RESUMO

O presente relato de caso avaliou o meloxicam solução oral spray com o sistema de absorção transmucosa no tratamento de um cão tripedal acometido por osteoartrose em joelho e coluna. Além da avaliação ortopédica, foram realizados questionários de avaliação de dor, baropodometria, termografia e monitoramento de atividade.

The present case report evaluated the meloxicam oral solution spray with the transmucosal absorption system in the treatment of a three-legged dog affected by osteoarthritis in the knee and spine. In addition to the orthopedic evaluation, assessments of pain, baropodometry, thermography, and activity monitoring were carried out.

El presente informe de caso evaluó el spray de solución oral de meloxicam con el sistema de absorción transmucosa en el tratamiento de un perro de tres patas afectado por osteoartritis en la rodilla y columna. Además de la evaluación ortopédica, se realizaron cuestionarios de evaluación del dolor, baropodometría, termografía y monitoreo de la actividad.

Assuntos

RESUMO

This study assessed the efficacy of an intra-articular injection of allogeneic adipose tissue-derived from mesenchymal stem cells (AD-MSCs) for the treatment of hip dysplasia in dogs. The study group included 12 otherwise healthy dogs of different breeds, ages, weights, and degrees of hip dysplasia diagnosed using radiography. An orthopedic assessment was performed on all dogs before and at 30, 60, and 90 days after infusion of AD-MSCs(2 × 106cells). On the same days, each dog's owner answered a questionnaire based on theHelsinkiChronic Pain Index. The data were converted to ordinal data based on the score for each variable, and the Friedman test for multiple comparisons was used to verify the results. Compared with the corresponding values on day 0, orthopedic and gait assessments and owners' reported pain indexes improved over the 90-day observation period. These results suggested that treatment with allogeneic AD-MSCs significantly reduced the clinical signs associated with hip dysplasia during the study period. However, long-term studies are needed to determine the optimal therapeutic protocol for routine clinical use of AD-MSCs in hip dysplasia.

O objetivo deste estudo foi avaliar a eficácia clínica da aplicação intra-articular de células-tronco mesenquimais alógenas derivadas do tecido adiposo (AD-CTM) no tratamento de cães portadores de osteoartrite secundária a displasia do coxofemoral (DCF). Doze cães de ambos os sexos, diferentes raças, idades e peso, portadores de graus variados de DCF comprovada em radiografia e livres de quaisquer outras alterações clínicas ou ortopédicas, foram utilizados no estudo. Todos os cães foram submetidos a avaliação ortopédica nos dias 0, 30, 60 e 90 após aplicação de AD-CTM na dose de 2 x 106. Além disso, os tutores preencheram a um questionário, baseado no Índice de dor crônica de Helsinque (IDCH) nos mesmos intervalos. Em comparação com o dia 0, observou-se melhora significativa na avalição em locomoção e físico-ortopédica assim como na avaliação dos tutores pelo IDCH ao longo dos 90 dias. Os resultados permitem inferir que as AD-CTM alógenas contribuíram significativamente para a redução dos sinais clínicos comumente associados a DCF durante o período de estudo. Entretanto, há necessidade de estudos de longo prazo para melhor determinação de protocolos terapêuticos baseados no uso de AD-CTM na rotina clínica.

Assuntos

RESUMO

Proliferative tenosynovitis (PT) is an inflammatory and proliferative disorder of the synovial membrane of the tendon sheath that is rare in animals. The histological alterations are characterized by multinodular neovascularization, with infiltration of histiocytic and multinucleated giant cells and haemosiderin deposition. We reviewed necropsy and biopsy records of horses submitted to the Setor de Anatomia Patológica of the Universidade Federal Rural do Rio de Janeiro from January 2017 to December 2020 to select cases of PT. We identified PT in three adult Brazilian Mangalarga Marchador horses with nodular lesions on the metacarpophalangeal, metatarsophalangeal or carpal joints. The three horses were under 6 years of age and presented with lameness and pain on palpation. There were recurrences in two horses after surgical removal. Radiographic and ultrasound examinations detected masses in the flexor or extensor tendons and subtendinous bursa. Histological study of synovial membrane and tendon sheath revealed an increased number of vessels, fibroplasia, osseous metaplasia and infiltration of lymphocytes, plasma cells and siderophages. This is the first description of PT in horses, which should be included as an orthopaedic differential diagnosis, especially in Mangalarga Marchador horses with lameness.

Assuntos

RESUMO

Introducción: La osteoartritis es una enfermedad articular crónica degenerativa con componente inflamatorio caracterizado por degeneración y pérdida progresiva del cartílago hialino y hueso subcondral y daño del tejido sinovial. Objetivo: Describir los aspectos clínicos y epidemiológicos de los pacientes con diagnóstico de osteoartritis en el Hospital Provincial de Zaire en la República de Angola, en el período comprendido entre septiembre de 2021 a septiembre de 2022. Método: Se realizó un estudio descriptivo, de cohorte longitudinal, con datos del Departamento de Ortopedia y Traumatología de dicha institución. El universo estuvo constituido por 489 pacientes, la muestra del estudio quedó conformada por n꓿167. Se realizaron pruebas de correlación bivariable con el análisis del coeficiente de correlación de Pearson. Resultados: El grupo etario predominante fue de 61 a 70 años (28,7 %), con predominio del sexo femenino (58,1 %), con un tiempo de evolución mayor a 5 años (35,9 %), la articulación mayormente afectada fue la rodilla con 62 pacientes. Se demostró que existe una correlación positiva considerable entre el tiempo de evolución de la enfermedad y el grado de discapacidad, mediante valor del coeficiente de Pearson (0,407), resultado que muestra significación estadística. Conclusiones: La osteoartritis es una enfermedad degenerativa de etiología variada que se presenta en edades tempranas, con mayor frecuencia en el sexo femenino asociada a la articulación de la rodilla, existiendo correlación entre el tiempo de evolución con el grado de discapacidad que produce.

Introduction: Osteoarthritis is a chronic degenerative joint disease, with an inflammatory component included, its characterized by degeneration and progressive loss of hyaline cartilage and subchondral bone and also for synovial tissue damage. Objective: To describe the clinical and epidemiological aspects of patients diagnosed with osteoarthritis at the Provincial Hospital of Zaire in the Republic of Angola, from September 2021 to September 2022. Method: A descriptive, longitudinal cohort study was carried out using the data gathered from the Department of Orthopedics and Traumatology of the institution. The universe consisted of 489 patients and the study sample consisted of n꓿167. Bivariate correlation tests were performed using the Pearson's correlation coefficient analysis. Results: The predominant age group was 61 to 70 years old (28.7%), with women sex as predominant (58.1%), with an evolution time of more than 5 years (35.9%), and the knee was the most affected joint (observed in 62 patients). A considerable positive correlation between the time of the disease evolution and the degree of disability was demonstrated using the Pearson's coefficient value (0.407), value that shows a great statistical significance. Conclusions: Osteoarthritis is a degenerative disease of varied etiology that occurs at early ages, more frequently in the female sex associated with the knee joint, and there is a correlation between the time of evolution and the degree of disability produces by the disease.

Introdução: A osteoartrite é uma doença articular degenerativa crônica com componente inflamatório caracterizada por degeneração e perda progressiva da cartilagem hialina e lesão do osso subcondral e tecido sinovial. Objetivo: Descrever os aspectos clínicos e epidemiológicos dos pacientes diagnosticados com osteoartrite no Hospital Provincial do Zaire na República de Angola, no período de setembro de 2021 a setembro de 2022. Método: Foi realizado um estudo descritivo, de coorte, longitudinal, com dados do Departamento de Ortopedia e Traumatologia da referida instituição. O universo foi composto por 489 pacientes, a amostra do estudo foi composta por n꓿167. Os testes de correlação bivariada foram realizados por meio da análise do coeficiente de correlação de Pearson. Resultados: A faixa etária predominante foi de 61 a 70 anos (28,7%), com predominância do sexo feminino (58,1%), com tempo de evolução superior a 5 anos (35,9%), a articulação mais acometida foi o joelho com 62 pacientes. Foi demonstrado que existe uma correlação positiva considerável entre o tempo de evolução da doença e o grau de incapacidade, através do valor do coeficiente de Pearson (0,407), resultado que apresenta significância estatística. Conclusões: A osteoartrite é uma doença degenerativa de etiologia variada que ocorre em idade precoce, mais frequentemente no sexo feminino associada à articulação do joelho, havendo correlação entre o tempo de evolução com o grau de incapacidade que produz.

RESUMO

O presente trabalho avaliou os efeitos analgésicos do carprofeno associado ou não à condroitina com glicosamina no tratamento de 26 cães com osteoartrite, distribuídos nos grupos: GT ­ carprofeno (Carproflan®); GTP ­ carprofeno e glicosaminoglicanos (Carproflan® e Procart®); e GC ­ somente analgésico (dipirona). A evolução dos pacientes foi classificada na escala de claudicação no dia do primeiro atendimento e aos 7, 14 e 21 dias. No GT, 60% dos animais apresentou melhora clínica a partir do 7º dia, 30% não alterou seu escore de claudicação e 10% apresentou êmese a partir do 7º dia, com suspensão da medicação. No GTP, 60% dos animais apresentou melhora clínica a partir do 7º dia, 30% não alterou seu escore de claudicação, 5% apresentou êmese a partir do 7º dia e 5% a partir do 14º dia, com suspensão da medicação. No GC, nenhum animal apresentou melhora clínica. Conclui-se que os animais submetidos ao tratamento com carprofeno apresentaram melhora na claudicação, principalmente quando associado aos glicosaminoglicanos.(AU)

The analgesic effects of carprofen associated or not with chondroitin with glucosamine were evaluated in the treatment of 26 dogs with osteoarthritis, distributed into groups: TG ­ carprofen (Carproflan®); PTG ­ carprofen and glycosaminoglycans (Carproflan® and Procart®); and CG ­ only analgesic (dipyrone). The evolution of patients was classified on the lameness scale on the first day of care and at 7, 14 and 21 days. In the TG, 60% of the animals showed clinical improvement from the 7th day, 30% did not change their lameness score and 10% had emesis from the 7th day, with discontinuation of the medication. In the PTG, 60% of the animals showed clinical improvement from the 7th day, 30% did not change their lameness score, 5% had emesis from the 7th day and 5% from the 14th day, with discontinuation of the medication. In the CG, no animal showed clinical improvement. It was concluded that animals undergoing treatment with carprofen showed improvement in lameness, especially when associated with glycosaminoglycans.(AU)

Assuntos

RESUMO

OBJECTIVES: This study aimed to evaluate the efficacy of hyaluronic acid in the viability and proliferation profile of human femoral-tibial joint cartilage affected by osteoarthritis using in vitro models of chondrocytes in a 2-dimensional (2D)- and 3-dimensional (3D)-based culture model by spheroids. DESIGN: In vitro study of knee cartilage affected by osteoarthritis that required surgical treatment. Samples were cultured and exposed to hyaluronic acid (100 and 500 µM; intervention group) or vehicle solution. In monolayer or 2D culture, proliferation and cell viability were measured, and nuclear morphometry was analyzed by 4',6'-diamino-2-fenil-indol (DAPI) staining. The 3D-based culture established from the culture of articular cartilage of patients submitted to total knee arthroplasty evaluated the diameter, viability, and fusion ability of the chondrospheres created. RESULTS: Samples from 3 patients resulted in viable cultures, with chondrocyte cells exhibiting a potential for cell proliferation and viability to establish a culture. Hyaluronic acid (100 and 500 µM) improved chondrocyte viability and proliferation up to 72 hours in contact when compared with the control group, and no nuclear irregularities in morphology cell characteristics were observed by DAPI. In the 3D evaluation, hyaluronic acid (500 µM) improved the cellular feedback mechanisms, increasing the survival and maintenance of the chondrospheres after 7 days of analysis, showing the intrinsic capacity of chondrospheres grouped in the attempt to rearrange and reestablish new articular tissue. CONCLUSIONS: The 2D- and 3D-based culture models with hyaluronic acid improved chondrocyte viability and proliferation and demonstrated the ability of freshly formed chondrospheres to undergo fusion when placed together in the presence of hyaluronic acid.

Assuntos

RESUMO

BACKGROUND: Hemophilia is characterized by the development of joint bleeds that cause long-term joint damage (hemophilic arthropathy). Joint damage leads to disability and affects psychosocial aspects in patients with hemophilia. OBJECTIVE: To compare the clinical situation, perception of disease and quality of life, and coping strategies in adult patients with hemophilia in El Salvador and Spain. METHODS: In this comparative clinical study, 43 patients with hemophilia aged between 18 and 50 years old from Spain and El Salvador participated. After obtaining the patients' consent, they completed the Illness Perception Questionnaire-Revised (IPQ-R), Hemophilia-QoL and Inventory of Coping strategies questionnaires. Joint status was assessed using the Hemophilia Joint Health Score and based on a record of clinical and treatment data. RESULTS: Hemophilia patients from Spain showed an improved perception of quality of life (p <0.05), although there were only differences in the self-criticism variable (p = 0.04) for coping strategies. Joint damage and age correlated (p <0.05) negatively with perception of disease, perceived quality of life and coping strategies in both populations. There were differences (p <0.05) between the two populations based on HIV and HCV coinfections in perception of disease and perceived quality of life. CONCLUSION: Patients with hemophilia in El Salvador exhibit a poorer perception of disease and quality of life. Despite differences in access to treatment from one country to the other, there is no difference in coping with the disease. Older patients are better able to adapt to the disease.

RESUMO

RESUMEN Introducción: La artropatía hemofílica (AH) cursa con diferentes manifestaciones clínicas importantes, como son las hemorragias articulares, el dolor, la disminución de la amplitud del movimiento y las alteraciones funcionales que pueden causar secuelas en la funciona lidad y movilidad. El ejercicio físico adaptado a los pacientes con hemofilia puede ser una adecuada estrategia terapéutica, que repercuta positivamente sobre la calidad de vida de dichos sujetos. Objetivos: Evaluar la eficacia de la rehabilitación física en el tratamiento de la artropatía hemofílica. Materiales y métodos: Se ha realizado una revisión sistemática y metaánálisis de ensayos clí nicos (seleccionados según criterios de elegibilidad). Para ello, se han utilizado las siguientes bases de datos: PEDro, Pubmed, Scopus y Web of Science. Se empleó la escala «PEDro¼ para evaluar la calidad metodológica de los estudios. Resultados: Tras aplicar los criterios de inclusión y exclusión, en la revisión final fueron incluidos siete artículos, los cuales aportaron resultados favorables sobre la fuerza y el diá metro muscular, el rango de movilidad, el estado articular y la calidad de vida. De ellos, dos estudios aportaron datos para metaanálisis, con resultados favorables sobre la variable dolor [Diferencia de medias estandarizada (DME) = -2,64; IC 95%: (-4,26; 1,03)]. Conclusiones: Se encontró evidencia sobre la eficacia de la rehabilitación física en el trata miento de la artropatía hemofílica. El ejercicio terapéutico (ET) es el principal tratamiento realizado; con este se obtuvieron mejoras significativas en distintas variables físicas.

ABSTRACT Introduction: Haemophilic arthropathy presents with different important clinical disorders, such as joint disease, pain, decreased range of motion, and functional alterations that can produce limitations in functionality and mobility. The physical exercise adapted to patients with haemophilia can be an adequate therapeutic strategy, having a positive impact on the quality of life of these subjects. Objectives: To identify the published clinical trials that evaluate the efficacy of physical rehabilitation in the treatment of haemophilic arthropathy. Materials and methods: A systematic review and meta-analysis of clinical trials was con ducted (using pre-defined eligibility criteria). The literature search was performed in the databases: PEDro, Pubmed, Scopus, and Web of Science. The quality of the methods used in the studies was evaluated using the PEDro scale. Results: After applying the inclusion and exclusion criteria, 7 studies were included in this review, providing favourable results on muscle strength and circumference, range of motion, joint disease, and quality of life. Moreover, 2 articles contributed information to the meta-analysis, showing favourable results on pain [Standardised mean difference (SMD) = -2.64; 95% CI: (-4.26; 1.03)]. Conclusions: This systematic review found evidence on the efficacy of physical rehabilitation in the treatment for haemophilic arthropathy. Therapeutic exercise is the main treatment carried out, obtaining significant improvements in the different physical outcomes.

Assuntos

RESUMO

RESUMEN: Introducción: Muchos estudios han demostrado que las enfermedades degenerativas articulares Temporomandibulares (EDATM) provocan dolor, alteran la función modificando las estructuras esqueletales que se traducen en asimetrías faciales. La valoración imagenológica contribuye a un adecuado diagnóstico con el objetivo de optimizar la evaluación morfológica de las articulaciones temporomandibulares. Metodología: Se realizó una búsqueda electrónica en las bases de datos de PubMed, Google Scholar y SciELO. La estrategia de búsqueda se realizó utilizando una combinación de términos con el objetivo de analizar la valoración de las características imagenológicas y de volumen condilar. Resultados y Discusión: De un total de 9807 artículos se seleccionaron 18 que cumplían con los requisitos. Se han propuesto muchas categorías para clasificar la severidad imagenológica de la EDATM sumado al advenimiento de softwares y reconstrucciones tridimensionales que han propuesto categorías a través de algoritmos matemáticos y de superposición de imagen que son un gran aporte para el diagnóstico, la toma decisiones en la elección del plan de tratamiento y en el seguimiento. Conclusiones: La valoración de la severidad de las EDATM son claves para que la investigación clínica permita esclarecer los procesos que se relacionan con el objeto de valorar la progresión de esta enfermedad.

ABSTRACT: Introduction: Many studies have shown that Temporomandibular degenerative joint diseases (TMDJD) cause pain, alter function by modifying skeletal structures that result in facial asymmetries. Imaging evaluation contributes to an adequate diagnosis with the aim of optimizing the morphological evaluation of the temporomandibular joints. Methodology: An electronic search was performed in the PubMed, Google Scholar and SciELO databases. The search strategy was performed using a combination of terms in order to analyze the assessment of imaging characteristics and condylar volume. Results and Discussion: From a total of 9807 articles, 18 were selected that met the requirements. Many categories have been proposed to classify the imaging severity of the TMDJD added to the advent of software and three-dimensional reconstructions that have proposed categories through mathematical algorithms and image superposition that are a great contribution to diagnosis, decision-making and choice of the treatment plan and follow-up. Conclusions: The assessment of the severity of TMDJD is key for clinical research in order to clarify the processes that are related to assessing the progression of this disease.

Assuntos

RESUMO

Objetive: The degenerative diseases of the tempo-romandibular joint (TMJ) are characterized by a progressive destruction of the articular tissues of the condyle and the glenoid fossa. The main aim of this review is to describe the effectiveness of the hyaluronic acid (HA) in the treatment of degenerative diseases of the TMJ in accordance with the available scientific evidence. Material and Methods: A literature search was made in the following databases EBSCO, Pubmed, Cochraneand Trip Database, using the keywords hyaluronic, hyaluronan, NaH, hyaluronate, TMJ, TMD, CMD, craniomandibular, orofacial pain and temporomandibular. There were no date or language restrictions applied. Results: After applying inclusion and exclusion criteria, 14 studies were included in this review (11 randomized controlled clinical trials and 3 non-randomized clinical trials). Conclusion: The studies reported a decrease in pain and improvement in functional parameters after treatment of TMJ osteoarthritis with HA . The use of arthrocentesis associated with the administration of HA provides effects synergistic, reaching a superiority the protocols with multiple injections with respect to those of a single session. The adverse effects related to the injection of HA with or without associated arthrocentesis were minor and transitory.

Resumen: Objetivo: Las enfermedades degenerativas de la articulación temporomandibular (ATM) se caracterizan por una destrucción progresiva de tejidos articulares en el cóndilo y la fosa glenoidea. El objetivo principal de esta revisión es describir la efectividad del uso de ácido hialurónico en el tratamiento de enfermedades degenerativas de la articulación temporomandibular de acuerdo con la evidencia científica disponible. Material y Métodos: Se realizó una búsqueda de la literatura en las bases de datos electrónicas EBSCO, PubMed, Cochrane y Trip Database, utilizando las palabras claves hyaluronic, hyaluronan, NaH, hyaluronate, tmj, tmd, cmd, craniomandibular, orofacial pain y temporomandibular, sin límite de fecha ni de idioma hasta Mayo del año 2020, complementada con una búsqueda retrógrada. Resultados: Con base en los criterios de inclusión y exclusión, 14 estudios fueron incluidos en esta revisión (11 ensayos clínicos controlados aleatorizados y 3 ensayos clínicos controlados no aleatorizados). Conclusión: Los estudios reportaron una disminución del dolor y mejora en los parámetros funcionales luego del tratamiento de osteoartritis de la ATM con AH. El uso de artrocentesis asociada a la administración del AH provee efectos sinérgicos, alcanzando una superioridad los protocolos con múltiples inyecciones con respecto a aquellos de una sola sesión. Los efectos adversos relacionados con la inyección de AH con o sin artrocentesis asociada fueron menores y transitorios.

Assuntos

RESUMO

Background: Osteoarthritis is a degenerative joint disease that affects specially cartilage, meniscus, and tendons. Ligaments, muscles, subchondral bone and synovium. This pathology is a common condition limiting the quality of life ofpatients. Imaging modalities have also been used for evaluation the progression of the osteoarthritis, or degenerative processes induced by acute injury. In order to use more accessible imaging modalities for experimentation, this study aimedto compare radiographic, computed tomography, and ultrasound findings in the evaluation of osteoarthritis induced by thecranial cruciate ligament transection model in rabbits.Materials, Methods & Results: Twenty-four male Norfolk rabbits aged approximately 5 months old were used. All rabbits were submitted to cranial cruciate ligament transection of the left stifle and evaluated 45 days after the surgery. Theradiographic findings were subchondral bone sclerosis (33.33%); joint space narrowing (66%); presence of osteophytesat medial femoral condyle (4.16%), lateral femoral condyle (4.16%), medial fabela (20.83%), lateral fabela (8.33%) andsesamoid of the popliteal muscle (4.16%). No osteophytes were seen at medial and lateral tibial condyles. The tomographiccomputed findings were joint space narrowing (62.5%); presence of osteophytes at medial femoral condyle (75%), lateralfemoral condyle (54.16%), medial fabela (66.66%), lateral fabela (37.5%), medial tibial condyle (75%), lateral tibialcondyle (20.83%) and sesamoid of the popliteal muscle (37.5%). The ultrasound findings were synovial hypertrophy(95.83%); effusion in the suprapatellar recess (75%), distal tibial recess (16.66%) and cranial joint space (75%); changes(hyperechogenic foci and heterogeneity) of the lateral meniscus (50%) and medial meniscus (25%); increased thickness ofthe medial condyle (54.16%) and lateral condyle (45.83%); irregularity of the medial condyle (66.66%) and lateral condyle...(AU)

Assuntos

RESUMO

Background: Osteoarthritis is a degenerative joint disease that affects specially cartilage, meniscus, and tendons. Ligaments, muscles, subchondral bone and synovium. This pathology is a common condition limiting the quality of life ofpatients. Imaging modalities have also been used for evaluation the progression of the osteoarthritis, or degenerative processes induced by acute injury. In order to use more accessible imaging modalities for experimentation, this study aimedto compare radiographic, computed tomography, and ultrasound findings in the evaluation of osteoarthritis induced by thecranial cruciate ligament transection model in rabbits.Materials, Methods & Results: Twenty-four male Norfolk rabbits aged approximately 5 months old were used. All rabbits were submitted to cranial cruciate ligament transection of the left stifle and evaluated 45 days after the surgery. Theradiographic findings were subchondral bone sclerosis (33.33%); joint space narrowing (66%); presence of osteophytesat medial femoral condyle (4.16%), lateral femoral condyle (4.16%), medial fabela (20.83%), lateral fabela (8.33%) andsesamoid of the popliteal muscle (4.16%). No osteophytes were seen at medial and lateral tibial condyles. The tomographiccomputed findings were joint space narrowing (62.5%); presence of osteophytes at medial femoral condyle (75%), lateralfemoral condyle (54.16%), medial fabela (66.66%), lateral fabela (37.5%), medial tibial condyle (75%), lateral tibialcondyle (20.83%) and sesamoid of the popliteal muscle (37.5%). The ultrasound findings were synovial hypertrophy(95.83%); effusion in the suprapatellar recess (75%), distal tibial recess (16.66%) and cranial joint space (75%); changes(hyperechogenic foci and heterogeneity) of the lateral meniscus (50%) and medial meniscus (25%); increased thickness ofthe medial condyle (54.16%) and lateral condyle (45.83%); irregularity of the medial condyle (66.66%) and lateral condyle...

Assuntos

RESUMO

RESUMEN: El objetivo: del presente estudio fue efectuar una revisión actualizada de la morfología, fisiopatología y aspectos moleculares de la capa fibrocartilaginosa de las ATM en humanos. Método: se realizó búsqueda electrónica y manual con los términos MeSH "TMJ" y "fibrocartilage", sin límite de fecha o idioma. Los desenlaces definidos fueron: morfología del fibrocartílago, fisiopatología del fibrocartílago articular, modeladores moleculares del fibrocartílago y deterioro del fibrocartílago. Resultados: Se identificaron 1.071 títulos de artículos que después de las exclusiones, fueron seleccionados 16 a texto completo para la revisión. El fibrocartílago (FC) que cubre las superficies de las ATM es un tejido crítico en el establecimiento y la tasa de progresión de las alteraciones óseas degenerativas, clínicamente sus discontinuidades se asocian a patologías que provocan dolor, ruidos y limitación funcional. Conclusiones: A pesar de la diversidad metodológica, heterogeneidad de objetivos y diferentes características de los estudios incluidos en la revisión, el fibrocartílago de la ATM, como tejido avascular, determina fisiología de baja capacidad reparativa y mayor frecuencia de patología del FC en mujeres en edad fértil, asociado a receptores hormonales. La fisiopatología muestra reacciones inmunitarias que incrementan la acción de MMPs, interleucinas y FNTα, responsables de la degradación de la matriz extracelular, destrucción celular y morfológica del fibrocartílago, que conducen a sintomatología inflamatoria y degenerativa de pacientes que presentan artralgias y sinovitis en las ATM.

ABSTRACT: The aim: of the present study was to carry out an updated review of the morphology, physiopathology and molecular aspects of the TMJ fibrocartilage in humans. Method: electronic/manual search was performed with the MeSH terms "TMJ" and "fibrocartilage", with no date or language limit. The defined outcomes were: morphology of the fibrocartilage, physiopathology of the articular fibrocartilage, fibrocartilage molecular modelers and fibrocartilage deterioration. Results: 1071 articles were identified and after exclusions, 16 full-texts were selected for review. The fibrocartilage (FC) that covers the surfaces of the TMJ is a critical tissue in the establishment and progression rate of degenerative bone diseases; clinically, its discontinuities are associated with pain, noise and functional limitation. Conclusions: In spite of the methodological diversity, heterogeneity of objectives and different characteristics of the patients included in the review, TMJ fibrocartilage, as avascular tissue, determines a physiology of low reparative capacity, observed with greater frequency of FC damage in women of fertile age, associated with a greater amount of hormonal receptors. The physiopathology shows that the immune reactions increase some MMPs, interleukins and FNTα, which are linked to the degradation of the extracellular matrix, FC cellular and morphological destruction and define the inflammatory and degenerative symptomatology of patients who present TMJ arthralgia´s and synovitis.

Assuntos

RESUMO

Anterior mandibular dislocation (AMD) is defined as the displacement of the condylar head out of the glenoid fossa beyond the articular eminence, and that does not reduce spontaneously to its normal position. The Hippocratic method is the usual approach for condylar repositioning at most health centers although it is perceived by the patient as an unpleasant, brusque technique and outcomes are not always favorable. OBJECTIVE: The aim of this work is to describe a new simplified nontraumatic manual technique and its application in a series of cases. METHOD: A procedure based on gently and constantly guiding the patient's mouth opening and closing movements is described in detail. RESULTS: Forty-two patients were treated with a treatment success rate of 100%, and no pain associated with the procedure. Procedure time was 1.5-7 min in 40 of the 42 treated cases. CONCLUSION: The procedure presented here is an improvement on the original technique: it is simple, fast, effective, can be performed in any setting, and avoids use of brusque force, which is the factor that causes the patient most discomfort and fear.

Assuntos

RESUMO

Na atualidade, a pesquisa envolvendo células-tronco mesenquimais destaca-se na busca de avanços na reparação da cartilagem articular. Objetivou-se, no presente estudo, comparar a regeneração cartilaginosa da articulação coxofemoral de coelhos, com e sem o transplante de células-tronco mesenquimais autólogas, por meio de exames radiográficos e histopatológicos. Dois grupos, com 15 animais da espécie leporina cada, foram submetidos à indução química de osteoartrite com solução de colagenase 2% na articulação coxofemoral direita. No Grupo 1 (Células-tronco) realizou-se a aplicação  intra-articular de células-tronco mesenquimais autólogas. Já o Grupo 2 (Controle) foi constituído por animais submetidos à aplicação intra-articular de solução salina estéril. Foram realizadas avaliações radiográficas e histopatológicas aos 30, 60 e 90 dias após a aplicação. Os resultados histológicos indicam que células-tronco mesenquimais (Grupo 1) melhoraram discretamente a qualidade do tecido de reparo, de acordo com os critérios da escala semi-quantitativa ICRS 1 (International Cartilage Repair Society). O Grupo 1 (Células-Tronco) demonstrou superioridade em relação ao Grupo 2 nos parâmetros: Superfície articular, matriz extracelular e distribuição celular, demonstrando que as células-tronco foram benéficas no tratamento da osteoartrite.

The aim of this study was to compare cartilage regeneration of the hip in rabbits, with and without the transplantation of autologous mesenchymal stem cells. Thirty rabbits were submitted to chemical induction of osteoarthritis with a 2% colagenase in the right hip. They were divided into 2 groups of 15 animals each: Group 1 (intra-articular application of autologous mesenchymal stem cells) and Group 2 (control - intra-articular application of sterile saline solution). Radiographic and histopathological evaluations were performed at 30, 60 and 90 days after application. The mesenchymal stem cells group (Group 1) showed slight improvement of the quality of the repair tissue, according to the semi-quantitative scale criteria ICRS 1 (International Cartilage Repair Society). The Group 1 (Stem Cells) showed superiority in relation to Group 2, especially in the parameters joint surface, extracellular matrix and cellular distribution, demonstrating that stem cells were beneficial in the treatment of osteoarthritis.

Assuntos

RESUMO

Na atualidade, a pesquisa envolvendo células-tronco mesenquimais destaca-se na busca de avanços na reparação da cartilagem articular. Objetivou-se, no presente estudo, comparar a regeneração cartilaginosa da articulação coxofemoral de coelhos, com e sem o transplante de células-tronco mesenquimais autólogas, por meio de exames radiográficos e histopatológicos. Dois grupos, com 15 animais da espécie leporina cada, foram submetidos à indução química de osteoartrite com solução de colagenase 2% na articulação coxofemoral direita. No Grupo 1 (Células-tronco) realizou-se a aplicação  intra-articular de células-tronco mesenquimais autólogas. Já o Grupo 2 (Controle) foi constituído por animais submetidos à aplicação intra-articular de solução salina estéril. Foram realizadas avaliações radiográficas e histopatológicas aos 30, 60 e 90 dias após a aplicação. Os resultados histológicos indicam que células-tronco mesenquimais (Grupo 1) melhoraram discretamente a qualidade do tecido de reparo, de acordo com os critérios da escala semi-quantitativa ICRS 1 (International Cartilage Repair Society). O Grupo 1 (Células-Tronco) demonstrou superioridade em relação ao Grupo 2 nos parâmetros: Superfície articular, matriz extracelular e distribuição celular, demonstrando que as células-tronco foram benéficas no tratamento da osteoartrite.(AU)

The aim of this study was to compare cartilage regeneration of the hip in rabbits, with and without the transplantation of autologous mesenchymal stem cells. Thirty rabbits were submitted to chemical induction of osteoarthritis with a 2% colagenase in the right hip. They were divided into 2 groups of 15 animals each: Group 1 (intra-articular application of autologous mesenchymal stem cells) and Group 2 (control - intra-articular application of sterile saline solution). Radiographic and histopathological evaluations were performed at 30, 60 and 90 days after application. The mesenchymal stem cells group (Group 1) showed slight improvement of the quality of the repair tissue, according to the semi-quantitative scale criteria ICRS 1 (International Cartilage Repair Society). The Group 1 (Stem Cells) showed superiority in relation to Group 2, especially in the parameters joint surface, extracellular matrix and cellular distribution, demonstrating that stem cells were beneficial in the treatment of osteoarthritis.(AU)

Assuntos

RESUMO

OBJECTIVE: Re-evaluate the pathological lesions found on a gomphothere recovered from Quebrada Quereo (Late Pleistocene), Coquimbo region, Chile (31º55'41" S, 71º34'43" W, 20 masl). MATERIALS: 227 axial and appendicular specimens from a young adult male individual (SGO.PV.267). METHODS: Macroscopic and radiographic analysis. RESULTS: Pathological conditions identified included asymmetries of a cervical vertebra and of thoracic vertebra 16, degenerative joint disease in thoracic and lumbar vertebrae, possible evidence of neoplastic lesions within the bodies of three thoracic vertebrae (possibly hemangiomas), and fusion at thoracic vertebrae 15 and 16, suggesting the presence of spondyloarthropathy. CONCLUSIONS: The original diagnosis of traumatic lesions on this specimen is unsupported. The re-evaluation identified the presence of developmental defects, degenerative joint disease, possible neoplastic lesions, and spondyloartropathy. SIGNIFICANCE: The present analysis adds data to the sparse paleopathological record of South American gomphotheres. LIMITATIONS: Taphonomic alteration of some skeletal elements, as well as the presence of an incomplete individual, limits the ability to determine the etiology of some of the lesions identified. SUGGESTIONS FOR FURTHER RESEARCH: Researchers are encouraged to re-examine specimens curated in museums in order to identify pathological conditions that might have been overlooked or might benefit from re-evaluation.

Assuntos

RESUMO

OBJECTIVES: Studies of osteoarthritis (OA) in human skeletal remains can come with scalar problems. If OA measurement is noted as present or absent in one joint, like the elbow, results may not identify specific articular pathology data and the sample size may be insufficient to address research questions. If calculated on a per data point basis (i.e., each articular surface within a joint), results may prove too data heavy to comprehensively understand arthritic changes, or one individual with multiple positive scores may skew results and violate the data independence required for statistical tests. The objective of this article is to show that the statistical methodology Generalized Estimating Equations (GEE) can solve scalar issues in bioarchaeological studies. MATERIALS AND METHODS: Using GEE, a population-averaged statistical model, 1,195 adults from the core and one colony of the prehistoric Tiwanaku state (AD 500-1,100) were evaluated bilaterally for OA on the seven articular surfaces of the elbow joint. RESULTS: GEE linked the articular surfaces within each individual specimen, permitting the largest possible unbiased dataset, and showed significant differences between core and colony Tiwanaku peoples in the overall elbow joint, while also pinpointing specific articular surfaces with OA. Data groupings by sex and age at death also demonstrated significant variation. A pattern of elbow rotation noted for core Tiwanaku people may indicate a specific pattern of movement. DISCUSSION: GEE is effective and should be encouraged in bioarchaeological studies as a way to address scalar issues and to retain all pathology information.

Assuntos

RESUMO

Joint diseases are relatively common in domestic animals, such as dogs. The involved inflammation produces thermal emission, which can be imaged using specific sensors that allow capturing of infrared images. Given that there have been few reports on the use of thermography in the diagnosis of inflammation associated with diseases of the hip joint in dogs, we here propose a method for identification of inflammatory foci in dogs by using infrared thermometry. The present study aimed to find non-invasive and low-cost resources that could facilitate a clinical diagnosis in cases with inflammation in the coxofemoral joint of dogs. To this end, we developed a system in which the Flir Systems TG165 thermograph is coupled to a black PVC cannula with a 30-cm focus-to-animal distance. External effects of the environment on the temperature of the animals were compared with the body temperature as measured by a conventional thermometer. Thirty-one dogs with and without inflammation in the coxofemoral joint underwent clinical evaluation. We verified that the temperature registered by the thermograph in the animals with joint inflammation was significantly different from that in control animals without inflammation, in the lateral projection. The method showed a sensitivity of 80%, specificity of 87.5%, and accuracy of 83.87%. This standardized method of diagnosis of inflammatory foci in the coxofemoral articulation of dogs by way of thermography showed sensitivity, specificity, and satisfactory accuracy.(AU)

Tentando buscar recursos não invasivos e de baixo custo, para auxiliar o diagnóstico clínico em casos de inflamação na articulação coxofemoral de cães, idealizou-se o presente trabalho, que teve como objetivo propor um método de diagnóstico, em casos de inflamação na articulação coxofemoral de cães, desenvolvido a partir do registro do aumento da temperatura no local da inflamação, mediante o emprego de um termógrafo do tipo TG165 da Flir Systems acoplado a uma cânula de PVC, negra, com 30 cm de distância foco-animal para diminuir os efeitos externos que o ambiente exerce sobre a temperatura dos animais, e comparando-a com a temperatura corpórea, aferida por um termômetro convencional. Foram submetidos à avaliação clínica, 31 cães com e sem inflamação na articulação coxofemoral, onde verificou-se que a temperatura, registrada pelo termógrafo, dos animais pertencente ao grupo com inflamação na articulação apresentou diferença significativa na projeção lateral, em relação a temperatura dos animais do grupo sem doença articular, também aferida através do aparelho termográfico. O método apresentou sensibilidade de 80%, especificidade de 87,5% e precisão de 83,87%. Conclui-se que a padronização do método de diagnóstico de focos inflamatórios na articulação coxofemoral de cães pela termografia apresentou sensibilidade, especificidade e precisão satisfatória.(AU)

Assuntos

RESUMO

Resumen La osteoartritis es una enfermedad articular crónica degenerativa, es la afección articular observada con más frecuencia en la población adulta y una de las principales causas de discapacidad en todo el mundo, por lo que es de importancia el diagnóstico y tratamiento en las fases tempranas de la enfermedad. En la actualidad los nuevos tratamientos, además de aliviar el dolor, pueden disminuir la limitación funcional y modificar el curso de la enfermedad. El objetivo de este artículo es actualizar la evidencia acerca del diagnóstico y de las nuevas formas de tratamiento de la osteoartritis, así como evaluar los cambios en la evidencia que ha habido en relación con la guía anterior. Para la elaboración de la guía motivo de esta reunión, se contó con la participación de especialistas en Medicina Interna, Reumatología, Ortopedia y Rehabilitación física, un bibliotecario y un experto en metodología; se realizó una búsqueda extensa en PubMed y en otros sitios web especializados. Se estableció una serie de recomendaciones y niveles de evidencia basados en la bibliografía consultada. Se concluye que la osteoartritis es una enfermead compleja que implica múltiples factores de riesgo, por lo que es importante tomar en cuenta que el tratamiento es multidisciplinario y consta de un enfoque no farmacológico y uno farmacológico; sin embargo, es necesario crear una cultura preventiva de la osteoartritis en los médicos tratantes, en la que se eduque y se dé información al paciente para evitar que la enfermedad progrese.

Abstract Osteoarthritis, a chronic degenerative joint disease, is the joint condition most frequently observed in the adult population; is one of the leading causes of disability worldwide. Therefore, it is important the diagnosis and treatment in the early stages of the disease. Currently new therapies, in addition to relieving pain, can reduce functional limitation and modify the course of the disease. The objective of this article is to update the evidence on diagnosis and new forms of osteoarthritis treatment, as well as to evaluate the changes in the evidence that has been in relation to the previous guide. For the elaboration of the guide, there was participation of specialists (Internal Medicine, Rheumatology, Orthopedics and Physical Rehabilitation), a librarian and an expert in methodology; an extensive search was carried out in PubMed and other specialized websites. A series of recommendations and levels of evidence were established based on the bibliography consulted. Concluding that osteoarthritis is a complex pathology involving multiple risk factors, it is important to consider that the treatment is multidisciplinary and consists of a non-pharmacological approach and a pharmacological treatment; however, it is necessary to create a preventive culture on osteoarthritis in treating doctors, in which the patient is educated and given information to prevent the disease from progressing.