170 research outputs found
The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases
Get PDFBACKGROUND
Ankle sprains are common in sports and can sometimes result in a persistent pain condition.
PURPOSE
Primarily to evaluate clinical symptoms, signs, diagnostics and outcomes of surgery for symptomatic chondral injuries of the talo crural joint in athletes. Secondly, in applicable cases, to evaluate the accuracy of MRI in detecting these injuries. Type of study: Prospective consecutive series.
METHODS
Over around 4 years we studied 61 consecutive athletes with symptomatic chondral lesions to the talocrural joint causing persistent exertion ankle pain.
RESULTS
43% were professional full time athletes and 67% were semi-professional, elite or amateur athletes, main sports being soccer (49%) and rugby (14%). The main subjective complaint was exertion ankle pain (93%). Effusion (75%) and joint line tenderness on palpation (92%) were the most common clinical findings. The duration from injury to arthroscopy for 58/61 cases was 7 months (5.7–7.9). 3/61 cases were referred within 3 weeks from injury. There were in total 75 cartilage lesions. Of these, 52 were located on the Talus dome, 17 on the medial malleolus and 6 on the Tibia plafond. Of the Talus dome injuries 18 were anteromedial, 14 anterolateral, 9 posteromedial, 3 posterolateral and 8 affecting mid talus. 50% were grade 4 lesions, 13.3% grade 3, 16.7% grade 2 and 20% grade 1. MRI had been performed pre operatively in 26/61 (39%) and 59% of these had been interpreted as normal. Detection rate of cartilage lesions was only 19%, but subchondral oedema was present in 55%. At clinical follow up average 24 months after surgery (10–48 months), 73% were playing at pre-injury level. The average return to that level of sports after surgery was 16 weeks (3–32 weeks). However 43% still suffered minor symptoms.
CONCLUSION
Arthroscopy should be considered early when an athlete presents with exertion ankle pain, effusion and joint line tenderness on palpation after a previous sprain. Conventional MRI is not reliable for detecting isolated cartilage lesions, but the presence of subchondral oedema should raise such suspicion
AAV-mediated ERdj5 overexpression protects against P23H rhodopsin toxicity
Get PDFRhodopsin misfolding caused by the P23H mutation is a major cause of autosomal dominant retinitis pigmentosa (adRP), to date there are no effective treatments for adRP. The BiP co-chaperone and reductase ERdj5 (DNAJC10) is part of the ER quality control machinery and previous studies have shown that overexpression of ERdj5 in vitro enhanced the degradation of P23H rhodopsin; whereas knockdown of ERdj5 increased P23H rhodopsin ER retention and aggregation. Here, we investigated the role of ERdj5 in photoreceptor homeostasis in vivo by using an Erdj5 knock-out mouse crossed with the P23H knock-in mouse, and by adeno associated viral (AAV) vector-mediated gene augmentation of ERdj5 in P23H-3 rats. Electroretinogram (ERG) and optical coherence tomography (OCT) of Erdj5−/− and P23H+/−:Erdj5−/− mice showed no effect of ERdj5 ablation on retinal function or photoreceptor survival. Rhodopsin levels and localisation were similar to those of control animals at a range of time points. By contrast, when AAV2/8-ERdj5-HA was subretinally injected into P23H-3 rats, analysis of the full field ERG suggested that overexpression of ERdj5 reduced visual function loss 10 weeks post-injection. This correlated with a significant preservation of photoreceptor cells at 4 and 10 weeks post-injection. Assessment of the outer nuclear layer (ONL) morphology showed preserved ONL thickness and reduced rhodopsin retention in the ONL in the injected superior retina. Overall, these data suggest that manipulation of the ER quality control and ERAD factors to promote mutant protein degradation could be beneficial for the treatment of adRP caused by mutant rhodopsin
Measuring Invisible Particle Masses Using a Single Short Decay Chain
Full text linkWe consider the mass measurement at hadron colliders for a decay chain of two
steps, which ends with a missing particle. Such a topology appears as a
subprocess of signal events of many new physics models which contain a dark
matter candidate. From the two visible particles coming from the decay chain,
only one invariant mass combination can be formed and hence it is na\"ively
expected that the masses of the three invisible particles in the decay chain
cannot be determined from a single end point of the invariant mass
distribution. We show that the event distribution in the
vs. invariant mass-squared plane, where , are the transverse
energies of the two visible particles, contains the information of all three
invisible particle masses and allows them to be extracted individually. The
experimental smearing and combinatorial issues pose challenges to the mass
measurements. However, in many cases the three invisible particle masses in the
decay chain can be determined with reasonable accuracies.Comment: 45 pages, 32 figure
Rehabilitation via HOMe Based gaming exercise for the Upper-limb post Stroke (RHOMBUS): protocol of an intervention feasibility trial
Get PDF© Author(s) (or their employer(s)) 2018. Introduction Effective interventions to promote upperlimb
recovery poststroke are characterised by intensive
and repetitive movements. However, the repetitive nature
of practice may adversely impact on adherence. Therefore,
the development of rehabilitation devices that can be used
safely and easily at home, and are motivating, enjoyable
and affordable is essential to the health and well-being
of stroke survivors. The Neurofenix platform is a nonimmersive
virtual reality device for poststroke upper-limb
rehabilitation. The platform uses a hand controller (a
NeuroBall) or arm bands (NeuroBands) that facilitate
upper-limb exercise via games displayed on a tablet. The
Rehabilitation via HOMe Based gaming exercise for the
Upper-limb post Stroke trial aims to determine the safety,
feasibility and acceptability of the Neurofenix platform for
home-based rehabilitation of the upper-limb poststroke.
Methods and analysis Thirty people poststroke will
be provided with a Neurofenix platform, consisting of a
NeuroBall or NeuroBands (dependent on impairment level),
seven specially designed games, a tablet and handbook
to independently exercise their upper limb for 7 weeks.
Training commences with a home visit from a research
therapist to teach the participant how to safely use the
device. Outcomes assessed at baseline and 8 weeks and
12 weeks are gross level of disability, pain, objectively
measured arm function and impairment, self-reported
arm function, passive range of movement, spasticity,
fatigue, participation, quality of life (QOL) and health
service use. A parallel process evaluation will assess
feasibility, acceptability and safety of the intervention
through assessment of fidelity to the intervention
measured objectively through the Neurofenix platform,
a postintervention questionnaire and semistructured
interviews exploring participants’ experiences of the
intervention. The feasibility of conducting an economic
evaluation will be determined by collecting data on QOL
and resource use.Innovate UK grant number 104188[3463]
The heat-shock response co-inducer arimoclomol protects against retinal degeneration in rhodopsin retinitis pigmentosa.
Get PDFRetinitis pigmentosa (RP) is a group of inherited diseases that cause blindness due to the progressive death of rod and cone photoreceptors in the retina. There are currently no effective treatments for RP. Inherited mutations in rhodopsin, the light-sensing protein of rod photoreceptor cells, are the most common cause of autosomal-dominant RP. The majority of mutations in rhodopsin, including the common P23H substitution, lead to protein misfolding, which is a feature in many neurodegenerative disorders. Previous studies have shown that upregulating molecular chaperone expression can delay disease progression in models of neurodegeneration. Here, we have explored the potential of the heat-shock protein co-inducer arimoclomol to ameliorate rhodopsin RP. In a cell model of P23H rod opsin RP, arimoclomol reduced P23H rod opsin aggregation and improved viability of mutant rhodopsin-expressing cells. In P23H rhodopsin transgenic rat models, pharmacological potentiation of the stress response with arimoclomol improved electroretinogram responses and prolonged photoreceptor survival, as assessed by measuring outer nuclear layer thickness in the retina. Furthermore, treated animal retinae showed improved photoreceptor outer segment structure and reduced rhodopsin aggregation compared with vehicle-treated controls. The heat-shock response (HSR) was activated in P23H retinae, and this was enhanced with arimoclomol treatment. Furthermore, the unfolded protein response (UPR), which is induced in P23H transgenic rats, was also enhanced in the retinae of arimoclomol-treated animals, suggesting that arimoclomol can potentiate the UPR as well as the HSR. These data suggest that pharmacological enhancement of cellular stress responses may be a potential treatment for rhodopsin RP and that arimoclomol could benefit diseases where ER stress is a factor
Tension-Compression Loading with Chemical Stimulation Results in Additive Increases to Functional Properties of Anatomic Meniscal Constructs
Get PDFObjective: This study aimed to improve the functional properties of anatomically-shaped meniscus constructs through simultaneous tension and compression mechanical stimulation in conjunction with chemical stimulation. Methods: Scaffoldless meniscal constructs were subjected to simultaneous tension and compressive stimulation and chemical stimulation. The temporal aspect of mechanical loadingwas studied by employing two separate five day stimulation periods. Chemical stimulation consisted of the application of a catabolic GAG-depleting enzyme, chondroitinase ABC (C-ABC), and an anabolic growth factor, TGF-b1. Mechanical and chemical stimulation combinations were studied through a full-factorial experimental design and assessed for histological, biochemical, and biomechanical properties following 4 wks of culture. Results: Mechanical loading applied from days 10–14 resulted in significant increases in compressive, tensile, and biochemical properties of meniscal constructs. When mechanical and chemical stimuliwere combined significant additive increases in collagen per wet weight (4-fold), compressive instantaneous (3-fold) and relaxation (2-fold) moduli, and tensile moduli in the circumferential (4-fold) and radial (6-fold) directions were obtained. Conclusions: This study demonstrates that a stimulation regimen of simultaneous tension and compression mechanical stimulation, C-ABC, and TGF-b1 is able to create anatomic meniscus constructs replicating the compressive mechanica
Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb in acute and subacute Stroke (RHOMBUS II): results of a feasibility randomised controlled trial
Get PDFData availability statement:
Data are available upon reasonable request. Data will be made available on the Figshare data repository.Objective: To investigate the safety, feasibility and acceptability of the Neurofenix platform for upper-limb rehabilitation in acute and subacute stroke.
Design: A feasibility randomised controlled trial with a parallel process evaluation.
Setting: Acute Stroke Unit and participants’ homes (London, UK).
Participants: 24 adults (>18 years), acute and subacute poststroke, new unilateral weakness, scoring 9–25 on the Motricity Index (elbow and shoulder), with sufficient cognitive and communicative abilities to participate.
Interventions: Participants randomised to the intervention or control group on a 2:1 ratio. The intervention group (n=16) received usual care plus the Neurofenix platform for 7 weeks. The control group (n=8) received usual care only.
Outcomes: Safety was assessed through adverse events (AEs), pain, spasticity and fatigue. Feasibility was assessed through training and support requirements and intervention fidelity. Acceptability was assessed through a satisfaction questionnaire. Impairment, activity and participation outcomes were also collected at baseline and 7 weeks to assess their suitability for use in a definitive trial.
Randomisation: Computer-generated, allocation sequence concealed by opaque, sealed envelopes.
Blinding: Participants and assessors were not blinded; statistician blinded for data processing and analysis.
Results: 192 stroke survivors were screened for eligibility, and 24 were recruited and randomised. Intervention group: n=16, mean age 66.5 years; median 9.5 days post stroke. Control group: n=8, mean age 64.6 years; median 17.5 days post stroke. Three participants withdrew before the 7-week assessment, n=21 included in the analysis (intervention group n=15; control group n=6). No significant group differences in fatigue, spasticity, pain scores or total number of AEs. The median (IQR) time to train participants was 98 (64) min over 1–3 sessions. Participants trained with the platform for a median (range) of 11 (1-58) hours, equating to 94 min extra per week. The mean satisfaction score was 34.9 out of 40.
Conclusion: The Neurofenix platform is safe, feasible and well accepted as an adjunct to usual care in acute and subacute stroke rehabilitation. There was a wide range of engagement with the platform in a cohort of stroke survivors which was varied in age and level of impairment. Recruitment, training and support were manageable and completion of data was good, indicating that a future randomised controlled trial would be feasible.
Trial registration number: ISRCTN11440079.This work was supported by The Stroke Association and MedCity grant number SA MC 21\10001
Influence of body mass index on outcomes after minimal-access aortic valve replacement through a J-shaped partial upper sternotomy
Full text linkA prospective randomized study of ACL-reconstructions using bone-patellar tendon-bone grafts fixed with bioabsorbable or metal interference screws
Get PDF- …
