HV Group Research Articles

Alterations of tibialis anterior muscle activation pattern in subjects with type 2 diabetes and diabetic peripheral neuropathy

Diabetic peripheral neuropathy (DPN) is associated with loss of motor units (MUs), which can cause changes in the activation pattern of muscle fibres. This study investigated the pattern of muscle activation using high-density surface electromyography (HD-sEMG) signals from subjects with type 2 diabetes mellitus (T2DM) and DPN. Thirty-five adults participated in the study: 12 healthy subjects (HV), 12 patients with T2DM without DPN (No-DPN) and 11 patients with T2DM with DPN (DPN). HD-sEMG signals were recorded in the tibialis anterior muscle during an isometric contraction of ankle dorsiflexion at 50% of the maximum voluntary isometric contraction (MVIC) during 30-s. The calculated HD-sEMG signals parameters were the normalised root mean square (RMS), normalised median frequency (MDF), coefficient of variation (CoV) and modified entropy (ME). The RMS increased significantly (p = 0.001) with time only for the DPN group, while the MDF decreased significantly (p < 0.01) with time for the three groups. Moreover, the ME was significantly lower (p = 0.005), and CoV was significantly higher (p = 0.003) for the DPN group than the HV group. Using HD-sEMG, we have demonstrated a reduction in the number of MU recruited by individuals with DPN. This study provides proof of concept for the clinical utility of this technique for identifying neuromuscular impairment caused by DPN.

Safety and immunogenicity of the COVID-19 vaccine BNT162b2 in patients undergoing chemotherapy for solid cancer

BackgroundAlthough COVID-19 severity in cancer patients is high, the safety and immunogenicity of the BNT162b2 mRNA COVID-19 vaccine in patients undergoing chemotherapy for solid cancers in Japan have not been reported. MethodsWe investigated the safety and immunogenicity of BNT162b2 in 41 patients undergoing chemotherapy for solid cancers and in healthy volunteers who received 2 doses of BNT162b2. We evaluated serum IgG antibody titers for S1 protein by ELISA at pre-vaccination, prior to the second dose and 14 days after the second vaccination in 24 cancer patients undergoing cytotoxic chemotherapy (CC group), 17 cancer patients undergoing immune checkpoint inhibitor therapy (ICI group) and 12 age-matched healthy volunteers (HV group). Additionally, inflammatory cytokine levels were compared between the HV and ICI groups at pre and the next day of each vaccination. ResultsAnti-S1 antibody levels were significantly lower in the ICI and CC groups than in the HV group after the second dose (median optimal density: 0.241 [0.063–1.205] and 0.161 [0.07–0.857] vs 0.644 [0.259–1.498], p = 0.0024 and p < 0.0001, respectively). Adverse effect profile did not differ among the three groups, and no serious adverse event occurred. There were no differences in vaccine-induced inflammatory cytokines between the HV and ICI groups. ConclusionAlthough there were no significant differences in adverse events in three groups, antibody titers were significantly lower in the ICI and CC groups than in the HV group. Further protection strategies should be considered in cancer patients undergoing CC or ICI.

Mammary tissue proteomics in a pig model indicates that dietary valine supplementation increases milk fat content via increased de novo synthesis of fatty acid.

Milk fat is a major source of energy that determines the growth of neonates. Recently, studies have shown that valine is closely related to lipid metabolism. Therefore, this study was designed to investigate the effects of dietary valine supplementation on milk fat synthesis using a pig model. Thirty gilts were allotted to low (LV, total valine:lysine = 0.63:1), medium (MV, total valine:lysine = 0.73:1), and high (HV, total valine:lysine = 0.93:1) valine feeding levels from Day 75 of gestation till farrowing. The results demonstrated that the concentration of milk fat at Days 1, 3, and 7 of lactation in the HV group was higher than that in the MV and LV groups. The HV group had an increased (p < .05) proportion of total saturated and monounsaturated fatty acids than the other groups. Examination of mammary tissue proteomics in the HV and LV groups revealed 121 differentially expressed proteins (68 upregulated and 53 downregulated in the HV group). The upregulated proteins in the HV group were relevant to some crucial pathways related to milk fat synthesis, including fatty acid biosynthesis and metabolism, the AMPK signaling pathway, and oxidative phosphorylation. Furthermore, the key proteins involved in fatty acid synthesis (ACACA and FASN) were identified, and their expression levels were verified (p < .05) using Western blotting. Our findings revealed that dietary valine supplementation improves milk fat synthesis by modulating the expression of fatty acid synthesis–related proteins in mammary tissues.

The Effects of a 11‐Week Resistance Training Program on Arterial Stiffness in Females

Arterial stiffness is an indicator of disease and is an independent predictor of cardiovascular events. There have been inconsistencies from previous investigations examining the effect of resistance training on arterial stiffness in female participants. Objective This study was conducted to examine the effect of two resistance training models on arterial stiffness in females. Hypothesis We tested the hypothesis that 11 weeks of either high-intensity or high-volume resistance training would not increase indices of arterial stiffness in young, healthy females. Methods 24 female, untrained college students aged 18-22 years were randomized into one of three groups: control (CON) group (n = 8), high-intensity resistance exercise (HI) group (n = 8), and high-volume resistance exercise (HV) group (n = 8). Subjects randomized to resistance training groups were required to perform strength training exercises three to five days a week for 11 weeks. The exercise regimen consisted of 2-3 sets of 3-8 repetitions (80-90% of 1-repetition maximum (1 RM)) for the HI group and 3-4 sets of 10-15 repetitions (50%-70% of 1 RM) for the HV group. All subjects were instructed to continue their normal diet and avoid cardiovascular exercise during the study. Results Following the intervention, there was a significant increase in carotid femoral pulse wave velocity (C-F PWV) (6.39±0.73 to 8.4±2.31; P < 0.05) and carotid radial (C-R) PWV (9.77±1.74 to 12.58±2.09; P < 0.05) in the CON group only. Both CON and HI groups had significantly decreased central pulse pressure (cPP) (-15.3±12.4 vs. -13.11±12.0 percent change; P < 0.05), respectively. Both the HI and HV groups increased their maximum squat (36.6±7.9 vs.41.3±31.8 percent change; P < 0.05), bench press (34.4±12.6 vs. 23.4±11.1 percent change; P < 0.05), and seated row (22.0±12.6 vs. 21.9±12.5 percent change; P < 0.05), respectively. Conclusion Our findings support the use of resistance training exercise without undue impact on vascular compliance in healthy, young females.

Abnormalities in distal first metatarsal joint surface orientation: Distal Metatarsal Articular Angle and Distal Metatarsal-2 Articular Angle

BackgroundHallux valgus (HV) in adults is an acquired pathology related to 1st metatarsal (M1) abduction. In children, it is related to abnormal M1 joint surface orientation. HypothesisHV deformities in children and adults differ. ObjectiveDescriptive study of radiologic abnormalities in a pediatric population of symptomatic HV, with comparison to a population without symptomatic HV. Materials and methodsWeight-bearing X-rays were studied in pediatric patients undergoing surgery for HV and in a control population. Measurements comprised M1P1, M1M2, DMAA, DM2AA, MPAA, and sesamoid subluxation index. ResultsTwenty-five patients (42 feet) were included in the HV group, and 16 patients (29 feet) in the control group. Mean age was 13 years in both. Interobserver reproducibility was excellent for M1P1, and good for M1M2, DMAA and DM2AA. In HV, 71% of feet showed M1M2 angle>12° and 98% DMAA>10°; DM2AA was>0°, except in 1 foot. DiscussionNormal values are the same in children and adults: M1P1<15°, DMAA<10° and M1M2<12°. In the HV group, DMAA was systematically pathological, while M1M2 was pathological in only 71% of cases. Childhood HV is related to abnormal DMAA, sometimes associated with increased M1M2 angle, especially in severe forms. DM2AA assesses distal M1 joint surface orientation with respect to the M2 axis; in the HV group, it was systematically>0° (except in 1 foot). Thus, in case of concomitant DMAA and M1M2 abnormalities, DMAA is more severely abnormal than M1M2 (DM2AA=DMAA-M1M2). ConclusionChildhood HV is mainly due to abnormal M1 joint surface orientation, sometimes associated with increased 1st metatarsal abduction. DM2AA reflects the balance between 1st metatarsal abduction and M1 joint surface orientation abnormality. Level of evidenceIII.

Disease related changes in vocal parameters of patients with type 2 diabetes mellitus

Background As the duration of diabetes progresses, various disease related complications might occur in patients. The main goal of this paper is to compare acoustic and aerodynamic measures of patients with type 2 diabetes mellitus (T2DM) with a control group of healthy subjects. Methods A total of 91 subjects, 51 individuals with type 2 diabetes mellitus (DM group) and 40 healthy volunteers (HV group) were participated in the study. Maximum phonation time (MPT) was captured for assessing phonatory mechanics. Acoustic voice parameters, including mean fundamental frequency (mean fo), jitter local (Jlocal), jitter absolute (Jabs), shimmer local (Slocal), shimmer decibel (SdB), and harmonics to noise ratio (HNR) were detected using the Praat software program. Results Only for Jabs, statically significant difference was found between the groups. There were no statically significant differences between any voice parameters of HV versus those with the duration of diabetes ≥10 years and the HbA1c level ≥7%. However, statically significant differences for MPT and Slocal were found between patients with neuropathy versus HV. In addition, a comparison between patients with voice complaint versus HV showed significant differences for Slocal and SdB. Conclusions The findings of the present study do not provide strong evidence about the possible effect of DM on the human voice. However, diabetic neuropathy is considered to be a factor affecting the voice parameters in the target population. The physicians should pay attention to the acoustic and aerodynamic voice parameters in patients with diabetes, particularly in those with neuropathy or voice complaints.

Identifying medication-related problems in pharmacist-run home visits

BackgroundHome visits (HVs) may be warranted for many reasons (e.g., uncontrolled disease states, suspected psychosocial issues, frequent hospitalizations, poor health literacy). Patients who frequently visit the emergency department (ED) are high-risk individuals, oftentimes exhibiting health-related barriers and medication-related problems (MRPs). ObjectivesThis study seeks to answer whether HVs for frequent ED users conducted by a pharmacist with pharmacy students will detect more MRPs compared to office visits (OVs) and enhance patient perception of HV services. MethodsPatients who visited the ED at least twice over a 12-month period were included in a retrospective chart review. Eligible patients were randomized into an HV group or OV group. Patients in the HV group were visited by a pharmacist and pharmacy students to identify and resolve MRPs, whereas patients in the OV arm brought their medications into the office for review. Patients in the HV group completed a pre- and postvisit survey about their experiences. ResultsEighteen patients participated in the study: 10 patients were randomized to the OV arm and 8 patients were randomized to the HV arm. A total of 39 MRPs were identified in 8 HVs versus 33 MRPs in 10 OVs (mean 5 ± 0.926 vs. 3.3 ± 1.89, P = 0.034). Overall, nonadherence was the most common MRP and medication reconciliation was the most common intervention. All 8 HV patients completed the pre- and post-HV surveys. Post-HV survey results indicated that patients agreed that student pharmacists were professional team members and that their HV was needed. The patients agreed to recommend a pharmacist-run HV. ConclusionPatient homes serve as alternative and convenient spaces for pharmacists to help manage their medications, specifically to identify MRPs and provide meaningful recommendations.

Synergetic effect of hookah smoking on varicocele-associated male reproductive impairment in the Saudi community in Al Jouf region, Saudi Arabia.

Purpose:The aim of this study is to explore the clinical relationship between the varicocele-associated male infertility with hookah smoking practice in the Saudi community in the al Jouf region.Materials and Methods:A total of 192 patients were categorized into two groups; varicocele with (Varicocele-Associated Hooka (VH) group; n = 100) and without smoking (NHV group; n = 92). Laboratory investigations such as hormonal (follicle-stimulating hormone, and luteinizing hormone [LH]), semen analysis were performed. Ultrasonography-based varicocele screening was performed. Data were analyzed with SPSS version 21.0. P < 0.05 was considered statistically significant.Results:Increased prevalence of varicocele Grade 2 (57%) and Grade 3 (52.5%) in HV groups. In contrast, Grade 1 was increased in NHV group (55.6%). A significant (P = 0.05) decrease in testosterone levels in the HV group (2.83 ± 0.21) as compared to NHV group (2.33 ± 0.07) observed. Decreased levels of sperm count (21.96 ± 6.31) and sperm morphology (14.09 ± 0.45) were observed in HV groups as compared to NHV group (22.5 ± 5.49, 14.51 ± 5.02, respectively). HV groups showed the increased diameter of the testicular vein (3.52 ± 0.71) as compared to NHV group (3.42 ± 0.72). Chronic smoking revealed a statistically significant effect on testosterone (P = 0.015) and LH levels (P < 0.041) in the HV group. In addition, hookah smoking sessions per week affect sperm motility (P = 0.02) in the HV group. A significant correlation was observed in sperm count (r = 0.24, P < 0.016) and motility (r = 0.25, P = 0.010) in HV group.Conclusion:Chronic hookah smoking significantly affects the reproductive hormonal and semen parameters in varicocele patients as compared to people with varicocele without smoking. This implies that hookah has an adverse effect on male reproductive and infertility.

Influence of viscosity and chemical composition of composite resins in non-carious cervical restorations: 12-month randomized clinical trial

Objective: The objective of this double-blind, randomized controlled clinical trial was to evaluate the clinicalperformance of two methacrylate-based flowable composite and ormocer-based flowable composite in non-cariouscervical lesions (NCCLs) of adult patients. Material and Methods: 183 restorations were performed on NCCLsusing the Futurabond U adhesive system, applied in the selective enamel etching mode in all cavities. After theadhesive application, the cavities were restored with one out of the three evaluated flowable composites (n = 61per group): ormocer-based flowable composite (Admira Fusion Flow, ORM), low viscosity methacrylate-basedcomposite (GrandioSO Flow, LV) and high viscosity methacrylate-based composite (GrandioSO Heavy Flow, HV).After 12 months of clinical performance, these restorations were evaluated according to FDI and USPHS criteriain the following items: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity andcaries recurrence. Results: eight restorations were lost/fractured after 12 months of clinical evaluation (1 inthe ORM and 7 in the HV group). The retention rates for 12- months (95% confidence interval) were 98.4%(91.3%-99.7%) for the ORM group, 100% (94.5%-100%) for the LV group and 88.5% (78.1%-94.3%) for theHV group, with no statistical difference identified between any pair of groups (p &gt; 0.05). Five restorationspresented small marginal adaptation defects at the 12-months evaluation recall, and all of them were consideredclinically acceptable. Conclusion: The clinical performance of the universal adhesive associated to ormocer-basedor methacrylate-based flowable composite were found to be promising after 12-month of clinical evaluation.KEYWORDSDental bonding; Dental restoration; Clinical trial.

Valine Supplementation Does Not Reduce Lipid Accumulation and Improve Insulin Sensitivity in Mice Fed High-Fat Diet.

Branched-chain amino acids (BCAAs), particularly leucine, were reported to decrease obesity and relevant metabolic syndrome. However, whether valine has a similar effect has rarely been investigated. In the present study, mice were assigned into four treatments (n = 10): chow diet supplemented with water (CW) or valine (CV) and high-fat diet supplemented with water (HW) or valine (HV). Valine (3%, w/v) was supplied in the drinking water. The results showed that valine treatment markedly increased serum triglyceride and insulin levels of chow diet-fed mice. The body weight, serum triglyceride level, white adipose tissue weight, and glucose and insulin intolerance were significantly elevated by valine supplementation in high-fat diet-fed mice. Metabolomics and transcriptomics showed that several genes related to fat oxidation were downregulated, and arachidonic acid and linoleic acid metabolism were altered in the HV group compared to the HW group. In conclusion, valine supplementation did not suppress lipid deposition and metabolic disorders in mice, which provides a new understanding for BCAAs in the modulation of lipid metabolism.

Efficacy and safety of high-viscosity cement in percutaneous vertebroplasty for treatment of Osteoporotic vertebral compression fractures: A retrospective cohort study.

To evaluate the efficacy and safety of high viscosity bone cement in the percutaneous vertebroplasty (PVP) for treatment of single-level osteoporotic vertebral compression fractures.Eighty patients were enrolled in this study. All patients were received PVP, and they were divided into 2 groups according to the viscosity of bone cement, either high viscosity bone cement (HV group) or low viscosity cement (LV group). Oswestry Disability Index questionnaire and visual analog scale as clinical assessments were quantified. The operative time and injected bone cement volume were recorded. The anterior vertebral height (AVH) and bone cement leakage were evaluated in the radiograph.No significant difference was observed in the operative time. Both groups showed significant improvements in pain relief and functional capacity status (visual analog scale and Oswestry disability index scores) after surgery. Less bone cement volume was injected into the the injured vertebra in the HV group and statistical significance was found between both groups. In the HV group, there was lower leakage rate and less patients of severe leakage compared with the LV group. However, the correction of AVH showed no significant differences between the 2 groups and no significant loss of AVH was observed in 2 groups.High-viscosity and low-viscosity PVP have the similar effects in improving quality of life and relieving pain. There were lower cement leakage rate and less patients of severe leakage in the PVP with high-viscosity bone cement.

Postural stability impairment in patients with bilateral hallux valgus: A case-control study using a stabilometer

BackgroundHallux valgus (HV) is an important risk factor for falls (in older people); however, the detailed relationship is less understood. We aimed to evaluate postural stability in bilateral HV patients. MethodsTwo groups of 20 female patients—an HV group and a C (i.e., non-HV) group—participated in this study. Evaluations were made using the Timed Up and Go (TUG) test, the Berg Balance Scale (BBS), the Falls Efficacy Scale (FES), track length (LNG), velocity (VEL), enveloped area (ENV), and root mean square area (RMS). ResultsTUG and FES scores were significantly higher and BBS scores were lower in the HV group than in the C group. LNG was significantly longer, VEL was higher, and ENV and RMS were wider in the HV group than in the C group. ConclusionsThe HV group exhibited impaired walking mobility, balance, and postural stability.

705 Evaluation of Burn Resuscitation Practices at a Large Burn Center

Abstract Introduction Large burns cause a systemic inflammatory response in the entire body leading to profound capillary leak, tissue edema and hemodynamic instability, a condition known as burn shock. If not managed appropriately, the patient can go into cardiac collapse and multi-organ failure. Adequate and timely burn resuscitation is a cornerstone in burn care. Different formulas have been studied to estimate fluid needs during the first 24hrs. The purpose of this study was to retrospectively evaluate burn resuscitation practices of large burns (20% TBSA and greater) and their associated outcomes at a large urban burn center. Methods This was a retrospective chart review of adult patients admitted to the burn center with burns of 20% TBSA or greater who survived the first 48hrs of admission. Primary outcome was evaluating the percentage of patients who received resuscitation according to predetermined volume ranges (&amp;lt; or equal to 4ml/kg/% TBSA vs &amp;gt;4ml/kg/%TBSA). Secondary outcomes included the use of adjuncts (colloids and ascorbic acid), markers of over- and under-resuscitation, the use of perfusion markers to guide resuscitation, and ICU and hospital length of stay. Results One hundred and fifty one adults with burns of 30–50% TBSA were included. Fifty nine per cent of them received a median of 2.9ml/kg/%TBSA (low volume- LV group) compared to 41% that received 5.1ml/kg/%TBSA (high volume-HV group). The HV group received more adjuncts in form of colloids (73% vs 61%) and ascorbic acid infusion (55% vs 37% of patients). Majority of patients in both groups had an adequate urine output and showed an improved base deficit at 24hrs from admission which were used as resuscitation markers; lactate levels were trended infrequently. The most common over-resuscitation complication was pulmonary edema, found in both groups in ~ 30% of patients. Only 6% of patients in both groups required renal replacement therapy initiation at 96hrs from admission. Patients in the LV group had a shorter ICU and hospital length of stay (16 vs 36 days, and 27 vs 39 days, respectively, p value &amp;lt; 0.05). Conclusions Patients who received median resuscitation volumes of ~ 3ml/kg/%TBSA had better outcomes compared to patients who received higher volumes. Protocolized monitoring of resuscitation markers is key to tailoring resuscitation efforts to patient’s individual response. The effect of the different adjunct therapies (colloids, ascorbic acid) should be further investigated. Applicability of Research to Practice Burn resuscitation is a cornerstone of specialized critical burn care. Additional data regarding the amount and type of resuscitation volume used and its associated outcomes can advance practice to guide successful resuscitation and decrease early set backs that may further complicate the patient’s clinical course.

Redistribution of joint moments and work in older women with and without hallux valgus at two walking speeds

BackgroundHallux valgus (HV) is a highly prevalent foot deformity in older women. Differences in lower extremity joint function of older women with and without HV during walking at slower and faster speeds are unknown. Research questionDoes walking speed affect lower extremity joint range of motion (ROM) and net extensor joint moment and associated work in older women with and without HV? MethodsThirteen older women with HV and 13 controls completed five walking trials at 1.1 and 1.3 m·s−1 as kinematic marker position and ground reaction force data were collected. Net ankle, knee, and hip joint moments were computed using inverse dynamics during the stance phase. Positive joint work was calculated by integrating hip power in early stance, knee power in mid stance, and ankle power in late stance. ResultsAverage ankle ROM and plantarflexor moment did not increase with walking speed in the HV group, while in the control group these variables were greater for the faster compared to the slower speed (p < 0.05). The magnitude of increase in ankle joint work with speed was 12 % lesser in the HV compared to the control group (p = 0.008). The hip ROM, extensor moment, and associated work was greater in the HV compared to the control group (p < 0.05). Knee and hip joint ROM, extensor moments, and work increased with walking speed in both groups (p < 0.05). SignificanceOlder women with HV compared to older women without HV demonstrate a distal-to-proximal redistribution by increasing hip motion and effort to compensate for reduced ankle contribution during walking.

Neuromuscular Electrical Stimulation Improves Energy Substrate Metabolism and Survival in Mice With Acute Endotoxic Shock.

ABSTRACTThis study investigated the therapeutic benefits of neuromuscular electrical stimulation (NMES).C57BL/6 mice were administered lipopolysaccharide (LPS; 20 mg/kg body weight) by intraperitoneal injection and divided into control (C) and NMES groups (n = 10–12 each). The latter received NMES to the bilateral gastrocnemius muscle for 1 h at low or high frequency (LF = 2 Hz and HF = 50 Hz, respectively) and low or high voltage (LV = 10 V and HV = 50 V, respectively). In LF–LV and LF–HV groups, NMES was performed twice and the results were compared with those for mice that received one round of NMES. Changes in energy metabolism were measured by indirect calorimetry up to 24 h; survival was evaluated up to 72 h after LPS administration; peroxisome proliferator-activated receptor gamma coactivator (PGC)-1α expression in the liver and gastrocnemius muscle was evaluated by quantitative PCR; and plasma concentration of interleukin (IL)-6 was determined by enzyme-linked immunosorbent assay.Survival was improved only in the LF–LV group with one round of NMES (P < 0.01) and the LF–HV group with two rounds of NMES (P < 0.05). Fatty acid oxidation (FAO) was slightly increased in these two groups, whereas carbohydrate oxidation (CHO) was decreased or not changed. Significant upregulation of PGC-1α in muscle as well as a decrease in plasma IL-6 level were also observed in these two groups (P < 0.05).Thus, NMES exerts therapeutic effects under conditions that induce a mild switch in energy metabolism from glucose to lipid predominant metabolism through PGC-1α upregulation and suppression of inflammation, and may be an effective early intervention even in hemodynamically unstable patients.

1809 Hysteroscopic Management of Retained Products of Conception: The New Gold Standard?

Study Objective To evaluate the safety and effectiveness of operative hysteroscopy for management of retained products of conception (RPOC) Design Retrospective chart review. Setting Operating room of a gynecology endoscopy unit of a large community center. Patients or Participants Patients who underwent hysteroscopic removal of RPOCs between November 1, 2008 and December 31, 2017 performed by a single physician. Interventions Hysteroscopic removal of retained products of conception performed in the operating room under general anesthesia. Cases were categorized with RPOC type 0 to 3 according to the vascularity of the retained tissue noted on Doppler vaginal ultrasound as per the Gutenberg classification of RPOC. Measurements and Main Results Forty-five (n=45) patients met inclusion criteria. The average age was 35.9 years of age (SD: 4.45). The preceding pregnancy resulting in retained POCs was abortion comprising 64.4% (n=29) followed by vaginal deliveries (13.3%, n=6) and cesarean (11.1%, n=5). Groups were divided into low vascularity group (Type 0 and 1 of the Gutenberg classification, NV Group) and moderate to high vascularity group (Type 2 and 3 of the Gutenberg classification, HV Group). 37.9% of patients of the NV Group had previous treatment compared to 62.5% of the HV Group (p Conclusion Hysteroscopic removal of RPOC is a highly effective and safe surgical procedure. The use of electrosurgical energy is frequently needed to obtain hemostasis in the presence of highly vascular RPOC. Physicians should ensure the capacity to use electrosurgical energy to avoid intraoperative complications when performing removal of highly vascular RPOCs.

Influence of foot position on the measurement of first metatarsal axial rotation using the first metatarsal axial radiographs

BackgroundThe purpose of this study was to clarify 1) the measurement error of the pronation angle using the first metatarsal axial radiograph with the pronation angle along the longitudinal axis of the first metatarsal as the reference standard, 2) the influence of variability in the foot position on the measurement error, and 3) the intra- and interrater reliability of pronation angle measurement using digitally reconstructed radiographs. MethodsDigitally reconstructed radiographs of the first metatarsal were generated from the computed tomography images of 10 feet without hallux valgus (non-HV group) and 10 feet with hallux valgus (HV group). In total, 135 images were created at different degrees of supination, plantarflexion, and adduction from each foot to simulate the first metatarsal axial view. Then, the pronation angle of the first metatarsal was measured. The measurement error was determined using the mean error and 95% limits of agreement. Simple linear regression analysis was used to test the correlations of the measurement error with pronation, plantarflexion and adduction angles. The intra- and interrater reliability of measurement was assessed using the intraclass correlation coefficient and minimum detectable change values. ResultsThe mean measurement errors were 0.1° for both the non-HV and HV groups. There was no significant correlation of the measurement error with pronation, plantarflexion or adduction angles for both groups. Additionally, the intraclass correlation coefficients for the intra- and interrater reliability were more than 0.9 in both the non-HV and HV groups with the minimum detectable change values ranging from 0.7° to 1.4°. ConclusionThe measurement error of first metatarsal pronation using the axial view was clinically acceptable. The measurements were not influenced by the variability in foot position while obtaining the radiograph. The first metatarsal axial view could be used to quantify the first metatarsal coronal rotation.

Short Call Abstracts

Short Call Abstracts

Ultrasound-guided rectus sheath block: an anatomic study in dog cadavers

ObjectivesTo describe the ultrasound-guided rectus sheath block technique and the anatomical spread of two volumes of methylene blue injection in dog cadavers. Study designBlinded, prospective, experimental cadaveric study. AnimalsA total of eight dog cadavers weighing 8.9 ± 1.6 kg. MethodsUltrasound-guided rectus sheath injections were performed bilaterally 1 cm cranial to the umbilicus using 0.25 mL kg–1 (low volume; LV) and 0.50 mL kg–1 (high volume; HV) of 0.5% methylene blue dye. A total of 16 hemiabdomens were injected. The ultrasound image quality of the muscular and fascial plane landmarks and needle visualization were scored using a standardized scale. Cadavers were dissected to determine the distribution of the dye and to assess staining of ventral branches of the spinal nerves. ResultsFewer ventral spinal nerve branches were stained in the LV group than in the HV group, at 2.00 ± 0 and 2.90 ± 0.83, respectively (p < 0.01). Ventral branches of thoracic (T) and lumbar (L) spinal nerves (T10, T11, T12, T13 and L1) were stained 25%, 100%, 75%, 25% and 0% of the time in LV group and 12.5%, 87.5%, 100.0%, 75.0% and 13.0% in HV group. A lesser extent of cranial–caudal dye distribution was observed in the LV group than in the HV group (7.1 ± 1.8 cm and 9.2 ± 1.8 cm, respectively; p = 0.03). There was no significant difference in medial–lateral spread of dye, number of test doses or ultrasound image quality scores between groups. Conclusions and clinical relevanceThe results of this study suggest that, on an anatomical basis, this easily performed block has the potential to provide effective abdominal wall analgesia for the ventral midline. This study supports the potential of the rectus sheath block for abdominal procedures, and further investigations on its clinical efficacy are warranted.

Effects of a 12-Week Resistance Training Program on Arterial Stiffness: A Randomized Controlled Trial.

Werner, TJ, Pellinger, TK, Rosette, VD, and Ortlip, AT. Effects of a 12-week resistance training program on arterial stiffness: a randomized controlled trial. J Strength Cond Res 35(12): 3281-3287, 2021-Arterial stiffness is an indicator of disease and is an independent predictor of cardiovascular events. Some reports indicate that resistance training increases indices of arterial stiffness, whereas others report no association. This study sought to determine the association between 2 common resistance training models and indices of arterial stiffness. We recruited 30 male, untrained subjects (18-30 years) and randomized them into 1 of 3 groups: control (CON, n = 10), high-intensity resistance exercise (HI, n = 10), and high-volume resistance exercise (HV, n = 10). Subjects randomized to the resistance training groups were required to perform whole-body strength training exercises 3-5 days a week for 12 weeks. The exercise regimen consisted of 2-3 sets of 3-8 repetitions (80-90% of 1 repetition maximum [1RM]) for the HI group and 3-4 sets of 10-15 repetitions (50-70% of 1RM) for the HV group. Anthropometry, carotid artery diameters, peripheral and central blood pressure, and maximal dynamic strength were measured before and after the 12-week study period. Subjects were instructed to maintain their normal diet and avoid aerobic exercise during the study. After the intervention, both the HI and HV groups increased their maximal strength on the back squat, bench press, and seated row (all p < 0.05). However, there were no changes in arterial stiffness indices between the groups. Using a randomized controlled trial with validated measurements of arterial stiffness, chronic resistance training does not appear to influence central arterial stiffness, regardless of training volume and load.