ItemDOES A REGULAR COMPRESSION COMBINED MOVEMENT TEST DIAGNOSE LUMBAR FACET JOINT PAIN?(British Editorial Society of Bone and Joint Journal, 2014-02-01) M, Challinor H; G, Hourigan P; R, Powell; D, ConnPurpose and BackgroundThis pilot study aimed to determine the accuracy of lumbar spine combined movement (CM) testing for diagnosing facet joint mediated pain, by comparing CM to medial branch blocks (MBB) - the gold standard in the diagnosis of facet joint pain. A regular compression pattern of CM combines active extension and lateral flexion, which is believed to compress the facet joints greater than physiological uni-planar movements.Method and Results96 patients attending a pain clinic day case unit for diagnostic MBB were recruited. Patients' pain responses to CMs were measured prior to and thirty minutes following MBB. The effect of weight bearing and recumbence, RMDQ, EQ-5D and MYMOP were also measured. The regular compression CM test had 80% sensitivity (95%CI: 71% to 89%) and 50% specificity (95%CI: 28% to 71%). The regular compression CM group had the largest pre-post VAS difference (median 4 points). The patients whose pain was not relieved in recumbence (n=15) showed a significant VAS difference of 6 points p=0.001). There was a significant positive correlation between the pre and post pain scores, p<0.001. There was no association between MBB response and RMDQ, EQ-5D, MYMOP scores, duration of symptoms or standing as a provoking activity.ConclusionRegular compression CM testing can be used as a diagnostic tool to identify patients with facet joint mediated pain, particularly when associated with high pain scores. Low back pain (LBP) provoked by standing and relieved with recumbence are common features in the LBP population but are not indicators of facet joint pathology, contrary to many clinicians' beliefs. ItemRectal Volume in Prostate Radiotherapy Planning – Is There Correlation between Diagnostic Staging and Radiotherapy Computed Tomography Planning Scans?(Elsevier, 2014-02-01) McGrane, John; Powell, Roy; Srinivasan, R. ItemIs C-reactive protein useful in prognostication for colorectal cancer? A systematic review.(Wiley, 2014-10) Pathak, S.; Nunes, Q. M.; Daniels, Ian R.; Smart, Neil J.With the advent of several different therapeutic strategies to manage the different stages of colorectal cancer, it would be beneficial to allow substratification of patients into groups who are most likely to benefit from costly interventions. The purpose of this review is to analyse the evidence from several retrospective studies examining the prognostic significance of C-reactive protein (CRP). ItemAcute bronchodilator responses decline progressively over 4 years in patients with moderate to very severe COPD.(BioMed Central, 2014-08-31) Tashkin, D.P.; Li, N.; Kleerup, E. C.; Halpin, David M; Celli, B.; Decramer, M.; Elashoff, R.We previously reported a progressive decline in absolute responses of FEV1 and FVC to a near-maximal dose of 2 different short-acting bronchodilators over 4 years. Since varying host factors and the method of expressing the response may impact the time trend of acute bronchodilator responses, we now examined the potential influence of salient host characteristics on changes in bronchodilator responses over time expressed in different ways.