Intra-rater reliability of the knee arthrometer GNRB® for measuring knee anterior laxity in healthy, active subjects.

Background: Arthrometers are used to assess knee anterior laxity and to evaluate the integrity of the anterior cruciate ligament. Assessment of knee anterior laxity is crucial part of the clinical examination. The aim of this study was to investigate the intra-rater reliability of the GNRB® in healthy subjects. Methods: In the study participated 97 subjects and two measurements using a GNRB® arthrometer were performed. Males were tested two times one week a part. Females were tested two times within 24 h. Measurements were performed at the following forces 134 N, 134 N, 150 N, 200 N, and 200 N. To evaluate the reliability of GNRB® measurements an intraclass correlation coefficient was calculated. Results: Intra-rater reliability of the GNRB® measurements is good for 134 N on the left knee (ICC = 0.848) and the right knee (ICC = 0.788) and for 200 N on the left knee (ICC = 0.805) and the right knee (ICC = 0.756). Conclusion: The GNRB® knee arthrometer has good intra-reliability for measurements at the 134 N and 200 N forces. Reliability can be increased with the standardize position of the subject, the stabilization of the patella and standardize measurement protocol.

PREDICTORS OF SEXUAL SATISFACTION: AN INTERNATIONAL STUDY.

The aim of this cross-cultural study was to examine predictors of sexual satisfaction. For the present analysis, we used a large-scale sample database that included 8821 individuals from 4 countries. All participants completed the same questionnaires, which were designed to capture numerous important variables that have been shown to correlate with sexual satisfaction. According to our results, predictors of sexual satisfaction were classified into four general categories (demographic factors, psychological factors, sociocultural factors, and pathophysiological factors). Our international study found statistically significantly higher satisfaction among homosexual participants, participants aged 18 to 23 years, those with a higher level of education, in a relationship, with a current sexual partner, in a current partnered (unmarried) relationship, and without a diagnosed sexual or mental disorder. At the same time, we found that the correlation between sexual satisfaction and the different predictors varieed considerably across countries, which calls for further research.

Analyzing the Photoprotection Efficiency of Sunscreens Containing Antioxidants under Disinfection Conditions.

Sunscreens ensure thorough protection against sunburn. The delivery of UV filters into the stratum corneum and viable epidermis could be reduced by the use of antioxidants (such as ß-carotene and trans-resveratrol, alone or combined). The presence/absence of antioxidants (trans-resveratrol and ß-carotene) in formulations containing benzophenone-3 (UV-filter) and their efficiency under disinfection and neutral conditions are studied and compared. The trial was conducted on 38 people. The prepared ointments were applied to the participants' forearms, irradiated and monitored by reflectance colorimetry after 0, 4, 6, and 8 min. Descriptive statistics were used to describe the skin color's main characteristics and the F-ratio was used to test overall differences. The ointments containing antioxidants and benzophenone-3 were the most efficient, followed by those with benzophenone-3 alone. It was proven that photoprotection with benzophenone-3 is still effective, despite the formation of its chlorinated products. Due to the short time of exposure to disinfecting conditions, it could be assumed that benzophenone-3 was only partially chlorinated. This clinical study demonstrated that formulations containing antioxidants are likely to be more suitable for protecting skin against UVB irradiation than a UV filter alone.

Corrigendum to "The Role of Antioxidants in Skin Cancer Prevention and Treatment".

[This corrects the article DOI: 10.1155/2014/860479.].

Bacterial adhesion on orthopedic implants.

Orthopedic implants are routinely used for fixation of fractures, correction of deformities, joint replacements, and soft tissue anchorage. Different biomaterials have been engineered for orthopedic implants. Previously, they were designed merely as mechanical devices, now new strategies to enhance bone healing and implant osteointegration via local delivery of molecules and via implant coatings are being developed. These biological coatings should enhance osteointegration and reduce foreign body response or infection. This article reviews current and future orthopedic implants, materials and surface characteristics, biocompatibility, and mechanisms of bacterial adhesion. Additionally, the review is addressing implant-related infection, the main strategies to prevent it and suggest possible future research that may control implant related-infection.

THE (A)SYMMETRY OF THE MALE GRAYING BEARD HAIRS AS AN INDICATION OF THE PROGRAMMED AGING PROCESS.

Aging interventions will be ineffective if we do not understand the basic principles of aging. Currently, there is no consensus on the issue whether aging is programmed or not. The hypothesis presented in this article indicates that aging (at least graying of male hairs) is programmed. This hypothesis is supported by the symmetry of the graying of male beard hairs. According to stochastic theories of aging, aging is a passive non-programmed process where random dispersion of graying hairs should result. On the contrary, programmed theories of aging would predict that there should be symmetry on the left and right parts of the face showing the same proportion, pattern and time of appearance of graying hairs.

PROOXIDANT ACTIVITIES OF ANTIOXIDANTS AND THEIR IMPACT ON HEALTH.

This review article is focused on the impact of antioxidants and prooxidants on health with emphasis on the type of antioxidants that should be taken. Medical researchers suggest that diet may be the solution for the control of chronic diseases such as cardiovascular complications, hypertension, diabetes mellitus, and different cancers. In this survey, we found scientific evidence that the use of antioxidants should be limited only to the cases where oxidative stress has been identified. This is often the case of specific population groups such as postmenopausal women, the elderly, infants, workers exposed to environmental pollutants, and the obese. Before starting any supplementation, it is necessary to measure oxidative stress and to identify and eliminate the possible sources of free radicals and thus increased oxidative stress.

Morphological Characteristics and Frequency of Accessory Right Hepatic Veins - Evaluation with Computed Tomography.

In the liver, there are many vascular variants, which are important in liver surgery, the presence of accessory right hepatic veins (aRHVs) in particular. Th eir frequency, number and diameter vary considerably. Detailed imaging diagnostics with computed tomography (CT) should be undertaken before surgery. Th e aim of our study was to examine the characteristics of aRHVs and their demographic correlations. Th e study included data on 188 patients that underwent CT examination of the abdomen with contrast media, 103 men (54.8%) men and 85 (45.2%) women, mean age 63.1±14.3 (range, 21-94) years. Th e measurements of hepatic veins were carried out on CT images, which were obtained from the Clinical Institute of Radiology, University Medical Centre of Ljubljana. Forty-fi ve of 142 patients had at least one aRHV: one aRHV in 37 (26.1%) cases, two aRHVs in seven (4.9%) cases, and three aRHVs in one (0.7%) case. Th e incidence of aRHV was between 24% and 39.3% (mean, 31.7%) and of more than one aRHV between 2.3% and 10.3% with 95% confi dence interval (CI). Based on the test of proportions, the proportion of cases with inferior aRHV of at least 7 mm was between 7.2% and 18.1% with 95% CI. Th e mean distance between the aRHV and the main RHV confl uences into the inferior vena cava was 3.73 cm (between 3.32 cm and 4.13 cm, 95% CI). Th e proportion of cases with confl uence distance of at least 4 cm was between 21.6% and 49.5% in cases with at least one aRHV. In cases with more than one aRHV, the distance between the middle aRHV and the main RHV ranged from 1.90 cm to 4.32 cm (95% CI). Th e T-test of independent samples showed no eff ect of age on the incidence of accessory veins (p=0.18), and the test of diff erences of interests showed no impact of sex (p=0.75). Evaluation of the incidence and diameter of aRHVs is of great importance for safe surgical procedure. Th eir presence can change the surgeon's decision in 10%-20% of cases when employing appropriate imaging technique. CT examination, which is easily accessible and minimally invasive for patients, was successful in only 80% cases, when using standard protocol for CT scanning.

Female Sexual Function and Dysfunction: A Cross-National Prevalence Study in Slovenia.

The purpose of the current study was to evaluate the prevalence of female sexual dysfunction in Slovenia. We aimed to explore the prevalence itself, comparison among demographic groups and potential correlations. Data were collected based on the validated standardized Female Sexual Function Index (FSFI) (N=605). Most participants had sexual intercourse with one partner (n=523), and the majority of sexual relationships were heterosexual (n=584). University educated subjects had the highest claims of arousal, followed by those with master/doctoral degrees and college educated ones. The lowest level was expressed by subjects with elementary school. The youngest subjects (18-23 years) expressed the highest levels of desire and arousal, followed by the 24-29 age group. The 42-47 age group reported higher levels of lubrication and orgasm. The claim of satisfaction was highest in the 24-29 age group, while the pain was highest in the 42-47 age group. Strong correlation was found between the claims of desire and arousal (r=0.585), arousal and lubrication (r=0.879), lubrication and pain (r=0.856), orgasm and lubrication (r=0.856), satisfaction and orgasm (r=0.782), and pain and arousal (r=0.776) (p<0.001). We identified a 31% prevalence of female sexual dysfunction in Slovenia.

The Assessment Of Energy And Protein Needs Coverage In Hospitalized Patients: OCENA POKRITOSTI POTREB PO ENERGIJI IN BELJAKOVINAH MED HOSPITALIZIRANIMI BOLNIKI.

AIM: Aiming at assessing sufficiency of energy/protein intake in hospitalized patients, the objective was to monitor and analyze actual food intake of patients hospitalized in three clinical wards of one of major Slovenian hospitals. METHODS: 53 patients were included in the study. Food intake was assessed 3 times daily from leftovers. Nutritional status was assessed with Nutritional Risk Screening tool 2002. The observed outcomes were percentage of energy coverage (PEC) and percentage of protein coverage (PPC). In PEC energy nutritional value of the menu (ENVM), and in PPC protein nutritional value of the menu (PNVM) were considered as the main modifiable risk factors. Data were analyzed univariately and multivariately by using logistic regression method. RESULTS: The patients did not cover energy needs (67.4±24.5%). Multivariate model for PEC was highly significant (R2=0.347; pmodel<0.001) with ENVM showing high strength of association (b=0.040; p=0.004). Patients also did not cover protein needs (84.0±40.2%). Multivariate model for PEC was highly significant (R2=0.477; pmodel<0.001) and PNVM showing high strength of association (b=0.937; p=0.002). CONCLUSION: For successful prevention and early detection of malnutrition, food intake in hospitals is vital and should be constantly monitored. A simple method for monitoring is proposed. The menus provided to patients should also be adequate in terms of energy and protein content.

The role of antioxidants in skin cancer prevention and treatment.

Skin cells are constantly exposed to reactive oxygen species (ROS) and oxidative stress from exogenous and endogenous sources. UV radiation is the most important environmental factor in the development of skin cancer and skin aging. The primary products caused by UV exposure are generally direct DNA oxidation or generation of free radicals which form and decompose extremely quickly but can produce effects that can last for hours, days, or even years. UV-induced generation of ROS in the skin develops oxidative stress when their formation exceeds the antioxidant defense ability. The reduction of oxidative stress can be achieved on two levels: by lowering exposure to UVR and/or by increasing levels of antioxidant defense in order to scavenge ROS. The only endogenous protection of our skin is melanin and enzymatic antioxidants. Melanin, the pigment deposited by melanocytes, is the first line of defense against DNA damage at the surface of the skin, but it cannot totally prevent skin damage. A second category of defense is repair processes, which remove the damaged biomolecules before they can accumulate and before their presence results in altered cell metabolism. Additional UV protection includes avoidance of sun exposure, usage of sunscreens, protective clothes, and antioxidant supplements.

Anatomy and surgical relevance of Rouviere's sulcus.

Rouviere's sulcus (RS) (i.e., incisura hepatis dextra, Gans incisura) represents an important anatomical landmark. The aim of the study was to determine the frequency of the RS, its description, its location, its relations to the right portal pedicle and to the plane of the common bile duct, and the evaluation of the surgical relevance of the obtained data. Forty macroscopically healthy and undamaged livers were removed during autopsies from cadavers of both sexes. The RS was present in 82% of the cases and in these the open RS was identified in 70% of the livers. The fused type was observed in 12% of the cases; 18% of the livers had no sulcus. The mean length of the open type RS was 28 ± 2 mm (range 24-32 mm) and its mean depth was 6 ± 2 mm (range 4-8 mm). The right posterior sectional pedicle was found in the RS in 70% of the cases. In 5% of the livers, we also dissected a branch of the anterior sectional pedicle. Inside 25% of the RS, we found the vein of segment 6. The RS identification may avoid bile duct injury during laparoscopic cholecystectomy and enables elective vascular control during the right liver resection.

Skin photoaging and the role of antioxidants in its prevention.

Photoaging of the skin depends primarily on the degree of ultraviolet radiation (UVR) and on an amount of melanin in the skin (skin phototype). In addition to direct or indirect DNA damage, UVR activates cell surface receptors of keratinocytes and fibroblasts in the skin, which leads to a breakdown of collagen in the extracellular matrix and a shutdown of new collagen synthesis. It is hypothesized that dermal collagen breakdown is followed by imperfect repair that yields a deficit in the structural integrity of the skin, formation of a solar scar, and ultimately clinically visible skin atrophy and wrinkles. Many studies confirmed that acute exposure of human skin to UVR leads to oxidation of cellular biomolecules that could be prevented by prior antioxidant treatment and to depletion of endogenous antioxidants. Skin has a network of all major endogenous enzymatic and nonenzymatic protective antioxidants, but their role in protecting cells against oxidative damage generated by UV radiation has not been elucidated. It seems that skin's antioxidative defence is also influenced by vitamins and nutritive factors and that combination of different antioxidants simultaneously provides synergistic effect.

Muscles within muscles: a tensiomyographic and histochemical analysis of the normal human vastus medialis longus and vastus medialis obliquus muscles.

The aim of this study was to show the connection between structure (anatomical and histochemical) and function (muscle contraction properties) of vastus medialis obliquus (VMO) and vastus medialis longus (VML). The non-invasive tensiomyography (TMG) method was used to determine the contractile properties (contraction time; T(c)) of VML and VMO muscle, as a reflection of the ratio between the slow and fast fibers in two groups of nine young men. VML and VMO significantly (P < 0.01) differ in the proportion of type 1 (59.6: 44%) and type 2b (6.3: 15%) fibers. The VML muscle is almost entirely composed of type 1 and type 2a fibers. In many samples of this muscle no type 2b fibers were found. The proportion of slow-twitch type 1 fibers is nearly twice as high as the proportion of fast-twitch type 2a fibers. These observations indicate that VML is a slower and more fatigue-resistant muscle than VMO muscle. These characteristics correspond to the different functions of the VML, which is an extensor of the knee, and to the VMO, which maintains the stable position of the patella in the femoral groove. Our results obtained by TMG provided additional evidence that muscle fibers within the segments of VM muscle were not homogenous with regard to their contractile properties, thereby confirming the histochemical results. T(c) can be attributed to the higher percentage of slow-twitch fibers - type 1. The statistically shorter T(c) (P ≤ 0.001) of VMO (22.8 ±â€…4.0 ms) compared with VML (26.7 ±â€…4.0 ms) in our study is consistent with previously found differences in histochemical, morphological and electrophysiological data. In conclusion, the results of this study provide evidence that the VML and VMO muscles are not only anatomically and histochemically different muscles, but also functionally different biological structures.

Skin and antioxidants.

It is estimated that total sun exposure occurs non-intentionally in three quarters of our lifetimes. Our skin is exposed to majority of UV radiation during outdoor activities, e.g. walking, practicing sports, running, hiking, etc. and not when we are intentionally exposed to the sun on the beach. We rarely use sunscreens during those activities, or at least not as much and as regular as we should and are commonly prone to acute and chronic sun damage of the skin. The only protection of our skin is endogenous (synthesis of melanin and enzymatic antioxidants) and exogenous (antioxidants, which we consume from the food, like vitamins A, C, E, etc.). UV-induced photoaging of the skin becomes clinically evident with age, when endogenous antioxidative mechanisms and repair processes are not effective any more and actinic damage to the skin prevails. At this point it would be reasonable to ingest additional antioxidants and/or to apply them on the skin in topical preparations. We review endogenous and exogenous skin protection with antioxidants.

Intrinsic skin aging: the role of oxidative stress.

Skin aging appears to be the result of two overlapping processes, intrinsic and extrinsic. It is well accepted that oxidative stress contributes significantly to extrinsic skin aging, although findings point towards reactive oxygen species (ROS) as one of the major causes of and single most important contributor; not only does ROS production increase with age, but human skin cells' ability to repair DNA damage steadily decreases over the years. We extrapolated mechanisms of intrinsic oxidative stress in tissues other than skin to the skin cells in order to provide effective anti-aging strategies and reviewed the literature on intrinsic skin aging and the role of oxidative stress.

The influence of the sleeping on the formation of facial wrinkles.

OBJECTIVE: The study addressed the influence of sleep as an important but overlooked contributory factor to the formation and progression of facial wrinkles and an alternative pillow was designed to reduce them. MATERIALS AND METHODS: Fifteen healthy young participants of both sexes (aged 26-42 years) volunteered for this study. We used a transparent PVC pillow filled with air to demonstrate mechanical forces and deformations of the face as a consequence of sleeping on a pillow. We used a Podometer (PDMTR) (integrated fluorescent luminaire lamp) as a diagnostic device to visualize and to document the imprint of facial deformities on a glass, as seen during sleeping. RESULTS: We observed various facial deformities and wrinkles during sleep ('crow's feet' fine lines, lines around the mouth, flattening of the forehead, blunting of the nasofrontal angle, melolabial and nasolabial folds) and design an alternative pillow to reduce them by redistributing the pressure from the wrinkling parts of the face.

Free radicals and extrinsic skin aging.

Human skin is constantly directly exposed to the air, solar radiation, environmental pollutants, or other mechanical and chemical insults, which are capable of inducing the generation of free radicals as well as reactive oxygen species (ROS) of our own metabolism. Extrinsic skin damage develops due to several factors: ionizing radiation, severe physical and psychological stress, alcohol intake, poor nutrition, overeating, environmental pollution, and exposure to UV radiation (UVR). It is estimated that among all these environmental factors, UVR contributes up to 80%. UV-induced generation of ROS in the skin develops oxidative stress, when their formation exceeds the antioxidant defence ability of the target cell. The primary mechanism by which UVR initiates molecular responses in human skin is via photochemical generation of ROS mainly formation of superoxide anion (O(2) (-) (∙)), hydrogen peroxide (H(2)O(2)), hydroxyl radical (OH(∙)), and singlet oxygen ((1)O(2)). The only protection of our skin is in its endogenous protection (melanin and enzymatic antioxidants) and antioxidants we consume from the food (vitamin A, C, E, etc.). The most important strategy to reduce the risk of sun UVR damage is to avoid the sun exposure and the use of sunscreens. The next step is the use of exogenous antioxidants orally or by topical application and interventions in preventing oxidative stress and in enhanced DNA repair.

Anatomy of the ligamentum venosum arantii and its contribution to the left hepatic vein and common trunk control. A study on cadaveric livers.

BACKGROUND: The control of the left hepatic vein (LHV) and the common trunk of the middle hepatic vein (MHV) and LHV (CT) is considered difficult during liver resection and could be improved by detailed knowledge on the ligamentum venosum Arantii (LV). AIM: The aim of this study was to describe the LV and its connections to the LHV and the CT and to present surgical relevance of the obtained data. MATERIAL AND METHODS: During autopsy of 50 cadavers of both sexes, the LV was exposed, measured and then dissected, simulating a surgical maneuver to facilitate the approach to the LHV and CT. The extrahepatic parts of the LHV, MHV and CT were measured. RESULTS: The LV was 52-70 mm long and 5-8 mm thick. It had a fibrotic structure and was not patent in 96% of the cases. The extrahepatic part of the LHV measured 3-19 mm, that of the MHV 3-18 mm and that of the CT 4-15 mm. CONCLUSION: LV dissection facilitated extraparenchymatous clamping of the hepatic veins: the extrahepatic parts of the LHV and CT measured > 3 mm in 86 and 84% of the cases, respectively.

Anatomy and surgical relevance of the hepatocaval ligament. A study on cadaveric livers.

BACKGROUND: There are nearly no data on the hepatocaval ligament (HCL) in the anatomical literature, though it is of high importance during surgery of the right hemiliver. AIM: The aim of this study was to determine the frequency of the HCL, its description and its relations to the inferior vena cava (IVC) and the right hepatic vein (RHV) as well as the evaluation of the surgical relevance of the data obtained. MATERIALS AND METHODS: The dissection of the livers of 43 cadavers of both sexes was performed and the presence of the HCL was established. The ligament was measured and dissected to expose the IVC and the extrahepatic part of the RHV from its inflow to the liver parenchyma. RESULTS: The ligament was present in 77% of the cases. It was 12-35 mm long and 3-18 mm wide. The extrahepatic part of the RHV was 2-12 mm long. CONCLUSION: Dissection of the HCL revealed the terminal extrahepatic part of the RHV in all cases. Anatomically, resection of the right hemiliver with elective vascular control would be possible in 85% of the cases in which the length of the extrahepatic part of the RHV was > or =3 mm.