Therapy For Treatment Of Patients Research Articles

The Application of Dhikr Spiritual Therapy to Reduce Signs of Risk of Violent Behavior in the Mawar Room at dr. Radjiman Wediodiningrat Hospital

The risk of violent behavior is a condition when an individual will endanger the safety of himself, others, family, community, because of his aggressive behavior. Spiritual dhikr therapy is a therapy that can help reduce signs and symptoms of the risk of violent behavior because when patients listen to reading the Al-Qur’an it can reduce stress hormones, increase feelings of relaxation and divert attention from fear, anxiety and tension. This study aims to apply how to apply spiritual dhikr killing treatment therapy in patients at risk of violent behavior. The method employed is through a case study research design using 5 nursing processes. The patients accept the implementation of nursing strategies to cotrol violent behavior using physical, drug, verbal and spiritual means. Interventions for clients with a risk of violent behavior are adjusted to violent behavior implementation strategies (SP) and then receive additional non-pharmacological therapy in the form of spiritual dhikr therapy at each meeting. Spiritual dhikr therapy is carried out for 10 consscutive days, each meeting consisting of 5 sessions with reading tahlil, tasbih, tahmid, takbir, istighfar. Each session reads the dhikr sentence 33 times wtithin 5 minutes. Before giving dhikr, spiritual therapy there were 9 signs of violent behavior, whereas after giving therapy for 10 days there was a decrease to 2 signs of violent behavior. Spiritual dhikr therapy can reduce signs and symptoms of violent behavior because dhikr can purify the heart and soul, be grateful for what Allah has given, make the body healthy, and prevent oneself from the dangers of lust. Nursing strategies (controlling violent behavior physically, drugs, verbally and spiritually and spiritual dhikr intervention can effectively reduce signs of violent behavior. This can reduce stress hormones, increase feelings of relaxation and distraction of fear, anxiety.

Efficacy of pelvic floor muscle training with physical therapy for low back pain: A systematic review and meta-analysis

Objective To assess the efficacy of pelvic floor muscle training and physical therapy interventions in patients with low back pain. Data sources The Ovid–Medline, Ovid–Embase, Cochrane Library, CINAHL, Web of Science, and PEDro databases were searched for randomised, controlled trials published in English or Korean between database inception and September 2024. Review Methods Studies providing pelvic floor muscle training in individuals with low back pain were included. The risk of bias using the Cochrane Risk of Bias 2 tool and the grading of recommendation, assessment, development, and evaluation (GRADE) system was used to evaluate the quality of evidence. The meta-analysis was performed using Review Manager software 5.4. Results Nineteen studies were included in this review. Pelvic floor muscle training showed low certainty evidence for improving pain (standardised mean difference = −0.73, 95% CI [−1.10, −0.36]) and reflected a clinically meaningful reduction in pain. The evidence for disability improvement had a low certainty (mean difference = −5.21, 95% CI [−7.15, −3.26]) due to high heterogeneity. Substantial improvements in pain and disability were observed when pelvic floor muscle training was added to standard physical therapy, with low certainty of evidence supporting these findings. Whereas pelvic floor muscle training substantially improved pain compared to other interventions, there was no marked improvement in disability. Conclusion Pelvic floor muscle training is potentially beneficial in addition to physical therapy for reducing low back pain, particularly in pregnancy-related cases. However, the evidence should be interpreted considering the quality and risk of bias.

Assessing the transparency in reporting of clinical trials investigating manual therapy interventions for low back pain: A methodological review.

Low back pain (LBP) is a common condition with a significant societal burden. Manual therapy is an effective treatment for LBP and recommended in clinical practice guidelines. While the quantity of literature supporting the use of manual therapy is large, the methodological quality and transparency of this collective work are unclear. Explore the transparency in reporting of clinical trials assessing manual therapy interventions in patients with LBP by comparing planned components in the trial registration with what was reported in the published manuscript. Three databases were searched to identify trials assessing the treatment effect of manual therapy for LBP from January 2005 to May 2023. Studies were included if the manual therapy consisted of thrust manipulations, mobilizations or muscle energy techniques. From 4462 studies initially identified, 167 studies remained in the final review after title, abstractand full-text review. Only 87 (52.1%) of the 167 studies were registered (n = 57 prospectively and n = 30 retrospectively). Primary outcomes in the publications were identical to the registration in 54 (62.1%) of the registered trials. Secondary outcomes in the publication were identical to the registration in 27 (31.0%) of the registered trials. The CONSORT reporting guideline was referenced in only 19 (21.8%) trials. Multiple discrepancies between registration and publication were noted for primary and secondary outcomes. All trials had eligibility criteria in the registration that matched their corresponding manuscript, while only four (4.6%) trial registrations addressed any type of statistical analysis plan. Approximately half of the trials were not registered. Of those registered, only half were registered prospectively. Substantial discrepancies existed between registered and published outcomes that were never addressed by the authors, raising questions about potential bias. Transparency can be improved through more stringent requirements during manuscript submission to journals, and better reporting of the rationale for discrepancies between registration and publication.

Defective recovery of QT dispersion due to no-reflow following acute interventional therapy in patients with ST-segment elevation myocardial infarction.

Previous studies have suggested that adequate myocardial reperfusion after percutaneous coronary intervention (PCI) can improve the inhomogeneity of myocardial repolarization. However, it remains unclear whether no-reflow (NR) following emergency PCI involves disadvantages related to ventricular repolarization indices. The present study aimed to determine the effect of NR on QT dispersion (QTd) in patients with ST-segment elevation myocardial infarction (STEMI) and to evaluate the prognostic value of the relative reduction of QTd on ventricular arrhythmia events (VAEs). A prospective case-control study was conducted. According to the inclusion criteria, 275 patients with STEMI who underwent primary PCI treatment at the First People's Hospital of Anqing affiliated to Anhui Medical University from January 2020 to May 2023 were enrolled. According to whether NR occurred during PCI, these patients were divided into two groups: an NR group and a non-NR group. Subsequently, the QT intervals were measured before and at 12 hours after PCI. Afterward, the QTd, corrected QTd (QTcd), and the relative reduction of QTd and QTcd 12 hours pre- and postprocedure (ΔQTd-R and ΔQTcd-R, respectively) were calculated. Finally, multivariable logistic regression analysis was performed to predict the risk of VAE occurrence. In the non-NR group, there was a significant decrease from baseline in postprocedure QTd (48±17 vs. 73±22 ms; P=0.009) and QTcd (54±19 vs. 80±23 ms; P=0.01); in contrast, the NR group showed no significant difference in QTd (64±20 vs. 75±23 ms; P=0.58) or QTd (70±22 vs. 82±26 ms; P=0.45). Furthermore, the ΔQTd-R and ΔQTcd-R were both lower in the NR group than in the non-NR group (P<0.05); however, the rate of VAEs was higher in the NR group than in the non-NR group (15.2% vs. 6.2%; P=0.02). The multivariable logistic regression analysis results revealed that each increase of 12% in ΔQTcd-R was an independent predictor of VAEs (odds ratio: 0.547; 95% confidence interval: 0.228-0.976). The NR phenomenon following primary PCI in patients with STEMI leads to the defective recovery of QTd and QTcd. Furthermore, ΔQTcd-R can be viewed as an effective indicator for evaluating the myocardial repolarization inhomogeneity, and short-term clinical outcomes.

Manual Therapy Interventions in Patients With Chronic Obstructive Pulmonary Disease: A Comprehensive Narrative Review.

Chronic obstructive pulmonary disease (COPD) is a breathing problem with ongoing airflow issues and changes in how the chest moves. Different manual therapy methods, like releasing the diaphragm, manipulating the spine and joints, and treating soft tissues, have been used for people with COPD. This review looks into how these manual therapy approaches affect COPD patients. Articles were searched in Google Scholar, PubMed, and Elsevier using keywords such as COPD, manual therapy, thoracic excursion, and pulmonary function. Only studies conducted between 2015 and 2023, employing randomized controlled trials (RCTs), crossover RCTs, or comparative studies with COPD subjects, thoracic excursion, chest expansion, or pulmonary function tests (PFTs) as outcome measures, and involving physiotherapy interventions were included. Out of 82 articles searched, 10 met the inclusion criteria, comprising six RCTs, three crossover RCTs, and one comparative study. Data extraction was performed by one reviewer, encompassing intervention descriptions, inclusion/exclusion criteria, baseline data, and outcome values. The findings suggest that conventional physiotherapy combined with manual therapy techniques such as stretching, osteopathic manual therapy, manual diaphragmatic release, soft tissue therapy, and spinal manipulation have improved thoracic excursion and pulmonary function in COPD patients. Therefore, these manual therapy techniques are recommended for enhancing thoracic excursion and pulmonary function in COPD patients.

Transcatheter Closure of Atrial Septal Defects with Absent Aortic Rim and the Predictors of Right Atrial Reverse Remodeling: 5 Years Experience in China

Plain Language SummaryAtrial septal defect (ASD) is a common congenital heart disease. The transcatheter approach is not recommended for absent aortic rim ASD. However, almost 30–40% of ASD patients in China are found to have an absent aortic rim with right atrial (RA) remodeling. We evaluated the safety and efficiency of transcatheter ASD closure in patients with an absent aortic rim and the predictors of RA reverse remodeling. No major operative complications occurred in all patients with the absence of an aortic rim and a normal edge. Without coronary heart disease, a lower plasma creatinine level, and less tricuspid regurgitation before the operation were the predictive factors for the reverse of RA remodeling after treatment.

Airway collapse hinders recovery in bronchoscopy therapy for postintubation tracheal stenosis patients.

Expiratory central airway collapse (ECAC) following postintubation airway stenosis (PITS) is a rare phenomenon. The impact of airway malacia and collapse on the prognosis and the success rate of bronchoscopic interventional therapy in patients with PITS had been inadequately investigated. The aim of this research was to assess the influence of airway malacia and collapse on the efficacy of bronchoscopic interventional therapy in patients with PITS. This retrospective analysis examined the medical documentation of individuals diagnosed with PITS who underwent bronchoscopic intervention at the tertiary interventional pulmonology center of Emergency General Hospital from 2014 to 2021. Data pertaining to preoperative, perioperative, and postoperative stages were documented and subjected to analysis. The patients in malacia and collapse group (MC group) exhibited a higher frequency of perioperative complications, including intraoperative hypoxemia, need for reoperation within 24h, and postoperative intensive care unit admission rate (P < 0.05, respectively). Meanwhile, patients in group MC demonstrated significantly worse postoperative scores (higher mMRC score and lower KPS score) compared to those in pure stenosis group (P < 0.05, respectively), along with higher degrees of stenosis after treatment and a lower success rate of bronchoscopic intervention therapy cured (P < 0.05, respectively). Pearson analysis results showed that these terms were all significantly correlated with the occurrence of airway malacia and collapse in the airway (P < 0.05, respectively). The presence of malacia or collapse in patients with PITS was associated with increased perioperative complications following bronchoscopic interventional therapy, and significantly reduced the long-term cure rate compared to patients with pure tracheal stenosis. Trial registration Chinese Clinical Trial Registry on 06/12/2021. ChiCTR2100053991.

Role of Proprotein Convertase Subtilisin Kexin Type 9 Inhibitor Therapy in treatment of Patients with Polycystic Ovary Syndrome: A systemic Review of Metabolic and Cardiovascular Outcomes

Polycystic Ovary Syndrome (PCOS) is a common endocrine condition that affects both obese and nonobese women of reproductive age group. Its clinical presentation is dysmenorrhea, hirsutism, acne, metabolic complications, infertility, and polycystic ovaries. The study is aimed to assess the efficacy of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors to lower dyslipidemia in women with PCOS to prevent long term cardio-metabolic complications. PCSK 9 Inhibitors ( Alirocumab, Evolocumab, and Inclisiran) bind to LDL receptors in liver and lower LDLC levels, preventing long term adverse side effects. This review aims at showing that these drugs can be effective when prescribed to women with PCOS earlyon to prevent some serious cardiovascular and metabolic complications in the long run. In terms of medical therapy, most physicians prescribe Metformin and Statins as first line agents to control risk factors. But much of the research supported the use of PCSK 9 Inhibitors early in the disease process or as an add-on to statins for controlling the lipid profile. When compared to Statins, the control rates of PCSK 9 Inhibitors were equal or superior and they showed additive effect when given along with other lipid lowering agents. Studies showed these drugs have only minor side effects and have good tolerability profile. They do not have severe side effects as compared to statins or fibrates.

Effects of Decompression therapy in leg pain and straight leg rise in patient with lumbar radiculopathy due to disc protrusion

One among many disc problems is disc protrusion, which has more prevalence in outpatient department physical therapy management Centre globally. The purpose of this study was to compare the effect of lumbar spine decompression therapy and standard physical therapy treatment in patients with lumbar radiculopathy due to disc protrusion. The single-blind randomized control trial of 71 patients was conducted at Max Rehab &amp; Physical Therapy Centre Islamabad, Pakistan. After setting inclusion criteria all the patients were randomly allocated into treatment and control group. Both group received standard physical therapy treatment including, Moist Hot pack, Lumbar Mobilization, Stretching &amp; strengthening exercises. The only difference was that Decompression Group received additional Decompression therapy. The data included demographics and Numeric Pain Rating Scale score in supine lying position for the painful leg and Straight Leg Raise Range for the painful side. The values for leg pain for control group decreased from 6 to 3 and the value for straight leg raise increased from 15° to 49°. The values for leg pain for the Decompression Group decreased from 6 to 2 and the value for the straight leg raise increased from 10° to 48°, the p value for both the variables was &lt;.001 showing statistically significant difference between pre and post values in treating patients leg pain and straight leg raise range of motion. It is concluded that decompression therapy is more effective in managing lumbar radiculopathy.

Significance of cell therapy in treatment of patients with thin endometrium and Asherman’s syndrome

Significance of cell therapy in treatment of patients with thin endometrium and Asherman’s syndrome

Results of stereotactic radiation therapy in treatment of patients with T1N0M0 kidney cancer

Background. Currently, the main treatment for T1N0M0 kidney cancer is surgery, mainly in the amount of kidney resection. However, not all patients can be operated on, and most often due to the severity of comorbidity, some patients refuse surgery. In such cases, it becomes necessary to search for an acceptable operation of an alternative method of treatment. Such requirements can be met by stereotactic radiotherapy (SBRT), being a non-invasive method of treating renal cell carcinoma.Purpose. To determine overall survival (OS), local control, and renal toxicity after treatment of T1N0M0 renal cell carcinoma (RCC) with stereotactic radiotherapy.Material and methods. Since 2011 to 2022 in the Chelyabinsk Regional Clinical Centre of Oncology and Nuclear Medicine, 50 patients with verified RCC underwent SBRT up to 30–45 Grey in three fractions using the CyberKnife. The mean age of the patients was 69.8 years. Primary tumor was diagnosed in 44 cases, recurrence after previous surgical treatment in 6 cases, including one patient with recurrence of cancer of both kidneys. The average tumor volume was 29.1 cm3 .Results. Median overall survival was not reached as most patients were alive at the time of the study. Indicators of 1-, 3- and 5-year OS are 94.8%, 87.3% and 75.1%, respectively. In 74.5% of cases, according to the RECIST 1.1 criteria, stabilization of the process was recorded 6 months after STLT, in 21.6% of cases – a partial response, in 3.9% – progression of the process. One-year local control – 98%. Renal toxicity occurred in 26% of patients 6 months after radiation therapy, but within a year, kidney function was restored in these patients.Conclusions. Stereotactic radiation therapy T1N0M0 of kidney cancer in SOD = 30–45 Grey allows to stabilize the tumor process with sufficiently high results of overall survival and local control with low renal toxicity, respectively, can be used in the treatment of inoperable patients with localized renal cell carcinoma.

Progress in the Prevention of Complications of Interventional Therapy in Patients with Lung Cancer Hemoptysis

Lung cancer is the malignant tumor with the highest incidence and mortality in our country and even in the world. The radical rate of conventional therapy, such as simple radiotherapy, chemotherapy, operation, traditional Chinese medicine treatment is low and the effect is not ideal. Bronchial lung cancer is one of the most common causes of massive hemoptysis. Vascular interventional therapy has become the first choice in clinical treatment of acute massive hemoptysis. Interventional therapy for lung cancer patients, as a safe, efficient, minimally invasive and economical treatment, has been widely used at home and abroad. However, due to inadequate patient assessment, equipment may not be advanced enough, and treatment techniques need to be developed, more or less postoperative complications associated with interventional therapy may occur. This article reviews the research status of interventional therapy and complication prevention in patients with lung cancer hemoptysis as follows.

Chinese Expert Consensus on Microvascular Protection Strategy During Emergency Percutaneous Coronary Intervention Therapy in Patients With ST-elevation Myocardial Infarction

Microcirculatory dysfunction (CMD) typically occurs in patients with acute ST-segment elevation myocardial infarction during percutaneous coronary intervention, which is associated with more severe myocardial injury and a worse prognosis. With the advancement of intracoronary physiology and imaging technology, the prevention and therapeutic interventions of CMD have attracted more attention. However, relevant guidelines or consensus on CMD are lacking in China. The current consensus summarizes the prevention and diagnostic strategies of emergency percutaneous coronary intervention-related CMD and gives suggestions to improve the prognosis of ST-segment elevation myocardial infarction patients based on evidence from recent clinical studies, guidelines, and consensus from international sources.

Value of Baseline Metabolic Tumor Volume for Survival Prognosis and Optimization of Risk-Adapted Treatment Therapy in Patients with Extranodal Nasal-Type Natural Killer/T-Cell Lymphoma

To assess the association of baseline metabolic tumor volume (MTV) with overall survival (OS) and to explore its potential role in optimization of existing risk-adapted therapy in ENKTCL. A total of 133 ENKTCL patients mainly treated by radiotherapy (RT) alone (33.8%) or RT combined with chemotherapy (combined-modality therapy [CMT]) (60.9%) were prospectively included. The impacts of MTV, SUVmax derived from 18F-FDG PET/CT image and clinical factors on OS were investigated. Survival analyses were conducted using Kaplan-Meier method with log-rank tests. Cox proportional hazards regression analysis was used to identify multivariate predictors of OS. Regression-based mediation analysis estimated the hazard ratio (HR) of death for direct effect (not through distant metastasis or locoregional recurrence) and indirect effect (through distant metastasis or locoregional recurrence) of the pathway MTV→distant metastasis→OS and pathway MTV→locoregional recurrence→OS. Inverse probability of treatment weighting (IPTW) analysis was employed to make covariate adjustments. MTV and SUVmax were correlated with LDH, PTI, Ann Arbor stage, and NRI score. In univariable analysis, SUVmax, MTV, ECOG PS, PTI and Ann Arbor stage were statistically significantly prognostic factors for OS. Multivariate analysis showed that MTV was the only independent factor of short OS (HR 4.98, 95% CI (1.85 - 13.42), p = 0.002). Mediation analysis showed that distant metastasis played a complete mediating role in the increased death caused by higher MTV (HR of indirect effect 3.15, 95% CI (1.34 - 7.41), p = 0.009; HR of direct effect 2.88, 95% CI (0.80 - 10.32), p = 0.767), with proportion of mediation 76.7%, while locoregional recurrence was not a mediating factor (HR of indirect effect 1.16, 95% CI (0.90 - 1.48), p = 0.255; HR of direct effect 4.48, 95% CI (1.30 - 15.44), p = 0.017) . After adjusting the clinical factors by IPTW between RT alone group and CMT group in early intermediate and high risk ENKTCL, CMT had no PFS and OS benefits compared with RT alone in the low-MTV group (MTV < 49.6ml), while in the high-MTV group (MTV ≥ 49.6ml), the use of CMT compared with RT alone prolonged PFS and OS. Baseline metabolic tumor volume is an independent prognostic factor for overall survival and distant metastasis rather than locoregional recurrence mediated increased risk of death in patients with MTV higher than 49.6ml. For early-stage intermediate and risk ENKTCL patients with MTV lower than 49.6ml, omission of chemotherapy may not result in loss of PFS and OS.

Evolution by innovation as a driving force to improve TCR-T therapies.

Adoptive cell therapies continually evolve through science-based innovation. Specialized innovations for TCR-T therapies are described here that are embedded in an End-to-End Platform for TCR-T Therapy Development which aims to provide solutions for key unmet patient needs by addressing challenges of TCR-T therapy, including selection of target antigens and suitable T cell receptors, generation of TCR-T therapies that provide long term, durable efficacy and safety and development of efficient and scalable production of patient-specific (personalized) TCR-T therapy for solid tumors. Multiple, combinable, innovative technologies are used in a systematic and sequential manner in the development of TCR-T therapies. One group of technologies encompasses product enhancements that enable TCR-T therapies to be safer, more specific and more effective. The second group of technologies addresses development optimization that supports discovery and development processes for TCR-T therapies to be performed more quickly, with higher quality and greater efficiency. Each module incorporates innovations layered onto basic technologies common to the field of immunology. An active approach of "evolution by innovation" supports the overall goal to develop best-in-class TCR-T therapies for treatment of patients with solid cancer.

Better late than never-a single-center review of delayed rib fixation for symptomatic rib fractures and nonunions.

Surgical stabilization of rib fractures (SSRFs) has become an emerging therapy for treatment of patients with rib fractures. More commonly, it is used in the acute setting; however, delayed SSRF can be utilized for symptomatic rib fracture nonunions. Here, we describe our institution's experience with delayed SSRF, hypothesizing it is safe and resolves patient symptoms. This is a retrospective review of patients presenting to our Level I trauma center to undergo delayed SSRF for symptomatic nonunions from January 2017 to September 2022. Delayed SSRF was defined as SSRF over 2 weeks in the outpatient setting. Basic demographics were obtained. Outcomes of interest included mean pain score (preoperatively and postoperatively), intensive care unit (ICU) and hospital length of stay (LOS), and resolution of preoperative symptoms, specifically chest wall instability, with return to activities of daily living (ADLs). Forty-four patients met inclusion criteria with a total of 156 symptomatic nonunion rib fractures that received delayed SSRF. The average age was 59.2 ± 11.9 years and median number of days from injury to SSRF was 172.5 (interquartile range, 27.5-200). The average number rib fractures plated per patient 3.5 ± 1.8. Only three patients required ICU admission postoperatively for no longer than 2 days. Median hospital LOS was 2 days (interquartile range 1-3 days). Average preoperative and postoperative pain score was 6.8 ± 1.9 and 2.02 ± 1.5, respectively ( p < 0.001). Chest wall instability and preoperative symptoms resolved in 93.2% of patients postoperatively ( p < 0.001). Two patients (4.5%) had postoperative complications that resolved after additional surgical intervention. Rib fracture healing was demonstrated on radiographic imaging during postoperative follow-up. Delayed SSRF is safe and demonstrates significant resolution of preoperative symptoms by decreasing pain, improving chest wall stability, and allowing patients to return to activities of daily living. Therapeutic/Care Management; Level IV.

Identification of immune-related lncRNA in sepsis by construction of ceRNA network and integrating bioinformatic analysis.

Sepsis is a high mortality disease which seriously threatens human life and health, for which the pathogenetic mechanism still unclear. There is increasing evidence showed that immune and inflammation responses are key players in the development of sepsis pathology. LncRNAs, which act as ceRNAs, have critical roles in various diseases. However, the regulatory roles of ceRNA in the immunopathogenesis of sepsis have not yet been elucidated. In this study, we aimed to identify immune biomarkers associated with sepsis. We first generated a global immune-associated ceRNA (IMCE) network based on data describing interactions pairs of gene-miRNA and miRNA-lncRNA. Afterward, we excavated a dysregulated sepsis immune-associated ceRNA (SPIMC) network from the global IMCE network by means of a multi-step computational approach. Functional enrichment indicated that lncRNAs in SPIMC network have pivotal roles in the immune mechanism underlying sepsis. Subsequently, we identified module and hub genes (CD4 and STAT4) via construction of a sepsis immune-related PPI network. Then, we identified hub genes based on the modular structure of PPI network and generated a ceRNA subnetwork to analyze key lncRNAs associated with sepsis. Finally, 6 lncRNAs (LINC00265, LINC00893, NDUFA6-AS1, NOP14-AS1, PRKCQ-AS1 and ZNF674-AS1) that identified as immune biomarkers of sepsis. Moreover, the CIBERSORT algorithm and the infiltration of circulating immune cells types were performed to identify the inflammatory state of sepsis. Correlation analyses between immune cells and sepsis immune biomarkers showed that the LINC00265 was strongly positive correlated with the macrophages M2 (r = 0.77). Collectively, these results may suggest that these lncRNAs (LINC00265, LINC00893, NDUFA6-AS1, NOP14-AS1, PRKCQ-AS1 and ZNF674-AS1) played important roles in the immune pathogenesis of sepsis and provide potential therapeutic targets for further researches on immune therapy treatment in patients with sepsis.

Computational fluid dynamics of upper airway aerodynamics for exercise-induced laryngeal obstruction: A feasibility study.

Use of computational fluid dynamic (CFD) simulations to measure the changes in upper airway geometry and aerodynamics during (a) an episode of Exercise-Induced Laryngeal Obstruction (EILO) and (b) speech therapy exercises commonly employed for patients with EILO. Magnetic resonance imaging stills of the upper airway including the nasal and oral cavities from an adult female were used to re-construct three-dimensional geometries of the upper airway. The CFD simulations were used to compute the maximum volume flow rate (l/s), pressure (Pa), airflow velocity (m/s) and area of cross-section opening in eight planes along the vocal tract, separately for inhalation and exhalation. Numerical predictions from three-dimensional geometrical modeling of the upper airway suggest that the technique of nose breathing for inhalation and pursed lip breathing for exhalation show most promising pressure conditions and cross-sectional diameters for rescue breathing exercises. Also, if EILO is due to the constriction at the vocal fold level, then a quick sniff may also be a proper rescue inhalation exercise. EILO affects both the inspiratory and the expiratory phases of breathing. A prior knowledge of the supraglottal aerodynamics and the corresponding upper airway geometry from CFD analysis has the potential to assist the clinician in choosing the most effective rescue breathing technique for optimal functional outcome of speech therapy intervention in patients with EILO and in understanding the pathophysiology of EILO on a case-by-case basis with future studies. 4.

Immunohistochemical expression of P53 protein in nephroblastoma: a predictor of unfavorable prognosis

ObjectiveImmunohistochemical expression of P53 protein is so closely related to status of mutation of P53 gene which is tightly linked with pathogenesis of nephroblastoma or Wilms tumor. This study aims to determine the immunohistochemical expression of P53 protein and its predictors in formalin-fixed paraffin-embedded tissue blocks of patients with nephroblastoma.Materials and methodsA series of 83 histologically diagnosed cases of nephroblastoma from formalin-fixed paraffin-embedded tissue blocks archived at the Department of Pathology, Makerere University, in Kampala, Uganda, were analyzed. Monoclonal anti-p53 antibody (DO-7, DAKO) was used to assess the expression of P53 protein expression. Multivariable logistic regression analysis was performed to determine the predictors of P53 protein immunohistochemical expression, and statistical significance was considered when p-value was less than 0.05.ResultsMost (42.2%, n = 35) of the cases were in advanced tumor stages (III–V), and almost one-quarter (21.7%, n = 18) of the cases were in high-risk group. The immunohistochemical expression of P53 protein was (8.4%, n = 7), and there were more (83.3%, n = 5) positive anaplastic cases for P53 protein compared with (2.6%, n = 2) of P53 expression for non-anaplastic cases. High risk (AOR = 3.42, 95% CI = 7.91–12.55, p = 0.037) and anaplasia (AOR = 1.41, 95% CI = 13.85–4.46, p = 0.001) were potential predictors of immunohistochemical expression of P53 protein.ConclusionMost of patients with nephroblastoma in resources-limited settings are diagnosed with advanced clinical stages. Association of P53 protein with anaplasia found in this study indicates the possibility of having novel target therapy for treatment of patients with anaplastic form of nephroblastoma with a focus of identifying molecules that lead to its suppression in such subpopulations of patients with nephroblastoma.

THE BENEFITS OF PHYSIOTHERAPY IN ALZHEIMER’S DISEASE SYMPTOMS

Introduction: The Alzheimer’s Disease is a progressive condition that affects the memory and other cognitive functions, impactaring negatively the the life of patients and their relatives. The physical therapy is an important alley in the treatment of these individuals, by aiming to improve their autonomy, well-being and independency. Objective: To show the benefits of the physical therapy treatment in patients with Alzheimer. Method: It was performed a bibliographic review research utilizing the Google Scholar, SciELO and PubMed databases in Portuguese, Spanish and English languages. Conclusion: It was found that the physical therapy is of high importance for the life quality maintenance in the population affected by the Alzheimer’s Disease, because it presents benefits in physical capabilities and motor skills such as: improved flexibility, strength gain, improved cardiovascular capacity, balance and better cognition.