Українська діаспора Кабардино-Балкарії

Кабардино-Балкарська республіка – суб’єкт Російської Федерації. За даними статистичного управління за 2000 рік, у республіці проживало близько 15 тисяч етнічних українців. З них в Нальчику - 5725 чоловік

Knee joint distraction results in MRI cartilage thickness increase up to 10 years after treatment

OBJECTIVES: Knee joint distraction (KJD) has been shown to result in long-term clinical improvement and short-term cartilage restoration in young OA patients. The objective of the current study was to evaluate MRI cartilage thickness up to 10 years after KJD treatment, using a 3D surface-based approach. METHODS: Twenty end-stage knee OA patients were treated with KJD. MRI scans (1.5 T) were performed before and at 1, 2, 5, 7, and 10 years after treatment. Tibia and femur cartilage segmentation and registration to a canonical surface were performed semi-automatically. Statistical parametric mapping with linear mixed models was used to analyse whole-joint changes. The influence of baseline patient characteristics was analysed with statistical parametric mapping using linear regression. Relevant weight-bearing parts of the femur were selected to obtain the average cartilage thickness in the femur and tibia of the most- (MAC) and least-affected compartment. These compartmental changes over time were analysed using repeated measures ANOVA; missing data was imputed. In all cases, P 0.05). Compartmental analyses showed significant short- and long-term thickness increase in the tibia and femur MAC (all P <0.05). CONCLUSION: KJD results in significant short- and long-term cartilage regeneration, up to 10 years post-treatment. TRIAL REGISTRATION: Netherlands Trial Register, https://www.trialregister.nl, NL419

Annual report on surveillance of respiratory infectious diseases 2013, the Netherlands

Het griepseizoen (influenza) 2013/2014 was erg mild, na de uitzonderlijk langdurende epidemie in het seizoen 2012/2013. Ook was het een mild seizoen wat betreft het aantal mensen dat een longontsteking (pneumonie) opliep. In 2013 waren er geen grote uitbraken van de meldingsplichtige luchtweginfectieziekten legionellose (308 meldingen), papegaaienziekte (psittacose; 51 meldingen), Q-koorts (19 meldingen) en tuberculose (848 meldingen). Deze aantallen waren in het verslagjaar vergelijkbaar of lager dan het aantal meldingen in voorgaande jaren. Dit blijkt uit de jaarlijkse surveillance luchtweginfectieziekten 2013 van het RIVM. Griep en longontsteking leiden tot veel ziekenhuisopnames en sterfte in Nederland, waardoor het RIVM ze actief volgt. In vergelijking met griep komen de meldingsplichtige luchtweginfecties in Nederlands maar weinig voor. Ze zijn meldingsplichtig, omdat tijdige maatregelen, zoals de besmettingsbron opsporen, belangrijk kunnen zijn om uitbraken of verdere verspreiding van de ziekte te voorkomen. Het RIVM volgt ook potentieel gevaarlijke nieuwe luchtweginfecties die elders in de wereld voorkomen. In mei 2014 werden voor het eerst in Nederland twee patiënten gediagnostiseerd met het MERS coronavirus. In het seizoen 2013/2014 lag het aantal mensen dat met griepachtige klachten bij de huisarts kwam begin 2014 gedurende vier weken boven de grens waarmee een griepepidemie wordt geduid. Bij de patiënten met griepachtige klachten kwam naast influenzavirus vaak RSV (respiratoir syncytieel virus) en neusverkoudheid (rhinovirus) voor. Er kwamen minder mensen met een longontsteking bij de huisarts dan voorgaande seizoenen, maar het aantal longontstekingpatiënten in verpleeghuizen bleef gelijk.The 2013/2014 influenza season was extremely mild in the Netherlands, compared to the exceptionally long-lasting epidemic in 2012/2013. In addition, the number of pneumonia patients and overall mortality, possible complications of influenza, were low. In 2013, no major outbreaks of the notifiable respiratory infectious diseases legionellosis (308 notifications), psittacosis (51 notifications), Q-fever (19 notifications) and tuberculosis (848 notifications) occurred. These incidences are either comparable to or lower than preceding years. These are the outcomes of the annual report: 'Surveillance of respiratory infectious diseases 2013, the Netherlands', published by the Dutch National Institute for Public Health and the Environment (RIVM). Influenza and pneumonia are an important cause of hospital admissions and death in the Netherlands, a reason for the RIVM to actively monitor these diseases. In comparison to influenza, notifiable respiratory infectious diseases only rarely occur. These diseases are notifiable, as timely measures like source finding, are important for preventing outbreaks and/ or ongoing transmission of the disease. The RIVM also monitors potential threats to public health from new (worldwide) respiratory infections. In May 2014, the first two cases of MERS coronavirus were diagnosed in the Netherlands. During the 2013/2014 influenza-season, the number of patients with influenza-like illness (ILI) consulting a general practitioner, was above the threshold set for an influenza epidemic for four weeks at the beginning of 2014. In nose and throat samples of ILI-patients, RSV (respiratory syncytial virus) and rhinovirus were found in addition to the influenza virus. During the 2013/2014 influenza-season, fewer patients consulted the general practitioner for pneumonia than in previous years, however the number of pneumonia patients in nursing homes was similar.Ministerie van VW

Cartilage collagen structure upon knee joint distraction and high tibial osteotomy as measured with T2-mapping MRI - post-hoc analyses of two RCTs

Objective High tibial osteotomy (HTO) and knee joint distraction (KJD) are joint-preserving treatments for knee osteoarthritis (OA) that have shown good clinical results and cartilage thickness increase. In this exploratory study, cartilage T2 relaxation times, as a measure of collagen structure, are evaluated after both treatments, and compared to natural OA progression. Design Ten patients indicated for total knee arthroplasty (TKA) were treated with KJD (KJDTKA). Thirty patients indicated for HTO were treated with KJD (KJDHTO; n = 10) or HTO (n = 20). 3T T2-mapping MRI scans were performed before and one (KJD groups only) and two years after treatment, from which cartilage was segmented and the volume and T2 relaxation times were calculated. Patients were matched with untreated patients from the Osteoarthritis Initiative (OAI) to compare the change in T2 values over time. Results KJDHTO (n = 8) and HTO (n = 17) patients both showed statistically significant increases in T2 values (worsening) but no volume changes. KJDTKA patients (n = 8) only showed a tendency for (first-year) T2 value increase, and a significant volume increase in the most affected compartment (MAC). There were no significant differences between the three groups. All treated patients combined showed a significantly higher increase in T2 times than untreated patients from the OAI for both femur and tibia. Conclusions KJD and HTO cause an increase in cartilage T2 relaxation times, which could indicate loss or reorganization of collagen structure integrity. In TKA-indicated KJD patients, this goes paired with volume increase, indicating it may be the result of maturation of newly formed cartilage

Radiographic joint damage in rheumatoid arthritis is associated with differences in cartilage turnover and can be predicted by serum biomarkers: an evaluation from 1 to 4 years after diagnosis

INTRODUCTION: The objective of this study was to determine whether serum biomarkers for degradation and synthesis of the extracellular matrix of cartilage are associated with, and can predict, radiographic damage in patients with rheumatoid arthritis (RA). METHODS: Clinical and radiographic data of 87 RA patients were recorded 1 year after disease onset and then annually up to four years. Serum concentrations of four cartilage biomarkers were determined at these time points: a neoepitope formed by collagenase cleavage of type II collagen (C2C), a neoepitope formed by collagenase cleavage of type II collagen as well as type I collagen (C1,2C), a carboxy propeptide of type II procollagen formed during synthesis (CPII), and a cartilage proteoglycan aggrecan turnover epitope (CS846-epitope). Biomarker concentrations between patients with rapid radiographic progression (>7.3 Sharp/van der Heijde units per year) and those with slow radiographic progression (<2.3 units per year) were compared. In addition, we evaluated the long-term and short-term predictive value of each biomarker for progression of radiographic damage. RESULTS: Patients with rapid radiographic progression had higher C2C, higher C1,2C, and higher CS846-epitope levels than slow progressors. CPII levels showed no differences. Most importantly, the long-term radiographic progression for C2C, for C1,2C, and for CS846-epitope can be predicted by the biomarker value at year 1 after disease onset. C2C was also a predictor for joint space narrowing and annual radiographic damage during the subsequent year. CONCLUSION: This study shows that the concentration of serum biomarkers of cartilage collagen breakdown and proteoglycan turnover, but not of collagen synthesis, are related to joint destruction in RA. The use of these biomarkers may be of value when studying progression of joint damage in patients with RA

Exploring the differences between radiographic joint space width and MRI cartilage thickness changes using data from the IMI-APPROACH cohort

[Abstract] Objective: Longitudinal weight-bearing radiographic joint space width (JSW) and non-weight-bearing MRI-based cartilage thickness changes often show weak correlations. The current objective was to investigate these correlations, and to explore the influence of different factors that could contribute to longitudinal differences between the two methods. Methods: The current study included 178 participants with medial osteoarthritis (OA) out of the 297 knee OA participants enrolled in the IMI-APPROACH cohort. Changes over 2 years in medial JSW (ΔJSWmed), minimum JSW (ΔJSWmin), and medial femorotibial cartilage thickness (ΔMFTC) were assessed using linear regression, using measurements from radiographs and MRI acquired at baseline, 6 months, and 1 and 2 years. Pearson R correlations were calculated. The influence of cartilage quality (T2 mapping), meniscal extrusion (MOAKS scoring), potential pain-induced unloading (difference in knee-specific pain scores), and increased loading (BMI) on the correlations was analyzed by dividing participants in groups based on each factor separately, and comparing correlations (slope and strength) between groups using linear regression models. Result: Correlations between ΔMFTC and ΔJSWmed and ΔJSWmin were statistically significant (p < 0.004) but weak (R < 0.35). Correlations were significantly different between groups based on cartilage quality and on meniscal extrusion: only patients with the lowest T2 values and with meniscal extrusion showed significant moderate correlations. Pain-induced unloading or BMI-induced loading did not influence correlations. Conclusions: While the amount of loading does not seem to make a difference, weight-bearing radiographic JSW changes are a better reflection of non-weight-bearing MRI cartilage thickness changes in knees with higher quality cartilage and with meniscal extrusion