Efficiency of Associating Therapeutic Patient Education with Rehabilitation in the Management of Chronic Low Back Pain: A Randomized Controlled Trial / 가정의학회지

Background@#This study aimed to assess the benefits of associating rehabilitation with therapeutic patient education (TPE) to decrease fear-avoidance belief and pain and improve function in adults with chronic low back pain (CLBP). @*Methods@#This randomized controlled study included 100 patients with CLBP according to the CONSORT (Consolidated Standards of Reporting Trials) guidelines. The patients were divided into two teams: group A that participated in the TPE in association with rehabilitation and group B that received rehabilitation only. Pain and functional amelioration were assessed initially (T0) and at the end of the program (T1) using a visual analog scale at rest, work, and activity, and the Echelle d’Incapacité Fonctionnelle pour l’Évaluation des Lombalgies scale. Psychological and apprehension and avoidance assessments were also conducted, including the evaluation of depression, anxiety, fear-avoidance belief, and kinesiophobia using the Hospital Anxiety and Depression Scale, Fear-Avoidance Beliefs Questionnaire, and Tampa scale of kinesiophobia scale. @*Results@#The evaluation of progression initially (T0) and then at the end of the program (T1) revealed a significant reduction in pain at rest (P=0.00) and while working (P=0.00) and doing physical activity (P=0.03); a decrease in anxiety (P=0.03), fear-avoidance belief (P=0.03), and kinesiophobia (P=0.02); and an improvement in function (P=0.00) for patients in group A without amelioration of depression (P=0.15). Concerning group B, we identified a significant regression in pain at rest (P=0.001) and while working (P=0.03) and doing physical activity (P=0.00); depression (P=0.01); fear-avoidance beliefs (P=0.00); and kinesiophobia (P=0.002). Comparison between the groups revealed that associating TPE with rehabilitation resulted in a more significant improvement in function (P=0.00), anxiety (P=0.00), fear-avoidance belief (P=0.00), and kinesiophobia (P=0.00). @*Conclusion@#Associating TPE with rehabilitation improved function and reduced fear, false beliefs, and kinesiophobia of movement in patients with CLBP.

Prune belly syndrome: Approaches to its diagnosis and management.

Prune Belly syndrome (PBS) or Eagle-Barrett syndrome is an anatomo-radiological syndrome consisting of a complex and rare malformation characterized by the following triad of symptoms: deficiency of the abdominal muscles, malformations of the urinary tract, and bilateral cryptorchidism. The exact etiology is unknown, though PBS predominantly occurs in males. The clinical manifestations can vary widely, from stillbirth to renal and major respiratory dysplasia to almost normal children. The current study included a total of 3 patients. The findings included clinical characteristics, diagnostics, therapy, and clinical outcomes. All patients were diagnosed with congenital aplasia of the abdominal wall and a variety of urogenital malformations. Cryptorchidism and a mega-bladder were observed in 2 patients and distinctive renal malformations, such as renal dysplasia, were observed in 1 patient. Treatment varies but usually includes surgical management of symptoms. One patient required urgent urinary surgery; a vesicotomy was urgently performed due to anuria. These aspects explain the great diversity of opinions on the approach to this syndrome, but the severity of renal dysplasia is the main prognostic factor. Two newborns died a few days later due to severe renal failure. Despite these concerns, many patients with PBS report being in physical and mental health and having a good quality of life.

Optimisation of the recovery of carotenoids from tomato processing wastes: application on textile dyeing and assessment of its antioxidant activity.

The present study has been focused on the extraction of natural pigments from tomato industry waste. At first, different solvents and solvents mixture were compared to determine which one is the best for extracting carotenoids compounds from tomato by-products. A mixture of hexane and acetone gave the highest carotenoids extraction yield among the others examined. The extraction conditions were optimised using a five-level-five-factor central composite design. Under optimal conditions, solvent solid ratio 90, hexane percentage in the solvent mixture 60, extraction duration 50, number of extractions 4 and extraction temperature 35 °C, the yield of carotenoids was 80.7 µg/g. The coloured extract of tomato by-products was applied on textile fabrics to investigate the dyeing characteristics and antioxidant activities. The results indicate that extract can be applied on textile fabrics (wool, silk and polyamide) to produce coloured clothing with acceptable antioxidant properties.

Retinol and Alpha-tocopherol in the Colostrum of Lactating Tunisian Women Delivering Prematurely: Associations with Maternal Characteristics.

BACKGROUND: This study aims to assess vitamin A and E concentrations in the premature colostrum of lactating Tunisian women and to identify maternal characteristics that may affect these concentrations. METHODS: Human colostrum was obtained from 105 mothers who gave birth prematurely in the Centre for Maternity and Neonatology of Tunis (Tunisia). Retinol and alpha-tocopherol were analyzed in the colostrum and in plasma by high-performance liquid chromatography. RESULTS: Retinol and alpha-tocopherol concentrations were 57.5 ± 50.1 µg/dL and 1222 ± 772 µg/dL in the colostrum, respectively, and 51.7 ± 20.0 µg/dL and 1351 ± 772 µg/dL in plasma, respectively. Concentrations of each vitamin in the colostrum were positively correlated with their respective concentrations in plasma (r = 0.415, p = 0.001 for retinol and r = 0.392, p = 0.003 for alpha-tocopherol). In multivariate analysis, colostrum vitamin A was associated with plasma vitamin A and preeclampsia, while colostrum vitamin E was associated with plasma vitamin E, gestational age, and preeclampsia. CONCLUSION: In Tunisian women, colostrum vitamin A and E levels are close to the average values reported in the literature. The levels are too low to cover the needs of very low birth weight (VLBW) infants, particularly in women with plasma vitamin deficiencies, preeclampsia, or very premature delivery. Given the undeniable beneficial effects of human colostrum, whenever feasible, VLBW infants should be fed colostrum. Infant vitamin A and E requirements should be met by milk fortification or supplementation.

[The contribution of home based exercise programme in case of osteoarthritis of the knee]. / Interet d'un programme d'auto reeducation a domicile dans la prise en charge de la gonarthrose.

BACKGROUND: Knee Osteoarthritis is the most frequent articular disease. It may cause disability and handicap. AIM OF THE STUDY: to assess the effect of a home based exercice programme in a Tunisian population having knee osteoarthritis, associated with medical treatment and education. METHODS: Prospective study during three months, including 34 Tunisian patients with knee osteoarthritis. A clinical and functional assessment of the patients was made using respectively the visual analogic scale for the pain, the Lequesne index, the Functional Independence Measure and the womac function score for the function, the HAQ and SF 36 for the assessment of the quality of life. RESULTS: Visual analogic scores for pain were reduced in the exercise group. Lequesne index scores reduced significantly in the exercise group and were unchanged in the controls. Quality of life was greater in the exercise group compared with the controls. CONCLUSION: Home based exercise programme contributes to relieving pain, maintaining function and to ameliorate the quality of life of people having knee osteoarthritis.