Biomedical subjects

Peter W Jones

Publications and source records attributed to Peter W Jones.

At least 19 recordsLinked to original sources

PubMed2006

Serotonin transporter, tryptophan hydroxylase, and monoamine oxidase A gene polymorphisms in premenstrual dysphoric disorder.

OBJECTIVE: The purpose of this study was to investigate whether common polymorphisms of key genes that control the serotonin (5-hydroxytryptamine) pathway are associated with premenstrual dysphoric disorder. STUDY DESIGN: The study sample comprised 53 women with clinically diagnosed premenstrual dysphoric disorder (age range, 27-46 years; mean age, 37.7 years) and 52 healthy control subjects (age range, 22-48 years; mean age, 36.2 years). Eight polymorphisms that encode the 5-hydroxytryptamine transporter (LPR, VNTR-2, and 3' UTR G/T), tryptophan hydroxylase 1 (TPH1 G-6526A, G-5806T, and A218C), and monoamine oxidase A (monoamine oxidase A promoter VNTR-1 and exon 8 Fnu 4H1) were genotyped. Genotype and allelic frequencies were analyzed by chi-square test and stepwise logistic regression analysis. RESULTS: There was no significant association between any genotype and clinical category and no significant allelic distribution profiles in either the premenstrual dysphoric disorder group or the control group. CONCLUSION: These findings do not support a major role for common 5-hydroxytryptamine transporter, TPH1, and monoamine oxidase A polymorphisms in contributing to susceptibility to premenstrual dysphoric disorder.

Adult↗

PubMed2006

Effects of intensity of electroacupuncture upon experimental pain in healthy human volunteers: a randomized, double-blind, placebo-controlled study.

Electroacupuncture is commonly used for pain relief. Despite an extensive evidence-base guiding the selection of stimulation parameters, little methodologically robust research exists regarding the level of intensity required to provide effective doses. This study investigated the hypoalgesic effects of two stimulation intensities compared to placebo on pressure pain thresholds (PPTs) in pain-free humans. Forty-eight acupuncture-naïve volunteers (mean age 23), stratified by gender, were screened for relevant contraindications and randomly allocated to four groups: control, placebo, high-intensity ("to tolerance but sub-noxious") or low-intensity ("strong but comfortable"). True or placebo electroacupuncture, using the Streitberger placebo needle, was administered to acupoints on dominant forearm (LI10, TH5) and ipsilateral leg (GB34, ST38). True needles (30 mm long, 0.3 mm diameter) were inserted 20-25 mm and "de-qi" was elicited from active groups, prior to administering 30 min of 4 Hz, 200 micros electroacupuncture. No electrical stimulation was performed on control and placebo groups, and placebo needles were used. After the intervention period, all needles were removed. Volunteers were monitored for 30 further minutes. Two PPT measurements were taken bilaterally from muscle bellies of first dorsal interosseous by an independent rater, at baseline and at six subsequent 10-min intervals. Square-root transformed data were analysed using repeated-measures ANOVA, with baseline data as covariate. The high-intensity group was significantly different from the placebo group for both measurement sites (p=.020, p=.033). The control group displayed stable PPT readings over time. No significant differences were observed between the placebo and control groups. These findings suggest that high-intensity levels may be important in optimal dose selection.

Adolescent↗

PubMed2006

Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse.

OBJECTIVE: To prospectively evaluate the effects of vaginal pessaries on symptoms associated with pelvic organ prolapse and identify the risk factors for failure. METHODS: All women referred to a specialist urogynecology unit with symptomatic pelvic organ prolapse who elected to use a pessary were included in this study. All completed the Sheffield pelvic organ prolapse symptom questionnaire before use and after 4 months of use. The primary outcome measure was change of symptoms from baseline to 4 months. RESULTS: Of 203 consecutive women fitted with a pessary, 153 (75%) successfully retained the pessary at 2 weeks, and 97 completed the questionnaires at 4 months. Multivariate logistic regression analysis showed that failure to retain the pessary was significantly associated with increasing parity (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.14-2.02, P = .004) and hysterectomy (OR 4.57, 95% CI 1.71-12.25, P = .002). In the success group at 4 months (n = 97), a significant improvement in voiding was reported by 39 participants (40%, P = .001), in urinary urgency by 37 (38%, P = .001), in urge urinary incontinence by 28 (29%, P = .015), in bowel evacuation by 27 (28%, P = .045), in fecal urgency by 22 (23%, P = .018), and in urge fecal incontinence by 19 (20%, P = .027), but there was no significant improvement in stress urinary incontinence in 22 participants (23% P = .275). Of the 26 (27%) who were sexually active, 16 (17%, P = .001) reported an increase in frequency of sexual activity, and 11 (11%, P = .041) had improved in sexual satisfaction. CONCLUSION: A vaginal pessary is an effective and simple method of alleviating symptoms of pelvic organ prolapse and associated pelvic floor dysfunction. Failure to retain the pessary is associated with increasing parity and previous hysterectomy. LEVEL OF EVIDENCE: II-3.

Aged↗

PubMed2006

Risk factors for obstetric anal sphincter injury: a prospective study.

BACKGROUND: Anal incontinence is an embarrassing condition that is largely underreported. Obstetric anal sphincter injuries are the major etiological factor. Recognition of risk factors may minimize the development of sphincter injuries. The objective of this study was to identify risk factors for sphincter injuries and measure dimensions of mediolateral episiotomies. METHODS: Women expecting their first vaginal delivery were invited to participate, and an experienced research fellow performed a perineal and rectal examination and classified tears according to the new international classification. Dimensions of episiotomies were measured and obstetric variables recorded prospectively. RESULTS: Of the 241 women recruited, 59 (25%) sustained sphincter injuries. Univariate analysis revealed that forceps delivery OR 4.03 (1.63-9.92), vacuum extraction OR 2.64 (1.25-5.54), gestation > 40 weeks OR 3.18 (2.35-4.29), and mediolateral episiotomy OR 5.0 (2.64-9.44) were associated with these injuries. In addition, compared with women who had no injuries, sphincter injuries were more common with higher birthweight (3.51 vs 3.17 kg, p < 0.01), larger head circumference (34.3 vs 33.3 cm, p < 0.01), and longer second stage of labor (76 vs 51 min, p < 0.01). Multiple logistic regression revealed higher birthweight and mediolateral episiotomy OR 4.04 (1.71-9.56) as independent risk factors. Episiotomies angled closer to the midline were significantly associated with such injuries (26 vs 37 degrees, p = 0.01). No midwife and only 13 (22%) doctors performed truly mediolateral episiotomies. CONCLUSIONS: Mediolateral episiotomy is an independent risk factor for anal sphincter injuries. Although a liberal policy of mediolateral episiotomy does not appear to reduce the risk of such injuries, it may be related to inappropriate technique. A concerted approach to educate trainees in appropriate episiotomy technique and identification of sphincter injuries is imperative to enable reexamination of the true merits or disadvantages of mediolateral episiotomy.

Anal Canal↗

PubMed2006

Occult anal sphincter injuries--myth or reality?

OBJECTIVES: To establish the true prevalence of clinically recognisable and occult obstetric anal sphincter injuries (OASIS). DESIGN: Prospective interventional study. SETTING: Busy district general hospital. SAMPLE: Two hundred and fifty-four women having their first vaginal delivery over a 12-month period were invited. Two hundred and forty-one (95%) participated and 208 (86%) attended follow up. METHODS: Women had a clinical examination at delivery by the accoucheur and repeated by an experienced research fellow immediately after delivery. All identified OASIS were verified and repaired by the duty specialist registrar or consultant. Endoanal ultrasound was performed immediately postpartum prior to suturing and repeated seven weeks later. MAIN OUTCOME MEASURES: Prevalence of recognised and occult anal sphincter injuries. RESULTS: Fifty-nine (24.5%) women sustained OASIS. The prevalence of OASIS increased significantly from 11% to 24.5% when women were re-examined. Of these, 30 occurred in deliveries by midwives who missed 26 (87%) and 29 following deliveries by doctors who missed 8 (28%) injuries. All clinically apparent OASIS were also identified on endoanal ultrasound. In addition, three (1.2%) women had an occult anal sphincter injury. Two of these occult sphincter injuries were isolated to the internal anal sphincter (IAS) and would not usually be clinically detectable. CONCLUSIONS: OASIS occur more frequently than previously reported. Many remain undiagnosed and are subsequently classified as occult when identified on anal endosonography. Genuine occult injuries are rare. Training in perineal anatomy and recognition of OASIS needs to be enhanced in order to increase detection of OASIS and minimise the risk of consequent anal incontinence.

Anal Canal↗

PubMed2006

Associations between G/A1229, A/G3944, T/C30875, C/T48200 and C/T65013 genotypes and haplotypes in the vitamin D receptor gene, ultraviolet radiation and susceptibility to prostate cancer.

Ultraviolet radiation (UVR) may protect against prostate cancer via a mechanism involving vitamin D. Thus, the vitamin D receptor (VDR) gene is a susceptibility candidate, though published data are discrepant. We studied the association of prostate cancer risk with five VDR single nucleotide polymorphisms (SNPs): G/A(1229) (SNP 1), A/G(3944) (SNP 2), T/C(30875) (SNP 3), C/T(48200) (SNP 4) and C/T(65013) (SNP 5), in 430 cancer and 310 benign prostatic hypertrophy (BPH) patients. The SNP 2 GG genotype frequency was lower in cancer than BPH patients (odds ratio = 0.63, 95% CI = 0.41-0.98, p = 0.039). SNPs 1 and 2, and SNPs 4 and 5, were in linkage disequilibrium. Two copies of haplotypes comprising SNPs 1-2, G-G (odds ratio = 0.63, p = 0.039), SNPs 2-3 G-C (odds ratio = 0.45, p = 0.008) and SNPs 1-2-3 G-G-C (odds ratio = 0.44, p = 0.006), but not SNPs 1-3, G-C (odds ratio = 0.81, p = 0.34), were associated with reduced risk (reference, no copies of the haplotypes). These associations were observed after stratification of subjects by extent of UVR exposure. These data show that SNP 2 GG genotype mediates prostate cancer risk, complementing studies reporting this allele is protective in malignant melanoma pathogenesis. They further suggest that published associations of risk with SNP 1 may result from linkage disequilibrium with SNP 2.

Base Sequence↗

PubMed2005

Coronary endarterectomy: impact on morbidity and mortality when combined with coronary artery bypass surgery.

BACKGROUND: The results of coronary endarterectomy (CE) performed in addition to coronary artery bypass grafting (CABG) have been controversial. We aimed to examine the impact of CE performed in addition to CABG when compared with CABG alone in our unit. METHODS: Patients who had CABG between January 1995 and December 2001 were included. They were divided into two groups, the CABG-only group and CABG and CE group. The following outcomes were compared: perioperative myocardial infarction, postoperative ventricular arrhythmias, cerebrovascular accident, renal impairment, and early mortality. RESULTS: Of 5,782 patients who underwent CABG, 461 patients (8.6%) required CE in addition to CABG. There was a higher mortality and incidence of postoperative renal impairment in the group of patients who had CABG and CE, with no significant difference in other outcomes. However, the patients in the CABG and CE group had a higher incidence of male sex, previous myocardial infarctions, preoperative renal impairment, and poor left ventricular function, with longer cross-clamp and cardiopulmonary bypass times than in the CABG-only patients. Although female sex, renal impairment, nonelective surgery, impaired left ventricular function, and peripheral vascular disease were associated with increased mortality in all the patients, and use of statins and aspirin was associated with a reduction in mortality, CE was not a predictor of mortality. Furthermore, on propensity scores analysis, CE was not associated with increased mortality. CONCLUSIONS: Coronary endarterectomy when combined with CABG seemed to be associated with a higher mortality than isolated CABG in our study groups, but this is related to comorbidities of these patients rather than the CE.

Aged↗

PubMed2005

Associations between ultraviolet radiation, basal cell carcinoma site and histology, host characteristics, and rate of development of further tumors.

BACKGROUND: Patients with basal cell carcinoma (BCC) frequently develop further tumors during follow-up. OBJECTIVE: We sought to elucidate the relative effects of pattern of ultraviolet radiation exposure, and site and histologic type of the first tumor, on the rate of increase in BCC numbers. METHODS: We used negative binomial regression analysis to study the association of selected variables on the rate of increase in BCC numbers in 266 Caucasian patients who first presented with a tumor on the head/neck or trunk with nodular or superficial histology. RESULTS: Patients with an initial truncal BCC with superficial histology demonstrated significantly faster increases in BCC numbers than did patients with other site and histology combinations. CONCLUSIONS: These data indicate that site and histology define subsets of patients with BCC.

Aged↗

PubMed2005

Desmethylabietospiran, a naturally occurring self-gelation agent.

A new self-gelating triterpenoid natural product has been isolated from the bark of the silver fir, Abies alba. The structure is desmethylabietospiran (3) on the basis of chemical and spectroscopic evidence. Also reported is a more efficient isolation procedure of abietospiran (1) from A. alba.

Abies↗

PubMed2005

Are mediolateral episiotomies actually mediolateral?

This study investigated potential differences in the cutting of mediolateral episiotomy between doctors and midwives. Depth, length, distance from midline and shortest distance from the midpoint of the anal canal to the episiotomy were measured in a sample of primigravid women. The angle subtended from the sagittal or parasagittal plane was calculated. Two hundred and forty-one women participated of whom 98 (41%) had a mediolateral episiotomy. Doctors performed episiotomies that were significantly deeper, longer and more obtuse than those by midwives. No midwife and only 13 (22%) doctors performed truly mediolateral episiotomies. It appears that the majority of episiotomies are not truly mediolateral but closer to the midline. More focused training in mediolateral episiotomy technique is required.

Anal Canal↗

PubMed2004

Associations between UVR exposure and basal cell carcinoma site and histology.

While sunlight is critical in basal cell carcinoma (BCC) pathogenesis the relationship between exposure and tumor site and histology is unclear. We determined if tumor site (trunk or head/neck) or histology (nodular or superficial) is determined by exposure pattern. In 66 cases with truncal and 362 patients with head/neck BCC at first presentation, average hours exposure/year, intermittency score, childhood sunburning and skin type were not significantly associated with tumor site or histology. However, often sunbathing was associated with a five-fold increased risk of truncal BCC. Average sunbathing score was significantly greater in 22 cases with truncal compared with 325 cases with head/neck nodular tumors and also in 44 cases with superficial truncal compared with superficial head/neck BCC. Thus, sunbathing determined tumor site but not histology.

Abdomen↗

PubMed2004

Polymorphisms in glutathione S-transferases and non-melanoma skin cancer risk in Australian renal transplant recipients.

Caucasian renal transplant recipients from Queensland, Australia have the highest non-melanoma skin cancer (NMSC) risk worldwide. Although ultraviolet light (UVR) exposure is critical, genetic factors also appear important. We and others have shown that polymorphism in the glutathione S-transferases (GST) is associated with NMSC in UK recipients. However, the effect of high UVR exposure and differences in immunosuppressive regimen on these associations is unknown. In this study, we examined allelism in GSTM1, GSTM3, GSTT1 and GSTP1 in 361 Queensland renal transplant recipients. Data on squamous (SCC) and basal cell carcinoma (BCC), UVR/tobacco exposure and genotype were obtained. Associations with both NMSC risk and numbers were examined using logistic and negative binomial regression, respectively. In the total group, GSTM1 AB [P = 0.049, rate ratio (RR) = 0.23] and GSTM3 AA (P = 0.015, RR = 0.50) were associated with fewer SCC. Recipients were then stratified by prednisolone dose (< or =7 versus >7 mg/day). In the low-dose group, GSTT1 null (P = 0.006, RR = 0.20) and GSTP1 Val/Val (P = 0.021, RR = 0.20) were associated with SCC numbers. In contrast, in the high-dose group, GSTM1 AB (P = 0.009, RR = 0.05), GSTM3 AB (P = 0.042, RR = 2.29) and BB (P = 0.014, RR = 5.31) and GSTP1 Val/Val (P = 0.036, RR = 2.98) were associated with SCC numbers. GSTM1 AB (P = 0.016) and GSTP1 Val/Val (P = 0.046) were also associated with fewer BCC in this group. GSTP1 associations were strongest in recipients with lower UVR/tobacco exposure. The data confirm our UK findings, suggesting that protection against UVR-induced oxidative stress is important in NMSC development in recipients, but that this effect depends on the immunosuppressant regimen.

Adult↗

PubMed2004

Polymorphisms in the vitamin D receptor gene, ultraviolet radiation, and susceptibility to prostate cancer.

Ultraviolet radiation (UVR) exposure may protect against prostate cancer development via a mechanism involving vitamin D. The vitamin D receptor (VDR) gene is therefore a candidate susceptibility factor for prostate cancer. This possibility has been previously investigated with conflicting results. We examined the association of VDR genotypes (variants at the CDX-2, Fok1, and Taq1 sites), haplotypes, and genotype combinations with risk by studying 368 prostate cancer and 243 benign prostatic hypertrophy (BPH) patients. CDX-2, Fok1, and Taq1 genotype and haplotype frequencies were not significantly different in cancer and BPH patients. As the impact of VDR polymorphisms may depend on UVR exposure, we studied associations of variants with risk in men stratified into low (below median) and high (above median) cumulative exposure/year groups. In men with UVR exposure above the median (1,100 hr/year), CDX-2 GA and AA (odds ratios [OR] = 2.11 and 2.02, respectively) and Fok1 ff (OR = 2.91) were associated with increased prostate cancer risk. No associations were observed for Taq1 genotypes. Of the genotype combinations, relative to all other CDX-2 and Taq1 and combinations, GGTT (P = 0.022, OR = 0.30), and relative to all other Fok1 and Taq1 combinations, FFTT (P = 0.026, OR = 0.35) were associated with reduced prostate cancer risk in the presence of the main effects. None of the other two- or three-genotype combinations was associated with risk. These data indicate that VDR variants influence prostate cancer risk and that this association is dependent on the extent of UVR exposure.

Disease Susceptibility↗

PubMed2004

PTCH polymorphism is associated with the rate of increase in basal cell carcinoma numbers during follow-up: preliminary data on the influence of an exon 12-exon 23 haplotype.

After first presentation with a basal cell carcinoma (BCC), patients demonstrate interindividual diversity in the rate of development of further BCCs (number/year of follow-up). The mechanism for this variation is unknown. In this study, we evaluated whether PTCH variants mediate this phenomenon. We used negative binomial regression analysis to identify associations between BCC numbers/year and host characteristics, parameters of exposure to ultraviolet radiation (UVR), and PTCH exon 12(1686) C/T, intron 15(2560+9) G/C, and exon 23(3944) C/T genotypes and haplotypes in 279 BCC cases who presented with an initial tumor on the head/neck. PTCH genotypes were not significantly associated with BCCs/year, although cases with two copies of the C1686-C3944 haplotype developed significantly fewer BCCs/year than those without this haplotype (rate ratio = 0.44; 95% CI = 0.27-0.71). Cases with one copy of T1686-T3944 developed more BCCs/year (rate ratio = 2.46; 95% CI = 1.27-3.97) than those without the haplotype. We found no significant associations between BCCs/year and the other PTCH haplotypes studied. We reexamined the association of C1686-C3944 with BCCs/year in a model that included UVR exposure parameters (sunburning in childhood, sunbathing score, intermittency of exposure between 40 and 60 years of age, exposure in hours/year) and skin type, gender, and age at first presentation. The association between C1686-C3944 and BCCs/year remained significant (rate ratio = 0.44; 95% CI = 0.26-0.73 for two copies of the haplotype). The data show that allelic variation in PTCH contributes to the rate of development of BCC.

Adult↗

PubMed2004

Understanding General Health Questionnaire (GHQ-28) score and its threshold.

BACKGROUND: The finding of variation in the optimal threshold of the General Health Questionnaire (GHQ) across different settings has proved difficult to explain. This analysis aimed to examine the optimal threshold of the GHQ, its variability and relationship with prevalence of psychiatric disorder. METHODS: A cross-sectional two-phase epidemiological survey was used in a study of non-psychotic psychiatric disorder of General Practice consulters. A total of 1670 consecutive patients were screened using the GHQ-28 and the GP encounter form, and 336 were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). The total prevalence of the psychiatric disorders was estimated using three different methods and was calculated in the rural and urban practices and among those attending the General Practitioners and Practice Nurses. RESULTS: The frequency distribution of the GHQ score for the whole sample of respondents was skewed resulting in the biased mean GHQ score. The mean values for different sample categories were found to be higher than the median values indicating that the median GHQ score may be a better parameter to describe the score distribution than the mean. The median value of the GHQ score showed a strong correlation with the prevalence estimated by the three different methods. CONCLUSIONS: The median of GHQ score gives a better estimate for the cut-off score than the mean. The median score may be used as an estimate for the optimal threshold, in settings where the sensitivity and specificity are not known or where an estimate of the prevalence from a questionnaire survey is required. Alternative methods are preferable when screening for individual cases or in the context of a two-phase design.

Adolescent↗

PubMed2004

The effectiveness of GnRHa with and without 'add-back' therapy in treating premenstrual syndrome: a meta analysis.

OBJECTIVE: To determine the effectiveness of gonadotrophin-releasing hormone analogues (GnRHa) with and without hormonal add-back therapy in the management of premenstrual syndrome. DESIGN: Randomised controlled trials were identified by searching multiple databases. SETTING: Exeter and North Devon Research and Development Support Unit and Keele University Academic Unit of Obstetrics and Gynaecology. POPULATION: Women with pre-diagnosed premenstrual syndrome and/or premenstrual dysphoric disorder. METHODS: A meta-analysis of published randomised placebo-controlled trials assessing the use of GnRHa in the management of premenstrual syndrome. The standardised mean difference for each individual study and subsequently an overall standardised mean difference were calculated after demonstrating the consistency or homogeneity of the study results. MAIN OUTCOME MEASURES: Overall improvement in premenstrual symptomatology and effectiveness of GnRHa with additional hormonal add-back therapy were the main outcome measures assessed in this analysis. A secondary analysis was performed to assess the effectiveness of GnRHa in treating physical and emotional symptoms. RESULTS: Overall standardised mean difference for all trials that assessed the efficacy of GnRHa was -1.19 (95% confidence interval [CI] -1.88 to -0.51). The equivalent odds ratio was 8.66 (95% CI 2.52 to 30.26) in favour of GnRHa. GnRHa were more efficacious for physical than behavioural symptoms, although the difference was not statistically significant. The addition of hormonal add-back therapy to GnRHa did not appear to reduce the efficacy of GnRHa alone; standardised mean difference 0.12 (95% CI -0.35 to 0.58). CONCLUSIONS: GnRHa appear to be an effective treatment in the management of premenstrual syndrome. The addition of hormonal add-back therapy to reduce side effects does not reduce efficacy.

Female↗

PubMed2004

p16INK4a polymorphism: associations with tumour progression in patients with sporadic colorectal cancer.

Deregulated tumour expression of p16INK4a has previously been described in association with clinical progression in sporadic colorectal cancer patients (CRC). Furthermore, p16INK4a promoter hypermethylation leading to gene silencing has been shown to occur in advanced colorectal tumours and has been associated with patient survival. p16INK4a is polymorphic, with variant alleles being associated with tumour progression in melanoma. In this study we have examined p16INK4a polymorphism as a marker of tumour progression in sporadic CRC. Polymorphic sites G/A(442), C/G(500), and C/T(540), were studied, these alleles obeyed Hardy Weinberg equilibrium in a control group, but not in the CRC cases. G/A(442) and CG(500) alleles were in linkage disequilibrium in both cases and controls. In controls the C/T(540) alleles demonstrated no linkage with either other site, whilst an association was demonstrated between C/G(500) and C/T(540) alleles in the cases (p=0.011). Furthermore, the distribution of C/T(540) genotypes was different between the groups (p=0.002). Within the CRC cases, patients with the GG(442) genotype were more commonly associated with decreased tumour differentiation (p=0.018), advancing Dukes' stage (p=0.006) and T-stage (p=0.007) than patients with the GA(442) and AA(442) genotypes. Patients with the CC(500) genotype were more commonly associated with decreased tumour differentiation (p=0.012), advancing Dukes' stage (p=0.015), and N-stage (p=0.031). No associations between patient C/T(540) genotype and clinical prognostic parameters were found. An analysis of patient tumour expression with p16INK4a genotype revealed patients with the CC(500) genotype were more commonly associated with reduced tumour p16 expression (p=0.046). In summary our data indicate that p16INK4a polymorphism is associated with tumour progression in patients with sporadic CRC.

Colorectal Neoplasms↗

PubMed2004

Assessment of the 3-dimensional Fastrak measurement system in measuring range of motion in ankylosing spondylitis.

OBJECTIVE: To assess the repeatability and validity of the electromagnetic 3-dimensional tracking system, Fastrak, in measuring cervical spine and shoulder movement in patients with ankylosing spondylitis (AS). METHODS: Fifty patients with AS had their cervical spine and shoulder movements measured on up to 3 occasions with the Fastrak. Patients also completed disease-specific and generic patient assessed health instruments, and their spinal mobility was assessed by tape measure methods. Repeatability over 2 weeks was assessed using intraclass correlation coefficients (ICC). Fastrak measurements were compared between patients with different self-ratings of AS related health. Comparisons between the Fastrak measurements and patient assessed health instruments and tape measurements were made using Spearman correlations and multilevel modeling. RESULTS: Patients with AS tended to be limited in both cervical spine and shoulder movements. ICC were all > 0.80 (except shoulder extension, 0.75), indicating substantial reliability. Fastrak was able to differentiate between patients with a high self-rating of AS related health and those with a poorer rating. Cervical spine flexion and shoulder flexion and abduction were most strongly related to the patient assessed health instruments, although the shoulder movements had limited relationships with the tape measurements of spinal mobility. CONCLUSION: The Fastrak appears to be reliable and valid in an AS population. Shoulder movements tended to have a stronger relationship with the patient assessed health instruments than cervical spine movements. Shoulder movement may be more related to everyday function measured by these instruments, which indicates the importance of this joint in assessment of AS.

Adult↗