Clinical outcomes of conservative versus surgical treatment for patients with proximal humeral fracture before physiotherapy.

Fear of movement, pain, and loss of shoulder function are the most common problems irrespective of their approach to management after proximal humeral fracture (PHF). However, it has been unclear whether there could be differences between both treatments in early clinical outcomes. It can help physiotherapists to guide in choosing treatment approaches. This study aimed to compare kinesiophobia, pain, range of motion (ROM), shoulder function, and Quality of life (QoL) in patients treated with either conservative (CT) versus surgical (ST) after PHF. In addition, it aimed to determine correlations between fear of movement and seconder outcome measures. This cross-sectional study enrolled the patients having 5-6 weeks (being permitted active movement) after being treated either CT or ST and receiving no physical therapy. Pain, passive and active ROMs, shoulder function, fear of movement, and QoL were evaluated. 42 patients were recruited. Kinesiophobia scores were similar (p=0.55) and moderate in both groups. There was a significant difference in degrees of shoulder active flexion, active and passive abduction in favor of the CT group (p=0.05, p=0.02, p=0.04, respectively). However, there was no difference between groups regarding the remaining clinical outcomes. Furthermore, kinesiophobia showed a moderate negative correlation with energy/fatigue, social functioning, and general health. These findings showed that patients treated surgically did not have more kinesiophobia, less function, and QoL before starting physiotherapy, despite having soft tissue damage and different types of fractures. However, surgically treated patients had significantly less range of motion.

Antiproliferative and antiapoptotic effect of thymoquinone on cancer cells in vitro.

OBJECTIVES: Nigella sativa oil and thymoquinone were comparatively tested in vitro for their effects on human cancer cell lines (glioma,T98; prostate, LnCaP) as well as mouse embryonic fibroblast cell lines (3T3), and for the induction of apoptosis. METHODS: Individual cell lines were treated with thymoquinone and N. sativa oil for 24 and 48 hr. Survival rate with MTT, apoptosis with flow cytometry and caspase-9 mRNA enzyme levels with RT-PCR were determined in vitro. RESULTS: Application of respective concentrations of N. sativa oil (excluding 100 µg/mL for 48 hr) did not change the number of tested cell lines, however, treatment with thymoquinone reduced the number of all cells significantly. Thymoquinone also exerted its apoptosis inducing effect through the activation of caspase-9. CONCLUSION: Differing with the type of cancer cells, thymoquinone posseses a strong contentration and time dependent survival reducing effect on cancer cells via apoptosis (Fig. 6, Ref. 22). Text in PDF www.elis.sk.

Effects of ceranib-2 on cell survival and TNF-alpha in colon cancer cell line.

OBJECTIVE: The aim of this study was to investigate the effects of a novel anti-cancer drug, ceranib-2, which targets the acid ceramidase, in human colon cancer cell line. MATERIALS AND METHODS: The cell lines were treated with 50 µM of ceranib-2. Relative mRNA expression of TNF-alpha, TNF-R1 and ASAH were assessed by quantitative RT-PCR. RESULTS: Ceranib-2 reduced cell viability in a dose-dependent manner and the apoptotic values of cells following treatment with the dose of 50 µM were reduced significantly both at 24 h and 48 h compared to the control cells (p < 0.001). TNF-alpha receptor 1 (TNF-R1) mRNA levels were reduced significantly in the cell lines treated with both 25 µM and 50 µM of ceranib-2 for 24 h compared to the control cells (p < 0.05), whereas the difference between the treatment and the control cell lines diminished at 48 h. The human acid ceramidase gene (ASAH) mRNA levels were significantly higher in the cell lines treated with 50 µM of ceranib-2 for 48 h than in the other cell lines (p < 0.001). CONCLUSION: The study shows that ceranib-2 increased apoptosis by inducing ASAH expression and reduced TNF-R1 expression in human colon cancer cell lines in a dose and time-dependent manner (Fig. 3, Ref. 17).

[Polymer fibers in surgery. III]. / Polimernye volokna v khirurgii. Chast' III.

Polyester fibres were started to be used as synthetic polymer material in the mid-1950's. In comparison with polyamides they have a greater chemical and biological durability. Their elasticity, resistance to weather, abrasive strength, low susceptibility to sorption, distortion strength, no toxicity, resistance to heat treatment in sterilization, moderate capillarity, gave the polyesters their present wide usability in various fields of surgery. Polyester fibres most frequently used are: ethyl terephthalate, lawsan, dacron, terylene, elana, torlene, terytal, tetron, etc. They are used as surgical threads, knitted and weaved fabric, vascular prostheses, tendons, ligaments and bands in hernia plastic operation, in reconstruction of abdomen wall and chest and in diaphragm prosthetics. In most cases the grafts had a high mechanical and physical resistance, were biologically immune, and healed well. Polyester fibres can be modified in order to increase the durability of their anastomosis with organic tissues and to give them long gemicidal activity. The main factors which cause the fibre decomposition are the processes of hydrolysis, oxidation, and enzymatic deconstruction. In many reports knitted and gauze fabric were said to be superior to the knitted ones. It was found that by use of polyester vascular prostheses good results can be obtained in implanting them to the aorta and its branches, while in implanting into small and medium blood vessels thrombi form. On the basis of macrokinetic parameters of lavsan prostheses destruction in the organism a method for predicting the length of the exploatation properties loss of the polymer were proposed. The results were mostly convergent with the experimental ones.

[Polymer fibers in surgery. II]. / Polimernye volokna v khirurgii. II.

Polyamide fibres were one of the first synthetic fibres to be widely used in surgery. They are durable, elastic, abrasion- and deformation-resistant, and withstand the biological action of chemical agents. Moreover, they have small susceptability to moisture sorption and large values of percentage elongation. In surgery polycaproamide fibres (PKA) are usually used--capron, nylon-6, perlon, stylon, sylon and others, they can be easily and reliably sterilized, do not facilitate infection spreading in the thread, and are relatively well resorbed. The fibres were used as surgical threads and nets, vascular prostheses, woven and knitted fabric in hernia treatment, diaphragm injuries, strengthening the diaphragm seam, an other reconstruction operations. In most cases the tissues adjoining the implant react moderately. It is suggested that porous materials should be used as implants, so that they overgrow with tissue, and gradually undergo biodestruction. Depending on the kind and structure of fibres, and specific tissue properties, the biodegradation period varies from 2-3 weeks to 2-3 years. According to the authors this depends on polymer breakdown by means of hydrolysis. In the paper conditions of fibre modifications are shown in order to improve their usability in therapy. Quantitative changes in biodestruction of various kinds of polycaproamide threads in the organism are described. It is stressed that polyundecanamide fibres (undecan, nylon-11) are less applicable in surgery than polyhexametyleno-2-amide ones (anid, nylon-6,6). Through of some favourable properties, polyamide fibres have a very restricted application in surgery; their surface is rough, which makes surgical binding difficult, thin threads, last shortly in tissues, lose elasticity, get brittle and fragile. The period of their biodestruction is rather short. In conclusion it is stated that polyamide fibres are not suitable for durable prostheses.

[Polymer fibers in surgery. I]. / Polimernye volokna v khirurgii. Chast' I.

The contemporary application of the numerous classes of polymer fibres fibres such as collagenous, polyethereal, polyolefinic, polyamidic etc. for the practical surgery is reviewed, as well as the superiority of synthetic fibres to natural ones is discussed. The basic criteria of application of those materials to surgery, as well as the possible modifications of polymers are described. The areas of medical complications of the numerous types of polymer fibres as well as its behaviour in the organisms are observed. The mechanism of biodegradation of polymers implanted into the organism is discussed. The method of prognosis of lifetime of implanted polymer articles is described.

[Adsorption of plasma proteins on the surface of hydrophobic polymers. Structural aspects]. / Adsorbtsiia plazmennykh belkov na poverkhnosti gidrofobnykh polimerov. Strukturnyi aspekt.

The qualitative and quantitative composition of the adsorbed protein layer is determined by thromboresistance of artificial polymer surface. The adsorption of albumine and gammaglobuline from buffer solution to the hydrofobic polymer surfaces was investigated with ESR and electron spectroscopic method. The existence of two kinds of protein covering was demonstrated: reversible and irreversible protein layer. During the nitroxyl labelled globuline adsorption the spectrum of label is due to superposition of both reversible and irreversible kinds of adsorption. It was demonstrated by the electron microscopic method that the strongly adsorbed protein layer corresponds with the denaturated protein, the reversibly adsorbed protein in contrast is native. The architecture of protein layer on polymer surface was also investigated. The comparison of structural and physiological properties of serum protein is important for the investigation of the thromboresistant materials.