The Applicability of Provocative Functional Tests in the Diagnosis of Rotator Cuff Muscle Injuries of the Best University Athletes.

Rotator cuff disease, external and internal impingement syndromes, low shoulder stability, various types of trauma, and overuse injuries are all related to sports activities. In order to check symptoms in patients with disability and shoulder pain, clinicians use different methods and diagnostic imaging assessment. The research is aimed at evaluating whether there is a difference between provocation function tests (PFT) and ultrasonographic (US) testing of muscles within the rotator cuff in elite collegiate athletes. Patients (n = 184) were recruited from university team sports selections and tested with a standardized US examination of the shoulder and five PFTs (Speed's test, Neer's test, Hawkins test, lift-off test, Yergason's test). Based on the VAS pain assessment scale, 60 subjects had some pain, which was taken for further processing in the work (124 subjects did not have the presence of pain and were excluded from further processing). The US examination was conducted using Voluson 730 apparatus, by a linear probe, with the frequency in the range of 6-12 MHz. The chi-square test showed significant differences between PFT and the occurrence of shoulder muscle tendinitis for the following variables: Speed's test and subscapularis tendinitis (p = 0.02) and Speed's test and infraspinatus tendinitis (p = 0.01); Neer test and biceps brachii caput longum tendinitis (p = 0.01), Neer test and supraspinatus tendinitis (p = 0.02) and Neer test and infraspinatus tendinitis (p = 0.01); lift-off test and subscapularis tendinitis (p = 0.05); and Yergason's test and biceps brachii caput longum tendinitis (p = 0.03) and Yergason's test and subscapitis tendinitis (p = 0.01). The greatest effect of differences was observed in Neer's test and biceps brachii caput longum tendinitis (φ = 0.60), while the other effects can be described as medium and small in most cases. It can be concluded that functional tests are good predictors of soft tissue changes in the muscles of the rotator cuff of the shoulder. Further monitoring and analysis are needed on a larger number of athletes.

GLUCOSAMINE SULFATE EFFICACY IN TREATING KNEE OSTEOARTHRITIS: A FOLLOW-UP STUDY.

Osteoarthritis (OA) can be treated using either a pharmacological or non-pharmacological approach, or a combination of both. The purpose of the present study was to investigate the efficacy of crystalline glucosamine sulfate (CGS) in patients with knee OA. This open-label prospective study (with a 12-month follow-up) included 111 patients of both genders suffering from knee OA, who attended the Special Hospital for Rheumatic Diseases in Novi Sad, Serbia during the 2011-2013 period. Patients were divided into the experimental (n=52) and the control (n=59) group. While the former was prescribed CGS 1500 mg/day, the latter was treated with nonsteroidal anti-inflammatory drugs (NSAIDs) according to the standard protocol. The efficacy of both treatment modes was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne index, along with the radiological findings which involved knee joint space width (JSW) measurements. One year following the initial assessment, all patients reported pain intensity reduction; however, those in the CGS group experienced significantly lower pain intensity when compared with controls. At the end of the study, no reduction in the progression of joint structure damage (p>0.5) was noted in either group. Thus, while CGS demonstrated symptomatic efficacy, it failed to delay the progression of knee OA.

Capture the vertebral fracture: Risk factors as a prediction.

OBJECTIVE: Vertebral fractures are the most common osteoporotic fractures occurring due to low bone mineral density, as well as other risk factors. The aim of the paper is to investigate risk factors for vertebral osteoporotic fracture occurrence in postmenopausal women. METHODS: Retrospective analysis of data pertaining to 651 postmenopausal women obtained from the National Osteoporosis Registry of Serbia was conducted. Further analyses were performed on 217 osteoporotic women identified from those records, whereby those in the experimental group (n= 110) had a vertebral fracture, while those assigned to the control group (n= 107) did not. The two groups were comparable in terms of age (t= 0.450; p> 0.01). Risk factors that could serve as the best predictors of vertebral fracture occurrence were investigated. Multivariate logistic regression analysis was used for testing effect of several factors on vertebral fracture occurrence as the dependent variable. RESULTS: Patients that have never suffered a vertebral fracture had a significantly higher bone mineral density (t= 8.161; p< 0.01) in comparison to those with a verified vertebral fracture. Factors that significantly contributed to the risk of vertebral fracture were presence of kyphosis (OR 708.338; 95% CI 19.238-26.081.950), use of glucocorticoids (OR 87.618; 95% CI 9.175-836.707), and presence of comorbidities (OR 7.327; 95% CI 1.500-35.793). Moreover, a unit increase in body mass index (BMI) was found to lower the probability of vertebral fracture by a factor of 0.846. Women that entered menopause later have lower chance of suffering a vertebral fracture (OR = 0.539; 95% CI 0.400-0.726). CONCLUSION: Lower body mass index, presence of kyphosis, use of glucocorticoids, early menopause onset, and presence of comorbidities are the factors that contribute the most to vertebral osteoporotic fracture occurrence.

Cerebral palsy in preterm infants.

Background/Aim: Cerebral palsy (CP) is one of the leading causes of neurological impairment in childhood. Preterm birth is a significant risk factor in the occurrence of CP. Clinical outcomes may include impairment of gross motor function and intellectual abilities, visual impairment and epilepsy. The aim of this study was to examine the relationships among gestational age, type of CP, functional ability and associated conditions. Methods: The sample size was 206 children with CP. The data were obtained from medical records and included gestational age at birth, clinical characteristics of CP and associated conditions. Clinical CP type was determined according to Surveillance of Cerebral Palsy in Europe (SCPE) and topographically. Gross motor function abilities were evaluated according to the Gross Motor Function Classification System (GMFCS). Results: More than half of the children with CP were born prematurely (54.4%). Statistically significant difference was noted with respect to the distribution of various clinical types of CP in relation to gestational age (p < 0.001). In the group with spastic bilateral CP type, there is a greater proportion of children born preterm. Statistically significant difference was noted in the functional classification based on GMFCS in terms of gestational age (p = 0.049), children born at earlier gestational age are classified at a higher GMFCS level of functional limitation. The greatest percentage of children (70.0%) affected by two or more associated conditions was found in the group that had extremely preterm birth, and that number declined with increasing maturity at birth. Epilepsy was more prevalent in children born at greater gestational age, and this difference in distribution was statistically significant (p = 0.032). Conclusion: The application of antenatal and postnatal protection of preterm children should be a significant component of the CP prevention strategy.