Laxity measurements of the Sacroiliac joints in women with pregnancy-related pelvic pain

The review of the origin, the diagnosis and treatment of pregnancy-related pelvic pain led to the conclusion that laxity of the S!Js may play a central role in the understanding of this syndrome. The department of Biomedical Physics and Technology and the department of Rehabilitation have studied the biomechanical properties of the pelvic joints, in particular the SUs for many years. Because no instrumented method was available, Snijders proposed a new vihration method for the in vivo assessment of SIJ laxity. This resulted in the method of Doppler imaginj\ of vibrations (DIV), which runs as a continuous thread throughout this thesis. 3·14 Chapter 2 describes the intra- and inter-tester reliability indexes of D!V in SIJ laxity measurements performed by several testers, including one experienced tester as well as inexperienced testers. The contribution of various sources of measurement enor associated with the measurement design is also addressed. Chapter 3 presents the pregnancy part of a longitudinal study on 163 subjects with and without PRPP. This study was designed to investigate the association between PRPP and S!J laxity at 36 weeks of pregnancy. Chapter 4 describes the postpartum part of the study presented in chapter 3. The aims of this study were to describe the association between PRPP and SIJ laxity 8 weeks after childbirth and to determine to what extent asymmetric laxity of the SUs during pregnancy has predictive power with regard to postpartum PRPP. Chapter 5 presents a study designed to establish the influence of a pelvic belt on S!J laxity. The belt was tested at two positions (low: at the level of the pubic symphysis, and high: just below the anterior superior iliac spines) and at two tensions (50 and 100 N) in ten healthy subjects. Finally, the study in chapter 6 investigates the influence of a pelvic belt at low and high position on SIJ laxity and its effect on the active straight leg raise (ASLR) test in 25 women with PRPP

Evidence for accelerated biological aging in young adults with prader-willi syndrome

Objective: Adults with Prader–Willi syndrome (PWS) are at increased risk of developing age-associated diseases early in life and, like in premature aging syndromes, aging might be accelerated. We investigated leukocyte telomere length (LTL), a marker of biological age, in young adults with PWS and compared LTL to healthy young adults of similar age. As all young adults with PWS were treated with growth hormone (GH), we also compared LTL in PWS subjects to GH-treated young adults born short for gestational age (SGA). Design: Cross-sectional study in age-matched young adults; 47 with PWS, 135 healthy, and 75 born SGA. Measurements: LTL measured by quantitative polymerase chain reaction, expressed as telomere/single copy gene ratio. Results: Median (interquartile range) LTL was 2.6 (2.4–2.8) at a median (interquartile range) age of 19.2 (17.7–21.3) years in PWS, 3.1 (2.9–3.5) in healthy young adults and 3.1 (2.8–3.4) in the SGA group. Median LTL in PWS was significantly lower compared to both control groups (P < .01). In PWS, a lower LTL tended to be associated with a lower total IQ (r = 0.35, P = .08). There was no association between LTL and duration of GH treatment, cumulative GH dose, or several risk factors for type 2 diabetes mellitus or cardiovascular disease. Conclusions: Young adults with PWS have significantly shorter median LTL compared to agematched healthy young adults and GH-treated young adults born SGA. The shorter telomeres might play a role in the premature aging in PWS, independent of GH. Longitudinal research is needed to determine the influence of LTL on aging in PWS

Lack of benefit for prophylactic drugs of tension-type headache in adults: a systematic review

Methods. We searched several databases from inception to August 2009. We selected randomized trials that reported the effects of prophylactic drugs in patients with TTH, with a pain measure (intensity, frequency, duration, improvement or index) as outcome measure. Two authors independently assessed risk of bias and extracted data from the original reports. A data synthesis was carried out according to the type of medication. Results. We included 44 trials (3399 patients), of which 15 (34.1%) were considered to be of low risk of bias. Main types of medications studied were antidepressants, muscle relaxants, benzodiazepines and vasodilator agents. Overall, antidepressants were no more effective than placebo, and there were no significant differences between different types of antidepressants. There was conflicting evidence about the effectiveness of benzodiazepines and vasodilator agents compared with placebo. Furthermore, there was limited evidence that propranolol had negative effects on depression in TTH patients, when compared with placebo or biofeedback. There was no evidence concerning the effectiveness of muscle relaxants alone or 5-HT receptor agonist compared with placebo. Conclusions. Overall, antidepressants were no more effective on headache intensity or frequency and analgesic use than placebo. Propranolol seemed to have negative effects on depression in TTH patients when compared with placebo or biofeedback. No evidence was found for the use of muscle relaxants alone or 5-HT receptor agonist