Thesis (M.S.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains vii, 118 p. Includes abstract. Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri-Columbia, 2000. / Typescript. Vita. Includes bibliographical references (leaves [106]-130). Also available on the Internet.

背景：肱骨外上髁炎（ Lateral epicondylitis, LP ），又名網球肘、肘勞等，是一種以肘外側疼痛、肘關節功能下降為主要臨床表現的運動系統疾病。溫針被廣泛運用於肱骨外上髁炎的臨床治療，但目前未有專門的文獻研究與系統評價，其臨床研究的開展情況、療效與安全性尚不明確。 目的：(1）運用計量分析的方法，分析總結溫針治療肱骨外上棵炎臨床研究的開展情況、使用規律與理論依據﹔（ 2 ）運用系統評價的方法，評估當前臨床隨機對照試驗(Randomized Controlled Trial, RCT)的開展質量，評估溫針治療肱骨外上髁炎的療效與安全性。方法：系統檢索中國知網、Pubmed 等12 個電子數據庫，將符合計量分析納入標準的文獻進行統計與分析。同時，對符合系統評價納入標準的RCT使用PEDro 、Cochrane 偏倚風險評估工具與STRICTA 進行質量評價，並根據干預措施的不同以分組的形式對溫針治療肱骨外上髁炎進行療效與安全性評價。結果：計量分析共納人文獻81 篇，結果顯示： (1) 《中醫病證診斷療效標準》為臨床試驗中最主要的診斷與療效標準（ n＝48，59.25% ﹔ n=68, 83. 95% ）﹔（ 2 ）臨床試驗中溫針與其它乾預措施聯合的比例為92.59%(n=75 ），且聯合特殊針刺方法較為普遍( n=34, 41. 98% ）﹔ (3 ）溫針取穴頻數前6 的穴位為：阿是穴（ n=61, 34.27% ）、曲池（ n=37, 20. 79% ）、手三里（ n=27, 15 . 17% ）、外關（ n=ll, 6.18%) 、肘膠(n＝10, 5.62% ）、合谷（n=lO, 5.62% ）,穴位歸經以手三陽經為主。系統評價共納入文獻12 篇，計患者1177 例，主要結果顯示：(1 ）根據PEDro 量表3 篇RCT被評估為「良好」, 偏倚風險評估結果，顯示所有RCT 至少含有1 項高風險或不詳風險﹔（ 2) 2 篇RCT顯示溫針療效優於普通針刺，合併治癒率RR=3 .84, 95%CI﹝ 1.85, 7.96](P = 0.0003 ），合併總有效率RR=l.29, 95%CI ﹝ 1.10, 1. 52] ( P=O. 002 ），均有統計學差異﹔ (3) 2 篇RCT顯示溫針療效優於電針，合併治癒率RR=l. 47, 95%CI [1.18, 1.84 ﹞, P=0.0008 ，合併總有效率RR=l.06, 95%CI [1. 00, 1.3]，p = 0.03 ，均有統計學差異﹔（ 4 ）溫針優於其他替代療法，包括推拿、封閉、TDP 照射﹔（ 5) 1 篇RCT報告不良事件，包括暈針、出針後出血。結論：(1 ）溫針治療肱骨外上髁炎具有豐富的中醫理論基礎﹔（ 2 ）阿是穴、手三里、外關、曲池、合谷、肘膠是臨床上溫針治療肱骨外上髁炎的優選穴位，並主要從手三陽經論治﹔（ 3 ）溫針治療肱骨外上髁炎優於其他替代療法，包括普通針刺、電針、TDP照射、推拿與穴位注射，但證據等級較低。由於不良事件報告過少，暫無法就溫針的安全性得到確切結論。確切的結論尚需更多高質量的RCT以求證，建議將來開展設計科學的大樣本、多中心RCT。關鍵字：肱骨外上髁炎，網球肘，溫針，系統評價

Magister Scientiae (Physiotherapy) - MSc(Physio) / Introduction: The majority of University of the Western Cape coaches believe that in most sport codes, many female and male athletes get injured at least once a season. Consequently, occurrence of injuries signifies many set-backs in any team sports. University of the Western Cape sports injury intervention and rehabilitation strategies are relatively under-developed, and have not been systematically implemented, despite their proven effectiveness. However, due to intensive training, local and national league competitions, the number of injured athletes at University of the Western Cape has increased, and so delays of athletes’ recovery are caused. Thus, it is assumed that University of the Western Cape efforts may have lack of the necessary injury precautions on prevention and rehabilitation such as proactive injury treatment, paying special attention to the therapeutic process, including other necessary mechanisms. The current study has explored facilitating factors and some of the barriers on the implementation of injury prevention strategies, and determined the effectiveness of rehabilitation within University of the Western Cape sport teams in views of athletes, coaches, and medical staff. Methods: This study used a sequential exploratory design which entailed an initial phase of quantitative data collection and analysis, followed by a phase of qualitative data collection and analysis. This study used a close-ended survey and semi-structured interviews to identify the barriers and facilitators associated with the implementation of injury prevention strategies among sports clubs at the University of the Western Cape. Results: Data were collected on the general knowledge of players and team coaches about injury prevention as well as their sources of information regarding injury prevention. Football players were 49.5% while 15.8% were basketball players in this study. Cricket players were 10.9% while rugby players were 9.9%. Sources of players’ knowledge of injury prevention included doctor/physiotherapist, coaches and the media. Sources of coaches’ knowledge of injury prevention included doctor/physiotherapist, media and seminars. Most players and coaches agreed that there is a greater chance of sustaining an injury during a competitive match than during training. Players and coaches also agree that the risk of injury is reduced by wearing preferred protective clothing and thoroughly warming up and stretching prior to training or competition. Barriers to the implementation of an injury prevention strategy include not having enough time, being too tired after training, no advice given on such techniques, the notion that nobody else does it and lack of proper equipment. Facilitators of an injury prevention strategy include availability of medical staff (doctors and physiotherapists), players’ understanding of the coach’s instructions, and injury prevention facilities at University of the Western Cape, services accessibility and quality, injury discovery and follow-up, and injury prevention policy at University of the Western Cape. Conclusion: Based on the findings of this study, the following recommendations were made: (i) Intervention directed at players and coaches in the form of health promotion programmes through education to increase their knowledge and support in implementation of all prevention strategies either in training or in competition; (ii) Governing bodies at University of the Western Cape should develop and disseminate written sports safety policies and guidelines and supervise clubs in their development programmes.

Made available in DSpace on 2014-06-11T19:25:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-05-09Bitstream added on 2014-06-13T19:52:57Z : No. of bitstreams: 1 rubira_cj_me_botfm.pdf: 645645 bytes, checksum: e75d94d4917e2b0afc20438d49f14b0f (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Cerca de um terço dos traumas de tórax necessitam de hospitalização, e a grande maioria destes pacientes é tratada com toracostomia tubular fechada. A principal morbidade associada a este procedimento é o empiema pleural. Devido aos possíveis índices de morbidade e mortalidade relacionados ao empiema pós- traumático e as implicações do uso irracional de antibióticos, acreditamos ser relevante a realização desta revisão sistemática. Objetivos: Avaliar a efetividade da administração de antibiótico na redução de empiema em pacientes com toracostomia tubular devido a trauma. Métodos: Revisão sistemática de ensaios clínicos aleatorizados, utilizando a metodologia Cochrane, através de busca eletrônica e manual. Foram incluídos pacientes com trauma de tórax isolado, submetidos a toracostomia tubular fechada, sem distinção de idade e sexo, incluídos nos estudos elegíveis, cuja intervenção foi a administração de antibióticos como tratamento preventivo comparado com placebo. Resultados: Foram selecionados 6 estudos totalizando 753 pacientes com trauma torácico isolado submetidos a toracostomia tubular fechada. A metanálise demonstrou efeito de tratamento superior dos antibióticos em relação ao placebo, tanto para o desfecho empiema, RR=0,18 (IC 95% 0,07 a 0,46) como para o desfecho pneumonia, RR= 0,43 (IC 95% 0,23 a 0,82). Conclusão: Antibióticos são efetivos para reduzir a frequência de empiema e pneumonia em pacientes com trauma de tórax isolado submetidos a toracostomia tubular fechada. / About a third of the thorax traumas need hospitalization, and the great majority of these patients is treated with closed tube thoracostomy. The main morbidity associated to this procedure is the pleural empyema. Due to the possible morbidity and mortality rates related to the empyema posttraumatic and the implications of the irrational use of antibiotics, we believed to be relevant the accomplishment of this systematic review. Objectives: to evaluate the effectiveness of the antibiotic administration in the empyema reduction in patients with tube thoracostomy trauma. Methods: Systematic review of randomized clinical trials, using the Cochrane methodology, through electronic and manual search. It was included patients with isolated thorax trauma, submitted to closed tube thoracostomy, without distinction of age and sex, included in the eligible studies, whose intervention was the administration of antibiotics as preventive treatment compared to placebo. Results: 753 patients with isolated thoracic trauma submitted to closed tube thoracostomy in 6 studies. The meta-analysis demonstrated superior effect of antibiotics treatment in relation to the placebo, as much for the outcome empyema, RR=0,18 (IC 95% 0,07 to 0,46) as for the outcome pneumonia, RR = 0,43 (IC 95% 0,23 to 0,82). Conclusion: Antibiotics are effective to reduce the pneumonia and empyema incidence in patients with trauma of isolated thorax submitted to closed tube thoracostomy.

No description available.

Structural changes in the frontal and temporal lobes and in subcortical white matter tracts often occur following closed head injury (CHI). In contrast to this well delineated structural pathology, the post-traumatic cognitively-related functional changes in these and other brain regions have not been adequately described. To characterize the long-term functional neuroanatomy of CHI, the present study compared regional cerebral blood flow (rCBF) patterns in 13 severely-injured, well-recovered, unmedicated patients to those from 13 well-matched healthy controls. rCBF was measured using oxygen-15 water intravenous bolus positron emission tomography (PET) while subjects performed the Wisconsin Card Sorting Test (WCST), an indicator of prefrontal lobe functioning that involves matching stimuli to a changing sorting principle based on external feedback, and a Cued Recall Memory Test (CRMT), which involves remembering semantically-related word pairs. The neuropsychological tasks were used to provoke specific neural systems believed to be important in task performance (the prefrontal cortex in the former, the hippocampus in the latter). Subjects also performed two specially designed sensorimotor control tasks to provide measures of baseline rCBF. Given the controversy regarding the statistical analysis of PET data, a two-pronged method was utilized: 1) Statistical Parametric Mapping, the state-of-the-art technique that examines rCBF throughout the entire brain, and 2) region of interest analysis, an anatomically-based method for examining rCBF in a limited set of brain regions. Between-group rCBF differences were tested in the four tasks separately and also in the two neuropsychological tasks after subtracting baseline rCBF (i.e., rCBF activation). To characterize the relationship between cerebral perfusion and behavior, correlations were performed between performance and rCBF activation (i.e., task-control) for each group separately, and between rCBF activation and an index of current neuropsychological functioning for the CHI patients. Analyses of each task separately revealed that, compared to controls, CHI patients showed lower rCBF in anterior cingulate cortex (ACC) and subcortical areas. Analyses of rCBF activation data revealed: 1) increases in left inferior frontal gyrus (including Broca's area) and left hippocampus of CHI patients relative to control subjects during the WCST, 2) a negative correlation between task performance and the right hippocampus during the WCST in CHI patients, and 3) correlations between the hippocampus and performance during the CRMT in the CHI patients that were in the opposite direction to those found in the control subjects. These neurofunctional changes are compatible with the structural and cognitive sequelae of CHI First, given a hypothesized role of the ACC in attentional processes, reduced rCBF in this region of CHI patients may relate to the persistent and often subtle difficulties in attention after CHI, whereas rCBF diminutions in subcortical regions may relate to diffuse damage to or deafferentation of subcortical regions in this CHI sample. Second, given similar (although slightly, but not significantly, poorer) performance on the WCST by the CHI patients, increased left prefrontal cortical activity may partially reflect behavioral compensation (e.g., subvocalization to aid memory during the task) and also physiological compensation for inefficiencies in other brain areas (e.g., subcortical regions). Finally, in light of the relatively poorer task performance of CHI patients (non-significant tendency in the WCST but highly significant in the CRMT), differences between the groups in the direction of the correlations between performance/cognition and hippocampal activation may suggest disorganization of hippocampal functioning in CHI patients. This exploratory and descriptive investigation identifies brain structures with post-traumatic changes that may be important to cognition. These results may provide evidence of both behavioral and neurophysiological compensation in patients with severe CHI. / Graduate

Made available in DSpace on 2014-06-11T19:22:49Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-16Bitstream added on 2014-06-13T19:06:39Z : No. of bitstreams: 1 vanderlei_fm_me_prud.pdf: 588511 bytes, checksum: c9f96baef024c54b17849da45490f3c1 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introdução: a participação de crianças e adolescentes na prática de atividade física, bem como no meio esportivo, tem se tornado cada vez mais frequente, sendo que este envolvimento desportivo crescente suscita preocupações sobre o risco de instalação de lesões desportivas (LD). Objetivos: identificar a ocorrência de LD em crianças e adolescentes. Materiais e Métodos: foram entrevistados 1.311 crianças e adolescentes, de ambos os gêneros, com idade de até 18 anos praticantes de diferentes modalidades esportivas e obtidas informações sobre LD ocorridas durante um período de 12 meses, incluindo treinamentos e/ou competições. Foi utilizado o Inquérito de Morbidade Referida como instrumento de coleta que continha dados pessoais e de treinamento dos voluntários, como: idade, variáveis antropométricas, modalidades, tempo de treinamento e horas de treino por semana e informações referentes às lesões, tais como local anatômico, mecanismo da lesão, momento da lesão, gravidade, retorno às atividades físicas normais e recidivas. Todas as conclusões foram descritas no nível de 5% de significância. Resultados: foram identificadas 261 lesões, o que corresponde a uma prevalência de 17%. Observouse uma tendência de aumento da taxa de lesão conforme... Resumo completo, clicar acesso eletrônico abaixo) / Introduction: the participation of children and adolescents in physical activity, as well as in sports, has become increasingly common, and this growing sport involvement raises concerns about the risk of installation of sports injuries. Objective: identify the occurrence of injuries sports in children and adolescents. Materials and Methods: interviewed 1,311 children and adolescents of both genders, aged 18 years practicing different sports and get information about injuries sports that occurred during a period of 12 months, including training and competitions. We used the Morbidity Survey a tool collecting that containing personal data and training of volunteers, such as age, anthropometric variables, modality, training time and training hours per week and information regarding the injuries, such as anatomical site, mechanism of injury, time of injury severity of the injury... (Complete abstract click electronic access below)

Made available in DSpace on 2014-10-09T12:32:55Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:08:33Z (GMT). No. of bitstreams: 1 17896.pdf: 536541 bytes, checksum: 914e67d2a1b839fa60af631909047c5a (MD5) / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP; Faculdade de Odontologia, Universidade de São Paulo, São Paulo

Orientador: Carlos Marcelo Pastre / Banca: Amélia Pasqual Marques / Banca: Jayme Netto Júnior / Resumo: Introdução: a participação de crianças e adolescentes na prática de atividade física, bem como no meio esportivo, tem se tornado cada vez mais frequente, sendo que este envolvimento desportivo crescente suscita preocupações sobre o risco de instalação de lesões desportivas (LD). Objetivos: identificar a ocorrência de LD em crianças e adolescentes. Materiais e Métodos: foram entrevistados 1.311 crianças e adolescentes, de ambos os gêneros, com idade de até 18 anos praticantes de diferentes modalidades esportivas e obtidas informações sobre LD ocorridas durante um período de 12 meses, incluindo treinamentos e/ou competições. Foi utilizado o Inquérito de Morbidade Referida como instrumento de coleta que continha dados pessoais e de treinamento dos voluntários, como: idade, variáveis antropométricas, modalidades, tempo de treinamento e horas de treino por semana e informações referentes às lesões, tais como local anatômico, mecanismo da lesão, momento da lesão, gravidade, retorno às atividades físicas normais e recidivas. Todas as conclusões foram descritas no nível de 5% de significância. Resultados: foram identificadas 261 lesões, o que corresponde a uma prevalência de 17%. Observouse uma tendência de aumento da taxa de lesão conforme... Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: the participation of children and adolescents in physical activity, as well as in sports, has become increasingly common, and this growing sport involvement raises concerns about the risk of installation of sports injuries. Objective: identify the occurrence of injuries sports in children and adolescents. Materials and Methods: interviewed 1,311 children and adolescents of both genders, aged 18 years practicing different sports and get information about injuries sports that occurred during a period of 12 months, including training and competitions. We used the Morbidity Survey a tool collecting that containing personal data and training of volunteers, such as age, anthropometric variables, modality, training time and training hours per week and information regarding the injuries, such as anatomical site, mechanism of injury, time of injury severity of the injury... (Complete abstract click electronic access below) / Mestre