Showing papers by "British Hospital published in 2012"

Myeloproliferative Neoplasm (MPN) Symptom Assessment Form Total Symptom Score: Prospective International Assessment of an Abbreviated Symptom Burden Scoring System Among Patients With MPNs

Abstract: Purpose Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent and representative MPN symptoms for subsequent serial use in assessing response to therapy. Patients and Methods The Myeloproliferative Neoplasm Symptom Assessment Form total symptom score (MPN-SAF TSS) was calculated as the mean score for 10 items from two previously validated scoring systems. Questions focus on fatigue, concentration, early satiety, inactivity, night sweats, itching, bone pain, abdominal discomfort, weight loss, and fevers. Results MPN-SAF TSS was calculable for 1,408 of 1,433 patients with MPNs who had a mean score of 21.2 (standard deviation [SD], 16.3). MPN-SAF TSS results significantly differed among MPN disease subtypes (P < .001), with a mean of 18.7 (SD, 15.3), 21.8 (SD, 16.3), and 25.3 (SD, 17.2) f...

Primary Sjögren's syndrome as a systemic disease: a study of participants enrolled in an international Sjögren's syndrome registry.

Abstract: Sjogren’s Syndrome (SS) is one of the most common autoimmune diseases, with an estimated prevalence of approximately 0.6% and a 20:1 female predilection (1, 2). SS may occur in isolation and has been referred to as primary Sjogren’s Syndrome (pSS) or in conjunction with another connective tissue disease, most commonly rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). This association is often termed secondary Sjogren’s Syndrome (sSS). The cardinal features of SS, including keratoconjunctivitis sicca and salivary gland hypofunction, presumably result from progressive lymphocytic inflammation in affected exocrine glands. While the hallmark features of SS are related to exocrine gland dysfunction, there is substantial evidence that pSS is a systemic autoimmune process. Such evidence includes: 1) the frequent presence of auto-antibodies [e.g., anti-nuclear antibodies (ANA), Sjogren’s Syndrome A (SSA/Ro) and Sjogren’s Syndrome B (SSB/La) antibodies]; 2) the presence of SS in conjunction with other systemic connective tissue diseases; and 3) the reported association of SS with a number of extra-glandular manifestations (EGM). There is an extensive literature describing EGM in SS. One of the earliest reported associations was the increased incidence of lymphoma in patients with SS (3–7). Several reports describe the occurrence of other EGM such as neurologic, pulmonary and other organ specific diseases. For example, renal tubular acidosis, thyroiditis, primary biliary cirrhosis and autoimmune hepatitis are classically thought to be related to SS. However the prevalence of these disorders among SS patients varies widely between cohorts and the association of these EGM with SS is less well defined. In the current study, we describe the prevalence of EGM among participants in the Sjogren’s International Collaborative Clinical Alliance (SICCA) registry (8) and we examine associations between EGM and specific objective phenotypic features of SS. SICCA participants are recruited worldwide into a registry designed to support studies of etiologic factors and outcomes in SS. The registry also provides an opportunity to study EGM prevalence in individuals suspected to have SS, but who fail to meet the 2002 American-European Consensus Group (AECG) criteria for SS. The diversity of the collection in terms of ethnicity, recruitment source, and disease severity, in conjunction with the extensive data collected on each participant, provide a valuable resource for studying EGM in SS.

Percutaneous cerclage wiring and minimally invasive plate osteosynthesis (MIPO): a percutaneous reduction technique in the treatment of Vancouver type B1 periprosthetic femoral shaft fractures

Abstract: Background Periprosthetic femoral fractures (PPFs) associated at or near a well-fixed femoral prostheses (Vancouver type-B1) present a clinical challenge due to the quality of the bone stock and instability of the fracture.

Underneath the cerclage: an ex vivo study on the cerclage-bone interface mechanics.

Abstract: Introduction Cerclages regain interest due to a rising number of periprosthetic fractures. The contact distribution at the circumferential cerclage-bone interface is still unknown. Local interface pressure depends on the amount of contact area. Cortical damage at the interface would provoke cerclage loosening. Therefore, the contact area, the bone pressure along the interface and the cortical resistance underneath loaded cerclages were determined in an ex vivo model.

Creatinine- vs. cystatin C-based equations compared with 99mTcDTPA scintigraphy to assess glomerular filtration rate in chronic kidney disease.

Abstract: BACKGROUND In chronic kidney disease (CKD), accurate estimation of the glomerular filtration rate (GFR) is mandatory. Gold standard methods for its estimation are expensive and time-consuming. We compared creatinine- versus cystatin C-based equations to measure GFR, employing (99m)Tc-DTPA scintigraphy as the gold standard. METHODS This was a prospective cross-sectional observational study including 300 subjects. CKD was defined according to K/DOQI guidelines, and patients were separated into groups: stage 1 (G1), n=26; stage 2 (G2), n=52; stage 3 (G3), n=90; stage 4 (G4), n=37; stage 5 (G5), n=60; and control group, n=35. Creatinine-based estimates were from 24-hour creatinine clearance using the Walser formula, Cockcroft-Gault, MDRD-4 and CKD-EPI; cystatin C equations used were Larsson, Larsson modified equation, Grubb and Hoek. RESULTS Age and body mass index were different among groups; proteinuria, hypertension, diabetes and primary glomerulopathies significantly increased as CKD worsened. In the global assessment, CKD-EPI and Hoek gave the highest correlations with (99m)Tc-DTPA: rho=0.826, p<0.001 and rho=0.704, p<0.001, respectively. Most significant linear regressions obtained: CKD-EPI vs. (99m)Tc-DTPA, Hoek vs. (99m)Tc-DTPA and CKD-EPI vs. Hoek. However, important differences emerged when each group was analyzed separately. Best significant correlations obtained with (99m)Tc-DTPA: control group, creatinine clearance rho=0.421, p=0.012; G1, Crockoft-Gault rho=0.588, p=0.003; G2, CKD-EPI rho=0.462, p<0.05; G3, CKD-EPI rho=0.508, p<0.001; G4, Hoek rho=0.618, p<0.001; G5, CKD-EPI rho=0.604, p<0.001. CONCLUSIONS At GFR <60 ml/min, CKD-EPI and Hoek equations appeared to best correlate with (99m)TcDTPA. In controls and at early stages of CKD, creatinine-based equations correlated better with (99m)Tc-DTPA, with CKD-EPI being the one with the best degree of agreement.

Late post-partum dyspareunia: does delivery play a role?

Abstract: Summary Objective To study whether post-partum dyspareunia one year after a delivery is associated with characteristics of delivery: perineal trauma, obstetric interventions and women's experience. Methods A self-administered questionnaire on post-partum sexual function was mailed in May 2002 to all consecutive women who gave birth to a live-born term infant in a maternity unit, between January 2001 and June 2001. Obstetric data were abstracted from the hospital computerized medical database. Late dyspareunia was defined as pain during intercourse, one year after delivery. Multiple logistic regression modeling was used to select independent predictors of late post-partum dyspareunia. Results Seventy (27.6%) of the 254 women studied experienced late dyspareunia. There was no relation between late post-partum dyspareunia and neither the mode of delivery nor state of the perineum, including perineal laceration or episiotomy. Multiple logistic regression analysis showed that late post-partum dyspareunia was associated with dyspareunia before pregnancy, low satisfaction with delivery, and employment status. Conclusions Late post-partum dyspareunia seemed to be linked more with the mother's experience of childbirth than with perineal trauma. This hypothesis should be investigated further.

Short-Term Monotherapy with IDX184, a Liver-Targeted Nucleotide Polymerase Inhibitor, in Patients with Chronic Hepatitis C Virus Infection

Abstract: IDX184 is a liver-targeted prodrug of 2′-methylguanosine (2′-MeG) monophosphate. This study investigated the safety, tolerability, antiviral activity, and pharmacokinetics of IDX184 as a single agent in treatment-naive patients with genotype-1 chronic hepatitis C virus (HCV) infection. Forty-one patients with baseline HCV RNA ≥ 5 log10 IU/ml, alanine aminotransferase (ALT) ≤ 2.5× the upper limit of normal, and compensated liver disease were dosed. Sequential cohorts of 10 patients, randomized 8:2 (active:placebo), received 25, 50, 75, and 100 mg of IDX184 once daily for 3 days, with a 14-day follow-up. There were no safety-related treatment discontinuations or serious adverse events. The adverse events and laboratory abnormalities observed for IDX184- and placebo-treated patients were similar. At the end of the 3-day treatment period, changes from baseline in HCV RNA levels (means ± standard deviations) were −0.5 ± 0.6, −0.7 ± 0.2, −0.6 ± 0.3, and −0.7 ± 0.5 log10 for the 25-, 50-, 75-, and 100-mg doses, respectively, while viral load remained unchanged for the pooled placebo patients (−0.05 ± 0.3 log10). Patients with genotype-1a and patients with genotype-1b responded similarly. Serum ALT levels decreased, especially at daily doses ≥ 75 mg. During the posttreatment period, plasma viremia and serum aminotransferase levels returned to near pretreatment levels. No resistance mutations associated with IDX184 were detected. Plasma exposure of IDX184 and its nucleoside metabolite 2′-MeG was dose related and low. Changes in plasma viral load correlated with plasma exposure of 2′-MeG. In conclusion, the results from this proof-of-concept study show that small doses of the liver-targeted prodrug IDX184 were able to deliver significant antiviral activity and support further clinical evaluation of the drug candidate.

Young's Procedure for the Treatment of Valgus Flatfoot Deformity Caused by a Posterior Tibial Tendon Dysfunction, Stage II

Abstract: Young’s procedure contains an action mechanism that works better than other techniques on the pathophysiology of FFD. It respects the anatomy and biomechanics of the foot to reach the necessary muscular balance. The benefits of this technique include that the ATT is not detached, so its function mechanism is still active; the new trajectory of the ATT provides a powerful sling function at the level of the navicular; and the horizontal trajectory of the ATT and the osteoperiosteal flaps constitute a powerful inner capsular–tendinous–ligamentous support. What is more, an insufficiency of the ATT is created, which results in a predominance of the peroneus lateral longus, that descends and prones the forefoot. Additional procedures, such as medial displacement calcaneal osteotomy, should be considered to correct the entire deformity. The combination of these techniques do not sacrifice the joint mobility.

A New Parallelizable Deformation Method - Automatic Comparision between Foot and Last.

Abstract: This document shows the research project developed by the Computer Graphics and Vision Group in collaboration with Inescop. The main objective of this project is to define a new methodology to design shoes exactly adapted to the shape foot. The system proposed is based on a biomechanical anatomical structure of the foot and using a deformable shape. Using with several joints adapted the different foots to different shoe last evaluating the error between the surfaces. The system is automatic driven in the selection of significant foot points. We consider several anthropometrical parts of the foot in order to apply the deformations of the shape with different axis. The proposed system is implemented in software. An associated Application Programming Interface (API) is also developed for commercial use of the system. Also the results presented evaluate the error between deformations.