Diagnosis, pathophysiology and surgical treatment of duodenogastric reflux in peptic ulcer

Results of the examination of 142 patients with ulcer disease were studied. The incidence of DGR was found to be 48% in gastric ulcer and 44% in duodenal ulcer. The unfavorable influence on the gastric mucosa was greater under conditions of the acidic intragastric medium. Special attention to causes of DGR in the surgical treatment of the ulcer disease and the use of areflux anastomoses can improve results of the surgical treatment of such patients.     

The impact of exercise on physical function,cardiovascular outcomes and quality of life in chronic kidney disease patients: a systematic review

The prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) is increasing steadily. CKD does not only relate to morbidity and mortality but also has impact on quality of life, depression and malnutrition. Such patients often have significantly decreased physical activity. Recent evidence suggests that low physical activity is associated with morbidity, mortality, muscle atrophy, quality of life impairment, cardiovascular outcomes and depression. Based on this, it is now recommended to regularly improve the physical activity of these patients. Furthermore, studies have shown the beneficial effects of various exercise programs with respect to outcomes such as low physical activity muscle atrophy, quality of life, cardiovascular outcomes and depression. Despite these encouraging findings, the subject is still under debate, with various aspects still unknown. In this review, we tried to critically summarize the existing studies, to explore mechanisms and describe future perspectives regarding physical activity in CKD/ESRD patients.     

The effect on neuromuscular stability,performance, multi-joint coordination and proprioception of barefoot,taping or preventative bracing

ObjectiveThe objective of this study was to assess the effects of taping and preventive bracing on functional balance, jumping performance, multi-joint coordination and proprioception on comparison to barefoot and each other.DesignControlled trial as an experiment with the independent variable testing in 3 trials: control (barefooted), preventive bracing, and taping.SettingThe sports physiotherapy research laboratory.ParticipantsTwenty physically active male university students aged between 20 and 28 who had been free from lower extremity pathology for 12 months and had no previous history of ankle sprain served as participants.Main outcome measuresSingle leg balance (s), jumping performance (cm), coordination and proprioception assessments by the Functional Squat System. The software automatically calculated the absolute average error (cm) and the standard deviation (SD) of the average error. Average errors were independently quantified as a function of the action mode (concentric versus eccentric) and of the lower limb (dominant versus non-dominant).ResultsThere was no significant difference among the groups for balance tests (p > 0.05). For vertical jump performance of bilateral and the dominant leg there were significant differences that the barefoot group had better results compared to the other groups (p = 0.059; 0.017). According to the coordination results of Functional Squat System participants were better in brace and tape situations since the deviations were less for all concentric and eccentric positions. Deviation results for the proprioception test were different for first visual and non-visual deviations for dominant leg (p < 0.05).ConclusionIn conclusion, bracing and taping may play an important role in preventing injury or rehabilitation of the injured ankle by improving concentric and eccentric coordination, proprioception with the ability of reproducing motion in closed kinetic chain while decreasing vertical jump performance. No superiority of brace over tape or vice versa was found in this study.     

Surgical treatment of postinfarction pseudoaneurysms of the left ventricle

BACKGROUND: Left ventricular pseudoaneurysm is a rare and frequently fatal complication of acute myocardial infarction. It occurs as a consequence of rupture of the ventricular free wall that gets confined by a portion of the pericardium. The purpose of this study was to present our surgical experience of postinfarction left ventricular pseudoaneurysms and to evaluate mid-term results. METHODS: The study population comprised five symptomatic patients diagnosed with left ventricular pseudoaneurysm and treated surgically in a short period of time. There were three males and two females. The mean age of the patients was 66.8 +/- 10.8 years. The diagnosis was made initially by echocardiography and subsequently confirmed by angiography. An additional cardiac magnetic resonance imaging study was performed in three patients. Surgical resection of the pseudoaneurysm was combined with an endoaneurysmorrhaphy procedure in all patients. Associated cardiac operations were performed in three patients. Definitive diagnosis of pseudoaneurysm was confirmed by histopathological evaluation of the excised wall in all patients. RESULTS: All patients survived the operation and were discharged to home care. The mean duration of hospital stay was 11.6 +/- 4.6 days. Patients were either in class I or II of New York Heart Association classification at discharge. All patients are still being followed after surgery with a mean follow-up period of 10.4 +/- 6.6 months with no further problems. CONCLUSION: Surgical repair is indicated in left ventricular pseudoaneurysm as it carries a high risk of rupture and sudden cardiac death. Surgical repair combined with an endoaneurysmorrhaphy procedure carries a low mortality risk and improves functional capacity.