Recommendations for the use of ultrasound in rheumatoid arthritis: literature review and SONAR score experience.

Ultrasound (US) has become a useful tool in the detection of early disease, differential diagnosis, guidance of treatment decisions and treatment monitoring of rheumatoid arthritis (RA). In 2008, the Swiss Sonography in Arthritis and Rheumatism (SONAR) group was established to promote the use of US in inflammatory arthritis in clinical practice. A scoring system was developed and taught to a large number of Swiss rheumatologists who already contributed to the Swiss Clinical Quality Management (SCQM) database, a national patient register. This paper intends to give a Swiss consensus about best clinical practice recommendations for the use of US in RA on the basis of the current literature knowledge and experience with the Swiss SONAR score. Literature research was performed to collect data on current evidence. The results were discussed among specialists of the Swiss university centres and private practice, following a structured procedure. Musculoskelatal US was found to be very helpful in establishing the diagnosis and monitoring the evolution of RA, and to be a reliable tool if used by experienced examiners. It influences treatment decisions such as continuing, intensifying or stepping down therapy. The definite modalities of integrating US into the diagnosis and monitoring of RA treatments will be defined within a few years. There are, however, strong arguments to use US findings as of today in daily clinical care. Some practical recommendations about the use of US in RA, focusing on the diagnosis and the use of the SONAR score, are proposed.

Supervised injection services : what has been demonstrated? A systematic literature review

BACKGROUND: Supervised injection services (SISs) have been developed to promote safer drug injection practices, enhance health-related behaviors among people who inject drugs (PWID), and connect PWID with external health and social services. Nevertheless, SISs have also been accused of fostering drug use and drug trafficking. AIMS: To systematically collect and synthesize the currently available evidence regarding SIS-induced benefits and harm. METHODS: A systematic review was performed via the PubMed, Web of Science, and ScienceDirect databases using the keyword algorithm [("supervised" or "safer") and ("injection" or "injecting" or "shooting" or "consumption") and ("facility" or "facilities" or "room" or "gallery" or "centre" or "site")]. RESULTS: Seventy-five relevant articles were found. All studies converged to find that SISs were efficacious in attracting the most marginalized PWID, promoting safer injection conditions, enhancing access to primary health care, and reducing the overdose frequency. SISs were not found to increase drug injecting, drug trafficking or crime in the surrounding environments. SISs were found to be associated with reduced levels of public drug injections and dropped syringes. Of the articles, 85% originated from Vancouver or Sydney. CONCLUSION: SISs have largely fulfilled their initial objectives without enhancing drug use or drug trafficking. Almost all of the studies found in this review were performed in Canada or Australia, whereas the majority of SISs are located in Europe. The implementation of new SISs in places with high rates of injection drug use and associated harms appears to be supported by evidence.

Response of Iowa Pavements to a Tracked Agricultural Vehicle, HR-1075, Phase II, 2000

The overall objective of the work summarized in this report and in the interim report was to study the effects of targeted implement-of-husbandry loads. This report is to complement phase I of this work, which was summarized in the interim report, entitled Response of Iowa Pavements to Heavy Agricultural Loads (December 1999). The response of newly constructed Portland cement concrete (PCC) and asphalt cement concrete (ACC) pavements under semitruck, single-axle single-tire grain wagon, single-axle dual-tire grain wagon, tandem and tridem tank wagons were summarized in the interim report. Phase II of this project, presented herein, was to complete the study in terms of how tracked agricultural vehicles relate to the reference 20,000-pound single-axle semi-truck. In this report the response of these two pavements under a tracked grain wagon is documented.

Response of Iowa Pavements to Heavy Agricultural Loads, HR-1075, 1999

Iowa's county road system includes several thousands of miles of paved roads which consist of Portland cement concrete (PCC) surfaces, asphalt cement concrete (ACC) surfaces, and combinations of thin surface treatments such as seal coats and slurries. These pavements are relatively thin pavements when compared to the state road system and therefore are more susceptible to damage from heavy loads for which they were not designed. As the size of the average farm in Iowa has increased, so have the size and weights of implements of husbandry. These implements typically have fewer axles than a truck hauling the same weight would be required to have; in other words, some farm implements have significantly higher axle weights than would be legal for semi-trailers. Since stresses induced in pavements are related to a vehicle's axle weight, concerns have been raised among county and state engineers regarding the possible damage to roadway surfaces that could result from some of these large implements of husbandry. Implements of husbandry on Iowa's highway system have traditionally not been required to comply with posted weight embargo on bridges or with regulations regarding axle-weight limitations on roadways. In 1999, with House File 651, the Iowa General Assembly initiated a phased program of weight restrictions for implements of husbandry. To help county and state engineers and the Iowa legislature understand the effects of implements of husbandry on Iowa's county roads, the following study was conducted. The study investigated the effects of variously configured grain carts, tank wagons, and fence-line feeders on Iowa's roadways, as well as the possible mitigating effects of flotation tires and tracks on the transfer of axle weights to the roadway. The study was accomplished by conducting limited experimental and analytical research under static loading conditions

Low-Cost Rural Surface Alternatives: Literature Review and Recommendations, TR-632, 2013

Freezing and thawing action induces damage to unbound gravel roads in Iowa resulting in maintenance costs for secondary road departments. Some approaches currently used by County Engineers to deal with this problem include temporarily spreading rock on the affected areas, lowering or improving drainage ditches, tiling, bridging the area with stone and geosynthetic covered by a top course of aggregate or gravel, coring boreholes and filling them with calcium chloride to melt lenses and provide drainage, and re-grading the crown to a slope of 4% to 6% to maximize spring drainage. However, most of these maintenance solutions are aimed at dealing with conditions after they occur. This study was tasked with identifying alternative approaches in the literature to mitigate the problem. An annotated bibliographic record of literature on the topic of frost-heave and thaw-weakening of gravel roads was generated and organized by topic, and all documents were assessed in terms of a suitable rating for mitigating the problem in Iowa. Over 300 technical articles were collected and selected down to about 150 relevant articles for a full assessment. The documents collected have been organized in an electronic database, which can be used as a tool by practitioners to search for information regarding the various repair and mitigation solutions, measurement technologies, and experiences that have been documented by selected domestic and international researchers and practitioners. Out of the 150+ articles, 71 articles were ranked as highly applicable to conditions in Iowa. The primary mitigation methods identified in this study included chemical and mechanical stabilization; scarification, blending, and recompaction; removal and replacement; separation, and reinforcement; geogrids and cellular confinement; drainage control and capillary barriers, and use of alternative materials. It is recommended that demonstration research projects be established to examine a range of construction methods and materials for treating granular surfaced roadways to mitigate frost-heave and thaw-weakening problems. Preliminary frost-susceptibility test results from ASTM D5916 are included for a range of Iowa materials.

Interactive readings of children's literature in day care: Microgenetic analysis of the semiopictorial construction.

In line with educational issues involved in emergent literacy practices in preschool, in particular those concerning comprehension processes, this paper focuses on picture-based narrative comprehension during an interactive reading session of a wordless picture book, involving a group of children aged three and their teacher. Children are asked to make inferences about the meaning and outcome of the story, a procedure which gradually elicits their responses on how events link together, thus enhancing their capacity to use prior and implicit knowledge to build the story meaning. Moreover, this study highlights the importance of interaction for developing comprehension. Data collected was analysed following didactic microgenesis, an analytical approach showing that knowledge built during interaction depends on the joint construction of a zone of common meaning by which teacher and children try to adjust to each other. In order to help the process of merging different meanings of the story built online, a text written by researchers, following the narrative structure of the story, was read by the teacher after the picture-based reading. This led us to examine through interactional analysis which semiotic cues were used during recall on the following day, as an additional measure of knowledge construction.

Anterior subluxation after reduction of a posterior traumatic sterno-clavicular dislocation: a case report and a review of the literature.

Sternoclavicular dislocations represent a rare injury. Based on our clinical experience with a patient showing an anterior subluxation after reduction of a posterior traumatic dislocation, we review the literature. The emergent reduction of the dislocation is mandatory, always keeping in mind the potentially devastating neurovascular complications. If the treatment of a residual anterior instability remains controversial, a residual posterior instability should be treated by a surgical procedure. The optimal treatment depends mainly on each surgeon's choice and practice.

Two Cases of Interferon-Alpha-Induced Sarcoidosis Koebnerized along Venous Drainage Lines: New Pathogenic Insights and Review of the Literature of Interferon-Induced Sarcoidosis.

Sarcoidosis is a systemic granulomatous disorder of unknown origin commonly affecting the lung, the lymphoid system and the skin. We report here two cases of cutaneous sarcoidosis in two former intravenous drug users following interferon (IFN)-α and ribavirin therapy for chronic hepatitis C. Both patients developed skin sarcoidosis along venous drainage lines of both forearms, coinciding with the areas of prior drug injections. The unique distribution of the skin lesions suggests that tissue damage induced by repeated percutaneous drug injections represents a trigger for the local skin manifestation of sarcoidosis. Interestingly, skin damage was recently found to induce the local expression IFN-α, a well-known trigger of sarcoidosis in predisposed individuals. Here we review the literature on sarcoidosis elicited in the context of IFN-α therapy and propose a new link between the endogenous expression of IFN-α and the induction of disease manifestations in injured skin. © 2013 S. Karger AG, Basel.

Nonunion after fracture of the anterior tibial spine: case report and review of the literature.

Nonunion of anterior tibial spine of tibia in children is quite rare, but it could be associated with significant instability of the knee as it involves the fixation of anterior cruciate ligament. We report one case in which open reduction and internal fixation was carried out with good functional results. A literature review was performed to identify the cases reported of tibial eminence nonunion in children.

Soils in an agricultural landscape of Jokioinen, south-western Finland

Selostus: Jokioisten seudun maannokset

Enhanced degradation of metalaxyl in agricultural soils of São Paulo State, Brazil

This work investigated the effect of repeated applications on enhanced degradation of metalaxyl in two different agricultural soils used for cultivation of orange and lemon from Casa Branca and Itapetininga districts of São Paulo State, Brazil. Soil samples were collected from areas repeatedly treated with commercial ridomil 50GR for six successive years, and from other areas never exposed to this fungicide. At the laboratory, soil samples received a 14C-metalaxyl solution and its degradation was studied through radiometric techniques to measure biomineralization and recovery of extractable- and soil-bound products. Enhanced degradation was verified only in one soil, although partial degradation and mineralization of the fungicide were detected in both soils. The different rates and patterns of metalaxyl degradation in the soils were probably due to their different physical, chemical, and biological characteristics.