Rehabilitation of amputees represents a complex process during the course of which an amputee receives professional aid and support, so as to adapt to the use of prosthesis, i.e. an artificial ...supplement for the lost body part. The process aims at achieving an independent performance of the amputee in all areas of everyday life and as high quality of life as possible. The rehabilitation encompasses not only the pre-amputation, postoperative, pre-prosthetic and prosthetic stage, within which an amputee is provided with a prosthetic
aiding device, but also the subsequent long-term monitoring and follow-up. The implementation of the rehabilitation process runs in line with the biopsychosocial model and requires a multidisciplinary and an interdisciplinary approach, so as to achieve a successful reintegration of an amputee and allow for a lifestyle resembling the pre-amputation one as much as possible.
The article brings the causes and types of amputation, the principles
underpinning contemporary amputation surgery, prosthetics and rehabilitation during preoperative, postoperative, pre-prosthetic and prosthetic stages, as well as the stage goals and MOs of their attainment. Principles of evaluation of prosthetic rehabilitation outcomes in limb amputees, which make use of appraisal questionnaires, have been discussed as well.
Molecular pathogenesis of papillary thyroid carcinoma (PTC) is largely associated with mutational changes in the BRAF, RAS family and RET genes. Our aim was to assess clinico-pathological and ...prognostic correlations of these PTC-specific gene alterations, with a particular emphasis on the BRAF mutation, in a group of 266 Serbian PTC patients, for the first time. The reference center-based retrospective cohort included 201 (75.6%) females and 65 (24.4%) males aged 48.0±16.1 years (8-83 years old, range) diagnosed and treated for PTC during 1993-2008. Follow-up period was 53.1±41.6 months (7-187 months, range). BRAF and RAS mutations were determined by direct sequencing of genomic DNA. RET/PTC rearrangements were analyzed by RT-PCR/Southern blotting. Genetic alterations were detected in 150/266 tumors (56.4%). One tumor displayed two genetic alterations. The BRAFV600E was found in 84/266 (31.6%) cases, RAS mutations in 11/266 (4.1%) and RET/PTC in 55/266 (20.7%; 42/266 (15.8%) RET/PTC1 and 13/266 (4.9%) RET/PTC3). On multivariate analysis BRAFV600E was associated with the classical papillary morphology (P = 0.05), the higher pT category (P = 0.05) and advanced clinical stage (P = 0.03). In a proportional hazard model, BRAFV600E did not appear to be an independent risk factor for the faster recurrence (P = 0.784). We conclude that under the extensive thyroid surgery and limited application of radioiodine ablation BRAFV600E may not be an indicator of poorer disease-free survival during the short to middle follow-up period. However, it has a potential to contribute to patients stratification into high- and low-risk groups.
Total and bone alkaline phosphatase are indicators of bone formation, a process essential in bone healing. The aim of this study was to assess the relationship of both total and bone alkaline ...phosphatase with the course and features of healing in surgically treated long bone fractures as compared to the callus volume. In this study, total and bone alkaline phosphatase levels and the callus volume were measured in two patients with long bone fractures. Fracture healing was rapid in one patient and slow in the other. Depending on the healing outcome, on day 7 an increase in the case of slow healing and a decrease in the case of rapid healing was noted for both total and bone alkaline phosphatase. In the case of slow healing, the callus volume was significant whereas in the case of rapid healing the callus was almost invisible on day 7. This result indicates a possible prognostic significance of aforementioned clinical biochemical and radiographic parameters in the monitoring of long bone fracture healing.
Aktivnosti ukupne i koštane alkalne fosfataze povezane su s
procesima izgradnje kosti, nužnih kod cijeljenja prijeloma. Svrha našeg
istraživanja bila je ispitati povezanost ukupne i koštane alkalne fosfataze s
tijekom i osobitostima cijeljenja kirurški zbrinutih prijeloma dugih kostiju u
korelaciji sa volumenom stvorenog kalusa. U ovom istraživanju aktivnost ukupnog
i koštanog izoenzima i količina stvorenog kalusa određivana je kod dvaju
pacijenata s prijelomom dugih kostiju. Jednog ispitanika karakterizira brzo
cijeljenje koštanog prijeloma, a drugog sporo cijeljenje koštanog prijeloma.
Rezultati ovog istraživanja pokazali su da je ovisno o ishodu, već 7-og dana
došlo do porasta vrijednosti aktivnosti ukupne i koštane alkalne fosfataze kod
sporog, odnosno do opadanja kod brzog koštanog cijeljenja. Također kod sporog
cijeljenja vidljiv je značajan kalus, dok kod brzog cijeljenja 7-og dana kalus
je bio gotovo nevidljiv. Ovaj rezultat ukazuje na moguću prognostičku
vrijednost navedenih kliničkih biokemijskih i rendgenskih parametra u praćenju
uspješnosti kirurškog cijeljenja prijeloma dugih kostiju
The amputees and quality of life Poljak-Guberina, Renata; Zivković, Ognjen; Muljacić, Ante ...
Collegium antropologicum,
12/2005, Letnik:
29, Številka:
2
Journal Article
Recenzirano
The application of highly sophisticated computer technology and high technology materials allows production of quality prosthetic replacements both in the functional and esthetic sense. The basic ...prerequisite for successful use of prostheses is an adequately shaped stump, which can be achieved using new operative technique used for extremity amputation. In this way, the possibilities of prosthetic device usage are enlarged to fulfill not only basic daily needs but also highly active work-related, sports-related or recreational needs of the modern man. However, the adequate and successfully performed operative procedure and the implementation of a quality prosthetic device do not guarantee that all patient requirements for improved quality of life are fulfilled. The aim of this study was to examine therapeutic effects of the applied method of surgical and prosthetic treatment, with a special focus on the improvement of patient's quality of life. The research was conducted in a sample of healthy and active patients with trauma-related lower extremity amputation. Following a positive objective evaluation by the physician, who stated that surgical and prosthetic treatment was satisfactory, the subjective evaluation was performed by the patient using a specially designed questionnaire. The factors possibly influencing the overall satisfaction of the patient with therapy were analyzed. The satisfaction with prosthesis function was evaluated as very good by 63.5% of the patients, excellent by 9.6% and good by 26.9% of the patients.
Alkaline phosphatase (ALP) and bone-specific alkaline phosphatase (S-bone ALP) activities may serve as markers of the course and rate of bone healing after sustained fractures. The aim of this study ...was to examine whether the assessment of S-bone ALP as a biochemical parameter in the early posttraumatic phase may indicate the course of fracture healing. To date, the methods used to monitor the bone healing process have been based on the patients' assessment and the radiographic findings. In view of the fact that patient opinion is highly subjective, that the radiographic findings depend on the radiologist's experience and that the monitoring of bone healing is a long-lasting process, measurements of biochemical parameters appear to be the only objective evidence of the changes occurring during bone regeneration. In this study, the activity of bone-specific alkaline phosphatase was measured in the serum of 41 patients who had sustained long bone fractures. The participants included 26 males and 15 females, aged 15 to 80 years. All patients were treated surgically. The activity of S-bone ALP was assessed every seven days over a period of 4 weeks. The study patients were followed up radiologically for several months. Our research showed that the increase of alkaline phosphatase correlated with an increase of S-bone ALP levels. In addition, changes in ALP levels on days 7 and 14 as compared to those on day 1 post injury were associated with changes in S-bone ALP levels on the same day. Likewise, the callus volume correlated with the decrease, no change or increase in the levels of ALP and S-bone ALP in the same way. Based on these results, it may be concluded that monitoring changes in the biochemical parameters alkaline phosphatase and bone-specific alkaline phosphatase allows early detection of fracture healing rates. A minor increase in the activity or no change in the level of the biochemical parameters ALP and S-bone ALP in the period of the first two weeks indicates successful fracture fixation, rapid bone healing and the formation of a minimal or insignificant callus. A major increase in the activity of the biochemical parameters ALP and S-bone ALP in the period of the first two weeks indicates inadequate fracture fixation, delayed bone healing and the formation of a visible and significant callus.
The aim of this study was to examine whether the volume of bone-specific alkaline phosphatase (BsALP) as a biochemical parameter in the early posttraumatic phase may indicate the speed of fracture ...healing. The evaluation of the bone healing process has been based on the patient's subjective statement and radiographic findings. The activity of bone-specific alkaline phosphatase has been measured in the sera of 41 patients who have been diagnosed with fractures of long bones. All the patients have been surgically treated. The activity of BsALP was measured on each seventh day during a four-week period. On the same patients the radiologically follow-up tests have been made during a period of seven months. Our research has shown that the increase of alkaline phosphatase correlates with an increase of BsALP levels. The volume of callus correlates with the level of ALP and BsALP. The result leads us to a conclusion that by monitoring the changes of biochemical parameters: alkaline phosphatase and bone-specific alcaline phosphatase, we can be able to predict the dynamics of the bone healing. PUBLICATION ABSTRACT
In this paper we presented three patients withknee disarticulation performed according toBaumgartner. The Baumgartner tehnique and theapplication of knee disarticulation prosthesis appearedto be ...superior in comparisson with othermethods.
The aim of this work was to assess the relationship of both total alkaline phosphatase (ALP) and bone-specific alkaline phosphatase (BsALP) with the course and outcome of operatively treated ...long-bone fractures. The activity of total ALP and BsALP was measured in 41 patients with a long bone fracture, comprising 26 men and 15 women. All patients were treated operatively. Total ALP and BsALP levels were measured in sera on day 1, 7, 14 and 21 after sustaining injury. Patient monitoring included X-rays. According to the outcome, patients were divided into two groups: the fast healing group and the slow healing group. The levels of total ALP and BsALP showed parallel trends in the course of this study. Depending on the healing outcome, on day 7 an increase in the case of slow healing, or a decrease in the case of fast healing, for both BsALP and total ALP was observed. No difference was found between various sites of bone fracture. This is an important result indicating the prognostic significance of total ALP and BsALP measurement in the monitoring of long bone fracture healing. In addition, an early change in the level of these enzymes was associated with the efficiency of the performed surgery.
The purpose of this paper is to evaluate the incidence of denture repairs in different districts of Croatia through the year of 2002. and to analyse the percentage of different repairs (relinings, ...simple repairs up to 2 elements and complicated repairs-more than 2 elements) in relation to prosthodontic teams. Data on the number of dentures, and the number and types of denture repairs delivered in the Croatian regions of Zagreb, Rijeka, Split and Karlovac were obtained from the Croatian Institute for Health Insurance for the whole of the year 2002. Information of the number of prosthodontic teams operating in those regions was also obtained. Proportionally more denture repairs were carried out in Karlovac (18%) than Split (5%). The smallest percantage of dentures that required relining was registered in Split and the highest in Rijeka (chi2 = 36.7, p < 0.01). The smallest percentage of simple repairs was registered in Rijeka and the highest in Split (chi2 = 24.3, p < 0.01). The smallest percentage of complicated repairs was registered in Split and the highest in Karlovac. In each region the proportion of denture repairs and types of repairs were correlated with a number of prosthodontic teams in that region. Karlovac had the smallest percentage of specialistic prosthodontic teams and the highest rate of denture repairs.
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