Alternative and complementary therapies in osteoarthritis and cartilage repair

Osteoarthritis (OA) is the most common joint condition and, with a burgeoning ageing population, is due to increase in prevalence. Beyond conventional medical and surgical interventions, there are an increasing number of ‘alternative’ therapies. These alternative therapies may have a limited evidence base and, for this reason, are often only afforded brief reference (or completely excluded) from current OA guidelines. Thus, the aim of this review was to synthesize the current evidence regarding autologous chondrocyte implantation (ACI), mesenchymal stem cell (MSC) therapy, platelet-rich plasma (PRP), vitamin D and other alternative therapies. The majority of studies were in knee OA or chondral defects. Matrix-assisted ACI has demonstrated exceedingly limited, symptomatic improvements in the treatment of cartilage defects of the knee and is not supported for the treatment of knee OA. There is some evidence to suggest symptomatic improvement with MSC injection in knee OA, with the suggestion of minimal structural improvement demonstrated on MRI and there are positive signals that PRP may also lead to symptomatic improvement, though variation in preparation makes inter-study comparison difficult. There is variability in findings with vitamin D supplementation in OA, and the only recommendation which can be made, at this time, is for replacement when vitamin D is deplete. Other alternative therapies reviewed have some evidence (though from small, poor-quality studies) to support improvement in symptoms and again there is often a wide variation in dosage and regimens. For all these therapeutic modalities, although controlled studies have been undertaken to evaluate effectiveness in OA, these have often been of small size, limited statistical power, uncertain blindness and using various methodologies. These deficiencies must leave the question as to whether they have been validated as effective therapies in OA (or chondral defects). The conclusions of this review are that all alternative interventions definitely require clinical trials with robust methodology, to assess their efficacy and safety in the treatment of OA beyond contextual and placebo effects

The influences of nursing transformational leadership style on the quality of nurses’ working lives in Taiwan: a cross-sectional quantitative study

- Background: Taiwan’s NHI system is one of the most successful health care models for countries around the globe. However, little research has demonstrated the mental health issues associated with nursing transformational leadership style under the NHI system, especially in the quality of nurses’ working lives in Taiwan. It is important to know the relationship between transformational leadership style and the mental health of nurses, organisational commitment and job satisfaction. The research aimed to understand the influences of nursing transformational leadership style on the quality of nurses’ working lives in Taiwan. The research hypothesis was that transformational leadership styles would have positive influence on the quality of nurses’ working lives. - Methods: This was a cross-sectional quantitative study. Nurses from each type of hospital ownership (private, public and religious) were recruited. Participation was voluntary and signed informed consent was obtained. The inclusion criteria were nurses with at least one year’s work experience in the hospitals. Self-administrated questionnaires were used. A total of 807 participants were contacted and 651 questionnaires were fully completed (response rate 80.7 %). A theory driven model was used to test the research hypotheses using structural equation modelling performed with AMOS 16.0. - Results: Transformational leadership contributes significantly to supervisor support. Workplace support, particularly from the supervisor, is an important mediator variable that explains the relationship between transformational leadership and job satisfaction. Organisational commitment was the strongest factor relevant to the general health well-being in Taiwanese nurses than job satisfaction. The hypothesized positive relationships between transformational leadership and all variables were supported by the data. - Conclusions: Our findings have important consequences for organisational health. Our model demonstrates a complete picture of the work relationships on the quality of nurses’ working lives. The results provided information about the subordinates’ perceptions of transformational nursing leadership styles and mental health outcomes in different hospital settings, as well as identified organisational factors that could improve the quality of nurses’ working lives

Histological Studies of the Calvarial Development of One-Humped Camel (Camelus Dromedarius) Fetuses

This study involved the use of thirty two camel fetuses, [23 (71.88%) males and 9 (28.12%) females]. Eleven fetuses were at the first trimester (34.4%), twelve at the second trimester (37.5%), and nine at the third trimester (28.1%). 1cm2 of bone samples obtained from the different fetal calvaria at the first, second and third trimester stages were decalcified and processed for normal Hematoxylin and Eosin (H&E) staining. There was an initial evidence of loose mesenchymal cells condensed together with some blood vessels, osteogenic cells and illdefined spicules. Ill-defined intertrabecular spaces were also seen at the first and second trimester levels. However, with advancement in age at the third trimester stage, prominent bone spicules or trabeculae were seen. Similarly, there were regularly arranged osteocytes within the trabecular matrix; and the intertrabecular spaces were more obvious. The findings of this research would help in understanding the microscopic anatomy of the developing calvaria in this animal species.Keywords: Histology, calvaria, one-humped, camel, fetusesNigerian Veterinary Journal, VOL:33 (1) 419-42

Evaluation of Healing Intervals of Incisional Skin Wounds of Goats Closed with Three Suture Patterns

The aim of this study was to compare the healing intervals among simple interrupted (SI), ford interlocking (FI) and subcuticular (SC) suture patterns in goats. We hypothesized that these common suture patterns used for closure of incisional skin wounds may have effect on the healing interval. To test this hypothesis, two parameters (subjective healing interval and histologic objective healing interval) were used to investigate the healing interval of the three suture patterns. Our findings showed that, there was significant differences (P<0.05) in subjective healing interval between subcuticular (SC) withford interlocking (FI), but there was nosignificant difference between subcuticular with simple interrupted patterns. There were also no significant differences between ford-interlocking and simple interrupted. Histologic findings at seventh day post surgery revealed low polymorphonuclear leukocytes (PMNL) infiltrations and early fibroblast, collagen fibers and epidermal keratinization in the subcuticular group in comparison with the two other groups. At fourteen day post-surgery, there was marked reduction of inflammatory infiltrates in the subcuticular group when compare with the two other groups, while the collagen fiber density and epidermal keratinization increased in the subcuticular group. At twenty first-day post - surgery , there were no inflammatory cells in subcuticular group, while collagen density was higher, and the orientation of the collagen fibers were horizontal, suggestive of faster healing in comparison with the simple interrupted and ford interlocking groups. It was concluded as measured by subjective healing interval and histologic objective healing interval that surgical skin-wound closed by subcuticular suture pattern alone healed faster than simple interrupted and ford interlocking suture patterns reinforced after subcuticular closure, on the other hand simple interrupted pattern healed faster than ford interlocking.Keywords: Incisional wound healing, histology, goat, suture patterns, healing interva