The Effect of Graston Technique on Pain, Proprioception, Flexibility, and Disability in Patients with Chronic Non-specific Low Back Pain.

Background: Chronic non-specific low back pain (CNLBP) causes significant dysfunction in patients. The Graston Technique (GT) is a new intervention in pain management but there is a lack of evidence in the literature regarding its effectiveness in low back pain. Study Objective: This study aims to investigate the effect of GT added to exercise on pain, proprioception, disability, flexibility, and quality of life in individuals with CNLBP. Methods: This was a randomized controlled trial with a total of 30 CNLBP patients. Setting: Karabük University Training and Research Hospital, Turkey. Participants: Thirty patients (mean age = 38.46 ± 9.03 years) with CNLBP for at least 12 weeks were included in the study. The patients were randomly divided into two groups intervention and control. Intervention: Graston was applied three times a week for four weeks in addition to the exercise program in the intervention group, while only the exercise program was applied to the control group. Outcome measures: Pain intensity, pressure pain threshold, proprioception, flexibility, disability, and quality of life were evaluated at the beginning and end of the study. Results: Significant improvements in pain, disability, and quality of life were found in both the control and intervention groups (P < .05). There was an increase in flexibility and a decrease in proprioception deviation angles of 15° and 30° in the GT group (P < .05). The improvement in pain and disability in the intervention group was significant compared to the control group (P < .05). However, there was no significant difference between the groups regarding pressure pain threshold, flexibility, proprioception, and quality of life (P > .05). Conclusion: GT added to exercise in patients with CNLBP better reduces pain and disability, improves proprioceptive sense, and increases mobility and quality of life. GT may be used as a supportive treatment during the rehabilitation of CNLBP patients.

Gender Inequality in Leadership Positions in Neurology and Neurosurgery Journals and Societies.

OBJECTIVE: Gender inequalities persist in several areas of medicine, despite the growing number of female doctors and medical students. In this study, we aimed to reveal the gender inequality in the top journals' editorial boards and national societies' leadership positions in the field of neurology and neurosurgery. METHOD: This is a cross-sectional study that uses public information accessed through the internet via journals' and academic societies' public websites. The medical journals are selected and included according to their h5-index in the field of neurology and neurosurgery. We evaluated the gender composition of the editorial boards and academic societies' leadership positions. RESULTS: The female editorial board member ratio was 44.0% in the top 10 neurology journals. However, this ratio was significantly decreased to 29.7% in the other journals(P < 0.001). The top 10 neurosurgery journals had a female editorial board member ratio of 13.7%. This ratio was significantly decreased to 5.3% in the other 10 journals with lower h5-index(P < 0.001). A significantly lower number of female individuals are present in the editorial boards of the neurosurgery journals than in neurology(P < 0.001). The female president or delegate ratio was 19.3% in the World Federation of Neurology-affiliated countries, and it was 4% in the World Federation of Neurosurgical Societies-affiliated countries. CONCLUSIONS: In conclusion, there is a significant gender inequality among editorial board members. The position of neurosurgical societies and journals is far different than the field of neurology. Furthermore, these findings should be evaluated as a continuum of the gender inequality in the professional societies' executive boards and delegates representing the national academical community.

Levetiracetam treatment in an experimental model of sciatic nerve injury: A randomized controlled trial.

AIM: This study examined whether levetiracetam contributes to improvements in the axon-nerve damage in an experimental rat model. MATERIALS AND METHODS: Forty-eight Wistar albino adult male rats weighing 250-300 gr were randomized into six groups having or not having sciatic nerve damages and receiving different (none, 300 and 600 mg/kg) levetiracetam doses, and control (non-levetiracetam). Functional gait analysis and tissue sample analysis with the aid of light microscopy and hematoxylin-eosin dye were evaluated between the groups. Additionally, scanning electron microscopy (SEM) was used for the detailed examination of sciatic nerves. S-100 (Schwann cell marker) immunoreactivities in sciatic nerve was detected by immunohistochemistry. RESULTS: Sciatic functional index of the injured rats receiving 300 mg/kg levetiracetam was -65.59 ± 29.48 and -47.13 ± 21.36 in the 2nd and 6th weeks, respectively (p < 0.001). Also, IMA and TOS levels were significantly higher in the control group compared to those receiving levetiracetam (p = 0.001 and p < 0.001, respectively).      The most significant nerve regeneration was in the group injured and treated with LEV 600 mg/kg (p < 0.05). CONCLUSION: There was a significant improvement in the sciatic functional index, histopathological findings, and parameters showing tissue oxidant status in rats with sciatic nerve injury receiving levetiracetam treatment. Further investigations should be performed to evaluate the contribution of levetiracetam as a treatment modality in sciatic nerve injuries.

Can chlorogenic acid reduce oxidative stress and in an experimental spinal cord injury?

BACKGROUND: We aimed to investigate antioxidant and neuroprotective properties of chlorogenic acid in spinal cord injury (SCI). METHODS: Twenty-one rats were divided into three groups. Laminectomy was performed in group L (n=7), spinal cord trauma was induced in group T (n=7), and spinal cord trauma was induced and chlorogenic acid treatment was started in group C (n=7). Blood samples were collected to analyze baseline values and the 12th h, 1st day, 3rd day, and 5th day catalase, native thiol (NT), total thiol (TT), disulfide (SS), SS/TT, SS/NT, and NT/TT levels. Functional analysis with Basso-Beattie and Bresnahan scores was performed at the same time points. Total antioxidant status (TAS), total oxidative stress, oxidative stress index, and cyclooxygenase-2 (Cox-2) were examined in the spinal cord of rats euthanized on day 7; results were statistically analyzed. RESULTS: On day 7, catalase levels in Group C were significantly higher than baseline levels, whereas those in Group T were significantly lower than baseline levels; Group L showed no significant difference (p=0.008). SS values on day 7 were lower in Group T than in Groups C and L. Group C showed the lowest decrease in NT/TT level after trauma. On day 7, SS/TT level was high in Group T but stable in Groups C and L (p=0.04). Histopathological examination revealed significantly lower Cox-2 and TAS levels in Group C than in Group T (p=0.003, p=0.017, respectively). CONCLUSION: In this study, SCI was primarily examined through thiol-SS balance, and it was demonstrated by experimental models that chlorogenic acid has antioxidant and neuroprotective effects in SCI.

Anti-inflammatory and antioxidative effects of genistein in a model of spinal cord injury in rats.

Background: Neurological damage from spinal cord injury (SCI) is a result of primary mechanical injury and secondary damage from oxidative stress and neuroinflammation. Although genistein has been shown to have potent antioxidant and anti-inflammatory effects in studies of brain injury, its effect on secondary damage in SCI has remained unknown. Objective: To determine effects of genistein in a model of SCI in rats. Methods: We divided 21 rats evenly into 3 groups, a control group, in which only a laminectomy was performed; a trauma group in which SCI was induced; and a genistein group in which genistein was administered subcutaneously after SCI. The rats were assessed using a Basso-Beattie and Bresnahan functional score at the 12th hour and on the 1st, 3rd, 5th, and 7th days. Biochemical analyses were conducted at the same time points to determine the serum levels of catalase, ischemia-modified albumin (IMA), disulfide (SS), total thiol (TT), native thiol (NT), disulfide/total thiol (SS/TT), and native thiol/total thiol (NT/TT). Total oxidant and antioxidant capacity, and oxidative stress index were determined in spinal cord tissue obtained on the 7th day together with immunohistochemistry for cyclooxygenase-2 levels. Result: Catalase activity on the 7th day was significantly (P = 0.001) higher in the genistein-treated rats than in other groups, and IMA levels became stable earlier (3rd day) in the genistein group. SS values were significantly (P = 0.004) lower in the genistein group. NT/TT ratio were significantly (P = 0.049) higher in the genistein-treated rats on the 7th day. Conclusion: Genistein has antioxidant, anti-inflammatory, and protective effects in a model of SCI in rats and warrants further study.

Short-term effects of sleeve gastrectomy on weight loss and diastolic function in obese patients.

diac structure and function in obese patients. This study was an examination of the short-term effects of sleeve gastrectomy on body measurements and diastolic function. METHODS: A total of 41 consecutive obese patients who were scheduled to undergo a sleeve gastrectomy procedure were included in the study. Baseline body and echocardiographic measurements and the follow-up counterpart data, including total and excess weight loss percentages, were recorded. RESULTS: The mean age of the patients was 42.85+-11.47 years. Of the total, 21 (51.1%) patients were female. The mean body mass index (BMI) was 44.86+-5.62 kg/m². The mean duration of follow-up was 91.24+-44.48 days. The participants demonstrated statistically significant weight loss (26.64+-10.95 kg), as well as a decrease in BMI (8.84+-3.93 kg/m²) and body surface area (0.27+-0.12 m²). A significant increase in E velocity and mitral annular e velocity were observed, as well as a significant decrease in A velocity, E/e ratio, left ventricle mass, and left atrial volume (LAV). No significant correlations between the body measurement changes and changes in echocardiographic parameters were observed, with the exception that the excessive weight loss percentage was moderately correlated with a change in LAV. CONCLUSION: Sleeve gastrectomy led to a significant decrease in body weight and improved diastolic function parameters in the short-term. No significant relationship was found between the amount of weight loss and change in echocardiographic measurements.

NT-proBNP levels and mortality in a general population-based cohort from Turkey: a long-term follow-up study.

AIM: We investigated the relationship between NT-ProBNP and mortality in a general population-based cohort. METHODS & RESULTS: A total of 2021 out of 4650 participants from previously published HAPPY study were included. Mean follow-up was 84.5 ± 10.4 months. After adjusting for risk factors, high levels of LogNT-proBNP predicted all-cause death (HR: 3.23; 95% CI: 2.20-4.75; p < 0.001) and cardiovascular death (HR: 3.85; 95% CI: 2.37-6.26; p < 0.001). Regression analysis revealed that LogNT-proBNP was an independent predictor of all-cause death (HR: 2.85; 95% CI: 1.91-4.24; p < 0.001) and cardiovascular death (HR: 3.02; 95% CI: 1.84-4.95; p < 0.001). Conclusion: Our study showed that in long term follow-up, NT-proBNP is associated with increased all-cause and cardiovascular mortality.

Toxic effects of deltamethrin and λ-cyhalothrin on Xenopus laevis tadpoles.

This study evaluates the toxic effects of deltamethrin and λ-cyhalothrin on Xenopus laevis tadpoles after 168 h of exposure. The LC(50) of deltamethrin and λ-cyhalothrin at 168 h was calculated as the µg of active ingredient per liter (µg AI/L). According to these values, the LC(50) was 6.26 and 3.94 µg AI/L for deltamethrin and λ-cyhalothrin, respectively. Several enzymes were studied for early signs of intoxication following exposure to the pesticides for 24 h. Glutathione-S-transferase,carboxylesterase, and lactate dehydrogenase were inhibited by λ-cyhalothrin, and both pesticides inhibited acid phosphatase and aspartate aminotransferase. In contrast, acetylcholinesterase was activated by deltamethrin. The results suggest that X. laevis is sensitive to the pyrethroids that were tested, and the enzyme responses suggest that they are potential biomarkers for evaluating the toxic effect of pyrethroids on amphibians in environmental conditions.

The value of copper and zinc levels in hernia formation.

BACKGROUND: A defect in collagen metabolism is suspected to be one of the factors responsible for hernia formation. Lysyl oxidase is a copper-dependent enzyme in the process that provides for the structural integrity of collagen molecules, while zinc is essential for tissue maintenance. MATERIALS AND METHODS: In a prospective fashion, copper and zinc levels were measured in plasma and tissue specimens obtained from indirect (n=23), direct (n=20) and incisional hernia patients (n=19) and from healthy controls (laparoscopic cholecystectomy patients, n=15) by enzymatic colorimetric analysis. RESULTS: Groups were similar in age, comorbid diseases and body mass index. Whereas plasma levels of Cu and Zn in hernia and control patients were similar, and tissue levels were significantly lower in all hernia groups (especially the incisional hernia group) compared to controls (P<0·001). The incisional hernia group had significantly lower tissue copper levels than direct hernia patients and lower zinc levels than indirect hernia patients. CONCLUSIONS: Patients with all types of hernia, especially those with incisional hernias, have significantly lower tissue copper and zinc levels than control patients, despite having similar plasma levels. This finding might reflect excessive consumption or dysfunction of lysyl oxidase as playing a role in the aetiology of hernias.

Chronic cigarette smoking affects left and right ventricular long-axis function in healthy young subjects: a Doppler myocardial imaging study.

OBJECTIVE: Cigarette smoking is one of the major risk factors for coronary artery disease. However, chronic smoking has additional cardiac adverse effects independent of coronary atherosclerosis. We assessed the possible effects of chronic smoking on left and right ventricular (LV, RV) long-axis function using Doppler myocardial imaging (DMI). METHODS: Forty otherwise healthy smokers (mean age = 26+/-3 years) and 40 age-matched nonsmoking controls enrolled. Standard echocardiography protocol was followed by DMI. Peak systolic (V(S)), early (V(E)) and late diastolic (V(A)) velocities, peak systolic strain (S), and strain rate (SR) were measured from septal, lateral, and RV free walls. RESULTS: The baseline characteristics of two groups were similar. There were significant differences regarding Doppler myocardial velocity, S, and SR indices. Septal V(E) (P < 0.04), S (P < 0.0001) and SR (P < 0.02) were significantly reduced in smokers. For both lateral and RV free wall, V(S) (P < 0.003, P < 0.002, respectively), V(E) (P < 0.0001, P < 0.002, respectively), S (P < 0.0001 for both), and SR (P < 0.0001, P < 0.002, respectively) were significantly reduced in smokers. There were significant correlations between the amount of smoking and septal, lateral, and RV free wall S and SR. CONCLUSIONS: Chronic cigarette smoking causes alterations in long-axis systolic and diastolic functions of right and left ventricles in healthy young subjects. These changes can be accurately detected with Doppler myocardial velocity and SR imaging.