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2. Increased risk of lower limb osteoarthritis among former professional soccer (football) players.

Author

Russell, E R, Spencer, S J, Atherton, C M, Lyall, D M, Mackay, D F, Stewart, K, MacLean, J A, Pell, J P, and Stewart, W

Subjects
OSTEOARTHRITIS, MALE athletes, ARTHROPLASTY, ELECTRONIC health records, PROFESSIONAL athletes, SOCCER players, MUSCULOSKELETAL system diseases
Abstract

Background Soccer is a high-speed contact sport with risk of injury. Despite long-standing concern, evidence to date remains inconsistent as to the association between playing professional-level soccer and lifelong musculoskeletal consequences. Aims The objectives were to assess risk of osteoarthritis in former professional soccer players compared to matched general population controls, and subsequently assess associated musculoskeletal disorders which may contribute to, or result from, osteoarthritis—specifically meniscal injury and joint replacement. Methods We conducted a retrospective cohort study using national electronic health records (EHRs) on a cohort of 7676 former professional soccer players aged 40 or over at recruitment, matched on year of birth, sex (all male) and socio-economic status with 23 028 general population controls. Outcomes of interest were obtained by utilizing individual-level record linkage to EHRs from general hospital inpatient and day-case admissions. Results Compared to controls, former soccer players showed a greater risk of hospital admission for osteoarthritis (hazard ratio [HR] 3.01; 95% confidence interval [CI] 2.80–3.25; P  < 0.001). This increased risk appeared age dependant, normalizing over age 80 years and reflective of increased risk of lower limb osteoarthritis. Further, risk of hospital admissions for meniscal injury (HR 2.73; 95% CI 2.42–3.08; P  < 0.001) and joint replacement (HR 2.82; 95% CI 2.23–3.57; P  < 0.001) were greater among former soccer players. Conclusions We report an increased risk of lower limb osteoarthritis in former soccer players when compared with matched population controls. The results of this research add data in support of lower limb osteoarthritis among former soccer players representing a potential industrial injury. [ABSTRACT FROM AUTHOR]

Published
2023
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4. Primary major amputation in the management of chronic critical lower limb ischaemia

Author

Pell, J. P.

Subjects
617
Abstract

A study was undertaken to derive specific indications for surgery in patients with chronic critical lower limb ischaemia, and to determine the extent to which practice throughout Scotland conformed with these indications. Consensus methods provide an explicit and systematic method of deriving indications from published evidence and clinical experience. A review was undertaken of the published literature on outcomes following arterial reconstruction and primary major amputation, in terms of life-expectancy, limb-salvage, healing, reoperation, social and physical functioning, quality of life and cost-effectiveness. Thereafter, consensus indications were agreed using a modified Delphi method in which a postal questionnaire was completed by 29 vascular surgeons on two occasions, with feedback between the rounds. This method has been used previously to develop indications for coronary artery bypass grafting and carotid endarterectomy. Use of a postal questionnaire avoids physical constraints on the selection of panellists, whilst also ensuring that undue weight is not given to the most dominant or vocal participants. Respondents indicated the appropriateness of arterial reconstruction and primary major amputation for 218 case-scenarios comprising all possible combinations of clinical and angiographic findings. Agreement was reached on 31 appropriate indications for major amputation and 65 for arterial reconstruction. The consensus indications were then compared with actual clinical practice in a stratified random sample of ten Scottish hospitals. Four hundred primary major amputations and arterial reconstruction operations were reviewed retrospectively. The clinical findings for 7 (4%) arterial reconstruction operations and 48 (24%) major amputations did not conform to the indications agreed by the Delphi method. The proportion of operations conforming to the agreed indications differed significantly by size of unit (p<0.05). The study demonstrated that consensus could be reached on indications for surgery in patients with chronic critical lower limb ischaemia. The proportion of procedures conforming to the indications varied between units, suggesting that differences in clinical decision-making were apparent.

Published
1997

12. Genome-wide analysis of over 106000 individuals identifies 9 neuroticism-associated loci

Author

Smith, D J, Escott-Price, V, Davies, G, Bailey, M ES, Colodro-Conde, L, Ward, J, Vedernikov, A, Marioni, R, Cullen, B, Lyall, D, Hagenaars, S P, Liewald, D CM, Luciano, M, Gale, C R, Ritchie, S J, Hayward, C, Nicholl, B, Bulik-Sullivan, B, Adams, M, Couvy-Duchesne, B, Graham, N, Mackay, D, Evans, J, Smith, B H, Porteous, D J, Medland, S E, Martin, N G, Holmans, P, McIntosh, A M, Pell, J P, Deary, I J, and OʼDonovan, M C

Published
2016
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14. Dementia in Scottish military veterans: early evidence from a retrospective cohort study.

Author

Bergman, B. P., Mackay, D. F., and Pell, J. P.

Subjects
DEMENTIA risk factors, CONFIDENCE intervals, RETROSPECTIVE studies, POST-traumatic stress disorder, RISK assessment, PSYCHOLOGY of veterans, SEX distribution, SCOTS, RESEARCH funding, DESCRIPTIVE statistics, ODDS ratio, LONGITUDINAL method, PROPORTIONAL hazards models, MIDDLE age, OLD age
Abstract

Background: Few studies have examined whether UK military veterans are at an increased risk of dementia. We explored the risk of dementia in Scottish military veterans aged up to 73 years in comparison with people who have never served. Methods: Retrospective cohort study of 78 000 veterans and 253 000 people with no record of service, matched for age, sex and area of residence, with up to 37 years follow-up, using Cox proportional hazard analysis to compare risk of dementia in veterans and non-veterans, overall and by subgroup. Results: Dementia was recorded in 0.2% of both veterans and non-veterans overall, Cox proportional hazard ratio 0.98, 95% confidence interval (CI) 0.82–1.19, p = 0.879 (landmark age: 50 years), with no difference for men but increased risk in veteran women and Early Service Leavers. Post-traumatic stress disorder (PTSD) was associated with a higher risk of dementia in both veterans and non-veterans, although possibly to a lesser degree in veterans. A history of mood disorder was strongly associated with developing dementia, greater in veterans than in non-veterans, odds ratio 1.54, 95% CI 1.01–2.35, p = 0.045. Conclusions: There was no evidence to suggest that military service increased the risk of dementia, although this may change as the cohort ages. The well-documented association with PTSD shows no evidence of being stronger in veterans; by contrast, the association of mood disorder with dementia is much stronger in veterans. Healthcare providers should carefully assess the cognitive status of older veterans presenting with depressive illness in order to identify early dementia and ensure optimum management. [ABSTRACT FROM AUTHOR]

Published
2023
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18. Hip and knee replacement as a proxy measure for lower limb osteoarthritis in Scottish military veterans

Author

Bergman, Beverly P., Mackay, D. F., and Pell, J. P.

Subjects
health care economics and organizations, humanities
Abstract

Introduction: Physical activity is an important component of military training. Although injuries and musculoskeletal disorders are the most common cause of medical retirement from the Armed Forces, the long-term risk of lower limb osteoarthritis in veterans is unknown. We used data on hip and knee replacement in Scottish military veterans as a proxy measure.\ud \ud Methods: Retrospective cohort study of 78 000 veterans born between 1945 and 1995 and a comparison group of 253 000 non-veterans, matched for age, sex and area of residence, followed up for up to 37 years, using survival analysis to examine the risk of hip and knee replacement.\ud \ud Results: Veterans were significantly less likely to undergo hip replacement than non-veterans, Cox proportional HR 0.87, 95% CI 0.80 to 0.95, p

Published
2021

39. Erratum: Genome-wide analysis of over 106 000 individuals identifies 9 neuroticism-associated loci

Author

Smith, D J, Escott-Price, V, Davies, G, Bailey, M E S, Colodro-Conde, L, Ward, J, Vedernikov, A, Marioni, R, Cullen, B, Lyall, D, Hagenaars, S P, Liewald, D C M, Luciano, M, Gale, C R, Ritchie, S J, Hayward, C, Nicholl, B, Bulik-Sullivan, B, Adams, M, Couvy-Duchesne, B, Graham, N, Mackay, D, Evans, J, Smith, B H, Porteous, D J, Medland, S E, Martin, N G, Holmans, P, McIntosh, A M, Pell, J P, Deary, I J, and O'Donovan, M C

Published
2016
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