Arthroscopic lavage of osteoarthritic knees.
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Arthroscopy↗
Biomedical subjects
R W Ike
Publications and source records attributed to R W Ike.
Tidal irrigation versus conservative medical management in patients with osteoarthritis of the knee: a prospective randomized study. Tidal Irrigation Cooperating Group.
To determine the efficacy of tidal knee irrigation for knee pain due to osteoarthritis (OA), we conducted a randomized, single blind, 14-week prospective trial comparing medical management with tidal knee irrigation in 77 patients with non-end stage OA of the knee and unilateral pain refractory to standard medical treatment. Fifty-seven patients completed the study. Statistically significant differences (p less than 0.05) favoring tidal knee irrigation over medical management were pain after 50' walk, pain after 4-stair climb, most intense pain in previous day, frequency of knee stiffness with inactivity, days of morning knee stiffness in previous week, physician assessment of knee tenderness and overall assessments of therapy effectiveness by both patient and physician. Tidal knee irrigation results in more favorable improvement of pain due to OA than can be accomplished with traditional medical management.
Aged↗
Risk factors for disability among U.S. adults with arthritis.
This article studies risk factors for physical and social disability among U.S. adults ages 55+ who have arthritis, compared to non-arthritis persons of those ages. The dependent variables refer to difficulties in walking, physical functioning (motions and strength), personal care, and household care. The data set is the Supplement on Aging (SOA) (n = 16,148) that accompanied the 1984 National Health Interview Survey. The SOA data are cross-sectional; relationships of risk factors to disability suggest causation but do not directly demonstrate it. Logistic regressions show that risk factors are similar for arthritis and non-arthritis people, with one important exception. (1) The similarities are: For both groups, odds of disability rise with age, diminish with education, and are higher for non-whites and non-married persons. Disability rises with number of chronic diseases and impairments, and it is elevated for underweight persons (Body Mass Index (BMI) less than 20; further analysis indicates this reflects incomplete control of their severe illness status). Long duration of arthritis and recent medical care for it are associated with disability. (2) The exception is: Severe overweight (BMI greater than or equal to 30) is a disability risk factor for arthritis people, but not for non-arthritis people. Previous research has shown that obesity/overweight is a risk factor for etiology of osteoarthritis; our analysis now shows its continued importance for disability when the disease is present.
Activities of Daily Living↗
Comparing information-gathering strategies of medical students and physicians in diagnosing simulated medical cases.
Using a broad range of written patient management problems (PMPs), this study examined (1) how each of three medical information-gathering processes (history-taking, physical examination, and diagnostic studies) influenced 175 second-year medical students' formulations of the differential (i.e., plausible) and the principal (i.e., most probable) diagnoses for each of 14 PMPs, and (2) the extent to which these results paralleled the emphases that experienced clinicians placed on these same information-gathering processes regarding each of the same PMPs. The results suggest that in ten of the 14 PMPs the students appeared to rely on specific information-gathering strategies in formulating their diagnoses, and that both similarities and differences existed between the levels of emphasis placed by the students and physicians on each of the three processes. In general, the physicians placed greater emphasis on the importance of the history, whereas the students relied more on diagnostic studies. These variations have implications for selecting medical problems for purposes of instruction and evaluation of students.
Diagnostic Techniques and Procedures↗
Osteoarthritis: definitions and criteria.
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Humans↗
Septic arthritis due to group C streptococcus: report and review of the literature.
A case of polyarticular septic arthritis due to Lancefield group C streptococcus is described and the clinical details of 9 reported cases of septic arthritis due to group C streptococcus reviewed. Several features of the presentation and course of these patients, including polyarticular involvement (4/10), bacteremia (5/10), clinically important dysfunction in other systems (4/10 patients: cardiac, 3; CNS, 2; pneumonia, 1; gastrointestinal, 1), fatal outcome (3/10 patients, 2 during the course of active infection) and poor functional outcome in affected joints (4/7 surviving patients), serve to place group C streptococcus septic arthritis as a syndrome distinct from that usually expected with streptococcal septic arthritis. Specific features of the bacteriology of group C streptococcus are reviewed (including confusion with group A streptococcus when analyzed using nonserologic methods, occasional zoonotic source, and frequency of tolerance to penicillin) in order to emphasize the importance of both the specific identification of this particular streptococcal strain and the initiation of aggressive antibiotic therapy when group C streptococcus is identified as the causative agent in a case of septic arthritis.
Aged↗
Bronchiolitis obliterans organizing pneumonia and Sjögren's syndrome.
A 52-year-old man developed a systemic illness with fever, malaise, cough, dry eyes and mouth. Investigation revealed bronchiolitis obliterans organizing pneumonia associated with retinal vasculitis, hepatic and renal involvement, lymphocytic sialoadenitis and symptoms of the sicca complex. High dose steroid treatment resulted in resolution of his symptoms and prolonged remission.
Bronchiolitis Obliterans↗
Case differences in the problem solving strategies of medical students and physicians.
Using a broad range of written patient management problems, this study examined 1) the influences of three medical information-gathering processes (history-taking, physical examination, and diagnostic studies) on the formulation of the differential and principal diagnosis by 175 medical students and 2) the extent to which the information-gathering processes used by the students paralleled the emphasis that experienced clinicians placed on these same processes. Results suggested that in 11 of 14 cases, the students appeared to be relying on specific information-gathering strategies in the formulation of the differential diagnosis, and that there were both similarities and differences in the relative emphases that these processes received from students and physicians.
Clinical Competence↗
Group G streptococcal arthritis and bowel disease: a rare enteropathic arthropathy.
Group G streptococci may be seen as normal flora in many parts of the body, including the gastrointestinal tract. They are rarely pathogens in humans, but they have been isolated from septic joints in debilitated patients. Three patients with group G streptococcal arthritis were further evaluated using contrast studies of the colon. Abnormalities, including an occult carcinoma and a colocutaneous fistula, were found. We conclude that group G streptococcal arthritis may be associated with gastrointestinal abnormalities that allow a portal of entry for an otherwise innocuous organism, and that this represents a rare enteropathic arthropathy.
Adult↗
Scleromyxedema with systemic involvement mimics rheumatic diseases.
Scleromyxedema is an infiltrative skin disease produced by hyaluronic acid deposition in the dermis. A benign monoclonal gammopathy is usually present. We report 2 patients with scleromyxedema and systemic illnesses. Both patients had muscle weakness, dysphagia, and weight loss in addition to the skin changes. One also had sclerodactyly, telangiectasias, and Raynaud's phenomenon. Scleromyxedema with systemic involvement may mimic rheumatic diseases.
Adult↗