Revisions and reoperations are more frequent and occur earlier with metal-on-metal hip resurfacing, except when discontinued devices are removed from the analyses. Results from the literature may be misleading without consistent definitions, standardized outcome metrics, and accounting for device market status. This is important when clinicians are assessing and communicating patient risk and when selecting which device is most appropriate for individual patients.

Methods: This cross-sectional study includes members of the Framingham Foot Study. A validated exam of the foot was used to assess the presence of hallux valgus, hallux rigidus, and plantar fasciitis. To determine foot type, center of pressure excursion index (CPEI) measurements were recorded using the TekScan Matscan (1.4 sensors/ cm2) system. CPEI is a dynamic measure of foot type that uses the concavity of the center of pressure curve in the metatarsal head region, normalized to foot width during the stance phase of gait. In a prior study by Hillstrom et al., utilizing the emed-x plantar pressure system (4 sensors/cm2), CPEI thresholds discriminated planus, rectus (normal arch), and cavus (high arch) feet. Due to the differences in system resolution, a scaling equation was developed in order to determine the equivalent CPEI threshold on a TekScan Matscan system that differentiated planus from non-planus (rectus and cavus) feet. This threshold was defined as a CPEI 19.4% on a TekScan Matscan system. Crude and adjusted logistic regression models, using generalized estimating equations (GEE) to account for the correlation between left and right feet, were used to calculate odds ratios for the relation between foot type and the prevalence of hallux rigidus, hallux valgus, and plantar fasciitis. Adjusted models included age, sex and body mass index (BMI). Results: This study included 2,994 participants (5,778 feet) with an age range of 36-98 years and 55% women. The results are shown in Table 1. Approximately 74% of the study population (mean age¼65.5AE9.9 years) was classified as having pes planus in at least one foot. Those with flat feet were at an increased odds for hallux valgus (OR 1.6, 95% CI 1.4, 1.8) and hallux rigidus (OR 1.6, 95% CI 1.1, 2.3). These results remained significant when adjusted for age, gender, and BMI. Conclusions: Those with planus foot type had a higher odds of hallux valgus and hallux rigidus, but not plantar fasciitis. The high prevalence rate of pes planus in the Framingham cohort may be because the average participant is 66 years old and arch height has been shown to decrease with age. Further, CPEI recordings may be more sensitive to less severe cases of pes planus, contributing to this high prevalence rate. Hallux valgus and hallux rigidus was more prevalent in pes planus versus non-planus feet. This is important because foot structure and function are potentially modifiable factors for these pathologies that have implications for prevention and treatment.

menopause. The mean age was 56.9 AE 10.7years. The intensity of pain was >50/100mm in 64.2% of patients, on a visual analogic scale at the time of diagnosis. Median pain duration was 1 year (Interquartile range: 7months-3.5 years). Obesity was present in 52% of patients, hypertension in 37.2% and diabetes in 8.8%. Knee x-ray showed that 35.5% of patients were beyond grade III according to Kellgen and Lawrence classification. Bilateral bi-compartmental knee osteoarthritis was found in 38.5% of patients, followed by bilateral tri-compartmental knee osteoarthritis in 14.2%. Pain intensity did not correlate with radiological findings whereas there was a positive correlation between pain and Lequesne disability index. Conclusion: Knee osteoarthritis is common in patients in Cameroon. Most patients present at later stages of the disease with a high disability index in a setting where access to health care is limited.

A 1 -A 2 9 8 A217 patients with and without dose escalation, respectively, and CDN$29,504 and CDN$25,449 for infliximab in patients with and without dose escalation, respectively. CONCLUSIONS: Results of this RAMQ database analysis illustrate that, in a real-world setting and over a long period of time, CD patients treated with infliximab had a significantly higher proportion of dose escalation compared with patients treated with adalimumab. In both recommended and adjusted dosing, adalimumab demonstrated significant cost savings over infliximab. OBJECTIVES:Assess the frequency and appropriateness of early repeated colonoscopy METHODS: Patients undergoing a colonoscopy in 2005 were identified using paid claims data from a nationwide privately insured population. Patients were screened to be between the ages of 50 and 64 years with at least one year continuous enrollment. Colonoscopies with evidence of positive results [e.g., paid claims for biopsy, fulguration, snare, etc.], or with evidence suggesting clinical indications three months prior to the screening were defined as non-screen tests. The cumulative probability of repeated screening colonoscopy was then documented and the related risk factors for appropriate and inappropriate repeat screening tests were assessed using survival analysis and Cox proportional hazard regression models. RESULTS: A total of 51,400 colonoscopies were identified from the paid claims in 2005 for patients age 50-64. The majority of these procedures were found to have either positive results [25,029 (48.7%)] or evidence of clinical indications for the procedure [17,842 (34.7%)]. Among 8,529 apparent screening colonoscopies with negative results, 8% had a repeated colonoscopy within six years, the majority of which were associated with evidence that the repeated test could be justified (78.7% with indications and 21.3% without indications). The initial regression analysis identified risk factors of repeated colonoscopy with indications including age over 55 (HR: 1.2; 95%CI: 1.0-1.5) and having at least one comorbidity (HR: 1.2; 95%CI: 1.0-1.5). The risk factors of repeated colonoscopy without indications include male (HR: 1.53; 95%CI: 1.07-2.20) and having at least one comorbidity (HR: 1.57; 95%CI: 1.04-2.31). CONCLUSIONS: The majority of all colonoscopies in 2005 were found not to be routine screening exams. The risk of a repeated screening colonoscopy within 6 years is low [8%]. Among these repeat procedures, the majority was done because of the existence of clinical indications. OBJECTIVES:Hip resurfacing (HR) was developed for younger, more active patients, as a surgical alternative to total hip arthroplasty (THA). The safety of metal-on-metal HR is controversial with concerns expressed over adverse events and early device failure. We conducted a systematic review comparing primary HR to conventional THA for patients with hip osteoarthritis (OA). Outcomes of interest were adverse event rates, early failure (revision/reoperation within 5 years), and post-operative component align...

English, human-only abstracts from January 1, 1992 to December 31. RESULTS: Quality of life evaluations for the following compounds were included in the review: abiraterone, cabazitaxel, docetaxel, enzalutamide, mitoxantrone, radium-223, samarium-153, and strontium-89. Significantly greater quality of life response was observed in the enzalutamide population compared to placebo (43% vs. 18%) while docetaxel showed significant difference in a head-to-head comparison with mitoxantrone on pain response (31-35% vs. 22%) as measured by the McGill questionnaire. Cabazitaxel did not show a significant difference in pain response compared to mitoxantrone. Abiraterone showed significant difference in multiple outcomes: pain palliation (44% vs. 27%) as measured by BPI-SF; reduction in fatigue intensity (58% vs. 40%) as measured by BFI; and time to HRQoL degradation (12.7 vs. 8.3 months) as measured by FACT-P. Abiraterone is the only agent reviewed to be effective in survival, pain palliation and progression and HRQoL. Additionally, abiraterone uniquely measured and showed benefit in fatigue. No patient-reported outcomes were pursued for sipuleucel-T. EORTC QLQ-C30 and FACT-P were the most common HRQoL instruments used. CONCLUSIONS: Studies in mCRPC typically include endpoints for pain palliation and quality of life improvement. Additionally, novel therapies are focusing on pain associated with bone metastases. There is no standard HRQoL or pain instrument being consistently used across prostate cancer trials.