Modified tension band wiring technique by safely inserting K-wires in olecranon fracture osteosynthesis.

AIM: The present study presents the results of a modified tension band technique by surgically inserting K-wires to treat olecranon fractures. MATERIALS AND METHODS: The modification includes inserting the K-wires from the olecranon's upper tip and directing them to the ulna's dorsal surface. Twelve patients (three males and nine females) from 35 to 87 years of age were operated for olecranon fracture. After the standard approach, the olecranon was reduced and fixed with two K-wires from the tip to the dorsal ulnar cortex. Then the standard tension band technique was carried out. RESULTS: The average operating time was 17.25±3.08 min. No image intensifier was used since the wires' discharge was either visible, penetrating the dorsal cortex, or palpable through this area's skin. The time needed for the bone union was six weeks. In one female patient, the wires were cut out. This patient showed a satisfactory painless range of motion (ROM) of the elbow but did not achieve full ROM. However, this particular patient had a previous removal of the radial head, and she spent some time in the ICU intubated. The modified technique used here is as stable as the classic operation, and it is safe since there is no risk of injuring the nerves and vessels of the olecranon fossa. There is less or no need for an image intensifier. CONCLUSION: The outcomes of the present study are entirely satisfactory. However, many patients and randomized studies are needed to establish this modified tension band wiring technique.

Ketogenic Diet and Vitamin D Metabolism: A Review of Evidence.

The ketogenic diet (KD), which is low in carbohydrates and high to normal in fat and protein, has been traditionally used in epilepsy for the last 100 years. More recently, its application in obesity has been introduced. The present review aimed to investigate the effects of the KD on vitamin D. In total, five studies were done in healthy adults, one in subjects with type 2 diabetes, and seven in subjects with epilepsy that assessed the levels of vitamin D pre- and post-intervention. In the majority of studies, increases in circulating vitamin D were reported. The relationship of the KD with vitamin D was explained through several mechanisms: ketone bodies, macronutrient intake, the status levels of other fat-soluble vitamins, weight loss, changes in the hormonal milieu, and effects on gut microbiota. Moreover, potential nutrient-gene-related interactions were discussed. There is still a need to conduct multiple arm studies to compare the effects of the KD versus other diets and better decipher the particular effects of the KD on vitamin D levels and metabolism. Moreover, differentiations of the diet's effects according to sex and genetic makeup should be investigated to prescribe KDs on a more personalized basis.

Clinical Application of the Food Compass Score: Positive Association to Mediterranean Diet Score, Health Star Rating System and an Early Eating Pattern in University Students.

Nutrient profiling systems (NPS) assist consumers in food choices. Several scores based on NPS have been proposed, but data on their clinical application are lacking. The food compass score (FCS) is a newly developed NPS per 100 kcal (from 1 "least healthy" to 100 "most healthy"). We examined the correlations of FCS with other indices, food groups, and meal patterns. A total of 346 students of the University of the Peloponnese (269 women and 77 men) participated. Dietary habits were evaluated with a food frequency questionnaire, and FCS, health star rating score (HSR), and MedDietScore were computed. Meal and snack frequency consumption was reported. Principal component analysis revealed three meal patterns: "early eater" (breakfast, morning snack and afternoon snack), "medium eater" (lunch and dinner), and "late eater" (bedtime snack). Pearson partial correlations between ranked variables were used to test the correlation coefficients between FCS, other scores, and meal patterns, after adjustment for age, sex, BMI, and underreporting. FCS was positively correlated to HSR (rho = 0.761, p ≤ 0.001) in a multi-adjusted analysis. In the highest tertile of MedDietScore FCS was also positively correlated to MedDietScore (rho = 0.379, p < 0.001). The FCS was positively correlated with juices, high-fat dairy, vegetables, legumes, fruits, and olive oil and negatively correlated with sodas, alcoholic drinks, red meat, refined grains, sweets, fats other than olive oil, fast foods, and coffee. In addition, it related positively to the "early eater" pattern (rho = 0.207, p < 0.001). The FCS was associated with other quality indices and better nutritional habits, such as being an early eater.

Managing anxiety disorders with the neuro-biofeedback method of Brain Boy Universal Professional.

Background: Biofeedback is a non-invasive therapeutic method used independently or as an adjunct alongside other methods. Objective: This study evaluated the efficacy of biofeedback in the treatment of anxiety disorders. Methods: The sample consisted of 85 individuals with anxiety symptoms who underwent neuro-biofeedback therapy using Brain Boy Universal Professional. Anxiety was assessed by both the Hamilton Rating Scale for Anxiety (HAM-A) and Zung Anxiety Self-Assessment Scale (SAS) before the initiation and after completing ten sessions with biofeedback. Results: Before biofeedback and based on the HAM-A scale, 27.0% of the individuals showed mild to moderate anxiety, 16.5% medium anxiety, and 56.5% severe anxiety. After the completion of biofeedback, 90.6% of the individuals experienced mild to moderate anxiety, 5.9% medium anxiety, and 3.5% severe anxiety. Based on the SAS scale, before biofeedback, 42.4% of the individuals showed minimal to moderate anxiety, 21.2% marked severe anxiety and 36.5% most extreme anxiety. After the biofeedback, 68.2% of the individuals were within a normal range, 27.1% had minimal to moderate anxiety, 4.7% marked severe anxiety, and none in most extreme anxiety. Conclusion: Both HAMA-A and SAS scales showed statistically reduced anxiety levels after biofeedback therapy. Thus, the primary symptom of anxiety can be addressed by the biofeedback method.

Quality of Life and Self-care Activities in Diabetic Ulcer Patients, Grade 3: Gender Differences.

Introduction: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus associated with increased morbidity and mortality and diminished quality of life (QoL). This study aimed to explore the effect of gender differences on QoL and adherence to self-care activities. Methods: In this cross-sectional study, we enrolled 135 male and 135 female patients with DFU. Data was collected using the Short Form Health Survey (SF-36) and a questionnaire that measured self-care activities (Diet, Exercise, Blood Examination, and Foot Check). Data analysis was performed using SPSS version 20. Results: In terms of QoL, male participants had moderate to high levels in the categories of energy/fatigue, emotional well-being, social functioning, and bodily pain, whereas they had low levels in physical functioning, physical role, and emotional role. Female patients had moderate QoL in the categories of energy/fatigue and social functioning, whereas they had low QoL in physical functioning, physical role, emotional role, emotional well-being, and bodily pain. Finally, regarding general health, male participants had moderate QoL and females had moderate to low QoL. Both males and females had low adherence to exercise and high in blood-examinations. For both genders, adherence to exercise had a statistically significant association with all sub-categories of QoL apart from those of role (physical and emotional). Conclusion: It is essential for health care professionals to provide gender-specific approaches in treatment of ulceration.

Linezolid: a Promising Agent for the Treatment of Multiple and Extensively Drug-Resistant Tuberculosis.

Tuberculosis is a severe, infectious disease caused by Mycobacterium tuberculosis. The aim of this review was to present the efficacy of linezolid as an agent against multidrug and extensively drug-resistant tuberculosis as gathered from many recent research studies. Linezolid seems to have strongly the potential of being used as an anti-tuberculosis agent because it blocks bacterial ribosomal protein synthesis. Nevertheless caution is required because of the adverse effects it causes, especially when the linezolid daily dosage exceeds 600 mg. The most severe adverse effects include anemia, peripheral neuropathy, optic neuropathy and thrombocytopenia. Still, more trials and research need to be done in order to gather more information and value the cost-benefit dosage of the treatment.

Comparison of radial extracorporeal shockwave therapy with ultrasound therapy in patients with lateral epicondylitis.

PURPOSE: Patients suffering from lateral epicondylitis exhibit diminished mobility due to pain. The aim of the study was to compare the efficacy of both shockwave and ultrasound therapies in patients with lateral epicondylitis. METHODS: The shockwave group consisted of 117 patients, 63 patients constituted the ultrasound group, and 18 patients made up the control group. The "University of Peloponnese Pain, Functionality and Quality of Life Questionnaire" was used for the evaluation of pain, functionality, and quality of life on a five-point Likert scale, pre-treatment, post-treatment, and at 4-week follow-up. RESULTS: The pain was reduced and the functionality and quality of life were improved in both the shockwave and ultrasound groups post-treatment (p < 0.001) and at 4-week follow-up (p < 0.001), but the results in the ultrasound group were not as pronounced as in the shockwave group (p < 0.001). CONCLUSION: Both radial shockwave and ultrasound therapies were significantly effective in patients with lateral epicondylitis. However, ultrasound therapy was less effective than shockwave therapy.

Radial Extra Corporeal Shockwave Therapy Versus Ultrasound Therapy in the Treatment of Plantar Fasciitis.

INTRODUCTION: Patients with plantar fasciitis usually suffer from reduced mobility due to the pain caused by the movement of the tendons involved. AIM: This study was aimed to compare both shockwave and ultrasound therapies in patients with plantar fasciitis by assessing the pain intensity, and both the functionality of the lower limbs and the quality of life impairments. METHODS: Total amount of 88 patients with plantar fasciitis constituted the shockwave group, 56 the ultrasound group and 15 the control group. The self-administered questionnaire "University of Peloponnese Pain, Functionality and Quality of Life Questionnaire" was used. The intensity of pain, functionality impairment and quality of life impairment were evaluated on a five-point Likert scale, before treatment, immediately after and at 4-week follow-up. RESULTS: The pain reduction and the improvement of functionality and quality of life after shockwave treatment and ultrasound treatment significantly increased both post-treatment (p<0,001) and at the 4-week follow-up (p<0,001) compared to post-treatment. However, the improvements in the ultrasound group were not as pronounced as in shockwave group (p<0,001). CONCLUSIONS: Although both radial shockwave and ultrasound therapies were found to be effective in patients with plantar fasciitis, the statistical analysis showed that radial shockwave is significantly more effective than ultrasound therapy.

Comparison of Radial Extracorporeal Shockwave Therapy versus Ultrasound Therapy in the Treatment of Rotator Cuff Tendinopathy.

INTRODUCTION: People suffering from rotator cuff tendinopathy exhibit reduced mobility due to pain. The pain and the limited functionality affect negatively the overall quality of life. AIM: The present study aimed to investigate the intensity of pain, the functionality of the upper limbs and the quality of life of patients with rotator cuff tendinopathy by using two different therapeutic modalities, shockwave and ultrasound, whose outcomes were assessed pre-treatment and post-treatment as well as after a 4-week follow-up. MATERIALS AND METHODS: Out of the total sample of 115 patients with rotator cuff tendinopathy, 56 patients constituted the shockwave intervention group, 47 patients constituted the therapeutic ultrasound group and 12 patients made up the control group. The self-administered questionnaire "The University of Peloponnese Pain, Functionality and Quality of Life Questionnaire, UoP ­ PFQ" was used where the intensity of pain, functionality and quality of life of the upper limbs were evaluated on a five-point Likert scale, pre-treatment, post-treatment and at a 4-week follow-up. RESULTS: The pain intensity was reduced and both the functionality and quality of life were improved after shockwave therapy post-treatment (p<0.001) and at a 4-week follow-up (p<0.001) compared with those found after the treatment. Similar improvements in all three parameters were also observed after ultrasound treatment but the outcomes were not as pronounced as in the shockwave group. CONCLUSION: Both radial shockwave and ultrasound therapies were found to be effective in the treatment of rotator cuff tendinopathy, the statistical analysis showing that radial shockwave therapy was superior to the ultrasound therapy post-treatment and at the 4-week follow-up.

Effectiveness and Safety of Shockwave Therapy in Tendinopathies.

INTRODUCTION: People suffering from tendinopathies exhibit reduced mobility due to the pain caused by the movement of the tendons involved. Recently, shockwave therapy has been used as a treatment option, which is non-invasive, simpler, faster and safer. AIMS: To record the intensity of the pain, the functionality of the upper and lower limbs and quality of life before treatment with shock waves, immediately after the treatment and the 4-week follow-up. METHODOLOGY: The sample consisted of 384 patients, suffering from a tendinopathy. 326 patients constituted the shockwave intervention groups and 58 patients made up the control groups. The researchers created a self-administered questionnaire (University of Peloponnese Pain, Functionality and Quality of Life Questionnaire) in which the intensity of pain, functionality and quality of life were evaluated on a five-point Likert scale, before, immediately after the treatment and at a 4-week follow-up. RESULTS: The pain reduction and the improvement of functionality and quality of life after shockwave treatment increased by at least two points on the five-point Likert scale both post-treatment (p<0,001) and at a 4-week follow-up (p<0,001) compared to post-treatment in elbow tendinopathy, Achilles tendinopathy, plantar fasciitis and rotator cuff tendinopathy. CONCLUSIONS: Shockwave therapy significantly reduced the pain that accompanies tendinopathies and improves functionality and quality of life. It might be first choice because of its effectiveness and safety.