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Arthritis Care & Research Apr 2021Little is known regarding what difference in functional performance measures is significant in individuals with chronic medical disease. Our objective was to examine the...
OBJECTIVE
Little is known regarding what difference in functional performance measures is significant in individuals with chronic medical disease. Our objective was to examine the important differences in gait speed in adults with radiographic knee osteoarthritis.
METHODS
Functional performance was measured by gait speed using 20-meter and 400-meter walk tests performed at a self-selected usual pace among adults with radiographic knee osteoarthritis participating in the Osteoarthritis Initiative at baseline and 2 years later. Both distribution-based methods and anchor-based methods were used to calculate the important differences in gait speed. Anchor-based methods used the chair stand rate and self-reported function to estimate gait speed differences related to physical function.
RESULTS
We included 2,527 participants with radiographic knee osteoarthritis. Distribution-based important difference estimates for the 20-meter walk ranged from 4.1 to 6.4 meters/minute and 400-meter walk estimates ranged from 2.9 to 6.5 meters/minute. Prevalent (cross-sectional) anchor-based estimates for the 20-meter walk ranged from 5.4 to 6.9 meters/minute and for the 400-meter walk ranged from 3.0 to 6.9 meters/minute. Longitudinal anchor-based estimates were deemed unreliable. Combining distribution-based with prevalent anchor-based methods showed that an important gait speed difference for the 20-meter walk is between 4.1 and 6.9 meters/minute and for the 400-meter walk is between 2.9 and 6.9 meters/minute.
CONCLUSION
Our results found that the important difference in gait speed for the 20-meter walk and the 400-meter walk is consistent with important difference estimates for older adult populations. These findings can provide benchmarks for assessing and understanding functional performance outcomes when comparing exposure groups and can be used in designing future studies targeting adults with radiographic knee osteoarthritis.
Topics: Aged; Female; Functional Status; Gait Analysis; Humans; Knee Joint; Male; Middle Aged; Osteoarthritis, Knee; Predictive Value of Tests; Prospective Studies; Time Factors; United States; Walking Speed
PubMed: 32004424
DOI: 10.1002/acr.24159 -
Undersea & Hyperbaric Medicine :... 2020The effects of physically exerting scuba dives on the airways are expected to affect the respiratory system and therefore the spirometric flow indices directly after...
The effects of physically exerting scuba dives on the airways are expected to affect the respiratory system and therefore the spirometric flow indices directly after surfacing. After on-air open-sea dives, the flow indices were examined with standard spirometry (maximal forced expiration) within 10 minutes pre- and post-dive. Twenty volunteers, age 49 ± 14 years (m ± SD) equipped with a dive computer to record the dive profile, cylinder pressures and water temperature (27°C), as well as a heart rate monitor, performed 5-meter dives of 27 minutes at maximal swimming velocity (v). Mean pulmonary ventilation (PV) was 48 ± 10 ambient L/minute (aL.min-1). Mean v was 34 ± 6 meters/minute and mean heart rate 143 beats per minute, about 80% of the on-land theoretical maximum. None of the flow variables changed except a decrease of 7.1% ± 8.3 (p=0.001) of the peak expiratory flow (PEF), pre-dive of 11.2 ± 2.7 L/minute. A likely major cause of the reduction of PEF is expiratory muscle fatigue. A small contribution of subclinical pulmonary edema cannot be excluded. The inhalation of dry air and the cooling of the airways are expected to affect PEF minimally. Although the change is normally clinically irrelevant, during emergency it may be of importance.
Topics: Air; Diving; Egypt; Female; Forced Expiratory Flow Rates; Healthy Volunteers; Heart Rate; Humans; Male; Middle Aged; Muscle Fatigue; Peak Expiratory Flow Rate; Pulmonary Ventilation; Seawater; Spirometry; Swimming; Time Factors
PubMed: 32931673
DOI: 10.22462/03.07.2020.12 -
Acupuncture & Electro-therapeutics... 1993Tissue compliance measurements were used for documentation of soft tissue consistency and made possible the diagnosis of muscle spasm and the effects of treatment. We...
Tissue compliance measurements were used for documentation of soft tissue consistency and made possible the diagnosis of muscle spasm and the effects of treatment. We have developed a new digital electronic operated tissue compliance meter to quantify the soft tissue hardness and resistance more objectively than the conventional hand-held mechanical tissue compliance meters. The ranges of measurements were able to perform to a maximum depth of 50 millimeters from the body surface with maximal load of 4000 grams. In lateral epicondylitis was demonstrated the effect of treatment by increase of total work (area).
Topics: Compartment Syndromes; Diagnosis, Differential; Elasticity; Electronics, Medical; Equipment Design; Female; Forearm; Hardness; Humans; Middle Aged; Muscle Contraction; Muscle Tonus; Muscles; Stress, Mechanical; Tennis Elbow; Transducers
PubMed: 7906476
DOI: 10.3727/036012993816357458 -
Journal of Diabetes Science and... Sep 2018The aim of this retrospective study is to evaluate the reliability and robustness of six glucose meters for point-of-care testing in our wards using a brand-new...
The aim of this retrospective study is to evaluate the reliability and robustness of six glucose meters for point-of-care testing in our wards using a brand-new protocol. During a 30-days study period a total of 50 diabetes patients were subjected to venous blood sampling and glucose meter blood analysis. The results of six glucose meters were compared with our laboratory reference assay. GlucoMen Plus (Menarini) with the 82% of acceptable results was the most robust glucose meter. Even if the Passing-Bablok analysis demonstrates the presence of constant systematic errors and the Bland-Altman test highlighted a possible overestimation, the surveillance error grid analysis showed that this glucose meter can be used safely. We proved that portable glucose meters are not always reliable in routinely clinical settings.
Topics: Adult; Aged; Blood Glucose; Blood Glucose Self-Monitoring; Diabetes Mellitus; Female; Humans; Male; Middle Aged; Point-of-Care Systems; Point-of-Care Testing; Reproducibility of Results; Retrospective Studies
PubMed: 29783898
DOI: 10.1177/1932296818774077 -
The Journal of Sports Medicine and... Dec 2016This study investigated which factors influence performance in a short distance swimming test (50-meters) in adolescent swimmers.
BACKGROUND
This study investigated which factors influence performance in a short distance swimming test (50-meters) in adolescent swimmers.
METHODS
Freestyle 50-meter personal best time (PBT) was registered for 67 swimmers (14.3±2.2 y; 46 males). Handgrip (HG), standing broad jump (SBJ), isometric knee-extension (KE), time to run 30 meters (V30m), maximal estimated oxygen-consumption (VO2max), swimming-technique (CTE), height, weight, fat mass, body fat percentage (BF%) and fat-free mass (FFM) were measured. Variables that presented correlation with PBT were further examined using multiple linear regressions.
RESULTS
PBT was correlated with SBJ, VO2max, HG, KE, CTE, Weight, Height, FFM, BF% and swimming hours per week (SHW). Multiple linear regressions showed that PBT was associated to Height, V30m, CTE and SBJ. Sex and age did not modify these associations.
CONCLUSIONS
PBT was found to be mainly associated with height, an anthropometric variable. SBJ and V30m, both fitness-related variables, highly influenced by muscle fiber type were also predictors, suggesting that for short distances physiological factors might be determinant to performance. Age modified predictive values suggesting that this is also a key factor to performance, and thus competitions during adolescence should be organized according to year of birth rather than by age category.
Topics: Adolescent; Body Mass Index; Child; Female; Hand Strength; Humans; Knee Joint; Linear Models; Male; Muscle Contraction; Muscle Strength; Oxygen Consumption; Physical Endurance; Swimming
PubMed: 26398204
DOI: No ID Found -
Journal of Anatomy Feb 1976Mechanisms of lubrication of human synovial joints have been analysed in terms of the operating conditions of the joint, the synovial fluid and articular cartilage. In...
Mechanisms of lubrication of human synovial joints have been analysed in terms of the operating conditions of the joint, the synovial fluid and articular cartilage. In the hip and knee during a walking cycle the load may rise up to four times body weight. In the knee on dropping one metre the load may go up to 25 time body weight. The elastic modulus of cartilage is similar to that of the synthetic rubber of a car tyre. The cartilage surface is rough and in elderly specimens the centre line average is 2-75 mum. The friction force generated in reciprocating tests shows that both cartilage and synovial fluid are important in lubrication. The viscosity-shear rate relationships of normal synovial fluid show that it is non-Newtonian. Osteoarthrosic fluid is less so and rheumatoid fluid is more nearly Newtonian. Experiments with hip joints in a pendulum machine show that fluid film lubrication obtains at some phases of joint action. Boundary lubrication prevails under certain conditions and has been examined with a reciprocating friction machine. Digestion of hyaluronate does not alter the boundary lubrication, but trypsin digestion does. Surface active substances (lauryl sulphate and cetyl 3-ammonium bromide) give a lubricating ability similar to that of synovial fluid. The effectiveness of the two substances varies with pH.
Topics: Cartilage, Articular; Elasticity; Hip Joint; Humans; Hydrogen-Ion Concentration; Lubrication; Synovial Fluid; Viscosity
PubMed: 3490
DOI: No ID Found -
Diabetes/metabolism Research and Reviews Mar 2012Blood glucose testing utilizing point-of-care (POC) glucose meters has become increasingly common--in hospital settings, in outpatient areas, and in the self-care of...
Blood glucose testing utilizing point-of-care (POC) glucose meters has become increasingly common--in hospital settings, in outpatient areas, and in the self-care of patients. It is rightly considered an essential tool for the management of diabetes. But many who rely on these meters are unaware of the pitfalls in their use and do not realize that there are settings where misleading results obtained by POC glucose meters may alter clinical decisions in the care of persons with diabetes and in some cases have caused catastrophic errors in care, even deaths. Their use in critical care settings is of great concern because many of the factors that increase the risk of inaccuracy of the POC glucose meters exist in critical care settings. Unfortunately, many clinicians are still uncritically accepting data from the POC glucose meters, to the potential detriment of the care of the patients. To improve the quality of care of those with diabetes, we need to establish better standards for the evaluation of POC glucose meters, encourage wider use of technologies that have improved the accuracy and precision of the meters, and adopt clear rules, particularly in inpatient settings, as to when to avoid using POC glucose meters and also when to verify their results before accepting the results of the POC glucose measurement. Such strategies are essential if we are to use these meters successfully.
Topics: Blood Glucose; Blood Glucose Self-Monitoring; Critical Care; Diabetes Complications; False Negative Reactions; False Positive Reactions; Humans; Point-of-Care Systems; Self Care
PubMed: 22215509
DOI: 10.1002/dmrr.2271 -
Journal of Visualized Experiments : JoVE Nov 2016A facile, controllable, inexpensive and green electrochemical synthesis of IrO2-graphene nanohybrid thin films is developed to fabricate an easy-to-use integrated paper...
A facile, controllable, inexpensive and green electrochemical synthesis of IrO2-graphene nanohybrid thin films is developed to fabricate an easy-to-use integrated paper microfluidic electrochemical pH sensor for resource-limited settings. Taking advantages from both pH meters and strips, the pH sensing platform is composed of hydrophobic barrier-patterned paper micropad (µPAD) using polydimethylsiloxane (PDMS), screen-printed electrode (SPE) modified with IrO2-graphene films and molded acrylonitrile butadiene styrene (ABS) plastic holder. Repetitive cathodic potential cycling was employed for graphene oxide (GO) reduction which can completely remove electrochemically unstable oxygenated groups and generate a 2D defect-free homogeneous graphene thin film with excellent stability and electronic properties. A uniform and smooth IrO2 film in nanoscale grain size is anodically electrodeposited onto the graphene film, without any observable cracks. The resulting IrO2-RGO electrode showed slightly super-Nernstian responses from pH 2-12 in Britton-Robinson (B-R) buffers with good linearity, small hysteresis, low response time and reproducibility in different buffers, as well as low sensitivities to different interfering ionic species and dissolved oxygen. A simple portable digital pH meter is fabricated, whose signal is measured with a multimeter, using high input-impedance operational amplifier and consumer batteries. The pH values measured with the portable electrochemical paper-microfluidic pH sensors were consistent with those measured using a commercial laboratory pH meter with a glass electrode.
Topics: Electrodes; Graphite; Hydrogen-Ion Concentration; Iridium; Microfluidics; Oxides; Reproducibility of Results
PubMed: 27911378
DOI: 10.3791/53339 -
Clinical Toxicology (Philadelphia, Pa.) Nov 2020Point-of-care glucose meters are an integral part in the assessment of patients with altered mental status. For this reason, glucose meters are checked for interference...
Point-of-care glucose meters are an integral part in the assessment of patients with altered mental status. For this reason, glucose meters are checked for interference from commonly encountered substances, including acetaminophen. The Nova StatStrip glucose meter has previously been reported to be resistant to interference. We report a case of a very high acetaminophen concentration causing interference with this point-of-care glucose meter. A 25-year-old female presented after an overdose of acetaminophen and diphenhydramine combination product. Patient was minimally responsive, so a point-of-care glucose check was attempted using the Nova StatStrip glucose meter. Five different meters were attempted, and each showed an error message. Laboratory analysis using Beckman Coulter Unicel DxC 800 revealed a glucose of 180 mg/dL and an acetaminophen concentration of 465 mg/L. Serum spiked with acetaminophen at different concentrations revealed interference with the Nova StatStrip glucose meter at a concentration of 399 mg/L and above. To our knowledge, this interference with the Nova StatStrip glucose meter has not been reported in the medical literature. Very high levels of acetaminophen can interfere with point-of-care glucose meters, even those that have previously been reported to be robust such as the Nova StatStrip glucose meter. Clinicians should be aware of this possible interference when treating patients with acetaminophen overdose.
Topics: Acetaminophen; Adult; Blood Glucose; Drug Overdose; Female; Humans; Point-of-Care Systems; Reagent Strips
PubMed: 32141341
DOI: 10.1080/15563650.2020.1732404 -
Diabetes Technology & Therapeutics Feb 2016The optimal treatment of diabetes in pregnancy requires accurate measurement of blood glucose levels, in order to minimize adverse outcomes for both mother and neonate....
BACKGROUND
The optimal treatment of diabetes in pregnancy requires accurate measurement of blood glucose levels, in order to minimize adverse outcomes for both mother and neonate. Self-monitoring of blood glucose is routinely used to measure glycemic control and to assess whether treatment targets are being met; however, the accuracy of blood glucose meters in pregnancy is unclear.
MATERIALS AND METHODS
Pregnant women with gestational, type 1, or type 2 diabetes mellitus were eligible to participate. Nonfasting capillary blood glucose levels were measured in duplicate using the BGStar(®) (Sanofi, Sydney, Australia) and FreeStyle Lite(®) (Abbott, Sydney) blood glucose meters. Venous blood samples were collected and analyzed for plasma glucose, hematocrit, and glycated hemoglobin. Capillary blood glucose was compared with plasma glucose and further assessed according to International Organization for Standardization (ISO) 15197:2013 standards.
RESULTS
One hundred ten women were recruited, providing 96 samples suitable for analysis. The mean ± SD laboratory plasma glucose level was 4.6 ± 1.4 mmol/L; the BGStar and FreeStyle Lite capillary blood glucose values were 5.3 ± 1.4 mmol/L and 5.0 ± 1.3 mmol/L, respectively. Both meters showed a positive bias (0.42 mmol/L for the FreeStyle Lite and 0.65 mmol/L for the BGStar). Furthermore, neither meter fulfilled the ISO 15197:2013 standards, and there was a nonsignificant improvement in meter performance at blood glucose levels of ≤4.2 mmol/L. Hematocrit did not affect the results of either blood glucose meter. Clarke Error Grid analysis demonstrated that approximately 70% of the results of both meters would lead to appropriate clinical action.
CONCLUSIONS
The BGStar and FreeStyle Lite blood glucose meters did not meet ISO 15197:2013 recommendations for blood glucose monitoring systems when assessed in a population of women with diabetes in pregnancy. Clinicians should consider this difference in blood glucose readings when making diabetes-related treatment decisions.
Topics: Adult; Ambulatory Care Facilities; Blood Glucose; Blood Glucose Self-Monitoring; Diabetes, Gestational; Female; Glycated Hemoglobin; Hematocrit; Humans; Pregnancy; Pregnancy in Diabetics; Prenatal Care
PubMed: 26440810
DOI: 10.1089/dia.2015.0104