Total hip arthroplasty for post-firearm hip arthritis complicated by coloarticular fistula: A case report / 中华创伤杂志(英文版)

Hip firearm injuries are rare injuries that could lead to serious complications, such as posttraumatic hip arthritis and coloarticular fistula. We report a case of a 25-year-old male who sustained a pelvic injury caused by a single bullet which led to a bilateral acetabular fracture, concomitant with a colon injury treated on an emergency basis by a diverting colostomy; acetabular fractures were treated conservatively by traction. After the patient recovered from the abdominal injury, he was presented with bilateral hip pain and limited motion; plain radiographs showed bilateral hip arthritis with proximal migration of the femoral head and bilateral acetabular defect classified as Paprosky type ⅢA. Reconstruction of the hips was performed using the same technique: impaction bone grafting for acetabular defect reconstruction and a reversed hybrid total hip arthroplasty (THA) 6 months apart. The patient presented with loosening of the left THA acetabular cup 3 years later, which was revised; then he presented with a discharging sinus from the left THA with suspicion of coloarticular fistula, which was confirmed using CT with contrast material. A temporary colostomy and fistula excision were performed, and a cement spacer was applied to the hip. After clearing the infection, a final revision THA for the left hip was performed. Treating post-firearm hip arthritis by THA is challenging, especially in the situation of neglected cases with the presence of an acetabular defect. Concomitant intestinal injury increases the risk of infection with the possibility of coloarticular fistula formation, which could present later. Working with a multidisciplinary team is paramount.

Glutathione (GSH) improves sperm quality and testicular morphology in streptozotocin-induced diabetic mice / 亚洲男科学杂志(英文版)

Diabetes mellitus (DM) is known to cause reproductive impairment. In men, it has been linked to altered sperm quality and testicular damage. Oxidative stress (OS) plays a pivotal role in the development of DM complications. Glutathione (GSH) is a part of a nonenzymatic antioxidant defense system that protects lipid, protein, and nucleic acids from oxidative damage. However, the protective effects of exogenous GSH on the male reproductive system have not been comprehensively examined. This study determined the impact of GSH supplementation in ameliorating the adverse effect of type 1 DM on sperm quality and the seminiferous tubules of diabetic C57BL/6NTac mice. GSH at the doses of 15 mg kg

Trans-oral, Carbon Dioxide-Assisted Excision of an Unusual Schwannoma of the Tongue Base: Case Report and Review of the Literature

Abstract Introduction Schwannomas are benign, solitary, encapsulated tumors that may originate at any site of the peripheral nervous system, with the exception of the olfactory and optic nerves. Schwannomas of the base of tongue are very rare, and only sporadic cases are documented. The tongue base represents a challenge for surgeons. Carbon dioxide (CO2) laser might provide an effective surgical option for such lesions because of the easy access to the lesion, the bloodless surgical field and optimum epithelization of wounds. Objective We present an unusual case of pedunculated schwannoma of the tongue base treated via transoral CO2-assisted excision. We also provide a review of the available literature, in English language, on humans. Data synthesis The authors searched the PubMed database and Google up to July 2018. The following search terms were applied: tongue and lingual, combined with schwannoma and neurilemmoma. Titles and abstracts were screened, and, then, only supraglottic (hypopharyngeal) tongue base masses were considered. Fourteen articles were included in this review, reporting 17 cases. The age of the patients ranged from 9 to 39 years, affecting predominantly females. Dysphagia and lump sensations were the most common presenting symptoms, and the mean follow-up period range was 1.5 to 60 months (mean = 13 months). There was no evidence of recurrence in any of the cases. Conclusion We could conclude that tongue base schwannomas are rare. Transoral complete excision of the tumor is the treatment of choice. CO2 laser surgery is a minimally invasive treatment option that has been performed in few reports with no recurrence and with favorable outcomes.

All types of component malrotation affect the early patient-reported outcome measures after total knee arthroplasty

PURPOSE@#Outcomes following total knee arthroplasty (TKA), whether clinical, radiological or survival analysis, have been well-studied. Still, there are some concerns about patient satisfaction with the outcome of the surgery and factors that might contribute to a suboptimal result. This study aims to determine if there is correlation between primary TKA malalignment and early patient-reported outcome measures (PROMs).@*MATERIALS AND METHODS@#Sixty patients, who had primary TKA and a minimum of 2 years of follow up, were recruited for a detailed clinical and radiological examination. Knee alignment was measured in the coronal, sagittal and axial planes. Normal and the outlier measurements of the patients' knees were defined and the clinical results (PROMs) compared to see if there was a statistically significant difference.@*RESULTS@#Correlation between postoperative limb malalignment in the coronal and the sagittal planes and PROMs was not significant. Conversely, there was significant negative correlation between all types of malrotation and PROMs.@*CONCLUSIONS@#Although malalignment has been linked to inferior outcome and implant survival, our results showed that coronal and sagittal limb malalignment has no significant effect on early PROMs. However, all types of component rotational malalignment significantly worsen early PROMs.

Pontos de corte da função pulmonar e capacidade funcional determinantes para sarcopenia e dinapenia em pacientes com DPOC / Pulmonary function and functional capacity cut-off point to establish sarcopenia and dynapenia in patients with COPD

RESUMO Objetivo Estabelecer ponto de corte entre as variáveis clínicas e funcionais para avaliar a prevalência de sarcopenia e dinapenia em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC), além de analisar o impacto da Disfunção Muscular Esquelética (DME) nestas variáveis. Métodos Realizado estudo transversal com pacientes diagnosticados com DPOC para determinar sarcopenia ou dinapenia por meio do índice de baixa massa muscular e Força de Preensão Palmar (FPP). Avaliadas a função pulmonar, força muscular respiratória e capacidade funcional (CF). A precisão das variáveis na determinação dos pontos de corte previstos para as doenças em questão foi obtida a partir da curva Receiver Operating Characteristic (ROC) e de uma análise bidirecional da variância. Resultados Ao final da análise, obtiveram-se 20 pacientes com DPOC estratificados por sarcopenia (n = 11) e dinapenia (n = 07). O grupo com sarcopenia apresentou menor massa magra e menor pressão inspiratória máxima (PImáx), diminuição da Força de Preensão Palmar (FPP) e redução da CF (p<0,050). O grupo com dinapenia apresentou redução da PImáx, menor FPP e menor distância percorrida no teste Incremental Shuttle Walk (ISWT) (p<0,050). Foram encontrados pontos de corte no Volume Expiratório Forçado (VEF1) durante o primeiro segundo na PImáx, na Pressão Expiratória Máxima (PEmáx) e no ISWT, o que possibilitou identificar sarcopenia ou dinapenia nestes pacientes. A partir destes resultados, foi possível encontrar coexistência das condições (efeito DME) na DPOC: redução da distância no ISWT (p = 0,002) e % ISWT (p = 0,017). Conclusões Em pacientes com DPOC moderada a muito grave, a sarcopenia pode ser prevista pelo VEF1 (% previsto) <52, PImáx <73 cm H2O, PEmáx <126 cm H2O e distância percorrida de <295 metros no ISWT. Já a dinapenia pode ser prevista pelo VEF1 <40%, PImáx <71 cm H2O, PEmáx <110 cm H2O e distância de <230 metros percorrida no ISWT.

ABSTRACT Objective To establish a cut-off point for clinical and functional variables to determinate sarcopenia and dynapenia in COPD patients, and to analyze the impact of skeletal muscle dysfunction (SMD) on these variables. Methods Cross-sectional study, screened COPD patients for sarcopenia or dynapenia through low muscle mass and hand grip strength (HGS). Clinical variables: pulmonary function, respiratory muscle strength and functional capacity (FC). The precision of the variables in determining points of predictive cut-off for sarcopenia or dynapenia were performed using the Receiver Operating Characteristic curve and two-way analysis of variance. Results 20 COPD patients stratified for sarcopenia (n = 11) and dynapenia (n = 07). Sarcopenia group presented lower lean mass and lower maximal inspiratory pressure (MIP), decreased HGS, reduced FC (p<0.050). Dynapenia group presented reduced MIP, lower HGS and walked a shorter distance at Incremental shuttle walk test (ISWT) (p<0.050). We found cut-off points of forced expiratory volume in one second (FEV1), MIP and maximal expiratory pressure (MEP) and ISWT. It is possible to identify sarcopenia or dynapenia in these patients. We found the coexistence of the conditions (SMD effect) in COPD - reduction in the distance in the ISWT (p = 0.002) and %ISWT (p = 0.017). Conclusion In moderate to very severe COPD patients the sarcopenia could be predicted by FEV1 (%predicted) < 52, MIP < 73 cmH2O, MEP < 126 cmH2O and distance traveled of < 295 m in ISWT. Whereas dynapenia could be predicted by FEV1 < 40%, MIP < 71 cmH2O, MEP < 110 cmH2O and distance of < 230 m traveled in ISWT.

Influência da prática de futsal amador na força muscular do assoalho pélvico / Influence of amateur futsal practice on pelvic floor muscle strength

INTRODUÇÃO: há poucas informações sobre o impacto do treinamento intenso de bola na biomecânica dos músculos do assoalho pélvico em atletas de futsal. OBJETIVO: avaliar a influência da prática de futsal amador na força muscular do assoalho pélvico. MATERIAIS E MÉTODOS: Estudo observacional descritivo, transversal, de natureza quantitativa, com atletas amadores de futsal. Aplicou-se um questionário sobre o histórico ginecológica e prática esportiva. O exame físico com um perineômetro demonstrou contração muscular através da Escala de Sauer. RESULTADOS: Idade média de 27,0 ± 4,1 anos, índice de massa corporal 23,9 ± 3,3 kg / cm2, atletas com função regular do assoalho pélvico (n = 8,80%), tempo de contração da musculatura do assoalho pélvico de 9,2 ± 1,6s tempo de jogo de 18,4 ± 4,9. Encontramos uma associação moderada entre o tempo de contração dos músculos do assoalho pélvico versus tempo de jogo (r=-0,653; p=0,040) e esse achado foi ratificado por uma análise de regressão linear simples, onde há uma influência de 36% da prática de futsal na força dos músculos do assoalho pélvico. CONCLUSÃO: Há influência direta da prática de futsal amador na força de contração dos músculos do assoalho pélvico. É essencial enfatizar a importância dos músculos do assoalho pélvico nesses atletas, uma vez que a fraqueza muscular é um fator predisponente para a presença de sintomas de perda urinária. [AU]

INTRODUCTION: In futsal athletes there is few information about the impact of intense ball training on pelvic floor muscles' biomechanics. OBJECTIVE: to evaluate the influence of amateur futsal practice on pelvic floor muscle strength. METHODS AND MATERIALS: Cross-sectional, descriptive observational study of a quantitative nature with 10 amateur futsal athletes. A questionnaire on gynecological history and sports practice was applied. Physical examination with a perineometer demonstrated muscle contraction through the Sauer Scale. RESULTS: Average adult age of 27.0 ± 4.1 years, body mass index 23.9±3.3 kg/cm2, the athletes had regular pelvic floor function (n =8, 80%), contraction time of the pelvic floor muscles 9.2 ± 1.6s, playing time 18.4±4.9. We found a moderate association between the pelvic floor muscles' contraction time vs. playing time (r = -0.653; p = 0.040) and this finding was ratified by a simple linear regression analysis, where there is a 36% influence of the futsal practice on pelvic floor muscles' strength. CONCLUSION: There is a direct influence of amateur futsal practice on pelvic floor muscles' contraction force. It is essential to emphasize pelvic floor muscles' importance in these athletes, since muscle weakness is a predisposing factor to the presence of urinary loss symptoms. [AU]

Influência das variáveis antropométricas sobre a força muscular do assoalho pélvico na Incontinência Urinária / Influence of anthropometric variables on pelvic floor muscular strength in Urinary Incontinence

INTRODUÇÃO: A Incontinência Urinária (IU) é definida como qualquer perda involuntária de urina. O aumento do peso e as medidas de circunferências elevadas são fatores de risco para o desenvolvimento destes sintomas. OBJETIVO: Avaliar a influência das variáveis antropométricas (VAs) na força muscular do assoalho pélvico de mulheres com IU. MATERIAIS E MÉTODOS: Estudo transversal com amostragem de conveniência. Iniciada a avaliação com a anamnese, após aferição das VAs seguiu-se para avaliação funcional do assoalho pélvico (AFA). Aplicada correlação de Spearman, e para avaliar a influência das VAs na AFA realizou-se regressão linear múltipla. RESULTADOS: Avaliadas 12 voluntárias com IU, média de idade 56,9±13,2 anos e maior frequência 10 (83,3%) de incontinência urinária de esforço. Encontradas correlações moderadas e negativas entre VAs e a AFA [Índice de massa corporal (IMC) vs AFA (r= -0,582 p=0,020); Circunferência da Cintura (CC) vs AFA (r= -0,567 p=0,033); Circunferência do Quadril (CQ) vs AFA (r= -0,593 p=0,050); Circunferência Abdominal (CA) vs AFA (r= -0,657 p=0.001)]. Estes achados foram ratificados através da análise de regressão linear múltipla, onde há influência direta de 37% do IMC e CA na AFA das voluntárias com IU. CONCLUSÃO: Valores elevados das VAs estão relacionadas diretamente com um pior desempenho na AFA, em mulheres com incontinência urinária. [AU]

INTRODUCTION: Urinary Incontinence (UI) is defined as any involuntary loss of urine, weight gain and high circumference measures are risk factors for UI symptoms development. OBJECTIVE: To evaluate the influence of anthropometric variables on the pelvic floor muscular strength of women with UI. METHODS AND MATERIALS: Cross-sectional study with convenience sample. Data were collected during anamnesis and after obtaining anthropometric variables, pelvic floor functional evaluation (PFE) was done. A Spearman correlation was performed and to evaluate anthropometrics variables' influence on PFE we did a multiple linear regression. RESULTS: 12 volunteers with UI were evaluated, mean age of 56.9±13.2 years with a frequency of 10 (83.3%) with stress urinary incontinence. Moderate and negative correlations between anthropometrics variables and PFE were found [Body mass index (BMI) vs PFE (r= -0,582 p=0,020); Waist circumference (WC) vs PFE (r= -0.567 p=0.033); Hip circumference (HC) vs PFE (r= -0.593 p=0.050); Abdominal circumference (AC) vs PFE (r= -0.657 p=0.001)]. The correlations findings can be ratified through a multiple linear regression analysis, where there is a direct influence of 37% of BMI and AC on PFE in the volunteers with UI. CONCLUSION: Higher values of the anthropometric measures are directly related to a worse performance on PFE, High VA values are directly related to poor performance in AFA in women with urinary incontinence. [AU]

Optimization of antibacterial activity of ethanolic extracts of eucalyptus tereticornis and nigella sativa: response surface methodology

The screening of plants for medicinal purposes represents an effort to discover newer, safer, and possibly more effective drugs. Design of the present study was made aiming to the optimization of the antibacterial activity of ethanolic extracts of Eucalyptus tereticornis [leaves] and Nigella sativa [seeds] against bacteria belongings to both Gram-positive [Bacillus subtilis and Staphylococcus aureus] and Gram-negative [Escherichia coli] spectrum by using response surface methodology. 20 g powder of each E. tereticornis [leaf] and N. sativa [seeds] were mixed with 200ml of ethanol at room temperature, and then it was centrifuged at 4000 rpm for 10 min to separate the supernatants, and allowed to dry in order to obtain ethanol free extracts. A fresh bacterial culture of 100microl of test microorganism was inoculated onto media and spread homogeneously. The antimicrobial activity of ethanolic extracts showed that all the concentrations tested were effective against the test microorganisms. The diameters of zones of inhibition exhibited by S. aureus PCSIR-83 were in the range of 0-28mm, E. coli PCSIR-102 [0-28mm] and B. subtilis PCSIR-05 [15-26mm]. The combination of N. sativa [15mg/micro l] and E. tereticornis [20mg/micro l] were found most effective at pH 9.0 and temperature 35°C. Our results clearly indicate that Gram positive bacteria showed more sensitivity than Gram-negative bacteria

Massive Plexiform Neurofibroma of the Neck and Larynx

Introduction Laryngeal neurofibromas are extremely rare, accounting for only 0.03 to 0.1% of benign tumors of the larynx. Objectives To report the first case of massive neck plexiform neurofibroma with intralaryngeal (supraglottic) extension in a 5-year-old boy with neurofibromatosis type 1 and to describe its treatment. Resumed Report This massive plexiform neurofibroma was surgically removed, relieving its significant respiratory obstructive symptoms without recurrence to date. Conclusion Massive neck plexiform neurofibroma with supraglottic part was found in a child with neurofibromatosis type 1; it should be included in differential diagnosis of stridor and neck mass in children. It was diagnosed and removed in early in childhood without recurrence.(AU)

Some indigenous medicinal plants knowledge for treating bronchial asthma in chittagong hill tracts, Bangladesh

Traditional medicinal plant knowledge of 20 plants species in the Chittagong Hill Tracts used in the treatment of asthma is documented. These plants are being used in the Chittagong Hill Tracts by the 13 tribal communities in traditional medicine for hundreds of years with reputation as efficacious remedies although there may not be sufficient data for sustaining their efficacy. Short diagnostic description, systematic position, tribal names of the plants are described. Plant preparation, dose and period of use are directly translated from Chakma Marma Pharmacopoeia in collaboration with tribal professional practitioners and bilingual tribal guides of Khagrachari Hill District, Chittagong Hill Tracts of Bangladesh

Documentation of some medicinal plants used by the tribal communities of chittagong Hill tracts of Bangladesh for treatment of skin diseases

The Tribal communities of The Chittagong Hill Tracts, Bangladesh use a lot of medicinally active plants to treat various diseases. The investigation revealed that, the Tribal communities in the Chittagong Hill Tracts use 41 plant species belonging to 27 families for treatment of skin diseases. These plants are being used by the Tribal communities for hundreds of years. All plants were collected and identified by the authors with the help of the Tribal communities, books, photographs and comparing identified herbarium. Short diagnostic descriptions of the plants, botanical name, family name, Bengali and English names, botanical features and dose information are described

Cardiovascular changes in patients with type I diabetes with and without autonomic dysfunction

Diabetic complications - either microvascular or macrovascular - represent a major cause of morbidity and mortality in diabetic patients[1]. Cardiovascular autonomic neuropathy is one of the complications of type I diabetes mellitus. It may lead to life discomfort or even it may be the direct cause of death in diabetic patients. Early detection of cardiovascular autonomic neuropathy is of major clinical interest that could lead to a more intensive supervision of diabetic patients.[2] Cardiovascular autonomic neuropathy induces different functional cardiac changes, especially a reduction in left ventricular contractility and changes in ventricular repolarization.[3] This study was designed to estimate the prevalence of cardiovascular autonomic neuropathy among a group of children with type I diabetes mellitus, to assess the cardiac function in the same group of patients by echocardiography and to relate the abnormalities to the duration of diabetes, glycemic control and other risk factors