903 resultados para DISTAL INTERPHALANGEAL JOINT
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Gray's Reinforcement Sensitivity Theory (RST) consists of the Behavioural Activation System (BAS) which is the basis of Impulsivity, and Behavioural Inhibition System (BIS) which is the basis of Anxiety. In this study, Impulsivity and Anxiety were used as distal predictors of attitudes to religion in the prediction of three religious dependent variables (Church attendance, Amount of prayer, and Importance of church). We hypothesised that Impulsivity would independently predict a Rewarding attitude to the Church and that Anxiety would independently predict an Anxious attitude to the church, and that these attitudes would be proximal predictors of our dependent variables. Moreover, we predicted that interactions between predictors would be proximal. Using structural equation modelling, data from 400 participants supported the hypotheses. We also tested Eysenck's personality scales of Extraversion and Neuroticism and found a key path of the structural equation model to be non-significant. (C) 2003 Elsevier Ltd. All rights reserved.
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Introduction: Enchondromas are among the most current benign bone tumours. Malignant degeneration is extremely rare (<1%) and generally presents as a low grade chondrosarcoma. For localized grade 1 lesions, the treatment of choice is curettage. Wide excision and reconstruction is generally not necessary, unless locally advanced or more aggressive behaviour is suspected at presentation. Case report: A healthy 72 yo male presented with pain and recurrent knee joint effusion. X-rays show a classical central distal metaphyseal enchondroma of the femur associated with subtle osteolysis of the lateral condyle. MRI confirms the presence of a locally aggressive chondromatous lesion based in a classical enchondroma. Core needle biopsy revealed a grade 1 chondrosarcoma, which was in contrast to the radiological aggressiveness of the lesion. Total body CT-scan did not reveal metastatic disease. A wide resection was planned, as a high-grade lesion and joint contamination was suspected. We performed an extra-articular knee resection and reconstruction with a hinged modular total knee megaprosthesis. The definitive histology was grade 1 chondrosarcoma, the surgical margins were wide. The evolution was favourable and the patient was able to perform all his activities of daily living independently without pain at 6 weeks postop. Knee flexion reached 90°. The oncologic screening at 18 months did not show local or distant recurrence. Conclusion: Joints near a benign tumour that suddenly become symptomatic or present an effusion might indicate a malignant transformation. Wide resection and prosthetic reconstruction remains an effective treatment option even in low grade cartilaginous lesions if (1) the adjacent joint is contaminated, or (2) joint-sparing surgery would result in a severe functional impairment of the limb.
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This thesis describes the process of design and modeling of instrument for knee joint kinematics measurement that can work for both in-vivo and in-vitro subjects. It is designed to be compatible with imaging machine in a sagittal plane. Due to the invasiveness of the imaging machine, the instrument is designed to be able to function independently. The flexibility of this instrument allows to measure anthropometrically different subject. Among the sixth degree of freedom of a knee, three rotational and one translational degree of freedom can be measured for both type of subject. The translational, proximal-distal, motion is stimulated by external force directly applied along its axis. These angular and linear displacements are measured by magnetic sensors and high precision potentiometers respectively
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La osteoporosis es una de las condiciones patológicas en mayor crecimiento a medida que la población de tercera edad aumenta, esto se traduce en fracturas por fragilidad como lo son las fracturas de radio distal y las fracturas de cadera, actualmente no se cuentas con datos de la población a estudio que correlacione este tipo de fracturas. Es un estudio retrospectivo de casos y controles donde se obtuvo un grupo de pacientes con fractura de cadera que consultaron a un hospital universitario de alta complejidad en la ciudad de Bogotá, se evaluó la presencia de antecedente de fractura de radio distal y se comparó con un grupo control de trauma en cadera. Se obtuvo un total de 325 casos (72,5%) y 123 (25%) controles. El promedio de edad fue de 81 años, el 70% de los pacientes en ambos grupos correspondió a mujeres. No hubo diferencia en cuanto a la prevalencia de tabaquismo, hipertensión arterial o diabetes en los grupos. No se encontraron diferencias significativas en cuanto a niveles de glicemia, calcio, vitamina D. La presencia de antecedente de fractura de radio distal en grupo con fractura de cadera fue del 7,1% encontrando un OR de 3,91 IC 95%(1,17– 13,10). La presencia de fractura de radio distal como antecedente es un predictor para la fractura de cadera en pacientes mayores. Se necesitan más estudios que correlacionen otras variables que pueden influir en la asociación para fractura de cadera y radio, para así identificar una población específica que se beneficie de un tratamiento temprano.
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This paper provides some additional evidence in support of the hypothesis that robot therapies are clinically beneficial in neurorehabilitation. Although only 4 subjects were included in the study, the design of the intervention and the measures were done so as to minimise bias. The results are presented as single case studies, and can only be interpreted as such due to the study size. The intensity of intervention was 16 hours and the therapy philosophy (based on Carr and Shepherd) was that coordinated movements are preferable to joint based therapies, and that coordinating distal movements (in this case grasps) helps not only to recover function in these areas, but has greater value since the results are immediately transferable to daily skills such as reach and grasp movements.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Medicina Veterinária - FCAV
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Reasons for performing study: Alternative methods to evaluate the joint condition in asymptomatic osteochondrosis dissecans (OCD) and other joint diseases may be useful. Objectives: To investigate possible changes in synovial fluid composition that may lead to joint conditions in asymptomatic OCD, in mature horses. Methods: Animals aged >2 years, of different breeds, with OCD in the intermediate ridge of distal tibia, symptomatic or not, were studied. Synovial fluid samples (10 healthy; 11 asymptomatic OCD; 25 symptomatic OCD) were collected by arthroscopy from 29 horses. Glycosaminoglycans (GAGs) were analysed by a combination of agarose gel electrophoresis and enzymatic degradation with specific GAG lyases. The viscosity, white blood cell (WBC) count, protein concentration and hyaluronic acid (HA) molecular weight were also determined. Results: The method used here to analyse synovial fluid GAGs is reliable, reproducible and specific. The main synovial fluid GAGs are HA and chondroitin sulphate (CS), 93% and 7% respectively in normal horses. In symptomatic OCD, the concentrations of both increased (expressed as GAG/urea ratios), but CS increased more. The CS increased also in asymptomatic OCD. An inflammatory reaction was suggested by the increased WBC counts in OCD. The molecular weight of the synovial fluid HA was reduced in OCD, explaining the lower viscosity observed. Conclusions: The increased CS in synovial fluid of OCD joints in mature horses suggests that the synovial fluid CS and the WBC count are good markers of the joint conditions, allowing the identification of pathological phase in joint diseases. Potential relevance: The analysis of synovial fluid GAGs shows that cartilage damage occurs even in asymptomatic OCD, implying that arthroscopic removal of osteochondral fragments should be performed even in asymptomatic OCD.
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OBJECTIVE: To evaluate the reliability and validity of a novel ultrasound (US) imaging method to measure metacarpophalangeal (MCP) and proximal interphalangeal (PIP) finger joint cartilage. METHODS: We examined 48 patients with rheumatoid arthritis (RA), 18 patients with osteoarthritis (OA), 24 patients with unclassified arthritis of the finger joints, and 34 healthy volunteers. The proximal cartilage layer of MCP and PIP joints for fingers 2-5 was bilaterally visualized from a posterior view, with joints in approximately 90 degrees flexion. Cartilage thickness was measured with integrated tools on static images. External validity was assessed by measuring radiologic joint space width (JSW) and a numeric joint space narrowing (JSN) score in patients with RA. RESULTS: Precise measurement was possible for 97.5% of MCP and 94.2% of PIP joints. Intraclass correlation coefficients for bilateral total joint US scores were 0.844 (95% confidence interval [95% CI] 0.648-0.935) for interobserver comparisons and 0.928 (95% CI 0.826-0.971) for intraobserver comparisons (using different US devices). The US score correlated with JSN for both hands (adjusted R(2) = 0.513, P < 0.001) and JSW of the same finger joints (adjusted R(2) = 0.635, P < 0.001). Reduced cartilage shown by US allowed discrimination of early symptomatic OA versus early RA and healthy joints. In patients with RA, US scores correlated with duration of treatment-resistant, progressive RA. CONCLUSION: The US method of direct visualization and quantification of cartilage in MCP and PIP joints is objective, reliable, valid, and can be useful for diagnostic purposes in patients with arthritis.
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To assess the effect of age and disease on mineral distribution at the distal third of the tibia, bone mineral content (BMC) and bone mineral density (BMD) were measured at lumbar spine (spine), femoral neck (neck), and diaphysis (Dia) and distal epiphysis (Epi) of the tibia in 89 healthy control women of different age groups (20-29, n = 12; 30-39, n = 11; 40-44, n = 12; 45-49, n = 12; 50-54, n = 12; 55-59, n = 10; 60-69, n = 11; 70-79, n = 9), in 25 women with untreated vertebral osteoporosis (VOP), and in 19 women with primary hyperparathyroidism (PHPT) using dual-energy x-ray absorptiometry (DXA; Hologic QDR 1000 and standard spine software). A soft tissue simulator was used to compensate for heterogeneity of soft tissue thickness around the leg. Tibia was scanned over a length of 130 mm from the ankle joint, fibula being excluded from analysis. For BMC and BMD, 10 sections 13 mm each were analyzed separately and then pooled to define the epiphysis (Epi 13-52 mm) and diaphysis area (Dia 91-130 mm). Precision after repositioning was 1.9 and 2.1% for Epi and Dia, respectively. In the control group, at any site there was no significant difference between age groups 20-29 and 30-39, which thus were pooled to define the peak bone mass (PBM).(ABSTRACT TRUNCATED AT 250 WORDS)
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Background Understanding the anatomy of the ligaments of the distal radius aids in the surgical repair of ligamentous injuries and the prediction of intraarticular fracture patterns. Purposes (1) to measure the horizontal and vertical distances of the origins of the radiocarpal ligaments from the most ulnar corner of the sigmoid notch and the joint line, respectively; and (2) to express them as a percentile of the total width of the bony distal radius. Methods We dissected 8 cadaveric specimens and identified the dorsal radiocarpal, radioscaphocapitate, and the long and short radiolunate ligaments. Results The dorsal radiocarpal ligament attached from the 16th to the 52nd percentile of the radial width. The radioscaphocapitate ligament attached around the radial styloid from the 86th percentile volarly to the 87th percentile dorsally. The long radiolunate ligament attached from the 59th to the 85th percentile, and the short radiolunate ligament attached from the 14th to the 41st percentile. Discussion There was a positive correlation between the radial width and the horizontal distance of the ligaments from the sigmoid notch. These findings may aid individualized surgical repair or reconstruction adjusted to patient size and enable further standardized research on distal radial fractures and their relationship with radiocarpal ligaments.
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The objective of the present study was to describe the arthroscopic anatomy of the bovine fetlock joint using one palmar/plantar and three dorsal joint approaches. A comparative anatomic, ultrasonographic and arthroscopic study using 20 cadaveric feet from 13 non-lame adult dairy cows was performed. Arthroscopy was accomplished using a rigid arthroscope to view the synovial cavities with their synovial villi and parts of the following structures: the distal ends of the metacarpal/metatarsal III/IV bones with their trochleae and sagittal ridges, synovial grooves, the articular surfaces of the proximal sesamoid bones, the proximal aspects of the first phalanges, the lateral and medial collateral ligaments, the suspensory ligament and the interdigital ligaments as parts of the interosseus muscle, the cruciate sesamoidean ligaments, the communication site between the lateral and medial pouch in the palmar/plantar area, and dorsally the septum between the lateral and the medial pouch. The technique allowed a good overall view of most relevant structures in the sound cadaver joint. Further investigations are warranted to evaluate the diagnostic, therapeutic and prognostic applications of these techniques in the treatment of septic arthritis.
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Adenoviral vectors were used to deliver genes encoding a soluble interleukin 1 (IL-1)-type I receptor-IgG fusion protein and/or a soluble type I tumor necrosis factor α (TNFα) receptor-IgG fusion protein directly to the knees of rabbits with antigen-induced arthritis. When tested individually, knees receiving the soluble IL-1 receptor had significantly reduced cartilage matrix degradation and white blood cell infiltration into the joint space. Delivery of the soluble TNFα receptor was less effective, having only a moderate effect on white blood cell infiltration and no effect on cartilage breakdown. When both soluble receptors were used together, there was a greater inhibition of white blood cell infiltration and cartilage breakdown with a considerable reduction of synovitis. Interestingly, anti-arthritic effects were also seen in contralateral control knees receiving only a marker gene, suggesting that sustained local inhibition of disease activity in one joint may confer an anti-arthritic effect on other joints. These results suggest that local intra-articular gene transfer could be used to treat systemic polyarticular arthritides.
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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014