Malikmeier1633

To evaluate the effectiveness of radial extracorporeal shock wave therapy on ankle flexor spasticity in stroke survivors and to reveal changes in the fibroelastic components of muscle.

Randomized controlled trial.

Inpatient neuro-rehabilitation clinic of a university hospital.

Stroke patients with ankle flexor spasticity.

Patients were randomized to three groups; radial extracorporeal shock wave therapy, sham, or control. Active and sham therapy were administered two sessions/week for two weeks. All patients received conventional rehabilitation.

The primary outcome was Modified Ashworth Scale. Secondary outcomes were the Tardieu Scale and elastic properties of plantar flexor muscles assessed by elastography (strain index). All assessments were performed before, immediately after the treatment, and four weeks later at follow-up.

Fifty-one participants were enrolled (active therapy

 = 17, sham

 = 17, control

 = 17). Modified Ashworth scores showed a significant decrease in the active therapy group (from 2.47 ± 0.72 to 1.41 ± 0.62) compared to sham (from 2.19 ± 1.05 to 2.06 ± 1.12) and control (from 2.06 ± 0.85 to 2.00 ± 0.73) groups immediately after the treatment (

 < 0.001). Tardieu results were also in concordance (

 < 0.001), however this effect was not preserved at follow-up. Elastic properties of the ankle flexors were improved in all groups at both assessments after the therapy showing significant decreases in strain index (

 < 0.001). However, there was no difference among the groups in terms of improvement in elastography.

Radial extracorporeal shock wave therapy has short-term anti-spastic effects on ankle flexor muscles when used as an adjunct to conventional rehabilitation.

Radial extracorporeal shock wave therapy has short-term anti-spastic effects on ankle flexor muscles when used as an adjunct to conventional rehabilitation.

High tibial osteotomy (HTO) is a surgical procedure aimed at inhibiting the progression of osteoarthritis of the knee joint. selleck screening library The aim of this study was to identify factors influencing the functional outcome after opening wedge valgus HTO.

A total of 175 cases (155 patients) of varus-correcting high tibial open-wedge osteotomies using the Tomofix plate were reviewed retrospectively. Patients answered the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire and 4 survey follow-up questions.

A total of 76 of the 155 patients studied (84 of the 175 knees) completed the KOOS questionnaire, on average 3.1 years (SD 1.8 years) after the surgery. The median scores (with median absolute deviations [MAD]) for the KOOS pain, symptoms, daily activities, sports, and quality of life sections were, respectively, 76.4 (MAD 12.5), 75.0 (MAD 14.3), 85.3 (MAD 11.8), 50.0 (MAD 25.0), and 59.4 (MAD 21.9). No cases of nonunion were observed throughout the length of the study. Identified predictors of worse outcomes were higher weight and body mass index, limited knee flexion, genu varum and tibial varus of small magnitude, active smoking status at the time of surgery, further surgery for plate removal, and some grades of chondropathy in the patellofemoral, medial tibial, and femoral compartments. Patient gender, joint obliquity and over- or undercorrection were not associated with any of the outcomes.

This study shows good results following valgus HTO that are comparable to outcomes following total knee arthroplasty, reinforcing the option of HTO as a valid alternative for total knee arthroplasty.

This study shows good results following valgus HTO that are comparable to outcomes following total knee arthroplasty, reinforcing the option of HTO as a valid alternative for total knee arthroplasty.CME Rheumatology 23 Rheumatoid Arthritis Following COVID-19/SARS-CoV-2 Infection Abstract. Individuals with rheumatic diseases, especially those on immuno-modulating treatment, have an increased risk of infection. On the other hand, it is known that viral infections may be a cause for acute arthralgias and of arthritis. We present in the following a case of ACPA-positive and RF-positive rheumatoid arthritis after an acute COVID-19/SARS-CoV-2 infection and discuss the possible association with the infection.Lyme disease is the most common vector-borne illness in Switzerland and Lyme arthritis the most prevalent manifestation of late-stage Lyme disease. It presents as a monoarthitis or oligoarthritis in large joints, often involving the knee. Such a clinical presentation, together with positive Lyme serologies or polymerase chain reactions from synovial fluid/tissue, is considered diagnostic. If there is no tick bite or erythema migrans in the patient's history the diagnosis can be challenging due to the many differential diagnoses. The initial treatment is a prolonged course of oral antibiotics.CME Giant Cell Arteritis Abstract. Giant cell arteritis (GCA) is the most common vasculitis among patients over the age of 50. Mainly large vessels are targeted. GCA can be differentiated into cranial and extra-cranial types; thus the symptoms can range from headache, blurred vision and jaw claudication to non-specific symptoms like fatigue, polymyalgia and fever. Complications such as an irreversible loss of vision are critical, which is why timeous diagnosis and treatment are essential. There are some recommendations for treatment, but no defined guidelines exist. Steroids have been the standard treatment for the past six decades and remain so, but side effects are common. Tocilizumab represents an alternative and more effective and safer treatment.Hazard or Harmless Fun? Injuries Caused by Fireworks -Study at the University Emergency Department (2013-2019) Abstract. Fireworks are often used to celebrate national, cultural or religious events. Despite strict regulations, fireworks are repeatedly causing accidents. The risk for injuries increases with the incautious use of pyrotechnic articles. This study analyzed injuries caused by fireworks with admittance to the Emergency Department of the University Hospital in Bern between 2013 and 2019. The results were compared with existing literature.

We conducted a retrospective study based on data from the Emergency Department of the University Hospital in Bern between January 1st 2013 and December 31st 2019. Among others, the following parameters were analyzed gender, age, type of injury and therapy.

We were able to include 59 patients in our study. 81.4 % were men, the mean age was 31 years (range 16-73; SD = 11.3). In a majority of all cases (83.6 %) the ears, eyes and face were affected. Most injuries watic data collection on injuries caused by fireworks would be necessary, as many injured patients are hospitalised in smaller, peripheral hospitals or not at all. These data would allow for the development of more comprehensive and detailed prevention strategies that could prevent fireworks injuries.The Role of Percutaneous Coronary Revascularization in Chronic Coronary Syndromes Abstract. Coronary heart disease represents the leading cause of morbidity and mortality worldwide. Optimal management of these patients is therefore crucial and includes lifestyle changes, optimal medical therapy, and coronary revascularization. This review summarizes diagnostic and therapeutic strategies of patients with chronic coronary syndromes, focusing on the 2019 European Society of Cardiology (ESC) guidelines for the diagnosis and management of chronic coronary syndromes. In particular, the role of invasive assessment and coronary revascularization in chronic coronary syndromes is discussed.Acute Traumatic Central Cord Syndrome Etiology, Pathophysiology, Clinical Manifestation, and Treatment Abstract. The acute traumatic central cord syndrome (ATCCS) represents an injury to the spinal cord with disproportionately greater motor impairment of the upper than the lower extremities, with bladder dysfunction and with varying degrees of sensory loss below the level of the respective lesion. The mechanism of ATCCS is most commonly a traumatic hyperextension injury of the cervical spine at the base of an underlying spondylosis and spinal stenosis. The mean age is 53 years, and segments C4 to Th1 are most frequently affected. In addition to medical history and clinical examination, the definitive diagnosis is made by magnetic resonance imaging, where T2-hyperintense lesions are typically observed in the affected spinal cord segment. Surgical decompression (and fusion) of the respective segment is recommended to prevent repetitive trauma to the spinal cord and to stop progression of clinical symptoms. Patients with diagnosed ATCCS and who are treated adequately usually have a good prognosis.Overall, heart patients should be advised individually with respect to their tolerance of altitudes. However, the historical reflex that altitude 'per se' is bad for heart patients should become a thing of the past. Adequately treated and stable patients can usually go up to an altitude of 2500 m without any restrictions. Higher altitudes are also possible for a large number of patients, but may require an adaptation of the medication and further clarification. This is especially the case when physical work is to be performed at great heights.CME Sonography 97/Answers Ultrasound Pathologies of the Hip Abstract. Abstract Hip pain has a broad differential diagnosis. A clinical examination is not enough to determine the underlying cause. In most cases, sonography helps to narrow the differential diagnosis or to make a specific diagnosis. Furthermore, ultrasound allows a targeted and anatomically precise diagnostic aspiration or therapeutic infiltration. Examples are used to illustrate different pathologies by region.It has been shown that the KCa3.1 channel-specific blocker, TRAM34, is a promising antiatherosclerosis (AS) agent, but its side effects restrict its clinical application. Notably, its effect on endothelial progenitor cells (EPCs) is unclear. We aim to unravel the effect of TRAM34 on EPCs and identify the underlying mechanism. Rats were injected intraperitoneally with TRAM34, and EPCs were isolated from bone marrow. The gene and protein levels of corresponding factors were detected by real-time PCR, enzyme-linked immunosorbent assay, western blotting, and fluorescence-activated cell sorting. Liquid chromatography-tandem mass spectrometry (LC-MS) was applied to detect metabolite differences. We showed that when rats were treated with TRAM34 in vivo, colony formation and proliferation of early EPCs were reduced, but their senescence and apoptosis were enhanced. Moreover, TRAM34 enhanced NOX activity, promoted an increase in intracellular ROS levels, increased PKC expression, and subsequently promoted EPC senescence, which is unfavorable for EPC angiogenesis in vivo and in vitro. Combining these results with LC-MS data, we found that TRAM34 significantly promoted pyrimidine and purine metabolism, leading to cellular senescence. Furthermore, the NOX inhibitor, Setanaxib, enhanced antioxidant metabolic pathways, especially S-adenosylmethioninamine (SAM) metabolism, to exert an antisenescence effect. Finally, we confirmed that SAM alleviates TRAM34-induced cellular senescence, suggesting an efficient approach to improve the quality of endogenous EPCs. This study reveals the mechanism of TRAM34-induced EPC senescence, providing a solution for the extended application of KCa3.1 inhibitor in AS.