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Background: During adolescence early maturers (EM) tend to be bigger and strong than their late maturing (LM) peers of the same chronological age (CA). This is because EM reach peak velocities in growth characteristics at earlier CA. Strength is dependent in part on muscle size, and muscle size on bone size; therefore, it is arguable that leg length (LL) growth and leg strength (LS) will be related. The nature of the relationship between LL and LS, and how the timing of maturation may influence these is unknown. The purpose of this study was to investigate if peak velocities for LL and LS, in males, occur in the same sequence regardless of maturity group. Methods: 227 males participated in the Saskatchewan Growth and Development Study. Between 1964 and 1973, annual measurements included height (H), sitting height (SH), weight and knee extension strength. LL was calculated from H and SH. Serial measures of anthropometrics were used to identify velocities for H, LL and LS. Age at peak height velocity (PHV) was used to create a biological age (BA - years from PHV) and maturity timing categories: average maturers (AM), EM, and LM. Mean differences between groups were test with t-tests and ANOVA. Alpha was set at .05. Results: There were no significant differences in the CA at which PLLV and PLSV occurred within maturity groupings (p>0.05). PLLV and PLSV occurred at a later BA in EM (BA0.0±.7, 0.2±1.1) than LM (-0.4±.9, -0.5±1.9) (p<0.05). The CA of PLLV between maturity groups was significantly earlier in EM (12.9±.8 yrs.) compared to AM (13.7±.9 yrs.) and LM (14.6±.9 yrs.) (p<.05). The CA's of PLSV (13.5+.4) were not significantly different between the maturity groups. Discussion: As would be expected EM reach PLLV at an earlier CA and with greater magnitude when compared to AM and LM. The time interval between PLLV and PLSV are not affected by timing of maturation; however, EM reach their peak velocities for LL and LS at a significantly later BA. The long-term implication of these findings on strength development is unknown. [ABSTRACT FROM AUTHOR]

Fifteen patients with active rheumatoid arthritis who had not previously received oral corticosteroids were recruited into an open study using the Leeds Human Model Screening System to assess whether prednisolone has any activity as a second-line agent. The daily dose of prednisolone was 10 mg/day, and all patients completed the full study duration of 24 weeks, with only one patient requiring a dose reduction to 7.5 mg. Patients were then recruited into a further open study during which dosage reduction of 1 mg/month was attempted. Patients were assessed using six clinical and six laboratory variables, and statistically significant improvement ( P<0.01) was seen in seven of 12 variables at 24 weeks. After 48 weeks, two variables showed statistically significant improvement at P<0.01, with improvement in a further four variables significant at P<0.05. This degree of change ranks prednisolone below established second-line agents such as sodium aurothiomalate and d-penicillamine but ahead of non-steroidal anti-inflammatory drugs, suggesting that in addition to their known anti-inflammatory properties corticosteroids may have some action as second-line agents. [ABSTRACT FROM AUTHOR]

Low-dose methotrexate has gained widespread acceptance as a second-line agent in rheumatoid arthritis (RA). The Leeds Human Model Screening System (LHMSS) is a validated screening mechanism allowing the rapid evaluation of compounds for their potential as anti-rheumatic agents, the results of which have been confirmed in longer term studies. We have evaluated methotrexate in patients with RA using the LHMSS at a maintenance dose of 10mg/week. Significant change occurred in four out of eleven variables over a 24-week period (p<0.01). This degree of change is greater than that seen with nonsteroidal anti-inflammatory agents but less than with other recognised second-line agents such as D-penicillamine, suggesting that methotrexate may have less potential as a second-line agent than D-penicillamine. [ABSTRACT FROM AUTHOR]

Among the issues to be debated at next month's RCN Congress in Harrogate is a resolution focusing on the right of people with learning disabilities to receive equitable health care. Here, Michelle Persaud and colleagues from the RCN Learning Disability Nursing Forum set out the background to this resolution and call on LDP readers to get involved. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor on the debate on equity of access to health care for people with learning disabilities at the 2004 RCN Congress.