Advances in Medicine http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Evaluating the Reproducibility of Motion Analysis Scanning of the Spine during Walking Thu, 17 Jul 2014 08:10:54 +0000 http://www.hindawi.com/journals/amed/2014/721829/ The Formetric 4D dynamic system (Diers International GmbH, Schlangenbad, Germany) is a rasterstereography based imaging system designed to evaluate spinal deformity, providing radiation-free imaging of the position, rotation, and shape of the spine during the gait cycle. Purpose. This study was designed to evaluate whether repeated measurements with the Formetric 4D dynamic system would be reproducible with a standard deviation of less than +/− 3 degrees. This study looked at real-time segmental motion, measuring kyphosis, lordosis, trunk length, pelvic, and T4 and L1 vertebral body rotation. Methods. Twenty healthy volunteers each underwent 3 consecutive scans. Measurements for kyphosis, lordosis, trunk length, and rotations of T4, L1, and the pelvis were recorded for each trial. Results. The average standard deviations of same-day repeat measurements were within +/− 3 degrees with a range of 0.51 degrees to 2.3 degrees. Conclusions. The surface topography system calculated reproducible measurements with error ranges comparable to the current gold standard in dynamic spinal motion analysis. Therefore, this technique should be considered of high clinical value for reliably evaluating segmental motion and spinal curvatures and should further be evaluated in the setting of adolescent idiopathic scoliosis. Aaron Gipsman, Lisa Rauschert, Michael Daneshvar, and Patrick Knott Copyright © 2014 Aaron Gipsman et al. All rights reserved. Identifying a Framework for Hope in Order to Establish the Importance of Generalised Hopes for Individuals Who Have Suffered a Stroke Sun, 29 Jun 2014 08:01:30 +0000 http://www.hindawi.com/journals/amed/2014/471874/ Hope and hopelessness are important psychological constructs that physiotherapists should consider when working with patients who have experienced a stroke. The view of hope in rehabilitation is often focused around the concept of goals and how hope works within this framework. However, the current paper proposes a broader framework for hope and the importance of a more generalised view of understanding why a certain hope exists or is identified by a patient. A narrative review using an a priori thematic analysis was undertaken to consider how more generalised hopes are expressed by individuals who have suffered a stroke. An electronic search of 4 databases from inception until April 2014 was undertaken. Qualitative articles were included if they considered the concept of hope for patients who had suffered a stroke. The results identified three themes which included (1) consideration of the patient’s identity/identities, (2) meaningful activities, experiences, and interactions, and (3) the experience of suffering and need for relief. An awareness of patients’ generalised hopes should be a priority for HCPs. Detailed implications for HCPs are identified within the discussion. Andy Soundy, Clive Liles, Brendon Stubbs, and Carolyn Roskell Copyright © 2014 Andy Soundy et al. All rights reserved. Treatment Alternatives to Negotiate Peri-Implantitis Sun, 15 Jun 2014 07:02:41 +0000 http://www.hindawi.com/journals/amed/2014/487903/ Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants’ surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable. Eli E. Machtei Copyright © 2014 Eli E. Machtei. All rights reserved. Comorbid Obsessive-Compulsive Symptoms in Schizophrenia: Insight into Pathomechanisms Facilitates Treatment Wed, 11 Jun 2014 10:51:52 +0000 http://www.hindawi.com/journals/amed/2014/317980/ Insight into the biological pathomechanism of a clinical syndrome facilitates the development of effective interventions. This paper applies this perspective to the important clinical problem of obsessive-compulsive symptoms (OCS) occurring during the lifetime diagnosis of schizophrenia. Up to 25% of schizophrenia patients suffer from OCS and about 12% fulfil the diagnostic criteria of obsessive-compulsive disorder (OCD). This is accompanied by marked subjective burden of disease, high levels of anxiety, depression and suicidality, increased neurocognitive impairment, less favourable levels of social and vocational functioning, and greater service utilization. Comorbid patients can be assigned to heterogeneous subgroups. It is assumed that second generation antipsychotics (SGAs), most importantly clozapine, might aggravate or even induce second-onset OCS. Several epidemiological and pharmacological arguments support this assumption. Specific genetic risk factors seem to dispose patients with schizophrenia to develop OCS and risk-conferring polymorphisms has been defined in SLC1A1, BDNF, DLGAP3, and GRIN2B and in interactions between these individual genes. Further research is needed with detailed characterization of large samples. In particular interactions between genetic risk constellations, pharmacological and psychosocial factors should be analysed. Results will further define homogeneous subgroups, which are in need for differential causative interventions. In clinical practise, schizophrenia patients should be carefully monitored for OCS, starting with at-risk mental states of psychosis and longitudinal follow-ups, hopefully leading to the development of multimodal therapeutic interventions. Mathias Zink Copyright © 2014 Mathias Zink. All rights reserved. Quality of Life among Egyptian Patients with Upper and Lower Limb Amputation: Sex Differences Wed, 04 Jun 2014 12:39:37 +0000 http://www.hindawi.com/journals/amed/2014/674323/ Background. Limb amputation is a life-changing event that can cause significant disruptions in many important areas of existence. Aim of this study. To evaluate the quality of life (QOL) of patients with limb amputation and identify the factors affecting the quality of life of patients with limb amputation among Egyptian patients. Research Design. It was a descriptive exploratory design. Setting. The study was conducted in Orthopedics and Surgical Department in Emergency Hospital at Mansoura University Hospitals. Sample. A sample of convenience of 100 adult male and female patients who met the inclusion criteria was included. Tools. (a) Structured interview questionnaire (SIQ) was used to collect personal data, (b) short form (36) health status questionnaires: this part was utilized to assess the quality of life among Egyptian patients with amputation. Results. The result of this study indicates that most participants experienced a change in the quality of life. There is a statistically significant difference between total QOL aspects and each of the following: age, gender, educational level, and type of work. Conclusion. Limb amputation tends to cause increased disability for those amputated patients. The age, gender, place of amputation, and marital status are found as statistically significant factors with physical component and psychological component. Salwa A. Mohammed and Amany M. Shebl Copyright © 2014 Salwa A. Mohammed and Amany M. Shebl. All rights reserved. Percutaneous Septal Ablation in Hypertrophic Obstructive Cardiomyopathy: From Experiment to Standard of Care Tue, 06 May 2014 12:05:13 +0000 http://www.hindawi.com/journals/amed/2014/464851/ Hypertrophic cardiomyopathy (HCM) is one of the more common hereditary cardiac conditions. According to presence or absence of outflow obstruction at rest or with provocation, a more common (about 60–70%) obstructive type of the disease (HOCM) has to be distinguished from the less common (30–40%) nonobstructive phenotype (HNCM). Symptoms include exercise limitation due to dyspnea, angina pectoris, palpitations, or dizziness; occasionally syncope or sudden cardiac death occurs. Correct diagnosis and risk stratification with respect to prophylactic ICD implantation are essential in HCM patient management. Drug therapy in symptomatic patients can be characterized as treatment of heart failure with preserved ejection fraction (HFpEF) in HNCM, while symptoms and the obstructive gradient in HOCM can be addressed with beta-blockers, disopyramide, or verapamil. After a short overview on etiology, natural history, and diagnostics in hypertrophic cardiomyopathy, this paper reviews the current treatment options for HOCM with a special focus on percutaneous septal ablation. Literature data and the own series of about 600 cases are discussed, suggesting a largely comparable outcome with respect to procedural mortality, clinical efficacy, and long-term outcome. Lothar Faber Copyright © 2014 Lothar Faber. All rights reserved. Ensuring Confidentiality of Geocoded Health Data: Assessing Geographic Masking Strategies for Individual-Level Data Tue, 29 Apr 2014 09:15:46 +0000 http://www.hindawi.com/journals/amed/2014/567049/ Public health datasets increasingly use geographic identifiers such as an individual’s address. Geocoding these addresses often provides new insights since it becomes possible to examine spatial patterns and associations. Address information is typically considered confidential and is therefore not released or shared with others. Publishing maps with the locations of individuals, however, may also breach confidentiality since addresses and associated identities can be discovered through reverse geocoding. One commonly used technique to protect confidentiality when releasing individual-level geocoded data is geographic masking. This typically consists of applying a certain amount of random perturbation in a systematic manner to reduce the risk of reidentification. A number of geographic masking techniques have been developed as well as methods to quantity the risk of reidentification associated with a particular masking method. This paper presents a review of the current state-of-the-art in geographic masking, summarizing the various methods and their strengths and weaknesses. Despite recent progress, no universally accepted or endorsed geographic masking technique has emerged. Researchers on the other hand are publishing maps using geographic masking of confidential locations. Any researcher publishing such maps is advised to become familiar with the different masking techniques available and their associated reidentification risks. Paul A. Zandbergen Copyright © 2014 Paul A. Zandbergen. All rights reserved. A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour Sun, 13 Apr 2014 16:53:06 +0000 http://www.hindawi.com/journals/amed/2014/704875/ Objectives. The study was aimed to assess the association between low maternal serum magnesium levels and preterm labour. Methods. It is a cross-sectional case-control study in which eligible participants were pregnant women admitted in labour within the labour ward complex of a Lagos tertiary hospital. Relevant data were extracted from the case records of these women and blood samples were obtained from all participants and serum magnesium levels measured. Results. The study showed that 36% of the study patients had varying degrees of hypomagnesaemia. The relative risk indicates that preterm labour is 1.83 times higher among the patients with low serum magnesium (less than 1.6 mg/dL). The mean difference in serum magnesium levels in both groups was statistically significant (). Conclusion. We can infer that low serum magnesium (hypomagnesaemia) is associated with preterm onset of labour. We can, also from this finding, formulate a proposition that would help in preventing preterm labour and birth with the use of prophylactic oral magnesium supplementation among patients with higher risk for development of preterm labour. Kehinde S. Okunade, Ayodeji A. Oluwole, and Maymunah A. Adegbesan-Omilabu Copyright © 2014 Kehinde S. Okunade et al. All rights reserved. Transplantation of Encapsulated Pancreatic Islets as a Treatment for Patients with Type 1 Diabetes Mellitus Thu, 30 Jan 2014 10:56:41 +0000 http://www.hindawi.com/journals/amed/2014/429710/ Encapsulation of pancreatic islets has been proposed and investigated for over three decades to improve islet transplantation outcomes and to eliminate the side effects of immunosuppressive medications. Of the numerous encapsulation systems developed in the past, microencapsulation have been studied most extensively so far. A wide variety of materials has been tested for microencapsulation in various animal models (including nonhuman primates or NHPs) and some materials were shown to induce immunoprotection to islet grafts without the need for chronic immunosuppression. Despite the initial success of microcapsules in NHP models, the combined use of islet transplantation (allograft) and microencapsulation has not yet been successful in clinical trials. This review consists of three sections: introduction to islet transplantation, transplantation of encapsulated pancreatic islets as a treatment for patients with type 1 diabetes mellitus (T1DM), and present challenges and future perspectives. Meirigeng Qi Copyright © 2014 Meirigeng Qi. All rights reserved. Mesenchymal Conversion of Mesothelial Cells Is a Key Event in the Pathophysiology of the Peritoneum during Peritoneal Dialysis Thu, 23 Jan 2014 16:32:48 +0000 http://www.hindawi.com/journals/amed/2014/473134/ Peritoneal dialysis (PD) is a therapeutic option for the treatment of end-stage renal disease and is based on the use of the peritoneum as a semipermeable membrane for the exchange of toxic solutes and water. Long-term exposure of the peritoneal membrane to hyperosmotic PD fluids causes inflammation, loss of the mesothelial cells monolayer, fibrosis, vasculopathy, and angiogenesis, which may lead to peritoneal functional decline. Peritonitis may further exacerbate the injury of the peritoneal membrane. In parallel with these peritoneal alterations, mesothelial cells undergo an epithelial to mesenchymal transition (EMT), which has been associated with peritoneal deterioration. Factors contributing to the bioincompatibility of classical PD fluids include the high content of glucose/glucose degradation products (GDPs) and their acidic pH. New generation low-GDPs-neutral pH fluids have improved biocompatibility resulting in better preservation of the peritoneum. However, standard glucose-based fluids are still needed, as biocompatible solutions are expensive for many potential users. An alternative approach to preserve the peritoneal membrane, complementary to the efforts to improve fluid biocompatibility, is the use of pharmacological agents protecting the mesothelium. This paper provides a comprehensive review of recent advances that point to the EMT of mesothelial cells as a potential therapeutic target to preserve membrane function. Manuel López-Cabrera Copyright © 2014 Manuel López-Cabrera. All rights reserved. Developmental Immunotoxicity, Perinatal Programming, and Noncommunicable Diseases: Focus on Human Studies Thu, 23 Jan 2014 07:39:05 +0000 http://www.hindawi.com/journals/amed/2014/867805/ Developmental immunotoxicity (DIT) is a term given to encompass the environmentally induced disruption of normal immune development resulting in adverse outcomes. A myriad of chemical, physical, and psychological factors can all contribute to DIT. As a core component of the developmental origins of adult disease, DIT is interlinked with three important concepts surrounding health risks across a lifetime: (1) the Barker Hypothesis, which connects prenatal development to later-life diseases, (2) the hygiene hypothesis, which connects newborns and infants to risk of later-life diseases and, (3) fetal programming and epigenetic alterations, which may exert effects both in later life and across future generations. This review of DIT considers: (1) the history and context of DIT research, (2) the fundamental features of DIT, (3) the emerging role of DIT in risk of noncommunicable diseases (NCDs) and (4) the range of risk factors that have been investigated through human research. The emphasis on the human DIT-related literature is significant since most prior reviews of DIT have largely focused on animal research and considerations of specific categories of risk factors (e.g., heavy metals). Risk factors considered in this review include air pollution, aluminum, antibiotics, arsenic, bisphenol A, ethanol, lead (Pb), maternal smoking and environmental tobacco smoke, paracetamol (acetaminophen), pesticides, polychlorinated biphenyls, and polyfluorinated compounds. Rodney R. Dietert Copyright © 2014 Rodney R. Dietert. All rights reserved.