Unnamed: 0
int64 0
2.02k
| ReviewID
int64 9.47M
32.4M
| Target_x
stringlengths 50
2.79k
| Background_x
stringlengths 68
3.52k
⌀ | Unnamed: 0_x
int64 0
49k
| PMID
int64 6.99k
32.6M
| Title
stringlengths 8
300
| Abstract
stringlengths 7
10.4k
| Unnamed: 0_y
int64 0
2.02k
| Target_y
stringlengths 50
2.79k
| Background_y
stringlengths 68
3.52k
⌀ |
|---|---|---|---|---|---|---|---|---|---|---|
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 500 | 10,707,032 | Treatment with metformin of non-diabetic men with hypertension, hypertriglyceridaemia and central fat distribution: the BIGPRO 1.2 trial. | BACKGROUND In the BIGPRO 1 trial , one year of treatment with metformin in non-diabetic obese subjects with a central fat distribution had no significant effect on fasting plasma triglyceride concentration or on blood pressure despite a decrease in weight , fasting plasma insulin and glucose concentrations . To re-evaluate the effect of metformin on fasting triglyceride concentration and on blood pressure , the BIGPRO 1.2 trial included non-diabetic men ( n=168 ) with a fasting plasma triglyceride concentration > or = 1.7 and < or = 6.5 mmol/l , high blood pressure ( systolic > or = 140 and < or = 180 and /or diastolic > or = 90 and < or = 105 mmHg , or treatment for hypertension ) and a waist-to-hip ratio > or = 0.95 . METHODS A r and omised double-blind trial comparing metformin treatment ( 850 mg bid ) with placebo . RESULTS Metformin had no significant effect either on blood pressure or plasma triglyceride concentration . In comparison with the placebo group , fasting plasma insulin ( p<0.04 ) , total cholesterol ( p<0.05 ) and Apo B ( p<0.008 ) concentrations decreased more in the metformin group in the BIGPRO 1 . 2 trial , confirming most of the previous results of the BIGPRO 1 trial . Tissue plasminogen activator antigen concentration decreased significantly ( p<0.01 ) only in the metformin group , but this was not significantly different from the placebo group ( p<0.12 ) ; further , there were no significant differences in the change in plasminogen activator inhibitor 1 . CONCLUSIONS The consistency of the two BIGPRO trials supports the conclusion that metformin affects several cardiovascular risk factors favourably in non-diabetic subjects with a central fat distribution | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 501 | 20,639,355 | Metformin and placebo therapy both improve weight management and fasting insulin in obese insulin-resistant adolescents: a prospective, placebo-controlled, randomized study. | OBJECTIVE To study whether metformin reduces obesity , homeostasis model assessment for insulin resistance index ( HOMA-IR ) , and the metabolic syndrome ( MtS ) in obese European adolescents in addition to previous unsuccessful lifestyle intervention . DESIGN AND METHODS After 6 months of multiprofessional lifestyle intervention , 70 out of 86 adolescents without improvement in body mass index ( BMI ) and HOMA-IR were r and omized into either the placebo ( n=34 ) or the metformin group ( 2 × 500 mg/day , n=36 ) in addition to ongoing lifestyle intervention for another 6 months . RESULTS Age was 13.8 years , BMI was 33.1 kg/m(2 ) , 65 % were female , and 89 % were Caucasians . During lifestyle intervention alone , BMI and HOMA-IR deteriorated significantly . In the subsequent medication period , HOMA-IR and fasting insulin improved similarly in the placebo and metformin groups ( HOMA-IR decreased 73 vs 54 % respectively in metformin versus placebo ; P=0.048 ) , but BMI remained unchanged . The insulin sensitivity index , however , only improved in the metformin group . High fasting insulin is correlated with a subsequent BMI increase irrespective of the medication . MtS remained unchanged . CONCLUSIONS Obese European adolescents ' insulin sensitivity improved without weight change during placebo or metformin intervention in addition to lifestyle intervention . Most differences did not reach statistical significance , probably due to improved compliance with lifestyle intervention as a placebo effect . In addition , the metformin dose may be too low | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 502 | 21,080,144 | A randomized, triple masked, placebo-controlled clinical trial for controlling childhood obesity | Background The efficacy of pharmacological treatment in controlling childhood obesity is controversial . We aim ed to compare the effects of three types of drug regimens and placebo on generalized and abdominal obesity among obese children and adolescents who did not succeed to lose weight 3 months after lifestyle modification ( diet and exercise ) . Methods This triple-masked r and omized clinical trial was conducted among 180 participants aged 10–16 years . They were assigned r and omly to 4 groups of equal number to receive metformin , fluoxetine , a combination of the two drugs , or placebo . The trial lasted for 12 weeks and participants were followed up for an additional 12-week period . Results Overall , 91.1 % ( n=164 ) of the enrolled participants completed the trial . After the 12-week trial , the body mass index decreased significantly in all groups receiving medications [ approximately −1.2 ( 0.2 ) kg/m2 , P<0.05 ] . This decrease was not significant in the placebo group . Waist circumference decreased significantly in the groups receiving metformin [ −2.1 ( 0.4 ) cm , P=0.03 ) ] as well as in the group receiving a combination therapy of metformin and fluoxetine [ −2.5 ( 0.4 ) cm , P=0.01 ) ] . In the 24-week follow-up study , these anthropometric indexes were lower than the baseline in the group that had received a combination therapy of metformin and fluoxetine . No serious drug side-effects were reported . Conclusions A limited period of such treatment may help weight control , and might be used to encourage those children who have been refractory to weight loss for continuing the non-pharmacological programs . Our findings should be confirmed in future studies with a longer follow-up period | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 503 | 11,289,473 | Effect of metformin on glucagon-like peptide 1 (GLP-1) and leptin levels in obese nondiabetic subjects. | OBJECTIVE To evaluate the effects of metformin on glucagon-like peptide 1 ( GLP-1 ) and leptin levels . RESEARCH DESIGN AND METHODS A total of 10 obese nondiabetic male patients were studied before and after a 14-day treatment with 2,550 mg/day metformin and were compared with 10 untreated obese control subjects . On days 0 and 15 , leptin and GLP-1(7 - 36)amide/(7 - 37 ) levels were assessed before and after an oral glucose load during a euglycemic hyperinsulinemic clamp to avoid the interference of variations of insulinemia and glycemia on GLP-1 and leptin secretion . The effects of metformin on GLP-1(7 - 36)amide degradation in human plasma and in a buffer solution containing dipeptidyl peptidase IV ( DPP-IV ) were also studied . RESULTS Leptin levels were not affected by the oral glucose load , and they were not modified after metformin treatment . Metformin induced a significant ( P < 0.05 ) increase of GLP-1(7 - 36)amide/(7 - 37 ) at 30 and 60 min after the oral glucose load ( 63.8 + /- 29.0 vs. 50.3 + /- 15.6 pmol/l and 75.8 + /- 35.4 vs. 46.9 + /- 20.0 pmol/l , respectively ) , without affecting baseline GLP-1 levels . No variations of GLP-1 levels were observed in the control group . In pooled human plasma , metformin ( 0.1 - 0.5 microg/ml ) significantly inhibited degradation of GLP-1(7 - 36)amide after a 30-min incubation at 37 degrees C ; similar results were obtained in a buffer solution containing DPP-IV . CONCLUSIONS Metformin significantly increases GLP-1 levels after an oral glucose load in obese nondiabetic subjects ; this effect could be due to an inhibition of GLP-1 degradation | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 504 | 10,391,395 | Effect of metformin on patients with impaired glucose tolerance. | AIMS To evaluate the effect of metformin on glucose metabolism , insulin sensitivity and rate of conversion diabetes in people with impaired glucose tolerance ( IGT ) . METHODS Seventy subjects with IGT were r and omized under double-blind conditions to receive either placebo ( n = 37 ) or metformin ( n = 33 ) at a dosage of 250 mg three times daily for a duration of 12 months . Glycaemic control , plasma insulin and other biochemical indexes were assessed before and after 3 , 6 and 12 months . RESULT At 12 months the conversion rate to diabetes was 16.2 % in the placebo group compared to 3.0 % for the metformin group ( P = 0.011 ) . Of subjects treated with metformin for 12 months , 84.9 % became normoglycaemic compared to 51.4 % of those receiving the placebo . Significant improvements in fasting glucose , glucose tolerance and insulin sensitivity were found at 12 months and at intermediate clinic assessment s. CONCLUSIONS Metformin can improve glucose metabolism in IGT patients and may be a treatment option in their management of IGT subjects | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 505 | 22,570,948 | Metformin use in children with obesity and normal glucose tolerance – effects on cardiovascular markers and intrahepatic fat | Abstract Objective : To determine if metformin improves markers of inflammation , thrombosis , and intrahepatic fat contents in children with uncomplicated obesity . Methods : Obese children with normal glucose tolerance but elevated highly sensitive C-reactive protein ( hsCRP ) and /or fibrinogen concentrations ( > 2 st and ard deviations ) were r and omized to structured diet/exercise or diet/exercise and metformin for 6 months . Blood sample s , dual energy X-ray absorptiometry data , and liver magnetic resonance images were obtained . Results : Forty-two of 66 recruited children ( 7–18 years ) completed 6 months . Weight loss was modest but more pronounced in the metformin group ( –4.9±1.0 kg ) than in the diet/exercise group ( –1.7±1.1 kg , p<0.03 ) , whereas hsCRP and fibrinogen decreased more in the diet/exercise pubertal group . Baseline intrahepatic fat was high but decreased only in the diet/exercise ( not metformin ) pubertal group . Conclusions : Six months of metformin therapy improved weight loss and reduced abdominal adiposity , but did not enhance the beneficial effect of diet and exercise on markers related to inflammation , thrombosis , or hepatic fat in obese children with normal glucose tolerance | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 506 | 18,721,166 | Treatment of non-alcoholic fatty liver disease with metformin versus lifestyle intervention in insulin-resistant adolescents. | The presence of fatty liver per ultrasound and liver-associated enzymes were measured in a select cohort of youth with both obesity and insulin resistance , and the effect of metformin on these parameters evaluated . Fifty obese , multiethnic , insulin-resistant adolescents ( mean age 15.1 yr , mean body mass index 39.8 kg/m2 ) were r and omized to receive lifestyle recommendations plus either twice per day doses of 850 mg of metformin or placebo . Fasting and post-glucose challenge biochemistries and liver ultrasounds were compared at baseline and 6 months . The prevalence of fatty liver was 74 % , elevated alanine aminotransferase ( ALT ) 14 % , aspartate aminotransferase ( AST ) 14 % , and gamma-glutamyl transferase ( GGT ) 17 % . Fatty liver was mild in 23 % , moderate in 31 % , and severe in 46 % . Fatty liver was more common in male and Hispanic subjects and elevated ALT more common in Hispanic subjects . Subjects with fatty liver appeared more insulin resistant ( higher fasting insulin and triglycerides , lower high-density lipoprotein cholesterol ) and had higher ALT and AST . At 6 months , mean ALT , GGT , and fasting insulin improved significantly in all subjects . Fatty liver prevalence ( p < 0.04 ) , severity ( p < 0.04 ) , and fasting insulin ( p < 0.025 ) improved significantly with metformin compared to placebo . Non-alcoholic fatty liver disease ( NAFLD ) occurs with a high prevalence and severity in obese , insulin-resistant adolescents . While metformin plus lifestyle intervention appears promising , defining NAFLD therapies capable of preventing fibrosis and cirrhosis requires further study | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 507 | 22,570,949 | The effects of metformin on inflammatory mediators in obese adolescents with insulin resistance: controlled randomized clinical trial | Abstract Objective : To compare serum concentrations of inflammatory cytokines , interleukin 6 ( IL-6 ) , high-sensitivity C-reactive protein ( hs-CRP ) , adiponectin , and tumor necrosis factor α ( TNFα ) , before and after 3 months treatment with metformin in obese adolescents with insulin resistance ( IR ) . Design and subjects : This was a r and omized , double-blinded , clinical trial of two groups of obese adolescents with IR , aged 9–18 years : a placebo group ( n=14 ) and a metformin group ( n=12 ) who received 500 mg metformin every 12 h for 3 months . Anthropometric and biochemical ( metabolic and inflammatory cytokines ) assessment s were compared at the beginning and end of treatment . Results : After 3 months of treatment , body mass index ( kg/m2 ) was reduced in both groups : placebo group ( 32.82±6.37–32.10±6.52 ; p=0.011 ) and metformin group ( 33.44±5.82–32.71±5.77 ; p=0.015 ) . Serum fasting insulin concentrations ( pmol/L ) increased in the placebo group ( 189.45±112.64–266.06±167.79 ; p=0.01 ) and showed a slight decrease in the metformin group ( 256.82±113.89–229.25±86.53 ; p=0.64 ) . Adiponectin concentrations ( μg/mL ) decreased in the placebo group ( 13.17±7.31–5.65±6.69 ; p=0.02 ) , while these remained stable in the metformin group ( 8.57±3.98–7.86±6.23 ; p=0.64 ) . In the metformin group , significant reductions were found in the variances of serum TNFα concentrations ( p=0.006 ; Levene test ) . Conclusion : These results suggest that treating obese adolescents with IR using metformin for 3 months is an option for patients without response to traditional lifestyle change because metformin improves inflammatory activity , which is an etiological factor in cardiovascular disease development | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 508 | 21,208,779 | GRADE guidelines: 3. Rating the quality of evidence. | This article introduces the approach of GRADE to rating quality of evidence . GRADE specifies four categories-high , moderate , low , and very low-that are applied to a body of evidence , not to individual studies . In the context of a systematic review , quality reflects our confidence that the estimates of the effect are correct . In the context of recommendations , quality reflects our confidence that the effect estimates are adequate to support a particular recommendation . R and omized trials begin as high- quality evidence , observational studies as low quality . " Quality " as used in GRADE means more than risk of bias and so may also be compromised by imprecision , inconsistency , indirectness of study results , and publication bias . In addition , several factors can increase our confidence in an estimate of effect . GRADE provides a systematic approach for considering and reporting each of these factors . GRADE separates the process of assessing quality of evidence from the process of making recommendations . Judgments about the strength of a recommendation depend on more than just the quality of evidence | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 509 | 25,333,776 | Metformin for overweight women at midlife: a double-blind, randomized, controlled trial | Abstract Aim This study was undertaken to determine whether metformin would ameliorate insulin resistance , reduce weight and waist circumference and improve lipids in obese , but not morbidly obese , euglycemic women . Methods Obese women ( body mass index ( BMI ) ≥ 30 and < 40 kg/m2 and /or waist circumference > 88 cm ) , aged 35–65 were r and omized ( 1:1 ) to metformin 850 mg or identical placebo , twice daily for 26 weeks . The primary outcome was the change in insulin resistance determined by the homeostasis model of assessment ( HOMA-IR ) . Secondary outcomes included fasting insulin , glucose , weight , waist circumference and BMI . Results Of the 125 women screened , 117 enrolled and 100 women , mean age 53 years , were included in the primary intention-to-treat analysis . Metformin result ed in statistically significant between-group difference in the change in HOMA-IR ( change in median − 0.04 vs. placebo + 0.1 , p = 0.018 ) and BMI ( mean change − 1.00 kg/m2 ; 95 % confidence interval ( CI ) 1.37 to − 0.62 vs. placebo mean change 0.00 ; 95 % CI − 0.29 to 0.28 , p < 0.001 ) . Statistically significant reductions in HbA1c ( p = 0.008 ) and fasting insulin ( p = 0.03 ) and a borderline decrease in high density lipoprotein cholesterol ( p = 0.07 ) were also observed for metformin , compared with placebo . No effects were seen for waist circumference , fasting glucose or other lipids . Conclusion Treatment of euglycemic , obese , middle-aged women with metformin 1700 mg per day reduced insulin resistance and weight compared with placebo . Further studies are needed to determine whether the use of metformin will prevent the progression of insulin resistance to type 2 diabetes mellitus in obese women | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 510 | 22,424,822 | Metformin decreases plasma resistin concentrations in pediatric patients with impaired glucose tolerance: a placebo-controlled randomized clinical trial. | The objective was to determine the effect of metformin on the concentrations of resistin and other markers of insulin resistance or inflammation ( C-reactive protein , cytokines , body weight , HbA1c , among others ) in minors with glucose intolerance . Patients aged 4 to 17 years with glucose intolerance were studied . They were r and omized to receive 850 mg of either metformin or placebo twice daily for 12 weeks , during which all followed an iso-caloric diet and an exercise program . High sensitivity C-reactive protein , TNF-alpha , IL-6 , IL1-beta , resistin , leptin , adiponectin , glucose , insulin , HbA1c , lipid profile and transaminases were measured at the beginning and at the end of the period . Fifty-two patients were included , 11.9±2.6 years old ; 28 ( 12 males/16 females ) received metformin and 24 placebo ( 11 males/13 females ) . Baseline characteristics were similar between groups ( except for body mass index , which in the metformin group was slightly higher ) . Percentage weight loss was greater in the metformin group ( -5.86 % vs 2.75 % , P<.05 ) . At study end , there were statistically significant differences in resistin concentrations , even after adjusting for confounding variables ( F=7.714 ; P<.006 ) . Also , metformin was associated with a significant decrease in HOMA-IR index ( P=.032 ) and HbA1c levels ( P=.001 ) , but no change was observed in the concentration of other markers of inflammation . Metformin result ed in significant reductions of plasma resistin levels in minors with glucose intolerance . This change is independent of its effects on body weight . In contrast , metformin did not alter the concentration of inflammatory markers | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 511 | 22,015,710 | Lifestyle intervention improves fitness independent of metformin in obese adolescents. | PURPOSE Obesity in adolescence increases the risk for early adult cardiovascular disease . We recently showed that 6 months of diet , exercise , and metformin result ed in reductions in adiposity and that diet/exercise alone reduced proinflammatory factors and intrahepatic fat in pubertal children with uncomplicated obesity . The purpose of the present study was to determine whether changes in cardiorespiratory fitness ( CRF ) after 6 months of structured diet and exercise ( DE ) or DE plus metformin are related to the previously observed changes in adiposity , markers of inflammation , and intrahepatic fat . METHODS Sixteen obese pubertal adolescents between the ages of 10 and 17 were r and omized into a structured lifestyle program consisting of DE or DE plus metformin . Subjects performed aerobic and resistance exercise 3 d·wk⁻¹ , 30 min per session . Cycle ergometer maximal oxygen consumption ( V˙O2max ) , body composition , blood markers ( glucose , insulin , homeostatic model assessment -insulin resistance , interleukin-6 , hsCRP ) , and intrahepatic fat were measured at baseline and 6 months . RESULTS In the cohort , as whole-body weight decreased by 4.0 % ( P = 0.009 ) , body mass index decreased by 4.9 % ( P = 0.003 ) , percent body fat decreased by 8.8 % ( P < 0.001 ) , and V˙O2max improved in 10 of 16 subjects . The addition of metformin provided no further effect on body composition , CRF , or inflammatory factors . More favorable changes in adiposity , adiponectin , and a trend toward blood glucose and interleukin-6 concentrations ( P = 0.07 ) were observed in subjects who increased V˙O2max at 6 months ( n = 10 ) compared with no change in these variables in those who did not improve V˙O2max . CONCLUSIONS Metformin did not provide benefits above lifestyle modification for improving CRF in obese adolescents . Improvements in V˙O2max seem to be associated with more favorable metabolic outcomes | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 512 | 23,175,691 | Metformin in obese children and adolescents: the MOCA trial. | CONTEXT Childhood obesity is increasingly associated with type 2 diabetes ( T2D ) . Metformin reduces the risk for T2D in adult obese nondiabetic patients , but the evidence in obese children and young people is inconclusive . OBJECTIVE The objective of the study was to assess the effect of metformin on body mass index sd score ( BMI -SDS ) , metabolic risk factors , and adipokines . DESIGN This was a prospect i ve , r and omized , double-blind , placebo-controlled trial . SETTING The study was conducted at six pediatric endocrine centers in the United Kingdom . PARTICIPANTS One hundred fifty-one obese children and young people with hyperinsulinemia and /or impaired fasting glucose or impaired glucose tolerance ( metformin : 74 , placebo : 77 ) . The study was comprised of 67.5 % females , 65.6 % postpubertal individuals , and 23.8 % British Asian or Afro-Caribbean participants . The age range was 8 - 18 yr , the mean age was 13.7 ( SD 2.3 ) yr , and the mean BMI -SDS was + 3.4 ( SD 0.5 ) . INTERVENTIONS The intervention included metformin 1 g in the morning and 500 mg in the evening vs. placebo for 6 months . MAIN OUTCOME MEASURE The main outcome measure was a reduction in BMI -SDS at 6 months . Secondary outcomes included insulin and glucose levels from oral glucose tolerance tests , alanine aminotransferase ( ALT ) , and adiponectin to leptin ratio ( ALR ) at 3 and 6 months . RESULTS Metformin was associated with a significant reduction in BMI -SDS compared with placebo at 6 months [ mean difference -0.1 SD ( 95 % confidence interval -0.18 to -0.02 ) , P = 0.02 ] . Significant improvements at 3 months were found in the metformin group : fasting glucose , -0.16 mmol/liter ( -0.31 to -0.00 ) , P = 0.047 ; ALT , 19 % ( 5 - 36 % ) , P = 0.008 ; and ALR , 32 % ( 4 - 67 % ) , P = 0.02 . CONCLUSIONS Metformin therapy has a beneficial treatment effect over placebo for BMI -SDS , fasting glucose , ALT , and ALR ratio at 3 months , with changes in BMI -SDS sustained at 6 months | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 513 | 4,376,958 | Efficacy and Safety of Linagliptin Co-Administered with Low-Dose Metformin Once Daily Versus High-Dose Metformin Twice Daily in Treatment-Naïve Patients with Type 2 Diabetes: a Double-Blind Randomized Trial | Introduction The aim of this study was to investigate the efficacy and safety of linagliptin + low-dose ( LD ) metformin once daily versus high-dose ( HD ) metformin twice daily in treatment-naïve patients with type 2 diabetes . Methods Patients ( n = 689 ) were r and omized ( 1:1 ) to double-blind treatment with linagliptin 5 mg + LD metformin ( 1000 mg ) or HD metformin ( 2000 mg ) for 14 weeks . Metformin was initiated at 500 mg/day and up-titrated within 2 weeks ; the dose then remained unchanged . The primary endpoint was change in glycated hemoglobin ( HbA1c ) from baseline to Week 14 in patients who tolerated a daily metformin dose of ≥1000 mg after 2 weeks . Results At Week 14 , HbA1c changed from a mean baseline of 8.0 % ( 64 mmol/mol ) by −0.99 % ( −11 mmol/mol ) for linagliptin + LD metformin , and −0.98 % ( −11 mmol/mol ) for HD metformin [ treatment difference −0.01 % ( 95 % confidence interval −0.13 , 0.12 ) ( 0 mmol/mol ) , P = 0.8924 ] . The proportion of patients who achieved HbA1c < 7.0 % ( 53 mmol/mol ) without occurrence of moderate or severe gastrointestinal ( GI ) events ( including abdominal pain , nausea , vomiting , diarrhea , and decreased appetite ) was the same in both groups ( 51.3 % for both ) . Although the occurrence of moderate or severe GI events was similar , the linagliptin + LD metformin group had fewer mild GI events ( 18.5 % versus 24.3 % ) . The incidence of hypoglycemia was low in both groups . Conclusion Linagliptin + LD metformin combination showed similar efficacy and safety to HD metformin . This combination may be an alternative treatment option in patients who may have difficulty tolerating metformin doses > 1000 mg/day . Funding Boehringer Ingelheim | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 514 | 12,882,612 | Reliability of the PEDro scale for rating quality of randomized controlled trials. | BACKGROUND AND PURPOSE Assessment of the quality of r and omized controlled trials ( RCTs ) is common practice in systematic review s. However , the reliability of data obtained with most quality assessment scales has not been established . This report describes 2 studies design ed to investigate the reliability of data obtained with the Physiotherapy Evidence Data base ( PEDro ) scale developed to rate the quality of RCTs evaluating physical therapist interventions . METHOD In the first study , 11 raters independently rated 25 RCTs r and omly selected from the PEDro data base . In the second study , 2 raters rated 120 RCTs r and omly selected from the PEDro data base , and disagreements were resolved by a third rater ; this generated a set of individual rater and consensus ratings . The process was repeated by independent raters to create a second set of individual and consensus ratings . Reliability of ratings of PEDro scale items was calculated using multirater kappas , and reliability of the total ( summed ) score was calculated using intraclass correlation coefficients ( ICC [ 1,1 ] ) . RESULTS The kappa value for each of the 11 items ranged from.36 to.80 for individual assessors and from.50 to.79 for consensus ratings generated by groups of 2 or 3 raters . The ICC for the total score was.56 ( 95 % confidence interval=.47-.65 ) for ratings by individuals , and the ICC for consensus ratings was.68 ( 95 % confidence interval=.57-.76 ) . DISCUSSION AND CONCLUSION The reliability of ratings of PEDro scale items varied from " fair " to " substantial , " and the reliability of the total PEDro score was " fair " to " good . | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 515 | 20,163,941 | The effect of comprehensive lifestyle intervention or metformin on obesity in young women. | BACKGROUND AND AIM Young women are at high risk of weight gain but few weight management interventions have been investigated in this group . This study aim ed to determine the effect of metformin on body weight , body composition , metabolic risk factors and reproductive hormone levels in overweight or obese young women compared to placebo and comprehensive lifestyle intervention . METHODS AND RESULTS 203 overweight or obese young women ( BMI 33.2+/-0.3 kg/m² , age 28+/-0.3 years ) were r and omised to 1500 mg/day metformin ( M ) plus general lifestyle advice , placebo ( P ) plus general lifestyle advice or comprehensive lifestyle intervention including structured diet , exercise and behavioural therapy ( L ) for 12-weeks . At 12-weeks , linear mixed models found that L group had greater weight loss ( -4.2+/-0.4 kg ) compared to M ( -1.0+/-0.4 kg ) and P groups ( -0.2+/-0.3 kg ) ( P < 0.0001 ) . Weight loss between M and P groups were not significantly different . Attrition rate was 48 % for L , 34 % for M and 29 % for P ( P = 0.08 ) . Intention-to-treat analysis showed that 10 % ( 8/79 ) of the subjects in P group had gained weight ( > 3 % ) , compared to 3 % ( 2/65 ) from M group and none ( 0/59 ) from L group ( P < 0.001 ) . The L group had the greatest decrease in waist circumference ( -5.2+/-0.7 cm ) and fat mass ( -5.4+/-0.7 kg ) compared to the other groups ( P < 0.05 ) . No significant time-by-group effects were seen in plasma lipids , SHBG , testosterone , blood pressure , serum folate , serum ferritin and serum vitamin B12 . CONCLUSION Lifestyle intervention was more effective in reducing body weight and improving body composition compared to metformin among healthy overweight or obese young women | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 516 | 18,492,523 | Addition of metformin to a lifestyle modification program in adolescents with insulin resistance. | OBJECTIVE To evaluate whether metformin , when added to a program of personal goal setting , improves weight loss and clinical status in obese adolescents . STUDY DESIGN In a r and omized double-blind placebo controlled trial , 85 adolescents with insulin resistance were r and omized to receive metformin ( 70 % ) or placebo ( 30 % ) , along with monthly goal setting for diet and exercise modification . Anthropometric measures , fasting blood analysis , and glucose tolerance tests were performed at baseline and 6 months . RESULTS Mean age was 15.7 years . Mean body mass index ( BMI ) was 39.7 kg/m(2 ) . 71 % were female , 58 % were Hispanic , and 34 % were African-American . 76 % of participants completed the study . Goal setting alone did not result in significant weight loss . In addition , there were no group differences between metformin and placebo in weight loss or measures of glucose metabolism . However , among females taking metformin , there was a significant decrease in BMI not seen in the placebo group . Furthermore , metformin adherence , when accompanied by lifestyle change , was a predictor of BMI decrease of 5 % or more . 60 % of 10 subjects who adhered to metformin and decreased portion size decreased BMI by > 5 % . CONCLUSIONS In this group of predominately minority adolescents , monthly goal setting alone did not lead to weight loss . Although the addition of metformin had no effect on weight loss overall , the agent did significantly increase weight loss among females and weight loss was predicted by degree of metformin adherence . However , weight loss was only found in those participants also reporting lifestyle change , particularly a decrease in portion sizes . These results suggest that metformin may be a useful agent to promote short-term weight loss among girls making modest lifestyle changes | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 517 | 11,735,093 | Beneficial effects of metformin in normoglycemic morbidly obese adolescents. | Hyperinsulinemia and insulin resistance are common features of obesity in humans and experimental animals . It has been demonstrated that metformin , an antihyperglycemic agent , decreases hyperinsulinemia and insulin resistance leading to decreased adiposity in obese and non-insulin-dependent diabetes mellitus ( NIDDM ) adults . To evaluate the antiobesity effect of metformin , we conducted a r and omized double-blind placebo controlled trial in 24 hyperinsulinemic nondiabetic obese adolescents ( body mass index [ BMI ] > 30 kg/m(2 ) ) . All subjects were placed on a low-calorie ( 1,500 kcal for women and 1,800 kcal for men ) meal plan . After an initial 1-week lead-in period , 12 subjects ( mean + /- SE for age and BMI , 15.6 + /- 0.4 and 41.2 + /- 1.8 , respectively ) received metformin ( 850 mg twice daily ) for 8 weeks , and 12 subjects ( mean + /- SE for age and BMI , 15.7 + /- 0.5 and 40.8 + /- 1.4 , respectively ) received placebo . Compared to the placebo group , the metformin group had greater weight loss ( 6.5 % + /- 0.8 % v 3.8 + /- 0.4 % , P < .01 ) , greater decrease in body fat ( P < .001 ) , greater increase in fat-free mass to body fat ratio ( P < .005 ) , and greater attenuation of area under the curve ( AUC ) insulin response to an oral glucose tolerance test ( P < .001 ) . This was associated with enhanced insulin sensitivity , as determined by the fasting plasma glucose : insulin , 2-hour glucose : insulin , and AUC glucose : AUC insulin ratios , in the metformin group compared to controls ( P < .01 ) . This corresponded to a significant reduction in plasma leptin ( P < .005 ) , cholesterol , triglycerides , and free fatty acid ( FFA ) levels ( P < .05 ) only in the metformin-treated subjects . Combined metformin treatment and low-calorie diet had a significant antiobesity effect in hyperinsulinemic obese adolescents compared to a low-calorie diet alone | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 518 | 20,124,139 | Metformin extended release treatment of adolescent obesity: a 48-week randomized, double-blind, placebo-controlled trial with 48-week follow-up. | BACKGROUND Metformin has been proffered as a therapy for adolescent obesity , although long-term controlled studies have not been reported . OBJECTIVE To test the hypothesis that 48 weeks of daily metformin hydrochloride extended release ( XR ) therapy will reduce body mass index ( BMI ) in obese adolescents , as compared with placebo . DESIGN Multicenter , r and omized , double-blind , placebo-controlled clinical trial . SETTING The 6 centers of the Glaser Pediatric Research Network from October 2003 to August 2007 . PARTICIPANTS Obese ( BMI > or = 95th percentile ) adolescents ( aged 13 - 18 years ) were r and omly assigned to the intervention ( n = 39 ) or placebo groups . Intervention Following a 1-month run-in period , subjects following a lifestyle intervention program were r and omized 1:1 to 48 weeks ' treatment with metformin hydrochloride XR , 2000 mg once daily , or an identical placebo . Subjects were monitored for an additional 48 weeks . Main Outcome Measure Change in BMI , adjusted for site , sex , race , ethnicity , and age and metformin vs placebo . RESULTS After 48 weeks , mean ( SE ) adjusted BMI increased 0.2 ( 0.5 ) in the placebo group and decreased 0.9 ( 0.5 ) in the metformin XR group ( P = .03 ) . This difference persisted for 12 to 24 weeks after cessation of treatment . No significant effects of metformin on body composition , abdominal fat , or insulin indices were observed . CONCLUSION Metformin XR caused a small but statistically significant decrease in BMI when added to a lifestyle intervention program . TRIAL REGISTRATION clinical trials.gov Identifiers : NCT00209482 and NCT00120146 | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 519 | 9,693,934 | Effect of metformin on food intake in obese subjects. | BACKGROUND It has been hypothesized that metformin inhibits food intake , but in humans such effect needs to be demonstrated . Our study aims at investigating the effect of metformin administration on food intake in obese , non-diabetic , normotensive patients . METHODS Thirty patients underwent a double-blind , r and omized study . Placebo ( P ; n = 15 ) and metformin ( M ; n = 15 ) were both given for 15 days , and food intake ( FI ) was recorded at baseline and in the last 4 days of each treatment period . RESULTS M administration allowed a stronger decline in body weight ( BW ) ( -2.8 + /- 1.6 vs. -0.3 + /- 0.4 kg P < 0.01 ) , body fat ( BF ) ( -1.4 + /- 1.2 vs. -0.3 + /- 1.1 kg P < 0.01 ) , plasma leptin concentration ( -5.2 + /- 8.9 vs. -1.8 + /- 10.4 ng mL-1 P < 0.05 ) and FI ( -642 + /- 491 vs.-70 + /- 1165 kJ per 24 h P < 0.01 ) than P. In M-treated subjects , changes in FI significantly correlated with those in BW ( r = 0.63 , P < 0.007 ) and BF ( r = 0.74 , P < 0.001 ) . Independently of sex and change in BF , the changes in FI and in fasting plasma leptin concentration ( r = 0.58 , P < 0.01 ) were still correlated . CONCLUSION Our study suggests that metformin administration is useful to inhibit FI and to lower BW and BF in obese non-diabetic patients | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 520 | 15,519,498 | Effect of metformin vs. placebo treatment on serum fatty acids in non-diabetic obese insulin resistant individuals. | Metformin improves insulin sensitivity , which is correlated to phospholipid fatty acid composition in obese type 2 diabetics . We aim ed at investigating the relationship between Metformin and fatty acids in obese insulin resistant non-diabetic individuals . A double-blind , placebo-controlled 20-week trial was performed in 21 BMI and age-matched insulin resistant non-diabetic individuals receiving either Metformin or placebo . Insulin sensitivity together with metabolic parameters and fatty acids in serum phospholipids were measured at baseline and at 20 weeks . A significant decrease in body weight , BMI , percentage body fat , the sum of saturated fatty acids in serum phospholipids and increase in insulin sensitivity index were observed following the 20-week treatment . These changes did not differ significantly between the groups . Energy restriction rather than Metformin treatment appears to be responsible for the observed changes . The associations previously found in diabetics between insulin sensitivity and phospholipid fatty acids may not be mediated by Metformin | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 521 | 15,715,892 | Effects of metformin on the body composition in subjects with risk factors for type 2 diabetes. | OBJECTIVES To measure the effect of metformin on the body composition , insulin resistance and sensitivity in subjects with risk factors for type 2 diabetes mellitus ( type 2 DM ) . DESIGN Placebo-controlled clinical trial . MATERIAL AND METHODS Twenty-three subjects with risk factors for type 2 DM were r and omly assigned to receive 850 mg of metformin or a placebo twice a day for 2 months . Before and after the treatment , the body mass index and waist/hip ratio were calculated , the body composition was measured through bioelectric impedance and the fasting levels of blood glucose , insulin , triglycerides and cholesterol were measured . The level of insulin resistance was calculated by the homeostatic model and the level of sensitivity by the quantitative insulin sensitivity check index method . The Wilcoxon rank test was used . RESULTS Twenty-one subjects completed the study , 12 of the metformin group and nine of the placebo group . In the metformin group , there was a decrease in fat weight from 25.9 + /- 9.4 to 20.8 + /- 9.2 kg , p < 0.01 , an increase in lean weight from 57.05 + /- 13.6 to 61.9 + /- 16.5 kg , p < 0.01 , an increase in basal metabolism from 1735 + /- 413 to 1878 + /- 505 calories/day , p < 0.05 and an increase in body water , p < 0.05 . There was no significant decrease in insulin resistance . In the placebo group , the blood glucose increased from 84.7 + /- 13 to 96.7 + /- 16 mg/dl , p < 0.05 . There were no significant modifications in lipids . CONCLUSIONS The administration of metformin for 2 months improves the parameters of body composition and insulin dynamics in subjects with risk factors for type 2 DM | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
27 | 30,511,328 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . | 522 | 16,595,599 | Randomized, controlled trial of metformin for obesity and insulin resistance in children and adolescents: improvement in body composition and fasting insulin. | CONTEXT Metformin therapy for adults and children with type 2 diabetes is well established . However , its role in the treatment of insulin resistance and obesity in children and adolescents is less clearly defined . OBJECTIVE We assessed the effect of metformin on body composition and insulin sensitivity in pediatric subjects with exogenous obesity . DESIGN AND SETTING Patients referred to a pediatric endocrine clinic were enrolled in a r and omized , double-blind , crossover trial . PATIENTS Twenty-eight patients ( 13 males ) aged 9 - 18 yr participated in the study . INTERVENTION Patients received metformin ( 1 g twice daily ) and placebo for 6 months , each with a 2-wk washout period . MAIN OUTCOME MEASURES Body composition ( anthropometry , dual-energy x-ray absorptiometry , and abdominal magnetic resonance imaging ) , and insulin sensitivity ( Si ; minimal model , fasting insulin and glucose ) were measured at baseline and 6 and 12 months . RESULTS Mean age of subjects at baseline was 12.5 + /- 2.2 yr , median body mass index z-score 2.54 ( range , 1.93 - 2.85 ) . Metformin had a greater treatment effect over placebo for weight ( -4.35 kg , P = 0.02 ) , body mass index ( -1.26 kg/m(2 ) , P = 0.002 ) , waist circumference ( -2.8 cm , P = 0.003 ) , sc abdominal adipose tissue ( -52.5 cm(2 ) , P = 0.002 ) , and fasting insulin ( -2.2 mU/liter , P = 0.011 ) . Si improved in 45 % of subjects while on metformin and 27 % of subjects while on placebo ( P = 0.21 ) . CONCLUSIONS Metformin therapy for obese insulin-resistant pediatric patients results in significant improvement in body composition and fasting insulin . Although improvement in Si was noted in many individuals , Si was a less useful parameter for analysis of group data , possibly because of effects of variable compliance and changing Si during puberty | 27 | Network meta- analysis revealed that in adolescents , intervention with 2000 mg/day metformin ranked better than other interventions ; however , 1000 mg/day metformin for 3 months may be most suitable for adolescents .
For adults , metformin at doses of 3000 and 1000 mg/day ranked the highest , other than minimeal and lifestyle interventions ; moreover , intervention with 3000 mg/day for 6 months and 1000 mg/day for 0.5 months may be suitable for adults .
Conclusion When considering the efficacy of interventions for losing weight , metformin offers clear advantages for overweight and obese population | Purpose Our aim was to assess the efficacy of metformin for weight loss in overweight and obese people through a systematic review and network meta- analysis and to identify the most suitable dosage and intervention period for using metformin in adolescents and adults . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 523 | 16,368,736 | Use of the 'STRATIFY' falls risk assessment in patients recovering from acute stroke. | OBJECTIVES To investigate the predictive validity and reliability of the STRATIFY falls risk assessment tool as applied to patients recovering from acute stroke . DESIGN Prospect i ve cohort study . SETTING Six stroke rehabilitation units in the North of Engl and . SUBJECTS All patients with a diagnosis of acute stroke admitted to the participating stroke units during a 6-month study period . ASSESSMENT on admission , falls risk ( STRATIFY ) , disability ( Barthel index ) , mobility ( Rivermead mobility index ) , cognitive impairment ( abbreviated mental test score ) and visual neglect ( Albert 's test ) were assessed . Then , STRATIFY was completed weekly and within 48 h of anticipated discharge . Consenting patients were contacted at 3 months after discharge to determine falls . OUTCOME MEASURES Occurrence of a fall within 28 days of the baseline STRATIFY ( in-patient study ) , falls in the first 3 months after discharge ( post-discharge study ) and falls during stroke unit stay ( reliability study ) . RESULTS From 387 patients admitted to the participating units during the study period , 225 contributed to the 28 day in-patient study , and 234 were followed up at 3 months after discharge . STRATIFY performed poorly in predicting falls in the first 28 days ( sensitivity 11.3 % and specificity 89.5 % ) and after discharge ( sensitivity 16.3 % and specificity 86.4 % ) . Agreement was ' fair ' between baseline and discharge scores ( kappa = 0.263 ) and ' good ' between the pre-hospital discharge score and that obtained in the week preceding discharge ( kappa = 0.639 ) . CONCLUSION STRATIFY performed poorly as a predictor of falls in a heterogeneous population of stroke patients . There is a need for a disease-specific rather than a generic falls risk assessment tool | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 524 | 15,031,238 | Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial | Abstract Objective To assess the effectiveness of a targeted , multiple intervention falls prevention programme in reducing falls and injuries related to falls in a subacute hospital . Design R and omised controlled trial of a targeted multiple intervention programme implemented in addition to usual care compared with usual care alone . Setting Three subacute wards in a metropolitan hospital specialising in rehabilitation and care of elderly patients . Participants 626 men and women aged 38 to 99 years ( average 80 years ) were recruited from consecutive admissions to subacute hospital wards . Intervention Falls risk alert card with information brochure , exercise programme , education programme , and hip protectors . Main outcome measures Incidence rate of falls , injuries related to falls , and proportion of participants who experienced one or more falls during their stay in hospital . Results Participants in the intervention group ( n = 310 ) experienced 30 % fewer falls than participants in the control group ( n = 316 ) . This difference was significant ( Peto log rank test P = 0.045 ) and was most obvious after 45 days of observation . In the intervention group there was a trend for a reduction in the proportion of participants who experienced falls ( relative risk 0.78 , 95 % confidence interval 0.56 to 1.06 ) and 28 % fewer falls result ed in injury ( log rank test P = 0.20 ) . Conclusions A targeted multiple intervention falls prevention programme reduces the incidence of falls in the subacute hospital setting | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 525 | 11,470,385 | Internal validation of predictive models: efficiency of some procedures for logistic regression analysis. | The performance of a predictive model is overestimated when simply determined on the sample of subjects that was used to construct the model . Several internal validation methods are available that aim to provide a more accurate estimate of model performance in new subjects . We evaluated several variants of split- sample , cross-validation and bootstrapping methods with a logistic regression model that included eight predictors for 30-day mortality after an acute myocardial infa rct ion . R and om sample s with a size between n = 572 and n = 9165 were drawn from a large data set ( GUSTO-I ; n = 40,830 ; 2851 deaths ) to reflect modeling in data sets with between 5 and 80 events per variable . Independent performance was determined on the remaining subjects . Performance measures included discriminative ability , calibration and overall accuracy . We found that split- sample analyses gave overly pessimistic estimates of performance , with large variability . Cross-validation on 10 % of the sample had low bias and low variability , but was not suitable for all performance measures . Internal validity could best be estimated with bootstrapping , which provided stable estimates with low bias . We conclude that split- sample validation is inefficient , and recommend bootstrapping for estimation of internal validity of a predictive logistic regression model | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 526 | 9,408,676 | Further validation of the Elderly Mobility Scale for measurement of mobility of hospitalized elderly people | Objective : To further assess the validity and inter-rater reliability of the Elderly Mobility Scale ( EMS ) . Also whether the scale reflects elderly people 's perceptions regarding their mobility , and whether it can predict discharge destination , or likelihood of falling . Design : Question naire-based study completed on admission and weekly after this on all patients referred to physiotherapy for mobility problems over the course of one month . Setting : Care of the elderly wards in the Bristol General Hospital . Subjects : Sixty-six patients ( ages 66 - 69 years , 66 % female ) were included in the validity study . Nineteen patients ( ages 71 - 95 years , 47 % female ) were included in the inter-rater reliability study . Interventions : EMS , Barthel and patients ' perceptions of mobility were tested with routine physiotherapy treatment carried out as necessary . Main outcome measures : Concurrent validity was assessed by correlating EMS scores with Barthel scores using Spearman 's test . Inter-rater reliability was also tested using a Spearman 's correlation . EMS scores of patients were also evaluated in conjunction with whether or not they fell and their destination on discharge . Results : A significant correlation between EMS and Barthel scores indicated concurrent validity . Inter-rater reliability was demonstrated on 19 patients with a significant correlation between scores . No predictive validity could be ascribed to EMS in terms of discharge destination or likelihood of falling . Results do indicate a possible predictive validity of the functional reach component of the EMS regarding the risk of future falls . Conclusions : The EMS was found to be a valid scale with good inter-rater reliability that could be readily applied during daily clinical work . However , it was found to have no predictive validity in terms of falling or discharge destination | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 527 | 7,993,168 | A randomized trial of identification bracelets to prevent falls among patients in a rehabilitation hospital. | This purpose of this study was to determine whether an identification bracelet is effective in preventing falls among high-risk patients who are undergoing in-patient physical rehabilitation . A stratified , r and omized , balanced controlled clinical trial was conducted ; participants were blinded as to the outcome and the study hypothesis . All patients having one or more risk factors that predisposed them to falls were r and omized to receive either a blue identification bracelet or no bracelet . The identification bracelet was intended to increase patients ' vigilance about falling . Two risk strata were specified . The high risk stratum consisted of patients with stroke or ataxia , urinary incontinence , or a history of falls . The low risk stratum comprised patients older than 80 years and those on one or more medications that had been identified as contributing to an individual 's risk of falling . This report presents the effect of the identification bracelet only among persons in the high-risk stratum . Over 1 year , 65 high-risk subjects were r and omized to receive the blue identification bracelet and 69 high-risk subjects were controls . In the intervention group , 27 persons ( 41 % ) fell at least once , whereas in the control group 21 persons ( 30 % ) fell at least once yielding a hazard ratio of 1.3 ( 95 % confidence interval : 0.8 to 2.4 ) . These results suggest that the identification system was of no benefit in preventing falls among high-risk persons | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 528 | 333,435 | Prediction of falls using a risk assessment tool in the acute care setting | Background The British STRATIFY tool was previously developed to predict falls in hospital . Although the tool has several strengths , certain limitations exist which may not allow generalizability to a Canadian setting . Thus , we tested the STRATIFY tool with some modification and re-weighting of items in Canadian hospitals . Methods This was a prospect i ve validation cohort study in four acute care medical units of two teaching hospitals in Hamilton , Ontario . In total , 620 patients over the age of 65 years admitted during a 6-month period . Five patient characteristics found to be risk factors for falls in the British STRATIFY study were tested for predictive validity . The characteristics included history of falls , mental impairment , visual impairment , toileting , and dependency in transfers and mobility . Multivariate logistic regression was used to obtain optimal weights for the construction of a risk score . A receiver-operating characteristic curve was generated to show sensitivities and specificities for predicting falls based on different threshold scores for considering patients at high risk . Results Inter-rater reliability for the weighted risk score indicated very good agreement ( inter-class correlation coefficient = 0.78 ) . History of falls , mental impairment , toileting difficulties , and dependency in transfer / mobility significantly predicted fallers . In the multivariate model , mental status was a significant predictor ( P < 0.001 ) while history of falls and transfer / mobility difficulties approached significance ( P = 0.089 and P = 0.077 respectively ) . The logistic regression model led to weights for a risk score on a 30-point scale . A risk score of 9 or more gave a sensitivity of 91 % and specificity of 60 % for predicting who would fall . Conclusion Good predictive validity for identifying fallers was achieved in a Canadian setting using a simple-to-obtain risk score that can easily be incorporated into practice | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 529 | 9,366,729 | Development and evaluation of evidence based risk assessment tool (STRATIFY) to predict which elderly inpatients will fall: case-control and cohort studies | Abstract Objectives : To identify clinical characteristics of elderly in patients that predict their chance of falling ( phase 1 ) and to use these characteristics to derive a risk assessment tool and to evaluate its power in predicting falls ( phases 2 and 3 ) . Design : Phase 1 : a prospect i ve case-control study . Phases 2 and 3 : prospect i ve evaluations of the derived risk assessment tool in predicting falls in two cohorts . Setting : Elderly care units of St Thomas 's Hospital ( phase 1 and 2 ) and Kent and Canterbury Hospital ( phase 3 ) . Subjects : Elderly hospital in patients ( aged 65 years ) : 116 cases and 116 controls in phase 1 , 217 patients in phase 2 , and 331 in phase 3 . Main outcome measures : 21 separate clinical characteristics were assessed in phase 1 , including the abbreviated mental test score , modified Barthel index , a transfer and mobility score obtained by combining the transfer and mobility sections of the Barthel index , and several nursing judgments . Results : In phase 1 five factors were independently associated with a higher risk of falls : fall as a presenting complaint ( odds ratio 4.64 ( 95 % confidence interval 2.59 to 8.33 ) ; a transfer and mobility score of 3 or 4 ( 2.10 ( 1.22 to 3.61 ) ) ; and primary nurses ' judgment that a patient was agitated ( 20.9 ( 9.62 to 45.62 ) ) , needed frequent toileting ( 2.48 ( 1.08 to 5.70 ) ) , and was visually impaired ( 3.56 ( 1.26 to 10.05 ) ) . A risk assessment score ( range 0 - 5 ) was derived by scoring one point for each of these five factors . In phases 2 and 3 a risk assessment score > 2 was used to define high risk : the sensitivity and specificity of the score to predict falls during the following week was 93 % and 88 % respectively in phase 2 and 92 % and 68 % respectively in phase 3 . Conclusion : This simple risk assessment tool predicted with clinical ly useful sensitivity and specificity a high percentage of falls among elderly hospital in patients | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 530 | 8,132,920 | Predicting which patient will fall again ... and again. | In order to compare the characteristics , preventive interventions and outcomes of single and multiple fallers , a retrospective cross-sectional study was conducted in a 680-bed acute-care hospital in Western Australia . Fifty patients falling more than once ( multiple fallers ) were r and omly selected from all patients reported to have fallen between 1 July 1989 and 31 December 1989 , and age-sex matched with 50 patients falling once in the trial period ( single fallers ) . In total , 382 in- patients were reported to have sustained 578 falls in the 6-month trial period . Fifty-two per cent of these falls involved multiple fallers . An analysis of the 100 single and multiple fallers showed that single fallers were more likely to have fallen from their bed ; be discharged home from hospital ; and be clinical ly deteriorating at the time of the fall . Multiple fallers were more likely to be transferred to a long-term nursing facility after discharge from hospital ; suffer blindness/poor vision ; be se date d post fall ; be ordered to be restrained following a fall ; and be hospitalized for longer periods . There was also a tendency for multiple fallers to repeat the type and location of the fall on successive falls . Stepwise logistic regression showed that falling from the bed on the first fall predicted remaining a single faller . Being ordered to be restrained following the first fall and hospitalized for longer periods predicted the patient would fall repeatedly . Further analytical research incorporating an exp and ed number of independent variables is needed to allow confident assertions of causality . To test the effectiveness of preventive measures , a prospect i ve longitudinal study is required | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 531 | 10,064,293 | Use of initial risk assessment and recording as the main nursing intervention in identifying risk of falls. | The consequences of falls among hospital patients are a great problem , for the patient , the family and society , and cost billions of dollars . In Sweden , almost one-third of all hip fractures occur in the hospital population . Despite this , very few prevention strategies have been developed and tested . In this study , a risk assessment and recording programme in relation to the risk of falling among patients in a geriatric department at a Swedish hospital was implemented . The records of all patients admitted to a geriatric unit during one year , and a stratified r and om sample of patient records , constituting the control group from the year before , were review ed . No recording of assessment s regarding the patients ' risk of falling , and no preventive nursing interventions , were found in the records of the control group . The study group , however , increased the recording of risk assessment to 96 % . Only implemented nursing interventions were found in the patients ' records , despite the fact that Swedish law makes it obligatory for the registered nurse to record both the planning and implementation of nursing care . In the study group there were explicit descriptions of problems of concern for nursing regarding the patients ' risk of falling in less than one-third of the records , the nursing care plans were rare , and the evaluations were not satisfactory . Nursing interventions consisted mostly of information or education , promotion of patient participation , and structuring of the environment . There was no agreement on any st and ard-care plan . Recording of falls was found more often in the study group than in the control group ( probably due to more careful recording ) , but the proportion of injuries in relation to falls was higher in the control group . The results of this study may be used as a baseline for developing a nursing strategy and documentation relating to falls | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 532 | 15,151,914 | Using targeted risk factor reduction to prevent falls in older in-patients: a randomised controlled trial. | BACKGROUND falls and related injuries are known to be a significant problem for older people . There is evidence that identifying and addressing individual risk factors can reduce the incidence of falls in the community but no evidence of the effectiveness of targeted risk factor reduction methods applied to hospital in- patients . OBJECTIVE to test the efficacy of a targeted risk factor reduction core care plan in reducing risk of falling while in hospital . DESIGN a group ( ward ) r and omised trial . SETTING elderly care wards and associated community units of a district general hospital in the North of Engl and . SUBJECTS all elderly patients who received care in eight wards and community units during a 12-month study period . METHODS matched pairs of wards were r and omly allocated to intervention or control groups . In the intervention wards , staff used a pre-printed care plan for patients identified as at risk of falling and introduced appropriate remedial measures . Numbers of falls in each group were then compared . RESULTS after introduction of the care plan there was a significant reduction in the relative risk of recorded falls on intervention wards ( relative risk 0.79 , 95 % CI 0.65 - 0.95 ) but not on control wards ( RR 1.12 , 95 % CI 0.96 - 1.31 ) . The difference in change between the intervention wards and control wards was highly significant ( RR 0.71 , 95 % CI 0.55 - 0.90 , P = 0.006 ) . There was no significant reduction in the incidence of falls-related injuries . CONCLUSION the use of a core care plan targeting risk factor reduction in older hospital in- patients was associated with a reduction in the relative risk of recorded falls | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 533 | 8,121,429 | Falls prevention: the efficacy of a bed alarm system in an acute-care setting. | The present study examined the clinical efficacy of a bed alarm system in reducing falls from bed on a geriatric evaluation and treatment unit . A nine-month case-controlled study was design ed , in which 70 patients ( 60 women , 10 men ; mean age 84 years , range 67 - 97 years ) at increased risk for bed falls were r and omly assigned to either an experimental or a control group . Subjects in the experimental group ( n = 35 ) received a bed alarm system and those in the control group ( n = 35 ) did not . Outcome measures included bed falls , performance of the bed alarm system , and staff attitudes toward the use of the system . Although results failed to demonstrate a statistical difference in bed falls between the experimental ( n = 1 ) and control ( n = 4 ) groups ( p = 1.00 ) , there was a clinical trend toward reduced falls in the experimental group . The system functioned properly , activating an alarm in all instances when patients were transferring from bed , and with the exception of one case , nurses could respond in a timely fashion to assist patients and prevent bed falls . The system did not produce any adverse effects in patients , nor did the device interfere with the rendering of medical care . The system was well accepted by patients , families , and nurses . These data suggest that bed alarm systems are beneficial in guarding against bed falls and are an acceptable method of preventing falls | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 534 | 16,426,952 | A new instrument for targeting falls prevention interventions was accurate and clinically applicable in a hospital setting. | BACKGROUND AND OBJECTIVE To describe the diagnostic accuracy and practical application of the Peter James Centre Falls Risk Assessment Tool ( PJC-FRAT ) , a multidisciplinary falls risk screening and intervention deployment instrument . METHODS In phase 1 , the accuracy of the PJC-FRAT was prospect ively compared to a gold st and ard ( the STRATIFY ) on a cohort of subacute hospital patients ( n = 122 ) . In phase 2 , the PJC-FRAT was temporally reassessed using a subsequent cohort ( n = 316 ) , with results compared to those of phase 1 . Primary outcomes were falls ( events ) , fallers ( patients who fell ) , and hospital completion rates of the PJC-FRAT . RESULTS In phase 1 , PJC-FRAT accuracy of identifying fallers showed sensitivity of 73 % ( bootstrap 95 % confidence interval CI = 55 , 90 ) and specificity of 75 % ( 95 % CI = 66 , 83 ) , compared with the STRATIFY ( cutoff > or = 2/5 ) sensitivity of 77 % ( 95 % CI = 59 , 92 ) and specificity of 51 % ( 95 % CI = 41 , 61 ) . This difference was not significant . In phase 2 , accuracy of nursing staff using the PJC-FRAT was lower . PJC-FRAT completion rates varied among disciplines over both phases : nurses and physiotherapists , > or = 90 % ; occupational therapists , > or = 82 % ; and medical officers , > or = 57 % . CONCLUSION The PJC-FRAT was practical and relatively accurate as a predictor of falls and a deployment instrument for falls prevention interventions , although continued staff education may be necessary to maintain its accuracy | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 535 | 12,801,247 | Fall risk assessment: a prospective investigation of nurses' clinical judgement and risk assessment tools in predicting patient falls. | A prospect i ve cohort study was used to determine the reliability and validity of two fall risk assessment tools and nurses ' clinical judgement in predicting patient falls . The study wards comprised two aged care and rehabilitation wards within a 570 bed acute care tertiary teaching hospital in Western Australia . Instrument testing included test-retest reliability and calculations of sensitivity , specificity , positive predictive value , negative predictive value and accuracy . The test retest reliability of all methods was good . In this setting , the three methods of assessing fall risk showed good sensitivity but poor specificity . Also , all methods had limited accuracy , and overall , exhibited an inability to adequately discriminate between patient population s at risk of falling and those not at risk of falling . Consequently , neither nurses ' clinical judgement nor the fall risk assessment tools could be recommended for assessing fall risk in this clinical setting | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 536 | 8,841,338 | Using the Downton index to predict those prone to falls in stroke rehabilitation. | BACKGROUND AND PURPOSE Falls are a major complication in inpatient stroke rehabilitation . An important issue in preventive strategies is the early identification of those at risk . This study aim ed at assessing the fall-prediction accuracy of an easily administered fall risk index in stroke rehabilitation . METHODS A consecutive series of 135 patients admitted to a geriatric stroke rehabilitation unit was studied . A score on the Downton fall risk index was obtained from the admission assessment data and used as a predictive indicator of the risk of falls . The patients ' falls were prospect ively recorded during their rehabilitation stay . The correlation between falls and the predicted risk was assessed by means of survival analysis and a multiple regression analysis , adjusting for the time of observation . RESULTS The risk of falls as a function of the time observed was significantly greater among those predicted to be at high risk ( index score > or = 3 ) than among the others ( P = .009 , log-rank test ; odds ratio , 2.9 ) . Furthermore , the number of falls during rehabilitation stay was moderately correlated ( R = .57 ) with the fall risk index sum when adjusted as for the time of observation . The sensitivity of the fall prediction as to outcome was 91 % , whereas the specificity was limited to 27 % . CONCLUSIONS A moderately high correlation was found between the predicted and the observed risk of falls in stroke rehabilitation when the Downton fall risk index was used . However , a low specificity rate limits the accuracy of the prediction | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 537 | 7,668,855 | Hospital falls: development of a predictive model for clinical practice. | A retrospective case-control study related to falls was conducted at an 1,120-bed acute care tertiary hospital . The case ( fall ) sample consisted of 102 falls and 236 control ( nonfall ) charts during a 1-month period . An instrument developed by Hendrich ( 1988 ) was modified for use in the study . Demographic data and risk factors were recorded . Descriptive statistics included risk factor percentages for each sample and the corresponding univariate relative risks . Logistic regression was used to develop a multivariate risk factor model with seven risk factors . The significant risk factors were recent history of falls , depression , altered elimination patterns , dizziness or vertigo , primary cancer diagnosis , confusion , and altered mobility . The adjusted relative risks were converted to risk points to be used to assess a patient 's level of fall risk . Within the data set , a sensitivity of 77 % ( 79 of 102 ) and specificity of 72 % ( 169 of 236 ) were calculated . The model was cross-vali date d in a 1987 data set with a sensitivity of 83 % ( 59 of 71 ) and specificity of 66 % ( 106 of 161 ) | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 538 | 12,624,858 | Validation of the Hendrich II Fall Risk Model: a large concurrent case/control study of hospitalized patients. | This large case/control study of fall and non-fall patients , in an acute care tertiary facility , was design ed to concurrently test the Hendrich Fall Risk Model . Cases and controls ( 355/780 ) were r and omly enrolled and assessed for more than 600 risk factors ( intrinsic/extrinsic ) . St and ardized instruments were used for key physical attributes as well as clinician assessment s. A risk factor model was developed through stepwise logistic regression . Two-way interactions among the risk factors were tested for significance . The best fitting model included 2 Log L chi square statistic as well as sensitivity and specificity values retrospectively . The result of the study is an easy to use vali date d Hendrich Fall Risk Model with eight assessment parameters for high-risk fall identification tested in acute care environments | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 539 | 12,593,120 | Evaluation of the STRATIFY falls prediction tool on a geriatric unit. | Accurate prediction of fall-prone hospitalized older adults may be integral to reducing falls . The STRATIFY , a simple 5-point falls prediction tool , was prospect ively vali date d on a Geriatric Assessment and Rehabilitation Unit as a one-time initial predictor of patients likely to fall . Sensitivity and specificity were lower than in the original British study . Introducing risk assessment s vali date d elsewhere on a patient care unit or on a hospital-wide scale requires caution | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 540 | 15,086,634 | Falls prevention revisited: a call for a new approach. | BACKGROUND Patient falls constitute a major threat to health services ' ability to provide care . Previous studies confirm that nurses can identify patients at risk and that a preventative programme can reduce the rate of falls but few studies have been evaluated over time . AIMS AND OBJECTIVES A study was undertaken to test a Falls Prevention Programme in an acute medical area that was re-evaluated 5 years later to determine if the effects were sustainable . DESIGN The design included two groups of patients admitted before and after the programme . Variables such as staffing , equipment , environment and routines were controlled . However , because of ethical approval constraints , some variables such as age , mental status , mobility and gender were not . METHODS The programme included a risk assessment tool , a choice of interventions , a graphic that alerted others to ' at risk patients ' and simple patient and staff education . Data were collected using incident forms and a formula was used to calculate a rate of falls . A non-paired t-test compared rates and anova examined the relationship of age , gender , mobility and mental status on the incidence of falls . Control graphs determined the stability of the process . RESULTS The falls rate was significantly reduced . Control graphs demonstrate that the process achieved greater control with less variation . In the next 5 years the falls rate increased to preprogramme levels and control graphs demonstrated that the process was no longer controlled . Compliance with the programme had deteriorated . CONCLUSIONS The practice review considered skill mix , patient activity and acuity but provided no definitive answers to explain non-compliance . The implication s to nursing are discussed . RELEVANCE TO CLINICAL PRACTICE Clinicians are called to conduct more rigorous research into falls prevention but it may be more useful to direct research towards examining nursing work and increasing nurse autonomy in falls prevention | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 541 | 15,935,030 | A comparative study of the use of four fall risk assessment tools on acute medical wards. | OBJECTIVES To compare the effectiveness of four falls risk assessment tools ( STRATIFY , Downton , Tullamore , and Tinetti ) by using them simultaneously in the same environment . DESIGN Prospect i ve , open , observational study . SETTING Two acute medical wards admitting predominantly older patients . PARTICIPANTS One hundred thirty-five patients , 86 female , mean age+/-st and ard deviation 83.8+/-8.01 ( range 56 - 100 ) . MEASUREMENTS A single clinician prospect ively completed the four falls risk assessment tools . The extent of completion and time to complete each tool was recorded . Patients were followed until discharge , noting the occurrence of falls . The sensitivity , specificity , negative predictive accuracy , positive predictive accuracy , and total predictive accuracy were calculated . RESULTS The number of patients that the STRATIFY correctly identified ( n=90 ) was significantly higher than the Downton ( n=46 ; P<.001 ) , Tullamore ( n=66 ; P=.005 ) , or Tinetti ( n=52 ; P<.001 ) tools , but the STRATIFY had the poorest sensitivity ( 68.2 % ) . The STRATIFY was also the only tool that could be fully completed in all patients ( n=135 ) , compared with the Downton ( n=130 ; P=.06 ) , Tullamore ( n=130 ; P=.06 ) , and Tinetti ( n=17 ; P<.001 ) . The time required to complete the STRATIFY tool ( average 3.85 minutes ) was significantly less than for the Downton ( 6.34 minutes ; P<.001 ) , Tinetti ( 7.4 minutes ; P<.001 ) , and Tullamore ( 6.25 minutes ; P<.001 ) . The Kaplan-Meier test showed that the STRATIFY ( log rank P=.001 ) and Tullamore tools ( log rank P<.001 ) were effective at predicting falls over the first week of admission . The Downton ( log rank P=.46 ) and Tinetti tools ( log rank P=.41 ) did not demonstrate this characteristic . CONCLUSION Significant differences were identified in the performance and complexity between the four risk assessment tools studied . The STRATIFY tool was the shortest and easiest to complete and had the highest predictive value but the lowest sensitivity | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
28 | 17,595,425 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . | 542 | 7,867,963 | Factors associated with falling in elderly hospital patients. | Forty-four patients aged 65 years and over who fell whilst in an acute hospital and 44 patients who did not fall during their hospital stay underwent structured medical examinations to identify factors associated with falling . The control subjects were matched for age ( + /- 3 years ) , sex , patient type , and primary diagnosis . The examination was based on established assessment s of posture , balance and gait , the musculoskeletal system , vision , cardiovascular status , and neurological function . Bivariate analyses revealed seven assessment measures that were significantly associated with falls : cognitive impairment , particularly impaired orientation ; evidence of previous cerebrovascular accident ; incoordination as measured clinical ly ; inability to perform the ' Get-up- and -go ' test , especially an inability to turn around after a 5-metre walk , and the use of psycho-active medications . Of these variables , impaired orientation , psycho-active drug use , evidence of stroke , and impaired performance in the ' Get-up- and -go ' test were included in a stepwise logistic regression which correctly classified 80 % of the patients into faller and non-faller groups . Falling was also related to the number of these identified risk factors . These findings suggest that a simple screening protocol , taking about 5 min to complete , can assist in the identification of patients at risk of falls whilst in hospital | 28 | Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular setting s , but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment | INTRODUCTION Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals .
Design -related bias in evaluations of tool predictive accuracy could lead to overoptimistic results , which would then contribute to program failure in practice . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 543 | 15,125,120 | A comparison of polyethylene wear rates between cemented and cementless cups. A prospective, randomised trial. | We selected r and omly a consecutive series of 162 patients requiring hip replacement to receive either a cementless , hemispherical , modular , titanium acetabular cup or a cemented , all-polyethylene cup . These replacements were performed by two surgeons in four general hospitals . The same surgical technique was used and a 26 mm metal-head femoral component was used in every case . After exclusions , 115 hips were studied for differences in rates of wear and osteolysis . The mean clinical follow-up was eight years and the mean radiological follow-up , 6.5 years . The cementless cups wore at a mean rate of 0.15 mm per year and the cemented cups at 0.07 mm per year . This difference was significant ( p < 0.0001 ) . Our findings in this mid-term study suggest that cementless cups wear more than cemented cups | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 544 | 17,463,110 | Long-term survivorship of the Charnley Elite Plus femoral component in young patients. | We studied prospect ively the long-term results of the Charnley Elite-Plus femoral stem in 184 consecutive young patients ( 194 hips ) . There were 130 men and 54 women with a mean age of 49.1 years ( 21 to 60 ) . The predominant diagnosis was osteonecrosis of the femoral head ( 63.6 % , 117 patients ) . Clinical and radiological evaluation was undertaken at each follow-up . The mean follow-up was 11.2 years ( 10 to 12 ) . The mean pre-operative Harris hip score was 43.4 ( 12 to 49 ) which improved to 91 ( 59 to 100 ) at the final follow-up . The survival of the femoral stem at 12 years was 99 % with revision as the end-point . The mean annual linear wear of the polyethylene liner was 0.17 mm ( 0.13 to 0.22 ) . The prevalence of acetabular osteolysis was 10.8 % ( 21 hips ) and osteolysis of the calcar femorale 12.9 % ( 25 hips ) . A third-generation cementing technique , accurate alignment of the stem and the use of a 22 mm zirconia head were important factors in the prevention of aseptic loosening of the Elite Plus femoral stem in these high-risk young patients | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 545 | 11,568,195 | The Porous Coated Anatomic Total Hip Replacement: A Ten to Fourteen-Year Follow-up Study of a Cementless Total Hip Arthroplasty | Background : We previously reported our two and five‐year results of arthroplasty with the Porous Coated Anatomic total hip prosthesis . We now report on the performance of this prosthesis at ten to fourteen years . Methods : The results of 311 total hip replacements in which a Porous Coated Anatomic prosthesis was inserted without cement in 279 patients were analyzed prospect ively . The average age of the patients at the time of the replacement was sixty-one years ( range , twenty to eighty‐one years ) . Sixty‐four patients ( seventy-six hips ) died postoperatively . Forty‐five patients ( forty‐seven hips ) were lost to follow‐up , and four were excluded because of their medical condition . One hundred and sixty‐eight patients ( 187 hips ) were followed for ten to fourteen years ( average , twelve years ) . Seventeen of those patients ( seventeen hips ) had a revision . Results : The overall survival rate ( with any revision as the end point ) was 90.0 % ± 5.4 % at fourteen years , with an average Harris hip score of 85 ± 14 points . The prevalence of thigh pain was 36 % ( fifty-six of 157 ) in the late period ( more than ten years postoperatively ) . Radiographs showed stable fixation , with bone ingrowth , of 83 % ( 130 ) of the 156 acetabular components and 88 % ( 137 ) of the 156 femoral components at the latest follow‐up evaluation . Men had a significantly higher rate of femoral osteolysis than did women ( p < 0.001 ) . The rates of acetabular and femoral osteolysis associated with 32‐mm femoral heads ( 49 % [ twenty-three ] of forty-seven and 70 % [ thirty-three ] of forty-seven , respectively ) were significantly higher ( p < 0.01 ) than those associated with 26‐mm heads ( 26 % [ twenty-eight ] of 109 and 30 % [ thirty-three ] of 109 , respectively ) . Despite this , revision ( removal or exchange of components ) was not directly related to head size ; instead , it was related to polyethylene thickness . Conclusions : There have been persistent problems with the Porous Coated Anatomic hip system , including thigh pain and an increasing prevalence of osteolysis with time . Revision because of aseptic loosening was related more to the thickness of the polyethylene liner than to the size of the femoral head . Femoral heads with a 32-mm diameter did not increase the risk for revision provided that an adequate thickness of polyethylene had been used | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 546 | 2,837,808 | No differences in outcomes between cemented and uncemented acetabular components after 12–14 years: results from a randomized controlled trial comparing Duraloc with Charnley cups | Background Even though there are multiple studies documenting the outcome of the Charnley low-friction arthroplasty as well as abundant studies on uncemented arthroplasties , there is a dearth of comparative studies of the uncemented acetabular component and a cemented component . In this study we aim ed to document the long-term clinical and radiographic outcome as well as component survival in a r and omized controlled trial . Material s and methods Two hundred fifteen patients ( 240 hips ) were r and omly allocated to receive a cemented Charnley cup or uncemented Duraloc 1200 cup . All patients received cemented Charnley stems and were evaluated clinical ly and radiographically after 6 months , and 2 , 5 , and 10 years . Results Harris Hip Scores improved from 48.3 [ 95 % confidence interval ( CI ) 45.0–51.6 ] to 90.2 [ 95 % CI 87.9–92.6 ] in the Charnley group and from 49.3 [ 95 % CI 86.9–91.3 ] in the Duraloc group at 6 months . After 10 years , the Charnley group ’s Harris Hip Score was 89.8 [ 95 % confidence interval ( CI ) 87.0–92.6 ] , and the Duraloc group ’s score was 87.3 ( 95 % CI 84.1–90.6 ) . In the radiographic analysis after 10 years , there was no statistical difference in the prevalence of radiographic signs of loosening . Nine cups were revised in the Charnley group , and five cups were removed in the Duraloc group . The difference was not statistically significant . There was no statistical difference between the cups when aseptic loosening was the end-point , nor in survival analyses . Conclusions There is no statistically significant difference in clinical or radiological outcome between the Charnley cup and the Duraloc after 10 years , and no difference in implant survival after 12–14 years . The uncemented Duraloc cup is as good as the cemented Charnley cup after 10 years | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 547 | 12,784,006 | Results of Porous-Coated Anatomic Total Hip Arthroplasty without Cement at Fifteen Years: A Concise Follow-up of a Previous Report* | Abstract : The purpose of this study was to up date the results of a prospect i ve series of primary cementless total hip arthroplasties after a minimum of fifteen years of follow-up . It is one of the first studies of cementless total hip arthroplasties followed for a minimum of fifteen years . One hundred consecutive Porous Coated Anatomic ( PCA ) total hip replacements were implanted between October 1983 and January 1986 . Fifty-five patients ( sixty-four hips ) that were alive at a minimum of fifteen years postoperatively are the focus of the present study . At this time of follow-up , at an average of 15.6 years ( range , fifteen to seventeen years ) after the total hip arthroplasty , 17 % ( seventeen hips ) of the entire cohort and 23 % ( fifteen hips ) of the living cohort had undergone revision because of loosening of the acetabular component or osteolysis . Seven percent ( seven hips ) of the entire cohort and 6 % ( four hips ) of the living cohort had undergone revision for loosening of the femoral component or osteolysis . Only four femoral stems had been revised for isolated loosening ( without osteolysis).The PCA femoral component proved to be durable at a minimum of fifteen years postoperatively , while the acetabular component was less durable . Level of Evidence : Therapeutic study , Level IV ( case series [ no , or historical , control group ] ) . See Instructions to Authors for a complete description of levels of evidence | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 548 | 8,951,001 | Long-term clinical and radiological results of the Lord total hip prosthesis. A prospective study. | We enrolled 98 patients ( 107 hips ) with a mean age of 47 years ( SD 8.6 ) into a prospect i ve study of the Madreporic Lord THR ; 34 hips had primary and 73 secondary osteoarthritis . After ten years , the survival rate using revision as the endpoint for failure was 70 % ( + /-9 ) for the cup and 98 % ( + /-0.3 ) for the stem . The combined clinical and radiological survival rates were 46 % ( + /-11 ) and 81 % ( + /-10 ) , respectively . Osteoporosis due to stress-shielding was observed in the proximal femur . Hips with radiologically dense bone postoperatively showed the most pronounced bone loss . We recommend continued radiological follow-up of patients with this type of implant to allow revision to be performed before there is severe bony destruction of the pelvis | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 549 | 18,827,236 | The results of the titanium-coated RM acetabular component at 20 years: a long-term follow-up of an uncemented primary total hip replacement. | In a prospect i ve study , 93 unselected consecutive uncemented hip arthroplasties were performed in 80 patients using the titanium-coated RM acetabular component and the CLS femoral component . The mean age of the patients at operation was 52 years ( 28 to 81 ) . None were lost to follow-up . In the 23 patients who had died ( 26 hips ) only one acetabular component had been revised . In the 57 living patients ( 67 hips ) , 13 such revisions had been performed . Of the 14 revisions , seven were for osteolysis , five for loosening and two for infection . Survival analysis of this implant showed a total probability of survival of 83 % ( 95 % confidence interval 73 to 90 ) , with all revisions as the endpoint , and a probability of 94 % ( 95 % confidence interval 87 to 98 ) with revision for aseptic loosening as the endpoint , indicating reliable long-term fixation of the titanium-coated RM acetabular component | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 550 | 15,069,131 | Results of Charnley total hip arthroplasty at a minimum of thirty years. A concise follow-up of a previous report. | The purpose of the current study was to up date the results of a prospect i ve , single-surgeon series of primary Charnley total hip arthroplasties performed with cement . This investigation is one of the first studies in which hips treated with total hip arthroplasty with cement were followed for a minimum of thirty years . Twenty-seven patients ( thirty-four [ 10.3 % ] of the hips in the initial study group ) were alive at a minimum of thirty years postoperatively . These patients served as the focus of the present study . Revision because of aseptic loosening of the acetabular component was performed in 7.3 % ( twenty-three ) of the hips from the original study group ( excluding those revised because of infection or dislocation ) and 26 % ( eight ) of the hips in the living cohort . Revision because of aseptic loosening of the femoral component was performed in 3.2 % ( ten ) of the hips from the original study group ( excluding those revised because of infection or dislocation ) and 10 % ( three ) of the hips in the living patients . Since the twenty-five-year review , three hips were revised ( one because of acetabular loosening , one because of femoral loosening , and one because of instability ) . This end- result study demonstrated the remarkable durability of cemented Charnley total hip replacements over a span of three decades , with 88 % of the original prostheses intact at the time of the final follow-up or at the patient 's death | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 551 | 21,464,481 | Comparison of total hip replacement with and without cement in patients younger than 50 years of age: the results at 18 years. | There have been comparatively few studies of the incidence of osteolysis and the survival of hybrid and cementless total hip replacements ( THRs ) in patients younger than 50 years of age . We prospect ively review ed 78 patients ( 109 hips ) with a hybrid THR having a mean age of 43.4 years ( 21 to 50 ) and 79 patients ( 110 hips ) with a cementless THR with a mean age of 46.8 years ( 21 to 49 ) . The patients were evaluated clinical ly using the Harris hip score , the Western Ontario and McMaster Universities ( WOMAC ) osteoarthritis score and the University of California , Los Angeles ( UCLA ) activity score . Radiographs and CT scans were assessed for loosening and osteolysis . The mean follow-up was for 18.4 years ( 16 to 19 ) in both groups . The mean post-operative Harris hip scores ( 91 points versus 90 points ) , the mean WOMAC scores ( 11 points versus 13 points ) and UCLA activity scores ( 6.9 points versus 7.1 points ) were similar in both groups . The revision rates of the acetabular component ( 13 % versus 16 % ) and the femoral component ( 3 % versus 4 % ) , and the survival of the acetabular component ( 87 % versus 84 % ) and the femoral component ( 97 % versus 96 % ) were similar in both groups . Although the long-term fixation of the acetabular metallic shell and the cemented and cementless femoral components was outst and ing , wear and peri-acetabular osteolysis constitute the major challenges of THR in young patients | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 552 | 19,330,391 | Inferior Survival of Hydroxyapatite versus Titanium-coated Cups at 15 Years | Hydroxyapatite ( HA ) particles have long been suspected to disintegrate from implant surfaces , become entrapped in joint spaces of orthopaedic bearing couples , and start a cascade leading to progressive polyethylene ( PE ) wear , increased osteolysis , and aseptic loosening . We compared cup revision at 15 years ’ followup in a r and omized group of patients with 26 cementless THA components with titanium ( Ti ) versus first-generation HA coating . We also assessed radiographic PE wear and osteolysis to the 12-year followup or end point revision at a minimum of 5 years ( mean , 10.9 years ; range , 5–12.6 years ) . Two Ti-coated cups ( 17 % ) and eight HA-coated cups ( 57 % ) were revised at 15 years ’ followup . Femoral head penetration rate was 0.46 mm/year ( st and ard deviation , 0.26 ) with the HA-coated cups ( n = 12 ) and 0.38 mm/year ( st and ard deviation , 0.14 ) with the Ti-coated cups ( n = 10 ) ; we observed a wide variance of linear wear with the HA-coated cups . We also observed a positive association between high wear rate and revision , and between a high volume of osteolysis and revision . Our findings suggest inferior survival of medium-thickness spray-dried HA-coated cups with individual cases of excessive PE wear and premature cup failure . These findings apply to first-generation modular cups and may not apply to other cup design s and new HA-coating technologies . Level of Evidence : Level III , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 553 | 20,625,950 | What Works Best, a Cemented or Cementless Primary Total Hip Arthroplasty?: Minimum 17-year Followup of a Randomized Controlled Trial | Background Total hip arthroplasty ( THA ) has been associated with high survival rates , but debate remains concerning the best fixation mode of THA . Questions / purpose sWe conducted a r and omized controlled trial ( RCT ) with 250 patients with a mean age of 64 years between October 1987 and January 1992 to compare the results of cementless and cemented fixation . Patients and Methods Patients were evaluated for revision of either of the components . One hundred twenty-seven patients had died ( 51 % ) and 12 ( 4.8 % ) were lost to followup . The minimum 17-year followup data ( mean , 20 years ; range , 17–21 years ) for 52 patients of the cementless group and 41 patients of the cemented group were available for evaluation . Results Kaplan-Meier survivorship analysis at 20 years revealed lower survival rates of cemented compared with cementless THA . The cementless tapered stem was associated with a survivorship of 99 % . Age younger than 65 years and male gender were predictors of revision surgery . Conclusions The efficacy of future RCTs can be enhanced by r and omizing patients in specific patient cohorts stratified to age and gender in multicenter RCTs . Including only younger patients might improve the efficacy of a future RCT with smaller sample sizes being required . A minimum 10-year followup should be anticipated , but this can be expected to be longer if the difference in level of quality between the compared implants is smaller . Level of Evidence Level I , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 554 | 15,995,120 | Effects of mechanical compression of a fibrous tissue interface on bone with or without high-density polyethylene particles in a rabbit model of prosthetic loosening. | BACKGROUND The mechanisms leading to aseptic loosening of a total hip replacement are not fully understood . A fibrous tissue interface can be present around the implant . Hypothetically , component micromovements can compress this interface and cause increased fluid pressure according to biphasic models . We tested the hypothesis that compression of a fibrous membrane with or without the presence of high-density polyethylene particles leads to bone degradation . METHODS A titanium implant was inserted in forty-five rabbit tibiae , and , after osseous integration was achieved , a fibrous tissue interface was generated . The animals were r and omized to undergo a sham operation , treatment with compression of the fibrous membrane , treatment with high-density polyethylene particles , or treatment with both compression and particles . Morphometric analysis of the surrounding bone was performed on cryostat sections after Giemsa staining and staining of tartrate-resistant acid phosphatase activity . RESULTS Forty specimens were available for analysis ; five tibiae with an infection were excluded . After nine weeks , the controls showed vital bone , whereas the specimens treated with compression showed necrosis of bone and replacement of bone by cartilage in a discontinuous layer ( p < 0.05 for both ) but not fibrous tissue . Treatment with high-density polyethylene particles caused replacement of bone by fibrous tissue ( p < 0.05 ) but not necrosis or cartilage formation . Compression combined with the presence of high-density polyethylene particles caused bone necrosis and loss of bone with replacement by cartilage and fibrous tissue ( p < 0.05 ) . CONCLUSIONS In this in vivo study in rabbits , fibrous membrane compression led to bone necrosis and cartilage formation , possibly because of fluid pressure or fluid flow , whereas the presence of high-density polyethylene particles led to the loss of bone with replacement of bone by fibrous tissue . Cartilage formation may be a protective response to fluid pressure and /or fluid flow . Fibrous membrane compression may play an important role in the early stages of loosening of a total hip replacement | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 555 | 11,547,367 | Matched-pair analysis of cemented and cementless acetabular reconstruction in primary total hip arthroplasty. | In a matched-pair study of primary total hip arthroplasty , 45 all-polyethylene cemented acetabular components were compared with 45 cementless , hemispheric , titanium acetabular components . At 9 to 12 years , 1 of the cemented acetabular components was revised for aseptic loosening , and 14 ( 31 % ) were radiographically loose . Nine ( 20 % ) cemented acetabular components had pelvic osteolysis . In the cementless acetabular component group , 2 well-fixed components were revised . No components were radiographically loose , and 3 ( 7 % ) had pelvic osteolysis . Thirty-eight ( 97 % ) of the patients in each group were satisfied with the surgery . The clinical results of the cemented and cementless components were excellent . The cementless components had less loosening ( P < .001 ) than the cemented components | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
29 | 23,324,965 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . | 556 | 18,176,810 | Long term results of the Corin C-Fit uncemented total hip arthroplasty in young patients | Introduction We conducted a prospect i ve study to evaluate the long-term results after Corin C-Fit uncemented total hip arthroplasty in young patients with hydroxyapatite or porous coated components . Material s and methods We prospect ively followed 36 patients ( 38 hips ) who had Corin C-Fit uncemented total hip arthroplasties by eight experienced consultant surgeons at two centres . The acetabular and femoral components were hydroxyapatite or porous coated . Results The overall 10-year survival rate for the Corin C-Fit arthroplasty was 43 % . The 10-year survivorship for the femoral implant was 56 % and for the acetabular component 59 % . Conclusion The evidence presented in this study suggests that the Corin C-Fit uncemented total hip arthroplasty has one of the highest mid- and long-term failure rates for both femoral and acetabular components in the literature . We believe this implant should not be used and patients who have had this form of total hip arthroplasty should be kept under regular review | 29 | RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade | BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 557 | 12,182,234 | Both serum receptors of tumor necrosis factor are influenced by mud pack treatment in osteoarthrotic patients. | Several authors have demonstrated the pivotal role of proinflammatory cytokines in inducing progressive cartilage degradation and secondary inflammation of the synovial membrane in osteoarthritis ( OA ) . It has recently been established that tumor necrosis factor (TNF)-alpha plays a well-defined role in the pathophysiology of inflammatory joint diseases and that binding to circulating soluble TNF-alpha receptors can inactivate it . We investigated the influence of mud pack treatment , which is able to diminish TNF-alpha serum values , on specific TNF receptor ( sTNF-R ) levels . Thirty-six patients with OA were enrolled and r and omized into two groups . Group A underwent mud pack treatment and group B underwent thermal bath treatment . A group of 20 healthy untreated subjects was used as a control . Blood sample s were collected at baseline and after treatment , and assays of sTNF-R55 and sTNF-R75 were performed in both groups . We found small changes in sTNF-Rs serum values but these were not statistically significant . sTNF-R55 serum values decreased by 0.4 % after the therapy in group A , while in group B the decrease was -17.7 % . sTNF-R75 was reduced by -21.17 % in group A and by -10.6 % in group B. In conclusion , through its thermic and ant/inflammatory activity mud pack treatment shows complex interaction with the most common factors of inflammatory and cartilage degradation . Our results suggest that the thermic component of this natural treatment is mainly involved in modulating inflammatory reaction and cartilage damage through binding of the circulating TNF , which controls the activation of the cells responsible for the production of proinflammatory cytokines | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 558 | 21,461,716 | Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study | We aim ed to evaluate the effectiveness of balneotherapy in fibromyalgia management . Fifty women with fibromyalgia under pharmacological treatment were r and omly assigned to either the balneotherapy ( 25 ) or the control ( 25 ) group . Four patients from the balneotherapy group and one patient from the control group left the study after r and omization . The patients in the balneotherapy group ( 21 ) had 2 thermomineral water baths daily for 2 weeks in Tuzla Spa Center . The patients in the control group ( 24 ) continued to have their medical treatment and routine daily life . An investigator who was blinded to the study arms assessed the patients . All patients were assessed four times ; at the beginning of the study , at the end of the 2nd week , the 1st month , and the 3rd month after balneotherapy . Outcome measures of the study were pain intensity , Fibromyalgia Impact Question naire ( FIQ ) , Beck Depression Inventory ( BDI ) , patient ’s global assessment , investigator ’s global assessment , SF-36 scores , and tender point count . Balneotherapy was found to be superior at the end of the cure period in terms of pain intensity , FIQ , Beck Depression Inventory , patient ’s global assessment , investigator ’s global assessment scores , and tender point count as compared to the control group . The superiority of balneotherapy lasted up to the end of the 3rd month , except for the Beck Depression Inventory score and the investigator ’s global assessment score . Significant improvements were observed in PF , GH , and MH subscales of SF-36 during the study period in the balneotherapy group ; however , no such improvement was observed in the control group . Balneotherapy was superior only in VT subscale at the end of therapy and at the end of the third month after the therapy as compared to the controls . It was concluded that balneotherapy provides beneficial effects in patients with fibromyalgia | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 559 | 17,033,835 | Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients | The purpose of this study was to investigate the clinical effects of balneotherapy in the treatment of Fibromyalgia Syndrome ( FMS ) and to determine if balneotherapy influences serum levels of inflammation markers , IL-1 , PGE2 and LTB4 . 24 primary fibromyalgia female patients diagnosed according to American College of Rheumatology criteria were included to the study . Their ages ranged between 33 and 55 years . FMS patients were r and omly assigned in two groups as , group 1 ( n = 12 ) and group 2 ( n = 12 ) . Group 1 received 20-min bathing , once in a day for five days per week . Patients participated in the study for 3 weeks ( total of 15 sessions ) in Denizli . Group 2 did not receive balneotherapy . FMS patients were evaluated by tenderness measurements ( tender point count and algometry ) , Visual Analogue Scale , Beck ’s Depression Index , Fibromyalgia Impact Question naire . Ten healthy women recruited group three as the controls . Serum PGE2 , LTB4 and IL1-α levels were measured in all three groups . The biochemical measurements and clinical assessment s were performed before and at the end of general period of therapy . Statistically significant alterations in algometric score , Visual Analogue score , Beck ’s Depression Index and PGE2 levels ( P < 0.001 ) , numbers of tender points ( P < 0.01 ) and Fibromyalgia Impact Question naire score ( P < 0.05 ) were found after the balneotherapy between group 1 and 2 . Mean PGE2 level of FMS patients were higher compared to healthy control group ( P < 0.0001 ) and decreased after the treatment period , only in group 1 ( P < 0.05 ) . As in the group 2 and 3 , detectable IL-1 and LTB4 measurements were insufficient , statistical analysis was performed , only in group 1 . After balneotherapy IL-1 and LTB4 significantly decreased in group 1 ( P < 0.05 ) . In conclusion , balneotherapy is an effective choice of treatment in patients with FMS relieving the clinical symptoms , and possibly influencing the inflammatory mediators | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 560 | 12,927,639 | The effect of combined therapy (ultrasound and interferential current) on pain and sleep in fibromyalgia | Multidisciplinary treatment has proven to be the best therapeutic option to fibromyalgia ( FM ) and physiotherapy has an important role in this approach . Considering the controversial results of electrotherapy in this condition , the aim of this study was to assess the effects of combined therapy with pulsed ultrasound and interferential current ( CTPI ) on pain and sleep in FM . Seventeen patients fulfilling FM criteria were divided into two groups , CTPI and SHAM , and su bmi tted to pain and sleep evaluations . Pain was evaluated by body map ( BM ) of the painful areas ; quantification of pain intensity by visual analog scale ( VAS ) ; tender point ( TP ) count and tenderness threshold ( TT ) . Sleep was assessed by inventory and polysomnography ( PSG ) . After 12 sessions of CTPI or SHAM procedure , patients were evaluated by the same initial protocol . After treatment , CTPI group showed , before and after sleep , subjective improvement of pain in terms of number ( BM ) and intensity ( VAS ) of painful areas ( P<0.001 , both ) ; as well as objective improvement , with decrease in TP count and increase in TT ( P<0.001 , both ) . Subjective sleep improvements observed after CTPI treatment included decrease in morning fatigue and in non‐refreshing sleep complaint ( P<0.001 , both ) . Objective ly , PSG in this group showed decrease in sleep latency ( P<0.001 ) and in the percentage of stage 1 ( P<0.001 ) , increase in the percentage of slow wave sleep ( P<0.001 ) and in sleep cycle count ( P<0.001 ) . Decrease in arousal index ( P<0.001 ) , number of sleep stage changes ( P<0.05 ) and wake time after sleep onset ( P<0.05 ) , were also observed and no difference regarding pain or sleep parameters were verified after SHAM procedure . This study shows that CTPI can be an effective therapeutic approach for pain and sleep manifestations in FM | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 561 | 10,450,540 | Function of the hypothalamic adrenal axis in patients with fibromyalgia syndrome undergoing mud-pack treatment. | Fibromyalgia ( FM ) is a nonarticular rheumatological syndrome associated with diverse clinical and psychological features . One of the major complaints in FM is reduced pain tolerance , especially in tender points ( TP ) for which patients derive significant benefit from nonsteroidal antiinflammatory drugs or corticosteroids . Patients with FM also have altered reactivity of the hypothalamic pituitary adrenal ( HPA ) axis where the predominant feature is reduced containment of the stress response system through diminished adrenocortical output and feedback resistance . Our results show that mud packs together with antidepressant treatment are able to influence the HPA axis , stimulating increased levels of adrenocorticotropic hormone , cortisol and beta-endorphin serum levels . The discharge of corticoids in the blood and the increase in beta-endorphin serum levels are followed by a reduction in pain symptoms , which is closely related to an improvement in disability , depression and quality of life . It seems that the synergic association between a pharmacological treatment ( trazodone ) and mud packs acts by helping the physiological responses to achieve homeostasis and to rebalance the stress response system . To clarify and optimize the effectiveness of this synergic association , studies involving a larger number of FM patients and a different pharmacological treatment are needed | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 562 | 14,508,601 | Investigation of the effects of pool-based exercise on fibromyalgia syndrome | Objective The aim of this study was to compare pool-based exercise and balneotherapy in fibromyalgia syndrome ( FMS ) patients . Methods Fifty female patients diagnosed with FMS according to the American College of Rheumatism ( ACR ) criteria were r and omly assigned to two groups : group 1 ( n=25 ) with pool-based exercise , and in group 2 ( n=25 ) balneotherapy was applied in the same pool without any exercise for 35 min three times a week for 12 weeks . In both groups , pre- ( week 0 ) and post-treatment ( weeks 12 and 24 ) evaluation was performed by one of the authors , who was blind to the patient group . Evaluation parameters included pain , morning stiffness , sleep , tender points , global evaluation by the patient and the physician , fibromyalgia impact question naire , chair test , and Beck depression inventory . Statistical analysis was done on data collected from three evaluation stages . Results Twenty-four exercise and 22 balneotherapy patients completed the study . Pretreatment ( week 0 ) measurements did not show any difference between the groups . In group 1 , statistically significant improvement was observed in all parameters ( P<0.01 ) except for the chair test at both weeks 12 and 24 . In group 2 , week 12 measurements showed significant improvement in all parameters ( P<0.01 ) except for the chair test and Beck depression inventory . Week 24 evaluation results in group 2 showed significant improvements in pain and fatigue according to visual analogue scale ( VAS ) , 5-point scale , number of tender points , algometric and myalgic scores , and patient and physician global evaluation ( P<0.01 and P<0.05 , respectively ) , while improvements were nonsignificant in morning stiffness , sleep , fibromyalgia impact question naire ( FIQ ) , chair test , and Beck depression inventory parameters in this group . Comparison of the two groups based on the post-treatment ( weeks 12 and 24 ) percent changes and difference scores relative to pretreatment ( week 0 ) values failed to show a significant difference between the groups for any parameter except Beck depression inventory ( P<0.01 ) . Conclusion The results of our study showed that pool-based exercise had a longer-lasting effect on some of the FMS symptoms , but statistical analysis failed to show a significant superiority of pool-based exercise over balneotherapy without exercise . While we believe that exercise is a gold st and ard in FMS treatment , we also suggest in light of our results that balneotherapy is among the valid treatment options in FMS , and further research regarding the type and duration of the exercise programs is necessary | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 563 | 20,074,436 | Phytothermotherapy: a possible complementary therapy for fibromyalgia patients. | OBJECTIVE It is a traditional practice in the Alpine region of Trentino and Alto Adige ( Italy ) to use phytothermotherapeutic treatment with fermenting grass ( " hay baths " ) for rheumatic diseases . However , despite its long history and popularity , a clinical validation of the efficacy and tolerability of the treatment has yet to be found in current literature . Fibromyalgia syndrome ( FMS ) is characterised by generalised musculoskeletal pain , high tender point counts , sleep disturbance , fatigue , headaches , irritable bowel syndrome , frequent psychological distress and depressed mood . There is no st and ard therapy regime for FMS and the variety of medical treatments used have given limited benefits . The aim of this study was to assess the efficacy and tolerability of a cycle of phytothermotherapy through a single-blind , controlled , r and omised trial , in patients with primary FMS . METHODS Fifty-six patients with primary FMS according to the ACR criteria were r and omly allocated to two groups : 30 were su bmi tted to phytothermotherapy at the thermal resort of Garniga Terme ( Trento , Italy ) and the other 26 were considered as controls . All patients were evaluated by FIQ , Tender Points Count , HAQ and AIMS 1 at baseline , after 10 days , then after 12 and 24 weeks . RESULTS Patients su bmi tted to phytothermotherapy showed visible and significant improvement of all evaluation parameters at the end of the treatment , which persisted during the follow-up period . No significant difference was found in the control group . Regarding the tolerability , none of the patients presented side effects . CONCLUSIONS Our results suggest the efficacy and the tolerability of phytothermotherapy in patients with primary FMS | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 564 | 17,520,260 | Effects of mud-bath treatment on fibromyalgia patients: a randomized clinical trial | The efficacy of balneotherapy in fibromyalgia syndrome ( FS ) has been well demonstrated , while controlled studies using mud packs are lacking . We performed a r and omized clinical trial to evaluate the effects and the tolerability of mud-bath treatment in FS patients , who are poor responders to pharmacological therapy . Eighty patients with primary FS , according to ACR criteria , were r and omly allocated to two groups : 40 were su bmi tted to a cycle of 12 mud packs and thermal baths , and 40 were considered as controls . At baseline , after thermal treatment and after 16 weeks , patients were evaluated by FIQ , tender points count , VAS for “ minor ” symptoms , AIMS 1 and HAQ . Control patients were assessed at the same time periods . A significant improvement of all evaluation parameters after mud-bath therapy and after 16 weeks was observed . Mud packs were well tolerated and no drop-outs were recorded . Our results suggest the efficacy and the tolerability of mud-bath treatment in primary FS | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 565 | 7,526,868 | Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. | OBJECTIVE To measure , and seek clinical correlates with , levels of substance P ( SP ) in the cerebrospinal fluid ( CSF ) of fibromyalgia syndrome ( FMS ) patients . METHODS CSF from 32 FMS patients and 30 normal control subjects was tested for SP by radioimmunoassay . Clinical measures included tender point examination and st and ardized question naires . RESULTS CSF SP levels were 3-fold higher in FMS patients than in normal controls ( P < 0.001 ) , but they correlated only weakly with tenderness found on examination . CONCLUSION SP is significantly elevated in FMS CSF , but other abnormalities must exist in FMS to more fully explain the symptoms | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 566 | 11,093,454 | Responsiveness of fibromyalgia clinical trial outcome measures. | OBJECTIVE To assess the responsiveness of the Fibromyalgia Impact Question naire ( FIQ ) , patient ratings of pain intensity , number of tender points , and total tender point pain intensity score to perceived changes in clinical status in patients with fibromyalgia ( FM ) . METHODS Using data from a r and omized placebo controlled study evaluating efficacy of magnetic therapy in patients with FM , the ability of primary outcomes to detect clinical ly meaningful changes over a 6 month period was assessed by : ( 1 ) degree of association between outcome change scores and patient global ratings of symptom change ( Spearman rank-order correlations ) ; ( 2 ) ability of these scores to discriminate among groups of patients whose perceived health status had changed to varying degrees ( ANOVA ) ; ( 3 ) ability of these scores , individually and jointly , to discriminate between patients who had reported improvement and those who did not ( logistic regression ) ; ( 4 ) effect size , st and ardized response mean , and Guyatt 's statistic were calculated to quantify responsiveness . RESULTS Correlations showed the outcome measures were moderately responsive to perceived symptomatic change . For FIQ , pain intensity ratings and number of tender points , differences in change scores between globally improved and unchanged groups and between globally improved and worsened groups were significant ; for total tender point pain intensity , the globally improved differed from worsened group . FIQ outperformed the other measures in discriminating between patients who reported improvement from those who did not . Summary statistics were consistent with discriminatory analyses , indicating the measures were sensitive to improvement , but relatively unresponsive to decline . CONCLUSION The FIQ was the most responsive measure to perceived clinical improvement and we recommend its inclusion as a primary endpoint in FM clinical trials | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 567 | 15,965,635 | SPA therapy in fibromyalgia: a randomised controlled clinic study | Objective : The aim of the present study is to evaluate the effectiveness of spa therapy in the management of fibromyalgia . Methods : Thirty women with fibromyalgia were r and omly assigned to either a spa therapy group or a control group . The spa therapy group ( n = 16 ) had spa treatment for 2 weeks in addition to their medical treatment . The control group ( n = 14 ) continued to have their medical treatment and /or daily exercises . An investigator who was blinded for the intervention assessed all the patients for 9 months . Improvements in Fibromyalgia Impact Question naire ( FIQ ) , pain and number of tender points were primary outcomes . Secondary outcome measures were improvement in sleep disturbance , fatigue , gastrointestinal symptoms , anxiety , Beck Depression Inventory and patient ’s global evaluation . Results : the spa group was found to be superior to the control group at the end of intervention in terms of FIQ , pain , tender point count , fatigue and patients ’ global assessment . This superiority remained for 6 months in FIQ , 1 month in pain and tender point count . Conclusion : It was concluded that the addition of spa therapy to medical therapy has both short- and long-term beneficial effects in female patients with fibromyalgia | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 568 | 9,526,176 | Cytokine levels in osteoarthrosis patients undergoing mud bath therapy. | Osteoarthritis is an important rheumatic condition characterized by the progressive destruction of cartilage . The pathophysiologic phenomena leading to the pathologic changes in the joint appear to result from biomechanical factors and activation of final common pathways of tissue damage influencing chondrocyte homeostasis and a functional program . Several cytokines and growth factors are reported to be responsible for inflammation and cartilage degradation . Among these , IL-1 and TNF alpha have been suggested as important in promoting cartilage inflammation and tissue destruction , while IGF I has a protective influence on cartilage structure . Chondrocytes and their metabolism have gained interest as targets of drug intervention ; the results of this study confirm that mud bath therapy is also able to influence chondrocyte activities . Our data suggest that mud bath therapy influences cytokines related to osteoarthrosis pathomechanism and maintenance , and encourage further investigations to evaluate possible synergism between pharmacological treatment and mud bath therapy | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
30 | 23,771,266 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . | 569 | 12,070,676 | The effects of balneotherapy on fibromyalgia patients | Abstract . Fibromyalgia syndrome ( FMS ) is a very common rheumatological diagnosis . There are various treatment modalities . This study was planned to investigate the effects of balneotherapy in the treatment of FMS . A total of 42 primary fibromyalgia patients diagnosed according to American College of Rheumatology criteria were included in the study . Their ages ranged between 30 and 55 years . Patients were r and omly assigned to two groups . None of them had had a cardiovascular disease before . Group 1 ( n=22 ) received 20-min bathing , once a day and five times per week . Patients participated in the study for 3 weeks ( total of 15 sessions ) . Group 2 ( n=20 ) was accepted as the control group . Patients were evaluated by the number of tender points , Visual Analogue Scale for pain , Beck 's Depression Index for depression , and Fibromyalgia Impact Question naire for functional capacity . Measurements were assessed initially , after the therapy , and at the end of the 6th month . In group 1 , there were statistically significant differences in numbers of tender points , Visual Analogue scores , Beck 's Depression Index , and Fibromyalgia Impact Question naire scores after the therapy program ( P<0.001 ) . Also , 6 months later in group 1 , there was still an improvement in the number of tender points ( P<0.001 ) , Visual Analogue scores , and Fibromyalgia Impact Question naire ( P<0.005 ) . But there was not a statistical difference in Beck 's Depression Index scores compared to the control group ( P>0.05 ) . Patients with FMS mostly complain about pain , anxiety , and the difficulty in daily living activities . This study shows that balneotherapy is effective and may be an alternative method in treating fibromyalgia patients | 30 | CONCLUSION Study data confirms that spa therapy could improve the symptoms of fibromyalgia including pain , depression and minor symptoms | BACKGROUND Fibromyalgia is characterized by chronic widespread pain , tenderness at muscle and tendon insertions point when digital pressure is applied , sleep disorders , chronic fatigue , depressive episodes , anxiety , and other functional somatic syndromes .
OBJECTIVE The aim of this study was to determine whether balneotherapy with mineral waters and mineral-water containing mud is effective in the management of fibromyalgia . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 570 | 3,079,434 | Longitudinal analysis of large social networks: Estimating the effect of health traits on changes in friendship ties | We develop novel mixed effects models to examine the role of health traits on the status of peoples ' close friendship nominations in the Framingham Heart Study . The health traits considered are both mutable ( body mass index ( BMI ) , smoking , blood pressure , body proportion , muscularity , and depression ) and , for comparison , basically immutable ( height , birth order , personality type , only child , and h and edness ) ; and the traits have varying degrees of observability . We test the hypotheses that existing ties ( i.e. close friendship nominations ) are more likely to dissolve between people with dissimilar ( mutable and observable ) health traits whereas new ties are more likely to form between those with similar ( mutable and observable ) traits while controlling for persons ' age , gender , geographic separation , and education . The mixed effects models contain r and om effects for both the nominator ( ego ) and nominated ( alter ) persons in a tie to account for the fact that people were involved in multiple relationships and contributed observations at multiple exams . Results for BMI support the hypotheses that people of similar BMI are less likely to dissolve existing ties and more likely to form ties , while smoker to non-smoker ties were the least likely to dissolve and smoker to smoker ties were the most likely to form . We also vali date d previously known findings regarding homophily on age and gender , and found evidence that homophily also depends upon geographic separation . Copyright © 2011 John Wiley & Sons , | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 571 | 22,084,103 | Dynamic social networks promote cooperation in experiments with humans | Human population s are both highly cooperative and highly organized . Human interactions are not r and om but rather are structured in social networks . Importantly , ties in these networks often are dynamic , changing in response to the behavior of one 's social partners . This dynamic structure permits an important form of conditional action that has been explored theoretically but has received little empirical attention : People can respond to the cooperation and defection of those around them by making or breaking network links . Here , we present experimental evidence of the power of using strategic link formation and dissolution , and the network modification it entails , to stabilize cooperation in sizable groups . Our experiments explore large-scale cooperation , where subjects ’ cooperative actions are equally beneficial to all those with whom they interact . Consistent with previous research , we find that cooperation decays over time when social networks are shuffled r and omly every round or are fixed across all rounds . We also find that , when networks are dynamic but are up date d only infrequently , cooperation again fails . However , when subjects can up date their network connections frequently , we see a qualitatively different outcome : Cooperation is maintained at a high level through network rewiring . Subjects preferentially break links with defectors and form new links with cooperators , creating an incentive to cooperate and leading to substantial changes in network structure . Our experiments confirm the predictions of a set of evolutionary game theoretic models and demonstrate the important role that dynamic social networks can play in supporting large-scale human cooperation | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 572 | 20,212,120 | Cooperative behavior cascades in human social networks | Theoretical models suggest that social networks influence the evolution of cooperation , but to date there have been few experimental studies . Observational data suggest that a wide variety of behaviors may spread in human social networks , but subjects in such studies can choose to befriend people with similar behaviors , posing difficulty for causal inference . Here , we exploit a seminal set of laboratory experiments that originally showed that voluntary costly punishment can help sustain cooperation . In these experiments , subjects were r and omly assigned to a sequence of different groups to play a series of single-shot public goods games with strangers ; this feature allowed us to draw networks of interactions to explore how cooperative and uncooperative behaviors spread from person to person to person . We show that , in both an ordinary public goods game and in a public goods game with punishment , focal individuals are influenced by fellow group members ’ contribution behavior in future interactions with other individuals who were not a party to the initial interaction . Furthermore , this influence persists for multiple periods and spreads up to three degrees of separation ( from person to person to person to person ) . The results suggest that each additional contribution a subject makes to the public good in the first period is tripled over the course of the experiment by other subjects who are directly or indirectly influenced to contribute more as a consequence . These results show experimentally that cooperative behavior cascades in human social networks | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 573 | 21,218,145 | Food-Sharing Networks in Lamalera, Indonesia | Exponential r and om graph modeling ( ERGM ) is used here to test hypotheses derived from human behavioral ecology about the adaptive nature of human food sharing . Respondents in all ( n = 317 ) households in the fishing and sea-hunting village of Lamalera , Indonesia , were asked to name those households to whom they had more frequently given ( and from whom they had more frequently received ) food during the preceding sea-hunting season . The responses were used to construct a social network of between-household food-sharing relationships in the village . The results show that kinship , proximity , and reciprocal sharing all strongly increase the probability of giving food to a household . The effects of kinship and distance are relatively independent of each other , although reciprocity is more common among residentially and genealogically close households . The results show support for reciprocal altruism as a motivation for food sharing , while kinship and distance appear to be important partner-choice criteria | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 574 | 18,678,885 | Emergence and Robustness of a Community Discussion Network on Mercury Contamination and Health in the Brazilian Amazon | Information exchanges , debates , and negotiations through community social networks are essential to ensure the sustainability of the development process initiated in participatory research . The authors analyze the structural properties and robustness of a discussion network about mercury issues in a community in the Brazilian Amazon involved in a participatory research aim ed at reducing exposure to the pollutant . Most of the villagers are connected in a large network and are separated from other individuals by few intermediaries . The structure of the discussion network displays resilience to the r and om elimination of villagers but shows vulnerability to the removal of one villager who has been a long-term collaborator of the project . Although the network exhibits a structure likely to favor an efficient flow of information , results show that specific actions should be taken to stimulate the emergence of a pool of opinion leaders and increase the redundancy of discussion channels | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 575 | 18,336,645 | Social networks and infant feeding in Oaxaca, Mexico. | The health benefits of delaying the introduction of complementary foods to infants ' diets are widely known . Many studies have shown that mothers with the support of close social network members are more compliant with medical recommendations for infant feeding . In our study , we examine the effects of a broader spectrum of network members ( 40 people ) on mothers ' infant feeding decisions . The survey was conducted in Oaxaca , Mexico as part of a follow-up to a nationwide Mexican Social Security Institute survey of infant health . Sixty mothers were interviewed from a stratified r and om sample of the original respondents . Multivariate tests were used to compare the efficacy of network-level variables for predicting the introduction of 36 foods into infants ' diets , when compared with respondent-level variables . The study yields four findings . First , network-level variables were better predictors of the timing of food introduction than socio-demographic variables . Second , mothers with more indigenous networks delayed the introduction of some grains ( oatmeal , cereal , noodle soup , rice ) and processed pork products ( sausage and ham ) to the infant 's diet longer than mothers with less indigenous networks . Third , mothers who had stronger ties to their networks delayed the introduction of rice and processed pork products ( sausage and ham ) to the infant 's diet longer than mothers who had weaker ties to their networks . Fourth , mothers who heeded the advice of distant network members introduced some grains ( rice and cereal ) earlier than mothers who did not heed the advice of distant network members | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 576 | 22,822,299 | Food-Sharing Networks in Lamalera, Indonesia: Status, Sharing, and Signaling. | Costly signaling has been proposed as a possible mechanism to explain food sharing in foraging population s. This sharing-as-signaling hypothesis predicts an association between sharing and status . Using exponential r and om graph modeling ( ERGM ) , this prediction is tested on a social network of between-household food-sharing relationships in the fishing and sea-hunting village of Lamalera , Indonesia . Previous analyses ( Nolin 2010 ) have shown that most sharing in Lamalera is consistent with reciprocal altruism . The question addressed here is whether any additional variation may be explained as sharing-as-signaling by high-status households . The results show that high-status households both give and receive more than other households , a pattern more consistent with reciprocal altruism than costly signaling . However , once the propensity to reciprocate and household productivity are controlled , households of men holding leadership positions show greater odds of unreciprocated giving when compared to households of non-leaders . This pattern of excessive giving by leaders is consistent with the sharing-as-signaling hypothesis . Wealthy households show the opposite pattern , giving less and receiving more than other households . These households may reciprocate in a currency other than food or their wealth may attract favor-seeking behavior from others . Overall , status covariates explain little variation in the sharing network as a whole , and much of the sharing observed by high-status households is best explained by the same factors that explain sharing by other households . This pattern suggests that multiple mechanisms may operate simultaneously to promote sharing in Lamalera and that signaling may motivate some sharing by some individuals even within sharing regimes primarily maintained by other mechanisms | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 577 | 18,379,421 | Raising the Level of Analysis of Food-Borne Outbreaks: Food-Sharing Networks in Rural Coastal Ecuador | Objectives : Consuming contaminated food is a well-documented individual-level risk factor for diarrheal disease . The sharing of food also influences the distribution of diarrheal disease risk through a community and region . Underst and ing this social process at a population level is therefore an important dimension of risk not captured by st and ard individual-level analyses . We examined social networks related to food-sharing in rural villages at 2 scales : within a village , examining whether connections within these networks clustered or were uniformly spread ; and among villages , looking at whether food-sharing networks differed according to the village 's remoteness from a population center . Methods : We surveyed 2129 individuals aged 13 years and older in 2003–2004 , within a representative ( block-r and omized ) sample of 21 rural villages in Esmeraldas province , northern coastal Ecuador . We calculated degree ( number of social contacts ) for a social network defined by sharing food . Results : Networks of households sharing food differ according to remoteness from a metropolitan center . On average , residents living in “ far villages ” had 2 more social contacts than those in “ close villages , ” and 12 more years of residence in their village . Estimates of transmissibility ( a measure of outbreak potential ) based on network structure varied as much as 2-fold across these villages . Conclusions : Food-sharing practice s link particular households in rural villages and have implication s for the spread of food-borne pathogens . The food-sharing networks in remote rural villages are heterogeneous and clustered , consistent with contemporary theories about disease transmitters . Network-based measures may offer tools for predicting patterns of disease outbreaks , as well as guidance for interventions | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
31 | 25,442,969 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . | 578 | 22,972,300 | A 61-million-person experiment in social influence and political mobilization | Human behaviour is thought to spread through face-to-face social networks , but it is difficult to identify social influence effects in observational studies , and it is unknown whether online social networks operate in the same way–. Here we report results from a r and omized controlled trial of political mobilization messages delivered to 61 million Facebook users during the 2010 US congressional elections . The results show that the messages directly influenced political self-expression , information seeking and real-world voting behaviour of millions of people . Furthermore , the messages not only influenced the users who received them but also the users ’ friends , and friends of friends . The effect of social transmission on real-world voting was greater than the direct effect of the messages themselves , and nearly all the transmission occurred between ‘ close friends ’ who were more likely to have a face-to-face relationship . These results suggest that strong ties are instrumental for spreading both online and real-world behaviour in human social networks | 31 | Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure . | In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 579 | 17,260,200 | Postoperative clodronate decreases prosthetic migration: 4–year follow-up of a randomized radiostereometric study of 50 total knee patients | Background We have previously reported that 6 months of oral treatment with clodronate reduced the migration of the NexGen total knee prosthesis during the first postoperative year , as measured by radiostereometry ( RSA ) . We now report the 4-year results . Methods This was a double-blind r and omized study , using RSA with maximal total point motion ( MTPM ) . Results With analysis according to the “ intention to treat ” principle , the only remaining difference between the groups at 4 years was reduced rotation around the transverse axis ( a secondary variable ) in the clodronate group . However , 3 patients ( all clodronate ) did not take any tablet after surgery . If they are excluded , there was an almost statistically significant difference between the groups at 4 years regarding MTPM from baseline , with the clodronate group showing 25 % less migration . From 1 to 4 years , there was no difference in migration rate by MTPM , but there was a continuous increase in rotation around the transverse axis in the controls , which differed from the clodronate group . There were no cases of aseptic loosening . 2 patients had migration of more than 1.3 mm from baseline to 4 years ; neither of them had taken clodronate . The others had migration of less than 0.9 mm . Interpretation Because migration was clearly reduced by clodronate during the first postoperative year , and there was still a difference at 4 years when analyzed per protocol , it appears likely that this treatment can diminish the risk of loosening . The difference in the number of outliers also points in this direction , and may be more relevant than mean migration values | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 580 | 24,088,976 | Fixation of high-flexion total knee prostheses: five-year follow-up results of a four-arm randomized controlled clinical and roentgen stereophotogrammetric analysis study. | BACKGROUND High-flexion total knee arthroplasty was introduced to meet the dem and s of daily activity requiring increased knee flexion . However , concerns have been raised regarding the fixation of high-flexion total knee arthroplasty components and increased rates of loosening have been reported . To date , migration , and thus fixation , of high-flexion total knee arthroplasty components has not been analyzed and the preferential bearing type ( mobile or fixed ) is unknown . METHODS Of eighty-six consecutive eligible patients , seventy-four patients ( seventy-eight knees ) scheduled for total knee arthroplasty were r and omized to one of four Legacy Posterior Stabilized ( LPS ) total knee prosthesis design s : ( 1 ) LPS-Flex mobile , ( 2 ) LPS-Flex fixed , ( 3 ) LPS mobile , and ( 4 ) LPS fixed . The primary outcome was component migration measured with use of Roentgen stereophotogrammetric analysis , and secondary outcomes were postoperative knee flexion and extension and Knee Society Score . Patients were evaluated postoperatively at six , twelve , twenty-six , and fifty-two weeks and annually thereafter . At the five-year follow-up , eight patients had died and two patients were lost to follow-up . Seventy-seven tibial and forty-two femoral components were suitable for migration measurements . RESULTS The overall five-year migration of the seventy-seven tibial components was not significantly different among the four total knee prosthesis design s ( compared with the LPS fixed design , the range of overall mean differences for the other three design s was 0.02 to 0.25 mm ) and migration was comparable at the two and five-year follow-up . Migration stabilized in all but three components ( two LPS-Flex mobile and one LPS fixed ) ; one of these components has already been revised and was aseptically loose . The overall five-year migration of the forty-two femoral components was comparable among the four design s ( compared with the LPS fixed design , the range of overall mean differences for the other three design s was 0.01 to 0.18 mm ) and was similar at two and five years postoperatively . One femoral component ( LPS-Flex mobile ) migrated excessively . In patients who had a mean postoperative flexion of ≥ 125 ° or a maximum flexion of ≥ 135 ° during the one to five-year follow-up period , migration of high-flexion components was comparable with that of conventional components and indicative of appropriate fixation . Postoperative flexion , extension , Knee Society Score , and Knee Society Score function were comparable during the five-year follow-up period and at the two and five-year follow-up . CONCLUSIONS The LPS-Flex total knee prosthesis with either a mobile or a fixed bearing had migration comparable that of with its conventional counterpart and is expected to have similar ( excellent ) long-term survival in these patients . LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 581 | 10,660,713 | Hydroxyapatite-Enhanced Tibial Prosthetic Fixation | Sixty-two knees ( 60 patients ) were r and omized to four noncemented groups . In Groups 1 , 3 , and 4 , the bone cuts were made with a cooled saw blade . In Group 1 , 15 patients were operated on with the porous coated Osteonic 7000 tibial component . In Group 2 , 15 patients were operated on with the same tibial component as in Group 1 but with the use of a st and ard saw blade . In Group 3 , 16 patients were operated on with the hydroxyapatite-coated Osteonic tibial component , and in Group 4 , 16 patients were operated on with the hydroxyapatite Duracon tibial component . All patients were followed up clinical ly and with roentgenstereometric analysis . There were no differences among the groups regarding clinical outcome . One knee was revised ( Group 2 ) after 1 year because of loosening of the tibial component . The maximum migration at 1 year was 1.7 mm in Group 1 , 1.9 mm in Group 2 , 1.3 mm in Group 3 , and 1 mm in Group 4 . At the 2-year followup , the migrations were 1.8 mm , 1.5 mm , 1.4 mm , and 1 mm in Groups 1 , 2 , 3 , and 4 , respectively . The inducible displacement that occurred at 1 year was 0.6 mm in Group 1 , 0.5 mm in Group 2 , 0.4 mm in Group 3 , and 0.4 mm in Group 4 . The hydroxyapatite coating had a strong positive effect on the tibial component fixation . No prosthesis in the hydroxyapatite groups showed continuous migration | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 582 | 24,974,301 | Similar early migration when comparing CR and PS in Triathlon™ TKA: A prospective randomised RSA trial. | OBJECTIVES The objective of this study was to compare the early migration of the cruciate retaining and posterior stabilising versions of the recently introduced Triathlon ™ total knee system , with a view to predicting long term fixation performance . METHODS Sixty patients were prospect ively r and omised to receive either Triathlon ™ posterior stabilised cemented knee prosthesis or Triathlon ™ cruciate retaining cemented knee prosthesis . Tibial component migration was measured by radiostereometric analysis postoperatively and at three months , one year and two years . Clinical outcome was measured by the American Knee Society Score and Knee Osteoarthritis and Injury Outcome Score . RESULTS There were no differences in rotation around the three coordinal axes or in the maximum total point motion ( MTPM ) during the two year follow-up . The posterior stabilised prosthesis had more posterior-anterior translation at three months and one year and more caudal-cranial translation at one year and two years . There were no differences in functional outcome between the groups . CONCLUSION The tibial tray of the Triathlon ™ cemented knee prosthesis showed similar early stability . LEVEL OF EVIDENCE Level I. ARTICLE SUMMARY Article focus : This was a prospect i ve r and omised trial aim ing to compare the single radius posterior stabilised ( PS ) Triathlon ™ total knee arthroplasty ( TKA ) to the cruciate retaining Triathlon ™ TKA system with regard to fixation . Strengths and limitations of this study : Strength of this study was that it is a r and omised prospect i ve trial using an objective measuring tool . The sample size of 25 - 30 patients was reportedly sufficient for the screening of implants using RSA [ 1 ] . TRIAL REGISTRATION Clinical Trials.gov Identifier : NCT00436982 | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 583 | 15,338,069 | The effect of Palamed® G bone cement on early migration of tibial components in total knee arthroplasty | Abstract Objective : Migration of the tibial component in total knee arthroplasty ( TKA ) is subject of many studies using roentgen stereophotogrammetric analysis ( RSA ) . In previous studies of cemented and uncemented tibial components , high migration values were found . Improvements in cementing technique , prosthetic design and pre-coating techniques reduced these values as shown in more recent studies . Material and subjects : A total of 35 patients were initially included in the study and operated on between 12/1999 and 10/2000 . All patients received a NexGen ® TKA cemented into the proximal tibia using Palamed ® G bone cement . The implants and the tibial metaphysis were marked with st and ard tantalum markers . Radiostereometric analysis was performed post-operatively and after 3 , 6 and 12 months using a st and ard digital radiostereometric analysis . Functional parameters were assessed using the Knee Society Score ( KSS ) clinical rating system . Results : There were no complications and failures within the first year . After 1 year radiostereometric measurements of the translational parameters along and the rotational parameters around the x- , y- and z-axis revealed : X-Trans –0.19 mm , Y-Trans + 0.02 mm , Z-Trans + 0.08 mm , X-Rot + 0.26 ° , Y-Rot –0.35 ° , Z-Rot + 0.09 ° . The maximum total point motion was + 0.96 mm and the mean maximum subsidence was –0.23 mm . Except for anterior-posterior , medio-lateral stability and extension leg all endpoints of the KSS clinical rating system showed a significant improvement . Conclusions : After 12 months , the use of Palamed ® G bone cement in total knee arthroplasty was demonstrated to be safe . Both the clinical and radiostereometric results were good and comparable to the results reported in other RSA studies in cemented total knee arthroplasty | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 584 | 23,015,562 | Differences in long-term fixation between mobile-bearing and fixed-bearing knee prostheses at ten to 12 years' follow-up: a single-blinded randomised controlled radiostereometric trial. | This single-blinded r and omised controlled trial investigated whether one design of mobile-bearing ( MB ) total knee replacement ( TKR ) has any advantage over a fixed-bearing ( FB ) design on long-term fixation as measured by radiostereometry . The amount of wear underneath the mobile bearing was also evaluated . A series of 42 knees was r and omised to MB or FB tibial components with appropriate polyethylene inserts and followed for between ten and 12 years , or until the death of the patient . The polyethylene in the MB group was superior in that it was gamma-irradiated in inert gas and was calcium-stearate free ; the polyethylene in the FB group was gamma-irradiated in air and contained calcium stearate . In theory this should be advantageous to the wear rate of the MB group . At final follow-up the overall mean migration was 0.75 mm ( SD 0.76 ) in the MB group and 0.66 mm ( SD 0.4 ) in the FB group , with the FB group demonstrating more posterior tilt and the MB group more internal rotation . In the FB group there was one revision for aseptic loosening , but none in the MB group . There were no significant differences in clinical or radiological scores . For the MB group , the mean linear wear rate on the under-surface was 0.026 mm/year ( SD 0.014 ) . This was significantly smaller than the wear rate of 0.11 mm/year ( SD 0.06 ) in the MB between femur and polyethylene ( p < 0.001 ) . Nevertheless , even in a best-case setting the mobile bearings of this TKR design had no apparent advantage in terms of fixation over the FB knee prosthesis at ten to 12 years . The wear underneath the mobile bearing was small and is unlikely to be clinical ly relevant | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 585 | 16,156,464 | Cemented tibial component fixation performs better than cementless fixation | Background The question whether the tibial component of a total knee arthroplasty should be fixed to bone with or without bone cement has not yet been definitely answered . We studied movements between the tibial component and bone by radiostereometry ( RSA ) in total knee replacement ( TKR ) for 3 different types of fixation : cemented fixation ( C-F ) , uncemented porous fixation ( UC-F ) and uncemented porous hydroxyapatite fixation ( UCHA-F ) . Patients 116 patients with osteoarthrosis , who had 146 TKRs , were included in 2 r and omized series . The first series included 86 unilateral TKRs stratified into 1 of the 3 types of fixation . The second series included 30 patients who had simultaneous bilateral TKR surgery , and who were stratified into 3 subgroups of pairwise comparisons of the 3 types of fixation . Results After 5 years 2 knees had been revised , neither of which were due to loosening . 1 UCHA-F knee in the unilateral series showed a large and continuous migration and a poor clinical result , and is a pending failure . The C-F knees rotated and migrated less than UC-F and UCHA-F knees over 5 years . UCHA-F migrated less than UC-F after 1 year . Interpretation Cementing of the tibial component offers more stable bone-implant contact for 5 years compared to uncemented fixation . When using uncemented components , however , there is evidence that augmenting a porous surface with hydroxyapatite may mean less motion between implant and bone after the initial postoperative year | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 586 | 2,823,240 | Celecoxib does not appear to affect prosthesis fixation in total knee replacement | Background and purpose After joint replacement , a repair process starts at the interface between bone and cement . If this process is disturbed , the prosthesis may never become rigidly fixed to the bone , leading to migration— and with time , loosening . Cox-2 inhibitors are widely used as postoperative analgesics , and have adverse effects on bone healing . This could tamper prosthesis fixation . We investigated whether celecoxib , a selective Cox-2 inhibitor , increases prosthesis migration in total knee replacement ( TKR ) . Methods 50 patients were r and omized to either placebo or celecoxib treatment , 200 mg twice daily , for 3 weeks after TKR ( NexGen ; Zimmer ) . Maximum total point motion ( MTPM ) of the tibial component was measured after 2 years using radiostereometric analysis ( RSA ) . In addition , range of motion , pain , and , subjective outcome were evaluated . Results No differences in prosthesis migration , pain scores , range of motion , and subjective outcome were found after 2 years . Confidence intervals were narrow . Interpretation It is unlikely that Celecoxib increases the risk of loosening , and it may be used safely in conjunction with TKR | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 587 | 3,339,526 | The beneficial effect of hydroxyapatite lasts | Background and purpose In contrast to early migration , the long-term migration of hydroxyapatite- ( HA- ) coated tibial components in TKA has been scantily reported . This r and omized controlled trial investigated the long-term migration measured by radiostereometric analysis ( RSA ) of HA-coated , uncoated , and cemented tibial components in TKA . Patients and methods 68 knees were r and omized to HA-coated ( n = 24 ) , uncoated ( n = 20 ) , and cemented ( n = 24 ) components . All knees were prospect ively followed for 11–16 years , or until death or revision . RSA was used to evaluate migration at yearly intervals . Clinical and radiographic evaluation was according to the Knee Society system . A generalized linear mixed model ( GLMM , adjusted for age , sex , diagnosis , revisions , and BMI ) was used to take into account the repeated-measurement design . Results The present study involved 742 RSA analyses . The mean migration at 10 years was 1.66 mm for HA , 2.25 mm for uncoated and 0.79 mm for the cemented group ( p < 0.001 ) . The reduction of migration by HA as compared to uncoated components was most pronounced for subsidence and external rotation . 3 tibial components were revised for aseptic loosening ( 2 uncoated and 1 cemented ) , 3 for septic loosening ( 2 uncoated and 1 cemented ) , and 1 for instability ( HA-coated ) . 2 of these cases were revised for secondary loosening after a period of stability : 1 case of osteolysis and 1 case of late infection . There were no statistically significant differences between the fixation groups regarding clinical or radiographic scores . Interpretation HA reduces migration of uncemented tibial components . This beneficial effect lasts for more than 10 years . Cemented components showed the lowest migration . Longitudinal follow-up of TKA with RSA allows early detection of secondary loosening | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 588 | 18,236,186 | Local peroperative treatment with a bisphosphonate improves the fixation of total knee prostheses: A randomized, double-blind radiostereometric study of 50 patients | Background Postoperative migration of a joint prosthesis is related to the risk of late loosening . We have previously reported that oral treatment with clodronate reduced migration of the cemented NexGen total knee prosthesis during the first postoperative year , as measured by radiostereometry ( RSA ) . Oral bisphosphonate treatment is sometimes unpleasant , and local treatment will enable higher local concentrations . We now report the results of local peroperative treatment with another bisphosphonate , ib and ronate , with the same prosthesis . Methods This is a double-blind , r and omized study of 50 patients using RSA with maximal total point motion ( MTPM ) as primary effect variable . 1 mg ib and ronate ( 1 mL ) or 1 mL saline was applied to the tibial bone surface 1 min before cementation . RSA examination was done on the first postoperative day , and at 6 , 12 , and 24 months . Results One ib and ronate-treated patient died of unrelated causes , and 1 control patient refused to come for follow-up , leaving 24 patients in each group for analysis . There were no cases of aseptic loosening . By repeated measures ANOVA , migration ( MTPM ) was reduced by local application of ib and ronate ( p = 0.006 ) . The effect was most pronounced at 6 months , with a reduction from 0.45 to 0.32 mm ( 95 % CI for reduction : 0.04–0.21 mm ) . At 12 months , the migration from the postoperative examination was reduced from 0.47 to 0.36 mm ( 95 % CI for reduction : 0.02–0.20 mm ) . At 24 months , the reduction was from 0.47 to 0.40 mm ( 95 % CI : -0.01–0.16 mm ) . Interpretation This is the first study to show improvement of prosthesis fixation by local pharmacological treatment in humans . The treatment appears to be safe , cheap , and easy to perform . However , the improvement in postoperative stability was not greater than with systemic clodronate treatment | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 589 | 9,855,228 | Inferior performance of Boneloc bone cement in total knee arthroplasty: a prospective randomized study comparing Boneloc with Palacos using radiostereometry (RSA) in 19 patients. | We compared Boneloc bone cement with conventional cement ( Palacos ) in fixating the tibial component during 2 - 5 years in 19 patients with gonarthrosis undergoing total knee arthroplasty in a prospect i ve r and omized study . Boneloc displayed significantly larger migration , subsidence and lift-off than Palacos . The difference was identifiable already within 3 months postoperatively , but became significant at 12 months . In the Boneloc group , all components showed subsidence of the posterior part and lift-off of the anterior part of the tibial component , whereas in the Palacos group , the locations of subsidence and lift-off were evenly distributed about the edge of the implant . At 5 years , both Boneloc knees so far investigated were clinical failures with high migration rates . We conclude that , even in total knee arthroplasty , there is a substantial risk that Boneloc leads to inferior clinical results , but later than in hip replacements | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 590 | 9,926,947 | Hydroxyapatite coating versus cemented fixation of the tibial component in total knee arthroplasty: prospective randomized comparison of hydroxyapatite-coated and cemented tibial components with 5-year follow-up using radiostereometry. | Fifty-three consecutive patients ( 57 knees ; mean age , 69 years ) entered a prospect i ve r and omized study to compare the fixation of hydroxyapatite (HA)-coated ( 29 knees ) with cemented ( 28 knees ) tibial components in the Tricon II total knee arthroplasty . The quality of the fixation during 5 years postoperatively was evaluated with radiostereometric analysis ( RSA ) . Three HA-coated implants were revised : 2 owing to infection , and 1 owing to early delamination of the coating and clinical loosening . Eight patients ( 9 knees ) died , 1 patient sustained a stroke , and 1 patient refused investigations after 1 year . In the 40 patients ( 19 HA-coated , 21 cemented ) remaining at 5 years , the magnitude of the micromotion between the HA-coated and cemented groups did not differ . The HA-coated implants displayed most of the migration within the initial 3 months then stabilized , whereas the cemented implants showed an initially lower , but over time continuously increasing migration . Between 1 and 2 years , 4 of 24 HA-coated and 10 of 23 cemented implants migrated > 0.2 mm and were categorized unstable , which has been shown to have a prognostic value as regards future aseptic loosening . Progressive radiolucent lines developed in 2 cemented knees , which both were categorized unstable . If HA-coated implants can sustain the forces that threaten the fixation in the early period after implantation , a strong and enduring fixation may be obtained | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 591 | 27,143,731 | Migration of a cemented fixed-bearing, polished titanium tibial baseplate (Genesis II) at ten years : a radiostereometric analysis. | AIMS The purpose of the present study was to examine the long-term fixation of a cemented fixed-bearing polished titanium tibial baseplate ( Genesis ll ) . PATIENTS AND METHODS Patients enrolled in a previous two-year prospect i ve trial ( n = 35 ) were recalled at ten years . Available patients ( n = 15 ) underwent radiostereometric analysis ( RSA ) imaging in a supine position using a conventional RSA protocol . Migration of the tibial component in all planes was compared between initial and ten-year follow-up . Outcome scores including the Knee Society Score , Western Ontario and McMaster Universities Arthritis Index , 12-item Short Form Health Survey , Forgotten Joint Score , and University of California , Los Angeles Activity Score were recorded . RESULTS At ten years , the mean migration of the tibial component was less than 0.1 mm and 0.1 ° in all planes relative to the post-operative RSA exam . Maximum total point movement increased with time ( p = 0.002 ) from 0.23 mm ( sd 0.18 ) at six weeks to 0.42 mm ( sd 0.20 ) at ten years . CONCLUSION The low level of tibial baseplate migration found in the present study correlates to the low rate of revision for this implant as reported in individual studies and in joint replacement registries . TAKE HOME MESSAGE Overall , the implant was found to be well fixed at ten years , supporting its continued clinical use and the predictive power of RSA for determining long-term fixation of implants . Cite this article : Bone Joint J 2016;98-B:616 - 21 | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 592 | 1,544,959 | Proximally cemented versus uncemented Freeman-Samuelson knee arthroplasty. A prospective randomised study. | We studied the effect of a layer of cement placed under the tibial component of Freeman-Samuelson total knee prostheses with a metal back and an 80 mm intramedullary stem , using roentgen stereophotogrammetry to measure the migration of the tibial component during one year in 13 uncemented and 16 cemented knees . The addition of cement produced a significant reduction in migration at one year , from a mean of 1.5 mm to one of 0.5 mm ( p less than 0.01 ) , including a significant reduction in pure subsidence . One year postoperatively the clinical results were similar between the groups , but , at three years , one uncemented knee had required revision | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 593 | 3,782,249 | Survival of knee arthroplasties. A nation-wide multicentre investigation of 8000 cases. | A prospect i ve nation-wide study of knee arthroplasty has been under way in Sweden since October 1975 . By the end of 1983 , 4505 arthroplasties for osteoarthritis and 3495 for rheumatoid arthritis had been recorded and review ed one , three and six years after the operation . Using actuarial methods , the probability of the prosthesis remaining in situ after six years was calculated . In osteoarthritis this probability ranged from 65 % for hinged prostheses to 90 % for medial compartment prostheses . Two- and three-compartment prostheses produced intermediate results with 87 % survival . In rheumatoid arthritis the probability varied from 72 % for medial compartment prostheses to 90 % for two- and three-compartment prostheses . The main reason for failure was loosening of the components , the second most common was infection . The probability of revision for infection by six years was 2 % in osteoarthritis and 3 % in rheumatoid arthritis . Most revisions were to a three-compartment prosthesis . Knee fusion at primary revision was required in 2 % of the cases at six years | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 594 | 7,801,757 | Effect of a cooled saw blade on prosthesis fixation. Randomized radiostereometry of 33 knee cases. | Tibial migration in 33 cementless total knee replacements , which were performed with a cooled saw blade vs. a conventional blade , was studied in a r and omized prospect i ve study using roentgen stereophotogrammetric analysis ( radiostereometry ) . All cases were clinical ly successful after 2 years and inducible displacement was smaller in the group operated with the cooled saw blade . This group also had a tendency towards less continuous migration | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 595 | 9,469,313 | Early Inducible Displacement of Tibial Components in Total Knee Prostheses Inserted with and without Cement. A Randomized Study with Roentgen Stereophotogrammetric Analysis* | The fixation of tibial components r and omized to insertion with or without cement in twenty-six knees was examined for inducible displacement at six weeks and one year postoperatively with use of roentgen stereophotogrammetric analysis . Furthermore , migration was studied during the first two postoperative years . Inducible displacement was found in all knees at both the six-week and the one-year follow-up examination , but no differences were detected with respect to the type of fixation ( p > 0.05 ) . All tibial components migrated for as long as one year postoperatively , after which most stabilized . No difference was found between the groups with respect to migration during the first two years postoperatively ( p > 0.05 ) , with the exception of subsidence of the component , which was found to be 0.0 ± 0.1 millimeter ( mean and st and ard error of the mean ) for the components inserted with cement and 0.5 ± 0.1 millimeter for the components inserted without cement ( p < 0.01 ) . Migration after one year was the same for both groups . We found a relationship between inducible displacement at six weeks and at one year as well as one between inducible displacement and migration at one year . To our knowledge , the present study is the first in which the micromotion of an interference-fit prosthesis was found to be similar to that of a device inserted with cement . The results of the present study emphasize the importance of the initial prosthetic fixation | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 596 | 12,440,496 | Fixation of the tibial component using CMW-1 or Palacos bone cement with gentamicin: Similar outcome in a randomized radiostereometric study of 51 total knee arthroplasties | We studied CMW-1 bone cement with gentamicin in the laboratory and in a r and omized clinical study . Palacos bone cement containing gentamicin was used as the control . In the pre clinical evaluation , the CMW cement had slightly less mechanical strength . In the clinical study , 51 patients ( 51 knees ) operated on with total knee arthroplasty were studied for 2 years . We used radiostereometric analysis to measure migration of the tibial components , r and omized to fixation with either of the two types of cement . The extent and pattern of migration were similar in both groups , and we found no differences in the number , size and extent of radiolucent lines or clinical outcome . No complications occurred . Our findings suggest a need for more studies of CMW-1 bone cement containing gentamicin in a larger cohort of patients | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 597 | 16,826,105 | Mobile Bearings Do Not Improve Fixation in Cemented Total Knee Arthroplasty | Mobile bearings were introduced to improve wear and knee kinematics . By uncoupling the forces generated at the articulation from the implant-bone interface this would , theoretically , also improve the fixation of the implant to bone . We did this study to evaluate whether mobile bearings improve the fixation of the tibial component to bone . Fifty-two consecutive knees in 47 patients ( average age , 72 years ; range , 62 - 84 years ) with primary osteoarthrosis were r and omized into two groups to receive a cemented total knee arthroplasty with either a fixed-bearing or mobile-bearing tibial component . The quality of fixation was analyzed with radiostereometric analysis for up to 2 years . Mobile bearings did not improve fixation . Both magnitudes and directions of component rotations were similar , and the number of implants with continuous migration was almost identical . Both implant types had a combination of subsidence and lift-off , but where the mobile bearing implants displayed more of subsidence , the fixed bearing knees showed more lift-off . It might be that the somewhat stiffer cobalt-chromium baseplate or the different joint conformity used in the mobile-bearing knees counteracts any potential effects of the mobile bearing . Level of Evidence : Therapeutic Level I. See the Guidelines for Authors for a complete description of levels of evidence | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 598 | 8,245,999 | Increased varus-valgus tilting of screw-fixated knee prostheses. Stereoradiographic study of uncemented versus cemented tibial components. | Twenty-six women and three men ( 34 knees ) with osteoarthrosis were operated with the Miller-Galante I ( Zimmer , Warsaw , IN ) knee prosthesis . The patients were r and omized to either cemented or uncemented fixation of the tibial component . All patients received a TiVaAl alloy tibial plate with four pegs and titanium fiber-mesh undersurface . In the uncemented knees four screws were added . The fixation of the tibial component was determined by roentgen stereophotogrammetric analysis during the first 2 postoperative years . Rotations of the entire tibial component were recorded , as well as proximal or distal translation of various parts of the prosthetic edge corresponding to subsidence and lift-off . The uncemented components displayed almost all rotation and translation during the first 6 weeks , whereas the cemented ones displayed a more gradually increasing migration during the 2 years . Tibial component rotation about the sagittal axis was significantly increased in the uncemented knees throughout the investigation period . This corresponded to increased subsidence medially or laterally in the uncemented knees , whereas lift-off was equal in the two groups . Thin ( 8.5 mm ) uncemented tibial components displayed more subsidence than the thicker ones at the medial or lateral edge 3 months after surgery | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
32 | 29,508,661 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . | 599 | 24,238,650 | The effect of tourniquet use on fixation quality in cemented total knee arthroplasty a prospective randomized clinical controlled RSA trial. | BACKGROUND A concern that arises with any change in technique is whether it affects the long-term implant stability . The objective of this study was to evaluate the early migration , measured by radiostereometric analysis ( RSA ) , and the functional outcome of the Triathlon ™ cemented knee prosthesis , operated on with or without a tourniquet . During the last decades RSA has emerged as a way to assess prosthetic fixation and long time prognosis . The method has been used extensively in both hip and knee arthroplasty . METHOD This was a single centre prospect i ve study including 60 patients r and omized into two groups operated on either with or without tourniquet . RSA investigation was done within 2 - 3 days postoperatively after full weight bearing , and then at 3 months , 1 year and 2 years postoperatively . RESULTS There were no differences between the groups regarding the translation along or rotation around the three coordinal axes , or in maximum total point motion ( MTPM ) . At 2 years the mean MTPM ( SD ) was 0.71 mm ( 0.64 ) for the tourniquet-group and 0.53 mm ( 0.21 ) for the non-tourniquet-group . CONCLUSIONS The tibial tray of the Triathlon ™ cemented knee prosthesis showed similar early stability whether operated on with or without tourniquet . LEVEL OF EVIDENCE Level I. ARTICLE SUMMARY Article focus : A safety study for total knee replacement operated on with or without perioperative tourniquet regarding the prosthetic fixation . Strengths and limitations : Strength of this study is that it is a r and omized prospect i ve trial using an objective measuring tool . The sample size of 25 - 30 patients is reportedly sufficient for the screening of implants using RSA ( 1 - 3 ) . TRIAL REGISTRATION Clinical trials NCT01604382 , Ethics Committee approval D-nr : 144/20085 | 32 | Cemented and uncemented tibial components had different migration patterns .
For cemented tibial components there was no difference in migration between all-poly and metal-backed components , between mobile bearing and fixed bearing , between cruciate retaining and posterior stabilized .
Furthermore , no difference existed between TKR measured with model-based RSA or marker-based RSA methods .
For uncemented TKR there was some variation in migration with the highest migration for uncoated TKR .
Interpretation - The results from this meta- analysis on RSA migration of TKR are in line with both the survival analyses results from joint registries of these TKRs as well as revision rates results from meta-analyses , thus providing further proof for the association between early migration and late revision for loosening . | Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies . |
Subsets and Splits