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State-of-the-Art management of knee osteoarthritis

World journal of Clinical Cases 2015年第2期3卷 89-101页

作者： Kenton H Fibel howa.d j hillstrom Brian C Halpern department of Medicine Primary Care Sports MedicineHospital for Special Surgery Leon Root Motion Analysis Laboratory Department of RehabilitationHospital for Special Surgery

Osteoarthritis(OA) is the most common type of arthritis found in the United States' population and is also the most common disease of joints in adults throughout the world with the knee being the most frequently affected of all joints. As the United States' population ages along with the increasing trends in obesity prevalence in other parts of the world, it is expected that the burden of OA on the population, healthcare system, and overall economy will continue to increase in the future without making major improvements in managing knee OA. Numerous therapies aim to reduce symptoms of knee OA and continued research has helped to further understand the complex pathophysiology of its disease mechanism attempting to uncover new potential targets for the treatment of OA. This review article seeks to evaluate the current practices for managing knee OA and discusses emerging therapies on the horizon. These practices include non-pharmacological treatments such as providing patient education and self-management strategies, advising weight loss, strengthening programs, and addressing biomechanical issues with bracing or foot orthoses. Oral analgesics and anti-inflammatories are pharmacologicals that are commonly used and the literature overall supports that some of these medications can be helpful for managing knee OA in the short-term but are less effective for long-term management. Additionally, more prolonged use significantly increases the risk of serious associated side effects that are not too uncommon. diseasemodifying osteoarthritis drugs are being researched as a treatment modality to potentially halt or slow disease progression but data at this time is limited and continued studies are being conducted to further investigate their effectiveness. Intra-articular injectables are also implemented to manage knee OA ranging from corticosteroids to hyaluronans to more recently plateletrich plasma and even stem cells while several other injection therapies are presently b

关键词： disease-modifying osteoarthritis drugs Knee osteoarthritis disease-modifying osteoarthritis drugs Osteoarthritis management Non-steroidal antiinflammatory drugs Hyaluronic acid Arthroscopy Platelet-rich plasma Corticosteroids Stem cells

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A Retrospective Analysis of the Capacity Built through a Community-Based Participatory Research Project Addressing diabetes and Obesity in South and East Los Angeles

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Health 2014年第12期6卷 1429-1435页

作者： Kathryn hillstrom Valerie Ruelas Anne Peters Turusew Gedebu-Wilson Ellen Iverson California State University Los Angeles USA

Chronic diseases, such as diabetes and obesity, are more prevalent in low-income and minority communities. One promising method to understand and address these chronic conditions is through Community Based Participatory Research (CBPR). CBPR engages and empowers community members to identify risk factors and work toward solutions as equal partners with researchers. One positive and lasting outcome may be an increase in the community capacity which includes individual and community leadership development, policy making, creating connections and utilizing existing community resources. Evaluating community capacity created as a result of a CBPR project is one way to measure its effectiveness. This paper is a retrospective analysis of the capacity built during a CBPR study of diabetes and obesity in East and South Los Angeles which are two low-income and minority neighborhoods. Four people, who were heavily involved in the project, completed a retrospective analysis of the capacity built utilizing a validated instrument. There was consensus about the capacity built, which included: excellent participation by community members, inclusion of members’ ideas to leverage additional funding, and pride of community members in their participation in the project. One area that could have been strengthened was increased access for leadership and research experience among community members, especially since the project ended prematurely. There were differences among the two community groups with East Los Angeles members focusing more on tangible interventions and grant writing, while South Los Angeles members had a greater policy focus. Communities and researchers who are embarking on a CBPR project can learn from those who have implemented the strategy. Measuring capacity built during and after the project, can be one way to understanding the contributions of a project in a community. CBPR is an empowering research methodology which, done correctly, can build community capacity a

关键词： Community-Based Participatory Research diabetes Minority Health Health Research

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