Biomedical subjects

Timothy E McAlindon

Publications and source records attributed to Timothy E McAlindon.

7 recordsLinked to original sources

PubMed2007

Effect of glutathione S-transferase polymorphisms and proximity to hazardous waste sites on time to systemic lupus erythematosus diagnosis: results from the Roxbury lupus project.

OBJECTIVE: The high prevalence of systemic lupus erythematosus (SLE) among African American women may be due to environmental exposures, genetic factors, or a combination of factors. Our goal was to assess association of residential proximity to hazardous waste sites and genetic variation in 3 glutathione Stransferase (GST) genes (GSTM1, GSTT1, and GSTP1) with age at diagnosis of SLE. METHODS: Residential histories were obtained by interviewing 93 SLE patients from 3 predominantly African American neighborhoods in Boston. Residential addresses and locations of 416 hazardous waste sites in the study area were geocoded using ArcView software. Time-varying Cox models were used to study the effect of residential proximity to hazardous sites, GST genotype, and interaction between genotype and exposure in determining age at diagnosis. RESULTS: The prevalence of SLE among African American women in these neighborhoods was 3.56 SLE cases per 1,000. Homozygosity for GSTM1-null and GSTP1 Ile105Val in combination was associated with earlier SLE diagnosis (P = 0.03), but there was no association with proximity to 416 hazardous sites. Available data on specific site contaminants suggested that, at a subset of 67 sites, there was higher potential risk for exposure to volatile organic compounds (P < 0.05 with Bonferroni correction). GST genotypes had a significant interaction with proximity (P = 0.03) in analyses limited to these sites. CONCLUSION: There was no independent association between residential proximity to hazardous waste sites and the risk of earlier SLE diagnosis in this urban population. However, analysis of a limited number of sites indicated that the risk of earlier SLE associated with proximity to hazardous sites might be modulated by GST polymorphisms.

Adolescent↗

PubMed2006

Alcohol consumption as a trigger of recurrent gout attacks.

BACKGROUND: Alcohol consumption has long been considered a trigger for recurrent gout attacks; however, this hypothesis has not been formally tested. METHODS: We conducted an Internet-based case-crossover study to assess several putative risk factors, including alcohol consumption, thought to trigger recurrent gout attacks. Subjects who had an attack within the past year were recruited online and asked to provide access to medical records pertaining to their gout. Data were obtained on the amount and type of alcoholic beverage consumed on each day over the 2-day period before a gout attack and on each day over a 2-day period during the intercritical period. We examined the amount and type of alcohol consumption and the risk of recurrent gout attacks using a conditional logistic regression adjusting for diuretic use and purine intake. RESULTS: A total of 197 subjects were recruited online over a 10-month period. Of those, 179 (91%) fulfilled the American College of Rheumatology Criteria for gout. Compared with no alcohol consumption, odds ratios for recurrent gout attacks were 1.1, 0.9, 2.0, and 2.5 for 1 to 2, 3 to 4, 5 to 6, and 7 or more drinks consumed over the 2-day period, respectively (P<.005). A dose-response relationship of risk of gout attacks was more evident for alcohol consumed over the last 24 hours. An increased risk of recurrent gout attacks was found for each type of beverage consumed. CONCLUSION: Alcohol consumption triggers recurrent gout attacks. This effect was likely to occur within 24 hours after its consumption.

Adult↗

PubMed2006

Nutraceuticals: do they work and when should we use them?

There are numerous biological mechanisms by which nutritional factors might be expected to exert favorable influences on pathophysiological processes in osteoarthritis. Such processes include oxidative damage, cartilage matrix degradation and repair, and chondrocyte function and responses in adjacent bone. Micronutrients for which preliminary evidence of benefit exists include vitamin C and vitamin D. In addition, numerous nutraceuticals that may influence osteoarthritis pathophysiology--including glucosamine, chondroitin, S-adenosylmethionine, ginger and avocado/soybean unsaponifiables--have been tested in clinical trials. These products are safe and well tolerated, but interpretation of the collective results is hampered by heterogeneity of the studies, inconsistent results, and the conundrum of how to reconcile an apparent structural benefit with absence or modest effect on symptoms.

Dietary Supplements↗

PubMed2006

Small vessel vasculitis in a patient with botryomycosis.

We describe a 53 year-old woman with primary biliary cirrhosis presenting with left ankle swelling and a purpuric rash. The skin biopsy of the rash revealed a small vessel vasculitis and a botryomycosis with Splendore-Hoeppli phenomenon. Botryomycosis is an uncommon histologic finding of a chronic suppurative bacterial infection whereby bacteria form aggregates, which are surrounded by an eosinophilic matrix. With guidance from the skin biopsy findings, the patient was appropriately treated with antibiotics, resulting in complete resolution of symptoms.

Anti-Bacterial Agents↗

PubMed2005

Considerations in the treatment of early osteoarthritis.

Osteoarthritis is the most common form of arthritis and it is one of the leading causes of disability in all elderly populations. It results in enormous societal burden, including the need for joint replacement at an annual cost to the community of billions of dollars. Two factors that predicate the formulation of a treatment strategy for an individual with "early" osteoarthritis include the risk for toxicity from long duration of exposure to pharmaceuticals and the desirability of a treatment with the potential to reduce the rate of disease progression. These considerations favor approaches that avoid or minimize chronic pharmaceutical use in favor of safer interventions, especially ones where current evidence suggests the potential of a disease-modification effect. These should include socio-behavioral interventions that promote weight optimization and exercise, consideration of orthotics, general dietary recommendations to increase vitamin D and C intake, and an emphasis towards topical or intermittent use of pharmaceutical agents rather than long term nonsteroidal anti-inflammatory drug use.

Disease Progression↗

PubMed2005

Nutritional factors and osteoarthritis: recent developments.

PURPOSE OF REVIEW: The role of nutrition and nutritional supplements in the development and progression of osteoarthritis is now a topic of considerable public, industry, and academic interest. This review focuses on how the evidence for a role of nutritional factors or nutritional supplements in the management of knee osteoarthritis has been changed by recent research. RECENT FINDINGS: Recent studies include clinical trials of weight loss and exercise as interventions for osteoarthritis of the knee, the elucidation of mechanisms of oxidative stress on the chondrocyte genome, further study of vitamin C supplementation in an animal with spontaneous osteoarthritis, and further clinical and pharmacodynamic evaluations of glucosamine and chondroitin sulfate. Perplexing findings among these studies include the deleterious effects of vitamin C on osteoarthritis in the Hartley guinea pig, the low levels of glucosamine achieved in serum after an oral dose, recent negative clinical studies of glucosamine, and the heterogeneity of results among glucosamine trials. SUMMARY: With an intensification of research in this field come new clinical and basic science data, sometimes with surprising results. These confirm the considerable potential for a role of nutritional interventions for osteoarthritis, but they emphasize the need for systematic scientific evaluation of the claims made for such products.

Animals↗

PubMed2003

Smoking, alcohol consumption, and risk of systemic lupus erythematosus in the Black Women's Health Study.

OBJECTIVE: Several case-control studies, mostly of prevalent disease, have suggested that systemic lupus erythematosus (SLE) is positively associated with cigarette smoking and inversely associated with alcohol consumption. We prospectively investigated the associations of smoking and alcohol consumption with incident SLE in the Black Women's Health Study (BWHS). METHODS: In 1995, 64,500 African-American women provided information on demographic characteristics, reproductive and medical histories, smoking, and alcohol consumption. Followup questionnaires in 1997 and 1999 ascertained incident cases of SLE. Cox proportional hazards regression was used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI). RESULTS: Sixty-seven women reported a new diagnosis of SLE and use of appropriate medication for that illness. In multivariate analyses, the IRR for current and past smoking were 1.6 (both 95% CI 0.8-3.3). The risk was greater for women who began smoking before age 19 years (IRR 1.9, 95% CI 1.0-3.6). Neither current alcohol consumption (IRR 1.0, 95% CI 0.4-2.4) nor past alcohol consumption (IRR 0.9, 95% CI 0.3-2.7) was associated with SLE. CONCLUSION: Our results suggest an increased risk of SLE among smokers, but no effect of alcohol consumption on risk. The inverse association of alcohol consumption with SLE found in studies of prevalent disease may have resulted from women with SLE giving up drinking.

Adult↗