ABSTRACT
OBJECTIVE: To compare the prevalence, severity and risk of acromioclavicular (AC) joint arthrosis in persons presenting with shoulder pain between a spinal cord injury (SCI) and able-bodied population. In the SCI population, prevalence and severity of AC joint arthrosis were examined with respect to age, gender and lesion characteristics. METHODS: Retrospective analysis of medical records and magnetic resonance images (MRI) collected in an outpatient orthopaedics clinic. RESULTS: Sixty-eight persons with SCI and 105 able-bodied persons were included in the study. The overall MRI prevalence of AC joint arthrosis was 98% and 92%, respectively. In both groups AC joint arthrosis was frequently accompanied by MRI diagnosis of rotator cuff tears and biceps tendon ruptures. Sensitivity of clinical testing was found to be low in SCI (0.31) and in able-bodied persons (0.24). The odds of increasingly severe arthrosis were nearly four times higher in persons with SCI as compared with able-bodied persons (P<0.0001), about 72% lower in females as compared with males (P=0.0001), and 10% higher per additional year of age (P<0.0001). Arthrosis severity in the SCI-group was weakly associated with time since injury, not with neurological classification of SCI or level of injury (paraplegia vs tetraplegia). CONCLUSION: SCI patients presenting with shoulder pain showed similar prevalence, yet more advanced, AC joint arthrosis than able-bodied patients. As early diagnosis of arthrosis is a prerequisite for the initiation of successful conservative interventions of shoulder deterioration, we recommend routine assessment of shoulder status including diagnostic imaging during check-ups.
Subject(s)
Acromioclavicular Joint/pathology , Arthritis/complications , Arthritis/epidemiology , Spinal Cord Injuries/complications , Spinal Cord Injuries/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Arthritis/pathology , Disability Evaluation , Edema/complications , Edema/epidemiology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Pain Measurement , Risk , Risk Factors , Sex Factors , Shoulder Pain/complications , Shoulder Pain/epidemiology , Shoulder Pain/pathology , Spinal Cord Injuries/pathology , Switzerland/epidemiology , Young AdultABSTRACT
PURPOSE: Suramin is known to inhibit proliferation of various tumor cells. This study was performed to investigate the effect of suramin on proliferating human arterial smooth muscle cells (HASMC) and thus to examine its suitability for the prevention of restenosis. METHOD: Proliferation of HASMC was stimulated with human whole blood serum (HWBS), as well as with platelet-derived growth factor (PDGF) and basic fibroblast growth factor (bFGF). Proliferation was assessed by measuring DNA synthesis and cell viability was assessed by measuring mitochondrial activity. RESULTS: Suramin exerted a strong attenuating effect on the proliferation stimulators HWBS, PDGF, and bFGF. A suramin concentration of 0.5 mmol/L, which is approximately twice the dosage used for systemic application, was sufficient for complete neutralization of proliferation stimulation by 10% HWBS added to the cell culture medium. CONCLUSION: The authors' data demonstrate a strong proliferation inhibiting effect of suramin on HASMC in vitro. Because it is known to interact not only with one but with a multitude of relevant growth factors, these results make suramin a most interesting substance for local application for prevention of hyperplastic neointima formation.
