首页 > 最新文献

Frontiers in Musculoskeletal Disorders最新文献

英文 中文
Assessment of fitting methods and variability of IVIM parameters in muscles of the lumbar spine at rest 评估拟合方法和静态腰椎肌肉 IVIM 参数的可变性
Pub Date : 2024-04-11 DOI: 10.3389/fmscd.2024.1386276
Erin K. Englund, David B. Berry, John J. Behun, Lawrence R. Frank, Samuel R. Ward, Bahar Shahidi
Intravoxel incoherent motion (IVIM) MRI provides insight into tissue diffusion and perfusion. Here, estimates of perfusion fraction (f), pseudo-diffusion coefficient (D*), and diffusion coefficient (D) obtained via different fitting methods are compared to ascertain (1) the optimal analysis strategy for muscles of the lumbar spine and (2) repeatability of IVIM parameters in skeletal muscle at rest. Diffusion-weighted images were acquired in the lumbar spine at rest in 15 healthy participants. Data were fit to the bi-exponential IVIM model to estimate f, D* and D using three variably segmented approaches based on non-linear least squares fitting, and a Bayesian fitting method. Assuming that perfusion and diffusion are temporally stable in skeletal muscle at rest, and spatially uniform within a spinal segment, the optimal analysis strategy was determined as the approach with the lowest temporal or spatial variation and smallest residual between measured and fit data. Inter-session repeatability of IVIM parameters was evaluated in a subset of 11 people. Finally, simulated IVIM signal at varying signal to noise ratio were evaluated to understand precision and bias. Experimental results showed that IVIM parameter values differed depending on the fitting method. A three-step non-linear least squares fitting approach, where D, f, and D* were estimated sequentially, generally yielded the lowest spatial and temporal variation. Solving all parameters simultaneously yielded the lowest residual between measured and fit data, however there was substantial spatial and temporal variability. Results obtained by Bayesian fitting had high spatial and temporal variability in addition to a large residual between measured and fit data. Simulations showed that all fitting methods can fit the IVIM data at signal to noise ratios >35, and that D* was the most challenging to accurately obtain. Overall, this study motivates use of a three-step non-linear least squares fitting strategy to quantify IVIM parameters in skeletal muscle.
体细胞内非相干运动(IVIM)核磁共振成像(MRI)有助于深入了解组织的弥散和灌注情况。本文比较了通过不同拟合方法获得的灌注分数(f)、伪扩散系数(D*)和扩散系数(D)的估计值,以确定(1)腰椎肌肉的最佳分析策略和(2)静息状态下骨骼肌中 IVIM 参数的可重复性。研究人员采集了 15 名健康参与者静止时腰椎的扩散加权图像。使用基于非线性最小二乘法拟合的三种可变分段方法和贝叶斯拟合方法,将数据拟合到双指数 IVIM 模型,以估计 f、D* 和 D。假定骨骼肌在静止状态下的灌注和扩散在时间上是稳定的,在脊柱节段内的空间上是均匀的,最佳分析策略被确定为时间或空间变化最小、测量数据与拟合数据之间的残差最小的方法。对 11 人的子集进行了 IVIM 参数的会话间重复性评估。最后,对不同信噪比的模拟 IVIM 信号进行了评估,以了解精度和偏差。实验结果表明,IVIM 参数值因拟合方法的不同而不同。三步非线性最小二乘法拟合方法(D、f 和 D* 依次估算)通常能产生最小的空间和时间变化。同时求解所有参数可使测量数据与拟合数据之间的残差最小,但仍存在很大的时空差异。贝叶斯拟合法得到的结果除了测量数据与拟合数据之间的残差较大外,时空变异性也很高。模拟显示,所有拟合方法都能在信噪比大于 35 时拟合 IVIM 数据,而 D* 是最难准确获得的。总之,这项研究鼓励使用三步非线性最小二乘法拟合策略来量化骨骼肌中的 IVIM 参数。
{"title":"Assessment of fitting methods and variability of IVIM parameters in muscles of the lumbar spine at rest","authors":"Erin K. Englund, David B. Berry, John J. Behun, Lawrence R. Frank, Samuel R. Ward, Bahar Shahidi","doi":"10.3389/fmscd.2024.1386276","DOIUrl":"https://doi.org/10.3389/fmscd.2024.1386276","url":null,"abstract":"Intravoxel incoherent motion (IVIM) MRI provides insight into tissue diffusion and perfusion. Here, estimates of perfusion fraction (f), pseudo-diffusion coefficient (D*), and diffusion coefficient (D) obtained via different fitting methods are compared to ascertain (1) the optimal analysis strategy for muscles of the lumbar spine and (2) repeatability of IVIM parameters in skeletal muscle at rest. Diffusion-weighted images were acquired in the lumbar spine at rest in 15 healthy participants. Data were fit to the bi-exponential IVIM model to estimate f, D* and D using three variably segmented approaches based on non-linear least squares fitting, and a Bayesian fitting method. Assuming that perfusion and diffusion are temporally stable in skeletal muscle at rest, and spatially uniform within a spinal segment, the optimal analysis strategy was determined as the approach with the lowest temporal or spatial variation and smallest residual between measured and fit data. Inter-session repeatability of IVIM parameters was evaluated in a subset of 11 people. Finally, simulated IVIM signal at varying signal to noise ratio were evaluated to understand precision and bias. Experimental results showed that IVIM parameter values differed depending on the fitting method. A three-step non-linear least squares fitting approach, where D, f, and D* were estimated sequentially, generally yielded the lowest spatial and temporal variation. Solving all parameters simultaneously yielded the lowest residual between measured and fit data, however there was substantial spatial and temporal variability. Results obtained by Bayesian fitting had high spatial and temporal variability in addition to a large residual between measured and fit data. Simulations showed that all fitting methods can fit the IVIM data at signal to noise ratios >35, and that D* was the most challenging to accurately obtain. Overall, this study motivates use of a three-step non-linear least squares fitting strategy to quantify IVIM parameters in skeletal muscle.","PeriodicalId":507589,"journal":{"name":"Frontiers in Musculoskeletal Disorders","volume":"11 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140714250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tendon evaluation with ultrashort echo time (UTE) MRI: a systematic review 利用超短回波时间(UTE)磁共振成像对肌腱进行评估:系统综述
Pub Date : 2024-03-15 DOI: 10.3389/fmscd.2024.1324050
B. Malhi, H. Jang, M. Malhi, David B. Berry, S. Jerban
Tendon disease ranks among the leading reasons patients consult their general practitioners, comprising approximately one-third of musculoskeletal appointments. Magnetic resonance imaging (MRI) is regarded as the gold standard for assessing tendons. Due to their short transverse relaxation time (T2), Tendons show up as a signal void in conventional MRI scans, which employ sequences with echo times (TEs) around several milliseconds. Ultrashort echo time (UTE) sequences utilize TEs that are 100–1,000 times shorter than those used in conventional sequences. This enables the direct visualization of tendons and assessment of their relaxation times, which is the basis for quantitative MRI. A systematic review was conducted on publications after 1990 in Google Scholar and PubMed databases. The search terms “ultrashort echo time,” “tendon,” and “UTE” were used to identify studies related to this investigation. This review discussed the current knowledge in quantitative UTE-MRI imaging of tendons. Quantitative UTE-T1, UTE-T2*, UTE-MT, and UTE-T1ρ techniques were described, and their reported applications in the literature were summarized in this review. We also discussed the advantages and challenges of these techniques and how these quantitative biomarkers may change in response to tendon pathology.
肌腱疾病是患者向全科医生咨询的主要原因之一,约占肌肉骨骼诊疗的三分之一。磁共振成像(MRI)被认为是评估肌腱的黄金标准。由于肌腱的横向弛豫时间(T2)较短,因此在采用回波时间(TE)约为几毫秒的序列的传统磁共振成像扫描中,肌腱显示为信号空白。超短回波时间(UTE)序列采用的回波时间比传统序列短 100-1000 倍。这样就能直接观察肌腱并评估其弛豫时间,这是定量磁共振成像的基础。我们对谷歌学术和 PubMed 数据库中 1990 年以后的出版物进行了系统性回顾。搜索关键词为 "超短回波时间"、"肌腱 "和 "UTE",以确定与该调查相关的研究。本综述讨论了肌腱定量UTE-MRI成像的现有知识。本综述介绍了定量UTE-T1、UTE-T2*、UTE-MT 和 UTE-T1ρ 技术,并总结了这些技术在文献中的应用。我们还讨论了这些技术的优势和挑战,以及这些定量生物标记物如何随肌腱病理变化而变化。
{"title":"Tendon evaluation with ultrashort echo time (UTE) MRI: a systematic review","authors":"B. Malhi, H. Jang, M. Malhi, David B. Berry, S. Jerban","doi":"10.3389/fmscd.2024.1324050","DOIUrl":"https://doi.org/10.3389/fmscd.2024.1324050","url":null,"abstract":"Tendon disease ranks among the leading reasons patients consult their general practitioners, comprising approximately one-third of musculoskeletal appointments. Magnetic resonance imaging (MRI) is regarded as the gold standard for assessing tendons. Due to their short transverse relaxation time (T2), Tendons show up as a signal void in conventional MRI scans, which employ sequences with echo times (TEs) around several milliseconds. Ultrashort echo time (UTE) sequences utilize TEs that are 100–1,000 times shorter than those used in conventional sequences. This enables the direct visualization of tendons and assessment of their relaxation times, which is the basis for quantitative MRI. A systematic review was conducted on publications after 1990 in Google Scholar and PubMed databases. The search terms “ultrashort echo time,” “tendon,” and “UTE” were used to identify studies related to this investigation. This review discussed the current knowledge in quantitative UTE-MRI imaging of tendons. Quantitative UTE-T1, UTE-T2*, UTE-MT, and UTE-T1ρ techniques were described, and their reported applications in the literature were summarized in this review. We also discussed the advantages and challenges of these techniques and how these quantitative biomarkers may change in response to tendon pathology.","PeriodicalId":507589,"journal":{"name":"Frontiers in Musculoskeletal Disorders","volume":"47 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Elastic modulus of cadaveric acetabular labrum correlates with ultrashort echo time (UTE) apparent spin-spin (T2*) and spin-lattice (T1) relaxation times 尸体髋臼唇的弹性模量与超短回波时间(UTE)表观自旋-自旋(T2*)和自旋-晶格(T1)弛豫时间的关系
Pub Date : 2024-03-01 DOI: 10.3389/fmscd.2024.1359296
Dina Moazamian, T. Hananouchi, Hamidreza Shaterian Mohammadi, Alireza Tayarani, Erik W. Dorthé, Darryl D'Lima, Saeed Jerban
The acetabulum labrum plays a critical role in hip function. Medical imaging techniques for measuring changes in labral properties due to its degeneration may help improve our knowledge of its role in hip osteoarthritis (OA). This study aimed to explore the correlation between the mechanical properties of the acetabulum labrum and ultrashort echo time (UTE) MRI properties.Acetabular labrum specimens were dissected from 12 fresh-frozen human cadaveric hip joints (64.6 ± 11.6 years old at the time of death, 7 female). UTE Cones sequences were used to measure apparent spin-spin (T2*) and spin-lattice (T1) relaxation times using a knee coil at 3 T in a clinical MR scanner. The stiffness and the elastic modulus (E) of the specimens were measured before MRI scans using uniaxial tensile tests. Spearman's rank correlation coefficients of Tendons' UTE-T2* and -T1 with their mechanical properties were calculated.The human labrum specimen elastic modulus showed a significant inverse correlation with UTE-T2* (R = −0.66, P < 0.01) and with UTE-T1 (R = −0.56, P = 0.05). The stiffness of the specimens showed significant inverse correlations with UTE-T2* (R = −0.53, P = 0.01) and UTE-T1 (R = −0.63, P = 0.02).This study highlighted the potential of UTE-MRI techniques for the mechanical assessment of the acetabular labrum. UTE-MRI may improve labrum degeneration detection and monitoring, which requires further investigations.
髋臼唇在髋关节功能中起着至关重要的作用。通过医学成像技术测量髋臼唇退化导致的髋臼唇特性变化,有助于我们更好地了解髋臼唇在髋关节骨性关节炎(OA)中的作用。本研究旨在探索髋臼唇的机械性能与超短回波时间(UTE)MRI 性能之间的相关性。髋臼唇标本从 12 个新鲜冷冻的人类尸体髋关节(死亡时年龄为 64.6 ± 11.6 岁,其中 7 人为女性)中剖取出。在临床磁共振扫描仪中,使用膝线圈在 3 T 下测量表观自旋-自旋(T2*)和自旋-晶格(T1)弛豫时间,并使用 UTE Cones 序列。在进行核磁共振扫描之前,使用单轴拉伸试验测量了试样的刚度和弹性模量(E)。计算了肌腱的UTE-T2*和-T1与其机械性能的斯皮尔曼秩相关系数。人体韧带标本的弹性模量与UTE-T2*(R = -0.66,P < 0.01)和UTE-T1(R = -0.56,P = 0.05)呈显著的反相关。标本的硬度与 UTE-T2* (R = -0.53, P = 0.01) 和 UTE-T1 (R = -0.63, P = 0.02) 呈显著的反相关。UTE-MRI可改善髋臼唇退变的检测和监测,这需要进一步研究。
{"title":"Elastic modulus of cadaveric acetabular labrum correlates with ultrashort echo time (UTE) apparent spin-spin (T2*) and spin-lattice (T1) relaxation times","authors":"Dina Moazamian, T. Hananouchi, Hamidreza Shaterian Mohammadi, Alireza Tayarani, Erik W. Dorthé, Darryl D'Lima, Saeed Jerban","doi":"10.3389/fmscd.2024.1359296","DOIUrl":"https://doi.org/10.3389/fmscd.2024.1359296","url":null,"abstract":"The acetabulum labrum plays a critical role in hip function. Medical imaging techniques for measuring changes in labral properties due to its degeneration may help improve our knowledge of its role in hip osteoarthritis (OA). This study aimed to explore the correlation between the mechanical properties of the acetabulum labrum and ultrashort echo time (UTE) MRI properties.Acetabular labrum specimens were dissected from 12 fresh-frozen human cadaveric hip joints (64.6 ± 11.6 years old at the time of death, 7 female). UTE Cones sequences were used to measure apparent spin-spin (T2*) and spin-lattice (T1) relaxation times using a knee coil at 3 T in a clinical MR scanner. The stiffness and the elastic modulus (E) of the specimens were measured before MRI scans using uniaxial tensile tests. Spearman's rank correlation coefficients of Tendons' UTE-T2* and -T1 with their mechanical properties were calculated.The human labrum specimen elastic modulus showed a significant inverse correlation with UTE-T2* (R = −0.66, P < 0.01) and with UTE-T1 (R = −0.56, P = 0.05). The stiffness of the specimens showed significant inverse correlations with UTE-T2* (R = −0.53, P = 0.01) and UTE-T1 (R = −0.63, P = 0.02).This study highlighted the potential of UTE-MRI techniques for the mechanical assessment of the acetabular labrum. UTE-MRI may improve labrum degeneration detection and monitoring, which requires further investigations.","PeriodicalId":507589,"journal":{"name":"Frontiers in Musculoskeletal Disorders","volume":"14 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140087557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of neuromuscular electrical stimulation therapy using the StimaWELL 120MTRS system on erector spinae morphology in patients with chronic low back pain 使用 StimaWELL 120MTRS 系统的神经肌肉电刺激疗法对慢性腰痛患者竖脊肌形态的影响
Pub Date : 2023-12-13 DOI: 10.3389/fmscd.2023.1240331
Loïck Balthazard, Daniel Wolfe, Maryse Fortin
Chronic low-back pain (CLBP) is the leading cause of disability globally. CLBP is associated with a decrease in cross-sectional area (CSA) and an increase in fat infiltration (FI) of the lumbar paraspinal muscles, such as erector spinae (ES). Neuromuscular electrical stimulation (NMES) therapy showed promising outcomes in the treatment of CLBP, but its impact on ES morphology is unknown. Therefore, this study aimed to compare the effect of two NMES protocols on ES CSA and FI in a cohort of patients with CLBP.Twenty participants with CLBP (aged 18–60 years old) were randomized into the phasic (n = 11) or the combined (n = 9) protocol groups. They completed a 10-week (20 sessions) NMES therapy using the StimaWELL 120MTRS device. Magnetic resonance imaging (MRI) examinations were acquired at baseline and post-intervention to assess ES CSA and FI at all spinal levels (e.g., L1–L2 to L5–S1). Statistical analyses were conducted to assess the effect of the intervention on ES morphology irrespective of groups, and between groups.Irrespective of groups, participants showed a decrease in left ES CSA (p = 0.005) at L2–L3 and left ES FI at L5–S1 (p = 0.040). We also observed a greater decrease in ES FI in the combined protocol compared to the phasic protocol on the right side at L3–L4 (p = 0.029) and L4–L5 (p = 0.015). No other changes in ES CSA or FI were observed (p > 0.05).NMES therapy demonstrated minimal effect on ES morphology in patients with CLBP. Further research is needed to extend and confirm our findings.
慢性腰背痛(CLBP)是导致全球残疾的主要原因。慢性腰背痛与腰椎旁肌肉(如竖脊肌)横截面积(CSA)的减少和脂肪浸润(FI)的增加有关。神经肌肉电刺激(NMES)疗法在治疗腰背痛方面取得了良好的效果,但其对 ES 形态的影响尚不清楚。因此,本研究旨在比较两种 NMES 方案对一组 CLBP 患者的 ES CSA 和 FI 的影响。20 名 CLBP 患者(18-60 岁)被随机分为相位方案组(n = 11)或联合方案组(n = 9)。他们使用 StimaWELL 120MTRS 设备完成了为期 10 周(20 次)的 NMES 治疗。在基线和干预后进行磁共振成像(MRI)检查,以评估所有脊柱水平(如 L1-L2 至 L5-S1)的 ES CSA 和 FI。我们进行了统计分析,以评估干预对ES形态的影响(不分组别)和组间影响。我们还观察到,在 L3-L4 (p = 0.029)和 L4-L5 (p = 0.015)处,联合方案与相位方案相比,右侧 ES FI 的下降幅度更大。没有观察到 ES CSA 或 FI 发生其他变化(p > 0.05)。NMES疗法对CLBP患者的ES形态学影响甚微。
{"title":"Effect of neuromuscular electrical stimulation therapy using the StimaWELL 120MTRS system on erector spinae morphology in patients with chronic low back pain","authors":"Loïck Balthazard, Daniel Wolfe, Maryse Fortin","doi":"10.3389/fmscd.2023.1240331","DOIUrl":"https://doi.org/10.3389/fmscd.2023.1240331","url":null,"abstract":"Chronic low-back pain (CLBP) is the leading cause of disability globally. CLBP is associated with a decrease in cross-sectional area (CSA) and an increase in fat infiltration (FI) of the lumbar paraspinal muscles, such as erector spinae (ES). Neuromuscular electrical stimulation (NMES) therapy showed promising outcomes in the treatment of CLBP, but its impact on ES morphology is unknown. Therefore, this study aimed to compare the effect of two NMES protocols on ES CSA and FI in a cohort of patients with CLBP.Twenty participants with CLBP (aged 18–60 years old) were randomized into the phasic (n = 11) or the combined (n = 9) protocol groups. They completed a 10-week (20 sessions) NMES therapy using the StimaWELL 120MTRS device. Magnetic resonance imaging (MRI) examinations were acquired at baseline and post-intervention to assess ES CSA and FI at all spinal levels (e.g., L1–L2 to L5–S1). Statistical analyses were conducted to assess the effect of the intervention on ES morphology irrespective of groups, and between groups.Irrespective of groups, participants showed a decrease in left ES CSA (p = 0.005) at L2–L3 and left ES FI at L5–S1 (p = 0.040). We also observed a greater decrease in ES FI in the combined protocol compared to the phasic protocol on the right side at L3–L4 (p = 0.029) and L4–L5 (p = 0.015). No other changes in ES CSA or FI were observed (p > 0.05).NMES therapy demonstrated minimal effect on ES morphology in patients with CLBP. Further research is needed to extend and confirm our findings.","PeriodicalId":507589,"journal":{"name":"Frontiers in Musculoskeletal Disorders","volume":"370 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139181125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Screening practices, efficacy, safety and adherence to biologic therapies in a South African tertiary hospital 南非一家三级医院的生物疗法筛查方法、疗效、安全性和依从性
Pub Date : 2023-12-13 DOI: 10.3389/fmscd.2023.1281548
Mohammed Awad Eltoum Ahmed, Christiaan Scott, A. Gcelu, Jonel Steffen, Thuraya Isaacs, Bridget Hodkinson
The high cost and concern of adverse events, particularly infections, limit the use of biologic therapies. We undertook this retrospective study to document their use for immune-mediated diseases, and explore the screening practices, efficacy, safety, and adherence to bDMARDs in a tertiary hospital.A folder review of all adult and paediatric patients treated for IMDs with bDMARDs. Changes in disease activity were measured by disease-specific tools at 6, 12, 24-months and at the last available visit, and patient adherence to bDMARDs was explored by folder and pharmacy record review.We studied 120 folders; 145 bDMARDs were prescribed (23 patients switched bDMARD). BDMARDs prescribed included tumour necrosis factor inhibitors (TNFi) (76), rituximab (54), tocilizumab (9), anakinra (3), abatacept (1), ustekinumab (1) and tofacitinib (1). The vast majority of patients had an excellent response and achieved low disease activity or remission at their last available visit. Adverse events included severe infection (9) including two cases of tuberculosis (TB), mild skin reaction (6) and severe infusion reactions (4). Therapy was discontinued in 13 patients, most commonly due to infection (5), lack of response (4), or poor adherence (3). Poor adherence was noted in 8/120 (6.7%). Complete latent TB infection screening was performed in only 35 patients (29.2%). Screening for Hepatitis B, C and HIV was performed in 28 (23.3%), 62 (51.7%) and 61 (50.8%) patients, respectively. Only 20.8% and 20.0% received the influenza and pneumococcal vaccination.Biologic therapy was effective, and the most important serious adverse effect was infection, which was significantly associated with TNFi therapy. Vaccination and screening for TB, viral hepatitis and HIV was suboptimal. Of concern, poor adherence to bDMARDs was frequently encountered.
高昂的费用和对不良反应(尤其是感染)的担忧限制了生物疗法的使用。我们开展了这项回顾性研究,以记录这些药物在免疫介导疾病中的使用情况,并探讨一家三级医院中 bDMARDs 的筛查方法、疗效、安全性和依从性。在6、12、24个月和最后一次就诊时,通过疾病特异性工具测量疾病活动性的变化,并通过文件夹和药房记录审查探讨患者对bDMARDs的依从性。我们研究了120个文件夹;开出了145种bDMARDs处方(23名患者更换了bDMARD)。开具的 BDMARDs 包括肿瘤坏死因子抑制剂 (TNFi) (76)、利妥昔单抗 (54)、妥西珠单抗 (9)、阿那曲 (3)、阿巴他赛 (1)、乌斯特库单抗 (1) 和托法替尼 (1)。绝大多数患者反应良好,在最后一次就诊时疾病活动度较低或病情缓解。不良反应包括严重感染(9 例),其中包括 2 例肺结核(TB)、轻微皮肤反应(6 例)和严重输液反应(4 例)。13名患者停止了治疗,最常见的原因是感染(5例)、缺乏反应(4例)或依从性差(3例)。8/120(6.7%)例患者的依从性较差。只有 35 名患者(29.2%)进行了全面的肺结核潜伏感染筛查。分别有 28 名(23.3%)、62 名(51.7%)和 61 名(50.8%)患者进行了乙肝、丙肝和 HIV 筛查。只有20.8%和20.0%的患者接种了流感疫苗和肺炎球菌疫苗。生物治疗效果显著,最重要的严重不良反应是感染,这与TNFi治疗密切相关。结核病、病毒性肝炎和艾滋病的疫苗接种和筛查效果不佳。值得关注的是,bDMARDs的依从性较差。
{"title":"Screening practices, efficacy, safety and adherence to biologic therapies in a South African tertiary hospital","authors":"Mohammed Awad Eltoum Ahmed, Christiaan Scott, A. Gcelu, Jonel Steffen, Thuraya Isaacs, Bridget Hodkinson","doi":"10.3389/fmscd.2023.1281548","DOIUrl":"https://doi.org/10.3389/fmscd.2023.1281548","url":null,"abstract":"The high cost and concern of adverse events, particularly infections, limit the use of biologic therapies. We undertook this retrospective study to document their use for immune-mediated diseases, and explore the screening practices, efficacy, safety, and adherence to bDMARDs in a tertiary hospital.A folder review of all adult and paediatric patients treated for IMDs with bDMARDs. Changes in disease activity were measured by disease-specific tools at 6, 12, 24-months and at the last available visit, and patient adherence to bDMARDs was explored by folder and pharmacy record review.We studied 120 folders; 145 bDMARDs were prescribed (23 patients switched bDMARD). BDMARDs prescribed included tumour necrosis factor inhibitors (TNFi) (76), rituximab (54), tocilizumab (9), anakinra (3), abatacept (1), ustekinumab (1) and tofacitinib (1). The vast majority of patients had an excellent response and achieved low disease activity or remission at their last available visit. Adverse events included severe infection (9) including two cases of tuberculosis (TB), mild skin reaction (6) and severe infusion reactions (4). Therapy was discontinued in 13 patients, most commonly due to infection (5), lack of response (4), or poor adherence (3). Poor adherence was noted in 8/120 (6.7%). Complete latent TB infection screening was performed in only 35 patients (29.2%). Screening for Hepatitis B, C and HIV was performed in 28 (23.3%), 62 (51.7%) and 61 (50.8%) patients, respectively. Only 20.8% and 20.0% received the influenza and pneumococcal vaccination.Biologic therapy was effective, and the most important serious adverse effect was infection, which was significantly associated with TNFi therapy. Vaccination and screening for TB, viral hepatitis and HIV was suboptimal. Of concern, poor adherence to bDMARDs was frequently encountered.","PeriodicalId":507589,"journal":{"name":"Frontiers in Musculoskeletal Disorders","volume":"380 5-6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139181171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lumbar multifidus characteristics and body composition in university level athletes 大学水平运动员的腰部多裂肌特征和身体组成
Pub Date : 2023-11-30 DOI: 10.3389/fmscd.2023.1235114
Meagan Anstruther, Amanda Rizk, S. Frenette, Maryse Fortin
Body composition is well known to affect sport performance and previous studies suggested that structural and functional lumbar multifidus (LM) impairments in athletes were associated with low back pain and lower leg injuries. However few studies have examined the relationship between LM characteristics and body composition in athletic populations.This cross-sectional study included a total of 134 university varsity athletes (hockey, soccer, rugby, and football players). Ultrasound imaging was used to examined LM characteristics at the L5 bilaterally [e.g., size, thickness at rest, thickness during contraction, echo-intensity (EI) and % thickness change from rest to contraction] and body composition parameters (dual-energy x-ray absorptiometry). Pearson correlations were used to assess the relationship between LM characteristics and body composition parameters. One-way ANOVA assessed differences in LM characteristics and body composition between sports. All analyses were performed separately by sex.LM size and thickness were positively correlated with weight, height, lean body mass and total bone mass (male: r = 0.23–0.55, p < 0.01–0.05; female: r = 0.30–0.39, p < 0.01–0.05). LM EI was strongly correlated with % body fat (male: r = 0.62, female: r = 0.71, p < 0.01). LM thickness at rest (r = 0.42, p < 0.01) and contracted (r = 0.27, p < 0.05) were positively correlated and % thickness change was negatively correlated with % body fat in male athletes (r = −0.43, p < 0.01).The significant differences in body composition and LM characteristics between sports may be attributed to sport specific demands. Understanding connections between body composition and LM may aid in preseason screening for athletes at risk of low back pain or lower leg injuries during the season.
众所周知,身体成分会影响运动表现,以往的研究表明,运动员腰部多裂肌(LM)的结构性和功能性损伤与腰痛和小腿损伤有关。这项横断面研究共纳入了 134 名大学校队运动员(曲棍球、足球、橄榄球和橄榄球运动员)。这项横断面研究共纳入了 134 名大学校队运动员(曲棍球、足球、橄榄球和足球运动员)。研究使用超声波成像技术检测了双侧 L5 肌的特征[如大小、静止时的厚度、收缩时的厚度、回声强度(EI)和从静止到收缩的厚度变化百分比]以及身体成分参数(双能量 X 射线吸收测量法)。皮尔逊相关性用于评估 LM 特征与身体成分参数之间的关系。单因素方差分析评估了不同运动之间 LM 特征和身体成分的差异。LM 大小和厚度与体重、身高、瘦体重和总骨量呈正相关(男性:r = 0.23-0.55,p < 0.01-0.05;女性:r = 0.30-0.39,p < 0.01-0.05)。LM EI 与体脂率密切相关(男性:r = 0.62;女性:r = 0.71,p < 0.01)。在男性运动员中,静止时(r = 0.42,p < 0.01)和收缩时(r = 0.27,p < 0.05)的LM厚度呈正相关,厚度变化率与体脂率呈负相关(r = -0.43,p < 0.01)。了解身体成分与低密度脂蛋白之间的关系有助于在赛季前筛查有腰痛或小腿受伤风险的运动员。
{"title":"Lumbar multifidus characteristics and body composition in university level athletes","authors":"Meagan Anstruther, Amanda Rizk, S. Frenette, Maryse Fortin","doi":"10.3389/fmscd.2023.1235114","DOIUrl":"https://doi.org/10.3389/fmscd.2023.1235114","url":null,"abstract":"Body composition is well known to affect sport performance and previous studies suggested that structural and functional lumbar multifidus (LM) impairments in athletes were associated with low back pain and lower leg injuries. However few studies have examined the relationship between LM characteristics and body composition in athletic populations.This cross-sectional study included a total of 134 university varsity athletes (hockey, soccer, rugby, and football players). Ultrasound imaging was used to examined LM characteristics at the L5 bilaterally [e.g., size, thickness at rest, thickness during contraction, echo-intensity (EI) and % thickness change from rest to contraction] and body composition parameters (dual-energy x-ray absorptiometry). Pearson correlations were used to assess the relationship between LM characteristics and body composition parameters. One-way ANOVA assessed differences in LM characteristics and body composition between sports. All analyses were performed separately by sex.LM size and thickness were positively correlated with weight, height, lean body mass and total bone mass (male: r = 0.23–0.55, p < 0.01–0.05; female: r = 0.30–0.39, p < 0.01–0.05). LM EI was strongly correlated with % body fat (male: r = 0.62, female: r = 0.71, p < 0.01). LM thickness at rest (r = 0.42, p < 0.01) and contracted (r = 0.27, p < 0.05) were positively correlated and % thickness change was negatively correlated with % body fat in male athletes (r = −0.43, p < 0.01).The significant differences in body composition and LM characteristics between sports may be attributed to sport specific demands. Understanding connections between body composition and LM may aid in preseason screening for athletes at risk of low back pain or lower leg injuries during the season.","PeriodicalId":507589,"journal":{"name":"Frontiers in Musculoskeletal Disorders","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139198420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Frontiers in Musculoskeletal Disorders
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1