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Introduction: This study aimed to gain insight into the real‐world complexity of the challenges experienced by patients, their significant others, care professionals and the work and education environment concerning rheumatic diseases as well as the interrelation between these challenges; it also aimed to prioritise the identified challenges. Method: Using the Dialog Model, 21 people with various rheumatic diseases, 24 care professionals, 9 significant others, and 3 education and work representatives were asked about rheumatic disease‐related challenges and needs in a series of focus groups and interviews. Data were inductively coded and analysed, resulting in a mind map thematically displaying the challenges. The mind map was translated into a survey, and respondents (N = 1802) prioritised themes and challenges. Results: Of the six identified themes, 'physical complaints' was prioritised the most, followed by 'collaboration in healthcare', 'social and mental wellbeing', 'self‐management', 'information and options in healthcare' and 'work and education'. Challenges of people with rheumatic diseases appeared to be complexly interrelated. For instance, fatigue and pain affect everyday functioning, but can also heavily impact social and mental wellbeing. To facilitate support for these challenges, which many patients desire, patients and care professionals said that better collaboration between primary and secondary care professionals is needed. Additionally, patients felt that their experiential expertise deserves more acknowledgement from care professionals. Results were similar across different rheumatic diseases. Conclusion: Many patients desire more support to manage life with their disease. To facilitate this, collaboration and communication between healthcare professionals, and between healthcare professionals and individual patients, should be improved. [ABSTRACT FROM AUTHOR]

Hispanic/Latinos have been underrepresented in genome-wide association studies (GWAS) for anthropometric traits despite their notable anthropometric variability, ancestry proportions, and high burden of growth stunting and overweight/obesity. To address this knowledge gap, we analyzed densely imputed genetic data in a sample of Hispanic/Latino adults to identify and fine-map genetic variants associated with body mass index (BMI), height, and BMI-adjusted waist-to-hip ratio (WHRadjBMI). We conducted a GWAS of 18 studies/consortia as part of the Hispanic/Latino Anthropometry (HISLA) Consortium (stage 1, n = 59,771) and generalized our findings in 9 additional studies (stage 2, n = 10,538). We conducted a trans-ancestral GWAS with summary statistics from HISLA stage 1 and existing consortia of European and African ancestries. In our HISLA stage 1 + 2 analyses, we discovered one BMI locus, as well as two BMI signals and another height signal each within established anthropometric loci. In our trans-ancestral meta-analysis, we discovered three BMI loci, one height locus, and one WHRadjBMI locus. We also identified 3 secondary signals for BMI, 28 for height, and 2 for WHRadjBMI in established loci. We show that 336 known BMI, 1,177 known height, and 143 known WHRadjBMI (combined) SNPs demonstrated suggestive transferability (nominal significance and effect estimate directional consistency) in Hispanic/Latino adults. Of these, 36 BMI, 124 height, and 11 WHRadjBMI SNPs were significant after trait-specific Bonferroni correction. Trans-ancestral meta-analysis of the three ancestries showed a small-to-moderate impact of uncorrected population stratification on the resulting effect size estimates. Our findings demonstrate that future studies may also benefit from leveraging diverse ancestries and differences in linkage disequilibrium patterns to discover novel loci and additional signals with less residual population stratification., Competing Interests: S.M.G. and A.M.S. receive funding from Seven Bridges Genomics to develop tools for the NHLBI BioData Catalyst consortium. All others authors declare no competing interests., (© 2022 The Author(s).)

Background: The diet of most adults is low in fish and, therefore, provides limited quantities of the long-chain, omega-3 fatty acids (LCn-3FAs), eicosapentaenoic and docosahexaenoic acids (EPA, DHA). Since these compounds serve important roles in the brain, we sought to determine if healthy adults with low-LCn-3FA consumption would exhibit improvements in neuropsychological performance and parallel changes in brain morphology following repletion through fish oil supplementation., Methods: In a randomized, controlled trial, 271 mid-life adults (30-54 years of age, 118 men, 153 women) consuming ⩽300 mg/day of LCn-3FAs received 18 weeks of supplementation with fish oil capsules (1400 mg/day of EPA and DHA) or matching placebo. All participants completed a neuropsychological test battery examining four cognitive domains: psychomotor speed, executive function, learning/episodic memory, and fluid intelligence. A subset of 122 underwent neuroimaging before and after supplementation to measure whole-brain and subcortical tissue volumes., Results: Capsule adherence was over 95%, participant blinding was verified, and red blood cell EPA and DHA levels increased as expected. Supplementation did not affect performance in any of the four cognitive domains. Exploratory analyses revealed that, compared to placebo, fish oil supplementation improved executive function in participants with low-baseline DHA levels. No changes were observed in any indicator of brain morphology., Conclusions: In healthy mid-life adults reporting low-dietary intake, supplementation with LCn-3FAs in moderate dose for moderate duration did not affect neuropsychological performance or brain morphology. Whether salutary effects occur in individuals with particularly low-DHA exposure requires further study.

Complications following hallux valgus surgery can occur and are a frequent source of patient dissatisfaction. The treatment of these complications begins with careful preoperative planning to ensure that the chosen procedure is appropriate for the specific patient. When complications occur, treatment must also be individualized to address the symptoms of the patient. This article presented an overview of the more common complications that are seen following hallux valgus surgery. Nonsurgical and surgical options for treatment were outlined to assist in the management of these complications.

The cases of seven patients who had had acute brachial neuritis (Parsonage-Turner syndrome) were reviewed retrospectively. The patients had been followed for a mean of six years (range, three to ten years) after the onset of the symptoms. All patients had had an acute onset of intense pain in the shoulder without antecedent trauma. The pain decreased spontaneously and eventually resolved completely in all patients. Weakness in the shoulder had developed at a mean of approximately four weeks after the initial onset of pain. The weakness decreased spontaneously but very gradually in all patients; three patients had persistent, mild weakness at the most recent follow-up evaluation.

This study examined 76 consecutive patients (100 feet) treated by a single surgeon for both flexible and rigid hammertoes with a PIP arthrodesis using custom-machined drills, a peg cutter, and hole cutter, combined with an extensor tenotomy and dorsal capsulotomy. Forty-eight percent of patients were defined as satisfied without reservation, 37% were defined as satisfied with reservations, and 15% were defined as dissatisfied. The incidence of radiographic fusion was 95% (130/137 toes). The most common reasons for either reservation or dissatisfaction included incomplete pain relief, residual toe angulation, and prolonged shoe wear restriction in the postoperative period. Based upon the results of this study, the authors suggest that when using a peg and socket arthrodesis for hammertoe correction (1) there is a 95% rate of radiographic fusion, (2) patients over 65 years old be alerted to a diminished rate of satisfaction, and (3) a distal flexor tenotomy be considered in patients with a preoperative DIP flexion contracture.

A retrospective study of patients who had had a primary total hip arthroplasty without cement between 1983 and 1990 was done to examine differences in clinical and radiographic results between obese and normal-weight individuals. Patients were considered to be of normal weight if the body-mass index (calculated as weight in kilograms divided by height in meters squared) was between twenty and less than thirty, and they were considered to be obese if the body-mass index was thirty or more. There were 127 normal-weight patients (142 hips) and fifty-five obese patients (sixty hips) in the analysis. Eight obese patients (eight hips) who had a body-mass index of forty or more were considered to be morbidly obese and were examined separately as a subset of the obese group. The duration of follow-up averaged forty-eight months (range, twenty-four to ninety-two months). There were no differences between the groups with regard to age, diagnosis, the type of stem or cup, the type of bone, the postoperative level of activity, or the duration of follow-up. The obese patients had a significantly greater loss of blood during the operation than the patients in the normal-weight group. There were no significant differences between groups with regard to the prevalence of perioperative complications, the number of units of blood transfused, the operative duration, or the duration of hospitalization. Of the 202 hips, 184 (91 percent) were pain-free or only mildly painful at the latest follow-up examination.(ABSTRACT TRUNCATED AT 250 WORDS)

The pentapeptide Ser-Asn-Val-Phe-Ala-OBzl has been identified as the smallest inhibitory peptide of myosin light chain kinase (MLCK) derived from the primary sequence of the light chain phosphorylation site. The specific contributions of individual amino acid side chains and backbone elements of this pentapeptide toward the stabilization of the enzyme-inhibitor (E-I) complex have been evaluated. The potency of these peptides as inhibitors of MLCK has been enhanced by the incorporation of synthetic nonnatural amino acids into the sequence. Finally, it has been demonstrated that these peptide sequences could be converted into pseudopeptides with synthetic nonpeptide subunits designed to mimic peptide bonds, and that certain pseudopeptides retained the high-affinity inhibition of the parent pentapeptides.