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Methods: Three study groups were included in the study: prolonged follow up TF group (at least 1-year post-treatment) (PF-TF), patients with acute TF and a control group. The first group was recruited retrospectively and included all patients who were diagnosed with TF in one orthopedic clinic and were contacted by phone, 109 agreed to participate. The acute TF and healthy controls participated in a previous controlled study. The Quick Disabilities of the Arm Shoulder and Hand (QuickDASH) and numeric pain scale (NPS) were the main outcome measures.
Results: Both TF groups reported significantly higher levels of disability, particularly in activities requiring strength and more severe pain in comparison with the control group. The acute TF group reported significantly higher levels of disability and pain than the PF-TF group. Seventy-two percent of acute TF group reported moderate to severe pain, in comparison with 37% of the PF-TF group.
Conclusion: According to these data, substantial long-term disability and pain persist in both the acute and chronic settings.
- Implications for rehabilitation
Recovery from TF may be a prolonged process and a long term follow up should be considered in clinical practice.
The present study found that TF leads to significant disability, therefore, activity and participation should be addressed in practice.
Assessment of TF interventions should include outcomes that address the client's perspective using standardized measures of disability, such as the QuickDASH.
Background
Diabetes and other obesity-related diseases are a worldwide pandemic that transcends geographic borders as well as socioeconomic levels. Currently, it is well known that medical treatment alone is insufficient to ensure adequate and sustainable weight loss and co-morbidity resolution. It has been well proven that bariatric surgery can produce almost immediate resolution of diabetes and other co-morbidities as well as long-term weight loss.Objectives
Here, we present our experience with the one anastomosis gastric bypass (OAGB) in terms of weight loss and diabetes resolution with 1 year of follow-up.Setting
Large, metropolitan, tertiary, university hospital.Methods
A retrospective analysis of all patients who underwent OAGB between March 2015 and March 2016 was performed. Patient demographic characteristics, co-morbidities, operative and postoperative data, as well as first year outcomes were collected and analyzed.Results
There were 407 patients who underwent OAGB (254 females, average age 41.8 ± 12.05 yr, body mass index = 41.7 ± 5.77 kg/m2). Of patients, 102 (25.1%) had diabetes with average glycosylated hemoglobin of 8.64 ± 1.94 g%, 93 (22.8%) had hypertension, 123 (28.8%) had hyperlipidemia, and 35 patients (8.6%) had obstructive sleep apnea. The average length of hospital stay was 2.2 ± .84 days (range, 2–10 d). The average excess weight loss 1 year after surgery was 88.9 ± 27.3. After 1 year, follow-up data were available for more than 85% of the study’s general population. Of 102 diabetic patients, only 8 (7.8%) were still considered diabetic and taking antidiabetic medication, with an average glycosylated hemoglobin of 5.4 ± 0.6.Conclusions
OAGB may be performed safely and with promising efficacy as both a primary and a revisional bariatric surgery, and it offers excellent resolution of diabetes. 相似文献Background and Purpose
Neurodegenerative diseases are now recognized to be multifunctional, whereby a heterogeneous set of reactions acts independently or cooperatively, leading eventually to the demise of neurons. This has led our group to design and synthesize the multifunctional, nontoxic, brain-permeable, iron chelator compound M30 with a range of pharmacological properties. Here, we have characterized the molecular targets of M30 in the brains of animal models of type 2 diabetes mellitus (T2DM).Experimental Approach
Effects of M30 on molecular mechanisms associated with neuroprotection in the CNS were investigated-in the high-fat diet (HFD) and ob/ob transgenic mouse models of T2DM, using real-time PCR and Western blotting analyses. Brain monoamine oxidase (MAO) activity and catecholamine levels, and peripheral glucose tolerance were assayed after treatment in vivo.Key Results
M30 increased cerebral levels of insulin and insulin receptor and phosphorylated-GSK-3β in HFD mice, compared with vehicle-treated HFD mice. In both T2DM mice models, M30 treatment significantly up-regulated cerebral hypoxia-inducible factor (HIF)-1α protein levels and induced the expression of several HIF-1 target genes involved in neuroprotection, glycolysis, neurogenesis, oxidative stress and anti-inflammation. Additionally, M30 inhibited MAO-A and -B activities in the cerebellum. Accordingly, M30 administration significantly reduced brain levels of dopamine metabolites and increased levels of 5-HT and noradrenaline. Glucose tolerance was also improved after M30 treatment in both models of T2DM.Conclusions and Implications
In the brain of HFD and ob/ob transgenic mice, M30 exerted a variety of beneficial neuroprotective regulatory effects that may act synergistically to delay or prevent neurodegenerative processes associated with T2DM.Tables of LinksTARGETS | LIGANDS |
---|---|
GLUT-1, glucose transporter 1 | 5-HT |
GSK-3β, glycogen synthase kinase 3β | Deprenyl (selegiline) |
HO-1, haem oxygenase | Dopamine |
InsR, insulin receptor | Noradrenaline |
Insulin | Rasagiline |
MAO-A, monoamine oxidase A | |
MAO-B, monoamine oxidase B |