1,720,969 research outputs found
Obesity
No full textObesity is a common condition in many societies, and its incidence is rising [1]. It is defined as an excess of body fat, which may contribute to cause peripheral vascular deficiencies through its known associations with atherosclerosis [2, 3], elevated cholesterol level [2-4], and diabetes and metabolic syndrome [5]. All these correlated pathologies may lead to hypoxia of the rotator cuff critical area; the consequent release of many reactive oxygen species causing oxidative stress and cell apoptosis may cause degeneration of the tendon and predispose it to rupture [6]
Natural history
No full textInternational literature has always shown more interest in the surgical treatment of the rotator cuff tear rather than in the medical or physiotherapy ones. However, the orthopedic surgeon should be able to propose, among the various treatment options, also the conservative treatment, as many tears can become asymptomatic over time. In addition, many patients with cuff tears are in their seventies and often carriers of chronic diseases that contraindicate surgery except for treatments closely related to patient survival
Shoulder pain intensity and distribution
No full textRotator cuff has always attracted great interest because it may be responsible for shoulder pain, loss of strength, simple or complex disabilities, partial or total inability to work, thus reducing quality of life. Several studies have been performed with the aim to understand the etiology and natural history of the lesion and how to treat it. In addition, countless studies have been conducted regarding clinical maneuvers that may help the physician to better understand if the cuff is healthy or torn; if the lesion has involved the anterior or postero-superior cuff; if it is probably a small-large or massive (repairable or unrepairable) tear; if the pain originates from the shoulder; or is caused by a cervical spine diseases
Diabetes
No full textDiabetes mellitus is a major public health problem worldwide. It is a clinical entity associated with a large number of complications such as nephropathy, retinopathy, autonomic neuropathy, heart disease, stroke, and musculoskeletal diseases (stiff hand syndrome, various types of tendinitis, plantar fasciitis, carpal tunnel syndrome, and Dupuytren’s contracture) [1-3]. Attar [3] believes that musculoskeletal manifestations occur in 18 % of adult diabetic patients; Cagliero et al. [4] retain that these disorders are present in almost 40 % of cases. Although musculoskeletal manifestations are more common in patients with type I than type II diabetes, type of diabetes is not associated with hand and shoulder syndromes after adjusting for duration of diabetes [4]
Epidemiology and demographics of the rotator cuff tear
No full textA lot of epidemiologic studies have been carried out to determinate the prevalence and incidence of the rotator cuff tear, the average age of the patients affected, the work activities that cause the lesion and a possible sex-linked predisposition. These works have been performed on cadavers, on healthy people, and on patients with shoulder pain
The association between alcohol consumption and rotator cuff tear
No full textMany studies [1-7] on human and animals have proved that habitual high dose intake of ethanol is responsible for various toxic effects on capillary microcirculation and tissue perfusion, depending on the total dose consumed per day and on the duration of the habit. Furthermore, these negative effects are different in males and females. In fact, the same amount of alcohol consumed leads to a greater blood level of ethanol and has more toxic effects in females rather than in males [8]
Hypercholesterolemia
No full textIt is known that high levels of cholesterol, triglycerides, and low-density lipoprotein (LDL) may determine vessel wall damage. As it is also known that tendon tissue insertion to the greater tuberosity of the humerus normally receives a poor blood supply, especially with the arm in adducted position [1], some authors have hypothesized that hypercholesterolemia may be an additional risk factor for tissue degeneration and, consequently, for rotator cuff tear
Arginine L-alpha-ketoglutarate, methylsulfonylmethane, hydrolyzed type I collagen and bromelain in rotator cuff tear repair: a prospective randomized study.
No full textArthroscopic rotator cuff repair generally provides
satisfactory result, in terms of decreasing shoulder pain, resulting in
improvement in range of motion. Unfortunately, imaging studies have shown that
after surgical repair re-rupture rate is potentially high. Literature data
indicate that each of the components present in a commercial supplement sold in
Italy as Tenosan * (arginine L-alpha-ketoglutarate, methylsulfonylmethane,
hydrolyzed type I collagen and bromelain) have a potential role in tendon healing
and mitigating the pain due to tendonitis. We evaluated the clinical and MRI
results of rotator cuff repair with and without the employment of this oral
supplement in patients with a large, postero-superior rotator cuff tear (RCT).
Research design and methods: We enrolled 90 consecutive patients who had a large,
postero-superior RCT. All the lesions were managed with an arthroscopic repair.
Patients were randomized and treated either with (Group I) or without (Group II)
the supplement. The primary outcomes were the difference between the pre- and
post-operative Constant score and repair integrity assessed by MRI according to
Sugaya's classification. The secondary outcome was the pre- and post-operative
Simple Shoulder Test. Results: No statistically significant differences were
identified between the two groups for each considered variable, except for
shoulder pain (follow-up: 6 months) and repair integrity (final follow-up).
Intensity of shoulder pain was lower in the Group I patients (p < 0.001).
Analogously, in Group I, the percentage of patients with a better repair
integrity result was significantly higher than Group II. Conclusion: The use of
the supplement for 3 months after cuff repair decreases shoulder post-operative
pain and leads to a slight improvement in repair integrity. This improvement does
not seem to correlate with an better objective functional outcome. However, these
effects could facilitate and abbreviate the post-operative rehabilitation program
and reduce re-rupture rate. The main limitations of this study are the relative
short follow-up period and small number of patients studied
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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