The association between walking speed from short- and standard-distance tests with the risk of all-cause mortality among adults with radiographic knee osteoarthritis: data from three large United States cohort studies

Objective: Adults with radiographic knee OA (rKOA) are at increased risk of mortality and walking difficulty may modify this relation. Little is known about specific aspects of walking difficulty that increase mortality risk. We investigated the association of walking speed (objective measure of walking difficulty) with mortality and examined the threshold that best discriminated this risk in adults with rKOA. Methods: Participants with rKOA from the Johnston County Osteoarthritis Project (JoCoOA, longitudinal population-based cohort), Osteoarthritis Initiative and Multicenter Osteoarthritis Study (OAI and MOST, cohorts of individuals with or at high risk of knee OA) were included. Baseline speed was measured via 2.4-meter (m) walk test (short-distance) in JoCoOA and 20-m walk test (standard-distance) in OAI and MOST. To examine the association of walking speed with mortality risk over 9 years, hazard ratios (HR) and 95% confidence intervals (CI) were calculated from Cox regression models adjusted for potential confounders. A Maximal Likelihood Ratio Chi-square Approach was utilized to identify an optimal threshold of walking speed predictive of mortality. Results: Deaths after 9 years of follow-up occurred in 23.3% (290/1244) of JoCoOA and 5.9% (249/4215) of OAI + MOST. Walking 0.2 m/s slower during short- and standard-distance walk tests was associated with 23% (aHR [95%CI]; 1.23 [1.10, 1.39]) and 25% (1.25 [1.09, 1.43]) higher mortality risk, respectively. Walking <0.5 m/s on short-distance and <1.2 m/s standard-distance walk tests, best discriminated those with and without mortality risk. Conclusion: Slower walking speed measured via short- and standard-distance walk tests was associated with increased mortality risk in adults with rKOA

Mortality associated with using medetomidine and ketamine for general anesthesia in pregnant and nonpregnant Wistar rats

Medetomidine and ketamine are injectable drugs that can be used in combination to induce general anesthesia in rats. After noticing a high incidence of morbidity and mortality in pregnant Wistar rats given medetomidine and ketamine for anesthesia, the authors further investigated the effects of this combination of anesthetic drugs in both pregnant and nonpregnant Wistar rats. The time to recumbency and the duration of general anesthesia were similar between pregnant and nonpregnant rats. Pregnancy status did not affect the rats' pulse rate, respiratory rate, rectal temperature, oxygen saturation or perfusion index during 2 h of anesthesia. Pregnant rats had significantly lower blood glucose concentrations than nonpregnant rats at all time points, though blood glucose concentrations increased in both groups. The mortality rate was ̂1/415% both for nonpregnant rats and for pregnant rats. Researchers using medetomidine and ketamine to anesthetize Wistar rats should carefully monitor the rats in order to minimize mortality