The effects of corticosteroid injection versus local anesthetic injection in the treatment of lateral epicondylitis: a randomized single-blinded clinical trial

Introduction

This study seeks to compare two treatment methods of lateral epicondylitis: corticosteroid injection (CSI) and a local anesthetic injection (LAI).

Materials and methods

In this single-blinded randomized clinical trial, 138 patients with the diagnosis of lateral epicondylitis were assigned either into CSI group receiving methylprednisolone 1 ml (49 patients) or LAI group (51 patients) receiving procaine 1 ml 2 % in a single dose at the maximal point tenderness site. The primary outcome measure was elbow disability using Quick DASH, and secondary outcome measures were pain intensity using Visual Analogue Scale (VAS) and recurrence rate at pretreatment visit and at 3-, 6- and 12-week post-treatment visits.

Results

There were no significant differences between the patients in both groups for demographic factors including age, gender, dominant hand, involved hand, and work pressure. Before treatment, the patients in both groups were suffering from the same rates of elbow disability and pain as measured by Quick DASH and VAS, respectively, (p > 0.05). In general, the recovery rate (comparison between pretreatment visit and last post-treatment visit) was significantly more effective and higher in CSI than LAI. CSI was dramatically more effective at 3-week visit, but less and less effective at 6- and 12-week visits. At 12-week visit the recurrence rate was 34.7 % (17 patients) in CSI group.

Conclusion

For lateral epicondylitis, CSI has the best short-term treatment results yet the highest recurrent rates. The combination of CSI with other treatment option or with a change in injection technique from single injection to peppering injection may be promising.     

Measurement of the mechanical properties of soccer balls using digital image correlation method

There are some features for an approved soccer ball by Fédération Internationale de Football Association (FIFA), such as properties of the material, mass, pressure, stitches, etc. Many of these features up to now have been studied; nevertheless, the mechanical properties of the soccer balls to date have not been well reported. The chief purposes of the current research, hence, were to calculate the mechanical properties of the soccer balls, i.e., linear elastic, nonlinear hyperelastic, and viscoelastic, at two different sizes, including 4 and 5 which are using for football and futsal, respectively. To do this, compressive and stress-relaxation loading were applied to 38 approved soccer balls to quantify the stress–strain as well as reduced relaxation function of the balls. The strain/displacement of the balls was also measured via a high-speed camera using Digital Image Correlation (DIC) technique. The results revealed the mean elastic modulus of 66 and 67 kPa for the football and futsal balls, respectively. In addition, the maximum stresses of the football and futsal balls were 16 and 13 kPa, respectively. The nonlinear mechanical response of the soccer balls were analyzed using hyperelastic material models, i.e., Mooney-Rivlin and Ogden. A Finite Element (FE) model was also developed to verify the hyperelastic data compared to the experimental ones and, remarkably, the numerical data were in consistence with the experimental data. Finally, Prony- series was employed to quantify the viscoelastic properties of the balls. During the game, a soccer ball can reach to a speed of 210 km/h that can damage the human eye; however, the injury detail still has not been studied.     

Albuminuria in type 2 diabetes mellitus: from remission to progression

Objective Albuminuria is an early marker of renal impairment and a powerful factor of progression of renal disease in type 2 diabetes (T2D). Approximately, one-third of patients with T2D have micro- or macroalbuminuria and these patients have a high risk of progression toward End Stage Renal Disease (ESRD) as well as increased cardiovascular disease. The aim of this study was to determine the prevalence of remission, regression, persistence, and progression of albuminuria, and to evaluate the impact of change in albuminuria on kidney disease and cardiovascular disease in a prospective cohort of patients with T2D. Methods This is a prospective study. The Ethics Committee of Morocco’s Mohammed V University in Rabat approved the study protocol. Inclusion criteria targeted patients who were type 2 diabetics with albuminuria?>30?mg/day, and who had been regularly followed-up in nephrology consultation for at least 36 months. Results Five-hundred twenty-four patients were included. 75.8 and 24.6% of all patients had micro- and macroalbuminuria at enrollment in the study. At the end of the study, 91, 141, 199, and 93 patients had remission, regression, persistence, and progression of albuminuria, respectively. Remission of microalbuminuria to normoalbuminuria was observed in 23.6% of cases. Regression of macroalbuminuria to micro- was observed in 29.9% of cases. Conclusion In our study, the incidence of remission and/or regression of micro- and macroalbuminuria was higher. The incidence of ESRD and the occurrence of cardiac events were greater in the regression, persistence, and progression groups than in the remission of albuminuria group.