Biomedical subjects

D Sholter

Publications and source records attributed to D Sholter.

4 recordsLinked to original sources

PubMed1999

Validity and reliability of the 6 minute walk in persons with fibromyalgia.

OBJECTIVE: To assess the reliability and construct validity of the 6 minute walk (6MW) in persons with fibromyalgia (FM) and to determine an equation for predicting peak oxygen consumption (pVO2) from the distance covered in 6 minutes. METHODS: Ninety-six women who met the American College of Rheumatology (ACR) criteria for FM were tested on the 6MW and the Fibromyalgia Impact Questionnaire (FIQ). A subset (n = 23) were tested on a separate day for pVO2 during a symptom-limited, incremental treadmill test. Twelve subjects repeated the 6MW five times over 10 days. Heart rate and rating of perceived exertion (RPE) were recorded for each walk. Intraclass correlations were used to determine the reliability of the 6MW. Validity was examined by correlating the 6MW with pVO2 and the FIQ. Body mass index (BMI) and 6MW were independent variables in a stepwise regression to predict pVO2. RESULTS: A significant increase in distance occurred from Walk 1 to Walk 2 (p = 0.000) with the distance maintained on the remaining walks (p = 0.148) The correlations of the 6MW with the FIQ and pVO2 were -0.325 and 0.657, respectively. The regression equation to predict pVO2 from 6MW distance and BMI was: pVO2 (ml/kg/min) = 21.48 + (-0.4316 x BMI) + [0.0304 x distance(m)] (R = 0.76, R2 = 0.66). CONCLUSION: When using the 6MW it is necessary to conduct a practice walk, with the second walk taken as the baseline measure. It was determined from the correlations that the 6MW cannot replace the FIQ as a measure of function. The 6MW may be used as an indicator of aerobic fitness, although obtaining VO2 by means of a graded exercise test is preferable.

Analysis of Variance↗

PubMed1997

Rheumatic manifestations of inherited diseases.

In this paper the rheumatic features of a selection of inherited diseases are reviewed. Further evidence has been reported strengthening the association between hypercholesterolemia and Achilles tendinous xanthomatosis, although the clinical manifestations of hyperlipidemic arthropathy remain poorly understood. Osteonecrosis of the femoral head is demonstrated to have a good functional prognosis in children and adolescents with Gaucher's disease. Magnetic resonance imaging of the liver may prove to be useful in monitoring enzyme replacement in Gaucher's disease because it correlates with the presence of avascular necrosis. A case of cervical myelopathy in Hunter's disease is also presented.

Genetic Diseases, Inborn↗

PubMed1997

Radiochemical synovectomy.

Radiochemical synovectomies have been used for nearly fifty years for the treatment of persistent monoarticular synovitis refractory to antiinflammatory drugs, disease modifying drugs, and intraarticular corticosteroids. It is a therapeutic alternative to surgical synovectomy. There are controversies concerning safety, choice of appropriate agent, and logistics of administration. These concerns are discussed in addition to reviewing some of the more recent trials examining the efficacy of radiochemical synovectomy. It is clear that in properly selected patients this procedure is safe and beneficial.

Anti-Inflammatory Agents↗

PubMed1997

Yttrium-90 radiochemical synovectomy in chronic knee synovitis: a one year retrospective review of 133 treatment interventions.

OBJECTIVE: To determine treatment success rates and factors predicting successful outcome using yttrium-90 intraarticular injections for chronic knee synovitis refractory to other treatments. METHODS: A retrospective one year review of 133 treatment interventions with yttrium-90 (Y-90) with response recorded at 3, 6, 9, and 12 mo after injection. RESULTS: An excellent, good, or fair response (a treatment benefit) as evaluated by objective (degree of joint effusion, joint tenderness, range of motion) and subjective (visual analog scale, degree of pain) assessments occurred in 81, 82, 80, and 75% of joints at 3, 6, 9, and 12 mo, respectively. When only excellent and good responses were considered successful treatment then 49, 48, 57, and 46% had successful treatment at 3, 6, 9, and 12 mo, respectively. 8 of 15 joints (53%) reinjected after primary treatment failure or relapse showed a beneficial response. Patients treated successfully were more likely to have a normal radiographic appearance rather than one showing destructive changes (78 vs 54% treatment success; p < 0.05); to have localized disease or systemic disease in remission, rather than active systemic disease (66 vs 30% treatment success; p < 0.001); and shorter duration of joint disease (6.9 vs 10.2 years; p < 0.05). CONCLUSION: Y-90 synovectomy successfully treats patients with chronic knee synovitis refractory to other therapies. Primary treatment failures or relapses may be successfully treated by reinjection. Patients with less destructive radiographic changes, shorter duration of joint disease, and localized disease tend to respond more favorably.

Adolescent↗