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Gostovic, M & Grube, R. Livet med venösa bensår. En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö Universitet: Fakulteten för Hälsa och Samhälle, Institutionen för Vårdvetenskap, 2022.   Bakgrund: Venösa bensår beror på venös insufficiens som är en kronisk sjukdom som orsakar cirkulatorisk svikt i de nedre extremiteterna och drabbar främst den äldre befolkningen. De venösa bensåren uppkommer ofta på grund av trombos, yttre trauma, fysisk inaktivitet eller hereditet. Det är vanligt med samsjuklighet vid venös insufficiens. Behandlingen består främst av omläggning och livslång kompressionsbehandling. Syfte: Syftet med litteraturstudien var att undersöka patienters upplevelser av att leva med venösa bensår. Metod: En litteraturstudie som är baserad på resultat från 13 empiriska studier med kvalitativ ansats från Cinahl, PubMed och PsycInfo. Studierna har granskats med hjälp av Kvalitetsgranskningsmall för studier med kvalitativ forskningsmetodik och de inkluderade studierna har bedömts vara av hög samt medelhög kvalitet. De inkluderade studiernas resultat analyserades med hjälp av integrerad sammanställning av kvalitativ forskning inspirerad av metasyntes. Resultat: Sex teman identifierades: Egenvårdens betydelse för välbefinnandet, Svårigheter i egenvården, Vården som en del av vardagen, Upplevelsen av smärta, Upplevd självbild och skam samt Social och psykisk påverkan. Konklusion: Litteraturstudien gav en ökad förståelse för vad det innebär att leva med venösa bensår och gav en insikt i vilka kunskapsluckor som vården behöver fylla för att kunna förse patienterna med en adekvat omvårdnad. / Gostovic, M & Grube, R. Life with venous leg ulcers. A Literature Review. Degree project in nursing 15 credit points. Malmö University: Faculty of Health and Society, Department of Care Science, 2022.   Background: Venous leg ulcers is caused by venous insufficiency which is a chronic disease caused by circulatory deficiency in the lower extremities and affects primarily the elderly population. The venous leg ulcers most commonly originates from thrombosis, external trauma, physical inactivity or heredity. Comorbidity is common among the patients with venous leg ulcers.  The treatment plan primarily consists of wound dressing and lifelong compression treatment. Aim: The aim of the study was to investigate the patients’ experiences of living with venous leg ulcers. Method: A literature review based on results from 13 empirical studies with qualitative design from Cinahl, PubMed and PsycInfo. The studies have been reviewed by using a review template intended for qualitative studies and the included studies were valued as high and medium high quality. The included studies results were analyzed with the help of an integrated compilation of qualitative research inspired by meta synthesis. Results: Six themes were identified: Self-care had an impact of the well-being, Health care as a part of the daily life, The experience of pain, Perceived self-image and shame and Social and psychological influence. Conclusion: The literature review increased the understanding of what it’s like to live with venous leg ulcers and gave an insight into which knowledge-gaps the health care needs to fill to provide the patients with adequate care.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Background: Classical ballet is an art form that seems graceful on the surface. However, beneath the disguise of beauty and ease lies an extremely physically demanding activity that calls for dedication, strength and perseverance. Ballet requires a specific body type and precise techniques, which predispose the dancer to musculoskeletal injury. Although a few studies have been conducted to investigate biomechanical factors as risk factors for injury in ballet dancers, few have included amateur ballet dancers and a range of biomechanical factors. Objectives: This study aimed to determine characteristics of ballet-related injury in amateur ballet dancers in the greater Durban area; to measure and record lower limb biomechanical measurements of these dancers; and to identify associations between the biomechanical measurements and characteristics of injury in the population. Method: A quantitative, questionnaire-based survey with biomechanical measurements was conducted on 21 amateur ballet dancers in the greater Durban area. Statistical analysis included the description of categorical variables using frequency and percentages in tables and bar charts. Continuous variables were summarised using mean, standard deviation and range, or median and range as appropriate. Independent Sample T-tests were used to compare biomechanical measurements between two independent groups. A p value <0.05 was considered as statistically significant. Pearson’s correlations and ANOVA testing were also used. Results: The period prevalence of ballet-related injury over the last 2 years was found to be 62% and the point prevalence 38%. There were 37 total previous injuries, most of which occurred in the hamstring (24%). Most of the worst previous injuries were reported to have occurred in the low back (31%). Most of the worst previous (70%) and current (93%) injuries occurred over time. The worst previous injuries reported ranged from mild to severe in severity, while the worst current injuries reported ranged from mild to moderate. Significant associations were found between right weight-bearing ankle dorsiflexion and previous injury; right weight-bearing ankle dorsiflexion and current injury; ‘functional turnout’ and onset of injury; right non weight-bearing ankle dorsiflexion and onset of injury; and ‘compensated turnout’ and onset of injury. Conclusion: The results suggest a significant association between musculoskeletal ballet-related injury and reduced weight-bearing ankle dorsiflexion; between injuries that occur over time (overuse injuries) and decreased ‘functional turnout’; and between overuse injuries and decreased non weight-bearing ankle dorsiflexion. These findings may help identify risk factors for injury in ballet dancers and contribute towards preventing ballet-related injury. / M

Inledning: Ny statistik visar att handboll är den lagidrott med störst förekomst av skador. Många kliniska studier beskriver svårigheterna med att veta när en spelare säkert kan återgå till idrott efter skada. I dagsläget jämförs det skadade benet med det friska vad gäller exempelvis muskelstyrka vid återgång till idrott. Det som i dagsläget är oklart är om det hos handbollsspelare är lämpligt att använda det friska benet som kontrollben. Syfte: Syftet var att undersöka hypotesen att kvinnliga handbollsspelare på elitnivå är starkare och har en bättre funktionell förmåga i sitt hoppben kontra icke- hoppben. Metod: En kvantitativ hypotesprövande tvärsnittsstudie utfördes där totalt 11 friska kvinnliga spelare i elitserien i handboll deltog. Deltagarna utförde vid ett tillfälle tre olika enbenstester vilka var sittande knäextensionsstyrka en repetition maximum (1 RM), enbensuppresning från box 30 sek samt enbenslängdhopp. Resultat: Deltagarna visade signifikant större styrka i hoppbenet kontra icke hoppbenet i knäextension 1 RM (p=0,03). Inga signifikanta skillnader kunde däremot påvisas mellan hoppben och icke-hoppben i enbensuppresning (p= 0,53) eller enbens längdhopp (p= 0,31). Slutsats: Studien visar att kvinnliga handbollsspelare är signifikant starkare i sitt hoppben kontra icke-hoppben i knäextension. Vid bedömning av muskelstyrka i samband med återgång till idrott efter knäskada på hoppbenet bör därför strängare kriterier än idag användas, förslagsvis 100 procent av icke-hoppben. Vid enbensuppresningstest och enbens längdhopp noterades inte några signifikanta sidoskillnader mellan hoppben kontra icke-hoppben, vilket gör att standardkriteriet, 90 procent förmåga jämfört med friskt ben bedöms vara tillräckligt för dessa test.       Nyckelord: Enbenstest, Lagidrott, Sidoskillnader, Återgång till idrott / Introduction: New statistics show that handball has the highest incidents of injuries in comparison to other team sports. Many clinical studies describe the difficulty of knowing when a player can safely return to sports after an injury. The meisurment in muscle strength before returning to sports is today a comparisment between the injuried leg and the healthy leg. It is rather unclear wether it is appropriate to use the healthy leg as the control leg when it comes to handball players. Purpose: The purpose of this study was to examine the hypothesis whether elite female handball players are stronger and have better functional capability in their jump leg compared to the non-jump leg. Method: A quantitative hypothesis examining study of 11 female players in the swedish handball premier league. Participants performed three different one leg tests each. These where, maximum strength seated knee extension using one repetition maximum (1 RM). One leg raised from a box for 30 seconds and one leg horizontal jump. Results: The participants had significantly greater strength in the jump leg versus the non-jump leg in the knee extension at 1 RM (p= 0.03). However no significant differences could be found between the jump leg and the non-jump leg in one leg raises (p=0.53) and in the one leg horizontal jump (p=0.31). Conclusion: This study has shown that female handball players are significantly stronger in their jump leg compared to the non-jump leg in knee extension. In assessing muscle strength associated with returning to the sport after an knee injury in the jump leg there should be a stricter criteria used. For example a 100 precent of the non-jump leg. The tests of the one leg raises and the one leg horizontal jumps found no significant differences between the jump leg and the non-jump leg. This results in the standard criteria of the 90 precent capacity comparing the injuried leg and healthy leg and therefore would be concidered sufficient enough for these tests when returning to sports.       Keywords: One leg tests, Team sports, Side differences, Return to sport

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Background: Classical ballet is an art form that seems graceful on the surface. However, beneath the disguise of beauty and ease lies an extremely physically demanding activity that calls for dedication, strength and perseverance. Ballet requires a specific body type and precise techniques, which predispose the dancer to musculoskeletal injury. Although a few studies have been conducted to investigate biomechanical factors as risk factors for injury in ballet dancers, few have included amateur ballet dancers and a range of biomechanical factors. Objectives: This study aimed to determine characteristics of ballet-related injury in amateur ballet dancers in the greater Durban area; to measure and record lower limb biomechanical measurements of these dancers; and to identify associations between the biomechanical measurements and characteristics of injury in the population. Method: A quantitative, questionnaire-based survey with biomechanical measurements was conducted on 21 amateur ballet dancers in the greater Durban area. Statistical analysis included the description of categorical variables using frequency and percentages in tables and bar charts. Continuous variables were summarised using mean, standard deviation and range, or median and range as appropriate. Independent Sample T-tests were used to compare biomechanical measurements between two independent groups. A p value <0.05 was considered as statistically significant. Pearson’s correlations and ANOVA testing were also used. Results: The period prevalence of ballet-related injury over the last 2 years was found to be 62% and the point prevalence 38%. There were 37 total previous injuries, most of which occurred in the hamstring (24%). Most of the worst previous injuries were reported to have occurred in the low back (31%). Most of the worst previous (70%) and current (93%) injuries occurred over time. The worst previous injuries reported ranged from mild to severe in severity, while the worst current injuries reported ranged from mild to moderate. Significant associations were found between right weight-bearing ankle dorsiflexion and previous injury; right weight-bearing ankle dorsiflexion and current injury; ‘functional turnout’ and onset of injury; right non weight-bearing ankle dorsiflexion and onset of injury; and ‘compensated turnout’ and onset of injury. Conclusion: The results suggest a significant association between musculoskeletal ballet-related injury and reduced weight-bearing ankle dorsiflexion; between injuries that occur over time (overuse injuries) and decreased ‘functional turnout’; and between overuse injuries and decreased non weight-bearing ankle dorsiflexion. These findings may help identify risk factors for injury in ballet dancers and contribute towards preventing ballet-related injury. / M

O autor realizou um estudo anatômico da região lateral e proximal da perna por meio de dissecção anatômica em cadáver, de exame arteriográfico e de mapeamento com Doppler em pacientes, visando a descrição da artéria denominada fibular superior, que se origina no tronco tíbio-fibular em 70% dos casos, da artéria fibular, em 20% e da artéria tibial anterior, em 10% e participa na irrigação do músculo sóleo e gastrocnêmio. Este vaso possui características adequadas para a realização de micro-anastomose. Após a conclusão da parte anatômica-descritiva, o autor aplicou o retalho derivado da artéria fibular superior, denominado retalho súpero-lateral da perna, na reconstrução de defeitos cutâneos e defeitos complexos tridimensionais, localizados no pé e tornozelo, em 10 pacientes, obtendo bons resultados / The author performed an anatomical study of the proximal and lateral aspect of the leg, consisting of cadaver dissection, arteriogram and Doppler mapping, in order to disclose the features of a new vessel, denominated superior peroneal artery. It originates from the tibiofibular trunk in 70 % of times, from the peroneal artery, 20%, and from the anterior tibial artery, 10%. It contributes to nourish the soleous and the lateral gastrocnemius muscle. The superior peroneal vessels are also suitable for microanastomosis. Therefore, the flap derived from the superior peroneal artery, called superolateral leg flap (SLL), was used for lower leg reconstructions in 10 patients, in two of them as chimeric flap for complex tridimensional defects, with good results

A diferenciação morfo-fisiológica entre rainhas e operárias de Apis mellifera decorre da alimentação recebida durante o desenvolvimento larval. Dentre as diferenças morfológicas entre as duas castas encontram-se estruturas especializadas para a coleta de pólen e própolis, localizadas nas pernas metatorácicas das operárias, ausentes nas pernas de rainhas. Os padrões de expressão de Ultrabithorax (Ubx) durante o desenvolvimento de operárias e rainhas estão associados aos padrões de cerdas das pernas de fêmeas adultas. Pernas mesotorácicas de operárias apresentam estruturas descritas como importantes na coleta de pólen, ausentes em rainhas. Por outro lado, as asas não possuem estruturas casta-específicas. No presente trabalho, análises globais de transcrição gênica por hibridação de lâminas de microarrays a partir de RNA total de pernas metatorácicas de operárias e rainhas em três estágios do desenvolvimento mostram 1952 genes diferencialmente expressos. Discos de pernas metatorácicas de larvas no início do quinto estágio larval, quando comparados aos de estágios mais tardios no desenvolvimento, têm alto níveis de transcritos de ativadores de Ubx, o qual está 25 vezes mais expresso em estágios subseqüentes do desenvolvimento. Buscas por motivos de ligação de fatores de transcrição nos promotores dos grupos de genes diferencialmente expressos revelam que os motivos para ligação de Ubx, Zeste e Twist estão super-representados em um dos conjuntos analisados. Dentro deste grupo, estão presentes genes cujos ortólogos em Drosophila são controlados por Ubx, como o caso do gene lola. Análises do processamento do mRNA de Ubx em pernas e asas de ambas as castas mostram que são produzidas três isoformas diferentes quanto à presença de dois microéxons (m1 and m2), que contêm 42 nt and 53 nt, respectivamente. A isoforma IIa-like, que contém o m2, entretanto, parece não ser capaz de produzir uma proteína Hox, já que possui um códon de terminação antes do homeodomínio. O perfil de transcrição diferencial de Ubx entre as castas está associado a apêndices que apresentam diferenças morfológicas, sendo Ubx mais transcrito em pernas meso e metatorácicas de operárias que rainhas. Quando analisadas as porcentagens de expressão de cada isoforma nos apêndices, claramente a isoforma IVa-like, sem microéxons, é a mais transcrita em todos os tecidos. Entretanto, nota-se que nas asas anteriores, onde há menos Ubx, a isoforma IIa-like é proporcionalmente mais transcrita que II nos outros apêndices. Destaca-se uma tendência à inclusão do microéxon m1 (isoforma IIIa-like) ao mRNA de Ubx transcrito em asas posteriores e pernas de rainhas em comparação a operárias, em detrimento da isoforma IVa-like. Análises do uso da região 3UTR em pupas de operárias mostram que há um microssatélite transcrito na porção distal da região 3UTR deUbx. A estrutura secundária predita agrupa separadamente as regiões codificadora e as regiões 3UTR proximal e distal. Análises de seqüenciamento de última geração revelaram que oito dos 51 microRNAs com sítios-alvo preditos na região 3UTR de Ubx estão mais expressos em asas anteriores, e outros dois em asas posteriores. Assim, nossos resultados mostram que o controle da expressão diferencial de Ubx é dada pela ativação desse gene por fatores de transcrição que se ligam ao promotor, controle do splicing alternativo, e expressão de microRNAs diferencial em cada casta e apêndice, controlando, assim, a morfogênese diferencial dos apêndices de fêmeas observada em A. mellifera. / Along with differences in physiological and behavioral characteristics, workers and queens of Apis mellifera also differ in appendage morphology. Some appendage specializations in the hind legs of honeybee workers, which are highly specialized pollinators, deserve special attention. The hind tibia of the worker has an expanded bristle-free region used for carrying pollen and propolis, the corbicula. In queens, this structure is absent. Although these morphological differences have been well characterized, the genetic inputs triggering the development of this alternative morphology have remained unknown. Through microarray analysis, we detected 1,952 genes that are differentially expressed during worker versus queen hind leg development. The gene expression signatures of the two castes have similar patterns of genes controlling development. At the beginning of the last larval instar, Ultrabithorax (Ubx) activators are more strongly expressed than in prepupae and early pupae; at this time Ubx expression is approximately 25 times higher. Within the gene expression signature, we identified a cluster formed by genes in which Ubx, Twist and Zeste binding sites are over-represented. This cluster includes genes for which Drosophila orthologs are known to be bound by Ubx, as in the case of lola. We also tested the extent of Ubx mRNA processing during wing and leg development. Unexpectedly, we found Ubx alternative splicing in both workers and queens; there were two microexons (m1 and m2) encoding 42 nt and 53 nt, respectively, arguing against the hypothesis that alternative splicing occurs exclusively within the Diptera. Inclusion of the m2 exon inserts a stop codon upstream from the exon containing the homeodomain, producing a truncated protein. Moreover, these bee microexons conserve the nucleotides known to be important for alternative splicing in Drosophila. During bee wing development, Ubx mRNA isoforms are transcribed in similar amounts in both castes; however, during leg development, queens produce 60% of the Ubx levels transcribed by workers. Analysis of 3UTR usage during bee development revealed a microsatellite region transcribed within the Ubx 3UTR. The predicted secondary structure locations separated the coding region into three branches and the proximal and the distal 3UTR regions. Deep-sequencing analysis revealed that eight out of 51 miRNAs predicted to target the Ubx mRNA are more highly expressed in worker forewings and two are more expressed in the hindwings. Therefore, we conclude that Ubx differential expression is activated by transcription factors that bind to its promoter, by control of alternative splicing, and moreover by microRNAs differentially expressed according to tissue and caste, resulting in differential morphogenesis of the hind leg in honeybee females.