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David D Sherry - One of the best experts on this subject based on the ideXlab platform.
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prevention of leg length discrepancy in young children with pauciarticular juvenile rheumatoid arthritis by treatment with intraarticular steroids
Arthritis & Rheumatism, 1999Co-Authors: David D Sherry, Leonard D Stein, Ann M Reed, Laura E Schanberg, Deborah W KredichAbstract:Objective To determine if intraarticular (IA) injection of triamcinolone hexacetonide (steroids) used early in the course of pauciarticular juvenile rheumatoid arthritis (pauci JRA) is associated with less leg length discrepancy (LLD) or Thigh Circumference discrepancy (TCD). Methods Children with pauci JRA who had asymmetric lower-extremity arthritis diagnosed before age 7 years in Seattle, Washington (WA; n = 16) and in Chapel Hill and Durham, North Carolina (NC; n = 14) were retrospectively identified. WA children were given IA steroids within 2 months of diagnosis; the injections were repeated if synovitis recurred in the same joint or in a different joint. These children were compared with NC children who were not treated with IA steroids. Thigh Circumference was measured at 10 cm above the patella, and leg length was measured from the anterior superior iliac spine to the mid-medial malleolus, by a single observer. LLD and TCD are reported as the percentage of difference between leg measurements in each subject. Results The WA and NC subjects had comparable disease severity and duration of followup (in months). Twelve WA children had subsequent IA steroid injections (mean 3.25 injections per child over mean ± SD 42 ± 11 months). The WA subjects had significantly less LLD (P = 0.005, by Student's 2-sided t-test) and prescriptions for shoe lifts (P = 0.002, by Fisher's 2-sided exact test). There was not a significant difference in TCD between the 2 groups (P = 0.139, by Student's 2-sided t-test). Similar findings were obtained when the analysis was limited to children with monarticular knee arthritis. Conclusion Early and continued use of IA steroids may be associated with less LLD in young children with pauci JRA. This may indicate decreased duration of synovitis.
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prevention of leg length discrepancy in young children with pauciarticular juvenile rheumatoid arthritis by treatment with intraarticular steroids
Arthritis & Rheumatism, 1999Co-Authors: David D Sherry, Leonard D Stein, Ann M Reed, Laura E Schanberg, Deborah W KredichAbstract:Objective To determine if intraarticular (IA) injection of triamcinolone hexacetonide (steroids) used early in the course of pauciarticular juvenile rheumatoid arthritis (pauci JRA) is associated with less leg length discrepancy (LLD) or Thigh Circumference discrepancy (TCD). Methods Children with pauci JRA who had asymmetric lower-extremity arthritis diagnosed before age 7 years in Seattle, Washington (WA; n = 16) and in Chapel Hill and Durham, North Carolina (NC; n = 14) were retrospectively identified. WA children were given IA steroids within 2 months of diagnosis; the injections were repeated if synovitis recurred in the same joint or in a different joint. These children were compared with NC children who were not treated with IA steroids. Thigh Circumference was measured at 10 cm above the patella, and leg length was measured from the anterior superior iliac spine to the mid-medial malleolus, by a single observer. LLD and TCD are reported as the percentage of difference between leg measurements in each subject. Results The WA and NC subjects had comparable disease severity and duration of followup (in months). Twelve WA children had subsequent IA steroid injections (mean 3.25 injections per child over mean ± SD 42 ± 11 months). The WA subjects had significantly less LLD (P = 0.005, by Student's 2-sided t-test) and prescriptions for shoe lifts (P = 0.002, by Fisher's 2-sided exact test). There was not a significant difference in TCD between the 2 groups (P = 0.139, by Student's 2-sided t-test). Similar findings were obtained when the analysis was limited to children with monarticular knee arthritis. Conclusion Early and continued use of IA steroids may be associated with less LLD in young children with pauci JRA. This may indicate decreased duration of synovitis.
Deborah W Kredich - One of the best experts on this subject based on the ideXlab platform.
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prevention of leg length discrepancy in young children with pauciarticular juvenile rheumatoid arthritis by treatment with intraarticular steroids
Arthritis & Rheumatism, 1999Co-Authors: David D Sherry, Leonard D Stein, Ann M Reed, Laura E Schanberg, Deborah W KredichAbstract:Objective To determine if intraarticular (IA) injection of triamcinolone hexacetonide (steroids) used early in the course of pauciarticular juvenile rheumatoid arthritis (pauci JRA) is associated with less leg length discrepancy (LLD) or Thigh Circumference discrepancy (TCD). Methods Children with pauci JRA who had asymmetric lower-extremity arthritis diagnosed before age 7 years in Seattle, Washington (WA; n = 16) and in Chapel Hill and Durham, North Carolina (NC; n = 14) were retrospectively identified. WA children were given IA steroids within 2 months of diagnosis; the injections were repeated if synovitis recurred in the same joint or in a different joint. These children were compared with NC children who were not treated with IA steroids. Thigh Circumference was measured at 10 cm above the patella, and leg length was measured from the anterior superior iliac spine to the mid-medial malleolus, by a single observer. LLD and TCD are reported as the percentage of difference between leg measurements in each subject. Results The WA and NC subjects had comparable disease severity and duration of followup (in months). Twelve WA children had subsequent IA steroid injections (mean 3.25 injections per child over mean ± SD 42 ± 11 months). The WA subjects had significantly less LLD (P = 0.005, by Student's 2-sided t-test) and prescriptions for shoe lifts (P = 0.002, by Fisher's 2-sided exact test). There was not a significant difference in TCD between the 2 groups (P = 0.139, by Student's 2-sided t-test). Similar findings were obtained when the analysis was limited to children with monarticular knee arthritis. Conclusion Early and continued use of IA steroids may be associated with less LLD in young children with pauci JRA. This may indicate decreased duration of synovitis.
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prevention of leg length discrepancy in young children with pauciarticular juvenile rheumatoid arthritis by treatment with intraarticular steroids
Arthritis & Rheumatism, 1999Co-Authors: David D Sherry, Leonard D Stein, Ann M Reed, Laura E Schanberg, Deborah W KredichAbstract:Objective To determine if intraarticular (IA) injection of triamcinolone hexacetonide (steroids) used early in the course of pauciarticular juvenile rheumatoid arthritis (pauci JRA) is associated with less leg length discrepancy (LLD) or Thigh Circumference discrepancy (TCD). Methods Children with pauci JRA who had asymmetric lower-extremity arthritis diagnosed before age 7 years in Seattle, Washington (WA; n = 16) and in Chapel Hill and Durham, North Carolina (NC; n = 14) were retrospectively identified. WA children were given IA steroids within 2 months of diagnosis; the injections were repeated if synovitis recurred in the same joint or in a different joint. These children were compared with NC children who were not treated with IA steroids. Thigh Circumference was measured at 10 cm above the patella, and leg length was measured from the anterior superior iliac spine to the mid-medial malleolus, by a single observer. LLD and TCD are reported as the percentage of difference between leg measurements in each subject. Results The WA and NC subjects had comparable disease severity and duration of followup (in months). Twelve WA children had subsequent IA steroid injections (mean 3.25 injections per child over mean ± SD 42 ± 11 months). The WA subjects had significantly less LLD (P = 0.005, by Student's 2-sided t-test) and prescriptions for shoe lifts (P = 0.002, by Fisher's 2-sided exact test). There was not a significant difference in TCD between the 2 groups (P = 0.139, by Student's 2-sided t-test). Similar findings were obtained when the analysis was limited to children with monarticular knee arthritis. Conclusion Early and continued use of IA steroids may be associated with less LLD in young children with pauci JRA. This may indicate decreased duration of synovitis.
Marieke B Snijder - One of the best experts on this subject based on the ideXlab platform.
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low subcutaneous Thigh fat is a risk factor for unfavourable glucose and lipid levels independently of high abdominal fat the health abc study
Diabetologia, 2005Co-Authors: Marieke B Snijder, Marjolein Visser, J M Dekker, Stephen B Kritchevsky, Nathalie De Rekeneire, Tamara B. Harris, Bret H Goodpaster, Alka M KanayaAbstract:Aims We investigated whether low subcutaneous Thigh fat is an independent risk factor for unfavourable glucose and lipid levels, and whether these associations differ between sexes, and between white and black adults. Our secondary aim was to investigate which body composition characteristics (lean tissue, fat tissue) are reflected by anthropometric measures (waist and Thigh Circumference).
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associations of hip and Thigh Circumferences independent of waist Circumference with the incidence of type 2 diabetes the hoorn study
The American Journal of Clinical Nutrition, 2003Co-Authors: Marieke B Snijder, Marjolein Visser, Jacqueline M Dekker, Coen D A Stehouwer, L M Bouter, Robert J Heine, G Nijpels, Piet J Kostense, John Yudkin, Jacob C. SeidellAbstract:BACKGROUND: The higher risk of type 2 diabetes in persons with a high waist-to-hip ratio (WHR) or waist-to-Thigh ratio (WTR) has mostly been attributed to increased visceral fat accumulation. However, smaller hip or Thigh Circumference may also explain the predictive value of the WHR or WTR for type 2 diabetes. OBJECTIVE: This study considered prospectively the association of hip and Thigh Circumferences, independent of waist Circumference, with the incidence of type 2 diabetes. DESIGN: The Hoorn Study is a population-based cohort study of diabetes. A total of 1357 men and women aged 50-75 y and nondiabetic at baseline participated in the 6-y follow-up examination. Glucose tolerance was assessed by use of a 75-g oral-glucose-tolerance test. Baseline anthropometric measurements included body mass index (BMI) and waist, hip, and Thigh Circumferences. RESULTS: Logistic regression analyses showed that a 1-SD larger hip Circumference gave an odds ratio (OR) for developing diabetes of 0.55 (95% CI: 0.36, 0.85) in men and 0.63 (0.42, 0.94) in women, after adjustment for age, BMI, and waist Circumference. The adjusted ORs for a 1-SD larger Thigh Circumference were 0.79 (0.53, 1.19) in men and 0.64 (0.46, 0.93) in women. In contrast with hip and Thigh Circumferences, waist Circumference was positively associated with the incidence of type 2 diabetes in these models (ORs ranging from 1.60 to 2.66). CONCLUSION: Large hip and Thigh Circumferences are associated with a lower risk of type 2 diabetes, independently of BMI, age, and waist Circumference, whereas a larger waist Circumference is associated with a higher risk.
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larger Thigh and hip Circumferences are associated with better glucose tolerance the hoorn study
Obesity Research, 2003Co-Authors: Marieke B Snijder, Marjolein Visser, Jacqueline M Dekker, John S Yudkin, Coen D A Stehouwer, L M Bouter, Robert J Heine, G Nijpels, Jacob C. SeidellAbstract:OBJECTIVE: A higher waist-to-hip ratio, which can be due to a higher waist Circumference, a lower hip Circumference, or both, is associated with higher glucose levels and incident diabetes. A lower hip Circumference could reflect either lower fat mass or lower muscle mass. Muscle mass might be better reflected by Thigh Circumference. The aim of this study was to investigate the contributions of Thigh and hip Circumferences, independent of waist Circumference, to measures of glucose metabolism. RESEARCH METHODS AND PROCEDURES: For this cross-sectional study we used baseline data from the Hoorn Study, a population-based cohort study of glucose tolerance among 2484 men and women aged 50 to 75. Glucose tolerance was assessed by a 75-g oral glucose tolerance test; hemoglobin A(1c) and fasting insulin were also measured. Anthropometric measurements included body mass index (BMI) and waist, hip, and Thigh Circumferences. RESULTS: Stratified analyses and multiple linear regression showed that after adjustment for age, BMI, and waist Circumference, Thigh Circumference was negatively associated with markers of glucose metabolism in women, but not in men. Standardized beta values in women were -0.164 for fasting, -0.206 for post-load glucose, -0.190 for hemoglobin A(1c) (all p < 0.001), and -0.065 for natural log insulin levels (p = 0.061). Hip Circumference was negatively associated with markers of glucose metabolism in both sexes (standardized betas ranging from -0.093 to -0.296, p < 0.05) except for insulin in men. Waist Circumference was positively associated with glucose metabolism. DISCUSSION: Thigh Circumference in women and hip Circumference in both sexes are negatively associated with markers of glucose metabolism independently of the waist Circumference, BMI, and age. Both fat and muscle tissues may contribute to these associations.
James F. Reed - One of the best experts on this subject based on the ideXlab platform.
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Thigh muscle size and strength after anterior cruciate ligament reconstruction and rehabilitation
Journal of Orthopaedic & Sports Physical Therapy, 1997Co-Authors: George A Arangio, Chaorong Chen, Matthew Kalady, James F. ReedAbstract:It is the hypothesis of the senior author (GAA) that Thigh Circumference measurements are not an accurate reflection of Thigh muscle cross-sectional area or muscle strength after standard rehabilitation following anterior cruciate ligament reconstruction. Likewise, normal quadriceps femoris strength is not achieved in these patients despite aggressive rehabilitation. The purpose of our study was to quantify Thigh muscle size and strength and correlate Thigh Circumference, muscle cross-sectional area by magnetic resonance imaging (MRI), and isokinetic strength in our patients. Thirty-three patients with anterior cruciate ligament repair utilizing autografts of iliotibial band (N = 28), semitendinosus autograft (N = 3), and bone-patellar tendon-bone autograft (N = 2) were retrospectively evaluated 48.7 ± 6.91 months after surgery. We compared involved operated extremities with uninjured, uninvolved contralateral extremities, measuring Thigh Circumference, isokinetic peak torque, and cross-sectional area by ...
Moutzouros Vasilios - One of the best experts on this subject based on the ideXlab platform.
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Adductor Canal Block Versus Femoral Nerve Block for Pain Control After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Trial
Henry Ford Health System Scholarly Commons, 2019Co-Authors: Okoroha K R, Lynch J, Lizzio, Vincent A, Yu, Charles C, Jildeh, Toufic R, Moutzouros VasiliosAbstract:Objectives: Regional anesthesia in the form of a femoral nerve block (FNB) is a commonly performed technique that has been proven to provide effective analgesia following anterior cruciate ligament (ACL) reconstruction. The adductor canal nerve block (ANB) employs a similar sensory block around the knee while avoiding motor blockade of the quadriceps. The purpose of our study was to compare the efficacy of FNB versus ANB for pain control following ACL reconstruction. Our hypothesis was that there would be no difference in pain levels or opioid requirements between the two groups. Methods: We performed a prospective, double-blinded, randomized controlled trial. Sixty patients undergoing primary ACL reconstruction using bone-tendon-bone autograft were randomized to receive either an ANB or FNB preoperatively. The primary outcomes assessed were pain levels (visual analog scale) and narcotic requirements for 4 days following surgery. Secondary outcomes included ability to perform a straight leg raise in the recovery room and difference in Thigh Circumference between the operative and nonoperative leg measured at 7 days postoperatively. Results: Morphine requirements were less in ACB in the first 4 hours postoperatively (p = .02). Aside from this time interval, there were no differences between the 2 groups with regard to opioid requirements and pain scores at any other time. Similarly, no differences were noted in the patient\u27s ability to perform a straight leg raise in the recovery room (p = .13) or in Thigh Circumference at the first postoperative visit (p = .09) Conclusion: The results of our study suggest similar efficacy in perioperative pain control with the use of an ANB for ACL reconstruction when compared to FNB. The potential long-term benefit of quadriceps preservation with the ACB is worthy of future study
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Adductor Canal Block Versus Femoral Nerve Block for Pain Control After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Trial.
Henry Ford Health System Scholarly Commons, 2019Co-Authors: Lynch, Jonathan R, Okoroha K R, Lizzio, Vincent A, Yu, Charles C, Jildeh, Toufic R, Moutzouros VasiliosAbstract:BACKGROUND:: Femoral nerve block (FNB) is a commonly performed technique that has been proven to provide effective regional analgesia after anterior cruciate ligament (ACL) reconstruction. The adductor canal block (ACB) uses a similar sensory block around the knee while avoiding motor blockade of the quadriceps muscles. PURPOSE/HYPOTHESIS:: The purpose of our study was to compare the efficacy of FNB versus ACB for pain control after ACL reconstruction. It was hypothesized that there would be no difference in pain levels or opioid requirements between the 2 groups. STUDY DESIGN:: Randomized controlled trial; Level of evidence, 1. METHODS:: We performed a prospective, double-blinded, randomized controlled trial. Sixty patients undergoing primary ACL reconstruction with bone-patellar tendon-bone autograft were randomized to receive either an ACB or an FNB preoperatively. The primary outcomes assessed were pain levels (visual analog scale) and narcotic requirements for 4 days after surgery. Secondary outcomes included ability to perform a straight leg raise in the recovery room and difference in Thigh Circumference between the operative and nonoperative leg measured at 7 days postoperatively. RESULTS:: Morphine requirements were less in the ACB group in the first 4 hours postoperatively ( P = .02). Aside from this time interval, no differences were found between the 2 groups with regard to opioid requirements and pain scores at any other time. Similarly, no differences were noted in patients\u27 ability to perform a straight leg raise in the recovery room ( P = .13) or in Thigh Circumference at the first postoperative visit ( P = .09). CONCLUSION:: The results of our study suggest similar efficacy in perioperative pain control with the use of an ACB for ACL reconstruction when compared with FNB. The potential long-term benefit of quadriceps preservation with the ACB is worthy of future study. REGISTRATION:: NCT03033589 (ClinicalTrials.gov identifier)