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Clinical Obesity Apr 2015Children with obesity report musculoskeletal pain more than normal-weight children; this may be linked with literature suggesting children with obesity have higher... (Review)
Review
Children with obesity report musculoskeletal pain more than normal-weight children; this may be linked with literature suggesting children with obesity have higher prevalence of pes planus (flatfoot). To further elucidate whether this relation occurs, we conducted a systematic literature review on the co-occurrence of pes planus and paediatric obesity. Empirical articles published until September 2013 were obtained through an electronic search of MEDLINE and SPORTDiscus; included articles examined the association between body weight and pes planus in children. Thirteen cross-sectional studies of varied designs were identified. Methods used to diagnose pes planus varied between studies: imaging modalities, anthropometric measurements and clinical examination. Across all studies, pes planus prevalence among children with obesity ranged widely from 14 to 67%. Nearly all studies indicated increasing pes planus in children with increasing weight. No studies evaluated pain/complications related to pes planus. Our review suggests increased prevalence of pes planus among children with obesity or increasing weight status. Because of differing methodologies, lack of consensus regarding the pes planus definition, the dearth of investigation into pain/complications and the few existing studies, more research is needed to determine a relation between children's body weight, pes planus and associated effects on pain and function.
Topics: Age Factors; Comorbidity; Flatfoot; Foot; Humans; Pain; Pediatric Obesity; Prevalence
PubMed: 25808780
DOI: 10.1111/cob.12091 -
African Journal of Reproductive Health Sep 2020Nigeria has a large number of congenital disorders (CD). For instance, two out of every hundred children born in Nigeria have sickle cell disorders (SCD). Making Nigeria... (Review)
Review
Nigeria has a large number of congenital disorders (CD). For instance, two out of every hundred children born in Nigeria have sickle cell disorders (SCD). Making Nigeria the country with the highest incidence of SCD. This article reviews the prevalence of CD in Nigeria; with emphasis on those having a heavy statistical burden on the country, the availability of community genetics services in Nigeria and the efforts being made to tackle the challenges of CD. A systematic review of birth prevalence of congenital malformations (CM) in Nigeria was done through a literature search, with no time restriction for publication dates. Only studies that included the birth prevalence of CM were included. Eligible studies with incorrect or missing data were excluded. This revealed a dearth of data on CD in Nigeria, as in most Low- and Middle-Income Countries. A predominance of CM of the musculoskeletal and gastrointestinal systems was found in Nigeria. However, the pattern of CM in the South-South region was more of the central nervous system. There is scarcity of resources to address the challenges of CD in Nigeria with feeble government assistance. Meanwhile, 70% of CD can be prevented and adequately managed by well implemented community genetics services.
Topics: Anemia, Sickle Cell; Central Nervous System; Community Health Services; Congenital Abnormalities; Genetic Counseling; Genetic Diseases, Inborn; Genetic Services; Humans; Infant, Newborn; Musculoskeletal Abnormalities; Nigeria
PubMed: 34077139
DOI: 10.29063/ajrh2020/v24i3.18 -
Osteoarthritis and Cartilage Aug 2018Subchondral bone abnormalities (SBAs) on magnetic resonance imaging (MRI) are observed frequently and associated with disease course in various musculoskeletal... (Comparative Study)
Comparative Study
Comparison of histological and morphometrical changes underlying subchondral bone abnormalities in inflammatory and degenerative musculoskeletal disorders: a systematic review.
OBJECTIVE
Subchondral bone abnormalities (SBAs) on magnetic resonance imaging (MRI) are observed frequently and associated with disease course in various musculoskeletal disorders. This review aims to map the existing knowledge of their underlying histological features, and to identify needs for future research.
DESIGN
We conducted a systematic review following PRISMA guidelines until September 2017, including all studies correlating histological features to on MRI defined SBAs in patients with osteoarthritis (OA), rheumatoid arthritis (RA), spondyloarthritis (SpA) and degenerative disc disease (DDD). Two authors independently retrieved articles and assessed study quality.
RESULTS
A total of 21 studies (466 patients) correlated histological features to SBAs in OA (n = 13), RA (n = 3), ankylosing spondylitis (AS) (n = 1) and DDD (n = 4). Reported changes in OA were substitution of normal subchondral bone with fibrosis and necrosis, and increased bone remodeling. In contrast, in RA, AS or DDD fibrosis was not reported and SBAs correlated to an increase in inflammatory cell number. In DDD necrosis was observed. Similar to OA, increased bone remodeling was shown in RA and DDD. The risk of bias assessment showed a lack in described patient criteria, blinding and/or adequate topographic correlation in approximately half of studies. There was heterogeneity regarding the investigated histological features between the different disorders.
CONCLUSIONS
Current studies suggest that SBAs correlate to various histological features, including fibrosis, cell death, inflammation and bone remodeling. In the majority of studies most quality criteria were not met. Future studies should aim for high quality research, and consistency in investigated features between different disorders.
Topics: Arthritis, Rheumatoid; Bone and Bones; Humans; Inflammation; Intervertebral Disc Degeneration; Musculoskeletal Diseases; Osteoarthritis; Spondylitis, Ankylosing
PubMed: 29777863
DOI: 10.1016/j.joca.2018.05.007 -
Rheumatology (Oxford, England) Mar 2016Musculoskeletal symptoms are common in SLE and are associated with significant morbidity. However, assessing their nature can be challenging, with implications for... (Review)
Review
OBJECTIVES
Musculoskeletal symptoms are common in SLE and are associated with significant morbidity. However, assessing their nature can be challenging, with implications for treatment decisions and measuring response. US has been shown to be valid and reliable for the assessment of other inflammatory arthritides, but data in SLE are more limited. The objectives of this systematic literature review were to determine the characteristics of musculoskeletal US abnormalities in SLE and to evaluate the metric properties of US in the detection and quantification of musculoskeletal symptoms.
METHODS
We systematically searched the literature using the PubMed, Embase and Cochrane Library databases for studies using musculoskeletal US for assessing SLE. Studies were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies tool and for their metric qualities, including reliability and validity.
RESULTS
Nine studies were identified. Most studies investigated construct validity. Rates of abnormality were highly variable: synovitis and tenosynovitis were reported in 25-94% and 28-65% of patients, respectively; power Doppler and erosions were reported in 10-82% and 2-41% of patients, respectively. There was poor to moderate association between US abnormalities and disease activity indices and immunological findings. There was moderate to high risk of bias and there were concerns about applicability in most studies.
CONCLUSION
US has potential value in the assessment of musculoskeletal symptoms in SLE. However, there is methodological variation between studies that may account for lack of consensus on US abnormalities. Studies that address these problems are required before US can used as an outcome measure in SLE.
Topics: Adult; Arthritis; Female; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Musculoskeletal Diseases; Role; Sensitivity and Specificity; Severity of Illness Index; Synovitis; Tenosynovitis; Ultrasonography, Doppler; Young Adult
PubMed: 26447163
DOI: 10.1093/rheumatology/kev343 -
The Cochrane Database of Systematic... Jan 2008Metacarpophalangeal (MCP) arthroplasty with implants, which is the replacement of painful knuckle joints with artificial knuckle joints, has been performed for people... (Review)
Review
BACKGROUND
Metacarpophalangeal (MCP) arthroplasty with implants, which is the replacement of painful knuckle joints with artificial knuckle joints, has been performed for people with rheumatoid arthritis (RA) since the 1960s. The surgery is done because RA can cause damage of the knuckle joints making them unable to straighten out (flexion deformity) and causing them to lean over toward the small finger (flexion or ulnar deviation deformity). For eight to 12 weeks following surgery, patients wear hand splints and perform exercises to maintain and increase motion in the healing hand. Post-operative therapy regimes share common aims of encouraging MCP flexion and extension without the recurrence of flexion or ulnar deviation deformity.
OBJECTIVES
To compare the effectiveness of post-operative therapy regimes for increasing hand function after MCP arthroplasty in adults with rheumatoid arthritis.
SEARCH STRATEGY
The Cochrane Musculoskeletal Group Register, MEDLINE (January 1950 to August 2006), EMBASE (January 1993 to August 2006), CINAHL (January 1982 to August 2006), Digital Dissertations (January 1960 to August 2006), DARE (The Cochrane Library 2006, Issue 3), Current Contents Connect (January 1998 to August 2006), and AMED (January 1985 to August 2006) were searched for randomised controlled trials and controlled clinical trials using rheumatoid arthritis and hand as the search terms. The bibliographies of all trials identified by this strategy were also searched and primary authors were contacted for unpublished data and also clarification regarding study protocols. We performed handsearches of all relevant society conference proceedings and reference lists of retrieved articles. No language limits were applied, although searches were only relevant after the 1950s when MCP arthroplasty began to be performed.
SELECTION CRITERIA
Randomised controlled trials and controlled clinical trials were accepted if they evaluated the efficacy of a post-operative therapy regime for MCP arthroplasty.
DATA COLLECTION AND ANALYSIS
No data analyses were performed as only one controlled clinical trial was found. The data from that study are described.
MAIN RESULTS
Our search only identified one controlled clinical trial involving 22 participants. The majority of the evidence for various splinting and exercise regimes consisted of case series and case studies. Results from the one (poor quality) trial suggest that the use of continuous passive motion is not effective in increasing motion or strength after MCP arthroplasty.
AUTHORS' CONCLUSIONS
Well-designed randomised controlled trials which compare the efficacy of different therapeutic splinting programmes following MCP arthroplasty are required. At this time, the results of one study (silver level evidence) suggest that continuous passive motion alone is not recommended for increasing motion or strength after MCP arthroplasty.
Topics: Arthritis, Rheumatoid; Arthroplasty, Replacement; Humans; Metacarpophalangeal Joint; Motion Therapy, Continuous Passive
PubMed: 18254021
DOI: 10.1002/14651858.CD003522.pub2 -
Current Drug Safety 2016Multiple pregnancies are a recognized adverse effect of assisted reproductive technologies; nevertheless, there is no consensus on the incremental risk associated with... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Multiple pregnancies are a recognized adverse effect of assisted reproductive technologies; nevertheless, there is no consensus on the incremental risk associated with the ovarian stimulation (OS) used alone and intrauterine insemination (IUI). The relationship between OS and IUI and the risk of major congenital malformations (MCM) is unclear.
OBJECTIVE
To summarise the literature and evaluate the risk of multiple pregnancy and MCM associated with OS used alone and IUI used with or without OS compared to natural conception (spontaneously conceived infants without any type of fertility treatments).
METHODS
We carried out a systematic review to identify published papers between 1966 and 2014 in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. We included observational studies and randomized clinical trials related to the risk of multiple pregnancies and MCM conceived following OS alone or IUI compared to natural conception (spontaneously conceived infants without any fertility treatments). The quality of the included studies was evaluated using The Cochrane Collaboration's tool for assessing risk of bias for RCTs and the Newcastle-Ottawa Scale for observational studies.
RESULTS
There were 63 studies included in this review. Our systematic review suggests that the use of any OS alone was associated with an increased risk of multiple pregnancy compared to natural conception (pooled RR 8.80, 95% CI 5.09- 15.20; p= 0.000; 9 studies). Similar increases in the risk of multiple pregnancies were observed following clomiphene citrate used without assisted reproductive technologies. Compared to natural conception, the use of IUI with or without OS was associated with an increased risk of multiple pregnancy (pooled RR 9.73, 95% CI 7.52 -12.60; p= 0.000; 6 studies). Compared to natural conception, the use of any OS alone was associated with an increased risk of any MCM (RR pooled 1.18, 95%CI 1.03-1.36; 11 studies), major musculoskeletal malformations (pooled RR 1.48, 95%CI 1.21-1.81; 7 studies), and malformations of the nervous system (pooled RR 1.73, 95%CI 1.15-2.61; 6 studies). Compared to natural conception, the use of IUI was associated with an increased risk of any MCM (pooled RR 1.23, 95%CI 1.10-1.37; 10 studies), major urogenital (pooled RR 1.52, 95%CI 1.04-2.22; 7 studies), and musculoskeletal malformations (pooled RR 1.54, 95%CI 1.20-1.98; 7 studies). The overall quality of the included studies was acceptable.
CONCLUSIONS
The increased risk of multiple pregnancy and certain types of MCM associated with the use of less invasive fertility treatments, such as OS and IUI, found in this review, highlights the importance of the practice framing. Heterogeneity in OS protocols, the combination with other fertility agents, the limited number of studies and the methodological quality differences reduce our ability to draw conclusions on specific treatment. More observational studies, assessing the risk of multiple pregnancy or MCM, as a primary outcome, using standardized methodologies, in larger and better clinically defined populations are needed.
Topics: Clinical Trials as Topic; Congenital Abnormalities; Female; Fertility Agents, Female; Humans; Insemination; Ovulation Induction; Pregnancy; Pregnancy, Multiple; Risk Factors
PubMed: 27484228
DOI: 10.2174/1574886311666160627094051 -
Medicine and Science in Sports and... Apr 2017Barefoot locomotion is widely believed to be beneficial for motor development and biomechanics but are implied to be responsible for foot pathologies and running-related... (Review)
Review
INTRODUCTION
Barefoot locomotion is widely believed to be beneficial for motor development and biomechanics but are implied to be responsible for foot pathologies and running-related injuries. Although most of available studies focused on acute effects of barefoot running and walking little is known regarding the effects of long-term barefoot versus shod locomotion. The purpose of this study was to systematically review the literature to evaluate current evidence of habitual barefoot (HB) versus habitual shod locomotion on foot anthropometrics, biomechanics, motor performance, and pathologies.
METHODS
Four electronic databases were searched using terms related to habitually barefoot locomotion. Relevant studies were identified based on title, abstract, and full text, and a forward (citation tracking) and backward (references) search was performed. Risk of bias was assessed, data pooling, and meta-analysis (random effects model) performed and finally levels of evidence determined.
RESULTS
Fifteen studies with 8399 participants were included. Limited evidence was found for a reduced ankle dorsiflexion at footstrike (pooled effect size, -3.47; 95% confidence interval [CI], -5.18 to -1.76) and a lower pedobarographically measured hallux angle (-1.16; 95% CI, -1.64 to -0.68). HB populations had wider (0.55; 95% CI, 0.06-1.05) but no shorter (-0.22; 95% CI, -0.51 to 0.08) feet compared with habitual shod populations. No differences in relative injury rates were found, with limited evidence for a different body part distribution of musculoskeletal injuries and more foot pathologies and less foot deformities and defects in HB runners.
CONCLUSIONS
Only limited or very limited evidence is found for long-term effects of HB locomotion regarding biomechanics or health-related outcomes. Moreover, no evidence exists for motor performance. Future research should include prospective study designs.
Topics: Athletic Performance; Biomechanical Phenomena; Foot; Foot Diseases; Foot Injuries; Humans; Running; Shoes; Time Factors; Walking
PubMed: 27801744
DOI: 10.1249/MSS.0000000000001141 -
Medicina (Kaunas, Lithuania) Nov 2022: Marfan syndrome (MS) is a genetic disorder with autosomal dominant inheritance that affects the connective tissue and consequently many organ systems. The... (Review)
Review
: Marfan syndrome (MS) is a genetic disorder with autosomal dominant inheritance that affects the connective tissue and consequently many organ systems. The cardiovascular manifestations of MS are notorious and include aortic root dilatation or acute aortic dissection, which can cause morbidity and early mortality. However, surgical treatment of aortic pathology may be complicated by musculoskeletal deformity of the chest wall, as in pectus excavatum. In this regard, single-stage combined Bentall and Ravitch surgery is an extreme rarity that has also been scarcely reported in the literature. : We present the medical history and single-stage Bentall and modified Ravitch surgical treatment of an 18-year-old male MS patient with symptomatic and severe pectus excavatum (PEX) in conjunction with a pear-shaped aortic root aneurysm. To discuss our case in the context of a synopsis of similar published cases, we present a systematic review of combined Bentall surgical aortic aneurysm repair and Ravitch correction of PEX. : A total of four studies (one case series and three case reports) and a case from our institution describing a single-stage combined Bentall and Ravitch operation were included. Patients were 22 ± 5.9 years of age (median = 22.5 years) and predominantly male (60%). All cases reported a midline vertical skin incision over the sternum. The most common surgical approach was midsternotomy (80%). In all cases metal struts were used to reinforce the corrected chest wall. Postoperative mortality was zero. : Single-stage combined Bentall and Ravitch surgery is an underutilized surgical approach. Its use in MS patients with concomitant PEX and ascending aortic aneurysm that require surgical treatment warrants further investigation. Midsternotomy seems to be a viable access route that provides sufficient exposure in the single-stage surgical setting. Although operative time is long, the intraoperative and postoperative risks appear to be low and manageable.
Topics: Humans; Male; Young Adult; Adult; Adolescent; Female; Funnel Chest; Marfan Syndrome; Sternum; Aortic Dissection; Aorta; Treatment Outcome
PubMed: 36556976
DOI: 10.3390/medicina58121774 -
Physical & Occupational Therapy in... Feb 2012This systematic review evaluates the validity, reliability, and clinical utility of outcome measures used to assess self-care skills among children with congenital... (Review)
Review
This systematic review evaluates the validity, reliability, and clinical utility of outcome measures used to assess self-care skills among children with congenital musculoskeletal conditions and assesses the applicability of these measures for children with osteochondrodysplasia aged 0-12 years. Electronic databases were searched to identify self-care assessments that addressed the self-care domain as defined by of the International Classification of Function Disability and included children with osteochondrodysplasia. Ten measures were identified and three met the inclusion criteria: the Functional Independence Measure for Children (WeeFIM), the Activities Scale for Kids (ASK), and the Pediatric Evaluation of Disability Inventory (PEDI). Although psychometric data specific to children with osteochondrodysplasia are limited, adequate to excellent reliability and evidence of validity were reported for all three instruments for children with physical disabilities. Further evaluation of psychometric properties of self-care instruments specifically for children with osteochondrodysplasia would be beneficial to help identify instruments that will assist with improved assessment and management.
Topics: Activities of Daily Living; Child; Disability Evaluation; Humans; Musculoskeletal Abnormalities; Osteochondrodysplasias; Outcome Assessment, Health Care; Reproducibility of Results
PubMed: 21728924
DOI: 10.3109/01942638.2011.593619 -
International Journal of Orthopaedic... Feb 2021Idiopathic scoliosis is a musculoskeletal condition leading to deformity of the spinal column. There is strong evidence reporting short term health-related quality of... (Review)
Review
INTRODUCTION
Idiopathic scoliosis is a musculoskeletal condition leading to deformity of the spinal column. There is strong evidence reporting short term health-related quality of life outcomes, but less is known about the longer-term impact of adolescent idiopathic scoliosis (AIS). This paper reports the current evidence on long-term non-clinical outcomes of AIS.
METHOD
A systematic scoping literature review combining descriptive and textual narrative synthesis was undertaken. Studies were included if they: sampled or followed up participants at least 10 years after diagnosis and/or treatment, contained health-related quality of life data that could be extracted, where the intervention (or diagnosis in the case of untreated) occurred after 1980, and where data was extractable for modern rod and screw or fusion techniques, non-surgical interventions or untreated patients.
RESULTS
Twenty-three studies were included. Overall, the HRQOL measures utilised by these studies suggest that HRQOL is not related to participant demographics or AIS characteristics or type or extent of surgical intervention. Some studies suggest that those with AIS scored worse than controls.
DISCUSSION
Results suggest that AIS participants had a generally good quality of life, although this was often worse than those without AIS. No other clear relationships were found. The available literature fails to address more fundamental questions about how HRQOL is conceptualised for those with AIS, and there is value in pursuing qualitative inquiry in this area.
Topics: Adolescent; Humans; Quality of Life; Scoliosis; Spinal Fusion; Spine
PubMed: 33500208
DOI: 10.1016/j.ijotn.2021.100844