This core set has been approved by the American College of Rheumatology (ACR) Board of Directors asProvisional. This signifies that the core set has been quantitatively validated using patient data, but it has not undergone validation based on an external data set. All ACR-approved core sets are expected to undergo intermittent updates.Objective. To validate a core set of outcome measures for the evaluation of response to treatment in patients with juvenile dermatomyositis (DM). Methods. In 2001, a preliminary consensus-derived core set for evaluating response to therapy in juvenile DM was established. In the present study, the core set was validated through an evidence-based, large-scale data collection that led to the enrollment of 294 patients from 36 countries. Consecutive patients with active disease were assessed at baseline and after 6 months. The validation procedures included assessment of feasibility, responsiveness, discriminant and construct ability, concordance in the evaluation of response to therapy between physicians and parents, redundancy, internal consistency, and ability to predict a therapeutic response. Results. The following clinical measures were found to be feasible, and to have good construct validity, discriminative ability, and internal consistency; furthermore, they were not redundant, proved responsive to clinically important changes in disease activity, and were associated strongly with treatment outcome and thus were included in the final core set: 1) physician's global assessment of disease activity, 2) muscle strength, 3) global disease activity measure, 4) parent's global assessment of patient's well-being, 5) functional ability, and 6) health-related quality of life. Conclusion. The members of the Paediatric Rheumatology International Trials Organisation, with the endorsement of the American College of Rheumatology and the European League Against Rheumatism, propose a core set of criteria for the evaluation of response to therapy that is scientifically and clinically relevant and statistically validated. The core set will help standardize the conduct and reporting of clinical trials and assist practitioners in deciding whether a child with juvenile DM has responded adequately to therapy.

In patients with polyarticular juvenile rheumatoid arthritis, methotrexate and leflunomide both resulted in high rates of clinical improvement, but the rate was slightly greater for methotrexate. At the doses used in this study, methotrexate was more effective than leflunomide.

Objective: To describe the postoperative complications and long-term functional outcome after surgical management of humeral intracondylar fissure (HIF) by transcondylar screw (TCS) placement. Study design: Retrospective study. Sample population: Nineteen dogs (26 elbows) Methods: Medical records (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009) were reviewed for dogs with a diagnosis of HIF according to results of computed tomography and treated by TCS placement at a single referral institution. Collected data included signalment, surgical technique, surgical duration, surgeon experience, use of antibiotics, and the presence and nature of any complications. Owner questionnaire, orthopedic examination, and pressure platform analysis were used to assess long-term outcome. The relationship between these variables was statistically analyzed. Results: In total, 18 of 26 surgically managed elbows were diagnosed with a postoperative complication; 11 of these consisted of a surgical site infection (SSI). No risk factors for short-term complications or long-term outcome were identified. Dogs with an SSI (n = 11) were 28 times more likely to have an unsatisfactory long-term outcome than dogs without an SSI (n = 8). Symmetry indices (SI) between thoracic and pelvic limbs did not return to published normal values. There was no difference in the SI of dogs with HIF and a surgically repaired contralateral humeral condylar fracture. Conclusion: Placement of a TCS was commonly associated with short-term complications, affecting long-term outcome. Clinical significance: The high complication rate after placement of lateromedial TCS provides evidence to justify the development of alternative strategies to manage HIF.

Summary In comparison with hip fractures, increased expression of genes in the Wnt pathway and increased Wnt activity were found in bone samples and osteoblast cultures from patients with osteoarthritis, suggesting the involvement of this pathway in subchondral bone changes. No consistent differences were found in the genetic association study.

The findings of this study suggest that increased surgical and anaesthesia times are significant risk factors for SSI in TTA, and that there is no evidence that postoperative prophylactic antimicrobial therapy is associated with SSI rate.

Retraction and protection of the caudoproximal tibial soft tissue envelope is recommended during TPLO; however, to prevent retention of microscopic particulate cotton debris, alternatives to cotton gauze sponges should be considered as protective devices.

OBJECTIVES Limited guidelines exist regarding the optimal treatment of traumatic canine elbow luxation, and there is a lack of information on long‐term functional outcome. Here we report reduction and stabilisation techniques for a series of traumatic elbow luxations and describe clinical outcome plus long‐term questionnaire‐based follow‐up. METHODS Retrospective review of canine traumatic elbow luxations (2006 to 2013) treated at five referral centres. Data recorded included signalment, luxation aetiology, time to reduction, reduction technique, surgical procedure, post‐reduction care and complications. Questionnaire follow‐up was attempted for all cases with owners completing the Canine Brief Pain Inventory. RESULTS Thirty‐seven dogs were included. The most frequent cause of luxation was road traffic accident (n=22). Twenty cases were treated surgically. Seven dogs suffered major postoperative complications: reluxation (n=6), infection requiring implant removal (n=1). Four of the six reluxations occurred in dogs that had other orthopaedic injuries. Twenty‐two owners completed the Canine Brief Pain Inventory questionnaire: there were 13 excellent, 6 very good, 1 good and 2 fair outcomes. Outcome was not associated with the reduction technique. CLINICAL SIGNIFICANCE Initial closed reduction, followed by surgical stabilisation if unsuccessful, results in good‐to‐excellent outcomes in the majority of traumatic canine elbow luxations. Reluxation was the most common major complication and there was a higher incidence of reluxation in patients with multiple orthopaedic injuries.

Based on the owner-completed questionnaire, cats have good-to-excellent medium- to long-term functional outcome after adequately performed FHNE.