NON-INVASIVE METHODS FOR DAMAGE DIAGNOSIS OF MENISUS OF THE KNEE JOINT

Цель исследования: оптимизация результатов хирургического лечения пациентов с повреждениями менисков коленного суставас использованием малоинвазивной органосохраняющей технологии «сшивания мениска». В статье приведены результаты хирургического лечения 70 больных с повреждениями менисков коленного сустава, лечившийся ГКП на ПХВ ГКБ № 7 г. Алматы за период с 2017 по 2020 гг. Все больные были распределены на контрольную и основную гроуппу. В контрольную группу вошли 40 (57,2%) больных. Им выполнена артроскопическая резекция мениска. Коленный сустав не иммобилизовали, больные получали физиолечение, ЛФК и массаж. 30 (42,8%) больных отнесены к основной группе, которым выполнен шов менисков под астроскопом по новому способу (свидетельство на авторское право № 9602 от 04.05.2020.). Коленный сустав иммобилизовали на 4 недель, больтные получали также физиолечение, ЛФК и массаж конечности. Комплексное лечение больных с использованием нового способа артроскопического сшивание мениска (свидетельство на авторское право № 9602 от 04.05.2020.), ранние активные движения в здоровых суставах нижней конечности (голеностопных и тазобедренных со второго дня) и ранние пассивные и активные движения в оперированном коленном суставе (со второго дня), поздняя нагрузка на оперированную конечность (через 4 недель), способствовало в 96,7% случаях получить хороших и удовлетворительных результатов лечения у пациентов основной группы. Частота неудовлетворительных исходов лечения в основной группе встречается на 6,2% реже в сравнении с пациентами контрольной группы. Objective of the study: to optimize the results of surgical treatment of patients with injuries of the knee menisci using the minimally invasive organ-preserving technology of "stitching the meniscus". The article presents the results of surgical treatment of 70 patients with injuries of the knee menisci, who were treated by the MCP at the PCV City Clinical Hospital № 7 in Almaty for the period from 2017 to 2020. All patients were divided into control and main groups. The control group included 40 (57.2%) patients. He performed arthroscopic resection of the meniscus. The knee joint was not immobilized, the patients received physiotherapy, exercise therapy and massage. Thirty (42.8%) patients were referred to the main group, who had meniscus suture performed under an astroscopic technique using a new method (copyright certificate № 9602 dated 05/04/2020). The knee joint was immobilized for 4 weeks, the patients also received physiotherapy, exercise therapy and limb massage. Complex treatment of patients using a new method of arthroscopic suturing of the meniscus (copyright certificate № 9602 dated 05/04/2020), early active movements in healthy joints of the lower limb (ankle and hip from the second day) and early passive and active movements in the operated knee joint (from the second day), late loading on the operated limb (after 4 weeks), contributed in 96.7% of cases to obtain good and satisfactory treatment results in patients of the main group. The incidence of unsatisfactory treatment outcomes in the main group is 6.2% less common in comparison with patients in the control group.

Feasibility of Continuous Distal Body Temperature for Passive, Early Pregnancy Detection

The majority of American women become aware of pregnancy ~3-7 weeks after conception, and all must seek testing to confirm their pregnant status. The delay between conception and awareness is often a time in which contraindicated behaviors take place. However, there is long standing evidence that passive, early pregnancy detection may be possible using body temperature. To address this possibility, we analyzed 30 individuals continuous distal body temperature (DBT) in the 180 days surrounding self-reported conception in comparison to self-reported pregnancy confirmation. Features of DBT nightly maxima changed rapidly following self-reported conception, reaching uniquely elevated values after a median of 5.5 +/- 3.5 days, whereas individuals reported a positive pregnancy test result at a median of 14.5 +/- 4.2 days. Together, we were able to generate a retrospective, hypothetical alert a median of 9 +/- 3.9 days prior to the date at which individuals received a positive pregnancy test. Continuous temperature-derived features can provide early, passive indication of pregnancy onset. We propose these features for testing and refinement in clinical settings, and for exploration in large, diverse cohorts. The development of pregnancy detection using DBT may reduce the delay from conception to awareness and increase the agency of pregnant individuals.

Rehabilitation after flexor tendon repair and others: a safe and efficient protocol

In this review I detail the protocol that I use after flexor tendon repair and outline my experience regarding how its framework might be used for other disorders. The early passive–active flexion protocol has a sufficient number of cycles of active flexion in each exercise session, which is at least 40, and ideally 60 to 80. The frequency of exercise sessions may range from 4 to 6 a day, distributed in the morning, afternoon and evening. Increasing the number of daily sessions without a sufficient number of runs in each session is ineffective. In the first 2–3 weeks after surgery, active digital flexion should go through only a partial range. In weeks 4–6, the patient gradually moves through the full range. With modifications, I suggest generalization of the partial-range finger motion to therapy after treating other hand injuries. I consider partial-range active flexion a generalizable working principle for different hand disorders.

Visual response of ventrolateral prefrontal neurons and their behavior-related modulation

The ventral part of lateral prefrontal cortex (VLPF) of the monkey receives strong visual input, mainly from inferotemporal cortex. It has been shown that VLPF neurons can show visual responses during paradigms requiring to associate arbitrary visual cues to behavioral reactions. Further studies showed that there are also VLPF neurons responding to the presentation of specific visual stimuli, such as objects and faces. However, it is largely unknown whether VLPF neurons respond and differentiate between stimuli belonging to different categories, also in absence of a specific requirement to actively categorize or to exploit these stimuli for choosing a given behavior. The first aim of the present study is to evaluate and map the responses of neurons of a large sector of VLPF to a wide set of visual stimuli when monkeys simply observe them. Recent studies showed that visual responses to objects are also present in VLPF neurons coding action execution, when they are the target of the action. Thus, the second aim of the present study is to compare the visual responses of VLPF neurons when the same objects are simply observed or when they become the target of a grasping action. Our results indicate that: (1) part of VLPF visually responsive neurons respond specifically to one stimulus or to a small set of stimuli, but there is no indication of a “passive” categorical coding; (2) VLPF neuronal visual responses to objects are often modulated by the task conditions in which the object is observed, with the strongest response when the object is target of an action. These data indicate that VLPF performs an early passive description of several types of visual stimuli, that can then be used for organizing and planning behavior. This could explain the modulation of visual response both in associative learning and in natural behavior.

Early Passive Leg Movement Prevents Against the Development of Heart Failure With Preserved Ejection Fraction in Rats

Exercising was reported by several studies to bring great benefits to heart failure with preserved ejection fraction (HFpEF), which reduced the hospitalization and the mortality of heart failure. However, the underlying mechanism of exercising on HFpEF remains unclear. In the present study, we designed and constructed a device that can perform early passive leg movement (ePLM) in rats and further observed whether treatment of ePLM exerts protective effects on HFpEF of rats. Rats were fed with high salt feed to establish an animal model of pre-clinical diastolic dysfunction (PDD), which would eventually develop into HFpEF, and then treated rats with ePLM. We conducted several experiments to evaluate the conditions of heart and blood vessel. The results show that diastolic functions of heart and blood vessel in rats were significantly improved by treatment of ePLM. We also found that pathological injuries of heart and blood vessel were ameliorated after treatment of ePLM. Moreover, treatment of ePLM decreased the protein levels of Collagen type I, Collagen type III, MMP2, and MMP9 in heart and blood vessel, indicating that cardiac and vascular fibrosis were reduced apparently by treatment of ePLM. Further investigation suggested that treatment of ePLM probably inhibit the activation of TGF-β1/Smad3 signaling pathway as well as promote the activation of Akt/eNOS signaling pathway in high salt diet induced HFpEF. In conclusion, treatment of ePLM alleviated high salt diet induced HFpEF by inhibiting fibrosis via suppressing TGF-β1/Smad3 signaling pathway as well as activating Akt/eNOS signaling pathway, implicating treatment of ePLM as a promising novel non-pharmacological approach for HFpEF.

Passive Smoking is Associated with Risk of Early Onset of Cardiac Dysfunction

Background: Second hand smoke (SHS) exposes infants and young children to many short and long term hazards. In adults PS was found to result in left sided diastolic dysfunction. Aim: To identify changes in the structure and function of the right side of the heart that can be influenced by exposure of infants to SHS. Methods: Echocardiographic evaluation of the right side of the heart was carried out for 75 infants aged 3 to 12 months of age; 39 were formula milk fed (FF) from birth and an age matched control of 36 breastfed (BF) infants. A sub-analysis was done for each group in relation to exposure to PS. Measurements included Tricuspid annular plane excursion (TAPSE) and S’ wave for peak systolic annular velocity for right systolic function, E wave (early passive ventricular filling) and E/A ratio, tissue Doppler imaging (TDI) for E’ and A’ and E/E’ prime ratio for assessing ventricular filling pressure for diastolic dysfunction. Findings: TDI in FF showed significantly higher values for E prime and E/E’ ratio in infants not exposed to SHS vs. those exposed to SHS (12.5±0.96 cm vs. 11.1±1.1 cm at P=0.000) and E/E’ (6.65±0.9 vs. 7.7±0.9 at P=0.003) respectively. There were no significant differences in systolic function (TAPSE) and S’ wave. However RV diameter was significantly higher in those exposed to SHS (1.3±0.09 cm) vs. no exposure (1.2±0.07 cm) at P<0.05. In the BF there were no significant differences in all dimensions examined for SHS exposures and no exposures. Conclusions: SHS in FF infants are at risk of right sided diastolic dysfunction while early breastfeeding seems to protect the heart from the hazards of SHS.

Differences between the Filling Velocities of the Left and Right Heart Ventricle in Racing Pigeons (Columba Livia F. Domestica) and the Influence of Anesthesia with Isoflurane

The ventricular filling velocities during diastole and the influence of isoflurane anesthesia on these blood flow velocities of the racing pigeon (n = 43) are evaluated by pulsed-wave (PW) Doppler sonography. Sonographic examination demonstrates an early passive ventricular (E wave) and late active (A wave) ventricular filling. The results indicate differences between the two heart ventricles. Especially, the E wave velocity of the right heart is significantly lower than in the left heart, which is explained by the crescent-shaped cavity of the right ventricle around the left ventricle. The faster active filling velocities are significantly influenced by heart rate in conscious birds. Anesthesia with isoflurane leads to a significant decrease of the diastolic blood flow velocities, and the A wave velocities of both ventricles are especially influenced. Anesthesia with isoflurane induces a high incidence of insufficiencies of the left atrioventricular valve in the preejection period. These observations indicate that a contraction of the left ventricle myocardium is important for a complete valvular closure and for normal functioning of this heart valve. The effective closure of the right atrioventricular muscle valve in anesthetized pigeons supports the observation of the fast innervation of this muscle valve via a direct connection to the right atrium.