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The impact was significant in all the three groups (p&lt;0.05). The effect was significantly better in group C than groups A and B.<br /><br /> Body mass index and body fat percentage values improved through aerobic, resistance and dynamic resistance exercises.<br /><br />Body mass index and body fat percentage values improved through aerobic, resistance and dynamic resistance exercises.<br /><br /> To compare the effects of Mulligan technique and muscle energy technique in patients with adhesive capsulitis.<br /><br /> The randomised controlled trial was conducted at the Department of Physiotherapy, Government Mian Munshi Hospital, Lahore, Pakistan, from September 1, 2019, to March 31, 2020, and comprised patients with adhesive capsulitis who were randomised into Mulligan mobilisation Group A and muscle energy technique Group B. The outcome assessor was kept blinded to the treatment plan. Pain, range of motion and functional disability were measured using Visual Analogue Scale, universal goniometer and Shoulder Pain and Disability Indexat baseline, and subsequently at the end of third and sixth weeks. Data was analysed using SPSS 24.<br /><br /> Of the 78 subjects, 39(50%) were in each of the two groups. Group A had 11(28%) male and 28(72%) female patients, while Group B had 20(51%) male and 19(49%) female patients. Both groups showed significant improvement (p&lt;0.001), and inter-group comparison showed the difference to be non-significant at baseline and third week (p&gt;0.05). However, post-intervention difference showed significantly better results in Group A compared to Group B (p&lt;0.05).<br /><br /> Mulligan technique was found to be more effective than muscle energy technique in improving range of motion, and in reducing pain and functional disability.<br /><br /> IRCT 20200605047660.<br /><br />IRCT 20200605047660.BACKGROUND The aim of this research was to investigate the analgesic effects of intravenous lidocaine on postoperative pain management in orthopedic patients after total joint arthroplasty and fractures of the limbs and to compare lidocaine efficacy between these orthopedic surgical procedures. MATERIAL AND METHODS Ninety patients scheduled for elective orthopedic surgery were recruited 46 patients with total knee arthroplasty, and 35 patients with femoral fractures. Patients in the lidocaine group received lidocaine during the induction phase of anesthesia as a bolus injection of 1.5·kg⁻¹·mg over 10 min, followed by intravenous infusion of 1.5 mg·kg⁻¹·h⁻¹ for 24 postoperative hours. Patients in the control group received an equal volume of saline as placebo administered at the same rate. Pain scores were assesed at intervals of 0, 15, 30, 60 min, and 6, 12, and 24 h postoperatively. The reduction rate of additional analgesics, total analgesic use, incidence of nausea and vomiting, mobilization, length of hospital stay, adverse effects, and hemodynamic parameters were secondary outcomes. RESULTS Pain scores at rest and during movement were significantly lower in the lidocaine group compared to those in controls starting at 30 min (P=0.03), the first postoperative hour, and also at 6, 12, and 24 h (P less then 0.001). Additional analgesics were administered at a significantly lower rate in the lidocaine group (P less then 0.05). Total analgesic use in the postoperative period was significantly higher in the control group (P less then 0.001). CONCLUSIONS This study showed that intravenous lidocaine provided adequate postoperative analgesia for orthopedic patients undergoing elective total joint arthroplasty and limb fracture repair.<br /><br /> Targeted regional optimization (TRO), a partial resuscitative endovascular balloon occlusion of the aorta strategy, may mitigate distal ischemia and extend the window of effectiveness for this adjunct. An automated device may allow greater control and precise regulation of flow past the balloon, while being less resource-intensive. The objective of this study was to assess the technical feasibility of the novel advanced partial occlusion controller (APOC) in achieving TRO at multiple distal pressures.<br /><br /> Female swine (n = 48, 68.1 ± 0.7 kg) were randomized to a target distal mean arterial pressure (MAP) of 25 mm Hg, 35 mm Hg, or 45 mm Hg by either manual (MAN) or APOC regulation (n = 8 per group). Uncontrolled hemorrhage was generated by liver laceration. Targeted regional optimization was performed for 85 minutes, followed by surgical control and a 6-hour critical care phase. Proximal and distal MAP and flow rates were measured continuously.<br /><br /> At a target distal MAP of 25 mm Hg, there was no difference in the MAP attained (APOC 26.2 ± 1.05 vs. [https://www.selleckchem.com/products/fin56.html FIN56 clinical trial] MAN 26.1 ± 1.78 mm Hg) but the APOC had significantly less deviance (10.9%) than manual titration (14.9%, p &lt; 0.0001). Similarly, at a target distal MAP of 45 mm Hg, there was no difference in mean pressure (44.0 ± 0.900 mm Hg vs. 45.2 ± 1.31 mm Hg) but APOC had less deviance (9.34% vs. 11.9%, p &lt; 0.0001). There was no difference between APOC and MAN in mean (34.6 mm Hg vs. 33.7 mm Hg) or deviance (9.95% vs. 10.4%) at a target distal MAP of 35 mm Hg, respectively. The APOC made on average 77 balloon volume adjustments per experiment compared with 29 by manual titrations.<br /><br /> The novel APOC consistently achieved and sustained precisely regulated TRO across all groups and demonstrated reduced deviance at the 25 mm Hg and 45 mm Hg groups compared with manual titration.<br /><br />The novel APOC consistently achieved and sustained precisely regulated TRO across all groups and demonstrated reduced deviance at the 25 mm Hg and 45 mm Hg groups compared with manual titration.<br /><br /> Platelet dysfunction is known to occur in patients with traumatic brain injury (TBI), and the correction of platelet dysfunction may prevent hemorrhagic progression in TBI. Thromboelastography with platelet mapping (TEG-PM; Haemonetics) evaluates the degree of platelet function inhibition through the adenosine diphosphate (ADP) and arachidonic acid (AA) pathways. We hypothesized that ADP and AA inhibition would improve with the transfusion of platelets in patients with TBI.<br /><br /> A retrospective review was conducted at a Level I trauma center of all patients presenting with TBI from December 2019 to December 2020. Per a practice management guideline, a platelet mapping assay was obtained on all patients with TBI upon admission. If ADP or AA was found to be inhibited (&gt;60%), the patient was transfused 1 unit of platelets and a repeat platelet mapping assay was ordered. Demographic data, laboratory values, and outcomes were analyzed.<br /><br /> Over the 13-month study period, 453 patients with TBI underwent TEG-PM withutic / Care Management, level III.<br /><br /> Kidney transplant patients are at high risk for coronavirus disease 2019 (COVID-19)-related mortality. However, limited data are available on longer-term clinical, functional, and mental health outcomes in patients who survive COVID-19.<br /><br /> We analyzed data from adult kidney transplant patients in the European Renal Association COVID-19 Database who presented with COVID-19 between February 1, 2020, and January 31, 2021.<br /><br /> We included 912 patients with a mean age of 56.7 (±13.7) y. 26.4% were not hospitalized, 57.5% were hospitalized without need for intensive care unit (ICU) admission, and 16.1% were hospitalized and admitted to the ICU. At 3 mo follow-up survival was 82.3% overall, and 98.8%, 84.2%, and 49.0%, respectively, in each group. At 3 mo follow-up biopsy-proven acute rejection, need for renal replacement therapy, and graft failure occurred in the overall group in 0.8%, 2.6%, and 1.8% respectively, and in 2.1%, 10.6%, and 10.6% of ICU-admitted patients, respectively. Of the surviving patients, 83.3% and 94.4% reached their pre-COVID-19 physician-reported functional and mental health status, respectively, within 3 mo. Of patients who had not yet reached their prior functional and mental health status, their treating physicians expected that 79.6% and 80.0%, respectively, still would do so within the coming year. ICU admission was independently associated with a low likelihood to reach prior functional and mental health status.<br /><br /> In kidney transplant recipients alive at 3-mo follow-up, clinical, physician-reported functional, and mental health recovery was good for both nonhospitalized and hospitalized patients. Recovery was, however, less favorable for patients who had been admitted to the ICU.<br /><br />In kidney transplant recipients alive at 3-mo follow-up, clinical, physician-reported functional, and mental health recovery was good for both nonhospitalized and hospitalized patients. Recovery was, however, less favorable for patients who had been admitted to the ICU.<br /><br /> The long-term effects of exercise in patients with McArdle disease-the paradigm of "exercise intolerance"-are unknown. This is an important question because the severity of the disease frequently increases with time.<br /><br /> This study aimed to study the effects of a long-term exercise intervention on clinical and fitness-related outcomes in McArdle patients.<br /><br /> Seventeen patients (exercise group n = 10, 6 male, 38 ± 18 yr; control n = 7, 4 male, 38 ± 18 yr) participated in a 2-yr unsupervised intervention including moderate-intensity aerobic (cycle-ergometer exercise for 1 h) and resistance (high load-low repetition circuit) training on 5 and 2-3 d·wk -1 , respectively. Patients were assessed at baseline and postintervention. Besides safety, outcomes included clinical severity (e.g., exercise intolerance features) on a 0-3 scale (primary outcome), and aerobic fitness, gross muscle efficiency, and body composition (total/regional fat, muscle, and bone mass; secondary outcomes).<br /><br /> The exercise program was safe and g aerobic and resistance exercise is safe and induces major benefits in the clinical course and aerobic fitness of patients with McArdle disease.<br /><br /> Syphilis continues to be a public health problem, and its diagnosis still has limitations. Molecular diagnosis provides an alternative for rapid and effective management. The objective is to determine the accuracy of tests in the molecular diagnosis of syphilis.<br /><br /> We searched PubMed and Web of Sciences for articles related to molecular detection of syphilis from January 1, 2009, to December 31, 2019. The bivariate Reitsma model and the hierarchical receiver operating characteristic curve model were used to evaluate the diagnostic performance of molecular tests at a 95% confidence interval. A subgroup meta-analysis was performed to explore sources of heterogeneity.<br /><br /> Forty-seven articles were identified for qualitative synthesis, of which 23 met the inclusion criteria for meta-analysis. The pooled sensitivities in conventional polymerase chain reaction (PCR) and real-time PCR were 77.52 (59.50-89.01) and 68.43 (54.96-79.39), respectively. The pooled specificities were 98.00 (90.73-99.59) and 98.84 (97.55-99.46), respectively. Ulcer samples had a better performance (sensitivity of 79.88 [69.00-87.62] and specificity of 98.58 [97.25-99.27]), and the major target genes were the polymerase A gene and tpp47 gene.<br /><br /> Our work showed that conventional PCR was more widely used than real-time PCR in the diagnosis of syphilis, and ulcers were the best specimens. Sample types and target genes are factors that may influence the quality of the different tests. These results could provide evidence for further work in the direction of providing a more efficient diagnostic test.<br /><br />Our work showed that conventional PCR was more widely used than real-time PCR in the diagnosis of syphilis, and ulcers were the best specimens. Sample types and target genes are factors that may influence the quality of the different tests. These results could provide evidence for further work in the direction of providing a more efficient diagnostic test.