ABSTRACT
Despite the fact that dietary supplements (DS) are not medicines, an increasing number of publications testify to the effectiveness of probiotics consumed with food in the complex treatment and prevention of a number of diseases of the gastrointestinal tract, including irritable bowel syndrome (IBS) and antibiotic-associated diarrhea (AAD). The purpose of the study was to evaluate the effectiveness of the complex probiotic in the relief of diarrheal syndrome associated with intestinal microbiota dysbiosis in patients with IBS with diarrhea and AAD. Material and methods. The study included 54 patients (31 with IBS with diarrhea and 23 with idiopathic AAD) aged 18 to 50 years. All patients included in the study were prescribed 1 capsule (350 mg) of the DS Neobiotic Lactobalance® per day for 21 days. One capsule contains: bifidobacteria (Bifidobacterium longum CBT BG7, Bifidobacterium lactis CBT BL3 Bifidobacterium bifidum CBT BF3), lactobacilli (Lactobacillus acidophilus CBT LA1, Lactobacillus rhamnosus CBT LR5), lactic acid bacteria (Streptococcus thermophilus CBT ST3), fructooligosaccharides, vitamin C. The daily intake of bifidobacteria was 8.7×108 CFU, lactobacilli - 6.1×109 CFU, lactic acid bacteria 3.1×108 CFU and vitamin C - 12 mg. The severity of symptoms was assessed in points (from 0 to 7 points) using the GSRS questionnaire (Gastrointestinal Symptom Rating Scale). All patients underwent a microbiological analysis of feces with an assessment of the degree of dysbiosis before and after the administration of DS. Results. In patients with IBS with diarrhea, the assessment of the manifestations of diarrheal syndrome according to the GSRS questionnaire decreased statistically significantly from 17 to 6 points (2.9 times), abdominal pain - from 12 to 4 points (3.0 times) and dyspeptic syndrome - from 8 to 3 points (in 2.7 times). In patients with AAD, also according to the GSRS questionnaire, the manifestations of diarrheal syndrome decreased statistically significantly from 13 to 3 points (4.3 times), abdominal pain - from 4 to 1 points (4.0 times) and dyspepsia syndrome - from 5 to 2 points (in 2.5 times). Against the background of DS intake, according to the data of bacteriological examination of feces, intestinal microbiota normalized by day 21 due to an increase in the number of lacto- and bifidobacteria (p=<0.05). Conclusion. The study showed that the DS Neobiotic Lactobalance® contributes to the normalization of the intestinal microbiota and reduces the severity of clinical manifestations (diarrheal disorders or manifestations of diarrhea) in IBS and idiopathic AAD.
Subject(s)
Gastrointestinal Microbiome , Irritable Bowel Syndrome , Probiotics , Humans , Irritable Bowel Syndrome/complications , Irritable Bowel Syndrome/microbiology , Dysbiosis/chemically induced , Dysbiosis/complications , Diarrhea/complications , Diarrhea/therapy , Lactobacillus , Probiotics/therapeutic use , Treatment Outcome , Bifidobacterium , Abdominal Pain , Vitamins , Anti-Bacterial Agents/therapeutic use , Ascorbic AcidABSTRACT
Myostatin is a protein belonging to the myokine class, the family of transforming growth factors ß (TGF-ß). The review article, based on the analysis of literature data, shows the key role of myostatin in the development of senile sarcopenia and cachexia in various pathological conditions, such as cancer, chronic heart failure, chronic renal failure, COPD, etc. The article discusses the structure of myostatin, provides a detailed diagram of the synthesis and activation of myostatin, the ways of implementing the mechanism of action as a negative regulator of muscle growth and differentiation in these pathological conditions. The main physiological properties and clinical significance are highlighted. Exogenous and endogenous factors regulating myostatin expression and possible mechanisms of their action are considered.
Subject(s)
Myostatin , Sarcopenia , Cachexia , Cell Differentiation , Humans , Muscle, Skeletal/pathology , Transforming Growth Factor betaABSTRACT
The macrocyclic ligand calix[4]arene (L1) and its sulphur-containing analogue thia[4]calixarene (L2) are promising precursors for functional molecular materials as they offer rational functionalization with various organic groups. Here, we present the first example of lanthanide-based coordination polymers built from the macrocyclic thiacalix[4]arene backbone bearing four carboxylic moieties, namely, ligand H4L3. The combination of H4L3 with the Tb3+ and Dy3+ cations led to the formation of 1D ladder-type coordination polymers with the formula [LnIIIHL3DMF3]·(DMF) (where DMF = dimethylformamide and Ln = Tb or Dy, denoted as HL3-Tb and HL3-Dy), which resulted from the coordination of the lanthanide cations with the partially deprotonated ligand HL33- that behaved as a T-shape connector. The coordination sphere around the metal was completed by the coordinated DMF solvent molecules. By combining both Tb3+ and Dy3+ cations, isostructural heterobimetallic solid solutions HL3-Tb1- x Dy x were also prepared. HL3-Tb and HL3-Dy showed visible light photoluminescence originating from the f-f electronic transitions of pale green emissive Tb3+ and pale yellow emissive Dy3+ with efficient sensitization by the functionalized thia[4]calixarene ligand HL3. In the HL3-Tb1- x Dy x solid solutions, the Tb/Dy ratio governed both the emission colour as well as the emission quantum yield, which reached even 28% at room temperature for HL3-Tb. Moreover, HL3-Dy exhibited a slow magnetic relaxation effect related to the magnetic anisotropy of the dodecahedral Dy3+ complexes, which were well isolated in the crystal lattice by expanded organic spacers.
ABSTRACT
OBJECTIVES: Available evidence suggests that genetic factors and overweight play major roles in the aetiology of osteoarthritis (OA). We analysed the association of 18 single-nucleotide polymorphisms (SNPs) from nine adipokine and adipokine receptor genes (LEP, LEPR, ADIPOQ, RETN, NAMPT, SERPINA12, ITLN1, RARRES2, and APLN) with radiographic hand OA. METHOD: The study design was cross-sectional. Bilateral hand radiographs of 542 occupationally active Finnish female dentists and teachers aged 45-63 years were examined and classified for the presence of hand OA using reference images. Hand OA was defined as at least three finger joints with radiographic OA of grade 2-4. The genotypes were determined using polymerase chain reaction-based methods. Body mass index (BMI) was calculated based on self-reported height and measured weight. Associations of the individual SNPs and their haplotypes with hand OA were tested using logistic regression analysis. RESULTS: The minor allele of RETN rs10401670 was associated with a decreased [odds ratio (OR) = 0.73, 95% confidence interval (CI) 0.55-0.97, p = 0.03] and RARRES2 rs4721 with an increased (OR 1.41, 95% CI 1.07-1.87, p = 0.01) prevalence of hand OA. Also, LEPR AC (OR 1.54, 95% CI 1.01-2.35, p = 0.05) and RETN GGTT (OR 0.58, 95% CI 0.37-0.93, p = 0.02) haplotypes were associated with hand OA. These associations were modified by BMI when comparing normal and overweight women. However, the associations lost their statistical significance after adjusting for multiple testing. CONCLUSION: Our results suggest weak associations between the studied variations in LEPR, RARRES2, and RETN genes and hand OA in Finnish women, and that the associations are modified by BMI. However, these associations could not be verified in the current study.
Subject(s)
Adipokines/genetics , Osteoarthritis/genetics , Alleles , Cross-Sectional Studies , Female , Finland , Genetic Predisposition to Disease , Genotype , Hand/pathology , Humans , Middle Aged , Polymerase Chain Reaction , Polymorphism, Single NucleotideABSTRACT
The aim of the present study was to investigate the impact of endogenous and exogenous factors for the expression of the daily rhythms of body temperature (BT), blood pressure (BP) and heart rate (HR). One hundred and seventy-three young adults (YA), 17-24 years old (y.o.), of both genders were studied under a modified constant-routine (CR) protocol for 26 h. Participants were assigned randomly to groups with different lighting regimens: CR-LD, n = 77, lights (>400 l×) on from 09:00 to 17:00 h and off (<10 l×) from 17:00 to 09:00 next morning; CR-LL, n = 81, lights on (>400 l×) during the whole experimental session; CR-DD, n = 15, constant dim light (<10 l×) during the whole experiment. Systolic (SBP) and diastolic (DBP) BP, HR and BT were measured every 2 h. For comparison, the results of the former studies performed under conditions of regular life with an activity period from 07:00 to 23:00 h and sleep from 23:00 till 07:00 h (Control) were reanalyzed. Seven-day Ambulatory Blood Pressure Monitoring (ABPM) records from 27 YA (16-38 y.o.) and BT self-measurement data from 70 YA (17-30 y.o.) taken on ≥ 3 successive days at 08:00, 11:00, 14:00, 17:00, 20:00, 23:00 and 03:00 were available. The obtained daily patterns were different between Control and CR-DD groups, due to effects of activity, sleep and light. The comparison of Control and CR-LD groups allowed the effects of sleep and activity to be estimated since the lighting conditions were similar. The activity level substantially elevated SBP, but not DBP. Sleep, on the other hand, lowered the nighttime DBP, but has no effect on SBP. HR was affected both by activity and sleep. In accordance with previous studies, these results confirm that the steep BP increase in the morning is not driven by the circadian clock, but rather by sympathoadrenal factors related to awakening and corresponding anticipatory mechanisms. The effect on BT was not significant. To investigate the impact of light during the former dark time and darkness during the former light time, the CR-LL and CR-DD groups were each compared with the CR-LD group. Light delayed the evening decrease of BT, most likely via a suppression of the melatonin rise. Besides, it had a prominent arousal effect on SBP both in the former light and dark phases, a moderate effect on DBP and no effect on HR. Darkness induced decline in BT. BP values were decreased during the former light time. No effects on HR were found. Altogether, the results of the present paper show that BT, BP and HR are affected by exogenous factors differently. Moreover, the effect was gender-specific. Especially, the response of BT and BP to ambient light was evident only in females. We suppose that the distinct, gender-specific responses of SBP, DBP and HR to activity, sleep and ambient light do reflect fundamental differences in the circadian control of various cardiovascular functions. Furthermore, the presented data are important for the elaboration of updated reference standards, the interpretation of rhythm disorders and for personalized chronotherapeutic approaches to prevent adverse cardiovascular events more effectively.
Subject(s)
Blood Pressure/physiology , Body Temperature/physiology , Circadian Rhythm , Heart Rate/physiology , Sleep/physiology , Adolescent , Exercise , Female , Humans , Light , Male , Young AdultABSTRACT
OBJECTIVE: To examine whether heavy physical workload in young adulthood increases the risk of local and radiating low back pain (LBP) in midlife. METHODS: Longitudinal nationally representative Young Finns Study data among women (n=414) and men (n=324), aged 18-24â years in 1986 (baseline), were used. Physical heaviness of work was reported at baseline and follow-up (2007), and local and radiating LBP at follow-up. Covariates were age, smoking and body mass index. Logistic regression was used to examine the associations between physical heaviness of work and LBP. Additionally, the mediating effect of back pain at baseline was examined (the Sobel test). RESULTS: After adjustment for the covariates, and as compared with sedentary/light physical workload, heavy physical workload was associated with radiating LBP among women (OR 4.09, 95% CI 1.62 to 10.31) and men (OR 2.01, 95% CI 1.06 to 3.82). Among men, early back pain mediated the association (p value from the Sobel test=0.006). Among women, early exposure to physically heavy work showed the most consistent associations, while early and late exposures were associated with radiating and local LBP among men. Persistently heavy physical work was associated with radiating LBP among women and men. CONCLUSIONS: Physically heavy work at a young age can have a long-lasting effect on the risk of LBP, radiating LBP in particular. These results highlight the need to consider early and persistent exposures to prevent the adverse consequences of physical workload for the low back.
Subject(s)
Low Back Pain/etiology , Occupational Diseases/etiology , Physical Exertion , Workload , Adolescent , Adult , Body Mass Index , Cardiovascular Diseases , Female , Finland/epidemiology , Humans , Logistic Models , Low Back Pain/epidemiology , Male , Occupational Diseases/epidemiology , Physical Exertion/physiology , Risk Factors , Sex Distribution , Smoking , Young AdultABSTRACT
BACKGROUND: Few studies have addressed the role of obesity in young adulthood in knee problems later in life. We assessed the associations of overweight/obesity with knee pain and functional limitations of the knee across the life course. METHODS: Military health records from 1967 to 2000 (baseline) were searched for 18- to 50-year-old Finnish men (n = 1913) who participated in the Health 2000 Study (follow-up). Visits to health care were followed during service. Height and weight were measured at baseline and follow-up and waist circumference at follow-up. Weight was inquired at follow-up for ages of 20, 30, 40 and 50 years, if applicable. Life course body mass index (BMI) was calculated. One-month knee pain and functional limitations (walking difficulties and limping) due to knee problems were enquired with interview at follow-up. Cox regression model, logistic regression and trajectory analysis were applied. RESULTS: Body mass index at the age of 20 increased the risk of unilateral knee pain by 38% and functional limitations by 27% for one standard deviation increment of BMI, respectively. One-unit increment of Z-score of life course BMI increased knee pain by 32%. Development of severe obesity during the follow-up increased the risk of knee pain by 80% and functional limitations by 93%. The effect of obesity on functional limitations was partly mediated by traumatic knee problems during military service. CONCLUSIONS: Reducing overweight already in adolescence and avoiding further weight gain during life course may prevent knee pain and associated disability. WHAT DOES THIS STUDY ADD?: BMI at the age of 20 increases the likelihood of knee pain and functional limitations of the knee later in life. Development of severe obesity in adulthood increases the risk of knee pain by 80% and functional limitations by more than 90%. Both general and abdominal obesity are associated with knee pain, associations being stronger for general obesity.
Subject(s)
Arthralgia/etiology , Knee Joint , Mobility Limitation , Obesity/complications , Adolescent , Adult , Body Mass Index , Humans , Logistic Models , Longitudinal Studies , Male , Walking , Young AdultABSTRACT
OBJECTIVES: Policies have been introduced to reduce sickness absence, but their effectiveness is largely unknown. In a natural experiment, we examined effects of legislative changes on return to work and work participation. METHODS: The source population consisted of up to 72,164 Finnish public sector employees with a permanent job contract in 2008-2011 (before) and in 2013-2014 (after). We used employees with a continuous sickness absence of at least 30 calendar-days (n=5708-6393), 60 compensated days (n=1481-1655) and 90 compensated days (n=766-932). We examined sustainable return to work (a minimum of 28 consecutive working days) with survival analysis as well as monthly work participation after a sickness absence, and annual gain in work participation after the intervention, using trajectory analyses. RESULTS: Sustainable return to work after 60â days of sickness absence occurred earlier after the legislative changes (p value 0.017), although the effect reduced towards the end of the follow-up. There were no differences in return to work after a 30 or 90â days of sickness absence. The largest annual gain, postintervention versus preintervention, in monthly work participation was observed among employees with 60â days of sickness absence and was 230.9 person-years/10,000 employees. The corresponding annual gains among those with 30â days and 90â days of sickness absence were 51.8 and 39.6, respectively. CONCLUSIONS: Our findings suggest that the legislative changes, obligating early notification of prolonged sickness absences as well as assessment of remaining work ability and possibilities to continue working, may enhance sustainable return to work in the short term. Other measures will be needed to enhance work participation, especially in the long term.
Subject(s)
Absenteeism , Return to Work/legislation & jurisprudence , Sick Leave/legislation & jurisprudence , Work Capacity Evaluation , Finland , Humans , Male , Middle Aged , Public Sector , Survival AnalysisABSTRACT
OBJECTIVES: We studied the long-term effects of early separation among aging Finnish evacuees and non-evacuees. A broad set of outcome variables reflecting the psychosocial well-being of both groups in 2005 was analyzed. The role of resilience was also analyzed. METHOD: To identify persons with similar patterns of psychosocial well-being among both evacuated (n = 887) and non-evacuated persons (n = 1748), a cluster analysis was conducted, using the mixture model of latent class analysis/latent profile analysis method. The psychosocial well-being of the evacuees and non-evacuees in 2005 was predicted by multinomial logistic regression analysis, with the nominal cluster variable as the dependent variable. RESULTS: Although the evacuees had experienced early separation trauma, they were not faring worse than the non-evacuees regarding psychosocial well-being in 2005. Favorable rearing home circumstances are a protective factor during the entire life span, when the psychosocial well-being of both groups was predicted in 2005. Sense of coherence was a significant predictor of psychosocial well-being. To rejoin the rearing family was stressful for many evacuees. CONCLUSION: The results show that even long-term separation from one's parents during childhood must be understood as representing a developmental context which makes the emergence of problems either less likely or more likely, depending on other risk and protective factors in both the rearing home and the foster family. After the war, when the evacuees returned home the families should have received help and support to amend the reunion.
Subject(s)
Child Rearing/psychology , Foster Home Care/psychology , Life Change Events , Personal Satisfaction , Refugees/psychology , Registries/statistics & numerical data , Aged , Child , Female , Finland , Humans , Male , Middle Aged , Sense of Coherence , Sweden , World War IIABSTRACT
BACKGROUND: Low back pain (LBP) is a prevalent problem and tends to be socio-economically patterned. Relatively little is known about life-course socio-economic circumstances as determinants of different types of LBP. Our aim was to examine whether childhood and adult socio-economic position and social mobility are associated with radiating and non-specific LBP and sciatica. METHOD: Data were derived from the Young Finns Study (n = 2231). Childhood socio-economic position was based on parental education, occupational class and family income at baseline in 1980. Data on own education and LBP outcomes were collected at the end of follow-up in 2007. Social mobility was based on parental and own education. Covariates were composed of age, parental body mass index and smoking. RESULTS: Both childhood and own socio-economic position remained associated with radiating LBP and sciatica after adjustments. However, the associations varied by socio-economic indicator and gender. Stable lower socio-economic position and downward mobility were associated with radiating LBP. CONCLUSION: Childhood socio-economic circumstances affect the risk of radiating LBP and sciatica in adulthood. To prevent low back disorders, early socio-economic circumstances need to be considered alongside own socio-economic position.
Subject(s)
Low Back Pain/epidemiology , Low Back Pain/therapy , Social Mobility/statistics & numerical data , Adolescent , Adult , Age Factors , Body Mass Index , Child , Child, Preschool , Educational Status , Female , Finland , Humans , Income , Male , Middle Aged , Parents , Prevalence , Sciatica/epidemiology , Sex Factors , Social Class , Socioeconomic Factors , Treatment OutcomeABSTRACT
The combination of the same organic tecton 1, a meta-pyridyl appended tetramercaptotetrathiacalix[4]arene in 1,3-alternate conformation offering four pyridyl units and eight thioether groups, with three silver salts AgX (X = BF4(-), NO3(-) and SbF6(-)) leads, under identical conditions (concentration, temperature and solvent system), to the formation of different silver coordination networks. Both the connectivity and the dimensionality of the three silver coordination networks depend on the nature of the anion used as a counter ion. Whereas the weakly coordinating BF4(-) anion does not participate in the formation of the non-tubular 1D coordination network, the coordinating NO3(-) anion is bound to the metal cation and this leads to the formation of a tubular 1D silver coordination network. In both cases, the eight S atoms of the tecton 1 do not take part in the binding of the cation. In marked contrast, when the SbF6(-) anion is used as a counter ion, the organic tecton 1 behaves as a tetrakismonodentate through its four meta-pyridyl moieties and as a bischelating unit of the SCCS type leading thus to the formation of a porous 3D diamondoid-type network.
ABSTRACT
Combinations of tetramercaptotetrathiacalix[4]arene pyridyl-appended positional isomers with HgCl2 lead to the formation of neutral coordination networks with their dimensionality imposed by the position of the N atom on the pyridyl group.
ABSTRACT
Three p-H-thiacalix[4]arene pyridyl appended coordinating tectons (2-4) in a 1,3-alternate conformation have been prepared and structurally characterised in the solid state. These compounds are positional isomers differing only by the position of the nitrogen atom on the pyridyl ring. Their combinations with HgCl2 lead to the formation of 1- and 2-D neutral mercury coordination networks. Whereas for tecton 2 (ortho isomer) a 2D architecture resulting from the bridging of consecutive tectons by the mononuclear HgCl2 unit is obtained, for tecton 3 (meta isomer) again a 2D network is formed. However, in that case, the interconnection of consecutive organic tectons 3 takes place through a binuclear Hg2Cl4 species. Finally, in the case of tecton 4 (para position), a 1D ribbon type double chain arrangement resulting from the bridging of consecutive tectons by trinuclear Hg3Cl6 units followed by the interconnection of two chains through the fusion of the trinuclear centres into a hexanuclear node is observed.
Subject(s)
Mercury/chemistry , Organometallic Compounds/chemical synthesis , Phenols/chemistry , Sulfides/chemistry , Models, Molecular , Molecular Structure , Organometallic Compounds/chemistry , StereoisomerismABSTRACT
Uveal melanoma (UM) is unique among cancers in displaying reduced endogenous levels of sister chromatid exchange (SCE). Here we demonstrate that FANCD2 expression is reduced in UM and that ectopic expression of FANCD2 increased SCE. Similarly, FANCD2-deficient fibroblasts (PD20) derived from Fanconi anaemia patients displayed reduced spontaneous SCE formation relative to their FANCD2-complemented counterparts, suggesting that this observation is not specific to UM. In addition, spontaneous RAD51 foci were reduced in UM and PD20 cells compared with FANCD2-proficient cells. This is consistent with a model where spontaneous SCEs are the end product of endogenous recombination events and implicates FANCD2 in the promotion of recombination-mediated repair of endogenous DNA damage and in SCE formation during normal DNA replication. In both UM and PD20 cells, low SCE was reversed by inhibiting DNA-PKcs (DNA-dependent protein kinase, catalytic subunit). Finally, we demonstrate that both PD20 and UM are sensitive to acetaldehyde, supporting a role for FANCD2 in repair of lesions induced by such endogenous metabolites. Together, these data suggest FANCD2 may promote spontaneous SCE by influencing which double-strand break repair pathway predominates during normal S-phase progression.
Subject(s)
Fanconi Anemia Complementation Group D2 Protein/genetics , Fanconi Anemia/genetics , Melanoma/genetics , Rad51 Recombinase/genetics , Sister Chromatid Exchange , Uveal Neoplasms/genetics , Base Sequence , Cell Line, Tumor , DNA Damage , DNA Methylation , DNA Primers , DNA Replication , Humans , Polymerase Chain Reaction , Promoter Regions, GeneticABSTRACT
Three new organic tectons (24) based on the p-tert-butylthiacalix[4]arene backbone, blocked in the 1,3-alternate conformation, bearing four pyridyl coordinating moieties, have been synthesised and characterised in the solid state. The ligands are positional isomers and differ by the position of the N atom on the pyridyl unit (ortho for 2, meta for 3 and para for 4). Their combination with the Ag+ cation leads, reproducibly, to the formation of 2- and 3-D infinite silver coordination networks. Independent of the nature of the anion, the combination of 2 offering four (N,S) type chelates with the Ag+ cation affords an unprecedented diamond type 3D network. Both 3 and 4, behaving as tetrakis monodentate ligands, lead to the formation of 2-D architectures.
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OBJECTIVES: Among female dentists and teachers, we investigated the relationship of pinch grip strength with radiographic hand osteoarthritis (OA) and hand joint pain. MATERIALS AND METHODS: We studied 295 female dentists and 248 female teachers aged 45-63 years for pinch grip strength using the Martin Vigorimeter. Hand radiographs were examined for the presence of OA in the wrist and each joint of the first, second, and third fingers. Joint pain and tasks with high hand loading during leisure were assessed by questionnaire. Glove size was used as proxy for hand size. RESULTS: Symptomatic hand OA (jointwise co-occurrence of radiological findings and pain) increased the risk of low pinch grip strength in both hands, with an odds ratio (OR) of 3.3 (95% CI 1.8-6.2) for the right and 2.0 (95% CI 1.1-3.8) for the left hand, allowing for age, occupation, body mass index (BMI), hand size, and hand-loading leisure-time activity. The occurrence of findings and pain in non-corresponding joints was also associated with pinch grip strength in the right hand, but not in the left. Having only radiographic findings or pain was not associated with pinch grip strength. CONCLUSIONS: Our findings support the view that hand function is related to the severity of hand OA.
Subject(s)
Dentists , Finger Joint/physiopathology , Osteoarthritis/physiopathology , Pinch Strength , Teaching , Age Factors , Arthralgia/diagnosis , Arthralgia/etiology , Body Mass Index , Cohort Studies , Confidence Intervals , Female , Finger Joint/diagnostic imaging , Finland , Follow-Up Studies , Functional Laterality , Hand/physiopathology , Humans , Incidence , Logistic Models , Middle Aged , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Odds Ratio , Osteoarthritis/diagnostic imaging , Osteoarthritis/epidemiology , Pain Measurement , Radiography , Risk Factors , Severity of Illness IndexABSTRACT
OBJECTIVE: To explore the combination of data on functioning and work load for early identification of patients at risk for diminished work productivity in rheumatoid arthritis (RA). PATIENTS AND METHODS: In the FIN-RACo trial, 162 patients with recent onset RA and available for the workforce were treated with either a combination of disease-modifying antirheumatic drugs (DMARDs) or a single DMARD for 2 years. Otherwise, they received routine care and were followed up for 5 years. Data on their individual income and lost work days came from official registers. Loss of productivity was computed by the human capital approach. Self-reported data on physical work demand (Finnish Institute for Occupational Health Questionnaire) at baseline and on functioning (HAQ) at 6 months were linked according to the International Classification of Functioning, Disability and Health. RESULTS: Data on 112 patients were analyzable at 6 months; 35 (31%) of them had diminished capacity in functions required at paid work. Any mismatch between perceived abilities and requirements predicted future (7 through 60 months) loss of productivity - on average Euro 14,040 (95% confidence interval (CI): 9,143-20,511) per year in patients with the mismatch compared to Euro 3,043 (1,623-5,534) in those without any mismatch - and was associated with RA-related permanent work disability (hazard ratio: 11.6; 95%CI: 4.0-33.4). CONCLUSION: Linking together self-reported data about functioning and work load helps in early identification of the RA patients at risk for loss of working days.
Subject(s)
Arthritis, Rheumatoid , Self Disclosure , Surveys and Questionnaires , Work Capacity Evaluation , Workload , Adult , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/physiopathology , Arthritis, Rheumatoid/psychology , Disability Evaluation , Drug Therapy, Combination , Efficiency/physiology , Female , Finland , Follow-Up Studies , Humans , Male , Middle Aged , Occupational Health , Risk FactorsABSTRACT
OBJECTIVES: To study the role of two COL2A1 single nucleotide polymorphisms (rs3737548 and rs2276455) and their haplotypes in individual susceptibility to osteoarthritis (OA) of the hand in Finnish women. METHODS: Bilateral hand radiographs of 543 Finnish female dentists and teachers aged 45-63 years were examined and classified for the presence of OA by using reference images. The COL2A1 genotypes were determined by PCR-based methods. Data regarding other risk factors were collected by questionnaire. The haplotypes were statistically reconstructed from the genotype data by the PHASE program. Associations between the genotypes/diplotypes and hand OA were studied by logistic regression. RESULTS: Allowing for age and occupation, the carriage of at least one COL2A1 intron 33 minor allele was associated with an increased risk of hand OA (odds ratio (OR) 1.58, 95% CI 1.05 to 2.36) and the number of affected joints. When stratified by occupation, the increased risk associated with the intron 33 minor allele carriage appeared to be mainly attributable to the dentists (OR 2.18, 95% CI 1.18 to 4.06). The 2-1 haplotype (exon 5B minor allele-intron 33 major allele) posed a significantly higher risk of hand OA (OR 3.21, 95% CI 1.08 to 9.55) compared with non-carriers. Moreover, an interaction was observed between intron 33 minor allele carriage and low task variation history in dental work (OR 2.87, 95% CI 1.05 to 7.89 for their joint effect). CONCLUSIONS: The results suggest that the studied COL2A1 gene polymorphisms may play a role in the aetiology of hand OA and that this effect may be enhanced by repetitive loading work tasks.
Subject(s)
Collagen Type II/genetics , Hand Joints , Occupational Diseases/genetics , Osteoarthritis/genetics , Polymorphism, Single Nucleotide , Cumulative Trauma Disorders/complications , Cumulative Trauma Disorders/epidemiology , Cumulative Trauma Disorders/genetics , Dentists, Women/statistics & numerical data , Female , Finland/epidemiology , Genetic Predisposition to Disease , Genotype , Humans , Middle Aged , Occupational Diseases/diagnostic imaging , Occupational Diseases/epidemiology , Osteoarthritis/epidemiology , Osteoarthritis/etiology , Prevalence , RadiographyABSTRACT
SUMMARY: The objective of this study was to examine associations between body mass index (BMI) and symptomatic and non-symptomatic radiographic osteoarthritis in the distal interphalangeal joints (DIP ROA). The subjects were 295 female dentists and 248 female teachers aged 45-63 years randomly selected from the registers of the Finnish Dental Association and the Finnish Teachers' Trade Union of the Helsinki metropolitan region. Radiographs of both hands were examined for the presence of osteoarthritis in each DIP joint. Information on the occurrence of pain in each DIP joint during the past 30 days and hand laterality was obtained by questionnaire. Current BMI was based on self-reported height and measured weight. BMI at the age of 25 years was based on self-reported height and weight. Overweight was defined as BMI ≥ 25.0 kg/m(2). Allowing for age, occupation, hand-loading leisure-time physical activity and smoking history, the risk of symptomatic DIP ROA was increased in currently overweight women (OR 1.98, 95% CI 1.18-3.34) and in women with overweight both currently and at the age of 25 (7.55; 1.33-42.83). The OR for an increase of one standard deviation in BMI at the age of 25 was 1.20 (1.05-1.38) and that for a similar increase in current BMI 1.08 (1.01-1.16), adjusted as above. No relationship of BMI with non-symptomatic DIP ROA or joint pain only was found. The study provides evidence that the risk of symptomatic DIP ROA is increased among overweight middle-aged women. Consideration even of BMI at young adulthood further underlines the association.:
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OBJECTIVES: To investigate the associations of radiographic finger joint osteoarthritis (ROA), hand laterality (right/left) and anatomical location within the hand, with finger joint pain. METHODS: Radiographs of both hands of 295 female dentists and 248 female teachers were examined for the presence of osteoarthritis in each finger joint, using grades 0 = no OA, 1 = doubtful OA, 2 = mild OA, 3 = moderate OA, 4 = severe OA. Information on the occurrence of pain in each finger joint during the past 30 days and hand laterality was obtained by questionnaire. RESULTS: Compared with subjects with no ROA, the prevalence ratio (PR) of finger joint pain was 1.92 [95% confidence interval (CI) 1.61-2.34] among those with mild ROA and 5.34 (4.51-6.54) among those with at least moderate ROA, based on a multivariate log-binomial regression model. Pain was slightly more common in the right than in the left hand (1.27; 1.15-1.40). Compared with the little finger, more pain occurred in the thumb (2.67; 2.25-3.16), the index finger (1.76; 1.50-2.07) and the middle finger (1.47; 1.24-1.74). Further, pain was more common in the proximal interphalangeal (1.77; 1.56-2.00) and the distal interphalangeal (1.51; 1.29-1.76) joints than in the metacarpophalangeal joints. The strength of the association between ROA and finger joint pain increased with the severity of pain. CONCLUSIONS: Our findings suggest that ROA, anatomic localization within the hand, and hand laterality have independent effects on finger joint pain.