Mulligan Knee Taping Using Both Elastic and Rigid Tape Reduces Pain and Alters Lower Limb Biomechanics in Female Patients With Patellofemoral Pain.

BACKGROUND: Evidence supports the use of Mulligan knee taping in managing patellofemoral pain (PFP). However, no studies have compared the efficacy of rigid and elastic tape using this technique. HYPOTHESIS: Mulligan knee taping applied with both rigid and elastic tape will produce similar reductions in knee pain, hip internal rotation, and knee flexion moments compared with no tape. Elastic tape will also be more comfortable than rigid tape. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 19 female patients (mean age, 26.5 ± 4.5 years) with PFP performed a self-selected pain provocative task, single-leg squat (SLSq) task, and running task while wearing Mulligan knee taping applied with rigid tape, elastic tape at 100% tension, and no tape. Pain and taping comfort were recorded using 11-point numeric rating scales. An 18-camera motion capture system and in-ground force plates recorded 3-dimensional lower limb kinematics and kinetics for the SLSq and running tasks. Statistical analysis involved a series of repeated-measures analyses of variance. The Wilcoxon signed rank test was used for analyzing taping comfort. RESULTS: Compared with no tape, both rigid and elastic tape significantly reduced pain during the pain provocative task (mean difference [MD], -0.97 [95% CI, -1.57 to -0.38] and -1.42 [95% CI, -2.20 to -0.64], respectively), SLSq (MD, -1.26 [95% CI, -2.23 to -0.30] and -1.13 [95% CI, -2.09 to -0.17], respectively), and running tasks (MD, -1.24 [95% CI, -2.11 to -0.37] and -1.16 [95% CI, -1.86 to -0.46], respectively). Elastic tape was significantly more comfortable than rigid tape generally (P = .005) and during activity (P = .022). Compared with no tape, both rigid and elastic tape produced increased knee internal rotation at initial contact during the running task (MD, 5.5° [95% CI, 3.6° to 7.4°] and 5.9° [95% CI, 3.9° to 7.9°], respectively) and at the commencement of knee flexion during the SLSq task (MD, 5.8° [95% CI, 4.5° to 7.0°] and 5.8° [95% CI, 4.1° to 7.4°], respectively), greater peak knee internal rotation during the running (MD, 1.8° [95% CI, 0.4° to 3.3°] and 2.2° [95% CI, 0.9° to 3.6°], respectively) and SLSq tasks (MD, 3.2° [95% CI, 2.1° to 4.3°] and 3.8° [95% CI, 2.3° to 5.2°], respectively), and decreased knee internal rotation range of motion during the running (MD, -3.6° [95% CI, -6.1° to -1.1°] and -3.7° [95% CI, -6.2° to -1.2°], respectively) and SLSq tasks (MD, -2.5° [95% CI, -3.9° to -1.2°] and -2.0° [95% CI, -3.2° to -0.9°], respectively). CONCLUSION: Mulligan knee taping with both rigid and elastic tape reduced pain across all 3 tasks and altered tibiofemoral rotation during the SLSq and running tasks. CLINICAL RELEVANCE: Both taping methods reduced pain and altered lower limb biomechanics. Elastic tape may be chosen clinically for comfort reasons.

Comparison of three CIDR-based fixed-time AI protocols in beef heifers.

Several effective fixed-time AI (FTAI) protocols have been developed to facilitate AI in beef heifers that circumvent the need for estrus detection. Among these are the 5-d CO-Synch + controlled intravaginal progesterone insert (CIDR) protocol (5dCO), PGF2α (PG) 6-d CIDR protocol (PG-6dCIDR), and 14-d CIDR-PG protocol (14dCIDR-PG). Although each of these protocols varies in duration and approach to synchronizing estrus and ovulation, each has been reported as an effective method to facilitate FTAI in beef heifers. Therefore, the objective of this study was to compare FTAI pregnancy rates in beef heifers synchronized with these 3 CIDR-based protocols. Virgin beef heifers (n = 801) at 4 locations were synchronized with 1 of 3 protocols: 1) 5dCO, an injection of GnRH (100 µg) and insertion of a CIDR on d -5, PG (25 mg) and CIDR removal on d 0 with a second injection of PG (>4 h after CIDR removal) on d 0 and FTAI at 72 h after CIDR removal, 2) PG-6dCIDR, PG (25 mg) on d -9, GnRH (100 µg) and insertion of a CIDR on d -6, PG and CIDR removal on d 0, and FTAI at 66 h after CIDR removal, or 3) 14dCIDR-PG, a 14-d CIDR insert from d -30 to -16, PG (25 mg) on d 0, and FTAI at 66 h after PG. All heifers received an injection of GnRH (100 µg) concurrent with FTAI. Timing of treatment initiation was offset to allow all heifers to receive FTAI concomitantly and at random. Pregnancy success was determined between 35 and 40 d after FTAI by transrectal ultrasonography. Blood samples were collected before the beginning of each protocol and at the initiation of each protocol to determine estrous cycling status (77%). Data were analyzed using the GLIMMIX procedures of SAS. As expected, because of the duration of protocols, fewer heifers in the 14dCIDR-PG treatment were pubertal at initiation of synchronization than in the 5dCO (P < 0.05) and PG-6dCIDR (P = 0.10) treatments. Fixed-time AI pregnancy success did not differ between treatments (P = 0.14; 62.6%, 56.9%, and 53.3% for 5dCO, PG-6dCIDR, and 14dCIDR-PG, respectively). However, heifers that had reached puberty by initiation of synchronization had greater (P < 0.01) pregnancy success compared to heifers that were prepubertal (60.7% and 47.3%, respectively). In summary, all 3 protocols had similar FTAI pregnancy success, and puberty status had the greatest impact on pregnancy success.

Influence of nitrogen and sulfur intake on bovine uterine pH throughout the luteal phase.

Previous research has reported that diets high in protein and sulfur decreased uterine pH in cattle. The objective of this study was to determine the effect of high N and high S intake on uterine pH. Holstein (n = 15) and Angus-cross (n = 5) heifers (337.5 ± 8.4 kg of BW) were randomly assigned to 1 of 4 diets: control (CON; 13.4% CP and 0.17% S); high nitrogen (HN; CON plus urea supplement); high sulfur (HS; CON plus calcium sulfate); or both high nitrogen and sulfur (HNS). Diets were individually fed at 2.6% of BW on a DM basis using Calan gates and estrus was synchronized to occur on d 13 (d 0 = start of dietary treatment). Blood samples were collected on d -2 and daily (d 1 to 28) at 1400 h to determine concentrations of plasma urea nitrogen (PUN), sulfate (d 1, 4, 8, 12, 16, 20, 24, and 28), and progesterone. Uterine pH was measured on d 16, 20, 24, and 28 (d 3, 7, 11, and 15 of the estrous cycle). There was a treatment, time, and treatment by time interaction (P < 0.01) on concentrations of PUN. There was an effect of treatment (P < 0.01) on concentrations of sulfate, with concentrations being increased in HS compared with CON, HN, and HNS (P < 0.01), and HNS increased compared with CON (P < 0.01) and HN (P < 0.01). Uterine pH was increased in HN and HNS compared with CON (P < 0.02), whereas HS was not different from any treatment (P > 0.11). There was no effect of time (P = 0.26) or treatment by time interaction (P = 0.71) on uterine pH. In summary, uterine pH was increased in HN and HNS compared with CON, whereas HS was intermediate and was associated with increased concentrations of PUN.

Influence of inducing luteal regression before a modified controlled internal drug-releasing device treatment on control of follicular development.

At the initiation of most controlled internal drug-releasing (CIDR) device protocols, GnRH has been used to induce ovulation and reset follicular waves; however, its ability to initiate a new follicular wave is variable and dependent on stage of the estrous cycle. The objectives of the current studies were to determine 1) if inducing luteal regression before the injection of GnRH at time of insertion of a CIDR resulted in increased control of follicular development, and 2) if removing endogenous progesterone by inducing luteal regression before insertion of the CIDR decreased variation in LH pulse frequency. In Exp. 1 and 2, Angus-cross cycling beef heifers (n = 22 and 38, respectively) were allotted to 1 of 2 treatments: 1) heifers received an injection of PGF(2α) on d -3, an injection of GnRH and insertion of a CIDR on d 0, and a PGF(2α) injection and CIDR removal on d 6 (PG-CIDR) or 2) an injection of GnRH and insertion of a CIDR on d 0 and on d 7 an injection of PGF(2α) and removal of CIDR (Select Synch + CIDR). In Exp. 3, Angus-cross beef heifers (n = 15) were assigned to 1 of 3 treatments: 1) PG-CIDR; 2) PGF(2α) on d -3, GnRH on d 0, and PGF(2α) on d 6 (PG-No CIDR); or 3) Select Synch + CIDR. Follicular development and ovulatory response were determined by transrectal ultrasonography. Across all experiments, more (P = 0.02) heifers treated with PG before GnRH initiated a new follicular wave after the injection of GnRH compared with Select Synch + CIDR-treated heifers. In Exp. 1, after CIDR removal, interval to estrus did not differ (P = 0.18) between treatments; however, the variance for the interval to estrus was reduced (P < 0.01) in PG-CIDR heifers compared with Select Synch + CIDR heifers. In Exp. 3, there was a tendency (P = 0.09) for LH pulse frequency to be greater among PG-CIDR and PG-No CIDR compared with the Select Synch + CIDR, but area under the curve, mean LH concentrations, and mean amplitude did not differ (P > 0.76). In summary, induction of luteal regression before an injection of GnRH increased the percentage of heifers initiating a new follicular wave. Removal of endogenous progesterone tended to increase LH pulse frequency, and the modified treatment increased the synchrony of estrus after CIDR removal.

Saturable binding of [3H]-promegestone in sheep liver cytosol is not to receptors for progesterone or glucocorticoids.

Saturable, high affinity binding of [3H]-promegestone has been observed in sheep liver cytosol. In two tissues specimens the Kd values were 5.9 and 6.3 nmol/l, and the concentrations of binding sites were 84.5 and 66.2 pmol/g wet tissue respectively. The synthetic steroids methyltrienolone and ORG 2058 were capable of some degree of competition. Progesterone was a weak competitor; cortisol, dexamethasone and testosterone were ineffective. Bound promegestone in liver cytosol was taken up by liver nuclei, but not by sheep uterine nuclei. These promegestone-binding sites are neither progesterone or glucocorticoid receptors.

Effect of sodium molybdate on the interaction of androgens and progestins with binding proteins in human hyperplastic prostatic tissue.

A reliable measurement of steroid hormone receptors is essential for attempts to correlate receptor levels with response to endocrine therapy in prostatic carcinoma. Evidence that receptors in many tissues are stabilized by sodium molybdate prompted the examination of the effects of this salt on the measurement of steroid-binding sites in human prostatic tissue. The presence of molybdate (10 mmol/l) during tissue homogenization, cytosol or nuclear extract preparation and binding-site assay led to a threefold increase in the amount of high-affinity androgen binding detected in cytosol, and a slight increase in the number of cytosol progestin-binding sites. The apparent binding affinity for steroids was increased in both cases. No effect of molybdate was observed on androgen-binding sites in nuclear extracts.

Diet, absorption, and hormone studies in relation to body weight in obstructive airways disease.

Sixteen male patients with stable chronic obstructive airways disease were separated into two groups of eight according to arterial carbon dioxide tensions. Hypercapnia was associated with lower arterial oxygen tensions, higher red cell volume, and increased weight, while normocapnic subjects were decidedly thin. The considerable difference in body weight between the two groups could not be explained by variation in caloric intake, and malabsorption was excluded as a cause of weight loss in the underweight subjects. Serum tri-iodothyronine, thyroxine, cortisol, and oestradiol concentrations were similar and normal in each group, but both groups had significantly low testosterone values as compared with controls, values in the hypercapnic being appreciably lower than in the normocapnic group. The adrenal androgen dehydroepiandrosterone was significantly high in the normocapnic group and low in the hypercapnic group compared with controls. Serum pituitary luteinising and follicle stimulating hormones were normal, but three hypercapnic individuals had high serum prolactin values. Early morning urinary aldosterone values were significantly higher in the hypercapnic than in the normocapnic group. Such hormone comparisons have not previously been made in subjects with chronic obstructive airways disease grouped according to arterial blood gas values, and it is concluded that major alterations in adrenal and testicular function may occur, possibly due to pituitary suppression from hypoxia. Such hormonal changes might in part account for the contrasting alterations in body habitus found in this condition.

Comparative studies of pulsatile and nonpulsatile flow during cardiopulmonary bypass. II. The effects on adrenal secretion of cortisol.

Previous studies have indicated that a significant reduction in plasma cortisol levels occurs during nonpulsatile cardiopulmonary bypass as a result of adrenocorticol hypofunction. The Stöckert pulsatile pump system described in Part I has been employed in a comparative study of plasma cortisol levels in 20 patients subjected to pulsatile or nonpulsatile perfusion during open-heart surgery. The plasma cortisol response pattern in the nonpulsatile group was identical to the pattern previously described, with no significant rise in cortisol levels during the period of perfusion. In the pulsatile group, however, plasma cortisol levels rose significantly during perfusion, reaching a mean level at the end of perfusion which was highly significantly greater than that in the nonpulsatile group (p less than 0.001). Correction of the plasma cortisol values for the effect of hemodilution was performed and, again, corrected cortisol values indicated a highly significant increase in end-bypass levels in the pulsatile groups (p less than 0.001). These results clearly indicate that the reduction in cortisol secretion during nonpulsatile bypass may be prevented by the use of pulsatile perfusion.

Androgen binding in cytosols and nuclei of human benign hyperplastic prostatic tissue.

Androgen binding sites have been detected in cytosols and nuclear extracts from human benign hyperplastic prostatic (BPH) tissue with exchange assays using [3H]methyltrienolone and [3H]5alpha-dihydrotestosterone respectively. The concentrations of binding sites and the equilibrium dissociation constants for the [3H]steroid-receptor interactions have been determined and the specificity of the binding has been examined. The observed properties of the binding sites are consistent with those characteristic of androgen receptors. The binding sites are present in nuclear extracts from all BPH tissue samples examined to date. The amount of binding detected in the nuclear fraction is higher than that found in the cytosol.

Binding of methyltrienolone (R1881) to a progesterone receptor-like component of human prostatic cytosol.

The synthetic steroid methyltrienolone (R1881, 17beta-hydroxy-17alpha-methyl-estra-4,9,11-trien-3-one) binds with high affinity to protein in cytosols prepared from human hyperplastic prostate. R1881 also binds to the androgen receptor of rat prostate and the progesterone receptor of rabbit uterus. Other steroids compete with R1881 for unoccupied binding sites in the human prostatic cytosols in a manner similar to that observed with the rabbit uterine progesterone receptor, rather than the rat prostatic androgen receptor. The progesterone receptor-like binding sites are a feature of the prostatic stroma rather than the epithelium.