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Frequency and Characteristics of Disease Flares in Ankylosing Spondylitis
Thursday, 06 May 2010 08:26

From Rheumatology

Roxanne Cooksey; Sinead Brophy; Mike B. Gravenor; Caroline J. Brooks; Claire L. Burrows; Stefan Siebert

Posted: 04/26/2010; Rheumatology. 2010;49(5):929-932.  2010 Oxford University Press

Abstract and Introduction


Objective. To examine the characteristics and frequency of disease flares in a cohort of people with AS.

Methods. A prospective data set from a randomized controlled trial (RCT) of a probiotic treatment/placebo was utilized to examine disease flares in 134 people with AS. Disease flares were defined as either minor/localized flares (pain/swelling localized to one area with fatigue and stiffness) or major/generalized flares (generalized pain, hot burning joints, muscle spasm, fever, sweating, extreme fatigue and stiffness).

Results. One hundred and thirty-four people were followed up for 1216 person follow-up weeks and there were 71.4 flares per 100 person-weeks. Of these, 12 were major/generalized flares and 59.4 were minor/localized flares. People who experienced at least one major/generalized flare during the study period had worse disease during flare-free periods in terms of disease activity, impaired function, self-reported night pain and iritis compared with those who did not experience any major/generalized flares during the study. Major/generalized flares lasted for an average of 2.4 weeks (S.D. 2.7), and were preceded by and followed by a minor/localized flare in 92% (55/60) of cases.

Conclusion. Seventy per cent of people with AS felt they had a flare in any given week. Those who experienced major/generalized flares appear to have more severe and active disease even during periods when not in flare, compared with those who do not experience major/generalized flares. These results have implications for the timing of assessments prior to starting anti-TNF therapy and suggest that the presence of major flares may be helpful in identifying patients with severe disease.

Fall Training Feasible for Osteoporosis Patients
Thursday, 06 May 2010 07:56
Patients with osteoporosis can be safely taught how to land from a fall in such a way that might prevent hip fracture, according to results of a feasibility study conducted in healthy young adults, published April 22 in BMC Research Notes.

Brenda E. Groen, MS, from Sint Maartenskliniek Research, Development and Education, Nijmegen, the Netherlands, and colleagues point out that roughly 90% of hip fractures are caused by falls. Martial arts fall training, they note, was recently included in a successful falls prevention program for healthy elderly people. Patients with osteoporosis would be expected to benefit the most from such training because of their high fracture risk if they fall. "For obvious safety reasons, however, this could not be directly assessed using persons with osteoporosis," the study team notes.

What Are the Long-term Effects of Repeated Joint Injections for Chronic Pain?
Thursday, 06 May 2010 07:44

From Medscape Orthopaedics & Sports Medicine > Viewpoints

Joseph Lee, MD 


Intra-articular injections are routinely performed in physicians' offices, typically with a mix of steroid and anesthetic medications. Recent studies, however, have shown potential chondrocyte toxicity when local anesthetics are used for intra-articular purposes.[1-5]

In Vivo Effects of A Single Intra-articular Injection of 0.5% Bupivacaine on Articular Cartilage

Chu CR, Coyle CH, Chu CT, et al
J Bone Joint Surg Am. 2010;92:599-608


Chu and colleagues at the University of Pittsburgh performed an in vivo study in 48 rats to compare the effects of intra-articular injections of preservative-free 0.5% bupivacaine with those of 0.9% normal saline solution (negative control) and 0.6 mg/mL monoiodoacetate (positive control).

Animals received injections of the negative control solution into 1 stifle joint (analogous to the human knee joint) and either bupivacaine or monoiodoacetate in the contralateral joint. The joints were evaluated at 1 week, 4 weeks, 12 weeks, and 6 months on the basis of anatomical examination, histologic findings, surface chondrocyte viability, and chondrocyte cell density.

Thursday, 22 April 2010 13:30

Pretoria The Health Professions Council of South Africa (HPCSA) will not tolerate extortion by certain medical aid schemes. The unlawful practices by leading medical aid schemes have been brought to our attention by a number of healthcare practitioners. The HPCSA has received information that certain medical aid schemes threaten, coerce and intimidate healthcare practitioners into signing acknowledgement of debt agreements where there are allegations of over-servicing of patients and/or claiming for services not rendered by practitioners registered with the HPCSA. Medical aids begin their investigation by collating "evidence" (which remains untested) against a practitioner suspected of over-servicing patients and/or submitting claims in respect of services not rendered. The scheme then invites the practitioner to attend a "mediation meeting". Untested evidence is presented and he/she is then given an ultimatum, or what is deemed to be a "once-off offer" to sign the acknowledgement of debt.

Thursday, 15 April 2010 16:46

As all members are aware, proposals have been made to effect material changes to the Constitution of the Society, to update and streamline our structures and processes in order to become more dynamic, efficient and cost effective in its current environment.

As a first step, the draft resolutions reflected below are being proposed as motions for discussion and approval, either as they stand or as amended.  Amendments proposed by members and seconded will be open for discussion.  Proposed amendments will be voted on, starting with the last amendment proposed.  If an amendment is carried, all other amendments and the original motion will fall away, but if no amendments are proposed or carried the final vote will be on the original motion.

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