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PloS One 2024Pain changes how we move, but it is often confounded by other factors due to disease or injury. Experimental pain offers an opportunity to isolate the independent effect...
Pain changes how we move, but it is often confounded by other factors due to disease or injury. Experimental pain offers an opportunity to isolate the independent effect of pain on movement. We used cutaneous electrical stimulation to induce experimental knee pain during locomotion to study the short-term motor adaptions to pain. While other models of experimental pain have been used in locomotion, they lack the ability to modulate pain in real-time. Twelve healthy adults completed the single data collection session where they experienced six pain intensity conditions (0.5, 1, 2, 3, 4, 5 out of 10) and two pain delivery modes (tonic and phasic). Electrodes were placed over the lateral infrapatellar fat pad and medial tibial condyle to deliver the 10 Hz pure sinusoid via a constant current electrical stimulator. Pain intensity was calibrated prior to each walking bout based on the target intensity and was recorded using an 11-point numerical rating scale. Knee joint angles and moments were recorded over the walking bouts and summarized in waveform and discrete outcomes to be compared with baseline walking. Knee joint angles changed during the swing phase of gait, with higher pain intensities resulting in greater knee flexion angles. Minimal changes in joint moments were observed but there was a consistent pattern of decreasing joint stiffness with increasing pain intensity. Habituation was limited across the 30-90 second walking bouts and the electrical current needed to deliver the target pain intensities showed a positive linear relationship. Experimental knee pain shows subtle biomechanical changes and favourable habituation patterns over short walking bouts. Further exploration of this model is needed in real-world walking conditions and over longer timeframes to quantify motor adaptations.
Topics: Humans; Male; Adult; Biomechanical Phenomena; Female; Knee Joint; Pain; Gait; Locomotion; Walking; Young Adult; Electric Stimulation; Range of Motion, Articular
PubMed: 38941337
DOI: 10.1371/journal.pone.0302752 -
JACC. Advances Jul 2023Arterial stiffness leads to several adverse events in the older population, but there is a lack of data on its association with frailty, disability, and mortality in the...
BACKGROUND
Arterial stiffness leads to several adverse events in the older population, but there is a lack of data on its association with frailty, disability, and mortality in the same population.
OBJECTIVES
The purpose of this study was to evaluate the role of arterial stiffness in the loss of functional ability (frailty and disability) and mortality.
METHODS
Data were taken from community-dwelling aged 65 years participants without diabetes in the Toledo Study of Healthy Ageing cohort. Pulse wave velocity (PWV), assessed through SphygmoCor, was recorded at baseline. Median follow-up time were 2.99 years for frailty (frailty phenotype [FP] and Frailty Trait Scale-5 [FTS5]) and disability (Katz Index) and 6.2 for mortality. Logistic regressions models were built for disability and frailty and Cox proportional hazards model for death, adjusted by age and sex, comorbidity, cardiovascular risk factors, asymmetric dimethylarginine levels, and polypharmacy.
RESULTS
Overall, 978 (mean age 74.5 ± 5.6 years, 56.7% female) participants were included. Different cut-off points were shown for each outcome. PWV >11.5 m/s was cross-sectionally associated with frailty (FP: OR fully-adjusted model: 1.69, 95% CI: 1.45-1.97; FTS5: OR: 1.51, 95% CI: 1.22-1.87) and disability (OR: 1.51, 95% CI: 1.26-1.79); PWV >10 m/s with incident frailty by FP (OR: 1.36, 95% CI: 1.10-1.68) and FTS5 (OR: 1.40, 95% CI: 1.12-1.75), and PWV >11 m/s with death (HR: 1.28, 95% CI: 1.09-1.50). For incident (OR: 1.28, 95% CI: 1.06-1.55) and worsening disability (OR: 1.21, 95% CI: 1.02-1.45) the threshold was 12.5 m/s. Below these cut-off points, age was the best predictor of adverse outcomes.
CONCLUSIONS
Arterial stiffness predicts frailty, disability, and mortality in older people, with different cut-off points, ie,severity degrees, for each of the assessed outcomes.
PubMed: 38939008
DOI: 10.1016/j.jacadv.2023.100423 -
Voprosy Kurortologii, Fizioterapii, I... 2024Thermal lesions in children leave behind cicatricial contractions, contractures, deformations of the wrists, feet, face. Sanatorium-resort treatment using balneotherapy... (Observational Study)
Observational Study
UNLABELLED
Thermal lesions in children leave behind cicatricial contractions, contractures, deformations of the wrists, feet, face. Sanatorium-resort treatment using balneotherapy is an integral part of rehabilitation measures in such patients.
OBJECTIVE
To analyze the results of hydrogen sulfide balneotherapy in children with consequences of thermal injury.
MATERIAL AND METHODS
A single-center observational retrospective non-controlled study was carried out, in which sanatorium-resort treatment concerning post-burn scars in 812 children aged 5-17 years was analyzed. Hydrogen sulfide balneotherapy was prescribed to patients depending on the age in mild (5-6 years) or moderate-to-high (7-17 years) exposure modes. The imported hydrogen sulfide mineral water from the T-2000 well of the Matsesta field with the HS total concentration of 410-420 mg/l was used for treatment. The applications were performed to children alternate days, 8 procedures of balneotherapy per course.
RESULTS
Lightening of the affected areas of the skin, reduction of the sensation of contraction and tension of the scars, which became softer, more elastic and more mobile with regard to the subjacent tissues have been noted in patients after the course of balneotherapy. The head mobility increased after applications in the presence of scars. The large joints' range of motion grew up. In addition, an increase in the mobility of the fingers of wrists and feet, a decrease in the stiffness of movements, increase or recovery of the affected skin's tactile sensitivity have been observed. Children well tolerated procedures, adverse events were seen in 0.7% of cases in the form of mild reactions at the beginning of the applications' course, namely of balneological (0.6%) and toxico-allergic (0.1%) nature.
CONCLUSION
Hydrogen sulfide balneotherapy in combination with rehabilitation exercises and other sanatorium-resort factors is an effective mean of post-burn scars correction in children.
Topics: Humans; Child; Child, Preschool; Health Resorts; Adolescent; Male; Female; Burns; Balneology; Cicatrix; Hydrogen Sulfide; Retrospective Studies
PubMed: 38934956
DOI: 10.17116/kurort202410103132 -
Frontiers in Veterinary Science 2024Intracapsular reconstruction (ICR) has long been recommended as a treatment for cranial cruciate ligament deficiency (CCLD) in dogs, but it has fallen out of favor due...
Intracapsular reconstruction (ICR) has long been recommended as a treatment for cranial cruciate ligament deficiency (CCLD) in dogs, but it has fallen out of favor due to its inferior long-term functional outcomes. These outcomes may be attributed to the poor stiffness and strength of the graft in the early period before ligamentization is completed. Additional placement of extracapsular sutures to mechanically protect the graft during the ligamentization process may be a viable method to address this problem. However, the biomechanical effect of this combined surgical approach remains unknown. This study aimed to evaluate the 3D kinematics of the CCLD stifle in dogs in response to ICR and combined extra- and intracapsular reconstruction (CEICR). Twelve hindlimbs were collected from nine cadavers of mature dogs. The limbs were tested using a custom-made testing apparatus that reproduces their sagittal plane kinematics during the stance phase. Four statuses of stifle joints were tested, namely, (a) cranial cruciate ligament (CCL) intact; (b) CCLD; (c) CCLD stifle stabilized by CEICR; and (d) CCLD stifle stabilized by ICR only. Three-dimensional stifle kinematics at the 5 instances of the stance phase were measured with an optoelectronic system. The results showed that ICR marginally corrects the increased adduction, internal rotation, and caudodistal stifle joint center displacement that occur as a result of CCLD. CEICR led to better restoration of the stifle kinematics, especially with respect to the internal rotation and cranial translation stabilities. Furthermore, CEICR only resulted in minor excessive restraints on other motion components. The findings indicated that the additional lateral fabellotibial suture offers immediate stability to the stifle, consequently lowering the risk of graft over-elongation in the short term postoperatively. Considering the propensity for the extracapsular suture to degrade over time, further studies are warranted to explore the long-term effects of the CEICR procedure.
PubMed: 38933704
DOI: 10.3389/fvets.2024.1336797 -
Pharmaceutics Jun 2024Graphene has become a prominent material in cancer research in recent years. Graphene and its derivatives also attract attention as carriers in drug delivery systems. In...
Graphene has become a prominent material in cancer research in recent years. Graphene and its derivatives also attract attention as carriers in drug delivery systems. In this study, we designed a graphene oxide (GO)-based methotrexate (MTX)-loaded and folic acid (FA)-linked drug delivery system. MTX and FA were bound to GO synthesized from graphite. MTX/FA/GO drug delivery system and system components were characterized using Fourier transform infrared spectroscopy (FTIR), differential calorimetric analysis (DSC), scanning electron microscopy (SEM), transmission electron microscopy (TEM), zeta potential analysis, and dimension measurement (DLS) studies. SEM and TEM images confirmed the nanosheet structure of GO synthesized from graphite, and it was shown that MTX/FA binding to GO transformed the two-dimensional GO into a three-dimensional structure. FTIR and DSC graphs confirmed that oxygen atoms were bound to GO with the formation of carboxylic, hydroxyl, epoxide, and carbonyl groups as a result of the oxidation of graphite, and GO was successfully synthesized. Additionally, these analyses showed that MTX and FA bind physicochemically to the structure of GO. The in vitro Franz diffusion test was performed as a release kinetic test. The release kinetics mathematical model and correlation coefficient (R2) of MTX-loaded GO/FA nanomaterials were found to be the Higuchi model and 0.9785, respectively. Stiffness analyses showed that adding FA to this release system facilitated the entry of the drug into the cell by directing the system to target cells. As a result of the stiffness analyses, the stiffness values of the control cell group, free MTX, and MTX/FA/GO applied cells were measured as 2.34 kPa, 1.87 kPa, and 1.56 kPa, respectively. According to these results, it was seen that MTX/FA/GO weakened the cancer cells. Combined use of the MTX/FA/GO drug delivery system had a higher cytotoxic effect than free MTX on the MDA-MB-231 breast cancer cell line. The results showed that the synthesized MTX/FA/GO material has promising potential in cancer cell-specific targeted therapy for MTX as a drug delivery system.
PubMed: 38931957
DOI: 10.3390/pharmaceutics16060837 -
Sensors (Basel, Switzerland) Jun 2024During city running or marathon races, shifts in level ground and up-and-down slopes are regularly encountered, resulting in changes in lower limb biomechanics. The...
BACKGROUND
During city running or marathon races, shifts in level ground and up-and-down slopes are regularly encountered, resulting in changes in lower limb biomechanics. The longitudinal bending stiffness of the running shoe affects the running performance.
PURPOSE
This research aimed to investigate the biomechanical changes in the lower limbs when transitioning from level ground to an uphill slope under different longitudinal bending stiffness (LBS) levels in running shoes.
METHODS
Fifteen male amateur runners were recruited and tested while wearing three different LBS running shoes. The participants were asked to pass the force platform with their right foot at a speed of 3.3 m/s ± 0.2. Kinematics data and GRFs were collected synchronously. Each participant completed and recorded ten successful experiments per pair of shoes.
RESULTS
The range of motion in the sagittal of the knee joint was reduced with the increase in the longitudinal bending stiffness. Positive work was increased in the sagittal plane of the ankle joint and reduced in the keen joint. The negative work of the knee joint increased in the sagittal plane. The positive work of the metatarsophalangeal joint in the sagittal plane increased.
CONCLUSION
Transitioning from running on a level surface to running uphill, while wearing running shoes with high LBS, could lead to improved efficiency in lower limb function. However, the higher LBS of running shoes increases the energy absorption of the knee joint, potentially increasing the risk of knee injuries. Thus, amateurs should choose running shoes with optimal stiffness when running.
Topics: Humans; Shoes; Male; Biomechanical Phenomena; Running; Lower Extremity; Adult; Range of Motion, Articular; Ankle Joint; Knee Joint; Young Adult
PubMed: 38931685
DOI: 10.3390/s24123902 -
Nutrients Jun 2024Osteoarthritis (OA) is a chronic degenerative joint disease that causes chronic pain, swelling, stiffness, disability, and significantly reduces the quality of life....
Osteoarthritis (OA) is a chronic degenerative joint disease that causes chronic pain, swelling, stiffness, disability, and significantly reduces the quality of life. Typically, OA is treated using painkillers and non-steroidal anti-inflammatory drugs (NSAIDs). While current pharmacologic treatments are common, their potential side effects have prompted exploration into functional dietary supplements. Recently, eggshell membrane (ESM) has emerged as a potential functional ingredient for joint and connective tissue disorders due to its clinical efficacy in relieving joint pain and stiffness. Despite promising clinical evidence, the effects of ESM on OA progression and its mechanism of action remain poorly understood. This study evaluated the efficacy of Ovomet, a powdered natural ESM, against joint pain and disease progression in a monosodium iodoacetate (MIA)-induced rodent model of OA in mice and rats. The results demonstrate that ESM significantly alleviates joint pain and attenuates articular cartilage destruction in both mice and rats that received oral supplementation for 5 days prior to OA induction and for 28 days thereafter. Interestingly, ESM significantly inhibited mRNA expression levels of pro-inflammatory cytokines including tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6), as well as inflammatory mediators, cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase in the knee joint cartilage at the early stage of OA, within 7 days after OA induction. However, this effect was not observed in the late stage at 28 days after OA induction. ESM further attenuates the induction of protein expression for cartilage-degrading enzymes like matrix metalloproteinase (MMPs) 3 and 13, and a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5), in the late-stage. In addition, MIA-induced reduction of the protein expression levels of cartilage components, cartilage oligomeric matrix protein (COMP), aggrecan (ACAN) and collagen type II α-1 chain (COL2α1), and cartilage extracellular matrix (ECM) synthesis promoting transcriptional factor SRY-Box 9 (SOX-9) were increased via ESM treatment in the cartilage tissue. Our findings suggest that Ovomet, a natural ESM powder, is a promising dietary functional ingredient that can alleviate pain, inflammatory response, and cartilage degradation associated with the progression of OA.
Topics: Animals; Egg Shell; Cartilage, Articular; Osteoarthritis; Male; Mice; Nitric Oxide Synthase Type II; Rats; Inflammation; Dietary Supplements; Cytokines; Disease Models, Animal; Rats, Sprague-Dawley; Arthralgia; Time Factors; Iodoacetic Acid; Anti-Inflammatory Agents
PubMed: 38931240
DOI: 10.3390/nu16121885 -
Journal of Personalized Medicine Jun 2024Osteoarthritis (OA) is the most common complex musculoskeletal disorder, resulting from the degeneration of the articular cartilage and characterized by joint pain and...
Osteoarthritis (OA) is the most common complex musculoskeletal disorder, resulting from the degeneration of the articular cartilage and characterized by joint pain and dysfunction that culminate in progressive articular cartilage loss. We present our experience in the management of hip and knee OA by means of the intra-articular injection of fat micrograft, describing our approach, which was developed from the belief in the powerful reparative effect of autologous fat graft on damaged tissue, as well as its natural lubricating effect on the joints. Inclusion criteria were as follows: men and women, aged 20 to 80 years, that referred articular pain of the hips and/or knees, showing initial-stage degenerative OA. From October 2018 to July 2023, a total of 250 patients underwent treatment with the Sefficare device (SEFFILINE srl, Bologna, Italy). The Superficial Enhanced Fluid Fat Injection device was used to perform autologous regenerative treatments in a safe, standardized, easy, and effective way on 160 women, 64%, and 90 men, 36%. A total of 190 procedures (76%) involved the knees, with 20 patients who were bilaterally treated, while 60 procedures, all unilateral, involved the hips (24%). The mean age at treatment was 52.4 years. Before treatment, each patient had undergone X-rays and Magnetic Resonance Imaging (MRI) of the painful hip/knee to evaluate and grade the articular OA. Postoperatively, each patient was assessed after one, three, six, and twelve months. The donor site postoperative course was uneventful other than minimal discomfort. Clinically, the ROM (range of motion) of the treated knee/hip increased an average of 10 degrees 3 months after treatment, but the stiffness was reduced, as reported by the patients. The VAS (Visual Analog Scale) was submitted at 3, 6, and 12 months, demonstrating a progressive reduction of pain, with the best score obtained at six months postoperatively. In total, 85% of patients were satisfied one year after treatment, with a considerable improvement in pain and quality of life. The satisfactory outcome of this minimally invasive procedure indicates that the intra-articular injection of fat micrograft can replace or considerably delay the need for the classical major joint replacement surgery, thanks to its impact on the quality of life of patients and financial cost.
PubMed: 38929825
DOI: 10.3390/jpm14060604 -
Medicina (Kaunas, Lithuania) Jun 2024: Coadministration of natural products to enhance the potency of conventional antirheumatic treatment is of high interest. This study aimed to assess the impact of... (Randomized Controlled Trial)
Randomized Controlled Trial
: Coadministration of natural products to enhance the potency of conventional antirheumatic treatment is of high interest. This study aimed to assess the impact of administration of silymarin (a nutritional supplement) in patients with active rheumatoid arthritis under treatment with conventional disease-modifying antirheumatic drugs. : One-hundred and twenty-two patients diagnosed with active rheumatoid arthritis and treated with conventional disease-modifying antirheumatic drugs were randomly assigned to either control or intervention groups; the latter was supplemented with silymarin (300 mg/day) for 8 weeks. Indicators of disease activity, inflammatory markers, disease activity and disability indices, European League Against Rheumatism responses, fatigue, depression, and anxiety scores were determined at baseline and week 8. : Silymarin supplementation significantly reduced the number of tender and swollen joints, duration of morning stiffness, severity of pain, disease activity and disability indices, European League Against Rheumatism responses, levels of fatigue, depression, and anxiety. According to our results, silymarin substantially improved patients' general condition. : Our study provides evidence for the benefits of silymarin supplementation to disease-modifying antirheumatic drugs in patients with active rheumatoid arthritis.
Topics: Humans; Silymarin; Arthritis, Rheumatoid; Female; Pilot Projects; Male; Middle Aged; Dietary Supplements; Adult; Treatment Outcome; Antirheumatic Agents; Aged
PubMed: 38929616
DOI: 10.3390/medicina60060999 -
Medicina (Kaunas, Lithuania) May 2024: Despite the established role of subtalar joint arthrodesis (SJA) for treatment of subtalar osteoarthritis, achieving bone union remains challenging, with up to 46%...
: Despite the established role of subtalar joint arthrodesis (SJA) for treatment of subtalar osteoarthritis, achieving bone union remains challenging, with up to 46% non-union rates. Adequate compression and stable fixation are crucial for successful outcomes, with internal screw fixation being the gold standard for SJA. The delta configuration, featuring highly divergent screws, offers stability, however, it can result in hardware irritation in 20-30% of patients. Solutions to solve this complication include cannulated compression screw (CCS) countersinking or cannulated compression headless screw (CCHS) application. The aim of this biomechanical study was to investigate the stability of a delta configuration for SJA utilizing either a combination of a posterior CCHS and an anterior CCS or a standard two-CCS combination. : Twelve paired human cadaveric lower legs were assigned pairwise to two groups for SJA using either two CCSs (Group 1) or one posterior CCHS and one anterior CCS (Group 2). All specimens were tested under progressively increasing cyclic loading to failure, with monitoring of the talocalcaneal movements via motion tracking. : Initial stiffness did not differ significantly between the groups, = 0.949. Talocalcaneal movements in terms of varus-valgus deformation and internal-external rotation were significantly bigger in Group 1 versus Group 2, ≤ 0.026. Number of cycles until reaching 5° varus-valgus deformation was significantly higher in Group 2 versus Group 1, = 0.029. : A delta-configuration SJA utilizing a posterior CCHS and an anterior CCS is biomechanically superior versus a standard configuration with two CCSs. Clinically, the use of a posterior CCHS could prevent protrusion of the hardware in the heel, while an anterior CCS could facilitate less surgical time and thus less complication rates.
Topics: Humans; Arthrodesis; Subtalar Joint; Cadaver; Bone Screws; Biomechanical Phenomena; Male; Female; Aged; Osteoarthritis; Middle Aged
PubMed: 38929461
DOI: 10.3390/medicina60060844