Intra-Articular Laser Therapy May Be a Feasible Option in Treating Knee Osteoarthritis in Elderly Patients.

Knee osteoarthritis (OA) is a common problem in elderly patients. They are often troubled with altered knee function, such as pain and weakness. However, not all these patients are able to receive autologous platelet-rich plasma (PRP) injections as they may be taking antiplatelet or anticoagulant medications. Their physical condition may not allow them to receive total knee replacement surgery as well. Long-term oral intake of nonsteroidal anti-inflammatory drugs may be detrimental to the gastrointestinal tract. As a result, it is crucial to discover new treatment options that can alleviate painful knee symptoms in elderly knee OA patients. In this study, 19 elderly patients diagnosed with moderate degree of knee OA as well as suprapatellar bursitis were recruited. They received low-level laser therapy (LLLT) to their affected knees. Under ultrasound guidance, flexible fiber optic wire was inserted intra-articularly into the knee joint. Red laser followed by infrared irradiation was performed once every 2 weeks for a total of 3 times. The Lequesne index for knee OA and the volume of suprapatellar synovial fluid (SF) were measured. SF proteomic analyses were also performed up to a period of 6 months. The results revealed that after 3 LLLT, the Lequesne index significantly decreased, signifying improvement in the knee joint functional status. The volume of suprapatellar SF and SF proteins associated with inflammation also decreased significantly in the SF. These findings lasted up to a period of at least 3 months. Therefore, LLLT may be considered as a feasible option in treating elderly patients with knee OA who are not suitable for surgical interventions or intra-articular PRP injections.

Cycling Exercise Training Enhances Platelet Mitochondrial Bioenergetics in Patients with Peripheral Arterial Disease: A Randomized Controlled Trial.

Exercise training influences the risk of vascular thrombosis in patients with peripheral arterial disease (PAD). Mitochondrial functionalities in platelets involve the cellular bioenergetics and thrombogenesis. This study aimed to elucidate the effect of cycling exercise training (CET) on platelet mitochondrial bioenergetics in PAD patients. Forty randomly selected patients with PAD engaged in general rehabilitation (GR) with CET (i.e., cycling exercise at ventilation threshold for 30 minute/day, 3 days/week) (GR + CET, n = 20) or to a control group that only received GR course (n = 20) for 12 weeks. Systemic aerobic capacity and platelet mitochondrial bioenergetics that included oxidative phosphorylation (OXPHOS) and electron transport system (ETS) were measured using automatic gas analysis and high-resolution respirometry, respectively. The experimental results demonstrated that GR + CET for 12 weeks significantly (1) elevated VO2peak and lowered VE-VCO2 slope, (2) raised resting ankle-brachial index and enhanced cardiac output response to exercise, (3) increased the distance in 6-minute walk test and raised the Short Form-36 physical/mental component scores, and (4) enhanced capacities of mitochondrial OXPHOS and ETS in platelets by activating FADH2 (complex II)-dependent pathway. Moreover, changes in VO2peak levels were positively associated with changes in platelet OXPHOS and ETS capacities. However, no significant changes in systemic aerobic capacity, platelet mitochondrial bioenergetics, and health-related quality of life (HRQoL) occurred following GR alone. Hence, we conclude that CET effectively increases the capacities of platelet mitochondrial bioenergetics by enhancing complex II activity in patients with PAD. Moreover, the exercise regimen also enhanced functional exercise capacity, consequently improving HRQoL in PAD patients.

Cerebellar-limbic neurocircuit is the novel biosignature of physio-cognitive decline syndrome.

Both physical and cognitive deficits occur in the aging process. We operationally defined the phenomenon as physio-cognitive decline syndrome (PCDS) and aimed to decipher its corresponding neuroanatomy patterns and neurocircuit. High resolution 3T brain magnetic resonance imaging (MRI) images from a community-dwelling longitudinal aging cohort were analysed. PCDS was defined as weakness (handgrip strength) and/or slowness (gait speed) concomitant with impairment in any cognitive domain (defined by 1.5 standard deviation below age, sex-matched norms), but without dementia or disability. Among 1196 eligible ≥ 50-year-old (62±9 years, 47.6%men) subjects, 15.9% had PCDS. Compared to the other participants, individuals with PCDS had significantly lower gray-matter volume (GMV) in the bilateral amygdala and thalamus, right hippocampus, right temporo-occipital cortex, and left cerebellum VI and V regions. The regions of reduced GMV in people with PCDS were similar between the middle-aged and older adults; whereas larger clusters with more extensive GMV-depleted regions were observed in ≥65-year-olds with PCDS. Diffusion-weighted tractography showed disrupted hippocampus-amygdala-cerebellum connections in subjects with PCDS. The neuroanatomic characteristics revealed by this study provide evidence for pathophysiological processes associated with concomitant physio-cognitive decline in the elderly. This neurocircuit might constitute a target for future preventive interventions.

High-intensity interval training enhances mitochondrial bioenergetics of platelets in patients with heart failure.

OBJECTIVE: Exercise improves cardiopulmonary fitness and reduces the risk of vascular thrombosis in patients with cardiovascular diseases. In platelets, mitochondria carry out cellular bioenergetics and thrombogenesis. This study aimed to elucidate the effect of high-intensity interval training (HIIT) on systemic aerobic capacity and platelet mitochondrial bioenergetics in patients with heart failure (HF). METHODS: Thirty-four randomly selected HF patients engaged in HIIT (3-min intervals at 40% and 80% of VO2peak, n = 17) for 30 min/day, 3 days/week for 12 weeks, or to a control group that received general healthcare (GHC; n = 17). Systemic aerobic capacity (i.e., peak O2 consumption, VO2peak) and platelet mitochondrial O2 consumption rate (OCR) in the HF patients were measured through automatic gas analysis and high-resolution respirometry, respectively. RESULTS: The HIIT group exhibited higher VO2peak and O2 uptake efficiency slope and lower VE-VCO2 slope after 12-week intervention, compared to those of the GHC group. Moreover, the HIIT regimen increased the maximal and reserve OCR capacities, enhanced the Complex I- and II-mediated OCRs, and elevated the bioenergetic health index in platelet mitochondria; however, these effects were not observed with the GHC regimen. Additionally, the VO2peak levels were positively correlated with the maximal and reserve OCR capacities and Complex I- and II-mediated OCRs in platelet mitochondria. CONCLUSION: Platelet mitochondrial function is an ideal bioenergetic indicator in patients with HF. HIIT for 12 weeks elevates platelet mitochondrial OCRs via increasing Complex I and II activities. Moreover, systemic aerobic capacity is positively associated with platelet mitochondrial OCRs in HF patients.

Low-level laser irradiation stimulates tenocyte migration with up-regulation of dynamin II expression.

Low-level laser therapy (LLLT) is commonly used to treat sports-related tendinopathy or tendon injury. Tendon healing requires tenocyte migration to the repair site, followed by proliferation and synthesis of the extracellular matrix. This study was designed to determine the effect of laser on tenocyte migration. Furthermore, the correlation between this effect and expression of dynamin 2, a positive regulator of cell motility, was also investigated. Tenocytes intrinsic to rat Achilles tendon were treated with low-level laser (660 nm with energy density at 1.0, 1.5, and 2.0 J/cm(2)). Tenocyte migration was evaluated by an in vitro wound healing model and by transwell filter migration assay. The messenger RNA (mRNA) and protein expressions of dynamin 2 were determined by reverse transcription/real-time polymerase chain reaction (real-time PCR) and Western blot analysis respectively. Immunofluorescence staining was used to evaluate the dynamin 2 expression in tenocytes. Tenocytes with or without laser irradiation was treated with dynasore, a dynamin competitor and then underwent transwell filter migration assay. In vitro wound model revealed that more tenocytes with laser irradiation migrated across the wound border to the cell-free zone. Transwell filter migration assay confirmed that tenocyte migration was enhanced dose-dependently by laser. Real-time PCR and Western-blot analysis demonstrated that mRNA and protein expressions of dynamin 2 were up-regulated by laser irradiation dose-dependently. Confocal microscopy showed that laser enhanced the expression of dynamin 2 in cytoplasm of tenocytes. The stimulation effect of laser on tenocytes migration was suppressed by dynasore. In conclusion, low-level laser irradiation stimulates tenocyte migration in a process that is mediated by up-regulation of dynamin 2, which can be suppressed by dynasore.

Influence of magnetic knee wraps on joint proprioception in individuals with osteoarthritis: a randomized controlled pilot trial.

OBJECTIVE: To determine the effects of magnetic knee wraps (MKWs) on joint position sense (JPS) in individuals with mild-to-moderate knee osteoarthritis. DESIGN: Randomized, double-blind, placebo-controlled pilot trial. SETTING: Rehabilitation clinic of a tertiary hospital. SUBJECTS: Fifty volunteers with mild-to-moderate knee osteoarthritis participated and 33 (66%) completed the trial; only one (2%) withdrew due to study-related adverse effects. INTERVENTIONS: Knee wraps with a static magnetic field (35 mT) were compared with control knee wraps for 12 weeks. MAIN MEASURES: The main outcome measure was JPS at first, fourth, and twelfth week while applying of the knee wrap, quantified as the ability to replicate target knee joint angles. The secondary outcome was the Comprehensive Osteoarthritis Test (COAT) total score. RESULTS: In the intention-to-treat analysis with an alpha-level of 0.05, 12-week application of the MKWs did not significantly reduce the mean absolute error (MAE) of JPS (n = 18; P = 0.627); contrarily, the MAE was found to decrease significantly after wearing the sham MKWs (n = 20; P = 0.01). The COAT total score gradually improved in both groups (P < 0.05). When comparing the improvement of MAE and COAT total score at each follow-up between two groups, no significant differences were found; the maximal difference in the improvement of MAE between two groups was noted at week 12 (mean difference: 1.2°; 95% confidence interval -0.4 to 2.9; P = 0.144). In the per-protocol analysis, the study group showed better improvement in the COAT total score at week 12 (P = 0.033). CONCLUSION: The 35-mT MKWs could not significantly influence knee JPS in individuals with mild-to-moderate knee osteoarthritis.

Ensaio clínico com fitostimoline óvulos no pós-cautério / Clinical trial with tablets of cauterization fitostimoline after uterine cervial

Os autores avaliaram a açäo do fitostimoline óvulos no proceso de reepitelizaçäo do colo uterino após diatermocoagulaçäo. O ensaio foi do tipo duplo-cego randomizado, com grupo controle utilizando placebo. Foram avaliadas 50 pacientes, portadoras de lesöes benignas do colo uterino e submetidas a diatermocoagulaçäo, que foram subdivididas por randomizaçäo em 2 grupos (Grupos I e II). As pacientes do Grupo I receberam, por via tópica vaginal, tratamento com óvulos de fitostimoline. As pacientes do Grupo II receberam placebo na forma de óvulos exatamente iguais àqueles contendo droga ativa. A avaliaçäo do efeito dos óvulos, com droga ativa ou placebo, no processo de reepitelizaçäo do colo uterino, foi baseada nos resultados dos exames ginecológico/colposcópico realizados no 14§ dia e 28§ dia após o início do tratamento local com os óvulos. No primeiro controle, enquanto 20 casos (76,92%) do Grupo I (droga ativa) apresentavam epitelizaçäo satisfatória, apenas sete casos (29,17%) do Grupo II estavam neste estágio do processo de reepitelizaçäo. No 2§ controle, enquanto 21 casos (80,77%) do Grupo I se encontravam já com a epitelizaçäo completa, apenas oito casos (33,33%) do Grupo II mostravam a mesma situaçäo. Os autores concluem pela significante utilidade do fitostimoline óvulos como coadjuvante no tratamento das lesöes benignas do colo uterino, bem como, pela sua excelente tolerabilidade