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The study compared superficial trunk muscle activity and postural control among an active extension subgroup of people with nonspecific chronic low back pain (AE-NSCLBP) with painfree controls during functional tasks. Thirty-two people (17 people with low back pain [LBP] and 15 painfree controls) participated in this study. Muscle activity of 5 trunk muscles and postural control were investigated during both standing tasks (eyes open/closed; single/double-leg balance) and dynamic functional tasks (spinal forward flexion and return, and a sit to stand transfer). Results showed that during single-leg standing, people with AE-NSCLBP exhibit higher muscle activity than painfree controls for 3 trunk muscles, especially with their eyes closed. There were no significant differences in muscle activity between eye conditions during double-leg standing and sit to stand transfer, forward flexion, and return from flexion. The AE-NSCLBP subgroup also demonstrated significantly impaired postural control (lower time to boundary) in 4 of 8 conditions, especially during single-leg standing and with their eyes closed. These findings show people with LBP typically demonstrated greater trunk muscle activity and poorer postural control while maintaining standing posture. This pattern was most evident when the postural challenge was higher, such as single-leg standing or with eyes closed. While this study design cannot infer causality, these findings have implications for LBP rehabilitation, particularly regarding approaches which seek to alter muscle activation among people with LBP. [ABSTRACT FROM AUTHOR]

Glucose is a primary fuel source to the brain, yet the influence of dysglycemia on neurodevelopment in children with type 1 diabetes remains unclear. We examined brain activation using functional MRI in 80 children with type 1 diabetes (mean ± SD age 11.5 ± 1.8 years; 46% female) and 47 children without diabetes (control group) (age 11.8 ± 1.5 years; 51% female) as they performed a visuospatial working memory (N-back) task. Results indicated that in both groups, activation scaled positively with increasing working memory load across many areas, including the frontoparietal cortex, caudate, and cerebellum. Between groups, children with diabetes exhibited reduced performance on the N-back task relative to children in the control group, as well as greater modulation of activation (i.e., showed greater increase in activation with higher working memory load). Post hoc analyses indicated that greater modulation was associated in the diabetes group with better working memory function and with an earlier age of diagnosis. These findings suggest that increased modulation may occur as a compensatory mechanism, helping in part to preserve working memory ability, and further, that children with an earlier onset require additional compensation. Future studies that test whether these patterns change as a function of improved glycemic control are warranted. [ABSTRACT FROM AUTHOR]

Objective: There are several methods for dialysis in children with chronic renal failure. One of the methods is the insertion of a peritoneal dialysis (PD) catheter, which can be embedded with para-median and midline approaches. In this study, we aim to compare the complications and the success rate of these two approaches. Materials and Methods: In this retrospective study, 41 patients under seven years who had undergone PD due to renal failure were included in this study. PD catheter was inserted via the paramedian approach in 15 and midline approach in 26 cases. Any early or late complications, as well as success rate, were compared between two approaches. Results: Paramedian compared to midline approach had a significantly lower rate of catheter obstruction (20% vs. 53.8%, p=0.03), leakage (13.3% vs. 46.2%, p=0.03) and local infection (13.3% vs. 50%, p=0.02) from early complications and lower rate of late fluid leakage (13.3% vs. 46.2%, p=0.03) and tunnel or exit site infection (6.7% vs. 38.5%, p=0.02) from late complications. The paramedian approach had a significantly higher rate of success (80% vs. 42.3%, p=0.02). Conclusion: Paramedian is a better approach for PD catheter insertion due to lower early and late complications, as well as a higher success rate. [ABSTRACT FROM AUTHOR]

Objective: Currently, postoperative thyroid hormone replacement dosing is weight-based with adjustments and made following Thyroid Stimulating Hormone (TSH) values, which may lead to delayed achievement of euthyroidism and failure in achieving an accurate estimation of the levothyroxine dose. We aimed to evaluate the relationship between Body Mass Index (BMI) and Lean Body Mass (LBM) with levothyroxine dose. Materials and Methods: Eighty patients with thyroid disease (benign and malignant) randomly enrolled the study. BMI and LBM were calculated during the pre-operative visit. Thyroid hormone replacement was started five day after surgery for benign and after a month for malignant cases, at a dose of 1.6 mcg/kg/day based on actual body weight. When euthyroidism was achieved, the levothyroxine dose was measured, and efforts were made to analyze its relationship with weight, BMI, and LBM. Results: In the benign group, levothyroxine dose was obtained at 1.51 mcg/kg per body weight. To determine the levothyroxine dose based on BMI and LBM, Y=-0.013+0.005 BMI and Y=0.048+0.002 LBM formulas were used, respectively. In the malignant group, a levothyroxine dose of 1.56 mcg/kg was obtained based on the weight variable. To determine the levothyroxine dose based on BMI and LBM, Y=0.01+0.004 BMI and Y=0.042+0.002 LBM formulas were used, respectively. In both groups, the levothyroxine dose that was calculated was more accurate using BMI with the obtained formula. Conclusion: Weight, BMI, and LBM can be used to determine the levothyroxine dose in patients receiving total thyroidectomy, but levothyroxine can be precisely measured using BMI. [ABSTRACT FROM AUTHOR]

Background: The paraspinal muscles, including multifidus (MF) and erector spinae (ES) play key roles in the stability and movement of the lumbar spine. This study aimed to determine the intra-rater reliability of the ES and MF muscle thickness measures of the rehabilitative ultrasound imaging (RUSI) in people with active extension pattern (AEP) non-specific chronic low back pain and controls., Methods: Fifteen females with AEP and 19 controls participated in this test-retest intra-rater reliability study, including two different testing sessions performed in four to seven days apart. The primary (raw) and derived (normalized) measures of the L4 MF and ES muscles`thickness were examined in three different positions (prone, sitting, and standing) on both days. A two-way mixed average of intra-class correlation coefficient (ICC3, K) with confidence interval (CI = 95%) was used to determine the relative reliability. The standard error of measurement (SEM) and minimal detectable change (MDC) values at a CI of 95% were computed to examine the absolute reliability., Results: The ICC values for the primary thickness of the L4 ES and MF muscles were from 0.85 to 0.91, except for MF muscle thickness in standing (ICC = 0.67) and sitting (ICC = 0.66) positions . The ICC values for derived data were lower in both groups. The SEM and MDC values were small enough to confirm the absolute reliability of the primary data., Conclusion: This study supports the use of RUSI for examining the primary measures of the L4 MF and ES muscles in asymptomatic and AEP participants, but it should be used cautiously for assessing the derived measures., Competing Interests: The authors declare that they have no competing interests., (© 2023 Iran University of Medical Sciences.)