7 research outputs found

    Õlavarre kakspealihase distaalse kõõluse kroonilise rebendi rekonstruktsioon m. semitendinosus’e autotransplantaadiga

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    Õlavarre kakspealihase distaalse kõõluse rebendid on haruldased vigastused. Vigastus tekib olukorras, kus kõõlusele rakendub ootamatu suur füüsiline jõud. Kõõluse täielik rebend tekib enamikul juhtudel kõõluse ja luu piiril ning haarab kõõluse kinnituskohta kogu ulatuses, osalisi kõõluse rebendeid esineb väga harva. Rebendiga kaasnevad kaebused on valu küünarliigese eespinnal ja küünarliigese fleksioonijõu vähenemine. Kõõluse rebendi diagnoosimise ja ravi hilinemisel võib kujuneda välja krooniline kõõluse rebend. Krooniliste täielike rebendite korral ei ole kõõluse anatoomiline taastamine kinnituskohale enamasti võimalik. Õlavarre biitsepsi funktsiooni ja käe jõu taastamiseksning valu lahendamiseks tehakse erinevate kõõluste auto- või allotransplantaatidega biitsepsi distaalse kõõluse rekonstruktsioon. Postoperatiivses faasis järgneb pikaajaline rehabilitatsiooniprogramm. Tartu Ülikooli Kliinikumi sporditraumatoloogia keskuses on 10 aasta jooksul tehtud kolm õlavarre biitsepsi distaalse kõõluse kroonilise rebendi rekonstruktsiooni m. semitendinosus’e kõõluse autotransplantaadiga. Kõigil patsientidel on taastunud käe funktsioon ja fleksioonijõud rahuldavale tasemele

    Põlveliigese funktsionaalne võimekus ja subjektiivne seisund 20 aastat pärast eesmise ristatisideme rekonstruktsiooni põlvekerdakõõluse autotransplantaadiga endistel tippsportlastel

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    Eesmise ristatisideme (ERS) vigastust peetakse üheks põlveliigese sidemete enam levinud vigastuseks. ERSi rekonstruktsiooni järgseid kaugtulemusi on patsientide subjektiivse hinnangu ning objektiivsete näitajate põhjal Eestis vähe uuritud. Töö eesmärk oli hinnata retrospektiivselt subjektiivseid ja objektiivseid kaugtulemusi 20 aastat pärast ERSi taastamist. Uuriti 15 meessoost patsienti, kellel taastati ERS, kasutades põlvekedra kõõluse autosiirikut. Kaugtulemustes esines kõikides KOOSi alakategooriates opereeritud ja terve jala võrdluses statistiliselt oluline erinevus, neist suurim elukvaliteedi alakategoorias (p ≤ 0,005). Sääre sirutajalihaste (reie nelipealihase) isokineetilise jõumomendi näitajates esines statistiliselt oluline erinevus opereeritud ja opereerimata jala võrdluses nurkkiirusel 60°/s (p ≤ 0,008) ja nurkkiirusel 180°/s (p ≤ 0,005). Sääre painutajalihaste (nn hamstring-lihaste) jõumomendi näitajate tulemustes statistiliselt olulised erinevused puudusid. 20 aastat pärast ERSi taastamist on opereeritud jalal reie nelipealihase jõunäitajad väiksemad ning kaebusi on rohkem võrreldes opereerimata jalaga. &nbsp

    Viljelusviisi ja väetamise mõju vihmaussidele

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    Earthworms are the easiest detectable species to evaluate soil conditions on arable land. The aim of current study was to investigate conventional and organic farming practices, including different fertilization schemes effect on earthworms’ abundance, biomass and species diversity. Data were collected in autumn of 2012 from a 5-year crop rotation experiment (pea, potato, barley undersown with red clover, red clover and winter wheat), established near Tartu, at Eerika on sandy loam Albic Stagnic Luvisol in 2008. This rotation was managed under 5 farming systems, two conventional: Conventional I (not fertilized but with addition of chemical pesticides) and Conventional II (mineral fertilized plots with a final fertilization rate of N150P25K95 and with the addition of chemical pesticides); and three organic: Organic 0 (without any fertilization), Organic I (with winter cover crops used lately as green manure) and Organic II (plots with the same cover crops plus a yearly amendment of 40 t ha–1 of cattle manure). Earthworms were collected from humus layer of the soil, counted by species and weighted. The dominating species on all treatments were Aporrectodea caliginosa L. and Lumbricus rubellus L. Only some individuals of Aporrectodea rosea L. were found under conventional farming in both fertilization treatment, but they were found almost on every plot under Organic I and II treatments. As it was expected, the highest number and biomass of earthworms was by using cattle manure. However, as the residues goes back into the soil in this experiment, there was no significant differences in earthworm abundance and biomass between highly fertilized conventional treatment and organic treatments with cover crops. Earthworms favoured red clover and pea and less potato and barley. The results revealed slightly improving effect of organic farming on earthworms. However, the main factor on earthworms seems to be the availability of suitable food (plant residues, manure) than farming practice itself

    Põlveliigese eesmise ristatisideme taastamise operatsioon – mitte alati õnnestumine

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    Põlveliigese eesmise ristatisideme (ERS) rebendite esinemissagedus on eri andmetel 37–61 juhtu 100 000 inimese kohta aastas. Eestis esineb see vigastus 300–400 isikul aastas ja järjest sagedamini rakendatakse sel korral operatiivset ravi. Sõltumata rakendatud operatiivse ravi meetodist on eri autorid hinnanud ERSi vigastuse operatiivse ravi tulemusi edukaks 75–97%-l ravitutest. Operatiivse ravi komplikatsioonideks võivad olla liigese süvainfektsiooni kujunemine, operatsioonjärgne artrofibroos ning liigese ebastabiilsus ja operatsioonijärgne valu. Oluline on ka operatsioonitehnika, eelkõige tunneli õige positsiooni valik. Komplikatsioonide ennetamisel on oluline osa patsientide õigel valikul ning kirurgi oskuste õigel hindamisel

    Fertilization and field crops effect on earthworms

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    Soil quality can be estimated through soil chemical, physical and biological properties, from which the detection of biological indicators is the most difficult. Usually the earthworms are the easiest detectable species to evaluate sustainability of soil biota on arable land

    Men have higher risk of kinesiophobia after anterior cruciate ligament reconstruction in long term follow up.

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    Background Psychological and physiological factors could negatively affect patients' recovery and increase re-injury rate after anterior cruciate ligament reconstruction (ACLR). In daily practice surgeons and physiotherapists see athletes struggling to improve muscle strength and complaining of lack of self-confidence during the progress of return to sport. The Tampa Scale for Kinesiophobia is a valid questionnaire to measure a patient's psychological status and isokinetic test is widely used to measure muscle recovery. Hypothesis Patients with kinesiophobia have inferior self reported and functional outcomes after ACLR. Methods 140 patients, 100 (71%) men and 40 (29%) women, mean age 32.5 (±8.3), were included in the study 5.5 (±1.25) years after ACLR. All patients were operated by two senior surgeons. Preoperative and postoperative assessments were performed by two sports specialized physical therapists. Patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS), Oxford Knee score and Tampa Scale of Kinesiophobia (TSK-17). Quadriceps and hamstring muscle isokinetic strength was assessed at 60°/sec and 180°/sec using the HumacNorm dynamometer. Functional performance was tested with the single-leg-hop test for distance and the Y-balance test for anterior reach. Variables of the study were described by means and standard deviations. Shapiro-Wilk test was conducted to test for normality of the variables and unpaired t-tests were used to test for differences between subgroups. After tests were conducted, simple Bonferroni adjustment was applied to account for the number of tests made. Results 68/140 patients (48.6%) reported a Tampa kinesiophobia score equal or higher than 37 points, above which is the cut off score for kinesiophobia. Patients with kinesiophobia had statistically significant lower scores in the KOOS Symptoms (p=0.001) and Quality of Life subscores (p=0.001), Total score (p=0.001) and the Oxford Knee Score (p=0.024). Isokinetic peak torque muscle strength mean deficits at 60°/sec and 180°/sec for knee flexion and extension were between 6% and 7% for patients with kinesiophobia and between 2% to 4% for patients without kinesiophobia compared with the contralateral side, with no significant differences between groups. There was no statistically significant difference in the Single-leg-hop test for distance leg ratio (0.98 (±0.19) and 1.00 (±0.26)) and the Y-balance test for anterior reach leg ratio (0.99 (±0.08) and 1.01 (±0.07)) respectively between the groups. Conclusion At 5 years after ACLR operated leg functional performance is equal to nonoperated leg. However kinesiophobia is present in nearly half of patients. Strength and functional tests alone are not good enough instruments for assessing complete recovery, on the other hand self-reported questionnaires have high correlation to kinesiophobia after ALCR. Further studies are needed to avoid development of kinesiophobia as well how to recognize phobia at early stages of rehabilitation
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