Management of musculoskeletal complications in patients with hemophilia: literature review and expert recommendations

2021 ◽  
Vol 21 ◽  
Author(s):  
E. Carlos Rodriguez-Merchan
Keyword(s):  
Ankle Arthrodesis ◽  
Joint Disease ◽  
Structural Defects ◽  
Childhood And Adolescence ◽  
Joint Degeneration ◽  
Hemophilic Arthropathy ◽  
Younger Age ◽  
The Moment ◽  
And Function ◽  
Expert Recommendations

: In people with hemophilia, hematological prophylaxis during childhood and adolescence could elude the occurrence of musculoskeletal complications (in joints and muscles) if the concentration of the defective factor is averted from decreasing under 1% of normal. Prompt management is of capital significance as the juvenile skeleton is hypersensitive to the adverse events of the disease; intense structural defects might appear rapidly. Important articular bleeds and inveterate hypertrophy of the articular synovial membrane must be treated vigorously to preclude joint degeneration (hemophilic arthropathy). At the moment that extreme joint disease is in place with intense affliction, the goal must be to reestablish activity whilst at the same time reducing the peril to the patient. Articular debridement is an efficacious surgical technique to accomplish this goal, particularly around the knee or ankle, and may be contemplated to be a backup to ankle arthrodesis or ankle or knee replacement in patients of younger age. Eventually joint replacement can commonly reestablish both articular mobility and function in an unhealthy articulation.

scholarly journals Why school-related content knowledge for pre-service chemistry teachers should include basic concepts in organic chemistry

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jolanda Hermanns ◽  
Nico Ermler
Keyword(s):  
Organic Chemistry ◽  
Mixed Methods ◽  
Content Knowledge ◽  
Structure And Function ◽  
Mixed Methods Study ◽  
Chemistry Teacher ◽  
Chemistry Teachers ◽  
Basic Concepts ◽  
The Moment ◽  
And Function

Abstract In this paper we describe and evaluate a study on the use of concepts in organic chemistry while solving tasks that are designed after the concept of school-related content knowledge (SRCK). The study was designed as a mixed methods study and conducted at a German university for the content of “organic chemistry”. As the results of this study show, the students rate the tasks and the use of anchoring concepts as for example “bonds” or “structure and function” as relevant for their future profession as a chemistry teacher. They therefore propose that concepts should be an integral part of their university studies as they find it lacking at the moment. Concepts can also be seen as an opportunity to build a bridge between school knowledge and university knowledge.

L'etica nella professione forense

2009 ◽  
pp. 163-172
Author(s):  
Angelo Abignente
Keyword(s):  
Public Interests ◽  
Legal Proceedings ◽  
Legal Professionals ◽  
Positive Law ◽  
Conflicting Interests ◽  
Discursive Participation ◽  
The Moment ◽  
The One ◽  
And Function ◽  
Role And Function

- The positive law tradition has hitherto had nothing to say about the legal profession's role and function, focusing more interest on questions of justice, of the legitimisation of power and of the genesis and organisation of normative material. This trend is now subject to a reversal promoted by new, neo-constitutionalist, narrativist, analytical and hermeneutic experiences, which no longer focuses attention on the moment when law is produced, but on the one when it is applied, reappraising and revitalising the function of the judge, of the attorneys and of other legal professionals. The attorney becomes an active protagonist, an intermediary not only between conflicting interests in a controversy, but also between opposing public interests, while the reappraisal of his role stimulates thinking about the ethical dimension of how the legal profession is practised. Referring to the theories of Habermas and of Alexy, the author treats the reasonable status of argumentation as the supreme ethical instance necessary for a decision that interferes in the sphere of another person's action. At the same time, however, the control of the reasonable status of the respective arguments on both sides is the ethical instance required of the attorneys taking part in the legal proceedings. It takes the form of compliance with the rules characteristic of the practical discourse, primarily the rule of free discursive participation that enables the onus of the argumentation to be explained. Ernesto de

scholarly journals Recent advances in understanding and managing psoriatic arthritis

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2670 ◽  
Author(s):  
Dafna D. Gladman
Keyword(s):  
Psoriatic Arthritis ◽  
Early Diagnosis ◽  
Clinical Laboratory ◽  
Joint Damage ◽  
Screening Tools ◽  
Therapeutic Interventions ◽  
Joint Disease ◽  
New Therapeutic Approaches ◽  
Recent Advances ◽  
And Function

This article reviews recent advances in psoriatic arthritis (PsA) over the past several years with emphasis on early diagnosis, better understanding of pathogenesis, and new therapeutic approaches. Early diagnosis is important, since people who present late do not fare as well. There are a number of clinical, laboratory, and ultrasound features that can help identify patients destined to develop PsA, and several screening tools have been developed. It is recognized that genetic and epigenetic factors, as well as T cells and cytokines, play a role in the pathogenesis of PsA, and several targets have been identified for therapeutic interventions. New therapies have been developed and tested in PsA and have been found to be highly effective for both skin and joint manifestations of the disease. The expectation is that, in the future, PsA patients will be treated early and more aggressively and that there will not be significant progression of joint damage. Moreover, with effective treatment of the skin and joint disease and management of risk factors for the comorbidities, we can expect to reduce their occurrence and further reduce the excess mortality and reduced quality of life and function in these patients.

Morphometry in schizophrenia revisited: height and its relationship to pre-morbid function

1998 ◽  
Vol 28 (3) ◽  
pp. 655-663 ◽  
Author(s):  
P. NOPOULOS ◽  
M. FLAUM ◽  
S. ARNDT ◽  
N. ANDREASEN
Keyword(s):  
Psychosocial Adjustment ◽  
Cognitive Abilities ◽  
Economic Status ◽  
The Body ◽  
Abnormal Development ◽  
Control Group ◽  
Childhood And Adolescence ◽  
Lower Quartile ◽  
And Function ◽  
The Brain

Background. Morphometry, the measurement of forms, is an ancient practice. In particular, schizophrenic somatology was popular early in this century, but has been essentially absent from the literature for over 30 years. More recently, evidence has grown to support the notion that aberrant neurodevelopment may play a role in the pathophysiology of schizophrenia. Is the body, like the brain, affected by abnormal development in these patients?Methods. To evaluate global deficit in development and its relationship to pre-morbid function, height was compared in a large group (N=226) of male schizophrenics and a group of healthy male controls (N=142) equivalent in parental socio-economic status. Patients in the lower quartile of height were compared to those in the upper quartile of height.Results. The patient group had a mean height of 177·1 cm, which was significantly shorter than the mean height of the control group of 179·4 (P<0·003). Those in the lower quartile had significantly poorer pre-morbid function as measured by: (1) psychosocial adjustment using the pre-morbid adjustment scales for childhood and adolescence/young adulthood, and (2) cognitive function using measures of school performance such as grades and need for special education. In addition, these measures of pre-morbid function correlated significantly with height when analysed using the entire sample.Conclusions. These findings provide further support to the idea that abnormal development may play a key role in the pathophysiology of schizophrenia. Furthermore, this is manifested as a global deficit in growth and function resulting in smaller stature, poorer social skills, and deficits in cognitive abilities.

scholarly journals Biophysical Stimulation in Athletes’ Joint Degeneration: A Narrative Review

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1206
Author(s):  
Lorenzo Moretti ◽  
Davide Bizzoca ◽  
Giovanni Angelo Giancaspro ◽  
Giuseppe Danilo Cassano ◽  
Francesco Moretti ◽  
...  
Keyword(s):  
Sports Injuries ◽  
Biological Response ◽  
Return To Sport ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Joint Degeneration ◽  
Shockwave Therapy ◽  
Positive Effects ◽  
Repetitive Impact ◽  
Pulsed Electromagnetic

Osteoarthritis (OA) is the most prevalent degenerative joint disease and the main cause of pain and disability in elderly people. OA currently represents a significant social health problem, since it affects 250 million individuals worldwide, mainly adults aged over 65. Although OA is a multifactorial disease, depending on both genetic and environmental factors, it is reported that joint degeneration has a higher prevalence in former athletes. Repetitive impact and loading, joint overuse and recurrent injuries followed by a rapid return to the sport might explain athletes’ predisposition to joint articular degeneration. In recent years, however, big efforts have been made to improve the prevention and management of sports injuries and to speed up the athletes’ return-to-sport. Biophysics is the study of biological processes and systems using physics-based methods or based on physical principles. Clinical biophysics has recently evolved as a medical branch that investigates the relationship between the human body and non-ionizing physical energy. A physical stimulus triggers a biological response by regulating specific intracellular pathways, thus acting as a drug. Preclinical and clinical trials have shown positive effects of biophysical stimulation on articular cartilage, subchondral bone and synovia. This review aims to assess the role of pulsed electromagnetic fields (PEMFs) and extracorporeal shockwave therapy (ESWT) in the prevention and treatment of joint degeneration in athletes.

scholarly journals Longitudinal structural and functional brain development in childhood and adolescence

2018 ◽  
Author(s):  
Kathryn L. Mills ◽  
Christian K. Tamnes
Keyword(s):  
Brain Development ◽  
Animal Studies ◽  
Diffusion Tensor ◽  
Childhood And Adolescence ◽  
Structural Development ◽  
Social Environments ◽  
Brain Structure And Function ◽  
Magnetic Resonance Imaging Mri ◽  
Methodological Considerations ◽  
And Function

The development of the human brain involves a prolonged course of maturation, enabling us to learn to navigate our complex social environments. Here, we give short introductions to post-mortem and animal studies on postnatal brain development and selected methodological considerations for longitudinal developmental neuroimaging. We then describe typical developmental changes in brain structure and function from childhood to adulthood. We focus on measurements derived from magnetic resonance imaging (MRI) and on longitudinal data. Specifically, we discuss brain structural development based on morphometry and diffusion tensor imaging (DTI) studies, and functional development based on resting-state and task-based functional MRI. Finally, we highlight selected current overarching research questions and argue that an important step in answering these questions is to study individual differences in longitudinal brain development.

scholarly journals Dampak perubahan jenis dan fungsi uang bagi perekonomian menurut perspektif ekonomi Islam

2020 ◽  
pp. 25-36
Author(s):  
Asra Asra
Keyword(s):  
Economic Problems ◽  
Paper Money ◽  
The Moment ◽  
And Function ◽  
Value Of Money

The alteration in the type and function of money which continue to roll creates a lot of new dynamics that are considered both positive and negative. In fact, this shift is influenced by many causes and reasons, this also affects the global economic problems. And it must be acknowledged that the issue of the type of money is the most crucial thing at the moment and continues to be debated on how to find solutions to the problem of paper money, especially related to inflation from the value of money itself. This paper tries to look out this issue, specifically from the perspective of the value of money (paper), where the value created is only based on perceptions or assumptions, not the value intrinsically attached to the medium of exchange itself, so it is very vulnerable to inflation.  

scholarly journals Left Atrial Shape and Function after Endovascular Device and Surgical Closure of ASDs in Children

2021 ◽  
Author(s):  
Alexander Sokolov ◽  
Viktor Varvarenko ◽  
Evgeny Krivoshchekov ◽  
Andrey Smorgon
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Surgical Correction ◽  
Control Group ◽  
Surgical Closure ◽  
Younger Age ◽  
Asd Closure ◽  
And Function ◽  
Endovascular Device

Retrospective analysis of echocardiograms was performed in 756 children who received endovascular device or surgical ASD closure from 2006 to 2016 in the Cardiac Center in Tomsk Russia. 564 patients had an endovascular closure and 192 had surgical correction. Follow-up duration was from 1 day to 10 years, mean 3.6 yrs for the device group and 4.2 yrs for the surgery group. The control group consisted of 3393 age-matched healthy patients. In patients with endovascular closure of an ASD, 35% had a change in the shape of the left atrium in early follow-up. Changes in the shape of the left atrium at early follow-up were more often observed in the device group and in children of a younger age. The left atrial changes were a decrease in sphericity and an increase in ellipsoidy. Changes in the shape of the left atrium persisted in 22% after transcatheter correction in the long-term. The change in shape of the left atrium after the placement of ASD devices was accompanied by activation of the mechanical function of the atrium and an increase in the filling pressure of the left ventricle. These changes were not accompanied by any disturbance in the contractility and volume of the heart chambers. In the group with surgical correction of ASD, the contractility and volume of the heart chambers did not significantly differ from those in the device closure group

Crohn Disease in Childhood and Adolescence

2018 ◽  
Author(s):  
Lori Zimmerman
Keyword(s):  
Weight Loss ◽  
Gastrointestinal Tract ◽  
Crohn Disease ◽  
Signs And Symptoms ◽  
Mucosal Healing ◽  
Joint Disease ◽  
Perianal Disease ◽  
Childhood And Adolescence ◽  
Chronic Inflammatory Condition ◽  
And Behavior

Crohn disease (CD) is a chronic inflammatory condition that can occur throughout the gastrointestinal tract (the mouth to the anus). CD is classified by location within the gastrointestinal tract and behavior of the disease (inflammatory, penetrating, and/or stricturing). It can also affect the extraintestinal tissue and cause perianal disease. It occurs from a complex interplay of genetic predisposition, altered gut microbiota, immunologic dysregulation, and likely environmental triggers. Children with CD often present with signs and symptoms related to the inflammation within their gastrointestinal tract. Most children with CD will present with diarrhea and abdominal pain, whereas some will present with rectal bleeding, fevers, weight loss, perianal disease, or joint disease. There is no single test to confidently diagnose a patient with CD. Instead, clinicians rely on a combination of biomarkers in the serum and stool, imaging studies, and endoscopic evaluation to make the diagnosis. The general aims of treatment of children with CD are to induce and maintain clinical remission of disease, optimize nutrition and growth, minimize adverse effects of therapies, and ultimately target mucosal healing. This review contains 3 figures, 3 tables and 34 references. Key Words: biologics, child, chronic diarrhea, Crohn disease, hematochezia, inflammatory bowel disease, immunodeficiency, pediatric, weight loss

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