Differences of diaphragmatic muscle contraction between female patients with chronic neck pain and asymptomatic controls: A case-control study based on ultrasonography.

BACKGROUND: Recent systematic reviews and meta-analyses show that individuals with chronic neck pain (CNP) have altered respiratory muscle strength and abnormal respiratory mechanics. However, no study has investigated the diaphragmatic function in individuals with CNP compared to asymptomatic peers. OBJECTIVES: This study aimed to compare the respiratory muscle strength and diaphragmatic function between patients with CNP and asymptomatic controls. DESIGN: Observational, case-control study. METHODS: A total of 25 women with CNP and 23 asymptomatic controls participated in this case-control study. The visual analog scale and neck disability index were used to assess the pain and disability characteristics of the CNP group. Maximum inspiratory and expiratory pressures (MIP and MEP) were measured to determine respiratory muscle strengths. The diaphragmatic function (muscle thickness in deep inspiration, Tins; and at the end of calm expiration, Texp; muscle thickness change, ΔT; contraction ratio, CR) were evaluated by two-dimensional ultrasonography. RESULTS: The MIP (p = 0.001, d = 1.11), ΔT (p = 0.033, d = 0.63), and CR (p = 0.012, d = 0.75) of the diaphragm were found significantly reduced in the CNP group compared to asymptomatic controls whilst MEP, Tins, and Texp of the diaphragm were similar between study groups (p > 0.05). The intensity of neck pain was moderately correlated with MIP (r = -0.48), Tins (r = -0.46), and ΔT (r = -0.42) while NDI (r = -0.42) had a moderate correlation with Tins (p < 0.05). CONCLUSION: The present findings revealed that women with CNP have altered diaphragmatic function. Thus, screening and targeting diaphragm may improve the rehabilitation process in CNP. However, further experimental studies regarding the efficacy of breathing exercise approaches are needed.

Comparison of the Characteristics of Brucella Patients Diagnosed With Blood Culture Positivity and/or Serology.

PURPOSE: The aim of this study is to investigate and compare the clinical, laboratory, and treatment response characteristics of patients diagnosed with positive culture or serology. In this way, we wanted to assess the validity of serological diagnosis. MATERIALS AND METHODS: The study was designed as a retrospective cross-sectional study between January 2010 and 2020. Patients with clinical and laboratory findings of acute/subacute brucellosis, patients with positive serological tests, and patients with growth of Brucella spp. in blood culture were included in the study. The patients were divided into three groups: Group 1 - Wright agglutination test result ≥ 1/160 and Brucella spp. growth in blood culture; Group 2 - Wright agglutination test result ≥ 1/160 and no growth in blood culture; and Group 3 - Brucella spp. growth in blood culture and negative serological test. These three groups were retrospectively evaluated for clinical features, laboratory parameters, areas of involvement, treatment options, and treatment response. RESULTS: We identified 294 patients diagnosed with brucellosis. Blood cultures were obtained from all patients, and Brucella spp. was detected in 40 patients (13.6%). There were 35 patients in Group 1, 254 patients in Group 2, and five patients in Group 3. When examining patients with symptoms, only fever showed a difference between the groups, which was significantly higher in Group 1. Laboratory investigations of the C-reactive protein (CRP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels of the patients showed significant differences between the groups; these parameters were significantly higher in Group 1. CONCLUSION: No significant difference was found in terms of treatment response and prognosis between patients with and without blood culture growth who were clinically compatible with acute/subacute brucellosis as diagnosed by serological methods. Therefore, serological tests are reliable methods for the diagnosis of brucellosis in cases where blood culture is inconclusive.

Speciation and Ammonia-Induced Precipitation of Neptunium and Uranium Ions.

The pH evolution and corresponding changes in the UV-Vis-NIR absorption spectra of oxygenated neptunium (NpO2+ and NpO22+) and uranyl ions (UO22+) in nitric acid are investigated during titration with an aqueous NH3 solution. The speciation and precipitation regimes between acidic (pH 1.5) and alkaline (pH 10) conditions at room temperature are discussed to assess the suitability of Np(V) or Np(VI) in sol-gel conversion processes for fuel target fabrication. Under the applied experimental conditions, Np(V) hydrolyzes and precipitates into the insoluble hydroxide NpO2OH only above pH values 7.5 and an increase up to pH 10.0 is required to precipitate quantitatively. Np(VI) displays changes in the coordination environment of NpO22+ ions in the pH interval 1.6-4.0, similar to what is observed for U(VI). Precipitation into NpO3·H2O or other hydroxide compounds takes place between pH 4.0 and 5.9, which overlaps largely with precipitation of ammonium diuranate species from the U(VI) solution. The use of concentrated NH3 aqueous solution, as commonly used in the external gelation process, will allow to quantitatively precipitate both Np(V) and Np(VI) species. Internal gelation process conditions, on the other hand, seem incompatible with the high pH required to precipitate Np(V) completely. For fabricating mixed-oxide (U,Np) targets using sol-gel conversion, a feed broth containing Np(VI) and U(VI) will be required to achieve homogeneous gelation.

Investigating fear of childbirth in pregnant women and its relationship between anxiety sensitivity and somatosensory amplification.

The causes of fear of childbirth and the factors that affect it are not fully explained. The aim of this study was to investigate the relationship between fear of childbirth in pregnant women and anxiety sensitivity and somatosensory amplification. The study included 100 healthy pregnant women who were admitted to the Obstetrics and Gynaecology Department of a tertiary hospital in Turkey at 28-40 weeks of gestation. Sociodemographic Data Form, Anxiety Sensitivity Index (ASI), Somatosensory Amplification Scale (SSAS), Spielberger State and Trait Anxiety Inventory (STAI), Wijma Expectancy/Experience Scale (W-DEQ) were applied to all cases. The mean age of the pregnant women included in the study was 29.20 ± 6.17 years, and 82% of them had high fear of childbirth. It was determined that factors such as age, education status, occupation, prior pregnancy experience, the number of pregnancies, miscarriage history, and abortion experience had no significant effect on the fear of childbirth. It was observed that there was a weak positive correlation between the fear of childbirth and the anxiety sensitivity and the amplification of somatosensory symptoms. According to the findings of our study, as the fear of childbirth increases, anxiety sensitivity, and somatosensory amplification increase. For this reason, it is crucial to carefully monitor prenatal anxiety, somatosensory amplification and the fear of childbirth of pregnant women with state-related concerns.IMPACT STATEMENTWhat is already known on this subject? Fear of childbirth or what is historically referred to as tokophobia is generally defined as a fear of severe birth and fear of pathological birth. The causes of fear of childbirth are stated as biological reasons, psychological reasons and lack of social support. However, it is not possible to explain the causes of the fear of childbirth in pregnant women and the risk factors affecting them. Similarly, fear of childbirth in individuals with anxiety sensitivity and amplification of somatosensory symptoms has not been adequately investigated.What do the results of this study add? In this study, we aimed to contribute to the related literature by examining the relationship between fear of childbirth in pregnant women and anxiety sensitivity and amplification of somatosensory symptoms. It was observed that there was a weak positive correlation between the fear of childbirth and the sensitivity of anxiety and the amplification of somatosensory symptoms. According to the findings of our study, as the fear of childbirth increases, anxiety sensitivity, and somatosensory amplification increase.What are the implications of these findings for clinical practice and/or further research? For this reason, it is crucial to carefully monitor the pregnants who have prenatal anxiety sensitivity, somatosensory amplification, and state-continuous anxiety. Due to insufficient number of studies related to the subject, extensive sample studies on the subject are needed.