Correlation of clinical examination,ultrasound sonography,and magnetic resonance imaging findings with arthroscopic findings in relation to acute and chronic lateral meniscus injuries

Purpose

The aim of this study was to evaluate whether ultrasound sonography (USS) performed by orthopedic surgeons is a reliable method of investigating lateral meniscus (LM) knee lesions as compared to magnetic resonance imaging (MRI), and arthroscopy, which is the gold standard in clinical practice.

Methods

In total, 107 patients were involved in this study. They were hospitalized for arthroscopy due to LM injury of the knee. Clinical examination (McMurray’s, Apley’s, and joint line tenderness tests), USS, and MRI were performed prior to arthroscopy. We compared the results of clinical examination, USS, and MRI with the arthroscopic findings for the knee, which were considered the reference values.

Results

McMurray’s clinical test, which is the most sensitive method of detecting lateral meniscus lesions, gave the same sensitivity rate for both acute and chronic LM injuries: 65 %. USS was observed to be more sensitive and specific for chronic LM injuries (85 and 90 %, respectively) than for acute LM injuries (71 and 87 %). MRI also yielded higher values of sensitivity and specificity for chronic lateral meniscus injuries (75 and 95 %, respectively) than for acute LM injuries (68 and 87 %).

Conclusions

The accuracy of ultrasound examination is demonstrated by the high reliability of this method in the diagnosis of lateral meniscus lesions of the knee, and the evaluation performed in this study showed that ultrasound is a useful clinical tool for diagnosing knee pathology.     

Managing the possible health risks of mobile telecommunications: Public understandings of precautionary action and advice

It has been suggested that precautionary approaches to managing the possible health risks of mobile telecommunications (MT) technology may cause or exacerbate public concerns. In contrast, precautionary approaches to managing such risks in the UK have been framed as a way of reducing public concerns. This article presents evidence from a series of focus groups about the understanding of the general public of the actions taken and advice given about potential MT health risks by the UK government. Eight focus groups were conducted with members of the public that varied in their age, their awareness and concern about mast siting, and their self-reported level of mobile phone use. From the analyses, a complex picture emerged in which the understanding of the general public was not primarily framed in terms of precautionary action and advice either provoking concern or providing reassurance. People made sense of precaution by drawing upon a range of evidence from their understanding of the costs and benefits of the technology, as well as the institutional context in which MT health risks were managed. For some of those involved in protesting against mast siting, precaution was seen as confirming existing concern. Further systematic exploration of the contexts within which different responses to precaution emerge is thus likely to be instructive.     

Changes in cortical inhibition during task-specific contractions in primary writing tremor patients.

Primary writing tremor (PWT) is a rare disease of unknown pathophysiology. We studied changes in silent period (SP) duration, after transcranial magnetic stimulation (TMS), set at 20% above the motor threshold in 6 PWT patients and 7 healthy control subjects. SP duration was tested during a task-specific act, i.e., writing that induced tremor in all patients in the affected hand (Wr); nonspecific voluntary contraction of intensity, matching that developed during writing (VCWr); and during near maximal voluntary contraction (VCNmax). There were no differences in SP duration during Wr and VCWr contraction on the right affected side or between sides in both PWT patients and control subjects, nor between the groups. However, during VCNmax, SP significantly shortened on both sides in PWT patients, whereas there were no changes in control subjects. Although it appears that inhibitory mechanism are not directly involved in the generation of the tremulous activity, the shortening of SP indicates that central inhibitory mechanisms are affected in PWT patients. Therefore, whereas the underlying pathophysiological mechanisms in PWT and writer's cramp may share common features, the results indicate that PWT is not a variant of focal task-specific dystonia but rather a separate nosological entity.     

A review of consumer awareness, understanding and use of food-based dietary guidelines

Food-based dietary guidelines (FBDG) have primarily been designed for the consumer to encourage healthy, habitual food choices, decrease chronic disease risk and improve public health. However, minimal research has been conducted to evaluate whether FBDG are utilised by the public. The present review used a framework of three concepts, awareness, understanding and use, to summarise consumer evidence related to national FBDG and food guides. Searches of nine electronic databases, reference lists and Internet grey literature elicited 939 articles. Predetermined exclusion criteria selected twenty-eight studies for review. These consisted of qualitative, quantitative and mixed study designs, non-clinical participants, related to official FBDG for the general public, and involved measures of consumer awareness, understanding or use of FBDG. The three concepts of awareness, understanding and use were often discussed interchangeably. Nevertheless, a greater amount of evidence for consumer awareness and understanding was reported than consumer use of FBDG. The twenty-eight studies varied in terms of aim, design and method. Study quality also varied with raw qualitative data, and quantitative method details were often omitted. Thus, the reliability and validity of these review findings may be limited. Further research is required to evaluate the efficacy of FBDG as a public health promotion tool. If the purpose of FBDG is to evoke consumer behaviour change, then the framework of consumer awareness, understanding and use of FBDG may be useful to categorise consumer behaviour studies and complement the dietary survey and health outcome data in the process of FBDG evaluation and revision.     

Muscle strength testing: evaluation of tests of explosive force production

The purpose of the study was to evaluate four tests of explosive force production (EFP). Specifically, the main aims of the study were to assess the reliability of different EFP tests, to examine their relationship with maximum muscle strength, and to explore the relationship between EFP tests and functional movement performance. After an extensive preliminary familiarization with the tasks, subjects (n=26) were tested on maximum explosive strength of the elbow extensor and flexor muscle, as well as on rapid elbow extension and flexion movements performed in both an oscillatory and a discrete fashion. In addition to maximum force (F _max), four different EFP tests were assessed from the recorded force–time curves: the time interval elapsed between achieving 30% and 70% of F _max (F _30–70%), the maximum rate of force development (RFD), the same value normalized with respect to F _max (RFD/F _max), and the force exerted 100 ms after the contraction initiation (F _{100 ms}). Excluding F _30--70%, all remaining EFP tests revealed either good or fair reliability (intraclass correlation coefficients being within 0.8–1 and 0.6–0.8 intervals, respectively) which was also comparable with the reliability of F _max. RFD and F _{100 ms} demonstrated a positive relationship with F _max, but not T _30–70% and RFD/F _max. Stronger elbow flexor muscles also demonstrated higher values of RFD and F _{100 ms} than weaker elbow extensor muscles, while no difference was observed between either T _30–70% or RFD/F _max recorded from two muscles. Despite the simplicity of the tested movement tasks, the relationship observed between the EFP tests and the peak movement velocity remained moderate and partly insignificant. It was concluded that most of the EFP tests could be reliable for assessing neuromuscular function in their muscle-force- (or, indirectly, muscle size) dependent (such as RFD and F _{100 ms}), or muscle-force-independent (T _30–70% and RFD/ F_max) forms. However, their external validity when applied to assess the ability to perform rapid movements could be questioned.     

Changing micronutrient intake through (voluntary) behaviour change. The case of folate

The objective of this study was to relate behaviour change mechanisms to nutritionally relevant behaviour and demonstrate how the different mechanisms can affect attempts to change these behaviours. Folate was used as an example to illuminate the possibilities and challenges in inducing behaviour change. The behaviours affecting folate intake were recognised and categorised. Behaviour change mechanisms from "rational model of man", behavioural economics, health psychology and social psychology were identified and aligned against folate-related behaviours. The folate example demonstrated the complexity of mechanisms influencing possible behavioural changes, even though this only targets the intake of a single micronutrient. When considering possible options to promote folate intake, the feasibility of producing the desired outcome should be related to the mechanisms of required changes in behaviour and the possible alternatives that require no or only minor changes in behaviour. Dissecting the theories provides new approaches to food-related behaviour that will aid the development of batteries of policy options when targeting nutritional problems.