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No description available.

No description available.

Inledning: Den optimala intensiteten för styrkeökning vid styrketräning anses vara 60–70% av 1RM (repetitions maximum). Ocklusionsträning innebär träning i samband med delvis strypning av det arteriella blodflödet via ett yttre tryck proximalt på extremiteten. Vid ocklusionsträning används oftast en yttre belastning som endast motsvarar 20–40% av 1RM. Syftet med den här litteraturöversikten var att undersöka effekten av lågintensiv ocklusionsträning i övre extremitet avseende styrka och hypertrofi i muskler proximalt och distalt om ocklusionen jämfört med hög- och/eller lågintensiv styrketräning. Metod: En systematisk litteratursökning genomfördes 2023-03-01. Databaserna som söktes var PubMed, SPORTDiscus och CINAHL. Sökningen kompletterades genom granskning av inkluderade studiers referenslistor. En kvalitetsgranskning av det sammanvägda resultatet utfördes enligt the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).Resultat: Sökningen genererade 151 enskilda artiklar varav 15 artiklar inkluderades i studien. Kvalitetsgranskningen av underlaget visade på låg (⨁⨁◯◯) evidensgrad enligt GRADE. Två studier visade något större styrkeökning för ocklusionsträning jämfört med lågintensiv styrketräning på distal muskulatur, en visade ingen skillnad. Två studier visade större hypertrofi i ocklusionsgruppen jämfört med lågintensiv styrketräning på distal muskulatur, en visade ingen skillnad. Jämfört med högintensiv styrketräning på distal muskulatur var resultaten motsägelsefulla gällande styrka och hypertrofi. För proximal muskulatur gav ocklusionsträning större styrkeökningoch hypertrofi jämfört med lågintensiv styrketräning enligt majoriteten av studierna men verkade ge lägre styrkeökning och hypertrofi än högintensiv styrketräning. Konklusion: Ocklusionsträning i övre extremitet hos friska vuxna ger med låg säkerhet större styrkeökning och hypertrofi i muskulatur distalt och proximalt om ocklusionen jämfört med lågintensiv styrketräning. Jämfört med högintensiv styrketräning verkar ocklusionsträning ge relativt likvärdiga resultat för muskulatur distalt om ocklusionen men lägre styrkeökning och hypertrofi för proximal muskulatur. Dock bör dessa resultat tolkas med försiktighet på grund av de stora diskrepanserna mellan studierna när det kommer till träningsprotokoll, ocklusionsprotokoll och utvärderingsmetoder. / Introduction: The optimal intensity for strength gain during resistance training is thought to be 60-70% of 1RM (repetition maximum). Blood flow restriction training (BFRT) is when the arterial blood flow is partially occluded by a cuff placed proximally on the extremity during training. Usually during BFRT an external load equal to only 20-40% of 1RM is used. The aim of this study was to examine the effect of low intensity BFRT in the upper extremity regarding strength and hypertrophy in muscles proximally and distally to the occlusion site compared to high intensity resistance training (HI-RT) and/or low intensity resistance training (LI-RT). Method: A systematic search was conducted 2023-03-01. The databases that were searched wasPubMed, SPORTDiscus and CINAHL. The original search was supplemented by exploring the reference lists from the included studies. A quality assessment of the overall result was conducted according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).Results: Of 151 identified articles, 15 were included in the study. The quality assessment showed low (⨁⨁◯◯) quality evidence according to GRADE. Two studies showed slightly higher strength gain after BFRT compared to LI-RT in distal muscles, one study showed no difference between groups. Two studies showed higher hypertrophy after BFRT compared to LI-RT in distal muscles, one study showed no difference between groups. Compared to HI-RT on distal muscles the results were contradictory regarding strength and hypertrophy. BFRT on proximal muscles produced higherstrength gain and hypertrophy than LI-RT according to most studies but seemed to provide lower strength gain and hypertrophy than HI-RT. Conclusion: BFRT in the upper extremity generates, with low certainty, higher strength andhypertrophy in muscles distally and proximally to the occlusion site compared to LI-RT. Compared to HI-RT, BFRT produces equivalent results in distal muscles but lower strength gain and hypertrophy in muscles proximally to the occlusion site. These results should be interpreted with caution due to the large discrepancy between the included studies regarding training protocols, occlusion protocols and assessment methods.

No description available.

If unaccounted for, differences in human anatomy can lead to adverse clinical outcomes for patients. The literature describes numerous variations of branches of the brachial artery; the most common anomaly is found as high as 25% of the time, in which the brachial artery passes over the median nerve, splitting the brachial artery into superficial and deep branches. Another common variation of the forearm arterial supply includes branching of the radial artery from the brachial artery proximal to the antecubital fossa (12.5%). Herein, we report a unique variation found in a 96-year-old white whole-body formalin-fixed male donor, dissected with typical dissection techniques. Although predictably bifurcating at the cubital fossa, the relative calibers and distribution of the ulnar and radial arteries in the forearm were notably atypical. The common interosseous artery branched from the radial artery rather than the ulnar artery, and distally branched into the anterior and posterior interosseous arteries. This morphology resulted in the deep anterior forearm and entirety of the posterior forearm relying on the radial artery for perfusion. There was also a notable size difference between the ulnar and radial arteries in which the radial artery was much larger. A review of the literature revealed two articles reporting this unique anomaly. It is important clinically to understand this abnormal branching pattern, as various medical procedures involve the radial artery. The radial artery is commonly used to gain access to circulation for cardiac catheterization and stent placement and can also be accessed for cannulation for a variety of medical procedures. Awareness of radial artery dominance reduces the possibility of iatrogenic injury and increases positive clinical outcomes. This protocol was reviewed by the VCOM IRB (#2022-050).

No description available.

No description available.

Interscalene nerve blocks are common procedures performed before upper extremity surgeries in order to provide post-op pain relief and improve recovery time. Here we present two cases of patients who underwent a unilateral supraclavicular and bilateral interscalene nerve block, respectively. The first patient had no risk factors but the second presented with a body mass index of 45.5 and a history of symptoms consistent with obstructive sleep apnea but never diagnosed. Both patients experienced some form of respiratory distress diagnosed via changes in chest x-ray and clinical presentation. The mechanism of injury that occurs in these procedures is typically from inadvertent damage to the phrenic nerve. Mild adverse effects in interscalene nerve block are relatively common. However, there is minimal data in regards to performing bilateral interscalene nerve blocks. The purpose of this study is to highlight that severe complication in both high and low-risk patients can occur but may be reduced with a safer approach and more effective communication among multidisciplinary team members.

Bakgrund: Protesen har existerat sedan forntida egypten. Att leva med en protes kan ha både negativ och positiv påverkan hos protesbäraren. Omställningen bidrar till en ny livsstil där varje individ kan påverkas i olika utsträckning både psykiskt och fysiskt. Sjuksköterskan behöver ha kunskap om protesbärarens upplevelser för att kunna hjälpa protesbäraren att anpassa sig till livet med en protes. Syfte: Syftet med studien var att belysa upplevelser av att leva med en protes för nedre extremitet. Metod: Allmän litteraturstudie bestående av tio resultatartiklar som söktes fram i databaserna CINAHL, PubMed, PsycINFO samt Sage Journals. Artiklarna analyserades med hjälp av en guide för kvalitativ forskning gjord av Popenoe et al. (2021). Resultat: Det framkom fem kategorier och dessa var: rörlighet, komfort och funktion, samhällets inverkan, utbildning, jobb och ekonomi och socialt stöd. Alla kategorier belyste hur det kan vara att leva med en protes för nedre extremitet. Konklusion: Protesen kan medföra en känsla av självständighet samtidigt som den kan upplevas som en begränsning med smärtor och problem med passform. Stöd från anhöriga och vårdpersonal var viktigt för återhämtningen. Att vårdpersonal gav god och tillräcklig information var också väsentligt. Ytterligare forskning behövs om protesbärares upplevelser av att leva med en protes för nedre extremitet där sjuksköterskor får den kunskap som krävs för att ge en god omvårdnad. / Background: The prosthesis has existed since ancient Egypt. Living with a prosthesis can have both negative and positive effects on the prosthesis user. The transition contributes to a new lifestyle where each individual can be affected to different extents both psychologically and physically. The nurse needs to have knowledge about the experiences of a prosthesis user in order to be able to help the prosthesis user adapt to life with a prosthesis. Aim: The aim of the study was to illustrate experiences of living with a lower extremity prosthesis. Method: The general literature review study included ten result articles that were searched in the databases CINAHL, PubMed, PsycINFO and Sage Journals. The articles were analyzed using a guide for qualitative research made by Popenoe et al. (2021). Results: Five categories emerged and these were: mobility, comfort and function, impact from the society, education, jobs and finances and social support. All categories highlighted what it can be like to live with a prosthesis for the lower limb. Conclusion: The prosthesis can bring a sense of independence as well as a limitation that includes pain and problems with the fitting of the prosthesis. Support from relatives and healthcare professionals was important for the recovery. It was also essential that healthcare staff provided good and sufficient information to the patient. Further research is needed on prosthesis users’ experiences of living with a lower extremity prosthesis where nurses gain the knowledge required to provide good nursing care.