Summary Objective To assess the cross-sectional association between meniscal status and joint effusion on magnetic resonance imaging (MRI) in knees without radiographic osteoarthritis (OA). Design ...Knees without OA (Kellgren/Lawrence grade 0) from the Framingham and MOST studies were examined by MRI. Meniscal status was assessed with a score of 0–4 in the anterior horn/body/posterior horn of the medial/lateral meniscus and effusion was assessed using a score of 0–3. The odds ratios (ORs) of joint effusion in those with meniscal damage were estimated using a logistic regression model. A subanalysis was performed for knees without MRI-detected cartilage damage. Results Of 1368 knees, 296 (21.6%) showed meniscal pathology in at least one subregion. Effusion was present in 133 (44.9%) of knees with meniscal damage vs 328 (30.6%) in those without meniscal damage. The adjusted OR of effusion in a knee with meniscal damage was 1.8, 95% confidence intervals (CI) 1.4, 2.4. The OR of effusion for the group with meniscal pathology in two compartments was 5.4, 95% CI 2.1, 14.3. For knees without any cartilage lesions but with meniscal damage in any compartment the OR was 2.3, 95% CI 1.1, 4.5. Conclusions Knees without OA but with meniscal pathology exhibit joint effusion to a significantly higher degree than knees without meniscal damage. The association persists for knees without cartilage damage. The prevalence of effusion is further increased when present in two compartments. Concomitant occurrence of synovial activation and meniscal damage contributes to understanding the pathophysiology of early degenerative joint disease.
Helminth eggs are the most difficult biological parasites to inactivate in wastewater and sludge. In developing countries, in particular, they are present in high concentrations and are the cause of ...many diseases that impact seriously on the human population. The process conditions for affordable inactivation are very variable, leading to different inactivation efficiencies. Temperature, dryness, pH and the developmental stage of the eggs must be taken into consideration to achieve complete inactivation. The objective of this research was to study the inactivation of six species of larval and non-larval helminth eggs of medical importance in developing countries under controlled conditions of temperature, pH, dryness and contact time. Results showed considerable differences in inactivation conditions among helminth eggs and a high level of resistance was confirmed for the eggs of Ascaris lumbricoides and Ascaris suum. The appropriate conditions for inactivation of all types of eggs were found by applying combinations of pH, temperature and dryness. At 45 °C it was possible to inactivate all species with a pH of 5.3 and 90% dryness within 6 days. If alkalization was applied, a pH of 12.7 was sufficient over 19 days at the same conditions of dryness and temperature. From these results it is proposed that both Ascaris spp. and Taenia solium may be used as indicators of biological contamination in wastewater and sludge.
Display omitted
► Helminth eggs are more vulnerable to acidification than to alkalization. ► Larval eggs are inactivated faster than the non-larval ones (coefficients provided). ► Ascaris and Taenia are more resistant than Toxocara, Trichuris and Hymenolepis. ► Except for Trichuris, pH changes were more inactivating than dryness changes. ► Full inactivation is achieved by properly combining pH, temperature and dryness.
Summary Background Previous studies suggest that the antioxidants vitamins C and E may protect against development of knee osteoarthritis (OA). We examined the association of circulating levels of ...vitamin C and E with incident whole knee radiographic OA (WKROA). Methods We performed a nested case–control study of incident WKROA in MOST, a cohort of 3,026 men and women aged 50–79 years with, or at high risk of, knee OA. Incident cases were knees without either tibiofemoral (TF) or patellofemoral (PF) OA at baseline that developed TF and/or PF OA by 30-month follow-up. Two control knees per case were selected from those eligible for WKROA that did not develop it. Vitamin C and E (alpha-tocopherol) assays were done on baseline supernatant plasma (PCA) and serum samples, respectively. We examined the association of gender-specific tertiles of vitamin C and E with incident WKROA using logistic regression with GEE, adjusting for age, gender, and obesity. Results Subjects without WKROA at baseline who were in the highest tertile of vitamin C had a higher incidence of WKROA adjusted OR = 2.20 (95% CI: 1.12–4.33); P -value = 0.021, with similar results for the highest tertile of vitamin E adjusted OR = 1.89 (1.02–3.50); P -value = 0.042, compared to those in the lowest tertiles. P -values for the trend of vitamin C and E tertiles and incident WKROA were 0.019 and 0.030, respectively. Conclusions Higher levels of circulating vitamin C and E did not provide protection against incident radiographic knee OA, and may be associated with an increased risk of knee OA.
The management of unruptured intracranial aneurysms is controversial. Investigators form the International study of Unrupted intracranial Aneurysms aimed to asses the natural history of unrupted ...Intracranial aneurysms and to measure the risk associalted with the repair.
Centres in the USA, Canada, and Europe enrolled patients for prospective assessment of unruptured aneurysms. Investigators recorded the natural history in patients who did not have surgery, and assessed morbidity and mortality associated with repair of unruptured aneurysms by either open surgery or endo-vascular procedures.
4060 patients were assessed-1692 did not have aneurysmal repair, 1917 had open surgery, and 451 had endovascular procedures. 5-year cumulative rupture rates for patients who did not have a history of subarachnoid haemorrhage with aneurysms located in internal carotid artery, anterior communicating or anterior cerebral artery, or middle cerebral artery were 0%, 2·6%, 14·5%, and 40% for aneurysms less than 7 mm, 7–12 mm, 13–24 mm, and 25 mm or greater, respectively, compared with rates of 2·5%, 14·5%, 18·4%, and 50%, respectively, for the same size categories involving posterior circulation and posterior communicating artery aneurysms. These rates were often equalled or exceeded by the risks associated with surgical or endovascular repair of comparable lesions. Patients' age was a strong predictor of surgical outcome, and the size and location of an aneurysm predict both surgical and endovascular outcomes.
Many factors are involved in management of patients with unruptured intracranial aneurysms. Site, size, and group specific risks of the natural history should be compared with site, size, and age-specific risks of repair for each patient.
Summary Objective The extent and factors associated with knee pain fluctuation are not well-known. We evaluated the prevalence, correlates, and association with function of consistency of knee pain. ...Design Participants of the Multicenter Osteoarthritis (MOST) Study, a cohort of individuals with or at high risk of knee osteoarthritis (OA) had baseline knee X-rays, questionnaires, and a question about frequent knee pain (FKnP) (pain on most of the past 30 days) at two time points: a telephone screen and a later clinic visit. We computed the prevalence of inconsistent knee pain (positive answer to FKnP question at only one time point) and consistent knee pain (positive answer to FKnP question at both time points). We evaluated the association of consistency of FKnP with a number of sociodemographic factors, pain severity, and function. Results There were 2940 participants with complete data (5867 knees) mean age 62, mean body mass index (BMI) 30.7, 60% female. Of those, 2977 knees had pain, with 43% having inconsistent and 57% having consistent knee pain. Those with radiographic OA odds ratio (OR) 0.46, depressive symptoms (OR 0.73), and widespread pain (OR 0.68) (all P < 0.05) were less likely to have inconsistent compared with consistent knee pain. Pain, function, and strength were significantly better in persons with two knees that had inconsistent compared with consistent pain. Conclusions A substantial proportion of persons with knee pain have inconsistent knee pain, associated with better physical function and strength (adjusting for pain severity). Such pain may be suggestive of an earlier stage of disease.
The study objective was to determine the prevalence of Staphylococcus aureus colonisation in the nares and oropharynx of healthy persons and identify any risk factors associated with such S. aureus ...colonisation. In total 263 participants (177 adults and 86 minors) comprising 95 families were enrolled in a year-long prospective cohort study from one urban and one rural county in eastern Iowa, USA, through local newspaper advertisements and email lists and through the Keokuk Rural Health Study. Potential risk factors including demographic factors, medical history, farming and healthcare exposure were assessed. Among the participants, 25.4% of adults and 36.1% minors carried S. aureus in their nares and 37.9% of adults carried it in their oropharynx. The overall prevalence was 44.1% among adults and 36.1% for minors. Having at least one positive environmental site for S. aureus in the family home was associated with colonisation (prevalence ratio: 1.34, 95% CI: 1.07-1.66). The sensitivity of the oropharyngeal cultures was greater than that of the nares cultures (86.1% compared with 58.2%, respectively). In conclusion, the nares and oropharynx are both important colonisation sites for healthy community members and the presence of S. aureus in the home environment is associated with an increased probability of colonisation.
PDF
