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2.
RMD Open ; 7(1)2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33479021

RESUMO

INTRODUCTION: Whether patients with inflammatory rheumatic and musculoskeletal diseases (RMD) are at higher risk to develop severe courses of COVID-19 has not been fully elucidated. Aim of this analysis was to describe patients with RMD according to their COVID-19 severity and to identify risk factors for hospitalisation. METHODS: Patients with RMD with PCR confirmed SARS-CoV-2 infection reported to the German COVID-19 registry from 30 March to 1 November 2020 were evaluated. Multivariable logistic regression was used to estimate ORs for hospitalisation due to COVID-19. RESULTS: Data from 468 patients with RMD with SARS-CoV-2 infection were reported. Most frequent diagnosis was rheumatoid arthritis, RA (48%). 29% of the patients were hospitalised, 5.5% needed ventilation. 19 patients died. Multivariable analysis showed that age >65 years (OR 2.24; 95% CI 1.12 to 4.47), but even more>75 years (OR 3.94; 95% CI 1.86 to 8.32), cardiovascular disease (CVD; OR 3.36; 95% CI 1.5 to 7.55), interstitial lung disease/chronic obstructive pulmonary disease (ILD/COPD) (OR 2.79; 95% CI 1.2 to 6.49), chronic kidney disease (OR 2.96; 95% CI 1.16 to 7.5), moderate/high RMD disease activity (OR 1.96; 95% CI 1.02 to 3.76) and treatment with glucocorticoids (GCs) in dosages >5 mg/day (OR 3.67; 95% CI 1.49 to 9.05) were associated with higher odds of hospitalisation. Spondyloarthritis patients showed a smaller risk of hospitalisation compared with RA (OR 0.46; 95% CI 0.23 to 0.91). CONCLUSION: Age was a major risk factor for hospitalisation as well as comorbidities such as CVD, ILD/COPD, chronic kidney disease and current or prior treatment with GCs. Moderate to high RMD disease activity was also an independent risk factor for hospitalisation, underlining the importance of continuing adequate RMD treatment during the pandemic.


Assuntos
/diagnóstico , Glucocorticoides/efeitos adversos , Doenças Musculoesqueléticas/complicações , Doenças Reumáticas/complicações , /genética , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , /terapia , Estudos de Casos e Controles , Comorbidade , Feminino , Alemanha/epidemiologia , Glucocorticoides/uso terapêutico , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/tratamento farmacológico , Sistema de Registros , Respiração Artificial/métodos , Estudos Retrospectivos , Doenças Reumáticas/tratamento farmacológico , Fatores de Risco
3.
Pain Med ; 21(12 Suppl 2): S110-S117, 2020 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-33313731

RESUMO

BACKGROUND: Veterans with significant chronic pain from musculoskeletal disorders are at risk of substance misuse. Veterans whose condition is the result of military service may be eligible for a disability pension. Department of Veterans Affairs compensation examinations, which determine the degree of disability and whether it was connected to military service, represent an opportunity to engage Veterans in pain management and substance use treatments. A multisite randomized clinical trial is testing the effectiveness and cost-effectiveness of Screening, Brief Intervention, and Referral to Treatment for Pain Management (SBIRT-PM) for Veterans seeking compensation for musculoskeletal disorders. This telephone-based intervention is delivered through a hub-and-spoke configuration. DESIGN: This study is a two-arm, parallel-group, 36-week, multisite randomized controlled single-blind trial. It will randomize 1,100 Veterans experiencing pain and seeking service-connection for musculoskeletal disorders to either SBIRT-PM or usual care across eight New England VA medical centers. The study balances pragmatic with explanatory methodological features. Primary outcomes are pain severity and number of substances misused. Nonpharmacological pain management and substance use services utilization are tracked in the trial. SUMMARY: Early trial enrollment targets were met across sites. SBIRT-PM could help Veterans, at the time of their compensation claims, use multimodal pain treatments and reduce existing substance misuse. Strategies to address COVID-19 pandemic impacts on the SBIRT-PM protocol have been developed to maintain its pragmatic and exploratory integrity.


Assuntos
Dor Crônica/tratamento farmacológico , Doenças Musculoesqueléticas/terapia , Manejo da Dor , Veteranos/psicologia , Adulto , Dor Crônica/virologia , Intervenção na Crise/métodos , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/diagnóstico , Manejo da Dor/métodos , Método Simples-Cego
4.
Zhonghua Xue Ye Xue Za Zhi ; 41(11): 903-907, 2020 Nov 14.
Artigo em Chinês | MEDLINE | ID: mdl-33333692

RESUMO

Objective: To study the orthopedic treatment strategy for hemophilia complicated with musculoskeletal disorders as well as the peri-operative consumption of clotting factor. Methods: Total 338 orthopedic surgeries were performed for 261 patients, average age of 30.6 y (6-65 y) , with hemophilia between January 1996 and December 2019 at our institute. Two hundred and twenty-six patients presented with bleeds within the joints. Sixty-one patients presented with intramuscular bleeds, 45 presented with hemophilic pseudotumors, and six presented with miscellaneous complaints. Strategy of clotting factor replacement therapy was designed as per differences in the level of the operation procedure. Information regarding clinical manifestation, operative strategy, clotting factor consumption, and re-operation for complications was retrospectively recorded. The costs for multiple joint procedure and single joint procedure were studied. Results: We found that 270 of the 338 surgical procedures were major surgical procedures (79.9%) . There were 203 procedures of joint arthroplasty (60%) . Fourteen patients underwent reoperations for local recurrence (4.2%) . The average factor Ⅷ consumption before the surgery was 44.4 ± 8.1 IU/kg. The average FⅧ consumption within postoperative 2 weeks was 40 962 IU (647±177 IU/kg) . Seven type A hemophilic patients developed F Ⅷ inhibitor following the surgical procedure, with an average level of 13.7±11.2 BU/mL. Sixty-eight patients underwent multiple joint procedures under one anesthesia session (26%) . There was no significant difference in the factor consumption between the multiple joint procedure and single joint procedure. Conclusions: Surgical treatment was found to be effective for hemophilic arthropathy and lesion of the musculoskeletal apparatus, with the clotting factor replacement therapy. Multiple joint procedures under one anesthesia were more cost effective for patients with hemophilia, with less factor consumption than staged single joint procedure.


Assuntos
Hemofilia A , Doenças Musculoesqueléticas/complicações , Adulto , Artrite , Fatores de Coagulação Sanguínea , Hemofilia A/complicações , Humanos , Manipulação Ortopédica , Estudos Retrospectivos
5.
Artigo em Inglês | MEDLINE | ID: mdl-33339263

RESUMO

This systematic review and meta-analysis aimed to identify the effect of multi-modal therapies that combined physical and psychological therapies for kinesiophobia caused by musculoskeletal disorders compared with uni-modal therapy of only phycological therapy or psychological therapy. The search terms and their logical connector were as following: (1) "kinesiophobia" at the title or abstract; and (2) "randomized" OR "randomized" at title or abstract; not (3) "design" OR "protocol" at the title. They were typed into the databases of Medline (EBSCO), PubMed, and Ovid, following the different input rules of these databases. The eligibility criteria were: (1) Adults with musculoskeletal disorders or illness as patients; (2) Multi-modal therapies combined physical and psychological therapy as interventions; (3) Uni-modal therapy of only physical or psychological therapy as a comparison; (4) The scores of the 17-items version of the Tampa Scale of Kinesiophobia as the outcome; (5) Randomized controlled trials as study design. As a result, 12 studies were included with a statistically significant polled effect of 6.99 (95% CI 4.59 to 9.38). Despite a large heterogeneity within studies, multi-modal therapies might be more effective in reducing kinesiophobia than the unimodal of only physical or psychological therapy both in the total and subdivision analysis. The effect might decrease with age. What's more, this review's mathematical methods were feasible by taking test-retest reliability of the Tampa Scale of Kinesiophobia into consideration.


Assuntos
Doenças Musculoesqueléticas , Transtornos Fóbicos , Adulto , Humanos , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/terapia , Transtornos Fóbicos/etiologia , Transtornos Fóbicos/terapia , Reprodutibilidade dos Testes
6.
Mayo Clin Proc ; 95(8): 1715-1731, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32753146

RESUMO

Telemedicine uses modern telecommunication technology to exchange medical information and provide clinical care to individuals at a distance. Initially intended to improve health care for patients in remote settings, telemedicine now has a broad clinical scope with the general purpose of providing convenient, safe, and time- and cost-efficient care. The coronavirus disease 2019 pandemic has created marked nationwide changes in health care access and delivery. Elective appointments and procedures have been canceled or delayed, and multiple states still have some degree of shelter-in-place orders. Many institutions are now relying more heavily on telehealth services to continue to provide medical care to individuals while also preserving the safety of health care professionals and patients. Telemedicine can also help reduce the surge in health care needs and visits as restrictions are lifted. In recent weeks, there has been a significant amount of information and advice on how to best approach telemedicine visits. Given the frequent presentation of individuals with musculoskeletal complaints to the medical practitioner, it is important to have a framework for the virtual musculoskeletal physical examination. This will be of importance as telemedicine continues to evolve, even after coronavirus disease 2019 restrictions are lifted. This article will provide the medical practitioner performing a virtual musculoskeletal examination with a specific set of guidelines, both written and visual, to enhance the information obtained when evaluating the shoulder, hip, knee, ankle, and cervical and lumbar spine. In addition to photographs, accompanying videos are included to facilitate and demonstrate specific physical examination techniques that the patient can self-perform.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Doenças Musculoesqueléticas/diagnóstico , Pandemias , Exame Físico/métodos , Pneumonia Viral/complicações , Telemedicina/métodos , Infecções por Coronavirus/epidemiologia , Humanos , Doenças Musculoesqueléticas/complicações , Pneumonia Viral/epidemiologia
7.
Medicine (Baltimore) ; 99(34): e21805, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846817

RESUMO

BACKGROUND: Impaired physical mobility, most often seen in people with neurological disorders (i.e., stroke and spinal cord injury survivors), musculoskeletal diseases or frailty, is a limitation in independent and purposeful physical movement of the body or one or more extremities. The physical restrictions result in negative consequences on an individual's physical and psychosocial functions. This proposal describes a systematic review protocol to determine the effectiveness and approaches of sitting Tai Chi intervention for individuals with impaired physical mobility. Our review would inform stakeholders' decisions in integrating this complementary therapy into current rehabilitation services. METHODS: Randomized controlled trials or quasi-experimental studies that compared an intervention group receiving sitting Tai Chi with a control group among adult participants with impaired physical mobility resulting from any health condition(s) will be included. Outcomes of interest will include physical and psychosocial health outcomes. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PubMed, CINAHL, Scopus, Web of Science, AMED, PsycINFO, SPORDiscus, PEDro, WanFang Data and China National Knowledge Infrastructure will be searched from their inception to January 2020. Additional searches will be performed to identify studies that are being refereed, to be published, unpublished or ongoing. Two reviewers will select the trials and extract data independently. The risk of bias of the included studies will be assessed using the Cochrane risk-of-bias tools. The Grading of Recommendations, Assessment, Development and Evaluation will be used to assess evidence quality for each review outcome. Data synthesis will be performed using Review Manager 5.3. When a meta-analysis is possible, we will assess the heterogeneity across the studies by computing the I statistics. RESULTS: A high-quality synthesis of current evidence of sitting Tai Chi for impaired physical mobility will be stated from several aspect using subjective reports and objective measures of performance. CONCLUSION: This protocol will present the evidence of whether sitting Tai Chi is an effective intervention for impaired physical mobility. PROSPERO REGISTRATION NUMBER: CRD 42019142681.


Assuntos
Fragilidade/reabilitação , Limitação da Mobilidade , Doenças Musculoesqueléticas/reabilitação , Doenças do Sistema Nervoso/reabilitação , Tai Ji , Fragilidade/complicações , Fragilidade/psicologia , Humanos , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/psicologia , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/psicologia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
9.
Am J Med ; 133(10): 1135-1142, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32442508

RESUMO

Chest pain is a common presenting complaint in the primary care setting. Imaging plays a key role in the evaluation of the multiple organ systems that can be responsible for chest pain. With numerous imaging modalities available, determination of the most appropriate test and interpretation of the findings can be a challenge for the clinician. In this 2-part series, we offer resources to guide primary care physicians in the selection of imaging studies and present the imaging findings of various causes of nonemergent chest pain. In Part 2, we focus on the radiologic appearance of common noncardiac sources of chest pain, including gastrointestinal, pulmonary, and musculoskeletal etiologies.


Assuntos
Dor no Peito/etiologia , Transtornos da Motilidade Esofágica/diagnóstico por imagem , Hérnia Hiatal/diagnóstico por imagem , Doenças Musculoesqueléticas/diagnóstico por imagem , Atenção Primária à Saúde , Doenças Respiratórias/diagnóstico por imagem , Transtornos da Motilidade Esofágica/complicações , Fraturas por Compressão/complicações , Fraturas por Compressão/diagnóstico por imagem , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnóstico por imagem , Hérnia Hiatal/complicações , Humanos , Imagem por Ressonância Magnética , Doenças Musculoesqueléticas/complicações , Derrame Pleural/complicações , Derrame Pleural/diagnóstico por imagem , Pneumonia/complicações , Pneumonia/diagnóstico por imagem , Pneumotórax/complicações , Pneumotórax/diagnóstico por imagem , Radiografia Torácica , Doenças Respiratórias/complicações , Fraturas das Costelas/complicações , Fraturas das Costelas/diagnóstico por imagem , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/diagnóstico por imagem , Parede Torácica/diagnóstico por imagem , Síndrome de Tietze/complicações , Síndrome de Tietze/diagnóstico por imagem , Tomografia Computadorizada por Raios X
10.
Artigo em Inglês | MEDLINE | ID: mdl-32443415

RESUMO

Stone, sand and gravel mining (SSGM) constitutes the vast majority of mining operations in the United States. Despite musculoskeletal disorders being one of the most common occupational health problems across several industries, limited research has examined the extent of reported musculoskeletal symptoms or disorders among actively employed SSGM workers. To address this knowledge gap, cross sectional data were collected from 459 SSGM workers in the Midwestern United States to determine the prevalence of musculoskeletal symptoms. Sociodemographic and job-related factors were examined to identify possible risk factors in SSGM. Musculoskeletal symptoms of the low back (57%), neck (38%), shoulder (38%) and knee (39%) were highly prevalent among SSGM employees. The results, among other findings, showed that working more than 60 h a week increased the likelihood of musculoskeletal symptoms at the low back (OR: 4.7 95% CI: 1.9-11.5), neck (OR: 5.1, 95% CI: 2.2-11.8) and knee (OR: 4.5, 95% CI: 2.0-10.3). Working as a mechanic/maintenance worker increased the likelihood of low back (OR: 2.1, 95% CI: 1.1-4.2) and knee (OR: 2.2, 95% CI: 1.1-4.6) musculoskeletal symptoms. Intervention measures aimed at improving ergonomic hazard identification for various job tasks as well as administrative controls limiting hours worked may help reduce the burden of musculoskeletal problems in the SSGM industry.


Assuntos
Mineradores , Doenças Musculoesqueléticas , Doenças Profissionais , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/etiologia , Doenças Profissionais/complicações , Prevalência , Fatores de Risco , Areia , Inquéritos e Questionários
11.
Artigo em Inglês | MEDLINE | ID: mdl-32397534

RESUMO

This study aimed to investigate level of work ability and quality of life (QOL) as well as the relationship between them among patients suffering from work-related musculoskeletal disorders (WMSDs) in Taiwan. A cross-sectional study design with continuous sampling and a questionnaire were used to obtain the research data. Controlling for personal characteristics, pain, psychological distress, and social support, multiple linear regressions were adopted to explore the relationship between work ability and overall QOL. Further analyses were also made to clarify the relationships between work ability and each domain of QOL. In total, 165 patients with WMSDs were recruited. Compared with general workers, the participants reported a lower level of work ability and overall QOL. Work ability was significantly associated with overall QOL when covariates were controlled. Among the four domains of QOL, work ability was significantly associated with both the physical and psychological domains. The conclusion was that work ability is a definite factor of QOL for patients with WMSDs; the essence of work ability may be beyond economic function or social support. Strategies to help workers with WMSDs enhance their work ability to fit their new or temporary jobs would be beneficial to their QOL.


Assuntos
Doenças Musculoesqueléticas , Qualidade de Vida , Avaliação da Capacidade de Trabalho , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/complicações , Inquéritos e Questionários , Taiwan , Adulto Jovem
12.
Nurs Clin North Am ; 55(2): 209-224, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32389255

RESUMO

To help reduce potentially devastating outcomes from spinal complications and venous thromboembolism, it is essential for the bedside nurse to have a comprehensive understanding of risk factors and assessments. The orthopedic nurse carries a responsibility for accurately assessing, documenting, and mobilizing the team when abnormal changes occur. Nurses act as patient advocates. The bedside nurse must communicate with the physician. If a patient or family sues the health care team, after a careful screening of the case for merit, the legal process begins. A health care provider should never give in to the temptation to alter medical records.


Assuntos
Doenças Musculoesqueléticas/enfermagem , Enfermagem Ortopédica/legislação & jurisprudência , Humanos , Doenças Musculoesqueléticas/complicações , Estados Unidos
13.
Mil Med ; 185(Suppl 1): 413-419, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-32074349

RESUMO

INTRODUCTION: Musculoskeletal (MSK) conditions are commonly seen among military service members (SM) and Veterans. We explored correlates of award of MSK-related service-connected disability benefits (SCDB) among SM seeking care in Veterans Affairs (VA) hospitals. MATERIALS AND METHODS: Department of Defense data on SM who separated from October 1, 2001 to May 2017 were linked to VA administrative data. Using adjusted logistic regression models, we determined the odds of receiving MSK SCDB. RESULTS: A total of 1,558,449 (79% of separating SM) had at least one encounter in VA during the study period (7.8% disability separations). Overall, 51% of this cohort had at least one MSK SCDB (88% among disability separations, 48% among normal). Those with disability separations (as compared to normal separations) were significantly more likely to receive MSK SCDB (odds ratio 2.37) as were females (compared to males, odds ratio 1.15). CONCLUSIONS: Although active duty SM with disability separations were more likely to receive MSK-related service-connected disability ratings in the VA, those with normal separations also received such awards. Identifying those at highest risk for MSK-related disability could lead to improved surveillance and prevention strategies in the Department of Defense and VA health care systems to prevent further damage and disability.


Assuntos
Avaliação da Deficiência , Pessoas com Deficiência/reabilitação , Previsões/métodos , Militares/estatística & dados numéricos , Doenças Musculoesqueléticas/complicações , Adulto , Campanha Afegã de 2001- , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Guerra do Iraque 2003-2011 , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/epidemiologia , Estados Unidos , United States Department of Veterans Affairs/organização & administração , United States Department of Veterans Affairs/estatística & dados numéricos , Veteranos/estatística & dados numéricos
14.
Acta Diabetol ; 57(7): 835-842, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32100106

RESUMO

AIMS: A sliding-scale (SS) regimen is discouraged to correct hyperglycemia in hospital patients, but there is resistance to adoption of basal-bolus (BB) treatment in surgical units. We tested the feasibility and the effects of a nurse-based BB regimen in orthopedic surgery. METHODS: Following an intense training to implement a protocol amenable by nurses, a group of patients admitted with hyperglycemia in an orthopedic institute were prospectively followed according to a basal-bolus insulin regimen (BB, n = 80). They were compared with a hyperglycemic group eventually treated by sliding-scale insulin on demand (SS, n = 122). Diabetes was present in 196 cases. Metabolic control was assessed during the first 3 days of surgery; outcome data were tested by logistic regression, after adjusting for propensity score. RESULT: Average blood glucose and glucose variability were lower in BB versus SS (P < 0.001), in the presence of similar 3-day insulin doses. Complications were recorded in 68 cases (16.2% vs. 45.1% in BB and SS, respectively). BB regimen was associated with propensity-adjusted reduction in all adverse events [odds ratio (OR) 0.36; 95% confidence interval (CI) 0.17-0.76] and of systemic infections (OR 0.18; 95% CI 0.07-0.50) and with shorter hospital stay (8.8 ± SD 5.2 days vs. 12.5 ± 7.4; P < 0.01). The superiority of BB regimen was confirmed in the pair-matched analysis. CONCLUSIONS: The study proves the feasibility and the superiority of nurse-based BB versus SS treatment in metabolic control and on the risk of adverse events in orthopedic surgery patients with hyperglycemia.


Assuntos
Hiperglicemia/tratamento farmacológico , Hiperglicemia/enfermagem , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Cuidados Intraoperatórios/enfermagem , Doenças Musculoesqueléticas/enfermagem , Doenças Musculoesqueléticas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Estudos de Coortes , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/enfermagem , Relação Dose-Resposta a Droga , Estudos de Viabilidade , Feminino , Humanos , Hiperglicemia/sangue , Hiperglicemia/complicações , Pacientes Internados , Cuidados Intraoperatórios/métodos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/sangue , Doenças Musculoesqueléticas/complicações , Procedimentos Ortopédicos/enfermagem , Admissão do Paciente , Pontuação de Propensão
15.
Radiol Med ; 125(7): 654-667, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32088810

RESUMO

The involvement of the cervical spine in musculoskeletal diseases can be crucial in terms of prognosis and morbidity. Early diagnosis of possible involvement of the craniocervical junction is essential to avoid the onset of neurological complications with poor prognosis. Among inflammatory diseases, rheumatoid arthritis affects the cervical spine frequently (in about 25% of patients). Atlantoaxial inflammatory changes are also detectable in spondyloarthritis. The involvement of the cervical spine in diffuse idiopathic skeletal hyperostosis is recognized as the cause of various clinical manifestations that may involve the pharynx, larynx and esophagus. The cervical spine may be specifically frequently implicated in crystal-associated arthropathies. Spinal cord infections are infrequent diseases that account for 3-4% of all spine infections. This pictorial review attempts to provide insights to interpret the radiological appearances of the craniocervical junction on conventional radiography, computed tomography and magnetic resonance imaging in relation to various musculoskeletal disease processes.


Assuntos
Articulação Atlantoccipital , Vértebras Cervicais , Doenças Musculoesqueléticas/complicações , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/etiologia , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/etiologia , Diagnóstico Precoce , Humanos
16.
Spine (Phila Pa 1976) ; 45(5): E280-E287, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31568093

RESUMO

STUDY DESIGN: A retrospective study using the Korean Health Insurance Review and Assessment Service-National Sample Cohort was performed. OBJECTIVE: To determine the rate and causes of mortality in vertebral fracture patients. SUMMARY OF BACKGROUND DATA: Vertebral fractures are associated with increased mortality in prior studies. METHODS: Of 1,125,691 patients, we collected data of 23,026 patients of all ages who experienced thoracic or lumber vertebral fractures between 2002 and 2013. The vertebral fracture participants were matched 1:4 with control participants, accounting for age, group, sex, income, and region of residence. Finally, 21,759 vertebral fracture participants and 87,036 control participants were analyzed. The index date was the date of diagnosis of vertebral fracture; participants from the control group were followed from the same index date as their matched counterparts. The follow-up duration was the index date to the death date or the last date of study (December 31, 2013). Patients were followed until death or censoring of the data. Death was ascertained in the same period, and causes of death were grouped into 12 classifications according to the Korean Standard Classification of Disease. A stratified Cox proportional hazards model was used. RESULTS: The adjusted hazard ratio (HR) for mortality of vertebral fracture was 1.28 (P < 0.001) with the higher adjusted HR in younger patients. Mortalities caused by neoplasms; neurologic, circulatory, respiratory, digestive, and muscular diseases; and trauma were higher in the vertebral fracture group (P < 0.05), with muscular disease showing the highest odds ratio for mortality. CONCLUSION: Vertebral fractures were associated with increased mortality in Korean. Disease in muscuoskeletal system and connective tissue that possibly be associated with the fractures was most responsible for elevated death rates following vertebral fracture. Our findings may help caregivers provide more effective care, ultimately decreasing the mortality rate of vertebral fracture patients. LEVEL OF EVIDENCE: 3.


Assuntos
Causas de Morte/tendências , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos de Coortes , Doenças do Tecido Conjuntivo/complicações , Doenças do Tecido Conjuntivo/mortalidade , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/mortalidade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Estudos Retrospectivos , Adulto Jovem
17.
Pain Pract ; 20(3): 269-276, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31638741

RESUMO

OBJECTIVES: This study aimed to determine the optimal cutoff score of the 9-item short version of the CSI, the CSI-9, by comparing patients with central sensitivity syndrome (CSS) not only to healthy volunteers as with the original version, but also to patients with musculoskeletal (MSK) disorders. METHODS: All participants filled out the CSI, EuroQol 5-dimension, Brief Pain Inventory, and Pain Catastrophizing Scale questionnaires. To identify a clinically relevant cutoff score, receiver operating characteristic analyses were conducted. The area under the curve was used to examine the ability of the CSI-9 to distinguish patients with fibromyalgia (FM) from patients with MSK disorders and healthy individuals. RESULTS: Twenty-six participants with FM, 30 patients with MSK disorders, and 28 healthy individuals were included. We determined 2 cutoff scores: 20 for distinguishing patients with FM from patients with MSK disorders and 17 for distinguishing patients with FM from healthy individuals. These cutoff scores had good sensitivity (patients with MSK disorders, 92.3%; healthy individuals, 96.2%) and specificity (patients with MSK disorders, 93.3%; healthy individuals, 100%). In addition, the patients who scored above the cutoff of 20 points exhibited worse clinical symptoms (higher pain intensity, higher pain interference, higher Pain Catastrophizing Scale scores, and lower EuroQol 5-dimension scores) than those who scored below it. Furthermore, a significantly higher number of subjects who scored more than 20 on the CSI-9 had a history of 2 or more diagnoses of CSS. CONCLUSION: The optimal CSI-9 cutoff score of 20 is beneficial to clinicians in the evaluation of central sensitization-related symptoms. The cutoff score helps to identify patients who need additional treatments, such as pain neuroscience education and cognitive behavioral therapy.


Assuntos
Sensibilização do Sistema Nervoso Central , Fibromialgia/diagnóstico , Doenças Musculoesqueléticas/diagnóstico , Inquéritos e Questionários , Adulto , Dor Crônica/diagnóstico , Dor Crônica/etiologia , Feminino , Fibromialgia/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/complicações , Curva ROC , Valores de Referência , Sensibilidade e Especificidade
19.
Pediatr Radiol ; 49(12): 1587-1594, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31686165

RESUMO

Cerebral palsy is a neurologic condition with myriad musculoskeletal and articular manifestations. While every patient is unique with innumerable variations in presentation, symptoms and treatments, there are broad themes and recognizable patterns of development. Many of these findings spill over to other neurodevelopmental disorders, and lessons learned from children with cerebral palsy translate well to multiple neurologic conditions. This review focuses on the more common manifestations involving the spine, knee, foot and ankle, with an emphasis on collecting and describing imaging features, along with clinical and radiologic pearls and pitfalls.


Assuntos
Paralisia Cerebral/complicações , Extremidade Inferior/diagnóstico por imagem , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/diagnóstico por imagem , Radiografia/métodos , Coluna Vertebral/diagnóstico por imagem , Tornozelo/diagnóstico por imagem , Tornozelo/fisiopatologia , Paralisia Cerebral/fisiopatologia , Pé/diagnóstico por imagem , Pé/fisiopatologia , Humanos , Joelho/diagnóstico por imagem , Joelho/fisiopatologia , Extremidade Inferior/fisiopatologia , Doenças Musculoesqueléticas/fisiopatologia , Coluna Vertebral/fisiopatologia
20.
Work ; 64(2): 283-290, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31476193

RESUMO

BACKGROUND: Several professionals in hospitals can be affected by work-related musculoskeletal disorders (WMSDs). OBJECTIVE: To evaluate and compare the body posture and self-reported musculoskeletal symptoms of employees in the healthcare and administrative section of a university hospital. METHODS: Body posture and self-reported musculoskeletal symptoms of 106 employees were quantitatively evaluated. The sample was divided into two groups: health care group (HCG) composed of 57 professionals (88% were females) with an average age of 34±7 years, mass of 66.52±14.78 kg, height of 1.62±0.07 m, and body mass index (BMI) of 25.37±4.50 kg/m2; and the administrative section group (ADMG) composed of 49 professionals (57% were females) with an average age of 30±7 years, mass of 74.90±14.12 kg, height of 1.68±0.09 m, and BMI of 26.76±4.40 kg/m2. RESULTS: The only significant difference between groups for the body posture was the greater right Q-angle in the CG (p = 0.039). Self-reported musculoskeletal symptoms in the seven days prior to assessment were not associated with work section. CONCLUSION: The work section within the university hospital did not influence body posture or self-reporting of musculoskeletal symptoms among the healthcare and administrative staff.


Assuntos
Pessoal Administrativo/psicologia , Pessoal de Saúde/psicologia , Doenças Musculoesqueléticas/complicações , Postura/fisiologia , Autorrelato , Adulto , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Doenças Musculoesqueléticas/psicologia , Traumatismos Ocupacionais/complicações , Traumatismos Ocupacionais/psicologia , Fatores de Risco , Estatísticas não Paramétricas , Inquéritos e Questionários
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