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Christian Carulli Fabrizio Matassi Roberto Civinini Massimo Morfini Massimiliano Tani Massimo Innocenti 《The Knee》2013,20(1):36-39
IntroductionHaemophilic arthropathy is the most common clinical manifestation of haemophilia, secondary to recurrent haemarthrosis and chronic synovitis, and the knee represents the main target joint. Modern bleeding prevention has significatively limited the incidence of severe arthropathy, and primary approach is usually conservative. Viscosupplementation is felt as one of the most efficient treatments for the early stages of knee haemophilic arthropathy, based on short-term follow-up studies. The aim of this prospective case series study is to assess the clinical effectiveness of intra-articular administration of hyaluronic acid in the knee, evaluating long-term results, and focusing on the necessity of further treatments after viscosupplementation.MethodsTwenty-seven haemophilic patients with knee arthropathy underwent at least two cycles of injections of hyaluronians between 2003 and 2009. They were evaluated with VAS, SF-36, WFH, Pettersson score, and WOMAC, with a seven-year follow-up.ResultsAll patients showed improvement in pain relief and functional recovery without any complications. Considering the severity of arthropathy in haemophilic patients, only a limited number of subjects (five) underwent total knee arthroplasty for persistent pain or functional limitation.ConclusionsViscosupplementation is a safe and effective therapeutic strategy in knee haemophilic arthropathy, with no complications, persisting good clinical results, and determining in most cases a delay of surgery. 相似文献
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Nicolas Chatron Véronique Haddad Joris Andrieux Julie Désir Odile Boute Anne Dieux Clarisse Baumann Séverine Drunat Marion Gérard Céline Bonnet Bruno Leheup Marianne Till Massimiliano Rossi Elisabeth Flori Yves Alembik Helen Stewart Joanna McParland Laura Bernardini Pia Castelluccio Laura Roos Zeynep Tümer Kerry Fagan Anna Hackett Nicole Bain Arie van Haeringen Claudia Ruivenkamp Brigitte Benzacken Damien Sanlaville Patrick Edery Azzedine Aboura Caroline Schluth‐Bolard 《American journal of medical genetics. Part A》2015,167(5):1008-1017
79.
Context:
Although balance is generally recognized to be an important feature in ensuring good performance in soccer, its link with functional performance remains mostly unexplored, especially in young athletes.Objective:
To investigate changes in balance induced by fatigue for unipedal and bipedal static stances in young soccer players.Design:
Crossover study.Setting:
Biomechanics laboratory and outdoor soccer field.Patients or Other Participants:
Twenty-one male soccer players (age = 14.5 ± 0.2 years, height = 164.5 ± 5.6 cm, mass = 56.8 ± 6.8 kg).Intervention(s):
Static balance was assessed with postural-sway analysis in unipedal and bipedal upright stance before and after a fatigue protocol consisting of a repeated sprint ability (RSA) test (2 × 15-m shuttle sprint interspersed with 20 seconds of passive recovery, repeated 6 times).Main Outcome Measure(s):
On the basis of the center-of-pressure (COP) time series acquired during the experimental tests, we measured sway area, COP path length, and COP maximum displacement and velocity in the anteroposterior and mediolateral directions.Results:
Fatigue increased all sway values in bipedal stance and all values except COP velocity in the mediolateral direction in unipedal stance. Fatigue index (calculated on the basis of RSA performance) was positively correlated with fatigue/rest sway ratio for COP path length and COP velocity in the anteroposterior and mediolateral directions for nondominant single-legged stance.Conclusions:
Fatigued players exhibited reduced performance of the postural-control system. Participants with better performance in the RSA test appeared less affected by balance impairment, especially in single-legged stance.Key Words: postural sway, repeated sprint ability test, athletesKey Points
- In young soccer players, balance was adversely affected by fatigue.
- A moderate correlation existed between balance impairment and repeated sprint ability performance.
Balance and Fatigue
Both localized and whole-body fatigue cause degradation of postural-control performance, which is evident in the form of increased postural sway (ie, constant, slight corrective deviations from vertical when standing upright).11 This phenomenon, which has been extensively reported in the literature, is mainly due to changes in cardiac and respiratory contractions, fluid movement in the body, and release of metabolic products by muscle fibers and is caused by altered sensory information from the proprioceptive system.12 The magnitude of sway increase is partly influenced by exercise intensity and duration, but it also depends on the muscular groups involved.13 From this point of view, localized fatigue and whole-body fatigue are thought to trigger different disturbances of the postural-control system,14 although the net effect in terms of balance impairment may appear similar.Typical experiments aimed at assessing the effect of fatigue on static balance involve exercise such as the treadmill,15–17 cycle or rowing ergometer,14,15,18 isokinetic concentric actions, squat jumps, and heel raises.14,19 A few authors20,21 have evaluated the fatiguing effects of actual sport performance in triathletes22 and soccer players. In particular, Zemkova and Hamar20 and Brito et al21 analyzed center-of-pressure (COP) velocity of 19- to 21-year-old players (unipedal and bipedal stances with eyes open or closed) before a game, in the break period between the first and second halves, and after a game. When visual input was present, single-legged balance was reduced after the match. Less evident was the effect of fatigue on bipedal standing: changes were observed only when the support surface was unstable and visual input suppressed.The lack of experimental data regarding the effects of fatigue on balance in soccer players is somewhat surprising, considering that fatigue is implicated in injury occurrence23 and that a deficit in postural control may increase the risk of ankle injuries.24 Thus, it is reasonable to hypothesize that not only may fatigue associated with performance in a match impair balance (and thereby increase the risk of injuries) but also that superior physical fitness in better-trained athletes may limit this effect.Our goal was to assess postural-sway changes induced by fatigue subsequent to a controlled field test (repeated sprint ability [RSA]) representative of actual soccer activity in a cohort of young elite soccer players. We had 2 questions: (1) Is unipedal and bipedal static balance impaired by fatigue? (2) Is there a functional relationship between performance level in RSA and balance alterations? 相似文献80.
Rossella Gioco Daniela Corona Burcin Ekser Lidia Puzzo Gaetano Inserra Flavia Pinto Chiara Schipa Francesca Privitera Pierfrancesco Veroux Massimiliano Veroux 《World journal of gastroenterology : WJG》2020,26(38):5797-5811
Gastrointestinal complications are common after renal transplantation, and they have a wide clinical spectrum, varying from diarrhoea to post-transplant inflammatory bowel disease(IBD). Chronic immunosuppression may increase the risk of post-transplant infection and medication-related injury and may also be responsible for IBD in kidney transplant re-cipients despite immunosuppression. Differentiating the various forms of post-transplant colitis is challenging, since most have similar clinical and histological features. Drug-related colitis are the most frequently encountered colitis after kidney transplantation, particularly those related to the chronic use of mycophenolate mofetil, while de novo IBDs are quite rare. This review will explore colitis after kidney transplantation, with a particular focus on different clinical and histological features, attempting to clearly identify the right treatment, thereby improving the final outcome of patients. 相似文献