المؤلفون: Hunter, David J, Deveza, Leticia A, Collins, Jamie E, Losina, Elena, Katz, Jeffrey N, Nevitt, Michael C, Lynch, John A, Roemer, Frank W, Guermazi, Ali, Bowes, Michael A, Dam, Erik B, Eckstein, Felix, Kwoh, C Kent, Hoffmann, Steve, Kraus, Virginia B

المصدر: Arthritis Care & Research. 74(7)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Prevention, Biomedical Imaging, Pain Research, Arthritis, Aging, Chronic Pain, Clinical Research, Musculoskeletal, Biomarkers, Cartilage, Articular, Disease Progression, Humans, Knee Joint, Magnetic Resonance Imaging, National Institutes of Health (U.S.), Osteoarthritis, Knee, Synovitis, United States, Public Health and Health Services, Psychology, Clinical sciences, Allied health and rehabilitation science

الوصف: ObjectiveTo determine the optimal combination of imaging and biochemical biomarkers for use in the prediction of knee osteoarthritis (OA) progression.MethodsThe present study was a nested case-control trial from the Foundation of the National Institutes of Health OA Biomarkers Consortium that assessed study participants with a Kellgren/Lawrence grade of 1-3 who had complete biomarker data available (n = 539 to 550). Cases were participants' knees that had radiographic and pain progression between 24 and 48 months compared to baseline. Radiographic progression only was assessed in secondary analyses. Biomarkers (baseline and 24-month changes) that had a P value of

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/64n63926Test

المؤلفون: Alves, Kristin, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: Journal of Bone and Joint Surgery. 101(4)

مصطلحات موضوعية: Bioengineering, Adolescent, Buttocks, Child, Child, Preschool, Female, Fibrosis, Hip Contracture, Humans, Male, Muscle, Skeletal, Postoperative Complications, Treatment Outcome, Biomedical Engineering, Clinical Sciences, Orthopedics

الوصف: BackgroundThe objective of this study was to analyze the literature regarding the diagnosis, pathogenesis, and prevalence of gluteal fibrosis (GF) and the outcomes of treatment.MethodsWe searched PubMed, Embase, and Cochrane literature databases, from database inception to December 15, 2016. We used the following search terms including variants: "contracture," "fibrosis," "injections," "injections, adverse reactions,' "gluteal," and "hip." All titles and abstracts of potentially relevant studies were scanned to determine whether the subject matter was potentially related to GF, using predefined inclusion and exclusion criteria. If the abstract had subject matter involving GF, the paper was selected for review if full text was available. Only papers including ≥10 subjects who underwent surgical treatment were included in the systematic analysis. Data abstracted included the number of patients, patient age and sex, the type of surgical treatment, the method of outcome measurement, and outcomes and complications.ResultsThe literature search yielded 2,512 titles. Of these, 82 had a focus on GF, with 50 papers meeting the inclusion criteria. Of the 50 papers reviewed, 18 addressed surgical outcomes. The surgical techniques in these papers included open, minimally invasive, and arthroscopic release and radiofrequency ablation. Of 3,733 operatively treated patients in 6 reports who were evaluated on the basis of the criteria of Liu et al., 83% were found to have excellent results. Few papers focused on the incidence, prevalence, and natural history of GF, precluding quantitative synthesis of the evidence in these domains.ConclusionsThis study provided a systematic review of surgical outcomes and a summary of what has been reported on the prevalence, diagnosis, prognosis, and pathogenesis of GF. Although GF has been reported throughout the world, it requires further study to determine the exact etiology, pathogenesis, and appropriate treatment. Surgical outcomes appear satisfactory.Level of evidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/08d0d736Test

المؤلفون: Alves, Kristin, Penny, Norgrove, Ekure, John, Olupot, Robert, Kobusingye, Olive, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC Musculoskeletal Disorders. 19(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Research, Pediatric, Prevention, Buttocks, Child, Child, Preschool, Female, Fibrosis, Humans, Injections, Intramuscular, Male, Paralysis, Prevalence, Retrospective Studies, Rural Health, Uganda, Gluteal fibrosis, Post-injection paralysis, Orthopedics, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise

الوصف: BackgroundThe purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/82b3m32wTest

المؤلفون: Alves, Kristin, Godwin, Christine L, Chen, Angela, Akellot, Daniella, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC Health Services Research. 18(1)

مصطلحات موضوعية: Health Services and Systems, Health Sciences, Clinical Research, Prevention, Health Services, 8.1 Organisation and delivery of services, Health and social care services research, Good Health and Well Being, Adult, Attitude of Health Personnel, Buttocks, Child, Delivery of Health Care, Female, Fibrosis, Health Personnel, Humans, Iatrogenic Disease, Injections, Intramuscular, Interviews as Topic, Male, Middle Aged, Motivation, Paralysis, Qualitative Research, Uganda, Gluteal fibrosis, Post-injection paralysis, Injection practices, Safe injection, Pediatric musculoskeletal health, Pediatric orthopaedics, Intramuscular injection, Library and Information Studies, Nursing, Public Health and Health Services, Health Policy & Services, Health services and systems, Public health

الوصف: BackgroundIatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector.MethodsWe conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis.ResultsWe identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities.ConclusionThis qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3nq1t9sfTest

المؤلفون: Alves, Kristin, Godwin, Christine L, Chen, Angela, Akellot, Daniella, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC health services research. 18(1)

مصطلحات موضوعية: Buttocks, Humans, Paralysis, Iatrogenic Disease, Fibrosis, Injections, Intramuscular, Attitude of Health Personnel, Motivation, Qualitative Research, Adult, Middle Aged, Child, Health Personnel, Delivery of Health Care, Uganda, Female, Male, Interviews as Topic, Gluteal fibrosis, Injection practices, Intramuscular injection, Pediatric musculoskeletal health, Pediatric orthopaedics, Post-injection paralysis, Safe injection, Injections, Intramuscular, Library and Information Studies, Nursing, Public Health and Health Services, Health Policy & Services

الوصف: BackgroundIatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector.MethodsWe conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis.ResultsWe identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities.ConclusionThis qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3nq1t9sfTest

المؤلفون: Alves, Kristin, Penny, Norgrove, Ekure, John, Olupot, Robert, Kobusingye, Olive, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC musculoskeletal disorders. 19(1)

مصطلحات موضوعية: Buttocks, Humans, Paralysis, Fibrosis, Injections, Intramuscular, Prevalence, Retrospective Studies, Child, Child, Preschool, Rural Health, Uganda, Female, Male, Gluteal fibrosis, Post-injection paralysis, Injections, Intramuscular, Preschool, Pediatric, Prevention, Clinical Research, Orthopedics, Clinical Sciences

الوصف: BackgroundThe purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/82b3m32wTest

المؤلفون: Alves, Kristin, Penny, Norgrove, Kobusingye, Olive, Olupot, Robert, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: International Orthopaedics. 42(8)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Pediatric, Brain Disorders, Neurosciences, Rehabilitation, Infection, Musculoskeletal, Adolescent, Child, Child, Preschool, Cohort Studies, Cost of Illness, Cross-Sectional Studies, Female, Humans, Infant, Male, Musculoskeletal Diseases, Prevalence, Retrospective Studies, Surveys and Questionnaires, Uganda, Pediatric musculoskeletal health, Pediatric orthopaedics, Gluteal fibrosis, Post-injection paralysis, MSK burden, Orthopedics, Clinical sciences

الوصف: PurposeThe purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2253879tTest

المؤلفون: Kraus, Virginia Byers, Collins, Jamie E, Hargrove, David, Losina, Elena, Nevitt, Michael, Katz, Jeffrey N, Wang, Susanne X, Sandell, Linda J, Hoffmann, Steven C, Hunter, David J

المصدر: Annals of the Rheumatic Diseases. 76(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Aging, Chronic Pain, Pain Research, Arthritis, Clinical Research, Musculoskeletal, Aged, Biomarkers, Case-Control Studies, Disease Progression, Female, Humans, Male, Middle Aged, Osteoarthritis, Knee, Pain Measurement, Predictive Value of Tests, Prognosis, ROC Curve, Radiography, Sensitivity and Specificity, Severity of Illness Index, OA Biomarkers Consortium, Disease Activity, Knee Osteoarthritis, Osteoarthritis, Immunology, Public Health and Health Services, Arthritis & Rheumatology, Clinical sciences

الوصف: ObjectiveTo investigate a targeted set of biochemical biomarkers as predictors of clinically relevant osteoarthritis (OA) progression.MethodsEighteen biomarkers were measured at baseline, 12 months (M) and 24 M in serum (s) and/or urine (u) of cases (n=194) from the OA initiative cohort with knee OA and radiographic and persistent pain worsening from 24 to 48 M and controls (n=406) not meeting both end point criteria. Primary analyses used multivariable regression models to evaluate the association between biomarkers (baseline and time-integrated concentrations (TICs) over 12 and 24 M, transposed to z values) and case status, adjusted for age, sex, body mass index, race, baseline radiographic joint space width, Kellgren-Lawrence grade, pain and pain medication use. For biomarkers with adjusted p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/18b9038bTest

المؤلفون: Roemer, Frank W, Guermazi, Ali, Collins, Jamie E, Losina, Elena, Nevitt, Michael C, Lynch, John A, Katz, Jeffrey N, Kwoh, C Kent, Kraus, Virginia B, Hunter, David J

المصدر: BMC musculoskeletal disorders. 17(1)

مصطلحات موضوعية: Cartilage, Articular, Menisci, Tibial, Bone Marrow, Humans, Osteoarthritis, Knee, Synovitis, Disease Progression, Magnetic Resonance Imaging, Case-Control Studies, Aged, Middle Aged, Female, Male, Osteophyte, Biomarkers, MRI, Osteoarthritis, Progression, Scoring, Cartilage, Articular, Menisci, Tibial, Knee, Clinical Sciences, Orthopedics

الوصف: BackgroundTo describe the scoring methodology and MRI assessments used to evaluate the cross-sectional features observed in cases and controls, to define change over time for different MRI features, and to report the extent of changes over a 24-month period in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium study nested within the larger Osteoarthritis Initiative (OAI) Study.MethodsWe conducted a nested case-control study. Cases (n = 406) were knees having both radiographic and pain progression. Controls (n = 194) were knee osteoarthritis subjects who did not meet the case definition. Groups were matched for Kellgren-Lawrence grade and body mass index. MRIs were acquired using 3 T MRI systems and assessed using the semi-quantitative MOAKS system. MRIs were read at baseline and 24 months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. We provide the definition and distribution of change in these biomarkers over time.ResultsSeventy-three percent of the cases had subregions with BML worsening (vs. 66 % in controls) (p = 0.102). Little change in osteophytes was seen over 24 months. Twenty-eight percent of cases and 10 % of controls had worsening in meniscal scores in at least one subregion (p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3d57p99kTest

المؤلفون: Roemer, Frank W, Guermazi, Ali, Collins, Jamie E, Losina, Elena, Nevitt, Michael C, Lynch, John A, Katz, Jeffrey N, Kwoh, C Kent, Kraus, Virginia B, Hunter, David J

المصدر: BMC musculoskeletal disorders. 17(1)

مصطلحات موضوعية: Cartilage, Articular, Menisci, Tibial, Bone Marrow, Humans, Osteoarthritis, Knee, Synovitis, Disease Progression, Magnetic Resonance Imaging, Case-Control Studies, Aged, Middle Aged, Female, Male, Osteophyte, Biomarkers, MRI, Osteoarthritis, Progression, Scoring, Chronic Pain, Arthritis, Pain Research, Clinical Research, Musculoskeletal, Clinical Sciences, Orthopedics

الوصف: BackgroundTo describe the scoring methodology and MRI assessments used to evaluate the cross-sectional features observed in cases and controls, to define change over time for different MRI features, and to report the extent of changes over a 24-month period in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium study nested within the larger Osteoarthritis Initiative (OAI) Study.MethodsWe conducted a nested case-control study. Cases (n = 406) were knees having both radiographic and pain progression. Controls (n = 194) were knee osteoarthritis subjects who did not meet the case definition. Groups were matched for Kellgren-Lawrence grade and body mass index. MRIs were acquired using 3 T MRI systems and assessed using the semi-quantitative MOAKS system. MRIs were read at baseline and 24 months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. We provide the definition and distribution of change in these biomarkers over time.ResultsSeventy-three percent of the cases had subregions with BML worsening (vs. 66 % in controls) (p = 0.102). Little change in osteophytes was seen over 24 months. Twenty-eight percent of cases and 10 % of controls had worsening in meniscal scores in at least one subregion (p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3d57p99kTest