1,721,145 research outputs found
'Natural remedies' in the treatment of osteoarthritis
No full textOsteoarthritis (OA) is a common, chronic and painful condition. It is the most common of all rheumatic disorders and is destined to become one of the most prevalent and costly diseases in our society. The conventional therapeutic options employed in the management of OA are simple analgesics and NSAIDs, but these options frequently produce sub-optimal benefit and are associated with an adverse-safety profile. Unsurprisingly patients are looking to alternative and complementary medicine.The aim of this article was to review the available literature on the effectiveness and safety of ‘natural remedies’ for the treatment of OA. Computerised literature searches were carried out for systematic reviews and randomised controlled trials examining the role of ‘natural remedies’ in the treatment of OA.There have been few randomised controlled trials of ‘natural remedies’ that have satisfied the internationally agreed standards. There was, however, evidence of efficacy for glucosamine, chondroitin sulfate and possibly avocado/soybean unsaponifiables for the symptomatic relief of OA. To date, it is not established whether any of the ‘natural remedies’ are capable of chondroprotection.Even if ‘natural remedies’ are only modestly effective, they are widely available and well tolerated, suggesting that they may play a significant role in the management of OA in the elderly
Musculoskeletal disorders in farmers and farm workers
No full textFarming is a physically arduous occupation and this places farm workers at potential risk of musculoskeletal disorders such as osteoarthritis (OA) of the hip and knee, low back pain (LBP), neck and upper limb complaints, and hand–arm vibration syndrome (HAVS). This review considers the epidemiological evidence concerning such risks. The strongest evidence relates to OA of the hip, for which the public health impact is likely to be considerable. There is also weaker, but suggestive evidence that farmers more often have knee OA and LBP than workers in occupations with fewer physical demands. Tractor drivers, in particular, seem to have more LBP. Relatively little information exists on the risks of soft tissue rheumatism in the limbs and neck. For some outcomes, the link with occupational risk factors (such as heavy loading of joints and whole-body vibration) is sufficient to suggest the course that future prevention should take, but for several outcomes more research is first needed
The changing spectrum of rheumatic disease in HIV infection
No full textBackground: Rheumatic manifestations were described soon after human immunodeficiency virus (HIV) was discovered. Since however, combination anti-retroviral therapy (cART) has revolutionized the course of the infection. Less clear is what effect cART has had on rheumatic manifestations. Sources of data: References were retrieved from the PubMed database using keywords including: ‘HIV’ and ‘arthritis’; ‘myalgia’; ‘arthralgia’ and other disease specific terms, e.g. ‘rheumatoid arthritis’. Areas of agreement: Musculoskeletal pain was common in HIV and increased with AIDS. Immune restoration inflammatory syndrome on initiation of cART causes de novo autoimmune inflammatory rheumatic disorders. Seronegative inflammatory arthritis with/without axial involvement has been reported widely with HIV. Areas of controversy: It is unclear if HIV causes these conditions, creates an environmental milieu supportive of these conditions or acts as a marker of other risk factors. It is unclear what effect cART has had on these conditions. Growing points: Variable diagnostic classification criteria have caused this literature to be poorly comparable. Areas timely for developing research: High-quality controlled epidemiological studies using standardized criteria are needed among cART users. Treatment of active autoimmune disease in HIV patients needs to be evaluated formally. <br/
Recognizing and treating secondary osteoporosis
No full textOsteoporosis, through its association with fragility fracture, is a major public health problem, costing an estimated $34.8 billion worldwide per annum. With projected demographic changes, the burden looks set to grow. Therefore, the prevention of osteoporosis, as well as its identification and treatment once established, are becoming increasingly important. Osteoporosis is secondary when a drug, disease or deficiency is the underlying cause. Glucocorticoids, hypogonadism, alcohol abuse and malnutrition are among the most frequently recognized causes of secondary osteoporosis but the list of implicated diseases and drugs is growing and some of the more recently recognized associations, such as those with haematological conditions and acid-suppressing medications, are less well publicized. In some cases, advancement in treatment of the primary disease has led to people living long enough to develop secondary osteoporosis; for example, successful treatment for breast and prostate malignancies by hormonal manipulation, improved survival in HIV with the advent of anti-retroviral therapies, and improved treatment for cystic fibrosis. This Review emphasizes the importance of secondary osteoporosis, discusses familiar and less well-known causes and what is known of their mechanisms, provides guidance as to the pragmatic identification of secondary osteoporosis and summarizes treatment options, where available.<br/
Hard work never hurt anyone: or did it? A review of occupational associations with soft tissue musculoskeletal disorders of the neck and upper limb
No full textPain in the neck and upper limb is common and contributes considerably to absence from work due to sickness. Evidence suggest that prolonged abnormal posture and repetition contribute to such conditions. Psychosocial risk factors may also play a part in the aetiology of upper limb disorders
Premenopausal risk factors for osteoporosis
No full textOsteoporosis is a major public health problem because of its association with fractures. Prevention of osteoporosis is of utmost importance in reducing the health and human costs related to the disease. Bone mass in adult life is determined partly by the peak bone mass accrued as a young adult, and partly by the subsequent rate of bone loss. Understanding the determinants of premenopausal bone mineral status is important in order to develop a prevention strategy. Non-modifiable risk factors are heredity and race/ethnicity. Potentially modifiable are non-genetic host factors such as intrauterine programming, body build, reproductive factors, diseases and drugs, and environmental factors such as diet, exercise and smoking and alcohol
Working hours and depression in the HEAF cohort
No full textBackground: long working hours and unemployment adversely affect mental health. Modern policies aim to keep adults working to older ages.Aims: to explore the bidirectional association between working hours and depression among older workers.Methods: we used data from the Health and Employment After Fifty (HEAF) longitudinal study of adults aged 50-64 years recruited from English general practices. Participants completed baseline (2013-14) and annual (until 2019) questionnaires, including questions about working hours (<20, 20 to <35, 35-40, >40 h/week) and the Centre for Epidemiologic Studies Depression Scale (scores ≥16 used to define depression). The association between working hours and incident depression, and the reverse association between baseline depression and reducing working hours, were explored using Poisson regression.Results: of 3866 HEAF participants in paid work without baseline depression, 32% developed incident depression. Those who were financially comfortable and working <20 h (incidence rate ratio (IRR) 1.47, 95% CI 1.11-1.95) and those of intermediate financial status working 20-35 h (IRR 1.26, 95% CI 1.05-1.52) were at increased risk of depression. Among participants with depression at baseline, only men of intermediate financial status were more likely to decrease working hours (IRR 1.19, 95% CI 1.06-1.33) or stop working altogether.Conclusions: incident depression was common in this older worker cohort and the risk varied by working hours and financial status. It is important to know more about reasons for leaving work in relation to depression to inform targeted strategies for supporting older adults to remain in work.</p
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