Monday, 14 March 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Risk Factors

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


                  Polymyalagia Arthritis (Rheumatica)

Polymalagia Arthritis is defined as a condition a common inflammatory rheumatic disease which causes pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdle as a result of the presence of a synovitis in proximal joints and periarticular structures.
                              The Risk factors

1. Gene
Patient carrying gene of rs20541 (R130Q) polymorphism in the IL-13 gene is showed to have an increased risk of Polymyalgia Rheumatica(PMR)(18). In elder, genetic abnomality of IL1RN polymorphism is also an risk factor for the disease but not associated to PMR severity(19), according Universidad de Cantabria. The influence of persistence high levels of interleukin 6 (IL-6)(Proinflammatory cytokines) also elevated the risk of PMR (20).

2. Aging
If you are over 50 years of age, you are at increased risk of Polymalagia Arthritis (PMR)(21), as a result of age-related chronic inflammatory conditions in increased effector functions of phagocytes, chemotaxis, phagocytosis, and oxidative burst as well as reduced immunity(22).  In support to the above, the Slovak Academy of Sciences study suggested that patient with Polymyalgia Rheumatica(PMR) are found to have low levels of cortisol, during ongoing inflammation, decreased levels of adrenal androgens which is an expression in aging population(23)

3. Diet
Diet plays an important in reduced and increased risk of PMR, depending to specific dietary components. Intake of red meat and certain dietary components have shown to predict the onset of Polymyalgia Rheumatica(PMR) depending to influential risk from other lifestyle causes(24).

4. Geographical and temporal differences
People who live in ceratain Geographical and temporal areas are susceptible to increased risk of Polymyalgia Rheumatica(PMR). Dr Cimmino MA and Zaccaria A said," Epidemiological studies have helped to unravel the etiopathogenic factors at work in PMR/GCA,... the incidence of PMR varies between 12.7/100,000 in Italy and 112.6/100,000 in Norway"(25).

5. Smoking
One of most additive form of human life style of thousands of year has found to causes many types of deathly cancer and viarity of chronic inflammatory diseases, including Polymyalgia Rheumatica(PMR)(25). According to the Kameda Medical Center, reviewed of review of patients with RS3PE and PMR treated in a community-based hospital between January 2000 and December 2009, smiking is the leading causes of PMR with the effective rate of 39%(26).
Dr. Harrison BJ and the research team at the University of Manchester, insisted that Cigarette smoking is known to increase rheumatoid factor (RF) and nodule formation in patients with rheumatoid arthritis (RA) and the early inflammatory polyarthritis (28).

6. Gender
According to the review of records of 163 cases of PMR and/or TA diagnosed over a 15 year period,
if you are women, you are at increased risk to develop Polymalagia Arthritis with severity of inflammatory response(29). Dr. Dejaco C, the leading researcher at the jopint study said,"Among prognostic factors, female sex, high erythrocyte sedimentation rate (ESR) and peripheral arthritis were associated in some studies with a higher relapse risk"(30).

5. Race
Polymyalgia Rheumatica(PMR) is one of most  common rheumatic diseases in  Asian popilation specially in China and Singapore, according to Singapore General Hospital(31) and Community Oriented Program for Control of Rheumatic Diseases (32) but The prevalence of rheumatic complaints varied with the locality surveyed(32)

Some researchers also suggested that increased levels of Procalcitonin (PCT) as an early marker of bacterial infection in patients diagnosed during the 2002-06 period randomly selected.may be correlated with inflammation status of the early onset of PMR as well as sun exposure, and nulliparity(27).

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(20) Relationship between interleukin 6 promoter polymorphism at position -174, IL-6 serum levels, and the risk of relapse/recurrence in polymyalgia rheumatica by Boiardi L1, Casali B, Farnetti E, Pipitone N, Nicoli D, Cantini F, Macchioni P, Bajocchi G, Catanoso MG, Pulsatelli L, Consonni D, Salvarani C.(PubMed)
(21) [Polymyalgia rheumatica mimicking neoplastic disease--significant problem in elderly patients].
[Article in Polish]by Kwiatkowska B1, Filipowicz-Sosnowska A.(PubMed)
(22) Phagocyte dysfunction in polymyalgia rheumatica and other age-related, chronic, inflammatory conditions by Álvarez-Rodríguez L1, López-Hoyos M, Calvo-Alén J, Aurrecoechea E, Villa I, Martínez-Taboada VM.(PubMed)
(23) Serum cytokines and steroidal hormones in polymyalgia rheumatica and elderly‐onset rheumatoid arthriti by M Cutolo, C M Montecucco, L Cavagna, R Caporali, S Capellino, P Montagna, L Fazzuoli, B Villaggio, B Seriolo, and A Sulli(PMC)
(24) Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption by Pattison DJ1, Symmons DP, Lunt M, Welch A, Luben R, Bingham SA, Khaw KT, Day NE, Silman AJ.(PubMed)
(25) Epidemiology of polymyalgia rheumatica by Cimmino MA1, Zaccaria A.(PubMed)
(26) Clinical characteristics of patients with remitting seronegative symmetrical synovitis with pitting edema compared to patients with pure polymyalgia rheumatica by Kimura M1, Tokuda Y, Oshiawa H, Yoshida K, Utsunomiya M, Kobayashi T, Deshpande GA, Matsui K, Kishimoto M.(PubMed)
(27) Procalcitonin at the onset of giant cell arteritis and polymyalgia rheumatica: the GRACG prospective study by Schmidt J1, Duhaut P, Bourgeois AM, Salle V, Smail A, Chatelain D, Betsou F, Mazière JC, Ducroix JP; Groupe de Recherche sur l'Artérite à Cellules Géantes (GRACG).(PubMed)

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