The aim of this study was to compare the efficacy of sodium hyaluronate (SH) injection with the most common treatment methods, intraarticular steroid injection and physical therapy modalities in patients with adhesive capsulitis (AC). A total of 95 shoulders of 90 patients were included in the study and were randomized in four groups. The patients were treated with SH injection (group 1), triamsinolone acetonide (group 2) or physical therapy modalities (group 3). Group 4 patients were served as controls. Pain severity, passive ranges of motion and functional considerations were measured before, and 15 days and 3 months after the treatments. In all treatment groups, there were significant improvements at both the 15th day and third month in all parameters (for each, p<0.001). The passive abduction values on the 15th day was found significantly higher in group 3 when compared with group 1 and controls (for each, p<0.001). At the third month, the passive abduction values of the groups 2 and 3 were improved when compared with the control group (p<0.001). Constant score was higher in group 3 on 15th day when compared with group 1. At the third month, all treatment groups were improved significantly compared with control group (p<0.001). We provided the best results in physical therapy modalities applied group for AC treatment. However, we think that SH injection may be administered as an alternative treatment method.
We investigated the effects of electrical stimulation (ES) and laser treatment on wound healing in rats. A randomized-controlled trial, conducted at the Experimental and Clinical Research Centre of Erciyes University (Kayseri, Turkey), divided 124 healthy female Swiss-Albino rats into four groups. A 6 cm linear incision was made at the dorsal skin of all rats. Group 1 was given a constant direct current of 300 µA for 30 min per day. The current was applied in negative polarity for the first 3 days and in positive polarity for the next 7 days. Group 3 received a full-contact, continuous galliumarsenide (GaAs) laser therapy, with a wavelength of 904 nm, an energy density of 1 J/cm 2 , and an average power of 6 mW for 10 min per day. The remaining two groups (Groups 2 and 4) were considered the control groups and received sham treatment. All groups were treated for 10 days. Histopathologic and biochemical evaluations were conducted on 10 rats from each group on the 4th and 10th days, and wound breaking strength was measured for biomechanical evaluation on the 25th day of the study. Both ES and laser treatment proved significantly effective in the inflammatory phase compared with control groups (p < 0.05); however, the ES was even more effective than laser treatment, with more significant results (p < 0.05). In the proliferation and maturation phases, while ES and laser treatment were both found to be significantly effective treatment methods compared with the control groups, no statistically significant difference was observed between the two treatment groups (p > 0.05). Although ES and laser treatment both were effective in the maturation phase, increasing wound breaking strength compared with their control groups (p < 0.05), there was no statistically significant difference between the two treatment groups (p > 0.05). We conclude that ES and laser treatment both have beneficial effects during the inflammatory, proliferation, and maturation phases of a wound. Both ES and laser treatment can be used successfully in decubitis ulcers and chronic wounds, in combination with conventional therapies such as daily care and debridement of wounds; however, ES has more beneficial effects during the inflammatory phase in some parameters than laser treatment.
Although US, L, and combined US + L treatments increased tendon healing biochemically and biomechanically more than the control groups, no statistically significant difference was found between them. Also we did not find significantly more cumulative positive effects of combined treatment. As a result, both of these physical modalities can be used successfully in the treatment of tendon healing.
We aimed to determine the importance of neutrophil activation and the source of oxidative stress in the pathogenesis of rheumatoid arthritis (RA) by quantification of advanced oxidation protein products (AOPP) and total thiol levels as markers of oxidative protein damage, malondialdehyde (MDA) levels as a marker of lipid peroxidation and myeloperoxidase (MPO) activity as a marker of neutrophil activation in patients with RA. Fifty-seven rheumatoid arthritis patients were included in the study and sub-grouped according to disease activity (active, n = 31; inactive, n = 26) and compared with healthy controls (n = 25). Serum MPO activity, AOPP, MDA, and thiol levels were measured by an enzymic spectrophotometric method. Serum MPO activity (p < 0.001), AOPP (p < 0.001), MDA (p < 0.001) and levels of thiol (p < 0.002), were higher in the patient group than the controls. Active and inactive RA groups were compared with the control group and there were significant differences between each parameter. MPO activity, AOPP, MDA and thiol levels were significantly higher in both active and inactive RA patients than the controls. On the other hand, when a comparison was made between active and the inactive stage, a statistically significant difference was present only in MDA (p < 0.05) and AOPP levels (p < 0.05). There was also a significant positive correlation between all parameters. These data strongly suggest that neutrophils, which constitute the most important source of chlorinated oxidants due to their high MPO content, may be involved in serum AOPP formation and therefore the production of a novel class of pro-inflammatory mediators of oxidative stress in RA patients and that protein oxidation could play an important role in the pathogenesis of RA as does lipid peroxidation.
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