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Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine 05/2010; 20(3):211-2. · 1.50 Impact Factor
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ABSTRACT: Obesity has been identified as a risk factor for the development of hip and knee osteoarthritis (OA) and may play a role in exacerbating existing disease. Therefore, we hypothesized that obese patients would present for hip and knee replacement surgery at a younger age than nonobese patients. From our registry, we performed a cross-sectional study of 841 hip and 804 knee replacement patients. Patients were categorized by BMI ≤ 25 kg/m(2), 25.1-29.9 kg/m(2), 30-34.9 kg/m(2), and ≥ 35 kg/m(2). Linear regression modeling was used to examine the relationship between BMI and age at surgery. Hip and knee replacement patients' mean age at surgery was 7.1 and 7.9 years younger, respectively, if their BMI was ≥ 35 kg/m(2) when compared to patients with a BMI ≤ 25 kg/m(2) (P = 0.002). BMI was a significant independent (of gender, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, surgeon, and comorbidity) predictor of age at knee replacement (P < 0.05). WOMAC scores were significantly worse preoperatively in patients with a BMI ≥ 35 kg/m(2) compared to those with a BMI ≤ 25 kg/m(2) (P < 0.05). Our study indicates that obese patients, especially those with a BMI ≥ 35 kg/m(2), presented for and underwent joint replacement surgery at a younger age as compared to nonobese patients.
Obesity 04/2010; 18(12):2362-6. · 4.28 Impact Factor
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Bruce Urch,
Mary Speck,
Paul Corey, David Wasserstein,
Michael Manno,
Karl Z Lukic,
Jeffrey R Brook,
Ling Liu,
Brent Coull,
Joel Schwartz,
Diane R Gold,
Frances Silverman
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ABSTRACT: Epidemiological studies have established significant associations between ambient pollutants, including fine particulate matter (PM(2.5)) and ozone (O(3)), and cardiopulmonary morbidity and mortality. One mechanism that has been proposed is a pulmonary/systemic inflammatory response. Although controlled human exposure studies have examined the independent inflammatory responses of PM(2.5) and O(3), no studies have previously examined their joint effects. The study objective was to examine the independent and combined associations between ambient PM(2.5) and O(3) and acute respiratory/inflammatory responses. Using their concentrated ambient particle (CAP) facility for PM(2.5), the authors studied 10 mild asthmatic and 13 nonasthmatic individuals. The 2-h exposures included CAP (range 48-199 microg/m(3)) and filtered air (FA), with/without O(3) (120 ppb), in a randomized block design. Response measures included pulmonary function and inflammatory indices in induced sputum (interleukin [IL]-6, cytology) and blood (IL-6, tumor necrosis factor [TNF]-alpha) measured before and after exposures. Three hours post exposure, there was an increase in blood levels of IL-6, but only after CAP alone exposures; the IL-6 increase was associated with increasing PM(2.5) mass concentration (p = .005). Some individuals switched to shallow breathing during CAP+O(3), possibly accounting for an attenuation of the resultant blood IL-6 response. Asthmatic and nonasthmatic responses were similar. There were no adverse changes in pulmonary function or other inflammatory measures. The study demonstrated an acute IL-6 response to PM(2.5), providing evidence to support the epidemiological findings of associations between ambient levels of particles and cardiopulmonary morbidity and mortality.
Inhalation Toxicology 02/2010; 22(3):210-8. · 1.92 Impact Factor
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ABSTRACT: Studies have shown associations between acute ambient particulate matter (PM) levels and increases in morbidity and mortality from cardiovascular diseases. We have previously reported in 24 healthy adults that exposure to concentrated ambient particles plus ozone (CAP + O(3)) caused a mean decrease of 0.09 mm in brachial artery diameter (BAD), which was significantly larger than a mean increase of 0.01 mm among the same individuals exposed to filtered air (FA). Our current objective is to examine the relationship between total and constituent PM(2.5) mass concentrations and the acute vascular response. We have analyzed both ambient and exposure filters from the brachial artery study for major chemical constituents, allowing us to compare the strength of the associations between each constituent and an individual's arterial response. We determined gravimetric PM(2.5) mass concentration and inorganic ion content from exposure filters. Twenty-three-hour ambient PM(2.5) filters collected from the same site and on the same day were used to estimate exposure concentrations of trace elements and organic and elemental carbon. We performed linear regression analyses on the levels of measured or estimated PM constituents using each subject's FA exposure as a control. We found, from our regression analyses, a significant negative association between both the organic and elemental carbon concentrations and the difference in the postexposure change in the BAD (Delta BAD) between and CAP + O(3) and FA exposure days. An understanding of the PM constituents most responsible for adverse health outcomes is critical for efforts to develop pollution abatement strategies that maximize benefits to public health.
Inhalation Toxicology 07/2004; 16(6-7):345-52. · 1.92 Impact Factor
