scholarly journals FRI0620-HPR THE EFFECT OF THERMOFORMABLE FOOT ORTHOSES ON WALKING IN RHEUMATOID ARTHRITIS PATIENTS: PRELIMINARY RESULTS FROM AN OPEN CLINICAL TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 915.3-915
Author(s):  
S. Fellous ◽  
H. Rkain ◽  
A. Ilham ◽  
L. Benzakour ◽  
T. Latifa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Small Sample ◽  
Foot Orthoses ◽  
Walk Test ◽  
Functional Impact ◽  
Before And After ◽  
The Impact ◽  
10 Meter Walk Test ◽  
Difficulty Walking

Background:Foot pain is common in rheumatoid arthritis and appears to persist despite modern day medical management.Objectives:To evaluate the impact of thermoformable foot orthoses on walking in rheumatoid arthritis (RA) patients.Methods:This is a open clinical trial, that included 14 consecutive patients (85,7% female, mean age 54,8 ± 10 years) with RA (median duration of progression of 9 [5-12] years), the average DAS28 was 2,7+/-1,2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The foot problem was bilateral in 100% and inaugural in 85.7% of the cases.The 14 rheumatoid subjects were examined and appropriate foot orthoses were prescribed according to each patient’s needs. All the patients were evaluated at baseline and 8 weeks after use of orthoses. Gait pain, difficulty walking and the 10 Meter Walk test were noted at each appointment.We used dynamic baropodometric analysis to assess postural evaluation. We calculated the lateral-medial index of each foot before and after the use of orthoses.Table 1.Assessment of walking before and after the use of orthosesBefore orthosesAfter orthosespPain when walking*(EVA 0-10)5 [3-5,2]0 [0-2]0,002Difficulty walking* (0-10)- In house4 [3-5,2]2 [0-2]0,002- Outside6 [4,7-7]2 [1,5-2,5]0,0210 Meter Walk test**(Normal comfortable speed)- Nomber of steps18,64 ± 3,716,9 ± 50,2- Duration (sec)11,9 ± 4,611,8 ± 5,20,9- Walking speed (m/min)56,4 ±17,758,6 ± 20,30,6latero-medial (L/M) index**- L/M index of the right foot1,18 ± 0,171,23 ± 0,230,1- L/M index of the left foot1,25 ± 0,171,26 ± 0,190,9*median and quartile**average and standard deviationp significant if< 0,05Results:A significant decrease in walking pain (p = 0.002) and difficulty walking (p = 0.02) was found with the use of orthoses. The variations in 10 meter walk test and dynamic baropodometric parameters were not significant (p>0,05).There were no significant correlations between pain and difficulty walking, the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Conclusion:Thermoformable foot orthoses significantly reduced pain and difficulty walking. The absence of factors associated with pain and difficulty walking could possibly be related to the small sample size.Disclosure of Interests:None declared

scholarly journals FRI0612-HPR EFFECT OF THERMOFORMABLE ORTHOSES ON FOOT FUNCTION IN RHEUMATOID ARTHRITIS PATIENTS: PRELIMINARY RESULTS FROM AN OPEN CLINICAL TRIAL.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 911.2-912
Author(s):  
I. Aachari ◽  
H. Rkain ◽  
F. Safaa ◽  
L. Benzakour ◽  
T. Latifa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Small Sample ◽  
Activity Limitation ◽  
Foot Orthoses ◽  
Functional Impact ◽  
Pain Disability ◽  
Before And After ◽  
Foot Function ◽  
The Impact

Background:Orthoses and footwear can play an important role in managing foot pathology in patients whose systemic disease is controlled. Foot orthoses are frequently prescribed in clinical practice as an intervention for people with rheumatoid arthritis (RA).Objectives:The aim of our study is to evaluate the impact of thermoformable orthoses on the functional index of the foot (FFI) in patients with rheumatoid arthritis.Methods:We conducted an open clinical trial, having consecutively included 14 patients (85.7% female, average age 54.8 ± 10 years) suffering from rheumatoid arthritis (median progression time of 9 years [5 - 12]). The average DAS28 was 2.7 ± 1.2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The median deadline from the start of RA and the onset of the foot problem was 3 years [0 – 7,75]. The foot problem was bilateral in 100% of the cases and inaugural in 85.7% of the cases.We evaluated the functional impact of foot injury for all our patients at baseline and 8 weeks after the use of thermoformable orthoses, based on the FFI (Foot function Index) measuring the impact of foot pathology on function in terms of pain, disability and activity limitation.The comparison of the FFI domains before and after the use of orthoses was carried out using parametric or nonparametric paired tests using The SPSS statistical software.Results:With the use of foot orthoses, FFI values decreased in all subscales (p=0,024) (pain, disability and activity limitation). This reduction was significant for disability (0,011) but not for pain and activity limitation.There were no significant correlations between the global FFI and the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Table 1. The comparison of the FFI domains before and after the use of orthoses.psignificatif if< 0,05; Test used: Non-parametric test for two linked samples.Conclusion:Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced disability as measured by the FFI. The absence of factors associated with pain and limitation of activity could possibly be related to the small sample size.Disclosure of Interests:None declared

scholarly journals A prospective, observational clinical trial on the impact of COVID-19-related national lockdown on thyroid hormone in young males

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giulia Brigante ◽  
Giorgia Spaggiari ◽  
Barbara Rossi ◽  
Antonio Granata ◽  
Manuela Simoni ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Serum Levels ◽  
Stressful Event ◽  
Italian Population ◽  
Reference Ranges ◽  
Endocrine Regulation ◽  
Before And After ◽  
Hpt Axis ◽  
The Impact

AbstractTrying to manage the dramatic coronavirus disease 2019 (COVID-19) infection spread, many countries imposed national lockdown, radically changing the routinely life of humans worldwide. We hypothesized that both the pandemic per se and the consequent socio-psychological sequelae could constitute stressors for Italian population, potentially affecting the endocrine system. This study was designed to describe the effect of lockdown-related stress on the hypothalamic-pituitary-thyroid (HPT) axis in a cohort of young men. A prospective, observational clinical trial was carried out, including patients attending the male infertility outpatient clinic before and after the national lockdown for COVID-19 pandemic. The study provided a baseline visit performed before and a follow-up visit after the lockdown in 2020. During the follow-up visit, hormonal measurements, lifestyle habits and work management were recorded. Thirty-one male subjects were enrolled (mean age: 31.6 ± 6.0 years). TSH significantly decreased after lockdown (p = 0.015), whereas no significant changes were observed in the testosterone, luteinising hormone, follicle-stimulating hormone, estradiol and prolactin serum levels. No patient showed TSH serum levels above or below reference ranges, neither before nor after lockdown. Interestingly, TSH variation after lockdown was dependent on the working habit change during lockdown (p = 0.042). We described for the first time a TSH reduction after a stressful event in a prospective way, evaluating the HPT axis in the same population, before and after the national lockdown. This result reinforces the possible interconnection between psychological consequences of a stressful event and the endocrine regulation.

Early Palliative Care Consultation in the Burn Unit: A Quality Improvement Initiative to Increase Utilization

2021 ◽  
Author(s):  
Heather Carmichael ◽  
Hareklia Brackett ◽  
Maurice C Scott ◽  
Margaret M Dines ◽  
Sarah E Mather ◽  
...  
Keyword(s):  
Palliative Care ◽  
Small Sample ◽  
Quality Improvement Initiative ◽  
Comfort Care ◽  
Early Palliative Care ◽  
Palliative Care Consultation ◽  
Before And After ◽  
Care Consultation ◽  
Patient Values ◽  
The Impact

Abstract Despite significant morbidity and mortality for major burns, palliative care consultation (PCC) is underutilized in this population. The purpose of this study is to examine the impact of a protocol using recommended “triggers” for PCC at a single academic burn center. This is a retrospective review of patient deaths over a four-year period. Use of life-sustaining treatments, comfort care (de-escalation of one or more life-sustaining treatments) and do not attempt resuscitation (DNAR) orders were determined. Use of PCC was compared during periods before and after a protocol establishing recommended triggers for early (&lt;72 hrs of admission) PCC was instituted in 2019. A total of 33 patient deaths were reviewed. Most patients were male (n=28, 85%) and median age was 62 years [IQR 42-72]. Median revised Baux score was 112 [IQR 81-133]. Many patients had life-sustaining interventions such as intubation, dialysis, or cardiopulmonary resuscitation, often prior to admission. Amongst patients who survived &gt;24 hrs, 67% (n=14/21) had PCC. Frequency of PCC increased after protocol development, with 100% vs. 36% of these patients having PCC before death (p=0.004). However, even during the later period, less than half of patients had early PCC despite meeting criteria at admission. In conclusion, initiation of life-sustaining measures in severely injured burn patients occurs prior to or early during hospitalization. Thus, value-based early goals of care discussions are valuable to prevent interventions that do not align with patient values and assist with de-escalation of life-sustaining treatment. In this small sample, we found that while there was increasing use of PCC overall after developing a protocol of recommended triggers for consultation, many patients who met criteria at admission did not receive early PCC. Further research is needed to elucidate reasons why providers may be resistant to PCC.

Effects of Comorbid Alcohol Use Disorder on the Clinical Outcomes of Schizophrenia: A Nationwide Population-based Study

2021 ◽  
Author(s):  
Soojin Ahn ◽  
Youngjae Choi ◽  
Woohyeok Choi ◽  
Young Tak Jo ◽  
Harin Kim ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Clinical Outcomes ◽  
Alcohol Use Disorder ◽  
Medication Possession Ratio ◽  
Small Sample ◽  
Control Group ◽  
Diagnostic Code ◽  
Psychiatric Admissions ◽  
Before And After ◽  
The Impact

Abstract BackgroundAlcohol use disorder (AUD) is a common psychiatric comorbidity in schizophrenia, associated with poor clinical outcomes and medication noncompliance. Most previous studies on the effect of alcohol use in patients with schizophrenia had limitations of small sample size and a cross-sectional design. Therefore, this study aimed to use a nationwide population database to investigate the impact of AUD on clinical outcomes of schizophrenia.MethodsData from the Health Insurance Review Agency database in South Korea from January 1, 2007 to December 31, 2016 was used. Among 64,442 patients with incident schizophrenia, 1,598 with comorbid AUD were selected based on the diagnostic code F10. We performed between- and within-group analyses to compare the rates of psychiatric admissions and emergency room (ER) visits and medication possession ratio (MPR) with control patients having schizophrenia matched for the onset age, sex, and observation period.ResultsThe rates of psychiatric admissions and ER visits decreased after the diagnosis of AUD in both groups; however, the decrease was significantly greater in patients with comorbid AUD compared to the control group. While the case group showed an increase in MPR after the diagnosis of AUD, MPR decreased in the control patients. The rates of psychiatric admissions, ER visits and MPR were worse in the schizophrenia group with comorbid AUD both before and after the diagnosis of AUD.ConclusionsClinical outcomes were worse in the comorbid AUD group than in the control group before and after the diagnosis of AUD. Considering that patients with schizophrenia with comorbid AUD had poorer clinical outcomes even before the diagnosis of AUD, schizophrenia with comorbid AUD could be a distinct subtype of schizophrenia.

Can Foot Orthoses Prevent Hallux Valgus Deformity in Rheumatoid Arthritis? A Randomized Clinical Trial

1995 ◽  
Vol 1 (6) ◽  
pp. 313-322 ◽  
Author(s):  
Elly Budiman-Mak ◽  
Kendon J. Conrad ◽  
Kathryn E. Roach ◽  
James W. Moore ◽  
Yongsuk Lertratanakul ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Foot Orthoses ◽  
Hallux Valgus Deformity

scholarly journals Navigated Transcranial Magnetic Stimulation: A Biologically Based Assay of Lower Extremity Impairment and Gait Velocity

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Heather T. Peters ◽  
Kari Dunning ◽  
Samir Belagaje ◽  
Brett M. Kissela ◽  
Jun Ying ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Tibialis Anterior ◽  
Evoked Potential ◽  
Outcome Measurement ◽  
Motor Evoked Potential ◽  
Gait Velocity ◽  
Walk Test ◽  
Navigated Transcranial Magnetic Stimulation ◽  
10 Meter Walk Test ◽  
Difficulty Walking

Objectives. (a) To determine associations among motor evoked potential (MEP) amplitude, MEP latency, lower extremity (LE) impairment, and gait velocity and (b) determine the association between the presence of a detectable MEP signal with LE impairment and with gait velocity.Method. 35 subjects with chronic, stable LE hemiparesis were undergone TMS, the LE section of the Fugl-Meyer Impairment Scale (LE FM), and 10-meter walk test. We recorded presence, amplitude, and latency of MEPs in the affected tibialis anterior (TA) and soleus (SO).Results. MEP presence was associated with higher LEFM scores in both the TA and SO. MEP latency was larger in subjects with lower LEFM and difficulty walking.Conclusion. MEP latency appears to be an indicator of LE impairment and gait.Significance. Our results support the precept of using TMS, particularly MEP latency, as an adjunctive LE outcome measurement and prognostic technique.

scholarly journals FRI0686 The effect of foot orthoses on balance in rheumatoid arthritis patients: a randomized clinical trial

2018 ◽  
Author(s):  
J. Z. Gaino ◽  
M. B. Bertolo ◽  
C. S. Nunes ◽  
C. M. Barbosa ◽  
Z. Sachetto ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Foot Orthoses

scholarly journals Statin Treatment in the Acute Phase and the Risk of Post-stroke Pneumonia: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Changling Li ◽  
Mengmeng Ma ◽  
Shuju Dong ◽  
Ye Hong ◽  
Jiajia Bao ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Acute Phase ◽  
Statin Treatment ◽  
Clinical Trial Registry ◽  
Clinical Trial Registration ◽  
Pneumonia Severity ◽  
Post Stroke ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

Background: We aimed to investigate the impact of statin treatment in the acute phase on the risk and severity of post-stroke pneumonia because of the uncertain effects of statins on post-stroke pneumonia.Methods: Consecutive cases of acute ischemic stroke (AIS) between January 2014 and February 2019 were retrospectively analyzed. Additionally, the association of statin treatment in the acute phase with the risk and severity of post-stroke pneumonia was estimated with logistic regression. We registered the present study in the Chinese Clinical Trial Registry (ChiCTR 2000032838).Results: Of the 1,258 enrolled patients, no significant difference was observed in post-stroke pneumonia risk between the two groups (with/without statin treatment in the acute phase) after propensity score matching (35.1 vs. 27.9%, p = 0.155). We did not find statin treatment in the acute phase to significantly increase the risk of post-stroke pneumonia both before and after matched analysis [odds ratio (OR) = 1.51, 95% confidence interval (CI) = 0.85–2.67, p = 0.157; OR = 1.57, 95% CI = 0.77–3.18, p = 0.213, respectively]. In the 271 patients with post-stroke pneumonia, no significant difference was found in its severity between two groups (19.6 vs. 19.4%, p = 0.964). No significant association was found between statin treatment and post-stroke pneumonia severity (OR = 0.95, 95% CI = 0.39–2.31, p = 0.918).Conclusions: There appeared to be no additional benefits of statin treatment in the acute phase for post-stroke pneumonia reduction among AIS patients.Clinical Trial Registration:http://www.chictr.org.cn, identifier: ChiCTR2000032838.

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