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1.
Int Ophthalmol ; 42(7): 2303-2310, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35048244

ABSTRACT

PURPOSE: Psoriasis, which is a chronic, immune-mediated skin disease of unknown etiology, not only affects the skin, but also is linked to many systemic conditions such as arthritis, cardiovascular disease, depression, and malignancy. Although many types of eye involvement are encountered in psoriasis patients, dry eye is the first among them. Uveitis is an entity that can be associated with psoriasis and can cause severe vision loss as a result of late diagnosis, inadequate and inappropriate treatment. In this review, we aimed to shed light on the diagnosis, type, prognosis and treatment of uveitis in psoriasis patients by compiling current datas obtained from published studies and to guide the follow-up and treatment of these patients. METHODS: A systematic literature search was done on PubMed using key words including "psoriasis", "psoriatic arthritis", "uveitis", "TNF- inhibitors", "HLA B27". RESULTS: In the literature, the frequency, type and treatment of uveitis developing in the course of psoriatic arthritis are clearly defined. However, the coexistence of psoriasis and uveitis has not yet been clarified due to few numbers published studies and designs of these studies. Since we examined the existing studies, we determined that the coexistence of psoriasis and uveitis could be acute or insidious, and the probability and severity of uveitis increased as the severity of skin and joint involvement increased. In addition, we found that psoriasis-associated uveitis can be bilateral, chronic, severe progression and with a high recurrence rate. CONCLUSION: The relations between non-arthritic psoriasis and uveitis have not yet been fully elucidated. Physicians who treat these diseases must be cautious, and refer their patients who have psoriasis to an ophthalmologist for periodic examination, even if they do not have eye symptoms. On the other hand, ophthalmologists must be careful in uveitis patients in terms of skin and joint involvement, and must not overlook the underlying disease.


Subject(s)
Psoriasis , Uveitis , HLA-B27 Antigen , Humans , Joints/physiopathology , Psoriasis/complications , Psoriasis/diagnosis , Skin/physiopathology , Uveitis/diagnosis , Uveitis/epidemiology , Uveitis/etiology
2.
Int J Antimicrob Agents ; 59(1): 106497, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34906675

ABSTRACT

Antibiotic treatment of native osteomyelitis caused by extended-spectrum ß-lactamase-producing Enterobacterales (ESBL-PE) is a challenge. Limited epidemiological and outcome data are available. This retrospective cohort study included osteomyelitis patients with ESBL-PE infections treated in a reference centre for bone and joint infections (BJIs) between 2011-2019. Twenty-nine patients with native BJI (mean age, 44.4 ± 15.7 years) were analysed. Fifteen cases were paraplegic patients with ischial pressure sores breaching the hip capsule. Other cases included eight other hip infections, four tibial infections and two foot infections. Infections were mostly polymicrobial (n = 23; 79.3%), including Staphylococcus aureus (n = 13; 8 methicillin-resistant). Klebsiella pneumoniae (n = 13) was the most frequent ESBL-producing species identified, followed by Escherichia coli (n = 10), including 3 E. coli/K. pneumoniae co-infections, and Enterobacter spp. (n = 9). ESBL-PE were rarely susceptible to fluoroquinolones (n = 4; 13.8%). Most therapies were based on carbapenems (n = 22) and combination therapies (n = 19). The median duration of treatment was 41 (5-60) days. Primary control of the infection was achieved in 62.1% (18/29) of cases and up to 86.2% after second look surgeries, after a median follow-up of 6 (1-36) months. Infection with ESBL-producing K. pneumoniae was associated with failure (P = 0.001), whereas age, infection location, prior colonisation and antimicrobial therapy were not found to be predictors of outcome. ESBL-PE native BJIs are often polymicrobial and fluoroquinolone-resistant infections caused by K. pneumoniae, highlighting the need for expert centres with pluridisciplinary meetings with experienced surgeons.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Bone and Bones/physiopathology , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae/metabolism , Joints/physiopathology , Osteomyelitis/drug therapy , beta-Lactamases/metabolism , Adult , Aged , Bone and Bones/microbiology , Communicable Diseases/diagnosis , Communicable Diseases/drug therapy , Enterobacteriaceae Infections/diagnosis , Female , Humans , Joints/microbiology , Male , Middle Aged , Osteomyelitis/diagnosis , Paris , Retrospective Studies , Treatment Outcome
3.
Biomed Res Int ; 2021: 2343404, 2021.
Article in English | MEDLINE | ID: mdl-34926682

ABSTRACT

PURPOSE: This was an in vivo study to develop a novel movable lumbar artificial vertebral complex (MLVC) in a goat model. The purpose of this study was to evaluate clinical and biomechanical characteristics of MLVC and to provide preclinical data for a clinical trial in the future. METHODS: According to the preoperative X-ray and CT scan data of the lumbar vertebrae, 3D printing of a MLVC was designed and implanted in goats. The animals were randomly divided into three groups: intact, fusion, and nonfusion. In the intact group, only the lumbar vertebrae and intervertebral discs were exposed during surgery. Both the fusion and nonfusion groups underwent resection of the lumbar vertebral body and the adjacent intervertebral disc. Titanium cages and lateral plates were implanted in the fusion group. MLVC was implanted in the nonfusion group. All groups were evaluated by CT scan and micro-CT to observe the spinal fusion and tested using the mechanical tester at 6 months after operation. RESULTS: The imaging results showed that with the centrum, the artificial endplates of the titanium cage and MLVC formed compact bone trabeculae. In the in vitro biomechanical test, the average ROM of L3-4 and L4-5 for the nonfusion group was found to be similar to that of the intact group and significantly higher in comparison to that of the fusion group (P < 0.05). The average ROM of flexion, extension, lateral bending, and rotation in the L2-3 intervertebral space significantly increased in the fusion group compared with the intact group and the nonfusion group (P < 0.001). There were no significant differences in flexion, extension, lateral bending, and rotation between the nonfusion and intact groups (P > 0.05). The average ROM of flexion, extension, lateral bending, and rotation in the L2-5 intervertebral space was not significantly different between the intact group, the fusion group, and the nonfusion group, and there was no statistical significance (P > 0.05). HE staining results did not find any metal and polyethylene debris caused by abrasion. CONCLUSION: In vivo MLVC can not only reconstruct the height and stability of the centrum of the operative segment but also retain the movement of the corresponding segment.


Subject(s)
Biomechanical Phenomena/physiology , Lumbar Vertebrae/physiopathology , Lumbar Vertebrae/surgery , Replantation/methods , Spinal Diseases/surgery , Animals , Cancellous Bone/physiopathology , Cancellous Bone/surgery , Cortical Bone/physiopathology , Cortical Bone/surgery , Goats , Joints/physiopathology , Lumbosacral Region/physiopathology , Lumbosacral Region/surgery , Models, Animal , Movement/physiology , Printing, Three-Dimensional , Range of Motion, Articular/physiology , Rotation , Spinal Diseases/physiopathology , Spinal Fusion/methods , Tomography, X-Ray Computed
4.
Sci Rep ; 11(1): 21548, 2021 11 03.
Article in English | MEDLINE | ID: mdl-34732820

ABSTRACT

ROI analysis is frequently used for obtaining acid content on rapid-kV-switching dual energy CT (DECT), providing inadequate accuracy. A new parameter derived from post-processing procedure, maximum lower limit with stain visible (MLLSV), was used by us to diagnose gout. 30 gout patients and 20 healthy volunteers were analyzed by using MLLSV. MLLSV was defined as the maximum lower limit of display window allowing only one stained site visible. Radiologists were asked to continuously increase the lower limit of display window of uric acid to decrease number of stained sites until the last stained site disappeared. MLLSV obtained by this way was compared between gout patients and volunteers. Receiver operating characteristic (ROC) curve was used to determine the performance. MLLSV of gout patients was significantly higher than that of volunteers (1373.3 ± 23.0 mg/cm3 vs. 1315.4 ± 20.7 mg/cm3, p = 0.000). The area under ROC curve of MLLSV was 0.993 in identifying gout. When using the optimal cutoff of 1342 mg/cm3, the sensitivity and specificity of MLLSV in identification of gout were 96.7% and 95% respectively. MLLSV derived from post-processing procedure of DECT is useful in discriminating gout patients from healthy people.


Subject(s)
Gout/diagnostic imaging , Image Processing, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Area Under Curve , Female , Humans , Joints/diagnostic imaging , Joints/physiopathology , Male , Middle Aged , Muscles/diagnostic imaging , Muscles/pathology , Musculoskeletal Diseases/complications , Musculoskeletal Diseases/diagnostic imaging , Osteoarthritis/complications , Osteoarthritis/diagnostic imaging , Prospective Studies , ROC Curve , Sensitivity and Specificity , Uric Acid/chemistry
5.
PLoS One ; 16(9): e0257147, 2021.
Article in English | MEDLINE | ID: mdl-34492074

ABSTRACT

Posttraumatic fibrotic scarring is a significant medical problem that alters the proper functioning of injured tissues. Current methods to reduce posttraumatic fibrosis rely on anti-inflammatory and anti-proliferative agents with broad intracellular targets. As a result, their use is not fully effective and may cause unwanted side effects. Our group previously demonstrated that extracellular collagen fibrillogenesis is a valid and specific target to reduce collagen-rich scar buildup. Our previous studies showed that a rationally designed antibody that binds the C-terminal telopeptide of the α2(I) chain involved in the aggregation of collagen molecules limits fibril assembly in vitro and reduces scar formation in vivo. Here, we have utilized a clinically relevant arthrofibrosis model to study the broad mechanisms of the anti-scarring activity of this antibody. Moreover, we analyzed the effects of targeting collagen fibril formation on the quality of healed joint tissues, including the posterior capsule, patellar tendon, and subchondral bone. Our results show that blocking collagen fibrillogenesis not only reduces collagen content in the scar, but also accelerates the remodeling of healing tissues and changes the collagen fibrils' cross-linking. In total, this study demonstrated that targeting collagen fibrillogenesis to limit arthrofibrosis affects neither the quality of healing of the joint tissues nor disturbs vital tissues and organs.


Subject(s)
Fibrillar Collagens/metabolism , Joint Diseases/pathology , Joint Diseases/physiopathology , Joints/physiopathology , Animals , Antibodies/metabolism , Biomarkers/blood , CHO Cells , Calcification, Physiologic , Cricetulus , Disease Models, Animal , Female , Fibrosis , Joint Capsule/metabolism , Joint Capsule/pathology , Joint Capsule/physiopathology , Male , Rabbits , Spectroscopy, Fourier Transform Infrared , Time Factors
6.
Nat Rev Rheumatol ; 17(11): 692-705, 2021 11.
Article in English | MEDLINE | ID: mdl-34588660

ABSTRACT

Non-coding RNAs have distinct regulatory roles in the pathogenesis of joint diseases including osteoarthritis (OA) and rheumatoid arthritis (RA). As the amount of high-throughput profiling studies and mechanistic investigations of microRNAs, long non-coding RNAs and circular RNAs in joint tissues and biofluids has increased, data have emerged that suggest complex interactions among non-coding RNAs that are often overlooked as critical regulators of gene expression. Identifying these non-coding RNAs and their interactions is useful for understanding both joint health and disease. Non-coding RNAs regulate signalling pathways and biological processes that are important for normal joint development but, when dysregulated, can contribute to disease. The specific expression profiles of non-coding RNAs in various disease states support their roles as promising candidate biomarkers, mediators of pathogenic mechanisms and potential therapeutic targets. This Review synthesizes literature published in the past 2 years on the role of non-coding RNAs in OA and RA with a focus on inflammation, cell death, cell proliferation and extracellular matrix dysregulation. Research to date makes it apparent that 'non-coding' does not mean 'non-essential' and that non-coding RNAs are important parts of a complex interactome that underlies OA and RA.


Subject(s)
Gene Expression Regulation , Joint Diseases , Joints , RNA, Untranslated , Arthritis, Rheumatoid/genetics , Arthritis, Rheumatoid/immunology , Arthritis, Rheumatoid/physiopathology , Biomarkers/analysis , Epigenesis, Genetic/immunology , Epigenesis, Genetic/physiology , Gene Expression Regulation/physiology , Genomics , Humans , Inflammation/genetics , Inflammation/immunology , Inflammation/physiopathology , Inflammation/therapy , Joint Diseases/genetics , Joint Diseases/immunology , Joint Diseases/physiopathology , Joint Diseases/therapy , Joints/immunology , Joints/physiology , Joints/physiopathology , Osteoarthritis/genetics , Osteoarthritis/immunology , Osteoarthritis/physiopathology , RNA/classification , RNA/physiology , RNA, Untranslated/biosynthesis , RNA, Untranslated/classification , RNA, Untranslated/physiology
7.
Sci Rep ; 11(1): 18077, 2021 09 10.
Article in English | MEDLINE | ID: mdl-34508166

ABSTRACT

Chronic obstructive pulmonary disease (COPD) produces skeletal muscle atrophy and weakness, leading to impairments of exercise performance. The mechanical work needed for movement execution is also provided by the passive tension developed by musculoarticular connective tissue. To verify whether COPD affects this component, the passive viscoelastic properties of the knee joint were evaluated in 11 patients with COPD and in 11 healthy individuals. The levels of stiffness and viscosity were assessed by means of the pendulum test, consisting in a series of passive leg oscillations. In addition, to explore the contribution of passive tension in the mechanical output of a simple motor task, voluntary leg flexion-extension movements were performed. Patients with COPD showed a statistically significant reduction in stiffness and viscosity compared to controls. Voluntary execution of flexion-extension movements revealed that the electromyographic activity of the Rectus Femoris and Biceps Femoris was lower in patients than in controls, and the low viscoelastic tension in the patients conditioned the performance of active movements. These results provide novel insights on the mechanism responsible for the movement impairments associated with COPD.


Subject(s)
Joints/physiopathology , Muscle, Skeletal/physiopathology , Pulmonary Disease, Chronic Obstructive/physiopathology , Aged , Aged, 80 and over , Biomechanical Phenomena , Case-Control Studies , Electromyography , Female , Humans , Male , Middle Aged , Motor Activity , Muscle Contraction , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/etiology , Range of Motion, Articular , Reflex
8.
J Neurophysiol ; 126(2): 591-606, 2021 08 01.
Article in English | MEDLINE | ID: mdl-34191634

ABSTRACT

The whole repertoire of complex human motion is enabled by forces applied by our muscles and controlled by the nervous system. The impact of stroke on the complex multijoint motor control is difficult to quantify in a meaningful way that informs about the underlying deficit in the active motor control and intersegmental coordination. We tested whether poststroke deficit can be quantified with high sensitivity using motion capture and inverse modeling of a broad range of reaching movements. Our hypothesis is that muscle moments estimated based on active joint torques provide a more sensitive measure of poststroke motor deficits than joint angles. The motion of 22 participants was captured while performing reaching movements in a center-out task, presented in virtual reality. We used inverse dynamic analysis to derive active joint torques that were the result of muscle contractions, termed muscle torques, that caused the recorded multijoint motion. We then applied a novel analysis to separate the component of muscle torque related to gravity compensation from that related to intersegmental dynamics. Our results show that muscle torques characterize individual reaching movements with higher information content than joint angles do. Moreover, muscle torques enable distinguishing the individual motor deficits caused by aging or stroke from the typical differences in reaching between healthy individuals. Similar results were obtained using metrics derived from joint accelerations. This novel quantitative assessment method may be used in conjunction with home-based gaming motion capture technology for remote monitoring of motor deficits and inform the development of evidence-based robotic therapy interventions.NEW & NOTEWORTHY Functional deficits seen in task performance have biomechanical underpinnings, seen only through the analysis of forces. Our study has shown that estimating muscle moments can quantify with high-sensitivity poststroke deficits in intersegmental coordination. An assessment developed based on this method could help quantify less observable deficits in mildly affected stroke patients. It may also bridge the gap between evidence from studies of constrained or robotically manipulated movements and research with functional and unconstrained movements.


Subject(s)
Ischemic Stroke/physiopathology , Joints/physiopathology , Movement , Muscle, Skeletal/physiopathology , Aged , Female , Hand Strength , Humans , Male , Middle Aged , Range of Motion, Articular , Torque , Young Adult
9.
Proc Natl Acad Sci U S A ; 118(25)2021 06 22.
Article in English | MEDLINE | ID: mdl-34161280

ABSTRACT

Osteogenesis imperfecta (OI) is a genetic disorder that features wide-ranging defects in both skeletal and nonskeletal tissues. Previously, we and others reported that loss-of-function mutations in FK506 Binding Protein 10 (FKBP10) lead to skeletal deformities in conjunction with joint contractures. However, the pathogenic mechanisms underlying joint dysfunction in OI are poorly understood. In this study, we have generated a mouse model in which Fkbp10 is conditionally deleted in tendons and ligaments. Fkbp10 removal substantially reduced telopeptide lysyl hydroxylation of type I procollagen and collagen cross-linking in tendons. These biochemical alterations resulting from Fkbp10 ablation were associated with a site-specific induction of fibrosis, inflammation, and ectopic chondrogenesis followed by joint deformities in postnatal mice. We found that the ectopic chondrogenesis coincided with enhanced Gli1 expression, indicating dysregulated Hedgehog (Hh) signaling. Importantly, genetic inhibition of the Hh pathway attenuated ectopic chondrogenesis and joint deformities in Fkbp10 mutants. Furthermore, Hh inhibition restored alterations in gait parameters caused by Fkbp10 loss. Taken together, we identified a previously unappreciated role of Fkbp10 in tendons and ligaments and pathogenic mechanisms driving OI joint dysfunction.


Subject(s)
Chondrocytes/pathology , Joints/physiopathology , Motor Activity , Osteogenesis Imperfecta/physiopathology , Osteogenesis , Tacrolimus Binding Proteins/metabolism , Animals , Animals, Newborn , Chondrogenesis/genetics , Collagen Type I/metabolism , Disease Models, Animal , Fibrosis , Gait , Gene Deletion , Gene Expression Regulation , Hedgehog Proteins/metabolism , Hydroxylation , Inflammation/genetics , Inflammation/pathology , Joints/pathology , Ligaments/pathology , Lysine/metabolism , Mice , Models, Biological , Ossification, Heterotopic/complications , Ossification, Heterotopic/genetics , Ossification, Heterotopic/pathology , Ossification, Heterotopic/physiopathology , Osteogenesis/genetics , Osteogenesis Imperfecta/complications , Osteogenesis Imperfecta/genetics , Osteogenesis Imperfecta/pathology , Peptides/metabolism , Sequence Analysis, RNA , Signal Transduction , Tacrolimus Binding Proteins/genetics , Tendons/pathology
10.
PLoS One ; 16(5): e0244120, 2021.
Article in English | MEDLINE | ID: mdl-33983958

ABSTRACT

PURPOSE: Macrophage accumulation in response to decreasing myonuclei may be the major mechanism underlying immobilization-induced muscle fibrosis in muscle contracture, an intervention strategy suppressing these lesions is necessary. Therefore, this research investigated the effect of belt electrode-skeletal muscle electrical stimulation (B-SES), a new electrical stimulation device, to the macrophage accumulation via myonuclei decrease in immobilization-induced muscle fibrosis. MATERIALS AND METHODS: 18 Wistar male rats were divided into the control group, immobilization group (with plaster cast fixation to immobilize the soleus muscles in a shortened position for 2 weeks), and B-SES group (with muscle contractile exercise through B-SES during the immobilization period). B-SES stimulation was performed at a frequency of 50 Hz and an intensity of 4.7 mA, muscle contractile exercise by B-SES was applied to the lower limb muscles for 20 minutes/session (twice a day) for 2 weeks (6 times/week). The bilateral soleus muscles were used for histological, immunohistochemical, biochemical, and molecular biological analyses. RESULTS: The number of myonuclei was significantly higher in the B-SES group than in the immobilization group, and there was no significant difference between the B-SES and control groups. The cross-sectional area of type I and II myofibers in the immobilization and B-SES groups was significantly lower than that in the control group, and the cross-sectional area of type I myofibers in the B-SES group was higher than that in the immobilization group. However, Atrogin-1 and MuRF-1 mRNA expression in the immobilization and B-SES groups was significantly higher than those in the control group. Additionally, the number of macrophages, IL-1ß, TGF-ß1, and α-SMA mRNA expression, and hydroxyproline expression was significantly lower in the control and B-SES groups than those in the immobilization group. CONCLUSION: This research surmised that muscle contractile exercise through B-SES prevented immobilization-induced muscle fibrosis, and this alteration suppressed the development of muscle contracture.


Subject(s)
Immobilization , Muscle, Skeletal/pathology , Actins/genetics , Actins/metabolism , Animals , Ankle/physiopathology , Chemokine CCL2/genetics , Chemokine CCL2/metabolism , Electric Stimulation , Electrodes , Fibrosis , Hydroxyproline/metabolism , Interleukin-1beta/genetics , Interleukin-1beta/metabolism , Joints/physiopathology , Macrophages/pathology , Male , Muscle Fibers, Skeletal/pathology , Muscle, Skeletal/physiopathology , RNA, Messenger/genetics , RNA, Messenger/metabolism , Range of Motion, Articular , Rats, Wistar , Transforming Growth Factor beta1/genetics , Transforming Growth Factor beta1/metabolism
11.
J Orthop Surg Res ; 16(1): 142, 2021 Feb 17.
Article in English | MEDLINE | ID: mdl-33596939

ABSTRACT

BACKGROUND: Leg length inequalities (LLI) are a common condition that can be associated with detrimental effects like low back pain and osteoarthritis. Inertial measurement units (IMUs) offer the chance to analyze daily activities outside a laboratory. Analyzing the kinematic effects of (simulated) LLI on the musculoskeletal apparatus using IMUs will show their potentiality to improve the comprehension of LLI. METHODS: Twenty healthy participants with simulated LLI of 0-4 cm were analyzed while walking with an inertial sensor system (MyoMotion). Statistical evaluation of the peak anatomical angles of the spine and legs were performed using repeated measurement (RM) ANOVA or their non-parametric test versions (Friedman test). RESULTS: Lumbar lateral flexion and pelvic obliquity increased during the stance phase of the elongated leg and decreased during its swing phase. The longer limb was functionally shortened by higher hip and knee flexion, higher hip adduction, dorsiflexion, and lower ankle adduction. Finally, the shorter leg was lengthened by higher hip and knee extension, hip abduction, ankle plantarflexion, and decreased hip adduction. CONCLUSION: We found differing compensation strategies between the different joints, movement planes, gait phases, and amounts of inequality. Overall the shorter leg is lengthened and the longer leg is shortened during walking, to retain the upright posture of the trunk. IMUs were helpful and precise in the detection of anatomical joint angles and for the analysis of the effects of LLI.


Subject(s)
Leg Length Inequality/physiopathology , Adult , Gait , Gait Analysis , Humans , Joints/physiopathology , Leg/physiopathology , Male , Posture , Range of Motion, Articular , Spine/physiopathology , Walking , Young Adult
12.
Phys Ther ; 101(7)2021 07 01.
Article in English | MEDLINE | ID: mdl-33580953

ABSTRACT

OBJECTIVE: It has been suggested that overweight/obesity (OW/OB) impairs the normal alignment of children and adolescents' musculoskeletal system. However, to date, no study has systematically reviewed or quantified the effect of OW/OB on the development of joint malalignments in children and adolescents. The purpose of this study was to systematically review the association between OW/OB and joint alignment in children and adolescents and to quantify the evidence on whether children and adolescents with OW/OB have a higher risk of developing joint malalignments than their peers of normal weight. METHODS: PubMed and Web of Science databases were systematically searched from inception to March 9, 2020. Studies investigating the association between OW/OB and joint alignment in children and adolescents were selected. Nonoriginal articles, participants with movement pattern diseases, and adolescents studied while pregnant were excluded. Two independent reviewers conducted the study selection and data extraction. Qualitative synthesis of evidence and random effect meta-analyses (risk ratio [RR]) were performed. RESULTS: Seventy-three studies (5 longitudinal and 68 cross-sectional) met the inclusion criteria involving 1,757,107 children and adolescents. There was consistent evidence supporting associations of OW/OB with rounded shoulder, lumbar hyperlordosis, genu valgum, and flatfoot. Our meta-analysis showed that children and adolescents with OW/OB had a significantly higher risk of lumbar hyperlordosis (RR = 1.41), genu valgum (RR = 5.92), flatfoot (RR = 1.49), and any joint malalignment (RR = 1.68) when compared with their peers of normal weight. The presence of genu valgum and flatfoot were the most robust results. CONCLUSION: Based on these findings, OW/OB is associated with the presence of joint malalignments in children and adolescents. IMPACT: This is the first study that has systematically reviewed the effect of OW/OB on the development of joint malalignments in children and adolescents.


Subject(s)
Joints/physiopathology , Musculoskeletal Diseases/etiology , Musculoskeletal Diseases/physiopathology , Pediatric Obesity/complications , Humans
13.
J Sports Sci ; 39(sup1): 91-98, 2021 Aug.
Article in English | MEDLINE | ID: mdl-33593245

ABSTRACT

This study aims were twofold: (1) to evaluate the construct validity of the Repetitive Movement Test (RMT) a novel test developed for Wheelchair Rugby classification which evaluates arm coordination impairment at five joints - shoulder, elbow, forearm, wrist and fingers - and (2), pending sufficiently positive results, propose objective minimum impairment criteria (MIC). Forty-two WR athletes with an eligible coordination impairment, and 20 volunteers without impairment completed the RMT and two clinically established coordination tests: the finger-nose test (FNT) and the spiral test (ST). Coordination deduction (CD), an ordinal observational coordination scale, currently used in WR classification, was obtained. Spearman-rank correlation coefficients (SCC) between RMT and ST (0.40 to 0.67) and between RMT and CD (0.31 to 0.53) generally supported RMT construct validity, SCC between RMT and FNT were lower (0.12-0.31). When the scores on ST, FNT and RMT from the sample of WR players were compared with the scores from volunteers without impairment, 93.5% to 100% of WR players had scores > 2SD below the mean of volunteers without impairment on the same test. In conclusion, RMT at the elbow, forearm, wrist and fingers have sufficient construct validity for use in WR. MIC were recommended with ST and RMT.


Subject(s)
Arm/physiopathology , Ataxia/physiopathology , Football/physiology , Joints/physiopathology , Sports for Persons with Disabilities/physiology , Adolescent , Adult , Ataxia/classification , Athletic Performance , Case-Control Studies , Cross-Sectional Studies , Elbow Joint/physiopathology , Female , Finger Joint/physiopathology , Football/classification , Forearm , Humans , Male , Middle Aged , Para-Athletes , Psychomotor Performance/physiology , Range of Motion, Articular/physiology , Reproducibility of Results , Shoulder Joint/physiopathology , Sports for Persons with Disabilities/classification , Statistics, Nonparametric , Wrist Joint/physiology , Young Adult
14.
Transl Res ; 232: 142-149, 2021 06.
Article in English | MEDLINE | ID: mdl-33582243

ABSTRACT

Soluble urokinase plasminogen activator receptor (suPAR) is intensively studied as a biomarker of inflammation and disease outcome in various diseases. In rheumatoid arthritis (RA), suPAR have shown an association with inflammation and swollen joints, but data on suPAR in relation to early disease course and disease progression are lacking. This study investigates the potential of suPAR to predict or reflect disease outcome in early RA. Serum suPAR was measured by enzyme-linked immunosorbent assay at disease onset and after 3 and 36 months in 252 patients from a Swedish prospective observational early RA cohort. Levels and changes of suPAR were analyzed in relation to the 28-joint disease activity score (DAS28) and joint damage according to the Larsen score at inclusion and during follow-up. 100 healthy blood donors served as controls. Circulating levels of suPAR were higher in RA patients at all time points as compared to healthy controls. Baseline suPAR was significantly associated with baseline disease activity whereas suPAR levels at 36 months were associated with joint damage at 36 months. No predictive value of suPAR levels or changes in suPAR levels over time were found. In conclusion, suPAR levels associate with disease activity in early untreated RA and reflects joint damage at later stages. Increased suPAR in established RA could indicate patients in need of frequent monitoring of joint status, irrespective of disease activity. In the view of suPAR as a rapidly emerging biomarker, it is important to be aware of its ability to reflect both inflammation and subsequent damage.


Subject(s)
Arthritis, Rheumatoid/blood , Arthritis, Rheumatoid/pathology , Biomarkers/blood , Joints/pathology , Receptors, Urokinase Plasminogen Activator/blood , Adult , Aged , Aged, 80 and over , Arthritis, Rheumatoid/physiopathology , Cohort Studies , Female , Humans , Joints/physiopathology , Male , Middle Aged , Prognosis , Prospective Studies , Severity of Illness Index , Sweden , Young Adult
15.
PLoS One ; 16(1): e0245616, 2021.
Article in English | MEDLINE | ID: mdl-33449939

ABSTRACT

Biomechanical deviations at individual joints are often identified by gait analysis of patients with cerebral palsy (CP). Analysis of the control of joint and leg stiffness of the locomotor system during gait in children with spastic diplegic CP has been used to reveal their control strategy, but the differences between before and after surgery remain unknown. The current study aimed to bridge the gap by comparing the leg stiffness-both skeletal and muscular components-and associated joint stiffness during gait in 12 healthy controls and 12 children with spastic diplegic CP before and after tendon release surgery (TRS). Each subject walked at a self-selected pace on a 10-meter walkway while their kinematic and forceplate data were measured to calculate the stiffness-related variables during loading response, mid-stance, terminal stance, and pre-swing. The CP group altered the stiffness of the lower limb joints and decreased the demand on the muscular components while maintaining an unaltered leg stiffness during stance phase after the TRS. The TRS surgery improved the joint and leg stiffness control during gait, although residual deficits and associated deviations still remained. It is suggested that the stiffness-related variables be included in future clinical gait analysis for a more complete assessment of gait in children with CP.


Subject(s)
Cerebral Palsy , Gait , Joints , Lower Extremity , Tendons , Tenotomy , Walking , Adolescent , Cerebral Palsy/physiopathology , Cerebral Palsy/surgery , Child , Female , Humans , Joints/physiopathology , Joints/surgery , Lower Extremity/physiopathology , Lower Extremity/surgery , Male , Tendons/physiopathology , Tendons/surgery
16.
Biomed Pharmacother ; 136: 111283, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33482616

ABSTRACT

BACKGROUND AND PURPOSE: The endocannabinoid system became a promising target for osteoarthritis (OA) treatment. Functional selectivity of cannabinoids may increase their beneficial properties while reducing side effects. The aim of the present study was to evaluate the analgesic potential of two functionally biased CB2 agonists in different treatment regimens to propose the best pharmacological approach for OA management. EXPERIMENTAL APPROACH: Two functionally selective CB2 agonists were administered i.p. - JWH133 (cAMP biased) and GW833972A (ß-arrestin biased), in a chemically induced model of OA in rats. The drugs were tested in acute and chronic treatment regimens. Analgesic effects were assessed by pressure application measurement and kinetic weight bearing. X-ray microtomography was used for the morphometric analysis of the femur's subchondral bone tissue. Underlying biochemical changes were analysed via RT-qPCR. KEY RESULTS: Dose-response studies established the effective dose for both JWH133 and GW833972A. In chronic treatment paradigms, JWH133 was able to elicit analgesia throughout the course of the experiment, whereas GW833972A lost its efficacy after 2 days of treatment. Later studies revealed improvement in subchondral bone architecture and decrement of matrix metalloproteinases and proinflammatory factors expression following JWH133 chronic treatment. CONCLUSION AND IMPLICATIONS: Data presents analgesic and disease-modifying potential of CB2 agonists in OA treatment. Moreover, the study revealed more pronounced tolerance development for analgesic effects of the ß-arrestin biased CB2 agonist GW833972A. These results provide a better understanding of the molecular underpinnings of the anti-nociceptive potential of CB2 agonists and may improve drug development processes for any cannabinoid-based chronic pain therapy.


Subject(s)
Analgesics/pharmacology , Arthralgia/prevention & control , Cannabinoid Receptor Agonists/pharmacology , Cannabinoids/pharmacology , Joints/drug effects , Osteoarthritis/prevention & control , Pain Threshold/drug effects , Pyridines/pharmacology , Pyrimidines/pharmacology , Receptor, Cannabinoid, CB2/agonists , Animals , Arthralgia/etiology , Arthralgia/metabolism , Arthralgia/physiopathology , Disease Models, Animal , Drug Tolerance , Iodoacetic Acid , Joints/metabolism , Joints/physiopathology , Male , Osteoarthritis/chemically induced , Osteoarthritis/metabolism , Osteoarthritis/physiopathology , Rats, Wistar , Receptor, Cannabinoid, CB2/metabolism , Signal Transduction , Time Factors
17.
Arthritis Care Res (Hoboken) ; 73(9): 1275-1281, 2021 09.
Article in English | MEDLINE | ID: mdl-32475031

ABSTRACT

OBJECTIVE: To describe early prosthesis implantations in a cohort of patients with juvenile idiopathic arthritis (JIA) followed in a tertiary referral hospital and to analyze possible factors influencing implant survival. METHODS: This was a retrospective cohort study. Charts of all patients with JIA who underwent total joint replacement at Gaetano Pini Hospital, Milan, Italy from January 1992 to June 2019 were retrieved, and relevant data were analyzed. RESULTS: Eighty-five patients met the inclusion criteria for this study, with a median follow-up period of 17.2 years. The median age at first prosthesis was 22.7 years. The total number of replaced joints was 198 over a period of 27 years. The hip was the most frequently replaced joint, accounting for almost two-thirds of the total number of implants; the other one-third refers mostly to knee implants. Polyarticular JIA and systemic JIA were the most represented JIA categories in the study cohort. A significant upward trend of the age at arthroplasty and of disease duration before arthroplasty over decades was found. The rates of implant survival at 5, 10, and 15 years were comparable (from 84% to 89%); 50% of implants lasted ≥20 years. CONCLUSION: We reported retrospective data on early joint replacement in a cohort of patients with JIA. We observed a progressive and significant upward trend of both age at arthroplasty and disease duration before the first arthroplasty over time. The JIA category, year of implant, and presence of complications significantly affected implant survivorship.


Subject(s)
Arthritis, Juvenile/surgery , Arthroplasty, Replacement, Ankle/instrumentation , Arthroplasty, Replacement, Hip/instrumentation , Arthroplasty, Replacement, Knee/instrumentation , Hip Prosthesis , Joints/surgery , Knee Prosthesis , Adolescent , Adult , Age Factors , Arthritis, Juvenile/diagnosis , Arthritis, Juvenile/physiopathology , Arthroplasty, Replacement, Ankle/adverse effects , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Knee/adverse effects , Female , Humans , Italy , Joints/diagnostic imaging , Joints/physiopathology , Male , Middle Aged , Prosthesis Failure , Retrospective Studies , Risk Assessment , Risk Factors , Tertiary Care Centers , Time Factors , Treatment Outcome , Young Adult
18.
Arthritis Care Res (Hoboken) ; 73(10): 1528-1536, 2021 10.
Article in English | MEDLINE | ID: mdl-32475060

ABSTRACT

OBJECTIVE: Despite the joint pain and significant dysfunction that characterizes arthritis, many people with arthritis continue to carry out everyday duties and responsibilities. The objective of the present study was to describe participation in informal caregiving (unpaid assistance to someone with a health issue or limitation) among people with arthritis. METHODS: Analysis of baseline data from the Canadian Longitudinal Study on Aging (CLSA), a nationally representative sample of people ages 45-85 years (n = 21,241), was performed. A questionnaire covering sociodemographic, health, and caregiving variables was completed by each study participant. Caregiving variables examined characteristics of the person who received the most care from the questionnaire respondent, as well as the types of caregiving (e.g., hands-on versus hands-off tasks) and amount of care provided (e.g., hours per week). RESULTS: There was no difference in the proportion of people with and without arthritis who provided informal care (46%). Individuals with arthritis reported worse health, but this did not affect the likelihood of providing care, nor the types or amount of care provided. Caregivers with and without arthritis were most likely to provide fewer than 7 hours per week of care, and the most common type of care was characterized as hands-off, particularly transportation assistance. Men were just as likely to provide care as women but were less likely to provide high intensity care or perform hands-on tasks. CONCLUSION: Despite reporting worse health on average, people with arthritis were just as likely as people without arthritis to provide informal care. The need to provide informal care among people with arthritis may impact their ability to engage in self-management activities for their arthritis.


Subject(s)
Arthralgia/physiopathology , Arthritis/physiopathology , Caregivers , Joints/physiopathology , Aged , Aged, 80 and over , Arthralgia/diagnosis , Arthralgia/psychology , Arthritis/diagnosis , Arthritis/psychology , Canada , Caregivers/psychology , Female , Functional Status , Humans , Longitudinal Studies , Male , Middle Aged , Surveys and Questionnaires , Time Factors
19.
Int J Rheum Dis ; 24(1): 106-111, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33159378

ABSTRACT

AIM: To study joint damage severity in rheumatoid arthritis (RA) patients classified using ultrasound power Doppler (PD) and gray-scale (GS) joint inflammation outcomes and the 28-joint Disease Activity Score (DAS28). METHOD: Ultrasound erosion scores were compared between (a) patients in group 1 (PD positive and GS ≥ median score), group 2 (PD negative and GS ≥ median score) and group 3 (PD positive and GS < median score) vs group 4 (PD negative and GS < median score) and (b) patients with high, moderate and low DAS28 scores vs those in DAS28 remission. Comparative analyses were performed using the 2-sample Student's t test. RESULTS: There were 1080 joints and 1800 joint recesses from 36 joints scanned in 30 RA adult patients (mean DAS28, 3.58; mean disease duration, 70.3 months) in this cross-sectional study. The mean and 95% CI ultrasound erosion scores were significantly higher (P = .026) for groups 1 (9.75, 6.69-12.81) vs 4 (3.4, 1.11-5.69) with a difference (95% CI) of 6.35 (0.78-11.83), but not significantly different (P values all > .05) for (a) groups 2 and 3 vs 4 and (b) patients with high, moderate and low DAS28 scores vs those in DAS28 remission. CONCLUSION: Severity of ultrasound-detected bone erosions was significantly greater when both positive PD and a greater degree of GS joint inflammation were present in RA. This association was not observed when either component was absent. Single time point ultrasound joint inflammation assessment - and not DAS28 - is reflective of joint damage severity in RA patients.


Subject(s)
Arthritis, Rheumatoid/diagnosis , Joints/diagnostic imaging , Ultrasonography, Doppler , Aged , Arthritis, Rheumatoid/physiopathology , Cross-Sectional Studies , Female , Humans , Joints/physiopathology , Male , Middle Aged , Pilot Projects , Predictive Value of Tests , Severity of Illness Index
20.
Arthritis Care Res (Hoboken) ; 73(9): 1300-1305, 2021 09.
Article in English | MEDLINE | ID: mdl-32339449

ABSTRACT

OBJECTIVE: To determine whether patient global assessment of disease activity (PtGA) over the first year of disease course, as part of a Boolean-based definition of remission and considered individually, had a significant relationship with structural progression over 3 years in patients with early arthritis. METHODS: We conducted a prospective, observational study using ESPOIR (Étude et Suivi des Polyarthrites Indifférenciées Récentes) cohort data. Remission states were defined as 1) 4-variable remission, which included a tender joint count in 28 joints, a swollen joint count in 28 joints (SJC28), a C-reactive protein (CRP; mg/dl) level, and PtGA (scored 0-10, all scores of ≤1); 2) PtGA near remission, which included the same parameters as 4-variable remission with only PtGA >1 (of a maximum possible score of 10); 3) 3-variable remission (sum of the proportion of patients in 4-variable remission and the proportion of patients in PtGA near remission); or 4) nonremission. The strictest status satisfied both at 6 and 12 months was considered. Radiographic progression was determined as a change of ≥5 points in the total Sharp/van der Heijde score (ΔSHS) from baseline to 3 years. The predictive capacities for radiographic damage of different remission definitions were assessed by odds ratio (OR). The association between each individual component of remission with ΔSHS was tested through multivariate linear regression analyses. RESULTS: Among 520 patients, 7% achieved 4-variable remission and 12% achieved PtGA near remission. Radiographic progression was observed in 29% of patients who achieved 4-variable remission (OR versus nonremission; OR 0.32 [95% confidence interval (95% CI) 0.15, 0.68]) and in 45% of patients with PtGA near remission (OR 0.65 [95% CI 0.38, 1.11]); the comparison was not statistically different (OR 0.49 [95% CI 0.20, 1.18]). In 3-variable remission, radiographic progression was observed in 39%. Of the individual components, only the SJC28 and CRP level were associated with radiographic progression. CONCLUSION: All definitions of remission led to low structural degradation in early arthritis, and 4-variable remission led to less radiographic progression than PtGA near remission, but without a statistically significant difference. Both 4-variable remission and 3-variable remission appear to be useful targets when aiming for structural nonprogression.


Subject(s)
Arthritis/diagnosis , Joints/diagnostic imaging , Patient Reported Outcome Measures , Physical Examination , Adult , Antirheumatic Agents/therapeutic use , Arthritis/drug therapy , Arthritis/physiopathology , Biomarkers/blood , C-Reactive Protein/metabolism , Disease Progression , Female , France , Humans , Inflammation Mediators/blood , Joints/drug effects , Joints/physiopathology , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Remission Induction , Time Factors , Treatment Outcome
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