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Background: Core Stability is the capacity to regulate the position and motion of the trunk over the pelvis for optimal force production, transmission, and motion control to the terminal segment during integrated sports activities. Obesity is linked to a number of debilitating musculoskeletal diseases in adults. The Foot Posture Index can be used to assess deviations in foot posture alignment, such as pronation and supination. Various studies were conducted to determine the impact of Body Mass Index on core stability and foot posture alignment in non-athletic males aged between 22 and 27 years. As a result, the current study is determining the impact of Body Mass Index on core stability and foot posture types in male and female participants of the age group (18 to 25 years). Materials and Methods: In this Observational study A total 100 samples were taken based on the inclusion and exclusion criteria which were categorized into two groups. Group A -50 male subjects, Group B - 50 female subjects. Foot Posture Index-6 was used to assess foot. Normal foot, Pronated and supinated foot type during static foot posture was obtained by Foot Posture index. Core Stability was checked by prone plank test. Conclusion: According to this study, both Men and Women are more likely to acquire pronated feet when their weight increases. In females, the likelihood of having a flat foot and a pronated foot type increases as the weight increases, especially those who are belonging to overweight and obese category of Body Mass Index. [ABSTRACT FROM AUTHOR]

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Copyright of Brazilian Journal of Kineanthropometry & Human Performance is the property of Brazilian Journal of Kineanthropometry & Human Performance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Physiotherapy interventions are well known and established in secondary and tertiary care. However, within the Brazilian primary health care (PHC), the role of physiotherapists is still under development, and there is a lack of representative data showing how and what is being implemented by these professionals. OBJECTIVE: The aim was to characterize the professional practices of physiotherapists working at PHC in Brazil. METHODS: This is an exploratory study that adopted a descriptive analysis based on the records of physiotherapists, considering assistance and sociodemographic aspects, in the period from 2016 to 2017. The following variables were extracted: region, federative unit and municipality, age group and sex of the attended user, condition/problem, procedure and place of attendance. RESULTS: A total of 318,780 procedures were recorded, concentrated in the South and southeast regions, with a predominance of clinical-assistance procedures and a higher frequency of attendance in Basic Health Units. Among the assisted users, the female gender prevailed in the age group of 20 to 59 years. Low back pain was the most frequently treated condition. CONCLUSION: The professional practices of physiotherapists working at PHC in Brazil were characterized by healthcare, clinical-assistance, preventive and health promotion activities, with emphasis on clinical-assistance practices focused on musculoskeletal conditions, especially low back pain. [ABSTRACT FROM AUTHOR]

Copyright of Revista Baiana de Enfermagem is the property of Universidade Federal da Bahia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: This study aimed to assess the clinical features, management, and long-term outcomes of pediatric patients with cow's milk protein allergy (CMPA). Materials and Methods: This is a retrospective study consisting of 246 children with CMPA. Data of the patients were collected from the medical files. Results: 95.8% of patients experienced the first reactions associated with cow's milk (CM) allergy during infancy. Hen's egg (56%) was the most frequent triggering food coexisting with CMPA, and this was followed by tree nuts (6%), wheat (5%) and lentil (3%). During five years of the follow-up period, tolerance occurred in 78.9% of the patients. The optimal cutoff value for CM sIgE to predict the tolerance status for CMPA was 7.39 kU/L with a sensitivity of 87.3% and a specificity of 58.3%, [95% confidence intervals (CI), 0.655-0.859, p<0.001]. IgE-mediated hypersensitivity reactions [odds ratios (OR) 4,369 (95% CI, 2,298-8,308), p<0.001], family history of atopy [OR 2,943 (95% CI, 1,324-6,541), p: 0.008), CM sIgE>7.39 [OR 9,683 (95% CI, 3,947-23,757), p<0.001], casein sIgE >0.56 [OR 6,909 (95% CI, 2,719-17,557), p<0.001], were the predictors for the persistence. Conclusion: This study showed that the majority of the CMPA in children gave rise to clinical manifestations in the infancy period, most of them less than six months of age. The prognosis of the disease was favorable with a spontaneous tolerance developed by the age of three in most patients. IgE-mediated hypersensitivity reactions, a family history of atopy and higher specific IgE values were predictive factors for the long-lasting disease. [ABSTRACT FROM AUTHOR]

Objective: Analyze postural control in the bipedal position as well as during gait and functional tests in patients with type 2 diabetes mellitus after supervised and unsupervised proprioceptive training. Design: A three-group randomized controlled trial. Setting: Physiotherapeutic Resources Lab, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo Subjects: Eighty patients with type 2 diabetes allocated to three groups: control, home training, and supervised training. Interventions: The supervised and home training groups performed two weekly sessions of proprioceptive exercises for 12 weeks. The control group was not submitted to any of treatment. Main measures: Bipedal balance, gait, and performance on functional tests were evaluated before and after 12 weeks using the Balance Evaluation Systems Test (BESTest) and the force plate. Results: No significant improvements were found regarding postural control, gait, or performance on the functional tests, as evidenced by the inter-group comparisons of the total BESTest score [control: 90.7 (81.5–92.6); home training: 85.2 (77.8–90.3); supervised training: 88.4 (82.6–91.4), P > 0.05] as well as the tests performed on the force plate (P > 0.05). The clinical effect size of the proposed intervention was less than 0.2, demonstrating no effect for the main outcome variable evaluated by the "Sensory Orientation" item of the BESTest and by the mCTSIB (pressure plate). Conclusions: The proposed proprioceptive training did not lead to improvements in postural control in patients with type 2 diabetes with no clinical signs of diabetic distal polyneuropathy when analyzed using the BESTest clinical evaluation and a force plate. Trial registration: NCT01861392 (clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

Introduction: Cancer drug therapy costs continue to rise and threaten the sustainability of Canada's public healthcare system. Previous studies have calculated potential savings utilizing different dosing regimens of cancer treatments. Our objectives were to determine the financial impact of drug wastage and to explore cost-effective dosing regimens for pembrolizumab. Methods: This was a retrospective study reviewing data for non-small cell lung cancer and melanoma patients at all six BC Cancer Regional Centres during fiscal years 2017 and 2018. Pembrolizumab waste amounts recorded in pharmacy wastage logs were totalled. Estimates of the number of vials used were compared between vial sharing and non-vial sharing practices to determine the cost differences. Costs for dosing regimens used during fiscal years 2017 and 2018 were compared to 2 mg/kg weight-based dosing (to a maximum of 200 mg), 2 mg/kg dosing rounding down within 5% and 10%, and flat dosing of 200 mg. Results: There were a total of 202 non-small cell lung cancer and 182 melanoma patients with 2948 doses dispensed. Documented wastage was valued at $1,829,047.44 (8.65%) and across all six centres, vial sharing could reduce costs by $3,207,600.00 using the 100 mg vials. Compared to fiscal years 2017 and 2018, 2 mg/kg dosing (to a maximum of 200 mg) was the most cost-effective, decreasing costs by $222,719.20; flat dosing of 200 mg was the most expensive, increasing costs by $6,625,260.40. Conclusions: Having smaller vial sizes, practicing vial sharing, and using weight-based dosing all improve cost savings. Further investigations on the allocation of resources to optimize drug use and minimize wastage are needed. [ABSTRACT FROM AUTHOR]

Background: Regarding the repair of vertebral compression fractures, there is a lack of adequate biomechanical verification as to whether only half of the vertebral body and the upper and lower intervertebral discs affect spinal biomechanics; there also remains debate as to the appropriate length of fixation. Methods: A model of old vertebral compression fractures with kyphosis was established based on CT data. Vertebral column resection (VCR) and posterior unilateral vertebral resection and reconstruction (PUVCR) were performed at T12; long- and short-segment fixation methods were applied, and we analyzed biomechanical changes after surgery. Results: Range of motion (ROM) decreased in all fixed models, with lumbar VCR decreasing the most and short posterior unilateral vertebral resection and reconstruction (SPUVCR) decreasing the least; in the long posterior unilateral vertebral resection and reconstruction (LPUVCR) model, the internal fixation system produced the maximum VMS stress of 213.25 mPa in a lateral bending motion and minimum stress of 40.22 mPa in a lateral bending motion in the SVCR. Conclusion: There was little difference in thoracolumbar ROM between PUVCR and VCR models, while thoracolumbar ROM was smaller in long-segment fixation than in short-segment fixation. In all models, the VMS was most significant at the screw-rod junction and greatest at the ribcage–vertebral body interface, partly explaining the high probability of internal fixation failure and prosthesis migration in these two positions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Inspirar Movimento & Saude is the property of Faculdade Inspirar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Obesity increases the stresses applied to the foot. Ergonomic rocker sole shoes increase energy expenditure of standing and walking in obese individuals but could potentially alter plantar pressure distribution. The aim of this study was to compare plantar pressure distribution during standing and walking between rocker sole and flat-bottomed shoes in obese subjects. Methods: Twenty adult obese women were asked to stand quietly and to walk at their preferred walking speed whilst wearing flat-bottomed or rocker sole shoes. Plantar pressure distribution was assessed using instrumented insoles. Results: During standing, toe pressure and as well as midfoot force were higher with rocker sole than with flat-bottomed shoes (p < 0.05). During walking with rocker sole shoes, mean pressure and maximal force were lower under the toes and the forefoot, but higher under the midfoot and rearfoot regions with respect to flat-bottomed shoes (p < 0.05). Conclusions: While standing with rocker sole shoes, obese subjects showed augmented pressure under the toes whereas forefoot and heel pressure had no significant difference compared to the flat-bottomed shoes. As walking with rocker sole shoes resulted in decreased forces and pressures under the forefoot but increased overload at heel and midfoot regions, obese individuals may not benefit from wearing rocker sole shoes during walking, at least from a plantar pressure distribution perspective. The use of ergonomic rocker sole shoes causes a redistribution of in-shoe plantar pressures leading to potentially detrimental adjustments that fail to attenuate the obesity-related increase in midfoot pressure during standing, while accentuating this region-specific impairment in dynamic conditions. Rocker sole shoes may best be avoided for walking in obese patients with heel pain or with any midfoot/rearfoot alteration such as medial arch flattening. [ABSTRACT FROM AUTHOR]

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Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Global is the property of Servicio de Publicaciones de la Universidad de Murcia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Clusters of cardiovascular risk (CVR) factors are associated with an increased risk of developing cardiovascular diseases (CVDs). This cross-sectional study assessed the associations between classic CVR factor clusters and inflammatory markers in Brazilian adolescents. Methods: Measurements included anthropometric, clinical and biochemical parameters and selected inflammatory markers in 487 adolescents (236 boys/251 girls; 12.06 ± 1.41 years). Results: After stratifying the population by gender and adjusting for potential confounding variables, principal component analysis was performed and it produced 5 independent components in both genders: adiposity, glucose metabolism, blood pressure, high-density lipoprotein (HDL)/triacylglycerols (TG), and cholesterol/low-density lipoprotein. Glucose metabolism was inversely associated with interleukin-1β (IL-1β) in both genders ( r = –0.026; r = –0.021); blood pressure was inversely associated with tumor necrosis factor alpha (TNF-α) in girls ( r = –0.046); HDL/TG was positively associated with interleukin-6 in girls ( r = 0.012), with IL-1β ( r = 0.010) TNF-α ( r = 0.045) in boys, and inversely associated with adiponectin in both genders ( r = –0.015; r = –0.013). Conclusion: The results suggest that lipid metabolism alterations, as potential early events in the development of CVDs, have a strong link to the inflammatory process, in contrast to other clusters of risk factors. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Kineanthropometry & Human Performance is the property of Brazilian Journal of Kineanthropometry & Human Performance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ConScientiae Saúde is the property of Nove de Julho University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Wstęp: Stopa ludzka jest ważną częścią statyczno-dynamiczną narządu ruchu. Zmiany które zachodzą z wiekiem w ukształtowaniu stóp powodują pogorszenie jakości życia, utratę mobilności oraz zwiększone ryzyko upadków. Celem pracy była ocena zmian zachodzących w ukształtowaniu stóp u kobiet i mężczyzn po 60 roku życia. Materiał i Metody: W badaniach wzięło udział 70 osób (35 kobiet i 35 mężczyzn), w wieku od 60 do 90 lat, średnia wysokości ciała badanych 167±5,6 cm, średnia masy ciała 78,1±12,1 kg. Grupę kontrolną stanowiło 70 osób (35 kobiet i 35 mężczyzn) w wieku 20-25 lat wysokość ciała badanych 172±7,3, masa ciała 70±8,4. Do oceny ukształtowania stóp wykorzystano bezinwazyjną metodę fotogrametryczną opartą na zjawisku mory projekcyjnej. Wyniki: Analiza statystyczna wykazała istotne różnice w ukształtowaniu stóp osób po 60 roku życia w porównaniu do grupy kontrolnej pomiędzy większością badanych parametrów. W przypadku porównania badanych parametrów pomiędzy grupą kobiet i mężczyzn istotne różnice zachodzą jedynie w przypadku długości (P:p=0,0000; L:p=0,0000) oraz szerokości stóp (P:p=0,0017; L:p=0,0007). Pozostałe parametry nie wykazują różnic istotnych statystycznie. Wnioski: 1. Ukształtowanie stóp kobiet i mężczyzn zmienia się wraz z wiekiem. 2. Zmiany w ukształtowaniu stóp kobiet i mężczyzn po 60 roku życia w większości parametrów nie są warunkowane przez płeć. Introduction: The human foot is an important static and dynamic part of motor organ. Changes that occur with age in shaping the feet causes worsening the quality of life, loss of mobility and increased risk of falls. The aim of this study was to assess changes in the women and men's over 60's feet shape parameters. Material and Methods: Seventy people (35 women and 35 men), aged between 60 and 90 years old, mean body height 167±5.6 cm, mean weight 78.1±12. kg participated in the study. The control group consisted of 70 people (35 women and 35 men) between the age of 20 and 25, mean body height 172±7,3 cm, mean body weight 70±8,4 kg. Non-invasive photogrammetric method based on the Moiré phenomenon has been used to evaluate the feet shape parameters. Results: Statistical analysis showed significant differences in the foot shape between men and women over sixty, compared to the control group for the majority of tested parameters. Analyzing the parameters between a group of men and women, statistically significant differences were found regarding the length (P:p=0.0000; L:p=0.0000) and the width of the foot (P:p=0.0017; L:p=0.0007). The other parameters do not show statistically significant differences. Conclusions: 1. The structure and the shape of a foot among men and women depends on age. 2. Changes in the foot shape among men and women over sixty, in most cases are not correlated with gender. [ABSTRACT FROM AUTHOR]

What is known and objective: High costs of novel agents increasingly put pressure on limited healthcare budgets. Demonstration of their real-world costs and cost-effectiveness is often required for reimbursement. However, few published economic evaluations of novel agents for multiple myeloma exist. Moreover, existing cost analyses were heavily based on conventionally treated patients. We investigated real-world health care costs of relapsed/refractory multiple myeloma in Dutch daily practice. Methods: A retrospective medical chart review was conducted for 139 patients treated between January 2001 and May 2009. Total monthly costs attributable to each cost component were described across all regimens and for bortezomib-, thalidomide- and lenalidomide-based treatment regimens. Results: Mean monthly total costs (€3,981) varied depending on the sequence of therapy (range: €442-€31,318). Significant cost drivers across all regimens included costs of therapy and hospital admissions. The acquisition costs for novel agents in particular accounted for 32% of mean total monthly costs. Prognostic factors associated with increased mean total monthly costs in multivariate regression analysis included low platelet counts ( P = 0·01) and worsening performance status ( P < 0·001). Mean total monthly costs of bortezomib- and lenalidomide-based regimens were significantly higher than those for thalidomide-based regimens in second, third and fourth treatment line. What is new and conclusions: Real-world costs during treatment of relapsed/refractory multiple myeloma vary greatly. Cost drivers include hospital admissions and acquisition costs of novel agents. Costs also vary by prognostic factors and treatment-related resource use. Future studies assessing the costs of combination therapy consisting of two or more novel agents are encouraged. [ABSTRACT FROM AUTHOR]

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)