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Biomedical subjects

Jon G Divine

Publications and source records attributed to Jon G Divine.

4 recordsLinked to original sources
PubMed2007

Viscosupplementation for knee osteoarthritis: a systematic review.

Due to the rising number of patients affected by osteoarthritis (OA), appropriate management decisions for minimizing pain and improving physical function for patients with OA are important. Hyaluronic acid (HA) knee injections have become a common tool for the management of OA of the knee, and the number of randomized controlled trials on the efficacy and safety of this treatment is growing. We performed a systematic review of the five published meta-analyses, which include single- or double-blinded randomized trials performed at one center or multiple centers (Level I evidence). Within each meta-analysis, a quality assessment tool for each trial was used based on outcome measures of OA-related pain, disease severity, trial period, and mean efficacy. We analyzed and compared the data collection and qualitative analysis methods, outcomes, and conclusions presented for each meta-analysis. Although they used different strategies, each used scientifically sound methods for analysis of many of the same trials; however, each used a different measure of trial quality and heterogeneity. Despite these differences, all come to a similar conclusion that when the strictest quality tools and interpretation of heterogeneity are used, Level I evidence demonstrates that the use of HA in patients with OA results in modest improvement in validated outcomes.

Humans↗
PubMed2003

The incidence, risk factors, and clinical manifestations of hyponatremia in marathon runners.

OBJECTIVE: To report on the incidence, identify the risk factors, and clarify the clinical manifestations of acute hyponatremia in marathon runners. DESIGN: An observational and retrospective case-controlled series. SETTING: The medical care area of the 2000 Houston Marathon. PATIENTS: Marathon finishers treated in medical area receiving intravenous fluids (N=55), including a more detailed analysis of 39 runners completing a retrospective questionnaire. MAIN OUTCOME MEASURES: Vital signs, serum electrolytes, and finish time were analyzed via ANOVA studies between all non-hyponatremic (NH: N=34)) and hyponatremic (H: N=21)) runners. Fluid intake, training variables, NSAID use, and Symptomatology were further analyzed to delineate all significant differences between groups. RESULTS: There were no significant differences in vital signs, training variables, or NSAID use between H and NH groups, although there was a trend towards the less experienced runners presenting with lower post-race sodium levels. H runners had lower potassium [K] (p=.04), chloride [Cl] (p<.001), and blood urea nitrogen [BUN] (p=.004) levels than NH runners. There was a significant inverse linear relationship between both finish time versus [Na] (r2 =.51) and total amount of fluid ingested versus [Na] (r2 =.39). The total cups of water (p=.004), electrolyte/carbohydrate solution (p=.005) and total amount of fluid ingested (p<.001) were significantly higher in H compared to NH runners and the degree of hyponatremia was related in a dose dependent manner. Vomiting was observed more frequently in H than NH runners (p=.03). CONCLUSION: 21 runners presented to the medical area of the Houston Marathon with hyponatremia (.31% of entrants). Excessive fluid consumption and longer finishing times were the primary risk factors for developing this condition. Vomiting was the only clinical sign differentiating hyponatremia from other conditions that induce exercise-associated collapse.

Drinking Behavior↗
PubMed2002

Baseline injury risk factors for runners starting a marathon training program.

OBJECTIVE: To describe the baseline characteristics of participants starting a 25-week marathon training program, and their relationship to injury risk factors. DESIGN: Prospective survey. SETTING: Community-based marathon training program. PARTICIPANTS: 1,548 of 2,314 registrants for the Houston Fit Marathon Training Program (mean age 35.8 +/- 9.3 years, mean body mass index 24.3 +/- 3.9, 63% female). INTERVENTION: 4-page survey administered at registration. MAIN OUTCOME MEASURE: Running experience, training practices, demographics, chronic medical problems and previous injuries. RESULTS: Females were more likely to be classified as underweight and males as overweight or obese (p < 0.0001). The mean number of years of running experience was 6.2 +/- 6.2. Most (87.5%) planned to train at a 9-minute mile or slower pace. 52.3% of the participants had not previously trained for a marathon. In the 3 months prior to starting the program 16.1% had been sedentary. Those runners who had not previously completed a marathon and not previously trained with Houston Fit had a higher prevalence of baseline training techniques that could be risk factors for injury. During the previous 3 years, 38.1% reported having an injury, and 35% of all injuries were still symptomatic at the start of the program. CONCLUSIONS: Training programs for the marathon attract more female athletes and those with less running and marathon experience. The prevalence of being overweight or obese is 35.6%. 16.1% are sedentary during the 3 months before starting this program. Training programs must take measures to establish baseline fitness, to educate on injury prevention training techniques, and to set appropriate fitness goals. CLINICAL RELEVANCE: The research study shows that many patients wanting to start a marathon training program are relatively untrained and inexperienced with reference to endurance running. These patients will need special care and education so as to minimize injury and maximize the effect on their physical activity habits.

Adolescent↗