Presence and Extent of Severe Facet Joint Osteoarthritis Are Associated with Back Pain in Older Adults

Objective To determine whether the presence and extent of severe lumbar facet joint osteoarthritis (OA) are associated with back pain in older adults, accounting for disc height narrowing and other covariates. Design Two hundred and fifty-two older adults from the Framingham Offspring Cohort (mean age 67 years) were studied. Participants received standardized computed tomography (CT) assessments of lumbar facet joint OA and disc height narrowing at the L2–S1 interspaces using four-grade semi-quantitative scales. Severe facet joint OA was defined according to the presence and/or degree of joint space narrowing, osteophytosis, articular process hypertrophy, articular erosions, subchondral cysts, and intraarticular vacuum phenomenon. Severe disc height narrowing was defined as marked narrowing with endplates almost in contact. Back pain was defined as participant report of pain on most days or all days in the past 12 months. We used multivariable logistic regression to examine associations between severe facet joint OA and back pain, adjusting for key covariates including disc height narrowing, sociodemographics, anthropometrics, and health factors. Results Severe facet joint OA was more common in participants with back pain than those without (63.2% vs 46.7%; P = 0.03). In multivariable analyses, presence of any severe facet joint OA remained significantly associated with back pain (odds ratio (OR) 2.15 [95% confidence interval (CI) 1.13–4.08]). Each additional joint with severe OA conferred greater odds of back pain [OR per joint 1.20 (95% CI 1.02–1.41)]. Conclusions The presence and extent of severe facet joint OA on CT imaging are associated with back pain in community-based older adults, independent of sociodemographics, health factors, and disc height narrowing

Quantitative Assessment of Abdominal Aortic Calcification and Disk Height Loss: The Framingham Study

Abstract Background context Vascular disease has been proposed as a risk factor for disc height loss (DHL). Purpose To examine the relationship between quantitative measures of abdominal aortic calcifications (AACs) as a marker of vascular disease, and DHL, on computed tomography (CT). Study design Cross-sectional study in a community-based population. Patient sample Four hundred thirty-five participants from the Framingham Heart Study. Outcome measures Quantitative AAC scores assessed by CT were grouped as tertiles of “no” (reference), “low,” and “high” calcification. Disc height loss was evaluated on CT reformations using a four-grade scale. For analytic purposes, DHL was dichotomized as moderate DHL of at least one level at L2–S1 versus less than moderate or no DHL. Methods We examined the association of AAC and DHL using logistic regression before and after adjusting for cardiovascular risk factors and before and after adjusting for age, sex, and body mass index (BMI). Results In crude analyses, low AAC (odds ratio [OR], 2.05 [1.27–3.30]; p=.003) and high AAC (OR, 2.24 [1.38–3.62]; p=.001) were strongly associated with DHL, when compared with the reference group of no AAC. Diabetes, hypercholesterolemia, hypertension, and smoking were not associated with DHL and did not attenuate the observed relationship between AAC and DHL. Adjustment for age, sex, and BMI markedly attenuated the associations between DHL and low AAC (OR, 1.20 [0.69–2.09]; p=.51) and high AAC (OR, 0.74 [0.36–1.53]; p=.42). Conclusions Abdominal aortic calcification was associated with DHL in this community-based population. This relationship was independent of cardiovascular risk factors. However, the association of AAC with DHL was explained by the effects of age, sex, and BMI

Biological properties of carotenoids extracted from Halobacterium halobium isolated from a Tunisian solar saltern

Background: Bioactive molecules have received increasing attention due to their nutraceutical attributes and anticancer, antioxidant, antiproliferative and apoptosis-inducing properties. This study aimed to investigate the biological properties of carotenoids extracted from Archaea. Methods: Halophilic Archaea strains were isolated from the brine of a local crystallizer pond (TS7) of a solar saltern at Sfax, Tunisia. The most carotenoid-producing strain (M8) was investigated on heptoma cell line (HepG2), and its viability was assessed by the MTT-test. The cells were incubated with different sub-lethal extract rates, with carotenoid concentrations ranging from 0.2 to 1.5 μM. Antioxidant activity was evaluated through exposing the cells to sub-lethal extract concentrations for 24 hours and then to oxidative stress induced by 60 μM arachidonic acid and 50 μM H2O2. Results: Compared to non-treated cells, bacterial carotenoid extracts inhibited HepG2 cell viability (50%). A time and dose effect was observed, with cell viability undergoing a significant (P < 0.05) decrease with extract concentration. After exposure to oxidative stress, control cells underwent a significant (P < 0.05) decrease in viability as compared to the non-treated cells. Conclusions: The bacterial extracts under investigation were noted to exhibit the strongest free radical scavenging activity with high carotenoid concentrations. The carotenoid extract also showed significant antiproliferative activity against HepG2 human cancer cell lines

Numerical investigation of plastic flow and residual stresses generated in hydroformed tubes

During tube hydroforming process, the friction conditions between the tube and the die have a great importance on the material plastic flow and the distribution of residual stresses of the final component. Indeed, a three-dimensional finite element model of a tube hydroforming process in the case of square section die has been performed, using dynamic and static approaches, to study the effect of the friction conditions on both plastic flow and residual stresses induced by the process. First, a comparative study between numerical and experimental results has been carried out to validate the finite element model. After that, various coefficients of friction were considered to study their effect on the thinning phenomenon and the residual stresses distribution. Different points have been retained from this study. The thinning is located in the transition zone cited between the straight wall and the corner zones of hydroformed tube due to the die–tube contact conditions changes during the process. In addition, it is clear that both die–tube friction conditions and the tube bending effects, which occurs respectively in the tube straight wall and corner zones, are the principal causes of the obtained residual stresses distribution along the tube cross-section

Osteoarthritis Bone Marrow Lesions.

Assessment and treatment of Bone Marrow Lesions (BMLs) could ultimately make step changes to the lives of people with osteoarthritis (OA). We here review the imaging and pathological characteristics of OA-BMLs, their differential diagnosis and measurement, and cross-sectional and longitudinal associations with pain and OA structural progression. We discuss how biomechanical and cellular factors may contribute to BML pathogenesis, and how pharmacological and non-pharmacological interventions that target BMLs might reduce pain and OA structural progression. We critically appraise semiquantitative and quantitative methods for assessing BMLs, and their potential utilities for identifying people at risk of symptomatic and structural OA progression, and evaluating treatment responses. New interventions that target OA-BMLs should both confirm their importance, and reduce the unacceptable burden of OA

Les barotraumatismes de l’oreille moyenne

Objectif : Le barotraumatisme de l’oreille moyenne est une entité pathologique particulière rare et spécifique.Matériel et méthodes : Nous rapportons une série rétrospective de 13 cas de barotraumatismes de l’oreille moyenne diagnostiqués et suivis au centre d’expertise et de médecine aéronautique de Tunis.Résultats : L’âge moyen de nos patients est de 34 ans. Les signes fonctionnels étaient dominés par l’otalgie et l’hypoacousie. L’atteinte était bilatérale dans deux cas. Il s’agissait d’atteinte bénigne de stade (I et II) chez huit patients et d’épanchement rétrotympanique dans quatre cas. Une perforation tympanique a été observée chez un seul pilote. Le bilan clinique a permis de mettre en évidence la présence de circonstances favorisantes à la survenue du barotraumatisme dans neuf cas. Sur le plan fonctionnel, nous avons observés quatre barotraumatismes à audition conservée .Par ailleurs, La surdité était de type transitionnelle. La prise en charge thérapeutique était fonction du bilan lésionnel. L’évolution était favorable chez neufs patients avec une récupération auditive totale.Une dispense de vol fût proclamée dans tous les cas. La durée  d’inaptitude initiale était fonction du bilan lésionnel anatomique et fonctionnel et a variée entre dix et soixante jours.Mots-clés : Barotraumatisme, Surdité, Oreille moyenne, Pilote

Mal de pott révelé par un abcès latéropharyngien chez un pilote

Introduction: Pott's disease is the most frequent localisation of osteoarticular tuberculosis. The authors report a case of cervical Pott's disease with lateropharyngeal abscess.Observation: Our patient is a 44 years old pilot; he presented since 6 months cervicalgy, dysphagia and weighting loss.  Clinical findings showed a swelling of posterior and lateral oropharyngeal wall extending to hypopharynx. A palsy of the XI th nerve and an abolition of the bicipital reflex were also noticed. CT scan showed a lateropharyngeal collection extending from C4 to D1. It was also noticed a subtotal destruction of C6.However, there were no medullar lesions in the cervical spine MRI.Tuberculosis was confirmed thanks to histological analysis of caseum taken during cervical biopy. The patient was operated using anterior approach. He had surgical removal of C6 which was replaced by iliac prothesis. Medical treatment was based on antituberculosis drugs used during 12 months. After three years of follow up, the out come was favourable with no recurrence and satisfying consolidation. For aeronautic considerations, the patient was declared unable for flying mission.Conclusion: Tuberculosis constitutes a problematic infectious disease in Tunisia which may have serious consequences on publish health. We insist on preventing measurements because there are neither specific clinical findings nor radiological characterising features.Keywords: Tuberculosis, Pott's disease, lateropharyngeal absces

Further investigation of confirmed urinary tract infection (UTI) in children under five years: a systematic review.

Background: Further investigation of confirmed UTI in children aims to prevent renal scarring and future complications. Methods: We conducted a systematic review to determine the most effective approach to the further investigation of confirmed urinary tract infection (UTI) in children under five years of age. Results: 73 studies were included. Many studies had methodological limitations or were poorly reported. Effectiveness of further investigations: One study found that routine imaging did not lead to a reduction in recurrent UTIs or renal scarring. Diagnostic accuracy: The studies do not support the use of less invasive tests such as ultrasound as an alternative to renal scintigraphy, either to rule out infection of the upper urinary tract (LR- = 0.57, 95%CI: 0.47, 0.68) and thus to exclude patients from further investigation or to detect renal scarring (LR+ = 3.5, 95% CI: 2.5, 4.8). None of the tests investigated can accurately predict the development of renal scarring. The available evidence supports the consideration of contrast-enhanced ultrasound techniques for detecting vesico-ureteric reflux (VUR), as an alternative to micturating cystourethrography (MCUG) (LR+ = 14.1, 95% CI: 9.5, 20.8; LR- = 0.20, 95%CI: 0.13, 0.29); these techniques have the advantage of not requiring exposure to ionising radiation. Conclusion: There is no evidence to support the clinical effectiveness of routine investigation of children with confirmed UTI. Primary research on the effectiveness, in terms of improved patient outcome, of testing at all stages in the investigation of confirmed urinary tract infection is urgently required

Clin Infect Dis

BackgroundGonorrhea (GC) and chlamydia (CT) are the most commonly reported notifiable diseases in the United States. The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) be screened for urogenital GC/CT, rectal GC/CT, and pharyngeal GC. We describe extragenital GC/CT testing and infections among MSM attending sexually transmitted disease (STD) clinics.MethodsThe STD Surveillance Network collects patient data from 42 STD clinics. We assessed the proportion of MSM attending these clinics during July 2011\u2013June 2012 who were tested and positive for extragenital GC/CT at their most recent visit or in the preceding 12 months and the number of extragenital infections that would have remained undetected with urethral screening alone.ResultsOf 21 994 MSM, 83.9% were tested for urogenital GC, 65.9% for pharyngeal GC, 50.4% for rectal GC, 81.4% for urogenital CT, 31.7% for pharyngeal CT, and 45.9% for rectal CT. Of MSM tested, 11.1% tested positive for urogenital GC, 7.9% for pharyngeal GC, 10.2% for rectal GC, 8.4% for urogenital CT, 2.9% for pharyngeal CT, and 14.1% for rectal CT. More than 70% of extragenital GC infections and 85% of extragenital CT infections were associated with negative urethral tests at the same visit and would not have been detected with urethral screening alone.ConclusionsExtragenital GC/CT was common among MSM attending STD clinics, but many MSM were not tested. Most extragenital infections would not have been identified, and likely would have remained untreated, with urethral screening alone. Efforts are needed to facilitate implementation of extragenital GC/CT screening recommendations for MSM.20142015-12-01T00:00:00ZCC999999/Intramural CDC HHS/United StatesRFA PS08-865/PS/NCHHSTP CDC HHS/United States24647015PMC466652