Time spent in primary care for hip osteoarthritis patients once the diagnosis is set: a prospective observational study

Background: Previous research on time to referral to orthopaedic surgery has predominantly used hip complaints as starting point instead of the moment the diagnosis of osteoarthritis (OA) of the hip is established, therefore little is known about the length of time a patient diagnosed with hip OA stays under the care of a general practitioner (GP). No knowledge on factors of influence on this time period is available either. Aim of this study was thus to determine the time an incident hip OA patient stays in the care of a GP until referral to an orthopaedic department. Influencing factors were also analyzed. Methods: A prospective observational study was conducted based on data over a 10-year period from a general practice-based registration network (17 GPs, > 30,000 patients registered yearly). Patients with the diagnosis of hip OA were included. A survival analysis was used to determine time until referral to an orthopaedic department, and to determine factors of influence on this time. Results: Of 391 patients diagnosed with hip OA, 121 (31%) were referred; average survival time until referral was 82.0 months (95% CI 76.6-87.5). Less contact with the GP for hip complaints before the diagnosis of hip OA was established resulted in a decreased time to referral. Conclusions: The results of this study show that patients with hip OA were under the care of a general practitioner, and thus in primary care, for a considerable amount of time once the diagnosis of hip OA was established

The Influence of Overweight/Obesity on Patient-Perceived Physical Functioning and Health-Related Quality of Life After Primary Total Hip Arthroplasty

# The Author(s) 2011. This article is published with open access at Springerlink.com Background Overweight/obesity in patients after total hip arthroplasty (THA) is a growing problem and is associated with postoperative complications and a negative effect on functional outcome. The objective of this study is to determine to what extent overweight/obesity is associated with physical functioning and health-related quality of life 1 year after primary THA

RODENT BIODISTRIBUTION AND METABOLISM OF TRITIATED 4-DAMP, A M(3) SUBTYPE-SELECTIVE CHOLINOCEPTOR LIGAND

The biodistribution of [H-3]4-DAMP (a M(3)-selective cholinoceptor antagonist) was studied in rats which had received either saline or saline containing atropine (to block cholinoceptors). Specific binding of the radioligand was observed in the urinary bladder, ileum, pancreas, stomach, submandibular gland and trachea. Maximal ratios of total-to-non-specific uptake reached values of 1.8 (trachea), 3.2 (bladder), 4.0 (stomach), 4.8 (ileum), 6.6 (pancreas) and 6.9 (submandibular gland) at 5-10 min post-injection; this rank order reflects the tissue densities of M(3) cholinoceptors. 4-DAMP did not bind to blood cells and it was rapidly cleared from the circulation (&gt;90% with a half-life of 0.2 min, the remainder with a half-life of 9.4 min). Labelled metabolites appeared within 5min in plasma, but metabolite uptake by the target organs was low (</p

RODENT BIODISTRIBUTION AND METABOLISM OF TRITIATED 4-DAMP, A M(3) SUBTYPE-SELECTIVE CHOLINOCEPTOR LIGAND

The biodistribution of [H-3]4-DAMP (a M(3)-selective cholinoceptor antagonist) was studied in rats which had received either saline or saline containing atropine (to block cholinoceptors). Specific binding of the radioligand was observed in the urinary bladder, ileum, pancreas, stomach, submandibular gland and trachea. Maximal ratios of total-to-non-specific uptake reached values of 1.8 (trachea), 3.2 (bladder), 4.0 (stomach), 4.8 (ileum), 6.6 (pancreas) and 6.9 (submandibular gland) at 5-10 min post-injection; this rank order reflects the tissue densities of M(3) cholinoceptors. 4-DAMP did not bind to blood cells and it was rapidly cleared from the circulation (>90% with a half-life of 0.2 min, the remainder with a half-life of 9.4 min). Labelled metabolites appeared within 5min in plasma, but metabolite uptake by the target organs was low

Positron emission tomography in primary brain tumours using cobalt-55

Primary brain tumours are usually assessed by computed tomography (CT) and magnetic resonance imaging (MRI), sometimes in conjunction with positron emission tomography (PET). We used cobalt-55 (Co-55) as a calcium (Ga) tracer to visualize decaying tumour tissue, based on the fact that Ca-influx is essential in both cell death and leukocyte activation. Net Co-55 uptake may be the result of cell decay, leukocyte infiltration, (re)perfusion and the pharmacological profile of Co-55. Three patients with primary malignant brain tumours (first presentation) were studied with CT, MRI and Go-PET after the intravenous administration of 0.5 mCi Co-55. Histopathological diagnosis was obtained by biopsy or resection. Go-PET demonstrated each of the brain tumours and showed good topographical agreement with CT and MRI. Go-PET provided additional detail as to the site and size of the necrotic core and the peri-necrotic rim of decaying tumour. The Co-55 uptake indices varied between 2.6 and 5.3. Co-55 demonstrated uptake in decaying tissue, irrespective of the integrity of the blood-brain barrier. Neither necrotic nor viable tumour tissue showed affinity for Co-55. Since Co-55 is readily applicable to both PET and single photon emission tomography (SPET), differences in the uptake mechanism and functional significance of the Co-55 tracer are discussed in relation to Tl-201 SPET. We present a (limited) pilot series of three patients to forward the claim of this new functional technique in nuclear neurology