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1.
BMC Musculoskelet Disord ; 25(1): 536, 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-38997710

RESUMO

BACKGROUND: Hypertension is a common comorbidity of osteoarthritis (OA). Joint pain is the main clinical manifestation of OA. Knowledge about the relationship between hypertension and OA pain is limited. This study aimed to investigate whether blood pressure parameters are associated with knee pain severity in individuals with or at risks for OA. METHODS: Our sample consisted of 2598 subjects (60.7% female, aged 45-79 years) collected from the Osteoarthritis Initiative. Blood pressure parameters included blood pressure stage, systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP). Radiographic evaluation using Kellgren-Lawrence system and pain severity evaluation using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Numeric Rating Scale (NRS) were performed for right knee. Linear regression was used to examine the relationship between blood pressure parameters and knee pain severity. RESULTS: For the overall sample, blood pressure stage, SBP, and PP were positively correlated with WOMAC and NRS pain scores when adjusting for age, sex, and body mass index (BMI) (p ≤ 0.024) and were inversely correlated with KOOS score (p ≤ 0.004). After further adjusting for all covariates, PP remained a positive correlation with WOMAC score (p = 0.037) while other associations between blood pressure parameters and pain scores did not reach the statistical significance. In female, higher blood pressure stage, SBP, and PP were significantly associated with increased WOMAC and NRS scores and decreased KOOS score after adjustments of age and BMI (p ≤ 0.018). When adjusting for all covariates, the correlations of PP with WOMAC, KOOS and NRS scores remained significant (p = 0.008-0.049). In male sample, SBP was positively correlated with WOMAC score when adjusting for age and BMI (p = 0.050), but other associations between blood pressure parameters and pain scores were not statistically significant. No significant correlation was observed in male when further adjusting for other covariates. CONCLUSIONS: Increased PP is a risk factor for knee pain and mainly affects females, which suggested that controlling PP may be beneficial in preventing or reducing knee pain in females with or at risks for OA.


Assuntos
Artralgia , Pressão Sanguínea , Osteoartrite do Joelho , Medição da Dor , Índice de Gravidade de Doença , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/diagnóstico , Pressão Sanguínea/fisiologia , Artralgia/fisiopatologia , Artralgia/epidemiologia , Artralgia/diagnóstico , Artralgia/etiologia , Fatores de Risco , Articulação do Joelho/fisiopatologia , Articulação do Joelho/diagnóstico por imagem , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Hipertensão/diagnóstico , Estudos Transversais
2.
Eur J Radiol ; 162: 110791, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36963331

RESUMO

PURPOSE: To investigate the association of lateral meniscal body extrusion (LMBE) with OA-related knee structural damage progression over 4 years and to obtain thresholds of LMBE in predicting knee structural damage progression. METHOD: We studied 196 subjects (67 male) with a mean age of 59.5 ± 7.9 (SD) years (range45-78 years) that were randomly selected from the Osteoarthritis Initiative. Radiological assessment was performed using the Osteoarthritis Research Society International grading system. Baseline LMBE was quantified on coronal sections of intermediate-weighted MRI sequences obtained at 3.0 T scanner. Knee structural damages were measured using the whole-organ MRI score. Linear regression analysis and binary logistic regression analysis was used to assess the correlation between LMBE and knee structural damage. ROC analysis and Youden index were used for calculating thresholds. RESULTS: Cross-sectionally, increased LMBE was significantly associated with more severe lateral meniscal damage, patellofemoral and lateral compartment cartilage damage, and posterior cruciate ligament damage. Longitudinally, LMBE was statistically associated with progression of lateral meniscal damage, lateral compartment cartilage damage and bone marrow edema patterns, posterior cruciate ligament lesions and popliteal cysts. The thresholds of LMBE in suggesting progression of lateral meniscal lesions and lateral compartment cartilage lesions were 1.4 mm and 1.3 mm, respectively. CONCLUSION: Baseline LMBE was associated with structural damage progression over 4 years in knees with or at risks for OA. Thresholds of 1.4 mm and 1.3 mm could be used in predicting progression over 4 years of lateral meniscal damage and lateral compartment cartilage damage, respectively.


Assuntos
Cartilagem Articular , Osteoartrite do Joelho , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/patologia , Cartilagem Articular/patologia , Meniscos Tibiais/diagnóstico por imagem , Meniscos Tibiais/patologia , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética , Progressão da Doença
3.
BMC Endocr Disord ; 23(1): 2, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36597099

RESUMO

BACKGROUND: Iron-overloaded patients are recognized as presenting an increased risk of osteoporosis. However, studies on the correlation between osteoporosis and organ iron overload are controversial or scarce. The aim of this study is to assess bone mineral density (BMD) and trabecular bone score (TBS) in correlation with hepatic and pancreatic iron overload. METHODS: Forty-one patients diagnosed with hemoglobinopathies, were studied. BMDs of the lumbar spine (LS), femoral neck (FN), and total hip (TH) were analyzed by Dual-energy X-ray absorptiometry (DXA) scan. LS bone quality was derived from each spine DXA examination using the TBS analysis. Hepatic and pancreatic iron overload were obtained with a multi-echo gradient echo T2* technique. RESULTS: Abnormal microarchitecture and abnormal bone mass were observed in 19/41 (46.3%) and 9/41 (22.0%) patients, respectively. For 26 males, BMD, T-score and Z-score of LS were significantly lower among subjects with moderate-severe hepatic iron-overload than their counterparts, as it is between no- and pancreatic iron-overload groups. For 15 females, patients with moderate-severe hepatic iron-overload had significantly lower BMD and T-score of FN and TH, and patients with pancreatic iron-overload had significantly lower BMD, T-score of FN, and lower BMD, T-score and Z-score of TH than their counterparts. Moreover, pancreatic T2*-value was positively correlated with BMD and T-score at all analyzed sites and Z-score at TH. CONCLUSION: These data showed lower bone mass in patients with organ iron overload, particularly for LS in males, FN and TH in females. TBS may well represent a complementary tool for the evaluation of bone quality and the risk of fracture in iron-overloaded patients.


Assuntos
Sobrecarga de Ferro , Osteoporose , Fraturas por Osteoporose , Masculino , Feminino , Humanos , Densidade Óssea , Osso Esponjoso , Osteoporose/etiologia , Osteoporose/complicações , Absorciometria de Fóton/efeitos adversos , Absorciometria de Fóton/métodos , Colo do Fêmur , Vértebras Lombares/diagnóstico por imagem , Sobrecarga de Ferro/complicações , Sobrecarga de Ferro/diagnóstico por imagem , Imageamento por Ressonância Magnética , Ferro
4.
Front Cardiovasc Med ; 9: 893355, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35647037

RESUMO

Mechanical circulatory support (MCS) has become a processing technique used in end-stage heart failure (ESHF) because it can significantly improve survival and quality of life in patients with ESHF as either a transitional support therapy or a permanent replacement therapy before heart transplant. However, various potential complications associated with MCS need to be considered, especially aortic root thrombus formation. It's critical to have an appropriate diagnosis of aortic root thrombus and "watershed" because the prognosis and treatment are different. Both "watershed" and aortic root thrombus formation can be characterized by computed tomography angiography. The CT manifestations of two patients who had MCS device implantation in our hospital (one with intra-aortic balloon pumps + extracorporeal membrane oxygenators, the other with left ventricular assist devices) were reported, and a literature review that recognized of "watershed" phenomenon in the aortic root was conducted.

5.
BMC Musculoskelet Disord ; 23(1): 218, 2022 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-35260117

RESUMO

BACKGROUND: Meniscal morphological changes are associated with knee OA. However, the correlation of meniscal height and OA-related knee structural abnormalities is still not well understood. The purpose of present study is to investigate whether and how meniscal anterior and posterior horn heights are associated with structural abnormalities in knees with symptomatic OA. METHODS: Our sample consisted of 106 patients (61 female, aged 40-73 years) with symptomatic knee OA. Kellgren-Lawrence system was used for radiographic evaluation. On sagittal sequence, medial meniscal posterior horn height (MPH), lateral meniscal anterior horn height (LAH) and lateral meniscal posterior horn height (LPH) were measured on the middle slice through the medial/lateral compartment. Knee structural abnormalities were assessed using the modified whole-organ magnetic resonance imaging score (WORMS). Associations between meniscal anterior and posterior horn heights and knee structural abnormalities were assessed using linear regression analysis. RESULTS: Higher MPH was significantly associated with higher WORMS score for medial meniscal anterior horn lesion (P = 0.016) but did not have a statistical association with other WORMS parameters. Increased LAH was statistically correlated with decreased WORMS scores for lateral compartmental cartilage lesions (P = 0.001-0.004) and lateral compartmental bone marrow edema patterns (BMEPs) (P = 0.021-0.027). Moreover, LPH was negatively associated with WORMS scores for lateral compartmental cartilage lesions (P = 0.007-0.041) and lateral compartmental BMEPs (P = 0.022-0.044). Additionally, higher MPH was statistically associated with lower trochlea cartilage WORMS score and higher LAH was significantly correlated with higher WORMS score for trochlea subarticular cysts. CONCLUSIONS: Changes of LAH and LPH were inversely associated with the severity of lateral compartmental cartilage lesions and BMEPs, while higher MPH was only significantly correlated with more severe medial meniscal anterior horn lesions. Besides, MPH and LAH were also significantly associated with patellofemoral structural abnormalities. The present study provided novel information for understanding the role of meniscal morphological changes in knee OA, which would be helpful in identifying and evaluating knees with or at risks for OA.


Assuntos
Cartilagem Articular , Osteoartrite do Joelho , Idoso , Cartilagem Articular/patologia , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética/métodos , Meniscos Tibiais/diagnóstico por imagem , Meniscos Tibiais/patologia , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/patologia
6.
Br J Radiol ; 94(1124): 20210152, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34192479

RESUMO

OBJECTIVES: To investigate whether and how meniscal height is associated with osteoarthritis (OA)-related knee structural changes in symptomatic knee OA. METHODS: We studied 106 patients (61 female, aged 40-73 years) with symptomatic knee OA. X-ray was used for Kellgren-Lawrence score. Meniscal body heights and extrusion were measured on coronal sections of intermediate-weighted MRI sequence. Knee structural changes were assessed using the modified whole-organ magnetic resonance imaging score (WORMS). Associations between meniscal body height and knee structural changes were assessed using linear regression analysis. RESULTS: Higher medial meniscal body height was significantly associated with severe medial meniscal lesions (p = 0.001-0.023), medial compartmental cartilage lesions (p = 0.045), patellofemoral compartmental and medial compartmental bone marrow edema patterns (p = 0.001-0.037), anterior cruciate ligament and patellar ligament abnormalities (p = 0.020-0.023), and loose bodies (p = 0.017). However, lateral meniscal body height was negatively correlated with WORMS scores for lateral meniscal lesions (p ≤ 0.018), lateral compartmental cartilage lesions (p ≤ 0.011), and lateral compartmental bone marrow edema patterns (p = 0.038). CONCLUSION: Higher medial meniscal body height was associated with more severe medial compartment structural abnormalities and patellofemoral bone marrow edema patterns, while lateral meniscal body height was inversely correlated with the severity of lateral compartment structural abnormalities. ADVANCES IN KNOWLEDGE: Our study revealed that meniscal body height was associated with multiple OA-related knee structural changes, which would be beneficial in identifying patients with or at risks for knee OA.


Assuntos
Meniscos Tibiais/patologia , Osteoartrite do Joelho/patologia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Meniscos Tibiais/diagnóstico por imagem , Pessoa de Meia-Idade , Tamanho do Órgão , Osteoartrite do Joelho/diagnóstico por imagem , Estudos Retrospectivos
7.
J Clin Densitom ; 23(3): 395-402, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30425005

RESUMO

INTRODUCTION: Bone mineral density measured by dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosis of osteoporosis. However, DXA interpretation can be influenced by analytic errors which can, in turn, interfere with diagnostic accuracy. One such source of potential error is the accurate identification of specific lumbar vertebrae on lumbar spine DXA images. Although the International Society for Clinical Densitometry has introduced several approaches to aid with this process, there remain individuals whose lumbar vertebrae cannot be labeled with certainty using these approaches. We designed the present study to systematically evaluate lumbar spine DXA images among a large cohort of Chinese patients and present an additional simple strategy for identifying L5 named the "em dash"-shaped L5 or "-"-shaped L5, based upon the two-dimensional relationship between the bilateral pedicles with the central spinous process on DXA images. METHODOLOGY: Lumbar spine posteroanterior DXA images from adult patients receiving care at a large tertiary hospital in Beijing, China from May to August 2016 were retrospectively reviewed. For each patient, data were collected regarding key anatomic features seen on DXA (positions of the most superior portions of the iliac crests, the lowest vertebra with ribs, and the longest transverse processes) and the proportion of patients presenting with "H"-shaped L4 and "-"-shaped L5. Chi-squared analyses were used to compare proportions across age strata. RESULTS: DXA images from 1125 patients (79.6% female) were evaluated. The mean age of patients was 52.5 ± 14.8 yr (range: 19-90 yr). A horizontal line drawn across the superior-most portions of the iliac crests crossed the disk space between L4 and L5 among 78.3% of patients. The lowest ribs were most frequently (83.9%) observed at T12. Almost 80% of individuals had the longest transverse processes at L3. L4 was predominantly "H"-shaped (73.3%), however we found that the proportion of individuals with "H"-shaped L4 decreased steadily after 50 yr of age (p < 0.001). By contrast we observed that L5 was predominantly "-"-shaped (80.3%), with no significant differences in proportions across all age strata (p = 0.063). CONCLUSIONS: The "-"-shaped L5 can be incorporated as an additional reference tool for lumbar spine DXA image analysis and may be particularly helpful for lumbar vertebrae identification among patients over 50 yr of age.


Assuntos
Absorciometria de Fóton , Vértebras Lombares/diagnóstico por imagem , Osteoporose/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
8.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 39(4): 459-464, 2017 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-28877821

RESUMO

Objective To explore whether baseline body composition and other clinical factors are associated with incomplete immune response after highly active antiretroviral therapy(HAART)in Chinese men with human immunodeficiency virus(HIV)or acquired immunodeficiency syndrome(AIDS).Methods A retrospective study was conducted among HIV/AIDS male patients who achieved viral suppression(maintained HIV-1 RNA levels<400 copies/ml)after a year of HAART between 2007 and 2015.Clinical,immunological,and virological data were collected from patients' files,including weight,height,and whole body composition measured within one month prior to staring HAART.Body mass index(BMI),lean mass index(LMI),fat mass index(FMI),and body bone mineral content/height were adjusted by height.According to whether the patients experienced incomplete immune responses(CD4 cell count<350 cells/µl)after a year of HAART,the patients were divided into two groups:the complete immune response(CD4 cell count≥350 cells/µl)and the incomplete immune response(CD4 cell count<350 cells/µl),respectively.Student's t test,chi-square test,and Wilcoxon rank test were used to assess differences between these two groups.Multiple Logistic regression analysis was used to assess factors associated with an incomplete immune response in patients with sustained viral suppression.Results Totally 84 HIV/AIDS male patients with viral suppression were included in this study.There were statistical differences between these two groups in terms of age(Z=-2.479,P=0.013),baseline BMI(t=2.030,P=0.045),LMI(t=2.200,P=0.029),and CD4 cell count(Z=6.416,P=0.000).However,there was no statistical differences in viral load,FMI,body bone mineral content/height,HAART duration,and HAART regimen(all P>0.05).BMI[OR=0.742,95% confidence interval(CI)=0.554-0.993,P=0.044],LMI(OR=0.459,95% CI=0.249-0.844,P=0.012),HAART duration(OR=10.161,95% CI=1.110-93.052,P=0.040),baseline CD4 cell count(OR=80.051,95% CI=8.396-762.563,P=0.000)were significantly associated with incomplete immune response.Age(OR=1.497,95% CI=0.213-10.505,P=0.685),viral load(OR=0.333,95% CI=0.071-1.572,P=0.164),FMI(OR=0.797,95% CI=0.546-1.164,P=0.240),body bone mineral content/height(OR=1.145,95% CI=0.037-35.676,P=0.938)and HAART regimen(OR=0.430,95% CI=0.159-1.159,P=0.095)were not associated with incomplete immune response.Conclusions Baseline CD4 cell count and HAART duration may affect immune response.Patients with higher baseline BMI or higher LMI may be less likely to develop incomplete immune response.Baseline FMI and body bone mineral content/height ratio are not associated with incomplete immune response.


Assuntos
Terapia Antirretroviral de Alta Atividade , Composição Corporal , Infecções por HIV/tratamento farmacológico , Contagem de Linfócito CD4 , Infecções por HIV/imunologia , Humanos , Masculino , Estudos Retrospectivos , Carga Viral
9.
J Clin Densitom ; 2017 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-28843432

RESUMO

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

10.
Arch Med Sci ; 13(4): 807-812, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28721148

RESUMO

INTRODUCTION: Dyslipidemia is associated with increased rho-associated kinase 2 (ROCK2) concentration. Whether moderate aerobic exercise could attenuate leukocyte ROCK2 concentration is unknown. MATERIAL AND METHODS: One hundred subjects with dyslipidemia and without statin treatment were enrolled and assigned to exercise and control groups. In the exercise group, at least 30 min of moderate aerobic exercise per day 5 times weekly was recommended. In the control group, participants were recommended to undertake exercise of the same intensity as the exercise group but not mandatorily. At baseline and 3 months later, between-group differences were compared. RESULTS: At baseline, dyslipidemia in both groups was characterized by increased serum levels of total cholesterol and low density lipoprotein cholesterol (LDL-C). Serum high-sensitivity C-reactive protein (hs-CRP) level was comparably increased too, and the average daily exercise time was extremely low: 5.8 ±2.7 min and 6.2 ±3.1 min respectively. Leukocyte ROCK2 concentration in the two groups was 38.4 ±7.5 mg/ml and 40.2 ±8.2 mg/ml respectively. Three months later, compared with the control group, average daily exercise time was significantly longer in the exercise group (37.4 ±4.3 min vs. 16.5 ±7.5 min, p < 0.05). Leukocyte ROCK2 concentration was also significantly reduced (27.6 ±4.3 mg/ml vs. 34.6 ±5.2 mg/ml, p < 0.05). Serum nitric oxide (NO) concentration in the exercise group was significantly higher than the control group (p < 0.05). Multivariate linear regression analysis revealed that NO and exercise time were significantly associated with leukocyte ROCK2 concentration after adjusting for traditional risk factors. CONCLUSIONS: Moderate aerobic exercise could effectively attenuate leukocyte ROCK2 concentration in subjects with dyslipidemia.

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