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1.
Zhongguo Zhong Yao Za Zhi ; 45(17): 4071-4080, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33164391

RESUMO

Moxa floss is the main material of moxibustion, which plays a therapeutic role through the thermal effect of combustion. In this paper, TG/DSC thermal analysis method was used to study the characteristic parameters of combustion heat of moxa floss produced in Qichun, and the thermal therapeutic effect and mechanism of moxibustion were studied through moxibustion OA animal model. The results show that the combustion process of moxa floss can be divided into three stages: drying, combustion oxidation and carbonization, and ash burnout. The combustion properties of moxa floss are between herbaceous and woody, and tend to be woody, with flammable, slow and lasting combustion characteristics. Moxibustion can relieve the pathological state of knee joint synovium to a certain extent, reduce knee joint swelling and blood stasis in OA rats, reduce interstitial edema, and improve local inflammation. The mechanism and target point of moxibustion treatment for OA may be up-regulating TRPM3 gene to activate ion channels, affecting calcium metabolism and reducing OA swelling degree; down-regulation of GAPDH affects glucose metabolism of knee synovial cells and mediates anti-inflammatory effect. Down-regulation of pain-related gene MMP24 is helpful to relieve OA pain. Up-regulation of CTNNB1 activates Wnt/ß-catenin signaling pathway and affects differentiation and regeneration of OA chondrocytes. This study reveals the pyrolysis characteristics of moxa floss for the first time and discusses the biological effect and possible mechanism of moxibustion heat, providing new ideas for the quality evaluation of moxa floss and the mechanism of moxibustion therapy.


Assuntos
Moxibustão , Osteoartrite , Animais , Modelos Animais de Doenças , Temperatura Alta , Oxirredução , Ratos
2.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(11): 1486-1491, 2020 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-33191711

RESUMO

Objective: To summarize the regulatory effect of long non-coding RNA (lncRNA) on osteoarthritis (OA) cartilage injury. Methods: The molecular functions and mechanisms of lncRNA were introduced and its regulatory effects on the pathological processes of OA were elaborated by referring to the relevant literature at domestic and abroad in recent years. Results: The pathological characteristics of OA are degeneration of articular cartilage and inflammation of synovial tissue, but its etiology and pathological mechanism have not been clarified. lncRNA is a kind of heterogeneous non-coding RNA, which plays a regulatory role in many inflammation-related diseases and exerts a wide range of biological functions. lncRNA is a regulator involved in the pathogenesis of OA, and is abnormally expressed in OA cartilage, leading to the degeneration of the extracellular matrix of cartilage. Conclusion: At present, there have been preliminary studies on the pathological effects of lncRNA in regulating OA and the biological functions of chondrocytes. However, the pathogenesis of lncRNA and its regulatory network in OA and the way in which it regulates inflammatory pathways are still unclear, and further exploration is needed.


Assuntos
Cartilagem Articular , Osteoartrite , RNA Longo não Codificante , Condrócitos , Matriz Extracelular , Humanos , Osteoartrite/genética , RNA Longo não Codificante/genética
3.
Clin Exp Rheumatol ; 38 Suppl 126(4): 64-72, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33025888

RESUMO

OBJECTIVES: To evaluate the presence of sicca symptoms and secondary Sjögren's syndrome (SS) and the association with clinical characteristics, functional tests and patient-reported outcomes in patients with rheumatoid arthritis (RA) at baseline and after 10 years of follow-up. METHODS: A cohort of RA patients was evaluated in 2008 and re-evaluated in 2018 with respect to sicca symptoms, presence of secondary SS according to AECG classification criteria, disease activity of RA and patient-reported outcomes. Patient characteristics were compared between the RA-non-sicca, RA-sicca and RA-SS groups. RESULTS: Of the original 2008 cohort of 96 RA patients, 32 (33%) had sicca symptoms and 6 (6.3%) secondary SS. Of the 36 patients who agreed to be re-evaluated in 2018, 6 (17%) had sicca symptoms and 2 (6%) developed secondary SS. In the majority of patients, sicca symptoms were reversible while the functional tests of salivary and lacrimal glands significantly decreased. 67% of RA-sicca patients had no sicca complaints at the second screening, while only two RA-sicca patients developed secondary SS. RA-SS patients and, to a slightly lesser extent, RA-sicca patients had significantly higher RA disease activity (DAS-28), lower lacrimal (Schirmer's test) and salivary gland function, more limitations in daily activities (HAQ), worse health-related quality of life (RAND-36), more fatigue (MFI) and more patient symptoms (ESSPRI) compared to RA-non-sicca patients. CONCLUSIONS: Secondary SS was found in a minor subset of the RA patients. Sicca symptoms of the eyes or mouth were more frequent, but their presence varied over time. Higher RA disease activity was associated with SS and sicca symptoms. These patients had lower gland function and worse patient-reported outcomes.


Assuntos
Artrite Reumatoide , Osteoartrite , Síndrome de Sjogren , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Seguimentos , Humanos , Qualidade de Vida , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/epidemiologia
4.
Wiad Lek ; 73(9 cz. 1): 1818-1823, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33099522

RESUMO

Arthrosis as osteoarthritis is a global problem that affects more and more people and is associated with severe chronic pain, reduced mobility and, consequently, disability. The etiology of degenerative disease is complex and depends on many factors. However, its course was not fully understood. One of the factors affecting the development of arthrosis is obesity. Obesity is a growing problem. Over the past 30 years, the number of overweight people has almost doubled. In people suffering from obesity, whose body mass index is above 30kg/m2, the risk of developing degenerative changes in articular cartilage is six times higher than the risk of developing this disease in people with normal body weight. Osteoarthritis is detected when the symptoms get worse where the changes are already at some stage. Therefore, a lot of research is currently underway to find suitable biomarkers, which would indicate the potential development of degenerative changes in the future and at the same time the possibility of inhibiting their activity. One of them may be adipokines, which are synthesized by adipose tissue and affect cartilage. In obese people, adipokines may contribute to the inflammation of the low charterer, whichaccompanies both obesity and arthrosis. These compounds can be specific biomarkers to assess the degree of progression and severity of osteoarthritis. The aim: To assess the importance of obesity and adipokines produced by adipose tissue as specific markers of arthrosis.


Assuntos
Adipocinas , Osteoartrite , Tecido Adiposo , Biomarcadores , Humanos , Obesidade/complicações
5.
Wiad Lek ; 73(9 cz. 1): 1870-1873, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33099532

RESUMO

Shoulder arthroplasty (SA) has improved significantly over the last twenty years. It offers the effective treatment for patients with severe shoulder dysfunctions. The indicationsfor this procedure have recently expanded tremendously. However, the most common are glenohumeral osteoarthritis, inflammatory shoulder arthropathies, rotator cuff-tear arthropathy, complex fractures of the proximal humerus and osteonecrosis of a humeral head. There is range of the procedures, such as resurfacing of humeral head, anatomictotal shoulder arthroplasty, hemiarthroplasty and reverse shoulder arthroplasty. All of them could significantly improve patients quality of life. The outcomes of the shoulder arthroplasty are very satisfying in terms of pain relief and considerable improvements in shoulder function as well as in motion. However, this procedure is not so popular as knee or hip arthroplasties. The reasons for this phenomenon are not clear. The complication rate is considerably low. The most common are periprosthetic fractures, infections, implant loosening and instability. The reasonable solution is a conversion to reverse total shoulder arthroplasty. The survivorship of the prosthesis is up to 12 years, which is acceptable by patients. Long term result are still not clear. Surgeons performing SA opt for deltopectoral approach which provides good exposure of the joint also for revisions. The aim: To summarize knowledge about SA based on current literature.


Assuntos
Artroplastia do Ombro , Artroplastia de Substituição , Osteoartrite , Articulação do Ombro , Humanos , Osteoartrite/cirurgia , Qualidade de Vida , Articulação do Ombro/cirurgia
6.
Wiad Lek ; 73(9 cz. 1): 1878-1881, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33099534

RESUMO

Hyaluronic acid (HA) as a compound was discovered in 1934 by Karl Meyer and John Palmer as one of the glycosaminoglycans (GAG) in the vitreous body of the bovine eye. HA occurs naturally in many organs, tissues and body fluids, and especially is presented in large quantities in articular cartilage and synovial fluid. It is a non-protein, non-sulfate glycosaminoglycan which has an important role in the physiological biomechanics of synovial fluid, there is responsible for lubrication and drug-elasticity. In the musculoskeletal system, hyaluronic acid is produced by synoviocytes, fibroblasts and chondrocytes. The concentration of hyaluronic acid decreases not only with age, but also in connection with the progression of certain diseases, for example osteoarthritis (OA). For this reason, it has been used for almost 50 years to try to alleviate and treat symptoms of OA in humans and animals. Numerous studies confirmed the beneficial effect of hyaluronic acid supplementation in OA. Patients which has intraarticular viscosupplementation of HA experience less pain and have a reduced need to take nonsteroidal anti-inflammatory drugs. Intra articular HA administration shows a low risk of local and systemic side effects while maintaining proper administration under aseptic conditions. Nevertheless, local inflammatory reactions occur, but it are most often self-limiting or do not require invasive treatment. The issue of recommending hyaluronic acid in osteoarthritis is still ambiguous and controversial.


Assuntos
Ortopedia , Osteoartrite , Animais , Bovinos , Humanos , Ácido Hialurônico/uso terapêutico , Injeções Intra-Articulares , Osteoartrite/tratamento farmacológico
7.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 897-901, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047726

RESUMO

OBJECTIVE: To evaluate the classification criteria of early rheumatoid arthritis (ERA) and compare the sensitivity and specificity with the criteria of 1987 American College of Rheumatology (ACR) criteria and 2010 ACR/European League Against Rheumatism (EULAR). METHODS: Patients from 4 hospitals, aged more than 16 years, with arthritis, whose disease duration was ≤1 year, and with ≥1 joint pain and swelling were enrolled in the study. The indicators including clinical manifestations, laboratory tests and imaging examinations were observed. The ERA patients were dignosed by two experienced rheumatologists based on the clinical features, drug therapy information and radiography features. RESULTS: (1) A total of 325 patients with arthritis were enrolled, including 98 males (30.15%) and 227 females (69.85%), The average age was (47.53±14.44) years, and the median disease duration was 5 (2, 8) months. Finally, 236 patients were dignosed with ERA, and 89 patients were dignosed with other diseases (Non-ERA, including osteoarthritis, reactive arthritis, undifferentiated arthritis, spondyloarthritis, etc). (2) The sensitivity of ERA criteria was 87.29%, and the specificity was 84.37%. The sensitivity was higher than that of 1987 ACR criteria (χ2=43.641, P < 0.001), and had no significant difference compared with 2010 ACR/EULAR criteria (χ2=0.446, P=0.593). But the specificity of ERA criteria was lower than that of 1987 ACR criteria (χ2=4.891, P=0.027), which was not statistically significant compared with 2010 ACR/EULAR criteria (χ2=0.044, P=1.000). (3) In the patients with arthritis whose disease duration was ≤3 months and ≤6 months, the sensitivity of ERA criteria was 81.71% and 86.79%, respectively, both were higher than the 1987 ACR criteria (χ2=7.131, P=0.008; χ2=22.015, P < 0.001) and had no statistically difference compared with the 2010 ACR/EULAR criteria (χ2=0.220, P=0.755; χ2=0.473, P=0.491). The differences of the three criteria in specificity were not statistically significant. (4) The three different classification criteria were consistent with the clinical diagnosis, among which the ERA criteria and 2010 ACR/EULAR criteria were slightly higher (Kappa>0.6). The results of the consistency comparison between the three criteria showed that the ERA criteria and 2010 ACR/EULAR criteria had a better consistency (Kappa=0.836). CONCLUSION: The sensitivity of ERA classification criteria in the diagnosis of ERA was higher than that of 1987 ACR criteria, and was equivalent to that of 2010 ACR/EULAR criteria. There is no significant difference in specificity between these three criteria. The ERA criteria can also identify patients with RA at a very early stage in arthritis with disease duration ≤3 months.


Assuntos
Artrite Reumatoide , Osteoartrite , Reumatologia , Adolescente , Adulto , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Sensibilidade e Especificidade , Estados Unidos
8.
Khirurgiia (Mosk) ; (10): 104-111, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33047593

RESUMO

The article discusses the place of symptomatic slow-acting drugs in current guidelines for the treatment of osteoarthritis. Special emphasis is put ot glucosamine preparations, the attitude towards which, until recently, was ambiguous. The results of experimental and clinical studies demonstrating the advantages of crystalline glucosamine sulfate over preparations/food additives of glucosamine hydrochloride are presented. The differences in the pharmacodynamics and pharmacokinetics of glucosamine sulfate and glucosamine hydrochloride, which may be the reason for the ineffectiveness of the latter in clinical trials, are discussed.


Assuntos
Glucosamina/administração & dosagem , Osteoartrite/tratamento farmacológico , Glucosamina/farmacocinética , Glucosamina/farmacologia , Humanos
9.
Khirurgiia (Mosk) ; (9): 130-136, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33030014

RESUMO

The analysis of literature data was performed on the pathogenesis, diagnosis and treatment of injuries of the posterior cruciate ligament (PCL) of the knee joint. PCL is the largest intra-articular ligament of the knee joint, can withstand the maximum loads compared with other ligaments. It was noted that, in general, in cases of damage to the PCL, it is necessary to use a set of diagnostic methods, and the basic principles for the choice of optimal treatment plan for this patient. It considered the results of the conservative treatment of PCL partial ruptures, and it is indicated that this approach increases the risk of degenerative anatomical structures and functional disorders of the joint. It was noted that it is advisable to conduct surgical treatment to restore the stability of the knee joint and normalize function, while a number of methods for the reconstruction of PCL have been proposed to date. The usage of chondroprotectors for prevention of the secondary osteoarthrosis of the knee joint affected by posterior cruciate ligament rupture was analyzed in the literature data.


Assuntos
Instabilidade Articular , Osteoartrite , Ligamento Cruzado Posterior , Fenômenos Biomecânicos , Humanos , Articulação do Joelho , Osteoartrite/prevenção & controle , Prevenção Secundária
10.
J Am Acad Orthop Surg ; 28(20): e878-e887, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33030854

RESUMO

The talus is unique in having a tenuous vascular supply and 57% of its surface covered by articular cartilage. Fractures of the head, neck, or body regions have the potential to compromise nearby joints and impair vascular inflow, necessitating surgical treatment with stable internal fixation in many cases. The widely preferred approach for many talar neck and body fractures is a dual anterior incision technique to achieve an anatomic reduction, with the addition of a medial malleolar osteotomy as needed to visualize the posterior talar body. Percutaneous screw fixation has also demonstrated success in certain patterns. Despite this modern technique, osteonecrosis and osteoarthritis remain common complications. A variety of new treatments for these complications have been proposed, including vascularized autograft, talar replacement, total ankle arthroplasty, and improved salvage techniques, permitting some patients to return to a higher level of function than was previously possible. Despite these advances, functional outcomes remain poor in a subset of severely injured patients, making further research imperative.


Assuntos
Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Procedimentos Ortopédicos/métodos , Tálus/lesões , Tornozelo/cirurgia , Artroplastia de Substituição , Autoenxertos/irrigação sanguínea , Parafusos Ósseos , Fraturas Ósseas/complicações , Humanos , Osteoartrite/etiologia , Osteoartrite/terapia , Osteonecrose/etiologia , Osteonecrose/terapia , Osteotomia/métodos , Prognóstico , Recuperação de Função Fisiológica , Tálus/irrigação sanguínea
11.
Rev. argent. neurocir ; 34(3): 200-208, sept. 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1120920

RESUMO

El dolor facetario lumbar es una de las principales causas de dolor lumbar; representa alrededor del 15-56%. La articulación facetaria estabiliza la columna vertebral, tiene un rol fundamental en el soporte, distribución del peso y regulación de los movimientos rotacionales de la columna. Por ello, el conocimiento de la anatomía y de la biomecánica de esta articulación ayuda a tener una mejor comprensión de su participación en la fisiopatología del dolor lumbar y, por ende, mejora su abordaje diagnóstico y terapéutico. Nosotros revisamos aquí los conceptos actuales de embriología, anatomía, biomecánica y la correlación clínica/imagenológica de los cambios asociados a la enfermedad degenerativa facetaria de la columna lumbar.


Low back pain is a very common reason for emergency room consultation, it is found in approximately 60% of adults, and, within it, facet lumbar pain is one of the main causes, accounting for about 15-56% of low back pain cases. The facet joint stabilizes the spine, helps to distribute loads and has a fundamental role in support, weight distribution, and rotational movements regulation of the spine. Consequently, knowledge of the anatomy and biomechanics of this joint is helpful to have a better understanding of their contribution to the low back pain pathophysiology and, therefore, improving diagnostic and therapeutic approaches. This paper aims to review the current concepts of embryology, anatomy, biomechanics, and clinical/imaging correlation of the changes associated with lumbar degenerative facet disease


Assuntos
Humanos , Dor Lombar , Osteoartrite , Coluna Vertebral , Anatomia , Articulações
12.
J Am Acad Orthop Surg ; 28(19): 781-789, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32986386

RESUMO

The Management of Glenohumeral Joint Osteoarthritis Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies for the treatment of glenohumeral joint osteoarthritis. The purpose of this clinical practice guideline is to address the management of patients with glenohumeral joint osteoarthritis. It is not intended to address the management of glenohumeral joint arthritis from etiologies other than osteoarthritis (ie, rheumatoid arthritis, inflammatory arthritis, posttraumatic arthritis, osteonecrosis, rotator cuff tear arthroplasty, capsulorrhaphy arthroplasty, and postinfections arthroplasty) This guideline contains 13 recommendations to assist all qualified and appropriately trained healthcare professionals involved in the management of glenohumeral joint osteoarthritis. In addition, the work group highlighted the need for better research for implant survivorship of total shoulder arthroplasty, the efficacy of physical therapy and other nonsurgical treatment modalities, the use of advanced imaging modalities and software and their impact on clinical and functional outcomes, complication rates or implant survivorship, and the need for high-quality studies demonstrating improved clinical outcomes and/or implant survivorship for the use of reverse shoulder arthroplasty as opposed to anatomic shoulder arthroplasty in challenging situations.


Assuntos
Osteoartrite/cirurgia , Guias de Prática Clínica como Assunto , Articulação do Ombro/cirurgia , Artroplastia do Ombro/métodos , Humanos , Osteoartrite/etiologia , Osteoartrite/terapia , Modalidades de Fisioterapia
13.
Life Sci ; 261: 118429, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-32931797

RESUMO

AIMS: Long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) have been reported as the important regulators in osteoarthritis (OA). However, the detailed mechanism is implicated. The aim of this study is to reveal the functional mechanism of lncRNA ARFRP1 and miR-15a-5p in osteoarthritis. MATERIALS AND METHODS: The expression level of genes was detected by quantitative real time polymerase chain reaction (qRT-PCR) or western blot assay. Cell Counting Kit-8 (CCK-8) was used to assess cell viability. Cell apoptosis rate was analyzed by flow cytometry analysis. Furthermore, Enzyme-linked immunosorbent assay (ELISA) was performed to measure tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-1ß contents. The interaction between miR-15a-5p and ARFRP1 or Toll-like receptor 4 (TLR4) was predicted by miRcode or PITA, and then confirmed by the dual luciferase reporter assay or pull down assay. Besides, NF-κB-driven luciferase activity was determined using NF-κB luciferase reporter assay. KEY FINDINGS: ARFRP1 and TLR4 levels were increased and miR-15a-5p level was decreased in OA cartilage tissues and lipopolysaccharides (LPS)-induced chondrocytes. ARFRP1 knockdown inhibited LPS-induced the injury of chondrocytes. Interestingly, miR-15a-5p downregulated by ARFRP1 negatively modulated TLR4 expression through interaction. ARFRP1 mediated LPS-induced the injury of chondrocytes via regulating miR-15a-5p/TLR4 axis. Furthermore, ARFRP1 exerted function by modulation of NF-κB pathway. SIGNIFICANCE: Our findings confirmed that ARFRP1 mediated LPS-induced the injury of chondrocytes through regulating NF-κB pathway by modulation of miR-15a-5p/TLR4 axis, providing theoretical basis for the treatment of OA patients.


Assuntos
Condrócitos/patologia , MicroRNAs/genética , NF-kappa B/imunologia , RNA Longo não Codificante/genética , Receptor 4 Toll-Like/genética , Adulto , Idoso , Células Cultivadas , Condrócitos/imunologia , Condrócitos/metabolismo , Regulação para Baixo , Técnicas de Silenciamento de Genes , Humanos , Lipopolissacarídeos/imunologia , MicroRNAs/imunologia , Pessoa de Meia-Idade , Osteoartrite/genética , Osteoartrite/imunologia , Osteoartrite/patologia , RNA Longo não Codificante/imunologia , Receptor 4 Toll-Like/imunologia , Regulação para Cima
14.
PLoS One ; 15(9): e0238449, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886713

RESUMO

Treatment of osteoarthritis (OA) is still a major clinical challenge due to the limited inherent healing capacity of cartilage. Recent studies utilising stem cells suggest that the therapeutic benefits of these cells are mediated through the paracrine mechanism of bioactive molecules. The present study evaluates the regenerative effect of stem cells from human exfoliated deciduous teeth (SHED) conditioned medium (CM) on OA chondrocytes. The CM was collected after the SHED were cultured in serum-free medium (SFM) for 48 or 72 h and the cells were characterised by the expression of MSC and pluripotency markers. Chondrocytes were stimulated with interleukin-1ß and treated with the CM. Subsequently, the expression of aggrecan, collagen type 2 (COL 2), matrix metalloproteinase-13 (MMP-13), nuclear factor-kB (NF-kB) and the level of inflammatory and anti-inflammatory markers were evaluated. SHED expressed mesenchymal stromal cell surface proteins but were negative for haematopoietic markers. SHED also showed protein expression of NANOG, OCT4 and SOX2 with differential subcellular localisation. Treatment of OA chondrocytes with CM enhanced anti-inflammation compared to control cells treated with SFM. Furthermore, the expression of MMP-13 and NF-kB was significantly downregulated in stimulated chondrocytes incubated in CM. The study also revealed that CM increased the expression of aggrecan and COL 2 in OA chondrocytes compared to SFM control. Both CM regenerate extracellular matrix proteins and mitigate increased MMP-13 expression through inhibition of NF-kB in OA chondrocytes due to the presence of bioactive molecules. The study underscores the potential of CM for OA treatment.


Assuntos
Condrócitos/efeitos dos fármacos , Meios de Cultivo Condicionados/farmacologia , Osteoartrite/metabolismo , Agrecanas/metabolismo , Cartilagem/metabolismo , Técnicas de Cultura de Células/métodos , Células Cultivadas , Colágeno Tipo II/metabolismo , Humanos , Metaloproteinase 13 da Matriz/metabolismo , Células-Tronco Mesenquimais/metabolismo , NF-kappa B/metabolismo , Osteoartrite/terapia , Regeneração , Células-Tronco/metabolismo , Dente Decíduo/metabolismo
17.
PLoS One ; 15(9): e0232911, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941429

RESUMO

Peer-reviewed published studies on tibial plateau fractures treated with either open reduction with internal fixation (ORIF) or circular external fixation were reviewed to compare functional, radiological outcomes, postoperative complications, and reoperation rates between the two methods. A systematic search of various databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), ScienceDirect, and Google Scholar from inception until June 2019 was performed. 17 studies with 1168 participants were included in the review. Most of the studies (76%) were retrospective in nature and had low or unclear bias risks. Incidence of total infection (Odds ratio [OR], 2.58; 95% CI, 1.33-5.02) and malunions (OR, 2.56; 95% CI, 1.12-5.84) were higher and length of hospital stay was shorter in patients treated with circular external fixator (Mean difference [MD], -6.1; 95% CI, -11.1--1.19). There were no differences in the incidence of secondary osteoarthritis (OR, 1.49; 95% CI, 0.92-2.42), range of motion (MD, 2.28; 95% CI, -11.27-15.82) non-union (OR, 1.44; 95% CI, 0.14-14.27) and reoperation rates (OR, 1.84; 95% CI, 0.90-3.78) between the two groups. Results from this investigation suggest that circular fixation may offer some advantages over ORIF such as a shortened length of hospital stay and early return to preinjury activities. Definitive clinical recommendations cannot be made as it also presents higher rates of postoperative complications than ORIF.


Assuntos
Fixação de Fratura/métodos , Fraturas Mal-Unidas/epidemiologia , Osteoartrite/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Fraturas da Tíbia/cirurgia , Adolescente , Adulto , Criança , Fixadores Externos/efeitos adversos , Feminino , Fixação de Fratura/efeitos adversos , Fixação de Fratura/instrumentação , Fraturas Mal-Unidas/diagnóstico por imagem , Fraturas Mal-Unidas/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico por imagem , Osteoartrite/etiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Amplitude de Movimento Articular , Reoperação/estatística & dados numéricos , Fraturas da Tíbia/terapia
18.
Medicine (Baltimore) ; 99(33): e21707, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872047

RESUMO

Osteoarthritis (OA) is a chronic degenerative joint disease with its onset closely related to the growth of synovial fibroblasts (SFs), yet the genes involved in are few reported. In our study, we aimed to identify the OA-associated key gene and pathways via the single-cell RNA sequencing (scRNA-seq) analysis on SFs.scRNA-seq data of SFs from OA sufferers were accessed from GEO database, then the genes involved in were subjected to principal component analysis (PCA) and T-Stochastic Neighbor Embedding (TSNE) Analysis. GO and KEGG enrichment analyses were performed to find the most enriched functions and pathways associated with marker genes and a PPI network was constructed to identify the key gene associated with OA occurrence.Findings revealed that marker genes in three cell types identified by TSNE were mainly activated in pathways firmly related to fibroblasts growth, such as extracellular matrix, immune and cell adhesion molecule binding-associated functions and pathways. Moreover, fibronectin1 (FN1) was validated as the key gene that was tightly related to the growth of SFs, as well as had the potential to play a key role in OA occurrence.Our study explored the key gene and pathways associated with OA occurrence, which were of great value in further investigation of OA diagnosis as well as pathogenesis.


Assuntos
Fibroblastos/metabolismo , Fibronectinas/genética , Osteoartrite/genética , Humanos , Osteoartrite/metabolismo , Mapas de Interação de Proteínas , Análise de Sequência de RNA , Análise de Célula Única , Membrana Sinovial/citologia
19.
Cochrane Database Syst Rev ; 9: CD008294, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32990945

RESUMO

BACKGROUND: Pine bark (Pinus spp.) extract is rich in bioflavonoids, predominantly proanthocyanidins, which are antioxidants. Commercially-available extract supplements are marketed for preventing or treating various chronic conditions associated with oxidative stress. This is an update of a previously published review. OBJECTIVES: To assess the efficacy and safety of pine bark extract supplements for treating chronic disorders. SEARCH METHODS: We searched three databases and three trial registries; latest search: 30 September 2019. We contacted the manufacturers of pine bark extracts to identify additional studies and hand-searched bibliographies of included studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) evaluating pine bark extract supplements in adults or children with any chronic disorder. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial eligibility, extracted data and assessed risk of bias. Where possible, we pooled data in meta-analyses. We used GRADE to evaluate the certainty of evidence. Primary outcomes were participant- and investigator-reported clinical outcomes directly related to each disorder and all-cause mortality. We also assessed adverse events and biomarkers of oxidative stress. MAIN RESULTS: This review included 27 RCTs (22 parallel and five cross-over designs; 1641 participants) evaluating pine bark extract supplements across 10 chronic disorders: asthma (two studies; 86 participants); attention deficit hyperactivity disorder (ADHD) (one study; 61 participants), cardiovascular disease (CVD) and risk factors (seven studies; 338 participants), chronic venous insufficiency (CVI) (two studies; 60 participants), diabetes mellitus (DM) (six studies; 339 participants), erectile dysfunction (three studies; 277 participants), female sexual dysfunction (one study; 83 participants), osteoarthritis (three studies; 293 participants), osteopenia (one study; 44 participants) and traumatic brain injury (one study; 60 participants). Two studies exclusively recruited children; the remainder recruited adults. Trials lasted between four weeks and six months. Placebo was the control in 24 studies. Overall risk of bias was low for four, high for one and unclear for 22 studies. In adults with asthma, we do not know whether pine bark extract increases change in forced expiratory volume in one second (FEV1) % predicted/forced vital capacity (FVC) (mean difference (MD) 7.70, 95% confidence interval (CI) 3.19 to 12.21; one study; 44 participants; very low-certainty evidence), increases change in FEV1 % predicted (MD 7.00, 95% CI 0.10 to 13.90; one study; 44 participants; very low-certainty evidence), improves asthma symptoms (risk ratio (RR) 1.85, 95% CI 1.32 to 2.58; one study; 60 participants; very low-certainty evidence) or increases the number of people able to stop using albuterol inhalers (RR 6.00, 95% CI 1.97 to 18.25; one study; 60 participants; very low-certainty evidence). In children with ADHD, we do not know whether pine bark extract decreases inattention and hyperactivity assessed by parent- and teacher-rating scales (narrative synthesis; one study; 57 participants; very low-certainty evidence) or increases the change in visual-motoric coordination and concentration (MD 3.37, 95% CI 2.41 to 4.33; one study; 57 participants; very low-certainty evidence). In participants with CVD, we do not know whether pine bark extract decreases diastolic blood pressure (MD -3.00 mm Hg, 95% CI -4.51 to -1.49; one study; 61 participants; very low-certainty evidence); increases HDL cholesterol (MD 0.05 mmol/L, 95% CI -0.01 to 0.11; one study; 61 participants; very low-certainty evidence) or decreases LDL cholesterol (MD -0.03 mmol/L, 95% CI -0.05 to 0.00; one study; 61 participants; very low-certainty evidence). In participants with CVI, we do not know whether pine bark extract decreases pain scores (MD -0.59, 95% CI -1.02 to -0.16; one study; 40 participants; very low-certainty evidence), increases the disappearance of pain (RR 25.0, 95% CI 1.58 to 395.48; one study; 40 participants; very low-certainty evidence) or increases physician-judged treatment efficacy (RR 4.75, 95% CI 1.97 to 11.48; 1 study; 40 participants; very low-certainty evidence). In type 2 DM, we do not know whether pine bark extract leads to a greater reduction in fasting blood glucose (MD 1.0 mmol/L, 95% CI 0.91 to 1.09; one study; 48 participants;very low-certainty evidence) or decreases HbA1c (MD -0.90 %, 95% CI -1.78 to -0.02; 1 study; 48 participants; very low-certainty evidence). In a mixed group of participants with type 1 and type 2 DM we do not know whether pine bark extract decreases HbA1c (MD -0.20 %, 95% CI -1.83 to 1.43; one study; 67 participants; very low-certainty evidence). In men with erectile dysfunction, we do not know whether pine bark extract supplements increase International Index of Erectile Function-5 scores (not pooled; two studies; 147 participants; very low-certainty evidence). In women with sexual dysfunction, we do not know whether pine bark extract increases satisfaction as measured by the Female Sexual Function Index (MD 5.10, 95% CI 3.49 to 6.71; one study; 75 participants; very low-certainty evidence) or leads to a greater reduction of pain scores (MD 4.30, 95% CI 2.69 to 5.91; one study; 75 participants; very low-certainty evidence). In adults with osteoarthritis of the knee, we do not know whether pine bark extract decreases composite Western Ontario and McMaster Universities Osteoarthritis Index scores (MD -730.00, 95% CI -1011.95 to -448.05; one study; 37 participants; very low-certainty evidence) or the use of non-steroidal anti-inflammatory medication (MD -18.30, 95% CI -25.14 to -11.46; one study; 35 participants; very low-certainty evidence). We do not know whether pine bark extract increases bone alkaline phosphatase in post-menopausal women with osteopenia (MD 1.16 ug/L, 95% CI -2.37 to 4.69; one study; 40 participants; very low-certainty evidence). In individuals with traumatic brain injury, we do not know whether pine bark extract decreases cognitive failure scores (MD -2.24, 95% CI -11.17 to 6.69; one study; 56 participants; very low-certainty evidence) or post-concussion symptoms (MD -0.76, 95% CI -5.39 to 3.87; one study; 56 participants; very low-certainty evidence). For most comparisons, studies did not report outcomes of hospital admissions or serious adverse events. AUTHORS' CONCLUSIONS: Small sample sizes, limited numbers of RCTs per condition, variation in outcome measures, and poor reporting of the included RCTs mean no definitive conclusions regarding the efficacy or safety of pine bark extract supplements are possible.


Assuntos
Antioxidantes/uso terapêutico , Doença Crônica/tratamento farmacológico , Flavonoides/uso terapêutico , Casca de Planta/química , Extratos Vegetais/uso terapêutico , Adolescente , Adulto , Asma/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Viés , Doenças Ósseas Metabólicas/tratamento farmacológico , Lesões Encefálicas Traumáticas/tratamento farmacológico , Doenças Cardiovasculares/tratamento farmacológico , Criança , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Disfunção Erétil/tratamento farmacológico , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Osteoartrite/tratamento farmacológico , Pinus , Ensaios Clínicos Controlados Aleatórios como Assunto , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Insuficiência Venosa/tratamento farmacológico
20.
Medicine (Baltimore) ; 99(37): e22142, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925767

RESUMO

Osteoarthritis (OA) is a high prevalent musculoskeletal problem, which can cause severe pain, constitute a huge social and economic burden, and seriously damage the quality of life. This study was intended to identify genetic characteristics of subchondral bone in patients with OA and to elucidate the potential molecular mechanisms involved. Data of gene expression profiles (GSE51588), which contained 40 OA samples and 10 normal samples, was obtained from the Gene Expression Omnibus (GEO). The raw data were integrated to obtain differentially expressed genes (DEGs) and were further analyzed with bioinformatic analysis. The protein-protein interaction (PPI) networks were built and analyzed via Search Tool for the Retrieval of Interacting Genes (STRING). The significant modules and hub genes were identified via Cytoscape. Moreover, Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) enrichment analysis were performed. Totally 235 DEGs were differentially expressed in the subchondral bone from OA patients compared with those of normal individuals, of which 78 were upregulated and 157 were downregulated. Eight hub genes were identified, including DEFA4, ARG1, LTF, RETN, PGLYRP1, OLFM4, ORM1, and BPI. The enrichment analyses of the DEGs and significant modules indicated that DEGs were mainly involved in inflammatory response, extracellular space, RAGE receptor binding, and amoebiasis pathway. The present study provides a novel and in-depth understanding of pathogenesis of the OA subchondral bone at molecular level. DEFA4, ARG1, LTF, RETN, PGLYRP1, OLFM4, ORM1, and BPI may be the new candidate targets for diagnosis and therapies on patients with OA in the future.


Assuntos
Biologia Computacional , Osteoartrite/genética , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Ontologia Genética , Humanos , Masculino , Pessoa de Meia-Idade , Mapas de Interação de Proteínas , Transcriptoma , beta-Defensinas
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