scholarly journals An Epidemic of Primary Tuberculosis in a Canadian Aboriginal Community

1991 ◽  
Vol 2 (4) ◽  
pp. 133-141 ◽  
Author(s):  
Manuel W Mah ◽  
Elizabeth Anne Fanning
Keyword(s):  
Positive Skin ◽  
Aboriginal Community ◽  
Primary Tuberculosis ◽  
Delay In Diagnosis ◽  
The Family ◽  
Source Case ◽  
The Mean ◽  
One Year ◽  
Isoniazid Prophylaxis

In 1987, an outbreak of primary tuberculosis occurred in a Canadian aboriginal community of 350 people. The source case was a young woman who had been symptomatic for four months with smear positive cavitary pulmonary tuberculosis. Her 17 siblings and their families were frequent close contacts. Among the 626 persons surveyed in the community and environs, 35 additional active cases of tuberculosis were identified. The mean age of cases was 13 years and the median age 10 years. The method of diagnosis was bacteriological in 20 and radiological in 16. There were 257 positive tuberculin reactors of whom 120 had no previous record of a positive skin test. Isoniazid prophylaxis was recommended to all new reactors, close household contacts, reactors under the age of 35 years and reactors with lung scars. One late case was identified at one year of follow-up in a contact who had refused prophylaxis. The rates of infection and disease were higher in the family (65% and 46%, respectively) than in the community and environs (19% and 5.6%, respectively). This report illustrates the nature of a point source epidemic of primary tuberculosis in a susceptible community with a predictable reservoir of infection. The delay in diagnosis of the source case allowed numerous new infections to occur. However, prompt aggressive contact follow-up was successful in containing the epidemic. To prevent future outbreaks, the reservoir of infected persons must be identified and administered chemoprophylaxis.

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

Outcomes of conbercept therapy for choroidal neovascularization secondary to pathological myopia

2021 ◽  
Vol 2 (4) ◽  
pp. 210-213
Author(s):  
Zheng-Feng Liu ◽  
◽  
Da-Dong Guo ◽  
Mei-Hua Ding ◽  
Hong-Sheng Bi ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Fundus Fluorescein Angiography ◽  
Pathological Myopia ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
The Mean ◽  
One Year

AIM: To evaluate the one-year outcome of intravitreal conbercept injections for the treatment of choroidal neovascularization secondary to pathological myopia (pm-CNV) by optical coherence tomography angiography (OCTA). METHODS: The medical records of 26 consecutive eyes of 23 patients who received intravitreal injections of conbercept for pm-CNV with a follow-up of one year were retrospectively reviewed. All the patients were diagnosed by fundus fluorescein angiography (FFA) and OCTA at the first visit. All approaches were performed as “1+PRN” treatment. Outcomes included best-corrected visual acuity (BCVA), central foveal thickness (CFT) and the mean CNV area by OCTA. RESULTS: Mean Logarithm BCVA improved from (0.66±0.51) at baseline to (0.39±0.38) at one year (t=3.528, P=0.004). The CFT before treatment and after one year after were 275.08±48.74) μm and (205.15±43.74) μm respectively (t=4.630, P=0.001). The mean pm-CNV areas before treatment and after one year treatment were (0.48±0.24) mm2 and (0.15±0.11) mm2 respectively, with a significant difference among them (t=5.329, P=0.000). Twenty-one eyes had no needs after the first treatment. Four eyes received 2 injections and only one eye received 3 injections. No severe adverse events were noted relevant to the therapy. CONCLUSION: Intravitreal conbercept can improve the vision and relieve CFT and CNV area for the treatment of pm-CNV with “1+PRN” by OCTA for one year, however, long-term follow-up still need to be performed.

482Direct oral anticoagulant rivaroxaban in very old and frail patients: A one-year prospective follow-up of a large-scale cohort (SAFIR-AC)

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O Hanon ◽  
J Vidal ◽  
E Chaussade ◽  
J P David ◽  
N Boulloche ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Major Bleeding ◽  
Large Scale ◽  
Bleeding Risk ◽  
Geriatric Population ◽  
Very Old ◽  
The Mean ◽  
One Year ◽  
The One

Abstract Background/Introduction Age is one of the strongest predictors/risk factors for ischemic stroke in subjects with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) have been shown to be effective in the prevention of this condition; however, clinical evidence on bleeding risk with this therapeutic strategy in very old and frail geriatric patients is poor. Purpose To assess bleeding risk in French geriatric patients aged ≥80 years and diagnosed with AF newly treated with rivaroxaban. Methods Subjects, presenting to one of 33 geriatric centers, with non-valvular AF and recent initiation of a treatment with rivaroxaban were enrolled in the study and followed-up every 3 months for 12 months. Clinical and routine laboratory data and evaluation scores, such as HAS-BLED, HEMORR2HAGES, ATRIA, and CHA2DS2-VASc, as well as comprehensive geriatric evaluation were reported. Major bleeding, as defined in ROCKET AF study, was reported at each visit, and this primary outcome was adjudicated by an independent committee. Results of this cohort were compared with findings from a similar cohort treated with vitamin K antagonists (VKAs) from the same centers (n=924). Results A total of 1045 subjects were enrolled in the study of whom 995 (95%) had a one-year follow-up (analyzed population). The mean (standard deviation (SD)) age was 86.0 (4.3) years, with the majority of patients being female (61%), 23% aged 90 years or older, and 48% having an estimated glomerular filtration rate (eGFR) <50 mL/min. The main comorbidities were hypertension in 77% of subjects, malnutrition 49%, anemia 43%, dementia 39%, heart failure 36%, and falls 27%. The mean (SD) score for CHA2DS2-VASc was 4.8 (1.4), HAS-BLED 2.4 (0.9), Mini-Mental State Examination (MMSE) 21.5 (6.9), Activities of Daily Living (ADL) 4.4 (1.9), and Charlson Comorbidity Index 6.7 (2.0). The one-year rate of major bleeding events was 6.4% of which 0.8% were fatal and 1.1% intracranial hemorrhages (ICH), whereas the one-year rate of ischemic stroke was 1.4% and all-cause mortality 17.9%. Computed with VKA cohort findings and adjusted for age, gender, eGFR and Charlson score, this would result in a hazard ratio of 0.54 (95% confidence interval [CI], 0.38 to 0.78) for major bleeding, 0.36 (0.17 to 0.76) for ICH, 0.62 (0.29 to 1.33) for ischemic stroke, and 0.82 (0.65 to 1.02) for all-cause mortality, in favor of rivaroxaban. Conclusions This is the first large-scale prospective study in geriatric population in AF subjects treated with DOAC (rivaroxaban) Major bleeding risk appeared higher in very old than younger population, however major bleeding and ICH rates were significantly lower with rivaroxaban than with VKAs when used in the same geriatric population. This study indicates that Rivaroxaban can be used in very old and frail patients for the treatment of non-valvular AF. Acknowledgement/Funding Unrestricted grant from Bayer

scholarly journals Meniscus Repair Outcomes with and without Bone Marrow Aspiration Concentrate

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0028 ◽  
Author(s):  
Patrick Allan Massey ◽  
Andrew Zhang ◽  
Christine Bayt Stairs ◽  
Stephen Hoge ◽  
Trevor Carroll ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Meniscus Repair ◽  
Control Group ◽  
Pain Level ◽  
Average Pain ◽  
The Mean ◽  
One Year ◽  
The One

Objectives: The purpose of the current study is to review the results of meniscus repairs with and without bone marrow aspiration concentrate (BMAC). It is hypothesized that with BMAC, meniscus repair outcomes will be improved when compared to without BMAC at 1 year after surgery. Methods: This is a prospective case control study performed from August 2014 until August 2017. Patients were included if they had a meniscus repair performed with no history of prior meniscus surgery to the operative knee. Patients were excluded if there was a full thickness cartilage tear or International Cartilage Repair Society (ICRS) Grade IV cartilage tear not treated in a single staged surgery. Patients were also excluded if they did not reach the one year follow-up, had a multi-ligamentous knee injury requiring multiple staged procedures. From August 2014 until November 2015, patients had meniscus repair without BMA. Menisci were all repaired arthroscopically using inside-out, outside-in and all-inside techniques. After November 2015, all meniscus repairs were augmented with BMAC. In the BMAC group, all bone marrow was obtained from the ipsilateral femur during the time of surgery. The Biocue BMAC system (Zimmer Biomet, Warsaw Indiana) was used for bone marrow aspiration and BMAC was injected directly into the tear site after repair. Numerical data such as VAS, lysholm and IKDC was analyzed using a 2 sample T-test. Categorical data such as sex, tear location, type of tear and zone of tear were analyzed using a chi-square. Results: A total of 150 patients were initially included in the study. The average age in the control group was 26.3 versus 29.4 in the BMAC group (P=0.27). Thirty seven percent of the control group had an ACL reconstruction versus 40% in the BMAC group (P= .77). The control group improved from an average pain level of 6.1 to 1.2 and the BMAC group improved from an average pain level of 5.9 to 0.7 at the 1 year end point. Both the control group and BMAC group improved with respect to pain with no difference at the 1 year end point (P=.19). There was, however a significantly larger reduction in pain at the 6 week and 3 month time point with BMAC compared to the control group (P=.02 and P=.02 respectively). At the 1-year follow-up, the mean lysholm score improved from 43 to 92 in the control group and 43 to 90 in the BMAC group. The mean IKDC score improved from 37 to 87 in the control group and 36 to 83 in the BMAC group at the one year follow-up. Conclusion: Meniscus repair outcomes were improved at 6 weeks and 3 months post-operatively, when BMAC is used to augment meniscus repair compared to repair without BMAC. Both groups, control group and BMAC meniscus repair group had improved outcomes at 1 year post-operatively with respect to VAS, lysholm and IKDC, with no difference in complication rate.

Vascularized fibular epiphyseal transfer for proximal humeral reconstruction in children with a primary sarcoma of bone

2018 ◽  
Vol 100-B (4) ◽  
pp. 535-541 ◽  
Author(s):  
J. D. Stevenson ◽  
R. Doxey ◽  
A. Abudu ◽  
M. Parry ◽  
S. Evans ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Avascular Necrosis ◽  
Proximal Humerus ◽  
Bone Tumour ◽  
Limb Salvage Surgery ◽  
Primary Sarcoma ◽  
Toronto Extremity Salvage Score ◽  
The Mean ◽  
One Year

Aims Preserving growth following limb-salvage surgery of the upper limb in children remains a challenge. Vascularized autografts may provide rapid biological incorporation with the potential for growth and longevity. In this study, we aimed to describe the outcomes following proximal humeral reconstruction with a vascularized fibular epiphyseal transfer in children with a primary sarcoma of bone. We also aimed to quantify the hypertrophy of the graft and the annual growth, and to determine the functional outcomes of the neoglenofibular joint. Patients and Methods We retrospectively analyzed 11 patients who underwent this procedure for a primary bone tumour of the proximal humerus between 2004 and 2015. Six had Ewing’s sarcoma and five had osteosarcoma. Their mean age at the time of surgery was five years (two to eight). The mean follow-up was 5.2 years (1 to 12.2). Results The overall survival at five and ten years was 91% (confidence interval (CI) 95% 75% to 100%). At the time of the final review, ten patients were alive. One with local recurrence and metastasis died one-year post-operatively. Complications included seven fractures, four transient nerve palsies, and two patients developed avascular necrosis of the graft. All the fractures presented within the first postoperative year and united with conservative management. One patient had two further operations for a slipped fibular epiphysis of the autograft, and a hemi-epiphysiodesis for lateral tibial physeal arrest. Hypertrophy and axial growth were evident in nine patients who did not have avascular necrosis of the graft. The mean hypertrophy index was 65% (55% to 82%), and the mean growth was 4.6 mm per annum (2.4 to 7.6) in these nine grafts. At final follow-up, the mean modified functional Musculoskeletal Tumour Society score was 77% (63% to 83%) and the mean Toronto Extremity Salvage Score (TESS) was 84% (65% to 94%). Conclusion Vascularized fibular epiphyseal transfer preserves function and growth in young children following excision of the proximal humerus for a malignant bone tumour. Function compares favourably to other limb-salvage procedures in children. Longer term analysis is required to determine if this technique proves to be durable into adulthood. Cite this article: Bone Joint J 2018;100-B:535–41.

Mortality after proximal hip fracture in the Singapore population

2005 ◽  
Vol 15 (3) ◽  
pp. 166-170 ◽  
Author(s):  
K.H. Lin ◽  
Y.W. Lim ◽  
Y.J. Wu ◽  
K.S. Lam
Keyword(s):  
Hip Fracture ◽  
Mortality Risk ◽  
Cox Regression ◽  
Regional Hospital ◽  
Age Group ◽  
Risk Of Death ◽  
The Past ◽  
The Mean ◽  
One Year

The aims were to prospectively assess the mortality risk following proximal hip fractures, identify factors predictive of increased mortality and to investigate the time trends in mortality with comparison to previous studies. Prospectively collected data from 68 consecutive patients who had been admitted to a regional hospital from May 2001 to September 2001 were reviewed. The mean age of the patients was 79.3 years old (range, 55–98) and 72.1% females. Patients were followed prospectively to determine the mortality risk associated with hip fracture over a two-year follow-up period. The acute in-hospital mortality rate at six months, one year and two years was 5.9% (4/68), 14.7% (10/68), 20.6% (14/68) and 25% (17/68) respectively. One-year and two-year mortality for those patients who were 80 or older was significantly higher than for other patients and the number of co-morbid illnesses also had significant effect. Cox regression was performed to determine the significant predictors for survival time. It was noted that patients 80 years or older were at higher risk of death compared with those less than 80 years as well as those with higher number of co-morbid illnesses. Our mortality rates have not declined in the past 10 years when compared with previous local studies. We conclude that for this group of patients studied, their mortality at one year and two years could be predicted by their age group and their number of co-morbid illnesses.

Identifying Effectors of Outcomes in Patients with Large Umbilical Hernias

2016 ◽  
Vol 82 (7) ◽  
pp. 613-621 ◽  
Author(s):  
Steven A. Groene ◽  
Davis W. Heniford ◽  
Tanushree Prasad ◽  
Amy E. Lincourt ◽  
Vedra A. Augenstein
Keyword(s):  
Umbilical Hernia ◽  
Defect Size ◽  
Long Term Outcomes ◽  
Preoperative Pain ◽  
The Mean ◽  
The Difference ◽  
One Year

Quality of life (QOL) has become an important focus of hernia repair outcomes. This study aims to identify factors which lead to ideal outcomes (asymptomatic and without recurrence) in large umbilical hernias (defect size ≥9 cm2). Review of the prospective International Hernia Mesh Registry was performed. The Carolinas Comfort Scale was used to measure QOL at 1-, 6-, and 12-month follow-up. Demographics, operative details, complications, and QOL data were evaluated using standard statistical methods. Forty-four large umbilical hernia repairs were analyzed. Demographics included: average age 53.6 ± 12.0 and body mass index 34.9 ± 7.2 kg/m2. The mean defect size was 21.7 ± 16.9 cm2, and 72.7 per cent were performed laparoscopically. Complications included hematoma (2.3%), seroma (12.6%), and recurrence (9.1%). Follow-up and ideal outcomes were one month = 28.2 per cent, six months = 42.9 per cent, one year = 55.6 per cent. All patients who remained symptomatic at one and two years were significantly symptomatic before surgery. Symptomatic preoperative activity limitation was a significant predictor of nonideal outcomes at one year ( P = 0.02). Symptomatic preoperative pain was associated with nonideal outcomes at one year, though the difference was not statistically significant ( P = 0.06). Operative technique, mesh choice, and fixation technique did not impact recurrence or QOL. Repair of umbilical hernia with defects ≥9 cm2 had a surprising low rate of ideal outcomes (asymptomatic and no recurrence). All patients with nonideal long-term outcomes had preoperative pain and activity limitations. These data may suggest that umbilical hernia should be repaired when they are small and asymptomatic.

scholarly journals Arthroscopic Management for the Unstable Inferior Leaf of the Lateral Meniscus Anterior Horn and Associated Cysts through a Direct Inframeniscal Portal: A Retrospective Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Dongyang Chen ◽  
Qiangqiang Li ◽  
Ye Sun ◽  
Jianghui Qin ◽  
Yao Yao ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Full Range ◽  
Lateral Meniscus ◽  
Clinical Results ◽  
Anterior Horn ◽  
Arthroscopic Management ◽  
The Mean ◽  
Magnetic Resonance Scanning ◽  
One Year

Introduction. To investigate the clinical results of arthroscopic management for the unstable inferior leaf of the lateral meniscus anterior horn and associated cysts through an inframeniscal portal. Methods. From March 2005 to October 2014, 64 patients with an unstable inferior leaf of the lateral meniscus anterior horn and associated cysts underwent arthroscopic management with an inframeniscal portal. The mean age of the patients was 36.9 years (range, 18 to 49 years). The mean follow-up period was 28 months (range, 24 to 44 months). Clinical results were assessed using physical examination, the Lysholm knee score, and postoperative magnetic resonance scanning. Results. The median Lysholm score improved significantly at 1 year after surgery and at final follow-up. Magnetic resonance scanning at least one year after the operation revealed no recurrent meniscal tears or cysts. No reoperations were required after an average follow-up of 28 months. All patients reported significant symptomatic relief after the operation. They had full range of motion at three months and returned to normal activities and sports one year after surgery. Conclusion. The direct inframeniscal portal can provide an effective approach to manage lesions in the anterior horn of the lateral meniscus with predictable clinical outcomes.

A European multicentric experience using the CardioSEAL® and Starflex double umbrella devices to close interatrial communications holes within the oval fossa

2000 ◽  
Vol 10 (5) ◽  
pp. 519-526 ◽  
Author(s):  
M. Carminati ◽  
S. Giusti ◽  
G. Hausdorf ◽  
S. Qureshi ◽  
M. Tynan ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Surgical Repair ◽  
Clinical Success ◽  
The Other ◽  
Thromboembolic Events ◽  
Clinical Complications ◽  
The Mean ◽  
One Year ◽  
Flap Valve

AbstractIn this review, we describe the experience from 13 European centres using the CardioSEAL and Starflex double umbrella devices to close interatrial communications within the oval fossa (so-called ‘stcundum’ defects). Between October 1996 and April 1999, the procedure was attempted in 334 patients with a mean age of 12 years and a mean weight of 44kg. The mean measured stretched diameter of the defect was 15 mm. In the overall group, the defect was solitary in 245 patients (73%), multiple in 21 (6%), associated with an aneurysm of the flap valve in 15 (5%), was represented by patency of the oval foramen in 44 (13%), and was a fenestration in a Fontan repair in 9 (3%). In all patients, the devices were inserted under general anesthesia, using fluoroscopic and transesophageal echocardiographic control. Implantation was achieved in 325 (97,3%). The device embolized within either a few minutes or a few hours in 13 patients (4%). Of these, uncomplicated surgical repair was undertaken in 10, while the device was retrieved in 3 using catheters and a second device was successfully implanted. Residual shunting was detected immediately after the procedure in 41% of the patients, with the incidence decreasing to 31% at discharge, 24% at 1 month, 21% at 6 months, and 20.5% at one year. During the period of follow-up, elective surgical repair became necessary in two patients, due to malposition of the device in one, and late embolization in the other. Fractures of arms were seen in 6.1%, most commonly with the largest devices. All those with fractured arms of the device were asymptomatic, and no clinical complications related to the fractures were observed. There were no arrythmias, endocarditis, valvar distortion, thromboembolic events, or other complications. After one year of follow-up, clinical success, defined as complete closure of the defect or presence of only a trivial leak, had been obtained in 92.5% of the patients. We conclude, therefore, that these devices produce excellent results when used to close defects of small to moderate size. Results are less than optimal, or else complications ensure, when attempts are made to close very large defects.

SaGA S, the Short and Graphic A bility Score: an alternative scoring method for the motor components of the Multiple Sclerosis Functional C omposite

2004 ◽  
Vol 10 (2) ◽  
pp. 231-242 ◽  
Author(s):  
C Vaney ◽  
S Vaney ◽  
D T Wade
Keyword(s):  
Multiple Sclerosis ◽  
Correlation Coefficients ◽  
Scoring Method ◽  
Left Hand ◽  
Disability Status ◽  
Study Population ◽  
The Mean ◽  
One Year ◽  
Independent Assessment

The timed performances of the 10-m timed walk (TMTW) and the nine-ho le peg test (NHPT) of 881 consecutive patients with multiple sclerosis (MS) undergoing a rehabilitation stay, were expressed as a logarithmic function of time in two subscores to form a composite score called the Short and G raphic A bility Score (SaGA S). The subscores (sS) were constructed in such a way that any interval of 0.5 unit corresponds to a change of 25% in the tests. The SaGA S was computed as the mean of four subscores: SaGAS=(2×2-TMTWsS+NHPTsS right hand+NHPTsS left hand). With the aid of a nomogram, the timed values of the tests are easily transformed into the corresponding subscores, which are then displayed graphically to facilitate follow-up over time. The correlation coefficients between the SaGA S and the two motor components of the MS Functional C omposite (MSFC) (r =0.987), the Expanded Disability Status Scale (EDSS)(r = -0.83), the Nottingham EADL Index (r =0.80) and the Rivermead Mobility Index (RMI) (r =0.90) were all statistically significant (P B-0.001), supporting the validity of the measure. SaGA S had a similar sensitivity to the RMI, but was significantly more sensitive than the EDSS in detecting changes occurring during the rehabilitation stay (14.9% versus 5.0%; P B-0.001) and over a one-year follow-up (35.3% versus 19.7%; P B-0.001). C ompared with the motor components of the MSFC, with which it shares several features, SaGA S has several advantages: it does not depend on the stratification of the study population; it does not skew the results of the NHPT towards improvement at the lower end; and it offers an independent assessment of both hands. SaGA S is a simple, intuitive, nonphysician-based measure, which could provide consistent scoring in future clinical trials.

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