PubMed Health⌕ Search

Biomedical subjects

Anthony D Woolf

Publications and source records attributed to Anthony D Woolf.

9 recordsLinked to original sources
PubMed2006

Healthcare services for those with musculoskeletal conditions: a rheumatology service. Recommendations of the European Union of Medical Specialists Section of Rheumatology/European Board of Rheumatology 2006.

Musculoskeletal conditions are very common across Europe. They affect all age groups, and the associated physical disability is an enormous burden on individuals and society. They can be effectively prevented and controlled in many situations, but this is not at present fully achieved. This report outlines what is required to achieve this and the role of rheumatology in providing these healthcare services. Strategies are given for the prevention and management of musculoskeletal conditions. The needs of people with these conditions are expressed in the PARE Manifesto and the clinical needs have been identified. The healthcare services required to implement these strategies and meet these needs are considered focusing on what services a rheumatology centre should provide. A key principle is that management of musculoskeletal conditions requires a coordinated, integrated, multidisciplinary and multiprofessional approach providing access to a combination of expertise and competencies. Guidance is given of what a rheumatology service should be expected to offer. For a rheumatology centre to provide these services, the need for appropriate facilities and resources is identified, which considers physical resources as well as personnel, training and management needs. Maintaining high standards of care and achieving the best outcomes at all times needs the monitoring of quality indicators as well as ongoing education and research. In conclusion, improving musculoskeletal health is dependent on access to effective treatments and this document shows how the services provided by a rheumatology centre is central to this.

Delivery of Health Care↗
PubMed2005

Burden of osteoporosis and fractures in developing countries.

The burden of osteoporosis in developing countries is increasing dramatically with the aging of the population and demographic trends; however, there is a lack of direct epidemiologic data. There are clear differences at present between and within populations that limits the validity of many estimates and more data is needed. Existing data and estimates are considered in terms of bone mass, bone structure, 10-year and lifetime probability of fracture, numbers sustaining fractures, the outcome of fracture, importance of differences in fracture management, and risk factors for their occurrence and outcome. Future trends are also considered.

Bone Density↗
PubMed2003

Burden of major musculoskeletal conditions.

Musculoskeletal conditions are a major burden on individuals, health systems, and social care systems, with indirect costs being predominant. This burden has been recognized by the United Nations and WHO, by endorsing the Bone and Joint Decade 2000-2010. This paper describes the burden of four major musculoskeletal conditions: osteoarthritis, rheumatoid arthritis, osteoporosis, and low back pain. Osteoarthritis, which is characterized by loss of joint cartilage that leads to pain and loss of function primarily in the knees and hips, affects 9.6% of men and 18% of women aged > 60 years. Increases in life expectancy and ageing populations are expected to make osteoarthritis the fourth leading cause of disability by the year 2020. Joint replacement surgery, where available, provides effective relief. Rheumatoid arthritis is an inflammatory condition that usually affects multiple joints. It affects 0.3-1.0% of the general population and is more prevalent among women and in developed countries. Persistent inflammation leads to joint destruction, but the disease can be controlled with drugs. The incidence may be on the decline, but the increase in the number of older people in some regions makes it difficult to estimate future prevalence. Osteoporosis, which is characterized by low bone mass and microarchitectural deterioration, is a major risk factor for fractures of the hip, vertebrae, and distal forearm. Hip fracture is the most detrimental fracture, being associated with 20% mortality and 50% permanent loss in function. Low back pain is the most prevalent of musculoskeletal conditions; it affects nearly everyone at some point in time and about 4-33% of the population at any given point. Cultural factors greatly influence the prevalence and prognosis of low back pain.

Adolescent↗
PubMed2003

Radiographic damage associated with low bone mineral density and vertebral deformities in rheumatoid arthritis: the Oslo-Truro-Amsterdam (OSTRA) collaborative study.

OBJECTIVE: To examine variables associated with bone mineral density (BMD) and vertebral deformities in women with rheumatoid arthritis (RA) from 3 northwest European countries. METHODS: Female patients were recruited from rheumatology clinics in Oslo, Norway; Truro, UK; and Amsterdam, The Netherlands (150 total, 50 per center, age 50-70 years, disease duration > or = 5 years). Demographic and clinical data were collected and BMD was measured by means of dual energy x-ray absorptiometry. Associations between demographic and clinical measures on the one hand and BMD and vertebral deformities on the other were investigated by single and multiple regression analyses. RESULTS: Body mass index (BMI), medication use, RA damage measures, and BMD differed significantly between the 3 centers. Overall, Norwegian patients had the lowest BMI, used more corticosteroids and anti-osteoporotic drugs, had lower joint damage measured by Larsen score, and lower BMD at both spine and hip. High age, low BMI, and high cumulative dose of corticosteroids (last 2 years) are related to low BMD. A high Larsen score was associated with low BMD at the hip. Larsen score was the independent determinant of vertebral deformities after correction for center, age, BMI, and BMD. CONCLUSION: Data from 3 countries on BMD and vertebral deformities in female patients aged 50-70 years with longstanding RA are presented, demonstrating an association between radiographic RA damage and low BMD and between radiographic RA damage and vertebral deformities.

Absorptiometry, Photon↗
PubMed2003

How to assess musculoskeletal conditions. History and physical examination.

Musculoskeletal conditions are common, their impact is pervasive and they are a major burden on health and social care. However, they are poorly managed because of lack of priority and inadequate competencies due to limited medical education in this spectrum of conditions. The ability to take a clear history and perform a competent examination are core skills to the appropriate management of musculoskeletal problems. This chapter outlines an approach that is followed by most specialists in rheumatology, orthopaedics or rehabilitation that can be used to teach other clinicians going into primary care or at the beginning of specialist training.

Clinical Competence↗
PubMed2003

The bone and joint decade. strategies to reduce the burden of disease: the Bone and Joint Monitor Project.

Musculoskeletal conditions are the major cause of morbidity and substantially influence health and quality of life, with enormous costs to health systems. This article describes the Bone and Joint Monitor Project, whose objective is to provide evidence to enable development of policies and strategies to improve the prevention and treatment of musculoskeletal conditions, relevant to their geographic and socioeconomic settings. By identifying the burden of disease and establishing strategies that can be implemented in routine clinical practice, musculoskeletal conditions can be managed more effectively and progress can be demonstrated through the establishment of routine health monitoring. With the interventions currently available, it is feasible that all people will be afforded the right to pain control, mobility, and independence.

Global Health↗