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AimAn exploratory study of the relationship between cumulative exposure to subcutaneous (sc) interferon (IFN) β-1a treatment and other possible prognostic factors with long-term clinical outcomes in relapsing–remitting multiple sclerosis (RRMS).MethodsPatients in the original PRISMS study were invited to a single follow-up visit 15 years after initial randomisation (PRISMS-15). Outcomes over 15 years were compared in the lowest and highest quartile of the cumulative sc IFN β-1a dose groups, and according to total time receiving sc IFN β-1a as a continuous variable per 5 years of treatment. Potential prognostic factors for outcomes were analysed.ResultsOf 560 patients randomised in PRISMS, 291 returned for PRISMS-15 and 290 (51.8%) were analysed. Higher cumulative dose exposure and longer treatment time appeared to be associated with better outcomes on: annualised relapse rate, number of relapses, time to Expanded Disability Status Scale (EDSS) progression, change in EDSS, proportions of patients with EDSS ≥4 or ≥6, ≤5 relapses and EDSS <4 or <6, and time to conversion to secondary-progressive MS (SPMS). Higher dose exposure was associated with lower proportions of patients with EDSS progression and conversion to SPMS, and longer time on treatment with lower risk of first relapse. Change in EDSS from baseline to 24 months was a strong predictor of evaluated clinical outcomes over 15 years.ConclusionsThese findings suggest that higher cumulative exposure to sc IFN β-1a may be associated with better clinical outcomes, and early change in EDSS score may have prognostic value, over many years, in RRMS.

The objective was to investigate adherence measured by an electronic auto-injector device, and self-reported adherence and treatment convenience in subjects with relapsing remitting multiple sclerosis (RRMS), using an electronic auto-injector Rebismart® to self-inject interferon β-1a. Thirty one patients with RRMS using the electronic auto-injector Rebismart® for selfinjecting interferon β-1a subcutaneously three times weekly were included in a reallife clinical multicenter study for 24 weeks in Finland. Mean adherence reported by the device and mean self-assessment of adherence were studied. Reasons for missing injections and treatment convenience were assessed. Association between adherence and gender and age were studied. The mean adherence calculated from the device data was 93.5%. The mean self-assessment of adherence was 96.6%. The most common reason for missing an injection was forgetfulness. Adherence (measured by the device) was not changed over time. In the high adherence group there were more females and young patients (<30 years of age). The auto-injector was found to substantially ease the treatment by 90% of the patients. The electronic auto-injector was associated with high adherence to treatment. The device was found to ease the patient’s treatment and it was perceived as easy to use. It is a convenient tool to assess patient’s adherence to treatment.

Background Knee osteoarthritis (KOA) is considered a whole-joint disease that is amenable to prevention and treatment in the early stages. Exercise is among the core treatment recommendations for KOA and it has been suggested that optimal exercise regimens should improve aerobic capacity and knee extensor strength. Subchondral bone and articular cartilage are functionally paired, and information on the responses of these tissues to exercise may help in the development of efficacious and feasible exercise regimens that can potentially improve bone and cartilage properties. This article describes a clinical trial investigating the effects of a multicomponent exercise regimen on the subchondral bone and articular cartilage of the knee joint in postmenopausal women with mild KOA. Methods A minimum of 90 postmenopausal women between the ages of 55 and 75 meeting the inclusion criteria will be recruited. After an initial assessment, the participants will be randomly assigned to two groups. The intervention group will participate in a progressive multicomponent exercise regimen, including step aerobics and resistance training alternating every 2 weeks, for 50 min three times a week for 8 months. The reference group will be conducting home exercise program representing standard rehabilitative management for KOA patients. The primary outcome measures of this trial are the 8-month changes in the biochemical composition of the knee articular cartilage measured by the T1r and T2 relaxation times from quantitative magnetic resonance imaging and subchondral bone sclerosis, density and structure as measured via cone beam computed tomography. Measurements will be performed at baseline, after the 8-month intervention period, and at 12 months of maintenance. Discussion This RCT investigates the effectiveness of a multicomponent exercise regimen on the subchondral bone and cartilage of the knee joint and the potential interaction between these tissues. The information gained will improve our understanding of the effects of exercise on subchondral bone and the biochemical properties of articular cartilage and improve the prescription of multicomponent exercise regimens in the management of mild KOA. Trial registration ClinicalTrials.gov NCT06173193. Retrospectively registered before completion of the recruitment on 31 October 2023, https://www.clinicaltrials.gov/study/NCT06173193 .

Background The Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) is developed to evaluate the shoulder and elbow function in overhead athletes. To date, the score has not been adapted into Finnish language. The aim of this study was to perform a cross-cultural adaptation of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) into Finnish language and evaluate its validity, reliability, and responsiveness in overhead athletes. Methods Forward–backward translation method was followed in the cross-cultural adaptation process. Subsequently, 114 overhead athletes (52 males, 62 females, mean age 18.1 ± 2.8 years) completed the Finnish version of KJOC score, Disabilities of the Arm, Shoulder and Hand (DASH), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and RAND-36 to assess validity of the KJOC score. To evaluate reliability and responsiveness, the participants filled in the KJOC score 16 days and eight months after the first data collection. Validity, reliability, and responsiveness of the Finnish KJOC score were statistically tested. Results Minor modifications were made during the cross-cultural translation and adaptation process, which were related to culture specific terminology in sports and agreed by an expert committee. Construct validity of the KJOC score was moderate to high, based on the correlations with DASH ( r  = − 0.757); DASH sports module ( r  = − 0.667); ASES ( r  = 0.559); and RAND-36 ( r  = 0.397) questionnaires. Finnish KJOC score showed excellent internal consistency ( α  = 0.92) and good test–retest reliability (2-way mixed-effects model ICC = 0.77) with acceptable measurement error level (SEM 5.5; MDC 15.1). Ceiling effect was detected for asymptomatic athletes in each item (23.2–61.1%), and for symptomatic athletes in item 5 (47.4%). Responsiveness of the Finnish KJOC score could not be confirmed due to conflicting follow-up results. Conclusion The Finnish KJOC score was found to be a valid and reliable questionnaire measuring the self-reported upper arm status in Finnish-speaking overhead athletes.