Małgorzata Paprocka-Borowicz

Evaluation of Bioelectrical Activity of Pelvic Floor Muscles and Synergistic Muscles Depending on Orientation of Pelvis in Menopausal Women with Symptoms of Stress Urinary Incontinence: A Preliminary Observational Study

Objectives. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles (PFM) and the synergistic muscles, depending on the orientation of the pelvis, in anterior (P1) and posterior (P2) pelvic tilt. Design. Preliminary, prospective observational study. Setting. Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Participants. Thirty-two menopausal and postmenopausal women with stress urinary incontinence were recruited. Based on inclusion and exclusion criteria, sixteen women aged 55 to 70 years were enrolled in the study. Primary Outcome Measures. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles by electromyography (sEMG) and vaginal probe. Secondary Outcome Measures. Evaluation of activity of the synergistic muscles by sEMG and surface electrodes. Results. No significant differences between orientations P1 and P2 were found in functional and resting sEMG activity of the PFM. During resting and functional PFM activity, higher electrical activity in P2 than in P1 has been recorded in some of the synergistic muscles. Conclusions. This preliminary study does not provide initial evidence that pelvic tilt influences PFM activation. Although different activity of synergistic muscles occurs in various orientations of the pelvic tilt, it does not have to affect the sEMG activity of the PFM.

Short-Term Effects of Kinesio Taping and Cross Taping Application in the Treatment of Latent Upper Trapezius Trigger Points: A Prospective, Single-Blind, Randomized, Sham-Controlled Trial.

Kinesio taping (KT) may be a new treatment in patients with myofascial trigger points (MTrPs). A new method available for taping practitioners is cross taping (CT). The main objective was to determine how CT, KT, and medical adhesive tape (sham group) affect the subjective assessment of resting bioelectrical activity and pain of the upper trapezius muscle (UT) in patients with MTrPs. 105 volunteers were recruited to participate. The primary outcome was resting bioelectrical activity of UT muscle as assessed by surface electromyography (sEMG) in each group and pain intensity on a visual analog scale (VAS). Assessments were collected before and after intervention and after the 24-hours follow-up. No significant differences were observed in bioelectrical activity of UT between pre-, post-, and follow-up results. In three groups patients had significantly lower pain VAS score after the intervention (CT—p < 0.001, KT—p < 0.001, and sham—p < 0.01). The Kruskal-Wallis ANOVA showed no significant differences in almost all measurements between groups. The application of all three types of tapes does not influence the resting bioelectrical activity of UT muscle and may not lead to a reduction in muscle tone in the case of MTrPs.

Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study

Objective Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman’s ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI. Materials and methods This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity. Results Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups. Conclusion In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the mechanism of continence.

Connection between Heat Shock Proteins 60/65 and Diabetic Vascular Complications

Introduction: Diabetes mellitus, as a metabolic disease, is closely associated with the development of atherosclerosis lesions. The share of heat shock proteins and antibodies in the HSP -60/65 atherogenesis in patients with type 2 diabetes is still an area subject to numerous studies. Material and methods: The study was conducted in the group of 46 patients with type 2 diabetes mellitus with macrovascular complications and 62 patients with atherosclerosis. The control group was comprised of a cohort of healthy volunteers in the corresponding age. Tissue material acquired during the planned endarterectomy from the internal carotid artery was used to measure the serum levels of anti HSP 60/65, the plasma levels of vWF, and to perform the immunohistochemistry study. Results: There was a higher concentration of anti HSP-60/65 in the group of patients with type 2 diabetes mellitus with macrovascular complications and patients with atherosclerosis without the endocrinopathies than in the control group (55.67 ± 65.43 vs. 26.09 ± 13.85, 82.98 ± 26.09 vs. 111.18 ± 13.85). Immunohistochemical method allowed observing a strong correlation between the concentration of antibodies to HSP60/65 in the blood serum and the protein expression of HSP 60/65 in the carotid arterial wall. The concentration of antibodies to HSP 60/65 was associated with the increase in the concentration of von Willebrand factor - marker of endothelial dysfunction (R=0.388, p<0.01). Conclusions: The research indicated an additional connection between the serum level of antibodies to HSP 60/65 and of vWF, in patients with type 2 diabetic mellitus with macrovascular complications, suggesting their influence on endothelial cell damage in the course of diabetic vascular complications.

Secondary Aortoenteric Fistula After Abdominal Aortic Graft Implementation in Our Own Material

BACKGROUND Secondary aortoenteric fistula is a rare but severe complication occurring after abdominal aortic graft implementation. OBJECTIVES The aim of our study was to review the clinical presentation, diagnosis and postoperative course of patients with aortoenteric fistulas following vascular operations on the abdominal aorta in the years 2000-2014. MATERIAL AND METHODS Among all the patients treated in our center, during a 10-year period, aortoenteric fistulas were observed in 24 cases. The first symptoms occurred between 4 weeks and 8 years after the procedure (3.4 years on average). The most common clinical presentation was gastrointestinal bleeding in 16 cases (66.7%). All patients underwent surgical repair of an aortoenteric fistula, with graft removal and replacement in situ using silver impregnated prosthesis. RESULTS The 30-day mortality rate after surgical treatment of SAEF was 37.5% (9 patients). Causes of death included: hemorrhagic shock, multi-organ failure and myocardial infarction. The early complications after the surgical repair of an aortoenteric fistula occurred in 19 (79.2%) patients. Mortality during the one-year follow-up period was 38.5% (5 patients) and the one-year complication rate was 69.2%. CONCLUSIONS Each patient with a history of abdominal aortic graft implementation and presenting symptoms of gastrointestinal bleeding requires careful diagnosing for aortoenteric fistula. New methods of surgical treatment offering lower mortality should be developed.

Comparison of the Short-Term Outcomes after Postisometric Muscle Relaxation or Kinesio Taping Application for Normalization of the Upper Trapezius Muscle Tone and the Pain Relief: A Preliminary Study

The main purpose of the study was to evaluate the resting bioelectrical activity of the upper trapezius muscle (the UT muscle) before and after one of the two interventions: postisometric muscle relaxation (PIR) and Kinesio Taping (KT). Moreover a comparison between group results was conducted. From the initial 61 volunteers, 52 were selected after exclusion criteria and were allocated randomly to 2 groups: PIR group and KT group. Outcome measures were assessed at baseline and completion of the intervention. The primary outcome measure was change in bioelectrical activity of UT muscle evaluated by surface electromyography (sEMG). Secondary outcomes included subjective assessment of pain using visual analogue scale (VAS). Significant differences were found only in KT group: the average resting bioelectrical activity decreased by 0.8 μV (p = 0.0237) and the average VAS result reduced by 2.0 points (p = 0.0001). Greater decrease of VAS results was recorded in KT group compared to PIR group (p = 0.0010). Both PIR and KT intervention did not influence significantly the resting bioelectrical activity of UT muscle. KT application was better for pain relief in the studied sample compared with PIR intervention.

Spine pain in the firefighter profession

BACKGROUND Musculoskeletal disorders mainly affecting the spine constitute one of the major social problems. Frequently, they constitute the cause of prolonged absence at work. Working in a fire brigade is specific because of the physical strain, working time under adverse conditions or stress related to rescue operations. MATERIAL AND METHODS The study group comprised 61 firefighters, 60 men (98.36%) and 1 woman (1.64%). The age of examined firefighters ranged 20–56 years old. The average age of the examined persons was 33.77 years old and the average working service in a fire brigade was 9.59 years. The following research instruments were applied as the study methods: own survey, the Numerical Rating Scale, the International Physical Activity Questionnaire (IPAQ) – long version and the Oswestry Disability Index (ODI) questionnaire. The Pearson correlation coefficient at significance level of p < 0.05 was used for determining the dependencies among the variables. RESULTS Knowledge of ergonomic lifting and handling principles concerning heavy loads was reported by 84% of the group, the remaining 16% declared ignorance of such rules. The dependence of pain on the length of service of the examined was insignificant and amounted to 0.281 Pearson’s r. The results of the ODI questionnaire did not significantly change statistically with age. CONCLUSIONS The IPAQ confirmed the high level of physical activity of the study population. Even though the study group was small, the results of ODI showed a minor degree of disability. Med Pr 2018;69(4):365-373

The Assessment of the Integrated Antioxidant System of the Body in the Course of Radon Therapy: A Pilot Study

Introduction The sources of Reactive Oxidative Species (ROS) in the organism are the respiratory processes occurring in cells catalyzed by different enzymes. Operation of ROS is balanced by antioxidants, the compounds; although present in low concentrations, they significantly inhibit the degree of oxidation of particular molecules. The Aim of the Study The aim of this study was to assess the changes in the integrated antioxidant system under the influence of radon therapy in osteoarthritis patients. Material and Methods Observation included 35 patients suffering from degenerative joints and disc disease (mean age 56.5 years) undergoing radon water therapy and control group that consisted of 15 osteoarthritis patients (mean age 54.2) without contact with radon water. Before therapy and after 18 days of treatment, serum total antioxidant status (TAS) was assessed with the use of standard colorimetric assay. Results In the study group, we observed trends to increase TAS concentration, whereas, in the control group, TAS concentration was decreasing. Conclusions (1) Radon waters treatment influenced the level of TAS of osteoarthritis patients treated with the radon water. (2) The change in TAS concentrations in the study group may be the result of low doses of ionizing radiation, but further studies on larger patients groups are demanded. This study is registered with number NCT03274128.

Trunk rotation due to persistence of primitive reflexes in early school-age children

BACKGROUND The angle of trunk rotation (ATR) is a measurement that allows an objective assessment of a growing childs spine. Early detection of trunk rotation prevents the progression of scoliosis. One of the factors that predispose children to the formation of faulty posture may be primitive reflexes, which should be integrated in the central nervous system (CNS) by the age of one year. If retained, primitive reflexes affect childrens physical development as well as their development at school. OBJECTIVES The aim of the study was to determine the prevalence of trunk asymmetry and the persistence of primitive reflexes and their inter-relationships in early school-age children. MATERIAL AND METHODS In this population-based survey, 61 children, average age 6.3 years (SD ±1.43), were examined. The ATR was examined using a scoliometer. The degree of integration of reflexes was assessed using tests developed by S. Goddard to assess the asymmetrical tonic neck reflex (ATNR), symmetrical tonic neck reflex (STNR), and spinal Galant reflex (SGR) on a 0-4 scale. Spearmans rank correlation coefficient and the χ2 test were used in the statistical analysis. RESULTS In almost half of the children body rotation was observed, in most cases toward the right (p = 0.012). This asymmetry was positively correlated with non-integrated Galant reflex on the same side (r = 0.335, p = 0.050). The presence of trunk rotation is associated with sex: There was higher frequency of asymmetry among the girls than among the boys. CONCLUSIONS In the evaluation of scoliosis, it could be useful to examine primitive reflexes as a possible reason for trunk rotation. In the treatment of scoliosis, primitive reflex integration methods should be used in some cases.

The assessment of the integrated antioxidant system of the bodyand the phenomenon of spa reaction in the courseof radon therapy: A pilot study

BACKGROUND Spa reaction is an adaptive response of an organism, emerging as a result of external factors. It is a positive element of spa therapy leading to metabolic changes, which are important for the body. The effect of these changes is an increase in immune activity and regenerative reactions of the body. The mechanism of the response is not fully known. OBJECTIVES The aim of the study was to evaluate the changes observed in the field of the integrated antioxidant system of the body in the course of radon therapy, especially in reference to spa reaction. MATERIAL AND METHODS The study was conducted in the health resort in Świeradów-Zdrój. The observation regarded patients undergoing treatment with radon water. Before the treatment, after 5 and 18 days of treatment, the total antioxidant status (TAS) was evaluated with the use of a standard colorimetric assay. The study group consisted of 35 patients with degenerative joints and disc disease. The control group consisted of 15 people selected from the employees of the spa, also suffering from osteoarthritis, who did not undergo radon therapy (without contact with radon). RESULTS On the 5th day of the treatment, in both groups, the TAS increase was observed with significantly worse results in the control group. After the treatment, in the study group, there was observed an increase in TAS, whereas in the control group, a significant decrease in the TAS concentration was noted. CONCLUSIONS A beneficial effect of radon treatments on the growth of TAS in the body of the patients treated in the spa was demonstrated. The increase in the TAS concentration on the 5th day of treatment may indicate the relationship between these changes and the phenomenon of spa response. The changes are a result of low doses of ionizing radiation originating from radon dissolved in medicinal water, used in the course of the therapy.