established. A 15–20-year mortality gap arises from factors such as the likelihood of developing noncommunicable diseases, unhealthy lifestyle behaviors, reduced access to and provision of physical health care, and side-effects of medication.
This has been labeled an international human rights scandal, since a large proportion of this risk is preventable. In recognition of these disparities, international health bodies have produced guidance to address poor physical health, including the World Health Organization, World Psychiatric Association, and a Lancet Psychiatry Commission.
The use of physical activity interventions in mental health care for adults has a large academic evidence base and numerous examples of real-world implementation. However, the use of physical activity within mental health care for children and young people (CYP) has received less attention to date.
The key conclusions from this article, suggest there is an increasingly strong evidence base for the benefits of using physical activity interventions to improve, prevent, and manage physical and mental health outcomes in CYP with mental illness. However, more work needs to be done to improve the evidence base, refine its implementation into standard mental health care, and develop strategies for large-scale dissemination of such interventions across various care and cultural contexts.
The Association for Child and Adolescent Mental Health JCPP Advances | 3 | | R485.00 | |
| | Joint-Preserving Surgery for Hyperextension Deformity of the Hallux Interphalangeal Joint in a Patient with Rheumatoid Arthritis | Joint-Preserving Surgery for Hyperextension Deformity of the Hallux Interphalangeal Joint in a Patient with Rheumatoid Arthritis
Joint-Preserving Surgery for Hyperextension Deformity of the Hallux Interphalangeal Joint in a Patient with Rheumatoid Arthritis
Overview Sesamoiditis secondary to gout is an extremely rare condition with few case reports in the literature. It is an important differential diagnosis because the treatment depends on targeted therapy, unlike the main causes of sesamoiditis that often involves immobilization with special orthoses and prescription of anti-inflammatory drugs. This here is a case of a 38-year-old male, athlete, with bipartite medial sesamoid, who had insidious pain in the base of the left hallux. Laboratory tests showed no alterations, and imaging examinations demonstrated sesamoiditis with suspicion of stress fracture. The patient was initially prescribed an immobilization boot and analgesic and anti-inflammatory drugs, but he did not respond to the measures taken. After the onset of the same condition in the contralateral foot and getting the same imaging findings, an investigation of systemic disease began, focusing on gout, because of a positive family history, which was confirmed by dual-energy computed tomography.
Authors Takumi Matsumoto, Yuki Shimizu, Song Ho Chang, Taro Kasai, Jun Hirose and Sakae Tanaka
Journal Hindawi Case Reports in Orthopedics | 3 | | R430.00 | |
| | Bilateral Sesamoiditis as First Manifestation of Gout | Bilateral Sesamoiditis as First Manifestation of Gout
Bilateral Sesamoiditis as First Manifestation of Gout
Overview Sesamoiditis secondary to gout is an extremely rare condition with few case reports in the literature. It is an important differential diagnosis because the treatment depends on targeted therapy, unlike the main causes of sesamoiditis that often involves immobilization with special orthoses and prescription of anti-inflammatory drugs. This here is a case of a 38-year-old male, athlete, with bipartite medial sesamoid, who had insidious pain in the base of the left hallux. Laboratory tests showed no alterations, and imaging examinations demonstrated sesamoiditis with suspicion of stress fracture. The patient was initially prescribed an immobilization boot and analgesic and anti-inflammatory drugs, but he did not respond to the measures taken. After the onset of the same condition in the contralateral foot and getting the same imaging findings, an investigation of systemic disease began, focusing on gout, because of a positive family history, which was confirmed by dual-energy computed tomography.
Authors Daniel de Oliveira Beraldo, Sasha Duarte, Gustavo Pacheco, Rodrigo Barbosa, Carolina Mendes, Marcela Silva, Fabiana Beraldo, Andrei Alkmim, Ricardo Teixeira and Alexandre Bonfim
Journal Hindawi Case Reports in Orthopedics | 3 | | R420.00 | |
| | Fabella Syndrome and Common Peroneal Neuropathy following Total Knee Arthroplasty | Fabella Syndrome and Common Peroneal Neuropathy following Total Knee Arthroplasty
Fabella Syndrome and Common Peroneal Neuropathy following Total Knee Arthroplasty
Overview The fabella is a sesamoid bone in the lateral gastrocnemius that is present in 10-30% of the population. Despite its high prevalence, the fabella rarely causes pathology leading to delayed diagnoses and prolonged patient discomfort when symptomatic. The fabella syndrome is often associated with a snapping or clicking sensation that is exacerbated by aerobic activates. Fabella pathology is rare but increasingly recognized as a source of posterolateral knee pain following TKA. Initially believed to be unique to adolescents, fabella syndrome also affects older adults. When conservative interventions fail, surgical excision for treatment of fabella syndrome or fabella-associated common peroneal neuropathy has improved patient reported outcomes and returns to preinjury level of activities.
Significant mechanical alignment changes may create eccentric mechanical loads across the gastrocnemius tendon and embedded fabella. Furthermore, the correction of a flexion contracture with TKA may affect soft tissues posterior to the knee including the gastrocnemius tendon.
Authors Connor C. Diaz, Avinesh Agarwalla and Brian Forsythe
Journal Hindawi Case Reports in Orthopedics
| 3 | | R460.00 | |
| | Amygdala pathology in amyotrophic lateral sclerosis and primary lateral Sclerosis | Amygdala pathology in amyotrophic lateral sclerosis and primary lateral Sclerosis
Amygdala pathology in amyotrophic lateral sclerosis and primary lateral Sclerosis
Overview Temporal lobe studies in motor neuron disease overwhelmingly focus on white matter alterations and cortical grey matter atrophy. Reports on amygdala involvement are conflicting and the amygdala is typically evaluated as single structure despite consisting of several functionally and cytologically distinct nuclei. A prospective, single-centre, neuroimaging study was undertaken to comprehensively characterise amygdala pathology in 100 genetically stratified ALS patients, 33 patients with PLS and 117 healthy controls. Our findings highlight that the amygdala is affected in ALS and our study demonstrates the selective involvement of specific nuclei as opposed to global atrophy. The genotype-specific patterns of amygdala involvement identified by this study are consistent with the growing literature of extra-motor clinical features. Mesial temporal lobe pathology in ALS is not limited to hippocampal pathology but, as a key hub of the limbic system, the amygdala is also affected in ALS.
Authors Rangariroyashe H. Chipikaa, Foteini Christidia, Eoin Finegan, Stacey Li Hi Shing, Mary Clare McKenna, Kai Ming Chang, Efstratios Karavasilis, Mark A. Doherty, Jennifer C. Hengeveld, Alice Vajda, Niall Pender, Siobhan Hutchinson, Colette Donaghy, Russell L. McLaughlin, Orla Hardiman, Peter Bede
| 3 | | R380.00 | |
| | Effectiveness of an Eye-Cervical Re-Education Program in Chronic Neck Pain: A Randomized Clinical Trial | Effectiveness of an Eye-Cervical Re-Education Program in Chronic Neck Pain: A Randomized Clinical Trial
Effectiveness of an Eye-Cervical Re-Education Program in Chronic Neck Pain: A Randomized Clinical Trial
Overview:
Proprioceptive training is popularly applied as a therapeutic exercise method in physiotherapy. Its effects on pain and range of motion are only poorly evaluated. Adults with neck pain commonly experience hyperalgesia of cervical muscles, as evidenced by a reduced pressure pain threshold (PPT). Pain symptoms are thought to worsen in response to prolonged static muscle activity and/or repetitive job tasks, causing muscle metabolic disturbances. The reduced range of neck motion (ROM) is another objective finding widely investigated in CNP. It could be argued that the optimal functioning of the cervical musculature is related to the ROM; changes in neck muscle activation that result in an altered stiffness distribution may affect cervical passive stability as well as the passive and active ROM.
This study assesses the effectiveness of proprioceptive training with an Eye-Cervical Re-education Program to decrease pain and increase the joint range in chronic neck pain patients. All patients were treated with a multimodal physiotherapy intervention. The experimental group was supplemented with an exercise program that included eye-cervical proprioception.
In conclusion the eye-cervical re-education program is effective at relieving pain pressure thresholds in the upper trapezius, right levator scapula, and left splenius capitis and especially effective for increasing the cervical range of motion.
Acknowledgments: Authors: Veronica Perez-Cabezas, Carmen Ruiz-Molinero, Jose Jesus Jimenez-Rejano, Gema Chamorro Moriana, Gloria Gonzalez-Medina and Raquel Chillon-Martinez
Journal: Evidence-Based Complementary and Alternative Medicine | 3 | | R410.00 | |
| | Previous History of Knee Arthroscopy in Patients Undergoing Total Knee Arthroplasty: An Examination of the Effect of the Literature and American Academy of Orthopaedic Surgeons 2013 Arthroscopy Guidelines on Clinical Practice | Previous History of Knee Arthroscopy in Patients Undergoing Total Knee Arthroplasty: An Examination of the Effect of the Literature and American Academy of Orthopaedic Surgeons 2013 Arthroscopy Guidelines on Clinical Practice
Previous History of Knee Arthroscopy in Patients Undergoing Total Knee Arthroplasty: An Examination of the Effect of the Literature and American Academy of Orthopaedic Surgeons 2013 Arthroscopy Guidelines on Clinical Practice
Overview The purpose of this study was to compare the rate of previous knee arthroscopy in patients undergoing total knee arthroplasty (TKA) before (2005-2006) and after (2018) publication of landmark studies that examined the effectiveness of knee arthroscopy as well as the American Academy of Orthopaedic Surgeons 2013 knee arthroscopy guidelines. In this study a retrospective chart review of 214 patients who underwent a TKA between 2005 and 2006 (Group 1) and 213 patients who underwent a TKA in 2018 (Group 2) was performed. The medical records were to determine whether previous knee arthroscopy was performed. The findings suggests that the recommendations set forth by landmark clinical trials that examined the effectiveness of knee arthroscopy and the AAOS 2013 knee arthroscopy guidelines did not have a sudden impact within the geographic region, however there is significant evidence to suggest a gradual shift in treatment, where knee arthroscopy is withheld near imminent knee arthroplasty.
Authors Melissa A. Kluczynski, M.S.., Griffin Lunn, Matthew J. Phillips, M.D., andJohn M. Marzo, M.D
Journal Arthroscopy, Sports Medicine, and Rehabilitation | 3 | | R485.00 | |
| | Effect of Deep Cervical Flexor Muscle Training Using Pressure Biofeedback on Pain and Forward Head Posture in School Teachers with Neck Pain: An Observational Study | Effect of Deep Cervical Flexor Muscle Training Using Pressure Biofeedback on Pain and Forward Head Posture in School Teachers with Neck Pain: An Observational Study
Effect of Deep Cervical Flexor Muscle Training Using Pressure Biofeedback on Pain and Forward Head Posture in School Teachers with Neck Pain: An Observational Study
Overview: Teaching is one of the professions where incidence and prevalence of neck pain is high. Prolonged use of computers, which has further increased due to online teaching amid pandemic, is known to cause neck pain and alter posture, while people with forward head posture (FHP) are prone to develop neck pain and related disability. Research has shown that impairment of deep cervical flexor (DCF) muscles leads to insufficiency in coordination, activation, overload, and poor support on cervical structures that further lead to development of neck pain and altered neck posture. The objective of this study was to see the effect of DCF muscle training using pressure biofeedback on pain and FHP in schoolteachers with neck pain.
This observational study was conducted at medical center in school premises. Fifty-five schoolteachers aged between 25 and 40 years with experience of more than 5 years were invited to participate in this study. Pain and FHP were assessed using NPRS and cranio-vertebral angle using digital photograph technique, respectively, at baseline and end of four weeks of treatment.
This study shows that although pain and FHP improved following conventional exercises in schoolteachers with neck pain, mean improvement was more significant among those who received additional DCF muscle training using pressure biofeedback.
Acknowledgments:
Authors: Ahmad H. Alghadir and Zaheen A. Iqbal
Journal: BioMed Research International | 3 | | R465.00 | |
| | Hypertension Part 3 | Hypertension Part 3
Overview Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. For patients who are symptomatic, however, uncontrolled elevations in blood pressure are true medical emergencies that require rapid intervention in the ED. It is therefore important to understand the disease of chronic hypertension and, perhaps more important, episodes of acute and uncontrolled elevations in blood pressure so that we, as prehospital care providers, can better stratify these patients into low- and high-risk groups that may or may not require transport to an ED for evaluation and treatment.
As we will discuss, it is reasonable to say that not every patient who presents with hypertension is at high risk of morbidity and mortality and absolutely requires evaluation and treatment at an ED. This is not to say EMTs and paramedics should talk patients out of going to EDs for evaluation. Rather, we will strive to give prehospital care providers a better understanding of the risks involved with acute hypertension so they can better work with their patients to find a solution that is safe, reasonable and responsible for everyone involved. This article discusses the topic of acute hypertension, hypertensive urgency and hypertensive emergencies in an effort to help EMS providers better understand these illnesses and help patients make the best decisions regarding their transport and care.
Authors:
Sharespike
| 3 | | R420.00 | |
| | Hypertension Part 2 | Hypertension Part 2
Overview Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. For patients who are symptomatic, however, uncontrolled elevations in blood pressure are true medical emergencies that require rapid intervention in the ED. It is therefore important to understand the disease of chronic hypertension and, perhaps more important, episodes of acute and uncontrolled elevations in blood pressure so that we, as prehospital care providers, can better stratify these patients into low- and high-risk groups that may or may not require transport to an ED for evaluation and treatment.
As we will discuss, it is reasonable to say that not every patient who presents with hypertension is at high risk of morbidity and mortality and absolutely requires evaluation and treatment at an ED. This is not to say EMTs and paramedics should talk patients out of going to EDs for evaluation. Rather, we will strive to give prehospital care providers a better understanding of the risks involved with acute hypertension so they can better work with their patients to find a solution that is safe, reasonable and responsible for everyone involved. This article discusses the topic of acute hypertension, hypertensive urgency and hypertensive emergencies in an effort to help EMS providers better understand these illnesses and help patients make the best decisions regarding their transport and care.
Authors:
Sharespike
| 3 | | R420.00 | |
| | Bee Sting and Anaphylaxis | Bee Sting and Anaphylaxis
Bee Sting and Anaphylaxis
Overview Hymenoptera stings account for more deaths in the United States than any other envenomation. The order Hymenoptera includes Apis species, ie, bees (European, African), vespids (wasps, yellow jackets, hornets), and ants. Most deaths result from immediate hypersensitivity reactions and anaphylaxis. Severe anaphylactoid reactions occur occasionally when toxins directly stimulate mast cells. In addition to immunologic mechanisms, some injury occurs from direct toxicity. While most stings cause only minor problems, stings cause a significant number of deaths.
Target organs are the skin, vascular system, and respiratory system. Pathology is like other immunoglobulin E (IgE)–mediated allergic reactions. Anaphylaxis is a common and life-threatening consequence of Hymenoptera stings and is typically a result of sudden systemic release of mast cells and basophil mediators. Urticaria, vasodilation, bronchospasm, laryngospasm, and angioedema are prominent symptoms of the reaction. Respiratory arrest may result in refractory cases
This study aims to discuss the different stings, prognosis and emergency reactions and treatment thereto.
Author Sharespike | 3 | | R410.00 | |
| | Effects of the Multidimensional Treatment on Pain, Disability, and Sitting Posture in Patients with Low Back Pain: A Randomized Controlled Trial | Effects of the Multidimensional Treatment on Pain, Disability, and Sitting Posture in Patients with Low Back Pain: A Randomized Controlled Trial
Effects of the Multidimensional Treatment on Pain, Disability, and Sitting Posture in Patients with Low Back Pain: A Randomized Controlled Trial
Overview
The purpose of this study was to investigate the effects of multidimensional approach model on the pain, disability, and sitting posture in patients with nonspecific low back pain (LBP). Sixty LBP patients were recruited and were randomly divided into two groups: multidimensional treatment (MT) group and unimodal treatment (UT) group. All participants underwent 48 sessions of treatment (40 min/session, two sessions per day, 2 days per week) for 12 weeks.
The MT group conducted a core stability exercise twice a day and additionally provided training on pain principles and management methods. The UT group only performed a core stability exercise twice a day. The visual analogue scale (VAS) and Oswestry Disability index (ODI) were used to measure pain intensity and disability. Thoracolumbar kyphosis and lumbar lordosis in the sitting position were measured using a motion capture system. After training, the pain and disability in the MT group improved significantly greater than the UT group (p < 0.05). In the MT group, the pain relief effect persisted 3 months after the end of training. Thoracolumbar kyphosis and lumbar lordosis in the MT group were significantly improved compared to the UT group (p < 0.05). Thus, MT combined with core stability exercise may be used to improve the pain, disability, and sitting posture in patients with LBP.
Authors Tae-Sung In, Jin-Hwa Jung, Kyoung-Sim Jung and Hwi-Young Cho
Journal Hindawi Pain Research and Management | 3 | | R465.00 | |
| | Studying the Bulging of a Lumbar Intervertebral Disc: A Finite Element Analysis | Studying the Bulging of a Lumbar Intervertebral Disc: A Finite Element Analysis
Studying the Bulging of a Lumbar Intervertebral Disc: A Finite Element Analysis
Overview The nucleus pulposus is a crucial compartment of the intervertebral disc. Low back pain is usually connected to the disc situation, how healthy the disc is, and it is also associated with the nucleus pulposus condition. Besides, the bulging (deformation) at the disc plays a vital role in patients suffering from disc degeneration. Increasing bulging causes to increase shear stresses at the annulus fibrosus and eventually leads to surgical intervention if classical treatments do not alleviate the pain. Therefore, knowing the behaviour of bulging in the intervertebral disc helps to prevent severe damage to the disc and contributes to finding a feasible treatment for damaged discs. In this study, a three-dimensional finite element (FE) model was used to investigate the bulging in the lumbar disc due to changing the nucleus pulposus status. The model resembles the overall anatomic geometry of the human spinal functional unit of the lumbar region, but without the posterior element. The findings showed that bulging direction in the disc agrees with literature data and removing the nucleus pulposus significantly affects the response of the disc
Authors Hassan Mansour Raheema, Mohanad Aljanabi
Journal Procedia Structural Integrity | 3 | | R410.00 | |
| | Pain Management through Neurocognitive Therapeutic Exercises in Hypermobile Ehlers–Danlos Syndrome Patients with Chronic Low Back Pain | Pain Management through Neurocognitive Therapeutic Exercises in Hypermobile Ehlers–Danlos Syndrome Patients with Chronic Low Back Pain
Pain Management through Neurocognitive Therapeutic Exercises in Hypermobile Ehlers–Danlos Syndrome Patients with Chronic Low Back Pain
Overview The hypermobile type of Ehlers–Danlos syndrome (hEDS) is likely the most common hereditary disorder of connective tissue mainly characterized by joint hypermobility. Patients with hEDS suffer joint pain, in particular low back pain, commonly resistant to drug therapy. The aim of this research was to evaluate a neurocognitive rehabilitation approach based not only on the motion and function recovery but also on the pain management. In this nonrandomized clinical trial, eighteen hEDS patients (4 males and 14 females) with mean age 21 years (range 13-55) were recruited and evaluated before and after three months of rehabilitation treatment. The clinical results observed in this study seem to confirm the role of a specific neurocognitive rehabilitation program in the chronic pain management in the Ehlers–Danlos syndrome; the rehabilitation treatment should be tailored on patient problems and focused not only in the recovery of movement but also on pain perception.
Authors Claudia Celletti, Teresa Paolucci , Loredana Maggi, Giordana Volpi, Mariangela Billi, Roberta Mollica,and Filippo Camerota
Journal Hindawi BioMed Research International | 3 | | R435.00 | |
| | Tissue Stiffness is Not Related to Pain Experience: An Individually Controlled Study in Patients with Chronic Neck and Back Pain | Tissue Stiffness is Not Related to Pain Experience: An Individually Controlled Study in Patients with Chronic Neck and Back Pain
Tissue Stiffness is Not Related to Pain Experience: An Individually Controlled Study in Patients with Chronic Neck and Back Pain
Overview Massage therapies such as cupping are often applied in patients with chronic neck and back pain with the assumption that they can reduce increased tissue stiffness and, therefore, improve pain. The aim of this study was to clarify whether tissue stiffness is related to pain experience in patients with chronic (>3 months) back and neck pain and whether it can be altered by a cupping massage.
The stiffness of the point of subjectively felt maximum pain intensity of 40 patients with neck (n = 20) or lower back pain (n = 20) was measured by a myometer. Exact contralateral side served as an individual control. Side of higher stiffness was then treated with a cupping massage. 5, 10, 15, and 20 minutes as well as 24 hours after treatment, tissue stiffness was measured again. Patients rated their pain on a standardized pain questionnaire (neck pain disability score (NDI) or Oswestry disability index (ODI), respectively) before and 24 hours after treatment. Results. Compared to the contralateral control side, the more painful side did not exhibit an increased stiffness of myofascial tissue before treatment (p = 0.827). The tissue stiffness and the side difference between treated and nontreated control sides decreased significantly after cupping but returned to baseline after 24 hours. NDI and ODI scores significantly decreased 24 hours after cupping
It was found that tissue stiffness might not be related to pain experience in patients with chronic neck and lower back pain.
Authors Ann-Kathrin Lederer, Christian Maly, Tomas Weinert, and Roman Huber Journal Hindawi Evidence-Based Complementary and Alternative Medicine | 3 | | R410.00 | |
| | Differences in Nonspecific Low Back Pain Between Young Adult Females with and without Lumbar Scoliosis | Differences in Nonspecific Low Back Pain Between Young Adult Females with and without Lumbar Scoliosis
Differences in Nonspecific Low Back Pain Between Young Adult Females with and without Lumbar Scoliosis
Overview There is no consensus as to whether NSLBP in scoliosis patients is related to scoliosis per se or is just a normal symptom that could happen in anyone. The aim of this study was to compare the differences in NSLBP between young adult female patients with and without lumbar scoliosis and to provide a theoretical basis for differential treatment of NSLBP in patients with and without lumbar scoliosis.
Ninety female young adults with NSLBP were divided into scoliosis and non-scoliosis groups. Characteristics of pain, lumbar mobility, muscle strength, Cobb angle, axial trunk rotation (ATR) angle, and surface electromyography (SEMG) signal were compared between the two groups. After the various results, it was concluded that the characteristics of NSLBP experienced by patients with lumbar scoliosis were distinct from those of NSLBP experienced by non-scoliotic patients. The treatment of NSLBP in scoliotic patients should be different from that in non-scoliotic patients.
Authors WangshuYuan1 JianxiongShen2 LixiaChen1 HaiWang2 Keyi Yu2 HuiCong1 Jingya Zhou3 and Youxi Lin2
Journal Hindawi Pain Research and Management
| 3 | | R435.00 | |
| | Comparison of Treatments for Frozen Shoulder | Comparison of Treatments for Frozen Shoulder
Comparison of Treatments for Frozen Shoulder
Overview There is a myriad of available treatment options for patients with frozen shoulder, which can be overwhelming to the treating health care professional. To assess and compare the effectiveness of available treatment options for frozen shoulder to guide musculoskeletal practitioners and inform guidelines, DATA SOURCES Medline, EMBASE, Scopus, and CINHAL were searched in February 2020. Pain and function were the primary outcomes, and external rotation range of movement (ER ROM) was the secondary outcome. Results of pairwise metanalyses were presented as mean differences (MDs) for pain and ER ROM and standardized mean differences (SMDs) for function. Length of follow-up was divided into short-term (12 weeks), mid-term (>12 weeks to 12 months), and long-term (>12 months) follow-up.
From a total of 65 eligible studies with 4097 participants that were included in the systematic review, 34 studies with 2402 participants were included in pairwise meta-analyses and 39 studies with 2736 participants in network meta-analyses. Despite several statistically significant results in pairwise meta-analyses, only the administration of intra-articular (IA) corticosteroid was associated with statistical and clinical superiority compared with other interventions in the short term for pain (vs no treatment or placebo. The findings of this study suggest that the early use of IA corticosteroid in patients with frozen shoulder of less than 1-year duration is associated with better outcomes. This treatment should be accompanied by a home exercise program to maximize the chance of recovery
Authors Dimitris Challoumas, MD; Mairiosa Biddle, MD; Michael McLean, MD; Neal L. Millar, MD, PhD
Journal JAMA Network Open. | 3 | | R465.00 | |
| | Intra-Articular versus Subacromial Corticosteroid Injection for the Treatment of Adhesive Capsulitis: A Meta-Analysis and Systematic Review | Intra-Articular versus Subacromial Corticosteroid Injection for the Treatment of Adhesive Capsulitis: A Meta-Analysis and Systematic Review
Intra-Articular versus Subacromial Corticosteroid Injection for the Treatment of Adhesive Capsulitis: A Meta-Analysis and Systematic Review
Overview
Adhesive capsulitis is one of the most well-known causes of pain and stiffness of the shoulder. Corticosteroid injections have been used for many years. However, it is still controversial where corticosteroid should be injected, whether subacromial or intra-articular.
The objective of this meta-analysis was to compare the effects of intra-articular (IA) and subacromial (SA) corticosteroid injections for the treatment of adhesive capsulitis. The Cochrane risk of bias tool and PEDro score were used to evaluate the quality of the studies. The primary clinical outcomes including VAS, Constant score, ASES score, and ROM were collected. The secondary outcome of corticosteroid-related adverse reactions was also compared between the two groups. The results were evaluated and compared at five time points. All studies were of low risk of bias and medium-high quality with the PEDro score =5 points. It was concluded that when corticosteroid injection is used to treat adhesive capsulitis, both injection sites can be selected.
Authors Xiaoke Shang, Zhong Zhang, Xuelin Pan, Jian Li and Qi Li
Journal Hindawi Biomedical Research International | 3 | | R425.00 | |
| | Incidence and Risk Factors of Low Back Pain in Marathon Runners | Incidence and Risk Factors of Low Back Pain in Marathon Runners
Incidence and Risk Factors of Low Back Pain in Marathon Runners
Overview The occurrence of low back pain (LBP) in marathon runners has been poorly understood. This study aimed to describe the risk factors and identify whether these factors can cause LBP in these athletes by using a self-developed questionnaire which was randomly distributed to 850 runners of running a half or a full marathon. Participants responded with the questionnaire focusing on previous training and running conditions after their competitions. In the final models, risk factors, including warm-up activities, fatigue, running gait posture, and environmental temperature, were significantly associated with LBP in marathoners. It was concluded that although LBP was uncommon in marathoners, it was linked to the factors such as insufficient warm-up activities, fatigue, poor running gait posture, and uncomfortable environmental temperature. Although future studies may be necessary these findings could still be useful for protecting the lower back area of runners clinically. Authors Bao Wu, 1,2 Chang-Cheng Chen , 2 Juan Wang , 2 and Xue-Qiang Wang Journal Hindawi Pain Research and Management Volume 2021, Article ID 666030 | 3 | | R465.00 | |
| | Preretinal hemorrhage following chiropractor neck manipulation | Preretinal hemorrhage following chiropractor neck manipulation
Preretinal hemorrhage following chiropractor neck manipulation
Overview The purpose of this study is to report a case of a new complication following complementary and alternative medicine chiropractor neck manipulation with multiple preretinal haemorrhages. A 59-year-old Caucasian female presented with the acute, painless constant appearance of 3 spots in her vision immediately after a chiropractor performed cervical spinal manipulation using the high-velocity, low-amplitude technique. Examination multiple unilateral preretinal haemorrhages with no retinal tears. The preretinal haemorrhages were self-limited and resolved by 2 months later. In conclusion, the Chiropractor neck manipulation has previously been reported leading to complications related to the carotid artery and arterial plaques. This presents the ?rst case of multiple unilateral preretinal haemorrhages immediately following chiropractic neck manipulation. This suggests that chiropractor spinal adjustment cannot only a?ect the carotid artery, but also could lead to preretinal haemorrhages.
Acknowledgement Authors Yannis M. Paulusa and Nicholas Belillb Journal American Journal of Ophthalmology
| 3 | | R435.00 | |
| | Locked-In Syndrome Following Cervical Manipulation by a Chiropractor: A Case Report | Locked-In Syndrome Following Cervical Manipulation by a Chiropractor: A Case Report
Locked-In Syndrome Following Cervical Manipulation by a Chiropractor: A Case Report
Overview Vertebrobasilar occlusion poses difficult diagnostic issues and even when properly diagnosed has a poor prognosis. Newer studies highlight a better outcome when thrombectomy was carried out between six and twenty-four hours after an initial diagnosis of stroke. This paper reports a case where a patient suffered a vertebrobasilar stroke secondary to a traumatic bilateral vertebral arteries dissection was treated with late thrombectomy. A 34-year-old woman was manipulated on the cervical spinal column by a chiropractor. Following three weeks of cervical pain, she presented with severe aphasia and quadriplegia (NIHSS = 28). An MRI scan indicated ischemia of the vertebrobasilar system. Thirty-one hours after the onset of these symptoms, a thrombectomy was performed. After one month, the patient could move her head and the proximal part of her limbs but remained confined to bed (NIHSS = 13). In conclusion, the current case illustrates the benefit of late mechanical thrombectomy for a posterior cerebral circulation infarct. Although there was a delay in treatment, partial recovery ensued. Acknowledgments
Authors Guillaume Giordano Orsini, Giorgios-Emmanouil Metaxas, Vincent Legros Journal
The Journal of Critical Care
| 3 | | R410.00 | |
| | Dyspnea: Pathophysiology and a clinical approach - EMT | Dyspnea: Pathophysiology and a clinical approach - EMT
Dyspnea: Pathophysiology and a clinical approach - EMT
Overview
Dyspnea is defined as a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity and may either be acute or chronic. This is a common and often distressing symptom reported by patients, and accounts for nearly half of hospital admissions.
The distinct sensations often reported by patients include effort/work of breathing, chest tightness, and air hunger (a feeling of not enough air on inspiration). Dyspnea should be assessed by the intensity of these sensations, the degree of distress involved, and its burden or impact on instrumental activities.
Dyspnea is a common and often distressing symptom and a frequent reason for general practitioner and clinic visits. Dyspnea is symptom, and its experience is subjective and varies greatly among individuals exposed to the same stimuli or with similar pathologies. This differential experience of Dyspnea among individuals emanates from interactions among multiple physiological, psychological, social, and environmental factors that induce secondary physiological and behavioural responses. The management of Dyspnea will depend on the underlying cause.
Author
Sharespike | 3 | | R420.00 | |
| | Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma | Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma
Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma
Overview Emphysema and chronic bronchitis are airflow-limited states contained within the disease state known as chronic obstructive pulmonary disease (COPD). Just as asthma is no longer grouped with COPD, the current definition of COPD put forth by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) also no longer distinguishes between emphysema and chronic bronchitis.
Emphysema is pathologically defined as an abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by the destruction of alveolar walls and without obvious fibrosis. This process leads to reduced gas exchange, changes in airway dynamics that impair expiratory airflow, and progressive air trapping. Clinically, the term emphysema is used interchangeably with chronic obstructive pulmonary disease, or COPD.
The theory surrounding this definition has been around since the 1950s, with a key concept of irreversibility and/or permanent acinar damage. However, new data posit that increased collagen deposition leads to active fibrosis, which inevitably is associated with breakdown of the lung’s elastic framework.
Discussions on how obstructive diseases share similar phenotypes have been emerging and evolving within the literature. This course provides a particularly good outline.
Author Sharespike
| 3 | | R435.00 | |
| | Hypertension Part 1 | Hypertension Part 1
Overview
Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. For patients who are symptomatic, however, uncontrolled elevations in blood pressure are true medical emergencies that require rapid intervention in the ED. It is therefore important to understand the disease of chronic hypertension and, perhaps more important, episodes of acute and uncontrolled elevations in blood pressure so that we, as prehospital care providers, can better stratify these patients into low- and high-risk groups that may or may not require transport to an ED for evaluation and treatment.
As we will discuss, it is reasonable to say that not every patient who presents with hypertension is at high risk of morbidity and mortality and absolutely requires evaluation and treatment at an ED. This is not to say EMTs and paramedics should talk patients out of going to EDs for evaluation. Rather, we will strive to give prehospital care providers a better understanding of the risks involved with acute hypertension so they can better work with their patients to find a solution that is safe, reasonable and responsible for everyone involved. This article discusses the topic of acute hypertension, hypertensive urgency and hypertensive emergencies in an effort to help EMS providers better understand these illnesses and help patients make the best decisions regarding their transport and care.
Authors:
Sharespike
| 3 | | R420.00 | |
| | PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials | PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials
PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials
Overview Blood derivatives are increasingly used to modulate the intraarticular environment, aiming at reducing inflammatory distress and stimulating anabolism in different tissues. In particular, products with an increased concentration of platelets have been developed to address osteoarthritis (OA), based on positive in vitro findings suggesting the potential of platelet-derived growth factors (GFs). Platelet concentrates (platelet-rich plasma [PRP]) are therefore a simple, low-cost, and minimally invasive way to obtain a natural concentration of these GFs and bioactive molecules.
The purpose of these trials was to evaluate effectiveness, in terms of patient-reported outcome measures, of platelet-rich plasma (PRP) injections for knee osteoarthritis compared to placebo and other intraarticular treatments.
It was conclusive that the effect of platelet concentrates goes beyond its mere placebo effect, and PRP injections provide better results than other injectable options. This benefit increases over time, being not significant at earlier follow-up but becoming clinically significant after 6 to 12 months.
Authors Giuseppe Filardo, Davide Previtali, Francesca Napoli, Christian Candrian, Stefano Zaffagnini, and Alberto Grassi
Journal Sage Journals - Cartilage
| 3 | | R385.00 | |
| | Sleep and the athlete: narrative review and 2021 expert consensus recommendations | Sleep and the athlete: narrative review and 2021 expert consensus recommendations
Sleep and the athlete: narrative review and 2021 expert consensus recommendations
Overview An ever-growing volume of peer-reviewed Publications speaks to the recent and rapid growth in scope and understanding of sleep for optimal athlete health and performance.
Herein, a panel of international experts review the current knowledge on sleep and the athlete, briefly covering the background, exploring continued controversies, highlighting fruitful avenues for future research and providing practical recommendations. The introduction section covers the need for sleep, including sleep architecture and the restorative benefits of sleep for the brain and body.
Pitfalls and challenges measuring athlete sleep are reviewed, and practical recommendations provided. The following section, entitled sleep and the athlete, covers the influence of sleep inadequacy and sleep extension on athletic performance. This article reviews the evidence that elite athletes are particularly susceptible to sleep inadequacy, for example, during intensified training and in those reporting symptoms of over-reaching and overtraining. The final section, entitled strategies to improve sleep, provides practical recommendations to alleviate the symptoms of jet lag, nutritional strategies to enhance sleep and a toolbox for practitioners to manage and optimise athlete sleep.
Authors Neil P Walsh et al.
Journal British Journal Sports Med 2020
| 3 | | R420.00 | |
| | Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides. | Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides.
Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides.
Overview The aim of the study was to evaluate the use of specific collagen peptides in reducing pain in athletes with functional knee problems during sport. The primary outcome of the study was in change in pain intensity during activity, which was evaluated by the participants and the attending physicians using a visual analogue scale. As secondary endpoints, pain intensity under resting conditions, the range of motion of the knee joint, and the use of additional therapeutic options were assessed. Due to the high joint mobility at baseline, no significant changes of this parameter could be detected. The use of additional treatment options was significantly reduced after BCP intake. The study demonstrated that the supplementation of specific collagen peptides in young adults with functional knee problems led to a statistically significant improvement of activity related joint pain.
Authors: Denise Zdzieblik, Steffen Oesser, Albert Gollhofer and Daniel König
| 3 | | R420.00 | |
| | Extracorporeal Shock Wave Therapy for Achilles Tendinopathy | Extracorporeal Shock Wave Therapy for Achilles Tendinopathy
Extracorporeal Shock Wave Therapy for Achilles Tendinopathy
Overview
Achilles tendinopathy is confirmed by a clinical symptom triad of pain, swelling, and limited function. Achilles tendon injuries are classified by the anatomical area into non-insertional and insertional. The major symptom of non-insertional tendinopathy is pain located 2 to 6 cm proximal to the insertion of the tendon into the calcaneus. Patients suffering from insertional pathology usually present with lesions in the distal portion of the structure, i.e., posterosuperior calcaneal protuberance. Extracorporeal shock wave therapy (ESWT) is among the conservative treatments for Achilles tendinopathy. Unfortunately, no optimal application parameters have been determined that would ensure ESWT effectiveness in this condition. +e aim of the paper is to use research reports on ESWT in patients with Achilles tendinopathy to help practising physiotherapists establish the most effective intervention parameters. The two modalities of shock wave therapy used for Achilles tendinopathy are focused shock waves and radial shock waves. The literature contains reports presenting mainly beneficial effects of ESWT in patients with Achilles tendinopathy.
Authors Magdalena Stania, Grzegorz Juras, Daria Chmielewska, Anna Polak, Cezary Kucio, and Piotr Król
Journal BioMed Research International / 2019 / Article | 3 | | R425.00 | |
| | Acute Physiological Response of Lumbar Intervertebral Discs to High-load Deadlift Exercise | Acute Physiological Response of Lumbar Intervertebral Discs to High-load Deadlift Exercise
Acute Physiological Response of Lumbar Intervertebral Discs to High-load Deadlift Exercise
Overview
A deadlift is a popular exercise that is frequently incorporated into athletic training programs. This exercise is effective in strengthening the back and lower extremity muscles, but the lumbar spine is subject to mechanical stress such as shear and compression forces during deadlift. The stress is expected to become greater with increasing exercise weight. Therefore, the lumbar region is most susceptible to injury during high-load deadlift. In addition, the repeated lifting of heavy weights has been identified as a risk factor for lumbar intervertebral disc degeneration/herniation. The lumbar intervertebral discs are thought to gradually degenerate through high-load deadlift training. However, to the best of our knowledge, little is known about the acute physiological changes of the lumbar intervertebral discs resulting from high-load deadlift exercise.
This study aimed to evaluate the acute physiological effects of high-load deadlift exercise on the lumbar intervertebral discs using MR diffusion-weighted imaging. Fifteen volunteers (11 men and 4 women;) without lumbar intervertebral disc degeneration performed deadlift exercise.
It was concluded that the movement of water molecules within the lumbar intervertebral discs is suppressed by high-load deadlift exercise, which would be attributed to mechanical stress on the lumbar intervertebral discs during deadlift exercise. In particular, the L5/S1 disc is subjected to greater mechanical stress than the other lumbar intervertebral discs.
Authors Osamu Yanagisawa, Tomoki Oshikawa, Naoto Matsunaga, Gen Adachi and Koji Kaneoka
Journal J-STAGE
| 3 | | R385.00 | |
| | Guideline summary review an evidence-based clinical guideline for the diagnosis and treatment of low back pain | Guideline summary review an evidence-based clinical guideline for the diagnosis and treatment of low back pain
Guideline summary review an evidence-based clinical guideline for the diagnosis and treatment of low back pain
Overview
To improve the knowledge base concerning the diagnosis and treatment of nonspecific low back pain in adult patients, the Low Back Pain Work Group of the North American Spine Society’s (NASS) Evidence-Based Guideline Development Committee developed an evidence-based clinical guideline on this topic. When employing the principles of evidence-based medicine, the clinical literature is extensively searched to answer specific clinical questions about a disease state or medical condition. The evidence with the highest possible levels of evidence obtained from the searches is utilized to answer the specific clinical questions. As a final step, the answers to clinical questions are reformulated as recommendations. Recommendations are then assigned a recommendation grade according to the level of evidence for the best clinical evidence available at the time of answering each question. The intent of the grade of recommendation is to indicate the strength of evidence used by the work group in answering the question asked. Eighty-two clinical questions were addressed in this guideline. Work group members engaged in a two-step screening process to determine article eligibility, including title and abstract screening and evidentiary review. The total number of articles retrieved, eligible for critical appraisal, 1000 D.S. Kreiner et al. / The Spine Journal 20 (2020) 998-1024 and meeting inclusion criteria for each individual clinical question can be accessed in the technical report. A total of 119 recommendations and two work group consensus statements were issued.
Authors D Scott Kreiner et al
Journal Spine J 2020 Jul;20(7):998-1024.
| 3 | | R425.00 | |
| | Neuromuscular Function of the Knee Joint Following Knee Injuries: Does It Ever Get Back to Normal? A Systematic Review with Meta Analyses | Neuromuscular Function of the Knee Joint Following Knee Injuries: Does It Ever Get Back to Normal? A Systematic Review with Meta Analyses
Neuromuscular Function of the Knee Joint Following Knee Injuries: Does It Ever Get Back to Normal? A Systematic Review with Meta Analyses
Overview
Knee injury is an independent risk factor for the development of knee osteoarthritis (OA) in young adults. The prevalence of post-traumatic OA (PTOA) can be as high as 80% at 10+years after the initial injury, with 4–6 times higher odds compared to a non-injured knee. PTOA mainly affects a younger and more active population when compared to non-traumatic OA, resulting in longer years lived with disability [5], and surgical interventions 7–9 years earlier in life. Therefore, prevention strategies for PTOA development require particular attention.
There is also evidence of bilateral neuromuscular changes following unilateral knee injury, suggesting a requirement for healthy control groups instead of using the contralateral ‘healthy leg’ for an unbiased evaluation of post-traumatic neuromuscular alterations. Therefore, this study aimed to determine how neuromuscular function of the knee joint changes over time following knee injuries involving ligament, meniscus or cartilage compared to healthy controls.
Neuromuscular deficits persist for years post-injury/surgery, though most evidence is from ACL injured populations. Muscle strength deficits are accompanied by neural alterations and changes in control and timing of muscle force, but more studies are needed to fill the evidence gaps we have identified. Better characterisation and therapeutic strategies addressing these deficits could improve rehabilitation outcomes, and potentially prevent PTOA.
Authors Beyza Tayfur, Chedsada Charuphongsa, Dylan Morrissey, Stuart Charles Miller
Journal
Sports Medicine
| 3 | | R410.00 | |
| | Application of tele-podiatry in diabetic foot management: A series of illustrative cases | Application of tele-podiatry in diabetic foot management: A series of illustrative cases
Application of tele-podiatry in diabetic foot management: A series of illustrative cases
Overview Telemedicine had been proposed as a tool to manage diabetes, but its role in management of diabetic foot ulcer is still evolving. The COVID-19 pandemic and related social restrictions have necessitated the use of telemedicine in the management of diabetic foot disease (tele-podiatry), particularly of patients classified as low-risk.
This article is a report of three cases of varied diabetic foot problems assessed during the present pandemic using different forms of telemedicine for triaging, management of low-risk cases and for follow-up. Telemedicine is a good screening tool for diagnosing and managing low-risk subjects with diabetic foot problems and enables a triaging system for deciding on hospital visits and hospitalization.
Telemedicine offers several benefits in the management of diabetic foot disease, although it also has some limitations. Based on the experience during the pandemic it is recommended its judicious use in the triaging of patients of diabetic foot disease and management of low-risk cases. Future innovation in technology and artificial intelligence may help in better tele-podiatry care in the time to come.
Acknowledgements Authors Karakkattu V. Kavitha, Shailesh R. Deshpande, Anil P. Pandit, Ambika G. Unnikrishnan
Journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews
| 3 | | R410.00 | |
| | Adolescent knee pain: fracture or normal? A case report. | Adolescent knee pain: fracture or normal? A case report.
Adolescent knee pain: fracture or normal? A case report.
Overview Knee injuries are the second to fourth most common injuries in youth soccer. In this population, sprains/strains, fractures and contusions are most common. Due to variations in the developing skeleton, it can be difficult to rule out fractures. We present a case of a 13-year-old presenting to the emergency department (ED) with patellar pain after pivoting during a soccer game. After radiographic clearance, he was allowed to return to sport. Following another fall and ED visit, his full leg was casted. He presented to a chiropractor after cast removal, who made recommendations for progressive rehabilitation owing to the lack of evidence for fracture on radiographs. We suggest a thorough history, physical and Ottawa knee rules to determine whether We suggest a thorough history, physical and Ottawa knee rules to determine whether radiographs are indicated in the management of a pediatric knee injury. Due to normal skeletal variance, we recommend bilateral radiographs and if findings are ambiguous, consultation with a radiologist to confirm clinical suspicions.
Authors: Melissa Corso and Scott Howitt
Journal: The Journal of the Canadian Chiropractic Association Volume 62 Issue 2 | 3 | | R465.00 | |