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1.
Minerva Med ; 113(4): 675-682, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35912803

RESUMO

BACKGROUND: Arthrosis is now intended as a multifactorial pathology that involves various joints and is caused by different biological functional alterations at the basis of the joints damage. Considering this new evidence, the prevention and the conservative treatment of arthrosis acquire an important role with respect to a surgical approach. The "Osteo-Experience" project was designed to collect, describe and compare the personal experiences of osteoarticular specialists in the field of the conservative treatment of the various forms of arthrosis. In addition, some useful insights for a correct management of conservative therapy in respect to the various forms of arthrosis were provided. METHODS: A group of Italian osteoarticular specialists with experience in the treatment of arthrosis were asked to describe their routine clinical practice regarding their more usual therapeutic schemes. The type of patients normally being treated by the osteoarticular specialists were described. An electronic question-and-answer form was provided. Each form simulates a patient visit, that must be imagined based on the most common personal experience. RESULTS: Seven hundred sixty-five forms were considered. A frequent use of NSAIDs and COX-2 inhibitors emerged, especially for early arthrosis and in older subjects with advanced osteoarthritis. Hyaluronic acid and chondroprotectors are used with great frequency in all types of osteoarthritis. A reduction of pain is reported in all settings of patients. Problems related to the conservative therapies are reported only in a small minority of cases, along with a good degree of satisfaction by doctors and patients. CONCLUSIONS: Observations collected within the "Osteo-Experience" project show that a more conscious use of the conservative therapy should be pursued for arthrosis. The present study denotes how it is necessary to better define some therapeutic schemes based on the different clinical characteristics of the patient, to improve the clinical outcome.


Assuntos
Tratamento Conservador , Osteoartrite , Idoso , Tratamento Conservador/efeitos adversos , Humanos , Osteoartrite/etiologia , Osteoartrite/terapia
3.
Int J Oral Sci ; 14(1): 40, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35927232

RESUMO

Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by cartilage loss and accounts for a major source of pain and disability worldwide. However, effective strategies for cartilage repair are lacking, and patients with advanced OA usually need joint replacement. Better comprehending OA pathogenesis may lead to transformative therapeutics. Recently studies have reported that exosomes act as a new means of cell-to-cell communication by delivering multiple bioactive molecules to create a particular microenvironment that tunes cartilage behavior. Specifically, exosome cargos, such as noncoding RNAs (ncRNAs) and proteins, play a crucial role in OA progression by regulating the proliferation, apoptosis, autophagy, and inflammatory response of joint cells, rendering them promising candidates for OA monitoring and treatment. This review systematically summarizes the current insight regarding the biogenesis and function of exosomes and their potential as therapeutic tools targeting cell-to-cell communication in OA, suggesting new realms to improve OA management.


Assuntos
Cartilagem Articular , Exossomos , Osteoartrite , Apoptose , Cartilagem/metabolismo , Cartilagem/patologia , Cartilagem Articular/metabolismo , Comunicação Celular , Condrócitos/metabolismo , Exossomos/metabolismo , Exossomos/patologia , Humanos , Osteoartrite/metabolismo , Osteoartrite/terapia
4.
Biomater Adv ; 136: 212802, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35929288

RESUMO

Articular cartilage encounters structural damage and tissue degeneration during osteoarthritis. It is of great significance to effectively deliver the therapeutic drug to the location of the cartilage lesion. Nanoparticle-based biomimetic systems provide an important solution for drug delivery, but they still lack the active targeting capability. Although some physical and chemical modifications could decrease non-specific interactions to some extent, a specific bio-interaction for active targeting is still required for many biomedical purposes. In this study, we proposed genetically-engineered mesenchymal stem cell membrane-derived nanoparticles with the active targeting capability. BMSCs were engineered for the high expression of CXCR4 to actively migrate to the injured locations, and cell membrane of the engineered BMSCs was isolated and camouflaged to fluorescent nanoparticles. The modified nanoparticles that loaded with the therapeutic drug were incubated with IL-1ß-induced injured articular chondrocytes and cartilage. The results invisibly demonstrated that these engineered nanoparticles could increase both cellular uptake and penetration depth in the target cells and tissues under inflammatory microenvironments to protect the injured cartilage. Therefore, this genetically-modified nanoparticle functionalization strategy is expected to provide evidence for active targeting in the tissue injury treatment.


Assuntos
Cartilagem Articular , Células-Tronco Mesenquimais , Nanopartículas , Osteoartrite , Condrócitos , Humanos , Osteoartrite/terapia
5.
Artigo em Inglês | MEDLINE | ID: mdl-35805363

RESUMO

Rural Canadians have high health care needs due to high prevalence of osteoarthritis (OA) but lack access to care. Examining realized access to three types of providers (general practitioners (GPs), orthopedic surgeons (Ortho), and physiotherapists (PTs)) simultaneously helps identify gaps in access to needed OA care, inform accessibility assessment, and support health care resource allocation. Travel time from a patient's postal code to the physician's postal code was calculated using origin-destination network analysis. We applied descriptive statistics to summarize differences in travel time, hotspot analysis to explore geospatial patterns, and distance decay function to examine the travel pattern of health care utilization by urbanicity. The median travel time in Alberta was 11.6 min (IQR = 4.3-25.7) to GPs, 28.9 (IQR = 14.8-65.0) to Ortho, and 33.7 (IQR = 23.1-47.3) to PTs. We observed significant rural-urban disparities in realized access to GPs (2.9 and IQR = 0.0-92.1 in rural remote areas vs. 12.6 and IQR = 6.4-21.0 in metropolitan areas), Ortho (233.3 and IQR = 171.3-363.7 in rural remote areas vs. 21.3 and IQR = 14.0-29.3 in metropolitan areas), and PTs (62.4 and IQR = 0.0-232.1 in rural remote areas vs. 32.1 and IQR = 25.2-39.9 in metropolitan areas). We identified hotspots of realized access to all three types of providers in rural remote areas, where patients with OA tend to travel longer for health care. This study may provide insight on the choice of catchment size and the distance decay pattern of health care utilization for further studies on spatial accessibility.


Assuntos
Clínicos Gerais , Cirurgiões Ortopédicos , Osteoartrite , Fisioterapeutas , Alberta/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Osteoartrite/epidemiologia , Osteoartrite/terapia , População Rural
6.
Int J Mol Sci ; 23(13)2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-35806306

RESUMO

To date, several in vivo models have been used to reproduce the onset and monitor the progression of osteoarthritis (OA), and guinea pigs represent a standard model for studying naturally occurring, age-related OA. This systematic review aims to characterize the guinea pig for its employment in in vivo, naturally occurring OA studies and for the evaluation of specific disease-modifying agents. The search was performed in PubMed, Scopus, and Web of Knowledge in the last 10 years. Of the 233 records screened, 49 studies were included. Results showed that within a relatively short period of time, this model develops specific OA aspects, including cartilage degeneration, marginal osteophytes formation, and subchondral bone alterations. Disease severity increases with age, beginning at 3 months with mild OA and reaching moderate-severe OA at 18 months. Among the different strains, Dunkin Hartley develops OA at a relatively early age. Thus, disease-modifying agents have mainly been evaluated for this strain. As summarized herein, spontaneous development of OA in guinea pigs represents an excellent model for studying disease pathogenesis and for evaluating therapeutic interventions. In an ongoing effort at standardization, a detailed characterization of specific OA models is necessary, even considering the main purpose of these models, i.e., translatability to human OA.


Assuntos
Cartilagem Articular , Osteoartrite , Animais , Cartilagem Articular/patologia , Modelos Animais de Doenças , Cobaias , Osteoartrite/etiologia , Osteoartrite/patologia , Osteoartrite/terapia
7.
Int J Mol Sci ; 23(13)2022 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-35806393

RESUMO

Articular cartilage is characterized by a poor self-healing capacity due to its aneural and avascular nature. Once injured, it undergoes a series of catabolic processes which lead to its progressive degeneration and the onset of a severe chronic disease called osteoarthritis (OA). In OA, important alterations of the morpho-functional organization occur in the cartilage extracellular matrix, involving all the nearby tissues, including the subchondral bone. Osteochondral engineering, based on a perfect combination of cells, biomaterials and biomolecules, is becoming increasingly successful for the regeneration of injured cartilage and underlying subchondral bone tissue. To this end, recently, several peptides have been explored as active molecules and enrichment motifs for the functionalization of biomaterials due to their ability to be easily chemically synthesized, as well as their tunable physico-chemical features, low immunogenicity issues and functional group modeling properties. In addition, they have shown a good aptitude to penetrate into the tissue due to their small size and stability at room temperature. In particular, growth-factor-derived peptides can play multiple functions in bone and cartilage repair, exhibiting chondrogenic/osteogenic differentiation properties. Among the most studied peptides, great attention has been paid to transforming growth factor-ß and bone morphogenetic protein mimetic peptides, cell-penetrating peptides, cell-binding peptides, self-assembling peptides and extracellular matrix-derived peptides. Moreover, recently, phage display technology is emerging as a powerful selection technique for obtaining functional peptides on a large scale and at a low cost. In particular, these peptides have demonstrated advantages such as high biocompatibility; the ability to be immobilized directly on chondro- and osteoinductive nanomaterials; and improving the cell attachment, differentiation, development and regeneration of osteochondral tissue. In this context, the aim of the present review was to go through the recent literature underlining the importance of studying novel functional motifs related to growth factor mimetic peptides that could be a useful tool in osteochondral repair strategies. Moreover, the review summarizes the current knowledge of the use of phage display peptides in osteochondral tissue regeneration.


Assuntos
Cartilagem Articular , Osteoartrite , Materiais Biocompatíveis/química , Cartilagem Articular/metabolismo , Humanos , Peptídeos e Proteínas de Sinalização Intercelular , Osteoartrite/terapia , Osteogênese , Peptídeos/química , Engenharia Tecidual/métodos , Tecidos Suporte/química
9.
Int J Mol Sci ; 23(14)2022 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-35887046

RESUMO

The beneficial effects of HBO in inflammatory processes make it an attractive type of treatment for chronic arthritis. In addition, the effects of combination therapy based on adipose stem cells and HBO on OA progression have not been fully investigated. The current study explored the efficacy of intra-articular injection of allogeneic adipose-derived mesenchymal stem cells (ADMSCs) combined with hyperbaric oxygenation treatment (HBO) in a rat osteoarthritis (OA) model. The rat OA model was induced by intra-articular injection of monoiodoacetate (MIA) and 7 days after application of MIA rats were divided into five groups: healthy control (CTRL), osteoarthritis (OA), ADMSCs (ADS), the HBO+ADS21day and HBO+ADS28day groups. A single dose of 1 × 106 allogeneic ADMSCs suspended in sterile saline was injected into the knee joint alone or in combination with HBO treatment. Rats were sacrificed at 3 or 4 weeks after MIA injection. Treatment outcomes were evaluated by radiographic, morphological and histological analysis and by specific staining of articular cartilage. We also measured the level of inflammatory and pro/antioxidative markers. We confirmed that combined treatment of ADMSCs and HBO significantly improved the regeneration of cartilage in the knee joint. Rtg score of knee joint damage was significantly decreased in the HBO+ADS21day and HBO+ADS28day groups compared to the OA. However, the positive effect in the HBO+ADS28day group was greater than the HBO+ADS21day group. The articular cartilage was relatively normal in the HBO+ADS28day group, but moderate degeneration was observed in the HBO+ADS21day compared to the OA group. These findings are in line with the histopathological results. A significantly lower level of O2-. was observed in the HBO+ADS28day group but a higher NO level compared to the HBO+ADS21day group. Moreover, in the HBO+ADS28day group significantly higher concentrations of IL-10 were observed but there was no significant difference in proinflammatory cytokine in serum samples. These results indicate that a single intra-articular injection of allogeneic ADMSCs combined with HBO efficiently attenuated OA progression after 28 days with greater therapeutic effect compared to alone ADMSCs or after 3 weeks of combined treatment. Combined treatment might be an effective treatment for OA in humans.


Assuntos
Cartilagem Articular , Oxigenoterapia Hiperbárica , Osteoartrite do Joelho , Osteoartrite , Animais , Cartilagem Articular/patologia , Modelos Animais de Doenças , Humanos , Injeções Intra-Articulares , Articulação do Joelho/patologia , Osteoartrite/tratamento farmacológico , Osteoartrite/terapia , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/terapia , Ratos , Células-Tronco
10.
RMD Open ; 8(2)2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35906024

RESUMO

OBJECTIVES: Data on work participation impairment and related societal costs for patients with hand osteoarthritis (OA) are scarce. Therefore, we aimed to investigate the association of hand OA with work limitations and costs of productivity loss in paid and unpaid work. METHODS: We used data from the Hand Osteoarthritis in Secondary Care cohort, including patients with hand OA diagnosed by their treating rheumatologist. Using the validated Health and Labour Questionnaire, we assessed experienced unpaid and paid work restrictions, unpaid work replacement by others and inefficiency and absence during paid work related to hand OA over the last 2 weeks. Societal costs (€) per hour of paid and unpaid work were estimated using Dutch salary data in 2019. RESULTS: 381 patients were included (mean age 61 years, 84% women, 26% high education level, 55% having any comorbidity). Replacement of unpaid work by others due to hand OA was necessary for 171 out of 381 patients (45%). Paid work was reported by 181/381 patients (47%), of whom 13/181 (7%) reported absenteeism, 28/181 (15%) unproductive hours at work and 120/181 (66%) paid work restrictions due to hand OA.Total estimated work-related societal costs per patient with hand OA (381 patients) were €94 (95% CI 59 to 130) per 2 weeks (€2452, 95% CI 1528 to 3377 per year). CONCLUSIONS: Hand OA is associated with impairment in paid and unpaid work participation, which translates into substantial societal costs of lost productivity. These results highlight the importance of adequate hand OA treatment.


Assuntos
Hosta , Osteoartrite , Estudos de Coortes , Eficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/complicações , Osteoartrite/epidemiologia , Osteoartrite/terapia , Salários e Benefícios
11.
J Bone Joint Surg Am ; 104(15): 1406-1414, 2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35867717

RESUMO

➤: Orthobiologics encompass numerous substances that are naturally found in the human body including platelet-rich plasma (PRP), isolated growth factors, and cell therapy approaches to theoretically optimize and improve the healing of cartilage, fractures, and injured muscles, tendons, and ligaments. ➤: PRP is an autologous derivative of whole blood generated by centrifugation and is perhaps the most widely used orthobiologic treatment modality. Despite a vast amount of literature on its use in osteoarthritis as well as in tendon and ligament pathology, clinical efficacy results remain mixed, partly as a result of insufficient reporting of experimental details or exact compositions of PRP formulations used. ➤: Mesenchymal stromal cells (MSCs) can be isolated from a variety of tissues, with the most common being bone marrow aspirate concentrate. Similar to PRP, clinical results in orthopaedics with MSCs have been highly variable, with the quality and concentration of MSCs being highly contingent on the site of procurement and the techniques of harvesting and preparation. ➤: Advances in novel orthobiologics, therapeutic targets, and customized orthobiologic therapy will undoubtedly continue to burgeon, with some early promising results from studies targeting fibrosis and senescence.


Assuntos
Osteoartrite , Plasma Rico em Plaquetas , Terapia Baseada em Transplante de Células e Tecidos , Humanos , Ligamentos/lesões , Osteoartrite/terapia , Plasma Rico em Plaquetas/fisiologia , Tendões/metabolismo
12.
RMD Open ; 8(2)2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35654458

RESUMO

BACKGROUND: A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed. METHODS: Systematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage). RESULTS: In total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression. CONCLUSION: The current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing.


Assuntos
Artrite Reumatoide , Doenças Musculoesqueléticas , Osteoartrite , Doenças Reumáticas , Dieta , Humanos , Estilo de Vida , Doenças Musculares , Doenças Musculoesqueléticas/epidemiologia , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/terapia , Osteoartrite/epidemiologia , Osteoartrite/etiologia , Osteoartrite/terapia , Doenças Reumáticas/epidemiologia , Doenças Reumáticas/terapia
13.
BMC Musculoskelet Disord ; 23(1): 555, 2022 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-35676666

RESUMO

BACKGROUND: In Sweden, core treatment for osteoarthritis is offered through a Supported Osteoarthritis Self-Management Programme (SOASP), combining education and exercise to provide patients with coping strategies in self-managing the disease. The aim was to study enablement and empowerment among patients with osteoarthritis in the hip and/or knee participating in a SOASP. An additional aim was to study the relation between the Swedish version of the Patient Enablement Instrument (PEI) and the Swedish Rheumatic Disease Empowerment Scale (SWE-RES-23). METHODS: Patients with osteoarthritis participating in a SOASP in primary health care were recruited consecutively from 2016 to 2018. The PEI (score range 0-12) was used to measure enablement and the SWE-RES-23 (score range 1-5) to measure empowerment. The instruments were answered before (SWE-RES-23) and after the SOASP (PEI, SWE-RES-23). A patient partner was incorporated in the study. Descriptive statistics, the Wilcoxon's signed rank test, effect size (r), and the Spearman's rho (rs) were used in the analysis. RESULTS: In total, 143 patients were included in the study, 111 (78%) were women (mean age 66, SD 9.3 years). At baseline the reported median value for the SWE-RES-23 (n = 142) was 3.6 (IQR 3.3-4.0). After the educational part of the SOASP, the reported median value was 6 (IQR 3-6.5) for the PEI (n = 109) and 3.8 (IQR 3.6-4.1) for the SWE-RES-23 (n = 108). At three months follow-up (n = 116), the reported median value was 6 (IQR 4-7) for the PEI and 3.9 (IQR 3.6-4.2) for the SWE-RES-23. The SWE-RES-23 score increased between baseline and three months (p ≤ 0.000). The analysis showed a positive correlation between PEI and SWE-RES-23 after the educational part of the SOASP (rs = 0.493, p < 0.00, n = 108) and at follow-up at three months (rs = 0.507, p < 0.00, n = 116). CONCLUSIONS: Patients reported moderate to high enablement and empowerment and an increase in empowerment after participating in a SOASP, which might indicate that the SOASP is useful to enable and empower patients at least in the short term. Since our results showed that the PEI and the SWE-RES-23 are only partly related both instruments can be of use in evaluating interventions such as the SOASP. TRIAL REGISTRATION: ClinicalTrials.gov. NCT02974036 . First registration 28/11/2016, retrospectively registered.


Assuntos
Osteoartrite , Autogestão , Idoso , Feminino , Humanos , Masculino , Osteoartrite/diagnóstico , Osteoartrite/terapia , Satisfação do Paciente , Estudos Prospectivos , Inquéritos e Questionários
14.
BMC Musculoskelet Disord ; 23(1): 558, 2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35681171

RESUMO

BACKGROUND: Patient-reported outcome measures (PROMs) are frequently used to assess the effects of treatments in patients with wrist osteoarthritis (OA), but their psychometric properties have not been evaluated in this group of patients. Our aim was to evaluate the psychometric properties of the Numeric Rating Scale (NRS pain at rest, pain on motion without load, and pain on load), the Disabilities of the Arm, Shoulder and Hand (DASH) and the Patient Rated Wrist Evaluation (PRWE) questionnaires in patients with wrist OA regarding test-retest reliability and construct validity. METHODS: The NRS, DASH and PRWE were self-administered by 50 patients (40 men and 10 women, mean age 66 years) in a postal survey on two occasions, two weeks apart. Test-retest reliability was evaluated by Kappa statistics and the Spearman rank correlation coefficients (rho) were calculated to evaluate construct validity. RESULTS: The Kappa coefficients for DASH, PRWE and NRS pain on motion without load and NRS pain on load were > 0.90, 95% CI ranging from 0.84 to 0.98, while NRS pain at rest was 0.83, 95% CI 0.73-0.92. The construct validity of the PROMs was confirmed by three formulated hypotheses: a higher correlation between PRWE and NRS (rho 0.80-0.91, p < 0.001) was found, compared to DASH and NRS (rho 0.68-0.80, p < 0.001); the NRS pain on motion without load and NRS pain on load correlated more strongly to PRWE and DASH (rho 0.71-0.91, p < 0.001) compared to NRS pain at rest (rho 0.68-0.80) and a high correlation between PRWE and DASH was found (rho 0.86, p < 0.001). CONCLUSIONS: The NRS, DASH and PRWE demonstrate excellent test-retest reliability and moderate to high construct validity in patients with wrist OA. These PROMs are highly related, but they also differ. Therefore, they complement each other in ensuring a comprehensive evaluation of perceived disability in wrist OA. As PRWE showed the highest test-retest reliability and the highest relation to the other PROMs, the sole use of the PRWE can be recommended in clinical practice.


Assuntos
Osteoartrite , Punho , Idoso , Avaliação da Deficiência , Feminino , Humanos , Masculino , Osteoartrite/complicações , Osteoartrite/diagnóstico , Osteoartrite/terapia , Dor , Medidas de Resultados Relatados pelo Paciente , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
15.
Br J Hosp Med (Lond) ; 83(5): 1-7, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35653315

RESUMO

Osteoarthritis is a syndrome characterised by joint pain, resulting in functional limitation and a decreased quality of life. This chronic condition is one of the major public health problems facing society today and is likely to become more prevalent. The expected increase is because of the primary causative factors, advancing age and obesity, becoming increasingly prevalent in society. The diagnosis of osteoarthritis can be made clinically when activity related joint pain is present, alongside morning joint stiffness that lasts for less than 30 minutes. However, a radiological diagnosis can also be made. This article examines the current management strategies, as outlined by the National Institute for Health and Care Excellence guidelines for osteoarthritis. Although numerous surgical options are available, this article focuses on the non-operative strategies currently used. The emphasis in this article is on general principles of treatment rather than treatment options for specific joints.


Assuntos
Osteoartrite , Qualidade de Vida , Artralgia , Doença Crônica , Humanos , Osteoartrite/diagnóstico , Osteoartrite/terapia , Saúde Pública
17.
Aust J Gen Pract ; 51(7): 490-496, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35773158

RESUMO

BACKGROUND: Stable and pain-free thumb function and pinch is vital for personal care, work, domestic and leisure activities. OBJECTIVE: The aim of this article is to increase awareness of timely referral to hand therapists for three common thumb conditions. This article covers three thumb conditions: acute trauma (ulnar collateral ligament), repetitive trauma (De Quervain's tendinopathy) and chronic progression (basal thumb osteoarthritis). DISCUSSION: The Australian Hand Therapy Association awards accreditation to occupational therapists and physiotherapists with specialist knowledge of the upper limb. Understanding the role of hand therapy in clinical testing, custom orthoses and exercise prescription benefits general practitioners, as timely referrals yield optimal functional outcomes for patients.


Assuntos
Osteoartrite , Médicos , Austrália , Terapia por Exercício , Humanos , Osteoartrite/terapia , Polegar
18.
Can Vet J ; 63(6): 597-602, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35656532

RESUMO

The aim of this study was to document the effects of mesotherapy in working dogs diagnosed with hip osteoarthritis (OA) and related pain. Ten police working dogs with hip OA and related pain were treated with a combination of lidocaine, piroxicam, and thiocolchicoside, injected in multiple intradermal points. Seven treatment sessions were conducted. The Canine Brief Pain Inventory (CBPI) and the Hudson Visual Analogue Scale (HVAS) were used in the assessment of response to treatment compared to evaluation before treatment (T0), after 15 d, 30 d, 60 d, 90 d, 120 d, 150 d, and 180 d after initial treatment. Results were compared using the Wilcoxon signed-rank test. Significant differences were experienced in CBPI scores comparing moments with T0: at 15 d (P = 0.03 for Pain Interference Score - PIS) and P = 0.02 for Pain Severity Score - PSS), 30 d (P < 0.05 for PIS and P < 0.05 for PSS), 60 d (P = 0.04 for PIS and P = 0.01 for PSS) and 180 d (P = 0.04 for PSS). Individual treatment results were considered successful in 40% of animals at 15 d and 30 d, 66.7% at 60 d, 44% at 90 d, 37.5% at 120 d, and 25% at 150 d. The HVAS scores showed no significant differences. Mesotherapy may be an option for the treatment of canine musculoskeletal-related pain. Further studies are required.


Mésothérapie en plusieurs séances pour la prise en charge de la douleur arthrosique coxofémorale chez 10 chiens de travail : une série de cas. Le but de cette étude était de documenter les effets de la mésothérapie chez les chiens de travail diagnostiqués avec une arthrose de la hanche (OA) et des douleurs associées. Dix chiens de travail policiers souffrant d'OA et de douleurs associées ont été traités avec une combinaison de lidocaïne, de piroxicam et de thiocolchicoside, injectée en plusieurs points intradermiques. Sept séances de traitement ont été réalisées. Le Canine Brief Pain Inventory (CBPI) et l'échelle visuelle analogique de Hudson (HVAS) ont été utilisés dans l'évaluation de la réponse au traitement par rapport à l'évaluation avant traitement (T0), après 15 j, 30 j, 60 j, 90 j, 120 j, 150 j et 180 j après le traitement initial. Les résultats ont été comparés à l'aide du test des rangs signés de Wilcoxon. Des différences significatives ont été observées dans les scores CBPI comparant les moments avec T0 : à 15 jours (P = 0,03 pour Pain Interference Score ­ PIS) et P = 0,02 pour Pain Severity Score ­ PSS), 30 jours (P < 0,05 pour PIS et P < 0,05 pour PSS), 60 jours (P = 0,04 pour PIS et P = 0,01 pour PSS) et 180 jours (P = 0,04 pour PSS). Les résultats du traitement individuel ont été considérés comme réussis chez 40 % des animaux à 15 jours et 30 jours, 66,7 % à 60 jours, 44 % à 90 jours, 37,5 % à 120 jours et 25 % à 150 jours. Les scores HVAS n'ont montré aucune différence significative. La mésothérapie peut être une option pour le traitement des douleurs musculosquelettiques canines. Des études complémentaires sont nécessaires.(Traduit par Dr Serge Messier).


Assuntos
Doenças do Cão , Mesoterapia , Dor Musculoesquelética , Osteoartrite , Animais , Doenças do Cão/terapia , Cães , Mesoterapia/veterinária , Dor Musculoesquelética/veterinária , Osteoartrite/terapia , Osteoartrite/veterinária , Medição da Dor/veterinária , Cães Trabalhadores
20.
Tissue Cell ; 77: 101830, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35644053

RESUMO

Osteoarthritis (OA), also known as degenerative osteoarthritis, has a complex etiology, and its pathogenesis remains unclear. Platelet-rich plasma (PRP) therapy has been widely used in medicine and other related professions since its clinical application was first reported in the 1980 s and the 1990 s. This study aimed to investigate the effects and potential mechanisms of PRP in OA. An in vitro model of osteoarthritis was constructed by lipopolysaccharide (LPS) stimulation, and the effect of PRP on LPS-induced chondrocytes was evaluated. The results indicated that although LPS inhibited chondrocyte proliferation and promoted inflammation and apoptosis, these effects were reversed by PRP. In addition, the LPS-suppressed expression of aggrecan, TGF-ß, PDGF, and COL2A1 was restored by PRP, whereas the LPS-enhanced expression of MMP3 was suppressed by PRP. Furthermore, PRP inhibited LPS-induced mitochondrial damage by suppressing reactive oxygen species production, mitochondrial permeability transition pore opening, Drp1 expression, and upregulating Mfn1 expression. In addition, PRP inhibited the phosphorylation of AMPK and NF-κB. Collectively, this study indicates that PRP might be a potential therapeutic candidate for the treatment of OA by repairing mitochondrial function through the activation of AMPK/NF-κB signaling.


Assuntos
Osteoartrite , Plasma Rico em Plaquetas , Proteínas Quinases Ativadas por AMP/metabolismo , Proteínas Quinases Ativadas por AMP/farmacologia , Células Cultivadas , Condrócitos/metabolismo , Humanos , Lipopolissacarídeos/toxicidade , Mitocôndrias/metabolismo , NF-kappa B/metabolismo , Osteoartrite/metabolismo , Osteoartrite/terapia , Plasma Rico em Plaquetas/metabolismo
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