scholarly journals Lower limbs lengthening over the intramedullary nail versus lengthening by Ilizarov technique

2021 ◽  
Vol 28 (1) ◽  
pp. 40-51
Author(s):  
E. A. Shchepkina ◽  
I. V. Lebedkov ◽  
L. N. Solomin ◽  
K. L. Korchagin ◽  
F. K. Sabirov ◽  
...  
Keyword(s):  
External Fixation ◽  
Ankle Joint ◽  
Intramedullary Nail ◽  
Clinical Applications ◽  
Joint Contracture ◽  
Lower Limbs ◽  
Ilizarov Technique ◽  
Tibial Lengthening

Introduction. Lengthening over the nail (LON) combines the advantages of external and internal fixations.The objective was to compare the effectiveness of the application, to assess the structure and frequency of complications in patients treated with lengthening by Ilizarov technique and lengthening over the nail.Methods and materials. We analyzed 55 LON cases and 64 cases lengthening by Ilizarov technique. The duration of the external fixation period, complications and quality of the patient life were compared.Results. The external fixation period in LON group was 4 times less than in the Ilizarov technique group. There were 25 complications (45.5 %) in LON group and 54 complications (84.4 %) in the Ilizarov technique group. Femur lengthening was associated with a greater number of complications in both groups. Pin infections were 2.5 times less frequently in the femur LON group. Knee contractures were only in Ilizarov technique group (11.4 %). Ankle joint contracture was noted with the same frequency during tibial lengthening in both groups. Disorders of the consolidation were 2 times more often in the femur LON group and 5 times more often in the tibial lengthening with Ilizarov technique. Premature fusion was observed only in the LON group. There were 2 times less fractures of the half-pins and wires in the LON group.Conclusions. A reduction of external fixation period in LON group correlates with the 2-fold decrease of complications and an increase of the treatment comfort. LON is promising for wider clinical applications.

scholarly journals Lower limb lengthening over an intramedullary nail: a long-term follow-up study of 28 cases

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Pasquale Farsetti ◽  
Fernando De Maio ◽  
Vito Potenza ◽  
Kristian Efremov ◽  
Martina Marsiolo ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Intramedullary Nail ◽  
Lower Limb ◽  
Average Length ◽  
Limb Lengthening ◽  
Limb Length ◽  
Tibial Lengthening ◽  
The Mean

Abstract Background Limb lengthening using an external fixator requires a long period of external fixation and may be associated with several complications such as axial deformity, fracture of the regenerated bone, and joint stiffness. With the goal of reducing the time of external fixation as well as some of these complications, we performed femoral or tibial lengthening over an intramedullary nail, according to Paley’s technique, in 28 patients, followed up after a mean period of 8 years. Materials and methods Twenty-eight patients treated for lower limb discrepancy by limb lengthening over an intramedullary nail were reviewed from 5 to 11 years after healing of regenerated bone. There were 20 femurs and 8 tibiae, with average age at surgery of 14.2 years and average length inequality of 6.1 cm for femurs and 5.3 cm for tibiae. Results The mean lengthening was 5.8 cm for femurs and 4.8 cm for tibiae. The mean period of radiographic consolidation of the regenerated bone was 6 months for femoral lengthening and 4.5 months for tibial lengthening. At follow-up, we observed 8 excellent results, 15 good results, 4 fair results, and 1 poor result, based on Paley’s evaluation criteria. The main complications were one deep infection, one nonunion of the distracted segment, one breakage of the distal fiche of the external fixator, and one breakage of both distal locking screws of the intramedullary nail. Discussion We believe that limb lengthening over an intramedullary nail still represents a good method to treat limb length discrepancy because it reduces the time of external fixation, prevents axial deformities and fractures of regenerated bone, and allows early rehabilitation. The new intramedullary lengthening nails, which theoretically are the ideal device for treating limb length inequality, are still very expensive and need longer follow-up for definitive evaluation. Level of evidence 4.

Treatment Peculiarity of the Chronic Trophic Ulcers with Different Pathogenic Mechanism

2020 ◽  
Vol 62 (1) ◽  
pp. 12-16
Author(s):  
Oksana K. Melekhovets ◽  
Tetyana O. Kharchenko ◽  
Victor F. Orlovskiy ◽  
Iuirii V. Melekhovets ◽  
Alevtina S. Radko ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Healing Process ◽  
Modern Medicine ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Second Stage ◽  
Group 2

Introduction: Trophic ulcers of the lower extremities are an unresolved problem of modern medicine. The treatment of this pathology requires new methods that optimize care regimens and improve patients’ quality of life. Aim: The study to improve efficacy of treatment of the patients with trophic ulcers of the lower limbs with consideration to pathogenesis. M aterials and Methods: The study included 32 patients with chronic venous disease C6 (1st group) and 31 with diabetes mellitus type 2, moderate severity, compensation stage with diabetic foot syndrome II stage according to Wagner’s classification (2nd group). In addition to basic therapy in both groups photodynamic therapy was added at the first stage of the study, and at the second stage plasma rich in growth factors was prescribed. Results: At baseline evaluating of the chronic venous disease demonstrates that a total score in patient of the 1st group was 20,9 points on a modified VCSS scale; after two weeks – 15,71 points (improvement by 24.83%), and 6 weeks after–9,72 points (improvement by 53.49%). In patients with DM (2nd group) at the baseline a total score average was 13,91 points according to S(AD)SAD-1 scale; after 2 weeks – 12,29 (improvement by 11,65%), after 6 weeks – 6,39 points (improvement by 54,06%). Conclusions: The inclusion of photodynamic therapy and plasmatherapy in complex therapy in both groups led to a significant improvement of the healing process and helps to reduce the depth and area of the wound surface. However, the wound healing in patients in group 2 was slower.

scholarly journals High Integrity and Fidelity of Long-Term Cryopreserved Umbilical Cord Blood for Transplantation

2021 ◽  
Vol 10 (2) ◽  
pp. 293
Author(s):  
Gee-Hye Kim ◽  
Jihye Kwak ◽  
Sung Hee Kim ◽  
Hee Jung Kim ◽  
Hye Kyung Hong ◽  
...  
Keyword(s):  
Stem Cell ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Clinical Applications ◽  
Hematopoietic Stem ◽  
Cd34 Cells ◽  
Hsc Transplantation

Umbilical cord blood (UCB) is used as a source of donor cells for hematopoietic stem cell (HSC) transplantation. The success of transplantation is dependent on the quality of cord blood (CB) units for maximizing the chance of engraftment. Improved outcomes following transplantation are associated with certain factors of cryopreserved CB units: total volume and total nucleated cell (TNC) count, mononuclear cell (MNC) count, and CD34+ cell count. The role of the storage period of CB units in determining the viability and counts of cells is less clear and is related to the quality of cryopreserved CB units. Herein, we demonstrate the recovery of viable TNCs and CD34+ cells, as well as the MNC viability in 20-year-old cryopreserved CB units in a CB bank (MEDIPOST Co., Ltd., Seongnam-si, Gyeonggi-do, Korea). In addition, cell populations in CB units were evaluated for future clinical applications. The stable recovery rate of the viability of cryopreserved CB that had been stored for up to 20 years suggested the possibility of uses of the long-term cryopreservation of CB units. Similar relationships were observed in the recovery of TNCs and CD34+ cells in units of cryopreserved and fresh CB. The high-viability recovery of long-term cryopreserved CB suggests that successful hematopoietic stem cell (HSC) transplantation and other clinical applications, which are suitable for treating incurable diseases, may be performed regardless of long-term storage.

scholarly journals The impact of symptoms on daily life as perceived by patients with Charcot-Marie-Tooth type 1A disease

2021 ◽  
Author(s):  
Stefano Tozza ◽  
Dario Bruzzese ◽  
Daniele Severi ◽  
Emanuele Spina ◽  
Rosa Iodice ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Daily Life ◽  
Short Form ◽  
Lower Limbs ◽  
Charcot Marie Tooth ◽  
Rank Analysis ◽  
Sf 36 ◽  
Tooth Type ◽  
The Impact

Abstract Introduction In Charcot-Marie-Tooth type 1A (CMT1A) patients, daily life is mainly influenced by mobility and ambulation dysfunctions. The aim of our work was to evaluate the perception of disturbances that mostly impact on daily life in CMT1A patients and its difference on the basis of age, gender, disability, and quality of life. Methods Forty-one CMT1A patients underwent neurological assessment focused on establishing clinical disability through the Charcot-Marie-Tooth Neuropathy Score (CMTNS) and quality of life through the Short Form-36 (SF-36) questionnaire. We identified from CMT disturbances 5 categories [weakness in lower limbs (WLL), weakness in upper limbs (WUL), skeletal deformities (SD), sensory symptoms (SS), balance (B)] and patients classified the categories from the highest to the lowest impact on daily life (1: highest; 5: lowest). Ranking of the 5 categories, in the overall sample and in the different subgroups (dividing by gender, median of age and disease duration, CMTNS, domains of SF-36), was obtained and differences among subgroups were assessed using a bootstrap approach. Results Rank analysis showed that WLL was the most important disturbance on daily life whereas WUL had the lowest impact. In the older CMT1A group, the most important disturbance on daily life was B that was also the most relevant disturbance in patients with a greater disability. SD influenced daily life in younger patients. SS had less impact on daily life, with the exception of patients with a milder disability. Discussion Our findings demonstrated that the perception of disturbances that mostly impact on CMT1A patients’ daily life changes over the lifetime and with degree of disability.

scholarly journals Coenzyme Q10: Clinical Applications beyond Cardiovascular Diseases

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1697
Author(s):  
Lara Testai ◽  
Alma Martelli ◽  
Lorenzo Flori ◽  
Alessandro Colletti ◽  
Arrigo F. G. Cicero
Keyword(s):  
Cardiovascular Diseases ◽  
Coenzyme Q10 ◽  
Inverse Correlation ◽  
Chronic Fatigue ◽  
Clinical Applications ◽  
Blood Levels ◽  
Muscle Disorders ◽  
Fatigue Syndrome ◽  
Antioxidant Agent

Coenzyme Q10 (CoQ10) is an essential cofactor in oxidative phosphorylation (OXPHOS), present in mitochondria and cell membranes in reduced and oxidized forms. Acting as an energy transfer molecule, it occurs in particularly high levels in the liver, heart, and kidneys. CoQ10 is also an anti-inflammatory and antioxidant agent able to prevent the damage induced by free radicals and the activation of inflammatory signaling pathways. In this context, several studies have shown the possible inverse correlation between the blood levels of CoQ10 and some disease conditions. Interestingly, beyond cardiovascular diseases, CoQ10 is involved also in neuronal and muscular degenerative diseases, in migraine and in cancer; therefore, the supplementation with CoQ10 could represent a viable option to prevent these and in some cases might be used as an adjuvant to conventional treatments. This review is aimed to summarize the clinical applications regarding the use of CoQ10 in migraine, neurodegenerative diseases (including Parkinson and Alzheimer diseases), cancer, or degenerative muscle disorders (such as multiple sclerosis and chronic fatigue syndrome), analyzing its effect on patients’ health and quality of life.

scholarly journals The effect of functional limitations and fatigue on the quality of life in people with multiple sclerosis

2009 ◽  
Vol 67 (3b) ◽  
pp. 812-817 ◽  
Author(s):  
Leandro Alberto Calazans Nogueira ◽  
Felipe Resende Nóbrega ◽  
Kátia Nogueira Lopes ◽  
Luiz Claudio Santos Thuler ◽  
Regina Maria Papais Alvarenga
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Functional Limitations ◽  
Case Series ◽  
Lower Limbs ◽  
Case Series Study ◽  
Modified Ashworth Scale ◽  
Mild Disability ◽  
Fatigue Severity

The purpose of this study was to determine the effect of functional limitations and fatigue on the quality of life (QoL) in people with multiple sclerosis (MS). A descriptive case series study at Lagoa Hospital - Rio de Janeiro, Brazil was carried. The main outcome measurements were demographic variables, QoL (SF-36 v.1), disability (EDSS), motor function of the upper limb (Box & Blocks test), Tone (Modified Ashworth Scale), gait (Hauser ambulatory index) and fatigue (Fatigue Severity Scale). Sixty one patients fulfilled the study criteria. The mean age of patients was 39 years and 74% of patients were female. The most of cases presented mild disability (EDSS<3.5). A decrease was found in all domains of QoL. It was found association between physical functioning and the variables of EDSS, fatigue, lower limb tone and gait. Gait, disability, hypertonia of the lower limbs and fatigue negatively affected QoL in people with MS.

Salivary peptide histatin 1 mediated cell adhesion: a possible role in mesenchymal-epithelial transition and in pathologies

2018 ◽  
Vol 399 (12) ◽  
pp. 1409-1419 ◽  
Author(s):  
Irene A. van Dijk ◽  
Enno C.I. Veerman ◽  
Eric A.J. Reits ◽  
Jan G.M. Bolscher ◽  
Jan Stap
Keyword(s):  
Cell Adhesion ◽  
Oral Cavity ◽  
Potential Function ◽  
Clinical Applications ◽  
Epithelial Barrier ◽  
Salivary Peptide ◽  
Mesenchymal To Epithelial Transition ◽  
Mesenchymal Epithelial Transition

Abstract Histatins are histidine-rich peptides present in the saliva of humans and higher primates and have been implicated in the protection of the oral cavity. Histatin 1 is one of the most abundant histatins and recent reports show that it has a stimulating effect on cellular adherence, thereby suggesting a role in maintaining the quality of the epithelial barrier and stimulating mesenchymal-to-epithelial transition. Here we summarize these findings and discuss them in the context of previous reports. The recent findings also provide new insights in the physiological functions of histatin 1, which are discussed here. Furthermore, we put forward a possible role of histatin 1 in various pathologies and its potential function in clinical applications.

scholarly journals Recent Developments in Clinical Applications of Mesenchymal Stem Cells in the Treatment of Rheumatoid Arthritis and Osteoarthritis

2021 ◽  
Vol 12 ◽  
Author(s):  
Joel Jihwan Hwang ◽  
Yeri Alice Rim ◽  
Yoojun Nam ◽  
Ji Hyeon Ju
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trials ◽  
Clinical Applications ◽  
Clinical Settings ◽  
Positive Outcomes ◽  
Joint Function ◽  
Safety And Efficacy ◽  
High Expectations ◽  
Recent Developments

Mesenchymal stem cell (MSC) therapies have been used as cell-based treatments for decades, owing to their anti-inflammatory, immunomodulatory, and regenerative properties. With high expectations, many ongoing clinical trials are investigating the safety and efficacy of MSC therapies to treat arthritic diseases. Studies on osteoarthritis (OA) have shown positive clinical outcomes, with improved joint function, pain level, and quality of life. In addition, few clinical MSC trials conducted on rheumatoid arthritis (RA) patients have also displayed some optimistic outlook. The largely positive outcomes in clinical trials without severe side effects establish MSCs as promising tools for arthritis treatment. However, further research is required to investigate its applicability in clinical settings. This review discusses the most recent advances in clinical studies on MSC therapies for OA and RA.

scholarly journals The nature and prevalence of chronic pain in homeless persons: an observational study

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 164 ◽  
Author(s):  
Rebecca Fisher ◽  
Judith Ewing ◽  
Alice Garrett ◽  
E Katherine Harrison ◽  
Kimberly KT Lwin ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Short Form ◽  
Homeless People ◽  
Brief Pain Inventory ◽  
Homeless Persons ◽  
Lower Limbs ◽  
Mcgill Pain Questionnaire ◽  
Wide Range

Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs.Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant’s reasons for homelessness, and whether they slept rough or in shelters.Findings: Of 168 shelter users approached, 150 (89.3%) participated: 93 participants (63%) reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs.Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable people’s lives.

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