A Randomized, Controlled Clinical Study to Assess the Effect of Anodal and Cathodal Electrical Stimulation on Periwound Skin Blood Flow and Pressure Ulcer Size Reduction in Persons with Neurological Injuries

The use of electrical stimulation (ES) should be considered for treating nonhealing pressure ulcers (PUs), but optimal ES wound treatment protocols have yet to be established. A randomized, controlled, double-blind clinical study was conducted to evaluate the effects of cathodal and anodal high-voltage monophasic pulsed current (HVMPC) on periwound skin blood flow (PSBF) and size reduction of Stage 2 to Stage 4 PUs of at least 4 weeks’ duration.Persons \u3e18 years of age, hospitalized with neurological injuries, at high risk for PU development (Norton scale \u3c14 \u3epoints; Waterlow scale \u3e15 points), and with at least 1 Stage 2 to Stage 4 PU were eligible to participate in the study. Persons with necrotic wounds, osteomyelitis, electronic or metal implants in the PU area, PUs in need of surgical intervention, acute wound inflammation, diabetes (HBA1c \u3e7%), diabetic neuropathy, cancer, and/or allergies to standard wound treatments were excluded. Patients were randomly assigned to 1 of 3 groups: anodal (AG), cathodal (CG), or placebo (PG) ES. All groups received individualized PU prevention and standard wound care. In the PG, sham ES was applied; the AG and CG were treated with anodal and cathodal HVMPC, respectively (154 μs 100 Hz; 360 µC/second; 1.08 C/day), 50 minutes per day, 5 days per week, for a maximum of 8 weeks. PSBF was measured using laser Doppler flowmetry at baseline, week 2, and week 4, and wound surface area measurements were obtained and analyzed using a digitizer connected to a personal computer. Data analysis utilized the maximum-likelihood chi-squared test, the analysis of variance Kruskal-Wallis test, the Kruskal-Wallis post-hoc test, and Spearman’s rank order correlation. Nonlinear approximation based on exponential function was used to calculate treatment time needed to reduce the wound area by 50%. In all tests, the level of significance was set at P ≤.05. Of the 61 participating patients, 20 were in the AG (mean age 53.2 ± 13.82 years), 21 in the CG (mean age 55.67 ± 17.83 years), and 20 in the PG (mean age 52.5 ± 13.18 years). PUs (baseline size range 1.01 cm2 to 59.57 cm2; duration 4 to 48 weeks) were most frequently located in the sacral region (73.77%) and classified as Stage 3 (62.29%). PSBF at week 2 was significantly higher in the AG and CG than in the PG (P P = .0391 and P = .0024, respectively). In both ES groups, PSBF at week 4 and percent wound surface area reductions between weeks 4 and 8 were positively correlated, but only the AG correlation was statistically significant (P = .049). In this study, both ES modalities improved blood flow and wound area reduction rate. Studies examining optimal ES treatment times for healing to occur, the effect of comorbidities and baseline wound variables on ES outcomes, and the nature of the relationship between blood flow and healing are necessary

Knee Joint Position Sense in Physically Active Patients after ACL Reconstruction

The term “proprioception” is defined as the conduction of sensory information deriving from proprioceptors that have an impact on conscious sensations, posture and trans-segmental sense. An ACL injury may lead to functional knee joint instability. According to research, this may result in impaired movement sensation and joint position. The purpose of this study was to evaluate the joint position sense (JPS) in patients before arthroscopic ACL reconstruction and 5 months after the surgery. The examinations were conducted in a group of twelve specifically selected male patients. The examination procedure consisted of JPS measurement in both lower limbs (the operated and the healthy one) during active extension in a range of angles: 30, 45, 60°. The level of significance was: p < 0.05. The analysis of variance performed for repeated measurements (ANOVA) did not indicate any statistically significant differences of JPS in comparisons made between the operated and the healthy limb. Statistical values for the absolute, relative, and variable errors were p = 0.7684, p = 0.1546, p = 0.5694 respectively. The obtained results do not indicate any limitation of proprioception in patients with ACL injury before the intervention or half a year later

Focused ion beam-based microfabrication of boron-doped diamond single-crystal tip cantilevers for electrical and mechanical scanning probe microscopy

In this paper, the fabrication process and electromechanical properties of novel atomic force microscopy probes utilising single-crystal boron-doped diamond are presented. The developed probes integrate scanning tips made of chemical vapour deposition-grown, freestanding diamond foil. The fabrication procedure was performed using nanomanipulation techniques combined with scanning electron microscopy and focused ion beam technologies. The mechanical properties of the cantilever were monitored by the measurement of thermally induced vibration of the cantilever after every fabrication step, allowing the mass changes in range of ng to be estimated. The endurance of the developed probes was tested during hundreds of topography measurements, which corresponds to a scanning length equal to 13.6 m, performed on a test sample in contact and lateral force microscopy modes. Analysis of the roughness parameters confirmed the extremely high wear resistance of the fabricated probes. The linear current voltage response on a highly-oriented pyrolytic graphite sample was recorded

Bioresorbable Stent in Anterior Cruciate Ligament Reconstruction

The exact causes of failure of anterior cruciate ligament (ACL) reconstruction are still unknown. A key to successful ACL reconstruction is the prevention of bone tunnel enlargement (BTE). In this study, a new strategy to improve the outcome of ACL reconstruction was analyzed using a bioresorbable polylactide (PLA) stent as a catalyst for the healing process. The study included 24 sheep with 12 months of age. The animals were randomized to the PLA group (n = 16) and control group (n = 8), subjected to the ACL reconstruction with and without the implantation of the PLA tube, respectively. The sheep were sacrificed 6 or 12 weeks post-procedure, and their knee joints were evaluated by X-ray microcomputed tomography with a 50 m resolution. While the analysis of tibial and femoral tunnel diameters and volumes demonstrated the presence of BTE in both groups, the enlargement was less evident in the PLA group. Also, the microstructural parameters of the bone adjacent to the tunnels tended to be better in the PLA group. This suggested that the implantation of a bioresorbable PLA tube might facilitate osteointegration of the tendon graft after the ACL reconstruction. The beneficial e ects of the stent were likely associated with osteogenic and osteoconductive properties of polylactide

Effects of Polylactide Copolymer Implants and Platelet-Rich Plasma on Bone Regeneration within a Large Calvarial Defect in Sheep

The aim of this study was to verify whether L-lactide/DL-lactide copolymer 80/20 (PLDLLA) and platelet-rich plasma (PRP) trigger bone formation within critical-sized calvarial defects in adult sheep ( = 6). Two craniectomies, each ca. 3 cm in diameter, were created in each animal. The first craniectomy was protected with an inner polylactide membrane, filled with PRP-polylactide granules, and covered with outer polylactide membrane. The second control craniectomy was left untreated. The animals were euthanized at 6, 7, 17, 19, 33, and 34 weeks after surgery, and the quality and the rate of reossification were assessed histomorphometrically and microtomographically.The study demonstrated that application of implantsmade of PLDLLA 80/20 combined with an osteopromotive substance (e.g., PRP) may promote bone healing in large calvarial defect in sheep. These promising proof-of-concept studies need to be verified in the future on a larger cohort of animals and over a longer period of time in order to draw definitive conclusions

Stress fractures in uncommon location : six case reports and review of the literature

BACKGROUND: Individuals’ interest in sports activities has been increasing, contributing to more stress fracture occurrences in uncommon locations on the skeleton. In this study, several cases of stress fractures in atypical locations are presented, and the possibility of combining diagnostic methods to make accurate and quick diagnoses is explored. Additionally, different causes of stress fractures, as well as various modalities of treatment, are highlighted. Other potential factors of stress fractures were identified by a literature review.CASE SUMMARY: Six cases of stress fractures in the calcaneus, intermediate cuneiform bone, sacrum, tibia (bilateral), navicular bone and femoral neck are presented, with different types of diagnostic imaging and treatments. All of the cases were associated with an aspect of mobility because all of the patients were physically active in various sport disciplines.CONCLUSION:The type of therapeutic procedure selected should depend on the specific clinical case, i.e., the patient’s condition and level of physical activity

Integration of fluorescent, NV-rich nanodiamond particles with AFM cantilevers by focused ion beam for hybrid optical and micromechanical devices

In this paper, a novel fabrication technology of atomic force microscopy (AFM) probes integrating cantilever tips with an NV-rich diamond particle is presented. Nanomanipulation techniques combined with the focused electron beam-induced deposition (FEBID) procedure were applied to position the NV-rich diamond particle on an AFM cantilever tip. Ultrasonic treatment of nanodiamond suspension was applied to reduce the size of diamond particles for proper geometry and symmetry. The fabricated AFM probes were tested utilizing measurements of the electrical resistance at highly oriented pyrolytic graphite (HOPG) and compared with a standard AFM cantilever performance. The results showed novel perspectives arising from combining the functionalities of a scanning AFM with optically detected magnetic resonance (ODMR). In particular, it offers enhanced magnetometric sensitivity and the nanometric resolution

Associations between the dopamine D4 receptor gene polymorphisms and personality traits in elite athletes

Personality traits and temperament may affect sports performance. Previous studies suggest that dopamine may play an important role in behavior regulation and physical exercise performance. The aim of this study is to determine associations between dopamine D4 receptor gene (DRD4 Ex3) polymorphisms and personality traits (such as neuroticism, extraversion, openness, agreeability and conscientiousness) in elite combat athletes. A total of 302 physically active, unrelated, self-reported Caucasian participants were recruited for this study. The participants consisted of 200 elite male combat athletes and 102 healthy male participants (control group). For personality trait measurements, the NEO Five-Factor Personality Inventory (NEO-FFI) and the State-Trait Anxiety Inventory questionnaires were used. For the genetic assays, blood was collected and all samples were genotyped using the real-time PCR method. A 2 x 3 factorial ANOVA revealed statistically significant differences on the Openness NEO Five Factor Inventory scale for both examined factors, i.e. sport status and genetics DTD4 Ex3. Combat athletes achieved higher scores on the Conscientiousness NEO-FFI scale when compared to controls (7.18 vs 5.98). On the other hand, combat athletes scored lower on the Openness scale in comparison with control group (4.42 vs. 4.63). Subjects with the DRD4 Ex3 s/s genotype had lower results on the openness scale in comparison with participants with the DRD4 Ex3 s/1 genotype (4.01 vs. 4.57) and higher DRD4 Ex3 1/1 genotype (4,01 vs. 3,50). In conclusion, we found an association between the dopamine D4 receptor gene in variable number tandem repeat (VNTR) polymorphisms and athletic status for two NEO-FFI factors: Openness and Conscientiousness. The DRD4 exon 3 polymorphism may be associated with the selected personality traits in combat athletes, thereby modulating athletes’ predisposition to participate in high risk sports

Caloric Restriction Diet (CR diet) or Mediterranean Diet (MD) - Which is the Best Choice for Former Athletes?

Overweight or obesity which often develop in athletes who end their careers is one of the most important issues of the world of sport. During aging, an increase in the amount of intra-abdominal fat is observed; this fat increases the risk of such metabolic disease as diabetes or hypertension. The participants of the study were 94 males. The people were randomly assigned to one of 2 groups: group 1 – people using the diet based on calorie restriction CRON (n = 32), and group 2 – those who followed the recommendations of the Mediterranean diet (n = 34). The patients who at the check-up declared not following any diet were assigned to the control group (n = 28). A change in parameters was observed in each of the sub-groups after the intervention. The most significant changes were observed in the sub-group which lost >2.6 kg. Both the diet based on mild calorie restriction and the Mediterranean diet had positive effect on the change of the former athlete’s body parameters after the 6-week long dietary intervention. Both diets which were being tested changed the body composition of the athletes who ended their careers in a similar way