Validity and internal consistency of the Helsinki Serratus Palsy Index for patients with serratus palsy.

Background: To our knowledge, no validated scales exist as yet for measuring quality of life and functioning level in patients with serratus palsy. This cross-sectional survey study examined whether a broadly validated Western Ontario Rotator Cuff Index (WORC) could be partially adapted for patients with serratus palsy.

Methods: The relevancy of WORC, 21 items, along with 4 additional new items, was tested by 95 patients with serratus palsy and a panel of 9 medical experts.

High burden of adverse events is associated with reduced remission rates in early rheumatoid arthritis.

Adverse events (AEs) are common during disease-modifying antirheumatic drug (DMARD) treatment, but their influence on treatment results is unclear. We studied AEs in relation to disease activity in early rheumatoid arthritis (RA). Ninety-nine patients started intensive treatment with three conventional synthetic DMARDs (csDMARDs) and oral prednisolone, and were randomized to a 6-month induction treatment with infliximab or placebo.

Total joint replacement in inhibitor-positive haemophilia: Long-term outcome analysis in fifteen patients.

Aim: To collect data from joint replacement in inhibitor patients, evaluate haemostatic and patient outcomes, and analyse the costs.

Methods: We report our 21-year, single-centre cumulative experience of 15 joint arthroplasties in six inhibitor patients.

Results: Two low responder inhibitor patients were in the early days treated with FVIII, whereas bypassing agents were used in the rest of the high responder patients.

Accuracy of 837 pedicle screw positions in degenerative lumbar spine with conventional open surgery evaluated by computed tomography.

Background: The spatial and directional accuracy of the positioning of pedicle screws in the lumbosacral spine with conventional open surgery assessed by computed tomography (CT) has been published in several studies, systematic reviews and meta-analyses with a short-term follow-up. Inaccurate pedicle screw insertion may cause neurologic symptoms and weakens the construct.

Methods: The data of 147 patients operated on with transpedicular screw fixation based on anatomical landmarks, supported by fluoroscopy, by a senior neurosurgeon in our clinic between 2000 and 2010 were analyzed retrospectively.

Is a long leg a risk for hip or knee osteoarthritis?

Background and purpose - 7% of the asymptomatic population has leg-length inequality (LLI) greater than 12 mm. It has been proposed that LLI of >5 mm can be associated with an increased risk of osteoarthritis (OA) of the knee and hip. We studied a possible association between LLI and OA of the knee and hip joint.

Laser-ultrasonic delivery of agents into articular cartilage.

Research is ongoing to develop drug therapies to manage osteoarthritis (OA) and articular cartilage (AC) injuries. However, means to deliver drug to localized AC lesions are highly limited and not clinically available. This study investigates the capability of laser ultrasound (laser-induced plasma sound source) to deliver agents (methylene blue, MB, in PBS) into bovine AC.

Isolated serratus palsy etiology influences its long-term outcome.

Hypothesis And Background: The cause of isolated serratus palsy is multifactorial, but evaluation of the mechanism of the injury indicates that the lesion to the long thoracic nerve is mechanical in origin in most cases. What is unknown, however, is how etiology influences its long-term outcome. We believed that overuse injuries may recover sooner and better than acute traumatic, infectious, or inflammatory injuries.

Reliability of Measuring Lower-Limb-Muscle Electromyography Activity Ratio in Activities of Daily Living With Electrodes Embedded in the Clothing.

Context: Using technical clothes with electrodes embedded in the clothing makes it possible to record the electrical activity produced by the activity of the skeletal muscles in activities of daily living.

Objective: To investigate the reliability of measuring lower-limb left-right electromyography (EMG) activity ratio with smart shorts during stair descent, stair ascent, and repeated unloaded squats among healthy working-aged subjects.

Methods: Seventeen females (mean age 25.

Progression of untreated mild thoracic Scheuermann's kyphosis - Radiographic and functional assessment after mean follow-up of 46 years.

Background: There is no data available on the radiographic development of the Scheuermann's deformity. Our purpose was to investigate radiographic deformity progression and the relation between kyphosis progression and clinical outcome in patients with untreated Scheuermann's kyphosis.

Methods: Thoracic kyphosis (Th4-Th12) was measured from standing lateral radiographs in 19 patients at baseline and after mean 46-year follow-up.

Effects of thromboprophylactic doses of apixaban and rivaroxaban on coagulation and thrombin generation in association with total hip replacement.

Factor Xa inhibitors (FXaI) apixaban and rivaroxaban are used for thromboprophylaxis after major elective orthopaedic surgery. Because few patient sample studies exist, we postoperatively assessed patients undergoing unilateral total hip arthroplasty, including 22 treated with apixaban (2.5 mg BID) and 20 treated with rivaroxaban (10 mg OD).

The interaction of emotion and pain in the insula and secondary somatosensory cortex.

Pain is processed in a large neural network that partially overlaps structures involved in emotion processing. Despite the fact that pain and emotion are known to share neural regions and interact in numerous clinical conditions, relatively little is known about the interaction of pain and emotion at the neural level. This study on healthy adults aimed to investigate the interaction between negative and positive emotional stimuli and experimental pain in an essential pain processing network.

Increased preoperative knowledge reduces surgery-related anxiety: a randomised clinical trial in 100 spinal stenosis patients.

Purpose: To assess the impact of preoperative knowledge on anxiety, health-related quality of life (HRQoL), disability, and pain in surgically treated spinal stenosis patients.

Methods: One hundred patients were randomised into an intervention group (IG, n = 50) or control group (CG, n = 50). Both groups received routine preoperative patient education.

Range of motion of diabetic frozen shoulder recovers to the contralateral level.

Objective To determine whether frozen shoulder heals equally well in patients with and without diabetes and whether dependency on insulin affects the outcome. Methods We retrospectively examined 178 patients with idiopathic frozen shoulder; 27 patients had diabetes. We evaluated range of motion, pain, and functional results.

Intra-articular glucocorticoid injections should not be neglected in the remission targeted treatment of early rheumatoid arthritis: a post hoc analysis from the NEO-RACo trial.

Objectives: To study the effects of neglecting intra-articular glucocorticoid injections (IAGCIs) into swollen joints in early rheumatoid arthritis (RA).

Methods: Ninety-nine patients with early, DMARD naive RA were treated, aiming at remission, with methotrexate, sulfasalazine, hydroxychloroquine, low-dose oral prednisolone and, when needed, IAGCIs for 2 years, and randomised to receive infliximab or placebo from weeks 4 to 26. During each of the 15 study visits, patients were scored retrospectively 0.

The Knowledge Test Feedback Intervention (KTFI) increases knowledge level of spinal stenosis patients before operation-A randomized controlled follow-up trial.

Objective: To assess the impact of a preoperative educational intervention on the knowledge level of patients with spinal stenosis.

Methods: One hundred spinal stenosis patients were randomized into a preoperative educational intervention group (IG, n=50) or a control group (CG, n=50). All the patients received routine preoperative education.

Patient outcome after surgical management of the spinal accessory nerve injury: A long-term follow-up study.

Objectives: A lesion in the spinal accessory nerve is typically iatrogenic: related to lymph node biopsy or excision. This injury may cause paralysis of the trapezius muscle and thus result in a characteristic group of symptoms and signs, including depression and winging of the scapula, drooped shoulder, reduced shoulder abduction, and pain. The elements evaluated in this long-term follow-up study include range of shoulder motion, pain, patients' satisfaction, delay of surgery, surgical procedure, occupational status, functional outcome, and other clinical findings.

Clinical evaluation of a biomechanical guidance system for periacetabular osteotomy.

Background: Populations suffering from developmental dysplasia of the hip typically have reduced femoral coverage and experience joint pain while walking. Periacetabular osteotomy (PAO) is one surgical solution that realigns the acetabular fragment. This challenging surgery has a steep learning curve.

The Role of Macrophages in the Biological Reaction to Wear Debris from Artificial Joints.

Normal usage of total joint replacements results in the production of wear debris and other byproducts. In particular, polyethylene particles are heavily involved in the stimulation of local and systemic biological reactions resulting in chronic inflammation, periprosthetic bone resorption (osteolysis), and eventually implant loosening. As sentinels of the innate immune system, cells of the monocyte/macrophage lineage initiate the inflammatory cascade that lead to osteolysis.

Differentially Expressed in Chondrocytes 2 (DEC2) Increases the Expression of IL-1β and Is Abundantly Present in Synovial Membrane in Rheumatoid Arthritis.

Objective: Patients with rheumatoid arthritis (RA) have altered circadian rhythm of circulating serum cortisol, melatonin and IL-6, as well as disturbance in the expression of clock genes ARNTL2 and NPAS2. In humans, TNFα increases the expression ARNTL2 and NPAS2 but paradoxically suppresses clock output genes DPB and PER3. Our objective was to investigate the expression of direct clock suppressors DEC1 and DEC2 (BHLHE 40 and 41 proteins) in response to TNFα and investigate their role during inflammation.

Soluble biglycan: a potential mediator of cartilage degradation in osteoarthritis.

Background: Soluble biglycan (sBGN) and soluble decorin (sDCN), are two closely related essential components of extracellular matrix which both have been shown to possess proinflammatory properties. We studied whether sBGN or sDCN were present in synovial fluid (SF) of osteoarthritis (OA) or rheumatoid arthritis (RA) patients and studied sBGN or sDCN potential role in the degradation of OA cartilage.

Methods: SF obtained from meniscus tear, OA, and RA patients were analysed for sBGN and sDCN using enzyme-linked immunosorbent assays.

Open Surgical Treatment for Snapping Scapula Provides Durable Pain Relief, but so Does Nonsurgical Treatment.

Background: Resection of the medial upper corner of the scapula is one option for treating patients with a painful chronic snapping scapula. However, the degree to which this procedure results in sustained relief of pain during long-term followup, and whether surgical treatment offers any compelling advantages over nonsurgical approaches at long-term followup, are not known.

Questions/purposes: We asked: (1) At long-term followup after surgical treatment of a painful snapping scapula, did patients' pain decrease? (2) Did scapulocostal crepitation improve? (3) Did patients return to work?

Methods: Between 1971 and 1992, 15 patients underwent surgery by one surgeon for persistent (> 1 year) and severely painful crepitus around the superomedial scapula that did not respond to nonsurgical approaches.

Diminished salivary epidermal growth factor secretion: a link between Sjögren's syndrome and autoimmune gastritis?

Objectives: Healthy human labial salivary glands produce epidermal growth factor (EGF). In Sjögren's syndrome (SS), EGF staining is diminished. SS is also associated with chronic autoimmune corpus gastritis.

Osteogenic differentiation of mesenchymal stromal cells in two-dimensional and three-dimensional cultures without animal serum.

Introduction: Bone marrow-derived mesenchymal stromal cells (MSCs) have been intensely studied for the purpose of developing solutions for clinical tissue engineering. Autologous MSCs can potentially be used to replace tissue defects, but the procedure also carries risks such as immunization and xenogeneic infection. Replacement of the commonly used fetal calf serum (FCS) with human platelet lysate and plasma (PLP) to support cell growth may reduce some of these risks.