ŠIVANJE MENISKA KOLJENSKOG ZGLOBA Starčević, Damir; Hašpl, Miroslav; Tršek, Denis
Hrvatski športskomedicinski vjesnik,
07/2010, Letnik:
25, Številka:
1
Paper
Odprti dostop
U članku se prikazuju osnove anatomije i histologije
meniska koljenskog zgloba, biomehanički principi
njegove funkcije, mogućnosti kirurškog liječenja, tehnike
šivanja meniska i rezultati liječenja.
...Menisci su vrlo važne anatomske strukture u
koljenskom zglobu. Ozljeda meniska predstavlja najčešću
ozljedu koljenskog zgloba. S razvojem i napretkom
artroskopske tehnike posljednjih 30-tak godina razvile su
se i razne minimalno invazivne, sigurne i učinkovite
tehnike šivanja meniska.
U našoj bolnici u razdoblju od rujna 2008. godine do
listopada 2009. godine su učinjene 503 artroskopije
koljena, od kojih je kod 39 pacijenata (7%) učinjeno
šivanje meniska. Koristili smo se tehnikama šivanja
te . Pratili smo 27 bolesnika prosječne
životne dobi 25 godina, 20 su bili muškarci, a 7 žene.
Sportom se rekreativno bavilo 14 pacijenata, a 9 aktivno.
Ozljeda je bila vezana uz sport kod 22 pacijenta. Ruptura
medijalnog meniska je bila 8 puta češća nego lateralnog.
Ruptura prednje ukrižene sveze bila je prisutna kod 10
pacijenata (37%). Pacijente smo u prosjeku pratili 13 (7-
18) mjeseci. Od 22 pacijenta koji su se prijeoperacijski
bavili sportom, njih 17 (81%) vratilo se potpuno istoj
razini aktivnosti u sportu. Od komplikacija smo zabilježili
kod dva bolesnika pojavu subkutanog seroma na mjestu
šavi. Kod jednog bolesnika učinjena je naknadna
meniscektomija zbog rerupture.
Iz dostupne literature vidljiva je uspješnost šivanja
meniska od 73% do 95%. Za šivanje meniska su
najpogodniji pacijenti mlađi od 50 godina, sa svježom,
uzdužnom, okomitom rupturom u vaskularnoj (crvenoj)
zoni meniska. Menisci pokazuju još bolju tendenciju
cijeljenja ukoliko se šivanje učini zajedno s
rekonstrukcijom prednje ukrižene sveze. Šivanje meniska
je postupak koji u najmanju ruku usporava nastanak ranog
sekundarnog osteoartritisa koljena. Zahtjeva iskusnog
operatera, poseban instrumentarij, produžuje vrijeme
operacijskog zahvata i produžuje rehabilitaciju. u odnosu
na meniscektomiju. Ali, zbog povoljnog definitivnog
ishoda liječenja potrebno ga je izvoditi što češće.
Nestabilnost pešća predstavlja rijetku ozljedu ručnoga zgloba koja može uzrokovati značajnu nesposobnost i morbiditet pacijenta. Iščašenje polumjesečaste kosti je četvrti i zadnji stadij perilunatne ...dislokacije. Obostrano iščašenje polumjesečaste kosti je još rjeđe stanje, te je svega nekoliko sličnih slučajeva opisano u literaturi. Ovdje prikazujemo slučaj obostranog iščašenja polumjesečaste kosti ručnoga zgloba kod
27-godišnjeg muškarca, koji je zadobio ozljede oba ručna zgloba prilikom pada s drveta visokog 7 metara.
A decade ago, when the Human Microbiome Project was starting, urinary tract (UT) was not included because the bladder and urine were considered to be sterile. Today, we are presented with evidence ...that healthy UT possesses native microbiota and any major event disrupting its "equilibrium" can impact the host also. This dysbiosis often leads to cystitis symptoms, which is the most frequent lower UT complaint, especially among women. Cystitis is one of the most common causes of antimicrobial drugs prescriptions in primary and secondary care and an important contributor to the problem of antimicrobial resistance. Despite this fact, we still have trouble distinguishing whether the primary cause of majority of cystitis cases is a single pathogen overgrowth, or a systemic disorder affecting entire UT microbiota. There are relatively few studies monitoring changes and dynamics of UT microbiota in cystitis patients, making this field of research still an unknown. In this study variations to the UT microbiota of cystitis patients were identified and microbial dynamics has been modeled. The microbial genetic profile of urine samples from 28 patients was analyzed by 16S rDNA Illumina sequencing and bioinformatics analysis. One patient with bacterial cystitis symptoms was prescribed therapy based on national guideline recommendations on antibacterial treatment of urinary tract infections (UTI) and UT microbiota change was monitored by 16S rDNA sequencing on 24 h basis during the entire therapy duration. The results of sequencing implied that a particular class of bacteria is associated with majority of cystitis cases in this study. The contributing role of this class of bacteria -
, was further predicted by generalized Lotka-Volterra modeling (gLVM). Longitudinal microbiota insight obtained from a single patient under prescribed antimicrobial therapy revealed rapid and extensive changes in microbial composition and emphasized the need for current guidelines revision in regards to therapy duration. Models based on gLVM indicated protective role of two taxonomic classes of bacteria,
and
class, which appear to actively suppress pathogen overgrowth.
Research background. In this study, we investigated the effects of soluble dietary fibre on improving neuromuscular and cardiovascular endurance and perception of fatigue in a closely monitored group ...of basketball players. Prebiotics have been sidelined in sports nutrition and their effect on performance remains poorly investigated and understood.
Experimental approach. Eighteen healthy male basketball players were divided into two groups; one received 17 g/day of soluble dietary fibre (Nutriose®) for four weeks and the other group received placebo. Their morphological characteristics, neuromuscular and cardiovascular endurance, and rating of perceived exertion according to the rating of perceived exertion (RPE) scale were assessed. Measurements were taken before supplementation and after four weeks of supplementation. Faecal samples were collected from all participants immediately before and after the supplementation period, their total DNA extracted and sent for amplicon sequencing.
Results and conclusions. In this study, fibre had no statistically significant effect on the vertical-type explosive power, no statistically significant effect on sprint-type explosive power, nor on aerobic and anaerobic endurance in the experimental group. Soluble fibre had a statistically significant effect on reducing the rating of perceived exertion of basketball players during the competitive part of the season (RPE 7.27±0.04 versus 8.82±0.81). This was confirmed by two-way ANOVA with replication, which showed that within-group interaction (p=0.0193), before and after dietary intake (p=0.0049), and between-group interaction before and after dietary intake (p=0.0313) had a significant effect on the result. The overall conclusion of the study is that soluble dietary fibre supplementation does not improve neuromuscular and cardiovascular endurance over a 4-week period. However, fibre supplementation could have a significant effect on reducing the rating of perceived exertion, as shown by the statistics. Both amplicon sequencing and subsequent bioinformatics results suggest that this could be the result of the beneficial effect on the intestinal microbiota and its metabolites.
Novelty and scientific contribution. This work highlights the importance of prebiotics in sports nutrition. Dietary fibre has been a neglected component of sports nutrition. This study demonstrated a statistically significant positive effect on the perception of fatigue, highlighting the need for further studies in this direction.
Successful genome mining is dependent on accurate prediction of protein function from sequence. This often involves dividing protein families into functional subtypes (e.g., with different ...substrates). In many cases, there are only a small number of known functional subtypes, but in the case of the adenylation domains of nonribosomal peptide synthetases (NRPS), there are >500 known substrates. Latent semantic indexing (LSI) was originally developed for text processing but has also been used to assign proteins to families. Proteins are treated as ‘‘documents’’ and it is necessary to encode properties of the amino acid sequence as ‘‘terms’’ in order to construct a term-document matrix, which counts the terms in each document. This matrix is then processed to produce a document-concept matrix, where each protein is represented as a row vector. A standard measure of the closeness of vectors to each other (cosines of the angle between them) provides a measure of protein similarity. Previous work encoded proteins as oligopeptide terms, i.e. counted oligopeptides, but used no information regarding location of oligopeptides in the proteins. A novel tokenization method was developed to analyze information from multiple alignments. LSI successfully distinguished between two functional subtypes in five well-characterized families. Visualization of different ‘‘concept’’ dimensions allows exploration of the structure of protein families. LSI was also used to predict the amino acid substrate of adenylation domains of NRPS. Better results were obtained when selected residues from multiple alignments were used rather than the total sequence of the adenylation domains. Using ten residues from the substrate binding pocket performed better than using 34 residues within 8 of the active site. Prediction efficiency was somewhat better than that of the best published method using a support vector machine.
An increasing amount of evidence implies that native microbiota is a constituent part of a healthy urinary tract (UT), making it an ecosystem on its own. What is still not clear is whether the origin ...of the urinary microbial community is the indirect consequence of the more abundant gut microbiota or a more distinct separation exists between these two systems. Another area of uncertainty is the existence of a link between the shifts in UT microbial composition and both the onset and persistence of cystitis symptoms. Cystitis is one of the most common reasons for antimicrobial drugs prescriptions in primary and secondary care and an important contributor to the problem of antimicrobial resistance. Despite this fact, we still have trouble distinguishing whether the primary cause of the majority of cystitis cases is a single pathogen overgrowth or a systemic disorder affecting the entire urinary microbiota. There is an increasing trend in studies monitoring changes and dynamics of UT microbiota, but this field of research is still in its infancy. Using NGS and bioinformatics, it is possible to obtain microbiota taxonomic profiles directly from urine samples, which can provide a window into microbial diversity (or the lack of) underlying each patient's cystitis symptoms. However, while microbiota refers to the living collection of microorganisms, an interchangeably used term microbiome referring to the genetic material of the microbiota is more often used in conjunction with sequencing data. It is this vast amount of sequences, which are truly "Big Data", that allow us to create models that describe interactions between different species contributing to an UT ecosystem, when coupled with machine-learning techniques. Although in a simplified predator-prey form these multi-species interaction models have the potential to further validate or disprove current beliefs; whether it is the presence or the absence of particular key players in a UT microbial ecosystem, the exact cause or consequence of the otherwise unknown etiology in the majority of cystitis cases. These insights might prove to be vital in our ongoing struggle against pathogen resistance and offer us new and promising clinical markers.
Probiotic – friend or foe? Zucko, Jurica; Starcevic, Antonio; Diminic, Janko ...
Current opinion in food science,
April 2020, 2020-04-00, Letnik:
32
Journal Article
Recenzirano
•Probiotics are very popular addition to human nutrition with proven health benefits.•They represent lucrative segment of food markets.•Their manufacturing is not sufficiently regulated on worldwide ...markets.•The safety is insufficiently tested while their intake might have adverse effects.•More work is necessary fully to confirm health benefits and safety of probiotics.
Probiotics are modern-day panacea with claims to alleviate or cure everything from diarrhea to obesity and Alzheimer’s disease. They seem effective for numerous conditions (e.g. antibiotic-associated diarrhea), although these views have been challenged recently. Greater issue is the lack of confirmed efficacy for majority of claims provided by producers. While offering products without adequate clinical research, industry has more simplistic approach for probiotic treatments, that is, ‘one-formula-fits-all.’ In contrast, recent studies showed different efficacies of probiotic mixtures with multiple strains without fully understanding factors behind it. Furthermore, important parameter for prescribing probiotic treatment is the individual native microbiota. Interactions among probiotic strains and microbiota need more research, so there is a long way paved with ‘big data’ and chemometric analysis before it is possible to make full use of probiotics.
Purpose
The purpose was to investigate the changes of the psoas major muscles (PM) cross-sectional area (CSA) and fat infiltration in the PM and to investigate the association between the morphology ...of the PM and expression of the degenerative changes of lumbar spine in patients with low back pain (LBP).
Methods
T2-weighted scans for measurements of the CSA and analysis of fat infiltration were performed on 42 patients and 49 controls using a 1.5 Tesla MR system. For a quantitative analysis of fat tissue infiltration a 4-grade visual scale was used.
Results
Patients had bigger CSA of the PM than controls at the levels of L3/L4 and L4/L5 intervertebral disc (
P
< 0.05). Patients with apparent degenerative changes of the lumbar spine had smaller CSA of the PM compared to the patients without apparent changes at the levels of L3/L4 and L4/L5 (
P
< 0.05). At the levels of L4/L5 and L5/S1 patients with present Modic changes in the lumbar vertebral bodies showed smaller CSA of the PM compared to the patients without Modic changes (
P
< 0.05). However, CSA of the PM in the patients with degenerative changes of lumbar spine and Modic changes was still bigger than the one of the controls. At all analyzed levels correlation between CSAs of the PM and fat infiltration of the lumbar paraspinal muscles was negative.
Conclusion
Results suggest increased activity of the PM in LBP patients but PM also remains active regardless of the presence of degenerative and Modic changes of the lumbar spine.
Contemporary coral reef research has firmly established that a genomic approach is urgently needed to better understand the effects of anthropogenic environmental stress and global climate change on ...coral holobiont interactions. Here we present KEGG orthology-based annotation of the complete genome sequence of the scleractinian coral Acropora digitifera and provide the first comprehensive view of the genome of a reef-building coral by applying advanced bioinformatics.
Sequences from the KEGG database of protein function were used to construct hidden Markov models. These models were used to search the predicted proteome of A. digitifera to establish complete genomic annotation. The annotated dataset is published in ZoophyteBase, an open access format with different options for searching the data. A particularly useful feature is the ability to use a Google-like search engine that links query words to protein attributes. We present features of the annotation that underpin the molecular structure of key processes of coral physiology that include (1) regulatory proteins of symbiosis, (2) planula and early developmental proteins, (3) neural messengers, receptors and sensory proteins, (4) calcification and Ca2+-signalling proteins, (5) plant-derived proteins, (6) proteins of nitrogen metabolism, (7) DNA repair proteins, (8) stress response proteins, (9) antioxidant and redox-protective proteins, (10) proteins of cellular apoptosis, (11) microbial symbioses and pathogenicity proteins, (12) proteins of viral pathogenicity, (13) toxins and venom, (14) proteins of the chemical defensome and (15) coral epigenetics.
We advocate that providing annotation in an open-access searchable database available to the public domain will give an unprecedented foundation to interrogate the fundamental molecular structure and interactions of coral symbiosis and allow critical questions to be addressed at the genomic level based on combined aspects of evolutionary, developmental, metabolic, and environmental perspectives.
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