Clinical and ultrasonographic features associated to response to intraarticular corticosteroid injection. A one year follow up prospective cohort study in knee osteoarthritis patient with joint effusion

<div><p>Objectives</p><p>Intraarticular injection is used for pain relief in knee osteoarthritis (OA), but there is not a well defined profile of patient who could get more benefit from it. The purpose of this study was to evaluate the frequency of pain relief at one year after corticosteroids intraarticular injection and to identify clinical factors associated to response in patients with knee osteoarthritis with joint effusion.</p><p>Methods</p><p>One-year prospective cohort study of patients with knee OA with joint effusion confirmed by ultrasound. An intraarticular injection was performed following a clinical protocol. Anthropometric measurements, laboratory parameters, clinical severity, ultrasound parameters and radiological severity were collected. Response regarding pain and presence of synovial fluid on ultrasound at one month and at one year were evaluated. Clinical responder were consider in subjects with enough improvement to carry out normal daily activities with pain VAS<40mm.</p><p>Results</p><p>One hundred and thirty-two patients were included.A significant number of patients (61.4%) improved pain at one year following the protocol established in this study. Pain and ultrasound synovial fluid at one month appeared to predict the response at one year. The Lequesne index and the percentage of body fat were independently associated to pain at one year while the Lequesne index and ultrasound synovial hypertrophy were independently related to the presence of synovial fluid at one year.</p><p>Conclusions</p><p>The status regarding pain or ultrasound synovial fluid at one month after an intraarticular joint injection appeared to predict the status at one year in patients with knee osteoarthritis and synovial effusion.</p></div

Adjusted associations with pain and effusion at one month follow-up, evaluating anthropometric measurements, clinical, radiological and ultrasound parameters.

<p>Adjusted associations with pain and effusion at one month follow-up, evaluating anthropometric measurements, clinical, radiological and ultrasound parameters.</p

Patient characteristics and comparison by gender.

<p>Patient characteristics and comparison by gender.</p

Significant associations between the different variables evaluated and pain and effusion at one month and at one year follow-up.

<p>Significant associations between the different variables evaluated and pain and effusion at one month and at one year follow-up.</p

Comparison of patients experiencing pain and effusion at one year follow-up by number of intraarticular injections received.

<p>Comparison of patients experiencing pain and effusion at one year follow-up by number of intraarticular injections received.</p

Adjusted associations with pain and effusion at one year follow-up, evaluating anthropometric measurements, clinical, radiological, ultrasound parameters and the status of pain and effusion at month.

<p>Adjusted associations with pain and effusion at one year follow-up, evaluating anthropometric measurements, clinical, radiological, ultrasound parameters and the status of pain and effusion at month.</p

A Metabolic Model for the Determination of Shell Composition in the Bivalve Mollusc, Mytilus Edulis

Rosenberg. G. D. & Hughes, W. W. 1991 01 15: A metabolic model for the determination of shell composition in the bivalve mollusc, Mytilus edulis. Lethaia, Vol. 24. pp. 83–96. Oslo. ISSN 0024–1164. This research describes compositional variations within the shell of the extant mussel Mytilur edulis and proposes that they are produced by metabolic gradients within the shell‐secreting mantle. Because we have previously proposed that the same metabolic gradients are responsible for variations in shell form (curvature), we establish here a model for molluscan shell growth integrating. for the first time. shell form and composition with mantle metabolism. The electron microprobe was used to measure the distribution of Mg. S, and Ca in the outer calcitic shell layer of sectioned. polished, and either A1‐ or C‐coated shell. Mg/Ca and S/Ca ratios in the outer shell are respectively 1.25 and 1.40 times higher along slow‐growing, commissure‐umbo axes of high shell curvature and high metabolic activity than along rapidly growing axes of low curvature and low metabolic activity. The ratios within the inner surface of the calcitic shell layer decline most rapidly along commissure‐umbo axes where mantle metabolic activity also declines rapidly. We reject the null hypothesis, generally at high levels of significance (1‐tests. F‐tests. regression analyses, and discriminant analysis. with p 4 0.01) that there is no difference in either Mg or S concentration in sections of the calcitic shell layer that differ in shell curvature and mantle metabolic activity. We conclude that calcium (mineral)‐rich portions of shells are energctically less costly to produce than matrix or minor element‐rich portions. in agreement with the proposal that natural selection favors mineral‐rich shells because they are more efficient to produce than matrix‐rich shells. Among‐specimen differences are also highly significant (mixed model ANOVA). This confirms our assertion that paleontologists need to describe variations in skeletal composition among populations and throughout ontogeny as systematically as classical taxonomists describe morphology. if ever the environmental and the genetic influences on skeletal composition are to be distinguished. Bivalves. biomineralization, shell composition. magnesium, sulfur, calcium, metabolism, growth. Mytillus edulis Copyright © 1991, Wiley Blackwell. All rights reserve

Additional file 2: of Synovial fluid adipokines are associated with clinical severity in knee osteoarthritis: a cross-sectional study in female patients with joint effusion

More detailed description of statistical methods. (DOCX 13 kb

Additional file 1 of Specific-cytokine associations with outcomes in knee osteoarthritis subgroups: breaking down disease heterogeneity with phenotyping

Additional file 1