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

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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

Effect of obesity in Independence and balance in people with intelectual disability

Background People with obesity often have problems with postural control. Some studies show that people with intellectual disabilities (ID) have a higher likelihood of having falls than the general population, with a prevalence in adults of between 29% and 70% (Cox et al., 2010). Currently, there are no studies that show the effects of obesity on independence and balance in people with ID. The objective of our study is analyse, in people with ID, the degree of influence that obesity has on independence with regard to activities of daily living, static and semi-static balance. Therefore, we can compare two groups: obese people and non-obese people. Our hypothesis is that obesity will exercise a negative influence on static and semi-static balance as well as on independence and the development of the activities of daily living. Method In a cross-sectional study, we compared static and semi-static balance in two groups of people with ID: the obese and the non-obese. All those in the sample had a low ID (IQ: 70-50) to mild ID (IQ 50-35). To measure balance we used a single leg balance test (SLBT) with opened eyes and closed eyes, and a functional reach test (FRT). In order to measure levels of dependence we used a Barthel index. The outcome variables were: time in balance in SLBT open eyes/closed eyes), maximum range of FRT and Barthel index. Results and Discussion We found significant differences in all outcome variables between two groups. To our knowledge, this is the first study to analyze how obesity affects independence, static balance and semi-static balance in people with ID. However, other studies have analyzed the effects of obesity on the general population (Singh et al., 2009). In both studies (General population: Singh et al. 2009 and people with ID in this study) we observed that obesity can be a determinant of negatively static balance and semi-static balance. Conclussion The main conclusion of this study is that obesity has a negative effect on independence, static balance and semi-static balance in people with ID. These results would have been carried out when we carry out an intervention on people with ID to prevent falls. References - Cox CR, Clemson L, Stancliffe RJ, Durvasula S, Sherrington C. Incidence of and risk factors for falls among adults with an intellectual disability. J Intellect Disabil Res. 2010 Dec;54(12):1045-57. doi: 10.1111/j.1365-2788.2010.01333.x. - Enkelaar L, Smulders E, van Schrojenstein Lantman-de Valk H, Weerdesteyn V, Geurts AC. Clinical measures are feasible and sensitive to assess balance and gait capacities in older persons with mild to moderate Intellectual Disabilities. Res Dev Disabil. 2013 Jan;34(1):276-85. doi: 10.1016/j.ridd.2012.08.014. - Singh D, Park W, Levy MS, Jung ES. The effects of obesity and standing time on postural sway during prolonged quiet standing. Ergonomics. 2009 Aug;52(8):977-86.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

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

Long-range transport and microscopy analysis of Sangay volcanic ashes in Ecuador

This study aims to conduct a spatiotemporal analysis of the long-range transportation of volcanic ashes that originates from the eruption of the Sangay volcano and reached Guayaquil during the months of June 2020; September 2020; and April 2021. The particulate matter data (PM2.5) was obtained using a low-cost air quality sensor. During the wet season of 2020 (Jan–May), PM2.5 average concentrations were 6 ± 2 μg m−3 while during the dry season of 2020 (July–Nov), PM2.5 average concentrations were 16 ± 3 μg m−3 in Guayaquil. The most prominent plumes occurred on September 20th of 2020, a month with no rain but high wind speeds created by the Andes Mountain topography to the coast. During this event, PM2.5 concentrations started at 12:00 UTC-5 in a volcanic plume event that lasted 4 h with a maximum peak of 133 + 40 μg m−3. Electron microscopy of selected samples showed that the ashes of the three eruptions may differ in size and morphology. EDX analysis reveals that the ash contains certain elements—C, Si, Na, Mg, Al, Ca, S, and Fe—in similar proportions. In summary, this study remarks on the meteorological role and the long-range transport of Sangay volcanic ashes

A review of evidence about behavioural and psychological aspects of chronic joint pain among people with haemophilia

Joint pain related to haemophilia affects large numbers of people and has a significant impact on their quality of life. This article reviews evidence about behavioural and psychological aspects of joint pain in haemophilia, and considers that evidence in the context of research on other chronic pain conditions. The aim is to inform initiatives to improve pain self-management among people with haemophilia. Reduced pain intensity predicts better physical quality of life, so better pain management should lead to improved physical quality of life. Increased pain acceptance predicts better mental quality of life, so acceptance-based approaches to self-management could potentially be adapted for people with haemophilia. Pain self-management interventions could include elements designed to: improve assessment of pain; increase understanding of the difference between acute and chronic pain; improve adherence to clotting factor treatment; improve knowledge and understanding about the benefits and costs of using pain medications; improve judgments about what is excessive use of pain medication; increase motivation to self-manage pain; reduce negative emotional thinking about pain; and increase pain acceptance. The influence of behavioural and psychological factors related to pain are similar in haemophilia and other chronic pain conditions, so there should be scope for self-management approaches and interventions developed for other chronic pain conditions to be adapted for haemophilia, provided that careful account is taken of the need to respond promptly to acute bleeding pain by administering clotting factor

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

Motivational and behavioural models of change: A longitudinal analysis of change among men with chronic haemophilia-related joint pain

Motivational and behavioural models of adjustment to chronic pain make different predictions about change processes, which can be tested in longitudinal analyses. We examined changes in motivation, coping and acceptance among 78 men with chronic haemophilia-related joint pain. Using cross-lagged regression analyses of changes from baseline to 6 months as predictors of changes from 6 to 12 months, with supplementary structural equation modelling, we tested two models in which motivational changes influence behavioural changes, and one in which behavioural changes influence motivational changes. Changes in motivation to self-manage pain influenced later changes in pain coping, consistent with the motivational model of pain self-management, and also influenced later changes in activity engagement, the behavioural component of pain acceptance. Changes in activity engagement influenced later changes in pain willingness, consistent with the behavioural model of pain acceptance. Based on the findings, a combined model of changes in pain self-management and acceptance is proposed, which could guide combined interventions based on theories of motivation, coping and acceptance in chronic pain. This study adds longitudinal evidence about sequential change processes; a test of the motivational model of pain self-management; and tests of behavioural versus motivational models of pain acceptance. [Abstract copyright: © 2017 European Pain Federation - EFIC®.