Psychosocial factors associated with disability in patients with non-specific chronic low back pain: A cross-sectional study / Factores psicosociales asociados a la discapacidad en pacientes con lumbalgia crónica inespecífica: un estudio transversal

Introduction and objectives: Chronic low back pain is the main cause of disability worldwide, generating high costs for society. To evaluate the prevalence of disability in patients with non-specific chronic low back pain and associated factors, including the impacts of low back pain and psychosocial factors linked to kinesiophobia, catastrophism, anxiety, and depression. Patients: A cross-sectional study was carried out with 108 adult individuals who had non-specific chronic low back pain. The patients answered previously validated questionnaires, namely the Brief Pain Inventory, the Roland-Morris Disability Questionnaire, the Pain Catastrophizing Scale, the Tampa Kinesiophobia Scale, and the Hospital Anxiety and Depression Scale. Results: The prevalence of disability observed was 65.7%, with the mean disability score being 15.7±5.3 points in the Roland-Morris Disability Questionnaire. Although pain intensity and other domains of the Brief Pain Inventory, like anxiety, depression, and severe kinesiophobia were significant in the bivariate analyses, they were not associated with disability in the multivariate analysis. Only catastrophic thoughts (prevalence ratio [PR]=1.19; 95% confidence interval [CI]: 1.07–1.32), and the ‘walking’ domain (PR=1.08; 95% CI: 1.03–1.14) remained statistically associated with disability. Conclusion: Pain catastrophization and impact on gait were associated with disability in individuals with non-specific chronic low back pain. Motor control thoughts and behaviors during functional activities were considered to be relevant aspects for the better assessment and treatment of these patients.(AU)

Introducción y objetivos: La lumbalgia crónica es la principal causa de discapacidad a nivel mundial, generando altos costos para la sociedad. Evaluar la prevalencia de discapacidad en pacientes con dolor lumbar crónico inespecífico y factores asociados, incluidos los impactos del dolor lumbar y factores psicosociales relacionados con la kinesiofobia, el catastrofismo, la ansiedad y la depresión. Pacientes: Se realizó un estudio transversal con 108 individuos adultos que presentaban lumbalgia crónica inespecífica. Los pacientes respondieron cuestionarios previamente validados, a saber, el Inventario Breve de Dolor, el Cuestionario de Discapacidad de Roland-Morris, la Escala de Catastrofización del Dolor, la Escala de Kinesiofobia de Tampa y la Escala de Ansiedad y Depresión Hospitalaria. Resultados: La prevalencia de discapacidad observada fue del 65,7%, siendo la puntuación media de discapacidad de 15,7±5,3 puntos en el Cuestionario de discapacidad de Roland-Morris. Aunque la intensidad del dolor y otros dominios del Inventario Breve de Dolor, como la ansiedad, la depresión y la kinesiofobia grave, fueron significativos en los análisis bivariados, no se asociaron con la discapacidad en el análisis multivariado. Sólo los pensamientos catastróficos (razón de prevalencia [PR]=1,19; intervalo de confianza [IC] del 95%: 1,07-1,32) y el dominio “caminar” (RP=1,08; IC del 95%: 1,03-1,14) permanecieron estadísticamente asociados con la discapacidad. Conclusión: La catastrofización del dolor y el impacto en la marcha se asociaron con discapacidad en personas con dolor lumbar crónico inespecífico. Los pensamientos y conductas de control motor durante las actividades funcionales se consideraron aspectos relevantes para una mejor valoración y tratamiento de estos pacientes.(AU)

Psychosocial factors associated with disability in patients with non-specific chronic low back pain: A cross-sectional study.

INTRODUCTION AND OBJECTIVES: Chronic low back pain is the main cause of disability worldwide, generating high costs for society. To evaluate the prevalence of disability in patients with non-specific chronic low back pain and associated factors, including the impacts of low back pain and psychosocial factors linked to kinesiophobia, catastrophism, anxiety, and depression. PATIENTS: A cross-sectional study was carried out with 108 adult individuals who had non-specific chronic low back pain. The patients answered previously validated questionnaires, namely the Brief Pain Inventory, the Roland-Morris Disability Questionnaire, the Pain Catastrophizing Scale, the Tampa Kinesiophobia Scale, and the Hospital Anxiety and Depression Scale. RESULTS: The prevalence of disability observed was 65.7%, with the mean disability score being 15.7±5.3 points in the Roland-Morris Disability Questionnaire. Although pain intensity and other domains of the Brief Pain Inventory, like anxiety, depression, and severe kinesiophobia were significant in the bivariate analyses, they were not associated with disability in the multivariate analysis. Only catastrophic thoughts (prevalence ratio [PR]=1.19; 95% confidence interval [CI]: 1.07-1.32), and the 'walking' domain (PR=1.08; 95% CI: 1.03-1.14) remained statistically associated with disability. CONCLUSION: Pain catastrophization and impact on gait were associated with disability in individuals with non-specific chronic low back pain. Motor control thoughts and behaviors during functional activities were considered to be relevant aspects for the better assessment and treatment of these patients.

Alteration of the angle of the coronoid process in prognathism.

Muscles and bones may dynamically affect the functions of each other, resulting in changes in the activity of the muscle and/or morphological change in the bones. However, alterations of the morphology of the coronoid process have not been documented in relation to the temporal muscle between the mandible and the cranium. Angles of the coronoid process to the line through the right and the left frontotemporale were measured on posteroanterior (PA) cephalograms in patients with normal occlusions and Class II, division 1 malocclusions, and those with true skeletal Class III malocclusions. Standard deviation of the angle of the coronoid process in patients with Class III malocclusions was greater than those subjects with normal occlusion or Class II, division 1 malocclusions. Differences of angles between the right and the left coronoid process in each patient of either sex were significantly large in true skeletal Class III malocclusions (both P < 0.001). Large variation of angle of the coronoid process was related to prognathism, and this effect may represent adaptation of temporal muscle function to a variety of alterations in mandibular morphology.

Multidrug resistance gene 1 expression in salivary gland adenocarcinomas and oral squamous-cell carcinomas.

In combined chemotherapy for head-and-neck cancer (HNC), salivary gland-cell adenocarcinoma (SGA) shows insufficient clinical outcome, and it has been suggested that the sensitivity and/or the mechanism of resistance to anti-cancer drugs are different between SGA and oral squamous-cell carcinoma (SCC). The aim of our study was to clarify whether P-glycoprotein (P-gp) expression is associated with multidrug resistance (MDR) in HNC and the difference in the process of its development between SGA and SCC. In immunohistochemical analysis, P-gp expression was found in the ductal cells of salivary glands but not in oral mucosal epithelium. In cancer tissues, a few SCC cells in 12 of 37 and most cells in all SGAs expressed P-gp. The intensive P-gp expression was significantly found in SGA compared with SCC. In an in vivo chemotherapeutic model using tumor-bearing nude mice, P-gp expression in counterparts was observed in only a few cells of the HSY line, while no P-gp expression was observed in Hepd cells. However, P-gp expression was developed in both HSY and Hepd cell lines after vincristine (VCR) treatment. RT-PCR showed that the mean ratios of mdr1 mRNA expression levels in HSY clones were 3.7-fold higher than those in Hepd clones after VCR treatment, while each cell line exhibited both induction and activated production of P-gp. These results suggest that P-gp-related MDR in SGA is an inherent phenotype caused by both high levels of P-gp induction and activated P-gp production during VCR treatment, while that in SCC is an acquired phenotype chiefly caused by induction of P-gp.

Lesöes linfáticas de membros inferiores pós-cirurgia de varizes: análise por linfocintilografia / ver

O objetivo deste estudo é avaliar as lesöes linfáticas nos membros inferiores empacientes submetidos à cirurgia de varizes. Foi realizada linfocintilografia com trissulfito de antimônio marcado com Tecnécio (99m) em 20 membros no primeiro dia de pós-operatório. O extravasamento de contraste foi interpretado como evidência de lesão dos canais linfáticos. Nove membros tiveram a excisão simples de veias varicosas; onze pacientes tiveram além das exicisöes das veias varicosas, também safenectomia parcial ou total da veia sefena magna. Oito dos vinte membros estudados (40 'por cento') apresentaram lesöes à linfocintilografia. Evidências de lesöes linfáticas foram encontradas em 7 dos 11 membros safenectomizados (63,3 'por cento') e somente um dos 9 membros no grupo de excisão simples de veias varicosas (11,1 'por cento'). A diferença entre os grupos foi estatisticamente significante (p<0,05; teste de Fisher). Os autores concluem que a lesão linfática é comum em cirurgia de varizes, especialmente quando a safenectomia magna é realizada.