Background: Hand osteoarthritis (HOA) is a highly prevalent rheumatic disease that predominates in females and causes pain and loss of functional capacity. Obesity and metabolic syndrome have been... Show moreBackground: Hand osteoarthritis (HOA) is a highly prevalent rheumatic disease that predominates in females and causes pain and loss of functional capacity. Obesity and metabolic syndrome have been previously suggested to associate with the severity of HOA, but clarity on these associations is yet to be achieved.Objective: Test the association between obesity and other components of the metabolic syndrome and disability in women with hand osteoarthritis (HOA).Design: Individuals from EpiReumaPt epidemiological community-based study (2011-2013) are representative of the Portuguese population. Women with diagnosis of primary HOA were included.Primary outcome: hand functional status, assessed by Cochin questionnaire.Secondary outcomes: hand pain, assessed by visual analogue scale and tender hand joint count (THJ).Explanatory variables: obesity, diabetes mellitus, arterial hypertension and hypercholesterolemia. Possible associations between obesity and the other components of metabolic syndrome with Cochin score, hand pain and THJ were tested in a multivariable linear regression model.Potential confounders considered: age, education level and countrywide distribution.Results: 473 women with primary HOA were included. Forty percent were overweight and 29% obese. Ninety-three (19.8%) participants had diabetes, 261 (55.8%) reported hypertension and 261 (55.9%) hypercholesterolemia. Mean Cochin score was 15.5 +/- 14.8, mean pain VAS was 4.7 +/- 2.6 and mean THJ 1.4 +/- 3. In the multivariable analysis, obesity (beta 4.6 CI 0.7;8.5) and diabetes (beta 4.0 CI 0.4;7.6) were found to significantly associate with HOA functional disability. In addition, diabetes, but not obesity, associated with hand pain. There was no association between obesity or diabetes with THJ.Conclusion: In a Portuguese female population with primary HOA, obesity and diabetes mellitus independently associated with a worse hand functional status. These data add to evidence suggesting a role of metabolic factors in the severity of HOA. Show less
Focussing on individuals and institutions, the economic and social condition of the people of Fort Cochin between 1781 and 1830 has been studied. This study of the Dutch East India Company's (VOC)... Show moreFocussing on individuals and institutions, the economic and social condition of the people of Fort Cochin between 1781 and 1830 has been studied. This study of the Dutch East India Company's (VOC) establishment on the south west coast of India provides a detailed research into the functioning of the company and its personnel there. To begin the company's presence on the coast around the year 1750, after it had been defeated by the raja of Travancore, on whom it was dependant for purchasing pepper, is summarized. It places the VOC's Malabar Command on the larger web of the VOC network in Asia. The VOC strove hard to maintain its pepper monopoly on the coast, but non-VOC trade in pepper contined. Three consecutive commanders between 1751 and 1764 constantly strove to expand the company's territorial possesions on the coast resulting in a metamorphosis in the command's functioning. The components of the Fort Cochinsociety and the relations among the different communities that made up the social world of Fort Cochin receive attention in the book. Starting with the company men and analysing the recruitment pattern of the VOC in Malabar Command, one is faced with rather startling facts. The majority of the VOC personnel in the mercantile sections were locally recruited. European women were a rare sight in Fort Cochin. The European company men married mestizo women and through them became rooted in Cochin. Their sons joined the Dutch company thereby forming 'VOC-family'. While Dutch men were securing their future on the Malabar Coast, the EIC was expanding in India. During the 1780-1784 Anglo-Dutch war, many Dutch settlements were lost to the British. Fort Cochin evaded the fate as the EIC was yet to conquer Mysore, a formidable power in the south. When in 1795, the British forces conquered Fort Cochin, the servants of the Dutch company were forced to decide their future course of action. The social and economic condition of the people of Fort Cochin under the British administration has been analysed and lives of former VOC servants and their families after the transition has been portrayed Show less
