Mechanistic Insights on Salicylic Acid-Induced Enhancement of Photosystem II Function in Basil Plants under Non-Stress or Mild Drought Stress.

Photosystem II (PSII) functions were investigated in basil (Ocimum basilicum L.) plants sprayed with 1 mM salicylic acid (SA) under non-stress (NS) or mild drought-stress (MiDS) conditions. Under MiDS, SA-sprayed leaves retained significantly higher (+36%) chlorophyll content compared to NS, SA-sprayed leaves. PSII efficiency in SA-sprayed leaves under NS conditions, evaluated at both low light (LL, 200 µmol photons m-2 s-1) and high light (HL, 900 µmol photons m-2 s-1), increased significantly with a parallel significant decrease in the excitation pressure at PSII (1-qL) and the excess excitation energy (EXC). This enhancement of PSII efficiency under NS conditions was induced by the mechanism of non-photochemical quenching (NPQ) that reduced singlet oxygen (1O2) production, as indicated by the reduced quantum yield of non-regulated energy loss in PSII (ΦNO). Under MiDS, the thylakoid structure of water-sprayed leaves appeared slightly dilated, and the efficiency of PSII declined, compared to NS conditions. In contrast, the thylakoid structure of SA-sprayed leaves did not change under MiDS, while PSII functionality was retained, similar to NS plants at HL. This was due to the photoprotective heat dissipation by NPQ, which was sufficient to retain the same percentage of open PSII reaction centers (qp), as in NS conditions and HL. We suggest that the redox status of the plastoquinone pool (qp) under MiDS and HL initiated the acclimation response to MiDS in SA-sprayed leaves, which retained the same electron transport rate (ETR) with control plants. Foliar spray of SA could be considered as a method to improve PSII efficiency in basil plants under NS conditions, at both LL and HL, while under MiDS and HL conditions, basil plants could retain PSII efficiency similar to control plants.

Modulation of Photosystem II Function in Celery via Foliar-Applied Salicylic Acid during Gradual Water Deficit Stress.

Water deficit is the major stress factor magnified by climate change that causes the most reductions in plant productivity. Knowledge of photosystem II (PSII) response mechanisms underlying crop vulnerability to drought is critical to better understanding the consequences of climate change on crop plants. Salicylic acid (SA) application under drought stress may stimulate PSII function, although the exact mechanism remains essentially unclear. To reveal the PSII response mechanism of celery plants sprayed with water (WA) or SA, we employed chlorophyll fluorescence imaging analysis at 48 h, 96 h, and 192 h after watering. The results showed that up to 96 h after watering, the stroma lamellae of SA-sprayed leaves appeared dilated, and the efficiency of PSII declined, compared to WA-sprayed plants, which displayed a better PSII function. However, 192 h after watering, the stroma lamellae of SA-sprayed leaves was restored, while SA boosted chlorophyll synthesis, and by ameliorating the osmotic potential of celery plants, it resulted in higher relative leaf water content compared to WA-sprayed plants. SA, by acting as an antioxidant under drought stress, suppressed phototoxicity, thereby offering PSII photoprotection, together with enhanced effective quantum yield of PSII photochemistry (ΦPSII) and decreased quantity of singlet oxygen (1O2) generation compared to WA-sprayed plants. The PSII photoprotection mechanism induced by SA under drought stress was triggered by non-photochemical quenching (NPQ), which is a strategy to protect the chloroplast from photo-oxidative damage by dissipating the excess light energy as heat. This photoprotective mechanism, triggered by NPQ under drought stress, was adequate in keeping, especially in high-light conditions, an equal fraction of open PSII reaction centers (qp) as of non-stress conditions. Thus, under water deficit stress, SA activates a regulatory network of stress and light energy partitioning signaling that can mitigate, to an extent, the water deficit stress on PSII functioning.

Laparoscopic removal of heterotopic cesarean scar pregnancy.

OBJECTIVE: To present the laparoscopic management of heterotopic cesarean scar pregnancy and discuss other treatment options. DESIGN: Surgical video article. The Institutional Ethics Committee approved the video reproduction. SETTING: Tertiary referral to a university hospital PATIENT: A 29-year-old woman with spontaneous heterotopic cesarean scar pregnancy presented for vaginal spotting. Ultrasound revealed two gestational sacs at 7 weeks and 6 days of gestation with fetal cardiac activity. One sac was in a normal intrauterine (IU) location, and the other was in a previous cesarean section scar. INTERVENTIONS: Scar pregnancy was excised laparoscopically, preserving IU pregnancy. No additional measures were taken to reduce bleeding. The bladder was filled with 150 cc isotonic to determine its boundaries. The peritoneum was dissected away from the cervix. After removing the ectopic pregnancy material, the myometrial defect was excised. The uterine wall was closed in three layers using 2-0 V-Loc sutures. MAIN OUTCOME MEASURES: Ongoing IU pregnancy after laparoscopic removal of cesarean scar pregnancy and term delivery. RESULTS: The procedure was completed in 67 minutes. Total blood loss was <100 cc. The ongoing pregnancy follow-up was uneventful. Delivery was planned for the 37th-38th weeks. Although instructed to visit immediately after experiencing pain, the patient arrived after the 38th week and reported having pain for 2 days. During the cesarean section, a rupture was observed at the previous incision site, which was fortunately incomplete. A healthy male infant (weight, 3,210 g; Apgar score, 9/10) was delivered. CONCLUSIONS: The most common approach for heterotopic scar pregnancy is embryo reduction with potassium chloride injection. However, the mass persists in the scar area, resulting in complications associated with excessive bleeding during a cesarean section in approximately half of cases. Moreover, almost all published cases of embryo reduction resulted in premature births before week 36. Considering the present case, laparoscopic surgery may be appropriate for managing heterotopic cesarean scar pregnancy by preserving IU pregnancy.

Salivary and serum asprosin hormone levels in the 2018 EFP/AAP classification of periodontitis stages and body mass index status: a case-control study.

OBJECTIVES: A newly discovered adipokine known asprosin in serum and saliva in patients with periodontitis has not been explored. The aim of this study was to determine the relationship between serum and saliva asprosin levels and periodontitis by grouping it according to body mass index (BMI). MATERIALS AND METHODS: The study was conducted on 65 systemically healthy patients (35 patients with periodontitis (periodontitis group), 30 periodontally healthy patients (control group)). In each patient, age, BMI, and clinical periodontal parameters (plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL)) were evaluated. Statistical analyses were conducted utilizing the Student t-test, ANOVA, and Pearson correlation analysis. For the significance level of the tests, p<0.05 were accepted. RESULTS: The serum and saliva were collected to assess asprosin levels. Both the serum and saliva asprosin levels were statistically significantly higher in the periodontitis group than in the control group (p<0.001). Saliva and serum asprosin levels were directly proportional to the severity of the periodontal disease (p<0.05). Asprosin levels were higher in patients with a higher BMI (p<0.05). CONCLUSION: Asprosin levels were increased in periodontitis, and even a high BMI status apparently affected the levels of this hormone. It is thought that asprosin may be a useful biomarker in evaluating the relationship between periodontal status and BMI. CLINICAL RELEVANCE: Asprosin may be a useful parameter as a biomarker of periodontal disease progression. However, BMI status should be considered when evaluating asprosin levels in patients with periodontitis.

Estimating and minimizing movement artifacts in surface electromyogram.

While recording surface electromyography [sEMG], it is possible to record the electrical activities coming from the muscles and transients in the half-cell potential at the electrode-electrolyte interface due to micromovements of the electrode-skin interface. Separating the two sources of electrical activity usually fails due to the overlapping frequency characteristics of the signals. This paper aims to develop a method that detects movement artifacts and suggests a minimization technique. Towards that aim, we first estimated the frequency characteristics of movement artifacts under various static and dynamic experimental conditions. We found that the extent of the movement artifact depended on the nature of the movement and varied from person to person. Our study's highest movement artifact frequency for the stand position was 10 Hz, tiptoe 22, walk 32, run 23, jump from box 41, and jump up and down 40 Hz. Secondly, using a 40 Hz highpass filter, we cut out most of the frequencies belonging to the movement artifacts. Finally, we checked whether the latencies and amplitudes of reflex and direct muscle responses were still observed in the highpass-filtered sEMG. We showed that the 40 Hz highpass filter did not significantly alter reflex and direct muscle variables. Therefore, we recommend that researchers who use sEMG under similar conditions employ the recommended level of highpass filtering to reduce movement artifacts from their records. However, suppose different movement conditions are used. In that case, it is best to estimate the frequency characteristics of the movement artifact before applying any highpass filtering to minimize movement artifacts and their harmonics from sEMG.

Total, free, and bioavailable 25-hydroxyvitamin D levels in patients with periodontitis (stage III): a case-control study.

OBJECTIVE: The aim of this study was to investigate the relationship between total, free and bioavailable 25-hydroxyvitamin D levels, and periodontitis. MATERIALS AND METHODS: Thirty-nine patients with periodontitis diagnosis and 44 healthy participants were included in this study. 25-Hydroxyvitamin D, vitamin D-binding protein, procalcitonin, and albumin levels were measured from the serum samples obtained. Free and bioavailable 25-hydroxyvitamin D levels were calculated. Total, free, and bioavailable 25-hydroxyvitamin D levels were compared between the healthy control and periodontitis groups. The association of total 25 (OH)D levels with periodontitis was tested through univariate analysis and multivariate logistic regression. RESULTS: Total 25-hydroxyvitamin D, bioavailable 25-hydroxyvitamin D, and free 25-hydroxyvitamin D levels were significantly lower in the periodontitis group than in the healthy control group (p < 0.001). In the logistic regression analysis, a significant correlation was observed between total 25-hydroxyvitamin D and periodontitis (p<0.001). CONCLUSION: Our study shows that there is a relationship between total, free and bioavailable 25-hydroxyvitamin D levels and periodontitis. In addition, it has been shown that the determination of free and bioavailable 25-hydroxyvitamin D levels does not provide additional advantages in terms of the relationship between periodontitis and vitamin D. CLINICAL RELEVANCE: In this case-control study, we examined the relationship between total, free and bioavailable 25-hydroxyvitamin D and periodontitis. We found lower total, free, and bioavailable 25-hydroxyvitamin D levels in periodontitis patients. It was also found that vitamin D-binding protein may be an important biomarker in the identification of various forms of periodontal disease. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT05343273.

Association of Endometrioma Size with Serum Anti-mullerian Hormone.

OBJECTIVE: To evaluate the relationship between the size of endometrioma and serum Anti-mullerian hormone (AMH). STUDY DESIGN: A Descriptive study. PLACE AND DURATION OF STUDY: This study was conducted at the Bagcilar Training and Research Hospital, Istanbul, Turkey, from January 2015 to January 2020. METHODOLOGY: Healthy women of reproductive age, who were found to have unilateral endometrioma in ultrasonography, were included in the study group. There were 82 female patients with unilateral endometrioma in the study group and 96 healthy female patients with male factor infertility in the control group. Women with autoimmune disease, a history of pelvic infection or surgery, polycystic ovary syndrome, pregnancy, those undergoing infertility treatment, family history of premature ovarian failure, and those with atypical or suspected endometrioma were excluded. Age, gravida, serum AMH value, and endometrioma size of the study and control groups were recorded. In addition, the endometrioma group was divided into 2 groups with a cut-off size of greater or less than 40 mm. AMH values ​​were evaluated in these two groups. RESULTS: AMH values ​​of women with endometrioma were significantly lower than the control group (2.03 ng/ml and 3.87 ng/ml, respectively, p<0.001). When the relationship between endometrioma size (greater than 40 mm and less than 40 mm) and AMH was examined, no statistically significant difference was found among serum AMH values (1.89 ng/ml and 2.07 ng/ml, respectively, p=0.65). CONCLUSION: The presence of endometrioma was associated with lower AMH suggesting lower ovarian reserve, but endometrioma size was not associated with significant difference in the AMH values. KEY WORDS: Endometrioma, AMH, Ovarian reserve, Endometrioma size.

Laurus nobilis L. Essential Oil-Loaded PLGA as a Nanoformulation Candidate for Cancer Treatment.

The aim of this study was to obtain essential oil (LNEO) from the Laurus nobilis L. plant, and to prepare LNEO-loaded poly lactic-co-glycolic acid (PLGA) nanoparticles (NPs) as an approach in cancer treatment. The components of the obtained LNEO were analyzed using GC-MS. The LNEO-NPs were synthesized by the single-emulsion method. The LNEO-NPs were characterized using UV-Vis spectrometry, Dynamic Light Scattering (DLS), Scanning Electron Microscopy (SEM), and a DNA binding assay, which was performed via the UV-Vis titration method. According to the results, the LNEO-NPs had a 211.4 ± 4.031 nm average particle size, 0.068 ± 0.016 PdI, and -7.87 ± 1.15 mV zeta potential. The encapsulation efficiency and loading capacity were calculated as 59.25% and 25.65%, respectively, and the in vitro drug release study showed an LNEO release of 93.97 ± 3.78% over the 72 h period. Moreover, the LNEO was intercalatively bound to CT-DNA. In addition, the mechanism of action of LNEO on a dual PI3K/mTOR inhibitor was predicted, and its antiproliferative activity and mechanism were determined using molecular docking analysis. It was concluded that LNEO-loaded PLGA NPs may be used for cancer treatment as a novel phytotherapeutic agent-based controlled-release system.

The efficacy of robot-assisted training for patients with upper limb amputations who use myoelectric prostheses: a randomized controlled pilot study.

The aim of this pilot study was to investigate whether a movement therapy robot can improve skills in using a myoelectric prosthesis by patients with upper limb amputations. This prospective randomized, controlled study included a total of eleven patients with upper limb amputations who use myoelectric prostheses. The patients were randomized into a robot-assisted exercise group (n = 6) and a control group (n = 5). The robot group received robot-assisted training. No training program was provided to the control group. The outcome measure was kinematic data (A-goal hand-path ratio, A-goal deviation, A-goal instability and A-move) evaluated by the Armeo®Spring movement therapy robot. Significant improvements were noted in the A-goal hand-path ratio; A-goal deviation and A-goal instability in the robot group after treatment while compared with control group. No significant changes in A-move scores. We concluded that robot-assisted training may improve myoelectric prosthesis use skills in patients with upper limb amputation.

A new method to determine stretch reflex latency.

INTRODUCTION/AIMS: Motion artifact signals (MASs) created by the relative movement of intramuscular wire electrodes are an indicator of the mechanical stimulus arrival time to the muscle belly. This study proposes a method that uses wire electrodes as an intramuscular mechanosensor to determine the stretch reflex (SR) latency without lag time. METHODS: Gastrocnemius SR was induced by tendon tap, heel tap, and forefoot tap. The MASs recorded by intramuscular wire electrodes were extracted from background electromyographic activity using the spike-triggered averaging technique. Simultaneous recordings were obtained from multiple sites to validate the MAS technique. RESULTS: Using intramuscular wire electrodes, the MASs were successfully determined and extracted for all stimulus sites. In the records from the rectus femoris, MASs were also successfully extracted; thus, the reflex latency could be calculated. DISCUSSION: Wire electrodes can be used as an intramuscular mechanosensor to determine the mechanical stimulus arrival time to the muscle belly.

Sarcopenia in patients following stroke: an overlooked problem.

Our aim was to investigate the prevalence of sarcopenia in stroke patients, the relationship between sarcopenia detected with different low muscle mass (LMM) adjustment methods, and between stroke-related parameters. Eighty-one patients with chronic stroke who underwent inpatient rehabilitation were included. Spasticity was evaluated by modified Ashworth scale, Brunnstrom staging approach was used for motor function evaluation, physical independence was evaluated using Barthel Index, quality-of-life was evaluated by EQ-5D-3L, and the Cumulative Illness Rating Scale was used to measure multimorbidity. Muscle strength was evaluated by handgrip strength, muscle quantity through a bioelectric impedance analysis, and physical performance by gait speed and short physical performance battery. LMM was calculated through two different methods: Skeletal muscle mass (SMM)/height2, and SMM/BMI. For the definition of sarcopenia, we followed the EWGSOP2 recommendation. Associated sarcopenia factors were predicted by multivariate binary logistic regression analysis. The prevalence of probable sarcopenia was 32.1%. The prevalence of confirmed/sarcopenia when LMM was adjusted for BMI was higher than when adjusted for height2 (16 and 1.2%, respectively). Age was significantly higher in those with probable sarcopenia (P = 0.006). Stroke duration was shorter in those with probable or confirmed sarcopenia (P = 0.004, P < 0.001, respectively). EQ-5D-3L scores were significantly lower in those with confirmed sarcopenia (P = 0.050). The strongest associated factor with confirmed sarcopenia was stroke duration (OR: 0.77; 95% CI, 0.618-0.965). This study suggests that prevalence of sarcopenia after a stroke is significantly high. LMM adjusted for BMI comes in front as the adjustment method for LMM after a stroke.

Effect of Home-Based Exercise Program on Physical Function and Balance in Older Adults With Sarcopenia: A Multicenter Randomized Controlled Study.

In the prospective, randomized, controlled multicenter study, 100 patients who were clinically diagnosed with sarcopenia were assigned to either a home-based exercise group or a control group. The home-based training program included exercises with gradually increasing intensity comprising posture, stretching and upper- and lower-extremity muscle-strengthening exercises, balance and coordination exercises, and gait training. Before and 3 months after the exercise program, all the patients were evaluated. The 6-min walking test and Berg Balance Scale scores increased significantly after 3 months in the home-based exercise group compared with the controls. There was also a significant decrease in timed up and go test scores and a significant improvement in quality of life in the exercise group compared with the control group. Our findings indicated that a home-based exercise program can have a positive effect on physical function, balance, and quality of life in patients with sarcopenia.

The Effect of Postamputation Pain and Phantom Sensations on Prosthesis Use, Body Image, and Quality of Life in Patients with Lower-extremity Amputation.

OBJECTIVE: The aim of this study was to investigate phantom limb pain (PLP), phantom limb sensation (PLS), and residual limb pain (RLP) after lower-extremity amputation and their effect on patients' effective prosthesis use, body image, and quality of life in prosthetic users. METHODS: Fifty-seven patients with lower-extremity amputation who used prosthesis for at least three months were included in our study. PLP, PLS, and RLP were evaluated via the prosthesis evaluation questionnaire (PEQ). Prosthetic use, locomotor skills, body image, quality of life were measured by administering Houghton scale, locomotor capabilities index (LCI), amputee body image scale (ABIS), and short-form health survey (SF-36), respectively. RESULTS: On the PEQ, 43.9% of the patients reported PLP, while 63.2% reported PLS, and 40.4% reported RLP. Correlation analyses revealed that as the frequency and duration of PLP increased, the patients' basic and advanced locomotor skills and quality of life decreased. When the intensity of PLP and the degree of distress caused by it increased, the patients' quality of life decreased, and when the frequency of PLS increased, the patients' emotional state worsened. When the intensity of PLS and the degree of bother caused by it increased, the patients' body image, emotional state, and social status worsened. There was no correlation between the rate, frequency, severity, or duration of RLP and scores on Houghton scale, LCI, ABIS, or SF-36. CONCLUSIONS: The presence of PLP and PLS decreases the use of prostheses and impairs body image and quality of life in prosthetic users.

Crocin attenuates oxidative and inflammatory stress-related periodontitis in cardiac tissues in rats.

BACKGROUND: Periodontitis, a chronic inflammatory disease affecting the supporting tissues around the teeth, causes significant inflammatory and oxidative changes in cardiac tissue. Crocin is the active constituent of Crocus sativus (saffron) which has antioxidant properties and is protective against cardiovascular disturbances. OBJECTIVES: The present study aimed to investigate the protective effects of crocin on periodontitis-induced oxidative/inflammatory cardiac degeneration in rats in vivo. MATERIAL AND METHODS: Thirty female Sprague Dawley rats were randomly divided into 3 groups: control group, periodontitis group (PD) and periodonditis plus crocin group (PD+Cr). Experimental periodontitis was induced by placing silk ligatures on the maxillary second molar teeth for 30 days. Afterward, crocin (100 mg/kg body weight/day) was administered to the PD+Cr group and saline was administered to the PD group and the control group for 15 days. The subjects were sacrificed on the 45th day. RESULTS: Histological and biochemical analyses demonstrated that inducing periodontitis caused obvious damage to cardiac tissues which was significantly ameliorated by crocin (p < 0.05). Significant improvements in bone resorption parameters (cross-linked C-telopeptide of type I collagen and bone alkaline phosphatase) were also observed in the PD+Cr group (p < 0.05). In addition, crocin caused significant reductions of malondialdehyde levels and total oxidant score while antioxidant levels (glutathione, superoxide dismutase, total antioxidant score, and catalase) were significantly higher in PD+Cr group (p < 0.05). CONCLUSIONS: This study reveals that periodontitis may cause oxidative damage in cardiac tissue and crocin improves periodontitis-induced degenerative changes in heart tissue, which is associated with its antioxidant properties.

The comparative effects of spinal manipulation, myofascial release and exercise in tension-type headache patients with neck pain: A randomized controlled trial.

OBJECTIVES: To evaluate the effects of two manual treatment methods on pain, disability, and pressure pain threshold (PPT) in tension-type headache (TTH) patients with and neck pain. METHODS: Forty-five patients with TTH were randomly assigned to one of three groups and received eight sessions treatment: manipulation plus exercise (manipulation), suboccipital inhibition plus exercise (myofascial release), and exercise only (control). Headache frequency, pain severity (VAS-headache, VAS-neck pain) and headache and neck disability (HIT-6 and NDI, respectively) were measured at baseline, posttreatment, and at the third month follow-up. PPT was also evaluated on the temporalis muscle. RESULTS: Manipulation group was statistically better than myofascial release group in terms of headache frequency, headache severity, and PPT scores. Also, manipulation group showed statistically significant improvements in all outcome criteria when compared control group. CONCLUSIONS: Manipulation and exercise, in addition to pharmacologic treatment in TTH patients with cervical dysfunction appear to be a promising approach.

Prevalence, etiology, and biopsychosocial risk factors of cervicogenic dizziness in patients with neck pain: A multi-center, cross-sectional study.

OBJECTIVES: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain. PATIENTS AND METHODS: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0±13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital Anxiety- Depression Scale [HADS]) were recorded. RESULTS: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p<0.001) significantly predicted the increased risk of dizziness in neck pain patients. Patient with dizziness due to MPS had lower dizziness severity scores (p=0.034) and milder impact of dizziness on QoL (p=0.005), lower DHI scores (p=0.004), shorter time to complete the TUG test (p=0.001) and higher BBS scores (p=0.001). CONCLUSION: Our findings suggest a significant impact of biopsychosocial factors on the likelihood and severity of dizziness and association of dizziness due to MPS with better clinical status.

Effects of microprocessor-controlled prosthetic knees on self-reported mobility, quality of life, and psychological states in patients with transfemoral amputations.

OBJECTIVE: This study aimed to determine the effects of the microprocessor-controlled prosthetic knee (MPK) joint on self-mobility, body perceptions, depression, and quality of life in patients with unilateral transfemoral amputations (TFAs). METHODS: Thirty consecutive patients (28 males, mean age=38.5 years, age range=22-57) who had previously used non-MPKs and who were approved to use swing and stance phase-control MPKs were included in this 12-week clinical study. Before the MPK use and after the three-month follow-up, prosthetic use and locomotor capabilities were evaluated using the Houghton Scale and the Locomotor Capabilities Index (LCI-5), respectively. Body perception was assessed using the Amputee Body Image Scale (ABIS). The depressive symptoms and quality of life were evaluated using the Beck Depression Inventory (BDI) score and the 36-Item Short- Form Health Survey (SF-36), respectively. RESULTS: After MPK use, statistically significant ameliorations were observed in all outcome measures. The basic and advanced LCI-5 increased from 26.7±2.2 and 24.8±5.2 to 27.6±1.2 (p=0.007) and 27±2.1 (p=0.004), respectively. Houghton scores improved from 9±1 to 10.3±0.8 (p=0.000). The ABIS and BDI scores decreased from 43.2±10.9 and 5.7±6.6 to 37.1±8.9 (p=0.000) and 3.8±4.5 (p=0.015), respectively. Also, the SF-36 physical function and vitality subscales increased from 71.2±24.0 and 75.5±14.6 to 85.6±16.6 (p=0.001) and 81.7±14.1 (p=0.015), respectively. CONCLUSION: MPK use provides significant improvements in the locomotor capabilities, quality of life, and activities of daily living to patients with TFAs as well as improves their body image perceptions and depressive symptoms. LEVEL OF EVIDENCE: Level III, Self controlled study.

Sleep quality in individuals with short-duration chronic spinal cord injury.

The aim of the study is to estimate the association between spinal cord injuries related medical factors and subjective sleep disturbance in individuals with short-duration chronic spinal cord injury. Seventy-nine individuals with traumatic spinal cord injuries were included in our study and evaluated using the Beck Depression Index for severity of depressive symptoms, Short-Form Health Survey for quality of life, Douleur Neuropathique 4 score for neuropathic pain severity, and the Pittsburgh Sleep Quality Index for subjective sleep disturbances in a tertiary rehabilitation center. Associated subjective sleep disturbance factors were predicted using multivariate binary logistic regression analysis. Subjective sleep disturbance frequency was 74.7 %, and significantly higher in individuals with paraplegia (P = 0.025, odds ratio, 9.74, 95% confidence interval, 1.21-78.14). Intermittent nighttime catheterization frequency and neuropathic pain severity levels were significantly higher in individuals with subjective sleep disturbance, and quality of life and depressive symptoms were significantly worse in individuals with subjective sleep disturbance. Poor-sleep quality was associated significantly with shorter spinal cord injury duration. The strongest associated factors for sleep disturbance were paraplegic involvement, severity of depressive symptoms (Beck Depression Index score), and quality of life (Short-Form Health Survey general health perceptions score) (odds ratio: 95% confidence interval, 29.75; 1.66-534.36, 1.47; 1.11-1.95, and 0.91; 0.85-0.97, respectively). Our study suggests that paraplegic involvement, low quality of life, and depressive mood are related to sleep disturbance in individuals with traumatic spinal cord injury.

A stimulus rate that is not influenced by homosynaptic post-activation depression in chronic stroke.

PURPOSE: To determine a stimulus rate that is not influenced by homosynaptic post-activation depression for H-reflex studies in patients with chronic spasticity. MATERIALS AND METHODS: A cohort of 15 chronic stroke patients with soleus spasticity who received inpatient treatment at our rehabilitation centre participated in this study. The effect of stimulus frequency related depression on H-reflex size was tested using four different stimulus rates (0.1, 0.2, 0.3 and 1 Hz). The affected sides stibial nerve was stimulated by a bipolar electrode. The H-reflex was recorded from the affected sideed sidee sidehe affected smine stimulus frequency related depression of H-reflex size, amplitude of the first H-reflex response (H1) was used as control and amplitude of the second H-reflex response (H2) as test. RESULTS: H2 amplitude for frequency of 1 Hz, 0.3 Hz, 0.2 Hz and 0.1 Hz were 74.3, 84.1, 85.5 and 92.7% of H1, respectively. Depression of H2 amplitude was statistically significant for 1 Hz, 0.3 Hz and 0.2 Hz (p < 0.001, p = 0.002, p = 0.024, respectively). CONCLUSIONS: Higher frequency stimulation of Ia afferents than 0.1 Hz induced a stimulus frequency-related depression of H-reflex size in patients with chronic spasticity. The optimal stimulus rate for H-reflex was found to be 0.1 Hz.