Low-dose Spironolactone: Treatment for Osteoarthritis-related Knee Effusion. A Prospective Clinical and Sonographic-based Study

2016 ◽  
Vol 43 (6) ◽  
pp. 1114-1120 ◽  
Author(s):  
Ahmed M. Elsaman ◽  
Ahmed R. Radwan ◽  
Walaa I. Mohammed ◽  
Sarah Ohrndorf

Objective.To evaluate the effectiveness of spironolactone as a treatment for osteoarthritis (OA)-related knee effusion in comparison to ibuprofen, cold compresses, and placebo.Methods.This study was carried out on 200 patients, aged 40 years or older, attending the outpatient clinic of the Rheumatology Department of Sohag University Hospital with unilateral knee effusion related to OA based on clinical examination, musculoskeletal ultrasonography (US), and synovial fluid analysis. In group 1, 50 patients received spironolactone 25 mg daily for 2 weeks; in group 2, 50 patients took ibuprofen 1200 mg daily for 2 weeks; in group 3, 50 patients used cold compresses 2 times daily for 2 weeks; and in group 4, 50 patients received placebo for the same duration. Fluid > 4 mm was considered as effusion. Decrease in fluid to reach below 4-mm thickness was considered complete improvement, and any decrease that did not reach below 4 mm thickness was considered partial improvement.Results.The mean age of the participants was 51.2 ± 8.1 years. The mean duration of effusion was 16.5 ± 3.6 days. In group 1, 66% had complete improvement, 20% partial improvement, and 14% no response. In group 2, 24% had complete improvement, 12% partial improvement, and 64% no response. In group 3, 28% had complete improvement, 14% partial improvement, and 58% no response. In group 4, only 6% had complete improvement, 10% partial improvement, and 84% no response.Conclusion.Low-dose spironolactone is a safe and effective medical treatment for OA-related knee effusion.

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Arnav R. Mistry ◽  
Daniel Uzbelger Feldman ◽  
Jie Yang ◽  
Eric Ryterski

Objective(s). The major challenge encountered to decrease the milliamperes (mA) level in X-ray imaging systems is the quantum noise phenomena. This investigation evaluated dose exposure and image resolution of a low dose X-ray imaging (LDXI) prototype comprising a low mA X-ray source and a novel microlens-based sensor relative to current imaging technologies.Study Design. A LDXI in static (group 1) and dynamic (group 2) modes was compared to medical fluoroscopy (group 3), digital intraoral radiography (group 4), and CBCT scan (group 5) using a dental phantom.Results. The Mann-Whitney test showed no statistical significance(α=0.01)in dose exposure between groups 1 and 3 and 1 and 4 and timing exposure (seconds) between groups 1 and 5 and 2 and 3. Image resolution test showed group 1 > group 4 > group 2 > group 3 > group 5.Conclusions. The LDXI proved the concept for obtaining a high definition image resolution for static and dynamic radiography at lower or similar dose exposure and smaller pixel size, respectively, when compared to current imaging technologies. Lower mA at the X-ray source and high QE at the detector level principles with microlens could be applied to current imaging technologies to considerably reduce dose exposure without compromising image resolution in the near future.


2019 ◽  
Vol 08 (02) ◽  
pp. 113-118
Author(s):  
Hakan AK ◽  
Iskender Samet Daltaban ◽  
Sevilay Vural

Abstract Aim In this experimental study, we aimed to investigate possible healing effects of memantine hydrochloride, an N-methyl-d-aspartate (NMDA) antagonist, with clinical, biochemical, and histopathologic methods on acute peripheral nerve injury (PNI). Material and Method Forty-eight adult Wistar albino rats were divided into four groups (n = 12). The groups were arranged as sham-operated group (group 1), acute compression model group (group 2), trauma + low-dose memantine group (group 3), and trauma + high-dose memantine group (group 4). Memantine was administered intraperitoneally for 7 days. Subjects were sacrificed after the measurement of the sciatic nerve function index (SNFI) on the eighth day. Cyclooxygenase 2 (COX-2) and tumor necrosis factor-α (TNF-α) levels were measured in nerve tissues. Histopathologic evaluation was performed by electron microscopy. Results The mean sciatic function index (SFI) scores of groups 1 to 4 were +3.27 (standard deviation [SD] ±4.66),–18.2 (SD = ±11.7),–8.5 (SD = ±7.5), and–2.5 (SD = ±9), respectively. The mean COX-2 values were 0.98 ng/mL (SD = ±0.51), 1.89 ng/mL (SD = ±0.22), 1.39 ng/mL (SD = ±0.36), and 1.35 ng/mL (SD = ±0.59), respectively. TNF-α values were 0.09 pg/mL (SD = ±0.23), 1 pg/mL (SD = ±0.96), 0.46 pg/mL (SD = ±0.55), and 0.48 pg/mL (SD = ±0.78), respectively. Group 1 showed normal histologic findings. Group 2 showed marked edema particularly in large-diameter myelins. Myelin configurations were detected in large myelinated axons in group 3. The number of mast cells in endoneurium was high in group 4. Conclusion The efficacy of memantine in the acute phase of PNI appears to be significant according to the SNFI and biochemical tests. However, histologic findings suggest that high doses of memantine have a negative effect on PNI.


2003 ◽  
Vol 112 (6) ◽  
pp. 506-510 ◽  
Author(s):  
Marcus Haug ◽  
Michael Fritz ◽  
Olivia Dan ◽  
Robert R. Lorenz ◽  
Sophie Wimberley ◽  
...  

Using a rat model of laryngeal transplantation, we sought to define the relationships between acute laryngeal rejection grade (RG) and cyclosporin A (CSA) concentration and CSA dosage. Five recipient Lewis rat groups (N = 10 per group) were administered intramuscular CSA doses of 1.0 (group 1), 2.5 (group 2), 5.0 (group 3), 7.5 (group 4), and 10 mg/kg per day (group 5) for 14 days. Immediately before sacrifice, 5 mL of whole blood was obtained to assay CSA trough levels by high-performance liquid chromatography. The specimens were graded microscopically by blinded reviewers by day of RG, 0 to 14 days after transplantation, as described in earlier reports. Despite high intragroup variability in CSA levels, significantly different mean CSA concentrations were achieved among all CSA dosage groups: 1,2,3,4, and 5 (.0001 < p < .02). The mean laryngeal RGs did not test significantly different from each other with groups 3, 4, and 5 (RG, 2.3 ± 1.3 versus 1.9 ± 1.1 versus 1.7 ±0.3, respectively, .2 < p < .6). The RG for group 1 was significantly greater than those for groups 2 through 5 (p < .001), and the group 2 RG was greater (p < .02) than those for groups 3, 4, and 5. Polynomial fitting was used to determine the continuous relationship between each individual specimen's CSA concentration and the RG. Significant pathological allograft rejection correlated with CSA concentrations below 250 ng/mL.


1976 ◽  
Vol 81 (3) ◽  
pp. 673-679 ◽  
Author(s):  
Hugo Scaglia ◽  
Martha Medina ◽  
Ada L. Pinto-Ferreira ◽  
Guadalupe Vazques ◽  
Carlos Gual ◽  
...  

ABSTRACT The plasma concentrations and episodic fluctuations of immunoreactive FSH and LH as well as the pituitary sensitivity to LH-RH stimulation were evaluated in post-menopausal women. The subjects were divided into 4 groups according to age. Group 1: 60–70 years old (n=11), group 2: 70–80 years old (n=22), group 3: 80–90 years old (n=31) and group 4: 90–100 years old (n=8). Standards used in gonadotrophin radioimmunoassays included the LER-907 preparation and a pooled post-menopausal serum. Since it was found that circulating gonadotrophins have an immunological pattern different from that shown by the pituitary preparation, the results were expressed in mIU/ml calculated accordingly to the immunological behaviour of pooled post-menopausal sera. The mean (± se) plasma levels of FSH (mIU/ml) were: group 1: 105.9 ± 9.5, group 2: 149.3 ± 10.5, group 3: 124.8 ± 7.1 and group 4: 149.4 ± 25.3. The mean (± se) plasma levels of LH (mIU/ml) were: group 1: 81.9 ± 12.5, group 2: 95.4 ± 9.9, group 3: 84.3 ± 7.7 and group 4: 113.5 ± 19.1. No statistically significant differences were observed among the 4 groups. One patient from each group was randomly selected in order to evaluate their LH and FSH episodic release as well as their pituitary responsiveness to exogenous stimulation. A pulsatile plasma pattern of gonadotrophin and a normal pituitary response to LH-RH injection were observed in the 4 patients studied. The results are interpreted as demonstrating that normal pituitary gonadotrophin function and pituitary reserve and responsiveness to exogenous stimulation are maintained in women of advanced age.


2011 ◽  
Vol 69 (2b) ◽  
pp. 365-370 ◽  
Author(s):  
J Bustamante ◽  
M Socolovsky ◽  
R S Martins ◽  
J Emmerich ◽  
M G Pennini ◽  
...  

Epineural stitches are a means to avoid tension in a nerve suture. We evaluate this technique, relative to interposed grafts and simple neurorraphy, in a rat model. METHOD: Twenty rats were allocated to four groups. For Group 1, sectioning of the sciatic nerve was performed, a segment 4 mm long discarded, and epineural suture with distal anchoring stitches were placed resulting in slight tension neurorraphy. For Group 2, a simple neurorraphy was performed. For Group 3, a 4 mm long graft was employed and Group 4 served as control. Ninety days after, reoperation, latency of motor action potentials recording and axonal counts were performed. Inter-group comparison was done by means of ANOVA and the non-parametric Kruskal-Wallis test. RESULTS: The mean motor latency for the simple suture (2.27±0.77 ms) was lower than for the other two surgical groups, but lower than among controls (1.69±0.56 ms). Similar values were founding in both group 1 (2.66±0.71 ms) and group 3 (2.64±0.6 ms). When fibers diameters were compared a significant difference was identified between groups 2 and 3 (p=0.048). CONCLUSION: Good results can be obtained when suturing a nerve employ with epineural anchoring stitches. However, more studies are needed before extrapolating results to human nerve sutures.


2012 ◽  
Vol 27 (12) ◽  
pp. 905-911 ◽  
Author(s):  
Jairo Zacchê de Sá ◽  
José Lamartine de Andrade Aguiar ◽  
Adriana Ferreira Cruz ◽  
Alexandre Ricardo Pereira Schuler ◽  
José Ricardo Alves de Lima ◽  
...  

PURPOSE: To evaluate the effect of local nitroglycerin on the viable area of a prefabricated flap for vascular implant in rats, and to investigate the surgical delay procedure. METHODS: A femoral pedicle was implanted under the skin of the abdominal wall in forty Wistar rats. The animals were divided into four groups of ten: group 1 - without surgical delay procedure and local nitroglycerin; group 2 - with surgical delay procedure, but without local nitroglycerin; group 3 - without surgical delay procedure, but with local nitroglycerin; and group 4 - with simultaneous surgical delay procedure and local nitroglycerin. The percentages of the viable areas, in relation to the total flap, were calculated using AutoCAD R 14. RESULTS: The mean percentage value of the viable area was 8.9% in the group 1. 49.4% in the group 2; 8.4% in the group 3 and 1.1% in the group 4. There was significant difference between groups 1 and 2 (p=0.005), 1 and 4 (p=0.024), 2 and 3 (p=0.003), 2 and 4 (p=0.001). These results support the hypothesis that the closure of the arterial venous channels is responsible for the phenomenon of surgical delay procedure. CONCLUSION: Local nitroglycerin did not cause an increase in the prefabricated viable flap area by vascular implantation and decreased the viable flap area that underwent delay procedures.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jong Jin Oh ◽  
Seok-Soo Byun ◽  
Sang Eun Lee ◽  
Gheeyoung Choe ◽  
Sung Kyu Hong

Objective. To investigate the effect of long duration exposure to electromagnetic field from mobile phones on spermatogenesis in rats using 4G-LTE. Methods. Twenty Sprague-Dawley male rats were placed into 4 groups according to the intensity and exposure duration: Group 1 (sham procedure), Group 2 (3 cm distance + 6 h exposure daily), Group 3 (10 cm distance + 18 h exposure daily), and Group 4 (3 cm distance + 18 h exposure daily). After 1 month, we compared sperm parameters and histopathological findings of the testis. Results. The mean spermatid count (×106/ml) was 398.6 in Group 1, 365.40 in Group 2, 354.60 in Group 3, and 298.60 in Group 4 (p=0.041). In the second review, the mean count of spermatogonia in Group 4 (43.00) was significantly lower than in Group 1 (57.00) and Group 2 (53.40) (p<0.001 and p=0.010, resp.). The sum of the germ cell counts was decreased in Group 4 compared to Groups 1, 2, and 3 (p=0.032). The mean Leydig cell count was significantly decreased in Group 4 (p<0.001). Conclusions. The longer exposure duration of electromagnetic field decreased the spermatogenesis. Our findings warrant further investigations on the potential effects of EMF from mobile phones on male fertility.


2015 ◽  
Vol 234 (4) ◽  
pp. 211-217 ◽  
Author(s):  
Hsi-Kung Kuo ◽  
I-Ting Sun ◽  
Mei-Yung Chung ◽  
Yi-Hao Chen

Purpose: To evaluate the refractive development of premature infants with retinopathy of prematurity (ROP) after treatment with laser photocoagulation or intravitreal injection of bevacizumab (IVB). Methods: The medical records of patients with ROP treated between 2003 and 2012 who underwent yearly follow-ups were retrospectively reviewed. Patients with residual ROP abnormalities were excluded. The cycloplegic refraction at 3 years of age, assessed using an autorefractometer, was recorded. Results: In total, 54 eyes from 54 patients were enrolled. Patients were divided into 4 groups: group 1, including 14 eyes of 14 patients treated with laser therapy; group 2, 15 eyes of 15 patients treated with IVB; group 3, 13 eyes of 13 patients with non-type 1 ROP under conservative follow-up, and group 4, 12 eyes of 12 premature patients without ROP. The mean spherical equivalent at 3 years of age was -1.71 ± 1.27 dpt in group 1, -1.53 ± 2.20 dpt in group 2, 0.63 ± 1.37 dpt in group 3, and 0.41 ± 1.95 dpt in group 4. The mean refractive error differed significantly among the 4 groups (p < 0.001). Patients in groups 1 and 2 were more prone to myopia compared with those in groups 3 and 4. Furthermore, patients with type 1 ROP treated by laser photocoagulation (group 1) and those treated by IVB (group 2) had similar refraction (p = 1). Conclusions: The results of this study suggest that treatment-demanding ROP eyes are susceptible to more severe myopia with age compared with eyes without ROP or those with spontaneously regressed ROP. In addition, the myopic status between laser and IVB treatment did not differ statistically.


1977 ◽  
Vol 24 (3) ◽  
pp. 333-342 ◽  
Author(s):  
R. M. MacPherson ◽  
F. D. Deb Hovell ◽  
A. S. Jones

SUMMARY1. Of 80 gilts reared on a restricted plane of nutrition, 75 were allocated to one of four groups. Group 1; 17 gilts mated at puberty were slaughtered after farrowing their first litter. Group 2; 20 gilts mated at puberty were observed for three parities. Group 3; 18 gilts mated at second oestrus were observed for three parties. Group 4; 18 gilts mated at third oestrus were observed for three parities. Group 5; nine additional gilts reared on feed ad libitum and mated at first oestrus were observed for three parities. All animals received the same ration after the first mating.2. The mean age (±SD) of the restricted gilts at puberty was 186 ± 17 days at a weight of 89 ± 9 kg. The gilts fed ad libitum were significantly (P<0·01) older and heavier at puberty (203 ± 15 days and 120 ± 27 kg).3. Conception rates were 83, 86, 94 and 82% for Groups 1 and 2 combined, 3, 4 and 5 respectively.4. Gilts mated at first, second and third oestrus produced, respectively, 7·8, 9·8 and 10·4 ± 2·2 piglets in the first parity. Group 5 gilts had 11·0 ± 2·2 piglets. All significant differences were confined to the first parity.5. By the end of the third parity there were no differences between the restricted gilts mated at first, second or third oestrus in total number of piglets born or reared.6. The gilts slaughtered (at 135 kg) after producing one litter yielded carcasses which were heavier but leaner than those from contemporary maiden gilts grown to 120 kg on a semi-restricted feeding scale.


2006 ◽  
Vol 11 (2) ◽  
pp. 167-171
Author(s):  
Sri Puji Astuti Wahyuningsih
Keyword(s):  
Group 4 ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  

Saprolegniasis was a primary fungal disease that attacks fish eggs and fish. This disease was caused by Saprolegnia sp. The infections of Saprolegnia sp. in fish eggs can be minimized with dip treatment in formalin solution. This esearch was the control of saprolegniasis on red nila eggs (Oreochromis sp.) with formalin. This research used 400 red nila eggs. It was dipped suspension of Saprolegnia sp. (OD550 = 0,5) for 36 jam. The treatment was divided into four groups. Each group used 10 replication and each treatment with 10 eggs. The eggs in group 1 as control were not treated. The egg in-group 2, 3, and 4 were dipped formalin for five minute. The concentration of formalin in-group 2, 3, and 4 were 4 ml/L, 5 ml/L, and 6 ml/L. These data was taken after the treatment and the investigating parameter was the mean percentage of totally eggs that not infected by Saprolegnia sp. These data was analyzed by ANAVA and LSD at α = 5 percent. The results of this experiment showed that the increasing of formalin concentrations at each treatment caused significantly decreasing at the growth of Saprolegnia sp. on the red nila fish eggs. The control (1) group was not decreasing of the growth of Saprolegnia sp. The growth of Saprolegnia sp. in-group 2 decreased until 82 percent. The growth of Saprolegnia sp. in-group 3 decreased until 92 percent. The growth of Saprolegnia sp. in-group 4 decreased until 96 percent.


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