scholarly journals Evaluation of the performances of ‘typical’ imaging abnormalities of axial spondyloarthritis: results of the cross-sectional ILOS-DESIR study

RMD Open ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e000918 ◽  
Author(s):  
Anna Molto ◽  
Laure Gossec ◽  
Marie-Martine Lefèvre-Colau ◽  
Violaine Foltz ◽  
Romain Beaufort ◽  
...  

ObjectiveTo evaluate the prevalence and performance as axial Spondyloarthritis (axSpA) diagnostic feature of radiographic and MRI lesions ‘typical’ of axSpA of the sacroiliac joint (SIJ) and spine in a mechanical chronic back pain (CBP) population and in an axSpA cohort.MethodsCross-sectional multicentre study. Patients: (1) recent onset axSpA (DESIR cohort) and (2) mechanical non-axSpA CBP matched for age and gender (ILOS study). Imaging: radiographs and MR scans were performed identically in both groups. All images were centrally read, blinded for diagnosis and for other imaging findings in the same patient. Statistical analysis: prevalence of lesions ‘typical of axSpA’ were compared in both groups. Sensitivity, specificity and positive likelihood ratios (LR+) of each lesion (and combination of lesions) were calculated.ResultsA total of 98 patients with CBP were included, and compared with 100 patients with recent onset axSpA. SIJ lesions were consistently more frequent in the axSpA group (35.0% vs 11.8% p<0.001, 35.0% vs 8.4% p<0.001% and 32.0% vs 10.0%. p<0.001 for modified New York criteria, MRI sacroiliitis and ≥3 erosions of the SIJ on MRI, respectively), and performed well (LR+ for ≥3 erosions 3.0 (95% CI 1.6 to 5.8)). Spine lesions were comparable across groups: radiographic lesions were rare, while all MRI lesions were frequent.ConclusionOur study confirms that ‘typical’ lesions can also be observed in patients with non-axSpA CBP but that SIJ lesions by all modalities remain the most valuable for diagnosis, including structural lesions of the SIJ. This suggests the potential interest of adding MRI SIJ structural lesions in the definition of MRI abnormalities for axSpA classification.

2014 ◽  
Vol 74 (6) ◽  
pp. 1218-1224 ◽  
Author(s):  
Sofia Ramiro ◽  
Astrid van Tubergen ◽  
Carmen Stolwijk ◽  
Désirée van der Heijde ◽  
Patrick Royston ◽  
...  

ObjectivesTo establish reference intervals (RIs) for spinal mobility measures as recommended for patients with axial spondyloarthritis, and to determine the effect of age, height and gender on spinal mobility, in normal individuals.MethodsA cross-sectional study (MOBILITY) was conducted among normal individuals aged 20–69 years. Recruitment was stratified by gender, age (10-year categories) and height (10 cm categories). Eleven spinal mobility measures were assessed. Age specific RIs and percentiles were derived for each measure.Results393 volunteers were included. All spinal mobility measures decreased with increasing age. Therefore, age specific RIs were developed. The 95% RIs (2.5th and 97.5th percentiles), as well as the 5th, 10th, 25th, 50th, 75th and 90th percentiles for each spinal mobility measure and different ages are presented. Mobility percentile curves were also plotted for each of the measures. For instance, the 95% RI for lateral spinal flexion was 16.2–28.0 cm for a 25-year-old subject, 13.2–25.0 cm for a 45-year-old subject and 10.1–21.9 cm for a 65-year-old subject. After adjustment for age, there was no need for gender specific RIs, while RIs of some measures are height-adjusted.ConclusionsAge specific RIs and percentiles were derived for each of the spinal mobility measures for normal individuals. These may guide clinicians when assessing the mobility of patients with axial spondyloarthritis. The RIs may serve as cut-off levels for ‘normal’ versus ‘abnormal’, whereas the mobility percentile curves may be used to assess the level of mobility of patients with axial spondyloarthritis.


2017 ◽  
Vol 77 (2) ◽  
pp. 221-227 ◽  
Author(s):  
Maxime Dougados ◽  
Walter P Maksymowych ◽  
Robert B M Landewé ◽  
Anna Moltó ◽  
Pascal Claudepierre ◽  
...  

ObjectiveTo compare 2 years of radiographic sacroiliac joint (SIJ) changes in patients with recent onset axial spondyloarthritis (axSpA) receiving etanercept in a clinical trial (EMBARK) to similar patients not receiving biologics in a cohort study (DESIR).MethodsEndpoints were changes at week 104 per the modified New York (mNY) grading system in total SIJ score (primary endpoint) and net percentage of patients with progression defined three ways. Treatment effect was analysed with and without adjustment for baseline covariates.ResultsAt 104 weeks, total SIJ score improved in the etanercept group (n=154, adjusted least-squares mean change: –0.14) and worsened in the control group (n=182, change: 0.08). The adjusted difference between groups (etanercept minus control) was –0.22 (95% CI –0.38 to –0.06), p=0.008. The net percentage of patients with progression was significantly lower in the etanercept versus the control group for two of three binary endpoints: –1.9% versus 1.6% (adjusted difference for etanercept minus control: –4.7%,95% CI –9.9 to 0.5, p=0.07) for change in mNY criteria; –1.9% versus 7.8% (adjusted difference: –18.2%,95% CI –30.9 to –5.6, p=0.005) for change ≥1 grade in ≥1 SIJ; and –0.6% versus 6.7% (adjusted difference: –16.4%,95% CI –27.9 to –5.0, p=0.005) for change ≥1 grade in ≥1 SIJ, with shift from 0 to 1 or 1 to 0 considered no change.ConclusionDespite the slow radiographic SIJ progression rate over 2 years in axSpA, this study suggests a lower rate of progression in the SIJ with etanercept than without anti-tumour necrosis factor therapy.Trial registration numbersNCT01258738, NCT01648907; Post-results.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
America E. McGuffee ◽  
Kailyn Chillag ◽  
Amber Johnson ◽  
Regan Richardson ◽  
Hallie Williams ◽  
...  

Purpose. Middle-aged males and females with diabetes are more likely to have poor physical (PH) and mental health (MH); however, there is limited research determining the relationship between MH and PH and routine check-up in diabetic middle-aged adults, especially by gender. The purpose of this study was to determine whether PH and MH status differ by routine check-up in middle-aged (age 45–64) adults with diabetes in the general population. Methods. This cross-sectional analysis used data from the 2017 BRFSS conducted by the CDC for adults aged 45–64 who reported having diabetes in Florida (N=1183), Kentucky (N=617), Maryland (N=731), New York (N=593), and Ohio (N=754). Multiple logistic regression by state and gender was used to determine the relationship between MH and PH status and routine check-up while controlling for health-related, socioeconomic, and demographic factors. Results. Across states, up to one-half reported good PH (32–50%), over one-half reported good MH (46–67%), and most reported having a routine check-up (87–93%). Adjusted analysis indicated that MH and PH were not significantly related to routine check-up, but both were inversely related to having diabetes plus two other health conditions. Conclusions. Overall, routine check-up was not related to good PH and MH in this target population; however, a number of health conditions were inversely related to good PH and MH status. In a primary care setting for this target population, there may be a low to moderate prevalence of good PH and MH and a high prevalence of having a routine check-up and having multiple health conditions. It is recommended to automatically screen this target population for PH, MH, other chronic conditions, and physical activity and treat concurrently.


2017 ◽  
Vol 11 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Karl Spiteri ◽  
Maria-Louisa Busuttil ◽  
Samuel Aquilina ◽  
Dorothy Gauci ◽  
Erin Camilleri ◽  
...  

Schoolbag weight in schoolchildren is a recurrent and contentious issue within the educational and health sphere. Excessive schoolbag weight can lead to back pain in children, which increases the risk of chronic back pain in adulthood. There is limited research regarding this among the Maltese paediatric population. A cross-sectional study was undertaken across all schools in Malta among students aged 8–13 years (inclusive). Data were collected using a questionnaire detailing schoolbag characteristics, self-reported pain and demographic variables, such as age and gender. Structured interviews with participants were also carried out by physiotherapists. A total of 4005 participants were included in the study, with 20% of the total Malta schoolchildren population. Over 70% of the subjects had a schoolbag that exceeded the recommended 10% bag weight to body ratio. A total of 32% of the sample complained of back pain, with 74% of these defining it as low in intensity on the face pain scale–revised. The presence of back pain was statistically related to gender, body mass index (BMI), school and bag weight to body weight ratio. After adjusting for other factors, self-reported back pain in schoolchildren is independently linked to carrying heavy schoolbags. This link should be addressed to decrease the occurrence of back pain in this age group.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A71-A71
Author(s):  
Luciana Giorgio ◽  
Carmela Alcantara

Abstract Introduction Although caregiving is associated with shorter sleep durations and worse sleep quality, particularly among employed individuals, these studies have mostly examined household (i.e., child, adult) and domestic caregiving among majority non-Latinx White samples. Sending remittances, a form of transnational caregiving whereby financial support is provided to relatives in one’s country of origin, is associated with positive mental health among Latinxs, yet its association with sleep remains unexamined. We examined the association of household and transnational caregiving with sleep duration and quality, and explored the moderating effects of employment status on these relationships. Methods Using cross-sectional data of healthy Latinx adults in New York City (N=188), we conducted separate age and gender-adjusted linear regressions or logistic regressions to examine the association of caregiving and sleep duration, and poor sleep quality, respectively. Sleep duration (continuous) and sleep quality (fairly/very poor) were measured using two items from the PSQI. Household caregiving was defined as caregiving for children or adults in the household. Transnational caregiving was operationalized as sending remittances. Moderation was tested using employment status*caregiving cross-products in adjusted models. Results Participants were Mage=37.61(SD=14.07), 71.3% employed, 66.5% female, and 59.6% immigrants. Overall, 14.9% were household caregivers and 28.72% sent remittances. Household caregiving was not significantly associated with sleep duration or quality. Those who sent remittances reported on average sleeping 27.63 minutes less than non-remitters (b=-27.63,SE=13.93,p&lt;0.05). Sending remittances was associated with 2.30 increased odds of reporting poor sleep quality (OR:2.30; 95%CI:1.03-5.14.) Employment status was a significant moderator (p&lt;0.05). Among those who were employed, sending remittances was associated with 3 times higher odds of poor sleep quality (OR:3.00;95%CI:1.46-10.59) and 48.94 fewer minutes of sleep duration than non-remitters (b=-48.94,SE=15.72,p&lt;0.05). These relationships were not observed among unemployed Latinxs. Conclusion Transnational caregivers were more likely to report shorter sleep duration and poorer sleep quality than their counterparts, and this was only observed among employed vs. unemployed Latinxs. Household caregiving was not significantly associated with sleep. Employed transnational caregivers may have multiple jobs that further constrain opportunities for longer and high-quality sleep. Future studies should examine potential upstream factors (e.g., working conditions) that may limit employed, transnational caregivers’ ability to obtain adequate sleep. Support (if any):


1996 ◽  
Vol 44 (1) ◽  
pp. 34-48 ◽  
Author(s):  
Stephen F. Zdzinski

This study examined relationships among selected aspects of parental involvement as they relate to the cognitive, affective, and performance outcomes of instrumental music students. Independent variables were music aptitude, parental involvement, grade level, and gender. Dependent variables were cognitive musical outcomes, performance outcomes, and affective outcomes. Subjects were instrumental music students ( N = 406) from five intact band programs located in rural New York and Pennsylvania. Wind and percussion volunteers from Grades 4 through 12 participated. Data were examined using descriptive analysis, correlational analysis, and analysis of variance. Major findings included: (1) Parental involvement was related to overall performance, affective, and cognitive musical outcomes. (2) For cognitive musical outcomes, parental involvement was only related at the elementary level. (3) For musical performance outcomes, parental involvement was only related at the elementary level. (4) For affective outcomes, the strength of the parental involvement relationship increased with student age. (5) Items concerning concert attendance, providing materials, participating in parent groups, and tape-recording student performances were related to all outcome areas.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 761
Author(s):  
Andrianto Andrianto ◽  
Ni Made Mertaniasih ◽  
Parama Gandi ◽  
Makhyan Jibril Al-Farabi ◽  
Yusuf Azmi ◽  
...  

Introduction: Xpert MTB/RIF is a rapid diagnostic instrument for pulmonary tuberculosis (TB). However, studies reported varied accuracy of Xpert MTB/RIF in detecting Mycobacterium tuberculosis in pericardial effusion. Methods: We performed a systematic review of literature in PubMed, published up to February 1, 2020, according to PRISMA guidelines. We screened cross-sectional studies, observational cohort studies, and randomized control trials that evaluated the accuracy of Xpert MTB/RIF in diagnosing TB pericarditis. Papers with noninterpretable results of sensitivity and specificity, non-English articles, and unpublished studies were excluded. The primary outcomes were the sensitivity and specificity of Xpert MTB/RIF. We conducted a quality assessment using QUADAS-2 to evaluate the quality of the studies. A bivariate model pooled the overall sensitivity, specificity, positive likelihood ratios (PLRs), and negative likelihood ratios (NLRs) of included studies. Results: In total, 581 subjects from nine studies were analyzed in this meta-analysis. Our pooled analysis showed that the overall sensitivity, specificity, PLRs and NLRs of included studies were 0.676 (95% CI: 0.580–0.759), 0.994 (95% CI: 0.919–1.000), 110.11 (95% CI: 7.65–1584.57) and 0.326 (95% CI: 0.246–0.433), respectively. Conclusions: Xpert MTB/RIF had a robust specificity but unsatisfactory sensitivity in diagnosing TB pericarditis. These findings indicated that although positive Xpert MTB/RIF test results might be valuable in swiftly distinguishing the diagnosis of TB pericarditis, negative test results might not be able to rule out TB pericarditis. Registration: PROSPERO CRD42020167480 28/04/2020


2019 ◽  
Vol 9 (3-4) ◽  
pp. 155-162
Author(s):  
Boonsak Hanterdsith

Although the arcus corneae (AC) has long been used as an age indicator for forensic purposes, its diagnostic value has not been evaluated. To evaluate the AC as a predictor of chronological age, the author has studied the correlation of AC with respect to age of the deceased. A cross-sectional study was conducted of 342 Thai corpses at the Maharat Nakhon Ratchasima Hospital, Thailand. AC was graded into three levels: no AC, incomplete ring, and complete ring. One-way analysis of variance, chi-square test, binomial logistic regression, sensitivity, specificity, predictive values, and likelihood ratios were used for analysis. The Cohen’s kappa was used to determine the intraobserver and interobserver reliability. The prevalence of AC and the probability of complete AC were significant higher in corpses aged 60 years and above than in those under 60 years. Consequently, this study confirmed that the prevalence of AC was significantly correlated with the age of Thai individuals. If the complete AC is used as an indicator of age of 60 years and above, complete AC has high sensitivity (92.56%) but low specificity (72.85%), low positive predictive value (65.12%), but high negative predictive value (94.71%). For diagnostic value, the presence of AC can be used for age screening but not for absolute confirmation. The absence of AC indicates young age, incomplete AC indicates middle age, and complete AC indicates old age. The high intraobserver and interobserver reliability provides assurance of the value of AC as a means to estimate personal age.


2018 ◽  
Vol 13 (3) ◽  
pp. 332-338 ◽  
Author(s):  
Derek Breen ◽  
Michelle Norris ◽  
Robin Healy ◽  
Ross Anderson

Purpose: Pacing strategies are key to overall performance outcome in distance-running events. Presently, no literature has examined pacing strategies used by masters athletes of all running levels during a competitive marathon. Therefore, this study aimed to examine masters athletes’ pacing strategies, categorized by gender, age, and performance level. Methods: Data were retrieved from the 2015 TSC New York City Marathon for 31,762 masters athletes (20,019 men and 11,743 women). Seven performance-classification (PC) groupings were identified via comparison of overall completion time compared with current world records, appropriate to age and gender. Data were categorized via, age, gender, and performance level. Mean 5-km speed for the initial 40 km was calculated, and the fastest and slowest 5-km-split speeds were identified and expressed as a percentage faster or slower than mean speed. Pace range, calculated as the absolute sum of the fastest and slowest split percentages, was then analyzed. Results: Significant main effects were identified for age, gender, and performance level (P < .001), with performance level the most determining factor. Athletes in PC1 displayed the lowest pace range (14.19% ± 6.66%), and as the performance levels of athletes decreased, pace range increased linearly (PC2–PC7, 17.52% ± 9.14% to 36.42% ± 18.32%). A significant interaction effect was found for gender × performance (P < .001), with women showing a smaller pace range (−3.81%). Conclusions: High-performing masters athletes use more-controlled pacing strategies than their lower-ranked counterparts during a competitive marathon, independent of age and gender.


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