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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ultrasound and MRI of affected joints help to confirm a diagnosis of arthritis. Radiography: may show changes similar to those of RA and ASAbdominal ultrasound and echocardiography: may be necessary to detect hepatosplenomegaly and pericarditis
Selected topics
Published in Henry J. Woodford, Essential Geriatrics, 2022
Non-pharmacological interventions include physiotherapy, weight reduction and increased exercise.24 Non-steroidal anti-inflammatory drugs (NSAIDs) are often used in younger patients, but carry a high risk of toxicity in older adults (including gastric bleeding, renal impairment, hypertension and heart failure). Cyclooxygenase 2 (COX-2) inhibitors may be less prone to cause gastric bleeding, but have all the other risks of harm plus a possible increase in cardiac ischaemic events. For these reasons all NSAIDs should be avoided in older adults unless absolutely necessary. Paracetamol (acetaminophen) and weak opioids are safer options for analgesia. Joint replacement surgery may be considered in those who have significant disability despite other therapeutic measures. In a cohort of older adults (mean age 75) with severe OA who underwent hip or knee replacement, post-operative complications occurred in 17% (none fatal), median time to independent walking was 12 days, and surgery was associated with significant symptomatic benefits at 12 months.25
Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
Mobility is the ‘ability to move freely and easily’ or ‘the ease with which joints can move’ (Oxford Dictionary). In conventional rehabilitation, mobility is generally associated with the movement of joints. A loss of mobility hampers a client’s ability to maintain biomechanically sound form and technique. When we walk, for example, the ankle is required to move through aproximately 20 degrees of dorsiflexion. Most healthy adults have 25 degrees of motion at the ankle. Even a small loss of ankle range forces a degree of compensation, increasing biomechanical stress and strain and potentially predisposing injury.
Morel mushroom, Morchella from Kashmir Himalaya: a potential source of therapeutically useful bioactives that possess free radical scavenging, anti-inflammatory, and arthritic edema-inhibiting activities
Published in Drug and Chemical Toxicology, 2022
Haridas Ramya, Korattuvalappil S. Ravikumar, Zuhara Fathimathu, Kainoor K. Janardhanan, Thekkuttuparambil A. Ajith, Manzoor Ahmad Shah, Ramona Farooq, Zafar A. Reshi
Recent investigations have shown that inflammation is a major factor in the progression of several chronic diseases and disorders including cancer, cardiovascular diseases, arthritis, diabetes, and obesity (Arulselvan et al. 2016, Ruparelia et al. 2017, Matczak et al.2018). Arthritis demonstrates chronic inflammation in joints. Non-steroidal anti-inflammatory agents and corticosteroids are generally recommended to treat arthritis (Weinblatt et al. 1985). However, these drugs can cause a number of side effects. Because of this, herbal medicines have been popular to treat arthritis in traditional systems of medicine especially in developing and under-developed countries (Ahmed et al. 2005). Thus, search for promising nontoxic anti-inflammatory agents is a target area of biomedical research.
Analytical review on the biocompatibility of surface-treated Ti-alloys for joint replacement applications
Published in Expert Review of Medical Devices, 2022
Joint replacement is a surgical procedure in which an artificial joint surgically replaces arthritic or damaged joints made up of metals or plastic components. Damage to the joint may be caused due to several reasons such as aging, accident, or osteoarthritis. So, such damage causes orthopedic surgery that generally requires internal fixation of joints to provide stability during the bone healing process. Historically, cemented and cementless implant designs were used for total joint replacement (TJR) [1]. Cementless techniques are achieving more attention and popularity for TJR due to the removal of the second surgery requirement in cemented implants [2]. In cemented technique, initially, implants possess excellent mechanical strength, but later osteolysis causes loosening of implants. The biological response of cementless implants provides long-term mechanical stability. These implants’ stability depends on several parameters, such as corrosion behavior, debris created, and ions released from the implant. So, bone adaptation to implant and stress shielding is the central areas of concern [3].
Molecular sequencing technologies in the diagnosis and management of prosthetic joint infections
Published in Expert Review of Molecular Diagnostics, 2022
Zakareya Gamie, Dileep Karthikappallil, Emane Gamie, Stavros Stamiris, Eustathios Kenanidis, Eleftherios Tsiridis
Joint replacement is an orthopedic surgical procedure carried out in order to improve joint mobility, relieve pain, and ultimately improve the patient’s quality of life [1,2]. This has proven to be a successful procedure; however, prosthetic joint infection (PJI) is a serious complication arising from arthroplasty, and although occurring in 1–2% of cases, PJI results in high morbidity and mortality with a rate of 5–8% at 1 year [3–6]. This can depend on patient age, sex, type of infecting organism (higher with enterococci), and type of surgical treatment [6]. As well as the clinical impact for patients such as prolonged hospitalization and treatment, complex patient care, and poor clinical outcomes, PJI is also associated with a significant economic impact such as increased healthcare costs [2,4,7]. With an increasing and aging population, the demand for arthroplasty is also increasing, and indeed because of this, the incidence of PJI is also expected to rise placing a burden on healthcare systems [1,7,8].