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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



NAVIGATION


         

 

A family history of Alzheimer’s is one of the biggest risk factors for developing the memory-robbing disease, which affects more than 5 million Americans and is the most common form of senile dementia. Now an international collaboration led by NYU Langone Medical Center researchers has found the likely basis for this heightened familial risk - especially from the maternal side…

 

In a study that promises to improve diagnosis and monitoring of Alzheimer’s disease, scientists at the University of California, San Diego have developed a fast and accurate method for quantifying subtle, sub-regional brain volume loss using magnetic resonance imaging (MRI). The study is published the week of November 16 in the Proceedings of the National Academy of Sciences (PNAS).

 

The eyes may be the windows to the soul, but new research indicates they also may mirror a brain ravaged by Alzheimer’s disease. UC Irvine neuroscientists have found that retinas in mice genetically altered to have Alzheimer’s undergo changes similar to those that occur in the brain - most notably the accumulation of amyloid plaque lesions.

 

Researchers’ ability to rapidly detect the macromolecular protein clumps implicated in Alzheimer’s and other neurodegenerative diseases will soon get a sizable boost in the lab of biochemist and Howard Hughes Medical Investigator Nikolaus Grigorieff. The National Institutes of Health has just awarded Grigorieff a $2.2 million grant for a second high-resolution electron microscope (EM) in his lab.

 

With the risk of developing dementia growing at an alarming pace, a University of Central Florida research team is working with the Boston University School of Medicine to develop a miniature diagnostic toolkit in the hopes of stimulating earlier detection and treatment.

 

UCLA scientists have discovered a way to measure the amount of amyloid beta that is being absorbed by immune cells in the blood. Amyloid beta forms the plaques considered the hallmark of Alzheimer’s disease, and if the immune system isn’t adequately clearing amyloid beta, it may indicate Alzheimer’s risk, according to the researchers.

 

Many people who discover that they have inherited a higher risk of developing Alzheimer’s can cope with the news, especially if they receive the it through genetic counseling: they may experience depression or anxiety at first, but it does not last long, according to a new study from the US.

 

Changes in the brain measured with MRI and PET scans, combined with memory tests and detection of risk proteins in body fluids, may lead to earlier and more accurate diagnosis of Alzheimer’s, according to new research reported at the Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease (ICAD 2009) in Vienna.

 

What if you could test your risk for Alzheimer’s disease much like your cholesterol levels - through a simple blood test? UCLA scientists have discovered a way to measure the amount of amyloid beta that is being absorbed by immune cells in the blood. Amyloid beta forms the plaques considered the hallmark of Alzheimer’s disease, and if the immune system isn’t adequately clearing amyloid beta, it may indicate Alzheimer’s risk, according to the researchers.

 

A doctor’s positive attitude to Alzheimer’s diagnosis and their trusting, personal relationships with local dementia support service providers are powerful enablers for early diagnosis of Alzheimer’s, according to new research reported at the Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease (ICAD 2009) in Vienna.




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