Effects of tibolone on blood flow resistance and intima-media thickness of the carotid arteries: effect of time since menopause.

OBJECTIVE: The aim of this prospective study was to evaluate the effects of tibolone on carotid atherosclerosis in healthy postmenopausal women. METHODS: Twenty-five healthy postmenopausal women were included in the study. Patients received tibolone 2.5 mg daily for 6 months. Resistance indices of the common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA) and vertebral arteries, and intima-media thickness of the CCA were measured both at baseline and at the end of the study with ultrasonography. RESULTS: No significant differences were observed in the resistance indices of the CCA, ICA, ECA and vertebral arteries, as well as intima-media thickness of CCA at 6 months in comparison with baseline. Tibolone significantly improved the intima-media thickness of the CCA of women who were less than 18 months since menopause. CONCLUSION: Overall, these results demonstrate no significant effects of tibolone on either intima-media thickness or blood flow resistance in the carotid arteries in postmenopausal women. However, the results suggest that tibolone may have a positive effect on the vascular system if commenced within 18 months since menopause; this warrants further investigation.     

Pulsed magnetic field therapy for osteoarthritis of the knee--a double-blind sham-controlled trial

BACKGROUND AND METHODS: Pulsed magnetic field therapy is frequently used to treat the symptoms of osteoarthritis, although its efficacy has not been proven. We conducted a randomized, double-blind comparison of pulsed magnetic field and sham therapy in patients with symptomatic osteoarthritis of the knee. Patients were assigned to receive 84 sessions, each with a duration of 30 minutes, of either pulsed magnetic field or sham treatment. Patients administered the treatment on their own at home, twice a day for six weeks. RESULTS: According to a sample size estimation, 36 consecutive patients were enrolled. 34 patients completed the study, two of whom had to be excluded from the statistical analysis, as they had not applied the PMF sufficiently. Thus, 15 verum and 17 sham-treated patients were enrolled in the statistical analysis. After six weeks of treatment the WOMAC Osteoarthritis Index was reduced in the pulsed magnetic field-group from 84.1 (+/- 45.1) to 49.7 (+/- 31.6), and from 73.7 (+/- 43.3) to 66.9 (+/- 52.9) in the sham-treated group (p = 0.03). The following secondary parameters improved in the pulsed magnetic field group more than they did in the sham group: gait speed at fast walking [+6.0 meters per minute (1.6 to 10.4) vs. -3.2 (-8.5 to 2.2)], stride length at fast walking [+6.9 cm (0.2 to 13.7) vs. -2.9 (-8.8 to 2.9)], and acceleration time in the isokinetic dynamometry strength tests [-7.0% (-15.2 to 1.3) vs. 10.1% (-0.3 to 20.6)]. CONCLUSION: In patients with symptomatic osteoarthritis of the knee, PMF treatment can reduce impairment in activities of daily life and improve knee function.     

Clinical and ultrasonographical findings in patients with multiseptate gallbladder

Multiseptate gallbladder is one of the rare congenital malformations of the gallbladder. We present clinical and ultrasonographic findings in seven patients with multiseptate gallbladder. One of them had nausea and right upper quadrant pain, three had recurrent abdominal pain, while the remaining three patients had no symptoms, physical finding and laboratory abnormality which could be attributable to the biliary system. In patients with multiseptate gallbladder, disturbed motility of the gallbladder may be an etiopathogenetic factor for stasis of bile flow and in turn for development of cholelithiasis, cholecystitis and right upper quadrant pain.     

Multiseptate gallbladder with acute acalculous cholecystitis

Multiseptate gallbladder is a rare congenital malformation of the gallbladder. In some cases, right upper quadrant pain, recurrent abdominal pain, and gallstones were present. We present the sonographic findings in a case of multiseptate gallbladder with acute cholecystitis, which (to our knowledge) has not been reported before. We hypothesize that bile sludge accumulated and subsequent cholecystitis developed as a result of bile stasis in our case because the classic predisposing factors that have been described were absent.     

Subcutaneous effusion resulting from an epidural catheter fragment

The breakage of an epidural catheter within a patient is uncommon,but troublesome, complication of epidural block, and its causeis rarely discovered. In this case report, our aim was to presentan effusion between s.c. tissue and fascia in the lumbar regionbecause of a broken fragment of epidural catheter which wasunnoticed during its removal.     

The Biomechanical and Histological Effects of Diabetes on Tendon Healing: Experimental Study in Rats

The aim of this study was to investigate the biomechanical and histological perspectives of healing of Achilles tendon in diabetic rats and compare the results with non-diabetic subjects. Fifty four adult Wistar Albino rats weighing 300–350 g were used throughout the study. Six animals were excluded from the study and replaced. Rats were randomly assigned to either the experimental or the control group comprised of 24 rats in each. Diabetes was induced in experimental group with streptozotocin. 3 days after the induction of diabetes, both Achilles tendons were transected 5 mm proximal to their insertions to the calcaneal bone and repaired by using 6/0 polypropylene sutures with modified Kessler method. At weeks 2, 4 and 6, eight rats from each group were euthanized. Left Achilles tendons including the repair site were prepared for histological evaluation and right legs were prepared for mechanical testing. When compared to control group, diabetic animals displayed a lower peak force for failure in each of the second, fourth and sixth week. The differences between the groups in each week were found to be significant in statistical assessments (p < 0.05). Histologic assessment revealed that the diabetic animals had significantly less amount of fibroblast proliferation and lymphocyte infiltration compared to the control group. There is significant delay in tendon strength at the end of week 2, 4 and 6 postoperatively in the diabetic rats. Therefore diabetic individuals require specific postoperative follow up and rehabilitation procedures.