RESUMO
OBJECTIVE: This study examined the prevalence of falls among older adults with generalized and localized osteoarthritis (OA) and identified the association between falls and both chronic diseases and medications. PATIENTS AND METHODS: A retrospective design using the Healthcare Enterprise Repository for Ontological Narration (HERON) database was used. A cohort of 760 patients aged ≥65 years with at least two diagnosis codes for either localized or generalized OA were included. The extracted data included demographics (age, sex, and race), body mass index (BMI), fall history, comorbid health conditions (i.e., type 2 diabetes, hypertension, dyslipidemia, neuropathy, cardiovascular diseases, depression, anxiety, and sleep disorders), and medications [i.e., pain medication (opioids, non-opioids), antidiabetics (insulin or hypoglycemic), antihypertensives, antilipemic, and antidepressants]. RESULTS: The prevalence rates of falls and recurrent falls were 27.77% and 9.88%, respectively. Individuals with generalized OA had a higher prevalence of falls (33.8%) than those with localized OA (24.2%). Multivariable logistic regression analysis showed that individuals with OA who had hypertension [odds ratio (OR):1.86, 95% CI, (1.20, 2.89), p=0.006] and used antidepressants [OR: 1.72, 95% CI, (1.04, 2.84), p=0.035] were more likely to have a fall. Individuals with OA who had hypertension [OR: 2.69, 95% CI, (1.30, 5.60), p=0.008], neuropathy [OR: 4.95, 95% CI, (2.95, 11.68), p<0.001], and insulin [OR: 2.85, 95% CI, (1.12, 7.22), p=0.035] were more likely to have a recurrent fall (two or more falls). CONCLUSIONS: Falls are common in individuals with generalized OA. Comorbid health conditions, including hypertension and neuropathy, need to be considered in the screening of the risk of fall. Fall risk needs to be considered when discussing medication prescriptions, especially antidepressants and insulin.
Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Insulinas , Osteoartrite , Humanos , Idoso , Acidentes por Quedas , Estudos Retrospectivos , Fatores de Risco , Osteoartrite/tratamento farmacológico , Osteoartrite/epidemiologia , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Antidepressivos , Doença CrônicaRESUMO
OBJECTIVE: Cell phones are carried by 79% of people between 18 and 44 years of age for nearly the entire day. Smartphone users spend an average of three hours/per day on their devices, whereas heavy smartphone users spend 8-10 hours/per day on their devices. Text neck is a dangerous disorder that can accelerate the degeneration of the spine. This study aimed to investigate the efficacy of neck stabilization training vs. Contrology or Pilates training in individuals with Text Neck Syndrome. PATIENTS AND METHODS: Participants (n=75) with a history of recurrent neck pain in the previous four months, having moderate pain (at least 4/10 on the numeric pain rating scale, NPRS), and constantly using mobile phones (>4 hours/day) were randomly allocated to one of three groups: a control group (neck isometric training) and two intervention groups (neck stabilization training and Contrology). They were assessed for craniovertebral angle (CVA), NPRS, and neck disability index (NDI) at baseline and at 4 weeks post-intervention. RESULTS: There was a significant difference in the CVA, NPRS, and NDI among individuals with Text Neck Syndrome following intervention as compared to the control. Both the neck stabilization and Contrology training increased CVA and reduced neck pain and neck disability in individuals with Text Neck Syndrome. The two intervention groups showed similar effects in all the clinical outcome measures, suggesting almost equivalent effectiveness in the individuals with Text Neck Syndrome. CONCLUSIONS: Neck stabilization seems to work better than Contrology training when it comes to increasing the craniovertebral angle, reducing pain intensity, and making it easier for individuals with Text Neck Syndrome to move their necks.
Assuntos
Telefone Celular , Cervicalgia , Humanos , Cervicalgia/terapia , Pescoço , Smartphone , Coluna VertebralRESUMO
The p75 neurotrophin receptor (p75NTR, a.k.a. CD271), a transmembrane glycoprotein and a member of the tumor necrosis family (TNF) of receptors, was originally identified as a nerve growth factor receptor in the mid-1980s. While p75NTR is recognized to have important roles during neural development, its presence in both neural and nonneural tissues clearly supports the potential to mediate a broad range of functions depending on cellular context. Using an unbiased in vivo selection paradigm for genes underlying the invasive behavior of glioma, a critical characteristic that contributes to poor clinical outcome for glioma patients, we identified p75NTR as a central regulator of glioma invasion. Herein we review the expanding role that p75NTR plays in glioma progression with an emphasis on how p75NTR may contribute to the treatment refractory nature of glioma. Based on the observation that p75NTR is expressed and functional in two critical glioma disease reservoirs, namely, the highly infiltrative cells that evade surgical resection, and the radiation- and chemotherapy-resistant brain tumor-initiating cells (also referred to as brain tumor stem cells), we propose that p75NTR and its myriad of downstream signaling effectors represent rationale therapeutic targets for this devastating disease. Lastly, we provide the provocative hypothesis that, in addition to the well-documented cell autonomous signaling functions, the neurotrophins, and their respective receptors, contribute in a cell nonautonomous manner to drive the complex cellular and molecular composition of the brain tumor microenvironment, an environment that fuels tumorigenesis.