Search

STUDY DESIGN: Systematic review with meta- analysis. OBJECTIVES: To review and critically appraise the literature for factors that increase the risk for meniscal tears. BACKGROUND: Meniscal tears are an important cause of disability and time lost from work, and are associated with a 4-fold increase in the long-term risk of knee osteoarthritis. Knowledge of the risk factors that lead to meniscal tears can help to correctly diagnose knee injuries and is important to the development of prevention strategies for knee osteoarthritis. METHODS: A search of the Cochrane Database of Systematic Reviews, MEDLINE, and Embase, from 1950 to January 2012, and a hand search of reference lists of all initially selected studies, without restriction on language or date of publication, were conducted. Prospective, retrospective, and case-control studies that included individuals over 16 years of age, who had no previous meniscal injuries or surgeries, were selected. A meta-analysis for 17 risk factors was performed. Where considerable heterogeneity among studies was present or the data did not provide sufficient information to perform a meta-analysis, a qualitative synthesis was conducted. RESULTS: Eleven studies, with a total of 7358 participants, were selected for systematic review. Data were available for meta-analysis for 10 of the 11 studies. Qualitative analysis was conducted using data from 3 of the 11 studies. Results showed strong evidence that age (older than 60 years), gender (male), work-related kneeling and squatting, and climbing stairs (greater than 30 flights) were risk factors for degenerative meniscal tears. We also found strong evidence that playing soccer and playing rugby were strong risk factors for acute meniscal tears. Waiting longer than 12 months between the anterior cruciate ligament injury and reconstructive surgery was a strong risk factor for a medial meniscal tear but not for a lateral meniscal tear. • CONCLUSION: The literature indicates a number of risk factors leading to either degenerative or acute meniscal tears, with some of these factors being potentially modifiable. [ABSTRACT FROM AUTHOR]

Background: The dopamine D4 receptor gene (DRD4) has been linked to attention deficit hyperactivity disorder (ADHD) and reading disorders. In this study, we examined whether diminished anticipatory dopamine cell firing - typical of the long variant of the DRD4 allele - is related to emergent and advanced alphabetic skills, and whether executive attention is a mediator between this allele and alphabetic skills. Method: We tested alphabetic skills in a normative sample of 159 children in both kindergarten and Grade 1, and executive attention 1 year earlier. Cheek cells were collected and genomic DNA was isolated from the samples using the Chemagic buccal swab kit on a chemagen Module I workstation. Results: Thirty-seven percent of the children were carriers of at least one DRD4 7-repeat allele. Carriers of the long variant scored lower on alphabetic skills, and executive attention appeared to be a mediator of the relation between characteristics of DRD4 and alphabetic skills in kindergarten and first grade. Conclusion: This study shows how a genetic factor which has been shown to relate to variation in attention and regulatory behavior can explain delays in alphabetic skills. A practical implication is that in many cases early interventions should not only target reading skills, but also support children's engagement in tasks. [ABSTRACT FROM AUTHOR]