Tennis- und Golfer-Ellenbogen

2015 ◽  
Vol 63 (4) ◽  
Keyword(s):  
Spontaneous Recovery ◽  
Clinical Symptoms ◽  
Lateral Epicondylitis ◽  
High Rate ◽  
Evidence Based ◽  
Physical Methods ◽  
Local Injections ◽  
One Year ◽  
Golfer’S Elbow ◽  
Non Surgical Treatment

“Tennis and golfer’s elbow” are common pathologies due to overload of forearm extensors and flexors, and actually occur mostly outside tennis and golf sports. Several differential diagnoses of medial and lateral epicondylitis have to be excluded as there are a number of other conditions with similar clinical symptoms. The high rate of spontaneous recovery has to be considered in treatment. Evidence based conservative treatment comprises excentric physiotherapy, local injections, and physical methods. Surgery is reserved for patients with persistence of symptoms for more than one year despite non-surgical treatment.

scholarly journals Hyaluronic Acid injections for Chronic Tennis Elbow

2021 ◽  
Author(s):  
Gershon Zinger ◽  
Alexander Bregman ◽  
Ori Safran ◽  
Shaul Beyth ◽  
Amos Peyser
Keyword(s):  
Hyaluronic Acid ◽  
Tennis Elbow ◽  
Treatment Options ◽  
Lateral Epicondylitis ◽  
Visual Analogue Score ◽  
Saline Control ◽  
Clinically Important Difference ◽  
Male Patients ◽  
One Year ◽  
Non Surgical Treatment

Abstract Background For most patients, tennis elbow (TE) resolves within six months of onset. For those with persistent and painful TE, nonsurgical treatment options are limited. Thousands of studies have tried to find effective treatment for TE, but usually fail. In this study, we test the hypothesis that injections with hyaluronic acid (HA) are effective at treating chronic pain from TE. Methods Patients with a minimum of six months of pain from TE were randomized equally into one of two groups, injection with HA or saline control, and followed for one year. Outcome measures included Visual Analogue Score (VAS pain), the shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH) and patient rated tennis elbow evaluation (PRTEE). Results Seventeen of the 18 HA-injected patients (94%) completed the study. The average age was 51.9 years and 10 were male. Patients had an average of 28.1 months of pain before entering the study. VAS in the HA group improved from a baseline of 76.4 to 14.3 at 12 months. All 17 patients in the HA group showed VAS improvement above minimal clinically important difference (MCID) of at least 18. PRTEE improved from 67 to 28.1. QuickDASH improved from 53.7 to 22.5. To our knowledge, this improvement is greater than can be seen in any other non-surgical treatment for TE. Conclusions HA injections showed significant success in pain relief by three months. Patients continued to improve for the 12-month duration of the study. This study indicates that patients with chronic lateral epicondylitis may benefit from injections of hyaluronic acid rather than having to undergo surgery.

Obtaining Secondary Treatment with RBC/Underflow Clarifiers

1982 ◽  
Vol 14 (6-7) ◽  
pp. 429-442
Author(s):  
I L Bogert
Keyword(s):  
Treatment Process ◽  
High Rate ◽  
Experimental Program ◽  
Secondary Treatment ◽  
Lower Zone ◽  
Treatment Efficiency ◽  
Winter Conditions ◽  
Rotating Biological Contactors ◽  
One Year ◽  
The U.S

A one-year experimental program conducted at Edgewater, New Jersey, U.S.A. evaluated the concept of providing secondary treatment by the installation of rotating biological contactors (RBC's) in modified primary sedimentation tanks. A primary tank was divided horizontally into two zones separated by an intermediate floor. Four RBC's were placed in the upper zone. The lower zone provided secondary sedimentation. High rate primary sedimentation was provided to remove grit and trash without removing substantial portions of BOD and SS. The experimental program funded by the U.S. EPA and the Borough of Edgewater was conducted over a full year at different loads. The system proved to be an effective secondary treatment process with little difference in treatment efficiency between summer and winter conditions.

scholarly journals Implementation of NAVIGATE Coordinated Specialty Care for First Episode Psychosis: the Michigan Experience

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 177-178
Author(s):  
Eric D. Achtyes ◽  
Kari Kempema ◽  
Zhehui Luo ◽  
Katharine N. Thakkar ◽  
Catherine Adams ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Symptoms ◽  
The United States ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Control Group ◽  
Evidence Based ◽  
Block Grant ◽  
Episode Psychosis

AbstractStudy ObjectivesCoordinated specialty care (CSC) is widely accepted as an evidence-based treatment for first episode psychosis (FEP). The NAVIGATE intervention from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study is a CSC intervention which offers a suite of evidence-based treatments shown to improve engagement and clinical outcomes, especially in those with shorter duration of untreated psychosis (DUP). Coincident with the publication of this study, legislation was passed by the United States Congress in 2014–15 to fund CSC for FEP via a Substance Abuse and Mental Health Services Administration (SAMHSA) block grant set-aside for each state. In Michigan (MI) the management of this grant was delegated to Network180, the community mental health authority in Kent County, with the goal of making CSC more widely available to the 10 million people in MI. Limited research describes the outcomes of implementation of CSC into community practices with no published accounts evaluating the use of the NAVIGATE intervention in a naturalistic setting. We describe the outcomes of NAVIGATE implementation in the state of MI.MethodsIn 2014, 3 centers in MI were selected and trained to provide NAVIGATE CSC for FEP. In 2016 a 4th center was added, and 2 existing centers were expanded to provide additional access to NAVIGATE. Inclusion: age 18–31, served in 1 of 4 FEP centers in MI. Data collection began in 2015 for basic demographics, global illness (CGI q3 mo), hospital/ED use and work/school (SURF q3 mo) and was expanded in 2016 to include further demographics, diagnosis, DUP, vital signs; and in 2018 for clinical symptoms with the modified Colorado Symptom Inventory (mCSI q6 mo), reported via an online portal. This analysis used data until 12/31/19. Mixed effects models adjusted by age, sex and race were used to account for correlated data within patients.ResultsN=283 had useable demographic information and were included in the analysis. Age at enrollment was 21.6 ± 3.0 yrs; 74.2% male; 53.4% Caucasian, 34.6% African American; 12.9 ± 1.7 yrs of education (N=195). 18 mo retention was 67% with no difference by sex or race. CGI scores decreased 20% from baseline (BL) to 18 mo (BL=3.5, N=134; 15–18 mo=2.8, N=60). Service utilization via the SURF was measured at BL (N=172) and 18 mo (N=72): psychiatric hospitalizations occurred in 37% at BL and 6% at 18 mo (p<0.01); ER visits occurred in 40% at BL and 13% at 18 mo (p<0.01). 44% were working or in school at BL and 68% at 18 mo (p<0.01). 21% were on antipsychotics (AP) at BL (N=178) and 85% at 18 mo (N=13) with 8% and 54% on long acting injectable-AP at BL and 18 mo, respectively. Limitations include missing data and lack of a control group.ConclusionThe implementation of the NAVIGATE CSC program for FEP in MI resulted in meaningful clinical improvement for enrollees. Further support could make this evidence-based intervention available to more people with FEP.FundingSupported by funds from the SAMHSA Medicaid State Block Grant set-aside awarded to Network180 (Achtyes, Kempema). The funders had no role in the design of the study, the analysis or the decision to publish the results.

scholarly journals Zika RNA and Flavivirus-Like Antigens in the Sperm Cells of Symptomatic and Asymptomatic Subjects

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 152
Author(s):  
Hernan Vanegas ◽  
Fredman González ◽  
Yaoska Reyes ◽  
Edwing Centeno ◽  
Jayrintzina Palacios ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Time Frame ◽  
Sperm Cells ◽  
Human Semen ◽  
Zikv Infection ◽  
Virus Shedding ◽  
One Year ◽  
Asymptomatic Subjects ◽  
A Prospective Study ◽  
Male Subjects

Zika virus (ZIKV) RNA has been found to remain in human semen for up to one year after infection, but the presence of Flavivirus antigens in the different compartments of semen has been largely unexplored. Following the introduction of ZIKV in Nicaragua (2016), a prospective study of patients with clinical symptoms consistent with ZIKV was conducted in León to investigate virus shedding in different fluids. ZIKV infection was confirmed in 16 male subjects (≥18 years of age) by RT-qPCR in either blood, saliva or urine. Of these, three provided semen samples at 7, 14, 21, 28, 60 and 180 days postsymptom onset (DPSO) for Flavivirus antigens and RNA studies. These cases were compared with 19 asymptomatic controls. Flavivirus antigens were examined by immunofluorescence (IF) using the 4G2 Mabs, and confocal microscopy was used to explore fluorescence patterns. The three (100%) symptomatic subjects and 3 (16%) of the 19 asymptomatic subjects had Flavivirus antigens and viral RNA in the spermatozoa fraction. The percentage of IF Flavivirus-positive spermatozoa cells ranged from 1.9% to 25% in specimens from symptomatic subjects, as compared with 0.8% to 3.8% in specimens from asymptomatic controls. A marked IF-pattern in the cytoplasmic droplets and tail of the spermatozoa was observed. The sperm concentrations (45 × 106/mL vs. 63.5 × 106/mL, p = 0.041) and the total motility percentage (54% vs. 75%, p = 0.009) were significantly lower in specimens from ZIKV-positive than in those of ZIKV-negative. In conclusion, this study demonstrated the presence of Flavivirus antigens and RNA within a time frame of 28 DPSO in sperm cells of symptomatic and asymptomatic subjects during the ZIKV epidemic. These findings have implications for public health, in terms of nonarthropod-born, silent transmission facilitated by sperm cells and potential transmission from asymptomatic males to pregnant women, with consequences to the fetus.

A role for traditional doctors in health promotion: experience from a trial of HIV prevention in Botswana

2018 ◽  
Vol 27 (2) ◽  
pp. 114-116 ◽  
Author(s):  
Anne Cockcroft ◽  
Leagajang Kgakole ◽  
Nobantu Marokoane ◽  
Neil Andersson
Keyword(s):  
Primary Prevention ◽  
Hiv Prevention ◽  
Young Women ◽  
Hiv Risk ◽  
Discussion Groups ◽  
Gender Violence ◽  
Evidence Based ◽  
Intervention Programme ◽  
Structural Intervention ◽  
One Year

Traditional doctors have been largely ignored in HIV prevention, particularly primary prevention. As part of a structural intervention programme to reduce HIV risk among young women in Botswana, we trained 147 traditional doctors in four districts as well as government health education assistants (HEAs) and teachers to run discussion groups in the community and schools, using an evidence-based eight-episode audio-drama, covering gender roles, gender violence, and how these are related to HIV risk. One year later, we contacted 43 of the 87 trained traditional doctors in two districts. Most (32) were running discussion groups with men and women, with links to the local HEAs and teachers. They were adept at recruiting men to their groups, often a challenge with community interventions, and reported positive changes in attitudes and behaviour of group participants. Traditional doctors can play an important role in primary prevention of gender violence and HIV.

scholarly journals Non-Surgical Treatment of Lateral Epicondylitis: A Aystematic Review of Randomized Controlled Trials

Hand ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. 419-446 ◽  
Author(s):  
Susan E. G. Sims ◽  
Katherine Miller ◽  
John C. Elfar ◽  
Warren C. Hammert
Keyword(s):  
Surgical Treatment ◽  
Randomized Controlled Trials ◽  
Lateral Epicondylitis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Non Surgical Treatment

Stenosis at the area of Transposition – An Under-Recognized Complication of Transposed Brachiobasilic Fistulas

2007 ◽  
Vol 8 (4) ◽  
pp. 268-274 ◽  
Author(s):  
M.C. Beaulieu ◽  
C. Gabana ◽  
C. Rose ◽  
P.S. Macdonald ◽  
J. Clement ◽  
...  
Keyword(s):  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
High Rate ◽  
Secondary Patency ◽  
Basilic Vein ◽  
Av Fistula ◽  
Surgical Interventions ◽  
Secondary Patency Rate ◽  
One Year ◽  
The Impact

Background With an increased focus on native AV fistula creation in hemodialysis patients, a transposed brachiobasilic fistula (tBBF) is becoming an increasingly utilized option. This study describes the outcomes of tBBFs in a chronic hemodialysis population. In particular, we focus on the incidence and location of stenosis, and review the impact of angioplasty on these lesions. Methods A retrospective cohort study using all patients with a tBBF created between January 2001 and December 2004. Results Of the 543 fistulas created during the study period, 93 were tBBFs. The mean age of patients was 65 years, 56% were male and 55% were diabetic. Stenosis occurred in 54% (46/85) of fistulas; the location of stenosis in the majority (74%) was at or near the area of basilic vein transposition and 50% of fistulas with stenosis in this location required three or more angioplasties. Primary (unassisted) patency was 42% at one year in this cohort. Secondary patency was 68% at 1 year and 58% and 53% at 2 and 3 years respectively. Conclusion In a cohort of hemodialysis patients who received a tBBF, we describe a reasonable primary and secondary patency rate and a high rate of stenosis at the point of transposition of the basilic vein. Such stenosis usually requires multiple percutaneous or surgical interventions to ensure or reestablish conduit patency. Further study is required regarding the optimal surgical technique, monitoring, and treatment of stenosis of this fistula type including the utility of repeat angioplasty.

scholarly journals Presence and importance of saprophyte fungal organisms on dog skin

2007 ◽  
pp. 261-265 ◽  
Author(s):  
Igor Stojanov ◽  
Sandra Jaksic ◽  
Jasna Prodanov
Keyword(s):  
Considerable Increase ◽  
Clinical Symptoms ◽  
Systemic Mycosis ◽  
Skin Changes ◽  
Contaminated Food ◽  
Fungal Organisms ◽  
Alternaria Sp ◽  
Fusarium Sp ◽  
Aspergillus Sp ◽  
One Year

Dogs are animals that are most often kept as pets in the cities. Their health problem may be the cause of infections of humans and animals. Skin changes and etiology factors present important segment of the diseases that disturb health of the pets. The objective of this work was mycology examination of scarifications and skin swabs from dogs with clinical symptoms. The aim was to find out which fungi species can be isolated from the changed parts of the skin, and whether is possible that, besides dermatophyte, saprophyte fungi from the environment may also be the cause of the changes, and to reveal their effect on the host. During a one year period, 67 swabs and scarifications from dogs were examined to detect the presence of fungi. The samples were streaked on Sabourdaud's dextrose agar and incubated for 10-21 days at 25?C. In microscopis examination according to their shape, and color, the colonies were identified as conidia, macroconidia and conidiaophora. From 59, of total 67 samples, the following saprophyte fungi were isolated: Aspergillus sp., Penicillium sp., Alternaria sp., Mucor sp. and Fusarium sp. Occurrence of these fungi means that a considerable increase of this microbiological flora may be expected in homes of the owners. This may be the cause of systemic mycosis and allergies in animals and humans, as well as a possibility of contaminated food and incidence of mycotoxicosis.

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