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1.
Clin Podiatr Med Surg ; 30(3): 351-95, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23827492

ABSTRACT

Hallux rigidus is defined as end-staged arthrosis of the first metatarsophalangeal joint. Although the literature supports arthrodesis as being the gold standard for the treatment of end-staged hallux rigidus, there are several other treatments available that can either prolong the life of the remaining joint or artificially mimic the original biomechanics by replacing a portion of or the entire joint with the added advantage of preserving joint mobility. There are several new and emerging joint preservative techniques that may delay or prevent the need for a joint-destructive procedure, such as arthrodesis or arthroplasty.


Subject(s)
Arthrodesis/methods , Arthroplasty/methods , Hallux Rigidus/surgery , Osteoarthritis/surgery , Osteotomy/methods , Prosthesis Design/methods , Adult , Aged , Female , Follow-Up Studies , Hallux Rigidus/pathology , Humans , Joint Prosthesis , Male , Metatarsophalangeal Joint/diagnostic imaging , Metatarsophalangeal Joint/surgery , Middle Aged , Osteoarthritis/diagnostic imaging , Osteoarthritis/physiopathology , Pain Measurement , Patient Satisfaction , Prosthesis Implantation/methods , Radiography , Range of Motion, Articular/physiology , Risk Assessment , Severity of Illness Index , Treatment Outcome
2.
Behav Brain Funct ; 8: 62, 2012 Dec 27.
Article in English | MEDLINE | ID: mdl-23270420

ABSTRACT

BACKGROUND: Neuropsychiatric symptoms such as psychosis are prevalent in patients with probable Alzheimer's disease (AD) and are associated with increased morbidity and mortality. Because these disabling symptoms are generally not well tolerated by caregivers, patients with these symptoms tend to be institutionalized earlier than patients without them. The identification of protective and risk factors for neuropsychiatric symptoms in AD would facilitate the development of more specific treatments for these symptoms and thereby decrease morbidity and mortality in AD. The E4 allele of the apolipoprotein E (APOE) gene is a well-documented risk factor for the development of AD. However, genetic association studies of the APOE 4 allele and BPS in AD have produced conflicting findings. METHODS: This study investigates the association between APOE and neuropsychiatric symptoms in a large sample of clinically well-characterized subjects with probable AD (n=790) who were systematically evaluated using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Behavioral Rating Scale for Dementia (BRSD). RESULTS: Our study found that hallucinations were significantly more likely to occur in subjects with no APOΕ4 alleles than in subjects with two Ε4 alleles (15% of subjects and 5% of subjects, respectively; p=.0066), whereas there was no association between the occurrence of delusions, aberrant motor behavior, or agitation and the number of Ε4 alleles. However, 94% of the subjects with hallucinations also had delusions (D+H). CONCLUSION: These findings suggest that in AD the Ε4 allele is differentially associated with D+H but not delusions alone. This is consistent with the hypothesis that distinct psychotic subphenotypes may be associated with the APOE allele.


Subject(s)
Alleles , Alzheimer Disease/genetics , Apolipoprotein E4/genetics , Genetic Association Studies , Phenotype , Psychotic Disorders/genetics , Aged , Aged, 80 and over , Alzheimer Disease/diagnosis , Alzheimer Disease/epidemiology , Delusions/diagnosis , Delusions/epidemiology , Delusions/genetics , Female , Genetic Association Studies/methods , Hallucinations/diagnosis , Hallucinations/epidemiology , Hallucinations/genetics , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Mental Disorders/genetics , Psychotic Disorders/diagnosis , Psychotic Disorders/epidemiology
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