Interactions between fascicles and tendinous tissues in gastrocnemius medialis and vastus lateralis during drop landing

Animal tendons have been shown to act as shock absorbers to protect muscle fascicles from exercise‐induced damage during landing tasks. Meanwhile, the contribution of tendinous tissues to damping activities such as landing has been less explored in humans. The aim of this study was to analyze in vivo fascicle‐tendon interactions during drop landing to better understand their role in energy dissipation. Ultrafast ultrasound images of the gastrocnemius medialis (GM) and vastus lateralis (VL), lower limb electromyographic activity, 2‐D kinematics, and ground reaction forces were collected from twelve participants during single‐ and double‐leg drop landings from various heights. For both muscles, length changes were higher in tendinous tissues than in fascicles, demonstrating their key role in protecting fascicles from rapid active lengthening. Increasing landing height increased lengthening and peak lengthening velocity of VL fascicle and GM architectural gear ratio, whereas GM fascicle displayed similar length and velocity patterns. Single‐leg landing lengthens the tendinous tissues of GM and, to a greater degree, VL muscles, without affecting the fascicles. These findings demonstrate the adjustment in fascicle‐tendon interactions to withstand mechanical demand through the tendon buffer action and fascicle rotation. The higher VL fascicle contribution to negative work as the drop height increases would suggest muscle‐specific damping responses during drop landing. This can originate from the distal‐to‐proximal sequence of joint kinetics, from differences in muscle and tendon functions (one‐ and two‐joint muscles), architectural and morphological properties (eg, tendon stiffness), as well as from the muscle activity of the GM and VL muscles.     

Etanercept provides a more physiological approach in the treatment of psoriasis

Psoriasis is a common chronic inflammatory disease affecting the skin and joints. Moderate to severe psoriasis is traditionally treated with systemic treatments, which can be effective but are often associated with relevant adverse effects, even when administered intermittently or rotationally. Biologic therapies may provide high and consistent efficacy over time, long-term safety, and simple administration schedules compared with nonbiologic therapies, and can be used in patients intolerant and/or resistant to these therapies. TNF-antagonists have a definite advantage over other biologic agents (e.g., T-cell targeting drugs) in the early and late manifestations of joint involvement. TNF-antagonists are a class of drugs with distinct pharmacokinetic and pharmacodynamic properties, and different safety profiles. Etanercept provides a more "physiological" mechanism of action compared to anti-TNF antibodies. Etanercept has less dramatic effects on TNF homeostasis although it has been proved to be highly effective in blocking psoriatic joint erosions. It maintains stable efficacy over time on skin psoriasis, also when used intermittently. Moreover, etanercept has been shown to be not immunogenic, and it only slightly increases the risk of granulomatous infections compared to anti-TNF antibodies. According to the "physiologic" paradigm of selection among TNF-antagonists linked to more or less physiologic mechanism of action, etanercept appears to be the anti-TNF of choice for treating most patients with moderate to severe plaque psoriasis and psoriatic arthritis, possibly even at an early stage.     

Incidence and mortality data from cutaneous melanoma in Trentino: registry-based study

BACKGROUND: The province of Trento has been the target of health campaigns for early diagnosis of cutaneous melanoma for 30 years. OBJECTIVE: To evaluate incidence and mortality data of skin melanoma in the province from January 1992 to December 2001. METHODS: The study is based on the provincial skin cancer registry and the regional mortality registry. Standardized incidence and mortality rates were computed, and time trends were evaluated. Incidence rates were modeled using Poisson regression. RESULTS: Five hundred fifty-four melanomas were diagnosed (226 in males and 328 in females). No period effect was revealed. Incidence rates in females were about 1.24 times those in males. No significant trend in mortality rates was observed. CONCLUSION: We examined incidence and mortality data of cutaneous melanoma during a 10-year period and failed to find any significant trend. It seems we have reached a plateau after many years of continuous, intensive health campaigns.