The aim: To study was to use mathematical modeling in assessing the stress-strain state of the bone-implant system during plate osteosynthesis with a PHILOS plate of a proximal humerus fracture with polylactic acid implants. Materials and methods: Two bone-implant systems with a three-fragment humerus fracture according to the Neer classification (type 11-C1 according to the AO / ASIF classification) were selected for the study, one of which was with additional reinforcement of the head fragment with two polylactic acid implants (PLA – polylactide Ingeo™ Biopolymer 4032D). Sawbones (Europe AB, Malmö, Sweden) built the humeral model on 3D scanning of the composite model № 3404 of the left humerus. Results: A comparative analysis of the obtained results of mathematical modeling of the stress-strain state of the bone-implant systems showed that with given constraints (hand abduction to 90°), the use of two polylactic acid implants can reduce the stress in the plate and screws, respectively, by 11% and 6% . Conclusions: The use of polylactic acid implants during osteosynthesis of three- and four-fragment fractures of the proximal humerus, especially in the case of osteoporosis, allows providing for the reinforcement of metal structures and supporting of the articular surface without deterioration of fixation rigidity.
Introduction: The biochemical markers of the connective tissue metabolism in blood serum may characterize the disturbances in inflammatory, destructive processes, and also serve the criteria for diagnostic evaluation of the state of cartilage and bone tissue of the joints in knee osteoarthritis to control the effectiveness of conservative treatment. The aim: determination of biochemical markers of connective tissue metabolism in the blood of patients with the 1st and 2nd stages of knee osteoarthritis in order to prove the effectiveness of the complex conservative treatment of patients with the use of low-intensity infrared laser radiation. Materials and methods: During the study we examined 80 patients with the 1st and 2nd stages of knee osteoarthritis according to the Kellgren and Lawrence classification. Some patients were prescribed diclofenac sodium and glucosamine hydrochloride, others were prescribed an additional course of laser therapy. Results: At the end of the treatment the group of patients with knee osteoarthritis who were treated with the use of laser therapy, diclofenac sodium and glucosamine hydrochloride, showed a decrease in the content of the following blood serum components: glycoproteins (by 28.9 %), sialic acids (by 28.8 %), chondroitinsulfates (by 91.3 %) due to chondroitin-6-sulfate, activity of alkaline phosphatase (by 36.1 %) compared with the indicators before treatment. Conclusions: a more significant decrease in the inflammation and destruction of the cartilage tissue of the affected joints was observed during knee osteoarthritis treatment with the use of laser therapy than without it.
The purpose of the study was to summarize new literature data on the effect of physical activity on the secretory function of skeletal muscles and their relationship with organs. Materials and methods. Analytical methods were used in the study. The search for scientific information was carried out in databases of search systems. Results. Muscles secrete proteins called myokines, which are involved in a variety of processes by interacting with tissues. Current research has shown that exercise, by stimulating the skeletal muscle system in vivo, leads to the release of myokines and causes several effects that explain the positive effect of exercise in the treatment of several diseases of the musculoskeletal system. Skeletal muscles synthesize and secrete a wide range of myokines that contribute to various functions in organs, including the brain. Recent publications have focused much attention on one such myokine, the recently discovered protein irisin, which is secreted into the bloodstream from skeletal muscle during exercise from the membrane-bound precursor fibronectin type III. Irisin promotes metabolic processes such as glucose homeostasis and the darkening of white adipose tissue. Irisin also crosses the blood-brain barrier and initiates a neuroprotective genetic program in the hippocampus, which culminates in increased expression of brain-derived neurotrophic factors. Most studies report that irisin concentration is closely related to health status. For example, irisin levels are significantly lower in patients with obesity, osteoporosis/fracture, muscular atrophy, Alzheimer's disease, and cardiovascular disease. Over the past decade, several myokines have been discovered, expanding our understanding of how muscles interact with other organs. In recent publications, a lot of attention is paid to the recently discovered protein irisin, which contributes to metabolic processes. A series of studies on irisin have provided new insights into the mechanisms of exercise to improve bone density, counteract cartilage degeneration, and maintain overall joint environmental homeostasis. These studies further contribute to the understanding of the role of exercise in the fight against osteoarthritis and may provide important assistance in advancing the prevention and treatment of this common disease. Research on the exercise-induced muscle factor irisin will help to better understand and explain the beneficial effects of exercise on maintaining physical health, especially in the fight against aging and age-related degenerative changes. Conclusion. Thus, exercise-induced stimulation of bioactive cytokines increases muscle anabolism, bone formation, mitochondrial biogenesis, glucose utilization, and fatty acid oxidation, and reduces chronic inflammation
The high risk of fall-risk in patients with Parkinson's disease leads to traumatic consequences, in particular, to the femoral neck fractures. Predictors of fall-risk are old age, sarcopenia, and polymorbidity. All of these conditions are independent indications for carrying out rehabilitation measures; but their combination in one patient should introduce specific features into the recovery process aimed at leveling the signs of each disease. The purpose of the study was to assess the dynamics of functional activity in older people with Parkinson's disease and frailty with the consequences of femoral neck fractures under the influence of physical therapy. Material and methods. We examined 21 elderly patients with Parkinson's disease and frailty in the recovery period after the femoral neck fracture. They were divided into two groups: group 1 practiced according to the principles of polyclinic rehabilitation with a predominance of the use of preformed physical factors and general principles of physical therapy and group 2 practiced according to a developed program of physical therapy with an emphasis on functional training aimed at improving physical qualities, movement stereotype, primarily movement and self-service, taking into account the polymorbidity of the pathology. The developed physical therapy program lasted 3 months; corrective sessions were held three times a week. The program was created taking into account the setting and consistent achievement of individual short- and long-term rehabilitation goals. The effectiveness of the program was assessed based on the results of the Barthel Activities of the daily living Index and the Lawton Instrumental activities of the daily living Scale. Results and discussion. In elderly patients with Parkinson's disease and frailty in the recovery period after the femur neck fracture, a low level of basic (according to the Bartel index) and instrumental (according to the Lawton scale) functional activities is diagnosed, which leads to restrictions in everyday activities and self-care. The developed program of physical therapy revealed a statistically significantly better effect on the indices of the basic and instrumental functional activities of the examined persons in comparison with the general polyclinic program: the increase in the general level of the basic functional activity of the Bartel index in group 1 was 15.52%, in group 2 was 35.59% (p <0.05). Improvement in the overall score of instrumental activity on the Lawton scale in group 1 was 18.70%, in group 2 it was 36.11% (p <0.05). Conclusion. Elderly patients with polymorbid pathology with traumatic bone injuries require the preparation of pathogenetically based physical therapy programs, taking into account and correcting the specificity of each disease, which increased the overall effectiveness of rehabilitation and, as a consequence, the functional activity of patients
Relevance. The analysis demonstrated that legislative documents in Ukraine were developed to prevent and combat domestic violence, protect and respect human rights. The basic standards of the regulatory framework of Ukraine are consistent with the Istanbul Convention. A positive moment in the modern legislation of Ukraine is the establishment of restrictive measures for people who have committed domestic violence in the form of a ban on staying in a place of joint residence with a person who has suffered from domestic violence. Some recommendations on conducting a forensic medical examination in cases of domestic violence are proposed. Displayed aspects of an ethical approach in the "Rules for the Examination of Victims, Accused, and Other Persons" in order to reduce psychological trauma during the examination. Objective: to analyze and summarize the legal and forensic aspects of providing legal assistance to victims of domestic violence in Ukraine and to offer recommendations for their improvement Material and methods. The materials are data from available Internet sources within the spring of 2020; 68 appeals to forensic medical institutions. The analysis was performed using a descriptive method; fixation methods, statistical processing of the results. Results. Ukraine is oriented towards European standards, including in the area of issues of prevention and counteraction to domestic violence and respect for human rights. Recommended using modern methods of fixation during data collection and further examination of the victim in order to be able to use the obtained data by the parties to criminal proceedings / Сourt. Conclusions. The issue of prevention and counteraction to domestic violence needs special attention and further resolution due to the increase in domestic violence cases, especially during quarantine caused by COVID-19.
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