Age but not BMI Predicts Accelerated Progression of KOA: Data from the Osteoarthritis Initiative

Background/Objectives: Knee osteoarthritis (KOA) accounts for about 35% of the arthritis burden among adults. Most adults with KOA have slowly-progressing, common knee osteoarthritis (CKOA); however, some individuals experience accelerated KOA (AKOA), rapid progression to end-stage disease within 48 months. This study analyzed individuals without radiographic evidence of KOA at baseline to determine which (baseline) characteristics were associated with progression to CKOA and/or AKOA status 48 months later.Methods: Data (n = 1,561) from the Osteoarthritis Initiative (OAI) were utilized. Multinomial logistic regression was employed to determine the magnitude of association between baseline risk factors and 48-month KOA status (AKOA and CKOA, compared to no KOA).Results: Older age (p = 0.032), greater baseline BMI (p < 0.001), female gender (p = 0.009), and greater baseline PASE score (p =0.036) were significantly associated with CKOA (11.9% of participants) and/or AKOA (3.5% of participants) at 48 months. Age, BMI, andPASE were all more strongly associated with greater risk of AKOA compared to risk of CKOA (Age: OR = 1.59 vs. 0.97; BMI: OR = 1.62vs. 1.28; PASE: OR = 1.21 vs. 1.08). Of these, only BMI was significantly associated with greater risk of both AKOA and CKOA.Conclusion: Certain factors impact the risk of AKOA and CKOA differently. Age did not increase the risk of CKOA, but among thosewith CKOA or AKOA, the proportion with AKOA increased with age. Thus, older age at onset is associated with more rapid KOA progression

Post-traumatic stress symptoms in pathological gambling: Potential evidence of anti-reward processes

Excessive gambling is considered to be a part of the addiction spectrum. Stress-like emotional states are a key feature both of pathological gambling (PG) and of substance addiction. In substance addiction, stress symptomatology has been attributed in part to “anti-reward” allostatic neuroadaptations, while a potential involvement of anti-reward processes in the course of PG has not yet been investigated. Methods To that end, individuals with PG (n = 22) and mentally healthy subjects (n = 13) were assessed for trauma exposure and post-traumatic stress symptomatology (PTSS) using the Life Events Checklist and the Civilian Mississippi Scale, respectively. Results In comparison with healthy subjects, individuals with PG had significantly greater PTSS scores including greater physiological arousal sub-scores. The number of traumatic events and their recency were not significantly different between the groups. In the PG group, greater gambling severity was associated with more PTSS, but neither with traumatic events exposure nor with their recency. Conclusions Our data replicate prior reports on the role of traumatic stress in the course of PG and extend those findings by suggesting that the link may be derived from the anti-reward-type neuroadaptation rather than from the traumatic stress exposure per se

Somatic Stimulation Causes Frontoparietal Cortical Changes in Neonates: A Functional Near-Infrared Spectroscopy Study

Palmar and plantar grasp are the foremost primitive neonatal reflexes and functions. Persistence of these reflexes in infancy is a sign of evolving cerebral palsy. Our aims were to establish measurement feasibility in a clinical setting and to characterize changes in oxyhemoglobin (HbO) and deoxyhemoglobin (HbD) concentration in the bilateral frontoparietal cortex in unsedated neonates at the crib-side using functional near-infrared spectroscopy (fNIRS). We hypothesized that bilateral concentration changes will occur upon somatic central and peripheral somatic stimulation. Thirteen preterm neonates (five males) underwent time 1, and six (two males) returned for time 2 (mean PMA ¼ 41.6 and 47.0 weeks, respectively). Signals from a total of 162 somatic stimuli responses were measured. Response amplitude, duration, and latency were log-transformed and compared between palmar, plantar, and oromotor stimuli using linear mixed models, adjusted for cap, electroencephalogram abnormality, time (1 versus 2), and Sarnat score, if necessary. The oromotor stimulus resulted in a 50% greater response than the palmar or plantar stimuli for HbO left and right hemisphere duration (p \u3c 0.0001). There were no other statistically significant differences between stimuli for any other outcome (p \u3e 0.05). Utilizing fNIRS in conjunction with occupational and physical therapy maneuvers is efficacious to study modifiable and restorative neurophysiological mechanisms

Age but not BMI Predicts Accelerated Progression of KOA: Data from the Osteoarthritis Initiative

Background/Objectives: Knee osteoarthritis (KOA) accounts for about 35% of the arthritis burden among adults. Most adults with KOA have slowly-progressing, common knee osteoarthritis (CKOA); however, some individuals experience accelerated KOA (AKOA), rapid progression to end-stage disease within 48 months. This study analyzed individuals without radiographic evidence of KOA at baseline to determine which (baseline) characteristics were associated with progression to CKOA and/or AKOA status 48 months later. Methods Data (n = 1,561) from the Osteoarthritis Initiative (OAI) were utilized. Multinomial logistic regression was employed to determine the magnitude of association between baseline risk factors and 48-month KOA status (AKOA and CKOA, compared to no KOA). Results Older age (p = 0.032), greater baseline BMI (p \u3c 0.001), female gender (p = 0.009), and greater baseline PASE score (p = 0.036) were significantly associated with CKOA (11.9% of participants) and/or AKOA (3.5% of participants) at 48 months. Age, BMI, and PASE were all more strongly associated with greater risk of AKOA compared to risk of CKOA (Age: OR = 1.59 vs. 0.97; BMI: OR = 1.62 vs. 1.28; PASE: OR = 1.21 vs. 1.08). Of these, only BMI was significantly associated with greater risk of both AKOA and CKOA. Conclusion Certain factors impact the risk of AKOA and CKOA differently. Age did not increase the risk of CKOA, but among those with CKOA or AKOA, the proportion with AKOA increased with age. Thus, older age at onset is associated with more rapid KOA progression

Age but not BMI Predicts Accelerated Progression of KOA: Data from the Osteoarthritis Initiative

Background/Objectives: Knee osteoarthritis (KOA) accounts for about 35% of the arthritis burden among adults. Most adults with KOA have slowly-progressing, common knee osteoarthritis (CKOA); however, some individuals experience accelerated KOA (AKOA), rapid progression to end-stage disease within 48 months. This study analyzed individuals without radiographic evidence of KOA at baseline to determine which (baseline) characteristics were associated with progression to CKOA and/or AKOA status 48 months later. Methods Data (n = 1,561) from the Osteoarthritis Initiative (OAI) were utilized. Multinomial logistic regression was employed to determine the magnitude of association between baseline risk factors and 48-month KOA status (AKOA and CKOA, compared to no KOA). Results Older age (p = 0.032), greater baseline BMI (p \u3c 0.001), female gender (p = 0.009), and greater baseline PASE score (p = 0.036) were significantly associated with CKOA (11.9% of participants) and/or AKOA (3.5% of participants) at 48 months. Age, BMI, and PASE were all more strongly associated with greater risk of AKOA compared to risk of CKOA (Age: OR = 1.59 vs. 0.97; BMI: OR = 1.62 vs. 1.28; PASE: OR = 1.21 vs. 1.08). Of these, only BMI was significantly associated with greater risk of both AKOA and CKOA. Conclusion Certain factors impact the risk of AKOA and CKOA differently. Age did not increase the risk of CKOA, but among those with CKOA or AKOA, the proportion with AKOA increased with age. Thus, older age at onset is associated with more rapid KOA progression

PTSD Symptom Severities, Interpersonal Traumas, and Benzodiazepines Are Associated with Substance-Related Problems in Trauma Patients

Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors were significantly associated with substance-related problems, particularly benzodiazepines (AOR = 2.78; 1.99 for alcohol, 2.42 for tobacco, 8.02 for illicit drugs), DSM-5 PTSD diagnosis (AOR = 1.92; 2.38 for alcohol, 2.00 for tobacco, 2.14 for illicit drugs), most PTSSs (especially negative beliefs, recklessness, and avoidance), and interpersonal traumas (e.g., assaults and child abuse). Conclusion: In this clinical sample, there were consistent and strong associations between several trauma-related variables and substance-related problems, consistent with our hypotheses. We discuss possible explanations and implications of these findings, which we hope will stimulate further research, and improve screening and treatment

Age-Related Changes in Spatiotemporal Characteristics of Gait Accompany Ongoing Lower Limb Linear Growth in Late Childhood and Early Adolescence

Walking gait is generally held to reach maturity, including walking at adult-like velocities, by 7-8 years of age. Lower limb length, however, is a major determinant of gait, and continues to increase until 13-15 years of age. This study used a sample from the Fels Longitudinal Study (ages 8-30 years) to test the hypothesis that walking with adult-like velocity on immature lower limbs results in the retention of immature gait characteristics during late childhood and early adolescence. There was no relationship between walking velocity and age in this sample, whereas the lower limb continued to grow, reaching maturity at 13.2 years in females and 15.6 years in males. Piecewise linear mixed models regression analysis revealed significant age-related trends in normalized cadence, initial double support time, single support time, base of support, and normalized step length in both sexes. Each trend reached its own, variable-specific age at maturity, after which the gait variables\u27 relationships with age reached plateaus and did not differ significantly from zero. Offsets in ages at maturity occurred among the gait variables, and between the gait variables and lower limb length. The sexes also differed in their patterns of maturation. Generally, however, immature walkers of both sexes took more frequent and relatively longer steps than did mature walkers. These results support the hypothesis that maturational changes in gait accompany ongoing lower limb growth, with implications for diagnosing, preventing, and treating movement-related disorders and injuries during late childhood and early adolescence. © 2012 Elsevier B.V

Surveying Teens in School to Assess the Prevalence of Problematic Drug Use

BACKGROUND: Illicit drug use by school-aged teens can adversely affect their health and academic achievement. This study used a survey administered in schools to assess the prevalence of problematic drug use among teenagers in a Midwestern community. METHODS: Self-report data were collected from 11th- and 12th-grade students (N = 3974) in 16 school districts in the Dayton, Ohio, area. Students responded to a drug use survey that also included CRAFFT, a brief substance abuse screening instrument. Binomial and zero-inflated Poisson regressions were used to examine the association between CRAFFT scores and drug use practices, including abstinence. RESULTS: More than one third of students had CRAFFT scores suggestive of problematic use. Of these, 14.1% had scores suggesting drug dependence. Although alcohol, marijuana, and tobacco were the drugs most commonly used, an array of other drugs including opioids, benzodiazepines, stimulants, hallucinogens, and dextromethorphan were also commonly used. Higher CRAFFT scores were associated with a greater number of drugs used (p \u3c .0001). Proportionately more 12th graders than 11th graders had CRAFFT scores indicating problems (p \u3c .0001). Among 12th graders, boys were more likely than girls to have CRAFFT scores indicating dependence (p = .01). CONCLUSIONS: The results suggest that problematic drug use among high school students is more prevalent than has been recognized previously. CRAFFT can be used easily to assess the prevalence of problematic drug use among teenagers in school settings. CRAFFT results can also inform prevention and intervention activities, particularly if the CRAFFT instrument is paired with a drug use survey

Predictors of Transition to Heroin Use among Initially Non-Opioid Dependent Illicit Pharmaceutical Opioid Users: A Natural History Study

Background Increases in illicit pharmaceutical opioid (PO) use have been associated with risk for transition to heroin use. We identify predictors of transition to heroin use among young, illicit PO users with no history of opioid dependence or heroin use at baseline. Methods Respondent-driven sampling recruited 383 participants; 362 returned for at least one biannual structured interview over 36 months. Cox regression was used to test for associations between lagged predictors and hazard of transition to heroin use. Potential predictors were based on those suggested in the literature. We also computed population attributable risk (PAR) and the rate of heroin transition. Results Over 36 months, 27 (7.5%) participants initiated heroin use; all were white, and the rate of heroin initiation was 2.8% per year (95% CI = 1.9%–4.1%). Mean length of PO at first reported heroin use was 6.2 years (SD = 1.9). Lifetime PO dependence (AHR = 2.39, 95% CI = 1.07–5.48; PAR = 32%, 95% CI = −2% to 64%), early age of PO initiation (AHR = 3.08, 95%; CI = 1.26–7.47; PAR = 30%, 95% CI = 2%–59%), using illicit POs to get high but not to self-medicate a health problem (AHR = 4.83, 95% CI = 2.11–11.0; PAR = 38%, 95% CI = 12%–65%), and ever using PO non-orally most often (AHR = 6.57, 95% CI = 2.81–17.2; PAR = 63%, 95% CI = 31%–86%) were significant predictors. Conclusion This is one of the first prospective studies to test observations from previous cross-sectional and retrospective research on the relationship between illicit PO use and heroin initiation among young, initially non-opioid dependent PO users. The results provide insights into targets for the design of urgently needed prevention interventions

Age-Related Changes in Spatiotemporal Characteristics of Gait Accompany Ongoing Lower Limb Linear Growth in Late Childhood and Early Adolescence

Walking gait is generally held to reach maturity, including walking at adult-like velocities, by 7-8 years of age. Lower limb length, however, is a major determinant of gait, and continues to increase until 13-15 years of age. This study used a sample from the Fels Longitudinal Study (ages 8-30 years) to test the hypothesis that walking with adult-like velocity on immature lower limbs results in the retention of immature gait characteristics during late childhood and early adolescence. There was no relationship between walking velocity and age in this sample, whereas the lower limb continued to grow, reaching maturity at 13.2 years in females and 15.6 years in males. Piecewise linear mixed models regression analysis revealed significant age-related trends in normalized cadence, initial double support time, single support time, base of support, and normalized step length in both sexes. Each trend reached its own, variable-specific age at maturity, after which the gait variables\u27 relationships with age reached plateaus and did not differ significantly from zero. Offsets in ages at maturity occurred among the gait variables, and between the gait variables and lower limb length. The sexes also differed in their patterns of maturation. Generally, however, immature walkers of both sexes took more frequent and relatively longer steps than did mature walkers. These results support the hypothesis that maturational changes in gait accompany ongoing lower limb growth, with implications for diagnosing, preventing, and treating movement-related disorders and injuries during late childhood and early adolescence. © 2012 Elsevier B.V