Wearable Sensor-Based Biofeedback Training for Balance and Gait in Parkinson Disease: A Pilot Randomized Controlled Trial.

PubMed

Carpinella, Ilaria; Cattaneo, Davide; Bonora, Gianluca; Bowman, Thomas; Martina, Laura; Montesano, Angelo; Ferrarin, Maurizio

2017-04-01

To analyze the feasibility and efficacy of a novel system (Gamepad [GAMing Experience in PArkinson's Disease]) for biofeedback rehabilitation of balance and gait in Parkinson disease (PD). Randomized controlled trial. Clinical rehabilitation gym. Subjects with PD (N=42) were randomized into experimental and physiotherapy without biofeedback groups. Both groups underwent 20 sessions of training for balance and gait. The experimental group performed tailored functional tasks using Gamepad. The system, based on wearable inertial sensors, provided users with real-time visual and acoustic feedback about their movement during the exercises. The physiotherapy group underwent individually structured physiotherapy without feedback. Assessments were performed by a blinded examiner preintervention, postintervention, and at 1-month follow-up. Primary outcomes were the Berg Balance Scale (BBS) and 10-m walk test (10MWT). Secondary outcomes included instrumental stabilometric indexes and the Tele-healthcare Satisfaction Questionnaire. Gamepad was well accepted by participants. Statistically significant between-group differences in BBS scores suggested better balance performances of the experimental group compared with the physiotherapy without biofeedback group both posttraining (experimental group-physiotherapy without biofeedback group: mean, 2.3±3.4 points; P=.047) and at follow-up (experimental group-physiotherapy without biofeedback group: mean, 2.7±3.3 points; P=.018). Posttraining stabilometric indexes showed that mediolateral body sway during upright stance was significantly reduced in the experimental group compared with the physiotherapy without biofeedback group (experimental group-physiotherapy without biofeedback group: -1.6±1.5mm; P=.003). No significant between-group differences were found in the other outcomes. Gamepad-based training was feasible and superior to physiotherapy without feedback in improving BBS performance and retaining it for 1 month. After training, 10MWT data were comparable between groups. Further development of the system is warranted to allow the autonomous use of Gamepad outside clinical settings, to enhance gait improvements, and to increase transfer of training effects to real-life contexts. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Active music therapy approach for stroke patients in the post-acute rehabilitation.

PubMed

Raglio, Alfredo; Zaliani, Alberto; Baiardi, Paola; Bossi, Daniela; Sguazzin, Cinzia; Capodaglio, Edda; Imbriani, Chiara; Gontero, Giulia; Imbriani, Marcello

2017-05-01

Guidelines in stroke rehabilitation recommend the use of a multidisciplinary approach. Different approaches and techniques with music are used in the stroke rehabilitation to improve motor and cognitive functions but also psychological outcomes. In this randomized controlled pilot trial, relational active music therapy approaches were tested in the post-acute phase of disease. Thirty-eight hospitalized patients with ischemic and hemorrhagic stroke were recruited and allocated in two groups. The experimental group underwent the standard of care (physiotherapy and occupational therapy daily sessions) and relational active music therapy treatments. The control group underwent the standard of care only. Motor functions and psychological aspects were assessed before and after treatments. Music therapy process was also evaluated using a specific rating scale. All groups showed a positive trend in quality of life, functional and disability levels, and gross mobility. The experimental group showed a decrease of anxiety and, in particular, of depression (p = 0.016). In addition, the strength of non-dominant hand (grip) significantly increased in the experimental group (p = 0.041). Music therapy assessment showed a significant improvement over time of non-verbal and sonorous-music relationships. Future studies, including a greater number of patients and follow-up evaluations, are needed to confirm promising results of this study.

BIOMIND Portal for Developing 21st Century Skills and Overcoming Students' Misconception in Biology Subject

ERIC Educational Resources Information Center

Vebrianto, Rian; Rery, Radjawaly Usman; Osman, Kamisah

2016-01-01

This research was conducted to investigate the effectiveness of BIOMIND portal in enhancing students' 21st century skills and overcoming their misconceptions in Biology subject. 118 Indonesian high school students were involved in this quasi-experimental study. The experimental group underwent learning experiences using BIOMIND portal whereas the…

Feasibility and effects of newly developed balance control trainer for mobility and balance in chronic stroke patients: a randomized controlled trial.

PubMed

Lee, So Hyun; Byun, Seung Deuk; Kim, Chul Hyun; Go, Jin Young; Nam, Hyeon Uk; Huh, Jin Seok; Jung, Tae Du

2012-08-01

To investigate the feasibility and effects of balance training with a newly developed Balance Control Trainer (BCT) that applied the concept of vertical movement for the improvements of mobility and balance in chronic stroke patients. Forty chronic stroke patients were randomly assigned to an experimental or a control group. The experimental group (n=20) underwent training with a BCT for 20 minutes a day, 5 days a week for 4 weeks, in addition to concurrent conventional physical therapy. The control group (n=20) underwent only conventional therapy for 4 weeks. All participants were assessed by: the Functional Ambulation Categories (FAC), 10-meter Walking Test (10mWT), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Korean Modified Barthel Index (MBI), and Manual Muscle Test (MMT) before training, and at 2 and 4 weeks of training. There were statistically significant improvements in all parameters except knee extensor power at 2 weeks of treatment, and in all parameters except MBI which showed further statistically significant progress in the experimental group over the next two weeks (p<0.05). Statistically significant improvements on all measurements were observed in the experimental group after 4 weeks total. Comparing the two groups at 2 and 4 weeks of training respectively, 10mWT, TUG, and BBS showed statistically more significant improvements in the experimental group (p<0.05). Balance training with a newly developed BCT is feasible and may be an effective tool to improve balance and gait in ambulatory chronic stroke patients. Furthermore, it may provide additional benefits when used in conjunction with conventional therapies.

How balance task-specific training contributes to improving physical function in older subjects undergoing rehabilitation following hip fracture: a randomized controlled trial.

PubMed

Monticone, Marco; Ambrosini, Emilia; Brunati, Roberto; Capone, Antonio; Pagliari, Giulia; Secci, Claudio; Zatti, Giovanni; Ferrante, Simona

2018-03-01

To evaluate the efficacy of a rehabilitation programme including balance task-specific training in improving physical function, pain, activities of daily living (ADL), balance and quality of life in subjects after a hip fracture. Randomized controlled trial. A total of 52 older subjects selected for internal fixation due to extra-capsular hip fracture were randomized to be included in an experimental ( n = 26) and control group ( n = 26). The experimental group underwent a rehabilitation programme based on balance task-specific training. The control group underwent general physiotherapy, including open kinetic chain exercises and walking training. Both groups individually followed programmes of 90-minute sessions five times/week for three weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a Pain Numerical Rating Scale, the Berg Balance Scale, the Functional Independence Measure and the 36-item Short-Form Health Survey. The participants were evaluated before and after training, and after 12 months. Significant effects of time, group and time × group were found for all outcome measures in favour of the experimental group. A clinically important between-group difference of 25 points was achieved after training and at follow-up in terms of the primary outcome (WOMAC function before treatment, after treatment and at follow-up was 84.8 (3.7), 39.8 (4.9) and 35.7 (6.2) for the experimental group and 80.9 (5.7), 65.2 (7.1) and 61.0 (11.1) for the control group). An inpatient rehabilitation programme based on balance task-specific training is useful in improving physical function, pain, ADL and quality of life in older patients after hip fracture.

Effect of whole body vibration training on mobility in children with cerebral palsy: a randomized controlled experimenter-blinded study.

PubMed

Lee, Byoung-Kwon; Chon, Seung-Chul

2013-07-01

To evaluate ambulatory function and leg muscle thickness after whole body vibration training in children with cerebral palsy. A block randomized controlled trial with two groups. Physical therapy department laboratory. A total of 30 (15 experimental, mean (SD) age 10.0 (2.26) years and 15 control, 9.6 (2.58)) children with cerebral palsy, 15 males and 15 females. The experimental group underwent whole body vibration training combined with conventional physical therapy training; the control group underwent conventional physical therapy training three days a week for eight weeks respectively. Three-dimensional gait analyses and ultrasonographic imaging of the leg muscles were measured at pre- and post-test of intervention for eight weeks. Whole body vibration training resulted in significantly better gait speed (P = 0.001, from 0.37 (0.04) m/s to 0.48 (0.06)), stride length (P = 0.001, from 0.38 (0.18) m to 0.48 (0.18)) and cycle time (P = 0.001, from 0.85 (0.48) s to 0.58 (0.38)) in the experimental group compared with that in the control group. The ankle angle (P = 0.019, from 7.30 (4.02) degree to 13.58 (8.79)) also showed a remarkable increase in the experimental group, but not the hip (P = 0.321) and knee angle (P = 0.102). The thicknesses of the tibialis anterior (P = 0.001, 0.48 (0.08) mm to 0.63 (0.10)) and soleus (P = 0.001, 0.45 (0.04) mm to 0.63 (0.12)) muscles were significantly higher in the experimental group than in the control group. However, no significant effect was observed in the thickness of the gastrocnemius muscle (P = 0.645). These findings suggest that whole body vibration may improve mobility in children with cerebral palsy, probably through a positive effect on the leg muscles.

Transfer of obturator nerve for femoral nerve injury: an experiment study in rats.

PubMed

Meng, Depeng; Zhou, Jun; Lin, Yaofa; Xie, Zheng; Chen, Huihao; Yu, Ronghua; Lin, Haodong; Hou, Chunlin

2018-07-01

Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied. In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the randomized control method. Sixty Sprague-Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, wherein rats underwent femoral neurectomy without nerve transfer. Functional outcomes were measured using the BBB score, muscle mass, and histological assessment. At 12 and 16 weeks postoperatively, the rats in the experimental group exhibited recovery to a stronger stretch force of the knee and higher BBB score, as compared to the control group (p < 0.05). The muscle mass and myofiber cross-sectional area of the quadriceps were heavier and larger than those in the control group (p < 0.05). A regenerated nerve with myelinated and unmyelinated fibers was observed in the experimental group. No significant differences were observed between groups at 8 weeks postoperatively (p > 0.05). Obturator nerve transfer for repairing femoral nerve injury was feasible and effective in a rat model, and can hence be considered as an option for the treatment of femoral nerve injury.

Combined effects of sensory cueing and limb activation on unilateral neglect in subacute left hemiplegic stroke patients: a randomized controlled pilot study.

PubMed

Fong, Kenneth N K; Yang, Nicole Y H; Chan, Marko K L; Chan, Dora Y L; Lau, Andy F C; Chan, Dick Y W; Cheung, Joyce T Y; Cheung, Hobby K Y; Chung, Raymond C K; Chan, Chetwyn C H

2013-07-01

To compare the effects of contralesional sensory cueing and limb activation with that of sham control in the treatment of unilateral neglect after stroke. A randomized, single-blinded, sham-controlled pilot study. Two rehabilitation hospitals. Forty subacute left hemiplegic stroke inpatients with unilateral neglect. Participants were assigned randomly to 1 of 2 groups. The experimental group wore a wristwatch cueing device over the hemiplegic arm for three hours a day, five days per week, for three weeks, and also underwent conventional rehabilitation. Patients were encouraged to move their hemiplegic arm five consecutive times after each prompt. The sham group underwent the same rehabilitation process, except they wore a sham device. Neglect, arm motor performance, and overall functioning were assessed pre- and posttraining, and at follow-up. There were no significant differences between groups in outcome measures except the neglect drawing tasks (p = 0.034) (the mean gain score from baseline to follow-up assessment was 5.2 (3.7) in the experimental group and 1.9 (3.5) in the sham group), across three time intervals. The experimental group showed greater improvement in arm motor performance than did the sham group. The results did not confirm that sensory cueing and limb activation treatment is effective when compared with those receiving placebo to reduce unilateral neglect, but it might be useful for promoting hemiplegic arm performance in stroke patients.

The effects of reminiscence in promoting mental health of Taiwanese elderly.

PubMed

Wang, Jing-Jy; Hsu, Ya-Chuan; Cheng, Su-Fen

2005-01-01

This study examined the effects of reminiscence on four selected mental health indicators, including depressive symptoms, mood status, self-esteem, and self-health perception of elderly people residing in community care facilities and at home. A longitudinal quasi-experimental design was conducted, using two equivalent groups for pre-post test and purposive sampling with random assignment. Each subject was administered pre- and post- tests at a 4 month interval but subjects in the experimental group underwent weekly intervention. Ninety-four subjects completed the study, with 48 in the control group and 46 in the experimental group. In the experimental group, a statistically significant difference (p = 0.041) was found between the pre-post tests on the dependent variable, depressive symptoms. However, no statistical significance was found in subjects' level of mood status, self-esteem, and self-health perception after the intervention in the experimental group, but slightly improvement was found. Reminiscence not only supports depression of the elderly but also empower nurses to become proactive in their daily nursing care activities.

Effects of 4% Icodextrin on Experimental Spinal Epidural Fibrosis.

PubMed

Karanci, Turker; Kelten, Bilal; Karaoglan, Alper; Cinar, Nilgun; Midi, Ahmet; Antar, Veysel; Akdemir, Hidayet; Kara, Zeynep

2017-01-01

The aim of this experimental study was to investigate whether spinal epidural 4% glucose polymer solution is effective in the prevention of postoperative fibrosis. Twenty eight adult Wistar albino rats were randomly divided into two equal groups, including treatment and control. Both groups underwent L1 vertebral total laminectomy to expose the dura. Topical treatment group received 4% icodextrin. Four weeks later, epidural fibrosis was examined in both groups histologically, biochemically and macroscopically. Topical use of 4% icodextrin prevented significantly epidural fibrosis following the laminectomy operation. Topical 4% icodextrin application inhibits postoperative epidural fibrosis with various mechanisms and prevents adhesions by playing barrier role between tissue surfaces through flotation. Our study is first to present evidence of experimental epidural fibrosis prevention with 4% icodextrin.

Testicular cellular toxicity of cadmium : transmission electron microscopy examination.

PubMed

Haffor, A S; Abou-Tarboush, F M

2004-07-01

It is clear that environmental heavy metals influence life systems and reproductive system. In the present study histological investigation revealed that cadmium was testicular toxicant in mice. Here we compared the fine-structure of spermatogenesis in two groups of mice (SWR), experimental and control. The experimental group underwent cadmium ingestion at 1 mg/kg daily for 4 weeks. The control group underwent ingestion of distilled water with equal dosages, using the same type of injectors, for 4-weeks. After cadmium exposure period both control and experimental groups were killed and samples of the testes were processed for microscopic examination. Ultra sections were examined and photographed by Transmission Electron Microscope (JEOL- 100SX) at 80KV. Ultrastructure examination revealed, vascular endothelial, interstitial, and sertoli cells damages. Early impairments of germinal cellular differentiation resulted in deformations in all parts of late spermatid. There were dislocation of accrosomal granules, nuclear damage associated with chromatin heterogeneity, detached spermatid from the apical process of sertoli cell, disarrangement of the mitochondria, abnormal oriented tail piece, and abnormal microtubules complex. These ultra morphological abnormalities relate to cell injury and to the resulting physiological abnormality, necrobiosis. Based on the results of this investigation it can be concluded that cadmium ingestion at 1000 microg/kg caused testicular toxicity and abnormalities in early sperm development.

Reducing surgical levels by paraspinal mapping and diffusion tensor imaging techniques in lumbar spinal stenosis.

PubMed

Chen, Hua-Biao; Wan, Qi; Xu, Qi-Feng; Chen, Yi; Bai, Bo

2016-04-25

Correlating symptoms and physical examination findings with surgical levels based on common imaging results is not reliable. In patients who have no concordance between radiological and clinical symptoms, the surgical levels determined by conventional magnetic resonance imaging (MRI) and neurogenic examination (NE) may lead to a more extensive surgery and significant complications. We aimed to confirm that whether the use of diffusion tensor imaging (DTI) and paraspinal mapping (PM) techniques can further prevent the occurrence of false positives with conventional MRI, distinguish which are clinically relevant from levels of cauda equina and/or nerve root lesions based on MRI, and determine and reduce the decompression levels of lumbar spinal stenosis than MRI + NE, while ensuring or improving surgical outcomes. We compared the data between patients who underwent MRI + (PM or DTI) and patients who underwent conventional MRI + NE to determine levels of decompression for the treatment of lumbar spinal stenosis. Outcome measures were assessed at 2 weeks, 3 months, 6 months, and 12 months postoperatively. One hundred fourteen patients (59 in the control group, 54 in the experimental group) underwent decompression. The levels of decompression determined by MRI + (PM or DTI) in the experimental group were significantly less than that determined by MRI + NE in the control group (p = 0.000). The surgical time, blood loss, and surgical transfusion were significantly less in the experimental group (p = 0.001, p = 0.011, p = 0.001, respectively). There were no differences in improvement of the visual analog scale back and leg pain (VAS-BP, VAS-LP) scores and Oswestry Disability Index (ODI) scores at 2 weeks, 3 months, 6 months, and 12 months after operation between the experimental and control groups. MRI + (PM or DTI) showed clear benefits in determining decompression levels of lumbar spinal stenosis than MRI + NE. In patients with lumbar spinal stenosis, the use of PM and DTI techniques reduces decompression levels and increases safety and benefits of surgery.

[The Effects of an Empowerment Education Program for Kidney Transplantation Patients].

PubMed

Kim, Sung Hee; You, Hye Sook

2017-08-01

This study was conducted to develop an Empowerment Education Program (EEP) for kidney transplant patients and to test the program's effects on uncertainty, self-care ability, and compliance. The research was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 53 outpatients (experimental group: 25, control group: 28) who were receiving hospital treatment after kidney transplants. After the pre-test, patients in the experimental group underwent a weekly EEP for six weeks. The post-test was conducted immediately after, and four weeks after the program's completion in the same manner as the pre-test. For the control group, we conducted a post-test six and ten weeks after the pre-test, without and program intervention. A repeated measure ANOVA was performed to compare the change scores on main outcomes. Uncertainty was significantly lower in the experimental group than in the control group, both immediately after (t=-3.84, p=<.001) and 4 weeks after (t=-4.51 p=<.001) the program, whereas self-care ability (t=5.81, p=<.001), (t=5.84, p=<.001) and compliance (t=5.07, p=<.001), (t=5.45, p=<.001) were significantly higher. Kidney transplant patients who underwent an EEP showed a decrease in uncertainty and an improvement in self-care ability and compliance. Thus, our findings confirmed that an EEP can be an independent intervention method for improving and maintaining the health of kidney transplant patients. © 2017 Korean Society of Nursing Science

Outward Bound in the Professional Education of Teachers. A Study of an Experimental Component in Field Experiences.

ERIC Educational Resources Information Center

Smathers, Keener M.

In an effort to measure the impact of Outward Bound (OB) education on teacher candidates, an 18-day stress experience was arranged for 12 Appalachian State University students and then compared with the effects of the normal 11-week student teacher experiences of two other groups. The OB group underwent a series of individual and group wilderness…

Effects of progressive backward body weight suppoted treadmill training on gait ability in chronic stroke patients: A randomized controlled trial.

PubMed

Kim, Kyung Hun; Lee, Kyoung Bo; Bae, Young-Hyeon; Fong, Shirley S M; Lee, Suk Min

2017-10-23

A stroke patient with hemiplegic gait is generally described as being slow and asymmetric. Body weight-supported treadmill training and backward gait training are recent additions to therapeutic gait trainings that may help improve gait in stroke patient with hemiplegic gait. Therefore, we examined the effect of progressive backward body weight-supported treadmill training on gait in chronic stroke patients with hemiplegic gait. Thirty subjects were divided to the experimental and control groups. The experimental group consisted of 15 patients and underwent progressive backward body weight-supported treadmill training. The control group consisted of 15 patients and underwent general treadmill gait training five times per week, for a total of four weeks. The OptoGait was used to analyze gait kinematics, and the dynamic gait index (DGI) and results of the 6-minute walk test were used as the clinical evaluation indicators. A follow-up test was carried out four weeks later to examine persistence of exercise effects. The experimental group showed statistically significant results in all dependent variables week four compared to the control group. However, until the eighth week, only the dependent variables, of affected step length (ASL), stride length (SL), and DGI differed significantly between the two groups. This study verified that progressive bodyweight-supported treadmill training had a positive influence on the temporospatial characteristics of gait and clinical gait evaluation index in chronic stroke patients.

The effects of reminiscence on depressive symptoms and mood status of older institutionalized adults in Taiwan.

PubMed

Wang, Jing-Jy

2005-01-01

This study examined the effects of reminiscence on depressive symptoms and mood status of elderly people residing in long-term care facilities. A longitudinal quasi-experimental design was conducted, using two equivalent groups for pre-post test and purposive sampling. Each subject was administered pre- and post- tests at a 4 month interval, but subjects in the experimental group underwent weekly individual reminiscence therapy. Geriatric Depression Scale short form (GDS-SF) and Apparent Emotion Rating Scale (AER) were used as study instruments. Forty-eight subjects completed the study, with 25 in the experimental group and 23 in the control group. The experimental findings indicated that the experimental group demonstrated fewer depressive symptoms (p < 0.05) and better mood status (p = 0.05) on the post-test comparing to the control group. These warranted that reminiscence therapy is a recommended therapy for older people who reside in care facilities. It can provide a basis for planning geriatric care in community to promote the well being and quality of life of older people.

A comparision of Twin-block and Forsus (FRD) functional appliance--a cephalometric study.

PubMed

Mahamad, Irfanulla Khan; Neela, Praveen Kumar; Mascarenhas, Rohan; Husain, Akhter

2012-01-01

The aim was to compare the effects of Twin-block & Forsus (FRD) functional appliances in the correction of Angles Class II division 1 malocclusions. Pre- and post-treatment lateral cephalograms of 25 patients who underwent treatment with twin block for the correction of class II div 1 were compared with 25 patients who underwent treatment with Forsus appliance. These were again compared with the pre follow up and post follow up lateral cephalograms of 25 patients who have not undergone any treatment during this period. All the 3 group patients were compared for skeletal, dental and soft tissue parameters. Cephalometric analysis revealed that both Twin-block & Forsus Fatigue Resistant Device (FRD) appliances stimulated mandibular growth. Statistically significant differences between the two groups were found. Twin-block patients showed statistically very high significant (p < 0.001) increase in mandibular length (6.02 mm) whereas Forsus appliance patients showed significant (p < 0.05) increase in mandibular length (1.6 mm) when compared with control group (0.3 mm). No significant restriction of maxillary growth was found in either of the two experimental groups when compared to control group. Significant increase in lower anterior facial height & posterior facial height was observed in both experimental groups in relation to control group. Significant reduction of overjet and overbite was observed in both experimental groups. Class I molar relationship and improvement in the soft tissue profile were achieved in both treatment groups compared with control group. Both Twin Block and Forsus were effective in the treatment of Class II Div 1 malocclusion. Class II correction with Twin-block is more due to mandibular skeletal and dentoalveolar changes whereas in Forsus, it is more due to dentoalveolar changes and less skeletal changes.

The Effectiveness of Mindfulness-based Cognitive Therapy on Psychological Symptoms and Quality of Life in Systemic Lupus Erythematosus Patients: 
A Randomized Controlled Trial.

PubMed

Solati, Kamal; Mousavi, Mohammad; Kheiri, Soleiman; Hasanpour-Dehkordi, Ali

2017-09-01

This study was conducted to determine the efficacy of mindfulness-based cognitive therapy (MBCT) on psychological symptoms and quality of life (QoL) in patients with systemic lupus erythematosus (SLE). We conducted a randomized single-blind clinical trial in patients with SLE referred from the Imam Ali Clinic in Shahrekord, southwest Iran. The patients (46 in total in two groups of 23 each) were randomly assigned into the experimental and control groups. Both groups underwent routine medical care, and the experimental group underwent eight group sessions of MBCT in addition to routine care. The patient , s QoL was assessed using the General Health Questionnaire-28 and 36-Item Short Form Health Survey before, after, and six months after intervention (follow-up). A significant difference was seen in psychological symptoms and QoL between MBCT and control groups immediately after the intervention and at follow-up ( p ≤ 0.050). However, the difference was not significant for the physical components of QoL ( p ≥ 0.050). MBCT contributed to decreased psychological symptoms and improved QoL in patients with SLE with a stable effect on psychological symptoms and psychological components of QoL, but an unstable effect on physical components.

Effect of whole-body cryotherapy on the rheological parameters of blood in older women with spondyloarthrosis.

PubMed

Kulis, Aleksandra; Misiorek, Anna; Marchewka, Jakub; Głodzik, Jacek; Teległów, Aneta; Dąbrowski, Zbigniew; Marchewka, Anna

2017-01-01

Cryotherapy is a physiotherapy method used to treat back pain in older persons. This study aims to evaluate the changes in the rheological parameters of blood in older women with spondyloarthrosis, who underwent whole-body cryotherapy. The experimental group comprised 69 older women with lumbar spondyloarthrosis, aged between 65 and 70 years. Due to the methodology of the procedure, the experimental group was randomly divided into three groups. Each group underwent two weeks of different types of physiotherapy: only whole-body cryotherapy (22 women); only kinesitherapy (23 women); and both cryotherapy and kinesitherapy (24 women). The control group comprised 25 women who did not undergo any form of therapy. The evaluation of the rheological properties of the blood encompassed measurements of the plasma viscosity, the erythrocyte elongation and aggregation indices, and the level of fibrinogen. The conducted rheological tests revealed a significant decrease in the erythrocyte elasticity and aggregation indices only in the group of women who had undergone both whole-body cryotherapy and kinesitherapy. Applying whole-body cryotherapy to older women with spondyloarthrosis decreases the elasticity of erythrocytes and, despite favourable changes in the aggregation parameters, problems with perfusion may still appear. For this reason, the benefit of using whole-body cryotherapy in these persons is debatable.

Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma.

PubMed

Huang, Jian-Kang; Ma, Ling; Song, Wen-Hua; Lu, Bang-Yu; Huang, Yu-Bin; Dong, Hui-Ming

2016-01-01

Endoscopic thyroidectomy for minimally invasive thyroid surgery has been widely applied in the past decade. The present study aimed to evaluate the effects of single-port access transaxillary totally endoscopic thyroidectomy on the postoperative outcomes and functional parameters, including quality of life and cosmetic result in patients with papillary thyroid carcinoma (PTC). Seventy-five patients with PTC who underwent endoscopic thyroidectomy via a single-port access transaxillary approach were included (experimental group). A total of 123 patients with PTC who were subjected to conventional open total thyroidectomy served as the control group. The health-related quality of life and cosmetic and satisfaction outcomes were assessed postoperatively. The mean operation time was significantly increased in the experimental group. The physiological functions and social functions in the two groups were remarkably augmented after 6 months of surgery. However, there was no significant difference in the scores of speech and taste between the two groups at the indicated time of 1 month and 6 months. In addition, the scores for appearance, satisfaction with appearance, role-physical, bodily pain, and general health in the experimental group were better than those in the control group at 1 month and 6 months after surgery. The single-port access transaxillary totally endoscopic thyroidectomy is safe and feasible for the treatment of patients with PTC. The subjects who underwent this technique have a good perception of their general state of health and are likely to participate in social activities. It is worthy of being clinically used for patients with PTC.

Mirror Therapy with Neuromuscular Electrical Stimulation for improving motor function of stroke survivors: A pilot randomized clinical study.

PubMed

Lee, DongGeon; Lee, GyuChang; Jeong, JiSim

2016-07-27

This study was to investigate the effects of Mirror Therapy (MT) combined with Neuromuscular Electrical Stimulation (NMES) on muscle strength and tone, motor function, balance, and gait ability in stroke survivors with hemiplegia. This study was a randomized controlled trial. Twenty-seven hemiplegic stroke survivors from a rehabilitation center participated in the study. The participants were randomly assigned to either an experimental or a control group. The experimental group (n = 14) underwent MT combined with NMES and conventional physical therapy, and the control group (n = 13) underwent conventional physical therapy alone. Muscle strength and tone, balance, and gait ability were examined at baseline and after 4 weeks of intervention. A hand-held dynamometer was used to assess muscle strength, the Modified Ashworth Scale (MAS) was used to assess muscle tone, the Berg Balance Scale (BBS) and Timed Up and Go test (TUG) were used to ascertain balance, and the 6-m Walk Test (6mWT) was used to examine gait ability. After the intervention, compared to baseline values, there were significant improvements in muscle strength and MAS, BBS, TUG, and 6mWT values in the experimental group (P< 0.05). In addition, at post-intervention, there were significant differences between the two groups in muscle strength and BBS (P< 0.05). MT combined with NMES may effectively improve muscle strength and balance in hemiplegic stroke survivors. However, further studies are necessary to demonstrate brain reorganization after MT combined with NMES.

[Timing and effectiveness of Brenner's IPT cognitive training in early psychosis. A pilot study].

PubMed

Borriello, Adriana; Balbi, Andrea; Menichincheri, Renato Maria; Mirabella, Fiorino

2015-01-01

The present study evaluates the outcome of cognitive training as part of Brenner's Integrated Psychological Therapy (IPT) in two groups of individuals with a schizophrenic spectrum disorder (F20-F24 ICD-10). 28 participants were divided into either an experimental group or a control group. The experimental group was composed of 13 individuals (46%) with a mean age of 21.2 years and a mean duration of illness (since their first episode of psychosis FEP) of 15.6 months. The control group included 15 individuals (54%) with a mean age of 25.6 years and a mean duration of illness of 74.4 months (beyond the critical period). Participants underwent an assessment of cognitive functioning which focused on attention, memory, executive functioning and cognitive flexibility as measured by the WCST (Wisconsin Card Sorting Test). Each individual was tested pre- and 6-month post-intervention. The original IPT method was altered by reducing the frequency of sessions to once a week and by limiting our sessions to 2-3 individuals per group. Cognitive flexibility (p<0.01) and long-term memory (p<0.01) improved only in the experimental group. These former skills worsened in the control group (p<0.01). Selective attention, short-term memory and verbal fluency improved in both groups (from p<0.05 to p<0.01). IPT cognitive training, when delivered in the early stages of psychosis (within 18 months from FEP), seems to be particularly effective in improving cognitive flexibility and long-term memory. We did not see improvements in those who had a longer duration of illness who also underwent the same treatment. Cognitive flexibility is linked to clinical insight and social cognition. Therefore, improving this function may lead to a better outcome for patients.

Hepatic resection with or without adjuvant iodine-131-lipiodol for hepatocellular carcinoma: a comparative analysis.

PubMed

Chua, Terence C; Saxena, Akshat; Chu, Francis; Butler, S Patrick; Quinn, Richard J; Glenn, Derek; Morris, David L

2011-04-01

Resection of hepatocellular carcinoma (HCC) is potentially curative; however, recurrence is common. To date, few or no effective adjuvant therapies have been adequately investigated. This study evaluates the efficacy of adjuvant iodine-131-lipiodol after hepatic resection through the experience of a single-center hepatobiliary service of managing this disease. All patients who underwent hepatic resection for HCC and received adjuvant iodine-131-lipiodol between January 1991 and August 2009 were selected for inclusion into the experimental group. A group composed of patients treated during the same time period without adjuvant iodine-131-lipiodol was identified through the unit's HCC surgery database for comparison. The endpoints of this study were disease-free survival and overall survival. Forty-one patients who received adjuvant iodine-131-lipiodol after hepatic resection were compared with a matched group of 41 patients who underwent hepatic resection only. The median disease-free and overall survival were 24 versus 10 months (P = 0.032) and 104 versus 19 months (P = 0.001) in the experimental and control groups, respectively. Rates of intrahepatic-only recurrences (73 vs. 37%; P = 0.02) and surgical and nonsurgical treatments for recurrences (84 vs. 56%; P = 0.04) were higher in the experimental group compared to the control group. The finding of this study corroborates the current evidence from randomized and nonrandomized trials that adjuvant iodine-131-lipiodol improves disease-free and overall survival in patients with HCC after hepatic resection. The lengthened disease-free survival after adjuvant iodine-131-lipiodol allows for further disease-modifying treatments to improve the overall survival.

Percutaneous transhepatic cholangiography and intraductal radiofrequency ablation combined with biliary stent placement for malignant biliary obstruction.

PubMed

Li, Teng-Fei; Huang, Guo-Hao; Li, Zhen; Hao, Chang-Fu; Ren, Jian-Zhuang; Duan, Xu-Hua; Zhang, Kai; Chen, Chen; Han, Xin-Wei; Jiao, De-Chao; Zhang, Meng-Fan; Wang, Yan-Li

2015-05-01

To determine the safety and feasibility of percutaneous transhepatic cholangiography (PTC) and intraductal radiofrequency (RF) ablation combined with biliary stent placement for malignant biliary obstruction. Data from patients with unresectable malignant biliary obstruction who underwent PTC, intraductal RF ablation, and biliary stent placement (n = 12) or PTC and biliary stent placement only (control group; n = 14) were reviewed. Postoperative complications, jaundice remission, and stent patency were assessed. All procedures were successful. No severe complications (eg, biliary bleeding, perforation) occurred. Two experimental group patients developed cholangitis, which resolved with conservative treatment. The 1-week jaundice remission and 3-month stent patency rates were similar in both groups, but the 6-month stent patency rate was higher in the experimental group (P < .05). In the experimental group, one death occurred as a result of gastrointestinal hemorrhage (unrelated to stent placement) by 3 months, and there were two cases of recurrent jaundice by 6 months. The latter two patients underwent repeat PTC, ablation, and stent placement. In the control group, one death occurred as a result of hepatic failure caused by progressive jaundice at 3 months, and another death resulted from disseminated intravascular coagulation caused by jaundice recurrence at 138 days after stent placement. In addition, seven patients developed jaundice recurrence (50-151 d after stent placement). PTC and repeat stent placement were performed in these patients. Percutaneous transhepatic cholangiography and intraductal RF ablation combined with biliary stent placement for malignant biliary obstruction is safe and feasible and effectively prolongs stent patency time. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Low-level laser therapy for pain relief after episiotomy: a double-blind randomised clinical trial.

PubMed

Santos, Jaqueline de O; de Oliveira, Sonia M J V; da Silva, Flora M B; Nobre, Moacyr R C; Osava, Ruth H; Riesco, Maria L G

2012-12-01

To evaluate the effectiveness of a low-level laser therapy for pain relief in the perineum following episiotomy during childbirth. Laser irradiation is a painless and non-invasive therapy for perineal pain treatment and its effects have been investigated in several studies, with no clear conclusion on its effectiveness. A double-blind randomised controlled clinical trial. One hundred and fourteen women who underwent right mediolateral episiotomies during vaginal birth in an in-hospital birthing centre in São Paulo, Brazil and reported pain ≥ 3 on a numeric scale (0-10) were randomised into three groups of 38 women each: two experimental groups (treated with red and infrared laser) and a control group. The experimental groups were treated with laser applied at three points directly on the episiotomy after suturing in a single session between 6-56 hours postpartum. We used a diode laser with wavelengths of 660 nm (red laser) and 780 nm (infrared laser). The control group participants underwent all laser procedures, excluding the emission of irradiation. The participants and the pain scores evaluator were blinded to the type of intervention. The perineal pain scores were assessed at three time points: before, immediately after and 30 minutes after low-level laser therapy. The comparison of perineal pain between the three groups showed no significant differences in the three evaluations (p = 0.445), indicating that the results obtained in the groups treated with low-level laser therapy were equivalent to the control group. Low-level laser therapy did not decrease the intensity of perineal pain reported by women who underwent right mediolateral episiotomy. The effect of laser in perineal pain relief was not demonstrated in this study. The dosage may not have been sufficient to provide relief from perineal pain after episiotomy during a vaginal birth. © 2012 Blackwell Publishing Ltd.

Efficacy of a Home-Based Exercise Program After Thyroidectomy for Thyroid Cancer Patients.

PubMed

Kim, Kyunghee; Gu, Mee Ock; Jung, Jung Hwa; Hahm, Jong Ryeal; Kim, Soo Kyoung; Kim, Jin Hyun; Woo, Seung Hoon

2018-02-01

The objective of this study was to determine the effect of a home-based exercise program on fatigue, anxiety, quality of life (QoL), and immune function of thyroid cancer patients taking thyroid hormone replacement after thyroidectomy. This quasi-experimental study with a non-equivalent control group included 43 outpatients taking thyroid hormone replacement after thyroidectomy (22 in the experimental group and 21 in the control group). After education about the home-based exercise program, subjects in the experimental group underwent 12 weeks of aerobic, resistance, and flexibility exercise. A comparative analysis was conducted between the two groups. Patients in the experimental group were significantly less fatigued or anxious (p < 0.01). They reported significantly improved QoL (p < 0.05) compared to those in the control group. Natural killer cell activity was significantly higher in the exercise group compared to that in the control group (p < 0.05). A home-based exercise program is effective in reducing fatigue and anxiety, improving QoL, and increasing immune function in patients taking thyroid hormone replacement after thyroidectomy. Therefore, such a home-based exercise program can be used as an intervention for patients who are taking thyroid hormone replacement after thyroidectomy.

Virtual reality-based training improves community ambulation in individuals with stroke: a randomized controlled trial.

PubMed

Yang, Yea-Ru; Tsai, Meng-Pin; Chuang, Tien-Yow; Sung, Wen-Hsu; Wang, Ray-Yau

2008-08-01

This is a single blind randomized controlled trial to examine the effect of virtual reality-based training on the community ambulation in individuals with stroke. Twenty subjects with stroke were assigned randomly to either the control group (n=9) or the experimental group (n=11). Subjects in the control group received the treadmill training. Subjects in the experimental group underwent the virtual reality-based treadmill training. Walking speed, community walking time, walking ability questionnaire (WAQ), and activities-specific balance confidence (ABC) scale were evaluated. Subjects in the experimental group improved significantly in walking speed, community walking time, and WAQ score at posttraining and 1-month follow-up periods. Their ABC score also significantly increased at posttraining but did not maintain at follow-up period. Regarding the between-group comparisons, the experimental group improved significantly more than control group in walking speed (P=0.03) and community walking time (P=0.04) at posttraining period and in WAQ score (P=0.03) at follow-up period. Our results support the perceived benefits of gait training programs that incorporate virtual reality to augment the community ambulation of individuals with stroke.

Benefits from an autobiographical memory facilitation programme in relapsing-remitting multiple sclerosis patients: a clinical and neuroimaging study.

PubMed

Ernst, Alexandra; Sourty, Marion; Roquet, Daniel; Noblet, Vincent; Gounot, Daniel; Blanc, Frédéric; de Seze, Jérôme; Manning, Liliann

2016-10-09

While the efficacy of mental visual imagery (MVI) to alleviate autobiographical memory (AM) impairment in multiple sclerosis (MS) patients has been documented, nothing is known about the brain changes sustaining that improvement. To explore this issue, 20 relapsing-remitting MS patients showing AM impairment were randomly assigned to two groups, experimental (n = 10), who underwent the MVI programme, and control (n = 10), who followed a sham verbal programme. Besides the stringent AM assessment, the patients underwent structural and functional MRI sessions, consisting in retrieving personal memories, within a pre-/post-facilitation study design. Only the experimental group showed a significant AM improvement in post-facilitation, accompanied by changes in brain activation (medial and lateral frontal regions), functional connectivity (posterior brain regions), and grey matter volume (parahippocampal gyrus). Minor activations and functional connectivity changes were observed in the control group. The MVI programme improved AM in MS patients leading to functional and structural changes reflecting (1) an increase reliance on brain regions sustaining a self-referential process; (2) a decrease of those reflecting an effortful research process; and (3) better use of neural resources in brain regions sustaining MVI. Functional changes reported in the control group likely reflected ineffective attempts to use the sham strategy in AM.

The effect of respiratory exercise on trunk control, pulmonary function, and trunk muscle activity in chronic stroke patients.

PubMed

Lee, Dong-Kyu; Kim, Se-Hun

2018-05-01

[Purpose] This study aims to identify the effect of respiratory exercise on trunk control, pulmonary function, and trunk muscle activity in chronic stroke patients. [Subjects and Methods] The study included 24 chronic stroke patients who were randomly assigned, 12 each, to the experimental and control groups, and received neurodevelopmental treatment. Moreover, the experimental group underwent respiratory exercise. In each patient, the trunk control was measured using the Trunk Impairment Scale (TIS); muscle activity of the trunk, through the surface electromyogram; and pulmonary function, using the pneumatometer. [Results] The intragroup comparison showed significant differences in TIS, Forced vital capacity (FVC), Forced expiratory volume at one second (FEV1), Rectus Abdominis (RA), Internal Oblique (IO) and External Oblique (EO) in the experimental group. The intergroup comparison showed that the differences in TIS, FVC, FEV1, RA, IO and EO within the experimental group appeared significant relative to the control group. [Conclusion] Based on these results, this study proved that respiratory exercise was effective in improving trunk control, pulmonary function, and trunk muscle activity in patients with chronic stroke.

[Development and evaluation of "Hospice Smart Patient" service program].

PubMed

Park, Chai-Soon; Yoo, Yang-Sook; Choi, Dong-Won; Park, Hyun-Jeong; Kim, Ji-In

2011-02-01

The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness. It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone "Hospice Smart Patient" Service at least once a week for 5 months. There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life. We have concluded that the "Hospice Smart Patient" Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.

[Resection anastomosis of the small intestine by celioscopy in swine. Comparative experimental study between manual and mechanical anastomosis].

PubMed

Noël, P; Fagot, H; Fabre, J M; Mann, C; Quenet, F; Guillon, F; Baumel, H; Domergue, J

1994-01-01

Laparoscopic intestinal anastomosis is not very reliable and needs to be evaluate in an experimental model in animals before being performed in man. The purpose of this study was to evaluate the feasibility, efficacy and safety of manual anastomosis comparatively to the standard stapling suture. Twenty female pigs weighing 20 +/- 5 kg. were used for this study. A 5 cm ileal segment resection was performed under laparoscopy. The animals were assigned to 2 groups. Group I: 10 animals underwent end-to-end hand-swen anastomosis with Polyglactin 910, dec 1.5. Group II: 10 animals underwent side-to-side anastomosis using the Endo stapler. Operating time and anastomosis time were compared using the Mann-Whitney test for statistical analysis. On the 15th postoperative day, the animals were sacrificed and the anastomoses were evaluated. There was no operating death in the 2 groups. The operative time was significantly longer in group I than in group II (p < 0.01), with 180 +/- 40 min vs 49 +/- 25 min respectively. This difference was due to the anastomosis time of 130 +/- 40 min vs 16 +/- 6 min respectively (p < 0.01). There was 1 postoperative death related to fistula and peritonitis in group I and none in group II. The post-operative follow-ing showed 5 anastomotic leakages (4 in group I and 1 in group II) and 2 relative stenoses in group I. This study shows the simplicity and rapidity of performing stapling intestinal anastomosis under laparoscopy. Hand-sewn anastomosis is technically more difficult to perform under laparoscopy and requires a greater experience.

The Effects of a Physical Education Intervention to Support the Satisfaction of Basic Psychological Needs on the Motivation and Intentions to be Physically Active.

PubMed

Franco, Evelia; Coterón, Javier

2017-10-01

The aim of the study was to investigate the effects of an intervention to support the basic psychological needs on the satisfaction of these needs, intrinsic motivation, intention to be physically active and some enjoyment-related outcomes in Physical Education. The present study incorporated strategies presented by Standage and Ryan (2012) in a previous study. A quasi-experimental study was conducted with two groups (n experimental = 30; n control = 23) of 2nd year Secondary Education students aged between 13 and 15 (M = 13.35, SD = .62) by delivering 24 physical education classes. The teacher in the experimental group underwent prior and continual training. The results revealed that the students from the experimental group showed a significant increase in the perception of autonomy and competence. Furthermore, the experimental group showed a greater perception than the control group in the enjoyment related to learning and contents. These results provide information about the efficacy of an intervention programme based on the strategies presented by Standage and Ryan (2012) to foster satisfaction of basic psychological needs and facilitate support for basic psychological needs to promote the development of positive learning-related outcomes.

Endometrial Injury May Increase the Pregnancy Rate in Patients Undergoing Intrauterine Insemination: An Interventional Randomized Clinical Trial.

PubMed

Bahaa Eldin, Ahmed M; Abdelmaabud, Karim H; Laban, Mohamed; Hassanin, Alaa S; Tharwat, Ahmed A; Aly, Tarek R; Elbohoty, Ahmed E; Elsayed, Helmy M; Ibrahim, Ahmed M; Ibrahim, Mohammed E; Sabaa, Haitham M; Abdelrazik, Azza A; Abdelhady, Ibrahim

2016-10-01

This study aimed to investigate the effect of endometrial injury using Pipelle catheter in the follicular phase (cycle day 5, 6, or 7) of the stimulation cycle on pregnancy rates in patients undergoing intrauterine insemination. This prospective randomized controlled study was carried out in the Assisted Reproductive Technology Unit of Ain Shams University Maternity Hospital, Cairo, Egypt, from July 1, 2013 to August 31, 2015. Three hundred sixty women, 20 to 35 years of age, with patent fallopian tubes, mild male factor infertility, or unexplained infertility were recruited. Participants were allocated randomly into 2 groups: experimental arm and control arm. Women in the experimental arm underwent endometrial biopsy using a Pipelle catheter on day 5, 6, or 7 of the stimulation cycle combined with intrauterine insemination. Women in the control group underwent intrauterine insemination with no endometrial biopsy done. The primary outcomes were the clinical and chemical pregnancy rates. Data of 344 participants were statistically analyzed. The chemical pregnancy rate was 23.66% in the experimental arm and 10.85% in the control arm (P = .002). The clinical pregnancy rate was 18.93% in the experimental arm and 7.42% in the control arm (P = .003). Endometrial injury using a Pipelle catheter in the stimulation cycle may improve pregnancy rates in women undergoing intrauterine insemination. © The Author(s) 2016.

Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: experimental study.

PubMed

Isık, Semra; Taşkapılıoğlu, M Özgür; Atalay, Fatma Oz; Dogan, Seref

2015-01-01

Epidural fibrosis is nonphysiological scar formation, usually at the site of neurosurgical access into the spinal canal, in the intimate vicinity of and around the origin of the radicular sheath. The formation of dense fibrous tissue causes lumbar and radicular pain. In addition to radicular symptoms, the formation of scar tissue may cause problems during reoperation. The authors aimed to investigate the effects of cross-linked high-molecular-weight hyaluronic acid (HA), an HA derivative known as HA gel, on the prevention of epidural fibrosis by using histopathological and biochemical parameters. Fifty-six adult female Sprague-Dawley rats were evaluated. The rats were divided into 4 groups. Rats in the sham group (n = 14) underwent laminectomy and discectomy and received no treatment; rats in the control group (n = 14) underwent laminectomy and discectomy and received 0.9% NaCl treatment in the surgical area; rats in the HA group (n = 14) received HA treatment at the surgical area after laminectomy and discectomy; and rats in the HA gel group (n = 14) underwent laminectomy and discectomy in addition to receiving treatment with cross-linked high-molecular-weight HA in the surgical area. All rats were decapitated after 4 weeks, and the specimens were evaluated histopathologically and biochemically. The results were statistically compared using the Mann-Whitney U-test. Compared with the sham and control groups, the HA and HA gel groups showed significantly lower fibroblast cell density and tissue hydroxyproline concentrations (p < 0.05). There was statistically significant lower dural adhesion and foreign-body reaction between the control and HA gel groups (p < 0.05). Granulation tissue and epidural fibrosis were significantly lower in the HA and HA gel groups compared with the sham group (p < 0.05). There were no significant differences in any histopathological parameters or biochemical values between Groups 3 and 4 (p > 0.05). Cross-linked high-molecular-weight HA had positive effects on the prevention of epidural fibrosis and the reduction of fibrotic tissue density. The efficacy of this agent should also be verified in further experimental and clinical studies.

Increased condylar growth after experimental relocation of the glenoid fossa.

PubMed

Pirttiniemi, P; Kantomaa, T; Tuominen, M

1993-09-01

Attempts to increase mandibular growth by the stimulation of condylar proliferative activity, either experimentally or with functional appliances in humans, have led to controversial results. The aim of this study was to measure changes in proliferative activity in the mandibular condyle after steady experimental posterior relocation of the glenoid fossa in the rabbit without actively interfering with normal masticatory action. The method differed from most previous experimental procedures, which force the mandible anteriorly to stimulate functional appliance therapy. Twelve 5-day-old rabbits underwent gluing of the interparietal, temporoparietal, and lambdoidal sutures. Three experimental and three control rabbits were injected with tritiated thymidine at 10, 15, 20, and 30 days and were killed after 2 h for histological and autoradiographic examination. The total number of labeled cells in the prechondroblastic layer was higher in the experimental group, the difference being greatest in the 20-day-old rabbits. The highest proliferative activity in the experimental group was found in the area immediately posterior to the articular contact surface. There was a tendency for the cartilage layers to be thicker in the experimental group, especially in the extreme anterior segments of the condyle.

Long-term functional recovery after facial nerve transection and repair in the rat.

PubMed

Banks, Caroline A; Knox, Christopher; Hunter, Daniel A; Mackinnon, Susan E; Hohman, Marc H; Hadlock, Tessa A

2015-03-01

The rodent model is commonly used to study facial nerve injury. Because of the exceptional regenerative capacity of the rodent facial nerve, it is essential to consider the timing when studying facial nerve regeneration and functional recovery. Short-term functional recovery data following transection and repair of the facial nerve has been documented by our laboratory. However, because of the limitations of the head fixation device, there is a lack of long-term data following facial nerve injury. The objective of this study was to elucidate the long-term time course and functional deficit following facial nerve transection and repair in a rodent model. Adult rats were divided into group 1 (controls) and group 2 (experimental). Group 1 animals underwent head fixation, followed by a facial nerve injury, and functional testing was performed from day 7 to day 70. Group 2 animals underwent facial nerve injury, followed by delayed head fixation, and then underwent functional testing from months 6 to 8. There was no statistical difference between the average whisking amplitudes in group 1 and group 2 animals. Functional whisking recovery 6 months after facial nerve injury is comparable to recovery within 1 to 4 months of transection and repair, thus the ideal window for evaluating facial nerve recovery falls within the 4 months after injury. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Selective peripheral nerve resection for treatment of persistent pain around the knee joint after total knee arthroplasty.

PubMed

Zhong, Guangjun; Liang, Zhu; Kan, Jiang; Muheremu, Aikeremujiang

2018-01-01

Objective This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA). Methods Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. Results The HSS knee scores were higher in both groups after than before the treatment, and HSS knee scores were significantly higher in the experimental group than in the control group. The VAS pain scores were lower in both groups after than before the treatment, and VAS pain scores were significantly lower in the experimental group than in the control group. Conclusions Selective peripheral nerve resection is an effective treatment method for persistent neuropathic pain after TKA.

Effects of Carnosine (Beta-Alanyl-L-Histidine) in an Experimental Rat Model of Acute Kidney Injury Due to Septic Shock

PubMed Central

Sahin, Sabiha; Donmez, Dilek Burukoglu

2018-01-01

Background Acute kidney injury (AKI) secondary to sepsis is a major cause of morbidity and mortality in the human intensive care unit (ICU). Kidney function and the histological findings of AKI were investigated in an experimental rat model with sepsis induced by cecal ligation and puncture (CLP) and compared with and without treatment with carnosine (beta-alanyl-L-histidine). Material/Methods Twenty-four Sprague-Dawley rats were randomly divided into three groups consisting eight rats in each: Group 1 – control; Group 2 – septic shock; and Group 3 – septic shock treated with carnosine. Femoral vein and artery catheterization were applied in all rats. Rats in Group 1 underwent laparotomy and catheterization. The other two groups with septic shock underwent laparotomy, CLP, catheterization, and bladder cannulation. Rats in Group 3 received an intraperitoneal (IP) injection of 250 mg/kg carnosine, 60 min following CLP. Rats were monitored for blood pressure, pulse rate, and body temperature to assess responses to postoperative sepsis, and 10 mL/kg saline replacement was administered. Twenty-four hours following CLP, rats were sacrificed, and blood and renal tissue samples were collected. Results Statistically significant improvements were observed in kidney function, tissue and serum malondialdehyde levels, routine blood values, biochemical indices, and in histopathological findings in rats in Group 3 who were treated with carnosine, compared with Group 2 exposed to septic shock without carnosine treatment. Conclusions Carnosine (beta-alanyl-L-histidine) has been shown to have beneficial effects in reducing AKI due to septic shock in a rat model of septicemia. PMID:29334583

Comparison of the effects on dynamic balance and aerobic capacity between objective and subjective methods of high-intensity robot-assisted gait training in chronic stroke patients: a randomized controlled trial.

PubMed

Bae, Young-Hyeon; Lee, Suk Min; Ko, Mansoo

2017-05-01

Robot-assisted gait training (RAGT) is effective for improving dynamic balance and aerobic capacity, but previous RAGT method does not set suitable training intensity. Recently, high-intensity treadmill gait training at 70% of heart rate reserve (HRR) was used for improving aerobic capacity and dynamic balance. This study was designed to compare the effectiveness between objective and subjective methods of high-intensity RAGT for improving dynamic balance and aerobic capacity in chronic stroke. Subjects were randomly allocated into experimental (n = 17) and control (n = 17) groups. The experimental group underwent high-intensity RAGT at 70% of HRR, whereas the control group underwent high-intensity RAGT at an RPE of 15. Both groups received their assigned training for 30 min per session, 3 days per week for 6 weeks. All subjects also received an additional 30 min of conventional physical therapy. Before and after each of the 18 sessions, the dynamic balance and aerobic capacity of all subjects were evaluated by a blinded examiner. After training, Berg Balance Scale (BBS) and Timed Up and Go Test scores, VO 2 max, and VO 2 max/kg were significantly increased in both groups (p < 0.05). These variables in experimental group were significantly greater than control group. However, the BBS score was not significantly different between both groups. All subjects completed high-intensity RAGT. No adverse effect of training was observed in both groups. High-intensity RAGT at 70% of HRR significantly improved dynamic balance and aerobic capacity more than RAGT at RPE of 15. These results suggest that high-intensity RAGT at 70% of HRR is safe and effective for improving dynamic balance and aerobic capacity in chronic stroke.

Medication-related osteonecrosis of the jaw. Introduction of a new modified experimental model.

PubMed

Curra, Cláudia; Cardoso, Camila Lopes; Ferreira, Osny; Curi, Marcos Martins; Matsumoto, Mariza Akemi; Cavenago, Bruno Cavalini; Santos, Pâmela Letícia Dos; Santiago, Joel Ferreira

2016-05-01

To evaluate a modified experimental model for medication-related osteonecrosis of the jaw (MRONJ) through the upper right central incisor extraction followed by intravenous bisphosphonate administration. Forty five rats underwent the upper right central incisor tooth extraction were divided in 2 groups: Group I - experimental group, 30 rats received an intravenous administration protocol of zoledronic acid 35μg/kg into the tail vein every two weeks, totalizing four administrations, during eight weeks of administration, previously the extraction, and Group II - control group, 15 rats didn't received any medication before extraction. The groups were subdivided in postoperative periods: 14/28/42 days. Clinical analysis and microtomography were performed to verify the presence of osteonecrosis. In addition, descritive histological analysis of hematoxylin-eosin stained sections was performed to evaluate the presence of osteonecrosis or necrotic foci. Twelve (40%) rats, from experimental group, showed clinical signs of MRONJ (p=0.005), however, all samples showed imaginologic findings like osteolysis and loss of integrity of the cellular walls (p≤0.001). Microscopic evaluation revealed osteonecrosis areas with microbial colonies and inflammatory infiltrate (p≤0.001). In the control group, all animals presented the chronology of a normal wound healing. The presence of medication-related osteonecrosis of the jaw after maxillary central incisor extraction in rats. This new experimental model may be considered an option for the study of MRONJ.

Effect of delayed breeding during the summer on profitability of dairy cows.

PubMed

Gobikrushanth, M; De Vries, A; Santos, J E P; Risco, C A; Galvão, K N

2014-07-01

The objective of this retrospective observational cohort study, combined with simulation, was to evaluate the effect of extending the voluntary waiting period (VWP) during the summer on profitability on a Florida dairy farm. Data from Holstein cows (n=1,416) that calved between June and September of 2007 and 2008 were used. Cows that calved between June 1 and July 21 (regular group; REG; n=719) were artificially inseminated (AI) for the first time upon estrus detection (ED) after the second PGF₂α of the Presynch protocol administered between 57 and 63 d in milk (DIM), or underwent timed AI using the Ovsynch protocol (TAI) if not detected in estrus. Cows that calved between July 22 and September 18 (extended group; EXT; n=697) underwent AI for the first time after the first or second PGF₂α starting November 14 or November 21 or underwent TAI if not detected in estrus. For second and subsequent AI, all cows underwent AI upon ED or enrolled on TAI after nonpregnancy diagnosis. Following these schemes, average VWP in the REG group and EXT group were 60 and 83 d, respectively. Overall profitability for both experimental and subsequent parities were calculated by subtracting the costs existing of feeding costs ($0.30/kg lactating cow diet; $0.25/kg dry cow diet), breeding costs ($2.65/dose PGF₂α; $2.40/dose GnRH; $0.25/injection administration; $10/semen straw; $5/AI; $3/pregnancy diagnosis), and other costs ($3/d) from the daily revenues with milk sales ($0.44/kg of milk), cow sales ($1.76/kg of live weight), and calf sales ($140/calf). A herd budget simulation was used to predict future cash flow after culling or end of subsequent parity until 6 yr after the start of the study to account for all cash flow consequences of extended VWP. Cows in the EXT group had greater first-service pregnancy per AI (PAI1) but still had greater days open and calving interval. Delaying breeding did not affect total cash flow because the EXT group had greater combined profitability for the experimental parity and subsequent parity but lesser future cash flow. Delayed breeding during the summer increased PAI1 but did not improve overall reproductive efficiency and did not affect overall profitability. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

The effect of peculiar complex core balance training on isokinetic muscle functions of the knee and lumbus.

PubMed

Lee, Myungsun; Han, Gunsoo

2016-04-01

[Purpose] This study aimed to investigate the effect of peculiar complex core balance training on the isokinetic muscle function of the knee joint and lumbus to provide fundamental data for establishing a training program that focuses on improving the performance and prevention of injury by developing the core and low extremity muscles. [Subjects and Methods] The participants in this study included a total of ten high school athletes involved in a throwing event for over five years. The subjects were randomly divided into two groups: The experimental group (N=5) and the control group (N=5). The experimental group underwent peculiar complex core balance training. [Results] According to the analysis of covariance, there was a significant effect of peculiar complex core balance training. Therefore, the isokinetic muscle function of the knee joint and lumbus in the experimental group participating in peculiar complex core balance training was significantly increased compared to the control group. [Conclusion] It is concluded that peculiar complex core balance training had a positive effect on the isokinetic muscle function of the knee and lumbus in throwing event athletes.

The Effect of Platelet-rich Fibrin Matrix on Rotator Cuff Healing in a Rat Model.

PubMed

Hasan, S; Weinberg, M; Khatib, O; Jazrawi, L; Strauss, E J

2016-01-01

The purpose of the current study was to determine if the application of platelet-rich fibrin matrix could improve regeneration of the tendon-bone insertion site in a rat rotator cuff repair model. 25 Lewis syngeneic rats underwent bilateral tenotomy and repair of the supraspinatus tendon. 10 separate rats were used for PRFM harvest. All left (control) shoulders underwent transosseous rotator cuff repair, while all right (treatment) shoulders were repaired similarly with PRFM augmentation. 9 rats were sacrificed at 2-weeks and ten at 4-weeks for biomechanical testing. 3 separate rats were sacrificed at 2-weeks and 4-weeks each for histologic analysis of the insertion site. At 2 weeks, the experimental group repairs were significantly stronger in ultimate load to failure (P=0.01), stress (P=0.03), and stiffness (P=0.03). Differences in biomechanical testing were not found between the groups at 4 weeks. Histological analysis revealed less collagen organization and cartilage formation at the insertion site in the experimental group. Semiquantitative histologic analysis confirmed our qualitative assessment of the specimens. PRFM does not recapitulate the native enthesis, but rather induces an exuberant and disordered healing response that is characterized by fibrovascular scar tissue. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of supplemental L-arginine on the intestinal adaptive response after massive small-bowel resection in rats.

PubMed

Oztürk, Hayrettin; Dokucu, Ali Ihsan; Yağmur, Yusuf; Sari, Ibrahim

2002-09-01

To evaluate whether L-arginine methyl ester (L-Arg) can improve the structure of the small intestine and enhance adaptation in an experimental model of short-bowel syndrome (SBS), 40 Sprague-Dawley rats were divided randomly into four groups of 10 each. In one group only a laparotomy was performed (G1). The remaining 30 rats underwent 90% small-bowel resection (SBR) and formed the three experimental groups: the SBR/untreated group (G2), the SBR/L-NAME-treated group (G3), and the SBR/ L-Arg-treated group (G4). Rats in G2 received no therapeutic treatment. Rats in the SBR/L-NAME and SBR/L-Arg treated groups received N-G-nitro-L-arginine-methyl ester (L-NAME) and L-Arg intraperitoneally for 3 weeks, respectively. The animals were weighed daily. All rats underwent a relaparotomy on day 21 of the experiment. Remnant small bowel was excised and evaluated for villus height and crypt cell mitoses. After the 90% SBR, all animals had from diarrhea and weight loss between the 1st and 6th postoperative days (POD). The body weight of the SBR/L-Arg group showed significant increases at POD 10 and 21 in comparison to the SBR/untreated and SBR/L-NAME groups (P < 0.001). The rats treated with L-Arg had significantly greater villus height and crypt-cell mitoses compared to the other groups (P < 0.0001, P < 0.001). These observations suggest that L-Arg treatment increases villus height and crypt-cell mitoses after massive SBR and may play a considerable role in the mucosal adaptive response in SBS in rats.

Application of a hyaluronic acid gel after intrauterine surgery may improve spontaneous fertility: a randomized controlled trial in New Zealand White rabbits.

PubMed

Huberlant, Stephanie; Fernandez, Herve; Vieille, Pierre; Khrouf, Mohamed; Ulrich, Daniela; deTayrac, Renaud; Letouzey, Vincent

2015-01-01

Intrauterine adhesions (IUAs) are the most common complication after hysteroscopy in patients of reproductive age. Intra-abdominal anti-adhesion gel reduces the incidence of adhesions, but effects on fertility after uterine surgery are not known. The objective of our work was to evaluate the effect of intrauterine anti-adhesion gel on spontaneous fertility after repeated intrauterine surgery with induced experimental synechiae in the rabbit model. Twenty New Zealand White rabbits underwent a double uterine curettage 10 days apart and were randomized into two groups. Each rabbit served as its own control: one uterine tube was the treatment group (A), the second uterine tube was the control group (B) to avoid bias through other causes of infertility. Group A received a post curettage intrauterine instillation of anti-adhesion gel whereas group B, the control group, underwent curettage without instillation of the gel. After a recovery period, the rabbits were mated. An abdominal ultrasound performed 21 days after mating allowed us to diagnose pregnancy and quantify the number of viable fetuses. There was a significant difference in total fetuses in favor of group A, with an average of 3.7 (range, 0-9) total fetuses per tube against 2.1 (0-7) in group B (p = .04). The number of viable fetuses shows a trend in favor of group A, with an average of 3.4 (0-7) viable fetuses per tube against 1.9 (0-6) viable fetuses per tube in group B (p = .05). The use of immediate postoperative anti-adhesion gel improved fertility in an animal model after intrauterine surgery likely to cause uterine synechiae. This experimental model will permit comparison of different anti-adhesion solutions, including assessment of their tolerance and potential mucosal toxicity on embryonic development.

Timing of neck dissection in patients undergoing transoral robotic surgery for head and neck cancer.

PubMed

Möckelmann, N; Busch, C-J; Münscher, A; Knecht, R; Lörincz, B B

2015-06-01

Oncologic transoral robotic surgery (TORS) requires in most cases the concurrent or staged surgical treatment of the regional lymph nodes in the neck as well. The purpose of this study was to determine whether the timing of the regional lymphadenectomy (neck dissection) has an impact on the surgical outcomes and on the complication rates. Single-institution, prospective case series with internal control group. Twenty-one patients underwent TORS and appropriate neck dissection concurrently (control group), while 20 patients underwent neck dissection in a timely staged fashion, 8.4 days (median; range, 3-28 days) following their TORS procedure (experimental group). Outcome measures included nodal yield, intraoperative pharyngocervical fistula formation, postoperative fistula formation, postoperative bleeding from the primary and from the neck dissection site, haematoma, seroma, and infection. Nodal yield values, as the oncologic quality indicator of a neck dissection, were comparable in the experimental and in the control group. Complication rates did not differ between the groups: intraoperative and postoperative fistula formation, postoperative bleeding, haematoma and seroma rates were similarly low in the two groups. There was no infection in either group. In the present cohort of 41 TORS-patients, the timing of neck dissection did not make a significant difference in the outcomes. We suggest therefore that aspiring and established TORS-teams do not restrict their appropriate indications due to robotic slot and theatre time constraints, but perform each indicated TORS-case as soon as possible within their given systems, even if the neck dissections cannot be done on the same day. Copyright © 2015 Elsevier Ltd. All rights reserved.

In Vitro Evaluation of the Effect of Chemical and Thermal Stress of the Mechanical Properties of Periodontal Curettes under Simulated Conditions of Sharpening Wear.

PubMed

De Pedro, Daniel; Puglisi, Rosario; Levi, Paul; Pascual, Andrés; Nart, José

To determine whether chemical and thermal stress as well as sharpening are aspects that must be considered to determine when a curette has become too weak to be used safely without the threat of breakage. A total sample of 35 curette blades was divided into 2 principal groups, control (groups 1 to 3) and experimental (groups 4 to 6). The control group was divided into 3 colour-coded groups of 19 similar curette blades and was only subjected to progressive sharpening wear (not sterilised). The test group included 16 Gracey curette blades that were subjected to various degrees of progressive wear and different numbers of sterilisation cycles in 3 subgroups (subgroup 4 had 5 sterilisation cycles; subgroup 5 had 30 cycles and experimental subgroup 6 had 55 cycles). Using a universal testing machine, all blades were tested for strength until they fractured. No evidence was found that the simple presence or absence of sterilisation cycles produced a statistically significant difference between the two studied groups (sterilised and not sterilised). However, when comparing the six subgroups that underwent different numbers of sterilisation cycles, the analysis showed that the more sterilisation cycles a curette underwent, the more likely the curette was to fracture (p = 0.047). Sterilisation by itself does not produce a significant change in the fracture strength, whereas the number of sterilisation cycles clearly weakens the instrument. Sterilisation is a factor to control when evaluating the life of a periodontal curette for the patients' and professionals' safety.

Electromyographic analysis of the masseter and buccinator muscles with the pro-fono facial exerciser use in bruxers.

PubMed

Jardini, Renata S R; Ruiz, Lydia S R; Moysés, Maria A A

2006-01-01

The aim of this study was to evaluate the efficiency of the Pró-Fono Facial Exerciser (Pró-Fono Productos Especializados para Fonoaudiologia Ltda., Barueri/SP, Brazil) to decrease bruxism, as well as the correlation between the masseter and the buccinator muscles using electromyography (EMG). In this study, 39 individuals ranging from 23 to 48 years of age were selected from a dental school and then underwent surface EMG at three different periods of time: 0, 10, and 70 days. They were divided into a normal control group, a bruxer control group (without device), and an experimental bruxer group who used the device. The bruxer group showed a greater masseter EMG amplitude when compared to the normal group, while the experimental group had deceased activity with a reduction in symptoms. The buccinator EMG spectral analysis of the experimental bruxist group showed asynchronous contractions of the masseter muscle (during jaw opening) after using the Pró-Fono Facial Exerciser. The normal group also showed asynchronous contractions. Upon correlation of the data between these muscles, the inference is that there is a reduction in bruxism when activating the buccinator muscle.

The effects of neurologic assessment E-learning in nurses.

PubMed

Shin, Ji Yeon; Issenberg, S Barry; Roh, Young Sook

2017-10-01

A firm understanding of the preliminary assessment of a patient with neurological disorders is needed for ensuring optimal patient outcomes. The purpose of this study is to evaluate the effects of using e-learning on neurologic assessment knowledge, ability, and self-confidence among nurses. This study used a non-equivalent control group pretest-posttest design. Nurses working in the neurology and neurosurgery wards, Republic of Korea PARTICIPANTS: A convenience sample of 50 nurses was assigned to either the experimental group (n=24) or the control group (n=26). The experimental group participated in the self-directed e-learning program related to neurologic assessment, and control group underwent self-directed learning with handout. Knowledge, ability, and self-confidence were measured at pretest and posttest. There were no significant differences in knowledge (U=270, p=0.399) and self-confidence (U=241.5, p=0.171) between the two groups. Nurses in the experimental group showed higher neurologic assessment ability compared with those in the control group (U=199, p=0.028). Self-directed neurologic assessment e-learning induced improvement in the neurologic assessment ability among nurses. Self-directed e-learning can be applied for improving competencies in neurologic assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Oral glucose efficacy on neonate's pain responses at the NICU: A quasi experimental trial of two clinical procedures.

PubMed

Matar, Eman M; Arabiat, Diana H; Foster, Mandie J

2016-11-01

This research was undertaken with the purpose of testing two research hypotheses regarding the efficacy of 10% oral glucose solution on procedural pain associated with venepuncture and nasopharyngeal suctioning within three neonatal intensive care units (NICU). The hypotheses were formulated from previous conclusions reached by other researchers highlighting the efficacy of sucrose solutions on neonates' pain responses during minor painful procedures. A quasi-experimental trial utilising a time series design with one group was used. Data from a total of 90 neonates included 60 neonates who underwent a venepuncture and 30 neonates who underwent a nasopharyngeal suctioning procedure for clinical purposes. The neonate's pain response for each procedure was scored using the Neonatal Pain Assessment Scale (NPAS) on two separate occasions over three time periods. The pre-procedural score (T 0 ) when the neonate received no sucrose, the inter-procedural score (T 1 ) when the neonate was given 2ml of 10% glucose solution two minutes before the procedure (intervention group) or where oral glucose was withheld (control group) and the post-procedural score (T 2 ) being at the end of the procedure. The results showed the mean NPAS scores in response to venepuncture or nasopharyngeal suctioning were significantly lower in the intervention group than the control group. This showed that oral glucose (10%) had a positive effect on the pain response during venepuncture and nasopharyngeal suctioning procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of guided reciprocal peer questioning on nursing students' self-esteem and learning.

PubMed

Lakdizaji, Sima; Abdollahzadeh, Farahnaz; Hassankhanih, Hadi; Kalantari, Manizhe

2013-07-01

Self-esteem is essential for clinical judgments. Nursing students in clinical environments should make a bridge between theoretical education and clinical function. This study was aimed to survey the effect of guided questioning in peer groups on nursing students' self-esteem and clinical learning. In this quasi-experimental study, all nursing students in semester 4 (60) were selected. The autumn semester students (n = 28) were chosen as the control group, and the spring semester students (n = 32) as the experimental group. The experimental group underwent the course of cardiac medical surgical training by the Guided Reciprocal Peer Questioning. The control group was trained by lecture. After confirmation of the validity and reliability of tools including Rosenberg Self-esteem Scale and the researcher-made questionnaire, data were collected and analyzed by SPSS version 17.0. There was no significant difference concerning demographic and educational characteristics between the two groups. Mean score differences of self-esteem and learning were not significant before teaching, while they were significantly promoted after teaching in the experimental (P < 0.001) and control (P < 0.05) groups. Promotion in the experimental group was more considerable than in the control group. As revealed by the results, inquiry method, due to its more positive impact on self-esteem and students' learning, can be applied alone or in combination with the other methods. Conducting this study for other students and for theoretical courses is suggested.

The effect of an eye health promotion program on the health protective behaviors of primary school students

PubMed Central

Kirag, Nukhet; Temel, Ayla Bayik

2018-01-01

INTRODUCTION: Undiagnosed and uncorrected refractive errors in childhood can negatively affect the development of vision and cause students to have low academic success and even quit school before graduation. This study aims to determine the effects of an eye health promotion program on the health protective behaviors of primary school students. MATERIALS AND METHODS: This experimental study using a pretest-posttest design with a control group was conducted in three public primary schools in Aydın, a city in the Western Anatolia Region of Turkey, between April and November 2014. The eye health promotion program was provided by the researchers to the experimental Group 2 days in 4 weeks. The data were analyzed using the t-test, Chi-square analysis, the Mann–Whitney U-test, the Wilcoxon signed-rank test, and the McNemar test. RESULTS: The average age of the students was identified as 9.0 ± 3.64 years. The students wearing glasses all in the experimental group and 53.3% in the control group were found to always wear their glasses after the education program was completed (P < 0.05). These students, 97.9% in the experimental group and 58.1% in the control group underwent eye examinations from an ophthalmologist (P < 0.05). The eye health protective behaviors of the experimental group were found to have positively changed in the final follow-up, compared to the control group (P < 0.05). CONCLUSION: The eye health promotion program was found to be effective in improving eye health protective behaviors within the experimental group. PMID:29619388

Sleep Deprivation Disrupts Recall of Conditioned Fear Extinction.

PubMed

Straus, Laura D; Acheson, Dean T; Risbrough, Victoria B; Drummond, Sean P A

2017-03-01

Learned fear is crucial in the development and maintenance of posttraumatic stress disorder (PTSD) and other anxiety disorders, and extinction of learned fear is necessary for response to exposure-based treatments. In humans, research suggests disrupted sleep impairs consolidation of extinction, though no studies have examined this experimentally using total sleep deprivation. Seventy-one healthy controls underwent a paradigm to acquire conditioned fear to a visual cue. Twenty-four hours after fear conditioning, participants underwent extinction learning. Twenty-four hours after extinction learning, participants underwent extinction recall. Participants were randomized to three groups: 1) well-rested throughout testing ("normal sleep"; n = 21); 2) 36 hours total sleep deprivation before extinction learning ("pre-extinction deprivation"; n = 25); or 3) 36 hours total sleep deprivation after extinction learning and before extinction recall ("post-extinction deprivation"; n = 25). The groups were compared on blink EMG reactivity to the condition stimulus during extinction learning and recall. There were no differences among the three groups during extinction learning. During extinction recall, the pre-extinction deprivation group demonstrated significantly less extinction recall than the normal sleep group. There was no significant difference between the normal sleep and post-extinction deprivation group during extinction recall. Results indicated sleep deprivation prior to extinction training significantly disrupts extinction recall. These findings suggest that (1) sleep deprivation in the immediate aftermath of trauma could be a potential contributor to PTSD development and maintenance via interference with natural extinction processes and (2) management of sleep symptoms should be considered during extinction-based therapy.

Effect of Sacroiliac Joint Manipulation on Selected Gait Parameters in Healthy Subjects.

PubMed

Wójtowicz, Sebastian; Sajko, Igor; Hadamus, Anna; Mosiołek, Anna; Białoszewski, Dariusz

2017-08-31

The sacroiliac joints have complicated biomechanics. While the movements in the joints are small, they exert a significant effect on gait. This study aimed to assess how sacroiliac joint manipulation influences selected gait parameters. The study enrolled 57 healthy subjects. The experimental group consisted of 26 participants diagnosed with dysfunction of one sacroiliac joint. The control group was composed of 31 persons. All subjects from the experimental group underwent sacroiliac joint manipulation. The experimental group showed significant lengthening of the step on both sides and the stride length in this group increased as well. Moreover, the duration of the stride increased (p=0.000826). The maximum midfoot pressure was higher and maximum heel pressure decreased. The differences were statistically significant. 1. Subclinical dysfunctions of the sacroiliac joints may cause functional gait disturbance. 2. Manipulation of the iliosacral joint exerts a significant effect on gait parameters, which may lead to improved gait economy and effec-tiveness. 3. Following manipulation of one iliosacral joint, altered gait parameters are noted on both the manipulated side and the contralateral side, which may translate into improved quality of locomotion.

The effect of preoperative stoma site marking on quality of life.

PubMed

Cakir, Selda Karaveli; Ozbayir, Turkan

2018-01-01

The objective of the study was to determine the effect of preoperative stoma site marking on the health- related quality of life (HRQOL). A nonrandomized, quasi-experimental design was used for the study performed from June 2013 to August 2014. The study sample (n:60) included patients for whom a stoma was opened after a planned colorectal surgery. The City of Hope Quality of Life-Ostomy Questionnaire (COHQOL-OQ) was used to measure HRQOL. The mean age of the participants in the experimental group was 53.5±12.83, 18(60%) had colostomies, mean BMI was 25.46 ± 4.25 and mean age of that of the control group was 58.00 ± 14.22, 19(63.3%) had colostomies, mean BMI was 25.28 ± 5.00. A comparison of the two groups indicates that the sixth-month total score of the patients in the experimental group on (COHQOL-OQ) is higher than that of the control group (p<0.05). The study results demonstrated that patient who underwent stoma site marking reported higher HRQOL than those who did not.

The effect of the degree of left renal vein constriction on the development of adolescent varicocele in Sprague-Dawley rats.

PubMed

Yao, Bing; Zhou, Wen-Liang; Han, Da-Yu; Ouyang, Bin; Chen, Xu; Chen, Sheng-Fu; Deng, Chun-Hua; Sun, Xiang-Zhou

2016-01-01

Experimental models have allowed inquiry into the pathophysiology of varicocele (VC) beyond that possible with human patients. A randomized controlled study in rats was designed to clarify the influence of the degree of left renal vein constriction on the development of adolescent VC. Fifty adolescent male Sprague-Dawley rats (Rattus norvegicus) were randomly assigned to five groups of 10: the experimental groups (I-IV) underwent partial ligation of left renal veins with 0.5-, 0.6-, 0.7-, and 0.8-mm diameter needles, respectively. The control group (V) underwent a sham operation. The diameter of the left spermatic vein (LSV) was measured at baseline and 30 days postoperatively. In addition, the lesion of the left kidney was examined with the naked eye and assessed by Masson's trichrome staining. VC was successfully induced in 2 (20%), 4 (40%), 7 (70%), and 10 (100%) rats in groups I-IV, respectively. The other rats failed to develop VCs primarily due to left renal atrophy. No VC was observed in group V. The postsurgical LSV diameters in VC rats in groups III and IV were 1.54 ± 0.16 and 1.49 ± 0.13 mm, respectively (P > 0.05), and their increments were 1.36 ± 0.10 and 1.31 ± 0.10 mm, respectively (P > 0.05). These results suggest that suitable constriction of the left renal vein is critical for adolescent VC development. In addition, the 0.8-mm diameter needle may be more suitable for inducing left renal vein constriction in adolescent rat models.

A new experimental three-dimensional, reticular intrauterine device (3-DRIUD) composed of nitinol and silicone rubber.

PubMed

Qiu, Yi; Wang, Lei-Guang; Zhang, Mei-Hua; Zhang, Yan-Ping; Zhang, Ai-Dong; Yang, Dan-Tong

2013-07-01

The aim of this study was to explore a new three-dimensional, reticular intrauterine device (3-DRIUD) composed of nitinol and silicone rubber and to observe the contraceptive effect of the device in rats. Two contraceptive experiments were performed. In the first, female rats underwent bilateral placement of a 20.0-35.0-mm 3-DRUID (experimental group, n=30) via an abdominal incision or a sham operation with no IUD (control group, n=30). Two weeks after the operation was performed, the rats from either group were caged together with male rats. The contraceptive effects of the 3-DRIUD were observed at 1 to 3 months postoperation, after which the 3-DRIUDs were removed. One month after this second operation, the rats from the two groups were again coupled with fertile male rats. In a second experiment, female rats underwent bilateral placement of a 10.0-mm 3-DRUID (n=5) via an abdominal incision or a two-dimensional IUD (2-DIUD, n=20) and mated 1 month after surgery. The single-pipeline IUD was placed in 10 rats, while the enfolded-pipeline IUD was placed in 10 different rats. In the first experiment, none of the females in the experimental 3-DRIUD group became pregnant (0/30, 0%) after 3 months, compared to 28/30 (93.3%, p<.0001) rats in the control group. After the 3-DRIUDs were removed from the experimental group after 3 months, 27/30 (90%) became pregnant, compared with 29/30 (97%, p>.05). The litter size (mean±SD) did not differ between groups (10.9±1.5 3-DRUID, 11.2±1.1 control, p>.05). In the second experiment, five rats had a 10.0-mm 3-DRUID (which was one third the length of one uterine horn) inserted into the bilateral uterine horns, and three of the five rats became pregnant. All 20 rats were pregnant 1 month after the insertion of the 2-DIUD. Thus, the contraceptive rate for the 2-DIUD group was 0. The primary contraceptive mechanism effect of the new 3-DRIUD in rodents appears to be a result of occupying physical space in the uterus. Copyright © 2013 Elsevier Inc. All rights reserved.

The impact of football training on motor development in male children.

PubMed

Erceg, Marko; Zagorac, Nebojsa; Katić, Ratko

2008-03-01

The aim of the study was to determine the effect of football school program and physical education curriculum on changes in the motor abilities of 7- and 8-year-old boys. The study included a sample of 180 boys divided into group 1 (7-year-old boys), subdivided to experimental (n = 40) and control (n = 50) groups, and group 2 (8-year-old boys), subdivided to experimental (n = 40) and control (n = 50) groups. Experimental groups included children attending three training units of football training over a 9-month period, in addition to the conventional physical education curriculum. Control groups included children attending only conventional physical education curriculum. All study subjects underwent testing with a battery of 12 motor tests at the beginning and at the end of the study. Results obtained by discriminative canonic analysis showed no statistically significant between-group difference in motor abilities at the beginning of the study. However, significant differences in favor of experimental groups were recorded at the end of the study. Favorable changes in all motor variables were observed in both experimental and control groups of children from the initial through the final state. These changes were more pronounced in experimental groups. Analysis of variance for difference variables (final to initial measurement) indicated programmed education in the form of football training in addition to regular physical education curriculum to predominantly influence the development of aerobic endurance, agility, speed and flexibility in 7-year-old boys, and of explosive strength, aerobic endurance, flexibility and speed in 8-year-old boys. In the latter, football training led to the formation of a motor complex integrating explosiveness, speed, coordination, endurance and flexibility as a general motor factor determining future quality development in football.

Skeletal pattern in subjects with temporomandibular joint disorders

PubMed Central

Almăşan, Oana Cristina; Almăşan, Horea Artimoniu; Bran, Simion; Lascu, Liana; Iancu, Mihaela; Băciuţ, Grigore

2013-01-01

Introduction To establish the skeletal pattern in subjects with malocclusions and temporomandibular disorders (TMD); to assess the relationship between craniofacial skeletal structures and TMD in subjects with malocclusions. Material and methods Sixty-four subjects with malocclusions, over 18 years of age, were included in the study. Temporomandibular disorders were clinically assessed according to the Helkimo Anamnestic Index. Subjects underwent a lateral cephalogram. Subjects were grouped according to the sagittal skeletal pattern (ANB angle) into class I, II and III. Parametric Student tests with equal or unequal variations were used (variations were previously tested with Levene test). Results Twenty-four patients with TMD (experimental sample); 40 patients without TMD (control group); interincisal angle was higher in class I and II (p < 0.05) experimental subjects; overjet was larger in experimental subjects; midline shift and Wits appraisal were broader in the experimental group in all three classes. In class III subjects, the SNB angle was higher in the experimental group (p = 0.01). Joint noises followed by reduced mandible mobility, muscular pain and temporomandibular joint (TMJ) pain were the most frequent symptoms in subjects with TMD and malocclusions. Conclusions Temporomandibular joint status is an important factor to consider when planning orthodontic treatment in patients with severe malocclusions; midline shift, large overjet and deep overbite have been associated with signs and symptoms of TMD. PMID:23515361

Improved gait after repetitive locomotor training in children with cerebral palsy.

PubMed

Smania, Nicola; Bonetti, Paola; Gandolfi, Marialuisa; Cosentino, Alessandro; Waldner, Andreas; Hesse, Stefan; Werner, Cordula; Bisoffi, Giulia; Geroin, Christian; Munari, Daniele

2011-02-01

The aim of this study was to evaluate the effectiveness of repetitive locomotor training with an electromechanical gait trainer in children with cerebral palsy. In this randomized controlled trial, 18 ambulatory children with diplegic or tetraplegic cerebral palsy were randomly assigned to an experimental group or a control group. The experimental group received 30 mins of repetitive locomotor training with an applied technology (Gait Trainer GT I) plus 10 mins of passive joint mobilization and stretching exercises. The control group received 40 mins of conventional physiotherapy. Each subject underwent a total of 10 treatment sessions over a 2-wk period. Performance on the 10-m walk test, 6-min walk test, WeeFIM scale, and gait analysis was evaluated by a blinded rater before and after treatment and at 1-mo follow-up. The experimental group showed significant posttreatment improvement on the 10-m walk test, 6-min walk test, hip kinematics, gait speed, and step length, all of which were maintained at the 1-mo follow-up assessment. No significant changes in performance parameters were observed in the control group. Repetitive locomotor training with an electromechanical gait trainer may improve gait velocity, endurance, spatiotemporal, and kinematic gait parameters in patients with cerebral palsy.

Effect of high saturated free fatty acids feeding on progression of renal failure in rat model of experimental nephrotoxicity.

PubMed

Ibraheem, Zaid O; Sattar, Munavvar A; Abdullah, Nor A; Rathore, Hassaan A; Johns, Edward J

2012-02-01

The current study evaluates the impact of high saturated fat feeding in rat model of experimental nephrotoxicity induced by gentamicin. Sprague-Dawley rats weighing 200 g were randomized into four groups; the first one received the standard rodents chow for 8 weeks and was treated as control, the second group (HFD)received an experimental high fat diet rich in palm kernel oil (40% of Calories as fat) for the same period. The third group (HFDG) was given 80 mg/kg (body weight)/day gentamicin sulphate intraperitoneally during the last 24 days of the feeding period while the fourth group was given gentamicin as above along with the standard rodents chow. Renal function was assessed through measuring serum creatinine, creatinine clearance and absolute and fractional excretion of both sodium and potassium. At the end, rats underwent a surgical procedure for blood pressure measurement. Renal function study showed a stronger nephrotoxicity for HFDG group. Hypertension was observed in HFD group while the pressure declined after gentamicin co-administration. Overall, changing the feeding behavior toward using more SAFFAs for rats injected with gentamicin promotes the progression of renal failure.

Effect of high saturated free fatty acids feeding on progression of renal failure in rat model of experimental nephrotoxicity

PubMed Central

Ibraheem, Zaid O.; Sattar, Munavvar A.; Abdullah, Nor A.; Rathore, Hassaan A.; Johns, Edward J.

2012-01-01

The current study evaluates the impact of high saturated fat feeding in rat model of experimental nephrotoxicity induced by gentamicin. Sprague-Dawley rats weighing 200 g were randomized into four groups; the first one received the standard rodents chow for 8 weeks and was treated as control, the second group (HFD)received an experimental high fat diet rich in palm kernel oil (40% of Calories as fat) for the same period. The third group (HFDG) was given 80 mg/kg (body weight)/day gentamicin sulphate intraperitoneally during the last 24 days of the feeding period while the fourth group was given gentamicin as above along with the standard rodents chow. Renal function was assessed through measuring serum creatinine, creatinine clearance and absolute and fractional excretion of both sodium and potassium. At the end, rats underwent a surgical procedure for blood pressure measurement. Renal function study showed a stronger nephrotoxicity for HFDG group. Hypertension was observed in HFD group while the pressure declined after gentamicin co-administration. Overall, changing the feeding behavior toward using more SAFFAs for rats injected with gentamicin promotes the progression of renal failure. PMID:22364300

The effect of peculiar complex core balance training on isokinetic muscle functions of the knee and lumbus

PubMed Central

Lee, Myungsun; Han, Gunsoo

2016-01-01

[Purpose] This study aimed to investigate the effect of peculiar complex core balance training on the isokinetic muscle function of the knee joint and lumbus to provide fundamental data for establishing a training program that focuses on improving the performance and prevention of injury by developing the core and low extremity muscles. [Subjects and Methods] The participants in this study included a total of ten high school athletes involved in a throwing event for over five years. The subjects were randomly divided into two groups: The experimental group (N=5) and the control group (N=5). The experimental group underwent peculiar complex core balance training. [Results] According to the analysis of covariance, there was a significant effect of peculiar complex core balance training. Therefore, the isokinetic muscle function of the knee joint and lumbus in the experimental group participating in peculiar complex core balance training was significantly increased compared to the control group. [Conclusion] It is concluded that peculiar complex core balance training had a positive effect on the isokinetic muscle function of the knee and lumbus in throwing event athletes. PMID:27190470

Inpatient rehabilitation improves functional capacity, peripheral muscle strength and quality of life in patients with community-acquired pneumonia: a randomised trial.

PubMed

José, Anderson; Dal Corso, Simone

2016-04-01

Among people who are hospitalised for community-acquired pneumonia, does an inpatient exercise-based rehabilitation program improve functional outcomes, symptoms, quality of life and length of hospital stay more than a respiratory physiotherapy regimen? Randomised trial with concealed allocation, intention-to-treat analysis and blinding of some outcomes. Forty-nine adults hospitalised for community-acquired pneumonia. The experimental group (n=32) underwent a physical training program that included warm-up, stretching, peripheral muscle strength training and walking at a controlled speed for 15 minutes. The control group (n=17) underwent a respiratory physiotherapy regimen that included percussion, vibrocompression, respiratory exercises and free walking. The intervention regimens lasted 8 days. The primary outcome was the Glittre Activities of Daily Living test, which assesses the time taken to complete a series of functional tasks (eg, rising from a chair, walking, stairs, lifting and bending). Secondary outcomes were distance walked in the incremental shuttle walk test, peripheral muscle strength, quality of life, dyspnoea, lung function, C-reactive protein and length of hospital stay. Measures were taken 1 day before and 1 day after the intervention period. There was greater improvement in the experimental group than in the control group on the Glittre Activities of Daily Living test (mean between-group difference 39 seconds, 95% CI 20 to 59) and the incremental shuttle walk test (mean between-group difference 130 m, 95% CI 77 to 182). There were also significantly greater improvements in quality of life, dyspnoea and peripheral muscle strength in the experimental group than in the control group. There were no between-group differences in lung function, C-reactive protein or length of hospital stay. The improvement in functional outcomes after an inpatient rehabilitation program was greater than the improvement after standard respiratory physiotherapy. The exercise training program led to greater benefits in functional capacity, peripheral muscle strength, dyspnoea and quality of life. ClinicalTrials.gov, NCT02103400. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Fluid and electrolyte shifts in women during +Gz acceleration after 15 days' bed rest

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Stinnett, H. O.; Davis, G. L.; Kollias, J.; Bernauer, E. M.

1977-01-01

Experiments were conducted on twelve women aged 23-34 yr - a bed rest (BR) group of eight subjects and an ambulatory (AMB) group of four subjects - to determine the effect of bed rest on shifts in plasma volume, electrolytes, and erythrocyte volume during +Gz acceleration on a centrifuge. The BR group underwent the +Gz acceleration during a two-week ambulatory control period, after 15 days of a 17-day BR period, and on the third day of ambulatory recovery. The AMB group underwent the same experimental procedures, but continued their normal daily routine during the BR period without additional prescribed physical exercise. Major conclusions are that (1) the higher the mean control tolerance, the greater the tolerance decline after BR; (2) relative confinement and reduced activity contribute as much to reduction in tolerance as does the horizontal body position during BR; (3) BR deconditioning has no effect on the erythrocyte volume during +3.0 Gz; and (4) about one-half the loss in tolerance after BR can be attributed to plasma volume and electrolyte shifts.

Morphologic variations in the pineal gland of the albino rat after a chronic alcoholisation process.

PubMed

Martínez-Salvador, J; Ruiz-Torner, A; Blasco-Serra, A; Martínez-Soriano, F; Valverde-Navarro, A A

2018-04-01

We studied the effect of alcohol on the pineal gland of 48 male Wistar rats. Animals were divided into control and experimental groups. The experimental group underwent a previous progressive alcoholisation period with ethanol diluted in water at a concentration of 40%. Animals were sacrificed at 3, 6, 9 and 12 months, and the ultrastructure, karyometric indices, and number of synaptic bodies in the pineal gland were analysed. The results showed progressive morphologic alterations in the ethanol-treated animals, which culminated in fatty degeneration of the pineal parenchyma after 6 months. The karyometric indices decreased in both the central and peripheral areas compared with the control group. Moreover, the seasonal rhythmicity observed in the controls disappeared in the experimental groups, whose number of different populations of synaptic bodies (synaptic ribbons and synaptic spherules) considerably lowered with inversion of their normal seasonal rhythm. These results support that chronic alcoholisation leads to fatty degeneration of the pineal parenchyma, and a considerable alteration in nuclear functional rhythms and synaptic bodies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effect of physical exercise prelabyrinthectomy on locomotor balance compensation in the squirrel monkey

NASA Technical Reports Server (NTRS)

Igarashi, M.; Ohashi, K.; Yoshihara, T.; MacDonald, S.

1989-01-01

This study examines the effectiveness of physical exercise, during a prepathology state, on locomotor balance compensation after subsequent unilateral labyrinthectomy in squirrel monkeys. An experimental group underwent 3 hr. of daily running exercise on a treadmill for 3 mo. prior to the surgery, whereas a control group was not exercised. Postoperatively, the locomotor balance function of both groups was tested for 3 mo. There was no significant difference in gait deviation counts in the acute phase of compensation. However, in the chronic compensation maintenance phase, the number of gait deviation counts was fewer in the exercise group, which showed significantly better performance stability.

Rapamycin treatment is associated with an increased apoptosis rate in experimental vein grafts.

PubMed

Schachner, Thomas; Oberhuber, Alexander; Zou, Yping; Tzankov, Alexandar; Ott, Harald; Laufer, Günther; Bonatti, Johannes

2005-02-01

Rapamycin is an immunosuppressive agent with marked antiproliferative properties and is effective in reducing in stent restenosis and vein graft neointimal hyperplasia. Apoptosis is one mechanism counterbalancing cellular proliferation. We therefore investigated the role of apoptosis in rapamycin treated vein grafts in a mouse model. C57BL6J mice underwent interposition of the inferior vena cava from isogenic donor mice into the common carotid artery using a cuff technique. In the treatment group 200 microg of rapamycin were applied locally in pluronic gel. The control group did not receive local treatment. Vein grafts were harvested at 4 weeks postoperatively and underwent morphometric analysis as well as immunohistochemical analysis for apoptosis (TUNEL). In grafted veins without treatment (controls) neointimal thickness was 50 (12-58) microm at 4 weeks postoperatively. In 200 microg rapamycin treated grafts the neointimal thickness was 17 (5-55) microm. Rapamycin treated vein grafts showed a significantly increased rate of apoptosis in the adventitia as compared with controls (P=0.032). In the neointima the apoptosis rate was lower in both groups with no significant difference between rapamycin treated grafts and controls. We conclude that treatment of experimental vein grafts with rapamycin is associated with an increased apoptosis rate in the vascular wall and a trend towards reduction of neointimal hyperplasia. These results suggest that apoptosis may be a beneficial antiproliferative component for the treatment of vein graft disease.

Subjective Organization in Free Recall as a Function of Adult Age and Type of Instruction.

ERIC Educational Resources Information Center

Hultsch, David Fries

This study focused on adult age differences in the organizational processes of memory as measured by performance (number of words recalled) and subject imposed organization (SO) of information. Thirty males in each of three age groups (16-19, 30-39, 45-54) underwent 16 inspection trials and 16 recall trails on an experimental list of 22 unrelated…

The importance of communication in the management of postoperative pain.

PubMed

Sugai, Daniel Y; Deptula, Peter L; Parsa, Alan A; Don Parsa, Fereydoun

2013-06-01

This study investigates the importance of communication in surgery and how delivering preoperative patient education can lead to better health outcomes postoperatively, via promoting tolerable pain scores and minimizing the use of narcotics after surgery. Patients who underwent outpatient surgery were randomly divided into groups to compare the pain scores of those who received preoperative patient education, the experimental group, and those who did not receive any form of patient education, the control group. Two weeks before surgery, the experimental group subjects received oral and written forms of patient education consisting of how the body responds to pain, and how endorphins cause natural analgesia. Moreover, patients were educated on the negative effects narcotics have on endorphin production and activity, as well as mechanisms of non-opioid analgesics. Of the 69 patients in the experimental group, 90% declined a prescription for hydrocodone after receiving preoperative education two weeks prior to surgery. The control group consisted of 66 patients who did not receive preoperative patient education and 100% filled their hydrocodone prescriptions. Patients in both groups were offered and received gabapentin and celecoxib preoperatively for prophylaxis of postoperative pain unless they declined. The control groups were found to have average pain scores significantly greater (P <.05) than the experimental groups and also a significantly longer (P <.005) duration of pain. This study illustrates the power of patient education via oral, written and visual communication, which can serve as an effective means to minimize narcotic analgesia after surgery.

[Experimental study of tendon graft fixation in anterior cruciate ligament reconstruction with cortical press-fit bolt in rabbits].

PubMed

Qi, Wei; Li, Chun-bao; Wang, Jun-liang; Zhu, Juan-li; Liu, Yu-jie

2013-05-21

To explore the histological outcomes of tendon-bone healing in anterior cruciate ligament (ACL) reconstruction with cortical press-fit bolt (CPB). Twenty-four healthy female or male New Zealand White rabbits (2-3 months old) underwent bilateral ACL reconstruction with extensor digitorum longus tendon. A random method was used to decide one knee would receive the routine ACL reconstruction (control group) and another cortical press-fit bolt fixation (experimental group). After general anesthesia, extensor digitorum longus tendon was harvested and ACL reconstruction performed. All animals were sacrificed at 4, 8 and 12 weeks postoperation. Radiological and histological examinations were made at each timepoint. The specimens were stained with different methods to observe the pathological changes of tendon graft, bone tunnel and cortical press-fit bolt. More revascularization and massive new bone were found in tendon-bone junction of experimental group at 4, 8 and 12 weeks postoperation. The circum-graft new vessel proportion of the experimental and control groups were 0.48 ± 0.12 and 0.26 ± 0.05 respectively (P < 0.05). In the experimental group, more cartilage cells were present in tendon-bone junction at 12 weeks and the circum-graft new bone areas in two groups were 0.41 ± 0.11 and 0.21 ± 0.10 mm(2) respectively (P < 0.05). Cortical press-fit blot may improve tendon-bone healing after ACL reconstruction in rabbits. The application prospects of this procedure are promising.

Effects of a brief psychosocial intervention in patients with cancer receiving adjuvant therapy.

PubMed

Oh, Pok Ja; Kim, Soo Hyun

2010-03-01

To test the effects of a brief psychosocial intervention using CD-ROM (BPIC) on psychosocial (fighting spirit, helplessness or hopelessness, anxiety, and depression) and behavioral (self-care behaviors) outcomes in patients with cancer receiving adjuvant therapy. Quasi-experimental. A comprehensive cancer center in Seoul, South Korea. 71 patients undergoing adjuvant therapy. The study participants were assigned to either BPIC or a control group. The experimental group underwent a two-week psychosocial intervention via CD-ROM, booklet, and telephone counseling. Fighting spirit, helplessness or hopelessness, anxiety, depression, and self-care behaviors. After BPIC, the experimental group showed significantly higher scores than the control group for fighting spirit (p = 0.005) and self-care behaviors (p < 0.001). However, the groups showed no significant differences in helplessness or hopelessness (p = 0.42), anxiety (p = 0.279), and depression (p = 0.068). BPIC use improved fighting spirit and self-care behaviors in study participants. The results partially support the effectiveness of BPIC for adaptation among patients with cancer receiving adjuvant therapy. A brief psychosocial intervention using multimedia can be used effectively in clinical oncology settings to accelerate adaptation among patients with cancer in the adjuvant phase.

The effect of preoperative stoma site marking on quality of life

PubMed Central

Cakir, Selda Karaveli; Ozbayir, Turkan

2018-01-01

Objective: The objective of the study was to determine the effect of preoperative stoma site marking on the health- related quality of life (HRQOL). Methods: A nonrandomized, quasi-experimental design was used for the study performed from June 2013 to August 2014. The study sample (n:60) included patients for whom a stoma was opened after a planned colorectal surgery. The City of Hope Quality of Life-Ostomy Questionnaire (COHQOL-OQ) was used to measure HRQOL. Results: The mean age of the participants in the experimental group was 53.5±12.83, 18(60%) had colostomies, mean BMI was 25.46 ± 4.25 and mean age of that of the control group was 58.00 ± 14.22, 19(63.3%) had colostomies, mean BMI was 25.28 ± 5.00. A comparison of the two groups indicates that the sixth-month total score of the patients in the experimental group on (COHQOL-OQ) is higher than that of the control group (p<0.05). Conclusions: The study results demonstrated that patient who underwent stoma site marking reported higher HRQOL than those who did not. PMID:29643897

The effect of permissive hypotension in combined traumatic brain injury and blunt abdominal trauma: an experimental study in swines.

PubMed

Vrettos, T; Poimenidi, E; Athanasopoulos, P; Balasis, S; Karagiorgos, N; Siklis, T; Gatzounis, G; Fligkou, F

2016-01-01

Optimal hemodynamic resuscitation strategy of the trauma patient with uncontrolled hemorrhage and severe head injury in the pre-hospital setting remains a special challenge. Permissive hypotension prior to definite surgical haemostasis promotes coagulation, decreases blood loss and favors survival. However, hypotension is associated with poor outcome in severe head injury. The purpose of this experimental animal study was to assess the impact of permissive hypotension on survival, hemodynamic profile and brain oxygenation parameters before and/or after definite surgical haemostasis. Six-week-old pigs (n=12) underwent general anesthesia and brain injury was produced by the fluid percussion model. Animals were instrumented to measure hemodynamic parameters and cerebral blood flow. All animals (n=12) were subjected to laparotomy and a surgical knot was placed through the abdominal aorta wall. Uncontrolled hemorrhage was simulated by pulling out the intentionally left protruding free ends of the suture (goal MAP=30 mmHg). Animals were randomly divided into two groups; group A (n=6) was subjected to aggressive fluid resuscitation (goal SAP >80 mmHg) and group B (n=6) was left hypotensive (permissive hypotension). Animals who survived one hour of hypotensive shock underwent definite surgical haemostasis and were resuscitated for one hour. We measured survival, hemodynamic and brain oxygenation parameters at different time points before and after surgical haemostasis. All animals from Group A and 50% from Group B died before surgical haemostasis. In surviving animals (Group B, 50%, p=0.033), MAP, CO, rCBF, SjO2 and AVDO2 were restored to pre-procedural levels. Permissive hypotension by delaying fluid resuscitation up to definite surgical haemostasis improves survival, hemodynamics and allows restoration of cerebral oxygenation in severe head injury.

Choledochorraphy (primary repair) versus t-tube drainage after open choledochotomy.

PubMed

Saeed, Nadia; Nasir, Muhammad Tauqeer; Khan, Muhammad Iqbal; Channa, Ghulam Asghar

2012-01-01

T-tube drainage used to be standard practice after surgical choledochotomy, but there is now a tendency in some canters to close the common bile duct primarily. This study was designed to compare the clinical results of primary closure with T-tube drainage after open choledocotomy and assess the safety of primary closure for future application. This study was conducted at surgical Unit-3, ward 26 Jinnah Postgraduate Medical Centre Karachi, from January 2007 to January 2008. Forty patients were included in this study out of which 20 underwent primary closure and 20 T-tube placements. It was Quasi-experimental, non-probability, purposive sampling. Main outcome measures were operating time, duration of hospital stay, and postoperative complications. SPSS-10 was used for data analysis. The age of patients in the study ranged from 29-83 years. There were 3 male while 37 female patients. Group-1 consisted of 20 patients underwent primary closure after choledocotomy, while Group-2 also consisted of 20 patients underwent T-tube drainage after duct exploration. Mean hospital stay in Group-1 patients was 7.63 days while in group 2 it was 13.6 days. Overall complication rate in group 1 was 15%, biliary leakage in 1 (5%), jaundice in 1 (5%), wound infection in 1 (5%). No re-exploration was required in Group-1. In Group-2 overall complication rate was 30%, biliary leakage in 2 (2%), jaundice in 1 (5%), dislodgement of T-tube in 1 (5%), wound infection in 1 (5%), and sepsis in 1 (5%) patients. Re-exploration was done in one patient. Primary closure of Common Bile Duct (CBD) is a safe and cost-effective alternative procedure to routine T-tube drainage after open choledocotomy.

HandTutor™ enhanced hand rehabilitation after stroke--a pilot study.

PubMed

Carmeli, Eli; Peleg, Sara; Bartur, Gadi; Elbo, Enbal; Vatine, Jean-Jacques

2011-12-01

This study assessed the potential therapeutic benefi t of using HandTutor™ in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutorTM treatment, against a control group receiving only traditional therapy. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutorTM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutorTM software. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor™ performance accuracy on x axis and performance accuracy on y axis p < 0.0003. The results from this pilot study support further investigation of the use of the HandTutorTM in combination with traditional occupational therapy and physiotherapy during post stroke hand function rehabilitation.

Reduce chest pain using modified silicone fluted drain tube for chest drainage after video-assisted thoracic surgery (VATS) lung resection.

PubMed

Li, Xin; Hu, Bin; Miao, Jinbai; Li, Hui

2016-02-01

The aim of this study was to assess the feasibility, efficacy and safety of a modified silicone fluted drain tube after video-assisted thoracic surgery (VATS) lung resection. The prospective randomized study included 50 patients who underwent VATS lung resection between March 2015 and June 2015. Eligible patients were randomized into two groups: experimental group (using the silicone fluted drain tubes for chest drainage) and control group (using standard drain tubes for chest drainage). The volume and characteristics of drainage, postoperative (PO) pain scores and hospital stay were recorded. All patients received standard care during hospital admission. In accordance with the exit criteria, three patients were excluded from study. The remaining 47 patients included in the final analysis were divided into two groups: experiment group (N=24) and control group (N=23). There was no significant difference between the two groups in terms of age, sex, height, weight, clinical diagnosis and type of surgical procedure. There was a trend toward less PO pain in experimental group on postoperative day (POD) 1, with a statistically significant difference. Patients in experimental group had a reduced occurrence of fever [temperature (T) >37.4 °C] compared to the control group. The silicone fluted drain tube is feasible and safe and may relieve patient PO pain and reduce occurrence of fever without the added risk of PO complications.

The effect of thought importance on stress responses: a test of the metacognitive model.

PubMed

Capobianco, Lora; Morrison, Anthony P; Wells, Adrian

2018-03-01

Negative metacognitive beliefs are central determinants of distress in the metacognitive model of psychological vulnerability to stress. The current study tested this assertion in 75 undergraduate students assigned to either experimental (metacognitive belief manipulation) or control (no metacognitive belief manipulation) condition. All participants underwent a fake EEG, where they were told that the EEG would detect negative thoughts. The experimental subjects were informed that if they had a negative thought they may be exposed to a contingent burst of loud noise, while the control condition was told that they may be exposed to a burst of loud noise at random. Participants also underwent the Trier Social Stress Test. The results showed that on physiological measures (skin conductance level) there were no significant differences between groups. However, on self-report measures (positive and negative affect) participants in the experimental condition reported greater levels of negative affect and lower levels of positive affect in response to stress and maintained low positive affect at recovery. The results are consistent with the metacognitive model and suggest that metacognitive beliefs impact on positive and negative affect in reaction to and recovery from stress exposure.

The impact of specialized physiotherapy methods on BODE index in COPD patients during hospitalization.

PubMed

Kurzaj, Monika; Wierzejski, Władysław; Dor, Anna; Stawska, Jolanta; Rożek, Krystyna

2013-01-01

To evaluate the effectiveness of specialized physiotherapy methods measured by the BODE index in patients with COPD during hospitalization. The study was conducted on a group of 30 patients diagnosed with COPD, all under treatment at the clinical hospital in Wroclaw due to the exacerbation of their symptoms. All patients were undergoing standard pharmacological treatment along with basic physiotherapy. The subjects of the study were randomly divided between an experimental group of 20 persons and a control group of 10 persons. Patients in the experimental group underwent a series of 6 additional massage treatments performed over a period of a few days, aimed at reshaping the following muscles: the sterno-cleidomastoid, pectoralis major, pectoralis minor, trapezius, levator scapulae, rhomboids and serratus anterior. Each massage lasted for 30 minutes and consisted of stroking, grinding, vibration and kneading techniques. Before and after therapy the patients were assessed based on the BODE index. First, the patient's BMI was calculated (B). Airflow obstruction (O) was determined by the percentage value of FEV1 while the MRC scale was used to evaluate a patient's dyspnea (D). Exercise capacity (E) was measured by the distance a patient could cover in a 6-minute walk test. Each variable of the BODE index was ranked on a scale from 0 to 3 points except the BMI, for which was given either 0 or 1 point. Analysis of the results showed a significant improvement of the BODE index in the experimental group while in the control group this ratio changed slightly. The FEV1 and MRC parameters changed significantly only in the experimental group. After a week of therapy the BODE index improved in both groups, but in the experimental group there was a significantly higher difference. In the experimental group all BODE components except BMI improved highly significantly, whereas in the control group only exercise capacity was significantly improved.

Effect of infrared laser in the prevention and treatment of paresthesia in orthognathic surgery.

PubMed

Prazeres, Lady Dayane Kalline Travassos; Muniz, Yuri Victor Siqueira; Barros, Keylla Marinho Albuquerque; Gerbi, Marleny Elizabeth Marquez de Martinez; Laureano Filho, José Rodrigues

2013-05-01

Orthognathic surgery is the surgical procedure that makes correcting deformities of the bones in the region of the maxilla and mandible a reality in the Brazilian dentistry. However, this type of surgery usually involves paresthesia in the postoperative period, concerning the surgeons who perform them and generating discomfort to patients. This study aimed at evaluating the effect of infrared laser (830 nm) in the prevention and treatment of paresthesias after orthognathic surgery. Six patients underwent orthognathic surgery: the experimental group composed of 4 patients and the control group that did not receive laser therapy composed of 2 patients. The experimental group received laser applications during the transoperative and 12 postoperative sessions. Tests for mechanical (deep and shallow) and thermal (cold) sensitivity were performed in the preoperative and postoperative period (during 12 sessions) in the lip and chin areas by the same operator. The paresthesia was classified into 1, strong; 2, moderate; 3, mild; and 4, absent, through the patient's response to stimuli. The results showed that all patients had no disturbance of sensitivity in the preoperative period, but paresthesia was presented at various levels in the postoperative period. Both groups showed recovery of deep mechanical sensitivity within a shorter time interval compared with the superficial mechanical and thermal sensitivity. However, at the 12th assessment, patients who underwent the laser therapy showed better reduction in the level of paresthesia or even complete regression of this. The laser, therefore, brought benefits to the treatment of paresthesia, accelerating the return of neurosensorial sensitivity.

Oleanolic acid improves pulmonary morphofunctional parameters in experimental sepsis by modulating oxidative and apoptotic processes.

PubMed

Santos, Raquel Souza; Silva, Pedro Leme; de Oliveira, Gisele Pena; Santos, Cintia Lourenço; Cruz, Fernanda Ferreira; de Assis, Edson Fernandes; de Castro-Faria-Neto, Hugo Caire; Capelozzi, Vera Luiza; Morales, Marcelo Marcos; Pelosi, Paolo; Gattass, Cerli Rocha; Rocco, Patricia Rieken Macedo

2013-12-01

We compared the effects of oleanolic acid (OA) vs. dexamethasone on lung mechanics and histology, inflammation, and apoptosis in lung and distal organs in experimental sepsis. Seventy-eight BALB/c mice were randomly divided into two groups. Sepsis was induced by cecal ligation and puncture, while the control group underwent sham surgery. 1h after surgery, all animals were further randomized to receive saline (SAL), OA and dexamethasone (DEXA) intraperitoneally. Both OA and DEXA improved lung mechanics and histology, which were associated with fewer lung neutrophils and less cell apoptosis in lung, liver, and kidney than SAL. However, only animals in the DEXA group had lower levels of interleukin (IL)-6 and KC (murine analog of IL-8) in bronchoalveolar lavage fluid than SAL animals. Conversely, OA was associated with lower inducible nitric oxide synthase expression and higher superoxide dismutase than DEXA. In the experimental sepsis model employed herein, OA and DEXA reduced lung damage and distal organ apoptosis through distinct anti-inflammatory mechanisms. Copyright © 2013 Elsevier B.V. All rights reserved.

Compelled body weight shift approach in rehabilitation of individuals with chronic stroke.

PubMed

Aruin, Alexander S; Rao, Noel; Sharma, Asha; Chaudhuri, Gouri

2012-01-01

This study was designed to evaluate the effectiveness of the compelled body weight shift (CBWS) therapy approach in the rehabilitation of individuals with chronic stroke. CBWS involves a forced shift of body weight toward a person's affected side by means of a shoe insert that establishes a lift of the nonaffected lower extremity. Eighteen individuals with chronic, unilateral stroke (mean age 57.7 ± 11.9 years, with a range of 35-75 years; mean time since stroke 6.7 ± 3.9 years, with a range of 1.1-14.1 years) who showed asymmetrical stance were randomly divided into 2 groups: the experimental group received 6 weeks of physical therapy combined with CBWS therapy, and the control group received only physical therapy. Both groups underwent a battery of identical tests (Fugl-Meyer Assessment, Berg Balance Scale, weight bearing, and gait velocity) before the start of the rehabilitation intervention, following its completion, and 3 months after the end of therapy. After the intervention, weight bearing on the affected side (measured with the Balance Master) increased in the experimental group to a larger degree compared to the control group (9.7% vs 6.4%). Similarly, gait velocity increased 10.5% in the experimental group compared to the control group. Improvements in weight bearing and gait velocity were maintained in the experimental group after the 3-month retention period. The study outcome revealed that a 6-week intervention involving CBWS therapy could result in a long-lasting improvement of the symmetry of weight bearing and velocity of gait in individuals with chronic stroke.

Effect of coordination movement using the PNF pattern underwater on the balance and gait of stroke patients

PubMed Central

Kim, Kyoung; Lee, Dong-Kyu; Jung, Sang-In

2015-01-01

[Purpose] To investigate the effect of coordination movement using the Proprioceptive Neuromuscular Facilitation pattern underwater on the balance and gait of stroke patients. [Subjects and Methods] Twenty stroke patients were randomly assigned to an experimental group that performed coordination movement using the Proprioceptive Neuromuscular Facilitation pattern underwater and a control group (n =10 each). Both the groups underwent neurodevelopmental treatment, and the experimental group performed coordination movement using the Proprioceptive neuromuscular facilitation pattern underwater. Balance was measured using the Berg Balance Scale and Functional Reach Test, and gait was measured using the 10-Meter Walk Test and Timed Up and Go Test. To compare in-group data before and after the intervention, paired t-test was used. Independent t-test was used to compare differences in the results of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test before and after the intervention between the groups. [Results] Comparison within the groups showed significant differences in the results of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test before and after the experimental intervention. On comparison between the groups, there were greater improvements in the scores of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test in the experimental group. [Conclusion] The findings demonstrate that coordination movement using the Proprioceptive Neuromuscular Facilitation pattern under water has a significant effect on the balance and gait of stroke patients. PMID:26834335

The effects of scenario-based communication training on nurses' communication competence and self-efficacy and myocardial infarction knowledge.

PubMed

Hsu, Li-Ling; Huang, Ya-Hsuan; Hsieh, Suh-Ing

2014-06-01

The aim of the study was to determine the effects of a simulated communication training course on nurses' communication competence, self-efficacy, communication performance, myocardial infarction knowledge, and general satisfaction with their learning experience. A randomized controlled trial was conducted with a pre-test and two post-tests. The experimental group underwent simulated communication training course and the control group received a case-based communication training course. The experimental group made more significant improvement in competence and self-efficacy in communication from pre-test to the second post-test than the control group. Although both groups' satisfaction with their learning experience significantly increased from the first post-test to the second post-test, the experimental group was found to be more satisfied with their learning experience than the control group. No significant differences in communication performance and myocardial infarction knowledge between the two groups were identified. Scenario-based communication training can be more fully incorporated into in-service education for nurses to boost their competence and self-efficacy in communication and enhance their communication performance in myocardial infarction patient care. Introduction of real-life communication scenarios through multimedia in communication education could make learners more motivated to practice communication, hence leading to improved communication capacity. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Quercetin dose affects the fate of hepatic ischemia and reperfusion injury in rats: An experimental research.

PubMed

Uylaş, Mustafa Ufuk; Şahin, Adnan; Şahintürk, Varol; Alataş, İbrahim Özkan

2018-05-01

Quercetin found in fruits and vegetables has an antioxidative effect. We aimed to investigate the protective effects of quercetin according to different doses on hepatic and ischemia-reperfusion (I/R) injury. Fifty mature male Sprague-Dawley rats were randomly divided into five groups (n = 10 for each). All the animal groups underwent laparotomy. Group 1 rats served as a sham-operated group. Groups 2-5 underwent 1 h hepatic ischemia and were followed by 2 h reperfusion. Group 3-5 animals received an additional intraperitoneal dose of 25, 50 or 100 mg/kg quercetin respectively before I/R operation. Blood samples were collected for determining serum aspartate transaminase (AST), alanine transaminase (ALT) and malondialdehyde (MDA) levels. Also, liver tissue samples were taken for measuring of liver MDA concentration and for histopathology assessment. The highest levels of biochemical parameters were observed in group 2. In quercetin-treated groups, serum AST, ALT, MDA levels, and tissue MDA concentration were decreased as inversely with increasing quercetin dose. Microscopic evaluation revealed that most conspicuous histological improvement was observed in 50 mg/kg quercetin co-treated rats. 25 and 100 mg/kg quercetin co-treatment could not protect completely against hepatic I/R injury. Quercetin can be effective in preventing of hepatic I/R injury when the correct dose was used. Copyright © 2018. Published by Elsevier Ltd.

Prevention of Intraabdominal Adhesions: An Experimental Study Using Mitomycin-C and 4% Icodextrin.

PubMed

Urkan, Murat; Özerhan, İsmail Hakkı; Ünlü, Aytekin; Can, Mehmet Fatih; Öztürk, Erkan; Günal, Armağan; Yağcı, Gökhan

2017-01-01

Intraabdominal adhesions remain a significant cause of morbidity and mortality. Moreover, intraabdominal adhesions can develop in more than 50% of abdominal operations. We compared the anti-adhesive effects of two different agents on postoperative adhesion formation in a cecal abrasion model. Experimental animal study. Forty Wistar albino type female rats were anesthetized and underwent laparotomy. Study groups comprised Sham, Control, Mitomycin-C, 4% Icodextrin, and Mitomycin-C +4% Icodextrin groups. Macroscopic and histopathological evaluations of adhesions were performed. The frequencies of moderate and severe adhesions were significantly higher in the control group than the other groups. The mitomycin-C and Mitomycin-C +4% Icodextrin groups were associated with significantly lower adhesion scores compared to the control group and 4% Icodextrin group scores (p=0.002 and p=0.008, respectively). The adhesion scores of the Mitomycin-C group were also significantly lower than those of the 4% Icodextrin group (p=0.008). Despite its potential for bone marrow toxicity, Mitomycin-C seems to effectively prevent adhesions. Further studies that prove an acceptable safety profile relating to this promising anti-adhesive agent are required before moving into clinical trials.

Patella morphological alteration after patella instability in growing rabbits.

PubMed

Niu, Jinghui; Qi, Qi; Niu, Yingzhen; Dong, Conglei; Dong, Zhenyue; Cui, Peng; Wang, Fei

2017-07-11

The shape of the patella has been considered to be a predisposing factor resulting in patellar instability, but the effects of abnormal patella position during its development are unclear. The present study evaluated patellar morphological changes after patella instability and evaluated the influence of patellar instability on the patella shape. Twenty rabbits that were 2 months old were included in the study. The left knee of each rabbit, defined as the experimental group (N = 20 knees/group), underwent a medial soft tissue restraint release. The right knee of each rabbit, defined as the control group (N = 20 knees/group), did not undergo any surgical procedures. A CT scan was performed on each knee before surgery and 6 months post-surgery to measure the transverse diameter, thickness, Wiberg index, and Wiberg angle for analysis of the patellar morphological changes. Cross-specimen examination was conducted to evaluate the differences between the experimental group and the control group. The four indices remained the same between the two groups before surgery. However, 6 months after surgery, the mean transverse diameter of the patellae in the experimental group was significantly longer than that in the control group (P < 0.001), while the mean thickness in the experimental group was not significantly greater than that in the control group (P = 0.314), resulting in a flattened shape. The Wiberg indices were not significantly different between the two groups. However, the mean Wiberg angle was higher in the experimental group than in the control group (P < 0.001), which resulted in a flattened articular surface of the patella. The sectional shape and articular surface of the patella became more flattened after patella instability in this study, which indicates that patella dysplasia could be caused by patella instability. Clinically, early intervention for adolescent patients with patella instability is important.

Asymmetric dimethylarginine may mediate increased heat pain threshold in experimental chronic kidney disease.

PubMed

Kielstein, Jan T; Suntharalingam, Mayuren; Perthel, Ronny; Rong, Song; Martens-Lobenhoffer, Jens; Jäger, Kristin; Bode-Böger, Stefanie M; Nave, Heike

2012-03-01

Thermal sensitivity in uraemia is decreased. Non-selective synthetic nitric oxide synthase (NOS) inhibitors significantly attenuate thermal hyperalgesia in preclinical models. The aim of our study was to evaluate the effect of experimental uraemia, which is associated with an increase of the endogenous NOS inhibitor asymmetric dimethylarginine (ADMA), on thermal sensitivity in rats. Furthermore, we intended to study the effect of chronic ADMA infusion alone on thermal sensitivity. Male Sprague-Dawley rats (n = 54), 10 weeks old, weight 370-430 g, were randomly assigned to three groups receiving either (i) isotonic saline or (ii) ADMA via osmotic mini pumps or (iii) underwent 5/6 nephrectomy (Nx). After 14 days, 50% of all animals from all groups underwent thermal sensitivity testing and terminal blood draw. After 28 days, the remaining animals underwent the same procedures. Thermal sensitivity examination was performed by the hot-plate test, measuring time from heat exposition to first paw licking or jumping of the animal. While the median [interquartile range] latency time between heat exposition to first paw licking or jumping of the animal in the NaCl infusion group remained unchanged between Day 14 (8.4 [6.75-11.50] s) and Day 28 (7.35 [6.10-7.90] s) both, ADMA infusion and 5/6 nephrectomy tended to increase the thermal pain threshold at Day 14 (9.25 [6.55-12.18] s) and (9.50 [5.8 ± 11.0] s), respectively, compared to NaCl on Day 14 (8.4 [6.75-11.50] s). This difference became statistical significant at Day 28 where the median latency time in the ADMA group (13.10 [11.85-15.95] s) and in the 5/6 Nx group (13.50 [10.85-17.55] s) were significantly higher than in the NaCl group (7.35 [6.10-7.90] s). Induction of progressive renal failure in rats by 5/6 nephrectomy, which is accompanied by a marked increase of the serum levels of the endogenous NOS inhibitor ADMA, leads to a significantly increased heat pain threshold at 28 days. The sole infusion of ADMA into healthy rats leads to the same increase in heat pain threshold.

Effects of anodal transcranial direct current stimulation combined with virtual reality for improving gait in children with spastic diparetic cerebral palsy: a pilot, randomized, controlled, double-blind, clinical trial.

PubMed

Collange Grecco, Luanda André; de Almeida Carvalho Duarte, Natália; Mendonça, Mariana E; Galli, Manuela; Fregni, Felipe; Oliveira, Claudia Santos

2015-12-01

To compare the effects of anodal vs. sham transcranial direct current stimulation combined with virtual reality training for improving gait in children with cerebral palsy. A pilot, randomized, controlled, double-blind, clinical trial. Rehabilitation clinics. A total of 20 children with diparesis owing to cerebral palsy. The experimental group received anodal stimulation and the control group received sham stimulation over the primary motor cortex during virtual reality training. All patients underwent the same training programme involving a virtual reality (10 sessions). Evaluations were performed before and after the intervention as well as at the one-month follow-up and involved gait analysis, the Gross Motor Function Measure, the Pediatric Evaluation Disability Inventory and the determination of motor evoked potentials. The experimental group had a better performance regarding gait velocity (experimental group: 0.63 ±0.17 to 0.85 ±0.11 m/s; control group: 0.73 ±0.15 to 0.61 ±0.15 m/s), cadence (experimental group: 97.4 ±14.1 to 116.8 ±8.7 steps/minute; control group: 92.6 ±10.4 to 99.7 ±9.7 steps/minute), gross motor function (dimension D experimental group: 59.7 ±12.8 to 74.9 ±13.8; control group: 58.9 ±10.4 to 69.4 ±9.3; dimension E experimental group: 59.0 ±10.9 to 79.1 ±8.5; control group: 60.3 ±10.1 to 67.4 ±11.4) and independent mobility (experimental group: 34.3 ±5.9 to 43.8 ±75.3; control group: 34.4 ±8.3 to 37.7 ±7.7). Moreover, transcranial direct current stimulation led to a significant increase in motor evoked potential (experimental group: 1.4 ±0.7 to 2.6 ±0.4; control group: 1.3 ±0.6 to 1.6 ±0.4). These preliminary findings support the hypothesis that anodal transcranial direct current stimulation combined with virtual reality training could be a useful tool for improving gait in children with cerebral palsy. © The Author(s) 2015.

The assessment of preschool children's motor skills after familiarization with motor tests.

PubMed

Tomac, Zvonimir; Hraski, Zeljko; Sporis, Goran

2012-07-01

This research study was conducted to establish the influence of familiarization on the information component of movement in a motor task for the assessment of preschool children's motor skills. The sample included 50 children whose mean age was 5.9 years (71.5 months). The experimental group consisted of 27 children who were 5.9 years (71.5 months) old, and the control group consisted of 23 children who were 5.9 years (71.5 months) old. The examinees performed 2 motor tasks, standing long jump (SJ, explosive strength) and standing on 1 leg on a beam "flamingo test" (FT, balance). The experimental group underwent a period of familiarization with the motor task in 3 sessions with 5 trials every 3 days. The results indicate statistically significant differences in the final testing between both groups of examinees; the experimental group mean was 112.73 cm, and the control group mean was 100.62 in the SJ test (p = 0.00), and the experimental group mean was 27.10 seconds and the control group mean was 15.01 seconds in the FT (for balance) (p = 0.00). The results obtained in this research indicate that children significantly improved the results in the motor test of strength and balance, being influenced by familiarization. It was confirmed that it was necessary for preschool children to be familiar with the test and it is not justified to use testing and assessment protocols and standards for adults. Physical educators and coaches, when testing preschool children, should introduce children to tests to obtain the best result.

Changes of serum neurohormone after renal sympathetic denervation in dogs with pacing-induced heart failure.

PubMed

Zhao, Qingyan; Huang, He; Wang, Xule; Wang, Xiaozhan; Dai, Zixuan; Wan, Peixing; Guo, Zongwen; Yu, Shengbo; Tang, Yanhong; Huang, Congxin

2014-01-01

Neurohormonal activation is a commonly cited array of phenomena in the body's physiologic response to heart failure (HF). The aim of the present study was to determine the change law of serum neurohormones after renal sympathetic denervation (RSD) in dogs with pacing-induced HF. Twenty-eight beagles were randomly divided into control group, RSD group, HF group and HF + RSD group. The control group was implanted pacemakers without pacing; the RSD group underwent renal artery ablation without pacing; the HF group was implanted pacemakers with ventricular pacing at 240 bpm for 3 weeks; and HF + RSD group underwent renal artery ablation and with ventricular pacing at 240 bpm for 3 weeks. Blood samples were taken at baseline, and 3, 6, 9, 12, 15, 18, 21 days in all the dogs for neurohormones measurement. After 3 weeks, the systolic femoral artery pressures in the HF and HF + RSD groups were reduced after pacing 3 weeks. There was an increase significantly in BNP, angiotensin II, aldosterone, endothelin-1 and decrease in renalase after 3 weeks when compared with baseline in HF group. RSD significantly suppressed the changes of plasma neurohormones concentration in experimental HF, but RSD had not obviously impact on the levels of plasma neurohormones during 3 weeks in RSD group. RSD attenuates the changes of levels of plasma neurohormones in the activated renin-angiotensin-aldosterone system (RAAS) but had not obviously effect in the normal physiology of RAAS.

Unilateral Nasal Obstruction during Later Growth Periods Affects Craniofacial Muscles in Rats

PubMed Central

Uchima Koecklin, Karin H.; Hiranuma, Maya; Kato, Chiho; Funaki, Yukiha; Kataguchi, Taku; Yabushita, Tadachika; Kokai, Satoshi; Ono, Takashi

2017-01-01

Nasal obstruction can occur at different life stages. In early stages of life the respiratory system is still under development, maturing during the growth period. Previous studies have shown that nasal obstruction in neonatal rats alters craniofacial function. However, little is known about the effects of nasal obstruction that develops during later growth periods. The aim of this study was to investigate the effects of nasal obstruction during later periods of growth on the functional characteristics of the jaw-opening reflex (JOR) and tongue-protruding muscles. In total, 102 6-day-old male Wistar rats were randomized into either a control or experimental group (both n = 51). In order to determine the appropriate timing of nasal obstruction, the saturation of arterial oxygen (SpO2) was monitored at 8 days, and at 3, 5, 7, 9, and 11 weeks in the control group. Rats in the experimental group underwent unilateral nasal obstruction at the age of 5 weeks. The SpO2 was monitored at 7, 9, and 11 weeks in the experimental group. The electromyographic responses of JOR and the contractile properties of the tongue-protruding muscles were recorded at 7, 9, and 11 weeks. In the control group, SpO2 decreased until 5 weeks of age, and remained relatively stable until 11 weeks of age. The SpO2 was significantly lower in the experimental group than in the control. In the experimental group, JOR changes included a longer latency and smaller peak-to-peak amplitude, while changes in the contractile properties of the tongue-protruding muscles included larger twitch and tetanic forces, and a longer half-decay time. These results suggest that nasal obstruction during later growth periods may affect craniofacial function. PMID:28119621

The influence of personal message with music on anxiety and side effects associated with chemotherapy.

PubMed

Sabo, C E; Michael, S R

1996-08-01

The purpose of this pilot study was to evaluate the benefits of a message from a patient's physician audiotaped over music on reducing anxiety and side effects of patients receiving chemotherapy. A convenience sample of 97 adult patients receiving chemotherapy for the first time was assigned to either an experimental or control group. Before beginning the first chemotherapy treatment, all subjects completed a demographic questionnaire and the Spielberger State Anxiety Inventory (SSAI). Participants in the experimental group (n = 47) received taped music and a message from their physicians during the next four chemotherapy treatments. Participants in the control group (n = 50) received no intervention from the researchers and underwent their next four chemotherapy treatments as prescribed. After the fourth chemotherapy treatment, the SSAI and a side-effects self-assessment evaluation were completed by all subjects. A paired one-tailed t test found a significant difference between pre- and postintervention scores on the state anxiety scale (p < 0.001). In addition, anxiety remained the same over time in the control group. There was no significant difference in the severity of side effects experienced between control and experimental groups. These preliminary findings indicate that a simple and cost-effective intervention can decrease a patient's anxiety when receiving chemotherapy.

Effects of flotation-REST on muscle tension pain.

PubMed

Kjellgren, A; Sundequist, U; Norlander, T; Archer, T

2001-01-01

The purpose of the present study was to investigate whether the floating form of the restricted environmental stimulation technique (REST) may be applied within the field of pain relief. Flotation-REST consists of a procedure whereby an individual is immersed in a tank filled with water of an extremely high salt concentration. Thirty-seven patients (14 men and 23 women) suffering from chronic pain consisting of aching muscles in the neck and back area participated in the study. They were randomly assigned to either a control group (17 participants) or an experimental group (20 participants). The experimental group received nine opportunities to use the flotation-REST technique in the water tank over a three-week period. The results indicated that the most severe perceived pain intensity was significantly reduced, whereas low perceived pain intensity was not influenced by the floating technique. Further, the results indicated that circulating levels of the noradrenaline metabolite 3-methoxy-4-hydroxyphenylethyleneglycol were reduced significantly in the experimental group but not in the control group following treatment, whereas endorphin levels were not affected by flotation. Flotation-REST treatment also elevated the participants' optimism and reduced the degree of anxiety or depression; at nighttime, patients who underwent flotation fell asleep more easily. The present findings describe possible changes, for the better, in patients presenting with chronic pain complaints.

Effectiveness of Resilience Training on Ego-control and Hardiness of Illicit Drug Users.

PubMed

Roustaei, Amin; Bakhshipoor, Babollah; Doostian, Younes; Goodiny, Ali Akbar; Koohikar, Mansoureh; Massah, Omid

2017-01-01

The aim of this research was to determine the effectiveness of resilience training upon ego-control and hardiness of the addicted persons. This was a semi-experimental study with pretest and posttest control groups which was conducted in Sari, Iran, during 2014-2015. Thirty persons were selected among 240 illicit drug users who underwent screening. Resilience training was performed in ten sessions for the experimental group. The Kobasa hardiness questionnaire and self-restraint scale (SRS) were used for data collection and multivariate covariance test was performed for data analysis. According to the data, ego-control and hardiness of participants were improved significantly by resilience training (P < 0.001). Resilience training is effective upon the rate of ego-control and self-restraint and hardiness. This method can be used in addiction treatment clinics and residential centers.

Histological study of right ventricle-pulmonary artery valved conduit implantation (RPVC) in dogs with pulmonic stenosis.

PubMed

Saida, Yuuto; Tanaka, Ryou; Fukushima, Ryuji; Hira, Satoshi; Hoshi, Katsuichiro; Soda, Aiko; Iizuka, Tomoya; Ishikawa, Taisuke; Nishimura, Taiki; Yamane, Yoshihisa

2009-04-01

We examined whether right ventricle-pulmonary artery valved conduit (RPVC) implantation can overcome the disadvantages of current procedures for pulmonic stenosis (PS). We histologically evaluated the feasibility of RPVC using a homograft in PS model dogs. Eight dogs underwent pulmonary artery banding (PAB) and then 12 weeks later were assigned to PAB (n=4) or PAB+RPVC (n=4) groups. Dogs in the PAB group received no treatment throughout the experimental period, whereas the PAB+RPVC group underwent RPVC. At 1 year after PAB, hearts and conduits were explanted from euthanized dogs and histologically evaluated. The ratios (%) of myocardial fibrosis on right ventricle (RV) epicardial, median and endocardial layers were significantly lower in the PAB+RPVC, than in the PAB group. The ratio of myocardial fibrosis on left ventricular (LV) epicardial and endocardial layers were significantly lower in the PAB+RPVC, than in the PAB group. Neo-intimal thickness in the anastomosis areas of the Denacol and PAB+RPVC groups was 42.77 +/- 30.19 and 88.30 +/- 27.24 microm, respectively, with no significant differences between the groups. Calcification and neo- intima hypertrophy were not obvious in the valve area. Immunohistological staining showed that the internal surface of the anastomosis and intermediate areas were positive for endothelial cells. We concluded that RPVC using a bioprosthetic graft can apparently overcome the disadvantages of current procedures for pulmonic stenosis.

Reduce chest pain using modified silicone fluted drain tube for chest drainage after video-assisted thoracic surgery (VATS) lung resection

PubMed Central

Li, Xin; Hu, Bin; Miao, Jinbai

2016-01-01

Background The aim of this study was to assess the feasibility, efficacy and safety of a modified silicone fluted drain tube after video-assisted thoracic surgery (VATS) lung resection. Methods The prospective randomized study included 50 patients who underwent VATS lung resection between March 2015 and June 2015. Eligible patients were randomized into two groups: experimental group (using the silicone fluted drain tubes for chest drainage) and control group (using standard drain tubes for chest drainage). The volume and characteristics of drainage, postoperative (PO) pain scores and hospital stay were recorded. All patients received standard care during hospital admission. Results In accordance with the exit criteria, three patients were excluded from study. The remaining 47 patients included in the final analysis were divided into two groups: experiment group (N=24) and control group (N=23). There was no significant difference between the two groups in terms of age, sex, height, weight, clinical diagnosis and type of surgical procedure. There was a trend toward less PO pain in experimental group on postoperative day (POD) 1, with a statistically significant difference. Patients in experimental group had a reduced occurrence of fever [temperature (T) >37.4 °C] compared to the control group. Conclusions The silicone fluted drain tube is feasible and safe and may relieve patient PO pain and reduce occurrence of fever without the added risk of PO complications. PMID:26941976

Use of Kinesiology Taping in Rehabilitation after Knee Arthroplasty: a Randomised Clinical Study.

PubMed

Woźniak-Czekierda, Weronika; Woźniak, Kamil; Hadamus, Anna; Białoszewski, Dariusz

2017-10-31

Proprioception and body balance after knee arthroplasty have a considerable impact on restoration of joint function and a normal gait pattern. Kinesiology Taping (KT) is a method that may be able to influence these factors. The aim of this study was to assess the effects of KT application on sensorimotor efficiency, balance and gait in patients undergoing rehabili-ta--tion after knee replacement surgery. The study involved 120 male and female patients (mean age was 69 years) after total knee repla-cement. The patients were randomly assigned to one of two groups: Experimental Group (n=51) and Control Group (n=60). Both groups underwent standard rehabilitation lasting 20 days. In addition, the Experimental Group received KT applications. Treat-ment outcomes were assessed based on tests evaluating balance, joint position sense and functional gait performance, conducted both before and after the therapy. Statistically significant improvements were noted across all the parameters assessed in the Experimental Group (p<0.005). Significant improvements were also seen in the Control Group (p<0.005), but, in percentage terms, the improvement was higher in the Experimental Group. The only exception was the right/left foot load distribution, whose symmetry improved proportionally in both groups. 1. Patients after knee replacement surgery have considerable proprioception deficits, impaired body balance and reduced functional performance, which may increase the risk of falls in this group of patients. 2. Both standard physiotherapy and combination therapy with Kinesiology Taping (modified by the present authors) used in patients after knee arthroplasty may considerably improve the level of proprioception, body balance and overall functional performance. 3. The technique of dynamic taping proposed in this paper may optimise standard physiotherapy used in patients after knee arthroplasty and increase its clinical efficacy. Further studies are required.

Tele-health-care in the elderly living in nursing home: the first Sicilian multimodal approach.

PubMed

De Luca, Rosaria; Bramanti, Alessia; De Cola, Maria Cristina; Trifiletti, Antonino; Tomasello, Provvidenza; Torrisi, Michele; Reitano, Simone; Leo, Antonino; Bramanti, Placido; Calabrò, Rocco Salvatore

2016-08-01

The continued aging of the population is affecting the health of the industrialized countries, with an increasing burden for the healthcare system. Thus, during the last decade, we assisted to relevant progress in the medical treatment and rehabilitation techniques and devices, including the development of telemedicine for geriatric care. To demonstrate the effectiveness of a novel tele-health-care model allowing a better management of elderly living in nursing homes. Fifty-nine elderly patients (19 males and 40 females; mean age 79.1 (±9.2), were randomly divided into two groups: the experimental group that performed a proper telemonitoring with a multimodal approach (including monitoring of the vital signs and neurological/psychological counseling), and the control group, which underwent standard in-home nursing care. Neurobehavioral symptoms and quality of life were assessed in both the groups at baseline, and after the telecare protocol's end. The experimental group had a statistically significant reduction in Geriatric Depression Scale (p < 0.01) and Brief Psychiatric Rating Scale (p < 0.05) scores, and an improvement in their quality of life. Moreover, mean blood pressure and heart rate were lower in the experimental than in the control group (p < 0.05), and admission to health care services was higher in the control than in the experimental group (p < 0.05). Telemedicine can be considered as an important tool in improving health and quality of life in the elderly living in nursing homes, and potentially reducing healthcare service access, hospitalization, and costs.

The effect of kinesio taping with exercise compared with exercise alone on pain, range of motion, and disability of the shoulder in postmastectomy females: a randomized control trial

PubMed Central

Tantawy, Sayed A; Kamel, Dalia M

2016-01-01

[Purpose] The aim of the study was to investigate the effect of kinesio tape on pain, range of motion, and disability of the shoulder. [Subjects and Methods] Seventy-four female patients who underwent modified radical mastectomy participated in this study. They were randomly divided into two groups, an experimental group that received kinesio tape for the shoulder joint in addition to a conventional physiotherapy program and a control group that received the physiotherapy program only. Outcome measures included the Visual Analogue Scale, shoulder range of motion, and Shoulder Pain and Disability Index. [Results] The experimental group showed significant differences in all outcome measures both within and between groups. The control group only showed a significant within group difference in shoulder flexion. [Conclusion] Clinicians should be able to recognize the benefits achieved through the use of adjunct treatment options such as kinesio tape in comparison with benefits that can be obtained through the use of individual modalities in physical therapy. Kinesio tape can be suggested and recommended for postmastectomy patients, especially for shoulder pain, range of motion, and disability. PMID:28174439

Effect of complex training on carbon monoxide, cardiorespiratory function, and body mass among college students at the initial stage of stopping smoking.

PubMed

Kim, Seungsuk

2017-08-01

[Purpose] This study aimed to analyze the effects of complex training on carbon monoxide, cardiorespiratory function, and body mass among college students with the highest smoking rate among all age group. [Subjects and Methods] A total of 40 college students voluntarily participated in this study. All subjects smoked and were randomly divided into two groups: the experimental group (N=20) and the control group (N=20). The experimental group underwent complex training (30 min of training five times a week for 12 weeks) while the control group did not participate in such training. The complex training consisted of two parts: aerobic exercise (walking and running) and resistance exercise (weight training). [Results] Two-way ANOVA with repeated measures revealed significant interactions among CO, VO2max, HRmax, VEmax, body fat, and skeletal muscle mass, indicating that the changes were significantly different among groups. [Conclusion] A 12 week of complex physical exercise program would be an effective way to support a stop-smoking campaign as it quickly eliminates CO from the body and improves cardiorespiratory function and body condition.

Parenteral arginine impairs intestinal adaptation following massive small bowel resection in a rat model.

PubMed

Sukhotnik, Igor; Mogilner, Jorge G; Lerner, Aaron; Coran, Arnold G; Lurie, Michael; Miselevich, Iness; Shiloni, Eitan

2005-06-01

The nitric oxide precursor L-arginine (ARG) has been shown to influence intestinal structure and absorptive function. It is also well known that the route of administration modulates the effects of ARG. The present study evaluated the effects of parenteral ARG on structural intestinal adaptation, cell proliferation, and apoptosis in a rat model of short bowel syndrome (SBS). Male Sprague-Dawley rats were divided into three experimental groups: Sham rats underwent bowel transection and reanastomosis, SBS rats underwent a 75% small bowel resection, and SBS-ARG rats underwent a 75% small bowel resection and were treated with ARG given subcutaneously at a dose of 300 mug/kg, once daily, from days 3 to 14. Parameters of intestinal adaptation, enterocyte proliferation, and enterocyte apoptosis were determined on day 15 following operation. The SBS rats demonstrated a significant increase in jejunal and ileal bowel and mucosal weight, villus height and crypt depth, and cell proliferation index compared with the sham group. The SBS-ARG animals demonstrated lower ileal bowel and mucosal weights, jejunal mucosal DNA and ileal mucosal protein, and jejunal and ileal villus height and crypt depth compared with SBS animals. The SBS-ARG rats also had a lower cell proliferation index in both jejunum and ileum and a greater enterocyte apoptotic index in ileum compared with the SBS-untreated group. In conclusion, in a rat model of SBS, parenteral arginine inhibits structural intestinal adaptation. Decreased cell proliferation and increased apoptosis are the main mechanisms responsible for decreased cell mass.

Effect of subcutaneous insulin on intestinal adaptation in a rat model of short bowel syndrome.

PubMed

Sukhotnik, Igor; Mogilner, Jorge; Shamir, Raanan; Shehadeh, Naim; Bejar, Jacob; Hirsh, Mark; Coran, Arnold G

2005-03-01

Insulin has been shown to influence intestinal structure and absorptive function. The purpose of the present study was to evaluate the effects of parenteral insulin on structural intestinal adaptation, cell proliferation, and apoptosis in a rat model of short bowel syndrome (SBS). Male Sprague-Dawley rats were divided into three experimental groups: sham rats underwent bowel transection and reanastomosis, SBS rats underwent a 75% small bowel resection, and SBS-INS rats underwent a 75% small bowel resection and were treated with insulin given subcutaneously at a dose of 1 U/kg, twice daily, from day 3 through day 14. Parameters of intestinal adaptation, enterocyte proliferation, and enterocyte apoptosis were determined on day 15 following operation. SBS rats demonstrated a significant increase in jejunal and ileal bowel and mucosal weight, villus height and crypt depth, and cell proliferation index compared with the sham group. SBS-INS animals demonstrated higher jejunal and ileal bowel and mucosal weights, jejunal and ileal mucosal DNA and protein, and jejunal and ileal crypt depth compared with SBS animals. SBS-INS rats also had a greater cell proliferation index in both jejunum and ileum and a trend toward a decrease in enterocyte apoptotic index in jejunum and ileum compared with the SBS untreated group. In conclusion, parenteral insulin stimulates structural intestinal adaptation in a rat model of SBS. Increased cell proliferation is the main mechanism responsible for increased cell mass.

Effects of music in combination with vibration in acupuncture points on the treatment of fibromyalgia.

PubMed

Weber, Augusto; Werneck, Lineu; Paiva, Eduardo; Gans, Paulo

2015-02-01

Fibromyalgia (FM) is a disease that causes widespread pain and increased sensitivity to pain because of a dysfunction in the central nervous system. This study investigated the effect of music combined with vibration on acupuncture points for the treatment of FM. A total of 120 patients with FM were allocated randomly to four groups (30 patients each). One group listened to a sequence of Bach's compositions. The second group was subjected to vibratory stimuli on a combination of acupuncture points on the skin. The third group (complete) underwent both procedures in a simultaneous and synchronized manner, with inclusion of binaural beats. The fourth group (control) received no stimulation. The participants underwent the experimental procedure during five sessions performed on alternate days. They were assessed by the Fibromyalgia Impact Questionnaire (FIQ) and the Health Assessment Questionnaire (HAQ) before the first session and after the last session (20 days). All groups showed a significant improvement in FIQ and HAQ scores at the evaluation after the intervention. The complete group exhibited the best result on both the FIQ and HAQ (p<0.001), and the improvement in HAQ score was significant (p<0.004). The results suggest that the placebo effect in FM may be substantial. However, comparison between groups revealed that the complete group had the greatest reduction in both FIQ and HAQ, with a significant improvement in HAQ, suggesting that the combined use of music and vibration exerts a greater effect on FM symptoms.

Compelled Body-Weight Shift Approach in Rehabilitation of Individuals with Chronic Stroke

PubMed Central

Aruin, Alexander S.; Rao, Noel; Sharma, Asha; Chaudhuri, Gouri

2013-01-01

Purpose To evaluate the effectiveness of the Compelled Body Weight Shift (CBWS) therapy approach in the rehabilitation of individuals with chronic stroke. CBWS involves a forced shift of body weight towards a person’s affected side by means of a shoe insert that establishes a lift of the non-affected lower extremity. Method Eighteen individuals with chronic, unilateral stroke (mean age 57.7 ± 11.9 years, with a range of 35–75 years, mean time since stroke 6.7±3.9 years with a range of 1.1–14.1 years) who showed asymmetrical stance were randomly divided into two groups: the experimental group received a six-week physical therapy combined with CBWS therapy and the control group received only physical therapy. Both groups underwent a battery of identical tests (Fugl-Meyer assessment, Berg Balance Scale, weight bearing, and gait velocity) before the start of the rehabilitation intervention, following its completion, and three months after the end of therapy. Results After the intervention, weight bearing on the affected side (measured with the Balance Master®) increased in the experimental group to a larger degree compared to the control group (9.7% vs. 6.4%). Similarly, gait velocity increased 10.5% in the experimental group compared to the control group. Improvements in weight bearing and gait velocity were maintained in the experimental group after the three month retention period. Conclusion The study outcome revealed that a six-week intervention involving CBWS therapy could result in a long-lasting improvement of the symmetry of weight bearing and velocity of gait in individuals with chronic stroke. PMID:23192720

Comparison of pharyngocutaneous fistula closure with and without bacterial cellulose in a rat model.

PubMed

Demir, Berat; Sarı, Murat; Binnetoglu, Adem; Yumusakhuylu, Ali Cemal; Filinte, Deniz; Tekin, İshak Özel; Bağlam, Tekin; Batman, Abdullah Çağlar

2018-04-01

The present study aimed to compare the effects of bacterial cellulose used for closure of pharyngocutaneous fistulae, a complication of total laryngectomy, with those of primary sutures in a rat model. Thirty female Sprague-Dawley underwent experimental pharyngoesophagotomy and were grouped depending on the material used for pharyngocutaneous fistula closure: group I, which received primary sutures alone, group II, which received bacterial cellulose alone; and group III, which received both. After 7 days, the rats were sacrificed. Pharyngocutaneous fistula development was assessed, the gross wound was inspected, and histological examination was conducted. Pharyngocutaneous fistulae developed in 12 rats (41%) in all: 6 from group I (21%), 4 from group II (14%) and 2 from group III (7%). Fibroblast density and inflammatory cell infiltration were significantly greater in group III than group I. We concluded that bacterial cellulose may be useful for pharyngocutaneous fistula closure. Copyright © 2017 Elsevier B.V. All rights reserved.

Multiple autoclave cycle effects on cyclic fatigue of nickel-titanium rotary files produced by new manufacturing methods.

PubMed

Hilfer, Paul B; Bergeron, Brian E; Mayerchak, Michael J; Roberts, Howard W; Jeansonne, Billie G

2011-01-01

Novel nickel-titanium rotary files with proprietary manufacturing techniques have recently been marketed. The purpose of this study was to assess multiple autoclave cycle effects on cyclic fatigue of GT Series X files (Dentsply Tulsa Dental Specialties, Tulsa, OK) and Twisted Files (SybronEndo, Orange, CA) METHODS: A jig using a 5-mm radius curve with 90° of maximum file flexure was used to induce cyclic fatigue failure. Files (n = 10) representing each experimental group (GT Series X 20/.04 and 20/.06; Twisted Files 25/.04 and 25/.06) were first tested to establish baseline mean cycles to failure (MCF). Experimental groups (n = 20) were then cycled to 25% of the established baseline MCF and then autoclaved. Additional autoclaving was accomplished at 50% and 75% of MCF followed by continual testing until failure. Control groups (n = 20) underwent the same procedures except autoclaving was not accomplished. The GT Series X (20/.04 and 20/.06) files showed no significant difference (p = 0.918/p = 0.096) in MCF for experimental versus control files. Twisted Files (25/.04) showed no significant difference (p = 0.432) in MCF between experimental and control groups. However, the Twisted Files (25/.06) experimental group showed a significantly lower (p = 0.0175) MCF compared with the controls. Under the conditions of this evaluation, autoclave sterilization significantly decreased cyclic fatigue resistance of one of the four file groups tested. Repeated autoclaving significantly reduced the MCF of 25/.06 Twisted Files; however, 25/.04 Twisted Files and both GT Series X files tested were not significantly affected by the same conditions. Published by Elsevier Inc.

Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults

PubMed Central

Fong, Shirley S.M.; Ng, Shamay S.M.; Cheng, Yoyo T.Y.; Zhang, Joni; Chung, Louisa M.Y.; Chow, Gary C.C.; Chak, Yvonne T.C.; Chan, Ivy K.Y.; Macfarlane, Duncan J.

2016-01-01

[Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants’ physical activity was evaluated using the International Physical Activity Questionnaire–Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results. PMID:27313391

Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Zhang, Joni; Chung, Louisa M Y; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Macfarlane, Duncan J

2016-05-01

[Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants' physical activity was evaluated using the International Physical Activity Questionnaire-Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results.

Student-centered tutoring as a model for patient-centeredness and empathy.

PubMed

Meirovich, Adaya; Ber, Rosalie; Moore, Michael; Rotschild, Avi

2016-01-01

Curriculum planners and medical teachers attempt to enhance medical students' empathy and patient-centeredness. Despite educational efforts, there is stability in medical students' empathy and patient-centered medicine during the preclinical stage and a decline in both of them throughout the clinical years. Student-tutor relationship plays a key role in students' learning. This study tests the effect of learner-centered tutoring on students' empathy, patient-centeredness, and behavior. The cohort of 55 students was divided into groups of seven or eight. The experimental group's tutors underwent LC mentoring. Empathy was assessed with the Jefferson Scale of Physician Empathy for Students; PC attitude was assessed with the Patient-Provider Orientation Scale (PPOS). Behavior was assessed by simulations of doctor-patient encounters with 32 students at the end of the third year. Each student participated in three such simulations, during which we analyzed ten aspects of physician-patient communication via Roter interaction analysis system (RIAS)-coded audiotapes. A significant group difference was found for three RIAS categories: building a relationship and patient-centeredness, where the mean percentage of the experimental group was significantly higher than that of the control group, and gathering data, where the mean percentage of the experimental group was significantly lower than that of the control group. A significant correlation was found in the experimental group between empathy and positive talk and between PPOS and three of the RIAS categories: gathering data, psychosocial talk, and patient-centeredness. A significant negative correlation was found in the experimental group between PPOS and two of the RIAS categories: negative talk and doctor-centeredness. Two significant negative correlations were found in the control group: between empathy and patient-centeredness and PPOS and negative talk. The LC approach supports two of the RIAS categories, corresponding to clinical empathy and PC care and the link between certain behaviors and the PPOS.

The new heterologous fibrin sealant in combination with low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve.

PubMed

Buchaim, Daniela Vieira; Rodrigues, Antonio de Castro; Buchaim, Rogerio Leone; Barraviera, Benedito; Junior, Rui Seabra Ferreira; Junior, Geraldo Marco Rosa; Bueno, Cleuber Rodrigo de Souza; Roque, Domingos Donizeti; Dias, Daniel Ventura; Dare, Leticia Rossi; Andreo, Jesus Carlos

2016-07-01

This study aimed to evaluate the effects of low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve with two surgical techniques: end-to-end epineural suture and coaptation with heterologous fibrin sealant. Forty-two male Wistar rats were randomly divided into five groups: control group (CG) in which the buccal branch of the facial nerve was collected without injury; (2) experimental group with suture (EGS) and experimental group with fibrin (EGF): The buccal branch of the facial nerve was transected on both sides of the face. End-to-end suture was performed on the right side and fibrin sealant on the left side; (3) Experimental group with suture and laser (EGSL) and experimental group with fibrin and laser (EGFL). All animals underwent the same surgical procedures in the EGS and EGF groups, in combination with the application of LLLT (wavelength of 830 nm, 30 mW optical power output of potency, and energy density of 6 J/cm(2)). The animals of the five groups were euthanized at 5 weeks post-surgery and 10 weeks post-surgery. Axonal sprouting was observed in the distal stump of the facial nerve in all experimental groups. The observed morphology was similar to the fibers of the control group, with a predominance of myelinated fibers. In the final period of the experiment, the EGSL presented the closest results to the CG, in all variables measured, except in the axon area. Both surgical techniques analyzed were effective in the treatment of peripheral nerve injuries, where the use of fibrin sealant allowed the manipulation of the nerve stumps without trauma. LLLT exhibited satisfactory results on facial nerve regeneration, being therefore a useful technique to stimulate axonal regeneration process.

The effect of integrating constructivist and evidence-based practice on baccalaureate nursing student's cognitive load and learning performance in a research course.

PubMed

Hsieh, Suh-Ing; Hsu, Li-Ling; Huang, Tzu-Hsin

2016-07-01

Baccalaureate nursing students perceive research as unattractive, doubt the value of nursing research, and do not appreciate the link of research with practice. No studies have examined students' cognitive load during an evidence-based practice research course versus a traditional research course. To assess the effect of integrating constructivist theories and evidence-based practice on student cognitive load and learning performance in a research course. A true experimental study. A Registered Nurse-to-Bachelor of Science in Nursing program. Six classes of second-year students. Students were randomly allocated to the control group (two classes) or the experimental group (two classes) using cluster randomization. The control group underwent "traditional research"; the experimental group experienced "integrating evidence-based practice into research." Instruments for outcome assessment include the Cognitive Load Scale, cognitive test, team critique paper, and qualitative feedback on course satisfaction. The between-subjects effects were compared by Analysis of Covariance. The experimental group had significantly higher mental load (8.74 vs. 7.27, p<.001), mental effort (11.07 vs. 10.07, p=.009), mental efficiency (0.33 vs. -0.31, p<.001), and research knowledge (70.61 vs. 44.92, p<.001) than the control group. The experimental group had better critique paper scores in introduction (92.80%), literature review (91.70%), and assignment requirement and writing (89.40%). Some experimental learners expressed satisfaction with learning evidence-based practice (17.78%) and critiquing a research article (7.78%). Integrating evidence-based practice into a research course not only improved the research knowledge of baccalaureate nursing students, but also increased their mental load, mental effort, and mental efficiency. Additional studies may track learners' responses to different learning systems using the developed instrument to measure the three types of cognitive load. These findings may help educators design more effective and interesting curricula for integrating research and evidence-based practice into the studies of student nurses. Copyright © 2016. Published by Elsevier Ltd.

Effect of N-Acetylserotonin on Intestinal Recovery Following Intestinal Ischemia-Reperfusion Injury in a Rat.

PubMed

Ben Shahar, Yoav; Sukhotnik, Igor; Bitterman, Nir; Pollak, Yulia; Bejar, Jacob; Chepurov, Dmitriy; Coran, Arnold; Bitterman, Arie

2016-02-01

N-acetylserotonin (NAS) is a naturally occurring chemical intermediate in the biosynthesis of melatonin. Extensive studies in various experimental models have established that treatment with NAS significantly protects heart and kidney injury from ischemia-reperfusion (IR). The purpose of the present study was to examine the effect of NAS on intestinal recovery and enterocyte turnover after intestinal IR injury in rats. Male Sprague-Dawley rats were divided into four experimental groups: (1) Sham rats underwent laparotomy, (2) sham-NAS rats underwent laparotomy and were treated with intraperitoneal (IP) NAS (20 mg/kg); (3) IR rats underwent occlusion of both superior mesenteric artery and portal vein for 30 minutes, followed by 48 hours of reperfusion, and (4) IR-NAS rats underwent IR and were treated with IP NAS (20 mg/kg) immediately before abdominal closure. Intestinal structural changes, Park injury score, enterocyte proliferation, and enterocyte apoptosis were determined 24 hours following IR. The expression of Bax, Bcl-2, p-ERK, and caspase-3 in the intestinal mucosa was determined using real-time polymerase chain reaction, Western blot, and immunohistochemistry. A nonparametric Kruskal-Wallis analysis of variance test was used for statistical analysis with p less than 0.05 considered statistically significant. Treatment with NAS resulted in a significant increase in mucosal weight in jejunum and ileum, villus height in the ileum, and crypt depth in jejunum and ileum compared with IR animals. IR-NAS rats also had a significantly proliferation rates as well as a lower apoptotic index in jejunum and ileum which was accompanied by higher Bcl-2 levels compared with IR animals. Treatment with NAS prevents gut mucosal damage and inhibits programmed cell death following intestinal IR in a rat. Georg Thieme Verlag KG Stuttgart · New York.

Electromyography function, disability degree, and pain in leprosy patients undergoing neural mobilization treatment.

PubMed

Véras, Larissa Sales Téles; Vale, Rodrigo Gomes de Souza; Mello, Danielli Braga de; Castro, José Adail Fonseca de; Lima, Vicente; Trott, Alexis; Dantas, Estélio Henrique Martin

2012-02-01

This study aimed to evaluate the effect of the neural mobilization technique on electromyography function, disability degree, and pain in patients with leprosy. A sample of 56 individuals with leprosy was randomized into an experimental group, composed of 29 individuals undergoing treatment with neural mobilization, and a control group of 27 individuals who underwent conventional treatment. In both groups, the lesions in the lower limbs were treated. In the treatment with neural mobilization, the procedure used was mobilization of the lumbosacral roots and sciatic nerve biased to the peroneal nerve that innervates the anterior tibial muscle, which was evaluated in the electromyography. Analysis of the electromyography function showed a significant increase (p<0.05) in the experimental group in both the right (Δ%=22.1, p=0.013) and the left anterior tibial muscles (Δ%=27.7, p=0.009), compared with the control group pre- and post-test. Analysis of the strength both in the movement of horizontal extension (Δ%right=11.7, p=0.003/Δ%left=27.4, p=0.002) and in the movement of back flexion (Δ%right=31.1; p=0.000/Δ%left=34.7, p=0.000) showed a significant increase (p<0.05) in both the right and the left segments when comparing the experimental group pre- and post-test. The experimental group showed a significant reduction (p=0.000) in pain perception and disability degree when the pre- and post-test were compared and when compared with the control group in the post-test. Leprosy patients undergoing the technique of neural mobilization had an improvement in electromyography function and muscle strength, reducing disability degree and pain.

Hydrotherapy for the treatment of pain in people with multiple sclerosis: a randomized controlled trial.

PubMed

Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo A; Lara-Palomo, Inmaculada; Saavedra-Hernández, Manuel; Arroyo-Morales, Manuel; Moreno-Lorenzo, Carmen

2012-01-01

Background. Multiple sclerosis (MS) is a chronic demyelinating neurological disease. Several studies have reported that complementary and alternative therapies can have positive effects against pain in these patients. Objective. The objective was to investigate the effectiveness of an Ai-Chi aquatic exercise program against pain and other symptoms in MS patients. Methods. In this randomized controlled trial, 73 MS patients were randomly assigned to an experimental or control group for a 20-week treatment program. The experimental group underwent 40 sessions of Ai-Chi exercise in swimming pool and the control group 40 sessions of abdominal breathing and contraction-relaxation exercises in therapy room. Outcome variables were pain, disability, spasm, depression, fatigue, and autonomy, which were assessed before the intervention and immediately and at 4 and 10 weeks after the last treatment session. Results. The experimental group showed a significant (P < 0.028) and clinically relevant decrease in pain intensity versus baseline, with an immediate posttreatment reduction in median visual analogue scale scores of 50% that was maintained for up to 10 weeks. Significant improvements were also observed in spasm, fatigue, disability, and autonomy. Conclusion. According to these findings, an Ai-Chi aquatic exercise program improves pain, spasms, disability, fatigue, depression, and autonomy in MS patients.

Hydrotherapy for the Treatment of Pain in People with Multiple Sclerosis: A Randomized Controlled Trial

PubMed Central

Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo A.; Lara-Palomo, Inmaculada; Saavedra-Hernández, Manuel; Arroyo-Morales, Manuel; Moreno-Lorenzo, Carmen

2012-01-01

Background. Multiple sclerosis (MS) is a chronic demyelinating neurological disease. Several studies have reported that complementary and alternative therapies can have positive effects against pain in these patients. Objective. The objective was to investigate the effectiveness of an Ai-Chi aquatic exercise program against pain and other symptoms in MS patients. Methods. In this randomized controlled trial, 73 MS patients were randomly assigned to an experimental or control group for a 20-week treatment program. The experimental group underwent 40 sessions of Ai-Chi exercise in swimming pool and the control group 40 sessions of abdominal breathing and contraction-relaxation exercises in therapy room. Outcome variables were pain, disability, spasm, depression, fatigue, and autonomy, which were assessed before the intervention and immediately and at 4 and 10 weeks after the last treatment session. Results. The experimental group showed a significant (P < 0.028) and clinically relevant decrease in pain intensity versus baseline, with an immediate posttreatment reduction in median visual analogue scale scores of 50% that was maintained for up to 10 weeks. Significant improvements were also observed in spasm, fatigue, disability, and autonomy. Conclusion. According to these findings, an Ai-Chi aquatic exercise program improves pain, spasms, disability, fatigue, depression, and autonomy in MS patients. PMID:21785645

Day surgery and recovery in women with a suspicious breast lesion: evaluation of a psychoeducational nursing intervention.

PubMed

Allard, Nicole

2006-01-01

The study assessed whether a nursing intervention based on self-regulation theory, the Attentional Focus and Symptom Management Intervention (AFSMI), could help women who underwent day surgery for breast cancer to achieve better pain management and decreased emotional distress. The sample consisted of 117 patients with breast cancer who were outpatients and undergoing surgery as part of the initial treatment for their cancer. All subjects were interviewed at three different occasions. The subjects were randomized into the experimental group (n = 61) or the usual care group (control, n = 56). The subjects in the experimental group received the intervention in two sessions, 3-4 days and 10-11 days after surgery. The outcomes were the subjects' pain and emotional distress. Results showed significant differences between the experimental and control group at post-test on home management, total mood disturbance, confusion and tension scores implying that the intervention was effective in achieving these outcomes. Clinical significance has illustrated that a nursing intervention applied during immediate recovery of breast cancer surgery is quite clinically relevant to reduce emotional distress. Self-regulation theory could effectively be used as a guide in developing nursing intervention programs in practice for patients with cancer undergoing day surgery as a primary treatment.

Student-centered tutoring as a model for patient-centeredness and empathy

PubMed Central

Meirovich, Adaya; Ber, Rosalie; Moore, Michael; Rotschild, Avi

2016-01-01

Background Curriculum planners and medical teachers attempt to enhance medical students’ empathy and patient-centeredness. Despite educational efforts, there is stability in medical students’ empathy and patient-centered medicine during the preclinical stage and a decline in both of them throughout the clinical years. Student–tutor relationship plays a key role in students’ learning. This study tests the effect of learner-centered tutoring on students’ empathy, patient-centeredness, and behavior. Participants and methods The cohort of 55 students was divided into groups of seven or eight. The experimental group’s tutors underwent LC mentoring. Empathy was assessed with the Jefferson Scale of Physician Empathy for Students; PC attitude was assessed with the Patient–Provider Orientation Scale (PPOS). Behavior was assessed by simulations of doctor–patient encounters with 32 students at the end of the third year. Each student participated in three such simulations, during which we analyzed ten aspects of physician–patient communication via Roter interaction analysis system (RIAS)-coded audiotapes. Results A significant group difference was found for three RIAS categories: building a relationship and patient-centeredness, where the mean percentage of the experimental group was significantly higher than that of the control group, and gathering data, where the mean percentage of the experimental group was significantly lower than that of the control group. A significant correlation was found in the experimental group between empathy and positive talk and between PPOS and three of the RIAS categories: gathering data, psychosocial talk, and patient-centeredness. A significant negative correlation was found in the experimental group between PPOS and two of the RIAS categories: negative talk and doctor–centeredness. Two significant negative correlations were found in the control group: between empathy and patient-centeredness and PPOS and negative talk. Conclusion The LC approach supports two of the RIAS categories, corresponding to clinical empathy and PC care and the link between certain behaviors and the PPOS. PMID:27555803

Isokinetic Testing in Evaluation Rehabilitation Outcome After ACL Reconstruction.

PubMed

Cvjetkovic, Dragana Dragicevic; Bijeljac, Sinisa; Palija, Stanislav; Talic, Goran; Radulovic, Tatjana Nozica; Kosanovic, Milkica Glogovac; Manojlovic, Slavko

2015-02-01

Numerous rehab protocols have been used in rehabilitation after ACL reconstruction. Isokinetic testing is an objective way to evaluate dynamic stability of the knee joint that estimates the quality of rehabilitation outcome after ACL reconstruction. Our investigation goal was to show importance of isokinetic testing in evaluation thigh muscle strength in patients which underwent ACL reconstruction and rehabilitation protocol. In prospective study, we evaluated 40 subjects which were divided into two groups. Experimental group consisted of 20 recreational males which underwent ACL reconstruction with hamstring tendon and rehabilitation protocol 6 months before isokinetic testing. Control group (20 subjects) consisted of healthy recreational males. In all subjects knee muscle testing was performed on a Biodex System 4 Pro isokinetic dynamo-meter et velocities of 60°/s and 180°/s. We followed average peak torque to body weight (PT/BW) and classic H/Q ratio. In statistical analysis Student's T test was used. There were statistically significant differences between groups in all evaluated parameters except of the mean value of PT/BW of the quadriceps et velocity of 60°/s (p>0.05). Isokinetic testing of dynamic stabilizers of the knee is need in diagnostic and treatment thigh muscle imbalance. We believe that isokinetic testing is an objective parameter for return to sport activities after ACL reconstruction.

Bioactive glass in cavitary bone defects: a comparative experimental study in rabbits

PubMed Central

Camargo, André Ferrari de França; Baptista, André Mathias; Natalino, Renato; de Camargo, Olavo Pires

2015-01-01

OBJECTIVES: To compare bioactive glass and autograft regarding their histomorphometric characteristics. METHODS: The authors conducted a prospective case-control experimental study on animals in order to compare the histomorphometric characteristics of bioactive glass versus autograft. Eight rabbits underwent surgery in which a cavitary defect was created in both proximal femurs. One side was filled with bioactive glass granules and the other, with autograft grafted from the contralateral side. The sides were randomized. Fourteen days after surgery, the animals were euthanized. RESULTS: Histologic analysis revealed that bone neoformation was equivalent among the two groups and the osteoblasts cell-count was higher in the femurs treated with bioactive glass. The osteocytes cell-count, however, was lower. The similarity in bone formation between both groups was consistent to literature findings. CONCLUSION: Bioactive glass is similar to autograft regarding bone neoformation in this animal model of cavitary bone defects. Level of Evidence III, Case-Control Study. PMID:26327802

Effectiveness of Resilience Training on Ego-control and Hardiness of Illicit Drug Users

PubMed Central

Roustaei, Amin; Bakhshipoor, Babollah; Doostian, Younes; Goodiny, Ali Akbar; Koohikar, Mansoureh; Massah, Omid

2017-01-01

Background The aim of this research was to determine the effectiveness of resilience training upon ego-control and hardiness of the addicted persons. Methods This was a semi-experimental study with pretest and posttest control groups which was conducted in Sari, Iran, during 2014-2015. Thirty persons were selected among 240 illicit drug users who underwent screening. Resilience training was performed in ten sessions for the experimental group. The Kobasa hardiness questionnaire and self-restraint scale (SRS) were used for data collection and multivariate covariance test was performed for data analysis. Findings According to the data, ego-control and hardiness of participants were improved significantly by resilience training (P < 0.001). Conclusion Resilience training is effective upon the rate of ego-control and self-restraint and hardiness. This method can be used in addiction treatment clinics and residential centers. PMID:29026500

Oxidative Damage and Mitochondrial Injuries Are Induced by Various Irrigation Pressures in Rabbit Models of Mild and Severe Hydronephrosis

PubMed Central

Cao, Zhixiu; Yu, Weimin; Li, Wei; Cheng, Fan; Rao, Ting; Yao, Xiaobing; Zhang, Xiaobin; Larré, Stéphane

2015-01-01

Objective We aimed to study whether tolerance to irrigation pressure could be modified by evaluating the oxidative damage of obstructed kidneys based on rabbit models experiencing different degrees of hydronephrosis. Methods A total of 66 rabbits were randomly divided into two experimental groups and a control group. In the experimental groups, the rabbits underwent a surgical procedure inducing mild (group M, n=24) or severe (group S, n=24) hydronephrosis. In each experimental group, the rabbits were then randomly divided into 4 subgroups (M0-M3 and S0-S3) consisting of 6 rabbits each. Group 0 received no perfusion. Groups 1 through 3 were perfused with 20, 60 and 100 mmHg fluid, respectively. For the control group, after a sham operation was performed, the rabbits were divided into 4 subgroups and were perfused with fluid at 0, 20, 60 or 100 mmHg of pressure. Kidney injuries was evaluated by neutrophil gelatinase associated lipocalin (NGAL). Oxidative damage was assessed by analyzing superoxide dismutase (Mn-SOD) activity, malondialdehyde (MDA) levels, glutathione reductase (GR), catalase (CAT) and peroxide (H2O2) levels, mitochondrial injuries was assessed by mitochondrial membrane potential (MMP), the mitochondrial ultrastructure and tubular cell apoptosis. Results In the experimental groups, all results were similar for groups 0 and 1. In group 2, abnormalities were observed in the S group only, and the kidneys of rabbits in group 3 suffered oxidative damage and mitochondrial injuries with increased NGAL, decreased Mn-SOD, GR and CAT,increased MDA and H2O2, lower levels of MMP, mitochondrial vacuolization and an increased apoptotic index. Conclusion In rabbits, severely obstructed kidneys were more susceptible to oxidative damage and mitochondrial injury than mildly obstructed kidneys when subjected to higher degrees of kidney perfusion pressure. PMID:26090815

Effects of tacrolimus and erythropoietin in experimental spinal cord lesion in rats: functional and histological evaluation

PubMed Central

de Mesquita Coutinho, P R; Cristante, A F; de Barros Filho, T E P; Ferreira, R; dos Santos, G B

2016-01-01

Study design: Experimental study with rats. Objective: To evaluate functional and histological effects of tacrolimus (FK 506) and erythropoietin (EPO) after experimental spinal cord contusion injury (SCI). Setting: Brazil. Methods: Wistar rats (n=60) were submitted to SCI with the NYU Impactor system. The control group received saline; the EPO group received EPO; the group EPO+FK 506 received EPO associated with tacrolimus and the group FK 506 received tacrolimus only. The Sham group underwent SCI, but did not receive any drug. Locomotor function was evaluated after SCI by BBB (Basso, Beattie and Bresnahan) weekly and by the motor-evoked potential test in 42 days. The spinal cord was histologically evaluated. Results: There was a significant difference between treated and the control groups from the seventh day on for BBB scores, with no difference between the groups EPO and EPO+FK 506 by the end of the study. There were significant differences between groups for necrosis and bleeding, but not for hiperemia, degeneration and cellular infiltrate. Axon neuron count was different between all groups (P=0.001), between EPO+FK 506 and FK 506 (P=0.011) and between EPO+FK 506 and Sham (P=0.002). Amplitude was significantly different between all groups except between control and sham. For latency, there was no difference. Conclusions: This study did not reveal significant differences in the recovery of locomotor function, or in the histological and electrophysiological analysis in animals treated with EPO and tacrolimus after thoracic SCI. PMID:26481712

Training strategy of explosive strength in young female volleyball players.

PubMed

Pereira, Ana; Costa, Aldo M; Santos, Patricia; Figueiredo, Teresa; João, Paulo Vicente

2015-01-01

The aim of this study was to examine the effect of an 8-week combined jump and ball throwing training program in the performance of upper and lower extremities among young female volleyball players of the high school. A total of 20 young female volleyball players playing at Scholar Sport in High School at the district level were divided in two groups: the experimental group (n=10; 14.0±0.0 years; 1.6±0.1 m; 52.0±7.0 kg and 20.7±2.4% body mass) and the control group (n=10; 13.8±0.4 years, 1.6±0.1 m; 53.5±4.7 kg and 20.3±1.7% body mass). The experimental group received additional plyometric and ball throwing exercises besides their normal volleyball practice. The control group underwent only their regular session of training. Strength performance in the experimental group significantly improved (medicine ball and volleyball ball throwing: P=0.00; and counter movement jump: P=0.05), with the improvement ranging from 5.3% to 20.1%. No significant changes in strength performance were observed in the control group (P>0.05). The 8-week combined jump and ball throwing training can significantly improve muscular performance in young female volleyball players. These findings may be useful for all physical education teachers and volleyball coaches. Copyright © 2015 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Aerobic Physical Exercise Improved the Cognitive Function of Elderly Males but Did Not Modify Their Blood Homocysteine Levels

PubMed Central

Antunes, Hanna Karen M.; De Mello, Marco Túlio; de Aquino Lemos, Valdir; Santos-Galduróz, Ruth Ferreira; Camargo Galdieri, Luciano; Amodeo Bueno, Orlando Francisco; Tufik, Sergio; D'Almeida, Vânia

2015-01-01

Background Physical exercise influences homocysteine (Hcy) concentrations, cognitive function and the metabolic profile. The purpose of this study was to investigate the influence of regular physical exercise on Hcy levels, the metabolic profile and cognitive function in healthy elderly males before and after an endurance exercise program. Methods Forty-five healthy and sedentary volunteers were randomized into 2 groups: (1) a control group asked not to change their normal everyday activities and not to start any regular physical exercise program and (2) an experimental group trained at a heart rate intensity corresponding to ventilatory threshold 1 (VT-1) for 60 min/day 3 times weekly on alternate days for 6 months using a cycle ergometer. All volunteers underwent cognitive evaluations, blood sample analyses and ergospirometric assessments. Results A significant improvement in cognitive function was observed in the experimental group compared with the control group (p < 0.05). No significant changes in Hcy levels were observed in the experimental group (p > 0.05), but there was a significant increase in peak oxygen consumption and workload at VT-1 as well as a significant improvement in cholesterol, triglycerides, HDL, glucose, alkaline phosphatase, urea, T3, T4 and prostate-specific antigen compared with the control group (p < 0.05). Conclusion The data suggest that a physical exercise program does not reduce Hcy levels in healthy elderly males, although it improves the cardiovascular and metabolic profile as well as cognitive function. PMID:25759715

Natural history of experimental intestinal atresia: morphologic and ultrastructural study.

PubMed

Baglaj, S M; Czernik, J; Kuryszko, J; Kuropka, P

2001-09-01

The aim of this study was to evaluate a natural history of congenital intestinal atresia (IA) in the chick embryo and to assess the type and nature of changes in the intestine at various developmental stages. Chick embryos underwent operative induction of IA on the 12th day of incubation. The procedure consisted of electrocoagulation of the mesenteric vessels supplying a 7- to 8-mm intestinal segment. The embryos were subjected to macroscopic examination, histologic and ultrastructural studies of the preatretic and postatretic bowel using the light microscope, scanning, and transmission electron microscopes. All investigations were performed in an experimental group (operated embryos), in a control group, and in a sham-operated group on the 15th, 17th, 19th, and 21st day of incubation. The original technique of an iatrogenic "vascular event" proved to be effective because IA developed in 96% of embryos surviving the procedure. The affected portion of the bowel underwent progressive necrosis, and signs of bowel obstruction could be observed 48 hours after operation. Cord atresia (type II) developed in 81% of embryos. Histologic investigations showed progressive thinning of mucosa, flattening of mucosal folds, and epithelial detachment within the intestine proximal to atresia. There was only mild hypertrophy of the muscular layers. All these pathomorphologic changes were of rapidly progressive nature until the 17th day of incubation. Later, the rate of distension of preatretic bowel and histologic changes were less. Ultrastructural investigation of the proximal bowel showed progressive flattening of the enterocytes associated with their apical bulging, widening of the intercellular spaces, and microvilli atrophy. Surprisingly, at days 19 and 21 of incubation, signs of induction of adaptive mechanisms with partial restoration of near-normal microvilli pattern were observed. Study of natural history of experimental IA indicates that histologic and ultrastructural lesions of the bowel are of dynamic nature and are not only the effect of pathologic intraluminal pressure. Copyright 2001 by W.B. Saunders Company.

Evaluation of the effects of pulsed wave LLLT on tibial diaphysis in two rat models of experimental osteoporosis, as examined by stereological and real-time PCR gene expression analyses.

PubMed

Mohsenifar, Zhaleh; Fridoni, Mohammadjavad; Ghatrehsamani, Mahdi; Abdollahifar, Mohammad-amin; Abbaszadeh, Hojjatallah; Mostafavinia, Atarodalsadat; Fallahnezhad, Somaye; Asghari, Mohammadali; Bayat, Saba; Bayat, Mohammad

2016-05-01

Osteoporosis (OP) and osteoporotic fracture are major public health issues for society; the burden for the affected individual is also high. Previous studies have shown that pulsed wave low-level laser therapy (PW LLLT) has osteogenic effects. This study intended to evaluate the impacts of PW LLLT on the cortical bone of osteoporotic rats' tibias in two experimental models, ovariectomized and dexamethasone-treated. We divided the rats into four ovariectomized induced OP (OVX-d) and four dexamethasone-treated (glucocorticoid-induced OP, GIOP) groups. A healthy (H) group of rats was considered for baseline evaluations. At 14 weeks following ovariectomy, we subdivided the OVX-d rats into the following groups: (i) control which had OP, (ii) OVX-d rats treated with alendronate (1 mg/kg), (iii) OVX-d rats treated with LLLT, and (iv) OVX-d rats treated with alendronate and PW LLLT. The remaining rats received dexamethasone over a 5-week period and were also subdivided into four groups: (i) control rats treated with intramuscular (i.m.) injections of distilled water (vehicle), (ii) rats treated with subcutaneous alendronate injections (1 mg/kg), (iii) laser-treated rats, and (iv) rats simultaneously treated with laser and alendronate. The rats received alendronate for 30 days and underwent PW LLLT (890 nm, 80 Hz, 0.972 J/cm(2)) three times per week during 8 weeks. Then, the right tibias were extracted and underwent a stereological analysis of histological parameters and real-time polymerase chain reaction (RT-PCR). A significant increase in cortical bone volume (mm(3)) existed in all study groups compared to the healthy rats. There were significant decreases in trabecular bone volume (mm(3)) in all study groups compared to the group of healthy rats. The control rats with OP and rats from the vehicle group showed significantly increased osteoclast numbers compared to most other groups. Alendronate significantly decreased osteoclast numbers in osteoporotic rats. Concurrent treatments (compounded by PW LLLT and alendronate) produce the same effect on osteoporotic bone.

No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle.

PubMed

Kim, Sung R; Chae, Hyun S; Yoon, Mi J; Han, Jung H; Cho, Kwang J; Chung, Sun J

2012-01-30

Supine recumbence has been widely performed to prevent post-lumbar puncture headache (PLPH). However, the optimal duration of supine recumbence is controversial. The aim of the study is to compare the occurrence of PLPH according to the duration of supine recumbence in patients with neurological disorders. A non-equivalent control/experimental pre-/post-test study design was used. Seventy consecutive patients were prospectively enrolled between July 2007 and July 2008. Thirty-five patients underwent supine recumbence for four hours after lumbar puncture (Group 1) and 35 patients underwent supine recumbence for one hour (Group 2). The overall frequency of PLPH was 31.4%. The frequency of PLPH was not significantly different between the Group 1 (28.6%) and Group 2 (34.3%) (P = 0.607). In patients with PLPH, the median severity (P = 0.203) and median onset time of PLPH (P = 0.582) were not significantly different between the two groups. In a logistic regression analysis, the previous history of post-lumbar puncture headache was a significant risk factor for the occurrence of PLPH (OR = 11.250, 95% CI: 1.10-114.369, P = 0.041). Our study suggests that short duration (one hour) of supine recumbence may be as efficient as long duration (four hours) of supine recumbence to prevent PLPH.

No effect of recumbency duration on the occurrence of post-lumbar puncture headache with a 22G cutting needle

PubMed Central

2012-01-01

Background Supine recumbence has been widely performed to prevent post-lumbar puncture headache (PLPH). However, the optimal duration of supine recumbence is controversial. The aim of the study is to compare the occurrence of PLPH according to the duration of supine recumbence in patients with neurological disorders. Methods A non-equivalent control/experimental pre-/post-test study design was used. Seventy consecutive patients were prospectively enrolled between July 2007 and July 2008. Thirty-five patients underwent supine recumbence for four hours after lumbar puncture (Group 1) and 35 patients underwent supine recumbence for one hour (Group 2). Results The overall frequency of PLPH was 31.4%. The frequency of PLPH was not significantly different between the Group 1 (28.6%) and Group 2 (34.3%) (P = 0.607). In patients with PLPH, the median severity (P = 0.203) and median onset time of PLPH (P = 0.582) were not significantly different between the two groups. In a logistic regression analysis, the previous history of post-lumbar puncture headache was a significant risk factor for the occurrence of PLPH (OR = 11.250, 95% CI: 1.10-114.369, P = 0.041). Conclusions Our study suggests that short duration (one hour) of supine recumbence may be as efficient as long duration (four hours) of supine recumbence to prevent PLPH. PMID:22289169

Early in situ changes in chondrocyte biomechanical responses due to a partial meniscectomy in the lateral compartment of the mature rabbit knee joint.

PubMed

Fick, J M; P Ronkainen, A; Madden, R; Sawatsky, A; Tiitu, V; Herzog, W; Korhonen, R K

2016-12-08

We determined the biomechanical responses of chondrocytes to indentation at specific locations within the superficial zone of cartilage (i.e. patellar, femoral groove, femoral condylar and tibial plateau sites) taken from female New Zealand white rabbits three days after a partial meniscectomy in the lateral compartment of a knee joint. Confocal laser scanning microscopy combined with a custom indentation system was utilized to image chondrocyte responses at sites taken from ten contralateral and experimental knee joints. Cell volume, height, width and depth changes, global, local axial and transverse strains and Young׳s moduli were determined. Histological assessment was performed and proteoglycan content from the superficial zone of each site was determined. Relative to contralateral group cells, patellar, femoral groove and lateral femoral condyle cells in the experimental group underwent greater volume decreases (p < 0.05), due to smaller lateral expansions (with greater decreases in cell height only for the lateral femoral condyle cells; p < 0.05) whereas medial femoral and medial tibial plateau cells underwent smaller volume decreases (p < 0.05), due to less deformation in cell height (p < 0.05). Proteoglycan content was reduced in the patellar (p > 0.05), femoral groove, medial femoral condyle and medial tibial plateau experimental sites (p < 0.05). The findings suggest: (i) cell biomechanical responses to cartilage loading in the rabbit knee joint can become altered as early as 3 days after a partial meniscectomy, (ii) are site-specific, and (iii) occur before alterations in tissue mechanics or changes detectable with histology. Copyright © 2016 Elsevier Ltd. All rights reserved.

Antifungal activity of caspofungin in experimental infective endocarditis caused by Candida albicans.

PubMed

Victorio, Gerardo Becerra; Bourdon, Lorena Michele Brennan; Benavides, Leonel García; Huerta-Olvera, Selene G; Plascencia, Arturo; Villanueva, José; Martinez-Lopez, Erika; Hernández-Cañaveral, Iván Isidro

2017-05-01

Infective endocarditis is a disease characterised by heart valve lesions, which exhibit extracellular matrix proteins that act as a physical barrier to prevent the passage of antimicrobial agents. The genus Candida has acquired clinical importance given that it is increasingly being isolated from cases of nosocomial infections. To evaluate the activity of caspofungin compared to that of liposomal amphotericin B against Candida albicans in experimental infective endocarditis. Wistar rats underwent surgical intervention and infection with strains of C. albicans to develop infective endocarditis. Three groups were formed: the first group was treated with caspofungin, the second with liposomal amphotericin B, and the third received a placebo. In vitro sensitivity was first determined to further evaluate the effect of these treatments on a rat experimental model of endocarditis by semiquantitative culture of fibrinous vegetations and histological analysis. Our semiquantitative culture of growing vegetation showed massive C. albicans colonisation in rats without treatment, whereas rats treated with caspofungin showed significantly reduced colonisation, which was similar to the results obtained with liposomal amphotericin B. The antifungal activity of caspofungin is similar to that of liposomal amphotericin B in an experimental model of infective endocarditis caused by C. albicans.

[CARDIOREABILITATION PECULIARITIES AND CORRECTION OF VIOLATIONS OF SISTOLIC, DIASOLIC FUNCTION AND HEART RATE VARIABILITY IN PATIENTS WITH ACUTE CORONARY SYNDROME AND CORONARY ARTERY REVASCULARIZATION].

PubMed

Shved, M; Tsuglevych, L; Kyrychok, I; Levytska, L; Boiko, T; Kitsak, Ya

2017-04-01

In patients with acute coronary syndrome (ACS) who underwent coronary arteries revascularization, violations of hemodynamics, metabolism and heart rate variability often develop in the postoperative period, therefore, the goal of the study was to establish the features of disturbances and the effectiveness of correction of left ventricular systolic and diastolic dysfunction and heart rate variability in stages of cardiorehabilitation in patients with acute coronary syndrome who underwent coronary arteries revascularization. The experimental group included 40 patients with ACS in the postoperative period who underwent balloon angioplasty and stenting of the coronary arteries (25 patients with ST-segment elevation ACS and 15 patients without ST-segment elevation ACS). The age of examined patients was 37 to 74 years, an average of 52.6±6.7 years. The control group consisted of 20 patients, comparable in age and clinico-laboratory manifestations of ACS, who underwent drug treatment with direct anticoagulants, double antiplatelet therapy, β-blockers, ACE inhibitors and statins. Clinical efficacy of cardiorespiratory process in patients of both groups was assessed by the dynamics of general clinical symptoms and parameters of natriuretic propeptide, systolic and diastolic function of the left ventricle and heart rate variability. In the initial state, clinical and laboratory-instrumental signs of myocardial ischemia disappear in patients with ACS undergoing surgical revascularization of the coronary arteries, but clinical and subclinical manifestations of heart failure were diagnosed. The use of the accelerated program of cardiac rehabilitation already during the first month of studies leads to a decreasement of the signs of systolic and diastolic dysfunction, the level of NT-proBNP and improve in the variability of the heart rhythm wich significantly improves the life quality of patients with ACS. To monitor the effectiveness and safety of cardiac rehabilitation in patients with ACS who underwent coronary arteries revascularization, in addition to the generally accepted methods (determination of heart rate, blood pressure, a 6-minute test), it is advisable to diagnose the subclinical stage of heart failure by determining the level of NT-proBNP, Doppler echocardiogram, parameters of the left ventricular systolic and diastolic function and heart rate variability.

Can FES-Augmented Active Cycling Training Improve Locomotion in Post-Acute Elderly Stroke Patients?

PubMed Central

Peri, Elisabetta; Ambrosini, Emilia; Pedrocchi, Alessandra; Ferrigno, Giancarlo; Nava, Claudia; Longoni, Valentina; Monticone, Marco; Ferrante, Simona

2016-01-01

Recent studies advocated the use of active cycling coupled with functional electrical stimulation to induce neuroplasticity and enhance functional improvements in stroke adult patients. The aim of this work was to evaluate whether the benefits induced by such a treatment are superior to standard physiotherapy. A single-blinded randomized controlled trial has been performed on post-acute elderly stroke patients. Patients underwent FES-augmented cycling training combined with voluntary pedaling or standard physiotherapy. The intervention consisted of fifteen 30-minutes sessions carried out within 3 weeks. Patients were evaluated before and after training, through functional scales, gait analysis and a voluntary pedaling test. Results were compared with an age-matched healthy group. Sixteen patients completed the training. After treatment, a general improvement of all clinical scales was obtained for both groups. Only the mechanical efficiency highlighted a group effect in favor of the experimental group. Although a group effect was not found for any other cycling or gait parameters, the experimental group showed a higher percentage of change with respect to the control group (e.g. the gait velocity was improved of 35.4% and 25.4% respectively, and its variation over time was higher than minimal clinical difference for the experimental group only). This trend suggests that differences in terms of motor recovery between the two groups may be achieved increasing the training dose. In conclusion, this study, although preliminary, showed that FES-augmented active cycling training seems to be effective in improving cycling and walking ability in post-acute elderly stroke patients. A higher sample size is required to confirm results. PMID:27990234

Can FES-Augmented Active Cycling Training Improve Locomotion in Post-Acute Elderly Stroke Patients?

PubMed

Peri, Elisabetta; Ambrosini, Emilia; Pedrocchi, Alessandra; Ferrigno, Giancarlo; Nava, Claudia; Longoni, Valentina; Monticone, Marco; Ferrante, Simona

2016-06-13

Recent studies advocated the use of active cycling coupled with functional electrical stimulation to induce neuroplasticity and enhance functional improvements in stroke adult patients. The aim of this work was to evaluate whether the benefits induced by such a treatment are superior to standard physiotherapy. A single-blinded randomized controlled trial has been performed on post-acute elderly stroke patients. Patients underwent FES-augmented cycling training combined with voluntary pedaling or standard physiotherapy. The intervention consisted of fifteen 30-minutes sessions carried out within 3 weeks. Patients were evaluated before and after training, through functional scales, gait analysis and a voluntary pedaling test. Results were compared with an age-matched healthy group. Sixteen patients completed the training. After treatment, a general improvement of all clinical scales was obtained for both groups. Only the mechanical efficiency highlighted a group effect in favor of the experimental group. Although a group effect was not found for any other cycling or gait parameters, the experimental group showed a higher percentage of change with respect to the control group (e.g. the gait velocity was improved of 35.4% and 25.4% respectively, and its variation over time was higher than minimal clinical difference for the experimental group only). This trend suggests that differences in terms of motor recovery between the two groups may be achieved increasing the training dose. In conclusion, this study, although preliminary, showed that FES-augmented active cycling training seems to be effective in improving cycling and walking ability in post-acute elderly stroke patients. A higher sample size is required to confirm results.

[Evaluation of the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction].

PubMed

Yang, Ying-yang; DU, Sheng-nan; Lv, Zong-kai

2015-08-01

To compare the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction. From May 2011 to May 2014, 83 patients undergoing impacted mandibular third molar extraction were enrolled into the study and randomly divided into 2 groups: 42 patients in group A (experimental group) and 41 patients in group B (control group). Group B underwent extraction with traditional method and group A underwent high-speed handpiece and minimally invasive extraction of the impacted mandibular third molar. The occurrences of the root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture and dislocation of temporomandibular joint during operation and lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation were observed and compared between 2 groups. The operation time, integrity of extraction sockets, VAS pain score and satisfaction from patients were collected and compared. SPSS 19.0 software package was used for statistical analysis. The occurrences of root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture, and dislocation of temporomandibular joint during operation in group A significantly decreased compared with group B (P<0.05). The occurrences of lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation in group A significantly decreased compared with group B (P<0.05). The operation time, integrity of extraction sockets, VAS pain scores and satisfaction scores in group A improved significantly compared with group B (P<0.05). High-speed handpiece and minimally invasive extraction should be widely used in impacted mandibular third molar extraction, due to the advantages of simple operation, high efficiency, minimal trauma, and few perioperative complications.

The "Skull Flap" a new conceived device for decompressive craniectomy experimental study on dogs to evaluate the safety and efficacy in reducing intracranial pressure and subsequent impact on brain perfusion.

PubMed

Salvatore, Chibbaro; Fabrice, Vallee; Marco, Marsella; Leonardo, Tigan; Thomas, Lilin; Benoit, Lecuelle; Bernard, George; Pierre, Kehrli; Eric, Vicaut; Paolo, Diemidio

2013-10-01

Decompressive craniectomy (DC) is a procedure performed increasingly often in current neurosurgical practice. Significant perioperative morbidity may be associated to this procedure because of the large skull defect; also, later closure of the skull defect (cranioplasty) may be associated to post-operative morbidity as much as any other reconstructive operation. The authors present a newly conceived/developed device: The "Skull Flap" (SF). This system, placed at the time of the craniectomy, offers the possibility to provide cranial reconstruction sparing patients a second operation. In other words, DC and cranioplasty essentially take place at the same time and in addition, patients retain their own bone flap. The current study conducted on animal models, represents the logical continuation of a prior recent study, realized on cadaver specimens, to assess the efficacy and safety of this recently developed device. This is an experimental pilot study on dogs to assess both safety and efficacy of the SF device. Two groups of experimental raised intracranial pressure animal models underwent DC; in the first group of dogs, the bone flap was left in raised position above the skull defect using the SF device; on the second group the flap was discarded. All dogs underwent transcranial Doppler (TCD) to assess brain perfusion. Head computed tomography (CT) scan to determine flap position was also obtained in the group in which the SF device was placed. SF has proved to be a strong fixation device that allows satisfactory brain decompression by keeping the bone flap elevated from the swollen brain; later on, the SF allows cranial reconstruction in a simple way without requiring a second staged operation. In addition, it is relevant to note that brain perfusion was measured and found to be better in the group receiving the SF (while the flap being in a raised as well as in its natural position) comparing to the other group. The SF device has proved to be very easy to place, well-adaptable to a different type of flaps and ultimately very effective in maintaining satisfactory brain decompression and later on, making easy bone flap repositioning after brain swelling has subsided.

[The Effects of Smart Program for Patients Who Underwent Percutaneous Coronary Intervention (SP-PCI) on Disease-Related Knowledge, Health Behavior, and Quality of Life: A Non-Randomized Controlled Trial].

PubMed

Lee, Jueun; Lee, Haejung

2017-12-01

To identify the effects of a smart program for the patients who underwent percutaneous coronary intervention (SP-PCI) on coronary disease-related knowledge, health behaviors, and quality of life. A nonequivalent control group with a non-synchronized design was utilized and 48 participants (experimental=22, control=26) were recruited from a university hospital in Gyeongsang area from May to December, 2016. The 12-week SP-PCI consisted of self-study of health information using smart phone applications (1/week), walking exercise (>5/week) using smart band, feedback using Kakao talk (2/week), and telephone counseling (1/week). Patients in the control group received usual care from their primary health care providers and a brief health education with basic self-management brochure after the PCI. Data were analyzed using the SPSS 21.0 program through descriptive statistics, χ² test, and t-test. After the 12-week SP-PCI, the experimental group showed higher levels of coronary disease-related knowledge (t=2.43, p=.019), heart-related health behaviors (t=5.96, p<.001), regular exercise (Z=-4.47, p<.001), and quality of life-MCS (t=3.04, p=.004) and showed lower levels of stress (Z=-3.53, p<.001) and sodium intake (t=-4.43, p<.001) than those in the control group. There were no significant group differences in medication adherence and food intake in total energy, lipids, and cholesterol. The suggested SP-PCI provided easy access and cost-effective intervention for patients after PCI and improved their knowledge of the disease, performance of health behaviors, and quality of life. Further study with a wider population is needed to evaluate the effects of SP-PCI on disease recurrence and quality of life for patients after PCI. © 2017 Korean Society of Nursing Science

[Occurence, etiology and clinical significance of trombocytopenia in pregnancy].

PubMed

Brychtová, P; Procházka, M; Lattová, V; Lubušký, M; Procházková, J; Slavík, L; Úlehlová, J; Simetka, O

2013-12-01

The principal objective of the study is to compare results from the experimental group of pregnant women suffering from thrombocytopenia in pregnancy with results from the control group of pregnant women with normal physiologic blood platelet count. Department of Obstetrics and Gynaecology of the Tomas Bata Regional Hospital Zlín, Obstetrics and Gynaecology Clinic, Haematology and Oncology Clinic of the Palacky University Teaching Hospital and Medical School in Olomouc, Obstetrics and Gynaecology Clinic of the Ostrava Teaching Hospital. A group of 200 pregnant women suffering from thrombocytopenia underwent thorough medical tests. The level of platelets, presence of anti-platelets agents, liver function (LFT), anti-phospholipid antibodies, complete blood count with differential, specific antibodies for hepatitis B and C, Lyme borreliosis and cytomegalovirus were determined from venous blood using the EIA, ELISA methods. Medical articles and books about thrombocytopenia divide the causes for thrombocytopenia as follows: 79.5% benign gestational thrombocytopenia, 16% preeclampsia, 2.5% HELLP syndrome, 1% immune thrombocytopenia, 1% HVC. The number of women who developed physiological anaemia in pregnancy and were overweight is identical in the experimental group of pregnant women suffering from thrombocytopenia and in the control group of pregnant women with normal physiologic blood platelet count, and the proportion of the different age groups in the two groups of pregnant women is also identical. 32% of pregnancies in the experimental group ended in a caesarean section, of which 13.5% in a group of 127 pregnant women suffering from mild thrombocytopenia, 17.5% in a group of 71 pregnant women suffering from moderate thrombocytopenia and 1% in a group of 2 pregnant women suffering from severe thrombocytopenia. 20.5% pregnancies in the control group ended in caesarean section.

Effect of Porcine Chondrocyte-Derived Extracellular Membrane (CDECM) on Postoperative Wound Healing in an Experimental Rabbit Model of Glaucoma Filtration Surgery.

PubMed

Kim, Jung Lim; Lee, Hye Sook; Lee, Yoonjin; Kang, Mi Seon; Lee, Sang Joon; Yang, Jae Wook

2017-06-01

We investigated whether a chondrocyte-derived extracellular membrane (CDECM) could reduce postoperative scar formation in an experimental rabbit model of glaucoma filtration surgery. Thirty-six male New Zealand white rabbits underwent experimental glaucoma filtration surgeries on the right eye and were randomly divided into the following two treatment groups: the CDECM group was treated with subconjunctival injections of 0.1ml CDECM (25 mg/ml; n = 18 eyes), and the operation (OP) group was treated with subconjunctival injections of 0.1 ml balanced salt solution (n = 18 eyes). The left eyes were used as controls (n = 36 eyes). The effects of the CDECM on the experimental rabbit model were investigated using histopathological, immunochemical analyses and Western blotting analyses of the inflammation, fibrosis and angiogenesis. On the 14th postoperative day, the eyes of the CDECM group displayed reduced vascularity and fibrosis compared with the OP group. The vascular endothelial growth factor (VEGF), CD31 and TNFβ immunostaining were also reduced in the CDECM group. The level of TNFα mRNA was increased in the OP group. On the 28th postoperative day, the eyes of the CDECM group also exhibited reduced vascularity and less inflammation and fibrosis than those of the OP group. The expressions of VEGF, CD31, macrophage, TNFβ and NF-κB p65 were also decreased in the CDECM group. The levels of TNFα mRNA significantly differ, and the level of matrix metallopeptidase 9 (MMP9) was increased in the OP group. To determine the specific upstream pathway that was associated with NF-κB activation due to glaucoma filtration surgery, we measured Akt, PKCs and MAPKs signaling. The phosphorylation of p38 MAPK was increased in the OP group, whereas this expression was decreased by CDECM treatment. CDECM seems to suppress angiogenesis, inflammation and fibrosis, which were related to wound healing in the experimental rabbit model of glaucoma filtration surgery. This effect, resulting from the inhibition of NF-κB expression, may be the blocking of the p38 MAPK signaling pathway.

Specific oral tolerance induction with raw hen's egg in children with very severe egg allergy: a randomized controlled trial.

PubMed

Dello Iacono, Iride; Tripodi, Salvatore; Calvani, Mauro; Panetta, Valentina; Verga, Maria Carmela; Miceli Sopo, Stefano

2013-02-01

Treatment of severe egg allergy is avoidance of hen's egg (HE) and carrying self-injectable epinephrine. Specific oral tolerance induction (SOTI) seems a promising alternative treatment. However, some aspects of SOTI are still considered experimental. We evaluated the efficacy and safety of an original 6-month SOTI protocol in children with very severe HE allergy using raw HE emulsion. Twenty children (age range: 5-11 yr) were randomized equally into a SOTI treatment group and a control group. The treatment group started SOTI and underwent a second challenge 6 months later. Control children were kept on an egg-free diet for 6 months and then underwent a second challenge. After 6 months, 9/10 children of the SOTI group (90%) achieved partial tolerance (at least 10 ml, but <40 ml of raw HE emulsion, in a single dose) and 1 (10%) was able to tolerate only 5 ml (no tolerance). After 6 months, nine control children tested positive to the second challenge at a dose ≤0.9 ml of raw HE emulsion, and one reacted to 1.8 ml (SOTI vs. control group p<0.0001). All children in the SOTI group had side effects, but no child had a grade 5 reaction according to the Sampson grading. Six months of SOTI with raw HE emulsion resulted in partial tolerance, with regular intake, in a significant percentage of children with severe egg allergy. © 2012 John Wiley & Sons A/S.

Articular disc and eminence modeling after experimental relocation of the glenoid fossa in growing rabbits.

PubMed

Pirttiniemi, P; Kantomaa, T; Tuominen, M; Salo, L

1994-02-01

The articular surface of the glenoid fossa shows some analogy to the mandibular condyle, since the surface is covered by secondary cartilage, which makes the process more elastic than purely bony structures. The condylar cartilage has been shown to be responsive to alterations in load pressures, and this secondary type of cartilage is also able to increase its proliferative activity to a limited extent when the load pressure is altered. The aim here was to measure changes in proliferative activity and type II collagen secretion in the articular surface of the glenoid fossa after steady experimental posterior relocation of the fossa in the rabbit without actively interfering with normal masticatory action. The shape of the articular disc and interrelations of the joint components were measured macroscopically. Twenty-four five-day-old rabbits underwent gluing of the interparietal, temporoparietal, and lambdoidal sutures. Three experimental and 3 control rabbits were injected with tritiated thymidine at 10, 15, 20, and 30 days and were killed after 2 h for histological, autoradiographic, and immunohistochemical examination. The total number of labeled cells in the proliferative layer near the articular eminence was higher in the experimental group, the difference being greatest in the 15- and 20-day-old rabbits. Immunohistochemical examination revealed less staining for type II collagen on the postero-inferior side of the eminence in the experimental group. The articular disc was flattened in the experimental group, and the elastic tissue bundle connecting the articular eminence and the anterior border of the disc was significantly narrower and longer.

Establishment of a hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol.

PubMed

Wang, Lei; He, Fu-Liang; Liu, Fu-Quan; Yue, Zhen-Dong; Zhao, Hong-Wei

2015-08-28

To determine the feasibility and safety of establishing a porcine hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol. Twenty-one healthy Guizhou miniature pigs were randomly divided into three experimental groups and three control groups. The pigs in the three experimental groups were subjected to hepatic arterial perfusion with 7, 12 and 17 mL of 80% alcohol, respectively, while those in the three control groups underwent hepatic arterial perfusion with 7, 12 and 17 mL of saline, respectively. Hepatic arteriography and direct portal phlebography were performed on all animals before and after perfusion, and the portal venous pressure and diameter were measured before perfusion, immediately after perfusion, and at 2, 4 and 6 wk after perfusion. The following procedures were performed at different time points: routine blood sampling, blood biochemistry, blood coagulation and blood ammonia tests before surgery, and at 2, 4 and 6 wk after surgery; hepatic biopsy before surgery, within 6 h after surgery, and at 1, 2, 3, 4 and 5 wk after surgery; abdominal enhanced computed tomography examination before surgery and at 6 wk after surgery; autopsy and multi-point sampling of various liver lobes for histological examination at 6 wk after surgery. In experimental group 1, different degrees of hepatic fibrosis were observed, and one pig developed hepatic cirrhosis. In experimental group 2, there were cases of hepatic cirrhosis, different degrees of increased portal venous pressure, and intrahepatic portal venous bypass, but neither extrahepatic portal-systemic bypass circulation nor death occurred. In experimental group 3, two animals died and three animals developed hepatic cirrhosis, and different degrees of increased portal venous pressure and intrahepatic portal venous bypass were also observed, but there was no extrahepatic portal-systemic bypass circulation. It is feasible to establish an animal model of hepatic cirrhosis and portal hypertension by hepatic arterial perfusion with 80% alcohol, however, the safety of this model depends on a suitable perfusion dose.

Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence.

PubMed

Houdayer, Elise; Cursi, Marco; Nuara, Arturo; Zanini, Sonia; Gatti, Roberto; Comi, Giancarlo; Leocani, Letizia

2016-01-01

The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits.

Comparison of the effects of vapocoolant spray and topical anesthetic cream on pain during needle electromyography in the medial gastrocnemius.

PubMed

Moon, Young-Eun; Kim, Sang-Hyun; Choi, Won-Hyeok

2013-05-01

To compare the effects of a vapocoolant spray and an eutectic mixture of local anesthetics (EMLA) cream in reducing pain during needle electromyography examination. Randomized controlled trial. Physical medicine and rehabilitation department of a university hospital. Adults who underwent needle electromyography (N=99) were randomized to 1 of 2 experimental groups or the control group. Two patients dropped out during the study. In the experimental groups, vapocoolant spray or EMLA cream were applied before needle electromyography. In the control group, needle electromyography was performed without pretreatment. Intensity of pain associated with needle electromyography was assessed using a 100-mm visual analog scale (VAS). Patient satisfaction and preference for repeated use were measured using a 5-point Likert scale. VAS score for pain intensity was significantly lower in the spray group (31.9; 95% confidence interval [CI], 22.0-41.7) compared with the control group (52.9; 95% CI, 45.9-60.0; P=.002), whereas there was no significant difference between the EMLA cream group (42.4; 95% CI, 34.2-50.7) and the control group. Patient satisfaction and preference for repeated use were higher in the spray group than the EMLA group. Vapocoolant spray was more effective than EMLA cream in reducing pain during needle electromyography. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Impact of Family Planning Health Education on the Knowledge and Attitude among Yasoujian Women

PubMed Central

Mahamed, Fariba; Parhizkar, Saadat; Shirazi, Alireza Raygan

2012-01-01

The aim of this study was to determine the effect of health education on the knowledge and attitude regarding family planning and contraception’s method among the women who obligatory attended the Premarital Counseling Center in Yasouj city, Iran. An experimental study was carried out and a total of 200 women were selected for the study using convenience sampling method among women who attended in the health centre in order to utilize the necessary premarital actions. Respondents were divided by two experimental and control groups randomly. A pre-evaluation was done on the knowledge and attitude on family planning using a structured questionnaire. After which, the health education for experimental group was done within four educational sessions during 4 consecutive weeks and control group underwent traditional education method. Post evaluation was utilized for any changes regarding their knowledge and attitude among the respondents immediately after the intervention. Independent and paired t-test was used to evaluate the mean knowledge and attitude scores differences among both groups. Results showed that there was a significant improvement in respondents’ knowledge and attitude after educational program in experimental group (p<0.001), while no significant difference was observed in knowledge and attitude of control group. The finding also indicated that age was significantly associated with the level of respondents’ knowledge. These results deal the effectiveness of the educational method. In conclusion, the educational method is effective in increasing the knowledge and improving the attitude of women regarding family planning in Yasouj compared to current used educational method. Future educational programs need to incorporate the features that have been associated with successful interventions in the past, as well as including their own evaluation procedures. PMID:22980158

Cyclophosphamide-induced hemorrhagic cystitis in rats that underwent colocystoplasty: experimental study.

PubMed

Rodó, J; Farré, X; Martín, E

2001-02-01

Cyclophosphamide and its derivatives induce hemorrhagic cystitis. A substantial number of patients receive bladder augmentation or replacements using bowel. If patients who have undergone colocystoplasty need treatment with cyclophosphamide before or after the operation, does hemorrhagic cystitis develop? We evaluated the histological changes produced in the colon wall and bladder related to cyclophosphamide and its derivatives in rats that underwent colocystoplasty. Sprague-Dawley rats of each sex were grouped according to whether they received a single 200 mg./kg. dose of cyclophosphamide, underwent colocystoplasty, underwent each technique or served as controls. The technique of colocystoplasty was the same in all groups. Results were analyzed according to previously reported criteria, by the gross appearance of the bladder and colon segment used for colocystoplasty, and by histological changes. Two weeks after surgery colocystoplasty had not resulted in secondary changes in the implanted colon segment or original bladder, while there were only nonspecific changes of an inflammatory type in the anastomotic area. After cyclophosphamide administration the animals lost considerable weight and in the bladder area we observed hemorrhagic cystitis that was greater in males than in females, and greater in isolated bladder than when the bladder was sutured to the colon segment. In the colon there was no inflammation or hemorrhage damage of the hemorrhagic cystitis type in the bladder. A total of 12 days after colocystoplasty there were no secondary histological changes except in the anastomotic area. A single 200 mg./kg. dose of cyclophosphamide caused substantial weight loss and hemorrhagic cystitis. Cystitis was quantitatively greater in males than in females and greater in isolated bladder than in bladder anastomosed to the colon. Administering a single dose of cyclophosphamide did not result in lesions in the colon segment used for colocystoplasty analogous to those of the bladder, such as hemorrhagic cystitis.

Irrigation of Abdomen With Imipenem Solution Decreases Surgical Site Infections in Patients With Perforated Appendicitis: A Randomized Clinical Trial

PubMed Central

Hesami, Mohammad Ali; Alipour, Hamid; Nikoupour Daylami, Hamed; Alipour, Bijan; Bazargan-Hejazi, Shahrzad; Ahmadi, Alireza

2014-01-01

Background: Perforated appendicitis is one of the most common causes of acute abdomen requiring emergent surgery for immediate appendectomy and peritoneal cavity irrigation; however, the efficacy of irrigation with antibiotic solutions is controversial. Objectives: The aim of this study was to assess the efficacy of imipenem solution irrigation on post-operative surgical site infections (SSIs), hospital length of stay, and hospital costs. We hypothesized that there would be lower rate of SSIs, a shorter hospital stay, and lower hospital cost in patients with perforated appendicitis who received peritoneal cavity irrigation with imipenem solution in comparison to their counterparts who received irrigation with normal saline. Patients and Methods: In this randomized single-blind parallel-group clinical trial, we enrolled 90 patients with perforated appendicitis with 12-50 years of age and randomly allocated them into experimental group (n = 45) and control group (n = 45). The control group received peritoneal irrigation with normal saline (0.9%) and experimental group underwent peritoneal irrigation with imipenem solution (1 mg/mL). All surgical procedures were performed in Imam Reza Hospital of Kermanshah University of Medical Sciences. The study primary outcome was surgical site infections (including wound infection and abdominal abscess) and the secondary outcomes were length of hospital stay and hospital cost. Chi-squared and t-tests were used to analyze the study data. Results: Imipenem solution irrigation was associated with significant clinical improvement at one-month follow-up. The experimental group presented with significantly lower rate of SSIs and shorter length of hospital stay. The experimental group had lower rate of SSIs compared to the control group (4.4% vs. 22.2%, respectively) (p= 0.013). The duration of hospital stay was nearly one day longer in control group (5.84 ± 2.58 days) vs. experimental group (4.91 ± 1.29 days) (P = 0.034), and hospital costs were $50 lower in experimental group ($500 ± $292) vs. control group ($450 ± $170) (P = 0.281). Conclusions: The study findings revealed that peritoneal lavage with imipenem solution (1 mg/mL) decreases the rate of post-operative SSIs in patients with perforated appendicitis in comparison to patients irrigated with normal saline alone. These patients also had shorter hospital stay, and lower hospital costs. PMID:24910794

[Establishment of animal model for Pneumocystis carinii and study on etiological and molecular biological detection technology].

PubMed

Tian, Li-guang; Ai, Lin; Chu, Yan-hong; Wu, Xiu-ping; Cai, Yu-chun; Chen, Zhuo; Chen, Shao-hong; Chen, Jia-xu

2015-04-01

To establish an animal model for Pneumocystis pneumonia (PCP) and to study the etiological and molecular biological technology for PCP detection. SD and Wistar rats were divided into experimental and control groups randomly. The animals in the experimental group were immunosuppressed by subcutaneous injection with dexamethasone 2 mg per time per rat, twice a week, while those in the control group underwent the same way of injection with physiological saline simultaneously. After the induction for 8 weeks, all the rats were killed and their bronchoalveolar lavage fluid (BALF) and lung tissues were collected for smear making and microscopic detection. Meanwhile, the BALF samples were detected by PCR, and the products were sequenced and compared with rat source PCP in GenBank. A total of 34 samples of lung tissue and BALF were observed. The etiological detection showed that the infection rates of the rats in the experimental and control groups were 29.2% (7/24) and 0, respectively. In the experimental group, the infection rates of SD and Wistar rats were 25.0% (3/12) and 33.3% (4/12), respectively, and the difference between them was not statistically significant (P = 0.31). The positive detection rates of the lung smears and BALF from SD rats in the experimental group were 25.0% (3/12) and 16.7% (2/12), respectively, while those in Wistar rats in the experimental group were 33.3% (4/12) and 16.7% (2/12), respectively, and there were no statistically significant difference between them (P = 0.34, 0.24). A total of 28 samples of BALF were detected by PCR, and the positive detection rates of rats in the experimental group and control group were 91.7% (26/28) and 0, respectively. The sequence analysis of the PCR products showed that it shared 100% homology with the genes of rat source PCP in Gen Bank (JX499145, GU133622 and EF646865). The animal model of PCP can be established by subcutaneous injection with dexamethasone. As animal models, there are no significant difference between SD rats and Wistar rats. PCR method is suitable for PCP detection at the early stage of infection, while etiological detection with high missing rate is not a right option.

Mental imagery. Effects on static balance and attentional demands of the elderly.

PubMed

Hamel, M F; Lajoie, Yves

2005-06-01

Several studies have demonstrated the effectiveness of mental imagery in improving motor performance. However, no research has studied the effectiveness of such a technique on static balance in the elderly. This study evaluated the efficiency of a mental imagery technique, aimed at improving static balance by reducing postural oscillations and attentional demands in the elderly. Twenty subjects aged 65 to 90 years old, divided into two groups (8 in Control group and 12 in Experimental group) participated in the study. The experimental participants underwent daily mental imagery training for a period of six weeks. Antero-posterior and lateral oscillations, reaction times during the use of the double-task paradigm were measured, and the Berg Balance Scale, Activities-specific Balance Confidence Scale, and VMIQ questionnaire were answered during both pre-test and post-test. Attentional demands and postural oscillations (antero-posterior) decreased significantly in the group with mental imagery training compared with those of the Control group. Subjects in the mental imagery group became significantly better in their aptitudes to generate clear vivid mental images, as indicated by the VMIQ questionnaire, whereas no significant difference was observed for the Activities-specific Balance Confidence Scale or Berg Scale. The results support psychoneuromuscular and motor coding theories associated with mental imagery.

The effects of pilates on balance, mobility and strength in patients with multiple sclerosis.

PubMed

Guclu-Gunduz, Arzu; Citaker, Seyit; Irkec, Ceyla; Nazliel, Bijen; Batur-Caglayan, Hale Zeynep

2014-01-01

Although there are evidences as to Pilates developing dynamic balance, muscle strength and flexibility in healthy people, evidences related to its effects on Multiple Sclerosis patients are insufficient. The aims of this study were to investigate the effects of Pilates on balance, mobility, and strength in ambulatory patients with Multiple Sclerosis. Twenty six patients were divided into two groups as experimental (n = 18) and control (n = 8) groups for an 8-week treatment program. The experimental group underwent Pilates and the control group did abdominal breathing and active extremity exercises at home. Balance and mobility were measured with Berg Balance Scale and Timed up and go test, upper and lower muscle strength with hand-held dynamometer. Confidence in balance skills while performing daily activities was evaluated with Activities Specific Balance Confidence Scale. Improvements were observed in balance, mobility, and upper and lower extremity muscle strength in the Pilates group (p < 0.05). No significant differences in any outcome measures were observed in the control group (p > 0.05). Due to its structure which is made up of balance and strengthening exercises, Pilates training may develop balance, mobility and muscle strength of MS patients. For this reason, we think that, Pilates exercises which are appropriate for the disability level of the patient may be suggested.

Transfer of Learning from Practicing Microvascular Anastomosis on Silastic Tubes to Rat Abdominal Aorta.

PubMed

Mokhtari, Pooneh; Tayebi Meybodi, Ali; Lawton, Michael T; Payman, Andre; Benet, Arnau

2017-12-01

Learning to perform microvascular anastomosis is difficult. Laboratory practice models using artificial vessels are frequently used for this purpose. However, the efficacy of such practice models has not been objectively assessed for the performance of microvascular anastomosis during live surgical settings. This study was conducted to assess the transfer of learning from practicing microvascular anastomosis on tubes to anastomosing rat abdominal aorta. Ten surgeons without any experience in microvascular anastomosis were randomly assigned to an experimental or a control group. Both groups received didactic and visual training on end-to-end microvascular anastomosis. The experimental group received 24 sessions of hands-on training on microanastomosis using Silastic tubes. Next, both groups underwent recall tests on weeks 1, 2, and 8 after training. The recall test consisted of completing an end-to-end anastomosis on the rat's abdominal aorta. Anastomosis score, the time to complete the anastomosis, and the average time to place 1 stitch on the vessel perimeter were compared between the 2 groups. Compared with the control group, the experimental group did significantly better in terms of anastomosis score, total time, and per-stitch time. The measured variables showed stability and did not change significantly between the 3 recall tests. The skill of microvascular anastomosis is transferred from practicing on Silastic tubes to rat's abdominal aorta. Considering the relative advantages of Silastic tubes to live rodent surgeries, such as lower cost and absence of ethical issues, our results support the widespread use of Silastic tubes in training programs for microvascular anastomosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of a Temperature-Sensitive, Anti-Adhesive Agent on the Reduction of Adhesion in a Rabbit Laminectomy Model

PubMed Central

Park, Jeong Woo; Cho, Tae Koo; Chun, Hyoung-Joon; Ryu, Je Il

2016-01-01

Objective A common cause of failure in laminectomy surgery is when epidural, peridural, or perineural adhesion occurs postoperatively. The purpose of this study is to examine the efficacy of a temperature-sensitive, anti-adhesive agent (TSAA agent), Guardix-SG®, as a mechanical barrier for the prevention or reduction of peridural scar adhesion in a rabbit laminectomy model. Methods Twenty-six mature rabbits were used for this study. Each rabbit underwent two separate laminectomies at lumbar vertebrae L3 and L6, left empty (the control group) and applied 2 mL of the TSAA agent (the experimental group), respectively. Invasive scar formation or inflammation after laminectomy was quantitatively evaluated by measuring the thickness of the dura, the distance from the surface of dura to the scar tissues, the number of inflammatory cells in the scar tissues at the laminectomy site, and the concentration of collagen in histological sections. Results At 6 weeks postsurgery, the dura was significantly thinner and the distance from the surface of dura to the scar tissues was greater in the experimental group than in the control group (p=0.04 and p=0.01). The number of inflammatory cells was not significantly different in the two groups (p=0.08), although the mean number of inflammatory cells was relatively lower in the experimental group than in the control group. Conclusion The current study suggests that the TSAA agent, Guardix-SG®, could be useful as an interpositional physical barrier after laminectomy for the prevention or reduction of adhesion. PMID:27226857

Alteration of functional connectivity during real-time fMRI regulation of PCC

NASA Astrophysics Data System (ADS)

Zhang, Gaoyan; Yao, Li; Long, Zhiying

2012-03-01

Real-time functional magnetic resonance imaging (rtfMRI) can be used to train the subjects to selectively control activity of specific brain area so as to affect the activation in the target region and even to improve cognition and behavior. So far, whether brain activity in posterior cingulate cortex (PCC) can be regulated by rtfMRI has not been reported. In the present study, we aimed at investigating whether real-time regulation of activity in PCC can change the functional connectivity between PCC and other brain regions. A total of 12 subjects underwent two training runs, each lasts 782s. During the training, subjects were instructed to down regulate activity in PCC by imagining right hand finger movement with the sequence of 4-2-3-1-3-4-2 during task and relax as possible as they can during rest. To control for any effects induced by repeated practice, another 12 subjects in the control group received the same experiment procedure and instruction except with no feedback during training. Experiment results show that increased functional connectivity of PCC with medial frontal cortex (MFC) was observed in both groups during the two training runs. However, PCC of the experimental group is correlated with larger areas in MFC than the control group. Because the positive correlation between task performance and MFC to PCC connectivity has been demonstrated previously, we infer that the stronger connectivity between PCC and MFC in the experimental group may suggest that the experimental group with neurofeedback can more efficiently regulate PCC than the control group without neurofeedback.

Isokinetic Testing in Evaluation Rehabilitation Outcome After ACL Reconstruction

PubMed Central

Cvjetkovic, Dragana Dragicevic; Bijeljac, Sinisa; Palija, Stanislav; Talic, Goran; Radulovic, Tatjana Nozica; Kosanovic, Milkica Glogovac; Manojlovic, Slavko

2015-01-01

Introduction: Numerous rehab protocols have been used in rehabilitation after ACL reconstruction. Isokinetic testing is an objective way to evaluate dynamic stability of the knee joint that estimates the quality of rehabilitation outcome after ACL reconstruction. Our investigation goal was to show importance of isokinetic testing in evaluation thigh muscle strength in patients which underwent ACL reconstruction and rehabilitation protocol. Subjects and methods: In prospective study, we evaluated 40 subjects which were divided into two groups. Experimental group consisted of 20 recreational males which underwent ACL reconstruction with hamstring tendon and rehabilitation protocol 6 months before isokinetic testing. Control group (20 subjects) consisted of healthy recreational males. In all subjects knee muscle testing was performed on a Biodex System 4 Pro isokinetic dynamo-meter et velocities of 60°/s and 180°/s. We followed average peak torque to body weight (PT/BW) and classic H/Q ratio. In statistical analysis Student’s T test was used. Results: There were statistically significant differences between groups in all evaluated parameters except of the mean value of PT/BW of the quadriceps et velocity of 60°/s (p>0.05). Conclusion: Isokinetic testing of dynamic stabilizers of the knee is need in diagnostic and treatment thigh muscle imbalance. We believe that isokinetic testing is an objective parameter for return to sport activities after ACL reconstruction. PMID:25870471

Strength Training Using Elastic Bands: Improvement of Muscle Power and Throwing Performance in Young Female Handball Players.

PubMed

Mascarin, Naryana Cristina; de Lira, Claudio Andre Barbosa; Vancini, Rodrigo Luiz; de Castro Pochini, Alberto; da Silva, Antonio Carlos; Dos Santos Andrade, Marilia

2017-05-01

Imbalance in shoulder-rotator muscles has been considered a risk factor for injuries in handball. Strength training programs (STPs) may play an important preventive role. To verify the effects of an STP using elastic bands on shoulder muscles and ball-throwing speed. Randomized and prospective controlled trial. Exercise physiology laboratory. Thirty-nine female handball players were randomly assigned to an experimental (EG, n = 21, 15.3 ± 1.1 y) or a control (CG, n = 18, 15.0 ± 0.8 y) group. The EG performed the STP with elastic-band progressive exercises for 6 wk before regular handball training, and the CG underwent only their regular training. Before and after the STP, both groups underwent a ball-throwing-speed test and isokinetic test to assess shoulder internal- (IR) and external-rotator muscle performance. Average power values for IR muscles presented a significant group-vs-time interaction effect (F = 3.9, P = .05); EG presented significantly higher values after the STP (P = .03). Ball speed presented higher values in EG after the STP in standing (P = .04) and jumping (P = .03) throws. IR peak-torque values and balance in shoulder-rotator muscles presented no group-vs-time interaction effect. STP using elastic bands performed for 6 wk was effective to improve muscle power and ball speed for young female handball players.

Visual Biofeedback Balance Training Using Wii Fit after Stroke: A Randomized Controlled Trial

PubMed Central

Barcala, Luciana; Grecco, Luanda André Collange; Colella, Fernanda; Lucareli, Paulo Roberto Garcia; Salgado, Afonso Shiguemi Inoue; Oliveira, Claudia Santos

2013-01-01

[Purpose] The aim of the present study was to investigate the effect of balance training with visual biofeedback on balance, body symmetry, and function among individuals with hemiplegia following a stroke. [Subjects and Methods] The present study was performed using a randomized controlled clinical trial with a blinded evaluator. The subjects were twenty adults with hemiplegia following a stroke. The experimental group performed balance training with visual biofeedback using Wii Fit® together with conventional physical therapy. The control group underwent conventional physical therapy alone. The intervention lasted five weeks, with two sessions per week. Body symmetry (baropodometry), static balance (stabilometry), functional balance (Berg Balance Scale), functional mobility (Timed Up and Go test), and independence in activities of daily living (Functional Independence Measure) were assessed before and after the intervention. [Results] No statistically significant differences were found between the experimental and control groups. In the intragroup analysis, both groups demonstrated a significant improvement in all variables studied. [Conclusion] The physical therapy program combined with balance training involving visual biofeedback (Wii Fit®) led to an improvement in body symmetry, balance, and function among stroke victims. However, the improvement was similar to that achieved with conventional physical therapy alone. PMID:24259909

Prevention of Pleural Adhesions by Bioactive Polypeptides - A Pilot Study

PubMed Central

Åkerberg, D.; Posaric-Bauden, M.; Isaksson, K.; Andersson, R.; Tingstedt, B.

2013-01-01

Objective: Postoperative pleural adhesions lead to major problems in repeated thoracic surgery. To date, no antiadhesive product has been proven clinically effective. Previous studies of differently charged polypeptides, poly-L-lysine (PL) and poly-L-glutamate (PG) have shown promising results reducing postoperative abdominal adhesions in experimental settings. This pilot study examined the possible pleural adhesion prevention by using the PL+PG concept after pleural surgery and its possible effect on key parameters; plasmin activator inhibitor-1 (PAI-1) and tissue growth factor beta 1 (TGFb) in the fibrinolytic process. Methods: A total of 22 male rats were used in the study, one control group (n=10) and one experimental group (n=12). All animals underwent primary pleural surgery, the controls receiving saline in the pleural cavity and the experimental group the PL+PG solution administered by spray. The animals were evaluated on day 7. Macroscopic appearance of adhesions was evaluated by a scoring system. Histology slides of the adhesions and pleural biopsies for evaluation of PAI-1 and TGFb1 were taken on day 7. Results: A significant reduction of adhesions in the PL+PG group (p<0.05) was noted at day 7 both regarding the length and severity of adhesions. There were no significant differences in the concentration of PAI-1 and TGFb1 when comparing the two groups. Conclusions: PL+PG may be used to prevent pleural adhesions. The process of fibrinolysis, and fibrosis was though not affected after PLPG administration. PMID:24151443

Effect of prophylactic non-invasive mechanical ventilation on functional capacity after heart valve replacement: a clinical trial

PubMed Central

de Araújo-Filho, Amaro Afrânio; de Cerqueira-Neto, Manoel Luiz; de Assis Pereira Cacau, Lucas; Oliveira, Géssica Uruga; Cerqueira, Telma Cristina Fontes; de Santana-Filho, Valter Joviniano

2017-01-01

OBJECTIVE: During cardiac surgery, several factors contribute to the development of postoperative pulmonary complications. Non-invasive ventilation is a promising therapeutic tool for improving the functionality of this type of patient. The aim of this study is to evaluate the functional capacity and length of stay of patients in a nosocomial intensive care unit who underwent prophylactic non-invasive ventilation after heart valve replacement. METHOD: The study was a controlled clinical trial, comprising 50 individuals of both sexes who were allocated by randomization into two groups with 25 patients in each group: the control group and experimental group. After surgery, the patients were transferred to the intensive care unit and then participated in standard physical therapy, which was provided to the experimental group after 3 applications of non-invasive ventilation within the first 26 hours after extubation. For non-invasive ventilation, the positive pressure was 10 cm H2O, with a duration of 1 hour. The evaluation was performed on the 7th postoperative day/discharge and included a 6-minute walk test. The intensive care unit and hospitalization times were monitored in both groups. Brazilian Registry of Clinical Trials (REBeC): RBR number 8bxdd3. RESULTS: Analysis of the 6-minute walk test showed that the control group walked an average distance of 264.34±76 meters and the experimental group walked an average distance of 334.07±71 meters (p=0.002). The intensive care unit and hospitalization times did not differ between the groups. CONCLUSION: Non-invasive ventilation as a therapeutic resource was effective toward improving functionality; however, non-invasive ventilation did not influence the intensive care unit or hospitalization times of the studied cardiac patients. PMID:29160424

Unilateral nasal obstruction affects motor representation development within the face primary motor cortex in growing rats.

PubMed

Abe, Yasunori; Kato, Chiho; Uchima Koecklin, Karin Harumi; Okihara, Hidemasa; Ishida, Takayoshi; Fujita, Koichi; Yabushita, Tadachika; Kokai, Satoshi; Ono, Takashi

2017-06-01

Postnatal growth is influenced by genetic and environmental factors. Nasal obstruction during growth alters the electromyographic activity of orofacial muscles. The facial primary motor area represents muscles of the tongue and jaw, which are essential in regulating orofacial motor functions, including chewing and jaw opening. This study aimed to evaluate the effect of chronic unilateral nasal obstruction during growth on the motor representations within the face primary motor cortex (M1). Seventy-two 6-day-old male Wistar rats were randomly divided into control ( n = 36) and experimental ( n = 36) groups. Rats in the experimental group underwent unilateral nasal obstruction after cauterization of the external nostril at 8 days of age. Intracortical microstimulation (ICMS) mapping was performed when the rats were 5, 7, 9, and 11 wk old in control and experimental groups ( n = 9 per group per time point). Repeated-measures multivariate ANOVA was used for intergroup and intragroup statistical comparisons. In the control and experimental groups, the total number of positive ICMS sites for the genioglossus and anterior digastric muscles was significantly higher at 5, 7, and 9 wk, but there was no significant difference between 9 and 11 wk of age. Moreover, the total number of positive ICMS sites was significantly smaller in the experimental group than in the control at each age. It is possible that nasal obstruction induced the initial changes in orofacial motor behavior in response to the altered respiratory pattern, which eventually contributed to face-M1 neuroplasticity. NEW & NOTEWORTHY Unilateral nasal obstruction in rats during growth periods induced changes in arterial oxygen saturation (SpO 2 ) and altered development of the motor representation within the face primary cortex. Unilateral nasal obstruction occurring during growth periods may greatly affect not only respiratory function but also craniofacial function in rats. Nasal obstruction should be treated as soon as possible to avoid adverse effects on normal growth, development, and physiological functions. Copyright © 2017 the American Physiological Society.

Efficacy of Laser Photobiomodulation on Morphological and Functional Repair of the Facial Nerve.

PubMed

Buchaim, Daniela Vieira; Andreo, Jesus Carlos; Ferreira Junior, Rui Seabra; Barraviera, Benedito; Rodrigues, Antonio de Castro; Macedo, Mariana de Cássia; Rosa Junior, Geraldo Marco; Shinohara, Andre Luis; Santos German, Iris Jasmin; Pomini, Karina Torres; Buchaim, Rogerio Leone

2017-08-01

Evaluate the efficacy of low-level laser therapy (LLLT) on qualitative, quantitative, and functional aspects in the facial nerve regeneration process. Forty-two male Wistar rats were used, randomly divided into a control group (CG; n = 10), in which the facial nerve without lesion was collected, and four experimental groups: (1) suture experimental group (SEG) and (2) fibrin experimental group (FEG), consisting of 16 animals in which the buccal branch of the facial nerve was sectioned on both sides of the face; an end-to-end epineural suture was performed on the right side, and a fibrin sealant was used on the left side for coaptation of the stumps; and (3) laser suture experimental group (LSEG) and (4) laser fibrin experimental group (LFEG), consisting of 16 animals that underwent the same surgical procedures as SEG and FEG with the addition of laser application at three different points along the surgical site (pulsed laser of 830 nm wavelength, optical output power of 30 mW, power density of 0.2586 W/cm 2 , energy density of 6.2 J/cm 2 , beam area of 0.116 cm 2 , exposure time of 24 sec per point, total energy per session of 2.16 J, and cumulative dose of 34.56 J). The animals were submitted to functional analysis (subjective observation of whisker movement) and the data obtained were compared using Fisher's exact test. Euthanasia was performed at 5 and 10 weeks postoperative. The total number and density of regenerated axons were analyzed using the unpaired t-test (p < 0.05). Laser therapy resulted in a significant increase in the number and density of regenerated axons. The LSEG and LFEG presented better scores in functional analysis in comparison with the SEG and FEG. LLLT enhanced axonal regeneration and accelerated functional recovery of the whiskers, and both repair techniques allowed the growth of axons.

Effects of an intensive clinical skills course on senior nursing students' self-confidence and clinical competence: A quasi-experimental post-test study.

PubMed

Park, Soohyun

2018-02-01

To foster nursing professionals, nursing education requires the integration of knowledge and practice. Nursing students in their senior year experience considerable stress in performing the core nursing skills because, typically, they have limited opportunities to practice these skills in their clinical practicum. Therefore, nurse educators should revise the nursing curricula to focus on core nursing skills. To identify the effect of an intensive clinical skills course for senior nursing students on their self-confidence and clinical competence. A quasi-experimental post-test study. A university in South Korea during the 2015-2016 academic year. A convenience sample of 162 senior nursing students. The experimental group (n=79) underwent the intensive clinical skills course, whereas the control group (n=83) did not. During the course, students repeatedly practiced the 20 items that make up the core basic nursing skills using clinical scenarios. Participants' self-confidence in the core clinical nursing skills was measured using a 10-point scale, while their clinical competence with these skills was measured using the core clinical nursing skills checklist. Independent t-test and chi-square tests were used to analyze the data. The mean scores in self-confidence and clinical competence were higher in the experimental group than in the control group. This intensive clinical skills courses had a positive effect on senior nursing students' self-confidence and clinical competence for the core clinical nursing skills. This study emphasizes the importance of reeducation using a clinical skills course during the transition from student to nursing professional. Copyright © 2017. Published by Elsevier Ltd.

Experimental sleep restriction causes endothelial dysfunction in healthy humans.

PubMed

Calvin, Andrew D; Covassin, Naima; Kremers, Walter K; Adachi, Taro; Macedo, Paula; Albuquerque, Felipe N; Bukartyk, Jan; Davison, Diane E; Levine, James A; Singh, Prachi; Wang, Shihan; Somers, Virend K

2014-11-25

Epidemiologic evidence suggests a link between short sleep duration and cardiovascular risk, although the nature of any relationship and mechanisms remain unclear. Short sleep duration has also been linked to an increase in cardiovascular events. Endothelial dysfunction has itself been implicated as a mediator of heightened cardiovascular risk. We sought to determine the effect of 8 days/8 nights of partial sleep restriction on endothelial function in healthy humans. Sixteen healthy volunteers underwent a randomized study of usual sleep versus sleep restriction of two-thirds normal sleep time for 8 days/8 nights in a hospital-based clinical research unit. The main outcome was endothelial function measured by flow-mediated brachial artery vasodilatation (FMD). Those randomized to sleep restriction slept 5.1 hours/night during the experimental period compared with 6.9 hours/night in the control group. Sleep restriction was associated with significant impairment in FMD (8.6±4.6% during the initial pre-randomization acclimation phase versus 5.2±3.4% during the randomized experimental phase, P=0.01) whereas no change was seen in the control group (5.0±3.0 during the acclimation phase versus 6.73±2.9% during the experimental phase, P=0.10) for a between-groups difference of -4.40% (95% CI -7.00 to -1.81%, P=0.003). No change was seen in non-flow mediated vasodilatation (NFMD) in either group. In healthy individuals, moderate sleep restriction causes endothelial dysfunction. ClinicalTrials.gov. Unique identifier: NCT01334788. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Corn silk extract improves benign prostatic hyperplasia in experimental rat model.

PubMed

Kim, So Ra; Ha, Ae Wha; Choi, Hyun Ji; Kim, Sun Lim; Kang, Hyeon Jung; Kim, Myung Hwan; Kim, Woo Kyoung

2017-10-01

This study was conducted to investigate the effect of a corn silk extract on improving benign prostatic hyperplasia (BPH). The experimental animals, 6-week-old male Wistar rats, were divided into sham-operated control (Sham) and experimental groups. The experimental group, which underwent orchiectomy and received subcutaneous injection of 10 mg/kg of testosterone propionate to induce BPH, was divided into a Testo Only group that received only testosterone, a Testo+Fina group that received testosterone and 5 mg/kg finasteride, a Testo+CSE10 group that received testosterone and 10 mg/kg of corn silk extract, and a Testo+CSE100 group that received testosterone and 100 mg/kg of corn silk extract. Prostate weight and concentrations of dihydrotestosterone (DHT), 5α-reductase 2 (5α-R2), and prostate specific antigen (PSA) in serum or prostate tissue were determined. The mRNA expressions of 5α-R2 and proliferating cell nuclear antigen (PCNA) in prostate tissue were also measured. Compared to the Sham group, prostate weight was significantly higher in the Testo Only group and decreased significantly in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups ( P < 0.05), results that were consistent with those for serum DHT concentrations. The concentrations of 5α-R2 in serum and prostate as well as the mRNA expression of 5α-R2 in prostate were significantly lower in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups than that in the Testo Only group ( P < 0.05). Similarly, the concentrations of PSA in serum and prostate were significantly lower in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups ( P < 0.05) than in the Testo Only group. The mRNA expression of PCNA in prostate dose-independently decreased in the Testo+CSE-treated groups ( P < 0.05). BPH was induced through injection of testosterone, and corn silk extract treatment improved BPH symptoms by inhibiting the mRNA expression of 5α-R2 and decreasing the amount of 5α-R2, DHT, and PSA in serum and prostate tissue.

Corn silk extract improves benign prostatic hyperplasia in experimental rat model

PubMed Central

Kim, So Ra; Ha, Ae Wha; Choi, Hyun Ji; Kim, Sun Lim; Kang, Hyeon Jung; Kim, Myung Hwan

2017-01-01

BACKGROUND/OBJECTIVES This study was conducted to investigate the effect of a corn silk extract on improving benign prostatic hyperplasia (BPH). MATERIALS/METHODS The experimental animals, 6-week-old male Wistar rats, were divided into sham-operated control (Sham) and experimental groups. The experimental group, which underwent orchiectomy and received subcutaneous injection of 10 mg/kg of testosterone propionate to induce BPH, was divided into a Testo Only group that received only testosterone, a Testo+Fina group that received testosterone and 5 mg/kg finasteride, a Testo+CSE10 group that received testosterone and 10 mg/kg of corn silk extract, and a Testo+CSE100 group that received testosterone and 100 mg/kg of corn silk extract. Prostate weight and concentrations of dihydrotestosterone (DHT), 5α-reductase 2 (5α-R2), and prostate specific antigen (PSA) in serum or prostate tissue were determined. The mRNA expressions of 5α-R2 and proliferating cell nuclear antigen (PCNA) in prostate tissue were also measured. RESULTS Compared to the Sham group, prostate weight was significantly higher in the Testo Only group and decreased significantly in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups (P < 0.05), results that were consistent with those for serum DHT concentrations. The concentrations of 5α-R2 in serum and prostate as well as the mRNA expression of 5α-R2 in prostate were significantly lower in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups than that in the Testo Only group (P < 0.05). Similarly, the concentrations of PSA in serum and prostate were significantly lower in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups (P < 0.05) than in the Testo Only group. The mRNA expression of PCNA in prostate dose-independently decreased in the Testo+CSE-treated groups (P < 0.05). CONCLUSIONS BPH was induced through injection of testosterone, and corn silk extract treatment improved BPH symptoms by inhibiting the mRNA expression of 5α-R2 and decreasing the amount of 5α-R2, DHT, and PSA in serum and prostate tissue. PMID:28989573

Pirfenidone vs. sodium hyaluronate/carboxymethylcellulose as prevention of the formation of intra-abdominal adhesions after colonic surgery. A randomized study in an experimental model.

PubMed

Bello-Guerrero, Jorge Alberto; Cruz-Santiago, César Alberto; Luna-Martínez, Javier

2016-01-01

Up to 93% of patients undergoing abdominal surgery will develop intra-abdominal adhesions with the subsequent morbidity that they represent. Various substances have been tested for the prevention of adhesions with controversial results; the aim of our study is to compare the capability of pirfenidone in adhesion prevention against sodium hyaluronate/carboxymethylcellulose. A randomized, prospective, longitudinal experimental study with Winstar rats. They were divided into 3 groups. The subjects underwent an exploratory laparotomy and they had a 4cm(2) cecal abrasion. The first group received saline on the cecal abrasion, and groups 2 and 3 received pirfenidone and sodium hyaluronate/carboxymethylcellulose respectively. All rats were sacrificed on the 21st day after surgery and the presence of adhesions was evaluated with the modified Granat scale. Simple frequency, central tendency and dispersion measures were recorded. For the statistical analysis we used Fisher's test. To evaluate adhesions we used the Granat's modified scale. The control group had a median adhesion formation of 3 (range 0-4). The pirfenidone group had 1.5 (range 0-3), and the sodium hyaluronate/carboxymethylcellulose group had 0 (range 0-1). There was a statistically significant difference to favor sodium hyaluronate/carboxymethylcellulose against saline and pirfenidone (P<0.009 and P<.022 respectively). The use of sodium hyaluronate/carboxymethylcellulose is effective for the prevention of intra-abdominal adhesions. More experimental studies are needed in search for the optimal adhesion prevention drug. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Hatha yoga on body balance

PubMed Central

Prado, Erick Tadeu; Raso, Vagner; Scharlach, Renata Coelho; Kasse, Cristiane Akemi

2014-01-01

Background: A good body balance requires a proper function of vestibular, visual, and somatosensory systems which can be reach with exercise practice and/or yoga. Aim: To determine the effects of a 5-month hatha yoga training program on body balance in young adults. Materials and Methods: This study used a controlled, nonrandomized design, where the experimental group underwent a 5-month training program and were then compared with the control group that had a sedentary lifestyle. A convenience sample of 34 out of 40 men aged 25-55 years old (34.0 ± 0.9) were deemed eligible for this study. They were randomly divided into two groups: Experimental and control groups. Subjects in the experimental group were engaged in 60 min sessions of hatha yoga three times a week for 5 months. We evaluated postural control by measuring the limit of stability and velocity of oscillation (VOS) in three conditions of the balance rehabilitation unit (BRU) and through field procedures (four position, plane, flamingo, hopscotch, and dynamic test). Results: We observed differences (P < 0.05) in postintervention scores between the groups regardless of BRU parameters and field procedures (except for flamingo) even after adjusting for preintervention scores, suggesting that these changes were induced by hatha yoga training. The partial eta squared on BRU parameters ranged from 0.78 (VOS1)-0.97 (COP2), and from 0.00 (flamingo)-0.94 (four position) for the field procedures. Conclusions: Our results provide substantial evidence that postural control in healthy young adults can be improved through practicing hatha yoga. PMID:25035623

Efficacy of a multidisciplinary treatment program in patients with severe fibromyalgia.

PubMed

Casanueva-Fernández, Benigno; Llorca, Javier; Rubió, Josep Blanch I; Rodero-Fernández, Baltasar; González-Gay, Miguel A

2012-08-01

The purpose of this study was to evaluate the efficacy of a multidisciplinary treatment program in patients severely affected by fibromyalgia. Thirty-four fibromyalgia patients were randomly divided into two groups. The control group: 17 women who continued their medical treatment and participated in four educational sessions and the experimental group that included 17 patients who besides the former medical treatment also underwent a weekly 1-h session program for 8 weeks including massage therapy, ischemic pressure on the 18 tender points, aerobic exercise and thermal therapy. At the beginning of the program, there were no significant differences between the two groups in any of the parameters. At the end of treatment, there was a significant improvement in the experimental group in the following items: vitality, social functioning, grip strength and the 6-min walk test. At 1 month after the end of treatment, the experimental group showed significant differences in overall health perception, social functioning, grip strength and the 6-min walk test. At that time, considering the threshold for clinical efficacy set at an improvement of 30% or above for the analyzed variables, 25% of the patients met the requirement for improvement of the following: number of symptoms: Visual Analogic Scale for fatigue, Fibromyalgia Impact Questionnaire and Beck Anxiety Inventory. In conclusion, patients with severe manifestations of fibromyalgia can obtain improvement with a short-term, low-cost and simple-delivery multidisciplinary program. However, additional studies including higher numbers of patients are needed to confirm the beneficial effect of this treatment program.

Effects of enteral arginine supplementation on the structural intestinal adaptation in a rat model of short bowel syndrome.

PubMed

Sukhotnik, Igor; Lerner, Aaron; Sabo, Edmund; Krausz, Michael M; Siplovich, Leonardo; Coran, Arnold G; Mogilner, Jorge; Shiloni, Eitan

2003-07-01

The nitric oxide precursor L-arginine (ARG) has been shown to influence intestinal morphology and intestinal absorptive function. The purpose of the present study was to determine the effect of enteral ARG supplementation on structural intestinal adaptation, cell proliferation, and apoptosis in a rat model of short bowel syndrome (SBS). Thirty male Sprague-Dawley rats were divided into three experimental groups: Sham rats underwent bowel transection, SBS rats underwent 75% small bowel resection, and SBS-ARG rats underwent bowel resection and were treated with ARG given in the drinking water (2%). Parameters of intestinal adaptation, enterocyte proliferation and enterocyte apoptosis were determined on day 14 following operation. We have demonstrated that SBS-ARG animals had a lower jejunal and ileal mucosal weight, jejunal mucosal DNA and protein, ileal mucosal protein, jejunal villus height, jejunal and ileal crypt depth, and enterocyte proliferation index and a greater enterocyte apoptosis compared to SBS untreated animals. We conclude that in a rat model of SBS enteral L-arginine inhibits structural intestinal adaptation. Possible mechanism for this effect may be decreased cell proliferation and increased cell apoptosis.

Effects of a dance-based aquatic exercise program in obese postmenopausal women with knee osteoarthritis: a randomized controlled trial.

PubMed

Casilda-López, Jesús; Valenza, Marie Carmen; Cabrera-Martos, Irene; Díaz-Pelegrina, Ana; Moreno-Ramírez, Maria Paz; Valenza-Demet, Gerald

2017-07-01

To evaluate the effects of a dance-based aquatic exercise program on functionality, cardiorespiratory capacity, postexercise heart rate, and fatigue in obese postmenopausal women with knee osteoarthritis. A randomized controlled trial was performed. In all, 34 obese women diagnosed with knee osteoarthritis participated. Women were randomly allocated to an experimental group (n = 17) or a control group (n = 17). Participants in the experimental group were included in an 8-week dance-based aquatic exercise program conducted in community swimming pools. Those in the control group underwent a global aquatic exercise program. The primary outcome measure was functionality assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were cardiorespiratory capacity evaluated with the 6-minute walk test, and postexercise heart rate and fatigue assessed using a visual analog scale. Variables were measured at baseline, after the intervention, and at 3-month follow-up. A between-group analysis showed significant postintervention differences in functionality (aggregate postintervention WOMAC score of 37.30 ± 16.61 vs 41.83 ± 13.69; P = 0.048) in favor of the experimental group. In addition, significant between-group differences were found after the 8 weeks in cardiorespiratory capacity, postexercise heart rate, and fatigue. Follow-up continued to show significant differences between groups in function (aggregate WOMAC score of 38.60 ± 13.61 vs 42.60 ± 9.05; P = 0.038), postexercise heart rate, and fatigue. An 8-week dance-based exercise program significantly improved function and cardiorespiratory capacity, and decreased postexercise heart rate and fatigue. Most of these improvements were maintained at 3-month follow-up in obese postmenopausal women.

How to improve outcome in surgery for Proximal Hypospadias?

PubMed

Qureshi, Abdul Hafeez; Zaidi, Syed Zafar

2016-02-01

To evaluate the role of subdartos fascial tissue as watertight layer in improving outcome for 2-stage proximal hypospadias surgery. The experimental study was conducted at the Department of Urology, Indus Hospital, Karachi, and comprised an audit of patients with proximal hypospadias who underwent surgery from July 1, 2007, to December 31, 2011. The initial two-stage repair of proximal hypospadias led to a high rate of urethrocutanous fistula formation (Group A), and, thus, a modification was introduced and subdartos facial double layer was applied over the urethral suture line (Group B). The results were compared regarding age, type of hypospadias, graft failure and urethrocutanous fistula in these patients. There were 27 patients in Group A and 16(59.3%) of them ended up having urethrocutanous fistula. Group B had 25 patients and only 2(8%) had fistula formation. The application of dartos facial flap waterproofing layer reduced fistula rate.

Colonic stenting as a bridge to surgery for obstructive colorectal cancer: advantages and disadvantages.

PubMed

Haraguchi, Naotsugu; Ikeda, Masataka; Miyake, Masakazu; Yamada, Takuya; Sakakibara, Yuko; Mita, Eiji; Doki, Yuichiro; Mori, Masaki; Sekimoto, Mitsugu

2016-11-01

To clarify the advantages and disadvantages of stenting as a bridge to surgery (BTS) by comparing the clinical features and outcomes of patients who underwent BTS with those of patients who underwent emergency surgery (ES). We assessed technical success, clinical success, surgical procedures, stoma formation, complications, clinicopathological features, and Onodera's prognostic nutritional index (OPNI) in patients who underwent BTS and those who underwent ES. Twenty-six patients underwent stenting, which was successful in 22 (BTS group). The remaining four patients with unsuccessful stenting underwent emergency surgery. A total of 22 patients underwent emergency surgery (ES group). The rates of technical and clinical success were 85.0 and 81.0 %, respectively. The proportion of patients able to be treated by laparoscopic surgery (P = 0.0001) and avoid colostomy (P = 0.0042) was significantly higher in the BTS group. Although the incidence of anastomotic leakage in the two groups was not significantly different, it was significantly reduced by colonoscopic evaluation of obstructive colitis (P = 0.0251). The mean number of harvested lymph nodes (P = 0.0056) and the proportion of D3 lymphadenectomy (P = 0.0241) were significantly greater in the BTS group. Perineural invasion (PNI) was noted in 59.1 and 18.2 % of the BTS group and ES group patients, respectively (P = 0.0053). OPNI and serum albumin decreased significantly after stenting (P = 0.0084). The advantages of stenting as a BTS were that it avoided colostomy and allowed for laparoscopic surgery and lymphadenectomy, whereas its disadvantage lay in the decreased PNI and OPNI levels. A larger study including an analysis of prognosis is warranted.

Exploring Spinal Cord Protection by Remote Ischemic Preconditioning: An Experimental Study.

PubMed

Herajärvi, Johanna; Anttila, Tuomas; Sarja, Henna; Mustonen, Caius; Haapanen, Henri; Mäkelä, Tuomas; Yannopoulos, Fredrik; Starck, Tuomo; Kallio, Mika; Tuominen, Hannu; Puistola, Ulla; Karihtala, Peeter; Kiviluoma, Kai; Anttila, Vesa; Juvonen, Tatu

2017-03-01

Paraplegia is one of the most severe complications occurring after the repair of thoracic and thoracoabdominal aortic aneurysms. Remote ischemic preconditioning (RIPC) has been shown to mitigate neurologic damage, and this study assessed its efficacy in preventing spinal cord ischemia. The study randomized 16 female pigs into an RIPC group (n = 8) and a control group (n = 8). The RIPC group underwent four cycles of 5-minute ischemia-reperfusion episodes by intermittent occlusion of the left iliac artery. All animals underwent systematic closure of the left subclavian artery and segmental arteries of the descending thoracic aorta to the level of diaphragm. Motor-evoked potential monitoring was performed in both hind limbs. Continuous electrocardiogram and hemodynamics were monitored, and pulmonary artery blood samples were collected. A neurologic assessment was performed 6 hours after the procedure. The thoracic and lumbar portions of the spinal cord were collected for histologic and immunohistochemical analysis. The bilateral motor-evoked potential amplitude responses were higher in the RIPC group (p < 0.05) than in the control group; the difference was detected already before spinal cord ischemia. Paraplegia occurred in 1 control animal. Immunohistochemical total scores of antioxidant response regulator nuclear factor erythroid 2-related factor 2 were better in the RIPC group (11.0; range, 8.5 to 14.0) than in the control group (5.2; range, 1.0 to 9.0; p = 0.023). RIPC induces electrophysiologic changes in the central nervous system that may confer spinal cord protection extending the resistance to ischemia. The significantly higher nuclear factor erythroid 2-related factor 2 scores suggest better neuronal cell protection against oxidative stress in the RIPC group. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Cigarette smoke affects bonding to dentin.

PubMed

Almeida e Silva, Junio S; de Araujo, Edson Medeiro; Araujo, Elito

2010-01-01

This in vitro study evaluated the microtensile bond strength (muTBS) of composite resin bonded to dentin that had been contaminated by cigarette smoke. Ten extracted unerupted human third molars were used: Six molars were prepared for muTBS testing, while the other four molars were assigned to pre- and post-etching scanning electronic microscopy (SEM) analysis. The 20 specimens obtained from the 10 coronal portions were distributed into two experimental groups so that each tooth served as its own control. Group 1 underwent a daily toothbrushing simulation and exposure to a smoking simulation chamber, while Group 2 received only a daily simulated toothbrushing. Student's t-test demonstrated that Group 1 samples demonstrated significantly lower bond strength (49.58 MPa) than Group 2 samples (58.48 MPa). Pre and postetching SEM analysis revealed the presence of contaminants on the dentinal surfaces of the Group 1 specimens. It was concluded that contamination by cigarette smoke decreases the bond strength between dentin and composite resin.

Sutural growth restriction and modern human facial evolution: an experimental study in a pig model

PubMed Central

Holton, Nathan E; Franciscus, Robert G; Nieves, Mary Ann; Marshall, Steven D; Reimer, Steven B; Southard, Thomas E; Keller, John C; Maddux, Scott D

2010-01-01

Facial size reduction and facial retraction are key features that distinguish modern humans from archaic Homo. In order to more fully understand the emergence of modern human craniofacial form, it is necessary to understand the underlying evolutionary basis for these defining characteristics. Although it is well established that the cranial base exerts considerable influence on the evolutionary and ontogenetic development of facial form, less emphasis has been placed on developmental factors intrinsic to the facial skeleton proper. The present analysis was designed to assess anteroposterior facial reduction in a pig model and to examine the potential role that this dynamic has played in the evolution of modern human facial form. Ten female sibship cohorts, each consisting of three individuals, were allocated to one of three groups. In the experimental group (n = 10), microplates were affixed bilaterally across the zygomaticomaxillary and frontonasomaxillary sutures at 2 months of age. The sham group (n = 10) received only screw implantation and the controls (n = 10) underwent no surgery. Following 4 months of post-surgical growth, we assessed variation in facial form using linear measurements and principal components analysis of Procrustes scaled landmarks. There were no differences between the control and sham groups; however, the experimental group exhibited a highly significant reduction in facial projection and overall size. These changes were associated with significant differences in the infraorbital region of the experimental group including the presence of an infraorbital depression and an inferiorly and coronally oriented infraorbital plane in contrast to a flat, superiorly and sagittally infraorbital plane in the control and sham groups. These altered configurations are markedly similar to important additional facial features that differentiate modern humans from archaic Homo, and suggest that facial length restriction via rigid plate fixation is a potentially useful model to assess the developmental factors that underlie changing patterns in craniofacial form associated with the emergence of modern humans. PMID:19929910

Efficacy of PPI, levofloxacin and amoxicillin in the eradication of Helicobacter pylori compared to conventional triple therapy at a Venezuelan hospital.

PubMed

Dib, Jacobo; Alvarez, Bethseidy; Mendez, Liskie; Cruz, Maria E

2013-09-01

Helicobacter pylori is the main cause of gastritis, gastroduodenal ulcers and gastric cancer. In the past two decades, the recommended treatment for its eradication as a first-line regimen is the standard triple therapy consisting of a proton pump inhibitor (PPI), amoxicillin and clarithromycin or metronidazole. However, the effectiveness of this traditional regime, which initially was 90%, progressively declined in many parts of the world and is currently 57-73%. The aim of this study was to evaluate whether the eradication rate with triple therapy with levofloxacin is superior as first-line therapy to that with treatment using clarithromycin in the population that attended as outpatients at the Hospital of Lídice. We designed a prospective study, with two groups of patients presenting dyspeptic symptoms, from October 2010 to October 2011, who underwent upper gastrointestinal endoscopy and whose biopsies were positive for infection with H. pylori. At the end, 81 patients were included in the order of biopsy result arrival to fill the quota of each group. The first group with 42 patients underwent triple therapy with clarithromycin and the second group with 39 patients underwent therapy with levofloxacin, amoxicillin and a PPI. The patients' age ranged between 23 and 76years, the average being 49.5. The predominant sex was female, at 72.84%. Both treatments lasted for 10days and the patients were clinically re-evaluated 15days after their conclusion and programmed for a second endoscopy to verify H. pylori eradication. Among the 42 patients in the control group, there were 14 eradication failures with 33.33% resistance to clarithromycin. Among the 39 patients in the experimental group, two eradication failures with 5.13% resistance to levofloxacin were observed. The χ(2) value was 6.96. Treatment with levofloxacin was more effective than conventional triple therapy. Triple therapy with levofloxacin can be implemented in populations where resistance to clarithromycin has been observed. Copyright © 2013 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.

[Comparison of the color difference between teeth underwent cold light whitening and two kinds of shade guides].

PubMed

Xu, Y X

2018-06-18

To investigate which shade guide, Vitapan Classical or Vita Bleachedguide 3DMaster, is better matched with the color of teeth in judging whitening effect, by comparing the color difference between shade tabs and corresponding teeth underwent cold light tooth whitening. A total of 60 patients underwent Beyond cold light tooth whitening from May 2014 to April 2016. The patients were divided into two experimental groups according to the shade guide used. Vitapan Classical shade guide was used to judge whitening effect in one group, and Vita Bleachedguide 3DMaster shade guide was used in another. Shade matching was carried out before and after whitening in both the two groups, and the results were recorded by digital photographs. Shade matching procedures were carried out by two doctors independently. If they chose the same tab, it would be seen as the shade matching result; While if they chose different tabs, another doctor would be invited to make a decision. Photographs were taken in preset conditions: intraoral photos of the full dentition in the front, and the proportion of shooting was 1:3; aperture was F22; shutter speed was 1/200; intensity of flash was M/8; ISO value was 200. The photographs were analyzed by Photoshop software. Chromatic values were measured, and color difference values were calculated. Measuring of chromatic values was carried out by three doctors independently, and all the photos were measured twice by each doctor. Six measure results of each photo were recorded, and the maximum and the minimum were excluded, then the mean was seen as the final result. The color difference values were compared by independent-sample t test. Besides, changes of shade tabs after whitening in the two groups were recorded. Color difference value was 5.06±1.71 in Vitapan Classical group, and 3.39±1.36 in Vita Bleachedguide 3D-Master group. There was statistically significant difference between the two groups (t=4.68,P<0.001). Change of shade tabs was 3.63±1.75 in Vitapan Classical group, and 2.23±1.01 in Vita Bleachedguide 3DMaster group. Vita Bleachedguide 3D-Master is better matched with the color of teeth, so it is preferred in judging the effect of cold light tooth whitening.

[Left atrial electric isolation in the treatment of atrial fibrillation secondary to rheumatic valvular disease].

PubMed

Graffigna, A; Pagani, F; Minzioni, G; Salerno, J; Viganò, M

1992-08-01

Surgical isolation of the left atrium was performed for the treatment of chronic atrial fibrillation secondary to valvular disease in 100 patients who underwent valve surgery. From May 1989 to September 1991, 62 patients underwent mitral valve surgery (Group I), 19 underwent mitral valve surgery and DeVega tricuspid annuloplasty (Group II), 15 underwent mitral and aortic surgery (Group III), and 4 patients underwent mitral and aortic surgery and DeVega tricuspid annuloplasty (Group IV). Left atrial isolation was performed prolonging the usual left paraseptal atriotomy towards the left fibrous trigone anteriorly, and the postero-medial commissure posteriorly. The incision was conducted a few millimeters apart from the mitral valve annulus, and cryolesion were placed at the edges to ensure complete electrophysiological isolation of the left atrium. Operative mortality accounted for 3 cases (3%). In 79 patients (81.4%) sinus rhythm recovered and persisted until discharge from the hospital. No differences were found between the groups (Group I: 80.7%; Group II: 68.5%; Group III 86.7%, Group IV 75% - p = N.S.). Three cases of late mortality (3.1%) were registered. long-term results showed persistence of SR in 71% of Group I, 61.2% of Group II, 85.8% of Group III, and 100% of Group IV. The unique risk factor for late recurrency of atrial fibrillation was found to be a duration of preoperative AF longer than 6 months. Due to the high success rate in recovering the sinus rhythm, we suggest left atrial isolation in patients with chronic atrial fibrillation undergoing valvular surgery.

Outcomes of De Vega versus biodegradable ring annuloplasty in the surgical treatment of tricuspid regurgitation (mid-term results).

PubMed

Basel, Halil; Aydin, Unal; Kutlu, Hakan; Dostbil, Aysenur; Karadag, Melike; Odabasi, Dolunay; Aydin, Cemalettin

2010-08-01

The aim of this study was to compare De Vega semicircular annuloplasty and a new biodegradable ring annuloplasty technique in patients requiring surgical intervention for tricuspid valve disease with concomitant disease of the mitral valve. Between January 2004 and May 2008, 129 consecutive patients underwent annuloplasty procedures to correct tricuspid valve regurgitation during a concomitant mitral valve operation requiring replacement. Additionally, 24 patients underwent aortic valve replacement (AVR), 11 underwent coronary artery bypass grafting (CABG), 5 underwent AVR plus CABG, 3 underwent mitral valve replacement plus atrial septal defect (ASD) closure, and 2 underwent ASD closure. The patients in this study were assigned to 2 groups: Kalangos ring annuloplasty was performed in 67 patients (group 1), and De Vega semicircular annuloplasty was performed in the remaining 62 patients (group 2). Both tricuspid valve repair techniques produced a low rate of complications; however, the number of patients who developed residual tricuspid regurgitation was significantly lower in group 1. The biodegradable ring annuloplasty technique may be used easily and safely in moderate and severe cases of tricuspid regurgitation; however, larger clinical series are necessary to confirm our promising results.

Effectiveness of Acupressure at the Zusanli (ST-36) Acupoint as a Comfortable Treatment for Diabetes Mellitus: A Pilot Study in Indonesia.

PubMed

Fitrullah; Rousdy, Addison

2017-04-01

Diabetes mellitus is a dangerous disease worldwide. Indonesia has 10 million diabetic and 17.9 million prediabetic citizens. Unfortunately, less than half of these diabetic individuals are aware of their conditions and less than 1% of those receiving medical treatment achieve their healing targets. Because acupressure is believed to be an effective treatment without the use of drugs, in this study we investigated acupressure as a comfortable and effective way of treating patients with diabetes mellitus. This pilot study involved 30 participants who were split into two groups: 15 each in the experimental and the control groups. The experimental group underwent acupressure at the Zusanli (ST-36) acupoint for 30 minutes per visit for 11 weeks, whereas the control group continued their regular treatment; participants in both groups had their blood glucose randomly checked weekly. Data were analyzed using the Generalized Estimating Equation model; the result showed that the two groups were significantly different (p=0.331 > α=0.05; mean difference=99.14; Bonferroni sig. p=0.000 < α=0.05) and that acupressure at ST-36 was effective in reducing blood sugar. This research showed that acupressure was an effective method for reducing blood glucose and was helpful for reducing complications due to diabetes. Copyright © 2017 Medical Association of Pharmacopuncture Institute. Published by Elsevier B.V. All rights reserved.

Outcomes Evaluation of Zero-Profile Devices Compared to Stand-Alone PEEK Cages for the Treatment of Three- and Four-Level Cervical Disc Disease.

PubMed

Gerszten, Peter C; Paschel, Erin; Mashaly, Hazem; Sabry, Hatem; Jalalod'din, Hasan; Saoud, Khaled

2016-09-10

Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease. Three- and four-level discectomies are known to be associated with a higher complication rate and lower fusion rate than single-level surgery. This study was performed to evaluate and compare zero-profile fixation and stand-alone PEEK cages for three- and four-level ACDF. Two cohorts of patients who underwent ACDF for the treatment of three- and four-level disease were compared. Thirty-three patients underwent implantation of zero-profile devices that included titanium screw fixation (Group A). Thirty-five patients underwent implantation of stand-alone PEEK cages without any form of screw fixation (Group B). In Group A, twenty-seven patients underwent a three-level and six patients a four-level ACDF, with a total of 105 levels. In Group B, thirty patients underwent a three-level and five patients underwent a four-level ACDF, with a total number of 110 levels. In Group A, the mean preoperative visual analog scale score (VAS) for arm pain was 6.4 (range 3-8), and the mean postoperative VAS for arm pain decreased to 2.5 (range 1-7). In group B, the mean preoperative VAS of arm pain was 7.1 (range 3-10), and the mean postoperative VAS of arm pain decreased to 2 (range 0-4). In Group A, four patients (12%) developed dysphagia, and in Group B, three patients (9%) developed dysphagia.  Conclusions: This study found zero-profile instrumentation and PEEK cages to be both safe and effective for patients who underwent three- and four-level ACDF, comparable to reported series using plate devices. Rates of dysphagia for the cohort were much lower than reports using plate devices. Zero-profile segmental fixation devices and PEEK cages may be considered as viable alternatives over plate fixation for patients requiring multi-level anterior cervical fusion surgery.

The effect of silymarin on hepatic regeneration after partial hepatectomy: is silymarin effective in hepatic regeneration?

PubMed Central

Cetinkunar, Suleyman; Tokgoz, Serhat; Bilgin, Bulent Caglar; Erdem, Hasan; Aktimur, Recep; Can, Serpil; Erol, Huseyin Serkan; Isgoren, Atilla; Sozen, Selim; Polat, Yilmaz

2015-01-01

Aim: Silymarin from Silybum marianum was found to reduce liver injury. The aim of the present study was to investigate the effects of silymarin on hepatic regeneration in partially hepatectomized rats. Methods: Thirty Wistar-Albino rats were divided into 3 groups of 10 animals as sham, control and experimental groups. In the sham group (n=10) abdominal incision was closed after laparotomy. In the control group (n=10), the rats underwent 70% hepatectomy after laparotomy. In the experimental group (n=10) after partial 70% hepatectomy, silymarin (200 mg/kg/d) were given to rats for 10 days. Rats in three groups were sacrificed on 10 days. Aspartate (AST) and alanine transaminase (ALT), gamma glutamyl transferase (GGT), ALP, LDH and total bilirubin levels were measured using intracardiac blood samples. Tissue malondialdehyde (MDA) and tissue glutathion (GSH) and Superoxide dismutase (SOD) levels were measured. To reveal the increase in the mass of the remnant liver tissue in the control and experimental groups relative weight of the liver was calculated. Histopathological analysis of the liver was performed using a semi-quantitative scoring system. Results: A statistically significant difference among three groups was not shown for AST and ALT levels. A statistically significant difference was found between the groups as for total bilirubin and gamma glutamyl transferase levels. Increases in relative liver weights were seen with time in Groups 2 and 3. A statistically significant difference was not found for tissue malondialdehyde, Glutathion and Superoxide dismutase levels between hepatectomy and hepatectomy + silymarin groups. On liver tissue sections of the rats in the hepatectomy + silymarin group, increased regeneration and lipid peroxidation were observed accompanied by decreased antioxidant response. Conclusion: It has been observed that silymarin with many established functions such as antiproliferative, anti-inflammatory and energy antioxidant effects, does not contributed to proliferative regeneration of the liver-which has very important metabolic functions -after partial hepatectomy; instead it will decrease serum levels of transaminases. PMID:25932204

Nerve regeneration using tubular scaffolds from biodegradable polyurethane.

PubMed

Hausner, T; Schmidhammer, R; Zandieh, S; Hopf, R; Schultz, A; Gogolewski, S; Hertz, H; Redl, H

2007-01-01

In severe nerve lesion, nerve defects and in brachial plexus reconstruction, autologous nerve grafting is the golden standard. Although, nerve grafting technique is the best available approach a major disadvantages exists: there is a limited source of autologous nerve grafts. This study presents data on the use of tubular scaffolds with uniaxial pore orientation from experimental biodegradable polyurethanes coated with fibrin sealant to regenerate a 8 mm resected segment of rat sciatic nerve. Tubular scaffolds: prepared by extrusion of the polymer solution in DMF into water coagulation bath. The polymer used for the preparation of tubular scaffolds was a biodegradable polyurethane based on hexamethylene diisocyanate, poly(epsilon-caprolactone) and dianhydro-D-sorbitol. EXPERIMENTAL MODEL: Eighteen Sprague Dawley rats underwent mid-thigh sciatic nerve transection and were randomly assigned to two experimental groups with immediate repair: (1) tubular scaffold, (2) 180 degrees rotated sciatic nerve segment (control). Serial functional measurements (toe spread test, placing tests) were performed weekly from 3rd to 12th week after nerve repair. On week 12, electrophysiological assessment was performed. Sciatic nerve and scaffold/nerve grafts were harvested for histomorphometric analysis. Collagenic connective tissue, Schwann cells and axons were evaluated in the proximal nerve stump, the scaffold/nerve graft and the distal nerve stump. The implants have uniaxially-oriented pore structure with a pore size in the range of 2 micorm (the pore wall) and 75 x 700 microm (elongated pores in the implant lumen). The skin of the tubular implants was nonporous. Animals which underwent repair with tubular scaffolds of biodegradable polyurethanes coated with diluted fibrin sealant had no significant functional differences compared with the nerve graft group. Control group resulted in a trend-wise better electrophysiological recovery but did not show statistically significant differences. There was a higher level of collagenic connective tissue within the scaffold and within the distal nerve stump. Schwann cells migrated into the polyurethane scaffold. There was no statistical difference to the nerve graft group although Schwann cell counts were lower especially within the middle of the polyurethane scaffold. Axon counts showed a trend-wise decrease within the scaffold. These results suggest that biodegradable polyurethane tubular scaffolds coated with diluted fibrin sealant support peripheral nerve regeneration in a standard gap model in the rat up to 3 months. Three months after surgery no sign of degradation could be seen.

Effects of virtual reality-based training with BTs-Nirvana on functional recovery in stroke patients: preliminary considerations.

PubMed

De Luca, Rosaria; Russo, Margherita; Naro, Antonino; Tomasello, Provvidenza; Leonardi, Simona; Santamaria, Floriana; Desireè, Latella; Bramanti, Alessia; Silvestri, Giuseppe; Bramanti, Placido; Calabrò, Rocco Salvatore

2018-02-02

Cognitive impairment occurs frequently in post-stroke patients. This study aimed to determine the effects of a virtual reality training (VRT) with BTs-Nirvana (BTsN) on the recovery of cognitive functions in stroke patients, using the Interactive-Semi-Immersive Program (I-SIP). We enrolled 12 subjects (randomly divided into two groups: experimental group (EG); and control group (CG)), who attended the Laboratory of Robotic and Cognitive Rehabilitation of IRCCS Neurolesi of Messina from January to June 2016. The EG underwent a VRT with BTsN, whereas CG received a standard cognitive treatment. Both the groups underwent the same conventional physiotherapy program. Each treatment session lasted 45 minutes and was repeated three times a week for 8 weeks. All the patients were evaluated by a specific clinical-psychometric battery before (T0), immediately (T1), and one month (T2) after the end of the training. At T1, the EG presented a greater improvement in the trunk control test (p = 0.03), the Montreal Cognitive Assessment (p = 0.01), the selective attention assessment scores (p = 0.01), the verbal memory (p = 0.03), and the visuospatial and constructive abilities (p = 0.01), as compared to CG. Moreover, such amelioration persisted at T2 only in the EG. According to these preliminary data, VRT with I-SIP can be considered a useful complementary treatment to potentiate functional recovery, with regard to attention, visual-spatial deficits, and motor function in patients affected by stroke.

[Effects of an exercise and relaxation aquatic program in patients with spondyloarthritis: A randomized trial].

PubMed

Fernández García, Rubén; Sánchez Sánchez, Laura de Carmen; López Rodríguez, María Del Mar; Sánchez Granados, Gema

2015-11-06

Spondyloarthritis is a general term referring to a group of chronic rheumatic illnesses that share clinical, genetic, radiological and epidemiological features. The clinical presentation of spondyloarthritis is characterized by the compromise of both the axial and peripheral articular skeleton. We aimed to evaluate the efficacy of an aquatic exercise plus relaxation program in patients with spondyloarthritis. This was a randomized single blind study including 30 patients with spondylitis who were randomly assigned to an experimental or control group. For 2 months, the experimental group underwent an aquatic fitness plus relaxation program (3 sessions per week). Evaluations were also performed in the control group the same days as the experimental group but they did not participate in any supervised exercise program. The following data were obtained at baseline and immediately after application of the last session: Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Health Questionnaire SF-12 and Sigma PC3(®) (Sigma-Elektro GmbH, Neustadt, Germany) Heart Rate Monitor. The Mann-Whitney test showed statistically significant differences in the quality of life (physical function [P=.05]), Bath Ankylosing Spondylitis Functional Index (P=.015), Bath Ankylosing Spondylitis Disease Activity Index (fatigue [P=.032], neck pain, back and hips [P=.045], pain or swelling in other joints [P=.032] and in waking morning stiffness [P=.019]). The results of the present study suggest that therapy with physical exercise plus relaxation provides benefits to spondyloarthritis patients and these are advised as a part of their usual treatment. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Near-Infrared Spectroscopy-Based Frontal Lobe Neurofeedback Integrated in Virtual Reality Modulates Brain and Behavior in Highly Impulsive Adults.

PubMed

Hudak, Justin; Blume, Friederike; Dresler, Thomas; Haeussinger, Florian B; Renner, Tobias J; Fallgatter, Andreas J; Gawrilow, Caterina; Ehlis, Ann-Christine

2017-01-01

Based on neurofeedback (NF) training as a neurocognitive treatment in attention-deficit/hyperactivity disorder (ADHD), we designed a randomized, controlled functional near-infrared spectroscopy (fNIRS) NF intervention embedded in an immersive virtual reality classroom in which participants learned to control overhead lighting with their dorsolateral prefrontal brain activation. We tested the efficacy of the intervention on healthy adults displaying high impulsivity as a sub-clinical population sharing common features with ADHD. Twenty participants, 10 in an experimental and 10 in a shoulder muscle-based electromyography control group, underwent eight training sessions across 2 weeks. Training was bookended by a pre- and post-test including go/no-go, n-back, and stop-signal tasks (SST). Results indicated a significant reduction in commission errors on the no-go task with a simultaneous increase in prefrontal oxygenated hemoglobin concentration for the experimental group, but not for the control group. Furthermore, the ability of the subjects to gain control over the feedback parameter correlated strongly with the reduction in commission errors for the experimental, but not for the control group, indicating the potential importance of learning feedback control in moderating behavioral outcomes. In addition, participants of the fNIRS group showed a reduction in reaction time variability on the SST. Results indicate a clear effect of our NF intervention in reducing impulsive behavior possibly via a strengthening of frontal lobe functioning. Virtual reality additions to conventional NF may be one way to improve the ecological validity and symptom-relevance of the training situation, hence positively affecting transfer of acquired skills to real life.

Continuous wound infusion and local infiltration analgesia for postoperative pain and rehabilitation after total hip arthroplasty.

PubMed

Fusco, Pierfrancesco; Cofini, Vincenza; Petrucci, Emiliano; Scimia, Paolo; Fiorenzi, Maurizio; Paladini, Giuseppe; Behr, Astrid U; Borghi, Battista; Flamini, Stefano; Pizzoferrato, Renzo; Colafarina, Olivo; Di Francesco, Alexander; Tabacco, Tito; Necozione, Stefano; Marinangeli, Franco

2018-05-01

Total hip arthroplasty is one of the most common procedures in orthopedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anesthetics in the first 72 hours after surgery could provide more effective postoperative analgesia with better rehabilitation. A double-blind, randomized, controlled study was conducted with 96 patients who underwent total hip arthroplasty. The patients were randomized to receive either a local infiltration analgesia and continuous wound infusion of anesthetics or a local infiltration analgesia and continuous wound infusion of saline solution. The patients in both groups received subarachnoid anesthesia and a local infiltration analgesia. A multihole catheter was placed next to the implant and connected to an electronic pump containing a 300-mL solution of 0.2% levobupivacaine (experimental group) or saline (control group). A total of 96 consecutive patients were enrolled and randomized. Of these, 48 patients received local infiltration analgesia and continuous wound infusion of local anesthetics, and the remainder received local infiltration analgesia and continuous wound infusion of saline solution. The analysis showed a significant main effect of treatment on the postoperative incident of pain (Ftreat(1,93)=22.62, P=0.000) and on resting pain during the post-surgery follow-up (Ftreat(1,93)=15.62, P=0.0002). The pain scores during the rehabilitation period were significantly less in the experimental group. Analgesic consumption was less in the experimental group. The addition of continuous wound infusion of anesthetics to local infiltration analgesia provided an extended analgesic effect associated with good rehabilitation performance.

Effects of movement imitation training in Parkinson's disease: A virtual reality pilot study.

PubMed

Robles-García, Verónica; Corral-Bergantiños, Yoanna; Espinosa, Nelson; García-Sancho, Carlos; Sanmartín, Gabriel; Flores, Julián; Cudeiro, Javier; Arias, Pablo

2016-05-01

Hypometria is a clinical motor sign in Parkinson's disease. Its origin likely emerges from basal ganglia dysfunction, leading to an impaired control of inhibitory intracortical motor circuits. Some neurorehabilitation approaches include movement imitation training; besides the effects of motor practice, there might be a benefit due to observation and imitation of un-altered movement patterns. In this sense, virtual reality facilitates the process by customizing motor-patterns to be observed and imitated. To evaluate the effect of a motor-imitation therapy focused on hypometria in Parkinson's disease using virtual reality. We carried out a randomized controlled pilot-study. Sixteen patients were randomly assigned in experimental and control groups. Groups underwent 4-weeks of training based on finger-tapping with the dominant hand, in which imitation was the differential factor (only the experimental group imitated). We evaluated self-paced movement features and cortico-spinal excitability (recruitment curves and silent periods in both hemispheres) before, immediately after, and two weeks after the training period. Movement amplitude increased significantly after the therapy in the experimental group for the trained and un-trained hands. Motor thresholds and silent periods evaluated with transcranial magnetic stimulation were differently modified by training in the two groups; although the changes in the input-output recruitment were similar. This pilot study suggests that movement imitation therapy enhances the effect of motor practice in patients with Parkinson's disease; imitation-training might be helpful for reducing hypometria in these patients. These results must be clarified in future larger trials. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Associations between Regional Gray Matter Structural Changes and Changes of Cognitive Performance in Control Groups of Intervention Studies.

PubMed

Takeuchi, Hikaru; Taki, Yasuyuki; Sassa, Yuko; Sekiguchi, Atsushi; Nagase, Tomomi; Nouchi, Rui; Fukushima, Ai; Kawashima, Ryuta

2015-01-01

In intervention studies of cognitive training, the challenging cognitive tests, which were used as outcome measures, are generally completed in more than a few hours. Here, utilizing the control groups' data from three 1-week intervention studies in which young healthy adult subjects underwent a wide range of cognitive tests and T1-weighted magnetic resonance imaging (MRI) before and after the intervention period, we investigated how regional gray matter (GM) density (rGMD) of the subjects changed through voxel-based morphometry (VBM). Statistically significant increases in rGMD were observed in the anatomical cluster that mainly spread around the bilateral dorsal anterior cingulate cortex (dACC) and the right superior frontal gyrus (rSFG). Moreover, mean rGMD within this cluster changes were significantly and positively correlated with performance changes in the Stroop task, and tended to positively correlate with performance changes in a divergent thinking task. Affected regions are considered to be associated with performance monitoring (dACC) and manipulation of the maintained information including generating associations (rSFG), and both are relevant to the cognitive functions measured in the cognitive tests. Thus, the results suggest that even in the groups of the typical "control group" in intervention studies including those of the passive one, experimental or non-experimental factors can result in an increase in the regional GM structure and form the association between such neural changes and improvements related to these cognitive tests. These results suggest caution toward the experimental study designs without control groups.

The hepatoprotective role of Silymarin in isoniazid induced liver damage of rabbits.

PubMed

Jahan, Sarwat; Khan, Moosa; Imran, Sana; Sair, Mohammad

2015-06-01

To evaluate the hepatoprotective role of Silymarin against isonicotinylhydrazine-induced hepatotoxicity in rabbit model. The experimental animal study was held at Jinnah Postgraduate Medical Centre, Karachi, from April to September 2013 and comprised rabbits weighing 1-1.5kgof either gender. The animals were divided randomly into equal groups: group I underwent liver function test without any drug; in group II effects of Silymarin (50mg/kg/day orally) was observed; in group III isoniazid (50mg/kg/dayorally) was administered; and in group IV combined effects of isoniazid and silymarin were observed. Liver function tests were performed at day0 and after the treatment at day19. SPSS 16 was used for statistical analysis. The 28 rabbits in the study were divided in four groups of 7(25%) each. No mortality was recorded in any group. In group III, bilirubin level was increased and alanine transaminase was decreased significantly (p<0.05 each). In group IV, there was significant improvement in serum billirubin and serum alanine transaminase (p<0.05 each). Isonicotinylhydrazine-induced hepatotoxicity was well treated by concurrent administration of Silymarin.

Preventing the Return of Fear Using Reconsolidation Update Mechanisms Depends on the Met-Allele of the Brain Derived Neurotrophic Factor Val66Met Polymorphism.

PubMed

Asthana, Manish Kumar; Brunhuber, Bettina; Mühlberger, Andreas; Reif, Andreas; Schneider, Simone; Herrmann, Martin J

2016-06-01

Memory reconsolidation is the direct effect of memory reactivation followed by stabilization of newly synthesized proteins. It has been well proven that neural encoding of both newly and reactivated memories requires synaptic plasticity. Brain derived neurotrophic factor (BDNF) has been extensively investigated regarding its role in the formation of synaptic plasticity and in the alteration of fear memories. However, its role in fear reconsolidation is still unclear; hence, the current study has been designed to investigate the role of the BDNF val66met polymorphism (rs6265) in fear memory reconsolidation in humans. An auditory fear-conditioning paradigm was conducted, which comprised of three stages (acquisition, reactivation, and spontaneous recovery). One day after fear acquisition, the experimental group underwent reactivation of fear memory followed by the extinction training (reminder group), whereas the control group (non-reminder group) underwent only extinction training. On day 3, both groups were subjected to spontaneous recovery of earlier learned fearful memories. The treat-elicited defensive response due to conditioned threat was measured by assessing the skin conductance response to the conditioned stimulus. All participants were genotyped for rs6265. The results indicate a diminishing effect of reminder on the persistence of fear memory only in the Met-allele carriers, suggesting a moderating effect of the BDNF polymorphism in fear memory reconsolidation. Our findings suggest a new role for BDNF gene variation in fear memory reconsolidation in humans. © The Author 2016. Published by Oxford University Press on behalf of CINP.

Transabdominal high-intensity focused ultrasound therapy of the prostate and determination of the protective effect of rectal cooling: an experimental study using canine prostates.

PubMed

Yoo, Dong Hyun; Cho, Jeong Yeon; Kwak, Cheol; Lee, Jae Young; Moon, Kyung Chul; Kim, Seung Hyup

2013-08-01

The purpose of this study was to report our initial experience with transabdominal high-intensity focused ultrasound (HIFU) therapy of the canine prostate and to determine the protective effect of rectal cooling during HIFU therapy. Fifteen male dogs underwent transabdominal HIFU therapy of the prostate. Transabdominal HIFU was performed on 9 dogs without using a rectal cooling device, and the remaining 6 dogs underwent transabdominal HIFU with introduction of the rectal cooling device. Magnetic resonance imaging (MRI) was performed before, immediately after, and 1 week after the HIFU procedure. Rectal changes on MRI were classified into 4 grades (grades 0-3), and a comparison of the rectal change grades on MRI between the two groups was performed with the Mann-Whitney U test. The procedure failed for the first dog because of inadequate skin preparation. Of the remaining 14 dogs (8 without rectal cooling and 6 with rectal cooling), 4 showed focal signal changes in the prostate. The average rectal change grades on immediate postprocedural MRI were 2.63 for the non-rectal cooling group and 1.17 for the rectal cooling group (P = .0216). On 1-week follow-up MRI, the average grades were 1.20 for the non-rectal cooling group and 0.33 for the rectal cooling group (P = .1956). Transabdominal HIFU of the canine prostate was technically feasible, but the effect was limited because of anatomic and physiologic factors of the canine prostate. The rectal cooling device seems to have a protective effect on the rectum during the transabdominal HIFU procedure.

Using mental visual imagery to improve autobiographical memory and episodic future thinking in relapsing-remitting multiple sclerosis patients: A randomised-controlled trial study.

PubMed

Ernst, Alexandra; Blanc, Frédéric; De Seze, Jérôme; Manning, Liliann

2015-01-01

The co-occurrence of autobiographical memory (AM) and episodic future thinking (EFT) impairment has been documented in relapsing-remitting multiple sclerosis (RR-MS) patients. On these bases, we aimed at probing the efficacy of a mental visual imagery (MVI)-based facilitation programme on AM and EFT functioning in the context of a randomised-controlled trial study in RR-MS patients. Using the Autobiographical Interview (AI), 40 patients presenting with an AM/EFT impairment were randomly assigned in three groups: (i) the experimental (n = 17), who followed the MVI programme, (ii) the verbal control (n = 10), who followed a sham verbal programme, and (iii) the stability groups (n = 13), who underwent the AM/EFT test twice, with no intervention in between. AI's second assessment scores showed a significant improvement of AM and EFT performance only for the experimental group, with a long-term robustness of treatment benefits. The control and stability groups' results ruled out nursing and test learning effects as explanations of AM/EFT improvement. These benefits were corroborated by the patients' comments, which indicated an effective MVI strategy transfer to daily life. Our results suggest that the MVI programme tackles a common cognitive process of scene construction present in AM and EFT.

Preliminary study of efficacy of hyaluronic acid on caustic esophageal burns in an experimental rat model.

PubMed

Cevik, Muazez; Demir, Tuncer; Karadag, Cetin Ali; Ketani, Muzaffer Aydin; Celik, Hakim; Kaplan, Davut Sinan; Boleken, Mehmet Emin

2013-04-01

The aim of this study was to investigate the effectiveness of hyaluronic acid on the prevention of esophageal damage and stricture formation after experimental caustic (alkaline) esophageal injury in rats. Twenty-one Wistar albino rats were randomly divided into three groups. A caustic esophageal burn was created following the Gehanno model: Group l (n=7) underwent operation, but no injury; Group 2 (n=7) was injured and left untreated; and Group 3 (n=7) was injured and treated with hyaluronic acid, first topically and then orally by gavage (2×0.3mL; 12.5mg/mL for 7days). The caustic esophageal burn was created by instilling 25% NaOH into the distal esophagus. All rats were euthanized on day 22 for evaluation. The efficacy of hyaluronic acid treatment was assessed histopathologically and biochemically via blood determination of the total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and sulfhydryl group (SH) and lipid hydroperoxidase (LOOH) levels. Statistical analyses were performed. Weight gain was significantly lower in Group 2 than in the other two groups (P<0.05). The mean stenosis index, histopathologic damage score, TAS, TOS, OSI, and SH and LOOH levels were higher in Group 2 than in the other two groups. The mean stenosis index, inflammation, TAS, SH and OSI in Group 2 were significantly different than those in the other two groups (P<0.05). Hyaluronic acid treatment is effective in treating damage and preventing strictures after caustic esophageal burn in rats. Copyright © 2013 Elsevier Inc. All rights reserved.

Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial.

PubMed

Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo A; Arroyo-Morales, Manuel; Saavedra-Hernández, Manuel; Fernández-Sola, Cayetano; Moreno-Lorenzo, Carmen

2011-09-01

To determine the effect of myofascial release techniques on pain symptoms, postural stability and physical function in fibromyalgia syndrome. A randomized, placebo-controlled trial was undertaken. Eighty-six patients with fibromyalgia syndrome were randomly assigned to an experimental group and a placebo group. Patients received treatments for 20 weeks. The experimental group underwent 10 myofascial release modalities and the placebo group received sham short-wave and ultrasound electrotherapy. Outcome variables were number of tender points, pain, postural stability, physical function, clinical severity and global clinical assessment of improvement. Outcome measures were assessed before and immediately after, at six months and one year after the last session of the corresponding intervention. After 20 weeks of myofascial therapy, the experimental group showed a significant improvement (P  <  0.05) in painful tender points, McGill Pain Score (20.6 ± 6.3, P < 0.032), physical function (56.10 ± 17.3, P < 0.029), and clinical severity (5.08 ± 1.03, P < 0.039). At six months post intervention, the experimental group had a significantly lower mean number of painful points, pain score (8.25 ± 1.13, P < 0.048), physical function (58.60 ± 16.30, P < 0.049) and clinical severity (5.28 ± 0.97, P < 0.043). At one year post intervention, the only significant improvements were in painful points at second left rib and left gluteal muscle, affective dimension, number of days feeling good and clinical severity. The results suggest that myofascial release techniques can be a complementary therapy for pain symptoms, physical function and clinical severity but do not improve postural stability in patients with fibromyalgia syndrome.

Does long-term passive stretching alter muscle-tendon unit mechanics in children with spastic cerebral palsy?

PubMed

Theis, Nicola; Korff, Thomas; Mohagheghi, Amir A

2015-12-01

Cerebral palsy causes motor impairments during development and many children may experience excessive neural and mechanical muscle stiffness. The clinical assumption is that excessive stiffness is thought to be one of the main reasons for functional impairments in cerebral palsy. As such, passive stretching is widely used to reduce stiffness, with a view to improving function. However, current research evidence on passive stretching in cerebral palsy is not adequate to support or refute the effectiveness of stretching as a management strategy to reduce stiffness and/or improve function. The purpose was to identify the effect of six weeks passive ankle stretching on muscle-tendon unit parameters in children with spastic cerebral palsy. Thirteen children (8-14 y) with quadriplegic/diplegic cerebral palsy were randomly assigned to either an experimental group (n=7) or a control group (n=6). The experimental group underwent an additional six weeks of passive ankle dorsiflexion stretching for 15 min (per leg), four days per week, whilst the control group continued with their normal routine, which was similar for the two groups. Measures of muscle and tendon stiffness, strain and resting length were acquired pre- and post-intervention. The experimental group demonstrated a 3° increase in maximum ankle dorsiflexion. This was accompanied by a 13% reduction in triceps surae muscle stiffness, with no change in tendon stiffness. Additionally, there was an increase in fascicle strain with no changes in resting length, suggesting muscle stiffness reductions were a result of alterations in intra/extra-muscular connective tissue. The results demonstrate that stretching can reduce muscle stiffness by altering fascicle strain but not resting fascicle length. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Cognitive disturbances observed in chronic hepatitis C patients during pegylated interferon alpha and ribavirin therapy].

PubMed

Pawełczyk, Tomasz; Pawełczyk, Agnieszka; Białkowska, Jolanta; Jabłkowski, Maciej; Strzelecki, Dominik; Dworniak, Daniela; Rabe-Jabłońska, Jolanta

2008-01-01

Chronic hepatitis C (CHC) patients treated with peg-interferon alpha and ribavirin (peg-IFNalpha/RBV) complain of irritability, attention and memory disturbances which may indicate cognitive impairment associated with treatment. Assessment of the probable connection between peg-IFNalpha/RBV treatment and the development of cognitive disturbances in CHC patients. 47 CHC patients were divided into two groups: experimental (n=26) and control (n=21). The experimental group patients were given peg-IFNalpha2a (n=18) or peg-IFNalpha2b (n=8) plus RBV in standard doses as recommended by the manufacturers. Control group patients did not receive the above treatment. Both groups underwent a neuropsychological examination consisting of R. Brickenkamp d2 test, Auditory Verbal Learning Test and Hooper Visual Organization Test at the beginning (t=0) and after 12 weeks of treatment or observation (t=1). The experimental group patients showed significant deterioration in all the measured cognitive functions in t=1 comparing to t=0. Cognitive decline was not seen in the control group. The observed cognitive performance changes could not be correlated sufficiently enough with the presence of organic affective disorders diagnosed according to ICD-10 criteria. The findings suggest that peg-IFNalpha/RBV therapy of CHC patients is connected with the deterioration in cognitive functioning including attention, auditory verbal memory and visuo-spatial skills. These changes may be the effect of peg-IFNalpha-induced neurotransmission abnormalities in the dorso-lateral prefrontal cortex, anterior cingulate cortex, hippocampus and parieto-orbital cortical regions and can impair patients' ability to drive a motor vehicle, operate machinery, or their engagement in hazardous activities requiring attention and coordination. Medical professionals should thoroughly inform patients about the possibility of cognitive decline associated with peg-IFNalpha/RBV therapy.

Effects of quantitative electroencephalography based neurofeedback training on autonomous regulations in patients with alcohol use disorder.

PubMed

Ko, Sangjin; Park, Wanju

2018-06-02

The study investigated whether neurofeedback training can normalize the excessive high-beta and low alpha waves indicative of hyperarousal, and subsequently improve autonomous regulation based on the self-determination theory in alcohol use disorders. A nonequivalent control group pretest-posttest design was used. Data were collected using self-report questionnaires from 36 Korean inpatients who met the Alcohol Use Disorder Identification Test in Korea criteria. Data were collected from quantitative electroencephalography to assess alpha (8-12 Hz) and high-beta (21-30 Hz) waves for hyperarousal. The questionnaires included Basic Psychological Need Satisfaction scales that assessed autonomy, competence, and relatedness, and the Alcohol Abstinence Self-Efficacy Scale and Treatment Self-Regulation Questionnaire. The experimental group underwent 10 sessions of neurofeedback training over four weeks. Data were analyzed using the chi-squared, Mann-Whitney U, and Wilcoxon signed-rank tests. In the experimental group, the alpha wave was increased in 15 of 19 sites and high-beta waves were decreased in 15 of 19 sites, but this difference was not significant. However, high-beta waves were increased in 15 of 19 sites in the control group, with seven sites (Fz, Cz, Pz, Fp2, F4, C4, and P4) showing significant increases. The experimental group showed a significant increase in basic psychological need satisfaction, alcohol abstinence self-efficacy, and self-regulation compared with the control group. Neurofeedback training is recommended for improving autonomous regulation in alcohol use disorder as a nursing intervention. However, for significantly attenuating hyperarousal through brain wave correction, it may be necessary to increase the number of neurofeedback sessions. Copyright © 2018. Published by Elsevier B.V.

Tissue reaction of deproteinized bovine bone matrix grafting in ectopic site: histological study on sheep.

PubMed

Grossi, João Ricardo Almeida; Bonacin, Rodrigo; Crivelaro, Viviane Rozeira; Giovanini, Allan Fernando; Zielak, João César; Deliberador, Tatiana Miranda

2016-12-01

The aim of this paper was to evaluate through histological analysis of the tissue reaction of deproteinized bovine bone matrix (DBBM) when inserted into the site of intramuscular ectopic sheep. In this study, 16 sheep received 3 groups and these were divided into 2 experimental times: Group 1-sham group, Group 2-particulate autogenous bone and Group 3-DBBM granules. All animals underwent surgical procedures for insertion of materials in an ectopic site (muscles of the lower back and after 3 and 6 months postoperatively, the samples were evaluated by histological analysis. The results indicated that the Sham group showed dense collagen fibers and thin, characterizing fibrosis at 3 and 6 months. In the autograft group there was a significant amount of collagen deposition and decreased inflammation at 6 months postoperatively. Group of DBBM, it was noted the presence of dense connective tissue and surrounding remaining particles was observed the formation of with osteoid characteristic tissue. The DBBM demonstrated biocompatibility, osteoconductivity and small osteogenesis capacity on ectopic site.

Trial of Tocilizumab in Giant-Cell Arteritis.

PubMed

Stone, John H; Tuckwell, Katie; Dimonaco, Sophie; Klearman, Micki; Aringer, Martin; Blockmans, Daniel; Brouwer, Elisabeth; Cid, Maria C; Dasgupta, Bhaskar; Rech, Juergen; Salvarani, Carlo; Schett, Georg; Schulze-Koops, Hendrik; Spiera, Robert; Unizony, Sebastian H; Collinson, Neil

2017-07-27

Giant-cell arteritis commonly relapses when glucocorticoids are tapered, and the prolonged use of glucocorticoids is associated with side effects. The effect of the interleukin-6 receptor alpha inhibitor tocilizumab on the rates of relapse during glucocorticoid tapering was studied in patients with giant-cell arteritis. In this 1-year trial, we randomly assigned 251 patients, in a 2:1:1:1 ratio, to receive subcutaneous tocilizumab (at a dose of 162 mg) weekly or every other week, combined with a 26-week prednisone taper, or placebo combined with a prednisone taper over a period of either 26 weeks or 52 weeks. The primary outcome was the rate of sustained glucocorticoid-free remission at week 52 in each tocilizumab group as compared with the rate in the placebo group that underwent the 26-week prednisone taper. The key secondary outcome was the rate of remission in each tocilizumab group as compared with the placebo group that underwent the 52-week prednisone taper. Dosing of prednisone and safety were also assessed. Sustained remission at week 52 occurred in 56% of the patients treated with tocilizumab weekly and in 53% of those treated with tocilizumab every other week, as compared with 14% of those in the placebo group that underwent the 26-week prednisone taper and 18% of those in the placebo group that underwent the 52-week prednisone taper (P<0.001 for the comparisons of either active treatment with placebo). The cumulative median prednisone dose over the 52-week period was 1862 mg in each tocilizumab group, as compared with 3296 mg in the placebo group that underwent the 26-week taper (P<0.001 for both comparisons) and 3818 mg in the placebo group that underwent the 52-week taper (P<0.001 for both comparisons). Serious adverse events occurred in 15% of the patients in the group that received tocilizumab weekly, 14% of those in the group that received tocilizumab every other week, 22% of those in the placebo group that underwent the 26-week taper, and 25% of those in the placebo group that underwent the 52-week taper. Anterior ischemic optic neuropathy developed in one patient in the group that received tocilizumab every other week. Tocilizumab, received weekly or every other week, combined with a 26-week prednisone taper was superior to either 26-week or 52-week prednisone tapering plus placebo with regard to sustained glucocorticoid-free remission in patients with giant-cell arteritis. Longer follow-up is necessary to determine the durability of remission and safety of tocilizumab. (Funded by F. Hoffmann-La Roche; ClinicalTrials.gov number, NCT01791153 .).

[Application of disparity discriminating accuracy test in evaluating the stereopsis of postoperative intermittent exotropia].

PubMed

Feng, L X; Yao, J Y; Chen, L; Tang, Y; Hou, F

2016-08-01

To discuss the application of disparity discriminating accuracy test in evaluating the stereopsis of postoperative intermittent exotropia. Patients with intermittent exotropia who underwent surgery during July 2011 to June 2013 were followed up. The stereoacuity was examined by Titmus Stereotest, Randot Stereotest and Frisby Stereotest. Twenty adult cases whose stereoacuity reached normal were chosen as experimental group. Twenty healthy adults were selected as normal control group. Both groups were examined with disparity discriminating accuracy test. Discriminating accuracy of the two groups were analyzed with Two-Way ANOVA method. Test-retest reliability was analyzed with Intraclass Correlation Coefficient analysis. The test-retest reliability of disparity discriminating accuracy test is excellent (ICC=0.99, P<0.01) . Discriminating accuracy under different disparities in experimental group were 0.56±0.09, 0.67±0.14, 0.77±0.15, 0.82±0.14, 0.85±0.11, 0.85±0.14, 0.87±0.10, 0.84±0.16, while those in control group were 0.77±0.09, 0.88±0.09, 0.93±0.08, 0.91±0.09, 0.95±0.08, 0.96±0.05, 0.97±0.06, 0.96±0.04. There were statistically significant differences between them (F=38.06, P<0.01) . The discriminating ability of group grating in both groups was affected by the size of disparity. Under situation of small disparity, a large difference was found between the experimental group (0.67±0.12)and control group(0.86±0.07) (F=4.84, P<0.05). Stereoscopic function can be evaluated comprehensively with disparity discriminating accuracy test. Use this test, a certain degree of dysfunction in stereopsis can still be found in postoperative intermittent exotropic patients who reached normal stereoacuity examined with traditional stereotests. (Chin J Ophthalmol, 2016, 52: 584-588).

Vitamin D, Race, and Experimental Pain Sensitivity in Older Adults with Knee Osteoarthritis

PubMed Central

Glover, T.L.; Goodin, B.R.; Horgas, A.L.; Kindler, L.L.; King, C.D.; Sibille, K.T.; Peloquin, C.A.; Riley, J.L.; Staud, R.; Bradley, L.A.; Fillingim, R.B.

2012-01-01

Objective Low levels of serum circulating 25-hydroxyvitamin D have been correlated with many health conditions, including chronic pain. Recent clinical practice guidelines define vitamin D levels < 20 ng/mL as deficient and values of 21–29 ng/mL as insufficient. Vitamin D insufficiency, including the most severe levels of deficiency, is more prevalent in black Americans. Ethnic and race group differences have been reported in both clinical and experimental pain, with black Americans reporting increased pain. The purpose of this study was to examine whether variation in vitamin D levels contribute to race differences in knee osteoarthritic pain. Methods The sample consisted of 94 participants (75% female), including 45 blacks and 49 whites with symptomatic knee osteoarthritis. Average age was 55.8 years (range 45–71 years). Participants completed a questionnaire on knee osteoarthritic symptoms and underwent quantitative sensory testing, including measures of heat and mechanical pain sensitivity. Results Blacks had significantly lower levels of vitamin D compared to whites, demonstrated greater clinical pain, and showed greater sensitivity to mechanical and heat pain. Low levels of vitamin D predicted increased experimental pain sensitivity, but did not predict self-reported clinical pain. Group differences in vitamin D significantly predicted group differences in heat pain and pressure pain thresholds on the index knee and ipsilateral forearm. Conclusion These data demonstrate race differences in experimental pain are mediated by differences in vitamin D level. Vitamin D deficiency may be a risk factor for increased knee osteoarthritic pain in black Americans. PMID:23135697

In vivo and ex vivo magnetic resonance spectroscopy of the infarct and the subventricular zone in experimental stroke

PubMed Central

Jiménez-Xarrié, Elena; Davila, Myriam; Gil-Perotín, Sara; Jurado-Rodríguez, Andrés; Candiota, Ana Paula; Delgado-Mederos, Raquel; Lope-Piedrafita, Silvia; García-Verdugo, José Manuel; Arús, Carles; Martí-Fàbregas, Joan

2015-01-01

Ex vivo high-resolution magic-angle spinning (HRMAS) provides metabolic information with higher sensitivity and spectral resolution than in vivo magnetic resonance spectroscopy (MRS). Therefore, we used both techniques to better characterize the metabolic pattern of the infarct and the neural progenitor cells (NPCs) in the ipsilateral subventricular zone (SVZi). Ischemic stroke rats were divided into three groups: G0 (non-stroke controls, n=6), G1 (day 1 after stroke, n=6), and G7 (days 6 to 8 after stroke, n=12). All the rats underwent MRS. Three rats per group were analyzed by HRMAS. The remaining rats were used for immunohistochemical studies. In the infarct, both techniques detected significant metabolic changes. The most relevant change was in mobile lipids (2.80 ppm) in the G7 group (a 5.53- and a 3.95-fold increase by MRS and HRMAS, respectively). In the SVZi, MRS did not detect any significant metabolic change. However, HRMAS detected a 2.70-fold increase in lactate and a 0.68-fold decrease in N-acetylaspartate in the G1 group. None of the metabolites correlated with the 1.37-fold increase in NPCs detected by immunohistochemistry in the G7 group. In conclusion, HRMAS improves the metabolic characterization of the brain in experimental ischemic stroke. However, none of the metabolites qualifies as a surrogate biomarker of NPCs. PMID:25605287

[An experimental study of successful tracheal replacement using pedicled latissimus dorsi muscle flap and soft Marlex mesh].

PubMed

Hayashi, A

1991-02-01

The present experimental study was undertaken to evaluate the efficacy of combined latissimus dorsi muscle flap and soft Marlex mesh in the reconstruction of the trachea. Thirty-one mongrel dogs underwent a two-stage operation. In the first stage operation, they were divided into four groups for implanting a different prosthesis. A silicone rod was used as the core and this was rolled with soft Marlex mesh to make a prosthesis (Group A and B: without reinforce, Group C: reinforced by wrapping stainless steel mesh, Group D: reinforced with helical stain steel wire). The latissimus dorsi muscle flap was rolled circumferentially around the prosthesis and it was left in place for a period of 4 to 6 weeks. In the second stage operation, the long pedicled muscle flap with the biologically organized prosthesis was mobilized to be guided into the cervix, and the tracheal reconstruction was done with them following circumferential tracheal resection. In result, five of six dogs of group D survived more than 6 months after the replacement without anastomotic leakage or stenosis causing inflammatory granulation. Organization with neo-vascularity of the prosthesis at the time of the tracheal reconstruction was important firstly to avoid incurring complications concerning anastomosis and secondly for long-term stability of the healing and epithelialization of the prosthesis.

Octreotide inhibits hepatic fibrosis, bile duct proliferation and bacterial translocation in obstructive jaundice.

PubMed

Türkçapar, Nuran; Bayar, Sancar; Koyuncu, Ayhan; Ceyhan, Koray

2003-01-01

The protective effect of octreotide on bacterial translocation, bile duct epithelial proliferation and hepatic fibrosis was studied in an experimental obstructive jaundice model. Forty-five healthy Wistar albino rats were randomly divided into three groups. Group I (n = 15): Median laparotomy and common bile duct manipulation performed (Sham group). Group II (n = 15): Laparotomy and common bile duct ligation performed. Group III (n = 15): After laparotomy and common bile duct ligation octreotide (Sandostatin, sandoz) was given. Simultaneously group I and II received 3 cc 0.9% NaCl and group III received 20 micrograms/kg/daily octreotide subcutaneously every 8 hours during 9 days. Two days after the procedure all rats were opened under ether anesthesia and sterile conditions. Group I had simple laparotomy but group II and III also had common bile duct ligation by 5/0 prolene. Seven days after the surgery (9th day after treatment) all rats underwent laparotomy and tests for bacterial translocation, liver biochemical tests and histopathologic analysis of liver and small bowel were carried out. In group II cecal population levels of bacteria were significantly higher than group I and group III (p < 0.05). In group II there was also statistically significant bacterial translocation to the mesenteric lymph nodes. Pathological changes were found in terminal ileum samples in group II which seemed to improve in group III. Hepatocyte function was preserved with octreotide treatment which also significantly decreased bile duct proliferation and periportal fibrosis in response to biliary obstruction. This experimental study showed that octreotide is effective in preventing bacterial translocation, bile duct proliferation and hepatic fibrosis in obstructive jaundice.

Identification of "binge-prone" women: an experimentally and psychometrically validated cluster analysis in a college population.

PubMed

Beebe, D W; Holmbeck, G N; Albright, J S; Noga, K; DeCastro, B

1995-01-01

This study investigated the escape model of binge eating through a cluster analysis using standardized measures. A sample of 126 undergraduate women underwent a manipulation of their level of cognition and were asked to "taste-test" several flavors of ice cream. Questionnaire data from these women were entered into a cluster analysis. Two groups emerged: women in the "binge-prone" group were significantly more depressed, had lower self-esteem, had more chaotic and extreme eating patterns, and were more self-conscious than those in the control group. In validation work, binge-prone women were shown to report elevated levels of bulimic symptomatology and, when in the presence of a food they enjoyed, to respond to increases in level of cognition by eating more. These results were consistent with some, but not all, of the components of the escape model.

A waitlist control-group study of cognitive, mood, and quality of life outcome after posteroventral pallidotomy in Parkinson disease.

PubMed

Carr, Jason A R; Honey, Christopher R; Sinden, Marci; Phillips, Anthony G; Martzke, Jeffrey S

2003-07-01

The aim of this study was to examine neuropsychological outcome from unilateral posteroventral pallidotomy (PVP) in Parkinson disease while controlling for confounding factors such as test practice and disease progression. Participants underwent baseline and 2-month follow-up assessments of cognition, quality of life, mood, and motor functioning. The surgery group (22 patients) underwent PVP (15 left, seven right) after baseline assessment. The waitlist group (14 patients) underwent PVP after follow up. At follow up, the left PVP group exhibited a decline on verbal measures of learning, fluency, working memory, and speeded color naming. The incidence of significant decline on these measures after left PVP ranged from 50 to 86%. The right PVP group did not exhibit a significant cognitive decline, but fluency did decline in 71% of patients who underwent right PVP. Participants who underwent PVP reported better bodily pain and social functioning at follow up than participants in the waitlist group. Improved bodily pain was evident for 62% of the surgery group, and social functioning improved for 19%. Surgery did not alter reported physical functioning or mood. Dyskinesia improved after surgery, but there were no improvements in "on-state" manual dexterity or handwriting. Most patients who underwent left PVP exhibited declines in learning, fluency, working memory, and speeded color naming. Accounting for retesting effects altered the magnitude of these declines by up to one quarter of a standard deviation, but did not increase the breadth of postsurgical neuropsychological decline beyond that typically reported in the literature. It was found that PVP improved dyskinesia, bodily pain, and social functioning, but did not lead to improvement on other objective and self-reported measures of motor functioning.

Antinociceptive and pronociceptive effect of levetiracetam in tonic pain model.

PubMed

Cortes-Altamirano, José Luis; Reyes-Long, Samuel; Olmos-Hernández, Adriana; Bonilla-Jaime, Herlinda; Carrillo-Mora, Paul; Bandala, Cindy; Alfaro-Rodriguez, Alfonso

2018-04-01

Levetiracetam (LEV) is a novel anticonvulsant with proven antinociceptive properties. However, the antinociceptive and pronociceptive effect of this drug has not yet been fully elucidated in a tonic pain model. Thirty-six male rats (Wistar) were randomized into six groups and underwent the formalin test as follows: rats in the control group were administered 50μL of 1% formalin in the paw; sham-group rats were administered 50μL of saline in the paw to mimick the application of formalin; the four experimental groups were administered LEV intragastrically (ig) (50, 100, 200 and 300mg/kg), and 40min later 50μL of 1% formalin was injected in the paw. LEV exhibited antinociceptive effect in the 300mg/kg LEV group (p<0.05) and a pronociceptive effect in the 100mg/kg LEV group (p<0.05) and in the 50mg/kg LEV group (p<0.001). The antinociceptive and pronociceptive effect of LEV in a tonic pain model is dose-dependent. Copyright © 2017 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier B.V. All rights reserved.

Protective effect of basic fibroblast growth factor on laser induced retinopathy

PubMed Central

Kartal, Unal; Koptagel, Emel; Bulut, H. Eray; Erdogan, Haydar

2013-01-01

AIM To investigate the side effects of the commonly used laser treatment along with testing the neuroprotective effect of bFGF on a potential retinal impairment. METHODS To do this, 30 chinchilla pigmented adult male rabbits were divided into the control and experimental groups. The control and experimental groups underwent both laser application and bFGF treatment. The retinal tissue impairment and its renewal rate were tested under the light and electron microscopical levels. RESULTS The focal laser application on rabbit eyes caused morphological alterations both in the application region and in the neighbouring areas. In the damaged areas, the outer nuclear layer of the neural retina was almost disappeared, retina pigment epithelium was interrupted, the retina pigment epithelium migrated intraretinally, and the damaged region along with neighbouring areas seemed to be not separated. bFGF application just after the laser photocoagulation, revealed better results in application areas. CONCLUSION It could be suggested that the bFGF application following laser photocoagulation might have protective, repairing and wound healing effects on the retina. PMID:24392319

[Influence of sterilization treatments on continuous carbon-fiber reinforced polyolefin composite].

PubMed

Guan, Shi-bing; Hou, Chun-lin; Chen, Ai-min; Zhang, Wei; Wang, Ji-e

2007-08-21

To evaluate the influence of sterilization treatment on continuous carbon-fiber reinforced polyolefin composite (CFRP) so as to provide experimental reference for selection of sterilization method for CFRP. Seventy bars of CFRP were divided into 7 equal groups to undergo sterilization by autoclave, 2% glutaraldehyde soaking, 75% alcohol soaking, ethylene oxide sterilization, and Co-60 gamma ray irradiation of the dosages 11 kGy, 25 kGy, and 18 kGy respectively, and another 10 bars were used as blank controls. Then the bars underwent three-point bending test and longitudinal compression test so as to measure the biomechanical changes after sterilization treatment, including the maximum load, ultimate strength, and elastic modulus. Three-point bending test showed that the levels of maximum load of the all experimental groups were lower than that of the control group, however, only those of the 3 Co-60 irradiation groups were significantly lower than that of the control group and that Co-60 radiation lowered the level of maximum load dose-dependently; and that the levels of ultimate strength of all the all experimental groups were lower than that of the control group, however, only those of the 3 Co-60 groups were significantly lower than that of the control group and that the higher the dosage of Co-60 radiation the lower the level of ultimate strength, however, not dose-dependently. The elastic modulus of the Co-60 25 KGy group was significantly higher than that of the control group, and there was no significant difference in the level of ultimate strength among the other groups. Longitudinal compression test showed that the levels of maximum load and ultimate strength of the 3 Co-60 irradiation groups, autoclave group, and circular ethylene groups were significantly lower than that of the control group, and there was no significant difference in elastic modulus among different groups. During sterilized package of CFRP products produced in quantity autoclave sterilization and Co-60 gamma ray irradiation sterilization should be avoided. Ethylene oxide is proposed as the best sterilization method. If gamma ray irradiation is to be used further technology improvement is necessary.

Postoperative complications of powered intracapsular tonsillectomy and monopolar electrocautery tonsillectomy in teens versus adults.

PubMed

Johnston, Douglas R; Gaslin, Michael; Boon, Maurits; Pribitkin, Edmund; Rosen, David

2010-07-01

This study was performed to determine whether teens have different rates of posttonsillectomy hemorrhage, admission for dehydration, or recurrent tonsillitis compared to adults. Specifically, these parameters were compared within two groups: patients who underwent powered intracapsular tonsillectomy (PIT) and those who underwent monopolar electrocautery tonsillectomy (MET). In a retrospective review of 579 patients at least 12 years of age from January 2000 to July 2006 in a tertiary referral center, outcome measures of reoperation for hemorrhage, readmission or emergency room visit for dehydration, and postoperative tonsillitis were compared for 200 patients 12 to 19 years of age and 379 patients more than 19 years of age. These outcome measures in teens were compared to those in adults who had tonsillectomy by the same technique (101 teens who underwent PIT compared to 117 adults who underwent PIT, and 99 teens who underwent MET compared to 262 adults who underwent MET). Outcome measures were also compared within the PIT and MET groups based on the indication for surgery (chronic tonsillitis, tonsillar hypertrophy, or both). In comparing teens to adults who underwent the same technique (PIT versus PIT, or MET versus MET), no statistically significant differences existed in the incidence of hemorrhage, dehydration, or postoperative tonsillitis. Greater hemorrhage rates for adults who underwent MET compared to teens, however, almost met statistical significance (p = 0.053). Analyzing complication rates by indication within the PIT and MET groups exclusively revealed higher rates of hemorrhage in adults who underwent the MET technique for the indication of chronic tonsillitis. Within the PIT comparison, no significant differences were found on the basis of indication for surgery. Teenage patients who undergo tonsillectomy should be considered unique as far as complication rates are concerned. Comparison of technique-specific complication rates between adults and teens showed no significant differences in either the PIT or MET groups, although adults who underwent MET had greater hemorrhage rates that almost met significance (p = 0.053). Adults who were undergoing tonsillectomy for chronic tonsillitis were more likely than teens to encounter postoperative hemorrhage if they underwent the MET technique.

Management of Bile Duct Injury at Various Stages of Presentation: Experience from a Tertiary Care Centre.

PubMed

Ibrarullah, Md; Sankar, S; Sreenivasan, K; Gavini, S R K

2015-04-01

The clinical presentation, management and outcome of all patients with bile duct injury who presented to our tertiary care centre at various stages after cholecystectomy were analyzed. The patients were categorized into three groups: group A-patients in whom the injury was detected during cholecystectomy, group B-patients who presented within 2 weeks of cholecystectomy and group C-patients who presented after 2 weeks of cholecystectomy. Our team acted as rescue surgeons and performed 'on-table' repair for injuries occurring in another unit or in another hospital. Strasberg classification of bile duct injury was followed. In group A, partial and complete transections were managed by repair over T-tube and high hepaticojejunostomy, respectively. Patients in group B underwent endoscopic retrograde cholangiogram and/or magnetic resonance cholangiogram to evaluate the biliary tree. Those with intact common bile duct underwent endoscopic papillotomy and stenting in addition to drainage of intra-abdominal collection when present. For those with complete transection, early repair was considered if there was no sepsis. In presence of intra-abdominal sepsis an attempt was made to create controlled external biliary fistula. This was followed by hepatico jejunostomy at least after 3 months. Group C patients underwent hepaticojejunostomy at least 6 weeks after the injury. The outcome was graded into three categories: grade A-no clinical symptoms, normal LFT; grade B-no clinical symptoms, mild derangement of LFT or occasional episodes of pain or fever; grade C-pain, cholangitis and abnormal LFT; grade D-surgical revision or dilatation required. Fifty nine patients were included in the study and the distribution was group A-six patients, group B-33 patients and group C-20 patients. In group A, one patient with complete transection of the right hepatic duct (type C) and partial injury to left hepatic duct (LHD) underwent right hepaticojejunostomy and repair of the LHD over stent. Two patients with type D and three patients with type E 2 injury underwent repair over T-tube and hepaticojejunostomy, respectively. In group B, all except one of the 18 patients with type A injury underwent endoscopic papillotomy and stenting. The bile leak subsided at a mean interval of 8 days in all, except one patient who died of fulminant sepsis. Of the 15 patients with type E injury, five underwent hepaticojejunostomy after a minimum gap of 3 months. Early repair was considered in 10 patients. Twenty patients in group C underwent hepaticojejunostomy. In a mean follow-up of 40 months, the outcome was grade A in 54 patients, grade B in three patients (one from each of the three groups) and grade D in one patient (group C). The latter patient with a type E3 injury developed recurrent stricture and cholangitis necessitating percutaneous transhepatic dilatation. The high success rate of bile duct repair in the present study can be attributed to the appropriate timing, meticulous technique and the tertiary care experience.

Midface distraction osteogenesis: internal vs. external devices.

PubMed

Meling, T R; Høgevold, H-E; Due-Tønnessen, B J; Skjelbred, P

2011-02-01

This study compares internal and external distraction devices in the treatment of midface retrusion. 20 patients were treated with midface distraction (12 Crouzon, 4 Apert, 4 others); 12 with internal distraction (MID device), 8 with external distraction (Red or Blue device). The two groups were compared regarding operation time, peroperative blood loss and complications. The groups were comparable regarding patient age, sex, weight and diagnosis. In the MID-group, 7 of 12 patients (58%) underwent Le Fort III, 5 underwent 12 monobloc (32%). In the Blue device group, three of eight patients underwent Le Fort II (38%), three of eight underwent Le Fort III (38%), and two of eight underwent monobloc (25%). Operation time was shorter in the Blue device (mean 298 min) than in the MID group (mean 354 min). Peroperative blood loss and complication rates were similar. The internal distraction device is the 'gold standard' for treating midface retrusion. The use of an external distraction device in midface distraction osteogenesis is associated with a shorter operation time; peroperative blood loss and complications were similar. An external device affords better 3-dimensional control during the distraction process, so external distraction is preferable in patients who will tolerate this treatment. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Application of a new collagen-based sealant for the treatment of pancreatic injury.

PubMed

Rosen, Michael; Walsh, R Matthew; Goldblum, John R

2004-08-01

Pancreatic injury is the most frequent serious morbidity that can occur following laparoscopic splenectomy. The presumed mechanism of injury is direct trauma to the pancreatic tail during hilar dissection or transection with endovascular staplers. It was our aim to study the direct application of topical sealants to a pancreatic injury to prevent a pancreatic leak. A porcine model of pancreatic injury in a normal pancreas was developed. Fourteen animals underwent midline laparotomy and subtotal (8 cm) distal pancreatectomy. The pancreas was sharply divided and minimal cauterization used. A (1/4)-inch round Jackson Pratt drain was secured to the pancreatic stump in all animals. The control group (n = 7) underwent no further treatment. Two groups underwent treatment with a sealant. Group 1 (n = 3) had a hydrogel applied to the pancreatic remnant. Group 2 (n = 4) had a biodegradable sealant of PEG (polyethylene glycol)-collagen formulation applied to the pancreatic stump by aerosol. During the postoperative period, animals were fed 2.2 lb/d of a high fat (10% lard) diet to stimulate pancreatic exocrine function. Total daily drain outputs were recorded, and drain amylase content and serum amylase concentration were measured on postoperative days 3, 7, and 10. A significant pancreatic leak was defined as a drain to serum amylase content of greater than 3:1. Animals were killed on day 10 and explored for undrained fluid collections. The pancreas was removed for histologic evaluation. Control and treatment groups were compared using repeated measures ANOVA of log-transformed data. All animals survived until elective necropsy. In group 1, average total drain outputs were not significantly less than the controls (125 mL versus 269; P = .66). The mean drain/serum amylase concentration on days 3, 7, and 10 were not significantly different between group 1 and the control group. Group 2 had significantly less overall average drainage output than controls (40 mL versus 269 mL; P = .0006). Furthermore, group 2 had a significant reduction in pancreatic leaks on days 3, 7, and 10 as measured by mean drain/serum amylase concentration. No undrained fluid collections were identified at autopsy. Based on our experimental porcine model, a novel collagen-based, biodegradable hydrogel can prevent a ductal leak following pancreatic injury. These encouraging data have fostered application by aerosol treatment to the hilar bed at laparoscopic splenectomy to diminish capsular disruption from mechanical injury.

Audiovisual cues benefit recognition of accented speech in noise but not perceptual adaptation

PubMed Central

Banks, Briony; Gowen, Emma; Munro, Kevin J.; Adank, Patti

2015-01-01

Perceptual adaptation allows humans to recognize different varieties of accented speech. We investigated whether perceptual adaptation to accented speech is facilitated if listeners can see a speaker’s facial and mouth movements. In Study 1, participants listened to sentences in a novel accent and underwent a period of training with audiovisual or audio-only speech cues, presented in quiet or in background noise. A control group also underwent training with visual-only (speech-reading) cues. We observed no significant difference in perceptual adaptation between any of the groups. To address a number of remaining questions, we carried out a second study using a different accent, speaker and experimental design, in which participants listened to sentences in a non-native (Japanese) accent with audiovisual or audio-only cues, without separate training. Participants’ eye gaze was recorded to verify that they looked at the speaker’s face during audiovisual trials. Recognition accuracy was significantly better for audiovisual than for audio-only stimuli; however, no statistical difference in perceptual adaptation was observed between the two modalities. Furthermore, Bayesian analysis suggested that the data supported the null hypothesis. Our results suggest that although the availability of visual speech cues may be immediately beneficial for recognition of unfamiliar accented speech in noise, it does not improve perceptual adaptation. PMID:26283946

Audiovisual cues benefit recognition of accented speech in noise but not perceptual adaptation.

PubMed

Banks, Briony; Gowen, Emma; Munro, Kevin J; Adank, Patti

2015-01-01

Perceptual adaptation allows humans to recognize different varieties of accented speech. We investigated whether perceptual adaptation to accented speech is facilitated if listeners can see a speaker's facial and mouth movements. In Study 1, participants listened to sentences in a novel accent and underwent a period of training with audiovisual or audio-only speech cues, presented in quiet or in background noise. A control group also underwent training with visual-only (speech-reading) cues. We observed no significant difference in perceptual adaptation between any of the groups. To address a number of remaining questions, we carried out a second study using a different accent, speaker and experimental design, in which participants listened to sentences in a non-native (Japanese) accent with audiovisual or audio-only cues, without separate training. Participants' eye gaze was recorded to verify that they looked at the speaker's face during audiovisual trials. Recognition accuracy was significantly better for audiovisual than for audio-only stimuli; however, no statistical difference in perceptual adaptation was observed between the two modalities. Furthermore, Bayesian analysis suggested that the data supported the null hypothesis. Our results suggest that although the availability of visual speech cues may be immediately beneficial for recognition of unfamiliar accented speech in noise, it does not improve perceptual adaptation.

A conditioned reinforcer did not help to maintain an operant conditioning in the absence of a primary reinforcer in horses.

PubMed

Lansade, Léa; Calandreau, Ludovic

2018-01-01

The use of conditioned reinforcers is increasingly promoted in animal training. Surprisingly, the efficiency of their use remains to be demonstrated in horses. This study aimed to determine whether an auditory signal which had previously been associated with a food reward 288 times could be used as a conditioned reinforcer to replace the primary reinforcer in an unrelated operant conditioning procedure. Fourteen horses were divided into two groups of 7: No Reinforcement (NR) and Conditioned Reinforcement (CR). All horses underwent nine sessions of Pavlovian conditioning during which the word "good" was associated with food (32 associations/session). The horses then followed five sessions of operant conditioning (30 trials/session) during which they had to touch a cone signaled by an experimenter to receive a food reward. The last day, horses underwent one test session of the operant response: no reward was given, but the word "good" was said each time a CR horse touched the cone. Nothing was said in the NR group. CR horses did not achieve more correct trials than NR horses during the test. These findings again show that the conditioned reinforcement was ineffective when used instead of the primary reinforcement to maintain conditioning. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of emissions from sugar cane burning on the trachea and lungs of Wistar rats

PubMed Central

Matos, Verena Sampaio Barbosa; Gomes, Felipe da Silva; Oliveira, Tarcio Macena; Schulz, Renata da Silva; Ribeiro, Lídia Cristina Villela; Gonzales, Astria Dias Ferrão; Lima, Januário Mourão; Guerreiro, Marcos Lázaro da Silva

2017-01-01

ABSTRACT Objective: To evaluate the effects of exposure to emissions from sugar cane burning on inflammatory mechanisms in tissues of the trachea and lung parenchyma in Wistar rats after different periods of exposure. Methods: This was an experimental open randomized study. The animals were divided into four groups: a control group (CG) underwent standard laboratory conditions, and three experimental groups were exposed to emissions from sugar cane burning over different periods of time, in days-1 (EG1), 7 (EG7), and 21 (EG21). After euthanasia with 200 mg/kg of ketamine/xylazine, fragments of trachea and lung were collected and fixed in 10% formalin. Histological analyses were performed with H&E and picrosirius red staining. Results: No inflammatory infiltrates were found in the tissues of CG rats. The histological examination of tissues of the trachea and lung parenchyma revealed that the inflammatory process was significantly more intense in EG7 than in the CG (p < 0.05 and p < 0.01, respectively). In comparison with the CG and EG1, angiogenesis in the lung parenchyma and collagen deposition in tracheal tissues were significantly greater only in EG21 (p < 0.001 and p < 0.01, respectively). Conclusions: In this sample, emissions from sugar cane burning induced acute focal and diffuse inflammation in the lamina propria of tracheal tissues, with no loss of ciliated epithelial tissue. In the lung parenchyma of the animals in the experimental groups, there was interstitial and alveolar edema, together with polymorphonuclear cell infiltrates. PMID:28746532

Experimental induction of thought-shape fusion in eating disorder patients: the role of coping strategies.

PubMed

Jáuregui Lobera, I; Santed, M A; Bolaños Ríos, P; Ruiz Prieto, I; Santiago Fernández, M J; Garrido Casals, O

2011-01-01

The aim was to induce the thought-shape fusion (TSF) distortion experimentally, testing: a) Whether the TSF distortion could be induced by anxiety in general or if it had a specific relationship with thoughts related to the intake of fattening foods; b) Whether the TSF could be induced in non-clinical participants as well as in the eating disorder patients; c) Whether participants with more appropriate coping strategies would experience less TSF than those who showed inadequate coping strategies; and d) That TSF could have behavioural effects (e.g., neutralization of TSF and food intake) related to emotions. The sample comprised two groups (eating disorder patients and students), with 45 participants each, aged between 18 and 25 years, 92.50% and 86.7% of women in the eating disorders group and the students group respectively. The two groups underwent three experimental conditions (TSF, anxiety, and control), measuring the results with regards to the emotional and behavioural responses. Participants in the TSF induction condition reported more guilt, more feelings of fatness, more likelihood of weight gain, and higher degree of moral wrong-doing compared with participants in both the anxiety and control induction conditions. The effect of the adequate coping strategies in decreasing the strength of the TSF bias was confirmed in both eating disorder patients and non-clinical participants. The study of the TSF distortion may have relevant implications in terms of treatment and prognostic of eating disorders. This distortion may be involved in the development and maintenance of eating disorder psychopathology.

Gender differences in organ density in a rat simulated microgravity model

NASA Astrophysics Data System (ADS)

Pettis, Christopher Ryan; Witten, Mark Lee

2004-01-01

Research investigating the physiological effects of microgravity on the human body has demonstrated a shift of body fluids in actual spaceflight and in simulated Earth-based microgravity models in both males and females, possibly causing many deleterious physiological effects. Twenty-five anatomically normal female (NF) and 20 ovariectomized (OE) Fischer 344 rats were randomly selected to be in an experimental ( 1 h of 45° head-down tilt, 45HDT) or control ( 1 h of prone position) group. At the end of the hour experimental period, the density of the brain, lungs, heart, liver, and left and right kidneys were measured using spiral computed tomography (SCT) while the rats remained in their experimental positions. A sub-group of OE rats ( N=6) was administered estrogen replacement therapy on a daily basis ( 5 μg/kg body weight, s.c.) for 4 days and then underwent 1 h of 45HDT and SCT analysis at one day, 2 days, and 5 days to determine if estrogen replacement therapy would alter organ densities. Our data demonstrate that 1 h of 45HDT produced significant increases ( p<0.05) in the organ densities of the brain, liver, left kidney, and lung of the OE female group compared to their prone controls. However, only the brain density was significantly increased in the NF group. Estrogen replacement therapy caused a significant decrease in brain organ density at the 5 day time point compared to the 24 h time point. We conclude that estrogen plays a role in fluid distribution in a rat 45HDT model.

Internal sphincterotomy versus topical nitroglycerin ointment for chronic anal fissure.

PubMed

Aslam, Muhammad I; Pervaiz, Arif; Figueiredo, Rodrigo

2014-01-01

Anal fissure is a common benign condition. An anorectal problem is defined as a split in the anal canal mucosa that extends from the dentate line to the anal verge. Chronic anal fissure is defined by a history of symptoms present for more than 2 months' duration and with a triad of external skin tags, namely, a hypertrophied anal papilla, an ulcer with rolled edges, and a base exposing the internal sphincter. Because complications such as incontinence are associated with surgical treatment, chemical sphincterotomy is currently favored. The objective of this study is to compare the difference in outcome between open partial lateral anal sphincterotomy and application of topical 0.2% nitroglycerin ointment for the treatment of chronic anal fissure. This was a quasi-experimental study carried out between January 16, 2007 and January 15, 2008 in the Surgical Department of Jinnah Hospital, Lahore, Pakistan. Sixty consecutive cases with a clinical diagnosis of chronic anal fissure were recruited in the study. All recruited patients met the study inclusion criteria and were randomly assigned to one of the two groups. Group A was managed conservatively using topical 0.2% nitroglycerin ointment, whereas Group B underwent open partial lateral anal sphincterotomy. Both groups were followed up at 1 week, 2 weeks, 4 weeks, and 6 weeks after the treatment. All the patients complained of pain. A total of 43 (71.7%) patients had pain with constipation, whereas 31 (51.7%) patients had bleeding per rectum. Upon clinically examining the anal area, tenderness was elicited in all 60 (100%) patients. Group A included 30 (11 females and 19 males) cases treated with topical 0.2% nitroglycerin ointment and Group B included 30 (11 females and 19 males) cases who underwent open partial lateral anal sphincterotomy. In Group A, only 15 patients with fissures were successfully treated (50%). By contrast, 28 (93%) patients with fissures in Group B were successfully treated, and only two (7%) remained uncured. These two patients (6.6%) in Group B suffered from incontinence due to flatus and feces as a complication of the procedure. This quasi-experimental study demonstrates that open partial lateral internal sphincterotomy is superior to topical 0.2% nitroglycerin application in the treatment of chronic anal fissure, with good symptomatic relief, high rate of healing, fewer side effects, and a very low rate of early continence disturbances. Copyright © 2013. Published by Elsevier B.V.

Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke.

PubMed

Lloréns, Roberto; Gil-Gómez, José-Antonio; Alcañiz, Mariano; Colomer, Carolina; Noé, Enrique

2015-03-01

To study the clinical effectiveness and the usability of a virtual reality-based intervention compared with conventional physical therapy in the balance recovery of individuals with chronic stroke. Randomized controlled trial. Outpatient neurorehabilitation unit. A total of 20 individuals with chronic stroke. The intervention consisted of 20 one-hour sessions, five sessions per week. The experimental group combined 30 minutes with the virtual reality-based intervention with 30 minutes of conventional training. The control group underwent one hour conventional therapy. Balance performance was assessed at the beginning and at the end of the trial using the Berg Balance Scale, the balance and gait subscales of the Tinetti Performance-Oriented Mobility Assessment, the Brunel Balance Assessment, and the 10-m Walking Test. Subjective data of the virtual reality-based intervention were collected from the experimental group, with a feedback questionnaire at the end of the trial. The results revealed a significant group-by-time interaction in the scores of the Berg Balance Scale (p < 0.05) and in the 10-m Walking Test (p < 0.05). Post-hoc analyses showed greater improvement in the experimental group: 3.8 ±2.6 vs. 1.8 ±1.4 in the Berg Balance Scale, -1.9 ±1.6 seconds vs. 0.0 ±2.3 seconds in the 10-m Walking Test, and also in the number of participants who increased level in the Brunel Balance Assessment (χ(2) = 2.5, p < 0.01). Virtual reality interventions can be an effective resource to enhance the improvement of balance in individuals with chronic stroke. © The Author(s) 2014.

Near-Infrared Spectroscopy-Based Frontal Lobe Neurofeedback Integrated in Virtual Reality Modulates Brain and Behavior in Highly Impulsive Adults

PubMed Central

Hudak, Justin; Blume, Friederike; Dresler, Thomas; Haeussinger, Florian B.; Renner, Tobias J.; Fallgatter, Andreas J.; Gawrilow, Caterina; Ehlis, Ann-Christine

2017-01-01

Based on neurofeedback (NF) training as a neurocognitive treatment in attention-deficit/hyperactivity disorder (ADHD), we designed a randomized, controlled functional near-infrared spectroscopy (fNIRS) NF intervention embedded in an immersive virtual reality classroom in which participants learned to control overhead lighting with their dorsolateral prefrontal brain activation. We tested the efficacy of the intervention on healthy adults displaying high impulsivity as a sub-clinical population sharing common features with ADHD. Twenty participants, 10 in an experimental and 10 in a shoulder muscle-based electromyography control group, underwent eight training sessions across 2 weeks. Training was bookended by a pre- and post-test including go/no-go, n-back, and stop-signal tasks (SST). Results indicated a significant reduction in commission errors on the no-go task with a simultaneous increase in prefrontal oxygenated hemoglobin concentration for the experimental group, but not for the control group. Furthermore, the ability of the subjects to gain control over the feedback parameter correlated strongly with the reduction in commission errors for the experimental, but not for the control group, indicating the potential importance of learning feedback control in moderating behavioral outcomes. In addition, participants of the fNIRS group showed a reduction in reaction time variability on the SST. Results indicate a clear effect of our NF intervention in reducing impulsive behavior possibly via a strengthening of frontal lobe functioning. Virtual reality additions to conventional NF may be one way to improve the ecological validity and symptom-relevance of the training situation, hence positively affecting transfer of acquired skills to real life. PMID:28928644

Anti-adhesive effect of poloxamer-based thermo-sensitive sol-gel in rabbit laminectomy model.

PubMed

Shin, Sung Joon; Lee, Jae Hyup; So, Jungwon; Min, Kyungdan

2016-11-01

Poloxamer-based thermo-sensitive sol-gel has been developed to reduce the incidence of postoperative scar formation at the laminectomy site. The purpose of this study was to evaluate the anti-adhesive effect of poloxamer based thermo-sensitive sol-gel compared to hyaluronate based solution after laminectomy, using a rabbit model. A thermo-sensitive anti-adhesive with a property of sol-gel transition was manufactured by a physical mixture of Poloxamer188/407, Chitosan and Gelatin. The viscosity in different temperatures was assessed. 72 adult New Zealand rabbits underwent lumbar laminectomy and were randomly divided into experimental (treated with the newly developed agent), positive (treated with hyaluronate based solution), and negative control groups. Each group was subdivided into 1 and 4-week subgroups. Gross and histological evaluations were performed to assess the extent of epidural adhesion. The experimental group showed significantly higher viscosity compared to the positive control group and showed a significant increase of viscosity as the temperature increased. Gross evaluation showed no statistically significant differences between the 1- and 4-week subgroups. However, histologic evaluation showed significant differences both in 1- and 4-week subgroups. Although the 4-week histologic results of the experimental and the positive control subgroups showed no significant difference, both subgroups revealed higher value compared to the negative control subgroup with regard to the ratio of adhesion less than 50 %. The new poloxamer based thermo-sensitive agent showed superior efficacy over the hyaluronate based agent at 1 week postoperatively. At 4 weeks postoperatively, there were no statistically significant differences between the two agents, although both showed efficacy over the sham group.

[Action of Calendula officinalis essence on bone preservation after the extraction].

PubMed

Uribe-Fentanes, Laura K; Soriano-Padilla, Fernando; Pérez-Frutos, Jorge Raúl; Veras-Hernández, Miriam Alejandra

2018-01-01

Calendula officinalis is a phytodrug used as analgesic, antiseptic and wound-healing agent due to its collagenogenic effect, which is why it is a convenient and affordable treatment that promotes alveolar bone preservation after tooth extraction in vivo. The aim of this study was to use Calendula officinalis during and after tooth extraction to determine its ability to preserve bone after this procedure. We established two groups matched by age, gender and position of the third molar. We used with patients on the experimental group Calendula officinalis diluted 10% as an irrigant during surgical extraction of third molars. We performed the conventional way with the control group irrigating with saline solution. Subsequently, both groups continued to make mouthwash for a week with the irrigating agent. Every week for a month, each patient underwent periapical radiography, out of which we took measurements of alveolar ridges and depth of alveolar bone, which were compared. There is statistically significant evidence to state that Calendula officinalis favorably affects bone preservation after extraction.

Clinical benefits and oncologic equivalence of self-expandable metallic stent insertion for right-sided malignant colonic obstruction.

PubMed

Ji, Woong Bae; Kwak, Jung Myun; Kang, Dong Woo; Kwak, Han Deok; Um, Jun Won; Lee, Sun-Il; Min, Byung-Wook; Sung, Nak Song; Kim, Jin; Kim, Seon Hahn

2017-01-01

The efficacy of stenting for right-sided malignant colonic obstruction is unknown. This study aimed to evaluate the safety, feasibility, and clinical benefits of self-expandable metallic stent insertion for right-sided malignant colonic obstruction. Clinical data from patients who underwent right hemicolectomy for right colon cancer from January 2006 to July 2014 at three Korea University hospitals were retrospectively reviewed. A total of 39 patients who developed malignant obstruction in the right-sided colon were identified, and their data were analyzed. Stent insertion was attempted in 16 patients, and initial technical success was achieved in 14 patients (87.5 %). No stent-related immediate complications were reported. Complete relief from obstruction was achieved in all 14 patients. Twenty-five patients, including two patients who failed stenting, underwent emergency surgery. In the stent group, 93 % (13/14) of patients underwent elective laparoscopic surgery, and only one surgery was converted to an open procedure. All patients in the emergency group underwent emergency surgery within 24 h of admission. In the emergency group, only 12 % (3/25) of patients underwent laparoscopic surgery, with one surgery converted to an open procedure. All patients in both groups underwent either laparoscopy-assisted or open right/extended right hemicolectomy with primary anastomoses as the first operation. The operative times, retrieved lymph nodes, and pathologic stage did not differ between the two groups. Postoperative hospital stay (9.4 ± 3.4 days in the stent group vs. 12.4 ± 5.9 in the emergency group, p = 0.089) and time to resume oral food intake (3.2 ± 2.1 days in the stent group vs. 5.7 ± 3.4 in the emergency group, p = 0.019) were shorter in the stent group. And there were no significant differences in disease-free survival and overall survival between the two groups. Stent insertion appears to be safe and feasible in patients with right-sided colonic malignant obstruction. It facilitates minimally invasive surgery and may result in better short-term surgical outcomes.

Effects of scaling task constraints on emergent behaviours in children's racquet sports performance.

PubMed

Fitzpatrick, Anna; Davids, Keith; Stone, Joseph A

2018-04-01

Manipulating task constraints by scaling key features like space and equipment is considered an effective method for enhancing performance development and refining movement patterns in sport. Despite this, it is currently unclear whether scaled manipulation of task constraints would impact emergent movement behaviours in young children, affording learners opportunities to develop relevant skills. Here, we sought to investigate how scaling task constraints during 8 weeks of mini tennis training shaped backhand stroke development. Two groups, control (n = 8, age = 7.2 ± 0.6 years) and experimental (n = 8, age 7.4 ± 0.4 years), underwent practice using constraints-based manipulations, with a specific field of affordances designed for backhand strokes as the experimental treatment. To evaluate intervention effects, pre- and post-test match-play characteristics (e.g. forehand and backhand percentage strokes) and measures from a tennis-specific skills test (e.g. forehand and backhand technical proficiency), were evaluated. Post intervention, the experimental group performed a greater percentage of backhand strokes out of total number of shots played (46.7 ± 3.3%). There was also a significantly greater percentage of backhand winners out of total backhand strokes observed (5.5 ± 3.0%), compared to the control group during match-play (backhands = 22.4 ± 6.5%; backhand winners = 1.0 ± 3.6%). The experimental group also demonstrated improvements in forehand and backhand technical proficiency and the ability to maintain a rally with a coach, compared to the control group. In conclusion, scaled manipulations implemented here elicited more functional performance behaviours than standard Mini Tennis Red constraints. Results suggested how human movement scientists may scale task constraint manipulations to augment young athletes' performance development. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

Application of a buprenorphine transdermal patch for the perioperative analgesia in patients who underwent simple lumbar discectomy

PubMed Central

Tang, Jian; Fan, Jin; Yao, Yilun; Cai, Weihua; Yin, Guoyong; Zhou, Wei

2017-01-01

Abstract This study aimed to investigate the perioperative analgesic effect of a buprenorphine transdermal patch in patients who underwent simple lumbar discectomy. In total, 96 patients were randomly divided into parecoxib intravenous injection (Group A), oral celecoxib (Group B), and buprenorphine transdermal patch groups (Group C). The pain status, degree of satisfaction, adverse effects, and condition in which the patient received tramadol hydrochloride for uncontrolled pain were recorded on the night before surgery, postoperative day 1, postoperative day 3, and postoperative day 5. The degree of patient satisfaction in Group C was higher than that in Groups A and B, with minimal adverse effects. The buprenorphine transdermal patch had a better perioperative analgesic effect in patients who underwent simple lumbar discectomy. PMID:28514299

EVALUATION OF THE EXTRACELLULAR MATRIX OF INJURED SUPRASPINATUS IN RATS

PubMed Central

Almeida, Luiz Henrique Oliveira; Ikemoto, Roberto; Mader, Ana Maria; Pinhal, Maria Aparecida Silva; Munhoz, Bruna; Murachovsky, Joel

2016-01-01

ABSTRACT Objective: To evaluate the evolution of injuries of the supraspinatus muscle by immunohistochemistry (IHC) and anatomopathological analysis in animal model (Wistar rats). Methods: Twenty-five Wistar rats were submitted to complete injury of the supraspinatus tendon, then subsequently sacrificed in groups of five animals at the following periods: immediately after the injury, 24h after the injury, 48h after, 30 days after and three months after the injury. All groups underwent histological and IHC analysis. Results: Regarding vascular proliferation and inflammatory infiltrate, we found a statistically significant difference between groups 1(control group) and 2 (24h after injury). IHC analysis showed that expression of vascular endothelial growth factor (VEGF) showed a statistically significant difference between groups 1 and 2, and collagen type 1 (Col-1) evaluation presented a statistically significant difference between groups 1 and 4. Conclusion: We observed changes in the extracellular matrix components compatible with remodeling and healing. Remodeling is more intense 24h after injury. However, VEGF and Col-1 are substantially increased at 24h and 30 days after the injury, respectively. Level of Evidence I, Experimental Study. PMID:26997907

Effects of ozone therapy on facial nerve regeneration.

PubMed

Ozbay, Isa; Ital, Ilker; Kucur, Cuneyt; Akcılar, Raziye; Deger, Aysenur; Aktas, Savas; Oghan, Fatih

Ozone may promote moderate oxidative stress, which increases antioxidant endogenous systems. There are a number of antioxidants that have been investigated therapeutically for improving peripheral nerve regeneration. However, no previous studies have reported the effect of ozone therapy on facial nerve regeneration. We aimed to evaluate the effect of ozone therapy on facial nerve regeneration. Fourteen Wistar albino rats were randomly divided into two groups with experimental nerve crush injuries: a control group, which received saline treatment post-crush, and an experimental group, which received ozone treatment. All animals underwent surgery in which the left facial nerve was exposed and crushed. Treatment with saline or ozone began on the day of the nerve crush. Left facial nerve stimulation thresholds were measured before crush, immediately after crush, and after 30 days. After measuring nerve stimulation thresholds at 30 days post-injury, the crushed facial nerve was excised. All specimens were studied using light and electron microscopy. Post-crushing, the ozone-treated group had lower stimulation thresholds than the saline group. Although this did not achieve statistical significance, it is indicative of greater functional improvement in the ozone group. Significant differences were found in vascular congestion, macrovacuolization, and myelin thickness between the ozone and control groups. Significant differences were also found in axonal degeneration and myelin ultrastructure between the two groups. We found that ozone therapy exerted beneficial effect on the regeneration of crushed facial nerves in rats. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Design and validation of a novel learning tool, the "Anato-Rug," for teaching equine topographical anatomy.

PubMed

Braid, Francesca; Williams, Sarah B; Weller, Renate

2012-01-01

Recognition of anatomical landmarks in live animals (and humans) is key for clinical practice, but students often find it difficult to translate knowledge from dissection-based anatomy onto the live animal and struggle to acquire this vital skill. The purpose of this study was to create and evaluate the use of an equine anatomy rug ("Anato-Rug") depicting topographical anatomy and key areas of lung, heart, and gastrointestinal auscultation, which could be used together with a live horse to aid learning of "live animal" anatomy. Over the course of 2 weeks, 38 third year veterinary students were randomly allocated into an experimental group, revising topographical anatomy from the "Anato-Rug," or a control group, learning topographical anatomy from a textbook. Immediately post activity, both groups underwent a test on live anatomy knowledge and were retested 1 week later. Both groups then completed a questionnaire to ascertain their perceptions of their learning experiences. Results showed that the experimental groups scored significantly higher than the control group at the first testing session, experienced more enjoyment during the activity and gained more confidence in identifying anatomical landmarks than the control group. There was not a significant difference in scores between groups at the second testing session. The findings indicate that the anatomy rug is an effective learning tool that aids understanding, confidence, and enjoyment in learning equine thorax and abdominal anatomy; however it was not better than traditional methods with regards to longer term memory recall. Copyright © 2012 American Association of Anatomists.

Enhanced control of dorsolateral prefrontal cortex neurophysiology with real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback training and working memory practice.

PubMed

Sherwood, Matthew S; Kane, Jessica H; Weisend, Michael P; Parker, Jason G

2016-01-01

Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback can be used to train localized, conscious regulation of blood oxygen level-dependent (BOLD) signals. As a therapeutic technique, rt-fMRI neurofeedback reduces the symptoms of a variety of neurologic disorders. To date, few studies have investigated the use of self-regulation training using rt-fMRI neurofeedback to enhance cognitive performance. This work investigates the utility of rt-fMRI neurofeedback as a tool to enhance human cognition by training healthy individuals to consciously control activity in the left dorsolateral prefrontal cortex (DLPFC). A cohort of 18 healthy participants in the experimental group underwent rt-fMRI neurofeedback from the left DLPFC in five training sessions across two weeks while 7 participants in the control group underwent similar training outside the MRI and without rt-fMRI neurofeedback. Working memory (WM) performance was evaluated on two testing days separated by the five rt-fMRI neurofeedback sessions using two computerized tests. We investigated the ability to control the BOLD signal across training sessions and WM performance across the two testing days. The group with rt-fMRI neurofeedback demonstrated a significant increase in the ability to self-regulate the BOLD signal in the left DLPFC across sessions. WM performance showed differential improvement between testing days one and two across the groups with the highest increases observed in the rt-fMRI neurofeedback group. These results provide evidence that individuals can quickly gain the ability to consciously control the left DLPFC, and this training results in improvements of WM performance beyond that of training alone. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Effect of Bioactive Glass air Abrasion on Shear Bond Strength of Two Adhesive Resins to Decalcified Enamel

PubMed Central

Eshghi, Alireza; Khoroushi, Maryam; Rezvani, Alireza

2014-01-01

Objective: Bioactive glass air abrasion is a conservative technique to remove initial decalcified tissue and caries. This study examined the shear bond strength of composite resin to sound and decalcified enamel air-abraded by bioactive glass (BAG) or alumina using etch-and-rinse and self-etch adhesives. Materials and Methods: Forty-eight permanent molars were root-amputated and sectioned mesiodistally. The obtained 96 specimens were mounted in acrylic resin; the buccal and lingual surfaces remained exposed. A demineralizing solution was used to decalcify half the specimens. Both sound and decalcified specimens were divided into two groups of alumina and bioactive glass air abrasion. In each group, the specimens were subdivided into two subgroups of Clearfil SE Bond or OptiBond FL adhesives (n=12). Composite resin cylinders were bonded on enamel surfaces cured and underwent thermocycling. The specimens were tested for shear bond strength. Data were analyzed using SPSS 16.0 and three-way ANOVA (α=0.05). Similar to the experimental groups, the enamel surface of one specimen underwent SEM evaluation. Results: No significant differences were observed in composite resin bond strength subsequent to alumina or bioactive glass air abrasion preparation techniques (P=0.987). There were no statistically significant differences between the bond strength of etch-and-rinse and self-etch adhesive groups (P=1). Also, decalcified or intact enamel groups had no significant difference (P=0.918). However, SEM analysis showed much less enamel irregularities with BAG air abrasion compared to alumina air abrasion. Conclusion: Under the limitations of this study, preparation of both intact and decalcified enamel surfaces with bioactive glass air abrasion results in similar bond strength of composite resin in comparison with alumina air abrasion using etch-&-rinse or self-etch adhesives. PMID:25628694

Bariatric Embolization: Pilot Study on the Impact of Gastroprotective Agents and Arterial Distribution on Ulceration Risk and Efficacy in a Porcine Model.

PubMed

Paxton, Ben E; Arepally, Aravind; Alley, Christopher L; Kim, Charles Y

2016-12-01

To assess whether the number of fundal arteries embolized and use of gastroprotective agents have an impact on ghrelin suppression and gastric ulceration rates. Twenty-two healthy, growing swine (mean, 38.4 kg; range, 30.3-47.0 kg) were evaluated. Six control swine underwent a sham procedure. Gastric embolization was performed by the infusion of 40-µm microspheres selectively into some or all gastric arteries supplying the gastric fundus. In group 1, 6 swine underwent embolization of all 4 arteries to the gastric fundus. In group 2, 5 swine underwent embolization of 2 gastric fundal arteries. In group 3, 5 swine underwent embolization of 1 gastric fundal artery. Animals in groups 2 and 3 were treated with gastroprotective agents (sucralfate and omeprazole). Weight and fasting plasma ghrelin levels were analyzed at baseline and at week 4. Upon animal euthanasia, gross analysis was performed for identification of ulcers. Only group 1 animals exhibited changes in serum ghrelin levels that rendered them significantly lower than those in control animals (P = .049). Group 3 animals exhibited marked elevations in serum ghrelin levels compared with control animals (P = .001). Gross pathologic evaluation revealed 0 ulcers in the control animals, 3 ulcers (50%) in group 1, 2 ulcers (40%) in group 2, and 2 ulcers (40%) in group 3. Administration of gastroprotective agents and embolization of fewer arteries to the gastric fundus did not prevent gastric ulceration in treated animals. Only animals that underwent embolization of all gastric arteries exhibited significant decreases in serum ghrelin levels. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Sports Hernia Treatment

PubMed Central

Economopoulos, Kostas J.; Milewski, Matthew D.; Hanks, John B.; Hart, Joseph M.; Diduch, David R.

2013-01-01

Background: The minimal repair technique for sports hernias repairs only the weak area of the posterior abdominal wall along with decompressing the genitofemoral nerve. This technique has been shown to return athletes to competition rapidly. This study compares the clinical outcomes of the minimal repair technique with the traditional modified Bassini repair. Hypothesis: Athletes undergoing the minimal repair technique for a sports hernia would return to play more rapidly compared with athletes undergoing the traditional modified Bassini repair. Methods: A retrospective study of 28 patients who underwent sports hernia repair at the authors’ institution was performed. Fourteen patients underwent the modified Bassini repair, and a second group of 14 patients underwent the minimal repair technique. The 2 groups were compared with respect to time to return to sport, return to original level of competition, and clinical outcomes. Results: Patients in the minimal repair group returned to sports at a median of 5.6 weeks (range, 4-8 weeks), which was significantly faster compared with the modified Bassini repair group, with a median return of 25.8 weeks (range, 4-112 weeks; P = 0.002). Thirteen of 14 patients in the minimal repair group returned to sports at their previous level, while 9 of 14 patients in the Bassini group were able to return to their previous level of sport (P = 0.01). Two patients in each group had recurrent groin pain. One patient in the minimal repair group underwent revision hernia surgery for recurrent pain, while 1 patient in the Bassini group underwent hip arthroscopy for symptomatic hip pain. Conclusion: The minimal repair technique allows athletes with sports hernias to return to play faster than patients treated with the modified Bassini. PMID:24427419

A prospective randomized study comparing percutaneous nephrolithotomy under combined spinal-epidural anesthesia with percutaneous nephrolithotomy under general anesthesia.

PubMed

Singh, Vishwajeet; Sinha, Rahul Janak; Sankhwar, S N; Malik, Anita

2011-01-01

A prospective randomized study was executed to compare the surgical parameters and stone clearance in patients who underwent percutaneous nephrolithotomy (PNL) under combined spinal-epidural anesthesia (CSEA) versus those who underwent PNL under general anesthesia (GA). Between January 2008 to December 2009, 64 patients with renal calculi were randomized into 2 groups and evaluated for the purpose of this study. Group 1 consisted of patients who underwent PNL under CSEA and Group 2 consisted of patients who underwent PNL under GA. The operative time, stone clearance rate, visual pain analog score, mean analgesic dose and mean hospital stay were compared amongst other parameters. The difference between visual pain analog score after the operation and the dose of analgesic requirement was significant on statistical analysis between both groups. PNL under CSEA is as effective and safe as PNL under GA. Patients who undergo PNL under CESA require lesser analgesic dose and have a shorter hospital stay. Copyright © 2011 S. Karger AG, Basel.

Controlling memory impairment in elderly adults using virtual reality memory training: a randomized controlled pilot study.

PubMed

Optale, Gabriele; Urgesi, Cosimo; Busato, Valentina; Marin, Silvia; Piron, Lamberto; Priftis, Konstantinos; Gamberini, Luciano; Capodieci, Salvatore; Bordin, Adalberto

2010-05-01

Memory decline is a prevalent aspect of aging but may also be the first sign of cognitive pathology. Virtual reality (VR) using immersion and interaction may provide new approaches to the treatment of memory deficits in elderly individuals. The authors implemented a VR training intervention to try to lessen cognitive decline and improve memory functions. The authors randomly assigned 36 elderly residents of a rest care facility (median age 80 years) who were impaired on the Verbal Story Recall Test either to the experimental group (EG) or the control group (CG). The EG underwent 6 months of VR memory training (VRMT) that involved auditory stimulation and VR experiences in path finding. The initial training phase lasted 3 months (3 auditory and 3 VR sessions every 2 weeks), and there was a booster training phase during the following 3 months (1 auditory and 1 VR session per week). The CG underwent equivalent face-to-face training sessions using music therapy. Both groups participated in social and creative and assisted-mobility activities. Neuropsychological and functional evaluations were performed at baseline, after the initial training phase, and after the booster training phase. The EG showed significant improvements in memory tests, especially in long-term recall with an effect size of 0.7 and in several other aspects of cognition. In contrast, the CG showed progressive decline. The authors suggest that VRMT may improve memory function in elderly adults by enhancing focused attention.

Substitution urethroplasty for anterior urethral strictures: buccal versus lingual mucosal graft.

PubMed

Kumar, Abhay; Das, Suren K; Trivedi, Sameer; Dwivedi, Udai S; Singh, Pratap B

2010-01-01

To compare the results of substitution urethroplasty and donor site morbidity between buccal mucosal graft (BMG) and lingual mucosal graft (LMG). Patients who underwent single-stage dorsal onlay free oral mucosal graft substitution urethroplasty by Barbagli's technique between January 2004 and August 2008 were included in this study. Patients who underwent buccal (cheek, lip) mucosal graft urethroplasty were included in group I and those who underwent LMG urethroplasty (tongue) were included in group II. All patients underwent complete evaluation of the stricture including inspection of the oral cavity. Exclusion criteria were stricture length <3 cm and complex strictures which required a multistage procedure. The results of urethroplasty were similar in both groups in terms of blood loss, duration of postoperative hospitalization, complications encountered at urethroplasty site, mean postoperative Q(max) and mean postoperative AUA symptom score. Early slurring of speech complications was seen in group II, but not in group I. The long-term complications of persistent oral discomfort, perioral numbness and tightness of the mouth were seen only in group I. LMG urethroplasty is a good substitute for BMG urethroplasty with equally good results of urethroplasty with lower donor site morbidity. Copyright 2010 S. Karger AG, Basel.

Hospitalization for esophageal achalasia in the United States.

PubMed

Molena, Daniela; Mungo, Benedetto; Stem, Miloslawa; Lidor, Anne O

2015-09-25

To assess the outcome of different treatments in patients admitted for esophageal achalasia in the United States. This is a retrospective analysis using the Nationwide Inpatient Sample over an 8-year period (2003-2010). Patients admitted with a primary diagnosis of achalasia were divided into 3 groups based on their treatment: (1) Group 1: patients who underwent Heller myotomy during their hospital stay; (2) Group 2: patients who underwent esophagectomy; and (3) Group 3: patients not undergoing surgical treatment. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS), discharge destination and total hospital charges. Among 27141 patients admitted with achalasia, nearly half (48.5%) underwent Heller myotomy, 2.5% underwent esophagectomy and 49.0% had endoscopic or other treatment. Patients in group 1 were younger, healthier, and had the lowest mortality when compared with the other two groups. Group 2 had the highest LOS and hospital charges among all groups. Group 3 had the highest mortality (1.2%, P < 0.001) and the lowest home discharge rate (78.8%) when compared to the other groups. The most frequently performed procedures among group 3 were esophageal dilatation (25.9%) and injection (13.3%). Among patients who died in this group the most common associated morbidities included acute respiratory failure, sepsis and aspiration pneumonia. Surgery for achalasia carries exceedingly low mortality in the modern era; however, in complicated patients, even less invasive treatments are burdened by significant mortality and morbidity.

Hospitalization for esophageal achalasia in the United States

PubMed Central

Molena, Daniela; Mungo, Benedetto; Stem, Miloslawa; Lidor, Anne O

2015-01-01

AIM: To assess the outcome of different treatments in patients admitted for esophageal achalasia in the United States. METHODS: This is a retrospective analysis using the Nationwide Inpatient Sample over an 8-year period (2003-2010). Patients admitted with a primary diagnosis of achalasia were divided into 3 groups based on their treatment: (1) Group 1: patients who underwent Heller myotomy during their hospital stay; (2) Group 2: patients who underwent esophagectomy; and (3) Group 3: patients not undergoing surgical treatment. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS), discharge destination and total hospital charges. RESULTS: Among 27141 patients admitted with achalasia, nearly half (48.5%) underwent Heller myotomy, 2.5% underwent esophagectomy and 49.0% had endoscopic or other treatment. Patients in group 1 were younger, healthier, and had the lowest mortality when compared with the other two groups. Group 2 had the highest LOS and hospital charges among all groups. Group 3 had the highest mortality (1.2%, P < 0.001) and the lowest home discharge rate (78.8%) when compared to the other groups. The most frequently performed procedures among group 3 were esophageal dilatation (25.9%) and injection (13.3%). Among patients who died in this group the most common associated morbidities included acute respiratory failure, sepsis and aspiration pneumonia. CONCLUSION: Surgery for achalasia carries exceedingly low mortality in the modern era; however, in complicated patients, even less invasive treatments are burdened by significant mortality and morbidity. PMID:26421106

Effect of motivational group interviewing-based safety education on Workers' safety behaviors in glass manufacturing.

PubMed

Navidian, Ali; Rostami, Zahra; Rozbehani, Nasrin

2015-09-19

Worker safety education using models that identify and reinforce factors affecting behavior is essential. The present study aimed to determine the effect of safety education based on motivational interviewing on awareness of, attitudes toward, and engagement in worker safety in the glass production industry in Hamedan, Iran, in 2014. This was a quasi-experimental interventional study including a total of 70 production line workers at glass production facilities in Hamedan. The workers were randomly assigned to either an intervention or a control group, with 35 workers in each group. Participants in the control group received four one-hour safety education sessions, in the form of traditional lectures. Those in the intervention group received four educational sessions based on motivational group interviewing, which were conducted in four groups of eight to ten participants each. The instruments used included a researcher-developed questionnaire with checklists addressing safety awareness, and attitude and performance, which were completed before and 12 weeks after the intervention. The data were analyzed using descriptive statistics, independent and paired t-tests, and chi-squared tests. Having obtained the differences in scores before and after the intervention, we determined mean changes in the scores of awareness, attitude, and use of personal protective equipment among workers who underwent motivational group interviewing (3.74 ± 2.16, 1.71 ± 3.16, and 3.2 ± 1.92, respectively, p < 0.05). These scores were significantly greater than those of control workers who underwent traditional educational sessions (1.28 ± 1.93, 1.1 ± 3.07, and 0.2 ± 1.26, respectively). Our findings revealed that incorporation of motivational interviewing principles into safety education programs had the positive effect of enhancing workers' knowledge, attitude, and, particularly, implementation of safe behaviors. The application of this advisory approach is recommended to increase workplace safety and minimize occupational hazards in the work environment.

Modification of Fear Memory by Pharmacological and Behavioural Interventions during Reconsolidation.

PubMed

Thome, Janine; Koppe, Georgia; Hauschild, Sophie; Liebke, Lisa; Schmahl, Christian; Lis, Stefanie; Bohus, Martin

2016-01-01

Dysfunctional fear responses play a central role in many mental disorders. New insights in learning and memory suggest that pharmacological and behavioural interventions during the reconsolidation of reactivated fear memories may increase the efficacy of therapeutic interventions. It has been proposed that interventions applied during reconsolidation may modify the original fear memory, and thus prevent the spontaneous recovery and reinstatement of the fear response. We investigated whether pharmacological (propranolol) and behavioural (reappraisal, multisensory stimulation) interventions reduce fear memory, and prevent reinstatement of fear in comparison to a placebo control group. Eighty healthy female subjects underwent a differential fear conditioning procedure with three stimuli (CS). Two of these (CS+) were paired with an electric shock on day 1. On day 2, 20 subjects were pseudo-randomly assigned to either the propranolol or placebo condition, or underwent one of the two behavioural interventions after one of the two CS+ was reactivated. On day 3, all subjects underwent an extinction phase, followed by a reinstatement test. Dependent variables were US expectancy ratings, fear-potentiated startle, and skin conductance response. Differential fear responses to the reactivated and non-reactivated CS+ were observed only in the propranolol condition. Here, the non-reactivated CS+ evoked stronger fear-potentiated startle-responses compared to the placebo group. None of the interventions prevented the return of the extinguished fear response after re-exposure to the unconditioned stimulus. Our data are in line with an increasing body of research stating that the occurrence of reconsolidation may be constrained by boundary conditions such as subtle differences in experimental manipulations and instructions. In conclusion, our findings do not support a beneficial effect in using reconsolidation processes to enhance effects of psychotherapeutic interventions. This implies that more research is required before therapeutic interventions may benefit from a combination with reconsolidation processes.

Effect of Chelerythrine on Intestinal Cell Turnover following Intestinal Ischemia-Reperfusion Injury in a Rat Model.

PubMed

Sukhotnik, Igor; Bitterman, Sivan; Shahar, Yoav Ben; Pollak, Yulia; Bitterman, Nir; Halabi, Salim; Coran, Arnold G; Bitterman, Arie

2017-02-01

Background  Chelerythrine (CHE) is a benzophenanthridine alkaloid that is a potent, selective, and cell-permeable protein kinase C inhibitor. The purpose of the present study was to examine the effect of CHE on intestinal recovery and enterocyte turnover after intestinal ischemia-reperfusion (IR) injury in rats. Methods  Male Sprague-Dawley rats were divided into four experimental groups: (1) sham rats underwent laparotomy, (2) sham-CHE rats underwent laparotomy and were treated with intraperitoneal CHE; (3) IR-rats underwent occlusion of both superior mesenteric artery and portal vein for 30 minutes followed by 48 hours of reperfusion, and (4) IR-CHE rats underwent IR and were treated with intraperitoneal CHE immediately before abdominal closure. Intestinal structural changes, Park injury score, enterocyte proliferation, and enterocyte apoptosis were determined 24 hours following IR. The expression of Bax, Bcl-2, p-ERK, and caspase-3 in the intestinal mucosa was determined using real Western blot and immunohistochemistry. Results  Treatment with CHE resulted in a significant decrease in Park injury score in jejunum (threefold decrease) and ileum (twofold decrease), and parallel increase in mucosal weight in jejunum and ileum, villus height in jejunum and ileum, and crypt depth in ileum compared with IR animals. IR-CHE rats also experienced a significantly lower apoptotic index in jejunum and ileum, which was accompanied by a lower Bax/Bcl2 ratio compared with IR animals. Conclusions  Treatment with CHE inhibits programmed cell death and prevents intestinal mucosal damage following intestinal IR in a rat. Georg Thieme Verlag KG Stuttgart · New York.

Contralateral peripheral neurotization for a hemiplegic hindlimb after central neurological injury.

PubMed

Zheng, Mou-Xiong; Hua, Xu-Yun; Jiang, Su; Qiu, Yan-Qun; Shen, Yun-Dong; Xu, Wen-Dong

2018-01-01

OBJECTIVE Contralateral peripheral neurotization surgery has been successfully applied to rescue motor function of the hemiplegic upper extremity in patients with central neurological injury (CNI). It may contribute to strengthened neural pathways between the contralesional cortex and paretic limbs. However, the effect of this surgery in the lower extremities remains unknown. In the present study the authors explored the effectiveness and safety of contralateral peripheral neurotization in treating a hemiplegic lower extremity following CNI in adult rats. METHODS Controlled cortical impact (CCI) was performed on the hindlimb motor cortex of 36 adult Sprague-Dawley rats to create severe unilateral traumatic brain injury models. These CCI rats were randomly divided into 3 groups. At 1 month post-CCI, the experimental group (Group 1, 12 rats) underwent contralateral L-6 to L-6 transfer, 1 control group (Group 2, 12 rats) underwent bilateral L-6 nerve transection, and another control group (Group 3, 12 rats) underwent an L-6 laminectomy without injuring the L-6 nerves. Bilateral L-6 nerve transection rats without CCI (Group 4, 12 rats) and naïve rats (Group 5, 12 rats) were used as 2 additional control groups. Beam and ladder rung walking tests and CatWalk gait analysis were performed in each rat at baseline and at 0.5, 1, 2, 4, 6, 8, and 10 months to detect the skilled walking functions and gait parameters of both hindlimbs. Histological and electromyography studies were used at the final followup to verify establishment of the traumatic brain injury model and regeneration of the L6-L6 neural pathway. RESULTS In behavioral tests, comparable motor injury in the paretic hindlimbs was observed after CCI in Groups 1-3. Group 1 started to show significantly lower slip and error rates in the beam and ladder rung walking tests than Groups 2 and 3 at 6 months post-CCI (p < 0.05). In the CatWalk analysis, Group 1 also showed a higher mean intensity and swing speed after 8 months post-CCI and a longer stride length after 6 months post-CCI than Groups 2 and 3 (p < 0.05). Transection of L-6 resulted in transient skilled walking impairment in the intact hindlimbs in Groups 1 and 2 (compared with Group 3) and in the bilateral hindlimbs in Group 4 (compared with Group 5). All recovered to baseline level within 2 months. Histological study of the rat brains verified comparable injured volumes among Groups 1-3 at final examinations, and electromyography and toluidine blue staining indicated successful regeneration of the L6-L6 neural pathways in Group 1. CONCLUSIONS Contralateral L-6 neurotization could be a promising and safe surgical approach for improving motor recovery of the hemiplegic hindlimb after unilateral CNI in adult rats. Further investigations are needed before extrapolating the present conclusions to humans.

Effects of autogenic training on stress response and heart rate variability in nursing students.

PubMed

Lim, Seung-Joo; Kim, Chunmi

2014-12-01

This study was undertaken to confirm the effects of autogenic training (AT) on stress response and heart rate variability in nursing school students experiencing stress related to clinical training. The study was carried out from September 2012 to April 2013 in a quasi-experimental nonequivalent control group using a pretest-posttest design. The participants were 40 nursing students in their third year at either of two nursing colleges. All consented to participate. Nineteen nursing students at one college were assigned to the experimental group and underwent the 8-week AT program, and the other 21 were assigned to the control group and did not undergo any training. Stress response was assessed by questionnaire and HRV was measured three times, that is, before the program, at the end of the program, and 6 months after the end of the AT program. A significant time/group interaction was found for stress response (F = 4.68, p = .012), a subjective indicator. However, no significant interaction was found for the objective indicators of heart rate variability, normalized low frequency (F = 2.59, p = .090), normalized high frequency (F = 2.59, p = .090), or low frequency to high frequency ratio (F = 1.38, p = .257). The results suggest that AT provides an acceptable approach to stress reduction in nursing students. Copyright © 2014. Published by Elsevier B.V.

Chemoprevention of esophageal adenocarcinoma in a rat model by ursodeoxycholic acid.

PubMed

Ojima, Eisuke; Fujimura, Takashi; Oyama, Katsunobu; Tsukada, Tomoya; Kinoshita, Jun; Miyashita, Tomoharu; Tajima, Hidehiro; Fushida, Sachio; Harada, Shin-ichi; Mukaisho, Ken-ichi; Hattori, Takanori; Ohta, Tetsuo

2015-08-01

Reflux of bile acid into the esophagus induces esophagitis, inflammation-stimulated hyperplasia, metaplasia such as Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC). Caudal-type homeobox 2 (Cdx2) via nuclear factor (NF)-κB induced by bile acid is an important factor in the development of BE and EAC. In colorectal cancer, experimental data suggest a chemopreventive effect of ursodeoxycholic acid (UDCA). We hypothesized that UDCA may protect against the esophageal inflammation-metaplasia-carcinoma sequence by decreasing the overall proportion of the toxic bile acids. Wistar male rats that underwent a duodenoesophageal reflux procedure were divided into two groups. One group was given commercial chow (control group), and the other was given experimental chow containing UDCA (UDCA group). The animals were killed at 40 weeks after surgery, and their bile and esophagus were examined. In the UDCA group, the esophagitis was milder and the incidence of BE was significantly lower (p < 0.05) than in the control group, and EAC was not observed (p < 0.05). In analysis of the compartment of bile acid, UDCA was markedly increased in the UDCA group compared with the control group (32.7 ± 11.4 vs. 0.82 ± 0.33 mmol/L, p < 0.05) and cholic acid was decreased (32.7 ± 4.05 vs. 60.9 ± 8.26 mmol/L, p < 0.05). Expression intensity of Cdx2 and NF-κB was greater in the control group than in the UDCA group (p < 0.05). UDCA may be a chemopreventive agent against EAC by varying the bile acid composition.

Psychological stress-induced changes in salivary alpha-amylase and adrenergic activity.

PubMed

Kang, Younhee

2010-12-01

The aim of the study was to examine the relationships among salivary alpha-amylase, plasma catecholamines, blood pressure, and heart rate during psychological stress. This study used a pretest-post-test experimental design with a control group, using repeated measures. A total of 33 participants was divided into the experimental group (n = 16) that underwent a college academic final test as the psychological stress and the control group (n = 17) that did not undergo the test. The levels of salivary alpha-amylase and plasma catecholamines, blood pressure, and heart rate were measured seven times and stress and anxiety were measured once and twice, respectively, as subjective stress markers. Significant changes in the level of salivary alpha-amylase were found in response to psychological stress. However, the correlations of salivary alpha-amylase with the plasma catecholamines, blood pressure, and heart rate were only partially found to be statistically significant. In conclusion, it was shown that salivary alpha-amylase was sensitive to stress throughout this study. Thus, salivary alpha-amylase may be used to measure stress uninvasively in both clinical settings and nursing research where the effects of stress might be scrutinized. Furthermore, the mechanisms of illnesses that are induced by stress could be explored. © 2010 Blackwell Publishing Asia Pty Ltd.

Documenting laryngeal change following prolonged loud reading. A videostroboscopic study.

PubMed

Gelfer, M P; Andrews, M L; Schmidt, C P

1996-12-01

This study investigated the effects of prolonged loud reading on trained and untrained subjects. Subjects were eight young women singers, and eight young women with limited musical experience. Each subject underwent videostroboscopic examination prior to and following 1 h of prolonged loud reading. The pretest and posttest videotaped samples were randomized and presented to three experienced judges, who evaluated various aspects of laryngeal appearance and vibratory characteristics. Analyses of group data revealed that untrained subjects showed a small but significant increase in amplitude of vocal fold excursion following the experimental task. No significant differences were noted in the trained singer group. When individual variation was analyzed, it was found that most subjects did not show many changes from pretest to posttest. It was concluded that a l-h loud-reading task was not sufficient to induce notable laryngeal alterations.

S-1 and irinotecan plus bevacizumab versus mFOLFOX6 or CapeOX plus bevacizumab as first-line treatment in patients with metastatic colorectal cancer (TRICOLORE): a randomized, open-label, phase III, noninferiority trial.

PubMed

Yamada, Y; Denda, T; Gamoh, M; Iwanaga, I; Yuki, S; Shimodaira, H; Nakamura, M; Yamaguchi, T; Ohori, H; Kobayashi, K; Tsuda, M; Kobayashi, Y; Miyamoto, Y; Kotake, M; Shimada, K; Sato, A; Morita, S; Takahashi, S; Komatsu, Y; Ishioka, C

2018-03-01

Combination therapy with oral fluoropyrimidine and irinotecan has not yet been established as first-line treatment of metastatic colorectal cancer (mCRC). We carried out a randomized, open-label, phase III trial to determine whether S-1 and irinotecan plus bevacizumab is noninferior to mFOLFOX6 or CapeOX plus bevacizumab in terms of progression-free survival (PFS). Patients from 53 institutions who had previously untreated mCRC were randomly assigned (1 : 1) to receive either mFOLFOX6 or CapeOX plus bevacizumab (control group) or S-1 and irinotecan plus bevacizumab (experimental group; a 3-week regimen: intravenous infusions of irinotecan 150 mg/m2 and bevacizumab 7.5 mg/kg on day 1, oral S-1 80 mg/m2 twice daily for 2 weeks, followed by a 1-week rest; or a 4-week regimen: irinotecan 100 mg/m2 and bevacizumab 5 mg/kg on days 1 and 15, S-1 80 mg/m2 twice daily for 2 weeks, followed by a 2-week rest). The primary end point was PFS. The noninferiority margin was 1.25; noninferiority would be established if the upper limit of the 95% confidence interval (CI) for the hazard ratio (HR) of the control group versus the experimental group was less than this margin. Between June 2012 and September 2014, 487 patients underwent randomization. Two hundred and forty-three patients assigned to the control group and 241 assigned to the experimental group were included in the primary analysis. Median PFS was 10.8 months (95% CI 9.6-11.6) in the control group and 14.0 months (95% CI 12.4-15.5) in the experimental group (HR 0.84, 95% CI 0.70-1.02; P < 0.0001 for noninferiority, P = 0.0815 for superiority). One hundred and fifty-seven patients (64.9%) in the control group and 140 (58.6%) in the experimental group had adverse events of grade 3 or higher. S-1 and irinotecan plus bevacizumab is noninferior to mFOLFOX6 or CapeOX plus bevacizumab with respect to PFS as first-line treatment of mCRC and could be a new standard treatment. UMIN000007834.

Structural Analysis of Enamel in Teeth from Head-and-Neck Cancer Patients Who Underwent Radiotherapy.

PubMed

Madrid, Cristhian C; de Pauli Paglioni, Mariana; Line, Sergio R; Vasconcelos, Karina G; Brandão, Thaís Bianca; Lopes, Marcio A; Santos-Silva, Alan Roger; De Goes, Mario Fernando

2017-01-01

To analyze macroscopic, microscopic, and ultrastructural aspects of enamel from head-and-neck cancer patients submitted to radiotherapy. Twenty sound extracted permanent molars were used and divided into 2 groups. The experimental group consisted of 10 molars from head-and-neck cancer patients submitted to radiotherapy with total doses that ranged from 50 to 70 Gy. Ten molars from patients who did not receive radiotherapy were matched with experimental-group samples by anatomic tooth group and comprised the control group. To perform a macroscopic analysis, standardized photos of different enamel faces were taken with a camera. Teeth were subjected to longitudinal cuts and hand polished to a final thickness of 0.1 mm. Enamel was analyzed under polarized light microscopy, and optical retardation values of birefringence were calculated in cervical, cusp, and occlusal pit areas. Subsequently, the same enamel areas were analyzed by scanning electron microscopy. Data from optical retardation values were statistically analyzed by 2-way ANOVA and Fisher's test (α < 0.05). No macroscopic differences were observed between the irradiated and control groups. Polarized light microscopy analysis revealed that cervical enamel exhibited darker areas characterized by discrete birefringence patterns compared to the control enamel. Optical retardation values were only significantly different in the cervical enamel of the irradiated and control groups (p < 0.0001). Scanning electron microscopy analysis revealed more evident interprismatic spaces in the cervical and outer cusp enamel of irradiated samples. Head-and-neck radiotherapy reduced optical retardation values of birefringence in cervical enamel, and the interprismatic spaces became more evident. © 2017 S. Karger AG, Basel.

The effectiveness and safety of combining laser-assisted liposuction and abdominoplasty.

PubMed

Aboelatta, Yasser Abdallah; Abdelaal, Mohammed Mahmoud; Bersy, Nada Abdelsatar

2014-02-01

Lipoabdominoplasty is nearly a daily aesthetic procedure. Despite the emergence of laser-assisted liposuction, to date, it has not been clearly evaluated combined with abdominoplasty. This prospective study aimed to evaluate the effectiveness and safety of laser-assisted liposuction relative to traditional liposuction combined with high-lateral-tension abdominoplasty. This study investigated 36 consecutive female patients who underwent high-lateral-tension abdominoplasty combined with liposuction of the upper central abdomen and both flanks. The patients were divided into three equal groups based on the technique used for liposuction. Group 1 underwent conventional liposuction with abdominoplasty. Group 2 underwent a mixture of conventional and laser-assisted liposuction with abdominoplasty. Group 3 underwent laser-assisted liposuction with abdominoplasty. The patients in groups 2 and 3 had a better aesthetic outcome than those in group 1 with regard to abdominal contour and skin tightness. No major complications were observed in groups 1 and 2. The patients in group 3 had a higher incidence of complications (3 seromas, 3 central necroses and dehiscence), and one patient underwent secondary sutures. Laser-assisted liposuction combined with abdominoplasty in the lateral abdomen seems to be a safe technique with good aesthetic outcomes. Although the combined use of laser-assisted liposuction in the lateral and central abdomen can achieve relatively better aesthetic results, it is associated with significant complications, and its use cannot be supported. Proper laser parameters in the central abdominal area still need further study. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Immunomodulatory Strategies Directed Towards Tolerance of Vascularized Composite Allografts

PubMed Central

Michel, Sebastian G.; Villani, Vincenzo; Muraglia, Glenn M. La; Torabi, Radbeh; Leonard, David A.; Randolph, Mark A.; Colvin, Robert B.; Yamada, Kazuhiko; Madsen, Joren C.; Cetrulo, Curtis L.; Sachs, David H.

2015-01-01

Background Achieving tolerance of vascularized composite allografts (VCAs) would improve the risk-to-benefit ratio in patients who undergo this life-enhancing, though not life-saving, transplant. Kidney co-transplantation along with a short course of high-dose immunosuppression enables tolerance of heart allografts across a full MHC mismatch. In this study, we investigated whether tolerance of VCA across full MHC disparities could be achieved in animals already tolerant of heart and kidney allografts. Methods Miniature swine that were tolerant of heart and/or kidney allografts long-term underwent transplantation of myocutaneous VCA across the same MHC barrier. Prior to VCA transplant, Group 1 (n=3) underwent Class I-mismatched kidney transplantation; Group 2 (n=3) underwent two sequential Class I-mismatched kidney transplantations; Group 3 (n=2) underwent haploidentical MHC-mismatched heart/kidney transplantation; and Group 4 (n=2) underwent full MHC-mismatched heart/kidney transplantation. Results All three animals in Group 1 and two of three animals in Group 2 showed skin rejection ≤85 days; one animal in Group 2 showed prolonged skin survival >200 days. Animals in Groups 3 and 4 showed skin rejection ≤30 days and regained in vitro evidence of donor responsiveness. Conclusion This is the first pre-clinical study in which hearts, kidneys, and VCAs have been transplanted into the same recipient. Despite VCA rejection, tolerance of heart and kidney allografts was maintained. These results suggest that regulatory tolerance of skin is possible but not generally achieved by the same level of immunomodulation that is capable of inducing tolerance of heart and kidney allografts. Achieving tolerance of skin may require additional immunomodulatory therapies. PMID:25757218

Strengthening the afferent limb of rapid response systems: an educational intervention using web-based learning for early recognition and responding to deteriorating patients.

PubMed

Liaw, Sok Ying; Wong, Lai Fun; Ang, Sophia Bee Leng; Ho, Jasmine Tze Yin; Siau, Chiang; Ang, Emily Neo Kim

2016-06-01

The timely recognition and response to patients with clinical deteriorations constitute the afferent limb failure of a rapid response system (RRS). This area is a persistent problem in acute healthcare settings worldwide. In this study, we evaluated the effect of an educational programme on improving the nurses' knowledge and performances in recognising and responding to clinical deterioration. The interactive web-based programme addressed three areas: (1) early detection of changes in vital signs; (2) performance of nursing assessment and interventions using airway, breathing, circulation, disability and expose/examine and (3) reporting clinical deterioration using identity, situation, background, assessment and recommendation. Sixty-seven registered nurses participated in the randomised control study. The experimental group underwent a 3 h programme while the control group received no intervention. Pretests and post-tests, a mannequin-based assessment and a multiple-choice knowledge questionnaire were conducted. We evaluated the participants' performances in assessing, managing and reporting the deterioration of a patient using a validated performance tool. A significantly higher number of nurses from the experimental group than the control group monitored respiratory rates (48.2% vs 25%, p<0.05) and pulse rates (74.3% vs 37.5%, p<0.01) in the simulated environment, after the intervention. The post-test mean scores of the experimental group was significantly higher than the control group for knowledge (21.29 vs 18.28, p<0.001), performance in assessing and managing clinical deterioration (25.83 vs 19.50, p<0.001) and reporting clinical deterioration (12.83 vs 10.97, p<0.001). A web-based educational programme developed for hospital nurses to strengthen the afferent limb of the RRS significantly increased their knowledge and performances in assessing, managing and reporting clinical deterioration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effects of nandrolone decanoate on time to consolidation of bone defects resulting from osteotomy for tibial tuberosity advancement.

PubMed

Marques, Danilo R C; Marques, Danilo; Ibanez, Jose F; Freitas, Itallo B; Hespanha, Ana C; Monteiro, Juliana F; Eggert, Mayara; Becker, Amanda

2017-09-12

Experimental study. The aim of this study was to evaluate the effect of nandrolone decanoate (ND) on the time taken for bone consolidation in dogs undergoing tibial tuberosity advancement surgery (TTA). Seventeen dogs that underwent TTA surgery were randomly divided into two groups: group C (TTA; 9 stifles), and group TTA+ND (TTA and systemic administration of ND; 8 stifles). Three observers (two radiologists and an orthopaedic surgeon), assessed bone consolidation by visual inspection of serial radiographs at intervals of 21 days following surgery. There were no differences in median weight and age between groups, nor between the medians of the variables right and left stifle. Only weight and age values were normally distributed. The other variables, right and left stifle and time to consolidation, showed non-normal distribution. Meniscal injury was present in all animals in group C and all animals in group TTA+ND. There was a significant difference between time to consolidation in groups C and TTA+ND (p <0.05). One animal in the group TTA+ND showed increased libido. Kappa agreement among observers on radiographs was 0.87. Administration of ND reduces time to bone consolidation in dogs undergoing TTA.

Iodine-125 Seeds Strand for Treatment of Tumor Thrombus in Inferior Vena Cava: An Experimental Study in a Rabbit Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Wen, E-mail: wenzhangxiao@126.com; Yan, Zhiping, E-mail: Yan.zhiping@zs-hospital.sh.cn; Luo, Jianjun, E-mail: luo.jianjun@zs-hospital.sh.cn

Objective: The purpose of this study was to establish an animal model of implanted inferior vena cava tumor thrombus (IVCTT) and to evaluate the effect of linear iodine-125 seeds strand in treating implanted IVCTT. Methods: Tumor cell line VX{sub 2} was inoculated subcutaneously into New Zealand rabbit to develop the parent tumor. The tumor strip was inoculated into inferior vena cava (IVC) to establish the IVCTT model. The IVCTT was confirmed by multidetector computed tomography (MDCT) after 2 weeks. Twelve rabbits with IVCTT were randomly divided into two groups. Treatment group (group T; n = 6) underwent Iodine-125 seeds brachytherapy,more » and the control group (group C; n = 6) underwent blank seeds strand. The blood laboratory examination (including blood routine examination, hepatic and renal function), body weight, survival time, and IVCTT volume by MDCT were monitored. All rabbits were dissected postmortem, and the therapeutic effects were evaluated on the basis of histopathology. The proliferating cell nuclear antigen index (PI) and apoptosis index (AI) of IVCTT were compared between two groups. T test, Wilcoxon rank test, and Kaplan-Meier survival curve analysis were used. Results: The success rate of establishing IVCTT was 100 %. The body weight loss and cachexia of rabbits in group C appeared earlier than in group T. Body weight in the third week, the mean survival time, PI, AI in groups T and C were 2.23 {+-} 0.12 kg, 57.83 {+-} 8.68 days, (16.73 {+-} 5.18 %), (29.47 {+-} 7.18 %), and 2.03 {+-} 0.13 kg, 43.67 {+-} 5.28 days, (63.01 {+-} 2.01 %), (6.02 {+-} 2.93 %), respectively. There were statistically significant differences between group T and group C (P < 0.05). The IVCTT volume of group T was remarkably smaller than that of group C. Conclusions: Injecting and suspensory fixing VX2 tumor strip into IVC is a reliable method to establish IVCTT animal model. The linear Iodine-125 seeds strand brachytherapy was a safe and effective method for treating IVCTT in rabbit model.« less

Enhancing the placebo response: fMRI Evidence of Memory and Semantic Processing in Placebo Analgesia

PubMed Central

Craggs, Jason G.; Price, Donald D.; Robinson, Michael E.

2014-01-01

Two groups of patients with irritable bowel syndrome (IBS) rated pain and underwent fMRI brain scanning during experimentally induced rectal distension (20 sec, 7 stimuli). Group #1 was tested under baseline (natural history) and a verbally induced placebo condition, whereas Group #2 was tested under baseline, and standard placebo (no verbal suggestion for pain reduction) and intrarectal lidocaine conditions. As hypothesized, intrarectal lidocaine reduced evoked pain and pain-related brain activity within Group #2Between-group comparisons showed that adding a verbal suggestion to a placebo condition increased neural activity involved in memory and semantic processing, areas that process the placebo suggestions. These areas, in turn, are likely to influence brain areas involved in emotions and analgesia and consequently the placebo effect. These placebo suggestions also added significant decreases in activity of brain areas that process pain. The test stimulus itself seems to cue these effects and is consistent with previous explanations that somatic focus and sensory feedback reinforce expectations and other factors that mediate placebo analgesic effects. PMID:24412799

Moving Forward in Fall Prevention: An Intervention to Improve Balance Among Older Adults in Real-World Settings

PubMed Central

Robitaille, Yvonne; Laforest, Sophie; Fournier, Michel; Gauvin, Lise; Parisien, Manon; Corriveau, Hélène; Trickey, Francine; Damestoy, Nicole

2005-01-01

Objectives. We investigated the effectiveness of a group-based exercise intervention to improve balancing ability among older adults delivered in natural settings by staff in local community organizations. Methods. The main component of the intervention consisted of biweekly group-based exercise sessions conducted over 12 weeks by a professional, coupled with home-based exercises. In a quasiexperimental design, 10 community organizations working with older adults offered the intervention to groups of 5 to 15 persons concerned about falls, while 7 organizations recruited similar groups to participate in the control arm of the study. Participants (98 experimental and 102 control) underwent balance assessments by a physiotherapist at registration and 3 months later. Results. Eighty-nine percent of participants attended the 3-month measurement session (n=177). A linear regression analysis showed that after adjusting for baseline levels of balance and demographic and health characteristics, the intervention significantly improved static balance and mobility. Conclusion. Structured, group-based exercise programs offered by community organizations in natural settings can successfully increase balancing ability among community-dwelling older adults concerned about falls. PMID:16195514

Mindfulness and the attenuation of post-event processing in social phobia: an experimental investigation.

PubMed

Cassin, Stephanie E; Rector, Neil A

2011-01-01

The present experimental study examined the ability of metacognitive strategies to reduce the distress associated with post-event processing (PEP). Individuals with DSM-IV generalized social phobia (N = 57) were randomly allocated to receive brief training in mindfulness, distraction, or no training (control group). Next, they underwent an experimental PEP induction. Following the induction, they were instructed to apply the metacognitive strategy (mindfulness or distraction) they were taught or to continue thinking about the social event the way they typically would following such an event (control). Participants rated their distress on a visual analogue scale prior to the PEP induction, and then every minute for 5 min while applying the metacognitive strategy. They also rated their affect immediately after applying the metacognitive strategy. Results suggest that mindfulness reduces distress significantly over the post-event period and results in significantly more positive affect than when receiving no training. In contrast, distraction does not reduce distress over the post-event period performs comparable to receiving no training. The results of this experimental investigation suggest that mindfulness has the potential to reduce distress associated with PEP and provide further support for the clinical utility of mindfulness in the treatment of generalized social phobia.

Effects of pinealectomy and melatonin supplementation on endometrial explants in a rat model.

PubMed

Koc, Onder; Gunduz, Bülent; Topcuoglu, Ata; Bugdayci, Güler; Yilmaz, Fahri; Duran, Bülent

2010-11-01

To determine the effects of pinealectomy on endometrial explants in rats and evaluate the activity of superoxide dismutase (SOD) and catalase (CAT) and the levels of malondialdehyde (MDA) in the rat endometriosis model. Rats with experimentally induced endometriosis were randomly divided into three groups after second-look laparotomies. Group 1 (pinealectomy, n = 8) and Group 2 (pinealectomy+melatonin, n = 8) underwent pinealectomies after the second-look laparotomies. Group 3 was presented as control group (vehicle solution+without pinealectomy (n = 6)). Melatonin was administered intraperitoneally for 4 weeks in Group 2, whereas an equal volume of vehicle solution was given to Groups 1 and 3. Evaluation of the volume of the endometrial explants, histopathological examination and preservation of explant epitheliums according to the scoring system were undertaken. There was a statistically significant increase in spherical explant volumes of Group 1 compared to Groups 2 and 3. In Group 1, the level of MDA was significantly higher and SOD and CAT activity was significantly lower compared to Groups 2 and 3. A statistically significant increase in the epithelial lining scores of explants was noted in Group 1 compared to Groups 2 and 3. The effects of pinealectomy on the progression of endometriosis explants were reversed by melatonin. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Occurrence of fat embolism after liposuction surgery with or without lipografting: an experimental study.

PubMed

Franco, Fernando F; Tincani, Alfio J; Meirelles, Luciana R; Kharmandayan, Paulo; Guidi, Marcelo C

2011-08-01

Liposuction in plastic surgery consists of the removal of excess fatty tissue in healthy individuals. In recent decades, this procedure has become more common worldwide. Associated with liposuction, lipografting has also been used for improving body contours, and has become known as liposculpture. Liposuction sometimes causes complications, including fat embolism, as described in the medical literature. The present study aims at ascertaining whether there is intravascular mobilization of fat after mechanical liposuction surgery and/or fat graft when carried out using one of the most common specific procedures used for liposuction, the superwet technique. A total of 30 Wistar rats were included in this study. Before the surgery, the animals were placed in the supine position and anesthetized with thiopental for 50 to 60 minutes, as it is generally performed in clinical practice. The animals were divided in the following 3 groups. Group A, consisting of 10 rats, served as controls, and were only anesthetized. Group B consisted of 10 rats, which underwent only liposuction. Group C also comprised 10 rats, which were liposuctioned and then lipografted in the dorsal region. Blood was collected just before and again, 48 hours after the procedure. After 48 hours, the animals were killed, and the lungs, kidneys, liver, and brain were histologically examined. All the collected samples were analyzed microscopically with 2 different stains, namely, hematoxylin and eosin, and Sudan black. Fat particles were found in the lungs of 3 animals in group B (those that underwent only liposuction) and in 6 animals of group C (liposuction and lipografting). No fat particles were found in any organ of the control group. With this experiment, the authors showed that there is a risk of systemic mobilization of fat after liposuction surgery and that this risk is even higher when fat grafts are also carried out.

Calcified neurocysticercosis lesions and antiepileptic drug-resistant epilepsy: a surgically remediable syndrome?

PubMed

Rathore, Chaturbhuj; Thomas, Bejoy; Kesavadas, Chandrasekharan; Abraham, Mathew; Radhakrishnan, Kurupath

2013-10-01

In contrast to the well-recognized association between acute symptomatic seizures and neurocysticercosis, the association between antiepileptic drug (AED)-resistant epilepsy and calcified neurocysticercosis lesions (CNLs) is poorly understood. We studied the association between AED-resistant epilepsy and CNLs, including the feasibility and outcome of resective surgery. From the prospective database maintained at our epilepsy center, we reviewed the data of all patients with AED-resistant epilepsy who underwent presurgical evaluation from January 2001 to July 2010 and had CNL on imaging. We used clinical, neuroimaging, and interictal, ictal, and intracranial electroencephalography (EEG) findings to determine the association between CNL and epilepsy. Suitable candidates underwent resective surgery. Forty-five patients fulfilled the inclusion criteria. In 17 patients, CNL was proven to be the causative lesion for AED-resistant epilepsy (group 1); in 18 patients, CNL was associated with unilateral hippocampal sclerosis (HS; group 2); and in 10 patients, CNLs were considered as incidental lesions (group 3). In group 1 patients, CNLs were more common in frontal lobes (12/17), whereas in group 2 patients, CNLs were more commonly located in temporal lobes (11/18; p = 0.002). Group 2 patients were of a younger age at epilepsy onset than those in group 1 (8.9 ± 7.3 vs. 12.6 ± 6.8 years, p = 0.003). Perilesional gliosis was more common among patients in group 1 when compared to group 3 patients (12/17 vs. 1/10; p = 0.006). Fifteen patients underwent resective surgery. Among group 1 patients, four of five became seizure-free following lesionectomy alone. In group 2, four patients underwent anterior temporal lobectomy (ATL) alone, of whom one became seizure-free; five underwent ATL combined with removal of CNL (two of them after intracranial EEG and all of them became seizure-free, whereas one patient underwent lesionectomy alone and did not become seizure-free. In endemic regions, although rare, CNLs are potential cause for AED-resistant and surgically remediable epilepsy, as well as dual pathology. Presence of perilesional gliosis contributes to epileptogenicity of these lesions. For those patients with CNL and HS, resection of both lesions favors better chance of seizure-free outcome. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Dexamethasone in unexplained infertility.

PubMed

Moradan, Sanam; Ghorbani, Raheb

2009-08-01

To determine if dexamethasone could be a suitable option in the treatment of patients with unexplained infertility. This study was carried out in the Obstetrics Department of Amir University Hospital, Semnan, Iran, from April 2001 to May 2008. One hundred and twenty-four cases of unexplained infertility that underwent ovulation induction and intrauterine insemination (IUI) (only one cycle) were evaluated, and divided into 2 groups. Sixteen cases were excluded, as they were unresponsive to the induction ovulation regimen. Group I (n=42) received clomiphene citrate (CC) + dexamethasone, and the control group (group II, n=66) received CC alone. These groups were the same in age, duration of infertility, and body mass index. The clinical pregnancy rates were evaluated in 2 groups by using statistical tests. The clinical pregnancy rate was 21.4% in group I, and 4.5% in group II. There was a significant statistical difference between the groups (relative risk=4.71, 95% confidence interval=1.35-16.42, p=0.0085). The pregnancy rate in women with unexplained infertility that underwent ovulation induction with CC + dexamethasone + IUI was significantly higher than those who underwent ovulation induction with CC alone + IUI.

Radiofrequency-induced heating versus mechanical stapler for pancreatic stump closure: in vivo comparative study.

PubMed

Burdío, Fernando; Dorcaratto, Dimitri; Hernandez, Lourdes; Andaluz, Anna; Moll, Xavier; Quesada, Rita; Poves, Ignasi; Grande, Luis; Cáceres, Marta; Berjano, Enrique

2016-05-01

The aim of this study was to assess the capacity of two methods of surgical pancreatic stump closure in terms of reducing the risk of pancreatic fistula formation (POPF): radiofrequency-induced heating versus mechanical stapler. Sixteen pigs underwent a laparoscopic transection of the neck of the pancreas. Pancreatic anastomosis was always avoided in order to work with an experimental model prone to POPF. Pancreatic stump closure was conducted either by stapler (ST group, n = 8) or radiofrequency energy (RF group, n = 8). Both groups were compared for incidence of POPF and histopathological alterations of the pancreatic remnant. Six animals (75%) in the ST group and one (14%) in the RF group were diagnosed with POPF (p = 0.019). One animal in the RF group and three animals in the ST group had a pseudocyst in close contact with both pancreas stumps. On day 30 post-operation (PO), almost complete atrophy of the exocrine distal pancreas was observed when the main pancreatic duct was efficiently sealed. Our findings suggest that RF-induced heating is more effective at closing the pancreatic stump than mechanical stapler and leads to the complete atrophy of the distal remnant pancreas.

Stabilization of multiple rib fractures in a canine model.

PubMed

Huang, Ke-Nan; Xu, Zhi-Fei; Sun, Ju-Xian; Ding, Xin-Yu; Wu, Bin; Li, Wei; Qin, Xiong; Tang, Hua

2014-12-01

Operative stabilization is frequently used in the clinical treatment of multiple rib fractures (MRF); however, no ideal material exists for use in this fixation. This study investigates a newly developed biodegradable plate system for the stabilization of MRF. Silk fiber-reinforced polycaprolactone (SF/PCL) plates were developed for rib fracture stabilization and studied using a canine flail chest model. Adult mongrel dogs were divided into three groups: one group received the SF/PCL plates, one group received standard clinical steel plates, and the final group did not undergo operative fracture stabilization (n = 6 for each group). Radiographic, mechanical, and histologic examination was performed to evaluate the effectiveness of the biodegradable material for the stabilization of the rib fractures. No nonunion and no infections were found when using SF-PCL plates. The fracture sites collapsed in the untreated control group, leading to obvious chest wall deformity not encountered in the two groups that underwent operative stabilization. Our experimental study shows that the SF/PCL plate has the biocompatibility and mechanical strength suitable for fixation of MRF and is potentially ideal for the treatment of these injuries. Copyright © 2014 Elsevier Inc. All rights reserved.

Decontamination methods using a dental water jet and dental floss for microthreaded implant fixtures in regenerative periimplantitis treatment.

PubMed

Park, Shin-Young; Kim, Kyoung-Hwa; Shin, Seung-Yun; Koo, Ki-Tae; Lee, Yong-Moo; Chung, Chong-Pyoung; Seol, Yang-Jo

2015-06-01

This study evaluated decontamination methods using a dental water jet and dental floss on microthreaded implants for regenerative periimplantitis therapy. In 6 beagle dogs, experimental periimplantitis was induced, and decontamination procedures, including manual saline irrigation (control group), saline irrigation using a dental water jet (group 1) and saline irrigation using a dental water jet with dental flossing (group 2), were performed. After in situ decontamination procedures, some of the implant fixtures (n = 4 per group) were retrieved for analysis by SEM, whereas other fixtures (n = 4 per group) underwent regenerative therapy. After 3 months of healing, the animals were killed. The SEM examination indicated that decontamination of the implant surfaces was the most effective in group 2, with no changes in implant surface morphology. The histological examination also revealed that group 2 achieved significantly greater amounts of newly formed bone (6.75 ± 2.19 mm; P = 0.018), reosseointegration (1.88 ± 1.79 mm; P = 0.038), and vertical bone fill (26.69 ± 18.42%; P = 0.039). Decontamination using a dental water jet and dental floss on microthreaded implants showed positive mechanical debridement effects and positive bone regeneration effects.

Results and complications of adolescent varicocele repair with intraoperative sodium morrhuate sclerotherapy.

PubMed

Lebed, Brett; Packer, Michael; Husmann, Douglas; Zaontz, Mark

2008-10-01

Adolescent varicocele has been shown to affect spermatogenesis and correlate with decreased ipsilateral testicular volume, prompting treatment in a select population. We report our experience with 3 varicocele ligation procedures in concordance with sclerotherapy in adolescent patients. A total of 120 males underwent varicocele surgery at our institutions during an 8-year period. Sodium morrhuate sclerotherapy was used in 91 patients and 73 adolescent males fulfilled the 6-month followup criteria. The 73 males who were 9 to 17 years old underwent a total of 75 (bilateral in 2) procedures for varicocele treatment. Of the patients 23 underwent subinguinal microscopic varicocelectomy (group 1), 9 underwent loupe assisted subinguinal varicocelectomy (group 2) and 41 underwent loupe assisted inguinal varicocelectomy (group 3). All patients received intraoperative sclerotherapy using sodium morrhuate injection. Outcome measures included recurrence, complications and catch-up growth at a minimum of 6 months of followup. The varicocele recurrence rate was 2.7% in patients receiving combined surgical ligation and sclerotherapy ablation. Group 1 had 2 recurrent varicoceles and no hydrocele formation, group 2 had no varicocele recurrence and no hydrocele formation, and group 3 had no varicocele recurrence and 2 postoperative hydroceles. Catch-up growth in the ipsilateral testis was seen in 85% of patients. No atrophy or testicular loss was noted. This preliminary experience with combined surgical ligation and sclerotherapy ablation in the adolescent population resulted in low varicocele recurrence with minimal morbidity. Outcomes of loupe assisted varicocelectomy appear to be improved compared to those in previous studies, alluding to an advantage in the addition of sclerotherapy.

Secondary glaucoma after pediatric cataract surgery

PubMed Central

Şahin, Alparslan; Çaça, Ihsan; Cingü, Abdullah Kürşat; Türkcü, Fatih Mehmet; Yüksel, Harun; Şahin, Muhammed; Çinar, Yasin; Ari, Şeyhmus

2013-01-01

AIM To determine the incidence and risk factors of secondary glaucoma after pediatric cataract surgery. METHODS Two hundred and forty nine eyes of 148 patients underwent cataract surgery without intraocular lens (IOL) implantation (group 1), and 220 eyes of 129 patients underwent cataract surgery with IOL implantation (group 2) retrospectively, were evaluated between 2000 and 2011. The outcome measure was the presence or absence of post-cataract surgery glaucoma, defined as an intraocular pressure (IOP) ≥26mmHg, as measured on at least two occasions along with corneal or optic nerve changes. RESULTS The mean follow-up periods of group 1 and 2 were (60.86±30.95) months (12-123 months) and (62.11±31.29) months (14-115 months) respectively. In group 1, 12 eyes of 8 patients (4.8%) developed glaucoma. None of the patients developed glaucoma after surgery in group 2. The mean age of the patients at the cataract surgery was (2.58±0.90) months (1 month-4 months) and the average period for glaucoma development after surgery was (9.50±4.33) months (4-16 months) in group 1. Three of the 12 glaucomatous eyes were controlled with antiglaucomatous medication and 9 eyes underwent trabeculectomy+mitomycin C surgery. One patient underwent a second trabeculectomy + mitomycin C operation for both of his eyes. CONCLUSION The incidence of glaucoma after pediatric cataract surgery is very low in patients in whom IOL is implanted. The aphakic eyes after pediatric cataract surgery are at an increased risk for glaucoma development particularly if they underwent surgery before 4 months of age. PMID:23638427

Effects of topical nasal steroids and diclofenac on the nasal mucosa during hyperbaric oxygen therapy: a double-blind experimental study.

PubMed

Vuralkan, Erkan; Cobanoglu, Hatice Bengu; Arslan, Abdullah; Arslan, Selcuk; Mungan, Sevdegul; Tatar, Selcuk; Toklu, Akın Savas

2014-08-01

We aimed to evaluate nasal mucosal changes and efficiency of nasal steroids and diclofenac on nasal mucosa during hyperbaric oxygen (HBO) treatment. Forty adult Albino-Wistar rats were randomized into four groups. Group 1 (control group) (n = 10) not exposed to hyperbaric or enhanced oxygen concentrations; group 2 (HBO group) (n = 10) underwent only HBO treatment; group 3 (n = 10) received HBO and intranasal mometasone furoate (10 μl/day); group 4 (n = 10) treated with HBO and diclofenac sodium (10 mg/kg/day ip). Specimens of nasal mucosa were collected after sacrificing and dissection of animals. The specimens were processed for light microscopic evaluation, and then evaluated histopathologically for fibroblastic proliferation and inflammation. Regarding the scores of inflammation, the level of inflammation in the control group was significantly less severe than the other groups (p < 0.05). Evaluation of the fibrosis scores showed that the scores of both groups 2 and 4 were significantly increased (p < 0.05). There were no statistically significant differences between groups 2, 3, and 4 as for fibrosis and inflammation (p > 0.05). Chronic HBO treatment induced mild inflammation of the nasal mucosa. These effects cannot be prevented adequately by administration of nasal steroids and diclofenac.

Impact of Polypharmacy on Adherence to Evidence-Based Medication in Patients who Underwent Percutaneous Coronary Intervention.

PubMed

Mohammed, Shaban; Arabi, Abdulrahaman; El-Menyar, Ayman; Abdulkarim, Sabir; AlJundi, Amer; Alqahtani, Awad; Arafa, Salah; Al Suwaidi, Jassim

2016-01-01

The primary objective of this study was to evaluate the impact of polypharmacy on primary and secondary adherence to evidence-based medication (EBM) and to measure factors associated with non-adherence among patients who underwent percutaneous coronary intervention (PCI). We conducted a retrospective analysis for patients who underwent PCI at a tertiary cardiac care hospital in Qatar. Patients who had polypharmacy (defined as ≥6 medications) were compared with those who had no polypharmacy at hospital discharge in terms of primary and secondary adherence to dual antiplatelet therapy (DAPT), beta-blockers (BB), angiotensin converting enzyme inhibitors (ACEIs) and statins. A total of 557 patients (mean age: 53±10 years; 85%; males) who underwent PCI were included. The majority of patients (84.6%) received ≥6 medications (polypharmacy group) while only 15.4% patients received ≥5 medications (nonpolypharmacy group). The two groups were comparable in term of gender, nationality, socioeconomic status and medical insurance. The non-polypharmacy patients had significantly higher adherence to first refill of DAPT compared with patients in the polypharmacy group (100 vs. 76.9%; p=0.001). Similarly, the non-polypharmacy patients were significantly more adherent to secondary preventive medications (BB, ACEI and statins) than the polypharmacy group. In patients who underwent PCI, polypharmacy at discharge could play a negative role in the adherence to the first refill of EBM. Further studies should investigate other parameters that contribute to long term non-adherence.

Comparison between conventional protective mechanical ventilation and high-frequency oscillatory ventilation associated with the prone position.

PubMed

Fioretto, José Roberto; Klefens, Susiane Oliveira; Pires, Rafaelle Fernandes; Kurokawa, Cilmery Suemi; Carpi, Mario Ferreira; Bonatto, Rossano César; Moraes, Marcos Aurélio; Ronchi, Carlos Fernando

2017-01-01

To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15). Ten minutes after the beginning of the specific ventilation of each group, arterial gasometry was collected, with this timepoint being called time zero, after which the animal was placed in prone position and remained in this position for 4 hours. Oxidative stress was evaluated by the total antioxidant performance assay. Pulmonary tissue injury was determined by histopathological score. The level of significance was 5%. Both groups with acute lung injury showed worsening of oxygenation after induction of injury compared with the Control Group. After 4 hours, there was a significant improvement in oxygenation in the HFOG group compared with CMVG. Analysis of total antioxidant performance in plasma showed greater protection in HFOG. HFOG had a lower histopathological lesion score in lung tissue than CMVG. High-frequency oscillatory ventilation, associated with prone position, improves oxygenation and attenuates oxidative damage and histopathological lung injury compared with conventional protective mechanical ventilation.

Comparison between conventional protective mechanical ventilation and high-frequency oscillatory ventilation associated with the prone position

PubMed Central

Fioretto, José Roberto; Klefens, Susiane Oliveira; Pires, Rafaelle Fernandes; Kurokawa, Cilmery Suemi; Carpi, Mario Ferreira; Bonatto, Rossano César; Moraes, Marcos Aurélio; Ronchi, Carlos Fernando

2017-01-01

Objective To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. Methods Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15). Ten minutes after the beginning of the specific ventilation of each group, arterial gasometry was collected, with this timepoint being called time zero, after which the animal was placed in prone position and remained in this position for 4 hours. Oxidative stress was evaluated by the total antioxidant performance assay. Pulmonary tissue injury was determined by histopathological score. The level of significance was 5%. Results Both groups with acute lung injury showed worsening of oxygenation after induction of injury compared with the Control Group. After 4 hours, there was a significant improvement in oxygenation in the HFOG group compared with CMVG. Analysis of total antioxidant performance in plasma showed greater protection in HFOG. HFOG had a lower histopathological lesion score in lung tissue than CMVG. Conclusion High-frequency oscillatory ventilation, associated with prone position, improves oxygenation and attenuates oxidative damage and histopathological lung injury compared with conventional protective mechanical ventilation. PMID:29236845

Corticospinal excitability in the non-dominant hand is affected by BDNF genotype.

PubMed

Chang, Won Hyuk; Hwang, Jung Min; Uhm, Kyeong Eun; Pascual-Leone, Alvaro; Kim, Yun-Hee

2017-02-01

The objective of this study was to assess the functional state of corticospinal projections in the non-dominant hand according to brain-derived neurotrophic factor (BDNF) Val66Met polymorphisms. We investigated this in 34 healthy right-handed individuals (12 men, mean age 27.4 ± 3.4 years) who underwent two experimental sessions consisting of corticospinal excitability measurements with single-pulse transcranial magnetic stimulation (TMS) and hand motor function assessments with a sequential finger motor task of the non-dominant hand. Experimental sessions were separated by periods of at least 2 days to avoid carryover effects. Data were analyzed according to BDNF polymorphism (Val/Val vs. Val/Met vs. Met/Met group). Ten (29.4%), seventeen (50.0%), and seven (20.6%) participants were allocated to the Val/Val, Val/Met, and Met/Met groups, respectively. Motor thresholds to TMS did not differ among groups, but the amplitude of the motor-evoked potentials in the non-dominant hand induced by suprathreshold (120% of MT) TMS was significantly lower in the Met/Met group than in the other two groups (p < 0.05). Movement accuracy and reaction time in the sequential finger motor task showed no significant differences among groups. These results indicate that Met/Met BDNF homozygote status affects corticospinal excitability, and should be controlled for in studies of motor system function using brain stimulation. Our findings may have clinical implications regarding further investigation of the impact of BDNF genotype on the human motor system.

Motivational interviewing-based training vs traditional training on the uptake of cervical screening: a quasi-experimental study.

PubMed

Zolfaghari, Z; Rezaee, N; Shakiba, M; Navidian, A

2018-07-01

Cervical cancer, a major health issue affecting women, is preventable and can be successfully treated. It is essential that measures are taken to improve the uptake of screening for this cancer. The aim of this study was to compare the effects of motivational interviewing (MI)-based training and traditional training on the frequency of cervical cancer screening tests in a group of working female teachers. This is a quasi-experimental study. This research was conducted in 2017 among 134 teachers (aged 30-60 years) working in southeastern Iran. The participants were selected from among the eligible individuals and subsequently divided into MI-based training and traditional training groups (n = 67 for each group). Each group received a three-session training program, and 20 weeks after the end of the last training session, the information obtained from cervical cancer screening tests was documented. To analyze the data, independent t-test and Chi-squared test were run in SPSS, version 21. There was no significant difference between the two groups in terms of demographic characteristics such as age, age at the first pregnancy, age of marriage, the number of parities, and educational level. Twenty weeks after intervention, 20.9% of the MI-based training group underwent Pap smear screening test, while 9% of the women in the traditional training group took the test, indicating a statistically significant difference between the two groups (P < 0.0.5). MI-based training has a significant positive effect on women's compliance with cervical cancer screening tests. Therefore, it is recommended that this technique be adopted in women's health centers. IRCT2017100729954N4. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Study of Methylene Blue Ototoxicity in the Guinea Pig.

PubMed

Belhassen, Sarah; Alzahrani, Musaed; Nader, Marc-Elie; Gaboury, Louis; Saliba, Issam

2017-11-01

Methylene blue is widely used in the medical field, especially as a blue dye for staining. It is also used as a photosensitizing agent in antimicrobial photodynamic therapy, which once photoactivated is effective for the eradication of several multi-resistant bacteria. The objective of this study was to investigate the ototoxic potential of methylene blue and precise its use in otology. It was a prospective animal study performed on guinea pigs in our tertiary medical center. We divided the animals into two groups: an experimental group and a control group, who underwent a series of three intratympanic (IT) injections. In the control group (n = 10), they received injections of gentamicin in one ear (positive control) and normal saline in the contralateral ear (negative control). The experimental group (n = 10) received injections of methylene blue in one ear, compared to injections of normal saline in the contralateral ear. We conducted auditory-evoked brainstem response (ABR) before and 1 week after the injection series. Once this is completed, the cochlea was dissected and caspase-3 was analyzed by immunohistochemistry. The mean difference of hearing loss in the methylene blue group compared to normal saline was 1.50 dB, and it was not shown to be statistically significant (P = 0.688). For the positive control group, which received IT injections of gentamicin, the mean threshold of hearing loss difference for all the frequencies combined was 66.25 dB (P < 0.001). Furthermore, uptake of caspase-3 by immunohistochemistry (apoptotic marker) was negative in our group, which received injections of methylene blue. In light of our results, IT injections of methylene blue did not demonstrate an ototoxic potential. We recommend further studies to precise its use in the otologic field.

Study of Methylene Blue Ototoxicity in the Guinea Pig

PubMed Central

Belhassen, Sarah; Alzahrani, Musaed; Nader, Marc-Elie; Gaboury, Louis; Saliba, Issam

2017-01-01

Background Methylene blue is widely used in the medical field, especially as a blue dye for staining. It is also used as a photosensitizing agent in antimicrobial photodynamic therapy, which once photoactivated is effective for the eradication of several multi-resistant bacteria. The objective of this study was to investigate the ototoxic potential of methylene blue and precise its use in otology. Methods It was a prospective animal study performed on guinea pigs in our tertiary medical center. We divided the animals into two groups: an experimental group and a control group, who underwent a series of three intratympanic (IT) injections. In the control group (n = 10), they received injections of gentamicin in one ear (positive control) and normal saline in the contralateral ear (negative control). The experimental group (n = 10) received injections of methylene blue in one ear, compared to injections of normal saline in the contralateral ear. We conducted auditory-evoked brainstem response (ABR) before and 1 week after the injection series. Once this is completed, the cochlea was dissected and caspase-3 was analyzed by immunohistochemistry. Results The mean difference of hearing loss in the methylene blue group compared to normal saline was 1.50 dB, and it was not shown to be statistically significant (P = 0.688). For the positive control group, which received IT injections of gentamicin, the mean threshold of hearing loss difference for all the frequencies combined was 66.25 dB (P < 0.001). Furthermore, uptake of caspase-3 by immunohistochemistry (apoptotic marker) was negative in our group, which received injections of methylene blue. Conclusion In light of our results, IT injections of methylene blue did not demonstrate an ototoxic potential. We recommend further studies to precise its use in the otologic field. PMID:29038666

Intramedullary pressure changes in rats after spinal cord injury.

PubMed

Dong, X; Yang, D; Li, J; Liu, C; Yang, M; Du, L; Gu, R; Hu, A; Zhang, H

2016-11-01

The objectives of this study were to explore the change of intramedullary pressure over time in rats after different degrees of spinal cord contusion injury and to verify the hypothesis that the more serious the injury, the higher the intramedullary pressure. The control group rats underwent laminectomy only, whereas the rats in the three experimental groups were subjected to mild, moderate or severe 10th thoracic cord (T10) contusion injury after laminectomy. In addition, an intramedullary pressure of T10 was measured by a Millar Mikro-Tip pressure catheter (Millar Incorporated Company, Houston, TX, USA) immediately in the control group or at different time points after injury in the experimental groups. The average intramedullary pressure of the rats in the control group was 6.88±1.67 mm Hg, whereas that of the rats in any injury group was significantly higher (P=0.000). There was statistical difference among the different time points in the mild or moderate injury group (P=0.007/0.017), but no in the severe (P=0.374). The curves of intramedullary pressure over time in the mild and moderate injury group were bimodal, peaking at 1 and 48 h after the injury. The intramedullary pressure after injury was positively correlated with the injury degree (r=0.438, P=0.000). The intramedullary pressure of the rats increased after traumatic spinal cord injury. If the injury was not serious, the intramedullary pressure fluctuated with time and peaked at 1 and 48 h after injury. If the injury was serious, the intramedullary pressure remained high. The more serious the injury, the higher the intramedullary pressure.

Standardization of a spinal cord lesion model and neurologic evaluation using mice

PubMed Central

Borges, Paulo Alvim; Cristante, Alexandre Fogaça; de Barros-Filho, Tarcísio Eloy Pessoa; Natalino, Renato Jose Mendonça; dos Santos, Gustavo Bispo; Marcon, Raphael Marcus

2018-01-01

OBJECTIVE: To standardize a spinal cord lesion mouse model. METHODS: Thirty BALB/c mice were divided into five groups: four experimental groups and one control group (sham). The experimental groups were subjected to spinal cord lesion by a weight drop from different heights after laminectomy whereas the sham group only underwent laminectomy. Mice were observed for six weeks, and functional behavior scales were applied. The mice were then euthanized, and histological investigations were performed to confirm and score spinal cord lesion. The findings were evaluated to prove whether the method of administering spinal cord lesion was effective and different among the groups. Additionally, we correlated the results of the functional scales with the results from the histology evaluations to identify which scale is more reliable. RESULTS: One mouse presented autophagia, and six mice died during the experiment. Because four of the mice that died were in Group 5, Group 5 was excluded from the study. All the functional scales assessed proved to be significantly different from each other, and mice presented functional evolution during the experiment. Spinal cord lesion was confirmed by histology, and the results showed a high correlation between the Basso, Beattie, Bresnahan Locomotor Rating Scale and the Basso Mouse Scale. The mouse function scale showed a moderate to high correlation with the histological findings, and the horizontal ladder test had a high correlation with neurologic degeneration but no correlation with the other histological parameters evaluated. CONCLUSION: This spinal cord lesion mouse model proved to be effective and reliable with exception of lesions caused by a 10-g drop from 50 mm, which resulted in unacceptable mortality. The Basso, Beattie, Bresnahan Locomotor Rating Scale and Basso Mouse Scale are the most reliable functional assessments, and but the horizontal ladder test is not recommended. PMID:29561931

Simultaneous tDCS-fMRI Identifies Resting State Networks Correlated with Visual Search Enhancement.

PubMed

Callan, Daniel E; Falcone, Brian; Wada, Atsushi; Parasuraman, Raja

2016-01-01

This study uses simultaneous transcranial direct current stimulation (tDCS) and functional MRI (fMRI) to investigate tDCS modulation of resting state activity and connectivity that underlies enhancement in behavioral performance. The experiment consisted of three sessions within the fMRI scanner in which participants conducted a visual search task: Session 1: Pre-training (no performance feedback), Session 2: Training (performance feedback given), Session 3: Post-training (no performance feedback). Resting state activity was recorded during the last 5 min of each session. During the 2nd session one group of participants underwent 1 mA tDCS stimulation and another underwent sham stimulation over the right posterior parietal cortex. Resting state spontaneous activity, as measured by fractional amplitude of low frequency fluctuations (fALFF), for session 2 showed significant differences between the tDCS stim and sham groups in the precuneus. Resting state functional connectivity from the precuneus to the substantia nigra, a subcortical dopaminergic region, was found to correlate with future improvement in visual search task performance for the stim over the sham group during active stimulation in session 2. The after-effect of stimulation on resting state functional connectivity was measured following a post-training experimental session (session 3). The left cerebellum Lobule VIIa Crus I showed performance related enhancement in resting state functional connectivity for the tDCS stim over the sham group. The ability to determine the relationship that the relative strength of resting state functional connectivity for an individual undergoing tDCS has on future enhancement in behavioral performance has wide ranging implications for neuroergonomic as well as therapeutic, and rehabilitative applications.

Acute sleep deprivation preconditions the heart against ischemia/ reperfusion injury: the role of central GABA-A receptors

PubMed Central

Parsa, Hoda; Imani, Alireza; Faghihi, Mahdieh; Riahi, Esmail; Badavi, Mohammad; Shakoori, Abbas; Rastegar, Tayebeh; Aghajani, Marjan; Rajani, Sulail Fatima

2017-01-01

Objective(s): Central γ-aminobutyric acid (GABA) neurotransmission modulates cardiovascular functions and sleep. Acute sleep deprivation (ASD) affects functions of various body organs via different mechanisms. Here, we evaluated the effect of ASD on cardiac ischemia/reperfusion injury (IRI), and studied the role of GABA-A receptor inhibition in central nucleus of amygdala (CeA) by assessing nitric oxide (NO) and oxidative stress. Materials and Methods: The CeA in sixty male Wistar rats was cannulated for saline or bicuculline (GABA-A receptor antagonist) administration. All animals underwent 30 min of coronary occlusion (ischemia), followed by 2 hr reperfusion (IR). The five experimental groups (n=12) included are as follows: IR: received saline; BIC+IR: received Bicuculline; MLP+IR: received saline, followed by the placement of animals in an aquarium with multiple large platforms; ASD+IR: underwent ASD in an aquarium with multiple small platforms; and BIC+ASD+IR: received bicuculline prior to ASD. Results: Bicuculline administration increased the malondialdehyde levels and infarct size, and decreased the NO metabolites levels and endothelial nitric oxide synthase (eNOS) gene expression in infarcted and non-infarcted areas in comparison to IR group. ASD reduced malondialdehyde levels and infarct size and increased NO metabolites, corticosterone levels and eNOS expression in infarcted and non-infarcted areas as compared to the IR group. Levels of malondialdehyde were increased while levels of NO metabolites, corticosterone and eNOS expression in infarcted and non-infarcted areas were reduced in the BIC+ASD+IR as compared to the ASD+IR group. Conclusion: Blockade of GABA-A receptors in the CeA abolishes ASD-induced cardioprotection by suppressing oxidative stress and NO production. PMID:29299201

Acute sleep deprivation preconditions the heart against ischemia/ reperfusion injury: the role of central GABA-A receptors.

PubMed

Parsa, Hoda; Imani, Alireza; Faghihi, Mahdieh; Riahi, Esmail; Badavi, Mohammad; Shakoori, Abbas; Rastegar, Tayebeh; Aghajani, Marjan; Rajani, Sulail Fatima

2017-11-01

Central γ-aminobutyric acid (GABA) neurotransmission modulates cardiovascular functions and sleep. Acute sleep deprivation (ASD) affects functions of various body organs via different mechanisms. Here, we evaluated the effect of ASD on cardiac ischemia/reperfusion injury (IRI), and studied the role of GABA-A receptor inhibition in central nucleus of amygdala (CeA) by assessing nitric oxide (NO) and oxidative stress. The CeA in sixty male Wistar rats was cannulated for saline or bicuculline (GABA-A receptor antagonist) administration. All animals underwent 30 min of coronary occlusion (ischemia), followed by 2 hr reperfusion (IR). The five experimental groups (n=12) included are as follows: IR: received saline; BIC+IR: received Bicuculline; MLP+IR: received saline, followed by the placement of animals in an aquarium with multiple large platforms; ASD+IR: underwent ASD in an aquarium with multiple small platforms; and BIC+ASD+IR: received bicuculline prior to ASD. Bicuculline administration increased the malondialdehyde levels and infarct size, and decreased the NO metabolites levels and endothelial nitric oxide synthase (eNOS) gene expression in infarcted and non-infarcted areas in comparison to IR group. ASD reduced malondialdehyde levels and infarct size and increased NO metabolites, corticosterone levels and eNOS expression in infarcted and non-infarcted areas as compared to the IR group. Levels of malondialdehyde were increased while levels of NO metabolites, corticosterone and eNOS expression in infarcted and non-infarcted areas were reduced in the BIC+ASD+IR as compared to the ASD+IR group. Blockade of GABA-A receptors in the CeA abolishes ASD-induced cardioprotection by suppressing oxidative stress and NO production.

Long-term follow-up of a randomized controlled trial on additional core stability exercises training for improving dynamic sitting balance and trunk control in stroke patients.

PubMed

Cabanas-Valdés, Rosa; Bagur-Calafat, Caritat; Girabent-Farrés, Montserrat; Caballero-Gómez, Fernanda Mª; du Port de Pontcharra-Serra, Helena; German-Romero, Ana; Urrútia, Gerard

2017-11-01

Analyse the effect of core stability exercises in addition to conventional physiotherapy training three months after the intervention ended. A randomized controlled trial. Outpatient services. Seventy-nine stroke survivors. In the intervention period, both groups underwent conventional physiotherapy performed five days/week for five weeks, and in addition the experimental group performed core stability exercises for 15 minutes/day. Afterwards, during a three-month follow-up period, both groups underwent usual care that could eventually include conventional physiotherapy or physical exercise but not in a controlled condition. Primary outcome was trunk control and dynamic sitting balance assessed by the Spanish-Version of Trunk Impairment Scale 2.0 and Function in Sitting Test. Secondary outcomes were standing balance and gait evaluated by the Berg Balance Scale, Tinetti Test, Brunel Balance Assessment, Spanish-Version of Postural Assessment Scale for Stroke and activities of daily living using the Barthel Index. A total of 68 subjects out of 79 completed the three-month follow-up period. The mean difference (SD) between groups was 0.78 (1.51) points ( p = 0.003) for total score on the Spanish-Version of Trunk Impairment Scale 2.0, 2.52 (6.46) points ( p = 0.009) for Function in Sitting Test, dynamic standing balance was 3.30 (9.21) points ( p= 0.009) on the Berg Balance Scale, gait was 0.82 (1.88) points ( p = 0.002) by Brunel Balance Assessment (stepping), and 1.11 (2.94) points ( p = 0.044) by Tinetti Test (gait), all in favour of core stability exercises. Core stability exercises plus conventional physiotherapy have a positive long-term effect on improving dynamic sitting and standing balance and gait in post-stroke patients.

Hydrostatic weighing without head submersion in morbidly obese females.

PubMed

Evans, P E; Israel, R G; Flickinger, E G; O'Brien, K F; Donnelly, J E

1989-08-01

This study tests the validity of hydrostatic weighing without head submersion (HWNS) for determining the body density (Db) of morbidly obese (MO) females. Eighty MO females who were able to perform traditional hydrostatic weighing at residual volume (HW) underwent four counterbalanced trials for each procedure (HW and HWNS) to determine Db. Residual volume was determined by oxygen dilution. Twenty subjects were randomly excluded from the experimental group (EG) and assigned to a cross-validation group (CV). Simple linear regression was performed on EG data (n = 60, means = 36.8 y, means % fat = 50.1) to predict Db from HWNS (Db = 0.569563 [Db HWNS] + 0.408621, SEE = 0.0066). Comparison of the predicted and actual Db for CV group yielded r = 0.69, SEE = 0.0066, E statistic = 0.0067, mean difference = 0.0013 kg/L. The SEE and E statistic for body fat were 3.31 and 3.39, respectively. Mean difference for percent fat was 0.66%. Results indicate that HWNS is a valid technique for assessing body composition in MO females.

Pre-Treatment with Metformin in Comparison with Post-Treatment Reduces Cerebral Ischemia Reperfusion Induced Injuries in Rats.

PubMed

Karimipour, Mojtaba; Shojaei Zarghani, Sara; Mohajer Milani, Majid; Soraya, Hamid

2018-04-01

To explore the effects of pre versus post ischemic treatment with metformin after global cerebral ischemia in rats. Male Wister rats underwent forebrain ischemia by bilateral common carotid artery occlusion for 17 min. Metformin (200 mg/kg) or vehicle was given orally by gavage for 7-14 days. Rats were divided into: control, metformin pre-treatment, metformin post-treatment and metformin pre and post continuous treatment groups. Cerebral infarct size, histopathology, myeloperoxidase and serum malondialdehyde were measured 7 days after ischemia. Histopathological analysis showed that metformin pre-treatment significantly decreased leukocyte infiltration, myeloperoxidase activity and also malondialdehyde level. Metformin pre-treatment and metformin post-treatment reduced infarct size compared with the control group, but it was not significant in the pre and post continuous treatment group. Our findings suggest that pre-treatment with metformin in comparison with post-treatment in experimental stroke can reduce the extent of brain damage and is more neuroprotective at least in part by inhibiting oxidative stress and inflammation.

Recombinant proteins secreted from tissue-engineered bioartificial muscle improve cardiac dysfunction and suppress cardiomyocyte apoptosis in rats with heart failure.

PubMed

Rong, Shu-Ling; Wang, Yong-Jin; Wang, Xiao-Lin; Lu, Yong-Xin; Wu, Yin; Liu, Qi-Yun; Mi, Shao-Hua; Xu, Yu-Lan

2010-12-01

Tissue-engineered bioartificial muscle-based gene therapy represents a promising approach for the treatment of heart diseases. Experimental and clinical studies suggest that systemic administration of insulin-like growth factor-1 (IGF-1) protein or overexpression of IGF-1 in the heart exerts a favorable effect on cardiovascular function. This study aimed to investigate a chronic stage after myocardial infarction (MI) and the potential therapeutic effects of delivering a human IGF-1 gene by tissue-engineered bioartificial muscles (BAMs) following coronary artery ligation in Sprague-Dawley rats. Ligation of the left coronary artery or sham operation was performed. Primary skeletal myoblasts were retrovirally transduced to synthesize and secrete recombinant human insulin-like growth factor-1 (rhIGF-1), and green fluorescent protein (GFP), and tissue-engineered into implantable BAMs. The rats that underwent ligation were randomly assigned to 2 groups: MI-IGF group (n = 6) and MI-GFP group (n = 6). The MI-IGF group received rhIGF-secreting BAM (IGF-BAMs) transplantation, and the MI-GFP group received GFP-secreting BAM (GFP-BAMs) transplantation. Another group of rats served as the sham operation group, which was also randomly assigned to 2 subgroups: S-IGF group (n = 6) and S-GFP group (n = 6). The S-IGF group underwent IGF-1-BAM transplantation, and S-GFP group underwent GFP-BAM transplantation. IGF-1-BAMs and GFP-BAMs were implanted subcutaneously into syngeneic rats after two weeks of operation was performed. Four weeks after the treatment, hemodynamics was performed. IGF-1 was measured by radioimmunoassay, and then the rats were sacrificed and ventricular samples were subjected to immunohistochemistry. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to examine the mRNA expression of bax and Bcl-2. TNF-α and caspase 3 expression in myocardium was examined by Western blotting. Primary rat myoblasts were retrovirally transduced to secrete rhIGF-1 and tissue-engineered into implantable BAMs containing parallel arrays of postmitotic myofibers. In vitro, they secreted consistent levels of hIGF (0.4 - 1.2 µg×BAM(-1)×d(-1)). When implanted into syngeneic rat, IGF-BAMs secreted and delivered rhIGF. Four weeks after therapy, the hemodynamics was improved significantly in MI rats treated with IGF-BAMs compared with those treated with GFP-BAMs. The levels of serum IGF-1 were increased significantly in both MI and sham rats treated with IGF-BAM. The mRNA expression of bax was lower and Bcl-2 expression was higher in MI-IGF group than MI-GFP group (P < 0.05). Western blotting assay showed TNF-α and caspase 3 expression was lower in MI-IGF group than MI-GFP group after therapy. rhIGF-1 significantly improves left ventricular function and suppresses cardiomyocyte apoptosis in rats with chronic heart failure. Genetically modified tissue-engineered BAMs provide a method delivering recombinant protein for the treatment of heart failure.

[Experimental study of repairing bone defect with tissue engineered bone seeded with autologous red bone marrow and wrapped by pedicled fascial flap].

PubMed

Yang, Xinming; Shi, Wei; Du, Yakun; Meng, Xianyong; Yin, Yanlin

2009-10-01

To investigate the effect of repairing bone defect with tissue engineered bone seeded with the autologous red bone marrow (ARBM) and wrapped by the pedicled fascial flap and provide experimental foundation for clinical application. Thirty-two New Zealand white rabbits (male and/or female) aged 4-5 months old and weighing 2.0-2.5 kg were used to make the experimental model of bilateral 2 cm defect of the long bone and the periosteum in the radius. The tissue engineered bone was prepared by seeding the ARBM obtained from the rabbits on the osteoinductive absorbing material containing BMP. The left side of the experimental model underwent the implantation of autologous tissue engineered bone serving as the control group (group A). While the right side was designed as the experimental group (group B), one 5 cm x 3 cm fascial flap pedicled on the nameless blood vessel along with its capillary network adjacent to the bone defect was prepared using microsurgical technology, and the autologous tissue engineered bone wrapped by the fascial flap was used to fill the bone defect. At 4, 8, 12, and 16 weeks after operation, X-ray exam, absorbance (A) value test, gross morphology and histology observation, morphology quantitative analysis of bone in the reparative area, vascular image analysis on the boundary area were conducted. X-ray films, gross morphology observation, and histology observation: group B was superior to group A in terms of the growth of blood vessel into the implant, the quantity and the speed of the bone trabecula and the cartilage tissue formation, the development of mature bone structure, the remodeling of shaft structure, the reopen of marrow cavity, and the absorbance and degradation of the implant. A value: there was significant difference between two groups 8, 12, and 16 weeks after operation (P < 0.05), and there were significant differences among those three time points in groups A and B (P < 0.05). For the ratio of neonatal trabecula area to the total reparative area, there were significant differences between two groups 4, 8, 12, and 16 weeks after operation (P < 0.05), and there were significant differences among those four time points in group B (P < 0.05). For the vascular regenerative area in per unit area of the junctional zone, group B was superior to group A 4, 8, 12, and 16 weeks after operation (P < 0.05). Tissue engineered bone, seeded with the ARBM and wrapped by the pedicled fascial flap, has a sound reparative effect on bone defect due to its dual role of constructing vascularization and inducing membrane guided tissue regeneration.

The surgical treatment of chronic gastric atony following Roux-Y diversion for alkaline reflux gastritis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vogel, S.B.; Woodward, E.R.

1989-06-01

Symptoms of severe nausea, vomiting, abdominal pain, and frequent bezoars, as well as objective gastric retention, can occur following Roux-Y biliary diversion for alkaline reflux gastritis. Medical therapy and prokinetic drugs have proven ineffective. This review evaluates 37 patients who underwent further gastric resection from 1979 to 1987 to improve gastric emptying and resolve symptoms. Fifteen patients underwent perioperative radionuclide solid-food gastric emptying studies. Seventy-three per cent (27 of 37 patients) of the patients who underwent further gastric resection (70% to 95%) had a satisfactory postoperative response. Twenty patients were graded Visick 1 or 2 and 7 Visick-3 patients, althoughmore » much improved, still had some symptoms of gastroparesis. Twenty-seven per cent (10 of 37 patients) failed to improve and underwent completion total gastrectomy. Overall, 70% of this group had almost complete resolution of their symptoms. Three of 10 patients were considered ''failures'' due to postprandial pain in 1 and early vasomotor dumping in 2. Of the 10 patients who failed initial revisional surgery, 7 underwent a 70% to 80% subtotal gastric resection (STG) and 3 patients underwent 85% to 95% extensive resection (EXT.G.). Of the 15 patients who underwent perioperative radionuclide evaluation, a mean two-hour gastric retention of 61.4% +/- 4% (SEM) decreased to 25% +/- 4% following further gastric resection. Eight patients were in the STG group and seven patients were in the EXT.G group. Following STG, mean two-hour gastric retention of 58.2% +/- 3.5% decreased to 38% +/- 3% (p less than 0.05). In seven patients who underwent EXT.G, mean two-hour retention of 65% +/- 4% decreased to 10% +/- 2.5% (p less than 0.005). EXT.G resulted in normal gastric emptying and few late failures.« less

Morphological changes in the liver and kidneys of rats subjected to terminal ileum exclusion during obstructive cholestasis.

PubMed

Costa, Evandro Luis de Oliveira; Azevedo, Geraldo Magela de; Petroianu, Andy

2014-06-01

To investigate the effects of ileal exclusion on hepatic and renal morphology in extra-hepatic cholestasis. Twenty four rats were distributed into three groups. Group 1 (control) underwent laparotomy and laparorrhaphy. The animals in groups 2 and 3 underwent hepatic duct ligature and kept in cholestasis for four weeks. After this period, the rats in groups 2 and 3 underwent internal biliary derivation. In Group 3, the last ten centimeters of the terminal ileum were by passed and excluded. Four weeks later, histological and biochemical analysis were performed in all animals of the three groups. In Group 1, no abnormalities regarding hepatic morphology were observed. All animals from groups 2 and 3 presented hepatic fibrosis. No difference was observed between the two groups. No morphological differences in renal histology could be identified among the three groups. There were differences in AST (p<0.05), ALT (p<0.05), direct bilirubin (p<0.05), ƔGT (p<0.05), urea (p<0.05) and creatinine (p<0.05) in Group 3 compared to control. The distal ileum exclusion had no influence upon the hepatic and renal morphological alterations, and biochemical liver and kidney tests have worsened.

Glutamine prevents oxidative stress in a model of portal hypertension.

PubMed

Zabot, Gilmara Pandolfo; Carvalhal, Gustavo Franco; Marroni, Norma Possa; Licks, Francielli; Hartmann, Renata Minuzzo; da Silva, Vinícius Duval; Fillmann, Henrique Sarubbi

2017-07-07

To evaluate the protective effects of glutamine in a model of portal hypertension (PH) induced by partial portal vein ligation (PPVL). Male Wistar rats were housed in a controlled environment and were allowed access to food and water ad libitum . Twenty-four male Wistar rats were divided into four experimental groups: (1) control group (SO) - rats underwent exploratory laparotomy; (2) control + glutamine group (SO + G) - rats were subjected to laparotomy and were treated intraperitoneally with glutamine; (3) portal hypertension group (PPVL) - rats were subjected to PPVL; and (4) PPVL + glutamine group (PPVL + G) - rats were treated intraperitoneally with glutamine for seven days. Local injuries were determined by evaluating intestinal segments for oxidative stress using lipid peroxidation and the activities of glutathione peroxidase (GPx), endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) after PPVL. Lipid peroxidation of the membrane was increased in the animals subjected to PH ( P < 0.01). However, the group that received glutamine for seven days after the PPVL procedure showed levels of lipid peroxidation similar to those of the control groups ( P > 0.05). The activity of the antioxidant enzyme GTx was decreased in the gut of animals subjected to PH compared with that in the control group of animals not subjected to PH ( P < 0.01). However, the group that received glutamine for seven days after the PPVL showed similar GTx activity to both the control groups not subjected to PH ( P > 0.05). At least 10 random, non-overlapping images of each histological slide with 200 × magnification (44 pixel = 1 μm) were captured. The sum means of all areas, of each group were calculated. The mean areas of eNOS staining for both of the control groups were similar. The PPVL group showed the largest area of staining for eNOS. The PPVL + G group had the second highest amount of staining, but the mean value was much lower than that of the PPVL group ( P < 0.01). For iNOS, the control (SO) and control + G (SO + G) groups showed similar areas of staining. The PPVL group contained the largest area of iNOS staining, followed by the PPVL + G group; however, this area was significantly smaller than that of the group that underwent PH without glutamine ( P < 0.01). Treatment with glutamine prevents gut mucosal injury after PH in rats.

Laparoscopy vs robotics in surgical management of endometrial cancer: comparison of intraoperative and postoperative complications.

PubMed

Seror, Julien; Bats, Anne-Sophie; Huchon, Cyrille; Bensaïd, Chérazade; Douay-Hauser, Nathalie; Lécuru, Fabrice

2014-01-01

To compare the rates of intraoperative and postoperative complications of robotic surgery and laparoscopy in the surgical treatment of endometrial cancer. Unicentric retrospective study (Canadian Task Force classification II-2). Tertiary teaching hospital. The study was performed from January 2002 to December 2011 and included patients with endometrial cancer who underwent laparoscopic or robotically assisted laparoscopic surgical treatment. Data collected included preoperative data, tumor characteristics, intraoperative data (route of surgery, surgical procedures, and complications), and postoperative data (early and late complications according to the Clavien-Dindo classification, and length of hospital stay). Morbidity was compared between the 2 groups. The study included 146 patients, of whom 106 underwent laparoscopy and 40 underwent robotically assisted surgery. The 2 groups were comparable in terms of demographic and preoperative data. Intraoperative complications occurred in 9.4% of patients who underwent laparoscopy and in none who underwent robotically assisted surgery (p = .06). There was no difference between the 2 groups in terms of postoperative events. Robotically assisted surgery is not associated with a significant difference in intraoperative and postoperative complications, even when there were no intraoperative complications of robotically assisted surgery. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Effect and Mechanism of QiShenYiQi Pill on Experimental Autoimmune Myocarditis Rats.

PubMed

Lv, Shichao; Wu, Meifang; Li, Meng; Wang, Qiang; Xu, Ling; Wang, Xiaojing; Zhang, Junping

2016-03-06

To observe the effect of QiShenYiQi pill (QSYQ) on experimental autoimmune myocarditis rats, and to explore its mechanism of action. Lewis rats underwent the injection of myocardial myosin mixed with Freund's complete adjuvant were randomized into 3 groups: model, valsartan, and QSYQ groups. Rats injected with phosphate-buffered saline (PBS) mixed with Freund's complete adjuvant were used as the control group. Rats were euthanized at 4 and 8 weeks, and we weighed rat body mass, heart mass, and left ventricular mass. Myocardium sections were stained with hematoxylin and eosin (H&E) and Masson trichrome. Myocardial TGF-β1 and CTGF protein expression was detected by immunohistochemistry, and myocardial TGF-β1 and CTGF mRNA expression was detected by real-time qPCR. QSYQ reduced HMI and LVMI, as well as the histological score of hearts and CVF, which further decreased over time, and its effect was significantly greater than that of valsartan at 4 and 8 weeks. After 4 weeks, QSYQ inhibited the protein and mRNA expression of TGF-β1 and CTGF, and its effect on lowering CTGF was significantly greater than that of valsartan. In addition, after 8 weeks, QSYQ also inhibited the protein and mRNA expression of CTGF, whereas there was no significant difference in the expression of myocardial TGF-β1. This study provides evidence that QSYQ can improve cardiac remodeling of experimental autoimmune myocarditis rats. It also effectively improved the degree of myocardial fibrosis, which is related to the mechanism of regulation of TGF-β1 CTGF.

Sleep Deprivation and Time-Based Prospective Memory.

PubMed

Esposito, Maria José; Occhionero, Miranda; Cicogna, PierCarla

2015-11-01

To evaluate the effect of sleep deprivation on time-based prospective memory performance, that is, realizing delayed intentions at an appropriate time in the future (e.g., to take a medicine in 30 minutes). Between-subjects experimental design. The experimental group underwent 24 h of total sleep deprivation, and the control group had a regular sleep-wake cycle. Participants were tested at 08:00. Laboratory. Fifty healthy young adults (mean age 22 ± 2.1, 31 female). 24 h of total sleep deprivation. Participants were monitored by wrist actigraphy for 3 days before the experimental session. The following cognitive tasks were administered: one time-based prospective memory task and 3 reasoning tasks as ongoing activity. Objective and subjective vigilance was assessed by the psychomotor vigilance task and a visual analog scale, respectively. To measure the time-based prospective memory task we assessed compliance and clock checking behavior (time monitoring). Sleep deprivation negatively affected time-based prospective memory compliance (P < 0.001), objective vigilance (mean RT: P < 0.001; slowest 10% RT: P < 0.001; lapses: P < 0.005), and subjective vigilance (P < 0.0001). Performance on reasoning tasks and time monitoring behavior did not differ between groups. The results highlight the potential dangerous effects of total sleep deprivation on human behavior, particularly the ability to perform an intended action after a few minutes. Sleep deprivation strongly compromises time-based prospective memory compliance but does not affect time check frequency. Sleep deprivation may impair the mechanism that allows the integration of information related to time monitoring with the prospective intention. © 2015 Associated Professional Sleep Societies, LLC.

Correlation between magnetic resonance T2 image signal intensity ratio and cell apoptosis in a rabbit spinal cord cervical myelopathy model.

PubMed

Ma, Lei; Zhang, Di; Chen, Wei; Shen, Yong; Zhang, Yingze; Ding, Wenyuan; Zhang, Wei; Wang, Linfeng; Yang, Dalong

2014-01-01

Cervical spondylotic myelopathy (CSM) is a common cause of disability in elderly patients. Previous studies have shown that spinal cord cell apoptosis due to spinal cord compression plays an important role in the pathology of myelopathy. Although changes in magnetic resonance imaging (MRI) T2 signal intensity ratio (SIR) are considered to be an indicator of CSM, little information is published supporting the correlation between changes in MRI signal and pathological changes. This study aims to testify the correlation between MRI T2 SIR changes and cell apoptosis using a CSM animal model. Forty-eight rabbits were randomly assigned to four groups: one control group and three experimental chronic compression groups, with each group containing 12 animals. Chronic compression of the cervical spinal cord was implemented in the experimental groups by implanting a screw in the C3 vertebra. The control group underwent sham surgery. Experimental groups were observed for 3, 6, or 9 months after surgery. MRI T2-weighted SIR Tarlov motor scores and cortical somatosensory-evoked potentials (CSEPs) were periodically monitored. At each time point, rabbits from one group were sacrificed to determine the level of apoptosis by histology (n = 6) and Western blotting (n = 6). Tarlov motor scores in the compression groups were lower at all time points than the control group scores, with the lowest score at 9 months (P < 0.001). Electrophysiological testing showed a significantly prolonged latency in CSEP in the compression groups compared with the control group. All rabbits in the compression groups showed higher MRI T2 SIR in the injury epicenter compared with controls, and higher SIR was also found at 9 months compared with 3 or 6 months. Histological analysis showed significant apoptosis in the spinal cord tissue in the compression groups, but not in the control group. There were significant differences in apoptosis degree over time (P < 0.001), with the 9-month group displaying the most severe spinal cord apoptosis. Spearman's rank correlation test showed that there was close relation between MRI SIR and degree of caspase-3 expression in Western blotting (r = 0.824. P < 0.001). Clear apoptosis of spinal cord tissue was observed during chronic focal spinal compression. Changes in MRI T2 SIR may be related to the severity of the apoptosis in cervical spinal cord.

Comparison of Voice Quality Between Patients Who Underwent Inferior Turbinoplasty or Radiofrequency Cauterization.

PubMed

Göker, Ayşe Enise; Aydoğdu, İmran; Saltürk, Ziya; Berkiten, Güler; Atar, Yavuz; Kumral, Tolgar Lütfi; Uyar, Yavuz

2017-01-01

The aim of this study was to analyze and compare the vocal quality in patients who underwent either submucosal turbinectomy or radiofrequency cauterization. In this study, we enrolled 60 patients diagnosed with inferior concha hypertrophy. These patients were divided into two groups by using computer program "Research Randomizer." Of the 60 patients, 30 underwent submucosal inferior turbinoplasty and 30 underwent radiofrequency cauterization. The control group was composed of 30 healthy adults with no nasal or upper aerodigestive system pathology. The patients were checked at weeks 1, 2, and 4. Voice records were taken before the procedure and at week 4 postprocedure. The mean age of patients in the inferior turbinoplasty group was 29.4 years (range: 19-42 years); in the radiofrequency group, it was 30.30 years (range: 18-50 years). There was no statistical difference in age between groups. In the inferior turbinoplasty group, there were 16 male and 14 female patients, and in the radiofrequency group, there were 13 male and 17 female patients. There was no significant difference in the number of males and females between groups. Voice professionals, especially singers, actors, and actresses, should be informed about possible voice changes before undergoing endonasal surgery because these individuals are more sensitive to changes in resonance organs. We believe that voice quality should be regarded as a highly important parameter when measuring the success of endonasal surgery. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Evolution of abdominal wall reconstruction: development of a unified algorithm with improved outcomes.

PubMed

Koltz, Peter F; Frey, Jordan D; Bell, Derek E; Girotto, John A; Christiano, Jose G; Langstein, Howard N

2013-11-01

Ventral hernia repair (VHR) continues to evolve and now frequently includes some form of component separation (CS) for large defects. To determine the optimal technique for VHR, we evaluated our outcomes before and after we refined and simplified our algorithm for repair. One hundred five consecutive patients undergoing VHR for large midline hernias over 9 years were examined. Patients were divided into those operated on after (group 1) and before (group 2) the institution of our simplified algorithm. Our algorithm emphasizes careful patient selection and a stepwise approach including, but not limited to, bilateral CS if appropriate, preservation of large perforators, retrorectus mesh placement as appropriate, linea alba or midline fascial closure, and vertical panniculectomy. Primary outcomes evaluated included wound infection, dehiscence, and hernia recurrence. Seventy-eight (74.3%) patients underwent repair using our algorithm (group 1), whereas 27 (25.7%) underwent repair before utilization of this algorithm (group 2). Ninety-eight (93.3%) underwent CS, whereas 7 (6.7%) underwent another form of VHR. There was no significant difference in patient age or defect size. The mean follow-up period in days for patients in group 1 and group 2 were 184.02 and 526.06, respectively (P < 0.001). Hernia recurrence in group 1 was 2.6% versus 29.6% in group 2 (P < 0.001). The incidence of wound infection in group 1 was 10.3%, whereas that in group 2 was 33.3% (P < 0.001). The rate of wound dehiscence in group 1 was 17.9% versus 25.9% in group 2 (P < 0.001). Simplifying and unifying our algorithm for VHR, notably with utilization of CS, has yielded improved results. Recurrence and wound healing complications using this approach are favorable compared with published outcomes.

The optimal minimally invasive percutaneous nephrolithotomy strategy for the treatment of staghorn stones in a solitary kidney.

PubMed

Liu, Chenli; Cui, Zelin; Zeng, Guohua; Wan, Shaw P; Li, Jiasheng; Zhu, Wei; Zeng, Tao; Liu, Yang

2016-04-01

The objective of the study was to analyze the treatment outcomes for staghorn stones in patients with solitary kidney using either the single-tract or the multi-tract minimally invasive percutaneous nephrolithotomy (MPCNL). We retrospectively reviewed 105 patients who underwent MPCNL for staghorn calculi in solitary kidney from 2012 to 2014. The patients who underwent the single-tract approach (71 patients) were assigned to Group 1. The 34 patients who underwent the multi-tract approach (34 patients) were assigned to Group 2. We recorded and compared the patient's demographics, intraoperative parameters, and post-operative outcomes. We also analyzed any complications as a result of the particular procedure, as well as any resulting stone-free rates (SFRs). The mean number of access tracts was 2.38 ± 0.70 (range 2-4) for Group 2. The mean operative time was longer for Group 2, p = 0.01. The initial SFR was 52.1% for Group 1 and 47.1% for Group 2 after the one-session procedure, p = 0.63.The final SFR improved to 83.1 and 79.4% for both groups following auxiliary treatment, p = 0.65. The mean hemoglobin drop was higher in Group 2 as compared to Group 1, p < 0.01. There was no significant difference in the change of mean serum creatinine in either group. There were fewer overall complications in Group 1 than in Group 2 (23.9 vs. 44.1%). Almost half of the patients who underwent multi-tract MPCNL required an additional procedure to achieve satisfactory stone clearance. The results showed that single-tract MPCNL might be a better treatment option for staghorn stones in a solitary kidney with the same therapeutic outcome, but with less complications.

Rapamycin and a hyaluronic acid-carboxymethylcellulose membrane did not lead to reduced adhesion formations in a rat abdominal adhesion model.

PubMed

Dietrich, Arne; Bouzidi, Maria; Hartwig, Thomas; Schütz, Alexander; Jonas, Sven

2012-06-01

Rapamycin, an immunosuppressive in transplant surgery, has an additional antiproliferative effect. The aim of this study was to investigate the potential protective effects of rapamycin on postoperative adhesion development. Ten rats per group underwent midline incision laparotomy and adhesion induction including bowel sutures. Therapy groups received daily intraperitoneal rapamycin injections (1.5 mg/kg body weight) for 3 weeks postoperatively. Controls were rats without any postoperative treatment, rats receiving the rapamycin solvent or a hyaluronic acid-carboxymethylcellulose membrane (Seprafilm(™)). Postoperative rapamycin application led to enhanced adhesion development and there was a higher rate of wound infections. In addition, Seprafilm(™) did not reduce adhesions, in subgroups there were even more. Rapamycin is not recommendable for perioperative immunosuppression, it enhances adhesion development and leads to a higher rate of wound infections. Surprisingly, the established Seprafilm(™) membrane led to more adhesions in our experimental setting.

Influence of the Conditioning Method for Pre-Sintered Zirconia on the Shear Bond Strength of Bilayered Porcelain/Zirconia

PubMed Central

Spintzyk, Sebastian; Yamaguchi, Kikue; Sawada, Tomofumi; Schille, Christine; Schweizer, Ernst; Ozeki, Masahiko; Geis-Gerstorfer, Jürgen

2016-01-01

This study evaluated the bond strength of veneering porcelain with an experimental conditioner-coated zirconia. Pre-sintered Y-TZP specimens (n = 44) were divided in two groups based on conditioning type. After sintering, all sample surfaces were sandblasted and layered with veneering porcelain. Additionally, half of the specimens in each group underwent thermal cycling (10,000 cycles, 5–55 °C), and all shear bond strengths were measured. After testing, the failure mode of each fractured specimen was determined. Differences were tested by parametric and Fisher’s exact tests (α = 0.05). The differences in bond strength were not statistically significant. Adhesive fractures were dominantly observed for the non-thermal cycled specimens. After thermal cycling, the conditioner-coated group showed cohesive and mixed fractures (p = 0.0021), whereas the uncoated group showed more adhesive fractures (p = 0.0021). Conditioning of the pre-sintered Y-TZP did not change the shear bond strength of the veneering porcelain, but did improve the failure mode after thermal cycling. PMID:28773885

Comparison of outcomes according to the operation for type A esophageal atresia

PubMed Central

Huh, Yeon-Ju; Kim, Hyun-Young; Lee, Seong-Cheol; Park, Kwi-Won

2014-01-01

Purpose The purpose was to evaluate outcomes according to different operative strategies of type A esophageal atresia (EA). Methods All patients who underwent surgery for type A EA between 1980 and 2011 were included. Patients were divided into 2 groups: E-E group included patients who received esophageal end-to-end anastomosis, whereas E-G group included patients who received esophago-gastric tube anastomosis. Results Twenty-two patients were included. The median gestational age was 37.5 weeks. The median birth weight was 2.5 kg. Twenty-one patients underwent gastrostomy as initial procedures, and one patient underwent primary esophageal end-to-end anastomosis. The median gap between both esophageal ends was six vertebral distance (VD). Seven patients underwent primary anastomosis of the esophagus, and 14 patients underwent gastric replacement. Three patients (13.6%) had anastomotic leakage and 10 patients (45.5%) had anastomotic stenosis. Most of the patients (90.9%) had gastroesophageal reflux, but only two patients required antireflux surgery. The median VD was significantly shorter in E-E group than in E-G group (3 VD vs. 6 VD). Stenosis was significantly more often in E-E group, but there was no significant difference in leakage and reflux symptoms. Conclusion The treatment for type A EA can include E-E anastomosis or E-G anastomosis, depending on the length of the end-to-end interval after performing gastrostomy. Appropriate tension and blood flow in the anastomosis site are essential for preventing postoperative stenosis and leakage, and esophageal replacement with gastric tube is believed to be feasible and safe in cases where excessive tension is present. PMID:24761413

Task complexity and maximal isometric strength gains through motor learning

PubMed Central

McGuire, Jessica; Green, Lara A.; Gabriel, David A.

2014-01-01

Abstract This study compared the effects of a simple versus complex contraction pattern on the acquisition, retention, and transfer of maximal isometric strength gains and reductions in force variability. A control group (N = 12) performed simple isometric contractions of the wrist flexors. An experimental group (N = 12) performed complex proprioceptive neuromuscular facilitation (PNF) contractions consisting of maximal isometric wrist extension immediately reversing force direction to wrist flexion within a single trial. Ten contractions were completed on three consecutive days with a retention and transfer test 2‐weeks later. For the retention test, the groups performed their assigned contraction pattern followed by a transfer test that consisted of the other contraction pattern for a cross‐over design. Both groups exhibited comparable increases in strength (20.2%, P < 0.01) and reductions in mean torque variability (26.2%, P < 0.01), which were retained and transferred. There was a decrease in the coactivation ratio (antagonist/agonist muscle activity) for both groups, which was retained and transferred (35.2%, P < 0.01). The experimental group exhibited a linear decrease in variability of the torque‐ and sEMG‐time curves, indicating transfer to the simple contraction pattern (P < 0.01). The control group underwent a decrease in variability of the torque‐ and sEMG‐time curves from the first day of training to retention, but participants returned to baseline levels during the transfer condition (P < 0.01). However, the difference between torque RMS error versus the variability in torque‐ and sEMG‐time curves suggests the demands of the complex task were transferred, but could not be achieved in a reproducible way. PMID:25428951

An eye movement pre-training fosters the comprehension of processes and functions in technical systems.

PubMed

Skuballa, Irene T; Fortunski, Caroline; Renkl, Alexander

2015-01-01

The main research goal of the present study was to investigate in how far pre-training eye movements can facilitate knowledge acquisition in multimedia (pre-training principle). We combined considerations from research on eye movement modeling and pre-training to design and test a non-verbal eye movement-based pre-training. Participants in the experimental condition watched an animated circle moving in close spatial resemblance to a static visualization of a solar plant accompanied by a narration in a subsequently presented learning environment. This training was expected to foster top-down processes as reflected in gaze behavior during the learning process and enhance knowledge acquisition. We compared two groups (N = 45): participants in the experimental condition received pre-training in a first step and processed the learning material in a second step, whereas the control group underwent the second step without any pre-training. The pre-training group outperformed the control group in their learning outcomes, particularly in knowledge about processes and functions of the solar plant. However, the superior learning outcomes in the pre-training group could not be explained by eye-movement patterns. Furthermore, the pre-training moderated the relationship between experienced stress and learning outcomes. In the control group, high stress levels hindered learning, which was not found for the pre-training group. On a delayed posttest participants were requested to draw a picture of the learning content. Despite a non-significant effect of training on the quality of drawings, the pre-training showed associations between learning outcomes at the first testing time and process-related aspects in the quality of their drawings. Overall, non-verbal pre-training is a successful instructional intervention to promote learning processes in novices although these processes did not directly reflect in learners' eye movement behavior during learning.

Spinal cord blood flow and ischemic injury after experimental sacrifice of thoracic and abdominal segmental arteries.

PubMed

Etz, Christian D; Homann, Tobias M; Luehr, Maximilian; Kari, Fabian A; Weisz, Donald J; Kleinman, George; Plestis, Konstadinos A; Griepp, Randall B

2008-06-01

Spinal cord blood flow (SCBF) after sacrifice of thoracoabdominal aortic segmental arteries (TAASA) during thoracoabdominal aortic aneurysm (TAAA) repair remains poorly understood. This study explored SCBF for 72 h after sacrifice of all TAASA. Fourteen juvenile Yorkshire pigs underwent complete serial TAASA sacrifice (T4-L5). Six control pigs underwent anesthesia and cooling to 32 degrees C with no TAASA sacrifice. In the experimental animals, spinal cord function was continuously monitored using motor evoked potentials (MEPs) until 1h after clamping the last TAASA. Fluorescent microspheres enabled segmental measurement of SCBF along the entire spinal cord before, and 5 min, 1 h, 5 h, 24 h and 72 h after complete TAASA sacrifice. A modified Tarlov score was obtained for 3 days after surgery. All the pigs with complete TAASA sacrifice retained normal cord function (MEP) until 1h after TAASA ligation. Seven pigs (50%) with complete TAASA sacrifice recovered after 72 h; seven pigs suffered paraparesis or paraplegia. Intraoperatively, and until 1h postoperatively, SCBF was similar among the three groups along the entire cord. Postoperatively, SCBF did not decrease in any group, but significant hyperemia occurred at 5h in controls and recovery animals, but did not occur in pigs that developed paraparesis or paraplegia in the T8-L2 segments (p=0.0002) and L3-S segments (p=0.0007). At 24h, SCBF remained marginally lower from T8 caudally; at 72h, SCBF was similar among all groups along the entire cord. SCBF in the segments T8-L2 at 5h predicted functional recovery (p=0.003). This study suggests that critical spinal cord ischemia after complete TAASA sacrifice does not occur immediately (intraoperatively), but is delayed 1-5h or longer after clamping, and represents failure to mount a hyperemic response to rewarming and awakening. The short duration of low SCBF associated with spinal cord injury suggests that hemodynamic and metabolic manipulation lasting only 24-72 h may allow routine preservation of normal cord function despite sacrifice of all TAASA secondary to surgical or endovascular repair of large TAAA.

Outcomes After Superior Rectus Transposition and Medial Rectus Recession Versus Vertical Recti Transposition for Sixth Nerve Palsy.

PubMed

Lee, Yeon-Hee; Lambert, Scott R

2017-05-01

To compare the effectiveness of superior rectus transposition and medial rectus recession (SRT/MRc) vs inferior and superior rectus transposition (VRT) for acquired sixth nerve palsy. Consecutive, interventional case series. The medical records of a consecutive series of patients with acquired sixth nerve palsy who underwent VRT or SRT/MRc by a single surgeon were reviewed. The preoperative and postoperative findings were compared between the 2 groups. Eight patients (mean age, 46.8 years) underwent SRT/MRc and 8 patients underwent VRT (mean age, 51.1 years). Lateral fixation was performed on all but 4 patients in the VRT group. Preoperative esotropia in primary position and abduction deficit were similar in both groups (SRT/MRc, 41.9 prism diopter [PD], -4.6; VRT, 55.6 PD, -4.5; P = .195, 1.0). The SRT/MRc group underwent a mean MR recession of 6 (range, 5-7) mm. Four patients in the VRT later underwent MR recession (mean 5.3 mm, range 5-6 mm). In addition, 5 patients in the VRT group had 1 or more botulinum toxin injections in the medial rectus muscle. No additional procedures were performed in the SRT/MR group. Fewer additional procedures were performed with SRT/MR (SRT/MR, 0; VRT, 1.8 ± 1.2; P < .010). At last follow-up, residual esotropia (SRT/MRc, 7.1 PD; VRT, 10.3 PD; P = .442) was similar in both groups, but abduction was better in the SRT/MRc group (SRT/MR, -3.0 ± 0.7; VRT, -3.8 ± 0.4; P = .038). There were no new persistent vertical deviations or torsional diplopia. Final outcomes were similar with SRT/MRc vs VRT. However, fewer additional surgical procedures were needed with SRT/MR. Copyright © 2017 Elsevier Inc. All rights reserved.

Outcomes of 23- and 25-gauge transconjunctival sutureless vitrectomies for dislocated intraocular lenses.

PubMed

Bajgai, Priya; Tigari, Basavraj; Singh, Ramandeep

2017-10-04

To compare the outcome of 23-gauge as compared with 25-gauge transconjunctival sutureless vitrectomy (TSV) in the management of dislocated intraocular lenses (IOLs). Retrospective, non-consecutive, comparative, interventional case series. Patients with dislocated intraocular lens who underwent sutureless PPV using either 23-gauge or 25-gauge instruments. The patients who presented with a dislocated IOL, underwent TSV with repositioning of the intraocular lens, either in the sulcus or scleral-fixated sutured/glued. Of the total 61 eyes, 33 (54.09%) underwent 23-gauge TSV and 28 (45.90%) underwent 25-gauge TSV. The mean logMAR BCVA at baseline and 6 months after surgery was 0.8 and 0.46 in the 23-gauge group, and 0.82 and 0.47 in the 25-gauge group. There was no significant difference in logMAR BCVA values between the two groups at any time point of time during the follow-up. The mean postoperative IOP on postoperative day 1 was 14.76 ± 5.4 in 23-gauge group and 17.57 ± 7.9 in the 25-gauge group (p = 0.10). Retinal break was noticed intraoperatively in two cases in 23-gauge group and in three cases in 25-gauge group (p = 0.509). Postoperative complications included IOL decentration in one case of 23-gauge vitrectomy and two cases in 25-gauge group (p = 0.5), cystoid macular edema in four patients in 23-gauge group and six cases of 25-gauge group (p = 0.3) and retinal detachment in one case in each group (p = 0.9). 25-gauge appears to be as safe and as effective as 23-gauge TSV in the management of dislocated intraocular lenses.

Exercise and Education Program After Breast Cancer: Benefits on Quality of Life and Symptoms at 3, 6, 12, and 24 Months' Follow-up.

PubMed

Leclerc, Anne-France; Slomian, Justine; Jerusalem, Guy; Coucke, Philippe; Bury, Thierry; Deflandre, Dorian; Devos, Martine; Bruyère, Olivier; Foidart-Dessalle, Marguerite; Kaux, Jean-François; Crielaard, Jean-Michel; Maquet, Didier

2018-05-19

Various clinical trials have demonstrated the benefits of physical training offered during and/or after breast cancer treatments. However, given the variety of adverse events that may be encountered, physical training could be combined with psychologic, relational, and social guidance. This kind of multidisciplinary program, as well as its long-term effects, have been little studied so far. Therefore, the objective of our study was to determine the benefits at 3, 6, 12, and 24 months of a 3-month exercise and education program among women after breast cancer treatment. Two hundred nine outpatients treated for primary breast carcinoma were divided into a control group (n = 106) and an experimental group (n = 103) which underwent a 3-month rehabilitation program including physical training and psychoeducational sessions. The assessments, performed before the program and at 3, 6, 12, and 24 months after inclusion, included validated questionnaires on quality of life and symptoms. The analyses revealed an improvement in quality of life and symptoms after the exercise and education program within the experimental group and a maintenance of these improvements during the 2 years of follow-up. These improvements were significantly better than those in the control group, clearly demonstrating that the program has benefits. This trial identified the benefits of a well-detailed 3-month exercise and education program over 24 months' follow-up among women after breast cancer treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

SURFACE DEGRADATION OF COMPOSITE RESINS BY ACIDIC MEDICINES AND pH-CYCLING

PubMed Central

Valinoti, Ana Carolina; Neves, Beatriz Gonçalves; da Silva, Eduardo Moreira; Maia, Lucianne Cople

2008-01-01

This study evaluated the effects of acidic medicines (Dimetapp® and Claritin®), under pH-cycling conditions, on the surface degradation of four composite resins (microhybrid: TPH, Concept, Opallis and Nanofilled: Supreme). Thirty disc-shaped specimens (Ø = 5.0 mm / thickness = 2.0 mm) of each composite were randomly assigned to 3 groups (n = 10): a control and two experimental groups, according to the acidic medicines evaluated. The specimens were finished and polished with aluminum oxide discs, and the surface roughness was measured by using a profilometer. After the specimens were submitted to a pH-cycling regimen and immersion in acidic medicines for 12 days, the surface roughness was measured again. Two specimens for each material and group were analyzed by scanning electron microscopy (SEM) before and after pH-cycling. Data were analyzed by the Student's-t test, ANOVA, Duncan's multiple range test and paired t-test (α=0.05). Significant increase in roughness was found only for TPH in the control group and TPH and Supreme immersed in Claritin® (p<0.05). SEM analyses showed that the 4 composite resins underwent erosion and surface degradation after being subjected to the experimental conditions. In conclusion, although the roughness was slightly affected, the pH-cycling and acidic medicines caused surface degradation of the composite resins evaluated. Titratable acidity seemed to play a more crucial role on surface degradation of composite resins than pH. PMID:19089257

Oral hygiene in patients with oral cancer undergoing chemotherapy and/or radiotherapy after prosthesis rehabilitation: protocol proposal.

PubMed

Rapone, B; Nardi, G M; DI Venere, D; Pettini, F; Grassi, F R; Corsalini, M

2016-01-01

This study was aimed at assessing the effectiveness and the importance of an oral hygiene (OH) protocol in patients undergoing radiation therapy and chemotherapy after prosthesis rehabilitation, in order to reduce or minimize oral complications. This study was carried out at the Department of Dental Science, at the University of Bari-Italy from December 2012 to December 2015 on 34 selected patients with primary oral cancer undergoing chemotherapy and radiotherapy after prosthesis rehabilitation. They were divided into 2 groups according to their age, sex and cancer therapy. Seventeen patients were assigned to the control group and seventeen in the experimental one. In the experimental group (Table 1), patients underwent an oral hygiene protocol whereas in the control group (Table 2) patients received the usual care provided within the clinical setting. All the patients gave written informed consent. It has been asked and obtained the authorisation from the Ethics Committee of the Dental Science and Surgery Department. Results show that in patients undergoing the oral hygiene protocol, the complications and the risks of infection and permanent dental problems have been minimized. Indeed, of the seventeen patients undergoing the OH protocol, 70% obtained positive results and were satisfied with the program outcome. The role of the health care providers is essential to educate patients to adhere to the prescribed treatments and reinforce their motivation in oral hygiene. The oral hygiene procedures prevent and ameliorate oral complications due to the radiation therapy and chemotherapy.

Comparison of the effects of cylindrical correction with and without iris recognition technology in wavefront laser-assisted in situ keratomileusis.

PubMed

Wang, Tsung-Jen; Lin, Yu-Huang; Chang, David C-K; Chou, Hsiu-Chu; Wang, I-Jong

2012-04-01

  To analyse the magnitude of cylindrical corrections over which cyclotorsion compensation with iris recognition (IR) technology is beneficial during wavefront laser-assisted in situ keratomileusis.   A retrospectively comparative case series.   Fifty-four eyes that underwent wavefront laser-assisted in situ keratomileusis without IR (non-IR group) and 53 eyes that underwent wavefront laser-assisted in situ keratomileusis with IR (IR group) were recruited.   Subgroup analysis based on baseline astigmatism were: a low degree of astigmatism (≥1.00 D to <2.00 D), a moderate degree of astigmatism (≥2.00 D to <3.00 D) and a high degree of astigmatism (≥3.00 D).   Vector and non-vector analyses were used for comparison.   The mean cylinder was -1.89 ± 0.76 D in the non-IR group and -2.00 ± 0.77 D in the IR group. Postoperatively, 38 eyes (74.50%) in the IR group and 31 eyes (57.50%) in the non-IR group were within ± 0.50 D of the target induced astigmatism vector (P = 0.063). The difference vector was 0.49 ± 0.28 in the IR group and 0.63 ± 0.40 in the non-IR group (P = 0.031). In the analysis of subgroups, the magnitude of error was significantly lower in the moderate IR subgroup than that of the moderate non-IR subgroup (P = 0.034). Furthermore, the moderate IR subgroup had a lower mean difference vector (P = 0.0078) and a greater surgically induced astigmatism (P = 0.036) than those of the moderate non-IR group.   Wavefront laser-assisted in situ keratomileusis for the treatment of astigmatism using IR technology was effective and accurate for the treatment of myopic astigmatism. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

The Effects of Age at Cleft Palate Repair on Middle Ear Function and Hearing Level.

PubMed

Lou, Qun; Zhu, Hongping; Luo, Yi; Zhou, Zhibo; Ma, Lian; Ma, Xiaoran; Fu, Yuan

2018-05-01

To investigate the age effects of cleft palate repair on middle ear function and hearing level in patients who underwent cleft palate repair at different ages by audiologic examination. Medical histories were gathered in detail, and audiologic tests (ie, tympanometry and pure tone hearing threshold) were conducted in 126 patients after palatoplasty. The patients were divided into the following 4 groups according to their ages when they underwent cleft palate repair: group I (0-3 years, 73 patients), group II (4-7 years, 29 patients), group III (8-11 years, 16 patients), and group IV (12 years and older, 8 patients). The data regarding tympanograms, hearing levels, and the average hearing thresholds of each group were analyzed using chi-square tests. The prevalence of middle ear dysfunction and hearing loss in the patients who underwent palatoplasty before 3 years old (27.4% and 2.0% respectively) was significantly lower than that in patients who underwent palatopalsty at 12 years or older (75.0% and 43.7%, respectively). Linear-by-linear association revealed that the prevalences of middle ear dysfunction and hearing loss among the 4 groups were significantly different ( P < .05). The prevalence of middle ear dysfunction and hearing loss tended to increase with advancing age at the time of cleft palate repair. From an audiologist's perspective, palatoplasty at an early age is very beneficial in helping children with cleft palates acquire better middle ear function and hearing level.

Comparison of libido, Female Sexual Function Index, and Arizona scores in women who underwent laparoscopic or conventional abdominal hysterectomy

PubMed Central

Kayataş, Semra; Özkaya, Enis; Api, Murat; Çıkman, Seyhan; Gürbüz, Ayşen; Eser, Ahmet

2017-01-01

Objective: The aim of the present study was to compare female sexual function between women who underwent conventional abdominal or laparoscopic hysterectomy. Materials and Methods: Seventy-seven women who were scheduled to undergo hysterectomy without oophorectomy for benign gynecologic conditions were included in the study. The women were assigned to laparoscopic or open abdominal hysterectomy according to the surgeons preference. Women with endometriosis and symptomatic prolapsus were excluded. Female sexual function scores were obtained before and six months after the operation from each participant by using validated questionnaires. Results: Pre- and postoperative scores of three different quationnaires were found as comparable in the group that underwent laparoscopic hysterectomy (p>0.05). Scores were also found as comparable in the group that underwent laparotomic hysterectomy (p>0.05). Pre- and postoperative values were compared between the two groups and revealed similar results with regard to all three scores (p>0.05). Conclusion: Our data showed comparable pre- and the postoperative scores for the two different hysterectomy techniques. The two groups were also found to have similar pre- and postoperative score values. PMID:28913149

Effects of Application of Social Marketing Theory and the Health Belief Model in Promoting Cervical Cancer Screening among Targeted Women in Sisaket Province, Thailand.

PubMed

Wichachai, Suparp; Songserm, Nopparat; Akakul, Theerawut; Kuasiri, Chanapong

2016-01-01

Cervical cancer is a major public health problem in Thailand, being ranked second only to breast cancer. Thai women have been reported to have a low rate of cervical cancer screening (27.7% of the 80% goal of WHO). We therefore aimed to apply the social marketing theory and health belief model in promoting cervical cancer screening in Kanthararom District, Sisaket Province. A total of 92 from 974 targeted women aged 3060 years were randomly divided into two groups. The experimental group underwent application of social marketing theory and a health belief model program promoting cervical cancer screening while the control group received normal services. Two research tools were used: (1) application of social marketing theory and health belief model program and (2) questionnaire used to evaluate perceptions of cervical cancer. Descriptive and inferential statistics including paired sample ttest and independent ttest were used to analyze the data. After the program had been used, the mean score of perception of cervical cancer of experimental group was at a higher level (x=4.09; S.D. =0.30), than in the control group (x=3.82; S.D. =0.20) with statistical significance (p<0.001). This research demonstrated an appropriate communication process in behavioral modification to prevent cervical cancer. It can be recommended that this program featuring social marketing and the health belief model be used to promote cervical cancer screening in targeted women and it can be promoted as a guideline for other health services, especially in health promotion and disease prevention.

Home-based virtual reality balance training and conventional balance training in Parkinson's disease: A randomized controlled trial.

PubMed

Yang, Wen-Chieh; Wang, Hsing-Kuo; Wu, Ruey-Meei; Lo, Chien-Shun; Lin, Kwan-Hwa

2016-09-01

Virtual reality has the advantage to provide rich sensory feedbacks for training balance function. This study tested if the home-based virtual reality balance training is more effective than the conventional home balance training in improving balance, walking, and quality of life in patients with Parkinson's disease (PD). Twenty-three patients with idiopathic PD were recruited and underwent twelve 50-minute training sessions during the 6-week training period. The experimental group (n = 11) was trained with a custom-made virtual reality balance training system, and the control group (n = 12) was trained by a licensed physical therapist. Outcomes were measured at Week 0 (pretest), Week 6 (posttest), and Week 8 (follow-up). The primary outcome was the Berg Balance Scale. The secondary outcomes included the Dynamic Gait Index, timed Up-and-Go test, Parkinson's Disease Questionnaire, and the motor score of the Unified Parkinson's Disease Rating Scale. The experimental and control groups were comparable at pretest. After training, both groups performed better in the Berg Balance Scale, Dynamic Gait Index, timed Up-and-Go test, and Parkinson's Disease Questionnaire at posttest and follow-up than at pretest. However, no significant differences were found between these two groups at posttest and follow-up. This study did not find any difference between the effects of the home-based virtual reality balance training and conventional home balance training. The two training options were equally effective in improving balance, walking, and quality of life among community-dwelling patients with PD. Copyright © 2015. Published by Elsevier B.V.

Quality of life in women following various surgeries of body manipulation: organ transplantation, mastectomy, and breast reconstruction.

PubMed

Pérez-San-Gregorio, M Angeles; Fernández-Jiménez, Eduardo; Martín-Rodríguez, Agustín; Borda-Más, Mercedes; Rincón-Fernández, M Esther

2013-09-01

This study aimed to determine biopsychosocial differences (anxious-depressive symptomatology and quality of life) among three groups of patients who underwent surgical interventions related to body manipulation, as well as to assess the clinical significance of these results versus reference values. Four groups were compared: women who underwent organ transplant (n = 26), mastectomy for breast cancer (n = 36), breast reconstruction (n = 36), and general population (n = 608). The Hospital Anxiety and Depression Scale and the EORTC QLQ-C30 were used. Women who underwent mastectomy showed the highest anxious-depressive symptomatology and quality-of-life impairment in comparison to the remaining groups, and they also displayed the most clinically significant deterioration in the majority of dimensions (large effect sizes). In contrast, the group with implantation of a healthy organ (transplantation) only showed higher biopsychosocial impairment than the group with reconstruction of an organ (breast reconstruction) in gastrointestinal dysfunctions and in the global self-perception of health.

Sternocleidomastoid muscle flap used for repairing the dead space after supraomohyoid neck dissection

PubMed Central

Li, Jinzhong; Han, Zhengxue

2015-01-01

Surgical site infection (SSI) is a common complication followed neck dissection and dead space is a common reason of SSI. The present study is aimed to explore whether the sternocleidomastoid muscle (SCM) flap transposition to repair the dead space in level II of neck could decrease the postoperative SSI in patients with oral squamous cell carcinoma (OSCC) underwent supraomohyoid neck dissection (SOND). Ninety-six patients with cT2-3N0 OSCC who underwent extended resection of primary cancer combined SOND and reconstructed with free flap from March 2011 to October 2014 in our department were included. Forty-eight cases underwent SCM transposition to repair the potential dead space in level II of the neck, the other 48 cases did not. The two groups were matched at age, gender, concomitant diseases, and perioperative treatments. All the patients underwent exhaustive hemostasis and careful placement of negative pressure drainage. The wound healing was observed on 7 days postoperatively. The SSI rates of neck between the two groups were compared using Fisher’s exact test. The dead space in level II was observed in all the neck wounds after SOND. The neck wounds healed by primary intention in 46 cases underwent SCM flap transposition, and in 39 cases underwent routine SOND only. Two cases with SCM flap transposition and 9 cases in the group without SCM flap transposition presented SSI in neck. There was significant difference in the SSI rate between the two groups (P = 0.0248). The dead space in level II could be an important cause of SSI in neck followed SOND. Repairing of the dead space in level II using SCM flap transposition reduce the SSI rate of neck followed SOND. PMID:25785129

Sternocleidomastoid muscle flap used for repairing the dead space after supraomohyoid neck dissection.

PubMed

Li, Jinzhong; Han, Zhengxue

2015-01-01

Surgical site infection (SSI) is a common complication followed neck dissection and dead space is a common reason of SSI. The present study is aimed to explore whether the sternocleidomastoid muscle (SCM) flap transposition to repair the dead space in level II of neck could decrease the postoperative SSI in patients with oral squamous cell carcinoma (OSCC) underwent supraomohyoid neck dissection (SOND). Ninety-six patients with cT2-3N0 OSCC who underwent extended resection of primary cancer combined SOND and reconstructed with free flap from March 2011 to October 2014 in our department were included. Forty-eight cases underwent SCM transposition to repair the potential dead space in level II of the neck, the other 48 cases did not. The two groups were matched at age, gender, concomitant diseases, and perioperative treatments. All the patients underwent exhaustive hemostasis and careful placement of negative pressure drainage. The wound healing was observed on 7 days postoperatively. The SSI rates of neck between the two groups were compared using Fisher's exact test. The dead space in level II was observed in all the neck wounds after SOND. The neck wounds healed by primary intention in 46 cases underwent SCM flap transposition, and in 39 cases underwent routine SOND only. Two cases with SCM flap transposition and 9 cases in the group without SCM flap transposition presented SSI in neck. There was significant difference in the SSI rate between the two groups (P = 0.0248). The dead space in level II could be an important cause of SSI in neck followed SOND. Repairing of the dead space in level II using SCM flap transposition reduce the SSI rate of neck followed SOND.

Thymoquinone protects end organs from abdominal aorta ischemia/reperfusion injury in a rat model.

PubMed

Aydin, Mehmet Salih; Kocarslan, Aydemir; Kocarslan, Sezen; Kucuk, Ahmet; Eser, İrfan; Sezen, Hatice; Buyukfirat, Evren; Hazar, Abdussemet

2015-01-01

Previous studies have demonstrated that thymoquinone has protective effects against ischemia reperfusion injury to various organs like lungs, kidneys and liver in different experimental models. We aimed to determine whether thymoquinone has favorable effects on lung, renal, heart tissues and oxidative stress in abdominal aorta ischemia-reperfusion injury. Thirty rats were divided into three groups as sham (n=10), control (n=10) and thymoquinone (TQ) treatment group (n=10). Control and TQ-treatment groups underwent abdominal aorta ischemia for 45 minutes followed by a 120-min period of reperfusion. In the TQ-treatment group, thymoquinone was given 5 minutes. before reperfusion at a dose of 20 mg/kg via an intraperitoneal route. Total antioxidant capacity, total oxidative status (TOS), and oxidative stress index (OSI) in blood serum were measured and lung, kidney, and heart tissue histopathology were evaluated with light microscopy. Total oxidative status and oxidative stress index activity in blood samples were statistically higher in the control group compared to the sham and TQ-treatment groups (P<0.001 for TOS and OSI). Control group injury scores were statistically higher compared to sham and TQ-treatment groups (P<0.001 for all comparisons). Thymoquinone administered intraperitoneally was effective in reducing oxidative stress and histopathologic injury in an acute abdominal aorta ischemia-reperfusion rat model.

Thromboelastogram-guided enoxaparin dosing does not confer protection from deep venous thrombosis: a randomized controlled pilot trial.

PubMed

Louis, Scott G; Van, Philbert Y; Riha, Gordon M; Barton, Jeffrey S; Kunio, Nicholas R; Underwood, Samantha J; Differding, Jerome A; Rick, Elizabeth; Ginzburg, Enrique; Schreiber, Martin A

2014-04-01

The incidence of deep venous thrombosis (DVT) remains high in general surgery and trauma patients despite widespread prophylaxis with enoxaparin. A recent study demonstrated decreased incidence of DVT if patients on enoxaparin had a change in R time (ΔR) of greater than 1 minute when heparinase-activated thromboelastography (TEG) was compared with normal TEG. We hypothesized that using ΔR-guided dosing would result in decreased DVT rates. A prospective, randomized controlled trial was performed at a Level 1 trauma center. Both trauma and general surgery patients were included. Upon enrollment, demographic data including age, sex, body mass index, and Acute Physiology and Chronic Health Evaluation II score were obtained. Enrolled patients were randomized to standard (30 mg twice a day) or TEG-guided dosing. Dose-adjusted patients underwent daily enoxaparin titration to achieve an ΔR of 1 minute to 2 minutes. Venous thromboembolism screening was performed per institutional protocol. Antithrombin III (AT-III) and anti-Xa levels were drawn at peak enoxaparin concentrations. A total of 87 patients were enrolled. There was no difference in demographic data between the groups. No pulmonary emboli were identified. The control group had a DVT rate of 16%, while the experimental group had a rate of 14% (p = nonsignificant). The experimental group's median enoxaparin dosage, 50 mg twice a day, was significantly higher than that of the control (p < 0.01). TEG ΔR was not different between the control and experimental groups. Beginning at Day 3, anti-Xa levels were higher in the experimental group (p < 0.05). There was no difference in AT-III activity between the two groups; 67% of the patients demonstrated AT-III deficiency. TEG adjusted enoxaparin dosing led to significant increases in anti-Xa activity, which did not correlate with a decreased DVT rate. Failure to reduce the DVT rate and increase ΔR despite increased dosing and increased anti-Xa activity is consistent with the high rate of AT-III deficiency detected in this study cohort. These data suggest that the future of DVT prevention may not lie in the optimization of low molecular weight heparin therapy but rather in compounds that increase antithrombin directly or operate independently of the AT-III pathway. Therapeutic study, level III.

Citrus aurantium Naringenin Prevents Osteosarcoma Progression and Recurrence in the Patients Who Underwent Osteosarcoma Surgery by Improving Antioxidant Capability.

PubMed

Zhang, Lirong; Xu, Xiaohua; Jiang, Tiechao; Wu, Kunzhe; Ding, Chuanbo; Liu, Zhen; Zhang, Xuanhe; Yu, Tianhua; Song, Changlong

2018-01-01

Citrus aurantium is rich in flavonoids, which may prevent osteosarcoma progression, but its related molecular mechanism remains unclear. Flavonoids were extracted from C. aurantium and purified by reparative HPLC. Each fraction was identified by using electrospray ionisation mass spectrometry (ESI-MS). Three main components (naringin, naringenin, and hesperetin) were isolated from C. aurantium . Naringenin inhibited the growth of MG-63 cells, whereas naringin and hesperetin had no inhibitory function on cell growth. ROS production was increased in naringin- and hesperetin-treated groups after one day of culture while the level was always lowest in the naringenin-treated group after three days of culture. 95 osteosarcoma patients who underwent surgery were assigned into two groups: naringenin group (NG, received 20 mg naringenin daily, n = 47) and control group (CG, received 20 mg placebo daily, n = 48). After an average of two-year follow-up, osteosarcoma volumes were smaller in the NG group than in the CG group ( P > 0.01). The rate of osteosarcoma recurrence was also lower in the NG group than in CG group. ROS levels were lower in the NG group than in the CG group. Thus, naringenin from Citrus aurantium inhibits osteosarcoma progression and local recurrence in the patients who underwent osteosarcoma surgery by improving antioxidant capability.

The transfer of skills from cognitive and physical training to activities of daily living: a randomised controlled study.

PubMed

Hagovska, Magdalena; Nagyova, Iveta

2017-06-01

Ageing is associated with the deterioration of all cognitive functions, including attention, memory and psychomotor speed. It has not yet been clearly confirmed whether the effects of cognitive and physical interventions can improve activities of daily living (ADL). This study compared the effectiveness of cognitive and physical training on cognitive functions and the transfer to ADL. Eighty older people with mild cognitive impairment (mean age 67.07 ± 4.3 years) were randomly divided into an experimental group ( n  = 40) and a control group ( n  = 40). Data were collected in an outpatient psychiatric clinic in a randomised controlled trial. Primary outcome measures included the following: cognitive functions were evaluated using the mini mental state examination, the AVLT-Auditory verbal learning test, the Stroop test, the TMT-trail making test, the DRT-disjunctive reaction time and the NHPT-nine hole peg test. Secondary outcome measure was the Bristol activities of daily living scale. The experimental group underwent a CogniPlus and physical training; consisting of 20 training sessions over 10 weeks. Both groups went through 30 min of daily physical training for 10 weeks. After the training, significant differences in favour of the experimental group were found in almost all the tests. In memory (AVLT) (p ≤ 0.0001, effect size (ES) η 2  = 0.218. In reduction of the response time on attention tasks (Stroop tasks) ( p  ≤ 0.006, ES = 0.092-0.115). In lower error rates in all tests: Stroop tasks, DRT, TMT, NHPT ( p  ≤ 0.02-0.001, ES = 0.062-0.176). In ADL ( p  ≤ 0.0001, ES = 0.176). The combined cognitive and physical training had better efficacy for most cognitive functions and for ADL when compared with the physical training only.

Effects of a home-exercise therapy programme on cervical and lumbar range of motion among nurses with neck and lower back pain: a quasi-experimental study.

PubMed

Freimann, Tiina; Merisalu, Eda; Pääsuke, Mati

2015-01-01

Cervical and lumbar range of motion limitations are usually associated with musculoskeletal pain in the neck and lower back, and are a major health problem among nurses. Physical exercise has been evaluated as an effective intervention method for improving cervical and lumbar range of motion, and for preventing and reducing musculoskeletal pain. The purpose of this study was to investigate the effects of a home-exercise therapy programme on cervical and lumbar range of motion among intensive care unit nurses who had experienced mild to moderate musculoskeletal pain in the neck and or lower back during the previous six months. A quasi-experimental study was conducted among intensive care unit nurses at Tartu University Hospital (Estonia) between May and July 2011. Thirteen nurses who had suffered musculoskeletal pain episodes in the neck and or lower back during the previous six months underwent an 8-week home-exercise therapy programme. Eleven nurses without musculoskeletal pain formed a control group. Questions from the Nordic Musculoskeletal Questionnaire and the 11-point Visual Analogue Scale were used to select potential participants for the experimental group via an assessment of the prevalence and intensity of musculoskeletal pain. Cervical range of motion and lumbar range of motion in flexion, extension, lateral flexion and (cervical range of motion only) rotation were measured with a digital goniometer. A paired t-test was used to compare the measured parameters before and after the home-exercise therapy programme. A Student's t-test was used to analyse any differences between the experimental and control groups. After the home-exercise therapy, there was a significant increase (p < 0.05) in cervical range of motion in flexion, extension, lateral flexion and rotation, and in lumbar range of motion in lateral flexion. Cervical range of motion in flexion was significantly higher (p < 0.01) in the experimental group compared to the control group after therapy. Our results suggest an 8-week intensive home-exercise therapy programme may improve cervical and lumbar range of motion among intensive care nurses. Further studies are needed to develop this simple but effective home-exercise therapy programme to help motivate nurses to perform such exercises regularly. Current Controlled Trials ISRCTN19278735. Registered 27 November 2015.

Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions

PubMed Central

Khosla, Rahul; McLean, Anna W; Smith, Jessica A

2016-01-01

Background: Computed tomography (CT) guided biopsies have long been the standard technique to obtain tissue from the thoracic cavity and is traditionally performed by interventional radiologists. Ultrasound (US) guided biopsy of pleural-based lesions, performed by pulmonologists is gaining popularity and has the advantage of multi-planar imaging, real-time technique, and the absence of radiation exposure to patients. In this study, we aim to determine the diagnostic accuracy, the time to diagnosis after the initial consult placement, and the complications rates between the two different modalities. Methods: A retrospective study of electronic medical records was done of patients who underwent CT-guided biopsies and US-guided biopsies for pleural-based lesions between 2005 and 2014 and the data collected were analyzed for comparing the two groups. Results: A total of 158 patients underwent 162 procedures during the study period. 86 patients underwent 89 procedures in the US group, and 72 patients underwent 73 procedures in the CT group. The overall yield in the US group was 82/89 (92.1%) versus 67/73 (91.8%) in the CT group (P = 1.0). Average days to the procedure was 7.2 versus 17.5 (P = 0.00001) in the US and CT group, respectively. Complication rate was higher in CT group 17/73 (23.3%) versus 1/89 (1.1%) in the US group (P < 0.0001). Conclusions: For pleural-based lesions the diagnostic accuracy of US guided biopsy is similar to that of CT-guided biopsy, with a lower complication rate and a significantly reduced time to the procedure. PMID:27625440

Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy with Concomitant Hiatal Hernia Repair: an Unresolved Question.

PubMed

Dakour Aridi, Hanaa; Asali, Mohammad; Fouani, Tarek; Alami, Ramzi S; Safadi, Bassem Y

2017-11-01

The effectiveness of the concomitant repair of hiatal hernia (HHR) during laparoscopic sleeve gastrectomy (LSG) in reducing gastroesophageal reflux disease (GERD) symptoms is still unclear. The aim of this study is to assess the effect of concomitant HHR on postoperative GERD symptoms in our patient population. A retrospective review of patients who underwent LSG with or without HHR between 2011and 2014 was performed. Pre- and postoperative GERD symptoms were assessed at different time intervals until a maximum of 2 years after the surgery. The study included 165 patients; 76 (46%) underwent LSG with concomitant HHR (group A) while the rest underwent only LSG (group B). Baseline GERD complaints were more prevalent in group A (61.8 vs 41.6%, p = 0.04), in which 44 patients (57.9%) had evidence of hiatal hernia on preoperative EGD. In the remaining 32 patients, it was diagnosed intraoperatively. GERD symptoms did not significantly differ between the two groups after years 1 and 2. GERD remission was observed in 21.3% of the 76 patients who underwent concomitant HHR (group A) and in 29.7% of those who did not (group B) while new-onset GERD symptoms were reported in 12 patients (41.4%) in group A and in 24 patients (46.2%) in group B. Routine HHR at the time of LSG does not show an improvement in GERD symptoms. More prospective studies are needed to clarify the role of the routine dissection, identification, and repair of concomitant hiatal hernia during LSG.

Tenon advancement and duplication technique to prevent postoperative Ahmed valve tube exposure in patients with refractory glaucoma.

PubMed

Tamcelik, Nevbahar; Ozkok, Ahmet; Sarıcı, Ahmet Murat; Atalay, Eray; Yetik, Huseyin; Gungor, Kivanc

2013-07-01

To present and compare the long-term results of Dr. Tamcelik's previously described technique of Tenon advancement and duplication with the conventional Ahmed glaucoma valve (AGV) implantation technique in patients with refractory glaucoma. This study was a multicenter, retrospective case series that included 303 eyes of 276 patients with refractory glaucoma who underwent glaucoma valve implantation surgery. The patients were divided into three groups according to the surgical technique applied and the outcomes compared. In group 1, 96 eyes of 86 patients underwent AGV implant surgery without patch graft; in group 2, 78 eyes of 72 patients underwent AGV implant surgery with donor scleral patch; in group 3, 129 eyes of 118 patients underwent Ahmed valve implant surgery with "combined short scleral tunnel with Tenon advancement and duplication technique". The endpoint assessed was tube exposure through the conjunctiva. In group 1, conjunctival tube exposure was seen in 11 eyes (12.9 %) after a mean 9.2 ± 3.7 years of follow-up. In group 2, conjunctival tube exposure was seen in six eyes (2.2 %) after a mean 8.9 ± 3.3 years of follow-up. In group 3, there was no conjunctival exposure after a mean 7.8 ± 2.8 years of follow-up. The difference between the groups was statistically significant. (P = 0.0001, Chi-square test). This novel surgical technique combining a short scleral tunnel with Tenon advancement and duplication was found to be effective and safe to prevent conjunctival tube exposure after AGV implantation surgery in patients with refractory glaucoma.

Astaxanthin ameliorates cartilage damage in experimental osteoarthritis.

PubMed

Huang, Li-juan; Chen, Wei-Ping

2015-09-01

Astaxanthin is a red-pigment carotenoid found in certain marine animals and plants. Astaxanthin has been shown to inhibit matrix metalloproteinases (MMPs) expression in vitro. However, the effect of astaxanthin on cartilage is still unclear. The aim of this study was to investigate the effects of astaxanthin on cartilage in experimental osteoarthritis (OA). New Zealand rabbits underwent anterior cruciate ligament transection to induce OA in right knee. Rabbits received intra-articular injection containing 0.3 ml of vehicle (dimethyl sulfoxide) or astaxanthin (50 μM). Injection was started on the day of operation, and the injection were performed once weekly for six consecutive weeks. Then, rabbits were sacrificed and the right knees were harvested for study. Cartilage degradation was reduced by astaxanthin, as assessed by morphological and histological examination. Astaxanthin inhibited the gene expression of MMP-1, MMP-3, and MMP-13 in cartilage as compared with the vehicle group. The results suggest that astaxanthin may be considered as pharmaceutical agent in OA treatment.

Are bariatric operations performed by residents safe and efficient?

PubMed

Major, Piotr; Wysocki, Michał; Dworak, Jadwiga; Pędziwiatr, Michał; Małczak, Piotr; Budzyński, Andrzej

2017-04-01

The growing need for surgeons who are educated and trained in bariatric surgery has raised many issues related to training in this field. This study was performed to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) performed by doctors-in-training during their residency in general surgery. Tertiary referral university teaching hospital, Poland. We retrospectively analyzed the data of patients who underwent bariatric surgery. One group underwent surgery performed by at least third-year residents learning particular types of surgeries (trainee group), and the second group underwent surgeries performed by experienced bariatric surgeons (mentor group). The primary endpoint was the safety of the procedures. We analyzed factors related to the intraoperative and postoperative course. The secondary endpoint was long-term weight reduction. A lower body mass index (BMI), fewer co-morbidities, and preferably female sex were the selection criteria for patients in the trainee group. We enrolled 408 patients who met all inclusion criteria. Among them, 233 underwent SG and 175 underwent LRYGB. For both SG and LRYGB, the median maximum preoperative weight was significantly lower in the trainee than mentor group. We found no statistically significant differences in the demographic factors or co-morbidities between the 2 groups. The median duration of SG and LRYGB surgery was significantly longer in the trainee than mentor group. The median number of stapler firings during SG was significantly lower in the trainee than mentor group. The number of stapler firings during LRYGB did not differ between the 2 groups. The incidence of intraoperative difficulties, which were based on the operator's subjective opinion, was higher in the trainee than mentor group for both SG and LRYGB. However, intraoperative difficulties had no significant impact on the intraoperative complication rate or risk of perioperative complications. The average percentage weight loss (%WL), percentage excess weight loss (%EWL), and percentage excess BMI loss (%EBMIL) in the all study group were 31.14%±9.11%, 56.17%±17.27%, and 65.42%±19.28%, respectively. For patients who underwent SG, we found no significant difference in %WL, %EWL, or %EBMIL between the trainee and mentor groups. The performance of bariatric surgeries by residents does not affect the risk of reoperation, intraoperative adverse events, or surgical complications. Performance of SG and LRYGB by trainees takes significantly longer but has no untoward consequences for the patient. Both SG and LRYGB performed by a doctor-in-training and experienced operator lead to comparable outcomes in terms of weight reduction. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Comparison of the complications of traditional 12 cores transrectal prostate biopsy with image fusion guided transperineal prostate biopsy.

PubMed

Huang, Haifeng; Wang, Wei; Lin, Tingsheng; Zhang, Qing; Zhao, Xiaozhi; Lian, Huibo; Guo, Hongqian

2016-11-17

To compare the complications of traditional transrectal (TR) prostate biopsy and image fusion guided transperineal (TP) prostate biopsy in our center. Two hundred and fourty-two patients who underwent prostate biopsy from August 2014 to January 2015were reviewed. Among them, 144 patients underwent systematic 12-core transrectal ultrasonography (TRUS) guided prostate biopsy (TR approach) while 98 patients underwent free-hand transperineal targeted biopsy with TRUS and multi-parameter magnetic resonance imaging (mpMRI) fusion images (TP approach). The complications of the two groups were presented and a simple statistical analysis was performed to compare the two groups. The cohort of our study include242 patients, including 144 patients underwent TR biopsies while 98 patients underwentTP biopsies. There was no significant difference of major complications, including sepsis, bleeding and other complication requiring admissionbetween the two groups (P > 0.05). The incidence rate of infection and rectal bleeding in TR was much higher than TP (p < 0.05), but the incidence rate of perineal swelling in TP was much higher than TR (p < 0.05). There were no significant differences of minor complications including hematuria, lower urinary tract symptoms (LUTS), dysuria, and acuteurinary retention between the two groups (p > 0.05). The present study supports the safety of both techniques. Free-handTP targeted prostate biopsy with real-time fusion imaging of mpMRI and TR ultrasound is a good approach for prostate biopsy.

[Investigation of postconditioning in intestinal ischemia-reperfusion experimental models].

PubMed

Rosero, Olivér; Onody, Péter; Stangl, Rita; Hegedus, Viktor; Lotz, Gábor; Blázovics, Anna; Kupcsulik, Péter; Szijártó, Attila

2011-02-01

The ischemic-reperfusion injury of the intestine, which occurs as a consequence of circulatory redistribution or occlusion of the superior mesenteric artery, is associated with high mortality rates. Postconditioning may reduce ischemic-reperfusion damage in such cases. Effects of this new surgical method were investigated in rats. Male Wistar rats underwent 60 minutes of superior mesenteric artery occlusion in four groups: sham-operated, control and two postconditioned groups with different algorithms. Postconditioning was performed immediately at the beginning of reperfusion, by repetitive cycles of reperfusion and reocclusion. 3 cycles of 1 minute and 6 cycles of 10 seconds were applied according to groups. Intestinal microcirculation was followed by laser Doppler flowmetry. Blood and tissue samples were taken after 60 minutes of reperfusion. Histological analayses of the small intestine, measurement of serum necroenzyme levels and IL-6, mesenterial venous blood gas analyses were preformed and antioxidant state of the mucosa was investigated. The microcirculation during the reperfusion showed significant improvement in both postconditioned groups. Histological damage, necroenzyme and IL-6 levels were significantly reduced, while antioxidant state was improved in the postconditioned groups. Postconditioning was capable of increasing the guts chance to survive ischemic-reperfusion injury caused by superior mesenteric artery occlusion.

[Analgesic effect of intra-artcular fentanyl in knee arthroscopy to treat patellofemoral lateral hyperpressure syndrome].

PubMed

Gutiérrez-Mendoza, Israel; Pérez-Correa, José J; Serna-Vela, Francisco; Góngora-Ortega, Javier; Vilchis-Huerta, Ventura; Pérez-Guzmán, Carlos; Hernández-Garduño, Eduardo; Vidal-Rodríguez, Francisco Alberto

2009-01-01

During arthroscopy for the treatment of patellofemoral lateral hyper-pressure syndrome (LHS), intra-articular morphine or its derivatives (fentanyl) may reduce postoperative pain when combined with anesthetics. We therefore decided to determine whether adding fentanyl to epinephrine and bupivacaine produced an increased analgesia. We randomly distributed 40 patients into two groups. The experimental group (n=20) was given 0.5% bupivacaine (2 mg/kg), epinephrine (100 microg) and fentanyl (2.5 microg/kg). The control group (n=20) received 0.5% bupivacaine (2 mg/kg) and epinephrine (100 microg). Patients underwent chondroplasty and retinacular release, and we assessed pain, time of analgesia and postoperative range of motion at postoperative hours 6 and 24. The age and the grade of patellofemoral chondromalacia (PFC) were similar in both groups (p > 0.05). No differences were found in pain and ranges of motion intraoperatively and at postoperative hours 6 and 24 (p > 0.05) between both groups. The postoperative analgesia time was similar (p > 0.05). Adding intra-articular fentanyl to the combination of epinephrine plus bupivacaine did not decrease pain, and did not increase neither the analgesia time nor the range of motion in patients with LHS undergoing knee arthroscopy.

Mitomycin C, 5-fluorouracil, and cyclosporin A prevent epidural fibrosis in an experimental laminectomy model.

PubMed

Yildiz, Kartal Hakan; Gezen, Ferruh; Is, Merih; Cukur, Selma; Dosoglu, Murat

2007-09-01

This study examined the preventive effects of the local application of mitomycin C (MMC), 5-fluorouracil (5-FU), and cyclosporine A (CsA) in minimizing spinal epidural fibrosis in a rat laminectomy model. Thirty-two 2-year-old male Wistar albino rats, each weighing 400 +/- 50 g, were divided into four equal groups: sham, MMC, 5-FU, and CsA. Each rat underwent laminectomy at the L5-L6 lumbar level. Cotton pads (4 x 4 mm2) soaked with MMC (0.5 mg/ml), 5-FU (5 ml/mg), or CsA (5 mg/ml) were placed on the exposed dura for 5 min. Thirty days after surgery, the rats were killed and the epidural fibrosis, fibroblast density, inflammatory cell density, and arachnoid fibrosis were quantified. The epidural and arachnoid fibroses were reduced significantly in the treatment groups compared to the sham group. Fibroblast cell density and inflammatory cell density were decreased significantly in the MMC and 5-FU groups, but were similar in the sham and CsA groups. The decreased rate of epidural fibrosis was promising. Further studies in humans are needed to determine the short- and long-term complications of the agents used here.

Additive treatment improves survival in elderly patients after non-curative endoscopic resection for early gastric cancer.

PubMed

Jung, Da Hyun; Lee, Yong Chan; Kim, Jie-Hyun; Lee, Sang Kil; Shin, Sung Kwan; Park, Jun Chul; Chung, Hyunsoo; Park, Jae Jun; Youn, Young Hoon; Park, Hyojin

2017-03-01

Endoscopic resection (ER) is accepted as a curative treatment option for selected cases of early gastric cancer (EGC). Although additional surgery is often recommended for patients who have undergone non-curative ER, clinicians are cautious when managing elderly patients with GC because of comorbid conditions. The aim of the study was to investigate clinical outcomes in elderly patients following non-curative ER with and without additive treatment. Subjects included 365 patients (>75 years old) who were diagnosed with EGC and underwent ER between 2007 and 2015. Clinical outcomes of three patient groups [curative ER (n = 246), non-curative ER with additive treatment (n = 37), non-curative ER without additive treatment (n = 82)] were compared. Among the patients who underwent non-curative ER with additive treatment, 28 received surgery, three received a repeat ER, and six experienced argon plasma coagulation. Patients who underwent non-curative ER alone were significantly older than those who underwent additive treatment. Overall 5-year survival rates in the curative ER, non-curative ER with treatment, and non-curative ER without treatment groups were 84, 86, and 69 %, respectively. No significant difference in overall survival was found between patients in the curative ER and non-curative ER with additive treatment groups. The non-curative ER groups were categorized by lymph node metastasis risk factors to create a high-risk group that exhibited positive lymphovascular invasion or deep submucosal invasion greater than SM2 and a low-risk group without risk factors. Overall 5-year survival rate was lowest (60 %) in the high-risk group with non-curative ER and no additive treatment. Elderly patients who underwent non-curative ER with additive treatment showed better survival outcome than those without treatment. Therefore, especially with LVI or deep submucosal invasion, additive treatment is recommended in patients undergoing non-curative ER, even if they are older than 75 years.

Flexible Ureterorenoscopy versus Mini-Percutaneous Nephrolithotomy for the Treatment of Renal Stones.

PubMed

Ergin, Giray; Kirac, Mustafa; Kopru, Burak; Ebiloglu, Turgay; Biri, Hasan

2018-04-22

To compare the pain status and stone free rates of flexible ureterorenoscopy (F-URS) versus mini-percutaneousnephrolithotomy (mini-PNL) for the treatment of 1-to 2-cm renal stones. This study was retrospectively designed with match paired method. Between January 2013 and December 2016, 387 patients underwent stone surgery for renal stones, 45 patients underwent FURS and 45 patients underwent mini-PNL. 90 patients were divided into two groups according to the surgical procedures. Group 1 patients underwent F-URS, and Group 2 patients underwent mini-PNL. During the intraoperative andpostoperative periods, pain management for all patients was standardized. Pain scores were determined using a visual analogue scale (VAS) completed at 2, 6, 12 and 24 hours postoperatively. The stone free status, hemoglobin levels, fluoroscopy time (FT), operation time (OT), hospitalization time (HT), return to work time (RWT), and complications were noted for each patient. Of all patients, the mean age was 41.1 ± 12.1 years and the mean stone size was 13.9 ± 2.9 mm. The VAS scores were significantly higher in the mini-PNL group at 2, 6, 12 and 24 hours (P < .05). The stone-free status and complication rates were similar between the two groups (P > .05); however, the hemoglobin decreases and the fluoroscopy, operation, hospitalization and return to work times were higher in the mini-PNL group than in the F-URS group (P < .05). F-URS is less painful than mini-PNL for the treatment of 1- to 2-cm renal stones. However, the stone free rate is similar between the two procedures while mini-PNL is superior in terms of fluoroscopy, operation, hospitalization and return to work duration. We think that F-URS is more comfortable and less painful than mini-PNL and achieves a similar stone free rate for the treatment of 1- to 2-cm renal stones.

Effect of low-intensity pulsed ultrasound on bone regeneration: biochemical and radiologic analyses.

PubMed

Pomini, Karina T; Andreo, Jesus C; Rodrigues, Antonio de C; de O Gonçalves, Jéssica B; Daré, Letícia R; German, Iris J S; Rosa, Geraldo M; Buchaim, Rogerio L

2014-04-01

The purpose of this study was to evaluate the effects of low-intensity pulsed ultrasound at 1.0 MHz on the healing process of fractures with bone loss in the rat fibula by alkaline phosphate level measurement and radiologic analyses. Thirty 70-day-old male Wistar rats underwent a bone resection of 2.5 to 3.0 mm between the proximal and middle third of the right fibular diaphysis. The animals were randomly divided into 3 experimental groups: reference (uninjured), control (injured only), and treated (injured and treated with 5 applications of ultrasound, interspersed by 2 days of rest, beginning 24 hours after the osteotomy). Euthanasia was performed at experimental periods of 7 and 14 days. The right hind limb was removed for radiologic analysis. The blood was collected via cardiac puncture to determine the serum alkaline phosphatase activity. The bone fractures had not been completely consolidated in the treated and control group when analysis of the bone took place. At day 7, the serum alkaline phosphatase activity was higher in the treated group (mean ± SD, 72.17 ± 7.02 U/L) compared to the control (65.26 ± 8.41 U/L) and reference (67.21 ± 7.86 U/L) groups. At day 14, higher alkaline phosphatase activity was seen in the control group (68.96 ± 8.12 U/L) compared to the treated (66.09 ± 8.46 U/L) and reference (67.14 ± 7.96 U/L) groups. The biochemical and radiologic results suggest that low-intensity pulsed ultrasound can be used as an auxiliary method to consolidate fractures and probably reduces the bone healing time, offering clinical benefits.

The effect of endometrial scratch injury on pregnancy outcome in women with previous intrauterine insemination failure: A randomized clinical trial.

PubMed

Ashrafi, Mahnaz; Tehraninejad, Ensieh Shahrokh; Haghiri, Mansooreh; Masomi, Masoumeh; Sadatmahalleh, Shahideh Jahanian; Arabipoor, Arezoo

2017-09-01

Endometrial scratch injury (ESI) has been recently proposed to enhance the implantation rate in assisted reproductive technology cycles. The present study was conducted to determine the effect of ESI on pregnancy rate in women with intrauterine insemination (IUI) failure. This prospective randomized controlled study was carried out in Imam-Khomeini Hospital and Royan Institute, Tehran, during a 12-month period from January 2013 to January 2014. After assessment, 169 patients who had IUI failure twice or more (no chemical or clinical pregnancy) with normal uterine anatomy and hysterosalpingography, were enrolled. They were randomly assigned into two groups. In the experimental group, all patients underwent ESI at day 8 or 9 of stimulation phase in the present IUI cycle, whereas no intervention was performed on the control group. IUI outcome was then compared between the two groups. A total of 150 patients completed the IUI cycle during the study. The chemical pregnancy rate was 10.7% and 2.7% in the experimental and control groups, respectively, without significant difference (P = 0.09). Also no significant differences were detected in terms of clinical pregnancy and miscarriage rates between the two groups (P > 0.05). No significant beneficial effect of ESI on fertility outcome in patients with repeated IUI failure was detected when it was carried out on day 8 or 9 of the same IUI stimulation cycle. Also, however, no negative impact secondary to ESI was observed. Therefore, confirmation or refutation of this hypothesis requires further studies with a larger sample size. IRCT201507271141N19. © 2017 Japan Society of Obstetrics and Gynecology.

Effect of Nd: YAG laser on the apical seal after root-end resection and MTA retrofill: a bacterial leakage study.

PubMed

Birang, Reza; Kiani, Sepideh; Shokraneh, Ali; Hasheminia, Seyed Mohsen

2015-02-01

Laser irradiation has been investigated in terms of preventing leakage in retrofilled root canals. The aim of the present study was to evaluate the effect of neodymium-doped yttrium aluminum garnet (Nd: YAG) laser on the bacterial leakage of mineral trioxide aggregate (MTA)-retrofilled roots. In this ex vivo experimental study, 90 single-rooted incisor teeth were filled with gutta-percha and AH26 sealer. The apical 3 mm of all the roots were resected and 3-mm retrocavities were prepared by an ultrasonic device. The specimens were randomly divided into two experimental (n = 25), one positive control (n = 10), and two negative control (n = 10) groups. In the laser + MTA group, the cavity walls were irradiated by Nd: YAG laser prior to MTA placement. In the MTA group, MTA was placed without laser irradiation. The root surfaces were covered with two layers of nail varnish except for the apical 2 mm. The specimens were then embedded in a bacterial leakage test system and examined daily for 90 days. Contamination periods were recorded. Data were analyzed by Kaplan-Meier and Mann-Whitney U tests (α = 0.05). Five teeth with and five teeth without laser irradiation underwent scanning electron microscopic evaluation. The specimens in the laser + MTA group were contaminated earlier than those in the MTA group (p < 0.05). Comparison of survival times between the two groups showed significant differences (p < 0.05). Nd: YAG laser irradiation can decrease the sealing capacity of MTA in comparison to the apical seal achieved by MTA without laser irradiation. Further studies are recommended to provide a better seal for the MTA-retrofilled teeth after laser irradiation.

Comparison of survival outcomes after anatomical resection and non-anatomical resection in patients with hepatocellular carcinoma

PubMed Central

Kim, Seheon; Kim, Seokwhan; Song, Insang

2015-01-01

Backgrounds/Aims Liver resection is a curative procedure performed worldwide for hepatocellular carcinoma (HCC). Deciding on the appropriate resection range for postoperative hepatic function preservation is an important surgical consideration. This study compares survival outcomes of HCC patients who underwent anatomical or non-anatomical resection, to determine which offers the best clinical survival benefit. Methods One hundred and thirty-one patients underwent liver resection with HCC, between January 2007 and February 2015, and were divided into two groups: those who underwent anatomical liver resection (n=88) and those who underwent non-anatomical liver resection (n=43). Kaplan-Meier survival analysis and Cox regressions were used to compare the disease-free survival (DFS) and overall survival (OS) rates between the groups. Results The mean follow-up periods were 27 and 40 months in the anatomical and non-anatomical groups, respectively (p=0.229). The 3- and 5-year DFS rates were 70% and 60% in the anatomical group and 62% and 48% in the non-anatomical group, respectively. The 3 and 5-year OS rates were 94% and 78% in the anatomical group, and 86% and 80% in the non-anatomical group, respectively. The anatomical group tended to show better outcomes, but the findings were not significant. However, a relative risk of OS between the anatomical and non-anatomical group was 0.234 (95% CI, 0.061-0.896; p=0.034), which is statistically significant. Conclusions Although statistical significance was not detected in survival curves, anatomical resection showed better results. In this respect, anatomical resection is more likely to perform in HCC patients with preserve liver function than non-anatomical resection. PMID:26693235

A comparison of two techniques for knee arthrodesis: the custom made intramedullary Mayday nail versus a monoaxial external fixator.

PubMed

Yeoh, David; Goddard, Richard; Macnamara, Paul; Bowman, Nicholas; Miles, Kim; East, Debra; Butler-Manuel, Adrian

2008-08-01

The most common indication for knee arthrodesis is pain and instability in an unreconstructable knee following an infected knee arthroplasty. In this study, we compare the use of the Mayday arthrodesis nail (Orthodynamics, Christchurch, UK) versus external fixation, Orthofix (Berkshire UK) and Stryker Hoffman II (County Cork, Ireland). All patients in this study underwent arthrodesis between 1995 and 2006 at Conquest Hospital, Hastings. In group A, 11 patients underwent arthrodesis with a Mayday nail. In all cases, the indications were infected total knee replacements (TKR). Three of these patients previously had failed attempts at arthrodesis with external fixation devices. In group B, seven patients underwent arthrodesis using external fixation. In six patients, the indication was infected TKRs. Results were reviewed retrospectively, with union assessed both clinically and radiologically. The mean inpatient stay for the Mayday nail group was 23 days (range 8-45 days) compared with 76 days (range 34-122) for the external fixation group (p<0.01, CI 95). Ten patients in group A went on to confirmed primary arthrodesis. One patient underwent revision arthrodesis with a Mayday nail and subsequently united. In group B only two patients achieved union. The rate of union was significantly greater in the Mayday nail group than the external fixation group (91% vs 29%, p<0.01). Of those patients that achieved union, there was no difference in the time to fusion between groups. Our study supported the existing literature and found that the Mayday nail appeared more effective than monoaxial external fixators for arthrodesis in the management of infected total knee replacements.

Effect and mechanism of propofol on myocardial ischemia reperfusion injury in type 2 diabetic rats.

PubMed

Lin, Changfu; Sui, Haijing; Gu, Jie; Yang, Xue; Deng, Lin; Li, Wenzhi; Ding, Wengang; Li, Dongmei; Yang, Yingchun

2013-11-01

Propofol has been reported to have an inhibitory effect on ischemia/reperfusion (I/R) injury in various experimental models by reducing oxidative stress, protecting mitochondrial function and suppressing apoptosis. The aim of this study was to investigate the effect and mechanism of propofol on myocardial I/R injury in type 2 diabetic rats. A total of 24 streptozotocin (STZ)-induced diabetic rats were randomly divided into three equal groups as follows: the DI group with myocardial I/R, which was induced by occluding the left anterior descending coronary artery for 30min, followed by 2h of reperfusion; the DP group, which underwent I/R and propofol infusion at 6mg·kg(-1)·h(-1); and the DC group, which underwent sham operations without tightening of the coronary sutures. As a control, 24 healthy, age-matched, male Wistar rats were randomly divided into three equal groups: the CI, CP and CC groups. The injured cardiac tissues were removed for microscopic examination after reperfusion. The serum concentrations of nitric oxide (NO) and endothelin (ET-1); the expression of Bax, Bcl-2 and Caspase-3 within the cardiac structures; and the number of apoptotic myocardial cells were measured. Compared with the baseline levels before ischemia, the serum concentration of ET-1 after 2h of reperfusion was increased in the CI and DI groups, while the concentration of NO in these groups decreased after reperfusion. Compared with the I/R groups, propofol increased the content of NO and decreased the content of ET-1. Compared with the sham operation groups, I/R decreased the ratio of the anti-apoptotic protein Bcl-2 to the pro-apoptotic protein Bax, which resulted in an elevation of the index of apoptosis (AI). In contrast, compared with the I/R group, propofol increased the Bcl-2-to-Bax ratio and decreased the AI. I/R increased the expression of caspase-3 compared with the sham treatment groups, while treatment with propofol reduced caspase-3 expression relative to the I/R groups. These data suggest that propofol can protect against myocardial ischemia-reperfusion injury in both normal and type 2 diabetic rats, possibly by attenuating endothelial cell injury and inhibiting the apoptosis of cardiomyocytes. © 2013.

Periacetabular osteotomy and combined femoral head-neck junction osteochondroplasty: a minimum two-year follow-up cohort study.

PubMed

Nassif, Nader A; Schoenecker, Perry L; Thorsness, Robert; Clohisy, John C

2012-11-07

Proximal femoral deformities and overcorrection of the acetabulum both can result in secondary femoroacetabular impingement and suboptimal clinical results after periacetabular osteotomy. The purpose of the present study was to determine the rate of complications, the need for reoperations, radiographic correction, and hip function among patients who underwent periacetabular osteotomy and combined femoral head-neck osteochondroplasty as compared with those who underwent periacetabular osteotomy alone. Patients who underwent periacetabular osteotomy with or without osteochondroplasty of the femoral head-neck junction were evaluated retrospectively after a minimum duration of follow-up of two years. We compared the two groups with regard to the modified Harris hip score, radiographic correction, complications, and reoperations. Forty patients (forty hips) who underwent periacetabular osteotomy in conjunction with a femoral head-neck osteochondroplasty were compared with forty-eight patients (forty-eight hips) who underwent an isolated periacetabular osteotomy. Patients were evaluated after a mean duration of follow-up of 3.4 years (range, 2.0 to 9.7 years). Preoperatively, the modified Harris hip score (and standard deviation) was 64.3 ± 13.2 for the study group and 63.2 ± 13.4 for the comparison group. At the time of the latest follow-up, the modified Harris hip score was not significantly different between the study group and the comparison group (p = 0.17). Patients demonstrated equivalent preoperative deformities and postoperative acetabular radiographic parameters. There was a significant decrease in the alpha angle and improvement in head-neck offset in the study group. There was one reoperation for secondary impingement and/or labral pathology in the study group, compared with four reoperations in the comparison group. There were no adhesions requiring surgery, femoral neck fractures, instances of osteonecrosis, or increases in heterotopic ossification in the study group. Femoral head-neck junction osteochondroplasty performed concurrently with a periacetabular osteotomy for the treatment of symptomatic acetabular dysplasia and associated femoral head-neck junction deformities is not associated with an increased complication rate. This combined procedure provides effective correction of associated femoral head-neck deformities and produces similar early functional outcomes when compared with isolated periacetabular osteotomy. Therapeutic Level III.

BIOCHEMICAL ANALYSIS AND BONE REMODELING IN RESPONSE TO OOPHORECTOMY AND AQUATIC TRAINING

PubMed Central

SOUZA, HELENA RIBEIRO; GIROL, ANA PAULA; SCHIAVETO, ADRIANA PAULA SANCHEZ; GEROMEL, MAIRTO ROBERIS; IYOMASA, MELINA MIZUSAKI; ARRUDA, MAURÍCIO FERRAZ DE

2016-01-01

ABSTRACT Objective: To investigate whether swimming could prevent bone loss and could be indicated to assist in treatment of osteoporosis. Methods: Female rats were divided into 4 groups (n=6), two of them were oophorectomized. Animals from two groups, one oophorectomized and another not oophorectomized, underwent aquatic training for eight weeks. After training, the animals were sacrificed and their blood was collected for calcium and alkaline phosphatase serum dosage; the femur was removed and subjected to radiological and histological densitometry analysis to assess bone loss and osteoclast counting on femoral head and neck. Results: Increase in serum calcium was not observed. There was an increasing activity of alkaline phosphatase in the oophorectomized groups. The radiographs suggest that there was a greater bone mass density in the trained groups. Concerning histology, the trained groups had better tissue structural organization than the sedentary groups. In the oophorectomized and sedentary group, higher presence of osteoclasts was observed a. Conclusion: Exercise and oophorectomy did not promote changes in serum calcium levels. The decrease of sex steroids caused by oophorectomy was responsible for severe bone loss, but swimming exercise was able to reduce this loss. Oophorectomy promoted the proliferation of osteoclasts and the exercise proved to be able to diminish it. Level of Evidence I, Experimental Study. PMID:28149187

Umbilical hernia management during liver transplantation.

PubMed

de Goede, B; van Kempen, B J H; Polak, W G; de Knegt, R J; Schouten, J N L; Lange, J F; Tilanus, H W; Metselaar, H J; Kazemier, G

2013-08-01

Patients with liver cirrhosis scheduled for liver transplantation often present with a concurrent umbilical hernia. Optimal management of these patients is not clear. The objective of this study was to compare the outcomes of patients who underwent umbilical hernia correction during liver transplantation through a separate infra-umbilical incision with those who underwent correction through the same incision used to perform the liver transplantation. In the period between 1990 and 2011, all 27 patients with umbilical hernia and liver cirrhosis who underwent hernia correction during liver transplantation were identified in our hospital database. In 17 cases, umbilical hernia repair was performed through a separate infra-umbilical incision (separate incision group) and 10 were corrected from within the abdominal cavity without a separate incision (same incision group). Six patients died during follow-up; no deaths were attributable to intraoperative umbilical hernia repair. All 21 patients who were alive visited the outpatient clinic to detect recurrent umbilical hernia. One recurrent umbilical hernia was diagnosed in the separate incision group (6 %) and four (40 %) in the same incision group (p = 0.047). Two patients in the same incision group required repair of the recurrent umbilical hernia; one of whom underwent emergency surgery for bowel incarceration. The one recurrent hernia in the separate incision group was corrected electively. In the event of liver transplantation, umbilical hernia repair through a separate infra-umbilical incision is preferred over correction through the same incision used to perform the transplantation.

Differences in recurrent prolapse at 1 year after total vs supracervical hysterectomy and robotic sacrocolpopexy.

PubMed

Myers, Erinn M; Siff, Lauren; Osmundsen, Blake; Geller, Elizabeth; Matthews, Catherine A

2015-04-01

Optimal management of the cervix at the time of hysterectomy and sacrocolpopexy for primary uterovaginal prolapse is unknown. Our hypothesis was that recurrent prolapse at 1 year would be more likely after a supracervical robotic hysterectomy (SRH) compared with a total robotic hysterectomy (TRH) at the time of robotic sacrocolpopexy (RSCP) for uterovaginal prolapse. This was a retrospective cohort analysis of 83 women who underwent hysterectomy with RSCP over a 24-month period (40 with TRH and 43 with SRH). At 1 year post-procedure, subjects completed validated questionnaires regarding pelvic floor symptoms, sexual function, and global satisfaction, and underwent a pelvic examination to identify mesh exposure and evaluate pelvic floor support. Demographics of the two groups were similar, except for a higher mean body mass index in the TRH group (31.9 TRH vs 25.8 SRH kg/m(2), p < 0.001). The rate of recurrent prolapse ≥ stage II was higher for women who underwent SRH compared with TRH (41.9 % vs 20.0 %, p = 0.03; OR 2.8, 95 % CI, 1.07-7.7). However, when this was analyzed as recurrence ≥ hymen, there was no difference between groups (12.5 % TRH vs 18.6 % SRH, p = 0.45). Likewise, there was no difference between groups when a composite measure of success was used (30 out of 40 [75 %] TRH vs 29 out of 43 [67.4 %] SRH, p = 0.45). Women who underwent an SRH were 2.8 times more likely to have a recurrent prolapse, ≥ stage II, at 1 year, compared with those who underwent a TRH, but when composite assessment scores were used there was no difference between the groups.

Anterior Cervical Corpectomy with free vascularized fibular graft versus multilevel discectomy and grafting for Cervical Spondylotic Myelopathy

PubMed Central

Addosooki, Ahmad I; El-deen, Mohamed Alam

2015-01-01

Purpose A retrospective study to compare the radiologic and clinical outcomes of 2 different anterior approaches, multilevel anterior cervical discectomy with fusion (ACDF) using autologus ticortical bone graft versus anterior cervical corpectomy with fusion (ACCF) using free vascularized fibular graft (FVFG) for the management of cervical spondylotic myelopathy(CSM). Methods A total of 15 patients who underwent ACDF or ACCF using FVFG for multilevel CSM were divided into two groups. Group A (n = 7) underwent ACDF and group B (n = 8) ACCF. Clinical outcomes using Japanese Orthopaedic Association (JOA) score, perioperative parameters including operation time and hospital stay, radiological parameters including fusion rate and cervical lordosis, and complications were compared. Results Both group A and group B demonstrated significant increases in JOA scores. Patients who underwent ACDF experienced significantly shorter operation times and hospital stay. Both groups showed significant increases in postoperative cervical lordosis and achieved the same fusion rate (100 %). No major complications were encountered in both groups. Conclusion Both ACDF and ACCF using FVFG provide satisfactory clinical outcomes and fusion rates for multilevel CSM. However, multilevel ACDF is associated with better radiologic parameters, shorter hospital stay and shorter operative times. PMID:26767152

The Effect of Music Listening on Pain, Heart Rate Variability, and Range of Motion in Older Adults After Total Knee Replacement.

PubMed

Hsu, Chih-Chung; Chen, Su-Ru; Lee, Pi-Hsia; Lin, Pi-Chu

2017-12-01

The purpose of this study was to investigate the effects that listening and not listening to music had on pain relief, heart rate variability (HRV), and knee range of motion in total knee replacement (TKR) patients who underwent continuous passive motion (CPM) rehabilitation. We adopted a single-group quasi-experimental design. A sample of 49 TKR patients listened to music for 25 min during one session of CPM and no music during another session of CPM the same day for a total of 2 days. Results indicated that during CPM, patients exhibited a significant decrease in the pain level ( p < .05), an increase in the CPM knee flexion angle ( p < .05), a decrease in the low-frequency/high-frequency ratio (LF/HF) and normalized LF (nLF) of the HRV ( p < .01), and an increase in the normalized HF (nHF) and standard deviation of all normal-to-normal intervals (SDNN; p < .01) when listening to music compared with no music. This study demonstrated that listening to music can effectively decrease pain during CPM rehabilitation and improve the joint range of motion in patients who underwent TKR surgery.

Neuromuscular Training Improves Lower Extremity Biomechanics Associated with Knee Injury during Landing in 11–13 Year Old Female Netball Athletes: A Randomized Control Study

PubMed Central

Hopper, Amanda J.; Haff, Erin E.; Joyce, Christopher; Lloyd, Rhodri S.; Haff, G. Gregory

2017-01-01

The purpose of this study was to examine the effects of a neuromuscular training (NMT) program on lower-extremity biomechanics in youth female netball athletes. The hypothesis was that significant improvements would be found in landing biomechanics of the lower-extremities, commonly associated with anterior cruciate ligament (ACL) injury, following NMT. Twenty-three athletes (age = 12.2 ± 0.9 years; height = 1.63 ± 0.08 m; mass = 51.8 ± 8.5 kg) completed two testing sessions separated by 7-weeks and were randomly assigned to either a experimental or control group. Thirteen athletes underwent 6-weeks of NMT, while the remaining 10 served as controls and continued their regular netball training. Three-dimensional lower-extremity kinematics and vertical ground reaction force (VGRF) were measured during two landing tasks, a drop vertical jump and a double leg broad jump with a single leg landing. The experimental group significantly increased bilateral knee marker distance during the bilateral landing task at maximum knee-flexion range of motion. Knee internal rotation angle during the unilateral landing task at maximum knee flexion-extension range of motion was significantly reduced (p ≤ 0.05, g > 1.00). The experimental group showed large, significant decreases in peak vertical ground reaction force in both landing tasks (p ≤ 0.05, g > −1.30). Control participants did not demonstrate any significant pre-to-post-test changes in response to the 6-week study period. Results of the study affirm the hypothesis that a 6-week NMT program can enhance landing biomechanics associated with ACL injury in 11–13 year old female netball athletes. PMID:29163219

Effect and Mechanism of QiShenYiQi Pill on Experimental Autoimmune Myocarditis Rats

PubMed Central

Lv, Shichao; Wu, Meifang; Li, Meng; Wang, Qiang; Xu, Ling; Wang, Xiaojing; Zhang, Junping

2016-01-01

Background To observe the effect of QiShenYiQi pill (QSYQ) on experimental autoimmune myocarditis rats, and to explore its mechanism of action. Material/methods Lewis rats underwent the injection of myocardial myosin mixed with Freund’s complete adjuvant were randomized into 3 groups: model, valsartan, and QSYQ groups. Rats injected with phosphate-buffered saline (PBS) mixed with Freund’s complete adjuvant were used as the control group. Rats were euthanized at 4 and 8 weeks, and we weighed rat body mass, heart mass, and left ventricular mass. Myocardium sections were stained with hematoxylin and eosin (H&E) and Masson trichrome. Myocardial TGF-β1 and CTGF protein expression was detected by immunohistochemistry, and myocardial TGF-β1 and CTGF mRNA expression was detected by real-time qPCR. Results QSYQ reduced HMI and LVMI, as well as the histological score of hearts and CVF, which further decreased over time, and its effect was significantly greater than that of valsartan at 4 and 8 weeks. After 4 weeks, QSYQ inhibited the protein and mRNA expression of TGF-β1 and CTGF, and its effect on lowering CTGF was significantly greater than that of valsartan. In addition, after 8 weeks, QSYQ also inhibited the protein and mRNA expression of CTGF, whereas there was no significant difference in the expression of myocardial TGF-β1. Conclusions This study provides evidence that QSYQ can improve cardiac remodeling of experimental autoimmune myocarditis rats. It also effectively improved the degree of myocardial fibrosis, which is related to the mechanism of regulation of TGF-β1 CTGF. PMID:26946470

Development and evaluation of a computerized intervention for low distress tolerance and its effect on performance on a neutralization task.

PubMed

Macatee, Richard J; Cougle, Jesse R

2015-09-01

A growing body of research has linked high distress intolerance (DI) to obsessions, but not other OCD symptom domains. However, existing research is correlational. Experimental studies are needed, but brief methods for reducing DI are lacking. To address these gaps in the literature, a brief, computerized intervention aimed at reducing DI was developed to determine if changing DI affected obsessional phenomena. Individuals reporting high DI were randomized to a treatment or waitlist control group (N = 53). Individuals in the treatment group received the DI treatment (i.e., a 2 h computerized intervention) over two weeks, and then underwent a post-assessment in which DI and obsession-relevant phenomena were measured. Individuals in the control group only received the post-assessment. Analyses revealed a greater reduction in self-reported DI on one measure and smaller decreases in behavioral DI in the intervention condition relative to the waitlist condition, as well as lower in-vivo urges to neutralize an intrusive thought; however, anxious reactivity to the intrusion and neutralization behavior were not affected. Further, bootstrapping analyses revealed that reductions in DI mediated the effect of the intervention on neutralization urges. A clinical sample and placebo control condition were not used. These results provide experimental evidence for the role of DI in obsessional phenomena, specifically in affecting urges to neutralize intrusions, findings consistent with negative reinforcement models of DI. Further, results revealed that DI can be reduced with a brief, computerized intervention, which has important implications for future experimental research and treatment development. Copyright © 2015 Elsevier Ltd. All rights reserved.

Modification of Fear Memory by Pharmacological and Behavioural Interventions during Reconsolidation

PubMed Central

Thome, Janine; Koppe, Georgia; Hauschild, Sophie; Liebke, Lisa; Schmahl, Christian; Lis, Stefanie; Bohus, Martin

2016-01-01

Background Dysfunctional fear responses play a central role in many mental disorders. New insights in learning and memory suggest that pharmacological and behavioural interventions during the reconsolidation of reactivated fear memories may increase the efficacy of therapeutic interventions. It has been proposed that interventions applied during reconsolidation may modify the original fear memory, and thus prevent the spontaneous recovery and reinstatement of the fear response. Methods We investigated whether pharmacological (propranolol) and behavioural (reappraisal, multisensory stimulation) interventions reduce fear memory, and prevent reinstatement of fear in comparison to a placebo control group. Eighty healthy female subjects underwent a differential fear conditioning procedure with three stimuli (CS). Two of these (CS+) were paired with an electric shock on day 1. On day 2, 20 subjects were pseudo-randomly assigned to either the propranolol or placebo condition, or underwent one of the two behavioural interventions after one of the two CS+ was reactivated. On day 3, all subjects underwent an extinction phase, followed by a reinstatement test. Dependent variables were US expectancy ratings, fear-potentiated startle, and skin conductance response. Results Differential fear responses to the reactivated and non-reactivated CS+ were observed only in the propranolol condition. Here, the non-reactivated CS+ evoked stronger fear-potentiated startle-responses compared to the placebo group. None of the interventions prevented the return of the extinguished fear response after re-exposure to the unconditioned stimulus. Conclusions Our data are in line with an increasing body of research stating that the occurrence of reconsolidation may be constrained by boundary conditions such as subtle differences in experimental manipulations and instructions. In conclusion, our findings do not support a beneficial effect in using reconsolidation processes to enhance effects of psychotherapeutic interventions. This implies that more research is required before therapeutic interventions may benefit from a combination with reconsolidation processes. PMID:27537364

The effect of extracorporeal shock wave lithotripsy on the rat spinal cord.

PubMed

Karatas, A; Dosoglu, M; Zeyrek, T; Kayikci, A; Erol, A; Can, B

2008-09-01

Experimental study. To determine the effects of extracorporeal shock wave lithotripsy (ESWL) on the rat spinal cord. Animals were randomly divided into three groups. Groups 1 and 2 consisted of five rats each that underwent ESWL (2000 impulses at 15 kV and 2000 impulses at 18 kV, respectively) and group 3 contained five control rats (no shock wave treatment). ESWL-treated and control rats were compared with regard to light and electron microscopic findings of the adjacent spinal cord. Gross neurological outcomes were normal in all groups. Light microscopic examination of group 1 showed extensive extravasation of red blood cells over all the interstitial spaces. Group 2 also had haemorrhagic areas and an irregular organization of axons in the white matter. Transmission electron microscopic examination of group 1 indicated extravasated red blood cells through the endothelium and swollen axoplasm, degenerated mitochondria, destruction of myelin sheaths and a slight increase in the number of lysosomes. Extravasated red blood cells were also seen in group 2. The axoplasmic mitochondria were enlarged, but no sign of mitochondrial degeneration was observed. Lamellar degeneration of myelin sheaths and abundant lysosomes were more predominant in group 2 than in group 1. Extracorporeal shock wave lithotripsy caused not only haemorrhage but also damage to neuronal structures except the nucleus. Our findings showed that higher-energy ESWL caused more myelin degeneration in the spinal cord.

Effect of Intravenous Administration of Contrast Media on Serum Creatinine Levels in Neonates.

PubMed

Bedoya, Maria A; White, Ammie M; Edgar, J Christopher; Pradhan, Madhura; Raab, Elisabeth L; Meyer, James S

2017-08-01

Purpose To assess the effect of intravenous contrast media on renal function in neonates. Materials and Methods Institutional review board approval was obtained with waiver of consent. Electronic health records from January 2011 to April 2013 were reviewed retrospectively. Measures of renal function were obtained in inpatient neonates who underwent magnetic resonance (MR) imaging or computed tomography (CT) and for whom serum creatinine (Cr) levels were obtained within 72 hours before imaging and at least one time after imaging (>1 day after administration of contrast material). A total of 140 neonates who received contrast material (59 who underwent CT with iohexol or iodixanol and 81 who underwent MR imaging with gadopentetate dimeglumine) were identified. These neonates were frequency matched according to sex, gestational and postnatal age, and preimaging serum Cr levels with neonates who underwent unenhanced MR imaging or CT. Cr levels and glomerular filtration rates (GFRs) were grouped according to when they were obtained (before imaging, 1-2 days after imaging, 3-5 days after imaging, 6-9 days after imaging, 10-45 days after imaging, and more than 45 days after imaging). Serum Cr levels and GFRs for each time period were compared between groups by using hierarchic regressions or χ 2 or Fisher exact tests and with repeated-measures analysis of variance to compare groups on the rate of change in serum Cr levels and GFRs from before to after imaging. Results Cr levels decreased and GFRs increased in both groups from before to after imaging (CT group, P ≤ .01; MR imaging group, P ≤ .01). The neonates who underwent contrast material-enhanced imaging and the neonates who underwent unenhanced imaging showed similar serum Cr levels at all examined time periods. Groups also did not differ in the proportion of neonates with serum Cr levels higher than the reference range (>0.4 mg/dL) at any time point (iodine- [P > .12] or gadolinium-based [P > .13] contrast material). Similar findings were observed for GFRs. None of the neonates developed nephrogenic systemic fibrosis. Conclusion In the absence of known renal failure, neonates receiving standard inpatient care do not appear to be at increased risk for developing renal toxicity due to administration of intravenous iodine- and gadolinium-based contrast material. © RSNA, 2017.

[Comparative clinical analysis of cesarean section technique by Misgav Ladach method and Pfennenstiel method].

PubMed

Popiela, A; Pańszczyk, M; Korzeniewski, J; Baranowski, W

2000-04-01

Clinical and biochemical parameters were analysed in 55 patients who underwent a caesarean section performed using Misgav Ladach method compared to reference group of 41 patients who underwent caesarean section using Pfannenstiel method. Shortened operation time, shortened hospitalisation time and less postoperative morbidity were observed in the Misgav Ladach group. This kind of method seems to have advantages in comparison to Pfannenstiel method.

The collagen, fibrinogen and thrombin biological adhesive is effective in treating experimental liver injuries.

PubMed

Oliveira, Frederico Michelino de; Carvalho, Marcus Vinícius H de; Marchi, Evaldo; Pinto, Clóvis Antônio Lopes

2016-01-01

to evaluate the effectiveness of an collagen-based adhesive associated with fibrinogen and thrombin in experimental liver injuries in rats. we randomly divided 30 Wistar rats into three groups: A, B and C. All underwent a standard liver traumatic injury. In group A, the lesion was treated with the adhesive; in group B, with conventional, absorbable suture; group C received no treatment. We analyzed the time of hemostasis, mortality, occurrence of adhesions and any histological changes. there was no statistical difference in relation to mortality (p=0.5820). The adhesive treated group showed the lowest hemostasis times (p=0.0573, odds ratio 13.5) and lower incidence of adhesions (p=0.0119). The histological alterations of the Groups A and B were similar, with foreign body granuloma formation separating the adhesive material and the hepatic stroma suture. the collagen adhesive associated with fibrinogen and thrombin was effective in treating experimental hepatic injury, providing a lower incidence of adhesions between the liver and surrounding structures. avaliar a eficácia de um adesivo a base de colágeno associado ao fibrinogênio e trombina, no trauma hepático experimental em ratos. toram incluídos no estudo 30 ratos Wistar, igualmente divididos aleatoriamente em três grupos: A, B e C. Todos foram submetidos à lesão traumática hepática padronizada. No grupo A, a lesão foi tratada com o adesivo, no grupo B, com sutura convencional com fio absorvível, e no grupo C, não houve tratamento da lesão. Foram analisados o tempo de hemostasia, mortalidade, ocorrência de aderências e eventuais alterações histológicas. os resultados mostraram que não houve diferença estatística em relação à mortalidade (p=0,5820). O grupo tratado com adesivo apresentou os menores tempos de hemostasia (p=0,0573 e odds ratio 13,5) e menor ocorrência de aderências (p=0,0119). Microscopicamente as alterações histológicas dos grupos A e B foram semelhantes, com a formação de granuloma de corpo estranho separando o material do adesivo e do fio de sutura do estroma hepático. o adesivo de colágeno associado ao fibrinogênio e trombina foi eficaz no tratamento do trauma hepático experimental, proporcionado menor ocorrência de aderências entre o fígado e as estruturas vizinhas.

Role of cytokine hemoadsorption in cardiopulmonary bypass-induced ventricular dysfunction in a porcine model.

PubMed

Vocelka, Craig R; Jones, Krystal M; Mikhova, Krasimira M; Ebisu, Ryan M; Shar, Ashley; Kellum, John A; Verrier, Edward D; Rabkin, David G

2013-12-01

Little is known about the effect of cardiopulmonary bypass alone on cardiac function; in an attempt to illuminate this relationship and test a possible mechanism, we used Cytosorb, a device capable of removing virtually all types of circulating cytokines to test the hypothesis that hemoadsorption of cytokines during bypass attenuates bypass-induced acute organ dysfunction. Twelve Yorkshire pigs (50-65 kg) were instrumented with a left ventricular conductance catheter. Baseline mechanics and cytokine expression (tumor necrosis factor [TNF], interleukin-6 [IL-6], and interleukin-10) were measured before and hourly after 1 hour of normothermic cardiopulmonary bypass. Animals underwent bypass without (cardiopulmonary bypass [CPB], n = 6) or with (CPB+HA, n = 6) the CytosorbTM device. Data were compared with "historical" controls (n = 6) that were similarly instrumented but underwent observation instead of bypass. Five hours after separation from bypass (or observation), animals were euthanized. Myocardial water content was determined postmortem. Neither TNF nor IL-6 was significantly elevated in either experimental group versus controls at any time point. Preload recruitable stroke work and dP/dtmax were significantly depressed immediately after separation from bypass in both CPB+HA and CPB and remained depressed for the duration of the experiment. Although Tau remained unchanged, dP/dTmin was significantly diminished in both bypass groups at all time points after separation from bypass. Cytokine hemoadsorption had no effect on any measurable index of function. Differences in postmortem data were not evident between groups. One hour of normothermic CPB results in a significant and sustained decline in left ventricular function that appears unrelated to changes in cytokine expression. Because we did not appreciate a significant change in cytokine concentrations postbypass, the capacity of cytokine hemoadsorption to attenuate CPB-induced ventricular dysfunction could not be assessed.

Effects of renal sympathetic denervation on the atrial electrophysiology in dogs with pacing-induced heart failure.

PubMed

Wang, Xiaozhan; Zhao, Qingyan; Deng, Hongping; Wang, Xule; Guo, Zongwen; Dai, Zixuan; Xiao, Jinping; Wan, Peixing; Huang, Congxin

2014-10-01

Heart failure (HF) and atrial fibrillation (AF) are associated with sympathetic activation. Renal sympathetic denervation (RSD) can suppress AF vulnerability. The impact of RSD on atrial electrophysiology in experimental HF is unclear. Twenty-two beagles were randomized into control, HF, and HF + RSD groups. Control dogs were implanted cardiac pacemakers without pacing. Dogs in the HF group underwent right ventricular pacing for 3 weeks at 240 beats/min to induce HF. The dogs in the HF + RSD group received RSD and underwent the same HF-inducing procedure. The P-wave dispersion was higher in HF dogs than in the control and HF + RSD dogs (19 ± 3.1 ms vs 13 ± 2.3 ms, 15 ± 2.9 ms, P = 0.04). Conduction time within the interatrium was significantly longer in the HF dogs than that in the control and HF + RSD dogs (39 ± 4 ms vs 31 ± 3 ms, 33 ± 4 ms; P = 0.03). Window of vulnerability (WOV) of AF was widened in the HF dogs than in the HF + RSD dogs (37 ± 5 ms vs 14 ± 3 ms; P < 0.01), while AF could not be induced (WOV = 0) in the control dogs during S1 S2 stimulation. The voltage in the threshold for AF inducibility was lower during ganglionated plexi stimulation in the HF dogs than in the control and HF + RSD dogs (1.8 ± 0.6 V vs 2.5 ± 0.6 V, 2.4 ± 0.4 V; P = 0.04). RSD could reverse the atrial electrical remodeling and decrease AF inducibility in dogs with pacing-induced HF. ©2014 Wiley Periodicals, Inc.

Pathogenesis of rheumatoid arthritis and the immune response

DOE Office of Scientific and Technical Information (OSTI.GOV)

Scheinberg, M.A.

1983-08-01

The interrelationship among lymphocytes, macrophages, and neutrophils appears to be an important aspect of the synovial inflammation that is characteristic of rheumatoid arthritis. In a study comparing gold sodium aurothiomalate (GST) with auranofin (Au), an orally absorbed compound, both appeared to inhibit the disease process and no difference between parenteral and oral administration was observed. Another study involved two groups of nine patients with severe rheumatoid arthritis. One group underwent plasmapheresis. The second group underwent total lymphoid irradiation. Both agents appeared to inhibit the disease process. Plasmapheresis was better tolerated that irradiation.

Scoliosis may increase the risk of recurrence of lumbar disc herniation after microdiscectomy.

PubMed

Chang, Hsuan-Kan; Chang, Huang-Chou; Wu, Jau-Ching; Tu, Tsung-Hsi; Fay, Li-Yu; Chang, Peng-Yuan; Wu, Ching-Lan; Huang, Wen-Cheng; Cheng, Henrich

2016-04-01

The aim of this paper was to investigate the risk of recurrence of lumbar disc herniation (LDH) in patients with scoliosis who underwent microdiscectomy. A series of consecutive patients who underwent microdiscectomy for LDH was retrospectively reviewed. The inclusion criteria were young adults younger than 40 years who received microdiscectomy for symptomatic 1-level LDH. An exclusion criterion was any previous spinal surgery, including fusion or correction of scoliosis. The patients were divided into 2 groups: those with scoliosis and those without scoliosis. The demographic data in the 2 groups were similar. All medical records and clinical and radiological evaluations were reviewed. A total of 58 patients who underwent 1-level microdiscectomy for LDH were analyzed. During the mean follow-up of 24.6 months, 6 patients (10.3%) experienced a recurrence of LDH with variable symptoms. The recurrence rate was significantly higher among the scoliosis group than the nonscoliosis group (33.3% vs. 2.3%, p = 0.001). Furthermore, the recurrence-free interval in the scoliosis group was short. Young adults (< 40 years) with uncorrected scoliosis are at higher risk of recurrent LDH after microdiscectomy.

Recent Surgical Results for Active Endocarditis Complicated With Perivalvular Abscess.

PubMed

Yoshioka, Daisuke; Toda, Koichi; Yokoyama, Jun-Ya; Matsuura, Ryohei; Miyagawa, Shigeru; Shirakawa, Yukitoshi; Takahashi, Toshiki; Sakaguchi, Taichi; Fukuda, Hirotsugu; Sawa, Yoshiki

2017-10-25

Surgical treatment for endocarditis patients with a perivalvular abscess is still challenging.Methods and Results:From 2009 to 2016, 470 patients underwent surgery for active endocarditis at 11 hospitals. Of these, 226 patients underwent aortic valve surgery. We compared the clinical results of 162 patients without a perivalvular abscess, 37 patients who required patch reconstruction of the aortic annulus (PR group) and 27 who underwent aortic root replacement (ARR group). Patients with a perivalvular abscess had a greater number ofStaphylococcusspecies and prosthetic valve endocarditis, a greater level of inflammation at diagnosis and symptomatic heart failure before surgery, especially in the ARR group. Nevertheless, the duration between diagnosis and surgery was similar, because of a high prevalence of intracranial hemorrhage in the ARR group. Hospital death occurred in 13 (9%) patients without a perivalvular abscess, in 4 (12%) in the PR and in 7 (32%) in the ARR group. Postoperative inflammation and end-organ function were similar between the groups. Overall survival of patients without a perivalvular abscess and that of the PR group was similar, but was significantly worse in the ARR group (P=0.050, 0.026). Freedom from endocarditis recurrence was similar among all patients. Patients treated with patch reconstruction showed favorable clinical results. Early surgical intervention is necessary when a refractory invasive infection is suspected.

The renoprotective effects of mannitol and udenafil in renal ischemia-reperfusion injury model.

PubMed

Özlülerden, Yusuf; Toktaş, Cihan; Aybek, Hülya; Küçükatay, Vural; Şen Türk, Nilay; Zumrutbas, Ali Ersin

2017-07-01

The aim of this study was to investigate and compare the effects of udenafil and mannitol in an experimental renal ischemia-reperfusion (I/R) injury model. A total of 64 female Wister Albino rats were used. Right nephrectomy was performed in all groups. In the control group; I/R injury was not performed. In the I/R group; left renal pedicle was clamped for 45 minutes and then underwent 60 minutes and 24 hours of reperfusion. In the mannitol group; 1 mL 20% mannitol was given intravenously 15 minutes before clamping. In the udenafil group; 10-mg/kg udenafil was given orally 1 hour before clamping. Creatinine (Cr), blood urea nitrogen (BUN), Cr clearance, malondialdehyde, neutrophil gelatinase associated lipocalin (NGAL), histological examination and DNA damage (Comet Assay method) levels were compared in tissue, serum and urine samples. Udenafil had a better protective effect than mannitol according to biochemical parameters (Cr, BUN, Cr clearance, and NGAL levels) and histopathological findings when compared with the I/R group. In the Comet sampling analysis no significant difference was detected. Udenafil has a better renoprotective effect than mannitol against I/R injury and this effect supports more functional improvements. Further clinical trials are needed to demonstrate those effects and clinical utility of udenafil for that purpose in humans.

The relationship between renal warm ischemia time and glomerular loss. An experimental study in a pig model.

PubMed

Damasceno-Ferreira, José Aurelino; Bechara, Gustavo Ruschi; Costa, Waldemar Silva; Pereira-Sampaio, Marco Aurélio; Sampaio, Francisco José Barcellos; Souza, Diogo Benchimol De

2017-05-01

To investigate the glomerular number after different warm ischemia times. Thirty two pigs were assigned into four groups. Three groups (G10, G20, and G30) were treated with 10, 20, and 30 minutes of left renal warm ischemia. The sham group underwent the same surgery without renal ischemia. The animals were euthanized after 3 weeks, and the kidneys were collected. Right kidneys were used as controls. The kidney weight, volume, cortical-medullar ratio, glomerular volumetric density, volume-weighted mean glomerular volume, and the total number of glomeruli per kidney were obtained. Serum creatinine levels were assessed pre and postoperatively. Serum creatinine levels did not differ among the groups. All parameters were similar for the sham, G10, and G20 groups upon comparison of the right and left organs. The G30 group pigs' left kidneys had lower weight, volume, and cortical-medullar ratio and 24.6% less glomeruli compared to the right kidney. A negative correlation was found between warm ischemia time and glomerular number. About one quarter of glomeruli was lost after 30 minutes of renal warm ischemia. No glomeruli loss was detected before 20 minutes of warm ischemia. However, progressive glomerular loss was associated with increasing warm ischemia time.

Protective effect of estrogen in endothelin-induced middle cerebral artery occlusion in female rats.

PubMed

Glendenning, Michele L; Lovekamp-Swan, Tara; Schreihofer, Derek A

2008-11-14

Estrogen is a powerful endogenous and exogenous neuroprotective agent in animal models of brain injury, including focal cerebral ischemia. Although this protection has been demonstrated in several different treatment and injury paradigms, it has not been demonstrated in focal cerebral ischemia induced by intraparenchymal endothelin-1 injection, a model with many advantages over other models of experimental focal ischemia. Reproductively mature female Sprague-Dawley rats were ovariectomized and divided into placebo and estradiol-treated groups. Two weeks later, halothane-anesthetized rats underwent middle cerebral artery (MCA) occlusion by interparenchymal stereotactic injection of the potent vasoconstrictor endothelin 1 (180pmoles/2microl) near the middle cerebral artery. Laser-Doppler flowmetry (LDF) revealed similar reductions in cerebral blood flow in both groups. Animals were behaviorally evaluated before, and 2 days after, stroke induction, and infarct size was evaluated. In agreement with other models, estrogen treatment significantly reduced infarct size evaluated by both TTC and Fluoro-Jade staining and behavioral deficits associated with stroke. Stroke size was significantly correlated with LDF in both groups, suggesting that cranial perfusion measures can enhance success in this model.

Novel experimental model of pressure overload hypertrophy in rats.

PubMed

Molina, Ezequiel J; Gupta, Dipin; Palma, Jon; Torres, Denise; Gaughan, John P; Houser, Steven; Macha, Mahender

2009-05-15

We studied a novel animal model of pressure overload hypertrophy in transition to heart failure following ascending aortic constriction. We sought to assess chronologic changes in hemodynamic parameters, echocardiographic signs of left ventricular (LV) remodeling, exercise tolerance, and profiles of systemic and local inflammation. A cohort of Sprague Dawley rats underwent aortic constriction proximal to the innominate artery and were followed by echocardiography. A group of animals were euthanized 20 wk after aortic constriction, before any detectable decline in fractional shortening (normal fractional shortening (FS) or control group; n = 6). When additional animals reached an absolute 25% decline in fractional shortening, they were randomized to be euthanized on d 0 (25% downward arrow FS group; n = 5), or d 21 (>25% downward arrow FS group; n = 6). Hemodynamic and echocardiographic assessment, swim testing to exhaustion, and measurement of systemic and local inflammatory markers was performed at each time interval. An absolute decline of 25% in FS after aortic constriction was observed between 24 and 28 wk for most animals. The transition from compensated to decompensated hypertrophy was associated with markedly decreased dP/dt(max) and dP/dt(min), increased LV end-systolic diameter and LV end-diastolic diameter, stabilization of LV free wall diameter, decreased exercise performance and up-regulation in expression of interleukin-1, interleukin-6, tumor necrosis factor-alpha, and atrial natriuretic peptide. All animals developed heart failure. This study demonstrates that proximal aortic constriction in young rats represents an excellent experimental model of pressure overload hypertrophy that may be useful for testing the efficacy of novel therapies for the treatment of heart failure.

Optimization of human tendon tissue engineering: peracetic acid oxidation for enhanced reseeding of acellularized intrasynovial tendon.

PubMed

Woon, Colin Y L; Pridgen, Brian C; Kraus, Armin; Bari, Sina; Pham, Hung; Chang, James

2011-03-01

Tissue engineering of human flexor tendons combines tendon scaffolds with recipient cells to create complete cell-tendon constructs. Allogenic acellularized human flexor tendon has been shown to be a useful natural scaffold. However, there is difficulty repopulating acellularized tendon with recipient cells, as cell penetration is restricted by a tightly woven tendon matrix. The authors evaluated peracetic acid treatment in optimizing intratendinous cell penetration. Cadaveric human flexor tendons were harvested, acellularized, and divided into experimental groups. These groups were treated with peracetic acid in varying concentrations (2%, 5%, and 10%) and for varying time periods (4 and 20 hours) to determine the optimal treatment protocol. Experimental tendons were analyzed for differences in tendon microarchitecture. Additional specimens were reseeded by incubation in a fibroblast cell suspension at 1 × 10(6) cells/ml. This group was then analyzed for reseeding efficacy. A final group underwent biomechanical studies for strength. The optimal treatment protocol comprising peracetic acid at 5% concentration for 4 hours produced increased scaffold porosity, improving cell penetration and migration. Treated scaffolds did not show reduced collagen or glycosaminoglycan content compared with controls (p = 0.37 and p = 0.65, respectively). Treated scaffolds were cytotoxic to neither attached cells nor the surrounding cell suspension. Treated scaffolds also did not show inferior ultimate tensile stress or elastic modulus compared with controls (p = 0.26 and p = 0.28, respectively). Peracetic acid treatment of acellularized tendon scaffolds increases matrix porosity, leading to greater reseeding. It may prove to be an important step in tissue engineering of human flexor tendon using natural scaffolds.

The role of mechanisms of buffering anxiety in HIV carriers. A study within the terror management theory paradigm.

PubMed

Kwiatkowska, Marta; Knysz, Brygida; Gąsiorowski, Jacek; Łuszczyńska, Aleksandra; Gładysz, Andrzej

2011-02-28

The paper concerns definition of the level of posttraumatic growth (PTG), the psychological adaptation mechanism occurring after extreme experiences in life, such as being informed of having HIV infection. The study is experimental, aiming to assess whether correlations between exposure to thoughts of stressful experiences and their psychological consequences are mediated by an efficient mechanism of buffering anxiety Fifty-four men and 26 women infected with HIV who underwent manipulated exposure to mortality according to the hypotheses of the terror management theory (TMT) were included. Subjects were randomly assigned to the control group (dental anxiety) or the experimental group (fear of dying). The results confirmed the assumptions of the terror management theory. The subjects had an efficient mechanism of alleviating the fear of dying, the so-called "anxiety buffer." The analysis revealed a high level of posttraumatic growth and advantages derived from the disease. The paper additionally characterizes the specific group of HIV-positive people, their functioning in society and the family. It touches on such issues as professional work, relations with relatives and friends, social life, and adherence. The study has shown that the specific group of people infected with HIV managed very well to adapt to the circumstances. One may say that as a consequence of acquiring the infection, the subjects have experienced significant changes of personality, which have ultimately led to an improvement of their lives and offered new possibilities for personal and social development to them. All the recorded changes fit into the TMT paradigm. ® Postepy Hig Med Dosw

Effect of low-level laser therapy (LLLT) on peripheral nerve regeneration using fibrin glue derived from snake venom.

PubMed

Buchaim, Rogerio Leone; Andreo, Jesus Carlos; Barraviera, Benedito; Ferreira Junior, Rui Seabra; Buchaim, Daniela Vieira; Rosa Junior, Geraldo Marco; de Oliveira, Alexandre Leite Rodrigues; de Castro Rodrigues, Antonio

2015-04-01

The purpose of this study was to assess whether the adhesive permits the collateral repair of axons originating from a vagus nerve to the interior of a sural nerve graft, and whether low-level laser therapy (LLLT) assists in the regeneration process. Study sample consisted of 32 rats randomly separated into three groups: Control Group (CG; n=8), from which the intact sural nerve was collected; Experimental Group (EG; n=12), in which one of the ends of the sural nerve graft was coapted to the vagus nerve using the fibrin glue; and Experimental Group Laser (EGL; n=12), in which the animals underwent the same procedures as those in EG with the addition of LLLT. Ten weeks after surgery, the animals were euthanized. Morphological analysis by means of optical and electron microscopy, and morphometry of the regenerated fibers were employed to evaluate the results. Collateral regeneration of axons was observed from the vagus nerve to the interior of the autologous graft in EG and EGL, and in CG all dimensions measured were greater and presented a significant difference in relation to EG and EGL, except for the area and thickness of the myelin sheath, that showed significant difference only in relation to the EG. The present study demonstrated that the fibrin glue makes axonal regeneration feasible and is an efficient method to recover injured peripheral nerves, and the use of low-level laser therapy enhances nerve regeneration. Copyright © 2015 Elsevier Ltd. All rights reserved.

Analysis of three surgical treatments for spontaneous supratentorial intracerebral hemorrhage.

PubMed

Cai, Qiang; Zhang, Huaping; Zhao, Dong; Yang, Zhaohui; Hu, Keqi; Wang, Long; Zhang, Wenfei; Chen, Zhibiao; Chen, Qianxue

2017-10-01

This retrospective study aimed to evaluate the effectiveness and safety of 3 surgical procedures for Spontaneous Supratentorial Intracerebral Hemorrhage (SICH).A total of 63 patients with SICH were randomized into 3 groups. Group A (n = 21) underwent craniotomy surgery, group B (n = 22) underwent burr hole, urokinase infusion and catheter drainage, and group C (n = 20) underwent neuroendoscopic surgery. The hematoma evacuation rate of the operation was analyzed by 3D Slice software and the average surgery time, visualization during operation, decompressive effect, mortality, Glasgow Coma Scale (GCS) improvement, complications include rebleeding, pneumonia, intracranial infection were also compared among 3 groups.All procedures were successfully completed and the hematoma evacuation rate was significant differences among 3 groups which were 79.8%, 43.1%, 89.3% respectively (P < .01), and group C was the highest group. Group B was smallest traumatic one and shared the shortest operation time, but for the lack of hemostasis, it also the highest rebleeding group (P = .03). Although there were different in complications, but there was no significant in pneumonia, intracranial infection, GCS improvement and mortality rate.All these 3 methods had its own advantages and shortcomings, and every approach had its indications for SICH. Although for neuroendoscopic technical's minimal invasive, direct vision, effectively hematoma evacuation rate, and the relatively optimistic result, it might be a more promising approach for SICH.

Analysis of three surgical treatments for spontaneous supratentorial intracerebral hemorrhage

PubMed Central

Cai, Qiang; Zhang, Huaping; Zhao, Dong; Yang, Zhaohui; Hu, Keqi; Wang, Long; Zhang, Wenfei; Chen, Zhibiao; Chen, Qianxue

2017-01-01

Abstract This retrospective study aimed to evaluate the effectiveness and safety of 3 surgical procedures for Spontaneous Supratentorial Intracerebral Hemorrhage (SICH). A total of 63 patients with SICH were randomized into 3 groups. Group A (n = 21) underwent craniotomy surgery, group B (n = 22) underwent burr hole, urokinase infusion and catheter drainage, and group C (n = 20) underwent neuroendoscopic surgery. The hematoma evacuation rate of the operation was analyzed by 3D Slice software and the average surgery time, visualization during operation, decompressive effect, mortality, Glasgow Coma Scale (GCS) improvement, complications include rebleeding, pneumonia, intracranial infection were also compared among 3 groups. All procedures were successfully completed and the hematoma evacuation rate was significant differences among 3 groups which were 79.8%, 43.1%, 89.3% respectively (P < .01), and group C was the highest group. Group B was smallest traumatic one and shared the shortest operation time, but for the lack of hemostasis, it also the highest rebleeding group (P = .03). Although there were different in complications, but there was no significant in pneumonia, intracranial infection, GCS improvement and mortality rate. All these 3 methods had its own advantages and shortcomings, and every approach had its indications for SICH. Although for neuroendoscopic technical's minimal invasive, direct vision, effectively hematoma evacuation rate, and the relatively optimistic result, it might be a more promising approach for SICH. PMID:29069046

The effect of modified bridge exercise on balance ability of stroke patients.

PubMed

Song, Gui-Bin; Heo, Ju-Young

2015-12-01

[Purpose] The purpose of this study was to verify the effects of a modified bridging exercise on stroke patients with improvement in weight bearing on the affected side in standing and static balancing ability. [Subjects] Thirty patients who had a stroke were randomly allocated into a supine bridge exercise group (SBG, n=10), a supine bridge exercise on a TOGU balance pad group (SBTG, n=10), and a unilateral bridge exercise group (UBG, n=10). [Methods] The SBG patients underwent supine bridge exercise, the SBTG patients underwent supine bridge exercise with a TOGU balance pad, and the UBG patients underwent unilateral bridge exercise. All groups received 20 minutes of training per day, five times per week, for four weeks. [Results] All groups showed significant changes in weight bearing in a standing position after the intervention. The SBTG and UBG groups showed significant changes in balance ability. [Conclusion] According to the results of this study, bridge exercise was effective in improving weight bearing in a standing position and improving balance on stroke patients. The bridge exercise with a TOGU balance pad and the unilateral bridge exercise were especially more effective in anterior, posterior length in limit of stability following on standing.

Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis

PubMed Central

Liang, Hung-Hua; Hung, Chin-Sheng; Wang, Weu; Tam, Ka-Wai; Chang, Chun-Chao; Liu, Hui-Hsiung; Yen, Ko-Li; Wei, Po-Li

2014-01-01

Background Laparoscopic surgery has become the standard for treating appendicitis. The cosmetic benefits of using single-incision laparoscopy are well known, but its duration, complications and time to recovery have not been well documented. We compared 2 laparoscopic approaches for treating appendicitis and evaluated postoperative pain, complications and time to full recovery. Methods We retrospectively reviewed the cases of consecutive patients with appendicitis and compared those who underwent conventional laparoscopic appendectomy (CLA) performed using 3 incisions and those who underwent single-incision laparoscopic appendectomy (SILA). During SILA, the single port was prepared to increase visibility of the operative site. Results Our analysis included 688 consecutive patients: 618 who underwent CLA and 70 who underwent SILA. Postsurgical complications occurred more frequently in the CLA than the SILA group (18.1% v. 7.1%, p = 0.018). Patients who underwent SILA returned to oral feeding sooner than those who underwent CLA (median 12 h v. 22 h, p < 0.001). These between-group differences remained significant after controlling for other factors. Direct comparison of only nonperforated cases, which was determined by pathological examination, revealed that SILA was significantly longer than CLA (60 min v. 50 min, p < 0.001). Patients who underwent SILA had longer in-hospital stays than those who underwent CLA (72 v. 55 h, p < 0.001); however, they had significantly fewer complications (3.0% v. 14.4%, p = 0.006). Conclusion In addition to its cosmetic advantages, SILA led to rapid recovery and no increase in postsurgical pain or complications. PMID:24869622

Effect of interferential current therapy on pain perception and disability level in subjects with chronic low back pain: a randomized controlled trial.

PubMed

Albornoz-Cabello, Manuel; Maya-Martín, Julián; Domínguez-Maldonado, Gabriel; Espejo-Antúnez, Luis; Heredia-Rizo, Alberto Marcos

2017-02-01

To assess the short-term efficacy of transregional interferential current therapy on pain perception and disability level in chronic non-specific low back pain. A randomized, single-blinded (the assessor collecting the outcome data was blinded), controlled trial. A private physiotherapy research clinic. A total of 64 individuals, 20 men and 44 women, mean (SD) age was 51 years (11.93), with low back pain of more than three months, with or without pain radiating to the lower extremities above the knee, were distributed into a control ( n = 20) or an experimental group ( n = 44). A 2:1 randomization ratio was used in favour of the latter. A transregional interferential current electrotherapy protocol was performed for participants in the experimental group, while the control group underwent a 'usual care' treatment (massage, mobilization and soft-tissue techniques). All subjects received up to 10 treatment sessions of 25 minutes over a two-week period, and completed the intervention and follow-up evaluations. Self-perceived pain was assessed with a Visual Analogue Scale. Secondary measure included the Oswestry Low Back Disability Index. Evaluations were collected at baseline and after the intervention protocol. Significant between-group differences were found for interferential current therapy on pain perception ( p = 0.032) and disability level ( p = 0.002). The observed differences in the between-group mean changes were of 11.34 mm (1.77/20.91) and 13.38 points (4.97/21.78), respectively. A two-week transregional interferential current treatment has shown significant short-term efficacy, when compared with a 'usual care' protocol, on self-perceived pain and functionality in subjects with chronic low back pain.

Neurofeedback fMRI-mediated learning and consolidation of regional brain activation during motor imagery

PubMed Central

Yoo, Seung-Schik; Lee, Jong-Hwan; O’Leary, Heather; Panych, Lawrence P.; Jolesz, Ferenc A.

2009-01-01

We report the long-term effect of real-time functional MRI (rtfMRI) training on voluntary regulation of the level of activation from a hand motor area. During the performance of a motor imagery task of a right hand, blood-oxygenation-level-dependent (BOLD) signal originating from a primary motor area was presented back to the subject in real-time. Demographically matched individuals also received the same procedure without valid feedback information. Followed by the initial rtfMRI sessions, both groups underwent two-week long, daily-practice of the task. Off-line data analysis revealed that the individuals in the experimental group were able to increase the level of BOLD signal from the regulatory target to a greater degree compared to the control group. Furthermore, the learned level of activation was maintained after the two-week period, with the recruitment of additional neural circuitries such as the hippocampus and the limbo-thalamo-cortical pathway. The activation obtained from the control group, in the absence of proper feedback, was indifferent across the training conditions. The level of BOLD activity from the target regulatory region was positively correlated with a self evaluative score within the experimental group, while the majority of control subjects had difficulty adopting a strategy to attain the desired level of functional regulation. Our results suggest that rtfMRI helped individuals learn how to increase region-specific cortical activity associated with a motor imagery task, and the level of increased activation in motor areas was consolidated after the two-week self-practice period, with the involvement of neural circuitries implicated in motor skill learning. PMID:19526048

Mechanical assistance by intra-aortic balloon pump counterpulsation during reperfusion increases coronary blood flow and mitigates the no-reflow phenomenon: an experimental study.

PubMed

Pierrakos, Charalampos N; Bonios, Michael J; Drakos, Stavros G; Charitos, Efstratios I; Tsolakis, Elias J; Ntalianis, Argirios; Nanas, Serafim N; Charitos, Christos E; Nanas, John N; Terrovitis, John V

2011-09-01

The effects of the intra-aortic balloon pump (IABP) counterpulsation on the extent of myocardial infarction (MI), the no-reflow phenomenon (NRP), and coronary blood flow (CBF) during reperfusion in an ischemia-reperfusion experimental model have not been clarified. Eleven pigs underwent occlusion of the mid left anterior descending coronary artery for 1 h, followed by reperfusion for 2 h. CBF, distal to the occlusion site, was measured. In six experiments, IABP support began 10 min before, and continued throughout reperfusion (IABP Group). Five pigs without IABP support served as controls. At the end of each experiment, the myocardial area at risk (MAR) of infarction and the extent of MI and NRP were measured. Hemodynamic measurements at baseline and during coronary occlusion were similar in both groups. During reperfusion, systolic aortic blood pressure was significantly lower in the IABP Group than in controls. In the IABP Group, CBF reached a peak at 5 min of reperfusion, gradually decreased, but remained higher than at baseline, and significantly higher than in controls throughout the 2 h of reperfusion. In controls, CBF increased significantly above baseline immediately after the onset of reperfusion, then returned to baseline within 90 min. The extent of NRP (37 ± 25% vs. 68 ± 17%, P = 0.047) and MI (39 ± 23% vs. 67 ± 13%, P = 0.036), both expressed as percentage of MAR, was significantly less in the IABP group than in controls. After prolonged myocardial ischemia, IABP assistance started just 10 min before and throughout reperfusion increased CBF and limited infarct size and extent of NRP. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Improvement of nutritional support strategies after surgery for benign liver tumor through nutritional risk screening: a prospective, randomized, controlled, single-blind clinical study.

PubMed

Lu, Xin; Li, Ying; Yang, Huayu; Sang, Xinting; Zhao, Haitao; Xu, Haifeng; Du, Shunda; Xu, Yiyao; Chi, Tianyi; Zhong, Shouxian; Yu, Kang; Mao, Yilei

2013-02-01

The rising of individualized therapy requires nutritional risk screening has become a major topic for each particular disease, yet most of the screenings were for malignancies, less for benign diseases. There is no report on the screening of patients with benign liver tumors postoperatively. We aim to evaluate the nutritional support strategies post operation for benign liver tumors through nutritional risk screening. In this prospective, randomized, controlled study, 95 patients who underwent hepatectomy for benign tumors were divided into two groups. Fifty patients in the control group were given routine permissive underfeeding nutritional supply (75 kJ/kg/d), and 45 patients in the experimental group were given lower energy (42 kJ/kg/d) in accordance of their surgical trauma. Routine blood tests, liver/kidney function were monitored before surgery and at the day 1, 3, 5, 9 after surgery, patients were observed for the time of flatus, complications, length of hospitalization (LOH), nutrition-related costs, and other clinical parameters. This completed study is registered with Clinicaltrials.gov, number NCT01292330. The nutrition-related expenses (494.0±181.0 vs. 1,514.4±348.4 RMB, P<0.05) and the total hospital costs (18,495.2±4735.0 vs. 21,432.7±8,291.2 RMB, P<0.05) for patients in the experimental group were significantly lower than those in the control group. Meanwhile, the lowered energy supply after the surgeries did not have adverse effects on clinical parameters, complications, and LOH. Patient with benign liver tumors can adopt an even lower postoperative nutritional supply that close to that for mild non-surgical conditions, and lower than the postoperative permissive underfeeding standard.

Influence of extremely low frequency, low energy electromagnetic fields and combined mechanical stimulation on chondrocytes in 3-D constructs for cartilage tissue engineering.

PubMed

Hilz, Florian M; Ahrens, Philipp; Grad, Sibylle; Stoddart, Martin J; Dahmani, Chiheb; Wilken, Frauke L; Sauerschnig, Martin; Niemeyer, Philipp; Zwingmann, Jörn; Burgkart, Rainer; von Eisenhart-Rothe, Rüdiger; Südkamp, Norbert P; Weyh, Thomas; Imhoff, Andreas B; Alini, Mauro; Salzmann, Gian M

2014-02-01

Articular cartilage, once damaged, has very low regenerative potential. Various experimental approaches have been conducted to enhance chondrogenesis and cartilage maturation. Among those, non-invasive electromagnetic fields have shown their beneficial influence for cartilage regeneration and are widely used for the treatment of non-unions, fractures, avascular necrosis and osteoarthritis. One very well accepted way to promote cartilage maturation is physical stimulation through bioreactors. The aim of this study was the investigation of combined mechanical and electromagnetic stress affecting cartilage cells in vitro. Primary articular chondrocytes from bovine fetlock joints were seeded into three-dimensional (3-D) polyurethane scaffolds and distributed into seven stimulated experimental groups. They either underwent mechanical or electromagnetic stimulation (sinusoidal electromagnetic field of 1 mT, 2 mT, or 3 mT; 60 Hz) or both within a joint-specific bioreactor and a coil system. The scaffold-cell constructs were analyzed for glycosaminoglycan (GAG) and DNA content, histology, and gene expression of collagen-1, collagen-2, aggrecan, cartilage oligomeric matrix protein (COMP), Sox9, proteoglycan-4 (PRG-4), and matrix metalloproteinases (MMP-3 and -13). There were statistically significant differences in GAG/DNA content between the stimulated versus the control group with highest levels in the combined stimulation group. Gene expression was significantly higher for combined stimulation groups versus static control for collagen 2/collagen 1 ratio and lower for MMP-13. Amongst other genes, a more chondrogenic phenotype was noticed in expression patterns for the stimulated groups. To conclude, there is an effect of electromagnetic and mechanical stimulation on chondrocytes seeded in a 3-D scaffold, resulting in improved extracellular matrix production. © 2013 Wiley Periodicals, Inc.

The Impact of Preoperative Stoma Marking on Health-Related Quality of Life: A Comparison Cohort Study.

PubMed

McKenna, Linda S; Taggart, Elizabeth; Stoelting, Joyce; Kirkbride, Geri; Forbes, Gordon B

2016-01-01

The purpose of this study was to compare health-related quality of life (HRQOL) in patients receiving preoperative stoma marking by a certified wound, ostomy and continence nurse (CWOCN) to patients who did not receive preoperative marking. Quasi-experimental, nonrandomized comparison cohort study. The sample comprised 59 patients immediately following creation of a fecal stoma during an 18-month period between 2008 and 2010. The experimental group consisted of 35 patients with a mean age of 49.7 years who received preoperative stoma site marking by a CWOCN. Six of those 35 patients (17%) received preoperative ostomy education and stoma site marking. The control group consisted of 24 patients with a mean age of 60.1 years who did not receive preoperative stoma site marking or preoperative ostomy education. The study setting was a 500-bed Midwest Magnet-designated teaching hospital. Data collection occurred at 2 points: within 72 hours before hospital discharge and 8 weeks after discharge. The Stoma Quality of Life (Stoma-QOL) instrument was used to measure HRQOL. Two CWOCNs and 3 RNs, all members of Memorial's Ostomy & Wound Services, administered the Stoma QOL within 72 hours before hospital discharge. The 2 CWOCNs followed a scripted message to collect functional lifestyle factors and administer the Stoma-QOL, for the second time at 8 weeks after discharge. Groups were compared using analysis of covariance to control for age; analysis demonstrated significantly higher HOQOL in the marked group compared to the unmarked group (F = 4.9, P = .031). Findings demonstrated that patients who underwent stoma site marking reported higher HRQOL than those who did not.

Short-term results of a randomized trial examining timing of carotid endarterectomy in patients with severe asymptomatic unilateral carotid stenosis undergoing coronary artery bypass grafting.

PubMed

Illuminati, Giulio; Ricco, Jean-Baptiste; Caliò, Francesco; Pacilè, Maria Antonietta; Miraldi, Fabio; Frati, Giacomo; Macrina, Francesco; Toscano, Michele

2011-10-01

This study evaluated the timing of carotid endarterectomy (CEA) in the prevention of stroke in patients with asymptomatic carotid stenosis >70% receiving a coronary artery bypass graft (CABG). From January 2004 to December 2009, 185 patients with unilateral asymptomatic carotid artery stenosis >70%, candidates for CABG, were randomized into two groups. In group A, 94 patients received a CABG with previous or simultaneous CEA. In group B, 91 patients underwent CABG, followed by CEA. All patients underwent preoperative helical computed tomography scans, excluding significant atheroma of the ascending aorta or aortic arch. Baseline characteristics of the patients, type of coronary artery lesion, and preoperative myocardial function were comparable in the two groups. In group A, all patients underwent CEA under general anesthesia with the systematic use of a carotid shunt, and 79 patients had a combined procedure and 15 underwent CEA a few days before CABG. In group B, all patients underwent CEA, 1 to 3 months after CABG, also under general anesthesia and with systematic carotid shunting. Two patients (one in each group) died of cardiac failure in the postoperative period. Operative mortality was 1.0% in group A and 1.1% in group B (P = .98). No strokes occurred in group A vs seven ipsilateral ischemic strokes in group B, including three immediate postoperative strokes and four late strokes, at 39, 50, 58, and 66 days, after CABG. These late strokes occurred in patients for whom CEA was further delayed due to an incomplete sternal wound healing or because of completion of a cardiac rehabilitation program. The 90-day stroke and death rate was 1.0% (one of 94) in group A and 8.8% (eight of 91) in group B (odds ratio [OR], 0.11; 95% confidence interval [CI], 0.01-0.91; P = .02). Logistic regression analysis showed that only delayed CEA (OR, 14.2; 95% CI, 1.32-152.0; P = .03) and duration of cardiopulmonary bypass (OR, 1.06; 95% CI, 1.02-1.11; P = .004) reliably predicted stroke or death at 90 days. This study suggests that previous or simultaneous CEA in patients with unilateral severe asymptomatic carotid stenosis undergoing CABG could prevent stroke better than delayed CEA, without increasing the overall surgical risk. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Unnecessary gastric decompression in distal elective bowel anastomoses in children: a randomized study.

PubMed

Davila-Perez, Roberto; Bracho-Blanchet, Eduardo; Tovilla-Mercado, Jose Manuel; Hernandez-Plata, Jose Alejandro; Reyes-Lopez, Alfonso; Nieto-Zermeño, Jaime

2010-05-01

The goal of this study was to investigate the role of nasogastric drainage in preventing postoperative complications in children with distal elective bowel anastomosis. Nasogastric drainage has been used as a routine measure after gastrointestinal surgery in children and adults to hasten bowel function, prevent postoperative complications, and shorten hospital stay. However, there has been no study that shows in a scientific manner the benefit of nasogastric drainage in children. We performed a clinical, controlled, randomized trial comprising 60 children who underwent distal elective bowel anastomoses and compared postoperative complications between a group with nasogastric tube in place (n = 29) and one without it (n = 31). Demographic data and diagnoses were comparable in both groups (P = NS). No anastomotic leaks or enterocutaneous fistulae were found in any patient. There were no significant differences between the two groups with respect to abdominal distension, infection, or hospital stay. Only one patient in the experimental group required placement of the nasogastric tube due to persistent abdominal distension (3.2%). The routine use of nasogastric drainage after distal elective intestinal surgery in children can be eliminated. Its use should depend on the individual patient's situation.

Computerized Tomography-Guided Paracentesis: An Effective Alternative to Bedside Paracentesis?

PubMed

Gaduputi, Vinaya; Tariq, Hassan; Chandrala, Chaitanya; Sakam, Sailaja; Abbas, Naeem; Chilimuri, Sridhar

2017-02-01

Ascites remains the most common cause of hospitalization among patients with decompensated cirrhosis. Paracentesis is a relatively safe procedure with low complication rates. Computerized tomography (CT)-guided therapeutic paracentesis could be a safe and effective alternative to unaided or aided (ultrasonogram-guided) bedside paracentesis. In this retrospective study, we aimed to compare the efficacy, safety, and cost-effectiveness of CT-guided paracentesis with bedside paracentesis. The period of study was from 2002 to 2012. All patients with cirrhosis who underwent therapeutic paracentesis were included in the study. These patients were divided into two groups. Group I consisted of patients who underwent CT-guided pigtail catheter insertion with ascitic fluid drainage. Group II consisted of patients who underwent beside therapeutic paracentesis after localization of fluid either by physical examination or sonographic localization. We measured the efficacy of CT-guided paracentesis and bedside paracentesis in terms of volume of fluid removed, length of stay, discharge doses of diuretics (spironolactone and furosemide) and number of days to readmission for symptomatic ascites. We also computed the cost-effectiveness of CT-guided therapeutic paracentesis when compared to a bedside procedure. Fischer exact test was used to analyze the distribution of categorical data and unpaired t -test was used for comparison of means. There were a total of 546 unique patients with diagnosed cirrhosis who were admitted to the hospital with symptomatic ascites and underwent therapeutic paracentesis. Two hundred and forty-seven patients underwent CT-guided paracentesis, while 272 patients underwent bedside paracentesis. There was significant inverse correlation between the amount of ascitic fluid removed and total length of stay in the hospital. We found that the volume of fluid removed via a CT-guided pigtail insertion and drainage (2.72 ± 2.02 L) is significantly higher when compared to fluid removed via bedside paracentesis (1.94 ± 1.69). We also found that the interval time period between two successive therapeutic paracenteses was significantly longer for CT group (106.56 ± 75.2 days) when compared to the bedside group (25.57 ± 7.68 days). CT-guided paracentesis with pigtail catheter insertion and drainage is a clinically effective, cheap and safe alternative to conventional bedside paracentesis.

Comparison of Intraperitoneal Honey and Sodium Hyaluronate-Carboxymethylcellulose (Seprafilm™) for the Prevention of Postoperative Intra-Abdominal Adhesions

PubMed Central

Emre, Arif; Akin, Murat; Isikgonul, Ipek; Yuksel, Osman; Anadol, Ahmet Ziya; Cifter, Cagatay

2009-01-01

BACKGROUND: Abdominal surgery can lead to postoperative intra-abdominal adhesions (PIAAs) with significant morbidity and mortality. This study compares the use of honey with a standard bioresorbable membrane (Seprafilm™) to prevent the formation of PIAAs in rats. METHODS: Thirty rats underwent laparotomy, and PIAAs were induced by scraping the cecum. The animals were divided into three groups, each containing ten rats. Group 1 (control) represented the cecal abrasion group, with no intraperitoneal administration of any substance. Group 2 (honey group) underwent cecal abrasion and intraperitoneal administration of honey. Group 3 (Seprafilm™ group) underwent cecal abrasion and intraperitoneal Seprafilm™ application. RESULTS: Group 1 exhibited higher adhesion scores for adhesions between the abdominal wall and the organs. Groups 2 and 3 had decreased adhesive attachments to the intra-abdominal structures. Compared to group 1, the incidence of adhesion formation was lower in both group 2 (p=0.001) and group 3 (p=0.001). The incidence of fibrosis was also lower in group 2 (p=0.016) and group 3 (p=0.063) compared to group 1. There was no significant difference between the histopathological fibrosis scores for the rats in group 2 and those in group 3 (p= 0.688). CONCLUSION: This study suggests that both honey and Seprafilm™ decrease the incidence of PIAAs in the rat cecal abrasion model. Although the mechanism of action is not clear, intraperitoneal administration of honey reduced PIAAs. The outcome of this study demonstrates that honey is as effective as Seprafilm™ in preventing PIAAs. PMID:19488596

Comparison of aortic media changes in patients with bicuspid aortic valve stenosis versus bicuspid valve insufficiency and proximal aortic aneurysm.

PubMed

Girdauskas, Evaldas; Rouman, Mina; Borger, Michael A; Kuntze, Thomas

2013-12-01

The aim of this study was to evaluate aortic media changes in bicuspid aortic valve (BAV) patients who underwent aortic valve replacement (AVR) and simultaneous replacement of the proximal aorta for BAV stenosis vs BAV insufficiency. Review of our institutional BAV database identified a subgroup of 79 consecutive BAV patients (mean age 52.3 ± 13 years, 81% men) with BAV stenosis or insufficiency and concomitant proximal aortic dilatation of ≥50 mm who underwent AVR and simultaneous replacement of proximal aorta from 1995 through 2005. All cases of BAV disease and concomitant ascending aortic dilatation of 40-50 mm underwent isolated AVR and therefore were excluded from this analysis. Proximal aortic media elastic fibre loss (EFL) was assessed (graded 0 to 3+) and compared between patients with BAV stenosis (Group I, n = 44) vs BAV insufficiency (Group II, n = 35). Follow-up (690 patient-years) was 100% complete and 9.1 ± 4.6 years long. Mean aortic media EFL was 1.3 ± 0.7 in Group I vs 2.5 ± 0.8 in Group II (P = 0.03). Moderate/severe EFL (i.e. defined as grade 2+/3+) was found in 13 patients (29%) in Group I vs 28 patients (80%) in Group II (P < 0.001). Logistic regression identified BAV insufficiency as the strongest predictor of moderate/severe EFL (OR 9.3; 95% CI 3.2-29.8, P < 0.001). Valve-related event-free survival was 64 ± 8% in Group I vs 93% ± 5% in Group II at 10 years postoperatively (P = 0.05). A total of 4 patients (5%, 3 from Group I and 1 from Group II) underwent redo aortic root surgery for prosthetic valve endocarditis during follow-up. Patients with BAV insufficiency and a proximal aorta of ≥50 mm have a significantly higher rate of moderate/severe EFL as compared to their counterparts with BAV stenosis.

Identification of inferior pancreaticoduodenal artery during pancreaticoduodenectomy using augmented reality-based navigation system.

PubMed

Onda, Shinji; Okamoto, Tomoyoshi; Kanehira, Masaru; Suzuki, Fumitake; Ito, Ryusuke; Fujioka, Shuichi; Suzuki, Naoki; Hattori, Asaki; Yanaga, Katsuhiko

2014-04-01

In pancreaticoduodenectomy (PD), early ligation of the inferior pancreaticoduodenal artery (IPDA) before efferent veins has been advocated to decrease blood loss by congestion of the pancreatic head to be resected. In this study, we herein report the utility of early identification of the IPDA using an augmented reality (AR)-based navigation system (NS). Seven nonconsecutive patients underwent PD using AR-based NS. After paired-point matching registration, the reconstructed image obtained by preoperative computed tomography (CT) was fused with a real-time operative field image and displayed on 3D monitors. The vascular reconstructed images, including the superior mesenteric artery, jejunal artery, and IPDA were visualized to facilitate image-guided surgical procedures. We compared operating time and intraoperative blood loss of six patients who successfully underwent identification of IPDA using AR-based NS (group A) with nine patients who underwent early ligation of IPDA without using AR (group B) and 18 patients who underwent a conventional PD (group C). The IPDA or the jejunal artery was rapidly identified and ligated in six patients. The mean operating time and intraoperative blood loss in group A was 415 min and 901 ml, respectively. There was no significant difference in operating time and intraoperative blood loss among the groups. The AR-based NS provided precise anatomical information, which allowed the surgeons to rapidly identify and perform early ligation of IPDA in PD. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Sutureless versus Conventional Aortic Valve Replacement: Outcomes in 70 High-Risk Patients Undergoing Concomitant Cardiac Procedures.

PubMed

Hanedan, Muhammet Onur; Yuruk, Mehmet Ali; Parlar, Ali Ihsan; Ziyrek, Ugur; Arslan, Ali Kemal; Sayar, Ufuk; Mataraci, Ilker

2018-02-01

In elderly, high-risk surgical patients, sutureless aortic valve replacement (AVR) can often be an alternative to conventional AVR; shorter aortic cross-clamp and cardiopulmonary bypass times are the chief advantages. We compared the outcomes of sutureless AVR with those of conventional AVR in 70 elderly patients who underwent concomitant cardiac surgical procedures. We retrospectively analyzed the cases of 42 men and 28 women (mean age, 70.4 ± 10.3 yr; range, 34-93 yr) who underwent cardiac operations plus AVR with either a sutureless valve (group 1, n=38) or a conventional bioprosthetic or mechanical valve (group 2, n=32). Baseline patient characteristics were similar except for worse New York Heart Association functional status and the prevalence of diabetes mellitus in group 1. In group 1, the operative, cross-clamp, and cardiopulmonary bypass times were shorter (all P =0.001), postoperative drainage amounts were lower ( P =0.009), hospital stays were shorter ( P =0.004), and less red blood cell transfusion was needed ( P =0.037). Echocardiograms before patients' discharge from the hospital showed lower peak and mean aortic gradients in group 1 (mean transvalvular gradient, 8.4 ± 2.8 vs 12.2 ± 5.2 mmHg; P =0.012). We found that elderly, high-risk patients who underwent multiple cardiac surgical procedures and sutureless AVR had better hemodynamic outcomes and shorter ischemic times than did patients who underwent conventional AVR.

Simultaneous bilateral stereotactic procedure for deep brain stimulation implants: a significant step for reducing operation time.

PubMed

Fonoff, Erich Talamoni; Azevedo, Angelo; Angelos, Jairo Silva Dos; Martinez, Raquel Chacon Ruiz; Navarro, Jessie; Reis, Paul Rodrigo; Sepulveda, Miguel Ernesto San Martin; Cury, Rubens Gisbert; Ghilardi, Maria Gabriela Dos Santos; Teixeira, Manoel Jacobsen; Lopez, William Omar Contreras

2016-07-01

OBJECT Currently, bilateral procedures involve 2 sequential implants in each of the hemispheres. The present report demonstrates the feasibility of simultaneous bilateral procedures during the implantation of deep brain stimulation (DBS) leads. METHODS Fifty-seven patients with movement disorders underwent bilateral DBS implantation in the same study period. The authors compared the time required for the surgical implantation of deep brain electrodes in 2 randomly assigned groups. One group of 28 patients underwent traditional sequential electrode implantation, and the other 29 patients underwent simultaneous bilateral implantation. Clinical outcomes of the patients with Parkinson's disease (PD) who had undergone DBS implantation of the subthalamic nucleus using either of the 2 techniques were compared. RESULTS Overall, a reduction of 38.51% in total operating time for the simultaneous bilateral group (136.4 ± 20.93 minutes) as compared with that for the traditional consecutive approach (220.3 ± 27.58 minutes) was observed. Regarding clinical outcomes in the PD patients who underwent subthalamic nucleus DBS implantation, comparing the preoperative off-medication condition with the off-medication/on-stimulation condition 1 year after the surgery in both procedure groups, there was a mean 47.8% ± 9.5% improvement in the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score in the simultaneous group, while the sequential group experienced 47.5% ± 15.8% improvement (p = 0.96). Moreover, a marked reduction in the levodopa-equivalent dose from preoperatively to postoperatively was similar in these 2 groups. The simultaneous bilateral procedure presented major advantages over the traditional sequential approach, with a shorter total operating time. CONCLUSIONS A simultaneous stereotactic approach significantly reduces the operation time in bilateral DBS procedures, resulting in decreased microrecording time, contributing to the optimization of functional stereotactic procedures.

Does L-arginine induce intestinal adaptation by epithelial growth factor?

PubMed

Camli, Alparslan; Barlas, Meral; Yagmurlu, Aydin

2005-01-01

To evaluate whether L-Arginine has an effect on endogenous epidermal growth factor secretion and intestinal adaptation in massive small bowel resection an experimental study was performed. Fourteen albino Wistar rats weighing 250-300 g were used for the study. After performing 50% small bowel resection and anastomosis the rats were randomly divided into two groups. The first group received 500 mg/kg/day of L-Arginine intraperitoneally for 14 days just after the surgical procedure. The control group received isotonic saline instead. Body weight measurement was preformed daily. At the end of the second postoperative week all rats underwent relaparotomy. Small bowel was resected for histopathological examination. Levels of epidermal growth factor were measured by enzyme-linked immunosorbent assay in serum, saliva, and urine at the end of second postoperative week in both groups. The weight gain was higher in the L-Arginine treated group (P < 0.05). Serum, saliva and urinary epidermal growth factor levels were significantly higher at the end of the second week compared to the control group (P < 0.05). The villus height was higher on histopathological examination in L-Arginine treated group compared to the control group (P < 0.05). L-Arginine resulted in a better intestinal adaptation after massive bowel resection. The high levels of epidermal growth factor in body fluids of L-Arginine treated rats could be the explanation for this effect.

Postlaminectomy Bone and Scar Formations in Presence of Ankaferd Blood Stopper and Bitter Melon (Momordica Charantia): An Experimental Study.

PubMed

Kuruoglu, Enis; Onger, Mehmet Emin; Marangoz, Abdullah Hilmi; Kocacan, Suleyman Emre; Cokluk, Cengiz; Kaplan, Suleyman

2017-01-01

A quantitative model of postlaminectomy was designed in rats. The effects of Momordica Charantia (MC) and Ankaferd blood stopper (ABS) on the bone and scar formation after laminectomy were concurrently evaluated. Eighteen adult Wistar albino rats underwent lumbar laminectomy at L2-L3 vertebral levels, and were randomly assigned to one of three groups of six rats each. The Treatment group received MC and ABS treatment and the Control group was left untreated. Rats were sacrificed 4 weeks after treatment. Then; the lumbar spine was excised en-block, fixed and decalcified. Sections were stained with hematoxylin and eosin (H&E) and Masson"s trichrome, and evaluated for peridural fibrosis (PF), new bone formation, and vascular proliferation. Total volume of new bone in the MC group was significantly increased in comparison to the Control group (p < 0.05). Also; there was highly significant increase in terms of the total volume of fibrous tissue in the MC and ABS groups when compared with the Control group (p < 0.01). Besides; there was a highly significant difference between the MC and the Control groups (p < 0.01) in point of total volume of vessel. Both MC and ABS are not convenient to prevent the PF formation and MC may promote new bone formation and angiogenesis after lumbar laminectomy in rats.

Transdermal monosialoganglioside with laser in the treatment of spinal cord lesion in rats

PubMed Central

de Souza, Fabiano Inácio; Cristante, Alexandre Fogaça; Marcon, Raphael Martus; Ferreira, Ricardo; dos Santos, Gustavo Bispo; de Barros, Tarcísio Eloy Pessoa

2013-01-01

OBJECTIVES: To evaluate the effects of monosialoganglioside (GM1) administered transdermally with laser in the recovery of spinal cord injury in rats. METHODS: Forty male Wistar rats underwent spinal cord contusion using the NYU Impactor. In Group 1, the rats received 0,2 ml of saline intraperitoneally daily; in Group 2, GM1 was administered intraperitoneally at a concentration of 30 mg/kg per day; in Group 3, rats were treated daily with laser at low temperature on the skin, and in Group 4, the daily laser session also contained GM1. All the groups were treated for 42 days. The animals were evaluated by the Basso, Baettie and Bresnahan (BBB) functional scale on days 7, 14, 21, 28, 35 and 42 after the injury, and by histopathology and motor evoked potential after 42 days of injury. RESULTS: The animals in Group 4 had higher BBB scores compared with the other groups. There were no differences between the groups, or in the comparisons over time. Histological evaluation showed no differences, and no differences were found in the motor evoked potential tests either. CONCLUSION: GM1 associated with the use of low-temperature laser shows no superior functional, neurological or histological results in the treatment of spinal cord lesions in rats. Evidence Level I, Experimental, Controlled, Animal Study. PMID:24453649

How can periorbital oedema and ecchymose be reduced in rhinoplasty?

PubMed

Caglar, Erdem; Celebi, Saban; Topak, Murat; Develioglu, Necati Omer; Yalcin, Enis; Kulekci, Mehmet

2016-09-01

Oedema and ecchymose are frequent morbidities of septorhinoplasty, a facial surgical procedure for reforming the shape and functions of the nose. Periorbital oedema (PO) and periorbital ecchymose (PE) are normal occurrences, but are undesirable for patients undergoing the procedure for aesthetic purposes. The present study examined 65 patients who underwent open technique septorhinoplasty for aesthetic and functional complaints. Patients were divided into two groups: Group 1 patients underwent lateral osteotomy following tip plasty, at the end of the surgical operation; Group 2 patients underwent lateral osteotomy before tip plasty, at the beginning of the surgical operation. Patients were followed on the postoperative first, third and seventh days. PO and PE values of patients were scored from 0 to 4. The plastering time (Pt) was significantly shorter for Group I than Group II (p < 0.05). The total surgical time (T) showed no significant difference (p > 0.05). The PO value at the first, third and seventh days was significantly smaller for Group I than Group II (p < 0.05). The PE value at the first, third and seventh days was also significantly smaller for Group I than Group II (p < 0.05). The obtained data indicate that performing a lateral osteotomy in the final stages of surgery, and subsequently applying a nasal plaster and splint as rapidly as possible, decreases PO and PE in the postoperative period.

Outcome of Laparoscopic Versus Open Resection for Transverse Colon Cancer.

PubMed

Zeng, Wei-Gen; Liu, Meng-Jia; Zhou, Zhi-Xiang; Hou, Hui-Rong; Liang, Jian-Wei; Wang, Zheng; Zhang, Xing-Mao; Hu, Jun-Jie

2015-10-01

Laparoscopic resection for transverse colon cancer remains controversial. The aim of this study is to investigate the short- and long-term outcomes of laparoscopic surgery for transverse colon cancer. A total of 278 patients with transverse colon cancer from a single institution were included. All patients underwent curative surgery, 156 patients underwent laparoscopic resection (LR), and 122 patients underwent open resection (OR). The short- and long-term results were compared between two groups. Baseline demographic and clinical characteristics were comparable between two groups. Conversions were required in eight (5.1 %) patients. LR group was associated with significantly longer median operating time (180 vs. 140 min; P < 0.001). Median estimated blood loss was significantly less in LR group (90 vs. 100 ml; P = 0.001). Time to first flatus and oral intake was significantly earlier in LR group. Perioperative mortality and morbidity rate were not significantly different between two groups. Tumor size, number of lymph nodes harvested, length of proximal, and distal resection margin were comparable between two groups. Postoperative hospital stay was significantly shorter in LR group (9 vs. 10d; P < 0.001). Five-year disease-free survival and overall survival rate were similar between two groups. Laparoscopic resection for transverse colon cancer is associated with better short-term outcomes and equivalent long-term oncologic outcomes.

Efficacy of long scleral tunnel technique in preventing Ahmed glaucoma valve tube exposure through conjunctiva.

PubMed

Kugu, Suleyman; Erdogan, Gurkan; Sevim, M Sahin; Ozerturk, Yusuf

2015-01-01

To evaluate the efficacy of long scleral tunnel technique used in Ahmed glaucoma valve (AGV) implantation in preventing tube exposure through conjunctiva. Patients of adult age, who were unresponsive to maximum medical treatment and underwent AGV implantation, were divided into two groups and investigated retrospectively. Group 1 consisted of 40 eyes of 38 patients that underwent surgery by long scleral tunnel technique and Group 2 consisted of 38 eyes of 35 patients that underwent implantation by processed pericardium patch graft method. The mean age was 54.8 ± 14.6 years (range 26-68 years) and the mean follow-up duration was 46.7 ± 19.4 months (range 18-76 months) for the patients in Group 1, whereas the mean age was 58.6 ± 16.7 years (range 32-74 years) and mean follow-up period was 43.6 ± 15.7 months (range 20-72 months) for the patients in Group 2 (p > 0.05). In the course of follow-up, tube exposure was detected in one (2.5%) eye in Group 1 and in three (7.9%) eyes in Group 2 (p = 0.042). Long scleral tunnel technique is beneficial in preventing conjunctival tube exposure in AGV implantation surgery.

Outcomes of esophagectomy for esophageal achalasia in the United States.

PubMed

Molena, Daniela; Mungo, Benedetto; Stem, Miloslawa; Feinberg, Richard L; Lidor, Anne O

2014-02-01

While the outcomes after Heller myotomy have been extensively reported, little is known about patients with esophageal achalasia who are treated with esophagectomy. This was a retrospective analysis using the Nationwide Inpatient Sample over an 11-year period (2000-2010). Patients admitted with a primary diagnosis of achalasia who underwent esophagectomy (group 1) were compared to patients with esophageal cancer who underwent esophagectomy (group 2) during the same time period. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay, postoperative complications, and total hospital charges. A propensity-matched analysis was conducted comparing the same outcomes between group 1 and well-matched controls in group 2. Nine hundred sixty-three patients with achalasia and 18,003 patients with esophageal cancer underwent esophagectomy. The propensity matched analysis showed a trend toward a higher mortality in group 2 (7.8 vs. 2.9 %, p = 0.08). Postoperative length of stay and complications were similar in both groups. Total hospital charges were higher for the achalasia group ($115,087 vs. $99, 654.2, p = 0.006). This is the largest study to date examining outcomes after esophagectomy in patients with achalasia. Based on our findings, esophagectomy can be considered a safe option, and surgeons should not be hindered by a perceived notion of prohibitive operative risk in this patient population.

Proximal gastrectomy with jejunal interposition and TGRY anastomosis for proximal gastric cancer.

PubMed

Zhao, Ping; Xiao, Shuo-Meng; Tang, Ling-Chao; Ding, Zhi; Zhou, Xiang; Chen, Xiao-Dong

2014-07-07

To compare the short-term outcomes of patients who underwent proximal gastrectomy with jejunal interposition (PGJI) with those undergoing total gastrectomy with Roux-en-Y anastomosis (TGRY). From January 2009 to January 2011, thirty-five patients underwent PGJI, and forty-one patients underwent TGRY. The surgical efficacy and short-term follow-up outcomes were compared between the two groups. There were no differences in the demographic and clinicopathological characteristics. The mean operation duration and postoperative hospital stay in the PGJI group were statistically longer than those in the TGRY group (P = 0.00). No anastomosis leakage was observed in two groups. No statistically significant difference was found in endoscopic findings, Visick grade or serum albumin level. The single-meal food intake in the PGJI group was more than that in the TGRY group (P = 0.00). The PG group showed significantly better hemoglobin levels in the second year (P = 0.02). The two-year survival rate was not significantly different (PGJI vs TGRY, 93.55% vs 92.5%, P = 1.0). PGJI is a safe, radical surgical method for proximal gastric cancer and leads to better outcomes in terms of the single-meal food intake and hemoglobin level, compared with TGRY in the short term.

Randomized Controlled Study on Safety and Feasibility of Transfusion Trigger Score of Emergency Operations.

PubMed

Liu, De-Xing; Liu, Jin; Zhang, Fan; Zhang, Qiu-Ying; Xie, Mian; Zhu, Zhao-Qiong

2015-07-05

Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin (Hb) level between 7 and 10 g/dl. As a result, the trigger point of blood transfusion may be different in the emergency use of the existing transfusion guidelines. The present study was designed to evaluate whether the scheme can be safely and effectively used for emergency patients, so as to be supported by multicenter and large sample data in the future. From June 2013 to June 2014, patients were randomly divided into the experimental group (Peri-operative Transfusion Trigger Score of Emergency [POTTS-E] group) and the control group (control group). The between-group differences in the patients' demography and baseline information, mortality and blood transfusion-related complications, heart rate, resting arterial pressure, body temperature, and Hb values were compared. The consistency of red blood cell (RBC) transfusion standards of the two groups of patients with the current blood transfusion guideline, namely the compliance of the guidelines, utilization rate, and per-capita consumption of autologous RBC were analyzed. During the study period, a total of 72 patients were recorded, and 65 of them met the inclusion criteria, which included 33 males and 32 females with a mean age of (34.8 ± 14.6) years. 50 underwent abdomen surgery, 4 underwent chest surgery, 11 underwent arms and legs surgery. There was no statistical difference between the two groups for demography and baseline information. There was also no statistical differences between the two groups in anesthesia time, intraoperative rehydration, staying time in postanesthetic care unit, emergency hospitalization, postoperative 72 h Acute Physiologic Assessment and Chronic Health Evaluation II scores, blood transfusion-related complications and mortality. Only the POTTS-E group on the 1 st postoperative day Hb was lower than group control, P < 0.05. POTTS-E group was totally (100%) conformed to the requirements of the transfusion guideline to RBC infusion, which was higher than that of the control group (81.25%), P < 0.01.There were no statistical differences in utilization rates of autologous blood of the two groups; the utilization rates of allogeneic RBC, total allogeneic RBC and total RBC were 48.48%, 51.5%, and 75.7% in POTTS-E group, which were lower than those of the control group (84.3%, 84.3%, and 96.8%) P < 0.05 or P < 0.01. Per capita consumption of intraoperative allogeneic RBC, total allogeneic RBC and total RBC were 0 (0, 3.0), 2.0 (0, 4.0), and 3.1 (0.81, 6.0) in POTTS-E groups were all lower than those of control group (4.0 [2.0, 4.0], 4.0 [2.0, 6.0] and 5.8 [2.7, 8.2]), P < 0.05 or P < 0.001. Peri-operative Transfusion Trigger Score-E evaluation scheme is used to guide the application of RBC. There are no differences in the recent prognosis of patients with the traditional transfusion guidelines. This scheme is safe; Compared with doctor experience-based subjective assessment, the scoring scheme was closer to patient physiological needs for transfusion and more reasonable; Utilization rate and the per capita consumption of RBC are obviously declined, which has clinical significance and is feasible. Based on the abovementioned three points, POTTS-E scores scheme is safe, reasonable, and practicable and has the value for carrying out multicenter and large sample clinical researches.

High-frequency ultrasound as an adjunct to neural electrophysiology: Evaluation and prognosis of Bell's palsy.

PubMed

Li, Shuo; Guo, Rui-Jun; Liang, Xiao-Ning; Wu, Yue; Cao, Wen; Zhang, Zhen-Ping; Zhao, Wei; Liang, Hai-Dong

2016-01-01

Bell's palsy is a form of temporary facial nerve paralysis that occurs primarily in young adults. Previously, various methods were used to assess outcomes in facial nerve disease. The aim of the present study was to characterize the main branches of the normal and abnormal facial nerve using high-frequency ultrasonography (HFUS). A total of 104 healthy volunteers, 40 patients with acute onset of Bell's palsy and 30 patients who underwent 3-month routine therapy for Bell's palsy disease were included in the study. The healthy volunteers and patients were selected for HFUS examination and VII nerve conduction. The results showed significant differences in nerve diameter, echogenicity, delitescence and amplitude in different groups. Statistically significant correlations were identified for severity grading in one of the experimental groups during HFUS examinations. In conclusion, HFUS as a complementary technique paired with neural electrophysiology may establish the normal values of facial nerve. Additionally, HFUS was beneficial in the process of evaluation and prognosis of Bell's palsy disease.

Parenteral glutamine supplement has synergic effects in minimally invasive surgery of subtotal gastrectomy patients.

PubMed

Chen, Chien-Chia; Chang, Tung-Cheng; Wang, Ming-Yang; Wu, Ming-Hsun; Lin, Ming-Tsan

2012-09-01

Exogenous glutamine supplement is known to improve morbidity and mortality of critically-ill patients. This study was conducted to elucidate the role of glutamine in minimally invasive surgery. We retrospectively reviewed subtotal gastrectomy patients in National Taiwan University Hospital from Dec 2005 to Dec 2008. The patients were divided into three groups. Group 1 underwent subtotal gastrectomy by laparotomy without glutamine supplement, group 2 underwent subtotal gastrectomy by laparotomy with glutamine supplement and group 3 underwent gasless laparoscopy-assisted subtotal gastrectomy with parenteral glutamine supplement. There were 155 patients in total; 85 patients in group 1, 17 in group 2 and 53 in group 3. The mean flatus days after operation are 3.6, 3.1 and 2.8 for groups 1, 2 and 3, respectively (p=0.001). Oral intake after operation was commenced after 6.7, 5.0 and 4.7 days (p=0.006). The body temperature had borderline differences between groups 3 and 1. There were significant differences in postoperative systemic responses including heart rates (p<0.001) and tenderness (p=0.011) 5 days after operation for group 3 vs. group 1. Minimally invasive surgery was a negative factor for postoperative body temperature change. Glutamine was a significant factor for postoperative heart rate change and reduction of tenderness. Glutamine supplement may have synergic effects of rapid recovery in minimal invasive surgery for subtotal gastrectomy patients by minimizing the postoperative systemic response and accelerating recovery.

Leaving the placenta in situ versus conservative and radical surgery in the treatment of placenta accreta spectrum disorders.

PubMed

Kutuk, Mehmet S; Ak, Mehmet; Ozgun, Mahmut T

2018-03-01

To compare different treatment methods in the management of placenta accreta spectrum (PAS) disorders. In a retrospective cohort study, medical records were retrieved for patients who underwent elective surgery at 24 weeks of pregnancy or more after a diagnosis of PAS disorder (creta, increta, or percreta) at a center in Turkey between May 2, 2010, and August 10, 2016. The final analysis included patients whose diagnosis was confirmed intraoperatively and for whom complete data were available. Patients were divided into three groups: group 1 included those who underwent hysterectomy without placental removal, group 2 included patients whose placenta was left in situ, and group 3 included those who underwent placental removal and conservative surgery. Among 79 included patients (33 creta, 18 increta, 28 percreta), 27 (34%) were in group 1, 15 (19%) in group 2, and 37 (47%) in group 3. Total blood loss and the amounts of blood products transfused were lowest in group 2; significant differences between groups were noted (all P ≤ 0.001). Surgical complication rates were similar between groups (4/27 [15%], 1/15 [7%], and 11/37 [30%], respectively; P=0.119). Overall uterine preservation rates were not significantly different between groups 2 and 3 (14/15 [93%] vs 33/37 [89%]; P>0.99). Leaving the placenta in situ could become the treatment of choice for PAS disorders. © 2017 International Federation of Gynecology and Obstetrics.

Lipid-induced thermogenesis is up-regulated by the first cold-water immersions in juvenile penguins.

PubMed

Teulier, Loïc; Rey, Benjamin; Tornos, Jérémy; Le Coadic, Marion; Monternier, Pierre-Axel; Bourguignon, Aurore; Dolmazon, Virginie; Romestaing, Caroline; Rouanet, Jean-Louis; Duchamp, Claude; Roussel, Damien

2016-07-01

The passage from shore to marine life is a critical step in the development of juvenile penguins and is characterized by a fuel selection towards lipid oxidation concomitant to an enhancement of lipid-induced thermogenesis. However, mechanisms of such thermogenic improvement at fledging remain undefined. We used two different groups of pre-fledging king penguins (Aptenodytes patagonicus) to investigate the specific contribution of cold exposure during water immersion to lipid metabolism. Terrestrial penguins that had never been immersed in cold water were compared with experimentally cold-water immersed juveniles. Experimentally immersed penguins underwent ten successive immersions at approximately 9-10 °C for 5 h over 3 weeks. We evaluated adaptive thermogenesis by measuring body temperature, metabolic rate and shivering activity in fully immersed penguins exposed to water temperatures ranging from 12 to 29 °C. Both never-immersed and experimentally immersed penguins were able to maintain their homeothermy in cold water, exhibiting similar thermogenic activity. In vivo, perfusion of lipid emulsion at thermoneutrality induced a twofold larger calorigenic response in experimentally immersed than in never-immersed birds. In vitro, the respiratory rates and the oxidative phosphorylation efficiency of isolated muscle mitochondria were not improved with cold-water immersions. The present study shows that acclimation to cold water only partially reproduced the fuel selection towards lipid oxidation that characterizes penguin acclimatization to marine life.

A New Era of Therapeutic Strategies for Chronic Thromboembolic Pulmonary Hypertension by Two Different Interventional Therapies; Pulmonary Endarterectomy and Percutaneous Transluminal Pulmonary Angioplasty

PubMed Central

Ando, Motomi; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru

2014-01-01

Background Pulmonary endarterectomy (PEA) is established for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). Recently, percutaneous transluminal pulmonary angioplasty (PTPA) has been added for peripheral-type CTEPH, whose lesions exist in segmental, subsegmental, and more distal pulmonary arteries. A shift in clinical practice of interventional therapies occurred in 2009 (first mainly PEA, later PTPA). We examined the latest clinical outcomes of patients with CTEPH. Methods and Results This study retrospectively included 136 patients with CTEPH. Twenty-nine were treated only with drug (Drug-group), and the other 107 underwent interventional therapies (Interventions-group) (39 underwent PEA [PEA-group] and 68 underwent PTPA [PTPA-group]). Total 213 PTPA sessions (failures, 0%; mortality rate, 1.47%) was performed in the PTPA-group (complications: reperfusion pulmonary edema, 7.0%; hemosputum or hemoptysis, 5.6%; vessel dissection, 2.3%; wiring perforation, 0.9%). Although baseline hemodynamic parameters were significantly more severe in the Interventions-group, the outcome after the diagnosis was much better in the Interventions-group than in the Drug-group (98% vs. 64% 5-year survival, p<0.0001). Hemodynamic improvement in the PEA-group was a 46% decrease in mean pulmonary arterial pressure (PAP) and a 49% decrease in total pulmonary resistance (TPR) (follow-up period; 74.7±32.3 months), while those in the PTPA-group were a 40% decrease in mean PAP and a 49% decrease in TPR (follow-up period; 17.4±9.3 months). The 2-year survival rate in the Drug-group was 82.0%, and the 2-year survival rate, occurrence of right heart failure, and re-vascularization rate in the PEA-group were 97.4%, 2.6%, and 2.8%, and those in the PTPA-group were 98.5%, 2.9%, and 2.9%, respectively. Conclusion The patients who underwent interventional therapies had better results than those treated only with drugs. The availability of both of these operative and catheter-based interventional therapies leads us to expect the dawn of a new era of therapeutic strategies for CTEPH. PMID:24728482

Quality of Life of Patients with Spinal Metastasis from Cancer of Unknown Primary Origin: A Longitudinal Study of Surgical Management Combined with Postoperative Radiation Therapy.

PubMed

Ma, Yifei; He, Shaohui; Liu, Tielong; Yang, Xinghai; Zhao, Jian; Yu, Hongyu; Feng, Jiaojiao; Xu, Wei; Xiao, Jianru

2017-10-04

Patients with spinal metastasis from cancer of unknown primary origin have limited life expectancy and poor quality of life. Surgery and radiation therapy remain the main treatment options, but, to our knowledge, there are limited data concerning quality-of-life improvement after surgery and radiation therapy and even fewer data on whether surgical intervention would affect quality of life. Patients were enrolled between January 2009 and January 2014 at the Changzheng Hospital, Shanghai, People's Republic of China. The quality of life of 2 patient groups (one group that underwent surgery followed by postoperative radiation therapy and one group that underwent radiation therapy only) was assessed by the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire during a 6-month period. A subgroup analysis of quality of life was performed to compare different surgical strategies in the surgical group. A total of 287 patients, including 191 patients in the group that underwent surgery and 96 patients in the group that underwent radiation therapy only, were enrolled in the prospective study; 177 patients completed all 5 checkpoints and 110 patients had died by the final checkpoint. The surgery group had significantly higher adjusted quality-of-life scores than the radiation therapy group in each domain of the FACT-G questionnaire (all p < 0.05). Subgroup analysis showed that adjusted functional and physical well-being scores were higher in the circumferential surgical decompression group. Surgery followed by postoperative radiation therapy improved and maintained quality of life in patients with spinal metastasis from cancer of unknown primary origin in the 6-month assessment. In terms of surgical strategies, circumferential decompression seems better than laminectomy alone in quality-of-life improvement. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Microdose flare-up vs. flexible-multidose GnRH antagonist protocols for poor responder patients who underwent ICSI.

PubMed

Esinler, I

2014-01-01

To compare the performance of microdose flare-up (MF) and flexible-multidose gonadotropin-releasing hormone (GnRH) antagonist protocols in poor responder patients who underwent intracytoplasmic sperm injection (ICSI). One hundred and 12 consecutive patients (217 cycles) suspected to have poor ovarian response were enrolled. Group 1 (MF GnRH agonist group) constituted 64 patients (135 cycles) who underwent MF GnRH agonist protocol. Group 2 (flexible-multidose GnRH antagonist group) constituted 48 patients (82 cycles) who underwent flexible-multidose GnRH antagonist protocol. The duration of stimulation (d) (11.5 +/- 2.1 vs. 10.4 +/- 2.7, p < 0.01) and the total dose of gonadotropin used (IU) (5,892.9 +/- 1,725.7 vs. 4,367.5 +/- 1,582.1, p < 0.05) were significantly lower in Group 2 when compared to Group 1. The numbers of retrieved oocyte-cumulus complexes (4.5 +/- 3.6 vs. 5.9 +/- 4.9, p < 0.05), metaphase II oocytes (3.6 +/- 3.1 vs. 4.9 +/- 4.2, p < 0.05), two pronucleated oocytes (2.6 +/- 2.3 vs. 4.0 +/- 3.4, p < 0.05), the number of available embryos at day 3 (2.6 +/- 2.2 vs. 4.2 +/- 3.2, p < 0.05) and the rate of embryos with > or = seven blastomeres and < 10% fragmentation at day 3 (35.9% vs. 65.1%, p < 0.05) were significantly lower in Group 1 when compared to Group 2. The number of embryos transferred (2.2 +/- 1.3 vs. 2.4 +/- 0.9), the clinical pregnancy per embryo transfer (16.3% vs. 25.8%), and the implantation rate (8.6% vs. 12.2%) were comparable between groups. Although the flexible-multidose GnRH antagonist protocol produced better oocyte and embryo parameters, the clinical pregnancy rate and the implantation rates were comparable between the flexible-multidose GnRH antagonist and MF protocols in poor responder patients.

Effect of diet-induced vitamin D deficiency on rotator cuff healing in a rat model.

PubMed

Angeline, Michael E; Ma, Richard; Pascual-Garrido, Cecilia; Voigt, Clifford; Deng, Xiang Hua; Warren, Russell F; Rodeo, Scott A

2014-01-01

Few studies have considered hormonal influences, particularly vitamin D, on healing. Vitamin D deficiency would have a negative effect on the structure of the healing tendon-bone interface in a rat model and would result in decreased tendon attachment strength. Controlled laboratory study. Vitamin D deficiency was induced in 28 male Sprague-Dawley rats using a specialized vitamin D-deficient diet and ultraviolet light restriction. Serum levels of vitamin D were measured after 6 weeks. These vitamin D-deficient animals (experimental group) plus 32 rats with normal vitamin D levels (controls) underwent unilateral detachment of the right supraspinatus tendon from the greater tuberosity of the humerus, followed by immediate repair using bone tunnel suture fixation. The animals were sacrificed at 2- and 4-week intervals after surgery for biomechanical analysis. A paired t test was used to compare serum vitamin D levels at day 0 and at 6 weeks. A nonparametric Mann-Whitney U test was used to compare load-to-failure and stiffness values between the experimental group and controls. Bone density and new bone formation at the tendon insertion site on the greater tuberosity were assessed with micro-computed tomography (CT). The organization of collagen tissue, new bone formation, vascularity at the tendon-bone interface, fibrocartilage at the tendon-bone interface, and collagen fiber continuity between the tendon and bone tissue were evaluated with safranin O and picrosirius red staining. Blood draws confirmed vitamin D deficiency at 6 weeks compared with time zero/baseline for rats in the experimental group (10.9 ng/mL vs 6.5 ng/mL, respectively; P < .001). Biomechanical testing demonstrated a significant decrease in load to failure in the experimental group compared with controls at 2 weeks (5.8 ± 2.0 N vs 10.5 ± 4.4 N, respectively; P < .006). There was no difference in stiffness at 2 weeks between the control and experimental groups. At 4 weeks, there was no significant difference in load to failure or stiffness between the control and experimental groups. Histological analysis showed less bone formation and less collagen fiber organization in the vitamin D-deficient specimens at 4 weeks as compared with controls. Micro-CT analysis showed no significant difference between groups for total mineral density and bone volume fraction of cortical, whole, or trabecular bone at 4 weeks. The biomechanical and histological data from this study suggest that low vitamin D levels may negatively affect early healing at the rotator cuff repair site. It is estimated that 1 billion people worldwide are vitamin D deficient. In the deficient state, acutely injured rotator cuffs may have a reduced ability for tendon healing. Further studies are needed to determine the exact mechanism by which vitamin D affects tendon healing and whether vitamin D supplementation can improve rotator cuff tendon healing and reduce the incidence of retears.

Effect of N-Acetylserotonin on TLR-4 and MyD88 Expression during Intestinal Ischemia-Reperfusion in a Rat Model.

PubMed

Sukhotnik, Igor; Ben Shahar, Yoav; Halabi, Salim; Bitterman, Nir; Dorfman, Tatiana; Pollak, Yulia; Coran, Arnold; Bitterman, Arie

2018-01-05

 Accumulating evidence indicates that changes in intestinal toll-like receptors (TLRs) precede histological injury in a rodent model of necrotizing enterocolitis. N-acetylserotonin (NAS) is a naturally occurring chemical intermediate in the biosynthesis of melatonin. A recent study has shown that treatment with NAS prevents gut mucosal damage and inhibits programmed cell death following intestinal ischemia-reperfusion (IR). The objective of this study was to determine the effects of NAS on TLR-4, myeloid differentiation factor 88 (Myd88), and TNF-α receptor-associated factor 6 (TRAF6) expression in intestinal mucosa following intestinal IR in a rat.  Male Sprague-Dawley rats were randomly assigned to one of the four experimental groups: 1) Sham rats underwent laparotomy; 2) Sham-NAS rats underwent laparotomy and were treated with intraperitoneal (IP) NAS (20 mg/kg); 3) IR rats underwent occlusion of both superior mesenteric artery and portal vein for 20 minutes followed by 48 hours of reperfusion; and 4) IR-NAS rats underwent IR and were treated with IP NAS immediately before abdominal closure. Intestinal structural changes, mucosal TLR-4, MyD88, and TRAF6 mucosal gene, and protein expression were examined using real-time PCR, Western blot, and immunohistochemistry.  Significant mucosal damage in IR rats was accompanied by a significant upregulation of TLR-4, MyD88, and TRAF6 gene and protein expression in intestinal mucosa compared with control animals. The administration of NAS decreased the intestinal injury score, inhibited cell apoptosis, and significantly reduced the expression of TLR-4, MyD88, and TRAF6.  Treatment with NAS is associated with downregulation of TLR-4, MyD88, and TRAF6 expression along with a concomitant decrease in intestinal mucosal injury caused by intestinal IR in a rat. Georg Thieme Verlag KG Stuttgart · New York.

Teaching renewable energy using online PBL in investigating its effect on behaviour towards energy conservation among Malaysian students: ANOVA repeated measures approach

NASA Astrophysics Data System (ADS)

Nordin, Norfarah; Samsudin, Mohd Ali; Hadi Harun, Abdul

2017-01-01

This research aimed to investigate whether online problem based learning (PBL) approach to teach renewable energy topic improves students’ behaviour towards energy conservation. A renewable energy online problem based learning (REePBaL) instruction package was developed based on the theory of constructivism and adaptation of the online learning model. This study employed a single group quasi-experimental design to ascertain the changed in students’ behaviour towards energy conservation after underwent the intervention. The study involved 48 secondary school students in a Malaysian public school. ANOVA Repeated Measure technique was employed in order to compare scores of students’ behaviour towards energy conservation before and after the intervention. Based on the finding, students’ behaviour towards energy conservation improved after the intervention.

Mitomycin C, 5-fluorouracil, and cyclosporin A prevent epidural fibrosis in an experimental laminectomy model

PubMed Central

Yildiz, Kartal Hakan; Gezen, Ferruh; Cukur, Selma; Dosoglu, Murat

2007-01-01

This study examined the preventive effects of the local application of mitomycin C (MMC), 5-fluorouracil (5-FU), and cyclosporine A (CsA) in minimizing spinal epidural fibrosis in a rat laminectomy model. Thirty-two 2-year-old male Wistar albino rats, each weighing 400 ± 50 g, were divided into four equal groups: sham, MMC, 5-FU, and CsA. Each rat underwent laminectomy at the L5–L6 lumbar level. Cotton pads (4 × 4 mm2) soaked with MMC (0.5 mg/ml), 5-FU (5 ml/mg), or CsA (5 mg/ml) were placed on the exposed dura for 5 min. Thirty days after surgery, the rats were killed and the epidural fibrosis, fibroblast density, inflammatory cell density, and arachnoid fibrosis were quantified. The epidural and arachnoid fibroses were reduced significantly in the treatment groups compared to the sham group. Fibroblast cell density and inflammatory cell density were decreased significantly in the MMC and 5-FU groups, but were similar in the sham and CsA groups. The decreased rate of epidural fibrosis was promising. Further studies in humans are needed to determine the short- and long-term complications of the agents used here. PMID:17387523

A Preliminary Observation of Weight Loss Following Left Gastric Artery Embolization in Humans

PubMed Central

Gunn, Andrew J.; Oklu, Rahmi

2014-01-01

Background/Objectives. Embolization of the left gastric artery (LGA), which preferentially supplies the gastric fundus, has been shown to produce weight loss in animal models. However, weight loss after LGA embolization in humans has not been previously established. The aim of this study was to evaluate postprocedural weight loss in patients following LGA embolization. Subjects/Methods. A retrospective analysis of the medical records of patients who underwent LGA embolization for upper gastrointestinal (GI) bleeding was performed. Postprocedural weight loss in this group was compared to a control group of patients who had undergone embolization of other arteries for upper GI bleeding. Results. The experimental group (N = 19) lost an average of 7.3% of their initial body weight within three months of LGA embolization, which was significantly greater than the 2% weight loss observed in the control group (N = 28) (P = 0.006). No significant differences were seen between the groups in preprocedural body mass index (BMI), age, postprocedural care in the intensive care unit, history of malignancy, serum creatinine, or left ventricular ejection fraction. Conclusions. The current data suggest that body weight in humans may be modulated via LGA embolization. Continued research is warranted with prospective studies to further investigate this phenomenon. PMID:25349724

Combination of Mangifera indica L. extract supplementation plus methotrexate in rheumatoid arthritis patients: a pilot study.

PubMed

López Mantecón, Ana M; Garrido, Gabino; Delgado-Hernández, René; Garrido-Suárez, Bárbara B

2014-08-01

The purpose of the present study was to evaluate the possible therapeutic effects and the safety of Mangifera indica extract (Vimang tablets, 300 mg) combined with methotrexate (MTX) on reducing disease activity in rheumatoid arthritis (RA). Twenty patients with active RA underwent a year of treatment with MTX (12.5 mg/week) associated to non-steroidal anti-inflammatory drugs (NSAIDs) and/or prednisone (5-10 mg/day) were randomly allocated to the experimental group (n=10), that received the extract supplementation (900 mg/day) or preceding usual treatment (n=10) during 180 days. RA activity was evaluated using the tender and swollen joint counts, erythrocyte sedimentation rate, disease activity score-28 (DAS 28), visual analogue scale (VAS) and health assessment questionnaire (HAQ). Treatment's efficacy was demonstrated with ACR criteria. Only the patients of MTX-Vimang group revealed statistically significant improvement in DAS 28 parameters with respect baseline data but no differences were observed between groups. ACR improvements amounted 80% only in MTX-Vimang group at the 90 days (p<0.001). In MTX-Vimang group, 100% of patients decreased NSAIDs administration (p<0.01) and 70% of those eradicated gastrointestinal side effects (p<0.01) ensuing of the preceding treatment. Other adverse effects were not reported. Copyright © 2013 John Wiley & Sons, Ltd.

Effect of Different Dosages of ST36 Indirect Moxibustion on the Skin Temperature of the Lower Legs and Feet.

PubMed

Kuge, Hiroshi; Mori, Hidetoshi; Morisawa, Tateyuki; Hanyu, Kazuyo; Miyazaki, Junji; Watanabe, Mayumi; Tanaka, Tim Hideaki

2018-06-15

Background: Indirect moxibustion (IM) has been previously performed between the spinous process while recording skin temperature of the trunk. However, moxibustion is often applied not only to acupuncture points on the back, but also to points located on the limbs. Thus, there is a need to investigate skin temperature (ST) responses following IM applied to the limbs. Methods: In Experiment 1 (Exp 1), subjects were randomly assigned to three groups: the left IM stimulation, right IM stimulation and control groups. In Experiment 2 (Exp 2), the subjects underwent two experimental sessions consisting of a single stimulation of IM or triple stimulations of IM. The IM stimulation was administered to the ST36 acupuncture point. A thermograph was used to obtain the ST on the lower limbs. Results: In Exp 1, the ST of the lower limbs increased in the stimulation groups whereas there was no increase in the non-stimulation group. In Exp 2, no significant response occurred between the single and triple stimulation of IM groups for all observed sites except for the left ankle ST. Conclusions: Lower limb ST increased following IM application to the ST36 point. No difference was observed between the dosage of the stimulation and ST responses.

Attempt to assess the infiltration of enamel made with experimental preparation using a scanning electron microscope.

PubMed

Skucha-Nowak, Małgorzata

2015-01-01

The resin infiltration technique, a minimally invasive method, involves the saturation, strengthening, and stabilization of demineralized enamel by a mixture of polymer resins without the need to use rotary tools or the risk of losing healthy tooth structures. To design and synthesize an experimental infiltrant with potential bacteriostatic properties.To compare the depth of infiltration of the designed experimental preparation with the infiltrant available in the market using a scanning electron microscope. Composition of the experimental infiltrant was established after analysis of 1H NMR spectra of the commercially available compounds that can penetrate pores of demineralized enamel. As the infiltrant should have bacteriostatic features by definition, an addition of 1% of monomer containing metronidazole was made. Thirty extracted human teeth were soaked in an acidic solution, which was to provide appropriate conditions for demineralization of enamel. Afterward, each tooth was divided along the coronal-root axis into two zones. One zone had experimental preparation applied to it (the test group), while the other had commercially available Icon (the control group). The teeth were dissected along the long axis and described above underwent initial observation with use of a Hitachi S-4200 scanning electron microscope. It was found that all samples contained only oxygen and carbon, regardless of the concentration of additions introduced into them. The occurrence of carbon is partially because it is a component of the preparation in question and partially because of sputtering of the sample with it. Hydrogen is also a component of the preparation, as a result of its phase composition; however, it cannot be detected by the EDS method. SEM, in combination with X-ray microanalysis, does not allow one to explicitly assess the depth of penetration of infiltration preparations into enamel.In order to assess the depth of penetration of infiltration preparations with use of X-ray microanalysis, it is recommended to introduce a contrast agent that is approved for use in dental materials, such as ytterbium III fluoride.

Retrospective analysis: Conservative treatment of placenta increta with methotrexate.

PubMed

Zhang, Chunhua; Li, Hongyan; Zuo, Changting; Wang, Xietong

2018-05-01

To evaluate the efficacy of conservative treatment with methotrexate against placenta increta by two different routes of administration through retrospective analysis. A total of 54 women diagnosed with placenta increta after vaginal delivery were enrolled in this retrospective study. The participants accepted conservative management with methotrexate through either intravenous injection or local multi-point injection under ultrasound guidance. The treatment was considered effective if no hysterectomy was mandatory during the follow-up period. Out of the 54 cases, 21 patients were treated with methotrexate intravenously (group 1), and 33 patients received local multi-point injection to the placenta increta under ultrasound guidance (group 2). No maternal death occurred. In group 1, 10 patients expelled the placentas spontaneously, 7 patients underwent uterine curettage and 4 patients underwent hysterectomy for uncontrollable post-partum hemorrhage and infection. In group 2, 25 patients expelled placentas spontaneously and 8 patients underwent uterine curettage with no incidence of hysterectomy. The success rate in group 1 and group 2 was 17/21 and 33/33, respectively. The average time of the spontaneous placenta expulsion was 79.13 ± 29.87 days in group 1 and 42.42 ± 31.83 days in group 2. Local multi-point methotrexate injection under ultrasound guidance is a better alternative for patients with placenta increta, especially for preserving fertility. © 2018 Japan Society of Obstetrics and Gynecology.

Value of pre-operative caloric test in predicting speech perception after cochlear implantation in adults with post-lingual hearing loss.

PubMed

Yang, Chan Joo; Lee, Jee Yeon; Ahn, Joong Ho; Lee, Kwang-Sun

2016-09-01

This study shows that, in cochlear implantation (CI) surgery, pre-operative caloric test results are not correlated with post-operative outcomes of dizziness or speech perception. To determine the role of pre-operative caloric tests in CI. The records of 95 patients who underwent unilateral CI were reviewed retrospectively. Patients were divided into four groups according to caloric response. Forty-six patients with normal caloric responses were classified as Group A, 19 patients who underwent CI in the ear with worse caloric responses as Group B, 18 patients with bilateral loss of caloric responses as Group C, and 12 patients who underwent CI in the ear with better caloric responses as Group D. Speech performance and post-operative dizziness were compared between the four groups. Speech perception was determined by evaluating consonant-vowel phoneme detection, closed-set word and open-set mono-syllabic and bi-syllabic word identification, and sentence comprehension test scores. The speech perception and aided pure-tone average (PTA) test results at 3 and 6 months and at 1, 2, and 3 years after implantation were not significantly different between Groups A, B, C, and D (p > 0.05). Eight patients (8.4%) reported post-operative dizziness, but there was no significant difference between the four groups (p = 0.627).

Total pancreatectomy with islet cell transplantation vs intrathecal narcotic pump infusion for pain control in chronic pancreatitis.

PubMed

Mokadem, Mohamad; Noureddine, Lama; Howard, Thomas; McHenry, Lee; Sherman, Stuart; Fogel, Evan L; Watkins, James L; Lehman, Glen A

2016-04-28

To evaluate pain control in chronic pancreatitis patients who underwent total pancreatectomy with islet cell transplantation or intrathecal narcotic pump infusion. We recognized 13 patients who underwent intrathecal narcotic pump (ITNP) infusion and 57 patients who underwent total pancreatectomy with autologous islet cell transplantation (TP + ICT) for chronic pancreatitis (CP) pain control between 1998 and 2008 at Indiana University Hospital. All patients had already failed multiple other modalities for pain control and the decision to proceed with either intervention was made at the discretion of the patients and their treating physicians. All patients were evaluated retrospectively using a questionnaire inquiring about their pain control (using a 0-10 pain scale), daily narcotic dose usage, and hospital admission days for pain control before each intervention and during their last follow-up. All 13 ITNP patients and 30 available TP + ICT patients were evaluated. The mean age was approximately 40 years in both groups. The median duration of pain before intervention was 6 years and 7 years in the ITNP and TP + ICT groups, respectively. The median pain score dropped from 8 to 2.5 (on a scale of 0-10) in both groups on their last follow up. The median daily dose of narcotics also decreased from 393 mg equivalent of morphine sulfate to 8 mg in the ITNP group and from 300 mg to 40 mg in the TP + ICT group. No patient had diabetes mellitus (DM) before either procedure whereas 85% of those who underwent pancreatectomy were insulin dependent on their last evaluation despite ICT. ITNP and TP + ICT are comparable for pain control in patients with CP however with high incidence of DM among those who underwent TP + ICT. Prospective comparative studies and longer follow up are needed to better define treatment outcomes.

Total pancreatectomy with islet cell transplantation vs intrathecal narcotic pump infusion for pain control in chronic pancreatitis

PubMed Central

Mokadem, Mohamad; Noureddine, Lama; Howard, Thomas; McHenry, Lee; Sherman, Stuart; Fogel, Evan L; Watkins, James L; Lehman, Glen A

2016-01-01

AIM: To evaluate pain control in chronic pancreatitis patients who underwent total pancreatectomy with islet cell transplantation or intrathecal narcotic pump infusion. METHODS: We recognized 13 patients who underwent intrathecal narcotic pump (ITNP) infusion and 57 patients who underwent total pancreatectomy with autologous islet cell transplantation (TP + ICT) for chronic pancreatitis (CP) pain control between 1998 and 2008 at Indiana University Hospital. All patients had already failed multiple other modalities for pain control and the decision to proceed with either intervention was made at the discretion of the patients and their treating physicians. All patients were evaluated retrospectively using a questionnaire inquiring about their pain control (using a 0-10 pain scale), daily narcotic dose usage, and hospital admission days for pain control before each intervention and during their last follow-up. RESULTS: All 13 ITNP patients and 30 available TP + ICT patients were evaluated. The mean age was approximately 40 years in both groups. The median duration of pain before intervention was 6 years and 7 years in the ITNP and TP + ICT groups, respectively. The median pain score dropped from 8 to 2.5 (on a scale of 0-10) in both groups on their last follow up. The median daily dose of narcotics also decreased from 393 mg equivalent of morphine sulfate to 8 mg in the ITNP group and from 300 mg to 40 mg in the TP + ICT group. No patient had diabetes mellitus (DM) before either procedure whereas 85% of those who underwent pancreatectomy were insulin dependent on their last evaluation despite ICT. CONCLUSION: ITNP and TP + ICT are comparable for pain control in patients with CP however with high incidence of DM among those who underwent TP + ICT. Prospective comparative studies and longer follow up are needed to better define treatment outcomes. PMID:27122666

Feasibility and safety of transfemoral intra-arterial chemotherapy for head and neck cancer using a 3-French catheter system: comparison with a 4-French catheter system.

PubMed

Watanabe, Shigeru; Yamamoto, Akira; Torigoe, Teruyuki; Kanki, Akihiko; Tamada, Tsutomu; Ito, Katsuyoshi

2016-02-01

To assess the technical feasibility of transfemoral intra-arterial chemotherapy for head and neck cancer using a 3-French catheter system (3-Fr). Sixty-two patients with head and neck cancer who underwent transfemoral intra-arterial chemotherapy were included in this study. Thirty-three patients underwent treatment using a 3-Fr (group 3-Fr). Twenty-nine patients underwent treatment using a 4-French catheter system (group 4-Fr). The technical success rate, duration of the procedure with fluoroscopy, and rate of procedure-related complications were compared between group 3-Fr and group 4-Fr. In addition, in group 3-Fr, bleeding at the puncture site after 1.5 h of bed rest was evaluated. The technical success rate was 100% in both groups. The duration of the procedure with fluoroscopy didn't differ between group 3-Fr (mean 28.0 min) and group 4-Fr (mean 30.2 min) (p = 0.524). There was no procedure-related complication in either group. In group 3-Fr, no hemorrhagic complication was observed. A 3-French catheter system can be used to perform transfemoral intra-arterial chemotherapy for head and neck cancer and is technically feasible with approximately the same duration of the procedure with fluoroscopy. Furthermore, this method may shorten the bed rest time without hemorrhagic complication, and may reduce the risk of pulmonary embolism.

Short-term surgical outcomes of reduced port surgery for esophageal achalasia.

PubMed

Omura, Nobuo; Yano, Fumiaki; Tsuboi, Kazuto; Hoshino, Masato; Yamamoto, Se Ryung; Akimoto, Shunsuke; Ishibashi, Yoshio; Kashiwagi, Hideyuki; Yanaga, Katsuhiko

2015-09-01

To clarify the feasibility and utility of reduced port surgery (RPS) for achalasia. Between September 2005 and June 2013, 359 patients with esophageal achalasia, excluding cases of reoperation, underwent laparoscopic Heller myotomy and Dor fundoplication (LHD) according to our clinical pathway. Three-hundred and twenty-seven patients underwent LHD with five incisions (conventional approach), while the other 32 patients underwent RPS, including eight via SILS. The clinical data were collected in a prospective fashion and retrospectively reviewed. We selected 24 patients matched for gender, age and morphologic type with patients in the RPS group from among the 327 patients (C group). The surgical outcomes were compared between the C and RPS groups. There were no significant differences between the two groups in the duration of symptoms, dysphagia score, chest pain score, shape of the distal esophagus and esophageal clearance. The operative time was significantly longer in the RPS group than in the C group (p < 0.001). There were no significant differences between the two groups in the length of postoperative hospital stay or rates of bleeding, mucosal injury of the esophagus and/or stomach and postoperative complications. The symptom scores significantly improved after surgery in both groups (p < 0.001). Furthermore, there were no significant differences between the C group and RPS group in terms of the postoperative symptom scores or satisfaction scores after surgery. The surgical outcomes of RPS for achalasia are comparable to those obtained with the conventional method.

Effects of Renal Ischemic Postconditioning on Myocardial Ultrastructural Organization and Myocardial Expression of Bcl-2/Bax in Rabbits

PubMed Central

Zhang, Wen-zhong; Li, Rong; Liu, Song; Ning, Xian-feng; Cai, Shang-lang

2016-01-01

We investigated the cardioprotective effect of renal ischemic postconditioning (RI-PostC) and its mechanisms in a rabbit model. Rabbits underwent 60 min of left anterior descending coronary artery occlusion (LADO) and 6 h of reperfusion. The ischemia-reperfusion (IR) group underwent LADO and reperfusion only. In the RI-PostC group, the left renal artery underwent 3 cycles of occlusion for 30 seconds and release for 30 seconds, before the coronary artery was reperfused. In the RI-PostC + GF109203X group, the rabbits received 0.05 mg/kg GF109203X (protein kinase C inhibitor) intravenously for 10 min followed by RI-PostC. Light microscopy and electron microscopy demonstrated that the RI-PostC group showed less pronounced changes, a smaller infarct region, and less apoptosis than the other two groups. Bcl-2 and Bax protein expression did not differ between the IR and RI-PostC + GF109203X groups. However, in the RI-PostC group, Bcl-2 protein expression was significantly higher and Bax protein expression was significantly lower than in the other two groups (P < 0.05). Changes in heart rate and mean arterial pressure were also smaller in the RI-PostC group than in the other two groups. These results indicate that RI-PostC can ameliorate myocardial ischemia-reperfusion injury and increase the Bcl-2/Bax ratio through a mechanism involving protein kinase C. PMID:28097153

Conventional fascial technique versus mesh repair for advanced pelvic organ prolapse: Analysis of recurrences in treated and untreated compartments.

PubMed

Damiani, G R; Riva, D; Pellegrino, A; Gaetani, M; Tafuri, S; Turoli, D; Croce, P; Loverro, G

2016-01-01

117 women with severe pelvic organ prolapse (POP; stage > 2) were enrolled to elucidate a 24-month outcome of POP surgery, using conventional or mesh repair with 3 techniques. 59 patients underwent conventional repair and 58 underwent mesh repair. Two types of mesh were used: a trocar-guided transobturator polypropylene (Avaulta, Bard Inc.) and a porcine dermis mesh (Pelvisoft, Bard Inc.). Women with recurrences, who underwent previous unsuccessful conventional repair, were randomised. Primary outcome was the evaluation of anatomic failures (prolapse stage > 1) in treated and untreated compartments. Anatomic failure was observed in 11 of 58 patients (19%; CI 8.9-29) in the mesh group and in 16 of 59 patients (27.1%; p value = 0.3) in the conventional group. 9 of 11 failures in the mesh group (15.5%; CI 6.2-24.8) were observed in the untreated compartment (de novo recurrences), 14.3% in Pelvisoft and 16.7% in Avaulta arm, while only 1 recurrence in the untreated compartment (1.7%) was observed in the conventional group (odds ratio 10.6, p = 0.03).

Laparoscopic ovarian cystectomy of endometriomas does not affect the ovarian response to gonadotropin stimulation.

PubMed

Marconi, Guillermo; Vilela, Martín; Quintana, Ramiro; Sueldo, Carlos

2002-10-01

To evaluate the ovarian response cycles of IVF-ET in patients who previously underwent laparoscopic cystectomy for endometriomas. Retrospective study with prospective selection of participants and controls. Instituto de Ginecología y Fertilidad Buenos Aires, Argentina. Thirty-nine patients underwent an operation for ovarian endometriomas by atraumatic removal of the pseudocapsule with minimal bipolar cauterization of small bleeders and an IVF-ET cycle (group A) and 39 control patients of similar age underwent an IVF-ET cycle for tubal factor infertility (group B). Laparoscopic endometrioma cystectomy, IVF-ET cycle. E(2) levels, number of gonadotropin ampoules, follicles, oocytes retrieved, number and quality of embryos transferred, and clinical pregnancy rate. There were no differences in all the parameters studied (E(2) levels, number of follicles, oocytes retrieved, number and quality of embryos transferred, and clinical pregnancy rate) except for the number of gonadotropin ampoules needed for ovarian hyperstimulation, which was significantly higher in group A than in group B. Our results indicate that laparoscopic cystectomy for endometriomas is an appropriate treatment since it did not negatively affect the ovarian response for IVF-ET.

An eye movement pre-training fosters the comprehension of processes and functions in technical systems

PubMed Central

Skuballa, Irene T.; Fortunski, Caroline; Renkl, Alexander

2015-01-01

The main research goal of the present study was to investigate in how far pre-training eye movements can facilitate knowledge acquisition in multimedia (pre-training principle). We combined considerations from research on eye movement modeling and pre-training to design and test a non-verbal eye movement-based pre-training. Participants in the experimental condition watched an animated circle moving in close spatial resemblance to a static visualization of a solar plant accompanied by a narration in a subsequently presented learning environment. This training was expected to foster top-down processes as reflected in gaze behavior during the learning process and enhance knowledge acquisition. We compared two groups (N = 45): participants in the experimental condition received pre-training in a first step and processed the learning material in a second step, whereas the control group underwent the second step without any pre-training. The pre-training group outperformed the control group in their learning outcomes, particularly in knowledge about processes and functions of the solar plant. However, the superior learning outcomes in the pre-training group could not be explained by eye-movement patterns. Furthermore, the pre-training moderated the relationship between experienced stress and learning outcomes. In the control group, high stress levels hindered learning, which was not found for the pre-training group. On a delayed posttest participants were requested to draw a picture of the learning content. Despite a non-significant effect of training on the quality of drawings, the pre-training showed associations between learning outcomes at the first testing time and process-related aspects in the quality of their drawings. Overall, non-verbal pre-training is a successful instructional intervention to promote learning processes in novices although these processes did not directly reflect in learners' eye movement behavior during learning. PMID:26029138

Strategies to enhance self-efficacy and adherence to home-based pelvic floor muscle exercises did not improve adherence in women with urinary incontinence: a randomised trial.

PubMed

Sacomori, Cinara; Berghmans, Bary; Mesters, Ilse; de Bie, Rob; Cardoso, Fernando Luiz

2015-10-01

Do strategies to enhance self-efficacy and exercise mastery affect adherence to home-based pelvic floor muscle exercises in women with urinary incontinence? Two-arm, parallel, randomised, controlled trial with intention-to-treat analysis. Randomisation was performed using computer-generated random numbers in five blocks of 20 women. Eighty-six women with stress, urgency or mixed urinary incontinence. All participants underwent three individual physiotherapy clinic visits at Day 0, 15 and 30, and 2 further months of home-based pelvic floor muscle exercises. The experimental group also received self-efficacy enhancing interventions, including a structured discussion on accomplishments and goals, a 9-minute video with testimonials, and a reminder. The primary outcome - adherence to at least 20 fast and 20 slow contractions every day - was evaluated with a structured questionnaire at 15, 30 and 90 days after enrolment and completion of a daily diary. A validated questionnaire was used to assess urinary incontinence. Self-efficacy and pelvic floor muscle function were also measured. Seven women withdrew from each group before the Day-30 assessment. There was no difference in adherence to pelvic floor muscle exercises at 90 days between the groups (MD 0.5 points, 95% CI -1.1 to 2.1) on the questionnaire, which was scored from 2 to 21. At Day 90, 56% of the experimental group and 44% of the control group were performing the exercises every day. Adherence scores of both groups decreased during the 2-month follow-up period without any supervised physiotherapy session (p<0.05). The groups did not differ on the remaining secondary outcomes. Discussion of accomplishments and goals, a testimonial video and a reminder did not increase exercise adherence more than exercise mastery. Brazilian Registry of Clinical Trials UTN:U1111-1128-8684. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Anterior and Posterior Instrumentation with Different Debridement and Grafting Procedures for Multi-Level Contiguous Thoracic Spinal Tuberculosis.

PubMed

Cui, Xu; Li, Li-Tao; Ma, Yuan-Zheng

2016-11-01

To evaluate the clinical outcomes of anterior and posterior instrumentation with different debridement and graft fusion methods for multi-level contiguous thoracic spinal tuberculosis. We retrospectively evaluated 81 patients with multi-level contiguous thoracic spinal tuberculosis who underwent anterior or posterior instrumentation combined with different methods of debridement, decompression, and graft fusion from January 2002 to December 2012. All patients were divided into an anterior instrumentation group and a posterior instrumentation group. In the anterior instrumentation group, there were 39 patients who underwent transthoracic debridement. In the posterior instrumentation group, there were 34 patients who underwent trans-costotransverse decompression and strut grafting with posterior instrumentation, and another 8 patients underwent combined anterior debridement and strut grafting with posterior instrumentation in a single-stage or two-stage procedure. The kyphotic angles were calculated from lateral spinal X-rays using the modified Konstam method. The symptoms and signs of tuberculosis, fusion level, fusion time of the bone graft, average kyphosis angle, average correction, average loss of correction, and clinical complications were recorded. The average follow-up period was 37 months (range, 17-72 months). The cohort consisted of 47 males and 34 females with an average age of 38 years. The mean durations of the operations were 3.5 ± 0.4 h in the anterior group and 4.0 ± 0.3 h in the posterior group ( P < 0.05). The mean blood loss volumes during surgery were 450 ± 42 and 560 ± 51 mL for the anterior group and the posterior group, respectively ( P < 0.01). The kyphotic deformities were corrected from 32.1° ± 10.3° to 10.2° ± 2.1° in the anterior group and from 33.8° ± 11.7° to 12.6° ± 2.7° in the posterior group ( P < 0.01). The neurologic statuses of the 23 patients with preoperative neurologic deficits improved in each group. Fusion was confirmed radiographically at 5.4 ± 1.2 months (range, 4-12 months) in the anterior group and 5.6 ± 1.4 months (range, 4-13 months) in the posterior group ( P > 0.05). Postoperative relapses were noted in 1 and 3 patients in the anterior and the posterior group, respectively. Posterior instrumentation was more effective than anterior instrumentation in the correction of kyphosis and the maintenance of the correction. However, postoperative sinus formation was more frequent in patients who underwent a single-stage posterior procedure. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

[The Diagnostic Value of Pre-Biopsy Magnetic Resonance Imaging (MRI) for Detecting Prostate Cancer].

PubMed

Mori, Kohei; Miyoshi, Yasuhide; Yoneyama, Shuko; Ishida, Hiroaki; Hattori, Yusuke; Teranishi, Jun-ichi; Kondo, Keiichi; Noguchi, Kazumi

2016-01-01

We examined the value of pre-biopsy magnetic resonance imaging (MRI) for detecting prostate cancer. We analyzed 267 men with prostate-specific antigen (PSA) levels of 3-10 ng/ml who underwent systematic prostate needle biopsy. From April 2009 to March 2011, a total of 98 male patients underwent 16-core prostatic biopsies without pre-biopsy magnetic resonance imaging (MRI) (nonenforcement group). From April 2011 to March 2013, 169 men underwent pre-biopsy MRI [T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI)] (enforcement group). When MRI findings indicated cancer in the latter group, in addition to the systematic 16-core biopsy one or two targeted biopsies were performed. Patients without suspicious MRI findings underwent only systematic 16-core biopsy. Cancer detection rates in the nonenforcement and enforcement groups were 42.9% (48/92) and 46. 2% (78/169), respectively. The difference did not reach significance (p＝0.612). Although the cancer detection rates were 39.4% (41/104) in the MRI-negative group and 56. 9% (37/65) in the MRI-positive group (p＝0.039), the sensitivity and specificity for cancer detection by MRI were relatively low: 47.4% and 69.2%, respectively. By receiver-operating curve analysis, the area under the curve for cancer detection by MRI was only 0.583. There were two study limitations. First, the patient sample size was small. Second, it is unclear whether an adequate sample of the suspicious lesion was obtained by biopsy. We thus demonstrated that it might be improper to base a diagnosis solely on pre-biopsy MRI (T2WI and DWI) findings in men with serum PSA levels of 3-10 ng/ml.

Platelet-rich plasma to treat experimentally-induced skin wounds in animals: A systematic review and meta-analysis.

PubMed

Tambella, Adolfo Maria; Attili, Anna Rita; Dupré, Gilles; Cantalamessa, Andrea; Martin, Stefano; Cuteri, Vincenzo; Marcazzan, Sabrina; Del Fabbro, Massimo

2018-01-01

The objective of the study was to review current literature to determine whether the topical application of platelet-rich plasma (PRP) promotes healing in experimentally-induced full-thickness skin wounds in animals. The hypothesis was that the adjunct of PRP has a positive effect on wound healing. An electronic search was carried out on the following databases: Web of Science, Cochrane Library, PubMed, Research Gate, Cochrane Wounds Group, Veterinary Information Network. No publication date nor language restrictions were applied. Randomised and not randomised controlled clinical trials comparing PRP with placebo or with other treatments were included. The reduction of open wound area in PRP-treated (test) wounds compared to control wounds was the primary outcome. Secondary outcomes were healing time and number of healed cases in test group compared to control. The following effect sizes were calculated: the Hedges' g for continuous variables; the odds ratio for binary data. Eighteen controlled clinical trials were included in the qualitative and quantitative synthesis, with a total of 661 wounds. All studies were published in the period 2007-2016. Eight studies were carried out on rodent/lagomorph mammals and 10 on non-rodent/lagomorph mammals. In all included studies, control wounds underwent placebo or were left untreated. The PRP group showed a better healing performance than the control group in each outcome. The effect size was statistically significant considering the primary outcome and the overall aggregation of the three outcomes. The effect size, although in favour of the treatment with PRP, was not significant considering the healing time and the number of healings. The overall heterogeneity was mild or moderate. Five studies reported a high risk of selection bias. The publication bias was always mild or absent. The results support the hypothesis of the positive effects of the PRP when compared to control groups in the treatment of experimentally-induced full-thickness skin wounds in animals. PRP can therefore be considered an effective adjunctive therapy in stimulating second intention healing of acute wounds in healthy animals.

Adventure-based training to promote physical activity and reduce fatigue among childhood cancer survivors: A randomized controlled trial.

PubMed

Li, William H C; Ho, K Y; Lam, K K W; Lam, H S; Chui, S Y; Chan, Godfrey C F; Cheung, A T; Ho, L L K; Chung, O K

2018-04-14

Cancer-related fatigue is one of the most distressing symptoms reported by childhood cancer survivors. Despite the body of evidence that regular physical activity helps alleviate cancer-related fatigue, insufficient participation in physical activity is frequently observed among childhood cancer survivors. This study examined the effectiveness of an adventure-based training programme in promoting physical activity, reducing fatigue, and enhancing self-efficacy and quality of life among Hong Kong Chinese childhood cancer survivors. A prospective randomised controlled trial. A paediatric oncology outpatient clinic, a non-governmental organisation, and a non-profit voluntary organisation. Hong Kong Chinese childhood cancer survivors aged 9-16 years who reported symptoms of fatigue and had not engaged in regular physical exercise in the past 6 months. The experimental group underwent a 4-day adventure-based training programme. The control group received a placebo intervention. The primary outcome was fatigue at 12 months. Secondary outcomes were physical activity levels, self-efficacy and quality of life at 12 months. Data collection was conducted at baseline, and 6 and 12 months after the intervention began. We performed intention-to-treat analyses. From 6 January, 2014 to 8 June, 2015, we randomly assigned 222 eligible childhood cancer survivors to either an experimental (n = 117) or a control group (n = 105). The experimental group showed statistically significantly lower levels of cancer-related fatigue (P < 0.001), higher levels of self-efficacy (P < 0.001) and physical activity (P < 0.001), and better quality of life (P < 0.01) than the control group at 12 months. This study provides evidence that adventure-based training is effective in promoting physical activity, reducing cancer-related fatigue, and enhancing self-efficacy and quality of life among Hong Kong Chinese childhood cancer survivors. These results may help inform parents and healthcare professionals that regular physical activity is crucial for the physical and psychological wellbeing and quality of life of childhood cancer survivors. Copyright © 2018 Elsevier Ltd. All rights reserved.

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training

PubMed Central

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme

2015-01-01

Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Conclusions Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice. PMID:26495971

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training.

PubMed

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme; Birbaumer, Niels; Ramos-Murguialday, Ander

2015-01-01

Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their recruitment after BMI training. This study suggests that changes in upper arm-forearm synergies contribute to stroke motor recovery, and provides candidacy guidelines for similar BMI-based clinical practice.

Platelet-rich plasma to treat experimentally-induced skin wounds in animals: A systematic review and meta-analysis

PubMed Central

Attili, Anna Rita; Dupré, Gilles; Cantalamessa, Andrea; Martin, Stefano; Cuteri, Vincenzo; Marcazzan, Sabrina; Del Fabbro, Massimo

2018-01-01

The objective of the study was to review current literature to determine whether the topical application of platelet-rich plasma (PRP) promotes healing in experimentally-induced full-thickness skin wounds in animals. The hypothesis was that the adjunct of PRP has a positive effect on wound healing. An electronic search was carried out on the following databases: Web of Science, Cochrane Library, PubMed, Research Gate, Cochrane Wounds Group, Veterinary Information Network. No publication date nor language restrictions were applied. Randomised and not randomised controlled clinical trials comparing PRP with placebo or with other treatments were included. The reduction of open wound area in PRP-treated (test) wounds compared to control wounds was the primary outcome. Secondary outcomes were healing time and number of healed cases in test group compared to control. The following effect sizes were calculated: the Hedges’ g for continuous variables; the odds ratio for binary data. Eighteen controlled clinical trials were included in the qualitative and quantitative synthesis, with a total of 661 wounds. All studies were published in the period 2007–2016. Eight studies were carried out on rodent/lagomorph mammals and 10 on non-rodent/lagomorph mammals. In all included studies, control wounds underwent placebo or were left untreated. The PRP group showed a better healing performance than the control group in each outcome. The effect size was statistically significant considering the primary outcome and the overall aggregation of the three outcomes. The effect size, although in favour of the treatment with PRP, was not significant considering the healing time and the number of healings. The overall heterogeneity was mild or moderate. Five studies reported a high risk of selection bias. The publication bias was always mild or absent. The results support the hypothesis of the positive effects of the PRP when compared to control groups in the treatment of experimentally-induced full-thickness skin wounds in animals. PRP can therefore be considered an effective adjunctive therapy in stimulating second intention healing of acute wounds in healthy animals. PMID:29324848

Minimally invasive instrumentation without fusion during posterior thoracic corpectomies: a comparison of percutaneously instrumented nonfused segments with open instrumented fused segments.

PubMed

Lau, Darryl; Chou, Dean

2017-07-01

OBJECTIVE During the mini-open posterior corpectomy, percutaneous instrumentation without fusion is performed above and below the corpectomy level. In this study, the authors' goal was to compare the perioperative and long-term implant failure rates of patients who underwent nonfused percutaneous instrumentation with those of patients who underwent traditional open instrumented fusion. METHODS Adult patients who underwent posterior thoracic corpectomies with cage reconstruction between 2009 and 2014 were identified. Patients who underwent mini-open corpectomy had percutaneous instrumentation without fusion, and patients who underwent open corpectomy had instrumented fusion above and below the corpectomy site. The authors compared perioperative outcomes and rates of implant failure requiring reoperation between the open (fused) and mini-open (unfused) groups. RESULTS A total of 75 patients were identified, and 53 patients (32 open and 21 mini-open) were available for followup. The mean patient age was 52.8 years, and 56.6% of patients were male. There were no significant differences in baseline variables between the 2 groups. The overall perioperative complication rate was 15.1%, and there was no significant difference between the open and mini-open groups (18.8% vs 9.5%; p = 0.359). The mean hospital stay was 10.5 days. The open group required a significantly longer stay than the mini-open group (12.8 vs 7.1 days; p < 0.001). Overall implant failure rates requiring reoperation were 1.9% at 6 months, 9.1% at 1 year, and 14.7% at 2 years. There were no significant differences in reoperation rates between the open and mini-open groups at 6 months (3.1% vs 0.0%, p = 0.413), 1 year (10.7% vs 6.2%, p = 0.620), and 2 years (18.2% vs 8.3%, p = 0.438). The overall mean follow-up was 29.2 months. CONCLUSIONS These findings suggest that percutaneous instrumentation without fusion in mini-open transpedicular corpectomies offers similar implant failure and reoperation rates as open instrumented fusion as far out as 2 years of follow-up.

[Beneficial effects of renal denervation on pulmonary vascular remodeling in experimental pulmonary artery hypertension].

PubMed

Zhang, Shujuan; Zhao, Qingyan; Jiang, Xuejun; Yang, Bo; Dai, Zixuan; Wang, Xiaozhan; Wang, Xule; Guo, Zongwen; Yu, Shengbo; Tang, Yanhong; Hu, Wei; Huang, Congxin

2015-04-14

To explore the effects of renal sympathetic denervation (RSD) on pulmonary vascular remodeling in a model of pulmonary arterial hypertension (PAH). According to the random number table, 24 beagles were randomized into control, PAH and PAH+RSD groups (n=8 each). The levels of neurohormone, echocardiogram and dynamics parameters were measured. Then 0.1 ml/kg dimethylformamide (control group) or 2 mg/kg dehydromonocrotaline (PAH and PAH+RSD groups) were injected. The PAH+RSD group underwent RSD after injection. At week 8 post-injection, the neurohormone levels, echocardiogram, dynamics parameters and pulmonary tissue morphology were observed. The values of right ventricular systolic pressure (RVSP) and pulmonary arterial systolic pressure (PASP) in PAH and PAH+RSD groups were both significantly higher than those in control group ((42.8±8.7), (30.8±6.8) vs (23.2±5.7) mmHg (1 mmHg=0.133 kPa) and (45.1±11.2), (32.6±7.9) vs (24.7±7.1) mmHg). Meanwhile, the values of RVSP and PASP in PAH group were higher than those in PAH+RSD group (all P<0.01). The levels of serum angiotensin II (Ang II) and endothelin-1 significantly increased after 8 weeks in PAH dogs ((228±41) vs (113±34) pg/ml and (135±15) vs (77±7) pg/ml, all P<0.01). And Ang II and endothelin-1 were higher in lung tissues of PAH group ((65±10) and (96±10) pg/ml) than in those of control group ((38±7) and (54±6) pg/ml) and PAH+RSD group ((46±8) and (67±9) pg/ml) (all P<0.01). Pulmonary tissues had marked collagen hyperplasia and lamellar corpuscles of type 2 alveolar cells were damaged more severely in PAH dogs than in PAH+RSD dogs. RSD suppresses pulmonary vascular remodeling and decreases pulmonary arterial pressure in experimental PAH. And the effect of RSD on PAH may contribute to decreased neurohormone levels.

[Long-term result of total versus partial fundoplication following esophagomyotomy for primary esophageal motor disorders].

PubMed

Zhu, Zi-jiang; Chen, Long-qi; Duranceau, Andre

2008-02-15

To compare the long-term results of total and partial fundoplication on esophagus myotomy. From January 1978 to October 1998, 64 patients with achalasia or diffuse esophageal spasm underwent esophagomyotomy and antireflux operation via left thoracotomy. Twenty-one patients underwent Nissen total fundoplication (Nissen group) and 43 patients underwent Belsey Marker IV partial fundoplication (Belsey group). Clinical, radiologic, radionuclide transit, manometric, 24-hour pH monitoring and endoscopic assessments were performed before and after the operation. There was no operative death and major complications for either group. At over 6 years follow-up and compared to Belsey group, patients in Nissen group revealed a higher frequency of dysphagia (P = 0.025) and more radionuclide material retention (P = 0.044). Both operative procedures reduced the lower esophageal sphincter pressure gradient. However, in Nissen group, the esophageal diameter observed on radiology was significantly increased from 3.9 cm preoperatively to 5.5 cm postoperatively (P = 0.012), while it kept the same for Belsey group (from 5.4 to 5.3 cm, P = 0.695). Reoperation in order to relieve the recurrent dysphagia and esophageal obstruction was performed on 8 patients in Nissen group and 1 in Belsey group (P < 0.01). When treating achalasia or diffuse esophageal spasm by esophageal myotomy and an antireflux operation, a total fundoplication is not appropriate, whereas a partial fundoplication provides proper antireflux effect without significant esophageal emptying difficulty.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shi Haibin, E-mail: shihb@vip.sina.com; Yang Zhengqiang; Liu Sheng

To evaluate the efficacy and safety of cyanoacrylate glue embolization in the treatment of severe arterioportal shunt (APS) presenting with hepatofugal portal venous flow in hepatocellular carcinoma (HCC) patients. Between July 2000 and January 2010, 27 HCC patients with severe APS presenting with hepatofugal portal venous flow underwent transarterial angiography and treatment. Among them, four patients were excluded from the study. Twelve patients underwent transarterial chemoperfusion and embolization of APS with cyanoacrylate glue between January 2006 and January 2010 (Emb group), and the other 11 patients undergoing only transarterial chemoperfusion without embolization of APS between July 2000 and December 2005more » served as a control group (non-Emb group). The change of APS, survival rates, and procedure related complications were analyzed. In the Emb group, APS was improved in all of the 12 patients after initial glue embolization; long-term APS improvement with hepatopetal portal flow was achieved in 80 % (8 of 10) patients who underwent follow-up angiography. Survival rates in the Emb group were 67 % at 6 months, 33 % at 1 year, and 8 % at 2 years, whereas those in the non-Emb group were 0 % at 6 months (P < 0.05). Median survival time in the Emb group was 275 days, which was longer than that of 107 days in the non-Emb group (P = 0.001). There were no major complications in both groups. The preliminary experience suggests that glue embolization may be an effective and safe therapy in the management of severe APS accompanied by HCC and also improve patient survival.« less

Long-term behavioral deficits and recovery after transient ischemia in middle-aged rats: Effects of behavioral testing.

PubMed

Yousuf, Seema; Atif, Fahim; Sayeed, Iqbal; Tang, Huiling; Wang, Jun; Stein, Donald G

2015-01-01

Most pre-clinical stroke studies address the acute phase after injury, with less attention to long-term effects of injury, treatment, and experimental testing itself. We addressed these questions: 1) Will functional deficits persist up to 8 weeks following transient stroke in older animals? 2) Will functional deficits resolve spontaneously, with time and/or repeated behavioral testing? Male Sprague-Dawley rats (12 months) were pre-trained on behavioral tasks to provide baseline data and then underwent transient middle artery occlusion (tMCAO) or sham surgery. We measured motor, sensory, cognitive and gait impairments over 8 weeks, and the extent of hemispheric brain infarction. One cohort underwent behavioral testing once at 8 weeks post-stroke (LT); a second cohort (RLT) was tested at 3, 6 and 8 weeks post-stroke. Significant deficits were exhibited in all functional outcomes in both cohorts after 8 weeks. We observed some recovery in some behavioral parameters in both cohorts at 8 weeks. Deficits persist for at least 8 weeks after tMCAO. The greater spontaneous recovery seen in the RLT groups suggest that repeated testing did reduce the severity of these stroke-induced impairments. These findings have implications for designing future studies of agents to induce long-term functional recovery following stroke.

Transumbilical laparoscopic-assisted appendectomy is a useful surgical option for pediatric uncomplicated appendicitis: a comparison with conventional 3-port laparoscopic appendectomy

PubMed Central

Go, Doo Yeon; Lee, Ji Sung; Jung, Cheol Woong

2016-01-01

Purpose Transumbilical laparoscopic-assisted appendectomy (TULA) is a single incision technique that uses a combined intra- and extracorporeal method. The aim of this study was to compare surgical outcomes of TULA with conventional 3-port laparoscopic appendectomy (LA). Methods A retrospective review of medical records between 2010 and 2014 identified 303 pediatric patients who underwent LA with uncomplicated acute appendicitis. Of these, 85 patients underwent TULA and 218 patients underwent conventional LA. Demographic data, clinical characteristics, perioperative outcomes and postoperative complications were compared between the 2 groups. Results The mean operation time in the TULA group was 30.39 minutes, which was significantly shorter than that of the LA group (47.83 minutes) (P < 0.001). The first day of oral intake after surgery was earlier (1.05 days vs. 1.32 days; P < 0.001) and the length of hospital stay was also shorter (2.54 days vs. 3.22 days; P < 0.001) for the TULA group than the LA group. Furthermore, the postoperative complication rate was lower in the TULA group (1 of 85, 1.25%) compared to the LA group (19 of 218, 8.7%) (P = 0.018). Conclusion In conclusion, TULA procedure is recommended for uncomplicated appendicitis in children due to its simplicity and better postoperative outcomes. PMID:27478813

Risk of Dumping Syndrome after Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: Early Results of a Multicentre Prospective Study.

PubMed

Ramadan, M; Loureiro, M; Laughlan, K; Caiazzo, R; Iannelli, A; Brunaud, L; Czernichow, S; Nedelcu, M; Nocca, D

2016-01-01

Background. Bariatric surgery is an important field of surgery. An important complication of bariatric surgery is dumping syndrome (DS). Aims. To evaluate the incidence of DS in patients undergoing bariatric surgery. Methods. 541 patients included from 5 nutrition and bariatric centers in France underwent either LSG or LRYGB. They were evaluated at 1 month (M1) and 6 months (M6) postoperatively by an interview and completion of a dumping syndrome questionnaire. Results. 268 patients underwent LSG (Group A) and 273 underwent LRYGB. From the LRYGB patients 229 had mechanical gastrojejunoanal anastomosis with 30 mm linear stapler (Group B) and 44 had manual (hand sewn) 15 mm gastrojejunal anastomosis (Group C). Overall incidence of DS was 8.5% at M1 and M6. In LSG group (Group A), only 4 patients (1.49%) reported episodes of DS at M1 and 3 (1.12%) at M6. In Group B, 41 patients (17.90%) reported episodes of DS at M1 and 43 (18.78%) at M6. Group C experienced one case (2.27%) of DS at M1 and none (0%) at M6. Conclusions. Patients undergoing LRYGB, especially with larger gastrojejunal anastomosis, are more prone to developing DS following surgery than patients undergoing LSG or LRYGB with calibrated manual anastomosis.

The effect of general and spinal anesthesia on balance control in elderly patients.

PubMed

Suárez, Alejo; Macadar, Omar

2008-01-01

Falls are a major problem in the elderly population, but few communications address the influence of anesthesia on balance control. This study reports how a general balanced anesthesia (GBA) and a spinal anesthesia (SA) affect balance control in the elderly. We divided into three groups, according to electronystagmography findings and type of anesthesia, 21 men older than 65 years (mean age, 72 years) who were scheduled for prostate adenectomy. One group, designated GBN, consisted of normal subjects who underwent surgery under GBA. In another group, designated GBP, were pathological subjects who had clinically compensated central vestibular disorders (CVDs) and underwent surgery under GBA. The third group, designated SP, contained CVD patients who underwent surgery under SA. We assessed balance control via static posturography preoperatively and 48 hours postoperatively. We observed no change in balance control parameters (center of pressure distribution area [COPa] or COP sway velocity [SV]) for those patients in the GBN group or for those in the SP group. We did observe a significant difference for the patients in the GBP group, with higher postoperative values of COPa and SV (Wilcoxon signed rank test). Our results showed that in subjects with clinically compensated underlying CVD prior to a GBA, balance control worsens after the procedure, whereas no change in balance control occurs after an SA. Balance control in subjects with normal vestibuloocular function did not change even after a GBA.

Long-term outcome of cochlear implant in patients with chronic otitis media: one-stage surgery is equivalent to two-stage surgery.

PubMed

Jang, Jeong Hun; Park, Min-Hyun; Song, Jae-Jin; Lee, Jun Ho; Oh, Seung Ha; Kim, Chong-Sun; Chang, Sun O

2015-01-01

This study compared long-term speech performance after cochlear implantation (CI) between surgical strategies in patients with chronic otitis media (COM). Thirty patients with available open-set sentence scores measured more than 2 yr postoperatively were included: 17 who received one-stage surgeries (One-stage group), and the other 13 underwent two-stage surgeries (Two-stage group). Preoperative inflammatory status, intraoperative procedures, postoperative outcomes were compared. Among 17 patients in One-stage group, 12 underwent CI accompanied with the eradication of inflammation; CI without eradicating inflammation was performed on 3 patients; 2 underwent CIs via the transcanal approach. Thirteen patients in Two-stage group received the complete eradication of inflammation as first-stage surgery, and CI was performed as second-stage surgery after a mean interval of 8.2 months. Additional control of inflammation was performed in 2 patients at second-stage surgery for cavity problem and cholesteatoma, respectively. There were 2 cases of electrode exposure as postoperative complication in the two-stage group; new electrode arrays were inserted and covered by local flaps. The open-set sentence scores of Two-stage group were not significantly higher than those of One-stage group at 1, 2, 3, and 5 yr postoperatively. Postoperative long-term speech performance is equivalent when either of two surgical strategies is used to treat appropriately selected candidates.

Minimally Invasive versus Open Approach for Right-Sided Colectomy: A Study in 12,006 Patients from the Dutch Surgical Colorectal Audit.

PubMed

Bosker, Robbert J I; Van't Riet, Esther; de Noo, Mirre; Vermaas, Maarten; Karsten, Tom M; Pierie, Jean-Pierre

2018-02-07

There is ongoing debate whether laparoscopic right colectomy is superior to open surgery. The purpose of this study was to address this issue and arrive at a consensus using data from a national database. Patients who underwent elective open or laparoscopic right colectomy for colorectal cancer during the period 2009-2013 were identified from the Dutch Surgical Colorectal Audit. Complications that occurred within 30 days after surgery and 30-day mortality rates were calculated and compared between open and laparoscopic resection. In total, 12,006 patients underwent elective open or laparoscopic surgery for right-sided colorectal cancer. Of these, 6,683 (55.7%) underwent open resection and 5,323 (44.3%) underwent laparoscopic resection. Complications occurred within 30 days after surgery in the laparoscopic group in 26.1% of patients and in 32.1% of patients in the open group (p < 0.001). Thirty-day mortality was also significantly lower in the laparoscopic group (2.2 vs. 3.6% p < 0.001). In this non-randomized, descriptive study conducted in the Netherlands, open right colectomy seems to have a higher risk for complications and mortality as compared to laparoscopic right colectomy, even after correction for confounding factors. © 2018 S. Karger AG, Basel.

The prophylactic and therapeutic effects of glutamine- and arginine-enriched diets on radiation-induced enteritis in rats.

PubMed

Ersin, S; Tuncyurek, P; Esassolak, M; Alkanat, M; Buke, C; Yilmaz, M; Telefoncu, A; Kose, T

2000-04-01

Recent studies indicated that glutamine and arginine support the mucosal barrier in several ways. This experimental study hypothesized that administration of glutamine- and arginine-enriched diets before abdominal radiation therapy would provide a radioprotective effect on intestinal mucosa, and this would augment the therapeutic effectiveness provided by postirradiation administration. A rat model of radiation enteritis was designed with a single dose of 1100 cGy to the abdomen. Thirty-five rats were randomized into five groups of seven. A 7-day glutamine-enriched diet for Group I and a 7-day arginine-enriched diet for Group II were administered both pre- and postradiation. For Groups III and IV, the same glutamine and arginine diets were given, respectively, postradiation only. Group V was fed a glutamine- and arginine-free diet and was the control group. The rats underwent laparotomy for culture of mesenteric lymph nodes and removal of segments of ileum, jejenum, and colon for microscopic examination. Bacterial translocation was significantly higher in Group V (P < 0.05), while intestinal villus count and villus height were significantly higher in all of the groups fed glutamine and arginine when compared with the control group (P < 0.0001 and P < 0.05, respectively). Both arginine- and glutamine-enriched diets have protective effects on gut mucosa in the postirradiation state; however, pre- and postirradiation administration together does not provide superior protection versus postradiation administration alone. Copyright 2000 Academic Press.

Radiofrequency ablation combined with transcatheter arterial embolisation in rabbit liver: investigation of the ablation zone according to the time interval between the two therapies.

PubMed

Lee, I J; Kim, Y I; Kim, K W; Kim, D H; Ryoo, I; Lee, M W; Chung, J W

2012-11-01

This study was designed to evaluate the extent of the radiofrequency ablation zone in relation to the time interval between transcatheter arterial embolisation (TAE) and radiofrequency ablation (RFA) and, ultimately, to determine the optimal strategy of combining these two therapies for hepatocellular carcinoma. 15 rabbits were evenly divided into three groups: Group A was treated with RFA alone; Group B was treated with TAE immediately followed by RFA; and Group C was treated with TAE followed by RFA 5 days later. All animals underwent perfusion CT (PCT) scans immediately after RFA. Serum liver transaminases were measured to evaluate acute liver damage. Animals were euthanised for pathological analysis of ablated tissues 10 days after RFA. Non-parametric analyses were conducted to compare PCT indices, the RFA zone and liver transaminase levels among the three experimental groups. Group B showed a significantly larger ablation zone than the other two groups. Arterial liver perfusion and hepatic perfusion index represented well the perfusion decrease after TAE on PCT. Although Group B showed the most elevated liver transaminase levels at 1 day post RFA, the enzymes decreased to levels that were not different from the other groups at 10 days post-RFA. When combined TAE and RFA therapy is considered, TAE should be followed by RFA as quickly as possible, as it can be performed safely without serious hepatic deterioration, despite the short interval between the two procedures.

Diagnostic value of signal peptide-CUB-EGF domain-containing protein 1 as an early and late biochemical marker in the ovarian torsion rat model.

PubMed

Uzun, Özgür; Kaban, Işık; Midi, Ahmet; Uysal, Hande; Boran, Ahmet B; Bacanakgil, Besim H; Tarbaghia, Marwa

2018-04-02

Signal peptide-CUB-EGF (epidermal growth factor-like protein) domain-containing protein 1 (SCUBE1) is an experimental marker of ischemia that has been previously studied both in rat models and humans. In this study, we aim to investigate the importance of SCUBE1 levels in ovarian torsion using an ovarian torsion model in rats. A total of 18 Sprague-Dawley rats were equally divided into three groups. Group 1 (n = 6) was the Sham group and was only given a laparotomy procedure. Group 2 (n = 6) underwent bilateral ovarian torsion and ovarian ischemia lasting 8 h. Group 3 (n = 6) was subjected to bilateral ovarian torsion and ischemia lasting 24 h. Blood samples were collected from all three groups after the operations, and SCUBE1 levels were studied. Ovarian samples were collected, and microscopic evaluation was performed. The correlation of SCUBE1 levels and histopathological findings were investigated. The mean SCUBE1 level of group 3 was statistically higher than other groups (P < 0.01). Follicular degeneration and infiltration of inflammatory cells were, respectively, statistically significant in groups 2 and 3 (P = 0.002 and P = 0.045, respectively). SCUBE1 can be useful in diagnosing ovarian torsion during the first 24 h, but more randomized controlled studies are necessary in order to implement it in clinical settings. © 2018 Japan Society of Obstetrics and Gynecology.

Hemorrhagic shock shifts the serum cytokine profile from pro- to anti-inflammatory after experimental traumatic brain injury in mice.

PubMed

Shein, Steven L; Shellington, David K; Exo, Jennifer L; Jackson, Travis C; Wisniewski, Stephen R; Jackson, Edwin K; Vagni, Vincent A; Bayır, Hülya; Clark, Robert S B; Dixon, C Edward; Janesko-Feldman, Keri L; Kochanek, Patrick M

2014-08-15

Secondary insults, such as hemorrhagic shock (HS), worsen outcome from traumatic brain injury (TBI). Both TBI and HS modulate levels of inflammatory mediators. We evaluated the addition of HS on the inflammatory response to TBI. Adult male C57BL6J mice were randomized into five groups (n=4 [naïve] or 8/group): naïve; sham; TBI (through mild-to-moderate controlled cortical impact [CCI] at 5 m/sec, 1-mm depth), HS; and CCI+HS. All non-naïve mice underwent identical monitoring and anesthesia. HS and CCI+HS underwent a 35-min period of pressure-controlled hemorrhage (target mean arterial pressure, 25-27 mm Hg) and a 90-min resuscitation with lactated Ringer's injection and autologous blood transfusion. Mice were sacrificed at 2 or 24 h after injury. Levels of 13 cytokines, six chemokines, and three growth factors were measured in serum and in five brain tissue regions. Serum levels of several proinflammatory mediators (eotaxin, interferon-inducible protein 10 [IP-10], keratinocyte chemoattractant [KC], monocyte chemoattractant protein 1 [MCP-1], macrophage inflammatory protein 1alpha [MIP-1α], interleukin [IL]-5, IL-6, tumor necrosis factor alpha, and granulocyte colony-stimulating factor [G-CSF]) were increased after CCI alone. Serum levels of fewer proinflammatory mediators (IL-5, IL-6, regulated upon activation, normal T-cell expressed, and secreted, and G-CSF) were increased after CCI+HS. Serum level of anti-inflammatory IL-10 was significantly increased after CCI+HS versus CCI alone. Brain tissue levels of eotaxin, IP-10, KC, MCP-1, MIP-1α, IL-6, and G-CSF were increased after both CCI and CCI+HS. There were no significant differences between levels after CCI alone and CCI+HS in any mediator. Addition of HS to experimental TBI led to a shift toward an anti-inflammatory serum profile--specifically, a marked increase in IL-10 levels. The brain cytokine and chemokine profile after TBI was minimally affected by the addition of HS.

Lumbar Scoliosis in Patients With Breast Cancer: Prevalence and Relationship With Breast Cancer Treatment, Age, Bone Mineral Density, and Body Mass Index.

PubMed

Jung, Sangeun; Kim, Mee Gang; Lee, Jong In

2017-10-01

To identify the prevalence of lumbar scoliosis in breast cancer patients and to investigate the potential risk factors of lumbar scoliosis. A retrospective chart review was performed in breast cancer patients aged more than 40 years who underwent dual energy X-ray absorptiometry (DEXA) scanning between January 2014 and December 2014. We divided the patients into control and experimental groups in order to investigate the influence of breast cancer treatment. The curvature of the lumbar spine was measured by using the Cobb method on a DEXA scan. Scoliosis was defined by the presence of a curvature 10° or larger. The variables, including age, bone mineral density (BMD), body mass index (BMI), and breast cancer treatments, were also obtained from the medical chart. Prevalence of lumbar scoliosis was evaluated, and it was compared between the two groups. The relationships between lumbar scoliosis and these variables were also investigated. Lumbar scoliosis was present in 16 out of our 652 breast cancer patients. There was no difference in the prevalence of lumbar scoliosis between the control group (7/316) and the experimental group (9/336) (p=0.70). According to the logistic regression analysis, lumbar scoliosis had no significant association with operation, chemotherapy, hormone therapy, BMI, and BMD (p>0.05). However, age showed a significant relationship with prevalence of lumbar scoliosis (p<0.001; odds ratio, 1.11; 95% confidence interval, 1.054-1.170). Prevalence of lumbar scoliosis in patients with breast cancer was 2.45%. Lumbar scoliosis had no association with breast cancer treatments, BMD, and BMI. Age was the only factor related to the prevalence of lumbar scoliosis.

Transareolar Single-Port Needlescopic Thoracic Sympathectomy Under Intravenous Anesthesia Without Intubation: A Randomized Controlled Trial.

PubMed

Chen, Jianfeng; Du, Quan; Lin, Min; Lin, Jianbo; Li, Xu; Lai, Fancai; Tu, Yuanrong

2016-12-01

Transareolar single-port needlescopic thoracic sympathectomy under intravenous anesthesia without intubation has rarely been attempted in managing primary palmar hyperhidrosis (PPH). The objective of this study is to evaluate the feasibility and safety of this minimally invasive technique. From May 2012 to May 2015, 168 male patients with severe PPH underwent single-port endoscopic thoracic sympathectomy (ETS) and were randomly allocated to groups A or B. Patients in group A underwent nonintubated transareolar ETS with a 2-mm needle endoscope, while those in group B underwent intubated transaxillary ETS with a 5-mm thoracoscope. All procedures were performed successfully. The palms of all patients became dry and warm immediately after surgery. The mean resuscitation time was significantly shorter in nonintubated patients than in intubated patients. Postoperative sore throat occurred in 4 patients in group A and in 32 patients in group B (P < .01). The mean incision length was significantly shorter in group A than in group B. The mean postoperative pain scores were markedly higher in group B than in group A. The mean cost of anesthesia was considerably lower in nonintubated patients than in intubated patients. The mean cosmetic scores were higher in group A than in group B (P < .01). Nonintubated transareolar single-port ETS with a needle endoscope is a safe, effective, and minimally invasive therapeutic procedure, which allows a smaller incision with less pain and excellent cosmetic results. This novel procedure can be performed in a routine clinical practice for male patients with severe PPH.

Simultaneous Versus Sequential Side-by-Side Bilateral Metal Stent Placement for Malignant Hilar Biliary Obstructions.

PubMed

Inoue, Tadahisa; Ishii, Norimitsu; Kobayashi, Yuji; Kitano, Rena; Sakamoto, Kazumasa; Ohashi, Tomohiko; Nakade, Yukiomi; Sumida, Yoshio; Ito, Kiyoaki; Nakao, Haruhisa; Yoneda, Masashi

2017-09-01

Endoscopic bilateral self-expandable metallic stent (SEMS) placement for malignant hilar biliary obstructions (MHBOs) is technically demanding, and a second SEMS insertion is particularly challenging. A simultaneous side-by-side (SBS) placement technique using a thinner delivery system may mitigate these issues. We aimed to examine the feasibility and efficacy of simultaneous SBS SEMS placement for treating MHBOs using a novel SEMS that has a 5.7-Fr ultra-thin delivery system. Thirty-four patients with MHBOs underwent SBS SEMS placement between 2010 and 2016. We divided the patient cohort into those who underwent sequential (conventional) SBS placement between 2010 and 2014 (sequential group) and those who underwent simultaneous SBS placement between 2015 and 2016 (simultaneous group), and compared the groups with respect to the clinical outcomes. The technical success rates were 71% (12/17) and 100% (17/17) in the sequential and simultaneous groups, respectively, a difference that was significant (P = .045). The median procedure time was significantly shorter in the simultaneous group (22 min) than in the sequential group (52 min) (P = .017). There were no significant group differences in the time to recurrent biliary obstruction (sequential group: 113 days; simultaneous group: 140 days) or other adverse event rates (sequential group: 12%; simultaneous group: 12%). Simultaneous SBS placement using the novel 5.7-Fr SEMS delivery system may be more straightforward and have a higher success rate compared to that with sequential SBS placement. This new method may be useful for bilateral stenting to treat MHBOs.

Post retention: the effect of sequence of post-space preparation, cementation time, and different sealers.

PubMed

Boone, K J; Murchison, D F; Schindler, W G; Walker, W A

2001-12-01

Many endodontic sealers contain constituents that have been shown to inhibit the polymerization of resin cements. This may be important when prefabricated posts are cemented at the same appointment as root canal obturation. This study evaluated the effects of cementing posts with a resin cement immediately or at a delayed time period after obturation using Roth's 801 Elite Grade or AH26 sealer cements. The contribution of mechanical post-space preparation was also assessed as a critical variable. One hundred twenty extracted canines were randomly divided into eight experimental groups. The variables evaluated were the order of post preparation (either before or after obturation), the type of sealer used, and the time of post cementation. All teeth received a stainless steel #6 Parapost XP cemented with a resin cement, Panavia 21. Each experimental group underwent tensile testing for retention using an Instron universal testing machine. For both sealers posts cemented in teeth in which the canal was obturated before post-space preparation and thus had sealer-contaminated dentin removed by the space preparation procedure had significantly higher retentive values than those obturated after post-space preparation in which contaminated dentin might remain. Sealer used and time of cementation had no specific effect on retention. Achieving a clean, "freshened" dentinal surface during mechanical post-space preparation seems to be a critical variable for post retention when a resin cement is used.

Exercise x BCAA Supplementation in Young Trained Rats: What are their Effects on Body Growth?

PubMed

de Campos-Ferraz, Patricia Lopes; Ribeiro, Sandra Maria Lima; Luz, Silmara Dos Santos; Lancha, Antonio Herbert; Tirapegui, Julio

2011-01-01

The purpose of this study was to evaluate whether Branched-chain amino acids (BCAAs) supplementation had any beneficial effects on growth and metabolic parameters of young rats submitted to chronic aerobic exercise. Thirty-two young rats (age: 21-d) were randomly assigned to four experimental groups (n = 8): Supplemented Trained (Sup/Ex), Control Trained (Ctrl/Ex), Supplemented Sedentary (Sup/Sed) and Control Sedentary (Ctrl/Sed). The trained groups underwent a five-week swimming protocol and received supplemented (45 mg BCAA/body weight/day) or control ration. Trained animals presented a lower body length and a higher cartilage weight, regardless of supplementation. Physical activity was responsible for a substantial reduction in proteoglycan synthesis in cartilage tissue, and BCAA supplementation was able to attenuate this reduction and also to improve glycogen stores in the liver, although no major differences were found in body growth associated to this supplementation. Key pointsCartilage proteoglycan synthesis was dramatically reduced in trained animals as a whole.BCAA supplementation augmented liver glycogen stores and reduced proteolysis in our experimental conditionsTrained animals receiving BCAA supplementation featured increased proteoglycan synthesis compared to sedentary ones, probably because BCAA may have attenuated the negative effects of exercise on cartilage development.BCAA supplementation was not capable of neutralizing directly the negative effects of long-term physical training and lower food intake in young male rats on body growth.

Collagen, fibrinogen and thrombin biological addesive is effective in treating experimental liver injuries.

PubMed

Oliveira, Frederico Michelino DE; Carvalho, Marcus Vinícius H DE; Marchi, Evaldo; Pinto, Clóvis Antônio Lopes

2016-01-01

: to evaluate the effectiveness of a collagen-based adhesive associated with fibrinogen and thrombin in experimental liver injury in rats. : the study included 30 Wistar rats randomly divided into three groups: A, B and C. All underwent standard liver traumatic injury. In group A the lesion was treated with the adhesive; in group B, with conventional absorbable suture; and in group C, there was no treatment. We analyzed the time of hemostasis, mortality, occurrence of adhesions and any histological changes. : there was no statistical difference in relation to mortality (p = 0.5820). The group treated with the adhesive showed the lowest hemostasis times (p = 0.0573, odds ratio 13.5) and lower incidence of adhesions (p = 0.0119). Microscopic histological alterations of Groups A and B were similar, with foreign body granuloma formation separating the adhesive material or the suture from the hepatic stroma. : the adhesive of collagen associated with fibrinogen and thrombin was effective in the treatment of experimental hepatic injury, providing a lower incidence of adhesions between the liver and surrounding structures. avaliar a eficácia de um adesivo à base de colágeno associado a fibrinogênio e trombina, no trauma hepático experimental em ratos. foram incluídos no estudo 30 ratos Wistar, igualmente divididos aleatoriamente em três grupos: A, B e C. Todos foram submetidos à lesão traumática hepática padronizada. No grupo A a lesão foi tratada com o adesivo, no grupo B com sutura convencional com fio absorvível e no grupo C não houve tratamento da lesão. Foram analisados o tempo de hemostasia, mortalidade, ocorrência de aderências e eventuais alterações histológicas. os resultados mostraram que não houve diferença estatística em relação à mortalidade (p=0,5820). O grupo tratado com adesivo apresentou os menores tempos de hemostasia (p=0,0573 e odds ratio 13,5) e menor ocorrência de aderências (p=0,0119). Microscopicamente, as alterações histológicas dos grupos A e B foram semelhantes, com a formação de granuloma de corpo estranho separando o material do adesivo e do fio de sutura do estroma hepático. o estudo concluiu que o adesivo de colágeno associado a fibrinogênio e trombina foi eficaz no tratamento do trauma hepático experimental, proporcionado menor ocorrência de aderências entre o fígado e as estruturas vizinhas.

Five-year Experience With Arterial Switch Operation in the First Hours of Life.

PubMed

Chasovskyi, Kyrylo; Mykychak, Yaroslav; Rudenko, Nadiia; Vorobyova, Hanna; Yemets, Illya

2017-01-01

We assessed morbidity after 2 management strategies for arterial switch operation (ASO) in a single institution: first hours of life surgery and conventional approach. From September 2009 to September 2014, 346 consecutive patients who underwent ASO were enrolled. The study group included 92 patients who underwent ASO in the first 24 hours after birth (group I). The control group consisted of 254 patients who underwent ASO after 24 hours of life in the conventional way (group II). Three outcomes were analyzed: postoperative ventilation time (VT), post-extubation hospital length of stay (peLOS), and a composite morbidity index, defined as postoperative VT + peLOS + occurrence of selected major complications. Overall 30-day survival was 98% (2 [2%] group I vs 5 [2%] group II, P = 1.000). Fifty (13.3%) major complications were observed: 14 (15%) in group I and 36 (15%) in group II (P = 0.635). Although peLOS and morbidity index did not differ significantly between groups, postoperative VT (42 hours [24, 67] vs 27 hours [22, 47], P = 0.008) and total hospital stay were significantly longer in group II (18 days [10, 19] vs 14 days [12, 18]). A median volume of 80 mL (60-100 mL) of autologous umbilical cord blood was collected (80 mL, group 1 vs 60 mL, group II; P = 0.090). Homologous blood cell transfusion was avoided in 70 patients (78%) in group I and in 13 patients (6%) in group II (P < 0.001). Arterial switch operation during the initial 24 hours of life has similar outcomes in view of morbidity and mortality to the conventional approach. Copyright © 2017 Elsevier Inc. All rights reserved.

Transcatheter Arterial Embolization for Upper Gastrointestinal Nonvariceal Hemorrhage: Is Empiric Embolization Warranted?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arrayeh, Elnasif; Fidelman, Nicholas, E-mail: nicholas.fidelman@ucsf.edu; Gordon, Roy L.

Purpose: To determine whether transcatheter arterial embolization performed in the setting of active gastric or duodenal nonvariceal hemorrhage is efficacious when the bleeding source cannot be identified angiographically. Methods: Records of 115 adult patients who underwent visceral angiography for endoscopically documented gastric (50 patients) or duodenal (65 patients) nonvariceal hemorrhage were retrospectively reviewed. Patients were subdivided into three groups according to whether angiographic evidence of arterial hemorrhage was present and whether embolization was performed (group 1 = no abnormality, no embolization; group 2 = no abnormality, embolization performed [empiric embolization]; and group 3 = abnormality present, embolization performed). Thirty-day ratesmore » and duration of primary hemostasis and survival were compared.ResultsFor patients with gastric sources of hemorrhage, the rate of primary hemostasis at 30 days after embolization was greater when embolization was performed in the setting of a documented angiographic abnormality than when empiric embolization was performed (67% vs. 42%). The rate of primary hemostasis at 30 days after angiography was greater for patients with duodenal bleeding who either underwent empiric embolization (60%) or embolization in the setting of angiographically documented arterial hemorrhage (58%) compared with patients who only underwent diagnostic angiogram (33%). Patients with duodenal hemorrhage who underwent embolization were less likely to require additional invasive procedures to control rebleeding (p = 0.006). Conclusion: Empiric arterial embolization may be advantageous in patients with a duodenal source of hemorrhage but not in patients with gastric hemorrhage.« less

Anti-inflammatory and antioxidant effects of infliximab in a rat model of intestinal ischemia/reperfusion injury.

PubMed

Pergel, Ahmet; Kanter, Mehmet; Yucel, Ahmet Fikret; Aydin, Ibrahim; Erboga, Mustafa; Guzel, Ahmet

2012-11-01

The aim of this study was to investigate the possible protective effects of infliximab on oxidative stress, cell proliferation and apoptosis in the rat intestinal mucosa after ischemia/reperfusion (I/R). A total of 30 male Wistar albino rats were divided into three groups: sham, I/R and I/R+ infliximab; each group comprised 10 animals. Sham group animals underwent laparotomy without I/R injury. I/R groups after undergoing laparotomy, 1 hour of superior mesenteric artery ligation occurred, which was followed by 1 hour of reperfusion. In the infliximab group, 3 days before I/R, infliximab (3 mg/kg) was administered intravenously. All animals were killed at the end of reperfusion and intestinal tissues samples were obtained for biochemical and histopathological investigation in all groups. To date, no biochemical and histopathological changes have been reported regarding intestinal I/R injury in rats due to infliximab treatment. Infliximab treatment significantly decreased the elevated tissue malondialdehyde levels and increased reduced superoxide dismutase and glutathione peroxidase enzyme activities in intestinal tissues samples. I/R caused severe histopathological injury including mucosal erosions, inflammatory cell infiltration, necrosis, hemorrhage, and villous congestion. Infliximab treatment significantly attenuated the severity of intestinal I/R injury, inhibiting I/R-induced apoptosis, and cell proliferation. Because of its anti-inflammatory and antioxidant effects, infliximab pretreatment may have protective effects on the experimental intestinal I/R model of rats.

Photobiomodulation laser improves the early repair process of hypothyroid rats

NASA Astrophysics Data System (ADS)

Uzêda e Silva, V. D.; Rodriguez, T. T.; Xavier, F. C. A.; dos Santos, J. N.; Vasconcelos, R. M.; Ramalho, L. M. P.

2018-04-01

Delay in wound healing has been observed in the hypothyroidism disfunction. Laser light can modulate various biological phenomena acting on different cell types. However, there are few reports in the literature regarding the effects of laser on wound healing of hypothyroid models. This study aimed to evaluate the differences in reepithelialization process of cutaneous wounds on hypothyroid and euthyroid rats treated with laser phototherapy. Forty-eight rats were divided into two main groups: euthyroid (EU) and hypothyroid (HYPO). Hypothyroidism was induced by Thyroidectomy. Each group was divided into subgroups: control (without laser) and laser groups. Standard surgical wound was created on the dorsum of each rat. The irradiation protocols (λ660 nm, 40 mW, CW; 10 J/cm2) was carried out immediately after wounding and repeated every 24h during 3 and 7 days. After animal death, specimens were taken, routinely processed, cut, stained with hematoxylin-eosin, and underwent histological analysis. Three days after the surgery, it was possible to observe initial reepithelialization in more advanced stages in the wound area of the irradiated hypothyroid group when compared to control hypothyroid group (p<0.05). No significant difference was found in the experimental period of 7 days among the groups. It was concluded that the laser light did influence reepithelialization process on hypothyroid rats in early stages of healing process.

The renoprotective effects of mannitol and udenafil in renal ischemia-reperfusion injury model

PubMed Central

Toktaş, Cihan; Aybek, Hülya; Küçükatay, Vural; Şen Türk, Nilay; Zumrutbas, Ali Ersin

2017-01-01

Purpose The aim of this study was to investigate and compare the effects of udenafil and mannitol in an experimental renal ischemia-reperfusion (I/R) injury model. Materials and Methods A total of 64 female Wister Albino rats were used. Right nephrectomy was performed in all groups. In the control group; I/R injury was not performed. In the I/R group; left renal pedicle was clamped for 45 minutes and then underwent 60 minutes and 24 hours of reperfusion. In the mannitol group; 1 mL 20% mannitol was given intravenously 15 minutes before clamping. In the udenafil group; 10-mg/kg udenafil was given orally 1 hour before clamping. Creatinine (Cr), blood urea nitrogen (BUN), Cr clearance, malondialdehyde, neutrophil gelatinase associated lipocalin (NGAL), histological examination and DNA damage (Comet Assay method) levels were compared in tissue, serum and urine samples. Results Udenafil had a better protective effect than mannitol according to biochemical parameters (Cr, BUN, Cr clearance, and NGAL levels) and histopathological findings when compared with the I/R group. In the Comet sampling analysis no significant difference was detected. Conclusions Udenafil has a better renoprotective effect than mannitol against I/R injury and this effect supports more functional improvements. Further clinical trials are needed to demonstrate those effects and clinical utility of udenafil for that purpose in humans. PMID:28681040

Management of Myofascial Pain of Upper Trapezius: A Three Group Comparison Study

PubMed Central

Kannan, Priya

2012-01-01

It is important to identify the most effective therapeutic modality in the management of myofascial trigger points (MTPt). Thus we aimed to study the effect of therapeutic ultrasound, laser and ischemic compression in reducing pain and improving cervical range of motion among patients with MTPt. Experimental study comparing three groups was designed as a 5 days trial, a co-relational design was considered. Outcome measures: VAS for pain, provocative pain test using “soft tissue tenderness grading scheme” and active cervical lateral flexion using inch tape. Methods- Patients were divided into 3 groups, Gr 1 underwent treatment using therapeutic ultrasound, Gr 2 with therapeutic laserand Gr 3 with ischemic compression. Assessments were done on day 1 and day 5 of treatment respectively. Results: ANOVA revealed improvement among all 3 groups as statistically significant difference (p<0.05) between the start and end of trial. Analysis using Chi square test shows a statistically significant difference in the improvement between laser and the other 2 groups. Mean difference in the change of scores between the assessments showed laser therapy to have a tendency towards progressive improvement over the treatment period and a better improvement than the other 2 groups. Weconclude that laser can be used as an effective treatment regimen in the management of myofascial trigger points thereby reducing disability caused due to musculoskeletal pathology. PMID:22980377

Minimally invasive secondary cytoreduction plus HIPEC versus open surgery plus HIPEC in isolated relapse from ovarian cancer: a retrospective cohort study on perioperative outcomes.

PubMed

Fagotti, Anna; Costantini, Barbara; Gallotta, Valerio; Cianci, Stefano; Ronsini, Carlo; Petrillo, Marco; Pacciani, Mara; Scambia, Giovanni; Fanfani, Francesco

2015-01-01

To compare the perioperative outcomes of minimally invasive secondary cytoreduction surgery (SCS) plus hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) versus open surgery plus HIPEC in a group of platinum-sensitive patients with advanced epithelial ovarian cancer (AEOC) with isolated relapse. Retrospective cohort study (Canadian Task Force classification II-2). Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy. We selected 22 patients with a peritoneal cancer index value of 2. The laparoscopic group consisted of 11 patients who underwent laparoscopic and/or robotic complete cytoreduction plus HIPEC, whereas the laparotomic group consisted of 11 patients who underwent complete laparotomic cytoreduction plus HIPEC. The minimally invasive surgery (MIS) group were platinum-sensitive single recurrent ovarian cancer patients who underwent either laparoscopic or robotic complete secondary cytoreduction plus HIPEC, whereas the open group were women with similar clinical characteristics who underwent complete secondary cytoreduction plus HIPEC by laparotomy. The median operative time, calculated from the skin incision to the end of SCS (i.e., excluding HIPEC phase) was 125 min (range 95-150 min) in the MIS group and 295 min (range 180-420) in the open group (p = .001), with a median estimated blood loss of 50 mL (range 50-100) and 500 mL (range 50-1300), respectively (p = .025). The median length of hospital stay was 4 days (range 3-17) in the MIS group and 8.5 days (range 4-30) in the open group (p = .002). No statistically significant differences were registered in terms of intra- and postoperative complications between the 2 groups. The minimally invasive approach for SCS plus HIPEC is safe and efficient in terms of toxicity and postoperative outcomes for single isolated relapse. HIPEC should not be considered a major contraindication to a minimally invasive approach. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

A Modified Personalized Image-Based Drill Guide Template for Atlantoaxial Pedicle Screw Placement: A Clinical Study

PubMed Central

Jiang, Lianghai; Dong, Liang; Tan, Mingsheng; Qi, Yingna; Yang, Feng; Yi, Ping; Tang, Xiangsheng

2017-01-01

Background Atlantoaxial posterior pedicle screw fixation has been widely used for treatment of atlantoaxial instability (AAI). However, precise and safe insertion of atlantoaxial pedicle screws remains challenging. This study presents a modified drill guide template based on a previous template for atlantoaxial pedicle screw placement. Material/Methods Our study included 54 patients (34 males and 20 females) with AAI. All the patients underwent posterior atlantoaxial pedicle screw fixation: 25 patients underwent surgery with the use of a modified drill guide template (template group) and 29 patients underwent surgery via the conventional method (conventional group). In the template group, a modified drill guide template was designed for each patient. The modified drill guide template and intraoperative fluoroscopy were used for surgery in the template group, while only intraoperative fluoroscopy was used in the conventional group. Results Of the 54 patients, 52 (96.3%) completed the follow-up for more than 12 months. The template group had significantly lower intraoperative fluoroscopy frequency (p<0.001) and higher accuracy of screw insertion (p=0.045) than the conventional group. There were no significant differences in surgical duration, intraoperative blood loss, or improvement of neurological function between the 2 groups (p>0.05). Conclusions Based on the results of this study, it is feasible to use the modified drill guide template for atlantoaxial pedicle screw placement. Using the template can significantly lower the screw malposition rate and the frequency of intraoperative fluoroscopy. PMID:28301445

Parental satisfaction in Ugandan children with cleft lip and palate following synchronous lip and palatal repair.

PubMed

Luyten, Anke; D'haeseleer, Evelien; Budolfsen, Dorte; Hodges, Andrew; Galiwango, George; Vermeersch, Hubert; Van Lierde, Kristiane

2013-01-01

The purpose of the present case control study was to assess parental satisfaction with speech and facial appearance in Ugandan children with complete unilateral or bilateral cleft lip and palate (CLP), who underwent a synchronous lip and palatal closure. The results are compared with an age- and gender-matched control group. The experimental group consisted of the parents or guardians of 44 Ugandan patients (21 males, 23 females) with complete unilateral or bilateral CLP (mean age: 3;1 years). The control group included the foster mothers of 44 orphan children matched by age and gender (mean age: 3;7 years). A survey based on the Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Overall high levels of satisfaction were observed in the experimental group for all features (range: 56-100%). No significant differences could be established regarding age, gender, age of lip and palatal closure, cleft type or maternal vs. paternal judgments. In participants who were dissatisfied with the appearance of the lip, the time period between the cleft closure and the survey was significantly larger compared with satisfied participants. Furthermore, significantly lower levels of satisfaction were observed in the cleft group for speech and the appearance of the teeth and the nose compared with the control group. Satisfaction with speech and facial appearance in Ugandan children with cleft lip and/or palate is important since normal esthetics and speech predominantly determine the children's social acceptance in the Ugandan society. As a result of reading this manuscript, the reader will be able to explain the attitudes of parents toward the surgical repair of their children's cleft lip and palate. As a result of reading this manuscript, the reader will be able to identify differences in parental attitudes toward synchronous lip and palate repair. Copyright © 2013 Elsevier Inc. All rights reserved.

Midfacial Changes Through Anterior Maxillary Distraction Osteogenesis in Patients With Cleft Lip and Palate.

PubMed

Kanzaki, Hiroyuki; Imai, Yoshimichi; Nakajo, Tetsu; Daimaruya, Takayoshi; Sato, Akimitsu; Tachi, Masahiro; Nunomura, Youhei; Itagaki, Yusuke; Nishimura, Kazuaki; Kochi, Shoko; Igarashi, Kaoru

2017-06-01

Maxillary hypoplasia is a major issue in cleft lip and palate patients, and predictable surgical maxillary advancement is required. In the present study, the changes and stability of the maxilla and soft tissue profile achieved after the application of anterior maxillary distraction osteogenesis (AMDO) using intraoral expander in unilateral cleft lip and palate and isolated cleft palate patients were investigated by comparing to the Le Fort I osteotomy (LFI) and maxillary distraction osteogenesis (DO) with rigid external distraction (RED) system.Ten patients who underwent orthognathic treatment with AMDO were examined (AMDO group). Changes in the positions of soft and hard tissue landmarks were calculated from the lateral cephalograms taken before the distraction, at the end of the distraction, and 1 year after the surgery. They were compared with the changes in 7 other unilateral cleft lip and palate patients who underwent LFI (LFI group) and 6 others who underwent DO with RED (RED group).The mean maxillary advancement of the AMDO group was similar to that of the RED group, judged by the change of point A. During DO, the AMDO group showed less clockwise rotation of mandible compared to the RED group. The soft tissue advancement of the upper lip and nose in the AMDO group was similar to that in the RED group, which was significantly larger than that in the LFI group.Our results indicate that AMDO can be surgical option to cleft lip and palate patients with less invasive but excellent improvement in both midfacial skeletal and soft tissue similar to DO-RED.

Fertility sparing surgery in early stage epithelial ovarian cancer

PubMed Central

Martinelli, Fabio; Lorusso, Domenica; Haeusler, Edward; Carcangiu, Marialuisa; Raspagliesi, Francesco

2014-01-01

Objective Fertility sparing surgery (FSS) is a strategy often considered in young patients with early epithelial ovarian cancer. We investigated the role and the outcomes of FSS in eEOC patients who underwent comprehensive surgery. Methods From January 2003 to January 2011, 24 patients underwent fertility sparing surgery. Eighteen were one-to-one matched and balanced for stage, histologic type and grading with a group of patients who underwent radical comprehensive staging (n=18). Demographics, surgical procedures, morbidities, pathologic findings, recurrence-rate, pregnancy-rate and correlations with disease-free survival were assessed. Results A total of 36 patients had a complete surgical staging including lymphadenectomy and were therefore analyzed. Seven patients experienced a recurrence: four (22%) in the fertility sparing surgery group and three (16%) in the control group (p=not significant). Sites of recurrence were: residual ovary (two), abdominal wall and peritoneal carcinomatosis in the fertility sparing surgery group; pelvic (two) and abdominal wall in the control group. Recurrences in the fertility sparing surgery group appeared earlier (mean, 10.3 months) than in radical comprehensive staging group (mean, 53.3 months) p<0.001. Disease-free survival were comparable between the two groups (p=0.422). No deaths were reported. All the patients in fertility sparing surgery group recovered a regular period. Thirteen out of 18 (72.2%) attempted to have a pregnancy. Five (38%) achieved a spontaneous pregnancy with a full term delivery. Conclusion Fertility sparing surgery in early epithelial ovarian cancer submitted to a comprehensive surgical staging could be considered safe with oncological results comparable to radical surgery group. PMID:25142621

Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section.

PubMed

Soyama, Hiroaki; Miyamoto, Morikazu; Sasa, Hidenori; Ishibashi, Hiroki; Yoshida, Masashi; Nakatsuka, Masaya; Takano, Masashi; Furuya, Kenichi

2017-09-01

To evaluate the effectiveness of routine rapid insertion of a Bakri balloon during cesarean section for placenta previa based on a retrospective control study. Women with singleton pregnancies who underwent cesarean section for placenta previa at our institution between 2003 and 2016 were enrolled. Between 2015 and 2016, women who routinely underwent balloon tamponade during cesarean section were defined as the balloon group. Between 2003 and 2014, women who underwent no hemostatic procedures except balloon tamponade were defined as the non-balloon group. The clinical outcomes of the two groups were retrospectively analyzed. Of the 266 women with placenta previa, 50 were in the balloon group and 216 were in the non-balloon group. The bleeding amounts were significantly smaller in the balloon group than in the non-balloon group: intraoperative bleeding (991 vs. 1250 g, p < 0.01), postoperative bleeding (62 vs. 150 g, p < 0.01), and total bleeding (1066 vs. 1451 g, p < 0.01). Furthermore, the mean surgical duration was shorter in the balloon group than the non-balloon group (30 vs. 50 min, p < 0.01). In the balloon group, five patients suffered from increasing hemorrhage due to prolapse of the balloon from the uterus after the operation, but the hemorrhage was controlled by balloon re-insertion without additional hemostatic procedures. This study demonstrated that the routine rapid insertion of Bakri balloon tamponade during cesarean section significantly decreased intra- and postoperative hemorrhage and shortened the surgical duration in women with placenta previa.

Quality-of-life outcomes in patients who underwent subcutaneous immunotherapy and sublingual immunotherapy in a real-world clinical setting.

PubMed

Schwanke, Theresa; Carragee, Eugene; Bremberg, Maria; Reisacher, William R

2017-09-01

To compare changes in quality of life (QOL) that resulted from sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) in a real-world clinical setting. SLIT is established as a viable alternative to SCIT for the treatment of allergic rhinitis. Although comparative trials are increasingly available, few studies have examined QOL outcomes between these two treatments. One hundred and five participants who underwent immunotherapy for airborne allergies were enrolled in this prospective, single-center study. Forty participants completed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at initiation of therapy, after 6 months, and after 1 year of therapy. Only patients with complete time points were included in the ultimate analysis. Twenty-nine of these participants underwent SCIT and 11 underwent SLIT. The effects of age, sex, and asthma history were also examined. The participants in both groups demonstrated improvements in QOL regarding allergic rhinoconjunctivitis over the study period. However, the change in the RQLQ score from both baseline to 6 months and baseline to 1 year was only statistically significant in the SCIT group (p = 0.002, 6 months and 1 year). The participants in the SCIT group also demonstrated statistically significant improvement from baseline to 1 year in the specific domains of practical and emotional functioning, nasal symptoms, non-nasal/eye symptoms, and sleep. After 1 year, both SCIT and SLIT demonstrated a minimally important difference from baseline in the overall RQLQ score. Age <35 years in the SCIT group had a significant positive impact on QOL improvement (p = 0.038). Although improvements in QOL were noted in both groups, changes in overall scores and the majority of domains only achieved statistical significance in the SCIT group. A small study population and difficulties adhering to immunotherapy dosing schedules in the SLIT group may be contributing factors.

Comparison of PSA value at last follow-up of patients who underwent low-dose rate brachytherapy and intensity-modulated radiation therapy for prostate cancer.

PubMed

Tanaka, Nobumichi; Asakawa, Isao; Nakai, Yasushi; Miyake, Makito; Anai, Satoshi; Fujii, Tomomi; Hasegawa, Masatoshi; Konishi, Noboru; Fujimoto, Kiyohide

2017-08-25

To compare the PSA value at the last follow-up of patients who underwent prostate low-dose rate brachytherapy (LDR-BT) with that of patients who underwent intensity-modulated radiation therapy (IMRT). A total of 610 prostate cancer patients (cT1c-3bN0M0) were enrolled, and 445 of them underwent LDR-BT, while 165 received IMRT (74-76 Gy). The median follow-up period of these two groups was 75 months (LDR-BT) and 78 months (IMRT), respectively. We also evaluated the biochemical recurrence (BCR)-free rate using two definitions (Phoenix definition and PSA ≥ 0.2 ng/mL). The percentage of patients who achieved PSA < 0.2 ng/mL at the last follow-up was 77.5% in the LDR-BT group and 49.7% in the IMRT group (p < 0.001). Among patients with a normal testosterone level at the last follow-up, the percentage of those who achieved PSA < 0.2 ng/mL at the last follow-up was 79.2% in the LDR-BT group and 32.1% in the IMRT group (p < 0.001). The 5-year BCR-free rate by the Phoenix definition in the IMRT and LDR-BT groups was 89.5 and 95.0% (p < 0.001), respectively. On the other hand, the 5-year BCR-free rate using the definition of PSA ≥ 0.2 ng/mL was 59.1 and 80.1% in the IMRT and LDR-BT groups, respectively (p < 0.001). The PSA value at the last follow-up of LDR-BT was significantly lower than that of IMRT, and this result was particularly marked in patients with a normal testosterone level at the last follow-up.

The value of three-dimensional photogrammetry in isolated sagittal synostosis: Impact of age and surgical technique on intracranial volume and cephalic index─a retrospective cohort study.

PubMed

Mertens, Christian; Wessel, Eline; Berger, Moritz; Ristow, Oliver; Hoffmann, Jürgen; Kansy, Katinka; Freudlsperger, Christian; Bächli, Heidrun; Engel, Michael

2017-12-01

The aim of this study was to compare the outcome of intracranial volume (ICV) and cephalic index (CI) between two different techniques for surgical therapy of sagittal synostosis. Between 2011 and 2015, all patients scheduled for surgical therapy of sagittal synostosis were consecutively enrolled. All patients younger than 6 months underwent early extended strip craniectomy (ESC group), and patients older than 6 months underwent late modified pi-procedure (MPP group). To measure ICV and CI, data acquisition was performed via three-dimensional photogrammetry, 1 day before (T0) and between 10 and 12 weeks after surgery (T1). Results were compared with an age-matched reference group of healthy children. Perioperative parameters, as duration of surgery and the amount of blood loss of both surgical procedures were analyzed. A total of 85 patients were enrolled. Of the patients, 48 underwent an extended strip craniotomy with parietal osteotomies and biparietal widening and 37 patients underwent a late modified pi-procedure. There was no significant difference between the ESC group and the MPP group regarding the efficacy of improving CI (p > 0.05). Both techniques were able to normalize CI and to improve head shape. ICV was normal compared to age-matched norm-groups with both techniques, pre- and postoperatively. However, duration of the surgical procedure and calculated blood loss were significantly lower in the ESC group (p < 0.05). ESC and MPP were effective techniques to normalize cephalic index (CI) and improve head shape at their recommended time of surgery. Measurement of ICV and CI with 3D photogrammetry is a valid method to objectively evaluate patients before and after surgery without exposing pediatric patients to ionizing radiation. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The Ergogenic Effect of Elastic Therapeutic Tape on Stride and Step Length in Fatigued Runners

PubMed Central

Ward, John; Sorrels, Kenneth; Coats, Jesse; Pourmoghaddam, Amir; Moskop, JoAnn; Ueckert, Kate; Glass, Amanda

2014-01-01

Objective The purpose of this study was to determine if elastic therapeutic tape placed on anterior lower limbs would affect stride and step length in fatigued runners’ gait. Methods Forty-two healthy participants were equally divided into a kinesiology tape group (Rocktape) and a no-tape control group. Participants in both groups underwent a baseline running gait test at 6 mph without tape. After this, participants engaged in an exhaustive lower body fatigue protocol until they reached maximal volitional exhaustion. Participants were then randomized to 1 of 2 interventions: (1) Experimental group, which had kinesiology tape placed under tension on the anterior aspect of their lower limbs bilaterally from the upper thigh to just below the patella, or (2) Control group, which did not receive taping. All participants then engaged in a similar 6-mph running gait postanalysis. Participant’s gait was analyzed for 90 seconds during each test iteration. Researchers used a 2-way repeated-measures analysis of variance considering fatigue (prefatigue, postfatigue) and group (tape, no-tape) as subject factors. Results After the fatigue protocol, the no-tape group demonstrated a significant decrease in step length of 14.2 mm (P = .041) and stride length of 29.4 mm (P = .043). The kinesiology tape group did not demonstrate a significant decline in these gait parameters. Conclusions In this preliminary study, placing elastic therapeutic tape over the anterior lower limbs demonstrated short-term preservation of runner step length and stride length in a fatigued state. PMID:25435835

Glutamine decreases the duration of postoperative ileus after abdominal surgery: an experimental study of conscious dogs.

PubMed

Ohno, Tetsuro; Mochiki, Erito; Ando, Hiroyuki; Fukasawa, Takaharu; Toyomasu, Yoshitaka; Ogata, Kyoichi; Aihara, Ryuusuke; Asao, Takayuki; Kuwano, Hiroyuki

2009-06-01

Postoperative ileus (POI) is a transient bowel dysmotility that occurs following many types of operations and is one of the most common complications of gastrointestinal surgery. We hypothesized that enteral supplementation of glutamine after abdominal surgery would restore fuel to the small intestine, suppress oxidative stress, and lead to improvement in POI. Twelve dogs underwent distal gastrectomy and were each randomly assigned to one of two groups based on postoperative treatment: the water injection (control) group and the glutamine injection group. Water (40 ml) or L(+)-glutamine (1 g/40 ml water) was injected into the residual stomach through the gastric tube every 12 h after surgery for 7 days. Changes in the plasma and intestinal intracellular concentration of glutamine and in gastrointestinal motility were measured. The plasma and intracellular glutamine levels decreased after the operation in both groups, although the decreased intracellular glutamine levels were not significantly different than preoperative levels. The glutamine group showed a significantly smaller decrease of the plasma glutamine level compared with the control group (P < 0.05). All the dogs showed gastrointestinal dysmotility after the operation. The mean length of time between the operation and the appearance of interdigestive migrating contractions in the glutamine group was significantly shorter than in the control group (22.4 +/- 3.1 h versus 37.8 +/- 4.0 h, respectively; P < 0.05). In conclusion, glutamine could act as a motility-recovery agent after abdominal surgery and thereby decrease the duration of POI.

Comparison of two cannulation methods for assessment of intracavernosal pressure in a rat model

PubMed Central

Luo, Lianmin; Wang, Jiamin; Li, Ermao; Luo, Jintai; Liu, Luhao; Wan, ShawPong

2018-01-01

Intracavernous pressure (ICP) measurement is a well-established technique for assessing the erectile function, which was performed by cannulating either crus or shaft of the penis. However, there are no studies concerning the experimental performance of the two cannulation sites yet. The aim of this study was to compare the measuring outcomes using two different cannulation sites. To validate the capacity of our study, both normal and the castration-induced erectile dysfunction rat models were conducted. Fifty adult male Sprague-Dawley rats were randomized equally into two groups: an intact group and a castration group. Five rats from each group firstly underwent different stimulation parameters to detect the optimal erectile responses. The residual rats in each group were further assigned into two subgroups (n = 10 per subgroup) according to two different cannulation sites (crus or shaft of the corpus cavernosum). The ICP values were compared between groups after different interventions. The optimal parameters for mean maximum ICP were recorded at 2.5V and a frequency of 15 Hz. The rats under the two different cannulation sites tended to show similar ICP values in both the intact and the castration groups. However, the success rate in monitoring ICP was significantly higher in the groups cannulating into the shaft of the penis compared to the crus (100% vs. 70%; P = 0.02). Our data suggested that the method of cannulation into the penile shaft could serve as a better alternative for the ICP measurement in rats. PMID:29486011

Effects of neuromuscular electrical stimulation combined with effortful swallowing on post-stroke oropharyngeal dysphagia: a randomised controlled trial.

PubMed

Park, J-S; Oh, D-H; Hwang, N-K; Lee, J-H

2016-06-01

Neuromuscular electrical stimulation (NMES) has been used as a therapeutic intervention for dysphagia. However, the therapeutic effects of NMES lack supporting evidence. In recent years, NMES combined with traditional swallowing therapy has been used to improve functional recovery in patients with post-stroke dysphagia. This study aimed to investigate the effects of effortful swallowing combined with neuromuscular electrical stimulation on hyoid bone movement and swallowing function in stroke patients. Fifty stroke patients with mild dysphagia who were able to swallow against the resistance applied by using NMES and cooperate actively in training were included. This study was designed as a 6-week single-blind, randomised, controlled study. In the experimental group, two pairs of electrodes were placed horizontally in the infrahyoid region to depress the hyoid bone. The NMES intensity was increased gradually until the participants felt a grabbing sensation in their neck and performed an effortful swallow during the stimulation. In the placebo group, the same procedure was followed except for the intensity, which was increased gradually until the participants felt an electrical sensation. All participants underwent this intervention for 30 min per session, 5 sessions per week, for 6 weeks. Videofluoroscopic swallowing studies (VFSS) were carried out before and after the intervention and kinematics of the hyoid bone and swallowing function were analysed based on the VFSS. The experimental group revealed a significant increase in anterior and superior hyoid bone movement and the pharyngeal phase of the swallowing function. This intervention can be used as a novel remedial approach in dysphagic stroke patients. © 2016 John Wiley & Sons Ltd.

Nonuniformity of axial and circumferential remodeling of large coronary veins in response to ligation.

PubMed

Choy, Jenny Susana; Dang, Quang; Molloi, Sabee; Kassab, Ghassan S

2006-04-01

The pressure-induced remodeling of coronary veins is important in coronary venous retroperfusion. Our hypothesis is that the response of the large coronary veins to pressure overload will depend on the degree of myocardial support. Eleven normal Yorkshire swine from either sex, weighing 31-39 kg, were studied. Five pigs underwent ligation of the left anterior descending (LAD) vein, and six served as sham-operated controls. The ligation of the coronary vein caused an increase in pressure intermediate to arterial and venous values. After 2 wk of ligation, the animals were euthanized and the coronary vessels were perfusion-fixed with glutaraldehyde. The LAD vein was sectioned, and detailed morphometric measurements were made along its length from the point of ligation near the base down to the apex of the heart. The structural remodeling of the vein was circumferentially nonuniform because the vein is partially embedded in the myocardium; it was also axially nonuniform because it is tethered to the myocardium to different degrees along its axial length. The wall area was significantly larger in the experimental group, whereas luminal area in the proximal LAD vein was significantly smaller in the same group compared with sham-operated controls. The wall thickness-to-radius ratio was also significantly larger in the experimental group in proportion to the increase in pressure. The major conclusion of this study is that the response of the vein depends on the local wall stress, which is, in part, determined by the surrounding tissue. Furthermore, the geometric remodeling of the coronary vein restores the circumferential stress to the homeostatic value.

Age-related differences in the neural correlates of empathy for pleasant and unpleasant touch in a female sample.

PubMed

Riva, Federica; Tschernegg, Melanie; Chiesa, Patrizia A; Wagner, Isabella C; Kronbichler, Martin; Lamm, Claus; Silani, Giorgia

2018-05-01

Empathy is essential for successful social interactions and relationships. The neural underpinnings of empathy have predominantly been studied in the young adult population, thus little is known about how they evolve across the life span. In the present study, we used functional magnetic resonance imaging to investigate age-related differences in brain activity associated to empathy for positive and negative emotions. Female participants of 3 age groups-adolescents, young, and older adults-underwent an experimental paradigm inducing both first-hand and empathic experience of pleasant and unpleasant touch. Group comparisons and regression analyses revealed that older adults showed lower activation within the anterior insula with respect to young adults, during both empathy conditions. Further analyses provided evidence that years of education, theory of mind ability, gray matter volume, and first-hand affect processing did not account for these effects. These findings indicate that the neural bases of empathy change across different age groups, from adolescence to old age. Different ages and in particular older age seem to significantly influence the way in which we represent and share others' positive and negative emotions. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of community-based virtual reality treadmill training on balance ability in patients with chronic stroke.

PubMed

Kim, Nara; Park, YuHyung; Lee, Byoung-Hee

2015-03-01

[Purpose] We aimed to examine the effectiveness of a community-based virtual reality treadmill training (CVRTT) program on static balance abilities in patients with stroke. [Subjects and Methods] Patients (n = 20) who suffered a stroke at least 6 months prior to the study were recruited. All subjects underwent conventional physical therapy for 60 min/day, 5 days/week, for 4 weeks. Additionally, the CVRTT group underwent community-based virtual reality scene exposure combined with treadmill training for 30 min/day, 3 days/week, for 4 weeks, whereas the control group underwent conventional physical therapy, including muscle strengthening, balance training, and indoor and outdoor gait training, for 30 min/day, 3 days/week, for 4 weeks. Outcome measurements included the anteroposterior, mediolateral, and total postural sway path lengths and speed, which were recorded using the Balancia Software on a Wii Fit(™) balance board. [Results] The postural sway speed and anteroposterior and total postural sway path lengths were significantly decreased in the CVRTT group. Overall, the CVRTT group showed significantly greater improvement than the control group. [Conclusions] The present study results can be used to support the use of CVRTT for effectively improving balance in stroke patients. Moreover, we determined that a CVRTT program for stroke patients is both feasible and suitable.

Comparison of cardiovascular risk of noncardiac surgery following coronary angioplasty with versus without stenting.

PubMed

Leibowitz, David; Cohen, Maurice; Planer, David; Mosseri, Morris; Rott, David; Lotan, Chaim; Weiss, A Teddy

2006-04-15

Previous studies have shown a high incidence of cardiovascular complications when noncardiac surgery (NCS) is performed after coronary stenting. No study has compared the outcomes of NCS after stenting compared with percutaneous transluminal coronary angioplasty (PTCA) alone. The records of all patients who underwent NCS within 3 months of percutaneous coronary intervention at our institution were reviewed for adverse clinical events with the end points of acute myocardial infarction, major bleeding, and death < or = 6 months after NCS. A total of 216 consecutive patients were included in the study. Of these, 122 (56%) underwent PTCA and 94 (44%) underwent stenting. A total of 26 patients (12%) died, 13 in the stent group (14%) and 13 in the PTCA group (11%), a nonsignificant difference. The incidence of acute myocardial infarction and major bleeding was 7% and 16% in the stent group and 6% and 13% in the PTCA group (p = NS), respectively. Significantly more events occurred in the 2 groups when NCS was performed within 2 weeks of percutaneous coronary intervention. In conclusion, our study has demonstrated high rates of perioperative morbidity and mortality after NCS in patients undergoing PTCA alone, as well as stenting. These findings support the current guidelines regarding the risk of NCS after stenting but suggest they be extended to PTCA as well.

Chromium ion release from stainless steel pediatric scoliosis instrumentation.

PubMed

Cundy, Thomas P; Delaney, Christopher L; Rackham, Matthew D; Antoniou, Georgia; Oakley, Andrew P; Freeman, Brian J C; Sutherland, Leanne M; Cundy, Peter J

2010-04-20

Case-control study. To determine whether serum metal ion levels and erythrocyte chromium levels in adolescents with stainless steel spinal instrumentation are elevated when compared with 2 control groups. Instrumented spinal arthrodesis is a common procedure to correct scoliosis. The long-term consequences of retained implants are unclear. Possible toxic effects related to raised metal ion levels have been reported in the literature. Thirty patients who underwent posterior spinal arthrodesis with stainless steel instrumentation for scoliosis (group 1) were included. Minimum postoperative duration was 3 years. Serum chromium, molybdenum, iron, and ferritin levels were measured. Participants with elevated above normal serum chromium levels (n = 11) also underwent erythrocyte chromium analysis. Comparisons were made with 2 control groups; 10 individuals with scoliosis with no spinal surgery (group 2) and 10 volunteers without scoliosis (group 3). All control group participants underwent serum and erythrocyte analysis. Elevated above normal serum chromium levels were demonstrated in 11 of 30 (37%) group 1 participants. Elevated serum chromium levels were demonstrated in 0 of 10 participants (0%) in group 2 and 1 of 10 (10%) in group 3. There was a statistically significant elevation in serum chromium levels between group 1 and group 2 participants (P = 0.001). There was no significant association between groups 1, 2, and 3 for serum molybdenum, iron, and ferritin levels. Erythrocyte chromium measurements were considered within the normal range for all participants tested (n = 31). Raised serum chromium levels were detected in 37% of patients following instrumented spinal arthrodesis for correction of scoliosis. This new finding has relatively unknown health implications but potential mutagenic, teratogenic and carcinogenic sequelae. This is especially concerning with most scoliosis patients being adolescent females with their reproductive years ahead.

The value of rapid on-site evaluation during EBUS-TBNA.

PubMed

Cardoso, A V; Neves, I; Magalhães, A; Sucena, M; Barroca, H; Fernandes, G

2015-01-01

Rapid on-site evaluation (ROSE) has the potential to increase endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) accuracy in the diagnosis of mediastinal lesions and lung cancer staging. However, studies have reported controversial results. The purpose of our study was to evaluate the influence of ROSE on sample adequacy and diagnostic accuracy of EBUS-TBNA. Prospective observational study that enrolled 81 patients who underwent EBUS-TBNA for investigation of hilo-mediastinal lesions or lung cancer staging. The first 41 patients underwent EBUS-TBNA with ROSE (ROSE group) and the last 40 patients without ROSE (non-ROSE group). Sample adequacy and diagnostic accuracy of EBUS-TBNA in both groups were compared. Adequate samples were obtained in 93% of the patients in the ROSE group and 80% in non-ROSE group (p=0.10). The diagnostic accuracy of EBUS-TBNA was 91% in ROSE group and 83% in non-ROSE group (p=0.08). Analyzing the EBUS-TBNA purpose, in the subgroup of patients who underwent EBUS-TBNA for investigation of hilo-mediastinal lesions, these differences between ROSE and non-ROSE group were higher compared to lung cancer staging, 93% of patients with adequate samples in the ROSE group vs. 75% in the non-ROSE group (p=0.06) and 87% of diagnostic accuracy in ROSE group vs. 77% in non-ROSE group (p=0.10). Despite the lack of statistical significance, ROSE appears to be particularly useful in the diagnostic work-up of hilo-mediastinal lesions, increasing the diagnostic yield of EBUS-TBNA. Copyright © 2014 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Temporary Piggyback Intraocular Lens Implantation Versus Single Intraocular Lens Implantation in Congenital Cataracts: Long-Term Clinical Outcomes.

PubMed

Hwang, Sungsoon; Lim, Dong Hui; Lee, Soomin; Choi, Daye Diana; Chung, Eui-Sang; Chung, Tae-Young

2018-04-01

To report the long-term results of temporary piggyback IOL implantation in congenital cataract and to compare the clinical outcomes of temporary piggyback IOL with those of single IOL implantation. This is a retrospective, comparative, interventional study. The medical records of all consecutive patients who underwent cataract extraction and single or temporary piggyback IOL implantation within the first 3 years of life from 1999 to 2013 at Samsung Medical Center were reviewed. Twenty-eight eyes from 18 patients underwent single IOL implantation (monopseudophakia group), and 32 eyes of 20 patients underwent temporary piggyback IOL implantation in congenital cataract surgery (polypseudophakia group). The mean age at initial cataract surgery was 15.8 months in the monopseudophakia group and 11.1 months in the polypseudophakia group (P = 0.144). The average follow-up duration was 133 months in the monopseudophakia group and 120 months in the polypseudophakia group (P = 0.391). The best-corrected visual acuity at the last visit was 0.36 logMAR in the monopseudophakia group and 0.55 logMAR in the polypseudophakia group (P = 0.044). Four (14%) and 14 (44%) reoperations for complications within the anterior segment were performed in the monopseudophakia group and polypseudophakia group, respectively (P = 0.042). Four cases (14.3%) in the monopseudophakia group and 13 cases (40.6%) in the polypseudophakia group had a glaucoma-related adverse event (P = 0.086). Compared with primary single IOL implantation in congenital cataract, temporary piggyback IOL implantation produced worse visual acuity, higher reoperation rate, and higher risk of secondary glaucoma. Temporary piggyback IOL implantation does not have benefit in congenital cataract.

Clinical and Radiologic Follow-up Study for Biopsy Diagnosis of Radial Scar/Radial Sclerosing Lesion without Other Atypia.

PubMed

Kalife, Elizabeth Tágide; Lourenco, Ana P; Baird, Grayson L; Wang, Yihong

2016-11-01

To determine the incidence of malignancy for radial scars (RS)/radial sclerosing lesions (RSL) without associated atypia or malignancy identified at needle biopsy. Retrospective review of the pathology data base from January 2004 to July 2013 yielded 100 needle biopsies diagnosed as RS/RSL without associated atypia/malignancy. The RS/RSL was considered "incidental" if the target was calcifications and "targeted" if imaging revealed a mass, architectural distortion, or suspicious magnetic resonance imaging enhancement. The electronic medical record was used to identify surgical pathology, follow-up imaging, and clinical course; all pathology slides and imaging were reviewed by a board-certified pathologist and radiologist, respectively. Patient age, laterality, RS/RSL size, microcalcifications, and associated benign lesions were recorded. Among 100 cases, 54 were "incidental" and 46 were "targeted." In the incidental group, 14 underwent excision, 30 had imaging follow-up, and 10 were lost to follow-up. In the targeted group, 27 underwent excision, 11 had imaging follow-up, and 8 were lost to follow-up. Atypia was identified in four excisions: three from the incidental group and one from the targeted group. Among these, three had negative imaging follow-up (mean 45 months; range 15-60 months); the fourth patient (one of the incidental group) underwent excision alone. One of the 27 "targeted" patients who underwent excision developed ductal carcinoma in situ of the contralateral breast at 96 months. There have been no ipsilateral malignancies. We found no evidence of associated malignancy at excision for either incidental or targeted biopsies of RS/RSL without atypia. Our study suggests that close imaging follow-up is adequate for patients with RS/RSL without associated atypia/malignancy on needle biopsy. © 2016 Wiley Periodicals, Inc.

Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery.

PubMed

Miranda, Matheus; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Hossne, Nelson Americo; Yoshimoto, Michele Costa; Fonseca, José Honorio de Almeida Palma da; Pestana, José Osmar Medina de Abreu; Buffolo, Enio

2016-12-01

Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7; p <0.0001) and increased need for blood components (77.7% vs. 25.6%; p <0.0001) and inotropic support (82.5% vs 35.8%; p <0.0001). In the postoperative course, the group "without ECC" required less vasoactive drugs, (61.5% vs. 82.5%; p = 0.0340) and shorter time of mechanical ventilation (13.0 hours vs. 36,3 hours, p = 0.0217), had higher extubation rates in the operating room (58.9% vs. 23.8%, p = 0.0006), lower infection rates (7.6% vs. 28.5%; p = 0.0120), and shorter ICU stay (5.2 days vs. 8.1 days; p = 0.0054) as compared with the group with ECC surgery. No difference in mortality was found between the groups. Myocardial revascularization with ECC in patients on dialysis resulted in higher morbidity in the perioperative period in comparison with the procedure without ECC, with no difference in mortality though.

Postoperative adjuvant OK-432 sclerotherapy for treatment of cervicofacial lymphatic malformations: an outcomes comparison.

PubMed

Kim, So Young; Lee, Sanghoon; Seo, Jeong-Meen; Lim, So Young

2015-04-01

Surgical treatment of extensive cervicofacial lymphatic malformations is often challenging due to a high rate of postoperative fluid re-accumulation and lesion recurrence resulting from incomplete resection. This study suggests a combined treatment of surgical resection and postoperative adjuvant OK-432 sclerotherapy via closed suction drainage. Using comparative analysis, this study aims to evaluate the efficacy of adjuvant sclerotherapy. A retrospective chart review was performed on patients who underwent surgical resection of cervicofacial lymphatic malformations between January 2009 and July 2013. Patients were divided into two groups based on whether or not adjuvant OK-432 sclerotherapy was administered via closed suction drainage after surgery. Both surgery-related and adjuvant sclerotherapy-related complications were assessed, and treatment effectiveness was measured based on the change in Cologne Disease Score (CDS) or the need for further treatment. A total of 17 patients underwent surgical resection. Nine of these patients underwent surgical resection only, while the other eight underwent surgical resection with adjuvant OK-432 sclerotherapy. The increase in total Cologne Disease Score (CDS) and change of progression parameters were significantly higher for the adjuvant sclerotherapy group compared to the surgery-only group. Additionally, there were no cases of postoperative lymphatic fluid retention among the adjuvant sclerotherapy group. The two groups exhibited similar complication rates with no statistically significant difference. Adjuvant OK-432 sclerotherapy via closed suction drainage is a safe and effective treatment modality. The combination of surgical resection and post-operative adjuvant sclerotherapy via closed suction drainage should be integrated into the treatment algorithm of extensive cervicofacial lymphatic malformation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Clinical assessment of diode laser-assisted endoscopic intrasphenoidal vidian neurectomy in the treatment of refractory rhinitis.

PubMed

Lai, Wen-Sen; Cheng, Sheng-Yao; Lin, Yuan-Yung; Yang, Pei-Lin; Lin, Hung-Che; Cheng, Li-Hsiang; Yang, Jinn-Moon; Lee, Jih-Chin

2017-12-01

For chronic rhinitis that is refractory to medical therapy, surgical intervention such as endoscopic vidian neurectomy (VN) can be used to control the intractable symptoms. Lasers can contribute to minimizing the invasiveness of ENT surgery. The aim of this retrospective study is to compare in patients who underwent diode laser-assisted versus traditional VN in terms of operative time, surgical field, quality of life, and postoperative complications. All patients had refractory rhinitis with a poor treatment response to a 6-month trial of corticosteroid nasal sprays and underwent endoscopic VN between November 2006 and September 2015. They were non-randomly allocated into either a cold instrument group or a diode laser-assisted group. Vidian nerve was excised with a 940-nm continuous wave diode laser through a 600-μm silica optical fiber, utilizing a contact mode with the power set at 5 W. A visual analog scale (VAS) was used to grade the severity of the rhinitis symptoms for quality of life assessment before the surgery and 6 months after. Of the 118 patients enrolled in the study, 75 patients underwent cold instrument VN and 43 patients underwent diode laser-assisted VN. Patients in the laser-assisted group had a significantly lower surgical field score and a lower postoperative bleeding rate than those in the cold instrument group. Changes in the VAS were significant in preoperative and postoperative nasal symptoms in each group. The application of diode lasers for vidian nerve transection showed a better surgical field and a lower incidence of postoperative hemorrhage. Recent advancements in laser application and endoscopic technique has made VN safer and more effective. We recommend this surgical approach as a reliable and effective treatment for patients with refractory rhinitis.

Natrelle Silicone Breast Implant Follow-Up Study: Demographics, Lifestyle, and Surgical Characteristics of More Than 50,000 Augmentation Subjects

PubMed Central

Picha, George J.; Murphy, Diane K.

2016-01-01

Background: A large, multicenter, 10-year observational study is being conducted to compare the long-term safety and effectiveness of Natrelle silicone breast implants with saline implants or national norms. Study baseline data and surgical characteristics are reported here. Methods: Women seeking primary augmentation, revision-augmentation, primary reconstruction, or revision-reconstruction participated. Eligible subjects had completed surgery and received one implant or matching implants. Baseline demographics, health, lifestyle, and surgical characteristics were recorded. Data are presented here for subjects (≥22 years old) who underwent primary augmentation or revision-augmentation. Results: Of 50,979 subjects who underwent augmentation procedures, 35,756 received silicone implants and 15,223 received saline implants. Of these, 86.3 percent underwent primary augmentation, and 13.7 percent underwent revision-augmentation; nearly all subjects (99.3 percent) received bilateral implants. In the primary augmentation group, 67.6 percent of subjects received silicone implants versus 86.1 percent in the revision-augmentation group. Median age was lower in the primary augmentation group compared with the revision-augmentation group (33 versus 42 years old, respectively). Most subjects were white nonsmokers and had attended college. Hispanic subjects and subjects with a body mass index of 25 kg/m2 or greater were more likely to receive saline versus silicone implants. Across groups, the most common characteristics by procedure or implant type included inframammary incision site (54.6 percent), partial (58.2 percent) or complete (31.9 percent) submuscular placement, smooth surface implants (93.1 percent), and implant size of 300 to 399 cc. Incision size was larger for silicone versus saline implants. Conclusion: These data add to the body of knowledge on women undergoing augmentation procedures by providing an unprecedented look at a large number of subjects. PMID:26710009

Ethnic differences in pain perception and patient-controlled analgesia usage for postoperative pain.

PubMed

Tan, Ene-Choo; Lim, Yvonne; Teo, Yik-Ying; Goh, Rachelle; Law, Hai-Yang; Sia, Alex T

2008-09-01

There are reports suggesting that sensitivity to and tolerance of both clinical and experimental pain differ among ethnic groups. We examined self-rated pain score and morphine usage in 1034 women who underwent elective lower cesarian section (LSCS) for their deliveries. Data on pain scores and amount of total morphine use according to patient-controlled analgesia were collected every 4 hours. Overall, lowest pain scores were recorded 12 hours after surgery and highest at 24 hours. Morphine consumption was highest within the first 4 hours and lowest between 12 and 16 hours. There were statistically significant ethnic group differences in pain scores (P = 1.7 x 10(-7)) and morphine usage (P = 2.8 x 10(-15)) between ethnic groups, with Indians having the highest mean pain score and using the highest amount of morphine. The ethnic differences in pain score and morphine self-administration persisted after controlling for age, body mass index, and duration of operation. Our findings of highly significant ethnic group difference in self-reported pain level and the amount of analgesia self-administered may have implications on optimal management of acute postoperative pain. Inadequate management of pain after cesarian deliveries might affect the emotional well-being and physical recovery of patients and affect mother-child bonding.

Prediction of wound healing after minor amputations of the diabetic foot.

PubMed

Caruana, Luana; Formosa, Cynthia; Cassar, Kevin

2015-08-01

To identify any significant differences in physiological test results between healing and non healing amputation sites. A single center prospective non-experimental study design was conducted on fifty subjects living with type 2 diabetes and requiring a forefoot or toe amputation. Subjects underwent non-invasive physiological testing preoperatively. These included assessment of pedal pulses, preoperative arterial spectral waveforms at the ankle, absolute toe pressures, toe-brachial pressure index and ankle-brachial pressure index. After 6 weeks, patients were examined to assess whether the amputation site was completely healed, was healing, had developed complications, or did not heal. There was no significant difference in ABPI between the healed/healing and the non-healing groups. Mean TBI (p=0.031) and toe pressure readings (p=0.014) were significantly higher in the healed/healing group compared to the non healing group. A significant difference was also found in ankle spectral waveforms between the two groups (p=0.028). TBIs, toe pressures and spectral waveforms at the ankle are better predictors of likelihood of healing and non-healing after minor amputation than ABPIs. ABPI alone is a poor indicator of the likelihood of healing of minor amputations and should not be relied on to determine need for revascularization procedures before minor amputation. Copyright © 2015 Elsevier Inc. All rights reserved.

Development and feasibility study of a sensory-enhanced robot-aided motor training in stroke rehabilitation.

PubMed

Liu, W; Mukherjee, M; Tsaur, Y; Kim, S H; Liu, H; Natarajan, P; Agah, A

2009-01-01

Functional impairment of the upper limb is a major challenge faced by many stroke survivors. The present study aimed at developing a novel sensory-enhanced robot-aided motor training program and testing its feasibility in stroke rehabilitation. A specially designed robot handle was developed as an attachment to the Inmotion2 robotic system. This handle provided sensory stimulation through pins connected to small servo motors inside the handle. Vibration of the pins was activated during motor training once pressure on the handle reached a certain threshold indicating an active motion of the study subject. Nine chronic stroke survivors were randomly assigned to either a sensory-enhanced robot-aided motor training group (SERMT) or robot-aided motor training only group (RMT). All participants underwent a 6-week motor training program, performing target reaching movements with the specialized handle with or without vibration stimulation during training. Motor Status (MS) scores were measured for functional outcome prior to and after training. The results showed significant improvement in the total MS scores after training in both experimental groups. However, MS sub-scores for the shoulder/elbow and the wrist/hand increased significantly only in the SERMT group (p<0.05). Future studies are required to confirm these preliminary findings.

Auditory-Perceptual Learning Improves Speech Motor Adaptation in Children

PubMed Central

Shiller, Douglas M.; Rochon, Marie-Lyne

2015-01-01

Auditory feedback plays an important role in children’s speech development by providing the child with information about speech outcomes that is used to learn and fine-tune speech motor plans. The use of auditory feedback in speech motor learning has been extensively studied in adults by examining oral motor responses to manipulations of auditory feedback during speech production. Children are also capable of adapting speech motor patterns to perceived changes in auditory feedback, however it is not known whether their capacity for motor learning is limited by immature auditory-perceptual abilities. Here, the link between speech perceptual ability and the capacity for motor learning was explored in two groups of 5–7-year-old children who underwent a period of auditory perceptual training followed by tests of speech motor adaptation to altered auditory feedback. One group received perceptual training on a speech acoustic property relevant to the motor task while a control group received perceptual training on an irrelevant speech contrast. Learned perceptual improvements led to an enhancement in speech motor adaptation (proportional to the perceptual change) only for the experimental group. The results indicate that children’s ability to perceive relevant speech acoustic properties has a direct influence on their capacity for sensory-based speech motor adaptation. PMID:24842067

EFFICACY OF THE ANTERIOR RESECTION IN MANAGMENT OF ACUTE COLONIC OBSTRUCTION IN PATIENTS WITH RECTAL CANCER.

PubMed

Minasyan, A; Sargsyan, R

2016-10-01

The aim of this study is to improve the results of surgical treatment of acute bowel obstruction caused by rectal cancer and to reduce the period of full recovery of patients. The presented research included 73 patients (study group) with rectal cancer who underwent emergent anterior resection of rectum with loop ileostomy and intra-operative decompression of colon. Patients of this group were compared to a group of 68 patients (control group) with the same diagnosis who underwent Hartmann's procedure. There was no essential difference between the two groups in the quantity of postoperative complications. However the results indicate significant difference in reversal rates and time to reversal. Thus, the technique of low anterior resection with intraoperative decompression and ileostomy that we used improves outcomes, significantly reduces the period of full recovery.

Surgical treatment of pain in patients with chronic pancreatitis.

PubMed

Prochorov, Alexandermiddle Victorovich; Oldhafer, Karl-Jurgen; Tretyak, Stanislaw Ivanovich; Rashchynski, Siarhei Markovich; Donati, Marcello; Rashchynskaya, Nina Timofeevna; Audzevich, Dzmitry Anatolyevich

2012-06-01

The objectives of the research were to compare the outcomes of pancreatoduodenectomy (PD) (Kausch-Whipple or Traverso-Longmire) and resection with drainage operations (RDO) (Frey or Partingtone-Rochelle) in patients suffering from chronic pancreatitis (CP), in management of pain syndrome and quality of life provided by these kinds of surgical procedures. From 2002 to 2008 sixteen patients suffering from CP underwent PD and 16 underwent RDO. Treatment results for the two groups were analyzed with respect to postoperative complications and results of the questionnaire MOS SF-36 v.2(TM). In the immediate postoperative period more complications were observed in the PD group (a<0.05). In both groups a positive effect on removing the painful syndrome and improvement of the quality of life (p<0.01) were observed. In the PD group there were the best results of management by General Health difference criterion (a<0.01). A greater improvement of Physical Functiong value (a<0.01) was noticed in patients who underwent RDO. Both PD and RDO adequately remove pain syndrome and improve the quality of life in patients suffering from CP. Under equal conditions the preference should be given to RDO, as improvement in life quality of operated patients is greater.

Surgical treatment outcomes of patients with bilateral warthin tumors in the parotid gland.

PubMed

Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Lim, Sang Chul

2014-01-01

We describe the treatment outcomes of patients with bilateral Warthin tumors in the parotid gland according to surgical methods. The medical records of ten patients with bilateral Warthin tumors in the parotid gland who underwent surgery between 2004 and 2011 were retrospectively reviewed. Ten patients were included in the study and 13 parotidectomies were performed. Patients with bilateral Warthin tumors in the parotid gland were divided into three groups according to the surgical methods used to treat these individuals. In group 1, the patients were closely observed without undergoing contralateral parotidectomy after unilateral parotidectomy. In group 2, the patients underwent concurrent bilateral parotidectomies. In group 3, the patient underwent contralateral parotidectomy 2 months after unilateral parotidectomy was performed. The overall rate of transient facial nerve dysfunction was 31%. Our findings suggest that concurrent superficial parotidectomy may be an appropriate method for treating bilateral Warthin tumors in the parotid gland, at least for desired patients. The symptoms of this type of tumor and physical examination findings are frequently non-specific and present in the unilateral parotid gland. Therefore, a high degree of discernment is needed and imaging techniques are essential for the determining the correct pre-operative diagnosis.

Hysteroscopic tubal electrocoagulation versus laparoscopic tubal ligation for patients with hydrosalpinges undergoing in vitro fertilization.

PubMed

El-Mazny, Akmal; Abou-Salem, Nermeen; Hammam, Mohamed; Saber, Walid

2015-09-01

To investigate the use and success rate of hysteroscopic tubal electrocoagulation for the treatment of hydrosalpinx-related infertility among patients undergoing in vitro fertilization (IVF) who have laparoscopic contraindications. A prospective study was conducted among patients who had unilateral or bilateral hydrosalpinges identified on hysterosalpingography and vaginal ultrasonography, and who were undergoing IVF at a center in Cairo, Egypt, between January 1, 2013, and October 30, 2014. All patients who had contraindications for laparoscopy were scheduled for hysteroscopic tubal electrocoagulation (group 1); the other patients underwent laparoscopic tubal ligation (group 2). For all patients, hysterosalpingography was performed 3 months after their procedure to evaluate proximal tubal occlusion. Among 85 enrolled patients, 22 underwent hysteroscopic tubal electrocoagulation and 63 underwent laparoscopic tubal ligation. The procedure was successful in terms of tubal occlusion for 25 (93%) of 27 hydrosalpinges in group 1, and 78 (96%) of 81 hydrosalpinges in group 2 (P=0.597). No intraoperative or postoperative complications were reported. Hysteroscopic tubal electrocoagulation was found to be a successful treatment for hydrosalpinges before IVF when laparoscopy is contraindicated. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.