The Relationship Between Knee Moments and Function with Western Ontario and McMaster Universities in Moderate Knee Osteoarthritis

Introduction: The knee is the most affected weight-bearing joint by osteoarthritis. The kinetics parameters are correlated with the progression of knee osteoarthritis (KOA). This study was done to investigate the relationship between kinetics parameters and functional tests with Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores in people with moderate KOA. Materials and Methods: Twenty- three participants with moderate KOA participated in this study. Gait analysis involved the measurement of the external peak knee adduction moment (PKAM), peak knee flexion moment (PKFM), knee adduction moment impulse (KAM impulse), and knee flexion moment impulse (KFM impulse) during level walking. Functional tests included timed up and go (TUG) and figure of eight walkings (FO8W) tests. Pearson’s correlation coefficient was used to investigate the correlation between kinetics parameters and functional test scores with WOMAC total scores and sub-scores. Results: There was a significant inverse correlation between the first PKAM and WOMAC total score and pain sub-score (r=-0.43 P=0.03 and r=-0.6 P=0.002, respectively). Also, there was a significant inverse correlation between the second PKAM and pain sub-score (r=-0.46 P=0.02). There was no significant correlation between functional tests and WOMAC scores. Conclusion: The low score of the WOMAC in the moderate KOA should not be attributed to the low level of joint knee moments

Treatment of Osteopenic Menopause Women as a Public Health Problem with Nasal Calcitonin; an Original Study on Follow up Markers

Introduction: Various therapeutic options such as Calcitonin are suggested for patients with low bone density. However, the efficacy remains uncertain in all patients. C-telopeptide of type I collagen (CTx) is the authentic bone marker which is recently used to assess the bone turnover. This study aimed at revealing the therapeutic effects of Calcitonin on osteopenic women via serum CTx and assessment of other biochemical markers. Methods: we conducted a before-after clinical trial on menopause women with low bone mineral density (bone mineral density score less than 1.5 SD of peak bone mass) attending Baqiyatallah hospital clinic. They received 200 IU Calcitonin nasal spray, calcium (1000 mg) and vitamin D (400 IU). Then the serum CTx and other laboratory parameters were compared after a 6 months treatment. The data was analyzed using SPSS ver.16, paired T-test and regression model. Results: The study population included 115 menopause women with the mean age of 58.75 ± 8.15 years. The CTx amount decreased significantly compared with that of the baseline level (3.203 ± 2.24 vs. 2.497 ± 1.657 Pmol/lit, P 0.05). Conclusion: Nasal spray of Calcitonin could be effective on the progression of osteoporosis by decreasing bone tissue turnover and improving the bone density. Further controlled-studies with a larger sample size and a longer duration of follow up are recommended

Fc-Gamma Receptor 3B Copy Number Variation Is Not a Risk Factor for Behçet's Disease

Behçet's disease (BD) is an immune-mediated systemic vasculitis associated with HLAB51. Other gene associations are likely and may provide further insight into the pathogenesis of this disease. Fc-gamma receptors play an important role in regulating immune function. Copy number variation (CNV) of the Fc-gamma receptor 3B (FCGR3B) gene is associated with other inflammatory conditions and may also play a role in BD. The aim of this study was to determine whether CNV of the FCGR3B gene is associated with BD or its clinical features. FCGR3B copy number was determined for 187 Iranian patients and 178 ethnicity-matched controls using quantitative real-time PCR. The genotype frequencies were comparable in both BD patients and controls. The odds ratio for low copy number (<2CN) was 0.6 (P = 0.16) and the odds ratio for high copy number (>2CN) was 0.75 (P = 0.50). There was no association found between high or low CN of the FCGR3B gene and BD or its clinical features in this Iranian population. We are the first to report this finding which, when looked at in the context of other genetic studies, gives us further insight into the complex pathogenesis of BD

Supporting Leadership Success in a Complex Global Economy: Best Practices in Executive Coaching

Today’s complex global economy is often referred to as VUCA (volatile, unpredictable, complex, ambiguous) to express the rapid pace of disruptive change and the unreliability of long held structures, processes and beliefs. These unprecedented changes are impacting global leadership practice. Leaders can no longer rely solely on decisive and authoritative decision making to help their organizations remain competitive. The rapid pace of unpredictable change and ambiguity of clear solutions is demanding more collaborative decision-making for today’s toughest challenges. Executive coaches who support global leaders are increasingly in positions of trusted adviser to senior level executives. This qualitative study interviews a group of seasoned executive coaches to gain a deeper understanding of the best practices for supporting global executives, the challenges they face in implementing these practices, the ways in which they measure their success, and their recommendations to other executive coaches who wish to support global leaders. Findings, therefore, contribute to the growing scholarly field of executive coaching in a number of areas, including: (a) executive coaching scholarship, (b) executive coaching training programs, (c) graduate business school curriculum, and (d) leadership development programs

Health-related quality of life and disease activity in rheumatoid arthritis

Background: The present study sought to 1) investigate the degrees of correlations between different disease activity scores (DASs) and health-related quality of life (HRQoL), and 2) determine if DASs correlate with either physical or mental HRQoL. Methods: Eighty patients with rheumatoid arthritis (RA) were assessed for different DASs, measured with erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), namely DAS4-ESR, DAS-3 ESR, DAS4-CRP, DAS3-CRP, DAS4-28 ESR, DAS3-28 ESR, DAS4-28 CRP, and DAS3-28 CRP, and Simplified Disease Activity Indexes namely SDAI-ESR, and SDAI-CRP. Physical and mental HRQoL were measured using the SF-36. The Pearson correlation test was employed to examine the correlations between HRQoL and different DAS indices. PASS 2000 (Power Analysis and Sample Size) software was utilized to find significant differences between the correlations. Results: SF-36 total score showed a significant inverse correlation with the DAS4-ESR, DAS-3 ESR, DAS4-CRP, DAS3-CRP, DAS4-28 ESR, DAS3-28 ESR, DAS4-28 CRP, and DAS3-28 CRP, with correlation coefficients of -0.320, -0.314, -0.330, -0.323, -0.327, -0.318, -0.360 and -0.348, respectively (P < 0.01 for all). The correlation coefficients between different DAS indices and the HRQoL score were not significantly different. In addition, all DASs showed significant correlations with physical HRQoL, but not with mental HRQoL. Conclusions: Among patients with RA, disease severity indices are associated with physical, but not mental HRQoL. However this study failed to show any differences between various DASs in their clinical use

Symptoms of anxiety and depression: A comparison among patients with different chronic conditions

Background: Although patients with chronic diseases are at high-risk for symptoms of anxiety and depression, few studies have compared patients with different chronic conditions in this regard. This study aimed to compare patients with different chronic medical conditions in terms of anxiety and depression symptoms after controlling for the effects of socio-demographic and clinical data. Methods: This cross-sectional study enrolled 2234 adults, either healthy (n = 362) or patients with chronic medical conditions (n = 1872). Participants were recruited from the outpatient clinic of Baqiyatallah Hospital, Tehran, Iran. Patients had one of the following five medical conditions: coronary artery disease (n = 675), renal transplantation (n = 383), chronic hemodialysis (n = 68), rheumatoid conditions (rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus and ankylosing spondylitis) (n = 666) and viral hepatitis (n = 80). Independent factors included socio-demographic data, pain disability, and somatic comorbidities (Ifudu index). Outcomes included symptoms of anxiety and depression through Hospital Anxiety and Depression Scale (HADS). Two multinomial regression models were used to determine the predictors of anxiety and depression symptoms. Results: After controlling the effect of age, sex, educational level, comorbidities, disability and pain, rheumatoid arthritis and hepatitis were predictors of higher anxiety symptoms, while coronary artery disease and chronic hemodialysis were predictors of depression symptoms. Conclusions: Although all chronic conditions may require psychological consideration; be that as it may, different chronic diseases are dissimilar in terms of their mental health need. Anxiety for rheumatoid arthritis and hepatitis as well as depression for coronary artery disease and chronic hemodialysis is more important

Correlation between bone mineral density of jaws and skeletal sites in an Iranian population using dual X-ray energy absorptiometry

Background: The aim of the present study was to evaluate the relationship between the bone density of various regions of jaws and skeletal bones. Materials and Methods: A total of 110 patients with a mean age of 55.01 ± 10.77 years were selected for the purpose of the present descriptive study. Dual X-ray Energy Absorptiometry (DXA) was carried out to determine bone mineral density (BMD) of the femur and lumbar vertebrae. Then all the subjects underwent DXA of the jaw bones and BMD values were determined at four jaw regions. Data were analyzed by SPSS 16 statistical software, and the correlation between the various BMD values was determined by Pearson′s correlation coefficient. Results: The results showed that 42.7% of females had normal BMD values in the femur, and in vertebrae, 20% were osteopenic and 37.3% suffered from osteoporosis, with statistically significant differences in the BMD values of the jaws between the three above-mentioned groups (P < 0.001). There was an increasing tendency toward osteopenia and osteoporosis with age. There was a positive correlation between BMD values of the femur and lumbar vertebrae and those of all the jaw regions under study (P < 0.005). There was a negative correlation (P < 0.01) between age and the BMD values of the femur, lumbar vertebrae and anterior maxilla. Conclusion: The bone density of the maxilla and mandible and presence of osteoporosis or osteopenia in these bones might reflect the same problem in skeletal bones