P4366Application of 3D-dual volume layout imaging for rapid intraprocedural guidance in Mitraclip procedure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Gavazzoni ◽  
M Z Zuber ◽  
M M Miura ◽  
A P Pozzoli ◽  
M T Taramasso ◽  
...  
Keyword(s):  
Color Image ◽  
Surface Zone ◽  
Mean Values ◽  
Echocardiographic Parameter ◽  
Volume Imaging ◽  
Number Of Patients ◽  
Hemodynamic Assessment ◽  
Correct Alignment ◽  
Reliable Parameter ◽  
The Mean

Abstract Introduction Intraprocedural guidance and monitoring with transesophageal echocardiography (TEE) and invasive hemodynamic assessment are currently the best available options for evaluating procedural success of percutaneous mitral valve (MV) repair with Mitraclip System (Abbott Vascular, Santa Clara, CA, USA). However, despite its crucial importance, echocardiography has some limitations in immediate evaluation of residual jets after clip implantation, so that, in absence of validated method for double orifice effective regurgitant orifice (ERO) assessment, the most reliable parameter that is currently used is the mean trans-valvular gradient. Purpose This prospective study aimed to assess the role of a new echocardiographic parameter obtained from 3D-Color-Full volume imaging of MR for evaluation of outcomes of mitraclip procedures, comparing it with invasive LAP measurements. Material and methods We prospectively performed the computation of a new parameter in patients with symptomatic moderate-severe to severe primary or secondary mitral regurgitation (MR) underwent MitraClip procedure. This parameter is easy and fast to be obtained out of 3D dataset and represents the 2D area of the proximal isovelocity surface zone visualized from the ventricular view, without any imaging processing (“3D dual volume PISA area”) (figure). It was obtained as following: i) acquisition of 3D-zoomed-color image of MR jet with adequate frame rates; ii)displaying of the volume sampling in “dual volume layout” so one can see the “ventricular aspect” of the jet area corresponding to proximal isovelocity surface “zone”; iii) awareness of correct alignment to the direction of the flow in proximal zone; iiii) freezing and direct measurement of this area (summarize if more than 1 orifice) (1 attached). We compared the variation of this parameter from the beginning to end of procedure with the variation of LAP measurements, that is currently the most important parameter for assessing outcome of procedures. Results The study includes dataset of 11 patients. The baseline value of 3D dual volume PISA area was 1,191±0,40 cm2 and the mean change we obtained was 0,65±0,30 cm2 (mean of 77% of reduction until the end of procedure). Mean values of LAP were slightly decreased in all cases: basal m-LAP was 12±3,3 mmHg and decreased by 15%. Despite the small number of patients, we observed a significant correlation between the changes of LAP and the change of 3D dual volume PISA area (R: 0.6, p: 0,048). Conclusions This is the first demonstration of the usefulness of echocardiographic parameter obtained by 3Ddual volume layout imaging for rapid intraprocedural guidance in Mitraclip procedure. This parameter is related to hemodynamic variations that it currently considerable surrogate of outcomes. These data need to be confirmed by a larger study.

Comparison of Overt and Cryptic Labile Plasma Iron In Thalassemia Patients In Israel and Gaza-Palestine

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5166-5166
Author(s):  
William Breuer ◽  
Hussam Ghoti ◽  
Hesham Jeadi ◽  
Ada Goldfarb ◽  
Eliezer A. Rachmilewitz ◽  
...  
Keyword(s):  
Iron Overload ◽  
Binding Capacity ◽  
Medical Center ◽  
Treatment Success ◽  
Redox Activity ◽  
Mean Values ◽  
Entire Cohort ◽  
Plasma Iron ◽  
Number Of Patients ◽  
The Mean

Abstract Abstract 5166 Background. Systemic iron overload (SIO) is characterized by persistently high levels of plasma iron that often surpass transferrin's (Tf) binding capacity and generate chemical forms identified as non-Tf bound iron (NTBI). These forms have been perceived as: a. clinically important indicators of SIO per se and of impending organ damage, because cells chronically exposed to iron overloaded plasma attain iron levels and ensuing ROS formation that override their antioxidant capacities and b. as pharmacological targets for chelation and thereby of prevention of tissue iron overload. However, NTBI determination in the clinical setting has been confounded by the chemical heterogeneity of iron forms found in fluids like plasma/sera of SIO patients, the presence of residual amounts of undefined chelates or chelators and the need to dislodge NTBI from native ligands with agents that facilitate its detection. We have assayed the overt forms of NTBI that represent the native pool of labile (= redox-active, chelatable and membrane permeant) iron in plasma/serum. We defined it as ‘labile plasma iron' or LPI and analyzed it by the Aferrix FeROS™ test (1) and used it to asses chelation regimens in their ability to maintain patients' plasma at relatively low (basal) LPI levels (<0.4 μ M, ref. 2). Detection of NTBI forms with both low redox activity and poor chelator accessibility (defined as cryptic LPI) can also be done with the FeROS™ test by supplementing samples with an agent (nitrilotriacetate= NTA < 0.5 mM) that in plasma “extracts” iron from native NTBI. Thus whereas LPI measures overtly labile NTBI in native plasma (i.e. LPI), LPIplus detects both overt + cryptic forms, as in classical NTBI assays that involve either mobilization + filtration (3) or in the DCI (directly chelatable iron) assay that measures deferrioxamine chelatable NTBI (4). Aim. To compare SIO parameters in polytransfused thalassemia major patients, chelated and non-chelated, as revealed by measurements of overt and cryptic LPI. Methods. The studies involved: 1. The Hadassah Medical Center (HMC) in Jerusalem, where 15–20 (randomly selected, age 14–35) patients were under regular transfusion/chelation treatment and 2. The European Medical Center in Gaza (EMC), where regularly transfused patients (age 10–22) were only sporadically chelated. NTBI assays were performed on sera prepared from blood, (where applicable taken after >10 hrs drug washout, as described for LPI (1,2) and DCI (4); for LPIplus, the LPI test was conducted in the presence of 0.5 mM NTA. Results. As shown previously (2,4), LPI was detected only in patients with >70% Tf-saturation. In HMC, the mean LPI of n=18 patients rose from 0.51±0.41 μ M to 1.00 ±0.46 μ M in the presence of NTA, matching the DCI level of 0.91±0.7 μ M. The LPI rise was detected in 12/15 (= 80%) of samples with LPI>0.4 μ M (≂p 66% of the entire cohort). Thus, despite chelation, a substantial number of patients had relatively low but significant levels of both overt and cryptic NTBI. Among the 3 patients with no significant LPI or DCI (0.2-0.4 μ M), 2/3 became LPI positive (0.6-0.8 μ M) when tested with NTA. Unexpectedly, in EMC-Gaza, among 20 transfused unchelated patients with serum ferritins > 5000 ng/ml and Tf saturation >100%, 8/20 of them (≂p 40%) had undetectable levels of overt LPI but substantial cryptic NTBI. In the remaining 12/20, the mean overt LPI of 0.69±0.65 μ M rose significantly (p<0.01) to 2.05 ±1.56 μ M when the cryptic component (NTA-extractable) was added. Discussion. Overt and cryptic NTBI components were detected by two modalities of the LPI assay in both regularly chelated and unchelated thalassemia patients, although to different extents and proportions. Compared to chelated patients, those unchelated had significantly higher mean values of both overt and cryptic NTBI components, despite the higher proportion of patients with only cryptic NTBI. On an individual basis, the persistent appearance of either/both LPI component(s) of NTBI could provide a measure of SIO and/or the success of individual chelation regimens. However, remaining to be established is the pathophysiological role of each component of NTBI to SIO, disease progression and treatment success. Supported by ISF and the Canadian Friends of HUJI. 1. Esposito et al. Blood 102:2670-7 (2003); 2. Zanninelli et al. Br. J. Hematol. 147: 744–51(2009); 3. Hider R. Eur J Clin Invest 32:S50–4 (2002); 4. Pootrakul et al. Blood 104: 1504–10 (2004). Disclosures: Cabantchik: Aferrix Ltd: Consultancy, Membership on an entity's Board of Directors or advisory committees.

Evaluation of monomeric prolactin level by TRACE method and precipitation with polyethylene glycol

2021 ◽  
Vol 66 (2) ◽  
pp. 69-74
Author(s):  
S. Yu. Vorotnikova ◽  
L. K. Dzeranova ◽  
N. S. Fedorova ◽  
E. A. Pigarova ◽  
M. G. Vershinina ◽  
...  
Keyword(s):  
Prolactin Level ◽  
Clinical Symptoms ◽  
Correct Diagnosis ◽  
Active Form ◽  
Biologically Active ◽  
Mean Values ◽  
Number Of Patients ◽  
Immunoenzyme Method ◽  
The Mean ◽  
Positive Results

Prolactin exists in various forms including the monomeric biologically active form (23kDa) and a higher molecular weight form, bound most commonly to IgG, known as macroprolactin (>100kDa). Macroprolactin lacks biological activity and is one of the causes of false-positive results. In Russian Federation the most common method for macroprolactin determination is PEG precipitation test. We had conducted a retrospective analysis of 37 samples of patients with hyperprolactinemia (3 of them were males). The mean age was 30 [25;35] years. Prolactin level was measured by the immunoenzyme method with manual PEG precipitation and TRACE. The mean values found by the immunoenzyme method with manual PEG precipitation were 461,6 [375,0;821,2] mU/l, by TRACE - 449,9 [357,2;749,2] mU/l. The number of patients with normal prolactin levels was 30% (11) confirmed by two methods, high prolactin level at 46% (17). The prevalence of clinical symptoms of hyperprolactinemia was not differ depend the groups. The phenomenon of macroprolactinemia was registered in 32% (12) of patients. In 8 persons of this group normal prolactin level was revealed and in 4 patients hyperprolactinemia was found by TRACE. Measurements of prolactin levels by the TRACE method is useful for correct diagnosis in patients with equivocal results received by traditional method with PEG precipitation.

P949 Step by step guidance of MitraClip procedure with a new quantitative parameter

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Gavazzoni ◽  
M T Taramasso ◽  
A P Pozzoli ◽  
M M Miura ◽  
F T Tanner ◽  
...  
Keyword(s):  
Color Image ◽  
Color Doppler ◽  
Second Step ◽  
P Value ◽  
Relative Reduction ◽  
Surface Zone ◽  
Volume Imaging ◽  
Hemodynamic Improvement ◽  
Mitraclip System ◽  
Double Orifice

Abstract Background/Introduction. In step by step guidance of percutaneous mitral valve (MV) repair with MitraClip System (Abbott Vascular, Santa Clara, CA, USA) evaluation of step by step MR reduction by color-Doppler echocardiography can be challenging requiring multiparametric approach and to freeze and process images while the procedure is going. Purpose: This prospective study aimed to assess the role of a new echocardiographic parameter obtained from 3D-Color-Full volume imaging of MR for evaluation of step-by-step MR reduction during MitraClip procedures by a comparison with step-by-step reduction of m-LAP. Methods: We prospectively performed the computation of a new parameter that is obtained by acquisition of MR by 3D-zoomed-color image in dual volume layout for seeing the ventricular aspect of the jet area corresponding to proximal isovelocity surface "zone"; then, measure of that area is traced, so that it represents the 2D area of the proximal isovelocity surface zone visualized from the ventricular view, without any imaging processing ("3D dual volume PISA area"). In double orifice, we added the two computations obtained by the two orifices. We compared the variation of this parameter with variations of m-LAP at the two steps of MitraClip procedures requiring implantation of 2 MitraClips. Results: The study includes dataset of 19 patients. The baseline value of 3D dual volume PISA area was 1,47 ± 0,49 cm2 and the mean change obtained after first clip was 0,25 ± 0,21 cm2 (- 65 % of reduction from baseline, p value: 0.001) and a further change from first to second clip was of 46% (p 0,1). Conversely, the m-LAP decreased more in the second step of procedure: basal m-LAP was 15 ± 13,3 mmHg and decreased by 32% by the end of procedure; in the first step m-LAP was reduced of 12% from baseline (from 15 ± 13,3 to 14,1 ± 9,8 mmHg) and in the second step of 18% (from 14,1 ± 9,8 to 11 ± 4 mmHg). We tested correlation between relative reduction of 3D-PISA and reduction of m-LAP at each of the procedural steps and we observed significant correlation only during the first procedural step (baseline-to-first clip) (R: 0,527, p 0.02), not in the second (1 st-to-2 nd clip) (R: 0,345, p 0.13). Considering the whole procedure, reduction of 3D-PISA was correlated to reduction of m-LAP at the end. Conclusions: Our study demonstrate that this new parameter is related to hemodynamic improvement during procedures, mostly in the first step, when the amount of reduction is marked; for further step invasive monitoring of LAP would be more pivotal. These data need to be confirmed by a larger study.

Redistribution of soil water after infiltration

Soil Research ◽  
1971 ◽  
Vol 9 (2) ◽  
pp. 59 ◽  
Author(s):  
AJ Peck
Keyword(s):  
Moisture Content ◽  
Surface Zone ◽  
Order Ordinary Differential Equation ◽  
Mean Values ◽  
Wide Range ◽  
Two Factors ◽  
Homogeneous Soil ◽  
The Mean ◽  
The One ◽  
Different Soils

The one-dimensional vertical redistribution of water is studied following infiltration into deep homogeneous soil with an initially uniform moisture content. There is assumed to be no loss of water by evaporation or transpiration during the redistribution. Assuming two factors to be constants, a first-order ordinary differential equation is derived which can be integrated numerically to compute the mean moisture content in the surface zone of draining soil as a function of the redistribution time. The depth of the draining zone increases with time, and this can be calculated too. That these factors are relatively constant is indicated by analysis of data for several soils and wetting depths over a wide range of redistribution times. Using mean values of the factors for several soils, and only wetting values of the diffusivity and conductivity functions, predicted redistribution behaviour agrees well with experimental data in four of six soils. In the remaining cases calculation of the factors for the particular soils, using an approximate method which includes hysteresis data, gives better results. The model is applied to predict the redistribution behaviour of different soils under identical treatments, and of a single soil for various infiltration quantities and initial moisture contents.

scholarly journals Comparison of Biometric Values and Intraocular Lens Power Calculations Obtained by Ultrasound and Optical Biometry

2016 ◽  
Vol 17 (4) ◽  
pp. 321-326
Author(s):  
Aleksandra Cvetkovic ◽  
Suncica Sreckovic ◽  
Marko Petrovic
Keyword(s):  
Intraocular Lens ◽  
Axial Length ◽  
Mean Values ◽  
Optical Biometry ◽  
Refractive Power ◽  
Number Of Patients ◽  
Significant Difference ◽  
Iol Power ◽  
The Mean ◽  
Lens Power

Abstract This study sought to compare the biometric values and intraocular lens (IOL) power obtained by standard ultrasound and optical biometry. We examined 29 eyes in preparation for cataract surgery. None of the patients had refractive surgery or corneal anomaly. In all patients, the horizontal and vertical refractive power of the cornea was determined using a keratometer (Bausch&Lomb). The axial length of the eye was determined via A-scan ultrasound (BVI-compact-V-plus) using Hollady’s formula. The IOL power and complete biometric measurements were obtained via an IOL Master-500-Zeiss using the Hollady-2 formula. All obtained values were compared and analysed using the statistical program SPSS 20. The average age of treated patients was 71.21±1.68 years. In 16 patients with dense cataracts (55.17%), it was not possible to determine the IOL power by optical biometry. Optical biometry obtained significantly increased axial length values of 24.04±0.29 mm compared with those obtained with ultrasound biometry (23.89±0.28 mm, p=0.003). The mean refractive cornea power values of the horizontal meridian measured using a keratometer (42.50±0.47 D) and an IOL Master (42.69±0.49 D) were not statistically different (p=0.187). The mean values of the refractive cornea power of the vertical meridian obtained using a keratometer (42.62±0.48D) and an IOL Master (43.36±0.51 D) exhibited a statistically significant difference (p=0.000). The keratometer obtained statistically significant lower mean values of corneal refractive power (42.73±0.32 D) compared with those obtained with optical biometry (43.22±0.35 D, p=0.000). Ultrasound biometry obtained significantly increased the mean values of IOL power (20.19±0.48D) compared with those obtained with optical biometry (19.71±0.48 D, p=0.018). The large number of patients who receive an operation for dense cataracts indicate the need for representation of both biometric methods in our clinical practice.

scholarly journals The effect of therapy on subclinical atherosclerosis of the carotid arteries in patients with calcium pyrophosphate crystal deposition disease and osteoarthritis (pilot study)

2021 ◽  
Vol 59 (6) ◽  
pp. 708-714
Author(s):  
M. S. Eliseev ◽  
O. V. Zhelyabina ◽  
M. N. Chikina ◽  
E. I. Markelova ◽  
I. G. Kirillova ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Carotid Arteries ◽  
Subclinical Atherosclerosis ◽  
Calcium Pyrophosphate ◽  
Anthropometric Parameters ◽  
Crystal Deposition ◽  
Mean Values ◽  
Number Of Patients ◽  
The Mean ◽  
Serum Crp

Endothelial dysfunction associated with chronic microcrystalline inflammation plays a role in the progression of atherosclerosis in calcium pyrophosphate crystal deposition diseases (CPPD).The aim of the study was to assess the dynamics of the development of atherosclerosis based on changes in the thickness of the intima-media complex (ICIM) of the carotid arteries (CA) in patients with CPPD receiving long-term anti-inflammatory therapy (colchicine, methotrexate, hydroxychloroquine).Materials and methods. 26 patients with CPPD and 26 patients with osteoarthritis aged over 18 years old were included. Exclusion criteria: age >65 years; presence of cardiovascular diseases. The blood lipid spectrum, hs-CRP level, anthropometric parameters were determined for all, and Doppler ultrasound ultrasonography of the carotid arteries (CA) was performed. Patients were followed up for not <6 months, assessed ICIM CA at 1 visit, then patients with CPPD, at the discretion of the attending physician, were prescribed methotrexate at a dose of 15 mg per week, hydroxychloroquine 200 mg 1 time per day or colchicine 0.5 mg 2 times a day. Patients could take NSAIDs if they were in pain. The SCORE index has been calculated for everyone.Results. Initially, ICIM values did not differ in patients with CPPD and OA. Initially, ICIM>0.9 mm were detected in 11 of 22 (50%) patients with CPPD and in OA in 8 of 19 (42%) (p=0.39). In dynamics, patients with CPPD revealed a decrease in the number of patients with ICIM>0.9 mm from 42 to 18%. At the same time, in 8 patients with CPPD, ICIM>0.9 mm was combined with a CRP level >0.2 mg/l. Out of 22 patients with CPPD, 14 (64%) patients showed a decrease in the mean values of ICIM, in 2 (9%) patients - an increase, in 5 patients the mean values of ICIM did not change. After 6 months of therapy, out of 11 patients with CPPD with ICIM >0.9 mm, after 6 months of therapy, in 7 cases there was a decrease in the indicator less than the specified value, in 5 of them a decrease in serum CRP level <2 mg/l was recorded. In patients with CPPD, the serum CRP level significantly decreased; in patients with OA, it did not change. Out of 19 patients with OA, 9 (47%) patients showed an increase in the mean ICIM over time, while the rest did not change. In those treated with hydroxychloroquine, a decrease in the mean ICIM parameters was observed in 5 out of 6 (83%) patients, colchicine - in 6 out of 9 (67%) patients, methotrexate - in 4 out of 7 (57%) patients.With CPPD, the result of therapy with colchicine, methotrexate and hydroxychloroquine in relation to the development of the initial signs of atherosclerosis according to Doppler ultrasound ultrasonography of CA can be realized based on the presence of chronic inflammation.

scholarly journals Expression of epithelial-mesenchymal transition markers E-cadherin and ZEB1 in colorectal cancer

2021 ◽  
Vol 8 (2) ◽  
pp. 23-33
Author(s):  
I. A. Novikova ◽  
O. I. Kit
Keyword(s):  
Colorectal Cancer ◽  
Tumor Cells ◽  
Epithelial Mesenchymal Transition ◽  
Stage Iv ◽  
Stage Ii ◽  
Mean Values ◽  
Mesenchymal Transition ◽  
Number Of Patients ◽  
The Mean ◽  
E Cadherin

Purpose of the study. Evaluation of expression of the epithelial-mesenchymal transition markers E-cadherin and ZEB1 in patients with stage II-IV colorectal cancer (CRC).Materials and methods. The study included operational material obtained from 299 patients aged 42–86 years (mean age 64.2±1.7 years) with stage II-IV CRC treated at National Medical Research Centre for Oncology in 2013-2017. Stage II CRC (T3-4 N0 M0 ) was diagnosed in 110 patients, stage III (T1-4 N1-2 M0 ) – in 88 patients, stage IV (T1-4 N0-2 M1 ) – in 101 patients. Polyclonal rabbit antibodies to ZEB1 (Biorbyt Ltd., UK) and mouse monoclonal antibodies to E-cadherin (Diagnostic BioSystems, USA) were used for an IHC analysis. The intensity and degree of tumor cell staining, percentage of stained tumor cells in the sample and the number of patients with positive and negative marker expression were determined. Groups were compared using the Mann–Whitney U test and the Pearson's chi-square test.Results. Positive expression of E-cadherin was found in 64.5 % (193 of 299 patients), ZEB1 – in 80.6 % (241 of 299 patients). The number of patients with E-cadherin-positive tumors statistically significantly decreased (χ2 =15.888 at p<0.001) from stage II to stage IV, while for ZEB1, on the contrary, it statistically significantly increased (χ2 =43.912 at p><0.001) from stage II to stage IV. The mean values of expression in positively stained cells were: in stage II – E-cadherin 55.3±6.8 %, ZEB1 43.0±5.9 %; in stage III – E-cadherin 38.4±5.8 %, ZEB1 77.0±5.5 %; in stage IV – E-cadherin 14.7±4.7 %, ZEB1 76.9±3.5 %. Significant differences were observed between the mean values of ZEB1 expression in stages III and IV compared to stage II, as well as between the mean values of E-cadherin expression in stages II and III compared to stage IV (p><0.05). No significant differences were found in the mean values of ZEB1 and E-cadherin expression in stages III and IV, II and III respectively.Conclusions. The study demonstrated statistically significant relationship between tumor stages and expression of E-cadherin and ZEB1 in the epithelial-mesenchymal transition. The loss of the E-cadherin expression in tumor cells of patients from stage II to stage IV and increased expression of ZEB1 in the studied groups were statistically significant (p<0.05).

Articulatory Behavior Pre and Post Full-Mouth Tooth Extraction and Alveoloplasty

1980 ◽  
Vol 23 (3) ◽  
pp. 630-645 ◽  
Author(s):  
Gerald Zimmermann ◽  
J.A. Scott Kelso ◽  
Larry Lander
Keyword(s):  
Control Subject ◽  
High Speed ◽  
Tooth Extraction ◽  
Kinematic Parameters ◽  
Experimental Conditions ◽  
Mean Values ◽  
Articulatory Movements ◽  
The Mean ◽  
Experimental Subjects ◽  
Normal Speech

High speed cinefluorography was used to track articulatory movements preceding and following full-mouth tooth extraction and alveoloplasty in two subjects. Films also were made of a control subject on two separate days. The purpose of the study was to determine the effects of dramatically altering the structural dimensions of the oral cavity on the kinematic parameters of speech. The results showed that the experimental subjects performed differently pre and postoperatively though the changes were in different directions for the two subjects. Differences in both means and variabilities of kinematic parameters were larger between days for the experimental (operated) subjects than for the control subject. The results for the Control subject also showed significant differences in the mean values of kinematic variables between days though these day-to-day differences could not account for the effects found pre- and postoperatively. The results of the kinematic analysis, particularly the finding that transition time was most stable over the experimental conditions for the operated subjects, are used to speculate about the coordination of normal speech.

Comparative Study of Intranasal, Subcutaneous and Intravenous Administration of Desamino-D-Arginine Vasopressin (DDAVP)

1986 ◽  
Vol 55 (01) ◽  
pp. 108-111 ◽  
Author(s):  
M Köhler ◽  
P Hellstern ◽  
C Miyashita ◽  
G von Blohn ◽  
E Wenzel
Keyword(s):  
Factor Viii ◽  
Von Willebrand Factor ◽  
Factor Xii ◽  
Additional Advantage ◽  
Mean Values ◽  
Routes Of Administration ◽  
The Mean ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Factor Antigen

SummaryThis study was performed to evaluate the influence of different routes of administration on the efficacy of DDAVP treatment. Ten healthy volunteers received DDAVP intranasally (i.n.), subcutaneously (s.c.) and intravenously (i.v.) in a randomized cross-over trial. Factor XII and high molecular weight (HMW)-kininogen levels increased only slightly after DDAVP administration. The mean increase of factor VIII: C was 3.1 (i. v.), 2.3 (s. c.), and 1.3 (i.n.) - fold over baseline. Ristocetin cofactor (von Willebrand factor antigen) increased 3.1 (2.5), 2.0 (2.3) and 1.2 (1.2) - fold over baseline mean values after i.v., s.c. and i.n. DDAVP, respectively. The half-disappearance time of factor VIII and von Willebrand factor (vWF) after DDAVP ranged from five (factor VIII: C) to eight hours (vWF). The mean increase of fibrinolytic activity was more pronounced after i.v. DDAVP. The antidiuretic effect was moderate with no apparent differences between the routes of application. This study provides further evidence that both i.v. and s.c. DDAVP administration result in an appropriate and reliable stimulation of haemostasis. An additional advantage of s. c. administration is its suitability for home treatment.

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

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