ABSTRACT:According to experimental studies, low-amplitude high-frequency vibration is anabolic to bone tissue, whereas in clinical trials, the bone effects have varied. Given the potential of whole body vibration in bone training, this study aimed at exploring the transmission of vertical sinusoidal vibration to the human body over a wide range of applicable amplitudes (from 0.05 to 3 mm) and frequencies (from 10 to 90 Hz). Vibration-induced accelerations were assessed with skin-mounted triaxial accelerometers at the ankle, knee, hip, and lumbar spine in four males standing on a high-performance vibration platform. Peak vertical accelerations of the platform covered a range from 0.04 to 19 in units of G (Earth's gravitational constant). Substantial amplification of peak acceleration could occur between 10 and 40 Hz for the ankle, 10 and 25 Hz for the knee, 10 and 20 Hz for the hip, and at 10 Hz for the spine. Beyond these frequencies, the transmitted vibration power declined to 1/10th−1/1000th of the power delivered by the platform. Transmission of vibration to the body is a complicated phenomenon because of nonlinearities in the human musculoskeletal system. These results may assist in estimating how the transmission of vibration-induced accelerations to body segments is modified by amplitude and frequency and how well the sinusoidal waveform is maintained. Although the attenuation of vertical vibration at higher frequencies is fortunate from the aspect of safety, amplitudes >0.5 mm may result in greater peak accelerations than imposed at the platform and thus pose a potential hazard for the fragile musculoskeletal system.
Objective: To study the safety and tolerability of Lymfactin R treatment combined with microvascular lymph node transfer surgery in patients with upper limb lymphedema. Background: Upper limb lymphedema is a common clinical challenge after breast cancer surgery and/or radiotherapy. Lymfactin R is an adenovirus type 5-based gene therapy involving expression of human vascular endothelial growth factor C (VEGF-C) in the damaged tissue. It aims to correct deficient lymphatic flow by promoting the growth and repair of lymphatic vessels.
Introduction: An acute diabetic foot infection (DFI) is a serious condition and a leading cause of hospitalization and major amputation in patients with diabetes. Aim of this study was to evaluate the long term survival and risk factors for death and amputation after the DFI requiring hospital treatment.Materials and Methods: A retrospective study included all adult patients hospitalized for DFI treatments during 2010–2014. Overall survival (OS) and amputation free survival (AFS) (without major amputation) was calculated. We performed a Cox regression analysis of several clinical parameters to evaluate the effects of clinical parameters on overall and amputation-free survival.Results: Total of 324 patients with mean age of 66.8 (SD 12.8) years were included. The one- and five-year OS after DFI 81.2% (95%CI 77.5–84.9%) and 49.7% (95%CI 44.8–54.6%), respectively. Major amputation, wound ischemia, older age, and a low glomerular filtration rate reduced the OS after DFI. After a major amputation, the one- and five-year OS was 41.7% (95%CI 13.9–69.5) and 8.3% (95%CI 0.0–24.0%), respectively. Wound ischemia, older age, and elevated C-reactive protein reduced AFS. In contrast, hypertensive medication use was identified as a protective factor.Conclusion: Mortality after a DFI remains high and is significantly increased after a major amputation. Findings highlight the importance of early wound and ischemia management for DFI prevention.
Background: Soft tissue infections, including postoperative wound infections, result in a significant burden for modern society. Rapid diagnosis of wound infections is based on bacterial stains, cultures, and polymerase chain reaction assays, and the results are available earliest after several hours, but more often not until days after. Therefore, antibiotic treatment is often administered empirically without a specific diagnosis. Methods: We employed our electronic nose (eNose) system for this proof-of-concept study, aiming to differentiate the most relevant bacteria causing wound infections utilizing a set of clinical bacterial cultures on identical blood culture dishes, and established bacterial lines from the gaseous headspace. Results: Our eNose system was capable of differentiating both methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pyogenes, Escherichia coli, Pseudomonas aeruginosa, and Clostridium perfringens with an accuracy of 78% within minutes without prior sample preparation. Most importantly, the system was capable of differentiating MRSA from MSSA with a sensitivity of 83%, a specificity of 100%, and an overall accuracy of 91%. Conclusions: Our results support the concept of rapid detection of the most relevant bacteria causing wound infections and ultimately differentiating MRSA from MSSA utilizing gaseous headspace sampling with an eNose.
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