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Biomedical subjects

P Croft

Publications and source records attributed to P Croft.

5 recordsLinked to original sources
PubMed1992

Osteoarthritis of the hip: an occupational disease in farmers.

OBJECTIVE: To test the hypothesis that farmers are at high risk of hip osteoarthritis and to investigate possible causes for such a hazard. DESIGN: Cross sectional survey. SETTING: Five rural general practices. SUBJECTS: 167 male farmers aged 60-76 and 83 controls from mainly sedentary jobs. All those without previous hip replacement underwent radiography of the hip. MAIN OUTCOME MEASURES: Hip replacement for osteoarthritis or radiological evidence of hip osteoarthritis. RESULTS: Prevalence of hip osteoarthritis was higher in farmers than controls and especially in those who had farmed for over 10 years (odds ratio 9.3, 95% confidence interval 1.9 to 44.5). The excess could not be attributed to any one type of farming, and heavy lifting seems the likely explanation. CONCLUSIONS: Manual handling in agriculture should be limited where possible. Consideration should be given to making hip osteoarthritis a prescribed industrial disease in farmers. There may be wider implications for the prevention of hip osteoarthritis in the general population.

Age Factors↗
PubMed1992

Is the hip involved in generalized osteoarthritis?

The authors examined the association of hip osteoarthritis with the presence of Heberden's nodes in a case-control study. Subjects were men aged 60-75 years who had undergone intravenous urography as out-patients. An examination of the hands was carried out in 240 patients who had a hip replacement for osteoarthritis or a joint space less than or equal to 2.5 mm, and in 290 controls whose joint space was greater than or equal to 3.5 mm in both hips. The presence of Heberden's nodes was associated with an increased risk of radiological hip osteoarthritis, the relationship being stronger in the 51 cases with severe joint-space narrowing (odds ratio = 3.4, 95% confidence interval 1.3-9.1). There was no evidence that this association differed according to the site of joint space narrowing within the hip. The finding provides further evidence that osteoarthritis of the hip can occur as part of a generalized process and does not only result from local damage to the joints.

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PubMed1992

Osteoarthritis of the hip and occupational activity.

This case-referent study investigated the relation between hip osteoarthritis and occupational activity. The subjects were 60- to 75-year-old men who had undergone intravenous urography. Interviews were obtained for 245 cases who had a hip replacement for osteoarthritis or a joint space of less than or equal to 2.5 mm and 294 referents whose joint space was greater than or equal to 3.5 mm in both hips. No clear associations were found in an analysis of all the cases, but severe disease (hip replacement for osteoarthritis or a joint space of less than or equal to 1.5 mm) was more common in the farmers, especially in those with greater than or equal to 10 years in agricultural work [odds ratio (OR) 2.0, 95% confidence interval (95% CI) 0.9-4.4]. Severe disease was also associated with prolonged standing at work (OR 2.7, 95% CI 1.0-7.3) and heavy lifting (OR 2.5, 95% CI 1.1-5.7). These associations could not be explained by obesity or sporting activity. The findings suggest an increased risk of degenerative hip disease for farmers and indicate that mechanical overloading may contribute to its pathogenesis.

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PubMed1977

Neuromuscular syndromes associated with malignant disease.

Malignant disorders may produce neuromuscular syndromes in a variety of ways, for some of which it is still difficult to determine the exact pathophysiology. In the myopathic and neuropathic disorders, one possible explanation is that they are due to a virus such as is found in the rare "progressive multifocal leukoencephalopathy". This is seen in association with the malignant lymphomas and with other conditions such as sarcoidosis where immune responses may be altered by either the disease or the treatment. No viral material has been found in the nonmetastatic neurological disorders apart from progressive multifocal leukoencephalopathy. An alternative theory is that there may be an autoimmune process, the nervous system sharing some antigenic determinant with the neoplasm (Urich, 1967). The prognosis in the paraneoplastic neurological disorders is usually poor. As well as the direct threat to life posed by the malignant disease, when the neurological disorder is due to destruction of neurones (for instance cerebellar degeneration or sensory neuronopathy) recovery of function is impossible. Spontaneous remissions have been recorded in cases of proximal muscle weakness and sensorimotor neuropathy, but it is difficult to know whether the remissions have been truly spontaneous or related to treatment (excision of the neoplasm or administration of steroids). Further immunological and virological studies will probably reveal the answers to some of the outstanding problems. In the meantime the clinician must continue to investigate patients with muscular weakness for evidence of an occult neoplasm, and to repeat investigations if no other cause for the neurological disorder is found. Also, in patients with known malignant disease, apart from trying to differentiate forms of neuromyopathy from the effects of metastases the various metabolic disorders must be considered because the therapeutic possibilities are a little more promising in the paraneoplastic endocrine disorders. Ross (1975) wisely said that "cancer has replaced syphilis as the great imitator".

Cachexia↗