Digital evaluation of the muscle functions of the lower extremities among inguinal hernia patients treated using three different surgical techniques: a prospective randomized study

Purpose  

An inguinal hernia is a common pathology that can be treated using several different surgical procedures. Although there have been many studies comparing the clinical results of these techniques, there has so far been no digital analysis of the alterations developing secondary to pain with regard to the muscle functions of the lower extremities. This prospective randomized trial was designed to compare this aspect for subjects treated using the laparoscopic techniques and those treated using the conventional method.     

Limberg Flap Versus Bascom Cleft Lift Techniques for Sacrococcygeal Pilonidal Sinus: Prospective, Randomized Trial

Background

Although various methods have been described for surgical treatment of pilonidal sinus disease, which is best is under debate. Tension-free techniques seem to be most ideal. We aimed to evaluate the effects of two tension-free methods in terms of patient satisfaction, postoperative complications, and early recurrence.

Methods

A group of 122 patients were prospectively included in the study. Patients were divided into two groups based on the operative method used: Limberg flap or Bascom cleft lift. Quality of life scores, pain scores, length of time for healing, hospital stay, surgical area-related complications, excised tissue weight, and early recurrence information were evaluated.

Results

Follow-up of patients in each group was completed. Patients in the Bascom cleft lift group had shorter operation duration, less excised tissue weight, better bodily pain score, and less role limitation due to physical problems score on postoperative day 10. There was no statistically significant difference between groups for the other criteria.

Conclusions

Although both techniques provided good results during the early period, the Bascom cleft lift procedure is a reliable technique that provides shorter operation duration and better quality of life during the early postoperative period.     

Exenatide upregulates gene expression of glucagon‐like peptide‐1 receptor and nerve growth factor in streptozotocin/nicotinamide‐induced diabetic mice

Glucagon‐like peptide‐1 (GLP‐1) is an incretin hormone that has modulating effects on insulin release. GLP‐1 and receptors for GLP‐1 are widely expressed throughout the body including the brain. The expression of GLP‐1 receptors is very specific to large neurons in hippocampus, neocortex, and cerebellum. GLP‐1 receptor stimulation enhances glucose‐dependent insulin secretion and lowers blood glucose in type 2 diabetes mellitus. Studies on adipobiology of neurotrophins have focused on nerve growth factor (NGF) as an example of adipose‐derived neurotrophins. Compromised trophic factor signaling may underlie neurodegenerative diseases ranging from Alzheimer's disease to diabetic neuropathies. Exenatide, a potent and selective agonist for the GLP‐1 receptor, is currently approved for the treatment of type 2 diabetes mellitus. The aim of this study was to assess the effect of chronic exenatide treatment on the hippocampal gene expression levels of GLP‐1 receptor and NGF in diabetic mice. The effects of chronic exenatide treatment (0.1 μg/kg, s.c., twice daily for 2 weeks) on GLP‐1 receptor and NGF gene expression levels in the hippocampus of streptozotocin/nicotinamide (STZ–NA)‐induced diabetic mice were assessed by quantitative real‐time polymerase chain reaction (RT‐PCR). The results of this study revealed that hippocampal gene expression of GLP‐1 receptor and NGF were downregulated in diabetic mice. Importantly, a significant increase in the gene expression level of GLP‐1 receptor and NGF was determined after 2 weeks of exenatide administration. Increased gene expression level of GLP‐1 receptor and NGF may underlie the beneficial action of exenatide in STZ/NA‐induced diabetes.     

Mini-open versus all-arthroscopic rotator cuff repair: Comparison of the operative costs and the clinical outcomes

Introduction Rotator cuff injury is one of the most frequently encountered problems of the shoulder in the daily practice of orthopaedic surgeons. This study compared all-arthroscopic cuff repair (ARCR) and mini-open rotator cuff repair (MORCR) methods in regard to clinical outcomes and costs. Methods Fifty patient charts and operative repairs were analysed (25 ARCR and 25 MORCR). Pre-and postoperative Constant-Murley and UCLA scores along with factors such as tear size, tear type, pre-operative physical therapy, motion and satisfaction levels were compared for the two procedures. Cost-benefit analysis was also performed for comparison between procedures. The duration of follow-up was 31.20 and 21.56 months for MORCR and ARCR groups, respectively. Results Tear sizes (P=0.68), pre-and postoperative Constant-Murley and UCLA scores (P=0.254) and satisfaction levels were not significantly different between groups. However, the differences between pre-and postoperative Constant-Murley and UCLA scores were statistically significant within both groups (P<0.01). The MORCR group stayed 1 day longer in hospital than the ARCR group, which was statistically significant (P=0.036). The differences regarding mean pain scores, abductions, internal and external rotations in Constant-Murley scores and forward flexion scores in UCLA scores were not significant. The ARCR group cost more, leaving less profit. Conclusion Results suggest that ARCR yields similar clinical results but at a higher cost compared with MORCR.     

Effects of chronic administration of adipokinetic and hypertrehalosemic hormone on animal behavior,BDNF, and CREB expression in the hippocampus and neurogenesis in mice

Neurosecretory cells in corpus cardiacum of insects synthesize a set of hormones that are called adipokinetic, hypertrehalosaemic or hyperprolinaemic, depending on insect in question. This study investigated effects of chronic administration of Anax imperator adipokinetic hormone (Ani‐AKH), Libellula auripennis adipokinetic hormone (Lia‐AKH), and Phormia‐Terra hypertrehalosaemic hormone (Pht‐HrTH) on depression, anxiety, analgesy, locomotion in forced swimming (FST), elevated plus‐maze (EPM), hot plate, and locomotor activity tests. Ani‐AKH (1 and 2 mg/kg), Lia‐AKH (1 and 2 mg/kg), and Pht‐HrTH (1 and 2 mg/kg) had antidepressant effects in forced swimming test. Lia‐AKH (2 mg/kg) and Pht‐HrTH (1 and 2 mg/kg) had anxiolytic effects when given chronically in elevated plus‐maze test. Ani‐AKH (1 and 2 mg/kg) and Pht‐HrTH (2 mg/kg) had antinociceptive effects in hot plate test in male balb‐c mice. Ani‐AKH (2 mg/kg), Lia‐AKH (1 and 2 mg/kg), and Pht‐HrTH had locomotion‐enhancing effects in locomotor activity test in male balb‐c mice. Drug treatment significantly increased brain‐derived neurotrophic factor (BDNF) and cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) gene expression levels compared to control levels. Pht‐HrTH and Ani‐AKH groups had significantly increased numbers of BrdU‐labeled cells, while neurodegeneration was lower in the Pht‐HrTH group. Our study showed that AKH/RPCH family peptides may be used in treatment of psychiatric illness such as depression and anxiety, in treatment of pain and in diseases related to locomotion system. AKH/RPCH family peptides increase neurotrophic factors in brain and have potential proliferative and neuroprotective effects in hippocampal neurogenesis and neurodegeneration.