Because the controversy about the relation of foot morphology and foot function is still present, we find it surprising that there are no studies published dealing with motor skills and athletic ...performance in flat-footed school children. Our aim in this study was to determine if there is an association between the degree of foot flatness and several motor skills that are necessary for sport performance.
The feet of 218 children aged 11 to 15 years were scanned, and the arch index was determined. The value of the arch index was corrected for the influence of age, and then the entire sample was categorized into 4 groups according to the flatness of their feet. The children were tested for eccentric-concentric contraction and hopping on a Kistler force platform, speed-coordination polygon (Newtest system), balance (3 tests), toe flexion (textile crunching), tiptoe standing angle, and repetitive leg movements. Altogether, 17 measures of athletic performance were measured.
No significant correlations between the arch height and 17 motor skills were found. Categorizing the sample into 4 groups did not reveal any differences between the groups in athletic performance. Also, several multivariate analysis of variance sets of multiple independent variables referring to a particular motor ability were not found to be significant. The differences were not found even after comparing only the 2 extreme groups, meaning children with very low and children with very high arches.
No disadvantages in sport performance originating from flat-footedness were confirmed. Children with flat and children with "normal" feet were equally successful at accomplishing all motor tests; thus, we suggest that there is no need for treatment of flexible flat feet with the sole purpose of improving athletic performance, as traditionally advised by many.
Osteoartritis (OA) je multifaktorijalna i poligenska bolest koja zahvaća cijeli zglob, ali i periartikularno tkivo te predstavlja golem ekonomski trošak za javno zdravstvo u cijelom svijetu. Poznati ...su brojni geni za koje se smatra da sudjeluju u patogenezi OA, a u novije vrijeme sve se više istražuju epigenetski mehanizmi kao potencijalni rizični čimbenici zaslužni za nastanak OA. MikroRNK (miRNK) su male nekodirajuće molekule koje imaju ulogu u postranskripcijskoj regulaciji genskog izražaja. Njihovi geni čine 1 – 2 % ukupnog genoma i smatra se da bi potencijalno mogli regulirati i do 30 % kodirajućih gena. MiRNK molekule imaju bitnu ulogu u patogenezi nekih karcinoma, kardiovaskularnih, autoimunih kožnih te nekih neuroloških bolesti. Također, navedene molekule imaju važnu ulogu u patogenezi osteoartritisa. Velik broj miRNK molekula drugačije je izražen u hrskavici zahvaćenoj osteoartritisom u odnosu na zdravu hrskavicu. Dokazano je da određene miRNK molekule reguliraju neke enzime zaslužne za razgradnju hrskavice, dok se neke povezuju s regulacijom apoptoze hondrocita, a neke s procesom regeneracije hrskavice. U svjetlu tih spoznaja napravljene su i prve studije koje nastoje dokazati povezanost određenih jednonukleotidnih polimorfizama nekih miRNK gena s predispozicijom za nastanak osteoartritisa. Budući da su svi današnji oblici terapije bolesnika s osteoartritisom usmjereni na liječenje posljedice bolesti, a ne uzroka, potrebna su daljnja istraživanja etiopatogeneze osteoartritisa. MiRNK molekule mogle bi igrati važnu ulogu u patogenezi OA te predstavljati jednu od potencijalnih meta za nove farmakoterapijske oblike liječenja.
Osteoarthritis (OA) is a multifactorial and polygenic disease, which affects joints as well as the periarticular tissue, and it represents a huge economic cost to public health systems worldwide. Numerous genes that are involved in the pathogenesis of the disease are already identified. More recently, the epigenetic mechanisms are being researched as the potential risk factors for osteoarthritis. MicroRNAs (miRNAs) are small non-coding molecules which play a role in the post-transcriptional regulation of gene expression. Their genes make up to 1-2% of the total genome and it is thought that they could potentially regulate up to 30% of the coding genes. MiRNAs have important role in the pathogenesis of some cancers, cardiovascular, autoimmune, skin and neurological diseases. Furthermore, the above mentioned molecules have an important role in the pathogenesis of osteoarthritis. Various miRNA molecules are expressed differently in the cartilage affected by osteoarthritis as compared to the healthy cartilage. Certain miRNA molecules have also been shown to regulate enzymes responsible for cartilage degradation, some were associated with the regulation of chondrocyte apoptosis and some involved in cartilage regeneration processes. Due to these findings, some of the following studies tried to prove the connection between certain single nucleotide polymorphisms of some miRNA genes and the proneness to osteoarthritis. Given that all current therapies for osteoarthritis aim at treating the consequences of the disease rather than curing the cause, further research into etiopathogenesis of osteoarthritis is required. The MiRNA molecules could play an important role in the pathogenesis of the osteoarthritis and might easily be among the potential targets for the new pharmaceutical therapies.
The muscle sparing total hip arthroplasty had generated a distinguishable interest, in both the patients and the surgeons, but its benefits are still often questioned. The main idea of this study was ...to compare the functional clinical outcome of the patients operated by the anterolateral approach with a muscle-sparing technique (modified Watson-Jones approach), and the patients operated by modified direct lateral approach without the muscle-sparing technique (Bauer/Hardinge approach).
The patients (N = 130) were divided into two groups: 68 in a standard method group (STAND) and 62 patients in a muscle sparing surgery group (MSS). The hip flexibility, mobility, the strength of the hip abduction, the pain scale, Harris hip scores, the duration of the hospital stay and the overall satisfaction were measured seven days, three months, one year and three years (in 80 patients) after the surgery. There were no differences in any of the parameters between the groups prior to the procedure.
The statistically significant differences in first three follow-ups (up to one year) were determined between the groups in passive and active hip flexion ability but the hip abduction strength, which is a crucial parameter for functional recovery, and 50 m walk test remained better in MSS group even after three years. Patients, who underwent MSS suffered also less pain, stayed in hospital shorter and were more satisfied with the operation outcome.
The functional recovery in patients treated with muscle sparing method was faster than in patients operated with conventional lateral approach. Based on the results, we could recommend anterolateral muscle sparing approach for a total hip replacement for its faster and fuller functional recovery.
This study explores the influence of test repetition on bipodal visually controlled balance, both static and dynamic. Our goal was to get an insight into the pattern of changes in posture maintenance ...results during repeated balance tests. Fifteen young, healthy male recreational athletes were tested for static and for dynamic balance using KAT 2000 balance platform. The subjects first performed three trial tests of static and dynamic balance to get used to the platform followed by seven repetitions of static as well as dynamic test which were recorded. During the repeated tests we could not determine any significant improvements of static balance test resulting from number of test repetitions neither in static nor in dynamic balance (Friedman ANOVA: Static balance p = 0.497, Dynamic balance p = 0.393). Correlating static and dynamic balance results we found that only one third of the dynamic balance was related to static balance abilities (r2 = 0.36). Possible patterns in front-back and left-right directions were analyzed as well, however, none of these balance scores were found to be related to the number of repetitions. In conclusion, this study found no significant influence of limited number of repetitions (seven) on test results in static and dynamic posture. However, as large number of repetitions might still influence test results we discourage the use of KAT 2000 as a training tool in patients in which it will be used as an instrument to validate postoperative rehabilitation or investigation results.
Abstract The “cello technique” is a new calcaneoplasty technique for the treatment of Haglund disease. It is an ultrasound-assisted technique for resection of the posterosuperior part of the ...calcaneus. It is possible to resect the posterosuperior part of the calcaneus under direct ultrasound control with the patient in the prone position, with a dorsally positioned ultrasound probe, in line with the Achilles tendon fibers (sagittal line), and with the abrader in the posteromedial working portal. We describe in detail the technique for this new procedure in foot and ankle surgery. This innovative technique offers the possibility of expanding the indications for ultrasound-guided surgery in other fields of orthopaedic surgery.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Although articular hyaline cartilage typically has low potential for regeneration, numerous methods and techniques have been proposed to induce the reparation process. In our work, we used ...microfracture techniques in combination with intraarticular application of hyaluronic acid in rabbit knee articular cartilage defect. In comparison with the control group, after 6 and 10 weeks we observed a higher potential of healing in the experimental group, with thicker and more organized repair tissue filling the defect. In conclusion, a combination of the microfracture technique and application of hyaluronic acid might be potentially beneficial in inducing articular cartilage defect reparation.
Željeznički prijevoznici danas sve više moraju primjenjivati marketinške
metode i modele poslovanja, osobito u putničkome prijevozu, gdje
se susreću sa snažnom konkurencijom u cestovnome prijevozu. ...Iako
su željeznička poduzeća tradicionalno bila usmjerena na jednostavne i
usko specijalizirane načine promocije svojih usluga, želja za stjecanjem
konkurentske prednost nameće potrebu primjene suvremenih načina
marketinške komunikacije, među kojima se ističe integrirana marketinška
komunikacija. Ovaj rad bavi se značajkama integrirane marketinške
komunikacije, a obrađen je primjer njezine primjene u jednoj kampanji
nacionalnoga željezničkog putničkog prijevoznika.
Liječenje oštećenja tetiva rotatorne manšete ovisi o veličini rupture i dobi bolesnika.
Sve akutne ozljede u mlađih i radno sposobnih bolesnika trebalo bi odmah operativno liječiti.
U većih ozljeda ...rupturirane tetive retrahiraju se, pa je rekonstrukcija nakon više mjeseci otežana.
Kod bolesnika koji imaju preko 70 godina prvo pokušamo s konzervativnim liječenjem. Rekonstrukcija
većih ruptura u starijih ljudi neizvjesna je, ovisi o dubini retrakcije tkiva i stupnju
masne degeneracije mišića. Ako palijativna terapija ne zadovoljava, treba se odlučiti na ugradnju
posebne vrste endoproteze. Operativne metode dijele se na otvorene i artroskopske. Svaka
metoda ima svoje prednosti, ali su funkcionalni rezultati podjednaki.
Artroskopija kuka spada u endoskopske metode minimalno invazivnog načina dijagnostike
i liječenja zglobova. Zbog anatomskih specifičnosti zgloba kuka te zahtjevnosti same tehnike,
artroskopija kuka ...dobiva širu primjenu u kliničkoj praksi tek posljednjih godina. Najčešća indikacija
za artroskopiju kuka je tretman lezija nastalih u sklopu femoroacetabularnog sraza.
Liječenjem femoroacetabularnog sraza, kao stanja preartroze kuka, razvoj artroskopije kuka
predstavlja važan iskorak u smislu prevencije razvoja artroze kuka. Osim femoroacetabularnog
sraza, indikacije za artroskopiju kuka predstavljaju lezije acetabularnog labruma, ozljede hrskavice
zgloba, slobodna zglobna tijela, lezija ligamenta teresa, promjene sinovijalne membrane, stanja
po ugradnji totalne endoproteze te infektivna stanja kuka. Kirurška podjela zgloba kuka na
periferni i centralni odjeljak determinira i dva naizgled različita pristupa operativnom zahvatu,
pristup prvo u periferni ili prvo u centralni odjeljak. U praksi je potrebno pregledati i eventualno
liječiti patoanatomske promjene u oba odjeljka te je potrebno ovladati tehničkim specifičnostima
artroskopije kuka, bilo da se započinje s perifernim ili centralnim odjeljkom. Specifičnost artroskopije
kuka u odnosu na artroskopiju drugih velikih zglobova potreba je korištenja ekstenzijskog
stola te intraoperativno korištenje rendgenskog aparata. Artroskopski je moguće
odstranjenje koštanih apozicija na femuru i acetabulumu, tretman lezija acetabularnog labruma,
hrskavičnih lezija, odstranjenje slobodnih zglobnih tijela, liječenje ozljeda ligamenta teresa i patologije
sinovijalne ovojnice zgloba, odstranjenje izljeva iz zgloba te liječenje stanja po ugradnji
totalne endoproteze kuka. Komplikacije artrokopije kuka većinom su rijetke, a njihova incidencija
može se dodatno smanjiti pravilnim postavljanjem indikacije i adekvatnom kirurškom tehnikom.
Daljnjim razvojem tehnike te dugoročnom evaluacijom rezultata liječenja očekuje se popularizacija
i sve šira primjena artroskopije kuka u svakodnevnoj ortopedskoj praksi.
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