Search

Cannabis spp. are some of the most controversial medicinal plants in the world. They contain great amounts of biologically active secondary metabolites, including the typical phenolic compounds called cannabinoids. Because of their low toxicity and complex biological activities, cannabinoids can be useful in the therapy of various diseases, but adverse psychological effects (of Δ9-THC in particular) raise concerns. This review summarizes the current knowledge of selected active C. indica compounds and their therapeutic potential. We summarize the main compounds contained in cannabis, the mechanisms of their effects, and their potential therapeutic applications. Further, we mention some of the clinical tests used to evaluate the efficacy of cannabinoids in therapy.

Brain death (irreversible loss of brain function), according to German regulations, is investigated exclusively by qualified specialists in a strictly hierarchical three-step pattern and a four-eyes principle. In step 1 all necessary prerequisites are to be checked and the pathophysiology of brain damage has to be classified. Step 2 comprises the clinical investigation of reactivity to external stimuli and the upper, middle and lower brain stem reflexes including apnea testing. Step 3 exclusively checks for irreversibility of this condition. The latter is achieved by appropriate technical investigations or by repeated clinical examinations within context-specified intervals (range 12-72 h). However, exclusion of contributing primarily infratentorial pathologies is necessary to avoid limitations of the clinical findings. In this paper, both the initiation of brain death diagnostics and the approved clinical tests regarding to their execution, their alternatives and limits are presented and special situations like conditions with extracorporeal membrane oxygenation (ECMO) are also examined.

The aim of the present study was to compare the diagnostic values of clinical tests and magnetic resonance imaging (MRI) which used for the diagnosis of subscapularis (SSc) tears in the patients who underwent arthroscopic rotator cuff surgery. Two-hundred and nine consecutive patients who underwent arthroscopic rotator cuff surgery between 2015 and 2019 were analyzed. The lift-off test, belly-press test and bear-hug test were performed preoperatively. 1.5 T MRI scans of all patients were evaluated for SSc integrity. The diagnostic values of both clinical tests and MRI were calculated. SSc tears were graded according to Fox and Romeo. Arthroscopic findings were used as the gold standard for diagnosis of SSc tears. There were 54 SSc tears accounting for an prevalence of 29%. The BHT showed the greatest sensitivity for both type II–II–IV (73.3%) and all types of (68.5%) SSc tears. The sensitivity and specificity of the combined test and MRI were 91.1–87.2% and 93.3–90.8% in Type II–III–IV SSc tears, respectively, and 81.5–88.6% and 88.9–94.7% in all SSc tears, respectively. There were no statistically significant difference between combined test and MRI in terms of sensitivity and specificity (n.s.). The present study is the first that compared both clinical tests and MRI with arthroscopic findings in terms of sensitivity and specificity in the same patient group. A combination of clinical tests increases their diagnostic values and shows similar sensitivity and specificity as MRI. I.

Parkinson’s disease (PD) is a chronic and progressive neurological illness affecting millions of people in the world. The cure for PD is not available. Drug therapies can handle some symptoms of disease like reducing tremor. PD is diagnosed with decrease in dopamine concentrations in the brain by using clinical tests. Early detection of the disease is important for the treatment. In this study, dynamic spiral test (DST) and static spiral test (SST) of PD patients were analyzed with pre-trained deep learning algorithms for early detection of PD. Fuzzy recurrence plot (FRP) technique was used to convert time-series signals to grayscale texture images. Several time-series signals were tested to observe the performances. The deep learning algorithms were employed as classifiers and feature extractors. Drawing and signal types’ performances for classifying PD were comprehensively investigated. In short, according to the experimental results Y signal produced the best results in DST approach and arithmetic combination of the Y and P signals performed better in SST method.

PURPOSE OF REVIEW: The purpose of this review will be to provide both a historical and recent review of the role of the kinetic chain for the overhead athlete. The kinetic chain concept will then be applied to clinical exercise modifications and integrations for prevention and treatment of shoulder injury. RECENT FINDINGS: The primary conclusion reached through this review is the important role the lower extremity, trunk, and scapular region play in the development of optimal terminal segment acceleration in the overhead throwing and serving motion. Failure of any links in the kinetic chain has implications for shoulder and elbow injury in the overhead athlete. Modifications of traditional shoulder exercises emphasizing activation of the scapular stabilizers and core musculature alongside concomitant rotator cuff activation are recommended and supported in EMG research. SUMMARY: Future research is needed to further identify risk factors and rehabilitation and prevention strategies and key clinical tests for the overhead athlete. The goal is to elucidate the important role the kinetic chain plays in both performance enhancement and injury prevention for the overhead athlete. Understanding the key role all segments of the kinetic chain play in the complex biomechanical segmental rotations required for high-level throwing and serving will assist clinicians who work with overhead athletes.

Available studies and information on the regulatory effect of the autonomic nervous system (ANS) in pregnancy are insufficient and contradictory due to a variety of research methods of ANS, the lack of a single standardized approach to the assessment of the functional tone of the ANS departments, and interpretation of the results. The aim of the study is investigation and predictive assessment of clinical and laboratory data in pregnant women with suprasegmental autonomic dysfunction with or without hypertension to determine the main directions of effective prevention of the nervous system damage. The material of the study included 206 pregnant women diagnosed with the syndrome of autonomic dysfunction in different variants. Age ranged from 17 to 47 years. All pregnant women had the following laboratory tests: general clinical tests, biochemical blood tests, including prothrombin index, fibrinogen, von Willebrand factor activity. The clinical and laboratory data were analyzed in pregnant women with autonomic dysfunction with or without hypertension. According to the results, it was found that in all groups of pregnant women a sympathetic effect prevails. This study showed that in the group of normotensive pregnant women, the main symptom is venous dysfunction, which poses a risk of an adverse course of cerebrovascular disease.

Cross-sectional research. To objectively evaluate grip force (GF) control while holding a freely movable object in individuals with cervical myelopathy (CM). Harunaso Hospital, Takasaki, Japan. We studied 52 hands from 26 individuals with CM. Participants performed a grip-and-lift task by pulp pinch using the thumb and index finger before surgery. We monitored individual finger GF (N) during the first 3 s while lifting and holding an object. Correlations between the GF and other clinical tests were evaluated. A multiple stepwise regression analysis was used to examine the contribution of the GF to the severity of clinical symptoms. Thumb GF was negatively correlated with the 10-s test (rs = −0.32), and index finger GF was positively correlated with its cutaneous pressure threshold (rs = 0.34). Multiple regression for the severity of upper extremity symptoms revealed that the model including the GF had a larger adjusted R2 and a lower AIC value than that of conventionally used clinical tests. These results suggested that the assessment of individual finger GF control could provide an indicator of the clinical severity of upper extremity in individuals with CM.

To investigate the prevalence of meibomian gland dysfunction (MGD) in patients presenting with subjective dry eye-related symptoms at their first-time consultation in a Norwegian specialized ocular surface clinic. Additionally, to explore the accuracy of the ocular surface disease index score (OSDI) as an extensively applied tool to assess the severity of dry eye symptoms and MGD diagnosis. Patients with subjective dry eye-related complaints (n = 900) attending the clinic for the first time, from 2012 to 2016, were included in the study. At the baseline, patients completed the OSDI questionnaire. Subsequently, objective clinical tests, including fluorescein break-up time (FBUT), Schirmer-I test, ocular surface staining (OSS), and meibomian gland function assessment using gland expressibility and meibum quality were performed. The association between MGD and its severity in relation to symptom severity defined by OSDI-score was examined. MGD was found in 93.8% of the study group. MGD prevalence was not significantly different between groups based on age (p = 0.302) or sex (p = 0.079). There was a significant association between severity of MGD and dry eye-related symptoms (p = 0.014). OSS was significantly higher in patients with severe symptoms (p = 0.031). Sensitivity and specificity of positive symptom-score (OSDI ≥ 13) for disclosing MGD were 85.5% and 30.4%, respectively. MGD was highly prevalent, not associated with age and sex. OSDI ≥ 13 had high sensitivity and high positive predictive value (PPV), but low specificity and negative predictive value (NPV) for disclosing MGD. This underscores the importance of meibomian gland assessment in patients with dry eye-related symptoms.

Sperm selection is crucial to assisted reproduction, influencing the success rate of the treatment cycle and offspring health. However, in the current clinical sperm selection practices, bypassing almost all the natural selection barriers is a major concern. Here, we present a biomimicry microfluidic method, inspired by the anatomy of the female reproductive tract, that separates motile sperm based on their rheotaxis behavior to swim against the flow into low shear rate regions. The device includes micropocket geometries that recall the oval-shaped microstructures of the female fallopian tube to create shear protected zones for sperm separation. Clinical tests with human samples indicate that the device is capable of isolating viable and highly motile sperm based on their rheotaxis responses, resulting in a separation efficiency of 100%. The device presents an automated alternative for the current sperm selection practices in assisted reproduction.

LanbotulinumtoxinA (LAN) is manufactured and registered in China since 1994. Despite its widespread use in China and its increasing use in other Asian countries and in South America, it is not yet well known elsewhere. We wanted to compare its potency labelling using the mouse diaphragm assay (MDA), an isolated muscle model for botulinum toxin (BT) potency measurements, which is superior to clinical tests and which was recently refined as an alternative batch release assay for BT manufacturing. We also wanted to estimate LAN manufacturing quality by testing its inter-batch potency consistency. Potencies of 20, 60 and 100 MU of LAN, onabotulinumtoxinA (ONA) and incobotulinumtoxinA (INCO) were measured by the inversely related paresis time (PT) in the MDA. The PT (M ± SD) of all doses of LAN, ONA and INCO was 90.4 ± 27.0 min, 114.9 ± 46.5 min and 94.3 ± 29.9 min, respectively. Statistical analysis demonstrated indistinguishable potency labelling of LAN and INCO, but revealed a slightly lower potency of ONA compared to LAN and INCO. PT of LAN batch 1 and LAN batch 2 was 86.9 ± 21.2 min and 94.0 ± 32.8 min, respectively (no statistically significant difference), suggesting an adequate LAN manufacturing consistency. The MDA is an appropriate instrument for potency testing of BT drugs, including new ones currently under development. Our results allow comparing therapeutic effects, adverse effects and economics of LAN, ONA and INCO. They also suggest adequate manufacturing consistency of LAN.

Purpose To propose a new method of identifying clusters in multifocal electrophysiology (multifocal electroretinogram: mfERG; multifocal visual-evoked potential: mfVEP) that conserve the maximum capacity to discriminate between patients and control subjects. Methods The theoretical framework proposed creates arbitrary N-size clusters of sectors. The capacity to discriminate between patients and control subjects is assessed by analysing the area under the receiver operator characteristic curve (AUC). As proof of concept, the method is validated using mfERG recordings taken from both eyes of control subjects (n = 6) and from patients with multiple sclerosis (n = 15). Results Considering the amplitude of wave P1 as the analysis parameter, the maximum value of AUC = 0.7042 is obtained with N = 9 sectors. Taking into account the AUC of the amplitudes and latencies of waves N1 and P1, the maximum value of the AUC = 0.6917 with N = 8 clustered sectors. The greatest discriminant capacity is obtained by analysing the latency of wave P1: AUC = 0.8854 with a cluster of N = 12 sectors. Conclusion This paper demonstrates the effectiveness of a method able to determine the arbitrary clustering of multifocal responses that possesses the greatest capacity to discriminate between control subjects and patients when applied to the visual field of mfERG or mfVEP recordings. The method may prove helpful in diagnosing any disease that is identifiable in patients’ mfERG or mfVEP recordings and is extensible to other clinical tests, such as optical coherence tomography., Agencia Estatal de Investigación

The design and functional capabilities of the portable device for laser-and-ultrasound therapy BINOM®-FIZIO LUZT are described together with the experience of its use for treating patients with chronic obstructive lung disease (COLD). Infrared laser pulses and ultrasound generated by an array of sources are the therapeutic agents used for treatment. The developed device makes it possible to implement a new physical therapy technique for simultaneous (concomitant) treatment with low-intensity laser radiation and ultrasound. Clinical tests showed the device to be cost-effective and improve the clinical effect of combination treatment. It allows better expectoration, peripheral blood parameters, and respiratory function to be achieved.

Linburg–Comstock variation, the tendinous interconnection between flexor pollicis longus and flexor digitorum profundus, is known to have a wide frequency range. Its prevalence is reported with a range of 13–66%. The aim of the study was to assess this variation in general population and to correlate it with gender and side. This prospective study included 215 subjects (82 males and 133 females). Two clinical tests were conducted to diagnose the variation and to detect any related symptomatology. The primary outcome was set to be the prevalence of Linburg–Comstock variation. Secondary outcomes were defined as gender-based prevalence, side-based prevalence, and Linburg–Comstock variation prevalence association with gender and side. Linburg–Comstock variation was clinically diagnosed in 130 (60.47%) participants. Unilateral and bilateral prevalence were of 17.21% and 43.26%, respectively, yielding a statistically significant difference. Right-sided and left-sided presence were calculated at 7.44% and 9.77%. Bilateral prevalence was statistically more common in females. Right-sided variation was found to be more frequent in males while left-sided variation was more prevalent in females. The index finger was the most commonly involved with prevalence of 91.03%. Symmetry was noted in 67.74% of subjects. The results of our study demonstrated a relatively high prevalence of the Linburg–Comstock variation in Serbian population. We noted a few unusual cases and this finding point to the existence of the broader spectrum of Linburg–Comstock variation, and complexity of the flexor apparatus of the hand, so, further investigations about this topic are needed to improve our knowledge. Due to the possibility of false-positive result during clinical testing we suggest to use expanded clinical method.

The function of pulmonary allografts is regularly impaired by alloimmune reactions with quite variable clinical outcomes, different involved effector cells and molecules, as well as affected anatomical compartments. Acute rejection of grafts after lung transplantation (LuTx) is not only associated with the subsequent development of acute graft dysfunction, but can also contribute - among other immunological and nonimmunological factors - to the development of chronic lung allograft dysfunction (CLAD), which is the main reason for the limited long-term survival after LuTx. In addition to ACR and analogous to other solid organ transplants, the importance of antibody-mediated (humoral) rejection (AMR) in LuTx has also been recognized. There are currently no specific laboratory, radiological, or clinical tests available for either ACR or AMR. Only by the synoptic examination of histopathological changes and interpretation against the background of microbiological, virological, serological, and functional findings, can adequate sensitivity and specificity be achieved in the diagnostics of rejection. In this article, the current criteria for histopathological diagnostics of rejection following LuTx are summarized and the most important differential diagnoses are discussed.

The growing need for biological information at the single cell level has driven the development of improved cytometry technologies. Flow cytometry is a particularly powerful method that has evolved over the past few decades. Flow cytometers have become essential instruments in biomedical research and routine clinical tests for disease diagnosis, prognosis, and treatment monitoring. However, the increasing number of cellular parameters unveiled by genomic, proteomic, and metabolomic data platforms demands an augmented multiplexability. Also, the need for identification and quantification of relevant biomarkers at low levels requires outstanding analytical sensitivity and reliability. In addition, growing awareness of the advantages associated with miniaturization of analytical devices is pushing forward the progress in integrated and compact, microfluidic-based devices at the point-of-care. In this context, novel types of flow cytometers are emerging during the search to tackle these challenges. Notwithstanding the relevance of other promising alternatives to standard optical flow cytometry (e.g., mass cytometry, various optical and electrical microcytometers), this report focuses on a recent microcytometric technology based on magnetic sensors and magnetic particles integrated into microfluidic structures for dynamic bioanalysis of fluid samples-magnetic flow cytometry. Its concept, main developments, targeted applications, as well as the challenges and trends behind this technology are presented and discussed. Graphical abstract ᅟ "Kindly advise whether there is online abstract figure for this paper. If so, kindly resupply.The graphical abstract is correctly supplied.

Background Dry eye disease is a multifactorial disease; causing various ocular symptoms with potential damage to the ocular surface. Applying hypotensive eye drops are presumed to initiate or exacerbate existing dry eye disease. The purpose of this study was to determine the frequency of signs and symptoms and severity of dry eye disease among glaucoma patients on topical hypotensive medications and controls. Methods A cross-sectional comparative study, involving 320 glaucoma patients and controls. Ocular Surface Disease Index (OSDI) symptoms score and Schirmer, tear breakup time and corneal staining tests were used to assess dry eye disease. Data was analyzed using SPSS version 24 software; p-value less than 0.05 was considered as statistically significant. Results Among the 160 study glaucoma patients, the mean duration of topical hypotensive medication use was 5.2 ± 5.21 years (range, 4 months - 32 years). Mild to severe level of OSDI score was found in 122 (76%) glaucoma patients and in 137 (86%) controls (p = 0.033). Mild to sever abnormal clinical tests in the glaucoma patients and control, respectively, were 106 (66%) vs 80 (50%) corneal staining (p = 0.045), 79 (49%) vs 72 (45%) TBUT (p = 0.021), and 91 (57%) vs 83 (52%) Schirmer test (p = 0.242). Test results at the level of sever: 2 (1%) vs 0 (0%) corneal staining, 50 (31%) vs 39 (24%) TBUT and 65 (41%) vs 60 (38%) Schirmer test in the glaucoma patents and controls, respectively. Corneal staining and TBUT had correlation with the number of drugs (p = 0.004 and 0.031, respectively), and more relationship of the two tests with total number of drops applied per day (p = 0.01 and p p = 0.011 and p p = 0.04 and 0.012), respectively]. Conclusions The study has identified glaucoma patients to be more affected by dry eye disease than non-glaucoma patients, and presence of significantly lower TBUT and higher corneal staining in the glaucoma patients on multidrops and multidose per day. We recommend consideration of evaluation and management of DED for glaucoma patients on multidrops and multidose hypotensive medications.

Background Mock-up based approach allows the preview of the aesthetic rehabilitation, however, it is crucial that the mock-up does not differ from the expected aesthetic outcomes. With CAD-CAM technologies, it is possible to directly create mock-ups from virtual planned smile project, with greater accuracy and efficiency compared to the conventional moulded mock-ups. In this study, we investigated the trueness of mock-ups obtained with milling and 3D printing technology and a full digital work-flow system. Methods Ten adults subjects were included and digital smile design/digital wax-up were performed to enhance the aesthetic of maxillary anterior region. Ten milled mock-ups and 10 prototyped mock-ups were obtained from the original .stl file and a digital analysis of trueness was carried out by superimposing the scanned-milled mock-ups and the scanned-prototyped mock-ups to the digital wax-up, according to the surface-to-surface matching technique. Specific linear measurements were performed to investigate and compare the dimensional characteristics of the physical manufactures, the 3D project and the scanned mock-ups. All data were statistically analyzed. A clinical test was also performed to assess the fitting of the final manufacture. Results The prototyped mock-ups showed a significant increment of the transversal measurements (p p p Conclusion Both prototype and milled mock-ups showed a slight dimensional increment comparing to the original 3D project, with milled-mock-ups showing less fitting after clinical tests. Caution must be taken when assessing the trueness of scanned manufacture since an intrinsic error in the system can underestimate the dimensions of the real object.

Dry eye disease aetiologies can be classified dichotomously into aqueous deficient and evaporative types although many cases involve combinations of both. Differential diagnosis can be confounded by some features of dry eye disease being common to both aetiologies. For example, short tear break-up times are prime diagnostic findings of tear instability due to lipid and/or mucin deficiencies, but thin tear layers in aqueous deficient eyes also shorten tear break-up times, even at normal range rates of evaporation in eyes without lipid and/or mucin deficiencies. Because tear instability and short tear film break-up times due to thin tear layers can be independent of lipid and/or mucin deficiency, aqueous deficiency can be another form of evaporation-related dry eye. Conversely, tear layers which are thickened by punctal occlusion can be less susceptible to tear break-up. An inflamed lacrimal gland producing reduced quantities of warmer tears can be a basis for thin tear layers and tear instability demonstrated by shorter tear break-up times. Commonly used clinical tests for aqueous deficiency can be unreliable and less sensitive. Consequently, failure to detect or confirm aqueous deficiency as a contributor to short tear break-up times could result in too much weight being given to a diagnosis of meibomian gland deficiency. Less successful treatment outcomes may be a consequence of failing to detect aqueous deficiency. Refining disease classification by considering aqueous deficiency as a contributor to, or even a form of evaporation-related dry eye, could be the basis for more comprehensive and appropriate treatment strategies. For example, some treatment methods for evaporation-related dry eye might be appropriate for aqueous and mucin-deficient as well as lipid-deficient dry eyes. Anti-inflammatory treatment for the lacrimal gland as well as the conjunctiva, may result in increased aqueous production, reduced tear temperature, tear instability and evaporation rates as well as lower osmolarity.

Autonomic disturbances often occur in patients with acute cerebrovascular disease due to damage of the central autonomic network. We summarize the structures of the central autonomic network and the clinical tests used to evaluate the functions of the autonomic nervous system. We review the clinical and experimental findings as well as management strategies of post-stroke autonomic disturbances including electrocardiographic changes, cardiac arrhythmias, myocardial damage, thermoregulatory dysfunction, gastrointestinal dysfunction, urinary incontinence, sexual disorders, and hyperglycemia. The occurrence of autonomic disturbances has been associated with poor outcomes in stroke patients. Autonomic nervous system modulation appears to be an emerging therapeutic strategy for stroke management in addition to treatments for sensorimotor dysfunction.

The paper describes the design and functionality of a device for low-frequency phonoelectrotherapy. The device provides simultaneous exposure to various modes of ultrasound (frequency range, 22-44 kHz; intensity, up to 1.0 W/cm2) and electrical currents of various types and intensity magnitudes. The device makes it possible to implement a new physiotherapeutic method for simultaneous treatment with ultrasound and different types of electric current. Clinical tests demonstrated high clinical efficacy and cost effectiveness of the device.

An early detection of a disease can save many lives but it is impractical to undergo all medical tests for many prevalent diseases. Further these tests are costly, painful, time consuming and may have side effects. We have tried to predict esophageal cancer using demographics, lifestyle, medical history information, and basic clinical tests initially and later removed all clinical tests one after another to study the change of the accuracy without these clinical tests. It is well studied that no single classification technique turns out to be best for all the problems. Here, we test Naive Bayes classification, random forests, support vector machines (SVM) and logistic regression (LR), which perform similarly when all tests are used. However, as we reduce the number of tests, naive versions of these classifiers perform worse than kernelized versions of SVM and LR. We test our methodology with electronic medical record (EMR) of 3500 patients (approx.). The four methods described above, demonstrate a high accuracy with all features, including basic clinical test and show very low accuracy without the basic clinical tests measured by medical practitioner (MP). LR with a polynomial feature transformation of degree three yields an accuracy of 100% (approx), even without the MP features. Further dropping clinical tests one after another we see a decline in the accuracy of detection to 96%. We have also observed high sensitivity to 100% which indicates that no real patients are undetected in this experiment.

The reliable diagnosis of partial-thickness tears of the rotator cuff is still elusive in clinical practise. Therefore, the purpose of the study was to determine the diagnostic accuracy of MR imaging and clinical tests for detecting partial-thickness tears of the rotator cuff as well as the combination of these parameters. 334 consecutive shoulder arthroscopies for rotator cuff pathologies performed during the time period between 2010 and 2012 were analyzed retrospectively for the findings of common clinical signs for rotator cuff lesions and preoperative MR imaging. These were compared with the intraoperative arthroscopic findings as “gold standard”. The reports of the MR imaging were evaluated with regard to the integrity of the rotator cuff. The Ellman Classification was used to define partial-thickness tears of the rotator cuff in accordance with the arthroscopic findings. Descriptive statistics, sensitivity, specificity, positive and negative predictive value were calculated. MR imaging showed 80 partial-thickness and 70 full-thickness tears of the rotator cuff. The arthroscopic examination confirmed 64 partial-thickness tears of which 52 needed debridement or refixation of the rotator cuff. Sensitivity for MR imaging to identify partial-thickness tears was 51.6%, specificity 77.2%, positive predictive value 41.3% and negative predictive value 83.7%. For the Jobe-test, sensitivity was 64.1%, specificity 43.2%, positive predictive value 25.9% and negative predictive value 79.5%. Sensitivity for the Impingement-sign was 76.7%, specificity 46.6%, positive predictive value 30.8% and negative predictive value 86.5%. For the combination of MR imaging, Jobe-test and Impingement-sign sensitivity was 46.9%, specificity 85.4%, positive predictive value 50% and negative predictive value 83.8%. The diagnostic accuracy of MR imaging and clinical tests (Jobe-test and Impingement-sign) alone is limited for detecting partial-thickness tears of the rotator cuff. Additionally, the combination of MR imaging and clinical tests does not improve diagnostic accuracy. Level II, Diagnostic study.

Tears of the subscapularis (SSC) tendon constitute a diagnostic challenge. The purpose of the present study was to evaluate the diagnostic capabilities of five clinical SSC tests. Five established clinical tests were evaluated in 106 consecutive patients prior to shoulder arthroscopy. The tests included the Lift Off Test, Internal Rotation Lag Sign, Belly Press Test, Belly Off Sign, and Bear Hug Test. The integrity of the SSC tendon at surgery was used as the gold standard. Lesions to the SSC were graded according to Fox and Romeo. There were 32 SSC lesions accounting for an incidence of 30.2%. The sensitivity for all tests was 0.66, while the specificity was 0.82. For all tests, positive tests results were found to be dependent on subscapularis integrity (p

The structure and the functionality of a device for low-frequency ultrasound therapy are described. The device provides different modes of exposure to ultrasound in the range of 20-100 kHz; the ultrasound intensity is ≤1.0 W/cm2. Clinical tests demonstrated high clinical and economical efficacy of the device for low-frequency ultrasound therapy.

Non-alcoholic fatty liver disease (NAFLD) is one of the most common diseases in the world. Recently the FibroScan device is used as a noninvasive, yet costly method to measure the liver’s elasticity as a NAFLD indicator. Other than the cost, the diagnosis is not widely accessible to all patients. On the other hand, early detection of the disease can prevent later risks. In this study, we aim to use learning methods to infer the NAFLD severity level, only based on clinical tests. A dataset was constructed from clinical and ultrasonography data of 726 patients who were diagnosed with different NAFLD severity levels. Artificial neural networks (ANN) were used to model the relationship between NAFLD and the clinical tests. Next, a method was used to analyze the ANN and extract compact and human understandable rules. The derived rules can detect the fatty liver disease with an accuracy above 80%.

Handgelenk und Hand bilden ein hochkomplexes Organ, das fur den Menschen bei fast allen Alltagstatigkeiten von groser Bedeutung ist – zum einen als Werkzeug, zum anderen als Tastorgan. Beschwerden und Verletzungen der Hand und des Handgelenkes sind haufig. Die detaillierte Anamneseerhebung fuhrt in vielen Fallen bereits zur Verdachtsdiagnose. Fast alle Strukturen sind der anschliesenden klinischen Untersuchung zuganglich und konnen anhand von Inspektion, Palpation und klinischen Tests und im Rahmen der dynamischen Untersuchung gut beurteilt werden. Die Ursachen fur Handbeschwerden sind vielfaltig. Neben traumatischen konnen auch degenerative, mechanische, neurologische oder systemisch entzundliche Veranderungen fur Beschwerden verantwortlich sein. Eine gezielte erganzende Bildgebung rundet die Diagnosestellung ab.

The testing process determines the specified characteristics of an object. Testing is commonly used to verify the quality, safety, reliability, efficiency, and environmental sustainability of products and services. In Brazil, the National Institute of Metrology, Quality and Technology (Inmetro) is responsible for accrediting the facilities that undertake testing and calibration activities. Typical accredited testing services include: water quality, clinical tests, emissions tests, and vehicle safety tests. Undertaking fraudulent behavior when testing processes can result in products that are dangerous to the ordinary citizen and to the environment. Further, fraudulent behavior produces unfair competition between concurrent organizations. This paper presents a method to detect possible fraudulent behavior in accredited testing facilities. The proposed technique combines the bootstrap method and the Dempster–Shafer theory of evidence, to investigate several fraudulent aspects at once. To validate the proposed method, we use a Brazilian real-world dataset with real cases of fraud. The proposed technique successfully detects the accredited testing facilities with fraudulent behavior.

In this work, the principle of operation of a device for determination of the optimum length of grafts used in reconstructive surgery of damaged tendons, vessels, and nerves is described. Clinical tests of the device showed that it can be recommended for broad use.

Conventional methods of intestinal inspection play an essential role in the assessment of bowel diseases and other relevant health issues, yet fail to obtain intestinal conditions in real time because of radiation limits and operation inconvenience. Herein, a flexible, skin-mounted device is developed for long-term, real-time monitoring, and for the evaluation of bowel sounds based on the integration of a three-dimensional printed elastomeric resonator with flexible electronics. The device is capable of being flexibly attached to abdominal surfaces without performance degradation during breathing. Clinical tests conduct in a normal volunteer and in patients with mechanical intestinal obstruction or paralytic ileus illustrate the usefulness of the device in capturing the characteristics of bowel sounds. Furthermore, a demonstration of collection and classification of bowel sounds by the flexible device based on machine learning methods can serve as a reference for possible applications of the system in the auxiliary diagnosis of bowel problems.

This is a letter to the editor commenting on “Carpal tunnel syndrome: evaluation of its provocative clinical tests.”

Valenta Pharm Co. compared the pharmacokinetic parameters in healthy volunteers of three prototype tizanidine dosage forms (delayed-release 6-mg tablets) and the reference drug sirdalud (2-mg tablets for a total dose of 6 mg, three tablets). This allowed the relative bioavailability of the three prototype tizanidine forms relative to sirdalud to be assessed. All three prototypes showed signs of delay based on MRT parameters of (2.217 ± 0.441) h for the sirdalud instant-release form and (6.529 ± 1.990), (5.951 ± 1.295), and (6.384 ± 2.339) h for prototypes T1, T2, and T3, respectively. High relative exposure levels of prototypes T1, T2, and T3 [AUC 103.80% (73.69 – 146.20), 124.14% (88.14 – 174.86), and 131.93% (93.66 – 185.82), respectively] with a significant decrease of C max (to 35.83, 38.78, and 40.79%, respectively) were demonstrated by analyzing the comparative bioavailability. A model pharmacokinetic study of the forms produced secondary modeling parameters that were similar to those obtained by an off-model method (89.19 – 122.71%). This confirmed that the developed model was acceptable for planning future clinical tests of these drugs.

Quantification of small, dense low-density lipoprotein (sdLDL) cholesterol is clinically significant. We propose a practical technique to estimate the amount of sdLDL cholesterol using dynamic light scattering (DLS). An analytical solution in a closed form has newly been obtained to estimate the weight fraction of one species of scatterers in the DLS measurement of two species of scatterers. Using this solution, we can quantify the sdLDL cholesterol amount from the amounts of the low-density lipoprotein cholesterol and the high-density lipoprotein (HDL) cholesterol, which are commonly obtained through clinical tests. The accuracy of the proposed technique was confirmed experimentally using latex spheres with known size distributions. The applicability of the proposed technique was examined using samples of human blood serum. The possibility of estimating the sdLDL amount using the HDL data was demonstrated. These results suggest that the quantitative estimation of sdLDL amounts using DLS is feasible for point-of-care testing in clinical practice.

Isolated lesions of the caudal portion of the subscapularis (SSC) tendon are rare and have not been subject of major attention in the literature yet. However, these lesions can lead to tremendous impairment of shoulder function. The purpose of the present study was to raise clinician’s awareness for these “hidden lesions” and to present the crucial steps for diagnosis and management. Five patients (three men, two women; mean age 40) with traumatic isolated caudal SSC lesion were enrolled in the present study. After clinical and radiological examination, all patients underwent diagnostic arthroscopy and open inferior SSC repair. The results of the clinical and radiological examination were documented along with the intraoperative findings. Post-operative pain level and shoulder function were assessed. In all patients the SSC lesion could be detected clinically. In two patients the caudal SSC tear was diagnosed delayed after initial conservative treatment. Preoperatively, all patients showed restricted active movement of the shoulder with positive clinical tests for the SSC. All SSC lesions could be detected on MR images and identified arthroscopically. After a mean follow-up of 12 months, all clinical SSC tests were negative, and the patients have almost regained preinjury shoulder function. The mean post-operative pain score (VAS) was 1 (range 0–1), and the mean ASES score was 93.3 (range 91.6–95). Arthroscopic visualization of the SSC tendon is incomplete rendering caudal SSC tears difficult to detect and easy to overlook. Clinicians’ awareness of this pathology along with accurate clinical and radiological examination leads to the correct diagnosis. Open caudal SSC repair provides pain relief and reliable shoulder function after short-term follow-up. IV.

Vanadium (20th in natural abundance) is omnipresent in the environment both naturally and in problematic or toxic concentrations, as pollutant. Ingested, e.g. with drinking water and food, or by inhalation in the form of oxides attached to dust particle, vanadium can cause health hazards. Since vanadate is a phosphate antagonist, vanadium—in appropriate low concentrations—is also expected to exert a variety of physiological actions, some of which have been documented in pre-medicinal or—in the case of diabetes type 2—in phase IIa clinical tests. Other potential implementations, elucidated and scrutinized in this report, include myocardial infarctions, viral, bacterial and parasitic infections (the latter essentially in tropical countries), and cancer.

Background The diagnosis of carpal tunnel syndrome (CTS) is established mainly on a clinical basis, and diagnosis is done after careful history taking and examination including known provocative tests with varying efficacy and reliability. Methods A prospective clinical study of 123 patients with 171 hands presenting with classical symptoms of carpal tunnel syndrome were included in this study, from October 2013 to October 2015, and they underwent open surgical release of flexor retinaculum at the Neurosurgery Department of Benha University Hospital. Results ART is positive in 88.3%. This is compared to 75, 81.3, 79.7, and 83.6% of positive results in Tinel’s test, compression test, Phalen’s test, and combined Phalen’s and compression test. ART is the most sensitive and specific test and has the highest positive predictive value of 98.3%, negative predictive value of 81.9%, and accuracy of 91.4%. Conclusion ART is a simple, reliable, and easily performed test for evaluating carpal tunnel syndrome; it is superior to other tests and could be used also to assess improvement after surgery.

Background Fatigue is a common problem among individuals with Parkinson’s disease (PD). It may occur before the overt symptoms of bradykinesia, rigidity and tremor. Little is understood about how to measure fatigue in PD. Here we determined the dimensionality of the constructs of fatigue. Methods Four recommended scales, the Fatigue Severity Scale, Functional Assessment of Chronic Illness Therapy-Fatigue, Parkinson Fatigue Scale and Visual Analog Fatigue Scale (VAFS) were tested against quality of life measures including cognition, depression, sleep, life orientation, physical activity and PD symptoms in 22 PD subjects and 15 caregivers. Results Fatigue was associated with many quality of life variables, with the PDQ-39 summary index showing the strongest association. PD subjects agreed more strongly than caregivers that they experienced higher levels of fatigue. 27% of PD subjects rated fatigue as one of their top three most bothersome symptoms. The constructs of fatigue was captured within one dimension which explained 67% of the total variance, of which the VAFS showed the highest internal consistency. The highest likelihood ratio gave a cut-off score of

To understand the prenatal origin of developmental and psychiatric disorders, studies in laboratory animals are imperative. However, the developmental pace differs between humans and animals; hence, corresponding human ages must be estimated to infer the most vulnerable developmental timings in humans. Because rats and mice are extensively used as models in developmental research, a correspondence between human foetal ages and rodents’ ages must be precisely determined; thus, developing a translational model is of utmost importance. Optimizing a translational model involves classifying the brain regions according to developmental paces, but previous studies have conducted this classification arbitrarily. Here we used a clustering method and showed that the brain regions can be classified into two groups. To quantify the developmental pace, we gathered data for a range of development events in humans and rodents and created a linear mixed model that translates human developmental timings into the corresponding rat timings. We conducted an automatic classification of brain regions using an EM algorithm and obtained a model to translate human foetal age to rat age. Our model could predict rat developmental timings within 2.5 days of root mean squared error. This result provides useful information for designing animal studies and clinical tests.

High serum concentrations of polychlorinated biphenyls (PCBs) have been reported previously among residents of Anniston, Alabama, where a PCB production facility was located in the past. As the second of two cross-sectional studies of these Anniston residents, the Anniston Community Health Survey: Follow-Up and Dioxin Analyses (ACHS-II) will yield repeated measurements to be used to evaluate changes over time in ortho-PCB concentrations and selected health indicators in study participants. Dioxins, non-ortho PCBs, other chemicals, heavy metals, and a variety of additional clinical tests not previously measured in the original ACHS cohort will be examined in ACHS-II. The follow-up study also incorporates a questionnaire with extended sections on diet and occupational history for a more comprehensive assessment of possible exposure sources. Data collection for ACHS-II from 359 eligible participants took place in 2014, seven to nine years after ACHS.

An immunotherapy approach targets nanoparticles to dendritic cells of the immune system, leading to an antitumour immune response with antiviral-like features. Initial clinical tests of this approach show promise. See Letter p.396

Advances in magnetic resonance imaging have recently allowed the demonstration of endolymphatic hydrops (EH) in human subjects. Meniere’s Disease (MD) is diagnosed based on a constellation of symptoms and can be corroborated with a variety of clinical tests. Prior to the current era, however, EH in MD could only be directly visualized on postmortem human temporal bone studies. Imaging techniques using both intratympanic and intravenous contrast have progressed with the help of animal models, and imaging protocols for evaluation of EH in humans continue to evolve as image resolution and post-processing techniques improve. Although the clinical implications of these imaging modalities seem promising, the details of the specific applications of MR imaging of EH remain to be elucidated.

Background A key element for movement of the arm is the position and motion of the scapula. A stable basis for efficient arm function is only possible if the scapula makes three dimensional movements coordinated with the upper arm. Aim This article presents a discussion of causes, diagnosis and therapy options for scapular dyskinesis. Material and methods The article is based on a literature search in the PubMed database and taking own experience into account. Results Soft tissue and bony injuries, muscle insufficiency and dysbalance can alter the position and function of the scapula. This pathological position and motion is called scapular dyskinesis. This clinically presents as a prominent medial border and malrotation (lacking external rotation and posterior tilt) of the scapula when raising the arm. The clinical examination includes a visual inspection followed by clinical tests of the scapula at rest and during movement. Specific exercises of the musculature surrounding the scapula and specific techniques for schooling the senses for positioning and movement can harmonize the sequence of movements and restore the dynamic scapular stability. Conclusion A conservative stepwise and stage-adapted exercise program can be used to treat scapular dyskinesis with good results.

Cervical and ocular vestibular-evoked myogenic potential (cVEMP/oVEMP) tests are widely used clinical tests of otolith function. However, VEMP testing may not be the ideal measure of otolith function given the significant inter-individual variability in responses and given that the stimuli used to elicit VEMPs are not physiological. We therefore evaluated linear motion perceptual threshold testing compared with cVEMP and oVEMP testing as measures of saccular and utricular function, respectively. A multi-axis motion platform was used to measure horizontal (along the inter-aural and naso-occipital axes) and vertical motion perceptual thresholds. These findings were compared with the vibration-evoked oVEMP as a measure of utricular function and sound-evoked cVEMP as a measure of saccular function. We also considered how perceptual threshold and cVEMP/oVEMP testing are each associated with Dizziness Handicap Inventory (DHI) scores. We enrolled 33 patients with bilateral vestibulopathy of different severities and 42 controls to have sufficient variability in otolith function. Subjects with abnormal oVEMP amplitudes had significantly higher (poorer) perceptual thresholds in the inter-aural and naso-occipital axes in age-adjusted analyses; no significant associations were observed for vertical perceptual thresholds and cVEMP amplitudes. Both oVEMP amplitudes and naso-occipital axis perceptual thresholds were significantly associated with DHI scores. These data suggest that horizontal perceptual thresholds and oVEMPs may estimate the same underlying physiological construct: utricular function.

Arthroscopic repair of the subscapularis tendon has been introduced later than arthroscopic repair of the rotator cuff because of technical difficulties and lack of anatomical knowledge of this tendon, the so-called “forgotten tendon”. The anatomic repair of this tendon is functional to maintain proper biomechanics of the shoulder. A careful evaluation of the patient, both with clinical tests and instrumental examinations, is mandatory prior to approaching arthroscopic evaluation. During arthroscopy possible and frequent biceps pathologies should be addressed and both releasing of the adhesions and coracoplasty should be considered. Arthroscopic repair is performed with suture anchor reinserting of the tendon at the footprint, with possible medialization of the insertion, with all the variable approaches described for rotator cuff repair; results can be comparable to the ones obtainable with open technique repair, however arthroscopic approach cannot adress the extrarticular retracted lesions.

Urine is an ideal body fluid for the detection of protein markers produced by urological cancers as it can be sampled noninvasively and contains secreted and directly shed proteins from the prostate, bladder and kidney. Major challenges of working with urine include high inter-individual and intra-individual variability, low protein concentration, the presence of salts and the dynamic range of protein expression. Despite these challenges, significant progress is being made using modern proteomic methods to identify and characterize protein-based markers for urological cancers. The development of robust, easy-to-use clinical tests based on novel biomarkers has the potential to impact upon diagnosis, prognosis and monitoring and could revolutionize the treatment and management of these cancers.

Parkinson’s disease (PD) is a neurodegenerative disease, which is not easily diagnosed using clinical tests and the discovery of proper methods would be a major step towards a successful diagnosis. In the present study, we employed metabolic profiling using proton nuclear magnetic resonance spectroscopy to find metabolites in serum, which are helpful for the diagnosis of PD. Classification of PD and healthy subject was done using random forest. Serum levels of selenium measured by atomic absorption spectrometry in PD group were lower than the serum selenium levels in the control group. The metabolites causing selenium changes in PD patients were identified using random forest, and a model was created for correlation between these metabolites and serum levels of selenium. The obtained classification model showed 88 % correct classification of PD and healthy samples for an external test set. The regression model of selenium and metabolites levels resulted in correlation value (R2) of 0.90 for the external test set. The findings of the present study indicate that serum metabonomics have great potential in PD detection and could be beneficial as a diagnostic method. As a novel approach, a model with good prediction capability was constructed between serum levels of selenium and nuclear magnetic resonance data.

Due to the increasing consumers’ interest in up-to-date nutrition nowadays the production of main part of fermented dairy products (e.g. yogurt, kefir) is performed using probiotic microbes. The majority of this product group are the flavoured variations, the sweetener is, first of all, still refined sugar (e.g. saccharose). Honey of natural origin, consequently preferred from the nutrition-physiological point of view, could be proposed to replace this refined carbohydrate. To check its availability for this purpose the growth of microbes of the Hungarian culture of trade name Prebiolact-2 was examined. The probiotic properties of the culture are proved by clinical tests. At the determination of recipes of control and experimental samples we took into consideration that the milk composition and carbohydrate content of samples should have been the same, and they could differ only in carbohydrate-free component content of honey. During processing of the samples the minimum heat-treatment was applied to protect the biologically active components of honey to the greatest degree. Pasteurized-homogenized milk was used as raw material, in which granulated sugar and the honeys were solved, respectively, at 60 °C. The inoculation was made by Prebiolact-2 culture injected into the batch-wessel; the closed cells were agitated intensively for 10 s. General conclusion of thermal investigation is that the proliferation rate is longer lasting in case of honey treated milks. The acacia- honey resulted in the same probiotic proliferation as sugar did. In case of other herb-honeys the effect was smaller, very probably because of the strong bactericidal effect of herbs, which is very important from medical point of view. According to the results of the consumer survey over 85 % of them think that the consumption of herbs in the form of honey is especially beneficial from both dietary and market view.

Critical soft tissue injuries may lead to a non-functional and insensate limb. In these cases standard reconstructive techniques will not suffice to provide a useful outcome, and solutions outside the biological arena must be considered and offered to these patients. We propose a concept which, after all reconstructive options have been exhausted, involves an elective amputation along with a bionic substitution, implementing an actuated prosthetic hand via a structured tech-neuro-rehabilitation program. Here, three patients are presented in whom this concept has been successfully applied after mutilating hand injuries. Clinical tests conducted before, during and after the procedure, evaluating both functional and psychometric parameters, document the benefits of this approach. Additionally, in one of the patients, we show the possibility of implementing a highly functional and natural control of an advanced prosthesis providing both proportional and simultaneous movements of the wrist and hand for completing tasks of daily living with substantially less compensatory movements compared to the traditional systems. It is concluded that the proposed procedure is a viable solution for re-gaining highly functional hand use following critical soft tissue injuries when existing surgical measures fail. Our results are clinically applicable and can be extended to institutions with similar resources.

The estimation of visual acuity (VA) via visual evoked potentials (VEP) is a valuable measure for all preverbal and non-verbal subjects whether adults or children. The aim of this study is to introduce a novel technique of VEP acquisition based on estimates of signal-to-noise ratio (SNR) and comparison to a predefined detection threshold. We aim to demonstrate the reduction in total study time without compromising the accuracy of the VEP-determined acuity estimate. The VEP-determined acuity of twelve normal subjects was assessed via a spatial frequency (SF) sweep. A pattern reversal checkerboard stimulus utilised SFs ranging from 0.1 to 28 cycles per degree (cpd). Using linear extrapolation and Bland–Altman analysis, VEP-acquired acuity was compared to a conventional Snellen Acuity measurement. An SNR test, Fsp, assessed signal quality to determine the minimum amount of sweep data required for VEP-based VA estimation. VEP acuity estimates correlated strongly (r 2 = 0.91, SD = 0.06), leading to a VA limit via extrapolation. Bland–Altman analysis revealed agreement between tests is statistically valid (95 % CI −0.11 to 0.42 logMAR). The Fsp statistic indicated SFs 1.3–3.6 cpd yielded Fsp >3.1 within 15 s of acquisition with frequencies >3.6 cpd being sub-threshold. The Kruskal–Wallis statistic compared final Fsp values for SFs as groups, where F = 208.82 ranking each frequency, with frequencies >7.2 cpd ranking lowest. The Fsp as an SNR measurement shows that rapid, quality-driven clinical tests for VEP-based acuity estimates can be conducted without compromising accuracy.

Infectious diseases, mostly caused by bacteria and viruses but also a result of fungal and parasitic infection, have been one of the most important public health concerns throughout human history. The first step in combating these pathogens is to get a timely and accurate diagnosis at an affordable cost. Many kinds of diagnostics have been developed, such as pathogen culture, biochemical tests and serological tests, to help detect and fight against the causative agents of diseases. However, these diagnostic tests are generally unsatisfactory because they are not particularly sensitive and specific and are unable to deliver speedy results. Nucleic acid-based diagnostics, detecting pathogens through the identification of their genomic sequences, have shown promise to overcome the above limitations and become more widely adopted in clinical tests. Here we review some of the most popular nucleic acid-based diagnostics and focus on their adaptability and applicability to routine clinical usage. We also compare and contrast the characteristics of different types of nucleic acid-based diagnostics.

Pollen grains as the angiosperm male gametophytes transfer male genetic material during sexual reproduction. Pollen grains are among the important plant allergens, such that almost 80–90 % of plant allergens are of pollen origin. Acacia farnesiana is a plant with economical values, and due to its resistance to dry climates, it has had a widespread distribution in Southern Iran. This study was aimed at investigating the allergenicity and the ontogeny of pollen grains of A. farnesiana. Pollen grains were collected from the blossoms and flowers of A. farnesiana in the suburbs of Ahvaz-Iran. Pollen extracts (15 %) were prepared in PBS (pH 7.2). 4–6-week-old male guinea pigs (Hartly) were used for allergenicity tests. Skin tests showed a significant increase in flare diameter. Clinical tests also showed a significant change in the levels of eosinophils, neutrophils, and IgE. Histotechnical analysis was performed on male gametophytes, and photographs were taken using a camera-equipped light microscope. Pollen characteristics were identified using both light and electron microscopy. Sporoderm ultrastructure and pollen morphology were studied using Scanning Electron Microscopy. PAGE analysis of the total protein content of mature pollen grains showed seven clear bands of 10–83 kDa.