The treatment of patellar tendinopathy

BACKGROUND: Patellar tendinopathy (PT) presents a challenge to orthopaedic surgeons. The purpose of this review is to revise strategies for treatment of PT MATERIALS AND METHODS: A PubMed (MEDLINE) search of the years 2002–2012 was performed using "patellar tendinopathy" and "treatment" as keywords. The twenty-two articles addressing the treatment of PT with a higher level of evidence were selected. RESULTS: Conservative treatment includes therapeutic exercises (eccentric training), extracorporeal shock wave therapy (ESWT), and different injection treatments (platelet-rich plasma, sclerosing polidocanol, steroids, aprotinin, autologous skin-derived tendon-like cells, and bone marrow mononuclear cells). Surgical treatment may be indicated in motivated patients if carefully followed conservative treatment is unsuccessful after more than 3–6 months. Open surgical treatment includes longitudinal splitting of the tendon, excision of abnormal tissue (tendonectomy), resection and drilling of the inferior pole of the patella, closure of the paratenon. Postoperative inmobilisation and aggressive postoperative rehabilitation are also paramount. Arthroscopic techniques include shaving of the dorsal side of the proximal tendon, removal of the hypertrophic synovitis around the inferior patellar pole with a bipolar cautery system, and arthroscopic tendon debridement with excision of the distal pole of the patella. CONCLUSION: Physical training, and particularly eccentric training, appears to be the treatment of choice. The literature does not clarify which surgical technique is more effective in recalcitrant cases. Therefore, both open surgical techniques and arthroscopic techniques can be used

Combining friend-of-friend and halo-based algorithms for the identification of galaxy groups

Galaxy groups provide the means for a great diversity of studies that contribute to a better understanding of the structure ofthe universe on a large scale and allow the properties of galaxies to be linked to those of the host halos. However, the identification ofgalaxy systems is a challenging task and therefore it is necessary to improve the techniques involved as much as possible.Aims. In view of the large present and forthcoming galaxy catalogues, we propose, implement, and evaluate an algorithm that combines the two most popular techniques used to identify galaxy systems. The algorithm can be easily applied to any spectroscopicgalaxy catalogue, but here we demonstrate its use on the Sloan Digital Sky Survey.Methods. Assuming that a galaxy group is a gravitationally bounded system that has at least one bright galaxy, we begin by identifying groups with a friends-of-friends algorithm adapted to fit this definition. In view of the shortcomings of this method, particularlythe lack of ability to identify low-number groups, and consequently the inability to study the occupation of halos throughout the massrange, we improve it by adding a halo-based procedure. To assess the performance, we construct a mock catalogue from a semianalytical model to compare the groups identified using our method with those obtained from the simulation.Results. The comparison of groups extracted using our method with those of a mock catalogue shows that the proposed algorithmprovides excellent results. The modifications introduced to the friends-of-friends algorithm in the first part of the procedure to fit theadopted group definition gave reliable groups. Furthermore, incorporation of the halo-based method reduces the interlopers whilemore accurately reproducing the number of galaxies per group. As a specific application, we use the algorithm to extract groups fromthe Sloan Digital Sky SurveyFil: Rodriguez, Facundo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; ArgentinaFil: Merchan, Manuel Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; Argentin

Taking advantage of photometric galaxy catalogues to determine the halo occupation distribution

Context. Halo occupation distribution (HOD) is a powerful statistic that allows the study of several aspects of the matter distribution in the Universe, such as evaluating semi-analytic models of galaxy formation or imposing constraints on cosmological models. Consequently, it is important to have a reliable method for estimating this statistic, taking full advantage of the available information on current and future galaxy surveys. Aims. The main goal of this project is to combine photometric and spectroscopic information using a discount method of background galaxies in order to extend the range of absolute magnitudes and to increase the upper limit of masses in which the HOD is estimated. We also evaluate the proposed method and apply it to estimating the HOD on the Sloan Digital Sky Survey Data Release 7 (SDSS DR7) galaxy survey. Methods. We propose the background subtraction technique to mel information provided by spectroscopic galaxy groups and photometric survey of galaxies. To evaluate the feasibility of the method, we implement the proposed technique on a mock catalogue built from a semi-analytic model of galaxy formation. Furthermore, we apply the method to the SDSS DR7 using a galaxy group catalogue taken from spectroscopic version and the corresponding photometric galaxy survey. Results. We demonstrated the validity of the method using the mock catalogue. We applied this technique to obtain the SDSS DR7 HOD in absolute magnitudes ranging from M = -21.5 to M = -16.0 and masses up to 1015 M⊙ throughout this range. On the brighter extreme, we found that our results are in excellent agreement with those obtained in previous works.Fil: Rodriguez, Facundo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; ArgentinaFil: Merchan, Manuel Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; ArgentinaFil: Sgró, Mario Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; Argentin

Pathogenesis and treatment options for hemophilic synovitis

INTRODUCTION: Hemophilia is characterized by recurrent bleeding episodes, most commonly in the knees, elbows and ankles. Repeated hemarthroses lead to synovial hypertrophy and a vicious cycle of chronic synovitis arises, leading to destruction of the joint. AREAS COVERED: This article covers the pathogenesis of chronic hemophilic synovitis and its treatment by means of different types of synovectomy. EXPERT OPINION: Both radiosynovectomy (RS) and arthroscopic synovectomy considerably improve the frequency of bleeding episodes. RS is the best option for patients with synovitis unresponsive to a three-month trial of hematological prophylaxis. If the bleeding is refractory to three successive episodes of RS at six monthly intervals, arthroscopic synovectomy is indicated. Open synovectomy should be reserved for adults with elbow synovitis requiring radial head removal and synovectomy in the same surgical session. RS is effective and safe, and particularly helpful in patients with inhibitors as they are at greatest risk of bleeding episodes and have the highest risk of complications of surgery

Platelet-Rich Plasma in the Treatment of Patellar Tendinopathy: A Systematic Review

BACKGROUND: Patellar tendinopathy (PT) is a major cause of morbidity in both high-level and recreational athletes. Whilst there is good evidence for the effectiveness of eccentric exercise regimens in its treatment, a large proportion of patients have disease which is refractory to such treatments. This has led to the development of novel techniques including platelet-rich plasma (PRP) injection, which aims to stimulate a normal healing response within the abnormal patellar tendon. However, little evidence exists at present to support its use. PURPOSE:The aim of this systematic review was to determine the safety and effectiveness of PRP in the treatment of PT, and to quantify its effectiveness relative to other therapies for PT. STUDY DESIGN: Systematic review. METHODS: A systematic review was conducted in accordance with the PRISMA guidelines. A literature review was conducted of the Medline, EMBASE and Cochrane databases, as well as trial registries. Both single-arm and comparative studies were included. The outcomes of interest were pain (as measured by visual-analogue or other, comparable scoring systems), functional scores and return to sport. Study quality and risk of bias were assessed using the MINORS score (for non-randomised studies) and the Cochrane risk of bias tool. RESULTS: Eleven studies fitted the inclusion criteria. Of these, two were randomised, controlled trials (RCTs), and one was a prospective, non-randomised cohort study. The remainder were single-arm case series. All noncomparative studies demonstrated a significant improvement in pain and function following PRP injection. Complications and adverse outcomes were rare. The results of the comparative studies were inconsistent and superiority of PRP over control treatments could not be conclusively demonstrated. CONCLUSION: PRP is a safe and promising therapy in the treatment of recalcitrant PT. However, its superiority over other treatments such as physiotherapy remains unproven. Further RCTs are required to determine the relative effectiveness of the many available treatments for PT, and to determine the subgroups of patients who stand to gain the most from the use of these therapies

The role of vancomycin-soaking of the graft in anterior cruciate ligament reconstruction

Approximately 1% of anterior cruciate ligament reconstruction (ACLR) procedures develop septic arthritis despite intravenous antibiotic prophylaxis and other preventive measures. Infection is most commonly due to contamination during autograft harvest and preparation by introducing bacteria into the knee during graft insertion. Presoaking ACL grafts in 5 mg/mL vancomycin (“vancomycin wrap”) has been utilised to eradicate such bacterial contamination. Many level III studies have reported a marked decrease in infection rates with no increase in graft failure rates. However, the lack of prospective randomised control trials and these studies’ heterogeneity do not allow a universal recommendation for vancomycin pre-soaking of all grafts during ACLR. Randomised controlled trials are needed to confirm efficacy in reducing sepsis rate

Титульные страницы и содержание

INTRODUCTION: Elderly patients with haemophilia (PWH) suffer from both haemarthrosis and haemophilic arthropathy (HA). Diagnosis of haemarthrosis in PWH is currently based on clinical presentation. No diagnostic protocols or validated criteria are available to identify haemarthrosis or to differentiate haemarthrosis from HA. AIM: The aim of this study is to identify symptoms and signs that can be used to differentiate haemarthrosis from HA. METHODS: A narrative literature review was performed on symptoms associated with haemarthrosis and symptoms associated with HA. Additionally, literature on the diagnosis of haemarthrosis in patients without haemophilia, imaging techniques and biomarkers was searched. RESULTS: This review shows that there is no consensus about the symptoms associated with haemarthrosis and that there is limited literature about the symptoms associated with HA. Additionally, symptoms associated with haemarthrosis partly overlap with symptoms of HA, particularly those symptoms associated with flare-ups of HA. Due to the overlap in symptoms differentiating between these conditions is complex. Furthermore, differentiating based on imaging techniques or biomarkers causes practical difficulties. CONCLUSION: Despite the overlap in symptoms, differentiating between joint bleeds and flare-ups of HA based on clinical presentation still seems the most convenient and practical solution. Further research is necessary to identify specific symptoms that can be used to differentiate between the two conditions

Rendimiento del tractor agrícola en función del sistema hidráulico.

En el Taller de la Facultad de Ciencias de la Ingeniería (FACI) de la Universidad Estatal de Milagro se encuentra un Tractor agrícola, con un uso irregular para las actividades del agro, las autoridades de la Facultad en su afán de seguir aportando a en actividades de vinculación a la comunidad en servicios de preparación de terrenos aportando al desarrollo del agro en la Ciudad de Milagro. En las gestiones de los equipos y maquinarias del taller, no cuenta con un plan de mantenimiento preventivo predictivo en las reparaciones de los equipos y maquinarias que hay en el Taller FACI

ECUACION GENERALIZADA PARA BALANCE DE MATERIA EN YACIMIENTOS NATURALMENTE FRACTURADOS

RESUMEN Este trabajo presenta un nuevo método lineal para estimar la cantidad de petróleo y gas in situ en yacimientos naturalmente fracturados (YNF). Mediante la inclusión tanto del gas disuelto como del aceite volatilizado fue posible superar las limitaciones de los métodos para el balance de materia en YNF existentes en la literatura, obteniéndose una única ecuación aplicable a todo tipo de fluido de yacimiento incluyendo aceite volátil, gas y condensado. Palabras claves: yacimientos naturalmente fracturados; convencionales, ecuación, generalizada, balance, materia, volumen, inicial, fluidos, in situ, gas disuelto, aceite volatilizado.   ABSTRACT This work presents a new straight line method to estimate the original oil and gas in place in naturally fractured reservoirs. By including both dissolved gas and volatilized oil was able to overcome the long standing limitations of the material balance in naturally fractured reservoirs resulting in a unique material balance equation wich is applicable to full range of reservoir fluids including volatile oils and gas –condensated systems Keywords: naturally fractured reservoirs, conventional reservoirs,generalized equation, material balance, initial volume, in situ fluids,dissolved gas, volatile oil