Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy.

PURPOSE: To investigate the outcome of ultrasound (US)-guided intratissue percutaneous electrolysis (EPI(®)) and eccentric exercise in the treatment of patellar tendinopathy during a long-term follow-up. METHODS: Forty patients with patellar tendinopathy were prospectively evaluated over a 10-year follow-up period. Pain and function were evaluated before treatment, at 3 months and at 2, 5 and 10 years using the Victorian Institute of Sport Assessment-Patella (VISA-P) score, the Tegner score and Blazina's classification. According to VISA-P score at baseline, patients were also dichotomized into Group 1 (<50 points) and Group 2 (≥50 points). There were 21 patients in Group 1 and 19 in Group 2. Patient satisfaction was measured according to the Roles and Maudsley score. RESULTS: The VISA-P score improved globally by 41.2 points (p < 0.01) after a mean 4.1 procedures. In Group 1, VISA-P score improved from 33.1 ± 13 to 78.9 ± 14.4 at 3-month and to 88.8 ± 10.1 at 10-year follow-up (p < 0.001). In Group 2, VISA-P score improved from 69.3 ± 10.5 to 84.9 ± 9 at 3-month and to 96.0 ± 4.3 at 10-year follow-up (p < 0.001). After 10 years, 91.2 % of the patients had a VISA-P score >80 points. The same level (80 % of patients) or the Tegner score at no more than one level lower (20 % of patients) was restored, and 97.5 % of the patients were satisfied with the procedure. CONCLUSION: Treatment with the US-guided EPI(®) technique and eccentric exercises in patellar tendinopathy resulted in a great improvement in knee function and a rapid return to the previous level of activity after few sessions. The procedure has proved to be safe with no recurrences on a long-term basis. LEVEL OF EVIDENCE: Therapeutic study, Level IV.

Mecanismos moleculares de reparación mediante la técnica Electrólisis Percutánea Intratisular en la tendinosis rotuliana / Molecular repair mechanisms using the Intratissue Percutaneous Electrolysis technique in patellar tendonitis

Objetivo. Investigar los mecanismos moleculares de respuesta tisular tras el tratamiento con la técnica Electrólisis Percutánea Intratisular (EPI®) en la tendinosis inducida por colagenasa tipo i en ratas Sprague Dawley. Métodos. En una muestra de 24 ratas Sprague Dawley de 7 meses de edad y 300 g se indujo tendinosis mediante la inyección en el tendón rotuliano de 50 μg de colagenasa tipo i . Se procedió a dividir la muestra en 4 grupos: un grupo control, un grupo colagenasa y 2 grupos de tratamiento con técnica EPI® a 3 y 6 mA, respectivamente. Se aplicó una sesión de tratamiento EPI® y tras 3 días se procedió al análisis de los tendones mediante técnicas de inmunodetección y electroforesis. Se analizaron las proteínas citocromo C, Smac/Diablo, factor de crecimiento endotelial vascular y su receptor 2. También se analizó el factor de transcripción nuclear peroxisoma proliferador activado del receptor gamma. Resultados. Se observó un aumento estadísticamente significativo en la expresión del citocromo C, Smac/Diablo, factor de crecimiento endotelial vascular, su receptor 2 y peroxisoma proliferador activado del receptor gamma en los grupos a los que se les aplicó la técnica EPI® respecto al grupo control. Conclusiones. La técnica EPI® produce, en la lesión tendinosa inducida con colagenasa tipo i en ratas, un aumento de los mecanismos moleculares antiinflamatorios y angiogénicos (AU)

Objective. To investigate the molecular mechanisms of tissue response after treatment with the Intratissue Percutaneous Electrolysis (EPI®) technique in collagenase-induced tendinopathy in Sprague-Dawley rats. Methods. Tendinopathy was induced by injecting 50 μg of type i collagenase into the patellar tendon of 24 Sprague Dawley rats of 7 months of age and weighting 300 g. The sample was divided into 4 groups: the control group, collagenase group, and two EPI® technique treatment groups of 3 and 6 mA, respectively. An EPI® treatment session was applied, and after 3 days, the tendons were analysed using immunoblotting and electrophoresis techniques. An analysis was also made of cytochrome C protein, Smac/Diablo, vascular endothelial growth factor and its receptor 2, as well as the nuclear transcription factor peroxisome proliferator-activated receptor gamma. Results. A statistically significant increase, compared to the control group, was observed in the expression of cytochrome C, Smac/Diablo, vascular endothelial growth factor, its receptor 2 and peroxisome proliferator-activated receptor gamma in the groups in which the EPI® technique was applied. Conclusions. EPI® technique produces an increase in anti-inflammatory and angiogenic molecular mechanisms in collagenase-induced tendon injury in rats (AU)

[Molecular repair mechanisms using the Intratissue Percutaneous Electrolysis technique in patellar tendonitis]. / Mecanismos moleculares de reparación mediante la técnica Electrólisis Percutánea Intratisular en la tendinosis rotuliana.

OBJECTIVE: To investigate the molecular mechanisms of tissue response after treatment with the Intratissue Percutaneous Electrolysis (EPI(®)) technique in collagenase-induced tendinopathy in Sprague-Dawley rats. METHODS: Tendinopathy was induced by injecting 50 µg of type i collagenase into the patellar tendon of 24 Sprague Dawley rats of 7 months of age and weighting 300 g. The sample was divided into 4 groups: the control group, collagenase group, and two EPI(®) technique treatment groups of 3 and 6 mA, respectively. An EPI(®) treatment session was applied, and after 3 days, the tendons were analysed using immunoblotting and electrophoresis techniques. An analysis was also made of cytochrome C protein, Smac/Diablo, vascular endothelial growth factor and its receptor 2, as well as the nuclear transcription factor peroxisome proliferator-activated receptor gamma. RESULTS: A statistically significant increase, compared to the control group, was observed in the expression of cytochrome C, Smac/Diablo, vascular endothelial growth factor, its receptor 2 and peroxisome proliferator-activated receptor gamma in the groups in which the EPI(®) technique was applied. CONCLUSIONS: EPI(®) technique produces an increase in anti-inflammatory and angiogenic molecular mechanisms in collagenase-induced tendon injury in rats.

Plasminogen activation system in goat milk and its relation with composition and coagulation properties.

The activity of plasmin (PL), plasminogen (PG), and plasminogen activator (PA) and their correlation with goat milk components and milk clotting parameters were investigated. Seven late-lactating Saanen goats were used to provide milk samples that were analyzed for PL, PG, and PA activity (colorimetric assay) fat, protein, noncasein nitrogen, nonprotein nitrogen, casein content, and somatic cell count (SCC). Milk clotting parameters (rennet coagulating time = coagulation time; K20 = firming rate of curd; A30 = curd firmness) were measured with a formagraph. Average milk yield and composition were similar to those previously observed in other studies. Plasmin, PG, and PA activity, expressed as units/ml, were, respectively, 20.04 +/- 0.94, 3.21 +/- 0.04, and 1154 +/- 57.61. Plasminogen activity was surprisingly low compared with other species (bovine, ovine), but it was consistent with the high activity of PA. A negative significant correlation was observed between PL and milk casein content. The correlation coefficients between PL and casein/protein ratio and PA and casein/protein ratio were negative and significant. A positive significant correlation was observed between PL and rennet clotting time and PA and rennet clotting time. Also positive was the correlation between PL and K20 and PA and K20. The plasmin activity was negatively correlated with A30. High plasmin and plasminogen activator activity in goat milk appeared to be negatively related with coagulating properties in late lactation, most probably via degradation of casein due to plasmin activity.

Tenderization of wether lambs meat through pre-rigor infusion of calcium ions.

A study involving 36 wether lamb carcasses was conducted in order to evaluate the effects of 0.3 M CaCl(2) injection on final tenderness in muscle Longissimus thoracis et lumborum. Injection of wether lamb carcasses with CaCl(2) accelerated the post mortem tenderization process. Both control and distilled water injected animals had similar Ca(2+)-dependent proteases (µ-calpain and m-calpain) and their inhibitor (calpastatin) activities, whereas these were all significantly decreased in CaCl(2) injected animals. The effect of CaCl(2) injection on tenderness was recorded by measuring shear force values 2 and 6 days post mortem. Tenderness was significantly improved by CaCl(2) injection at both at 2 and 6 days post mortem. It was concluded that activation of µ-calpain and m-calpain was responsible for the observed post mortem proteolysis and tenderization.

Reactivity and event-related potentials during attentional tests in athletes.

A series of attentional tests involving reaction times (RTs) was administered to 12 high-level young (age 17-18 years) volleyball players. During the tests, event-related potentials were recorded by electroencephalogram. In a simple reaction-time test (SRT), the subjects had to respond to a letter that appeared on a white screen. Other tests (attentional shifting tests) consisted of a go/no-go reaction time and a choice reaction time (CRT), divided into a short-latency CRT and a long-latency CRT. In the pre-stimulus period of these tests, there is a shift from broad attention to selective attention, represented by a crowding of black points on the computer screen, followed by the appearance of a letter in the centre of the crowding. The results show that RT increased from SRT to CRT. In the attentional shifting tests, averaged waves of event-related potentials showed a contingent-negative-variation-like wave that was closely related to selective attention (selective attention wave, SAW) before the onset of the stimulus. After the stimulus, a P3 complex was recorded. Correlations were found between the SAW amplitude and P3 latency and amplitude, and between these parameters and RT and its variability. Higher SAW and P3 amplitudes were accompanied by a shorter RT and a lower variability. The characteristics and the correlations that exist between the various parameters are consistent with a possible use of these tests in the analysis of the attentional styles of athletes, and in the evaluation of their progress with training.

Effect of recombinant bovine somatotropin and calcium salts of long-chain fatty acids on milk from Italian buffalo.

Fifty-one lactating Italian river buffalo were used in an 84-d study to evaluate the effects of recombinant bovine somatotropin (bST) and Ca salts of long-chain fatty acids on productive performance. Treatments were 1) control diet, 2) the control diet plus 0.3 kg/d of added Ca salts of long-chain fatty acids, 3) the control diet plus 320 mg of recombinant bST injected every 21 d for four cycles, and 4) the control diet plus 0.3 kg/d of added Ca salts of long-chain fatty acids and 320 mg of recombinant bST administered as previously described. Administration of bST and Ca salts of long-chain fatty acids increased milk production. Milk fat percentage was not affected by treatments. The percentage of short-chain fatty acids in milk fat was reduced by the addition of Ca salts. Medium-chain, long-chain, and unsaturated fatty acids in milk fat were increased by bST treatment. Milk protein percentage was decreased by the addition of Ca salts of long-chain fatty acids. Milk casein content, as a percentage of total protein or as a percentage of true protein, was unaffected by bST. Body condition score was lowered by bST administration, but the addition of Ca salts of long-chain fatty acids reduced body condition loss in buffalo that were treated with somatotropin.

Hormonal and metabolic responses to the stress of transport and slaughterhouse procedures in clenbuterol-fed pigs.

The aim of this study was to evaluate if metabolic and endocrine adaptive responses to stressful stimuli are influenced by clenbuterol treatment in pigs. Two groups of nine Goland barrows of 167 kg liveweight, fed diets containing 0 (control) or 1 ppm of clenbuterol (clenbuterol-treated) for 40 days, were used. Blood samples were collected by jugular venipuncture the day before (day 40) and at slaughter (day 41). On day 40 clenbuterol-treated pigs had lower levels of thyroxin, tri-iodothyronine, insulin, urea and higher levels of lactate and creatine phosphokinase activity. On day 41, thyroxin concentration was lower and creatine phosphokinase activity higher in clenbuterol-treated pigs than in controls. In response to transport and slaughterhouse procedures, most of the parameters considered both in clenbuterol-treated and in control pigs increased.