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1.
J Shoulder Elbow Surg ; 31(1): e1-e13, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34352401

RESUMO

BACKGROUND: Diabetic patients have a greater incidence of adhesive capsulitis (AC) and a more protracted disease course than patients with idiopathic AC. The purpose of this study was to compare gene expression differences between AC with diabetes mellitus and AC without diabetes mellitus. METHODS: Shoulder capsule samples were prospectively obtained from diabetic or nondiabetic patients who presented with shoulder dysfunction and underwent arthroscopy (N = 16). Shoulder samples of AC with and without diabetes (n = 8) were compared with normal shoulder samples with and without diabetes as the control group (n = 8). Shoulder capsule samples were subjected to whole-transcriptome RNA sequencing, and differential expression was analyzed with EdgeR. Only genes with a false discovery rate < 5% were included for further functional enrichment analysis. RESULTS: The sample population had a mean age of 47 years (range, 24-62 years), and the mean hemoglobin A1c level for nondiabetic and diabetic patients was 5.18% and 8.71%, respectively. RNA-sequencing analysis revealed that 66 genes were differentially expressed between diabetic patients and nondiabetic patients with AC whereas only 3 genes were differentially expressed when control patients with and without diabetes were compared. Furthermore, 286 genes were differentially expressed in idiopathic AC patients, and 61 genes were differentially expressed in diabetic AC patients. On gene clustering analysis, idiopathic AC was enriched with multiple structural and muscle-related pathways, such as muscle filament sliding, whereas diabetic AC included a greater number of hormonal and inflammatory signaling pathways, such as cellular response to corticotropin-releasing factor. CONCLUSIONS: Whole-transcriptome expression profiles demonstrate a fundamentally different underlying pathophysiology when comparing diabetic AC with idiopathic AC, suggesting that these conditions are distinct clinical entities. The new genes expressed explain the differences in the disease course and suggest new therapeutic targets that may lead to different treatment paradigms in these 2 subsets.


Assuntos
Bursite , Diabetes Mellitus , Articulação do Ombro , Artroscopia , Bursite/genética , Diabetes Mellitus/genética , Humanos , Pessoa de Meia-Idade , Ombro
2.
Iowa Orthop J ; 41(2): 45-57, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34924870

RESUMO

Background: While excision of the trochanteric bursae to treat lateral hip pain has increased in popularity, no comparison exists between the surgical outcomes and complications of the open and arthroscopic techniques involving trochanteric bursectomy. The purpose of this study was to determine the efficacies and complication rates of arthroscopic and open techniques for procedures involving trochanteric bursectomy. Methods: The terms "trochanteric," "bursectomy," "arthroscopic," "open," "outcomes," and "hip" were searched in five electronic databases. Fifteen studies from 120 initial results were included. Patient-reported outcomes (PRO), pain, satisfaction, and complications were included for analysis. Results: Five hundred-two hips in 474 total patients (77.7% female) were included in this study. The average age was 54. The fourteen distinct PRO scores that were reported by the included studies improved significantly from baseline to final mean follow-up (12-70.8 months for open; 12-42 months for arthroscopic) for both approaches, demonstrating statistically significant patient benefit in a variety of hip arthroscopy settings (P > 0.05). The complication rates of all procedures ranged from 0%-33% and failure to improve pain ranged from 0%-8%. Patient satisfaction with surgery was high at 95% and 82% reported a willingness to undergo the same surgery again. No significant mean differences were found between the open and arthroscopic techniques. Conclusion: The open and arthroscopic approaches for trochanteric bursectomy are both safe and effective procedures in treating refractory lateral hip pain. No significant differences in PROs, pain, total complications, severity of complications, and total failures were seen between technique outcomes.Level of Evidence: IV.


Assuntos
Artroscopia , Bursite , Artralgia , Bursite/cirurgia , Feminino , Articulação do Quadril/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
3.
BMC Musculoskelet Disord ; 22(1): 1048, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34930192

RESUMO

BACKGROUND: Greater trochanteric pain syndrome (GTPS) is a musculoskeletal condition which can cause disability and reduce quality of life. However, limited evidence is available on the long-term outcomes of people with GTPS. Our aims were to determine the long-term prevalence of GTPS; to calculate the proportion of people with GTPS who had developed hip osteoarthritis (OA); and to determine the level of function and quality of life, 11-years after initial GTPS diagnosis. METHODS: A prospective 11-year natural history study. Two groups [GTPS group (n = 24), asymptomatic control (ASC) group (n = 20)] were evaluated at baseline, 12-months and 11-years. At 11-years all participants completed the modified Harris Hip Score (mHHS), Oswestry Disability Index (ODI) and Assessment of Quality-of-Life questionnaire. At 11-year follow-up 20/24 GTPS and 19/20 ASC participants were clinically assessed for GTPS and hip OA, completed the 10 metre-walk-test, timed up and go, and hip abduction and external rotation strength testing. RESULTS: At 11-year follow-up 45.0% of GTPS participants had GTPS compared to 5.3% of ASC participants (p = 0.008), OR [95% CI]: 10.19 [1.95, 104.3], and 35.0% of GTPS participants were clinically diagnosed with hip OA compared to none of the ASC participants (p = 0.002), OR [95% CI]: 21.6, [2.3, 2898.0]. GTPS participants reported more pain and disability than ASC participants via the ODI, mean difference [95% CI]: 6.1 [0.7, 11.6] but not the modified Harris Hip Score, mean difference [95% CI]: -3.3 [-10.3, 3.7]. Both groups had similar levels of quality of life and measures of function. CONCLUSIONS: GTPS is a chronic condition: people with GTPS at baseline had twice the odds of being clinically diagnosed with GTPS or hip OA than the control group at 11-years. Further, there appears to be a temporal relationship between GTPS and the development of hip OA. This finding highlights the need to identify effective treatments that address the underlying impairments associated with GTPS. Pain and function results varied depending on the assessment tools used. Between group differences in quality of life seen at baseline are not found at the 11-year follow-up. The small sample size means the results must be considered with caution. LEVEL OF EVIDENCE: Level II Natural history Study.


Assuntos
Bursite , Qualidade de Vida , Seguimentos , Humanos , Dor , Estudos Prospectivos
4.
Artigo em Inglês | MEDLINE | ID: mdl-34948688

RESUMO

Although several studies have reported the effect of exercise therapy for adhesive capsulitis (AC), studies on the comparison of different exercise types on shoulder muscle strength and function in patients with AC are lacking. This study aimed to investigate the effect of different exercise types on shoulder muscle strength and function in patients with AC. Thirty female patients with AC were categorized into an eccentric contraction exercise group (ECG, n = 15; age, 51.53 ± 4.73 years) and a concentric contraction exercise group (CCG, n = 15; age, 52.40 ± 4.03 years). The participants in each group performed a different exercise program three times per week for 60 min per session for 12 weeks. The range of motion (ROM) of the shoulder joint, visual analog scale, shoulder muscle strength, and Constant-Murley score (CMS) were measured before the intervention and after 12 weeks of the exercise intervention. Shoulder ROM in flexion (increase of 31%) and external rotation (ER) (increase of 54%) showed a significant improvement in the ECG (p < 0.05). Muscle strength in ER was significantly different between the two groups (p < 0.05). Pain severity showed improvement in the ECG (decrease of 61%) after the intervention (p < 0.01). The CMS in the ECG (increase of 48%) showed a greater improvement than that in the CCG after the intervention (p < 0.01). This study showed that eccentric contraction exercise had a more beneficial effect than concentric contraction exercise for improving shoulder muscle strength and function in females with AC.


Assuntos
Bursite , Articulação do Ombro , Bursite/terapia , Terapia por Exercício , Feminino , Humanos , Pessoa de Meia-Idade , Força Muscular , Amplitude de Movimento Articular , Ombro , Dor de Ombro , Resultado do Tratamento
5.
Rev Assoc Med Bras (1992) ; 67(11): 1719-1723, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34909904

RESUMO

OBJECTIVE: This study aims to investigate magnetic resonance imaging (MRI) findings in adhesive capsulitis (AC) and determine the most valuable MRI finding in diagnosis using easily applied quantitative methods. METHODS: Shoulder MRI was performed on 193 patients who were diagnosed with AC by clinical examination and 116 controls. Axillary pouch thickness (APT), superior and inferior glenohumeral ligament (SGHL and IGHL) thickness, coracohumeral ligament (CHL) thickness, fluid increase and soft-tissue thickness in the rotator interval (RI), and increases in the fluid and signal in the localization of biceps tendon attachment were evaluated. MRI examinations were assessed by three radiologists blinded to the clinical findings of the patients, and the results were obtained based on consensus and records. RESULTS: There were 119 women and 74 men in the AC group and 80 women and 36 men in the control group. IGHL, SGHL, RI, and CHL thicknesses were measured thicker in AC patients than in the control group. When IGHL=4, RI=3.6, SGHL=2.0, CHL=4.6-mm cutoff, the area under the receiver operating characteristic (ROC) curve (AUC) values were 0.700, 0.922, 0.972, and 0.783, respectively. CONCLUSIONS: According to the results obtained in this study, IGHL=4 mm, RI=3.6 mm, SGHL=2.0 mm, and CHL=4.6 mm can support the diagnosis of AC. Using the quantitative values in diagnosis can provide objective criteria and prevent variability among interpreters.


Assuntos
Bursite , Articulação do Ombro , Axila , Bursite/diagnóstico por imagem , Feminino , Humanos , Ligamentos Articulares , Imageamento por Ressonância Magnética , Masculino , Articulação do Ombro/diagnóstico por imagem
6.
Acta Orthop Traumatol Turc ; 55(6): 459-465, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34967732

RESUMO

OBJECTIVE: The aim of this study was to evaluate the short and long-term effects of the combination of suprascapular nerve block (SSNB) and intra-articular corticosteroid injection (IAI) on pain, shoulder range of motion (ROM), disability, and quality of life in the management of patients with adhesive capsulitis (AC). METHODS: Forty patients (ages 30-70 years) who were diagnosed with AC stages 1 and 2 were randomlyassigned to one of two groups: Group-1 received IAI and SSNB combination, while group-2 only-IAI. Both groups started a three-week rehabilitation program after the intervention. The Shoulder Pain and Disability Index (SPADI), Numeric Rating Scale (NRS), active and passive shoulder ROMs, and the Short Form 36(SF-36) were assessed by a physiatrist who was blinded to the allocation at baseline and three weeks, three months, and twelve months. The NRS and shoulder ROMs were also examined in the first hour. RESULTS: Nineteen patients from each group with mean ages of 55.84±2.19 (15 females, 4 males) and51.79 ± 1.58 (14 females, 5 males) were included. Within the groups, SPADI and NRS scores were decreased, while active and passive ROMs and the physical function, physical role, and bodily pain domains of SF-36 were increased by time (P < 0.05). Between the groups, the change in NRS value and active flexion in the first hour was more remarkable in group 1 (P < 0.05). No significant difference between outcome measurements was found at the 3rd week, 3rd month, and 12th month (P > 0.05). CONCLUSIONS: SSNB as an adjunct to IAI in AC positively affected the immediate pain relief and functional improvement after the intervention; however, it did not yield any additional benefit in the short and long-terms. LEVEL OF EVIDENCE: Level I, Therapeutic Study.


Assuntos
Bursite , Bloqueio Nervoso , Articulação do Ombro , Corticosteroides/uso terapêutico , Adulto , Idoso , Bursite/tratamento farmacológico , Feminino , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Amplitude de Movimento Articular , Dor de Ombro/diagnóstico , Dor de Ombro/tratamento farmacológico , Resultado do Tratamento
7.
Zhongguo Gu Shang ; 34(12): 1158-64, 2021 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-34965635

RESUMO

OBJECTIVE: To explore the clinical efficacy of focused extracorporeal shock wave therapy with centrifugal exercise in the treatment of greater trochanteric pain syndrome. METHODS: From September 2017 to June 2019, 53 eligible cases of greater trochanteric pain syndrome were randomly divided into observation group (29 cases) and control group (24 cases). In observation group, there were 8 males and 21 females, aged from 38 to 62 years old with an average of (49.96±6.39) years old; the course of disease ranged from 6 to 13 months with an average of (8.58±1.99) months;treated with focused extracorporeal shock wave therapy with centrifugal exercise. In control group, there were 5 males and 19 females, aged from 39 to 62 years old with an average of (52.79±5.86) years old;the course of disease ranged from 6 to 14 months with an average of (9.04±2.51) months;treated with centrifugal exercise alone. Visual analogue scale (VAS) and hip Harris score were measured before ESWT treatment and at 1, 2, and 6 months to evaluate relieve degree of pain and functional recovery of hip joint, respectively. RESULTS: At 1 month after treatment, there were no significant differences in VAS, hip Harris score and treatment success rate (all P>0.05). At 2 months after treatment, VAS score in observation group (3.20±0.81) was lower than that of control group (3.87±0.61, P=0.002), there were no significant differences in hip Harris score score between observation group (81.93±2.43) and control group (82.12±2.34, P=0.770), the treatment success rate in observation group (58.62%, 17 / 29) was higher than that of control group (29.16%, 7 / 24) (P=0.032). At 6 months after treatment, VAS score in observationgroup (2.24±0.68) was lower than that of control group (3.12±0.53, P<0.001), hip Harris score score in observation group(85.10±1.75) was higher than that of control group (83.66±1.78)(P=0.005), there were no significant differences in treatment success rate between observation group (82.75%, 24 / 29) and control group (62.50%, 15 / 24)(P=0.096). CONCLUSION: In treatment of greater trochanteric pain syndrome, focused extracorporeal shock wave therapy with centrifugal exercise could significantly relieve symptoms of lateral hip pain, improve functional recovery of hip joint with good safety. This treatment strategy is worthy of application and promotion in clinical practice.


Assuntos
Bursite , Tratamento por Ondas de Choque Extracorpóreas , Adulto , Artralgia , Feminino , Quadril , Articulação do Quadril , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
8.
JAAPA ; 34(12): 12-14, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34772852

RESUMO

ABSTRACT: Adhesive capsulitis, a common primary care and orthopedic diagnosis often referred to as frozen shoulder, is a painful inflammatory process that leads to a mechanical block in active and passive range of shoulder motion. Risk factors include diabetes and thyroid dysfunction. Diagnosis is made based on physical examination, but can be augmented by diagnostic imaging. Nonsurgical management is the mainstay of treatment because the disease is self-limiting. However, some patients may need surgical intervention.


Assuntos
Bursite , Articulação do Ombro , Bursite/diagnóstico , Bursite/etiologia , Bursite/terapia , Humanos , Dor , Amplitude de Movimento Articular , Articulação do Ombro/diagnóstico por imagem
9.
Mymensingh Med J ; 30(4): 903-906, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605454

RESUMO

Retrocalcaneal bursitis is one of the important causes of posterior heel pain which is due to repetitive friction of the retrocalcaneal bursa between the postero-superior calcaneal tuberosity (haglund deformity) and Achilles tendon. Most of the patients are treated by conservative methods. But when the condition becomes chronic and not responding to the conservative treatment, surgical treatment is an option of these cases. This prospective interventional study was conducted in the Department of Orthopaedic Surgery, BSMMU (Bangabandhu Sheikh Mujib Medical University), Dhaka, Bangladesh from September 2017 to August 2019. Within this period, total 40 cases of chronic retrocalcaneal bursitis were operated at BSMMU. The clinical and functional outcome was evaluated according to AOFAS (American Orthopedic Foot Ankle Society) scale. The results of this study showed significantly improvement of pain, functional status and deformity at the time of final follow-up period of 1 year, total mean score improved from 46/100 to 89/100. The outcome of the subjects was satisfactory 90% and unsatisfactory 10%. Surgical intervention is an effective option of treatment with satisfactory outcome, in the treatment of chronic retrocalcaneal bursitis.


Assuntos
Tendão do Calcâneo , Bursite , Calcâneo , Bangladesh , Bursite/cirurgia , Calcâneo/diagnóstico por imagem , Calcâneo/cirurgia , Humanos , Estudos Prospectivos , Resultado do Tratamento
10.
J Pak Med Assoc ; 71(Suppl 5)(8): S17-S21, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34634009

RESUMO

OBJECTIVE: To compare the combination of corticosteroid injection and physiotherapy with physiotherapy alone in patients of frozen shoulder in terms of SPADI score. Methods: This study included 80 patients of either gender from PMC and affiliated hospitals of Faisalabad with ages between 18-55 years having frozen shoulder of either gender with more than 1 month duration. Patients having frozen shoulder secondary to trauma, cerebrovascular accident and taking steroid injections were excluded. Combination of corticosteroid injection and physiotherapy was performed in combination therapy group (n=40) and physiotherapy alone was performed in Single therapy group (n=40). RESULTS: A total of 80 patients, 30(37.5%) males and 50(62.5%) females were selected for the study. Each group, combination therapy and single therapy had 40 patients each. The combination therapy group included 18(45.0%) males and 22(44.0%) females whereas the single therapy group comprised of 12(39.9%) males and 28(70%) females. The treatment method was independent of duration of disease (p= 0.251 for c2= 1.317). After six weeks of treatment, the t-test applied on SPADI score showed that combined treatment is better than the single treatment method (p= 0.016). However, both treatment methods were found same after stratification of duration of disease. CONCLUSIONS: Combination of corticosteroid injection and physiotherapy is more effective than the physiotherapy alone in resolving the shoulder pain and disability of shoulder.


Assuntos
Bursite , Corticosteroides/uso terapêutico , Bursite/terapia , Pré-Escolar , Feminino , Humanos , Lactente , Injeções Intra-Articulares , Masculino , Modalidades de Fisioterapia , Dor de Ombro
13.
Agri ; 33(4): 276-277, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34671956

RESUMO

Myofascial pain syndrome is a more common problem than thought. Treatment of miyofasyal trigger point may contribute to the pain and functionality parameters in adhesive capsulitis. In particular, the subscapulis muscle should be evaluated in detail.


Assuntos
Bursite , Síndromes da Dor Miofascial , Humanos , Medição da Dor , Dor de Ombro , Pontos-Gatilho
14.
J Int Med Res ; 49(10): 3000605211050535, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34704481

RESUMO

OBJECTIVE: Bilateral frozen shoulder (FS) is often treated with intra-articular corticosteroid injection (IACI). No studies have been performed to establish whether IACI must be administered in both shoulders or in only one shoulder to improve function. This study was therefore performed to determine whether unilateral IACI improves shoulder pain and passive range of motion (pROM) in bilateral FS. METHODS: The medical records of 165 patients with bilateral primary FS who underwent ultrasonography-guided IACI (2 mL of 10-mg/mL triamcinolone acetonide mixed with 5 mL of 1% lidocaine) in one shoulder were retrospectively reviewed. The outcome measures, namely the numeric rating scale (NRS) scores and pROM values (abduction, external rotation, flexion, hyperextension, and internal rotation), were evaluated pre- and post-injection. RESULTS: The patients' mean age was 54.0 ± 8.0 years. The mean symptom duration was 6.5 ± 2.8 months. The mean follow-up period after injection was 6.7 ± 0.8 weeks. The NRS scores and pROM values significantly improved in both the injected and non-injected shoulders. CONCLUSIONS: This study showed that unilateral IACI in patients with bilateral FS improves the clinical outcome of the non-injected shoulder. We suggest that physicians observe the non-injected shoulder after unilateral injection rather than performing bilateral injections.


Assuntos
Bursite , Corticosteroides/uso terapêutico , Bursite/diagnóstico por imagem , Bursite/tratamento farmacológico , Humanos , Injeções Intra-Articulares , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
15.
BMC Musculoskelet Disord ; 22(1): 828, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579697

RESUMO

BACKGROUND: Adhesive capsulitis (AC) of the shoulder, also known as frozen shoulder, causes substantial pain and disability. In cases of secondary AC, the inflammation and fibrosis of the synovial joint can be triggered by trauma or surgery to the joint followed by extended immobility. However, for primary AC the inciting trigger is unknown. The burden of the disorder among the elderly is also unknown leading to this age group being left out of therapeutic research studies, potentially receiving delayed diagnoses, and unknown financial costs to the Medicare system. The purpose of this analysis was to describe the epidemiology of AC in individuals over the age of 65, an age group little studied for this disorder. The second purpose was to investigate whether specific medications, co-morbidities, infections, and traumas are risk factors or triggers for primary AC in this population. METHODS: We used Medicare claims data from 2010-2012 to investigate the prevalence of AC and assess comorbid risk factors and seasonality. Selected medications, distal trauma, and classes of infections as potential inflammatory triggers for primary AC were investigated using a case-control study design with patients with rotator cuff tears as the comparison group. Medications were identified from National Drug codes and translated to World Health Organization ATC codes for analysis. Health conditions were identified using ICD9-CM codes. RESULTS: We found a one-year prevalence rate of AC of approximately 0.35% among adults aged 65 years and older which translates to approximately 142,000 older adults in the United States having frozen shoulder syndrome. Diabetes and Parkinson's disease were significantly associated with the diagnosis of AC in the elderly. Cases were somewhat more common from August through December, although a clear seasonal trend was not observed. Medications, traumas, and infections were similar for cases and controls. CONCLUSIONS: This investigation identified the burden of AC in the US elderly population and applied case-control methodology to identify triggers for its onset in this population. Efforts to reduce chronic health conditions such as diabetes may reduce seemingly unrelated conditions such as AC. The inciting trigger for this idiopathic condition remains elusive.


Assuntos
Bursite , Articulação do Ombro , Idoso , Bursite/diagnóstico , Bursite/epidemiologia , Estudos de Casos e Controles , Humanos , Medicare , Manguito Rotador , Estados Unidos/epidemiologia
16.
Proc Natl Acad Sci U S A ; 118(39)2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34544860

RESUMO

Frozen shoulder is a common fibroproliferative disease characterized by the insidious onset of pain and restricted range of shoulder movement with a significant socioeconomic impact. The pathophysiological mechanisms responsible for chronic inflammation and matrix remodeling in this prevalent fibrotic disorder remain unclear; however, increasing evidence implicates dysregulated immunobiology. IL-17A is a key cytokine associated with inflammation and tissue remodeling in numerous musculoskeletal diseases, and thus, we sought to determine the role of IL-17A in the immunopathogenesis of frozen shoulder. We demonstrate an immune cell landscape that switches from a predominantly macrophage population in nondiseased tissue to a T cell-rich environment in disease. Furthermore, we observed a subpopulation of IL-17A-producing T cells capable of inducing profibrotic and inflammatory responses in diseased fibroblasts through enhanced expression of the signaling receptor IL-17RA, rendering diseased cells more sensitive to IL-17A. We further established that the effects of IL-17A on diseased fibroblasts was TRAF-6/NF-κB dependent and could be inhibited by treatment with an IKKß inhibitor or anti-IL-17A antibody. Accordingly, targeting of the IL-17A pathway may provide future therapeutic approaches to the management of this common, debilitating disease.


Assuntos
Bursite/fisiopatologia , Fibrose/patologia , Inflamação/patologia , Interleucina-17/imunologia , Linfócitos T/imunologia , Estudos de Casos e Controles , Células Cultivadas , Citocinas/metabolismo , Feminino , Fibroblastos/imunologia , Fibroblastos/metabolismo , Fibroblastos/patologia , Fibrose/imunologia , Fibrose/metabolismo , Humanos , Inflamação/imunologia , Inflamação/metabolismo , Interleucina-17/metabolismo , Masculino , Pessoa de Meia-Idade , NF-kappa B/metabolismo , Transdução de Sinais
17.
BMC Vet Res ; 17(1): 291, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479562

RESUMO

BACKGROUND: Septic arthritis often occurs in young calves when the passive transfer of maternal immunoglobulins has failed, which results in hypogammaglobulinaemia in the calf. Another important cause is suboptimal herd health management which often leads to general health impairment and, subsequently, to septic arthritis. CASE PRESENTATION: A dairy farmer consulted the Herd Health Service of the University Clinic reporting general herd health impairment, a high incidence of respiratory diseases, unsatisfactory weight gain and arthritis in calves, as well as mastitis and high milk cell counts. Clinical examinations were performed, and diagnostic measures were taken. A transtracheal lavage (TTL) was performed, and synovial swab samples were taken from the carpal joint and the subcutaneous tarsal bursae of two calves. Microbiological examinations of synovial swabs revealed co-infections of Trueperella pyogenes and Helcococcus ovis in one calf and Helcococcus ovis in pure culture in the other. The TTLs confirmed the presence of Mycoplasma spp. associated with respiratory diseases. CONCLUSIONS: Helcococcus ovis is currently regarded as a co-infective bacterial agent. However, it seems to play a significant role as the primary pathogen in this case.


Assuntos
Artrite Infecciosa/veterinária , Bursite/veterinária , Firmicutes/isolamento & purificação , Infecções por Bactérias Gram-Positivas/veterinária , Actinomycetaceae/isolamento & purificação , Animais , Artrite Infecciosa/microbiologia , Líquido da Lavagem Broncoalveolar/microbiologia , Bursite/microbiologia , Bovinos , Doenças dos Bovinos/microbiologia , Feminino , Masculino , Infecções por Mycoplasma/veterinária
18.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(9): 1141-1146, 2021 Sep 15.
Artigo em Chinês | MEDLINE | ID: mdl-34523279

RESUMO

Objective: To investigate the effectiveness of arthroscopic 360° capsular release for frozen shoulder. Methods: Between April 2018 and April 2019, 42 patients with frozen shoulders were treated with arthroscopic 360° capsular release. There were 13 males and 29 females, with an average age of 52.3 years (range, 45-56 years). There were 14 left shoulders and 28 right shoulders. The disease duration ranged from 5 to 18 months (mean, 11.1 months). The main clinical symptoms were limited active and passive movement of the shoulder joint with severe pain. All patients excluded impingement syndrome and shoulder osteoarthritis. Preoperative range of motion was as follows: forward flexion (93.2±15.4)°, external rotation at side (15.9±6.0)°, external rotation at 90° abduction (18.4±9.9)°, and internal rotation reaching the greater trochanter in 5 cases, buttocks in 20 cases, S 1 level in 17 cases. The visual analogue scale (VAS) score was 6.7±1.7 and the American Society of Shoulder and Elbow Surgery (ASES) score was 41.6±9.3. The active range of motion of shoulder joint, VAS score, and ASES score were recorded during follow-up. Results: All incisions healed by first intention, and no early complications occurred. Patients were followed up 12-24 months (mean, 15.6 months). After operation, forward flexion, external rotation at side, and external rotation at 90° abduction significantly improved when compared with preoperatively ( P<0.05). The range of internal rotation restored to the level of T 6-12 at 3 weeks, which was equivalent to that of the normal side at 12 months after operation ( Z=-0.943, P=0.346). VAS scores decreased and ASES scores increased after operation, and the differences between pre- and post-operation were significant ( P<0.05); and with time, the VAS scores and ASES scores improved further ( P<0.05). Conclusion: Arthroscopic 360° capsular release can significantly increase the range of motion of the shoulder joint, release pain, and improve function. It is an effective method for the treatment of frozen shoulders.


Assuntos
Bursite , Articulação do Ombro , Artroscopia , Bursite/cirurgia , Feminino , Humanos , Liberação da Cápsula Articular , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Rotação , Ombro , Articulação do Ombro/cirurgia , Resultado do Tratamento
19.
Br Med Bull ; 139(1): 86-99, 2021 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-34405857

RESUMO

INTRODUCTION: Greater trochanter pain syndrome (GTPS) is characterized by a persistent and debilitating pain around the greater trochanter. GTPS can be caused by a combination of gluteus medius or minimus tendinopathy, snapping hip or trochanteric bursitis. SOURCE OF DATA: Recent published literatures identified from PubMed, EMBASE, Google Scholar, Scopus. AREAS OF AGREEMENT: Platelet rich plasma (PRP) and corticosteroids (CCS) injections are useful options to manage symptoms of GTPS. AREAS OF CONTROVERSY: Whether PRP leads to superior outcomes compared to CCS injections is unclear. GROWING POINTS: A systematic review and meta-analysis comparing PRP versus CCS in the management of GTPS was conducted. AREAS TIMELY FOR DEVELOPING RESEARCH: PRP injections are more effective than CCS at approximately 2 years follow-up.


Assuntos
Bursite , Plasma Rico em Plaquetas , Tendinopatia , Bursite/tratamento farmacológico , Fêmur , Humanos , Dor , Esteroides , Síndrome , Tendinopatia/tratamento farmacológico , Resultado do Tratamento
20.
Sci Rep ; 11(1): 16589, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34400659

RESUMO

Worldwide, knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability. There is a low correlation between joint tissue damage and pain intensity. Periarticular structures may be involved and cannot be identified in X-rays. To describe the main ultrasonography (USG) changes in symptomatic patients with primary KOA; to correlate the number of USG findings with KOA severity assessed by Kellgren and Lawrence (K&L) radiological scores, with pain intensity measured by a visual analogue scale (VAS) and with functioning scores assessed with the Timed up and go test (TUG) and Western Ontario and McMaster Universities (WOMAC) questionnaire. 100 patients with primary symptomatic KOA were assessed with X-ray and USG. Quantitative and qualitative analyses were evaluated in a systematic manner. The most frequent findings were joint effusion, pes anserinus bursitis, quadriceps tendon enthesopathy, popliteal cyst, iliotibial band tendinitis and patellar tendinitis. Pearson's correlation analysis demonstrated a significant moderate positive association between VAS scores and the number of USG findings (r = 0.36; p < 0.0001). The number of USG findings was different between K&L grades I and III (p = 0.041), I and IV (p < 0.001), and II and IV (p = 0.001, analysis of variance with Bonferroni correction). There was significant association between number of USG findings and TUG (r = 0.18; p = 0.014) and WOMAC scores for pain (r = 0.16; p < 0.029) and physical function domains (r = 0.16; p < 0.028). The most frequent USG finding was joint effusion. Periarticular structures should be explored as potential sources of pain and disability.


Assuntos
Osteoartrite do Joelho/diagnóstico por imagem , Ultrassonografia , Idoso , Artralgia/etiologia , Bursite/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Estudos Prospectivos , Radiografia , Inquéritos e Questionários , Escala Visual Analógica
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