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71.
ObjectiveOur aim was to evaluate the histopathological effects of tissue adhesives on peripheral nerve regeneration after experimental sciatic nerve transection in rats and to search whether these tissue adhesives may possess a therapeutic potential in peripheral nerve injuries.MethodsThis experimental study was performed using 42 female Wistar-Albino rats distributed in 6 groups subsequent to transection of right sciatic nerves. Group I underwent external circumferential neurolysis; Group II received suture repair; Group III had local polymeric hydrogel based tissue adhesive administration; Group IV received suture repair and polymeric hydrogel based tissue adhesive application together; Group V had gelatin based tissue adhesive application and Group VI had suture repair and gelatin based tissue adhesive together. After a 6-week follow-up period, biopsies were obtained from site of neural injury and groups were compared with respect to histopathological scoring based on inflammatory, degenerative, necrotic and fibrotic changes.ResultsThere were remarkable differences between control group and study groups with respect to inflammation (p=0.001), degeneration (p=0.002), necrosis (p=0.007), fibrosis (p<0.001) and vascularity (p=0.001). Histopathological scores were similar between study groups and the only noteworthy difference was that Group V displayed a lower score for necrosis and higher score in terms of vascularization.ConclusionOur results imply that tissue adhesives can be useful in repair of peripheral nerve injuries by decreasing the surgical trauma and shortening the duration of intervention. Results with gelatin based tissue adhesive are especially promising since more intense vascularity was observed in tissue after application. However, trials on larger series with longer durations of follow-up are essential for reaching more reliable conclusions. 相似文献
72.
73.
Camli Adil Teoman Ayd?n ?zgür Ta?p?nar Huriye K?z?ltan Ali Hikmet Eri? Ilknur Turk Hocaoglu Sevde Po?ul Muge Kepekci Ebru Denizli Mustafa Güler 《Journal of Physical Therapy Science》2015,27(1):179-182
[Purpose] Diabetes mellitus is a metabolic disorder resulting from a defect in insulin
secretion, insulin action, or both. A consequence of this is chronic hyperglycemia with
disturbances in carbohydrate, fat and protein metabolism. We investigated whether there is
any difference among DM patients and a control group in terms of lumbar and femur BMD
(bone mineral density), and standard deviation scores (Z score and T score). [Subjects and
Methods] This randomized, prospective, controlled, single-blind study was conducted in the
Physical Medicine and Rehabilitation Department Faculty of Medicine, Bezm-i Alem Vakıf
University. Patients with type 2 diabetes mellitus were included in the patient groups.
Healthy individuals were included in the control group. [Results] A total of 126 patients
completed the study (63 in the study group, 63 in the control group). There was no
significant difference in the results of the laboratory examinations of the cases. The
bone mineral densities of the cases were found to be significantly low in terms of the
lumbar (L1–4) T scores in the type 2 diabetes group. [Conclusion] Although osteoporosis is
one of the potential complications of type 1 diabetes, its effect on bone mineral density
in type 2 DM is controversial. In different studies, the bone mineral density values have
increased, decreased or remained normal. With the exception of the lumbar (L1–4) T score,
similar results were obtained in this study.Key words: Type 2 diabetes mellitus, Osteoporosis, Bone mineral density 相似文献
74.
?zlem ??nar ?zdem?r Yesim Bakar Nuriye ?zeng?n Bülent Duran 《Journal of Physical Therapy Science》2015,27(7):2133-2137
[Purpose] The purpose of this study was to analyze the pelvic floor muscle (PFM) activity
after vaginal birth, and the effect of parity on PFM strength and quality of life (QoL) in
women with urinary incontinence. [Subjects and Methods] Patients (n=241) who gave birth
vaginally and experienced urinary incontinence were divided into three groups: group 1
consisted of women having 1–3 children, group 2 consisted of women having 4–6 children,
and group 3 consisted of women having more than 6 children. All patients underwent
detailed examination of the PFM. The Turkish version of the self-administered Incontinence
Quality of Life Instrument (I-QoL) questionnaire was used to evaluate the effects of
stress urinary incontinence on participants’ QoL. [Results] Comparison of PFM strengths
showed a significant intergroup difference. Group 1 showed significantly higher PFM
strength scores than those of groups 2 and 3. I-QoL scores related to stress incontinence
showed a significant intergroup difference. As number of deliveries increased, quality of
life decreased. Comparison of PFM strengths and I-QoL scores related to stress
incontinence showed a significant intergroup difference. [Conclusion] Increasing the
awareness of PFM training in women will reduce potential postpartum incontinence due to a
weak PFM strength; and will increase quality of life.Key words: Parity, Pelvic floor muscle strength, Urinary incontinence 相似文献
75.
P?nar Doruk Analan Berrin Leblebici Mehmet Adam 《Journal of Physical Therapy Science》2015,27(10):3113-3117
[Purpose] The aim of this prospective, double-blind, randomized, placebo-controlled study
was to evaluate the effects of therapeutic continuous ultrasound (US) on patients with
rotator cuff disease. [Subjects and Methods] Twenty-two patients were treated with a
standard physiotherapy program consisting of a hot-pack, transcutaneous electrical nerve
stimulation (TENS), exercises, and US that was supervised by the same physiotherapist. The
patients were randomly assigned to either a group that received true US (n=11) or one that
received sham US (n=11). [Results] There were significant differences between the pre- and
post-intervention UCLA Shoulder Rating Scale and Constant-Murley Shoulder Outcome scores,
VAS, and external rotation (ER) peak torque 60°/second values for both the true and sham
US groups. However, the between-group differences were not statistically significant.
[Conclusion] In patients with rotator cuff disease, physiotherapy interventions
effectively treat the pain, improve the clinical status, and increase the muscle strength
of the shoulder ER at a low constant angular velocity, with functional improvement being
seen immediately after treatment. However, at the end of the intervention, the US had
yielded no additional efficacy to the physiotherapy treatment regimen of the patients with
rotator cuff disease.Key words: Rotator cuff disease, Therapeutic ultrasound, Shoulder rehabilitation 相似文献
76.
77.
Background
In terms of ethical decision making, every clinical case, when seen as an ethical problem, may be analyzed by means of four topics: medical indications, patient preferences, quality of life, contextual features. The aim of this study was to compare the performance of 4th year dental students on Ethical Decision Making before and after a course on ethics.Methods
Fourth year dental students (n?=?37) from academic year 2013–2014 participated in the study. A 3-h lecture, which was about four topics approach to clinical ethical case analysis, was given to the students. The lecture was based on case scenarios related with dental ethics. After the completion of lectures,a case scenario was presented to the students to assess their ethical decision making abilities. At the end of the exam, four topics and ethical judgment were evaluated. Their performances on this examination were evaluated before and after lectures. Statistical evaluation was performed with the significance level set at p?<?0.05.Results
A statistically significant difference was found between the means of four topics (p?<?0.05). There was no statistically significant difference between the mean scores of judgment of ethical decision (p?>?0.05). The mean total score of the students after the course was significantly higher than before course (67.5 and 54.4, respectively; p?<?0.05).Conclusion
More lectures should be implemented to the curriculum to increase the student awareness of ethical issues and to reach the ultimate goals of dental education.78.
David Zemanek Pavol Tomasov Milo? Bělehrad Katarína Hladká Jana Ko??álová Tomá? Kára Josef Veselka 《Archives of Medical Science》2015,11(4):751-755
Introduction
A left ventricular outflow tract (LVOT) obstruction assessment with a provoking test should be a routine part of the evaluation of patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to compare the utility of the Valsalva maneuver (VM) and sublingual spray application of isosorbide dinitrate (ISDN) for detection of an obstruction.Material and methods
We prospectively evaluated 81 consecutive HCM patients without severe rest LVOT obstruction (defined as peak rest pressure gradient (PG) ≥ 50 mm Hg). We measured PG at rest, during the VM, after sublingual ISDN spray, and during the VM after ISDN. An obstruction was defined as a PG ≥ 30 mm Hg.Results
An obstruction was present in 15 patients (19%) at rest (median and interquartile range of PG 16 (7–26) mm Hg), in 38 patients (47%) during the VM (PG 28 (12–49) mm Hg), in 50 (62%) patients after ISDN (PG 50 (12–79) mm Hg), and in 55 patients (68%) during the VM after ISDN (PG 59 (20–87) mm Hg). The difference in occurrence of obstruction among different provoking tests was statistically significant for all comparisons (p < 0.001, except for the comparison of the ISDN test with the VM during ISDN, p = 0.025).Conclusions
The ISDN test and the VM are useful screening methods for the detection of an HCM obstruction. Although ISDN appears to be more precise than the VM, the best option is a combination of both methods, which maximizes inducement of LVOT obstruction in patients with HCM. 相似文献79.
Gabriella Freitas Ferreira Julliana Ribeiro Alves Santos Marliete Carvalho da Costa Rodrigo Assun??o de Holanda ?ngelo Márcio Leite Denadai Gustavo José Cota de Freitas áquila Rodrigues Costa Santos Priscila Batista Tavares Tatiane Alves Paix?o Daniel Assis Santos 《Antimicrobial agents and chemotherapy》2015,59(8):4600-4609
Cryptococcus gattii is the main etiological agent of cryptococcosis in immunocompetent individuals. The triazole drug itraconazole is one of the antifungals used to treat patients with cryptococcosis. Heteroresistance is an adaptive mechanism to counteract the stress of increasing drug concentrations, and it can enhance the ability of a microorganism to survive under antifungal pressure. In this study, we evaluated the ability of 11 C. gattii strains to develop itraconazole heteroresistance. Heteroresistant clones were analyzed for drug susceptibility, alterations in cell diameter, capsule properties, and virulence in a murine model. Heteroresistance to itraconazole was intrinsic in all of the strains analyzed, reduced both the capsule size and the cell diameter, induced molecular heterogeneity at the chromosomal level, changed the negatively charged cells, reduced ergosterol content, and improved the antioxidant system. A positive correlation between surface/volume ratio of original cells and the level of heteroresistance to itraconazole (LHI) was observed in addition to a negative correlation between capsule size of heteroresistant clones and LHI. Moreover, heteroresistance to itraconazole increased the engulfment of C. gattii by macrophages and augmented fungal proliferation inside these cells, which probably accounted for the reduced survival of the mice infected with the heteroresistant clones and the higher fungal burden in lungs and brain. Our results indicate that heteroresistance to itraconazole is intrinsic and increases the virulence of C. gattii. This phenomenon may represent an additional mechanism that contributes to relapses of cryptococcosis in patients during itraconazole therapy. 相似文献
80.
P?nar Kocaay Zeynep ??klar Emine ?amtosun Tan?l Kendirli Merih Berbero?lu 《Journal of clinical research in pediatric endocrinology》2014,6(4):254-257
A very rare syndrome of rapid-onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) has been recently described as causing morbidity due to hypothalamic dysfunction and respiratory arrest. Its prognosis is poor and often cardiac arrest occurs due to alveolar hypoventilation. This disorder can mimic genetic obesity syndromes and several endocrine disorders. We present a 13-year-old female patient who was reported to be healthy until the age of 3 years. She was admitted to our emergency department, presenting with respiratory distress. Features matching ROHHAD syndrome such as rapid-onset obesity, alveolar hypoventilation, central hypothyroidism, hyperprolactinemia, Raynaud phenomenon and hypothalamic hypernatremia were detected in the patient. In addition to these features, the patient was found to have hypergonadotropic hypogonadism and megaloblastic anemia. Because of its high mortality and morbidity, the possibility of ROHHAD syndrome needs to be considered in all pediatric cases of early- and rapid-onset obesity associated with hypothalamic-pituitary endocrine dysfunction. 相似文献