Hand osteoarthritis and aging: the results of a large-scale cross-sectional study

<i>Background</i>: Because osteoarthritis (OA) is associated with morbidity and mortality, we hypothesized that radiographic hand OA would generally be associated with chronic systemic morbidity and it will be less prevalent in longevity populations than in non-longevity populations. <i>Aims</i>: 1) to evaluate the association between chronic systemic morbidity and radiographic hand OA; 2) to compare the prevalence and the mode of the development of radiographic hand OA in three longevity populations (Abkhazian, Azerbaijani and Georgian) vs. two non-longevity populations (Russian and Chuvashians). <i>Methods</i>: Radiographic hand OA was evaluated using the left hand radiograms in 14 joints according to the Kellgren and Lawrence’s (K-L) grading system. Each individual was characterized by the total number of affected (K-L≥2) joints (NAJ). The prevalence of hand OA was defined as the presence of at least one affected joint. Morbidity data were attained from their medical records and divided into 9 categories by a research physician. The longevity index was calculated as a ratio of the number of individuals aged >90 years versus the number of people aged >60, expressed in per mills (‰). The population with the longevity index >40‰ was considered as the longevity population. Statistical analyses included the prevalence estimation and ANOVA. <i>Results</i>: Radiographic hand OA was statistically significantly and positively associated with the ischemic heart disease. A significant difference in the age standardized prevalence of hand OA was found between each pair of the studied samples, except between the Chuvashians, Russians and Georgians and between the Azerbaijanis and Abkhazians. The lowest prevalence was found in the Abkhazians followed by the Azerbaijanis and Georgians. The highest prevalence was found in the Chuvashians. ANOVA showed significant differences between the age-adjusted means of NAJs. The lowest age-adjusted NAJ was found in the Abkhazian population followed by the Azerbaijanis and Georgians. The highest NAJ was found in the Chuvashians. <i>Conclusions</i>: The results of our study showed association between ischemic heart diseases and hand OA. Longevity populations showed lower hand OA prevalence and NAJ compared to a non-longevity population, that can be interpreted as that longevity populations age slower. Additional follow-up studies are needed to verify this hypothesis

Finger length ratio and body composition in Chuvashians

Very few studies that evaluated the association between finger length ratio and body composition in adult population showed very diverse results. We carried out a radiographic study on a large population sample who had participated in a Chuvashian skeletal aging study investigating different aspects of skeletal aging. The aims of this study were to evaluate the association between 2D:4D ratio and various indices of body composition in Chuvashian males and females. The study sample included 802 males (mean age 46.98±17.10 years) and 783 females (mean age 48.65±16.62 years). Single plain radiographs of both hands were taken. Each hand was classified according to whether the index finger was longer (Type 1), equal to (Type 2) or shorter than the ring finger (Type 3) by visual comparison of the soft tissue outline of the finger ends on the radiograph. Anthropometry, including body weight, stature, and six circumferences from the body trunk and extremities were taken from each participant. We found no evidence of substantial associations between visually assessed finger length ratio and adult BMI, WC, hip and chest circumferences, WHT and WCR for men and women. These results suggest that associations between finger length ratio and hormone-related diseases and disorders can be interpreted directly, independent of any mediating effects of adult body composition parameters

Finger Length Ratio (2D:4D) and Aging

This study aimed to evaluate the association between the index to ring (2D:4D) finger length ratio and aging-related traits (hand osteoarthritis (OA), the osseographic score (OSS), and reproductive period), as well as to assess the heritability of finger length. A Chuvashian population-based sample included 802 males (mean age 46.98±17.10 years) and 738 females (mean age 48.65±16.62 years). Age, sex, basic demographics, anthropometric data, reproductive indices (age at menarche, menopausal age, and length of the reproductive period), and x-rays of both hands were collected. Finger length ratio was measured on x-ray and each hand was visually classified as either type 1 – 2D>4D; type 2 ― 2D=4D; or type 3 ― 2D<4D. Hand OA was defined by the number of affected joints (Kellgren-Lawrence score ≥2) and the total of Kellgren-Lawrence scores (total OA score). OSS is a skeletal biomarker that comprises osteoporotic and OA changes observable on a hands x-ray. We calculated the familial correlations and performed a heritability analysis of 2D:4D ratio traits in a studied sample. After comparing the OA variables of individuals with different finger length ratio types (after adjustment for age and BMI) significant differences were found only in females between finger ratio types of the right hand in a number of affected joints (F=3.153, p=0. 043) and finger ratio types of the left (F=3.330, p=0. 036) and right (F=2.397, p=0. 047) hands of the total OA score. Females with type 3 ratio had the highest adjusted values of hand OA parameters. Results of one-way ANCOVA for finger length ratio types of the right hand showed a significant difference in OSS (df =2, F=7.569, P=0.001), after adjustment for age, sex, and BMI. The posthoc comparison showed that individuals with type 3 (2D<4D) ratio showed significantly higher OSS scores than ones with type 1 (p=0.012) and type 2 (p=0.003). In an analysis of finger length ratio types of left hand also a significant difference in OSS was found (df=2, F=3.290, P=0.038). The posthoc comparison showed that individuals with type 3 ratio showed significantly higher OSS scores than ones with type 2 (p=0.33) ratio. We found that a low finger length ratio, a masculine visually evaluated finger length ratio type, was associated with later menarche and a shorter reproductive period. No association was found with menopausal age. Familial correlations of finger length ratio traits showed no significant correlation for spouses, however, parent-offspring (0.15―0.28, p<0.001) and sibling correlations (0.13―0.38, p<0.009) were found significant. Heritability (H2) of visual classification of finger length ratio was 0.36 for the left and 0.28 for the right hand; finger ratio was 0.55 and 0.66, respectively; the ray ratio was 0.49 and 0.59, respectively, thus indicating the existence of a clear familial aggregation of finger length ratio variation in the Chuvashian pedigrees, which cannot be explained by pure common environmental effects

Finger length ratio and body composition in Chuvashians

Very few studies that evaluated the association between finger length ratio and body composition in adult population showed very diverse results. We carried out a radiographic study on a large population sample who had participated in a Chuvashian skeletal aging study investigating different aspects of skeletal aging. The aims of this study were to evaluate the association between 2D:4D ratio and various indices of body composition in Chuvashian males and females. The study sample included 802 males (mean age 46.98±17.10 years) and 783 females (mean age 48.65±16.62 years). Single plain radiographs of both hands were taken. Each hand was classified according to whether the index finger was longer (Type 1), equal to (Type 2) or shorter than the ring finger (Type 3) by visual comparison of the soft tissue outline of the finger ends on the radiograph. Anthropometry, including body weight, stature, and six circumferences from the body trunk and extremities were taken from each participant. We found no evidence of substantial associations between visually assessed finger length ratio and adult BMI, WC, hip and chest circumferences, WHT and WCR for men and women. These results suggest that associations between finger length ratio and hormone-related diseases and disorders can be interpreted directly, independent of any mediating effects of adult body composition parameters

Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review

INTRODUCTION: Hand osteoarthritis (OA) is associated with pain, reduced grip strength, loss of range of motion and joint stiffness leading to impaired hand function and difficulty with daily activities. The effectiveness of different rehabilitation interventions on specific treatment goals has not yet been fully explored. The objective of this systematic review is to provide evidence based knowledge on the treatment effects of different rehabilitation interventions for specific treatment goals for hand OA. METHODS: A computerized literature search of Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ISI Web of Science, the Physiotherapy Evidence Database (PEDro) and SCOPUS was performed. Studies that had an evidence level of 2b or higher and that compared a rehabilitation intervention with a control group and assessed at least one of the following outcome measures - pain, physical hand function or other measures of hand impairment - were included. The eligibility and methodological quality of trials were systematically assessed by two independent reviewers using the PEDro scale. Treatment effects were calculated using standardized mean difference and 95% confidence intervals. RESULTS: Ten studies, of which six were of higher quality (PEDro score >6), were included. The rehabilitation techniques reviewed included three studies on exercise, two studies each on laser and heat, and one study each on splints, massage and acupuncture. One higher quality trial showed a large positive effect of 12-month use of a night splint on hand pain, function, strength and range of motion. Exercise had no effect on hand pain or function although it may be able to improve hand strength. Low level laser therapy may be useful for improving range of motion. No rehabilitation interventions were found to improve stiffness. CONCLUSIONS: There is emerging high quality evidence to support that rehabilitation interventions can offer significant benefits to individuals with hand OA. A summary of the higher quality evidence is provided to assist with clinical decision making based on current evidence. Further high-quality research is needed concerning the effects of rehabilitation interventions on specific treatment goals for hand OA

Scheuermann’s Disease: Radiographic Pathomorphology and Association with Clinical Features

Study Design Cross-sectional analytical study. Purpose To evaluate the spinal radiological features in patients with Scheuermann’s disease and the association between the thoracic kyphosis angle and clinical presentation. Overview of the Literature Scheuermann’s disease is the most common cause of hyperkyphosis of the thoracic and thoracolumbar spine in adolescents; however, literature is limited in this area. Methods Data regarding 150 successive X-ray images of 95 males and 55 females diagnosed with Scheuermann’s disease were retrieved from the digital archives of the Maccabi Healthcare Services in Tel Aviv. Data included thoracic kyphosis angle (T3–T12), cervical lordosis (C2–C7), lumbar lordosis (L1–S1), sacral slope (SS), number and location of the anterior wedged vertebrae (AWV, minimum 5°), and C7 plumb line. Other data included age, sex, height, family history, Risser sign, self-perceived body image (rated by the Numeric Rating Scale [NRS]), and back pain during the previous week (rated by the Numeric Pain Rating Scale [NPRS]). Results Significant positive associations were observed between the Cobb angle of thoracic kyphosis and age (r =0.186, p =0.023), cervical lordosis (r =0.263, p <0.001), lumbar lordosis (r =0.576, p <0.001), SS (r =0.236, p <0.004), T10–T12 Cobb angle (r =0.319, p <0.001), and number of AWV (r =0.519, p <0.001). The highest frequency of vertebral wedging was noted in T7 (68%), followed by T8 (65%) and T9 (44%). The NPRS showed a significant association only with SS (r =0.219, p =0.014). Significant positive associations were observed between the NRS for self-perceived body image, the thoracic kyphosis (r =0.494, p <0.001), and the number of AWV (r =0.361, p <0.001). Conclusions Thoracic kyphosis was significantly associated with cervical and lumbar lordosis, SS, T10–T12 Cobb angle, and AWV number. Pain was not substantial; however, self-perceived body image, the most common complaint of patients with Scheuermann’s disease, was high and significantly associated with thoracic kyphosis and the number of AWV

Taste Sensitivity to Phenylthiocarbamide Found in South Sinai Bedouin Tribes

The aim of this work was to study taste sensitivity to phenylthiocarbamide (PTC) amongst Bedouin tribes and compare the Bedouins with Arab and Jewish populations. Data obtained by the classic method of serial dilutions in 317 healthy male Bedouins, aged 16–70 belonging to different tribes, were examined. We discovered significant differ­ences in chemosensitivity to PTC in the Bedouin communities. A high frequency of the t allele was documented in the Bedouin tribes of Hamada, Muzeina, and “other Bedouins” and a relatively low level of the t allele frequency in the Gebelia tribe. The frequencies of non-tasters amongst Arab groups were similar in values to those of the Gebelia tribe. Three other Bedouin tribes showed very high values for the non-tasters’ frequencies. The revealed intertribal differ­ences can be explained by the genetic drift in isolated populations, on the other hand, this may be the result of endog­amy

Adaptive Changes in Basal Metabolic Rate in Humans in Different Eco-Geographical Areas

Our aim was to establish whether the human basal metabolic rate (BMR) shifts towards the reduction of vital functions as an adaptation response to extreme environmental conditions. Data was collected in arid and Extreme North zones. The arid zone samples included Bedouins living in the Sinai Peninsula in Egypt, Turkmen students, the Pedagogical University of Chardzhou, Turkmenistan born Russians and Russian soldiers. Soldiers were divided into 3 groups according to the length of their tour of duty in the area: 1st group: up to six months, 2nd group: up to 2 years and the 3rd group: 3-5 years. The Extreme North samples comprised Chukchi natives, 1st generation Russian immigrants born in the area and 3 groups of soldiers comparable to the soldiers from Turkmenistan. BMR values of the new recruits had the highest values of total and relative BMR (1769±16 and 28.3±0.6, correspondingly). The total and relative BMR tended to decrease within a longer adaptation period. The BMR values of officers who served >3 years in Turkmenistan were very similar to the Turkmenistan born Russians (1730±14 vs. 1726±18 and 26.5±0.6 vs. 27.3±0.7, correspondingly). Similarly, in Chukotka, the highest relative BMR was found in the new recruits, serving up to 6 months (28.1±0.7) and was significantly (p3 years, compared to the middle-aged Chukchi or Chukotka-born Russians (25.8±0.5 vs. 25.6±0.5 and 25.5±0.6, correspondingly). The BMR parameters demonstrated a stronger association with body weight than with age. In extreme environmental conditions, migrant populations showed a decrease in BMR, thus reducing its vital functions. The BMR reduction effect with the adequate adaptive transformation is likely to be the key strategy for developing programs to facilitate human and animal adaptation to extreme factors. This process is aimed at preserving the optimum energy balance and homeostasis while minimizing stress on the body’s vital functions

Transcutaneous electrostimulation for osteoarthritis of the knee

BACKGROUND: Osteoarthritis is the most common form of joint disease and the leading cause of pain and physical disability in the elderly. Transcutaneous electrical nerve stimulation (TENS), interferential current stimulation and pulsed electrostimulation are used widely to control both acute and chronic pain arising from several conditions, but some policy makers regard efficacy evidence as insufficient. OBJECTIVES: To compare transcutaneous electrostimulation with sham or no specific intervention in terms of effects on pain and withdrawals due to adverse events in patients with knee osteoarthritis. SEARCH STRATEGY: We updated the search in CENTRAL, MEDLINE, EMBASE, CINAHL and PEDro up to 5 August 2008, checked conference proceedings and reference lists, and contacted authors. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials that compared transcutaneously applied electrostimulation with a sham intervention or no intervention in patients with osteoarthritis of the knee. DATA COLLECTION AND ANALYSIS: We extracted data using standardised forms and contacted investigators to obtain missing outcome information. Main outcomes were pain and withdrawals or dropouts due to adverse events. We calculated standardised mean differences (SMDs) for pain and relative risks for safety outcomes and used inverse-variance random-effects meta-analysis. The analysis of pain was based on predicted estimates from meta-regression using the standard error as explanatory variable. MAIN RESULTS: In this update we identified 14 additional trials resulting in the inclusion of 18 small trials in 813 patients. Eleven trials used TENS, four interferential current stimulation, one both TENS and interferential current stimulation, and two pulsed electrostimulation. The methodological quality and the quality of reporting was poor and a high degree of heterogeneity among the trials (I(2) = 80%) was revealed. The funnel plot for pain was asymmetrical (P < 0.001). The predicted SMD of pain intensity in trials as large as the largest trial was -0.07 (95% CI -0.46 to 0.32), corresponding to a difference in pain scores between electrostimulation and control of 0.2 cm on a 10 cm visual analogue scale. There was little evidence that SMDs differed on the type of electrostimulation (P = 0.94). The relative risk of being withdrawn or dropping out due to adverse events was 0.97 (95% CI 0.2 to 6.0). AUTHORS' CONCLUSIONS: In this update, we could not confirm that transcutaneous electrostimulation is effective for pain relief. The current systematic review is inconclusive, hampered by the inclusion of only small trials of questionable quality. Appropriately designed trials of adequate power are warranted

The association between patellar alignment on magnetic resonance imaging and radiographic manifestations of knee osteoarthritis

The aim of our study was to evaluate the association between patellar alignment by using magnetic resonance imaging images and radiographic manifestations of patello-femoral osteoarthritis (OA). Subjects were recruited to participate in a natural history study of symptomatic knee OA. We examined the relation of patellar alignment in the sagittal plane (patellar length ratio (PLR)) and the transverse plane (sulcus angle (SA), lateral patellar tilt angle (LPTA), and bisect offset (BO)) to radiographic features of patello-femoral OA, namely joint space narrowing and patellar osteophytes, using a proportional odds logistic regression model while adjusting for age, sex, and bone mass index (BMI). The study sample consisted of 126 males (average age 68.0 years, BMI 31.2) and 87 females (average age 64.7 years, BMI 31.6), 75% of whom had tibiofemoral OA (a Kellgren-Lawrence score of 2 or more). PLR showed a statistically significant association with joint space narrowing and osteophytosis in the lateral compartment. SA showed significant association with medial joint space narrowing and with lateral and medial patellar osteophytosis. LPTA and BO showed significant association with both radiographic indices of the lateral compartment. Clear linear trends were found in association between PLR, LPTA and BO, and with outcomes associated with lateral patello-femoral OA. SA, LPTA, and BO showed linear trends of association with medial joint space narrowing. Results of our study clearly suggest the association between indices of patellar alignment and such features of patello-femoral OA as osteophytosis and joint space narrowing. Additional studies will be required to establish the normal and abnormal ranges of patellar alignment indices and their longitudinal relation to patello-femoral OA