The Effect of Chest Physiotherapy After Bariatric Surgery on Pulmonary Functions, Functional Capacity, and Quality of Life.

PURPOSE: The aim of this study was to investigate the effect of chest physiotherapy (CP) applied to patients undergoing bariatric surgery on pulmonary functions, dyspnea levels, functional capacity, and quality of life. METHODS: The patients were randomized and divided into two groups each comprising 74 patients. CP and mobilization was applied to the patients in the first group, and only mobilization was applied to the patients in the second group. The treatment of the patients was started on the first postoperative day and continued until the postoperative 4th day. CP and mobilization were applied twice a day, 8 times in total. The following parameters were evaluated: arterial blood gas, oxygen saturation, respiratory function test for pulmonary functions, pulmonary artery pressure for pulmonary hypertension, Borg dyspnea score for severity of dyspnea, 6-min walk test(6MWT) for functional capacity, Nottingham Health Profile for quality of life. RESULTS: The mean age of the patients was 38.00 ± 7.04 years. Compared with pretreatment and posttreatment dyspnea score, 6MWT, oxygen saturation, vital capacity, tidal volume, PEF, pulmonary arterial pressure, and quality of life were significantly higher in patients who underwent CP compared with the control group(p = 0.008, 0.004, 0.005, 0.027, 0.029, 0.028, 0.007, 0.012).There was a significant improvement in all the parameters of the patients who underwent chest physiotherapy when compared with the intragroup comparisons, whereas in the control group, only 6MWT and quality of life score showed a significant improvement in the border (p = 0.037, 0.046). CONCLUSION: Postoperative CP applied to patients who had bariatric surgery showed that the patients improved their respiratory functions, regulated arterial blood gases, increased oxygen saturation, functional capacity and quality of life, and decreased dyspnea levels.

Effects of the Three-Dimensional Vision System on Surgical Performance, Muscular Fatigue, and Pain During Urologic Laparoscopic Tasks: Results of Objective Assessments and a Mini Questionnaire Survey.

BACKGROUND: The three-dimensional (3D) vision system was released to the medical market to improve laparoscopic outcomes. We analyzed the muscular pain and fatigue, and the performance outcomes after several laparoscopic urologic tasks were completed with the 3D vision system. METHODS: A total of 49 participants with different surgical expertise levels were enrolled in the study. All the participants performed some laparoscopic urologic tasks using two-dimensional (2D) and 3D vision systems separately. A mini questionnaire survey was also completed by the participants. The duration and quality of the tasks and the muscular fatigue and pain were objectively determined. All the parameters were compared between the 2D and 3D systems. RESULTS: Although all the tasks were completed in significantly shorter times with the 3D vision system in each expertise level, maximal shortening was seen in the residents. The overall quality scores were significantly higher with the 3D vision system. However, a maximal increase was seen in the residents. The muscular pain of the participants was lower with 3D vision system. The overall handgrip strength significantly increased from 41.2 to 42.4 kg after the tasks with the 3D vision system, but the difference was significant in only the residents. Twenty-seven participants (56.2%) declared that the 3D system contributed to their performance, and most of the participants (83.3%) preferred the 3D system in the questionnaire survey. CONCLUSION: 3D technology may be effective for use in urologic laparoscopic training programs of novice surgeons. It may also contribute to the skills of specialists and experts, shortening the surgical time, which may decrease the surgical morbidity.

Fibroblast Transplantation Results to the Degenerated Rabbit Lumbar Intervertebral Discs.

BACKGROUND: Our study is an analysis of the histological and radiological changes in degenerated lumbar intervertebral discs, after transplantation of fibroblasts in rabbits. With that study we aimed to show the viability of the fibroblasts injected to the degenerated discs, and observe their potential for further studies. METHOD: The apoptosis of the cell is one of the factors at the disc degeneration process. Fibroblasts may act as mesenchymal stem cells at the tissue to which they are injected and they may replace the apoptotic cells. The nucleus pulposus of the discs from eight rabbits were aspirated under scopic guidance to induce disc degeneration. RESULTS: One month later, cultured fibroblasts, which had been taken from the skin, were injected into the disc. The viability and the potential of the injected cells for reproduction were studied histologically and radiologically. Cellular formations and organizations indicating to the histological recovery were observed at the discs to which fibroblasts were transplanted. The histological findings of the discs to which no fibroblasts were transplanted, did not show any histological recovery. Radiologically, no finding of the improvement was found in both groups. The fibroblasts injected to the degenerated discs are viable. CONCLUSION: The findings of improvement, observed in this study, suggest that fibroblast transplantation could be an effective method of therapy for the prevention or for the retardation of the degenerative disease of the discs.