Dissertations / Theses on the topic 'Hip injury'
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Heath, Douglas. "Factors Affecting Occupant Risk of Knee-Thigh-Hip Injury in Frontal Vehicle Collisions." Digital WPI, 2010. https://digitalcommons.wpi.edu/etd-theses/422.
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Every year, millions of people are killed or injured in motor vehicle accidents in the United States. Although recent improvements to occupant restraint systems, such as seatbelts and airbags, have significantly decreased life threatening injuries, which usually occur to the chest or head, they have done little to decrease the occurrence of lower extremity injuries. Although lower extremity injuries are not usually life threatening, they can result in chronic disability and high psychosocial cost. Of all lower extremity injuries, injuries to the knee-thigh-hip (KTH) region have been shown to be among the most debilitating. This project used a finite element (FE) model of the KTH region to study injury. A parametric investigation was conducted where the FE KTH was simulated as a vehicle occupant positioned to a range of pre-crash driving postures. The results indicate that foot contact force and knee kinematics during impact affects the axial force absorbed by the KTH region and the likelihood of injury. The results of the study could be used to reevaluate the lower extremity injury thresholds currently used to regulate vehicle safety standards. Also, the results could be used to provide guidelines to vehicle manufacturers for developing safer occupant compartments.
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Wilcox, Christopher Richard James. "The development and implementation of a hip injury screening protocol within elite ice hockey." Thesis, University of Hull, 2015. http://hydra.hull.ac.uk/resources/hull:13607.
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The primary aim of this project was to both investigate injury epidemiology and create methods to potentially reduce injuries within elite ice hockey athletes. Chapter Four assessed the injury problem within ice hockey by retrospectively collecting data from two National Collegiate Athletic Association (NCAA) division III teams across a four year period investigating the prevalence, location, severity and type of injuries sustained. Findings showed that contact injuries were more prevalent (58%) than non-contact injuries (42%), with the knee (15%), shoulder (12%) and hip (13%) being the most frequently injured locations when both contact and non-contact injuries were combined. When investigating only non- contact injuries the hip complex (hip, groin and thigh) (50%) was by far the most injured location with similar frequencies, in terms of injury severity, observed. Chapter Five analysed intrinsic risk factors of the ice hockey athlete by investigating differences of hip range of motion (ROM), strength and functional tests between ice hockey athletes, soccer athletes and control participants. Results demonstrated that ice hockey athletes had significantly weaker hip adduction (p = 0.023) and flexion in sitting (p = 0.001) strength compared to soccer athletes and less external rotation strength compared to control participants (p = 0.010). Ice hockey athletes also displayed greater strength than control participants in flexion in sitting (p = 0.005). Ice hockey athletes exhibited greater ROM in abduction (p = 0.001) than control participants and greater adduction than both soccer athletes (p = 0.003) and control participants (p = 0.004). Ice hockey athletes exhibited less hip flexion in lying (p = 0.001) and external rotation (p < 0.001) when compared to control participants. Ice hockey athletes also presented with an increased number of positive flexion, abduction and external rotation (FABER) tests compared to both soccer athletes and control participants. Chapter Six investigated the effectiveness of the newly created hip screen by comparing ice hockey athletes with and without a previous non-contact hip injury and their performance during the hip screen. Findings demonstrated that athletes who had no previous hip injury had greater internal (p = 0.004) and external rotation ROM (p = 0.022) on the dominant (Dom) limb and greater flexion in sitting (p = 0.031) and internal rotation ROM (p = 0.050) on the non-dominant (Ndom) limb. Although non-significant, previously injured athletes also displayed less ROM in all hip movements compared to previously uninjured athletes. Similar trends were found in strength measures with previously uninjured athletes showing significantly stronger abduction (p = 0.012) on the Dom limb and flexion in lying on both the Dom (p = 0.008) and Ndom limb (p < 0.001). Previously injured athletes displayed more positive FABER (Dom; 13% vs. 0%, Ndom; 13% vs. 5%), Trendelenburg (Dom; 75% vs. 58%, Ndom; 50% vs. 5%) and Ober’s (Dom; 13% vs. 5%, Ndom; 75% vs. 68%) tests with higher scores on the overall screen than uninjured athletes. Chapter Seven investigated the intra and inter-tester reliability of the hip screen finding that intra-class correlation coefficients (ICC) of intra-tester reliability of the ROM (0.49), strength (0.80) and overall screen (0.76) was moderate to near perfect. Inter-tester reliability again showed very large ICCs for ROM (0.71), strength (0.77) and overall screen scores (0.81). The minimum criterion change (MCC) (3.78 points) was also found to be small for the screen score change needed to be viewed as clinically worthwhile. These findings demonstrate that the screening procedure developed is useful, reliable and repeatable when assessing the ice hockey athlete’s hip. Chapter Eight demonstrated that all participants regardless of group improved their ROM and strength measures following the intervention period. However, it was demonstrated that the ice hockey intervention (IHI) group saw a decrease in the amount of positive FABER tests following the intervention compared to ice hockey control (IHC) and intervention control (IC) group (IHI: pre 15 vs. post 6; IHC: pre 15 vs. post 14; IC: pre 10 vs. post 9). It was also demonstrated that the IHI group improved above the MCC value presented within Chapter Seven with regards to the overall hip injury screen score (pre 48 vs. post 52) indicating that ice hockey athletes who participated in the intervention programme may be at a decreased risk of sustaining a non-contact hip injury due to the intervention exercises targeting weaknesses highlighted in the hip injury screen. In summary, the current project achieved the stated aims by demonstrating that the hip complex was the most common location for injuries of a non-contact nature and the creation of a reliable and repeatable hip injury screen that allows clinicians to potentially highlight athletes considered as ‘at risk’. To complete the injury prevention sequence, future work would be necessary to track athletes who scored low on the hip injury screen over time either following the intervention or as a control to assess if they were more or less likely to sustain a non-contact hip injury. Future work should also continue to optimise the intervention strategy to further develop and enhance its effectiveness in the prevention of non-contact hip injuries. This could be achieved either through a longer protocol that is incorporated into routine training or individualisation of the programme and as such provide a valuable tool for clinicians and medical teams wishing to reduce the risk of ice hockey athletes sustaining a non-contact hip injury.
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Reynolds, Abby Mae. "The Relationship of Static and Dynamic Hip Muscle Activation on Running Related Injury Rates in Recreational Runners." Thesis, North Dakota State University, 2016. https://hdl.handle.net/10365/28015.
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Running has become an increasingly popular sport and research is necessary to examine the variables associated with running related injury. The purpose of this study was to analyze the overall relationship between static and dynamic hip strength and the rate of running related lower limb injuries in recreational runners. In addition, gender differences in hip muscle activation were analyzed. Surface electromyography was used to quantify static and dynamic hip muscle activation. Statistically significant decreases in muscle activation were observed in the one-mile testing period in both genders. Significant differences in muscle activation were present between genders. Although there was no statistically significant differences in muscle activation between injured and uninjured runners, the trends reported can help guide future researchers. As the running population continues to increase, number of running related injuries will follow. This research has provided evidence for allied health care providers to base future running related injury evaluations.Mark Knutson with the Fargo Marathon and the Post-Professional Athletic Training program at North Dakota State University
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Harrison, Kathryn. "THE INFLUENCE OF TRAINING ON KINEMATICS RELATED TO KNEE INJURY IN NOVICE RUNNERS." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/6076.
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Running is known to provide important health benefits. However, the incidence of injury among runners is high, particularly among novice runners, which discourages long term participation in the sport. The knee is the most commonly injured joint in novice runners. In general, aberrant frontal and transverse plane kinematics are associated with the development of knee injuries in runners. It was unknown whether the high rate of knee injury in novice runners was due to abnormal kinematics. Further, it was unclear whether these risk factors for injury could be improved. This dissertation includes four studies investigating kinematics in novice runners, how they change with training and evaluation of a running assessment. The first study compared frontal and transverse plane kinematics of female novice and experienced runners. Novice runners displayed more knee kinematics associated with injury than experienced runners, which may contribute to their higher risk of injury. The second study investigated the effects of two different training programs on kinematics of novice runners: one program consisted of 8 weeks of walking followed by 8 weeks of running, the other consisted of 8 weeks of strength/plyometric training followed by 8 weeks of running. Results demonstrated that training produced small changes in kinematics, however all types of training produced a mix of beneficial and detrimental effects. Participants who completed the study displayed better knee kinematics 8 than those who dropped out, which may have influenced their ability to complete the program. The third study sought to investigate changes in coordination of the hip and ankle joints, and their contributions to knee joint angles thought to contribute to injury. Results demonstrated that both the hip and the ankle may influence changes in knee kinematics, however the relative motion of the hip and the ankle appears to remain stable with training. In the final study, we investigated the reliability and validity of the Running Readiness Scale (RRS), as a low cost assessment of kinematics related to injury in runners. The RRS demonstrated good inter and intra rater reliability. Further, the RRS appeared to effectively discriminate between runners according to knee abduction, but not knee internal rotation.
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Peel, Nancye M. "The protective effect of healthy ageing on the risk of fall-related hip fracture injury in older people /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19388.pdf.
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Dall, Philippa Margaret. "The function of orthotic hip and knee joints during gait for individuals with thoracic level spinal cord injury." Thesis, University of Strathclyde, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.401337.
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Kinder, Jessica Marie. "The Relationship of Hip Muscle Activation and the Incidence of Shoulder Injury in Collegiate Women's Volleyball Athletes: A Pilot Study." Thesis, North Dakota State University, 2018. https://hdl.handle.net/10365/28776.
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Previous studies have indicated weak hip muscle activation in baseball pitchers leads to an increased incidence of shoulder injuries. This relationship, however, has not been explored in other overhead athletes, such as volleyball players. Surface electromyography (EMG) was used to evaluate each participant?s muscle activation during five dynamic activities. Dynamic activity was normalized according to MMTs for the rectus femoris, biceps femoris, gluteus maximus, and gluteus medius. The GMed during the eccentric box jump was statistically significant for position where setters showed the greatest activation and defensive players the least. The GMax during the single-leg deadlift was statistically significant for position where setters showed the greatest activation and defensive players the least. The hamstring showed statistically significant activation during the eccentric box jump where defensive players showed the highest activation and setters the least. The results should serve as a pilot study for future research due to the limited population.
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Olsson, Anna. "Prevention av ljumsksmärta hos herrfotbollsspelare - en möjlighet med enkla medel? : En kvantitav studie i 14 herrfotbollslag." Thesis, Linnéuniversitetet, Institutionen för idrottsvetenskap (ID), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-35912.
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Bakgrund: Ljumskskador, ljumsk- och höftsmärta hos fotbollsspelare har oftast samband med minskat rörelseomfång i höfter, svaghet i bål och höftmuskulatur. Risk för ljumsksmärta ökar hos idrottare som inte tränar skadepreventivt. Syfte: Att undersöka om ett preventionsprogram med sex övningar för styrka och rörlighet kan minska förekomsten av ljumsksmärta hos herrfotbollsspelare. Material och metod: En kvantitativ experimentell fallstudie med kontrollgrupp, som utfördes med 14 herrfotbollslag (7 lag interventionsgrupp, 7 lag kontrollgrupp). I studien deltog 514 manliga fotbollspelare i åldern mellan 15-47 år. Resultat: I interventionsgruppen som genomförde ett preventionsprogram var antalet spelare med ljumsksmärta oförändrat, medan antalet deltagare med ljumsksmärta i kontrollgruppen ökade. Konklusion: Ett preventionsprogram med övningar för styrka och rörlighet kan förebygga förekomst av ljumsksmärta hos herrfotbollsspelare. Nyckelord: Fotboll, prevention, ljumskskada, ljumsksmärta, höftsmärtaBackground:Groin injuries, groin pain and hip pain for soccer players are often associated with decreased range of motion (ROM) in the hip, weakness in abdominal muscles and poor hip muscles. The risk of groinpain increases for athletes who do not practice any preventing exercises. Objective:To research if an injury prevention program with six exercises for strength and mobility has any effect on groin pain and hip pain for male soccer players. Measures and Methods: Quantitative experimental study with control group. 14 male soccer teams participated (7 teams in intervention group, 7 teams in control group). In the study 514 male soccer players participated, in the age of 15-47 years. Result: In the intervention group who practiced the prevention program did not the number of players with groinpain increased, compared with the control group where the numbers of players with grioinpain increased. Conclusion: An injury prevention program for male soccer players with exercises for strength and mobility could prevent increase of groinpain among male soccer players. Keywords: Soccer, prevention, groin injury, groin pain, hip pain
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Chang, Sarah Randall. "A Comprehensive Strategy for Controlling the Hip and Knee with a Muscle-Driven Exoskeleton for Mobility after Paraplegia." Case Western Reserve University School of Graduate Studies / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=case1481151499958917.
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Hopkins, Susan Jane. "Disuse osteopenia : the short- and long-term effects of post-traumatic and post-surgical immobilisation following lower limb injury or total knee replacement." Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/13721.
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Low trauma hip fractures, due to bone fragility, are a major healthcare burden with serious consequences for individuals in terms of long-term morbidity and mortality; and also for society due to the high medical and care costs associated with these injuries. Because of the association with low bone mass, these fractures are particularly prevalent in elderly populations and are likely to become more common as longevity increases globally. Avoidance of these fractures is therefore an extremely important goal. Low bone mass, manifested in the conditions of osteopenia and osteoporosis, is the primary cause of bone fragility, and reductions in bone mass are the inevitable corollary of aging and menopause. Bone loss may be exacerbated by immobilisation and reduced weight-bearing activity, giving rise to the condition of disuse osteopenia. Immobilisation may itself be the result of low trauma leg fragility fractures that potentially causes further bone density loss. If this loss occurs at the hip, there is an increased risk for hip fracture as a sequela to the original injury. Osteoarthritis is also a condition strongly associated with aging that may necessitate knee arthroplasty as a last stage treatment, potentially causing a period of reduced mobility and weight-bearing activity following surgery. Leg fracture and knee replacement both present additional risk factors for hip fracture due to changes in muscle mass, gait and postural stability that may increase the risk of falls. This study aims primarily to investigate the effects of immobilisation on leg fracture and knee replacement patients, immediately following injury or surgery, in order to quantify bone and muscle loss and to monitor recovery over a one year period. A postmenopausal population were studied as they are already losing bone density systemically and may be at greater risk of further bone loss following immobilisation. Factors of activity, function, weight-bearing, pain, treatments, therapies, health perceptions and mental wellbeing, that potentially contribute to bone loss and recovery, were also investigated. Results from the study may provide information relating to increased future hip fracture risk and lead to treatment options to alleviate bone loss in these groups.
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Hailer, Yasmin D. "Legg-Calvé-Perthes Disease – Is it just the hip? : Epidemiological, Clinical and Psychosocial Studies with special focus on Etiology." Doctoral thesis, Uppsala universitet, Ortopedi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-219158.
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The overall aim of the thesis was to add some pieces to the etiological puzzle of LCPD with special focus on vascular origin and hyperactivity. Furthermore we wanted to evaluate some consequences of LCPD in adulthood. Swedish registry data were used to identify a cohort of patients with the diagnosis of LCPD. This cohort was compared with a general population– based cohort without LCPD to assess the relative risk of cardiovascular diseases, blood or coagulation defects, injury, ADHD, depression and mortality. In a clinical study we assessed health-related quality of life (EQ-5D-3L), physical activity level (IPAQ) and screened for ADHD (ASRSv1.1) in 116 patients with a history of LCPD who were diagnosed or treated in Uppsala University Hospital between 1978 and 1995. The results confirmed our hypothesis: Patients with a history of LCPD had a 1.7-fold higher risk of cardiovascular diseases, and a 1.4-fold higher risk for blood or coagulation defects compared with gender- and age-matched individuals without LCPD. We found a 1.2-fold higher risk for injuries requiring hospital admission than in gender- and age-matched individuals without LCPD. The risk was more pronounced among females. Furthermore, we found a 1.5-fold higher risk for ADHD. Stratified analysis revealed a 2.1-fold higher risk for ADHD among females with LCPD than among females without LCPD. The risk for depression was 1.3-fold higher, and more pronounced among females with LCPD. Patients with LCPD had a slightly higher mortality risk with higher risk for death from suicide and cardiovascular causes. Patients with a history of LCPD reported a lower health-related quality of life and were more physically active than the Swedish population norm. 28% of 116 patients were likely to have ADHD or had already been diagnosed with ADHD. Both vascular and blood diseases could be present even in childhood and could, in combination with hyperactive behavior pattern and a high physical activity level, contribute to the etiology of LCPD. The lower health-related quality of life and higher risk for depression might reflect the mental burden of LCPD. Patients with LCPD have a higher mortality risk with higher risk for death from suicide and cardiovascular causes.
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Gustavsson, Johanna. "Fallolyckor och höftfrakturer i Svenska kommungrupper." Thesis, Karlstad University, Faculty of Social and Life Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-4647.
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Timms, Stephen Allan. "The 3D kinematics of the single leg flat and decline squat." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/53119/1/Stephen_Timms_Thesis.pdf.
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Background: Pre-participation screening is commonly used to measure and assess potential intrinsic injury risk. The single leg squat is one such clinical screening measure used to assess lumbopelvic stability and associated intrinsic injury risk. With the addition of a decline board, the single leg decline squat (SLDS) has been shown to reduce ankle dorsiflexion restrictions and allowed greater sagittal plane movement of the hip and knee. On this basis, the SLDS has been employed in the Cricket Australia physiotherapy screening protocols as a measure of lumbopelvic control in the place of the more traditional single leg flat squat (SLFS). Previous research has failed to demonstrate which squatting technique allows for a more comprehensive assessment of lumbopelvic stability. Tenuous links are drawn between kinematics and hip strength measures within the literature for the SLS. Formal evaluation of subjective screening methods has also been suggested within the literature.
Purpose: This study had several focal points namely 1) to compare the kinematic differences between the two single leg squatting conditions, primarily the five key kinematic variables fundamental to subjectively assess lumbopelvic stability; 2) determine the effect of ankle dorsiflexion range of motion has on squat kinematics in the two squat techniques; 3) examine the association between key kinematics and subjective physiotherapists’ assessment; and finally 4) explore the association between key kinematics and hip strength.
Methods: Nineteen (n=19) subjects performed five SLDS and five SLFS on each leg while being filmed by an 8 camera motion analysis system. Four hip strength measures (internal/external rotation and abd/adduction) and ankle dorsiflexion range of motion were measured using a hand held dynamometer and a goniometer respectively on 16 of these subjects. The same 16 participants were subjectively assessed by an experienced physiotherapist for lumbopelvic stability. Paired samples t-tests were performed on the five predetermined kinematic variables to assess the differences between squat conditions. A Bonferroni correction for multiple comparisons was used which adjusted the significance value to p = 0.005 for the paired t-tests. Linear regressions were used to assess the relationship between kinematics, ankle range of motion and hip strength measures. Bivariate correlations between hip strength measures and kinematics and pelvic obliquity were employed to investigate any possible relationships.
Results: 1) Significant kinematic differences between squats were observed in dominant (D) and non-dominant (ND) end of range hip external rotation (ND p = <0.001; D p = 0.004) and hip adduction kinematics (ND p = <0.001; D p = <0.001). With the mean angle, only the non-dominant leg observed significant differences in hip adduction (p = 0.001) and hip external rotation (p = <0.001); 2) Significant linear relationships were observed between clinical measures of ankle dorsiflexion and sagittal plane kinematic namely SLFS dominant ankle (p = 0.006; R2 = .429), SLFS non-dominant knee (p = 0.015; R2 = .352) and SLFS non-dominant ankle (p = 0.027; R2 = .305) kinematics. Only the dominant ankle (p = 0.020; R2 = .331) was found to have a relationship with the decline squat. 3) Strength measures had tenuous associations with the subjective assessments of lumbopelvic stability with no significant relationships being observed. 4) For the non-dominant leg, external rotation strength and abduction strength were found to be significantly correlated with hip rotation kinematics (Newtons r = 0.458 p = 0.049; Normalised for bodyweight: r = 0.469; p = 0.043) and pelvic obliquity (normalised for bodyweight: r = 0.498 p = 0.030) respectively for the SLFS only. No significant relationships were observed in the dominant leg for either squat condition. Some elements of the hip strength screening protocols had linear relationships with kinematics of the lower limb, particularly the sagittal plane movements of the knee and ankle. Strength measures had tenuous associations with the subjective assessments of lumbopelvic stability with no significant relationships being observed; Discussion: The key finding of this study illustrated that kinematic differences can occur at the hip without significant kinematic differences at the knee as a result of the introduction of a decline board. Further observations reinforce the role of limited ankle dorsiflexion range of motion on sagittal plane movement of the hip and knee and in turn multiplanar kinematics of the lower limb. The kinematic differences between conditions have clinical implications for screening protocols that employ frontal plane movement of the knee as a guide for femoral adduction and rotation. Subjects who returned stronger hip strength measurements also appeared to squat deeper as characterised by differences in sagittal plane kinematics of the knee and ankle. Despite the aforementioned findings, the relationship between hip strength and lower limb kinematics remains largely tenuous in the assessment of the lumbopelvic stability using the SLS. The association between kinematics and the subjective measures of lumbopelvic stability also remain tenuous between and within SLS screening protocols. More functional measures of hip strength are needed to further investigate these relationships.
Conclusion: The type of SLS (flat or decline) should be taken into account when screening for lumbopelvic stability. Changes to lower limb kinematics, especially around the hip and pelvis, were observed with the introduction of a decline board despite no difference in frontal plane knee movements. Differences in passive ankle dorsiflexion range of motion yielded variations in knee and ankle kinematics during a self-selected single leg squatting task. Clinical implications of removing posterior ankle restraints and using the knee as a guide to illustrate changes at the hip may result in inaccurate screening of lumbopelvic stability. The relationship between sagittal plane lower limb kinematics and hip strength may illustrate that self-selected squat depth may presumably be a useful predictor of the lumbopelvic stability. Further research in this area is required.
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Lopes, Junior Osmar Valadão. "Avaliação da articulação coxofemoral ipsilateral em indivíduos do sexo masculino com ruptura do ligamento cruzado anterior com e sem contato físico." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/88429.
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Objetivo: Avaliar a amplitude de movimento (ADM) do quadril em pacientes que sofreram lesão do ligamento cruzado anterior (LCA), por traumatismo direto, e compará-la a de pacientes com a lesão por entorse sem contato físico sobre o joelho. Fazer uma análise radiográfica do quadril dos indivíduos avaliados. Método: A ADM do quadril foi avaliada em 35 pacientes com lesão do LCA ocorrida por traumatismo direto (grupo com contato) e comparada a de 45 pacientes que sofreram a lesão por entorse do joelho sem contato físico (grupo sem contato). A amplitude rotacional do quadril também foi avaliada segundo os pontos de corte de 70° e 80°. Exames radiográficos do quadril foram realizados para avaliar a presença de deformidade tipo cam e tipo pincer. Resultados: A ADM do quadril foi estatisticamente superior nos pacientes do grupo com contato. Os pacientes do grupo sem contato tiveram uma amplitude rotacional do quadril de 66,1° ± 8,4° comparada a 79,4° ± 10,6° do grupo com contato (p<0,001). Dos pacientes do grupo sem contato, 77,8% e 93,3% tiveram uma amplitude de rotação do quadril menor do que 70° e 80°, respectivamente, comparada a 17,1% e 42,9% do grupo com contato (p<0,001). Não houve diferença na prevalência de deformidade tipo cam ou pincer entre os grupos. A prevalência de cam e pincer não foi maior nos pacientes com limitação da amplitude de movimento. Conclusão: Na amostra avaliada, os pacientes com lesão do LCA ocorrida por entorse do joelho sem contato físico tiveram menor amplitude de movimento do quadril do que pacientes vítimas da lesão do LCA por traumatismo direto. A presença de deformidade tipo cam ou pincer foi semelhente em ambos os grupos e não esteve relacionada a uma diminuição da amplitude de movimento do quadril.Objective: To evaluate the range of motion (ROM) of the hip in patients who suffered contact anterior cruciate ligament (ACL) injury and compare it to patients with non-contact ACL injury. To performe a hip radiographic analysis of all subjects included. Method: ROM of the hip was evaluated in 35 patients with contact ACL injury (contact group) and compared to that of 45 patients who suffered a non-contact ACL injury (non-contact group). The sum of hip rotation (IR+ER) was also assessed according to the cutoff points of 70° and 80°. Radiographic hip were performed to assess the presence of deformity cam and pincer type. Results: ROM of the hip was statistically higher in the patients with contact ACL injury. The average sum of hip rotation was 66.1° ± 8.4° in non-contact group compared to 79.4° ± 10.6° in contact group (p<0.001). Seventy-seven percent of patients in non-contact group had a sum of hip rotation less than 70° and 93% had less than 80°, repectivally, compared to 17.1% and 42.9% in the contact group (p<0.001). The prevalence of cam or pincer deformity was similar between groups. Cam or pincer deformity was not more frequent in patients with limited range of motion of the hip. Conclusion: In our study, patients with contact ACL injury had greater range of motion of the hip than patients that suffered non-contact ACL injury. The presence of deformity cam or pincer was similar in both groups and was not related to a decreased range of motion of the hip.
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Corletto, Federico. "Role of the HIF system in brain injury." Thesis, University of Cambridge, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.609260.
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MacDuff, Andrew. "Role of myeloid Hif-1α in acute lung injury." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/5581.
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Acute Lung Injury, characterised clinically as the Acute Respiratory Distress Syndrome is a catastrophic response to a range of pulmonary and non-pulmonary insults. Despite much work the key mechanisms involved in generating the exaggerated immune response that results in lung injury are not completely understood. Hypoxia-inducible factor-1 has been shown to be a key transcription factor in the myeloid cell response to inflammatory signals. The aims of this thesis were to develop a model of acute lung injury and to study the role of Hif-1 in the generation of lung injury in this model. A model of direct pulmonary injury as a result of intratracheal instillation of endotoxin is described. Using this model the role of myeloid cell Hif-1α was characterised using a myeloid cell specific conditional knockout system. The injury in Hif-1α deficient mice was quantitatively similar to the injury seen in wild type animals over a range of time points. However, the quality of the injury, assessed by a measure of nitric oxide mediated damage was reduced. The in vivo data were supported by in vitro studies using a murine macrophage cell line which showed that manipulation of the cellular oxygen tension in the presence of endotoxin alters the ability of the cell to generate nitric oxide. Furthermore, pharmacological manipulation of cellular Hif-1 levels by Dimethyloxallyl Glycine (DMOG) in the macrophage cell increased the generation of nitric oxide in response to endotoxin by altering the expression of a number of the isoforms of Nitric Oxide Synthase. In a final set of experiments the response to intratracheal endotoxin was modulated in mice by the concurrent administration of DMOG. As expected the qualitative response to endotoxin was similar but the NO mediated damage was enhanced in the animals administered DMOG. Manipulation of Hif-1 may have a role in the therapy of lung injury by altering the characteristics of the response.
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Van, den Berg Julie. "Healing and functional outcomes after obstetric anal sphincter injury in HIV positive vs HIV negative patients." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/3055.
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Includes abstract.Includes bibliographical references (leaves 64-71).
Aim: To determine whether HIV-positive patients have a longer time to healing, more complications and poorer functional outcomes after Obstetric Anal Sphincter Injury (OASI) than an HIV-negative control group.
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Huebenthal, Jan. "Injury & Resistance: Centering HIV/AIDS Histories in Times of Queer Equality." W&M ScholarWorks, 2019. https://scholarworks.wm.edu/etd/1563898925.
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Using methods of critical queer genealogy and discourse analysis, Injury & Resistance historicizes the HIV/AIDS epidemic through four lenses—activism, criminalization, memory, and “post-AIDS” queer health—in national and transnational U.S. locales from 1987 to the present. Unlike in the 1980s, when white middle-class gay men were the most visible demographic of what was known as the “gay plague,” today’s American AIDS epidemic is becoming more and more racialized. And unlike 30 years ago, HIV today is a chronic condition that is effectively treatable with antiretroviral drug regimens. Concurrent with the medical survivability of HIV/AIDS, queer Americans have won legal rights to marry, serve openly in the military, and adopt and raise children. Meanwhile, however, for many the AIDS crisis has remained just that: a crisis. If current patterns persist, today one in two African American gay men will become HIV-positive within his lifetime—amidst a healthcare landscape in which racial, regional, and socioeconomic disparities abound. To date, little scholarly work has attended to how the epidemic’s American histories, having fueled an LGBT politics of individual “equality,” have in fact produced these stark simultaneities in which HIV is a chronic reality for some but has remained an emergency for others. Indebted to Michel Foucault, Injury & Resistance historicizes this evolution through a queer “history of the present” that explores the non-linear and asynchronous motions between and among AIDS past and HIV present. In the absence of a multitemporal critique, I argue, we risk ceding the urgency of HIV/AIDS to the past and preclude confronting what is an ongoing public health epidemic. Sources include oral histories from the ACT UP Oral History Project, memoirs of survival, activist photography, medical science statistics and publications, public health campaigns, newspaper records, and documentary film, as well as archival holdings from the Smithsonian National Archive Center, the Archiv der Sozialen Bewegungen (Archive of Social Movements) in Hamburg, Germany, the Special Collections at the James Branch Cabell Library at Virginia Commonwealth University (VCU), and the New York Public Library, among others. This diverse body of sources re-contextualizes national and transnational U.S. AIDS histories that anticipate an ongoing crisis with peculiar dualities: yesterday yet today, ghostly yet present, and acute yet chronic. Arranged loosely from past to present, the four chapters and epilogue present evidence, readings, theories, and speculations, listening for past and present echoes of HIV/AIDS histories that reverberate in experiential chasms between injury and resistance. Chapters present a critical genealogy of feminist activism in the New York chapter of the AIDS Coalition to Unleash Power (ACT UP) from 1987 to 1993, explore a 1987 West German court case against African American ex-soldier Linwood Boyette for alleged HIV transmission, trace Derridean hauntology and queer temporalities in two AIDS memoirs and the National AIDS Memorial Grove, place narratives of “post-AIDS” queer health in relation to neoliberal LGBT rights politics, and consider Uganda’s 2011 “Kill the Gays Bill” as a transcultural circulation of U.S. anti-queer affect and violence. Throughout, this dissertation insists that the ongoing HIV/AIDS crisis, with its rich histories of resistance and dissent, must again become cornerstones of contemporary queer culture and politics.
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Weir, Angela E. "Changing lives, the impact of a child's brain injury on his/her siblings." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0020/MQ47155.pdf.
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Esteve, Caupena Ernest. "Groin problems in male football: beyond the time-loss approach." Doctoral thesis, Universitat de Girona, 2020. http://hdl.handle.net/10803/671198.
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This Thesis aimed at studying the prevalence and severity and broadening the knowledge of aetiology and risk factors of groin injuries in male football. The four papers, which form part of this Thesis, are based on the same research project conducted on a cohort of amateur players from 17 Spanish teams. Variables such as information about groin pain in the previous season, pre-season short- and long-lever hip adductor squeeze strength, together with demographic and anthropometric data were collected at pre-season. Hip- and groin-related sporting function was registered at baseline, and every fourth week during the in-season, using the Sport and Recreation subscale from The Copenhagen Hip and Groin Outcome Score (HAGOS (Sport)) questionnaire. Time-loss groin injuries, registered by the team physiotherapist, in addition to self-reported groin pain, irrespective of time loss, were registered over 44 weeks to document all groin problems, and groin problems with and without time lossAquesta Tesi va tenir com a objectiu l'estudi de la prevalença i la severitat, i l’exemplar coneixement sobre l’etiologia i factors de risc de les lesions de l'engonal en futbolistes. Els quatre articles que formen la tesi estan basats en el mateix projecte de recerca, conduit en una cohort de futbolistes amateurs Espanyols. El dolor inguinal en la temporada passada, la força d'adductors, juntament amb dades demogràfiques i antropomètriques es van recollir a la pre-temporada. La funció esportiva relacionada amb el maluc i l'engonal es va registrar a l'inici de l'estudi i també durant la temporada cada quatre setmanes utilitzant el qüestionari Hip And Groin Outcome Score (HAGOS). Les lesions de l'engonal amb "time-loss", registrades pels fisioterapeutes dels equips, el dolor de l'engonal autoreportat i irrespectiu de "time-loss" es van registrar durant 44 setmanes per documentar tots els problemes de l'engonal, i problemes amb i sense "time-loss"
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Davis, Laurie Michelle Helene. "THE UNDERLYING MECHANISM(S) OF FASTING INDUCED NEUROPROTECTION AFTER MODERATE TRAUMATIC BRAIN INJURY." UKnowledge, 2008. http://uknowledge.uky.edu/gradschool_diss/673.
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Traumatic brain injury (TBI) is becoming a national epidemic, as it accounts for 1.5 million cases each year. This disorder affects primarily the young population and elderly. Currently, there is no treatment for TBI, which means that ~2% of the U.S. population is currently living with prolonged neurological damage and dysfunction. Recently, there have been many studies showing that TBI negatively impacts mitochondrial function. It has been proposed that in order to save the cell from destruction mitochondrial function must be preserved. The ketogenic diet, originally designed to mimic fasting physiology, is effective in treating epilepsy. Therefore, we have used fasting as a post injury treatment and attempted to elucidate its underlying mechanism. 24 hours of fasting after a moderate TBI increased tissue sparing, cognitive recovery, improved mitochondrial function, and decreased mitochondrial biomarkers of injury. Fasting results in hypoglycemia, the production of ketones, and the upregulation of free fatty acids (FFA). As such, we investigated the neuroprotective effect of hypoglycemia in the absence of fasting through insulin administration. Insulin administration was not neuroprotective and increased mortality in some treatment groups. However, ketone administration resulted in increased tissue sparing. Also, reduced reactive oxygen species (ROS) production, increased the efficiency of NADH utilization, and increased respiratory function. FFAs and uncoupling proteins (UCP) have been implicated in an endogenously regulated anti-ROS mechanism. FFAs of various chain lengths and saturation were screened for their ability to activate UCP mediated mitochondrial respiration and attenuate ROS production. We also measured FFA levels in serum, brain, and CSF after a 24 hour fast. We also used UCP2 transgenic overexpressing and knockout mice in our CCI injury model, which showed UCP2 overexpression increased tissue sparing, however UCP2 deficient mice did not show a decrease in tissue sparing, compared with their wild type littermates. Together our results indicate that post injury initiated fasting is neuroprotective and that this treatment is able to preserve mitochondrial function. Our work also indicates ketones and UCPs may be working together to preserve mitochondrial and cellular function in a concerted mechanism, and that this cooperative system is the underlying mechanism of fasting induced neuroprotection.
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Kerrigan, Michael V. "Evaluation of advanced materials to protect against fall-related head injuries." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0003103.
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Pukenytė, Evelina. "Veiksniai, sąlygojantys vaistų nuo tuberkuliozės sukeliamą kepenų pažeidimą, gydant živ infekuotus ir neinfekuotus aktyvia tuberkulioze sergančius pacientus." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2007~D_20080129_145950-51261.
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Bendros nuomonės vertinant rizikos veiksnius, sąlygojančius kepenų pažeidimą gydant vaistais nuo tuberkuliozės ŽIV infekuotus ir neinfekuotus pacientus, sergančius tuberkulioze, nėra. ŽIV infekcijos įtaka šiam pažeidimui atsirastinėra išaiškinta. Daugelis darbų atlikta su nedideliu ŽIV infekuotų pacientų skaičiumi ir gauti rezultatai yra skirtingi. Darbo tikslas Nustatyti rizikos veiksnius, sąlygojančius sunkaus kepenų pažeidimo atsiradimą gydant vaistais nuo tuberkuliozės pirmus du tuberkuliozės gydymo mėnesius ŽIV infekuotus ir neinfekuotus ligonius, sergančius aktyvia tuberkulioze, taip pat nustatyti šio pažeidimo pasireiškimo dažnį bei pažeidimo atsiradimo laiką. Darbo uždaviniai 1. Išnagrinėti tuberkulioze sergančių bei gydomų nuo tuberkuliozės ligonių demografines, klinikines ypatybes bei kai kurių laboratorinių tyrimų duomenis tuberkuliozės gydymo pradžioje. 2. Nustatyti bei palyginti kepenų pažeidimo pasireiškimo dažnį bei atsiradimo laiką gydant vaistais nuo tuberkuliozės ŽIV infekuotus ir neinfekuotus pacientus. 3. Nustatyti ir palyginti demografinius, laboratorinius ir klinikinius rizikos veiksnius, galinčius turėti įtakos sunkiam kepenų pažeidimui atsirasti gydant vaistais nuo tuberkuliozės pirmus du tuberkuliozės gydymo mėnesius ŽIV infekuotus ir neinfekuotus ligonius. 4. Nustatyti vaistų, kurie pradėti vartoti kartu su per pirmą savaitę paskirtais vaistais nuo tuberkuliozės, įtaką kepenų pažeidimui atsirasti.Although there are many hepatotoxicity risk factors describe for patients on antituberculosis therapy. However, the risk factors for liver injury and its occurence during this antituberculosis therapy have been assessed in HIV non-infected patients, they have rarely been assessed in HIV-infected patients, especially those treated for active tuberculosis. Most studies with HIV-infected patients on antituberculosis therapy have been carried out with a small amount of HIV-infected patients and results received are different. Aims and objectives The aim of this study is therefore to evaluate the incidence of severe liver injury in HIV-infected and non-infected patients on antituberculosis therapy, the time to its occurrence, and the clinical, biological and therapeutic risk factors for this injury. The objectives were as follows: 1. To investigate into demographic, clinical particularities and laboratory data of patients on antituberculosis treatment. 2. To define and compare the incidence of severe liver injury as well as the time of these occurrence in HIV-infected and non-infected patients on antituberculosis treatment. 3. To define and compare demographic, biological and clinical risk factors for severe liver injury in HIV-infected and non-infected patients on antituberculosis treatment within the first two month of this therapy. 4. To define the impact on liver injury occurrence of medications used in the first week of the tuberculosis treatment.
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Kieser-Muller, Christel. "Needle stick injury and the personal experience of health care workers." Diss., Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-01302006-144425.
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Hamborg, Inger Helene. "High-level mobility in adults with traumatic brain injury and adults bom with very low birth weight." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for bevegelsesvitenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-17484.
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Background and aim: Persons sustaining different types of brain injury may experience difficulties with advanced mobility. Both persons with traumatic brain injury (TBI) and persons born with very low birth weight (VLBW) have similar brain abnormalities, such as reduced white matter and connectivity, and may thus experience similar mobility problems. However, few studies have assessed advanced motor abilities, and none have compared mobility functions in adult TBI and VLBW populations. Our aim was to investigate high level mobility functions in adults with TBI and VLBW adults compared to matched controls, and to compare high-level mobility in TBI and VLBW adults. Methods: Participants consisted of 22 subjects (mean age 22.9 ± 2.0 yrs) with chronic traumatic brain injury, and 35 subjects (mean age 22.5 ± 0.7 yrs) born preterm with birth weight (below 1500 grams). Two TBI participants were not able to complete all test items due to pain. The VLBW group included three subjects with cerebral palsy (CP). Each group was matched with its own control group, consisting of 24 subjects each from the same geographical area matched by age and sex. Mean age in the control group was 23.3 ± 1.8 yrs for TBI and 22.8 ± 0.5 yrs for VLBW. Advanced mobility functions were assessed by the High-level Mobility Assessment Tool (HiMAT), which consists of 13 timed mobility tasks, with a maximum total HiMAT score of 54. Results: Mean total HiMAT score in the TBI group was 47.0 ± 7.7 compared to 50.3 ± 3.9 for the controls (U=193, p=0.116). Three of 13 mobility tasks differed significantly from the control group: ‘walking’, ‘walk over obstacle’ and ‘bound non-affected leg’. When the two subjects who reported pain were excluded from the analysis, mean total HiMAT score was 48.9 ± 4.9 (U=193, p=0.264), with ‘walking’ and ‘walk over obstacle’ remaining significantly different from the control group. In the TBI group, nine (40.9%) participants performed at or below the 5th percentile compared to 6 (25%) of the TBI controls. Mean total HiMAT score in the VLBW group was 45.1 ± 7.8 compared to 49.9 ± 3.5 in its control group (U = 256, p=0.011). Five of the 13 mobility task scores were significantly different from the control group: ‘walking backwards’, ‘running’, ‘hop affected leg’, ‘bound affected leg’, and ‘bound non-affected leg’. When the three subjects with CP were excluded, mean total HiMAT score was 46.8 ± 5.5 in the VLBW group (U=256, p=0.033) and three mobility task scores remained significantly different from the controls: ‘walking backwards’, ‘hop affected leg’ and ‘bound non-affected leg’. In the VLBW group, 17 (48.6%) participants performed at or below the 5th percentile compared to 4 (16.7%) of the VLBW controls. When directly compared to the VLBW group, the TBI group had (OR 0.733, CI 0.249 – 2.154) lower risk for performing at or below the 5th percentile, although not significant. Conclusions: Compared to controls, adults with TBI had reduced high-level mobility in specific tasks. Adults born with VLBW had reduced overall high level mobility. Furthermore, the HiMAT seems to be a valuable tool for assessing high-level mobility in VLBW populations, and should be formally tested for further use. Keywords: High-level mobility, high-level mobility assessment tool, traumatic brain injury, very low birth weight
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Bartsch, Adam Jesse. "Biomechanical Engineering Analyses of Head and Spine Impact Injury Risk via Experimentation and Computational Simulation." Case Western Reserve University School of Graduate Studies / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=case1291318455.
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Cirera, Eva. "Evolució de les lesions en la gent gran. Espanya 2000-2010." Doctoral thesis, Universitat Pompeu Fabra, 2014. http://hdl.handle.net/10803/294997.
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Les lesions traumàtiques en la gent gran són un problema de salut
pública important, donat que són una de les principals causes de
morbiditat en aquest col·lectiu. L’estudi de la incidència de lesions en
la gent gran i la seva evolució ofereix una visió parcel·lada de la
situació, ja que en la majoria de casos les dades que es mostren es
redueixen a un únic mecanisme - com per exemple l’evolució de les
lesions per caigudes -, o a lesions en concret - com les fractures de
maluc -, o d’una certa gravetat – com l’estudi de les lesions que han
requerit ingrés hospitalari.
Es plantegen com objectius d’aquesta tesi estimar la incidència
hospitalària de lesions traumàtiques en la gent gran a Espanya, segons
sexe i grup d’edat, així com en els diferents grups de gravetat i tipus
de mecanisme, identificar les lesions més habituals en les persones
grans i analitzar l’evolució de la incidència calculada en cada cas al
llarg d’onze anys.
S’ha portat a terme un estudi descriptiu. Depenent dels objectius el
disseny utilitzat ha estat transversal o de tendències. La població
d’estudi son les persones majors de 64 anys residents a Espanya
durant el període 2000-2010.
Les taxes d’incidència hospitalària s’han calculat a partir de les altes
hospitalàries del Conjunt Mínim Bàsic de Dades Hospitalàries
(CMBDH) del Ministerio de Sanidad, Políticas Sociales e Igualdad i de
les dades del Padró Municipal d’Habitants del Instituto Nacional de
Estadística. Els casos són residents majors de 64 anys amb diagnòstic
principal de lesió traumàtica. L‘evolució de la incidència s’ha analitzat
utilitzant models lineals generalitzats assumint distribució de Poisson i
funció d’enllaç logaritme per a cada una de les variables depenents i
s’ha ajustat per sobredispersió. S’ha calculat el Percentatge Anual de
Canvi (APC) de la taxa a partir de l’estimació del risc relatiu (RR)
anual de lesió i el seu interval de confiança al 95%.
La incidència hospitalària de lesió traumàtica és superior en dones que
en homes i augmenta amb la edat. En els últims anys s’observa una
tendència a l’augment de la incidència, sobretot a partir dels 75-80
anys (grans-grans). Aquest augment és més ràpid en les persones de
més edat. En les lesions per col·lisió de trànsit és en l’únic cas en què
s’observa un descens. Les lesions més habituals continuen sent les
fractures de maluc, per bé que en el cas de les dones de menys de 75
anys (grans-joves) la incidència hospitalària ha mostrat un descens
important, i en el cas dels homes fins a aquesta edat s’ha mostrat
estable al llarg del període. L’efecte d’aquest descens s’ha vist
contrabalançat per l’augment important de lesions com els
traumatismes cranioencefàlics i les fractures en les extremitats
superiors que, tot i de magnitud força menor que les fractures de
maluc, han mostrat augments importants al llarg del període.
Els resultats d’aquesta tesi porten a identificar dos grans grups dins
del col·lectiu de les persones grans, els grans-joves (fins als 75-80
anys) i els grans-grans (a partir d’aquesta edat).
Tot i que les fractures de maluc són la lesió amb més presència en tots
els grups d’edat, el descens de la incidència en les dones grans-joves
conjuntament amb l’increment de les fractures d’extremitats superiors
i dels traumatismes cranioencefàlics porta a que en aquest grup les
fractures de maluc perdin protagonisme. En el cas dels grans-grans,
l’increment de la incidència de lesió traumàtica s’afegeix al creixement
poblacional que està experimentant aquest grup d’edat en els últims
anys. Aquest doble increment porta a que cada vegada siguin més, en
termes absoluts, el nombre de persones grans-grans a tractar a nivell
hospitalari. Alhora, també suposa un augment de la demanada de
serveis posteriors per tal que la persona lesionada pugui assolir el
màxim nivell d’autonomia després de la lesió que li permeti gaudir
d’un envelliment actiu.Traumatic injuries in older people are a major public health problem, since they are one of the leading causes of morbidity in this age group. Studies of the incidence of injury and it trends among older people provide only a partial insight into the situation, since in most cases the data are limited to a single injury mechanism, such as the evolution of fall-related injuries, to specific injury types, such as hip fractures, or to injuries of a certain severity, such as those requiring hospitalization. The objectives of this thesis are to estimate the incidence of traumatic injuries among elderly individuals that were attended at hospitals in Spain, stratified by sex and age, as well as by severity and mechanism of injury. We also identify the most common injuries in older people, and finally analyse the evolution of their incidence over a period of eleven years. We conducted a descriptive study, using a cross-sectional or longitudinal design, depending on the objectives. The population study consists of individuals over 64 years of age who were resident in Spain between 2000 and 2010. Incidence rates were calculated using data provided by the National Hospital Discharge Register (NHDR) from the Spanish Institute of Health Information (Ministerio de Sanidad, Servicios Sociales e Igualdad), and the National Institute of Statistics. Cases were Spanish residents older than 64 years discharged from a Spanish hospital with a primary diagnosis of traumatic injury. Incidence trends were analysed using generalized linear models, assuming Poisson distribution and log link function for each dependent variable, and adjusting for overdispersion. The Annual Percent Change (APC) of the rate is computed from the estimated relative risk (RR) and its 95% confidence interval. The incidence of traumatic injuries attended at hospital is higher among women than men, and increases with age. A positive trend in incidence has been observed in recent years, especially in individuals over 75-80 years of age, and this increase is accentuated by age. Traffic injuries are the only injury type in which we observe a decline. Hip fractures are still the most common injury type, although in the case of individuals under 75 years, their incidence decreased significantly in women and remained stable in men throughout the study period. The effect of this decline has been counterbalanced by an increase in the incidence of other types of injury such as head injuries and fractures in the upper extremities. The results of this thesis allow us to identify two large groups within the population of older people, the elderly (up to 75-80 years) and the super-elderly (from this age onward). While hip fractures remain the most common injury type in all age groups, their decrease in incidence among elderly women along with the increase in frequency of fractures of the upper extremities and of traumatic brain injuries means that hip fractures are losing importance in this age group. In the case of super-elderly individuals, the increase
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Lloyd, Jacobus. "Behavioural and protective factors contributing to the risk and vulnerability to HIV/AIDS among individuals with spinal cord injuries in South Africa." University of the Western Cape, 2019. http://hdl.handle.net/11394/7025.
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Philosophiae Doctor - PhDHIV/AIDS has made a huge impact on human development and sexual reproductive habits in this century in the world and especially in sub-Saharan Africa. It has only recently been acknowledged that HIV/AIDS has an equal if not greater effect on or threat to people with disabilities. Survivors of traumatic spinal cord injury (TSCI) with resultant disability are incorrectly believed to be sexually inactive, unlikely to use drugs or alcohol and at less risk of violence or rape than their non-disabled peers. This group can thus be described as economically, educationally and socially disadvantaged, which in itself, suggest that they are a high-risk group for HIV infection. The overall aim of this study is to examine the factors that could contribute to the risk and vulnerability to HIV/AIDS among individuals with spinal cord injuries in South Africa. The specific objectives of the study are to assess the behavioral and protective factors that could contribute to risk and vulnerability to HIV infection among individuals and spinal cord injuries; and to explore the socio-cultural issues that might increase individuals with spinal cord injuries’ vulnerability to HIV/AIDS. The design of this study was a mixed methods design, particularly the sequential explanatory strategy was used will used in this study. The study was conducted in four (4) conveniently selected provinces (highest prevalence of SCI). The Quad-Para Association of South Africa’s (QASA) provincial databases was used to invite individuals with SCI to participate in the study. Data for quantitative part of the study was collected by means of self-administered questionnaires. The questionnaire consisted of various sections requesting for information on: Demographics; HIV-Knowledge (HIV- KQ-18); Sexual behaviours; Sexual communication and negotiation skills; Self-efficacy to refuse sex. Separate binary logistics analysis was done to assess which of the selected factors are associated with risky sexual behaviour. The forced entry method approach was used to determine which of these factors have the greatest productive power to predict sexual risk behaviour. No “a priori” sample size was developed for the qualitative part, but participants were recruited until saturation has been reached of all the categories. Consenting participants were visited by the researcher for data collection in the environment indicated by the participant. Permission to conduct the study was obtained from the Research Ethics Committee at the University of the Western Cape (UWC). The study was conducted according to ethical practices pertaining to the study of human subjects as specified by the UWC and Faculty of Community and Health Sciences Research Ethics Committee of the UWC.
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Anjos, Carlos Frederico Dantas. "Ventilação mecânica não invasiva com pressão positiva em vias aéreas, em pacientes HIV/AIDS com lesão pulmonar aguda e insuficiência respiratória: estudo de avaliação do melhor valor de PEEP." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5167/tde-09112011-134108/.
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INTRODUÇÃO: A síndrome da imunodeficiência adquirida (AIDS) é atualmente uma pandemia, e as doenças pulmonares são a principal causa de morbidade e mortalidade dos pacientes com AIDS. Nesse sentido, as infecções respiratórias são frequente causa de hipoxemia e morte. Os pacientes com AIDS e insuficiência respiratória hipoxêmica frequentemente necessitam de ventilação mecânica invasiva, a qual é independentemente associada com mortalidade. A ventilação não invasiva com pressão positiva refere-se à oferta de assistência ventilatória mecânica sem a necessidade de invasão artificial das vias aéreas, sendo reconhecida por melhorar a oxigenação e a dispneia dos pacientes com insuficiência respiratória hipoxêmica, principalmente se aplicada de forma sequencial e progressiva, e esta pode reduzir a necessidade de ventilação mecânica invasiva nestes pacientes. Tendo em vista as incertezas quanto à resposta da oxigenação a PEEP nos pacientes com AIDS com insuficiência respiratória aguda hipoxêmica e usando o racional da pressurização progressiva das vias aéreas e seu potencial benefício na oxigenação sanguínea, nós fizemos a hipótese de que o incremento sequencial dos níveis de PEEP até 15 cmH2O pode melhorar a oxigenação sanguínea sem afetar o conforto e a hemodinâmica do paciente. O objetivo principal deste estudo foi investigar os efeitos de diferentes sequências de níveis de PEEP aplicado de forma não invasiva sobre as trocas gasosas, a sensação de dispneia e os padrões hemodinâmicos em pacientes com AIDS e insuficiência respiratória aguda hipoxêmica. O objetivo secundário foi avaliar o tempo livre de ventilação mecânica invasiva em 28 dias e a mortalidade hospitalar em 60 dias. MÉTODOS: Foram estudados 30 pacientes adultos com HIV/AIDS e insuficiência respiratória aguda hipoxêmica. Todos os pacientes receberam uma sequência randomizada de PEEP não invasivo (os valores usados foram 5, 10 ou 15 cmH2O) por vinte minutos. A PEEP foi fornecida através de máscara facial com pressão suporte (PSV) de 5 cmH2O e uma FiO2 = 1. Um período de washout de 20 minutos com respiração espontânea foi permitido entre cada PEEP. Variáveis clínicas e uma gasometria arterial foram registradas após cada etapa de PEEP. RESULTADOS: Analisando os 30 pacientes, a oxigenação melhorou linearmente com a elevação da PEEP, contudo, estudando os pacientes conforme a PEEP inicial randomizada, a oxigenação foi similar independentemente da primeira PEEP randomizada (5, 10 ou 15 cmH2O), e somente o subgrupo com PEEP inicial = 5 cmH2O melhorou mais a oxigenação quando PEEPs maiores foram usadas. A PaCO2 também aumentou junto com a elevação da PEEP, especialmente com uma PEEP = 15 cmH2O. O uso de PSV = 5 cmH2O foi associado com significante e consistente melhora da sensação subjetiva de dispnéia e da frequência respiratória com PEEP de 0 a 15 cmH2O. CONCLUSÕES: Os pacientes com SIDA e insuficiência respiratória hipoxêmica melhoram a oxigenação com a elevação progressiva e sequencial da PEEP até 15 cmH2O, contudo a elevação da PaCO2 limita a PEEP até 10 cmH2O. Uma PSV = 5 cmH2O promove uma melhora da sensação subjetiva da dispnéia independentemente do uso de PEEPINTRODUTION: The acquired immunodeficiency syndrome (AIDS) is a pandemic, and lung diseases are the leading cause of morbidity and mortality and are often associated with respiratory infections, hypoxemia and death. The noninvasive ventilation with positive pressure refers to the provision of mechanical ventilatory assistance without the need for artificial airway invasion, being recognized for improving oxygenation and dyspnea in patients with hipoxemic respiratory failure. Patients with AIDS and hypoxemic respiratory failure often require invasive mechanical ventilation, which is independently associated with mortality. Given the uncertainties about response in oxygenation with PEEP in patients with AIDS with acute hypoxemic respiratory failure and using the rational for progressive pressurization of the airway and its potential benefits on blood oxygenation, we made the hypothesis that increased levels of sequential PEEP up to 15 cmH2O may improve blood oxygenation without affecting the comfort and hemodynamics of the patient. The main objective of this study was to investigate the effects of different sequences of PEEP levels on gas exchange, the sensation of dyspnea and hemodynamics in patients with AIDS and acute hypoxemic respiratory failure. The secondary objective was to assess the time free of invasive mechanical ventilation in 28 days and hospital mortality within 60 days. METHODS: We studied 30 adults patients with HIV/AIDS and acute hypoxemic respiratory failure. All patients received a randomized sequence of noninvasive PEEP (the values used were 5,10 or 15 cmH2O) for twenty minutes. PEEP was delivered via face mask with pressure support (PSV) of 5 cmH2O and FiO2 = 1. A washout period of 20 minutes with spontaneous breathing was allowed between each PEEP trial. Clinical variables and arterial blood gases were recorded after each PEEP step. RESULTS: Analyzing the 30 patients, oxygenation improved linearly with increasing PEEP, however studying the patients randomized according to the initial PEEP, oxygenation was similar regardless of the first randomized PEEP (5,10 or 15 cmH2O), and only the subgroup with initial PEEP = 5 cmH2O further improve the oxygenation when high PEEP were used. The PaCO2 also rose beside the PEEP elevation, especially with a PEEP = 15 cmH2O. The use of PSV = 5 cmH2O was associated with significant and consistent improvement of subjective sensation of dyspnea and respiratory rate with a PEEP from 0 to 15 cmH2O. CONCLUSION: AIDS-patients with hypoxemic respiratory failure improve oxygenation with a progressive sequential elevation of PEEP up to 15 cmH2O, however the elevation of PaCO2 limit the PEEP up to 10 cmH2O. A PSV = 5 cmH2O promotes an improvement of subjective sensation of dyspnea independently from the use of PEEP
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Soares, Alexandre Learth. "Instilação nasal de LPS ou suco gástrico como fator exacerbador da inflamação pulmonar ocasionada pela isquemia e reperfusão intestinal em camundongos." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/42/42136/tde-06102009-151646/.
Full textAbstract:
A isquemia e reperfusão intestinal (I/R-i) é relevante fator para o desenvolvimento da síndrome do desconforto respiratório agudo (SDRA). A lesão tecidual decorrente da I/R-i pode ser local e em órgãos distante do sitio isquêmico, notadamente o pulmão. Indivíduos submetidos à isquemia intestinal ao tornarem-se vulneráveis, desenvolvem resposta exacerbada a estímulos inflamatórios secundários constituindo assim a percepção de lesão decorrente de uma dupla agressão. Neste estudo desenvolvemos modelo murino de dupla agressão pulmonar ocasionada pela I/R-i seguida de estímulo da instilação nasal de LPS ou de suco gástrico (SG). A fase de caracterização do modelo de I/R-i revelou aumento de IL-6, G-CSF, KC, IP-10 e MCP-1, mas não de TNF-a no soro e em homogeneizados de pulmão e intestino. Anticorpos anti TNF-a e o etanercepte falharam em inibir o aumento de MPO pulmonar e intestinal após a I/R-i. A instilação nasal de LPS após a I/R-i aumentou a atividade pulmonar de MPO e exacerbou a permeabilidade vascular pulmonar. Neste caso, aminoguanidina ou a vimblastina reverterem o aumento da permeabilidade vascular, sugerindo a participação conjunta de neutrófilos e óxido nítrico no processo lesivo causado pela dupla agressão. A instilação nasal de SG induziu aumento inicial (2h) de MPO pulmonar seguido de influxo de neutrófilos (24h) para o espaço alveolar. Tal processo foi acompanhado por expressão inicial e transiente de TNF-a no LBA e contrabalanceada por IL-10. A resposta inflamatória aumentada de camundongos IL-10 KO à instilação de suco gástrico mostra o papel fundamental desta citocina do controle da inflamação. O rolipram ou o composto PKF 241-466 (inibidores de TNF-a) reduziram a inflamação pulmonar induzida pelo SG. A instilação de SG após a I/R-i (I/R-i +SG) exacerbou o aumento da permeabilidade vascular pulmonar. Os dados apresentados sugerem que a exposição do organismo ao trauma intestinal torna o pulmão suscetível a um estímulo secundário como o LPS e o suco gástrico. Visto a gama de estímulos inflamatórios a que indivíduos internados em unidades de terapia intensiva podem ser submetidos, os resultados deste estudo podem contribuir para a compreensão dos mecanismos reguladores do recrutamento de neutrófilos e geração de mediadores inflamatórios na síndrome do desconforto respiratório agudo.Intestinal ischemia and reperfusion (I/R) is implicated as a prime initiating event in the development of systemic inflammatory syndrome and Acute Respiratory Distress Syndrome (ARDS). Several studies pointed the possibility of massive systemic inflammatory events rendering the lungs more susceptible to an exacerbated inflammatory response, the so called two-hit hypothesis. In this way, minor local inflammatory stimuli could be a trigger for ARDS. In this study we investigated the effects of low-dose LPS or gastric juice (GJ) administered by nasal instillation to mice previously submitted to intestinal I/R. Our data showed that i-I/R alone induced histological signs of edema in lung as well as an increase of lung MPO activity and IL-6, G-CSF, KC, IP-10 and MCP-1 levels. Nasal instillation of LPS following i-I/R increased lung MPO activity and exacerbated lung vascular permeability. In this case, aminoguanidine or vinblastine blocked the increase of vascular permeability, suggesting the role of neutrophils and nitric oxide in injury induced by the two-hit stimuli. Instillation of GJ induced an initial (2h) increase of lung MPO followed by the influx of neutrophils (24h) to the alveolar space. Such process was followed by the transient expression of TNF-a in BAL and balanced by IL-10. The exacerbated inflammatory response of IL-10 KO mice to GJ instillation shows the importance of this cytokine in the control of the inflammation in such model. Treatment with rolipram or PKF 241-466 compound (TNF-a inhibitors) reduced lung inflammation induced by GJ. Nasal instillation of GJ after i-I/R exacerbated the increase in lung vascular permeability. The data shown suggest that the exposition of the organism to mesenteric trauma primes the host organism to a secondary inflammatory stimulus such as LPS or gastric juice. Considering the possible multiple insults to lung to which patients in intensive care units are submitted, the results of this study might contribute to the understanding of the regulatory mechanisms of neutrophils and generation of inflammatory mediators in the context of ARDS.
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Blom, Malin. "Vägen till 2.0 : Att hantera en allvarlig hjärnskada." Thesis, Konstfack, Institutionen för design, inredningsarkitektur och visuell kommunikation (DIV), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:konstfack:diva-6307.
Full textAbstract:
Mitt masterprojekt är en bok som syftar till att stötta anhöriga till personer med förvärvad hjärnskada, där jag använder mig själv och min egen rehabilitering efter en smitningsolycka som fallstudie.My master project is a book that aims to support relatives of people with aquired brain injuries, where I use myself and my own rehabilitetion after a hit-and-run accident as a case study.
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Ralaidovy, Ambinintsoa Haritiana. "Efficiency in health ressource allocation : three empirical studies in Eastern Sub-Sahara Africa and Southeast Asia." Thesis, Université Clermont Auvergne (2017-2020), 2019. http://www.theses.fr/2019CLFAD016.
Full textAbstract:
La définition des priorités en matière de santé, dans le contexte de la couverture sanitaire universelle, met l'accent sur trois valeurs : améliorer la santé de la population, garantir l'égalité d'accès aux services et la qualité de ceux-ci et éviter l'appauvrissement des usagers ou la sous-utilisation des services par ceux-ci en raison de dépenses non remboursables. L’efficience allocative peut être mesurée par rapport à l'une quelconque de ces valeurs, ou par rapport à l'ensemble, par différentes variantes de l'analyse coût-efficacité. Dans cette thèse, nous utilisons la « Generalized Cost-Effectiveness Analysis », une approche normalisée développée par le programme « Choosing Interventions that are Cost-Effective » de l’Organisation Mondiale de la Santé, (WHO-CHOICE), qui peut être appliquée à toutes les interventions dans différents contextes. En utilisant cette approche, notre travail de thèse fournit une estimation quantitative de l'efficience allocative des ressources pour trois groupes de problèmes de santé : les maladies transmissibles, les maladies non transmissibles, les accidents de la circulation, en mettant l'accent sur deux régions économiquement et épidémiologiquement différentes : l'Afrique subsaharienne de l’Est et l'Asie du Sud-Est. Nos objectifs étant d’éclairer les débats sur les politiques de santé, d’améliorer le corpus mondial de connaissances sur le rapport coût-efficacité de différentes interventions en fournissant davantage d’informations sur l’efficience de l’allocation de ressources pour les trois groupes de problèmes de santé précités et de contribuer aux discussions sur l’élaboration des programmes de soins de santé universelsPriority setting in health, in the context of Universal Health Coverage, emphasizes three values: improving population health, ensuring equity in access to and quality of services and avoiding impoverishment or underutilization of services as a result of out-of-pocket expenditures. Allocative efficiency can be measured with respect to any one of these values, or with respect to all together by different variants of Cost-Effectiveness Analysis. In this thesis, we use the Generalized Cost-Effectiveness Analysis, a standardized approach developed by the World Health Organization’s programme, ‘Choosing Interventions that are Cost-Effective’ (WHO-CHOICE) that can be applied to all interventions in different settings. This thesis provides a quantitative assessment of allocative efficiency within three health categories: communicable diseases, noncommunicable diseases, and road traffic injuries, focusing on two economically and epidemiologically diverse regions: Eastern sub-Saharan Africa and Southeast Asia. Our objectives are to inform health policy debates, improve the world’s body of knowledge on the cost-effectiveness of different interventions by providing more information on the allocative efficiency in those three disease groups and contribute to discussions on Universal Health Care packages
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Liu, Chi-Tzu, and 劉紀慈. "Effectiveness of hip motor control training in young dancers with ankle-foot injury." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/227rc4.
Full textAbstract:
碩士國立陽明大學
物理治療暨輔助科技學系
106
INTRODUCTION: Ballet movement requires a great movement range and control of the hip joint. It has been shown that hip joint control bears an important role in balance strategy, and is associated with lower extremity injuries. Past studies mentioned that subjects with insufficient hip muscle strength had a higher risk of ankle sprain during landing. Researchers showed hip strengthening program could improve lower extremity neuromuscular control in patients with chronic ankle instability. However, few studies have assessed the differences in hip musculoskeletal characteristics between the injured dancers and healthy dancers, and the effectiveness of hip motor control training in dancers with ankle-foot injury. Therefore, aim of this study was to compare the hip musculoskeletal characteristics between the dancers, and to determine the the effectiveness of hip motor control training on lower extremity muscle performance. METHODS: First, we recruited 33 young dancers with ankle-foot injury (7 males and 26 females, 19.34±2.35 years old) and 12 healthy dancers (2 males and 10 females, 18.33±2.61 years olf). All participants received the measurement of muscle activation (gluteus maximus, gluteus medius, biceps femoris, femoris rectus, tibialis anterior, peroneal longus and soleus), lower extremities muscle length and muscle strength. The Multivariate Analysis of Variance (MANOVA) was used to statistically compare differences in lower extremity musculoskeletal control characteristics between the injured group and healthy group. Subjects in the injured group were then randomized to either the hip motor control training group (experimental group, 3 males and 13 females, 19.24±3.03 years old, n=16) or the control group (4 males and 13 females, 19.45±1.41 years old, n=17) and received hip motor control training for 4 weeks. The outcome measures as well as lower extremity muscle strength (pound/body mass), muscle length (degree), compensated turnout, muscle activation (%MVC) were measured before and after intervention. Injury rate was measured 6 months after the intervention. Two-way repeated measures analysis of variances (ANOVAs) and Two-way repeated measures analysis of covariances (ANCOVAs) were used to examine if the experimental group improved more than the control group after intervention. A statistical significance was set at P < 0.05. RESULTS AND DISCUSSION: Injured group demonstrated higher compensated turnout (47.36±13.18 vs. 36.29±12.62, p=0.019), lower gluteus maximum muscle activation (34.13±9.83 vs. 39.26±11.09 vs. 41.35±7.56, p=0.046) as compared to the healthy group. And hip motor control training group resulted in significantly better improved in lower extremity muscle strength (affected side hip abductors, hip adductors, hip internal rotators, ankle dorsiflexors and non-affected side hip abductors, hip external rotators, hip internal rotators, knee flexors, ankle evertors, ankle invertors, ankle dorsiflexors), affected side calf muscle length, muscle activation during jump landing (affected side femoris rectus, 45.13±18.14 and 50.13±14.88 vs. 47.62±12.15 and 51.52±10.16, p=0.026) as compared to the control group after 4-week intervention. CONCLUSIONS: Young dancers with ankle-foot injury showed bigger compensated turnout angle and lower gluteus maximus muscle activation as compared to the healthy group. Hip motor control training was effective in improving lower extremity muscle strength and affected-side calf muscle length improvement.
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Levine, Iris Claire. "The Effects of Body Mass Index and Gender on Pelvic Stiffness and Peak Impact Force During Lateral Falls." Thesis, 2011. http://hdl.handle.net/10012/6287.
Full textAbstract:
Fall-related hip fractures are a substantial public health issue. Unfortunately, little is known about whether the effective stiffness of the pelvis, a critical component governing impact force during lateral falls, differs substantially across different segments of the population. The objective of this thesis was to enhance the knowledge base surrounding pelvis impact dynamics by assessing the influence of gender and body mass index (BMI) on the effective stiffness of the pelvis, and on resulting peak loads applied to the hip, during sideways falls. Towards this end I conducted pelvis release trials (in which the pelvis was suspended and suddenly released onto a force plate) with males and females with low (<22) and high (>28) BMIs.
One resonance-based (kvibe), and three force-deflection based (k1st, kcombo 300, and kcombo opt) methods of effective pelvic stiffness estimation were examined. The resulting stiffness estimates, and peak forces sustained during the pelvis release experiments, were compared between each BMI and sex group.
The optimized force-deflection stiffness estimation method, kcombo opt provided the strongest fit to the experimental data. Strong main effects of BMI (f (1,13) = 10.87, p = 0.003) and sex (f (1,13) = 5.97, p = 0.022) were found for this stiffness estimation method. Additionally, a significant BMI-sex interaction was observed (f (3,6) = 5.31, p = 0.030), with low BMI males having much higher stiffness estimates than any other group. Normalized peak forces were higher in low BMI participants than in high BMI participants (f(1,13)=24.9, p<0.001). Linear regression demonstrated that peak impact force was positively associated with effective pelvic stiffness (β = 0.550, t(25) = 3.110, p=0.005), height (β = 0.326, t(25) = 2.119, p=0.045) and soft tissue thickness (β = 0.785, t(25) = 4.573, p<0.001).
This thesis has demonstrated that body habitus and sex have significant effects on the stiffness of the pelvis during lateral falls. These differences are likely related to a combination of soft tissue and pelvic anatomical differences between BMI and sex groups. Pelvic stiffness, along with other easily collected variables, may be helpful in predicting peak forces resulting from lateral falls in the elderly. Differences in pelvic stiffness estimates between BMI and sex groups, and estimation method, necessitate careful consideration. These data will aid in selecting the most appropriate pelvic stiffness parameters when modeling impact dynamics for higher energy falls.
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Kit, Alanna Katharine. "A feasibility study to test the potential efficacy of a rowing-related yoga program on male varsity competitive rowers." Thesis, 2020. http://hdl.handle.net/1828/11740.
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The purpose of this present study was to assess the feasibility and determine the potential short-term efficacy of implementing a specific 9-week “Yoga for Rowers” (ROWGA) program on male varsity rowers during a competitive training season. Sixteen competitive male varsity rowers (20.6 ± 2.1 years) were recruited to participate, using a single group, pre-test-post-test, quasi-experimental research design. All participants performed two 60 min ROWGA sessions per week for 9 weeks during their fall competitive season. The primary objectives were to test the efficacy of a ROWGA program in a real-world context by evaluating: 1) the feasibility of implementing the program during the training and competitive season as measured by program adherence; 2) its potential effect on strength by evaluating hip muscle strength acting in the sagittal, frontal, and transverse planes as well as on hip muscle strength ratios between the agonist versus antagonist muscle groups; and 3) its potential effect on hip flexion range of motion (ROM). Two pre-test baseline measurements were performed on all participants over 1- week prior to initiating the ROWGA sessions while a single post-test was conducted following the ROWGA intervention. Intraclass correlation coefficients for ROM and strength were used to determine reliability of measurements by taking the two pre-intervention test scores. Outcome measures included hip flexion range of motion, peak isometric hip muscle forces normalized to body weight, including hip flexors, extensors, abductors, adductors, both internal and external rotators as well as peak isometric agonist-antagonist hip muscle strength ratios. Pre and post peak isometric hip strength measurements were calculated for agonist-antagonist muscle groups within each plane by dividing flexors by extensors, adductors by abductors, and internal by external rotators. Feasibility of the ROWGA program was determined from program attendance and adherence rates.
The adherence rate was considered high with 89% attending all sessions, after adjusting for compulsory competitions. Significant improvements in peak isometric strength were demonstrated for hip flexors, extensors, abductors, and adductors, and external rotators, while a significant reduction for hip flexion ROM was observed. No significant changes in isometric hip muscle strength agonist-antagonist ratios were demonstrated. The results from this research support the feasibility of the ROWGA program in terms of rower’s acceptance, adherence, and the ability to accommodate the time requirements within their schedule as well as potential strength benefits gained. This research could help provide a platform for future large-scale research related to injury prevention in rowing.Graduate
2021-04-06
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Gustavsson, Johanna. Thesis, Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-4647.
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Seedat, Faheem. "Renal impairment in HIV infected patients receiving tenofovir-based antiretroviral therapy in a South African hospital." Thesis, 2017. http://hdl.handle.net/10539/23269.
Full textAbstract:
A research report submitted to the Faculty of Health Sciences, University of
Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree
of Master of Medicine in the branch of Internal Medicine
Johannesburg, 2017Objective: There is limited data describing acute kidney injury (AKI) in HIV-infected adult patients in resource-limited settings where increasingly, tenofovir (TDF), which is potentially nephrotoxic, is prescribed. We describe risk factors for, and prognosis of AKI in HIV-infected individuals receiving and naïve to TDF. Methods: This was a prospective case cohort study of hospitalized HIV-infected adults with AKI (as defined by the 2012 KDIGO Clinical Practice Guideline for AKI) stratified by TDF exposure. Adults (≥18 years) were recruited: clinical and biochemical data was collected at admission; their renal recovery, discharge or mortality was ascertained as an in-patient and, subsequently, to a scheduled 3-month follow-up. Results: Amongst this predominantly female (61%), almost exclusively black African cohort of 175 patients with AKI, 93 (53%) were TDF exposed; median age was 41 years (IQR 35-50). Median CD4 count and VL and creatinine at baseline was 116 cells/mm3 and 110159 copies/ml, respectively. A greater proportion of the TDF group had severe AKI on admission (61% v 43% p=0.014); however, both groups had similar rates of newly diagnosed tuberculosis (TB) (52%) and NSAID (32%) use. Intravenous fluid was the therapeutic mainstay; only 7 were dialyzed. Discharge median serum creatinine (SCr) was higher in the TDF group (p=0.032) and fewer in the TDF group recovered renal function after 3-months (p=0.043). 3-month mortality was 27% in both groups but 55% of deaths occurred in hospital. Those that died had a higher SCr and more severe AKI than survivors; TB was diagnosed in 33 (70%) of those who died. Conclusions: AKI was more severe and renal recovery slower in the TDF group; comorbidities, risk factors and prognosis were similar regardless of TDF exposure. Because TB is linked to higher mortality, TB co-infection in HIV-infected patients with AKI warrants more intensive monitoring. In all those with poor renal recovery, our data suggests that a lower threshold for dialysis is needed.
MT2017
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Brilha, Sara Sofia dos Santos 1985. "Strategies for early detection of renal injury in HIV-infected patients : the new troponin." Master's thesis, 2011. http://hdl.handle.net/10451/4179.
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Tese de mestrado, Doenças Infecciosas Emergentes, Faculdade de Medicina, Universidade de Lisboa, 2011Background: HIV-infected patients have a known increased risk of kidney disease. For that reason, a biomarker that enables reliable detection of early and mild kidney dysfunction would be advantageous. Cystatin C is considered to be a better marker of kidney function than creatinine. Objectives: This study aimed to evaluate if serum cystatin C was a better marker than creatinine in a HIV-infected population. Material and Methods: This was an observational study of HIV-infected patients that attend the Infectious Diseases Department, at the Hospital Santa Maria, Lisbon. Patients with known kidney disease or HIV-2 infection were excluded. Clinical and demographic data was recorded and serum creatinine and cystatin C levels were determined. Results: A total of 242 patients were included. Cystatin C is an independent factor of age, gender, ethnicity and body mass index. Of the 17 patients with elevated levels of cystatin C but with an estimated creatinine clearance within normal range, 11 were on antiretroviral therapy with tenofovir and/or atazanavir. Fourteen patients were smokers and 10 patients had hepatitis C virus co-infection, which are known causes of inflammation. In a matched control group of 27 patients, with cystatin C within normal range, the majority of patients also were on an antiretroviral regimen with tenofovir and/or atazanavir. However, none of them had hepatitis C virus co-infection. Moreover, a statistical association was found between high levels of cystatin C and alanine transaminase. Differences between biomarkers’ levels and patients on combinations with tenofovir, ritonavir boosted atazanavir or both were also studied. Although it was not found any statistically significant difference in creatinine and estimated creatinine clearance, with cystatin C, patients that were on atazanavir or tenofovir and had a higher level of cystatin C, compared with patients that never were on these drugs. Conclusion: Cystatin C levels may be increased in inflammatory conditions. Therefore, in HIV-infected patients, where chronic systemic inflammation is present, often associated to other inflammation sources, such as chronic hepatitis C virus co-infection, the use of cystatin C to monitor kidney function may overestimate kidney impairment. In what concerns to nephrotoxicity, it was found that patients on atazanavir had higher levels of cystatin C. It is important to develop prospective studies, in order to assess the real long-time impact of the more recent antiretroviral drugs on kidney function.
Introdução: Os doentes infectados por VIH possuem um risco aumentado para o desenvolvimento de doença renal. Por esta razão, seria importante utilizar um marcador que permitisse uma detecção precoce de alterações da função renal. A cistatina C tem sido referida na literatura como um melhor marcador da função renal, comparativamente com a creatinina. Objectivos: O objectivo deste estudo é analisar se a cistatina C sérica constitui um melhor marcador da função renal que a creatinina, para a população de doentes infectados por VIH. Material e métodos: Este é um estudo observacional de doentes infectados por VIH, seguidos no Serviço de Doenças Infecciosas do Hospital de Santa Maria, Lisboa. Os doentes com doença renal documentada e infecção por VIH-2 foram excluídos deste estudo. Foram recolhidos dados clínicos e demográficos e foram determinados os níveis séricos de creatinina e cistatina C. Resultados: Um total de 242 doentes foi incluído neste estudo. Os níveis de cistatina C mostraram-se independentes da idade, sexo, etnia e índice de massa corporal. Dos 17 doentes com níveis elevados de cistatina C mas com clearance da creatinina dentro dos valores de referência, 11 doentes estavam sob terapêutica antirretroviral com tenofovir e/ou atazanavir potenciado com ritonavir. Catorze doentes eram fumadores e 10 estavam co-infectados por vírus da hepatite C, que constitui um factor conhecido de inflamação. Num grupo controlo de 27 doentes, com cistatina C dentro dos valores normais, a maioria dos doentes também se encontrava sob terapêutica antirretroviral com tenofovir e/ou atazanavir. No entanto, nenhum possuía co-infecção por vírus da hepatite C. Foram também analisadas diferenças entre os níveis dos marcadores e doentes em combinações com tenofovir, atazanavir potenciado com ritonavir ou com ambos. Embora não tenha sido encontrada nenhuma diferença estatisticamente significativa nos níveis de creatinina e clearence da creatinina estimado, com a cistatina C, doentes sob atazanavir ou tenofovir e atazanavir possuíam níveis mais elevados deste marcador, comparativamente com os doentes que nunca estiveram sob estes antirretrovirais. Conclusão: Os níveis de cistatina C podem aumentar com factores inflamatórios. Por esta razão, no caso dos doentes infectados por VIH, onde existe uma inflamação sistémica crónica, muitas vezes associada a outras fontes de inflamação, como a co-infecção por vírus da hepatite C, a utilização exclusiva da cistatina C para a monitorização da função renal pode conduzir a uma sobrestimação de uma lesão renal. Em termos de nefrotoxicidade, verificou-se que doentes sob atazanavir possuíam níveis mais elevados de cistatina C. É de extrema importância, o desenvolvimento de novos estudos prospectivos, de forma a permitir a análise do impacto a longo prazo destes antirretrovirais mais recentes na função renal.
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Shih, Hsin-Chin, and 施信嶔. "The Effect of Using Magnolol on Hemorrhagic Shock and Second-hit Injury in Rats." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/27699465787420841501.
Full textAbstract:
博士國立陽明大學
臨床醫學研究所
94
Background: Systemic inflammatory response syndrome accompanying inflammatory cytokine response is evoked after severe injury in patients and frequently culminates in sepsis and multiple organ dysfunction. Involvement of cytokines, such as tumor necrosis factor- alpha (TNF-��) and interleukin-10 (IL-10) in inflammatory response, is related to oxidative stress. Ischemia-reperfusion following resuscitation from trauma and hemorrhagic shock primes the trauma victims for an exaggerated response to a second inflammatory stimulus, the so-called second hit. Hemorrhagic shock and fluid resuscitation (HS) can induce an unfavorable condition in animals and increase their mortality in subsequent sepsis. However, brief period of hemorrhagic shock in rats, so-called sublethal hemorrhage (SLH), can induce endotoxin tolerance and protect the animals from subsequent endotoxin challenge (EC). Both SLH and HS are associated with an initial surge of pro-inflammatory cytokines. Magnolol has been shown to be a potent antioxidant with anti-inflammatory effects. Our study was performed to test the hypothesis that magnolol could inhibit the initial pro-inflammatory cytokine response after HS or SLH and alter the outcome of the episode in subsequent second hit. Materials and methods: In the first two-hit model, intra-abdominal sepsis was performed following HS in rats. The rats were randomly segregated into one of three groups. Rats in control group rats were sham-operated. Rats in the untreated or treated group received HS and treatment with vehicle or magnolol, respectively; cecal ligation punctures were perfromed 24 hous later. In the second two-hit model, EC was performed following SLH in rats. Rats were randomly segregated into one of four groups. Rats in the Sham/Veh or Sham/Mag group received a sham operation for SLH and treatment with vehicle or magnolol, respectively. Rats in the SLH/Veh or SLH/Mag group received SLH and treatment with vehicle or magnolol, respectively. Animals were subjected to EC at 12, 24, or 36 h after these procedures. Plasma cytokine levels and tissue cytokine contents of lung, including TNF-�� and IL-10 were assayed. Pulmonary injury study was performed by using Evans blue dye method following sepsis. RT-PCR for cytokines, lipid peroxidation, and superoxide dismutase activity were measured in lung tissue following SLH. Survival analyses of rats were performed after sepsis or EC. Results: Plasma and tissue TNF-�� levels increased after HS or SLH. Magnolol treatment blunted the TNF-�� levels in plasma and tissue. Plasma IL-10 level increased after HS but not after SLH, whereas the tissue level of IL-10 did not change. Magnolol treatment significant increased tissue IL-10 level after HS or SLH. Lipid peroxidation and SOD activity increased after SLH; magnolol suppressed the lipid peroxidation but not the SOD activity. After sepsis or EC, TNF-�� levels significantly increased in both plasma and tissue. Magnolol-treated animals had significantly lower TNF-�� levels than those in untreated animals. Pulmonary injury study and survival analysis showed that magnolol-treated rats had decreased pulmonary injury and increased survival after sepsis. On the other hand, If EC was performed 12 or 24 h after SLH, greater survival with decreased TNF-�� and increased IL-10 in plasma was observed in the SLH/Mag group. If EC was performed 24 or 36 h after SLH, greater survival with decreased plasma TNF-�� was observed in the SLH/Veh group. Conclusion: This study reveals that magnolol modifies cytokine response and provides protection of the rats early after HS or SLH. However, magnolol attenuates the protraction of endotoxin tolerance and inhibits late protection against EC following SLH. Our results show that magnolol may provide early protection of animals following hemorrhagic shock.
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Gojo, Mawande Khayalethu Edson. "Investigation of acute systemic inflammatory response and myocardial injury after cardiac surgery in patients infected with human immunodeficiency virus." Thesis, 2016. http://hdl.handle.net/10321/2577.
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Submitted in fulfillment of the requirements for the degree of Masters of Health Sciences in Clinical Technology, Durban University of Technology, Durban, South Africa, 2016.Introduction: The immediate post-cardiopulmonary bypass (CPB) immune responses and organ injuries in immune- compromised patients remain poorly documented. We conducted a prospective clinical study to determine whether or not human immunodeficiency virus (HIV) seropositive patients generate higher acute systemic inflammatory response and suffer greater myocardial injury, compared to HIV seronegative patients. Methodology: Sixty-one consecutive patients i.e. Thirty HIV seropositive patients and Thirty-one seronegative, undergoing elective cardiac valve(s) replacement were enrolled, over a period of nine months from a single center hospital, after informed consent was acquired. The C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were used as biomarkers of acute inflammatory response, and cardiac troponin I (cTnI) as a biomarker for measuring postoperative myocardial injury. Single tests were measured preoperatively and postoperatively, in both groups, and these were compared and correlated to perioperative events and CPB parameters. Results: The mean age group was similar between the HIV seropositive and negative group (37.8 and 37.1 years, respectively). Preoperatively both groups had relatively equal CRP levels (p=0.388), ESR levels (p=0.817) and cTnI (p=0.489). The CPB events and durations were significantly different between the two groups, CPB duration (p=0.021). Other CPB events include, clamp aortic duration (p=0.026), CPB blood transfusion (p=0.013), CPB total urine output (p=0.035) and CPB peak lactate (p=0.040). Postoperatively we observed significant increased biomarkers level in both groups, with no significant difference between the groups: mean CRP (p=0.115), mean ESR (p=0.214) and cTnI (p=0.363). We observed a significant negative correlation between the mean change in CRP levels and mechanical ventilation (r=- 0.548, p=0.002) in the seropositive group, but not in the uninfected group (r=0.025, p=0.893). The correlation between the difference in CRP and ICU stay was not significant between in both group (r=-0.231, p=0.229 and r=0.25, p=0.975, respectively). A significant positive correlation between postoperative cTnI and the inotropic support duration (r=0.384, p=0.040) was seen in the seropositive groups, but not in the negative group (r=0.092, p=0.622). Furthermore we observed a significant drop in CD4 cells postoperatively (p=<0.001) in the HIV seropositive group. Antiretroviral treatment appeared to influence the degree of change in CD4 cells postoperatively. Conclusion: We conclude that HIV positive patients’ postoperative reactions to cardiac surgery supported by CPB are similar to those of HIV seronegetive patients. We further report non-paralleling correlations between the biomarkers and perioperative events; however these do not seem to affect the overall outcomes between the two groups.
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Hung, Chia-Yu, and 洪嘉鈺. "Using HAp as Bletilla striata polysaccharide carrier toprevent muscle injured by sarcopenia." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/cq2mka.
Full textAbstract:
碩士國立臺灣大學
醫學工程學研究所
105
Sarcopenia is a disease of muscle mass loss and muscle function decline caused by aging. Because there are no effective and no side effects treatments to treat sarcopenia, and hydroxyapatite is one of the components of bones and teeth in human body, has well biocompatibility and biodegradability. Not only can supplement the body of the lack of calcium in the body but also through the drug long-term Release to reduce the drug injection frequency, mitigate the pain suffered by the elderly. In this study, the starting point is that prevention is better than treatment . Inject HAp─BSP first then inject lipopoly- saccharide extracted from E.coli which is going to induce muscle injury and re- duction muscle mass that are similar to the symptoms of sarcopenia. To observe the difference between the experimental group and the control group (induced by LPS-induced muscle injury and inflammatory reaction), and to analyze the results of muscle tension test, muscle endurance test, blood analysis, HE stain and MRI image to find whether HAp─BSP can prevent muscle injury and anti-inflammatory. According to ISO-10993, HAp, BSP and HAp-BSP prepared in this experiment are biologically toxic and have good biocompatibility. Through the TGA analysis, HAp-BSP drug loading efficiency is about 13%, and the BSP volatilization at 300 oC, which is the same as the re- ference. In this study, we successfully used LPS to induce muscle injury that similar to sarcopenia, and HAp-BSP could prevent the symptoms caused by LPS. It was confirmed that HAp-BSP had its anti-oxidation and promoting tissue capacity.
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CHEN, CHIA-YEN, and 陳家彥. "A Study on the「Resulting in Death or Injury」 of Hit and Run Offense Under Criminal Law and Other Concurrent Crime Issues." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/2n477k.
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碩士國立臺北大學
法律學系一般生組
102
Since legislators ordered the Criminal Code Article 185-4, the problem of interpretation of the provisions that began to appear. In a variety of controversial issues, the most discrepancies two parts of opinion among the scholars, the interpretation of「Resulting in Death or Injury」of Hit and Run Offense and Issues of the Criminal Code Article 294. For the former, the focus of the debate was that the「Resulting in Death or Injury」belonging to "illegal Elements," or are "objective penalties Conditions" .The problem with this argument is most directly related to the person in hit and run offense, whether the person should be aware of Killed or injured people in the accident. For the latter, the focus of debate in the hit and run offense is what the legal interest is. If Article 185-4 and Article 294 of the Criminal Code are to protect individual life, physical benefits, the judge should apply to the former; Conversely, if Article 185-4 of the Criminal Code is not the protection of personal life, physical benefits, but belongs the social legal interest, on the competing relationship, should be applicable to the latter. Therefore in research to protect the interests article 185-4 of the Criminal Code, We can understand How to apply the right article. Furthermore, in order to delineate the scope of punishment, this paper is to study the scope of the above two arguments and to read the various points of view, try to publish individual views. In addition, in order to grasp the Supreme Court for the crime of hit and run offense so far in the development and updating of changes on the legal opinions over the years, this paper will examine the legal opinion of the Supreme Court for the crime of hit and run offense and trying to assessment, in order to understand the application of the crime.
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Haladuick, Tyler. "Numerical Simulation of Blast Interaction with the Human Body: Primary Blast Brain Injury Prediction." Thesis, 2014. http://hdl.handle.net/10012/8265.
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In Operations Enduring Freedom and Iraqi Freedom, explosions accounted for 81% of all injuries; this is a higher casualty percentage than in any previous wars. Blast wave overpressure has recently been associated with varying levels of traumatic brain injury in soldiers exposed to blast loading. Presently, the injury mechanism behind primary blast brain injury is not well understood due to the complex interactions between the blast wave and the human body. Despite these limitations in the understanding of head injury thresholds, head kinematics are often used to predict the overall potential for head injury. The purpose of this study was to investigate head kinematics, and predict injury from a range of simulated blast loads at varying standoff distances and differing heights of bursts.
The validated Generator of body data multi-body human surrogate model allows for numerical kinematic data simulation in explicit finite element method fluid structure interaction blast modeling. Two finite element methods were investigated to simulate blast interaction with humans, an enhanced blast uncoupled method, and an Arbitrary Lagrangian Eularian fully coupled method. The enhanced blast method defines an air blast function through the application of a blast pressure wave, including ground reflections, based on the explosives relative location to a target; the pressures curves are based on the Convention Weapons databases. LBE model is efficient for parametric numerical studies of blast interaction where the target response is the only necessary result. The ALE model, unlike classical Lagrangian methods, has a fixed finite element mesh that allows material to flow through it; this enables simulation of large deformation problems such as blast in an air medium and its subsequent interaction with structures. The ALE model should be used when research into a specific blast scenario is of interest, since this method is more computationally expensive. The ALE method can evaluate a blast scenario in more detail including: explosive detonation, blast wave development and propagation, near-field fireball effects, blast wave reflection, as well as 3D blast wave interaction, reflection and refraction with a target.
Both approaches were validated against experimental blast tests performed by Defense Research and Development Valcartier and ConWep databases for peak pressure, arrival time, impulse, and curve shape. The models were in good agreement with one another and follow the experimental data trend showing an exponential reduction in peak acceleration with increasing standoff distance until the Mach stem effect reached head height. The Mach stem phenomenon is a shock front formed by the merging of the incident and reflected shock waves; it increases the applied peak pressure and duration of a blast wave thus expanding the potential head injury zone surrounding a raised explosive. The enhanced blast model was in good agreement with experimental data in the near-field, and mid-field; however, overestimated the peak acceleration, and head injury criteria values in the far-field due to an over predicted pressure impulse force. The ALE model also over predicted the response based on the head injury criteria at an increased standoff distance due to smearing of the blast wave over several finite elements leading to an increased duration loading.
According to the Abbreviated Injury Scale, the models predicted a maximal level 6 injury for all explosive sizes in the near-field, with a rapid acceleration of the head over approximately 1 ms. There is a drastic exponential reduction in the insult force and potential injury received with increasing standoff distance outside of the near-field region of an explosive charge.
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Shen, Wen-Ching, and 沈紋君. "Endothelial progenitor cells derived from Wharton’s jelly of the umbilical cord reduces ischemia-induced hind limb injury in diabetic mice by inducing HIF-1α/IL-8 expression." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/485smp.
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博士國立臺灣大學
解剖學暨細胞生物學研究所
101
Peripheral arterial diseases, the major complication of diabetes, can result in lower limb amputation. As endothelial progenitor cells (EPCs) are involved in neovascularization, the study was to examine whether EPCs isolated from Wharton’s jelly (WJ-EPCs) of the umbilical cord, a rich source of mesenchymal stem cells, could reduce ischemia-induced hind limb injury in diabetic mice. We evaluated the effects of WJ-EPC transplantation on hind limb injury caused by femoral artery ligation in mice with streptozotocin (STZ)-induced diabetes. We found that the ischemic hind limb in mice with streptozotocin-induced diabetes showed decreased blood flow and capillary density and increased cell apoptosis and that these effects were significantly inhibited by injection of WJ-EPCs. In addition, HIF-1α and IL-8 were highly expressed in transplanted WJ-EPCs in the ischemic skeletal tissues and were present at high levels in hypoxia-treated cultured WJ-EPCs. Moreover, incubation of the NOR skeletal muscle cell line under hypoxic conditions in conditioned medium from EPCs cultured for 16 h under hypoxic conditions resulted in decreased expression of pro-apoptotic proteins and increased expression of anti-apoptotic proteins. The inhibition of HIF-1α or IL-8 expression by EPCs using HIF-1α siRNA or IL-8 siRNA, respectively, prevented this change in expression of apoptotic-related proteins. Wharton’s jelly in the umbilical cord is a valuable source of EPCs and transplantation of these EPCs represents an innovative therapeutic strategy for treating diabetic ischemic tissues. The HIF-1α/IL-8 signalling pathway plays a critical role in the protective effects of EPCs in the ischemic hind limb of diabetic mice.
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Chang, Pei-Lin, and 張佩琳. "The Effects of Low-Level Laser Therapy on Recovery of Neuropathic Pain and Neural Function -Possible Involvement of HIF-1α in Rats with Chronic Constriction Injury of the Sciatic Nerve." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/54720111664521388621.
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碩士中國醫藥大學
物理治療學系復健科學碩士班
99
Background Peripheral nerve injury may induce nerve inflammation and neuropathic pain,and these phenomena not only cause physical and psychological discomfort of patients, but may also indirectly affect their quality of life. Low-energy laser treatment (low level laser therapy, LLLT) is often used to reduce pain, inflammation, wound healing and to help accelerate tissue regeneration, but the literatures and studies concerned about the therapeutic effects on the peripheral nerve injury and the molecular biological mechanism of LLLT were very few. In addition, in recent years, many researches explored that hypoxia inducible factor-1α (HIF-1α) involves in the process of inflammation, but its role and mechanism in regulation of peripheral nerve injury-induced inflammation was still not clear. Therefore, the animal model of sciatic chronic constriction injury (CCI) was used in this study for investigating the effects of LLLT on neuropathic pain and functional recovery. Purpose The purposes of this study were to assess the suppressive effects of LLLT on nerve function, accumulation of hypoxia-inducible factor-1 alpha (HIF-1α), proinflammatory cytokines interleukin-1β (IL-1β), tumor necrosis factorα (TNF-α) , inducible nitric oxide syntheses (iNOS), cyclooxygenase enzymes-2 (COX-2), tumor suppressor protein p53 (p53) and macrophages for controlling neuropathic pain after peripheral injury. Moreover, the effects of LLLT on activation of vascular endothelial growth factor (VEGF), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and repair of injured myelin sheath for promoting functional recovery were also assessed in CCI model. Methods Totally 120 rats were divided randomly into four groups based on the surgical procedure of CCI (operated VS sham-operated) and the treatment (LLLT VS sham-operated LLLT).Each group was further divided into three subgroups according to the duration of LLLT treatment. The experimental groups in this study included (1) CCI + LLLT (CL group) included the 1-week (n=10), 2-week (n=10) and 3-week (n=10) of LLLT; (2) CCI+ sLLLT (CsL group) included the 1-week (n=10), 2-week (n=10) and 3-week (n=10) of sLLLT; (3) sCCI + LLLT (sCL group) included the 1-week (n=10), 2-week (n=10) and 3-week (n=10) of LLLT;(4) sCCI + sLLLT(sCsL group)：included the 1-week (n=10), 2-week (n=10) and 3-week (n=10) of sLLLT. Seven days after surgery, animals started using the continuous 660-nm Ga-Al-As diode laser, and the output power of the laser irradiation was 30 mW per session with irradiation time for 60 sec/ per spot. The energy densities were 9 J/cm2. Effects of LLLT in CCI animals were determined by the measurements of mechanical pain threshold, sciatic function index, (SFI), tibial function index (TFI), peroneal function index (PFI), sciatic static index (SSI ), histopathological and immunohistochemical examination, ELISA and Western blot analysis. Histopathological and immunological assessements included accumulation of hypoxia-inducible factor-1 alpha (HIF-1α), proinflammatory cytokines interleukin-1β (IL-1β), tumor necrosis factorα (TNF-α), inducible nitric oxide syntheses (iNOS), cyclooxygenase enzymes-2 (COX-2), tumor suppressor protein p53 (p53) and macrophages for controlling neuropathic pain. Results Our results demonstrated that LLLT significantly improved mechanical pain threshold, sciatic functional index SFI, TFI, PFI, SSI (CL vs. CsL: P <0.05) after CCI. LLLT can also significantly reduce overexpressions of HIF-1α, TNF-α, IL-1β, iNOS, COX-2, p53, and the excessive macrophage accumulation (CL vs. CsL: P <0.05), and significantly promote the amounts of VEGF, NGF, and BDNF and myelin sheath (CL vs. CsL: P <0.05). But there was no significant differences among 1-, 2- and 3-week of LLLT on the expression of these protein factors (P>0.05). Conclusions After CCI nerve injury, LLLT can reduce neuropathic pain by suppressing the HIF-1α, TNF-α, IL-1β, iNOS, COX-2, p53 accumulation and macrophages infiltration and promote functional recovery by increasing the amounts of VEGF, NGF, BDNF and myelin sheath.
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Soukupová, Zlata. "Poškozený v trestním řízení a jeho ochrana." Doctoral thesis, 2016. http://www.nusl.cz/ntk/nusl-352084.
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