Colchicine versus Physical Therapy in Knee Osteoarthritis

Background: The treatment of osteoarthritis remains a major challenge due to the unavailability of a disease-modifying medication and the limitations of current therapeutic perspectives, which mainly target the symptoms, not the disease itself. The purpose of our study is to compare the efficacy of colchicine treatment versus physical therapy. Methods: The study included 62 patients diagnosed with knee osteoarthritis (KOA) according to the American College of Rheumatology (ACR) criteria, hospitalized within the time frame of October 2020–March 2022 in the Department of Rehabilitation Medicine and Physical Therapy of the Emergency Clinical County Hospital of Craiova. The participants were randomly divided into two groups. The observation period was 16 weeks long. The first group (31 patients) received colchicine at a dosage of 1 mg/day together with analgesics (acetaminophen < 2 g/day), while the second group (31 patients) received analgesics (acetaminophen < 2 g/day) together with a 16-week plan of physiotherapy. Results: Group II, in which patients underwent physical therapy, demonstrated a statistically significant decrease in both left (p < 0.001) and right (p = 0.012) knee VAS and WOMAC (p = 0.038) scores at 16 weeks, compared to the group treated with colchicine. Regarding the MSUS examination at 16 weeks, there were no significant changes in the structural abnormalities and no improvement in cartilage aspect or thickness. Higher BMI was associated with higher WOMAC score (p = 0.012), but not with higher VAS score (p = 0.062). Cholesterol and triglyceride levels were associated with high WOMAC (p < 0.001; p = 0.021) and high VAS (p = 0.023; p < 0.001) scores. Conclusions: Our study monitored VAS and WOMAC scores in two groups of patients with KOA, showing that physical therapy is more effective than colchicine in reducing symptoms. We found no statistically significant difference in musculoskeletal ultrasound (MSUS) feature improvement during the 16-week study

CRPS DIAGNOSIS BASED ON INFLAMMATION MARKER ANALYSIS

Objectives. The biological markers that can indicate specifically and sensitively the absence or presence of a certain condition or its state can be used for diagnostic support and disease monitoring. Thus, this research set out to study the changes in neuropeptides (substance P and calcitonin gene-related peptide) pro-inflammatory (TNFα, IL-1β and IL-6) and anti-inflammatory (IL-10) cytokine levels in the blood of patients with CRPS. Material and methods. Sixty patients were enlisted from the local Rheumatology Clinic of the Emergency County Hospital of Craiova and split into two groups (acute and chronic). CRPS related symptoms were estimated by means of the Neuropathic Pain Questionnaire. The quantification of cytokines and neuropeptides in blood was achieved using the high sensitivity colorimetric ELISA method. Outcomes. Cytokine analysis led to statistically insignificant results, while for the neuropeptides we obtained significantly increased values in the patient groups. ROC curves were used to assess the diagnostic accuracy of the neuropeptides both returning good AUC values. Conclusions. Our results indicate that the neuropeptide (substance P and calcitonin gene-related peptide) profile has a good diagnostic sensitivity. A limitation of the study is the low number of patients in the acute group, including more patients in this phase might offer more insights on the cytokines’ role, as they could be increased in comparison to chronic patients, due to their short half-life and low acting concentrations

Management of Upper-Limb Spasticity Using Modern Rehabilitation Techniques versus Botulinum Toxin Injections Following Stroke

Our purpose is to emphasize the role of botulinum toxin in spasticity therapy and functional recovery in patients following strokes. Our retrospective study compared two groups, namely ischemic and hemorrhagic stroke patients. The study group (BT group) comprised 80 patients who received focal botulinum toxin as therapy for an upper limb with spastic muscle three times every three months. The control group (ES group) comprised 80 patients who received only medical rehabilitation consisting of electrostimulation and radial shockwave therapy for the upper limb, which was applied three times every three months. Both groups received the same stretching program for spastic muscles as a home training program. We evaluated the evolution of the patients using muscle strength, Ashworth, Tardieu, Frenchay, and Barthel scales. The analysis indicated a statistically significant difference between the two groups for all scales, with better results for the BT group (p p-value p-value = 0.001; in the ES group, MRC scale: rho = −0.445, p-value p-value = 0.033). Our results demonstrated the effectiveness of botulinum toxin therapy compared with the rehabilitation method, showing a reduction of the recovery time of the upper limb, as well as an improvement of functionality and a reduction of disability. Although all patients followed a specific kinetic program, important improvements were evident in the botulinum toxin group