RESUMO
Robot manipulators are robotic systems that are frequently used in automation systems and able to provide increased speed, precision, and efficiency in the industrial applications. Due to their nonlinear and complex nature, it is crucial to optimize the robot manipulator systems in terms of trajectory control. In this study, positioning analyses based on artificial neural networks (ANNs) were performed for robot manipulator systems used in the textile industry, and the optimal ANN model for the high-accuracy positioning was improved. The inverse kinematic analyses of a 6-degree-of-freedom (DOF) industrial denim robot manipulator were carried out via four different learning algorithms, delta-bar-delta (DBD), online back propagation (OBP), quick back propagation (QBP), and random back propagation (RBP), for the proposed neural network predictor. From the results obtained, it was observed that the QBP-based 3-10-6 type ANN structure produced the optimal results in terms of estimation and modeling of trajectory control. In addition, the 3-5-6 type ANN structure was also improved, and its root mean square error (RMSE) and statistical R2 performances were compared with that of the 3-10-6 ANN structure. Consequently, it can be concluded that the proposed neural predictors can successfully be employed in real-time industrial applications for robot manipulator trajectory analysis.
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BACKGROUND: : The purpose of this study is to investigate whether the etiological factors accepted as causes of idiopathic subscapularis tears are true or not when the comparison is made with the opposite side healthy shoulder of the patients who underwent arthroscopic repair for an isolated subscapularis tear. METHODS: Sixteen patients who underwent shoulder arthroscopy between February 2016 and January 2018 and were diagnosed with isolated subscapularis tear were evaluated. The coracohumeral distance (CHDax), coracoid overlap (CO), and tuberculum minus cysts (TMC) were evaluated on the axial images of the MRI studies while the acromiohumeral distance (AHDsag), CHDsag, and subscapularis tendon slip number (STSN) on the sagittal oblique images and the AHDcor and SLAP lesion on the coronal oblique images. Degeneration of the coracoacromial ligament was evaluated during arthroscopy. RESULTS: The mean CHDsag (11.26-10.08), CHDax (10.63-9.98), CO (14.2-15.43), AHDsag (8-7.66), and AHDcor (7.65-7.68) measurements (operated side-healthy side, respectively) were statistically similar (p > 0.05). No statistically significant difference was found between TMC and STSN in healthy and operated shoulders (p > 0.05). There was mild coracoacromial ligament fraying in 4 (25%) and obvious coracoacromial ligament fraying in 8 (50%) which indicated subacromial impingement in 75% of the patients. DISCUSSION: The parameters of the coracoid process did not reveal any significant difference between the operated (for an isolated subscapularis tear) and opposite-side healthy shoulders of the patients. However, coracoacromial ligament degeneration was present in 75% of the patients.
Assuntos
Lesões do Manguito Rotador , Síndrome de Colisão do Ombro , Articulação do Ombro , Humanos , Manguito Rotador , Lesões do Manguito Rotador/diagnóstico por imagem , Lesões do Manguito Rotador/cirurgia , Síndrome de Colisão do Ombro/diagnóstico por imagem , Síndrome de Colisão do Ombro/cirurgia , Imageamento por Ressonância Magnética/métodos , Extremidade Superior , Artroscopia/métodos , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/cirurgiaRESUMO
The real-time vibrations occurring in a leaf spring system may cause undesirable effects, such as stresses, strains, deflections, and surface deformations over the system. In order to detect the most appropriate working conditions in which the leaf spring system will work more stably and also to design optimized leaf spring systems, these external effects have to be detected with high accuracy. In this work, artificial neural network-based estimators have been proposed to analyze the vibration effects on leaf spring systems. In the experimental studies carried out, the vibration effects of low, medium, and high-pressure values applied by a hydraulic piston on a steel leaf spring system have been analyzed by a 3-axial accelerometer. After the experimental studies, the Radial Basis Artificial Neural Network (RBANN) and Cascade-Forward Back-Propagation Artificial Neural Network (CFBANN) based nonlinear artificial neural network structures have been proposed to analyze the vibration data measured from the leaf spring system under relevant working conditions. The simulation results represent that the RBANN structure can estimate the real-time vibrations occurring on the leaf spring system with higher accuracy and reaches lower RMS error values when compared to the CFBANN structure. In general, it can be concluded that the RBANN and CFBANN network structures can successfully be used in the estimation of real-time vibration data.
Assuntos
Redes Neurais de Computação , Vibração , Simulação por ComputadorRESUMO
BACKGROUND: This study aimed to determine the prevalence of the Buford complex and to investigate its association with labral pathologies (superior labrum anterior-posterior [SLAP] lesion and anterior, posterior, or multidirectional instability) using a very large patient database. Furthermore, the prevalence of the Buford complex in patients without any labral pathology was also determined. METHODS: A total of 3129 consecutive shoulder arthroscopy procedures were retrospectively evaluated for the presence of the Buford complex and coexisting labral pathologies. The relationships between the Buford complex and SLAP lesions, as well as instability, were evaluated statistically. RESULTS: The Buford complex was observed in 83 shoulders (2.65%). SLAP lesions were significantly more frequent in patients with the Buford complex than in those without it (81.9% vs. 33.1%, P < .001) Shoulders with the Buford complex presented a lower frequency of anterior instability (10.8% vs. 19.3%, P = .052) and a higher frequency of posterior instability (1.2% vs. 0.9%, P = .789). The prevalence of the Buford complex in patients with and without labral pathologies was 4.6% and 0.3%, respectively (P < .001). CONCLUSIONS: This study, to our knowledge, includes the largest cohort in the literature reporting the prevalence of the Buford complex (2.65%). In the 1461 patients without labral tears or multidirectional instability, the prevalence of the Buford complex was 0.3%. This result suggests that the real prevalence of the Buford complex might be lower than that reported previously. In addition to the aforementioned conclusions, the identification of the Buford complex should prompt a thorough evaluation for concomitant SLAP lesions.
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Articulação do Ombro , Artroscopia , Humanos , Prevalência , Estudos Retrospectivos , Ombro , Articulação do Ombro/cirurgiaRESUMO
The objective of this study was to determine the optimum concentrations of rainbow trout seminal plasma (RTS) supplemented extenders for goat semen quality at post-thaw and after incubation. Five sexually mature Saanen goat (Capra aegagrus hircus) were used for semen collection. Pooled semen was diluted with soybean lecithin-based extender without RTS (control) or supplemented with different concentrations of RTS (1%, 2%, 4% or 8%), at a final concentration of 150 × 106 spermatozoon/ml. Sperm motility, plasma membrane functional integrity (HOST), damaged acrosome (PSA-FITC), mitochondrial activity (rhodamine123) and DNA integrity (TUNEL) were evaluated. Spermatological parameters were evaluated at post-thaw and after 6 hr incubation. RTS8 group preserved sperm motility, acrosomal integrity, plasma membrane functional integrity and mitochondrial function better than the control group (p < .05). The study demonstrated that RTS supplemented lecithin-based extenders have useful effects on goat spermatozoa. In addition, the results of the current study represented the positive effect of using 8% RTS supplemented extender.
Assuntos
Criopreservação , Cabras , Oncorhynchus mykiss , Sêmen , Animais , Fragmentação do DNA , Lecitinas , Masculino , Motilidade dos EspermatozoidesRESUMO
This study aimed to determine oxidative stress in the tissue after testicular torsion biochemically and histopathologically and to examine the effects of Nesfatin-1 treatment on this injury. Thirty-two rats were randomly divided into four groups: sham, torsion + detorsion (4 hr torsion followed by 1 hr detorsion), ischaemia/reperfusion + saline (I/R + S) and I/R + nesfatin-1. I/R + S group a single-dose saline treatment was administered intraperitoneally at the two-hundred-tenth minute of torsion (ischaemia; 10 cc/kg). Similarly, I/R + nesfatin-1 group a single dose of nesfatin-1 treatment was administered intraperitoneally at the two-hundred-tenth minute of ischaemia (10 µg/kg). Myeloperoxidase, total oxidant status and oxidative stress index values were significantly increased in the I/R and I/R + S group compared to the sham group. Superoxide dismutase was significantly decreased in the I/R + S group compared to the sham group. No significant difference was found between the I/R + nesfatin-1 group and the other I/R groups (I/R and I/R + S) in terms of biochemical parameters. The mean diameter of the seminiferous tubule decreased in the I/R groups. However, the mean diameter of the seminiferous tubules was not significantly different between the I/R + S group and the I/R + nesfatin-1 group. Thus, the administration of nesfatin-1 after ischaemia did not reduce testicular-oxidative stress.
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Traumatismo por Reperfusão , Torção do Cordão Espermático , Animais , Humanos , Masculino , Malondialdeído/metabolismo , Estresse Oxidativo , Ratos , Ratos Wistar , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/prevenção & controle , Torção do Cordão Espermático/tratamento farmacológico , Torção do Cordão Espermático/metabolismo , Testículo/metabolismoRESUMO
BACKGROUND: The purpose of this study was to assess the frequency of superior labrum anterior posterior (SLAP) lesions, long head of biceps tendon (LHBT) pathologies, and superior rotator cuff tears accompanying subscapularis tears. We hypothesised that LHBT lesions, superior rotator cuff tears, and especially SLAP lesions were very frequent with subscapularis tears. METHODS: The digital files of patients who underwent shoulder arthroscopy were reviewed retrospectively. One hundred and eleven patients with subscapularis tears evident on surgery videos were examined. Superior labrum, LHBT, and superior rotator cuff lesions were investigated by the authors of this study. The statistical analyses were made with SPSS statistics software, and significance was set at P < 0.05 value. RESULTS: There were 111 patients with both subscapularis tears and surgery videos. The mean age was 58.09 ± 10.21, and 63.1% of the patients were female. 98.2% of the 111 patients had a SLAP lesion. 7.2% of those were SLAP I and 91% were SLAP II lesions while 1.8% were healthy. The 75.7% of the patients had a LHBT pathology, and 83.8% had superior cuff tear. CONCLUSIONS: Subscapularis tears were almost always accompanied by SLAP lesions. On the other hand, biceps tendon pathologies and superior rotator cuff tears were also very frequent with subscapularis tears. LEVEL OF EVIDENCE: Prognostic study, Level IV (retrospective cohort study).
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Artroscopia/métodos , Lesões do Manguito Rotador/cirurgia , Manguito Rotador/cirurgia , Tendinopatia/complicações , Adulto , Idoso , Anestesia Geral/métodos , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/lesões , Medição da Dor , Posicionamento do Paciente/métodos , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Medição de Risco , Manguito Rotador/patologia , Lesões do Manguito Rotador/diagnóstico por imagem , Entorses e Distensões/complicações , Entorses e Distensões/fisiopatologia , Entorses e Distensões/cirurgia , Tendinopatia/diagnóstico por imagem , Resultado do Tratamento , Adulto JovemRESUMO
PURPOSE: To investigate the effects of the subscapularis tendon slip number (STSN) and coracoid morphology by magnetic resonance imaging in patients with and without subscapularis tears. METHODS: Patients who underwent shoulder arthroscopy between February 2004 and June 2015 were re-evaluated. Those with a subscapularis tear (study group) and those with other pathologies (control group) were compared with each other. Magnetic resonance imaging scans and surgery videos of the patients were reassessed. Transverse and sagittal coracohumeral distance (CHD), coracoid overlap (CO), coraco-coracoid base angle (CBA), coracoglenoid distance (CGD), and STSN were measured. RESULTS: The study and control groups comprised 141 and 78 patients, respectively. The mean age was 57.01 ± 10.95 (similar in both the groups). The mean transverse CHD and sagittal CHD were not different between the groups and also between female and male patients. For the study and control groups, the mean CBA and CGD values were also similar. The mean CO was 24.01 ± 4.9 and 21.29 ± 4.58 for the study and control groups, respectively (P < .001). With the receiver operating characteristic curve of the CO, the sensitivity was 62% and the specificity was 64% at the cutoff value of 22.85 mm. The STSN was in the range between 1 and 6; the STSN was 3 or less in 61.5% of the study group and in 38.5% of the control group (P = .005). CONCLUSIONS: The CO was the most valuable parameter predicting any potential subcoracoid impingement, and the STSN was inversely correlated with subscapularis tears. However, in predicting a potential subcoracoid impingement, the CHD measurements were not significant, as well the CGD and CBA. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
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Processo Coracoide/diagnóstico por imagem , Cabeça do Úmero/diagnóstico por imagem , Imageamento por Ressonância Magnética , Lesões do Manguito Rotador/diagnóstico por imagem , Manguito Rotador/diagnóstico por imagem , Síndrome de Colisão do Ombro/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Cavidade Glenoide/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
PURPOSE: To describe a modified technique for arthroscopic-assisted transfer of the latissimus dorsi tendon in a selected group of patients with irreparable rotator cuff tears and pseudoparalysis and to evaluate its short-term results. METHODS: Fifteen patients with irreparable rotator cuff tears and pseudoparalysis treated by arthroscopic-assisted latissimus dorsi tendon transfer were included. The mean patient age was 61.53 ± 6.24 years (range, 52-71 years). Patients were assessed with physical examination, University of California Los Angeles (UCLA) Score and Constant-Murley score, as well as visual analog scale score at a mean follow-up of 26.4 ± 2.58 months (range, 24-31 months). RESULTS: At final follow-up, mean UCLA score increased to 27.47 ± 6.31 compared with the preoperative UCLA score of 6.53 ± 2.1 (P < .001). Constant-Murley score was 21 ± 7.41 and 59.73 ± 13.62 (P < .001), visual analog scale pain score was 7.47 ± 1.06 and 2.47 ± 0.91 (P < .001), active forward flexion was 58° ± 21.11° and 130° ± 30.05° (P < .001), active abduction was 51° ± 21.64° and 129.67° ± 25.45° (P < .001), and active external rotation was 13.33° ± 21.68° and 32° ± 18.03° (P < .001) preoperatively and postoperatively, respectively. Mean acromiohumeral distance was 3.13 ± 1.40 mm preoperatively, whereas it was 5.67 ± 1.67 mm postoperatively (P < .001). No significant complications requiring a revision surgery was observed during the final follow-up. CONCLUSIONS: The modified technique of arthroscopic-assisted transfer of the latissimus dorsi tendon is a feasible, minimally invasive option for the surgical treatment of irreparable rotator cuff tears in a subset of patients with pseudoparalysis. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
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Lesões do Manguito Rotador/cirurgia , Manguito Rotador/cirurgia , Músculos Superficiais do Dorso/cirurgia , Transferência Tendinosa/métodos , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Paralisia/cirurgia , Período Pós-Operatório , Amplitude de Movimento Articular , Rotação , Lesões do Manguito Rotador/terapia , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
BACKGROUND: We aimed to evaluate cysts in the lesser tuberosity of humeral head seen on magnetic resonance imaging (MRI) and their relationship with subcoracoid impingement and subscapularis tears evident on arthroscopic surgery videos. Our hypothesis was that the cysts would be more frequent with subscapularis tears and in the case of subcoracoid impingement. METHODS: Patients who underwent shoulder arthroscopy between January 2010 and January 2016 were retrieved to evaluate subscapularis tears on surgery videos and lesser tuberosity cysts (LTC), coracohumeral distances (CHD) on both sagittal oblique and transverse sections of MRI retrospectively. There were 137 patients meeting the study criteria with subscapularis tear evident on surgery video and having preoperatively studied magnetic resonance images. All the tears were classified according to the Lafosse's system. The control group was constituted with 121 patients who underwent shoulder arthroscopy and were diagnosed with no subscapularis tear. Then, any statistically significant relationship between these parameters was investigated by the use of statistics software. RESULTS: The mean age (57), gender distribution (female for 67.1%), and involved shoulder (right for 62.8%) rate of the groups were statistically similar. The existence rate of LTC was 55.5% and 19% for the study and control groups, respectively (P = .000). The study group was then evaluated in two groups regarding the existence of a cyst in the lesser tuberosity. There was no statistical difference between these two groups in terms of coracohumeral distances and tear type (P > .05). The study group was also divided into two depending on the transverse section CHD whether it was under 7 mm or not. There was still no statistical difference between these subgroups in terms of a cyst existence (P > .05). The supraspinatus tear rate and age distribution was also not differing in patients with and without LTC. CONCLUSIONS: The LTCs were significantly associated with subscapularis tears, and could be used as an indicator in the interpretation of MRI scans. However, there was no relationship between the subcoracoid impingement and LTCs.
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Artroscopia/métodos , Cistos/patologia , Cabeça do Úmero/patologia , Lesões do Manguito Rotador/diagnóstico por imagem , Síndrome de Colisão do Ombro/diagnóstico por imagem , Adulto , Idoso , Análise de Variância , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Cistos/complicações , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Manguito Rotador , Lesões do Manguito Rotador/cirurgia , Índice de Gravidade de Doença , Síndrome de Colisão do Ombro/cirurgia , Estatísticas não Paramétricas , Resultado do Tratamento , Gravação em VídeoRESUMO
BACKGROUND CONTEXT: Pigmented villonodular synovitis (PVNS) is a rare, locally aggressive benign proliferative pathology of synovial tissue. Lesions are classified regarding location as diffuse or localised which are same as histologically. Intra-articularly localised type is relatively rare, especially in the ankle joint. Because of the high recurrence rate and aggressive nature, localised lesions should be excised totally. PURPOSE: We performed a retrospective study of 4 patients with intra-articularly localised PVNS in the ankle joint who were treated by total arthroscopic excision and evaluated for functional results and recurrence rate. STUDY DESIGN: Case series. PATIENT SAMPLE: The mean age of the patients was 27 (17-46) years at the time of arthroscopic surgery. The mean follow-up time was 33 (24-48) months. METHODS: Functional evaluation according to the Musculoskeletal Tumour Society Score was performed, and patients were evaluated for recurrence by MR imaging. RESULTS: In all patients, functional results were excellent and there was no recurrence. CONCLUSIONS: This study demonstrates that the intra-articularly localised PVNS can be successfully treated with arthroscopic procedures without recurrence.
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Articulação do Tornozelo/cirurgia , Sinovite Pigmentada Vilonodular/cirurgia , Adolescente , Adulto , Articulação do Tornozelo/diagnóstico por imagem , Artroscopia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Sinovectomia , Sinovite Pigmentada Vilonodular/diagnóstico por imagem , Adulto JovemRESUMO
BACKGROUND: The purpose of this study was to investigate the role of coracoacromial ligament degeneration and specific anatomic parameters in the etiology of partial-thickness rotator cuff tears. MATERIALS AND METHODS: This study retrospectively assessed 96 patients (mean age, 50.1 years [17-76]; 34 men, 62 women) diagnosed with bursal-side and articular-side rotator cuff tears with a history of failed conservative treatment and persistent shoulder pain who underwent arthroscopic surgery. Video records of the surgery were used to evaluate the type of cuff tear, grade of coracoacromial ligament degeneration, and associated pathologic changes; preoperative magnetic resonance images were used to measure acromioglenoid angle, supraspinatus glenoid angle, and subacromial distance. RESULTS: Most of the patients with articular-side tears demonstrated grade 0 and grade 1 coracoacromial ligament degeneration, whereas patients with bursal-side tears had grade 1 and grade 2. There was a significant positive correlation between the grade of coracoacromial ligament degeneration and bursal-side partial rotator cuff tears, whereas no correlation was observed with articular-side tears. There was no significant difference between bursal-side and articular-side partial cuff tears regarding acromioglenoid angle, supraspinatus glenoid angle, and subacromial distance. CONCLUSIONS: Grade 1 and grade 2 coracoacromial ligament degeneration is a strong predictive factor for impingement syndrome in the etiology of bursal-side partial cuff tears and can guide the surgeon to consider ligament release and débridement or acromioplasty in these patients.
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Ligamentos Articulares/fisiopatologia , Lesões do Manguito Rotador/fisiopatologia , Síndrome de Colisão do Ombro/fisiopatologia , Adolescente , Adulto , Idoso , Artroscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Lesões do Manguito Rotador/cirurgia , Síndrome de Colisão do Ombro/cirurgia , Dor de Ombro/fisiopatologia , Dor de Ombro/cirurgia , Adulto JovemRESUMO
PURPOSE: This study was performed on miscarriage samples for chromosome analysis to detect copy number variations (CNVs) related to subtelomeric regions, and with these results we aimed to adapt multiplex ligation-dependent probe amplification (MLPA) method for prenatal diagnosis. MATERIALS AND METHODS: The cell cultures and DNA isolations were performed on 60 miscarriage samples. For maternal contamination analysis, DNA isolations and quantitative fluorescent polymerase chain reactions were done using peripheric blood of mothers who had miscarriages. We compared short tandem repeat peak profiles of miscarriage samples and mothers. The subtelomeric regions of the chromosomes were assessed using the MLPA method. RESULTS: Of 43 miscarriage samples, 19 had normal karyotype (44.2%), 10 had numerical abnormalities (23.3%), and 2 had structural abnormalities (4.7%). Subtelomeric 16q duplication was determined in 2 of the 30 miscarriage samples investigated with MLPA method (6.6%). CONCLUSION: There is no statistically significant difference between two groups (p > 0.05). However, the fact that the 6.6% subtelomeric CNV found in miscarriage samples was not found in controls, showed that further studies are required. We recommend that the miscarriage samples of the couples with recurrent miscarriage should be analyzed in terms of subtelomeric CNV after the exclusion of other clinical reasons.
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Feto Abortado/metabolismo , Aborto Espontâneo/genética , Variações do Número de Cópias de DNA/genética , Repetições de Microssatélites/genética , Aborto Habitual/genética , Adulto , Estudos de Casos e Controles , Aberrações Cromossômicas , Feminino , Humanos , Cariotipagem , Reação em Cadeia da Polimerase Multiplex , Reação em Cadeia da Polimerase , GravidezRESUMO
BACKGROUND CONTEXT: The incidence of glucocorticoid-induced osteoporosis is approximately 50% in patients treated for >6 months, and in the long-term usage fracture risk is approximately 34%. The awareness of pediatric vertebral fractures due to glucocorticoid-induced osteoporosis is increasing. Although most of these fractures are asymptomatic, a small number of children may have severe pain. PURPOSE: In this case report we are presenting long-term result of a 9-year-old patient with intractable pain due to glucocorticoid-induced osteoporotic vertebral fracture managed by kyphoplasty. STUDY DESIGN: Case report. PATIENT SAMPLE: Case report of a 9-year-old girl who had L3 vertebral fracture due to glucocorticoid-induced osteoporosis treated by kyphoplasty. METHODS: The patient was a 9-year-old girl with severe back pain, and lupus nephritis. Glucocorticoid-induced L3 vertebral fracture was detected and the case was resistant to conservative treatment. Seeing this, we have performed balloon kyphoplasty procedure to L3 vertebrae. RESULTS: No complication and pain was observed after the operation although L3 vertebral height could not restored. On the 8-year control, L3 vertebral height was almost totally restored with a compression index of 10% without any clinical problem. CONCLUSIONS: To the best of the authors' knowledge, the patient sample of this case report is the first and the youngest patient who was treated with kyphoplasty for vertebral compression fracture intractable pain due to glucocorticoid-induced osteoporosis, mentioned in literature. During the 8-year follow-up, no adverse effect was reported that was related to kyphoplasty procedure. This case report indicates that kyphoplasty can be an alternative method for selective pediatric intractable painful vertebral glucocorticoid-induced osteoporotic fractures, but it should be performed after careful consideration in pediatric group. We do not advise routine usage of kyphoplasty for pediatric vertebral fractures.
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Dor nas Costas , Glucocorticoides/efeitos adversos , Cifoplastia/métodos , Vértebras Lombares/lesões , Osteoporose , Fraturas da Coluna Vertebral , Dor nas Costas/etiologia , Dor nas Costas/fisiopatologia , Dor nas Costas/terapia , Criança , Feminino , Seguimentos , Fraturas por Compressão/complicações , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Compressão/cirurgia , Glucocorticoides/administração & dosagem , Humanos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Osteoporose/induzido quimicamente , Osteoporose/complicações , Fraturas por Osteoporose/complicações , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/cirurgia , Manejo da Dor , Dor Intratável/etiologia , Dor Intratável/terapia , Radiografia , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of this study is to present our initial experience in peritoneal carcinomatosis treatment and the technical details of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the light of current literature. MATERIAL AND METHODS: Data of 27 consecutive patients who were treated with CRS and HIPEC for peritoneal carcinomatosis in Medical Park Samsun Hospital, between November 2012 and September 2014 were retrospectively reviewed. Treatment indication and management were evaluated at the multidisciplinary oncology council. All patients underwent CRS and HIPEC with the aim of complete cytoreduction. Patients with unresectable disease and/or palliative surgery were excluded from analysis. Perioperative complications were classified according to Clavien-Dindo classification, and HIPEC-related side effects were identified using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) criteria. Demographic, clinical and histopathological data of the patients were analyzed. RESULTS: The mean age was 54 (32-72). Nineteen patients were female. The origin of peritoneal carcinomatosis was colorectal cancer in 12 patients, ovarian cancer in 12 patients, gastric cancer in 2 patients and pseudomyxoma peritonei in 1 patient. The mean Peritoneal Carcinomatosis Index was 12 (3-32), with a mean operative time of 420 (300-660) minutes. Perioperative morbidity, HIPEC-related toxicity and perioperative mortality were observed in eight (30%), one (3.7%) and four patients (14.8%), respectively. During a mean follow up of 13 (1-22) months, overall and disease-free survival rates were 95.8% and 82.6%, respectively. Two patients with colorectal cancer (after 9 and 12 months) and one patient with ovarian cancer (after 11 months) had intra-abdominal recurrence. One patient with ovarian cancer had liver metastases 13 months after surgery, and underwent resection of segments 6-7. The remaining patients are being followed-up without any recurrence. CONCLUSION: Cytoreductive surgery and HIPEC have favorable results in the treatment of patients with peritoneal carcinomatosis. Compatible with the literature, surgical outcomes of the presented series are encouraging for this treatment modality that have been recently popularized in our country. Careful perioperative evaluation, proper patient selection and multidisciplinary approach are essential for success in curative treatment of peritoneal carcinomatosis.
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BACKGROUND: The etiology of overactive bladder (OAB) remains unclear. Observed neurogenic factors in the literature are limited to suprapontine or spinal pathologies. The blink reflex is a useful tool in the evaluation of brainstem functions. Blink reflex latency times were evaluated in order to reveal pathology in the brainstem. METHODS: A total of 60 women, 30 patients with idiopathic OAB and 30 healthy controls, were enrolled in the study. Blink reflex latency times were analyzed by electrical stimulation of the supraorbital nerve. Two responses in the orbicularis oculi muscle, early ipsilateral response (R1) and late bilateral response (R2) latency times, were recorded. RESULTS: Mean ages of the patients and controls were 51.9 ± 5.3 and 49.2 ± 6.2 years, respectively. R2 latency times were significantly higher in patients than in controls. However, R1 latency times were similar between the two groups. CONCLUSIONS: The results of the study suggest a significant relation between late blink latency times and OAB. An oligosynaptic path via the trigeminal nuclei is responsible for R1; however, R2 response is relayed through the reticular formation. Stimulation of pontine reticular formation inhibits micturition contraction. In some patients, idiopathic OAB may result from reticular formation-originated pathology. Additional studies on other reticular formation-mediated reflexes are needed to reveal possible dysfunction of reticular formation.
Assuntos
Piscadela , Formação Reticular/fisiopatologia , Bexiga Urinária Hiperativa/fisiopatologia , Adulto , Estudos de Casos e Controles , Estimulação Elétrica , Eletromiografia , Feminino , Humanos , Pessoa de Meia-Idade , Formação Reticular/fisiologia , Bexiga Urinária Hiperativa/etiologia , MicçãoRESUMO
PURPOSE: The aim of this study was to analyze the outcomes of IVF/ICSI cycles in women aged 43 and beyond. METHODS: Retrospective analysis of clinical pregnancy and live birth rates in 168 fresh, non donor, ART cycles performed in two Connecticut university IVF programs. RESULTS: In women of 43 and 44 years the overall clinical pregnancy and live birth rates were 8.3% and 5.3% per initiated cycle, respectively. There were no clinical pregnancies in women ≥45 years old. First cycle characteristics were not different from repeated cycles in terms of duration of ovulation induction, number of collected oocytes and transferred embryos (p > 0.05). CONCLUSIONS: Pregnancies can still be achieved with IVF/ICSI up to the age of 44. Since most pregnancies occurred within the first 3 cycles, another attempt may be a reasonable option before resorting to oocyte donation for patients who failed two previous cycles. Women 45 years and beyond do not benefit from ART procedures using their own oocytes.
Assuntos
Infertilidade/terapia , Idade Materna , Recuperação de Oócitos , Técnicas de Reprodução Assistida , Adulto , Connecticut/epidemiologia , Transferência Embrionária/métodos , Feminino , Fertilização in vitro , Hospitais Universitários/estatística & dados numéricos , Humanos , Infertilidade/diagnóstico , Infertilidade/epidemiologia , Masculino , Pessoa de Meia-Idade , Recuperação de Oócitos/métodos , Recuperação de Oócitos/normas , Recuperação de Oócitos/estatística & dados numéricos , Oócitos/citologia , Gravidez , Taxa de Gravidez , Técnicas de Reprodução Assistida/estatística & dados numéricos , Injeções de Esperma Intracitoplásmicas , Resultado do TratamentoRESUMO
Within the entire mesomorphic range, high-precision dielectric anisotropy data with the high-temperature resolution is presented for a highly polar smectic-A liquid crystal 8CB (octylcyanobiphenyl) as well as 8CB nanocomposites doped with both pristine multi-walled carbon nanotubes (p-MWCNTs) and carboxyl group (-COOH) functionalized MWCNTs (f-MWCNTs). The temperature variation of the nematic order parameter across both the nematic-isotropic (N-I) and the nematic-smectic-A (N-Sm-A) phase transitions of the neat 8CB and 8CB+MWCNT nanocomposites has then been derived from the dielectric anisotropy data within the framework of the Maier-Meier theory. With the inclusion of MWCNTs, both the N-I and the N-Sm-A transition temperatures have been noted to shift to lower temperatures as compared to the 8CB host. Also, for all 8CB+MWCNT nanocomposites, regardless of the surface functionalization, it has been well documented that the N-I transition is weakly first order, whereas the N-Sm-A transition remains continuous within the experimental resolution. For all investigated samples, the temperature dependence of the nematic order parameter has been shown to be quasitricritical, within the experimental resolution. From the attentive inspection of the dielectric anisotropy data in the vicinity of the N-Sm-A transition, the upper limits for a possible latent heat ΔH_{NA} for the 8CB host and all 8CB+MWCNT composites, for the first time, have been derived. The so-derived ΔH_{NA} values for all investigated samples have also been compared with those extracted from the optical birefringence data, and an excellent consistency has then been noted. The N-Sm-A pretransitional anomaly has been investigated and the effective specific heat capacity exponent α values have been yielded from the power-law analysis of our high-resolution ΔÉ(T) data across the N-Sm-A transition for all investigated samples. It has been well documented that the incorporation of MWCNTs to the 8CB host leaves the N-Sm-A transition essentially bulklike. We discussed that, to some extent, the compliance of MWCNTs does not drive the N-Sm-A transition to 3D-XY-like behavior, that is the strength of de Gennes coupling will remain the same for all nanocomposites. This issue can be ascribed to the weaker nature of MWCNT disorder. In this work, for the first time, high-resolution ΔÉ(T) data has been shown to be very adequate and offer an easy way to investigate the N-Sm-A transition as compared to calorimetric methods.
RESUMO
The caregiving burden experienced by informal caregivers of individuals with schizophrenia (ICIWS) can affect their perceived occupational balance (OB). This study examines the differences in OB among ICIWS with different caregiving burden levels. This cross-sectional study was conducted with a sample of 149 ICIWS. The Occupational Balance Questionnaire 11-Turkish Version (OBQ11-T) was used to assess the participants' OB. The Zarit Caregiver Burden Scale was employed to evaluate caregiving burden levels. Statistically significant differences were found in the total score of OBQ11-T, Item 3 (time for doing things wanted), Item 5 (having sufficient time for doing obligatory occupations), and Item 9 (balance between obligatory/voluntary occupations) between the severe and little caregiving burden groups (p < .05). Caregiving for individuals with schizophrenia can lead to varying levels of caregiving burden, which negatively affects OB. Occupational therapists working with ICIWS should assess OB and address OB-related challenges to alleviate caregiver burden.