scholarly journals The Influence of Viewing Photos of Different Types of Rural Landscapes on Stress in Beijing

2019 ◽  
Vol 11 (9) ◽  
pp. 2537
Author(s):  
Xiaobo Wang ◽  
Hanlun Zhu ◽  
Zhendong Shang ◽  
Yencheng Chiang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Relief ◽  
Rural Landscape ◽  
Rural Landscapes ◽  
Significant Difference ◽  
Different Types ◽  
Type 3

The environment can affect people’s health by relieving stress, and rural landscape as a special environment might influence human’s stress relief. This study takes different types of rural landscapes as the research object to explore their impact on stress levels, which are shown by photos. As an independent variable, the rural landscape is divided into three levels: Type 1 (natural landscape), type 2 (productive landscape), and type 3 (artificial landscape). Seventy-three subjects were randomly assigned to each type of rural landscape. Salivary cortisol, blood pressure, heart rate, and a subjective rating state scale (brief profile of mood states, BPOMS) were used as indicators of stress. At the same time, the influence of preference and familiarity on the stress relieving effect was also discussed. A paired t-test and one-way analysis of variance (ANOVA) were used as the main statistical methods. In the results of t-test for pre-posttest, significant difference was observed in high blood pressure, heart rate, and total mood disturbance (TMD) of type 1 and type 2, and the high and low blood pressure of type 3; ANOVA analysis revealed that for the difference of pre-posttest, significant difference was observed in the TMD value among the three types; except for type 3, blood pressure, heart rate, and BPOMS values were significantly affected by preference and familiarity. The conclusions include the following: The three types of rural landscapes have a positive effect on relieving stress; the productive landscape has the best effect on relieving stress; and users’ landscape preferences and familiarity with the environment can affect the effect of stress relief in rural landscapes.

FUNCTIONAL STATUS AND ADAPTIVE POTENTIAL IN FOREIGN STUDENTS WITH DIFFERENT TYPES OF VEGETATIVE REGULATION DURING TUITION

2020 ◽  
pp. 118-126
Author(s):  
A.M. Satarkulova
Keyword(s):  
Heart Rate ◽  
Foreign Students ◽  
Autonomic Regulation ◽  
The Body ◽  
Functional Changes ◽  
Different Types ◽  
Type 3 ◽  
Adaptive Abilities

The assessment and dynamic control over students’ status is a very important task. It allows timely detection of prenosological status prior to pathology and health maintenance in students. The objective of the paper is to assess the adaptive abilities of the body, to analyze changes in heart rate variability indicators in students with various types of autonomic regulation, to identify prenosological status and precursory pathological symptoms. Materials and Methods. The study enrolled 302 students from India, aged 21.54±1.43. Programming complex «Psychophysiologist» was used to register the main HRV parameters within 5 minutes. Health status was evaluated according to the index of functional changes and the scale of functional states. Results. N.I. Shlyk (2009) distinguished two groups of students with different types of autonomic regulation: type 1 (53 %) with moderate and type 2 (5 %) with marked characteristics of central regulation profile, type 3 (35 %) with moderate and type 4 (7 %) with marked characteristics of autonomous regulation profile. Main parameters of HRV and adaptation potential were defined for each student.All the parameters characterized functional and health status. Conclusions. It was shown that 82 % of trial subjects (type 1), 53 % (type 2), 94 % (type 3) and 95 % (type 4) demonstrated satisfactory adaptation and their physiological processes were at an optimal level. 18 % of students (type 1) demonstrated reduced adaptive abilities of the body. Moreover, they were under moderate stress. 47 % of subjects (type 2) were also under a significant stress, which was proven by excessively high SI, low SDNN and TP, and an increased index of functional changes. 5 % of students (type 4) revealed dysfunctional characteristics in the heart rhythm, peculiar to pathology. Keywords: foreign students, heart rate variability, types of autonomic regulation, adaptation potential, functional status. Оценка состояния студентов и динамический контроль за ним является важной задачей, поскольку позволяет своевременно выявлять у студентов донозологические состояния, предшествующие патологии, и способствовать сохранению здоровья. Цель. Оценка адаптивных возможностей организма, анализ изменений показателей вариабельности сердечного ритма у студентов с различными типами вегетативной регуляции, выявление донозологических состояний и ранних признаков патологии. Материалы и методы. В исследовании участвовало 302 студента в возрасте 21,54+1,43 года из Индии. Регистрировались основные параметры ВСР в течение 5 мин с использованием программно-аппаратного комплекса «Психофизиолог». Состояние и уровень здоровья оценивались по индексу функциональных изменений и шкале функциональных состояний. Результаты. По способу, предложенному Н.И. Шлык, выделены группы студентов с различными типами вегетативной регуляции: I (53 %) и II типы (5 %) – с умеренным и выраженным преобладанием центрального контура регуляции соответственно, III (35 %) и IV типы (7 %) – с умеренным и выраженным преобладанием автономного контура регуляции соответственно. У каждого из студентов определены основные параметры ВСР и адаптационного потенциала, характеризующие функциональное состояние и уровень здоровья. Выводы. Показано, что для 82 % обследуемых с I типом, 53 % со II типом, 94 % c III типом и 95 % с IV типом регуляции характерно состояние удовлетворительной адаптации, физиологические процессы сохраняются на оптимальном уровне. В группе студентов I типа у 18 % студентов адаптивные возможности организма снижены, выявлено состояние умеренного напряжения. У 47 % обследуемых II типа также зафиксировано состояние резко выраженного напряжения, индикатором которого является чрезмерно высокое значение SI, низкие величины SDNN и ТP, повышенное значение индекса функциональных изменений. В группе студентов с IV типом у 5 % учащихсяв регуляции ритма сердца выявлены дисфункциональные признаки, характерные для патологии. Ключевые слова: иностранные студенты, вариабельность сердечного ритма, типы вегетативной регуляции, адаптационный потенциал, функциональное состояние.

scholarly journals CNNM2-Related Disorders: Phenotype and Its Severity Were Associated With the Mode of Inheritance

2021 ◽  
Vol 9 ◽  
Author(s):  
Han Zhang ◽  
Ye Wu ◽  
Yuwu Jiang
Keyword(s):  
De Novo ◽  
Serum Magnesium ◽  
Brain Magnetic Resonance Imaging ◽  
Functional Studies ◽  
Pathogenic Variants ◽  
Significant Difference ◽  
Domain Variations ◽  
Type 3

CNNM2 (Cystathionine-β-synthase-pair Domain Divalent Metal Cation Transport Mediator 2) pathogenic variants have been reported to cause hypomagnesemia, epilepsy, and intellectual disability/developmental delay (ID/DD). We identified two new cases with CNNM2 novel de novo pathogenic variants, c.814T>C and c.976G>C. They both presented with infantile-onset epilepsy with DD and hypomagnesemia refractory to magnesium supplementation. To date, 21 cases with CNNM2-related disorders have been reported. We combined all 23 cases to analyze the features of CNNM2-related disorders. The phenotypes can be classified into three types: type 1, autosomal dominant (AD) inherited simple hypomagnesemia; type 2, AD inherited hypomagnesemia with epilepsy and ID/DD; and type 3, autosomal recessive (AR) inherited hypomagnesemia with epilepsy and ID/DD. All five type 1 cases had no epilepsy or ID/DD; they all had hypomagnesemia, and three of them presented with symptoms secondary to hypomagnesemia. Fifteen type 2 patients could have ID/DD and seizures, which can be controlled with antiseizure medications (ASMs); their variations clustered in the DUF21 domain of CNNM2. All three type 3 patients had seizures from 1 to 6 days after birth; the seizures were refractory, and 1/3 had status epilepticus; ID/DD in these AR-inherited cases was more severe than that of AD-inherited cases; they all had abnormalities of brain magnetic resonance imaging (MRI). Except for one patient whose serum magnesium was the lower limit of normal, others had definite hypomagnesemia. Hypomagnesemia could be improved after magnesium supplement but could not return to the normal level. Variations in the CBS2 domain may be related to lower serum magnesium. However, there was no significant difference in the level of serum magnesium among the patients with three different types of CNNM2-related disorders. The severity of different phenotypes was therefore not explained by decreased serum magnesium. We expanded the spectrum of CNNM2 variants and classified the phenotypes of CNNM2-related disorders into three types. We found that DUF21 domain variations were most associated with CNNM2-related central nervous system phenotypes, whereas hypomagnesemia was more pronounced in patients with CBS2 domain variations, and AR-inherited CNNM2-related disorders had the most severe phenotype. These results provide important clues for further functional studies of CNNM2 and provide basic foundations for more accurate genetic counseling.

scholarly journals Global sagittal spinal alignment in patients with degenerative low-grade lumbar spondylolisthesis

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901988519
Author(s):  
Hiroto Kobayashi ◽  
Kenji Endo ◽  
Yasunobu Sawaji ◽  
Yuji Matsuoka ◽  
Hirosuke Nishimura ◽  
...  
Keyword(s):  
Sacral Slope ◽  
Low Grade ◽  
Spinal Alignment ◽  
Sagittal Spinal Alignment ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Type 3

Purpose: Global sagittal spinal alignment undergoes changes on the basis of sagittal malalignment (trunk inclined forward) in natural degenerative progression. We hypothesized that this change would associate with the disease state of the degenerative lumbar spondylolisthesis (DS). This study aimed to evaluate the global sagittal spinal alignment of low-grade DS by classifying in accordance with sagittal vertical axis (SVA). Methods: The DS group was classified into three types according to the adult spinal deformity classification: type 1, SVA < 40 mm; type 2, 40 mm ≤ SVA < 95 mm; and type 3, 95 mm ≤ SVA. Age and sagittal spinal parameters (thoracic kyphosis, lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI)) were compared among three types. Results: There were statistically significant differences in age, LL, PI, and PT among the three types. In comparison between two types, there was a statistically significant difference between type 1 and type 2 and between type 1 and type 3, but not between type 2 and type 3 in these parameters. PI tended to increase as the type increases. Furthermore, there was significant difference between types 1 and 3. Conclusion: We evaluated the features of the DS types classified by sagittal alignment. Large PI is one of the risk factors for SVA deterioration of DS. PI may be involved in the onset and progression of DS.

scholarly journals Analysis of the Characteristics and Number of Bicycle–Passenger Conflicts at Bus Stops for Improving Safety

2019 ◽  
Vol 11 (19) ◽  
pp. 5263 ◽  
Author(s):  
Xingchen Yan ◽  
Tao Wang ◽  
Jun Chen ◽  
Xiaofei Ye ◽  
Zhen Yang ◽  
...  
Keyword(s):  
Video Recording ◽  
Longitudinal Direction ◽  
Percentage Error ◽  
Significant Difference ◽  
Conflict Duration ◽  
Passenger Volume ◽  
Bus Stops ◽  
Type 3

This study aimed to analyze the characteristics of bicycle–passenger conflicts at bus stops and develop a model to predict the number of conflicts accurately. This paper investigated the traffic flow operation at bus stops by video recording. Duration and distribution characteristics of bicycle–passenger conflicts were statistically analyzed. Then four types of conflicts defined based on evasive behavior (cyclist yielding as Type 1, cyclist bypassing as Type 2, passenger yielding as Type 3, and passenger bypassing as Type 4) were compared. A generalized event count (GEC) model was established for bicycle–passenger conflict estimation and analysis. The main results indicated that: (1) The average conflict duration was 1.716 s, whilst 60.9% of conflicts existed near the accesses of bus stops in longitudinal direction; (2) Type 1 conflict was significantly different from Type 2, 3, and 4 conflicts in duration, whilst the three had no significant difference; (3) the proposed GEC model showed good performance in predicting bicycle–passenger conflicts, with 15.71% of mean-absolute-percentage-error and 0.8772 of R2; and (4) bicycle volume, bus passenger volume, and passenger crossing time were critical factors impacting the number of bicycle–passenger conflicts. Finally, transport agencies may consider installing separations and crosswalks to improve the safety of the stop area.

New Concept: Different Types of Insufficiency of the Saphenofemoral Junction Identified by Duplex as a Chance for a More Differentiated Therapy of the Great Saphenous Vein

2013 ◽  
Vol 28 (5) ◽  
pp. 268-274 ◽  
Author(s):  
M Stücker ◽  
R Moritz ◽  
P Altmeyer ◽  
S Reich-Schupke
Keyword(s):  
Clinical Practice ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Effective Therapy ◽  
Optimal Therapy ◽  
Different Types ◽  
Type 3 ◽  
Saphenofemoral Junction

Even though the item ‘saphenofemoral junction’ (SFJ) is anatomically well defined, the incontinence of the SFJ is often incompetently described in clinical practice and studies. Especially with regard to the optimal therapy of the great saphenous vein, it might be of importance to have a more distinct regard to the SFJ as it is known that about 10–30% of the saphenous refluxes have no femoral origin. Considering the terminal and preterminal valve three types of incompetence of the SFJ may be differentiated: Type 1: Incompetent terminal, but competent preterminal valve; Type 2: Competent terminal, but incompetent preterminal valve; Type 3: Incompetent terminal and preterminal valve (complete incompetence). A review on prior studies and reports leads to the assumption that the differentiation of the distinct types of SFJ-incompetence allows a more individual and – perhaps – more effective therapy. Finally, studies are necessary to evaluate the here given new concept.

scholarly journals Relationship Between the of Type of Accessory Navicular Bone and Radiological Parameters of the Foot

2021 ◽  
Author(s):  
Serkan Bayram ◽  
Mustafa Kara
Keyword(s):  
Contralateral Side ◽  
Navicular Bone ◽  
First Metatarsal ◽  
Radiological Parameters ◽  
Metatarsal Angle ◽  
Significant Difference ◽  
Different Types ◽  
Accessory Navicular

BACKGROUND:In this study, we evaluated to the relationship between the type of accessory navicular bone (ANB) and radiological parameters of foot in patients with bilateral ANB of different types. METHODS:Patients with bilateral ANB of different types participated in this study, from May 2019 to April 2020. Patient data, including age, sex, body mass index (BMI), and presence of symptoms were obtained. We aimed to compare the radiological parameters of both the feet for evaluate the differences from one another in patients with bilateral ANB of different types (one side type 1 and contralateral side type 2) because the foot angles may differ in each person. Seven radiographic parameters were measured, including calcaneal pitch angle, talocalcaneal angle, tibiocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, anteroposterior talo-first metatarsal angle, and the lateral talo-first metatarsal angle, which evaluated hindfoot, midfoot, and forefoot alignment. RESULTS: Twenty patients (13 women and 7 men) with a mean age (and standard deviation) of 38.5 {plus minus} 12.3 years were included in the study. The patients had a mean height of 168.1 {plus minus} 7.1 cm, a mean weight of 77.2 {plus minus} 10.5 kg, and a mean BMI of 27.4 {plus minus} 4.3 kg/m2. There was no significant difference between type 1 and type 2 in all radiological parameters. There was no significant correlation between radiological parameters and age, BMI, or the presence of symptoms. CONCLUSIONS: We found that the type of ANB had no effect on the radiological measurements of the foot in which we evaluate the parameters patients with bilateral ANB of different types. Additionally, age, BMI, and the presence of symptoms, also demonstrated no correlation with the radiological parameters of the foot.

Lactoseries carbohydrate antigen, Gal beta 1-4GlcNAc-R, is expressed by a subpopulation of capsaicin-sensitive rat sensory neurons

1996 ◽  
Vol 76 (4) ◽  
pp. 2192-2199 ◽  
Author(s):  
L. P. Del Mar ◽  
R. S. Scroggs
Keyword(s):  
Carbohydrate Antigen ◽  
Current Amplitude ◽  
Membrane Properties ◽  
High Threshold ◽  
Outer Cell ◽  
Inward Current ◽  
Significant Difference ◽  
Type 3

1. The membrane properties of dorsal root ganglion (DRG) cells expressing the lactoseries carbohydrate antigen Gal beta 1-4GlcNAc-R were studied and compared with those of DRG cells lacking this antigen. Acutely dissociated rat DRG cells that expressed Gal beta 1-4GlcNAc-R on their outer cell membranes were detected with the use of a primary monoclonal mouse IgM antibody (A5), directed against Gal beta 1-4GlcNAc-R, and a fluorescent secondary antibody (fluorescein-conjugated goat anti-mouse IgM). We found 12.8 micrograms/ml of A5 to be a saturating concentration of primary antibody that labeled approximately 19% of the DRG cells. A battery of membrane properties including action potential (AP) duration; sensitivity to capsaicin; expression of H current (IH), A current (IA), and Ca2+ current subtypes (L, N, and T); and inhibition of high-threshold Ca2+ currents by serotonin (5HT) or 8-hydroxy-2-(di-N-propylamino)-tetralin (8-OH-DPAT) was measured in DRG cells labeled (A5+) and unlabeled (A5-) by a saturating concentration of A5. 2. There was a significant difference in the number of capsaicin-sensitive DRG cells and a significant difference in the magnitude of the capsaicin-induced inward current in A5+ versus A5- DRG cells. Of 35 A5+ cells tested, 33 were sensitive to 1 microM capsaicin, which produced an inward current averaging 4 +/- 0.46 (SE) nA (n = 33). In contrast, only 12 of 33 A5- cells were sensitive to 1 microM capsaicin, which produced an inward current averaging 1.2 +/- 0.52 nA (n = 12). 3. There were also significant differences between A5+ and A5- cells regarding average AP duration, N- and T-type Ca2+ current amplitude, and number of cells that expressed IH and IA. A5+ cells had significantly larger N-type Ca2+ currents and expressed IA more frequently than A5- cells. Conversely, A5- cells had significantly longer AP duration and larger T-type Ca2+ currents, and expressed IH more frequently compared with A5+ cells. 4. A5+ and A5- cells differed regarding the inhibition of high-threshold Ca2+ currents by maximal concentrations of 5HT1A agonists (10 microM 5HT or 1 microM 8-OH-DPAT). Inhibition of Ca2+ currents in A5+ cells by 1 microM 8-OH-DPAT (n = 15) or 10 microM 5HT (n = 18) averaged 4 +/- 0.9%. In contrast, inhibition of Ca2+ currents in A5- cells by 10 microM 5HT (n = 33) averaged 20 +/- 3.8%. 5. Cells for which sufficient data were collected were categorized as type 1, 2, 3, or 4 on the basis of sensitivity to capsaicin and expression of IH, IA, and T-type Ca2+ current amplitude, and the distribution of A5+ and A5- cells among the various groups was observed. The categories were defined as follows: type 1 (capsaicin sensitive, no IH or IA); type 2 (capsaicin sensitive, significant IA); type 3 (capsaicin insensitive, T-type Ca2+ currents < 1 nA, significant IH but no IA); and type 4 (capsaicin insensitive, T-type Ca2+ currents > 2.4 nA). On the basis of this criteria, 6 of 15 type 1 cells and all type 2 cells (n = 19) were A5+. All type 3 cells (n = 8) and all type 4 cells (n = 11) were A5-. 6. As indicated above, the expression of the Gal beta 1-4GlcNAc-R antigen differentiated two subgroups of DRG cells in the type 1 category (A5+, n = 6 and A5-, n = 9). These two groups varied regarding the sensitivity of Ca2+ currents to maximally effective concentrations of 5HTIA agonists. In type 1 A5+ DRG cells, high-threshold Ca2+ currents were not significantly inhibited by 1 microM 8-OH-DPAT (average inhibition = 1.2 +/- 0.8%, n = 6). However, in type 1 A5- cells, high-threshold Ca2+ currents were reduced 47 +/- 6.0% (n = 9) by 10 microM 5HT. 7. The several significant differences in membrane properties between A5+ and A5- DRG cells suggest that the Gal beta 1-4GlcNAc-R antigen is expressed by a distinct subset of DRG cells, consisting predominately of type 1 and type 2 cells. The observation that most A5+ DRG cells were capsaicin sensitive suggests that the Gal beta 1-4GlcNAc-R antigen is expressed primarily by n

New insights into the magmatic system southeast of El Hierro from high-resolution 2D seismic data

2020 ◽  
Author(s):  
Kai-Frederik Lenz ◽  
Felix Gross ◽  
Andreas Klügel ◽  
Rachel Barrett ◽  
Philipp Held ◽  
...  
Keyword(s):  
High Resolution ◽  
Canary Islands ◽  
Magmatic Activity ◽  
Magmatic System ◽  
El Hierro ◽  
Specific Distribution ◽  
Different Types ◽  
Type 3

&lt;p&gt;A new high-resolution seismic dataset is used to investigate the distribution and influence of different phases of magmatic activity in the southeast of El Hierro, Canary Islands. The Canary Archipelago off NW-Africa has largely been formed over the past 20&amp;#160;Myr, but older volcanic edifices exist. One of those older edifices is Henry Seamount, an extinct 126&amp;#160;Ma volcano located 40&amp;#160;km southeast of El Hierro, the youngest (1.1&amp;#160;Ma) and westernmost of the Canary Islands. Hence, the area southeast of El Hierro is influenced by both older and younger magmatic activity. We also found evidence for comparatively young volcanic activity at Henry Seamount, probably contemporaneous to El Hierro. Therefore, a complex magmatic system is assumed to have resulted in the different phases of magmatic activity.&lt;/p&gt;&lt;p&gt;A detailed high-resolution 2D seismic reflection dataset was collected in an area between El Hierro and Henry Seamount during RV Meteor expedition M146 in 2018 to image the expressions of this magmatic system in the upper sub-surface. Several acoustic blanking zones were discovered and identified as the most prominent features in this seismic dataset. We classify these blanking zones into three different types. Type 1 blanking zones are related to volcanic edifices, which crop out at the seafloor and cut through all imaged sedimentary units. Type 2 blanking zones are characterised by upward bending of adjacent reflectors and are most likely caused by hydrothermal doming resulting from saucer-shaped sill intrusions. Type 3 blanking zones cut clearly through adjacent reflectors, and are probably related to fluids or gases that were mobilized by the sill intrusions. The type 1 and 2 blanking zones cluster in the central part of the working area, whereas the blanking zones of type 3 are located on the outskirts. This specific distribution and the occurrence of the varying blanking zone types are combined to make a conceptual model of this complex magmatic system. Our model takes sill intrusions, hydrothermal doming, as well as volcanic out-crops and mobilized fluids into account. Therefore, this study provides new insights into the magmatic evolution of the youngest Canary Island, which can help to achieve a better understanding of the whole system.&lt;/p&gt;

scholarly journals Failed Dermal Allograft Procedures in Irreparable Rotator Cuff Tears Can Still Improve Pain and Function. The “Biologic Tuberoplasty Effect”

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0009
Author(s):  
Raffy Mirzayan ◽  
Michael Allan Stone ◽  
Michael Batech ◽  
Daniel Acevedo ◽  
Anshu Singh
Keyword(s):  
Rotator Cuff ◽  
Average Length ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Significant Difference ◽  
Goutallier Classification ◽  
And Function ◽  
Type 3

Objectives: Massive rotator cuff tears (MRCT) are a challenging problem. Dermal allografts have been used in “bridging” procedures and superior capsule reconstruction (SCR). Both have led to clinical improvement, but without correlation with post-operative imaging. The purpose of this study is to examine graft integrity on MRI in patients who underwent an SCR or bridging procedure to determine if graft integrity correlates with functional outcome. We also propose a new classification of dermal allograft re-tear on MRI. Methods: This study was approved by our IRB. Between 2006 and 2016, 11 patients (12 shoulders) underwent a bridging procedure and 10 patients underwent an SCR for MRCT with a dermal allograft by a single surgeon. The grafts were secured to the tuberosity in a double-row, trans-osseous equivalent (DR-TOE) fashion. Pre- and post-operative VAS, acromiohumeral distance (AHD), and ASES scores, and pre-operative Hamada grade and Goutallier classification were prospectively collected and retrospectively reviewed. An MRI was obtained on all patients post-operatively to assess graft integrity. The status of the graft was divided into three types based on MRI findings: Type 1- Graft intact medially (rim of cuff or glenoid) AND laterally (greater tuberosity); Type 2- Graft intact laterally but torn medially; Type 3- Graft torn laterally. The shoulders were then grouped based on these types for further analysis. Results: The average age was 61 (range: 49-73). Average follow-up was 21.6 months (range: 8-80). Average length from surgery to MRI was 13.9 months (range: 6-80). There was a significant improvement in VAS (pre-8.1 to post-1.3) and ASES (pre-26.3 to post-84.6) in Type 1 (P<0.01) and in VAS (pre-7.0 to post-0.7) and ASES (pre-32.6 to post-91.2) in Type 2 (P<0.01). There was no difference in post-operative VAS (1.3 vs 0.7) and ASES (84.6 vs 91.2) between Type 1 and Type 2 (P=0.8). There was no improvement in VAS (pre-7.3 vs post-5.7) and ASES (pre-30.6 vs post-37.2) in Type 3. There was a significant difference in post-operative VAS (5.7 vs 1) and ASES (37.2 vs 88.1) between Type 3 versus Types 1+2, respectively (P<0.01). The AHD decreased in type 3 (pre-7.8 mm to post-3.2 mm, P=0.02) but did not change in Types 1+2 (pre-7.8 mm to post-8.0 mm, P=0.7). Conclusion: In patients who have SCR or “bridging” procedures for MRCT with a dermal allograft, there is significant improvement in VAS and ASES scores if the graft heals to the tuberosity, regardless if it is still intact to the glenoid (in SCR) or the rim of rotator cuff tendon (“bridging”). Individuals whose graft is torn from the tuberosity did not have improvement in VAS or ASES scores versus baseline. There was no significant difference in AHD in all groups. We believe that the dermal graft acts as a “biologic (interpositional) tuberoplasty,” preventing bone-to-bone contact between the tuberosity and the acromion, thus eliminating pain and improving function. We still recommend performing an SCR when indicated because it has been shown to restore the normal kinematics of the shoulder in a laboratory setting. However, careful attention should be paid to the repair of the graft to the tuberosity, so that in case the primary procedure fails medially, the graft can still improve pain and function.

Orthotic variations in the management of infantile tibia vara and the results of treatment

2013 ◽  
Vol 37 (5) ◽  
pp. 375-383 ◽  
Author(s):  
Serap Alsancak ◽  
Senem Guner ◽  
Hakan Kinik
Keyword(s):  
Successful Outcome ◽  
Foot Orthoses ◽  
Full Time ◽  
Duration Of Treatment ◽  
Tibia Vara ◽  
Ankle Foot Orthoses ◽  
Different Types ◽  
Type 3

Background:Infantile tibia vara is an acquired form of tibial deformity associated with tibial varus and internal torsion. Several methods have been described for orthotics treatment. The purpose of this study was to determine the effectiveness of orthotics treatment in infantile tibia vara.Study design:Controlled trial.Objective:The aim of this study was to compare the effect of different types of orthoses and correction methods on decreasing the curve in children with severe genu varum.Methods:Three different types of knee–ankle–foot orthoses were applied to 35 lower extremities of 22 pediatric participants who were 19–38 months of age. The same orthotic design principles were used to correct the femur, while different designs were applied to correct the tibia. The orthoses used on 20 participants were evaluated for differences among them and their effects on the treatment process. In addition, methods used in the treatment, problems encountered, production of different types of orthoses, convenience of application of the orthoses, and degree of patients satisfaction are discussed in this article.Results:The mean duration of treatment of the participants until completion of treatment was 25.3 ± 9.7 weeks with a minimum of 9 weeks and a maximum of 41 weeks. No statistically significant correlation was found between the duration of orthotic use in patients with a successful outcome and percentile height and percentile weight. When the duration of treatment using the different types of orthoses was analyzed, significant differences were found between Type 1 and Type 2, and Type 1 and Type 3 orthoses (p < 0.05), while no difference was observed between Type 2 and Type 3 orthoses (p > 0.05).Conclusion:We found that bracing is an effective form of treatment for infantile tibia vara up to 38 months of age. We conclude that full-time use of knee–ankle–foot orthoses exerting corrective forces from five points along the full length of the limb was effective.Clinical relevance:The localization of the distal tibial correction, the quality of the midtibial correction band, and the importance of the application of corrective forces from five points with rigid methods were found.

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