24,803 results for Journal article

  • Fitness to practice of medical graduates: one programme???s approach

    Braatvedt, C; Poole, Phillippa; Merry, Alan; Gorman, Desmond; Reid, Mary-Jane; Bagg, Warwick (2014)

    Journal article
    The University of Auckland Library

    Aim Doctors must ensure they are fit to practise medicine. There is a relationship between unprofessional behaviour at medical school and in subsequent medical practice. This study describes one programme???s Fitness to Practice (FtP) policy and outcomes since inception in 2005. Method FtP notifications were classified into: health or personal; professional attitudes, or external issues. Seriousness was classified as non-critical, critical or extraordinarily critical. Anonymous data were extracted and analysed from a confidential FtP database. Results There were 157 FtP notifications involving 132 (5.5%) students. 87.2% were for issues with professional attitudes and 80.3% were non-critical. 17 students received more than one FtP notification. Students in clinical years were over-represented (p<0.0001) as were males (57% vs. 43%: p=0.0286). 96% of students continued the programme after remedial action. Two students were excluded from the programme on FtP grounds. The national regulatory body was notified of nine individual students with the potential for ongoing FtP concerns. Conclusion Over 9 years, 5.5% of medical students received a FtP notification, with most of these isolated noncritical incidents of a professional nature. A small subset of students had repeated or serious concerns, underscoring the need for a FtP policy in any medical programme.

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  • Anaesthesia information - What patients want to know

    Garden, AL; Merry, Alan; Holland, RL; Petrie, Keith (1996)

    Journal article
    The University of Auckland Library

    We developed and introduced into clinical practice a leaflet to improve the delivery of information to patients before obtaining their consent to anaesthesia. The amount of information needs to be what a 'reasonable' patient thinks appropriate; therefore we tested patients' responses to three levels of information: 'full' disclosure, 'standard' disclosure (as contained in our leaflet) and 'minimal' disclosure. Forty-five patients scheduled to undergo cardiac surgery were enrolled in the study. None of the information sheets caused a significant change in state anxiety score and only the 'full' disclosure significantly increased knowledge about anaesthesia (P = 0.016). All leaflets were easy to understand. When only one leaflet was provided 64-73% of patients thought the content was 'just right', whereas when all three leaflets were viewed together; 63% of patients thought the 'minimal' leaflet withheld too much information.

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  • The neuroleptic malignant syndrome in an adolescent

    Merry, Sally; Werry, JS; Merry, Alan; Birchall, N (1986)

    Journal article
    The University of Auckland Library

    A case of the neuroleptic malignant syndrome (NMS) in a 14-year-old schizophrenic boy receiving 60 mg (1 mg/kg) trifluoperazine daily, is described. NMS is a rare complication of antipsychotic drug therapy characterized by hyperpyrexia, akinesia, rigidity and autonomic instability, leukocytosis and elevated blood enzymes, such as creatinine phosphokinase, with a 20% mortality rate. Though there have been few previous reports in children and younger adolescents, this and other cases demonstrate the possibility of its occurrence and the need for awareness of the syndrome.

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  • A 15-year experience with primary breast augmentation

    Codner, MA; Mejia, JD; Locke, Michelle; Mahoney, A; Thiels, C; Nahai, FR; Hester, TR; Nahai, F (2011-03)

    Journal article
    The University of Auckland Library

    BACKGROUND: This study evaluated patients who underwent primary breast surgery within a single group practice from 1994 to 2009. Reoperations were divided by reoperation reason into total reoperations and implant-specific reoperations. The authors hypothesized that the implant-specific reoperation rate will provide the most accurate measurement of complications caused by the breast implant device. METHODS: A total of 812 patients received the same brand of breast implant for primary breast augmentation or augmentation/mastopexy. Safety and efficacy data were recorded and complication rates were calculated. Statistics were applied using Kaplan-Meier estimated cumulative incidence calculations. RESULTS: This study included 482 patients with saline and 330 patients with silicone implants. The most common complications included capsular contracture, rippling, rupture, infection, and hematoma. A total of 8.2 percent of patients developed Baker grade III/IV capsular contracture by 6 years. The raw incidence of rippling was 7.1 percent, and the rate was significantly increased in underweight patients with subglandular saline implants (p = 0.045). The rate of total reoperation at 1 year was 14.2 percent. While a significantly increased rate of total reoperation was seen for silicone compared with saline implants (p < 0.01), no difference was seen in the rate of implant-specific reoperation for saline compared to silicone implants (p = 0.582). CONCLUSIONS: The use of total reoperation rates as an indication of complications of breast implants can lead to both an overestimation of implant-related complications and the inaccurate conclusion that silicone implants result in higher complication rates than saline implants. The implant-specific reoperation rate may provide a more accurate incidence of implant complications than the total reoperation rate, which includes reoperations for factors unrelated to the implant.

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  • Posture and the spread of extradural analgesia in labour

    Merry, Alan; Cross, JA; Mayadeo, SV; Wild, Christopher (1983)

    Journal article
    The University of Auckland Library

    Thirty-five patients kept in a sitting position for S min after a standard extradural injection in labour were compared with 54 patients maintained in the left lateral position throughout. The mean upper limit of analgesia was unchanged. A significant shift of the mean lower limit occurred in the sitting patients (p= 0.05, two-tailed), but contrary to classical teaching this was in a cephalad direction. Successful sacral blockade (analgesia at S234) and asymmetry of blockade occurred in a similar proportion of each group. It was concluded that the sitting position conferred no Hiniral advantage to patients receiving extradural analgesia in labour.

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  • Prospective, controlled, double-blind study of i.v. tenoxicam for analgesia after thoracotomy

    Merry, Alan; Wardall, GJ; Cameron, RJ; Peskett, MJ; Wild, Christopher (1992-07)

    Journal article
    The University of Auckland Library

    We have shown that a single i.v. dose of tenoxicam 20 mg, after thoracotomy, when compared with placebo in 20 patients (with one exclusion), was associated with a reduction in consumption of papaveretum, assessed by patient-controlled analgesia, of 2.2 mg h-1 (22%) to 4 h and 1.4 mg h-1 (23%) to 12 h after operation (repeated measures analysis of variance: P less than 0.01). There was no reduction from 12 to 24 h. There was no significant difference between groups in pain scores or in side effects.

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  • High pressure processing of milk: Modeling the inactivation of psychrotrophic Bacillus cereus spores at 38-70??C

    Evelyn; Oliveira, Maria (2015-11)

    Journal article
    The University of Auckland Library

    Bacillus cereus is a pathogen that can grow in foods and beverages with low acidity. The main objective of this work was to model the inactivation of psychrotrophic B. cereus spores in reconstituted milk treated by high pressure (HPP) combined with a thermal process, and to compare it with thermal inactivation kinetics. First, the effect of HPP pressure (200, 400 and 600 MPa) for up to 40 min at 70 ??C on B. cereus spores was investigated. A pressure increment from 200 to 600 MPa slightly reduced the spore numbers in the reconstituted milk. Then the influence of temperature at 600 MPa on spore inactivation for up to 40 min was studied. Increasing the HPP temperature from 38 to 70 ??C increased the spore inactivation in milk by 3.5 log. The 600 MPa combined with heat enhanced the spore inactivation in milk, requiring a temperature 20 ??C lower to achieve the same spore inactivation. However, for a 5 log spore inactivation, the pressure???thermal process required a higher specific energy than the thermal processing. The resistance of two psychrotrophic strains of B. cereus spores in milk was also investigated and showed similar results. The Weibull model described spore inactivation by pressure???heat, whereas the first order kinetics was more appropriate for the thermal inactivation alone. The results of this study confirmed the advantage of HPP technology to further increase the thermal inactivation of B. cereus spores in milk.

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  • Bone mineral density in patients with treated Addison's disease

    Braatvedt, GD; Joyce, MB; Evans, M; Clearwater, J; Reid, IR (1999-11)

    Journal article
    The University of Auckland Library

    Some studies have reported low bone mineral density (BMD) in patients with Addison???s disease, whereas others have found BMD to be normal. It is possible that over-replacement of corticosteroids and adrenal androgen deficiency may contribute to a reduction in BMD in these patients. The aims of this study were to examine BMD using dual-energy X-ray absorptiometry in patients with treated Addison???s disease at multiple skeletal sites and to investigate the relationships between these measurements and corticosteroid dose. Nineteen men, 3 premenopausal and 7 postmenopausal women with Addison???s disease were studied and data from these patients were analyzed separately and as a group. The mean SEM age and duration of Addison???s disease of the men were 44 ?? 3.8 years and 15 ?? 2.2 years, in the premenopausal women 40 ?? 2 years and 5 ?? 2.4 years, and in the postmenopausal women 68 ?? 4 years and 20 ?? 5 years, respectively. Eight men were unexpectedly hypogonadal (serum testosterone <13 nmol/l). BMD was expressed as a percent of values in normal controls (n= 418) adjusted for age, sex, ethnic origin, menopausal status and body weight. In the whole group (n= 29), mean BMD of the patients with Addison???s disease was not different from normal at any site [mean (?? SEM) lumbar spine 99.5%?? 2.9%; femoral neck 99.3%?? 2.5%; Ward???s triangle 96.2%?? 3.5%; trochanter 99.2%?? 2.9%; radius 99.8%?? 2.1%; total body 98.5%?? 1.4%]. However, there was a wide range of bone densities, with some patients having a low BMD at multiple sites. Bone density was negatively correlated with current and cumulative corticosteroid dose per kilogram body weight and duration of Addison???s disease. In conclusion, BMD in patients with Addison???s disease is little different from normal, but may be lower in patients with disease of long duration and a high cumulative corticosteroid dose. Unexpected hypogonadism in men with Addison???s disease is common.

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  • Screening for hyperuricaemia and gout: a perspective and research agenda.

    Stamp, L; Dalbeth, Nicola (2014-12)

    Journal article
    The University of Auckland Library

    The goal of a screening programme is to reduce an adverse health outcome in a defined population. Screening can be undertaken at several stages throughout the disease course: before the onset of disease, early in the course of the disease, or in established disease (for complications). In the setting of asymptomatic hyperuricaemia and gout, the aim of screening would be to identify those individuals with hyperuricaemia and therefore at risk of gout, with the aim of introducing interventions to prevent the onset of gout. Herein we consider the concepts of screening for hyperuricaemia and gout, potential screening methods, and target populations that might benefit from such an approach.

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  • The assessment of lesions of the Achilles tendon by ultrasound imaging in inflammatory arthritis: A systematic review and meta-analysis

    Carroll, M; Dalbeth, Nicola; Boocock, M; Rome, K (2015-03)

    Journal article
    The University of Auckland Library

    OBJECTIVE: Ultrasound (US) is a highly sensitive, reliable and non-invasive tool, which allows for the assessment of lesions of tendons and entheseal sites. The aim of this systematic review and meta-analysis is to identify differences in US lesions of the Achilles tendon (AT) between people with inflammatory arthritis (IA) and healthy controls. METHODS: An electronic literature search was performed on Medline, CINAHL, SportDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Odds ratios with 95% confidence intervals (CI) were determined. Meta-analysis was conducted on those studies that were considered to be homogenous. RESULTS: A total of 13 high-to-medium quality studies met the inclusion criteria. The majority of studies reported US lesions in spondyloarthropathy (SpA), with limited evidence for other forms of IA. US lesions were not consistently defined with regard to Outcome Measures in Rheumatology Clinical Trials (OMERACT) definitions, and numerous scoring systems were used across the majority of studies. The mean AT thickness at the enthesis in people with SpA was 0.54mm thicker (95% CI: 0.10-0.97mm) with more frequent erosions in people with SpA (odds ratio = 7.43, 95% CI: 1.99-27.77, P = 0.003) and rheumatoid arthritis (RA) (odds ratio = 9.60, 95% CI: 1.23-74.94, P = 0.03), compared to controls. There was no significant difference in the frequency of enthesophyte formation in people with SpA compared to the controls (odds ratio = 2.48, 95% CI: 0.64-9.70, P = 0.19). CONCLUSIONS: The systematic review identified that a majority of studies reporting US lesions were in SpA, but limited evidence relating to other forms of IA. Consistent application of the OMERACT US definitions and scoring of US lesions is required in future studies of AT disease in IA. Further work is also required to distinguish between US lesions reflective of inflammation and structural damage.

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  • The mechanism of E-H (E = N, O) bond activation by a Germanium Corrole Complex: A combined experimental and computational study

    Fang, H; Jing, H; Ge, H; Brothers, Penelope; Fu, X; Ye, S (2015-06-10)

    Journal article
    The University of Auckland Library

    (TPFC)Ge(TEMPO) (1, TPFC = tris(pentafluorophenyl)corrole, TEMPO(???) = (2,2,6,6-tetramethylpiperidin-1-yl)oxyl) shows high reactivity toward E-H (E = N, O) bond cleavage in R1R2NH (R1R2 = HH, (n)PrH, (i)Pr2, Et2, PhH) and ROH (R = H, CH3) under visible light irradiation. Electron paramagnetic resonance (EPR) analyses together with the density functional theory (DFT) calculations reveal the E-H bond activation by [(TPFC)Ge](0)(2)/TEMPO(???) radical pair, generated by photocleavage of the labile Ge-O bond in compound 1, involving two sequential steps: (i) coordination of substrates to [(TPFC)Ge](0) and (ii) E-H bond cleavage induced by TEMPO(???) through proton coupled electron transfer (PCET).

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  • The incidence and risk factors for falls in adults with rheumatoid arthritis: a systematic review

    Brenton-Rule, A; Dalbeth, Nicola; Bassett, S; Menz, HB; Rome, K (2015-02)

    Journal article
    The University of Auckland Library

    OBJECTIVE: To conduct a systematic review of the incidence and risk factors for falls in people with rheumatoid arthritis (RA). METHODS: A search was conducted of the electronic databases AMED, CINAHL, MEDLINE, Scopus and The Cochrane Library. Study participants were adults with RA. Outcome measures were falls experienced in the preceding 6-12 months or prospective falls over a 12-month period. Articles were scored for quality using a modified version of the Downs and Black Quality Index Tool. RESULTS: Nine articles were included with mean (range) quality scores 72% (43-93%). The quality assessment revealed inconsistency in falls data attainment. Falls incidence ranged from 10% to 50% and was independent of age, gender or RA disease duration. History of a prior fall (odds ratio (OR) = 3.6 and 9.8) and increasing number of medications (OR = 1.4 and 2.1) were consistently associated with falls in RA. Number of co-morbid conditions, swollen and tender lower extremity joints, anti-depressants, anti-hypertensives, psychotropics, pain intensity and static balance were also identified as significant fall risk factors in at least one study. However, the evidence was limited to a single study or conflicted with other studies. CONCLUSION: In studies of falls in people with RA, there is a wide range in reported falls incidence, which may be due to inconsistency in falls data attainment. Numerous potential fall risk factors have been evaluated, producing limited or conflicting evidence. It is recommended that future studies follow previous consensus guidelines for collecting and reporting falls data.

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  • Impaired response or insufficient dosage? Examining the potential causes of "inadequate response" to allopurinol in the treatment of gout

    Stamp, LK; Merriman, TR; Barclay, ML; Singh, JA; Roberts, RL; Wright, DF; Dalbeth, Nicola (2014-10)

    Journal article
    The University of Auckland Library

    OBJECTIVES: Gout is one of the most common forms of arthritis. It is well established that urate-lowering therapy that aims for a serum urate less than at least 0.36 mmol/l (6 mg/dl) is required for the successful management of gout. Allopurinol, a xanthine oxidase (XO) inhibitor, is the most commonly used urate-lowering therapy. However, many patients fail to achieve the target serum urate on allopurinol; these patients can be considered to have "inadequate response" to allopurinol. Herein, we examine the potential mechanisms and implications of inadequate response to allopurinol. METHODS: The literature was reviewed for potential causes for failure to reach target serum urate in patients receiving allopurinol. RESULTS: The two most common causes of inadequate response to allopurinol are poor adherence and under-dosing of allopurinol. Adherent patients who fail to achieve target serum urate on standard doses of allopurinol form a group that could be considered to be "partially resistant" to allopurinol. There are four potential mechanisms for partial allopurinol resistance: decreased conversion of allopurinol to oxypurinol; increased renal excretion of oxypurinol; abnormality in XO structure and/or function such that oxypurinol is rendered less effective and/or drug interactions. CONCLUSIONS: It is important to determine the reasons for failure to achieve treatment targets with allopurinol, particularly as newer agents become available. The knowledge of the mechanisms for inadequate response may help guide the clinician towards making a therapeutic choice that is more likely to result in achieving the serum urate target.

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  • Mono- and diboron corroles: Factors controlling stoichiometry and hydrolytic reactivity

    Albrett, AM; Thomas, KE; Maslek, S; M??odzianowska, A; Conradie, J; Beavers, CM; Ghosh, A; Brothers, Penelope (2014-06-02)

    Journal article
    The University of Auckland Library

    The first example of a diboryl corrole complex, [(BF2)2(Br8T(4-F-P)C)](-) (Br8T(4-F-P)C = trianion of 2,3,7,8,12,13,17,18-octabromo-5,10,15-tris(4-fluorophenyl)corrole), has been isolated using the strongly electron-withdrawing and sterically crowded triaryl octabromocorrole ligand. Density functional theory (DFT) calculations show that the hydrolysis reaction producing the partially hydrolyzed complexes [B2OF2(Cor)](-) is more favored for the less sterically crowded triaryl corrole complexes. Monoboryl complexes BF2(H2Cor) (Cor = trianions of 5,10,15-triphenylcorrole (TPC), 5,10,15-tris(4-methylphenyl)corrole (T(4-CH3-P)C), 5,10,15-tris(4-trifluoromethylphenyl)corrole (T(4-CF3-P)C), and 5,10,15-tris(pentafluorophenyl)corrole (TPFPC)) were prepared and characterized. The experimental data are consistent with an out-of-plane dipyrrin coordination mode for these complexes, and DFT optimizations suggest that internal BF??????HN hydrogen bonding may be significant in stabilizing these complexes. Further examples of the anionic diboron corrole [B2OF2(Cor)](-) containing the electron-withdrawing 5,10,15-tris(pentafluorophenyl)corrole (TPFPC) and the sterically hindered 10-(4-methoxyphenyl)-5,15-dimesitylcorrole (Mes2(4-MeOP)C) trianions are reported.

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  • Cardiac response to low-energy field pacing challenges the standard theory of defibrillation

    Caldwell, Bryan; Trew, Mark; Pertsov, AM (2015-06)

    Journal article
    The University of Auckland Library

    BACKGROUND: The electric response of myocardial tissue to periodic field stimuli has attracted significant attention as the basis for low-energy antifibrillation pacing, potentially more effective than traditional single high-energy shocks. In conventional models, an electric field produces a highly nonuniform response of the myocardial wall, with discrete excitations, or hot spots (HS), occurring at cathodal tissue surfaces or large coronary vessels. We test this prediction using novel 3-dimensional tomographic optical imaging. METHODS AND RESULTS: Experiments were performed in isolated coronary perfused pig ventricular wall preparations stained with near-infrared voltage-sensitive fluorescent dye DI-4-ANBDQBS. The 3-dimensional coordinates of HS were determined using alternating transillumination. To relate HS formation with myocardial structures, we used ultradeep confocal imaging (interrogation depths, >4 mm). The peak HS distribution is located deep inside the heart wall, and the depth is not significantly affected by field polarity. We did not observe the strong colocalization of HS with major coronary vessels anticipated from theory. Yet, we observed considerable lateral displacement of HS with field polarity reversal. Models that de-emphasized lateral intracellular coupling and accounted for resistive heterogeneity in the extracellular space showed similar HS distributions to the experimental observations. CONCLUSIONS: The HS distributions within the myocardial wall and the significant lateral displacements with field polarity reversal are inconsistent with standard theories of defibrillation. Extended theories based on enhanced descriptions of cellular scale electric mechanisms may be necessary. The considerable lateral displacement of HS with field polarity reversal supports the hypothesis of biphasic stimuli in low-energy antifibrillation pacing being advantageous.

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  • Error, blame, and the law in health care - An Antipodean Perspective

    Runciman, WB; Merry, Alan; Tito, F (2003)

    Journal article
    The University of Auckland Library

    Patients are frequently harmed by problems arising from the health care process itself. Addressing these problems requires understanding the role of errors, violations, and system failures in their genesis. Problem-solving is inhibited by a tendency to blame those involved, often inappropriately. This has been aggravated by the need to attribute blame before compensation can be obtained through tort and the human failing of attributing blame simply because there has been a serious outcome. Blaming and punishing for errors that are made by well-intentioned people working in the health care system drives the problem of iatrogenic harm underground and alienates people who are best placed to prevent such problems from recurring. On the other hand, failure to assign blame when it is due is also undesirable and erodes trust in the medical profession. Understanding the distinction between blameworthy behavior and inevitable human errors and appreciating the systemic factors that underlie most failures in complex systems are essential for the response to a harmed patient to be informed, fair, and effective in improving safety. It is important to meet society's needs to blame and exact retribution when appropriate. However, this should not be a prerequisite for compensation, which should be appropriately structured, fair, timely, and, ideally, properly funded as an intrinsic part of health care and social security systems.

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  • Bivalirudin versus heparin and protamine in off-pump coronary artery bypass surgery

    Merry, Alan; Raudkivi, PJ; Middleton, NG; McDougall, JM; Nand, P; Mills, BP; Webber, BJ; Frampton, CM; White, Harvey (2004)

    Journal article
    The University of Auckland Library

    Background Bivalirudin is a short-acting direct thrombin inhibitor, with advantages over unfractionated heparin for anticoagulation in cardiac surgery. We hypothesized that bivalirudin is not associated with a clinically important increase in blood loss compared with heparin with protamine reversal in patients undergoing off pump coronary artery bypass (OPCAB) surgery. We also assessed flow with angiography at 3 months using a modified Thombolysis in Myocardial Infarction (TIMI) grade in the grafted coronary arteries. Methods One hundred patients were randomly assigned to receive bivalirudin (0.75 mg/kg bolus, 1.75 mg/kg/h infusion) or heparin (150 to 300 U/kg bolus) with protamine reversal. Results A median of 3 (range, 1 to 5) grafts were inserted per patient. Blood loss for the 12 hours after study drug initiation in the bivalirudin group (median, 793 mL; interquartile range, 532 to 1,214 mL; range, 320 to 4,909 mL; n = 50) was not significantly greater than in the heparin group (median, 805 mL; interquartile range, 517 to 1,117 mL; range, 201 to 2,567 mL; n = 50; p = 0.165). Median graft flow was 3.0 in the bivalirudin group (n = 40) and 2.67 in the heparin group (n = 39; p = 0.047). The bivalirudin group had more patients with grade 3 (ie, full) flow in at least 1 graft (100% versus 90%; p = 0.04), a trend toward more patients with grade 3 flow in all grafts (60% versus 38%; p = 0.06), and more grafts with grade 3 flow (82% versus 67%; p = 0.03). Conclusions Anticoagulation for OPCAB surgery with bivalirudin was feasible without a clinically important increase in perioperative blood loss. Graft flow was better in the bivalirudin patients; the impact of this on clinical outcomes requires a larger study.

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  • Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis

    Carroll, M; Parmar, P; Dalbeth, Nicola; Boocock, M; Rome, Keith (2015)

    Journal article
    The University of Auckland Library

    BACKGROUND: Gait analysis is increasingly being used to characterise dysfunction of the lower limb and foot in people with inflammatory arthritis (IA). The aim of the systematic review was to evaluate the spatiotemporal, foot and ankle kinematic, kinetic, peak plantar pressure and muscle activity parameters between patients with inflammatory arthritis and healthy controls. METHODS: An electronic literature search was performed on Medline, CINAHL, SportsDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Effect sizes with 95% confidence intervals (CI) were calculated as the standardised mean difference (SMD). Meta-analysis was conducted if studies were homogenous. RESULTS: Thirty six studies with quality ranging from high to low met the inclusion criteria. The majority of studies reported gait parameters in Rheumatoid arthritis (RA). The gait pattern in RA was characterised by decreased walking speed (SMD 95% CI -1.57, -2.25 to -0.89), decreased cadence (SMD -0.97, -1.49 to -0.45), decreased stride length (SMD -1.66, -1.84 to -1.49), decreased ankle power (SMD -1.36, -1.70 to -1.02), increased double limb support time (SMD 1.03, 0.84 to 1.22), and peak plantar pressures at the forefoot (SMD 1.11, 0.76 to 1.45). Walking velocity was reduced in psoriatic arthritis and gout with no differences in ankylosing spondylitis. No studies have been conducted in polymyalgia rheumatica, systemic sclerosis or systemic lupus erythematosus. CONCLUSIONS: The review identified the majority of studies reporting gait adaptations in RA, but limited evidence relating to other IA conditions. Poor data reporting, small sample sizes and heterogeneity across IA conditions limit the interpretation of the findings. Future studies may consider a standardised analytical approach to gait analysis that will provide clinicians and researchers with objective evidence of foot function in people with IA.

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  • Patient safety in an interprofessional learning environment

    Horsburgh, Margaret; Merry, Alan; Seddon, Mary (2005)

    Journal article
    The University of Auckland Library

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  • How safe are our hospitals?

    Seddon, Mary; Merry, Alan (2002-12-13)

    Journal article
    The University of Auckland Library

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