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The spectrum of group A streptococcal joint pathology in the acute care setting.

OBJECTIVES: Group A streptococcus (GAS) is a frequent cause of pediatric musculoskeletal infections including septic arthritis, acute rheumatic fever (ARF), and a more benign arthritis called post-streptococcal reactive arthritis. Children with painful joints are frequently evaluated in the acute care setting, and because the presentation of each of these entities is similar, the diagnosis can be difficult to make. Five cases of children with GAS arthridities are presented to demonstrate the spectrum of GAS-associated joint pathologies encountered in the acute care setting and also to discuss

Thyroid cell growth: sphingomyelin metabolism as non-invasive marker for cell damage acquired during spaceflight.

Prolonged spaceflights are known to elicit changes in human cardiovascular, musculoskeletal, and nervous systems, whose functions are regulated by the thyroid gland. It is known that sphingomyelin metabolism is involved in apoptosis (programmed cell death) of thyroid cells induced by UVC radiation, but at present no data exists with regard to this phenomenon, which occurs during space missions. The aim of this study was to analyze, for the first time, the effect of spaceflight on the enzymes of sphingomyelin metabolism, sphingomyelinase, and sphingomyelin synthase, and to determine whether the

Phase 2 open-label study of weekly docosahexaenoic acid-paclitaxel in patients with metastatic uveal melanoma.

Docosahexaenoic acid (DHA)-paclitaxel is a taxane with a unique pharmacokinetic profile. We investigated the safety and response rate of DHA-paclitaxel weekly in patients with metastatic uveal melanoma. Chemotherapy-naive and previously treated patients were eligible for this open-label phase II study. DHA-paclitaxel (500 mg/m²/week) was administered by a 1-hour intravenous infusion for five consecutive weeks in a 6-weeks cycle. Response was assessed using the Response Evaluation Criteria in Solid Tumors every 6 weeks. Twenty-two patients were enrolled. The patients' median age was 56 years (r

Empirical foundations for the diagnosis of somatization: implications for DSM-5.

BACKGROUND: The aim of this study was to develop empirically validated criteria for the diagnoses of clinically relevant somatization. METHOD: This study was performed in a population-representative cohort consisting of 461 males (47.8%) and 503 females (52.2%), with an average age of 55.8 years (s.d.=11.1). Somatization, anxiety and depression were derived from the Composite International Diagnostic Interview. Mplus was used to perform confirmative factor analyses on the current DSM-IV symptom groups; on alternative symptom clusters previously suggested; and to perform latent class analysis

Intravenous gammaglobulin and thalidomide may be an effective therapeutic combination in refractory scleromyxedema: case report and discussion of the literature.

OBJECTIVES: Scleromyxedema, a rare systemic disease of unknown etiology, presents with progressive dermal mucin deposition, causing skin thickening and a variety of gastrointestinal, neurologic, pulmonary, cardiac, and renal complications. Scleromyxedema is notoriously difficult to treat. Our objective was to suggest a new treatment option and to propose a novel tool, musculoskeletal ultrasound, for diagnosis and disease monitoring. METHODS: We present a patient with a severe scleromyxedema with cutaneous, gastrointestinal, hematologic, and neurologic manifestations. Having failed multiple th

Current clinical aspects of dialysis-related amyloidosis in chronic dialysis patients.

The current understanding of dialysis-related amyloidosis has evolved over the past two decades. In the early 1980s, several researchers found amyloid deposits in the synovia of carpal tunnel syndrome (CTS), which have been recognized as a complication of chronic hemodialysis. The enigma was resolved in 1985, when beta2-microglobulin (beta2-m) with a molecular weight of 12,000 Da was identified as the major constitutional protein of this amyloid. Amyloid fibrils of this type that contain the sub-unit protein of human leukocyte antigens (HLA), beta2-m, deposit predominantly in osteoarticular ti

Marfan syndrome--a diagnostic challenge caused by phenotypic and genetic heterogeneity.

OBJECTIVES: Marfan syndrome (MFS) is an autosomal dominant inherited connective tissue disorder caused by mutations in the fibrillin-1 (FBN1) gene with variable clinical manifestations in the cardiovascular, musculoskeletal and ocular systems. METHODS: Data of moleculor genetic analysis and a catalogue of clinical manifestations including aortic elastic parameters were mined in order to (i) assess aortic abnormality before and during medical treatment, and to (ii) identify novel correlations between the genotype and phenotype of the disease using hierarchical cluster analysis and logistic reg

Pain and high sensitivity C reactive protein in patients with chronic low back pain and acute sciatic pain.

BACKGROUND: The severity of pain from musculoskeletal disorders might be associated with high sensitivity C reactive protein (hsCRP), a sensitive marker of low grade systemic inflammation. OBJECTIVE: To study the association between pain as assessed by a visual analogue scale (VAS) and hsCRP in patients with chronic low back pain and acute sciatic pain. METHODS: Information on pain severity, determinants of hsCRP, and hsCRP values were obtained prospectively at up to 10 time points during six months in 72 consecutive patients (mean age 43.3 years; 59.7% female): 41 with chronic low back pain

Rancho Los Amigos Medical Center. A unique orthopaedic resource and teaching institution.

Rancho Los Amigos Medical Center, initially a poor farm in the County of Los Angeles, CA became a world renown medical institution because of the polio epidemics in the 1950s. Responding to the need for day to day inpatient care were an overflow of victims of polio who had spine and extremity weakness and were dependent on respirators. Team care, developed at the institution, was used by Vernon L. Nickel, chief orthopaedic surgeon so that maximum use of the limited staff's efforts would be to take care of patients. This need spawned many innovative developments through clinical observations an

Rheumatic manifestations in patients with thromboangiitis obliterans (Buerger's disease).

OBJECTIVE: To evaluate articular involvement in a large cohort of patients with thromboangiitis obliterans (TAO). METHODS: A retrospective chart review of all patients with TAO admitted to our rheumatology or vascular medicine departments between 1975 and 1995 was undertaken. Patients with a history of osteoarticular involvement were further investigated. This evaluation entailed taking a detailed rheumatologic and musculoskeletal history and physical examination. Laboratory tests and osteoarticular radiographs were obtained. RESULTS: Initial rheumatic manifestations were observed in 11 (12.

Silicone breast implant--associated musculoskeletal manifestations.

Three hundred consecutive women with silicone breast implants (SBI), referred to the arthritis clinic with a variety of musculoskeletal complaints, were evaluated for the presence of underlying connective tissue disease. A complete history and physical examination were performed, as well as laboratory testing for C-reactive protein, rheumatoid factor; and autoantibody determination by indirect immunofluorescence and immunodiffusion. The group mean age was 44.4 years (range 25-69), the mean time from initial implant surgery to appearance of symptoms was 6.8 years (range: 6m-19y) and 83.3% of wo

Demography of a regional pediatric rheumatology patient population. Affiliated Children's Arthritis Centers of New England.

OBJECTIVE: To examine the descriptive epidemiology of a regional cohort of children with rheumatic disease, and to document the variety and frequency of diseases encountered among pediatric rheumatology centers. METHODS: Pediatric rheumatology centers in southern New England participated in a prospective multicenter patient registry. All outpatients attending clinics at 8 pediatric rheumatology centers were enrolled as subjects during the 8-year period of study (n = 4585). Diagnostic criteria defined the rheumatic disease cases which were determined by clinical examination by a pediatric rheu

Clinical parameters associated with falls in an elderly population.

Eighty-one elderly residents of a hostel for the aged (mean age 83.3 years) underwent clinical medical assessments to examine susceptibility to falling. The medical examination was structured and followed a clinical format with particular emphasis upon posture and gait, in addition to routine examination of the cardiovascular, respiratory, neurological, gastrointestinal, haemopoietic, genitourinary, musculoskeletal and visual systems. These subjects were then followed up for 1 year to assess whether these clinical measures were associated with falls. Seventy-six residents were available for fo

Pathological Fractures of the Proximal Femur in Children and Adolescents Treated with LCP Paediatric Hip Plate.

PURPOSE OF THE STUDY Exploring the therapeutic potential of pathological fractures treatment of the proximal femur in childhood with LCP paediatric hip plate system according to the principles of AO. MATERIAL AND METHODS Six children with pathological fractures of the proximal femur and with an unicameral bone cyst have undergone surgery in our institution, in the period between June 2018 up until December 2020. All patients were young boys with a mean age of 11.83 ± 3.43 years. According to the classification of Delbet-Colonna, three of the fractures were Type IV - intertrochanteric fractures

Ultrasound-Detected Salivary Gland and Joint Inflammation Strongly Reflect Patient-Perceived Symptom Burden in Primary Sjögren's Syndrome: A Cross-Sectional Multicenter Study.

Aims. To investigate the relationship between ultrasound (US)-detected parenchymal abnormalities in the major salivary glands (MSG), joint and tendon inflammation, and systemic disease activity in patients with primary Sjögren's syndrome (pSS). Patients and methods. This cross-sectional, multicenter study enrolled 60 patients with pSS and 20 healthy controls (HCs). Systemic disease activity was evaluated using the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), while symptom burden was assessed with the EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI). MSG evaluation included

Терапевтический потенциал зубных мезенхимальных стволовых клеток в сравнении с мезенхимальными стволовыми клетками из других источников: систематический обзор исследований животных.

ЦЕНТРАЛЬНАЯ терапия на основе стволовых клеток, являющаяся одной из важнейших областей регенеративной медицины, направлена на совершенствование механизмов ремонта тела (d) путем стимулирования, модуляции и регулирования внутренних стволовых клеток или пополнения пулов клеток, способствуя тем самым развитию гомеостаза и регенерации тканей и предлагая перспективное лечение многочисленных системных заболеваний. В настоящем систематическом обзоре содержится всеобъемлющее резюме исследований животных, в ходе которых изучается эффективность зубоврачебных мезенхимальных стволовых клеток (НКЦ) в лечен

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… The focus is on the effectiveness in addressing various systemic diseases and their role in regeneration treatments, including those affecting the musculoskeletal system [ 12 – 22 ], mouth [ 23 , 24 ], eyes [ 25 , 26 ], nervous system [ 27 – 31 ], immune system [ 32 – 34 ], skin [ 35 , 36 ], metabolic …

Mitigating errors in musculoskeletal radiology: a multilevel framework.

Reporting errors are an unavoidable reality for any active, practicing radiologist. However, they can be minimised through open discussion, meticulous training, and openness to feedback. In an era marked by escalating imaging volumes, complex caseloads, and systemic workforce burnout, achieving an error-free practice is a statistical impossibility; baseline radiological error rates are estimated in the literature to range between 3% and 5% for decades. However, this reality should not deter radiologists from pursuing continuous diagnostic refinement. This article explores the intricate cogniti

Post-stroke pain syndromes in Africa: epidemiology, clinical phenotypes, and unmet needs in assessment and management.

Stroke disproportionately affects Africa, where incidence and prevalence rates rank among the highest reported worldwide, and case-fatality remains high. As acute survival improves in many, though not all, African settings, the burden of chronic post-stroke sequelae is growing, yet non-motor complications such as pain remain comparatively neglected in both clinical practice and research relative to motor and cognitive outcomes. Post-stroke pain is a heterogeneous group of syndromes, including central post-stroke pain, hemiplegic shoulder pain, spasticity-related musculoskeletal pain, post-stro

Cortistatin as a pleiotropic regulator of neuroimmune and inflammatory pathways in experimental disease: a scoping review of preclinical evidence.

BACKGROUND: Inflammatory diseases represent a major global health burden, and current therapies frequently fail to achieve sustained control of inflammation or prevent progressive tissue damage. Cortistatin (CST), an endogenous neuropeptide structurally related to somatostatin, has emerged as a multifunctional regulator of neuroimmune and immunometabolic pathways. METHODS: This scoping review was conducted in accordance with PRISMA-ScR guidelines and maps and synthesizes preclinical evidence on the biological roles and therapeutic potential of CST across experimental disease models. RESULTS:

Adductor Injuries in Athletes: Evidence-Based Treatment.

Adductor injuries represent a notable musculoskeletal burden among athletes accounting for half of acute hip injuries in soccer and nearly one quarter in professional basketball. The pyramidalis-anterior pubic ligament-adductor longus complex represents a critical anatomic concept for understanding injury patterns with the adductor longus most injured. Clinical evaluation follows the Doha agreement classification, emphasizing adductor tenderness and pain on resisted adduction testing to differentiate adductor-related groin pain from other etiologies. Magnetic resonance imaging provides compreh