ABSTRACT
Music is often associated with joy, pleasure and leisure. However, like any other profession, it has its constraints and risks.The purpose of this update is to present a non-exhaustive inventory of musculoskeletal hand disorders most frequently associated with music practice.All music instruments are concerned. The difference lies in damage location as well as in the frequency of specific pathologies according to the used instrument. The most feared disorder by musicians is focal dystonia, which is characterized by a painless and repetitive coordination disorder. It only appears in the realization of specific professional movements. The overuse syndrome and the nerve entrapment syndrome constitute other dreaded disorders. Specific and multidisciplinary care is often necessary.
La musique rime souvent avec joie, plaisir et loisir. Cependant, comme toute autre profession, elle a ses contraintes et ses risques. Cette mise au point a pour objectif de faire un inventaire, non exhaustif, des pathologies musculo-squelettiques de la main les plus fréquemment associées à la pratique de la musique. Aucune famille d'instruments n'est épargnée. La différence réside dans la localisation de l'atteinte ainsi que dans la fréquence de l'association entre certains instruments et une pathologie précise. La dystonie de fonction, caractérisée par un trouble de la coordination indolore mais répétitif, est une pathologie redoutée par les musiciens. La symptomatologie ne se manifeste que lors de la réalisation de certains gestes professionnels précis. Le syndrome de surmenage ainsi que les syndromes canalaires peuvent également se rencontrer. Une prise en charge spécifique et multidisciplinaire est souvent nécessaire.
Subject(s)
Dystonic Disorders , Musculoskeletal Diseases , Music , Occupational Diseases , Dystonic Disorders/diagnosis , Dystonic Disorders/epidemiology , Dystonic Disorders/etiology , Hand , Humans , Musculoskeletal Diseases/diagnosis , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/etiology , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Occupational Diseases/etiologyABSTRACT
The acronym SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) includes diseases with similar osteoarticular manifestations and skin conditions. Making this diagnosis is not always obvious, especially when the clinical presentation does not fit the typical pattern of the disease or it occurs in a particular field. We described three cases where the diagnosis was difficult. A 46 year-old woman presented with cervical pain. The cervical X-ray showed the aspect of an ivory C5 vertebra. The patient had, however, preserved general condition, no signs of underlying neoplasia, nor other joint complaints. Blood analysis was normal. Tomography did not find any suspect lesion but showed sclerosis and hyperostosis of the manubrium. Scintigraphy showed the characteristic "bullhead" appearance. A 61-year-old woman had thoracic and lumbar pain. MRI showed spondylodiscitis in D3-D4, D4-D5, D5-D6, D6-D7, and L1-L2 with paraspinal soft tissue involvement, simulating infectious spondylodiscitis. Infectious investigations and discovertebral biopsy performed twice were negative. SAPHO syndrome was then suspected. Bone scintigraphy showed uptake in the chondrosternal articulations and D4 to D7 vertebrae. The diagnosis of SAPHO was established. The third case was a 46-year-old man with a lung adenocarcinoma. Staging for metastatic disease, a TAP tomography was performed and showed osteosclerosis of D8 to D12 and intra-articular bridges in the sacroiliac joints. MRI and scintigraphy eliminated malignancy and confirmed the diagnosis of SAPHO. In our cases, imaging findings could facilitate differentiating SAPHO syndrome from other diseases.
ABSTRACT
Gastrointestinal risk factors after organ transplantation are prevalent, due to the chronic use of immunosuppressant. The immunosuppressive drugs such as tacrolimus/mycophenolate mofetil (TAC/MMF) association are the most commonly used therapy. TAC and MMF have been implicated in gastrotoxicity, but their direct effects, alone and combined, on intestinal cells are not completely elucidated. This study investigated the effect of TAC and MMF alone and combined on human colon carcinoma cells. Our results demonstrated that TAC and MMF individually inhibit clearly cells proliferation, enhanced free radicals, lipid peroxidation production, induced DNA lesions and reduced mitochondrial membrane potential. In this study, we also showed that the two molecules TAC and MMF combined at high concentrations amplified the cell damage. Furthermore, the TAC (5 µM) prevented cell death induced by MMF (half maximal inhibitory concentration (IC(50))). Also, MMF (50 µM) induced cytoprotection in HCT116 cells against TAC (IC(50)) toxicity. Our findings provide additional evidence that oxidative damage is the major contribution of TAC and MMF combined toxicities. In fact, MMF and TAC exert a gastroprotective effect by modulating reactive oxygen species production. These data underscore the pleiotropic effect of TAC and MMF on HCT116 cells that play a preventive and critical role on intestinal function.
