Immediate effect of individual bars of insoles and their combination on gait parameters in asymptomatic healthy adults

Abstract

Objective: The way how individual bars of sensorimotor insoles influence the gait kinematics is not fully understood yet. Therefore, this study aimed to explore the effect of three sensorimotor orthotic conditions (the medial calcaneal and retrocapital lateral bars and their combination) on the gait parameters in healthy adults during the stance phase of gait cycle.

Materials and methods: Twenty-six young adults performed 20 gait cycles in each condition using their self-selected cadence and provided standardised shoes with the base-sole and the three types of orthotics. A three-dimensional motion analysis system (8 cameras; 200?Hz) was used and a six-degrees of freedom model was applied. The cadence, the stride length, the first peaks of foot external rotation, eversion and dorsal flexion as well as the first peak of hip adduction were analysed.

Results: Significant differences (p?<?0.05) were found for all parameters between the orthotic conditions, except the cadence. Significant difference in the first peak of hip adduction (p?=?0.008) was found between the dominant and non-dominant leg. There were no significant interactions between the factors of condition and leg dominance (p?>?0.05).

Conclusions: There seems to be overall tendencies in immediate changes in ankle joint kinematics caused by all three sensorimotor orthotic conditions and besides the mechanical principles, also ‘proprioceptive mechanism’ seems to play a role. However, maximum observed average angular change was 2° and some variability in reactions to each orthotic condition exists among the individuals. Therefore, clinical relevance of such changes remains unclear and careful analysis of expected outcomes should be the common part of every orthotic intervention.     

Serum prolidase activity and oxidative–antioxidative status in patients with developmental dysplasia of the hip and its relationship with radiographic severity

Background: We aimed to investigate serum prolidase activity and to investigate its association with oxidative–antioxidative status in patients with developmental dysplasia of the hip (DDH).

Methods: Oxidative status parameters, including lipid hydroperoxide (LOOH), total oxidant status (TOS), and the oxidative stress index (OSI), and antioxidative status parameters, free sulfhydryl groups (Total –SH), and total antioxidative capacity (TAC), as well as serum prolidase activity were assessed in patients with DDH (n?=?93), and in healthy controls (n?=?82). The severity of dysplasia was evaluated according to the Tonnis grading system.

Results: Serum prolidase activity and the oxidant parameters (LOOH, TOS, and OSI) were significantly higher and the antioxidant parameters (Total –SH and TAC) were significantly lower in patients with DDH compared to the controls (P?P?P?Conclusion: Increased levels of serum prolidase activity, LOOH, TOS, and OSI, and decreased levels of total –SH and TAC, may be associated with DDH, and these parameters may be useful adjunctive tools to assess the severity of DDH.     

Alteration of thiol-disulphide homeostasis in acute tonsillopharyngitis

Objective: Thiol-disulphide homeostasis (TDH) has a critical role in various clinical disorders. We aimed to assess the association of TDH with acute tonsillopharyngitis (AT) in children.

Methods: This study included 94 (73 viral and 21 bacterial) tonsillopharyngitis patients and 88 control children. Their native thiol, total thiol, and disulphide levels were measured.

Results: Viral and bacterial tonsillopharyngitis patients had lower native thiol levels compared with healthy children (P?P?=?0.008, respectively). Both groups had lower total thiol levels compared with control children (P?=?0.002 for viral, P?=?0.011 for bacterial). The disulphide levels were lower in bacterial than in viral tonsillopharyngitis patients (P?=?0.04), and there was a significant difference between viral tonsillopharyngitis patients and the control group (P?P?P?=?0.017 for bacterial). The disulphide/native thiol and disulphide/total thiol ratios were significantly higher in viral (P?P?=?0.017 for both) than in healthy children. In all patients, a correlation was found between the levels of C-reactive protein (CRP) and native thiol (r?=??0.211, P?=?0.04), CRP and total thiol (r?=??0.217, P?=?0.036), white blood cell (WBC) and native thiol (r?=??0.228, P?=?0.002), WBC and total thiol (r?=??0.191, P?=?0.01), and WBC and disulphide (r?=?0.160, P?=?0.03).

Discussion: TDH is altered in AT in children. The alteration is more prominent in viral than in bacterial tonsillopharyngitis.     

Preclinical cost analysis of orthopaedic implants: a custom versus standard cementless femoral component for revision total hip arthroplasty

A preclinical cost analysis method was introduced to assess the cost effectiveness of using a custom implant instead of standard “off-the-shelf” implants for revision total hip arthroplasty. Finite element models of proximal femur–implant systems were constructed and an array of environmental factors, including loads and bone properties, was incorporated into a computer experiment to evaluate relative motion between implant and bone. Implant performance related cost was then determined from relative motion measures using a quality loss function. Unit manufacturing cost was added to implant performance cost to determine the cost difference between the two implants. The reduction in relative motion achieved by the custom implant with respect to an equivalent-lengthed standard implant justified its additional unit manufacturing costs. In response to these results and suggestions by surgeons, we increased the length of the standard implant by 50 mm and performed an identical series of analyses. We found that increasing the stem length to 120 mm substantially decreased the relative motion of the standard implant to values less than for the custom implant. This case study provides preliminary evidence that a surgical inventory consisting of longer-stemmed standard implants or modular distal stems is more cost effective than designing custom devices on a case-by-case basis. Additional design studies are warranted before generalizing such a claim.     

Effects of exercise and lifestyle intervention on oxidative stress in chronic kidney disease

Objectives: Determine the effects of a 12-month exercise and lifestyle intervention program on changes in plasma biomarkers of oxidative stress in pre-dialysis chronic kidney disease (CKD) patients.

Methods: A total of 136 stage 3–4 CKD patients were randomized to receive standard nephrological care with (N?=?72) or without (N?=?64) a lifestyle and exercise intervention for 12 months. Plasma total F₂-isoprostanes (IsoP), glutathione peroxidase (GPX) activity, total antioxidant capacity (TAC), anthropometric and biochemical data were collected at baseline and at 12 months.

Results: There were no significant differences between groups at baseline. There were no significant differences in changes for standard care and lifestyle intervention, respectively, in IsoP (p?=?0.88), GPX (p?=?0.87), or TAC (p?=?0.56). Patients identified as having high IsoP at baseline (>250 pg/mL) had a greater decrease in IsoP with lifestyle intervention compared to standard care; however, the difference was not statistically significant (p?=?0.06). There was no difference in the change in kidney function (eGFR) between standard care and lifestyle intervention (p?=?0.33).

Discussion: Exercise and lifestyle modification in stage 3–4 CKD did not produce changes in systemic biomarkers of oxidative stress over a 12-month period, but patients with high IsoP may benefit most from the addition of intervention to standard care.     

Safety and efficacy of balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension in the Netherlands

Background

Balloon pulmonary angioplasty (BPA) is an emerging treatment in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic disease (CTED). We describe the first safety and efficacy results of BPA in the Netherlands.

Methods

We selected all consecutive patients with inoperable CTEPH and CTED accepted for BPA treatment who had a six-month follow-up in the St. Antonius Hospital in Nieuwegein and the Amsterdam University Medical Center (UMC) in Amsterdam. Functional class (FC), N?terminal pro-brain natriuretic peptide (NT-proBNP), 6?minute walking test distance (6MWD) and right-sided heart catheterisation were performed at baseline and six months after last BPA. Complications for each BPA procedure were noted.

Results

A hundred and seventy-two BPA procedures were performed in 38 patients (61% female, mean age 65?±?15 years). Significant improvements six months after BPA treatment were observed for functional class (63% FC I/II to 90% FC I/II, p?=?0.014), mean pulmonary artery pressure (?8.9?mm?Hg, p?=?0.0001), pulmonary vascular resistance (?2.8 Woods Units (WU), p?=?0.0001), right atrial pressure (?2.0?mm?Hg, p?=?0.006), stroke volume index (+5.7?ml/m², p?=?0.009) and 6MWD (+48m, p?=?0.007). Non-severe complications occurred in 20 (12%) procedures.

Conclusions

BPA performed in a CTEPH expert centre is an effective and safe treatment in patients with inoperable CTEPH.

     

Thiol/disulphide homeostasis in pregnant women with Familial Mediterranean fever

Objective: To investigate the presence of oxidative stress (OS) in pregnant women with Familial Mediterranean fever (FMF) in the first trimester by evaluating thiol/disulphide homeostasis.

Study design: A total of 31 pregnant women with a diagnosis of FMF, between 11⁰ and 13⁶ weeks of gestation, were compared with 51 healthy pregnant controls at the same gestational weeks. A recently defined method was used to measure plasma native thiol, total thiol and disulphide levels.

Results: There were no differences between groups in terms of maternal age, body mass index and numbers of gravida and parity. Antenatal complications (45.2% vs. 9.8%, P?=?0.001) and primary caesarean section (22.6% vs. 5.9%, P?=?0.037) were higher in the FMF group. Pregnant women with FMF had significantly lower first trimester serum levels of native thiol (297.5?μmol/l (153.2–441.8) vs. 366.1?μmol/l (288.7–432.4), P?=?0.000), total thiol (327.2?μmol/l (171.0–471.0) vs. 389.9?μmol/l (317.1–449.8), P?=?0.000) and higher levels of disulphide (14.2?±?4.5?μmol/l vs. 12.4?±?3.4?μmol/l, P?=?0.045). No differences were found in these parameters among FMF patients with and without antenatal complications.

Conclusions: The main outcome demonstrates a relation between OS and pregnant women with FMF in the first trimester of gestation. OS in the first trimester may be a major aetiological factor of unfavourable pregancy outcomes in this group of patients.     

Medicaid Payer Status Is Associated With Increased 90-Day Resource Utilization,Reoperation, and Infection Following Aseptic Revision Total Hip Arthroplasty

BackgroundPrior literature has demonstrated increased resource utilization and perioperative complications in patients with a Medicaid payor status undergoing primary total hip and knee arthroplasty. This relationship has yet to be explored in patients undergoing revision total hip arthroplasty (rTHA).MethodsThe National Readmissions Database was queried from 2010 to 2015 for all patients undergoing aseptic rTHA. 90-day complication data were collected, and patients were separated into two cohorts based on insurance payor type: Medicaid and non-Medicaid. Patients were propensity score matched 2:1 on a number of comorbid and operative characteristics. The relationship between Medicaid payor status and postoperative outcomes was then assessed using binomial logistic regression analysis.Results3,110 Medicaid patients were identified and matched to 6,175 non-Medicaid patients. Medicaid patients had increased odds of an early prosthetic joint infection (Odds Ratio [OR] 1.29, p=0.019), superficial surgical site infection (OR: 1.48, p=0.003), and early reoperation (OR: 1.18, p=0.045). Medicaid patients also experienced higher odds of readmissions, extended length of stay, non-home discharge status, and medical complications. Finally, the Medicaid cohort had a $3,332 (95% CI: 2,412-4,253, p<0.001) increased adjusted total cost of care when compared to the non-Medicaid cohort.ConclusionThis study identifies the Medicaid payor status as an independent risk factor for increased resource utilization, reoperation, and infection in the early postoperative period for patients undergoing rTHA. This relationship is likely due to an interplay of multiple variables, including socioeconomic status and access to care. Level of Evidence: IV     

内固定与关节置换手术治疗骨质疏松性髋部骨折的临床效果及术后并发症的影响因素分析

目的:分析内固定与关节置换手术治疗骨质疏松性髋部骨折的临床效果及其术后并发症的影响因素。方法:将2017年4月至2018年5月因骨质疏松性髋部骨折于我院进行手术治疗的78例患者作为研究对象,参考患者自身意愿按照采取手术方案的不同将所有患者分为内固定组与关节置换组。内固定组主要采用动力髋螺钉内固定治疗;关节置换组采用全髋关节置换术治疗。对比分析两组治疗后并发症的发生情况及关节功能恢复程度。结果:关节置换组手术治疗后关节功能的恢复情况显著优于内固定组(P0.05),术后并发症发生率低于内固定组(P0.05);患者术后并发症发生的主要影响因素包括:术前存在合并症、手术时机≥2h、采用内固定手术。结论:与内固定术相比,关节置换手术治疗骨质疏松性髋部骨折患者的疗效和安全性均更高,但采用该手术治疗时需注意手术操作的规范性及手术时机。     

Similar Outcomes Achieved Between Anterior and Posterior Approach Total Hip Arthroplasty Using Dual Mobility Implants

BackgroundDual mobility (DM) bearings for total hip arthroplasty (THA) have been proposed to reduce the risk of instability in high-risk patients; however, their utility in primary THA remains relatively unexplored. No previous reports have described whether surgical approach influences outcomes associated with DM implant systems. This study aims to compare patient reported outcomes and post-operative groin pain between patients undergoing anterior approach versus posterior approach following primary THA with DM implants.MethodsWe retrospectively reviewed all patients who underwent primary THA and received a DM implant between 2011-2021. Patients were stratified into two cohorts based on surgical approach (anterior vs. posterior approach). Primary outcomes included the presence of substantial postoperative groin pain as well as readmission and revision rates. Demographic differences were assessed using chi-square and independent sample t-tests. Outcomes were compared using multilinear and logistic regressions.ResultsOf the 495 patients identified, 55 (11%) underwent THA via the anterior approach and 440 (89%) via the posterior approach. Surgical time (100.24 vs. 109.42 minutes, p=0.070), length of stay (2.19vs.2.67 days,p=0.072), discharge disposition (p=0.151), and significant postoperative groin pain (1.8%vs.0.7%,p=0.966) did not statistically differ between the cohorts. 90-day readmission (9.1%vs.7.7%,p=0.823) and revision rate (0.0%vs.3.0%,p=0.993) did not significantly differ as well. Specifically, readmission (p=0.993) and revision (p=0.998) for instability did not significantly differ between the cohorts. We found no statistical difference in HOOS, JR (p=0.425), VR-12 PCS (p=0.718), and VR-12 MCS (p=0.257) delta score improvement from preoperative to 1-year follow-up between the two groups.ConclusionComparable outcomes following implantation of DM constructs may be achievable irrespective of the surgical approach employed. The incidence of iliopsoas injections for groin pain did not significantly differ between anterior and posterior approaches. Future investigation is needed to determine whether surgical approach influences long-term outcomes in patients receiving DM implants. Level of Evidence: III     

The effect of tumor necrosis factor alpha (-308G/a) and interferon gamma (+874T/a) polymorphisms on susceptibility to coronary heart disease

Abstract

Background: Coronary heart disease (CHD) is a chronic inflammatory disease, which is still regarded as a major cause of morbidity and mortality worldwide. Several studies have suggested that polymorphisms in cytokine genes are associated with the pathogenesis of CHD. The genotype distribution of Tumor necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) genes polymorphisms have been shown to be different in various ethnic populations. This study was aimed to investigate the association of TNF-α-308?G/A and IFN-γ?+?874T/A polymorphisms with risk of CHD in an Iranian population.

Methods: A total of 187 unrelated subjects comprised 96 CHD patients and 91 healthy controls were enrolled in this cross-sectional study. The TNF-α-308?G/A and IFN-γ?+?874T/A polymorphisms were genotyped using amplification refractory mutation system-PCR (ARMS-PCR). The chi-square and logistic regression tests were used to calculate the odds ratios (ORs) as a measure of differences in genotype frequencies.

Results: A significant differences in the allelic and genotypic distribution of TNF-α-308?G/A and IFN-γ?+?874T/A polymorphisms was found between CHD patients and healthy controls (P?=?0.017, P?=?0.011, P?=?0.006 and P?=?0.002, respectively). Logistic regression analyses were also revealed statistically significant risk for CHD with respect to TNF-α-308?A and IFN-γ?+?874?T carriers either in crude or after adjustment for potential confounders (P?=?0.003 and P?=?0.006, respectively).

Conclusion: This study provides strong evidence supporting the association of TNF-α-308G/A and IFN-γ?+?874T/A polymorphisms with the increased risk of CHD. Therefore, these two cytokine polymorphisms may play a role in predisposition to coronary heart disease.     

Diagnostic utility of MR-proANP and NT-proBNP in elderly outpatients with a high risk of heart failure: the Copenhagen heart failure risk study

Abstract

Background: Amino-terminal-pro-B-type-natriuretic-peptide (NT-proBNP) is a diagnostic biomarker for heart failure (HF), but plasma concentrations are influenced by numerous factors. Mid-regional-pro-atrial-natriuretic-peptide (MR-proANP) have comparable diagnostic value in acute HF. However, data are lacking in the non-acute setting. This study sought to assess the diagnostic utility of MR-proANP in outpatients with a high risk of HF.

Methods: This prospective study included 399 outpatients. Inclusion criteria were: age?≥?60?years, ≥1 risk factor for HF (diabetes, chronic kidney disease, vascular disease, atrial fibrillation, hypertension), without known or suspected HF. Unrecognized HF was diagnosed based on clinical signs, patient-reported symptoms and echocardiography. Plasma concentrations of MR-proANP and NT-proBNP were analysed.

Results: In total, 65 patients were diagnosed with HF or asymptomatic left ventricular systolic dysfunction (N?=?12 LVEF?≤?40%, N?=?7 LVEF?>?40% to ≤50%, N?=?46 LVEF?>?50%). Both MR-proANP (odds-ratio: 1.77; 95% CI:1.16–2.72; p?=?0.009) and NT-proBNP (odds-ratio: 1.49; 95% CI:1.22–1.82; p?<?0.001) were associated with HF. Area under receiver-operator characteristics curve (AUC) for the diagnosis of HF or asymptomatic left ventricular systolic dysfunction was higher for MR-proANP (AUC?=?0.886; p?<?0.001) and NT-proBNP (AUC?=?0.910; p?<?0.001) compared to patient-reported symptoms of HF (AUC?=?0.830), but NT-proBNP added more diagnostic information compared to MR-proANP (p?=?0.022).

Conclusions: Both NT-proBNP and MR-proANP are useful biomarkers in the diagnosis of HF or asymptomatic left ventricular systolic dysfunction in a non-acute setting. However, NT-proBNP added more diagnostic information compared to MR-proANP.     

Serum paraoxonase level and paraoxonase polymorphism in patients with acromegaly

Background: Acromegalic patients have increased cardiometabolic risk factors due to an elevation of growth hormone (GH) levels. Human serum paraoxonase (PON), a high-density lipoprotein (HDL)-related enzyme, is one of the major bioscavengers and decreases the oxidation of low-density lipoprotein (LDL), a key regulator in the pathogenesis of atherosclerosis. In this study, we investigated a potential relationship between serum PON levels or PON polymorphisms and acromegaly.

Methods: A total of 48 acromegalic patients and 44 healthy controls were included in this study. Serum GH levels, insulin-like growth factor-1 levels and lipid profiles were measured. Serum PON levels, as well as PON 1 L55M and Q192R gene polymorphisms, were examined.

Results: No significant differences were found in terms of age, gender, presence of diabetes, serum LDL cholesterol (LDL-C), HDL-C, or triglyceride levels between the case and control groups (P?>?0.05). A statistically significant difference was found in serum PON levels between the cases and controls (P?=?0.007). The median serum PON level was 101?±?63.36?U/l in the case group and 63?±?60.50?U/l in the control group. There was a significant correlation between serum PON levels and IGF-1 levels (P?=?0.004, r?=?0.319); however, no significant differences were found in PON1 L55M and PON Q192R polymorphisms between the patients and controls (P?=?0.607 and P?=?0.308, respectively). In addition, no significant differences were found in serum PON levels in acromegalic patients who were and were not in remission (P?=?0.385), nor between those with PON1 L55M and Q192R polymorphisms (P?=?0.161 and P?=?0.336, respectively).

Conclusions: Elevated serum PON levels were detected in acromegalic patients, independently of their remission status. This suggests protective effects for cardiometabolic risk parameters.     

Cross-training effect of chronic whole-body vibration exercise: a randomized controlled study

Abstract

Purpose: To determine whether unilateral leg whole-body vibration (WBV) strength training induces strength gain in the untrained contralateral leg muscle. The secondary aim was to determine the potential role of spinal neurological mechanisms regarding the effect of WBV exercise on contralateral strength training.

Materials and Methods: Forty-two young adult healthy volunteers were randomized into two groups: WBV exercise and Sham control. An isometric semi-squat exercise during WBV was applied regularly through 20 sessions. WBV training was applied to the right leg in the WBV group and the left leg was isolated from vibration. Sham WBV was applied to the right leg of participants in the Control group. Pre- and post-training isokinetic torque and reflex latency of both quadricepses were evaluated.

Results: The increase in the strength of right (vibrated) knee extensors was 9.4?±?10.7% in the WBV group (p?=?.001) and was 1.2?±?6.6% in the Control group (p?=?.724). The left (non-vibrated) extensorsvibrated) knee extensors w4?±?8.4% in the WBV group (p?=?.038), whereas it decreased by 1.4?±?7.0% in the Control (p?=?.294). The strength gains were significant between the two groups. WBV induced the reflex response of the quadriceps muscle in the vibrated ipsilateral leg and also in the non-vibrated contralateral leg, though with a definite delay. The WBV-induced muscle reflex (WBV-IMR) latency was 22.5?±?7.7?ms for the vibrated leg and 39.3?±?14.6?ms for the non-vibrated leg.

Conclusions: Chronic WBV training has an effect of the cross-transfer of strength to contralateral homologous muscles. The WBV-induced muscular reflex may have a role in the mechanism of cross-transfer strength.     

Maternal association and influence of DHFR 19 bp deletion variant predisposes foetus to anencephaly susceptibility: a family-based triad study

Abstract

Objective: Previous studies have not used family-based methods to evaluate maternal-paternal genetic effects of the folate metabolizing enzyme, dihydro folate reductase (DHFR) essential during embryogenesis. Present study focuses on evaluating the association and influence of parental genetic effects of DHFR 19?bp deletion in the development of foetal neural tube defects (NTDs) using family-based triad approach.

Materials and methods: The study population (n?=?924) including 124 NTD case-parent trios (n?=?124?×?3?=?372) and 184 healthy control-parent trios (n?=?184?×?3?=?552) from Telangana, India, was genotyped for DHFR 19?bp deletion. Statistical analysis was used by SPSS and parent-of-origin effects (POE).

Results: Foetuses with deletion genotype (DD) were at risk of developing anencephaly (OR =?3.26, p?=?0.020). Among parents, increased maternal risk of having an anencephaly foetus (OR =?2.66, p?=?0.028) was observed in mothers with DD genotype. In addition, POE analysis also demonstrated higher risk of maternal transmission of the deletion allele to anencephaly foetus compared with paternal transmission (OR =?6.00, p?=?0.016). Interestingly, maternal-paternal-offspring genotype incompatibility revealed maternal deletion genotype (DD) in association with paternal heterozygous deletion genotype (WD) significantly increased risk for NTDs (OR =?5.29, p?=?0.013).

Conclusions: This study, using family-based case-parent and control-parent triad approach, is the first to report influence of maternal transmission of DHFR 19?bp deletion in the development of anencephaly in the foetus.     

直接前方入路与直接外侧入路人工全髋关节置换术的临床效果比较研究

目的:探讨平卧位直接前方入路(DAA)与侧卧位直接外侧入路(DLA)对行初次全髋关节置换术(THA)患者髋关节功能、平衡功能和步态参数的影响。方法:选取2018年2月～2019年10月期间我院收治的初次THA患者97例,根据入路方式的不同随机分为A组(n=47)和B组(n=50),A组行侧卧位DLA,B组行平卧位DAA,比较两组髋关节功能、影像学参数、平衡功能和步态参数,记录两组术后并发症发生率。结果:术后1周、1个月、3个月及6个月两组髋关节Harris评分(HHS)、Berg平衡量表评分(BBS)依次升高,且B组高于A组(P0.05)。B组手术时间长于A组,术中出血量少于A组,切口长度、初次下床行走时间短于A组(P0.05)。术后3个月、6个月两组步频、步速、步长依次升高,且B组高于A组(P0.05)。两组并发症发生率对比,组间比较未见统计学差异(P0.05)。两组术后6个月髋臼假体外展角、前倾角对比,组间比较无显著差异(P0.05)。结论:与侧卧位DLA相比,初次THA患者行平卧位DAA可获得与其相当的手术效果,同时能更好地改善患者髋关节功能、平衡功能和步态,且安全性有保障。     

Blood and plasma titanium levels associated with well-functioning hip implants

BackgroundHip implants are usually manufactured from cobalt-chromium and titanium alloys. As the implants wear and corrode, metal debris is released into the surrounding tissue and blood, providing a potential biomarker for their function. Whilst there are laboratory reference levels for blood cobalt and chromium in patients with well and poorly functioning hip implants, there are no such guidelines for titanium. This is despite the increasing use of titanium implants worldwide.Patients and methodsWe recruited a consecutive series of 95 patients (mean age 71 years, mean time after surgery 8.5 years) with one hip implant type, inserted by the same surgeon. We assessed clinical and radiological outcome, and measured blood and plasma titanium using high resolution inductively-coupled plasma mass spectrometry.ResultsThe upper normal reference limit for blood and plasma titanium was 2.20 and 2.56 μg L⁻¹, respectively, and did not differ significantly between males and females.ConclusionWe are the first to propose a laboratory reference level for blood and plasma titanium in patients with well-functioning titanium hip implants. This is an essential starting point for further studies to explore the clinical usefulness of blood titanium as a biomarker of orthopaedic implant performance, and comes at a time of considerable controversy regarding the use of certain titanium alloys in hip arthroplasty.     

Changes in resting motor threshold of the tongue with normal aging and stroke

Aim of study: To examine the resting motor threshold of the tongue in healthy adults and stroke survivors.

Methods: Thirty-five healthy adults were classified into three groups: Group 1 (19–38?years; n?=?11), Group 2 (50–64?years; n?=?12) and Group 3 (66–78?years; n?=?12). Six chronic stroke survivors (mean age =59?years, SD?=?9.1?years) were recruited (Group 4). The resting motor thresholds (RMTs) of the tongue were measured and compared (i) among the four groups and (ii) between stroke survivors and age-matched healthy adults.

Results: Group 3 showed significantly higher RMTs than Group 1 (p?=?.001) and 2 (p =?0.007). Group 4 showed significantly higher RMTs than Group 1 (p =?.003) and 2 (p?=?.001). The RMTs of Group 3 and 4 were not significantly different (p =?.385). The RMT was positively correlated with age (r?=?0.534; p =?.001). Group 4 showed significantly higher RMTs than the age-matched controls (U?= 2.5, p?=?.009, r?=?0.77).

Conclusions: The resting motor threshold of the tongue is significantly increased in adults aged above 65 and in stroke survivors when compared with healthy adults. The findings suggested that the cortical excitability of the tongue deteriorates in the elderly and the stroke population.     

CHRONIC SLEEP DEFICIT AND PERFORMANCE OF A SUSTAINED ATTENTION TASK—AN ELECTROOCULOGRAPHY STUDY

Electrooculography (EOG) was used to explore performance differences in a sustained attention task during rested wakefulness (RW) and after 7 days of partial sleep deprivation (SD). The RW condition was based on obtaining regular sleep, and the SD condition involved sleep restriction of 3?h/night for a week resulting in a total sleep debt of 21?h. The study used a counterbalanced design with a 2-wk gap between the conditions. Participants performed a sustained attention task for 45?min on four occasions: 10:00–11:00, 14:00–15:00, 18:00–19:00, and 22:00–23:00?h. The task required moving gaze and attention as fast as possible from a fixation point to a target. In each session, 120 congruent and 34 incongruent stimuli were presented, totaling 1232 observations/participant. Correct responses plus errors of omission (lapses) and commission (false responses) were recorded, and the effect of time-of-day on sustained attention following SD was investigated. The analysis of variance (ANOVA) model showed that SD affected performance on a sustained attention task and manifested itself in a higher number of omission errors: congruent stimuli (F_(1,64)?=?13.3, p?<?.001) and incongruent stimuli (F_(1,64)?=?14.0, p?<?.001). Reaction times for saccadic eye movements did not differ significantly between experimental conditions or by time-of-day. Commission errors, however, exhibited a decreasing trend during the day. The visible prevalence of omissions in SD versus RW was observed during the mid-afternoon hours (the so-called post-lunch dip) for both congruent and incongruent stimuli (F_(1,16)?=?5.3, p?=?.04 and F_(1,16)?=?5.6, p?=?.03, respectively), and at 18:00?h for incongruent stimuli (F_(1,13)?=?5.7, p?=?.03). (Author correspondence: magda.fafrowicz@uj.edu.pl)     

The population biology of the exploited crab Ucides cordatus (Linnaeus, 1763) in a southeastern Atlantic Coast mangrove area,Brazil

Ucides cordatus (Linnaeus, 1763), found in mangroves along the Brazilian coast, is an artisanal fishery resource harvested as a source of income and for subsistence. A 12?month study of U. cordatus was conducted in a mangrove area of the southeastern Brazilian coast to estimate the growth, longevity, sex ratio and population density of the crabs. A total of 1024 crabs (505 males and 519 females) were sampled. Carapace width (CW) ranged from 49 to 90?mm (mean?±?SD: 71.2?mm?±?6.0) for males and from 52 to 83?mm (69.3?mm?±?4.9) for females. Males dominated the largest CW classes. The asymptotic size (CW_∞) and the asymptotic weight (WW_∞) were estimated as 93.4?mm and 305.5?g, respectively, for males and as 87.1?mm and 221.5?g, respectively, for females. The estimated maximum longevities were 17.6?years for males and 15.7?years for females. The males (k?=?0.17, Φ?=?1.171) and females (k?=?0.19, Φ?=?1.159) showed similar growth rates. The mean density was 0.41?±?0.19?burrows?m^?2. Of this total mean density, 85.8% corresponded to the immediate harvesting potential and 14.2% to the future harvesting potential. Given that U. cordatus is a long-lived species that grows slowly, an appropriate strategy for the management is crucial to ensure the sustainable exploitation of this resource.