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A Naimark

Publications and source records attributed to A Naimark.

At least 19 recordsLinked to original sources
PubMed1992

Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study.

OBJECTIVE: To evaluate the effect of weight loss in preventing symptomatic knee osteoarthritis in women. DESIGN: Cohort analytic study. SETTING: The Framingham Study, based on a sample of a defined population. PATIENTS: Women who participated in the Framingham Knee Osteoarthritis Study (1983 to 1985): Sixty-four out of 796 women studied had recent-onset symptomatic knee osteoarthritis (knee symptoms plus radiographically confirmed osteoarthritis) were compared with women without disease. MEASUREMENTS: Recalled date of symptom onset was used as the incident date of disease. Historical weight was defined as baseline body mass index up to 12 years before symptom onset. Change in body mass index was assessed at several intervals before the current examination. Odds ratios assessing the association between weight change and knee osteoarthritis were adjusted for age, baseline body mass index, history of previous knee injury, habitual physical activity level, occupational physical labor, smoking status, and attained education. RESULTS: Weight change significantly affected the risk for the development of knee osteoarthritis. For example, a decrease in body mass index of 2 units or more (weight loss, approximately 5,1 kg) over the 10 years before the current examination decreased the odds for developing osteoarthritis by over 50% (odds ratio, 0.46; 95% Cl, 0.24 to 0.86; P = 0.02). Among those women with a high risk for osteoarthritis due to elevated baseline body mass index (greater than or equal to 25), weight loss also decreased the risk (for 2 units of body mass index, odds ratio, 0.41; P = 0.02). Weight gain was associated with a slightly increased risk for osteoarthritis, which was not statistically significant. CONCLUSION: Weight loss reduces the risk for symptomatic knee osteoarthritis in women.

Aged↗
PubMed1991

Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study.

We sought to assess occupational joint use and osteoarthritis (OA) longitudinally in a large population with multiple occupations. Subjects were members of the Framingham Heart Study cohort followed over 40 years with occupational status assessed at the beginning of the Heart Study [from Examination 1 (1948-51) through Examination 6 (1958-61)] and knee OA assessed by weight bearing knee radiograph at Examination 18 (1983-85) when mean age of subjects was 73 years. Each subject's job was characterized by its level of physical demand and whether the job was associated with knee bending. Odds ratios (OR) testing the association of job demand with OA were adjusted by logistic regression for age, body mass, knee injury history, smoking, and educational level. Men whose jobs required knee bending and at least medium physical demands had higher rates of later radiographic knee OA (at least definite osteophytes) than men whose jobs required neither (43.4 vs 26.8%; OR of OA = 2.22, 95% CI 1.38, 3.58). Rates of severe radiographic OA (osteophytes and joint space narrowing) and of bilateral radiographic OA were also significantly increased in these men. Few women had jobs requiring knee bending or that were physically demanding and these jobs were generally unassociated with later radiographic OA. Only a small number of men (n = 28) had symptomatic knee OA, and we could not confirm that it was associated with occupation in men. Thus, among men, occupations which combine knee bending and physical demands may be an important cause of radiographic OA.

Aged↗
PubMed1990

Estrogen use and radiographic osteoarthritis of the knee in women. The Framingham Osteoarthritis Study.

Female participants of the Framingham Osteoarthritis Study (n = 831, mean age 73, age range 63-93) were evaluated for osteoarthritis with weight-bearing radiographs of the knee during 1983-1985. At each biennial examination (1963-1981), the women were asked about their use of estrogen during the previous 2 years. We categorized estrogen use as no use reported, use reported at 1 examination, or use reported at 2 or more examinations. We found no positive association of estrogen use with radiographic knee osteoarthritis after controlling for age, body mass index, age at menopause, physical activity, history of knee injury, and smoking. In fact, a modest but nonsignificant protective effect for both radiographic osteoarthritis (odds ratio 0.71, 95% confidence interval 0.42, 1.20) and severe radiographic osteoarthritis (odds ratio 0.66, 95% confidence interval 0.33, 1.32) was seen in women who reported estrogen use at 2 or more examinations. Subgroup analyses also showed no association between estrogen use and radiographic knee osteoarthritis. We conclude that estrogen use in women is not associated with an increased risk of radiographic knee osteoarthritis.

Aged↗
PubMed1989

Does smoking protect against osteoarthritis?

While studying knee osteoarthritis (OA) in the first Health and Nutrition Examination Survey, we unexpectedly found a protective association between smoking and OA. After adjustment for age, sex, and weight, smokers had a significantly lower rate of OA than did nonsmokers, and heavier smokers were less likely to have the disease than were light smokers. To test this association in a separate study and see if it was due to confounding factors, we looked at the Framingham Osteoarthritis Study, a study of elderly members of the Framingham Heart Study cohort. We evaluated whether the presence of knee OA in 1983-1985 was related to smoking status at the first Framingham examination, 36 years earlier. Subjects who had been smokers at examination 1 had a lower rate of OA (190 of 679, 28%) than did nonsmokers (276 of 736, 37.5%). In an analysis adjusted for age, sex, and weight, heavy smokers had a modestly lower risk of developing knee OA than did nonsmokers (relative risk 0.81). Also, the adjusted risk of severe OA was less in heavy smokers than in nonsmokers (relative risk 0.73). The negative association with OA persisted when we examined the average cigarette consumption over the first 10 years of the Framingham study. Furthermore, after controlling for age, sex, weight, knee injury history, sports activity history, physical activity level, coffee and alcohol consumption, and weight change after examination 1, and after modeling weight and age in a nonlinear manner, smoking remained a significant protector against later knee OA. It appears that smoking or some unidentified factor correlated with smoking modestly protects against the development of knee OA.

Adult↗
PubMed1989

The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham Study.

Chondrocalcinosis and osteoarthritis (OA) both increase in prevalence with age, yet previous studies assessing their association have often been too small to adjust for age and have had biased selection of subjects. We assessed the prevalence of chondrocalcinosis and its link with OA in the Framingham Knee Osteoarthritis Study, a large population based study of the elderly. After controlling for age, we found a modestly increased rate of radiographic OA in those with chondrocalcinosis (relative risk = 1.52 (95% CI 1.22, 1.90). There was a similar link between chondrocalcinosis and severe radiographic OA (relative risk = 1.52). Chondrocalcinosis was positively associated with both symptomatic and asymptomatic radiographic OA. The proportion of radiographic OA potentially attributable to chondrocalcinosis was only 4.4%. Our results confirm that chondrocalcinosis is significantly associated with OA after controlling for age, but they also suggest that chondrocalcinosis and OA increase independently with age.

Aged↗
PubMed1988

Obesity and knee osteoarthritis. The Framingham Study.

STUDY OBJECTIVE: To determine whether obesity preceded knee osteoarthritis and was thus a possible cause. DESIGN: Cohort study with weight and other important variables measured in 1948 to 1951 (mean age of subjects, 37 years) and knee arthritis evaluated in 1983 to 1985 (mean age of subjects, 73 years). SETTING: Population-based participants; a subset (n = 1420) of the Framingham Heart Study cohort. METHODS: For those subjects in the Framingham Study having knee radiographs taken as part of the 18th biennial examination (1983 to 1985), we examined Metropolitan Relative Weight, a measure of weight adjusted for height at the onset of the study (1948 to 1951). Relative risks were computed as the cumulative incidence rate of radiographic knee osteoarthritis in the heaviest weight groups at examination 1 divided by the cumulative rate in the lightest 60% weight groups at examination 1. Relative risks were adjusted for age, physical activity level, and uric acid level. RESULTS: In 1983 to 1985, 468 subjects (33%) had radiographic knee osteoarthritis. For men, the risk of knee osteoarthritis was increased in those in the heaviest quintile of weight at examination 1 compared with those in the lightest three quintiles (age-adjusted relative risk, 1.51; 95% confidence interval [CI], 1.14 to 1.98); risk was not increased for those in the second heaviest quintile (relative risk, 1.0). The association between weight and knee osteoarthritis was stronger in women than in men; for women in the most overweight quintile at examination 1, relative risk was 2.07 (95% CI, 1.67 to 2.55), and for those in the second heaviest group, relative risk was 1.44 (95% CI, 1.11 to 1.86). This link between obesity and subsequent osteoarthritis persisted after controlling for serum uric acid level and physical activity level, and was strongest for persons with severest radiographic disease. Obesity at examination 1 was associated with the risk of developing both symptomatic and asymptomatic osteoarthritis. CONCLUSIONS: These results and other corroborative cross-sectional data show that obesity or as yet unknown factors associated with obesity cause knee osteoarthritis.

Activities of Daily Living↗
PubMed1987

The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study.

To investigate the prevalence of osteoarthritis (OA) of the knee in elderly subjects, we studied the Framingham Heart Study cohort, a population-based group. During the eighteenth biennial examination, we evaluated the cohort members for OA of the knee by use of medical history, physical examination, and anteroposterior (standing) radiograph of the knees. Radiographs were obtained on 1,424 of the 1,805 subjects (79%). Their ages ranged from 63-94 years (mean 73). Radiographs were read by a radiologist who specializes in bone and joint radiology, and were graded 0-4 according to the scale described by Kellgren and Lawrence. OA was defined as grade 2 changes (definite osteophytes), or higher, in either knee. Radiographic evidence of OA increased with age, from 27% in subjects younger than age 70, to 44% in subjects age 80 or older. There was a slightly higher prevalence of radiographic changes of OA in women than in men (34% versus 31%); however, there was a significantly higher proportion of women with symptomatic disease (11% of all women versus 7% of all men; P = 0.003). The age-associated increase in OA was almost entirely the result of the marked age-associated increase in the incidence of OA in the women studied. This study extends current knowledge about OA of the knee to include elderly subjects, and shows that the prevalence of knee OA increases with age throughout the elderly years.

Age Factors↗
PubMed1979

Case report 85.

Explore the source record for details and available documents.

Adult↗
PubMed1979

Intertrochanteric fractures: current concepts of an old subject.

The pre- or intraoperative classification of intertrochanteric fractures into stable and unstable is based on the status of the bone in the critical calcar femorale area and the obliquity of the fracture line. Modern management of unstable intertrochanteric fractures may include displacement at the fracture site, osteotomy, and fixation with a sliding screw system. These procedures produce postoperative films of an "unusual" appearance. The radiologist must understand the principles of classification and management to properly interpret the pre- and postoperative films.

Bone Screws↗
PubMed1979

Primary pulmonary sporotrichosis.

The diagnosis of primary pulmonary sporotrichosis was made in a 53-year-old male alcoholic four years after initial presentation with cavitary lung disease. Clinical and radiologic awareness of this extremely rare entity will allow optimal study of bronchial secretions in the bacteriology laboratory. Important clues include: (1) exposure to thorny plants, (2) cavitary pulmonary disease resistant to both diagnosis and treatment, and (3) a history of alcoholism.

Alcoholism↗
PubMed1978

Cardiac fibrosarcoma with bone metastases.

The diagnosis of a primary cardiac sarcoma with bone metastases was suspected in a previously normal patient because of the development of unremitting pulmonary edema and lytic bone lesions. Echocardiography substantiated the diagnosis, which proved at autopsy to be a primary fibrosarcoma of the heart. This represents only the third such case reported with bone metastases.

Bone Neoplasms↗
PubMed1977

Are breast patterns a risk index for breast cancer? A reappraisal.

A retrospective study was designed to test J.N. Wolfe's theory that xeromammographic breast patterns can be used as a risk index for breast cancer. After analyzing breast types of all breast cancer patients over a 4 year period at the Jewish General Hospital, Montreal, who had xeromammography prior to surgery, we were unable to support Wolfe's hypothesis. We conclude that an inherent bias in the design of his experiment led to erroneous conclusions.

Breast↗
PubMed1975

Effect of alveolar liquid on distribution of blood flow in dog lungs.

Previous studies have shown that a shift in blood flow away from edematous regions does not occur until the alveoli contain liquid. The present experiments were designed to examine the separate effect of air space liquid, air space plus interstitial liquid, and reduced lung volume on blood flow. We found that reduced lung volume was not associated with significant changes in blood flow and that no systematic change in blood flow occurred when alveoli were filled with isosmotic liquid (autologous plasma). However, when hyposmotic liquid (dilute plasma) was instilled so that both the air space and the alveolar wall interstitial space were filled, blood flow was systematically reduced. This suggested that interstitial liquid was responsible raising vascular resistance in these experiments and that it might also be important in raising local vascular resistance in pulmonary edema. This latter hypothesis was tested in isolated perfused lobes where rapid freezing and quantitative histology showed that the number of open capillaries was significantly reduced in the liquid-filled alveoli (P less than 0.001). These observations suggest that interstitial pressure rises in pulmonary edema with the result that the transmural pressure of the alveolar vessels falls and vascular resistance is increased.

Animals↗