Relationship between knee and ankle degeneration in a population of organ donors

<p>Abstract</p> <p>Background</p> <p>Osteoarthritis (OA) is a progressive degenerative condition of synovial joints in response to both internal and external factors. The relationship of OA in one joint of an extremity to another joint within the same extremity, or between extremities, has been a topic of interest in reference to the etiology and/or progression of the disease.</p> <p>Methods</p> <p>The prevalence of articular cartilage lesions and osteophytes, characteristic of OA, was evaluated through visual inspection and grading in 1060 adult knee/tali pairs from 545 cadaveric joint donors.</p> <p>Results</p> <p>Joint degeneration increased more rapidly with age for the knee joint, and significantly more knee joints displayed more severe degeneration than ankle joints from as early as the third decade. Women displayed more severe knee degeneration than did men. Severe ankle degeneration did not exist in the absence of severe knee degeneration. The effect of weight on joint degeneration was joint-specific whereby weight had a significantly greater effect on the knee. Ankle grades increasingly did not match within a donor as the grade of degeneration in either the left or the right knee increased.</p> <p>Conclusions</p> <p>Gender and body type have a greater effect on knee joint integrity as compared to the ankle, suggesting that knees are more prone to internal causative effects of degeneration. We hypothesize that the greater variability in joint health between joints within an individual as disease progresses from normal to early signs of degeneration may be a result of mismatched limb kinetics, which in turn might lead to joint disease progression.</p

Evaluation of disease burden, patient journey, unmet diagnosis and treatment needs of patients with HIP and knee osteoarthritis in Turkey: A study through Delphi Methodology

Objective: To get information-driven insights from expert physicians regarding multiple aspects of the patient journey in knee and hip OA and establish a consensus for future studies and decision tree models in Turkey. Design: 157 questions were asked in total during this three-round modified Delphi-method panel to 10 physical medicine and rehabilitation specialists (2 have rheumatology and 3 have algology subspeciality), one orthopaedic surgeon and one algology specialist from anaesthesia specialty background. A consensus was achieved when 80% of the panel members agreed with an item. Contradictions between different disciplines were accepted as a non-consensus factor. Results: Panellists agreed that American College of Rheumatology classification criteria is mostly sufficient to provide an OA diagnosis in clinical practice, OA patients with ≥5 Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain or physical function score can be defined as moderate-to-severe OA if they have an additional ≥2 Kellgren-Lawrence (KL) score, a minimum improvement of 30% from baseline in WOMAC pain or function subscales or in PGA score can be accepted as moderate treatment response where ≥50% improvement from baseline in those scores as substantial response. Panellists stated that arthroplasty procedures need to be delayed as long as possible, but this delay should not jeopardize a beneficial and successful operation. Conclusions: These findings show that there is a significant disease burden, unmet treatment needs for patients with moderate-to-severe OA in Turkey from experts’ perspective. Therefore, an updated systematic approach and decision tree models are needed to be implemented. © 202

Assessment of the Environmental and Physical Ergonomic Conditions of ORs in Turkey

This descriptive, cross-sectional study in hospital ORs in Izmir, Turkey, assessed the environmental and physical ergonomic conditions that may place perioperative personnel at risk for injury or illness. We used an ergonomic conditions and risk factor description form to collect data in 58 ORs in nine different hospitals. We identified that the noise level and general air quality in the ORs were within recommended levels. However, none of the ORs had a surgical smoke evacuation system, pressure-absorbing mats, or special equipment to facilitate patient moving and lifting. Approximately 70% of the ORs had high stools to provide short periods of rest for the surgical personnel. In addition, perioperative personnel did not wear protection to prevent intraoperative radiation exposure. These results indicate that although some environmental factors were within acceptable limits, other physical ergonomic risks were not adequately addressed, thereby placing perioperative staff members at risk for health concerns

The impacts of occupational risks and their effects on work stress levels of health professional (The sample from the Southeast region of Turkey)

OBJECTIVES: This study was performed to determine the occupational risks and their effects on the work stress of the health professionals working in state hospitals in the Southeast of Turkey. METHODS: This cross-sectional and descriptive study was composed of 360 health professionals of the Pazarcık, Ergani, and Şehitkamil State Hospitals between December 2014 and January 2015. The data of the study were obtained by performing the survey which was composed of questions related to the socio-demographic characteristics, factors that were thought to affect the occupational risks and job stress, as well as, the questions of the Work Stress Scale. The analyses of the data have been performed using Student’s t test and one-way analysis of variance. RESULTS: The working hours, the number of being on-duty, insomnia, and burnout in health professionals were determined to be with the highest mean scores among other stressful risks and hazards. The mean work stress level, which increases the success by creating the group-stimulus effect, was indicated as 2.4 and 2.5 for the health professionals in Pazarcık and Ergani State Hospital, respectively. However, the stress level which poses a threat for the group-health and efficiency was found to be 4.0 for the health professionals of the Şehitkamil State Hospital. CONCLUSIONS: As the exposure of the occupational risks increases in the health professionals, the work stress scores also increase (p < 0.05). The occupational risks and work stress of the health professionals in the Şehitkamil State Hospital should be evaluated in terms of occupational health and safety