Joint-specific hand symptoms and self-reported and performance-based functional status in African Americans and Caucasians: The Johnston County Osteoarthritis Project

OBJECTIVE

To assess associations between joint-specific hand symptoms and self-reported and performance-based functional status.

METHODS

Participants were from the population-based Johnston County Osteoarthritis Project. Symptoms in the distal interphalangeal (DIP), proximal interphalangeal (PIP), first carpometacarpal (CMC), and metacarpophalangeal (MCP) joints were assessed on a 30-joint diagram of both hands. Self-reported function was assessed by Health Assessment Questionnaire (HAQ) and performance-based function by timed repeated chair stands and 8-foot walk time. Separate multiple logistic regression models examined associations between symptoms in specific hand joint groups, symptoms in >/=2 hand joint groups and number of symptomatic hand joints, and functional status measures, controlling for age, race/ethnicity, sex, body mass index, radiographic knee and hip OA, knee and hip symptoms and depressive symptoms.

RESULTS

Those with symptomatic hand joint groups were more likely than those without these complaints to report more difficulty and require longer times for performance measures. Those with 2 or more symptomatic hand joint groups were more likely to have higher HAQ scores (OR = 1.97 (1.53 to 2.53)) and require more time to complete 5 chair stands (OR = 1.98 (1.23 to 3.18)) and the 8 foot walk test (OR = 1.49 (1.12 to 1.99)).

CONCLUSIONS

Joint-specific hand symptoms are associated with difficulty performing upper- or lower-extremity tasks, independent of knee and hip OA and symptoms, suggesting that studies examining functional status in OA should not ignore symptomatic joints beyond the joint site of interest, even when functional measures appear to be specific for the joint site under study.

Effectiveness and safety of an emergency department short-stay unit as an alternative to standard inpatient hospitalisation

BACKGROUND

Emergency department short-stay units (EDSSUs) are currently emerging worldwide as an alternative to standard inpatient hospitalisation. In our hospital, a 960-bed teaching tertiary institution in Barcelona, Spain, an EDSSU has been in operation during winter periods (November-March) since 1997.

AIM

To determine the efficacy and safety of our EDSSU.

METHODS

Retrospective analysis of activity and quality outcomes, assessment of patient satisfaction levels and determination of the diagnostic-related groups that were mainly responsible for admissions to the EDSSU, comparing the clinical characteristics of those patients with the characteristics of patients with similar clinical diagnoses admitted to standard hospitalisation units.

RESULTS

5666 patients were treated in the EDSSU, with a progressive increase in the number of patients admitted per period, ranging from 707 in 1997-8 to 1227 in 2003-4 (73.5% increase). The mean length of stay ranged from 3.1 to 2.8 days, mortality from 2.5% to 5.1%, home discharge rate from 84% to 90%, and hospital readmission rate within the first week after discharge from 3.9% to 6.2%. In all, 98% of patients were satisfied with their stay at the EDSSU. The main diagnostic-related groups were chronic obstructive pulmonary disease (COPD = 50%) and acute heart failure (28%). Patients with COPD admitted at the EDSSU (n = 545) showed significantly (p = 0.05) lower mean length of stay (3.4 v 12 days) and mortality (1.7% v 8.1%), but a higher hospital readmission rate (9.9% v 7%) than those admitted to standard inpatient units (n = 1961).

CONCLUSIONS

In our experience, the EDSSU proved to be an effective and safe alternative to standard inpatient hospitalisation.

Feature extraction & lips posture detection oriented to the treatment of CLP children

Adequate recognition of lips posture for speech articulation analysis requires of the measurement of several anthropometric mouth parameters. These are needed to estimate the position and contour of the lips and teeth and tongue positions, as well. Here, a method is proposed for lips contour detection under natural conditions without any extra hardware requirements for image acquisition. The purpose of the suggested process is to obtain the lips contour based on red hue fields detection. Afterward, geometrical features of lips are extracted from their detected contour. Image processing is divided into the following steps: Face and mouth search, lips contour detection and feature estimation from lips geometry. Due to high dimensionality of the initial feature space, it is very important to evaluate the performance of the lips features regarding their ability to discriminate pathological lip postures in the case of children with cleft lip and palate. In this paper, a proposed method for effective selection of the image feature set was developed using multivariate analysis techniques. Finally, the discriminant performance of the selected training sets was evaluated using bayesian estimators. Results of the comparison for different common testing algorithms show that the proposed processing method exposes better performance.

Incidence and molecular typing of Mycobacterium kansasii in a defined geographical area in Catalonia, Spain

A retrospective population-based study was conducted between January 1990 and December 1998 to investigate the incidence of Mycobacterium kansasji disease and the heterogeneity of the isolates in a well-defined geographical area in Catalonia, Spain. A total of 136 patients were identified. Overall incidence and incidence in AIDS patients was 1.5 (95% CI 1.2-1.8) and 1089.6 (95% CI 689-1330) cases/100,000 persons per year respectively, which is comparable to that reported from most of other geographical areas. Surprisingly, although 7 subtypes of M. kansasii have been consistently reported, in the present study 91 of the 93 isolates (97.8%) tested for genotype were subtype I, regardless of HIV status of the patients. In conclusion, the high rate of infection observed in the AIDS population contributes significantly to the burden of the M. kansasii disease in our area. M. kansasii disease in our geographical area was almost exclusively caused by subtype I regardless of HIV status.

Comparison of the performance of the Gea extracorporeal knot with the Roeder extracorporeal knot and the classical knot

BACKGROUND

Laparoscopy is useful to treat surgical diseases, yet tying sutures in the cavity is a challenge. A knot to secure tissue approximation, which would be hand-made, secure, simple, easy, quick, reliable, and extracorporeal without extra mechanical devices, was developed and named the Gea knot.

METHODS

A comparative study of the Gea knot, the Roeder knot, and the classical surgical knot, as the gold standard, using polypropylene, silk, catgut, polyglycolic acid, and Polyglactin 910, all of them of 1-0 caliber, was performed in pigs. Measurements were time to perform, slippage, and breaking point which was measured with a manual digital tensiometer.

RESULTS

The Gea knot was significantly faster statistically to perform than the Roeder knot and more resistant against rupture and slippage. The slippage rate was significantly lower statistically in the Gea knot than in the Roeder knot when Polyglactin 910 and polypropylene were used.

CONCLUSION

The Gea knot is a good alternative for laparoscopic procedures.

Laparoscopic hand-assisted living donor nephrectomy: the Calgary experience

Laparoscopic techniques, such as hand-assisted live donor nephrectomy (HALDN), have the potential to increase the number of living kidney donors. For these techniques to be acceptable, however, the standards for donor, recipient, and graft survival achieved by the open technique need to be matched. In this study we present the results of the first 20 HALDN procedures at our center. The 20 donors included nine men and 11 women of mean (+/-SD) donor age 41 (+/-10) years and mean donor weight 78 (+/-13) kg. Mean operative time was 174 (+/-32) minutes. Only one patient required an open conversion to procedure because of venous bleeding. All kidneys were successfully implanted; there were no episodes of primary nonfunction or delayed graft function. There were no surgical complications, either in the donor or the recipient. The range of postoperative stay was 3 to 5 days. One recipient died 62 days after transplant from influenza virus pneumonia. There were no other causes of graft loss. Our preliminary results suggest that HALDN is safe and is associated with short-term donor, recipient, and graft outcomes that are at least comparable to the standard open technique.

APOE genotype influences acquisition and recall following traumatic brain injury

APOE has been demonstrated to influence traumatic brain injury (TBI) outcome. The relationship between APOE genotype and memory following TBI was examined in 110 participants in the Defense and Veterans' Head Injury Program. Memory performance was worse in those who had an APOE epsilon 4 allele (n = 30) than those who did not (n = 80), whereas genotype groups did not differ on demographic or injury variables or on measures of executive functioning. These data support a specific role for the APOE protein in memory outcome following TBI, and suggest an APOE isoform-specific effect on neuronal repair processes.

Serum amyloid A and high-density lipoprotein cholesterol: serum markers of inflammation in sarcoidosis and other systemic disorders

Hypocholesterolemia has been observed in several inflammatory diseases such as rheumatoid arthritis, myeloproliferative disorders, systemic lupus erythematosus and sarcoidosis. Serum amyloid A is an acute-phase reactant that is related to the high-density lipoprotein cholesterol. This review discusses the relationship between the activation of the cells of the monocyte-macrophage system, determined by the serum amyloid A levels, and the lipid metabolism, measured as alterations in plasma lipoprotein concentrations. The mechanisms of this association during acute inflammation are also discussed in this review.

Estimation of the EEG power spectrum using MRI T(2) relaxation time in traumatic brain injury

OBJECTIVES

To study the relationship between magnetic resonance imaging (MRI) T(2) relaxation time and the power spectrum of the electroencephalogram (EEG) in long-term follow up of traumatic brain injury.

METHODS

Nineteen channel quantitative electroencephalograms or qEEG, tests of cognitive function and quantitative MRI T(2) relaxation times (qMRI) were measured in 18 mild to severe closed head injured outpatients 2 months to 4.6 years after injury and 11 normal controls. MRI T(2) and the Laplacian of T(2) were then correlated with the power spectrum of the scalp electrical potentials and current source densities of the qEEG.

RESULTS

qEEG and qMRI T(2) were related by a frequency tuning with maxima in the alpha (8-12Hz) and the lower EEG frequencies (0.5-5Hz), which varied as a function of spatial location. The Laplacian of T(2) acted like a spatial-temporal "lens" by increasing the spatial-temporal resolution of correlation between 3-dimensional T(2) and the ear referenced alert but resting spontaneous qEEG.

CONCLUSIONS

The severity of traumatic brain injury can be modeled by a linear transfer function that relates the molecular qMRI to qEEG resonant frequencies.

Quantitative analysis of two-dimensional gel electrophoresis protein patterns: a method for studying genetic relationships among Globodera pallida populations

A method based in two-dimensional protein gel electrophoresis has been developed in order to improve the analysis of genetic relationships among populations of Globodera. It has been used to estimate genetic divergence among nine Globodera pallida nematode populations. Sixty-one anonymous polypeptide spots were resolved using silver-stained high-resolution 2D gels and they were quantified in each population to establish genetic variation among G. pallida populations. The results of this analysis were compared with those obtained after a study of allelic frequency variation, which was carried out using seven previously described loci. Genetic distances among populations were calculated by means of both studies, the quantitative analysis and the allelic frequency variation, and phylogenetic trees were constructed for each type of analysis. A correlation analysis between the two distance matrices was carried out and a bootstrap analysis was performed to determine the strength of the clusters obtained with each method. The results obtained support the idea that quantitative protein analysis can be successfully applied to phylogenetic analysis of G. pallida populations.