[Phytothermotherapy with fermenting alpine grass in knee osteoarthritis: mid-long term results]. / Fitobalneoterapia con bagni nell'erba di montagna in fermentazione nella gonartrosi: risultati a medio-lungo termine.

This is an observational study of the mid-long-term results of a single course of phytothermotherapy with grass baths (group A, 54 patients), of a course of usual medical care (group B, 58 patients) and of a course of physiokinesistherapy (FKT, group C, 30 patients) in knee osteoarthritis. For each group of consecutively treated patients we evaluated the Lequesne algo-functional Index, the drug consumption, the frequency of the patient-physician contacts and laboratory or radiological examinations after 10-15 days of treatment and at 3, 6, 9 and 12 months with blind telephonic follow-up. The mean Lequesne-score at basal time was 7.5+/-3.3, 11.9+/-5.3 and 11.0+/-2.7 in group A, B and C respectively. In each group this score diminished at the end of the treatment (p<0.001). At 3, 6, 9 and 12 months the score remained lower than at basal time in group A (p<0.001) and group B (p<0.01), but not in group C. Drug consumption, patient-physician contacts and lab examinations were 5 times lower in group A than in group B and group C at basal time and throughout the follow-up. The study underlines the mid-long term efficacy of grass baths on both pain and functionality in knee osteoarthritis; this effect, compared to basal values, was even more evident at 3 and 6 months than that of usual medical care. FKT shows improvement only at the end of the treatment, but not long-lastingly.

The direct and indirect costs of the chronic management of osteoporosis: a prospective follow-up of 3440 active subjects.

INTRODUCTION: The objective of this study was to estimate the direct and indirect costs attributable to osteoporosis (OP) from a societal and a payer's perspective among active subjects living in Belgium and employed in the public workforce. MATERIALS AND METHODS: A cohort of 3440 subjects employed by the Liege City Council was followed for 6 months. The City Council employees were invited to fill a monthly log of the data related to their utilization of health resources (contacts with health professionals, medical examinations, drug use,...) due to OP. Information on work disability (number of days of sick leave) and on informal care (number of days off work incurred by active subjects in helping relatives or friends suffering from OP) was also collected. RESULTS: Of those asked to participate in the study, 1,811 subjects filled in at least one questionnaire. The mean duration of follow-up was 3.46 months. Self-reported prevalence of OP at inclusion was 5.3%. OP subjects were significantly older (52.7+/-6.1 years) than normal subjects (45.5+/-9.8 years) (p<0.05) and included more women (85.3 vs. 55.9%). Direct costs came to 44.6 euros per OP patient-month: 10.9 euros was spent on contact with health professionals, 19.0 euros on medical examinations, 12.1 euros on drugs and 2.6 euros on hospitalizations. During this 6-month study, a total of 140 days of sick leave was recorded (mean: 0.4 per OP patient-month). From a payer's perspective, this loss in productivity yielded a mean cost of 34.05 euros per OP patient-month. A mean number of days off work of 0.018 per active subject-month, attributable to informal care, was recorded. These days of inactivity represented, for the employer, a mean cost of 1.8 euros per active subject-month. CONCLUSION: The results of this survey of a large sample of active subjects confirm that OP-related expenditures, both for medical care and for loss of productivity, are significant.

[The detectability of osteoarticular lesions of the extremities on the television monitor]. / Riconoscibilità delle lesioni osteoarticolari delle estremità al monitor televisivo.

The diagnostic accuracy of the light-box reading of conventional (film screen) radiographs of the extremities was compared with that of the same set of images displayed on a 1 k x 1 k interactive monitor after laser digitization. 389 alterations (23 nondisplaced fractures, 129 soft-tissue calcifications and 237 articular bone erosions), identified by two experienced radiologists on 66 conventional radiographs, were the reference standard. ROC statistical analysis was performed on 1,556 observations expressed by four readers. The overall diagnostic performance of the two display modalities were substantially equivalent: no statistically significant differences resulted on the whole, but two individual readers performed better with conventional images. No overall nor individual statistically significant difference was reobserved for the subset of articular erosions either. Light-box reading of conventional radiographs allowed a higher number of calcifications in the soft-tissues and of proximal (carpal) abnormalities to be detected. Although our results indicate the overall high fidelity of monitor-displayed laser-digitized images, major improvements in the performance of digital diagnostic workstations are still required before adopting monitors for routine radiologic activity.