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1.
BMC Infect Dis ; 19(1): 1004, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775718

RESUMO

BACKGROUND: Chikungunya virus (CHIKV) is a widespread mosquito-borne virus representing a serious challenge to public health. The largest outbreak in the Middle-East was recorded in 2016-2017 in Pakistan. Sistan and Baluchistan Province of Iran shares a wide border with Pakistan; accordingly, introduction of CHIKV from Pakistan to Iran seems to be probable. The current study is aimed at investigating CHIKV infection in Sistan and Baluchistan Province. METHODS: Between April 2017 and June 2018, a total of 159 serum samples of CHIK suspected cases from 10 cities of Sistan and Baluchistan Province were tested by molecular and serological assays. Samples obtained up to 4 days after onset of illness were tested by real time PCR (n = 8). Samples collected 5-10 days after disease onset were subjected to ELISA, as well as real time PCR tests (n = 72). Samples obtained after the 10th day of disease onset were tested by only ELISA (n = 79). Phylogenetic analysis of real time PCR positive samples was carried out by sequencing of a 1014-bp region of Envelope 1 gene (E1 gene). Chi-square and independent t tests were used to evaluate the association between variables and CHIKV infection. RESULTS: In total, 40 (25.1%) out of 159 samples tested positive either by real time PCR or ELISA tests.Out of 151 samples serologically analyzed, 19 (12.6%) and 28 (18.6%) cases were positive for anti-CHIKV IgM and anti-CHIKV IgG antibodies, respectively. Of 80 samples tested by real time PCR, CHIKV RNA was detected in 11 (13.7%) sera, all of them had recent travel history to Pakistan. Additionally, phylogenetic analysis of 5 samples indicated their similarity with recent isolates of Pakistan outbreak 2016-2017 belonging to Indian Ocean sub-lineage of ECSA genotype. A significant correlation between abroad travel history and CHIKV infection was observed (P < 0.001). The most common clinical symptoms included fever, arthralgia/arthritis, myalgia, headache, and chill. CONCLUSIONS: These results present substantial evidence of CHIKV introduction to Iran from Pakistan and emphasize the need for the enhancement of surveillance system and preventive measures.


Assuntos
Febre de Chikungunya/epidemiologia , Vírus Chikungunya/genética , Vírus Chikungunya/imunologia , Doenças Transmissíveis Importadas/virologia , Surtos de Doenças , Adolescente , Adulto , Animais , Anticorpos Antivirais/sangue , Artralgia/epidemiologia , Vírus Chikungunya/isolamento & purificação , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Febre/epidemiologia , Genótipo , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Mosquitos Vetores/virologia , Paquistão/epidemiologia , Filogenia , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Viagem , Proteínas do Envelope Viral/genética , Adulto Jovem
2.
Pan Afr Med J ; 33: 169, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31565130

RESUMO

Introduction: hepatitis C virus (HCV) has several extra-hepatic manifestations including cryoglubulinemia. Cryoglobulinemia is defined as the abnormal presence in the blood of one or several proteins (cryoglobulins) that can precipitate at low temperatures. Method: We conducted a cross-sectional analytical study in the Laboratory of Biology and in the Unit of Hepatology of the General Hospital in Douala (HGD) over a period of 6 months. All patients agreeing to participate to the study and with anti-hepatitis-C antibodies under treatment or not were enrolled. Cryoglobulins were detected using biuret method and the classification was performed using Brouet immunoelectrophoresis. A multivariate analysis was conducted, confounding factors such as age, sex and the length of time after Hepatitis C Virus screening were adjusted. Results: The study enrolled 116 patients. The average age of patients was 58.47±9.95 years. Male sex accounted for 50.86% of cases. Arthralgia was found in 69.80% of cases. Cryoglobulin was found in 63.80% of patients. After adjustment, female sex (OR =2.18; CI 95% [0,97-4,90]; p= 0.059), asthenia alone (OR =2.45;CI 95% [1,04-5,80]; p= 0.041), asthenia combined with arthralgia (OR =2.84;CI 95% [1,13-7, 10]; p= 0.026) and the presence of HCV RNA (OR =2.84;CI 95% [1,13-7,10]; p= 0.028) were factors independently associated with the presence of cryoglobulin. Conclusion: The prevalence of cryoglobubin is high in patients with anti-hepatitis-C antibodies at the HGD. Simple biological methods are used to detect it. Cryoglobulin test in patients with HCV is essential in resource-limited countries.


Assuntos
Crioglobulinemia/epidemiologia , Crioglobulinas/análise , Anticorpos Anti-Hepatite C/sangue , Hepatite C/complicações , Idoso , Artralgia/epidemiologia , Artralgia/etiologia , Camarões , Estudos Transversais , Crioglobulinemia/virologia , Feminino , Humanos , Imunoeletroforese , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , RNA Viral/análise
3.
Clin Exp Rheumatol ; 37 Suppl 120(5): 3-6, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621562

RESUMO

Osteoarthritis (OA) is the most common form of arthritis, affecting 1 in 3 people over age 65 and women more so than men. The prevalence of OA is rising due, in part, to the increasing prevalence of OA risk factors, including obesity, physical inactivity, and joint injury. OA-related joint pain causes functional limitations, poor sleep, fatigue, depressed mood and loss of independence. Compared to age and sex-matched peers, OA patients incur higher out of pocket health-related expenditures and substantial costs due to lost productivity. Most people with OA (59-87%) have at least one other chronic condition, especially cardiometabolic conditions. Symptomatic OA may impair the ability of people with cardiometabolic conditions to exercise and lose weight, resulting in increased risk for poor outcomes. People with OA and other chonic conditions are less likely to receive a diagnosis or recommended treatment. Further, in these individuals the most effective and safest treatment is physical activity/exercise coupled with self-management strategies, which is only moderately effective. Given the already high, and growing, burden of OA, enhanced effort is required to identify better - more effective and safe - treatments for the majority of people with OA who are living with other chronic conditions.


Assuntos
Gastos em Saúde , Osteoartrite , Artralgia/epidemiologia , Doença Crônica , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Osteoartrite/economia , Osteoartrite/epidemiologia , Prevalência
4.
BMC Musculoskelet Disord ; 20(1): 402, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31481049

RESUMO

BACKGROUND: The lower limb joints, including hip and knee, are the most commonly involved joints in haemophilic arthropathy. With a higher risk of transfusion, total hip and knee arthroplasty (THA and TKA) are still the first choice after failure of conservative treatment. In the present study, we aimed to analyze clinical outcomes and complications rate after total joint arthroplasty of the lower limbs using tranexamic acid (TXA) or not. METHODS: Thirty-four patients with haemophilia A undergoing 24 TKA and 18 THA were evaluated in this retrospective study (No. 201302009). Based on using TXA or not, they were divided into either TXA (12 knees and 10 hips) or Non-TXA groups (12 knees and 8 hips). Total blood loss, intraoperative blood loss, total amount of FVIII usage, range of motion, inflammatory biomarkers, joint function, pain status, complication rate and patient satisfaction were assessed and compared at a mean follow-up of 68 months. RESULTS: Usage of TXA can decrease not only the perioperative blood loss (p = 0.001), transfusion rate (p = 0.017) and supplemental amount of FVIII (p < 0.001) but also swelling ratio, surgical joint pain. Moreover, compared with non-TXA group, the patients in TXA group had a lower level of inflammatory biomarkers and better joint function. CONCLUSION: The hemophiliacs treated with TXA had less perioperative blood loss, hidden blood loss, transfusion rate, a lower ratio of postoperative knee swelling, less postoperative joint pain, lower levels of inflammatory biomarkers and better joint function. Further studies need performing to assess the long-term effects of TXA in these patients.


Assuntos
Antifibrinolíticos/administração & dosagem , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Hemofilia A/complicações , Ácido Tranexâmico/administração & dosagem , Administração Intravenosa , Adulto , Antifibrinolíticos/efeitos adversos , Artralgia/epidemiologia , Artralgia/etiologia , Artralgia/prevenção & controle , Perda Sanguínea Cirúrgica/prevenção & controle , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Transfusão de Sangue/estatística & dados numéricos , Fator VIII/administração & dosagem , Feminino , Hemofilia A/diagnóstico , Hemofilia A/tratamento farmacológico , Articulação do Quadril/fisiologia , Articulação do Quadril/cirurgia , Humanos , Articulação do Joelho/fisiologia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/fisiopatologia , Osteoartrite do Quadril/cirurgia , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/cirurgia , Dor Pós-Operatória/epidemiologia , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Hemorragia Pós-Operatória/epidemiologia , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/prevenção & controle , Cuidados Pré-Operatórios/métodos , Estudos Prospectivos , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Estudos Retrospectivos , Ácido Tranexâmico/efeitos adversos , Resultado do Tratamento
5.
Ulus Travma Acil Cerrahi Derg ; 25(5): 514-519, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31475328

RESUMO

BACKGROUND: High-energy traumas are common occurrences worldwide. The rate of overlooked neck fractures in polytrauma cases is also high. Previous studies have shown that articular hip pathologies, particularly neck fractures, are associated with fractures of the femoral shaft. This study sets out to describe cases of intra-articular hip pathology following traumatic femoral shaft fracture. Thus, the present study aims to investigate the relationship between ipsilateral hip pain and femoral shaft fractures. METHODS: Patients who were diagnosed with a fracture of the femur shaft and who were operated on (intramedullary fixation or plate) were included in this study. Patients with pathologic fractures, femoral neck fractures, femoral intertrochanteric fractures, or pelvic fractures were excluded. Patients with at least six months of follow-up and who were capable of independent walking without support were grouped according to AO/OTA fracture classification. Patients were questioned for deep anterior groin pain, and physical examination tests and hip imaging (X-ray and MR arthrography) were performed by calling patients with the indicated complaints. RESULTS: The presence of labral tears were noted in two patients. The incidence of osseous bump of the femoral neck identified by MR arthrography (MRA) was found in three of 16 hips. Assessment of the presence of gluteal tendinosis or tear and herniation pit identified three of 16 hips. The presence of osteophytes was noted in one patient. MRA identified three of 16 hips with more than one type of intra-articular pathology. Two patients with an osseous bump of the femoral neck were also diagnosed with additional hip pathology as herniation pit. CONCLUSION: Anterior groin pain in patients with a history of femoral shaft fracture is not always related to implants. Orthopedic surgeons should become suspicious in cases of intra-articular hip pathology in patients who have persistent hip pain after severe lower extremity trauma.


Assuntos
Artralgia , Fraturas do Colo Femoral , Lesões do Quadril , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artralgia/complicações , Artralgia/epidemiologia , Feminino , Fraturas do Colo Femoral/complicações , Fraturas do Colo Femoral/epidemiologia , Lesões do Quadril/complicações , Lesões do Quadril/epidemiologia , Articulação do Quadril/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo , Estudos Retrospectivos , Adulto Jovem
6.
Lupus ; 28(11): 1360-1367, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31382851

RESUMO

OBJECTIVE: The objective of this article is to investigate the distinct features, morbidity and mortality of systemic lupus erythematosus (SLE) patients registered in rheumatology tertiary centers of Shiraz University of Medical Sciences from 2008 to 2018. METHOD: A cross-sectional study was conducted on registered patients by reviewing their medical records. The clinical presentations were classified based on each organ's distinct involvement. RESULT: Data of 1322 patients with a mean age of 40 at the time of the study were reviewed. The most common primary manifestation of the disease was arthralgia (37.5%), and the most common clinical presentation in course of the disease was skin involvement (61.8%). The most common cause of hospital admission was disease flare (27.8% (108/388)), and mortality was mainly due to pulmonary complications (27.5% (8/29)). Patients who had hypothyroidism had statistically significantly lower rates of constitutional symptoms (p = 0.006), gastrointestinal involvement (p = 0.024), hypertension (p = 0.002), headache (p = 0.019), depression (p = 0.049) and anemia (p = 0.014). Patients who presented with malar rash and photosensitivity in their course of disease were detected to have statistically significantly lower ages of disease onset (p = 0.013 and 0.003, respectively). CONCLUSION: This study is an update to an epidemiologic study conducted in 2008 in the south of Iran. By comparing results between the two studies, we have tried to investigate the change in morbidity and mortality of SLE during these years.


Assuntos
Artralgia/epidemiologia , Hospitalização/estatística & dados numéricos , Lúpus Eritematoso Sistêmico/fisiopatologia , Adulto , Idade de Início , Artralgia/etiologia , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
Spine (Phila Pa 1976) ; 44(17): E1024-E1030, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31415028

RESUMO

STUDY DESIGN: A retrospective study. OBJECTIVE: To examine the postoperative incidence of sacroiliac joint pain (SIJP) at the lower fusion level following multisegment fusion. SUMMARY OF BACKGROUND DATA: Recently, multisegment fusion is being increasingly performed. While proximal junctional kyphosis (PJK) commonly develops following multisegment fusion, SIJP also commonly occurs following this surgery. In surgery for adult spinal deformity, fixation is often extended to the pelvis to include the sacroiliac joint. Therefore, the question of whether SIJP occurs in such cases is interesting. Here, we examined postoperative incidence of SIJP at the lower fusion level, including the incidence of PJK, and postoperative lumbopelvic alignment. METHODS: Participants included 77 patients who underwent corrective fusion (≥3 segments). Patients were divided into three groups based on the lower fixation end: L5 (L5), S (sacrum), and P (pelvis). In the P group, an S2 alar iliac screw was used. Postoperative incidence of SIJP and PJK in each group was examined along with lumbopelvic parameters. RESULTS: SIJP incidence was 16.7%, 26.1%, and 4.2% in the L5, S, and P groups, respectively, indicating the highest value in the S group and a significantly lower value in the P group. PJK incidence was 23.3%, 30.4%, and 29.2% in the L5, P, and S groups, respectively, with no significant differences. Regarding postoperative lumbopelvic parameters, there was no significant difference between the groups; however, lumbar lordosis tended to be better in the P group. CONCLUSION: SIJP incidence was extremely high with fixation to the sacrum, and in the group with fixation to the pelvis, there was hardly any SIJP. Sacropelvic fixation using S2 alar iliac screws could prevent SIJP onset following multisegment fusion. LEVEL OF EVIDENCE: 3.


Assuntos
Artralgia , Parafusos Ósseos , Dor Lombar , Articulação Sacroilíaca/cirurgia , Fusão Vertebral , Artralgia/epidemiologia , Artralgia/prevenção & controle , Humanos , Incidência , Dor Lombar/epidemiologia , Dor Lombar/prevenção & controle , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Fusão Vertebral/efeitos adversos , Fusão Vertebral/instrumentação , Fusão Vertebral/estatística & dados numéricos
8.
BMC Musculoskelet Disord ; 20(1): 379, 2019 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-31421680

RESUMO

BACKGROUND: The aim of this study was to investigate the correlation between radiographic measurement in lumbar spine and clinical information including symptoms or results of functional testing using a baseline data of longitudinal cohort study. METHODS: A total of 314 elderly subjects were recruited from 5 orthopedic clinics or affiliated facilities. Data for the present investigation were collected via an interviewer-administered questionnaire, which included questions on past medical history, drug history, pain area. And also results of functional testing and X-ray imaging of the lumbar spine were collected. Analysis was carried out to determine any correlation between results of X-ray imaging of the lumbar spine and other collected data, and sorted regarding Akaike Information Criterion (AIC). The correlations among these variables and odds ratio were also analyzed. RESULTS: T12/L1% disc height showed a minimum AIC value with buttock pain (- 4.57) and history of vertebral fracture (- 4.05). The L1/L2, L2/L3, and L3/L4% disc height had a minimal AIC value with knee pain (- 4.11, - 13.3, - 3.15, respectively), and odds ratio of knee pain were 3.5, 3.8, and 2.7, respectively. CONCLUSIONS: Correlation was recognized between the T12/L1% disc height and both buttock pain and previous vertebral fractures, and the L1/L2, L2/L3, and L3/L4% disc height showed a correlation with knee pain. Especially the L2/L3% disc height and knee pain had a strong correlation. It was suggested that these findings may provide additional basis to the concept that lumbar spinal lesion associates with knee pain clinically.


Assuntos
Artralgia/epidemiologia , Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Fraturas da Coluna Vertebral/epidemiologia , Espondilose/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Artralgia/etiologia , Artralgia/fisiopatologia , Feminino , Humanos , Disco Intervertebral/patologia , Articulação do Joelho/fisiopatologia , Estudos Longitudinais , Masculino , Fatores de Risco , Fraturas da Coluna Vertebral/complicações , Espondilose/patologia
9.
Medicine (Baltimore) ; 98(26): e16060, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261513

RESUMO

The purpose of this study was to investigate the association between objectively-measured lifestyle factors and health factors in patients with knee osteoarthritis (OA).In this cross-sectional study, 52 patients with knee OA were examined. Lifestyle factors were measured using a wearable smartwatch (step counts, walking distance, calorie consumption, sleep hours) and by self-report (eating speed). Body mass index (BMI), waist circumference, blood pressure, muscle strength of knee extensor and hip abductor, knee pain, symptoms, daily living function, sports recreation function, quality of life by knee injury and OA outcome score (KOOS) were measured to obtain data on health factors. Correlations and regression analysis were used to analyze the relationship between lifestyle factors and health factors.KOOS subscales (pain, symptom, daily living function) and hip abductor strength were positively correlated with daily step count, which was the only independently contributing lifestyle factor. Additionally, knee pain duration and diastolic blood pressure were negatively correlated with daily step count. BMI and waist circumference showed no correlation with physical activity data, but were negatively correlated with sleep duration and eating speed.The findings of this study contribute to expanding the knowledge on how lifestyle habits of older patients with knee OA contribute to their health status. Daily step counts were associated with knee OA-related pain, symptom, function in daily living, duration of knee pain, blood pressure, and strength of hip abductor. BMI and waist circumference were associated with sleep duration and eating speed.


Assuntos
Nível de Saúde , Estilo de Vida , Osteoartrite do Joelho/epidemiologia , Acelerometria , Idoso , Artralgia/epidemiologia , Artralgia/etiologia , Artralgia/fisiopatologia , Pressão Sanguínea , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Exercício , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Sono , Circunferência da Cintura
10.
BMC Res Notes ; 12(1): 326, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182146

RESUMO

OBJECTIVE: Increase in the evidence of global occurrence of Zika viral infection suggests that in Africa the circulation of the virus which causes 80% of asymptomatic infection could be undetected and/or overlooked. We sought to serologically detect Zika virus infection in febrile patients at Greater Accra Regional Hospital, Ghana. RESULTS: Of the 160 patient serum samples analyzed, 33 were found to have antibodies against Zika virus infection. Among the sero-positives 30 (91%) of the cases were anti-Zika virus IgM with the 21-30-year age group recording the highest number of 8 (26%) and 2 (7%) cases being the least for the 61 years and above age group. All sero-positive febrile patients developed at least one symptom consistent with Zika virus infection: 33 (100%) fever, 25 (76%) muscle pain, 24 (73%) joint pain, and conjunctivitis 2 (6%). Digestive symptoms recorded include 16 (49%) nausea, 12 (36%) vomiting and diarrhea 18 (55%). In addition, 28 (85%) loss of appetite, 14 (75%) rapid respiration and chest pain 15 (42%) were reported by seropositive febrile patients. Our data indicates exposure to Zika virus which suggests the possible circulation of the virus among febrile patients in Ghana with a sero-prevalence rate of 20.6%.


Assuntos
Anticorpos Antivirais/sangue , Artralgia/imunologia , Febre/imunologia , Mialgia/imunologia , Infecção por Zika virus/imunologia , Zika virus/imunologia , Adolescente , Adulto , Idoso , Artralgia/diagnóstico , Artralgia/epidemiologia , Artralgia/fisiopatologia , Criança , Pré-Escolar , Conjuntivite Viral/diagnóstico , Conjuntivite Viral/epidemiologia , Conjuntivite Viral/imunologia , Conjuntivite Viral/fisiopatologia , Estudos Transversais , Diarreia/diagnóstico , Diarreia/epidemiologia , Diarreia/imunologia , Diarreia/fisiopatologia , Feminino , Febre/diagnóstico , Febre/epidemiologia , Febre/fisiopatologia , Gana/epidemiologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Mialgia/diagnóstico , Mialgia/epidemiologia , Mialgia/fisiopatologia , Náusea/diagnóstico , Náusea/epidemiologia , Náusea/imunologia , Náusea/fisiopatologia , Estudos Soroepidemiológicos , Vômito/diagnóstico , Vômito/epidemiologia , Vômito/imunologia , Vômito/fisiopatologia , Zika virus/crescimento & desenvolvimento , Zika virus/patogenicidade , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/fisiopatologia
11.
Int Marit Health ; 70(2): 107-112, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31237670

RESUMO

BACKGROUND: Previous publications have indicated a high risk of musculoskeletal complaints among professional divers. This study aims to investigate which factors influence professional divers' risk of musculoskeletal complaints. MATERIALS AND METHODS: Based on data gathered from a postal questionnaire sent to Norwegian inshore divers in 2011, the prevalence of musculoskeletal complaints, strain injuries and joint pain among divers with different certification levels, work-related tasks and decompression sickness (DCS) experiences were analysed. RESULTS: The risk of musculoskeletal complaints, strain injuries and joint pain was significantly higher among divers working in the quay/construction industry versus divers not working in this industry, and among divers who had experienced DCS. Likewise, a higher risk was found among divers doing construction, inspection, pipelaying, blasting and welding, other physically demanding work, and working with vibrating and/or rotating tools. Having experienced tingling and/or numbness in fingers after working with vibrating and/or rotating tools or having sick leave due to tendonitis, periosteum inflammation, stretch injuries or sprains caused by diving also increased the risk. CONCLUSIONS: Professional divers working in the quay/construction industry, divers doing tasks with heavy physical demands and divers having experienced DCS are at a higher risk of musculoskeletal complaints than other professional divers.


Assuntos
Mergulho , Doenças Musculoesqueléticas/epidemiologia , Doenças Profissionais/epidemiologia , Adulto , Artralgia/epidemiologia , Indústria da Construção , Doença da Descompressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Licença Médica/estatística & dados numéricos , Entorses e Distensões/epidemiologia , Inquéritos e Questionários , Vibração
12.
J Pak Med Assoc ; 69(6): 823-827, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31189289

RESUMO

OBJECTIVE: To investigate the relationships of pain beliefs with clinical/functional status and kinesiophobia in patients with knee osteoarthritis. Methods: The descriptive cross-sectional study was conducted at the Department of Physical Therapy and Rehabilitation, Acibadem Hospitals Group, Istanbul, Turkey, between May 2015 and April 2016, and comprised chronic patients who were either overweight or obese. Patients were evaluated using visual analogue scale, Western Ontario and McMaster University Osteoarthritis Index, Lequesne Index (LI), Tampa Scale for Kinesiophobia and the Pain Beliefs Questionnaire. Statistical analysis was done using SPSS 15. . RESULTS: Of the 78 patients, there were 10(13%) males, 68(87%) females with an overall mean age of 56.09}11.79 years and mean body mass index of 29.3}4.91. There were moderate positive correlations among kinesiophobia, pain and functional scores, while organic pain beliefs had a moderate positive correlation with body mass index scores and positive weak correlations with clinical/functional status scores and kinesiophobia (p<0.05 each). There were no associations between the organic subscale and psychological subscale of the Pain Beliefs Questionnaire (p>0.05).. CONCLUSIONS: Possible fear of movement and pain belief should be taken into consideration in the management of patients with knee osteoarthritis.


Assuntos
Artralgia , Osteoartrite do Joelho , Transtornos Fóbicos , Adulto , Idoso , Artralgia/complicações , Artralgia/epidemiologia , Artralgia/fisiopatologia , Artralgia/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/psicologia , Transtornos Fóbicos/complicações , Transtornos Fóbicos/epidemiologia , Turquia/epidemiologia
13.
J Athl Train ; 54(6): 662-670, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31184959

RESUMO

OBJECTIVE: To identify the prevalence of pain in people with chronic ankle instability (CAI) and how pain is related to the impairments of CAI. DATA SOURCES: We searched the databases of AMED, CINAHL, EMBASE, MEDLINE, PubMed, Scopus, SPORTDiscus, and Web of Science from inception to March 2017. STUDY SELECTION: Eligible studies were peer-reviewed research in which investigators reported the presence of ankle pain or assessed the effects of pain on impairments in participants with CAI. Age and language were not restricted. Studies that included only surgical interventions were excluded. DATA EXTRACTION: Studies identified by the search strategy were screened according to the eligibility criteria, and 2 independent reviewers extracted the data. Outcome measurements were (1) pain ratings using measures such as a visual analog scale and (2) other residual impairments, such as feelings of weakness, giving way, or deficits in functional performance. DATA SYNTHESIS: Of the 5907 records identified through the database search, 14 studies were included in this review. All authors assessed ankle pain by self-report questionnaires or physical examination, or both. Pain was self-reported by 23% to 79% of participants and present on physical examination in 25% to 75% of participants, depending on the test applied. Among these studies, the highest reported pain level was 4.9 on the 11-point visual analog scale. Studies were heterogeneous for pain measures, participant groups, interventions, and follow-up periods. The relationship between pain and the structural and functional impairments associated with CAI was not investigated in the included studies. CONCLUSIONS: Pain was present in a large proportion of people who had CAI, but pain levels were low. Information about the effects of pain was not reported, so researchers should examine the association between pain and function, balance, or other activities in people with CAI.


Assuntos
Traumatismos do Tornozelo/complicações , Artralgia/epidemiologia , Instabilidade Articular/complicações , Autorrelato , Traumatismos do Tornozelo/fisiopatologia , Artralgia/etiologia , Doença Crônica , Saúde Global , Humanos , Instabilidade Articular/epidemiologia , Prevalência
14.
Scand J Rheumatol ; 48(5): 408-414, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31170850

RESUMO

Objective: Pain is a common and distressing feature of juvenile idiopathic arthritis (JIA). Pain interference (PI) is underexplored in long-term conditions such as JIA. The aim of this study was to explore the factors associated with PI in young adults with JIA. Methods: All consecutive JIA patients aged 18-30 years in three tertiary rheumatology and rehabilitation centres in Finland between September 2015 and April 2016 were included. The patients completed questionnaires addressing demographics, disability, depressive symptoms, pain anxiety, pain intensity, and PI. PI was measured with a single item from the RAND-36 questionnaire. Five response categories were coded into three groups: patients reporting 'extremely', 'quite a bit' or 'moderate' were classified as having significant PI; 'a little bit' as having minor PI; and 'not at all' as having no PI. A leisure-time physical activity metabolic equivalent of task (LTPA MET) was calculated. Statistical comparisons between PI and categorical variables were made using chi-squared or Fisher-Freeman-Halton tests. Results: Of the total 195 patients, 97 (50%) patients reported PI. PI was associated with a wide spectrum of sociodemographic and disease-related variables. Pain intensity scores were higher in patients expressing greater PI (p < 0.001). Greater PI was associated with higher disability (p < 0.001), higher pain anxiety scores (p < 0.001), lower LTPA MET (p = 0.027), and poorer leisure-time activity (p < 0.001). Conclusions: PI is common in young adults with JIA. We suggest that PI should be taken into account in future outcome studies exploring the impact of pain in children and young adults with JIA.


Assuntos
Artralgia/epidemiologia , Artrite Juvenil/complicações , Nível de Saúde , Atividade Motora/fisiologia , Medição da Dor/métodos , Adolescente , Adulto , Artralgia/diagnóstico , Artralgia/etiologia , Artrite Juvenil/diagnóstico , Artrite Juvenil/fisiopatologia , Feminino , Finlândia/epidemiologia , Humanos , Incidência , Masculino , Prognóstico , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
15.
J Pak Med Assoc ; 69(5): 610-614, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31105277

RESUMO

OBJECTIVE: To determine the overall health status of the elderly in an area Pakistan's Punjab province. METHODS: The cross-sectional study was conducted from April to June 2016 in Tehsil Kharian of district Gujrat, Punjab, Pakistan district, and comprised people aged 60 years or more who were enrolled through multistage random sampling. To measure the health status, and adapted and modified version of Short Form-36 health survey was used. SPSS 23 was used for data analysis. RESULTS: Of the 395 subjects, 254(65%) were males, and the overall mean age was 69.18} 8.93 years. Of the total, 151(38%) subjects reported having no health issues. Among those who reported health issues, 63(16%) had joint problem as their primary health illness. Health status score suggested 286(72%) participants to have poor health, and in the 60-69 years age group, females were more likely to report poor health status compared to males (p<0.05). CONCLUSIONS: The majority of the elderly subjects reported to have poor health status, and females reported more health issues compared to males..


Assuntos
Artralgia/epidemiologia , Diabetes Mellitus/epidemiologia , Nível de Saúde , Cardiopatias/epidemiologia , Hipertensão/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Paquistão/epidemiologia , Distribuição por Sexo , Inquéritos e Questionários
16.
J Orthop Surg Res ; 14(1): 153, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31126348

RESUMO

OBJECTIVES: Osteoarthritis of the knee is common and often leads to significant physical disability. While classic conservative therapeutic approaches aim for symptoms like pain and inflammation, procedures like the intraarticular application of hyaluronic acids (HA) or platelet-rich plasma (PRP) are thought to stimulate the endogenous HA production, stop catabolism of cartilage tissue, and promote tissue regeneration. To analyse whether the positive effects of PRP injections are associated with the level of cartilage damage, patient satisfaction with the treatment was correlated with the level of knee joint osteoarthritis quantified by MRI. METHODS: PRP was performed with a low-leukocyte autologous conditioned plasma (ACP) system in 59 patients. A pre-treatment MRI was performed and a Whole-Organ MRI Score (WORMS) was used to score the level of knee osteoarthritis by 14 features: integrity of the cartilage, affection of the bone marrow, subcortical cysts, bone attrition, osteophytes, integrity of the menisci and ligaments, presence of synovitis, loose bodies, and periarticular cysts. A multivariate analysis with ordinary least squares regressions was used. RESULTS: Although pain symptoms and severity of clinical osteoarthritis symptoms decreased, regression analysis could not detect a correlation between the degree of cartilage damage measured by the WORMS score and a positive response to PRP therapy. CONCLUSION: This study suggests that intraarticular injection of PRP might improve osteoarthritis symptoms and reduces the pain in patients suffering from osteoarthritis of the knee joint independent from the level of cartilage damages quantified by the whole-organ MRI scoring method WORMS.


Assuntos
Cartilagem Articular/diagnóstico por imagem , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/terapia , Plasma Rico em Plaquetas , Artralgia/diagnóstico por imagem , Artralgia/epidemiologia , Artralgia/terapia , Exercício/fisiologia , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/epidemiologia , Manejo da Dor/métodos , Resultado do Tratamento
17.
MMWR Morb Mortal Wkly Rep ; 68(17): 381-387, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31048678

RESUMO

An estimated 54.4 million (approximately one in four) U.S. adults have doctor-diagnosed arthritis (arthritis) (1). Severe joint pain and physical inactivity are common among adults with arthritis and are linked to adverse mental and physical health effects and limitations (2,3). CDC analyzed 2017 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate current state-specific prevalence of arthritis and, among adults with arthritis, the prevalences of severe joint pain and physical inactivity. In 2017, the median age-standardized state prevalence of arthritis among adults aged ≥18 years was 22.8% (range = 15.7% [District of Columbia] to 34.6% [West Virginia]) and was generally highest in Appalachia and Lower Mississippi Valley regions.* Among adults with arthritis, age-standardized, state-specific prevalences of both severe joint pain (median = 30.3%; range = 20.8% [Colorado] to 45.2% [Mississippi]) and physical inactivity (median = 33.7%; range = 23.2% [Colorado] to 44.4% [Kentucky]) were highest in southeastern states. Physical inactivity prevalence among those with severe joint pain (47.0%) was higher than that among those with moderate (31.8%) or no/mild joint pain (22.6%). Self-management strategies such as maintaining a healthy weight or being physically active can reduce arthritis pain and prevent or delay arthritis-related disability. Evidence-based physical activity and self-management education programs are available that can improve quality of life among adults with arthritis.


Assuntos
Artralgia/epidemiologia , Artrite/epidemiologia , Comportamento Sedentário , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
18.
An Pediatr (Barc) ; 90(5): 280-284, 2019 May.
Artigo em Espanhol | MEDLINE | ID: mdl-31056091

RESUMO

INTRODUCTION: The aetiological agent of erythema infectiosum is Erythrovirus B19 (also known as parvovirus B19), frequently found in children and adolescents, but also associated with arthropathy, aplastic crisis, and abortion in adults. MATERIAL AND METHODS: A retrospective study of Erythrovirus B19 cases in the years 2010-2015. RESULTS: Of the 56 cases of Erythrovirus B19 diagnosed, 34 were adults (32 women and 2 men) and 22 younger than 18 years (12 girls and 10 boys). Six cases were in pregnant women. Infections mainly occurred between spring and summer. In childhood, fever (64%), rash (50%), and anaemia (55%) were the most frequent symptoms. However, arthralgia (59%) was the most frequent symptom in adults, and less frequent were anaemia (41%), fever (32%), and rash (29%). CONCLUSIONS: The characteristic clinical presentation in childhood was rash and fever, whereas in adults it was arthralgia. Anaemia is also frequent, but only severe in previous haematological disease. It should be pointed out that Erythrovirus B19 infection during pregnancy could severely affect the foetus.


Assuntos
Eritema Infeccioso/epidemiologia , Parvovirus B19 Humano/isolamento & purificação , Complicações Infecciosas na Gravidez/virologia , Adulto , Fatores Etários , Artralgia/epidemiologia , Artralgia/virologia , Criança , Pré-Escolar , Eritema Infeccioso/fisiopatologia , Exantema/epidemiologia , Exantema/virologia , Feminino , Febre/epidemiologia , Febre/virologia , Seguimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos
19.
PLoS One ; 14(4): e0215738, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31022217

RESUMO

BACKGROUND: Extraintestinal manifestations (EIM) contribute significantly to the burden of disease in inflammatory bowel disease (IBD). Pain is a leading symptom in IBD and could be seen as an EIM itself. Treatment of IBD associated pain is challenging and insufficiently studied. A better knowledge on the association of pain and IBD specific treatment is warranted to improve the management of IBD patients. METHODS: All patients of the Swiss IBD Cohort Study (SIBDCS) (n = 2152) received a questionnaire regarding pain localization, pain character, and the use of IBD specific medication. RESULTS: 1263 completed questionnaires were received. Twenty-one out of 184 patients (10%) receiving anti-TNF treatment compared to 142 out of 678 patients (21%) not receiving anti-TNF medication reported elbow pain (p = 0.002) while 28 out of 198 patients (14%) receiving steroid treatment significantly more often reported elbow pain compared to 59 from 696 patients (8%) not receiving steroids (p = 0.021). Furthermore, we found significantly more female patients under anti-TNF treatment to report knee/ lower leg pain and ankle/ foot pain compared to their male counterparts (36% vs. 20% and 22% vs. 10%, respectively, p = 0.015 for both comparisons). The frequency of knee, lower leg, ankle and foot pain was especially low in male patients under anti-TNF treatment, indicating a high benefit of male patients from anti-TNF therapy regarding EIM. CONCLUSIONS: The frequency of elbow pain was lower in IBD patients treated with anti-TNF but higher in patients treated with steroids.


Assuntos
Anti-Inflamatórios/uso terapêutico , Artralgia/epidemiologia , Doenças Inflamatórias Intestinais/tratamento farmacológico , Anti-Inflamatórios/farmacologia , Artralgia/etiologia , Artralgia/prevenção & controle , Articulação do Cotovelo , Feminino , Seguimentos , Articulações do Pé , Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/imunologia , Articulação do Joelho , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Suíça/epidemiologia , Resultado do Tratamento , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/imunologia
20.
J Shoulder Elbow Surg ; 28(6): 1098-1103, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31003885

RESUMO

BACKGROUND: Several guidelines for the prevention of throwing injuries recommend a sufficiently long off-season; however, few studies providing scientific evidence to support these recommendations exist. Our study aimed to clarify the association between off-season duration and throwing elbow injuries among elementary school-aged baseball players. METHODS: This study enrolled 680 elementary school-aged baseball players who underwent medical checkups. The experience with elbow pain and the off-season duration were investigated via the administration of a self-completed questionnaire. Ultrasonographic assessment of the elbow joint was performed on the day of the medical checkup to assess for morphologic abnormalities. RESULTS: The prevalence of elbow pain and morphologic abnormalities of the medial epicondyle (medial epicondyle lesions) was significantly decreased when the subjects' off-season duration was longer. Multivariate analysis revealed that the risk of elbow pain was significantly lower in the group whose off-season lasted 1 to 2 months (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.15-0.62; P = .0006) and in the group whose off-season lasted longer than 2 months (OR, 0.59; 95% CI, 0.37-0.95; P = .0316). The risk of medial epicondyle lesions was also significantly lower in the group whose off-season lasted 1 to 2 months (OR, 0.39; 95% CI, 0.22-0.67; P = .0005) and in the group whose off-season lasted longer than 2 months (OR, 0.36; 95% CI, 0.23-0.56; P < .0001). On the contrary, no significant correlation was found between capitellar osteochondritis dissecans and off-season duration. CONCLUSION: Off-season duration has a significant correlation with elbow pain and morphologic abnormalities of the medial elbow joint in elementary school-aged baseball players.


Assuntos
Artralgia/epidemiologia , Traumatismos em Atletas/epidemiologia , Beisebol/lesões , Articulação do Cotovelo/lesões , Traumatismos em Atletas/diagnóstico por imagem , Criança , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/patologia , Humanos , Exame Físico , Prevalência , Descanso , Inquéritos e Questionários , Fatores de Tempo , Ultrassonografia
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