Abstract
Microcatheters have enabled diverse minimally invasive endovascular operations and notable health benefits compared with open surgeries. However, with tortuous routes far from the arterial ...puncture site, the distal vascular regions remain challenging for safe catheter access. Therefore, we propose a wireless stent-shaped magnetic soft robot to be deployed, actively navigated, used for medical functions, and retrieved in the example M4 segment of the middle cerebral artery. We investigate shape-adaptively controlled locomotion in phantoms emulating the physiological conditions here, where the lumen diameter shrinks from 1.5 mm to 1 mm, the radius of curvature of the tortuous lumen gets as small as 3 mm, the lumen bifurcation angle goes up to 120
°
, and the pulsatile flow speed reaches up to 26 cm/s. The robot can also withstand the flow when the magnetic actuation is turned off. These locomotion capabilities are confirmed in porcine arteries ex vivo. Furthermore, variants of the robot could release the tissue plasminogen activator on-demand locally for thrombolysis and function as flow diverters, initiating promising therapies towards acute ischemic stroke, aneurysm, arteriovenous malformation, dural arteriovenous fistulas, and brain tumors. These functions should facilitate the robot’s usage in new distal endovascular operations.
To determine the short- and long-term effectiveness of the muscle energy technique (MET) compared with corticosteroid injections (CSIs) for chronic lateral epicondylitis (LE).
Randomized controlled ...trial with 1 year of follow-up.
Outpatient clinic of a university's department of physical medicine and rehabilitation.
Patients with chronic LE (N=82; 45 women, 37 men).
Eight sessions of MET, or a single CSI was applied.
Grip strength, pain intensity, and functional status were assessed using the pain-free grip strength (PFGS), a visual analog scale (VAS), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, respectively. Measurements were performed before beginning treatment and at 6, 26, and 52 weeks afterward.
When the baseline PFGS, VAS, and DASH scores were compared with the scores at the 52-week follow-up, statistically significant improvements were observed in both groups over time. The patients who received a CSI showed significantly better effects at 6 weeks according to the PFGS and VAS scores, but declined thereafter. At the 26- and 52-week follow-ups, the patients who received the MET were statistically significantly better in terms of grip strength and pain scores. At 52 weeks, the mean PFGS score in the MET group was significantly higher (75.08±26.19 vs 62.24±21.83; P=.007) and the mean VAS score was significantly lower (3.28±2.86 vs 4.95±2.36; P=.001) than those of the CSI group. Although improvements in the DASH scores were more pronounced in the MET group, the differences in DASH scores between the groups were not statistically significant.
This study showed that while both MET and CSI improved measures of strength, pain, and function compared with baseline, subjects receiving MET had better scores at 52 weeks for PFGS and the VAS for pain. We conclude that MET appears to be an effective intervention in the treatment of LE.
Fibromyalgia may have negative effects on sexual function in women.
To evaluate the sexuality of women with fibromyalgia and healthy control subjects, and to investigate the relation between ...sexuality and clinical parameters of fibromyalgia.
Female Sexual Function Index (FSFI), Tender Points Count (TPC), Beck Depression Inventory (BDI), Fibromyalgia Impact Questionnaire (FIQ), and Visual Analog Scale (VAS).
Clinical evaluation and surveys were done with 126 women with fibromyalgia and 132 healthy women.
Patients with fibromyalgia had higher BDI scores and lower frequency of sexual intercourse than control subjects. The mean FSFI scores (total and all domains) were significantly lower in patients with fibromyalgia than control subjects. Mean FSFI scores (total and most domains) were significantly lower in patients with fibromyalgia who had BDI score ≥ 17 than those who had BDI score < 17. In women with fibromyalgia, a significant negative correlation was noted between total FSFI score, and both FIQ and BDI scores.
Fibromyalgia has negative effects on female sexual function that are aggravated by depression. Yilmaz H, Yilmaz SD, Polat HAD, Salli A, Erkin G, and Ugurlu H. The effects of fibromyalgia syndrome on female sexuality: a controlled study. J Sex Med 2012;9:779–785.
To evaluate sexual function in women with rheumatoid arthritis (RA) and compare them with healthy controls.
Ninety‐five patients with RA and 108 healthy controls were included in the study. ...Depression levels and sexual functions of all participants were evaluated by the Beck Depression Inventory (BDI) and Index of Female Sexual Function (IFSF), respectively. Morning stiffness in women with RA, pain (Visual Analog Scale—VAS), disability rate (Health Assessment Questionnaire—HAQ), and disease activity score (DAS‐28) were defined.
Total IFSF and mean of IFSF subgroup scores and significance of sexual life score were lower in patients with RA than controls, whereas mean BDI score was higher. The mean of the total IFSF scores was significantly lower in patients with RA with BDI ≥17 than that of patients with BDI <17. The mean of the total IFSF score decreased as disease severity increased. There was a strong negative correlation between total IFSF and DAS‐28 scores, a moderate negative correlation between total IFSF score and HAQ, BDI, VAS score, age, and morning stiffness, and weak negative correlation between total IFSF and body mass index.
RA is observed to have negative effects on sexual functions of women. Presence of depressive symptoms with RA and increased disease severity increase the degree of sexual dysfunction. Women patients with RA should also be asked about their sexual lives while being evaluated. Yilmaz H, Polat HAD, Yilmaz SD, Erkin G, Kucuksen S, Salli A, and Ugurlu H. Evaluation of sexual dysfunction in women with rheumatoid arthritis: A controlled study. J Sex Med **;**:**–**.
Objective of this study is to asses the relationship between tender point count (TPC) and the severity of disease in patients with primary fibromyalgia (FM). One hundred and seven female patients ...with FM diagnosis according to ACR criteria were included to the study. Main outcome measures were fibromyalgia impact questionnaire (FIQ), Beck depression inventory (BDI), visual analog scale (VAS) and tender point assessment. Mean TPC was 14.66 ± 2.50 and mean VAS was 6.6 ± 1.2 cm. Mean total FIQ score and BDI was 62.75 ± 15.57 and 16.17 ± 7.12, respectively. TPC was correlated positively with FIQ and VAS scores. There was no correlation between TPC and age and duration of symptoms. In conclusion, TPC is a simple and noninvasive examination finding that can supply information about the disease severity and the depression in FM.
The objective of this study was to assess the prevalence of fibromyalgia (FM) in patients with episodic migraine and to evaluate the relationship between migraine characteristics and FM. One hundred ...and eighteen consecutive patients (mean age = 38 years, 75 % women) fulfilling the International Classification of Headache Disorders-II criteria for migraine with (
n
= 22) and without (
n
= 96) aura from an outpatient headache clinic of a university hospital were evaluated. The diagnosis of FM was made based on the 1990 American College of Rheumatology classification criteria. Participants completed some self-administered questionnaires ascertaining sociodemographics, headache severity, frequency and duration, headache-related disability (Headache Impact Test HIT-6) and Migraine Disability Assessment Scale, widespread musculoskeletal pain (visual analog scale), depression (Beck depression inventory), anxiety (Beck anxiety inventory), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Assessment of Fatigue), and quality of life (Short Form-36 Health Survey SF-36). In patients with FM, the tender point count and the Fibromyalgia Impact Questionnaire were employed. FM was diagnosed in 37 (31.4 %) of the patients. FM comorbidity was equally distributed across patients with and without aura. Severity of migraine headache, HIT-6, and anxiety were especially associated with FM comorbidity. Patients suffering from migraine plus FM reported lower scores on all items of the SF-36. This study indicates that the assessment and management of coexisting FM should be taken into account in the assessment and management of migraine, particularly when headache is severe or patients suffer from widespread musculoskeletal pain.
Aim: To determine the effects of reproductive factors on bone mineral density (BMD) in postmenopausal women. Materials and Methods: A total of 1196 postmenopausal women with BMD (g/cm2) measurements ...at lumbar vertebra (LS) and femur neck (FN) were enrolled. Demographic, reproductive characteristics and Body Mass Index (BMI) of patients were defined. In order to define BMD related factors, multiple regression analysis was employed. Results: Main results were as follows: mean age= 59.97±8.56 yrs; weight= 73.49±13.06 kg; BMI= 29.25±5.22kg/m², age of menarche= 14.00±1.64 yrs; number of deliveries 4.22±2.09; total breastfeeding duration= 60.77±38.80 months; number of breastfeeding per day= 8.23±3.91; menopausal age= 47.12±4.22 yrs; duration of menopause= 12.80±9.10 yrs; LS BMD= 0.993±0.171 gr/cm2; FN BMD 0.844±0.14 gr/cm2. There were negative correlations between LS BMD and FN BMD values and age, menopause duration, total breastfeeding duration, and number of breastfeeding per day. There were positive correlations between LS and FN BMD values, and weight and BMI scores. Additionally, there were negative correlations between LS and FN BMD values, and age of menarche and number of deliveries. In linear stage regression analysis, weight, number of breastfeeding per day, postmenopausal duration, duration of total breastfeeding and age of menarche were defined as the most significant predictors for LS BMD, whereas weight, postmenopausal duration and number of breastfeeding per day were defined as the most significant predictors for FN BMD. Conclusion: LS and FN BMD in postmenopausal women are related to reproductive factors, so reproductive factors should also be considered in the evaluation of risk factors in postmenopausal women. (Turkish Journal of Osteoporosis 2012;18:8-12)
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