Effectiveness of Blended Instruction on Pain and Requirement for Analgesic after Knee Arthroplasty Surgery

Background and aims: Most patients undergoing knee replacement surgery have pain and limited range of motion during recovery and rehabilitation and due to pain and lack of experience and knowledge are not able to run an effective rehabilitation program. So, this study was aimed to determine the effect of blended instruction on the intensity and the admission palliative of patients undergoing knee surgery. Methods: 64 patients scheduled for knee replacement surgery randomized block Foursome assigned to two experimental and control groups. The training program including film screenings and providing face to face training, manual and training video in the individual manner was implemented days before the surgery for the experimental group. The control group received routine care. Data by demographic and clinical form and pain assessment checklist were collected using a visual analogue scale. Numerical data about the pain from the second to fifth days and one month after surgery were collected and analyzed useing the SPSS software and Independent t-test, Chi-square and Repeated measure tests. Results: The results of this study showed that the experimental group reported significantly less pain than the control group at most times (P=0.012). According to independent t-test statistically significant difference between the 2 groups in terms of the amount of admission palliative at the time was found (P>0.054). However, based on analysis of variance with repeated measures between the admission palliative on study, there was a significant difference in both groups (P<0.001). Conclusion: According to our results, the combined intervention before surgery can reduce the level of pain experienced after surgery and as a training method used to teach these patients after surgery

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Spontaneous slow oscillation-associated slow wave activity represents an internally generated state which is characterized by alternations of network quiescence and stereotypical episodes of neuronal activity - slow wave events. However, it remains unclear which macroscopic signal is related to these active periods of the slow wave rhythm. We used optic fiber-based calcium recordings of local neural populations in cortex and thalamus to detect neurophysiologically defined slow calcium waves in isoflurane anesthetized rats. The individual slow wave events were used for an event-related analysis of simultaneously acquired whole-brain BOLD fMRI. We identified BOLD responses directly related to onsets of slow calcium waves, revealing a cortex-wide BOLD correlate: the entire cortex was engaged in this specific type of slow wave activity. These findings demonstrate a direct relation of defined neurophysiological events to a specific BOLD activity pattern and were confirmed for ongoing slow wave activity by independent component and seed-based analyses

Detection sensitivity of lymph nodes of various sizes using USPIO nanoparticles in magnetic resonance imaging

Ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles-based magnetic resonance imaging (MRI) have offered new promise for early detection of lymph nodes and their metastases. These nanoparticles are taken up by macrophages in normal lymph nodes and produce signal changes based on susceptibility artifact and dipolar relaxation. The effects of MR protocols and their parameters on artifact size and detection sensitivity have been studied before. In this study USPIO nanoparticles were used as MRI contrast agent, and their detection sensitivity in axillary lymph nodes was evaluated using earlier defined pulse sequences. The minimum amount (dose) of USPIO nanoparticles that delineates lymph nodes of various sizes using susceptibility-based gradient echo pulse sequences was also determined. It was found that a dose administration of as low as 0.028 mg iron (Fe)/kg for subcutaneous injection and 0.16 mg Fe/kg for intravenous injection can be used to visualize axillary lymph nodes when a sensitive MR protocol is employed. From the Clinical Editor: Ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles are taken up by macrophages and have been shown to be promising negative contrast agents in the early detection of metastases in lymph nodes. In this study, their detection sensitivity in axillary lymph nodes was evaluated using previously defined MRI pulse sequences. The minimum dose of USPIO to delineate lymph nodes using gradient echo-based optimized pulse sequences was 0.028 mgFe/kg for subcutaneous and 0.16 mgFe/kg for intravenous injection. © 2010 Elsevier Inc. All rights reserved