bluuebunny/crossref_metadata_2025_split huggingface dataset:
FUNCTIONAL RECOVERY AND RE-INTRODUCTION TO SPORT, AFTER REPAIR OF DISTAL BICEPS TEAR BY TWO-INCISION TECHNIQUE MAYO
Authors: León R A F , Ibañez E I , Mont R N , Jaen T F 
Published: May 2013

IntroductionThree percent of all biceps tendon ruptures occur at the distal aspect, the rupture typically occuring in middle aged males after an eccentric extension load is applied to the elbow. Rupture of distal biceps tendon was once thought to be an uncommon injury, but an increase in athletic activities in middle age may account for its increase in incidence. There is an increased frequency of tendon rupture associated with use of statins and smoke.Patients usually complain of a sudden and painful tearing sensation in the anterocubital region, with a palpable defect. Biceps squeeze test, hook test and Popeye sign are useful to the diagnosis. Testing images from MRI and ultrasound may be helpful to diagnose. Early anatomic re-attachment is the goal, no operative treatment typically results in loss of flexion and supination strength and endurance.The objective of this study is the evaluation of the functional outcome and sport re-introduction in patients operated on for rupture of distal biceps tendon after rehabilitation.MethodsA retrospective study was done with 12 patients with a mean age of 46.41 years, who suffered biceps distal tendon tear treated by early surgery with the two incision of Mayo technique. Rehabilitation treatment was performed and functional outcomes were assessed from the sixth month of the intervention, using the Mayo Elbow Score (MES). The range of movement was measured by manual goniometer, and the force with medical research council scale.ResultsTwo of our 12 patients were taking statin, and three of them were smokers. The time from the break until surgery was 9.5 days on average, arrested by maintaining a splint for 5 weeks. Patients needed an average of 6 weeks of rehabilitation. Functional outcome showed a mean 95.11/100 with MES, at 6 months after surgery, which was considered excellent, with a range of motion that averaged 140°±15° and a muscular balance average of 4+/5, compared with the healthy arm. The reintroduction to usual sport was 88.9% at 10 month after surgery.DiscussionEarly repair of distal biceps tear followed by a rehabilitation treatment allows a good functional recovery and reintroduction to the sport.
SHORT- AND LONG-TERM OUTCOMES OF ELECTROLYSIS PERCUTANEOUS INTRATISSUE (EPI) IN CHRONIC LATERAL ELBOW EPICONDYLITIS
Authors: Valera-Garrido F , Minaya-Muñoz F , Sánchez-Ibáñez J M , Medina-Mirapeix F , Polidori F 
Published: May 2013

IntroductionChronic lateral elbow epicondylitis is a tendinosis with angiofibroblastic degeneration of the wrist extensors' origin. Electrolysis Percutaneous Intratissue (EPI) is a minimally invasive technique that involves the application of a galvanic current with an acupuncture needle in the soft tissue to initiate a local inflammatory process allowing phagocytosis and repair of the affected tissue. The aim of the study was evaluate the effectiveness of the EPI in chronic epicondylitis lateral.MethodsDesign:Cases series.Setting.MVClinic Physiotherapy.Subjects:Inclusion criteriawere clinically diagnosed lateral epicondylitis (based on symptoms, site of tenderness, and pain elicited with resisted active extension of the wrist in pronation and elbow extension), onset of symptoms (equal to or more than 3 months), no previous local injections (eg. cortisone), no cervicoarthrosis C5–C6, no rheumatic disorder, no history of trauma, and no signs of posterior interosseous nerve entrapment.Outcome measures.Sonographic assessment, pain was evaluated using a visual analogue scale (VAS), algometry, and functional status was evaluated by completion of the DASH and Cozen´s test and Thomson´s test which were recorded at base line and at the end of treatment, at 6w and 6m post-treatment.Intervention.All patients received Electrolysis Percutaneous Intratissue (EPI)-one treatment session per week. At home, a simple programme of stretching and eccentric loading exercises to be performed on an individual basis twice every day.No cortisone or non-steroidal anti-inflammatories were prescribed during follow-up. For pain relief only, oral paracetamol and ice therapy were used.Results36 subjects were included in the study, 52.8% men (47.2% women) with a mean age of 38 years. 80.5% of subjects reached a complete response after four sessions of EPI with a VAS<2, 86.2% negative Cozen´s test and Thomson´s test, and algometry values changed very significantly from 7.9 kg of pressure on the lateral epicondyle to 29.3 kg. DASH questionnaire showed significant changes, the mean score in the total of 36 subjects was 37.4 points, which means that there was an improvement of over 40% in functional capacity. Sonographic assessment showed change in the structure of the tendon, or hypoechoic region (long term outcomes, no short outcomes) and neovascularization (short outcomes).DiscussionThe combined programme of EPI, more eccentric exercise and stretching is an effective treatment for chronic elbow lateral epicondylitis.Limitations of the study.The main limitation is the absence of a control group to compare the results obtained with a placebo or another intervention. In scientific literature, there are no similar studies as the technique has been recently developed. The next step is to launch a pilot study to validate the results.
DOES THE TENDINOPATHIC PATELLAR TENDON NORMALISE, ACCORDING TO ULTRASOUND FINDINGS, AFTER TREATMENT WITH SCLEROSING INJECTIONS OR ARTHROSCOPIC SHAVING? A LONG TERM FOLLOW-UP (3–5 YEARS)
Authors: Sunding K , Willberg L , Niklasson U , Werner S 
Published: May 2013

IntroductionTreatment of patellar tendinopathy/jumper's knee with ultrasound-guided sclerosing injections and arthroscopic shaving has shown good clinical results, but patients treated with the one-stage procedure arthroscopic shaving had a faster return to full activity, less pain and were more satisfied with the treatment result at follow-up approximately 1 year after end of treatment.1 There are studies suggesting that tendon structure in a tendinotic, chronic painful tendon does not sonographically normalise after successful treatment. However those results are based on a relatively short term follow up.MethodsWe have evaluated patellar tendons according to a routine ultrasound examination protocol for chronic painful patellar tendons/proximal patellar tendinopathy, 3 to 5 years after treatment with sclerosing injections (n=19) or arthroscopic shaving (n=25). Tendon thickness was measured and tendon structure and the amount of neovascularization was evaluated and scored, to be compared with corresponding values at baseline and at the 1 year follow-up. Self-reported pain during rest and patellar tendon loading activity, and patient satisfaction with the result of the treatment was registered on a visual analogue scale (VAS).ResultsAt the 3–5 years follow-up, preliminary results showed that tendon structure seemed to improve, and the neovascularisation was reduced, in both groups. There was a trend towards a decrease in antero-posterior thickness of the proximal part of the patellar tendon in patients treated with arthroscopic shaving, but not for tendons treated with sclerosing injections. There were no differences in VAS score at rest and during activity between the two treatment groups or in VAS score for satisfaction with treatment.DiscussionTreatment of patellar tendinopathy/jumper's knee with ultrasound and colour Doppler-guided sclerosing injections and arthroscopic shaving showed remaining good clinical results after 3–5 years for both methods. Treatment with sclerosing injections requires multiple injections with 6–8 weeks in between, but in the 3–5 years perspective seems to reach the same result in terms of ultrasound findings and self-reported pain (VAS) as treatment with the one-stage procedure arthroscopic shaving. This is in contrast to the results at 1 year follow-up where the surgical method showed better results in all evaluated variables. One remaining difference between the two treatments was that only the surgical method showed a decrease in antero-posterior thickness. In fact tendon thickness in the group treated with sclerosing injections were increased at the 1 year follow-up, while now 3–5 years after treatment the thickness seems to be back at the same level as at baseline, before treatment.
STEM CELL THERAPY FOR TENDINOPATHY: LESSONS FROM A LARGE ANIMAL MODEL
Authors: Smith R K W 
Published: May 2013

IntroductionTendon disorders compromise pain-free activity and often progress to chronic pain with a major impact on quality of life. Achilles tendinopathy (AT) is particularly common with many proposed therapies. However, apart from eccentric loading exercises, none have been shown to be more effective than placebo.1 Even the recent popular use of platelet-rich plasma has shown poor efficacy.2 3 There is therefore a clear need for new effective non-surgical treatments. Mesenchymal stem cells (MSCs) offer the potential for tendon regeneration and improved functional outcome via either direct or paracrine effects. We have therefore investigated the efficacy of bone marrow-derived MSCs (BM-MSCs) implanted into naturally-occurring over-strain injury of the equine superficial digital flexor tendon (SDFT), a commonly-injured weight-bearing tendon with many similarities to human AT. We hypothesised that autologous implanted MSCs would survive in the tendon and induce normalisation of the tendon matrix and reduce re-injury rates.MethodsLabelling MSCs with technetium99m linked to HMPAO enabled non-invasive monitoring of cell fate in clinical cases (n=13). This revealed high initial cell loss (∼75% over 24 h). Longer term labelling with a fluorescent cytoplasmic dye showed the retention of small numbers of labelled cells for up to 5 months, similar to that reported for shorter term studies.4 5ResultsIn a controlled experimental study of naturally-occurring SDFT injuries (n=12), MSC-treated tendons had greater elasticity, reduced cross-sectional area, and cellularity, improved organisational scores, and lower GAG content compared to saline-treated tendons, although not all parameters were statistically significant.In 113 treated racehorses, the re-injury percentage was 27.4%, which was significantly less than published for racehorses treated in other ways (p<0.05 vs 56% 6; p<0.01 vs 50% 7).These findings in a large animal model of naturally-occurring tendinopathy provide supportive evidence for the efficacy and safety for the use of MSCs for the treatment of tendinopathy in humans.
GENE EXPRESSION IN TENOCYTES SUGGESTS DEGNERATIVE TENDON TEARS ATTEMPT TO HEAL
Authors: Fearon A M , Cook J L , Smith P , Scott A 
Published: May 2013

IntroductionThe breakdown of the extracellular matrix (ECM) is well recognised in tendinopathy and likely the cause of degenerative tendon tears. Tendinopathy and degenerative tears can be hard and expensive to treat. Understanding the cellular processes that lead to ECM breakdown will likely lead to improved treatments. With this in mind, the gene transcript profile for extracellular matrix remodelling of tendon specimens from people with greater trochanteric pain syndrome (GTPS) and associated gluteal tendon tears were compared to an age and sex matched reference group.MethodsTendon specimens were collected from six participants undergoing gluteal tendon reconstruction for long standing (mean duration=41 months) GTPS, and four participants from an age-matched reference group (REF) of hip OA patients asymptomatic for GTPS. Specimens were collected using sterile technique and were stored at −80°C. RNA was isolated via laser capture micro-dissection (LCM) of areas of tendon that typified tendon rather than para-tendon or vessels within the specimen—identified using light microscopy and H&E staining. Specimens were tested using the SABiosciences array (PAHS-013). Immunohistochemistry was used to confirm the site of a subset of the expressed genes.ResultsWe report on gene regulation changes of at least five fold that were seen in the GTPS group compared to the REF group. Genes involved in extracellular matrix modelling were both up regulated (MMP7) and down regulated (MMP3). The following cell adhesion genes were up regulated: ITGAV, NCAM1, ITGAM, while ITG3 was down regulated. The following genes involved in ECM synthesis were up regulated (LAMC1, COL1A1, COL5A1, Col6A1), while ADMATS1, LAMB3, VTN were down regulated.ConclusionsThis paper presents a novel method of tissue specimen selection (LCM), reducing the likelihood of RNA contamination from cells other than tenocytes. Further, these results suggest that there is increased cell activity and collagen production indicating that the tendon is continuing to actively remodel despite prolonged tissue damage. This supports the role of appropriate advice regarding tendon loading and compression, exercises to strengthen the musclo-tendinous unit, and ongoing support to patients. Recovery from tendinopathy may be possible—even in longstanding cases.
INCREASED LEVELS OF APOPTOSIS AND P53 IN PARTIAL-THICKNESS SUPRASPINATUS TENDON TEARS
Authors: Lundgreen K , Lian Ø , Scott A , Engebretsen L 
Published: May 2013

IntroductionThe role of apoptosis in the progression of rotator cuff tendinopathy is poorly understood. The primary aim of this study was to quantify the amount of apoptosis in supraspinatus tendons presenting partial-thickness tears and matched intact subscapularis tendons.Methods9 partially torn supraspinatus tendons and matched intact subscapularis tendons were biopsied and compared to 10 reference subscapularis tendon samples. Immunohistochemistry was used to assess apoptotic cells (activated caspase-3; Asp175), proliferation (Ki67) and p53 (M7001), a key protein involved in regulating cell death. The Bonar scale was used to evaluate tendon degeneration.ResultsThe partially torn supraspinatus tendons and matched subscapularis tendons demonstrated a significant increase in the density of apoptotic cells and p53 expression. The Bonar score revealed significant tendon degeneration in the partially torn supraspinatus tendon compared to both matched and reference subscapularis tendon. The number of proliferating tendon cells was higher in the partially torn supraspinatus than in the matched or reference subscapularis tendons.DiscussionThe presence of increased apoptosis and p53 in partial-thickness tears of the supraspinatus tendon is accompanied by features of both degeneration as well as ongoing repair. Apoptosis may be a relatively early feature in the continuum of rotator cuff tendinopathy.
ECCENTRIC EXERCISES COMBINED WITH ELECTRICAL STIMULATION IN THE TREATMENT OF JUMPER'S KNEE: A STUDY ON SIX HIGH LEVEL JUMPING ATHLETES
Authors: Basas García A , Lorenzo A , Gómez-Ruano M A , Fernández Jaén T , Álvarez Rey G 
Published: May 2013

IntroductionTreatment of patellar tendinopathy (PT)/Jumper's knee (JK) is known to be difficult, and there is no treatment of choice. This work analyses the development of a protocol using eccentric exercises and electrical stimulation, both using maximum tendon loading, to treat elite athletes suffering from Jumper's knee.MethodsSix high level jumping athletes with chronic painful PT/JK completed a 6-month treatment/training programme using eccentric exercises and electrical stimulation. The protocol was done12 weeks in the winter pre-season and 10 weeks in the summer pre-season, for all together 36 months. Pain during patellar tendon loading activity was evaluated on a VAS, before the first session and then every 6 months.ResultsThe VAS average fell significantly when the initial measurement is compared with those at 18, 24 and 48 months (p<0.01). There were no significant differences between the other comparisons, although they always improved when the protocol was followed and worsened following interruption of the latter (p>0.05).DiscussionIn a small group of high level jumping athletes with chronic painful PT/JK, eccentric exercises combined with electrical stimulation showed promising clinical results with significant pain reduction during tendon loading activity.
TENDONS: TIME TO REVISIT INFLAMMATION?
Authors: Rees J D , Stride M , Scott A 
Published: May 2013

It is currently widely accepted that chronic tendinopathy is caused by a degenerative process devoid of inflammation. Current treatment strategies have focused on physical treatments including eccentric exercises, peritendinous injections of blood or blood products and interruption of painful stimuli. Results have been at best moderately good and at worst a failure.The evidence for degeneration alone as the cause of tendinopathy is surprisingly weak. There is compelling evidence that inflammation is a key component of chronic tendinopathy. Newer anti-inflammatory modalities provide alternative potential opportunities in treating chronic tendinopathies and should be explored further.
Tracking of cardiovascular risk factors across generations: family linkage within the population-based HUNT study, Norway
Authors: Vik Kirsti L , Romundstad Pål , Nilsen Tom IL 
Published: May 2013

BackgroundParent-offspring studies have shown that cardiovascular risk factors cluster within families. However, most studies have assessed the offspring cardiovascular risk factor level at a young age, and whether an association persists into the offspring's adult life is less clear. This study linked information between parents and their adult offspring to investigate the intergenerational association of anthropometric measures, blood pressure, blood lipid levels and physical activity.MethodsThe study population consisted of parent and adult offspring pairs (11 931 fathers–sons, 12 563 fathers–daughters, 15 626 mothers–sons and 16 449 mothers–daughters) who participated in the second and third cross-sectional waves of the Nord-Trøndelag Health Study (HUNT 2, 1995–1997 and HUNT 3, 2006–2008). A general linear model and logistic regression were used to estimate the association between the parent and offspring risk factor levels.ResultsAll continuously measured cardiovascular risk factors under study showed a statistically significant positive association between parents and offspring, except the waist-hip ratio. Adjusted coefficients from linear regression ranged from 0.09 (95% CI 0.07 to 0.11) for waist circumference to 0.29 (95% CI 0.27 to 0.32) for body weight. Moreover, offspring were two to three times more likely to be obese, have a high cholesterol level, or hypertension when comparing extreme categories of the corresponding parental risk factor level. Physically active parents had a lower risk of having physically inactive offspring.ConclusionsThe results suggested that cardiovascular risk factors track across generations and persist into the offspring's adult life.
FINITE VORONOI DECOMPOSITIONS OF INFINITE VERTEX TRANSITIVE GRAPHS
Authors: FINUCANE HILARY 
Published: May 2013

In this paper, we consider the Voronoi decompositions of an arbitrary infinite vertex-transitive graph G. In particular, we are interested in the following question: what is the largest number of Voronoi cells that must be infinite, given sufficiently (but finitely) many Voronoi sites which are sufficiently far from each other? We call this number the survival number s(G). The survival number of a graph has an alternative characterization in terms of the number of balls of radius r-1 required to cover a sphere of radius r. The survival number is not a quasi-isometry invariant, but it remains open whether finiteness of s(G) is. We show that all vertex-transitive graphs with polynomial growth have finite s(G); vertex-transitive graphs with infinitely many ends have infinite s(G); the lamplighter graph LL(Z), which has exponential growth, has finite s(G); and the lamplighter graph LL(Z2), which is Liouville, has infinite s(G).
Characterizing discontinuities in naturally fractured outcrop analogues and rock core: the need to consider fracture development over geological time
Authors: Hencher S. R. 
Published: May 2013

Abstract
This paper reviews aspects of the procedures for characterizing rock masses from outcrop mapping and core logging. It is argued that current definitions of discontinuities and joints are too simple and too coarse to deal adequately with the range of geological features that are found in the field and that range from open fractures through to incipient joint traces. A generic approach is proposed that differentiates between discontinuities on the basis of relative tensile strength compared to the intact parent rock. Examples are provided of how fracture frequency and extent vary with degree of weathering and erosion, and it is suggested that the concept of dynamic development of geological discontinuities needs to be appreciated by geotechnical engineers and structural geologists when analysing fracture networks. This concept has major implications for the use of rock mass classifications to zone the rock mass into engineering units.
Tumor Heterogeneity and Permeability as Measured on the CT Component of PET/CT Predict Survival in Patients with Non–Small Cell Lung Cancer
Authors: Win Thida , Miles Kenneth A. , Janes Sam M. , Ganeshan Balaji , Shastry Manu , Endozo Raymondo , Meagher Marie , Shortman Robert I. , Wan Simon , Kayani Irfan , Ell Peter J. , Groves Ashley M. 
Published: May 2013

Abstract
Purpose: We prospectively examined the role of tumor textural heterogeneity on positron emission tomography/computed tomography (PET/CT) in predicting survival compared with other clinical and imaging parameters in patients with non–small cell lung cancer (NSCLC).
Experimental Design: The feasibility study consisted of 56 assessed consecutive patients with NSCLC (32 males, 24 females; mean age 67 ± 9.7 years) who underwent combined fluorodeoxyglucose (FDG) PET/CT. The validation study population consisted of 66 prospectively recruited consecutive consenting patients with NSCLC (37 males, 29 females; mean age, 67.5 ± 7.8 years) who successfully underwent combined FDG PET/CT-dynamic contrast-enhanced (DCE) CT. Images were used to derive tumoral PET/CT textural heterogeneity, DCE CT permeability, and FDG uptake (SUVmax). The mean follow-up periods were 22.6 ± 13.3 months and 28.5± 13.2 months for the feasibility and validation studies, respectively. Optimum threshold was determined for clinical stage and each of the above biomarkers (where available) from the feasibility study population. Kaplan–Meier analysis was used to assess the ability of the biomarkers to predict survival in the validation study. Cox regression determined survival factor independence.
Results: Univariate analysis revealed that tumor CT-derived heterogeneity (P &lt; 0.001), PET-derived heterogeneity (P = 0.003), CT-derived permeability (P = 0.002), and stage (P &lt; 0·001) were all significant survival predictors. The thresholds used in this study were derived from a previously conducted feasibility study. Tumor SUVmax did not predict survival. Using multivariable analysis, tumor CT textural heterogeneity (P = 0.021), stage (P = 0.001), and permeability (P &lt; 0.001) were independent survival predictors. These predictors were independent of patient treatment.
Conclusions: Tumor stage and CT-derived textural heterogeneity were the best predictors of survival in NSCLC. The use of CT-derived textural heterogeneity should assist the management of many patients with NSCLC. Clin Cancer Res; 19(13); 3591–9. ©2013 AACR.