The degree of radiographic abnormalities and postural instability in patients with knee osteoarthritis.

Aim: to determine the degree of radiographic abnormalities based on Kellgren-Lawrence criteria, to determine posturography features in patients with knee OA. Methods: ninety nine subjects were recruited by consecutive sampling at the outpatient clinic of Internal Medicine in Cipto Mangunkusumo Hospital. History taking and physical examination including rheumatology examination were conducted, followed by knee radiographic examination in weight bearing and 30 degree skyline position. A cross sectional design was performed to evaluate the variable results for degree of radiolographic abnormalites and posturography results. Results: the subjects were 79.8% women and 20.2% men, mostly >/= 60 year-old (78.8%), with low education 76.8%, BMI >/= 23 74.7%, mean value of active VAS was 5.4, mean value of passive VAS 2.8. Mild radiographic abnormality was found in 77.8% subjects, and the others were severe, i.e. 22.2%. There were increase in length of postural sway, increase of postural sway velocity, and increase in area of postural sway in patients with knee OA compared with normal subjects with 40-60 years old. Conclusion: there is an increase in nearly all variables of posturography in patients with knee OA.

Endotoxin in patients with terminal renal failure undergoing dialysis with re-processing dialyser.

AIM: to determine the level of endotoxin in the blood of patients with renal failure prior to and following hemodialysis using re-processing dialyser to know possibility of pyrogenic reactions in hemodialysis patients. METHODS: this study subjects consisted of 10 patients with terminal renal failure undergoing regular hemodialysis. The collected samples were then sent in frozen condition for endotoxin examination in Japan. The normal level of endotoxin in the blood was < 9.8 pg/ml based on standard E.Coli E.0111 endotoxin quantitatively measured using Limulus Amoebocyte lysate test (the endospecy test). Statistical analysis was performed using paired student test. RESULTS: Ten patients with terminal renal failure who were undergoing hemodialysis were obtained, consisting of 1 female and 9 males. The mean age was 55.5 years (SD 6.74), the mean hemoglobin level 7.26 g/dl (SD 2.19), mean white blood cell (WBC) count 8660/mm(3) (SD 3064.2), and mean albumin level 3.59 g/l (SD 247). The etiologies of renal failure were as follows: glomerulonephritis (GN) 30%, Diabetic nephropathy (DN) 20%, hypertension (HT) 10%, interstitial nephritis (IN) 10%, obstruction/infection (01) 10%, unknown (U) 10%. The mean duration of hemodialysis was 97.9 month (SD 54.86). The mean endotoxin level prior to hemodialysis (ET pre-hemodialysis) was 5.4 pg/dl (SD 8). CONCLUSION: we conclude that terminal renal patients who undergoing re-processing hemodialysis did not have endotoxemia both prior to and following hemodialysis unless if they associated with infection, or other complications.