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Edurne Villar-Mateo Update l'année dernière

Transversus Abdominis Muscular Training and Chronic Low Back Pain Low back pain is not a diagnosis; it is a symptom describing the presence of pain in the lumbar vertebral or paravertebral region without any reference to the structure or cause of the process. It is one of the most widespread diseases and one of the most common reasons for visits in primary care setting. Exercises to improve lumbar stability involving co-contraction of the transversus abdominis have proved to be effective in reducing pain and improving function. It has been stated by ultrasound images that specific stabilization exercises cause contraction of the deep abdominal muscles, but it remains unclear whether training produce thickness muscle improvement and if this improvement is related to clinical findings. To try to resolve this issue a project of an experimental trial, double-blind (patient and evaluator) with two groups randomly assigned is presented. All participants will be recruited in an primary care center of the Catalan Health Institut and will sign informed consent. All will receive a protocolized treatment with therapeutic exercises and thermotherapy and, additionally, those assigned to the intervention group were instructed in performing lumbar stability exercises. Pain (VAS), function (Roland-Morris Questionnaire) and the thickness of the transversus abdominis, internal and external oblique muscles (measured by ultrasound) at baseline, end of treatment protocol (12 sessions) and three months after the end of treatment will be assessed. Results in pain, function, and its correlation with the mean changes in the thickness of transversus abdominis will be analyzed.

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Kristoffer W Barfod, MD Update l'année dernière

Metabolic Complications Following Achilles Tendon Rupture - A Cohort Study Introduction This study will evaluate the effect on glucose, lipid and bone metabolism following conservative orthopaedic procedures in patients who suffered from acute Achilles tendon rupture. The sedentary rehabilitation period following these procedures may impact negatively upon glucose, lipid and bone metabolic pathways whereas the more physically active rehabilitation period instituted 8 weeks after the injury is hypothesized to impose positive metabolic effects. The study is addition to the on-going clinical trial, Non-operative Treatment of Acute Achilles Tendon Rupture: Early Controlled Mobilization Compared With Immobilization, ClinicalTrials.gov Identifier: NCT02015364. Perspective This study will establish whether the well-known effects on glucose, lipid and bone metabolism of a sedentary lifestyle can be observed already following 8 weeks of almost total abstain from physical activity in non-diabetic individuals, who suffered an acute Achilles tendon rupture. Thereby, we will add knowledge to the previous findings following strict bed-rest in healthy individuals on glucose and lipid metabolism and bone turnover. In a clinical perspective it is important to examine the extent to which individuals deteriorate in various metabolic pathways to better understand the pathophysiology behind these defects both in healthy individuals and in patients, who undergo bed rest or an equal reduction in physical activity as part of their rehabilitation. Study design The present study includes 50 cases, who are examined early following injury (< 2 weeks) (baseline), 8 weeks (6 - 10 weeks) after injury and 52 weeks (40 - 64 weeks) after injury, respectively. Oral glucose tolerance test (OGTT) with ingestion of 75 g of glucose during a maximum of 3 min from baseline (0 min). Plasma for glucose, insulin, C-peptide, NEFA will be drawn. The individual will bring in morning spot urine for measurement of suPAR, creatinine, albumin and orosomucoid. The individual will have drawn blood for measurement of HbA1c, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, Na, K, creatinine, HgB, CRP, leukocytes, ALAT, alkaline phosphatase, Ca++, D vitamin, TSH, albumine and amylase. Also blood for BTM and plasma suPAR, IL6, TNFa and hsCRP will be drawn. Finally blood for lipid density profiling and lipid particle size will be drawn DXA of hip and lumbar spine including abdominal visceral and subcutaneous fat is done on a Hologic Discovery scanner.

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Closed trial
Cindy O'Bryant, PharmD Update l'année dernière

Glucose Variability in Cancer Patients Receiving Dexamethasone Dexamethasone is a steroid commonly used for the prevention of chemotherapy-induced nausea and vomiting (CINV). While effective, high dose dexamethasone is associated with numerous side effects, even when used for a short duration. One such effect is elevated blood glucose, or hyperglycemia. Current literature suggests increased risk of infection, poor wound healing, and increased mortality in non-cancer surgical patients with steroid-induced hyperglycemia. There is also evidence to support that elevations in blood glucose are associated with worsened outcomes in cancer patients. Much of this data comes from cancer patients that are treated in an inpatient setting where blood glucose is routinely checked. Limited data is available describing the fluctuations in blood glucose following dexamethasone administration in cancer patients being managed in an outpatient setting, such as the Anschutz Cancer Pavilion (ACP) Infusion Clinic. This study aims to characterize the effects dexamethasone has on blood glucose in cancer patients by utilizing Continuous Glucose Monitoring (CGM) devices. These devices are minimally invasive, are FDA approved, and can produce real-time data of blood glucose fluctuations over a course of 3-7 days. By inserting the devices under the skin of the abdomen, the investigators can evaluate the temporal relationship between glucose abnormalities and dexamethasone administration. Results from this study will not only increase the knowledge base of dexamethasone-induced hyperglycemia and identify patients at increased risk, but also allow future research to be conducted in order to determine if standard protocols can proactively minimize steroid-induced glucose fluctuations.

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Opened trial