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de Winter J, de Hooge M, van de Sande M, de Jong H, van Hoeven L, de Koning A, Berg IJ, Ramonda R, Baeten D, van der Heijde D, Weel A, Landewé R. Magnetic Resonance Imaging of the Sacroiliac Joints Indicating Sacroiliitis According to the Assessment of SpondyloArthritis international Society Definition in Healthy Individuals, Runners, and Women With Postpartum Back Pain. Arthritis Rheumatol 2018. [PMID: 29513924 PMCID: PMC6032910 DOI: 10.1002/art.40475] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective To compare magnetic resonance images (MRIs) of the sacroiliac (SI) joints of healthy subjects and individuals with known mechanical strain acting upon the SI joints to those of patients with axial spondyloarthritis (SpA) and patients with chronic back pain. Methods Three readers who had received standardized training and were blinded with regard to study group randomly scored MRIs of the SI joints of 172 subjects, including 47 healthy individuals without current or past back pain, 47 axial SpA patients from the Spondyloarthritis Caught Early (SPACE) cohort (with a previous MRI confirmed positive for sacroiliitis), 47 controls with chronic back pain (irrespective of MRI results) from the SPACE cohort, 7 women with postpartum back pain, and 24 frequent runners. MRIs were scored according to the Assessment of SpondyloArthritis international Society (ASAS) definition and Spondyloarthritis Research Consortium of Canada (SPARCC) index. Results Of the 47 healthy volunteers, 11 (23.4%) had an MRI positive for sacroiliitis, compared to 43 (91.5%) of 47 axial SpA patients and 3 (6.4%) of 47 patients with chronic back pain. Three (12.5%) of the 24 runners and 4 (57.1%) of the 7 women with postpartum back pain had a positive MRI. Using a SPARCC cutoff of ≥2 for positivity, 12 (25.5%) of 47 healthy volunteers, 46 (97.9%) of 47 positive axial SpA patients, 5 (10.6%) of 47 controls with chronic back pain, 4 (16.7%) of 24 runners, and 4 (57.1%) of 7 women with postpartum back pain had positive MRIs. Deep bone marrow edema (BME) lesions were not found in healthy volunteers, patients with chronic back pain, or runners, but were found in 42 (89.4%) of 47 positive axial SpA patients and in 1 (14.3%) of 7 women with postpartum back pain. Conclusion A substantial proportion of healthy individuals without current or past back pain has an MRI positive for sacroiliitis according to the ASAS definition. Deep (extensive) BME lesions are almost exclusively found in axial SpA patients.
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Affiliation(s)
- Janneke de Winter
- Amsterdam Rheumatology and Immunology Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, and Zuyderland Medical Center, Heerlen, The Netherlands
| | - Manouk de Hooge
- Leiden University Medical Center, Leiden, The Netherlands, and Ghent University Hospital, Ghent, Belgium
| | - Marleen van de Sande
- Amsterdam Rheumatology and Immunology Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, and Zuyderland Medical Center, Heerlen, The Netherlands
| | - Henriëtte de Jong
- Amsterdam Rheumatology and Immunology Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, and Zuyderland Medical Center, Heerlen, The Netherlands
| | | | | | | | | | - Dominique Baeten
- Amsterdam Rheumatology and Immunology Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, and UCB, Brussels, Belgium
| | | | | | - Robert Landewé
- Amsterdam Rheumatology and Immunology Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands and Zuyderland Medical Center, Heerlen, The Netherlands
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Batehup L, Porter K, Gage H, Williams P, Simmonds P, Lowson E, Dodson L, Davies NJ, Wagland R, Winter JD, Richardson A, Turner A, Corner JL. Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months. Support Care Cancer 2017; 25:2063-2073. [PMID: 28197848 PMCID: PMC5445145 DOI: 10.1007/s00520-017-3595-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/23/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare patient-triggered follow-up (PTFU) for curatively treated colorectal cancer against traditional outpatient follow-up (OPFU). METHODS Questionnaires were mailed at four time points over one-year post-treatment to two prospectively-recruited cohorts: A, patients entering follow-up and receiving OPFU pre-implementation of PTFU; B, patients entering follow-up (FU) and receiving either OPFU (B1) or PTFU (B2) post-implementation of PTFU. Bi-variate tests were used to compare patient characteristics and outcomes eight months after entering follow-up (generic and cancer-specific quality of life (QoL), satisfaction). Regression analysis explored associations between follow-up model and outcomes. Resource implications and costs of models were compared. RESULTS Patients in Cohort B1 were significantly more likely to have received chemotherapy (p < 0.001), radiotherapy (p < 0.05), and reported poorer QoL (p = 0.001). Having a longstanding co-morbid condition was the most important determinant of QoL (p < 0.001); model of care was not significant. Patients were satisfied with their follow-up care regardless of model. Health service costs were higher in PTFU over the first year CONCLUSIONS: PTFU is acceptable to patients with colorectal cancer and can be considered to be a realistic alternative to OPFU for clinically suitable patients. The initial costs are higher due to provision of a self-management (SM) programme and remote surveillance. Further research is needed to establish long-term outcomes and costs.
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Affiliation(s)
- L Batehup
- Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK.
| | - K Porter
- Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK
| | - H Gage
- School of Economics, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - P Williams
- Department of Mathematics, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - P Simmonds
- Cancer Research UK, Clinical Research Unit, University of Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK
| | - E Lowson
- Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK
| | - L Dodson
- Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK
| | - N J Davies
- Health Psychology Consultancy Ltd., Staffordshire, UK
| | - R Wagland
- Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK
| | - J D Winter
- University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, Hampshire, SO16 6YD, UK
| | - A Richardson
- Health Sciences, Nightingale Building, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK
- University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, Hampshire, SO16 6YD, UK
| | - A Turner
- Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Priory Street, Coventry, CV1 5FB, UK
| | - J L Corner
- The University of Nottingham, Executive Office, Trent Building, University Park, Nottingham, NG7 2RD, UK
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de Winter J, van de Sande M, Landewé R, Baeten D. Reply. Arthritis Rheumatol 2017; 69:1124-1125. [DOI: 10.1002/art.40030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 12/13/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Janneke de Winter
- Academic Medical Center, University of AmsterdamAmsterdam The Netherlands
| | | | - Robert Landewé
- Academic Medical Center, University of AmsterdamAmsterdam The Netherlands
| | - Dominique Baeten
- Academic Medical Center, University of AmsterdamAmsterdam The Netherlands
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Winter JD. "Stones in the eye": post cataract suture irritation--a transcultural study from Sierra Leone, West Africa. Insight 1994; 19:8-10. [PMID: 7798732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A retrospective study of 1214 outpatients in Sierra Leone, West Africa was done to answer the question, "What is the visual acuity following extracapsular cataract extraction (ECCE) with an intraocular lens (IOL) for patients in a developing country?" Only 24% achieved uncorrected pseudophakic visual acuity of 20/20 to 20/50. Additionally, postoperative complications and patient complaints were tracked. Results showed suture irritation was less prevalent in those patients when 10-0 nylon suture was used, cut close, and the knot rotated and buried.
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