Podcasts about Synovial

This week Jonathan is joined by Isabelle Amigues, CEO and Founder of UnabridgedMD, Denver, Colorado, USA. Together, they discuss the first part of her career as an academic clinician followed by how her diagnosis of Stage IV breast cancer shaped her approach to use the best in data-driven Western medicine combined with traditional Eastern healing.   Timestamps:    (00:00) - Introduction (02:02) - Isabelle's unique hobby: rock climbing (03:33) - Isabelle's journey into rheumatology (05:58) - Being diagnosed with Stage IV breast cancer (14:17) - The mind-body connection (20:25) - “Hope driven by science” (24:25) - The benefits of holistic approaches (32:29) - Psychological distress in healthcare professionals (37:10) - Synovial fluid and biomarker proteins (39:48) - Isabelle's three wishes for healthcare (42:37) - Outro

Dr Warner discusses the FDA approval of afami-cel for patients with advanced synovial sarcoma and key findings from the pivotal SPEARHEAD-1 trial.

In a conversation with CancerNetwork®, Brian A. Van Tine, MD, PhD, spoke about the FDA accelerated approval of afamitresgene autoleucel (afami-cel; Tecelra) for patients with metastatic or unresectable synovial sarcoma expressing MAGE-A4. He discussed the data from the phase 2 SPEARHEAD-1 trial (NCT04044768) supporting the agent's use in this patient population and highlighted how this approval might pave the way for other potential developments in the sarcoma landscape. Van Tine, a professor of medicine and pediatrics and a medical oncologist at Siteman Cancer Center of Washington University in St. Louis, detailed results from SPEARHEAD-1 leading to the FDA's approval of afami-cel. Based on these findings and the agent's potential availability as a one-time intravenous fusion, afami-cel may offer improvements in quality of life to patients with synovial sarcoma compared with standard treatment options such as chemotherapy. Topline data from cohort 1 of the SPEARHEAD-1 trial showed that treatment with afami-cel produced an objective response rate of 43% among 44 evaluable patients, which included a complete response rate of 4.5%. Additionally, the median duration of response was 6 months (95% CI, 4.6-not reached). Of patients with a response, durable responses lasting for 12 months or longer occurred in 39%.  In terms of other potential benefits following the accelerated approval of afami-cel, Van Tine said that the T-cell therapy may increase treatment access to specific subsets of patients. For those who are unable to relocate and live near certain treatment centers during their therapy, afami-cel may offer a more readily accessible alternative that can allow patients to undergo treatment at home. Van Tine also described how this accelerated approval may “open the gateway” for other advancements related to the use of afami-cel and similar agents in solid tumors.  “We're all working hard to get these therapies open at our institutions,” Van Tine said regarding the next steps for increasing access to afami-cel following the accelerated approval. “Knowing who [has] HLA-A*02–positive [disease], knowing who has synovial sarcoma, and being ready to trigger the screening for MAGE-A4 is in every patient's best interest. If you're one of the patients who have synovial sarcoma, you need to know your status [to determine] how we're going to integrate this into your care plan.” Reference Adaptimmune receives U.S. FDA accelerated approval of TECELRA® (afamitresgene autoleucel), the first approved engineered cell therapy for a solid tumor. News release. Adaptimmune Therapeutics. August 2, 2024. Accessed August 14, 2024. https://tinyurl.com/mw6k4hjh

In this episode of Targeted Talks, Edwin Choy, MD, PhD, discussed the FDA approval of afamitresgene autoleucel for the treatment of patients with advanced synovial sarcoma.

The FDA give an updated on the availability of obesity drugs; The CDC has issued an updated guideline on contraceptive use; The first T-cell gene therapy is approved for synovial sarcoma; Lymphir gains approval for relapsed or refractory cutaneous T-cell lymphoma; Fabhalta gains a new indication.

Follow along with our Nailed it Board/OITE Podcast Companion book. Get your copy by clicking here >> https://a.co/d/cr4i8nD  Enjoy another episode from our board review series featuring Dr. Cole and Dr. Woolwine.   This episode is sponsored by the American Academy of Orthopaedic Surgeons: Filled with content that has been vetted by some of the top names in orthopaedics, the AAOS Resident Orthopaedic Core Knowledge (ROCK) program sets the standard for orthopaedic education. Whether ROCK is incorporated into your residency curriculum, or you use it independently as a study tool, the educational content on ROCK is always free to residents. You'll gain the insights and confidence needed to ensure a successful future as a board-certified surgeon who delivers the best patient care. Log on at https://rock.aaos.org/. 

Visit learnamastyle.com for free downloads and free courses related to writing in medicine and science.  - The FDA has approved donanemab (Kisunla) for early symptomatic Alzheimer's disease, making it the third drug in a new class aimed at slowing cognitive decline in early-stage patients. Eli Lilly will make the drug available within weeks following this approval. Donanemab is an anti-amyloid monoclonal antibody that targets amyloid plaques in the brain, a key feature of Alzheimer's.  - The FDA approval was based on clinical trials showing significant benefits in slowing cognitive decline despite concerns about long-term safety. The advisory committee voted unanimously in favor of the drug, with the FDA granting the approval to Eli Lilly. - The FDA has approved bedaquiline (Sirturo) for treating multidrug-resistant pulmonary tuberculosis (TB) in adults and children aged five and above. Sirturo initially received accelerated FDA clearance for adults in 2012, with later label expansions for younger patients. Bedaquiline, the first TB drug with a new action mechanism in over 40 years, inhibits mycobacterial ATP synthase, essential for energy production in TB bacteria.. - The FDA is nearing a decision on KarXT, a novel antipsychotic for schizophrenia developed by Karuna Therapeutics. KarXT has shown efficacy in reducing symptom severity in clinical trials, with a favorable side effect profile compared to older antipsychotics. Concerns about insurance coverage exist due to the availability of cheaper generics, but a decision is expected by September 26. - MDMA-assisted therapy for PTSD, developed by Lykos Therapeutics, has shown significant symptom reduction in clinical trials but faces approval challenges. Despite positive trial results, the FDA advisory panel voted against recommending the drug, citing safety concerns. The FDA's final decision is expected by August 11.  - Seladelpar, under consideration for primary biliary cholangitis (PBC), is a drug Gilead recently acquired through the purchase of CymaBay. If approved by August 14, it would expand Gilead's liver disease portfolio. Clinical trials have shown seladelpar to be effective in reducing the itching associated with PBC. - TransCon PTH by Ascendis Pharma is a treatment for hypoparathyroidism, designed to replace parathyroid hormone and help patients achieve normal calcium levels. Despite manufacturing concerns delaying the FDA's decision, the drug has already been approved in Europe and the UK. A final FDA decision is expected by August 14.  - Afami-cel, a T-cell receptor therapy for synovial sarcoma developed by Adaptimmune Therapeutics, awaits FDA approval by August 4. The therapy targets the MAGE A4 cancer target and is designed as a single-dose treatment. Clinical trial data supporting the application showed efficacy in treating advanced synovial sarcoma.

In this episode, we review the high-yield topic of⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Synovial Sarcoma⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Pathology section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message

BUFFALO, NY- February 13, 2024 – A new #research paper was #published in Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 16, Issue 2, entitled, “IL-17 promotes IL-18 production via the MEK/ERK/miR-4492 axis in osteoarthritis synovial fibroblasts.” The concept of osteoarthritis (OA) as a low-grade inflammatory joint disorder has been widely accepted. Many inflammatory mediators are implicated in the pathogenesis of OA. Interleukin (IL)-18 is a pleiotropic cytokine with versatile cellular functions that are pathogenetically important in immune responses, as well as autoimmune, inflammatory, and infectious diseases. IL-17, a proinflammatory cytokine mainly secreted by Th17 cells, is upregulated in OA patients. However, the role of IL-17 in OA progression is unclear. In this new study, researchers Kun-Tsan Lee, Chih-Yang Lin, Shan-Chi Liu, Xiu-Yuan He, Chun-Hao Tsai, Chih-Yuan Ko, Yuan-Hsin Tsai, Chia-Chia Chao, Po-Chun Chen, and Chih-Hsin Tang from National Chung-Hsing University, Taichung Veterans General Hospital, Shin-Kong Wu Ho-Su Memorial Hospital, Mackay Medical College, China Medical University, Show-Chwan Memorial Hospital, Fu-Jen Catholic University, National Taiwan Normal University, Asia University, and China Medical University Hsinchu Hospital used synovial tissues collected from healthy donors and OA patients to detect the expression level of IL-18 by immunohistochemistry stain. “Elucidation of the molecular mechanisms and main factors involved in OA pathogenesis may help with the development of novel therapeutic targets that relieve OA pain or prevent the disease from progressing.” The OA synovial fibroblasts (OASFs) were incubated with recombinant IL-17 and subjected to Western blot, qPCR, and ELISA to examine IL-18 expression level. The chemical inhibitors and siRNAs which targeted signal pathways were used to investigate signal pathways involved in IL-17-induced IL-18 expression. The microRNAs which participated IL-18 expression were surveyed with online databases miRWalk and miRDB, followed by validation with qPCR. This study revealed significantly higher levels of IL-18 expression in synovial tissue from OA patients compared with healthy controls, as well as increased IL-18 expression in OASFs from rats with severe OA. In vitro findings indicated that IL-17 dose-dependently promoted IL-18 production in OASFs. Molecular investigations revealed that the MEK/ERK/miR-4492 axis stimulated IL-18 production when OASFs were treated with IL-17. “This study provides novel insights into the role of IL-17 in the pathogenesis of OA, which may help to inform OA treatment in the future.” DOI - https://doi.org/10.18632/aging.205462 Corresponding authors - Po-Chun Chen - pcchen@ntnu.edu.tw, and Chih-Hsin Tang - chtang@mail.cmu.edu.tw Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts About Aging-US Launched in 2009, Aging-US publishes papers of general interest and biological significance in all fields of aging research and age-related diseases, including cancer—and now, with a special focus on COVID-19 vulnerability as an age-dependent syndrome. Topics in Aging-US go beyond traditional gerontology, including, but not limited to, cellular and molecular biology, human age-related diseases, pathology in model organisms, signal transduction pathways (e.g., p53, sirtuins, and PI-3K/AKT/mTOR, among others), and approaches to modulating these signaling pathways. Please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc Media Contact 18009220957 MEDIA@IMPACTJOURNALS.COM

ChatGPT4 in medical writing and editing at learnAMAstyle.com Nascentmc.com for medical writing assistance for your company. Visit nascentmc.com/podcast for full show notes Tricuspid Valve Replacement System for Tricuspid Regurgitation The FDA approved the Evoque tricuspid valve replacement system, a first in the U.S. for a transcatheter tricuspid device, after the TRISCEND II trial showed significant improvements in TR grade and patient symptoms. TR, where the heart's valve does not close properly causing blood backflow, can now be treated with this device, which also received CE Mark approval in Europe and is produced by Edwards Lifesciences. Afami-Cel for Synovial Sarcoma The FDA is prioritizing the review of afamitresgene autoleucel (afami-cel) for advanced synovial sarcoma, based on positive results from the SPEARHEAD-1 trial showing a 39% response rate and increased survival rates. Afami-cel targets MAGE-A4 in synovial sarcoma, a rare soft tissue sarcoma, offering a new treatment option for this aggressive disease. It's manufactured by Adaptimmune Therapeutics with a decision expected by August 4, 2024.  Pulsed Field Ablation for Atrial Fibrillation Boston Scientific's FARAPULSE PFA System has been FDA approved for treating intermittent atrial fibrillation, offering a non-thermal, tissue-selective ablation alternative with proven safety and efficacy. The approval was based on the ADVENT study and real-world data, highlighting shorter ablation times and no severe side effects. Boston Scientific plans an immediate U.S. launch. Shorter Turnaround Time for Axi-cel The FDA approved a manufacturing process change for axi-cel (Yescarta), reducing delivery time from 16 to 14 days, which is a CD19-directed CAR T-cell therapy for certain lymphomas. This change, granted to Kite, a Gilead Sciences subsidiary, aims to improve treatment accessibility by offering faster delivery of this personalized therapy. AI Algorithm for Cervical Cancer Screening Hologic's Genius™ Digital Diagnostics System with the Genius™ Cervical AI algorithm has been FDA approved, introducing the first digital cytology platform integrating AI for cervical cancer screening. This system digitizes traditional Pap test slides, applying AI to enhance detection of pre-cancerous and cancerous cells, improving sensitivity and enabling remote case review. It will be available in the U.S. in early 2024. Trastuzumab Deruxtecan for Solid Tumors The FDA granted priority review to trastuzumab deruxtecan for treating unresectable or metastatic HER2-positive solid tumors, potentially marking it as the first HER2-directed, tumor-agnostic therapy. Based on the DESTINY-PanTumor02 study, showing promising survival outcomes, a decision is expected in the second quarter of 2024. The drug is developed by AstraZeneca and Daiichi Sankyo.  

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Synovium & Synovial Fluid ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Basic Science section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message

durée : 00:05:03 - Un Landais sensibilisent des jeunes et des médecins à propos de son sarcome synovial

Darien CT- Knee Pain TreatmentIf you have knee pain that won't go away your doctor has probably told you about gel shots to help the knee pain Hyaluronic acid is a substance that occurs naturally in the synovial fluid of joints, providing lubrication and cushioning. Gel shots for knee pain typically refer to intra-articular injections of viscosupplements, also known as hyaluronic acid injections the effectiveness of hyaluronic acid injections for knee pain remains a topic of debate among medical professionals The Knee on Trac is a therapy device that stimulates the knee to produce synovial fluid naturally. The synovium is responsible for producing synovial fluid naturally Synovial fluid lubricates the joint surfaces, reducing friction during movement and allowing for smooth articulation of the bones The Knee on Trac allows your knee to produce more of it's own synovial fluid to stop your knee pain The lubricating effect heals meniscus tears and provides cushioning to your knee Core Health Darien is the only facility in Connecticut to offer The Knee on Trac Before you consider knee replacement or knee surgery call 203-656-3636 and try the Knee on Trac This podcast welcomes your feedback here are several ways to reach out to me. If you have a topic you would like to hear about send me a message. I appreciate your listening. Dr. Brian Mc Kayhttps://twitter.com/DarienChiro/https://www.facebook.com/ChiropractorBrianMckayhttps://chiropractor-darien-dr-brian-mckay.business.sitehttps://podcasts.apple.com/us/podcast/not-just-chiropractor-for-stamford-darien-norwalk-new/id1503674397?uo=4Core Health Darien-Dr.Brian Mc Kay 551 Post RoadDarien CT 06820203-656-363641.0833695 -73.46652073GMP+87 Darien, Connecticuthttps://youtu.be/WpA__dDF0O041.0834196 -73.46423349999999https://darienchiropractor.comhttps://darienchiropractor.com/darien/darien-ct-understanding-pain/Find us on Social Mediahttps://chiropractor-darien-dr-brian-mckay.business.site https://www.youtube.com/channel/UCNHc0Hn85Iiet56oGUpX8rwhttps://docs.google.com/spreadsheets/d/1nJ9wlvg2Tne8257paDkkIBEyIz-oZZYy/edit#gid=517721981https://goo.gl/maps/js6hGWvcwHKBGCZ88https://www.youtube.com/my_videos?o=Uhttps://www.linkedin.com/in/darienchiropractorhttps://www.facebook.com/ChiropractorBrianMckayhttps://sites.google.com/view/corehealthdarien/https://sites.google.com/view/corehealthdarien/home

Ask the Experts: Medical vs Surgical Management of Synovial Cyst Bryan Lee, MD Scott Kreiner, MD Jacob Rohrs, MD Edward Dohring, MD

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Synovial Facet Cyst⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠from the Spine section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message

Episode 146: RA vs OA    Future Dr. Magurany explains how to differentiate rheumatoid arthritis from osteoarthritis.  Written by Thomas Magurany, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.1. Etiology: Rheumatoid Arthritis (RA): RA is an autoimmune disease wherein the immune system mistakenly attacks healthy tissues, particularly the synovial joints, usually between the ages of 30-50. Genetic predisposition, environmental factors such as smoking or infections, hormonal imbalances, and lower socioeconomic status have been associated with an increased risk of developing RA(1).Osteoarthritis (OA): OA primarily arises due to mechanical stress on the joints over time. Factors contributing to OA include age, obesity, joint injury or trauma, repetitive joint use or overuse, genetic abnormalities in collagen structure, and metabolic disorders affecting cartilage metabolism (2).The greatest risk factor for the development of OA is age with most patients presenting after 45 years of age. The greatest modifiable risk factor for OA is weight. People with a BMI >30 were found to have a 6.8 times greater risk of developing OA. (3) Primary OA is the most common and is diagnosed in the presence of associated risk factors such as: older age, female gender, obesity, anatomical factors, muscle weakness, and joint injury (occupation/sports activities) in the absence of trauma or disease. Secondary OA occurs alongside a pre-existing joint deformity including trauma or injury, congenital joint disorders, inflammatory arthritis, avascular necrosis, infectious arthritis, Paget disease, osteopetrosis, osteochondritis dissecans, metabolic disorders (hemochromatosis, Wilson's disease), Ehlers-Danlos syndrome, or Marfan syndrome.2. Pathogenesis:Rheumatoid Arthritis (RA):In some patients, RA is triggered by some sort of environmental factor in a genetically predisposed person. The best example is tobacco use in a patient with HLA-DRB1. The immune response in RA starts at sites distant from the synovial joints, such as the lung, gums, and GI tract. In these tissues, modified proteins are produced by biochemical reactions such as citrullination. (4)In RA, an abnormal immune response leads to chronic inflammation within the synovium lining the joints. The inflammatory cytokines released cause synovitis and lead to the destruction of articular cartilage and bone erosion through pannus formation. Immune cells infiltrate the synovium causing further damage. (4) In summary: formation of antibodies to citrullinated proteins, these antibodies begin attacking wrong tissues.Osteoarthritis (OA):The primary pathological feature of OA is the degeneration of articular cartilage that cushions the joints causing surface irregularity, and focal erosions. These changes progress down the bone and eventually involve the entire joint surface. Mechanical stress triggers chondrocyte dysfunction, leading to an imbalance between cartilage synthesis and degradation that cause cartilage outgrowths that ossify and form osteophytes. This results in the release of enzymes that degrade the extracellular matrix, leading to progressive cartilage loss. As more of the collagen matrix is damaged, chondrocytes undergo apoptosis. Improperly mineralized collagen causes subchondral bone thickening; in advanced disease, bone cysts infrequently occur (5). In summary: Osteophytes formation and cartilage loss.3. Clinical Presentation:Rheumatoid Arthritis (RA):The most common and predominant symptoms include joint pain and swelling, usually starting insidiously over a period of weeks to months. RA typically affects multiple joints symmetrically, commonly involving small joints of the hands, wrists, feet and progresses to involve proximal joints if left untreated. Morning stiffness lasting more than an hour is a characteristic feature. The affected joint will be painful if pressure is applied to the joint or on movement with or without joint swelling. Synovial thickening with a "boggy" feel on palpation will be noted. The classical physical findings of ulnar deviation, metacarpophalangeal joint subluxation, swan neck deformity, Boutonniere deformity, and the "bowstring" sign (prominent and tight tendons on the dorsum of the hand) are seen in advanced chronic disease. (4) Around ¼ of patients with RA may present with rheumatoid noduleswhich are well demarcated, flesh-colored subcutaneous lumps. They are usually described as being doughy or firm and are not typically tender unless they are inflamed. They are usually found on areas susceptible to repeated trauma or pressure and include the elbows, fingers and forearms. Osteoarthritis (OA):OA primarily affects weight-bearing joints such as knees, hips, spine, and hands. Symptoms include joint pain aggravated by activity and relieved with rest, morning stiffness lasting less than 30 minutes, joint swelling due to secondary inflammation, and occasionally the formation of bony outgrowths called osteophytes (6). Tenderness may be present at joint lines, and there may be pain upon passive motion. Classic physical exam findings in hand OA include Heberden's nodes (posterolateral swellings of DIP joints), Bouchard's nodes (posterolateral swellings of PIP joints), and “squaring” at the base of the thumb (first Carpal-Metarcapal or CMC joints), bony enlargement, crepitus, effusions (non-inflammatory), and a limited range of motion. Patients may also experience bony swelling, joint deformity, and instability (patients complain that the joint is “giving way” or “buckling,” a sign of muscle weakness). (5)4. Lab findings:Rheumatoid Arthritis: Laboratory testing often reveals anemia of chronic disease (increased ferritin, decreased iron and TIBC) and thrombocytosis. Neutropenia may be present if Felty syndrome is present. RF is present in 80-90% of patients with a sensitivity of 69%. In patients who are asymptomatic or those that have arthralgias, a positive RF and especially CCP predicts the onset of clinical RA. Patients with RA with RF, ACPA, or both are designated as having seropositive RA. About 10% of RA patients are seronegative. ESR and levels of CRP are usually elevated in patients with active disease and can be used to assess disease activity. The synovial fluid in RA will also reveal low C3 and C4 levels despite elevated serum levels.(4) Some non-specific inflammatory markers such as ESR, CRP can help you guide your diagnosis of RA.Osteoarthritis:Lab findings are not significant. Clinical diagnosis if the following are present: 1) pain worse with activity and better with rest, 2) age more than 45 years, 3) morning stiffness lasting less than 30 minutes, 4) bony joint enlargement, and 5) limitation in range of motion. Blood tests such as CBC, ESR, rheumatoid factor, ANA are usually normal but usually ordered to rule out an inflammatory process. Synovial fluid should show a white blood cell count less than 2,000/microL, predominantly mononuclear cells (non-inflammatory). X-rays of the affected joint can show findings consistent with OA, such as marginal osteophytes, joint space narrowing, subchondral sclerosis, and cysts; however, radiographic findings do not correlate to the severity of the disease and may not be present early in the disease. (5)5. Treatment Approaches:Rheumatoid Arthritis (RA):There is no cure for RA.The goal of treatment in RA is inducing remission and optimizing quality of life. This is initially done by beginning DMARDs, include methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide. Methotrexate is the initial DMARD of choice. Anti-TNF-alpha inhibitors include etanercept, infliximab, adalimumab, golimumab, and certolizumab may be used if DMARDs fail. NSAIDs are used to control joint pain and inflammation. Corticosteroids may be used as a bridge therapy to DMARDs in a newly diagnosed patient with a very active disease. (7) Coronary artery disease has a strong association with RA. RA is an independent risk factor for the development of coronary artery disease (CAD) and accelerates the development of CAD in these patients. Accelerated atherosclerosis is the primary cause of morbidity and mortality. There is increased insulin resistance and diabetes mellitus associated with RA and is thought to be due to chronic inflammation. When treated with specific DMARDs such as hydroxychloroquine, methotrexate, and TNF antagonists, there was a marked improvement in glucose control in these patients. (8) RA is not just a disease of the joints, it is able to affect multiple organ systems.Osteoarthritis (OA):OA treatment aims at reducing pain and improving joint function through a combination of non-pharmacological interventions like exercise programs tailored to strengthen muscles around affected joints, weight management strategies, and assistive devices like braces or walking aids if required (9). Medications including analgesics or nonsteroidal anti-inflammatory drugs may be prescribed for pain relief when necessary. Duloxetine has modest activity in relieving pain associated with OA. Intraarticular glucocorticoid joint injections have a variable response but are an option for those wanting to postpone surgical intervention. In severe cases where conservative measures fail, surgical options like joint replacement may be considered (9). Weight loss is a critical intervention in those who have overweight and obesity; each pound of weight loss can decrease the load across the knee 3 to 6-fold. (5) Summary: Medications (NSAIDs, topical, duloxetine), weight loss, PT, intraarticular injections of corticosteroids, and joint replacement.________________________________Conclusion: Now we conclude episode number 146, “RA vs. OA.” Future Dr. Magurany explained that rheumatoid arthritis is an autoimmune disease that presents with joint pain and inflammation, mostly on hands and small joints, accompanied by morning stiffness longer than 1 hour. The rheumatoid factor and ACPA may be positive in a percentage of patients but not always. The base of treatment is early treatment with disease-modifying antirheumatic drugs to induce remission of the disease. OA affects weight-bearing joints with little to no inflammation, treatment is mainly lifestyle modifications, analgesics, intraarticular injections, and joint replacement.This week we thank Hector Arreaza and Thomas Magurany. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Myasoedova E, Crowson CS & Gabriel SE et al. (2010). Is the incidence of rheumatoid arthritis rising?: Results from Olmsted County, Minnesota, 1955-2007. Arthritis and Rheumatism, 62(6), 1576-1582.Goldring MB & Goldring SR. (2007). Osteoarthritis. Journal of Cellular Physiology, 213(3), 626-634.King LK, March L, Anandacoomarasamy A. Obesity & osteoarthritis. Indian J Med Res. 2013;138(2):185-93. PMID: 24056594; PMCID: PMC3788203.Chauhan K, Jandu JS, Brent LH, et al. Rheumatoid Arthritis. [Updated 2023 May 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.Sen R, Hurley JA. Osteoarthritis. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.Hunter DJ, Bierma-Zeinstra S. & Eckstein F. (2014). OARSI Clinical Trials Recommendations: Design and conduct of clinical trials for primary hip and knee osteoarthritis: An expert consensus initiative of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) Task Force in collaboration with the Osteoarthritis Research Society International (OARSI). Osteoarthritis Cartilage, 22(7), 363-381.van Everdingen AA, Jacobs JW, Siewertsz Van Reesema DR, Bijlsma JW. Low-dose prednisone therapy for patients with early active rheumatoid arthritis: clinical efficacy, disease-modifying properties, and side effects: a randomized, double-blind, placebo-controlled clinical trial. Ann Intern Med. 2002 Jan 1;136(1):1-12. doi: 10.7326/0003-4819-136-1-200201010-00006. PMID: 11777359.Nicolau J, Lequerré T, Bacquet H, Vittecoq O. Rheumatoid arthritis, insulin resistance, and diabetes. Joint Bone Spine. 2017 Jul;84(4):411-416.Fernandes L, Hagen KB, Bijlsma JWJ et al. (2019). EULAR recommendations for non-pharmacological core management of hip and knee osteoarthritis. Annals of Rheumatic Diseases, 79(6), 715-722.Royalty-free music used for this episode: "Driving the Point." Downloaded on July 29, 2023, from https://www.videvo.net/ 

Drs. Garett Pearson and Heidi Reesink, authors of "Synovial sepsis diagnostics and antimicrobial resistance: a one-health perspective in: Journal of the American Veterinary Medical Association Volume 261 Issue 8 (2023) (avma.org)" and "Equine synovial sepsis laboratory submissions yield a low rate of positive bacterial culture and a high prevalence of antimicrobial resistance in: American Journal of Veterinary Research - Ahead of print (avma.org)" discuss the current state of diagnostics for synovial sepsis. Hosted by Associate Editor Dr. Sarah Wright and Editor-in-Chief Dr. Lisa Fortier.INTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA OR AJVR?JAVMA: https://avma.org/JAVMAAuthorsAJVR: https://avma.org/AJVRAuthorsFOLLOW US:JAVMA:Facebook: Journal of the American Veterinary Medical Association - JAVMA | FacebookInstagram: JAVMA (@avma_javma) • Instagram photos and videosTwitter: JAVMA (@AVMAJAVMA) / Twitter AJVR: Facebook: American Journal of Veterinary Research - AJVR | FacebookInstagram: AJVR (@ajvroa) • Instagram photos and videosTwitter: AJVR (@AJVROA) / TwitterJAVMA and AJVR LinkedIn: https://linkedin.com/company/avma-journals#VeterinaryVertexPodcast #JAVMA #AJVRINTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA ® OR AJVR ® ? JAVMA ® : https://avma.org/JAVMAAuthors AJVR ® : https://avma.org/AJVRAuthorsFOLLOW US:JAVMA ® : Facebook: Journal of the American Veterinary Medical Association - JAVMA | Facebook Instagram: JAVMA (@avma_javma) • Instagram photos and videos Twitter: JAVMA (@AVMAJAVMA) / Twitter AJVR ® : Facebook: American Journal of Veterinary Research - AJVR | Facebook Instagram: AJVR (@ajvroa) • Instagram photos and videos Twitter: AJVR (@AJVROA) / Twitter JAVMA ® and AJVR ® LinkedIn: https://linkedin.com/company/avma-journals

A new case report was published in Oncotarget's Volume 14 on July 7, 2023, entitled, “Intrathoracic synovial sarcoma with BRAF V600E mutation.” Synovial sarcoma (SS) is a highly malignant mesenchymal tumor that occurs mainly in adolescents and young adults. The treatment of SS is multimodal, involving surgery, radiotherapy and chemotherapy. The overall prognosis is generally quite satisfactory in children and adolescents with localized SS at diagnosis. However, the outcome remains poor for patients who relapse, with a reported 5-year post-relapse survival of around 30%. In this new paper, researchers Ida Russo, Sabina Barresi, Pier Luigi Di Paolo, Valentina Di Ruscio, Giada Del Baldo, Annalisa Serra, Silvia Vallese, Evelina Miele, Angela Mastronuzzi, Rita Alaggio, Andrea Ferrari, and Giuseppe Maria Milano from Italy's Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) report the case of a 15-year-old boy with intrathoracic synovial sarcoma who relapsed after standard chemotherapy, surgery and radiotherapy. The molecular analysis of the tumor identified a BRAF V600E mutation at time of progression of relapsed disease under third line systemic treatment. This mutation is commonly seen in melanomas and papillary thyroid cancers, but less prevalent (typically

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Synovial Sarcoma ⁠⁠from the Pathology section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message

Herzlich Willkommen zu einer neuen Podcast Folge. Danke für deine Zeit, denn Zeit ist das wertvollste, was wir besitzen. Danke, dass du dir bewusst Zeit nimmst, diese so humorvolle Greschichte anzuhören, über eine ganz besondere Mutmacherin. Die liebe Susanne war bei mir zu Gast. Susanne hatte 2018 die Diagnose Synovial Sarkom und 2019 wurde ihr rechts Bein amputiert. Seit Dezember ist sie Palliativpatientin. Der Tod soll sich um jemand anderes kümmern, ich habe keine Zeit für ihn sagt sie, Hey, Ich bin Susanne und ich lebe jetzt! Für später habe ich keine Zeit, denn ich bin 39 Jahre alt, habe ein metastasierendes Synovialsarkom und bin Palliativepatientin. Ich möchte euch sagen, das ihr niemals nie den Mut verlieren dürft weil aufgeben keine Option ist Niemals Nie! Das Leben ist es wert gelebt zu werden, jetzt erst recht. Schau unbedingt bei Susanne vorbei @gina_stafflove Ich hoffe sehr, dass dir die Folge gefallen hat und du etwas mitnehmen konntest. Schreib mir von Herzen gern, eine positive Bewertung oder wenn du magst, abonniere meinen Podcast, um keine Folge zu verpassen. Ich würde mich riesig über deine Gedanken zu dieser Folge freuen, schau gern bei Instagram vorbei unter der aktuellen Podcast Folge und kommentiere dort deine Gefühle und Gedanken. Was konntest du für dich mitnehmen? Denk immer daran, DU bist nicht allein. Ich freue mich schon auf die nächste Folge mit dir. Bleib gesund! Danke, dass es dich gibt. Teile den Podcast mit den Menschen, die genau jetzt Mut, Kraft und Hoffnung brauchen. Hast du deine eigene Krebs Erfahrung, die du mit der Welt teilen möchtest? Oder hast du jemanden aus deiner Familie an Krebs verloren? Oder bist du vielleicht selber Arzt/Heilpraktiker/Ernährungsexperte/Yoga/Onkologe/Psycho Onkologe/ Vielleicht möchtest du uns aber auch über deinen Verein erzählen, den du gegründet hast, für Betroffene und Angehörige?? Ich möchte jedem eine Chance geben, über das Thema Krebs zu sprechen. Fühl dich von Herzen umarmt. Deine Kendra ❤

Kelli Ritschel Boehle's son Nick passed away from Synovial Sarcoma in March of 2012. During his cancer battle which lasted for 3 1/2 years, Nick was undergoing a clinical trial at the National Institute of Health when he met a young man named Nate. Nick was just young enough after he was diagnosed to be able to take advantage of the Make A Wish Foundation who granted he and his family a trip to Hawaii but Nate was too old to be given a similar opportunity. On today's podcast, Kelli will talk about  how upset Nick was about Nate and asked his mother if she could help him in any way. .After Nick passed away, not only did Kelli help Nate, but she is now helping many other cancer patients who range in age from 18-24 by starting the Nickolas Ritschel Foundation which grants wishes to this age group, in similar fashion to what the Make A Wish Foundation has been doing for many many years.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.05.05.539599v1?rss=1 Authors: Varela, L., van de Lest, C., Boere, J., Libregts, S., Lozano-Andres, E., van Weeren, R., Wauben, M. Abstract: Inflammation is the hallmark of most joint disorders. However, the precise regulation of induction, perpetuation, and resolution of joint inflammation is not entirely understood. Since extracellular vesicles (EVs) are critical for intercellular communication, we aim to unveil their role in these processes. Here, we investigated the EVs' dynamics and phospholipidome profile from synovial fluid (SF) of healthy equine joints and from horses with lipopolysaccharide (LPS)-induced synovitis. LPS injection triggered a sharp increase of SF-EVs at 5-8hr post-injection, which started to decline at 24h post-injection. Importantly, we identified significant changes in the lipid profile of SF-EVs after synovitis induction. Compared to healthy joint-derived SF-EVs (0h), SF-EVs collected at 5, 24, and 48h post-LPS injection were strongly increased in hexosylceramides. At the same time, phosphatidylserine, phosphatidylcholine, and sphingomyelin were decreased in SF-EVs at 5h and 24h post-LPS injection. Based on the lipid changes during acute inflammation, we composed specific lipid profiles associated with healthy and inflammatory state-derived SF-EVs. The sharp increase in SF-EVs during acute synovitis and the correlation of specific lipids with either healthy or inflamed states-derived SF-EVs are findings of potential interest for unveiling the role of SF-EVs in joint inflammation, as well as for the identification of EV-biomarkers of joint inflammation. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

In this episode, we review the high-yield topic of Synovial Facet Cyst from the Spine section. **This episode is sponsored by Robin Healthcare. Learn more about what Robin can do for your current or future Orthopaedic surgery practice: https://www.robinhealthcare.com/orthobullets Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message

What is The Knee on Trac?The Knee on Trac is a medical device that helps your knee joint to produce more synovial fluid. In case you do not know what synovial fluid is I will tell you. The synovial fluid acts like a lubricant for the knee. Synovial fluid is made up of many components like hyaluronan, lubricin, proteinase, collagenases, and prostaglandins. The knee takes on a great deal of stress and can be a major cause of discomfort for many people. When the stress on the knee becomes too great it can start to wear down or tear the meniscus causing irritation and knee pain. Adequate levels of synovial fluid helps protect the knee from inflammation which leads to degeneration of the knee.People with knee pain who want to avoid knee surgery or even knee replacement would do themselves a great service by trying out the Knee on Trac. It gently tractions the knee joint and stimulates the synovium to produce soothing synovial fluid. Less inflammation means less pain. Just consider how your car runs when it has the proper amount of oil in the engine. Your knee is a mechanical wonder my job is to keep it running as smoothly as possible.Core Health Darien-Dr.Brian McKay203-656-3636This podcast welcomes your feedback here are several ways to reach out to me. If you have a topic you would like to hear about send me a message. I appreciate your listening. Dr. Brian Mc Kayhttps://twitter.com/DarienChiro/https://www.facebook.com/ChiropractorBrianMckayhttps://chiropractor-darien-dr-brian-mckay.business.sitehttps://podcasts.apple.com/us/podcast/not-just-chiropractor-for-stamford-darien-norwalk-new/id1503674397?uo=4

Understanding Chronic Knee Pain What's the most common cause of chronic knee pain?People often ask me, "How do I stop constant knee pain?". My first question back is usually what are you doing to aggravate your knee? Did you have an accident? Is there an old sports injury? Did your parents have arthritis? Do you exercise regularly? Are you overweight? All of these and more are solid reasons to have chronic knee pain There are so many ways that someone can have chronic knee pain. It is nice to know what caused knee pain but if you have chronic knee pain figuring out how to fix it is more important. Let's get into how we do this at Core Health Darien.How to Stop Chronic Knee Pain?It all starts with an examination. Chances are that if you have had knee pain for more than 12 months you will need advanced imaging. X-rays are less expensive and might suffice but MRIs are a better diagnostic tool to see soft tissue injuries. Your doctor along with a radiologist's report will identify the problem. Now a solution for your chronic knee pain can be derived.For my patients, once I determine that I can help their knee issues I begin to order the Knee on Trac. The Knee on Trac is a special therapy that helps your body to produce more synovial fluid. Synovial fluid is a lubricant. Since there is pain there will be inflammation. Synovial fluid acts to quell the swelling associated with pain and inflammation.How to tell if your knee pain is serious?When simple activities of daily living start to become more of a burden you will know that your chronic knee pain is in need of attention. When your knee pain is unbearable you probably are doing more damage. When knee pain is left untreated it will only worsen. Quite often people with knee pain think that since there was no trauma or injury that it should go away on its own. This is not true, it is not normal to have knee pain for months. Pain is your body's way of saying something is wrong. Pain left untreated can last years, consider all that you are missing out on in life.How to Fix Chronic Knee PainAs mentioned earlier the Knee on Trac is a cornerstone of knee pain care at Core Health Darien. We also use shockwave therapy to break up muscle adhesions and enhance blood flow via angiogenesis. A newer method of treating chronic knee pain is to use blood flow, restriction bands. The elastic bands are placed at the hips and limit blood flow and therefore oxygen to the muscles of the leg. This creates a deficit that causes a rush of oxygenated blood into damaged tissue to rejuvenate the muscles and to some extent the ligaments. Core Health Darien also offers Tri-Genics as a way to stimulate nerve fibers from the muscles and tendons to the spinal cord to help inhibit pain. We also use laser therapy to allow the body to ramp up the production of nitric oxide, a powerful vasodilator to drive more healing blood to the muscles causing your chronic knee pain.When Knee Pain Doesn't Go Away?Call us 203-656-3636 and make an appointment! Now if you have been told that you require a knee replacement we may not be a good fit. We have helped some people after knee replacement failed and they still had knee pain. Having sThis podcast welcomes your feedback here are several ways to reach out to me. If you have a topic you would like to hear about send me a message. I appreciate your listening. Dr. Brian Mc Kayhttps://twitter.com/DarienChiro/https://www.facebook.com/ChiropractorBrianMckayhttps://chiropractor-darien-dr-brian-mckay.business.sitehttps://podcasts.apple.com/us/podcast/not-just-chiropractor-for-stamford-darien-norwalk-new/id1503674397?uo=4

In this episode, we review the high-yield topic of Synovial Sarcoma from the Pathology section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message

Arthritis in the knees, hips, or wrists is extremely common, particularly in the second half of life. If you're feeling pain and inflammation in your joints, the natural impulse is to reduce your movement and limit your activities, but movement is medicine. The fluid between your joints wants and needs movement to nourish, heal, and lubricate your connective tissues. But how much movement is helpful? And how often? There are no easy answers to these questions, but yoga for arthritis teacher and best-selling author, Ann Swanson, joins us to share her personal and professional findings.  Listen to learn:  The importance of strength as we age How to modify for your body and your pain   How hyaline (articular) cartilage health is crucial and how degradation of this tissue can lead to pain and restricted movement How the synovial fluid around your joints responds to movement and compression Links Ann's Site ABOUT OUR GUEST Ann Swanson is a certified yoga therapist and author of the best-selling book, Science of Yoga. She specializes in helping people manage stress, pain and arthritis. 

Today we discuss the anatomy of the knee, the largest joint in the human body. Let's explore movements, function, bones involved, main ligaments and the menisci. We will also cover one of Sam's favourite topics, articular cartilage. Terms covered this week; The femur, tibia, fibular and patella bones. Synovial joints, fluid and capsule. The articular and hyaline cartilage and bursae. Cruciate ligaments (anterior & posterior), & collateral ligaments of the knee (medial and lateral). Condyles vs Epicondyles, tibial plateau and menisci.

Synovial Sarcomas are rare malignant tumors of soft tissue. Unlike most soft tissue sarcomas they are more likely to affect younger individuals. This tumor type is unique because of a common chromosomal translocation and mutation. They also have a high predilection of metastasis to lung and to the lymph nodes. Links & Article(s) Gazendam AM, Popovic S, Munir S, Parasu N, Wilson D, Ghert M. Synovial Sarcoma: A Clinical Review. Curr Oncol. 2021;28(3):1909-1920. Published 2021 May 19. doi:10.3390/curroncol28030177 Find out More about our Doctors: Dr. Izuchukwu Ibe: www.linkedin.com/in/izuchukwu-ibe-a073537a/ Dr. Elyse Brinkmann: www.linkedin.com/in/elyse-brinkmann/

Synovial folds are a critical spinal structure that chiropractors work with everyday in practice. In this episode we explore the landmark study showcasing the histology, function, and challenges associated with these important and often overlooked structures.Episode Notes:Synovial folds - a pain in the neck?Designed by a Podiatrist over 30 years ago after seeing similarities in many of the custom devices he was creating, PowerStep offers an affordable, same day solution that combines support and cushioning. Want to try a pair for yourself, click here for a free sample pair.The Smart Chiropractor powers your patient journey to provide you with more qualified leads, more new patients, better patient retention, and consistent reactivations, without any money spent on advertising.ChiroMatchMakers specializes in DC and CA hiring. We have over 100 positions available right now with salaries starting at $85K. Discover the available positions today by clicking here. Our members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!

On this episode of the Dr. Tyna Show, I am sitting down with Dr. Shawn Baker.  He is the author of The Carnivore Diet. Dr. Baker has spent 20 years as an Orthopedic Surgeon and his insight is incredibly valuable.  I can't wait for you to listen.   On This Episode We Cover: Orthopedic surgeries  Dextrose  Prolotherapy  Fixing underlying issues in your body  Stem cell therapy  Issues with stem cell therapy if you are inflamed  Ultra processed foods  Auto immune responses  Asthma and autoimmunity  Why arthritis is common but not normal   Synovial inflammation  Knee replacements  Osteoporosis  Vegans and bone health  Leptin  Leptin resistance  Carnivore Diet Follow Dr. Shawn Baker on Instagram Dr. Bakers Website Follow Dr. Tyna on Instagram  Download my FREE BOOK and get on my email list.  Follow me on my Substack Blog Sponsored by: The Dr. Tyna Store Get 10% OFF my Main Store and my CBD Store here. Bundle MetaboFlex and CarbBlunt w/code METABOLISM10  Further Listening: The Belly Fat Effect with Mike Mutzel The Carnivore Code with Dr. Paul Saladino

Episode 89: Gonorrhea Basics. Written by Robert BensacenezRobert, Dr. Schlaerth, and Dr. Arreaza discuss the basics of gonorrhea, including presentation, treatment, and even a potential gonococcal vaccine.Introduction: Gonorrhea is commonly known as “the clap” or “the drip”. This ancient disease, described as “the perilous infirmity of burning” in a book called The History of Prostitution, has been treated with many remedies throughout history, including mercury, sulfur, silver, multiple plants, and even gold. Today we will discuss the clinical features, diagnosis, and current therapy of gonorrhea. By the way, did you know that gonorrhea in Spanish is used as an insult in Colombia? Well, now you know it. Definition: Gonorrhea is a sexually transmitted disease caused by the bacterium Neisseria gonorrhoeae (common name gonococcus), which is a gram-negative, intracellular, aerobic, diplococci. This disease leads to genitourinary tract infections such as urethritis, cervicitis, pelvic inflammatory disease (PID), and epididymitis. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ___________________________Gonorrhea. Written by Robert Besancenez, MS4, Ross University School of Medicine. Moderated and edited by Hector Arreaza, MD. Discussion participation by Katherine Schlaerth, MD. Epidemiology: The disease primarily affects individuals between 15–24 years of age (half of the STI patients in the US). CDC estimates that approximately 1.6 million new gonococcal infections occurred in 2018. Incidence rates are highest among African Americans, American Indians, and Hispanic populations.Transmission is sexual (oral, genital, or anal) or perinatal (causing gonococcal conjunctivitis in neonates). Risk factors include unsafe sexual behaviors (lack of barrier protection, multiple partners, men who have sex with men (MSM), and asplenia, complement deficiencies. Individuals with low socioeconomic status are at the highest risk: poor access to medical treatment and screening, poor education, substance use, and sex work. Presentation: The incubation period is ~ 2–7 days, and sometimes patients do not develop any symptoms. Urogenital infection: Gonorrhea is commonly asymptomatic, especially in women, which increases the chance of further spreading and complications. When symptoms are present, typical symptoms include purulent vaginal or urethral discharge (purulent, yellow-green, possibly blood-tinged). Discharge is less common in female patients. Urinary symptoms include dysuria, urinary frequency, and urgency. Male: - Typical presentation is urethritis. - Penile shaft edema without other signs of inflammation.- Epididymitis: unilateral scrotal fullness sensation, scrotal swelling, redness, tenderness, relief of pain with elevation of scrotum —Prehn Sign— and positive cremasteric reflex.- Robert: Prostatitis: fever, chills, general malaise, pelvic or perineal pain, cloudy urine, prostate tenderness (examine prostate gently). Female: - Cervicitis: Friable cervix and discharge (purulent, yellow, malodorous), - PID: pelvic or lower abdominal pain, dyspareunia, fever, cervical discharge, cervical motion tenderness but also uterine or adnexal tenderness, abnormal intermenstrual bleeding. PID can be subclinical and diagnosed retroactively when tubal occlusion is discovered as part of a workup for infertility. PID can cause Fitz-Hugh-Curtis syndrome (perihepatitis with RUQ pain).- Bartholinitis presents with introitus pain, edema, and discharge from the labia. - Vulvovaginitis may occur but is rare (due to the tissue preference of gonococci)Extragenital infection: Proctitis: Rectal purulent discharge, possible anorectal bleeding and pain, rectal mucosa inflammation, or rectal abscess (less common).Pharyngitis: sore throat, pharyngeal exudate, cervical lymphadenitis.  Disseminated gonococcal infection (DGI): Triad of arthritis, pustular skin lesions, and tenosynovitis.  As mentioned in Episode 46, on December 23, 2020, the California Department of Public Health (CDPH) sent a “Dear Colleague” letter to warn the medical community about the increased cases of DGI in California and Michigan. Increased cases may be caused by decreased STD testing and treatment because of the COVID-19 pandemic, and not necessarily because of a more virulent strain of gonorrhea. Later, treatment of gonorrhea was updated because of resistance.  Epidemiology: ∼ 2% of cases. Most common in individuals younger than 40 years old, the female to male ratio is 4:1. A history of recent symptomatic genital infection is uncommon. Asymptomatic infections increase the risk of dissemination due to delayed diagnosis and treatment. Clinical features: Two distinct clinical presentations are possible. Arthritis-dermatitis syndrome:Polyarthralgias: migratory, asymmetric arthritis that may become purulent.Tenosynovitis: simultaneous inflammation of several tendons (e.g. fingers, toes, wrist, ankle).Dermatitis: vesicular, pustular, or maculopapular lesions, possibly with a necrotic or hemorrhagic center.  Most commonly distributed on the trunk, extremities (sometimes involving the palms and soles). Typically, < 10 lesions with a transient course (subside in 3–4 days). Additional manifestations: fever and chills (especially in the acute phase). Purulent gonococcal arthritis: Abrupt inflammation in up to 4 joints (commonly knees, ankles, and wrists). No skin manifestations, rarely tenosynovitis. Genitourinary manifestations in only 25% of affected individuals. Not to be confused with reactive arthritis.  Health care providers living in California: Order Nucleic acid amplification test (NAAT) and culture specimens from urogenital, extragenital mucosal sites (e.g., pharyngeal and rectal), and from disseminated sites (e.g., skin, synovial fluid, blood, and cerebrospinal fluid) before initiating empiric antimicrobial treatment for patients with suspected DGI. Report within 24 hours of diagnosis to the California Department of Public Health. Complications of DGI: sepsis with endocarditis, meningitis, osteomyelitis, or pneumonia. Diagnosis of gonorrhea: The test of choice is Nucleic acid amplification testing (NAAT) of first-catch urine or swabs of urethra, endocervix and pharynx, and synovial fluid in disseminated infection. Other possible tests: gram stains and bacterial cultures (Thayer-Martin agar, useful for antibiotic resistance, results may take 48 hours, sensitivity is lower than NAAT.)Synovial fluid analysis: Appearance of fluid can be clear or cloudy (purulent), high Leukocyte count (up to 50,000 cells/mm3): especially segmented neutrophils, gram stain positive in < 25% of cases. Treatment: Ceftriaxone and doxycycline for uncomplicated cases, but may require different approaches in case of allergies or intolerance to these antibiotics, or in severe cases.  Uncomplicated gonorrhea (affecting cervix, urethra, rectum, pharynx)First-line treatment: single-dose ceftriaxone 500 mg IM (1 G for patients >150 Kg) PLUS doxycycline 100 mg PO twice a day for 7 days If a chlamydial infection has not been excluded.During pregnancy: Ceftriaxone PLUS single-dose azithromycin 1 gram PO(doxy is contraindicated – teratogen) Complicated gonorrhea (salpingitis, adnexitis, PID/ epididymitis, orchitis)Single-dose ceftriaxone IM PLUS doxycycline PO for 10–14 days  (women may require additional administration of Metronidazole PO for 14 days).  DGICeftriaxone IV every 24 hours for 7 days In case Chlamydia infection has not been ruled out: PLUS doxycycline PO twice a day for 7 daysDrainage of purulent joint(s) Sequelae: Without treatment, a prolonged infection may lead to complications, such as hymenal and tubal synechiae that lead to infertility in women. Prevention:-Screening for gonorrhea (USPSTF recommendations, September 2021, Grade B): Annual NAAT screening of gonorrhea AND chlamydia for sexually active women ≤ 24 years (including pregnant persons) or > 25 years with risk factors (e.g. new or multiple sex partners, sex partner with an STI, etc.). Evaluate for other STIs if positive (e.g. chlamydia, syphilis, and HIV).  There is insufficient evidence to recommend for or against screening gonorrhea in asymptomatic males (Grade I).In all patients: Evaluate and treat the patient's sexual partners from the past 60 days. Provide expedited partner therapy if the timely evaluation of sexual partners is not feasible. Single-dose cefixime PO (if chlamydia has been excluded in the patient) OR Single-dose cefixime PO PLUS doxycycline PO for 7 days. Sexual partners must be treated simultaneously to avoid reinfections. A possible gonococcal vaccine: A gonococcal vaccine is theoretically possible, let's remember that the meningococcal vaccine exists. Meningococcus is closely related to gonococcus. A study published in 2017 showed that MeNZB® (a vaccine used in New Zealand until 2011 to fight against a meningitis epidemic) provided partial protection against gonorrhea. Food for thought for you guys. Conclusion: Let's remember to screen asymptomatic women for gonorrhea, identify symptomatic patients and start treatment promptly, and prevent serious complications, and more importantly, let's promote safe sex practices to prevent this disease.Now we conclude our episode number 89 “Gonorrhea Basics”. Gonorrhea affects mainly the urogenital area, but it can spread to the pharynx, rectum, skin, and even joints. When you see septic arthritis in patients with high risk for gonorrhea, suspect disseminated gonococcal infection and start treatment promptly. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created for educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Robert Besancenez, and Katherine Schlaerth. Audio edition: Suraj Amrutia. See you next week! _____________________References:Seña, Arlene C, MD, MPH; and Myron S Cohen, MD.  Treatment of uncomplicated Neisseria gonorrhoeae infections, UpToDate, updated on Jan 27, 2022. Accessed on April 5, 2022. https://www.uptodate.com/contents/treatment-of-uncomplicated-neisseria-gonorrhoeae-infections Ghanem, Khalil G, MD, PhD. Clinical manifestations and diagnosis of Neisseria gonorrhoeae infection in adults and adolescents, UpToDate, updated on Sep 17, 2021, accessed on April 5, 2022. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-neisseria-gonorrhoeae-infection-in-adults-and-adolescents Klausner, Jeffrey D, MD, MPH. Disseminated gonococcal infection, UpToDate, updated on March 3, 2022. Accessed on April 5, 2022. https://www.uptodate.com/contents/disseminated-gonococcal-infection Petousis-Harris H, Paynter J, Morgan J, et al. Effectiveness of a group B OMV meningococcal vaccine on gonorrhea in New Zealand – a case control study. Abstract presented at: 20th International Pathogenic Neisseria Conference. Manchester, UK; 2016. 

Show notes at: Dr. Tessa Balach @tbalachMD is a board-certified orthopaedic surgeon. She earned her medical degree from New York Medical College and later on completed her internship, residency and fellowship at University of Medicine Chicago. Dr. Balach specializes in Orthopaedic Surgery and Oncology with multiple areas of expertise on Bone and Soft Tissue Cancers and Knee/Hip Replacement, where she treats both adults and children with malignant tumors. She is also the residency director at UChicago Orthopaedic residency program and founder of Ortho Access Info ! She is also a researcher who is currently leading and participating in clinical studies aimed at improving the treatment and management of bone illnesses and injuries. Dr. Balach works with medical students, residents, and fellows as a mentor and educator. She has also published multiple articles in peer-reviewed journals and medical journals, as well as giving speeches at a variety of professional conferences. Also, Dr. Balach works together with experts in the Medical Center where they provide highly specialized care for patients with both common and rare bond and soft tissue tumors. Moreover, she also treats patients with metastatic bone disease to strengthen weak bones to avoid fractures caused by breast, lung, prostate and kidney metastases.  Goal of episode: To develop a baseline knowledge on Soft Tissue Sarcoma. We cover: Presentation Predisposing factors Imaging Diagnosis Mets Treatment Fibrous tumors Fatty Tissue tumors Neural tissue tumors Muscle Tissue tumors Vascular tumors Synovial disorders Synovial sarcoma Epithelioid sarcoma Clear cell sarcoma Alveolar cell sarcoma

In this episode, we review the high-yield topic of Synovial Sarcoma from the Pathology section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message

Kaue e Raíza discutem um caso de monoartrite aguda apresentado pelo Iago. Quais as causas mais importantes no pronto-socorro? Como iniciar a investigação? O que pedir no líquido sinovial? Referências: 1) Margaretten ME, Kohlwes J, Moore D, Bent S. Does this adult patient have septic arthritis? JAMA. 2007;297(13):1478-1488 2) Sack K. Monarthritis: differential diagnosis. Am J Med 1997; 102:30S. 3) Mohana-Borges AV, Chung CB, Resnick D. Monoarticular arthritis. Radiol Clin North Am 2004; 42:135. 4) Shmerling RH, Delbanco TL, Tosteson AN, Trentham DE. Synovial fluid tests. What should be ordered? JAMA 1990; 264:1009. 5) McCutchan HJ, Fisher RC. Synovial leukocytosis in infectious arthritis. Clin Orthop Relat Res 1990; :226. 6) Siva C, Velazquez C, Mody A, Brasington R. Diagnosing acute monoarthritis in adults: a practical approach for the family physician. Am Fam Physician. 2003 Jul 1;68(1):83-90. PMID: 12887114. 7) Becker JA, Daily JP, Pohlgeers KM. Acute Monoarthritis: Diagnosis in Adults. Am Fam Physician. 2016 Nov 15;94(10):810-816. PMID: 27929277. 8) Jeong H, Kim AY, Yoon HJ, et al. Clinical courses and predictors of outcomes in patients with monoarthritis: a retrospective study of 171 cases. Int J Rheum Dis. 2014;17(5):502–510. 9) Ma L, Cranney A, Holroyd-Leduc JM. Acute monoarthritis: what is the cause of my patient's painful swollen joint? CMAJ. 2009;180(1):59–65. 10) Baker DG, Schumacher HR Jr. Acute monoarthritis. N Engl J Med. 1993;329(14):1013–1020. 11) Kienhorst LB, Janssens HJ, Fransen J, Janssen M; British Society for Rheumatology. The validation of a diagnostic rule for gout without joint fluid analysis: a prospective study. Rheumatology (Oxford). 2015;54(4):609–614. 12) Bardin T. Gonococcal arthritis. Best Pract Res Clin Rheumatol. 2003;17(2):201–208. 13) Davis, Benjamin T., and Mark S. Pasternack. "Case 19-2007: A 19-Year-Old College Student with Fever and Joint Pain." New England Journal of Medicine 356.25 (2007): 2631-2637.

In this episode, we review the high-yield topic of Synovial Facet Cyst from the Spine section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message

Drs Arner and Anz discuss Platelet-Rich Plasma Devices Can Be Used to Isolate Stem Cells From Synovial Fluid at the Point of Care

Not sure how to interpret the results of an arthrocentesis you ordered? In this BuzzBite, Andrew walks through the four main classes of joint effusions and the hallmark lab patterns of each.

Bursa Synovial sheaths human anatomy

This podcast summarises the article 'Intra-synovial triamcinolone treatment is not associated with incidence of acute laminitis’ by Haseler et al.

Today’s FITPRO Session Podcast is all about the joints of the body Neale and I give you a bitesize revision session, including: Understanding that Joints Act and Muscles React - So you need to know about joints before muscles Clarity on the three classifications of joints: Synovial, Cartilaginous and Fibrous The 6 Types of Synovial Joints in the body and examples of where they are found As well as linking this knowledge to you as a FITPRO, in relation to the planning exercises for your clients Join our Parallel Coaching Inner Circle with other fitness professionals like you. Leave a comment with #Joints and your big takeaway from today's episode... https://www.facebook.com/groups/parallelcoachinginnercircle/ Dedicated to More Hayley “Joint Anatomy Revision Bite” Bergman Parallel Coaching P.S. You can also find us on the following platforms: Instagram: https://www.instagram.com/parallelcoaching Facebook: https://www.facebook.com/ParallelCoaching Twitter: https://twitter.com/ParallelCoach YouTube: http://bit.ly/2F1Z1bs Download all FitPro Session Shownotes: HERE Listen on Itunes: http://bit.ly/itunes-fitpro-sessions Download on Spotify: http://bit.ly/spotify-fitpro-sessions --- Send in a voice message: https://anchor.fm/fitpro-sessions/message

In this episode, we review the high-yield topic of Synovium & Synovial Fluid from the Basic Science section. --- Send in a voice message: https://anchor.fm/orthobullets/message

This episode covers synovial fluid analysis!

This episode of Cancer Healing Journeys features our talk with Hunny Kapoor - an inspirational human being who dares to take on life every day. His recent achievement of winning a 5 km marathon despite being an amputee is proof of his unconquerable spirit. Never letting his disabilities get in the way, he swims and hits the gym daily and walks without any support.

It's all about GoFundMe campaigns and new music this episode. Links to GoFundMe campaigns will be added to our LinkTree, and make sure you check out the phenomenal list of musicians covered here:Marina City, Nick Sky, Synovial, Isaiah Eby, Ashen Swan, MMCM, Daniel Izaaks, Council of Fools, Microcosms, He Who Walks Three Ways (Juba Kalamka), and Laura Les.PS: Got some great news coming in August. Stay tuned to the show and our profiles on Facebook and Instagram for more information.Linktreehttps://linktr.ee/UnderbellyHoursThe Underbelly Hours | Adela | Danhttps://www.auxchicago.com/the-underbelly-hourshttps://www.facebook.com/UnderbellyHours/https://www.instagram.com/theunderbellyhours/https://www.instagram.com/cellocabbage/https://www.instagram.com/dan_asio_music/https://www.youtube.com/channel/UCvYgbu_m3EH__ifRrUVe2RQ

In this episode, we review the high-yield topic of Synovial Chondromatosis from the Pathology section. --- Send in a voice message: https://anchor.fm/orthobullets/message

Dr. Bret White from Keiser University shares a story about a retired mail worker with back and leg pain as a result of a synovial cyst. Dr. Bret White is an Assistant Professor for the Keiser University, College of Chiropractic Medicine in West Palm Beach, FL.  He is also an Attending Physician in the KUCCM Student Clinic.  He was the first chiropractor to hold a faculty position at the prestigious Tufts University School of Medicine in Boston, where he was a Clinical Instructor in the Department of Public Health and Family Medicine for 5 years.  Dr. White graduated in 1995 from the New York Chiropractic College. He practiced for 10 years in Boston and has been practicing in south Florida for the last 15 years, with a special emphasis on sports injuries and orthopedics.  Dr. White is diplomate of the American Board of Chiropractic Orthopedists. Resources: Keiser University Spine Care Clinic Find a Back Doctor The Cox 8 Table by Haven Medical thebackdoctorspodcast.com

Increased Synovial Fluid Lessens Knee PainMaybe you have been living with knee pain. Chances are that if you are active and exercise regularly you will experience some twinges in your knees as you get older. You know it as pain, we doctors know it as osteoarthritis which is the most common cause of knee pain in people 50 years or older. With the number of people over 50 in the United States, "arthritis affected an estimated 52.5 million [22.7 percent] adults in 2010-2012 and has been projected to affect 78.4 million adults by 2040," wrote the team led by CDC researcher Kamil Barbour. He and his colleagues tracked 2002-2014 data from the U.S. National Health Interview Survey. This level of discomfort "can limit a person's ability to perform basic functions and seriously compromise their quality of life," Barbour's team said. What can you do about it? Well, exercise is probably the best thing, it may hurt afterward however lack of exercise will only make it worse as the osteoarthritis will continue to get worse. Losing weight will take more pressure off and greatly decrease your knee pain. What about medicating? painkillers such as acetaminophen and NSAID analgesics which include ibuprofen and naproxen/Aleve or Advil may help some. Stronger, prescription painkillers such as opioids are not recommended, however. There are serious risks associated with long-term use of opioid therapy to treat chronic knee pain which we won't get into here. There is a unique way to help produce more synovial fluid to ease your knee pain from osteoarthritis. It is called the Knee on Trac Solution. This is a mechanical traction unit that distracts the knee joint using 30 lbs. of pressure. How does this equate to less knee pain? The synovium is a lubricant for the articular surface of the knee joint. Your car can run with low oil but it certainly won't run well. Your knee is a biomechanical wonder and it needs its lubricant to work efficiently, just like your car needs oil. Now it would make sense to take omega-3 fatty acids from fish oil to help grease the skids. Personally, I recommend turmeric for its anti-inflammatory properties. So get some exercises going and start taking some supplements to help ease your knee pain. Try not to go the NSAID route, the pain will subside but you will do further damage to the surface of the joint. This leads to more osteoarthritis as the years go by, and neither of us wants that.

Move For Your Mind - The Most Important Part of Your Immune SystemHumans need to move. Movement affects our minds and emotions. Movement is also crucial to circulate two vital fluids within the body. These are cerebral spinal fluid and the synovial fluid. learn more about the ways your practice of Tai Chi, Qi Gong, Northern Shaolin, Xing Yi Quan or other classical martial arts helps you move in the ways that build your health in subtle but profound ways.Visit our website:Sign up for our newsletterLearn more about Tai Chi, Qi Gong, Northern Shaolin, and Xing Yi Quan!

Arthur Mandelin MD/PhD, RMSK, RhMSUS discusses ultra-sound guided synovial biopsy. He examines the RhEumatoid Arthritis SynOvial tissue Network (REASON), it’s objective and why it was formed. He shares how Northwestern Medicine is utilizing ultrasound-guided synovial tissue biopsies for RA research and how he envisions this research translating into patient care.

In this episode, we review the high-yield topic of Synovial Facet Cyst from the Spine section. --- Send in a voice message: https://anchor.fm/orthobullets/message

¡Gracias por escuchar! En este episodio hablaré del papel que juega la inflamación en la generación de dolor en pacientes con osteoartritis. La OA tiene una morbilidad asociada sustancial y constituye un creciente problema de salud pública derivado en gran medida del envejecimiento poblacional. Los síntomas de la OA pueden ser funcionales pero se manifiestan principalmente como dolor y el manejo de la enfermedad se centra principalmente en su control.Agradezco que escuchen este podcast y les recuerdo que se encuentra disponible en el catálogo de iTunes, en Google Play (siendo accesible a través del gestor de podcasts de su dispositivo móvil), así como en Spotify. Agradezco también su retroalimentación en estas plataformas y les pido amablemente que califiquen el podcast ya que esto es importante para su continuado desarrollo.A continuación se enlistan las referencias mencionadas en este episodio: Grace, P. M., Hutchinson, M. R., Maier, S. F. & Watkins, L. R. Pathological pain and the neuroimmune interface. Nat. Rev. Immunol. 14, 217–231(2014).Owens, C. & Conaghan, P. G. Improving joint pain and function in osteoarthritis. Practitioner 260, 17–20 (2016).O’Neil, C. K., Hanlon, J. T. & Marcum, Z. A. Adverse effects of analgesics commonly used by older adults with osteoarthritis: focus on non-opioid and opioid analgesics. Am. J. Geriatr. Pharmacother. 10, 331–342 (2012).Wang, Y., Teichtahl, A. J. & Cicuttini, F. M. Osteoarthritis year in review 2015: imaging. Osteoarthritis Cartilage 24, 49–57 (2016).Haringman, J. J., Smeets, T. J., Reinders-Blankert, P. & Tak, P. P. Chemokine and chemokine receptor expression in paired peripheral blood mononuclear cells and synovial tissue of patients with rheumatoid arthritis, osteoarthritis, and reactive arthritis. Ann. Rheum. Dis. 65, 294–300 (2006).de Lange-Brokaar, B. J. et al. Degree of synovitis on MRI by comprehensive whole knee semi-quantitative scoring method correlates with histologic and macroscopic features of synovial tissue inflammation in knee osteoarthritis. Osteoarthritis Cartilage 22, 1606–1613 (2014).Cook, A. D., Christensen, A. D., Tewari, D., McMahon, S. B. & Hamilton, J. A. Immune cytokines and their receptors in inflammatory pain. Trends Immunol. 39, 240–255 (2018).Malfait, A. M. & Schnitzer, T. J. Towards a mechanism-based approach to pain management in osteoarthritis. Nat. Rev. Rheumatol. 9, 654–664 (2013).Bellamy, N. et al. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst. Rev. 2, CD005328 (2006).McAlindon, T. E. et al. Effect of intra-articular triamcinolone versus saline on knee cartilage volume and pain in patients with knee osteoarthritis:a randomized clinical trial. JAMA 317, 1967–1975 (2017).Aitken, D. et al. A randomised double-blind placebo-controlled crossover trial of HUMira (adalimumab) for erosive hand OsteoaRthritis — the HUMOR trial. Osteoarthritis Cartilage 26, 880–887 (2018).Cohen, S. B. et al. A randomized, double-blind study of AMG 108 (a fully human monoclonal antibody to IL-1R1) in patients with osteoarthritis of the knee. Arthritis Res. Ther. 13, R125 (2011).Wang, S. X. et al. Safety, tolerability, and pharmacodynamics of an anti-interleukin-1alpha/beta dual variable domain immunoglobulin in patients with osteoarthritis of the knee: a randomized phase 1 study. Osteoarthritis Cartilage 25, 1952–1961 (2017).Eitner, A., Hofmann, G. O. & Schaible, H. G. Mechanisms of osteoarthritic pain. Studies in humans and experimental models. Front. Mol. Neurosci. 10, 349 (2017).Basbaum, A. I., Bautista, D. M., Scherrer, G. & Julius, D. Cellular and molecular mechanisms of pain. Cell 139, 267–284 (2009).Ji, R. R., Xu, Z. Z. & Gao, Y. J. Emerging targets in neuroinflammation-driven chronic pain. Nat. Rev. Drug Discov. 13, 533–548 (2014).McMahon, S. B., La Russa, F. & Bennett, D. L. Crosstalk between the nociceptive and immune systems in host defence and disease. Nat. Rev. Neurosci. 16, 389–402 (2015).Pinho-Ribeiro, F. A. et al. Blocking neuronal signaling to immune cells treats streptococcal invasive infection. Cell 173, 1083–1097 (2018).Shechter, R. et al. Infiltrating blood-derived macrophages are vital cells playing an anti-inflammatory role in recovery from spinal cord injury in mice. PLOS Med. 6, e1000113 (2009).Willemen, H. L. et al. Monocytes/macrophages control resolution of transient inflammatory pain. J. Pain 15, 496–506 (2014).Barthel, C. et al. Nerve growth factor and receptor expression in rheumatoid arthritis and spondyloarthritis. Arthritis Res. Ther. 11, R82 (2009).Skaper, S. D. Nerve growth factor: a neuroimmune crosstalk mediator for all seasons. Immunology 151, 1–15 (2017).Denk, F., Bennett, D. L. & McMahon, S. B. Nerve growth factor and pain mechanisms. Annu. Rev. Neurosci. 40, 307–325 (2017).Minnone, G., De Benedetti, F. & Bracci-Laudiero, L. NGF and its receptors in the regulation of inflammatory response. Int. J. Mol. Sci. 18, E1028 (2017).Bagal, S. K. et al. Discovery of potent, selective, and peripherally restricted Pan-Trk kinase inhibitors for the treatment of pain. J. Med. Chem. 61, 6779–6800 (2018).Pinho-Ribeiro, F. A., Verri, W. A. Jr & Chiu, I. M. Nociceptor sensory neuron-immune interactions in pain and inflammation. Trends Immunol. 38, 5–19 (2017).Robinson, W. H. et al. Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis. Nat. Rev. Rheumatol. 12, 580–592 (2016).de Lange-Brokaar, B. J. et al. Synovial inflammation, immune cells and their cytokines in osteoarthritis: a review. Osteoarthritis Cartilage 20, 1484–1499 (2012).Rahmati, M., Mobasheri, A. & Mozafari, M. Inflammatory mediators in osteoarthritis: a critical review of the state-of-the-art, current prospects, and future challenges. Bone 85, 81–90 (2016).Urban, H. & Little, C. B. The role of fat and inflammation in the pathogenesis and management of osteoarthritis.Rheumatology 57, iv10–iv21 (2018).Dawes, J. M., Kiesewetter, H., Perkins, J. R.,Bennett, D. L. & McMahon, S. B. Chemokine expression in peripheral tissues from the monosodium iodoacetate model of chronic joint pain. Mol. Pain 9, 57 (2013).Driscoll, C. et al. Nociceptive sensitizers are regulated in damaged joint tissues, including articular cartilage, when osteoarthritic mice display pain behavior. Arthritis Rheumatol. 68, 857–867 (2016).Sweitzer, S. M., Hickey, W. F., Rutkowski, M. D., Pahl, J. L. & DeLeo, J. A. Focal peripheral nerve injury induces leukocyte trafficking into the central nervous system: potential relationship to neuropathic pain. Pain 100, 163–170 (2002).Hu, P., Bembrick, A. L., Keay, K. A. & McLachlan, E. M. Immune cell involvement in dorsal root ganglia and spinal cord after chronic constriction or transectionof the rat sciatic nerve. Brain Behav. Immun. 21, 599–616 (2007).Lems, W. F. Bisphosphonates: a therapeutic option for knee osteoarthritis? Ann. Rheum. Dis. 77, 1247–1248 (2018).Wenham, C. Y. et al. A randomized, double-blind, placebo-controlled trial of low-dose oral prednisolone for treating painful hand osteoarthritis. Rheumatology 51, 2286–2294 (2012).Dorleijn, D. M. J. et al. Intramuscular glucocorticoid injection versus placebo injection in hip osteoarthritis: a 12-week blinded randomised controlled trial. Ann. Rheum. Dis. 77, 875–882 (2018).McCabe, P. S. et al. Synovial fluid white blood cell count in knee osteoarthritis: association with structural findings and treatment response. Arthritis Rheumatol. 69, 103–107 (2017).Leung, Y. Y. et al. Colchicine lack of effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): a randomized controlled trial. Osteoarthritis Cartilage 26, 631–640 (2018).Kingsbury, S. R. et al. Hydroxychloroquine effectiveness in reducing symptoms of hand osteoarthritis: a randomized trial. Ann. Intern. Med. 168, 385–395 (2018).Lee, W. et al. Efficacy of hydroxychloroquine in hand osteoarthritis: a randomized, double-blind, placebo-controlled trial. Arthritis Care Res. 70, 1320–1325 (2018).Wenham, C. Y. et al. Methotrexate for pain relief in knee osteoarthritis: an open-label study. Rheumatology 52, 888–892 (2013).Kingsbury, S. R. et al. Significant pain reduction with oral methotrexate in knee osteoarthritis; results from a randomised controlled phase III trial of treatment effectiveness [abstract 428]. Arthritis Rheumatol. 70 (Suppl. 9), 454–455 (2018).Ridker, P. M. et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N. Engl. J. Med. 377, 1119–1131 (2017).Kashyap, M. P., Roberts, C., Waseem, M. & Tyagi, P. Drug targets in neurotrophin signaling in the central and peripheral nervous system. Mol. Neurobiol. 55, 6939–6955 (2018).Bannwarth, B. & Kostine, M. Nerve growth factor antagonists: is the future of monoclonal antibodies becoming clearer? Drugs 77, 1377–1387 (2017).Baamonde, A., Lastra, A., Juarez, L., Hidalgo, A. & Menendez, L. TRPV1 desensitisation and endogenous vanilloid involvement in the enhanced analgesia induced by capsaicin in inflamed tissues. Brain Res. Bull. 67, 476–481 (2005).Hamilton, J. A., Cook, A. D. & Tak, P. P. Anti-colony- stimulating factor therapies for inflammatory and autoimmune diseases. Nat. Rev. Drug Discov. 16, 53–70 (2017).Schett, G. et al. A phase IIA study of anti-GM-CSF antibody GSK3196165 in subjects with inflammatory hand osteoarthritis [abstract 1365]. Arthritis Rheumatol. 70 (Suppl. 9), 1494 (2018).Achuthan, A. et al. Granulocyte macrophage colony-stimulating factor induces CCL17 production via IRF4 to mediate inflammation. J. Clin. Invest. 126, 3453–3466 (2016).Wylde, V., Hewlett, S., Learmonth, I. D. & Dieppe, P. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain 152, 566–572 (2011).Beswick, A. D., Wylde, V., Gooberman-Hill, R., Blom, A. & Dieppe, P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2, e000435 (2012).Li, H., Wang, R., Lu, Y., Xu, X. & Ni, J. Targeting G protein-coupled receptor for pain management. Brain Circ. 3, 109–113 (2017).

Dale & Keefe are joined by Ron Melampy of Marshfield, who survived cancer back in 1997 and in 2017. Ron explains his diagnoses and treatments for both battles. Dr. Atish Choudhury gives details on why different patients need to be treated differently and why prostate cancer disproportionately afflicts older men.

In this episode, we review multiple-choice questions related to the high-yield topics of Synovial Sarcoma & Humeral Shaft Fractures. --- Send in a voice message: https://anchor.fm/orthobullets/message

In this episode, we review the high-yield topic of Synovial Sarcoma from the Pathology section. --- Send in a voice message: https://anchor.fm/orthobullets/message

Get ready for some breakthrough research-based information that, I believe, is revolutionary for hard-training climbers! The topic is sinew training—that is, new training and nutritional interventions shown to promote tendon, ligament, and muscle matrix strength and health. We all know how hard climbing (and training) is on the flexor tendons and ligament pulleys of the fingers, as well as the elbows and shoulders; so what could be more valuable to climbers than strategies to improve sinew health, strength, and performance? This is an information-rich podcast that might require a couple of listens...to determine how you can best apply and benefit from this new material. The next three podcasts will expand on this topic with details on specific training interventions for strengthening (and rehabbing) sore or tweaked tendons and pulleys. If you are a proactive, early adapter kind of person, then this is cutting-edge information I'm sure you'll be all over...like chalk on a crux hold! A final note: If you enjoy this podcast, then please share it with a friend, post to social media, or write a review. Thank you! Rundown 1:00 – Introduction to a new series of podcasts on sinew training—how to develop stronger, stiffer, healthier tendons and ligaments. This is the first of four episodes in the series…breaking new ground that I feel is revolutionary for climbers. 3:00 – Tendons and ligaments are not inert—they change and adapt to training in adulthood, but at a much slower rate than muscles do. And, sinew training requires unique training modalities and nutritional interventions. PhysiVāntage 5:20 – A quick rundown of the next 3 episodes in this series….and the exciting ground I’ll be covering. 7:00 – Eric gives a brief introduction of himself and his background for new listeners. Additional comments of recent advances in training for climbing. 10:10 – A reflection on last year’s series of podcasts on Energy System Training—powerful material for intermediate, advanced, and elite climbers. If you haven’t already, listen to these podcasts! # ??? 13:00 – Introduction to sinew training…and the exciting new sport science I’m bringing to the climbing world in this series of podcasts. 15:30 – The importance of training to avoid injury and stay healthy, so that you can reach your goals! There’s a huge cost to injuries…lost seasons, missed competitions, setbacks and lost seasons. 20:00 – There are decades of knowledge gathered and distributed on muscle training and adaptations…but until recently there’s little research and scant instruction on sinew training. 23:00 – The importance of staying curious! Embracing and applying the latest research is key to progress and breakthroughs in most complex fields/endeavors. 28:00 – Three findings of my two years of research into sinew health and sinew training. 28:30 – Finding #1: Sinew is plastic. Tendons, ligaments, and extracellular muscle matrix change, adapt, and remodel very slowly…and you can play a role in this process! 34:00 – Distinct training and nutritional interventions do influence sinew health, strength, and performance. 35:00 – Finding #2: Tendons can hypertrophy. In certain situations, chronic mechanical loading can lead to slightly hypertrophy over years of exercise. Research has documented that the finger flexor tendons of veteran climbers are up to 50% thicker than non-climbers. 39:00 – Hypertrophy results from long-term training stimulus that slightly degrades collagen…followed by a rise in collagen synthesis during a recovery period of 48 to 72 hours. This cyclic process will gradually build stronger connective tissues given appropriate mechanical loading and rest periods. Nutrition plays an important role in the process, too—more on this in a bit! 41:35 – Sinew has poor blood flow compared to muscles…and there’s scant blood flow to sinew after training. 44:45 – Homeostasis perturbation from long-term overtraining (under-resting and perhaps poor nutrition) leads to disorganized and damaged collagen fibrils…that may be the root cause of the sudden “surprise” finger pulley tweak or onset of painful tendons in the elbows and shoulders. 48:15 – Finding #3: There is a proven nutritional intervention that increases collagen synthesis in connective tissues…and can support sinew recovery and strengthening. Research by Keith Baar and Greg Shaw has shown a doubling of collagen synthesis with vitamin C enriched hydrolyzed collagen consumed 30 to 60 minutes before exercise. 55:30 – Why nutrients consumed after exercise aren’t as effective for nourishing tendons. Synovial fluid diffusion during mechanical loading is the primary method of nourishment to sinew—thus, consuming a glycine and proline rich food before training is the best method of “feeding” sinew. 59:20 – My morning ritual for optimally feeding the tendon and ligaments of my fingers, arms and shoulders—15 minutes to stronger tendons. Supercharged Collagen works! 1:03:00 – You are playing a role in your tendon health…every day! Cease the opportunity to play an active role in the process. 1:04:10 – Introducing PhysiVāntage!  Our flagship product is Supercharged Collagen. Based on the research of Drs. Baar and Shaw, this is the most advanced tendon and ligament support supplement on the market. Use it daily to get a PhysiVantage! Get 10% off at PhysiVantage.com with the discount code SAVE10 at checkout. Instagram - @PhysiVantage Facebook - @PhysiVantage For a comprehensive study of Training for Climbing, check out the 3rd edition of Hörst's best-selling book! Follow Eric on Twitter @Train4Climbing Check out Eric’s YouTube channel. Follow Eric on Facebook! Music by: Misty Murphy Subscribe on iTunes (or other podcast player) to "Eric Hörst's Training For Climbing" podcast. You can also listen to the T4C podcast on Stitcher and  Spotify! Please write a review on iTunes!

Learn about left and right hand and eye dominance, and how they're related; why running might actually be good for your knees; why Buzz Aldrin claimed 33 dollars in travel expenses for his trip to the moon; and two traits that determine how whether you're more likely to cheat on your partner. In this podcast, Cody Gough and Ashley Hamer discuss the following stories from Curiosity.com to help you get smarter and learn something new in just a few minutes: Running May Actually Be Good for Your Knees Buzz Aldrin Claimed $33.31 in Travel Expenses for His Moon Trip Two Traits Determine How Likely You Are to Cheat on Your Partner Please tell us about yourself and help us improve the show by taking our listener survey! https://www.surveymonkey.com/r/curiosity-listener-survey Plus, we discuss hand/eye dominance using the following research: More than 500,000 years of right-handedness in Europe | Taylor & Francis Left-handedness: Genes and matter of chance | Genetic Literacy Project Footedness of left- and right-handers | American Journal of Psychology Sighting dominance, handedness, and visual acuity preference: three mutually exclusive modalities? | Opthalmic & Physiological Optics What being right or left-handed says about your brain | Quartz If you love our show and you're interested in hearing full-length interviews, then please consider supporting us on Patreon. You'll get exclusive episodes and access to our archives as soon as you become a Patron! Learn about these topics and more onCuriosity.com, and download our5-star app for Android and iOS. Then, join the conversation onFacebook,Twitter, andInstagram. Plus: Amazon smart speaker users, enable ourAlexa Flash Briefing to learn something new in just a few minutes every day! See omnystudio.com/listener for privacy information.

Spine specialist, Dr. James Schantz shares a story of an owner of a landscaping business and his unusual cause of back pain. When the nation's top chiropractic organizations teamed up with Prevention Magazine to honor six U.S. doctors with the Chiropractic Award of Excellence, they chose Dr. Schantz. He was selected to represent the pinnacle of community service and clinical excellence for the Southeast. Dr. Schantz has been twice honored by the Georgia Chiropractic Association as Humanitarian of the Year- a distinction shared with former President Jimmy Carter. Dr. Schantz volunteers his time with Flying Doctors of America, having performed chiropractic on medical missions to Peru, Guatemala, Vietnam and Cambodia.​ Dr. Schantz is one the few chiropractors in the State of Georgia Certified to treat patients using the Cox Technic Flexion-Distraction and Decompression protocols. This method is based on significant clinical research as well as clinical documentation. These protocols were started 48 years ago by Dr. James Cox. At our office, we are very proud to be offering this cutting-edge, non-surgical pain relief method.​ Dr. Schantz graduated with honors in 1986 from the nation's leading chiropractic school, the National College of Chiropractic in Chicago. He has completed CEUs at Harvard Medical School in Low Back Pain, Sciatica, and Mind-Body Medicine. He is also Cox Technic Certified. Dr. Schantz has been a member of the American Chiropractic Association Sports Injuries and Fitness Council and the Federation of International Sport Chiropractors. He has trained as a Certified Golf Conditioning Expert. Dr. Schantz serves as an External Faculty Member for Life University School of Chiropractic, mentoring student interns.​ In his free time, Dr. Schantz enjoys rock climbing, kayaking, running, biking, yoga and volunteer work with his friends and family. Resources: Contact Dr. Schantz Find a Back Doctor

On this episode, spine specialist Dr. Ted Siciliano explains what a synovial cyst is and how it can cause low back pain.  More importantly, Dr. Siciliano discusses the treatment options for this condition. Dr. Ted Siciliano has been in active practice for 35 years in the Manahawkin, NJ area.  Dr. Siciliano is a long-time certified Cox Technic practitioner who attends courses regularly to keep up on all the latest in research, biomechanics, and application of Cox Technic protocols. He has written several case reports for the monthly Cox Technic Case Report publication and shares cases at Cox Seminars on a regular basis. He conducts practical, hands-on workshops with his colleagues at his Mayetta, New Jersey office. Resources: Contact Dr. Siciliano Find a Back Doctor Published Case Report Discat Disc & Joint Pain Relief Complex Enhanced

PACES_UE2-B31 Capsules articulaires et liquide synovial_P. DUBUS duration : 00:08:03

Have you ever been in a gym and seen a really muscular guy doing a lot of pull-ups really fast, but if you look at him closely you see that he’s really only moving his body about 6 inches in either direction and then when he hops down, despite being ‘strong’ his shoulders are so anteriorly rotated forward, it looks like he would have trouble scratching his chin? or Have you ever been to the mall at 9am and watched the seniors walking groups, where some people have shoulders equally rolled forward, yet others are able to stay upright and swing their arms with swagger? And yes 80 year olds can have swagger. My best guess is you have. So what makes some people closer to the hunchback of Notre Dame and others closer to a military man in his prime? You guessed it, shoulder and spine mobility. ------- Fitness For Freedom Online Personal Training Subscribe to Our YouTube Channel Follow us On Instagram - fitness_for_freeedom_1

The boys look at two more poll winners, a recent jazz trio album, and a historic reissue of a white house concert. Fond memories of seventies' odes to automotive cleanliness ensue. Christine McBride – LIVE AT VILLAGE VANGUARD; Eri Yamamoto – LIFE ; Dave Brubeck and Tony Bennett– WHITE HOUSE SESSIONS – LIVE 1962; Steve Coleman – SYNOVIAL JOINTS.

Dr. Greenwood is a founding partner of the Vancouver Spine Care Centre in beautiful downtown Vancouver, BC.  He is a1981 graduate of the Palmer College of Chiropractic, a board certified Chiropractic Orthopedist, a member of the Royal College of Chiropractic Sports Sciences and a certified Cox Technic practitioner.  He just completed his Masters of Advanced Clinical Practice program at National University of Health Sciences.  Dr. Greenwood's practice specializes in the non-surgical management of herniated disc, spinal stenosis, scoliosis, and degenerative disc disease. He discusses a case of a synovial cyst causing low back pain as well as loss of muscle mass in the thigh of an active woman named Lana. Following her treatments Lana states, "For me, your methodology and treatment helped to mitigate surgery and potentially a long term mobility disability. I credit your care 100% for recovering from such pain". Resources: Vancouver Spine Care Centre 102-1678 W Broadway Vancouver, British Columbia  V6J1X6 604-873-6029 www.coxspinecare.com mail@vancouverspinecarecentre.com   FIND A DOCTOR

Posttraumatic osteoarthritis (PTOA) can occur after intra-articular fracture despite anatomic fracture reduction. It has been hypothesized that an early inflammatory response after intra-articular injury could lead to irreversible cartilage damage that progresses to PTOA. Therefore, in addition to meticulous fracture reduction, it would be ideal to prevent this initial inflammatory response but little is known about the composition of the synovial environment after intra-articular fracture. The purpose of this work was to characterize the inflammatory cytokine and matrix metalloproteinase (MMP) composition in the synovial fluid (SF) of patients with acute intra-articular ankle fractures. These data indicate that after intra-articular ankle fracture the SF exhibits a largely pro-inflammatory and extra-cellular matrix degrading environment similar to that described in idiopathic osteoarthritis. IL-6, IL-8, MMP-1, MMP-2, MMP-3, MMP-9, and MMP-10 were significantly elevated and may play a role in the development of PTOA.   To view the article, click here. 

In this podcast I'll be exploring Water and Hydration: I'll explain what water is and what it does in your body I'll talk about how not getting enough water affects your health and the importance of water quality Finally, I'll give some simple tips on how to know if you're dehydrated and how to improve your hydration and overall health CLICK HERE TO LEARN WHAT ARE THE BEST FOODS TO GET YOU LEAN You cannot survive a week without water making H2O one the most important nutrients for your body. Water covers around 70% of planet Earth. Your body is about 30% solid and 70% water. Also, your blood has a similar amount of salinity as ocean water. Isn't it amazing how similar your physical body is to that of the Earth? I mean it's as if you and Mother Nature are intimately connected and ultimately come from the same place. Well I think it's an awesome idea. Anyhoo... Water comes in three well-known forms or phases -- liquid, solid, and gas -- but there is also a fourth phase of water called Exclusion Zone, EZ water, or living water. If you'd like to learn more about EZ water I recommend the book The Fourth Phase Of Water by Gerald Pollack. It's a beast of a book too nerdy for me believe it or not, but was still a very profound read for me personally. Water is a solvent meaning it dissolves other substances creating a solution, a mix of water and whatever is in the water. The best quality drinking water is not naked water meaning it's not just H2O. Health affirming water also has minerals, trace minerals, electrolytes and other stuff inside of it. The measurement of these inorganic and organic substances found within water is called Total Dissolved Solids or TDS. I'll come back to this later. When you look at water in its frozen phase you can see crystals within the ice. In its liquid state water still has these crystal-like structures. So water is a liquid crystal and just as LCD technology makes use of these liquid crystals to store and transmit energy and information in LCD televisions your body uses water in much the same way. Energy, nutrition, hormones, neurotransmitters, and waste products are stored, transmitted and transported around your body and eliminated in your sweat, in your urine, and in your poo all thanks to water. Water! Your blood is mostly water. The lymph found in your lymphatic system your sewage system is mostly water. The cerebral spinal fluid that surrounds your brain and spine is made up of water. Synovial fluid, which provides lubrication for your joints and the discs in your spine, again water. About 80% of your brain is water. Water also provides stability and integrity to the cells in your body giving them proper structure and form as it makes up part of the cytoplasm, which is the thick solution or gel inside each cell. If your body is too acidic due to high sugar consumption and chronic stress for example it will retain water in order to buffer and stabilise your pH levels leading to additional weight gain. Also, for every gram of carbohydrate you eat your body will hold onto 4 grams of water. Meaning if you're eating too many carbo-HYDRATES your body will be heavier on the scale and look softer in the mirror. So unless you like feeling bloated and looking so fluffy dropping a lot of processed and refined sugars from your diet may be action step number one in your 'improve body composition' plan. So without the right amount of hydration all of these different areas of your body will begin to slowly, but surely breakdown and as a plum becomes a prune your body will become a flat wrinkled empty skin-bag of puny muscles and porous bones. It's crucial to keep yourself hydrated with high quality water. According to internationally renowned researcher, author, and advocate of the natural healing power of water Dr F Batmanghelidj in his book Your Body's Many Cries For Water (which I highly recommend) ...

Veterinary Pathology podcast editor Leah Schutt talks with Duncan Lascelles about feline degenerative joint disease and his article “Pathology of Articular Cartilage and Synovial Membrane From Elbow Joints With and Without Degenerative Joint Disease in Domestic Cats,” from the September 2014 issue. To view this article, click here.

THE HEALING AND MIRACLE PODCASTwith Prince HandleyWWW.PRINCEHANDLEY.COM HEALING FROM BACKPAIN~ A MIRACLE PODCAST PRODUCTION ~  You can listen to this podcast NOW. Click the center of the Libsyn pod circle at top left. Listen now ... or download for later  Or, LISTEN HERE >>> LISTEN NOW  After you listen to this message, you can scroll down for all messages previously in the LibSyn Archives (with Show Notes).  Email this message to a friend!  24/7 release of Prince Handley blogs, teachings, and podcasts >>> STREAM   Text: "follow princehandley" to 40404 (in USA)  Or, Twitter: princehandley  Subscribe to THE APOSTLES E-zine newsletter: princehandley@gmail.com  _____________________________________________________________  DESCRIPTION: There are many types, as well as causes, of back pain. Also, there are severities ranging from moderate to extreme … and some, life threatening. Many people suffer for years with a condition that could have been taken care of in a short time … and some, instantly. God is the Healer and the Creator – and by virtue of this fact – He knows exactly what you need. There is nothing wrong with going to physicians or seeking medical help or advice.   But what we should do is seek the LORD first to see what He wants us to do. He may want to heal us by His sovereign power, over a period of time, or instantaneously. _____________________________________________________________  HEALING FROM BACKPAIN~ A MIRACLE PODCAST PRODUCTION ~ MUSIC / INTRO There are many types, as well as causes of, back pain. There is neck pain, upper back pain, mid and lower back pain, and then the sacrum related coditions at the base of the spine. You have probably heard someone complain of sciatica which is caused by irritation ot the nerve roots that lead to the sciatic nerve coming out of the spinal cord in the lower back. A bulging or ruptured disc is usually the primary culprit is such a condition. However, there can be other conditions involved. Arthritis can cause bone spurs which can cause or exacerbate sciatica. Also, an injury can cause compression of the nerve roots. There are several other causes for sciatica, and the source of the irritation will usually dictate the treatment prescribed: physical therapy, medicine and sometimes surgery. Be very careful of exercise regimen with any type of back condtion, especially spinal related, as you could be aggravating the situation. Always check with your medical professional concerning any type of workouts, exercise and even stretching. CAUTION: There is a condition known as Cauda Equina Syndrome which you might think is sciatica; however, it is very dangerous and without a MIRACLE from God may require urgent surgical treatment. It's symptoms can be similar to sciatica, and causes can be: A severe ruptured disk in the lumbar area (the most common cause). Narrowing of the spinal canal (stenosis). A spinal lesion or tumor. A spinal infection, inflammation, hemorrhage, or fracture. A complication from a severe lumbar spine injury such as a car crash, fall, gunshot, or stabbing. A birth defect such as an abnormal connection between blood vessels. There are types of bone pain attributed to bone fusion or where the vertebrae grow over. One such conditon is known as Ankylosing Spondylitis (AS). It affects the spine with pain and stiffness from the neck down to the lower back and does not necessarily confine itself to older people; it happens most often to teenagers and men in their twenties, and is characterized by stiffness from the neck down to the lower back, and can result in a rigid spine. Back pain can be caused from injury, work, poor posture (sitting or standing), sports and recreation. But … the Good News is that YOU can be healed of back pain! You may be thinking … or saying … “I've had this condition for years!” Well, let me tell you, my friend, that Jesus, the Healer, has been healing for years! There are some practical things you can do to help your situation: 1. Exercise (check with a medical professional before starting an exercise or stretching regimen); 2. Take proper nutrition and supplements; 3. Get the required amount of sunshine (for Vitamin D); 4. Rest your body and your mind. 5. Take advantage of physical helps like the “Teeter HangUps” inversion table. This helps reverse the effects of gravity and disc compression. (Check with your medical professional before using.) The scope of this teaching is NOT to discuss specific types of therapy or treatments, but rather to present an alternative solution to problems that you or a loved one may be experiencing with back related issues.You can be healed today...NOW...by calling on the name of the LORD:  Who forgives all your sins, and Who heals all your diseases [Psalm 103:3]  The LORD's healing nature never changes.  It is God's will to heal you! Remember the lady in the Bible who was bent over for 18 years? “And, behold, there was a woman which had a spirit of infirmity eighteen years, and was bowed together (bent over), and could not in anyway lift herself up. And when Jesus saw her, he called her to him, and said unto her, Woman, you are loosed from your infirmity. And he laid his hands on her: and immediately she was made straight, and glorified God.” (Matthew 13:11-13) _____________   MY TESTIMONIES I am completely back pain FREE at this time in my life … and I have been on Planet Earth for quite a while! My advice to you – especially if you know the Great Physician, Yeshua HaMashiach (Jesus, the Messiah) – is: NEVER GIVE UP! I went for 13 years with terrible back pain. I don't know what caused it. I was a varsity wrestler in school, but I don't remember any happenings that would have caused (the devil's) pain. (I say “the devil's pain” because it was NOT my pain; it was pain the devil wanted me to have!) Also, I had been in NO serious accidents, not even small ones. By God's grace I have never had a broken bone in my lifetime. I have claimed the scripture for years (a prophetic one about Messiah Jesus' death on the cross) that says, “He keeps all his bones; not one of them is broken.” (Psalm 34:20) Here is how I was healed. My pain was so bad and so aggravating. I had been to a chiropractor years before and had learned or remembered how he had “fixed” my back to alleviate pain. So, I would lie on the floor and try to “fix” my back the way the chiropractor did. I was miserable, and it got worse and worse! I was addicted to”cracking” my back. I probably was compounding the situation. It was such a miserable condition … and, to make matters worse, at that time in my life I did NOT know about the healing power of Christ! Finally, I began to wonder if the situation was NOT a physical problem, but possibly a “spirit” problem; in other words, a “spirit of affliction” sent by the devil to plague me while I was trying to do God's work! To give you an idea of how bad the situation was, if I were in a business environment where I had never been before, I would look to see if the receptionist stepped out of the office so I could lie on the floor and “crack” my back. I was miserable! One day as I was on the floor ready to “crack” my back, the Holy Spirit spoke to me. He said, “Why don't you let me take care of that for you?!” Wow! I knew exactly what He meant. Instead of ME trying to fix the problem and compounding it each time I “cracked” my back, the Holy Spirit wanted to FIX it. It was such a temptation because when – and immediately after – I would “crack” my back, I would feel so much better … until it started hurting again! I really had to resist “cracking” my back … but realized at the same time, I didn't want to go through that all of my life. So … I said, “OK, Holy Spirit, I give this problem – this back condition – to You!” That was it, it was over. PRAISE GOD! That was many years ago. Another time, I experienced extreme pain in my upper back below my shoulder. It was not a spinal problem, but it would hurt so badly that I would cry. I asked God different times to either heal me or take me home to Heaven! I went to medical doctors, I went to specialists, I went to physical therapy … nothing worked. I even told two of the doctors I had that I asked the LORD, “Either heal me or take me to Heaven,” so they would know how bad the situation was. Nothing worked! Finally, one night while travelling in another area of the country, before I went to bed, I prayed to God and said, “Father, you can just send an Angel to touch me and I will be healed.” That night, while I was sleeping, I was awakened with a loud “POP” in my back where the problem had been. It was so loud it awakened me. And I was perfectly healed. I have never had that problem since, and never will, thank God … and thank the Holy Angel that God sent to touch me. Yes, “Touched by an Angel” has a special meaning to me! _____________ PRAISE is also an important remedy for back pain. 1. It lifts up and straightens the spinal column and relaxes it from a “stooped” condition. Learn to practice praise to God several times a day for at least 30 seconds. 2. God lives in the praise of His people. “But You are holy, O You that inhabits the praises of Israel.” (Psalm 22:3)3. The anointing breaks the yoke. Since God lives in the praise of His people, there is an anointing present with true praise, which can break an “assigned” attack on the body, mind or spirit. “And it shall come to pass in that day, that his burden shall be taken away from off thy shoulder, and his yoke from off thy neck, and the yoke shall be destroyed because of the anointing.” (Isaiah 10:27)4. Praise brings victory. King Jehoshaphat and the inhabitants of Judah and Jerusalem won a large battle utilising praise. (Read 2 Chronicles Chapter 20, verses 1-30 in the Tanakh.) _____________ CHECK THIS OUT:  An Egyptian friend of mine, Magdy Girgis, was a member of our Board of Directors. He worked for Hughes Aircraft as did several Christians who had been Baptized in the Holy Spirit, all of which spoke in tongues. They had Bible studies together every morning before work and also at luch time. One day a man named Warren Meisenbach, who worked in the Engineering Department, came to their Bible study at lunch. Warren was NOT a believer and he asked them, “What's this born again stuff you keep talking about?” Warren had been a “hunch back” for 15 years (like the lady in the Bible I discussed earlier who had been bent over 18 years). Warren received Christ as his Lord that day, and asked the men to lay hands on him for healing. Instantly … they could hear his back "cracking' like: POP, POP, POP. He was perfectly straightend in a normal position. (See Note #3 at bottom to listen to a podcast of this MIRACLE.) When he went home his wife was dumbfounded because he was not only “straightened” but smiling for the first time in years! Jesus is the Healer … the Great Physician. Will you let Him heal YOU? If you want to meet the Healer, Yeshua HaMashiach – Jesus the Anointed One – NOW is the time!  Invite God’s Son, Yeshua, to come into your life by praying the following prayer: "Messiah Jesus, I know that you are The Great Physician. You loved me enough to shed your sinless blood and die for me on the cross stake that I might be healed.   I know you are alive. Please forgive my sins, come into my life, and be my Master. Help me to live for you, and take me to Heaven when I die." _____________ I have selected three (2) books which will help you to know how to deal with back pain, and any type of pain – so you can live PAIN FREE and serve God – and enjoy life the way God wants you to. Here they are … just click on the image.     _____________ ADDENDUM I have seen many people healed by the LORD of back pain, back conditions and paralysis. I have witnessed many people walking out of their wheel chairs. I was holding a three day seminar and I had asked the people present to join me in prayer and fasting for the last day as I was going to teach on healing. A man was present who had been in a wheel chair for nine years due to two conditions: 1. A large 18 wheel semi-tractor truck had run into his automobile and he had five breaks in his spine; 2. He had muscular dystrophy. During Holy Communion he walked out of his wheel chair and never went back! Two years later, he gave his testimony in a large Presbyterian church and hundreds of people fell out of their seats under the Power of the Holy Spirit. NEVER GIVE UP! _____________ Baruch haba b'Shem Adonai Your friend, Prince Handley President / Regent University of Excellence MUSIC Podcast time: 17 minutes, 45 seconds (with music) NOTES: 1. Healing and Miracle Podcast – Source A: www.healing.libsyn.com 2. Healing and Miracle Podcast – Source B: www.hmpodcast.wordpress.com 3. To listen to the account of the hunchback being healed, go here: POP-POP   Copyright 2014 Prince Handley All rights reserved. ________________________________________ Real Miracles ResourcesPrince Handley BooksFree Bible & Rabbinical StudiesFAST READS24/7 Prince Handley Blogs, Podcasts & Teachings _________________________________________  Handley WORLD SERVICES Incorporated Box 1001 Bonsall, California 92003 USA NOTE: Scroll down for ALL previous podcasts.    

May 08, 2011 In this fourth episode of TWiPO host Dr. Tim Cripe and co-host Dr. Jim Geller discuss updates after two recent meetings and then discuss an exciting paper just published on "Tumor regression in patients with metastatic synovial cell sarcoma and melanoma using genetically engineered lymphocytes reactive with NY-ESO-1" J Clin Oncol. 2011 Mar 1;29(7):917-24. Epub 2011 Jan 31. by Paul Robbins and colleagues at the NCI. 1:23 Conference on oncolytic viruses (see recent http://vimeo.com/20002455 webinar on pediatric trials). 7:28 Conference on DIPG (Diffuse Intrinsic Pontine Glioma) at Cincinnati Children's; discussion on biology, new tumor models, and genetic profiling. 12:50 Discussion on adoptive immunotherapy using tumor-infiltrating lymphocytes in patients with metastatic melanoma and synovial cell sarcoma. 28:28 Listener email questions and answers. (send emails to twipo@solvingkidscancer.org)

Vous pourriez découvrir que cette vilaine bosse qui se trouve sur votre main ou votre poignet et qui entraîne de la douleur ou de l'inconfort est en fait un " kyste synovial " qui pourrait être causé par le type de travail que vous faites. Le balado aborde plus en détails les ganglions, ce qui les cause et la façon de les prévenir. Date de diffusion : le 17 février 2012 Taille du fichier: 3.01 mb Durée: 3:17 minutes

Computed tomography (CT) and magnetic resonance imaging (MRI) were used to study the anatomy of clinically and radiographically normal carpal joints in 12 large-breed dogs that were euthanatised for medical reasons. Preparations made by sectioning the carpal joints from these same dogs were used as controls. Computed tomographic and magnetic resonance images were taken in transverse, sagittal and dorsal planes. The computed tomographic examination focused on the depiction of the ligaments, muscles and tendons of the carpal joint using a soft tissue window. Reconstruction algorithms of a medium-sized kernel proved to be applicable. Window settings with a centre of between 50 and 110 HU and a width of 200 to 300 HU provided the best soft tissue contrast in the carpal region. A single-slice helical third generation CT scanner was used together with software that allowed a multi-planar reconstruction of the transverse slices in sagittal and dorsal planes. A low-field open magnetic resonance unit (0.2 T) was used for MRI. T1 and T2 weighted images with different sequences and different slice thickness were obtained in the transverse, sagittal and dorsal planes. T1 weighted spin echo sequences (TR: 640 ms, TE: 26 ms, slice thickness: 3 mm) provided good quality images. Upon completion of the imaging modalities, the joints were sectioned and anatomical preparations were made. These included cryostat sections and permanent transparent slice plastinations. There was a good correlation between the anatomical structures of the frozen sections and those of the slice plastinations. The computed tomographic and magnetic resonance images and the anatomical sections were compared. Viewing the computed tomographic and magnetic resonance images on a monitor using a navigation system offered more advantages than conventional viewing of single images. Projection of the chosen image together with the corresponding images in the other two planes allowed faster and more precise identification of the anatomic structures than viewing single images alone. The superimposition-free depiction of computed tomographic and magnetic resonance images allowed good visualisation of ligaments, tendons and muscles of the carpal region. Compared to muscles, the tendons and ligaments appeared slightly hyperdense on computed tomographic images and markedly hypointense on magnetic resonance images. The palmar flexor tendons, the strong palmar ligaments and the collateral ligaments could be identified on images generated by CT and MRI. Magnetic resonance imaging was superior to CT for visualisation of the extensor tendons and the weaker dorsal ligaments. Most of the extensor tendons and many of the smaller ligaments and tendons could be seen via MRI. Clear differentiation of the medial collateral ligament and the tendon of the long abductor muscle of the first digit (musculus abductor digiti I longus) was not possible with either CT or MRI. As well, the lateral collateral ligament could not be clearly differentiated from surrounding tissue. The medial and lateral accessory metacarpal ligaments could be depicted on both computed tomographic and magnetic resonance images. The palmar fibrocartilage could also be visualised; on computed tomographic images, it was slightly hyperdense with an irregular border and with MRI, it had a low and irregular signal and could be better differentiated. The ligaments that are situated palmar to the antebrachiocarpal joint space could be seen better on magnetic resonance images than on computed tomographic images. The short digital muscles could be visualised with both imaging modalities, but could not be differentiated from each other. Individual carpal bones could be easily distinguished from each other on magnetic resonance images. On computed tomographic images, these bones could not be differentiated well using a soft tissue window, but could be clearly distinguished using a bone window. Some of the large nerves and vessels could be seen on magnetic resonance images; however, reliable identification of these structures was not possible. Contrast studies are required for identification of individual vessels. Synovial bursae and tendon sheaths were barely recognisable on magnetic resonance images and could not be identified on computed tomographic images. Magnetic resonance imaging was superior to CT for identification of all soft tissue structures of the canine carpus. Therefore, soft tissue injuries of that joint should be evaluated using MRI rather than CT.

A better understanding of the initial mechanisms that lead to arthritic disease could facilitate development of improved therapeutic strategies. We characterized the synovial microcirculation of knee joints in susceptible mouse strains undergoing intradermal immunization with bovine collagen II in complete Freund's adjuvant to induce arthritis (i.e. collagen-induced arthritis [ CIA]). Susceptible DBA1/J and collagen II T-cell receptor transgenic mice were compared with CIA-resistant FVB/NJ mice. Before onset of clinical symptoms of arthritis, in vivo fluorescence microscopy of knee joints revealed marked leucocyte activation and interaction with the endothelial lining of synovial microvessels. This initial inflammatory cell response correlated with the gene expression profile at this disease stage. The majority of the 655 differentially expressed genes belonged to classes of genes that are involved in cell movement and structure, cell cycle and signal transduction, as well as transcription, protein synthesis and metabolism. However, 24 adhesion molecules and chemokine/cytokine genes were identified, some of which are known to contribute to arthritis ( e. g. CD44 and neutrophil cytosolic factor 1) and some of which are novel in this respect ( e. g. CC chemokine ligand-27 and IL-13 receptor alpha(1)). Online in vivo data on synovial tissue microcirculation, together with gene expression profiling, emphasize the potential role played by early inflammatory events in the development of arthritis.

Inhibition of angiogenesis might be a therapeutic approach to prevent joint destruction caused by the overgrowing synovial tissue during chronic joint inflammation. The aim of this study was to investigate angiogenesis in the knee joint of mice with antigen-induced arthritis (AIA) by means of intravital microscopy. In 14 mice (C57BL6/129Sv) intravital microscopic assessment was performed on day 8 after AIA induction in two groups (controls, AIA). Synovial tissue was investigated by intravital fluorescence microscopy using FITC-dextran (150 kD). Quantitative assessment of vessel density was performed according to the following categories: functional capillary density (FCD, vessels 10 mum) and FVD of vessels with angiogenic criteria (convoluted vessels, abrupt changes of diameter, vessels which are generated by sprouting and progressively pruned and remodelled). Microvessel count was performed using immunohistochemistry. There was no significant difference in FCD between the control group (337 +/- 9 cm/cm(2); mean +/-SEM) and the AIA group (359 +/- 13 cm/cm(2)). The density of vessels larger than 10 gm diameter was significantly increased in animals with AIA (135 +/- 10 vs. 61 +/- 5 cm/cm(2) in control). The density of blood vessels with angiogenic criteria was enhanced in arthritic animals (79 +/- 17 vs. 12 +/- 2 cm/cm(2) in control). There was a significant increase in the microvessel count in arthritic animals (297 +/- 25 vs. 133 +/- 16 mm(-2) in control). These findings demonstrate that angiogenesis in murine AIA can be assessed quantitatively using intravital microscopy. Further studies will address antiangiogenic strategies in AIA.

Production of nitric oxide by the inducible NO synthase (iNOS) is known to be enhanced in chronic joint inflammation and osteoarthritis as well as aseptic loosening of joint prostheses. Initial studies yielded promising results after inhibition of the nitric oxide synthase (NOS). However, the effect of NOS inhibition has not been studied at the site of the primary function of NO, the microcirculation of the synovium in vivo. Using our recently developed model for the in vivo study of synovial microcirculation in the mouse knee joint, the effects of selective versus nonselective inhibition of iNOS were investigated by means of intravital fluorescence microscopy. After resection of the patella tendon, the synovial fatty tissue was exposed for intravital microscopy. Diameter of arterioles, functional capillary density (FCD), diameter of venules, venular red blood cell velocity and leukocyte-endothelial cell interaction were quantitatively analyzed before, and 10 and 60 min after intravenous injection of NOS inhibitors {[}selective iNOS inhibitor N-iminoethyl-L-lysine (L-NIL), and nonselective NOS inhibitor N-G-nitro-L-arginine methyl ester (L-NAME)]. Our results demonstrate that L-NAME causes a significant decrease in the arteriolar diameter and FCD associated with an increase in the leukocyte accumulation in the synovium in vivo. In contrast, L-NIL neither altered the microhemodynamics nor the leukocyte-endothelial cell interaction in the synovium, indicating its potential use for selective inhibition of iNOS in joint inflammation. Using our method, further studies will provide new insights into the unknown effect of NOS inhibition on the synovial microvasculature in inflammatory joint disease in vivo. Copyright (C) 1999 S. Karger AG, Basel.

Tissue kallikrein (TK) and 1-antitrypsin (AT)/TK complexes can be detected in SF from patients with RA if components of the fluids which interfere with the detection of TK are removed. 2-Macroglobulin (2-M) in SF was demonstrated to contain trapped proteases which were still active in amidase assays. Removal of 2-M from RA SF reduced their amidase activity. However, at least some of the remaining activity was due to TK because it was soya bean trypsin inhibitor resistant and trasylol sensitive and was partly removed by affinity chromatography on anti-TK sepharose. Removal of RF from the fluids reduced the values obtained for TK levels by ELISA. Addition of SF to human urinary kallikrein (HUK) considerably reduced the levels of TK detected suggesting the presence of a TK ELISA inhibitor in the fluids. Removal of components of >300 kDa from SF markedly reduced the TK ELISA inhibitory activity and increased the values for both the TK and l-AT/TK levels in fluids as measured by ELISA. It is considered this novel inhibitor does not bind to the active site of TK but rather binds to the site reactive with anti-TK antibodies.

Tissue kallikrein is an enzyme that forms the vasoactive peptide kallidin from an endogenous substrate L-kininogen. Tissue kallikrein has been identified in joint fluids and in inflammatory infiltrates within synovial membranes. It is suggested that tissue kallikrein and kinins have an important role in synovitis and joint damage. Immunoreactive tissue kallikrein and amidase activity were both measured in the synovial fluid of 24 patients with rheumatoid arthritis (RA) and 12 with osteoarthritis (OA). Active enzyme concentrations were higher in RA than in OA and correlated well with the lysosomal enzymes beta-glucuronidase and lactate dehydrogenase. Both total immunoreactive tissue kallikrein and the proenzyme values were similar in RA and OA. Tissue kallikrein was localised by immunocytochemistry to the polymorphonuclear leucocytes present in the synovial fluid and membranes of patients with RA.