1,721,007 research outputs found
Usefulness of rehabilitation in patients with rotator cuff calcific tendinopathy after ultrasound-guided percutaneous treatment
No full textNeoangiogenesis is reduced in chronic tendinopathies of type 2 diabetic patients.
No full textIn diabetes, the prevalence of tendon degeneration is increased. As neoangiogenesis is impaired in several diabetic complications, the aim of this study is to evaluate the neovessel formation in tendinopathies. Patients aged > 55 years were selected, and divided into two groups: a) type 2 diabetic patients, and b) non-diabetic subjects. In both groups, those with ultrasound features of tendinopathy were included, and intratendinous vascularisation was estimated by means of Power Doppler. Ultrasound features of tendinopathy were observed in 104 diabetic subjects and in 221 controls. Neovascularisation, with higher Power Doppler scores, was found more frequently in controls, while lower Power Doppler scores were prevalent in diabetic subjects. In subjects with diabetes, tendinopathic features are significantly higher than healthy controls, while the prevalence of neovascularization inside tendons is less represented. Copyright © by BIOLIFE, s.a.s
Acid-base equilibria in ethaline. An approach providing a strategy for the pH modulation in deep eutectic solvents
Full text linkThe possibility of changing the pH in deep eutectic solvents when they are used as solvent media is fundamental in chemistry, since acid-base equilibria are of critical importance for almost all areas of chemistry, such as synthetic reactions, isolation of specific analytes, chromatographic separations, protein stability and enzyme catalysis. Such a possibility of modulating the pH of DESs is particularly interesting for enhancing the electrocatalytic properties of some electrode surfaces or promoting the stability and in some cases improving the activity of biorecognition systems such as antibodies, enzymes and aptamers that are particularly useful for biosensor applications. The aim of this investigation was the evaluation of the possibility of easily modulating the acid-base properties of the DES ethaline, adopted in our tests as the prototype of DESs because it displays a moderate viscosity at room temperature, by simply adding typical pH buffers such as weak acids or bases or salts consisting of weak acids and strong bases. This approach results to be particularly advantageous compared to that often used of modifying the proton activity of DESs by changing one or both of its precursors (HBA or HBD), since it allows their chemical-physical properties, such as density, viscosity, conductivity and surface tension, to be kept unchanged. With this purpose, acid-base equilibria in the DES ethaline were studied using cyclic voltammetry, pH measurements at glass electrodes, acid-base titrations and spectrophotometric measurements by exploiting suitable electrochemical probes, such as hydroquinone and alizarin: this last being an acid-base indicator. The results obtained with these measurements are all consistent with each other and provide an effective strategy to achieve pH modulation in DES, since the approach taken here in ethaline can be easily transferred to any other DES, provided it is capable of solubilizing the desired buffer species
The use of hyaluronic acid after tendon surgery and in tendinopathies
Full text linkViscosupplementation with hyaluronic acid is safe and effective in the management of osteoarthritis, but its use in the treatment of tendon disorders has received less attention. The aim of this review is to summarize the current knowledge on this topic, evaluating experimental and clinical trials. A search of English-language articles was performed using the key search terms "hyaluronic acid" or "viscosupplementation" combined with "tendon," "tendinopathy," "adhesions," or "gliding," independently. In quite all the experimental studies, performed after surgical procedures for tendon injuries or in the treatment of chronic tendinopathies, using different hyaluronic acid compounds, positive results (reduced formation of scars and granulation tissue after tendon repair, less adhesions and gliding resistance, and improved tissue healing) were observed. In a limited number of cases, hyaluronic acid has been employed in clinical practice. After flexor tendon surgery, a greater total active motion and fingers function, with an earlier return to work and daily activities, were observed. Similarly, in patients suffering from elbow, patellar, and shoulder tendons disorders, pain was reduced, and function improved. The positive effect of hyaluronic acid can be attributed to the anti-inflammatory activity, enhanced cell proliferation, and collagen deposition, besides the lubricating action on the sliding surface of the tendon
Achilles tendinopathy in elderly subjects with type II diabetes: the role of sport activities
No full textBACKGROUND:
Exercise is an important therapeutic tool in the management of diabetes in older people. Aim of this study was to assess the relationship among type II diabetes, sport, overweight, and symptomatic Achilles tendinopathy in elderly subjects.
METHODS:
Thirty-eight patients suffering from Achilles tendinopathy and thirty-eight controls were enrolled. The prevalence of diabetes and sport practice as well as BMI and Glycated Hemoglobin (HbA1c) values were registered. An ultrasound evaluation of Achilles tendon was performed.
RESULTS:
Patients showed an increased prevalence of diabetes (42 vs. 13.1 %, p = 0.004), and practice of sport (60.5 vs. 28.9 %, p = 0.0001), and higher BMI values (26.8 ± 3 vs. 24.8 ± 2.3, p = 0.001). Sonographic abnormalities, being diagnostic criteria, were present in all the patients with Achilles tendinopathy, but signs of degeneration were also found in 36.8 % of asymptomatic controls. Symptomatic subjects with diabetes, compared to those without, showed a higher prevalence of severe degeneration (75 vs. 36.3 %, p = 0.01). HbA1c values were significantly lower in sport practitioners, both diabetics and non-diabetics. Moreover, patients practicing sport showed a trend towards lower BMI values, compared to the sedentary counterpart.
CONCLUSIONS:
Sport practice in elderly diabetics provides relevant metabolic advantages, reducing HbA1c and BMI. However, some sport activities (e.g., speed walking, jogging or tennis) can expose to the risk of Achilles tendinopathy. So, sport practice should be encouraged, but practitioners should follow individual training programs and be submitted to periodic sonographic controls
Hyaluronic acid in ankle osteoarthritis: why evidence of efficacy is still lacking?
No full textIntra-articular injections of hyaluronic acid (HA) are useful in the treatment of osteoarthritis (OA), as shown by studies on knee, hip, and trapezio-metacarpal joints. The positive results can be explained by several factors: the restoration of elastic and viscous properties of intra-articular fluid, the anti-inflammatory and the anti-nociceptive activity, and the normalisation of hyaluronan synthesis and inhibition of hyaluronic acid degradation. However, evidence of efficacy of hyaluronic acid in ankle osteoarthritis is still lacking: several studies have been performed without a control group, or have shown similar results to those obtained with different therapeutic procedures. The aim of this paper is to analyse the reasons which can explain the discrepancy between the sound biological background and the inconclusive clinical results. First, it must be considered that the ankle joint, from a biomechanical point of view, is more complex than other joints, and that greater stress is sustained by the articular surfaces. Second, the limited benefit can be related to the use of hyaluronic acid mostly in cases of post-traumatic osteoarthritis, where the treatment must be addressed to solve the biomechanical problems, and then to restore the rheological properties of the ankle joint. A third important explanation of the failure may be the improper technique of administration, that has been performed in all studies, but one, without imaging guidance. Indeed, it is well known that hyaluronic acid, if not delivered directly into the intra-articular space, is unlikely to be effective
Management of limited joint mobility in diabetic patients.
Full text linkSeveral rheumatologic manifestations are more pronounced in subjects with diabetes, ie, frozen shoulder, rotator cuff tears, Dupuytren's contracture, trigger finger, cheiroarthropathy in the upper limb, and Achilles tendinopathy and plantar fasciitis in the lower limb. These conditions can limit the range of motion of the affected joint, thereby impairing function and ability to perform activities of daily living. This review provides a short description of diabetes-related joint diseases, the specific pathogenetic mechanisms involved, and the role of inflammation, overuse, and genetics, each of which activates a complex sequence of biochemical alterations. Diabetes is a causative factor in tendon diseases and amplifies the damage induced by other agents as well. According to an accepted hypothesis, damaged joint tissue in diabetes is caused by an excess of advanced glycation end products, which forms covalent cross-links within collagen fibers and alters their structure and function. Moreover, they interact with a variety of cell surface receptors, activating a number of effects, including pro-oxidant and proinflammatory events. Adiposity and advanced age, commonly associated with type 2 diabetes mellitus, are further pathogenetic factors. Prevention and strict control of this metabolic disorder is essential, because it has been demonstrated that limited joint motion is related to duration of the disease and hyperglycemia. Several treatments are used in clinical practice, but their mechanisms of action are not completely understood, and their efficacy is also debated
Cigarette smoking and musculoskeletal disorders.
Full text linkCigarette smoking has deleterious effects on the musculo-skeletal system. The loss of bone mineral content and increased incidence of fractures are the best known negative consequences. The pathogenesis is complex, due to direct toxic effects on osteoblasts/osteoclasts activity of nicotine, and indirect actions on sex and adrenocortical hormones, vitamin D, intestinal calcium absorption, vessels and oxygen supply. Smoking may favour the onset or aggravate the progression of rheumatoid arthritis and back pain. Negative influences have been observed on muscle and on tendons. Moreover, smoking habit is associated to a number of short term post-operative complications and higher resource consumption. Smoking cessation is highly advisable with positive effects on the bone metabolism on the long term. More positive and immediate results can be obtained in patients submitted to orthopedic surgery: the healing process is improved, the frequency of complications is reduced, and the length of hospital stay is shortened
Viscosupplementation with intra-articular hyaluronic acid for treatment of osteoarthritis in the elderly
No full textOsteoarthritis (OA) is very disabling condition in the elderly. The current therapeutic approaches (analgesics, NSAIDs, COX-2 inhibitors, steroids) do not delay the OA progression or reverse joint damage. Moreover, they may cause relevant systemic side effects. Hyaluronic acid (HA) is a physiologic component of the synovial fluid and is reduced in OA joints. Therefore, intra-articular injection of HA, due to its viscoelastic properties and protective effect on articular cartilage and soft tissue surfaces of joints, can restore the normal articular homoeostasis. These effects are evident when HA is properly administered into the articular space; therefore, the use of "image-guided" infiltration techniques is mandatory. Viscosupplementation (VS), with different HA preparations (Low and High molecular weight), can be considered when the patient has not found pain relief from other therapies or is intolerant to analgesics or NSAIDs. A 3-5 doses regimen is usually recommended with 1 week interval between each injection. Several studies have shown the efficacy of HA for the treatment of knee OA, with positive effects on pain, articular function (Western Ontario and Mc Master Universities Osteoarthritis Index [WOMAC], Lequesne Index [LI], Range of Motion [ROM]), subjective global assessment and reduction in NSAIDs consumption. In general, the benefit is evident within 3 months and persists in the following 6-12 months. Encouraging but inconclusive results have also been observed for the treatment of shoulder, carpo-metacarpal, hip and ankle OA. However there is the need of better designed studies to prove the effectiveness of these medications, in order to rule out a placebo effect. The therapy is well tolerated with absence of systemic side effects and only with limited local discomfort
Hyaluronic acid in knee osteoarthritis: preliminary results using a four months administration schedule
No full textAim: To evaluate the therapeutic trajectory of intra-articular injections of hyaluronic acid at high concentration (2%) performed at 4-month intervals.Methods: Subjects with knee osteoarthritis received, after a weekly injection of 32 mg/2 mL hyaluronic acid for 3 weeks, a single injection of 50 mg/2.5 mL hyaluronic acid (not cross-linked, molecular weight 8001200 kDa) at 4-month interval (4, 8 and 12 months). Clinical assessment (visual analogic scale [VAS] for pain at rest and during activities, Lequesne Index [LI], Knee Injury and Osteoarthritis Outcome Score (KOOS), and monthly non-steroidal anti-inflammatory drug consumption) was performed at baseline, and after 1, 4, 6, 8, 12 and 14 months.Results: In the 15 knees treated, pain decreased (baseline vs. 14 months: VAS at rest, 3.7 +/- 1.7 vs. 1 +/- 0.7 [P < 0.000]; VAS activities, 6.2 +/- 1.7 vs. 2.6 +/- 1.3 [P < 0.000]) and function improved (baseline vs. 14 months: KOOS, 51.9 +/- 15.3 vs. 70.2 +/- 13.7 [P < 0.000]; LI, 10 +/- 3.8 vs. 5.4 +/- 2.4 [P < 0.000]) significantly.Conclusions: This schedule provides persistent positive results in terms of reduced pain and improved function, optimizing the protective properties of the hyaluronic acid used
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