667 research outputs found
Hylan G-F 20: Review of its Safety and Efficacy in the Management of Joint Pain in Osteoarthritis
BACKGROUND:
Osteoarthritis (OA) is a chronic degenerative joint disease that is a clinically and economically important disease. The increased prevalence of OA with aging, coupled to the demographics of aging populations, make OA a high priority health care problem. Viscosupplementation (VS) is a well-established treatment option in knee OA that is included in the professional guidelines for treatment of this joint disease, and could potentially provide a useful alternative in treating such patients with painful OA. Theoretically VS is an approach that should apply to all synovial joints.
OBJECTIVES:
The aim of this review is to assess the efficacy and safety of viscosupplementation with Hylan GF-20 (Synvisc(®)) in the management of joint pain in osteoarthritis.
METHODS:
THE FOLLOWING DATABASES WERE SEARCHED: Medline, Database of Abstract on Reviews and Effectiveness, Cochrane Database of Systematic Reviews. Furthermore, the lists of references of retrieved publications were manually checked for additional references. The search terms Review, Viscosupplementation, Osteoarthritis, Hyaluronic acid, Hyaluronan, Sodium Hyaluronate, Hylan GF-20, Synvisc, intra-articular injection were used to identify all studies relating to the use of Synvisc(®) viscosupplementation therapy in OA.
RESULTS:
Hylan GF-20 is a safe and effective treatment for decreasing pain and improving function in patients suffering from knee and hip OA but new evidences are emerging for its use in other joints
Spontaneous internal carotid artery rupture during neck dissection in osteogenesis imperfecta patient.
Several connective tissue disorders are associated with vascular wall abnormalities, including spontaneous dissection of the cervical arteries. Osteogenesis imperfecta (OI) is a hereditary disorder, with rare neurovascular complications, which potentially lead to life-threatening events.We presented a case of spontaneous internal carotid artery (ICA) rupture that occurred in a 52-year-old-woman, suffering from OI type I, and who underwent a bilateral modified radical neck dissection (mRND) plus total thyroidectomy for a T4aN1b thyroid cancer. During mRND, an ICA's spontaneous rupture occurred.Histopathologic report suggested a structural defect of the arterial wall without cancer infiltration. The patient did not experience any neurologic complications.Head and neck surgeons have to be aware about early clinical recognition of possible cervical vascular abnormalities, in patients with connective tissue disorders, potentially responsible for dramatic vascular rupture during cervical surgical procedures
Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics
Interstitial lung disease (ILD) represents a severe manifestation in connective tissue diseases (CTD), with an overall incidence of 15%, and it is still a challenge for clinicians evaluation and management. ILD is the most common manifestation of lung involvement in Rheumatoid Arthritis (RA), observed in up to 80% of biopsies, 50% of chest Computed Tomography (CT) and only 5% of chest radiographs. Histopatological patterns of ILD in RA may present with different patterns, such as: usual interstitial pneumonia, non specific interstitial pneumonia, desquamative interstitial pneumonia, organizing pneumonia, and eosinophilic infiltration. The incidence of ILD in RA patients is not only related to the disease itself, many drugs may be in fact associated with the development of pulmonary damage. Some reports suggest a causative role for TNFα inhibitors in RA-ILD development/worsening, anyway, no definitive statement can be drawn thus data are incomplete and affected by several variables. A tight control (pulmonary function tests and/or HRCT) is mandatory in patients with preexisting ILD, but it should be also performed in those presenting risk factors for ILD and mild respiratory symptoms. Biologic therapy should be interrupted, and, after excluding triggering infections, corticosteroids should be administered
Enhanced flexibility of the O2 + N2 interaction and Its effect on collisional vibrational energy exchange
12 págs.; 8 figs.; 1 app. This article is part of the Piergiorgio Casavecchia and Antonio Lagana Festschrift special issue.Prompted by a comparison of measured and
computed rate coefficients of Vibration-to-Vibration and
Vibration-to-Translation energy transfer in O2 + N2 nonreactive
collisions, extended semiclassical calculations of the
related cross sections were performed to rationalize the role
played by attractive and repulsive components of the
interaction on two different potential energy surfaces. By
exploiting the distributed concurrent scheme of the Grid
Empowered Molecular Simulator we extended the computational
work to quasiclassical techniques, investigated in this
way more in detail the underlying microscopic mechanisms, singled out the interaction components facilitating the energy transfer, improved the formulation of the potential, and performed additional calculations that confirmed the effectiveness of the improvement introduced.The authors acknowledge financial support from the Phys4entry
FP7/2007-2013 project (Contract No. 242311), ARPA Umbria,
INSTM, the EGI-Inspire project (Contract No. 261323),
MIUR PRIN 2008 (2008KJX4SN 003) and 2010/2011
(2010ERFKXL_002), the ESA-ESTEC Contract No. 21790/
08/NL/HE and the Spanish CTQ2012-37404 and FIS2013-
48275-C2-1-P projects. Computations have been supported by
the use of Grid resources and services provided by the European
Grid Infrastructure (EGI) and the Italian Grid Infrastructure
(IGI) through the COMPCHEM Virtual Organization. Thanks
are also due to the COST CMST European Cooperative Project
CHEMGRID (Action D37) EGI Inspire.Peer reviewe
Efficiency of Collisional O2 + N2 Vibrational Energy Exchange
10 pags.; 6 figs.; 5 tabs. In press.By following the scheme of the Grid Empowered Molecular
Simulator (GEMS), a new O2 + N2 intermolecular potential, built on ab initio
calculations and experimental (scattering and second virial coefficient) data, has
been coupled with an appropriate intramolecular one. On the resulting potential
energy surface detailed rate coefficients for collision induced vibrational energy
exchanges have been computed using a semiclassical method. A cross comparison
of the computed rate coefficients with the outcomes of previous semiclassical
calculations and kinetic experiments has provided a foundation for characterizing
the main features of the vibrational energy transfer processes of the title system as
well as a critical reading of the trajectory outcomes and kinetic data. On the
implemented procedures massive trajectory runs for the proper interval of initial
conditions have singled out structures of the vibrational distributions useful to
formulate scaling relationships for complex molecular simulations.The authors acknowledge financial support from the Phys4-
entry FP7/2007-2013 project (Contract 242311), ARPA
Umbria, INSTM, the EGI-Inspire project (Contract 261323),
MIUR PRIN 2008 (2008KJX4SN 003) and 2010/2011
(2010ERFKXL_002), the ESA-ESTEC contract 21790/08/
NL/HE, and the Spanish CTQ2012-37404 and FIS2013-
48275-C2-1-P projects. Computations have been supported by
the use of Grid resources and services provided by the
European Grid Infrastructure (EGI) and the Italian Grid
Infrastructure (IGI) through the COMPCHEM Virtual
Organization. Thanks are also due to the COST CMST
European Cooperative Project CHEMGRID (Action D37) EGI
Inspire.Peer reviewe
Analysis of gut microbiota in rheumatoid arthritis patients. Disease-related dysbiosis and modifications induced by etanercept
A certain number of studies were carried out to address the question of how dysbiosis could affect the onset and development of rheumatoid arthritis (RA), but little is known about the reciprocal influence between microbiota composition and immunosuppressive drugs, and how this interaction may have an impact on the clinical outcome. The aim of this study was to characterize the intestinal microbiota in a groups of RA patients treatment-naïve, under methotrexate, and/or etanercept (ETN). Correlations between the gut microbiota composition and validated immunological and clinical parameters of disease activity were also evaluated. In the current study, a 16S analysis was employed to explore the gut microbiota of 42 patients affected by RA and 10 healthy controls. Disease activity score on 28 joints (DAS-28), erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti-cyclic citrullinated peptides, and dietary and smoking habits were assessed. The composition of the gut microbiota in RA patients free of therapy is characterized by several abnormalities compared to healthy controls. Gut dysbiosis in RA patients is associated with different serological and clinical parameters; in particular, the phylum of Euryarchaeota was directly correlated to DAS and emerged as an independent risk factor. Patients under treatment with ETN present a partial restoration of a beneficial microbiota. The results of our study confirm that gut dysbiosis is a hallmark of the disease, and shows, for the first time, that the anti-tumor necrosis factor alpha (TNF-α) ETN is able to modify microbial communities, at least partially restoring a beneficial microbiota
Editorial: Chronic autoimmune arthritis, infections and vaccines
The link between autoimmunity and infection continues to represent an intriguing immunologic conundrum for scientist and a frequent clinical challenge for patients and physicians.
Patients with chronic autoimmune arthritis indeed have an increased risk of infections, mainly due to the dysregulation of their immune system and the use of immunosuppressive therapy. Infections in these patients are more frequent, have a more severe clinical course, eventually with prolonged viral persistence, compared to the general population and represent a frequent cause of death.
Besides, infections can trigger autoimmune diseases via different immunologic mechanisms such as molecular mimicry, epitope spreading, by-stander activation and can also induce disease relapses.
SARS-CoV-2 infection represents a dramatic example of this complex connection.
It is known, indeed, that different autoimmune manifestations can complicate SARS-CoV-2 infection such as uncontrolled host-immune response leading to life-threatening condition known as cytokine release syndrome, or autoimmune hemolytic anemia, immune thrombocytopenic purpura, Guillain-Barre syndrome, and the detection of different autoantibodies.
This Research Topic includes seventeen contributions, fifteen original articles and two review articles, providing several new insights into the efficacy and safety of SARS-CoV-2 vaccine in autoimmune patients, immunologic biomarkers for diagnosis and therapeutic outcome of autoimmune arthritis
Use of botulinum toxin in aesthetic medicine and gynaecology. current approaches, controversies, and future directions
This review looks at the use of botulinum toxin in the gynaecological field with the aim of determining what needs to be further investigated to achieve a standardized application. Numerous studies have been conducted to explore how botulinum toxins (BoNT) can be applied, and it is becoming popular for treating various disorders such as chronic pelvic pain, vestibulodynia, and vaginism. However, the exact dosage and ideal location for injections still need to be clarified. The objective of this study is to point out which aspects need to be more carefully studied to ensure a consistent use of BoNT in gynaecology
DTI Parameter Optimisation for Acquisition at 1.5T: SNR Analysis and Clinical Application
Background. Magnetic Resonance (MR) diffusion
tensor imaging (DTI) is able to quantify in vivo tissue
microstructure properties and to detect disease related pathology
of the central nervous system. Nevertheless, DTI is limited by low
spatial resolution associated with its low signal-to-noise-ratio
(SNR). Aim. The aim is to select a DTI sequence
for brain clinical studies, optimizing SNR and resolution.
Methods and Results. We applied 6 methods for SNR
computation in 26 DTI sequences with different parameters using 4
healthy volunteers (HV). We choosed two DTI sequences for their
high SNR, they differed by voxel size and b-value. Subsequently,
the two selected sequences were acquired from 30 multiple
sclerosis (MS) patients with different disability and lesion load
and 18 age matched HV. We observed high concordance between mean
diffusivity (MD) and fractional anysotropy (FA), nonetheless the
DTI sequence with smaller voxel size displayed a better
correlation with disease progression, despite a slightly lower
SNR. The reliability of corpus callosum (CC) fiber tracking with
the chosen DTI sequences was also tested.
Conclusions. The sensitivity of DTI-derived
indices to MS-related tissue abnormalities indicates that the
optimized sequence may be a powerful tool in studies aimed at
monitoring the disease course and severity
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