Administration of glucocorticoid agonists before or after initial extinction training

enhances extinction retention (Cai et al., 2006 and Yang et al., 2006), while blocking glucocorticoid activity impairs its consolidation (Barrett and Gonzalez-Lima, 2004 and Yang et al., 2006). Repeated glucocorticoid exposure, which leads to down-regulation of glucocorticoid release, has been shown to impair the retention of extinction memory (Gourley et al., 2008), suggesting that as in other forms of memory consolidation glucocorticoids play a HDAC inhibitor critical role in the storage of extinction learning. In humans, less work has assessed the effects of stress on extinction retention and retrieval. A recent investigation of extinction retrieval in women at different stages of their menstrual cycles revealed that extinction recall is better when preceded by stress in mid-cycling women with high estradiol status whereas the opposite was true of early cycling woman with low estradiol status (Antov and Stockhorst, 2014). This study highlights the important of expanding investigations to assess how endogenous sex and stress hormones may interact

and work synergistically or in opposition during emotional learning processes. We have recently demonstrated that inducing acute stress find more using the CPT in humans impaired extinction retrieval relative to non-stressed controls 24 h after intact fear learning and extinction training, irrespective of gender (Raio et al., 2014). Interestingly, conditioned responses across the extinction retrieval session were positively correlated with cortisol in both conditions. Although speculative, these results may be related to the not abundance of glucocorticoid receptors in both the amygdala and vmPFC, making these regions especially sensitive to stress. Given the vmPFC’s crucial role in extinction retrieval, dysfunction of this region or its connectivity to the amygdala is the most likely candidate by which stress might lead to extinction retrieval deficits. Consistent with this hypothesis,

recent work in humans has shown that functional connectivity between the amygdala and vmPFC is disrupted after CPT stress exposure (Clewett et al., 2013). Based on the animal and human work reviewed above, stress exposure appears to influence extinction processes differently depending on the phase at which stress is induced and extinction performance is assessed. Stress can impair the acquisition of extinction learning by potentially disrupting the inhibition conditioned fear responses. Likewise, stress hormones can impair the retrieval of extinction memory after intact learning. In contrast, stress and stress hormones can enhance the consolidation and storage of intact extinction training, leading to stronger retrieval when later tested.

Recent studies have further suggested that only particular PDZ pools or isoforms within the cell are susceptible to degradation [119] and [120], and that this function of E6 may be carefully regulated during the virus life-cycle [118]. Further studies are needed to precisely define the role of these interactions in vivo. Other unique characteristics of the high-risk E6 proteins include their capacity to upregulate telomerase activity [121], [122] and [123] and to maintain telomere integrity during repeated cell divisions, and their ability to mediate the degradation of p53 within the cell. Both high- and low-risk E6 proteins inactivate aspects of p53 function,

which suggests an important life-cycle function,

but only the high-risk types stimulate its ubiquitination and proteosome-dependent degradation [124], [125] and [126]. In fact the high-risk types use degradatory pathways A-1210477 cost to target many of their substrates. For E7, this involves components of the CUL2 ubiquitin ligase complex, while for E6 it involves the cellular ubiquitin ligase E6AP [127]. With the use of more advanced proteomics technology, it is becoming clear that both E6 and E7 have a very large number of cellular substrates, and that the identity of these substrates differs between HPV types of the same high-risk clade, as well as between the high- and low-risk groupings themselves [128]. Indeed, there appears to be no single characteristic that can define high-risk types selleck compound as cancer-causing. This is exemplified by studies showing very little concordance between cancer risk, and the capacity of the E6 oncoproteins from the high-risk types to degrade p53, degrade PDZ substrates and induce keratinocyte

immortalisation. In the case of E6, recent structural studies are suggestive of a complex multimeric protein that has potential to associate with multiple protein partners at any given time [125] and [129]. While such functional differences of undoubtedly contribute to the respective abilities of the high- and low-risk HPV types to cause neoplasia and cancer, it is important to remember that a key function of the E6 and E7 proteins in most HPV types is not to promote basal cell proliferation, but rather, to stimulate cell cycle re-entry in the mid-epithelial layers in order to allow genome amplification. The expression of the E6 and E7 proteins in the upper epithelial layers allows the infected cell to re-enter S-phase, and for viral genome copy-number to rise. There is also a need for the viral replication proteins E1 and E2, which increase in abundance following the upregulation of the HPV ‘late’ or ‘differentiation dependent’ promoter [130]. In HPV16, this promoter (P670) resides within the E7 open reading frame near to nucleotide position 670.

In general

inactivated whole virion vaccines are more immunogenic than split/subunit vaccines [56]. However, it has been shown that whole virion vaccines may be more effective without an additional adjuvant [57], and it was mentioned that the neutralizing activity of an adjuvanted whole virion H5N1 vaccine was lower than that of an adjuvanted split-virion H5N1 vaccine [58]. The intratracheal route of virus inoculation establishes a reproducible severe pneumonia in the ferret model [36]. Ferrets immunized with nasal Endocine™ formulated vaccines, but not ferrets immunized with parenteral TIV were protected from severe pneumonia. Protection from pneumonia corresponded with the absence of detectable virus replication in the lung and absent or significantly reduced virus replication in the upper respiratory tract. Also the previously developed CT-scanning [14], [15], [28] and [29], confirmed

that nasal Endocine™ formulated Luminespib price vaccine, but not parenteral TIV protected the ferrets from severely affected and see more inflamed lungs and marked alterations in ALVs. Current candidate influenza vaccine design has a strong focus on mucosal immunity and the crucial role of mucosal adjuvants in the development of effective inactivated or subunit nasal vaccines [14], [15], [16], [17] and [18]. Adjuvanted nasal vaccines may have the advantage to induce systemic as well as mucosal immunity, including specific secretory IgA (S-IgA) [6]. Locally produced antibodies, particularly S-IgA have been demonstrated to play an important role in responses to natural infection. Pre-existing S-IgA antibodies can prevent infection by neutralizing

influenza virus before it passes the mucosal barrier, can through effectively prevent infection of epithelial cells and have been shown to contribute to the establishment of cross-protection [59]. In the present ferret study, nasal wash and swab samples were collected for detection of antibodies against influenza. Interestingly, the nasal wash procedure clearly yielded higher antibody titers than the nasal cotton swabs. Endocine™ formulated split antigen (15 μg HA) induced significantly (p < 0.05) higher nasal Ig titers in nasal wash samples after two immunizations compared to the parenteral vaccine (manuscript in preparation). Furthermore, the present study showed that the Endocine™ formulated inactivated pH1N1/09 influenza vaccines administered nasally induced broad specific systemic antibody responses in naïve ferrets. The Endocine™ formulated split antigen (15 μg HA) vaccine induced cross reactive HI antibody titers of >40 (GMT) against distant viruses of swine origin already after one immunization and both HI and VN cross reactive titers>200 (GMT) was achieved after two immunizations. Overall this study shows the feasibility to induce protective systemic immunity after intranasal administration of relatively low doses inactivated pH1N1/09 antigens when formulated with Endocine™.

Taken together,

cordycepin may be a potential candidate antimetastatic agent through inhibiting the activity of MMPs and accelerating the release of TIMPs from cancer cells. In in vivo studies, Yoshikawa et al. investigated whether platelet aggregation accelerates hematogenous metastasis of B16-F1 mouse melanoma (B16-F1) selleck cells in C57BL/6Cr mice and the effect of cordycepin on hematogenous metastasis accelerated by ADP. ADP significantly increased the number of metastatic lung nodules in mice injected intravenously with B16-F1 cells in a dose-dependent manner, and cordycepin significantly reduced the number of metastatic nodules of B16-F1 cells formed in the lung accelerated by ADP injected simultaneously with B16-F1 cells (17). Accordingly, ADP accelerated hematogenous metastasis and cordycepin had an inhibitory action on hematogenous metastasis of B16-F1 cells via the blocking of ADP-induced ZD1839 price platelet aggregation in vivo. In in vivo studies, Sprague-Dawley rats received a single i.v. injection of a colloidal carbon solution, and then the clearance rate from the blood was measured. The rats had been administered WECS p.o. daily at a dose of 200 mg/kg for twenty-five days

until the day before the injection of colloidal carbon. The half-life of the colloidal carbon in the blood of rats administered WECS at 200 mg/kg was significantly shorter than that of the control rats (18). These results indicate that orally administered WECS activates one of the immune systems in rats. In in vitro studies, Yamaguchi et al. indicated that WECS

exhibited potent antioxidant and antilipid peroxidation activities and inhibited the accumulation of cholesteryl ester in macrophages via the suppression of low-density lipoprotein (LDL) oxidation (19). Furthermore, Yamaguchi et al. showed that WECS administered orally prevented cholesterol deposition in the aorta of atherosclerotic ICR mice by the inhibition of LDL oxidation mediated MTMR9 by free radicals rather than by reduction of the serum lipid level (20). Guo et al. reported that cordycepin administered i.g. at 25 and 50 mg/kg for two weeks prevented hyperlipidemia in Syrian golden hamsters fed a high-fat diet via the activation of AMP-activated protein kinase (AMPK) (21). In addition, Won et al. demonstrated that cordycepin injected orally at 10 mg/kg for 14 days attenuated neointimal formation by inhibiting reactive oxygen species-mediated responses in vascular smooth muscle cells in Sprague-Dawley rats (22). Accordingly, cordycepin, as an active ingredient of WECS, may exert beneficial effects on the formation of atherosclerotic lesions induced by oxidative stress.

The burden of cervical cancer in Australia is about three times higher than that of oropharyngeal cancer (http://www.aihw.gov.au/cancer/data/datacubes/index.cfm).

However, the proportion of HPV-positive cancers potentially preventable in the oropharynx is higher than in the cervix since about 70% of cancers worldwide are caused by types 16 and 18 [11]. Data from different regions are needed to help inform current debates on whether HPV vaccination programmes should be extended to males. Published Australian data on HPV in head and neck cancer are limited to our earlier studies showing an HPV-positivity rate of 46% in tonsillar cancer [6] and [12]. We have determined the HPV-positivity rate and type distribution in a large Australian series of oropharyngeal cancers and used these data, and Australian cancer incidence data to quantify the burden of oropharyngeal cancer in males induced by HPV types targeted by the vaccine. Cancer incidence high throughput screening data were obtained from the National Cancer Statistics Clearing House database of the Australian Institute of Health and Welfare (www.aihw.gov.au/cancer/data/datacubes/index.cfm), which incorporates data from the eight Australian state and territory cancer registries. Combining the base of tongue (C01),

tonsil (C09) and other sites within the oropharynx (C10)—there were, on average, 367 new cases of oropharyngeal cancer per year in males 2001–2005 (age-standardised incidence rate 3.7 per 100,000 males) and 107 new cases in females (age-standardised incidence tuclazepam PF-02341066 research buy rate 1.04 per 100,000 females). Among new cases in males, 184 were in the tonsil (age-standardised incidence rate 1.85 per 100,000 males), 130 in the base of tongue (age-standardised incidence rate 1.31 per 100,000 males) and 53 at other sites (age-standardised incidence rate 0.54 per 100,000 males). The study cohort comprised 302 patients with primary AJCC Stage 1–4 oropharyngeal SCC treated at Sydney hospitals, Australia between 1987 and 2006; 228 were treated at The Royal Prince

Alfred Hospital, a tertiary referral centre for metropolitan and rural NSW. The study was approved by Sydney South West Area Health Service Ethics committees (Protocols X05-0308, CH62/6/2006-041, 2006/055). The oropharynx is defined as lateral wall (palatine tonsil, tonsillar fossa and tonsillar pillars), base of tongue, vallecula, soft palate, uvula, and posterior wall. Patient selection was based on the availability of tumour and clinicopathological data. Data were retrieved from the Sydney Head and Neck Cancer Institute and Department of Radiation Oncology databases. Patient characteristics are summarised in Table 1. An HPV-positive tumour was defined as one testing positive for both HPV DNA and p16 to ensure virus causality [13]. Presence and type of HPV DNA were determined on two to six 4–5 μm sections of formalin-fixed paraffin-embedded tumour using an HPV E6-based multiplex real-time PCR assay (MT-PCR) modified from Stanley and Szewczuk [14].

graphpad.com). The data were not normally distributed and hence statistical significance was tested using the Kruskal–Wallis test. When the results were significant, differences among the individual medians were examined using the Mann–Whitney test. Significant effects were declared when P < 0.05. The incorporation efficiency of PTd in the MPs was estimated to be around 78% for PTd and 95%

for CpG and HDP. Previous studies showed that particles less than 10 μm are preferentially taken up by APC [12], [15] and [16]. As such, SEM of MPs that comprised of PCEP with CpG ODN, and IDR-1002 was performed to ensure that the resulting size of the particles was compatible with uptake into APC to ensure that an effective dosage of antigen would be processed. Our previous studies of encapsulated CpG ODN using the same methodology VRT752271 not only showed that the MPs generated were less than 10 μm, but also revealed 99% uptake into murine macrophages [12] and [15]. Indeed, the addition of IDR-1002 into the MP was consistent with these previous findings revealing particles ranging in size from 0.5 to 5 μm in diameter (Fig. 1A and B). At higher magnification (20,000×), a close inspection of the surface of these MP revealed that it was not smooth; instead, the surface of these MP seem to be composed

of smaller nanoparticle structures (Fig. 1C). To assess the efficacy of MP formulation, we compared the levels of the pro-inflammatory cytokines CH5424802 price TNFα, IL-6 and IL-12p40 in murine J774 macrophages treated with CpG ODN-IDR (AQ), PCEP-CpG ODN-IDR (SOL) and MP co-encapsulating PCEP-CpG ODN-IDR. Other than measuring pro-inflammatory responses, we also looked for the chemokine MCP-1, a chemotactic agent for monocytes/macrophages, T cells, NK cells, and neutrophils, since

it was previously shown that both CpG ODN and the IDR-HH2 alone enhanced MCP-1 Mephenoxalone production [17], while their complexes demonstrated a synergistic increase in production [11]. The induction of MCP-1 was strongest with the SOL formulation compared to the MP formulation (Fig. 2A) co-encapsulating CpG ODN-IDR complexes or CpG ODN and HDP delivered in uncomplexed MP. The release of pro-inflammatory cytokines TNF-α and IL-6 was significantly higher in MP treated macrophages than AQ or SOL formulation treated groups (Fig. 2B and D). The IL-12p40 levels were two-fold higher in the MP than SOL or AQ formulation treated groups (Fig. 2C). LPS was used as a positive control to demonstrate the viability of the cells. Based on these results, we conclude that the MP delivery induced higher levels of pro-inflammatory cytokines in mouse macrophages.

La conférence d’Awaji a ainsi valorisé la présence de fasciculations dans le diagnostic de SLA

en considérant qu’elles témoignaient comme les potentiels de fibrillations et les potentiels lents d’un processus de dénervation active [60]. Cette analyse contredisait des conclusions précédentes en faveur de l’apport diagnostique des fasciculations dans la SLA dans la mesure où elles pouvaient : (1) être absentes chez des patients atteints de SLA ; (2) être présentes dans d’autres affections neurologiques buy NVP-BKM120 mimant une SLA comme la neuropathie motrice à blocs de conduction, les neuropathies démyélinisantes chroniques, la maladie de Kennedy ou la myosite à inclusions ou les plexopathies post-radiques et (3) ne pas avoir obligatoirement de signification pathologique dans la mesure où

elles peuvent survenir chez des sujets sains et être alors étiquetées bénignes [61], [62] and [63]. L’ENMG étudiant les neurones périphériques peut être complété par une technique d’exploration des voies motrices centrales par stimulation magnétique transcrânienne. Non invasive et peu douloureuse, elle permet l’étude du NMC. Elle peut être très utile pour le diagnostic différentiel, GSK1120212 mais aussi pour le diagnostic positif, en mettant en évidence des signes Parvulin d’atteinte du NMC : aide au diagnostic positif. Plusieurs paramètres peuvent être étudiés : la période de silence cortical, le seuil d’excitabilité du cortex moteur, l’étude du faisceau cortico-bulbaire, la technique de triple collision sont les paramètres les plus intéressants. Le diagnostic de SLA repose sur l’examen clinique et les signes électro-neuro-myographiques, parfois complétés

par les PEM. Si les techniques d’imagerie peuvent, dans certaines circonstances, être une aide au diagnostic en montrant une atteinte du neurone moteur central, elles participent essentiellement au diagnostic différentiel. L’étude du liquide cérébro-spinal (LCS), examen privilégié au cours de l’étude du système nerveux, a un rôle essentiel pour le diagnostic différentiel. L’IRM conventionnelle comprend l’IRM cérébrale (coupes sagittales T1 et axiales T2, flair, densité de protons au minimum) et médullaire (coupes sagittales T1 et T2 et axiales T2). Elle peut montrer une atteinte du faisceau pyramidal sous la forme d’un hypersignal rond, symétrique, siégeant le long du faisceau pyramidal (cortex frontal, corona radiata, capsule interne, pont) sur les séquences pondérées en T2. Sa spécificité est faible car il est retrouvé chez les sujets normaux.

Study design: To be included, studies had to investigate the association between communication factors (verbal factors, nonverbal factors, or interaction styles) and constructs of the therapeutic alliance (collaboration, affective bond, agreement, trust, or empathy),

measured during encounters between health mTOR inhibitor practitioners and patients. Settings and participants: To be included, studies had to investigate any interaction between patients and clinicians (eg, physicians, nurses, physiotherapists) in primary care or rehabilitation settings (Box 1). Studies on mental illness were excluded because the nature of care and consultation may demand different interactions. Longitudinal studies and cross-sectional studies Clinicians interacting with patients in primary care or rehabilitation settings Association between communication factors and patient satisfaction, including: satisfaction with the consultation; satisfaction with the treatment approach used by clinicians; or satisfaction with the clinical outcomes after treatment Verbal, nonverbal, and interaction style factors used by clinicians: Studies were eligible if they investigated, during an interaction between clinicians and patients, the association of any verbal, nonverbal, and/or interaction style factors used by clinicians with a satisfaction Ku-0059436 nmr outcome. Verbal factors consisted of speech content used

between clinicians and patients, eg, psychosocial talk, defined as statements of empathy, reassurance and information

involving aspects of social and psychological behaviour ( Hall et al 1994). Nonverbal factors were defined as communication behaviour without speech content, eg, facial expression, body movement, tone of voice and interaction physical distance ( Haskard et al 2009). Interaction styles incorporate aspects of both verbal and nonverbal factors and include features such as affective connection and openness to patients, sharing of control and negotiation of options ( Flocke et al 2002). There was no restriction to coding systems used by studies to from categorise: verbal, nonverbal, and/or interaction style factors, eg, Roter Interaction Analysis System and Bales Process Analysis System (Oths 1994, Smith et al 1981); method of observation, eg, observed encounters, videotapes or audiotapes; or coders, eg, neutral observers, clinicians or patients. Studies that included actors or simulated patients were excluded. Satisfaction with care: Studies were included if they investigated the association of verbal, nonverbal, and/or interaction style factors with at least one of the following patient satisfaction outcomes: 1. Satisfaction with the consultation; Satisfaction needed to be reported by patients and there was no restriction on the tools employed to rate it.

Cultural characterization was done on ISP (International Streptomyces Project) JQ1 media; yeast extract – malt extract agar (ISP-2), oatmeal agar (ISP-3), glycerol asparagine agar (ISP-5), peptone yeast extract iron agar (ISP-6), inorganic salts starch agar (ISP-4), tyrosine agar (ISP-7) and nutrient agar at 28 °C. All media were obtained from Hi-Media, Mumbai. The growth of the

organism was studied at different temperatures and salt concentrations such as 22, 28, 37, 42 °C and 2, 4, 6, 8, 10% respectively. Utilization of different carbon and nitrogen sources such as d-glucose, d-galactose, d-fructose, d-mannitol, d-xylose, l-arabinose, l-rhamnose, l-raffinose, l-cysteine, l-histidine, l-tyrosine, d-alanine, l-leucine, l-phenylalanine and l-valine was studied. Chemotaxonomic studies were done by analyzing the cells for 2,6-diaminopimelic acid.9 16S rRNA studies were conducted and isolate MS02, was submitted in Microbial Type Culture Collection, IMTECH, Chandigarh, India. The preparation of total genomic DNA was conducted in accordance with the methods described by Sambrook et al7 PCR amplification of the 16S rRNA gene of the local Streptomyces strain MS02 was conducted

in accordance with the method described by Edwards et al 10 The sequence data were deposited in the GenBank database, under the accession number JF915304. The BLAST program (www.ncbi.nlm.nih.gov/blst) was employed in order to assess the degree of DNA similarity. Multiple sequence alignment and molecular phylogeny were evaluated using

BioEdit Epigenetic inhibitor datasheet software and the phylogenetic tree was displayed using the TREE and VIEW program. 11 Spore suspension of Streptomyces isolate MS02, was prepared from the freshly grown culture on starch casein nitrate agar slant and inoculated into 100 ml starch casein nitrate broth (107 spores/ml of the medium) in 500 ml Erlenmeyer flask. The flask was incubated on rotary shaker (180 rpm) for 5 days at 28 °C. The culture was centrifuged at 8000 rpm for 20 min. The culture supernatant was used as a source of antifungal metabolite against C. albicans MTCC 183, as a target organism. Antifungal metabolite production was carried out in 100 ml starch casein nitrate broth (soluble starch – 10 g, Potassium phosphate dibasic – 2 g, Potassium nitrate – 2 g, Sodium chloride – 2 g, Casein –0.3 g, MgSO4. 7H2O – 0.05 g, CaCO3 – 0.02 g, FeSO4· 7H20 – 0.01 g, Distilled water – 1000 ml, pH – 7) in 500 ml Erlenmeyer flasks. The initial pH of the starch casein nitrate broth was adjusted to 4, 5, 6, 7, 8 and 9 separately with 0.1N NaOH/0.1N HCl. The pH 7.2 was used as control. All flasks were inoculated as mentioned above and incubated at 28 °C on rotary shaker at 180 rpm for 5 days.

Polatajko, PhD, OT(C) Editor-in-Chief Canadian Journal of Occupational Therapy Derick T. Wade, MD Editor-in-Chief Clinical Rehabilitation Suzanne McDermott, PhD, and Margaret A.

Turk, Venetoclax in vivo MD Co-Editors-in-Chief Disability and Health Journal Stefano Negrini, MD Editor-in-Chief European Journal of Physical and Rehabilitation Medicine Steven Vogel, DO(Hon) Editor-in-Chief The International Journal of Osteopathic Medicine Črt Marinček, MD, PhD Editor-in-Chief International Journal of Rehabilitation Research M. Solomonow, PhD, MD(hon) Editor-in-Chief Journal of Electromyography & Kinesiology Paolo Bonato, PhD Editor-in-Chief Journal of NeuroEngineering and Rehabilitation Edelle [Edee] Field-Fote, PT, PhD Editor-in-Chief Journal of Neurologic Physical Therapy Guy G. Simoneau, PhD, PT Editor-in-Chief Journal of Orthopaedic & Sports Physical Therapy (JOSPT) Mark Elkins, PhD, MHSc, BA, BPhty Editor-in-Chief Journal of Physiotherapy

Stacieann C. Yuhasz, PhD Editor-in-Chief Journal of Rehabilitation Research and Development Bengt H. Sjölund, MD, DMSc Editor-in-Chief Endocrinology antagonist Journal of Rehabilitation Medicine Carl G. Mattacola, PhD, ATC Editor-in-Chief Journal of Sport Rehabilitation Ann Moore, PhD and Gwendolen Jull, PhD Co-Editors-in-Chief Manual Therapy Randolph J. Nudo, PhD Editor-in-Chief Neurorehabilitation & Neural Repair Kathleen Matuska, PhD, OTR/L Editor-in-Chief Occupational Therapy Journal of Research: Occupation, Participation, and Health Ann F Van Sant, PT, PhD Editor-in-Chief Pediatric Physical Therapy Greg Carter, MD Consulting Editor Physical Medicine and Rehabilitation Clinics of North America Rebecca L. Craik, PT, PhD Editor-in-Chief Physical Therapy Dina Brooks, PhD Scientific Editor Physiotherapy Canada Stuart

below M. Weinstein, MD Editor-in-Chief PM&R Elaine L. Miller, PhD, RN Editor-in-Chief Rehabilitation Nursing Elliot J. Roth, MD Editor-in-Chief Topics in Stroke Rehabilitation Dilşad Sindel, MD Editor-in-Chief Turkish Journal of Physical Medicine and Rehabilitation “
“Patellar tendinopathy (jumper’s knee) is a clinical diagnosis of pain and dysfunction in the patellar tendon. It most commonly affects jumping athletes from adolescence through to the fourth decade of life. This condition affects health and quality of life by limiting sports and activity participation for recreational athletes and can be career-ending for professional athletes. Once symptoms are aggravated, activities of daily living are affected, including stairs, squats, stand to sit, and prolonged sitting. Patellar tendinopathy clinically presents as localised pain at the proximal tendon attachment to bone with high-level tendon loading, such as jumping and changing direction. Tendon pain at the superior patellar attachment (quadriceps tendinopathy) and at the tibial attachment occurs less frequently, but the diagnosis and management are similar to jumper’s knee.