Syfte: Att utreda sambandet mellan den lösliga formen av urokinas-receptorn (suPAR) i saliv hos patienter med artrit i käkleden (A-TMJ) och friska kontroller, för att skapa en grund för vidare forskning av suPAR som prediktor för inflammationsgraden i käkleden hos patienter med A-TMJ.Material och metod: En fall-kontrollstudie utfördes med 6 kontroller (medelåldern 31±11år) och 5 patienter med A-TMJ (medelåldern 24±5år). Undersökningen bestod av salivprov, registrering av blödning vid sondering (BoP), blodprovstagning, och undersökning av tuggsystemet där antalet smärtsamma käkledsrörelser (PM) mättes. Sist samlades käkledvätska in. Halten suPAR analyserades i saliv, plasma och käkledsvätska. Resultat: En signifikant skillnad mellan suPAR i saliv kunde ej påvisas (A-TMJ 4,4±3,91ng/ml, kontroller 4,96±4,80ng/ml), emellertid hade patienter en signifikant högre halt av suPAR i plasma (A-TMJ 2,71±0,62ng/ml, kontroller: 1,86±0,35ng/ml, P=0,017). Halten av suPAR i käkledsvätska mättes till 1,57±1,50ng/ml hos patienter men kunde inte detekteras hos kontroller. BoP mättes till 16±9% hos patienter och 14±7% hos kontroller, och median(IQR) för PM var 3(1) i höger käkled och 0(3) i vänster käkled hos patienter. Slutsatser: (i) Ingen slutsats kan dras gällande sambandet mellan suPAR i saliv och A-TMJ, men (ii) patienter med A-TMJ har till viss mån en högre smärta i käkleden vid käkledsrörelse medan deras koncentration av suPAR i plasma är högre jämfört med friska kontroller. Det verkar som (iii) BoP skulle kunna vara kopplat till suPAR i saliv. Resultat från denna studie bör tolkas med försiktighet på grund av litet stickprov, fortsatt forskning behövs för att klargöra sambandet mellan suPAR i saliv och A-TMJ. / Aims: To investigate the levels of soluble urokinase plasminogen activator receptor (suPAR) in saliva between patients with arthritis in the temporomandibular joint (A-TMJ) and healthy controls to create a foundation for further research of the potential predictive value of suPAR in patients with A-TMJ.Materials and method: A case- control study was conducted, 6 controls (mean age 31±11years) and 5 patients with A-TMJ (mean age 24±5years) enrolled in the study. Saliva, blood, synovial fluid (SF) were sampled, and the masticatory system was examined according to DC/TMD, and bleeding on probing (BoP) was assessed, as was painful mandibular movement (PM). The level of suPAR was analyzed in saliva, plasma and SF.Results: Level of salivary suPAR did not differ significantly between A-TMJ patients and healthy controls (P > 0.05). Patients had a significantly higher level of suPAR in plasma than controls (A-TMJ 2.71±0.62ng/mL, controls: 1.86±0.35ng/mL, P=0.017). suPAR level in SF was measured to 1.57±1.50ng/mL in A-TMJ patients and not detected in controls. BoP was 16±9% in patients and 14±7% in controls, and median(IQR) of PM was 3(1) in the right TMJ and 0(3) in the left in patients.Conclusions: (i) No conclusion can be drawn regarding suPAR in saliva and A-TMJ, but (ii) to some degree A-TMJ patients have higher PM meanwhile their plasma concentration of suPAR is higher than controls. A trend that (iii) higher BoP is connected with higher suPAR in saliva could be distinguished. Results must be interpreted with caution due to small study sample, more research is required to further elucidate the association between suPAR in saliva and A-TMJ.

Bakgrund: ​​Reumatoid artrit (RA) eller ledgångsreumatism är den dominerande artrit sjukdom som drabbar flest vuxna i befolkning, mellan 0.3 - 1% i världen. Orsaken av sjukdomen är okänd men det finns en ärftlighet och miljömässiga faktorer som spelar en stor roll. RA ökar risk för hjärtkärlsjukdomar och osteoporos​ Syfte: ​​Syftet var att beskriva patienters upplevelse att leva med RA.​ Metod: ​​För att besvara litteraturöversiktens syfte gjordes en systematisk ​sökning i två databaser, CINALH Complete och PubMed. Åtta kvalitativa vetenskapliga artiklar inkluderades vars resultat analyserades och tematiserades baserat på likheter och skillnader mellan deltagarnas beskrivningar av erfarenheter av att leva med RA. Resultat: Analysen resulterade i fyra huvudteman: Fysiska upplevelser och begränsningar vid RA, Emotionell påverkan av RA, Sociala konsekvenser av RA, Anpassningsstrategier för att leva med RA. Slutsats: Resultaten visar att personer med RA möter en rad utmaningar såsom fysiska och psykosociala hinder. Symtom som smärta, stelhet, trötthet och funktionsnedsättning påverkar patienternas vardag negativt. För att uppnå en god livskvalitet med RA är det avgörande med stöd från omgivningen, inklusive familj och hälso- och sjukvården. Sjuksköterskans roll är att erbjuda detta stöd genom personcentrerad vård, vilket innebär att stödja patienten och deras närstående med kunskap och resurser för att hantera sjukdomen. Genom att främja patientens egenvård kan sjuksköterskan bidra till att balansera vårdbehov och självständighet. Detta är avgörande för patientens välbefinnande vid RA. / Background: Rheumatoid arthritis (RA) is the predominant arthritis disease affecting the adult population, estimated to affect between 0.3 - 1% of the world’s population. The cause of the disease is unknown, but both hereditary and environmental factors play a significant role. RA increases the risk of cardiovascular diseases and osteoporosis Aim: ​​The aim was to describe patients' experiences of living with RA.​ Method: To address the aim of the literature review, a systematic search was conducted in two databases, CINALH Complete and PubMed. Eight qualitative scientific articles were included, and their results were analysed and thematised based on similarities and differences in participants’ descriptions of living with RA Results: The analysis resulted in four main themes: Physical experiences and limitations with RA, Emotional impact of RA, Social consequences of RA, Adaptation strategies for living with RA. Conclusion: ​​The results show that individuals with RA face a range of challenges such as physical and psychosocial barriers. Symptoms such as pain, stiffness, fatigue, and functional impairment negatively affect patients’ daily lives. To achieve a good quality of life with RA, support from the environment, including family and healthcare, is crucial. The role of the nurse is to provide this support through person-centered care, which involves supporting the patient and their relatives with knowledge and resources to manage the disease. By promoting patient self-care, the nurse can contribute to balancing care needs and independence. This is crucial for the patient’s well-being with RA. ​

Rhinoceroses were an important part of North America’s Paleogene and Neogene ecosystems, with Teleoceras aepysoma being one of the last representatives of this family. Specimens of T. aepysoma from the Gray Fossil Site (GFS) possess distinct/peculiar pathologies: including a pair of fused ribs and ankylosed phalanges. A qualitative description of the pathologies in the GFS T. aepysoma, including new material, was conducted to accurately identify pathologies and make interpretations about the life history of the GFS rhinos. Analysis suggests that rheumatoid arthritis is common in the lower limb bones of GFS rhinos. Additionally, the rib and toe pathologies are more severe than anticipated, with the ribs showing multiple stages of healing indicating repeated trauma, likely being the first direct evidence of agonistic behavior in Teleoceras. This study provides a glimpse of what pathological conditions rhinocerotids may have been vulnerable to through time, as well as a baseline for future studies.

Yes / Exaggerated Janus kinase-signal transducer and activator of transcription (JAKSTAT) signalling is key to the pathogenesis of pro-inflammatory disorders, such as rheumatoid arthritis and cardiovascular diseases. Mutational activation of JAKs is also responsible for several haematological malignancies, including myeloproliferative neoplasms and acute lymphoblastic leukaemia. Accumulating evidence links adenosine 5′-monophosphate (AMP)–activated protein kinase (AMPK), an energy sensor and regulator of organismal and cellular metabolism, with the suppression of immune and inflammatory processes. Recent studies have shown that activation of AMPK can limit JAK-STAT-dependent signalling pathways via several mechanisms. These novel findings support AMPK activation as a strategy for management of an array of disorders characterised by hyper-activation of the JAKSTAT pathway. This review discusses the pivotal role of JAK-STAT signalling in a range of disorders and how both established clinically used and novel AMPK activators might be used to treat these conditions. / British Heart Foundation; Diabetes UK; Chief Scientist Office; NHS Greater Glasgow and Clyde Research Endowment Fund; Chest, Heart and Stroke Scotland

Individuals with rheumatic diseases such as Osteoarthritis (OA), Rheumatoid Arthritis (RA) and axial Spondyloarthritis (axSpA) usually are less physically active and engage in low-intensity training. Pain and function impairment lead to reduction in their quality of life. Evidence prove High-Intensity Training (HIT) can positively impact pain and function, however, usually neglected. Assessing the previous research and addressing knowledge gaps in this area can lead to more beneficial intervention to improve the overall quality of life among these populations. HIT is a beneficial and promising approach in most situations to managing symptoms including pain and function in individuals with OA, RA, and axSpA. However, contradictory results arise the need for further meticulous and high-quality studies in this area.

Humans use their hands on a daily basis, and they are a fundamental part of our lives both in terms of our work and our everyday activities. One of the key things that our hands allow us to do is grab onto objects. Unfortunately however, sometimes this ability to grab onto things becomes weakened, for example due to old age or diseases such as arthritis. This project was aimed to see if mechatronic engineering could be implemented to remedy this problem, while maintaining good accessibility and design. The resulting solution was a glove with pressure sensors and an integrated pulley system, which would provide a pulling force on the fingers and allow the user to get a reinforced grip on objects. A key factor in this design was to provide adequate function, without compromising form, i.e making the glove easy to wear and not clunky. The resulting glove provided substantial support to the test subjects grip strength, and presented a valid way to counteract their weekend state. However, the form was still considered too clunky and not efficient enough to warrant daily use. For future work, alternative pulley systems might be a valid option to slim down the glove and make it more accessible. Collaborating with people from the mechatronics industry, specifically those geared towards human augmentation, may also be beneficial to those with lacking experience or connections in the subject area. Conducting research specifically about what is considered “easy to use” may also be necessary to further solidify any changes in design. / Människor använder sina händer vardagligen, och de är en fundamental del av våra liv vad gäller både vardagssysslor och arbete. En av de viktigaste funktionerna våra händer utgör är att de tillåter oss att greppa tag i saker. Tyvärr händer det dock att denna förmåga försvagas exempelvis på grund av ålder eller sjukdomar såsom artros. Detta projekt var ämnat att se om en mekatronisk lösning kunde användas för att åtgärda detta problem, utan att göra uppoffringar vad gäller enkel design och tydlig form. Resultatet var en handske med trycksensorer och en integrerad motor som erbjöd en dragande kraft i fingrarna och ett förstärkt grepp. Den resulterande handsken erbjöd tillfredsställande support till testpersonerna greppstyrka och visade sig vara en rimlig lösning på de problem som individens artros ställt till med. Dessvärre ansågs formen fortfarande lite för otymplig och svårhanterad för att tillfredsställa önskemålen i den aspekten. För fortsatt arbete kan en annorlunda integration av motorn vara ett rimligt alternativ för att slimma ner handsken. Samarbete med företag inom robotik och mänskliga proteser kan också vara gynnsamt, speciellt för de med liten erfarenhet eller med fåtal kontakter inom testområdet. Tydligare efterforskning på vad som är “enkelt att använda” kan också leda designen i en bättre riktning.

Innerhalb der Juvenilen Idiopathischen Arthritis (JIA) bilden Patienten mit Antinukleären Antikörpern (ANA) Subgruppen-übergreifend eine klinisch homogene Erkrankungsgruppe. Ob diesen klinischen Gemeinsamkeiten jedoch auch eine einheitliche Pathogenese zugrunde liegt, ist bisher unbekannt. Sogenannte periphere T-Helferzellen (TPH) spielen im Kontext zahlreicher Autoimmunerkrankungen eine entscheidende Rolle bei der Aktivierung autoreaktiver B-Zellen. Ziel dieser Arbeit war daher die phänotypische und funktionelle Analyse von PD-1hiCXCR5-CD4+ TPH-Zellen, sowie deren Verteilung in der Synovialflüssigkeit von Patienten unterschiedlicher Subgruppen der JIA. Hierzu wurden Phänotyp und Zytokinprofil von PD-1hiCD4+ T-Zellen durchflusszytometrisch analysiert. Der funktionelle Einfluss von PD-1hiCD4+ T-Zellen auf die B-Zell-Differenzierung wurde mittels in vitro Kokulturen FACS-sortierter TPH-Zellen der Synovialflüssigkeit untersucht. IL-21- und IL-17-produzierende T-Gedächtniszellen der Synovialflüssigkeit zeigten eine negative Korrelation zueinander. Die IL-21-Produktion ging besonders von PD-1hiCXCR5-HLA-DR+CD4+ T-Zellen aus, welche besonders in den Gelenken ANA-positiver JIA-Patienten akkumulierten. Diese Population zeigte phänotypische Ähnlichkeit mit TPH-Zellen und leistete in vitro effiziente B-Zell-Hilfe zu Plasmazelldifferenzierung und Immunglobulinsekretion, induzierte jedoch zudem einen CD21lo/-CD11c+T-bet+ Phänotyp in B-Zellen. Passend hierzu bestand auch ex vivo eine signifikante Korrelation zwischen TPH und CD21lo/-CD11c+T-bet+ doppelt-negativen B-Zellen (BDN). Es konnte also die Expansion einer spezifischen T-Zellpopulation mit phänotypischen und funktionellen Charakteristika von TPH-Zellen beobachtet und deren funktioneller Zusammenhang mit CD21lo/-CD11c+T-bet+ BDN in der Synovialflüssigkeit von JIA-Patienten aufgezeigt werden. Dies könnte die Autoimmunantwort auf ubiquitäre Autoantigene innerhalb betroffener Gelenke ANA-positiver JIA-Patienten widerspiegeln. / Within Juvenile Idiopathic Arthritis (JIA), patients with antinuclear antibodies (ANA) form a clinically homogeneous group across different subgroups. However, it is currently unknown whether ANA-positive patients also share a common pathogenesis. Peripheral T helper cells (TPH) play a crucial role in the activation of autoreactive B cells in the context of numerous autoimmune diseases. Therefore, the aim of this study was the phenotypic and functional analysis of PD-1hiCXCR5-CD4+ TPH cells, as well as their distribution in the synovial fluid of patients from different JIA subgroups. For this purpose, the phenotype and cytokine profile of PD-1hiCD4+ T cells were analyzed using flow cytometry. The functional influence of PD-1hiCD4+ T cells on B cell differentiation was examined using in vitro co-cultures of FACS-sorted TPH cells from the synovial fluid. IL-21 and IL-17 producing T memory cells in the synovial fluid showed a negative correlation with each other. IL-21 production primarily originated from PD-1hiCXCR5-HLA-DR+CD4+ T cells, which particularly accumulated in the joints of ANA-positive JIA patients. This population exhibited phenotypic similarity to TPH cells and efficiently provided B cell help in in vitro experiments for plasma cell differentiation and immunoglobulin secretion, but also induced a CD21lo/-CD11c+T-bet+ phenotype in B cells. Correspondingly, there was a significant ex vivo correlation between TPH and CD21lo/-CD11c+T-bet+ double-negative B cells (BDN). Thus, an expansion of a specific T cell population with phenotypic and functional characteristics of TPH cells was observed, and their functional association with CD21lo/-CD11c+T-bet+ BDN in the synovial fluid of JIA patients was demonstrated. This could reflect the autoimmune response to ubiquitous autoantigens within the affected joints of ANA-positive JIA patients.

The pain relieving efficacy of music listening combined with vibrotactile cutaneous stimulation was determined. Music with mechanical vibration (30min. session; average amplitude of 26μm; frequency range of 60-600Hz.) was applied to subjects with rheumatoid arthritis using the Music Vibration Table (MVT). Scores from pain relief visual analogue scales (VAS) and McGill Pain Questionnaires (MPQ) were compared to groups with music alone and placebo. ANOVA and post hoc analysis indicated that VAS scores from music with vibration were significantly greater than music alone or placebo. MPQ scores also indicated larger percentages of change in pain perception for the music with vibration condition. However, subjects receiving music alone showed a large percentage of change on the affective dimension of the MPQ. This investigation supports the application of music with a controlled, measurable music vibration for the relief of pain. The results of this study warrant further evaluation and development of treatment protocols using music and music vibration.

No description available.

<p>Intraoperativna kontaminacija autokalema tokom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta je i dalje tema koja je predmet stalne debate među ortpedskim hirurzima, a koja se preteţno odnosi na potrebu i način njenog tretmana. Ona nastaje kao posledica naseljavanja uzročnika kontaminacije iz vazduha, sa koţe i sluznica kako pacijenata tako i osoblja, kao i preko nesterilisanih ili nedovoljno sterilisanih instrumenata. Patogeni koji je izazivaju su identični uzročnicima koji izazivaju septični arthritis, pa se smatra jednim od faktora rizika za njegov nastanak. Septični arthritis predstavlja najče&scaron;ću komplikaciju u artroskopskoj hirurgiji uop&scaron;te, a njegove posledice mogu bitno uticati na funkcionalni i mentalni status pacijenata. Zbog toga se smatra da je tretman intraoperativne kontaminacije autokalema tokom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena mandatoran. Najče&scaron;će primenjivani agensi u tretmanu intraoperativne kontaminacije alokalema predstavljaju različite vrste antiseptičnih i antibiotskih solucija. I pored toga &scaron;to intraoperativna irigacija fiziolo&scaron;kim rastvorom predstavlja jednu od najče&scaron;če primenjivanih procedura tokom hirur&scaron;kih operacija, u savremenoj literaturi je objavljen mali broj radova na temu primene ove procedure u tretmanu intraoperativne kontamninacije. Cilj ove studije je bio da pokaţe da se dekontaminacija autoklema tokom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena moţe uspe&scaron;no tretirati intraoperativnom mehaničkom irigacijom čistim fiziolo&scaron;kim rastvorom, kao i da odredi koja je količina fiziolo&scaron;kog rastvora dovoljna da izvr&scaron;i potpunu dekontaminaciju autokalema. Jedan od ciljeva se odnosio na utvrđivanje uticaja faktora okruţenja na pojavu intraoperativne kontaminacije. Studija se sastojala iz dva dela- eksperimentalnog i kliničkog. Eksperimentalni deo studije je bio sproveden na Odeljenju za kliničku bakteriologiju Centra za mikrobiologiju Instituta za javno zdravlje Vojvodine i sastojao se iz pravljenja eksperimentalnog modela koji je imao za cilj da u in vitro uslovima obezbedi iste ili pribliţno iste uslove kao i operacionoj sali. On se sastojao od pedeset ispreparisanih i sterilisanih svinjskih tetiva dubokih pregibača prstiju koje su po svojim dimenzijama pribliţno odgovarale humanom prednjem ukr&scaron;tenom ligamentu kolena. Tetive su potom bile kontaminirane unapred određenom koncetracijom najče&scaron;ćeg uzročnika kontaminacije, a to je koagulaza negativan stafilokok ( ATCC 12228 Staphylococcus epidermidis). One su se potom mehanički ispirale sa 500 ml, 1000 ml, i 1500 ml fiziolo&scaron;kog rastvora, a nakon svakog ispiranja uzimao se bris. Brisevi su nakon toga bili zasejavani na krvni agar, a nakon 24h inkubacije su očitavane vrednosti brojanjem kolonija uzročnika. Rezultati eksperimentalnog dela pokazuju da je količina od 1500 ml fiziolo&scaron;kog rastvora dovoljna da izazove potpunu dekontaminaciju tetive. Rezultati eksperimentalnog dela su potom bili primenjivani u kliničkom delu studije koji je obuhvatao 200 ispitanika starosne dobi između 15-50 godina i koje je je bilo sprovedeno na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine. Kontrolnu grupu su činili onih 100 pacijenata kod kojih je mehaničko intraoperativno ispiranje autokalema neposredno pred njegovu implantaciju vr&scaron;eno pomoću 500 ml fiziolo&scaron;kog rastvora, a ispitivanu grupu su činili drugih sto pacijenata kod kojih je isto to ispiranje izvr&scaron;eno sa 1500 ml fiziolo&scaron;kog rastvora. Rezultati kliničkog dela studije jasno ukazuju da je količina od 1500 ml fiziolo&scaron;kog rastvora kojim se vr&scaron;i intraoperativna mehanička irigacija dovoljna da izvr&scaron;i potpunu dekonaminaciju autokalema kao i da stepen kontaminacije autokalema raste sa povećanjem vremena koje kalem provodi na vazduhu tokom obrade, &scaron;to je u direktnoj vezi sa vremenskim trajanjem operacije i vrstom kalema koji se koristi za rekonstrukciju. Rezultati pokazuju da je rizik za nastanak kontaminacije autokalema u direktnoj vezi sa faktorima okruţenja, odnosno da se porastom broja ljudi u operacionoj sali, kao i redosledom operativnih procedura u toku jednog operativnog dana u smislu da operacije koje počinju kasnije na operativnom programu, povećava i procenat kontaminacije. Intraoperativna mehanička irigacija kontaminiranog autokalema se pokazala kao metoda koja se uspe&scaron;no moţe koristiti u intaoperativnoj dekontaminaciji autokalema tokom rekonstrukcije prednje ukr&scaron;tene veze kolena. Rezultati ove studije se mogu se primeniti i na druge asetne hirurgije i mogu posluţiti i daljim kliničkim istraţivanjima.</p> / <p>Intraoperative contamination of autograft during anterior cruciate ligament reconstruction still remains a topic for debate among orthopaedic surgeons mainly concerning the need and the way of its treatment. Graft contamination arises after pathogen settlement from the surrounding air, from skin and mucoses of patient and staff, as well as not enough sterilized instruments. Pathogens found in graft contamination are the same ones who are causes of septic arthritis, which is the most common complication in arthroscopic surgery in general. Consequences of septic arthritis usually leave a huge impact on patient&rsquo;s mental and physical status. In modern surgery, it is mandatory to prevent potential auto-graft contamination by irrigation (during anterior cruciate ligament reconstruction in knee). Most commonly used agents for intraoperative auto-graft irrigation are variety of antiseptic and antibiotic solutions. Even though intraoperative irrigation with saline solution presents one of the most commonly used procedures during different surgical interventions in general, little is said in literature about its usage in auto-graft contamination. The aim of this study was to show that decontamination of auto-graft during anterior cruciate ligament reconstruction of the knee can be successfully done by mechanical irrigation with saline (0,9%) solution and also to define a precise quantity of saline for complete decontamination. Furthermore, effects of different factors in surroundings were inspected. The study consisted of two parts: experimental and clinical. Experimental part was conducted at the Department for clinical bacteriology, at Microbiology Centre at the Institute for public health of Vojvodina. It consisted in making the experimental model with in vitro conditions similar to or as the same as in the operating theatre. Experimental model was made of 50 preparated and sterilized pig tendons of deep finger flexors, which are similar dimensions as human anterior cruciate ligament of the knee. Then, the tendons were contaminated with previously defined concentration of most common cause of contamination which is coagulase negative staphylococcus (ATCC 12228 Staphylococcus epidermidis). Contaminated tendons were mechanicaly irrigated with 500ml, 1000ml and 1500ml saline solution. After each irrigation a swab was taken and put in blood agar to grow. Following 24h of incubation, bacterial colonies were counted. Results of experimental model show that 1500ml of saline solution is required for decontamination of tendon. Results of experimental model were used in clinical part of the study which was conducted at the Clinic for orthopaedic surgery and traumatology in Clinical Centre of Vojvodina. It comprised of 200 patients, who were 15-50 years old. Patients were divided in two equal groups: tested and control group. In control group mechanical irrigation of auto-graft was done prior to its implementation with 500ml saline solution, while in tested group 1500ml of saline was used for irrigation. Results of clinical part of the study show that intraoperative irrigation with 1500ml of saline solution is enough for complete decontamination of auto-graft. Furthermore, degree of auto-graft contamination rises with prolonged exposure time on surrounding air, with incrised number of people in the operating theatre and also with number and sequence of operations during the day. Intraoperative mechanical irrigation proved to be a sufficient method that can be used in intraoperative autograft decontamination during anterior cruciate ligament reconstruction. The results of this study can be applied to other aspects of the surgery and could be used and further clinical<br />studies.</p>