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Degenerative Meniscus Tear in Older Athletes.

老年运动员退行性半月板撕裂。

  • 影响因子:1.82
  • DOI:10.1016/j.csm.2019.08.005
  • 作者列表:"Wolf BR","Gulbrandsen TR
  • 发表时间:2020-01-01
Abstract

:Older athletes consist of a relatively healthier population with a high desire for return to sport despite knee injury. A meniscal tear is a common injury that has lasting impacts on joint function and activity level. Lower extremity loading from sporting activity in conjunction with degenerative meniscal changes increases the risk of meniscal tear in older athletes. Optimal treatment of degenerative meniscal tears is often debated with varying studies reporting the benefits of strictly nonoperative treatment or the value of surgery. Postoperative rehabilitation is crucial to enhance the possibility of return to sport.

摘要

: 老年运动员由相对健康的人群组成,尽管膝盖受伤,但仍有很高的恢复运动的愿望。半月板撕裂是一种常见的损伤,对关节功能和活动水平有持久的影响。运动活动引起的下肢负荷与退行性半月板改变一起增加了老年运动员半月板撕裂的风险。退行性半月板撕裂的最佳治疗经常被争论,不同的研究报告了严格非手术治疗的益处或手术的价值。术后康复对增强恢复运动的可能性至关重要。

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DOI:10.1002/acr.23821
作者列表:["Beltai A","Barnetche T","Daien C","Lukas C","Gaujoux-Viala C","Combe B","Morel J"]

METHODS:OBJECTIVE:Patients with immune-mediated inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus are at increased risk of cardiovascular disease. However, the cardiovascular risk of patients with primary Sjögren's syndrome (SS) remains poorly studied. We aimed to investigate the association between primary SS and cardiovascular morbidity and mortality. METHODS:We performed a systematic review of articles in Medline and the Cochrane Library and recent abstracts from US and European meetings, searching for reports of randomized controlled studies of cardiovascular morbidity and cardiovascular mortality in primary SS. The relative risk (RR) values for cardiovascular morbidity and mortality associated with primary SS were collected and pooled in a meta-analysis with a random-effects model by using Review Manager (Cochrane collaboration). RESULTS:The literature search revealed 484 articles and abstracts of interest; 14 studies (67,124 patients with primary SS) were included in the meta-analysis. With primary SS versus control populations, the risk was significantly increased for coronary morbidity (RR 1.34 [95% confidence interval (95% CI) 1.06-1.38]; P = 0.01), cerebrovascular morbidity (RR 1.46 [95% CI 1.43-1.49]; P < 0.00001), heart failure rate (odds ratio 2.54 [95% CI 1.30-4.97]; P < 0.007), and thromboembolic morbidity (RR 1.78 [95% CI 1.41-2.25]; P < 0.00001), with no statistically significant increased risk of cardiovascular mortality (RR 1.48 [95% CI 0.77-2.85]; P = 0.24). CONCLUSION:This meta-analysis demonstrates that primary SS is associated with increased cardiovascular morbidity, which suggests that these patients should be screened for cardiovascular comorbidities and considered for preventive interventions, in a multidisciplinary approach with cardiologists.

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影响因子:4.13
发表时间:2020-01-01
DOI:10.1002/acr.23824
作者列表:["Chen SK","Liao KP","Liu J","Kim SC"]

METHODS:OBJECTIVE:We aimed to evaluate the comparative risk of hospitalized infection among patients with rheumatoid arthritis (RA) who initiated abatacept versus a tumor necrosis factor inhibitor (TNFi). METHODS:Using claims data from Truven MarketScan database (2006-2015), we identified patients with RA ages ≥18 years with ≥2 RA diagnoses who initiated treatment with abatacept or a TNFi. The primary outcome was a composite end point of any hospitalized infection. Secondary outcomes included bacterial infection, herpes zoster, and infections affecting different organ systems. We performed 1:1 propensity score (PS) matching between the groups in order to control for baseline confounders. We estimated incidence rates (IRs) and hazard ratios (HRs) with 95% confidence intervals (95% CIs) for hospitalized infection. RESULTS:We identified 11,248 PS-matched pairs of patients who initiated treatment with abatacept and TNFi with a median age of 56 years (83% were women). The IR per 1,000 person-years for any hospitalized infection was 37 among patients who initiated treatment with abatacept and 47 in those who initiated treatment with TNFi. The HR for the risk of any hospitalized infection associated with abatacept versus TNFi was 0.78 (95% CI 0.64-0.95) and remained lower when compared to infliximab (HR 0.63 [95% CI 0.47-0.85]), while no significant difference was seen when compared to adalimumab and etanercept. The risk of secondary outcomes was lower for abatacept for pulmonary infections, and similar to TNFi for the remaining outcomes. CONCLUSION:In this large cohort of patients with RA who initiated treatment with abatacept or TNFi as a first- or second-line biologic agent, we found a lower risk of hospitalized infection after initiating abatacept versus TNFi, which was driven mostly by infliximab.

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影响因子:4.13
发表时间:2020-01-01
DOI:10.1002/acr.23827
作者列表:["Lee RR","Rashid A","Thomson W","Cordingley L"]

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