124 research outputs found
CONSORT_2010_Checklist_VOLT01 – Supplemental material for Zoledronic acid plus methylprednisolone <i>versus</i> zoledronic acid or placebo in symptomatic knee osteoarthritis: a randomized controlled trial
No full textSupplemental material, CONSORT_2010_Checklist_VOLT01 for Zoledronic acid plus methylprednisolone versus zoledronic acid or placebo in symptomatic knee osteoarthritis: a randomized controlled trial by Guoqi Cai, Laura L Laslett, Dawn Aitken, Flavia Cicuttini, Lyn March, Catherine Hill, Tania Winzenberg and Graeme Jones in Therapeutic Advances in Musculoskeletal Disease</p
Deteriorating tactile sensation in patients with hand syndromes associated with diabetes: a two-year observational study
No full textAimsTo observe the natural history of hand function during a two-year period in participants with hand syndromes associated with diabetes and to determine factors related to changing function.MethodsHand function was measured over three annual visits using Disability of the Arm, Shoulder and Hand (DASH) and SF-36v2 questionnaires, grip strength, light touch and 9-hole peg tests. Light touch was tested with WEST monofilaments at 7 sites on the hand (score 35 to 0). Data were analyzed using repeated-measures ANOVA, Spearman's correlation, and Wilcoxon signed-rank tests.ResultsParticipants (n=60) were aged 61 ± 10.5 years, 57% female, diagnosed with diabetes and at least one of four associated hand disorders. Presentations of carpal tunnel syndrome, or past release (n=27, 45%) and trigger finger (n=24, 40%) were common. Tactile sensation was reduced during the two-year period (median, range; 30 months, 25-40 months). Initial median (inter-quartile range) scores for the dominant hand of 25.5 (22-28.5) were reduced to 23 (21.5-27). This sensory loss was weakly associated with HbA1c (r=0.30, p=0.05) and occurred predominantly in participants with trigger finger (p=0.05).ConclusionsLight touch perception was reduced in longstanding diabetic hand syndromes. Tactile abnormalities that were detected by clinical examination progressed during a two year period and were related to metabolic control and musculoskeletal diagnosis.Christine L. Redmond, Gregory I. Bain, Laura L. Laslett and Julian D. McNei
Hand syndromes associated with diabetes: Impairments and obesity predict disability
No full textObjectiveWe determined patterns of disability in diabetic hand conditions and identified factors that contributed to functional limitations.MethodsHand assessments were performed on 60 adults with DM1 or DM2 and carpal tunnel syndrome, trigger finger, Dupuytren's disease, or the syndrome of limited joint mobility. The examination included measurement of grip strength, light touch perception, and dexterity, as well as self-reported function using the Disabilities of the Arm, Shoulder and Hand (DASH) instrument and the Medical Outcomes Study Short Form-36 questionnaire. Associations with hand disability were analyzed using correlation and regression.ResultsThe most frequent presentation was carpal tunnel syndrome (45%) but it was common for patients to present with clinical features associated with more than one hand syndrome (47%). Overall, women had greater difficulties, with significantly higher DASH scores than men [mean 30.3 (95% CI 23.2, 37.5) vs 18.0 (95% CI 12.1, 23.9), respectively; p = 0.01]. Grip strength, dexterity, and obesity were associated with hand disability (p ConclusionIn adults with hand syndromes associated with diabetes, disability was related to impaired muscle function and carpal tunnel syndrome. Obesity and overall physical functioning influenced hand disability, particularly in women.Christine L. Redmond, Gregory I. Bain, Laura L. Laslett, and Julian D. Mcnei
Osteoporosis education improves osteoporosis knowledge and dietary calcium: comparison of a 4 week and a one-session education course
No full textBackgroundEducation is ideal for osteoporosis because many risk factors are modifiable. However, the efficacy of shortened education courses compared to a standard 4 week course for improving osteoporosis knowledge and healthy behaviours is not known. This study aimed to assess whether education changed knowledge and healthy behaviours over 3 months of follow-up; and whether changes in these outcomes were different between participants receiving the different education courses.MethodsAdults aged ≥ 50 years presenting to Emergency with mild to moderate trauma fractures received either the Osteoporosis Prevention and Self-Management Course (OPSMC) (4 × 2.5 h) (n = 75) or a one-session course (1 × 2.5 h) (n = 71) in a non-randomised prospective study with single-blinded allocation. Participants completed questionnaires measuring osteoporosis knowledge, dietary calcium, physical activity, calcium and exercise self-efficacy, and osteoporosis medications at baseline and 3 months. Data were analysed using mixed models and GEE regression models.ResultsOsteoporosis knowledge and calcium from food (% of RDI) increased from baseline to 3 months in both groups (P ConclusionsOsteoporosis education (either the OPSMC or the one-session course) improved osteoporosis knowledge and calcium intake after 3 months. Participants attending the OPSMC maintained medication compliance. We were unable to determine other differences between the courses. This study confirms the value of osteoporosis education for improving osteoporosis knowledge.Laura L. Laslett, Joan Lynch, Thomas R. Sullivan and Julian D. McNei
Predictors of shoulder pain and shoulder disability after one year in diabetic outpatients
No full text© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology.Objective. To investigate factors associated with changes in shoulder pain and disability in diabetic outpatients over 1 yr. Methods. Cross-sectional study with 12-month follow-up in diabetic outpatients (n = 179) using the shoulder pain and disability index (SPADI) and SF-36 version 2. Results. Patients with diabetes and shoulder pain or disability are more likely to be older and female. After 12 months of follow-up, one-quarter of participants without pre-existing symptoms at baseline developed clinically significant pain (28%) or disability (25%). Of the patients with pre-existing shoulder pain or disability, half reported clinically significant worsening (10 percentage points) in shoulder pain (58%) or disability (45%) over 12 months. Few patients demonstrated clinically significant improvement in pain (11%) or disability scores (19%). The remaining one-third of the patients reported no change in symptoms (30% pain; 35% disability). Increasing intensity of pain scores between baseline and 12 months was associated with older age, higher HbA1c and less pain at baseline. Increasing disability score between baseline and 12 months was associated with having had eye laser surgery, greater pain at baseline and less disability at baseline. Conclusion. Shoulder pain and disability are common, and persistent in adults with diabetes. Having higher HbA1c levels or having had treatment for retinopathy was associated with worsening shoulder pain and disability, confirming that glycaemic control and diabetic complications are associated with worsening shoulder pain or disability over 12 months of observation.L. L. Laslett, S. P. Burnet, C. L. Redmond and J. D. McNei
The association between change in bone marrow lesion size and change in tibiofemoral cartilage volume and knee symptoms
No full textObjective. To describe the association between change in subchondral bone marrow lesions (BMLs) and change in tibiofemoral cartilage volume and knee symptoms in patients with symptomatic knee OA. Methods. In total, 251 participants (mean 61.7 years, 51% female) were included. Tibiofemoral cartilage volume was measured at baseline and 24 months, and BML size at baseline, 6 and 24 months. Knee pain and function scores were evaluated at baseline, 6 and 24 months. Change in total and compartment-specific BML size was categorized according to the Least Significance Criterion. Linear mixed-effects models were used to evaluate the associations of change in BMLs over 6 and 24 months with change in cartilage volume over 24 months and knee symptoms over 6 and 24 months. Results. Total BML size enlarged in 26% of participants, regressed in 31% and remained stable in 43% over 24 months. Compared with stable BMLs in the same compartment, enlarging BMLs over 24 months were associated with greater cartilage loss (difference: -53.0mm3, 95% CI: -100.0, -6.0), and regressing BMLs were not significantly associated with reduced cartilage loss (difference: 32.4mm3, 95% CI: -8.6, 73.3) over 24 months. Neither enlargement nor regression of total BML size over 6 and 24 months was associated with change in knee pain and function over the same time intervals. Conclusions. In subjects with symptomatic knee osteoarthritis and BMLs, enlarging BMLs may lead to greater cartilage loss but regressing lesions are not associated with reduced cartilage loss while neither is associated with change in knee symptoms.Guoqi Cai, Dawn Aitken, Laura L. Laslett, Catherine Hill, Anita E. Wluka, Lyn March, Flavia Cicuttini, Jean-Pierre Pelletier, Johanne Martel-Pelletier and Graeme Jone
Discounting Dollars, Discounting Lives: Intergenerational Distributive Justice and Efficiency
No full textThe view that intergenerational distributive justice and efficiency should be treated separately is familiar, yet controversial. This article elaborates the often-implicit justifications for separate treatment and provides a more express statement of how and when such treatment is appropriate. Substantial attention is devoted to an approach that holds constant the intra- and intergenerational distribution of well-being, which proves to be a valuable analytical device even for intergenerational policies that are not distribution neutral. Also explored are possible interrelationships between intergenerational distributive justice and efficiency, the choice of interest rate for discounting dollars, and how the present approach relates to those that would employ direct social weights to dollars at different points in time.
Recommended from our members
STOCHASTICITY
No full textDetailed examination of computed particle trajectories has revealed a complexity and disorder that is of increasing interest to accelerator specialists. To introduce this topic, the author would like you to consider for a moment the analysis of synchrotron oscillations for a particle in a coasting beam, regarded as a problem in one degree of freedom. A simple analysis replaces the electric field of the RF-v cavity system by a traveling wave, having the speed of a synchronous reference particle, and leads to a pair of differential equations of the form dy/dn = -K sin {pi}x, (1A) where y measures the fractional departure of energy from the reference value {pi}x measures the electrical phase angle at which the particle traverses the cavity, and K is proportional to the cavity voltage; and dx/dn = {lambda}{prime}y, (1b) in which {lambda}{prime} is proportional to the change of revolution period with respect to particle energy. It will be recognized that these equations can be derived from a Hamiltonian function H = (1/2){lambda}{prime}y{sup 2}-(K/{pi})cos {pi}x. (2) Because this Hamiltonian function does not contain the independent variable explicitly, it will constitute a constant of the motion and possible trajectories in the x,y phase space will be just the curves defined by H = Constant, namely the familiar simple curves in phase space that are characteristic of a physical (non-linear) pendulum
Thermal and structural evolution of the East Carpathians in northern Romania : from Cretaceous orogeny to final exhumation during Miocene collision
No full textCombining thermochronological methods with structural field data, this study aims to reconstruct the Tertiary burial and exhumation history of the northeastern part of the Tisza‐ Dacia block during its invasion in the Carpathian embayment and final soft collision with the European margin. Zircon fission track data additionally provide information about the last metamorphic overprint during the Cretaceous. Within the basement units of the northern Central East Carpathians (Bucovinian nappe stack) and the Preluca massif (Biharia unit) zircon fission tracks are largely reset during the last (Cretaceous) orogeny. Temperatures during this Alpine metamorphic overprint increase from external to internal within the northern East Carpathians from sub‐greenschist facies conditions to at least greenschist facies conditions. Greenschist facies conditions are also observed in the Preluca massif. The close neighbourhood of Coniacian to Campanian zircon FT cooling ages with Cenomanian sediments suggests Late Cretaceous tectonic exhumation in the northern East Carpathians. The most likely explanation for this tectonic exhumation is a ‐ so far undocumented ‐ Late Cretaceous extension related to orogenic collapse (Gosau type basins). The Tertiary evolution is characterised by the invasion of the previously amalgamated Tisza‐Dacia and ALCAPA blocks into the Carpathian embayment and Miocene soft collision of both these blocks with the European margin. The juxtaposition of the ALCAPA and Tisza‐Dacia blocks, with Tisza‐Dacia in a lower plate position, is announced by the onset of Oligocene turbiditic sedimentation. The Burdigalian SE‐directed over‐thrusting of the Pienides (non‐ metamorphic flysch units) is interpreted to express the final stages of this juxtaposition. Burial heating caused full annealing of fission tracks in apatite (i.e. >120°C) in the Central East Carpathian basement in the NE of the study area, while in the basement of the Preluca massif in the SW of the study area temperatures related to Paleogene to Early Miocene burial did not exceed 80°C. The post‐Burdigalian (post‐16 Ma) soft collision of Tisza‐Dacia with the European margin occurred in two stages expressed by predominantly sinistral strike‐slip deformation during constant NE‐SW shortening. During and following soft collision, combined uplift and erosion caused exhumation of the buried rocks along the European margin. Uplift reaches up to 9 km in the Rodna horst The first post‐Burdigalian transpressional stage (16‐12 Ma) is related to perpendicular convergence of Tisza‐Dacia with the NW‐SE striking European margin. Minor exhumation during this stage resulted in Middle Miocene apatite fission track cooling ages (15‐13 Ma) in the west of the study area. The transtensional stage (12–10 Ma) led to the formation of the Bogdan‐Dragos‐Voda fault system. Sinistral transtension allowed for the docking and fitting of Tisza‐Dacia with the NW‐ SE striking European margin. Oblique E‐W convergence led to strain partitioning with thrusting in the external thrust belt and internal strike‐slip deformation. Differential lateral movements are distributed and deformation is accommodated by E‐W striking sinistral strike slip faults and SW‐NE striking normal faults, which led to fragmentation into SW‐tilted blocks. Fragmentation and differential offset along the bounding faults resulted in the formation of triangular‐shaped graben and corresponding horst structures. Enhanced exhumation during transtensional activity led to advective heat transport and resulted in Middle to Late Miocene apatite fission track cooling ages (13‐7) in the east of the study area
- …
