Pub Date : 2017-08-31DOI: 10.4172/2167-7921.1000250
B. Elnady, T. Elkhouly, M. Alshaar, Hawazen Alqahtani, M. Algethami, Abdulmajeed Algethami
Behcet's disease (BD) is a multisystem vasculitis of unknown origin that involves the parenchymal central nervous system (neuro-BD) in less than 10 percent of patients affecting both brain and spinal cord. We reported a rare case of 21-year-old male patient with NBD-myelitis in the form of neuromyelitis optica (NMO) which treated successfully with cyclophosphamide, with marvelous MRI radiographic regression as no disease activity was detected and the patient reported no adverse event, after six cyclophosphamide cycles, cervical MRI marked regression. This case may be an example for decision making and management in such rare cases.
{"title":"Neuromyelitis Optica in Behçet's Disease Successfully Treated with Radiographic MRI Regression: Case Report","authors":"B. Elnady, T. Elkhouly, M. Alshaar, Hawazen Alqahtani, M. Algethami, Abdulmajeed Algethami","doi":"10.4172/2167-7921.1000250","DOIUrl":"https://doi.org/10.4172/2167-7921.1000250","url":null,"abstract":"Behcet's disease (BD) is a multisystem vasculitis of unknown origin that involves the parenchymal central nervous system (neuro-BD) in less than 10 percent of patients affecting both brain and spinal cord. We reported a rare case of 21-year-old male patient with NBD-myelitis in the form of neuromyelitis optica (NMO) which treated successfully with cyclophosphamide, with marvelous MRI radiographic regression as no disease activity was detected and the patient reported no adverse event, after six cyclophosphamide cycles, cervical MRI marked regression. This case may be an example for decision making and management in such rare cases.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"2017 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48196399","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}
Pub Date : 2017-08-24DOI: 10.4172/2167-7921.1000247
E. RussellVickers
Unilateral osteoarthritis of the mandibular condyle is typically associated with trauma to the temporomandibular joint from sports activities, falls and criminal assaults. In this unusual case the complete destruction of the condyle occurred after a long difficult extraction of a 3rd molar wisdom tooth in a young adult. Downward and lateral pressure from a dental forceps extraction that was applied anterior to the angle of the mandible, combined with the masseter muscle acting as the fulcrum resulted in rapid and complete resorption of the condyle. Clinical signs showed a marked deviation of the maxillary-mandibular incisal midline and formation of an open bite malocclusion on the unaffected side. There was a restricted oral opening, difficulty in chewing food and the patient was psychologically depressed. Acute pain management was achieved with a soft diet, heat applications and non-steroidal antiinflammatory drugs. Long term pain management strategies included an explanation of current surgical techniques of temporalis muscle flap advancement and joint prosthesis, and the future potential of the ‘stem cell in bioscaffold’ approach for joint regeneration in this young patient.
{"title":"Iatrogenic Resorption of a Mandibular Condyle Following 3rd Molar Wisdom Tooth Surgery","authors":"E. RussellVickers","doi":"10.4172/2167-7921.1000247","DOIUrl":"https://doi.org/10.4172/2167-7921.1000247","url":null,"abstract":"Unilateral osteoarthritis of the mandibular condyle is typically associated with trauma to the temporomandibular joint from sports activities, falls and criminal assaults. In this unusual case the complete destruction of the condyle occurred after a long difficult extraction of a 3rd molar wisdom tooth in a young adult. Downward and lateral pressure from a dental forceps extraction that was applied anterior to the angle of the mandible, combined with the masseter muscle acting as the fulcrum resulted in rapid and complete resorption of the condyle. Clinical signs showed a marked deviation of the maxillary-mandibular incisal midline and formation of an open bite malocclusion on the unaffected side. There was a restricted oral opening, difficulty in chewing food and the patient was psychologically depressed. Acute pain management was achieved with a soft diet, heat applications and non-steroidal antiinflammatory drugs. Long term pain management strategies included an explanation of current surgical techniques of temporalis muscle flap advancement and joint prosthesis, and the future potential of the ‘stem cell in bioscaffold’ approach for joint regeneration in this young patient.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48442297","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}
Pub Date : 2017-08-24DOI: 10.4172/2167-7921.1000249
Khaled M Alsubiaee, Mohammad S Alshahrani, Alnashmi B Alazmi, Rifca A Alsadoon
Background: Implementing safety procedures and precautions minimize the risk of exposure to toxic chemicals and costs of a consequence of a hazardous work environment. Therefore, the aim of this study is to measure the perception of safety standards implementation at different laboratories at the Kingdom of Saudi Arabia. Methods: A cross-sectional study use questionnaire consists of 25 questions. A total of 73 employees, researchers, and students participate in questionnaires distributed in Riyadh, Dammam and Abha cities on 2016, May 10th to June 5th. Results: The majority of participants is male, living in Riyadh, married and has an education higher than secondary school. The age of participants is 28 ± 5 years. Conclusion: The study shows variations in the implementation of security measures and standards at laboratories in three different cities in Saudi Arabia. The Large-scale longitudinal study is recommended for next research.
{"title":"Implementation of Safety Standards in Saudi Arabian Scientific Laboratories: An Empirical Study","authors":"Khaled M Alsubiaee, Mohammad S Alshahrani, Alnashmi B Alazmi, Rifca A Alsadoon","doi":"10.4172/2167-7921.1000249","DOIUrl":"https://doi.org/10.4172/2167-7921.1000249","url":null,"abstract":"Background: Implementing safety procedures and precautions minimize the risk of exposure to toxic chemicals and costs of a consequence of a hazardous work environment. Therefore, the aim of this study is to measure the perception of safety standards implementation at different laboratories at the Kingdom of Saudi Arabia. \u0000Methods: A cross-sectional study use questionnaire consists of 25 questions. A total of 73 employees, researchers, and students participate in questionnaires distributed in Riyadh, Dammam and Abha cities on 2016, May 10th to June 5th. \u0000Results: The majority of participants is male, living in Riyadh, married and has an education higher than secondary school. The age of participants is 28 ± 5 years. \u0000Conclusion: The study shows variations in the implementation of security measures and standards at laboratories in three different cities in Saudi Arabia. The Large-scale longitudinal study is recommended for next research.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48711204","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}
Pub Date : 2017-08-24DOI: 10.4172/2167-7921.1000248
E. S. Stumberga, G. Krūmiņa, H. Mikažāne, S. Seņkāne, Liana Ziediana
Introduction: Carotid ultrasound based on assessment of intima media thickness (IMT) and presence of plaques has been considered to be a cheap and efficient way to measure clinical atherosclerosis. Both carotid IMT and carotid plaques have been proved to be good predictors of CV (cardiovascular) events of rheumatic patients, offering additional value to the traditional risk scores in the prediction of CVD (cardiovascular disease). The objective of the study was to determine whether atherosclerotic brachiocephalic plaques, traditional CV risk factors as well as RA (rheumatoid arthritis) disease activity have an effect on the risk of myocardial infarction in RA patients with comparable disease duration. Methods: A case control study was performed within the prospective cohort of 92 RA patients, out of them were female 81%, aged 40-84. In cases there were 20 patients who had developed their first myocardial infarction (MI) after the diagnosis of RA. The case and control groups were matched by sex and disease duration. RA activity and severity were determined by DAS28 scores and HAQ questionnaires, ultrasonography of synovitis. Information about traditional (BMI, smoking history, diabetes mellitus, primary arterial hypertension) and disease-specific risk factors was thoroughly gathered. AIP (atherogenic index of plasma (log10 TG/HDLC) was calculated. Brachiocephalic artery hemodynamic parameters, IMT and plaques were assessed using the high resolution B mode and Doppler–mode ultrasound. Results: Patients with MI (myocardial infarction) were older in comparison to control RA patients, mostly females (85%). The case and control groups were matched by disease duration and gender. One of the classic risk factors for 95% of patients with MI had been suffering from arterial hypertension (HTN). The odds ratio for MI patients with HTN was 12 (95% CI 1.5 to 95.4). Seropositivity, erosions and synovitis of small joints, joint replacement surgery was similar for case and control groups. Seropositivity was found in 95% of the case group. Despite that, RF (rheumatoid factor) was more presented in case group. High RA disease activity (DAS 28 above 5.1) was observed among 55% of patients with MI (p=0.007). The odds ratio for MI patients with a high disease activity (DAS 28>5.1) was 3.95 (95% CI 1.40 to 11.13). About 50% of cases were smokers. Smoking status, BMI, diabetes, atherogenix index did not differ between cases and controls. IMT (intima media thickness) dx et sin were age dependent, correlated with hemodinamicaly non-significant atherosclerotic plaques. Furthermore, atherosclerotic lesions were not more pronounced in RA patients with versus without CVD. Non-hemodinamicaly significant atherosclerotic plaques and IMT sin were associated with hypertensive disease. Conclusion: In our case-control study, MI was observed in older individuals RF positive, being positively associated with systolic arterial hypertension. Increased risk to MI was found in patients
{"title":"Are Brachiocephalic Atherosclerotic Plaques to be considered as Predictors of Myocardial Infarction in Rheumatoid Arthritis Patients","authors":"E. S. Stumberga, G. Krūmiņa, H. Mikažāne, S. Seņkāne, Liana Ziediana","doi":"10.4172/2167-7921.1000248","DOIUrl":"https://doi.org/10.4172/2167-7921.1000248","url":null,"abstract":"Introduction: Carotid ultrasound based on assessment of intima media thickness (IMT) and presence of plaques has been considered to be a cheap and efficient way to measure clinical atherosclerosis. Both carotid IMT and carotid plaques have been proved to be good predictors of CV (cardiovascular) events of rheumatic patients, offering additional value to the traditional risk scores in the prediction of CVD (cardiovascular disease). The objective of the study was to determine whether atherosclerotic brachiocephalic plaques, traditional CV risk factors as well as RA (rheumatoid arthritis) disease activity have an effect on the risk of myocardial infarction in RA patients with comparable disease duration. \u0000Methods: A case control study was performed within the prospective cohort of 92 RA patients, out of them were female 81%, aged 40-84. In cases there were 20 patients who had developed their first myocardial infarction (MI) after the diagnosis of RA. The case and control groups were matched by sex and disease duration. RA activity and severity were determined by DAS28 scores and HAQ questionnaires, ultrasonography of synovitis. Information about traditional (BMI, smoking history, diabetes mellitus, primary arterial hypertension) and disease-specific risk factors was thoroughly gathered. AIP (atherogenic index of plasma (log10 TG/HDLC) was calculated. Brachiocephalic artery hemodynamic parameters, IMT and plaques were assessed using the high resolution B mode and Doppler–mode ultrasound. \u0000Results: Patients with MI (myocardial infarction) were older in comparison to control RA patients, mostly females (85%). The case and control groups were matched by disease duration and gender. One of the classic risk factors for 95% of patients with MI had been suffering from arterial hypertension (HTN). The odds ratio for MI patients with HTN was 12 (95% CI 1.5 to 95.4). Seropositivity, erosions and synovitis of small joints, joint replacement surgery was similar for case and control groups. Seropositivity was found in 95% of the case group. Despite that, RF (rheumatoid factor) was more presented in case group. High RA disease activity (DAS 28 above 5.1) was observed among 55% of patients with MI (p=0.007). The odds ratio for MI patients with a high disease activity (DAS 28>5.1) was 3.95 (95% CI 1.40 to 11.13). About 50% of cases were smokers. Smoking status, BMI, diabetes, atherogenix index did not differ between cases and controls. IMT (intima media thickness) dx et sin were age dependent, correlated with hemodinamicaly non-significant atherosclerotic plaques. Furthermore, atherosclerotic lesions were not more pronounced in RA patients with versus without CVD. Non-hemodinamicaly significant atherosclerotic plaques and IMT sin were associated with hypertensive disease. \u0000Conclusion: In our case-control study, MI was observed in older individuals RF positive, being positively associated with systolic arterial hypertension. Increased risk to MI was found in patients","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46872096","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}
Pub Date : 2017-07-20DOI: 10.4172/2167-7921.1000E116
P. Lee, A. Davies, Bethan Whiting, S. Masud
Catering for all educational levels, ethnicities and ages with medical consent has always been difficult. There is a general consensus in the literature that there is a need for a review of treatment consent to ensure patient comprehension and satisfaction. In recent years, the medical profession has found an increase in the cost of litigation. Marino et al. [1] highlighted that in Italy Trauma and Orthopaedics is the “most sued” specialty and Kadakia et al. [2] showed that patients actually have very little understanding when questioned about their own trauma. The study found that less than half of the patients knew what bone they had fractured and less than 20% knew their recovery time. This suggests the need for a reform in how patients are given information to ensure higher comprehension and satisfaction in surgical procedures. The General Medical Council [3], in “Good Medical Practice” 2013, detailed that exchange of information is key to good decision making and so how are patients expected to make informed decisions when they do not know the information? A recent supreme court judgement has altered the legal landscape in the consent process in the UK. The outcome of the Montgomery v Lanarkshire Health Board legal battle has become a landmark Scottish case and has had a profound effect on the British legal system as the judgment disseminated from the highest British court.
{"title":"Consent for Treatment in the UK - 2017 Update","authors":"P. Lee, A. Davies, Bethan Whiting, S. Masud","doi":"10.4172/2167-7921.1000E116","DOIUrl":"https://doi.org/10.4172/2167-7921.1000E116","url":null,"abstract":"Catering for all educational levels, ethnicities and ages with medical consent has always been difficult. There is a general consensus in the literature that there is a need for a review of treatment consent to ensure patient comprehension and satisfaction. In recent years, the medical profession has found an increase in the cost of litigation. Marino et al. [1] highlighted that in Italy Trauma and Orthopaedics is the “most sued” specialty and Kadakia et al. [2] showed that patients actually have very little understanding when questioned about their own trauma. The study found that less than half of the patients knew what bone they had fractured and less than 20% knew their recovery time. This suggests the need for a reform in how patients are given information to ensure higher comprehension and satisfaction in surgical procedures. The General Medical Council [3], in “Good Medical Practice” 2013, detailed that exchange of information is key to good decision making and so how are patients expected to make informed decisions when they do not know the information? A recent supreme court judgement has altered the legal landscape in the consent process in the UK. The outcome of the Montgomery v Lanarkshire Health Board legal battle has become a landmark Scottish case and has had a profound effect on the British legal system as the judgment disseminated from the highest British court.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"6 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000E116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45208974","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}
Pub Date : 2017-07-14DOI: 10.4172/2167-7921.1000245
A. Sobti, J. Sudhakar
Osteoarthritis (OA) is the leading cause of disability and knee OA alone affects over 250 million people worldwide [1]. Joint arthroplasty for knee is one of the most common elective and cost effective surgical intervention for end stage lower-limb arthritis [1]. The National Joint Registry (NJR) indicates that by the year 2030 the demand for total knee replacement (TKR) will be nearly 3.5 million cases. The current cost burden to the National Health Service (NHS) is enormous and its estimated to rise in excess of £7000 per case [2]. This will have a huge bearing on the already cash crushed health care system.
{"title":"High Body Mass Index and its Effect on Total Knee Replacement","authors":"A. Sobti, J. Sudhakar","doi":"10.4172/2167-7921.1000245","DOIUrl":"https://doi.org/10.4172/2167-7921.1000245","url":null,"abstract":"Osteoarthritis (OA) is the leading cause of disability and knee OA alone affects over 250 million people worldwide [1]. Joint arthroplasty for knee is one of the most common elective and cost effective surgical intervention for end stage lower-limb arthritis [1]. The National Joint Registry (NJR) indicates that by the year 2030 the demand for total knee replacement (TKR) will be nearly 3.5 million cases. The current cost burden to the National Health Service (NHS) is enormous and its estimated to rise in excess of £7000 per case [2]. This will have a huge bearing on the already cash crushed health care system.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"2017 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42811794","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}
Pub Date : 2017-07-07DOI: 10.4172/2167-7921.1000E115
C. Perkins, Bethan Whiting, P. Lee
Corticosteroids are used in the treatment of arthritis. Despite the differences in the aetiology of rheumatoid and osteoarthritis; joint pain, stiffness, swelling and deformity remain features of both conditions. These factors contribute to the disability of both conditions and impact patients’ quality of life [1]. Current management is focused on reducing joint pain and inflammation, whilst improving or maintaining joint function [2] Although not recommended as the first line treatment in rheumatoid or osteoarthritis, steroids have been used selectively in the management of these symptoms. Corticosteroids are used in combination with other treatments and in various preparations. Other injectable substances are available and is explained by Golding et al in this issue. For the purpose of this editorial we will focus on the use of injected corticosteroids.
{"title":"Steroids and Osteoarthritis","authors":"C. Perkins, Bethan Whiting, P. Lee","doi":"10.4172/2167-7921.1000E115","DOIUrl":"https://doi.org/10.4172/2167-7921.1000E115","url":null,"abstract":"Corticosteroids are used in the treatment of arthritis. Despite the differences in the aetiology of rheumatoid and osteoarthritis; joint pain, stiffness, swelling and deformity remain features of both conditions. These factors contribute to the disability of both conditions and impact patients’ quality of life [1]. Current management is focused on reducing joint pain and inflammation, whilst improving or maintaining joint function [2] Although not recommended as the first line treatment in rheumatoid or osteoarthritis, steroids have been used selectively in the management of these symptoms. Corticosteroids are used in combination with other treatments and in various preparations. Other injectable substances are available and is explained by Golding et al in this issue. For the purpose of this editorial we will focus on the use of injected corticosteroids.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"6 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000E115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44372237","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}
Pub Date : 2017-06-20DOI: 10.4172/2167-7921.1000243
P. Lee, J. Charity, J. Timperley
This paper details a tendon–sparing surgical technique allowing hemiarthroplasty through a posterior approach in all cases whilst preserving the Quadriceps coxa. The SPAIRE (Sparing Piriformis and Internus, Repair Externus) technique, described by Hanly et al. for routine use in total hip replacement, theoretically offers the functional benefits of the posterior approach with reduced risk of dislocation. It may also facilitate early mobilisation after hip fracture surgery with potential reduction in medical complications and mortality. In this study, we report our initial experience using the same SPAIRE technique for hemiarthroplasty to treat all patients with displaced intracapsular neck of femur fractures, irrespective of skeletal dimension and BMI. Our results suggest that the SPAIRE technique is feasible and safe to be used in all cases requiring hemiarthroplasty. Further research should be encouraged to investigate the role of the SPAIRE technique in fractured neck of femur surgery.
本文详细介绍了一种保留肌腱的手术技术，该技术允许在所有情况下通过后部入路进行半关节成形术，同时保留股四头肌-髋关节。Hanly等人描述的用于全髋关节置换术的SPAIRE（Sparing Piriformis and Internus，Repair Externus）技术在理论上提供了后入路的功能优势，降低了脱位风险。它还可以促进髋部骨折手术后的早期动员，从而潜在地降低医疗并发症和死亡率。在这项研究中，我们报告了我们使用相同的SPAIRE技术进行半关节成形术治疗所有股骨颈囊内移位骨折患者的初步经验，无论骨骼尺寸和BMI如何。我们的研究结果表明，SPAIRE技术在所有需要半关节成形术的病例中都是可行和安全的。应鼓励进一步研究SPAIRE技术在股骨颈骨折手术中的作用。
{"title":"Details of a Tendon–Sparing Posterior Approach in Hemiarthroplasty in the Treatment of Displaced Intracapsular Neck of Femur Fracture","authors":"P. Lee, J. Charity, J. Timperley","doi":"10.4172/2167-7921.1000243","DOIUrl":"https://doi.org/10.4172/2167-7921.1000243","url":null,"abstract":"This paper details a tendon–sparing surgical technique allowing hemiarthroplasty through a posterior approach in all cases whilst preserving the Quadriceps coxa. The SPAIRE (Sparing Piriformis and Internus, Repair Externus) technique, described by Hanly et al. for routine use in total hip replacement, theoretically offers the functional benefits of the posterior approach with reduced risk of dislocation. It may also facilitate early mobilisation after hip fracture surgery with potential reduction in medical complications and mortality. In this study, we report our initial experience using the same SPAIRE technique for hemiarthroplasty to treat all patients with displaced intracapsular neck of femur fractures, irrespective of skeletal dimension and BMI. Our results suggest that the SPAIRE technique is feasible and safe to be used in all cases requiring hemiarthroplasty. Further research should be encouraged to investigate the role of the SPAIRE technique in fractured neck of femur surgery.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"2017 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46271882","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}
Pub Date : 2017-05-20DOI: 10.4172/2167-7921.1000242
D. Golding, James P. Brock, Bethan Whiting, P. Lee
Knee pain is an increasingly common presentation to general practitioners worldwide which is thought to be related to the obesity epidemic, an ageing population and increasingly sedentary lifestyles in more developed nations. Degenerative osteoarthritis (OA) accounts for the majority of presentations in older age groups and this has traditionally been treated with analgesia, lifestyle modifications and adjuncts such as physiotherapy, braces and insoles. All these therapies aim to delay the need of total knee replacement (TKR), which is often the end-point for severe knee OA. However, TKR is associated with poor levels of patient satisfaction, low functional outcomes and has recently been shown to have low levels of cost-effectiveness except in patients with severe disabling OA. Increasingly doctors are turning to intra-articular injections which can provide temporary pain relief such as corticosteroids, hyaluronic acid and platelet rich plasma. This article aims to review the current options for intraarticular injections, comment on their efficacy and suggest areas for future development.
{"title":"Intra-articular Injections for Management of Knee Osteoarthritis","authors":"D. Golding, James P. Brock, Bethan Whiting, P. Lee","doi":"10.4172/2167-7921.1000242","DOIUrl":"https://doi.org/10.4172/2167-7921.1000242","url":null,"abstract":"Knee pain is an increasingly common presentation to general practitioners worldwide which is thought to be related to the obesity epidemic, an ageing population and increasingly sedentary lifestyles in more developed nations. Degenerative osteoarthritis (OA) accounts for the majority of presentations in older age groups and this has traditionally been treated with analgesia, lifestyle modifications and adjuncts such as physiotherapy, braces and insoles. All these therapies aim to delay the need of total knee replacement (TKR), which is often the end-point for severe knee OA. However, TKR is associated with poor levels of patient satisfaction, low functional outcomes and has recently been shown to have low levels of cost-effectiveness except in patients with severe disabling OA. Increasingly doctors are turning to intra-articular injections which can provide temporary pain relief such as corticosteroids, hyaluronic acid and platelet rich plasma. This article aims to review the current options for intraarticular injections, comment on their efficacy and suggest areas for future development.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"6 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41495353","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}
Pub Date : 2017-05-05DOI: 10.4172/2167-7921.1000240
P. Raghavan
Metadichol® is a Nano emulsion of long-chain alcohols called as Policosanol and is present in foods such as rice, sugar cane, wheat, and peanuts. Metadichol® acts on Nuclear Vitamin D receptors (VDR) that are present in cells throughout the body to stimulate the immune system and inhibit a variety of disease processes, resulting from inflammation to infection [1]. We present a case study of a patient with Rheumatoid arthritis with the high levels of RF antibodies, CRP and ESR levels, and low bone mineral density leading to osteoporosis. The case report shows how Metadichol® by its actions on the VDR has affected key biomarkers and mitigated the disease conditions without any side effects. Also, his bone density improved dramatically. Metadichol® is safe because it consists of natural components of conventional foods and has no known adverse side effects. Its constituents are present in many foods that we consume every day. Metadichol® has the potential to serve as a novel, safe solution to help patients with RA and other autoimmune diseases that confront the world today.
{"title":"Rheumatoid Arthritis and Osteoporosis: A Case Study","authors":"P. Raghavan","doi":"10.4172/2167-7921.1000240","DOIUrl":"https://doi.org/10.4172/2167-7921.1000240","url":null,"abstract":"Metadichol® is a Nano emulsion of long-chain alcohols called as Policosanol and is present in foods such as rice, \u0000 sugar cane, wheat, and peanuts. Metadichol® acts on Nuclear Vitamin D receptors (VDR) that are present in cells \u0000 throughout the body to stimulate the immune system and inhibit a variety of disease processes, resulting from \u0000 inflammation to infection [1]. \u0000We present a case study of a patient with Rheumatoid arthritis with the high levels of RF antibodies, CRP and \u0000 ESR levels, and low bone mineral density leading to osteoporosis. The case report shows how Metadichol® by its \u0000 actions on the VDR has affected key biomarkers and mitigated the disease conditions without any side effects. Also, \u0000 his bone density improved dramatically. \u0000Metadichol® is safe because it consists of natural components of conventional foods and has no known adverse \u0000 side effects. Its constituents are present in many foods that we consume every day. \u0000Metadichol® has the potential to serve as a novel, safe solution to help patients with RA and other autoimmune \u0000 diseases that confront the world today.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44719887","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：