Search PubMed⌕ Search

Biomedical subjects

Flavia Cicuttini

Publications and source records attributed to Flavia Cicuttini.

26 records · Page 2Linked to original sources
PubMed2004

Slice thickness in the assessment of medial and lateral tibial cartilage volume and accuracy for the measurement of change in a longitudinal study.

OBJECTIVE: The optimal magnetic resonance image (MRI) slice thickness required to assess cartilage volume accurately and efficiently in cross-sectional and longitudinal studies is unknown. We compared cartilage volume measured from MRI of the knees using different slice thicknesses (1.5 to 7.5 mm) and assessed longitudinal change. METHODS: A total of 123 subjects with osteoarthritis had baseline and followup MRI on their symptomatic knee at 2 years. Medial and lateral tibial cartilage volumes were calculated using increasing slice thickness by extracting each second, third, fourth, or fifth slice area to calculate total volume, which was compared to the "gold standard" volume calculated from the original 1.5 mm slices. RESULTS: There was little difference in the average medial and lateral tibial cartilage volume observed as the slice thickness increased from 1.5 to 7.5 mm; medial tibial cartilage volume ranged from 1750 microl to 1787 microl and lateral tibial cartilage volume ranged from 1949 microl to 2007 microl. There was also little absolute difference in the average change in medial and lateral tibial cartilage volume measured over 2 years. However, with increasing slice thickness, there was a decreased correlation between the tibial cartilage volume change calculated from the increased slice thickness, with the lowest correlation being 0.77 (p < 0.001) when the lateral cartilage volume calculated from the 7.5 mm slice was compared to the 1.5 mm slices. CONCLUSION: Increasing slice thickness may provide sufficiently accurate measurement of tibial cartilage volume and change over time in some studies. This would result in reduction in MRI scanning and postimaging processing time, which has the potential of increasing the feasibility of this technique.

Aged↗
PubMed2003

Knee articular cartilage development in children: a longitudinal study of the effect of sex, growth, body composition, and physical activity.

The aim of this study was to describe the effect of sex, growth, Tanner stage, and physical activity on knee articular cartilage volume development. A total of 74 randomly selected male and female children aged 9-18 y were measured on two occasions at an average interval of 1.6 y (range 1.3-1.9). Articular cartilage volume was determined at the patella, medial tibial, and lateral tibial compartments by processing images acquired in the sagittal plane using T1-weighted fat saturation magnetic resonance. Height, weight, and BMI were measured while Tanner stage and physical activity were assessed by questionnaire. Articular cartilage volume increased at all sites peaking in Tanner stage two. Males gained articular cartilage faster than females at all sites (patella +233 microL/y, 95% CI -7, +473, medial tibial +350 microL/y, 95% CI +118, +582, lateral tibial +256 microL/y, 95% CI +22, +488). In both sexes, articular cartilage volume accrual at tibial but not patella sites correlated significantly with height change but not weight change. Overweight children did not differ significantly from normal children in articular cartilage volume either cross-sectionally or longitudinally. The most consistent physical activity association was with average intensity of sport with those above the median gaining approximately twice as much as those below the median at tibial (p < 0.05) but not patella sites. In conclusion, most children gain articular cartilage during growth, but there is wide variation in the amount of articular cartilage accrual. In particular, younger children, males, and those undertaking more vigorous sports have substantially higher accrual rates. These results provide novel data on articular cartilage development in humans. The long-term significance of these results with regard to osteoarthritis of the knee in later life remains hypothetical.

Adolescent↗
PubMed2003

The Victorian ambulatory care sensitive conditions study: rural and urban perspectives.

OBJECTIVES: Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable with the application of preventive care and early disease management, usually delivered in the ambulatory setting. This study presents detailed analyses of ACSCs as a measure of health outcome that might vary with access to primary health care in rural and urban regions of Victoria. METHOD: The Victorian Admitted Episodes Dataset (VAED), and data from the Health Insurance Commission, Medical Labour Force Annual Survey, socio-economic indexes for areas, and accessibility/remoteness index of Australia were merged to identify individual and aggregate level predictors of urban/rural differentials of ACSCs. Estimates of odds ratios and 95% confidence intervals were based on random effect multi-level generalised linear models. RESULTS: After adjustment for age, sex, and severity of illness, significant predictors of higher admission rates of ACSCs within rural areas include lack of insurance, emergency admissions, higher degree of remoteness, lower population density, lower number of general practitioners/10,000 population by local government area (LGA), lower number of general practitioner visits per person by LGA, and areas with lower socio-economic status, education and occupation, and economic resources. CONCLUSIONS: This study suggests that lack of timely and effective care may have a significant impact on rates of admissions for ACSCs in rural areas of Victoria especially in lower socio-economic groups.

Adolescent↗
PubMed2003

Congestive cardiac failure: urban and rural perspectives in Victoria.

OBJECTIVE: Effective and timely care for congestive cardiac failure (CCF) should reduce the risks of hospitalisation. The purpose of this study is to describe variations in rates of hospital admissions for CCF in Victoria as an indicator of the adequacy of primary care services. Detailed analyses identify trends in hospitalisations, urban/rural differentials and variations by the Primary Care Partnerships (PCP). SETTING: Acute care hospitals in Victoria. DESIGN: Routine analyses of age and sex standardised admission rates of CCF in Victoria using the Victorian Admitted Episodes Dataset from 1993-1994 to 2000-2001. SUBJECTS: All patients admitted to acute care hospitals in Victoria with the principal diagnosis of CCF between 1993-1994 and 2000-2001. RESULTS: There were 8359 admissions for CCF in Victoria with an average of 7.37 bed days in 2000-2001. There was a significantly higher admission rate for CCF in rural areas compared to metropolitan in 2000/200--(2.53/1000 (2.44-2.62) and 1.80/1000 (1.75-1.85))--respectively. Small area analyses identified 17 PCP (14 of which were rural) with significantly higher admission rate ratios of CCF compared to Victoria. CONCLUSION: Small area analyses of CCF have identified significant gaps in the management of CCF in the community. This may be a reflection of deficit in primary care availability, accessibility, or appropriateness. Detailed studies may be needed to determine the relative importance of these factors in Victoria for targeting specific interventions at the PCP level.

Age Distribution↗
PubMed2003

Licofelone (Merckle).

EuroAlliance (a consortium of Alfa Wassermann SpA, Lacer SA and Merckle GmbH) is developing licofelone, a dual cyclooxygenase and 5-lipoxygenase inhibitor for the potential treatment of inflammatory disorders including osteoarthritis.

Acetates↗
PubMed2002

The Victorian Ambulatory Care Sensitive Conditions study: reducing demand on hospital services in Victoria.

Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable if preventive care and early disease management are applied, usually in the ambulatory setting. The Victorian ACSCs study offers a new set of indicators describing differentials and inequalities in access to the primary healthcare system in Victoria. The study used the Victorian Admitted Episodes Dataset (1999-2000) for analysing hospital admissions for diabetes complications, asthma, vaccine preventable influenza and pneumococcal pneumonia. The analyses were performed at the level of Primary Care Partnerships (PCPs). There were 12,100 admissions for diabetes complications in Victoria. There was a 12-fold variation in admission rates for diabetes complications across PCPs, with 13 PCPs having significantly higher rates than the Victorian average, accounting for just over half of all admissions (6114) and 39 per cent total bed days. Similar variations in admission rates across PCPs were observed for asthma, influenza and pneumococcal pneumonia. This analysis, with its acknowledged limitations, has shown the potential for using these indicators as a planning tool for identifying opportunities for targeted public health and health services interventions in reducing demand on hospital services in Victoria.

Ambulatory Care↗
PubMed2002

The determinants of change in patella cartilage volume in osteoarthritic knees.

OBJECTIVE: The rate of change in patella articular cartilage and factors influencing it, in subjects with osteoarthritis (OA), is unknown. We performed a cohort study to determine this. METHODS: One hundred ten subjects with OA had baseline skyline and lateral radiographs and magnetic resonance imaging (MRI) on their knee. They were followed 2 years later with a repeat MRI of the same knee. Patella and tibial cartilage volume was measured at baseline and followup. Risk factors assessed at baseline were tested for their association with change in patella cartilage volume over time. RESULTS: The annual percentage loss of patella cartilage was 4.5 +/- 4.3%. Sex, body mass index (BMI), and pain score at baseline were associated with an increase in cartilage loss. The rate of patella cartilage loss was greater in women than men, 5.3% versus 3.5% (p < 0.03), independent of age, BMI, and pain score. No association was seen between change in patellar cartilage volume and change in either medial or lateral tibial cartilage volume (r = 0.02, p = 0.86 and r = 0.08, p = 0.43, respectively). CONCLUSION: In OA, patella cartilage volume is lost at 4.5 +/- 4.3% per year. The main factors affecting this are sex, BMI, and baseline pain score. The poor correlation between patella cartilage loss and cartilage loss in the tibial compartment suggests that the pathogenetic mechanisms for OA in the patellofemoral and tibiofemoral joint may differ. Further work will be required to determine whether the rate of patella cartilage loss in OA is steady or phasic, and to determine which factors can be modified to reduce cartilage loss.

Arthrography↗