Epidermal growth factor (EGF) promotes bone healing in surgically induced osteonecrosis of the femoral head (ONFH)

Angiogenic effects of epidermal growth factor (EGF), a potent mitogen, have been demonstrated previously. Moreover, different in vitro studies showed that EGF affects processes associated with bone healing, such as osteoblast differentiation and bone resorption. The aim of this study was to investigate the effect of combined core decompression (CD) and recombinant human EGF (rhEGF) treatment on early-stage osteonecrosis of the femoral head (ONFH) surgically induced in rats. ONFH was induced by dissecting the cervical periosteum and placing a ligature tightly around the femoral neck. Thirty rats were assigned to one of the following groups (n = 10 each group): sham-operated control, CD, and CD+rhEGF group. rhEGF was injected intraosseously into infarcted areas 2 weeks after the surgery. Preservation of femoral head architecture was assessed at 8 weeks post treatment by radiographic and histomorphological analyses. Osteopontin (OPN) and cluster of differentiation 31 (CD31) were detected by immunochemistry, as indicators of bone remodeling and vascular density, respectively. Inter- and intra-group (non-operated left and operated right femur) differences in radiographic and histomorphological results were analyzed. The femoral head area and sphericity were more preserved in CD+rhEGF compared to CD and sham-control group. CD31 levels were significantly different between the three groups, and were higher in CD+rhEGF compared to CD group. OPN levels were increased in CD and CD+rhEGF groups compared to sham control, but with no significant difference between CD and CD+rhEGF groups. Overall, our results indicate that EGF promotes bone formation and microvascularization in ONFH and thus positively affects the preservation of femoral head during healing

Ultrasonography-Guided Injection for Quadriceps Fat Pad Edema: Preliminary Report of a Six-Month Clinical and Radiological Follow-Up

Purpose: To investigate efficacy and safety of ultrasonography-guided local corticosteroid and anesthetic injection followed by physical therapy for the management of quadriceps fat pad (QFP) edema. Materials and Methods: We prospectively evaluated 1671 knee MRI examinations in 1542 patients for QFP edema with mass effect, which was present in 109 (6.5%) knees. Participants were assigned into injection and therapy groups (both received the same physical therapy program). Injection group was first treated with ultrasonography-guided QFP injection of 1 mL corticosteroid and 1 mL local anesthetic agent. Patients were evaluated at baseline and 1-, 2-, 6-month follow-up for pain using static and dynamic visual analogue scale (VAS), suprapatellar tenderness, and QFP edema on MRI. Results: Final sample size consisted of 19 knees (injection group, 10; therapy group, 9) in 17 patients. An overall improvement was detected in both groups between baseline and final assessments. The injection group fared better than the therapy group in static VAS scores (3.33 ± 1.70 versus 0.56 ± 1.33), while there was no such difference for dynamic VAS. Incidence of suprapatellar tenderness decreased in both groups, statistically significantly in the injection group (from 100% to 0%). Pain reduction was greater in the injection group at the first month (88.9% – 90% good response versus 50% – 66.7% good response, static-dynamic VAS scoring, respectively), whereas there was no such superiority at the sixth month. No severe adverse events were identified. Conclusion: Ultrasonography-guided local injection followed by physical therapy is safe in the management of QFP edema; however, it is not superior to stand-alone physical therapy program in the long term

The effect of an exercise program in conjunction with short-period patellar taping on pain, electromyogram activity, and muscle strength in patellofemoral pain syndrome

Background: McConnell recommended that patellar tape be kept on all day, until patients learn how to activate their vastus medialis obliquus (VMO) during an exercise program. This application may pose problems because prolonged taping may be inadvisable for some patients or even contraindicated owing to skin discomfort, irritation, or allergic reaction. Hypothesis: Wearing patellofemoral tape for a shorter duration during an exercise program would be just as beneficial as a prolonged taping application. Study Design: Prospective cohort. Methods: Twelve patients and 16 healthy people participated. Patients underwent short-period patellar taping plus an exercise program for 3 months. Numeric pain rating, muscle strength of the knee extensors, and electromyogram activity of the vastus lateralis and VMO were evaluated. Results: There were significant differences in electromyogram activity (P=.04) and knee extensor muscle strength (P=.03) between involved and uninvolved sides before treatment. After treatment, pain scores decreased, and there were no significant differences between involved and uninvolved sides in electromyogram activity (P=.68) and knee extensor strength (P=.62). Before treatment, mean VMO activation started significantly later than that of vastus lateralis, as compared with the matched healthy control group (P=.01). After treatment, these differences were nonsignificant (P=.08). Conclusion: Short-period patellar taping plus an exercise program improves VMO and vastus lateralis activation. Clinical Relevance: A shorter period of taping for the exercise program may be as beneficial as a prolonged taping application. © 2009 The Author(s)

Teaching the Academic Word List in Foreign Language Speaking Classes

WOS: 00043485270039

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Is Attention Deficit Hyperactivity Disorder a Risk for Kohlers Disease? Osteonecrosis of Navicular Bone of Foot

Osteonecrosis, also referred to as avascular necrosis, refers to the death of cells within bone caused by a lack of circulation. It has been documented in bones throughout the body. In the foot, osteonecrosis is most commonly seen in the talus, the first and second metatarsals, and the navicular. Although uncommon, osteonecrosis has been documented in almost every bone of the foot and therefore should be considered in the differential diagnosis when evaluating both adult and pediatric foot pain. Kohler's disease is a rare, self-limiting, avascular necrosis of the navicular bone, first described in 1908. It is usually unilateral and most often affects boys. Its usual onset is between 4 to 5 years of age but can present as early as 2 years of age. Girls with this condition are often younger than boys, probably owing to earlier onset of ossification. In this case report we present the diagnosis and therapy of Kohlers Disease of a 5-year-old boy who had Attention Deficit Hyperactivity Disorder. Our goal is elucidate the etiology of these cases and their relationship with behavioral disorders. Our goal is elucidate the etiology of these cases and their relationship with behavioral disorders. [Med-Science 2015; 4(3.000): 2516-20

The Outcomes Of Anterior Cruciate Ligament Reconstructed And Rehabilitated Knees Versus Healthy Knees: A Functional Comparison

Objective: In this study, we aimed to evaluate and compare the functional performance and muscle strength of cases of ACL reconstruction using bone-patellar tendon-bone graft followed by rehabilitation with those of healthy subjects. Methods: This study included fifteen patients (range: 20 to 35 years) who underwent ACL reconstruction 18 to 24 months previously and a control group of 15 healthy volunteers with similar characteristics. Cases were evaluated with physical examinations, functional tests, subjective scales (Lysholm, Hospital for Special Surgery Knee Score (HSSS), and Tegner activity scale) and isokinetic test. Differences between the reconstruction group and control group were analyzed. Results: Significant differences were found in the activity level of the reconstruction group (p<0.05) and in the clinical findings of the subjects with involved and uninvolved legs (p<0.05). When the reconstructed and control groups were compared according to the limb symmetry index, there were significant differences in single-leg hop test, timed hop test, shuttle run and stair hop test (p<0.05). The study also revealed a significant correlation between the vertical hop and quadriceps strength in the isokinetic test (r=0.56). When the operated knees were compared to the healthy side, mean limb symmetry index was over 92% (with two cases at 88%). When the dominant leg was compared to the non-dominant leg in the control group, the mean limb symmetry index was over 95%. Conclusion: Functional outcomes similar to those of healthy legs can be achieved following ACL reconstruction with bone-patellar tendon-bone grafting and rehabilitation. The similar functional test results of the operated and healthy subjects prove the effectiveness of the rehabilitation program.WoSScopu

Hospital-Based Versus Home-Based Proprioceptive And Strengthening Exercise Programs In Knee Osteoarthritis

Objectives: This study aimed to establish the effects of hospital- and home-based proprioceptive and strengthening exercise programs on proprioception, pain, and functional status in patients with knee osteoarthritis (OA). Methods: Sixty patients with bilateral knee OA were randomly allocated into either a home-based or hospital-based exercise program. Hospital-based exercise group (n=30, mean age 50.23 +/- 9.07 years) received functional training program with proprioceptive ability, ice, and home exercises. Home-based exercise group (n=30, mean age 54.4 +/- 7.9 years) had a program of ice and home exercises. Treatment programs was conducted 5 days per week for 6 weeks (30 sessions). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Monitorized Functional Squat System-Proprioceptive Test (MFSS), timed performance test (TUG), and visual analogue scale (VAS) for the intensity of pain were used to quantify the variables. Results: Both groups demonstrated significant improvement when pre- and post-treatment results were compared for pain intensity, WOMAC, and TUG test scores (p0.05). Hospital-based group demonstrated significantly greater improvement in MFSS, TUG test, and VAS in activity when compared with the home-based group (p<0.05). Conclusion: Both hospital- and home-based exercise programs decreased joint symptoms and improved function in patients with knee OA.WoSScopu

The Effects of Additional Kinesio Taping Over Exercise in the Treatment of Patellofemoral Pain Syndrome

Objective: The purpose of this prospective, randomized, controlled study was to determine the effects of kinesio taping in the treatment of patients with patellofemoral pain syndrome (PFPS). Methods: Thirty-one women with PFPS (mean age: 44.88 years; range: 17 to 50 years) were randomly assigned to either a kinesio taping (KT) (n=15) or control (n=16) group. Both groups received the same muscle strengthening and soft tissue stretching exercises for six weeks and the KT group additionally received kinesio taping at four day intervals for six weeks. Visual analog scale was used to measure pain intensity. Tension of the iliotibial band/tensor fascia lata and hamstring muscles and the mediolateral location of the patella were measured before the treatment and at the end of the third and sixth week. The Anterior Knee Pain Scale / Kujala Scale was used for the analysis of functional performance. Results: Comparing pretreatment and 6th week values, significant improvements were found in pain, soft tissue flexibility and functional performance of both groups (p0.05). The KT group had significantly better hamstring flexibility than the control group at the end of three weeks (p<0.05). Conclusion: The addition of kinesio taping to the conventional exercise program does not improve the results in patients with PFPS, other than a faster improvement in hamstring muscle flexibility

An experience in the COVID-19 pandemic period: Turkish Cardiovascular Surgery Online Board Exam 2020

Background: The aim of this study was to provide information about the results of the Turkish Cardiovascular Surgery Board written exam, which was held online due to the pandemic. Methods: This cross-sectional study included a total of 41 cardiovascular surgeons and residents (39 males, 2 females) in November 21st, 2020 between 10:00 A.M. and 12:00 P.M. After the online exam was completed, data on participant information and answers to exam questions were obtained from the information system. Results: Of all participants, 39% were working in university hospitals. A total of 82.9% of the participants were specialists. The total mean score of the participants was 60.3 +/- 10.2 and 53.7% of them were declared successful-passed. Aortic surgery (63%), heart failure surgery (50%), and mitral valve surgery (50%) were the most incorrectly answered questions. Conclusion: With the online exam, the Board gained different experiences regarding exam planning and implementation. The Turkish Cardiovascular Surgery Board did not give up the Board exam during the pandemic period and conducted a reliable written exam with many participants