The effectiveness of intra-articular injectionc of Hyalubrix combined with exercise therapy in the tratment of hip osteoarthritis

Purpose. Osteoarthritis (OA) is the most common joint disorder in the elderly, causing significant pain which negatively affects mobility and quality ol liie. The aim of the study was to assess the effectiveness of ultrasound \ucdmage-guided intra-articular injections of Hyalubrix@ combined with exercise therapy in the treatment of hip osteoarthritis. Methods. This was a single site, prosp\ue8ctive, open-fabel, Investigator-initiated study. Forty patients rilere enrolled and received three ultrasound image.guided injections of Hyalubrix@, 45 days apart, combined with three sessions a week of phys\uedcal therapy (proprioceptive rehabilitation of the lower limbs; gait training; balance training) up to a total of 30 sessions (10 weeks), starting from one week after the first injection. Results. The primary obiective was to achieve a lasting reduction in OA symptoms related to pain during activity. During the course of the study the pain perceived by the patient during activity dropped from a mean value of 6.94 cm to a mean value of 1.46 cm and showed a statistically significant decrease from visit 1 compared to baseline (p < 0.05) which was confirmed at all the subsequent time points. Significant improvements were also observed in the evaluation of the secondary objectives: hip disability; OA-related pain at rest; daily functioning and NSAIDs intake. Conclusions. Results from this study including 40 patients for a total of 65 treated hips demonstrate a significant improvement in OA-related pain, hip disability, and patient's daily functioning as well as a reduction in NSAIDS intake. Patients suffering from hip OA s\ue8em to benefil from the treatment wiih Hyalubrix@ injections plus exercise therapy

Studio RIFRA: il rischio fratturativo in Italia

L'osteoporosi \ue8 un disordine scheletrico cronico-evolutivo, caratferizzato dalla perdita dell'equilibrio del metabolismo osseo con conseguente degenerazione quantitativa e qualitativa che compromette la resistenza dell'osso e predispone ad un aumentato rischio di fratture. Colpisce soprattutto il sesso femminile,conunaprevalenza del33%nelrange tra60eT0aacheaumentaconl'avanzaredell'et\ue0. Pu\uf2 rimanere clinicamente silente e successivamente manifestarsi con fratture (vertebrali 100.000 casi/anno, di polso 85.000 casi/anno e femorali 80.000 casi/anno). Le fratture da fragilit\ue0 comportano gravi conse gse\ueeze, sia a livello clinico individuale che sociale ed economico; rappresenrano pertanto una fonte di disabilit\ue0 complessa, che in quanto tale necessita di una presa in carico globale. Lo studio RIFRA nasce da un'idea del GISMO per rispondere alla necessit\ue0 primaria di quantificare il reale rischio fratturativo in Italia attraverso una specifica scheda e di valutare l'influenza delle comorbilit\ue0 e delle terapie corelate al rischio di frattura. L'obiettivo secondario analizzare \a percentuale di pazienti sottoposti a trattamento farmacologico in relazione ai valori densitometrici e alle pregresse fratture, nonch\ue9 valutare la prevalenza di fratture da fragilit\ue0 nella popol azione in studio

Synergistic Effect of Physical Therapy Plus Pharmacological Therapy with Eperisone in Tension-Type Cervicalgia

Background. This study assessed the effect of eperisone + physical therapy compared with physical therapy alone on the alleviation of pain and disability experienced by patients with tension-type cervicalgia. Methods. Patients with tension-type cervicalgia were randomized to eperisone + physical therapy (Group A) or physical therapy alone (Group B). Patients were assessed at baseline (T0), after 4-weeks’ treatment (T1), and at 2 months’ follow-up (T2). Outcome measures included the Numerical Rating Scale, the Italian version of the Neck Pain and Disability Scale, the Short Form-McGill Pain Questionnaire, and the Italian version of the Neck Disability Index. Results. Ninety-eight patients (50 patients in Group A and 48 patients in Group B) completed the study. Pain and disability scores for all outcome measures were significantly lower at both T1 and T2 for patients in Group A compared with Group B (all p<0.001). A small, improvement between T1 and T2 was observed in Group A patients but not in Group B patients, and significantly more Group B than Group A patients were worse at 2 months’ follow-up (all p<0.001). Conclusions. Eperisone in synergy with physical therapy can be a valuable tool in the therapeutic management of patients suffering from tension-type cervicalgia

Intra-Articular Hybrid Hyaluronic Acid Injection Treatment in Overweight Patients with Knee Osteoarthritis: A Single-Center, Open-Label, Prospective Study

Abstract: Background: A BMI > 25 is the most decisive, albeit modifiable, risk factor for knee osteoarthritis (KOA). This study aimed at assessing the efficacy of intra-articular injections of hybrid hyaluronic acid (HA) complexes (Sinovial® H-L) for the treatment of KOA in overweight patients in terms of disease severity, cardiocirculatory capacity, and quality of life. Materials: In this single-site, open-label, prospective trial, 37 patients with symptomatic knee OA were assessed at baseline and 3 months after ultrasound-guided intra-articular injection of hybrid HA complexes (Sinovial® H-L). Results: Primary variables displaying a statistically significant improvement after treatment were pain (VAS), disease severity (WOMAC), and cardiopulmonary capacity (6 min walk test). Among secondary variables, quality of life (SF-12) improved significantly, as did analgesic intake for pain control. No statistically significant difference was observed in body fat and muscle mass percentage measured by bioelectrical impedance analysis. Conclusions: Intra-articular hybrid HA injections are significantly effective in improving OA-related disease severity, cardiopulmonary function, and analgesic intake. This supports the role of hybrid HA viscosupplementation as a nonpharmacological treatment to relieve pain, reduce disability, improve quality of life, and limit the risk of polypharmacy in overweight patients with knee OA

Il trattamento riabilitativo integrato alla terapia farmacologica con anticorpo anti RANK-L

abstract pubblicato su atti congressual

Physical Agent Modalities in Early Osteoarthritis: A Scoping Review

Early osteoarthritis (EOA) still represents a challenge for clinicians. Although there is no consensus on its definition and diagnosis, a prompt therapeutic intervention in the early stages can have a significant impact on function and quality of life. Exercise remains a core treatment for EOA; however, several physical modalities are commonly used in this population. The purpose of this paper is to investigate the role of physical agents in the treatment of EOA. A technical expert panel (TEP) of 8 medical specialists with expertise in physical agent modalities and musculoskeletal conditions performed the review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) model. The TEP searched for evidence of the following physical modalities in the management of EOA: “Electric Stimulation Therapy”, “Pulsed Electromagnetic field”, “Low-Level Light Therapy”, “Laser Therapy”, “Magnetic Field Therapy”, “Extracorporeal Shockwave Therapy”, “Hyperthermia, Induced”, “Cryotherapy”, “Vibration therapy”, “Whole Body Vibration”, “Physical Therapy Modalities”. We found preclinical and clinical data on transcutaneous electrical nerve stimulation (TENS), extracorporeal shockwave therapy (ESWT), low-intensity pulsed ultrasound (LIPUS), pulsed electromagnetic fields stimulation (PEMF), and whole-body vibration (WBV) for the treatment of knee EOA. We found two clinical studies about TENS and PEMF and six preclinical studies—three about ESWT, one about WBV, one about PEMF, and one about LIPUS. The preclinical studies demonstrated several biological effects on EOA of physical modalities, suggesting potential disease-modifying effects. However, this role should be better investigated in further clinical studies, considering the limited data on the use of these interventions for EOA patients

Effectiveness of Rehabilitative Intervention on Pain, Postural Balance, and Quality of Life in Women with Multiple Vertebral Fragility Fractures: A Prospective Cohort Study

Patients with vertebral fragility fractures often experience chronic pain, postural and balance disorders, and poor quality of life (QoL). Although several studies have investigated the role of rehabilitation in severe osteoporosis, the effectiveness of this intervention in patients with multiple vertebral fractures is poorly known. The aim of our longitudinal cohort study is to evaluate the effectiveness of rehabilitation, including postural training, resistance exercises, and visual stabilization exercises, for a 7-week period, on the pain, postural balance, and QoL of subjects with at least two vertebral fragility fractures receiving denosumab and vitamin D. We investigated, before (T0) and after (T1, at 7 weeks) rehabilitation, the following outcome measures on 28 patients: pain (Numerical Rating Scale (NRS)), self-perceived QoL (36-Item Short Form Survey (SF-36) and Mini-Osteoporosis Quality of Life Questionnaire (Mini-OQOL)), dizziness (Dizziness Handicap Inventory (DHI-I)), mobility (Timed-Up and Go (TUG) test), and instrumental posturographic assessment (FreeMed posturography system). At the end of the treatment, improvements of pain and QoL were recorded. Pain relief was highly obtained in patients with more than two vertebral fractures. Moreover, a significant functional improvement (TUG test) was found in those with two vertebral fractures, without any statistically significant change reported for other outcomes. Our findings suggest that combined intervention, including anti-osteoporotic drugs and postural rehabilitation, should be proposed to osteoporotic patients with multiple vertebral fractures

NUDT2 initiates viral RNA degradation by removal of 5′-phosphates.

While viral replication processes are largely understood, comparably little is known on cellular mechanisms degrading viral RNA. Some viral RNAs bear a 5 '-triphosphate (PPP-) group that impairs degradation by the canonical 5 '-3 ' degradation pathway. Here we show that the Nudix hydrolase 2 (NUDT2) trims viral PPP-RNA into monophosphorylated (P)-RNA, which serves as a substrate for the 5 '-3 ' exonuclease XRN1. NUDT2 removes 5 '-phosphates from PPP-RNA in an RNA sequence- and overhang-independent manner and its ablation in cells increases growth of PPP-RNA viruses, suggesting an involvement in antiviral immunity. NUDT2 is highly homologous to bacterial RNA pyrophosphatase H (RppH), a protein involved in the metabolism of bacterial mRNA, which is 5 '-tri- or diphosphorylated. Our results show a conserved function between bacterial RppH and mammalian NUDT2, indicating that the function may have adapted from a protein responsible for RNA turnover in bacteria into a protein involved in the immune defense in mammals. RNA of some viruses is protected from degradation by a 5 ' triphosphate group. Here the authors identify nudix hydrolase 2 (NUDT2) as novel antiviral defense protein that dephosphorylates viral RNA and thereby enables its degradation.We thank the core facility of the MPI of biochemistry for support