Corticosteroid injection for de Quervain's tenosynovitis.

Background: De Quervain's tenosynovitis is a disorder characterised by pain on the radial (thumb) side of the wrist and functional disability of the hand. It can be treated by corticosteroid injection, splinting and surgery.

Objectives: To summarise evidence on the efficacy and safety of corticosteroid injections for de Quervain's tenosynovitis.

Diagnosis and management of patients with hand and wrist problems in general practice.

Objectives: 1) To describe diagnoses made by general practitioners (GPs) in patients with hand or wrist problems, 2) to describe management, and 3) to determine the association between diagnostic information and two outcomes: persistent symptoms and specialist referral.

Methods: GPs recruited patients with hand or wrist problems and completed a standardized form recording information about patient history, observations, palpation, and physical tests. Patients were sent a questionnaire at baseline, 3, and 12 months, containing questions on characteristics and symptom severity.

Systematic review: accuracy of symptom-based criteria for diagnosis of irritable bowel syndrome in primary care.

Background: Despite the trend towards making a positive diagnosis of irritable bowel syndrome (IBS), many health care providers approach IBS as a diagnosis of exclusion.

Aim: To summarize available evidence on the diagnostic performance of symptom-based IBS criteria in excluding organic diseases, and of individual signs and symptoms in diagnosing IBS and to additionally assess the influence of sources of heterogeneity on diagnostic performance.

Methods: We searched PubMed and EMBASE and screened references.

Co-occurrence and associations of pain and fatigue in a community sample of Dutch adults.

Widespread pain and chronic fatigue are common in the general population. Previous research has demonstrated co-occurrence of syndromes that are associated with pain and fatigue (fibromyalgia and chronic fatigue syndrome), but there is limited existing data on the co-occurrence of these symptoms in general. This study investigates the co-occurrence of pain and fatigue, and characterises people with these symptoms individually, and in combination.

Radiographic hand osteoarthritis: patterns and associations with hand pain and function in a community-dwelling sample.

Objective: Patterns of radiographic osteoarthritis (ROA) of the hand are often examined by row, with the four joints of the thumb studied inconsistently. The objectives of this study were to determine relationships of ROA at different hand joints, use the findings to define radiographic sub-groups and investigate their associations with pain and function.

Methods: Sixteen joints in each hand were scored for the presence of ROA in a community-dwelling cohort of adults, 50-years-and-over, with self-reported hand pain or problems.

Measurement of dysprosium optical constants in the 2-830 eV spectral range using a transmittance method, and compilation of the revised optical constants of lanthanum, terbium, neodymium, and gadolinium.

The optical constants beta, delta of the complex refractive index (ñ = 1-delta+ibeta) of Dy were obtained in the 2-830 eV energy range using a novel transmittance method. Si/W/Dy/W films were deposited by dc-magnetron sputtering on Si photodiode substrates, and the transmittance was characterized using synchrotron radiation. The extinction coefficients beta of Dy and the transmittance of a Si capping layer and two W interface barrier layers as functions of energy were solved simultaneously using a nonlinear optimization routine.

Realization and characterization of an XUV multilayer coating for attosecond pulses.

The experimental characterization of an aperiodic reflecting multilayer (ML) structure designed to reflect and compress attosecond pulses in the extreme ultraviolet spectral region is presented. The MLs are designed for the 75-105 eV spectral interval with suitable reflectance and phase behavior, in particular high total spectral reflectivity coupled with very wide bandwidth and spectral phase compensation. The experimental phase behavior of the multilayer has been obtained through electron photoemission signal using an innovative method that is presented and discussed in this paper.

Prediction of outcome in patients presenting with fatigue in primary care.

Background: Although fatigue is a common problem presenting to primary care, few prospective studies have examined the contribution of a wide range of prognostic factors.

Aim: To determine the combination of factors most strongly associated with a favourable or unfavourable course of fatigue, when fatigue is presented as a main symptom in primary care.

Design Of Study: Prospective, observational cohort study with a 1-year follow-up.

Effectiveness of manual therapy compared to usual care by the general practitioner for chronic tension-type headache: design of a randomised clinical trial.

Background: Patients with Chronic Tension Type Headache (CTTH) report functional and emotional impairments (loss of workdays, sleep disturbances, emotional well-being) and are at risk for overuse of medication. Manual therapy may improve symptoms through mobilisation of the spine, correction of posture, and training of cervical muscles.We present the design of a randomised clinical trial (RCT) evaluating the effectiveness of manual therapy (MT) compared to usual care by the general practitioner (GP) in patients with CTTH.

Does age modify the relationship between morbidity severity and physical health in English and Dutch family practice populations?

Purpose: To investigate the co-influences of age and morbidity severity on physical health in adult family practice populations.

Methods: Morbidity data in a 12-month period for 7,833 older English consulters aged 50 years and over and 6,846 Dutch consulters aged 18 years and over was linked to their physical health status obtained from cross-sectional health surveys. Individual patients were categorised using 78 consulting morbidities classified by a chronicity measure (acute, acute-on-chronic and chronic) into an ordinal scale of morbidity severity ranging from single to multiple chronicity groups.

The choice of anatomical site for islet transplantation.

Islet transplantation into the portal vein is the current clinical practice. However, it has now been recognized that this implantation site has several characteristics that can hamper islet engraftment and survival, such as low oxygen tension, an active innate immune system, and the provocation of an inflammatory response (IBMIR). These factors result in the loss of many transplanted islets, mainly during the first hours or days after transplantation, which could in part explain the necessity for the transplantation of islets from multiple pancreas donors to cure type 1 diabetes.

Corticosteroid injection for trigger finger in adults.

Background: Trigger finger is a disease of the tendons of the hand leading to triggering (locking) of affected fingers, dysfunction and pain. Available treatments include local injection with corticosteroids, surgery, or splinting.

Objectives: To summarize the evidence on the efficacy and safety of corticosteroid injections for trigger finger in adults using the following endpoints: treatment success, frequency of triggering or locking, functional status of the affected fingers, and severity of pain of the fingers.

Research priorities for non-pharmacological therapies for common musculoskeletal problems: nationally and internationally agreed recommendations.

Background: Musculoskeletal problems such as low back pain, neck, knee and shoulder pain are leading causes of disability and activity limitation in adults and are most frequently managed within primary care. There is a clear trend towards large, high quality trials testing the effectiveness of common non-pharmacological interventions for these conditions showing, at best, small to moderate benefits. This paper summarises the main lessons learnt from recent trials of the effectiveness of non-pharmacological therapies for common musculoskeletal conditions in primary care and provides agreed research priorities for future clinical trials.

Early patient screening and intervention to address individual-level occupational factors ("blue flags") in back disability.

Objective: To develop a consensus plan for research and practice to encourage routine clinician screening of occupational factors associated with long-term back disability.

Methods: A 3-day conference workshop including 21 leading researchers and clinicians (the "Decade of the Flags Working Group") was held to review the scientific evidence concerning clinical, occupational, and policy factors in back disability and the development of feasible assessment and intervention strategies.

Results: The Working Group identified seven workplace variables to include in early screening by clinicians: physical job demands, ability to modify work, job stress, workplace social support or dysfunction, job satisfaction, expectation for resuming work, and fear of re-injury.

Prognosis of fatigue and functioning in primary care: a 1-year follow-up study.

Purpose: Although fatigue is a common presenting symptom in primary care and its course and outcomes often remain unclear, cohort studies among patients seeking care for fatigue are scarce. We therefore aimed to investigate patterns in the course of fatigue and relevant secondary outcomes in a large cohort of patients who sought care for a main symptom of fatigue.

Methods: We performed an observational cohort study in 147 primary care practices.

Recovery of endogenous beta-cell function in nonhuman primates after chemical diabetes induction and islet transplantation.

Objective: To describe the ability of nonhuman primate endocrine pancreata to reestablish endogenous insulin production after chemical beta-cell destruction.

Research Design And Methods: Eleven monkeys (Macaca fascicularis) were rendered diabetic with streptozotocin. Eight diabetic monkeys received intraportal porcine islet transplantation.

Content and outcome of usual primary care for back pain: a systematic review.

Background: Most patients seeking help for back pain are managed in primary care.

Aim: To describe the content and outcome of 'usual care' for low back pain in primary care trials.

Design Of Study: A systematic review of randomised controlled trials published since 1998.

Multiple hepatic adenomas associated with liver steatosis at CT and MRI: a case-control study.

Objective: The objective of our study was to investigate the relationship between hepatic adenoma and liver steatosis.

Materials And Methods: Radiology and pathology records from January 1999 to March 2007 were reviewed to identify 24 patients (22 women and two men; mean age, 40 years) with a pathology-proven diagnosis of hepatic adenoma (mean size +/- SD, 7.2 +/- 3.

High performance EUV multilayer structures insensitive to capping layer optical parameters.

We have designed and tested a-periodic multilayer structures containing protective capping layers in order to obtain improved stability with respect to any possible changes of the capping layer optical properties (due to oxidation and contamination, for example)-while simultaneously maximizing the EUV reflection efficiency for specific applications, and in particular for EUV lithography. Such coatings may be particularly useful in EUV lithographic apparatus, because they provide both high integrated photon flux and higher stability to the harsh operating environment, which can affect seriously the performance of the multilayer-coated projector system optics. In this work, an evolutive algorithm has been developed in order to design these a-periodic structures, which have been proven to have also the property of stable performance with respect to random layer thickness errors that might occur during coating deposition.

Clinical course and prognosis of hand and wrist problems in primary care.

Objective: To describe the course of a new episode of hand and wrist problems in general practice and to identify predictors that are associated with poor outcome at short-term and long-term followup.

Methods: Patients consulting their general practitioner with hand or wrist problems (no prior consultation in the preceding 3 months) were sent a questionnaire at baseline and at 3, 6, and 12 months of followup. Potential predictors included sociodemographic variables, characteristics of the symptoms, physical activity, and psychosocial factors.

The Choice of Anatomical Site for Islet Transplantation.

Islet transplantation into the portal vein is the current clinical practice. However, it has now been recognized that this implantation site has several characteristics that can hamper islet engraftment and survival, such as low oxygen tension, an active innate immune system, and the provocation of an inflammatory response (IBMIR). These factors result in the loss of many transplanted islets, mainly during the first hours or days after transplantation, which could in part explain the necessity for the transplantation of islets from multiple pancreas donors to cure type 1 diabetes.

Evaluation of work-related psychosocial factors and regional musculoskeletal pain: results from a EULAR Task Force.

Objectives: To establish whether review articles provide consistent conclusions on associations between workplace psychosocial factors and musculoskeletal pain and, if differences exist, to explore whether this is related to the methods used.

Methods: Reviews, reported up to February 2007, that included consideration of workplace psychosocial factors and upper limb, back or knee pain were identified through searches of multiple databases. The specific work-related psychosocial factors considered were job demands, support, job autonomy and job satisfaction.

Aperiodic multilayers with enhanced reflectivity for extreme ultraviolet lithography.

We have developed novel aperiodic multilayers, covered by capping layers resistant to environmental attack, that offer superior performance for extreme ultraviolet lithography. We have designed these coatings using an optimization procedure based on an algorithm able to acquire domain knowledge inside the space of possible solutions. An integrated intensity increase of up to 2.

Normal-incidence silicon-gadolinium multilayers for imaging at 63 nm wavelength.

Si/Gd multilayers designed as narrowband reflective coatings near 63 nm were developed. The highest peak reflectance of 26.2% at a 5 degrees incident angle was obtained at 62 nm, and the spectral bandwidth was 7.