A Retrospective Study on the Efficacy of Two Different Rehabilitation Interventions on KOA: Shock Wave Therapy vs. Electroacupuncture Therapy

Objective. In this paper, we retrospectively reviewed the difference in clinical effectiveness of shock wave therapy and electroacupuncture therapy on knee osteoarthritis. Methods. A total of 128 treatment cases of knee osteoarthritis patients were extracted from the medical record system of Shenzhen Longhua District Central Hospital during the period from January 1, 2018, to January 30, 2020. The cases were divided into three groups for different treatments: shock wave group ( n = 54 ), electroacupuncture group ( n = 41 ), and control group ( n = 33 ). The shock wave group was given shock wave therapy combined basis clinical treatment; meanwhile, the electroacupuncture group was given electroacupuncture on the basis of actual clinical treatment. The control group was given conventional topical nonsteroidal anti-inflammatory drugs (Voltaren). Osteoarthritis index scale, NRS scale, and WHOQOL-BREF were observed before treatment, after 2 weeks, and 4 weeks after treatment. Results. This study found that the osteoarthritis index scale and NRS scale of the shock wave group and the electroacupuncture group were lower than those before treatment; it had significant difference ( P < 0.001 ). In WHOQOL-BREF, the shock wave group and the electroacupuncture group improved significantly four weeks after treatment ( P < 0.001 ), which was statistically different from the conventional group ( P = 0.04 ). Conclusion. Physical and rehabilitation medicine treatment (shock wave therapy) and traditional medical treatment (electroacupuncture) have better clinical effects on knee osteoarthritis, compared with conventional treatment. Shock wave and electric acupuncture have no apparent adverse reaction, suggesting that the treatment is safe and effective.

Modern surgical methods for the treatment of urolithiasis

The article presents historical data showing the following: how methods for the treatment of urolithiasis have been developed and improved; how endoscopic equipment has been introduced and modernized; how the prevention of postoperative complications and metaphylaxis of recurrent stone formation have changed recently. Approaches to choosing the surgical treatment method depend on many individual factors (localization, concretion size and density, the presence of complicating disease factors) and are personalized. Attention to this problem is focused because of the large number of patients suffering from urolithiasis (at least 3% of the population). Modern diagnostics and treatment technologies are able to sanitize and get rid of the stone of almost any patient, as the working-age population suffers from it, as a rule — these are highly qualified specialists who are forced to be treated for a long time due to urolithiasis complications or relapse. The general social significance of this disease, which can haunt a person throughout life, determines the need to study the pathogenetic mechanisms of stone formation, methods of metaphylaxis and to reduce the number of invasive methods for removing urinary tract concretions, which have many dangerous complications leading to a decrease in working capacity. KEYWORDS: urolithiasis, kidney, surgical treatment, shock wave lithotripsy, ureterorenoscopy, contact ureterolithotripsy, percutaneous nephrolitholapaxy. FOR CITATION: Berezhnoy A.G., Dunaevskaya S.S. Modern surgical methods for the treatment of urolithiasis. Russian Medical Inquiry. 2021;5(3):118–122. DOI: 10.32364/2587-6821-2021-5-3-118-122.

Desalination Performance Assessment of Scalable, Multi-Stack Ready Shock Electrodialysis Unit Utilizing Anion-Exchange Membranes

Incumbent electromembrane separation processes, including electrodialysis (ED) and electrodeionization (EDI), provide competitive techniques for desalination, selective separation, and unique solutions for ultra-pure water production. However, most of these common electrochemical systems are limited by concentration polarization and the necessity for multistep raw water pre-treatment. Shock electrodialysis (SED) utilizes overlimiting current to produce fresh, deionized water in a single step process by extending ion depleted zones that propagate through a porous medium as a sharp concentration gradient or a shock wave. So far, SED has been demonstrated on small scale laboratory units using cation-exchange membranes. In this work, we present a scalable and multi-stack ready unit with a large, 5000 mm2 membrane active area designed and constructed at the Technical University of Liberec in cooperation with MemBrain s.r.o. and Mega a.s. companies (Czechia). We report more than 99% salt rejection using anion-exchange membranes, depending on a dimensionless parameter that scales the constant applied current by the limiting current. It is shown that these parameters are most probably associated with pore size and porous media chemistry. Further design changes need to be done to the separator, the porous medium, and other functional elements to improve the functionality and energy efficiency.

Refractory patella tendinopathy with failed conservative treatment—shock wave or arthroscopy?

Aim: To identify whether the location of refractory patella tendinopathy (PT) has an effect on treatment modality (radial extracorporeal shock wave therapy (rESWT) or arthroscopic debridement). Methods: Between 2012 and 2014, 40 patients with PT underwent a magnetic resonance imaging (MRI) scan. This confirmed the diagnosis as either involving the tendon itself (group A, 20) or with retropatella fat pad extension (group B, 20). All patients underwent rESWT. If there was no improvement patients proceeded with surgery in the form of arthroscopic debridement (by senior authors CW and AG). Outcomes were assessed before and after treatment using the Victorian Institute of Sports Assessment-Patella (VISA-P) score. Results: There were 18 males and 2 females in group A and 15 males and 5 females in group B. The mean age was 41.4 years in group A (23–59) and 34.7 in group B (19–52). Seventeen of 20 in group A reported good or excellent outcomes and did not require surgical intervention (remaining three improved after second course of ESWT). All patients in group B failed to improve with rESWT, resulting in arthroscopic debridement and reported good or excellent outcomes. After 6 months, group A mean VISA-P score increased from 50.2 to 65.0 ( p = 0.01) and group B from 39.6 to 78.4 ( p = <0.001). Conclusion: An MRI should be performed to determine the precise location of tendinosis in patients with refractory PT who fail standard conservative management. If the MRI scan shows intratendon changes only, ESWT should be performed and those with extension into the fat pad should proceed to arthroscopic debridement without rESWT.

Resistance of Legionella to disinfection in hot water distribution systems

The efficiency of various disinfection treatments against Legionella was tested on a hot water distribution system (HWDS) pilot unit. The results demonstrated clearly that most Legionella in the networks were fixed in the biofilm at the surface of the pipe (more than 98% for each loop). Chemical treatments (continuous chlorination, hyperchlorination, hydrogen peroxide and peracetic acid mixing) commonly used for the eradication of Legionella in hot water distribution networks appeared to be inadequate for eradicating the bacteria in the biofilm. Unfortunately, the biofilm contained most of the pathogens in an HWDS whereas legislation is only restricted to the Legionella concentration in the water phase. Thermal treatment appeared to be efficient to disinfect most of the biofilm but seemed to promote the biofilm re-growth as well. It was then concluded that the best solution to prevent Legionella contamination in hot water distribution systems would be to have perfect control of the temperature in the networks (temperature &gt; 55°C at all points). Nevertheless, in many cases it is difficult to have such control, so during the time necessary to modify networks, the best solution to control Legionella proliferation appears to be to apply a treatment shock (thermal or chlorination as a function of pipe characteristics). These treatments must be followed by a continuous chlorination that is totally controlled and equipped with alarm systems. This study demonstrates that biofilm sampling devices must be installed in hot water distribution systems to anticipate Legionella contamination and correctly determine the efficiency of the treatments.

Attenuation of Latent Inhibition by Post-Acquisition Reminder

Using lick suppression by water-deprived rats as an associative index, white noise-footshock pairings resulted in less manifest conditioning when repeated non-reinforced presentations of the white noise preceded conditioning than when no stimulus pre-exposure was given, i.e., latent inhibition was observed. However, the latent inhibition deficit was reduced in animals who received as a reminder treatment shock-alone presentations in another context during the retention interval. Animals conditioned without prior stimulus pre-exposure and those exposed to the white noise and shock unpaired during the conditioning phase of the study showed no change in lick suppression as a result of the reminder treatment. These results suggest that the behavioural deficit produced by non-reinforced pre-exposure to the to-be-conditioned stimulus arises at least in part from a reversible retrieval failure rather than a lack of acquisition.

The response of the bovine ovary to pregnant mares’ serum and horse pituitary extract

The response of the bovine ovary to single subcutaneous injections of pregnant mares’ serum (P. M. S.) and horse pituitary extract has been studied both quantitatively and qualitatively. For the former both time-response and dose-response data were obtained, for the latter time-response data only. Quantitative changes were measured by the following ovarian indices: mean follicular diameter (M. D.); percentage of follicles M. D. ≥ 10 mm.; number of follicles M. D. ≥ 4 mm.; number of follicles M. D. ≥ 10 mm.; total follicular volume, and weight. Only the first two criteria were found to have more than a rough relationship with the duration and magnitude of the treatment given. The threshold dose of P. M. S. for quantitative effects was between 1000 and 2000 i. u. For higher doses the ovarian response was most pronounced, but there was evidence that the maximal rate of stimulation had been reached with doses of 3000-4000 i. u. For both gonadotrophins the stage of the oestrous cycle at which injections were given had no differentiating effect upon the quantitative response obtained. In particular, the total number of follicles stimulated to growth, an index that ranged widely, showed no correla­tion with this variable. Qualitative changes observed included multiple ovulation, anovulatory luteinization, the formation of abnormally small corpora lutea (P. M. S. only), and the occurrence of haemorrhagic follicles. An effect caused by horse pituitary injections only was the rupture of a single follicle within 1-2 days of treatment (‘shock’ effect). Ovulation following treatment with P. M. S. only occurred when the injection was given in the last, or follicular, phase of the oestrous cycle. With horse pituitary injections ovulation followed treatment given at all stages of the cycle. The differences in the biological properties of these two gonadotrophic preparations have been discussed in the light of the new evidence arising from this study.