Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis

There is an ongoing discussion regarding abdominal muscle (AbM) and pelvic floor muscle (PFM) synergism. Therefore, this study aimed to investigate the cocontraction between AbMs and PFMs in women with or without pelvic floor dysfunction (PFD). The following databases were searched up to December 21, 2018: MEDLINE, EMBASE, LILACS, PEDro and CENTRAL. We included any study that assessed the cocontraction between PFMs and AbMs in women with and without PFD. Two reviewers independently screened eligible articles and extracted data. The outcomes were extracted and analyzed as continuous variables with random effect models. Twenty studies were included. A meta-analysis did not show differences in women with and without PFD. However, a sensitivity analysis suggested cocontraction of the transversus abdominis (TrA) during PFM contraction in healthy women (standardized mean difference (SMD) 1.02 [95% confidence interval (CI) 1.90 to 0.14], P=0.02; I2 = not applicable; very low quality of evidence). Women with PFD during contraction of PFMs showed cocontraction of the obliquus internus (OI) (SMD 1.10 [95% CI 0.27 to 1.94], P=0.01; I2 = not applicable; very low quality of evidence), and obliquus externus (OE) (SMD 2.08 [95% CI 1.10 to 3.06], Po0.0001; I 2 = not applicable; very low quality of evidence). Increased cocontraction of the TrA may be associated with maximal contraction of PFMs in women without PFD. On the other hand, there is likely an increased cocontraction with the OI and OE in women with PFD

Estabilidade esquel?tica da mentoplastia de avan?o : compara??o entre fixa??o com parafusos posicionais e placa pr?-conformada

Made available in DSpace on 2015-04-14T13:30:30Z (GMT). No. of bitstreams: 1 453105.pdf: 815759 bytes, checksum: 659cc00433933dc2531b046154e2f3ee (MD5) Previous issue date: 2013-08-13Genioplasty is the surgical correction of the deformities of the chin. It is performed mainly to enhance facial harmony, however improvement in inferior lip posture and elimination of labial incompetence are noteworthy. Even though it is considered to be very stable, several factors can affect its stability, such as osteosynthesis performed. Several fixation methods have been described, such as wire osteosynthesis, positioning screws, plates and screws, Kirschner wires, resorbable plates and screws, which suggests a lack of a gold-standard. This retrospective study compared two of the most used fixation methods nowadays, two positioning screws and one pre-shaped plate, with regard to skeletal stability after advancement genioplasties. Cephalometric records from 26 fully grown, not consecutive patients (8 who had the osteotomy fixed with two positioning screws and 18 with one pre-shaped plate) were selected from the files of Hospital S?o Lucas da PUCRS. Immediate and 6-month postoperative cephalometric radiographs were inserted into Dolphing Imaging 11.7 for digital cephalometric analysis. Stability of the osteotomy was assessed through tracings superimposition and observation of differences in the vertical position of Menton and horizontal position of Pogonion. The two groups did not differ statistically, neither in Pg horizontal position (p=0.470), nor in Me vertical position (p=0.040). The fact that few patients had a complete documentation may have influenced the result. Further research with bigger samples is required.A mentoplastia ? a corre??o cir?rgica das deformidades do mento. ? realizada principalmente com o intuito detornar a face mais harm?nica, por?m deve-se ressaltar a melhora na postura do l?bio inferior e elimina??o da incompet?ncia labial que acompanha algumas deformidades dentofaciais. Mesmo sendo considerada bastante est?vel, v?rios fatores podem influenciar sua estabilidade. Um deles ? o m?todo de osteoss?ntese usado para fixar a osteotomia. Diversos m?todos j? foram descritos, desde fios de a?o, parafusos posicionais, placas e parafusos, fios de Kirschner, at? placas e parafusos reabsorv?veis, o que sugere n?o haver um padr?o-ouro para a fixa??o desta osteotomia. Esse estudo retrospectivo comparou dois dos m?todos mais utilizados atualmente para a fixa??o da mentoplastia, dois parafusos posicionais e uma placa pr?-conformada, quanto ? estabilidade esquel?tica ap?s mentoplastias de avan?o. A documenta??o cefalom?trica de 26 pacientes adultos, n?o-consecutivos (oito cuja fixa??o foi feita com dois parafusos posicionais e dezoito com uma placa pr?-conformada) foi selecionada dos registros do Hospital S?o Lucas da PUCRS. Radiografias p?s-operat?rias imediatas e de seis meses foram inseridas no programa Dolphin Imaging 11.7 para an?lise cefalom?trica digital. A estabilidade da osteotomia foi verificada atrav?s da sobreposi??o dos tra?ados e observa??o de diferen?as na posi??o horizontal do Pog?nio e na posi??o vertical do Menton. Os dois grupos n?o diferiram estatisticamente, seja na posi??o horizontal do Pog?nio (p=0.470), seja na posi??o vertical do Menton (p=0.040). O fato de poucos pacientes apresentarem uma documenta??o completa pode ter influenciado os resultados. Mais pesquisas com maiores amostras se fazem necess?rias