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The Archives of Bone and Joint Surgery 2024Primary idiopathic frozen shoulder (FS) causes pain and stiffness in the shoulder joint. Over time, this disease causes restriction of shoulder motion. We undertook this...
OBJECTIVES
Primary idiopathic frozen shoulder (FS) causes pain and stiffness in the shoulder joint. Over time, this disease causes restriction of shoulder motion. We undertook this study to evaluate possible correlation of MRI findings with outcome of conservative management in FS.
METHODS
A total of 65 cases participated in prospective cohort study. The correlation of MRI findings obtained before commencing the treatment with outcome of non-operative management (Mean of ROM, VAS, SST and OSS) was evaluated.
RESULTS
Anterior extracapsular edema significantly correlated with FF, EXR, VAS (a) and OSS. The effusion in humeral side of axillary recess significantly correlated with ROM restriction in ABD, EXR. Capsular thickness of glenoid portion showed good significance with FF, ABD, VAS (a) and OSS. Increased thickness of CHL showed negative correlation with improvement of EXR (P=0.049) (r=-0.617). Thickening of IGHL showed negative correlation with improvement of ABD (p=0.005 r=-0.862) and FF (p=0.007 r=-0.831). Mean Height of Axillary recess (HAR) was 7.2mm (3.5-11mm). HAR showed negative correlation with VAS pain scale (P=0.036) (r=-0.682) and OSS (P=0.038) (r=-0.668).
CONCLUSION
Thickness of the joint capsule and effusion at the axillary fold are important factors for refractory frozen shoulder. We can recommend MRI for refractive cases and low threshold of expectation can be set for conservative management in patients with above findings.
PubMed: 38716178
DOI: 10.22038/ABJS.2023.73913.3423 -
Veterinary Research May 2024Klebsiella pneumoniae has become one of the most intractable gram-negative pathogens infecting humans and animals due to its severe antibiotic resistance. Bacteriophages...
Klebsiella pneumoniae has become one of the most intractable gram-negative pathogens infecting humans and animals due to its severe antibiotic resistance. Bacteriophages and protein products derived from them are receiving increasing amounts of attention as potential alternatives to antibiotics. In this study, we isolated and investigated the characteristics of a new lytic phage, P1011, which lyses K5 K. pneumoniae specifically among 26 serotypes. The K5-specific capsular polysaccharide-degrading depolymerase dep1011 was identified and expressed. By establishing murine infection models using bovine strain B16 (capable of supporting phage proliferation) and human strain KP181 (incapable of sustaining phage expansion), we explored the safety and efficacy of phage and dep1011 treatments against K5 K. pneumoniae. Phage P1011 resulted in a 60% survival rate of the mice challenged with K. pneumoniae supporting phage multiplication, concurrently lowering the bacterial burden in their blood, liver, and lungs. Unexpectedly, even when confronted with bacteria impervious to phage multiplication, phage therapy markedly decreased the number of viable organisms. The protective efficacy of the depolymerase was significantly better than that of the phage. The depolymerase achieved 100% survival in both treatment groups regardless of phage propagation compatibility. These findings indicated that P1011 and dep1011 might be used as potential antibacterial agents to control K5 K. pneumoniae infection.
Topics: Animals; Klebsiella pneumoniae; Mice; Klebsiella Infections; Bacteriophages; Disease Models, Animal; Phage Therapy; Female; Glycoside Hydrolases; Cattle
PubMed: 38715095
DOI: 10.1186/s13567-024-01311-z -
Frontiers in Immunology 2024Rheumatoid arthritis (RA) is a systemic immune-related disease characterized by synovial inflammation and destruction of joint cartilage. The pathogenesis of RA remains...
BACKGROUND
Rheumatoid arthritis (RA) is a systemic immune-related disease characterized by synovial inflammation and destruction of joint cartilage. The pathogenesis of RA remains unclear, and diagnostic markers with high sensitivity and specificity are needed urgently. This study aims to identify potential biomarkers in the synovium for diagnosing RA and to investigate their association with immune infiltration.
METHODS
We downloaded four datasets containing 51 RA and 36 healthy synovium samples from the Gene Expression Omnibus database. Differentially expressed genes were identified using R. Then, various enrichment analyses were conducted. Subsequently, weighted gene co-expression network analysis (WGCNA), random forest (RF), support vector machine-recursive feature elimination (SVM-RFE), and least absolute shrinkage and selection operator (LASSO) were used to identify the hub genes for RA diagnosis. Receiver operating characteristic curves and nomogram models were used to validate the specificity and sensitivity of hub genes. Additionally, we analyzed the infiltration levels of 28 immune cells in the expression profile and their relationship with the hub genes using single-sample gene set enrichment analysis.
RESULTS
Three hub genes, namely, ribonucleotide reductase regulatory subunit M2 (), DLG-associated protein 5 (), and kinesin family member 11 (), were identified through WGCNA, LASSO, SVM-RFE, and RF algorithms. These hub genes correlated strongly with T cells, natural killer cells, and macrophage cells as indicated by immune cell infiltration analysis.
CONCLUSION
, , and could serve as potential diagnostic indicators and treatment targets for RA. The infiltration of immune cells offers additional insights into the underlying mechanisms involved in the progression of RA.
Topics: Humans; Arthritis, Rheumatoid; Gene Regulatory Networks; Machine Learning; Gene Expression Profiling; Transcriptome; Synovial Membrane; Kinesins; Biomarkers; Databases, Genetic; Computational Biology; Support Vector Machine; Ribonucleoside Diphosphate Reductase
PubMed: 38711508
DOI: 10.3389/fimmu.2024.1387311 -
Nan Fang Yi Ke Da Xue Xue Bao = Journal... Apr 2024To explore the inhibitory effect of , a traditional Miao herbal medicine formula, on articular bone and cartilage destruction and synovial neovascularization in rats...
OBJECTIVE
To explore the inhibitory effect of , a traditional Miao herbal medicine formula, on articular bone and cartilage destruction and synovial neovascularization in rats with collagen-induced arthritis (CIA).
METHODS
In a SD rat model of CIA, we tested the effects of daily gavage of at low, moderate and high doses (10, 20, and 40 g/kg, respectively) for 21 days, with Tripterygium glycosides (GTW) as the positive control, on swelling in the hind limb plantar regions by arthritis index scoring. Pathologies in joint synovial membrane of the rats were observed with HE staining, and serum TNF-α and IL-1β levels were detected with ELISA. The expressions of NF-κB p65, matrix metalloproteinase 1 (MMP1), MMP2 and MMP9 at the mRNA and protein levels in the synovial tissues were detected using real-time PCR and Western blotting. Network pharmacology analysis was conducted to identify the important target proteins in the pathways correlated with the therapeutic effects of topical treatment for RA, and the core target proteins were screened by topological analysis.
RESULTS
Treatment with GTW and at the 3 doses all significantly alleviated plantar swelling, lowered arthritis index scores, improved cartilage and bone damage and reduced neovascularization in CIA rats (<0.05), and the effects of showed a dose dependence. Both GTW and treatments significantly lowered TNF-α, IL-1β, NF-κB p65, MMP1, MMP2, and MMP9 mRNA and protein expressions in the synovial tissues of CIA rats (<0.05). Network pharmacological analysis identified MMPs as the core proteins associated with topical treatment of RA.
CONCLUSION
alleviates articular bone and cartilage damages and reduces synovial neovascularization in CIA rats possibly by downregulating MMPs the TNF-α/IL-1β/NF-κB-MMP1, 2, 9 signaling pathway, and MMPs probably plays a key role in mediating the effect of though the therapeutic pathways other than oral administration.
Topics: Animals; Rats; Arthritis, Rheumatoid; Rats, Sprague-Dawley; Arthritis, Experimental; Drugs, Chinese Herbal; Matrix Metalloproteinase 1; Synovial Membrane; Tumor Necrosis Factor-alpha; Interleukin-1beta; Matrix Metalloproteinase 2; Down-Regulation; Matrix Metalloproteinase 9; Matrix Metalloproteinases; Tripterygium; Transcription Factor RelA
PubMed: 38708508
DOI: 10.12122/j.issn.1673-4254.2024.04.16 -
International Journal of Sports... 2024Femoroacetabular impingement (FAI), particularly cam morphology, is highly prevalent among elite hockey athletes. Moreover, hip and groin pain has become a common issue...
UNLABELLED
Femoroacetabular impingement (FAI), particularly cam morphology, is highly prevalent among elite hockey athletes. Moreover, hip and groin pain has become a common issue in hockey, with approximately 50% of European professional athletes reported to experience a hip or groin problem during a season. While most athletes will not miss training or competition due to this, restricted competitive performance and increased risk of reduced physical and psychological well-being are likely. Recent research suggests that the development of cam morphology is related to the repetitive shear stresses experienced at the hip joint during adolescence from skating. This condition likely increases the potential for intra-articular and extra-articular injuries in these athletes later in their careers. Research also indicates that the hip joint mechanics during forward skating substantially increase the possibility of sustaining a labral tear compared to other sports. Such an injury can increase femoral head movement within the joint, potentially causing secondary damage to the iliofemoral ligament, ligamentum teres and joint capsule. These injuries and the high density of nociceptors in the affected structures may explain the high prevalence of hip and groin pain in hockey athletes. Compensatory adaptations, such as reduced hip strength, stability, and range-of-motion (ROM) likely increase the opportunity for core muscle injuries and hip flexor and adductor injuries. Specifically, the limited hip ROM associated with cam morphology appears to exacerbate the risk of these injuries as there will be an increase in pubic symphysis stress and transverse strain during rotational movements. It is hoped that this article will assist practitioners currently working with hockey athletes to develop evidence-informed monitoring strategies and training interventions, aimed at reducing the incidence and severity of hip and groin problems, ultimately enhancing athlete performance and well-being. Therefore, the purpose of this clinical commentary was to examine current evidence on common hip pathologies in hockey athletes, exploring potential associations between hip and groin pain and the biomechanics of hockey activities.
LEVEL OF EVIDENCE
5.
PubMed: 38707850
DOI: 10.26603/001c.116580 -
JSES International May 2024Because of the proximity of several ligaments, aponeuroses, and capsule in the limited area of the elbow joint, the precise anatomy is difficult to understand. In the... (Review)
Review
BACKGROUND
Because of the proximity of several ligaments, aponeuroses, and capsule in the limited area of the elbow joint, the precise anatomy is difficult to understand. In the current narrative review, we focused on two anatomical perspectives: the capsular attachment and structures consisting of ligaments.
METHODS
Based on the previously performed studies regarding the elbow anatomy, a narrative review was prepared in terms of the capsular attachment and structures consisting of ligaments.
RESULTS
At the tip of the coronoid process, the joint capsule attaches roughly 6 mm distal to its tip with 6-12 mm length. On the lateral epicondyle of the humerus, the capsular attachment at the anterior part of the extensor carpi radialis brevis origin is narrower than the one distal to it. A single interpretation of the lateral collateral ligament is the capsulo-aponeurotic membrane, which is composed of the joint capsule intermingling with the supinator aponeurosis. The anterior bundle of the ulnar collateral ligament could be interpreted as the grossly separated collagenous structure from the tendinous complex, which is composed of the tendinous septum between the flexor digitorum superficialis and pronator teres muscle, the medial part of the brachialis muscle, and deep aponeurosis of the flexor digitorum superficialis muscle.
DISCUSSION
Based on these perspectives, ligaments could function as a "static-dynamic" stabilizer rather than a simple static one.
PubMed: 38707559
DOI: 10.1016/j.jseint.2024.01.006 -
In Vivo (Athens, Greece) 2024Rheumatoid arthritis (RA) is an inflammatory autoimmune disease, and management of it is still a challenge. The present investigation assessed the potential preventive...
BACKGROUND/AIM
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease, and management of it is still a challenge. The present investigation assessed the potential preventive effect of phlorizin on rats with RA.
MATERIALS AND METHODS
A total of 40 healthy Wistar rats were used for this study. Bovine type II collagen and Freund's incomplete adjuvant (1:1 and 1 mg/ml) were administered on days 1 and 8 of the protocol to induce RA in rats; treatment with phlorizin at 60 or 120 mg/kg was started after the 4th week of the protocol, and its effect on inflammation, level of inflammatory cytokines, and expression of proteins were estimated in RA rats. Moreover, an in vitro study was performed on fibroblast-like synoviocytes (FLSs), and the effects of phlorizin on proliferation, apoptosis, and expression of the mechanistic target of rapamycin kinase pathway protein after stimulating these cells with tumor necrosis factor α (TNF-α) were estimated.
RESULTS
The data obtained from the study indicate that phlorizin has the potential to mitigate inflammation and enhance weight management in rats with RA induced by bovine type II collagen (CII). The level of inflammatory cytokines in the serum and the expression of protein kinase B (AKT), phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K), and mechanistic target of rapamycin kinase (mTOR) proteins in the joint tissue were reduced in phlorizin-treated rats with RA. In this investigation, phlorizin was shown to reverse the histological abnormalities in the joint tissue of rats with RA. The in-vitro study showed that phlorizin reduced proliferation and had no apoptotic effect on TNF-α-stimulated FLSs. Expression of AKT, PI3K, and mTOR proteins was also down-regulated in phlorizin-treated TNF-α-stimulated FLSs.
CONCLUSION
Phlorizin protects against inflammation and reduces injury to synovial tissues in RA by modulating the AKT/PI3K/mTOR pathway.
Topics: Animals; Arthritis, Rheumatoid; TOR Serine-Threonine Kinases; Rats; Hyperplasia; Signal Transduction; Phlorhizin; Inflammation; Synoviocytes; Synovial Membrane; Disease Models, Animal; Cytokines; Cell Proliferation; Apoptosis; Male; Arthritis, Experimental; Rats, Wistar; Proto-Oncogene Proteins c-akt
PubMed: 38688626
DOI: 10.21873/invivo.13553 -
Endoscopy Dec 2024
Topics: Capsule Endoscopy; Humans; Equipment Design
PubMed: 38684197
DOI: 10.1055/a-2299-2351 -
Cureus Mar 2024Adhesive capsulitis following vaccination is a rare complication secondary to improper intramuscular (IM) deltoid vaccine administration. It is considered a subset of...
Adhesive capsulitis following vaccination is a rare complication secondary to improper intramuscular (IM) deltoid vaccine administration. It is considered a subset of the broad category known as shoulder injury related to vaccine administration (SIRVA). SIRVA typically results from improper shoulder anatomic localization prior to injection, leading to erroneous placement of the needle into the glenohumeral joint capsule or subacromial space. This can trigger a wide array of pathologies, including adhesive capsulitis. We present the first known case of adhesive capsulitis following improper tetanus-diphtheria (Td) vaccine administration. The patient, a previously healthy middle-aged female, began experiencing significant anterior left shoulder pain the day following a Td booster vaccination. She remarked receiving the injection "higher up" in the shoulder than normal. Over the next two weeks, she began noting significant shoulder stiffness, which was followed by a progressive loss of shoulder range of motion. Her symptoms persisted for four months without definitive diagnosis or treatment. After four months of symptoms, the patient visited an outpatient sports medicine clinic where the diagnosis of adhesive capsulitis was made. Although the patient was referred for physical therapy, focusing on gentle range of motion (ROM) and stretches, followed by a planned isometric strengthening program once ROM improved, she was eventually lost to follow-up, and her recovery is unclear. Given the rarity of the diagnosis, it is unclear if adhesive capsulitis, secondary to improper IM vaccination, follows the same temporal course as "classic" adhesive capsulitis or results in a different timeframe of recovery. Further studies are needed on this subject.
PubMed: 38681273
DOI: 10.7759/cureus.57113