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Brown RJL, Treat-Jacobson D, Schorr E, Lindquist R, Pruinelli L, Wolfson J. Symptom Descriptors in Individuals Living With Undiagnosed Lower Extremity Peripheral Artery Disease. West J Nurs Res 2024; 46:773-781. [PMID: 39206689 DOI: 10.1177/01939459241274275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Most individuals with lower extremity peripheral artery disease (PAD) experience symptoms other than claudication and live with undiagnosed PAD yet no tools exist to detect atypical PAD symptoms. The purpose of this study was to identify discriminating PAD symptom descriptors from a community-based sample of patients with no current diagnosis of PAD. METHODS Symptoms descriptors were obtained in a sample of 22 participants with persistent lower extremity symptoms pre/post exercise. An ankle brachial index with exercise was used to classify participants as "PAD" or "No PAD." RESULTS Thirteen (59%) participants had a positive ankle brachial index (<0.9, ≥20% drop postexercise, or 30 mmHg drop postexercise). Symptoms do not disappear while walking, trouble keeping up with friends/family, positive response to pain or discomfort while sitting, and pain outside of the calves and thighs were associated with a positive ankle brachial index. CONCLUSION Atypical symptoms were common among study participants. Symptoms while sitting and symptoms outside of the calf and thigh were negatively associated with a positive ankle brachial index. More precise descriptions of symptom characteristics are needed to improve PAD symptom recognition.
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Affiliation(s)
- Rebecca J L Brown
- Veterans Affairs Health Services Research and Development Center for Care Delivery and Outcomes Research Minneapolis Veterans Affairs Healthcare System, Minneapolis, MN, USA
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | | | - Erica Schorr
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Ruth Lindquist
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Lisiane Pruinelli
- University of Florida College of Nursing and College of Medicine, Gainesville, FL, USA
| | - Julian Wolfson
- University of Minnesota School of Public Health, Minneapolis, MN, USA
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Sun CK, Huang AC, Hsueh TY, Ting CT, Lin LC, Tsai TH. Multi-microdialysis analytical system to monitor acetaminophen and its pharmacokinetic interaction with A. bidentata in rat blood, forelimb extensor muscle, brain striatum, and the knee joint cavity. J Pharm Biomed Anal 2024; 248:116285. [PMID: 38878452 DOI: 10.1016/j.jpba.2024.116285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 07/20/2024]
Abstract
Acetaminophen (APAP), or paracetamol, is one of the most widespread and commonly used non-prescription pain medication in the world, and is effective at managing wide range of pain, including headache, muscle ache, and minor arthritic pain. While the pharmacokinetics of APAP is generally understood, there is a lack of data for its transfer ratio especially into the knee. A novel multi-microdialysis model was developed to simultaneously sample from blood, forelimb extensor muscle, brain striatum, and the knee joint cavity in the same experimental subject to investigate the potential interaction between APAP and Achyranthes bidentata Blume (A. bidentata), another widely used traditional Chinese medicininal herb especially for pain in the lower extremity. Rats were pre-treated with A. bidentata extract (ABex), APAP was then administered (60 mg/kg, i.v.), dialysates then subsequently analyzed using HPLC-PDA. Our analysis demonstrated that APAP concentrations, achieved after its administration either alone or in combination with ABex (1 and 3 g/kg, q.d. gavage), could be modelled effectively with a one-compartment model. The distribution ratio (AUCorgan/AUCblood) of blood-to-muscle, blood-to-brain and blood-to-knee was 0.372 ± 0.053, 0.277 ± 0.095 and 0.191 ± 0.042, respectively after administration of APAP (60 mg/kg, i.v.). No significant difference was observed between the pharmacokinetics of APAP administered alone and in combination with ABex; and APAP concentration exceed the half maximal effective concentration (EC50) in all sampled organs for close to 3 hours with one single dose of drug administration, providing evidence for its broad-range analgesic effect.
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Affiliation(s)
- Chung-Kai Sun
- Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Andy C Huang
- Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taipei 106, Taiwan
| | - Thomas Y Hsueh
- Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taipei 106, Taiwan; Department of Urology, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chin-Tsung Ting
- Division of Gastrointestinal Surgery, Department of Surgery, Ren-Ai Branch, Taipei City Hospital, Taipei 106, Taiwan; General Education Center, University of Taipei, Taipei 100, Taiwan
| | - Lie-Chwen Lin
- National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei 112, Taiwan
| | - Tung-Hu Tsai
- Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; Graduate Institute of Acupuncture Science, China Medical University, Taichung 404, Taiwan; Graduate Institute of Law and Interdisciplinary Studies, College of Law, National Chengchi University, Taipei 116, Taiwan; School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
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Boehnke KF, Scott JR, Martel MO, Smith T, Bergmans RS, Kruger DJ, Williams DA, Fitzcharles MA. Substituting Medical Cannabis for Medications Among Patients with Rheumatic Conditions in the United States and Canada. ACR Open Rheumatol 2024. [PMID: 39236308 DOI: 10.1002/acr2.11717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/04/2024] [Accepted: 06/10/2024] [Indexed: 09/07/2024] Open
Abstract
OBJECTIVE There are numerous reports of people substituting medical cannabis (MC) for medications. Our obejctive was to investigate the degree to which this substitution occurs among people with rheumatic conditions. METHODS In a secondary analysis from a cross-sectional survey conducted with patient advocacy groups in the US and Canada, we investigated MC use and medication substitution among people with rheumatic conditions. We subgrouped by whether participants substituted MC for medications and investigated differences in perceived symptom changes and use patterns, including methods of ingestion, cannabinoid content (cannabidiol vs delta-9-tetrahydrocannabinol [THC]), and use frequency. RESULTS Among 763 participants, 62.5% reported substituting MC products for medications, including nonsteroidal anti-inflammatory drugs (54.7%), opioids (48.6%), sleep aids (29.6%), and muscle relaxants (25.2%). Following substitution, most participants reported decreases or cessation in medication use. The primary reasons for substitution were fewer adverse effects, better symptom management, and concerns about withdrawal symptoms. Substitution was associated with THC use and significantly higher symptom improvements (including pain, sleep, anxiety, and joint stiffness) than nonsubstitution, and a higher proportion of substitutors used inhalation routes than those who did not. CONCLUSION Although the determination of causality is limited by our cross-sectional design, these findings suggest that an appreciable number of people with rheumatic diseases substitute medications with MC for symptom management. Inhalation of MC products containing some THC was most commonly identified among those substituting, and disease characteristics did not differ by substitution status. Further study is needed to better understand the role of MC for symptom management in rheumatic conditions.
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Affiliation(s)
| | - J Ryan Scott
- University of Michigan Medical School, Ann Arbor
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Hernandez SG, Mannix R, Kerr ZY, Lempke LB, Chandran A, Walton SR, DeFreese JD, Echemendia RJ, Guskiewicz KM, McCrea MA, Meehan Iii WP, Brett BL. Longitudinal Characterization of Pain Interference and Influential Factors in Former National Football League (NFL) Players Over a 19-Year Period: An NFL-LONG Study. THE JOURNAL OF PAIN 2024; 25:104577. [PMID: 38796128 DOI: 10.1016/j.jpain.2024.104577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/23/2024] [Accepted: 05/18/2024] [Indexed: 05/28/2024]
Abstract
Previous studies on pain experiences in retired contract sport athletes have been cross-sectional, leaving gaps in our understanding of the evolution of pain interference (PI) and factors that influence trajectories decades after sport discontinuation. This study investigated the longitudinal course of PI in former male National Football League (NFL) players over a 19-year period following sport discontinuation and examined factors influencing overall levels and trajectories of PI. Former NFL players completed health surveys in 2001, 2010, and 2019, with PI ratings measured using the 36-Item Short Form Health Survey (2001 and 2010) and the Patient-Reported Outcomes Measurement Information System (2019). Unconditional latent growth curve models analyzed overall PI severity and trajectories. Conditional latent growth curve models explored the influence of musculoskeletal injuries, osteoarthritis (OA), and depression diagnosis on PI. Over 19 years (N = 338; mean age = 48.96 ± 9.35), PI significantly increased (slope = .179, P < .001; mean Patient-Reported Outcomes Measurement Information System PI t-scores 2001 = 54.19, 2010 = 54.64, 2019 = 57.38). Cumulative musculoskeletal injuries (B = .092, P < .001) and baseline depression diagnosis (B = 4.463, P < .001) were associated with overall PI levels but not change over time. OA was significantly associated with overall PI levels (B = 6.536, P < .001) and trajectory (B = -.253, P < .001); those endorsing OA in 2001 had lower PI increases over 19 years. The body region of injury and level of play during injuries mirrored overall injury effects. PI mildly increased over 19 years, with multiple factors independently influencing overall PI levels. Enhancing former contact sport athletes' daily functionality may be achieved through holistic biopsychosocial interventions addressing musculoskeletal injuries, OA, and depression. Future research should identify factors influencing elevated trajectories of long-term PI post-sport discontinuation. PERSPECTIVE: This study assessed PI in former NFL athletes over 2 decades, revealing notable interindividual variability in trajectories over time. Musculoskeletal injuries, depression, and OA correlated with overall PI. Prevention and intervention in these 3 areas present the potential to improve disruptions in daily living due to pain in former athletes.
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Affiliation(s)
- Sean G Hernandez
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Landon B Lempke
- Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan
| | - Avinash Chandran
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana
| | - Samuel R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - J D DeFreese
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ruben J Echemendia
- Psychological and Neurobehavioral Associates, Inc, State College, Pennsylvania; Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri
| | - Kevin M Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - William P Meehan Iii
- Sports Medicine Division, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics and Orthopedics, Harvard Medical School, Boston, Massachusetts
| | - Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
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Wu J, Wu J, Liu Z, Gong Y, Feng D, Xiang W, Fang S, Chen R, Wu Y, Huang S, Zhou Y, Liu N, Xu H, Zhou S, Liu B, Ni Z. Mesenchymal stem cell-derived extracellular vesicles in joint diseases: Therapeutic effects and underlying mechanisms. J Orthop Translat 2024; 48:53-69. [PMID: 39170747 PMCID: PMC11338158 DOI: 10.1016/j.jot.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/09/2024] [Accepted: 07/08/2024] [Indexed: 08/23/2024] Open
Abstract
Joint diseases greatly impact the daily lives and occupational functioning of patients globally. However, conventional treatments for joint diseases have several limitations, such as unsatisfatory efficacy and side effects, necessitating the exploration of more efficacious therapeutic strategies. Mesenchymal stem cell (MSC)-derived EVs (MSC-EVs) have demonstrated high therapeutic efficacyin tissue repair and regeneration, with low immunogenicity and tumorigenicity. Recent studies have reported that EVs-based therapy has considerable therapeutic effects against joint diseases, including osteoarthritis, tendon and ligament injuries, femoral head osteonecrosis, and rheumatoid arthritis. Herein, we review the therapeutic potential of various types of MSC-EVs in the aforementioned joint diseases, summarise the mechanisms underlying specific biological effects of MSC-EVs, and discuss future prospects for basic research on MSC-EV-based therapeutic modalities and their clinical translation. In general, this review provides an in-depth understanding of the therapeutic effects of MSC-EVs in joint diseases, as well as the underlying mechanisms, which may be beneficial to the clinical translation of MSC-EV-based treatment. The translational potential of this article: MSC-EV-based cell-free therapy can effectively promote regeneration and tissue repair. When used to treat joint diseases, MSC-EVs have demonstrated desirable therapeutic effects in preclinical research. This review may supplement further research on MSC-EV-based treatment of joint diseases and its clinical translation.
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Affiliation(s)
- Jinhui Wu
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Jiangyi Wu
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Zheng Liu
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Yunquan Gong
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
| | - Daibo Feng
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
| | - Wei Xiang
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
| | - Shunzheng Fang
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
| | - Ran Chen
- War Trauma Medical Center, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical Center, Daping Hospital, Army Medical University, Chongqing, 40038, China
| | - Yaran Wu
- Department of Clinical Biochemistry, Faculty of Pharmacy and Laboratory Medicine, Army Medical University, Gantaoyan Street, Shapinba District, Chongqing, 400038, China
| | - Shu Huang
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Yizhao Zhou
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Ningning Liu
- Department of Laboratory Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, 450003, China
| | - Hao Xu
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University Zhengzhou, 450003, China
| | - Siru Zhou
- War Trauma Medical Center, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical Center, Daping Hospital, Army Medical University, Chongqing, 40038, China
| | - Baorong Liu
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Zhenhong Ni
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
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Turner SG, Pillemer K, Demetres M, Heaney K, Joshi S, Luebke M, Messay G, Reid MC. Physical pain among family caregivers to older adults: A scoping review of the literature. J Am Geriatr Soc 2024; 72:2853-2865. [PMID: 38895995 PMCID: PMC11368645 DOI: 10.1111/jgs.19037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 05/02/2024] [Accepted: 05/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Scholarship on the health of family caregivers to older adults continues to expand. Although existing research suggests that many family caregivers experience pain, which impacts their ability to perform caregiving tasks and is associated with care recipients' unmet needs, the scope of research on family caregivers' pain remains poorly characterized. We conducted a scoping review of research on pain among family caregivers to older adults to characterize existing evidence and identify knowledge gaps. METHODS We searched multiple databases spanning from January 2012 to July 2023, identified eligible studies using predefined inclusion/exclusion criteria, and extracted key data (e.g., study design/methodology, pain measurement, caregiver pain type, and major findings). RESULTS We identified 46 eligible studies conducted in the United States (n = 19) and internationally (n = 27). Studies often focused on caregivers for older adults with specific health conditions, such as cancer (n = 11), dementia (n = 8), or stroke (n = 3). The most commonly employed pain measure was a single-item dichotomous question about pain (n = 16), followed by a visual numeric or visual analog scale (n = 11). Nine studies (five randomized controlled trials) reported on five caregiver pain management interventions, including yoga/exercise programs and caregiver education programs. DISCUSSION Existing research on family caregivers' pain offers an important foundation. However, more robust research designs are necessary. We identify possibilities for future studies in addition to opportunities for systematic investigations to support the family caregivers being relied upon to care for the increasing number of older adults.
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Affiliation(s)
- Shelbie G Turner
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
| | - Karl Pillemer
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Michelle Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA
| | - Kathleen Heaney
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
| | - Sama Joshi
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Matthew Luebke
- College of Human Ecology, Cornell University, Ithaca, New York, USA
- Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Gelila Messay
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
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Onks C, Weaver L, Latorre J, Silvis M, Berg A, Phillips S, Loeffert J, French C, Armstrong A. The most effective corticosteroid dose in the treatment of glenohumeral osteoarthritis: Feasibility pilot and protocol for double blinded randomized controlled trial. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100484. [PMID: 38800822 PMCID: PMC11126843 DOI: 10.1016/j.ocarto.2024.100484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
Objective Osteoarthritis affects over 5.4 million people in the United States. A common treatment is to perform intra-articular corticosteroid injections. However, the ideal steroid dose is unknown. This study aimed to pilot a corticosteroid injection protocol for primary glenohumeral OA. Methods We conducted a double blinded randomized feasibility pilot study. Patients with primary osteoarthritis of the glenohumeral joint were recruited and randomized to receive 20 mg, 40 mg, or 80 mg of triamcinolone. The primary outcome was the feasibility of the protocol and change in the Shoulder Pain and Disability Index (SPADI) 6 months following injection. Results 300 patients were screened for participation with 78 meeting inclusion criteria. 19 subjects completed the study. The most common reason for not participating was concern they would receive a smaller dose than previous injections. There was a 26% dropout rate, with 2 patients undergoing a total shoulder arthroplasty. There was no clinically significant difference (p = 0.090) between the groups at 6-months for the SPADI although all treatment groups showed a reduction of SPADI from baseline at 6 months. There was one adverse event in the 20 mg group, with a patient experiencing facial flushing after the injection. Conclusion We were successful in developing a feasible protocol. In the future excluding those who have received previous injections would be helpful for a higher enrollment rate. This patient concern highlights the need to complete clinical trials to guide medical decisions surrounding corticosteroid administration. NCT03586687.
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Affiliation(s)
- Cayce Onks
- Penn State Health Department of Family Medicine, Penn State Hershey Medical Center, 500 University Drive, H154, Hershey, PA 17033-0850, United States
| | - Lynn Weaver
- University Health Services, University of Massachusetts, Amherst, United States
| | - Johan Latorre
- University of Alabama at Birmingham Department of Physical Medicine and Rehabilitation, United States
| | - Matthew Silvis
- Penn State Health Department of Family Medicine, Penn State Hershey Medical Center, 500 University Drive, H154, Hershey, PA 17033-0850, United States
| | - Arthur Berg
- Penn State College of Medicine Department of Public Health Sciences, United States
| | - Shawn Phillips
- Penn State Health Department of Family Medicine, Penn State Hershey Medical Center, 500 University Drive, H154, Hershey, PA 17033-0850, United States
| | - Jayson Loeffert
- Penn State Health Department of Family Medicine, Penn State Hershey Medical Center, 500 University Drive, H154, Hershey, PA 17033-0850, United States
| | - Cristy French
- Penn State Health Department of Radiology, United States
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Murphy EN, An YW, Lee SR, Wood RH. Postural change, gait, and physical function in older adults. Gait Posture 2024; 113:178-183. [PMID: 38905853 DOI: 10.1016/j.gaitpost.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 04/29/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024]
Abstract
In a more clinical setting, abrupt posture change may be used to determine the presence of orthostatic hypotension, a hemodynamic response with relationships to physical function. Certain gait features and physical function performance are also associated with risk of falling in older adults. However, the extent to which posture change is associated with subsequent gait and physical function has received little attention in the literature. This study aims to determine the effects of posture change on spatiotemporal parameters of gait and Timed Up-and-Go (TUG) performance. METHODS Forty-two volunteers (age 73.21 ± 6.22 years) participated in the study. A custom Tekscan Strideway (Tekscan, Boston, MA.) gait system was used to measure gait velocity (VEL), cadence (CAD), stride length (SL), and percent of time spent in active propulsion (AP). Dependent t-tests were used to compare TUG time, VEL, CAD, SL and AP after at least 10 mins of seated rest and supine rest. RESULTS Time to complete the TUG was significantly slower after supine rest compared to seated (11.47 ± 0.51 and 10.01 ± 0.33 s, respectively, p<0.001); VEL was significantly slower after supine rest compared to seated (0.888 ± 0.042 and 1.049 ± 0.033 m/s, respectively, p=0.003); CAD was significantly slower after supine rest compared to seated (111.21 ± 2.87 and 120.97 ± 2.56spm, respectively, p=0.001); and AP was significantly lower after supine rest compared to seated (56.87 ± 4.76 and 70.79 ± 4.05 %, respectively, p<0.001). No significant differences were detected in stride length between conditions. CONCLUSIONS Among this sample of older adults, standing from a supine posture is associated with spatiotemporal gait parameters consistent with a risk for falling and aging. Additionally, TUG performance worsens significantly after supine rest. Future studies could explore the sensitivity and specificity of falls risk screening after supine rest.
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Affiliation(s)
| | - Yong Woo An
- Loyola Marymount University, Los Angeles, CA, USA
| | - Sang-Rok Lee
- New Mexico State University, Las Cruces, NM, USA
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Hu Y, Yang Y, Gao Y, Zhao L, Chen L, Sui W, Hu J. The impact of chronic diseases on the health-related quality of life of middle-aged and older adults: the role of physical activity and degree of digitization. BMC Public Health 2024; 24:2335. [PMID: 39198736 PMCID: PMC11351089 DOI: 10.1186/s12889-024-19833-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 08/20/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND The incidence of chronic diseases is on the rise worldwide, with a high mortality rate in China, posing a serious threat to the health-related quality of life (HRQoL) of middle-aged and older adults. This study explores the association between chronic diseases and the HRQoL of middle-aged and older adults, as well as the role of physical activity (PA) and degree of digitization in this relationship. METHODS The data used in this study was obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which included 13,620 middle-aged and older Chinese adults (≥ 45 years). The study utilized correlation analysis, and bootstrapping to investigate the mediating role of PA and the moderating influence of the degree of digitization. Data analysis was conducted using SPSS 26.0. RESULTS The study findings indicate that the severity of chronic disease has a significant negative predictive effect on HRQoL (PCS, physical component summary; MCS, mental component summary) (PCS: β = -2.515, p < 0.01, MCS: β = -0.735, p < 0.01). Further analysis revealed that PA plays a mediating and masking role in the impact of chronic disease on PCS and MCS. Additionally, the degree of digitization moderates the relationship between chronic disease and PA, chronic disease and PCS, and PA and PCS. CONCLUSION For middle-aged and older persons, chronic diseases have a detrimental effect on their HRQoL; nevertheless, PA can help. Furthermore, proper internet usage can help older individuals to some extent in mitigating the negative impact of chronic diseases. Therefore, it is encouraged to promote PA among the elderly with chronic diseases to improve their physical health, as well as to guide them in the proper use of the Internet to establish healthy behaviors.
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Affiliation(s)
- Yining Hu
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, 250061, Shandong Province, People's Republic of China
| | - Yuke Yang
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, 250061, Shandong Province, People's Republic of China
| | - Yan Gao
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, 250061, Shandong Province, People's Republic of China.
| | - Liangyu Zhao
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, 250061, Shandong Province, People's Republic of China
| | - Lu Chen
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, 250061, Shandong Province, People's Republic of China
| | - Wenze Sui
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, 250061, Shandong Province, People's Republic of China
| | - Jingquan Hu
- School of Physical Education, Shandong University, No. 17923, Jingshi Road, Lixia District, Jinan City, 250061, Shandong Province, People's Republic of China
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Tang S, Zhang C, Feng S. The relationship between arthritis and nocturia among adults under 60: A cross-sectional study based on National Health and Nutrition Examination Survey. Neurourol Urodyn 2024. [PMID: 39188062 DOI: 10.1002/nau.25572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/14/2024] [Accepted: 08/02/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVE This study aims to investigate how arthritis, including osteoarthritis and rheumatoid arthritis, affects the incidence of nocturia in adults aged 20-59. METHODS This study utilized data from the National Health and Nutrition Examination Survey from 2005 to 2020, involving 18 745 adults aged 20-59. Arthritis, including osteoarthritis and rheumatoid arthritis, was considered as the exposure factor, with nocturia as the outcome variable. We first compared the baseline characteristics of individuals with and without nocturia. The impact of arthritis on nocturia was assessed using weighted multivariate logistic regression models. To ensure the stability of the results, propensity score matching analysis and subgroup analyses were conducted. RESULTS The incidence of nocturia was approximately 22.31%, and the incidence of arthritis was about 15.32% (2871/18 745), with osteoarthritis accounting for 35.49% (1019/2871) and rheumatoid arthritis accounting for 20.20% (580/2871). Adjusted multivariate logistic regression analysis revealed that the risk of nocturia was increased by arthritis (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.28-1.65, p < 0.0001), including osteoarthritis (OR = 1.45, 95% CI: 1.18-1.78, p < 0.001) and rheumatoid arthritis (OR = 1.51, 95% CI: 1.14-2.00, p = 0.004). After propensity score matching using nearest neighbor methods at a 1:1 ratio, this relationship still exists. Subgroup analyses showed no significant differences in the interactions between arthritis and the risk of nocturia across various factors, such as age, family income to poverty ratio, education level, body mass index, smoking status, hypertension, and diabetes. However, significant differences were observed across different sex groups and sleep trouble groups. CONCLUSIONS This study revealed that arthritis, including osteoarthritis and rheumatoid arthritis, increased the risk of nocturia in adults under the age of 60.
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Affiliation(s)
- Siyuan Tang
- Department of Urology, The First People's Hospital of Wenling, Taizhou, Zhejiang, China
| | - Cunming Zhang
- Department of Urology, The First People's Hospital of Wenling, Taizhou, Zhejiang, China
| | - Senqiang Feng
- Department of Urology, Yuhang District Second People's Hospital of Hangzhou, Hangzhou, Zhejiang, China
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11
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Clarke H, Miles S, Peer M, Fitzcharles MA. The Elusive Truth of Cannabinoids for Rheumatic Pain. Curr Rheumatol Rep 2024:10.1007/s11926-024-01162-9. [PMID: 39120750 DOI: 10.1007/s11926-024-01162-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE OF REVIEW Medical cannabis (MC) has entered mainstream medicine by a unique route. Regulatory acceptance as a medical product in many jurisdictions has bypassed the traditional evidence-based pathway required for therapies. Easier access to MC, especially related to recreational legalization of cannabis, has led to widespread use by patients for symptom relief of a variety of medical conditions and often without medical oversight. Musculoskeletal pain remains the most common reason for MC use. This review examines real-world issues pertaining to MC and offers some guidance for clinical care of patients with rheumatic diseases being treated with MC. RECENT FINDINGS Controlled clinical studies of cannabis products in patients with rheumatic diseases have been small and tested a range of compounds, routes of administration, and clinical populations, limiting our ability to generate conclusions on MC's effectiveness in this population. Observational cohort studies and surveys suggest that use of MC and related products in patients with rheumatic diseases improves pain and associated symptoms but is commonly accompanied by mild to moderate side effects. Conflicting evidence contributes to practitioner and patient uncertainty regarding the use of MC for rheumatic disease-related pain. Despite promising preclinical and observational evidence that MC and cannabis-derived compounds are useful in the management of rheumatic disease-related pain, there remains limited high-quality clinical evidence to substantiate these findings. There are a significant number of clinical trials on this topic currently planned or underway, however, suggesting the next decade may yield more clarity. Nevertheless, given that many people with rheumatic diseases are using cannabis products, healthcare professionals must remain apprised of the evidence pertaining to cannabinoids, communicate such evidence to patients in a meaningful way that is free from personal bias and stigma, and maintain strong collaborative clinical care pertaining to MC.
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Affiliation(s)
- Hance Clarke
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
- Department of Anesthesia and Pain Management, Pain Research Unit, Toronto General Hospital, Toronto, Canada
- Transitional Pain Service, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | - Sarah Miles
- Department of Anesthesia and Pain Management, University Health Network, Sinai Health System, and Women's College Hospital, Toronto, ON, Canada
| | - Miki Peer
- Department of Anesthesia and Pain Management, University Health Network, Sinai Health System, and Women's College Hospital, Toronto, ON, Canada
| | - Mary-Ann Fitzcharles
- Department of Rheumatology, Montreal General Hospital, McGill University, Montreal, Canada.
- Alan Edwards Pain Management Unit, Montreal General Hospital, McGill University, Montreal, Canada.
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Halvorson RT, Su F, Ghanta RB, Garcia-Lopez E, Lalchandani GR, Shapiro LM. Adoption of reverse total shoulder arthroplasty for surgical treatment of proximal humerus fractures differs by patient race. J Shoulder Elbow Surg 2024:S1058-2746(24)00533-0. [PMID: 39097137 DOI: 10.1016/j.jse.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 06/01/2024] [Accepted: 06/09/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Reverse total shoulder arthroplasty (rTSA) has gained popularity for the operative treatment of proximal humerus fractures (PHF). The purpose of this study was to compare racial differences in surgical management of PHF between open reduction and internal fixation (ORIF), hemiarthroplasty, and rTSA. Our hypothesis was that there would be no difference in fixation by race. METHODS The National Surgical Quality Improvement Program database was queried for ORIF, rTSA, and hemiarthroplasty between 2006 and 2020 for patients with a PHF. Race, ethnicity, age, sex, body mass index, and American Society of Anesthesiologists (ASA) class were recorded. Chi squared tests were performed to assess relationships between patient factors and operative intervention. Factors significant at the 0.10 level in univariable analyses were included in a multivariable multinomial model to predict operative intervention. RESULTS Seven thousand four hundred ninety-nine patients underwent surgical treatment for a PHF, including 526 (7%) undergoing hemiarthroplasty, 5011 (67%) undergoing ORIF, and 1962 (26%) undergoing rTSA. 27% of white patients with PHF underwent rTSA compared to 21% of Black patients, 16% of Asian patients, and 14% of Native American and Alaskan Native patients (P < .001). In the multivariable analysis, utilization of rTSA increased over time (OR 1.2 per year since 2006, P < .001) and hemiarthroplasty decreased over time (OR 0.86 per year since 2006, P < .001). Non-White patients had significantly lower odds of undergoing rTSA vs. ORIF (OR 0.75, 95% CI 0.58-0.97), as did male patients (OR 0.77, 95% CI 0.66-0.88). Patients over 65 (OR 3.86, 95% CI 3.39-4.38), patients with higher ASA classifications (ASA2: OR 3.24, 95% CI 1.86-5.66, ASA3: OR 4.77, 95% CI 2.74-8.32, ASA4: OR 5.25, 95% CI 2.89-9.54), and patients who were overweight (OR 1.33, 95% CI 1.14-1.55) or obese (OR 1.52, 95% CI 1.32-1.75) had higher odds of undergoing rTSA vs. ORIF. DISCUSSION As utilization of rTSA increases, understanding disparities in surgical treatment of PHF is crucial to improving outcomes and equitable access to emerging orthopedic technologies. While patient factors such as age, body mass index, and comorbidities are known to directly impact outcomes and thus may be predictive of the type of surgical intervention, patient race should not dictate treatment.
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Affiliation(s)
- Ryan T Halvorson
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Favian Su
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Ramesh B Ghanta
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Edgar Garcia-Lopez
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Gopal Ram Lalchandani
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Lauren Michelle Shapiro
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA.
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Argyrou C, Papagrigorakis E, Tzefronis D, Pliaka V, Fotis C, Kamariotis S, Chatzinikolaidou M, Tsiamtsouris K, Vasiliadis ES, Alexopoulos L, Macheras GA. Multiplex cytokine analysis for the identification of novel potential synovial fluid biomarkers for periprosthetic joint infections. Injury 2024; 55:111659. [PMID: 38917741 DOI: 10.1016/j.injury.2024.111659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 05/03/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024]
Abstract
INTRODUCTION Periprosthetic joint infections (PJIs) are a devastating complication of total hip (THA) and knee (TKA) arthroplasty. The use of novel techniques like multiplex cytokine analysis could contribute immensely to the identification of potential novel biomarkers. PATIENTS AND METHODS This is a single-centre study of patients that were treated with revision TKA, THA or hemiarthroplasty. Serum's white blood cells (WBCs), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and synovial fluid's WBCs, percentage of polymorphonuclear neutrophils (%PMNs) and CRP were measured. Proteomic analysis targeting the secreted cytokines in synovial fluid was conducted using a 73-plex assay panel. The results were statistically compared between the septic and aseptic cases and ROC analysis to establish the area under the curve (AUC), sensitivity and specificity of each biomarker. RESULTS The study included 30 patients (18 revision THA cases; 3 conversion of hemiarthroplasty to THA and 9 revision TKA cases); 14 cases were considered infected, 1 likely infected and 15 not infected. The results showed statistically significant differences (p < 0.05) between infected and not infected cases in serum's ESR, CRP and synovial fluid's%PMNs, growth-regulated oncogene alpha (GROA), interleukin-8, interleukin-5, S100-A8/calprotectin and resistin (RETN) with AUCs of 0.75, 0.72, 0.95, 0.75, 0.72, 0.95, 0.83, 0.73, 0.75, 0.81 and 0.76 respectively. CONCLUSIONS In the present study, serum ESR and CRP as well as synovial %PMNs, GROA, IL-8, IL-5, calprotectin and RETN protein levels were identified as potential biomarkers. Further studies are needed to further investigate their diagnostic utility and optimal cut-off values.
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Affiliation(s)
- Chrysoula Argyrou
- 4th Department of Orthopaedics, KAT Attica General Hospital, Athens, Greece.
| | - Eftychios Papagrigorakis
- 3rd Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, KAT Attica General Hospital, Athens, Greece
| | - Dimitrios Tzefronis
- 7th Department of Orthopaedic Surgery, Henry Dunant Hospital Center, Athens, Greece
| | - Vaia Pliaka
- Biotechnology, Protavio Ltd., Athens, Greece
| | | | - Spyros Kamariotis
- Microbiology Department, KAT Attica General Hospital, Athens, Greece
| | - Maria Chatzinikolaidou
- Department of Materials Science and Technology, University of Crete, 70013 Heraklion, Greece & FORTH-IESL, 70013 Heraklion, Greece
| | | | - Elias S Vasiliadis
- 3rd Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, KAT Attica General Hospital, Athens, Greece
| | - Leonidas Alexopoulos
- Biotechnology, Protavio Ltd., Athens, Greece; School of Mechanical Engineering, National Technical University of Athens, Athens, Greece
| | - George A Macheras
- 4th Department of Orthopaedics, KAT Attica General Hospital, Athens, Greece; 7th Department of Orthopaedic Surgery, Henry Dunant Hospital Center, Athens, Greece
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Cavazos-Escobar E, Lozano MR, Rizzo AV, Al Snih S. Metabolic syndrome and arthritis among Mexican American older adults: findings from a 23-year follow-up. Eur Geriatr Med 2024; 15:1111-1118. [PMID: 38368571 PMCID: PMC11330538 DOI: 10.1007/s41999-024-00940-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/10/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE To examine the sex differences in the relationship of metabolic syndrome (MetS) criteria with arthritis and symptomatic arthritis among Mexican American older adults aged ≥ 65 without self-reported arthritis at baseline over 23-years of follow-up. METHODS Participants (N = 1447) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1993/94-2016). Measures included MetS criteria, arthritis defined as self-reported physician-diagnosed arthritis, socio-demographics, morbidities, depressive symptoms, pain on weight-bearing, cognitive and physical function, handgrip strength, mobility, and activities of daily living (ADLs) limitations. Symptomatic arthritis was defined as self-reported arthritis and having ≥ 1 of the following: pain, mobility limitation, or limited ADLs. RESULTS At baseline, the mean age was 72.6 years and 730 (50.5%) of our participants were females. Female participants with 2 and 3 MetS criteria had greater odds of arthritis [odds ratio (OR) = 1.77, 95% Confidence Interval (Cl) = 1.28-2.45 and OR = 2.68, 95% CI = 1.69-4.27, respectively) and symptomatic arthritis (OR = 1.74, 95% Cl = 1.24-2.44 and OR = 3.27, 95% CI = 2.04-5.26, respectively) after controlling for covariates. Male participants with 2 and 3 MetS criteria had greater odds of arthritis (OR = 1.65, 95% Cl = 1.14-2.39 and OR = 2.52, 95% CI = 1.51-4.19, respectively) and symptomatic arthritis (OR = 1.93, 95% Cl = 1.30-2.86 and OR = 2.98, 95% CI = 1.62-5.47, respectively) after controlling for covariates. Both females and males with pain on weight-bearing had greater odds of arthritis than those without pain. CONCLUSIONS At 23-years of follow-up, Mexican American older adults with MetS have an increased risk of arthritis and symptomatic arthritis. Early MetS screening and management may reduce arthritis in this population at high risk of disability.
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Affiliation(s)
- Emilio Cavazos-Escobar
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Mauricio Ramos Lozano
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Alan Villarreal Rizzo
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Soham Al Snih
- Department of Population Health and Health Disparities/School of Public and Population Health, The University of Texas Medical Branch, Galveston, TX, 77555-0177, USA.
- Division of Geriatric and Palliative Medicine/Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, 77555, USA.
- Sealy Center of Aging, The University of Texas Medical Branch, Galveston, TX, 77555, USA.
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15
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Fan W, Pi Z, Kong K, Qiao H, Jin M, Chang Y, Zhang J, Li H. Analyzing the impact of heavy metal exposure on osteoarthritis and rheumatoid arthritis: an approach based on interpretable machine learning. Front Nutr 2024; 11:1422617. [PMID: 39101010 PMCID: PMC11294220 DOI: 10.3389/fnut.2024.1422617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/11/2024] [Indexed: 08/06/2024] Open
Abstract
Introduction This investigation leverages advanced machine learning (ML) techniques to dissect the complex relationship between heavy metal exposure and its impacts on osteoarthritis (OA) and rheumatoid arthritis (RA). Utilizing a comprehensive dataset from the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2020, this study aims to elucidate the roles specific heavy metals play in the incidence and differentiation of OA and RA. Methods Employing a phased ML strategy that encompasses a range of methodologies, including LASSO regression and SHapley Additive exPlanations (SHAP), our analytical framework integrates demographic, laboratory, and questionnaire data. Thirteen distinct ML models were applied across seven methodologies to enhance the predictability and interpretability of clinical outcomes. Each phase of model development was meticulously designed to progressively refine the algorithm's performance. Results The results reveal significant associations between certain heavy metals and an increased risk of arthritis. The phased ML approach enabled the precise identification of key predictors and their contributions to disease outcomes. Discussion These findings offer new insights into potential pathways for early detection, prevention, and management strategies for arthritis associated with environmental exposures. By improving the interpretability of ML models, this research provides a potent tool for clinicians and researchers, facilitating a deeper understanding of the environmental determinants of arthritis.
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Affiliation(s)
- Wenxuan Fan
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhipeng Pi
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Keyu Kong
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hua Qiao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Minghao Jin
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yongyun Chang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jingwei Zhang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Huiwu Li
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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16
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Yoshikawa A, Fortinsky RH. Pain Medication Frequency and Fall Risk Among Community-Dwelling Older Adults With Arthritis. J Appl Gerontol 2024:7334648241261425. [PMID: 39023773 DOI: 10.1177/07334648241261425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Pain medication is commonly used among older adults with arthritis, elevating the risk of falling. We examined fall risks related to the frequency of taking pain medication among community-dwelling older adults with arthritis by analyzing a nationally representative sample of community-dwelling Medicare beneficiaries aged >65 with self-reported arthritis (n = 4,225) in the 2015 National Health and Aging Trends Study. The survey-weighted logistic regression revealed that after controlling for confounding factors, recent falls were associated with taking pain medication daily compared to never (OR = 1.45, 95% CI: 1.06, 1.96). The other categories of medication frequency, compared to never, were not associated with fall risk. Findings suggest that more prudent use of pain medication should be stressed by health care providers for older adults with arthritis to help reduce the risk of falls and fall injuries. Nonpharmacological pain management is encouraged to support active living among older adults with arthritis.
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Affiliation(s)
- Aya Yoshikawa
- School of Health Promotion & Kinesiology, College of Health Sciences, Texas Woman's University, Denton, TX, USA
- Institute for Women's Health, Texas Woman's University, Denton, TX, USA
| | - Richard H Fortinsky
- UConn Center on Aging, University of Connecticut, School of Medicine, Farmington, CT, USA
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17
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Sun F, Zajacova A, Grol-Prokopczyk H. The geography of arthritis-attributable pain outcomes: a county-level spatial analysis. Pain 2024; 165:1505-1512. [PMID: 38284413 PMCID: PMC11190894 DOI: 10.1097/j.pain.0000000000003155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/08/2023] [Accepted: 11/24/2023] [Indexed: 01/30/2024]
Abstract
ABSTRACT Research on the geographic distribution of pain and arthritis outcomes, especially at the county level, is limited. This is a high-priority topic, however, given the heterogeneity of subnational and substate regions and the importance of county-level governments in shaping population health. Our study provides the most fine-grained picture to date of the geography of pain in the United States. Combining 2011 Behavioral Risk Factor Surveillance System data with county-level data from the Census and other sources, we examined arthritis and arthritis-attributable joint pain, severe joint pain, and activity limitations in US counties. We used small area estimation to estimate county-level prevalences and spatial analyses to visualize and model these outcomes. Models considering spatial structures show superiority over nonspatial models. Counties with higher prevalences of arthritis and arthritis-related outcomes are mostly clustered in the Deep South and Appalachia, while severe consequences of arthritis are particularly common in counties in the Southwest, Pacific Northwest, Georgia, Florida, and Maine. Net of arthritis, county-level percentages of racial/ethnic minority groups are negatively associated with joint pain prevalence, but positively associated with severe joint pain prevalence. Severe joint pain is also more common in counties with more female individuals, separated or divorced residents, more high school noncompleters, fewer chiropractors, and higher opioid prescribing rates. Activity limitations are more common in counties with higher percentages of uninsured people. Our findings show that different spatial processes shape the distribution of different arthritis-related pain outcomes, which may inform local policies and programs to reduce the risk of arthritis and its consequences.
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Affiliation(s)
- Feinuo Sun
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, United States
| | - Anna Zajacova
- Department of Sociology, University of Western Ontario, London, ON, Canada
| | - Hanna Grol-Prokopczyk
- Department of Sociology, University at Buffalo, State University of New York, Buffalo, NY, United States
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18
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Hay AM, Rhoades MJ, Bangerter S, Ferguson SA, Lee H, T. Gill M, Page GL, Pope A, Measom GJ, Hager RL, Seeley MK. Serum Cartilage Oligomeric Matrix Protein Concentration Increases More After Running Than Swimming for Older People. Sports Health 2024; 16:534-541. [PMID: 37697665 PMCID: PMC11195858 DOI: 10.1177/19417381231195309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Knee osteoarthritis is common in older people. Serum cartilage oligomeric matrix protein (sCOMP) is a biomarker of knee articular cartilage metabolism. The purpose of this study was 2-fold: to (1) determine acute effects of running and swimming on sCOMP concentration in older people; and (2) investigate relationships between sCOMP concentration change due to running and swimming and measures of knee health in older people. HYPOTHESES Running would result in greater increase in sCOMP concentration than swimming, and increase in sCOMP concentration due to running and swimming would associate positively with measures of poor knee health. STUDY DESIGN Cross-sectional. LEVEL OF EVIDENCE Level 3. METHODS A total of 20 participants ran 5 km and 19 participants swam 1500 m. sCOMP concentration was measured immediately before, immediately after, and 15, 30, and 60 minutes after running or swimming. sCOMP concentration change due to running and swimming was compared. Correlations between sCOMP concentration change due to running and swimming, and other measures of knee health were evaluated, including the Tegner Activity Scale and Knee injury and Osteoarthritis Outcome Score. RESULTS sCOMP concentration increased 29% immediately after running, relative to baseline, but only 6% immediately after swimming (P < 0.01). No significant relationship was observed between acute sCOMP change due to running and swimming, and observed measures of knee health (P > 0.05). Participants with clinically relevant knee symptoms exhibited greater sCOMP concentration before and after running and swimming (P = 0.03) and had greater body mass (P = 0.04). CONCLUSION Running results in greater acute articular cartilage metabolism than swimming; however, the chronic effects of this are unclear. Older people with clinically relevant knee symptoms possess greater sCOMP concentration and are heavier, independent of exercise mode and physical activity level. CLINICAL RELEVANCE These results describe the effects of exercise (running and swimming) for older physically active persons, with and without knee pain.
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Affiliation(s)
- Alexandra M. Hay
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | | | | | - Seth A. Ferguson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Martha T. Gill
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Garritt L. Page
- Department of Statistics, Brigham Young University, Provo, Utah
| | - Andrew Pope
- Department of Statistics, Brigham Young University, Provo, Utah
| | - Gary J. Measom
- Department of Nursing, Utah Valley University, Orem, Utah
| | - Ronald L. Hager
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Matthew K. Seeley
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
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Mao Y, Qiu B, Wang W, Zhou P, Ou Z. Efficacy of home-based exercise in the treatment of pain and disability at the hip and knee in patients with osteoarthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:499. [PMID: 38926896 PMCID: PMC11201901 DOI: 10.1186/s12891-024-07585-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND An increasing body of evidence suggests that home-based exercise (HBE) therapy has significant therapeutic effects on knee osteoarthritis (KOA) and hip osteoarthritis (HipOA), and it has advantages such as cost savings, strong operability, and good compliance compared with hospitalization and exercise courses. OBJECTIVE To evaluate the efficacy of HBE in the treatment of KOA and HipOA. METHODS A systematic search was conducted in PubMed, Cochrane, Web of Science, and Embase to collect randomized controlled trials. The retrieval time was from database establishment until March 6, 2024. Stata 15.1 software was used for data analysis. RESULTS A total of 16 randomized controlled trials involving 3,015participants were included, with 1,519 participants in the intervention group and 1,496 in the control group. The meta-analysis showed that, compared to the control group, HBE can significantly improve pain [SMD=-0.38, 95% CI (-0.58, -0.18); P = 0.001], joint function [SMD=-0.60, 95% CI (-1.01, -0.19); P = 0.004], balance ability [SMD=-0.67, 95% CI (-1.00, -0.34); P = 0.001], mobility (ADL) [SMD = 0.51, 95% CI (0.19, 0.82); P = 0.002] in patients with KOA and HipOA. There is no statistical difference in the improvement of joint stiffness [WMD = -0.80, 95% CI (-1.61, 0.01); P = 0.052]. In addition, subgroup analysis showed that HBE significantly improved pain, joint function, and balance ability in KOA patients compared with the control group. HipOA patients showed significant improvement in pain and joint function; However, HBE only improved activity ability in patients with comorbidities of KOA and HipOA. CONCLUSION HBE can effectively alleviate pain, improve joint function, and enhance physical function in patients with KOA and HipOA. However, more high-quality randomized controlled trials (RCTs) with large sample sizes and long-term interventions are needed to validate the efficacy of HBE due to limitations in the methodology and consistency of indicator outcomes in the included RCTs. REGISTRATION NUMBER We've registered with PROSPERO, and the number is CRD42023443085.
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Affiliation(s)
- Yichen Mao
- Guilin Traditional Chinese Medicine Hospital, No. 2, Lingui Road, Xiangshan District, Guilin City, Guangxi Province, 541000, China
| | - Boyuan Qiu
- Guilin Traditional Chinese Medicine Hospital, No. 2, Lingui Road, Xiangshan District, Guilin City, Guangxi Province, 541000, China
- Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi, 530000, China
| | - Weiwei Wang
- Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi, 530000, China
| | - Pengwei Zhou
- Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi, 530000, China
| | - Zhixue Ou
- Guilin Traditional Chinese Medicine Hospital, No. 2, Lingui Road, Xiangshan District, Guilin City, Guangxi Province, 541000, China.
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20
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Ferucci ED, Holck P. Disparities in Total Knee and Total Hip Arthroplasty Rates in the Population of Alaska, 2015 to 2018. Arthritis Care Res (Hoboken) 2024. [PMID: 38932453 DOI: 10.1002/acr.25394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Racial and ethnic disparities in total joint replacements have been documented. Our objective was to determine the rates of total joint replacements for Alaska Native/American Indian (AN/AI) individuals compared with non-AN/AI individuals in Alaska and investigate the differences in characteristics and outcomes by race. METHODS We used hospital discharge data from the Alaska Health Facilities Data Reporting Program from 2015 to 2018. We identified people with an inpatient primary or revision total knee arthroplasty (TKA) or total hip arthroplasty (THA). We determined the population proportion of each procedure, age-adjusted rates by race, age-specific rates, and multivariable adjusted rate ratios for TKA or THA. We compared the characteristics of people undergoing primary TKA and THA by race. RESULTS In 2,195,806 person-years, there were 8,131 arthroplasty procedures (4,594 primary TKAs, 2,791 primary THAs, 378 revision TKAs, and 368 revision THAs). Primary TKAs and THAs were less likely in people of AN/AI or "Other" race compared with people of White race, with some heterogeneity in the "Other" race category. In multivariable models, the adjusted rate ratio for AN/AI compared with White race for TKA was 0.70 (95% confidence interval [CI] 0.60-0.82) and for THA was 0.69 (95% CI 0.55-0.85). AN/AI individuals undergoing TKA and THA were more likely to reside in rural locations, be younger than 65 years, have longer hospital stay, and discharge to home. CONCLUSION This study confirmed the existence of racial disparities in TKA and THA in Alaska. There may be many underlying causes, and future research should focus on improving access to care.
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Affiliation(s)
| | - Peter Holck
- Alaska Native Tribal Health Consortium, Anchorage
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21
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Brahmachary P, Erdogan E, Myers E, June RK. Metabolomic Profiling and Characterization of a Novel 3D Culture System for Studying Chondrocyte Mechanotransduction. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.10.598340. [PMID: 38915493 PMCID: PMC11195103 DOI: 10.1101/2024.06.10.598340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Articular chondrocytes synthesize and maintain the avascular and aneural articular cartilage. In vivo these cells are surrounded by a 3D pericellular matrix (PCM) containing predominantly collagen VI. The PCM protects chondrocytes and facilitates mechanotransduction, and PCM stiffness is critical in transmitting biomechanical signals to chondrocytes. Various culture systems with different hydrogels have been used to encapsulate chondrocytes for 3D culture, but many lack either the PCM or the in vivo stiffness of the cartilage matrix. Here, we demonstrate that primary chondrocytes cultured in alginate will form a pericellular matrix and display a phenotype similar to in vivo conditions. We found that primary human and bovine chondrocytes, when cultured in alginate beads with addition of sodium L-ascorbate for 7 days, had a pronounced PCM, retained their phenotype, and synthesized both collagens VI and II. This novel culture system enables alginate-encapsulated chondrocytes to develop a robust PCM thereby creating a model system to study mechanotransduction. We also observed distinct compression-induced changes in metabolomic profiles between the monolayer-agarose and alginate-released agarose-embedded chondrocytes indicating physiological changes in cell metabolism. Our data suggest that 3D preculture of chondrocytes in alginate before encapsulation in physiologically-stiff agarose leads to a pronounced development of pericellular matrix that is sustained in the presence of ascorbate. This novel model can be useful in studying the mechanism by which chondrocytes respond to cyclical compression and other types of loading simulating in vivo physiological conditions.
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Affiliation(s)
- Priyanka Brahmachary
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717
| | - Ebru Erdogan
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717
| | - Erik Myers
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717
| | - Ronald K June
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717
- Department of Microbiology & Cell Biology, Montana State University, Bozeman, MT 59717
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22
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Xu S, Shen X, Chen B, Sun Y, Tang X, Xiao J, Qin Y. Trends in prevalence of arthritis by race among adults in the United States, 2011-2018. BMC Public Health 2024; 24:1507. [PMID: 38840090 PMCID: PMC11151635 DOI: 10.1186/s12889-024-18966-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/27/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND There is currently a lack of comprehensive prevalence information on arthritis and its various classifications among adults in the U.S., particularly given the notable absence of detailed data regarding the Asian population. We examined the trends in the prevalence of arthritis, including osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), and other types of arthritis, among U.S. adults by race between 2011 and 2018. METHODS We analyzed data from the National Health and Nutrition Examination Survey (NHANES), spanning from 2011 to 2018. Our study focused on a nationally representative sample of U.S. adults aged 20 and older. Participants who answered "y es" to the research question "Doctors ever said you had arthritis?" were classified as having arthritis. Further classification into specific diseases was based on responses to the question "Which type of arthritis was it?" with options including "OA or degenerative arthritis, " "RA, " "PsA, " or "Other. " RESULTS: We analyzed 22,566 participants from NHANES (2011-2018), averaging 44.8 years, including 10,927 males. The overall arthritis prevalence rose significantly from 22.98% (95% CI: 21.47-24.55%) in 2011-12 to 27.95% (95% CI: 26.20-29.76%) in 2017-18 (P for trend < 0.001). OA increased from 12.02% (95% CI: 10.82-13.35%) in 2011 to 14.93% (95% CI: 13.47-16.51%) in 2018 (P for trend < 0.001). RA and PsA remained stable (P for trend = 0.220 and 0.849, respectively), while other arthritis rose from 2.03% (95% CI: 1.54-2.67%) in 2011-12 to 3.14% (95% CI: 2.56-3.86%) in 2017-18 (P for trend = 0.001). In Whites, Asians, and other races , arthritis and RA prevalence increased significantly (P for trend < 0.05). OA and other arthritis rose in Whites and other races (P for trend < 0.05), but no significant change occurred in the black population. The prevalence of PsA remained stable across all racial groups, with no statistically significant changes. CONCLUSIONS In this nationally representative U.S. adult survey spanning 2011 to 2018, we identified a rising prevalence trend in arthritis, OA, and other arthritis, with notable variations among different racial groups.
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Affiliation(s)
- Shenghao Xu
- Department of Orthopedics, The Second Hospital of Jilin University, Ziqiang St No. 218, Changchun, Jilin Province, 130041, China
- Joint International Research Laboratory of Ageing Active Strategy and Bionic Health in Northeast Asia of Ministry of Education, Jilin University, Changchun, Jilin Province, 130041, China
| | - Xianyue Shen
- Department of Orthopedics, The First Affiliated Hospital of University of Science and Technology of China, Lujiang Road No. 17, Hefei, Anhui Province, 230001, China
| | - Bo Chen
- Department of Orthopedics, The Second Hospital of Jilin University, Ziqiang St No. 218, Changchun, Jilin Province, 130041, China
- Joint International Research Laboratory of Ageing Active Strategy and Bionic Health in Northeast Asia of Ministry of Education, Jilin University, Changchun, Jilin Province, 130041, China
| | - Yingqiao Sun
- Department of Orthopedics, The Second Hospital of Jilin University, Ziqiang St No. 218, Changchun, Jilin Province, 130041, China
- Joint International Research Laboratory of Ageing Active Strategy and Bionic Health in Northeast Asia of Ministry of Education, Jilin University, Changchun, Jilin Province, 130041, China
| | - Xiongfeng Tang
- Department of Orthopedics, The Second Hospital of Jilin University, Ziqiang St No. 218, Changchun, Jilin Province, 130041, China.
- Joint International Research Laboratory of Ageing Active Strategy and Bionic Health in Northeast Asia of Ministry of Education, Jilin University, Changchun, Jilin Province, 130041, China.
| | - Jianlin Xiao
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Xiantai St No.126, Changchun, Jilin Province, 130033, China.
| | - Yanguo Qin
- Department of Orthopedics, The Second Hospital of Jilin University, Ziqiang St No. 218, Changchun, Jilin Province, 130041, China.
- Joint International Research Laboratory of Ageing Active Strategy and Bionic Health in Northeast Asia of Ministry of Education, Jilin University, Changchun, Jilin Province, 130041, China.
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Chapman JH, Ghosh D, Attari S, Ude CC, Laurencin CT. Animal Models of Osteoarthritis: Updated Models and Outcome Measures 2016-2023. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2024; 10:127-146. [PMID: 38983776 PMCID: PMC11233113 DOI: 10.1007/s40883-023-00309-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/19/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2024]
Abstract
Purpose Osteoarthritis (OA) is a global musculoskeletal disorder that affects primarily the knee and hip joints without any FDA-approved disease-modifying therapies. Animal models are essential research tools in developing therapies for OA; many animal studies have provided data for the initiation of human clinical trials. Despite this, there is still a need for strategies to recapitulate the human experience using animal models to better develop treatments and understand pathogenesis. Since our last review on animal models of osteoarthritis in 2016, there have been exciting updates in OA research and models. The main purpose of this review is to update the latest animal models and key features of studies in OA research. Method We used our existing classification method and screened articles in PubMed and bibliographic search for animal OA models between 2016 and 2023. Relevant and high-cited articles were chosen for inclusion in this narrative review. Results Recent studies were analyzed and classified. We also identified ex vivo models as an area of ongoing research. Each animal model offers its own benefit in the study of OA and there are a full range of outcome measures that can be assessed. Despite the vast number of models, each has its drawbacks that have limited translating approved therapies for human use. Conclusion Depending on the outcome measures and objective of the study, researchers should pick the best model for their work. There have been several exciting studies since 2016 that have taken advantage of regenerative engineering techniques to develop therapies and better understand OA. Lay Summary Osteoarthritis (OA) is a chronic debilitating disease without any cure that affects mostly the knee and hip joints and often results in surgical joint replacement. Cartilage protects the joint from mechanical forces and degrades with age or in response to injury. The many contributing causes of OA are still being investigated, and animals are used for preclinical research and to test potential new treatments. A single consensus OA animal model for preclinical studies is non-existent. In this article, we review the many animal models for OA and provide a much-needed update on studies and model development since 2016.
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Affiliation(s)
- James H. Chapman
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030-3711, USA
- Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA
- Department of Orthopedic Surgery, UConn Health, Farmington, CT 06030, USA
| | - Debolina Ghosh
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030-3711, USA
- Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA
- Department of Orthopedic Surgery, UConn Health, Farmington, CT 06030, USA
| | - Seyyedmorteza Attari
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030-3711, USA
- Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA
- Department of Orthopedic Surgery, UConn Health, Farmington, CT 06030, USA
- Department of Materials Science and Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Chinedu C. Ude
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030-3711, USA
- Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA
- Department of Orthopedic Surgery, UConn Health, Farmington, CT 06030, USA
| | - Cato T. Laurencin
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030-3711, USA
- Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA
- Department of Orthopedic Surgery, UConn Health, Farmington, CT 06030, USA
- Department of Materials Science and Engineering, University of Connecticut, Storrs, CT 06269, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
- Department of Chemical and Bimolecular Engineering, University of Connecticut, Storrs, CT 06269, USA
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Rogge AA, Liegl G, Snyder C, Rose M, Nolte S. EORTC QLQ-C30 general population normative data for the United States. Eur J Cancer 2024; 202:114030. [PMID: 38552543 DOI: 10.1016/j.ejca.2024.114030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a frequently used cancer-specific health-related quality of life (HRQoL) questionnaire. To aid interpretation of data obtained via EORTC QLQ-C30, general population norm data have been published for many countries. However, despite its frequent use in the United States, no normative data by sex and age exist to date. Therefore, this study aimed to generate sex- and age-specific EORTC QLQ-C30 normative data for the United States. METHODS Recruitment and data collection were carried out via online panels as part of a larger cross-sectional study. For the recruitment, the sample was stratified by sex and age (18-39, 40-49, 50-59, 60-69, ≥ 70 years) to achieve a balanced distribution, with n = 100 per subgroup. Descriptive statistics are presented by age and age/sex. RESULTS A total of N = 1009 respondents completed the survey (n = 508 females, n = 501 males). More than two thirds of participants (72.5%) reported at least one health condition, e.g., arthritis (26%). Across EORTC QLQ-C30 scales, women and men 60 years and older reported generally better/higher functioning and better/lower symptom scores compared to the younger age groups. CONCLUSION To date, no specific EORTC QLQ-C30 general population normative data have been published for the United States. This paper provides these important normative data, which will greatly support the interpretation of EORTC QLQ-C30 scale scores obtained from US cancer patients, and also enable comparison with European norms.
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Affiliation(s)
- Alizé A Rogge
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Gregor Liegl
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claire Snyder
- Johns Hopkins Schools of Medicine and Public Health, Baltimore, MD, USA
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; German Centre for Mental Health (DZPG) - - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sandra Nolte
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia; School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
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25
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Jelinek T, Shumard A, Modi J, Smith C, Nees D, Hughes G, Vassar M. Endorsement of reporting guidelines and clinical trial registration across Scopus-indexed rheumatology journals: a cross-sectional analysis. Rheumatol Int 2024; 44:909-917. [PMID: 37861727 DOI: 10.1007/s00296-023-05474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/16/2023] [Indexed: 10/21/2023]
Abstract
The purpose of this study was to investigate the instructions for authors of rheumatology journals and analyze their endorsement of reporting guidelines and clinical trial registration. Sixty rheumatology journals were selected by a research librarian and an investigator through the 2021 Scopus CiteScore tool. The instructions for authors' subsection of each journal was assessed to determine endorsement of study design-specific reporting guidelines or clinical trial registration. Descriptive statistics were calculated using R (version 4.2.1) and RStudio. Of the 58 journals analyzed, 34 (34/58; 59%) mentioned the EQUATOR Network: an online compendium of best practice reporting guidelines. The most commonly mentioned reporting guidelines were CONSORT with 44 journals (44/58; 75%), and PRISMA with 35 journals (35/58; 60%). The least mentioned guidelines were QUOROM with 56 journals not mentioning the guideline (56/58; 97%), and SRQR with 53 journals not mentioning the guideline (53/57, 93%). Clinical trial registration was required by 38 journals (38/58; 66%) and recommended by 8 journals (8/58; 14%). Our study found that endorsement of reporting guidelines and clinical trial registration within rheumatology journals was suboptimal with great room for improvement. Endorsement of reporting guidelines have shown to not only mitigate bias, but also improve research methodologies. Therefore, we recommend rheumatology journals broadly expand their endorsement of reporting guidelines and clinical trial registration to improve the quality of evidence they publish.
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Affiliation(s)
- Trevon Jelinek
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17Th St., Tulsa, OK, 74107, USA.
| | - Alexandra Shumard
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17Th St., Tulsa, OK, 74107, USA
| | - Jay Modi
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17Th St., Tulsa, OK, 74107, USA
| | - Caleb Smith
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17Th St., Tulsa, OK, 74107, USA
| | - Danya Nees
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17Th St., Tulsa, OK, 74107, USA
| | | | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17Th St., Tulsa, OK, 74107, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Zhu GC, Chen KM, Belcastro F. Comparing Different Stretching Exercises on Pain, Stiffness, and Physical Function Disability in Older Adults With Knee Osteoarthritis. Arch Phys Med Rehabil 2024; 105:953-962. [PMID: 37467937 DOI: 10.1016/j.apmr.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/06/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To assess and compare the effects of different stretching exercise programs on pain, stiffness, and physical function disability in older adults with knee osteoarthritis (KOA). DATA SOURCES This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline for network meta-analysis (NMA). Relevant randomized controlled trials were identified by searching 7 databases up to December 2022. STUDY SELECTION Inclusion criteria included (1) older adults with KOA; (2) intervention included stretching exercises; (3) control groups received no stretching exercise; and (4) outcome measurements included pain, stiffness, or physical function disability. Methodological quality was assessed using the Cochrane risk-of-bias tool for randomized trials version 2. DATA EXTRACTION NMA was performed using R and MetaInsight, with results presented as a standardized mean difference (SMD) with 95% confidence interval (CI). DATA SYNTHESIS We examined 17 studies, and NMA results indicated that proprioceptive neuromuscular facilitation (PNF) stretching, mind-body exercises, and multi-component exercise programs were effective in mitigating pain in older adults with KOA (SMD=2.54 [95% CI: 1.23; 3.84], SMD=1.09 [95% CI: 0.27; 1.92], SMD=0.57 [95% CI: 0.06; 1.09]). Moreover, mind-body exercises and multi-component exercises were the most effective programs in reducing stiffness (SMD=1.31 [95% CI: 0.12; 2.51]) and physical function disability (SMD=1.67 [95% CI: 0.01; 3.33]) in older adults with KOA, respectively. CONCLUSION Findings suggest that PNF stretching, mind-body exercises, and multi-component exercises can be incorporated into exercise programs to better mitigate pain, stiffness, and physical function disability in older adults with KOA.
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Affiliation(s)
- Guan-Cheng Zhu
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| | - Frank Belcastro
- Department of Education and Psychology, University of Dubuque, Dubuque, IA
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Turner SG, Robinson JRM, Pillemer KA, Reid MC. Prevalence Estimates of Arthritis and Activity-Limiting Pain Among Family Caregivers to Older Adults. THE GERONTOLOGIST 2024; 64:gnad124. [PMID: 37656675 PMCID: PMC11020308 DOI: 10.1093/geront/gnad124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known about the prevalence of physical pain among family caregivers to older adults. We used national survey data to assess the relative prevalence of caregivers' arthritis and activity-limiting bothersome pain by caregiver and care-recipient characteristics to identify which caregivers may be at a higher risk for physical pain. RESEARCH DESIGN AND METHODS We analyzed data collected from 1,930 caregivers who participated in the National Study on Caregiving (2017). We utilized modified Poisson models to estimate adjusted associations of caregiver and care-recipient characteristics with the relative prevalence of arthritis and bothersome pain. RESULTS Forty percent of caregivers had a lifetime diagnosis of arthritis. Seventy-five percent of caregivers with arthritis reported bothersome pain, nearly 30% of whom endorsed bothersome pain that limited their activities on most or every day of the previous month (i.e., activity-limiting bothersome pain). Regardless of whether they had arthritis, 51% of the sample reported bothersome pain in the previous month, 24% of whom indicated activity-limiting bothersome pain. Caregivers who were older or more highly educated had a higher prevalence of arthritis. Black caregivers had a lower prevalence of arthritis and activity-limiting bothersome pain compared to White caregivers. Caregivers with physical difficulty providing care had a higher prevalence of arthritis and activity-limiting bothersome pain than caregivers without physical difficulty providing care. DISCUSSION AND IMPLICATIONS Arthritis and activity-limiting bothersome pain are highly prevalent among caregivers. Given increased prevalence of pain among certain caregivers, it may be efficient to target these groups for pain management interventions.
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Affiliation(s)
- Shelbie G Turner
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
| | | | - Karl A Pillemer
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - M Carrington Reid
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
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Kinara SN, Kimani HM, Ogweno GO. Prevalence and predictors of arthritis among adults in a rural set-up in Kenya: a cross-sectional study. Pan Afr Med J 2024; 47:158. [PMID: 38974697 PMCID: PMC11226762 DOI: 10.11604/pamj.2024.47.158.42890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/04/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction arthritis is a significant public health problem affecting many people globally. Exposure to various risk factors puts individuals at risk of developing arthritis. Therefore, this study aimed to assess the prevalence and predictors of arthritis among residents of a rural set-up in Nyamira County, Kenya. Methods a community-based cross-sectional study design was employed. Simple random sampling was utilized to select households from a household list. All the residents of the sampled household above 40 years were included. Descriptive analysis was done to describe the study population. Bivariate and multivariate analysis was also done to identify statistically significant arthritis-related variables. Results the prevalence of arthritis was 44.6%. Previous joint injury/infection [AOR=2.74; 95%CI=1.59-4.77; p<0.001], being unemployed [AOR=2.77; 95%CI=1.50-5.21; p=0.001], age above 51 years, and hypertension [AOR=1.90; 95%CI=1.03-3.53, p=0.040] were associated with an increased risk of arthritis. Conversely, being male [AOR=0.42; 95% CI=0.22-0.75; p=0.005], standing for > 2 hours [AOR=0.48; 95%CI=0.29-0.81; p=0.006], and constant shifting from sit to stand positions [AOR=0.45; 95% CI=0.26-0.76; p=0.003] were associated with a lower risk of arthritis. Most participants (75%) had an arthritis knowledge score of more than 66%. Conclusion the study found a high prevalence of arthritis in the community. Arthritis was strongly associated with various risk factors under study. Therefore, there is a need to take preventive measures for modifiable factors to enhance a reduced prevalence of arthritis.
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Affiliation(s)
- Shem Nyarunda Kinara
- Department of Family Medicine Community Health and Epidemiology, Kenyatta University, Nairobi, Kenya
| | - Harun Mbugua Kimani
- Department of Family Medicine Community Health and Epidemiology, Kenyatta University, Nairobi, Kenya
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Hussain MS, Altamimi ASA, Afzal M, Almalki WH, Kazmi I, Alzarea SI, Gupta G, Shahwan M, Kukreti N, Wong LS, Kumarasamy V, Subramaniyan V. Kaempferol: Paving the path for advanced treatments in aging-related diseases. Exp Gerontol 2024; 188:112389. [PMID: 38432575 DOI: 10.1016/j.exger.2024.112389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/17/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
Aging-related diseases (ARDs) are a major global health concern, and the development of effective therapies is urgently needed. Kaempferol, a flavonoid found in several plants, has emerged as a promising candidate for ameliorating ARDs. This comprehensive review examines Kaempferol's chemical properties, safety profile, and pharmacokinetics, and highlights its potential therapeutic utility against ARDs. Kaempferol's therapeutic potential is underpinned by its distinctive chemical structure, which confers antioxidative and anti-inflammatory properties. Kaempferol counteracts reactive oxygen species (ROS) and modulates crucial cellular pathways, thereby combating oxidative stress and inflammation, hallmarks of ARDs. Kaempferol's low toxicity and wide safety margins, as demonstrated by preclinical and clinical studies, further substantiate its therapeutic potential. Compelling evidence supports Kaempferol's substantial potential in addressing ARDs through several mechanisms, notably anti-inflammatory, antioxidant, and anti-apoptotic actions. Kaempferol exhibits a versatile neuroprotective effect by modulating various proinflammatory signaling pathways, including NF-kB, p38MAPK, AKT, and the β-catenin cascade. Additionally, it hinders the formation and aggregation of beta-amyloid protein and regulates brain-derived neurotrophic factors. In terms of its anticancer potential, kaempferol acts through diverse pathways, inducing apoptosis, arresting the cell cycle at the G2/M phase, suppressing epithelial-mesenchymal transition (EMT)-related markers, and affecting the phosphoinositide 3-kinase/protein kinase B signaling pathways. Subsequent studies should focus on refining dosage regimens, exploring innovative delivery systems, and conducting comprehensive clinical trials to translate these findings into effective therapeutic applications.
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Affiliation(s)
- Md Sadique Hussain
- School of Pharmaceutical Sciences, Jaipur National University, Jagatpura, 302017 Jaipur, Rajasthan, India
| | | | - Muhammad Afzal
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, P.O. Box 6231, Jeddah 21442, Saudi Arabia
| | - Waleed Hassan Almalki
- Department of Pharmacology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, 21589, Jeddah, Saudi Arabia
| | - Sami I Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, 72341, Sakaka, Aljouf, Saudi Arabia
| | - Gaurav Gupta
- Centre for Global Health Research, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, India; Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, Ajman 346, United Arab Emirates
| | - Moyad Shahwan
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, Ajman 346, United Arab Emirates; Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India
| | - Ling Shing Wong
- Faculty of Health and Life Sciences, INTI International University, Nilai 71800, Malaysia
| | - Vinoth Kumarasamy
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, 56000 Kuala Lumpur, Malaysia.
| | - Vetriselvan Subramaniyan
- Pharmacology Unit, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia.
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Welhaven HD, Welfley AH, Brahmachary P, Bergstrom AR, Houske E, Glimm M, Bothner B, Hahn AK, June RK. Metabolomic Profiles and Pathways in Osteoarthritic Human Cartilage: A Comparative Analysis with Healthy Cartilage. Metabolites 2024; 14:183. [PMID: 38668311 PMCID: PMC11051929 DOI: 10.3390/metabo14040183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Osteoarthritis (OA) is a chronic joint disease with heterogenous metabolic pathology. To gain insight into OA-related metabolism, metabolite extracts from healthy (n = 11) and end-stage osteoarthritic cartilage (n = 35) were analyzed using liquid chromatography-mass spectrometry metabolomic profiling. Specific metabolites and metabolic pathways, including lipid and amino acid pathways, were differentially regulated in osteoarthritis-derived and healthy cartilage. The detected alterations in amino acids and lipids highlighted key differences in bioenergetic resources, matrix homeostasis, and mitochondrial alterations in OA-derived cartilage compared to healthy cartilage. Moreover, the metabolomic profiles of osteoarthritic cartilage separated into four distinct endotypes, highlighting the heterogenous nature of OA metabolism and the diverse landscape within the joint in patients. The results of this study demonstrate that human cartilage has distinct metabolomic profiles in healthy and end-stage OA patients. By taking a comprehensive approach to assess metabolic differences between healthy and osteoarthritic cartilage and within osteoarthritic cartilage alone, several metabolic pathways with distinct regulation patterns were detected. Additional investigation may lead to the identification of metabolites that may serve as valuable indicators of disease status or potential therapeutic targets.
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Affiliation(s)
- Hope D. Welhaven
- Department of Chemistry & Biochemistry, Montana State University, Bozeman, MT 59717, USA
| | - Avery H. Welfley
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717, USA
| | - Priyanka Brahmachary
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717, USA
| | - Annika R. Bergstrom
- Department of Chemical & Biological Engineering, Villanova University, Villanova, PA 19085, USA
| | - Eden Houske
- Department of Biological and Environmental Sciences, Carroll College, Helena, MT 59625, USA
| | - Matthew Glimm
- Department of Biological and Environmental Sciences, Carroll College, Helena, MT 59625, USA
| | - Brian Bothner
- Department of Chemistry & Biochemistry, Montana State University, Bozeman, MT 59717, USA
| | - Alyssa K. Hahn
- Department of Biological and Environmental Sciences, Carroll College, Helena, MT 59625, USA
| | - Ronald K. June
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, MT 59717, USA
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Li W, Feng SL, Herrschaft L, Samulski RJ, Li C. Rationally engineered novel AAV capsids for intra-articular gene delivery. Mol Ther Methods Clin Dev 2024; 32:101211. [PMID: 38435130 PMCID: PMC10907215 DOI: 10.1016/j.omtm.2024.101211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
Intra-articular adeno-associated virus (AAV) gene therapy has been explored as a potential strategy for joint diseases. However, concerns of low transduction efficacy, off-target expression, and neutralizing antibodies (Nabs) still need to be addressed. In this study, we demonstrated that AAV6 was the best serotype to transduce joints after screening serotypes 1 to 9. To develop a more effective AAV vector, a set of novel AAV capsids were rationally engineered. The mutant AAV62 created by swapping variable region I (VRI) of AAV2 into AAV6 induced a higher transduction efficiency per AAV genome copy number. To further investigate the roles of specific amino acids in the transduction of AAV62 and AAV6, we found out that AAV6D with the deletion of threonine at residue 265 induced a 2-fold higher transduction than AAV6, while the transduction efficiency from AAV6M with the mutation of alanine to glutamine at residue 263 was 10-fold lower. AAV6D efficiently transduced both synoviocytes and chondrocytes with low AAV genome copy numbers in other tissues and less Nab formation. This study demonstrates that novel AAV mutants with rational engineering may enhance joint transduction after intra-articular administration in mice, with the potential to evade AAV Nabs and minimize off-target effects in the liver.
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Affiliation(s)
- Wenjun Li
- Gene Therapy Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Division of Oral and Craniofacial Biomedicine, University of North Carolina Adams School of Dentistry, Chapel Hill, NC, USA
| | - Susi Liu Feng
- Gene Therapy Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Lizette Herrschaft
- Gene Therapy Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - R. Jude Samulski
- Gene Therapy Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Chengwen Li
- Gene Therapy Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, NC 27510, USA
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Levinson J, Buehring B. Pitfalls and pearls in diagnosing inflammatory arthritis in older patients. Joint Bone Spine 2024; 91:105719. [PMID: 38452885 DOI: 10.1016/j.jbspin.2024.105719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
Given current demographic shifts, the number of older adults continues to grow, with almost half of patients over 65 being diagnosed with some form of arthritis. Rheumatic diseases pose unique diagnostic challenges in older patients due to the convergence of physiologic changes of aging, confounding difficulties to care, and atypical disease manifestations. This review summarizes the current published evidence to guide clinicians in evaluating geriatric patients with rheumatologic concerns, focusing on inflammatory arthritis. Using the background of epidemiologic data on various musculoskeletal diseases, clinical presentations, current diagnostic tests, and known physiologic changes of aging, this review highlights five diagnostic pitfalls in inflammatory polyarthritis among older patients. The pitfalls include: 1) broader differential diagnosis; 2) atypical presentations; 3) communication, cognitive, and social impairments; 4) the role of chronological vs. biological age; and 5) anchoring bias by assuming older adults are simply "older young adults". These pitfalls are discussed in the context of geriatric principles such as the "hallmarks of aging" and the expected pathophysiologic changes of organ systems. Furthermore, the review discusses the strengths and weaknesses of diagnostic tests used in arthritis and introduces some of the geriatric assessment tools that systematically evaluate multimorbidity and geriatric syndromes. With familiarity of the potential diagnostic pitfalls, knowledge of both normal and pathologic aging processes, awareness of the difference between biological and chronological age, and the ability to use geriatric assessment tools to better characterize older patients, clinicians will be better able to diagnose and manage rheumatic conditions in this population.
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Affiliation(s)
- Justin Levinson
- Rheumatology Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685, Highland avenue, Madison, WI, USA.
| | - Bjoern Buehring
- Division of Rheumatology, Krankenhaus Sankt Josef, Wuppertal, Germany.
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Stevenson RDM, Chowdhury EA, Inza VB, Western MJ, Walsh NE, Jones SL, Bilzon JLJ. Development of the intelligent knee osteoarthritis lifestyle app: a person-based approach. BMC Musculoskelet Disord 2024; 25:189. [PMID: 38431553 PMCID: PMC10908108 DOI: 10.1186/s12891-024-07313-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/26/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Knee osteoarthritis is one of the most prevalent long term health conditions globally. Exercise and physical activity are now widely recognised to significantly reduce joint pain, improve physical function and quality of life in patients with knee osteoarthritis. However, prescribed exercise without regular contact with a healthcare professional often results in lower adherence and poorer health outcomes. Digital mobile health (mHealth) technologies offer great potential to support people with long-term conditions such as knee osteoarthritis more efficiently and effectively and with relatively lower cost than existing interventions. However, there are currently very few mHealth interventions for the self-management of knee osteoarthritis. The aim of the present study was to describe the development process of a mHealth app to extend the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through self-management, personalised physical activity, education, and social support. METHODS The development of the intelligent knee osteoarthritis lifestyle application intervention involved an iterative and interconnected process comprising intervention 'planning' and 'optimisation' informed by the person-based approach framework for the development of digital health interventions. The planning phase involved a literature review and collection of qualitative data obtained from focus groups with individuals with knee osteoarthritis (n = 26) and interviews with relevant physiotherapists (n = 5) to generate 'guiding principles' for the intervention. The optimisation phase involved usability testing (n = 7) and qualitative 'think aloud' sessions (n = 6) with potential beneficiaries to refine the development of the intervention. RESULTS Key themes that emerged from the qualitative data included the need for educational material, modifying activities to suit individual abilities and preferences as well as the inclusion of key features such as rehabilitation exercises. Following a user-trial further changes were made to improve the usability of the application. CONCLUSIONS Using a systematic person-based, development approach, we have developed the intelligent knee osteoarthritis lifestyle application to help people maintain physical activity behaviour. The app extends the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through personalised physical activity guidance, education, and social support.
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Affiliation(s)
- Richard D M Stevenson
- Department for Health, The University of Bath, Bath, BA2 7AY, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Bath, Bath, UK
| | - Enhad A Chowdhury
- Department for Health, The University of Bath, Bath, BA2 7AY, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Bath, Bath, UK
| | - Victor B Inza
- Visual Computing Centre, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Max J Western
- Department for Health, The University of Bath, Bath, BA2 7AY, UK
| | - Nicola E Walsh
- Faculty of Health and Applied Science, University of the West of England, Bristol, UK
| | - Simon L Jones
- Department of Computer Science, The University of Bath, Bath, BA2 7AY, UK
| | - James L J Bilzon
- Department for Health, The University of Bath, Bath, BA2 7AY, UK.
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Bath, Bath, UK.
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Mohammadi S, Salehi MA, Jahanshahi A, Shahrabi Farahani M, Zakavi SS, Behrouzieh S, Gouravani M, Guermazi A. Artificial intelligence in osteoarthritis detection: A systematic review and meta-analysis. Osteoarthritis Cartilage 2024; 32:241-253. [PMID: 37863421 DOI: 10.1016/j.joca.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/11/2023] [Accepted: 09/27/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVES As an increasing number of studies apply artificial intelligence (AI) algorithms in osteoarthritis (OA) detection, we performed a systematic review and meta-analysis to pool the data on diagnostic performance metrics of AI, and to compare them with clinicians' performance. MATERIALS AND METHODS A search in PubMed and Scopus was performed to find studies published up to April 2022 that evaluated and/or validated an AI algorithm for the detection or classification of OA. We performed a meta-analysis to pool the data on the metrics of diagnostic performance. Subgroup analysis based on the involved joint and meta-regression based on multiple parameters were performed to find potential sources of heterogeneity. The risk of bias was assessed using Prediction Model Study Risk of Bias Assessment Tool reporting guidelines. RESULTS Of the 61 studies included, 27 studies with 91 contingency tables provided sufficient data to enter the meta-analysis. The pooled sensitivities for AI algorithms and clinicians on internal validation test sets were 88% (95% confidence interval [CI]: 86,91) and 80% (95% CI: 68,88) and pooled specificities were 81% (95% CI: 75,85) and 79% (95% CI: 80,85), respectively. At external validation, the pooled sensitivity and specificity for AI algorithms were 94% (95% CI: 90,97) and 91% (95% CI: 77,97), respectively. CONCLUSION Although the results of this meta-analysis should be interpreted with caution due to the potential pitfalls in the included studies, the promising role of AI as a diagnostic adjunct to radiologists is indisputable.
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Affiliation(s)
- Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Ali Jahanshahi
- Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | | | - Seyed Sina Zakavi
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Sadra Behrouzieh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahdi Gouravani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Guermazi
- Department of Radiology, VA Boston Healthcare System, Boston University School of Medicine, Boston, MA, USA.
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Gell NM, Smith PA, Wingood M. Physical Therapist and Patient Perspectives on Mobile Technology to Support Home Exercise Prescription for People With Arthritis: A Qualitative Study. Cureus 2024; 16:e55899. [PMID: 38601402 PMCID: PMC11006223 DOI: 10.7759/cureus.55899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Mobile applications (apps) for exercise prescription may enhance communication between healthcare providers and patients while addressing common barriers to exercise among people with osteoarthritis. However, little is known about preferences and barriers to the use of mobile apps by physical therapists or people aging with osteoarthritis. Therefore, we aimed to examine physical therapist and patient perspectives on mobile apps to support physical therapist-prescribed home exercise for people with osteoarthritis. Methods Eighteen physical therapists and 17 individuals with a history of physical therapy for osteoarthritis participated in the study. Focus groups (n = 6, three each with physical therapists and patients) were conducted to gather perspectives on three commercially available mobile apps designed for physical therapy exercise prescription. Semi-structured questions assessed feature preferences, ease of use, exercise completion support, clinical feasibility, and potential barriers and facilitators to using the apps. Recordings of the focus groups were transcribed verbatim. The study team iteratively coded transcripts using thematic analysis. Results Perspectives of patients and physical therapists intersected but differed on the mobile apps. All patients preferred video exercise prescription over traditional methods and both patients and therapists predicted challenges and opportunities with mobile communication. Four themes emerged: accountability, data-driven, communication boost, and duality of technology. Facilitators of home exercise through mobile apps included exercise tracking, feedback loop, personalization, and the potential for reduced in-person visits. Barriers included technological challenges, complex interface design, lack of universal applicability, and security concerns. Conclusion Mobile app technology has the potential to support exercise adherence for people with osteoarthritis. However, patients' and therapists' perspectives differ and highlight numerous challenges that limit the universal clinical adoption of this technology. While physical therapists acknowledged the potential to improve the rehabilitation experience with mobile apps, there was concern about reimbursement and time constraints in the current fee-for-service environment.
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Affiliation(s)
- Nancy M Gell
- Rehabilitation and Movement Science, University of Vermont, Burlington, USA
| | - Paula A Smith
- Rehabilitation and Movement Science, University of Vermont, Burlington, USA
| | - Mariana Wingood
- Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA
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Huffman KF, Ambrose KR, Nelson AE, Allen KD, Golightly YM, Callahan LF. The Critical Role of Physical Activity and Weight Management in Knee and Hip Osteoarthritis: A Narrative Review. J Rheumatol 2024; 51:224-233. [PMID: 38101914 PMCID: PMC10922233 DOI: 10.3899/jrheum.2023-0819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
Physical activity (PA) and weight management are critical components of an effective knee and hip osteoarthritis (OA) management plan, yet most people with OA remain insufficiently active and/or overweight. Clinicians and their care teams play an important role in educating patients with OA about PA and weight management, eliciting patient motivation to engage in these strategies, and referring patients to appropriate self-management interventions. The purpose of this review is to educate clinicians about the current public health and clinical OA guidelines for PA and weight management and highlight a variety of evidence-based self-management interventions available in community and clinical settings and online.
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Affiliation(s)
- Katie F Huffman
- K.F. Huffman, MA, K.R. Ambrose, MS, Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
| | - Kirsten R Ambrose
- K.F. Huffman, MA, K.R. Ambrose, MS, Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amanda E Nelson
- A.E. Nelson, MD, Osteoarthritis Action Alliance, Thurston Arthritis Research Center, and Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kelli D Allen
- K.D. Allen, PhD, Osteoarthritis Action Alliance, Thurston Arthritis Research Center, and Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, and Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, North Carolina
| | - Yvonne M Golightly
- Y.M. Golightly, PhD, Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, and College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska
| | - Leigh F Callahan
- L.F. Callahan, PhD, Osteoarthritis Action Alliance, Thurston Arthritis Research Center, and Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Department of Orthopaedics, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Zhao H, Chen X, Ni J, Fang L, Chen Y, Ma Y, Cai G, Pan F. Associations of perchlorate, nitrate, and thiocyanate exposure with arthritis and inflammation indicators in young and middle-aged adults, NHANES 2005-2016. Front Immunol 2024; 15:1318737. [PMID: 38495893 PMCID: PMC10940346 DOI: 10.3389/fimmu.2024.1318737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
Background Perchlorates, nitrates, and thiocyanates are prevalent environmental chemicals. Their potential association with arthritis remains unexplored. This study aimed to investigate the link between perchlorate, nitrate, and thiocyanate exposure and arthritis, as well as the potential role of inflammation in this context. Methods Utilizing the National Health and Nutrition Examination Survey (NHANES) data spanning from 2005 to 2016, the study enrolled 6597 participants aged 20-59 (young and middle-aged), of which 1045 had arthritis. Employing multivariate logistic regression modeling, multiple linear regression models, restricted cubic spline analysis, Bayesian kernel machine regression (BKMR) modeling, and mediation analysis, we assessed these relationships. Results There was a significant positive association between elevated urinary thiocyanate levels and arthritis risk [1.19 (1.11, 1.28)]. This association held true across subgroups of osteoarthritis (OA) [1.24 (1.10, 1.40)] and rheumatoid arthritis (RA) [1.33 (1.15, 1.55)]. Thiocyanate levels displayed a dose-dependent relationship with arthritis risk, showing a linear trend (nonlinear P > 0.05). Conversely, perchlorate and nitrate did not exhibit associations with arthritis risk. BKMR outcomes highlighted a positive correlation between a mixture of perchlorate, nitrate, and thiocyanate and arthritis risk, with thiocyanate being the predominant predictors. Moreover, BKMR and generalized linear model analyses unveiled no significant synergistic effect of urinary perchlorate, nitrate, and thiocyanate on arthritis risk. Furthermore, thiocyanate exposure has been linked to elevated levels of inflammatory indicators (white blood cell, neutrophils, lymphocytes, and systemic immune-inflammatory index (SII)). Conclusion Heightened thiocyanate exposure may be linked to elevated arthritis risk, either single or in combined effects. Additionally, thiocyanate exposure is associated with heightened inflammation levels.
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Affiliation(s)
- Hui Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China
| | - Xuyang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China
| | - Jianping Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China
| | - Lanlan Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China
| | - Yuting Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China
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Nyayapathi N, Zheng E, Zhou Q, Doyley M, Xia J. Dual-modal Photoacoustic and Ultrasound Imaging: from preclinical to clinical applications. FRONTIERS IN PHOTONICS 2024; 5:1359784. [PMID: 39185248 PMCID: PMC11343488 DOI: 10.3389/fphot.2024.1359784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Photoacoustic imaging is a novel biomedical imaging modality that has emerged over the recent decades. Due to the conversion of optical energy into the acoustic wave, photoacoustic imaging offers high-resolution imaging in depth beyond the optical diffusion limit. Photoacoustic imaging is frequently used in conjunction with ultrasound as a hybrid modality. The combination enables the acquisition of both optical and acoustic contrasts of tissue, providing functional, structural, molecular, and vascular information within the same field of view. In this review, we first described the principles of various photoacoustic and ultrasound imaging techniques and then classified the dual-modal imaging systems based on their preclinical and clinical imaging applications. The advantages of dual-modal imaging were thoroughly analyzed. Finally, the review ends with a critical discussion of existing developments and a look toward the future.
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Affiliation(s)
- Nikhila Nyayapathi
- Electrical and Computer Engineering, University of Rochester, Rochester, New York, 14627
| | - Emily Zheng
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, 14226
| | - Qifa Zhou
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90007
| | - Marvin Doyley
- Electrical and Computer Engineering, University of Rochester, Rochester, New York, 14627
| | - Jun Xia
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, 14226
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Lee YH, Hong SJ, Lee GJ, Shin SI, Hong JY, Chung SW, Lee YA. Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers. Sci Rep 2024; 14:4316. [PMID: 38383594 PMCID: PMC10881463 DOI: 10.1038/s41598-024-55004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57 years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621-0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529-0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37-6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18-207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854-0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, Korea.
| | - Seung-Jae Hong
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Gi-Ja Lee
- Department of Biomedical Engineering, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Sang Wan Chung
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Yeon-Ah Lee
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea.
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Martínez-Ramos S, García S. An update of murine models and their methodologies in immune-mediated joint damage and pain research. Int Immunopharmacol 2024; 128:111440. [PMID: 38176343 DOI: 10.1016/j.intimp.2023.111440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
Murine models have played an indispensable role in the understanding of rheumatic and musculoskeletal disorders (RMD), elucidating the genetic, endocrine and biomechanical pathways involved in joint pathology and associated pain. To date, the available models in RMD can be classified as induced or spontaneous, both incorporating transgenic alternatives that improve specific insights. It is worth noting that the selection of the most appropriate model together with the evaluation of their specific characteristics and technical capabilities are crucial when designing the experiments. Furthermore, it is also imperative to consistently adhere to the ethical standards concerning animal experimentation. Recognizing the inherent limitation that any model can entirely encapsulates the complexity of the pathophysiology of these conditions, the aim of this review is to provide an updated overview on the methodology of current murine models in major arthropathies and their immune-mediated pathways, addressing to basic, translational and pharmacological research in joint damage and pain.
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Affiliation(s)
- Sara Martínez-Ramos
- Rheumatology & Immuno-mediated Diseases Research Group (IRIDIS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain; Rheumatology Department, University Hospital Complex of Vigo, Vigo, Spain.
| | - Samuel García
- Rheumatology & Immuno-mediated Diseases Research Group (IRIDIS), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain; Rheumatology Department, University Hospital Complex of Vigo, Vigo, Spain
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Liang Z, Wu D, Zhang H, Gu J. Association between asymptomatic hyperuricemia and risk of arthritis, findings from a US National Survey 2007-2018. BMJ Open 2024; 14:e074391. [PMID: 38346893 PMCID: PMC10862310 DOI: 10.1136/bmjopen-2023-074391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Arthritis is thought to be closely related to serum uric acid. The study aims to assess the association between asymptomatic hyperuricemia (AH) and arthritis. METHODS A multistage, stratified cluster was used to conduct a cross-sectional study of adult US civilians aged≥20 years from the 2007-2018 National Health and Nutrition Examination Survey. Participants with hyperuricemia and without hyperuricemia prior to gout were included. A questionnaire was used to determine whether participants had arthritis and the type of arthritis. Logistic regression was used to investigate the association between hyperuricemia and arthritis. RESULT During the past 12 years, the percentage of participants with arthritis changed from 25.95% (22.53%-29.36%) to 25.53% (21.62%-29.44%). The prevalence of osteoarthritis (OA) increased from 8.70% (95% CI: 6.56% to 10.85%) to 12.44% (95% CI: 9.32% to 15.55%), the prevalence of AH changed from 16.35% (95% CI: 14.01% to 18.40%) to 16.39% (95% CI: 13.47% to 19.30%). Participants with AH were associated with onset of arthritis (OR=1.34, 95% CI: 1.07 to 1.69), but the association was muted after adjusting demographic and socioeconomic factors. For participants aged 40-49 years, AH is associated with incident arthritis (OR=1.96, 95% CI: 1.23 to 2.99) and the relationship remained after adjusting for education level, income to poverty ratio, body mass index, diabetes, hypertension and smoking (OR=2.00, 95% CI: 1.94 to 3.36). Compared with male, female participants with AH are more likely to develop arthritis, especially in OA (OR=1.35, 95% CI: 1.14 to 1.60). CONCLUSION Our data identified AH as the risk factor for incident arthritis, especially for OA, which might be exaggerated in aged population and female population.
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Affiliation(s)
- Zhenguo Liang
- Department of Rheumatology and Immunology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China
- Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Dongze Wu
- Department of Rheumatology and Immunology, University of Electronic Science and Technology of China Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Hua Zhang
- Department of Rheumatology and Immunology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China
| | - Jieruo Gu
- Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
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Yan Z, Luan X, Meng L, Wu Y, Qu W, Zhang S, Wei H, Wu S. Longitudinal relationship between social participation, depressive symptoms, and activity impairment among older patients with arthritis: a moderated mediation analysis. BMC Geriatr 2024; 24:139. [PMID: 38326792 PMCID: PMC10851568 DOI: 10.1186/s12877-024-04735-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Arthritis primarily affects older people and is a prominent cause of their activity impairment. This study aimed to examine the mediating role of depressive symptoms in the relationship between social participation and activity impairment, as well as to determine whether sex moderated the mediating effect. METHODS A total of 2247 older patients with arthritis were included from the China Health and Retirement Longitudinal Study between 2015 and 2018. We first examined a simple mediation model where depressive symptoms were a mediator between social participation and activity impairment. Furthermore, sex was systematically integrated into the model as a moderator. The mediation model and moderated mediation model were analyzed using PROCESS macro. RESULTS Mediation analysis revealed that the association between social participation and activity impairment was partially mediated by depressive symptoms (B = -0.10, 95% CI = [-0.14, -0.06]) with intermediary effect of 28.6%. Moderated mediation analysis indicated that mediation model was moderated by sex. The indirect effect of social participation on activity impairment among female patients (B = -0.15, 95% CI = [-0.21, -0.09]) was stronger than male patients (B = -0.04, 95% CI = [-0.09, -0.01]). CONCLUSION Social participation was the key protective factor associated with depressive symptoms and activity impairment among arthritis patients. Encouraging arthritis patients to social participation and improving the depressive symptoms might avoid activity impairment, especially for female patients.
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Affiliation(s)
- Zeping Yan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, China
| | | | - LiJun Meng
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yu Wu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
- University of Health and Rehabilitation Sciences, Qingdao, China
| | - Wenran Qu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Simeng Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huimin Wei
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shicai Wu
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.
- University of Health and Rehabilitation Sciences, Qingdao, China.
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Valachová K, Hassan ME, Šoltés L. Hyaluronan: Sources, Structure, Features and Applications. Molecules 2024; 29:739. [PMID: 38338483 PMCID: PMC10856924 DOI: 10.3390/molecules29030739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Hyaluronan (HA) is a non-sulfated glycosaminoglycan that is present in a variety of body tissues and organs. Hyaluronan has a wide range of biological activities that are frequently influenced by molar mass; however, they also depend greatly on the source, purity, and kind of impurities in hyaluronan. High-molar-mass HA has anti-inflammatory, immunosuppressive, and antiangiogenic properties, while low-molar-mass HA has opposite properties. A number of chemical modifications have been performed to enhance the stability of HA and its applications in medical practice. Hyaluronan is widely applied in medicine, such as viscosupplementation, ophthalmology, otolaryngology, wound healing, cosmetics, and drug delivery. In this review, we summarized several medical applications of polymers based on the hyaluronan backbone.
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Affiliation(s)
- Katarína Valachová
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Dúbravská cesta 9, 84104 Bratislava, Slovakia
| | - Mohamed E. Hassan
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Dúbravská cesta 9, 84104 Bratislava, Slovakia
- Centre of Excellence, Encapsulation & Nanobiotechnology Group, Chemistry of Natural and Microbial Products Department, National Research Centre, El Behouth Street, Cairo 12622, Egypt
| | - Ladislav Šoltés
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Dúbravská cesta 9, 84104 Bratislava, Slovakia
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Periasamy S, Chen YJ, Hsu DZ, Hsieh DJ. Collagen type II solution extracted from supercritical carbon dioxide decellularized porcine cartilage: regenerative efficacy on post-traumatic osteoarthritis model. BIORESOUR BIOPROCESS 2024; 11:21. [PMID: 38647941 PMCID: PMC10992551 DOI: 10.1186/s40643-024-00731-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/14/2024] [Indexed: 04/25/2024] Open
Abstract
Osteoarthritis (OA) of the knee is a common degenerative articular disorder and is one of the main causes of pain and functional disability. Cartilage damage is frequently linked to elevated osteoarthritis incidence. Supercritical carbon dioxide (scCO2) decellularized cartilage graft produced from the porcine cartilage is an ideal candidate for cartilage tissue engineering. In the present study, we derived collagen type II (Col II) solution from the scCO2 decellularized porcine cartilage graft (dPCG) and compared its efficacy with hyaluronic acid (HA) in the surgical medial meniscectomy (MNX) induced post-traumatic osteoarthritis (PTOA) model. Dose-dependent attenuation of the OA (12.3 ± 0.8) progression was observed in the intra-articular administration of Col II solution (7.3 ± 1.2) which significantly decreased the MNX-induced OA symptoms similar to HA. The pain of the OA group (37.4 ± 2.7) was attenuated dose-dependently by Col II solution (45.9 ± 4.1) similar to HA (43.1 ± 3.5) as evaluated by a capacitance meter. Micro-CT depicted a dose-dependent attenuation of articular cartilage damage by the Col II solution similar to HA treatment. A significant (p < 0.001) dose-dependent elevation in the bone volume was also observed in Col II solution-treated OA animals. The protective competence of Col II solution on articular cartilage damage is due to its significant (p < 0.001) increase in the expression of type II collagen, aggrecan and SOX-9 similar to HA. To conclude, intra-articular administration of type II collagen solution and HA reestablished the injured cartilage and decreased osteoarthritis progression in the experimental PTOA model.
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Affiliation(s)
- Srinivasan Periasamy
- R&D Center, ACRO Biomedical Co., Ltd, 2nd. Floor, No.57, Luke 2nd. Rd., Luzhu District, Kaohsiung City, 82151, Taiwan
| | - Yun-Ju Chen
- R&D Center, ACRO Biomedical Co., Ltd, 2nd. Floor, No.57, Luke 2nd. Rd., Luzhu District, Kaohsiung City, 82151, Taiwan
| | - Dur-Zong Hsu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, 70428, Taiwan
| | - Dar-Jen Hsieh
- R&D Center, ACRO Biomedical Co., Ltd, 2nd. Floor, No.57, Luke 2nd. Rd., Luzhu District, Kaohsiung City, 82151, Taiwan.
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Yongolo NM, Halliday J, Bunn C, Mtesha B, Kelly C, Krauth SJ, Mwingwa A, Biswaro SM, Siebert S, Kipengele AH, Walker RW, McIntosh E, Mmbaga BT. Estimating the prevalence and predictors of musculoskeletal disorders in Tanzania: a cross-sectional pilot study. Pan Afr Med J 2024; 47:36. [PMID: 38586069 PMCID: PMC10998254 DOI: 10.11604/pamj.2024.47.36.38258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/11/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction musculoskeletal (MSK) disorders account for approximately 20% of all years lived with disability worldwide however studies of MSK disorders in Africa are scarce. This pilot study aimed to estimate the community-based prevalence of MSK disorders, identify predictors, and assess the associated disability in a Tanzanian population. Methods a cross-sectional study was conducted in one village in the Kilimanjaro region from March to June 2019. The Gait, Arms, Legs, Spine (GALS) or paediatric GALS (pGALS) examinations were used during household and school visits. Individuals positive in GALS/pGALS screening were assessed by the regional examination of the musculoskeletal system (REMS) and Modified Health Assessment Questionnaire (MHAQ). Results among the 1,172 individuals enrolled in households, 95 (8.1%, 95% CI: 6.6 - 9.8) showed signs of MSK disorders using the GALS/pGALS examination and 37 (3.2%, 95% CI: 2.2 - 4.3) using the REMS. Among 682 schools enrolled children, seven showed signs of MSK disorders using the GALS/pGALS examination (1.0%, 95% CI: 0.4 - 2.1) and three using the REMS (0.4%, 95% CI: 0.0 - 1.3). In the household-enrolled adult population, female gender and increasing age were associated with GALS and REMS-positive findings. Among GALS-positive adults, increasing age was associated with REMS-positive status and increasing MHAQ score. Conclusion this Tanzanian study demonstrates a prevalence of MSK disorders and identifies predictors of MSK disorders comparable to those seen globally. These findings can inform the development of rheumatology services and interventions in Tanzania and the design of future investigations of the determinants of MSK disorders, and their impacts on health, livelihoods, and well-being.
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Affiliation(s)
- Nateiya Mmeta Yongolo
- Kilimanjaro Clinical Research Institute (KCRI), Moshi, Tanzania
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Liverpool School of Tropical Medicine, Liverpool, England
| | - Jo Halliday
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Christopher Bunn
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Benson Mtesha
- Kilimanjaro Clinical Research Institute (KCRI), Moshi, Tanzania
| | - Clive Kelly
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Stefanie Jennifer Krauth
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Anthon Mwingwa
- Kilimanjaro Clinical Research Institute (KCRI), Moshi, Tanzania
| | | | - Stefan Siebert
- School of Infection and Immunity, University of Glasgow, Glasgow, United Kingdom
| | | | - Richard William Walker
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma McIntosh
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Blandina Theophil Mmbaga
- Kilimanjaro Clinical Research Institute (KCRI), Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Welhaven HD, Welfley AH, Brahmachary P, Bergstrom AR, Houske E, Glimm M, Bothner B, Hahn AK, June RK. Metabolomic Profiles and Pathways in Osteoarthritic Human Cartilage: A Comparative Analysis with Healthy Cartilage. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.25.577269. [PMID: 38328065 PMCID: PMC10849731 DOI: 10.1101/2024.01.25.577269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Objective Osteoarthritis (OA) is a chronic joint disease with heterogenous metabolic pathology. To gain insight into OA-related metabolism, healthy and end-stage osteoarthritic cartilage were compared metabolically to uncover disease-associated profiles, classify OA-specific metabolic endotypes, and identify targets for intervention for the diverse populations of individuals affected by OA. Design Femoral head cartilage (n=35) from osteoarthritis patients were collected post-total joint arthroplasty. Healthy cartilage (n=11) was obtained from a tissue bank. Metabolites from all cartilage samples were extracted and analyzed using liquid chromatography-mass spectrometry metabolomic profiling. Additionally, cartilage extracts were pooled and underwent fragmentation analysis for biochemical identification of metabolites. Results Specific metabolites and metabolic pathways, including lipid- and amino acid pathways, were differentially regulated between osteoarthritis-derived and healthy cartilage. The detected alterations of amino acids and lipids highlight key differences in bioenergetic resources, matrix homeostasis, and mitochondrial alterations in osteoarthritis-derived cartilage compared to healthy. Moreover, metabolomic profiles of osteoarthritic cartilage separated into four distinct endotypes highlighting the heterogenous nature of OA metabolism and diverse landscape within the joint between patients. Conclusions The results of this study demonstrate that human cartilage has distinct metabolomic profiles between healthy and end-stage osteoarthritis patients. By taking a comprehensive approach to assess metabolic differences between healthy and osteoarthritic cartilage, and within osteoarthritic cartilage alone, several metabolic pathways with distinct regulation patterns were detected. Additional investigation may lead to the identification of metabolites that may serve as valuable indicators of disease status or potential therapeutic targets.
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Affiliation(s)
- Hope D. Welhaven
- Department of Chemistry & Biochemistry, Montana State University, Bozeman MT
| | - Avery H. Welfley
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman MT
| | - Priyanka Brahmachary
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman MT
| | - Annika R. Bergstrom
- Department of Chemical & Biological Engineering, Villanova University, Villanova, PA
| | - Eden Houske
- Department of Biological and Environmental Sciences, Carroll College, Helena, MT
| | - Matthew Glimm
- Department of Biological and Environmental Sciences, Carroll College, Helena, MT
| | - Brian Bothner
- Department of Chemistry & Biochemistry, Montana State University, Bozeman MT
| | - Alyssa K. Hahn
- Department of Biological and Environmental Sciences, Carroll College, Helena, MT
| | - Ronald K. June
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman MT
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Barnes RC, Banjara S, McHann MC, Almodovar S, Henderson-Redmond AN, Morgan DJ, Castro-Piedras I, Guindon J. Assessing Dose- and Sex-Dependent Antinociceptive Effects of Cannabidiol and Amitriptyline, Alone and in Combination, and Exploring Mechanism of Action Involving Serotonin 1A Receptors. J Pharmacol Exp Ther 2024; 388:655-669. [PMID: 38129125 PMCID: PMC10801786 DOI: 10.1124/jpet.123.001855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/08/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
Inflammatory pain is caused by tissue hypersensitization and is a component of rheumatic diseases, frequently causing chronic pain. Current guidelines use a multimodal approach to pain and sociocultural changes have renewed interest in cannabinoid use, particularly cannabidiol (CBD), for pain. The tricyclic antidepressant amitriptyline (AT) is approved for use in pain-related syndromes, alone and within a multimodal approach. Therefore, we investigated sex- and dose-dependent effects of CBD and AT antinociception in the 2.5% formalin inflammatory pain model. Male and female C57BL/6J mice were pretreated with either vehicle, CBD (0.3-100 mg/kg), or AT (0.1-30 mg/kg) prior to formalin testing. In the acute phase, CBD induced antinociception after administration of 30-100 mg/kg in males and 100 mg/kg in females and in the inflammatory phase at doses of 2.5-100 mg/kg in males and 10-100 mg/kg in females. In the acute phase, AT induced antinociception at 10 mg/kg for all mice, and at 0.3 mg/kg in males and 3 mg/kg in female mice in the inflammatory phase. Combining the calculated median effective doses of CBD and AT produced additive effects for all mice in the acute phase and for males only in the inflammatory phase. Use of selective serotonin 1A receptor antagonist N-[2-[4-(2-methoxyphenyl)-1 piperazinyl]ethyl]-N-2-pyridinylcyclohexanecarboxamide (WAY-100635) maleate (0.1 mg/kg) before co-administration of CBD and AT reversed antinociception in the acute and partially reversed antinociception in the inflammatory phase. Administration of AT was found to enhance cannabinoid receptor type 1mRNA expression only in female mice. These results suggest a role for serotonin and sex in mediating cannabidiol and amitriptyline-induced antinociception in inflammatory pain. SIGNIFICANCE STATEMENT: Inflammatory pain is an important component of both acute and chronic pain. We have found that cannabidiol (CBD) and amitriptyline (AT) show dose-dependent, and that AT additionally shows sex-dependent, antinociceptive effects in an inflammatory pain model. Additionally, the combination of CBD and AT was found to have enhanced antinociceptive effects that is partially reliant of serotonin 1A receptors and supports the use of CBD within a multimodal approach to pain.
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Affiliation(s)
- Robert C Barnes
- Department of Pharmacology and Neuroscience (R.C.B., S.B., M.C.M., I.C.-P., J.G.), Department of Immunology and Molecular Microbiology (S.A.), and Center of Excellence for Translational Neuroscience and Therapeutics (J.G.), Texas Tech University Health Sciences Center, Lubbock, Texas; and Department of Biomedical Sciences (A.N.H.-R., D.J.M.), Marshall University, Huntington, West Virginia
| | - Satish Banjara
- Department of Pharmacology and Neuroscience (R.C.B., S.B., M.C.M., I.C.-P., J.G.), Department of Immunology and Molecular Microbiology (S.A.), and Center of Excellence for Translational Neuroscience and Therapeutics (J.G.), Texas Tech University Health Sciences Center, Lubbock, Texas; and Department of Biomedical Sciences (A.N.H.-R., D.J.M.), Marshall University, Huntington, West Virginia
| | - Melissa C McHann
- Department of Pharmacology and Neuroscience (R.C.B., S.B., M.C.M., I.C.-P., J.G.), Department of Immunology and Molecular Microbiology (S.A.), and Center of Excellence for Translational Neuroscience and Therapeutics (J.G.), Texas Tech University Health Sciences Center, Lubbock, Texas; and Department of Biomedical Sciences (A.N.H.-R., D.J.M.), Marshall University, Huntington, West Virginia
| | - Sharilyn Almodovar
- Department of Pharmacology and Neuroscience (R.C.B., S.B., M.C.M., I.C.-P., J.G.), Department of Immunology and Molecular Microbiology (S.A.), and Center of Excellence for Translational Neuroscience and Therapeutics (J.G.), Texas Tech University Health Sciences Center, Lubbock, Texas; and Department of Biomedical Sciences (A.N.H.-R., D.J.M.), Marshall University, Huntington, West Virginia
| | - Angela N Henderson-Redmond
- Department of Pharmacology and Neuroscience (R.C.B., S.B., M.C.M., I.C.-P., J.G.), Department of Immunology and Molecular Microbiology (S.A.), and Center of Excellence for Translational Neuroscience and Therapeutics (J.G.), Texas Tech University Health Sciences Center, Lubbock, Texas; and Department of Biomedical Sciences (A.N.H.-R., D.J.M.), Marshall University, Huntington, West Virginia
| | - Daniel J Morgan
- Department of Pharmacology and Neuroscience (R.C.B., S.B., M.C.M., I.C.-P., J.G.), Department of Immunology and Molecular Microbiology (S.A.), and Center of Excellence for Translational Neuroscience and Therapeutics (J.G.), Texas Tech University Health Sciences Center, Lubbock, Texas; and Department of Biomedical Sciences (A.N.H.-R., D.J.M.), Marshall University, Huntington, West Virginia
| | - Isabel Castro-Piedras
- Department of Pharmacology and Neuroscience (R.C.B., S.B., M.C.M., I.C.-P., J.G.), Department of Immunology and Molecular Microbiology (S.A.), and Center of Excellence for Translational Neuroscience and Therapeutics (J.G.), Texas Tech University Health Sciences Center, Lubbock, Texas; and Department of Biomedical Sciences (A.N.H.-R., D.J.M.), Marshall University, Huntington, West Virginia
| | - Josée Guindon
- Department of Pharmacology and Neuroscience (R.C.B., S.B., M.C.M., I.C.-P., J.G.), Department of Immunology and Molecular Microbiology (S.A.), and Center of Excellence for Translational Neuroscience and Therapeutics (J.G.), Texas Tech University Health Sciences Center, Lubbock, Texas; and Department of Biomedical Sciences (A.N.H.-R., D.J.M.), Marshall University, Huntington, West Virginia
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Wang Y, Sun M, Yao N, Qu S, Guo R, Wang X, Li J, Xie Z, Liu Y, Wu Z, Wang F, Li B. Ideal cardiovascular health metrics have better identification of arthritis. BMC Public Health 2024; 24:114. [PMID: 38191356 PMCID: PMC10775435 DOI: 10.1186/s12889-023-17602-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND This study aimed to explore the association between ideal cardiovascular health metrics (ICVHM) and arthritis (AR), as well as the interactions of various indicators in ICVHM on AR in US adults. METHODS We involved 17,041 participants who were interviewed by NHANES from 2011 to 2018. AR included osteoarthritis or degenerative arthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis and other arthritis (Other AR). Logistic regression was applied to analyze the association between AR and ICVHM. Mixed graphical model (MGM) was used to explore the interaction between variables in ICVHM. RESULTS Higher ICVHM scores had a protective effect on AR. Compared to "≤1" score, the ORs of AR in participants with 2, 3, 4, and ≥5 were 0.586, 0.472, 0.259, and 0.130, respectively. Similar results were also found in different types of AR. ICVHM has a maximum area under the curve value of 0.765 and the interaction between blood pressure and total cholesterol was 0.43. CONCLUSIONS ICVHM correlates significantly with AR and is better at identifying AR than individual indicators. ICVHM can be better improved by controlling the indicators with stronger interactions. Our findings provide guidance for promoting health factors, which have important implications for identification and prevention of AR.
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Affiliation(s)
- Yuxiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Shifang Qu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Ruirui Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Zechun Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Zibo Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Fengdan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, 130021, Changchun, P. R. China.
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Pritchard KT, Baillargeon J, Lee WC, Doulatram G, Raji MA, Kuo YF. Inequitable access to nonpharmacologic pain treatment providers among cancer-free U.S. adults. Prev Med 2024; 178:107809. [PMID: 38072313 PMCID: PMC10872296 DOI: 10.1016/j.ypmed.2023.107809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 11/01/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE Using evidence-based nonpharmacologic pain treatments may prevent opioid overuse and associated adverse outcomes. There is limited data on the impact of access-promoting social determinants of health (SDoH: education, income, transportation) on use of nonpharmacologic pain treatments. Our objective was to examine the relationship between SDoH and use of nonpharmacologic pain treatment providers. Our goal was to understand policy-actionable factors contributing to inequity in pain treatment. METHODS Based on Andersen's Health Utilization Model, this cross-sectional analysis of 2016-2019 Medical Expenditure Panel Survey data evaluated whether use of outpatient nonpharmacologic pain treatment providers is driven by enabling (i.e., advantageous socioeconomic resources) or need (i.e., perceived disability and diagnosed disease) factors. The study sample (unweighted n = 28,188) represented a weighted N = 81,912,730 noninstitutionalized, cancer-free, U.S. adults with pain interference. The primary outcome measured use of nonpharmacologic providers relative to exclusive prescription opioid use or no treatment (i.e., neither opioids nor nonpharmacologic). To quantify equitable access, we compared the variance-between access-promoting enabling factors versus medical need factors-that explained utilization. RESULTS Compared to enabling factors, need factors explained twice the variance predicting pain treatment utilization. Still, the adjusted odds of using nonpharmacologic providers instead of opioids alone were 39% lower among respondents identifying as Black (95% Confidence Interval [CI], 0.49-0.76) and respondents residing in the U.S. South (95% CI, 0.51-0.74). Higher education (95% CI, 1.72-2.79) and income (95% CI, 1.68-2.42) both facilitated using nonpharmacologic providers instead of opioids. CONCLUSIONS These findings highlight the substantial influence access-promoting SDoH have on pain treatment utilization.
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Affiliation(s)
- Kevin T Pritchard
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Jacques Baillargeon
- Department of Epidemiology, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA.
| | - Wei-Chen Lee
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA.
| | - Gulshan Doulatram
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA.
| | - Mukaila A Raji
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
| | - Yong-Fang Kuo
- Department of Biostatistics and Data Science, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA.
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50
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Meng Q, Wang Y, Yuan T, Su Y, Ge J, Dong S, Sun S. Association between combined exposure to dioxins and arthritis among US adults: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:5415-5428. [PMID: 38123769 DOI: 10.1007/s11356-023-31423-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
Dioxins and dioxin-like compounds (DLCs) are common pollutants hazardous to human health. We applied 12 dioxins and DLCs data of 1851 participants (including 484 arthritis patients) from National Health Examination Survey (NHANES) 2001-2004 and quadrupled them into rank variables. Multivariate logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were used to explore the relationship between individual or mixed exposure to the pollutants and arthritis after adjusting for multiple covariates. In multivariable logistic regression with an individual dioxin or DLC, almost every chemical was significantly positively associated with arthritis, except PCB66 (polychlorinated biphenyl 66) and 1,2,3,4,6,7,8-heptachlorodibenzofuran (hpcdf). The WQS model indicated that the combined exposure to the 12 dioxins and DLCs was positively linked to arthritis (OR: 1.884, 95% CI: 1.514-2.346), with PCB156 (weighted 0.281) making the greatest contribution. A positive trend between combined exposure and arthritis was observed in the BKMR model, with a posterior inclusion probability (PIP) of 0.987 for PCB156, which was also higher than the other contaminants.
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Affiliation(s)
- Qi Meng
- Department of Joint Surgery, Shandong Provincial Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Yi Wang
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Orthopaedic Research Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China
| | - Tao Yuan
- Department of Joint Surgery, Shandong Provincial Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Yang Su
- Department of Joint Surgery, Shandong Provincial Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Jianxun Ge
- Department of Joint Surgery, Shandong Provincial Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Shankun Dong
- Department of Joint Surgery, Shandong Provincial Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Shui Sun
- Department of Joint Surgery, Shandong Provincial Hospital, Shandong University, Jinan, 250012, Shandong, China.
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
- Orthopaedic Research Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China.
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