ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Replication of similar findings in diverse study populations using different study designs provides important evidence for causal inferences regarding risk factors reported in epidemiologic studies. Risk factors for knee osteoarthritis have been substantiated in a number of cross-sectional and longitudinal cohort studies. Longitudinal cohort studies have also added to our understanding of risk factors associated with hip osteoarthritis and hand osteoarthritis. In contrast, studies of hormonal and reproductive factors and the risk of developing rheumatoid arthritis continue to report conflicting results, and the importance of these risk factors remains unresolved. Recent studies suggest that the protective effect is limited only to the development of definite rheumatoid arthritis with a more severe clinical course. Cross-sectional studies of diverse populations show consistent age- and gender-specific differences in the rates of hip fracture among persons of Japanese ancestry and rates among several different groups of whites in the United States. The results of a population-based longitudinal cohort study suggest that women who live in communities where the drinking water has a high content of fluoride have a greater risk of osteoporosis and subsequent fractures than those living in communities with low fluoride in the drinking water. Finally, several recent reports provide additional evidence of the increasing incidence of acute rheumatic fever in the United States and other parts of the world.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Chronic rheumatic diseases can severely compromise a patient's functional ability. These limitations are often better appreciated through a patient's self-report and a physician examination than through laboratory and radiographic assessments. Researchers are adapting the established health status questionnaires for non-English-speaking patients and for other rheumatic conditions besides rheumatoid arthritis. Rather than tailoring existing instruments for other diseases, some clinician investigators are developing entirely new disease-specific self-assessment questionnaires. Physicians are also addressing the subjectivity of their physical examination techniques. They are devising consistent and sensitive parameters that can be combined with health status questionnaires to monitor disease activity, gauge therapeutics, predict health services utilization, and predict work disability.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Thirty-seven million Americans suffer from some form of arthritis and the prevalence of arthritis among the elderly is particularly high. Therefore it is not surprising that there is a large new literature directed toward the epidemiology and health services for the older individual with arthritis. Many studies in osteoarthritis have refined the minutia or confirmed earlier work. Osteoarthritis increases with age and accounts for 46 million patient visits each year, with knee arthritis accounting for the most common complaint initiating such visits. Late stage rheumatoid arthritis has again been strongly associated with shortened life span, and factors predicting early death have been identified. Meanwhile, the “pyramid model” of rheumatoid arthritis treatment has been challenged. Of interest is the identification of obesity as a major risk factor for disability in elderly patients with arthritis and the fact that the incidence of hip fracture in the elderly, already known to be high, may be increasing. A provocative report suggests that mass screening for osteoporosis followed by selective treatment may be more cost effective than empirical treatment of all postmenopausal women.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This paper reviews recent studies in national patterns of disability related to arthritis, longitudinal studies of outcome in arthritis, the effects of the prospective payment system on outcomes of hip fracture patients, and recent studies of geographic variation in treatment of arthritis and musculoskeletal disease. It also reviews recent papers on clinimetric issues and advances in measuring disease activity.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This paper reviews two strains of research within rheumatology relevant to contemporary health policy debates. The first concerns studies of the effectiveness of medical care on outcomes among persons with musculoskeletal conditions; the second, studies of functional status and disability among such persons. The studies of the effectiveness of medical care, largely funded by the Agency for Health Care Policy and Research, are designed to assist in the development of practice guidelines concerning lower back pain, knee replacement, hip disease, and other conditions for use by physicians and other providers as well as third party payers. The studies of functional status and disability in arthritis, largely funded by the National Institute of Arthritis, Musculoskeletal, and Skin Diseases as part of its Multipurpose Arthritis Center Program, are designed to provide measures of outcome for use in studies of medical effectiveness and to assess the societal impacts of musculoskeletal conditions.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Advances in our understanding of disability is important to the development of new rehabilitation ideas for patients with rheumatic disease. Large epidemiologic and focused clinical and laboratory studies that deal with risk factors and treatment for physical and social disability, exercise, gait analysis, and biomechanics are reviewed.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A wide variety of disorders affects the pediatric hip. The most common of these are developmental dysplasia of the hip, Legg-Calvé-Perthes disease, and slipped capital femoral epiphysis. Magnetic resonance imaging and ultrasound improve the imaging of these diseases, but the ultimate impact of this technology on treatment is unknown. Complications of treatment for these and other pediatric hip diseases can be devastating; so much recent research concentrates on the etiology, prevention, and effects of these complications. Finally, these diseases occur in skeletally immature individuals, and long-term follow-up is essential for accurate evaluation of results.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The wide range of publications that are the basis of the following discussion highlight the difficulties of scientific assessment of surgical treatment in rheumatoid arthritis. Some factors that bedevil objective assessment include the variable clinical course of the disease, parallel pharmacologic and surgical treatments, the virtual impossibility of identifying appropriate control subjects and imprecision in endpoint measurement. Nevertheless, study design in rheumatoid arthritis surgery is becoming more sophisticated through the efforts of numerous individuals and groups such as the European Rheumatoid Arthritis Surgical Society.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID