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Functional Index (functional + index)
Kinds of Functional Index Selected AbstractsThe Ankylosing Spondylitis Quality of Life Questionnaire: validation in a New Zealand cohortINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 4 2010Katherine JENKS Abstract Aim:, To examine the validity of the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) in a New Zealand population with defined axial spondyloarthritis (SpA). Once validated, the ASQoL will be included as an outcome measure in a proposed multicentre New Zealand study. Methods:, Five healthy participants were interviewed to identify any issues related to local dialect or linguistic comprehension of the questionnaire. Cognitive debriefing interviews were conducted with four participants with SpA to assess the relevance and comprehensiveness of the questionnaire. Internal consistency was established by determining the Cronbach's alpha. Finally, convergent validity of the ASQoL was assessed by testing the correlation with the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and patient global visual analogue scale (VAS) scores in a cohort of 63 SpA patients. Results:, The language used in the ASQoL was considered clear, comprehensible and accessible to speakers of New Zealand English. The questionnaire displayed content validity for patients with SpA. The ASQoL had good internal consistency in the present sample (, = 0.854). A positive correlation was found between the ASQoL and the BASFI (rho = 0.635, P < 0.001), BASDAI (rho = 0.521, P < 0.001) and patient global assessment VAS (rho = 0.546, P < 0.001), providing evidence that the ASQoL has convergent validity among patients with SpA in New Zealand. Test,retest reliability was good over 16 weeks (rho = 0.730, P < 0.001). Conclusions:, The ASQoL has been demonstrated in this study to be feasible, internally consistent and to have content and convergent validity in a New Zealand population of patients with axial spondyloarthritis; it is a measure of quality of life which is both easy to employ and reliable. [source] Osteitis condensans ilii: a significant association with sacroiliac joint tenderness in womenINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2009Katey JENKS Abstract Aim:, To determine whether subjects with radiological evidence of osteitis condensans ilii exhibit symptoms and signs in common with sacroiliitis when compared with an age-matched control group and to examine demographic features. Methods:, The Dunedin Hospital radiology database was searched for all subjects with changes of osteitis condensans ilii over a 10-year period. An age-matched control group with plain X-rays of the pelvis was recruited from the same database. All subjects were sent a questionnaire enquiring about back pain and details of previous pregnancies. Those who responded to the questionnaire were invited for clinical assessment. Results:, Thirty-five individuals with osteitis condensans ilii were identified over the 10-year period. All were female and reported prior pregnancy supporting an association between osteitis condensans ilii and pregnancy. Stress testing of the sacroiliac joints was associated with greater tenderness in the osteitis condensans ilii group with a mean of 1.8 positive tests out of a possible 4, compared to 0.8 in the control group (Wilcoxon rank-sum test P = 0.02). Comparison between the two groups showed no difference in number of pregnancies, newborn weight, presence of back pain, back pain assessed by the Oswestry Low Back Pain Questionnaire or loss of function using the Bath Ankylosing Spondylitis Functional Index (BASFI). Conclusion:, Osteitis condensans ilii is associated with tenderness during sacroiliac joint compression tests and should be considered in the differential diagnosis when sacroiliac joint tenderness is elicited. [source] Outcome of active disease in ankylosing spondylitis: A prospective studyMUSCULOSKELETAL CARE, Issue 1 2010Grad Dip Phys, J. Martindale PhD Abstract Background:,People with ankylosing spondylitis (AS) typically experience episodic exacerbations, but the extent to which they subsequently experience a sustained reduction in disease markers below recognized thresholds for active disease is unclear. Objective:,To investigate changes in, and associations between, disease markers over 18 months in people with active AS. Methods:,Within a cohort of 89 participants with AS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores of 4 or higher were used to identify those with active disease. Standard assessment tools were used to monitor participants prospectively at four consecutive six-monthly intervals. Participants received standard treatments but none received anti-tumor necrosis factor-alpha (TNF,) medication during the study. Results:,The median age of the cohort was 50 years (inter-quartile range [IQR] 38.5,55.5), the median age of disease onset was 25 years (IQR 18,33) and the median disease duration was 18 years (IQR 13,27). Forty-seven (53%) participants had a BASDAI score of 4 or higher on the first assessment, of whom 45 (51%) scored 4 or higher on all subsequent assessments. Furthermore, 38 (43%) and 16 (18%) participants scored BASDAI 5 or 6, respectively, or higher, throughout. BASDAI scores correlated strongly with Bath Ankylosing Spondylitis Functional Index (BASFI) scores. Compared with 19 (21%) participants whose BASDAI scores were consistently below 4 throughout, participants with persistently high BASDAI scores showed higher scores for anxiety and depression, and some evidence of functional deterioration during the study period. Conclusions:,In this cohort, disease markers in most people with active AS were sustained above the standard threshold for active disease. This has important implications for planning care pathways and for optimal utilization of anti-TNF, treatment. Copyright © 2009 John Wiley & Sons, Ltd. [source] Clinical and imaging efficacy of infliximab in HLA,B27,Positive patients with magnetic resonance imaging,determined early sacroiliitis,ARTHRITIS & RHEUMATISM, Issue 4 2009Nick Barkham Objective To evaluate the efficacy of infliximab in HLA,B27,positive patients with magnetic resonance imaging (MRI),determined early sacroiliitis, using both clinical and MRI assessments. Methods Forty patients with recent-onset inflammatory back pain, as assessed by the Calin criteria, HLA,B27 positivity, clinical disease activity as measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), pain and morning stiffness, and magnetic resonance imaging (MRI),determined sacroiliac joint bone edema were randomized in a double-blind manner to receive infliximab 5 mg/kg or placebo at 0, 2, 6, and 12 weeks. MRI scans were performed at baseline and 16 weeks and scored by 2 observers (blinded to both the order of the scans and to treatment group), using the Leeds scoring system. Clinical assessments included the BASDAI, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Quality of Life (ASQoL) instrument, the ASsessment in Ankylosing Spondylitis International Working Group criteria (ASAS) for improvement, and markers of inflammation. Results The mean reduction in the total MRI score from week 0 to week 16 was significantly greater in infliximab-treated patients compared with placebo-treated patients (P = 0.033). On average, significantly more lesions resolved in the infliximab group (P < 0.001), while significantly more new lesions developed in the placebo group (P = 0.004). Significantly greater improvement in the infliximab group versus the placebo group was also observed for changes from week 0 to week 16 in the BASDAI (P = 0.002), BASFI (P = 0.004), and ASQoL (P = 0.007) scores. Responses according to the ASAS criteria for 40% improvement, the ASAS criteria for 20% improvement in 5 of 6 domains, and ASAS partial remission were achieved by 61%, 44%, and 56% of infliximab-treated patients, respectively. Infliximab was well tolerated, and no serious adverse events were observed. Conclusion Infliximab was an effective therapy for early sacroiliitis, providing a reduction in disease activity by week 16. This study is the first to show that infliximab is effective for reducing clinical and imaging evidence of disease activity in patients with MRI-determined early axial spondylarthritis. [source] Reduction in glutamate uptake is associated with extrasynaptic NMDA and metabotropic glutamate receptor activation at the hippocampal CA1 synapse of aged ratsAGING CELL, Issue 5 2010Brigitte Potier Summary This study aims to determine whether the regulation of extracellular glutamate is altered during aging and its possible consequences on synaptic transmission and plasticity. A decrease in the expression of the glial glutamate transporters GLAST and GLT-1 and reduced glutamate uptake occur in the aged (24,27 months) Sprague,Dawley rat hippocampus. Glutamatergic excitatory postsynaptic potentials recorded extracellularly in ex vivo hippocampal slices from adult (3,5 months) and aged rats are depressed by DL-TBOA, an inhibitor of glutamate transporter activity, in an N -Methyl- d- Aspartate (NMDA)-receptor-dependent manner. In aged but not in young rats, part of the depressing effect of DL-TBOA also involves metabotropic glutamate receptor (mGluRs) activation as it is significantly reduced by the specific mGluR antagonist d-methyl-4-carboxy-phenylglycine (MCPG). The paired-pulse facilitation ratio, a functional index of glutamate release, is reduced by MCPG in aged slices to a level comparable to that in young rats both under control conditions and after being enhanced by DL-TBOA. These results suggest that the age-associated glutamate uptake deficiency favors presynaptic mGluR activation that lowers glutamate release. In parallel, 2 Hz-induced long-term depression is significantly decreased in aged animals and is fully restored by MCPG. All these data indicate a facilitated activation of extrasynaptic NMDAR and mGluRs in aged rats, possibly because of an altered distribution of glutamate in the extrasynaptic space. This in turn affects synaptic transmission and plasticity within the aged hippocampal CA1 network. [source] Achilles Detachment in Rat and Stable Gastric Pentadecapeptide BPC 157: Promoted Tendon-to-Bone Healing and Opposed Corticosteroid AggravationJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2006Andrija Krivic Abstract Stable gastric pentadecapeptide BPC 157 (BPC 157, as an antiulcer agent in clinical trials for inflammatory bowel disease; PLD-116, PL 14736, Pliva, no toxicity reported) alone (without carrier) ameliorates healing of tendon and bone, respectively, as well as other tissues. Thereby, we focus on Achilles tendon-to-bone healing: tendon to bone could not be healed spontaneously, but it was recovered by this peptide. After the rat's Achilles tendon was sharply transected from calcaneal bone, agents [BPC 157 (10 µg, 10 ng, 10 pg), 6,-methylprednisolone (1 mg), 0.9% NaCl (5 mL)] were given alone or in combination [/kg body weight (b.w.) intraperitoneally, once time daily, first 30-min after surgery, last 24 h before analysis]. Tested at days 1, 4, 7, 10, 14, and 21 after Achilles detachment, BPC 157 improves healing functionally [Achilles functional index (AFI) values substantially increased], biomechanically (load to failure, stiffness, and Young elasticity modulus significantly increased), macro/microscopically, immunohistochemistry (better organization of collagen fibers, and advanced vascular appearance, more collagen type I). 6,-Methylprednisolone consistently aggravates the healing, while BPC 157 substantially reduces 6,-methylprednisolone healing aggravation. Thus, direct tendon-to-bone healing using stabile nontoxic peptide BPC 157 without a carrier might successfully exchange the present reconstructive surgical methods. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res [source] LANDSCAPE-SCALE ANALYSIS AND MANAGEMENT OF CUMULATIVE IMPACTS TO RIPARIAN ECOSYSTEMS: PAST, PRESENT, AND FUTURE,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 6 2001Eric D. Stein ABSTRACT: Analyses of cumulative impacts to riparian systems is an important yet elusive goal. Previous analyses have focused on comparing the number of hectares impacted to the number of hectares restored, without addressing the loss of riparian function or the effect of the spatial distribution of impacts. This paper presents an analysis of the spatial distribution of development-related impacts to riparian ecosystems, that were authorized under Section 404 of the Clean Water Act. Impacts on habitat structure, contiguity, and landscape context were evaluated using functional indices scaled to regional reference sites. Impact sites were mapped using GIS and analyzed for spatial associations. Positive spatial autocorrelation (i.e. clustering of impact sites) resulted from the piecemeal approach to impact assessment, which failed to prevent cumulative impacts. Numerous small projects in close proximity have resulted in adverse impacts to entire stream reaches or have fragmented the aquatic resources to a point where overall functional capacity is impaired. Additionally, the ecological functions of unaffected areas have been diminished due to their proximity to degraded areas. A proactive approach to managing cumulative impacts is currently being used in Orange County, California as part of a Corps of Engineers sponsored Special Area Management Plan (SAMP). The SAMP process is evaluating the ecological conditions and physical processes of the study watersheds and attempting to plan future development in a manner that will guard against cumulative impacts. [source] The prevalence, clinical features and association of HLA-B27 in sacroiliitis associated with established Crohn's diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2009T. R. ORCHARD Summary Background Sacroiliitis is a recognized complication of Crohn's disease and may occur distinct from progressive ankylosing spondylitis (AS). Aim To estimate prospectively the prevalence of sacroiliitis in patients with established Crohn's disease, to characterize the clinical features and to correlate these with the presence of HLA-B27. Methods All Crohn's disease patients under active follow-up of between 5 and 12 years duration were invited to participate. Patients underwent a clinical evaluation including symptom questionnaire, rheumatological examination and underwent HLA genotyping. Patients then underwent magnetic resonance imaging (MRI) of the sacroiliac joints. The clinical and radiological factors were correlated with HLA-B27 status. Results 56 patients underwent initial assessment and 44 had MRI scans. Seventeen of 44 (39%) patients had MRI evidence of sacroiliitis, of whom 5 fulfilled the criteria for AS. Symptoms of low back pain were elicited in a majority of these patients , 11/17 (65%) compared to 3 of 27 (11%) patients with normal scans (P = 0.003). There were no differences in functional indices with the exception of patients with AS. HLA-B27 was present in seven patients, and all seven had MRI evidence of sacroiliitis, five had AS. Conclusions Sacroiliitis is common in patients with established Crohn's disease and in the majority of cases, patients have symptoms of inflammatory low back pain if questioned carefully. HLA-B27 is not associated with isolated sacroiliitis, but is associated with AS. However, possession of HLA-B27 appears to convey a very high risk of developing axial inflammation in Crohn's disease. [source] | |||||||||||||