Return to Preinjury Function Following Knee Injury

2020 ◽  
pp. 1-12
Author(s):  
Aaron D. Sciascia ◽  
Arthur J. Nitz ◽  
Patrick O. McKeon ◽  
Jennifer Havens ◽  
Timothy L. Uhl
Keyword(s):  
Knee Injury ◽  
Injury Severity ◽  
Multiple Time ◽  
Balance Test ◽  
Patient Recall ◽  
Initial Injury ◽  
Baseline Values ◽  
Multiple Time Points ◽  
Time Point

Athletic preinjury function is typically determined via patient recall, however obtaining preinjury function before injury occurs should be attempted. The purpose of this study was to obtain preinjury physical function baseline values using the Knee Injury and Osteoarthritis Outcome Score (KOOS), single-leg hop for distance (SLH), and Star Excursion Balance Test (SEBT) anterior reach to determine if athletes return to those baseline values following knee injury. Out of 27 qualifying injuries, KOOS scores were significantly reduced at initial injury compared to baseline and all follow-up points (p ≤ .02). In most instances, baseline KOOS scores were not met at the discharge time point. SLH and SEBT recovered to baseline values by discharge. Injury severity and previous injury created variations in KOOS scores across multiple time points. Subjective and objective preinjury function can be re-established following knee injury but recovery may not occur at discharge from rehabilitation.

The association of D4, 3-keto-abi (D4A) and response to abiraterone in castration-resistant prostate cancer (CRPC).

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 245-245
Author(s):  
Hamid Emamekhoo ◽  
Mohammad Alyamani ◽  
Zhenfei Li ◽  
Paul Elson ◽  
Petros Grivas ◽  
...  
Keyword(s):  
Median Time ◽  
Specific Antigen ◽  
Response To Treatment ◽  
Multiple Time ◽  
Castration Resistant Prostate Cancer ◽  
Androgen Receptor Antagonist ◽  
Duration Of Response ◽  
Multiple Time Points ◽  
The Impact

245 Background: Abiraterone (Abi), a potent inhibitor of 17α-hydroxylase/17,20-lyase (CYP17A1), is a standard treatment for men with metastatic CRPC. Abi is converted to D4A by 3β-hydroxysteroid dehydrogenase (3βHSD). D4A inhibits CYP17A1, 3βHSD, and steroid-5α-reductase (SRD5A) and has direct androgen receptor antagonist activity, which together make it a more potent agent than Abi in xenograft models. It is not known if conversion to D4A in patients (pts) correlates with response or resistance to Abi. Methods: Blood was collected (single time point on Abi) from CRPC pts who started Abi during 2011-2015. Abi and D4A were extracted from serum and analyzed by mass spectrometry. The purpose of this ongoing study is to assess the potential correlation between D4A and response to treatment. Results: 32 patients with CRPC had blood collected. 4 pts (12.5%) received ketoconazole and 6 (18.8%) chemotherapy prior to Abi. Median pre-Abi prostate-specific antigen (PSA) was 14.3 ng/ml (0.6-646.1). Median time from initiation of androgen deprivation therapy (ADT) to CRPC was 34.3 months (m) (6-129.6) and median time from CRPC to Abi initiation was 4.8 m (0-14.9). PSA decline > 50% (PSA50) on Abi was seen in 68% (12/31) and 73% (19/26) of pts at 3 and 6 m, respectively. Treatment with Abi was ongoing in 23/32 pts (74%), and discontinued in 8 pts (26%) due to disease progression (no follow up data on 1 pt) with median duration of Abi treatment 14.6 m (2.9-44.4 m) at last follow up. As the absolute concentration of detected levels of Abi and D4A varied significantly among pts, the percentage of the total extracted metabolites was used to assess correlation with response. Abi and D4A comprised 94.3% (73.8-97.4%) and 5.7% (2.6-26.2%), respectively, of total levels. Conclusions: Abi absorption and metabolism significantly vary among pts. Most of these pts had prolonged duration of response to Abi (74% ongoing treatment and median treatment duration 13.3 m in 8 pts that came off treatment). Longer follow up, accrual of pts with shorter duration of response, and sampling at multiple time points on Abi and at progression is ongoing to further evaluate the impact of D4A on treatment response.

Cognitive performance and the course of depressive symptoms over 7 years of follow-up: the SMART-MR study

2014 ◽  
Vol 45 (8) ◽  
pp. 1741-1750 ◽  
Author(s):  
M. Kooistra ◽  
N. P. A. Zuithoff ◽  
A. M. Grool ◽  
M. Zinsmeester ◽  
G. J. Biessels ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Performance ◽  
Estimating Equation ◽  
Multiple Time ◽  
Information Processing Speed ◽  
Cognitive Domains ◽  
Interaction Terms ◽  
Multiple Time Points ◽  
Mr Study

BackgroundDepressive symptoms and cognitive impairment often co-occur, but their interactive relationship is complex and the direction of causation is still a topic of research. We examined the influence of cognitive performance on the course of depressive symptoms during 7 years of follow-up in patients with vascular disease.MethodWithin the SMART-MR study, 736 patients (mean age 62 ± 10 years) had neuropsychological assessment on four cognitive domains at baseline [memory (MEM), working memory (WMEM), executive functioning (EXEC), and information processing speed (SPEED)]. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9) at baseline and every 6 months during 7 years of follow-up. Generalized Estimating Equation (GEE) models were used to assess the association between cognitive performance with depressive symptoms at multiple time points during follow-up. Interaction terms between the respective cognitive domains and time was included to examine if the course of depressive symptoms differed according to baseline cognitive performance.ResultsThe GEE analyses showed no significant interactions between the respective cognitive domains and time indicating no different course of depressive symptoms according to baseline cognitive performance. Lower MEM, EXEC or SPEED, but not WMEM performance, was significantly associated with more depressive symptoms during follow-up per z score decrease: MEM [B = 0.70, 95% confidence interval (CI) 0.35–1.05]; EXEC (B = 0.88, 95% CI 0.41–1.36), and SPEED (B = 0.57, 95% CI 0.21–0.92).ConclusionsPoorer cognitive performance on the domains MEM, EXEC and SPEED, but not WMEM, was associated with higher levels of depressive symptoms over 7 years of follow-up, but not with a different course of depressive symptoms over time.

scholarly journals Serial measurements of Paraoxonase-1 (PON-1) activity in horses with experimentally induced endotoxemia

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Donatella Scavone ◽  
Micaela Sgorbini ◽  
Alexandre S. Borges ◽  
José P. Oliveira-Filho ◽  
Valentina Vitale ◽  
...  
Keyword(s):  
Acute Phase ◽  
Paraoxonase 1 ◽  
Multiple Time ◽  
Naturally Occurring ◽  
Septic Inflammation ◽  
Post Infusion ◽  
Baseline Values ◽  
Multiple Time Points ◽  
Serial Measurements ◽  
Experimentally Induced

Abstract Background Paraoxonase-1 (PON-1) is an antioxidant enzyme, whose activity decreases during the acute phase response in many species. Little is known about PON-1 and its role as a negative acute phase protein during septic inflammation in horses, but promising findings about its utility in diagnosing SIRS and predicting the outcome in diseased horses, were recently highlighted. The objective of the study was to investigate the behaviour of PON-1 in horses after experimentally induced endotoxemia. To this aim, PON-1 activity was measured on 66 plasma samples collected from six clinically healthy mares, previously included in another study, before and at multiple time points between 12 and 240 h after intravenous infusion of Escherichia coli O55:B5 lipopolysaccharide (LPS). Results Compared with baseline values, a progressive transient decrease of PON-1 activity was observed starting from 24 h post-infusion, with lowest values observed between 3 to 7 days post-infusion, followed by a normalisation to pre-infusion levels the tenth day. Conclusions The results of this study suggest that measurement and monitoring of PON-1 activity might be useful to evaluate progression and recovery from endotoxemia in horses. Further studies in horses with naturally occurring sepsis are warranted.

scholarly journals A Normotensive Patient with Primary Aldosteronism

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Xiao Lin ◽  
Xiaoyu Miao ◽  
Pengli Zhu ◽  
Fan Lin
Keyword(s):  
Blood Pressure ◽  
Primary Aldosteronism ◽  
Adrenal Incidentaloma ◽  
Confirmatory Test ◽  
Multiple Time ◽  
Normal Blood Pressure ◽  
Normotensive Patient ◽  
History Of ◽  
Multiple Time Points

This study was to report a case of normotensive patient with primary aldosteronism who was admitted to our department recently. The patient was a 33-year-old male with right adrenal incidentaloma, but without any symptom. He has no history of hypertension, and blood pressure was normal when measured at multiple time points during hospitalization stay. The 24-hour ambulatory blood pressure prompted a normal blood pressure with the existence of circadian rhythm. The patient was diagnosed with primary aldosteronism by screening and confirmatory test. Due to the absence of symptom, surgery was not preferred. Blood pressure was found to be normal with the 2-month follow-up from discharge until now.

The Clinical Course of Depression: Chronicity is the Rule Rather than the Exception

2017 ◽  
Vol 41 (S1) ◽  
pp. S144-S145 ◽  
Author(s):  
J. Verhoeven ◽  
J. Verduijn ◽  
Y. Milaneschi ◽  
A. Beekman ◽  
B. Penninx
Keyword(s):  
Recovery Rate ◽  
Multiple Time ◽  
Depression And Anxiety ◽  
Major Depressive ◽  
Chronic Disorder ◽  
Co Morbidity ◽  
Multiple Time Points ◽  
Chronic Course ◽  
Course Of Depression

IntroductionMajor depressive disorder (MDD) is often considered an episodic disorder. However, literature might underestimate the chronicity of MDD since results depend on follow-up duration and the extent to which psychiatric co-morbidity is taken into account.AimTo determine, whether MDD should be considered an episodic or chronic disorder.ObjectiveTo examine the 6 year course of MDD, incorporating data of multiple time points and taking common psychiatric comorbidities into account.MethodsData were from 903 patients with current MDD at baseline in the Netherlands study of depression and anxiety, with subsequent data from 2 year, 4 year and 6 year follow-up. Four course trajectories were created taking all information during follow-up into account classifying patients as (1) recovered, (2) recurrent without chronic episodes, (3) recurrent with chronic episodes or (4) consistently chronic. A chronic episode was defined as having symptoms consistently over 2 years.ResultsThe recovery rate of MDD was 58% at 2 year follow-up but looking at 6 year follow-up and taking into account co-morbid dysthymia, (hypo) mania and anxiety disorders reduced this recovery rate to 17%. Moreover, more than half of the patients experienced chronic episodes.ConclusionsLongitudinal data of this psychiatric cohort study showed that full recovery is the exception rather than the rule. MDD follows a chronic course and, moreover, persons are prone to switch to other psychiatric disorders.

scholarly journals The Effects of Early Physical Activity Compared to Early Physical Rest on Concussion Symptoms

2019 ◽  
Vol 28 (1) ◽  
pp. 99-105 ◽  
Author(s):  
Landon Lempke ◽  
Abbis Jaffri ◽  
Nicholas Erdman
Keyword(s):  
Physical Activity ◽  
Acute Phase ◽  
Current Evidence ◽  
Symptom Duration ◽  
Multiple Time ◽  
Initial Examination ◽  
Bottom Line ◽  
Time Points ◽  
Multiple Time Points

Clinical Scenario: Currently, rest following concussion serves as the keystone of concussion treatment, but substantial evidence to support it is lacking. Recent literature suggests that early physical activity may be beneficial in reducing concussion symptoms which may influence clinical recovery time. Clinical Question: Does early physical activity decrease postconcussion symptoms compared to physical rest following concussion? Summary of Key Findings: A total of 5 articles were included that examined symptom duration changes at multiple time points. All 5 studies utilized follow-up time points compared to initial examination, but there was variance in the specific time points reported. Two studies employed control groups and compared strict or recommended rest to early activity or limited rest. Three studies were observational studies that directly compared baseline measurements to follow-up assessments. Clinical Bottom Line: Current evidence suggests that early physical activity in the acute phase following a concussion may decrease the time needed for symptom resolution compared to immediate rest. Strength of Recommendation: Using Centre for Evidence-Based Medicine 2011 level 3 evidence and higher, the results suggest that early physical activity during the acute phase of a concussion may decrease symptom duration; however, a lack of high-quality studies and inconsistent interventions are limitations to this recommendation.

scholarly journals Estimating the effect of a scanner upgrade on measures of grey matter structure for longitudinal designs

2020 ◽  
Author(s):  
Evelyn Medawar ◽  
Ronja Thieleking ◽  
Iryna Manuilova ◽  
Maria Paerisch ◽  
Arno Villringer ◽  
...  
Keyword(s):  
Grey Matter ◽  
Correction Method ◽  
Multiple Time ◽  
Imaging Data ◽  
Brain Images ◽  
The Difference ◽  
Longitudinal Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Multiple Time Points

1AbstractLongitudinal imaging studies are crucial for advancing the understanding of brain development over the lifespan. Thus, more and more studies acquire imaging data at multiple time points or with long follow-up intervals. In these studies changes to magnetic resonance imaging (MRI) scanners often become inevitable which may decrease the reliability of the MRI assessments and introduce biases.We therefore investigated the difference between MRI scanners with subsequent versions (3 Tesla Siemens Verio vs. Skyra fit) on the cortical and subcortical measures of grey matter in 116 healthy, young adults using the well-established longitudinal FreeSurfer stream for T1-weighted brain images. We found excellent between-scanner reliability for cortical and subcortical measures of grey matter structure (intra-class correlation coefficient > 0.8). Yet, paired t-tests revealed statistically significant differences in at least 75% of the regions, with percent differences up to 5%, depending on the outcome measure. Offline correction for gradient distortions only slightly reduced these biases. Further, T1-imaging based quality measures systematically differed between scanners.We conclude that scanner upgrades during a longitudinal study introduce bias in measures of cortical and subcortical grey matter structure. Therefore, before upgrading a MRI scanner during an ongoing study, researchers should prepare to implement an appropriate correction method for these effects.

scholarly journals 127. Development of a Kinetic ELISA (kELISA) and Reactive B-cell Frequency (RBF) Assay to Detect Respiratory Syncytial Virus (RSV) Pre-Fusion F Protein-Specific Immune Responses in Infants

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S77-S78
Author(s):  
Stephanie L Rolsma ◽  
Sandy M Yoder ◽  
Rachel S Nargi ◽  
Eric Brady ◽  
Natalia Jimenez-Truque ◽  
...  
Keyword(s):  
Panel Member ◽  
Multiple Time ◽  
Research Support ◽  
Review Panel ◽  
Cell Frequency ◽  
Material Support ◽  
F Protein ◽  
Multiple Time Points ◽  
Research Grant

Abstract Background RSV is a major cause of pediatric respiratory disease. Antibodies to the prefusion conformation of the RSV fusion (pre-F) protein are needed for virus neutralization. Methods We measured RSV-specific responses in two groups of children < 3 years of age; subjects with laboratory-confirmed RSV (RSV-infected) or infants born in the period May to September and enrolled prior to their first RSV season (RSV-uninfected). RSV-infected infants had blood samples obtained at 1, 6, 9, and 12 months after infection. RSV-uninfected infants had blood samples obtained at enrollment, at the end of their first RSV season, and 6 months later. A kELISA to measure RSV pre-F-specific antibodies and an RBF assay to identify RSV F-specific B cells were developed. Results 102 subjects were enrolled; 11 were excluded due to missed visits or withdrawal. Of the 65 subjects in the RSV-uninfected group, all were kELISA positive at enrollment, consistent with maternal antibody transfer. 53 subjects had sufficient samples for analysis at multiple time points; 29 became seronegative and 24 remained seropositive. In the seronegative group, the kELISA value decreased rapidly to < 0.25 by 6 months after the RSV season in 27/29 (93%), (Figure 1a). In the persistently seropositive group, all 24 subjects maintained a positive kELISA value, with some developing higher values over time, consistent with asymptomatic infection (Figure 1b). An RBF assay was used to determine whether antibodies were due to persistent maternal antibodies or endogenous production (Figure 2). In the seronegative group, 24/29 (80%) had a negative RBF; in the seropositive group, 23/24 (96%) had a positive RBF during follow-up. There were 26 subjects in the RSV-infected group; 22 had sufficient samples for analysis at multiple time points. All were seropositive by kELISA at one month post-infection with variable kELISA values during follow-up (Figure 3). 17/22 (77%) had a positive RBF, although 4 of the subjects without a positive RBF had indeterminate results at ≥ 1 visit. Figure 1. kELISA values of baseline RSV-negative subjects, by subject age at time of sample. Panel A: Subjects classified as seronegative (n=29). Panel B: Subjects without known RSV classified as persistently seropositive (n=24). Figure 2. Reactive B-cell frequency assay. The first step in the RBF assay is growth of Lymphoblastoid Cell Lines (LCLs), as shown over days 1-3 (Left-Day 1, Middle-Day 2, Right-Day 3, magnification 200X). The cells circled in the figure indicate a single LCL’s growth over time. LCL supernatant is used to detect RSV F-protein specific antibodies using traditional ELISA, resulting in a positive, indeterminate, or negative result. Indeterminate results occur due to a lack of cell viability and/or failure to form LCLs, resulting in failure to exceed an optical density of 5x background. Figure 3. kELISA values of RSV-infected subjects, by subject age at time of sample. First sample was obtained at approximately one month after laboratory-confirmed RSV. Conclusion Assays measuring F-specific immune responses in infants will be critical for RSV vaccine development. A kELISA targeting RSV pre-F epitopes, with an RBF assay targeting RSV F-specific B cells, may allow discrimination for maternal and infant-derived antibodies. Disclosures Isaac Thomsen, MD, MSCI, Horizon Therapeutics (Individual(s) Involved: Self): Consultant James E. Crowe, Jr., MD, Astra Zeneca (Grant/Research Support)IDBiologics (Board Member, Grant/Research Support, Shareholder)Luna Biologics (Consultant)Meissa Vaccines (Advisor or Review Panel member)Takeda Vaccines (Grant/Research Support) Kathryn M. Edwards, MD, Bionet (Individual(s) Involved: Self): Consultant; CDC (Individual(s) Involved: Self): Research Grant or Support; IBM (Individual(s) Involved: Self): Consultant; Merck (Individual(s) Involved: Self): member DSMC, Other Financial or Material Support; Moderna (Individual(s) Involved: Self): member DSMC, Other Financial or Material Support; NIH (Individual(s) Involved: Self): Research Grant or Support; Pfizer (Individual(s) Involved: Self): member DSMC, Other Financial or Material Support; Roche (Individual(s) Involved: Self): member of DSMB, Other Financial or Material Support; Sanofi Pasteur (Individual(s) Involved: Self): member DSMB, Other Financial or Material Support; Sequiras (Individual(s) Involved: Self): Member DSMB, Other Financial or Material Support; X4 Pharmaceuticals (Individual(s) Involved: Self): Consultant Buddy Creech, MD, MPH, Altimmune (Consultant)Astellas (Other Financial or Material Support, Data and Safety Monitoring Committee)Diotheris (Consultant)GSK (Consultant)Horizon (Consultant)Merck (Scientific Research Study Investigator)Premier Healthcare (Advisor or Review Panel member)Vir (Consultant)

scholarly journals Serial measurements of Paraoxonase-1 (PON-1) activity in horses with experimentally induced endotoxemia

2020 ◽  
Author(s):  
Donatella Scavone ◽  
MICAELA SGORBINI ◽  
Alexandre Secorun Borges ◽  
Josè Paes de Oliveira-Filho ◽  
Valentina Vitale ◽  
...  
Keyword(s):  
Acute Phase ◽  
Paraoxonase 1 ◽  
Multiple Time ◽  
Naturally Occurring ◽  
Septic Inflammation ◽  
Post Infusion ◽  
Baseline Values ◽  
Multiple Time Points ◽  
Serial Measurements ◽  
Experimentally Induced

Abstract Background: Paraoxonase-1 (PON-1) is an antioxidant enzyme, whose activity decreases during the acute phase response in many species. Little is known about PON-1 and its role as a negative acute phase protein during septic inflammation in horses, but promising findings about its utility in diagnosing SIRS and predicting the outcome in diseased horses, were recently highlighted. The objective of the study was to investigate the behaviour of PON-1 in horses after experimentally induced endotoxemia. To this aim, PON-1 activity was measured on 66 plasma samples collected from six clinically healthy mares, previously included in another study, before and at multiple time points between 12 and 240 hours after intravenous infusion of Escherichia coli O55:B5 lipopolysaccharide (LPS). Results: compared with baseline values, a progressive transient decrease of PON-1 activity was observed starting from 24 hours post-infusion, with lowest values observed between 3 to 7 days post-infusion, followed by a normalisation to pre-infusion levels the tenth day. Conclusions: the results of this study suggest that measurement and monitoring of PON-1 activity might be useful to evaluate progression and recovery from endotoxemia in horses. Further studies in horses with naturally occurring sepsis are warranted.

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