scholarly journals A hospital-based observational cohort study exploring pain and biomarkers in patients with hand osteoarthritis in Norway: The Nor-Hand protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016938 ◽  
Author(s):  
Marthe Gløersen ◽  
Elisabeth Mulrooney ◽  
Alexander Mathiessen ◽  
Hilde Berner Hammer ◽  
Barbara Slatkowsky-Christensen ◽  
...  
Keyword(s):  
Underlying Disease ◽  
Special Focus ◽  
Hand Osteoarthritis ◽  
Dominant Hand ◽  
Cross Sectional ◽  
Pain Mechanisms ◽  
Written Information ◽  
Registration Number ◽  
Hands And Feet ◽  
Baseline Examination

IntroductionWe have limited knowledge about the underlying disease mechanisms and causes of pain in hand osteoarthritis (OA). Consequently, no disease-modifying drug exists, and more knowledge about the pathogenesis of hand OA is needed, as well as a validation of different outcome measures. Our first aim of this study is to explore the validity of various imaging modalities for the assessment of hand OA. Second, we want to gain a better understanding of the disease processes, with a special focus on pain mechanisms.Methods and analysisThe Nor-Hand study is a hospital-based observational study including 300 patients with evidence of hand OA by ultrasound and/or clinical examination. The baseline examination consists of functional tests and joint assessment of the hands, medical assessment, pain sensitisation tests, ultrasound (hands, acromioclavicular joint, hips, knees and feet), CT and MRI of the dominant hand, conventional radiographs of the hands and feet, fluorescence optical imaging of the hands, collection of blood and urine samples as well as self-reported demographic factors and OA-related questionnaires. Two follow-up examinations are planned. Cross-sectional analyses will be used to investigate agreements and associations between different relevant measures at the baseline examination, whereas the longitudinal data will be used for evaluation of predictors for clinical outcomes.Ethics and disseminationThe protocol is approved by the Norwegian Regional Committee for Medical and Health Research Ethics (Ref. no: 2014/2057). The participants receive oral and written information about the project and sign a consent form before participation. They can, whenever they want, withdraw from the study, and all de-identified data will be safely stored on the research server at Diakonhjemmet Hospital. Results will be presented at international and national congresses and in peer-reviewed rheumatology journals.Trial registration numberNCT03083548; Pre-results.

scholarly journals AC-CUTE: An Open-Label Study to Evaluate Progression of Structural Joint Damage and Inflammation in Subjects with Moderate to Severe Rheumatoid Arthritis

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Paul Bird ◽  
Charles Peterfy ◽  
Peter Countryman ◽  
Hedley Griffiths ◽  
Rina Barrett ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Damage ◽  
Cartilage Loss ◽  
Dominant Hand ◽  
Severe Rheumatoid Arthritis ◽  
Open Label ◽  
Das28 Remission ◽  
Registration Number ◽  
Hands And Feet ◽  
And Cartilage

Aim. Examine the efficacy of once-weekly subcutaneous tocilizumab (SC-TCZ) on joint damage at 24 weeks based on radiography of the hands and feet and magnetic resonance imaging (MRI) of the hand in subjects with moderate to severe rheumatoid arthritis (RA). Methods. In this Australian open-label, multicentre, prospective, single-arm study, subjects received 162 mg SC-TCZ weekly. Primary endpoint was change in radiographic Genant-modified Total Sharp Score (TSS) between baseline and Week 24. Secondary endpoints included change from baseline to Week 24 in RA MRI scoring (RAMRIS) of erosions, synovitis, and osteitis and Cartilage Loss Score (CARLOS) in the dominant hand and disease activity score 28 (DAS28). Results. 52 subjects were enrolled (80% female, mean (SD) age 57  (12) years). Radiography showed mild but not significant progression of joint damage (mean (SD) change in TSS 0.46 (1.29)). Synovitis reduced significantly on MRI; however, osteitis, erosion, and cartilage loss did not change significantly. DAS28 improved significantly by Week 24; 78% of subjects achieved DAS28 remission. SC-TCZ was generally well tolerated. Conclusion. Synovitis and DAS28 decreased significantly; however, no significant change in osteitis or joint damage was observed at Week 24. Trial registration. This trial is registered with Clinicaltrials.gov registration number NCT01951170 (ML28703).

scholarly journals Risk factor for phlebitis: a questionnaire study of nurses' perception

2015 ◽  
Vol 23 (4) ◽  
pp. 677-684 ◽  
Author(s):  
Dragana Milutinović ◽  
Dragana Simin ◽  
Davor Zec
Keyword(s):  
Risk Factors ◽  
Underlying Disease ◽  
Questionnaire Study ◽  
Special Focus ◽  
Intravenous Fluids ◽  
Cross Sectional ◽  
Perceptions Of Risk ◽  
Related Risk ◽  
Potential Risk Factors ◽  
Nurses Perceptions

AbstractObjectives: to assess nurses' perceptions of risk factors for the development of phlebitis, with a special focus on the perception of phlebitic potentials of some infusion medications and solutions.Method: a cross-sectional questionnaire study, which included a sample of 102 nurses.Results: Nurses recognized some factors that may reduce the incidence of phlebitis; however, more than half of the nurses were unaware that the material and diameter of the cannula can affect the incidence rate of phlebitis. Furthermore,underlying disease and high pH of medications or solutions were identified as potential risk factors, whereas low pH and low osmolality were not. Nurses identified Vancomycin and Benzylpenicillin antibiotics with the strongest phlebitic potential. Among other medications and intravenous fluids, Aminophylline, Amiodaronehydrochloride and Potassium chloride 7.4% were identified as potentially causing phlebitis.Conclusion: predisposing factors for phlebitis relating to patients and administered therapy were identified by nurses, while some cannula related risk factors, in particular its physicochemical properties and the time for cannula replacement, were not fully perceived.

scholarly journals Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001450
Author(s):  
Clementina López-Medina ◽  
Anna Molto ◽  
Joachim Sieper ◽  
Tuncay Duruöz ◽  
Uta Kiltz ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Latin American ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Joint Involvement ◽  
Cross Sectional ◽  
Small Joint ◽  
Musculoskeletal Manifestations ◽  
Inflammatory Bowel

ObjectivesTo characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.MethodsCross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.ResultsA total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).ConclusionThese results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.

scholarly journals FRI0635-HPR PATIENTS’ MOTIVATION AND GOALS FOR THUMB CARPOMETACARPAL OSTEOARTHRITIS SURGERY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 921.2-922
Author(s):  
E. M. H. Gravås ◽  
I. Kjeken ◽  
R. Nossum ◽  
R. E. Mehl Eide ◽  
Å. Klokkeide ◽  
...  
Keyword(s):  
Pharmacological Treatment ◽  
Cross Sectional Study ◽  
Activity Limitations ◽  
Hand Osteoarthritis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Eular Recommendations ◽  
High Motivation ◽  
Thumb Carpometacarpal ◽  
Carpometacarpal Osteoarthritis

Background:Osteoarthritis (OA) in the thumb carpometacarpal joint (CMCJ) is a prevalent disease which may lead to structural damage, severe pain and functional limitations, but for which there is yet no cure. Evidence-based treatment recommendations state that all patients with hand OA should be offered patient education, hand exercises, and provision of assistive devices and orthoses. Pharmacological therapy is recommended as a symptom relieving supplement. The main indication for CMCJ surgery is pain and poor function, and such surgery should be considered only when other treatment has proven insufficient in relieving pain (1). Previous research has shown that high motivation is a significant predictor for deciding to undergo CMCJ surgery (2), but there is little knowledge regarding which factors that motivates patients for undergoing such surgery.Objectives:The objective of this study was to explore patient goals and motivation for surgery, and factors characterizing patients highly motivated for surgery.Methods:This cross-sectional study included 180 patients referred from their general practitioner for CMCJ surgical consultation. Goals for surgery were collected with an open-ended question and analysed by linking the content of each goal to domains in the International Classification of Functioning, Disability and Health coding system. Motivation for surgery was rated with a Numeric Rating Scale (NRS, 0-10, 0=no motivation). Activity limitations was self-reported using the Measure of Activity Performance of the Hand (MAP-Hand, score 1 to 4, 1=no activity problems) and the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH; score 0-100, 0=no disability). Factors that characterized patients highly motivated for surgery (NRS≥8) were explored with multivariate regression analyses.Results:Mean age of participants was 63 years (SD 7.6) and 142 (79%) were women. The most common goals for surgery were to reduce pain and improve arm and hand use. Fifty-six (31%) of the patients were characterized as highly motivated for surgery. High motivation for surgery was strongly associated with more activity limitations (MAP-Hand; (OR 4.00, p=0.008)), living alone (OR 3.18, p=0.007) and a young age (OR 0.94, p=0.002).Conclusion:Decisions on CMCJ OA surgery should be based on assessment and discussion of patients’ life situation, hand pain, activity limitations and motivation and goals for surgery. According to the EULAR recommendations, previously received conservative and pharmacological treatment should also be evaluated.References:[1] Kloppenburg, M., et al. (2018). “2018 update of the EULAR recommendations for the management of hand osteoarthritis.” Ann Rheum Dis. 0; 1-9[2] Gravas, E. M. H., et al. (2019). “Non-pharmacological treatment gap preceding surgical consultation in thumb carpometacarpal osteoarthritis - a cross-sectional study.” BMC Musculoskelet Disord 20(1): 180.Disclosure of Interests:None declared

scholarly journals Reference values and factors associated with hand grip strength among older adults living in southeastern Poland

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Agnieszka Wiśniowska-Szurlej ◽  
Agnieszka Ćwirlej-Sozańska ◽  
Justyna Kilian ◽  
Natalia Wołoszyn ◽  
Bernard Sozański ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Reference Values ◽  
Handgrip Strength ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Normative Values ◽  
Dominant Hand ◽  
Cross Sectional ◽  
Factors Associated

AbstractHandgrip strength (HGS) is used as a biomarker for the state of health of older people, but the number of research publications containing the normative values of HGS in older adult populations is limited. The aim of the study was to define reference values and factors associated with HGS in older adults living in southeastern Poland. A cross-sectional study including 405 participants aged 65 and older was conducted. Handgrip strength for the dominant hand was assessed by the average of three trials using a JAMAR dynamometer. The sample was categorized into the following age groups: 65–69 years, 70–74 years, 75–79 years, 80–84 years, 85 and over. The average HGS was 19.98 kg (16.91 kg for women and 26.19 kg for men). There was a decrease in handgrip strength across the age range in both sexes. The average handgrip strength of the older people was 17.97 kg (14.47 kg for women and 25.66 kg for men) for those aged 80–85 and 16.68 kg (13.51 kg for women and 21.77 kg for men) in the group over 85 years old. In both sexes, marital status was an independent factor associated with reduced handgrip strength. In conclusion, this study described, for the first time, handgrip strength values for the southeastern Polish population aged ≥ 65 years according to age and gender.

scholarly journals Exploring activity levels in physical education lessons in the UK: a cross-sectional examination of activity types and fitness levels

2021 ◽  
Vol 7 (1) ◽  
pp. e000924
Author(s):  
Nick Beale ◽  
Emma Eldridge ◽  
Anne Delextrat ◽  
Patrick Esser ◽  
Oliver Bushnell ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Education ◽  
Multilevel Models ◽  
Activity Levels ◽  
Cross Sectional ◽  
Registration Number ◽  
Global Norms ◽  
Cross Sectional Design ◽  
The Uk ◽  
Fitness Levels

ObjectivesTo establish pupil fitness levels, and the relationship to global norms and physical education (PE) enjoyment. To measure and describe physical activity (PA) levels during secondary school PE lessons, in the context of recommended levels, and how levels vary with activity and lesson type.MethodsA cross-sectional design; 10 697 pupils aged 12.5 (SD 0.30) years; pupils who completed a multistage fitness test and wore accelerometers to measure PA during PE lessons. Multilevel models estimated fitness and PE activity levels, accounting for school and class-level clustering.ResultsCardiorespiratory fitness was higher in boys than girls (ß=−0.48; 95% CI −0.56 to −0.39, p<0.001), within absolute terms 51% of boys and 54% of girls above the 50th percentile of global norms. On average, pupils spent 23.8% of PE lessons in moderate-to-vigorous PA (MVPA), and 7.1% in vigorous PA (VPA). Fitness-focused lessons recorded most VPA in co-educational (ß=1.09; 95% CI 0.43 to 1.74) and boys-only lessons (ß=0.32; 95% CI −0.21 to 0.85). In girls-only lessons, track athletics recorded most VPA (ß=0.13; 95% CI −0.50 to 0.75) and net/wall/racket games (ß=0.97; 95% CI 0.12 to 1.82) the most MVPA. For all lesson types, field athletics was least active (ß=−0.85; 95% CI −1.33 to −0.36). There was a relationship of enjoyment of PE to fitness (ß=1.03; 95% CI 0.83 to 1.23), and this relationship did not vary with sex (ß=−0.14 to 0.23; 95% CI −0.16 to 0.60).ConclusionsPE lessons were inactive compared with current guidelines. We propose that if we are to continue to develop a range of sporting skills in schools at the same time as increasing levels of fitness and PA, there is a need to introduce additional sessions of PE activity focused on increasing physical activity.Trial registration numberNCT03286725.

scholarly journals Multiple breath washout (MBW) testing using sulfur hexafluoride: reference values and influence of anthropometric parameters

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-214717
Author(s):  
Frederik Trinkmann ◽  
Máté Maros ◽  
Katharina Roth ◽  
Arne Hermanns ◽  
Julia Schäfer ◽  
...  
Keyword(s):  
Reference Values ◽  
Sulfur Hexafluoride ◽  
Early Adulthood ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
Outcome Parameters ◽  
Ventilation Heterogeneity ◽  
Multiple Breath Washout ◽  
Registration Number ◽  
Never Smokers

BackgroundMultiple breath washout (MBW) using sulfur hexafluoride (SF6) has the potential to reveal ventilation heterogeneity which is frequent in patients with obstructive lung disease and associated small airway dysfunction. However, reference data are scarce for this technique and mostly restricted to younger cohorts. We therefore set out to evaluate the influence of anthropometric parameters on SF6-MBW reference values in pulmonary healthy adults.MethodsWe evaluated cross-sectional data from 100 pulmonary healthy never-smokers and smokers (mean 51 (SD 20), range 20–88 years). Lung clearance index (LCI), acinar (Sacin) and conductive (Scond) ventilation heterogeneity were derived from triplicate SF6-MBW measurements. Global ventilation heterogeneity was calculated for the 2.5% (LCI2.5) and 5% (LCI5) stopping points. Upper limit of normal (ULN) was defined as the 95th percentile.ResultsAge was the only meaningful parameter influencing SF6-MBW parameters, explaining 47% (CI 33% to 59%) of the variance in LCI, 32% (CI 18% to 47%) in Sacin and 10% (CI 2% to 22%) in Scond. Mean LCI increases from 6.3 (ULN 7.4) to 8.8 (ULN 9.9) in subjects between 20 and 90 years. Smoking accounted for 2% (CI 0% to 8%) of the variability in LCI, 4% (CI 0% to 13%) in Sacin and 3% (CI 0% to 13%) in Scond.ConclusionSF6-MBW outcome parameters showed an age-dependent increase from early adulthood to old age. The effect was most pronounced for global and acinar ventilation heterogeneity and smaller for conductive ventilation heterogeneity. No influence of height, weight and sex was seen. Reference values can now be provided for all important SF6-MBW outcome parameters over the whole age range.Trial registration numberNCT04099225.

scholarly journals What does my neighbourhood have to do with my weight? A protocol for systematic review and meta-analysis of the association between neighbourhood socioeconomic status and body weight

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017567
Author(s):  
Shimels Hussien Mohammed ◽  
Mulugeta Molla Birhanu ◽  
Tesfamichael Awoke Sissay ◽  
Tesfa Dejenie Habtewold ◽  
Balewgizie Sileshi Tegegn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Neighbourhood Socioeconomic Status ◽  
Using Data

IntroductionIndividuals living in poor neighbourhoods are at a higher risk of overweight/obesity. There is no systematic review and meta-analysis study on the association of neighbourhood socioeconomic status (NSES) with overweight/obesity. We aimed to systematically review and meta-analyse the existing evidence on the association of NSES with overweight/obesity.Methods and analysisCross-sectional, case–control and cohort studies published in English from inception to 15 May 2017 will be systematically searched using the following databases: PubMed, EMBASE, Web of Sciences and Google Scholar. Selection, screening, reviewing and data extraction will be done by two reviewers, independently and in duplicate. The Newcastle–Ottawa Scale (NOS) will be used to assess the quality of evidence. Publication bias will be checked by visual inspection of funnel plots and Egger’s regression test. Heterogeneity will be checked by Higgins’s method (I2statistics). Meta-analysis will be done to estimate the pooled OR. Narrative synthesis will be performed if meta-analysis is not feasible due to high heterogeneity of studies.Ethics and disseminationEthical clearance is not required as we will be using data from published articles. Findings will be communicated through a publication in a peer-reviewed journal and presentations at professional conferences.PROSPERO registration numberCRD42017063889.

Diclofenac Sodium Gel in Patients with Primary Hand Osteoarthritis: A Randomized, Double-blind, Placebo-controlled Trial

2009 ◽  
Vol 36 (9) ◽  
pp. 1991-1999 ◽  
Author(s):  
ROY D. ALTMAN ◽  
RENÉE-LILIANE DREISER ◽  
CHESTER L. FISHER ◽  
WALTER F. CHASE ◽  
DONATUS S. DREHER ◽  
...  
Keyword(s):  
Disease Activity ◽  
Pain Intensity ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Diclofenac Sodium ◽  
Global Rating ◽  
Hand Osteoarthritis ◽  
Dominant Hand ◽  
Double Blind ◽  
Secondary Outcomes

Objective.To measure the efficacy and safety of diclofenac sodium gel in patients with primary hand osteoarthritis (OA).Methods.In a randomized, double-blind, placebo-controlled trial, men and women aged ≥ 40 years diagnosed with primary OA in the dominant hand were randomly assigned to self-apply topical 1% diclofenac sodium gel (Voltaren® Gel) (n = 198) or vehicle (n = 187) to both hands 4 times daily for 8 weeks. Primary outcome measures included OA pain intensity (100-mm visual analog scale), total Australian/Canadian Osteoarthritis Hand Index (AUSCAN) score, and global rating of disease activity at 4 and 6 weeks. Secondary outcomes included onset of efficacy in Weeks 1 and 2, durability of efficacy at 8 weeks, measures of disease activity in the dominant hand, pain intensity in the non-dominant hand, AUSCAN subindices, end of study rating of efficacy, and Osteoarthritis Research Society International response criteria.Results.Diclofenac sodium gel decreased pain intensity scores by 42%–45%, total AUSCAN scores by 35%–40%, and global rating of disease by 36%–40%. Significant differences favoring diclofenac sodium gel over vehicle were observed at Week 4 for pain intensity and AUSCAN, with a trend for global rating of disease activity. At Week 6, diclofenac sodium gel treatment significantly improved each primary outcome measure compared with vehicle. Secondary outcomes generally supported the primary outcomes. The most common treatment-related adverse event (AE) was application-site paresthesia. Most AE were mild. No cardiac events, gastrointestinal bleeding, or ulcers were reported.Conclusion.Topical diclofenac sodium gel was generally well tolerated and effective in primary hand OA. (NCT ID: NCT00171665)

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