COMPLEX CHARACTERISTICS OF PATIENTS WITH COXARTHROSIS IN IRKUTSK REGION

Coxarthorosis is a degenerative-dystrophic disorder affecting all layers of population with increasing sickness rate among adult people. Coxarthoris is characterized by steadily progressive course leading patients to disability without ability of self-service. Closer attention of all kinds of medical workers is necessary in diagnostics and. rendering of all kinds of assistance available for this category of patients: not only qualified, medical attention, but also help in social rehabilitation

Assessing socio-economic damage caused by coxarthrosis in the population

Background. About 40 % of patients diagnosed with coxarthrosis annually seek medical help and receive social support due to this disease. Increased use of an expensive surgery for treatment of coxarthrosis and projected growth of its prevalence in the population determine the relevance of socio-economic analysis. The aim of the study. To assess the value and structure of economic damage caused by the delivering health and social care to patients with coxarthrosis at the state level of the Russian Federation. Methods. To assess economic damage, we used the average annual number of various categories of patients and disabled people with coxarthrosis in the Irkutsk region for 2008–2017. Three main categories were identified: patients who visited the outpatients’ clinic; patients with total hip replacement; disabled people due to coxarthrosis. For each category, we calculated weighted average damage per  1  conventional patient, taking into account direct and indirect costs and subsequent multiplication by the average annual number of individual categories of patients. Calculations were performed in 2017 prices. Results. The average annual socio-economic damage from coxarthrosis amounted to 1.39 (1.34÷1.43) billion rubles or 0.1 % of the gross regional product. The most of the damage (64.4 %) were indirect costs associated with disability due to coxarthrosis, 22.2  % of the total amount were the costs of hip replacement surgery, 13.4 % were the costs of outpatient visits. Indirect economic losses due to disability in patients of working age were 4.2 times higher than losses due to disability of oldage pensioners. Conclusion. The results of the study confirm the economic feasibility of surgical treatment of coxarthrosis, especially in patients of working age

PREVALENCE AND STRUCTURAL CHARACTERISTIC OF COXARTHROSIS IN THE UST-ORDYNSK BURYAT DISTRICT

The prevalence of coxarthrosis in Ust-Ordynsk Buryat Region was defined as 19,8 ‰0 This article gives complex characteristics of coxarthrosis in the named region

Клініко-рентгенологічна і гематологічна оцінка застосування кераміки, легованої кремнієм, за осколкових переломів кісток у собак

None of the methods of osteosynthesis provides the consolidation of bone fragments which have lost contact with soft tissues. It makes extremely difficult treating of this type fractures. Bone defect between the fragments and absence of a primary biological matrix complicates revascularization, causes long-term life of the connective tissue and cells of cartilaginous phenotype in the fracture zone. It is leads to a long-term consolidation of the fracture. Composites of hydroxyapatite and calcium phosphates are considered as bioactive and therefore the most promising for bone defects replacing. The aim of this investigation was clinical, radiological and hematological evaluation using of silicon-doped ceramics for fragmented bone fractures in dogs. For study was chosen dogs with accidental fragmented fractures of tubular bones which treated by extracortical osteosynthesis method. Animal was divided into two groups. A bone defects were filled with ceramics (GTlKg-3) for experimental animal group (n = 7), while no filling of bone defects in control animal group(n = 7) was performed. Protocol of anesthesia included medetomidine, butorphanol tartrate and epidural anesthesia with 2 % lidocaine solution. Animals of the control group began to lean on the injured limb from the 12–15th day after surgery, while the animal of research group from the 8-9th day. Complete limb repair in dogs of the control group occurred on the 38–42th day, but such period for experimental group animals was shorter – 25–27th day after the osteosynthesis. X-ray investigation (60th day) of experimental group dogs showed new formed bone tissue with osteosclerotic zones without a periosteal reaction, bone tissue, with a normal view of the epiphyseal areas and the bone marrow cavity. This is evidence of localized reparative osteogenesis (within bone trauma only), and completed fracture consolidation. At the same time in cases of the control group we found lower X-ray density of new bone, periosteum was thickened with excessive proliferation of the endosteum, especially below the site of bone injury. Thus, in case the absence of hydroxyapatite matrix in bone defects there were compensatory increasing proliferation of periosteum and endoosteum. Fragmented fractures of tubular bones in dogs have occurred by erythrocytopenia, that quickly disappear due to the reparative osteogenesis in dog of experimental group. These animals have had leukocytosis increasing due to the first three days after osteosynthesis as a reaction to the implantation of a calcium-phosphorus composite material. Dogs of control group have had second wave of leukocytosis increasing on forty-second day associated with elongated remodeling process. Areparative osteogenesis can be accelerated in 1.5 times in case of replacement of bone defects with silicon doped hydroxyapatite ceramics. It is possibility realized thru moderate reduction of active phase of inflammation and acceleration of proliferative phase, mainly from endosteum side with early mineralization of bone regenerate. The dynamics of hematology parameters is a typical for the tubular bone consolidation that indicates about moderate inflammation and demonstrate biological tolerance of silicon-doped hydroxyapatite ceramics.Ні один зі способів остеосинтезу не забезпечує консолідації осколкових фрагментів кістки, які втратили зв’язок з м’якими тканинами, що надзвичайно ускладнює лікування переломів такого типу. Внаслідок кісткового дефекту між уламками відсутність первинної біологічної матриці ускладнює реваскуляризацію, зумовлює тривале функціонування в зоні перелому сполучнотканинного і хрящового фенотипу клітин, що призводить до тривалої в часі консолідації перелому. Композити гідроксиапатиту і фосфатів кальцію, вважаються біоактивними, а тому найбільш перспективними для заміщення кісткових дефектів. Мета дослідження – клініко-рентгенологічна і гематологічна оцінка застосування кераміки, легованої кремнієм, за осколкових переломів кісток у собак. Сформували дослідну (n = 7) і контрольну (n = 7) групу собак із випадковими осколковими переломами довгих трубчастих кісток, у яких виконували екстракортикальний остеосинтез, а в дослідній кісткові дефекти заповнювали керамікою (ГТлКг-3). Анестезіологічне забезпечення включало внутрішньом’язове введення медитомідину, буторфанолу тартрат та епідуральну анестезію 2 % розчином лідокаїну. Тварини контрольної групи починали опиратись на травмовану кінцівку із 12–15-ї доби, а дослідної – вже з 8–9-ї доби. Повне відновлення функції кінцівки в контрольній групі відбувалося на 38–42-у, а в дослідній – на 25–27-у добу після проведення остеосинтезу. На 60-ту добу в собак дослідної групи рентгенологічно досить чітко в ділянці кісткової травми візуалізувалася кісткова тканина з остеосклеротичними зонами без періостальної реакції з нормальною рентгенологічною картиною епіфізарних ділянок і кістковомозкової порожнини. Це було свідченням повної консолідації перелому та перебігом репаративного остеогенезу в межах лише кісткової травми. Натомість у контрольній групі на 60-у добу кістковий регенерат мав меншу рентгенологічну щільність, періост був потовщеним з надмірною проліферацією ендоосту, особливо нижче ділянки кісткової травми. Тобто за відсутності заміщення кісткових дефектів композитними імплантами відбувається компенсаторне посилення проліферації пері-та ендоосту. За осколкових переломів довгих трубчастих кісток у собак має місце помірна еритроцитопенія, яка досить швидко усувається в динаміці репаративного остеогенезу за використання в якості імплантів  у кістковий дефект гідроксиапатитної кераміки, легованої кремнієм. У дослідних тварин в перші три доби після остеосинтезу лейкоцитоз посилюється як реакція на імплантацію кальцій-фосфорного композитного матеріалу, а в контрольних його посилення на 42-у добу пов’язане з процесами ремоделювання. У випадку заміщення кісткових дефектів за осколкових переломів довгих трубчастих кісток у собак керамікою на основі гідроксиапатиту і β-трикальційфосфату, легованої кремнієм, репаративний остеогенез прискорюється в 1,5 разу за рахунок скорочення його запально-резорбтивної стадії та прискорення проліферативної, головним чином з боку ендоосту з ранньою мінералізацією кісткового регенерату. Динаміка гематологічних показників є типовою для консолідації довгих трубчастих кісток у собак, що свідчить про відсутність вираженої реакції організму на імплантацію гідроксиапатитної кераміки, легованої кремнієм

Hydrotherapy as a recovery strategy after exercise: a pragmatic controlled trial

Trial registration ClinicalTrials.gov Identifier: NCT01765387Background Our aim was to evaluate the recovery effects of hydrotherapy after aerobic exercise in cardiovascular, performance and perceived fatigue. Methods A pragmatic controlled repeated measures; single-blind trial was conducted. Thirty-four recreational sportspeople visited a Sport-Centre and were assigned to a Hydrotherapy group (experimental) or rest in a bed (control) after completing a spinning session. Main outcomes measures including blood pressure, heart rate, handgrip strength, vertical jump, self-perceived fatigue, and body temperature were assessed at baseline, immediately post-exercise and post-recovery. The hypothesis of interest was the session*time interaction. Results The analysis revealed significant session*time interactions for diastolic blood pressure (P=0.031), heart rate (P=0.041), self perceived fatigue (P=0.046), and body temperature (P=0.001); but not for vertical jump (P=0.437), handgrip (P=0.845) or systolic blood pressure (P=0.266). Post-hoc analysis revealed that hydrotherapy resulted in recovered heart rate and diastolic blood pressure similar to baseline values after the spinning session. Further, hydrotherapy resulted in decreased self-perceived fatigue after the spinning session. Conclusions Our results support that hydrotherapy is an adequate strategy to facilitate cardiovascular recovers and perceived fatigue, but not strength, after spinning exercise

Changes in muscle contractile characteristics and jump height following 24 days of unilateral lower limb suspension

We measured changes in maximal voluntary and electrically evoked torque and rate of torque development because of limb unloading. We investigated whether these changes during single joint isometric muscle contractions were related to changes in jump performance involving dynamic muscle contractions and several joints. Six healthy male subjects (21 ± 1 years) underwent 3 weeks of unilateral lower limb suspension (ULLS) of the right limb. Plantar flexor and knee extensor maximal voluntary contraction (MVC) torque and maximal rate of torque development (MRTD), voluntary activation, and maximal triplet torque (thigh; 3 pulses at 300 Hz) were measured next to squat jump height before and after ULLS. MVC of plantar flexors and knee extensors (MVCke) and triplet torque decreased by 12% (P = 0.012), 21% (P = 0.001) and 11% (P = 0.016), respectively. Voluntary activation did not change (P = 0.192). Absolute MRTD during voluntary contractions decreased for plantar flexors (by 17%, P = 0.027) but not for knee extensors (P = 0.154). Absolute triplet MRTD decreased by 17% (P = 0.048). The reduction in MRTD disappeared following normalization to MVC. Jump height with the previously unloaded leg decreased significantly by 28%. No significant relationships were found between any muscle variable and jump height (r < 0.48), but decreases in torque were (triplet, r = 0.83, P = 0.04) or tended to be (MVCke r = 0.71, P = 0.11) related to decreases in jump height. Thus, reductions in isometric muscle torque following 3 weeks of limb unloading were significantly related to decreases in the more complex jump task, although torque in itself (without intervention) was not related to jump performance

Characteristics of fast voluntary and electrically evoked isometric knee extensions during 56 days of bed rest with and without exercise countermeasure

The contractile characteristics of fast voluntary and electrically evoked unilateral isometric knee extensions were followed in 16 healthy men during 56 days of horizontal bed rest and assessed at bed rest days 4, 7, 10, 17, 24, 38 and 56. Subjects were randomized to either an inactive control group (Ctrl, n = 8) or a resistive vibration exercise countermeasure group (RVE, n = 8). No changes were observed in neural activation, indicated by the amplitude of the surface electromyogram, or the initial rate of voluntary torque development in either group during bed rest. In contrast, for Ctrl, the force oscillation amplitude at 10 Hz stimulation increased by 48% (P < 0.01), the time to reach peak torque at 300 Hz stimulation decreased by 7% (P < 0.01), and the half relaxation time at 150 Hz stimulation tended to be slightly reduced by 3% (P = 0.056) after 56 days of bed rest. No changes were observed for RVE. Torque production at 10 Hz stimulation relative to maximal (150 Hz) stimulation was increased after bed rest for both Ctrl (15%; P < 0.05) and RVE (41%; P < 0.05). In conclusion, bed rest without exercise countermeasure resulted in intrinsic speed properties of a faster knee extensor group, which may have partly contributed to the preserved ability to perform fast voluntary contractions. The changes in intrinsic contractile properties were prevented by resistive vibration exercise, and voluntary motor performance remained unaltered for RVE subjects as well

Electrical Stimulation Influences Satellite Cell Proliferation and Apoptosis in Unloading-Induced Muscle Atrophy in Mice

Muscle atrophy caused by disuse is accompanied by adverse physiological and functional consequences. Satellite cells are the primary source of skeletal muscle regeneration. Satellite cell dysfunction, as a result of impaired proliferative potential and/or increased apoptosis, is thought to be one of the causes contributing to the decreased muscle regeneration capacity in atrophy. We have previously shown that electrical stimulation improved satellite cell dysfunction. Here we test whether electrical stimulation can also enhance satellite cell proliferative potential as well as suppress apoptotic cell death in disuse-induced muscle atrophy. Eight-week-old male BALB/c mice were subjected to a 14-day hindlimb unloading procedure. During that period, one limb (HU-ES) received electrical stimulation (frequency: 20 Hz; duration: 3 h, twice daily) while the contralateral limb served as control (HU). Immunohistochemistry and western blotting techniques were used to characterize specific proteins in cell proliferation and apoptosis. The HU-ES soleus muscles showed significant improvement in muscle mass, cross-sectional area, and peak tetanic force relative to the HU limb (p<0.05). The satellite cell proliferative activity as detected within the BrdU+/Pax7+ population was significantly higher (p<0.05). The apoptotic myonuclei (detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling) and the apoptotic satellite cells (detected by cleaved Poly [ADP-ribose] polymerase co-labeled with Pax7) were reduced (p<0.05) in the HU-ES limb. Furthermore the apoptosis-inducing factor and cleaved caspase-3 were down-regulated while the anti-apoptotic Bcl-2 protein was up-regulated (p<0.05), in the HU-ES limb. These findings suggest that the electrical stimulation paradigm provides an effective stimulus to rescue the loss of myonuclei and satellite cells in disuse muscle atrophy, thus maintaining a viable satellite cell pool for subsequent muscle regeneration. Optimization of stimulation parameters may enhance the outcome of the intervention

Alkaline residues and the environment: A review of impacts, management practices and opportunities

Around two billion tonnes of alkaline residues are produced globally each year by industries such as steel production, alumina refining and coal-fired power generation, with a total production estimate of 90 billion tonnes since industrialization. These wastes are frequently stored in waste piles or landfills, and can be an environmental hazard if allowed to generate dust, or if rainwater infiltrates the waste. This review will focus on the environmental impacts associated with alkaline residues, with emphasis on the leachates produced by rainwater ingress. Many alkaline industrial wastes can produce leachates that are enriched with trace metals that form oxyanions (e.g. As, Cr, Mo, Se, V), which can be very mobile in alkaline water. The management options for the residues and their leachates are also discussed, distinguishing active and passive treatment options. Potential reuses of these materials, in construction materials, as agricultural amendments, and in environmental applications are identified. The mechanisms of carbon sequestration by alkaline residues are assessed, and the potential for enhancing its rate as a climate change off-setting measure for the industry is evaluated. The potential for recovery of metals critical to e-technologies, such as vanadium, cobalt, lithium and rare earths, from alkaline residues is considered. Finally research needs are identified, including the need to better understand the biogeochemistry of highly alkaline systems in order to develop predictable passive remediation and metal recovery technologies