Wolffbanke1506

OBJECTIVES The Bournemouth Questionnaire is a comprehensive and short form multidimensional instrument developed to evaluate the health status of individuals with low back pain. The objective of this study was to verify the construct validity and the test-retest reliability of the Brazilian version of Bournemouth Questionnaire in individuals with low back pain. METHODS This is a methodological study that included 65 patients with low back pain. The Brazilian Bournemouth Questionnaire was applied twice, and the test-retest reliability was assessed using intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MDC), and internal consistency. The construct validity of the Brazilian Bournemouth Questionnaire was assessed using the numeric pain rating scale (NPRS) and also with the following questionnaires Roland-Morris Questionnaire (RMDQ), Oswestry Disability Index (ODI), and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). RESULTS The total score of the Brazilian Bournemouth Questionnaire showed ICC of 0.82 (95% CI 0.72, 0.90), Cronbach´s alpha of 0.85, SEM of 5.97, and MDC of 15.54, without evidence of ceiling and floor effects. The total score of the Brazilian Bournemouth Questionnaire was correlated to the NPRS for current (r = 0.64), highest (r = 0.49), and lowest (r = 0.67) pain as well as scores on the RMDQ (r = 0.58), ODI (r = 0.42), and SF-36 (r = -0.58). CONCLUSION The total score of the Brazilian version of the Bournemouth Questionnaire is valid and reliable to be used with patients with low back pain. OBJECTIVE Considering the osteoarthritis (OA) model that integrates the biological, mechanical, and structural components of the disease, the present study aimed to investigate the association between urinary C-Telopeptide fragments of type II collagen (uCTX-II), knee joint moments, pain, and physical function in individuals with medial knee OA. METHODS Twenty-five subjects radiographically diagnosed with knee OA were recruited. Participants were evaluated through three-dimensional gait analysis, uCTX-II level, the WOMAC pain and physical function scores, and the 40m walk test. The association between these variables was investigated using Pearson's product-moment correlation, followed by a hierarchical linear regression, controlled by OA severity and body mass index (BMI). RESULTS No relationship was found between uCTX-II level and knee moments. A significant correlation between uCTX-II level and pain, physical function, and the 40m walk test was found. The hierarchical linear regression controlling for OA severity and BMI showed that uCTX-II level explained 9% of the WOMAC pain score, 27% of the WOMAC physical function score, and 7% of the 40m walk test. CONCLUSION Greater uCTX-II level is associated with higher pain and reduced physical function and 40m walk test performance in individuals with medial knee OA. BACKGROUND As the incidence of primary total joint arthroplasty rises in the United States, it is important to investigate how this will impact rates of revision arthroplasty. The purpose of this study was to analyze the incidence and future projections of revision total hip arthroplasty (rTHA) and revision total knee arthroplasty (rTKA) to 2030. click here Anticipating surgical volume will aid surgeons in designing protocols to efficiently and effectively perform rTHA/rTKA. METHODS The national inpatient sample was queried from 2002 to 2014 for all rTHA/rTKA. Using previously validated measures, Poisson and linear regression analyses were performed to project annual incidence of rTHA/rTKA to 2030, with subgroup analyses on modes of failure and age. RESULTS In 2014, there were 50,220 rTHAs and 72,100 rTKAs. From 2014 to 2030, rTHA incidence is projected to increase by between 43% and 70%, whereas rTKA incidence is projected to increase by between 78% and 182%. The 55-64 and 65-74 age groups increased in revision incidence during the study period, whereas 75-84 age group decreased in incidence. For rTKA, infection and aseptic loosening are the 2 most common modes of failure, whereas periprosthetic fracture and infection are most common for rTHA. CONCLUSION The incidence of rTHA/rTKA is projected to increase, particularly in young patients and for infection. Given the known risk factor profiles and advanced costs associated with revision arthroplasty, our projections should encourage institutions to generate revision-specific protocols to promote safe pathways for cost-effective care that is commensurate with current value-based health care trends. LEVEL OF EVIDENCE IV. The notion of immuno-metabolism refers to the crosstalk between key metabolic pathways and the development/maintenance of protective immunity in the context of physiological processes and anti-microbial defenses. Enthusiasm for immuno-metabolism in the context of HIV-1 infection, especially among T-cell lineages, continues to grow over time as science opens new therapeutic perspectives to limit viral pathogenesis and to boost anti-viral responses. The idea of "metabolism as a therapeutic target" is called metabolic reprogramming and is based on the use of specific metabolism-targeting drugs that are currently available for cancer therapy. In this review, we will focus on the evidence that shows the key role of mitochondria, the cell's powerhouses, and their ability to use diverse metabolic resources (referred to as metabolic plasticity) in providing optimal immune T-cell protection among HIV-1-infected patients. Conversely, we highlight observations indicating that mitochondria metabolic dysfunction associated with excessive glucose dependency, a phenomenon reported as "Warburg effect", results in the inability to mount and maintain effective T-cell-dependent immunity during persistent HIV-1 infection. Therefore, helping mitochondria to regain the metabolic plasticity and allow specific T-cells to adapt and thrive under unfavorable environmental conditions during HIV-1 infection may represent the next generation of combinatory treatment options for patients. OBJECTIVE Quality of breaking bad news can seriously affect the course of disease. A frequently applied guideline is the SPIKES-Protocol that have been designed from the physician's perspective. Little is known about patients' preferences in breaking bad news. Our aim was to develop a questionnaire based on the SPIKES-protocol to detect patients´ preferences for breaking bad news communication. METHODS TheMarburg Breaking Bad News Scale (MABBAN) was developed and administered to 336 cancer patients. We used exploratory factor analysis. To examine potential relationships according to demographic and medical variables, regression analyses were conducted. RESULTS The novel questionnaire supported the six SPIKES-components of breaking bad news Setting, Perception, Invitation, Knowledge, Emotions, and Strategy. Perception and Invitation clustered together to one subscale. Depending on clinical and demographic variables different components were rated as important. CONCLUSION Communication preferences in breaking bad news can be assessed using a SPIKES-based questionnaire.