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1.
Clin Nucl Med ; 46(3): 261-263, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323733

RESUMO

ABSTRACT: Pancreatitis, panniculitis, and polyarthritis syndrome is a rare disease. A 49-year-old man recently complained of bilateral ankle and epigastric pain. An ankle x-ray showed subcutaneous soft tissue swelling. Subsequent 99mTc-MDP bone scan showed foci of abnormal activity around joints in all extremities, especially in the knees and ankles. In addition, multiple nodular calcifications in the head of the pancreas were found in the abdominal CT scan. The patient also had increased blood amylase and lipase. The symptoms were resolved after the treatment of his pancreatitis.


Assuntos
Artrite/complicações , Artrite/diagnóstico , Pancreatite/complicações , Paniculite/complicações , Medronato de Tecnécio Tc 99m , Tomografia Computadorizada por Raios X , Dor Abdominal/complicações , Humanos , Masculino , Pessoa de Meia-Idade
2.
Medicine (Baltimore) ; 99(50): e23579, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327319

RESUMO

Approximately 30% to 40% of all patients with adult-onset Still disease (AOSD) experience relapses, sometimes presenting as chronic damage, and these events can subsequently increase the morbidity and mortality in patients with AOSD. However, few studies are investigating the factors related to relapse in such patients. Therefore, this study aimed to explore the risk factors associated with relapse of AOSD.This cohort study enrolled 112 AOSD patients who satisfied the Yamaguchi criteria and obtained available data from Chonnam National University Hospital. The demographic, clinical, and laboratory data as well as treatment history of the patients from January 2008 to December 2019 were retrospectively reviewed. Relapse events were defined as the presence of one or more recurrent events. Multivariate logistic regression analysis was performed to investigate the possible risk factors for relapse.During a mean follow-up of 103.3 months, 47 of 112 patients (41.9%) developed a relapse. According to the results of multivariate logistic regression analysis, arthritis (odds ratio [OR] = 19.530, 95% confidence interval [CI]: 5.047-75.582, P < .001) and lymphadenopathy (OR = 6.539, 95% CI: 2.329-18.358, P < .001) predicted the development of recurrent events in patients with AOSD.Patients with AOSD had frequent relapses during the clinical course of their disease. Risk factors associated with flares were the presence of arthritis and lymphadenopathy.


Assuntos
Doença de Still de Início Tardio/etiologia , Adulto , Artrite/complicações , Feminino , Humanos , Modelos Logísticos , Linfadenopatia/complicações , Masculino , Pessoa de Meia-Idade , Recidiva , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Doença de Still de Início Tardio/epidemiologia
3.
Pain Res Manag ; 2020: 5626948, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33376567

RESUMO

Background: Hong-Hui-Xiang (HHX) is a sterilized aqueous solution extracted from Illicium lanceolatum A.C. Smith widely used for pain relief in China. Despite its history, it is not well understood. In the present study, we used a mouse model of arthritic knee pain to investigate the antinociceptive effects of HHX and its potential side effects on weight and respiratory function, as well as on the liver, kidney, and heart. Methods: Mice were randomly assigned to four groups: saline and HHX at three doses (1 µl, 10 µl, and 50 µl). Each group was randomly divided to two subgroups: saline and CFA. After the first injection of HHX or saline on day 7, mechanical hyperalgesia was tested via the hind paw. Only after the tests had established that the analgesic effect had subsided was the next injection administered. A total of five injections were administered. Blood, knee joints, and other organs were collected for histopathological observation and biochemical detection. Objectives: We found that mechanical threshold of hind paw increased 2 h after of the initial injection HHX (10 µl and 50 µl), which lasted for at least 3 h. The analgesic effect lasted for three days after the second injection on day 8 and was approximately maintained for five days each time after the third injection. We also found a reduction in the diameter of the knee joint and suppression of synovial inflammation in response to treatment of HHX (10 µl and 50 µl). Meanwhile, HHX had no toxic effects on the liver, kidneys, and heart via histological and biochemical assays in all groups. Conclusion: HHX exerts antinociceptive and anti-inflammatory effects in a mouse model of arthritic knee pain. There were no obvious side effects on the liver, kidneys, or heart.


Assuntos
Artrite/patologia , Medicamentos de Ervas Chinesas/farmacologia , Articulação do Joelho/efeitos dos fármacos , Dor , Animais , Artrite/complicações , China , Modelos Animais de Doenças , Illicium , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Dor/etiologia
7.
Reumatol. clín. (Barc.) ; 16(2,pt.2): 177-179, mar.-abr. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-194344

RESUMO

En los apicultores se ha descrito una artropatía inflamatoria de etiología desconocida pero relacionada con su actividad profesional. Se expone el caso de un apicultor que tras la picadura de abeja presentó una artritis de la articulación interfalángica del primer dedo de la mano izquierda. Aunque el curso clínico subagudo y los hallazgos de la RMN obligaban a plantear el diagnóstico diferencial con un proceso infeccioso, el resto de pruebas analíticas, de imagen y la evolución, junto al antecedente de episodio similar unos años antes en un dedo de otra mano tras la picadura de abeja, permitió el diagnóstico de esta entidad


An acute inflammatory arthritis of unknown cause has been described in beekeepers in relation to their work with the hives. We present the case of a beekeeper who, after a bee sting, developed arthritis of the interphalangeal joint of the first finger of his left hand. Although the subacute clinical course and the magnetic resonance imaging findings required the differential diagnosis with an infectious process, the rest of the laboratory tests. other imaging studies and the course, together with a history of a similar episode a few years earlier on a finger of the other hand after a bee sting, enabled us to diagnosis this condition


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Artropatias/diagnóstico por imagem , Artropatias/etiologia , Abelhas , Mordeduras e Picadas de Insetos/complicações , Anti-Inflamatórios não Esteroides/administração & dosagem , Artrite/complicações , Articulação da Mão/diagnóstico por imagem , Articulação da Mão/patologia , Antibacterianos/uso terapêutico , Manejo da Dor , Diagnóstico Diferencial
8.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(2): 207-212, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32220189

RESUMO

Objective: To observe the changes of cardiac function in arthritic rats and the effect of triptolide on it. Methods: Forty rats were divided in random into normal control (NC) group, model control (MC) group, leflunomide (LEF) group and triptolide (TP) group. Except for the normal group, rats in the other three groups were injected with Freund's complete adjuvant to create arthritic inflammation in the right hind paws, and the interventional drug was administered on the 12th day after the inflammation. By treating for 30 d, the cardiac function of rats was detected by left ventricular catheterization. The expressions of superoxide dismutase (SOD), malondialdehyde (MDA), reacitve oxygen species (ROS), total antioxidation (T-AOC), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in serum were measured by enzyme-linked immunosorbent assay. The expressions of keap-like protein 1 ( Keap1), muscular aponeurotic fibrosarcom ( maf) and nuclear factor-E2 related factor2 ( Nrf2) mRNAs in cardiac tissue were detected by real-time PCR. The expressions of Keap1, maf and Nrf2 proteins in heart tissues were detected by Western blot. Results: Comparing with the normal group, the heart rate (HR), heart index (HI), left ventricular systolic pressure (LVSP), and left ventricular end-diastolic pressure (LVEDP) of the model group were significantly increased, whereas the maximum change rate of ventricular pressure rise or decline (±dp/dtmax) was significantly decreased ( P<0.01). SOD, MDA, ROS, T-AOC, and TNF-α were all increased, and IL-10 was significantly decreased ( P<0.01). The mRNA and protein expressions of Keap1, maf and Nrf2 in heart tissues were increased ( P<0.01). Comparing with the model group, HR, HI, LVSP, and LVEDP in the triptolide group were significantly decreased, whereas the ±dp/dtmax was significantly increased ( P<0.01). SOD, MDA, T-AOC, ROS, TNF-α decreased while the IL-10 increased ( P<0.05, P<0.01). The expressions of Keap1, maf and Nrf2 mRNAs and proteins in the heart tissues of the triptolide group were decreased ( P<0.01). Conclusion: Triptolide could improve cardiac function in arthritic rats, and the mechanism may related to its ability of improving the anti-oxidationin cardiomyocytes, reducing oxidative stress damage, and inhibiting abnormal immune inflammatory response.


Assuntos
Artrite/complicações , Diterpenos/farmacologia , Cardiopatias/tratamento farmacológico , Coração/efeitos dos fármacos , Imunossupressores/farmacologia , Miócitos Cardíacos/efeitos dos fármacos , Fenantrenos/farmacologia , Animais , Compostos de Epóxi/farmacologia , Cardiopatias/complicações , Proteína 1 Associada a ECH Semelhante a Kelch , Miócitos Cardíacos/fisiologia , Fator 2 Relacionado a NF-E2 , Estresse Oxidativo/efeitos dos fármacos , Ratos
9.
Am J Ophthalmol ; 218: 330-336, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32112773

RESUMO

PURPOSE: The purpose of this study was to investigate the etiology and clinical features of nontraumatic rhegmatogenous retinal detachment (RRD) in children. DESIGN: Consecutive, cross-sectional study. METHODS: In this study, 112 operative eyes of 102 patients ≤18 years of age with nontraumatic RRD were included. Comprehensive ophthalmic examinations were performed in all patients. Genetic testing was performed in 34 patients with hereditary congenital/developmental diseases. The etiology of RRD was analyzed. RESULTS: The average age was 12.2 ± 4.5 years (range, 1-18 years). The percentages of male and female patients were 74.5% (76/102) and 25.5% (26/102), respectively. The most common etiologic factors were congenital/developmental anomalies (51/102, 50%), followed by simple myopia (34/102, 33.3%) and previous intraocular surgery (6/102, 5.9%). More than half (31/51, 60.8%) of the patients with congenital/developmental anomalies had familial exudative vitreoretinopathy. Further analysis of the underlying etiologic factors based on age revealed that the most common etiology of RRD in patients ≤12 years of age was congenital/developmental anomalies (28/48, 58.3%); however, simple myopia was the major etiologic factor in patients >12 years of age (27/54, 50%). CONCLUSIONS: Congenital/developmental diseases were the most common etiologies of pediatric nontraumatic RRD in China. Familial exudative vitreoretinopathy accounted for most of the congenital/developmental anomalies.


Assuntos
Anormalidades Congênitas/etiologia , Deficiências do Desenvolvimento/complicações , Vitreorretinopatias Exsudativas Familiares/complicações , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Adolescente , Artrite/complicações , Criança , Pré-Escolar , Doenças do Tecido Conjuntivo/complicações , Estudos Transversais , Feminino , Testes Genéticos , Perda Auditiva Neurossensorial/complicações , Humanos , Lactente , Masculino , Síndrome de Marfan/complicações , Miopia/complicações , Descolamento Retiniano/complicações , Fatores de Risco , Sequenciamento Completo do Exoma
10.
Rev Med Suisse ; 16(685): 504-507, 2020 Mar 11.
Artigo em Francês | MEDLINE | ID: mdl-32167253

RESUMO

Cancer management has been revolutionised by immune checkpoint inhibitors. Their use and indications increase in parallel with the recognition of their various side effects. Arthritis, myositis, and vasculitis are among the most common rheumatologic immune-related adverse events (irAE) of immunotherapy. Rheumatological irAEs can be of late onset, occur even after the cessation of the culprit drug and persist into time. In this article we discuss the principles of cancer immunotherapy, clinical manifestations and management of the most common rheumatologic irAEs, and aspects of immune checkpoint inhibitors therapy in patients with pre-existing autoimmune disease.


Assuntos
Imunoterapia/efeitos adversos , Neoplasias/tratamento farmacológico , Neoplasias/imunologia , Doenças Reumáticas/induzido quimicamente , Artrite/induzido quimicamente , Artrite/complicações , Artrite/terapia , Humanos , Miosite/induzido quimicamente , Miosite/complicações , Miosite/terapia , Neoplasias/complicações , Doenças Reumáticas/complicações , Doenças Reumáticas/terapia
11.
Am J Nurs ; 120(3): 26-31, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32049688

RESUMO

BACKGROUND: The American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention recommend an adequate level of physical activity for cancer prevention and survivorship. Many adults have been diagnosed with arthritis, with a significantly higher rate in women. People with arthritis tend to be less physically active than those without arthritis, and are less likely to engage in moderate or vigorous activity. The proportion of adults meeting ACS physical activity guidelines is especially low among those with arthritis. OBJECTIVE: We wanted to explore the extent to which arthritis-related functional limitations are predictive of inadequate physical activity in female adult cancer survivors after accounting for other known predictors. METHODS: Data included in the analyses were from a sample of 729 adult women diagnosed with cancer who participated in the U.S. National Health and Nutrition Examination Survey between 2011 and 2016. Inadequate physical activity was defined as not meeting ACS physical activity guidelines. Bivariate and multivariate logistic regression analyses were conducted to identify correlates of inadequate physical activity. RESULTS: Being age 65 years or older, having no more than a high school education, being overweight or obese, being clinically depressed, and having arthritis-related functional limitations were found to be significant correlates of inadequate physical activity in the study population. CONCLUSIONS: Our results indicate that, in addition to previously identified predictors of inadequate physical activity in cancer survivors, having arthritis-related functional limitations is a significant predictor of inadequate physical activity in female adult cancer survivors. Assessment and management of arthritis-related functional limitations by health care providers are needed to facilitate successful adherence to physical activity guidelines.


Assuntos
Artrite/complicações , Sobreviventes de Câncer/estatística & dados numéricos , Exercício Físico , Desempenho Físico Funcional , Adulto , Idoso , Feminino , Fidelidade a Diretrizes , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais
12.
Yonsei Med J ; 61(3): 251-256, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32102126

RESUMO

PURPOSE: This study aimed to evaluate the validity of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) for the assessment of musculoskeletal disorders. We evaluated whether WOMAC-SF correlated with the World Health Organization Disability Assessment Schedule 12 (WHODAS-12) and Kaigo-Yobo questionnaires for assessing health-outcomes in Korea. MATERIALS AND METHODS: This cross-sectional study used data from the Namgaram-2 cohort. WOMAC, WOMAC-SF, WHODAS-12, and Kaigo-Yobo questionnaires were administered to patients with musculoskeletal disorders, including radiology-confirmed knee osteoarthritis (RKOA), sarcopenia, and osteoporosis. The relationships among WOMAC-SF, WHODAS-12, and Kaigo-Yobo scores were analyzed by stepwise multiple regression analysis. RESULTS: WOMAC-SF was associated with the WOMAC questionnaire. The results of confirmatory factor analysis for the hypothesized model with two latent factors, pain and function, provided satisfactory fit indices. WOMAC-SF pain and function were associated with RKOA. Kaigo-Yobo was associated with WOMAC-SF pain (B=0.140, p=0.001) and WOMAC-SF function (B=0.042, p=0.004). WHODAS-12 was associated with WOMAC-SF pain (B=0.679, p=0.003) and WOMAC-SF function (B=0.804, p<0.001). CONCLUSION: WOMAC-SF was validated for the evaluation of low extremity musculoskeletal disorders and health-related quality of life in a community-based population. Furthermore, we confirmed that WOMAC-SF were reflective of disability and frailty, which affect health outcomes.


Assuntos
Artrite/complicações , Avaliação da Deficiência , Fragilidade/complicações , Universidades , Idoso , Estudos de Coortes , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Masculino , Ontário , Qualidade de Vida , Análise de Regressão , Reprodutibilidade dos Testes , República da Coreia , Inquéritos e Questionários
13.
BMC Infect Dis ; 20(1): 18, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910802

RESUMO

BACKGROUND: We report a rare case of chronic brucellosis accompanied with myelodysplastic syndrome and neutrophilic dermatosis, which to the best of our knowledge, has never been reported. CASE PRESENTATION: A young man was admitted to our hospital complaining of recurrent fever, arthritis, rashes and anemia. He had been diagnosed with brucellosis 6 years prior and treated with multiple courses of antibiotics. He was diagnosed with myelodysplastic syndrome and neutrophilic dermatosis following bone marrow puncture and skin biopsy. After anti-brucellosis treatment and glucocorticoid therapy, the symptoms improved. CONCLUSIONS: Clinicians should consider noninfectious diseases when a patient who has been diagnosed with an infectious disease exhibits changing symptoms.


Assuntos
Artrite/complicações , Brucelose/complicações , Exantema/complicações , Síndromes Mielodisplásicas/complicações , Febre Recorrente/complicações , Síndrome de Sweet/complicações , Adulto , Biópsia , Brucelose/tratamento farmacológico , Doença Crônica , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pele/patologia , Resultado do Tratamento
14.
Int J Pediatr Otorhinolaryngol ; 131: 109842, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31927149

RESUMO

OBJECTIVES: Classically, Pierre Robin Sequence (PRS) is a triad of micrognathia, glossoptosis, and airway obstruction, although frequently associated with cleft palate. Current literature reports that Stickler syndrome is the most common syndrome associated with PRS, and 22q11 deletion syndrome (22q11 DS) as the second most common. This study identifies associations between PRS and genetic syndromes. METHODS: A retrospective chart review was performed to identify patients diagnosed with PRS over a 10-year period from 4/1/2007 to 4/1/2017 at a tertiary children's hospital. RESULTS: 4,052 consecutive charts were reviewed and 234 patients had a diagnosis of PRS confirmed with the triad of micrognathia, glossoptosis, and airway obstruction. Of note, all of these patients had cleft palate. Of the 234 patients with PRS, 65 patients had syndromic diagnoses (28%). One patient had 22q11 DS (0.43%), and 31 patients had Stickler syndrome (13.2%). Additionally, 3 patients had central hypoventilation syndrome, 3 patients had Duane syndrome, 2 patients had Cornelia de Lange syndrome, 2 patients had Emanuel syndrome, 2 patients had Gordon syndrome, 2 patients had Mobius syndrome, 2 patients had Nager syndrome. Multiple other syndromes were identified, but occurred in isolated cases. CONCLUSION: This study supports literature that PRS is most commonly associated with Stickler Syndrome but rarely associated with 22q11 DS given that only 1 patient had both PRS and 22q11 DS.


Assuntos
Artrite/complicações , Doenças do Tecido Conjuntivo/complicações , Perda Auditiva Neurossensorial/complicações , Síndrome de Pierre Robin/complicações , Descolamento Retiniano/complicações , Síndrome da Deleção 22q11/complicações , Adolescente , Artrogripose/complicações , Criança , Pré-Escolar , Transtornos Cromossômicos/complicações , Fissura Palatina/complicações , Pé Torto Equinovaro/complicações , Síndrome de Cornélia de Lange/complicações , Síndrome da Retração Ocular/complicações , Feminino , Deformidades Congênitas da Mão/complicações , Cardiopatias Congênitas/complicações , Humanos , Hipoventilação/complicações , Hipoventilação/congênito , Lactente , Recém-Nascido , Deficiência Intelectual/complicações , Masculino , Disostose Mandibulofacial/complicações , Síndrome de Möbius/complicações , Hipotonia Muscular/complicações , Estudos Retrospectivos , Apneia do Sono Tipo Central/complicações
15.
Int J Mol Sci ; 21(2)2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31947680

RESUMO

Arthritis, including osteoarthritis (OA) and rheumatoid arthritis (RA), is the leading cause of years lived with disability (YLD) worldwide. Although pain is the cardinal symptom of arthritis, which is directly related to function and quality of life, the elucidation of the mechanism underlying the pathogenesis of pain in arthritis has lagged behind other areas, such as inflammation control and regulation of autoimmunity. The lack of therapeutics for optimal pain management is partially responsible for the current epidemic of opioid and narcotic abuse. Recent advances in animal experimentation and molecular biology have led to significant progress in our understanding of arthritis pain. Despite the inherent problems in the extrapolation of data gained from animal pain studies to arthritis in human patients, the critical assessment of molecular mediators and translational studies would help to define the relevance of novel therapeutic targets for the treatment of arthritis pain. This review discusses biological and molecular mechanisms underlying the pathogenesis of arthritis pain determined in animal models of OA and RA, along with the methodologies used.


Assuntos
Artrite/complicações , Suscetibilidade a Doenças , Dor/etiologia , Animais , Artrite/metabolismo , Artrite/patologia , Artrite Reumatoide/complicações , Artrite Reumatoide/patologia , Biomarcadores , Modelos Animais de Doenças , Osteoartrite/complicações , Osteoartrite/patologia , Dor/diagnóstico , Dor/metabolismo , Manejo da Dor , Medição da Dor
17.
Am J Med ; 133(6): 733-740, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31862331

RESUMO

PURPOSE: Our objective was to determine if there are ethnic differences in the use of over-the-counter (OTC) and prescription oral nonsteroidal anti-inflammatory drugs (NSAIDs) and if observed ethnic differences persist after adjustment for sociodemographic and clinical factors. METHODS: Knee and hip osteoarthritis study participants were identified. Surveys were administered to collect sociodemographics, clinical information, and oral treatment methods for arthritis. Multivariable logistic regression models were created using a fully conditional method. RESULTS: Hispanics (n = 130), compared to non-Hispanic whites (n = 204), were less likely to have a high school education (26.9% vs 63.2%, P <0.001), less likely to have private medical insurance (P <0.001), and more likely to have worse health (P = 0.004). OTC oral NSAID use was less common (52.9% vs 66.3%, P = 0.019), whereas prescription oral NSAID use was more common (43.4% vs 31.7%, P = 0.042) among Hispanics than non-Hispanic whites in the last 6 months. The ethnic difference in using an OTC NSAID instead of not using any oral NSAID was attenuated and no longer significant when adjusted for age, sex, education, and medical insurance (odds ratio [OR] 0.54 [95% confidence interval [CI]: 0.28-1.02]). The odds of using a prescription instead of an OTC NSAID remained significantly higher among Hispanics than non-Hispanic whites when adjusted for the same variables (odds ratio 2.17 [95% confidence interval: 1.16-4.05]). CONCLUSIONS: Among patients with osteoarthritis, OTC NSAIDs were less commonly used but prescription NSAIDs were more commonly used by Hispanics than non-Hispanic whites. Sociodemographic factors partially mediate ethnic differences in the use of oral NSAIDs.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite/tratamento farmacológico , Dor Crônica/tratamento farmacológico , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Idoso , Artrite/complicações , Artrite/etnologia , Dor Crônica/etnologia , Dor Crônica/etiologia , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Medicamentos sem Prescrição/uso terapêutico , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/tratamento farmacológico , Osteoartrite do Quadril/etnologia , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/etnologia , Fatores Socioeconômicos
18.
Arthritis Care Res (Hoboken) ; 72(7): 965-973, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31074577

RESUMO

OBJECTIVE: To examine the associations of prevalent arthritis with systemic inflammation in older men and to test whether sleep health mediates the associations. METHODS: Cross-sectional data came from 2,562 community-dwelling older men (all were age 65 years or older; mean age 76 years) in the Osteoporotic Fractures in Men Study who participated in a sleep ancillary study in 2003-2005. Participants were classified as having osteoarthritis (OA) (24%) or rheumatoid arthritis (RA) (0.7%) based on self-reported diagnoses and medication use. We constructed a composite score of multidimensional sleep health (i.e., perceived sleep quality, sleepiness, frequency of daytime napping, wake after sleep onset, and sleep duration) measured by both self-report and actigraphy. We also created binary indicators of elevated inflammation using C-reactive protein (CRP) (>3 mg/liter) and interleukin-6 (IL-6) (>1.08 pg/ml) levels. Analyses controlled for age, diagnosed sleep disorders, body mass index, smoking status, relevant medication use, and comorbidities. RESULTS: Older men with OA did not have higher risk of elevated CRP or IL-6 levels. However, indirect associations of OA through sleep health were found. OA was associated with poorer sleep health, which was further associated with 16% higher odds of elevated CRP (P < 0.001) and 12% higher odds of elevated IL-6 (P < 0.01) levels after controlling for OA. Older men with RA had higher odds of elevated CRP and IL-6 levels, but the associations were not mediated by sleep health. CONCLUSION: Findings suggest that promoting sleep health may help reduce the risk of systemic inflammation in older men with OA.


Assuntos
Artrite , Inflamação , Sono , Idoso , Artrite/complicações , Artrite/imunologia , Proteína C-Reativa/análise , Estudos Transversais , Humanos , Inflamação/etiologia , Inflamação/imunologia , Interleucina-6/sangue , Masculino , Prevalência
19.
Gerontologist ; 60(3): 450-459, 2020 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-31150535

RESUMO

BACKGROUND AND OBJECTIVES: Given their increasing prevalence with age, chronic health conditions (CHCs) are substantially affecting older workers and organizations. An important question is whether and how flexible work arrangements and organizational climates may help to reduce the work limitations experienced by older workers. Grounded on the Job Demand-Resource model, we hypothesize that access to flexible work arrangements (working-time flexibility, workplace flexibility, phased retirement) and supportive organizational climates (healthy ageing climate, psychological safety climate) are vital job resources that are associated with fewer health-related work limitations among older workers experiencing CHCs. RESEARCH DESIGN AND METHODS: Multilevel data were collected among 5,419 older workers (60-65 years) in 624 organizations in the Netherlands. Perceived health-related work limitations of older workers diagnosed with arthritis (N = 2,330), cardiovascular disease (N = 720), and sleep disorders (N = 816) were analyzed. RESULTS: Multilevel ordered logistic regression analyses revealed that perceived access to flexible working hours and a psychologically safe organizational climate was associated with fewer health-related work limitations among older workers with CHCs. DISCUSSION AND IMPLICATIONS: Facilitating longer working lives is a key policy challenge within organizations, in particular if older workers are constraint by CHCs. This study shows that offering flexible working hours and ensuring a psychologically safe climate, where older workers with health issues are inclined to share their work needs and preferences, are likely to contribute to healthy ageing in the workplace.


Assuntos
Emprego/psicologia , Cultura Organizacional , Local de Trabalho/organização & administração , Idoso , Artrite/complicações , Artrite/epidemiologia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Política Organizacional , Aposentadoria/psicologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia
20.
Arthritis Care Res (Hoboken) ; 72(1): 41-62, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30941870

RESUMO

OBJECTIVE: To systematically review evidence of the impact of inflammatory arthritis on, or association of inflammatory arthritis with, intimate relationships and sexual function. METHODS: Ovid Medline, Ovid PsycINFO, Ovid Embase, and EBSCO CINAHL databases were searched. Two independent reviewers selected articles, extracted data, and conducted manual searches of reference lists from included studies and previous reviews. The quality of evidence was assessed using standard risk-of-bias tools. RESULTS: Fifty-five eligible studies were reviewed. Of these, 49 (89%) were quantitative, 5 (9.1%) were qualitative, and 1 (1.8%) used a mixed-method design. Few quantitative studies were rated as low risk of bias (n = 7 [14%]), many were rated as moderate (n = 37 [74%]) or high risk (n = 6 [12%]). Quantitative study sample sizes ranged from 10 to 1,272 participants, with a reported age range 32-63 years. Qualitative study sample sizes ranged from 8 to 57 participants, with a reported age range 20-69 years. In studies reporting the Female Sexual Function Index, all inflammatory arthritis groups demonstrated mean scores ≤26.55 (range of mean ± SD scores: 14.2 ± 7.8 to 25.7 ± 4.7), indicating sexual dysfunction. In studies reporting the International Index of Erectile Function, all inflammatory arthritis groups reported mean scores ≤25 (range of mean ± SD scores: 16.0 ± 5.3 to 23.8 ± 7.0), indicating erectile dysfunction. Key qualitative themes were impaired sexual function and compromised intimate relationships; prominent subthemes included inflammatory arthritis-related pain and fatigue, erectile dysfunction, diminished sexual desire, and sexual function fluctuations according to disease activity. CONCLUSION: Sexual dysfunction appears highly prevalent among men and women with inflammatory arthritis, and increased clinician awareness of this impairment may guide provision of tailored education and support.


Assuntos
Artrite/psicologia , Relações Interpessoais , Comportamento Sexual , Disfunções Sexuais Psicogênicas/etiologia , Sexualidade , Artrite/complicações , Artrite/fisiopatologia , Humanos , Disfunções Sexuais Psicogênicas/fisiopatologia , Disfunções Sexuais Psicogênicas/psicologia
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