07.07.2014

Articles on risk factors for breast cancer

Osteoarthritis: What is it?Osteoarthritis (OA) is a degenerative joint disease that’s sometimes called 'wear and tear' arthritis and involves the progressive breakdown of the joints' natural shock absorbers.
To provide even greater transparency and choice, we are working on a number of other cookie-related enhancements. Chronic Cholecystitis and Cholelithiasis: Gross natural color opened gallbladder with obviously thickened wall and fill-ed with faceted black calculi. Stress fractures occur frequently in athletes and may lead to significant disability and loss of time from sports training and competition. In the diagnosis of stress fractures, the athlete's sport and sex and the location of symptoms should be considered. In the menopause study, Horvath and first author Morgan Levine tracked methylation, a chemical biomarker linked to aging, to analyze DNA samples from more than 3,100 women enrolled in four large studies, including the Women’s Health Initiative (WHI) a major 15-year research program that addressed the most common causes of death, disability and poor quality of life in postmenopausal women. In the sleep study, Carroll and her colleagues drew their data from more than 2,000 women in the WHI. While both studies are bad news for many women, Horvath suggests that scientists in the future may use the epigenetic clock as a diagnostic tool to evaluate the effects of therapies, like hormone therapy for menopause. Source: Medical Express, Menopause accelerates biological aging, Proceedings of the National Academy of Sciences. Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon. Possible treatments for tenosynovitis include cortisone injections (then a course of paracetomal and ibuprofen for pain) and an outpatient surgery to enlarge the synovium. This can cause discomfort when you use the affected joints – perhaps an ache when you bend at the hips or knees, or sore fingers when you type.
It is intended for general information purposes only and does not address individual circumstances. Appropriate evaluation, diagnosis, and treatment are needed to return athletes to play as quickly and safely as possible. Epigenetics is the study of changes to DNA packaging that influence which genes are expressed but don’t affect the DNA sequence itself. Eight years later, he said, her body would be a full year older biologically than another 50-year-old woman who entered menopause naturally at age 50. Using the epigenetic clock, they found that postmenopausal women with five insomnia symptoms were nearly two years older biologically than women the same chronological age with no insomnia symptoms.
Symptoms of tenosynovitis include pain, swelling , and difficulty moving a particular joint where the inflammation occurs. The health care provider may touch or stretch the tendon or have you move the muscle to which it is attached to see whether you experience pain.
Chastain is keeping an eye on the current women's national team — without retired star Abby Wambach — after helping the U.S.
Most people over 60 have some degree of OA, but it also affects people in their 20s and 30s. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. However, the single most frequently injured bone is the tibia.1,2,7,9,12 The anatomical site of a stress fracture varies by sport. The incidence and distribution of stress fractures in competitive track and field athletes: a twelve-month prospective study. Our mission is to save precious time by offering the best and latest on rheumatology in an easy-to-read format, always hyperlinked for more in-depth reading later. What's inside? When you straighten your finger, the tendon locks or sticks as it squeezes through the too-small synovium. Trigger Finger sometimes runs in families, and is generally seen more often in males than in females. Never ignore professional medical advice in seeking treatment because of something you have read on the BootsWebMD Site. Tennis, volleyball, soccer, and basketball players and distance runners have a higher incidence of stress fractures in the long bones, such as the tibia (Figure 1).
News summaries based on studies published in leading medical journals and specialty medical journals, conference coverage, case-based quizzes and more. The causes for children are even less known and have a recurrence rate of less than 1-5% after treatment. You may notice pain or soreness when you move certain joints or when you've been inactive for a prolonged period. Sprinters, hurdlers, jumpers, gymnasts, and skaters tend to have more stress fractures in the feet.1,12,13 Other sports are associated with stress fractures in non–lower extremity sites.
We also publish case studies and practice-related articles by rheumatologists and other specialists. For example, rowers are at increased risk for rib stress fractures and throwers for humeral and forearm stress fractures.14,15Understanding of stress fracture epidemiology, risk factors, underlying causes, and assessment techniques is needed for effective diagnosis and treatment. In this article, we describe a comprehensive approach to evaluation and management of these injuries.RISK FACTORSIdentifying and addressing risk factors for stress fractures in athletes may help prevent these injuries.
When osteoarthritis affects the hands, some people develop bony enlargements in the fingers, which may or may not cause pain. Potential intrinsic and extrinsic factors include biomechanics, bone geometry, muscle mass and strength, changes in training regimens, menstrual function, and bone mineral density (BMD). Factors associated with stress fracture in young army women: indications for further research. Soccer approved no headers for children under 11 last year, the whistle is blown for a foul if the ball is headed in a game. Osteoarthritis: Where does it hurt?In most cases, osteoarthritis develops in the weight-bearing joints of the knees, hips, or spine. Particular attention has been paid to identifying risk factors in female athletes because the incidence of injury is higher in these persons.Lower extremity biomechanical factors, including leg, knee, and foot alignment, may contribute to stress fracture risk by leading to areas of stress concentration in bone or muscle when it is fatigued.
Chastain would like the ban to extend to 14 and under, but for now, it's about reducing headers in practice and "teaching kids spacial awareness, getting their head up and away from the ball.


When the kids get fixated on the ball, their eyes never leave it, so they don't see any danger that potentially could be coming."She tells her boys' youth team they're not quite ready for headers and cautions her boys' high school Bellarmine team.
However, it was not able to identify the best design for such inserts or comment on risk in athletes because all studies included in the review involved military recruits.17In the first study to evaluate acetabular retroversion, another potential biomechanical risk factor, Kuhn and associates18 demonstrated that military personnel experiencing femoral neck stress fractures have greater acetabular retroversion than uninjured controls.
Osteoarthritis: What causes it?Every joint comes with a natural shock absorber in the form of cartilage. In athletes with recurring stress fractures, Korpelainen and associates19 found that pes cavus, leg-length inequality, and excessive forefoot varus are risk factors. This firm, rubbery material cushions the ends of the bones and reduces friction in healthy joints. Military studies evaluating biomechanical risk factors for recurring stress factors have produced inconsistent results. Because the available evidence is contradictory, no firm conclusions can be drawn regarding biomechanical factors and risk of stress fractures, except that leg-length discrepancy probably adds to stress fracture risk.Because bone strength is directly related to the cross-sectional area of bone and the cross-sectional moment of inertia, bone geometry may contribute to the risk of stress fracture.
If it deteriorates enough, bone rubs against bone, causing pain and reducing your range of motion.
The cause isn't exactly known, but doctors think it's a combination of genetics, an over-reactive immune system and environmental factors. Risk factors you can’t controlOne of the major risk factors for osteoarthritis is something none of us can control - getting older. Other investigators have not noted an increased risk of stress fracture on the basis of differences in type or amount of training.1,19,29Another small study found that treadmill runners may be at decreased risk for stress fracture compared with road runners because of less tibial strain seen with treadmill running.
I had to take a step back and know I'm not always in control, and Jaden will take the lead. In most cases, the condition results from normal wear and tear over the years, but some people have a genetic defect or joint abnormality that makes them more vulnerable. This finding indicates that training surface may have an influence on stress fracture risk.30The athlete's fitness level also may play a role in stress fracture risk.
Risk factors you can controlBecause injured joints are more vulnerable to osteoarthritis, doing anything that damages the joints can raise your risk. Military studies have demonstrated that recruits who have lower levels of fitness are significantly more likely to experience stress fractures than their more fit counterparts.31Stress fracture in female athletes may be a sign of the female athlete triad (disordered eating, amenorrhea, and low BMD). This includes sports that have a high rate of injury and jobs that require repetitive actions, such as bending the knees to install flooring. Therefore, researchers have investigated the roles of BMD, menstrual irregularity, and nutrition in stress fracture risk.Low BMD or bone mineral content (BMC) may lead to reduced bone strength and contribute to the risk of stress fracture.
Obesity is another risk factor -- it has been linked specifically to osteoarthritis of the knees and hips.
A prospective study of 127 competitive female runners found that decreased whole-body BMC increases the risk of stress fracture.32 In a prospective study of female track and field athletes conducted by Bennell and colleagues,1 athletes who had stress fractures had lower BMC and lower BMD in the lumbar spine and feet than those who did not have stress fractures. Surprisingly, lower extremity BMD and total-body BMC were still higher in the women with stress fractures than in sedentary controls.
It's more about distribution, given the money the federation receives from TV revenue, sponsorships and FIFA."I'm a big advocate for equal reward for the work we do on the field," she said. However, investigators have proposed that decreased estrogen is not the only factor contributing to bone loss and that the energy deficiency observed in these athletes plays an important role.4Some investigators have found that poor eating behaviors may be more prevalent in athletes who sustain stress fractures. If bony knobs develop in the small joints of the fingers, tasks such as buttoning up a shirt can become difficult.
In the study by Bennell and colleagues,1 athletes with stress fractures displayed more restrictive eating behaviors and scored higher on the Eating Attitudes Test, a screening tool designed to assess symptoms characteristic of eating disorders. Chastain believes people will eventually look back at the wage issue and consider it archaic."Women — and not just women, there are a lot of male advocates out there — are saying, 'It's time. Diagnosing osteoarthritisTo help your doctor make an accurate diagnosis, you'll need to describe your symptoms in detail, including the location and frequency of any pain. The groups did not differ in protein, fiber, alcohol, caffeine, vitamin D, or phosphorus intake. Your doctor will examine the affected joints and may arrange X-rays or other imaging studies to see how much damage there is, and to rule out other joint conditions.
More investigations are needed to determine the relationship between nutrition and stress fractures. Acute weight loss also may be a risk factor.DIAGNOSISHistory and physical examinationUsually, patients with stress fracture report activity-related pain that worsened gradually over time. Long-term complicationsUnlike rheumatoid arthritis, osteoarthritis does not affect the body's organs or cause illness. Initially, pain often is noted only during athletic activity, but with continued activity, pain persists during rest.Typically, physical examination reveals localized pain with palpation at the site of the stress fracture. Stress injuries to bone in college athletes: a retrospective review of experience at a single institution.
The role of foot pronation in the develoment of femoral and tibial stress fractures: a prospective biomechanical study. Severe loss of cartilage in the knee joints can cause the knees to curve out, creating a bow-legged appearance (shown on the left). The patient may have pain with percussion distal to the site of fracture or when a tuning fork is placed over the site. Bony spurs along the spine (shown on the right) can irritate nerves, leading to pain, numbness or tingling in some parts of the body.
Treatment: PhysiotherapyThere is no treatment to stop the erosion of cartilage in the joints, but there are ways to improve joint function. One of these is physiotherapy to increase flexibility and strengthen the muscles around the affected joints. Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults.
Bone scintigraphy has been used widely and was long regarded the gold standard in stress fracture diagnosis. Support devicesSupportive devices, such as finger splints or knee braces, can reduce stress on the joints and ease pain.


However, false-negative bone scan results have been reported in both the femoral neck and tibia in patients in whom the diagnosis was made with MRI.44,45T1-weighted MRI with short tau inversion recovery sequences and T2-weighted MRI have been useful in the diagnosis of stress fracture.
If walking is difficult, walking sticks, crutches, or walking (Zimmer) frames may be helpful.
People with osteoarthritis of the spine may benefit from changing to a firmer mattress and wearing a back brace or neck collar.
Medication for OAWhen osteoarthritis flares up, many patients find relief with over-the-counter pain and anti-inflammatory medication, such as aspirin, ibuprofen or paracetamol. Higher grades indicate longer recovery times.Laboratory testingAthletes who have multiple stress fractures may require additional workup, including laboratory testing. Various tests are listed in Table 2.TREATMENTRegardless of the site of stress fracture, early treatment should include rest and avoidance of all exacerbating activities.
If pain persists despite the use of tablets or creams, your doctor may suggest an injection of corticosteroid directly into the joint. Athletes should be encouraged to maintain fitness by engaging in nonpainful activities, such as bicycling, swimming, and pool-running. Osteoarthritis and weightIf you're overweight, one of the most effective ways to relieve pain in the knee or hip joints is to shed a kilo or so. Some athletes—those who have high-risk stress fractures or pain with activities of daily living—may require complete non–weight bearing with crutches, bracing, or casting to allow for healing and relieve pain.This period of rest should be followed by a gradual return to activity. Even modest weight loss has been shown to reduce symptoms of osteoarthritis by easing the strain on weight-bearing joints. Osteoarthritis and exercisePeople with osteoarthritis may avoid exercise out of concern that it will cause pain. But low-impact activities such as swimming, walking or cycling can improve mobility and increase strength. Patients with stress fractures of the tarsal navicular bone require significant periods of non–weight-bearing immobilization to allow for proper healing. Training with light weights can help by strengthening the muscles that surround your joints.
Typically, athletes with navicular stress fractures need 4 to 6 weeks of immobilization in a non–weight-bearing cast.Femoral neck stress fractures, particularly those in the superior cortex, are associated with multiple complications, such as osteonecrosis of the femoral head, delayed union, and nonunion. Stress fractures on the tension side of the neck indicate a high risk of complete fracture. Patients with these fractures need careful monitoring and often require surgical fixation.55Special consideration should be given to female athletes who have stress fracture and an additional risk factor for the female athlete triad, such as disordered eating, amenorrhea, or recurring stress fracture.
Is an operation for you?If osteoarthritis interferes significantly with everyday life and the symptoms don't improve with physiotherapy or medication, a joint replacement operation is an option. This procedure is used for those with severe OA and replaces a damaged joint with an artificial one. In treatment of patients with menstrual dysfunction and decreased BMD, the usefulness of estrogen replacement is unclear.
Preventing osteoarthritisThe most important thing you can do to ward off osteoarthritis is keep your weight in check. In several case studies, a program of diet supplementation and moderately decreasing training frequency was found to allow for weight gain, eventual return of menstrual function, and accompanying improvement in athletic performance.60,61Drinkwater and colleagues62 found that calcitonin-salmon nasal spray improves BMD in the proximal femur and spine in amenorrheic athletes.
Over the years, extra weight puts stress on the joints and may even alter the normal joint structure.
Other medications that are useful in the treatment of postmenopausal women with osteoporosis, such as bisphosphonates and selective estrogen receptor modulators, are not approved for use in amenorrheic women of childbearing age. Dual-energy x-ray absorptiometry derived structural geometry for stress fracture prediction in male U.S. The effect of leg strength on the incidence of lower extremity overuse injuries during military training. Relationship of fatigued run and rapid stop to ground reaction forces, lower extremity kinematics, and muscle activation. Stress fracture in military recruits: gender differences in muscle and bone susceptibility factors. Menstrual function and bone mass in elite women distance runners: endocrine and metabolic features. Low energy availability, not stress of exercise, alters LH pulsatility in exercising women. Stress fractures in female army recruits: implications of bone density, calcium intake, and exercise. Nutritional factors that influence change in bone density and stress fracture risk among young female cross-country runners.
MR imaging, bone scintigraphy, and radiography in bone stress injuries of the pelvis and the lower extremity.
The superiority of magnetic resonance imaging in differentiation the cause of hip pain in endurance athletes.
Tibial stress reactions in runners: correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system. Bone mineral density in young women with long-standing amenorrhea: limited effect of hormone replacement therapy with ethinylestradiol and desogestrel. Low energy availability, not exercise stress, suppresses the diurnal rhythm of leptin in healthy young women.
Energy and nutrient status of amenorrheic athletes participating in a diet and exercise training intervention program.



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