Long-term functional outcome of trigger finger

Purpose: The purpose of this study was to explore the long-term functional outcomes of trigger finger (TF) as perceived by the patient.

Methods: Three study groups were included in the study: prolonged follow up TF group (at least 1-year post-treatment) (PF-TF), patients with acute TF and a control group. The first group was recruited retrospectively and included all patients who were diagnosed with TF in one orthopedic clinic and were contacted by phone, 109 agreed to participate. The acute TF and healthy controls participated in a previous controlled study. The Quick Disabilities of the Arm Shoulder and Hand (QuickDASH) and numeric pain scale (NPS) were the main outcome measures.

Results: Both TF groups reported significantly higher levels of disability, particularly in activities requiring strength and more severe pain in comparison with the control group. The acute TF group reported significantly higher levels of disability and pain than the PF-TF group. Seventy-two percent of acute TF group reported moderate to severe pain, in comparison with 37% of the PF-TF group.

Conclusion: According to these data, substantial long-term disability and pain persist in both the acute and chronic settings.

• Implications for rehabilitation

• Recovery from TF may be a prolonged process and a long term follow up should be considered in clinical practice.

• The present study found that TF leads to significant disability, therefore, activity and participation should be addressed in practice.

• Assessment of TF interventions should include outcomes that address the client's perspective using standardized measures of disability, such as the QuickDASH.

     

Diabetes resolution after one anastomosis gastric bypass

Background

Diabetes and other obesity-related diseases are a worldwide pandemic that transcends geographic borders as well as socioeconomic levels. Currently, it is well known that medical treatment alone is insufficient to ensure adequate and sustainable weight loss and co-morbidity resolution. It has been well proven that bariatric surgery can produce almost immediate resolution of diabetes and other co-morbidities as well as long-term weight loss.

Effects of novel neuroprotective and neurorestorative multifunctional drugs on iron chelation and glucose metabolism

Iron accumulation and iron-related oxidative stress are involved in several pathological conditions and provide a rationale for the development of iron chelators as novel promising therapeutic strategies. Thus, we have recently synthesized multifunctional non-toxic, brain permeable iron chelating compounds, M30 and HLA20, possessing the neuroprotective N-propargyl moiety of the anti-Parkinsonian drug, monoamine oxidase (MAO)-B inhibitor, rasagiline and the antioxidant-iron chelating moiety of an 8-hydroxyquinoline derivative of the iron chelator, VK28. Here, we examined the hepatic regulatory effects of these novel compounds using two experimental approaches: chelation activity and glucose metabolism parameters. The present study demonstrated that M30 and HLA20 significantly decreased intracellular iron content and reduced ferritin expression levels in iron-loaded hepatoma Hep3B cells. In electron microscopy analysis, M30 was shown to reduce the electron-dense deposits of siderosomes by ~30 %, as well as down-regulate cytosolic ferritin particles observed in iron-overloaded cells. In vivo studies demonstrated that M30 administration (1 mg/kg, P.O. three times a week) reduced hepatic ferritin levels; increased hepatic insulin receptor and glucose transporter-1 levels and improved glucose tolerance in C57BL/6 mice and in a mouse model of type-2 diabetes, the ob/ob (leptin^?/?). The results clearly indicate that the novel multifunctional drugs, especially M30, display significant capacity of chelating intracellular iron and regulating glucose metabolism parameters. Such effects can have therapeutic significance in conditions with abnormal local or systemic iron metabolism, including neurological diseases.     

The Effect of Helping Behavior and Physical Activity on Mood States and Depressive Symptoms of Elderly People

The current study examines the effects of helping behavior and physical activity on mood states and depressive symptoms of older adults. Participants (n = 102) reported their chronic conditions, volunteering, supporting behavior, and physical activity. Helping behavior, as well as physical activity, was practiced by more than half of the participants. Physical activity was positively associated with cheerfulness and vigor and explained 4% of the variance in both moods. No links were detected between the level of physical activity and depressive symptoms. Helping behavior was positively correlated with cheerfulness and vigor and explained 6% and 22% of these moods, respectively. It was negatively correlated with depressive symptoms and explained 6% of the variance in their occurrence. The positive link between helping behavior and physical exercise can be explained by adaptation theories of aging which regard the psychological benefits of multiple forms of activity in late life.     

Revisional Surgery of One Anastomosis Gastric Bypass for Severe Protein–Energy Malnutrition

Background: One anastomosis gastric bypass (OAGB) is safe and effective. Its strong malabsorptive component might cause severe protein–energy malnutrition (PEM), necessitating revisional surgery. We aimed to evaluate the safety and outcomes of OAGB revision for severe PEM. Methods: This was a single-center retrospective analysis of OAGB patients undergoing revision for severe PEM (2015–2021). Perioperative data and outcomes were retrieved. Results: Ten patients underwent revision for severe PEM. Our center’s incidence is 0.63% (9/1425 OAGB). All patients were symptomatic. Median (interquartile range) EWL and lowest albumin were 103.7% (range 57.6, 114) and 24 g/dL (range 19, 27), respectively, and 8/10 patients had significant micronutrient deficiencies. Before revision, nutritional optimization was undertaken. Median OAGB to revision interval was 18.4 months (range 15.7, 27.8). Median BPL length was 200 cm (range 177, 227). Reversal (n = 5), BPL shortening (n = 3), and conversion to Roux-en-Y gastric bypass (RYGB) (n = 2) were performed. One patient had anastomotic leak after BPL shortening. No death occurred. Median BMI and albumin increased from 22.4 kg/m² (range 20.6, 30.3) and 35.5 g/dL (range 29.2, 41), respectively, at revision to 27.5 (range 22.2, 32.4) kg/m² and 39.5 g/dL (range 37.2, 41.7), respectively, at follow-up (median 25.4 months, range 3.1, 45). Complete resolution occurs after conversion to RYGB or reversal to normal anatomy, but not after BPL shortening. Conclusions: Revisional surgery of OAGB for severe PEM is feasible and safe after nutritional optimization. Our results suggest that the type of revision may be an important factor for PEM resolution. Comparative studies are needed to define the role of each revisional option.     

Molecular targets of the multifunctional iron-chelating drug,M30, in the brains of mouse models of type 2 diabetes mellitus

Background and Purpose

Neurodegenerative diseases are now recognized to be multifunctional, whereby a heterogeneous set of reactions acts independently or cooperatively, leading eventually to the demise of neurons. This has led our group to design and synthesize the multifunctional, nontoxic, brain-permeable, iron chelator compound M30 with a range of pharmacological properties. Here, we have characterized the molecular targets of M30 in the brains of animal models of type 2 diabetes mellitus (T2DM).

Experimental Approach

Effects of M30 on molecular mechanisms associated with neuroprotection in the CNS were investigated-in the high-fat diet (HFD) and ob/ob transgenic mouse models of T2DM, using real-time PCR and Western blotting analyses. Brain monoamine oxidase (MAO) activity and catecholamine levels, and peripheral glucose tolerance were assayed after treatment in vivo.

Key Results

M30 increased cerebral levels of insulin and insulin receptor and phosphorylated-GSK-3β in HFD mice, compared with vehicle-treated HFD mice. In both T2DM mice models, M30 treatment significantly up-regulated cerebral hypoxia-inducible factor (HIF)-1α protein levels and induced the expression of several HIF-1 target genes involved in neuroprotection, glycolysis, neurogenesis, oxidative stress and anti-inflammation. Additionally, M30 inhibited MAO-A and -B activities in the cerebellum. Accordingly, M30 administration significantly reduced brain levels of dopamine metabolites and increased levels of 5-HT and noradrenaline. Glucose tolerance was also improved after M30 treatment in both models of T2DM.

Conclusions and Implications

In the brain of HFD and ob/ob transgenic mice, M30 exerted a variety of beneficial neuroprotective regulatory effects that may act synergistically to delay or prevent neurodegenerative processes associated with T2DM.Tables of Links