The near-miss rate was 4.4 cases per 1,000 live births. The near-miss/death

ratio was GSK1210151A ic50 8.6 near-misses for each maternal death, and the overall mortality index was 10.4%. Hypertensive syndromes were the main cause of admission (67.7% of the cases, 107/158); however, hemorrhage, mainly due to uterine atony and ectopic pregnancy complications, was the main cause of maternal near-misses and deaths (17/43 cases of near-miss and 2/5 deaths).

CONCLUSIONS: Hypertension was the main cause of admission and of potentially life-threatening conditions; however, hemorrhage was the main cause of maternal near-misses and deaths at this institution, suggesting that delays may occur in implementing appropriate obstetrical care.”
“Towards establishing association of ISSR markers with antioxidant activity in Valeriana jatamansi, 5 distantly located populations were analysed. Total phenolics, flavonoids contents and antioxidant activity measured by three different in vitro assays, revealed a significant variation (p < 0.01) across populations.

The higher total phenolics (14.63 +/- 0.05 mg GAE/g dw), flavonoids (6.96 +/- 0.11 mg QE/g dw), tannin content (3.85 +/- 0.54 mg GAE/g dw) and antioxidant activity (ABTS – 4.82 +/- 0.18 mM AAE/100 mg; DPPH – 4.92 +/- 10.02 mM AAE/100 mg and FRAP – 7.54 +/- 0.02 mM AAE/100 mg) was observed in Kalika population. Information generated from 31 genotypes Pinometostat datasheet of the species using 13 ISSR markers showed a total of 97 fragments with high mean genetic diversity [percentage of polymorphic bands (PPB) - 69.90%, Shannon's information index (I) -0.39]. Out of 97 ISSR markers, only three (HB8-5, HB12-1

and 17898B-8) exhibited significant (p < 0.05) association with antioxidant activity measured by DPPH assay. Hence, it is recommended that any further selection of the genotypes/population using these markers can be useful for breeding programme that has associated with high antioxidant activity especially when no other genetic information such as linkage maps and Quantitative Trait Loci (QTL) are available for the species. (C) 2012 Elsevier B.V. All rights reserved.”
“Study design: A retrospective study.

Objective: To elucidate the correlation PP2 in vivo between compound muscle action potentials (CMAPs) amplitudes and responsible level of compressive cervical myelopathy (CCM), and the accuracy of level diagnosis by using CMAPs.

Setting: This study was conducted at the Department of Orthopedic surgery, Yamaguchi University Graduate School of Medicine, Japan.

Method: A total of 28 patients with CCM were investigated in this study. Erb’s point-stimulated CMAPs were measured from deltoid, biceps, triceps in all patients as compared with 88 healthy subjects. We performed a level diagnosis on the basis of CMAPs amplitudes.

CONCLUSIONS: Refractive stability and predictability were high at the 1-year follow-up. There was no gain in corrected visual acuity. Despite 2 iridotomies performed 2 weeks preoperatively, the main complication was early pupillary block.”
“Introduction: Metabolic syndrome (MS) is a cardiovascular risk predictor. Prevalence of MS after

heart transplantation (HTx) is high. Recent data suggest a positive metabolic effect of telmisartan. Aim: To describe the influence of telmisartan on lipid and glycide metabolism in MS after HTx.

Methods: Fifteen patients aged 55+/-12 yr, 88+/-25 months after HTx with MS receiving statins were followed. The reason for telmisartan administration was arterial hypertension with either

drug intolerance or poor control. Body mass index (BMI), waist circumference, total STI571 Protein Tyrosine Kinase inhibitor cholesterol, low density lipoprotein LDL-cholesterol, high density lipoprotein-cholesterol, triglycerides, C-reactive protein (CRP), fasting glucose, immunoreactive insulin (IRI), C-peptide and the homeostasis model assessment (HOMA) index were determined. Ambulatory blood pressure monitoring was performed. After MAPK inhibitor initial evaluation, telmisartan 80 mg was started. After 20 +/- 5 wk follow-up, identical parameters were measured. Statistical significance was evaluated using Student’s t-test.

Results: BMI, waist circumference, systolic and diastolic blood pressures, serum lipids and CRP remained unchanged after telmisartan. Significant reduction

in fasting glucose (6.7 vs. 5.6 mmol/L, p < 0.02), IRI (8.8 vs. 8.5 U/mL p = 0.05), HOMA (7.3 vs. 5.8 mmol/L x mu U/mL, p < 0.05) and C-peptide (4.0 vs. 3.3 ng/mL, p < 0.02) was found.

Conclusions: Telmisartan had a positive impact on insulin sensitivity parameters (fasting glucose, IRI, C-peptide and HOMA) in this population. No effect on obesity, serum lipids and systemic inflammation was observed.”
“Purpose We attempt to shed light on the truth-telling attitudes and practices CUDC-907 ic50 of oncologists working with a geriatric population in Italy. Participants and method Physicians caring for cancer patients were asked to complete a specific survey centred on their beliefs, attitudes and practices towards truth telling to elderly cancer patients. Results Of 50 physicians surveyed, 68% were men. Physicians practising in the south of Italy were significantly older and more likely to be of male gender in comparison with physicians practising from the north and central areas. Eighty-four per cent of physicians consider the family to be an obstacle to a direct communication with the elderly. Forty-four per cent of male physicians who are faced with a family’s request of nondisclosure talk with the patient, whereas 37.5% of female physicians talk with the family. For 60% of interviewed physicians, the reason underpinning the caregiver’s choice of nondisclosure is to delay the emotional confrontation.

After application of etch-and-rinse adhesive, composite built-ups were created Dinaciclib cost with a nanoceramic composite. Specimens were sectioned into serial 1-mm(2) sticks, and mu TBS was measured in five sticks from each tooth randomly selected (n = 30). Failure modes were determined under a stereomicroscope. mu TBS test data were analyzed by Welch-ANOVA followed by Dunnett’s T3 tests and failure mode distributions were analyzed by Pearson Chi-square test (p = 0.05). mu TBS was higher for enamel

and dentin after additional acid etching than laser irradiation alone. E-SSP-A group exhibited the highest mu TBS for enamel (p < 0.05). The D-SP-A group showed the highest value but the difference was not significant in comparison to D-C (p > 0.05). The mu TBS of laser-irradiated but not acid-etched groups decreased when longer pulse durations were used. Laser treatment could enhance or impair the mu TBS to enamel and dentin depending

on the pulse duration used and additional acid application.”
“Objective: To describe an active auditory rehabilitation method (clip vibroplasty) for conductive or mixed hearing loss in cases of a preserved stapes superstructure.

Patients: After temporal bone experiments, the new clip vibroplasty was clinically used in 4 patients with chronic otitis media.

Interventions: MK-4827 clinical trial A new titanium double clip device (clip vibroplasty) was developed for a standardized and effective coupling of the floating mass transducer of the Vibrant Soundbridge to the intact stapes. Temporal selleck kinase inhibitor bone experiments using laser Doppler vibrometry were performed to evaluate

the device’s acoustic efficiency. The audiologic outcomes of the first 4 patients were analyzed. The subjective benefits and satisfaction were assessed using the standardized International Outcome Inventory for Hearing Aids in all patients.

Main Outcome Measures: Transfer characteristics of laser Doppler vibrometry experiments; audiologic outcomes of the 4 patients.

Results: In the temporal bone experiment, coupling of the FMT using the titanium double clip support produced transfer characteristics across all tested frequencies comparable to our former total ossicular reconstruction prosthesis or an optimal round window application. The intraoperative application of the clip vibroplasty was uneventful in all cases. No signs of prosthesis dislocation were noted within the follow-up period of approximately 12 months. The audiologic outcome of the first patients showed good hearing gain in pure-tone and speech audiometry, with results that are unobtainable using a conventional air conduction hearing aid.

This trend will lead to much more BPA contamination in the environmental media and in the general population in China. This paper reviews the current literature concerning the pollution status of BPA in China (the mainland, Hong Kong, and Taiwan) and its potential impact on human health. Due to potential human health risks from long-term exposure to BPA, body burden of the contaminant should be monitored. (C) 2011 Elsevier Ltd. All rights reserved.”
“Body Selleckchem Vorinostat mass index (BMI) and physical activity (PA) affect health-related quality of life

(HRQL); however, the long-term impact of youth BMI and PA on adult HRQL is unknown. We investigated the relationship of youth BMI and PA to adult HRQL 22 years later.

Subjects included 310 participants aged 7 to 18 in the 1981 Canada Fitness Survey, followed

up in 2002-2004. The associations of youth BMI and leisure time PA to adult HRQL were examined, comparing to age- and sex-adjusted Canadian SF-36 norms.

Bivariate analyses revealed positive associations between youth overweight and mental aspects of adult HRQL, but little association with physical aspects. In logistic regression adjusting for adult BMI and other covariates, overweight youth were 7 times more likely than healthy weight youth to score at/above the norm on both mental health (MH) selleck chemicals llc and bodily pain, and almost 18 times more likely on the mental component score (MCS). Youth BMI was also positively associated with general health (GH), social functioning, and role emotional. Removing adult BMI from the models led to attenuated

associations with mental HRQL and no association with GH. Longitudinal BMI status change was explored, and findings supported the main regression results. Youth PA was not associated with adult HRQL.

Youth overweight conveyed a long-term positive impact on several aspects of adult HRQL, and this impact may be both direct and indirect through BMI change and the effect on adult BMI. Youth PA had no long-term impact on adult HRQL.”
“AimTo investigate hormonal dynamics in a group of non-obese polycystic ovary syndrome (PCOS) patients under myo-inositol (MYO) administration.

MethodsHormonal profiles, insulin response to oral glucose tolerance test (OGTT) and luteinizing hormone (LH) response to gonadotropin-releasing hormone (GnRH) stimulation test before and PI3K inhibitor after the administration of a preparation of MYO (3g p.o. daily) mixed with lactoferrin and bromelin, in a group (n=24) of normal weight PCOS patients.

ResultsAfter the treatment interval, body mass index (BMI) did not change while LH, LH/follicle-stimulating hormone, 17-hydroxy-progesterone and androstenedione decreased significantly. Insulin response to OGTT was significantly reduced after the treatment interval (P<0.05) as well as GnRH-induced LH response (P<0.05). High-sensitivity C-reactive protein decreased significantly after the treatment interval.

This is a case of a 51-year-old gentleman who sustained a significant seatbelt injury in a plane crash. Laparotomy, performed due to persistent abdominal pain, revealed that the

common bile duct (CBD) was completely avulsed from the duodenum. Following insertion of drains and transfer to a hepatobiliary centre, the devascularised CBD was excised and Selleckchem ALK inhibitor replaced with a roux-en-y hepaticojejunostomy. Necrotic tissue was debrided from the pancreatic head. A persistent bile leak developed from the sub-hepatic drain. Repeat laparotomy revealed a bile leak from small ducts on the liver surface. Ligation of the ducts and bioglue sealing of the area were successfully performed. Subsequent to this a pancreatic fistula developed from the main pancreatic duct, which has since resolved. This unusual case illustrates the need for prompt recognition and early repair to optimise outcomes in traumatic CBD injury.”
“An emergence of drug-resistant tuberculosis (DR-TB) in settings affected by human immunodeficiency virus (HIV) and tuberculosis (TB) has been observed. We investigated the prevalence of DR-TB in P1041, a multicentred, randomised, double-blind trial which compared the administration of isoniazid (INH) to placebo, in HIV-exposed, non-infected and -infected African

infants in the absence of any documented TB exposure. The prevalence of multidrug-resistant TB (MDR-TB) was 22.2% (95%CI 8.5-45.8) and INH Pfizer Licensed Compound Library high throughput monoresistance 5.6% (95%CI 0.1-27.6) among culture-confirmed cases, with all MDR-TB occurring in a single site. There was no association between INH treatment

or placebo group, or between HIV infection status, and DR-TB prevalence. There was a high prevalence of DR-TB among HIV-exposed and -infected children. Surveillance of DR-TB among children in high-burden TB-HIN settings should be routine.”
“We present a case of a young health care professional from the Indian subcontinent, who presented with a low anal fistula and underwent exploration, debridement and fistulotomy twice. The initial working diagnosis was Crohn’s disease. However, Mycobacterium tuberculosis, click here fully sensitive to all first-line drugs was cultured from the specimens sent from the second surgical procedure. On initiation of anti-tubercular therapy the symptoms improved within 5 weeks. The origin of the patient, high index of suspicion for non-infectious reactivation of tuberculosis in migrant health care workers, importance of a proper history taking including previous exposure and diagnostic workup is stressed.”
“SETTING : Brewelskloof Hospital, Western Cape, South Africa.

OBJECTIVES: To verify the perceived increase in rifampicin monoresistant tuberculosis (RMR-TB) in the Cape Winelands-Overberg region and to identify potential risk factors.

The tobacco genome contains duplicated QPT genes; QPT1 is expressed at a constitutive basal level, whereas QPT2 is regulated coordinately with other structural genes involved in nicotine biosynthesis, in terms of tissue specificity, jasmonate induction, and regulation by ERF189. The binding-site specificity of ERF189 was defined as 5′-(A/C) GC(A/C)(A/C) NCC-3′ by using a characterized tobacco putrescine N-methyltransferase promoter, and was then used to search for potential binding sites in the QPT promoters. Assays

involving in vitro DNA binding, transient transactivation, and transgenic hairy GDC-0068 price roots revealed that the QPT2 promoter contains three functional ERF189-binding sites, which individually confer incremental ERF189-mediated activation to the promoter. The QPT1 promoter is

not bound and regulated by ERF189. These results indicate that one copy of the duplicated QPT genes was recruited to a tobacco alkaloid regulon by evolving multiple target cis-regulatory elements of ERF189 in its promoter, to cope with an increased metabolic demand for pyridine AG 14699 precursors during active alkaloid biosynthesis.”
“To increase wetland acreage and biodiversity, Delaware agencies constructed >220 depressional wetlands. During construction, agencies included amendments thought to increase biodiversity. Because the efficacy of amendments is unknown, we investigated their effects on macroinvertebrate and vegetative communities. We selected 20 standardized wetlands (five contained

coarse woody debris (CWD) and microtopography amendments (land surface ridges and furrows), five had neither, five had CWD only, and five had microtopography only). Additionally, 12 wetlands had received organic matter amendments (i.e., straw). Insect richness (P = 0.010; r(2) = 0.16), insect biomass (P = 0.023; r(2) = 0.13), intolerant insect biomass (P = 0.033, r(2) = 0.03), Ephemeroptera biomass (P SYN-117 = 0.027; r(2) = 0.12), and Odonata biomass (P = 0.046; r(2) = 0.10) increased with CWD volume. Obligate plant percent cover increased with microtopographic variation (P = 0.029; r(2) = 0.120). Although organic matter amendments did not increase percent soil organic matter (t(13.7) = -1.16, P = 0.264), total (P = 0.027; r(2) = 0.12), native (P = 0.036; r(2) = 0.11), and facultative (P = 0.001; r(2) = 0.24) plant richness increased with percent soil organic matter. To enhance biodiversity, constructed wetlands should contain CWD, but additional research is needed to understand the benefits of microtopography and organic matter amendments. (C) 2008 Elsevier Ltd. All rights reserved.

We also found

that treatment of 293T cells with the histone deacetylase (HDAC) inhibitor Trichostatin A (TSA) increased hPTTG promoter activity. Meanwhile, we provided evidence that HDAC3 decreased hPTTG promoter activity. These data implicate an important role of the historic acetylation modification in the regulation of hPTTG.”
“Background and aim: Cell adhesion molecules play an important role in the development of atherosclerosis mediating the attachment of monocytes to the endothelium. The aim of our study was to assess the cell surface expression of CD11b/CD18 integrin on the phagocytes of children this website affected by hypercholesterolemia.

Methods and Results: Twenty-six children with hypercholesterolemia (15 mates, mean age 8.3, range 2-18) with a family history of early Cardiovascular disease, as well as 26 children with normocholesterolemia matched for gender and age (15 mates, mean age 8.3) were studied. Cell surface expression of CD11b/CD18 on peripheral blood mononuclear cells (PBMC) were analyzed by flow cytometry. The geometric mean percentages of CD11b BMS-754807 and CD18 expression were significantly

tower in the hypercholesterolemic group [52 (95% confidence intervals, 40-68) and 88 (84-93)] than in the control group [87 (83-91), P < 0.0001 and 93 (89-96), P < 0.05], respectively. After correction for age, gender, and pubertal status, CD11b cell surface expression on PBMC was inversely and independently correlated with total cholesterol concentrations (r = -0.395; P < 0.01) and LDL (r = -0.307; P < 0.05), as well as with triglycerides Quisinostat ic50 (r = -0.406; P < 0.01).

Conclusions: In children with hypercholesterolemia, cell surface expression of CD11b and CD18 on PBMC was significantly decreased. Follow-up studies are necessary to determine the clinical implications of these findings in the context of the natural course and progression

of atherosclerosis in high risk children. (C) 2008 Elsevier B.V. All rights reserved.”
“Purpose: To explore how initial trajectories of distress experienced during the first year following diagnosis with early-stage breast cancer (ESBC) relate to subsequent long-term (6 years) psychosocial outcomes.

Methods: 285/303 Chinese women recruited 1-week post-surgery for predominantly ESBC were assessed for distress with the Chinese Health Questionnaire at 1, 4, and 8 months later. Latent growth mixture modeling revealed four distinct distress trajectories during the first 8 months following surgery (Lam et al., 2010). Six years later we reassessed 186 of these 285 women, comparing scores on the Hospital Anxiety and Depression Scale, Impact of Events Scale, and Chinese Social Adjustment Scale by first 8 months’ distress trajectory.

Results: Distress trajectories over the first 8 months post-operatively predicted psychosocial outcomes 6 years later.

92 to 1.00) for the fellow. The combined intraclass correlation coefficient for intraobserver agreement was 0.76. The reviewers as a group disagreed with their own measurements an average of 26% of the time. The intraclass correlation coefficient for interobserver reliability with regard to the measurements on the anteroposterior radiographs for the group was 0.80 (95% confidence interval, 0.64 to 0.89), and the reviewers disagreed with each other an average of 54% of the time. The intraclass correlation selleck chemicals llc coefficient for interobserver agreement was 0.28 (95% confidence interval, 0.03 to 0.76) for the measurements on the lateral radiographs and 0.62 (95% confidence interval,

0.34 to 0.89) for the measurements on the oblique radiographs, with reviewers disagreeing an average of 87% of the time with regard to the measurements on the lateral radiographs and 64% of the time with regard to the measurements on the oblique radiographs.

Conclusions: Intraobserver agreement with regard to measurement of displacement of medial epicondyle fractures of the humerus varied among the reviewers but was low overall. Interobserver agreement was best Selleckchem S3I-201 for the measurements on the anteroposterior radiographs, but this was also low overall. These findings cast doubt on whether

the amount of perceived displacement should be used as a criterion for choosing operative or nonoperative management of fractures of the humeral medial epicondyle. Agreement may be improved to acceptable levels by adopting a standard set of measurement guidelines, which include use of the anteroposterior radiograph when possible

and consistently measuring at the point of maximal displacement.”
“BACKROUND: In Izmir, Turkey, wastewaters from the petrochemical industry are treated using conventional activated sludge systems. A significant proportion of poly-aromatic hydrocarbons (PAHs) with high-molecular weights remains in this treatment system and inhibits the biological activity. Biosurfactants increase PAHs degradation by enhancing the solubility of the petroleum components. The aerobic inhibition kinetics of PAHs has not previously been investigated in the selleck presence of biosurfactants for a real petrochemical industry wastewater.

RESULTS: Among the kinetic models used (Monod-type, zero, first-order and second-order) it was found that the Monod kinetic was effective for describing the biodegradation of PAHs in petrochemcal industry wastewater in the presence of three biosurfactants, namely Rhamnolipid (RD), Surfactine (SR) and Emulsan (EM) in an aerobic activated sludge reactor (AASR). The maximum PAH removal rate (Rmax) and specific growth rate of PAH degrading bacteria (mu max) increased, while the half saturation concentration of PAH (Ks) decreased at 15 mg L-1 RD concentration compared with the control without biosurfactant at a sludge retention time (SRT) of 25 days.

We reviewed the medical records of patients who underwent vaginal uterosacral ligament PND-1186 nmr suspensions using braided polyester suture. Outcome measures included rate and timing of suture complications, patient symptoms post-operatively, efficacy of treatment modalities and surgical success.

Eighty-three patients had undergone USLS

with braided, polyester suture over the study period that met inclusion criteria. Thirty-seven patients (44.6%) had suture-related complications post-operatively with a mean follow-up of 10.4 months. When only silver nitrate was applied, 16.7% improved, and when the suture was cut in clinic, 77.8% resolved.

Permanent polyester braided suture for suspension of vaginal vault may lead to an unacceptably high suture erosion rate, cutting the suture in clinic results in the highest resolution.”
“Objective-To determine diagnostic accuracy of a compartmented bacteriologic culture and antimicrobial susceptibility testing plate (CCSP) for detection of bacterial urinary tract infection (UTI) in dogs and antimicrobial susceptibility testing of bacterial isolates.

Design-Evaluation study.

Sample-62 frozen, previously characterized bacterial isolates from canine urine cultures and 147 canine urine samples.

Procedures-The study was conducted in

2 phases: preliminary assay validation click here (phase 1) and diagnostic validation (phase 2). For phase 1, the frozen bacterial isolates were revitalized and tested with the CCSP and with standard aerobic microbiological culture (SAMC). For phase 2, the urine samples were tested with the CCSP and SAMC in parallel.

Results-For CH5424802 phase 1, after 24 hours of culture, 46 of 62 (74%) bacterial isolates had growth on the CCSP and all (100%) had growth in SAMC. For bacterial isolates with growth, the CCSP allowed correct identification of 45 of 46 (98%)

isolates. Isolates yielding no growth on the CCSP were gram-positive cocci (Staphylococcus spp [n = 7] and Enterococcus spp [9]. In phase 2, the overall diagnostic accuracy of the CCSR compared with SAMC, was 94% (sensitivity, 81%; specificity, 99%).The positive predictive value was 98% and negative predictive value was 92%. Susceptibility results for enrofloxacin and trimethoprim-sulfamethoxazole as determined with the CCSP had greatest concordance with those determined by SAMC (71% and 96%, respectively), compared with other antimicrobial susceptibilities.

Conclusions and Clinical Relevance-Use of the CCSP led to accurate exclusion of UTI in dogs without a UTI but was less reliable for diagnosis of UTI, particularly infections caused by gram-positive cocci. Standard aerobic microbiological culture remains the gold standard for detection of UTI in dogs.

The prepared inclusion complexes were characterized by FTIR and DSC. Significant improvement in the dissolution was found with S and R enantiomers of amlodipine base where as no improvement was found with enantiomers of amlodipine besylate (p > 0.05) after complexation with HPBC. This indicates the formation of inclusion complexes with only enantiomers of amlodipine base (p < 0.05). No stereospecific dissolution was found with pure amlodipine besylate enantiomers. In case of

physical mixing no inclusion complexes were formed even with enantiomers of amlodipine base (p > 0.05). Stereospecific dissolution was observed with pure enantiomers of amlodipine base when its inclusion complexes were prepared by solvent evaporation method with 1:1 and 1:2 molar ratios but not with 1:3 molar ratio.”
“Background: Hip dysplasia leads to abnormal loading check details of articular cartilage, which results in osteoarthritis. The purpose of this study was to investigate the anatomic and demographic factors associated with the early onset of osteoarthritis in dysplastic hips by utilizing the delayed gadolinium-enhanced

magnetic resonance imaging of cartilage (dGEMRIC) index as a marker of the disease.

Methods: Ninety-six symptomatic dysplastic hips in seventy-four patients were assessed with standard radiographs and a dGEMRIC scan. The lateral center-edge angle of Wiberg, the acetabular index of Tonnis, and the break in the Shenton line were measured on a standing MAPK inhibitor selleck products anteroposterior radiograph. Anterior undercoverage was assessed by measuring the anterior center-edge angle on a Lequesne false-profile view. A labral tear was considered to be present when contrast agent was seen through the entire thickness of the labrum on magnetic resonance arthrography. Osteoarthritis

was defined as a dGEMRIC value of <390 msec (two standard deviations below the dGEMRIC index in normal hips).

Results: The mean dGEMRIC index (and standard deviation) for this cohort (473 +/- 104 msec) was significantly lower than that of a morphologically normal hip (570 90 msec). The anterior center-edge angle, the joint space width, and the presence of a labral tear were all found to be associated with osteoarthritis in the univariate analysis. Multivariate analysis identified age, the anterior center-edge angle, and the presence of a labral tear as independent factors associated with osteoarthritis. A second model was fitted with omission of the anterior center-edge angle because the lateral and anterior center-edge angles were highly correlated and the lateral center-edge angle is a more common clinical measure. This model identified age, the lateral center-edge angle, and the presence of a labral tear as significant independent factors associated with osteoarthritis.