A 12-week exercise program improves functional status in postmenopausal osteoporotic women: randomized controlled study - European Journal of Physical and Rehabilitation Medicine 2021 February;57(1):120-30 - Minerva Medica - Journals

Fibromyalgia (FM) is a chronic condition characterized by generalized musculoskeletal pain associated with other symptoms, especially sleep and mood disorders, fatigue, and cognitive dysfunctions. The etiopathogenesis of FM is not sufficiently known, and regardless of numerous research, the clinical presentation is nonspecific, which makes it difficult to approve a timely diagnosis and, subsequently, an adequate therapeutic approach. Genetic, hormonal, immunological, and environmental factors are cited as potential factors in the development of this condition. Diagnosis is based on a clinical approach and known diagnostic criteria, while additional methods, such as radiographic, magnetic resonance, or laboratory analyses, can be useful to exclude other conditions. The heterogeneity of FM significantly impacts both diagnosis and treatment, as it presents a wide spectrum of symptoms that vary in severity, combinations, and underlying contributing factors. This variability is a challenge for clinicians and requires a holistic, comprehensive, multidisciplinary, patient-centered approach. According to The European League Against Rheumatism (EULAR) from 2016, treatment begins with patient education and involves the simultaneous application of pharmacological and nonpharmacological treatments. The application of only pharmacological or nonpharmacological treatment is most often not successful. Due to differences in pain threshold, psychological factors, and comorbidities, patients may respond differently to the same interventions. Although there is no universal treatment, this review brings up the fact that the timely recognition of symptoms and a tailored treatment with a patient-centered plan can significantly improve the quality of life of patients.

Background. Osteoporosis is a disease characterized by decreased bone density and destruction of bone microarchitecture. Indicators for altered bone homeostasis are changes in the serum level of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). The purpose of the current study was to evaluate the effect of a 12‐week exercise program on enzyme activity of serum MMP‐9 and TIMP‐1 in postmenopausal osteoporotic patients. Materials and methods. Participants were randomized in two groups: exercise (EG) (N = 37) and control (CG) (N = 31). The exercise group completed a 12‐week supervised exercise program, while the control group did not take part in any physical activity. Enzyme activities of serum MMP‐9 and TIMP‐1 were detected by gelatin zymography and ELISA in both groups, respectively. Results. Significant differences between pretreatment and posttreatment enzyme activities of serum MMP‐9 (p = 0.009), TIMP‐1 (p ≤ 0.001), and MMP‐9/TIMP‐1 ratio (p ≤ 0.001) were detected in the exercise group. Exercises decreased the activity of serum MMP‐9 and increased the activity of TIMP‐1, while the enzyme activities of MMP‐9 (0.583) and TIMP‐1 (0.210) have not been significantly changed in CG. Patients from the exercise group had better treatment. Conclusion. Our results suggest that a 12‐week exercise program has an influence on enzyme activity of serum MMP‐9, revealing a possible role of MMPs in initiating training‐specific adaptation. Although measurements of circulating MMP‐9 and TIMP‐1 allowed us to detect effects of exercise, as of today, they have no real role in the diagnosis of osteoporosis and/or follow‐up of osteoporotic patient’s response to treatment. MMP‐9 might be used as an important prognostic marker for the evaluation of patient’s response to exercise. Larger‐randomized controlled studies need to be performed to expand this area of knowledge. This trial is registered with trial registration number: NCT03816449).

Background and Objectives: The aim of this study was to validate the Serbian version of the Boston Carpal Tunnel Questionnaire (BCTQ) and to evaluate temporal stability for the purpose of its implementation in the evaluation of Serbian patients with carpal tunnel syndrome (CTS). Materials and Methods: For the validation of the Serbian version of the BCTQ (BCTQ_SR), we tested 69 individuals with diagnosed CTS that were referred for a conservative treatment at the Institute for Rehabilitation. Neurophysiological tests were used for the electrophysiological grading (EG) of CTS severity in the study sample. The final version of the BCTQ_SR was given to the tested participants from the study on two occasions: test and retest, with a five-day period between the two measurements. Results: The mean value for the symptom severity subscale (SSS) of the BCTQ_SR was 3.01 ± 0.94; for the functional status subscale (FSS) of the BCTQ_SR it was 2.85 ± 1.00. Cronbach’s α for the SSS was 0.91 and 0.93 for the FSS. The intraclass correlation coefficients (ICCs) concerning the test–retest were significant (p < 0.001) and were 0.949 for the SSS and 0.959 for the FSS. Those with a higher EG grade had higher values of the SSS and FSS but without a statistical significance (p = 0.103 and p = 0.053, respectively). The intercorrelation of the BCTQ_SR subscales (SSS and FSS) on the test was significant (p < 0.001) with a correlation coefficient equal to 0.777. Conclusion: The Serbian version of the BCTQ (BCTQ_SR) was successfully culturally adopted. The BCTQ_SR was a valid and reliable instrument for the measurement of symptom severity and functional status in adults with CTS. Therefore, it can be used in clinical practice for patients with CTS.

Emphysematous pancreatitis represents the presence of gas within or around the pancreas on the ground of necrotizing pancreatitis due to superinfection with gas-forming bacteria. This entity is diagnosed on clinical grounds and on the basis of radiologic findings. Computed tomography is the preferred imaging modality used to detect this life-threating condition. The management of emphysematous pancreatitis consists of conservative measures, image-guided percutaneous catheter drainage or endoscopic therapy, and surgical intervention, which is delayed as long as possible and undertaken only in patients who continue to deteriorate despite conservative management. Due to its high mortality rate, early and prompt recognition and treatment of emphysematous pancreatitis are crucial and require individualized treatment with the involvement of a multidisciplinary team. Here, we present a case of emphysematous pancreatitis as an unusual occurrence and discuss disease features and treatment options in order to facilitate diagnostics and therapy.