Abstract:Background: Literature has shown a growing number of published studies on Patellofemoral Pain Syndrome every year. The increasing evidence base has revealed a significant number of reviews which makes it confusing for clinicians and researchers to choose from the best evidence. This study aimed to gather the reviews on Patellofemoral Pain Syndrome and provide information about the most common clinical tests, risk factors, exercise treatment and outcome measures. In addition, secondary questions aimed to report the study settings and patient characteristics of the primary included studies.Methods: Studies eligible for this Review of Reviews were those published from 1993 to July 2013. Databases searched included PubMed, CINAHL, SPORTDiscus, Pedro and the Cochrane Library. Four key areas were searched using the words: PFPS, Anterior Knee Pain (AKP) or Chondromalacia patella (CP), plus a keyword. The keywords for the four research topics were a) risk factors; b) exercise treatment; c) diagnostic clinical tests and d) psychometric outcome measurements. Only reviews with clear methodological strategy were included. A two-stage evaluation was performed in each review assessment. At first, the level of evidence was graded and then the methodological quality of each review was assessed.Results: Full text screening revealed that only 18 reviews were eligible for use. The selected reviews included 213 primary studies. After excluding duplicates, 144 primary studies were screened to answer the secondary questions. A gold standard clinical test for PFPS assessment cannot be reached and the use of functional tasks should be considered. The quadriceps strength deficits are still the only evidence based risk factors along with the dynamic malalignment of the lower limb. More research is still required on strength and flexibility deficits of other lower limb muscles. The quadriceps-based exercises are still the only ones to have strong evidence together with hamstrings, quadriceps, gastrocnemius and anterior hip muscles stretching. Finally, the usage of Activities of Daily Living Scale is recommended as the best outcome measure. Conclusion:There is no evidence on whether the above treatment and assessment methods should be used in sedentary people or differently across population groups or gender. More RCTs with large populations, powered correctly, in clinical environments are called for in further research.
2,3-Butanediol (2,3-BD) is a reagent with remarkable commercial use as a platform chemical in numerous industries. The present study aims to determine the capabilities of non-pathogenic and cellulolytic Bacillus licheniformis 24 as a 2,3-BD producer. By applying the Plackett–Burman design and response surface methodology through central composite design (CCD), a complex optimization of medium and process parameters was conducted. Thus, among ten studied factors of medium content, four components were evaluated with a significant positive effect on 2,3-BD formation. Their optimal values for 2,3-BD production (yeast extract, 13.38 g/L; tryptone, 6.41 g/L; K2HPO4, 4.2 g/L; MgSO4, 0.32 g/L), as well as the optimal temperature (37.8 °C), pH (6.23) and aeration rate (3.68 vvm) were predicted by CCD experiments and validated in a series of batch processes. In optimized batch fermentation of 200 g/L of glucose 91.23 g/L of 2,3-BD was obtained, with the overall productivity of 1.94 g/L/h and yield of 0.488 g/g. To reveal the maximum 2,3-BD tolerance of B. licheniformis 24, fed-batch fermentation was carried out. The obtained 138.8 g/L of 2,3-BD with a yield of 0.479 g/g and productivity of 1.16 g/L/h ranks the strain among the best 2,3-BD producers.
ObjectiveBrain atrophy and brain herniation are gaining a lot of attention separately, but a limited amount of studies connected them together, and because of this, we are going to review and examine the subject in the current meta-analysis.MethodsThe authors collected data reporting brain atrophy of alcoholic and schizophrenic cause, as well as data on control patients, all of which was published on MEDLINE between 1996 and 2018. The included 11 articles were processed with a statistical program.ResultsWe found that the pericerebral space is unequal among the groups, while the intracranial volume is strongly correlated to the biggest foramen of the body. The effect of this inequality, however, is expressed in emergency cases, where the patients with brain atrophy will have more time before the final stage of brain herniation.ConclusionThe current study raises a controversial issue that requires careful investigation and high attention from the health care personnel.
Objective: Spinal arteriovenous malformations (AVM) manifest in the pediatric population very differently from the ones in adulthood. Despite that fact, the treatment strategy is quite the same, which provokes a question – whether some of the therapies have an advantage and if so, in which age group. Methods: For this reason, the authors searched the world literature between 1989 and 2018 for spinal AVM in children and further categorized the studies into two age groups: < 12 and ≥12. Results: The total number of included studies in this meta-analysis is 35. Seventeen of them are on the subject of AVM and 15 on the subject of arteriovenous fistula. Three studies encompass both types of lesions. Conclusion: After processing the data, we observed that there is no relationship between age group and the utilized management, except for the endovascular AVF in children less than 12 years of age. Because of this, it should be strongly considered in further management planning.
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