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1.
Gut-Joint Axis: The Role of Physical Exercise on Gut Microbiota Modulation in Older People with Osteoarthritis.
de Sire, A, de Sire, R, Petito, V, Masi, L, Cisari, C, Gasbarrini, A, Scaldaferri, F, Invernizzi, M
Nutrients. 2020;(2)
Abstract
Osteoarthritis (OA) is considered one of the most common joint disorders worldwide and its prevalence is constantly increasing due to the global longevity and changes in eating habits and lifestyle. In this context, the role of gut microbiota (GM) in the pathogenesis of OA is still unclear. Perturbation of GM biodiversity and function, defined as 'gut dysbiosis', might be involved in the development of inflammaging, one of the main risk factors of OA development. It is well known that physical exercise could play a key role in the prevention and treatment of several chronic diseases including OA, and it is recommended by several guidelines as a first line intervention. Several studies have shown that physical exercise could modulate GM composition, boosting intestinal mucosal immunity, increasing the Bacteroidetes-Firmicutes ratio, modifying the bile acid profile, and improving the production of short chain fatty acids. Moreover, it has been shown that low intensity exercise might reduce the risk of gastrointestinal diseases, confirming the hypothesis of a strict correlation between skeletal muscle and GM. However, up to date, there is still a lack of clinical trials focusing on this research field. Therefore, in this narrative, we aimed to summarize the state-of-the-art of the literature regarding the correlation between these conditions, supporting the hypothesis of a 'gut-joint axis' and highlighting the role of physical exercise combined with adequate diet and probiotic supplements in rebalancing microbial dysbiosis.
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2.
The difference between native septic arthritis and prosthetic joint infections: A review of literature.
Roerdink, RL, Huijbregts, HJTAM, van Lieshout, AWT, Dietvorst, M, van der Zwaard, BC
Journal of orthopaedic surgery (Hong Kong). 2019;(2):2309499019860468
Abstract
Current literature occasionally considers septic arthritis in native joints and prosthetic joint infections as equal pathologies. However, significant differences can be identified. The aim of this review of literature is to describe these differences in definitions, pathology, diagnostic workups, treatment strategies, and prognosis.
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3.
Can Resistance Training Enhance the Rapid Force Development in Unloaded Dynamic Isoinertial Multi-Joint Movements? A Systematic Review.
Van Hooren, B, Bosch, F, Meijer, K
Journal of strength and conditioning research. 2017;(8):2324-2337
Abstract
Van Hooren, B, Bosch, F, and Meijer, K. Can resistance training enhance the rapid force development in unloaded dynamic isoinertial multi-joint movements? A systematic review. J Strength Cond Res 31(8): 2324-2337, 2017-The objectives of this systematic review were to (a) evaluate whether resistance training can improve the rapid force development in unloaded dynamic isoinertial multi-joint movements and (b) investigate whether these effects differ between untrained/recreationally trained and well-trained individuals. Four electronic databases were screened for studies that measured the effects of resistance training on rapid force development in unloaded dynamic isoinertial multi-joint movements. Twelve studies with a total of 271 participants were included. 10/26 (38%) and 6/14 (43%) of the measures of rapid force development in unloaded dynamic isoinertial multi-joint movements significantly improved following training in the untrained/recreationally trained and well-trained individuals, respectively. Additionally, 7/14 (50%) and 3/12 (25%) of the measures significantly improved during a countermovement and squat jump in the untrained/recreationally trained individuals and 4/6 (67%) and 2/8 (25%) significantly improved during a countermovement and squat jump in the well-trained individuals, respectively. These findings indicate that resistance training has a limited transfer to rapid force development in unloaded dynamic isoinertial multi-joint movements, especially for well-trained individuals and in movements without a countermovement. Furthermore, rapid force development has likely a limited transfer from movements with countermovement to movements without a countermovement and from bilateral movements to unilateral movements. Therefore, it is important to specifically mimic the actual sport movement in order to maximize the transfer of training and testing.
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4.
Evolving Role of Molecular Imaging with (18)F-Sodium Fluoride PET as a Biomarker for Calcium Metabolism.
Raynor, W, Houshmand, S, Gholami, S, Emamzadehfard, S, Rajapakse, CS, Blomberg, BA, Werner, TJ, Høilund-Carlsen, PF, Baker, JF, Alavi, A
Current osteoporosis reports. 2016;(4):115-25
Abstract
(18)F-sodium fluoride (NaF) as an imaging tracer portrays calcium metabolic activity either in the osseous structures or in soft tissue. Currently, clinical use of NaF-PET is confined to detecting metastasis to the bone, but this approach reveals indirect evidence for disease activity and will have limited use in the future in favor of more direct approaches that visualize cancer cells in the read marrow where they reside. This has proven to be the case with FDG-PET imaging in most cancers. However, a variety of studies support the application of NaF-PET to assess benign osseous diseases. In particular, bone turnover can be measured from NaF uptake to diagnose osteoporosis. Several studies have evaluated the efficacy of bisphosphonates and their lasting effects as treatment for osteoporosis using bone turnover measured by NaF-PET. Additionally, NaF uptake in vessels tracks calcification in the plaques at the molecular level, which is relevant to coronary artery disease. Also, NaF-PET imaging of diseased joints is able to project disease progression in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Further studies suggest potential use of NaF-PET in domains such as back pain, osteosarcoma, stress-related fracture, and bisphosphonate-induced osteonecrosis of the jaw. The critical role of NaF-PET in disease detection and characterization of many musculoskeletal disorders has been clearly demonstrated in the literature, and these methods will become more widespread in the future. The data from PET imaging are quantitative in nature, and as such, it adds a major dimension to assessing disease activity.
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5.
High-Resolution US of Rheumatologic Diseases.
Taljanovic, MS, Melville, DM, Gimber, LH, Scalcione, LR, Miller, MD, Kwoh, CK, Klauser, AS
Radiographics : a review publication of the Radiological Society of North America, Inc. 2015;(7):2026-48
Abstract
For the past 15 years, high-resolution ultrasonography (US) is being routinely and increasingly used for initial evaluation and treatment follow-up of rheumatologic diseases. This imaging technique is performed by using high-frequency linear transducers and has proved to be a powerful diagnostic tool in evaluation of articular erosions, simple and complex joint and bursal effusions, tendon sheath effusions, and synovitis, with results comparable to those of magnetic resonance imaging, excluding detection of bone marrow edema. Crystal deposition diseases including gouty arthropathy and calcium pyrophosphate deposition disease (CPPD) have characteristic appearances at US, enabling differentiation between these two diseases and from inflammatory arthropathies. Enthesopathy, which frequently accompanies psoriatic and reactive arthritis, also has a characteristic appearance at high-resolution US, distinguishing these two entities from other inflammatory and metabolic arthropathies. The presence of Doppler signal in examined joints, bursae, and tendon sheaths indicates active synovitis. Microbubble echo contrast agents augment detection of tissue vascularity and may act in the future as a drug delivery vehicle. Frequently, joint, tendon sheath, and bursal fluid aspirations and therapeutic injections are performed under US guidance. The authors describe the high-resolution US technique including gray-scale, color or power Doppler, and contrast agent-enhanced US that is used in evaluation of rheumatologic diseases of the wrist and hand and the ankle and foot in their routine clinical practice. This article demonstrates imaging findings of normal joints, rheumatoid arthritis, gouty arthritis, CPPD, psoriatic and reactive arthritis, and osteoarthritis.
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6.
The potential for dietary factors to prevent or treat osteoarthritis.
Green, JA, Hirst-Jones, KL, Davidson, RK, Jupp, O, Bao, Y, MacGregor, AJ, Donell, ST, Cassidy, A, Clark, IM
The Proceedings of the Nutrition Society. 2014;(2):278-88
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Abstract
Osteoarthritis (OA) is a degenerative joint disease for which there are no disease-modifying drugs. It is a leading cause of disability in the UK. Increasing age and obesity are both major risk factors for OA and the health and economic burden of this disease will increase in the future. Focusing on compounds from the habitual diet that may prevent the onset or slow the progression of OA is a strategy that has been under-investigated to date. An approach that relies on dietary modification is clearly attractive in terms of risk/benefit and more likely to be implementable at the population level. However, before undertaking a full clinical trial to examine potential efficacy, detailed molecular studies are required in order to optimise the design. This review focuses on potential dietary factors that may reduce the risk or progression of OA, including micronutrients, fatty acids, flavonoids and other phytochemicals. It therefore ignores data coming from classical inflammatory arthritides and nutraceuticals such as glucosamine and chondroitin. In conclusion, diet offers a route by which the health of the joint can be protected and OA incidence or progression decreased. In a chronic disease, with risk factors increasing in the population and with no pharmaceutical cure, an understanding of this will be crucial.
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7.
Gout: joints and beyond, epidemiology, clinical features, treatment and co-morbidities.
Robinson, PC, Horsburgh, S
Maturitas. 2014;(4):245-51
Abstract
Gout is a common inflammatory arthritis precipitated by an inflammatory reaction to urate crystals in the joint. Gout is increasingly being recognised as a disease primarily of urate overload with arthritis being a consequence of this pathological accumulation. It is associated with a number of important co-morbidities including chronic kidney disease, obesity, diabetes and cardiovascular disease. The prevalence of gout is increasing around the world. Significant progress has been made in determining the genetic basis for both gout and hyperuricaemia. Environmental risk factors for gout have been identified as certain foods, alcohol and several medications. There is, however, little evidence that changing these environmental risks improves gout on an individual level. Treatment of gout encompasses two strategies: firstly treatment of inflammatory arthritis with non-steroidal anti-inflammatories, corticosteroids, colchicine or interleukin-1 inhibitors. The second and most important strategy is urate lowering, to a target of 0.36 mmol/L (6 mg/dL) or potentially lower in those with tophi (collections of crystalline urate subcutaneously). Along with urate lowering, adequate and prolonged gout flare prophylaxis is required to prevent the precipitation of acute attacks. Newer urate lowering agents are in development and have the potential to significantly expand the potential treatment options. Education of patients regarding the importance of life long urate lowering therapy and prophylaxis of acute attacks is critical to treatment success as adherence with medication is low in chronic diseases in general but especially in gout.
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8.
Ultrasound in crystal-related arthritis.
Filippucci, E, Di Geso, L, Girolimetti, R, Grassi, W
Clinical and experimental rheumatology. 2014;(1 Suppl 80):S42-7
Abstract
In the last decade, an increasing number of rheumatologists have been using ultrasound (US) for assessing patients with gout and calcium pyrophosphate deposition (CPPD) disease. The high reflectivity of the crystalline aggregates and the ability of US to detect even minimal crystal deposits explain the high sensitivity of this imaging technique. Furthermore, the peculiar distribution within the target tissues results in the generation of typical US patterns and explains the excellent specificity of some US findings. The large spectrum of US findings and their wide combination generate different scenarios in different patients and also in the same subject. Such a high variety impaired the standardisation of the definitions of each US finding. This review presents the main US findings indicative of crystal deposits, discusses the available evidence supporting the use of US in patients with gout and CPPD disease, and provides a research agenda to guide further investigations. The combined US examination of the target tissues and the clinically involved sites represents the key issue to obtain the best compromise between accuracy and feasibility, in the daily US assessment of patients with crystal-related arthropathies. Moreover, the US guided aspiration of synovial fluid may enhance the possibility to reach a crystal-proven diagnosis, making US a complementary tool, not in contrast, with microscopy, which rests the current gold standard. Finally, even if at moment other US findings are not included among the typical ones for crystal-related arthropathies, it is possible that in the future, thanks to continuous technological advances, we will be able to identify other specific patterns of pathology.
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9.
Injury and illnesses prevention for ultramarathoners.
Krabak, BJ, Waite, B, Lipman, G
Current sports medicine reports. 2013;(3):183-9
Abstract
The popularity of ultramarathon races continue to grow with runners participating in races throughout the world. These events offer challenges unique to an ultramarathon compared to a marathon race. These challenges require the athlete to focus on factors including race distance, race stages, race environment (temperature, humidity, and altitude), appropriate training, nutritional preparation, and equipment. Athletes ill prepared for these challenges will be at risk from injury and illness. The goal of this article is to review preventive strategies for managing commonly encountered musculoskeletal injuries and medical illnesses in ultramarathon runners.
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10.
[Assessment of joint structure in patients with rheumatoid arthritis].
Tanaka, Y
Clinical calcium. 2013;(3):409-17
Abstract
Recent progress in the treatment of rheumatoid arthritis (RA) with TNF-inhibitors has brought a paradigm shift, in which clinical and structural remission is now a target to be approached. However, joint damage already develops in a majority of patients before appropriate treatments are provided. Joint damage results from the destruction of bone and cartilage, which can be visualized via radiography as joint erosion (JE) and joint space narrowing (JSN) , respectively. JSN is a surrogate marker for loss of cartilage and it also reflects damage to tissues causing joint dislocation, a phenomenon that is less prevalent among patients with early RA. JE has been perceived to be the most critical indicator of permanent disability in RA. The combination of TNF-inhibitor and MTX reduces the risk of joint damage, measured by radiographic modified total Sharp score (mTSS) . Biologics targeting cytokines and lymphocytes not only expand the array of treatments for RA but also provide important insights into pathogenesis of this disease.