Addressing adverse mechanical factors

2016 ◽  
Author(s):  
Christelle Nguyen ◽  
François Rannou
Keyword(s):  
Research Society ◽  
Joint Loading ◽  
Factors Affecting ◽  
Knee Oa ◽  
Mechanical Joint ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Joint Biomechanics ◽  
Mechanical Factors ◽  
The Individual

Non-pharmacological approaches are widely and consistently recommended for the management of osteoarthritis (OA). This recommendation is based on biomechanical observations and emphasizes the therapeutic interest of biomechanical interventions able to modulate adverse mechanical factors affecting the symptomatic OA joint. Therapeutic approaches include braces, orthoses, insoles, joint protection, joint-preserving surgical procedures, walking sticks, and other aids. Overall, biomechanical interventions aim to modulate joint biomechanics, in order to improve joint mechanosensitivity, decrease mechanical joint loading, and eventually reduce pain. These interventions must be adjusted to the biomechanical specificities of each joint, and of the individual patient. This chapter uses an evidence-based approach, including the most recent European League Against Rheumatism, Osteoarthritis Research Society International, and American College of Rheumatology recommendations, to describe and to review non-pharmacological strategies available in daily clinical practice, designed to modulate mechanical joint loading, with a focus on the management of hand, hip, and knee OA. The interest of weight loss, specific and non-specific exercises, patient education, and self-care programmes is discussed elsewhere in this book.

Efficacy and safety of pamapimod in patients with active rheumatoid arthritis receiving stable methotrexate therapy

2009 ◽  
Vol 69 (2) ◽  
pp. 364-367 ◽  
Author(s):  
R E Alten ◽  
C Zerbini ◽  
S Jeka ◽  
F Irazoque ◽  
F Khatib ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Active Rheumatoid Arthritis ◽  
Study Drug ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Acr20 Response ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Efficacy Measure ◽  
The Individual

Objective:To determine the efficacy and safety of pamapimod in adult patients with active rheumatoid arthritis (RA) who had an inadequate clinical response to methotrexate (MTX).Methods:Patients receiving stable doses of MTX were randomised to one of six dose groups and received 12 weeks of double-blind pamapimod (up to 300 mg once daily) or matching placebo. The primary efficacy measure was the proportion of patients with ⩾20% improvement in RA based on the American College of Rheumatology criteria (ACR20) at 12 weeks. Secondary measures were ACR50, Disease Activity Score (DAS)/European League Against Rheumatism (EULAR) responses and the individual ACR core set of parameters. Safety measures included adverse events (AEs), laboratory testing and immunology assessments.Results:On a background of MTX, the percentage of patients with an ACR20 response at week 12 in the pamapimod groups (31% to 43%) was not significantly different from placebo (34%). Secondary efficacy end points showed a similar pattern. AEs were typically mild and included infections, gastrointestinal disturbances, dizziness and rashes; AEs resulting in discontinuation of study drug were primarily attributed to infections.Conclusion:In patients with active RA receiving stable doses of MTX, pamapimod showed non-significant improvement in efficacy outcomes compared to placebo.

scholarly journals Interactive effects between travel behaviour and COVID-19: a questionnaire study

2021 ◽  
Author(s):  
Jinbao Zhang ◽  
Jaeyoung Lee
Keyword(s):  
Early Stage ◽  
Travel Behaviour ◽  
Interactive Effects ◽  
Factors Affecting ◽  
Individual Level ◽  
Passenger Volume ◽  
Spatial Autoregressive ◽  
Railway Passenger ◽  
The Individual ◽  
And Control

Abstract This study has two main objectives: (i) to analyse the effect of travel characteristics on the spreading of disease, and (ii) to determine the effect of COVID-19 on travel behaviour at the individual level. First, the study analyses the effect of passenger volume and the proportions of different modes of travel on the spread of COVID-19 in the early stage. The developed spatial autoregressive model shows that total passenger volume and proportions of air and railway passenger volumes are positively associated with the cumulative confirmed cases. Second, a questionnaire is analysed to determine changes in travel behaviour after COVID-19. The results indicate that the number of total trips considerably decreased. Public transport usage decreased by 20.5%, while private car usage increased by 6.4%. Then the factors affecting the changes in travel behaviour are analysed by logit models. The findings reveal significant factors, including gender, occupation and travel restriction. It is expected that the findings from this study would be helpful for management and control of traffic during a pandemic.

scholarly journals SAT0560 THE PROGNOSTIC VALUE OF ULTRASONOGRAPHIC FINDINGS IN INDIVIDUALS WITH ASYMPTOMATIC HYPERURICEMIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1238.2-1238
Author(s):  
W. Li ◽  
W. Fan ◽  
J. Zhu ◽  
Z. Chen ◽  
F. Liu
Keyword(s):  
Blood Flow ◽  
Prognostic Value ◽  
Soft Tissues ◽  
Bone Erosion ◽  
Gouty Arthritis ◽  
Diagnostic Value ◽  
First Metatarsal ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Peking University

Background:Chronic and steady asymptomatic hyperuricemia (AHU) can eventually lead to the deposition of monosodium urate crystals in joints and soft tissues. The rate of progression from AHU to clinically evident gout varies and mainly depends on serum uric acid levels. However, little is known about the prognostic value of ultrasonographic findings in individuals with AHU in detail.Objectives:To explore the prognostic value of ultrasonographic findings in individuals with asymptomatic hyperuricemia.Methods:We analyzed the ultrasonographic findings (snowstorm sign, double-contour (DC) sign, tophi, bone erosion, and abnormal blood flow) of bilateral knees, ankles and the first metatarsal-phalangeal joints (1st MTP) of individuals with AHU at Peking University People’s hospital between June 2014 and May 2016. All individuals were followed up for two years.Results:Among 218 individuals with AHU, the prevalence of snowstorm sign, DC sign, tophi, bone erosion and abnormal blood flow was 41%, 23%, 4%, 9% and 13%, respectively. Gout attacked in 36 patients during 2-year follow-up with 4.5 years of HU duration. The first attack affected the 1st MTP in 60%, the ankle in 31%, and the knee in 11% of the patients with gout. Patients with gout attack has longer hyperuricemia duration compared with individuals with AHU without gout attack. DC sign, tophi, and bone erosion on ultrasound were more frequently presented in patients with gout attack compared with individuals with AHU without gout attack. However, the prevalence of snowstorm sign and and abnormal blood flow on ultrasound has no significant differences between patients with gout attack and individuals with AHU without gout attack.Conclusion:Longer hyperuricemia duration, DC sign, tophi, and bone erosion on ultrasound in individuals with AHU could be associated with gout attack.References:[1]Neogi T, Jansen TL, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2015;74(10):1789-98.[2]Estevez-Garcia IO, Gallegos-Nava S, Vera-Pérez E, Silveira LH, Ventura-Ríos L, Vancini G, et al. Levels of cytokines and MicroRNAs in individuals with asymptomatic hyperuricemia and ultrasonographic findings of gout: A Bench-to-Bedside Approach. Arthritis Care Res. 2018;70(12):1814-21.[3]Elsaman AM, Muhammad EM, Pessler F. Sonographic findings in gouty arthritis: diagnostic value and association with disease duration. Ultrasound Med Biol. 2016;42(6):1330-6.[4]Joosten LAB, Crişan TO, Bjornstad P, Johnson RJ. Asymptomatic hyperuricaemia: a silent activator of the innate immune system. Nat Rev Rheumatol. 2020;16(2):75-86.Acknowledgments:This work was supported by National Natural Science Foundation of China (No. 81571684 to Jiaan Zhu), Peking University People’s Hospital Research and Development Funds (RDC2014-02 to Wenting Fan).Disclosure of Interests:None declared

scholarly journals Tophaceous gout of the atlantoaxial joint: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Andrew Benjamin Romero ◽  
Evan Paul Johnson ◽  
John S. Kirkpatrick
Keyword(s):  
Cervical Spine ◽  
Tissue Sample ◽  
Significant Finding ◽  
Atlantoaxial Joint ◽  
Tophaceous Gout ◽  
Case Presentation ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
History Of ◽  
Clinically Significant

Abstract Background To report the occurrence of tophaceous gout in the cervical spine and to review the literature on spinal gout. Case presentation This report details the occurrence of a large and clinically significant finding of tophaceous gout in the atlantoaxial joint of the cervical spine in an 82-year-old Caucasian man with a 40-year history of crystal-proven gout and a 3-month history of new-onset progressive myelopathy. The patient's American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria score was 15.0. Conclusion Spinal gout is more common than previously thought, and it should be considered in patients who present with symptoms of myelopathy. Diagnosis can be made without a tissue sample of the affected joint(s) with tools like the ACR/EULAR criteria and the use of the “diagnostic clinical rule” for determining the likelihood of gout. Early conservative management with neck immobilization and medical management can avoid the need for surgical intervention.

scholarly journals Treadmill Exercise after Controlled Abnormal Joint Movement Inhibits Cartilage Degeneration and Synovitis

Life ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 303
Author(s):  
Yuichiro Oka ◽  
Kenij Murata ◽  
Kaichi Ozone ◽  
Takuma Kano ◽  
Yuki Minegishi ◽  
...  
Keyword(s):  
Treadmill Exercise ◽  
Cruciate Ligament ◽  
Cartilage Degeneration ◽  
Research Society ◽  
Therapeutic Effects ◽  
Joint Movement ◽  
Knee Oa ◽  
Anterior Cruciate ◽  
Safranin O ◽  
Walking Group

Cartilage degeneration is the main pathological component of knee osteoarthritis (OA), but no effective treatment for its control exists. Although exercise can inhibit OA, the abnormal joint movement with knee OA must be managed to perform exercise. Our aims were to determine how controlling abnormal joint movement and treadmill exercise can suppress cartilage degeneration, to analyze the tissues surrounding articular cartilage, and to clarify the effect of treatment. Twelve-week-old ICR mice (n = 24) underwent anterior cruciate ligament transection (ACL-T) surgery on their right knees and were divided into three groups as follows: ACL-T, animals in the walking group subjected to ACL-T; controlled abnormal joint movement (CAJM), and CAJM with exercise (CAJM + Ex) (n = 8/group). Walking-group animals were subjected to treadmill exercise 6 weeks after surgery, including walking for 18 m/min, 30 min/day, 3 days/week for 8 weeks. Safranin-O staining, hematoxylin-eosin staining, and immunohistochemical staining were performed. The OARSI (Osteoarthritis research Society international) score was lower in the CAJM group than in the ACL-T group and was even lower in the CAJM + Ex group. The CAJM group had a lower meniscal injury score than the ACL-T group, and the CAJM + Ex group demonstrated a less severe synovitis than the ACL-T and CAJM groups. The observed difference in the perichondrium tissue damage score depending on the intervention method suggests different therapeutic effects, that normalizing joint motion can solve local problems in the knee joint, and that the anti-inflammatory effect of treadmill exercise can suppress cartilage degeneration.

scholarly journals Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2960 ◽  
Author(s):  
Ross H. Miller ◽  
Rebecca L. Krupenevich ◽  
Alison L. Pruziner ◽  
Erik J. Wolf ◽  
Barri L. Schnall
Keyword(s):  
Knee Joint ◽  
Limb Loss ◽  
Service Members ◽  
Model Parameters ◽  
Joint Loading ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa ◽  
Joint Contact ◽  
Intact Limb

BackgroundIndividuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss.MethodsCross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW).ResultsPeak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters.DiscussionAssuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.

scholarly journals Factors affecting the organizational performance of manufacturing firms

2017 ◽  
Vol 9 ◽  
pp. 184797901771262 ◽  
Author(s):  
Ahmad Adnan Al-Tit
Keyword(s):  
Organizational Performance ◽  
Measurement Instrument ◽  
Manufacturing Firms ◽  
Factors Affecting ◽  
Mediating Role ◽  
Values And Beliefs ◽  
The Individual ◽  
The Impact ◽  
The Relationship

Numerous studies have been conducted to explore the individual effects of organizational culture (OC) and supply chain management (SCM) practices on organizational performance (OP) in different settings. The aim of this study is to investigate the impact of OC and SCM on OP. The sample of the study consisted of 93 manufacturing firms in Jordan. Data were collected from employees and managers from different divisions using a reliable and valid measurement instrument. The findings confirm that both OC and SCM practices significantly predict OP. The current study is significant in reliably testing the relationship between SCM practices and OP; however, it is necessary to consider cultural assumptions, values and beliefs as the impact of OC on OP is greater than the impact of SCM practices. Based on the results, future studies should consider the moderating and mediating role of OC on the relationship between SCM practices and OP.

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