Local inflammation in the adjacent bone may be a secondary effect

Local inflammation in the adjacent bone may be a secondary effect due to cytokine and propionic acid production.

Patients undergoing primary surgery at a single spinal level for lumbar disc herniation with an MRI-confirmed lumbar disc herniation, where the annular fibres were penetrated by visible nuclear tissue, had the nucleus material removed. Stringent antiseptic GSK1210151A supplier sterile protocols were followed.

Sixty-one patients were included, mean age 46.4 years (SD 9.7), 27 % female. All patients were immunocompetent. No patient had received

a previous epidural steroid injection or undergone previous back surgery. In total, microbiological cultures were positive in 28 (46 %) patients. Anaerobic cultures were positive in 26 (43 %) patients, and of these 4 (7 %) had dual microbial infections, containing both one aerobic and one anaerobic culture.

No tissue specimens had more than two types of bacteria identified. Two (3 %) cultures only had aerobic bacteria isolated.

In the discs with AS1842856 a nucleus with anaerobic bacteria, 80 % developed new MC in the vertebrae adjacent to the previous disc herniation. In contrast, none of those with aerobic bacteria and only 44 % of patients with negative cultures developed new MC. The association between an anaerobic culture and new MCs is highly statistically significant (P = 0.0038), with an odds ratio of 5.60 (95 % CI 1.51-21.95).

These findings support the theory that the occurrence of MCs Type 1 in the vertebrae adjacent to a previously herniated disc may be due to oedema surrounding an infected disc. The discs infected with anaerobic bacteria were more likely (P < 0.0038) to develop this website MCs in the adjacent vertebrae than those in which no bacteria

were found or those in which aerobic bacteria were found.”
“Two new phenylalkanoids, 5-hydroxy-1-(4`,5`-dihydroxy-3`-methoxy-phenyl)-decan-3-one (1) and 1-(4`,5`-dihydroxy-3`-methoxy-phenyl)-dec-4-en-3-one (2), were isolated from the rhizomes of Chinese ginger (Zingiber officinale Roscoe (Zingiberaceae)). The structures of these new phenylalkanoids were elucidated by chemical and physical evidence.”
“Modic type 1 changes/bone edema in the vertebrae are present in 6 % of the general population and 35-40 % of the low back pain population. It is strongly associated with low back pain. The aim was to test the efficacy of antibiotic treatment in patients with chronic low back pain (> 6 months) and Modic type 1 changes (bone edema).

The study was a double-blind RCT with 162 patients whose only known illness was chronic LBP of greater than 6 months duration occurring after a previous disc herniation and who also had bone edema demonstrated as Modic type 1 changes in the vertebrae adjacent to the previous herniation. Patients were randomized to either 100 days of antibiotic treatment (Bioclavid) or placebo and were blindly evaluated at baseline, end of treatment and at 1-year follow-up.


“Three different experimental techniques were used to stud


“Three different experimental techniques were used to study structural phase transitions in melt-spun poly(vinylidene fluoride) fibers, which were ICG-001 chemical structure produced with different process parameters and processed in the draw-winding process at different temperatures and draw ratios. The fibers are examined with the help of wide-angle X-ray diffraction at elevated temperatures, differential scanning calorimetry with stochastic temperature modulation, and dynamic mechanical analysis. An oriented mesophase and deformed crystal structures can be observed

in all fibers and assigned to the mechanical stress occurring in the processes. Furthermore, several phase transitions during melting and two mechanical relaxation processes could be Compound Library cell assay detected. The observed transitions affect the crystal geometry, the orientation distribution, anisotropic thermal expansion, and the mechanic response of the fiber samples. The relaxation processes can be related with an increasing amount of crystalline beta-phase in fibers drawn at different temperatures. The detailed information about phase transitions and the related temperatures are used to produce fibers with an extended amount

of b-phase crystallites, which are responsible for piezoelectric properties of the material. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 120: 21-35, 2011″
“Background: Recent National Institute for Health and Clinical Excellence (NICE) guidance recommended that when traditional NSAIDs or cyclooxygenase (COX)-2 selective inhibitors are used by people with osteoarthritis (OA), they should be prescribed along with a proton pump inhibitor (PPI). However, specific Selleck Kinase Inhibitor Library recommendations about the type of NSAID or COX-2 could not be made

due to high levels of uncertainty in the economic evaluation.

Objective: To investigate the value of obtaining further evidence to inform the economic evaluation of NSAIDs, COX-2s and PPIs for people with OA.

Methods: An economic evaluation with an expected value of perfect information (EVPI) analysis was conducted, using a Markov model with data identified from a systematic review. The base-case model used adverse event data from the three largest randomized trials of COX-2 inhibitors, and we repeated the analysis using observational adverse event data. The model was run for a hypothetical population of people with OA, and subgroup analyses were conducted for people with raised gastrointestinal (GI) and cardiovascular (CV) risk. The EVPI was based upon the OA population in England approximately 2.8 million people. Of these, 50% were assumed to use NSAIDs or COX-2 selective inhibitors for 3 months per year and 56% of these were assumed to be patients with raised GI and CV risk.

Results: The value of further information for this decision problem was very high. Population-level EVPI was (sic)85.1 million in the low-risk group and (sic)179.5 million in the high-risk group (2007-8 values).

[DOI: 10 1063/1 3120787]“
“This review considers why and how

[DOI: 10.1063/1.3120787]“
“This review considers why and how embryos are selected for transfer and with what consequences. It concludes that:

(i) current selection methods are inadequate or at least inadequately subjected to evidential scrutiny; (ii) decisions about number of embryos should be based not solely on input (numbers transferred) but on the likelihood of the transfer resulting in multiple pregnancies – out turn; and (iii) what is needed are better methods not just for selecting better embryos, but also for selecting responsible clinicians who collude less with their patients’ demands but advise them more responsibly. (C) 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“Thermally

induced phase transformation of buy GSK1210151A AS1842856 mouse Si-III/Si-XII zones formed by nanoindentation has been studied during low temperature (200 < T < 300 degrees C) thermal annealing by Raman microspectroscopy and transmission electron microscopy. Two sizes of spherical indenter tips have been used to create substantially different volumes of phase transformed zones in both crystalline (c-Si) and amorphous silicon (a-Si) to study the zone size and starting matrix effects. The overall transformation is from Si-III/XII to poly-or nanocrystalline Si-I through intermediate phases of Si-XIII and Si-IV. Attempts have been made to determine the exact transformation pathways. Two scenarios are possible: either Si-XII first MS-275 in vivo transforms to Si-III before transforming to Si-I through the intermediate phases or that Si-XII goes through the intermediate phases while Si-III transforms directly to Si-I. Finally, the phase transformations are slower in the larger indents and the starting matrix (crystalline or amorphous) has a substantial effect on the transformation kinetics of the small indents compared to the larger ones. We attribute this increased stability to both matrix effects (nucleation) and a difference in overall residual stress in indents made in a-Si compared to c-Si. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.3124366]“
“Efforts

aimed at improving pregnancy rates have focused on the search for additional markers of viability to supplement current criteria for embryo selection. Time-lapse technology represents a powerful tool in assisted reproduction for evaluating embryos dynamically. Whilst standard methods of embryo assessment are based on subjective morphology evaluation at discrete time points, thereby limiting the information produced for embryo selection, time-lapse recording introduces several additional morphokinetic parameters for embryo evaluation. This additional information can improve implantation rates and reproductive outcomes. This review surveys available knowledge on time-lapse imaging to provide an overview of the advantages and applications of this technology. (C) 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

To our knowledge, this is the first pediatric case of geniculate

To our knowledge, this is the first pediatric case of geniculate ganglion venous malformation presenting solely with conductive hearing loss. Proper management requires differentiating this condition from other geniculate and temporal bone lesions. (C) 2012 Elsevier Ireland Ltd. All rights reserved.”
“Quantum-chemical method B3LYP/6-311++G(df,p) was applied to the study of complex formation between phenol and methanol. The complexes of molecules bound by the hydrogen bond possess enhanced donoracceptor and acid-base properties as

compared to monomer molecules. The reactions of phenol and methanol complexes with methyl isocyanate proceed through a concerted late asymmetric transition state by the type of nucleophilic addition. The most kinetically and thermodynamically favorable transformation selleck products is the process involving the complex “”phenol-acceptor, methanol-donor.”"

Phenol compounds are able to catalyze the addition of alcohols to isocyanates.”
“Background: Chronic obstructive pulmonary disease (COPD) AZD8055 is characterized by airway inflammation and is associated with acute exacerbations. Macrolide antibiotics have been shown to exhibit anti-inflammatory effects in some chronic airway inflammatory diseases. Objective: The aim of this study was to assess the effect of treatment with erythromycin on airway inflammation and health outcome in COPD patients. Methods: We conducted a randomized, placebo-controlled, double-blind trial of erythromycin for a period of 6 months. Thirty-six COPD patients were randomized to treatment with oral erythromycin (125 mg, three times/day) 3-Methyladenine molecular weight or placebo. The primary outcomes were neutrophil number in sputum and

exacerbations. Results: Thirty-one patients completed the study. At the end of treatment, neutrophil counts in the sputum were significantly decreased in the group treated with erythromycin compared with placebo-treated patients (p = 0.005). Total cells in the sputum and neutrophil elastase in sputum supernatant were also significantly decreased in those treated with erythromycin compared with the placebo group (p = 0.021 and p = 0.024, respectively). The mean exacerbation rate was lower in the erythromycin group than in the placebo group (relative risk = 0.554, p = 0.042). Kaplan-Meier survival analysis showed that erythromycin significantly delayed the time to the first COPD exacerbation compared with placebo (p = 0.032). Conclusions: Erythromycin treatment in COPD patients can reduce airway inflammation and decrease exacerbations and may therefore be useful in the management of COPD. Copyright (C) 2010 S. Karger AG, Basel”
“Nasal dermoid sinus cysts are the most common congenital midline nasal lesions. The frequency of intracranial extensions varies from 5% to 45%.

8Ce0 2(Fe1-xMnx)(11 5)Si-1 5 (C)

2011 American Institute

8Ce0.2(Fe1-xMnx)(11.5)Si-1.5. (C)

2011 American Institute of Physics. [doi:10.1063/1.3549560]“
“Objective. The purpose of this study was to analyze the long-term changes in the horizontal transverse mandibular width (TMW) between the angles of mandible after intraoral vertical ramus osteotomy (IVRO) with respect to hard and soft tissues.

Study design. A total of 107 from a pool of 207 patients with mandibular prognathism who had undergone bilateral IVRO were retrospectively evaluated radiographically and photographically. A comparison study of the changes of horizontal transverse width in hard and soft tissues after surgery was performed using preoperative, and 1-, 3-, 6-, and 12-month postoperative posteroanterior (PA) cephalograms and clinical photos. Three groups were divided

according to the amount of mandibular setback performed (Group 1: <5 mm, Group 2: 5-10 CDK inhibitor mm, Group 3: >10 mm).

Results. The overall average amount of mandibular setback in all patients was 8.58 mm. Statistically significant increases of TMW in hard and Thiazovivin soft tissue from preoperative to postoperative 1 month were seen. TMW in hard tissue showed a gradually decreasing pattern postoperatively from 1 month to 1 year, and the changes were statistically significant at 1 year postop. TMW in soft tissue was not changed uniformly after 1 month, and showed less than 1% change at 1-year postoperatively compared with preoperatively. The amount of increase in the TMW postoperatively www.selleckchem.com/products/Roscovitine.html was not proportional or statistically

significant to the amount of mandibular setback performed.

Conclusions. The results show that mandibular setback using BIVRO did not significantly influence the TMW changes in soft tissue. Therefore, IVRO technique can be safely used without compromising esthetic results through soft tissue TMW increase. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:25-31)”
“BACKGROUND: A prolonged-release formulation of tacrolimus for once-daily administration (tacrolimus QD) has been developed. This phase II, open-label, multicenter, prospective single-arm study compared the pharmacokinetics (PK) of tacrolimus in stable heart transplant patients before and after conversion from twice-daily tacrolimus (tacrolimus BID) to tacrolimus QD.

METHODS: Heart transplant recipients (>= 6 months after transplant), previously maintained on tacrolimus BID based therapy, received tacrolimus BID from Days 1 to 7 and were converted on a I: I (mg/mg) basis to tacrolimus QD. Five 24-hour PK profiles were collected (Days 1, 7, 8, 14, 21). Safety parameters were also evaluated.

RESULTS: Of 85 patients, 45 (50.6%) completed all 5 evaluable PK profiles. Steady-state tacrolimus area under the curve, 0 to 24 hours (AUC(0-24)) and minimum concentration (C-min) were comparable for both formulations, with treatment ratio means of 90.5% (90% confidence intervals [CI], 86.4%-94.6%) and 87.4% (95% CI, 82.9%-92.0%), respectively (acceptance interval, 80%-125%).

The cress plant was chopped; the obtained product was centrifuged

The cress plant was chopped; the obtained product was centrifuged, filtered (0.22 mu m) and conserved to -20 degrees C. Two concentrations of the aqueous extract (13.2-26.4 mg/ml of culture) were assayed in human peripheral blood culture of healthy volunteers. No statistically significant differences were detected

in our experimental conditions for any of the evaluated biomarkers (p > 0.05). These findings indicate that the watercress extract would not induce cytotoxicity, Alvocidib molecular weight chromosomal instability, clastogenicity or DNA double and single strand breaks or alkali-labiles sites. Hence, monitoring the toxicogenetic activity of different aqueous extracts would provide a better understanding of their potential ability to improve healthiness or prevent DNA damage.”
“This study aimed to explore the feasibility of ultra-short-course chemotherapy in the treatment of spinal tuberculosis.

One hundred and eighty-five patients with confirmed spinal tuberculosis and surgical indication were included. The chemotherapy regimen was 2SHRZ/XHRZ. According to the duration of the chemotherapy, the patients were

divided into two groups, the ultra-short-course AZD8931 order chemotherapy group with an average duration of 4.5 months, and the standard chemotherapy group with an average duration of 9 months. The same surgery was performed for patients in the two groups.

The duration of the follow-up ranged from 61 to 87 months, with an average of 69.1 months. Erythrocyte sedimentation rate and C-reactive protein, kyphosis and nerve function, recovery of work, and activities of daily living were not significantly different between the two groups before or after treatment; however, the aforementioned indices were significantly different before and after treatment

within groups. There was no significant difference in postoperative bone graft healing between the two groups. The drug side effects were significantly different between the two groups.

With thorough focus debridement, bone grafting, and internal fixation, the efficacy of ultra-short A-769662 chemotherapy was similar to that of standard chemotherapy for the treatment of spinal tuberculosis. The ultra-short-course chemotherapy can shorten the course of treatment and reduce drug side effects.”
“The methanol extract of the dried barks of Aegiceras corniculatum Blanco (Myrsinaceae) was investigated for its possible antinociceptive, cytotoxic and antidiarrhoeal activities in animal models. The preliminary studies of A. corniculatum bark showed the presence of alkaloids, glycosides, steroids, flavonoids, saponins and tannins.

The frequency of treatments with symptomatic hypotension was redu

The frequency of treatments with symptomatic hypotension was reduced from 32% +/- 23% in standard HD to 24% +/- 21% with BV-controlled UF (p = 0.04). Changes in blood pressure and heart rate from start to end of the HD session were not different between the 2 treatment modes.

Conclusions: This crossover study showed improved intradialytic stability with BV-controlled UF, compared with standard HD.”
“A crisis AMPK inhibitor continues to

brew within the pharmaceutical research and development (R&D) enterprise: productivity continues declining as costs rise, despite ongoing, often dramatic scientific and technical advances. To reverse this trend, we offer various suggestions for both the expansion and broader adoption of modeling and simulation (M&S) methods. We suggest strategies and scenarios intended to enable new M&S use cases that directly engage R&D knowledge generation

and build actionable mechanistic insight, thereby opening the door to enhanced productivity. What M&S requirements must be satisfied to access and open the door, and begin reversing the productivity decline? Can current methods and tools fulfill the requirements, or are new methods necessary? We draw on the relevant, recent literature to provide and explore answers. In so doing, we identify RWJ 64809 essential, key roles for agent-based and other methods. We assemble a list of requirements necessary for M&S to meet the diverse needs distilled from a collection of research, review, and opinion articles. We argue that to realize its full potential, M&S should be actualized

within a larger information technology frameworka dynamic knowledge repositorywherein models of various types execute, evolve, and increase in accuracy over time. We offer some details of the issues that must be addressed for such a repository to accrue the AZD8055 inhibitor capabilities needed to reverse the productivity decline. (C) 2013 Wiley Periodicals, Inc.”
“The occurrence of intra-abdominal hypertension (IAH), as well as its promoting factors in cardiac surgery, has been poorly explored. The aim of the present study was to characterize intra-abdominal pressure (IAP) variations in patients undergoing cardiac surgical procedures, and to identify the risk factors for IAH in this setting.

All consecutive adult patients requiring postoperative intensive care unit admission for > 24 h were enrolled. Demographic data, pre-existing comorbidities, type and duration of surgery, cardiopulmonary bypass (CPB) use and duration, perioperative IAP, organ function and fluid balance were recorded. IAH was defined as a sustained increase in IAP > 12 mmHg. Multivariate logistic regression and stepwise analyses identified the baseline and perioperative variables associated with IAH.

Of 69 patients, 22 (31.8%) developed IAH.

We then discuss the important challenges of IPT in PLHIV, namely

We then discuss the important challenges of IPT in PLHIV, namely responsibility and accountability for the implementation, identification of latent TB infection, exclusion of active selleck products TB and prevention of isoniazid resistance, length of treatment and duration of protective efficacy. We also highlight several research questions that currently remain unanswered. We finally offer practical suggestions about how to scale up IPT in the field, including the need to integrate IPT into a package of care for PLHIV, the setting up of operational projects with the philosophy of ‘learning while doing’, the

development of flow charts for eligibility for IPT, the development and implementation of care prior to antiretroviral treatment, and finally issues around procurement, distribution, monitoring and evaluation. We support the implementation of IPT, but only if it is done in a safe and structured way. There is a definite risk that ‘sloppy’ IPT will be inefficient and, worse, could lead to the development of multi drug-resistant TB, and this must be avoided at all costs.”
“Rationale and aim: Among foreign bodies causing injuries in children, magnets have been reported to cause serious complications and being life-threatening. The aim of this study is to design a risk profile and an epidemiological figure of such injuries, for being used for prevention.

Methods: Data on 366 injuries have been collected

from public surveillance databases

and from published scientific literature, and check details compared with the data of the Susy Safe registry, which is a pan-European registry of foreign bodies injuries co-funded by the European Commission.

Results: A median age of 48 months was observed, with a 63% prevalence of males is characterizing the injuries. Magnets have a median volume of 87.9 mm(3) vs the median volume of 41.86 mm(3) of the overall foreign bodies of the Susy Safe registry). Only 43% of the magnets were involving only on piece or objects, with a median number of two objects per injury, up to a maximum of 32 objects. Children are referred to the medical care system with a median delay of 3 days after onset of symptoms. selleck compound Median length of stay in the hospital was 7 days with respect to 1 day as in the Susy Safe registry.

Conclusion: Most of complications, and event the death of a child can be eventually re-conducted to either or both a delay in patient referral or appropriate diagnosis. Thus, it is an absolute priority that an information initiative is taken toward families and emergency doctors to avoid unnecessarily delays respectively in patient referral and in diagnosis. (C) 2012 Published by Elsevier Ireland Ltd.”
“Transformations of peroxide products of ozonolysis of various olefins with different degrees of substitution at the double bond by the action of hydroxylamine and semicarbazide hydrochloride in methanol in the presence of water as co-solvent were studied.

8-1 3 and OR 2 57, 95%CI 1 4-5 7) for ages 15-25, 26-50 and >

8-1.3 and OR 2.57, 95%CI 1.4-5.7) for ages 15-25, 26-50 and > 50 years, respectively.

CONCLUSIONS: Our results suggest that HIV infection mainly increases the risk of TB following recent M. tuberculosis transmission, and that TB control measures in HIV-endemic settings should therefore

focus on controlling M. tuberculosis transmission rather than treating individuals with latent M. tuberculosis infection.”
“A novel flavonoid, (-)-2R,3R-3,5,4′-trihydoxyflavan-[6,7:5 '',6 '']-2 ”-pyranone, named uncariechin (1), was isolated from the methanolic extract of the leaves of Uncaria longiflora var. pteropoda (Miq.) Ridsd. along with the known (-)-epiafzelechin (2) and (-)-epicatechin (3), methyl 4-hydroxybenzoate and 4-hydroxybenzaldehyde, four pentacyclic oxindole alkaloids, isopteropodine, pteropodine,

uncarine F and isopteropodic acid, previously found in the stems, and two coumarins, scopoletin and 3,4-dihydroxy-7-methoxycoumarin. EPZ-6438 order Structures of the compounds were elucidated by 1D and 2D NMR, FTIR, UV, MS, and experimental as well as calculated electronic circular dichroism (ECD) data. Compounds 2 and 3 were evaluated for their neurotoxic and neuroprotective properties against differentiated SH-SY5Y neuroblastoma cell lines using the MTS assay. Compounds 2 and 3 did Akt inhibitor not show any neurotoxic effects but showed strong protective potential against hydrogen peroxide-induced neurotoxicity with maximum cell viability

at a concentration of 1 mu M. (C) 2013 Phytochemical Society of Europe. Published by Elsevier B. V. All rights reserved.”
“OBJECTIVE: To study the association between TB and household expenditure in a nationwide TB prevalence survey in Viet Nam using nine household characteristics.

METHOD: To assess the prevalence of TB in Viet Nam, a nationwide stratified cluster sample survey was conducted from 2006 to 2007. Nine household characteristics used in the second Viet Nam Living Standards Survey (VLSS) were scored per buy LY2090314 household. In the VLSS dataset, we regressed these nine characteristics against household expenditure per capita, and used the coefficients to predict household expenditure level (in quintiles) in our survey and assess its relation with TB prevalence.

RESULTS: The prevalence of bacteriologically confirmed TB was 307 per 100000 population in persons aged >= 15 years (95 %CI 249-366). After adjustment for confounders, prevalence was found to be associated with household expenditure level: the rate was 2.5 times higher for those in the lowest household expenditure quintile (95 %CI 1.6-3.9) than those in the highest quintile.

CONCLUSION: With a set of nine household characteristics, we were able to predict household expenditure level fairly accurately. There was a significant association between TB prevalence rates and estimated household expenditure level, showing that TB is related to poverty in Viet Nam.

Keywords used in these searches were “”colorectal cancer”, “”liv

Keywords used in these searches were “”colorectal cancer”, “”liver metastasis”, “”chemotherapy”, “”liver resection”, “”monoclonal antibody”,

“”steatohepatitis”, “”sinusoidal obstruction” and “”liver regeneration”. Databases were searched for the period January 1970 to September 2009 inclusively. In addition hand referencing of retrieved articles was performed.

Results: Modern chemotherapy BLZ945 regimens can effectively downstage initially unresectable disease such that surgical resection can be performed with the prospect of long term cure. There is insufficient evidence however to recommend its use in either the neoadjuvant or adjuvant setting in those with resectable disease from the outset.

Conclusion: Chemotherapy can be associated with significant changes to the hepatic parenchyma with subsequent increased risk of morbidity and mortality in the perioperative period. Much work needs to be done to understand

the molecular mechanisms underlying these changes to make extended resections safer in patients who are at risk. (C) 2009 Elsevier Ltd. All rights reserved.”
“Objectives: The aim was to study the incidence of joint replacements among biologic drug and disease-modifying anti-rheumatic drug (DMARD) users as well as to investigate the plausible effect of biologic treatment on survival of prostheses in patients with Rheumatoid arthritis Flavopiridol (RA).

Methods: The study P005091 in vivo population comprised 2 cohorts of patients [Register of biologic treatment in Finland (ROB-FIN) and the Central Finland RA database) from 1999 to 2010. Records of joint replacements performed in the study population

between 1980 and 2010 were retrieved from the Finnish Arthroplasty Register. Propensity score matching was used to equalize patient characteristics between biologics and DMARD users. The incidence rates of primary and revision operations were compared between the 2 treatment groups. Kaplan-Meier survival analysis was used to analyze prosthesis survival.

Results: Of the 2102 biologics and 2710 DMARD users identified from the registries, 1587 were included in both groups after the matching. Median follow-up times were 3.1 and 8.0 years, respectively. There were more primary operations per 100 patient years in the biologics (3.89, CI 95% 3.41-4.41) vs. DMARD (2.63, 2.35-2.94) group but slightly fewer revisions (0.65, 0.46-0.88 vs. 0.83, 0.68-1.01). Biologics users were more likely to receive a joint replacement to small joints (p < 0.001). The survival of the prostheses installed during or prior to follow-up was similar in both treatment groups.

Conclusions: The use of biologic drugs did not reduce the need for joint replacement surgery in patients with a similar on-medication disease activity. Despite possibly lower rate of revisions among biologic users, the durability of prostheses was not improved. (C) 2013 Elsevier Inc. All rights reserved.