This new paper by TA Lee et al from the From Midwest Center for Health Services and Policy Research, at Hines VA is available on pubmed by using the identifier 17462546
PURPOSE: Diseases are often described and studied in isolation, yet there is increasing recognition of the complex interrelatedness of diseases and treatments in patients with multiple chronic diseases. Our objective was to describe the impact of selected diseases involving chronic inflammation (chronic obstructive pulmonary disease, osteoarthritis, and rheumatoid arthritis) on mortality.
METHODS: We identified a cohort aged 55 to 64 years with one or more chronic conditions. Clusters of mutually exclusive disease combinations were created. Five-year all-cause mortality was determined and the relative risk (RR) of mortality was estimated when chronic obstructive pulmonary disease , osteoarthritis, and rheumatoid arthritis were added to clusters.
RESULTS: In 741,847 persons the 5-year mortality rates were lowest among persons with one condition and increased with more chronic conditions. The presence of osteoarthritis in a cluster was an exception where the risk was lower compared with that cluster without osteoarthritis: chronic obstructive pulmonary disease (RR = 0.73 [95% confidence interval (CI), 0.65, 0.81]); ischemic heart disease (0.63 [0.52, 0.76]); hypertension (0.77 [0.71, 0.83]); dementia (0.63 [0.42, 0.93]); depression (0.65 [0.50, 0.84]); hypertension plus diabetes (0.85 [0.77, 0.93]); and ischemic heart disease plus hypertension (0.83 [0.73, 0.94]).
CONCLUSIONS: The association between osteoarthritis and lower rates of mortality is notable and replicating these findings to explore causal relationships is important.
Posted in osteoarthritis April 28th, 2007 by admin | No comments
This review by R Christensen from the Parker institute in Denmark takes a look into the association of knee osteoarthritis and weight reduction stress. The full article is available from pubmed using the ID 17204567.
This review aims to assess by meta-analysis of randomised controlled trials (RCTs) changes in pain and function when overweight patients with knee osteoarthritis (OA) achieve a weight loss.
Systematic searches were performed and reference lists from the retrieved trials were searched. RCTs were enclosed in the systematic review if they explicitly stated diagnosis of knee OA and reported a weight change as the only difference in intervention from the control group. Outcome Measures for Arthritis Clinical Trials III outcome variables were considered for analysis. Effect size (ES) was calculated using RevMan, and meta-regression analyses were performed using weighted estimates from the random effects analyses. Among 35 potential trials identified, four RCTs including five intervention/control groups met our inclusion criteria and provided data from 454 patients.
Pooled ES for pain and physical disability were 0.20 (95% CI 0 to 0.39) and 0.23 (0.04 to 0.42) at a weight reduction of 6.1 kg (4.7 to 7.6 kg). Meta-regression analysis showed that disability could be significantly improved when weight was reduced over 5.1%, or at the rate of >0.24% reduction per week. Clinical efficacy on pain reduction was present, although not predictable after weight loss. Meta-regression analysis indicated that physical disability of patients with knee OA and overweight diminished after a moderate weight reduction regime. The analysis supported that a weight loss of >5% should be achieved within a 20-week period-that is, 0.25% per week.
Posted in osteoarthritis March 21st, 2007 by admin | No comments
A computer-based classification system is proposed for the characterization of hips from pelvic radiographs as normal or osteoarthritic and for the discrimination among various grades of osteoarthritis (OA) severity. Pelvic radiographs of 18 patients with verified unilateral hip osteoarthritis were evaluated by three experienced physicians, who assessed osteoarthritis severity employing the Kellgren and Lawrence scale as: normal, mild/moderate and severe. Five run-length, 75 Laws’ and 5 novel textural features were extracted from the digitized radiographic images of each patient’s osteoarthritic and contralateral normal hip joint spaces (HJSs). Each one of the three sets of textural features (run-lengths, Laws’ and novel features) was separately utilized for assigning hips into the three OA severity categories, by means of a probabilistic neural network (PNN) classifier based hierarchical tree structure. The highest classification accuracy (100%) for characterizing hips as normal, of mild/moderate or of severe OA was obtained for the novel textural features set. Additionally, the novel textural features were used to design a mathematical regression model for providing a quantitative estimation of OA severity. Measured OA severity values, as expressed by HJS-narrowing, correlated highly (r=0.85, p<0.001) with the predicted values by the mathematical regression model. The proposed system may be valuable in OA-patient management.
This article is by Boniatis et al from the University of Patris in Greece
the Pub med Id is 16624611
Posted in osteoarthritis January 29th, 2007 by admin | No comments
