aging

As people get older, chronic diseases become an important reason of disability while a decline in physical functions is related to aging among the elders, which may lead to dependency and isolation of the older adults. Body asymmetry and imbalance body alignment can bring added stress to the joint structures that can cause dysfunction of the joint, ligaments, tendons, bursas, and related muscles, which in return brings about problem while walking or during activities of daily living. Joint Functional Screening (JFS) is a systemic clinical examination with clinical reasoning of the entire human joints body, with or without causative limitation to derive a holistic analysis of musculoskeletal system. JFS profile helps to assess body disorder of older people. This clinical screening include documentation of balance of the body, lower and upper body strength, joints flexibility, body composition, and body alignment. This is an innovation build to profile a normal musculoskeletal state to decode any anomaly in an otherwise a normal subject, who might be preparing to take up any activities in one’s lifespan that could elicit an injury which could be prevented. JFS could be a useful tool for physiotherapists, exercise therapist or even the personal trainers to screen a body prior to rehabilitative or an exercise program; and this clinical screening is presently a best guidance to prevent risk of fall or injury among individual healthy people and older adult.

Everyone can be placed somewhere on an exercise continuum with the idle at one end and the hyperactive at the other. At both extremes, health suffers. Exercise is essential to health and managing it is the responsibility of individuals but few know what they should do. Doctors seldom teach how to be healthy and act only when repair is needed.

The present study examined the effect of the European-Based ‘Alive and Kicking’ exercise program on the health-related physical fitness of individuals with (Experimental Group: EG) and without (Control Group: CG) (Intellectual Disability: ID). The Self-Determination Theory: SDT, guided both the 6-month preparatory phase and the 9-month exercise program, which was conducted in five separate European countries (Cyprus, France, Greece, Portugal and Spain). The total sample (n = 200, 54% males and 46% females) comprised of 168 individuals with ID (age: 26.54 years, + 7.78) and 32 individuals without ID (age: 25.81 years, + 8.73) respectively. The statistical analyses revealed that the ID group’s performance (EG) improved significantly in a range of health-related physical fitness variables (sit & reach, pushups, sit ups, long jump, ½ mile walk/ run). In turn, the participants from the CG improved mainly in muscular endurance (sit ups and pushups). The results are discussed in accordance with SDT and the dairies kept from the staff involved (coaches and psychologists) during the 9–month intervention. The present findings, although subjective to certain limitations, are encouraging, given the large-scale, real-world nature of the research design, and provide evidence supporting the integration of theoretical strategies enhancing motivation into traditional coaching programs for individuals with ID.

Woven coronary artery (WCA) is an extremely rare and still not a clearly defined coronary anomaly. It is characterized by the division of epicardial coronary artery into thin channels which then reanastomose with the distal part of the abnormal coronary artery [1]. Since the angiographic imaging of WCA looks like an intracoronary thrombus and dissection; the differential diagnosis between atherothrombotic coronary arteries with recanalization of organized thrombi in coronary arteries and WCA may be very difficult for invasive cardiologists, especially in patients with single or two coronary artery involvements [2].

Post cardiac surgery stroke is a devastating complication with an incidence as high as 50%1. The association between intra-operative mean arterial blood pressure (MAP- better called linear blood pressure) during cardiopulmonary bypass (CPB) and the development of postoperative stroke-as diagnosed by neuroimaging- and of cognitive dysfunction (POCD) is controversial. This is due to differences in the study populations, stroke assessment tools, operation and conduction of MAPs, variations in neurocognitive testing and duration of follow up. As a result there is a gap in the knowledge on an ideal MAP as a preventive measure of post CPB stroke and POCD.

The purpose of the present study was to define the period of time in which aerobic training does not increase further serum S-Klotho levels in untrained young adult males, and to examine the relation between plasma S-Klotho concentration and maximal oxygen uptake (VO2max). Methods: Sixty (60) untrained subjects (27.05±1.1 years) were divided into 2 groups, both exercised six months 4×wk-1 for the duration of 45 min×session. One group (LTI) exercised below the anaerobic threshold at 40-50% of VO2max, while the second group (HTI) worked above the anaerobic threshold at 65-70% of VO2max. Testing sessions were performed at 0, 2, 4, and 6 months. Blood samples were drawn after overnight fasting; S-Klotho was analyzed using an ELISA kit. Results: Following 2 and 4 months, significant (p≤0.05) increases were noted in the HTI group, at the fourth testing session, S-Klotho leveled off. In the LTI group, S-Klotho remained almost unchanged. Findings of the present study, support emerging evidence suggesting that a relation between plasma S-Klotho concentration and VO2max exists. Conclusion: Data suggest that increases in S-Klotho is tidally associated with VO2max levels. In addition, the S-Klotho increase levels-off following 4 months of aerobic training. Exercising below the anaerobic threshold does not increase VO2max and thus, does not increase S-Klotho.  

Blunt chest trauma leads to a wide range of lesions, relatively minor parietal injuries to potentially fatal cardiac lesions, making diagnosis and management difficult. The diagnosis is currently facilitated by imaging, however, these lesions may go unnoticed and be discovered late through complications. We report the case of a neglected heart wound revealed by a heart failure. This case is notable due to a favourable outcome despite a delay in diagnosis due to a lack of pericardial effusion and the absence of cardiac symptoms, and a long delay from injury to appropriate treatment in the presence of a penetrating cardiac wound deep enough to cause a muscular ventricular septal defect and lacerate the anterior mitral leaflet.

Background: Hypertrophic cardiomyopathy (HCM) patients have a predisposition for malignant VT/VF and consequently, sudden cardiac death (SCD). In single center studies, late gadolinium enhancement (LGE) defined fibrosis has been linked to VT/VF. However, despite innumerable investigations, SCD has not been definitely attributable to LGE. Explanations for these are believed to be related to insufficient statistical power. Methods: We performed an electronic search of MEDLINE, PubMed: and CMR abstracts for original data published or presented between Jan 2001 to Mar 2011. Key search terms: HCM, LV fibrosis, SCD and LGE. Studies were screened for eligibility based on inclusion criteria: referral for CMR exam with LGE for HCM; and follow-up for incidence of VT/VF and SCD. Categorical variables were evaluated between patient groups via Chi-square test. Results: A total of 64 studies were initially identified. Of these, 4 (6.3%) were identified and included (n = 1063 patients). Three prospective and one retrospective study were included. LGE was detected in 59.6% of patients. As expected, the presence of myocardial fibrosis was associated with VT/VF (x2 = 6.5, p < 0.05; OR 9.0, (95% CI 1.2 to 68.7). Moreover, myocardial fibrosis strongly predicted SCD (x2 = 6.6, p < 0.05; OR 3.3 (95% CI 1.2 to 9.7). Conclusion: Despite single center CMR studies, LGE has consistently predicted VT/VF while prediction of SCD has remained paradoxically unlinked. Although the lack of studies meeting our criteria limited our ability to perform a comprehensive meta-analysis, we have been able to demonstrate for the first time that LGE-defined fibrosis is a predictor of SCD in patients with HCM0.

This is a review of features in ECG to diagnose the culprit artery responsible for the infarction. Localization of the occluded vessel in acute myocardial infarction is important for many reasons: to know which artery is to dilate and stent; to assess the severity of the lesion; to compare with the echocardiographic area with hypokinesia or akinesia and to differentiate the recent from the old occluded vessel. The ST-segment changes in 12-lead ECG form the basis of diagnosis, management, and prognosis.

Atherosclerosis is an important promoter of cardiovascular disease potentiating myocardial infarction or stroke. Current demand in biomedical imaging necessitates noninvasive characterization of arterial changes responsible for transition of stable plaque into rupture-prone vulnerable plaque. in vivo contrast enhanced magnetic resonance (MR) imaging (MRI) allows quantitative and functional monitoring of pathomorphological changes through signal differences induced by the contrast agent uptake in the diseased vessel wall, therefore it is the ideal modality toward this goal. However, studies have so far focused on the cellular targets of persisting inflammation, leaving extracellular matrix (ECM) far behind. In this review, we portray ECM remodeling during atherosclerotic plaque progression by summarizing the state of the-art in MRI and current imaging targets. Finally, we aim to discuss glycosaminoglycans (GAGs) and their functional interactions, which might offer potential toward development of novel imaging probes for in vivo contrast-enhanced MRI of atherosclerosis.

Desmodium adscendens is a rain forest medicinal herb used in managing quite a number of medical conditions. Its efficacy in the treatment of several diseases has made it a first line herb for doctors, especially in managing all forms of spasm. It is however common knowledge that some of these medicinal herbs impact severely on the normal functioning of some vital organs of the body during their administration. The present study was carried out to assess the renal and cardiovascular performance in subjects undergoing treatment with Desmodium adscendens with a view to advising against its indiscriminate use. The parameters used for the assessment of renal functions were serum creatinine and urea concentrations and their clearance. Also, changes in electrolyte concentration of Sodium, Potassium and Chloride concentration were used to assess cardiovascular performance. The histology of the kidney and heart tissues was also done to determine if the extract has impact on the cyto-architecture of the organs. Twenty-four (24) wistar rats were used for the experiment. The rats were grouped randomly into four groups (n = 6). Group 1 served as control, and the rats in the group were given normal rat feeds and water. Group 2 served as low dose group, and rats in this group were administered with low dose of extract 300 mg/kg. Group 3 served as medium group, and rats in this group were treated with medium dose of extract, 450 mg/kg. Group 4 served as high dose group, and rats in this group were treated with high dose of extract 600 mg/kg. The extract was administered for 28 days. Result showed that the extract did not impact negatively on the normal function of the renal and cardiovascular system of the treated groups, rather it enhanced their performances. It can therefore be concluded that the extract is beneficial to renal and cardiovascular functions if used within the treatment dosage. 

Objectives: To check if there is any significant difference in the immediate outcome of pregnancy with diabetes using the new values of FBS & 2hrs post prandial with 75g OGTT for 1 year (from 1st June 2013-31st May 2014) in comparison to the previous data done in the same institute with other values and with international figures. The data in our study included fetal, maternal morbidities, intra partum and postnatal outcomes, in order to help, if possible, on deciding the best values to use for screening for gestational diabetes mellitus. Furthermore, to know the new percentages of gestational diabetes mellitus in SFH by utilizing the new values of Blood Sugar readings. Design: Retrospective cohort study Setting: Security Forces Hospital-Riyadh-Saudi Arabia Patients: Done (from 1st June 2013 – 31st May 2014), on patients who had attended Security Forces Hospital, Riyadh, Saudi Arabia. This chosen year’s data was compared with data collected in the three previous years using different figures. Main Outcome measured: Average age of mother, maternal aspects of parity, history of GDM, number of abortions``````````````````````````````, estimated blood loss in labor, associated medical disorder, complications of previous pregnancies, methods of control of GDM, gestational age for IOL and associated intrapartum complications. Immediate neonatal outcome in cases of GDM, comparison of birth weights of babies & any specific congenital abnormalities and delayed causes of admission to NICU in the 4 years studied were also reviewed. Results: The percentage of diagnosed cases of gestational diabetes mellitus (GDM) after screening was 24 % as compared with 14.5% in previous study of 2003-2004 & with the number of screened patients amounting to 93% out of the total number of deliveries between 2013-2014 (in both years universal method of screening was used). The multidisciplinary set up of our GDM specialized clinic which was composed of dieticians, diabetic educators, endocrinologists and obstetric physicians operating together, helped to reduced the use of insulin in combination with diet to only 24% in comparison to 76% of patient using diet and exercise alone. The study showed a mean age of 33years and weight of 77kg. It was also noted that 16% of the patients diagnosed with GDM were multiparous averaging 1-5 deliveries. Almost 62% of patient didn’t give any history of GDM and no history of previous medical diseases. The majority of the patient with GDM delivered without complications during labor, with 30% having vaginal lacerations & 73% of patient had an estimated blood loss of less than 500cc. NICU admissions secondary to hyperbilirubinaemia averaged almost 17% in comparison to previous studies and only one baby expired in a GDM patient. Our study revealed a good fetal and maternal out come with less delivery complications and less incidence of postpartum hemorrhage (5.7%). Conclusion: It is concluded that Universal Screening of Pregnant women whether with previously used glucose value or new ones for gestational diabetes mellitus is a better option, which has proven to improve both maternal and fetal outcomes. The 75 OGTT test is a cost effective test and with both easy accessibility and good screening pick up number (92.5%) of the patients in Security Forces Hospital, Riyadh. Recommendation: We recommend annual follow up for patients, both the mother and the baby after postpartum, to prevent the development of type 2 diabetes.

We describe here the case of a 23-year old woman with small cell carcinoma of the ovary of the hypercalcemic type (SCCOHT) with SMARC-A4 mutation who benefited from surgery in two steps leading to a total hysterectomy with bilateral salpingo-oophorectomy, omentectomy, pelvic and lombo-aortic lymph nodes dissection. She also received 6 courses of poly-chemotherapy after the surgery. A close follow-up was then performed by clinical examination every three months with determination of serum calcium and CA125 level as well as imaging with thoraco-abdominal CT scan. To date, the patient has a disease-free survival of more than 9 years. We also reviewed the literature on this topic and discuted the new diagnostic and prognostic genetic tool SMARC-A4 mutation.

Introduction: Radioiodine therapy is a standard procedure in thyroid autonomy treatment. Discrepancies in the visual comparisons of the scintigraphies prepared for this purpose using Tc-99m-O4- and I-131 have been known for years. In this study a new method is used to calculate and perform a quantitative comparison of both uptakes using subtraction analysis and 3D imaging. The results and their causes are discussed together with practice-relevant conclusions for better clinical results. Material and Methods: The new method was used in 38 patients with thyroid autonomies for the subtraction analysis of standardized pretherapeutic and intratherapeutic scintigraphies. The parametric distribution of activity was calculated absolutely and as a percentage and displayed three-dimensionally. These results were compared with the visual assessment of the different scintigraphies by the experts. Inclusion criteria were pretherapeutic and intratherapeutic hyperthyroidism without medication affecting the thyroid. The time difference between acquiring the scintigraphies was 28 days maximum. Results: Activity distribution was visually discrepant in 39.5% of cases. 60.5% displayed comparable uptake. The calculated values showed reversed results after applying the new method. The results using our method show a higher rate of calculated discrepancies compared with visual analysis. Conclusion: Accurate functional imaging of the thyroid is next to further aspects very important in establishing the diagnosis and deciding about the therapy activity for thyroid treatment. In combination with clinical symptoms and laboratory values, Tc-99m-O4 - scintigram can be used for an orientated, preliminary assessment of functional disorders of the thyroid. But because of the higher rate of found discrepancies, the solely use of Tc-99m-O4 - scintigram is not always capable for exact and reliable diagnosis. The known reason for this is most probably due to the different biokinetics of both radiopharmaceuticals, which can be imaged more sensitively with this method. Consequently, a scintigram should be performed in the pretherapeutic radioiodine uptake test. Despite higher costs and radiation exposure, alternatively, pretherapeutic use of other diagnostic iodine isotopes like I-123 or -124 should be discussed, because they could overcome the limitation of the different biokinetics. Following this approach the preliminary assessment using Tc-99m-O4 - scintigraphy can be precised and double checked to improve diagnostic confi dence and treatment results for a better outcome of the patients.  

Aim: The aim of this study was to determine the sensitivity of the tumor markers and diagnostic methods used in the preoperative period for dermoid cysts, the most common benign neoplasm of the ovary. Material and Methods: 136 patients who were operated for any reason and reported as ovarian dermoid cyst in the Department of Obstetrics and Gynecology, Ankara Atatürk Training and Research Hospital between January 2004 and September 2005 were included in the study. The medical records of the cases were obtained retrospectively from Ankara-Atatürk Training and Research Hospital, HIS, archive files and patient numbers where necessary. Results: In the preoperative period, 119 patients underwent ultrasonographic examination, 33 underwent Computed Tomography, and 17 underwent Magnetic Resonance Imaging.10 of the cases only underwent CT, while 3 of the cases underwent only MRI 22 of them underwent both USG and CT, USG and MRI were performed on 13 cases and only 1 case underwent all three of the imaging methods. Tumor markers were CEA, CA 125, CA 19-9, CA 15-3 and AFP. Conclusions: The reviews of ultrasonography and / or computed tomography and / or magnetic resonance imaging (n = 132) revealed that 103 of the cases were put into operation and the sensitivity of the preoperative screening methods were calculated to be 75.5%. The sensitivity of the tumor marker CA 19-9 was calculated to be 31%.

Chondromyxoid fibroma (CMF) is a very rare benign cartilaginous tumor representing less than 0.5% of all bone tumors while also being the rarest cartilaginous bone tumor. Common locations of occurrence include the metaphysial region of the proximal tibia and distal femur. We report a case of a 10-year-old female affected by a CMF of the left lower tibia. The radiological features demonstrated by X-ray and magnetic resonance imaging (MRI) are discussed.

Background: The foot is an important and complex structure that provides support, balance and propulsion to locomotion, thus, its proper care can help to have a better life quality avoiding pain. The medial longitudinal arch is an important structure that is related to injury risks when it shows some impairment. The purpose of this study was to characterize the foot arch index in people in relation to age and gender. Methods: The sample was composed of a total of 122 subjects, 79 healthy young subjects (40 women and 39 men) and 43 healthy elderly subjects (32 women and 11 men). Ten seconds of standing barefoot plantar pressure was measure through Tekscan F-Scan device, and the data processing, filtering, and arch index (AI) calculation were performed using MATLAB™ 7.0. Findings: The elderly group presented a lower arch (AI-0.23) than the young group (AI-0.13) (p=0.000); young female and male groups show similar AI, while the elderly female group showed lower arch (AI-0.23) than the elderly male group (AI-0.18) (p=0.033). Interpretation: The foot arch has a trend to be lower with aging, and even lower within elderly female subjects, probably due to some decrease within plantar muscle’s stiffness, that in turn may be related to lower physical activity and footwear choices.

Epilepsy is commonly seen in women of reproductive age and it is affecting their reproductive and pregnancy outcomes in an adverse manner [1]. It has seen that there are increased numbers of maternal deaths of pregnant women with epilepsy than those who have no any epilepsy symptoms or episodes. In many studies the common outcome observed is spontaneous miscarriage, ante partum hemorrhage or early pre term deliveries. Malformation and congenital anomalies are quite common in new born of epileptic women and also those who are on some kind of anti-epileptic medicines like valproate sodium. Death or still birth of new born babies is another complication witnessed because of epilepsy in pregnant women [2].

In this work an efficient method developed for the synthesis of 125I-benzofuran-2-yl) pyridin-2-amine (125IBPA), followed by radioiodination with 125I by using Chloramine-T at pH 8. The reaction proceeds within 10 min at room temperature (20-25°C). The radiochemical yield determined by Thin-Layer Chromatography (TLC) using hexane:ethyl acetate (1:6 v/v) and the purity analyzed by high-performance liquid chromatography using a reversed-phase RP18column and acetonitrile:0.1 M ammonium bicarbonate (pH 7.5) (1:1) as the mobile phase at a flow rate of 1 ml×min−1. The radiochemical yield using aH2O2 oxidant found equal to 96.5% with a radiochemical purity of 125I-BPA of over 96.5%. The biodistribution data in normal mice indicated a high initial uptake of 6.54±0.10 (% ID/g±SD) in the brain within 30 min post-injection. These results promote a further the use of 125I-BPA as a novel agent for brain imaging.

This report presents an adult patient suffering from sacroiliitis like low back pain, lumbosacral radiculopathy and elbow swelling. Multimodality imaging revealed multiple lytic bone lesions located in supra acetabular iliac bone, sacrum, and distal end of radius. Painful numerous lesions due to the extension to the articular surfaces are not expected for Brown tumors. Less than ten cases with multiple Brown tumor due to primary hyperparathyroidism has been reported. Although Brown tumors are mostly diagnosed incidentally, this case would awake the physicians about rheumatological symptoms in the presentation of Brown tumors. Since Brown tumors are non-touch bone lesions that are expected to regress after parathyroid adenoma removal, it is important to distinguish Brown tumors from the giant cell tumors.