The comparison between the results of treatment of patients after ACL reconstruction using double-folded semitendinosus and gracilis tendons and quadruple-folded semitendinosus tendon

Introduction. Injuries of knee are considered as a significant clinical issue according to difficulties in diagnostics, therapy and rehabilitation of patients. One of the most common pathologies are injuries of anterior cruciate ligament (ACL), which represent  around 90% of all damages. There are four basic mechanisms of ACL injury, but the most common are sudden hyperextension and internal rotation of the lower leg outside the physiological range of movements. Breaking of ACL in young and active people is undisputable indication for surgery – failure to do so leads to further damages of menisci and to osteoarthritis.Purpose of research. The aim of this study was to compare the long-term outcomes of ACL reconstruction with the use of the technique of double-folded tendons of semitendinosus and gracilis musles and quadruple-folded tendon of semitendinosus muscle.Materials and methods. A retrospective study consisted of two stages. The results of the post-reconstructive knee rehabilitation opinion survey and postoperative records were analyzed. The study examined 46 patients aged 19-59 years, hospitalized in the Department of Orthopedics and Traumatology SPSK4 in Lublin.Results. In order to better visualize the results, the patients were divided into four groups, depending on the KOOS score. Statistically significant, in favor of double-folded tendons of semitendinosus and gracilis muscles, were patient’s assessments of the condition in two categories: presence and severity of pain and specific symptoms. The statistically insignificant result was obtained for the parameters: the possibility of active sports, the effects on daily activities and the general quality of life.Conclusions. The relationship between the technique used and the patient experiencing pain and specific symptoms was found. Patients undergoing surgery using double-folded semitendinosus and gracilis muscles experienced lesser symptoms

Psoriatic arthritis – classification, diagnostic and clinical aspects

From 5% to 40% patients with psoriatic skin lesions develop psoriatic arthritis, but 15% to 30% of patients with psoriasis suffer from undiagnosed psoriatic arthritis. The key role in development o-f psoriasis is played by T-lymphocytes and release of proinflammatory cytokines, interferon and adhesive proteins. Infection may exert an influence on psoriasis vulgaris and psoriatic arthritis development. The presence of antibodies against the antigens of Yersinia spp., Campylobacter spp. and Chlamydia trachomatis was more frequently observed in the serum of patients with psoriatic arthritis. Diagnosis of psoriatic arthritis may be based on CASPAR criteria. Diagnostic imaging (CT, MRI, USG) are routine diagnostic procedures in psoriatic arthritis. Several sub-types of psoriatic arthritis have been identified. Questionnaires to identify early stages of the disease have been constructed. Genetic factors, cigarette smoking, alcohol abuse, infections, stress and environmental factors may affect clinical course and results of treatment of psoriasis vulgaris and psoriatic arthritis. In severe cases, the disease may lead to disability

Measurements of Energetic States Resulting from Ion Exchanges in the Isomorphic Crystals of Apatites and Bioapatites

Developments in the field of nanostructures open new ways for designing and manufacturing innovative materials. Here, we focused on new original ways of calculating energy changes during the substitution of foreign ions into the structure of apatites and bioapatites. Using these tools, the energetic costs of ion exchanges were calculated for the exemplary cases known from the literature. It was established that the most costly were ion exchanges of some cations inside apatites and of anions, and the least costly exchanges in tetrad channel positions. Real energy expenses for bioapatites are much smaller in comparison to mineral apatites due to the limited involvement of magnesium and carbonates in the structure of hard tissues. They are of the order of several electron volts per ion. The rigorous dependences of the energy changes and crystallographic cell volumes on the ionic radii of introduced cations were proved. The differentiation of the positioning of foreign ions in locations of Ca(I) and Ca(II) could be calculated in the case of a Ca-Pb reaction in hydroxyapatite. The energetic effects of tooth aging were indicated. The ability of energy change calculation during the ion exchange for isomorphic substances widens the advantages resulting from X-ray diffraction measurements

Hierarchy of Bioapatites

Apatites are one of the most intensively studied materials for possible biomedical applications. New perspectives of possible application of apatites correspond with the development of nanomaterials and nanocompounds. Here, an effort to systematize different kinds of human bioapatites forming bones, dentin, and enamel was undertaken. The precursors of bioapatites and hydroxyapatite were also considered. The rigorous consideration of compositions and stoichiometry of bioapatites allowed us to establish an order in their mutual sequence. The chemical reactions describing potential transformations of biomaterials from octacalcium phosphate into hydroxyapatite via all intermediate stages were postulated. Regardless of whether the reactions occur in reality, all apatite biomaterials behave as if they participate in them. To conserve the charge, additional free charges were introduced, with an assumed meaning to be joined with the defects. The distribution of defects was coupled with the values of crystallographic parameters “a” and “c”. The energetic balances of bioapatite transformations were calculated. The apatite biomaterials are surprisingly regular structures with non-integer stoichiometric coefficients. The results presented here will be helpful for the further design and development of nanomaterials

Metabolic syndrome is associated with similar long-term prognosis in non-obese and obese patients. An analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 cohort studies

Aims We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. Methods The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006 and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III) and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS and obese patients with MetS. Differences in all-cause mortality was analyzed using Kaplan-Meier and Cox regression analyses. Results 45,615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14,202 (31%) by NCEP/ATP III criteria, and 17,216 (37.7%) by JIS criteria. Follow-up was available for 44,620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese (hazard ratio, HR: 1.88 [95% CI, 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively) and non-obese individuals (HR: 2.11 [95% CI 1.85-2.40] and 1.7 [95% CI, 1.56-1.85] according to NCEP/ATP III and JIS criteria respectively). Obese patients without MetS had a higher mortality risk than non-obese patients without MetS (HR: 1.16 [95% CI 1.10-1.23] and HR: 1.22 [95%CI 1.15-1.30], respectively in subgroups with NCEP/ATP III and JIS criteria applied). Conclusions MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised