986 resultados para Injections, Intra-Articular


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Pós-graduação em Medicina Veterinária - FMVZ

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Pós-graduação em Medicina Veterinária - FMVZ

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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This study aimed at evaluating the effectiveness of partial use of anterior repositioning appliances in the management of TMJ pain and dysfunction when compared to stabilization splints and a control group in a one-year follow-up. Sample was initially constituted by 60 patients, randomly divided into three groups: I- stabilization splints, II- repositioning splints and III- no treatment. The whole sample was evaluated by means of TMJ and muscle palpation, mandibular AROM, analysis of occlusal contacts, joint sounds inspection and Visual Analogue Scale (VAS) for one year; 52 patients composed the final sample. A significant (after 15 days) improvement in pain report (VAS) and palpation index was found for group II (p≤0.01). The occurrence of occlusal alterations as posterior open bite or gross interferences after the splint therapy and increased muscle tenderness were not problems in this study. Similar results in joint noises reduction were observed for the entire sample. It was concluded that controlled partial use of repositioning splints is a beneficial tool in the management of intra-articular pain and dysfunction, with no risks of irreversible occlusal changes.

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Individuals with temporomandibular disorders (TMD) often have signs and symptoms such as intra-articular pain, muscle spasm, neck pain radiating from others who interfere with this balance. Over time can lead to postural changes and correction of the cervical spine, anterior head and shoulder asymmetry. The aim was to verify the effects of manual therapy on posture in subjects with TMD. Materials and methods: 30 volunteers (mean: 21.43± SD:1.43) of both sexes who had TMD classified according to axis I of the Research Diagnostic Criteria participated in this study. These were photographed in the anterior frontal and sagittal planes for analysis of the following angles (acromion clavicular joint, sternoclavicular joint, orbicular external, corners of the mouthand and protruding head). After, the volunteers were divided into groups ATM (manual therapy in the treatment of temporomandibular joint), Cervical (manual therapy in the treatment of cervical joint) and Control. The Kolmogokov-Smirnov test, followed by ANOVA, considering a significance level of 5% was used. Results: Groups ATM, Cervical and Control were considered homogeneous with respect to the values of the angles measured. These also showed no significant difference between the 1st, 5th and 10th sessions, so the manual therapy techniques applied to the TMJ and Cervical groups were not sufficient to change postural alignment. Conclusion: The postural alignment, the TMD patients evaluated in this study did not change after attending the sessions proposals with manual therapy techniques in the cervical and TMJ.

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Pain control is an important aspect of equine medicine. Musculoskeletal and gastrointestinal diseases are the most important clinical and surgical painful situations in this specie. In these cases, opioids have been used successfully for the treatment of pain, administered both local (intra-articular and epidural) and systemically. Otherwise, opioids, specially mu agonists like morphine, present important side effects in horses. Amongst these effects, CNS stimulation with increased motor activity and impairment of intestinal motility are observed in several cases. Therefore, adequate dosing of administration are essential for the safe use of opioids in horses

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One of the main causes of incapacity in athletes, be they human or equines, is the occurrence of intra-articular lesions. The equines are each time more required in his athletic performance, resulting in intense stress to the structures that composes the locomotor device. The leading cause of human and equine athlete’s functional incapacity is the intra-articular disorders. One of the greatest advances in sports medicine was the development of arthroscopy as a minimal invasive intra-articular surgery. The defining characteristic of diagnostic or surgical arthroscopy is featured by minimal tissue damage and broad inspection of internal structures inside the joint associated with low morbidity and complications. The advantages of surgical arthroscopy over traditional surgery are well known: limited hospitalization, early return to competition, lower risks of post-operative joint rigidity, magnification of inspected structures, joint lavage associated or not with removal of potentially dangerous substances. Arthroscopy cannot replace conventional methods and must not do so; however, the intrinsic limitations of conventional diagnostic techniques, such as radiology and synovial fluid analysis, must be kept in mind, particularly in evaluating damage to cartilage and the synovial membrane. Arthroscopy has now become the accepted method of performing all joint surgery, however it is mainly used for radical surgery, such as osteochondral fragment removal, surgical curettage and arthroplasty

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Temporomandibular joint arthrocentesis is a method of flushing out the synovial fluid that is currently performed by providing a double puncture to the upper joint space. The traditional 2-needle technique has some restrictions, such as the difficulty in performing it in the presence of intra-articular adherences and in the female patients, because the space is very small. The adoption of a single-needle for fluid injection might have some advantages with respect to the traditional 2-needle approach in terms of easily, time of execution and tolerability. We describe a single needle technique and we recommend the use.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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The purpose of this study was to assess the effect of low level laser therapy on subjects with intra-articular temporomandibular disorders (IA-TMD), and to quantify and compare severity of signs and symptoms before, during, and after the laser applications. The sample consisted of 45 subjects randomly divided into three groups (G) of 15 subjects each: G-I: 15 individuals with IA-TMD submitted to an energy dose of 52.5 J/cm(2); G-II: dose of 105.0 J/cm(2); and G-III: placebo group (0 J/cm(2)). In all groups, the applications were performed on condylar points on the masseter and anterior temporalis muscles. Two weekly sessions were held for five weeks, totaling 10 applications. The assessed variables were: mandibular movements and painful symptoms evoked by muscle palpation. These variables were measured before starting the study, then immediately after the first, fifth, and tenth laser application, and finally, 32 days after completing the applications. The results showed that there were statistically significant differences for G-I and G-II at the level of 1% between the doses, as well as between assessments. Therefore, it was concluded that the use of low level laser increased the mean mandibular range of motion and reduced painful symptoms in the groups that received effective treatment, which did not occur in the placebo group.

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PURPOSE: To assess comparatively the inflammatory response that follows CO2 or Ringer's lactate joint capsular distension of horses submitted to experimental arthroscopy METHODS: Each animal was submitted to a bilateral tarsocrural arthroscopy employing gas distention in one joint and fluid distention in the contralateral joint. Synovial fluid was evaluated at 0, six, 12, 24 and 48 hours post-operative. RESULTS: The use of CO2 for arthroscopy causes an acute and mild synovitis alike to the liquid capsular distension, showing similar synovial fluid increase of leukocytes, TP, and TNF-alpha. Although synovial fluid PGE(2) content was higher in joints submitted to CO2 distension, lower levels of hemoglobin and leukocytes oxidative burst after surgery indicates that CO2 arthroscopy decreased intra-articular bleeding and activation of infiltrating leukocytes. CONCLUSIONS: The use of CO2 for arthroscopic examination causes acute and mild synovitis that is similar to the effects caused by the liquid capsular distension. CO2 also seems to decrease intra-articular bleeding and activation of leukocytes.

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The purpose of the present study was to determine ultrasound (US) arthrography diagnostic accuracy in patients with recurrent shoulder dislocation by comparing US arthrography and magnetic resonance arthrography (MRA) with intraoperative findings. Fifty-six consecutive patients with diagnosis of chronic anterior instability of the shoulder were evaluated for assessment of bone and soft tissue lesions by three radiologists. Twenty-five cases were confirmed by surgery. Sensitivity, specificity, inter-and intraobserver agreement were calculated. Ultrasound sensitivity ranged from 20% to 100% and specificity from 25% to 90%. MRA sensitivity ranged from 80% to 100% and specificity from 50% to 100%. Interobserver agreement was good for MRA (0.54-0.70) and fair for US arthrography (0.19-0.40). Despite a higher interobserver variability for US arthrography than for MRA, our results indicate that US is capable of demonstrating bone and soft tissue lesions related to chronic instability of the shoulder in the presence of intra-articular fluid. (E-mail: marcelo_simao@hotmail.com) (C) 2012 World Federation for Ultrasound in Medicine & Biology.

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Arthritis of the knee is the most common type of joint inflammatory disorder and it is associated with pain and inflammation of the joint capsule. Few studies address the effects of the 810-nm laser in such conditions. Here we investigated the effects of low-level laser therapy (LLLT; infrared, 810-nm) in experimentally induced rat knee inflammation. Thirty male Wistar rats (230-250 g) were anesthetized and injected with carrageenan by an intra-articular route. After 6 and 12 h, all animals were killed by CO(2) inhalation and the articular cavity was washed for cellular and biochemical analysis. Articular tissue was carefully removed for real-time PCR analysis in order to evaluate COX-1 and COX-2 expression. LLLT was able to significantly inhibit the total number of leukocytes, as well as the myeloperoxidase activity with 1, 3, and 6 J (Joules) of energy. This result was corroborated by cell counting showing the reduction of polymorphonuclear cells at the inflammatory site. Vascular extravasation was significantly inhibited at the higher dose of energy of 10 J. Both COX-1 and 2 gene expression were significantly enhanced by laser irradiation while PGE(2) production was inhibited. Low-level laser therapy operating at 810 nm markedly reduced inflammatory signs of inflammation but increased COX-1 and 2 gene expression. Further studies are necessary to investigate the possible production of antiinflammatory mediators by COX enzymes induced by laser irradiation in knee inflammation.

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Hev b 13 is an allergenic esterase obtained from the rubber tree Hevea brasiliensis, which has been shown recently to induce human monocytes to release interleukin (IL)-10 in vitro, and to exert a potent anti-inflammatory effect in vivo. Moreover, Hev b 13 has been shown to reduce clinical signs of inflammation and also histological damage to the distal colon of mice with 2,4,6-trinitrobenze sulphonic acid (TNBS)-induced colitis after its oral administration. The aim of this study was to investigate the effect of Hev b 13 on human mononuclear cells, as well as its therapeutic use in the methylated bovine serum albumin (mBSA) model of antigen-induced arthritis. Five days before the intra-articular challenge, and daily thereafter for 8 days, Hev b 13 was administered by oral gavage. In mice treated with a dose of 0.5 mg/kg of Hev b 13, the severity of oedema, leucocyte infiltration, pannus formation and cartilage erosion were reduced significantly. These findings underscore the anti-inflammatory activity suggested previously for Hev b 13, an activity speculated to be related to its interaction with monocytes/macrophages and the consequent stimulation of IL-10 release and reduction of tumour necrosis factor (TNF) release. The study also opens a wide range of possible applications in the field of immune-mediated inflammatory diseases.