Showing papers by "Cyrus Cooper published in 1998"
TL;DR: Obesity and hip injury are important independent risk factors for hip osteoarthritis, which might be amenable to primary prevention in a population-based case-control study.
Abstract: Hip osteoarthritis is a major cause of pain and disability. The authors explored individual risk factors for hip osteoarthritis in a population-based case-control study. The study was performed in two English health districts (Portsmouth and North Staffordshire) from 1993 to 1995. A total of 611 patients (210 men and 401 women) listed for hip replacement because of osteoarthritis over an 18-month period were compared with an equal number of controls selected from the general population and individually matched for age, sex, and family practitioner. Information about suspected risk factors was obtained by a questionnaire administered at interview and a short physical examination. Obesity (odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.3-2.4; highest vs. lowest third of body mass index), previous hip injury (OR = 4.3, 95% CI 2.2-8.4), and the presence of Heberden's nodes (OR = 1.6, 95% CI 1.2-2.2) were independent risk factors for hip osteoarthritis among men and women. Hip injury was more closely related to unilateral as compared with bilateral disease. There were a negative association between cigarette smoking and osteoarthritis among men and a weak positive association with prolonged regular sporting activity. Obesity and hip injury are important independent risk factors for hip osteoarthritis, which might be amenable to primary prevention. Hip osteoarthritis may also arise as part of the polyarticular involvement found in generalized osteoarthritis.
346 citations
TL;DR: A UK Consensus Group on management of glucocorticoid‐induced osteoporosis: an update (Review).
Abstract: In the UK, over 250 000 patients take continuous oral glucocorticoids (GCs), yet no more than 14% receive any therapy to prevent bone loss, a major complication of GC treatment. Bone loss is rapid, particularly in the first year, and fracture risk may double. This review, based wherever possible on clinical evidence, aims to provide easy-to-use guidance with wide applicability. A treatment algorithm is presented for adults receiving GC doses of 7.5 mg day(-1) or more for 6 months or more. General measures, e.g. alternative GCs and routes of administration, and therapeutic interventions, e.g. cyclical etidronate and hormone replacement, are recommended.
321 citations
TL;DR: Clinically apparent vertebral deformities are associated with reduced survival and part of this excess can be explained by an association with other adverse health and lifestyle factors linked to mortality.
Abstract: Clinically apparent vertebral deformities are associated with reduced survival. The majority of subjects with radiographic vertebral deformity do not, however, come to medical attention. The aim of this study was to determine the association between radiographic vertebral deformity and subsequent mortality. The subjects who took part in the analysis were recruited for participation in a multicentre population-based survey of vertebral osteoporosis in Europe. Men and women aged 50 years and over were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Radiographs were evaluated morphometrically and vertebral deformity defined according to established criteria. The participants have been followed by annual postal questionnaire – the European Prospective Osteoporosis Study (EPOS). Information concerning the vital status of participants was available from 6480 subjects, aged 50–79 years, from 14 of the participating centres. One hundred and eighty-nine deaths (56 women and 133 men) occurred during a total of 14 380 person-years of follow-up (median 2.3 years). In women, after age adjustment, there was a modest excess mortality in those with, compared with those without, vertebral deformity: rate ratio (RR) = 1.9 (95% confidence interval (CI) 1.0,3.4). In men, the excess risk was smaller and non-significant RR = 1.3 (95% CI 0.9,2.0). After further adjusting for smoking, alcohol consumption, previous hip fracture, general health, body mass index and steroid use, the excess risk was reduced and non-significant in both sexes: women, RR = 1.6 (95% CI 0.9,3.0); men RR = 1.2 (95% CI 0.7,1.8). Radiographic vertebral deformity is associated with a modest excess mortality, particularly in women. Part of this excess can be explained by an association with other adverse health and lifestyle factors linked to mortality.
224 citations
TL;DR: There are marked differences in pelvic morphometry between Britain and Japan, and the acetabular dimensions of Japanese subjects are considerably shallower than those of their British counterparts of similar age and sex.
Abstract: OBJECTIVE Geographic differences in the prevalence of hip osteoarthritis (OA) have been ascribed to differences in the frequency of acetabular dysplasia among different ethnic groups. However, there are few data on the shape of the acetabulum in various populations around the world. We examined this issue in samples of pelvic radiographs from Britain and Japan. METHODS Measurements were made on the pelvic radiographs of 1303 men and 195 women, aged 60-75 yr, who attended for i.v. urography in two British centres. These were compared with 99 men and 99 women aged 60-79 yr who were included in a population-based study in a rural community in Japan, and who agreed to undergo standardized pelvic radiography. Acetabular dysplasia was assessed by morphometric measurement of the centre-edge (CE) angle and acetabular depth. RESULTS The mean CE angle among men was 36 degrees (95% CI 35-37 degrees ) in Britain and 31 degrees (95% CI 29-32 degrees ) in Japan; that in women was 37 degrees (95%, CI 36-38 degrees ) in Britain and 31 degrees (95% CI 29 33 degrees ) in Japan. The mean values of acetabular depth were also significantly (P < 0.001) lower in Japan than in Britain. However, the prevalence of hip OA was lower in Japan (0% in men, 2% in women) than in Britain ( 11% in men, 4.8 / in women). In a random effects model, there were negative relationships between measures of acetabular dysplasia and minimum joint space among individuals. CONCLUSIONS We conclude that there are marked differences in pelvic morphometry between Britain and Japan. The acetabular dimensions of Japanese subjects are considerably shallower than those of their British counterparts of similar age and sex. Nevertheless, hip OA is more frequent in Britain than in Japan. Further studies are required on the risk factors for hip OA in Oriental populations, in order that the aetiology of this disorder can be better understood.
153 citations
TL;DR: The associations between early growth and markers of ageing suggest that in some systems, ageing may be programmed by events in early life, and a potential mechanism is the impaired development of repair systems.
Abstract: Background: epidemiological studies have shown that poor early growth is associated with cardiovascular and other degenerative diseases. This has been explained by programming, whereby undernutrition and other influences which restrict early growth permanently change the structure and physiology of the body. The long-term effects of poor early nutrition on ageing have been demonstrated in animals but not studied in man. Objectives: to determine if poor early growth was associated with increased markers of ageing in later life. Methods: we traced 1428 men and women, born in Hertfordshire between 1920 and 1930, for whom records of early weight were available. 824 (58%) were interviewed at home and 717 (50%) attended clinic for eye examination, audiometry, grip strength measurement, skin thickness ultrasound and anthropometry. Results: lower weight at 1 year was associated with increased lens opacity score, higher hearing threshold, reduced grip strength and thinner skin. Visual acuity, macular degeneration and intraocular pressure were not related to early growth. Conclusions: the associations between early growth and markers of ageing suggest that in some systems, ageing may be programmed by events in early life. A potential mechanism is the impaired development of repair systems. Keywords: ageing prenatal growth, programming, repair
145 citations
TL;DR: High peak GH values drive IGF-I production and maintain bone mineralization in adult life, however, integrated GH secretion, after adjusting for the effect of pulse amplitude, is negatively associated with bone density inAdult life.
Abstract: Epidemiological studies suggest that retarded growth in infancy is associated with low adult bone mass. The mechanism underlying this association is unknown, but the programming of GH secretion or sensitivity by environmental influences during early development may play a role. We examined this issue in a sample of 37 healthy men, aged 63-73 yr, whose weight gain in infancy had been recorded. Venous blood samples were obtained under standard conditions every 20 min over a 24-h period. Measurements were made of the GH secretory profile, insulin-like growth factor I (IGF-I), IGF-binding protein-1 and -3, and GH-binding protein. Bone mineral density was measured at the lumbar spine and femoral neck using dual energy x-ray absortiometry. There was a statistically significant association between peak GH concentration (r = 0.46; P < 0.01) and fasting IGF-I concentration (r = 0.46; P < 0.01) with femoral neck bone density. After allowing for the peak GH concentration, median GH was negatively (P < 0.05) associated with bone mineral density. Weight at 1 yr was not related to peak GH, but was strongly related to the median GH concentration (r = 0.42; P = 0.01). These observations are consistent with a dual effect of GH secretion on bone density. High peak GH values drive IGF-I production and maintain bone mineralization in adult life. However, integrated GH secretion, after adjusting for the effect of pulse amplitude, is negatively associated with bone density in adult life. This particular characteristic of the GH secretory profile correlates with growth during infancy and might be programmed by environmental factors during intrauterine or early postnatal life.
136 citations
TL;DR: There is now a strong case for regarding hip osteoarthritis as an occupational disease in men whose work has involved prolonged and frequent heavy lifting, as well as other studies consistent with the results of other studies.
Abstract: To test the hypothesis that occupational lifting is a cause of hip osteoarthritis, the authors examined associations with lifting and other occupational activities in a case-control study. The study was performed in two English health districts (Portsmouth and North Staffordshire) from 1993 to 1995. A total of 611 patients (210 men and 401 women) listed for hip replacement because of osteoarthritis over an 18-month period were compared with an equal number of controls selected from the general population and individually matched for age, sex, and general practice. Information about suspected risk factors was obtained by a questionnaire administered at interview and a short physical examination. Analysis was by conditional logistic regression. After adjustment for potential confounders, the risk in men increased progressively with the duration and heaviness of occupational lifting. Relative to those with low exposure, men who had regularly lifted weights in excess of 50 kg for 10 years or longer had an odds ratio of 3.2 (95% confidence interval 1.6-6.5). No comparable association was found in women. Of the other occupational activities examined, only frequent climbing of stairs showed a pattern suggestive of a causal relation. These findings are consistent with the results of other studies, and there is now a strong case for regarding hip osteoarthritis as an occupational disease in men whose work has involved prolonged and frequent heavy lifting.
113 citations
TL;DR: The results confirm the importance of back pain duration and the occurrence of associated disability and sciatica as predictors of future symptoms, and allow more reliable quantification of the natural history of low back pain in women of working age.
Abstract: Study Design. Longitudinal study. Objectives. To assess the natural history of low back pain. of Background Data. Most episodes of low back pain resolve or improve within a few weeks, but chronic or recurrent symptoms are common. Previous studies of natural history have usually relied on people's long-term recall of symptoms, or they have been limited to patients seeking clinical care Methods. Nurses (1.165 women completed a baseline questionnaire and up to eight foilow-up questionnaires 3 months apart. Each questionnaire asked whether they naa experienced low back pain in the past month. One-month prevaiences of pain at specified follow-ups were calculated according to histories of pain reported on earlier questionnaires. Results. The 1-month prevalence of low back pain at individual follow-ups ranged from 16% to 19%. Of 906 women who completed the baseline questionnaire and at least three follow-up questionnaires, 38 (4.2%) reported pain every time they returned a questionnaire, and 190 (21.0%) reported pain on at least three occasions. The presence or absence of low back pain at baseline was highly predictive of future pain throughout follow-up. The longer that back pain was consistently reported, the more likely it was to be present at the next follow-up. Later risk was lowest in women who reported no bacK pain at baseline or either of the first two follow-ups. Back pain carried a worse prognosis if it was disabling or associated with sciatica. Conclusions. Our results confirm the importance of back pain duration and the occurrence of associated disability and sciatica as predictors of future symptoms. and allow more reliable quantification of the natural history of back pain in women of working age, in the absence of other information, the differentials in risk associated with a person's history of back pain appear to remain constant for a period of at least 2 years.
91 citations
TL;DR: Clinical observations supporting the anti-fracture efficacy of cyclical etidronate therapy are extended and complement and extend clinical observations supporting that of cyclic etidonate therapy.
Abstract: This study examined the effects of cyclical etidronate, when used in routine clinical practice, on the prevention of fracture. Information was obtained from 550 general practices in the UK that provide their medical records to the General Practice Research Database. A total of 7977 patients taking cyclical etidronate treatment and 7977 age-, sex- and practice-matched control patients with a diagnosis of osteoporosis were analysed. People taking cyclical etidronate had a significantly reduced risk of non-vertebral fracture (by 20%) and of hip fracture (by 34%) relative to the osteoporosis control patients. The relative risk of non-vertebral fracture was 0.80 (95% confidence interval 0.70-0.92), that of hip fracture 0.66 (0.51-0.85) and that of wrist fracture 0.81 (0.58-1.14). When fracture incidence rates were compared between the two groups, the rate of non-vertebral, hip and wrist fracture decreased significantly (P < 0.05) with increasing etidronate exposure. The results of this study complement and extend clinical observations supporting the anti-fracture efficacy of cyclical etidronate therapy.
83 citations
TL;DR: To the Editor: The susceptibility to osteoporotic fracture varies markedly among ethnic groups, and the differences are partly independent of differences in bone mass.
Abstract: To the Editor: The susceptibility to osteoporotic fracture varies markedly among ethnic groups, and the differences are partly independent of differences in bone mass. For example, hip fractures ar...
59 citations
TL;DR: It is possible to adjust routine national HES data to take account of multiple episodes within a single admission of hip fracture, and these methods should be applied to national comparative indicators for hip fracture admission and deaths.
Abstract: Background We investigated the validity of routine hospital and mortality hip fracture data in one English Region and estimated trends in hip fracture between 1978-1981 and 1993-1995. Methods We identified from Hospital Episode System (HES) data for 1993-1995 all hip fracture episodes relating to individual patients aged over 65 years resident in Wessex. We determined from the discharge method code whether an individual had died during that admission. The number of individual regional and district admissions and deaths were compared with those presented in the Public Health Common Data Set. We compared regional admission rates with data for 1978-1981 from a previous study. Results National comparative indicators for hip fracture overestimated individual admissions in Wessex by 17 per cent (in health authorities by 1-56 per cent). National comparative indicators for hip fracture mortality underestimated individual deaths in Wessex by 48 per cent. Between 1978-1981 and 1993-1995 the age-sex-standardized hip fracture rates rose from 1.90 to 2.63 per 1000 per year for men and from 5.70 to 7.70 per 1000 per year for women. Rates increased in all age groups except those aged 65-69 years. There was also a small fall in absolute mean annual numbers in this age group. The rates also fell in females aged 70-74. Conclusions It is possible to adjust routine national HES data to take account of multiple episodes within a single admission. These methods should be applied to national comparative indicators for hip fracture admission and deaths. Hip fracture rates continue to rise in those aged over 70 years. There may be a cohort effect with those born after 1925 showing stable rates which needs further investigation.
TL;DR: These data provide estimates of the rate of bone loss among Japanese men and women aged 40– 79 years and suggest that body build and menstrual function in women are important determinants ofBone loss.
Abstract: The objective of this study was to assess the rate of bone loss and characterize its determinants, among the inhabitants of Taiji, a rural Japanese community. A cohort of 2261 inhabitants aged 40–79 years was established using resident registration in 1992. Fifty men and 50 women in each of four age strata between 40 and 79 years were randomly selected and completed a self-administered risk factor questionnaire. Baseline bone density of lumbar spine and proximal femur was measured by dual-energy X-ray absorptiometry in 1993. BMD was measured again on the same participants in 1996. The rates of change of lumbar spine BMD in men in their 40s, 50s, 60s and 70s were 0.20%, 0.34%, 0.43% and 0.28% respectively. Rates in women were –0.35%, –1.02%, –0.10% and –0.20% respectively. At the femoral neck, rates of change in BMD among men in their 40s, 50s, 60s and 70s were 0.09%, –0.07%, 0.34% and 0.31% respectively. Femoral neck rates of change among women were –0.55%, 0.02%, 0.49% and –0.25% respectively. The rate of change of lumbar spine BMD was –0.24% in premenopausal women with regular periods, –1.99% in premenopausal women with irregular periods and –0.33% in postmenopausal women. Anthropometric measurements at baseline were also related significantly to change in bone density. Baseline weight and height were statistically significant predictors of bone loss rate.These data provide estimates of the rate of bone loss among Japanese men and women aged 40– 79 years. They suggest that body build and menstrual function in women are important determinants of bone loss.
TL;DR: The relative contribution of specific and non-specific rheumatic disorders of upper limb and neck to handicap from occupational and leisure activities is not clear (despite the fact that the risk factors may vary substantially between the two groups).
Abstract: Musculoskeletal disorders of the upper limb and neck are a common cause of morbidity, and in some occupational groups they contribute importantly to loss of time from work.1-5Community-based surveys have indicated point prevalences of 4–20% for pain at specific sites in the neck and upper limb,6-9with lifetime prevalences as high as 60%. Morbidity surveys in primary care have found an annual incidence of first consultation for upper limb disorders of approximately 25 per 1000 person years, with rates increasing from 25 to 45 years of age and then levelling off.10
Upper limb pain may arise from discrete pathological conditions, such as adhesive capsulitis, rotator cuff tendinitis, lateral epicondylitis, and tenosynovitis, or as part of non-specific regional pain syndromes. However, few community surveys have included a clinical examination as an integral component, to enable a distinction to be drawn between these very different categories of disorder. Furthermore, the relative contribution of specific and non-specific rheumatic disorders of upper limb and neck to handicap from occupational and leisure activities is not clear (despite the fact that the risk factors may vary substantially between the two groups).
As table 1 illustrates, investigations have differed in their choice of age range, source population, prevalence period, and …
Journal Article•
TL;DR: Weight at 1 year was negatively correlated with nuclear opacity score in adult life, the first time that such an association has been reported; it needs to be replicated in other populations.
Abstract: PURPOSE: The aim of this study was to assess the relationship between fetal and infant growth, as measured by birthweight and weight at 1 year and the development of age-related lens opacities. METHODS: A total of 1428 men and women who were born in Hertfordshire, United Kingdom, between 1920 and 1930, and for whom records of birthweight and weight at 1 year were available, were traced and invited for examination. Of these, 717 (50%) attended for ophthalmic examination. After dilation with tropicamide 1%, lens opacities were graded using the Lens Opacities Classification System (LOCS) III. RESULTS: In this population of English men and women aged 64 to 74 years, most opacities were of the nuclear type. There was no association between birthweight and nuclear lens opacities. Weight at 1 year was negatively correlated with nuclear opacity score in adult life (P=0.001). Subjects in the highest tertile for weight at 1 year (>23 pounds) had an odds ratio of 0.35 (95% confidence interval, 0.17 to 0.74) for having a significant nuclear lens opacity (LOCS score of > or = 3) compared with people in the lowest tertile for weight at 1 year (<21 pounds). This association remained after controlling for age, sex, smoking, social class, adult height, and diabetes. CONCLUSIONS: To our knowledge, this is the first time that such an association has been reported; it needs to be replicated in other populations. It could provide part of the explanation for the observed excess risk of cataract in developing countries.
TL;DR: This question is best answered by considering the balance between the risks and benefits of steroid use for short periods (two to three months), with the objective of determining the quality of the evidence to support the use of corticosteroids in rheumatoid arthritis.
Abstract: Papers p 811
The millennium brings with it the 50th anniversary of Hench's discovery that corticosteroids might be used to treat rheumatoid arthritis.1 Attitudes towards such use have waxed and waned since then. Initial hope that steroids might dramatically alter the long term course of the disorder gave way to a recognition of the serious adverse effects that accompany high dose treatment. As a result the use of low dose corticosteroids in arthritis remains highly controversial.
Corticosteroids are used widely in medicine today. A recent survey in general practice found that 1.4% of patients aged over 54 were using corticosteroids at a mean dose of 8 mg daily2: rheumatoid arthritis was the indication in 23% of cases. Although rheumatologists claim to use steroids relatively infrequently, audits of patients attending outpatient departments suggest a high prevalence of use (as great as 80%). 3 4 What, then, is the quality of the evidence to support the use of corticosteroids in rheumatoid arthritis?
This question is best answered by considering the balance between the risks and benefits of steroid use for short periods (two to three months), with the objective …
TL;DR: On current evidence, it is certainly not appropriate to target hormone replacement therapy for women at the menopause on the basis of a bone density screening programme, but newer bone-specific agents are being developed which might be administered at later ages, closer to the time when fracture incidence rates rise steeply.
Abstract: Osteoporosis is a common condition, which is recognised by the occurrence of fragility fractures and leads to considerable mortality and morbidity with huge financial implications world-wide. Based on predicted demographic changes, the implications of this disease are set to increasingly affect the healthcare budgets of all nations. The determinants of fracture are skeletal factors, such as peak bone mass, the rate of bone loss and extra-skeletal factors, which include trauma and the response to that trauma. Some of these factors are genetically determined, but several have environmental origins, which could, theoretically, be manipulated. There are two potential means whereby osteoporotic fractures might be prevented. Measures could be targeted at the entire population, with the aim of shifting the distribution of bone mass in a beneficial direction, through modifying the behaviour of all individuals. The alternative is a high risk approach, whereby intervention is targeted only at those considered to have the greatest risk of future fracture. Mass bone density screening falls into the second approach. Bone density is a good predictor of future fracture risk, and cost-effectiveness analyses of the high risk approach suggest economic benefits of policies targeting pharmacological treatment to those individuals at highest risk. However, there are important concerns about the levels of compliance achievable with such therapeutic interventions, the balance of risks and benefits for some of these interventions (for example, hormone replacement therapy), and the outcome when treatment is discontinued. On current evidence, it is certainly not appropriate to target hormone replacement therapy for women at the menopause on the basis of a bone density screening programme. However, newer bone-specific agents are being developed which might be administered at later ages, closer to the time when fracture incidence rates rise steeply. Bone densitometry has been shown to predict fractures even in the elderly, and high risk strategies for the targeting of such agents (for example, the bisphosphonates or selective oestrogen receptor modulators) will remain important research issues for the future.
TL;DR: No medically significant increases in frequency were observed among patients taking cyclic etidronate for a broad group of diseases that may potentially be induced by exposure to the drug, and data support the favorable risk:benefit ratio of cyclic Etidronates.
Abstract: To evaluate the safety of cyclic etidronate in routine clinical practice, we obtained information from 550 general practices in the United Kingdom that provide the medical records to the General Practice Research Database. A group of 7977 patients taking cyclic etidronate and two age-, gender-, and practice-matched control groups, one with osteoporosis and one without, were analyzed. For the group taking cyclic etidronate, the average age was 71.6 years and follow-up was 10,328 person-years. Conditions that do not induce osteoporosis generally occurred in these patients at a rate comparable to that in the control groups. The incidence of osteomalacia was low and comparable between patients taking cyclic etidronate and controls with osteoporosis. No medically significant increases in frequency were observed among patients taking cyclic etidronate for a broad group of diseases that may potentially be induced by exposure to the drug. These data support the favorable risk:benefit ratio of cyclic etidronate.
TL;DR: A number of preventive and therapeutic strategies are now available to retard bone loss and reduce the incidence of fracture, and the most cost-effective use of these pharmacological agents has become a focus for health economic research in osteoporosis.
Abstract: Osteoporosis constitutes a major public health problem through its association with fractures at several skeletal sites, most notably the hip, wrist and vertebra. The lifetime risk of hip fracture in White women and men in the UK from age 50 years is 14% and 3%, respectively. These fractures account for considerable mortality, morbidity and healthcare expenditure. Methods of measuring bone density provide useful clinical tools for the assessment of future fracture risk, and a number of preventive and therapeutic strategies are now available to retard bone loss and reduce the incidence of fracture. The most cost-effective use of these pharmacological agents has become a focus for health economic research in osteoporosis. Such research will better define the setting in which various approaches to prevention and treatment are most effective.
TL;DR: Vision impairment was found to be associated with refractive error, cataract, age-related maculopathy, and elevated macular threshold, and increasing age remained a significant predictor of poorer visual acuity.
Abstract: We investigated the relationship between visual acuity, early growth and eye disease in a retrospective cohort study of 700 individuals in North Hertfordshire. Records of birth weight and weight at one year were used to determine early growth. We measured visual acuity and age-related eye diseases using standard instruments in those same individuals (now aged 63 to 73). Visual acuity below the legal threshold for driving in the UK (6/11 or poorer) was present in 13% of subjects. There was no clear association between birth weight or weight at one year and visual acuity. Vision impairment was found to be associated with refractive error, cataract, age-related maculopathy, and elevated macular threshold. After controlling for the effects of eye disease, increasing age remained a significant predictor of poorer visual acuity.
TL;DR: No evidence was found to support fetal or infant growth as being important factors for the subsequent development of raised intraocular pressure and a significant inverse relation was found between systolic blood pressure and birth weight.
Abstract: Aim—To determine whether fetal and infant growth, as assessed by weight at birth and weight at 1 year, are related to intraocular pressure. Methods—717 men and women born in Hertfordshire between 1920 and 1930, for whom records of birth weight and weight at 1 year were available, were examined. Visual fields were assessed using the Takagi central 25 degree 75 point static threshold screening program. Tonometry was performed using the Perkin’s tonometer. The disc was assessed by direct ophthalmoscopy through dilated pupils. Results—A significant inverse relation was found between systolic blood pressure and birth weight. However, no association was found between birth weight or weight at 1 year and intraocular pressure, cup/ disc ratio, or visual field defects. Conclusions—There was no evidence to support fetal or infant growth as being important factors for the subsequent development of raised intraocular pressure. (Br J Ophthalmol 1998;82:1125‐1130)
Journal Article•
Journal Article•
TL;DR: The Bone and Joint Decade 2000-2010 for prevention of musculo-skeletal disorders: Lund, Sweden, April 17-18, 1998, pp. 21-27.
Abstract: (1998). Osteoporosis 2000–2010. Acta Orthopaedica Scandinavica: Vol. 69, The Bone and Joint Decade 2000–2010 for prevention of musculo-skeletal disorders: Lund, Sweden, April 17–18, 1998, pp. 21-27.